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In recent years, in Poland and in Europe, we have seen a steady increase in the incidence of malignant tumors of the head and neck. On the basis of national cancer registries, the increase in new cases in the last ten years is over 15% and that worries epidemiologists and the medical community. Taken in Europe prevention programs aimed at reducing new cases. In Grater Poland from 2012 has initiated an innovative program for Early Detection of Cancer, Department of Head and Neck Surgery Medical University in Poznan and the Department of Health Marshal's Office in Poznan. The aim of the study was to evaluate dental and oral hygiene habits analysis of patients reporting to the Programme for Early Detection of Head and Neck Cancer. The study conducted involved 678 patients reporting to the Department of Head and Neck Surgery in Grater Poland Cancer Center under the prevention of cancers of the head and neck. All patients underwent ENT assessment and standard dental examination assessing condition of teeth and oral mucosa. All patients were asked to fill out prepared questionnaire, which included questions concerning socio-economic conditions of the patient, hygiene habits and risk factors for oral cancer. Most of the patients participating in the study, 441 people (65.9%) smoke or smoked cigarettes. Smoking habit among female dominated. Within smokers responders declared, at the same time,consumption of alcohol at least three times a week; 192 people (81.1%). Almost half (49.8%) of all respondents reported consuming alcohol occasionally. Regular practice of oral sex with frequent change of partner, belonging to the high risk of head and neck cancer, were found in 21.9% of patients. During the assessment of oral hygiene was observed 155 patients (23.4%) correctly cleansing the teeth and oral cavity, while more than half (62.4%) did not abide rules of daily oral hygiene. The use of additional tools to correct hygienization (dental floss, interdental brushes, rinses the mouth) was recorded in 51.7% of patients. As a result, 85% of the patients of the head and neck cancer prevention program was found bad condition of the oral cavity, and dental procedures in 30% of patients were applied. Patients diagnosed with invasive cancer was in 19 cases. Results of this study indicate that, the dentist should be an integral part of interdisciplinary team treating patients with head and neck cancer, and regular dental care plays a key role in the early diagnosis of patients with head and neck cancer.
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Atención Odontológica , Neoplasias de Cabeza y Cuello/prevención & control , Higiene Bucal , Odontólogos , Diagnóstico Precoz , Femenino , Neoplasias de Cabeza y Cuello/diagnóstico , Neoplasias de Cabeza y Cuello/epidemiología , Humanos , Masculino , Polonia , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
INTRODUCTION: Head and neck cancers account for about 6% of all malignant tumors. Head and neck cancers are responsible for about 650,000 new cases and approximately 260,000 deaths in the world annually. About 50% of patients fail to achieve cure or relapse of cancer occurs despite intensive combined treatment. A small number of patients is eligible for re-treatment, and for most of them symptomatic treatment is used. Photodynamic therapy(PDT) may be an alternative these patients. PDT improves the quality of life in patients who are at the stage of the disease recognized as incurable according to present knowledge. MATERIALS AND METHODS: Study group consisted of three patients treated in the Department of Head and Neck Surgery in Poznan due to recurrence of squamous cell carcinoma of the head and neck. Patients were qualified to the palliative PDT ( Photodynamic therapy)with Foscan. when other possibilities of treatment have been used up. RESULTS: Two patients achieved a partial response (PR) by RECIST criteria. One patient achieved disease stabilization (SD). DISCUSSION: Photodynamic therapy is a therapeutic option in the palliative treatment of patients with squamous cell carcinoma of the head and neck. The careful qualification of the patients for this type of treatment is very important. One should take into account the location of the tumor and its size. Great advantage of photodynamic therapy is that it can be used repeatedly. Treatment with photodynamic therapy should be performed in specialized centers because of the need of adequate technical facilities. PDT may improve the quality of life of selected patients with incurable cancer of the head and neck.
