OBJECTIVE: Cutaneous Squamous Cell Carcinoma (cSCC), a tumor with a significantly increasing incidence, is mostly diagnosed in the head region, where tumors have a worse prognosis and a higher risk of metastases. The presence of metastases reduces specific five-year survival from 99% to 50%. As the risk of occult metastases does not exceed 10%, elective dissection of the tributary parotid and neck lymph nodes is not recommended. METHODS: We retrospectively analyzed a group of 12 patients with cSCC of the head after elective dissections of regional (parotid and cervical) nodes by means of superficial parotidectomy and selective neck dissection. RESULTS: We diagnosed occult metastases neither in the cervical nor parotid nodes in any patient. None were diagnosed as a regional recurrence during the follow-up period. CONCLUCION: Our negative opinion on elective parotidectomy and neck dissection in cSCC of the head is in agreement with the majority of published studies. These elective procedures are not indicated even for tumors showing the presence of known (clinical and histological) risk factors for lymphogenic spread, as their positive predictive value is too low. Elective parotidectomy is individually considered as safe deep surgical margin. If elective parotidectomy is planned it should include only the superficial lobe. Completion parotidectomy and elective neck dissection are done in rare cases of histologically confirmed parotid metastasis in the parotid specimen. Preoperatively diagnosed parotid metastases without neck involvement are sent for total parotidectomy and elective selective neck dissection. Cases of clinically evident neck metastasis with no parotid involvement, are referred for comprehensive neck dissection and elective superficial parotidectomy. The treatment of concurrent parotid and cervical metastases includes total conservative parotidectomy and comprehensive neck dissection. LEVEL OF EVIDENCE: How common is the problem? Step 4 (Case-series) Is this diagnostic or monitoring test accurate? (Diagnosis) Step 4 (poor or non-independent reference standard) What will happen if we do not add a therapy? (Prognosis) Step 4 (Case-series) Does this intervention help? (Treatment Benefits) Step 4 (Case-series) What are the COMMON harms? (Treatment Harms) Step 4 (Case-series) What are the RARE harms? (Treatment Harms) Step 4 (Case-series) Is this (early detection) test worthwhile? (Screening) Step 4 (Case-series).
- MeSH
- krční disekce metody MeSH
- lidé MeSH
- nádory hlavy a krku * chirurgie patologie MeSH
- nádory kůže * chirurgie patologie MeSH
- nádory příušní žlázy * chirurgie patologie MeSH
- retrospektivní studie MeSH
- spinocelulární karcinom * patologie MeSH
- staging nádorů MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: An ocular adnexal apocrine adenocarcinoma (OAAA) is an extremely rare, but potentially aggressive and life-threatening tumor with ill-defined management based only on recommendations from a limited number of reported cases. The development of cervical lymphocele following neck dissection is a very rare complication, but one with well established methods for prevention and treatment. Here we describe a previously unreported case of salvage surgery including neck dissection for OAAA in addition to an emergence of cervical lymphocele. A literature review of current knowledge on both pathological conditions is included. METHODS AND RESULTS: A 58-year-old man suffering from OAAA, previously treated with multiple eye-sparing excisions and adjuvant proton therapy, underwent salvage surgery for locoregional recurrence of the tumor. A partial orbitectomy with orbital exenteration, primary reconstruction and left-sided neck dissection was performed. The procedure was complicated by a cervical lymphocele resolved after the surgical therapy. The patient remained disease-free during the one-year follow-up. CONCLUSION: OAAA is a locally aggressive tumor with potential to local or distant metastatic spread. Whole-body staging, regular clinico-radiological follow-up and stage-dependent therapy with surgery as the first-choice treatment is required. A cervical lymphocele as a complication of especially left-sided neck dissection is managed with a conservative or surgical therapy according to the level of lymph leakage, extent and localization of lesions, presence of local or systemic disorders and the period from primary surgery.
- MeSH
- adenokarcinom * patologie chirurgie MeSH
- krční disekce škodlivé účinky metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru MeSH
- lymfokela * etiologie chirurgie MeSH
- nádory prsu * chirurgie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
Česká kooperativní skupina pro nádory hlavy a krku (CHNCCG) uspořádala ve dnech 11. - 12. října 2019 v Táboře zasedání s cílem dosáhnout mezioborového konsensu v některých kontroverzních bodech, ve kterých není jednota v mezinárodní rovině. Výsledkem setkání jsou doporučení, která se týkají terminologie značení velikosti resekčních okrajů (definice termínů: negativní okraj, blízký okraj a pozitivní okraj) a převzetí terminologie reportování krčních disekcí podle mezinárodního doporučení International Head and Neck Scientific Group a vyšetřování HPV/p16 statusu u nádorů hlavy a krku.
