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Salivary gland transfer surgery can reduce xerostomia in oropharyngeal squamous cell carcinoma patients undergoing primary chemoradiation. A potential drawback of salivary gland transfer is the treatment delay associated with the surgery, and its complications. This study aimed to determine whether the treatment delay affects patient survival and to evaluate patient quality of life after salivary gland transfer.
A retrospective analysis of 138 patients (salivary gland transfer group, n = 58; non-salivary gland transfer group, n = 80) was performed. Patient survival was compared between these groups using multivariate analysis. Salivary gland transfer patients were further evaluated for surgical complications and for quality of life using the head and neck module of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire.
Salivary gland transfer and non-salivary gland transfer patients had comparable baseline clinical characteristics. Salivary gland transfer patients experienced a median treatment delay of 16.5 days before chemoradiation (p = 0.035). Multivariate analysis showed that this did not, however, correspond to a survival disadvantage (p = 0.24 and p = 0.97 for disease-free and disease-specific survival, respectively). A very low complication rate was reported for the salivary gland transfer group (1.7 per cent). Questionnaire scores for the item ‘xerostomia’ were very low in salivary gland transfer patients.
The treatment delay associated with salivary gland transfer surgery does not negatively affect patient survival. Oropharyngeal squamous cell patients have an excellent quality of life after salivary gland transfer.
Merkel cell carcinoma is a rare, aggressive neurocutaneous malignancy. This study investigated whether patients with Merkel cell carcinoma in the head and neck had poorer outcomes than patients with Merkel cell carcinoma located elsewhere.
A retrospective study was performed of patients with Merkel cell carcinoma treated at the Jewish General Hospital in Montréal, Canada, from 1993 to 2013. Associations between clinicopathological characteristics and disease-free and disease-specific survival rates were examined according to the Kaplan–Meier method.
Twenty-seven patients were identified. Although basic clinicopathological characteristics and treatments were similar between head and neck and non-head and neck Merkel cell carcinoma groups, disease-free and disease-specific survival rates were significantly lower in the head and neck Merkel cell carcinoma group (log-rank test; p = 0.043 and p = 0.001, respectively). Mortality was mainly due to distant metastasis.
Patients with head and neck Merkel cell carcinoma had poorer survival rates than patients with non-head and neck Merkel cell carcinoma in our study. The tendency to obtain close margins, a less predictable metastatic pattern, and/or intrinsic tumour factors related to the head and neck may explain this discrepancy.
Papillary microcarcinoma of the thyroid has been described as either a normal variant or a serious malignancy. We describe our experience with papillary microcarcinoma and lymph node metastases.
A total of 685 consecutive total thyroidectomies with central compartment neck dissection were reviewed for papillary microcarcinoma. Association of central compartment lymph node metastases with age, gender, tumour multifocality, bilaterality and extrathyroidal extension was analysed.
Out of 170 papillary microcarcinoma cases, multifocality was found in 72 (42.4 per cent), bilaterality in 49 (28.8 per cent) and extrathyroidal extension in 16 (9.4 per cent). In all, 23 patients (13.5 per cent) had lymph node metastases. There was a significant association (p < 0.05) between extrathyroidal extension (but no other tumour characteristics) and lymph node metastases.
In all, 13.5 per cent of papillary microcarcinomas in our series showed lymph node metastases. Lymph node metastases were associated with extrathyroidal invasion of the papillary microcarcinoma.