Oral Oncology 2022-01-21

Rarity of mucormycosis in oral squamous cell carcinoma: A clinical paradox?

Dhanraj Ganapathy, Ramya Ramadoss, Monal Yuwanati, Murthykumar Karthikeyan

Publication date 21-01-2022


Pubmed PDF Web

Reviewing the potential application of miR-21 inhibitors in oral cancer therapeutics

Auxzilia Preethi K, Sushmaa Chandralekha Selvakumar, Jayaraman Selvaraj, Ullas Mony, Vishnu Priya Veeraraghavan, Durairaj Sekar, Sujatha Govindarajan, A. Thirumal Raj, Shankargouda Patil

Publication date 19-01-2022


Pubmed PDF Web

Head and neck radiotherapy leading to extensive late oral soft-tissue necrosis

Isabel Schausltz Pereira Faustino, Maria Georgaki, Alan Roger Santos-Silva, Pablo Agustin Vargas, Marcio Ajudarte Lopes

Publication date 16-01-2022


Radiotherapy is generally used as an adjuvant treatment in malignant head and neck tumors, which can cause a series of toxicities to tissues involved in the radiation field. Hard tissue necrosis surrounding the tumor is widely debated and recognized; however, oral mucosa necrosis as a late effect of head and neck radiotherapy is a toxicity that has been little explored and understood in the literature. The present report describes a 53-year-old Caucasian, diabetic man with a painful yellowish mass in the buccal mucosa, remaining oral mucositis with history of radiotherapy completed 90 days ago as adjuvant treatment for a polymorphic adenocarcinoma in the palate. Photobiomodulation was used as therapy for tissue necrosis with good therapeutic response despite discontinuation of treatment by the patient. Since there are few descriptions and illustrations of radiotherapy-related soft tissue necrosis, the current case may bring some new experience with this important topic, which directly impacts on the patient's quality of life.

Pubmed PDF Web

Inoperable scalp cutaneous angiosarcoma: Complete response after definitive external beam radiation therapy – brachytherapy association

Charlotte Le Roy, Cécile Le Péchoux, Claire Alapetite, Ratislav Bahleda, Carine Ngo, Charles Honoré, Matthieu Faron, Axel Le Cesne, Olivier Mir, Christine Haie-Meder, Cyrus Chargari, Antonin Levy

Publication date 15-01-2022


Effective treatments are scarce in non-operable scalp cutaneous angiosarcoma patients. Curative-intent definitive sequential IMRT and plesiobrachytherapy allowed complete response with limited side effect in two elder patients. This could represent a non-invasive therapeutic option for patients with locally advanced presentation.

Pubmed PDF Web

Field cancerization revisited in purview of quantum entanglement: Delving into the unexplored

Rahul Anand, Deepak Pandiar, Pratibha Ramani, Mala Kamboj

Publication date 14-01-2022


Pubmed PDF Web

Spindle cell carcinoma of the lip: An immunohistochemical study of a challenging case

João Figueira Scarini, Bruno Augusto Linhares Almeida Mariz, Reydson Alcides de Lima-Souza, Luccas Lavareze, Carolina Emerick, Álfio José Tincani, Érika Said Abu Egal, Albina Altemani, Fernanda Viviane Mariano

Publication date 14-01-2022


Spindle cell carcinoma (SpCC) or sarcomatoid carcinoma, is a rare variant of squamous cell carcinoma (SCC) that has a variable proportion of carcinomatous and sarcomatous components. Here, we reported an immunohistochemical study of a spindle cell carcinoma with a challenging morphological diagnosis. A 50-year-old woman with a previous history of nodular melanoma was referred for evaluation of a painful papule in the lower lip. After surgical resection, neoplastic cells showed focal positivity for CK-14, αSMA, p63, and confirmed the strong positivity for S100 and vimentin. Tumor cells were negative for HMB-45, Melan A, SOX-10, AE1/AE3, 34βE12, CK5-6, CAM5.2, EMA, desmin, calponin, CD10, CD34, and CD68. With these findings, a diagnosis of SpCC was rendered. The patient presented lung and dorsal metastases after 12 months and after 3 years of follow-up, the patient died. In summary, a careful correlation of microscopy and immunohistochemical characteristics is required for the proper diagnosis of this lesion.

Pubmed PDF Web

The rs6942067 genotype is associated with a worse overall survival in young or non-smoking HPV-negative patients with positive nodal status in head and neck squamous cell carcinoma

Guillaume B. Cardin, Monique Bernard, Jessica Bourbonnais, Houda Bahig, Phuc Félix Nguyen-Tan, Edith Filion, Denis Soulieres, Olguta Gologan, Tareck Ayad, Louis Guertin, Eric Bissada, Francis Rodier, Apostolos Christopoulos

Publication date 14-01-2022


Pubmed PDF Web

Concurrent plexiform ameloblastoma and COVID-19-associated mucormycosis of the maxilla

Yashwant Ingle, Sachin C Sarode, Gargi Sarode, Manjusha Ingle, Sanyukta Ingle

Publication date 12-01-2022


Pubmed PDF Web

Phenotypic reflection of white sponge nevus in histomorphological features of oral squamous cell carcinoma

Gargi Sarode, Sachin C. Sarode, Nilesh Kumar Sharma

Publication date 11-01-2022


Pubmed PDF Web

Modified nasolabial flap- the nasomentolabial flap: A new arrow in surgeon’s quiver

Anupam Das, Kaberi Kakati, Kishore Das, Gontu Gopi Satya Sai Reddy

Publication date 10-01-2022


To describe an inferior extension of a naso-labial flap as an adjunct to a maleo-labial flap in reconstruction of complete thickness defects around the oral commissure in 2 cases that we performed at our institute. Two elderly cases of carcinoma buccal mucosa who underwent wide local excision along with neck dissection had moderately large peri-oral defects that are large to cover with nasolabial flap alone. An inferior extension to the maleo-labial flap was added, making it a naso-mento-labial flap to reconstruct the defects with an acceptable outcome aesthetically and functionally. The reconstructed defects' size was around 7 × 7cms and 8.5 × 6cms full-thickness defect in the buccal mucosa, respectively, with the extension of the defect in both the patients being almost the same with anterior extension to commissure, posteriorly to retro-molar trigone (RMT), laterally full-thickness, medially not involving alveolus. The incision at the donor site was closed primarily. The reconstruction did achieve the patient acceptable aesthetics, functionality, color and texture. The mean follow up of the patients is around 1 year with no complications. Naso-mento-labial flap, an inferiorly extended inferiorly based nasolabial flap is a useful addition to surgeon's armamentarium for reconstructing the buccal mucosa and peri-oral defects in patients whose general health prevents the using pedicled or free flaps.

Pubmed PDF Web

Primary oral melanoma: ABCDE or AEIOU criteria for clinical diagnosis?

Satya Ranjan Misra, Namrata Mishra, Saawan Kumar Satpathy

Publication date 10-01-2022


Pubmed PDF Web

Sinonasal renal cell-like adenocarcinoma arising in von Hippel Lindau (VHL) syndrome

Satish Maharaj, Karan Seegobin, Kristina Wakeman, Simone Chang, Kevin Potts, Brian Williams, Rebecca Redman

Publication date 09-01-2022


Sinonasal renal cell-like adenocarcinoma (SNRCLA) is a rare and relatively novel diagnosis. Hereditary and somatic genomic signatures are not well defined in this disease. We report the case of a 35-year-old African-American male with von Hippel Lindau (VHL) syndrome who developed SNRCLA. He underwent surgical resection followed by adjuvant radiation and has no recurrence one year from diagnosis. A review of the literature yielded two similar cases in the setting of VHL. In our case with associated VHL syndrome, next generation sequencing detected MST1R mutation, a possible driver. SNRCLA is an emerging tumor associated with VHL syndrome and it is hoped that future studies shed light on the underlying biology of this unique tumor.

Pubmed PDF Web

Chronic wounds of traumatic origin and oral cancer arising de novo: A potential association?

Gerardo Gilligan, Eduardo Piemonte, Jerónimo Lazos, René Panico

Publication date 08-01-2022


Pubmed PDF Web

Hypomagnesemia in patients with locally advanced head and neck cancer treated weekly cisplatin-incidence and impact on outcomes

Vijay Patil, Netra Ghandade, Vanita Noronha, Nandini Menon, Kumar Prabhash

Publication date 07-01-2022


Pubmed PDF Web

Squamous odontogenic tumor like proliferations in dentigerous cyst- a great mimicker

Pratibha Ramani, Reshma Poothakulath Krishnan, Deepak Pandiar, Aklesha Behera, Abilasha Ramasubramanian

Publication date 04-01-2022


Pubmed PDF Web

To be (2b), or not to be (2b), that is the question

Pirabu Sakthivel, Muthuswamy Dhiwakar, Ezhir Selvan, Kalpakasserimannil Aruljith

Publication date 02-01-2022


Pubmed PDF Web

Regarding the “The spiral ladder technique of facial nerve trunk identification during parotidectomy: A convenient roadmap for the beginners”

Dmitry Tretiakow, Andrzej Skorek, Iwona Łapińska

Publication date 01-01-2022


Pubmed PDF Web

Adenoid ameloblastoma: A neglected variant of ameloblastoma or a separate entity?