The Czech Head and Neck Cancer Cooperative Group (CHNCCG) held a meeting in Tabor on 11-12 October 2019 with the aim of reaching an interdisciplinary consensus on some controversial points where international unity is absent. The meeting resulted in recommendations on resection margin size terminology (definition of terms: negative margin, close margin and positive margin) and on the adoption of terminology for neck dissections reporting according to the International Recommendation of the International Head and Neck Scientific Group and on assessment of HPV/p16 status in head and neck tumors.
Česká kooperativní skupina pro nádory hlavy a krku (CHNCCG) uspořádala ve dnech 11.-12. října 2019 v Táboře zasedání s cílem dosáhnout mezioborového konsenzu v některých kontroverzních bodech, ve kterých není jednota v mezinárodní rovině. Výsledkem setkání jsou doporučení, která se týkají terminologie značení velikosti resekčních okrajů (definice termínů: negativní okraj, blízký okraj a pozitivní okraj) a převzetí terminologie reportování krčních disekcí podle mezinárodního doporučení International Head and Neck Scientific Group a vyšetřování HPV/p16 statusu u nádorů hlavy a krku.
The Czech Head and Neck Cancer Cooperative Group (CHNCCG) held a meeting in Tabor on 11-12 October 2019 with the aim of reaching an interdisciplinary consensus on some controversial points where international unity is absent. The meeting resulted in recommendations on resection margin size terminology (definition of terms: negative margin, close margin and positive margin) and on the adoption of terminology for neck dissections reporting according to the International Recommendation of the International Head and Neck Scientific Group and on assessment of HPV/p16 status in head and neck tumors.
- MeSH
- krční disekce MeSH
- lidé MeSH
- lidský papilomavirus 16 izolace a purifikace MeSH
- nádory hlavy a krku * chirurgie diagnóza MeSH
- resekční okraje MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- směrnice pro lékařskou praxi MeSH
Česká kooperativní skupina pro nádory hlavy a krku (CHNCCG) uspořádala ve dnech 11.–12. října 2019 v Táboře zasedání s cílem dosáhnout mezioborového konsenzu v některých kontroverzních bodech, ve kterých není jednota v mezinárodní rovině. Výsledkem setkání jsou doporučení, která se týkají terminologie značení velikosti resekčních okrajů (definice termínů: negativní okraj, blízký okraj a pozitivní okraj) a převzetí terminologie reportování krčních disekcí podle mezinárodního doporučení International Head and Neck Scientific Group a vyšetřování HPV/ p16 statusu u nádorů hlavy a krku.
The Czech Head and Neck Cancer Cooperative Group (CHNCCG) held a meeting in Tabor on 11-12 October 2019 with the aim of reaching an interdisciplinary consensus on some controversial points where international unity is absent. The meeting resulted in recommendations on resection margin size terminology (definition of terms: negative margin, close margin and positive margin) and on the adoption of terminology for neck dissections reporting according to the International Recommendation of the International Head and Neck Scientific Group and on assessment of HPV/ p16 status in head and neck tumors.
- MeSH
- geny p16 MeSH
- infekce papilomavirem MeSH
- krční disekce MeSH
- lidé MeSH
- nádory hlavy a krku * diagnóza MeSH
- resekční okraje MeSH
- terminologie jako téma MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- směrnice pro lékařskou praxi MeSH
BACKGROUND: Standard treatment of oropharyngeal squamous cell carcinoma (OPSCC) is associated with high morbidity, whereas immunotherapeutic approaches using PD-1:PD-L1 checkpoint blockade only show moderate response rates in OPSCC patients. Therefore, a better stratification of patients and the development of novel therapeutic protocols are crucially needed. The importance of tumor-infiltrating B cells (TIL-Bs) in shaping antitumor immunity remains unclear; therefore, we analyzed frequency, phenotype, prognostic value and possible roles of TIL-Bs in OPSCC. METHODS: We utilized transcriptomic analysis of immune response-related genes in 18 OPSCC samples with respect to human papillomavirus (HPV) status. The density and localization of CD20+, CD8+ and DC-LAMP+ cells were subsequently analyzed in 72 tissue sections of primary OPSCC samples in relation to patients' prognosis. The immunohistochemical approach was supplemented by flow cytometry-based analysis of phenotype and functionality of TIL-Bs in freshly resected primary OPSCC tissues. RESULTS: We observed significantly higher expression of B cell-related genes and higher densities of CD20+ B cells in HPV-associated OPSCC samples. Interestingly, CD20+ TIL-Bs and CD8+ T cells formed non-organized aggregates with interacting cells within the tumor tissue. The densities of both intraepithelial CD20+ B cells and B cell/CD8+ T cell interactions showed prognostic significance, which surpassed HPV positivity and CD8+ TIL density in stratification of OPSCC patients. High density of TIL-Bs was associated with an activated B cell phenotype, high CXCL9 production and high levels of tumor-infiltrating CD8+ T cells. Importantly, the abundance of direct B cell/CD8+ T cell interactions positively correlated with the frequency of HPV16-specific CD8+ T cells, whereas the absence of B cells in tumor-derived cell cultures markedly reduced CD8+ T cell survival. CONCLUSIONS: Our results indicate that high abundance of TIL-Bs and high density of direct B cell/CD8+ T cell interactions can predict patients with excellent prognosis, who would benefit from less invasive treatment. We propose that in extensively infiltrated tumors, TIL-Bs might recruit CD8+ T cells via CXCL9 and due to a highly activated phenotype contribute by secondary costimulation to the maintenance of CD8+ T cells in the tumor microenvironment.
