Łukasz Łuczewski

Analysis of selected recurrence risk factors after treatment of head and neck basal cell carcinoma

Introduction Basal cell carcinoma (BCC) is the most common type of non-melanoma malignant skin tumors. Eighty-five percent of all cases are located on the skin of the head and neck. The risk of recurrence after surgery is estimated at 5–15%. Aim To evaluate the selected risk factors for recurrence after surgical treatment of head and neck BCC at the Department of Head and Neck Surgery in the Greater Poland Cancer Centre of the Poznan University of Medical Sciences. Material and methods A retrospective analysis was made of patients treated at the Department of Head and Neck Surgery in the Greater Poland Cancer Centre of the Poznan University of Medical Sciences in 2007–2012 for BCC of the head and neck region. The study covered 312 patients: 198 males (63%) and 114 females (37%), aged 32–96 years. Results In the study group of 312 tumors, recurrence after initial treatment in this Centre was diagnosed in 18 patients (9%), whereas in patients who were previously operated elsewhere, recurrence was found in 22 cases (17%). The nodular type was the most common BCC type in the study group and concerned 175 patients (56%). The most numerous group (114; 37%) in this study group comprised patients with external nose and cheek tumors. Conclusions The importance of preoperative biopsy to assess the histological type as a routine treatment of patients with BCC is essential. Ultrasound evaluation to assess the exact size and depth of tumor invasion should also be implemented.

2D and 3D cell cultures – a comparison of different types of cancer cell cultures

Cell culture is a widely used in vitro tool for improving our understanding of cell biology, tissue morphology, and mechanisms of diseases, drug action, protein production and the development of tissue engineering. Most research regarding cancer biology is based on experiments using two-dimensional (2D) cell cultures in vitro. However, 2D cultures have many limitations, such as the disturbance of interactions between the cellular and extracellular environments, changes in cell morphology, polarity, and method of division. These disadvantages led to the creation of models which are more closely able to mimic conditions in vivo. One such method is three-dimensional culture (3D). Optimisation of the culture conditions may allow for a better understanding of cancer biology and facilitate the study of biomarkers and targeting therapies. In this review, we compare 2D and 3D cultures in vitro as well as different versions of 3D cultures.

Występowanie i rola aktywnej infekcji wirusem brodawczaka ludzkiego (HPV) w rakach płaskonabłonkowych głowy i szyi

Summary HPV, mainly HPV type 16 and to a lesser extent type 18, is a newly identified causal factor for SCCHN. The association between HPV and SCCHN is strongest for cancers of the tonsil, intermediate for the rest of the oropharynx, and weakest for the oral cavity and larynx. However, The prevalence of HPV in SCCHN in Poland reported in the literature varies from 0–72% One of the reasons of such a different results may be in our opinion method-related false positive results. The aim of the study, was the assessment of HPV prevalence in the head and neck cancer patients in polish population of SCCHN patients. The material comprised of tumor tissue obtained from 50 HNSCC patients with a primary tumor in the oral cavity, oropharynx or larynx, who were scheduled for surgical treatment. For all cases algorithm was performed: First p16 immunostaining was conducted and secondly the HPV DNA has been detected with the use of HPV DNA general primer (GP)5+/6+ PCR, followed by RLB hybridization. In 8% of cases the staining was observed in 50% of cancer cells or more. There was no HPV DNA detected in any case. There was no HPV DNA detected in any case, which may indicate the lower HPV prevalence in polish population than in Western Europe and US and smoking and drinking associated carcinogenesis. The p16 expression has been found in 8% of the patients and supplementary (GP)5+/6+ PCR did not detect the presence of HPV DNA. Thus, the p16 immunostaining is of limited use as a sole method of HPV detection and needs to be complemented by other techniques.

Guzy oczodołu w materiale Oddziału Chirurgii Głowy i Szyi i Onkologii Laryngologicznej Wielkopolskiego Centrum Onkologii w Poznaniu w latach 2007–2010