Deepak Pandiar, Pratibha Ramani, P.M. Shameena, Reshma Poothakulath Krishnan, K. Monica

Publication date 01-01-2022


Pubmed PDF Web

Ramucirumab-related osteonecrosis of the jaw

Annu Singh, Andrew Pischek, Joseph R. Randazzo, Joseph M. Huryn, Cherry L. Estilo, Isabel Preeshagul, SaeHee K. Yom

Publication date 27-12-2021


Pubmed PDF Web

Oral cancer in India, a growing problem: Is limiting the exposure to avoidable risk factors the only way to reduce the disease burden?

Anand Subash, BhanuPrakash Bylapudi, Shalini Thakur, Vishal U.S. Rao

Publication date 27-12-2021


Cancer represents an uncontrolled growth of cells that invade and cause damage to the adjacent tissues. Globally oral cancer ranks as the sixth most common type of cancer. As compared to the west, the problem of oral cancer is significantly higher in India. The spectrum of oral diseases is formed with oral cancer at one extreme and potentially malignant disorders (PMDs) at the other extreme. Screening programs for the early detection and prevention of oral cancer indicate that visual examination as a part of a population-based screening program reduces the mortality rate of oral cancer in high-risk individuals. Tobacco and alcohol consumption remains the main factors for oral cancer and education of the population about the ill effects of tobacco and alcohol consumption is necessary at a broader scale.

Pubmed PDF Web

The submandibular gland in neck dissection: A necessary casualty or a hapless victim?

Yash P. Merchant, Mathan Mohan, Sameep Shetty, Mahesh Bandemegal, Lohith Reddy, Vishal U.S. Rao

Publication date 27-12-2021


Pubmed PDF Web

Traumatic ulcer, TUGSE and malignant ulcer on lateral tongue: A trio of similar clinical entities confounding the oral diagnostician!

Satya Ranjan Misra, Abhishek Banerjee, Rupsa Das

Publication date 25-12-2021


Pubmed PDF Web

Association between E-cigarette use and oral HPV-16 infection

Patrick Herndon, Japnam S. Jassal, John D. Cramer

Publication date 24-12-2021


Pubmed PDF Web

Cemento-ossifying fibroma with odontogenic epithelial remnants: A hallmark of its odontogenic nature

Krissya María Villegas, María Luisa Paparella

Publication date 21-12-2021


Pubmed PDF Web

Inter-rater concordance and operating definitions of radiologic nodal feature assessment in human papillomavirus-positive oropharyngeal carcinoma

Olivia Chin, Laila Alshafai, Brian OSullivan, Jie Su, Andrew Hope, Eric Bartlett, Aaron R. Hansen, John Waldron, Douglas Chepeha, Wei Xu, Shao Hui Huang, Eugene Yu

Publication date 18-01-2022


This study aims to evaluate the reliability of radiologic nodal feature assessment in clinical node-positive human papillomavirus-positive oropharyngeal carcinoma. Baseline CTs or MRIs of clinical node-positive human papillomavirus-positive oropharyngeal carcinoma diagnosed between 2012 and 2015 were reviewed independently by two neuroradiologists for seven nodal features: radiologic nodal involvement, cystic change, presence of necrosis, clustering, conglomeration, coalescence, and extranodal extension. Consensus operating definitions were derived after discussion. The features were re-reviewed in a randomly selected cohort. Levels of certainty (probability of presence: <25%, ∼50%, ∼75%, and >90%) were recorded. Interrater concordance was calculated using Cohen's kappa coefficient. A total of 413 patients (826 necks) were eligible. At initial review, the inter-rater kappa values for: radiologic nodal involvement, cystic change, necrosis, clustering, conglomeration, coalescence, and extranodal extension were 0.92, 0.64, 0.48, 0.32, 0.32, 0.62, and 0.56, respectively. A re-review of 94 randomly selected cases (188 necks) after consolidation of operating definitions for nodal features showed that the inter-rater kappa values of these features were 0.83, 0.62, 0.58, 0.32, 0.18, 0.68, and 0.74 when considering ≥50% certainty as positive, and improved to 0.94, 0.66, 0.59, 0.33, 0.19, 0.76, and 0.86 when considering ≥75% certainty as positive. Clearly defined nomenclature results in improved interrater reliability when assessing radiologic nodal features, especially for coalescent adenopathy and extranodal extension. Higher levels of certainty are associated with higher inter-rater agreement. Radiology reporting should include clear definitions of clinically relevant nodal features as well as levels of certainty to serve various needs in clinical care and research.

Pubmed PDF Web

Anatomic variants of the subscapular-thoracodorsal arterial system: A radiologic analysis of 200 arterial systems

Thomas F Barrett, Hilary Orlowski, Jason Rich, Ryan S Jackson, Patrik Pipkorn, Sidharth V Puram

Publication date 09-01-2022


Composite flaps based on the subscapular arterial system are excellent choices for complex defects, including those of the head and neck, though rates of anatomic variants are not well described. Characterize subscapular-thoracodorsal arterial system in a large cohort of patients using CT chest angiography. CTA chest studies from 100 adult patients were analyzed to characterize the bilateral subscapular-thoracodorsal arterial systems. Out of 200 arterial systems, 25 (12.5%) were lacking a subscapular artery, with the thoracodoral and circumflex scapular arteries arising independently off of the axillary (or other nearby vessels). Strikingly, the subscapular artery was absent bilaterally in 5 patients and absent unilaterally in 15 patients, meaning that one in five patients harbored abnormal anatomy on at least one side. There was no radiographic evidence of atherosclerosis in the studied vessels in any patient, including smokers and patients with atherosclerosis in other vessels. Variations in the subscapular-thoracodorsal arterial system appear more frequent than previously described. For select patients requiring complex reconstruction using the scapular system, CTA chest may aide surgical planning.

Pubmed PDF Web

Case series of docetaxel, trastuzumab, and pertuzumab (DTP) as first line anti-HER2 therapy and ado-trastuzumab emtansine (T-DM1) as second line for recurrent or metastatic HER2-positive salivary duct carcinoma

M.J.M. Uijen, G. Lassche, A.C.H. van Engen-van Grunsven, C.M.L. Driessen, C.M.L. van Herpen

Publication date 08-01-2022


Salivary duct carcinoma (SDC) overexpresses Human Epidermal growth factor Receptor 2 (HER2) in 29-46% of cases, favoring anti-HER2 therapy. Here, we present the results of patients with recurrent or metastatic HER2-positive SDC treated with docetaxel, trastuzumab, and pertuzumab (DTP) as first line anti-HER2 therapy and subsequently ado-trastuzumab emtansine (T-DM1) in second line. Furthermore, we searched for potential biomarkers. Retrospective case series from a tertiary hospital. First line anti-HER2 treatment consisted of DTP, after progression T-DM1 was considered for patients with an adequate performance status. Objective response rate (ORR), progression-free survival (PFS) and overall survival (OS) were assessed and related to mRNA-based PI3K and MAPK signaling pathway activity scores. Thirteen SDC HER2 + patients received DTP. In twelve evaluable patients, one complete response (CR) and six partial responses (PR) were observed (ORR 58%), with a median PFS of 6.9 months (95%-CI 5.3-8.5). Seven patients received subsequent T-DM1 in second line, resulting in four PR (ORR 57%), with a median PFS of 4.4 months (95%-CI 0-18.8). Median OS after start of DTP was 42.0 months (95%-CI 13.8-70.1). Grade ≥ 3 toxicity on DTP was seen in 39% of patients, and 14% on T-DM1. Highest combined PI3K and MAPK signaling was seen in the patient with CR and lowest in the patient with progressive disease on DTP. In R/M HER2-positive SDC patients DTP followed by T-DM1 upon progression are promising treatments, leading to responses in the majority (58%) of the patients at an acceptable toxicity profile.

Pubmed PDF Web

Phantom study of SPECT/CT augmented reality for intraoperative localization of sentinel lymph nodes in head and neck melanoma

Ryusuke Nakamoto, Jialin Zhuo, Kip E. Guja, Heying Duan, Stephanie L. Perkins, Christoph Leuze, Bruce L. Daniel, Benjamin Lewis Franc

Publication date 07-01-2022


To show that augmented reality (AR) visualization of single-photon emission computed tomography (SPECT)/computed tomography (CT) data in 3D can be used to accurately localize targets in the head and neck region. Eight head and neck styrofoam phantoms were painted with a mixture of radioactive solution (Tc-99m) detectable with a handheld gamma probe and fluorescent ink visible only under ultraviolet (UV) light to create 10-20 simulated lymph nodes on their surface. After obtaining SPECT/CT images of these phantoms, virtual renderings of the nodes were generated from the SPECT/CT data and displayed using a commercially available AR headset. For each of three physician evaluators, the time required to localize lymph node targets was recorded (1) using the gamma probe alone and (2) using the gamma probe while wearing the AR headset. In addition, the surface localization accuracy when using the AR headset was evaluated by measuring the misalignment between the locations visually marked by the evaluators and the ground truth locations identified using UV stimulation of the ink at the site of the nodes. For all three evaluators, using the AR headset significantly reduced the time to detect targets (P = 0.012, respectively) compared to using the gamma probe alone. The average misalignment between the location marked by the evaluators and the ground truth location was 8.6 mm. AR visualization of SPECT/CT data in 3D allows for accurate localization of targets in the head and neck region, and may reduce the localization time of targets.