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Neoplasias de Cabeza y Cuello/terapia , Recurrencia Local de Neoplasia/terapia , Cuidados Paliativos/métodos , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Femenino , Humanos , Masculino , Calidad de VidaRESUMEN
550,000 new cases of cancer of the oral cavity and pharynx and 160,000 of larynx are diagnosed each year worldwide. It is estimated that each year because of head and neck cancer 400,000 of patients will die. Head and neck neoplasms are the tumors which, because of their location, secretly develop and produce uncharacteristic symptoms identical to those that accompany the banal infections of the upper respiratory tract. Results of treatment of patients with head and neck cancer in Poland are highly unsatisfactory. This is due to significant advancement of tumor at the moment of diagnosis. Therefore, raising awareness and improving knowledge of health care workers on head and neck cancers by creating access to prevention research is a priority that will ensure improvement in treatment outcomes in this group of tumors in Poland and abroad.
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Detección Precoz del Cáncer/métodos , Neoplasias de Cabeza y Cuello/epidemiología , Educación en Salud/organización & administración , Prevención Primaria/métodos , Neoplasias de Cabeza y Cuello/prevención & control , Humanos , Programas Nacionales de Salud/organización & administración , Polonia/epidemiologíaRESUMEN
Recurrent respiratory papillomatosis is an increasingly common disease which leads to organic and functional limitations. Clinical symptoms depend on the location and extent of the papillomatosis. They include hoarseness, cough, and, in some cases, significant narrowing of the respiratory and digestive tracts. The present report describes a fatal case of a young man (28 years old) who developed a very dynamic papilloma infection of the larynx, which spread to the trachea, the oesophagus, the soft tissues of the neck, and the mediastinum. Multimodal treatment did not stop the progression of the disease. The papillomatous lesion was removed with a CO2 laser used in a Kleinsasser microlaryngoscopy and under a microscope using a electrocoagulation loop with argon plasma during the gastroscopy. Antiviral treatment with cidofovir was introduced, as well as in further follow-up radiotherapy. Congenital or acquired immunodeficiency was also excluded. Despite multimodal treatment, successful eradication of the infection was not possible. In our case, aggressive progression of the disease was observed. We were unable to confirm malignant transformation. Papillomatosis was the only disease, and its aggressive development led to the patient's death. In the case of aggressive, uncontrolled progression - when the infiltration spreads beyond the larynx and the hypopharynx - there are no alternative treatment methods that would lead to an effective cure.
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Infecciones por Papillomavirus/diagnóstico , Infecciones del Sistema Respiratorio/diagnóstico , Biopsia , Terapia Combinada , Resultado Fatal , Humanos , Masculino , Infecciones por Papillomavirus/terapia , Infecciones por Papillomavirus/virología , Infecciones del Sistema Respiratorio/terapia , Infecciones del Sistema Respiratorio/virología , Tomografía Computarizada por Rayos X , Insuficiencia del TratamientoRESUMEN
INTRODUCTION: Oral cancer is the second most prevalent head and neck malignancy in Poland. The incidence of these types of cancer is constantly growing. A reason for a treatment failure of the oral cancer is local recurrence. AIM OF THE STUDY: To find out why the rate of recurrence of the oral cancer is so high despite radical surgical treatment combined with radiochemotherapy. MATERIALS AND METHODS: The study comprised a group of 160 oral cancer patients. 30 patients who showed local recurrence were given an extended histopathological examination in keeping to the guidelines of the Royal College of Pathologists. RESULTS: In 9 patients, primary tumours were found to be histologically aggressive as indicated by the proliferation of the vessels, nerves and muscles. In next 9 cases, the cancer infiltrated both the vessels and nerves or the vessels and muscles, and in the 8 other cases, just one of those structures. The tumours which were found to penetrate the vessels, nerves and muscles were also characterised with peri- and intraneural infiltration. The aggressiveness of invasion measured by the extent of damage done to the muscles, vessels and nerves correlated with the depth of invasion from the mucous membrane, the occurrence of embolisms in blood vessels, and a high (score 4) risk assessment as proposed by Margaret Brandwein-Gensler. CONCLUSION: The progression of cancer depends strongly on histopathological features. The incidence of penetration of the vessels, nerves and muscles correlates with aggressiveness of the front of tumour and few other histological features.
