Considerations for environmentally sustainable head and neck surgical oncology practice.

Objective: To evaluate the potential role of head and neck oncologic surgeons in environmental protection, sustainability of health-care systems and avoidance of procedures contributing to climate change in the future.

Review Methods: This literature review searched for relevant literature about the relevance of waste in surgical head and neck oncology practice and the innovative alternatives to decrease its effect on environment.

Conclusions: Head and neck oncologic surgeons have a role in environmental protection, sustainability of health-care systems and avoidance of procedures contributing to climate change in the future.

Priority setting in head and neck oncology in low-resource environments.

Purpose Of Review: Most information about priority setting comes from developed countries. In low-resource settings, many factors should be considered to select the best candidate for the treatments that are available. The physician is always under pressure to obtain better results in spite of the lower quantity of resources.

Elective neck dissection in oral squamous cell carcinoma: Past, present and future.

In 1994 a decision analysis, based on the literature and utility ratings for outcome by a panel of experienced head and neck physicians, was presented which showed a threshold probability of occult metastases of 20% to recommend elective treatment of the neck. It was stated that recommendations for the management of the cN0 neck are not immutable and should be reconfigured to determine the optimal management based on different sets of underlying assumptions. Although much has changed and is published in the almost 25 years after its publication, up to date this figure is still mentioned in the context of decisions on treatment of the clinically negative (cN0) neck.

Classification of GLOSSECTOMIES: Proposal for tongue cancer resections.

Background: Surgery of tongue tumors includes different procedures ranging from mucosal resection to complex combined resection. Numerous terms have been used to describe such procedures, but there is no consensus between the terminology and the extent of resection.

Methods And Results: We searched the medical literature and found a lack of published information.

Surgical margins in head and neck cancer: Intra- and postoperative considerations.

Objective: To provide a perspective on the significance of recent reports for optimizing cancer free surgical margins that have challenged standard practices.

Methods: We conducted a review of the recent literature (2012-2018) using the keywords surgical margin analysis, frozen and paraffin section techniques, head and neck cancer, spectroscopy and molecular markers.

Results: Of significance are the reports indicating superiority of tumor specimen directed sampling of margins compared to patient directed (tumor bed) sampling for frozen section control of oral cancers.

Detection of Distant Metastases in Head and Neck Cancer: Changing Landscape.

As head and neck squamous cell carcinoma (HNSCC) patients with distant metastases (DM) were generally treated only palliatively, the value of screening for DM was usually limited to attempts to avoid extensive locoregional treatment when DM were present pretreatment. Recently, the concept of treating oligometastases, e.g.

Selective neck dissection in surgically treated head and neck squamous cell carcinoma patients with a clinically positive neck: Systematic review.

Adequate treatment of lymph node metastases is essential for patients with head and neck squamous cell carcinoma (HNSCC). However, there is still no consensus on the optimal surgical treatment of the neck for patients with a clinically positive (cN+) neck. In this review, we analyzed current literature about the feasibility of selective neck dissection (SND) in surgically treated HNSCC patients with cN + neck using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines.

Preservation of the internal jugular vein in the radical treatment of node-positive neck--is it safe?

Background: The aim of this study was to evaluate risk factors of neck recurrence in patients with pN+ necks submitted to a modified or a classic radical neck dissection and the safety of preserving the internal jugular vein in the treatment of a subgroup of these patients.

Methods: The medical records of 311 untreated patients with squamous cell carcinoma of the oral cavity (106 cases), oropharynx (95 cases), larynx (49 cases), and hypopharynx (61 cases) were reviewed. Their clinical stages (CS) were CS II in 1%, CS III in 19.

Alpha-v-beta3 integrin expression in melanocytic nevi and cutaneous melanoma.

Background: Alpha-v-beta3 integrin (alphavbeta3) is a vitronectin ligand and plays an important role in melanoma progression.

Objectives: The purpose of the study was to evaluate the expression of alphavbeta3 in superficial spreading cutaneous melanoma, in both conventional and tissue microarray (TMA) paraffin-embedded-tissue specimens, and correlate with histopathological variables and patient survival.

Material And Methods: A total of 159 tissue samples from compound nevi (n = 19), in situ melanoma (n = 5), thin melanoma (n = 34), thick melanoma (n = 72) and metastatic melanoma (n = 29) were studied.

The addition of ifosfamide/etoposide to cisplatin/teniposide improves the survival of children with retinoblastoma and orbital involvement.

This study aimed to determine the impact of the addition of ifosfamide/etoposide to a regimen containing cisplatin/teniposide on the survival of patients with retinoblastoma with orbital involvement. Thirty patients were treated at the A. C.

Internal jugular vein preservation in neck dissection for pN1-N2c oral and oropharyngeal carcinoma.

Purpose: The aim of this study is to evaluate risk factors of neck recurrence in patients with pN1-N2 neck stage, submitted to a modified radical neck dissection with preservation of the internal jugular vein.

Materials And Methods: We reviewed the medical records of 72 patients with squamous cell carcinoma of the oral cavity (43 cases) and oropharynx (29 cases). The clinical stage of the neck was N1 in 23 cases and N2a-c in 49.

Do proliferating cell nuclear antigen and MIB-1/Ki-67 have prognostic value in penile squamous cell carcinoma?

Objectives: To evaluate the role of proliferating cell nuclear antigen (PCNA) and MIB-1/Ki-67 immunohistochemical expression in predicting lymph node metastasis and survival in primary penile squamous cell carcinoma.

Methods: We conducted a retrospective evaluation of 125 patients with penile squamous cell carcinoma submitted to primary tumor treatment, with information on lymph node status. Clinical and pathologic data for PCNA and MIB-1/Ki-67 expression in the primary tumor were analyzed.