Pubmed PDF Web

Prognostic factors in acinic cell carcinoma of the head and neck: The Amsterdam experience

Stijn van Weert, Matthijs Valstar, Birgit Lissenberg-Witte, Elisabeth Bloemena, Laura Smit, Jacqueline van der Wal, Marije Vergeer, Ludi Smeele, C.René Leemans

Publication date 02-01-2022


The aim was to analyse prognosticators in acinic cell carcinoma (AciCC) in two head and neck referral centers in Amsterdam, the Netherlands. Eighty- nine cases of AciCC treated between 1979 and 2016 were retrospectively reviewed. Five, - 10 -and 20- year estimates of survival were executed as well as univariate analysis of prognosticators. The majority of AciCC were T1-T2; 89%. Two percent had nodal disease (2%). The most affected organ was the parotid gland (84%) with a female preponderance (67%). Mean age was 52 years with most cases diagnosed in the fourth to sixth decade. The majority of patients received adjuvant radiotherapy. Elective neck dissection (END) in the N0 neck showed no metastases. High grade transformation (HGT) was found in 21% of cases. Median follow up was 101.9 months. Median time to recurrence was 26 months. Nine patients developed distant metastases (DM) of whom 6 had HGT-AciCC. Median survival with DM was 7 months. Five,- ten -and twenty- year estimates were 84%, 81% and 81% for recurrence free survival respectively. Negative clinical features were advanced stage disease and tumour size > 2.6 cm. Negative histological features were a high mitotic rate, HGT, close and involved surgical margins and necrosis. AciCC- HGT excluded- of the head and neck has an excellent prognosis and shows acceptable long term results. END can be considered as part of the standard treatment due to the relative high incidence of HGT- AciCC and low accuracy of cytology.

Pubmed PDF Web

Impact of invasion into cervical esophagus for patients with hypopharyngeal squamous cell carcinoma

Tseng-Cheng Chen, Chi Wang, Liang-Yen Su, Mei-Chun Lin, Tsung-Lin Yang, Pei-Jen Lou, Jenq-Yuh Ko, Cheng-Ping Wang

Publication date 02-01-2022


The invasion into cervical esophagus (ICE) sometimes could be encountered in patients with hypopharyngeal squamous cell carcinoma (HypoSCC). However, the incidence, predictive factors, and prognostic impact of ICE on the patients with HypoSCC remain unclear. Patient diagnosis with HypoSCC at the National Taiwan University Hospital between January 2007 and December 2018 were reviewed.
All patients were classified into two groups: with and without ICE. The curative treatment included upfront laryngectomy or pharyngo-laryngo-esophagectomy (PLE) with adjuvant chemoradiation, or definite organ-sparing chemoradiation. We analyzed 527 HypoSCC patients, 71 (13.47%) with and 456 (86.53%) without ICE. ICE presented more frequently in females (odds ratio (OR) = 3.01, p = 0.03) and posterior pharyngeal wall (OR = 2.34, p = 0.04). The 5-year disease-free survival of patients with and without ICE were 21.7% and 54.1%, respectively (p < 0.0001) and the 5-year overall survival were 13.1% and 53.8%, respectively (p < 0.0001). Among patients with ICE, the disease-free and overall survival of patients with upfront PLE were worse than the patients without upfront PLE (p = 0.21 and p = 0.27, respectively). After multivariant cox analysis, ICE was an independent risk factor for disease-free survival (p < 0.001) and overall survival (p < 0.001). ICE was occasionally present (13.47%) in HypoSCC patients. Unfortunately, the presence of ICE had a significant impact on disease-free and overall survival. For the HypoSCC patients with ICE, organ-sparing chemoradiation should be considered first as upfront PLE had no additional benefit.

Pubmed PDF Web

Guideline - Adherence in advanced stage head and neck cancer is associated with improved survival – A National study

Oded Cohen, Philip R. Brauer, Benjamin L. Judson, Barbara A. Burtness, Joseph Earles, Saral Mehra

Publication date 01-01-2022


Understanding the prevalence of guideline non-adherence among patients with advanced head and neck cancer (HNC) and its impact on survival may facilitate increased adherence. Our objective was to perform a detailed analysis of overall National Comprehensive Care Network (NCCN) guideline adherence in a national cohort. Using the National Cancer Database, we analyzed site-specific NCCN guideline adherence for treatment of 100,074 overall stage III and IVA HNC patients from 2004 to 2013. Main outcomes were guideline adherence rates and overall survival (OS).
Adherence was categorized by treatment: surgery/ radiation.
Reasons were categorized as: (1) high risk; (2) refusal; (3) not planned. After exclusion, the care of 25,620 patients was defined as non-adherent (25.6%), yet adherence rates significantly improved across the study's years. After multivariate analysis, non-adherence was associated with age ≥ 65, female gender, black race, comorbidity score ≥ 1, insurance status, clinical staging, primary site, and facility type. Patients not managed according to NCCN guidelines had a significantly reduced OS compared with patients treated on-guideline (hazard ratio (HR) = 1.51 (95 %CI 1.48-1.54), p < 0.001). 'Not planned' patients had reduced OS when compared to adherent patients (HR = 1.27 (95 %CI 1.23-1.30), p < 0.001). Off-guideline treated patients due to 'risk factors' had a decrease in overall survival (OS) compared with other reasons (p < 0.001 for all). Despite improvement over time, non-adherence to NCCN guidelines for advanced stage HNC remains high. Non-adherence is associated with decreased OS, regardless of the reason. Despite concerns from both patient and physician, efforts should be made to increase guideline awareness and adherence.

Pubmed PDF Web

The prognosis of HPV-associated metastatic pharyngeal patients by primary and distant site

Juncheng Wang, Yuxi Tian, Huimei Huang, Donghai Huang, Yong Liu, Yongquan Tian, Gangcai Zhu, Xin Zhang, Robert L. Ferris

Publication date 31-12-2021


Human papillomavirus (HPV) positivity is a favorable prognostic factor in the general population of head and neck squamous cell carcinoma (HNSCC) patients. However, its impact on the survival of metastatic HNSCC of pharynx (mHNSC-P) patients is unclear. This study aims to investigate the associations between HPV status and survival in mHNSC-P patients. 735 mHNSC-P patients diagnosed at first presentation from 2010 to 2016 were retrieved from the Surveillance, Epidemiology and End Result database (SEER). Chi-Squared test, univariate and multivariate cox proportional hazards model, Kaplan-Meier analysis, and log-rank test were applied to compare HPV-positive and -negative mHNSC-P patients. Using univariate cox proportional hazards analysis, HPV status, primary site, T stage, treatment and distant metastatic site correlate with the overall survival (OS) and disease-specific survival (DSS) in mHNSC-P patients. Multivariate cox regression analysis shows that HPV-positive mHNSC-P patients experienced significantly better OS (HR: 0.
62 CI: 0.51-0.76, p < 0.001) and DSS (HR: 0.
73 CI: 0.58-0.91, p < 0.01) as compared to HPV-negative mHNSC-P patients. Subgroup analysis indicates that HPV-associated OS and DSS benefits exist in patients with metastatic HNSCC of oropharynx (mHNSC-OP) but not in patients with metastatic HNSCC of non-oropharynx (mHNSC-non-OP). Among mHNSC-OP patients, HPV positivity confers disease-specific survival benefit in patients with oligometastatic rather than polymetastatic patients. Furthermore, HPV associated OS and DSS advantages in mHNSC-OP with lung metastasis was observed. HPV-positive mHNSC-OP patients with lung metastasis show better survival than HPV-negative mHNSC-OP patients, providing key information to guide patient treatment approaches.