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Neoplasias de la Boca/patología , Neoplasias de la Boca/terapia , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/terapia , Quimioterapia Adyuvante , Supervivencia sin Enfermedad , Femenino , Humanos , Incidencia , Terapia por Láser , Masculino , Neoplasias de la Boca/epidemiología , Invasividad Neoplásica , Recurrencia Local de Neoplasia/epidemiología , Polonia , Procedimientos de Cirugía Plástica , Tasa de SupervivenciaRESUMEN
BACKGROUND: Head and neck squamous cell carcinoma (HNSCC) is a disease of middle-aged to elderly adults. However, an increased incidence of HNSCC in young people under 45 years of age has been reported recently. In the present review, we focused on the epidemiology and aetiology of HNSCC in adults under 45 years of age. METHODS: We reviewed literature related to HNSCC in adult patients less than 45 years of age and discussed current treatment options and prognosis. RESULTS: HNSCC in young adults is associated with a higher incidence rate in nonsmokers, lower female-to-male ratio, a higher percentage of oral cavity and oropharynx tumours, and fewer second primary tumours. However, aside from traditional risk factors of tobacco and alcohol exposure, the causes of these cancers in young adults remain unclear. Agents that might contribute to risk include infection with high-risk human papillomavirus subtypes as well as genetic factors or immunodeficiency status. The expected increase in incidence and mortality of the young with HNSCC may become a major public health concern if current trends persist, particularly lifestyle habits that may contribute to this disease. CONCLUSIONS: Given the younger age and potential long-term adverse sequelae of traditional HNSCC treatments, young adults should be treated on a case-by-case basis and post-therapy quality of life must be considered in any treatment-decision making process.
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PURPOSE: The aim of the study was to evaluate the usefulness of ¹8F-FDG-PET/CT in diagnosis of head and neck cancer. MATERIAL AND METHODS: 60 ¹8F-FDG-PET/CT examinations were performed in 50 patients diagnosed and treated for head and neck cancer in Department of Head and Neck Surgery and Nuclear Medicine Department of The Greater Poland Cancer Centre in Poznan, Poland from 2007 to 2011. Patients were divided into 2 subgroups: CUP Syndrome patients (25 PET/CT exams) and patients being under control after treatment (35 PET/CT exams). RESULTS: In the group of CUP Syndrome patients 6 PET/CT examinations were negative, in 7--possible primary tumor was indicated, in 10--only cervical lymph node metastases were diagnosed, in 2 cases--distant metastases occured. Within the second subgroup 14 PET/CT examinations were negative, 11 exams--indicated the recurrent disease, 2--cervical lymph node metastases and 8--distant metastases. The sensitivity and specificity of ¹8F-FDG-PET/CT in this study within the CUP Syndrome patients group were 100% and 55% respectively. The positive predictive value was 74%. The negative predictive value was 100%. The sensitivity and specificity of ¹8F-FDG-PET/CT in this study within the second group of patients were 88% and 66% respectively. The positive predictive value was 71%. The negative predictive value was 86%. CONCLUSIONS: ¹8F-FDG-PET/CT is useful for staging of head and neck cancer, identification of an unknown primary tumor, delineation of the extent of regional lymph node involvement, detection of distant metastases and occasional synchronous primary tumor.
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Carcinoma/diagnóstico por imagen , Carcinoma/secundario , Fluorodesoxiglucosa F18 , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Melanoma/diagnóstico por imagen , Melanoma/secundario , Tomografía de Emisión de Positrones , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Neoplasias Primarias Desconocidas/diagnóstico por imagen , Valor Predictivo de las Pruebas , Sensibilidad y EspecificidadRESUMEN
INTRODUCTION: The incidence of basal-cell carcinomas (BCC) in Europe is estimated at 10 cases per 100,000 people and is continuously increasing. Recurrent cases of BCC tend to have a more aggressive progression. The treatment methods include: conventional surgery, Mohs surgery, laser therapy, cryosurgery, curettage and radiotherapy. The recurrence of basalcell carcinoma depends on the method of treatment and ranges between 4% and 18%. In the case of recurrent BCC the treatment method of choice is margin control surgery. AIM OF THE STUDY: The purpose of this paper is to conduct a retrospective analysis of patients with facial BCC treated with classic surgery and laser therapy as well as to present a strategy for action in the case of recurrence. MATERIAL AND METHODS: The retrospective analysis was conducted on patients with diagnosed facial BCC, treated at the Head and Neck Surgery Ward and Laryngological Oncology Clinic of the Greater Poland Cancer Centre in the years 2007-2010. The research included 58 patients aged 56-80; 34 women and 24 men. RESULTS: Out of 58 patients 8 had recurrent BCC - 4 cases after laser therapy (Group A), and 4 cases after classic surgery (Group B). In 2 cases from Group A and all cases from Group B further treatment involved removal of the recurrent tumour by margin control surgery and skin flap plastic surgery. In 2 remaining cases from Group A further CO(2) laser therapy was performed under local anaesthesia and analgosedation. This type of treatment was chosen due to general medical and cardiological concerns which disqualified the use of general anaesthesia and conventional surgery. So far no further local recurrent cases of BCC have been diagnosed, and the follow-up periods range from 4 to 26 months. CONCLUSION: Recurrent cases of BCC are 10% more frequent in patients treated with cryosurgery or laser therapy without margin control than in patients who had the tumour removed by margin control surgery. Margin control surgery remains the method of choice in cases involving large tumours, recurrence or spread by invasion.
