Laryngeal Cancer Research Articles

A systematic review of ultrasonography-guided transcutaneous fine needle aspiration cytology in the diagnosis of laryngeal malignancy.

Direct laryngoscopy and biopsy is the gold standard for obtaining a tissue diagnosis in patients with suspected laryngeal cancer. In patients with advanced disease or other medical comorbidities, this may come with significant anaesthetic risks, including tracheostomy. Ultrasonography-guided biopsy has been widely used in the diagnosis of malignancy involving cervical lymph nodes but it is not commonly employed in the diagnosis of laryngeal tumours. A systematic review was undertaken to assess the literature looking at whether ultrasonography-guided transcutaneous fine needle aspiration cytology (FNAC) is an adequate method in diagnosing laryngeal malignancy. Two independent researchers conducted a systematic review of the literature using the MEDLINE® and Cochrane Library databases in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. A total of 568 studies were identified from the search, of which 3 met the inclusion criteria, resulting in 162 patient episodes. The pooled accuracy of transcutaneous FNAC in acquiring a sample adequate for histological diagnosis was 74.9%. Data on complications were limited, with a few cases of mild haemoptysis being recorded. Transcutaneous FNAC can be considered a safe and quick method for establishing a histological diagnosis of laryngeal lesions, particularly in patients who may be severely comorbid, and it could therefore could reduce the risks of general anaesthesia and tracheostomy prior to commencing definitive treatment.

Malignancy risk in diabetes; A population study based on electronic health records

Objective: To document the risk of the most common types of malignancies in people with diabetes compared to the people without diabetes. Methods: The data source of this study is the national electronic health records system of Turkey (e-Nabız). We analysed only the data of people over 14 years old in 2019. All the people with ICD-O-3 codes recorded for the first time in 2019 were accepted as new tumour cases. Tumours with /3 behaviour codes were accepted as malignant. Results: We detected 6,775,054 (10.6%) people with diabetes and 57,167,598 people without diabetes in our database. There were 63,696 new malignant cases in the group with diabetes and 123,662 new malignant cases in the group without diabetes. The total number of malignant tumours was 187,358. All types of major tumours seem to have increased risk. Pancreas cancer has the highest OR (odds ratio), 4.02 (3.71-4.36, 95% confidence interval), and larynx cancer has the lowest OR, 1.29 (1.19-1.41). OR for the presence of any malignancy in a person with diabetes is 1.87 (1.85-1.89). Conclusion: All major types of malignant tumours have an increased incidence in people with diabetes. The results confirm the presence of a relationship between diabetes and malignancy.

NID1 promotes laryngeal cancer stemness via activating WNT pathway.

Laryngeal cancer (LCA) is one of the most common head and neck squamous cell carcinoma with poor outcome. LCA stem cells are the main reason for LCA therapy resistance and relapse. Understanding the molecular mechanisms of the self-renew of LCA stem cells is critical to develop now targets and strategies for LCA therapy. Q-PCR and western blotting assays were used to determine NID1 level in LCA tissues and normal laryngeal tissues. MTT, colony formation assay, apoptosis assay and animal model were used to investigate the effect of NID1 on radiotherapy resistance. Side population assay and sphere formation assay were used to determine the role of LCA in the self-renew of LCA stem cells. NID1 was upregulated in LCA tissues, particularly in LCA tissues derived from relapsed patients, and associated with had poor outcome. NID1 knockdown suppressed radiotherapy resistance and the self-renew of LCA stem cells, while NID1 overexpression promoted radiotherapy resistance and the self-renew of LCA stem cells. Further analysis showed that NID1 promotes radiotherapy resistance and the self-renew of LCA stem cells via activating WNT pathway. Moreover, NID1 level was positively correlated with nuclear β-Catenin level in LCA tissues. Our results show that NID1 promotes radiotherapy resistance and the self-renew of LCA stem cells via activating WNT pathway, providing a novel potential target for LCA treatment.

