Fine needle aspiration cytology in the evaluation of head and neck masses

Article Abstract:

Fine needle aspiration (FNA) is a technique whereby abnormal lumps or masses are sampled with a fine needle attached to a syringe. Analysis of the extracted cells may then be performed. A report is provided which evaluates the effectiveness of this method in diagnosing masses of the head and neck in 165 patients. A total of 182 FNAs were performed on these patients. The aspirates were classified as benign, malignant, suspicious, inconclusive, or unsatisfactory. The findings from FNA were confirmed with histology (microscopic slides) for 52 percent of the patients. Seventeen FNAs were unsatisfactory. Out of the remaining samples, 71 were malignant. Fifty-six showed metastatic disease (cancer that had spread), a diagnosis that was unsuspected in six patients. The results included 13 correctly diagnosed cases of lymphoma. There were no false-positive FNAs. Overall, the positive predictive value (number of true positive results divided by the sum of the number of true negative results plus the number of false negative results) of FNA of these masses was 100 percent, with sensitivities (number of true positives divided by the sum of the true positives and false negatives) of 92 percent and 100 percent for metastatic carcinoma and lymphoma, respectively. The positive predictive value of the procedure for benign salivary gland lesions was 94 percent, and for malignant salivary gland lesions was 100 percent. One malignancy was not detected. The method, as described, allows sampling of material by clinicians in different institutions who may send samples for evaluation. FNA is safe and does not lead to some complications of open biopsy, such as the possible spreading of tumor cells into other tissue areas. The approach also allows quick assessment of the feasibility of surgery, and the extent to which surgery should be performed. FNA is recommended for the evaluation of head and neck masses. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Biopsy, Needle, Needle biopsy, Aspiration and aspirators, Aspiration (Physiology), Head and neck tumors

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Multimodality preoperative treatment for advanced stage IV (MO) Cancer of the head and neck

Article Abstract:

Advanced cancer of the head and neck has a poor prognosis. Many chemotherapeutic drugs, such as cisplatin, can cause tumors to regress, but there is no definite evidence that this therapy alters the ultimate prognosis and outcome. A study was undertaken to determine the usefulness of induction chemotherapy and radiation treatment in unresectable (i.e. unable to be removed) squamous cell tumors of the head and neck. Sixty-three patients with unresectable cancer were treated with a combination of chemotherapy, radiation and surgery. Patients were to have two courses - although 11 patients had only one course - of induction chemotherapy, followed by radiation. Chemotherapy included methotrexate, leucovorin, cisplatin and bleomycin. After completion of radiotherapy, patients were reevaluated for possible surgery which, if indicated, was performed. There was a 75 percent response rate after chemotherapy. One patient died due to the toxicity of the chemotherapy (high-dose methotrexate). Of the 58 patients who completed the full course of treatment, 36 patients were then able to benefit from surgery, having undergone tumor regression. Thirteen patients refused surgery; 12 of those have died. The five-year survival rate for the study group (63 patients) was 20 percent; at eight years only three patients were still alive. The patients who completed the full treatment and then had surgery had a five-year survival of 43 percent, compared with 20 percent for patients who had full treatment but refused surgery. It is concluded that use of induction chemotherapy can improve results of treatment in advanced unresectable cancer of the head and neck. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Surgery, Radiotherapy, Chemotherapy, Chemotherapy, Combination, Combination chemotherapy, Head and neck cancer

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