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Carcinoma Basocelular/cirugía , Neoplasias de Cabeza y Cuello/cirugía , Terapia por Láser , Recurrencia Local de Neoplasia/cirugía , Neoplasias Cutáneas/cirugía , Anciano , Anciano de 80 o más Años , Cara/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polonia , Procedimientos de Cirugía Plástica , Estudios RetrospectivosRESUMEN
INTRODUCTION: Cancer patients after neck surgeries require specific operative and postoperative management, which to some extent determines the final outcome of the surgery. Such procedures require particular attention due to the respiratory and gastrointestinal tracts as well as the presence of functionally and morphologically important anatomical structures on the neck. The majority of patients qualified for surgery have concomitant medical conditions, which increases the probability of certain operative and postoperative complications. Preparation for the procedure requires close cooperation between the laryngologist-head and neck surgeon, general practitioner and anaesthetist. AIM: The purpose of the paper was to analyse the factors that influence the normal process of healing in the operative and postoperative periods in patients after neck surgery. MATERIAL AND METHODS: The study group consisted of 220 patients who underwent neck surgery in the years 2007-2010. 92.8% of the operations were performed due to a malignant cancer. The following factors were taken into consideration in the evaluation of the healing process: RESULTS: On average, following surgery, patients stayed in the ward for: 5-7 days after selective removal of lymph nodes, 5 days after removal of branchial cleft cyst or persistent thyroglossal duct, 14 days after total laryngectomy, and 12 days after reconstructive laryngeal surgery. All patients after oncological surgery of the oral cavity, oropharynx and larynx stayed in the ICU for the first 24 hours and remained under analgosedation. Laryngeal surgery was performed using a separate surgical incision for tracheotomy. In all cases suction drainage was used for 48 hours. After surgery, patients were mobilised during the first 24 hours in the ward. CONCLUSION: Appropriate operative and postoperative management, following specific standards, increases the safety of the patient. Providing optimal conditions for healing shortens the patient's stay in the ICU, which reduces the cost of hospitalisation and increases the patient's comfort and quality of life.
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Neoplasias de Cabeza y Cuello/cirugía , Cuello/cirugía , Cuidados Posoperatorios , Complicaciones Posoperatorias/terapia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Tiempo de Internación , Escisión del Ganglio Linfático , Metástasis Linfática , Masculino , Persona de Mediana Edad , Polonia , Calidad de Vida , Adulto JovenRESUMEN
AIM: The aim is to find out why the rate of recurrence of tongue and floor of the mouth cancer is so high despite radical surgical treatment combined with radiochemotherapy. BACKGROUND: Oropharyngeal cancer is the second most common head and neck cancer in Poland. Tongue cancers account for 40% of all oral cavity tumours. A frequent reason for a failure in treatment of tongue and floor of the mouth cancers is local recurrence. Based on that examination, cancer treatment can be precisely planned. MATERIALS AND METHODS: The study comprised a group of 56 tongue and floor of the mouth cancer patients. 9 patients who showed local recurrence were given an extended histopathological examination. The infiltration of the vessels, nerves and muscles was examined. The examination also checked the largest dimension of the tumour, the greatest depth of invasion from the mucous membrane, invasive front of the cancer, vessel embolisms, intra- and perineural infiltrations in the cancer invasive front. Tumour aggressiveness was assessed according to M. Brandwein-Gensler. RESULTS: In five patients, primary tumours were found to be histologically aggressive as indicated by the infiltration of the vessels, nerves and muscles. Tumours which penetrate these structures were characterized with peri- and intraneural infiltration and were correlated with the depth of invasion from the mucous membrane, the occurrence of embolisms, and a high risk assessment as proposed by M. Brandwein-Gensler. CONCLUSION: The progression of cancer depends strongly on histopathological traits. The incidence of penetration of the vessels, nerves and muscles correlates with aggressiveness of the tumour front.