Individual approach to the treatment of patients with stage III–IV laryngeal and laryngopharyngeal cancer in the Altai territory

Laryngeal and laryngopharyngeal cancer is the most common malignancy within the head and neck. Although there are many treatments for laryngeal and laryngopharyngeal cancer, the treatment still faces great challenging.The aim of the study was to evaluate the effectiveness of personalized treatment and one-year recurrence-free survival in patients with stage III–IV laryngeal and laryngopharyngeal, including postoperative complications (VTE, bleeding) within a year.Material and Methods. From July 2022 to October 2023, 100 patients with stage III–IV laryngeal and laryngopharyngeal cancer were treated in the Department of Head and Neck Tumors at the Altai Regional Oncology Center (AROC), Barnaul. There were 95 men (95 %) and 5 women (5 %). Patients were divided into two groups. Group I patients (n=50) with locally advanced laryngeal cancer underwent laryngectomy followed by radiation therapy with a total dose of 54 Gy delivered to the bed of the removed tumor and lymph node drainage region. Group II patients (n=50) received 3 courses of chemotherapy followed by radiation therapy at a dose of 70–74 Gy.Results. In group I patients, clinically insignifcant bleeding from the upper third of the trachea (in the area of contact with the tracheostomy tube) was observed in 3 patients (6.0 %) 3–4 days after surgery. No VTE during hospital stay and within 6–12 months after completion of treatment was observed. The 1-year cumulative survival rate in this group of patients was 90.0 %. In group II patients receiving chemotherapy, bleeding from a pharyngeal tumor was detected in 4 (8.0 %) patients. There were no signs of VTEO in this group. The 1-year cumulative survival rate of these patients was 70 %.Conclusion. Patients with laryngeal/laryngopharyngeal cancer require an individual approach not only in determining therapeutic strategies, but also in the prevention of VTE and hemorrhagic complications.

Self-Attention Mechanisms-Based Laryngoscopy Image Classification Technique for Laryngeal Cancer Detection.

The early diagnosis of laryngeal cancer (LCA) is crucial for prognosis, driving our search for an accurate, precise, and sensitive deep learning model to assist in LCA detection. We collected 5768 laryngoscopic images from 1462 patients and created the intelligent laryngeal cancer detection system (ILCDS) based on Swin-Transformer. Following training and validation, we assessed the ILCDS performance on the internal and external test sets and compared it with previous convolutional neural network (CNN) models and three professional laryngologists. The ILCDS outperformed the six CNNs, with the highest accuracy of 92.78% and an area under the curve (AUC) of 0.9732. Despite a slight drop in performance on external sets, the ILCDS maintained the best superiority, with 85.79% accuracy and an AUC of 0.9550. Surpassing professional laryngologists, the ILCDS achieved 92.00% accuracy. The ILCDS offers high accuracy and stability for LCA detection, reducing the burden on laryngologists.

Computed tomography radiomics reveals prognostic value of immunophenotyping in laryngeal squamous cell carcinoma: a comparison of whole tumor- versus habitats-based approaches.

To compare the performance of whole tumor and habitats-based computed tomography (CT) radiomics for predicting immunophenotyping in laryngeal squamous cell carcinomas (LSCC) and further evaluate the stratified effect of the radiomics model on disease-free survival (DFS) and overall survival (OS) of LSCC patients. In all, 106 LSCC patients (40 with inflamed and 66 with non-inflamed immunophenotyping) were randomly assigned into a training (n = 53) and testing (n = 53) cohort. Briefly, 750 radiomics features from contrast-enhanced CT images were respectively extracted from the whole tumor and two Otsu method-derived subregions. Intraclass correlation coefficients (ICCs) were calculated to evaluate the reproducibility. The radiomics models for predicting immunophenotyping were respectively created using K-nearest neighbors (KNN), logistic regression (LR), and Naive bayes (NB) classifiers. The performance of models in the testing cohort were compared using area under the curve (AUC). The prognostic value of the optimal model was determined by survival analysis. The radiomics features derived from whole tumor showed better reproducibility than those derived from habitats. The best model for the whole tumor (LR classifier) showed superior performance than that for the habitats (KNN classifier) in the testing cohort, but there were no significant differences (AUC: 0.741 vs. 0.611, p = 0.112). Multivariable Cox regression analysis showed that the immunophenotyping predicted by the optimal model was an independent risk factor of unfavorable DFS (p = 0.009) and OS (p = 0.008) in LSCC patients. Whole tumor-based CT radiomics could serve as a potential predictive biomarker of immunophenotyping and outcome prediction in LSCC patients.