Pubmed PDF Web

Results of sequential swallowing assessments in patients undergoing upfront surgery for oral tongue squamous cell carcinoma

Shikhar Sawhney, Shivakumar Thiagarajan, Arun Balaji, Pranav Sathe, Siddhanth Jain, T.M. Rukmangathan, Sadhana Kannan, Snehal Shah, Devendra Chaukar

Publication date 29-12-2021


The swallowing outcomes in patients undergoing glossectomy have been inconsistently reported in the literature owing to variable follow up times, different tools for assessment and lack of single institution large scale studies. The aim of our study was to assess the patterns of swallowing outcomes over time and identify factors affecting nasogastric tube dependency at 1-year post-surgery. This was a retrospective study of treatment naïve patients with oral tongue carcinoma who underwent surgery and attended the speech and swallow clinic between January 2016 and December 2019 at our institute were included in the study. The findings of swallowing assessment by a speech language pathologist at three time points were recorded. A total of 606 patients were found eligible for the study. The median age of the patients was 50 years with the 211 (34.8%) patients having T3/T4 disease. The swallowing outcomes in terms of tube dependence and the spectrum of diet tolerance seem to improve over time with an increasing number of patients switching over to a solid diet by 1 year. A higher defect class (HR = 24.43 [3.48-171.27]) and presence of co-morbidities (HR = 4.17 [1.59-10.92]) were associated with sustained feeding tube dependency status at 1 year. A nomogram was developed based on these findings. The swallowing outcomes in terms of tube dependence and the spectrum of diet tolerance seem to improve over time. A higher defect class and presence of co-morbidities were associated with NGT dependency at 1 year.

Pubmed PDF Web

Reflectance confocal microscopy (RCM)-based criteria for progression of lower-lip squamous cell carcinoma: A prospective study

Paula Silva Ferreira, Lilian Rocha, Ana Patricia Carneiro Bezerra, Marcello Menta Simonsen Nico, Silvia Vanessa Lourenço

Publication date 21-12-2021


Actinic cheilitis (AC) presents as a diffuse clinical-histopathological alteration throughout the lower lip. To analyze AC lesions using reflectance confocal microscopy (RCM) and evaluate criteria for the early diagnosis of incipient squamous cell carcinoma (SCC). This prospective study comprised cases of clinically diagnosed AC. RCM was performed over the entire extension of the lower lip. The sites that showed the highest degree of morphological alteration by RCM, according to established criteria for AC and SCC, were biopsied. The RCM findings and histopathology were correlated to establish the precise and early diagnosis of SCC. A total of 61 cases that had been clinically diagnosed with AC were included.
The RCM findings that correlated independently with SCC were: nonedged papillae (sensitivity 84% and specificity 88%, p < 0.0001, and OR 42), cell-filled papillae (sensitivity 82% and specificity 93%, p < 0.0001, and OR 71.3), inflammation (sensitivity 68% and specificity 68%, p = 0.0163, and OR 4.8), large and roundish cells in the lamina propria (sensitivity 65% and specificity 100%, p < 0.0001, and OR infinity), and nests in the lamina propria (sensitivity 54% and specificity 100%, p < 0.0001, and OR infinity). An independent histopathological analysis classified the cases as partial epithelial dysplasia (25 cases, 41%) and SCC (36, 59%), and in 57 cases (94%), the results agreed with the categorization that was rendered by the RCM exam. RCM can be used to monitor AC cases, guide the biopsy site, and identify the early progression of AC to SCC with good sensitivity and specificity.

Pubmed PDF Web

Validity of functional patient-reported outcomes in head and neck oncology: A systematic review

Adrian I. Mendez, Jacob G.J. Wihlidal, Dean T. Eurich, Anthony C. Nichols, S. Danielle MacNeil, Hadi R. Seikaly

Publication date 13-01-2022


Malignancy and treatment effects in head and neck oncology can be devastating to functional aspects of patient life such as swallowing, blinking, speech, salivation, and facial expression. Historically, the subjective nature of patient experience has resulted in difficulty with quantification and measurement of functional outcomes. Patient-Reported Outcomes (PROs) are questionnaires developed with patient input, forming the new gold standard for clinician assessment of subjective functional outcomes.
The current review aims to identify and characterize the validation of PROs pertaining to four critical functional outcomes in head and neck oncology: swallowing, speech, dry mouth, and chewing. A literature search was conducted using MEDLINE, EMBASE, and the Cochrane databases for published, English language, peer-reviewed abstracts involving patients ≥ 18 years of age. Of 708 results, 705 were excluded at abstract or full text screening for not meeting inclusion criteria, exclusion of head and neck SCC patients in development, or absence of a functional domain measurement. The three reviewed studies-Xerostomia Questionnaire, Swallowing Outcomes After Laryngectomy, and Edmonton 33-exhibited strong reliability and construct and content validity, though two applied only to individual functional outcomes within specific patient populations receiving radiation or laryngectomy. While many PROs have been developed in head and neck oncology, very few properly employed extensive patient input in the development process. Further work must be committed to increasing head and neck cancer patient input in PRO development, particularly in the functional domains of speech and chewing.

Pubmed PDF Web

Radiotherapy and immunotherapy combination in head and neck cancer: Does current failure qualify as an ending or is it a key to future success?

Panagiota Economopoulou, Ioannis Kotsantis, Amanda Psyrri

Publication date 18-01-2022


Pubmed PDF Web

“A to Z”s of tobacco control and cessation

Pirabu Sakthivel, Abhishek Shankar, Pranav Ish, Nipun Malhotra, Shekhar Kunal

Publication date 09-01-2022


Pubmed PDF Web

Dentinogenic ghost cell tumor with focal atypical features suggesting ghost cell odontogenic carcinoma: Report of a challenging diagnosis

Danielle Castex Conde, Gustavo de Souza Vieira, Pâmella de Pinho Montovani, João Pedro Roque Beserra, Mauro César Gaspar Ribeiro, Rafaela Elvira Rozza-de-Menezes, Karin Soares Cunha

Publication date 18-09-2021


Dentinogenic ghost cell tumor (DGCT) represents a rare benign odontogenic neoplasm that can appear in a central or peripheral form and may rarely undergo malignant transformation to ghost cell odontogenic carcinoma (GCOC). We aim to report a case of a central DGCT with focal cytological malignant aspects. A 24-year-old woman exhibited a painful enlargement and dental mobility in the left posterior maxilla for about one year, which appeared as an expansive well-defined hypodense maxillary image with hyperdense foci invading ipsilateral maxillary sinus. Incisional biopsy showed a predominantly solid hyperchromatic basaloid epithelium presenting cellular pleomorphism and mitotic activity, admixed with abundant ghost cell aggregates and dentinoid material. The lesion was immunopositive for p53 and had 21% of Ki-67 proliferation index (PI). These microscopic features suggested initially a GCOC diagnosis. Partial left maxillectomy was performed without complications. The surgical specimen presented an exuberant variation of the epithelial parenchyma, including ameloblastomatous, fusiform, and cribriform areas, with numerous ghost cells and dentinoid material, lacking any signs of malignancy. The final diagnosis was DGCT. The patient is in a strict regular follow-up for over two years, and there are no signs of recurrence.

Pubmed PDF Web

8 “S” of obturators in Head and Neck Cancer Rehabilitation during COVID-19 pandemic

Pirabu Sakthivel, Akshat Malik, Smriti Panda, Muthuswamy Dhiwakar

Publication date 17-09-2021


Pubmed PDF Web

A rare combined motley variety of odontogenic tumors – Hybrid lesion or a new entity?

Pratibha Ramani, Reshma Poothakulath Krishnan, Deepak Pandiar, Snega Thamilselvan

Publication date 13-09-2021


Pubmed PDF Web

Treatment of early glottic carcinoma: Is it a paradox of choices?

Akshat Malik, Smriti Panda, Pirabu Sakthivel

Publication date 11-09-2021


Pubmed PDF Web

Use of rotational thromboelastometry (ROTEM®) to predict thrombotic complications of microvascular head and neck reconstruction

Katie K. Spielbauer, Jumin Sunde, Marisa Buchakjian, Keith A. Casper, Kelly M. Malloy, Chaz L. Stucken, Mark E. Prince, Andrew J. Rosko, Samuel Schechtman, Steven B. Chinn, Sathish S. Kumar, Matthew E. Spector

Publication date 06-09-2021


Pubmed PDF Web

What is the impact of charcoal on human health and oral carcinogenesis?

Prashanth Panta, Sravya Reddy Dhopathi, Prashanthi Reddy

Publication date 05-09-2021


Pubmed PDF Web

Oral verrucous carcinoma arising from pemphigus vulgaris: A rare coincidence

Sara Fakhraei, Pouran Layegh, Emadodin Darchini-Maragheh, Naser Tayyebi Meybodi

Publication date 15-09-2021


Pubmed PDF Web

PRAME immunohistochemistry is useful in the diagnosis of oral malignant melanoma

Daniel Hovander, Joshua Allen, Dolphine Oda, Ata S. Moshiri

Publication date 29-08-2021


While the incidence of cutaneous melanoma has dramatically increased in recent years, oral malignant melanoma (OMM) remains a rare form of noncutaneous melanoma with poor survival. PRAME (PReferentially expressed Antigen in MElanoma) is reported to have diagnostic and some prognostic utility in cutaneous melanomas and some head and neck malignancies. We sought to explore the diagnostic utility of PRAME in OMM. A total of ten specimens from eight unique cases of OMM were identified from the Oral Pathology Biopsy Service (OPBS) at University of Washington School of Dentistry between 2005 and 2019. For all cases, standard histology and immunohistochemistry stains were performed, including a stain against PRAME. The diagnoses were reviewed and confirmed by two pathologists. Clinical and epidemiologic features were described. Patient ages ranged from 55 to 82. The group consisted of five males and three females. All eight cases were located on the hard palate. Six cases represented invasive melanoma while two were early melanoma in situ.
PRAME immunohistochemistry was successfully performed on seven of eight cases: six were positive (86%), one was negative (14%) and one case lacked sufficient tissue for staining. Our results suggest that PRAME immunohistochemistry may be useful in the diagnosis of OMM, including early melanoma in situ. Further studies with clinical follow-up and a larger number of cases are needed to explore prognostic value as well as the ability to distinguish between benign, intermediate and malignant melanocytic proliferations of the oral cavity.

