Raul Pellini - Academia.edu (original) (raw)

Papers by Raul Pellini

Otolaryngology -- Head and Neck Surgery, 2013

Objective. To evaluate the oncologic results only in T3 glottic and supraglottic cancers regardin... more Objective. To evaluate the oncologic results only in T3 glottic and supraglottic cancers regarding supracricoid partial laryngectomy (SCPL) not requiring total laryngectomy and to assess functional results by self-evaluation by the patient.

Head & neck, 2005

Carcinoids are neuroendocrine tumors that typically occur in the gastrointestinal tract and lung ... more Carcinoids are neuroendocrine tumors that typically occur in the gastrointestinal tract and lung and less frequently in the head and neck region. Whereas the metastatic potential of laryngeal carcinoid is well documented, only one case of metastasis of temporal bone carcinoid to the cervical lymph nodes has been reported. We present the case of a 55-year-old woman with cervical metastases almost 3 years after a primary diagnosis of temporal bone carcinoid. The patient had undergone a subtotal petrosectomy for a temporal bone carcinoid and, 29 months later, revision surgery for a local recurrence. Four months later, multiple laterocervical swelling appeared, and the patient underwent modified radical neck dissection. Histologic examination after the neck dissection was suggestive of lymph node metastases from a carcinoid tumor. Immunohistochemical analysis of the lymph node metastases showed neoplastic cells positive for keratin, vimentin, chromogranin, and neuron-specific enolase an...

Three-dimensional (3D) minimally invasive video-assisted thyroidectomy (MIVAT) was carried out wi... more Three-dimensional (3D) minimally invasive video-assisted thyroidectomy (MIVAT) was carried out with a 4-mm, 3D 0-degree stereoscopic endoscope. The procedure was applied on 3 patients who underwent total thyroidectomy and data were prospectively collected. Operative time for total thyroidectomy ranged from 72 to 90 minutes. Neither intra-nor post-operative complications were reported during the study. The surgical team noticed a good perception of depth and easy recognising of anatomic structures, especially concerning the upper and lower vascular pedicle, the parathyroids, the superior and inferior laryngeal nerves. Preliminary impression emerging from this study seems to suggest that 3D MIVAT is safe and effective. Future studies with larger case series are required to determine the role of this procedure.

Journal of experimental & clinical cancer research : CR, 2007

The diagnosis of oral cavity and oropharyngeal tumors can be obtained through clinical examinatio... more The diagnosis of oral cavity and oropharyngeal tumors can be obtained through clinical examination and biopsy. CT and MRI can then be used to define the extension of the disease. The aim of this study was to define the accuracy of clinical and MRI T staging of oral cavity and base of the tongue tumors and correlate the results with pathological data. Mandibular involvement, in a subgroup of patients, was determined and sensitivity, specificity, accuracy and positive and negative predictive values were evaluated. Fifty-nine patients affected by squamous cell carcinoma and 1 case of adenoido-cystic carcinoma were examined by means of a superconductive MR unit, using SE T1, and fat-suppressed T2 weighted sequences before contrast medium infusion. SE T1 and T1 fat-suppressed sequences after gadolinium-DTPA infusion were used. T stage accuracy of both clinical examination and MRI were found to be respectively 62% (k 0.459) and 82% (k 0.775). The sensitivity, specificity and accuracy of M...

Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery, 2014

To investigate the ability of neck ultrasounds (US), magnetic resonance imaging (MRI) and positro... more To investigate the ability of neck ultrasounds (US), magnetic resonance imaging (MRI) and positron emission tomography (FDG-PET/TC) in detecting residual nodal disease after chemoradiotherapy in patients with advanced oropharyngeal squamous cell carcinoma (OPSCC). From 2006 to 2009, 36 consecutive patients affected by OPSCC with bulky nodal disease (>3 cm), treated with primary concurrent chemoradiotherapy, were enrolled prospectively. Nodal response to treatment was assessed by using US, MRI and FDG-PET/CT. Planned neck dissection (ND) was performed in all the patients, and the histopathological node status was compared to the imaging findings in order to establish sensitivity, specificity, accuracy and predictive values of each technique. Metastatic disease was assessed in 18/37 (48.6%) hemi-necks, always localized in levels II-IV. US showed greater sensitivity (77.8%) and, combined with FDG-PET/TC, produced the highest negative predictive value (93.3%). US, MRI and FDG-PET/TC ...