Demographic Characteristics of Locally Advanced Laryngeal Cancer with Concurrent Chemo Radiotherapy along with Weekly Paclitaxel versus Weekly Cisplatin in Rajshahi Medical College

Modern multi-modality approaches using definitive concurrent chemoradiation has shown promising results in the treatment of locally advanced laryngeal cancer with intact cartilage and functional larynx. The aim of this study to estimate demographic Characteristics of Locally Advanced Laryngeal Cancer with Concurrent Chemo Radiotherapy along with Weekly Paclitaxel versus Weekly Cisplatin. This quasi-experimental study was conducted at the Department of Radiotherapy, Rajshahi Medical College Hospital, from January 2021 – June 2022 following ethical approval. Total 60 patients with locally advanced squamous cell carcinoma of larynx were included and divided into Arm-A (n=30) and Arm-B (n=30). After taking informed written consent, patients were given injection paclitaxel 30mg/m2 (Arm-A) or injection cisplatin 40mg/m2 (Arm-B) along with radiotherapy 66Gy in 33 fractions over 6.5 weeks. In this study, mean age of all study patients was 56.03±8.88 (SD) years with male predominance (88.3%). Demographic characteristics were similar across the two arms regarding age, gender, and tobacco history (p>0.05). Treatment response was evaluated at 6, 12 and 24 weeks after the completion of treatment. In Arm- A 80.00% showed complete response whereas in Arm- B showed 70.00%. Partial response was 20.00% and 30.00% in Arm-A and Arm-B respectively. Both Arm-A and Arm-B had similar rate of treatment response at each follow up (p>0.05).

Racial Disparities in 30 Day Outcomes Following Total Laryngectomy.

Despite the growing literature on racial disparities in the utilization of total laryngectomy (TL), and survival following the treatment of laryngeal cancers, there is a paucity of research in TL cohorts evaluating disparities in the immediate postoperative setting. In a national multi-institutional cohort, TL cases between 2010 and 2021 were identified using relevant Current Procedural Terminology (CPT) codes. Logistic regression analyses investigated the association between race/ethnicity and adverse outcomes within 30 days postoperatively. This study consisted of 1493 patients who underwent TL with or without radical neck dissection. Black patients underwent free flap and pedicled flap reconstruction more frequently than their counterparts (P = .023) and exhibited a 1.532 times higher odds of surgical complications (P < .001). There are increased rates of surgical complications in Black patients undergoing TL. Given the limited oncologic and socioeconomic variables available through National Surgical Quality Improvement Program, future study of disparate postoperative outcomes in this population is recommended.

The Association of TP53, BCL2, BAX and NOXA SNPs and Laryngeal Squamous Cell Carcinoma Development.

Head and neck cancer is the seventh leading cancer diagnosis worldwide. One of the most common cancers in the head and neck region is laryngeal cancer. In past years, the incidence of laryngeal squamous cell carcinoma has risen by 23%, and despite progress in treatment modalities, the survival rate has not changed. It is well known that genetic alterations may contribute to individuals' susceptibility to cancer. Research of genetic alterations, such as single nucleotide polymorphisms, is essential to understanding carcinogenesis and susceptibility of laryngeal squamous cell carcinoma. A total of 200 LSCC patients and 200 controls were included in this retrospective case-control study; both groups were matched by age and sex. In the present study, we analyzed six SNPs in genes essential for apoptosis regulation: TP53 (rs9895829, rs17884306), BCL2 (rs1564483, rs4987855), BAX (rs704243), NOXA (PMAIP1) (rs1041978, rs78800940). We evaluated their associations with the risk of LSCC development, its pathomorphological manifestation, and patients' overall survival rate. Genotyping was carried out using RT-PCR. The AG genotype of rs9895829 was more prevalent in controls than in cancer patients, leading to lower susceptibility to LSCC (OR = 0.301; 95%CI 0.096-0.940; p = 0.039). None of the analyzed SNPs showed an association with pathomorphological features of LSCC, but NOXA rs1041978 T allele carriers were found to be diagnosed with LSCC at an older age (OR = 1.962; 95%CI 1.072-3.592; p = 0.031). There was no statistically significant association between investigated SNPs and patient OS. The present study indicates that the AG genotype of rs9895829 provides a protective effect against LSCC development.

MiR-525-5p modulates cell proliferation, cell cycle, and apoptosis in Burkitt's lymphoma by targeting MyD88 and regulating the NF-κB signaling pathway.