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Cigarette smoking and excessive alcohol drinking result in the rise of numbers of patients suffering from the head and neck cancer. Addiction to any of these stimulants carry a risk of developing a cancerogenesis process. Using them simultaniously lead not to a summary of each of those risks but multiplies them. Scientific research also indicates the important difference in the incidence of cancer in people who have never smoked cigarettes or drunk alcohol in comparison to those, whose exposure to these stimulatns was longterm - in such case, the former group had a lower percentage of developing the disease. Human body burdened with the ongoing cancer shows disturbances on various levels of the system. One of such disturbances is change of the concetration levels of physiological metals, such as calcium, magnesium, iron, copper, zinc or mangenese. They play key roles in maintaing the hormonal and ionic stability, they act as cofactors in many enzymes in metabolic processes. Diagnostic research of any deviations in levels of those essential elements enables a full estimation of a patient condition. The aim of this study was physiological metal levels evaluation in different kinds of biological material in patients with tumors of larynx, salivary glands and oral cavity and tongue. Hair and nail samples were used as examples of alternative material, beside the serum samples, which is a standard material and often used. Subjects were patients of Otolaryngology and Laryngological Oncology Clinic of Poznan University of Medical Sciences (Samodzielny Publiczny Szpital Kliniczny nr 2 im. Heliodora Swiecickiego Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu) and The Head and Neck Surgery Ward of The Greater Poland Cancer Centre in Poznan. Subjects were 41 men and 18 women with tumors of larynx, salivary glands and oral cavity and tongue. The control group consisted of patients from the Otolaryngology and Laryngological Oncology Clinic of Poznan University of Medical Sciences (Samodzielny Publiczny Szpital Kliniczny nr 2 im. Heliodora Swiecickiego Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu), The Head and Neck Surgery Ward of The Greater Poland Cancer Centre in Poznan and patients of Department of Endocrinology, Metabolism and Internal Medicine of Poznan University of Medical Sciences (Samodzielny Publiczny Szpital Kliniczny nr 2 im. Heliodora Swiecickiego Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu) and Department of Conservative Dentistry and Periodontology Poznan University of Medical Sciences. They gave answers to the questionnaire concerning smoking habits, alcohol consumption and dietary habits, Then the samples of their serum, hair and nails were collected. After careful preparations the biological material has underwent the process of digestion, and then calcium, magnesium, iron, copper, zinc, mangenese were determined quantitatively using the method of ICP-MS. Profile of the patients who took part in the research displayed a strong correlation between tobacco smoking with alcohol drinking and appearance of larynx, salivary gland and oral cavity and tongue cancer as well as between exclusively tobacco smoking and appearance of these types of cancer. There is a higher incidence of larynx, salivary gland and oral cavity and tongue cancer when there is a deficiency of grain products or fibre in everyday diet. A higher level of calcium, magnesium, iron and manganese was found in patients' hair and nails who suffered from salivary gland cancer. According to applied Chemometric Analysis of Principal Component 1 - concentrations of iron, copper and manganese with magnesium and zinc in patients' nail samples showed strong correlation between measured variables. In patiens' hair samples measured correlation between variables was decreased - concentrations of calcium and magnesium as well as of iron and manganese were highlighted as two groups of variables which showed some correlation in this type of biological material. Further research is required to indicate which of alternative biological materials - hair or nail samples - in relation to serum, would provide a better evaluation of physiological metal levels.