Journal of Craniofacial Surgery, 2009

Head and neck squamous cell carcinomas (HNSCCs) are tumors with propensity mostly for locoregiona... more Head and neck squamous cell carcinomas (HNSCCs) are tumors with propensity mostly for locoregional spread. Most frequent sites of metastasis from cancer of the oral cavity include lung, bone, liver, adrenal, heart, and kidney. The advent of newer surgical techniques and an improved understanding of head and neck cancer have further improved control of cancer above the clavicles. Furthermore, the overall survival rate in patients with advanced head and neck cancer has not improved significantly. This has been partly because of the emergence of second primary cancers and the development of distant metastasis defined as cancer deposits below the clavicles. Authors reported a case of a 60 years-old man affected by squamous cell carcinoma of the oral cavity treated with surgery and adjuvant radiochemotherapy that developed a metastatic lesion to the left talus 10 months after primary treatment. In conclusion, bone is a rare metastatic site for HNSCC, much rarer in case of sites distal to the knee. Owing to paucity of the literature on this, no definite predisposing factor is identifiable. Because of the rarity of these lesions, bone scintigraphy remains not indicated in case of HNSCC, but attention has to be paid to eventual symptoms, also if frequently sensitive for advanced lesions.

Head & Neck, 2008

Background. Radiation therapy (RT) is one of the gold standard treatments for early laryngeal can... more Background. Radiation therapy (RT) is one of the gold standard treatments for early laryngeal cancer, and total laryngectomy is still the most applied surgical procedure after failure. Selected recurrences can be managed by supracricoid partial laryngectomies (SCPLs).

Head & Neck, 2005

Background. Carcinoids are neuroendocrine tumors that typically occur in the gastrointestinal tra... more Background. Carcinoids are neuroendocrine tumors that typically occur in the gastrointestinal tract and lung and less frequently in the head and neck region. Whereas the metastatic potential of laryngeal carcinoid is well documented, only one case of metastasis of temporal bone carcinoid to the cervical lymph nodes has been reported. We present the case of a 55-year-old woman with cervical metastases almost 3 years after a primary diagnosis of temporal bone carcinoid.

European Archives of Oto-Rhino-Laryngology, 2010

The management of the mandible when dealing with oral cavity cancer is still controversial. In th... more The management of the mandible when dealing with oral cavity cancer is still controversial. In this article, we present our experience with marginal mandibulectomy over a 13-year period. We retrospectively evaluated 56 patients who underwent marginal mandibulectomy between 1990 and 2002. Mean age at surgery was 60.3 § 9.5 SD years. Neither intraoperative nor perioperative deaths were observed. InWltration of the resected bone was detected in only one patient (1.8%). Fracture of the mandible was a complication in only one patient (1.8%). Eight patients (14.3%) presented a local and/or regional recurrence. Distant metastases were diagnosed in two patients (3.6%). The 5-year overall and disease-speciWc survival rates were 60.7 and 77.3%, respectively. Marginal mandibulectomy allows to conduct the resection in a safe tissue or to excise tumors of the Xoor of the mouth with a limited involvement of the alveolar periosteum. Whenever the tumor is close to the mandible or when it adheres to the alveolar periosteum, marginal mandibulectomy oVers the possibility to perform an oncologically sound procedure.

Dysphagia, 2008

Rhabdomyoma is an exceedingly rare soft tissue benign tumor of skeletal muscle origin classified ... more Rhabdomyoma is an exceedingly rare soft tissue benign tumor of skeletal muscle origin classified into cardiac and extracardiac types based on location. Extracardiac rhabdomyoma is further classified into adult, genital, and fetal type depending on the degree of differentiation. Adult rhabdomyomas are rare, but morphologically characteristic, benign mesenchymal tumors with mature skeletal muscle differentiation that in 90% of cases arise in the head and neck region, mainly in the mucosa of the oropharynx, nasopharynx, and larynx, from the branchial musculature of third and fourth branchial arches. Most patients are between 40 and 70 years old, with a mean age of 60 years with a male predominance. Usually presenting symptoms include upper airway obstruction, Eustachian tube dysfunction, and mucosal or neck mass, but rarely does it arise as pure dysphagia. This article presents a case of parapharyngeal rhabdomyoma presenting with only progressive dysphagia.