MiR-525-5p functions as an oncomiRNA or tumor suppressor, and has been reported in various cancer types, including laryngeal squamous cell carcinoma, glioma, breast cancer, and cervical cancer. However, the biological functions and precise mechanisms of miR-525-5p remain unclarified in Burkitt's lymphoma (BL). This study aimed to explore the roles of miR-525-5p in BL, with the goal of ascertaining its regulatory effects on the nuclear factor-kappaB (NF-κB) signaling pathway by targeting Myeloid differentiation factor 88 (MyD88). The expression levels of miR-525-5p and MyD88 were measured by quantitative real-time PCR and immunohistochemical staining, respectively. The effects of miR-525-5p overexpression on BL cell proliferation, colony-forming, and migration were evaluated by cell counting kit-8, soft agar colony-forming, and transwell assays, while cell cycle and cell apoptosis were analyzed by flow cytometry. Possible interactions between miR-525-5p and MyD88 was examined via luciferase reporter assay. The expression of MyD88 and NF-κB signaling pathway-related proteins, including p65, p-p65, IκBa, and p-ΙκBa was determined by western blotting. BL cells overexpressing miR-525-5p were treated with phorbol 12-myristate 13-acetate (PMA), and Hoechst 33258 staining and Calcein AM/EthD-I staining were used to analyze the changes in chemotherapy sensitivity of BL cells to doxorubicin (DOX). Compared with reactive lymphoid hyperplasia, miR-525-5p was dramatically downregulated in BL tissues, while the rate of MyD88 protein positivity was significantly increased. Upregulation of miR-525-5p suppressed cell proliferation, colony-forming, and migration, induced cell cycle arrest and apoptosis, and enhanced the chemosensitivity to DOX in BL cells. MiR-525-5p targeted MyD88 to inhibit the activation of NF-κB signaling pathway. PMA treatment reactivated the NF-κB pathway and reversed apoptosis mediated by miR-525-5p overexpression. These findings revealed that miR-525-5p acts as a tumor suppressor, targeting MyD88 to modulate proliferation, cell cycle progression, and apoptosis in BL cells by regulation of NF-κB signaling pathway.

Long-term trends and future projections of larynx cancer burden in China: a comprehensive analysis from 1990 to 2030 using GBD data

Larynx cancer poses a significant public health challenge in China, with rising incidence and mortality rates over the past decades. Understanding the long-term trends and underlying factors is crucial for effective intervention and policy formulation. Data were utilized from the global burden of disease (GBD) Study 2021 to analyze the incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) due to larynx cancer in China from 1990 to 2021. Joinpoint regression analysis identified key changes in trends, while age-period-cohort (APC) analysis and decomposition analysis quantified the contributions of aging, epidemiological changes, and population growth to these trends. Our study found a significant increase in the incidence and prevalence of larynx cancer in China, particularly among males. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for males were substantially higher than those for females. Decomposition analysis revealed that aging was the primary driver of increasing incidence and mortality rates, while epidemiological changes had a mitigating effect. Joinpoint analysis identified periods of rapid urbanization and economic growth as key turning points for increased incidence. Bayesian APC models projected a continued upward trend in incidence rates up to 2030. The rising burden of larynx cancer in China underscores the need for targeted public health interventions, including smoking cessation programs, environmental pollution control, and early detection strategies. Addressing gender disparities and implementing effective prevention measures are crucial to mitigating the impact of larynx cancer in China.

Prophylactic Swallowing Exercises in Patients with Laryngeal Cancer Who Underwent Total Laryngectomy—A Randomized Trial

Objectives: This study aims to determine the efficacy of prophylactic swallowing exercises on swallowing function in patients undergoing total laryngectomy for laryngeal cancer. Methods: The design was a randomized controlled trial set in one tertiary care academic medical center. A total of 92 patients undergoing total laryngectomy for stages III and IV laryngeal cancer performed five targeted swallowing exercises for a period of three months after their surgery, starting two weeks after the surgery. Weekly swallowing therapy sessions were held with the patients in order to encourage adherence and proper technique. The controls received no preventive exercise and were referred for swallowing treatment following the surgery, as well as radiation therapy if necessary. The Functional Oral Intake Scale (FOIS) and the Performance Status Scale for Head and Neck Cancer Patients (PSS-H&amp;N) were used to measure swallowing function at the baseline, one week following the surgery, and three, six, nine, and twelve months following the surgery. Results: Right after the surgery, there were no statistically significant variations between the intervention and control groups in the FOIS scores (p value = 0.64), the Eating in Public subscale scores (p value = 1) and Normalcy of Diet subscale scores (p = 0.33) of the PSS-H&amp;N. The scores were significantly better among the intervention patients at months 3, 6, 9, and 12 for all the scores, with p values smaller than 0.000. Conclusions: Although not immediately following the surgery, the patients who engaged in prophylactic swallowing exercises showed improvements in their ability to swallow at 3, 6, 9, and 12 months following their procedure.