- MeSH
- adjuvantní chemoradioterapie MeSH
- aktivace lymfocytů MeSH
- B-lymfocyty imunologie MeSH
- CD8-pozitivní T-lymfocyty imunologie MeSH
- dlaždicobuněčné karcinomy hlavy a krku imunologie mortalita terapie virologie MeSH
- dospělí MeSH
- infekce papilomavirem imunologie mortalita terapie virologie MeSH
- Kaplanův-Meierův odhad MeSH
- kohortové studie MeSH
- krční disekce MeSH
- lidé středního věku MeSH
- lidé MeSH
- mezibuněčná komunikace imunologie MeSH
- nádorové mikroprostředí imunologie MeSH
- nádory orofaryngu imunologie mortalita terapie virologie MeSH
- orofarynx patologie chirurgie MeSH
- Papillomaviridae imunologie izolace a purifikace MeSH
- prognóza MeSH
- progrese nemoci MeSH
- senioři MeSH
- tumor infiltrující lymfocyty imunologie MeSH
- výběr pacientů MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Klíčová slova
- hemityreoidektomie,
- MeSH
- krční disekce MeSH
- lidé MeSH
- lymfadenektomie klasifikace MeSH
- medulární karcinom chirurgie MeSH
- metastázy nádorů terapie MeSH
- nádory štítné žlázy * chirurgie klasifikace MeSH
- nervus laryngeus recurrens patologie MeSH
- poranění krku etiologie MeSH
- terminologie jako téma MeSH
- tyreoidektomie * klasifikace metody škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- dítě MeSH
- dospělí MeSH
- folikulární adenokarcinom * chirurgie patologie MeSH
- hodnocení rizik MeSH
- hypoparatyreóza epidemiologie MeSH
- karcinom * chirurgie patologie MeSH
- krční disekce MeSH
- krk MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru * chirurgie patologie MeSH
- lymfatické uzliny MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mnohočetné primární nádory * chirurgie patologie MeSH
- multivariační analýza MeSH
- nádory štítné žlázy * chirurgie patologie MeSH
- ochrnutí hlasivek epidemiologie MeSH
- papilární karcinom štítné žlázy MeSH
- papilární karcinom MeSH
- pooperační komplikace epidemiologie MeSH
- prognóza MeSH
- reoperace * metody MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- sexuální faktory MeSH
- tumor burden MeSH
- tyreoidektomie MeSH
- věkové faktory MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- souhrny MeSH
BACKGROUND: Papillary thyroid carcinoma is typical by regional lymph nodes metastases. Therefore we decided to analyse associated risk factors. OBJECTIVE: In this retrospective study we focused on the incidence of metastatic involvement of the central compartment's lymph nodes correlated with age, size of the primary tumour, infiltration of thyroid gland capsule, positive lymphangioinvasion in order to assess risk factors. METHOD: We analysed group of 156 patients with papillary carcinoma, who have undergone total thyroidectomy and bilateral elective central compartment neck dissection. We evaluated the occurrence of metastases, size, infiltration and lymphangioinvasion based on definitive histology of the whole group and separately for subgroups of patients under and over 45 years. RESULT: We found metastatic involvement in 88 (56.4%) patients. When comparing the subgroups of patients under (73 patients) and over 45 years (83 patients), we found metastases in 56 vs. 32 (76.7% vs. 38.6%) patients. In the subgroup of younger patients we found significant higher incidence of metastases compared with the group of over 45 years, P < 0.001 (P = 0.000027). We found significant higher incidence of metastases in patients with positive capsule infiltration in the whole group, P < 0.001 (P = 0.00049); in the subgroup of under 45 years, P < 0.001 (P = 0.00091) and in patients with positive lymphangioinvasion in the whole group, P < 0.01 (P = 0.00177); in the subgroup of over 45 years, P < 0.001 (P = 0.0002). In patients with metastases we found tumour size ≥1cm more frequently in all groups. CONCLUSION: We recorded higher incidence of regional metastases in patients under 45 years, positive capsule infiltration, lymphangioinvasion. Age under 45 years itself does not correlate with less aggressive disease, to the contrary some of other analysed risk factors correlate with more aggressive disease.
- MeSH
- adenokarcinom patologie chirurgie MeSH
- dospělí MeSH
- krční disekce MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfatické metastázy diagnóza MeSH
- nádory hlavy a krku patologie chirurgie MeSH
- papilární karcinom patologie chirurgie MeSH
- staging nádorů MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
