Browsing by Author "Triantafyllou, Asterios"
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- Cervical lymph node metastasis in adenoid cystic carcinoma of oral cavity and oropharynx: A collective international reviewPublication . Suarez, Carlos; Barnes, Leon; Silver, Carl E.; Rodrigo, Juan P.; Shah, Jatin P.; Triantafyllou, Asterios; Rinaldo, Alessandra; Cardesa, Antonio; Pitman, Karen T.; Kowalski, Luiz P.; Robbins, K. Thomas; Hellquist, Henrik; Medina, Jesus E.; Bree, Remco de; Takes, Robert P.; Coca-Pelaz, Andres; Bradley, Patrick J.; Gnepp, Douglas R.; Teymoortash, Afshin; Strojan, Primoz; Mendenhall, William M.; Eloy, Jean Anderson; Bishop, Justin A.; Devaney, Kenneth O.; Thompson, Lester D. R.; Hamoir, Marc; Slootweg, Pieter J.; Vander Poorten, Vincent; Williams, Michelle D.; Wenig, Bruce M.; Skalova, Alena; Ferlito, AlfioThe purpose of this study was to suggest general guidelines in the management of the NO neck of oral cavity and oropharyngeal adenoid cystic carcinoma (AdCC) in order to improve the survival of these patients and/or reduce the risk of neck recurrences. The incidence of cervical node metastasis at diagnosis of head and neck AdCC is variable, and ranges between 3% and 16%. Metastasis to the cervical lymph nodes of intraoral and oropharyngeal AdCC varies from 2% to 43%, with the lower rates pertaining to palatal AdCC and the higher rates to base of the tongue. Neck node recurrence may happen after treatment in 0-14% of AdCC, is highly dependent on the extent of the treatment and is very rare in patients who have been treated with therapeutic or elective neck dissections, or elective neck irradiation. Lymph node involvement with or without extracapsular extension in AdCC has been shown in most reports to be independently associated with decreased overall and cause-specific survival, probably because lymph node involvement is a risk factor for subsequent distant metastasis. The overall rate of occult neck metastasis in patients with head and neck AdCC ranges from 15% to 44%, but occult neck metastasis from oral cavity and/or oropharynx seems to occur more frequently than from other locations, such as the sinonasal tract and major salivary glands. Nevertheless, the benefit of elective neck dissection (END) in AdCC is not comparable to that of squamous cell carcinoma, because the main cause of failure is not relaied to neck or local recurrence, but rather, to distant failure. Therefore, END should be considered in patients with a cN0 neck with AdCC in some high risk oral and oropharyngeal locations when postoperative RT is not planned, or the rare AdCC-high grade transformation. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
- Cervical lymph node metastasis in adenoid cystic carcinoma of the larynx: a collective international reviewPublication . Coca-Pelaz, Andres; Barnes, Leon; Rinaldo, Alessandra; Cardesa, Antonio; Shah, Jatin P.; Rodrigo, Juan P.; Suarez, Carlos; Eloy, Jean Anderson; Bishop, Justin A.; Devaney, Kenneth O.; Thompson, Lester D. R.; Wenig, Bruce M.; Strojan, Primoz; Hamoir, Marc; Bradley, Patrick J.; Gnepp, Douglas R.; Silver, Carl E.; Slootweg, Pieter J.; Triantafyllou, Asterios; Vander Poorten, Vincent; Williams, Michelle D.; Skalova, Alena; Hellquist, Henrik; Teymoortash, Afshin; Medina, Jesus E.; Robbins, K. Thomas; Pitman, Karen T.; Kowalski, Luiz P.; de Bree, Remco; Mendenhall, William M.; Takes, Robert P.; Ferlito, AlfioAdenoid cystic carcinoma (AdCC) of the head and neck is a well-recognized pathologic entity that rarely occurs in the larynx. Although the 5-year locoregional control rates are high, distant metastasis has a tendency to appear more than 5 years post treatment. Because AdCC of the larynx is uncommon, it is difficult to standardize a treatment protocol. One of the controversial points is the decision whether or not to perform an elective neck dissection on these patients. Because there is contradictory information about this issue, we have critically reviewed the literature from 1912 to 2015 on all reported cases of AdCC of the larynx in order to clarify this issue. During the most recent period of our review (1991-2015) with a more exact diagnosis of the tumor histology, 142 cases were observed of AdCC of the larynx, of which 91 patients had data pertaining to lymph node status. Eleven of the 91 patients (12.1%) had nodal metastasis and, based on this low proportion of patients, routine elective neck dissection is therefore not recommended.
