Publications by authors named "Francisco Civantos"
Adenoid cystic carcinoma (ACC) is a rare and lethal malignancy that originates in secretory glands of the head and neck. A prominent molecular feature of ACC is the overexpression of the proto-oncogene MYB. ACC has a poor long-term survival due to its high propensity for recurrence and protracted metastasis.
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- - NUT carcinoma (NC) is a rare and aggressive cancer associated with a specific gene fusion resulting from a chromosomal translocation (t(15:19)), primarily found in the upper part of the body but also emerging in other areas.
- - Diagnosing NC is difficult based on appearance alone, but can be effectively done using specialized tests like immunohistochemistry for the NUT protein or by detecting the BRD4::NUTM1 fusion gene.
- - A recent case involved a 39-year-old man previously diagnosed with sinonasal squamous cell carcinoma, whose condition was reclassified to NC after further examination and testing, demonstrating the importance of accurate diagnosis for effective targeted treatment options currently in development.
Poorly differentiated thyroid carcinomas (PDTC) are rare diseases; nevertheless, they account for the majority of deaths from non-anaplastic follicular cell-derived thyroid carcinomas. Establishing the diagnosis and treatment of PDTC is challenging given the low incidence and the lack of standardization of diagnostic criteria. These limitations hamper the ability to compare therapeutic modalities and outcomes between recent and older studies.
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- The study aimed to see if adding local treatments, like surgery or radiation, improves survival for patients with metastatic oropharyngeal squamous cell carcinoma (OPSCC).
- Researchers analyzed data from the National Cancer Database from 2010 to 2015, focusing on patients who received systemic chemotherapy and comparing their overall survival based on treatment combinations.
- Results showed that local radiation therapy significantly improved survival rates, while local surgery did not offer a significant benefit; patients with HPV-positive tumors and those receiving multiagent chemotherapy had better overall survival outcomes.
Article Synopsis
- The study aimed to compare surgical outcomes for infranotch T4b oral cancers with T4a oral cancers by analyzing data from clinical studies.
- A total of 11,790 patients were reviewed, and findings indicated overall survival, disease-free survival, and disease-specific survival rates for IN-T4b patients.
- The meta-analysis concluded there were no significant differences in survival outcomes between IN-T4b and T4a oral cancers, suggesting that IN-T4b could be categorized as T4a.
Non-melanoma skin cancer (NMSC) represents the most common malignancy in the world, comprising exceedingly common lesions such as basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) and rare lesions such as Merkel cell carcinoma. Risk factors are widely recognized and include ultraviolet (UV) light exposure, radiation exposure, immunosuppression, and many others. As a whole, survival and functional outcomes are favorable, but each histopathological subtype of NMSC behaves differently.
View Article and Find Full Text PDFBackground: Voice outcome after carbon dioxide transoral laser microsurgery (COTOLMS) for glottic cancer is of prime importance. However, a comprehensive overview according to the European Laryngological Society (ELS) classification of cordectomies is still lacking. The aim of this systematic review is to summarize data on voice outcome associated with individual types of ELS glottic cordectomy after COTOLMS.
View Article and Find Full Text PDFBackground: The extent of cervical lymphadenectomy required for primary parotid cancer is not well-established.
Methods: In this retrospective case-control study, 84 patients who underwent primary parotidectomy and neck dissection for primary parotid cancer between 2010 and 2019 were identified and analyzed.
Results: Of the 84 patients, 37 underwent elective level V neck dissection.
Salivary gland neoplasms are uncommon, and most exhibit epithelial differentiation. Mesenchymal neoplasms of the salivary gland are rare, and the incidence ranges from 1.9% to 5%.
View Article and Find Full Text PDFPrimary sarcomas of the larynx are rare and are associated with diagnostic and treatment challenges. Studies of these tumors are limited, and most examples have been reported as small series. To further increase our understanding of laryngeal sarcomas, we reviewed our experience of an adult cohort.
View Article and Find Full Text PDFWhat is the role of sentinel lymph node biopsy in the management of oral cancer in 2020?
Eur Arch Otorhinolaryngol
September 2021
Article Synopsis
- * SLNB is less invasive than traditional elective neck dissection (END) and improves staging accuracy, especially in the contralateral neck, but may miss metastases in floor of mouth cancers due to their proximity to lymphatics.
- * New techniques and tracers are being developed to enhance SLNB's effectiveness, and updated guidelines for SLNB in OSCC have recently been published, emphasizing the need for neck treatment in metastatic cases. *
Background: Patients with metastases in the lymph nodes of the neck and no obvious primary tumor, neck cancer with unknown primary (NCUP), represent a management challenge. A majority of patients have metastatic squamous cell carcinoma (SCC), although other histologies do occur.
Methods: We comprehensively reviewed the literature, compared available guidelines, and conferred with an international team of experts.
Article Synopsis
- This narrative review examines the reasons for performing elective and therapeutic neck dissections in patients with well-differentiated thyroid cancer, along with follow-up and treatment options for recurrent nodal disease.
- Recent advancements in imaging have led to better detection of nodal metastases, which are more prevalent in younger patients and those with larger tumors or specific genetic and histological profiles.