Pubmed PDF Web

Oral epithelioid rhabdomyosarcoma: Report of a rare case and literature review of a distinct variant of rhabdomyosarcoma

Carla Isabelly Rodrigues-Fernandes, Celeste Sánchez-Romero, Oslei Paes de Almeida, Fábio de Abreu Alves, Elaine Judite de Amorim Carvalho, Jurema Freire Lisboa de Castro, Danyel Elias da Cruz Perez

Publication date 25-08-2021


Epithelioid rhabdomyosarcoma is a new and rare morphological variant of rhabdomyosarcoma, with only a few reports in the literature. We aimed to describe an atypical case of this variant involving the oral cavity. A 33-year-old male patient presented with an asymptomatic, gingival mass adjacent to the left maxillary canine with progressive growth over approximately 3 months. Microscopic and immunohistochemical assessment of the biopsy specimen were consistent with epithelioid rhabdomyosarcoma. After initial chemotherapy and radiotherapy, the patient had a partial response. Surgical resection was performed, followed by adjuvant chemotherapy. After local and distant recurrences, the patient died 22 months after the initial diagnosis. According to the literature, epithelioid rhabdomyosarcoma still lacks data regarding its aetiologic factors and therapeutic options. Whether this tumour is a true subtype or simply a variant of other subtypes of rhabdomyosarcoma also remains unconfirmed. Final diagnosis leads to a broad array of microscopic and immunohistochemical analyses.

Pubmed PDF Web

COVID-19 pandemic and lock-down protocols: Impact in an indian tertiary cancer center

Theerthika Dillibabu, Saranya Varadarajan, Thodur Madapusi Balaji, Priyanka Balakrishnan, Shashank Tangutur, Shankargouda Patil, A. Thirumal Raj

Publication date 18-08-2021


Pubmed PDF Web

Spindle cell squamous cell carcinoma of alveolus with heterologous mesenchymal differentiation and synchronous contralateral buccal squamous cell carcinoma in a background of oral submucous fibrosis: Recapitulation of embryonic plasticity?

Deepak Pandiar, Pratibha Ramani, Reshma Poothakulath Krishnan, Snega Thamilselvan, Deepa R. Viswasini

Publication date 10-08-2021


Pubmed PDF Web

Head and neck surgical oncology training in the current era of molecular oncology

Bipin T. Varghese

Publication date 08-08-2021


Lack of regional confines limits surgical oncology training, which undoubtedly is an evolving sought-after surgical super speciality programme. Training and practice of region or domain-specific surgical oncology and the recent introduction and popularization of the concept of site-specific multidisciplinary clinics practised worldwide have provided the answer to this issue in a big way. Head and Neck Surgical oncology is one of the classic examples of such developed training pathways globally.

Pubmed PDF Web

Response to: Should ultrasound-guided resection be the new norm for oral tongue resections?

Klijs J. de Koning, Mark A. Varvares, Robert J.J. van Es, Jan Willem Dankbaar, Gerben E. Breimer, Remco de Bree, Rob Noorlag

Publication date 07-08-2021


Pubmed PDF Web

Chondromyxoid fibroma affecting the maxilla in a 1-year-old child: Immunohistochemical analysis and literature review

Beatriz Zamboni Martins Panucci, Evânio Vilela Silva, Rafael Humberto Artero Arévalo, Ricardo Ernesto Rivera Miranda, Florence Juana Maria Cuadra Zelaya, Heitor Albergoni Silveira, Jorge Esquiche León

Publication date 29-07-2021


Chondromyxoid fibroma (CMF) is a benign chondroid/myxoid matrix-producing tumor that often develops in the long bones of young adults. CMF is rarely reported in the craniofacial skeleton, with most cases presenting with bone erosion or destruction, which may lead to a misdiagnosis. To date, approximately 129 cases of CMF in the craniofacial region have been reported, with only three cases in patients aged less than 1 year. Of these 129 cases, only 34 affected the jaws. A 1-year-old boy presented with a mass in the left anterior maxilla, extending and compressing the ipsilateral nasal cavity. After surgical excision of the lesion, microscopy revealed spindle-to-stellate tumor cells surrounded by a predominant myxoid stroma containing focal slit-like vascular channels and hemorrhagic areas. Immunohistochemistry showed positivity for vimentin, CD10, and α-SMA (focal). The Ki-67 labeling index was 6%. CFM should be included in the differential diagnosis when assessing maxillary tumors in pediatric patients.

Pubmed PDF Web

Locally advanced undifferentiated sarcomatoid carcinoma of the right maxillary sinus with PDCD6-TERT fusion: A rare case report

Li Zhang, Lin Chen, Mingzhe Xiao, Xiaoqi Xie, Feng Wang

Publication date 06-08-2021


Sarcomatoid carcinoma of maxillary sinus tumor is extremely rare in head and neck tumors and has poor prognosis and frequently occurs to relapse locally after surgery. We first reported a case of locally advanced undifferentiated sarcomatoid carcinoma of right maxillary sinus with PDCD6-TERT fusion gene. The patient with a previous history of moderate alcohol drinking and smoking. The patient underwent surgical treatment. The tumor tissue using NGS analysis, no other driver gene mutations, and the PD-L1 IHC was negative. He received TPF regimen induction chemotherapy combined with anti-PD1 inhibitor and radiotherapy. The effect of treatment was good.

Pubmed PDF Web

A rare case of extensive gingival lymphatic malformation

Hui Xiao, Babita Pradhan, Sushmita Pradhan, Xin Ran, Lei Wang, Hong-Jie Liu, Yu-Ping Ran

Publication date 04-08-2021


Lymphatic malformation is a benign lesion, seldom affecting the gingiva. Gingival lesions are characterized by pebbly hyperplasia, occasional pain, and bleeding. The treatment for large and exceptional areas of involvement may face difficulties. Herein we report a rare case of gingival lymphatic malformation in a 10-year-old girl.

Pubmed PDF Web

Are taxanes more effective than 5FU in combination chemotherapy for recurrent and metastatic head and neck cancer?

Muhammad Shahid Iqbal, Josef Kovarik, Rahul Patil, Charles G. Kelly

Publication date 14-07-2021


Pubmed PDF Web

Machine learning in head and neck cancer: Importance of a web-based prognostic tool for improved decision making

Alhadi Almangush, Rasheed Omobolaji Alabi, Antti A. Mäkitie, Ilmo Leivo

Publication date 17-07-2021


Pubmed PDF Web

Extent of neck dissection in the N+ neck: Adjudicating a Conundrum!

Yash P. Merchant, Akshay Kudpaje, Vishal U.S. Rao

Publication date 15-07-2021


Pubmed PDF Web

Covid-19 negatively impacted on small oncology surgery but none on major procedures: Regional experience

Luca DAscanio, Gino Latini, Manlio Pandolfini, AORMN Head and Neck Cancer Team, Luca Imperatori, Arianna Di Stadio

Publication date 29-07-2021


To understand the impact of COVID pandemic on the activity and patients' care of the Head and Neck regional Unit, temporary moved in a COVID-free hospital. We retrospectively analyzed the yearly activity of the "Head & Neck Cancer Unit" at the Azienda Ospedali Riuniti Marche Nord (Italy) during 2020 (COVID-19 pandemic) and we compared it with the one performed in 2019. Statistical analyses were performed using Chi-square. No significant differences were observed comparing the total number of patients treated for H&N squamous cell carcinoma (SCC) in 2019 with the ones in 2020. Moreover, no differences were identified in term of cancer stage at the moment of the surgery between 2019 and 2020. On the contrary, a significant reduction in the number of surgical procedures carried out for thyroid (p < 0.05) and skin (p < 0.001) malignancies was identified. Despite Covid-19 limitations, our institution was able to preserve the number of major oncologic procedures without negative impact on patients' care. We believe that the creation of specific COVID-free hospital can be the key preserve quality of care in epidemic emergency.

Pubmed PDF Web

Psychosocial Factors in an Oral Cancer Survivor Leading to Delay in Seeking Help

Mohammed Imaduddin, Mahesh Sultania, B. Vigneshwaran, Dillip Kumar Muduly, Madhabananda Kar

Publication date 10-07-2021


Pubmed PDF Web

Should sitting time be a treatment target in head and neck cancer patients receiving curative treatment?

