- MeSH
- gastrointestinální nádory diagnóza farmakoterapie klasifikace MeSH
- karcinoid diagnóza klasifikace MeSH
- lidé MeSH
- nádory hrtanu diagnóza farmakoterapie komplikace patologie MeSH
- náhodný nález MeSH
- neuroendokrinní nádory * diagnóza farmakoterapie klasifikace patologie MeSH
- radioterapie metody MeSH
- senioři MeSH
- tenké střevo * patologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- kazuistiky MeSH
PURPOSE: Narrow-band imaging is the state of the art in the diagnosis of mucosal lesions of the vocal cords. It is also used in the follow-up of patients after surgical therapy. Unfortunately, if a patient has received radiotherapy the follow-up is much more difficult. Radiation induces inflammatory changes in the mucosa, which lead to changes in the vascular architecture and thus affect the results of the examination. The dynamics and time dependence of vascular changes after radiotherapy have not yet been described. The purpose of this study is to describe the evolution of the vascular pattern in vocal cords after primary radiotherapy for glottic cancer. METHODS: This was a retrospective cohort study. Each patient underwent NBI videolaryngoscopy and was followed every 3 months. RESULTS: The tumor-related mucosal changes diminished at 3 months after radiotherapy. Afterward, growth of new longitudinal vasculature was observed and significantly slowed after 9 months. No perpendicular vasculature or tumor recurrence was observed during the course of the study. CONCLUSIONS: According to our data, we can conclude that post-radiation mucosal vasculature changes are only longitudinal.
INTRODUCTION: Narrow band imaging (NBI) is an endoscopic imaging method intended for the diagnosis of mucosal lesions of the larynx that are not visible in white-light endoscopy, but are typical of pre-tumor and tumor lesions of the larynx. THE PURPOSE OF THE STUDY: To compare preoperative/perioperative white light endoscopy and NBI endoscopy with the results of histopathological examinations in pre-tumor and tumor lesions of the larynx. METHODS: A prospective study, over a period of five years (5/2018-5/2023), included 87 patients with laryngeal lesions aged 24-80 years. We evaluated preoperative/ perioperative white light and NBI endoscopy, established a working prehistological diagnosis, and compared this with the definitive histopathological results of laryngeal biopsies. RESULTS: In relation to the definitive histology score, a statistically significant correlation was found between the evaluation of the finding and the definitive histology for preoperative and perioperative white light endoscopy and NBI endoscopy (p < 0.001). Both methods showed higher precision when used perioperatively. CONCLUSION: NBI endoscopy is an optical method that allows us to improve the diagnosis of laryngeal lesions, perform a controlled perioperative biopsy, and refine the surgical scope. The NBI endoscopy is a suitable method for the diagnosis of early cancerous lesions of the larynx. The use of preoperative/perioperative NBI endoscopy allowed us to achieve a high level of agreement correlation (p < 0.001) between the prehistological working diagnosis and the final histopathological result. The NBI method proves its application in the diagnosis of pre-tumor and tumor lesions of the larynx.
- MeSH
- gastrointestinální endoskopie MeSH
- larynx * diagnostické zobrazování chirurgie patologie MeSH
- lidé MeSH
- nádory hrtanu * diagnostické zobrazování chirurgie MeSH
- prospektivní studie MeSH
- úzkopásmové zobrazení metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
INTRODUCTION: Narrow band imaging (NBI) is an endoscopic imaging method intended for the diagnosis of mucosal lesions of the larynx that are not visible in white-light endoscopy, but are typical of pre-tumor and tumor lesions of the larynx. THE PURPOSE OF THE STUDY: To compare preoperative/perioperative white light endoscopy and NBI endoscopy with the results of histopathological examinations in pre-tumor and tumor lesions of the larynx. METHODS: A prospective study, over a period of five years (5/2018-5/2023), included 87 patients with laryngeal lesions aged 24-80 years. We evaluated preoperative/ perioperative white light and NBI endoscopy, established a working prehistological diagnosis, and compared this with the definitive histopathological results of laryngeal biopsies. RESULTS: In relation to the definitive histology score, a statistically significant correlation was found between the evaluation of the finding and the definitive histology for preoperative and perioperative white light endoscopy and NBI endoscopy (p < 0.001). Both methods showed higher precision when used perioperatively. CONCLUSION: NBI endoscopy is an optical method that allows us to improve the diagnosis of laryngeal lesions, perform a controlled perioperative biopsy, and refine the surgical scope. The NBI endoscopy is a suitable method for the diagnosis of early cancerous lesions of the larynx. The use of preoperative/perioperative NBI endoscopy allowed us to achieve a high level of agreement correlation (p < 0.001) between the prehistological working diagnosis and the final histopathological result. The NBI method proves its application in the diagnosis of pre-tumor and tumor lesions of the larynx.
