British Association of Dermatologists and U.K. Cutaneous Lymphoma Group guidelines for the management of primary cutaneous lymphomas 2018

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The prognostic impact of pathologic lymph nodes in HPV-positive oropharyngeal cancers

Publication date: February 2019

Source: Oral Oncology, Volume 89

Author(s): Margueritta El Asmar, Hua-Ling Tsai, Carole Fakhry, Christopher A. Maroun, Rajarsi Mandal, Drew M. Pardoll, Hao Wang

Abstract

Purpose

Recent pathologic staging of HPV-positive oropharyngeal squamous cell carcinomas (OPSCC) is solely dependent on number of pathologic nodes. Using a large dataset, we aimed to understand how increase in pathologic lymph nodes (LN) associated with overall survival.

Materials and methods

National Cancer Database was queried for HPV-positive OPSCC patients undergoing primary surgery with LN dissection between 2010 and 2013. Kaplan-Meier, univariate and multivariate Cox models were used to evaluate overall survival. Interaction between nodal status and radiotherapy was examined.

Results

Implications of pathologic LN on overall survival differed according to receipt of post-operative radiotherapy (p-value_interaction = 0.008). In patients who did not receive adjuvant radiotherapy, there were no significant differences in risk of death from 0 to 2 pathologic nodes (adjusted HR (aHR) 0.92, 95%CI 0.61–1.4). However, risk increased by 18% on average with each additional LN thereafter (aHR 1.18, 95%CI 1.1–1.27). Among radiotherapy patients, after adjusting for other variables, patients with 1 pathologic LN had 70% lower risk of death than those with 0 pathologic LN (aHR 0.30, 95%CI 0.14–0.64). Thereafter, risk increased on average by 7% with each additional LN (aHR 1.07, 95%CI 1–1.14).

Conclusion

The prognostic impact of pathologic nodes in resected HPV-positive OPSCC differs by receipt of radiotherapy, with better outcomes in post-operative radiotherapy treated patients with one pathologic LN than none. These findings suggest that LN involvement may improve anti-tumor immune responses following radiotherapy, or result in earlier detection and treatment of disease. These results merit further studies to corroborate these findings and establish the underlying mechanism.

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Bringing benign ectomesenchymal odontogenic tumours to the lab: an in vitro study using an organotypic culture model

Abstract

Background

Benign neoplasms exhibit most of the cellular phenomena considered hallmarks of cancer, except the capacity to metastasize. Thus, the elucidation of the mechanisms associated with the progression of benign neoplasms may complement and clarify the mechanisms involved in carcinogenesis. Benign odontogenic tumours often result in facial deformities and morbidities, and have complex pathogenesis, mainly due to the diversity of interactions between the odontogenic epithelium and the ectomesenchyme. Primary cell culture of such tumours is not only difficult to be established and maintained, but also tumour cells lose characteristic cellular morphology. Considering gene expression, growth, migration, proliferation and cellular morphology are controlled by cell‐cell interactions and cell‐extracellular matrix interactions, cell culture in 3D substrates has gained space as a way to overcome some of the limitations of traditional monolayer cell culture systems.

Methods

In this study, fragments obtained from mesenchymal odontogenic tumours were cultured in collagen type I scaffolds. Invasion tests were performed in these models, as well as phenotypic characterization of the cultured tumours.

Results

The results obtained for the odontogenic myxoma and the cemento‐ossifying fibroma demonstrate a good reproduction of the growth pattern of these tumours under ex vivo conditions. Microscopic evaluation showed maintenance of cell viability in the explants for more than 30 days, without the presence of necrosis.

Conclusion

This is the first study involving long‐term 3D primary cultures of benign odontogenic tumours, which is expected to support complex approaches to cell and molecular biology, and serve as an experimental model for testing molecular therapies.

This article is protected by copyright. All rights reserved.

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Integrative Medizin bei Patientinnen mit Ovarialkarzinomen

Zusammenfassung

Hintergrund

Unter integrativer Medizin versteht man die Kombination von Methoden der konventionellen Medizin mit anderen Methoden, die primär dem Umfeld der komplementären und alternativen Medizin entstammen und sich in Studien nachweislich als sinnvoll erwiesen haben.

Ziel

Dieser Beitrag versucht die Frage zu beantworten, ob und ggf. welche Methoden sinnvoll mit den Strategien der konventionellen Medizin bei Patientinnen mit Ovarialkarzinom kombiniert werden können.

Ergebnisse

Unter Berücksichtigung der Aspekte Effektivität, Sicherheit, Kosten und Verfügbarkeit finden sich z. T. aus Metaanalysen stammende Daten, die zeigen, dass sich das Management der Behandlung des Ovarialkarzinoms im Hinblick auf supportive Maßnahmen begleitend zu OP und Chemotherapie verbessern lässt. Kaugummikauen führt dazu, dass die Darmtätigkeit früher wiederhergestellt wird, Eiswürfellutschen und Honig können eine chemotherapieinduzierte Mukositis verringern, um nur einige Beispiele zu nennen. Ergänzende Maßnahmen, die die Prognose des Ovarialkarzinoms verbessern würden, sind weniger gut erforscht.

Schlussfolgerung

Wenngleich bislang keine Behandlungskonzepte offiziell als integrativ gelten dürfen, so gibt es doch Ansätze, die sinnvoll die Behandlung bei Patientinnen mit Ovarialkarzinom ergänzen können. Hinweise, dass alternative oder esoterische Therapiekonzepte sinnvoll sein könnten, finden sich nicht.

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Algorithmus Tumorschmerztherapie

Zusammenfassung

Um Krebspatienten mit Tumorschmerzen im stationären Rahmen zeitnah Linderung zu verschaffen, wurde ein Algorithmus als Handreichung für alle primär behandelnden Teams entworfen. Aus stationsinternen Standards wurde ein kurzer Leitfaden entwickelt, der insbesondere im Krankenhaus sowohl bei palliativen wie auch sterbenden Patienten eingesetzt werden kann. Hierbei werden kurze Hilfestellungen in übersichtlicher tabellarischer Form gegeben, jedoch ohne ein Lehrbuch ersetzen zu wollen. So werden Patienten nach opioiderfahren und opioidunerfahren unterschieden und eine kurze Therapiemöglichkeit für die unterschiedlichen Stadien der Erkrankung dargestellt.

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Effect of Red Light Rhinophototherapy on Nasal Patency in Patients with Allergic Rhinitis

Purpose. The effect of red light rhinophototherapy (RLRPT) on nasal patency in patients with a clinical diagnosis of allergic rhinitis was investigated. Materials and Methods. Subjects were randomly divided into 2 groups, with patients in one group given one treatment session of RLRPT, followed by medical treatment. Those in the second group were treated with medical treatment only. The rhinitis symptoms were evaluated both before and 30 minutes after RLRPT and 2 days later. The nasal patency was objectively measured through the use of both active anterior rhinomanometry and acoustic rhinometry before and 30 minutes after RLRPT. Results. All rhinitis symptoms, including nasal congestion, significantly improved 30 minutes after a single RLRPT treatment, but worsened again, particularly for sneezing, 2 days later. Nasal resistance slightly decreased 30 minutes after RLRPT. The first minimal cross-sectional area did not change after RLRPT, but the second minimal cross-sectional area with the volume of the nasal cavity between 2.0 and 5.0 cm from the tip of the nosepiece significantly lessened. Conclusions. This study showed that RLRPL did not objectively improve patient's nasal patency. Registration Number. The trial is registered with NCT03752645.

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In this issue

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