The publisher's final edited version of this article is available at J Clin Endocrinol Metab See other articles in PMC that cite the published metastatic cancer fourth stage. Abstract Context The P enzyme aromatase CYP19 plays a crucial role in the endocrine and paracrine biosynthesis of estrogens from androgens in many diverse estrogen-responsive tissues. Complete aromatase deficiency has been reported in a small number of 46,XX girls with genital ambiguity and absent pubertal development, but it is unknown whether non-classic phenotypes exist. Objective The objective of the study was to determine whether variant forms of aromatase insufficiency can occur in humans.
Therapeutic strategies for locally advanced laryngeal cancer. Part 1: Radical treatment. Source: ORL.
The main therapeutic goals are local control and survival, but also the functional organ preservation speech, swallowing and airway patencyif possible. Metastatic cancer fourth stage achieve these objectives, the management should be established by a multidisciplinary tumor board, based on the analysis of patient-specific factors age, performance status, comorbidities, and psychosocial supportmetastatic cancer fourth stage topography and staging, but also the helminth infections ascariasis trichuriasis expertise and the availability of rehabilitation services.
Regarding the larynx preservation, there are two major therapeutic strategies: total laryngectomy associated with adjuvant radio- and chemotherapy and larynx preservation strategy, metastatic cancer fourth stage includes neoadjuvant chemotherapy followed by exclusive radiotherapy or concurrent radio-chemotherapy or radio-biotherapy.
Total laryngectomy can be performed by open surgery or, in order to avoid a wide surgical field and reduce the local morbidity, by transoral metastatic cancer fourth stage.
After laryngectomy, the recurrence can be local, at the resection site, nodal, at cervical lymph nodes, or distal, the lung being the most common site of recurrence as a distant metastasis.
To improve locoregional control and survival, adjuvant treatments are proposed, including radiotherapy, chemoand biotherapy. Copyright of ORL.
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