Aim and objective: Our investigation attempts to identify factors associated with improved survival for early-stage laryngeal cancer based on primary therapy using the National Cancer Database (NCDB).
Materials and methods: This is a retrospective cohort with data abstracted from the NCDB. Patients with T1 or T2N0M0 laryngeal cancer from 1998 to 2011 who received radiation only, laser surgery, or laser surgery with adjuvant radiation were included. The Chi-square analysis were used to assess the association between treatment and factors investigated. Overall survival was assessed via the Kaplan-Meier method. Log-rank methods were used to determine factors significant for survival, and a multivariable Cox regression model was performed.
Results: There were 14,276 patients from the NCDB eligible for this study. The majority (91.2%) of patients received primary radiation, 4.7% laser resection, and 4.0% laser resection with radiation. Five-year survival for laser surgery was 78.8% (95% CI 75.5–82.1) vs 67.2% (95% CI 66.4–68.1%) for radiation alone. The multivariate analysis demonstrated advanced age, increased comorbidities, public or uninsured, T2 stage, and supraglottic subsite to be independently associated with worse survival. Treatment with laser only and laser with adjuvant radiation demonstrated a hazard ratio of 0.77 (p = 0.055) and 0.65 (p = 0.001) when compared to primary radiation.
Conclusion and clinical significance: Survival analysis on early-stage glottic patients in the NCDB showed multiple factors to be independently associated with survival. Outcomes based on treatment suggest an improved survival when utilizing endoscopic surgery as the primary treatment modality.
How to cite this article:
Khurana A, Kaur P, Gupta S, Chauhan A. Polymorphous Low-grade Adenocarcinoma of Base of the Tongue: A Case Report and Review of Literature of an Orphan Disease. Int J Head Neck Surg 2020; 11 (4):71-74.
Here, we are presenting a case of polymorphous low-grade adenocarcinoma (PLGA) of base of tongue, which is a malignancy with low-grade aggressiveness, less metastatic potential in a 76-year-old male with swelling on the left side of the neck for 2 weeks. The patient received a radical external beam radiation therapy on face and neck. Now, the patient is disease free and is on follow-up a year after the treatment.
Sarcomatoid carcinoma (SC) is an unusual and aggressive variant of squamous cell carcinoma, which frequently recurs and metastasizes; for this reason, the right diagnosis is very important. It is a biphasic tumor consisting of epithelial and mesenchymal components. The diagnosis often presents a clinicopathological challenge solved only by immunohistochemistry. Because of different behavior and treatment response, there is a need to diagnose this entity accurately for better management and therapeutic intervention. In the present article, we report a case of SC of the tongue in a 65-year-old male who presented with a polypoidal growth over the lateral border of his tongue with a short history of 1 month. Immunohistochemical expression of cytokeratin was strongly positive in the epithelial component and focally in the spindle cell component. The spindle cell component showed a strong positivity for vimentin.
Jyoti M Bothra,
A congenital pyriform sinus fistula comprises of the anomalies of the third and the fourth branchial tract and is the rarest of all the cervical anomalies. We present a case of pyriform sinus fistula which was misdiagnosed and treated with incision and drainage before the definitive management by us.
An aneurysmal bone cyst (ABC) is a rare bone lesion. Its origin and precise nature remain unknown. It is seen as a locally destructive, rapidly expandable, and benign multicystic mass. We report a 26-year-old male patient with an ABC of the maxilla, with extensive local involvement and bony expansion that was treated surgically.
Primary thyroid lymphoma (PTL) is a rarely encountered clinical entity that occurs in late age intrinsically associated with Hashimoto\'s thyroiditis, comprising of 0.6–5% of thyroid cancers in most series. We present a case of B-cell origin thyroid lymphoma. The diagnosis was made by combined histology and immunochemistry. A 60-year-old woman presented with an enlarging neck mass with odynophagia. On admission, the sonogram of the thyroid gland showed an enlarged mass and computed tomography scan demonstrated diffuse enlargement of the thyroid. The histological investigation revealed the presence of a diffuse large B-cell non-Hodgkin\'s lymphoma. The patient underwent chemotherapy. Clinicians should include PTL in the differential diagnosis of a rapidly enlarging thyroid mass. Thyroid ultrasound and fine-needle aspiration cytology, using flow cytometry and immunohistochemistry, remain the main modalities used to confirm the presence of lymphoma. The prognosis is generally excellent but can be varied because of the heterogeneous nature of thyroid lymphomas. Despite its rarity, PTL should be promptly recognized because its management is quite different from the treatment of other neoplasms of the thyroid gland.