The Influence of the Microbiome on the Complications of Radiotherapy and Its Effectiveness in Patients with Laryngeal Cancer.

Radiotherapy is an effective method of treating cancer and affects 50% of patients. Intensity-modulated radiotherapy (IMRT) is a modernized method of classical radiation used in the treatment of laryngeal cancer. Treatment with intent to preserve the larynx is not always safe or complication-free. The microbiome may significantly influence the effectiveness of oncological treatment, especially radiotherapy, and may also be modified by the toxic response to radiation. The aim of the study was to prospectively assess the microbiome and its influence on radiotherapy toxicity in patients with laryngeal cancer. Statistically significant risk factors for complications after radiotherapy were the percentage of Porphyromonas of at least 6.7%, the percentage of Fusobacterium of at least 2.6% and the percentage of Catonella of at least 2.6%. The importance of the microbiome in oncology has been confirmed in many studies. Effective radiotherapy treatment and the prevention of radiation-induced oral mucositis is a challenge in oncology. The microbiome may be an important part of personalized cancer treatment. The assessment of the microbiome of patients diagnosed with cancer may provide the opportunity to predict the response to treatment and its effectiveness. The influence of the microbiome may be important in predicting the risk group for radiotherapy treatment failure. The possibility of modifying the microbiome may become a goal to improve the prognosis of patients with laryngeal cancer. Fusobacterium, Porphyromonas and Catonella are important risk factors for radiation-induced oral mucositis in patients with laryngeal cancer.

Berberine inhibits the malignant cell phenotype by inactivating PI3K/AKT/mTOR signaling in laryngeal squamous cell carcinoma.

Berberine is an active compound found in different herbs used in Chinese medicine and is well-known for its potential anticancer properties. The study aimed to figure out the role of berberine in regulating the malignant behavior of laryngeal squamous cell carcinoma (LSCC) cells. LSCC cell lines (SNU-899 and AMC-HN-8) were treated with different concentrations of berberine (0-200 μM) to determine its cytotoxicity. The migration, invasion, and apoptosis of LSCC cells were measured by wound healing assays, Transwell assays, and flow cytometry. Western blot was performed for the quantification of proteins involved in PI3K/AKT/mTOR signaling. The viability of LSCC cells was dose-dependently reduced by berberine. Berberine dampened LSCC cell migration and invasion while augmenting cell apoptosis, as evidenced by a reduced wound closure rate, a decrease in invaded cell number, and a surge in cell apoptosis in the context of berberine stimulation. Importantly, the effects of berberine on the cancer cell process were enhanced by LY294002 (an inhibitor for PI3K) treatment. Moreover, the protein levels of phosphorylated PI3K, AKT, and mTOR were markedly reduced in response to berberine treatment. Berberine inhibits cell viability, migration, and invasion but augments cell apoptosis by inactivating PI3K/AKT/mTOR signaling in LSCC.

The Diagnostic And Prognostic Role Of Immunohistochemistry In Head &amp; Neck Tumours Along With Radiological &amp; Histopathological Study

Background: Head &amp; neck tumors are defined as benign, premalignant &amp; malignant tumors above the clavicles, except the tumors of brain, spinal cord and esophagus. This includes tumors of paranasal sinus, nasal cavity, salivary glands, thyroid and upper aerodigestive tract, lymph nodes of neck, skin &amp; its appendages, soft tissue tumors, midline carcinomas &amp; metastatic tumors. Ultrasonography, computed tomography, magnetic resonance imaging were the modalities for initial evaluation. Histopathology was the GOLD standard for diagnosis followed by IHC for confirmation because correct diagnosis &amp; cancer subtyping of the neoplasia is essential for successful therapy and prognosis. Materials &amp; Methods: Study was conducted for 2 years with 100 specimens of head &amp; neck tumors. Thorough Radiological investigation was done followed by Histopathological examination including biopsy &amp; whole resected specimens. IHC markers appropriate to the histopathological diagnosis was done. Results: Among 100 patients of head &amp; neck tumors, most belonged to 5th decade with male: female ratio of 2.3:1. Squamous cell carcinoma (66%) followed by Lymphoma(11%), tumors of salivary glands(8%), metastatic lymphadenopathy(7%) were the lesions present. SCC was most common carcinoma in oral cavity, larynx, nasopharynx and ear with positive p63 marker. 1 case of Basal cell carcinoma with positive BerEP4 &amp; in NHL, salivary gland tumors &amp; Metastatic lymphadenopathy panel of IHC were included for confirmation. Conclusion: Immunohistochemistry has a diagnostic &amp; prognostic role in Head &amp; Neck tumors along with Radiological &amp; histopathological examination.

