Browsing by Author "Vukasinovic, Milan (23476034200)"

Background We provided preliminary psychometric data for the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Head and Neck Module, updated version (QLQ-H&N43) from a group of Serbian laryngectomized patients. Methods The study included 170 subjects. The QLQ-H&N43 is a 43-item questionnaire, with 12 multi-item scales and 7 single-item symptom scales. All subjects also completed the Quality of Life Questionnaire-Core 30-questions (QLQ-C30). Results Good internal consistency (Cronbach's α of above 0.7) was found for 5 of the 7 scales. All QLQ-H&N43 scales correlated negatively as predicted with all QLQ-C30 functioning scales. The correlations with the QLQ-C30 symptoms supported discriminant validity, with only one exception: the head and neck social eating scale overlapped with the QLQ-C30 pain scale. For 14 of 19 QLQ-H&N43 scale scores, significant known-group differences were observed between those who differ in type of laryngectomy, adjuvant therapy, or 5-year survival. Conclusion Preliminary evidence suggests that a great majority of the QLQ-H&N43 scales have acceptable internal consistency and promising construct validity, but more research studies are needed with other cancer groups to extend these findings. © 2015 Wiley Periodicals, Inc..

Purpose: Laser transoral laryngeal microsurgery has become widely accepted treatment method because of its organ and function preservation and shorter period of hospitalization. The aim of this study was to examine the overall, disease-specific and disease-free survival in patients with early laryngeal carcinoma treated with laser depending on age, gender, common risk factors (tobacco and alcohol use), histopathological tumor grade, anterior commissure involvement, performed tracheotomy, positive surgical margins, T stage, type of endoscopic cordectomy, postoperative radiotherapy and laryngeal preservation. Methods: Retrospective study included 234 patients with squamocellular carcinoma of the larynx treated with laser transoral laryngeal microsurgery. 5-year overall, disease-specific and disease-free survival and the prognostic impact of mentioned factors were evaluated using Kaplan–Meier and Cox proportional hazard analyses. Results: 5-year OS and DSS was 92.5% and 95.3%, respectively. OS was significantly lower for older patients and in patients with histologically poorly differentiated tumors, 3 and 5 years postoperatively (Log rank test; p = 0.031). DSS was significantly lower in patients with anterior commissure involvement, positive surgical margins and patients who underwent postoperative RT. DFS was significantly lower in patients with anterior commissure involvement, patients with T1b tumor stage and patients who underwent cordectomies type Vb and VI (Log rank, p < 0.05). Laryngeal preservation significantly influenced 5-year OS, DSS and DFS (Log rank, p ≤ 0.001). Multivariate Cox regression analysis showed that age, histological tumor grade and laryngeal preservation were significant negative prognostic factors for 5-year DSS and DFS. Conclusion: Transoral laryngeal microsurgery delivers excellent oncological results, even in selected patients with higher stages of early laryngeal cancer and anterior commissure involvement. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.

Vocal fold pathology changes the appearance and vibratory patterns observed during stroboscopic examination, but a strict correlation between the vibratory pattern and the dysplasia type does not exist. The aims of this study were to determine the role of stroboscopy in vocal fold dysplasia assessment and to determine whether stroboscopy is the deciding factor when performing laryngomicroscopy with biopsy in suspicious lesions. This prospective controlled study involved 112 patients with laryngeal dysplasia treated over a 2-year period at a tertiary medical center. Patient data and clinical, stroboscopy, laryngomicroscopy, and histopathologic reports were reviewed. During the stroboscopy, glottic occlusion, phase symmetry, periodicity, amplitude, mucosal wave, and nonvibratory segments were followed. Laryngomicroscopy with different types of endoscopic cordectomies (types I-III) was performed as a therapeutic measure, with a 12-month follow-up period. Nonvibrating segments were present in 15.1% of the patients with mild dysplasia and in 38.5% of the patients with moderate dysplasia. In 45.5% of the patients with severe dysplasia (carcinoma in situ), nonvibrating segments were absent. The amplitude of vocal fold vibrations in patients with mild dysplasia (P = 0.03) was a significant factor indicative of recurrent disease, but none of the stroboscopic signs was significant for the disease progression. Severe dysplasia can be related to both nonvibrating and vibrating vocal fold segments. Stroboscopy cannot be used reliably for classifying laryngeal dysplasia and may indicate the need to perform laryngomicroscopy with biopsy in suspicious vocal fold lesions. The warning factors for recurrence and progression of dysplasia are treatment modality, abnormal amplitude of vibration, and nonvibrating segment. © 2014 The Voice Foundation.

Vocal fold pathology changes the appearance and vibratory patterns observed during stroboscopic examination, but a strict correlation between the vibratory pattern and the dysplasia type does not exist. The aims of this study were to determine the role of stroboscopy in vocal fold dysplasia assessment and to determine whether stroboscopy is the deciding factor when performing laryngomicroscopy with biopsy in suspicious lesions. This prospective controlled study involved 112 patients with laryngeal dysplasia treated over a 2-year period at a tertiary medical center. Patient data and clinical, stroboscopy, laryngomicroscopy, and histopathologic reports were reviewed. During the stroboscopy, glottic occlusion, phase symmetry, periodicity, amplitude, mucosal wave, and nonvibratory segments were followed. Laryngomicroscopy with different types of endoscopic cordectomies (types I-III) was performed as a therapeutic measure, with a 12-month follow-up period. Nonvibrating segments were present in 15.1% of the patients with mild dysplasia and in 38.5% of the patients with moderate dysplasia. In 45.5% of the patients with severe dysplasia (carcinoma in situ), nonvibrating segments were absent. The amplitude of vocal fold vibrations in patients with mild dysplasia (P = 0.03) was a significant factor indicative of recurrent disease, but none of the stroboscopic signs was significant for the disease progression. Severe dysplasia can be related to both nonvibrating and vibrating vocal fold segments. Stroboscopy cannot be used reliably for classifying laryngeal dysplasia and may indicate the need to perform laryngomicroscopy with biopsy in suspicious vocal fold lesions. The warning factors for recurrence and progression of dysplasia are treatment modality, abnormal amplitude of vibration, and nonvibrating segment. © 2014 The Voice Foundation.