Ilda Patrícia Ribeiro, Teresa Lopes, Nicole Pedro, Leonor Barroso, Rui Costa, Isabel Marques Carreira, Fernando Ribeiro

Publication date 01-07-2021


Pubmed PDF Web

The medial sural artery perforator flap: An underutilized flap in oral cavity reconstruction

Allen L. Feng, Hassan B. Nasser, Keith A. Casper, Kelly M. Malloy, Chaz L. Stucken, Mark E. Prince, Steven B. Chinn, Andrew J. Rosko, Matthew E. Spector

Publication date 07-07-2021


Pubmed PDF Web

Poorly differentiated “insular” thyroid carcinoma with solitary vascular mandibular metastasis – A rare histology and management

Sachin Ambre, Mahesh Sultania, Sandhya Biswal, Suvradeep Mitra, Biswajit Sahoo, Dillip Kumar Muduly, Madhabananda Kar

Publication date 29-06-2021


Pubmed PDF Web

Exome sequencing reveals candidate mutations implicated in sinonasal carcinoma and malignant transformation of sinonasal inverted papilloma

Sanna Viitasalo, Piia-Riitta Karhemo, Juho Väänänen, Taru Ilmarinen, Markus Lilja, Riku Katainen, Outi Monni, Leena-Maija Aaltonen

Publication date 17-12-2021


We explored somatic mutations in dysplastic sinonasal inverted papilloma (SNIP), SNIP with concomitant sinonasal squamous cell carcinoma (SNSCC), and SNSCC without preceding SNIP. Ten SNIP and SNSCC samples were analyzed with exome sequencing and tested for human papillomavirus. The identified mutations were compared to the most frequently mutated genes in head and neck squamous cell carcinoma (HNSCC) in the COSMIC database. Exome sequencing data were also analyzed for mutations not previously linked to SNSCC. Seven of the most commonly mutated genes in HNSCC and SNSCC in COSMIC harbored mutations in our data. In addition, we identified mutations in 23 genes that are likely to contribute to SNIP and SNSCC oncogenesis.

Pubmed PDF Web

Myoepithelial carcinoma of the minor salivary glands: A case report of a rare tumor

Thalita Santana, Ivan José Correia Neto, Norberto Nobuo Sugaya, Marília Trierveiler

Publication date 17-12-2021


Pubmed PDF Web

Chronic mechanical irritation and oral squamous cell carcinoma: A case series

Prashanth Panta, Satya Ranjan Misra

Publication date 17-12-2021


Pubmed PDF Web

The spiral ladder technique of facial nerve trunk identification during parotidectomy: A convenient roadmap for the beginners

Vishal U.S. Rao, BhanuPrakash Bylapudi, Piyush Sinha, Anand Subash

Publication date 17-12-2021


The intricate relationship between the facial nerve and the parotid gland makes the surgeries involving the gland challenging. Though several landmarks have been described to locate the nerve trunk, variations do exist due to the physical and racial characteristics of an individual. The spiral ladder technique described here uses multiple landmarks that appear in a stepwise manner as a beginner proceeds through the surgery as a road map to the nerve trunk. This simple adoption of a cluster of existing landmarks increases the certainty factor. This method may help beginners and in turn, reduce the chances of iatrogenic facial nerve injuries.

Pubmed PDF Web

Can koilocytes without dysplasia in OPMDs be an early indicator and prognostic factor for oral squamous cell carcinoma?

Ramya Ramdoss, Monal Yuwanati, Abigail Viola E, Pratibha Ramani, M. Senthil Murugan

Publication date 18-12-2021


Pubmed PDF Web

The ‘AEIOU’ system to identify primary oral melanoma

José Cândido Caldeira Xavier-Junior, Juliana Polizel Ocanha-Xavier, Marcel Arakaki Asato, Daniel Galera Bernabé

Publication date 17-12-2021


Primary oral melanoma (POM) is a rare entity that is often asymptomatic and is associated with a poor prognosis. Following the example of the ABCDE acronym for the clinical diagnosis of early cutaneous melanoma, we would like to introduce another acronym, AEIOU, to identify lesions that are clinically suspicious for POM. The letter "A" means age older than 50; "E" means ethnicity in reference to the higher occurrence among Asians, Hispanics, and Africans; "I" means irregularity in reference to irregular borders or color; "O" means oral palate, the most frequent site of POM; and "U" means ulceration. To the best of our knowledge, this paper is the first to describe an acronym AEIOU as a diagnostic aid for POM among health practitioners and the general population. Future studies should test the acronym's sensitivity and specificity for POM diagnosis in clinical practice.

Pubmed PDF Web

Lichenoid infiltrate in oral submucous fibrosis: A new marker of malignant transformation

Gargi S. Sarode, Sachin C. Sarode, Monal Yuwanati, Amol Gadbail, Shailesh Gondivkar

Publication date 17-12-2021


Pubmed PDF Web

MYC-PDL1 axis reduces sensitivity to nivolumab in recurrent head and neck squamous cell carcinoma

Rika Noji, Yoshihito Kano, Hideaki Hirai, Iichiroh Onishi, Naoto Nishii, Ryoichi Yoshimura, Satoshi Miyake, Sadakatsu Ikeda, Hiroyuki Harada

Publication date 14-12-2021


Patients with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M HNSCC) have a poor prognosis. Recently, the use of immune checkpoint inhibitors (ICIs) for drug treatment has been expanding . However, the response rate to immunotherapy is low. Therefore, the identification of predictive biomarkers of response and resistance to ICIs is required for various types of malignant tumors. We report the case of a patient with recurrent and metastatic HNSCC who simultaneously showed different responses to nivolumab in metastatic lesions. After administering nivolumab, metastasis to the multiple cervical lymph node metastases showed a significant reduction, whereas a new metastasis to the right axillary lymph node occurred . Each surgical specimen was analyzed using the cancer gene panel test (Foundation One CDx) to elucidate why treatment response is distinct among the same patient. Next-generation sequencing revealed MYC amplification and programmed cell death-1 loss in the right axillary lymph nodes but not cervical lymph nodes. Furthermore, t he histopathological findings suggested that MYC amplification regulated programmed death-ligand 1 expression and was involved in a decreased response to ICIs. This result is expected to help predict the efficacy of ICI treatment and select therapeutic agents.

Pubmed PDF Web

Comment on “Oral squamous cell carcinoma due to chronic mechanical irritation.”

Satya Ranjan Misra, Rupsa Das

Publication date 14-12-2021


Pubmed PDF Web

A machine learning based survival prediction model for advanced parotid gland mucoepidermoid carcinoma

Tae Hoon Kim, Young-Gyu Eun, Young Chan Lee

Publication date 14-12-2021


Pubmed PDF Web

Results of concurrent radiotherapy and immunotherapy in recurrent and metastatic head and neck cancer: A single-center experience

Sezin Yuce Sari, Melek Tugce Yilmaz, Burak Yasin Aktas, Sercan Aksoy, Ibrahim Gullu, Mustafa Cengiz, Gokhan Ozyigit, Gozde Yazici

Publication date 10-12-2021


In metastatic and recurrent head and neck cancer (M/R HN-SCC), the median survival is less than a year and locoregional recurrence is the main cause of death. Our aim was to evaluate the results of concurrent stereotactic body radiotherapy (SBRT) and immunotherapy (ICI) in these patients. Fifteen patients diagnosed with M/R HN-SCC were evaluated retrospectively. All patients received SBRT (3x8 Gy) to all recurrent and metastatic foci with concurrent ICI. Six months overall survival (OS) rates and progression-free survival (PFS) rates were 93% and 86%, respectively. Local control (LC) rate in the site of SBRT was 96%. Higher survival and LC rates were achieved with lower doses of radiotherapy with the synergistic effect of SBRT and ICI. Concurrent ICI and SBRT was feasible with excellent LC.