XCT as a Predictor for Survival in a Population-Based Cohort of Head and Neck Squamous Cell Carcinoma.

xCT, also known as SLC7A11 (solute carrier Family 7 Member 11), is a cystine/glutamate antiporter protein that mediates regulated cell death and antioxidant defense. The aim of this study was to investigate the effect of xCT on the outcome of patients diagnosed with new head and neck squamous cell carcinoma (HNSCC). This retrospective cohort study utilized a population-based dataset, comprising all patients (n = 1033) diagnosed with new HNSCC during 2005-2015 in a population of 697,000 people. All patients (n = 585) with a tumor tissue sample available for immunohistochemical (IHC) staining were included. The follow-up rates were 97% and 81% at 3 and 5 years, respectively. Also, the specificity of the anti-xCT antibody was validated. The expression level and prognostic significance of xCT were strongly dependent on tumor location. In oropharyngeal squamous cell carcinoma (OPSCC) patients, xCT expression was a significant prognostic factor for 5-year overall survival (OAS) (HR: 2.71; 95% CI 1.67-4.39; p < 0.001), disease-specific survival (DSS) (HR: 2.58; 95% CI 1.47-4.54; p = 0.001), and disease-free survival (DFS) (HR: 2.69; 95% CI 1.55-4.64; p < 0.001). Five-year survival rates for OPSCC patients with high and low levels of xCT were OAS 34% versus 62%; DSS 51% versus 73%; DFS 43% versus 73%, respectively. According to a multivariate model adjusted for age, T-class, nodal positivity, and tobacco consumption, xCT was an independent prognostic factor for 3-year survival, in which it outperformed p16 IHC. Similar associations were not observed in squamous cell carcinomas of oral cavity or larynx. Regarding treatment modalities, xCT was most predictive in HNSCC patients who received radiotherapy. High xCT expression was associated with poor prognosis in OPSCC. Our findings suggest that joint analysis of xCT and p16 may add significant value in OPSCC treatment stratification.

Calreticulin-Driven Autophagy Enhances Cell Proliferation in laryngeal Squamous Cell Carcinoma

BackgroundCalreticulin (CALR) is a multifunctional calcium-binding protein. Recent studies have revealed that CALR contributes to tumor development and promotes cancer cell proliferation. However, how CALR affects the development of laryngeal squamous cell carcinoma (LSCC) remains mysterious. Thus, this study aimed to explore the effect of CALR on LSCC development and uncover its underlying mechanisms. MethodsCALR expression in LSCC cell lines and tissues was examined by qRT-PCR and western blot analysis and its functional role was detected via in vivo and in vitro assays. Cell proliferation was discriminated with CCK-8 and colony formation assays, while apoptosis was analyzed using flow cytometry. Autophagy levels were measured via LC3 immunofluorescence, and western blot assay was conducted to assess apoptosis- and autophagy-related proteins. Additionally, a mouse xenograft model was employed to determine the impact of CALR knockdown on tumor growth. ResultsWe found that CALR knockdown reduced LSCC cell viability and proliferation while enhancing apoptosis, whereas CALR overexpression showed opposite effects. In vivo experiments verified that CALR knockdown suppressed tumor growth. In addition, elevated CALR expression induced autophagy in LSCC cells, while autophagy inhibitor 3-MA (2.5mM) reversed the anti-apoptosis effects of CALR overexpression. ConclusionOur study identifies CALR as an oncogene in LSCC, where it promotes tumor progression by inducing autophagy and inhibiting apoptosis. Targeting CALR or modulating autophagy may represent novel therapeutic strategies for LSCC.

