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Malignant Soft Tissue Deposits in Advanced Cancer Larynx, a Prospective Study.

Ahmad Mohamed Eltelety1, Amir Zaki1, Hazem Dewidar1

  • 1Otolaryngology Department, Al Kasr Al Ainy School of Medicine, Cairo University, Giza, 11562 Egypt.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
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Summary

Malignant soft tissue deposits (MSTDs) are uncommon in advanced laryngeal squamous cell carcinoma and do not significantly impact recurrence or outcomes. Extranodal extension (ENE) is a more critical prognostic factor than MSTDs.

Keywords:
Advanced laryngeal cancerHead and neck cancerLymph node metastasisMalignant soft tissue depositsNeck dissection

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Area of Science:

  • Oncology
  • Pathology
  • Surgical Oncology

Background:

  • Advanced laryngeal carcinoma presents unique challenges in predicting patient outcomes.
  • Malignant soft tissue deposits (MSTDs) are a potential, yet understudied, prognostic indicator in laryngeal cancer.
  • Understanding predictors and prognostic value of MSTDs is crucial for refining treatment strategies.

Purpose of the Study:

  • To determine the incidence and predictors of malignant soft tissue deposits (MSTDs) in advanced laryngeal carcinoma.
  • To evaluate the prognostic significance of MSTDs on locoregional recurrence and overall outcomes post-surgery.
  • To compare the prognostic value of MSTDs with other established factors like extranodal extension (ENE).

Main Methods:

  • Prospective study involving 40 patients with cT3/cT4 N0 laryngeal squamous cell carcinoma (SCC).
  • Histopathological examination of soft tissue specimens for the presence of MSTDs.
  • Analysis of clinicopathological factors including cTNM staging, preoperative tracheostomy, tumor grade, surgical margins, and ENE.

Main Results:

  • MSTDs were identified in 4 out of 40 patients (10% incidence).
  • Extranodal extension (ENE) was present in 6 patients, with 4 of them also showing MSTDs.
  • No significant association was found between MSTDs and cTNM staging, preoperative tracheostomy, tumor grade, or surgical margins.
  • MSTDs did not significantly influence locoregional recurrence rates or overall patient outcomes.
  • ENE emerged as a more significant prognostic factor compared to MSTDs.

Conclusions:

  • The incidence of MSTDs in advanced laryngeal SCC appears lower than previously reported.
  • MSTDs are not a significant predictor of locoregional recurrence or overall outcome in this patient cohort.
  • Extranodal extension (ENE) holds greater prognostic importance than MSTDs in advanced laryngeal carcinoma.