Squamous cell carcinomas of the head and neck: descriptive analysis of 1293 cases (original) (raw)
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IP innovative publication pvt. ltd, 2019
Introduction: The magnitude of head and neck cancers in the Indian subcontinent is very high. Involvement of neck nodes is indicative of higher stage and subsequent adverse prognosis when compared with node negative disease. The frequency of such spread is high, approximately 20% for head and neck squamous cell carcinomas (SCC). The purpose of this study was to analyse the pattern of nodal involvement in patients presenting with SCC of oral cavity and oropharynx and its correlation with survival. Materials and Methods: Forty cases of carcinoma of oral cavity and oropharynx were analysed retrospectively. Data were collected and reviewed from the patient’s case files. Patients were analysed for age and sex distribution, tumour staging, metastasis and overall survival. Results: The majority of cases were T4 lesions (n=18, 45%), followed by T2 lesions (n=14, 35%) and T3 lesions (n=8, 20%). 65% patients (n=26) had positive neck nodes, with/without adverse pathologic features mandating post-operative radiotherapy, while 35% patients had nodes negative neck. The mean overall survival of the node negative was 15 months (range 01 – 65 months) and was significantly more(p value 0.0028) than that of node positive patients 9months (range 01-40 months). A statistically significant difference in survival was seen between the nodes negative patients than those with ≥3 positive neck nodes. (p=0.03) Conclusion: Involvement of neck nodes in cases of carcinoma of oral cavity and oropharynx is an indicator of poor prognosis. The number of pathologically positive neck nodes can be used as a predictor of treatment outcome.
Head and Neck Squamous Cell Carcinoma: A Review Article
Post-Graduate Medical Journal of NAMS, 2020
Head and Neck Squamous Cell Cancer (HNSCC) is one of the major health related burdens worldwide, causing high morbidities and significant number of mortalities, accounting for more than 800,000 new cases every year. HNSCC usually develops in males in the 6th and 7th decade. Major risk factors of HNSCC are the consumption of tobacco and alcohol and infection with high-risk types of human papillomavirus. HNSCC often develops from preexisting dysplastic lesions. Particular chromosomal alterations appear to be associated with distinct stages of tumor progression. Management of head and neck cancers is complex and involves multiple modalities therefore a multidisciplinary approach is mandatory. Surgery, radiation and chemotherapy are the backbones of the treatment. Majorities of the patients present in the locoregionally advanced disease. Similarly, almost 10% of newly diagnosed patients present with distant metastatic disease. Almost 60% of these patients even after aggressive, site-specific multimodality therapy, fail locally and up to a 30% develop distant metastases. Targeted therapy and Immunotherapy are recent advances in the management of refractory HNSCC to conventional treatments.
BMJ, 2002
Public awareness of this common form of cancer needs to be increased because despite important advances in treatment, prognosis still largely depends on the stage of presentation More than 90% of tumours in the head and neck are squamous carcinomas. Cancer of the head and neck, which can arise in several places, is often preventable, and if diagnosed early is usually curable. Unfortunately, patients often present with advanced disease that is incurable or requires aggressive treatment, which leaves them functionally disabled. We have reviewed current practice and potential future advances in the referral, diagnosis, and management of head and neck cancer. Methods We gathered information from several sources, including personal experience of treating head and neck cancer in a multidisciplinary tertiary referral centre and the Medline and Cochrane databases.
A Study on Secondary Neck Nodes from Squamous Cell Carcinoma of the Head and Neck Region
AIM: To find out the incidence of cervical node metastases on clinical examination in squamous cell carcinoma of the head and neck region. To find the incidence of cervical nodal metastases commonly involved according to the primary tumour at the time of presentation. To describe the distribution of cervical node metastases by the site of the primary tumour. To correlate individually the size of the tumour and cervical nodal metastases. To correlate individually the degree of histopathological differentiation of tumour and cervical nodal metastases. METHODS: The materials used in the study consisted of 60 cases of histologically proven squamous cell carcinoma in the head and neck region which were admitted in all surgical wards of Government Mohan Kumaramangalam Medical College and Hospital, Salem during June 2018-June 2020. RESULTS: Males are predominantly affected by squamous cell carcinoma of head and neck region. 75% of patients had nodal metastasis at the time of admission. Posteriorly situated tumours displayed greater propensity of nodal metastases than anteriorly situated tumours. Carcinoma arising in the buccal mucosa, alveolus, floor of mouth, hard palate and maxillary antrum predominantly metastasized to the submandibular nodes, whereas those arising in the tongue (both anterior 2/3rd and posterior 1/3rd), tonsils and soft palate predominantly metastasized to the upper deep cervical group. A progressive increase in the incidence of node metastases was observed with increasing tumour size. A progressive increase in the incidence of node metastasis was observed with increasing histological undifferentiation of the tumour. CONCLUSION: Males are predominantly affected by squamous cell carcinoma of head and neck region. 75% of patients had nodal metastasis at the time of admission Site of the primary appeared to influence the incidence of regional nodal metastases. Posteriorly situated tumours arising in the oropharynx (base of tongue, tonsils, soft palate) displayed a greater propensity for regional metastases(66% to 100%) as compared to anteriorly situated tumours arising in the oral cavity(33% to 83%). Amongst the posteriorly situated tumours, carcinoma of the tonsils showed the highest incidence of nodal metastases(100 percent). Amongst the anteriorly situated tumours, carcinoma of buccal mucosa showed the highest incidence of node metastases (83.33%). The large primaries (more than 4cm) and those with higher histologic grade (moderate to poorly differentiated) have a greater propensity for developing regional nodal metastasis.
