S17. The role of primary surgery in the management of oropharyngeal carcinoma

2009 ◽  
Vol 3 (1) ◽  
pp. 19
Author(s):  
T.P. O’Dwyer
Keyword(s):  
Oropharyngeal Carcinoma ◽  
Primary Surgery

scholarly journals APOPTOSIS AND CELL PROLIFERATION IN CHRONIC TONSILLITIS AND OROPHARYNGEAL CARCINOMA: ROLE OF NITRIC OXIDE AND CYTOKINES

2004 ◽  
Vol 148 (2) ◽  
pp. 225-227 ◽  
Author(s):  
Tomas Kucera ◽  
Hana Pacova ◽  
David Vesely ◽  
Jaromir Astl ◽  
Jindrich Martinek
Keyword(s):  
Nitric Oxide ◽  
Cell Proliferation ◽  
Chronic Tonsillitis ◽  
Oropharyngeal Carcinoma

P18 The role of decompressive craniectomy for traumatic brain injury: should we be leaving the lid off?

2019 ◽  
Vol 90 (3) ◽  
pp. e30.3-e29
Author(s):  
LF Saukila ◽  
B Little ◽  
NI Phillips ◽  
IA Anderson
Keyword(s):  
Length Of Stay ◽  
Decompressive Craniectomy ◽  
Management Strategies ◽  
Severe Disability ◽  
Local Data ◽  
Primary Surgery ◽  
Outcome Scores ◽  
Discharge Location ◽  
Pupil Reaction

ObjectivesThe RESCUEicp study has not culminated in consensus about the role of decompressive craniectomy following head injury. Another study (RESCUE-ASDH) also questions craniectomy for patients with ASDH. We examined our own practice over 5 years.DesignRetrospective analysis at a single UK unit. Comparison of outcomes with RESCUEicp results and national data obtained from the Neurosurgical National Audit Programme (NNAP).Subjects82 patients over 5 years. 87% male. 90% adults (age >16).MethodsLocal data: demographics, CT features, pre-op GCS/pupil reaction/ICP, primary/secondary craniectomy, operative timings, length of stay (critical care/overall), Extended Glasgow Outcome Scores, discharge location. NNAP data analysis.Results43% had ASDH with MLS >5 mm (91% primary decompression). Median time to primary surgery from referral 1 h37. 11 primary, 6 secondary decompressions/year; no change over 5 years 3 extensions of craniectomy, 3 had previous craniotomy converted. 30 day mortality 28%. Overall GOS-E: death 33%, lower severe disability 6%, upper severe disability 6%, moderate disability 16%, good recovery 37% (improved by better presentation GCS). 75% had cranioplasty. Median length of stay 41 days.ConclusionsOur practice has not changed over time, despite RESCUEicp. Good outcomes observed may be due to local specialist management of these patients, or reflect judicious case selection. Case-by-case decisions are crucial and may explain why large trials fail to change real-world management strategies. NNAP data comparison ongoing.

The role of concomitant chemoradiotherapy in AJCC 7th edition T1-2N1 oropharyngeal carcinoma in the human papillomavirus era

Oral Oncology ◽  
2020 ◽  
Vol 110 ◽  
pp. 104882
Author(s):  
Diana J. Lu ◽  
Michael Luu ◽  
Anthony T. Nguyen ◽  
Stephen L. Shiao ◽  
Kevin Scher ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Oropharyngeal Carcinoma ◽  
Concomitant Chemoradiotherapy ◽  
7Th Edition

The impact of primary surgery on stage IV breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1113-1113
Author(s):  
Ella Harris ◽  
Malcolm R. Kell ◽  
Reem Salman ◽  
Maurice Stokes ◽  
Tom Gorey
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Stage Iv ◽  
Primary Carcinoma ◽  
Primary Surgery ◽  
Primary Disease ◽  
Stage Iv Breast Cancer ◽  
Stage Iv Disease ◽  
The Impact

1113 Background: The role of primary surgery in metastatic breast cancer is unclear. Here in we have performed metaanalysis on available data to assess the role of surgery on oncological outcome in patients with stage IV breast cancer. Methods: A comprehensive search for published trials that examined outcome following removal of primary disease in stage IV breast cancer was performed using MEDLINE and cross referencing available data. Reviews of each study were conducted, and data were extracted. Primary outcome was overall survival related to surgical removal of primary disease. Results: We identified 15 relevant studies of which 10 were appropriate for analysis. Data was available on 28,693 patients with stage IV disease, of whom 52.8% underwent removal of the primary carcinoma. Patients undergoing primary surgery in this setting were more likely to be alive at 3 years 40% vs. 22% (OR 2.32 CI 2.08-2.6, p<0.01 (surgery vs. no surgery)). Analysis of subgroups for selection to surgery or not, favoured smaller tumours, fewer comorbidities, fewer metastases (p<0.01). There was no difference between the two groups in location of metastases, grade of tumour or receptor status. Conclusions: Patients undergoing removal of primary carcinoma in the setting of stage IV breast cancer appear to have an improved overall survival. However the available data suggest that these surgical patients probably have better prognosis stage IV disease than those patients not undergoing surgery.