The use of silicone expander and cecal transposition after pelvic exenteration.

Aims: Describe a new approach for pelvic floor treatment employing a temporary mechanical support device with silicone expander, with or without association to cecal transposition.

Methods: From January 2000 to June 2006, 106 patients were submitted to pelvic exenteration. A retrospective evaluation was done of the last 30 patients previously submitted to total pelvic exenteration without neither urinary nor faecal sphincter preservation who latter were submitted to a pelvic floor treatment with silicone expander with or without association to cecal rotation.

Voice and vocal self-assessment after thyroidectomy.

Background: Voice alterations after thyroidectomy can be found even with preserved function of laryngeal nerves. The purpose of this study was to evaluate voice before and after thyroid surgery and the role of orotracheal intubation on voice changes.

Methods: We conducted a prospective nonrandomized study of patients who underwent thyroid surgery and compared the results with a control group of patients who underwent breast surgery.

Trends in childhood renal cancer mortality in Brazil, 1980-2000.

Mortality from childhood cancers has shown substantial declines in developed countries since 1960, with smaller favourable trends in South America. This study describes mortality trends in renal childhood cancer mortality in São Paulo state, Brazil, from 1980 to 2000. The age-standardised mortality rates among the boys decreased from 0.

Front pattern of invasion in squamous cell carcinoma of the penis: new prognostic factor for predicting risk of lymph node metastases.

Objectives: Treatment of penile carcinoma is based on excision of the primary tumor and regional lymphadenectomies. Lymph node metastasis is the most important prognostic factor, yet it cannot be reliably evaluated by imaging studies or clinical examinations; thus, new prognostic factors such as the pattern of invasion must be investigated.

Methods: The data of 112 patients with penile carcinoma who underwent amputation and lymphadenectomy were analyzed.

Brazilian-Portuguese validation of the University of Washington Quality of Life Questionnaire for patients with head and neck cancer.

Background: The University of Washington Quality of Life (UW-QOL) questionnaire is an English-language survey instrument used worldwide to assess the quality of life of patients with head and neck cancer. To be used in other cultures, such instruments require careful translation and psychometric validation in other languages.

Methods: The translation and cultural adaptation of the questionnaire were performed following accepted international guidelines.

Treatment of retinoblastoma patients with chemoreduction plus local therapy: experience of the AC Camargo Hospital, Brazil.

To evaluate the efficacy of conservative management of intraocular retinoblastoma with chemoreduction combined with local therapy with or without plaque radiation in the preservation of the eye, and avoidance of external beam radiation therapy (EBRT) (success rate). From 1995 to 2000, 84 newly diagnosed patients with intraocular retinoblastoma were admitted to the Pediatric Department of the Hospital do Cancer A.C.

Trilateral retinoblastoma.

Background: Trilateral retinoblastoma (TRB) is a syndrome consisting of unilateral or bilateral hereditary retinoblastoma (Rb) associated with an intracranial neuroblastic tumor. Although its incidence is low, the prognosis is very poor. This article reports four cases of TRB and discusses the role of neuroimaging screening for early detection.

E-cadherin, MMP-2, and MMP-9 as prognostic markers in penile cancer: analysis of 125 patients.

Objectives: The treatment of choice for invasive penile carcinoma is amputation and lymphadenectomy. The latter is associated with a high morbidity rate. Analysis of new prognostic factors such as E-cadherin, matrix metalloproteinase (MMP)-2, and MMP-9 may help to select candidates for lymphadenectomy.

Trends in eye cancer mortality among children in Brazil, 1980-2002.

Background: In the last few decades mortality from childhood cancers has shown substantial declines in industrialized countries, with smaller favorable trends in South America.

Objective: This study describes mortality trends in childhood eye cancer in Brazil from 1980 to 2002.

Procedure: Age-specific eye cancer death rates (0-4, 5-9, and 10-14 years) were calculated according to gender.

Prognostic factors in salvage surgery for recurrent oral and oropharyngeal cancer.

Background: Therapeutic decisions in recurrent oral and oropharyngeal squamous carcinoma (SCC) remain controversial.

Methods: Two hundred forty-six consecutive patients who underwent salvage surgery for recurrent squamous cell carcinoma (SCC) of the oral cavity and oropharynx were studied. The tumor sites were lip, 33 cases; oral cavity, 143; oropharynx, 70.

The importance of long-term follow-up of head and neck cancer patients for reliable survival analysis.

Objective: Analyze the influence of patients lost to follow-up in estimated survival rates calculated by the Kaplan-Meier method.

Study Design: Only patients with previously untreated squamous cell carcinoma of the upper aerodigestive tract were selected. For the patients lost to follow-up anytime, the last medical evaluation date was collected to calculate the "estimate A" survival time.

High-dose-rate brachytherapy as part of a multidisciplinary treatment of nasopharyngeal lymphoepithelioma in childhood.

Background: Nasopharyngeal carcinoma in childhood is rare. Radiochemotherapy is considered the standard treatment and yields increased survival and local control rates. In this article, the authors report on the results from the multidisciplinary treatment of pediatric patients who had nasopharyngeal lymphoepithelioma with radiochemotherapy, including high-dose-rate brachytherapy of the primary tumor site.

Predictive factors for distant metastasis from oral and oropharyngeal squamous cell carcinoma.

The presence of distant metastasis after the initial treatment of head and neck squamous cell carcinoma is not considered a common event and is associated with a poor outcome. The objective of this study was to investigate the prevalence and risk factors associated with the diagnosis of distant metastasis in oral and oropharyngeal carcinoma patients. The medical charts of 2327 patients treated from 1954 to 1997 were reviewed.