1,720,969 research outputs found
Twenty-five years experience with laser surgery for head and neck tumors
No full textDuring the last 25 years, the treatment of tumors arising in the upper aerodigestive tract has changed fundamentally. Whereas surgery in the 1970s aimed at radical block resection and defect repair from outside, the establishment of transoral laser microsurgery marked a new era of organ- and function-preserving therapy. An international symposium, held on 10 and 11 June 2005 in Gottingen, was dedicated to a critical review and assessment of the current role of laser surgery for the treatment of head and neck cancer. Experts from five continents presented their experiences and scientific results and had an intensive exchange with participants from different countries. The topics of the symposium were focused on the surgical principles of laser resection, the oncological and functional results in comparison with traditional therapy, the difficulties and limits of laser surgery in distinct anatomical regions and on the role of radiotherapy. This report summarizes the most important results and statements and gives an overview of actual developments. The names and addresses of the participants mentioned in this report are appended below
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Impact of Re‐resection for Inadequate Margins on the Prognosis of Upper Aerodigestive Tract Cancer Treated by Laser Microsurgery
No full textObjectives: Positive or uncertain surgical margins left untreated have a distinct prognostic relevance in squamous cell carcinoma of the upper aerodigestive tract. An advantage of transoral laser microsurgery is that it can be easily repeated if inadequate resection margins are found postoperatively. The present study investigates the impact of laser surgical reresection on the outcome of patients. Study Design: The authors conducted a retrospective unicenter study. Methods: A review of 1,467 patients with squamous cell carcinoma of the upper aerodigestive tract who were initially treated by transoral laser microsurgery with curative intent between August 1986 and December 2002 was conducted. Locoregional control as well as TNM adjusted and overall survival were analyzed using the Kaplan-Meier method. Results. Three hundred eighty-six patients have required reresection to obtain clear surgical margins, in 70 of whom residual carcinoma has been detected in revision specimens. Patients without need for revision and those in whom revision specimens were found tumor-free had an almost identical locoregional control (P =.4611). In patients with positive revision specimens, however, locoregional control was significantly worsened (P =.0058). Neither the need for reresection nor the detection of further tumor tissue in revision specimens affected TNM adjusted or overall survival. Conclusions. Survival of patients was similar whether clear resection margins were reached within the first surgical step or with revision surgery. However, patients in whom reresection specimens contained residual carcinoma had an increased risk of locoregional failure and should undergo a further reresection or at least a very close follow up
Transoral laser microsurgery for T1a glottic cancer: Review of 404 cases
No full textBackgroundVarious therapeutic options exist for treatment of T1a glottic squamous cell cancer (SCC). Radiotherapy (RT) has been favored over surgical excision. This has been challenged by transoral laser microsurgery (TLM) showing low morbidity and good functional results. MethodsA retrospective chart review was carried out. Patients with untreated T1a glottic SCC were included in the study. Endpoints were locoregional control, overall survival, disease-specific survival, and absolute rate of larynx preservation. ResultsFour hundred four patients were included in this study. Five-year Kaplan-Meier estimates were: local control 86.8%, overall survival 87.8%, disease-specific survival 98.0%, recurrence-free survival 76.1%, and larynx preservation 97.3%. The complication rate was 1%; the majority of patients had either normal or mildly dysphonic voices. ConclusionLow complication rates, excellent functional outcome, and high rates of organ preservation favor TLM. In agreement with the literature, TLM should be the treatment of choice for patients presenting with T1a glottic SCC. (c) 2014 Wiley Periodicals, Inc. Head Neck 37: 889-895, 201
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Value of postoperative radiotherapy in patients with pathologic N1 neck disease
No full textBackground, The aim of this study was to assess the efficacy of postoperative radiotherapy for the treatment of patients with pathologic N1 neck disease. Methods. One hundred eighteen consecutive patients with upper aerodigestive tract cancer who were initially treated with curative surgery between 1986 and 2002 and had pN1 disease without extracapsular spread were reviewed. Postoperative radiotherapy was given to 46 patients. Results. Fight isolated regional recurrences were observed, 3 of which occurred in contralateral undissected necks. Seven of the 72 patients treated with surgery alone and 1 of the 46 who received postoperative radiotherapy were affected. The respective 3-year neck recurrence rates amounted to 11.2% and 2.9% (p = .0921). A survival benefit of irradiated patients could not be established. Conclusions. The data confirm a trend toward improved regional control of pN1 disease if postoperative radiotherapy is applied. However, as a survival benefit is uncertain, use of radiation treatment cannot be recommended generally, but requires individual decisions. (c) 2008 Wiley Periodicals, Inc
Enoral laser microsurgery for squamous cell carcinoma of the oral cavity
No full textBackgroundThe purpose of this study was to investigate oncological and functional results of enoral laser microsurgery in treatment for cancer of the oral cavity. MethodsA retrospective chart analysis was carried out. Two hundred thirty-two patients with cancer of the oral cavity were treated by enoral laser microsurgery selective neck dissection postoperative (chemo)radiotherapy. ResultsSeventy-three percent of the patients (n = 170) received a unilateral or bilateral selective or modified radical neck dissection, 32% (n = 75) received adjuvant (chemo)radiotherapy. The median follow-up period was 71.89 months. The 5-year overall survival (OS) was 54.6%, recurrence-free survival (RFS) was 60.2%, and disease-specific survival (DSS) was 70.3%. Nasogastric feeding tubes were needed in 96 patients, only 2 patients required a temporary gastrostomy tube. ConclusionEnoral laser microsurgery is an efficient therapeutic option in the treatment of oral cavity cancer. Oncological and functional results are comparable to any other treatment regimen, whereas morbidity and complications tend to be lower. (c) 2013 Wiley Periodicals, Inc. Head Neck 36: 787-794, 201
Results of 226 patients with T3 laryngeal carcinoma after treatment with transoral laser microsurgery
No full textBackground The purpose of this study was to assess the feasibility of transoral laser microsurgery (TLM) in treatment of pT3 laryngeal cancer. Methods We conducted a retrospective case series study of 226 patients with pT3 glottic (n = 122; 54%) or supraglottic laryngeal carcinoma (n = 104; 46%). All patients were treated by TLM in combination with neck dissection (63%) and with postoperative radiotherapy (18%). Our main outcome measures were local control, organ preservation, functional outcome, overall survival, recurrence-free survival, and disease-specific survival. Results Median follow-up period was 57.8 months. The 5-year organ-preservation and local control rates for all patients were 87% and 71.4%, respectively. The 5-year overall, recurrence-free, and disease-specific survival were 64.4%, 63.0%, and 83.3%, respectively. Conclusion Results are comparable to partial or total laryngectomy, while being superior to primary chemo(radio)therapy. TLM results in low morbidity, rapid recovery, and good function and can be a valid option for organ-preserving surgery of pT3 glottic and supraglottic cancer. (c) 2013 Wiley Periodicals, Inc. Head Neck 36: 652-659, 201
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