- While visible nodal disease correlates with worse patient outcomes and should be surgically addressed to minimize recurrence, the significance of microscopic metastases on overall survival remains limited, questioning the need for elective neck dissections.
False-positive reverse transcriptase polymerase chain reaction screening for SARS-CoV-2 in the setting of urgent head and neck surgery and otolaryngologic emergencies during the pandemic: Clinical implications.
Head Neck
July 2020
Background: No reports describe falsepositive reverse transcriptase polymerase chain reaction (RT-PCR) for novel coronavirus in preoperative screening.
Methods: Preoperative patients had one or two nasopharyngeal swabs, depending on low or high risk of viral transmission. Positive tests were repeated.
Background: Coronavirus has serially overtaken our metropolitan hospitals. At peak, patients with acute respiratory distress syndrome may outnumber mechanical ventilators. In our Miami Hospital System, COVID-19 cases have multiplied for 4 weeks and elective surgery has been suspended.
View Article and Find Full Text PDFMyeloid Derived suppressor cells (MDSCs) play a key role in the progression and recurrence of human malignancies and in restraining the efficacy of adjuvant therapies. We have previously shown that Tadalafil lowers MDSCs and regulatory T cells (Treg) in the blood and in the tumor, primes a tumor specific immune response, and increases the number of activated intratumoral CD8T cells in patients with primary Head and Neck Squamous Cell Carcinoma (HNSCC). However, despite these important immune modulatory actions, to date no clinically significant effects have been reported following PDE5 inhibition.
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- The optimal surgical method for treating oropharyngeal carcinoma is still uncertain, with transoral laser surgery (TLS), transoral robotic surgery (TORS), and conventional oropharyngectomy being the main techniques.
- A systematic review of 17 studies involving nearly 1,200 patients was conducted to compare these surgical approaches, examining factors like early T classification and complication rates.
- The findings suggest that while there are differences in early T classification among the groups, there is no clear evidence that one surgical technique is better than the others in terms of patient outcomes.
Article Synopsis
- * It's particularly effective for superficial tumors and is also applied in cases of extensive dysplastic changes and superficial carcinomatosis; interstitial PDT can handle more invasive cancers.
- * While there is some data from case studies, there is a notable lack of randomized clinical trials, and the paper reviews PDT’s mechanisms, history, existing knowledge, and future clinical applications.
Article Synopsis
- The study examined survival outcomes for oropharyngeal squamous cell carcinoma (SCC) patients treated with transoral robotic surgery (TORS) versus primary radiotherapy, focusing on HPV status.
- Data from 1,873 patients revealed that 73% were HPV-positive, with TORS showing no significant survival difference (95% vs. 91%) in this group, while HPV-negative patients showed improved survival with TORS (84% vs. 66%).
- The findings suggest that TORS offers better survival for HPV-negative SCC patients, but not for those who are HPV-positive.
Article Synopsis
- The study aimed to compare sentinel lymph nodes (SLN) detected via planar lymphoscintigraphy (LS) with those identified through gamma probe-directed sentinel lymph node biopsy (SLNB) in patients with early-stage oral cavity cancer.
- Conducted on 140 adults with untreated T1/T2 N0 squamous cell carcinoma, the research involved evaluating SLN locations and comparing them to historical data on regional metastases.
- Results showed that SLNs were mainly found in levels I to IV but revealed significant differences in detection rates between LS and SLNB, especially in levels II and III, indicating that planar LS is not reliable for predicting SLN locations.
Background: [(99m)Tc]Tilmanocept, a novel CD206 receptor-targeted radiopharmaceutical, was evaluated in an open-label, phase III trial to determine the false negative rate (FNR) of sentinel lymph node biopsy (SLNB) relative to the pathologic nodal status in patients with intraoral or cutaneous head and neck squamous cell carcinoma (HNSCC) undergoing tumor resection, SLNB, and planned elective neck dissection (END). Negative predictive value (NPV), overall accuracy of SLNB, and the impact of radiopharmaceutical injection timing relative to surgery were assessed.
Methods And Findings: This multicenter, non-randomized, single-arm trial (ClinicalTrials.
Article Synopsis
- Regional metastasis is a significant concern in head and neck squamous cell carcinoma (HNSCC) and greatly impacts patient prognosis.
- Current imaging methods for evaluating neck status have limitations, leading to unnecessary treatments for many patients without regional metastasis.
- New advancements in imaging and more invasive procedures like sentinel node biopsy (SNB) are essential for improving diagnostic accuracy and staging of the neck in HNSCC patients.
Objective: To compare the different modalities for treatment of Zenker's diverticulum and the associated clinical outcomes.
Study Design: Case series with chart review.
Setting: Tertiary care hospital.
From 18% to 35% of cutaneous melanomas are located in the head and neck, and nearly 70% are thin (Breslow thickness ≤ 1 mm). Sentinel lymph node biopsy (SLNB) has an established role in staging of intermediate-thickness melanomas, however its use in thin melanomas remains controversial. In this article, we review the literature regarding risk factors for occult nodal metastasis in thin cutaneous melanoma of the head and neck (CMHN).
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