Pubmed PDF Web

Cetuximab: Its role in patients unfit for cisplatin

Francesca De Felice, Andrea Botticelli

Publication date 06-12-2021


Pubmed PDF Web

Autotransplantation of teeth: An alternative for patients with malignant transformation of oral submucous fibrosis

Aiman Itrat Abbasi, Sameep S. Shetty, José Alcides Almeida de Arruda

Publication date 04-12-2021


Pubmed PDF Web

Robot assisted modified retro-auricular approach for posterior triangle of neck: The path differently taken

Bhinyaram Jat, Kinjal Shankar Majumdar, Abhinav Thaduri, Shahab Ali Usmani, Jay Dave, Amit Kumar, Amit Kumar Tyagi

Publication date 03-12-2021


Pubmed PDF Web

Potential prognostic and predictive role of baseline circulating tumor cells in head and neck squamous cell carcinoma

Anshika Chauhan, Rajandeep Kaur, Sushmita Ghoshal, Debajyoti Chatterjee, Arnab Pal

Publication date 01-12-2021


Pubmed PDF Web

In reply to immune desert in head and neck squamous cell carcinoma: A review of challenges and opportunities for modulating the tumor immune microenvironment

Nerina Denaro, Marco Merlano, Ornella Garrone

Publication date 29-11-2021


Pubmed PDF Web

Addressing the challenges of head and neck cancer care in India – A compelling need of the hour

Abhinav Thaduri, Dilip Dungala, Achyuth Panuganti, Kinjal Shankar Majumdar, Amit Sehrawat

Publication date 28-11-2021


Pubmed PDF Web

Glandular metaplasia in oral squamous cell carcinoma: Prognostic indicators? Deriving inference from urothelial and breast carcinoma

Ramya Ramadoss, Monal Yuwanati, Pratibha Ramani, Rajkumar Krishnan, Rameshkumar Annasamy

Publication date 28-11-2021


Pubmed PDF Web

Dysbiotic tumor microbiota associates with head and neck squamous cell carcinoma outcomes

Yu Dou, Chao Ma, Ketao Wang, Shaohua Liu, Jintang Sun, Wanye Tan, Markus Neckenig, Qingjie Wang, Zuoqing Dong, Wenjuan Gao, Anwei Chen, Dong Zhang, Bing Wang, Liang Shi, Zhaodi Nan, Dan Ai, Wenjie Yu, Jia Liu, Bingfeng Song, Lei Zhao

Publication date 17-12-2021


The need for an effective tool to predict prognosis of head and neck squamous cell carcinoma (HNSCC) patients is critical and unmet. Microbiota has recently been found involved in tumor progression and response to immunotherapy. However, the association of microbiota with the prognosis of HNSCC patients remains obscure. This study aims to investigate the association between tumor microbiota and outcomes of HNSCC patients. A retrospective study including 129 primary tumors of HNSCC was conducted. Using 16S rRNA sequencing, the profile and the composition of tumor microbiota were measured and their associations with overall survival (OS) and disease free survival (DFS) were examined. We observed a reduced richness and enriched abundances of genera Schlegelella and Methyloversatilis in tumor microbiota of HNSCC patients with poor prognosis. However, a richer tumor microbiota with greater abundances of genera Bacillus, and Lactobacillus and Sphingomonas was characterized in the patients with favorable prognosis.
The ratio of these differentially abundant taxa, microbial dysbiosis index (MDI), was significantly associated with OS (hazard ratio [HR], 4.67, 95% confidence interval [CI], 2.51 to 8.69,P < 0.001) and DFS (HR, 2.89; 95% CI, 1.74 to 4.80, P < 0.001) independently of age, tumor size, lymph node metastasis, differentiation and p16 status. The risk score of multivariate Cox regression exhibited an excellent performance for estimating three-year OS (AUC of 0.826). We also found a richer tumor microbiota was correlated with moderate peritumoral inflammatory infiltration. These results indicate that tumor microbiota associates with outcomes of HNSCC patients.

Pubmed PDF Web

TransOral UltraSonic surgery (TOUSS) for oral cavity, oropharyngeal and supraglottic malignancy: A prospective study of feasibility, safety, margins, functional and survival outcomes

Pirabu Sakthivel, Alok Thakar, Mario M. Fernández-Fernández, Smriti Panda, Kapil Sikka, Chirom Amit Singh, Rajeev Kumar, Aanchal Kakkar, Atul Sharma, Suman Bhasker

Publication date 14-12-2021


With the advent of Trans Oral Robotic Surgery (TORS) the ease of transoral procedures has been dramatically improved. TORS is already established for its feasibility, functional and oncological outcomes for selected lesions of oral cavity, oropharynx and laryngopharynx. This study reports on preliminary results with Trans Oral Ultra Sonic Surgery (TOUSS) for oncologic resections of oral cavity, oropharyngeal and supraglottic malignancies. Eighteen patients with malignancies of oral cavity, oropharynx and supraglottis underwent TOUSS with simultaneous neck dissection and adjuvant therapy as indicated, from January 2018 to April 2019. Essential equipment included the FK-retractor (Gyrus Medical, Tuttilngen, Germany) for Trans Oral exposure, the Olympus ENDOEYE Flex 5 mm 2D/10 mm 3D deflecting tip video laparoscopes, and 35 cm long ultrasonic harmonic scalpel (Thunderbeat). Parameters evaluated include tumor staging, mouth opening, TOUSS setup time, TOUSS primary removal time, surgical margins, blood transfusions, tracheostomy, postoperative complications, enteral feeding and resumption of oral diet, duration of hospital stay, and survival outcomes. Eighteen patients underwent complete Trans Oral Ultra Sonic Surgery (TOUSS), with simultaneous unilateral or bilateral neck dissection. No procedure was abandoned intraoperatively due to difficulty in extirpation of the tumor. Margins were negative for ten patients (55.6%), close in five (27.8%), and positive in three patients (16.7%). Average TOUSS set-up time was 22.5 min (range, 10-30 min) and average TOUSS primary tumor removal time was 35.3 min (range, 15-60 min). Patients started tolerating oral feeds even in the second post op day (mean 6 days), and transitioning to complete oral feeds with removal of the nasogastric tube was achieved in all (mean, 16 days). The average hospital stay was 7.4 days (range 2-16 days). Secondary hemorrhage occurred in two cases and required an emergency tracheostomy and ligation of lingual artery. Minor cervicopharyngeal fistula occurred in four cases and settled in all with conservative non-surgical treatment. Overall survival at 3 years was 70.5%, and disease-specific survival was 94.4%. Trans Oral Ultra Sonic Surgery (TOUSS) is a safe and sound alternative method of endoscopic surgical treatment of oral cavity, oropharynx and supraglottic neoplasms. Advantages of this technique include faster resection time, intraoperative assistance from Narrow Band Imaging, easy affordability compared to TORS, and excellent functional outcomes.

Pubmed PDF Web

Effects of Interleukin-6 on STAT3-regulated signaling in oral cancer and as a prognosticator of patient survival

Ling-Ying Wei, Hsuan-Chao Lin, Feng-Chiao Tsai, Jenq-Yuh Ko, Sang-Heng Kok, Shih-Jung Cheng, Jang-Jaer Lee, Jean-San Chia

Publication date 11-12-2021


Human oral squamous cell carcinoma (OSCC) produces an inflammatory microenvironment enriched with cytokines including interleukin-6 (IL-6); however, the underlying molecular mechanisms of OSCC progression are unclear. We aimed to delineate the STAT3-mediated signaling pathways involved in tumor cell survival and growth. Immunohistochemistry was used to semi-quantitate IL-6 and STAT3 in 111 OSCC tissues. IL-6-induced STAT3 signaling pathways and effects on tumor cell survival and progression were investigated in vitro and in xenograft mouse models. Effects of blocking IL-6-induced activation of STAT3 in an OSCC cell line were determined in vitro. A higher level of IL-6 or STAT3 in situ was associated with an unfavorable prognosis in OSCC patients with regard to both disease-free and overall survival rates. Overexpressed or exogenous IL-6 could induce SAS cell proliferationin vitroand significantly enhanced tumor growthin vivo. In addition, knockdown or inhibition of STAT3 expression in SAS cells significantly reduced tumor growth and abolished the responsiveness to IL-6 stimulation. Siltuximab or Tocilizumab could also significantly suppress IL-6-induced STAT3 phosphorylation and STAT3 nuclear translocation, resulting in a significant decrease of downstream anti-apoptotic proteins Bcl-2, Bcl-xL, and survivin. The IL-6 level in the tumor microenvironment could serve as a stage-independent predictor of OSCC progression and survival. Further, IL-6 may play a role in this disease through STAT3-dependent upregulation of anti-apoptotic genes and subsequent proliferation of tumor cells.

Pubmed PDF Web

Omitting elective neck irradiation in clinically N0 sinonasal adenoid cystic carcinoma: A propensity score-matched analysis

Zekun Wang, Runye Wu, Jianghu Zhang, Xuesong Chen, Jingbo Wang, Kai Wang, Yuan Qu, Xiaodong Huang, Jingwei Luo, Jianping Xiao, Guozhen Xu, Li Gao, Junlin Yi, Ye Zhang

Publication date 07-12-2021


To explore the effects of elective neck irradiation (ENI) in clinically node-negative (cN0) sinonasal adenoid cystic carcinoma (SNACC). Between January 2000 and December 2016, 60 patients with cN0 sinonasal adenoid cystic carcinoma receiving surgery combined with radiotherapy were analyzed retrospectively, there were 39 received ENI (ENI group) and 21 with no ENI (non-ENI group). Propensity score matching (PSM) was performed to balance clinical factors and match patients. Kaplan-Meier method and Cox proportional hazard model were used to evaluate the impact of ENI on regional relapse risk and survival outcomes. The median follow-up time for our cohort was 82.0 months (12.4-190.7 months). Four patients (6.7%) developed neck nodal relapses, with a median time to progression of 38.8 months. Among them, two patients in ENI group but failed out-field. After PSM, 21 patients were matched in each group. The 7-year regional relapse-free survival (RRFS), distant metastasis free survival (DMFS), progression-free survival (PFS), and overall survival (OS) between ENI group and non-ENI group were 85.4% vs 73.3% (p = 0.845), 65.2% vs 65.6% (p = 0.548), 68.3% vs 66.2% (p = 0.425), and 87.3% vs 84.0% (p = 0.953). Multivariate Cox analysis showed ENI was not an independent prognostic factor associated with RRFS, DMFS, PFS and OS. Our findings firstly demonstrated the omission of elective neck irradiation in the management of cN0 sinonasal adenoid cystic carcinoma might be safe without compromising disease control and should be further investigated.