- MeSH
- gastrointestinální endoskopie MeSH
- larynx * diagnostické zobrazování chirurgie patologie MeSH
- lidé MeSH
- nádory hrtanu * diagnostické zobrazování chirurgie MeSH
- prospektivní studie MeSH
- úzkopásmové zobrazení metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Chondrosarcoma of the thyroid cartilage is a sporadic disease with nonspecific clinical presentation. Smooth swelling of the supraglottic area should arouse suspicion of possible pathology. In addition to laryngoceles, which usually do not have a significant impact, otolaryngologists should consider chondrosarcoma of the thyroid cartilage and indicate computed tomography (CT). Late diagnosis leads to worse prognosis, particularly worse voice after more extensive surgery, need for tracheostomy, and worse survival from higher degree chondrosarcomas.
- MeSH
- chondrosarkom * diagnostické zobrazování chirurgie MeSH
- laryngektomie metody MeSH
- laryngocele * chirurgie MeSH
- lidé MeSH
- nádory hrtanu * patologie MeSH
- tyreoidální chrupavka chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Laryngektómia je chirurgický výkon, ktorým sa odstraňuje celá časť hrtana. Ide o radikálny zásah do organizmu, ktorý pacienta ovplyvní nielen po somatickej, ale aj po psychickej stránke. Pacient sa musí vyrovnať s mnohými zmenami, ktoré ho po zákroku čakajú. Jeho kvalita života je narušená napríklad zmenou vzhľadu, narušenou komunikáciou, ťažkosťami s príjmom potravy, či problémami s prehĺtaním. Všetky zmeny, ktoré vzniknú, vyvolávajú u pacienta pocit menejcennosti, neistoty a ďalšie maladaptačné prejavy. Z uvedeného dôvodu je hlavným cieľom nášho príspevku poukázať na náročnosť ochorenia a jeho dopad na kvalitu života pacientov.
Laryngectomy is a surgical procedure that removes the entire part of the larynx. It is a radical intervention in the organism, which will affect the patient not only from a somatic point of view, but also from a psychological point of view. The patient has to cope with many changes that await him after the procedure. His quality of life is impaired, for example, by a change in appearance, impaired communication, difficulties with food intake or problems with swallowing. All the changes that arise cause the patient a feeling of inferiority, insecurity and other maladaptive manifestations. For this reason, the main goal of our contribution is to point out the severity of the disease and its impact on the quality of life of patients.
Imunoterapie jako samostatná léčebná modalita nebo v kombinaci s chemoterapií se stala novým zlatým standardem léčby nemocných s recidivujícími či metastazujícími nádory hlavy a krku s vyčerpanými možnostmi lokoregionální terapie. V naší kazuistice prezentujeme pacienta s recidivou nádoru hlasivky po kurativní radioterapii a následně první linii paliativní léčby cisplatinou s 5-fluorouracilem s rychlou progresí onemocnění, druhou linií imunoterapie nivolumabem, po které následovala opět progrese, a teprve po třetí linii s docetaxelem došlo k dlouhodobé kompletní remisi onemocnění. Tuto skutečnost si vysvětlujeme buď opožděnou aktivací imunitního systému, nebo imunomodulačním účinkem docetaxelu, jelikož dlouhodobá kompletní remise po třetí linii paliativní léčby docetaxelem se nedá úplně očekávat.
Immunotherapy as monotherapy or in combination with chemotherapy represents the new gold standard for the treatment of the relapsed or metastatic head and neck cancer where local therapy is not possible. In our case report we present the patient with laryngeal cancer relapse after radical radiotherapy and first line palliative chemotherapy cisplatin and 5-fluorouracil with rapid disease progression followed by second line palliative treatment with immunotherapy nivolumab, again with progression and finally followed by third line palliative treatment with docetaxel with long term complete remission. This excellent result can be explained by delayed activation of the immune system or immunomudulatory effect of the docetaxel, since long term remission cannot be expected solely after third line docetaxel palliative treatment.
- MeSH
- adjuvantní chemoterapie MeSH
- analýza přežití MeSH
- cetuximab terapeutické užití MeSH
- cisplatina terapeutické užití MeSH
- docetaxel terapeutické užití MeSH
- fluorouracil terapeutické užití MeSH
- hlasové řasy patologie MeSH
- imunoterapie MeSH
- klinické zkoušky, fáze III jako téma MeSH
- lidé MeSH
- lokální recidiva nádoru MeSH
- metastázy nádorů MeSH
- nádory hrtanu * farmakoterapie MeSH
- nivolumab terapeutické užití MeSH
- PET/CT MeSH
- progrese nemoci MeSH
- protinádorové látky imunologicky aktivní terapeutické užití MeSH
- regulační T-lymfocyty účinky léků MeSH
- senioři MeSH
- spinocelulární karcinom MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- kazuistiky MeSH
PURPOSE: The principal goal of treatment of laryngeal cancer is to eliminate a tumour while preserving laryngeal function with radio(chemo)therapy being the mainstay of treatment. The aim of this report is to present the influence of comorbidities and lifestyle factors on treatment outcomes in our cohort of patients. METHODS: During the period 2009-2018, curative radio(chemo)therapy for laryngeal cancer was performed on 189 patients. RESULTS: The median OS was 50.8 months, with a mean PFS of 96.5 months, mean LC of 101.4 months and a median follow-up of 38.1 months. Acute and late treatment toxicity grade 3-4 was observed in 39.2% patients and 10.1% patients, respectively. A significant effect on overall survival was confirmed for the baseline PS (performance status), severity of weight loss, baseline haemoglobin values, history of alcohol abuse, marital status and comorbidities according to the Charlson Comorbidity Index, as well as the ACE-27 and ASA scores. CONCLUSIONS: In our cohort of patients treated with radio(chemo)therapy for laryngeal cancer, we found good therapeutic results and an acceptable side-effect profile. Statistically significant predictors of overall survival were the baseline PS, weight loss, anaemia, associated comorbidities, history of alcohol abuse and marital status.
