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Diagnostic accuracy of MRI and PET/CT for neck staging prior to salvage total laryngectomy

Journal of Cancer Metastasis and Treatment 2022年第1期8卷 1-14页

作者： Jonas Galli Roland Giger Olgun Elicin Martin Wartenberg Lukas Anschuetz Lluís Nisa Department of Otorhinolaryngology Head and Neck SurgeryInselspitalBern University Hospitaland University of BernBern 3010Switzerland Department of Radiation Oncology InselspitalBern University Hospitaland University of BernBern 3010Switzerland Institute of Pathology University of BernBern 3008Switzerland

Aim:Lymph node(LN)metastases are associated with poor outcomes in patients with recurrent larynx squamous cell carcinoma(LSCC).Neck dissection(ND)is therefore commonly performed along with salvage total laryngectomy(STL).Here,we assess the rate of occult LN metastases and the diagnostic value of MRI and PET/CT for detecting them in recurrent ***:This retrospective study included patients with recurrent LSCC after primary(chemo)radiotherapy[(C)RT]who were re-staged by MRI and/or PET/CT and treated with STL and ND between 2004 and *** histopathology of ND samples was used as the reference ***:Forty-one patients were *** prevalence of occult metastases in MRI-negative and PET/CT-negative neck nodes was between 3.2%and 6.1%.Negative predictive values of neck node re-staging were 93.9%for MRI,96.8%for PET/CT,and 96.2%for MRI and PET/CT ***:Both MRI and PET/CT afforded good negative predictive values for nodal staging in patients with recurrent LSCC after(C)RT prior to *** selected patients,these radiological modalities,particularly PET/CT,could help to avoid unnecessary surgery to the neck and its associated morbidity.

关键词： Laryngeal squamous cell carcinoma recurrence salvage total laryngectomy re-staging neck dissection MRI PET/CT occult nodal metastasis

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The use of Montgomery salivary bypass tubes and pharyngocutaneous fistula following salvage laryngectomy

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第1期10卷 43-48页

作者： Courtney B.Shires Mackenzie Latour Merry Sebelik Karuna Dewan West Cancer Center GermantownTennesseeUSA Department of Otolaryngology-Head and Neck Surgery Louisiana State University Health ShreveportShreveportLouisianaUSA Department of Otolaryngology-Head and Neck Surgery Emory UniversityAtlantaGeorgiaUSA

Objectives:Pharyngocutaneous fistula(PCF)is the most common complication to follow total laryngectomy(TL)and is associated with increases in length of hospital stay and with a need for revision surgery or readmission,as well as with delays in return to oral *** who require salvageTL(STL)or primary(chemo)radiation therapy are at higher risk for developing *** to the quality‐of‐life burden of PCF on patients,limiting this occurrence is ***:We conducted a retrospective cohort study of patients undergoing STL with placement of Montgomery salivary bypass tube(MSBT)^(TM)for at least 2 weeks duration between 2013 and 2017 at a single *** patients all underwent free flap *** primary outcome of interest was development of *** outcomes included demographics,previous treatment,base of tongue(BOT)involvement,extent of defect,concurrent neck dissection(ND),and margin ***χ^(2) analysis was used to evaluate factors associated with ***:Forty‐four patients underwent STL with Montgomery tube placement and free flap *** developed PCF(18.2%).The average age was 61.6 years;36 patients were male(81.8%),whereas eight patients were female(18.2%).There was no association between PCF and previous chemoradiation versus radiation(15.8%vs.33.3%,P<0.30),BOT involvement versus not(11.1 vs.22.2%,P<0.38),circumferential versus partial defect(18.8%vs.17.9%,P<0.94),ND versus none(10%vs.25%,P<0.20),or margin ***:PCF complicated 18.2%of STL cases at our institution and was not associated with differences in primary treatment modality,presence of concomitant ND,extent of pharyngeal defect,BOT involvement,or positive frozen or permanent surgical margin.

关键词： free flap reconstruction Montgomery pharyngocutaneous fistula salivary bypass tube salvage total laryngectomy total laryngectomy

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