Vulval Crohn disease: A case series of 26 patients

Abstract

Vulval Crohn disease is rare and likely under‐reported, leading to difficulty in diagnosis and delay in treatment. In this case series, we report the clinical features and discuss therapy in 26 consecutive patients with vulval Crohn disease, with or without documented gastrointestinal disease, presenting between January 2016 and July 2018. We highlight the need for treatment that is in some cases more aggressive than the requirement to manage the patient's gastrointestinal involvement.

https://ift.tt/2QMapC2

Charcoal pocket hand warmers – a rare cause of BCC carcinogenesis?

https://ift.tt/2SJP7lA

Evaluation of the theranostic properties of gadolinium‐based nanoparticles for head and neck cancer

Abstract

Background

The aim of the study was to evaluate the benefits of the combination of Gadolinium‐based nanoparticles AGuIX and radiotherapy on the recurrence free survival after tumor resection in a head and neck animal orthotopic model.

Methods

Human head and neck CAL33 orthotopic tumors were implanted in female NMRI nude mice. The biodistribution of AGuIX was studied by fluorescence imaging. Tumor resection was performed 19 days after tumor implantation. Radiotherapy was performed 23 days after resection (10 Gy), 1 hour after AGuIX IV injection.

Results

After systemic administration, AGuIX passively accumulated in the orthotopic tumors. After tumor surgery, the combination of AGuIX with radiotherapy significantly improved the recurrence free survival and the median survival time (196 days) compared to irradiated only mice (75 days).

Conclusion

This study demonstrated the improvement of the recurrence free survival following combination of AGuIX injection with radiotherapy after Head and neck tumor resection.

https://ift.tt/2ULgaz0

Mutational profiles of persistent/recurrent laryngeal squamous cell carcinoma

Abstract

Background

We sought to describe targeted DNA sequencing data of persistent/recurrent laryngeal squamous cell carcinoma (LSCC) and to compare gene‐specific alteration frequencies with that of primary, untreated LSCC specimens from The Cancer Genome Atlas (TCGA).

Methods

The tumors of 21 patients with persistent/recurrent LSCC were subjected to targeted DNA sequencing using the Ion AmpliSeq Comprehensive Cancer Panel. Gene‐specific alteration frequencies were compared (Chi‐Square test) to primary, untreated LSCC sequencing data from TCGA using the cBioPortal platform.

Results

Persistent/recurrent LSCC was characterized by a high rate of inactivating alterations in TP53 (38.1%) and CDKN2A (33%), amplification events of CCND1 (19.1%), and ERBB2 (14.3%), and NOTCH1 (19.1%) mutations. Comparison of primary vs persistent/recurrent LSCC revealed significant differences in alteration frequencies of eight critical genes: BAP1, CDKN2A, DCUN1D1, MSH2, MTOR, PIK3CA, TET2, and TP53.

Conclusions

Our results provide preliminary support for a distinct mutational profile of persistent/recurrent LSCC that requires validation in larger cohorts.

https://ift.tt/2Bc4wUD

Pathway based prognostic gene expression profile of buccal and gingivo‐buccal oral squamous cell carcinoma in smokeless tobacco chewers

Abstract

Background

The objective was to study comprehensive mRNA expression profiles of buccal mucosa oral squamous cell carcinoma (OSCC‐BM) and gingivo‐buccal OSCC (OSCC‐GB) in smokeless tobacco chewers to understand the biological behavior of OSCC at these specific sites and identify diagnostic and prognostic markers.

Methods

High throughput RNA sequencing transcriptome of fresh buccal mucosa (4 samples) and gingivo‐buccal (4 samples) OSCC with normal oral mucosa (3 samples) was performed on Illumina NextSeq500 paired end sequencing with 75x2bp.

Results

In the comparison between OSCC and normal, there were 402 differentially expressed genes (DEGs); between OSCC‐BM and normal, there were 467 DEGs; and between OSCC‐GB and normal oral tissue, there were 608 DEGs. Pathway‐based analysis of gene expression was done. The inflammation mediated by chemokine and cytokine signaling pathway had the maximum gene hits.

Conclusions

FZD2 and its interactions with the cadherins have a role in invasion and metastasis. immunosurveillance is evident in OSCC‐GB with the downregulation of CADM1.

https://ift.tt/2BcQPF2

A systematic review of validated tools assessing functional and aesthetic outcomes following fibula free flap reconstruction of the mandible

Abstract

Background

Segmental mandibulectomy impairs health‐related quality of life (QoL), by altering speech, mastication, swallowing, and facial aesthetics. Fibula free flap (FFF) used for mandible reconstruction is known to improve outcomes; however, minimal information exists in the literature regarding patient‐reported outcomes. We aim to assess how current studies evaluate patient perception following segmental mandibulectomy and FFF mandible reconstruction.

Methods

Following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, a search was conducted for publications involving FFF mandible reconstruction from 2005 to 2017 using PubMed, Cochrane, EMBASE, Web of Science, and PsychInfo.

Results

Of 2212 articles identified initially, only 7 studies were deemed suitable. Six studies used the University of Washington Quality of Life questionnaire, 3 Oral Health Impact Profile, and 1 used European Organization for Research and Treatment of Cancer Head and Neck (EORTC‐H&N35).

Conclusions

There is a paucity of information in published reports on QoL outcomes following mandible reconstruction with FFF. In the era of patient‐centered health care, observations warrant attention from researchers for physician‐assessed patient‐reported measures to factor in QoL expectation during surgical decision‐making about the choice of reconstruction.

https://ift.tt/2BaeZ30

High‐dose versus standard‐dose radiation therapy for cervical esophageal cancer: A retrospective single‐institution study

Abstract

Background

To evaluate the role of definitive radiotherapy using higher‐than‐standard‐dose radiation of 50 Gy for carcinoma of the cervical esophagus (CCE).

Methods

We reviewed 79 patients with stage I‐III CCE, treated between 2000 and 2012. Patients received 5‐fluorouracil/cisplatin‐based chemotherapy concurrently and were divided into high‐dose (≥59.4 Gy, n = 44) and standard‐dose (<59.4 Gy, n = 35) groups.

Results

The median follow‐up was 35 months for surviving patients. The high‐dose group had significantly better 3‐year local (90.0% vs 60.4%, P = .001) and locoregional (70.4% vs 45.3%, P = .04) control. Progression‐free (45.4% vs 37.5%, P = .32) and overall (58.4% vs 49.1%, P = .69) survival rates were not different. High‐dose radiation was an independent prognostic factor for locoregional control (P = .04). No differences in late toxicities (esophageal stenosis or tracheoesophageal fistula) were observed.

Conclusion

High‐dose radiation for CCE improves local and locoregional control, without increasing severe toxicities.

https://ift.tt/2UElc03