Pubmed PDF Web

Modeling oral cancer screening in the United States population

John D. Cramer, Jordan Grauer

Publication date 06-12-2021


To evaluate the impact of oral cancer screening if applied to the United States (US) population or various high-risk populations in the US. We modeled the effects of applying an oral cancer screening program to the US population assuming a similar mortality reduction as seen in the randomized Kerala trial. We combined data on the incidence of oral cancer in the Surveillance, End Results, and Epidemiology database, data on the relative risk in various high-risk groups from the Prostate, Lung, Cervical, and Ovarian screening trial, and the National Lung Screening Trial and data on the prevalence of cigarette use from the National Health Interview Survey. When extrapolating to the US population we predict the number needed to screen to prevent one oral cancer death (NNS) = 9,845 in all individuals aged 35 + . Screening efficiency would increase if applied to higher-risk populations. If oral cancer screening were applied to male ≥ 60 pack-year current smokers or former smokers who have quit within 15 years aged 50-79 we predict a 4.6% reduction in oral cancer mortality with an NNS = 1,485. Targeted screening of individuals at high risk for oral cancer has the potential to maximize the efficiency of screening and meaningfully impact oral cancer mortality. We suggest a future screening trial in high-risk individuals be considered to clarify the role of oral cancer screening in the US.

Pubmed PDF Web

Distant metastasis in oral squamous cell carcinoma: Does the neutrophil-to-lymphocyte ratio act as a surrogate of the host immune status?

Daniella Karassawa Zanoni, Cristina Valero, Marlena R. McGill, Pablo H. Montero, Jatin P. Shah, Richard J. Wong, Ian Ganly, Snehal G. Patel

Publication date 06-12-2021


Distant metastasis (DM) is an important prognostic factor for oral squamous cell carcinoma (OSCC). The aim of this study is to evaluate the influence of host and tumor factors in development of DM. After IRB approval, 1369 patients with OSCC undergoing primary surgery were eligible for the study. The primary endpoint was the development of distant metastasis (DM). Patients were pathologically staged according to the American Joint Committee on Cancer, 8th Edition. Pre-operative peripheral blood counts were used to calculate neutrophil-to-lymphocyte ratio (NLR). Median follow-up was 39 months (range 1-221). DM were identified in 126 patients during follow-up. When analyzed as a time-dependent covariate, neck recurrence (NR) was a significant predictor of DM (HR 16.35, 95% CI: 11.39-23.47, p < 0.001). NLR, margin status, vascular invasion, perineural invasion (PNI), grade, pT, number of metastatic lymph nodes, level IV involvement, and extra nodal-extension (ENE) were also significant. In multivariable analysis, NLR, margins, PNI, number of metastatic lymph nodes, and ENE maintained independent predictive capacity. Patients with NLR ≥ 5.7 were 3 times more likely to develop DM compared to NLR ≤ 2.9 (95% CI: 1.74-5.59, p < 0.001), patients with ≥ 5 metastatic lymph nodes were 2 times more likely to develop DM (95% CI: 1.18-3.60, p = 0.011), and those with ENE were 4 times more likely (95% CI: 2.67-8.20, p < 0.001) when compared to p Nx/pN0 patients. NLR, number of metastatic lymph nodes, and ENE were the strongest independent predictors of DM in OSCC treated with primary surgery and appropriate adjuvant therapy.

Pubmed PDF Web

Pembrolizumab plus docetaxel for the treatment of recurrent/metastatic head and neck cancer: A prospective phase I/II study

Thorsten Fuereder, Christoph Minichsdorfer, Martina Mittlboeck, Christina Wagner, Gerwin Heller, Eva M. Putz, Felicitas Oberndorfer, Leonhard Müllauer, Marie-Bernadette Aretin, Christian Czerny, Ursula Schwarz-Nemec

Publication date 30-11-2021


Taxane-based checkpoint inhibitor combination therapy might improve the outcome in recurrent/metastatic (R/M) head and neck cancer (HNSCC) patients. Thus, we investigated the efficacy and safety of docetaxel (DTX) plus pembrolizumab (P) in a prospective phase I/II trial. Platinum-resistant R/M HNSCC patients received DTX 75 mg/m^ Twenty-two patients were enrolled. Nine patients (40.9%) had a primary tumor in the oropharynx, 8 (36.4%) in the oral cavity, 3 (13.6%) in the hypopharynx and 2 (9.1%) in the larynx. The ORR was 22.7% (95% CI 10.1%-43.4%) and one (4.5%) complete response was achieved. The DCR was 54.6% (95% 34.7%-73.1%). The median PFS was 5.8 months (95% CI 2.7-11.6) and the median OS 21.3 months (95% CI 6.3-31.1). The 1-year PFS and OS rates were 27.3% and 68.2%, respectively. While the most frequent adverse event (AE) was myelosuppression, which was reported in all 22 patients, 3 (13.6%) patients experienced grade 3 febrile neutropenia. The most common immune-related AEs were grade skin rash (40.9%) and hypothyroidism (40.9%). One patient (4.5%) experienced grade 5 immune thrombocytopenia. DXT in combination with P shows promising activity accompanied with a manageable side effect profile in pre-treated R/M HNSCC patients.

Pubmed PDF Web

Chemotherapeutics-induced osteonecrosis of the jaw in a patient with acute promyelocytic leukemia: A rare case report

Liping Wang, Junhui Huang, Zhangui Tang

Publication date 11-12-2021


Medication related osteonecrosis of the jaw (MRONJ) is a commonly observed adverse reaction after taking anti-resorption and anti-angiogenic drugs. As we all know, arsenic compounds are used as drugs for pulp devitalization therapy and its local diffusion can cause osteonecrosis. As the treatment of leukemia, the medical records of osteonecrosis are rarely reported. Arsenic compounds may be a potential risk factor for osteonecrosis, which should be brought to the attention of dentists.

Pubmed PDF Web

Systematic review and meta-analysis of randomized controlled trials comparing elective neck dissection versus sentinel lymph node biopsy in early-stage clinically node-negative oral and/or oropharyngeal squamous cell carcinoma: Evidence-base for practice and implications for research

Tejpal Gupta, Guncha Maheshwari, Sadhana Kannan, Sudhir Nair, Pankaj Chaturvedi, Jai Prakash Agarwal

Publication date 04-12-2021


Management of clinically node-negative (N0) neck in early-stage (T1-T2) oral and/or oropharyngeal squamous cell carcinoma (OOSCC) has been controversial. The purpose of this systematic review and meta-analysis was to compare sentinel lymph node biopsy (SLNB) with elective neck dissection (END) in early-stage OOSCC. Studies comparing SLNB versus END in early-stage clinically node-negative OOSCC were identified using validated search strategy. To be considered eligible, trials had to include patients with early-stage, clinically node-negative OOSCC who had been randomly assigned to either SLNB or END. Primary outcome of interest was overall survival (OS), while secondary outcomes included isolated neck nodal recurrence (NNR), loco-regional recurrence (LRR), and neck-shoulder function. Outcome data was pooled using random-effects model and reported as hazard ratio (HR) or risk ratio (RR) with 95% confidence interval (CI). Any p-value < 0.05 was considered statistically significant. A total of 608 patients from three trials comparing SLNB versus END in early-stage clinically node-negative OOSCC were included. The pooled HR of death for SLNB versus END was 1.18 (95% CI: 0.79-1.78, p = 0.41) which was not statistically significant. The rates of isolated NNR (pooled RR = 1.11, 95% CI: 0.69-1.80, p = 0.66) and LRR (pooled RR = 1.18, 95% CI: 0.81-1.72, p = 0.39) were also similar. Pooled analysis of the neck-shoulder function significantly favoured SLNB arm (pooled RR = 1.21, 95% CI: 1.12-1.32, p < 0.00001). There is low-certainty evidence that SLNB is oncologically non-inferior to END and is associated with potentially lesser functional morbidity making it an emerging alternative standard of care in patients with early-stage clinically node-negative OOSCC.

Pubmed PDF Web

Lymph node yield and ratio in the central compartment

Ashok R. Shaha

Publication date 14-12-2021


Pubmed PDF Web

ERα: A biomarker and treatment target for oropharyngeal cancer?

Michael M. Li, Edmund A. Mroz, William C. Faquin, Abberly Lott-Limbach, James W. Rocco

Publication date 04-12-2021


Pubmed PDF Web

Adjuvant chemotherapy in locoregionally advanced nasopharyngeal carcinoma: Finding the suitable population

Bi-Cheng Wang

Publication date 02-10-2021


Pubmed PDF Web

Copyright © KNO-T, 2020 | R/Abma