Optical image-guided cancer surgery: challenges and limitations.

Optical image-guided cancer surgery is a promising technique to adequately determine tumor margins by tumor-specific targeting, potentially resulting in complete resection of tumor tissue with improved survival. However, identification of the photons coming from the fluorescent contrast agent is complicated by autofluorescence, optical tissue properties, and accurate fluorescent targeting agents and imaging systems. All these factors have an important influence on the image that is presented to the surgeon.

The impact of treatment modality and radiation technique on outcomes and toxicity of patients with locally advanced oropharyngeal cancer.

Objectives/hypothesis: To investigate the impact of treatment modality and radiation technique on oncologic outcomes and toxicity of patients with locally advanced oropharyngeal cancer (OPC).

Study Design: Retrospective analysis of outcomes and toxicity.

Methods: Between 2000 and 2011, 204 consecutive patients with locally advanced OPC were treated with definitive (chemo)radiotherapy using 3-dimensional conformal (3DCRT) or intensity-modulated radiotherapy (IMRT).

Development and (pre-) clinical assessment of a novel surgical tool for primary and secondary tracheoesophageal puncture with immediate voice prosthesis insertion, the Provox Vega Puncture Set.

Development and (pre-) clinical assessment were performed of a novel surgical tool for primary and secondary tracheoesophageal puncture (TEP) with immediate voice prosthesis (VP) insertion in laryngectomized patients, the Provox Vega Puncture Set (PVPS). After preclinical assessment in fresh frozen cadavers, a multicenter prospective clinical feasibility study in two stages was performed. Stage-1 included 20 patients, and stage-2 had 27.

Dual wavelength tumor targeting for detection of hypopharyngeal cancer using near-infrared optical imaging in an animal model.

Optical imaging is a promising technique to visualize cancer tissue during surgery. In this study, we explored the use of combinations of near-infrared (NIR) fluorescence agents that emit fluorescence signal at different wavelengths and each target specific tumor characteristics. Two combinations of agents (ProSense680 combined with 2DG CW800 and MMPSense680 combined with EGF CW800) were used to detect hypopharyngeal cancer in an animal model.

Translational optical imaging in diagnosis and treatment of cancer.

In cancer imaging, many different modalities are used that each have their specific features, leading to the combined use of different techniques for the detection, staging and treatment evaluation of cancer. Optical imaging using near-infrared fluorescence light is a new imaging modality that has recently emerged in the field of cancer imaging. After extensive preclinical research, the first steps of translation to the clinical practice are currently being made.

High complication risk of salvage surgery after chemoradiation failures.

Conclusions: Although organ preservation can be achieved with chemoradiation protocols for laryngeal or pharyngeal cancers, salvage surgery is accompanied by high complication rates.

Objectives: To determine the rate of complications associated with salvage surgery after chemoradiation for laryngeal and pharyngeal cancers.

Methods: A multicenter retrospective study was performed of 24 patients treated with total laryngectomy combined with total or partial pharyngectomy between 1995 and 2004 who had previously been treated with chemoradiation.

Optical imaging of oral squamous cell carcinoma and cervical lymph node metastasis.

Background: In oral cancer surgery, intraoperative optical imaging could help the surgeon to determine adequate tumor-free margins.

Methods: Tumor-specific near-infrared fluorescence agents targeting epidermal growth factor receptor (CW800 EGF) or glucose transporter system (CW800 2-DG) were administered to mice with tongue carcinoma and cervical lymph node metastases. Tumor growth was followed by bioluminescence imaging.

Targeting integrins and enhanced permeability and retention (EPR) effect for optical imaging of oral cancer.

Background And Objectives: Near-infrared (NIR) fluorescence optical imaging is a promising technique to assess the tumor margins during cancer surgery. This technique requires targeting by specific fluorescence agents to differentiate tumor from normal surrounding tissue. We assessed the feasibility of cancer detection using NIR fluorescence agents that target either αvβ3 integrins or the enhanced permeability and retention (EPR) effect in an orthotopic mouse model of oral cancer.

Chemoradiation for advanced hypopharyngeal carcinoma: a retrospective study on efficacy, morbidity and quality of life.

Chemoradiation (CRT) is a valuable treatment option for advanced hypopharyngeal squamous cell cancer (HSCC). However, long-term toxicity and quality of life (QOL) is scarcely reported. Therefore, efficacy, acute and long-term toxic effects, and long-term QOL of CRT for advanced HSCC were evaluated,using retrospective study and post-treatment quality of life questionnaires.