- Cervical lymph node metastasis in high-grade transformation of head and neck adenoid cystic carcinoma: a collective international reviewPublication . Hellquist, Henrik; Skalova, Alena; Barnes, Leon; Cardesa, Antonio; Thompson, Lester D. R.; Triantafyllou, Asterios; Williams, Michelle D.; Devaney, Kenneth O.; Gnepp, Douglas R.; Bishop, Justin A.; Wenig, Bruce M.; Suarez, Carlos; Rodrigo, Juan P.; Coca-Pelaz, Andres; Strojan, Primoz; Shah, Jatin P.; Hamoir, Marc; Bradley, Patrick J.; Silver, Carl E.; Slootweg, Pieter J.; Vander Poorten, Vincent; Teymoortash, Afshin; Medina, Jesus E.; Robbins, K. Thomas; Pitman, Karen T.; Kowalski, Luiz P.; de Bree, Remco; Mendenhall, William M.; Eloy, Jean Anderson; Takes, Robert P.; Rinaldo, Alessandra; Ferlito, AlfioAdenoid cystic carcinoma (AdCC) is among the most common malignant tumors of the salivary glands. It is characterized by a prolonged clinical course, with frequent local recurrences, late onset of metastases and fatal outcome. High-grade transformation (HGT) is an uncommon phenomenon among salivary carcinomas and is associated with increased tumor aggressiveness. In AdCC with high-grade transformation (AdCC-HGT), the clinical course deviates from the natural history of AdCC. It tends to be accelerated, with a high propensity for lymph node metastasis. In order to shed light on this rare event and, in particular, on treatment implications, we undertook this review: searching for all published cases of AdCC-HGT. We conclude that it is mandatory to perform elective neck dissection in patients with AdCC-HGT, due to the high risk of lymph node metastases associated with transformation.
- Neuroendocrine neoplasms of the sinonasal regionPublication . Bell, Diana; Hanna, Ehab Y.; Weber, Randal S.; DeMonte, Franco; Triantafyllou, Asterios; Lewis, James S., Jr.; Cardesa, Antonio; Slootweg, Pieter J.; Stenman, Goran; Gnepp, Douglas R.; Devaney, Kenneth O.; Rodrigo, Juan P.; Rinaldo, Alessandra; Wenig, Bruce M.; Westra, William H.; Bishop, Justin A.; Hellquist, Henrik; Hunt, Jennifer L.; Kusafuka, Kimihide; Perez-Ordonez, Bayardo; Williams, Michelle D.; Takes, Robert P.; Ferlito, AlfioNeuroendocrine neoplasms of the sinonasal region, which are relatively uncommon but clinically very important, are reviewed here in the light of current knowledge. Using a definition for neuroendocrine based on phenotypic, histologic, immunohistochemical, and electron microscopic features rather than histogenetic criteria, sinonasal neuroendocrine carcinomas are examined with a particular emphasis on the small-cell and large-cell subtypes. This is followed by revisiting olfactory neuroblastoma because it is also a tumor that shows a neuroendocrine phenotype. Kadish clinical and Hyams histologic grading systems as prognosticators of olfactory neuroblastoma are also considered in detail. Finally, controversies regarding sinonasal undifferentiated carcinoma as a neuroendocrine tumor are discussed and a possible relationship with high-grade olfactory neuroblastoma is explored. Genetic events and current management of these tumors are also outlined. (C) 2015 Wiley Periodicals, Inc.
- Neutrophil to lymphocyte ratio in oropharyngeal squamous cell Carcinoma: A systematic review and meta-analysisPublication . Rodrigo, Juan P.; Sánchez-Canteli, Mario; Triantafyllou, Asterios; de Bree, Remco; Mäkitie, Antti A.; Franchi, Alessandro; Hellquist, Henrik; Saba, Nabil F.; Stenman, Göran; Takes, Robert P.; Valero, Cristina; Zidar, Nina; Ferlito, AlfioNeutrophil-to-lymphocyte ratio (NLR) has been associated with survival in various cancers, including head and neck cancer. However, there is limited information on its role in oropharyngeal squamous cell carcinomas (OPSCC) according to HPV status. This prompted the present metaanalysis. Studies were selected when the prognostic value of NLR prior to treatment was evaluated in OPSCC patients, the cutoff value of NLR was available, and the prognostic value of NLR was evaluated by time-to-event survival analysis. A total of 14 out of 492 articles, including 7647 patients, were analyzed. The results showed a worse prognosis for the patients with a high NLR: The combined hazard ratios (HR) for overall survival (OS) in patients with an elevated NLR was 1.56 (95% confidence interval (CI) 1.21–2.02; p = 0.0006), for disease-free survival was 1.52 (95% CI 1.34–1.73; p < 0.00001), and for recurrence-free survival was 1.86 (95% CI 1.50–2.30; p < 0.00001). This worse prognosis ofhigh NLR was exclusive of HPV-positive patients: HR for OS in the HPV-positive subgroup was 4.05 (95% CI 1.90–8.62 (p = 0.0003), and in the HPV-negative subgroup 0.92 (95% CI 0.47–1.80; p = 0.82). The prognosis of NLR was not influenced by treatment: The HR for OS for patients treated with radiotherapy/chemoradiotherapy (RT/CRT) was 1.48 (95% CI 1.09–2.01; p = 0.01), and for patients treated with surgery (±RT/CRT) was 1.72 (95% CI 1.08–2.72; p = 0.02). In conclusion, an elevated NLR relates to worse outcomes in patients with HPV-positive OPSCC.
