| Abstract | Uvod: Tumori regije glave i vrata sedmi su po učestalosti u općoj populaciji s više od 660 000 novih slučajeva i 325 000 smrtnih slučajeva godišnje diljem svijeta. Zloćudni tumori navedene regije u velikoj većini (90%) su karcinomi pločastih stanica koji nastaju u usnoj i nosnoj šupljini, paranazalnim sinusima, ždrijelu i grkljanu. Ovisno o karakteristikama tumora, liječe se kirurški, radioterapijom i kemoterapijom u različitim kombinacijama. Rano otkrivanje recidiva bolesti od iznimnog je značaja za učinkovito liječenje. Za detekciju recidiva korisnima su se pokazali različiti radiološki modaliteti uključujući: CT, MR, PET i ultrazvuk. Obzirom na nižu cijenu i dostupnost CT je preferirani modalitet, no MR je osjetljivija metoda koja nam daje odgovore na pitanja kao što su razlikovanje recidiva od promjena uzrokovanih liječenjem, opseg zahvaćanja sluznice, procjena intrakranijalne ekstenzije i ekstenzije u orbite, infiltracija koštane srži te perineuralno širenje tumora.
Cilj: Utvrditi učestalost recidiva tumora regije glave i vrata detektiranih u ispitanika podvrgnutih MR pregledu, potom analizirati pojavnost recidiva obzirom na spol i dob, kao i analizirati učestalost rizičnih faktora (konzumacija alkohola, pušenje) u ispitanika s dokazanim recidivom tumora regije glave i vrata.
Ispitanici i metode: U ovo retrospektivno istraživanje uključeni su svi pacijenti koji su u razdoblju od 1. siječnja 2020. do 31. prosinca 2022. bili podvrgnuti MR pregledu regije glave i vrata, u KBC-u Rijeka, s kliničkim pitanjem recidiva. Iz elektroničkih medicinskih zapisa (dobivenih iz IBIS-a) zabilježili smo demografske podatke (dob, spol), postojanje čimbenika rizika te patohistološki nalaz tkiva za koje se prema MR nalazu sumnjalo da je recidiv.
Rezultati: U vremenskom periodu od 3 godine učinjeno je 404 MR pregleda regije glave i vrata od čega njih 150 (89 pacijenata) s kliničkim pitanjem recidiva. Radiološki je postavljena sumnja na recidiv i potom patohistološki potvrđena u njih 21 (23,6%), od čega 11 žena te 10 muškaraca. Prosječna životna dob pacijenata s recidivom bila je 66 godina. U 14 pacijenata (66,7%) radilo se o karcinomu pločastih stanica. Zabilježena su 4 slučaja perineuralnog širenja. Anamnestički podatak o konzumacija alkohola i pušenju zabilježen je u 4, odnosno 7 pacijenata s dokazanim recidivom.
Zaključak: MR ima važnu ulogu u procjeni lokalne proširenosti bolesti te ulogu u diferenciranju recidiva tumora od postoperativnih promjena te predstavlja metodu izbora za detekciju i procjenu proširenosti perineuralnog širenja. |
| Abstract (english) | Introduction: Tumors of the head and neck region are the seventh most common in the general population with more than 660,000 new cases and 325,000 deaths annually worldwide. The vast majority (90%) of malignant tumors in the mentioned region are squamous cell carcinomas that arise in the oral and nasal cavities, paranasal sinuses, pharynx and larynx. Depending on the characteristics of the tumor, they are treated with surgery, radiotherapy and chemotherapy in different combinations. Early detection of recurrence is extremely important for effective treatment. Various radiological modalities including: CT, MR, PET and ultrasound have proven to be useful for the detection of recurrence.Considering the lower price and availability, CT is the preferred modality, but MR is a more sensitive method that gives us answers to questions such as distinguishing recurrence from changes caused by treatment, the extent of mucosal involvement, assessment of intracranial extension and extension into the orbits, bone marrow infiltration and perineural tumor spread.
Aim: To determine the frequency of recurrence of tumors of the head and neck region detected in subjects who underwent MR examination, then to analyze the incidence of recurrence according to gender and age, as well as to analyze the frequency of risk factors (alcohol consumption, smoking) in subjects with proven recurrence of tumors of the head and neck region.
Subjects and methods: This retrospective study included all patients who, in the period from January 1, 2020 to December 31, 2022, underwent an MR examination of the head and neck region, at KBC Rijeka, with a clinical question of recurrence. From the electronic medical records (obtained from IBIS), we recorded demographic data (age, gender), the existence of risk factors, and the pathohistological findings of tissue suspected of recurrence according to the MR findings.
Results: In a period of 3 years, 404 MR examinations of the head and neck region were performed, of which 150 (89 patients) had a clinical issue of recurrence. Recurrence was suspected radiologically and then pathohistologically confirmed in 21 (23,6%)of them, of which 11 were women and 10 were men. The average age of patients with recurrence was 66 years. In 14 patients (66.7%), it was squamous cell carcinoma. 4 cases of perineural spread were recorded. Anamnesis data on alcohol consumption and smoking were recorded in 4 and 7 patients with proven recurrence.
Conclusion: MR has an important role in estimating the local extent of the disease and a role in differentiating tumor recurrence from postoperative changes, and is the method of choice for detecting and assessing the extent of perineural spread. |