Detection of oral squamous cell carcinoma and cervical lymph node metastasis using activatable near-infrared fluorescence agents.

Objective: To assess the feasibility of optical imaging using activatable near-infrared fluorescence (NIRF) agents to detect oral cancer and cervical lymph node metastasis in vivo.

Design: In vivo study.

Setting: University medical center.

Diagnostic accuracy of fine-needle aspiration cytology in Warthin tumors.

Background: Our aim was to evaluate the diagnostic accuracy of fine-needle aspiration cytology (FNAC) for Warthin tumors of the parotid gland.

Methods: All cytologic diagnoses of Warthin tumor between 1990 and 2007 were correlated with available histology. In addition, our results were compared to current literature.

Optical image-guided surgery--where do we stand?

In cancer surgery, intra-operative assessment of the tumor-free margin, which is critical for the prognosis of the patient, relies on the visual appearance and palpation of the tumor. Optical imaging techniques provide real-time visualization of the tumor, warranting intra-operative image-guided surgery. Within this field, imaging in the near-infrared light spectrum offers two essential advantages: increased tissue penetration of light and an increased signal-to-background-ratio of contrast agents.

Early and long-term morbidity after total laryngopharyngectomy.

To determine the early and long-term morbidity of patients treated with a total laryngopharyngectomy and reconstruction using a jejunum interposition or gastric pull-up procedure. It is a retrospective study; and it is conducted in tertiairy referral center. Sixty-three patients were included in whom 70 reconstructions were performed (51 jejunum interpositions and 19 gastric pull-up procedures) between 1990 and 2007.

Prognostic value of plasminogen activator inhibitor-1 in head and neck squamous cell carcinoma.

Background: Tumor cell biological factors, such as urokinase plasminogen activator (uPA) and its inhibitor plasminogen activator inhibitor-1 (PAI-1), cathepsin D, and c-myc play a role in tumor invasion, metastasis, and proliferation. In this study, the prognostic importance of these factors in patients with primary head and neck squamous cell carcinoma (HNSCC) was evaluated and correlated with clinicopathologic variables.

Methods: In 46 paired primary tumors and normal tissues, levels of uPA, PAI-1, cathepsin D, and c-myc amplification were determined.

Supracricoid partial laryngectomy with cricohyoidoepiglottopexy for recurrent laryngeal cancer.

Objectives: Recurrent laryngeal cancer can be treated either with total laryngectomy or in selected cases with supracricoid laryngectomy with cricohyoidoepiglottopexy (CHEP). We performed a retrospective study to analyze the functional and oncological results of supracricoid laryngectomy with CHEP.

Methods: Fourteen patients were treated with supracricoid laryngectomy with CHEP.

Osteoblastoma of the larynx: a case report.

We describe a unique case of an osteoblastoma in the cricoid cartilage of a 50-year-old man who presented with hoarseness and progressive dyspnea. Panendoscopic examination revealed a reddish tumor at the left side of the cricoid cartilage. Computed tomography (CT) imaging showed a sclerotic lesion involving the cricoid cartilage, protruding in the airway lumen.

An extra letter, care gets better? Informing general practitioners about planned surgery for head and neck cancer.

Objective: To investigate how general practitioners (GPs) value an additional letter from the hospital. This so-called preadmission letter informs the GP about planned surgery for head and neck cancer in one of their patients.

Design: Prospective survey among GPs by means of a questionnaire attached to the preadmission letter.

Surgery for recurrent laryngeal carcinoma after radiotherapy: partial laryngectomy or total laryngectomy for a better quality of life?

Objective: To investigate the quality of life after partial laryngectomy versus total laryngectomy for recurrent laryngeal carcinomas after radiotherapy.

Study Design And Setting: A retrospective study performed at least one year after treatment. This study was performed in a university hospital.

Partial laryngectomy for recurrent glottic carcinoma after radiotherapy.

Background: Early laryngeal cancer is treated with surgery or radiotherapy. A partial laryngectomy instead of a total laryngectomy can be used for treating patients with radiation failures.

Methods: Patients were grouped by the two types of partial laryngectomies we performed: group I, endoscopic laser surgery (n = 42); and group II, frontolateral partial laryngectomy (n = 21).