Defining the Role of Primary Surgery in the Era of Chemoradiation Therapy

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P13-P13
Author(s):  
Jonas T Johnson ◽  
Bruce H Haughey ◽  
Petruzzelli Guy J ◽  
Keane William M ◽  
Christine G. Gourin
Keyword(s):  
Chemoradiation Therapy ◽  
Primary Surgery

scholarly journals PET Imaging in Recurrent Medullary Thyroid Carcinoma

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Giorgio Treglia ◽  
Vittoria Rufini ◽  
Massimo Salvatori ◽  
Alessandro Giordano ◽  
Luca Giovanella
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Fdg Pet ◽  
Medullary Thyroid ◽  
Primary Surgery ◽  
Pet Tracer ◽  
Positron Emission ◽  
Pet Ct ◽  
Pet Radiopharmaceuticals

Purpose. To perform an overview about the role of positron emission tomography (PET) or PET/computed tomography (PET/CT) using different radiopharmaceuticals in recurrent medullary thyroid carcinoma (MTC) based on biochemical findings (increased tumor marker levels after primary surgery). Methods. A comprehensive literature search of studies published in PubMed/MEDLINE, Scopus, and Embase databases through February 2012 regarding PET or PET/CT in patients with recurrent MTC was performed. Results. Twenty-nine studies comprising 714 patients with suspected recurrent MTC were retrieved. Twenty-seven articles evaluated the role of fluorine-18-fluorodeoxyglucose (FDG) PET or PET/CT in recurrent MTC with conflicting results. Diagnostic accuracy of FDG-PET and PET/CT increased in MTC patients with higher calcitonin and carcinoembryonic antigen values, suggesting that these imaging methods could be very useful in patients with more advanced and aggressive disease. Eight articles evaluated the role of fluorine-18-dihydroxyphenylalanine (FDOPA) PET or PET/CT in recurrent MTC reporting promising results. Overall, FDOPA seems to be superior but complementary compared to FDG in detecting recurrent MTC. Few studies evaluating other PET tracers are also discussed. Conclusions. PET radiopharmaceuticals reflect different metabolic pathways in MTC. FDOPA seems to be the most useful PET tracer in detecting recurrent MTC based on rising levels of tumor markers. FDG may complement FDOPA in patients with more aggressive MTC.

The role of postoperative chemoradiation for oropharyngeal carcinoma: A critical appraisal revisited

Cancer ◽  
2016 ◽  
Vol 123 (5) ◽  
pp. 887-888 ◽  
Author(s):  
Parul Sinha ◽  
Bruce H. Haughey ◽  
Dorina Kallogjeri ◽  
Edward L. Spitznagel ◽  
Jay F. Piccirillo
Keyword(s):  
Critical Appraisal ◽  
Oropharyngeal Carcinoma ◽  
Postoperative Chemoradiation

scholarly journals Re-explorative Parathyroid Surgery for Persistent and Recurrent Primary Hyperparathyroidism

2011 ◽  
Vol 3 (3) ◽  
pp. 107-111 ◽  
Author(s):  
Karolina Afors ◽  
Rachel L O'Connell ◽  
Martin H Thomas
Keyword(s):  
Primary Hyperparathyroidism ◽  
Imaging Techniques ◽  
Parathyroid Tissue ◽  
Parathyroid Surgery ◽  
Redo Surgery ◽  
Normal Gland ◽  
Primary Surgery ◽  
High Calcium ◽  
Targeted Approach

ABSTRACT Primary hyperparathyroidism (HPT) is treated by parathyroidectomy. Excision of abnormal parathyroid tissue is curative in the majority of cases. Postoperative persistent or recurrent HPT has been reported up to 30%. The purpose of this study was to evaluate the role of imaging techniques and determine the efficacy of reexplorative surgery. A total of 306 patients underwent parathyroidectomy between 2000 and 2009. Twelve patients (3.9%) were not cured. Two patients declined further treatment, the other 10 patients underwent further investigation and surgery. Imaging and results of redo surgery together with associated complications were evaluated. All 10 patients were investigated with sestamibi, which accurately localized aberrant parathyroid tissue in three cases and ultrasound scans which also localized three cases. CT was useful in one of the three cases for which it was used. PET and MRI were not helpful. Twelve glands were resected, six adenomas, five hyperplastic and one normal gland. Nine of the 10 reoperated patients became normocalcemic. Complications included a bilateral recurrent laryngeal paresis. In total, 317 operations were performed and 303 of 306 (99%) patients were cured. Redo surgery for HPT is challenging and carries higher risks than primary surgery. Sestamibi and ultrasound scans are the most helpful imaging modalities. When there is concordance a targeted approach may be considered, otherwise a more extensive dissection is required. Redo parathyroid surgery should be considered, even if scans are unhelpful, for patients who are symptomatic or young or have a persistently high calcium level.

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