Objective: To determine the risk of factors involved in order to promote the education of the community for better prevention of the disease. Material and Methods: This study was conducted at AIMS hospital and the duration of this study was from July 2019 to March 2020. 98 patients were the participants of this study. The mean age of patients is 51±9.31 years the enrolled 55% of patients were male and 45% females. Among the patients enrolled for the study, 66% were from urban areas and 34% belonged to rural areas. Conclusion: Head and Neck squamous carcinoma is the most common form of tumor in Head and Neck region. The most common site is hypopharynx and the most important risk factor is smoking. The highest incidence of the disease in 5 th decade. Head and Neck tumor comprises Neoplastic growth of the oral cavity including Nasal cavity, Pharyngeal cavity, salivary glands, lips and Paranasal sinuses. HNC (head and neck carcinoma) comprises 6% of total tumors of the world. 110,000 patients are diagnosed with HNC in Europe/year.
Head and neck squamous cell carcinoma : Mansoura 10 years experience
2005
Head and neck (H&N) cancers are the sixth most prevalent cancers in the world with squamous cell carcinoma (SCC) constituting around 90% of it. One hundred and eighty eight patients with H&N SCC were treated at Mansoura University Hospital in the period from January 1990 to December 1999 inclusive. For those 188 cases we analyzed their clinicoepidemiologic data, survival, prognostic factors, patterns of failure and toxicity of therapy. Unfortunately 75.5% of the cases presented in advanced stages. The median eventfree survival duration was 14 months, while the median overall survival duration was 22 months. The 5-year eventfree survival and overall survival were 45% and 53%, respectively. On multivariate analysis for event-free survival, only performance status and grade were significant (p ≤0.05). On the other hand multivariate analysis for overall survival found only performance status and stage to be significant (p ≤0.05). Local failure exceeded in incidence both nodal and distan...
High-Risk Cutaneous Squamous Cell Carcinoma of the Head and Neck: A Clinical Review
Annals of Surgical Oncology, 2021
BACKGROUND. Most patients with cutaneous squamous cell carcinoma (cSCC) of the head and neck (HN) are at low-risk (Ͻ 5%) of developing metastatic SCC to regional lymph nodes. However, patients with unfavorable clinicopathologic factors often are under appreciated by clinicians but remain at higher risk for developing metastatic lymph node disease and dying. METHODS. Patients were identified who had metastatic cSCC to lymph nodes (parotid and cervical) of the HN and who were treated within the context of a multidisciplinary HN cancer service between 1980 and 2005 at Westmead Hospital (Sydney, Australia). Relevant patient details and data from primary lesions were analyzed and reported. RESULTS. In total, 266 patients were treated with curative intent. The median patient age was 69 years among 219 males and 47 females. The majority of metastatic lymph nodes (162 of 266 lymph nodes; 61%) were located in the parotid with or without cervical lymph node involvement. The median tumor thickness was 6 mm (range, 0.5-28 mm), and the median tumor size was 15 mm (range, 3-70 mm). Most tumors (65%) that measured Ն5 mm in thickness, and 30% of patients had lesions that measured Ն2 cm in greatest dimension. Recurrent cSCC was present in 15% of patients, and most lesions were located within the lymphatic drainage of the parotid on the temple/forehead (28%), on or around the ear (20%), or on the cheek (12%). Forty-six percent of patients had moderately or poorly differentiated cSCC, and 5% of patients were immunosuppressed. A minority of patients (27%) did not have an identifiable index lesion. CONCLUSIONS. Data from this large, prospective data base, in concordance with other series, suggested that a patient with thick cSCC (Ͼ4-5 mm) located in proximity to the parotid gland can be considered at high-risk. Increasing lesion size and recurrence contribute to this risk.
Epidemiological and clinical presentation of head and neck neoplasia: a review
International Journal Of Community Medicine And Public Health
Head and neck squamous cell carcinoma (HNSCC) stand at the sixth position most, amongst all the malignancies worldwide. Neoplasms arising in the oral cavity, larynx, pharynx, salivary gland and nasal cavity are all included in the head and neck malignancies. More than 90% of malignancies of the oral cavity are squamous cell carcinomas (SCC). Among the four head neck cancer sub-sites combined, the mean age at the time of diagnosis has risen, in the last four decades. Studies have documented a male predilection. A small percentage of SCC cases are inherited or are familial. Cigarette smoking, alcohol consumption, betel quid chewing, poor nutrition, poor oral hygiene, HPV, Epstein-Barr virus and Candida albicans infections are the etiological agents who have the ability to cause HNSCC. Non healing ulcer, difficulty in swallowing, change in voice, swelling, sore throat- that doesn’t get better- are the symptoms of head and neck cancers. Moreover, there may be unusual bleeding, facial s...
Clinicopathological Study of Nonsquamous Cell Malignancies of the Head and Neck
International Journal of Head and Neck Surgery, 2013
There is a tendency among the head and neck surgeons to classify head and neck tumors as squamous and nonsquamous. The latter is a miscellaneous collection of less common, but certainly no less significant neoplasms. The rarity of these tumors is evident from the limited data available on clinical characteristics and outcomes. This study is thus an attempt to meet the need and fill the void by providing practical information regarding different pathological subtypes, their treatment and prognosis. In our study, we documented a total of 48 cases of nonsquamous cell cancers of the head and neck region including all sites like nose and paranasal sinuses, oral cavity and oropharynx, neck and larynx and documented important clinical, pathological and treatment features of these.