- Rhabdomyoblastic Differentiation in Head and Neck Malignancies Other Than RhabdomyosarcomaPublication . Bishop, Justin A.; Thompson, Lester D. R.; Cardesa, Antonio; Barnes, Leon; Lewis, James S., Jr.; Triantafyllou, Asterios; Hellquist, Henrik; Stenman, Goran; Hunt, Jennifer L.; Williams, Michelle D.; Slootweg, Pieter J.; Devaney, Kenneth O.; Gnepp, Douglas R.; Wenig, Bruce M.; Rinaldo, Alessandra; Ferlito, AlfioRhabdomyosarcoma is a relatively common soft tissue sarcoma that frequently affects children and adolescents and may involve the head and neck. Rhabdomyosarcoma is defined by skeletal muscle differentiation which can be suggested by routine histology and confirmed by immunohistochemistry for the skeletal muscle-specific markers myogenin or myoD1. At the same time, it must be remembered that when it comes to head and neck malignancies, skeletal muscle differentiation is not limited to rhabdomyosarcoma. A lack of awareness of this phenomenon could lead to misdiagnosis and, subsequently, inappropriate therapeutic interventions. This review focuses on malignant neoplasms of the head and neck other than rhabdomyosarcoma that may exhibit rhabdomyoblastic differentiation, with an emphasis on strategies to resolve the diagnostic dilemmas these tumors may present. Axiomatically, no primary central nervous system tumors will be discussed.
- Sinonasal undifferentiated carcinoma (SNUC): from an entity to morphologic pattern and back again-a historical perspectivePublication . Agaimy, Abbas; Franchi, Alessandro; Lund, Valerie J.; Skalova, Alena; Bishop, Justin A.; Triantafyllou, Asterios; Andreasen, Simon; Gnepp, Douglas R.; Hellquist, Henrik; Thompson, Lester D. R.; Rinaldo, Alessandra; Ferlito, AlfioSince the first description of sinonasal undifferentiated carcinoma (SNUC) as a distinctive highly aggressive sinonasal neoplasm with probable origin from the sinonasal mucosa (Schneiderian epithelium), SNUC has been the subject of ongoing study and controversy. In particular, the SNUC category gradually became a "wastebasket" for any undifferentiated or unclassifiable sinonasal malignancy of definite or probable epithelial origin. However, with the availability of more specific and sensitive immunohistochemical antibodies and increasing implementation of novel genetic tools, the historical SNUC category became the subject of progressive subdivision leading to recognition of specific genetically defined, reproducible subtypes. These recently recognized entities are characterized by distinctive genetic aberrations including NUTM1-rearranged carcinoma (NUT carcinoma) and carcinomas associated with inactivation of different members of the SWI/SNF chromatin-remodeling gene complex such as SMARCB1-deficient and less frequently SMARCA4-deficient carcinoma. The ring became almost closed, with recent studies highlighting frequent oncogenic IDH2 mutations in the vast majority of histologically defined SNUCs, with a frequency of 82%. A review of these cases suggests the possibility that "true SNUC" probably represents a distinctive neoplastic disease entity, morphologically, phenotypically, and genetically. This review addresses this topic from a historical perspective, with a focus on recently recognized genetically defined subsets within the SNUC spectrum.
- Update on neuroendocrine carcinomas of the larynxPublication . Strosberg, Carolina; Ferlito, Alfio; Triantafyllou, Asterios; Gnepp, Douglas R.; Bishop, Justin A; Hellquist, Henrik; Strojan, Primoz; Willems, Stefan M; Stenman, Göran; Rinaldo, Alessandra; Hernandez-Prera, Juan C.Laryngeal neuroendocrine carcinomas are heterogeneous neoplasms characterized by neuroendocrine differentiation. Their prognoses are dependent on tumor type, therefore different classifications have been developed. Moreover, other tumors have overlapping pathologic features posing a range of diagnostic possibilities.
- Well-differentiated neuroendocrine carcinoma of the larynx: Confusion of terminology and uncertainty of early studiesPublication . Hunt, Jennifer L.; Barnes, Leon; Triantafyllou, Asterios; Gnepp, Douglas R.; Devaney, Kenneth O.; Stenman, Goran; Halmos, Gyorgy B.; Bishop, Justin A.; Skalova, Alena; Willems, Stefan M.; Hellquist, Henrik; Rinaldo, Alessandra; Ferlito, AlfioWell-differentiated neuroendocrine carcinoma (also known as "carcinoid") of the larynx is an exceedingly rare tumor that has an epithelial origin. These tumors are malignant and have a low, but definite, risk of metastasis. Although it can be challenging, this tumor should be differentiated from moderately differentiated neuroendocrine carcinoma (also known as "atypical carcinoid"). The clinical and pathologic features of this tumor, as well as treatment and prognosis, are reviewed in detail.