Ten-Year Outcome After Supracricoid Partial Laryngectomy in cT3M0 Laryngeal Squamous Cell Carcinoma-A STROBE Analysis.

The aim of this study was to document 10-year outcomes after supracricoid partial laryngectomy (SCPL) in selected cT3M0 laryngeal squamous cell carcinoma (SCC) patients. This real-life retrospective observational study analyzed an inception cohort of 168 patients with isolated, untreated, selected cT3M0 laryngeal SCC, that were consecutively managed by SCPL during the period 1973-2013, and followed up until death or for a minimum of 10 years in 92% of cases at a single French academic and tertiary referral care center. Prior induction chemotherapy, arytenoid cartilage removal, level II-IV neck dissection, and postoperative radiation therapy were performed on 148, 77, 136, and 27 patients, respectively. The main objective was to determine 10-year actuarial local control and laryngeal preservation estimates. Secondary objectives included 10-year actuarial survival and cause-of-death analysis, and assessment of correlations between endpoints and clinical variables. The significance threshold was set at p < 0.005. Ten-year actuarial local control, laryngeal preservation, and survival estimates were 90%, 85%, and 52%, respectively. Salvage treatment resulted in an overall 99% local control rate. Metachronous second primary cancer, intercurrent disease without evidence of SCC, SCPL-related death, and uncontrolled local recurrence accounted for 31%, 26%, 7%, and 2% of causes of death. On univariate analysis, overall local recurrence and laryngeal preservation rates varied significantly, from 5% to 54% and 90% to 46% when resection margins were R0 and R1, respectively. The present study highlighted successful 10-year outcomes after SCPL, providing further evidence in favor of its integration into the conservative armamentarium for endolaryngeal cT3 SCC. 4 Laryngoscope, 134:4557-4563, 2024.

Tissue-Engineered Implant for Hemilaryngectomy Reconstruction with Recurrent Laryngeal Nerve Injury.

Laryngeal cancer resections often require excision of portions of the larynx along with sacrifice of the ipsilateral recurrent laryngeal nerve (RLN). In such cases, there are no reconstructive options that reliably restore laryngeal function, rendering patients with severe functional impairment. To address this unmet clinical need, we extend our evaluation of a 3-implant mucosal, muscle, cartilage reconstruction approach aimed at promoting functional laryngeal restoration in a porcine hemilaryngectomy model with ipsilateral RLN transection. Six Yucatan mini-pigs underwent full-thickness hemilaryngectomies with RLN transection followed by transmural reconstruction using fabricated collagen polymeric mucosal, muscle, and cartilage replacements. To determine the effect of adding therapeutic cell populations, subsets of animals received collagen muscle implants containing motor-endplate-expressing muscle progenitor cells (MEEs) and/or collagen cartilage implants containing adipose stem cell (ASC)-derived chondrocyte-like cells. Acoustic vocalization and laryngeal electromyography (L-EMG) provided functional assessments and histopathological analysis with immunostaining was used to characterize the tissue response. Five of six animals survived the 4-week postoperative period with weight gain, airway maintenance, and audible phonation. No tracheostomy or feeding tube was required. Gross and histological assessments of all animals revealed implant integration and regenerative remodeling of airway mucosa epithelium, muscle, and cartilage in the absence of a material-mediated foreign body reaction or biodegradation. Early voice and L-EMG data were suggestive of positive functional outcomes. Laryngeal reconstruction with collagen polymeric mucosa, muscle, and cartilage replacements may provide effective restoration of function after hemilaryngectomy with RLN transection. Future preclinical studies should focus on long-term functional outcomes. NA Laryngoscope, 134:4604-4613, 2024.

Contribution of Imagery in Larynx Cancer: About 61 Cases

Extensional imaging of laryngeal tumors relies on multi-bar helical CT scans. This examination requires compliance with a few simple rules in its preparation and performance. The protocol for performing cervico-mediastinal CT scans will be developed. Imaging must take into account not only the initial tumor pathology, but also the entire upper aero-digestive tract and lymph node areas, i.e. acquisition must extend from the base of the skull to the cervico-mediastinal orifice. Thoracic imaging should be performed as a matter of course for overall patient management. Certain deep extensions, only accessible by imaging, are decisive in the choice of treatment: surgery or radio-chemotherapy. In the case of surgery, imaging is a key factor in the choice of total or partial surgery. A complete lymph node survey is also essential in the management of these lymphophilic tumors.