Laryngeal Cancer

Objective (1) To evaluate the expression of p63 in laryngeal squamous cell carcinoma (2) To analyze its prognostic significance. Methods p63 expression was examined in 127 patients submitted to total laryngectomy between 1998 and 2000 (111 male/16 female; 69 ...

In Sweden the most common treatment for T3-T4 laryngeal carcinoma is radical radiotherapy (with surgery for salvage), because the voice is thus preserved. A Swedish study showed that surgery yielded a significantly better 5-year survival and locoregional control at 3 years in T4 laryngeal carcinoma than radical radiotherapy. With these results in mind, we wanted to compare the different modes of treatment (surgery with a tracheoesophageal [TE] fistula and radical radiotherapy) with respect to the patients' speech proficiency. Twenty-eight subjects (with 14 patients in each treatment group) were judged by inexperienced and experienced listeners according to intelligibility by transcription and three perceptual ratings. From the perceptual ratings of speech intelligibility, voice quality, and speech acceptability we conclude that there is a significant difference, the irradiated speakers being rated higher than the tracheoesophageal speakers. It is also clear that most of the TE and irradiated laryngeal speaking patients are comparable to normal laryngeal speakers in intelligibility by transcription. Experienced and inexperienced listeners are able to rate TE and irradiated laryngeal speech reliably and similarly according to intelligibility by transcription. The inexperienced listeners rated the TE speakers significantly higher than did the experienced listeners.

Background: Despite several lines of evidence suggesting the biological plausibility of marijuana being carcinogenic, epidemiologic findings are inconsistent. We conducted a population-based case-control study of the association between marijuana use and the risk of lung and upper aerodigestive tract cancers in Los Angeles. Methods: Our study included 1,212 incident cancer cases and 1,040 cancer-free controls matched to cases on age,

The absence of a vaccine and the rampant resistance to almost all antimalarial drugs have accentuated the urgent need for new antimalarial drugs and drug targets for both prophylaxis and chemotherapy. The aim of the study was to discover effective plant extracts against Plasmodium falciparum. In the present study, the hexane, chloroform, ethyl acetate, acetone, and methanol extracts of Citrus sinensis (peel), Leucas aspera, Ocimum sanctum, Phyllanthus acidus (leaf), Terminalia chebula (seed) were tested for their antimalarial activity against chloroquine (CQ)-sensitive (3D7) strain of P. falciparum which was cultured following the candle-jar method. Antimalarial evaluations of daily replacement of culture medium containing CQ and different plant crude extracts were performed on 96-well plates at 37°C for 24 and 48 h. Parasitemia was determined microscopically on thin-film Giemsa-stained preparations. Plant extracts were tested for their cytotoxicity using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay on human laryngeal cancer cell line (HEp-2) and normal cell line (Vero). Out of the 25 extracts tested, six showed good (IC(50) 4.76-22.76 μg/mL), 15 exhibited moderate (IC(50) 31.42-88.03 μg/mL), while four displayed mild (IC(50) > 100 μg/mL) antiplasmodial activity. The leaf ethyl acetate and methanol extracts of L. aspera; ethyl acetate, acetone, and methanol extracts of P. acidus; and seed acetone extract of T. chebula had good antiplasmodial activity (IC(50) = 7.81, 22.76, 9.37, 14.65, 12.68, and 4.76 μg/mL) with selectivity indices 5.43, 2.04, 4.88, 3.35, 3.42, and 9.97 for HEp-2 and >5.79, >2.20, >11.75, >3.41, >3.94, and >7.38 for Vero cells, respectively. These analyses have revealed for the first time that the components present in the solvent extracts of L. aspera, P. acidus, and T. chebula have antiplasmodial activity. The high antiplasmodial activity observed make these plants good candidates for isolation of anti-protozoal compounds which could serve as new lead structures for drug development.

Laryngeal cancer is the second most common respiratory cancer after lung cancer. Its incidence is increasing over time in much of the world and this increase is generally accepted to be related to changes in tobacco and alcohol consumption. It is a relatively common cancer in men, but rarer in women. Moreover, interesting new issues have been raised recently about the influence of other possible risk factors. Evidence from epidemiological studies which supports the involvement of new risk factors in the aetiology of larynx cancer, as well as new perspectives in therapy, must be taken into consideration in order to realise primary and tertiary prevention. However, it remains clear that, even as new evidence continues to amass about a wide range of risk factors, primary prevention of the great majority of laryngeal cancers could be achieved by elimination of tobacco smoking and reduction of consumption of alcoholic beverages. With an additional contribution from adoption of a diet rich in fruits and vegetables, the great majority of laryngeal cancer appears to be preventable within our current epidemiological knowledge.

In order to determine what should be done for laryngeal cancer patients when surgical margins are positive, and to evaluate their prognosis, a retrospective review of 21 laryngeal cancer patients with positive surgical margins out of 714 surgically treated cases (2.9%) was carried out. Nineteen patients were treated with postoperative radiation therapy. Two patients who had had endolaryngeal partial laryngectomy were treated with vertical partial laryngectomy. Two patients were lost to follow-up. Ten patients (10/19; 53%) were recurrence-free. Four patients had local, two had regional, and two had locoregional recurrences. Only one patient with a local recurrence could be salvaged with total laryngectomy and is disease-free. One patient developed liver metastasis. Nineteen patients had a mean and median disease-free survival of 48 and 36 months, respectively. Nine out of fourteen patients (64%) treated curatively were recurrence-free. The patients with positive margins developed significantly more locoregional recurrences than those with free margins (P

This review focuses on selected aspects of the relation between alcohol consumption and cancer risk. Heavy alcohol consumption (i.e., ≥4 drinks/day) is significantly associated with an increased risk of about 5-fold for oral and pharyngeal cancer and esophageal squamous cell carcinoma, 2.5-fold for laryngeal cancer, 50% for colorectal and breast cancers, and 30% for pancreatic cancer. These estimates are based on a large number of epidemiological studies and are generally consistent across strata of several covariates. The evidence suggests that at low doses of alcohol consumption (i.e., ≤1 drink/day) the risk is also increased by about 20% for oral and pharyngeal cancer and 30% for esophageal squamous cell carcinoma. Thus, for these sites there is little evidence of a threshold effect. While consumption of fewer than 3 alcoholic drinks/wk is not associated with an increased risk of breast cancer, an intake of 3 to 6 drinks/wk might already yield a (small) increase in risk. On the o...

100 patients with Tis-T4 laryngeal cancer were included prior to treatment onset. Patients answered four questionnaires at six occasions during one year; the S-SECEL, the European Organisation for Research and Treatment of Cancer (EORTC) Core Quality of Life Core Questionnaire ( ...