Archives of Otolaryngology–Head & Neck Surgery, 2007

To evaluate the prevalence of sublevel IIB lymph node (LN) metastases for head and neck primary t... more To evaluate the prevalence of sublevel IIB lymph node (LN) metastases for head and neck primary tumors in a large cohort of patients. Prospective study. One referral university hospital and 2 national institutes of oncology. Between 2003 and 2005, 297 patients (male to female ratio, 3.5:1; mean age, 58.8 years [range, 18-89 years]) affected by head and neck cancer were treated by surgery on the primary tumor and/or the neck. Primary site distribution included the following: oral cavity in 111 patients, larynx in 92, oropharynx in 32, thyroid gland in 22, skin of the lateral face or scalp in 16, hypopharynx in 11, unknown primary in 7, and parotid gland in 6. Sublevel IIB was evaluated for the number of LNs and pathologic N (pN) status. All patients underwent unilateral or bilateral neck dissection (ND) with therapeutic or elective intent according to the primary site and clinical T (cT) and clinical N (cN) status. Sublevel IIB was selectively dissected at the beginning of ND, labeled, and processed independently. The distribution of metastases among the different levels was analyzed. The influence of several factors (institution in which the surgical procedure was performed, sex of the patient, site of primary, histotype, pathologic T [pT] status, cN status, lower level involved in the neck together with sublevel IIB, association with sublevel IIA metastasis, ipsilateral number of involved levels, and previous surgical treatment limited on the primary site) on the prevalence of sublevel IIB metastasis was statistically evaluated by the Pearson chi(2) test or Fisher exact test. A total of 443 NDs were performed (unilateral in 151 patients and bilateral in 146). Among the patients, the tumors were staged cN0/pN0 in 27%, cN+/pN+ in 50%, cN+/pN0 in 7%, and cN0/pN+ in 16%. The mean number of LNs collected at sublevel IIB was 5.4 (range, 0-24). The overall prevalence of sublevel IIB metastases was 5.6% (26 neck sides). Tumor histologic type in the sublevel IIB+ population was squamous cell carcinoma in 80%, papillary carcinoma in 8%, melanoma in 8%, and adenocarcinoma in 4%. The chi(2) test showed a significantly higher risk for LN metastases at sublevel IIB in patients affected by parotid gland primary tumors (33%), tumors of the skin or scalp (25%), unknown primary tumors (14%), and cancers of the oral cavity (10%) (P = .02) and in those clinically staged as cN+ (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). Sublevel IIB dissection is strongly recommended for all patients with cN+ tumors and in those affected by tumor of the parotid gland, skin, and scalp scheduled for elective ND. Patients affected by laryngeal cancer scheduled for elective ND can be considered the ideal candidates for preservation of sublevel IIB. However, whether this policy could be associated with a better functional outcome remains to be demonstrated by prospective studies on a large series of patients.

Archives of Otolaryngology–Head & Neck Surgery, 2006

Journal of Cranio-Maxillofacial Surgery, 2014

To evaluate the oncological outcome of malignant parotid tumours and identify the prognostic fact... more To evaluate the oncological outcome of malignant parotid tumours and identify the prognostic factors for survival. Retrospective study. One hundred and forty-one patients with primary epithelial carcinoma of the parotid gland were examined. The overall survival (OS) and disease specific survival (DSS) rates were calculated. The DSS was evaluated according to different parameters. The 5- and 10-year OS rates were 72.3% and 58.4%. The 5- and 10-year DSS rate was 75% and 71%, respectively. The univariate analysis showed that the pathological staging, clinical and pathological tumour and nodal status, surgical procedure and histological subtype significantly influenced the DSS (P ≤ 0.05). The 5- and 10-year loco-regional control rates were 82.1% and 78%. The multivariate analysis showed that the pathological nodal status and the pathological staging influenced the DSS. It further demonstrated that the clinical tumour status and the histological subtype were the most important preoperative prognostic factors. The pathological nodal status, the pathological staging, the clinical tumour status and the histological subtype are the most important factors influencing survival in malignant parotid tumours.