- MeSH
- alkoholismus * etiologie MeSH
- chemoradioterapie škodlivé účinky MeSH
- komorbidita MeSH
- lidé MeSH
- nádory hrtanu * patologie MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- životní styl MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: We analyzed the pooled case-control data from the International Head and Neck Cancer Epidemiology (INHANCE) consortium to compare cigarette smoking and alcohol consumption risk factors for head and neck cancer between less developed and more developed countries. SUBJECTS AND METHODS: The location of each study was categorized as either a less developed or more developed country. We compared the risk of overall head and neck cancer and cancer of specific anatomic subsites associated with cigarette smoking and alcohol consumption. Additionally, age and sex distribution between categories was compared. RESULTS: The odds ratios for head and neck cancer sites associated with smoking duration differed between less developed and more developed countries. Smoking greater than 20 years conferred a higher risk for oral cavity and laryngeal cancer in more developed countries, whereas the risk was greater for oropharynx and hypopharynx cancer in less developed countries. Alcohol consumed for more than 20 years conferred a higher risk for oropharynx, hypopharynx, and larynx cancer in less developed countries. The proportion of cases that were young (<45 years) or female differed by country type for some HNC subsites. CONCLUSION: These findings suggest the degree of industrialization and economic development affects the relationship between smoking and alcohol with head and neck cancer.
- MeSH
- ethanol MeSH
- lidé MeSH
- nádory hlavy a krku * epidemiologie MeSH
- nádory hrtanu * epidemiologie MeSH
- pití alkoholu epidemiologie škodlivé účinky MeSH
- rizikové faktory MeSH
- rozvojové země MeSH
- studie případů a kontrol MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Úvod: Totální laryngektomie je jedna z možností léčby pacientů v pokročilém stadiu karcinomu hrtanu. Tento výkon je spojen s výrazným ovlivněním kvality života pacientů po operaci, kteří přichází o možnost přirozené tvorby hlasu vedoucí k psychologické i sociální stigmatizaci. Nejmodernější a nejvíce preferovaná možnost náhrady hlasu je implantace hlasové protézy. Implantovat lze primárně, v průběhu totální laryngektomie, anebo sekundárně s časovým odstupem od operace. Na našem pracovišti jsme zahájili sekundární implantaci hlasových protéz v květnu 2016. Metodika: Retrospektivní studie má za cíl vyhodnotit průměrný interval výměn hlasových protéz, četnost a důvody výměn u pacientů se sekundárně implantovanou hlasovou protézou na Klinice otorinolaryngologie a chirurgie hlavy a krku ve Fakultní nemocnici Olomouc v období od května 2016 do konce června 2021. Výsledky: Ve sledovaném souboru 17 pacientů se sekundárně implantovanou hlasovou protézou jsme provedli celkem 94 výměn. Průměrná životnost hlasové protézy je v našem souboru pacientů 127 dnů. Nejčastější indikací k výměně protézy bylo protékání v 52 % případů. Závěr: Životnost protéz v našem souboru je delší než uváděná v literatuře. Protékání je nejčastější indikací k výměně protézy.
Introduction: Total laryngectomy is one of the treatment options for patients with advanced laryngeal cancer. As a result of this procedure, patients lose their capacity to create natural voice. It is associated with a psychological and social stigma. Currently, implantation of a voice prosthesis is the most modern and preferred option for voice restoration. Voice prostheses are either implanted primarily during total laryngectomy or secondarily after the surgery. At our workplace, we started the secondary implantation of voice prostheses in May 2016. Methodology: The retrospective study aims to evaluate the average interval of voice prosthesis replacements, the frequency, and reasons for replacements in patients with a secondarily implanted voice prosthesis at the Department of Otorhinolaryngology and Head and Neck Surgery at the Olomouc University Hospital from May 2016 to June 2021. Results: We performed a total of 94 exchanges in the group of 17 patients. The average lifespan of a voice prosthesis in our study is 127 days. The most frequent indication for prosthesis replacement was leakage in 52% of all cases. Conclusion: The lifespan of prostheses in our group is longer than the one reported in the literature. Leakage is the most common indication for prosthesis replacement.
- MeSH
- laryngektomie MeSH
- larynx umělý MeSH
- lidé MeSH
- nádory hrtanu MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