INTRODUCTION Tumors of the orbit are diagnosed sporadically. Based on the tumor registry of the American Cancer Society the incidence of tumors of the orbit is assessed at fewer than 1 per 100 000 persons. Tumors of the orbit can be divided into three groups: primary tumors, tumors penetrating the orbit from neighboring structures, and tumors that are metastases of malignant cancers from distant organs. AIM OF THE STUDY To present the results of treatment of patients with tumors of the orbit treated in the Head and Neck Surgery and Laryngological Oncology Ward of the Greater Poland Cancer Centre in Poznań during 2007-2010. MATERIAL AND METHODS The study group consisted of 26 patients surgically treated during 2007-2010 in the Head and Neck Surgery and Laryngological Oncology Ward of the Greater Poland Cancer Centre in Poznań. RESULTS In the postoperative histopathological examination 18 patients (69%) were diagnosed with malignant tumors, 7 patients (27%) with non-malignant tumor and 1 patient (4%) with inflammatory lesion. Among malignant tumors the most frequent was basal cell carcinoma, diagnosed in 7 patients (27%). When removing the tumors of the orbit 4 types of operation were performed: lateral orbitotomy, superior orbitotomy, eye enucleation, and exenteration of the orbit. In 3 patients (12%) cancer recurrences occurred. All patients with recurrences underwent reoperation. In a patient with an extensive recurrence of squamous cell carcinoma the surgery was not radical and the patient died during palliative chemotherapy. CONCLUSIONS Patients with tumors of the orbit should be treated operatively in appropriately prepared centers. In our material the confirmation of this thesis is the group of patients with recurrences of basal cell carcinoma, operated on many times in the past, who due to the extent of the cancerous process had to have the seeing eye removed. In the case of malignant cancers of the orbit an interdisciplinary approach to the problem and the assurance of psychological care for patients who have lost an orbit are essential.Summary Introduction Tumors of the orbit are diagnosed sporadically. Based on the tumor registry of the American Cancer Society the incidence of tumors of the orbit is assessed at fewer than 1 per 100 000 persons. Tumors of the orbit can be divided into three groups: primary tumors, tumors penetrating the orbit from neighboring structures, and tumors that are metastases of malignant cancers from distant organs. Aim of the study To present the results of treatment of patients with tumors of the orbit treated in the Head and Neck Surgery and Laryngological Oncology Ward of the Greater Poland Cancer Centre in Poznan during 2007–2010. Material and methods The study group consisted of 26 patients surgically treated during 2007–2010 in the Head and Neck Surgery and Laryngological Oncology Ward of the Greater Poland Cancer Centre in Poznan. Results In the postoperative histopathological examination 18 patients (69%) were diagnosed with malignant tumors, 7 patients (27%) with non-malignant tumor and 1 patient (4%) with inflammatory lesion. Among malignant tumors the most frequent was basal cell carcinoma, diagnosed in 7 patients (27%). When removing the tumors of the orbit 4 types of operation were performed: lateral orbitotomy, superior orbitotomy, eye enucleation, and exenteration of the orbit. In 3 patients (12%) cancer recurrences occurred. All patients with recurrences underwent reoperation. In a patient with an extensive recurrence of squamous cell carcinoma the surgery was not radical and the patient died during palliative chemotherapy. Conclusions Patients with tumors of the orbit should be treated operatively in appropriately prepared centers. In our material the confirmation of this thesis is the group of patients with recurrences of basal cell carcinoma, operated on many times in the past, who due to the extent of the cancerous process had to have the seeing eye removed. In the case of malignant cancers of the orbit an interdisciplinary approach to the problem and the assurance of psychological care for patients who have lost an orbit are essential.

Znaczenie badań PET/CT w diagnostyce nowotworów głowy i szyi – doświadczenia własne

PURPOSE The aim of the study was to evaluate the usefulness of ¹⁸F-FDG-PET/CT in diagnosis of head and neck cancer. MATERIAL AND METHODS 60 ¹⁸F-FDG-PET/CT examinations were performed in 50 patients diagnosed and treated for head and neck cancer in Department of Head and Neck Surgery and Nuclear Medicine Department of The Greater Poland Cancer Centre in Poznan, Poland from 2007 to 2011. Patients were divided into 2 subgroups: CUP Syndrome patients (25 PET/CT exams) and patients being under control after treatment (35 PET/CT exams). RESULTS In the group of CUP Syndrome patients 6 PET/CT examinations were negative, in 7--possible primary tumor was indicated, in 10--only cervical lymph node metastases were diagnosed, in 2 cases--distant metastases occured. Within the second subgroup 14 PET/CT examinations were negative, 11 exams--indicated the recurrent disease, 2--cervical lymph node metastases and 8--distant metastases. The sensitivity and specificity of ¹⁸F-FDG-PET/CT in this study within the CUP Syndrome patients group were 100% and 55% respectively. The positive predictive value was 74%. The negative predictive value was 100%. The sensitivity and specificity of ¹⁸F-FDG-PET/CT in this study within the second group of patients were 88% and 66% respectively. The positive predictive value was 71%. The negative predictive value was 86%. CONCLUSIONS ¹⁸F-FDG-PET/CT is useful for staging of head and neck cancer, identification of an unknown primary tumor, delineation of the extent of regional lymph node involvement, detection of distant metastases and occasional synchronous primary tumor.

Doświadczenia własne w zastosowaniu wolnych płatów udowych w rekonstrukcji ubytków po rozległych operacjach nowotworów złośliwych głowy i szyi

Summary Introduction Free flaps with vascular anastomosis have been widely used in clinical practice for more than 30 years. They are standard in reconstructive surgery following extensive resections caused by neoplasms of the head and neck. The anterolateral thigh flap (ALT) constitutes very good reconstructive material due to the long vascular pedicle, the appropriate diameter of vessels, the large skin island plane, and thickness depending on requirements. Material The own material comprises 5 patients who have had extensive neoplastic infiltrations removed at different anatomic locations within the area of healthy tissue. Results Reconstructions have been conducted using a microvascular thigh flap (ALT). All of the operated patients are under constant supervision. The observation period ranges from 2 to 3 months. No recurrence of the neoplastic process or graft rejection has been observed in any of the patients.