Molecular profiling of head and neck squamous cell carcinoma.

Molecular profiling of head and neck squamous cell carcinoma.

Head Neck. 2015 Nov 28;

Authors: Feldman R, Gatalica Z, Knezetic J, Reddy S, Nathan CA, Javadi N, Teknos T

Abstract
BACKGROUND: Head and neck squamous cell carcinoma (HNSCC) exhibits high rates of recurrence, and with few approved targeted agents, novel treatments are needed. We analyzed a molecular profiling database for the distribution of biomarkers predictive of chemotherapies and targeted agents.
METHODS: Seven hundred thirty-five patients with advanced HNSCC (88 with known human papillomavirus [HPV] status), were profiled using multiple platforms (gene sequencing, gene copy number, and protein expression).
RESULTS: Among the entire patient population studied, epidermal growth factor receptor (EGFR) was the protein most often overexpressed (90%), TP53 gene most often mutated (41%), and phosphatidylinositol 3-kinase (PIK3CA) most often amplified (40%; n = 5). With the exception of TP53 mutation, other biomarker frequencies were not significantly different among HPV-positive or HPV-negative patients. PIK3CA mutations and phosphatase and tensin homolog (PTEN) loss are frequent events, independent of HPV status. The immune response-modulating programmed cell death 1 (PD1) and programmed cell death ligand 1 (PDL1) axis was active across sites, stages, and HPV status.
CONCLUSION: Molecular profiling utilizing multiple platforms provides a range of therapy options beyond standard of care. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26614708 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1OxQBZc
via IFTTT

Influence of thyroid gland status on the thyroglobulin cutoff level in washout fluid from cervical lymph nodes of patients with recurrent/metastatic papillary thyroid cancer.

Influence of thyroid gland status on the thyroglobulin cutoff level in washout fluid from cervical lymph nodes of patients with recurrent/metastatic papillary thyroid cancer.

Head Neck. 2015 Nov 28;

Authors: Lee JH, Lee HC, Yi HW, Kim BK, Bae SY, Lee SK, Choe JH, Kim JH, Kim JS

Abstract
BACKGROUND: The influence of serum thyroglobulin (Tg) and thyroidectomy status on Tg in fine-needle aspiration cytology (FNAC) washout fluid is unclear.
METHODS: A total of 282 lymph nodes were prospectively subjected to FNAC, fine-needle aspiration (FNA)-Tg measurement, and frozen and permanent biopsies. We evaluated the diagnostic performance of several predetermined FNA-Tg cutoff values for recurrence/metastasis in lymph nodes according to thyroidectomy status.
RESULTS: The diagnostic performance of FNA-Tg varied according to thyroidectomy status. The optimized cutoff value of FNA-Tg was 2.2 ng/mL. However, among FNAC-negative lymph nodes, the FNA-Tg cutoff value of 0.9 ng/mL showed better diagnostic performance in patients with a thyroid gland. An FNA-Tg/serum-Tg cutoff ratio of 1 showed the best diagnostic performance in patients without a thyroid gland.
CONCLUSION: Applying the optimal cutoff values of FNA-Tg according to thyroid gland status and serum Tg level facilitates the diagnostic evaluation of neck lymph node recurrences/metastases in patients with papillary thyroid carcinoma (PTC). © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26614648 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1Q6dQeB
via IFTTT

Human papillomavirus and induction chemotherapy versus concurrent chemoradiotherapy in locally advanced oropharyngeal cancer: The Dana Farber Experience.

Human papillomavirus and induction chemotherapy versus concurrent chemoradiotherapy in locally advanced oropharyngeal cancer: The Dana Farber Experience.

Head Neck. 2015 Nov 28;

Authors: Lorch JH, Hanna GJ, Posner MR, O'Neill A, Thotakura VL, Limaye SA, Rabinowits G, Sher DJ, Tischler RB, Haddad RI

Abstract
BACKGROUND: Human papillomavirus (HPV) infection indicates favorable prognosis in oropharyngeal squamous cell carcinoma (SCC). The purpose of this study was for us to assess the impact of HPV in patients treated with sequential therapy versus concomitant chemoradiotherapy (CRT).
METHODS: Patients with stage III and IVA and B oropharyngeal SCC were reviewed spanning 10 years.
RESULTS: Among 500 cases, 291 (58%) received CRT versus 209 (42%) sequential therapy. HPV status was known in 279 of patients (56%) and positive in 77% (determined by polymerase chain reaction [PCR; 91%], p16 immunohistochemical [IHC], or both). Median follow-up was 2.8 years. Overall survival (OS) did not differ for sequential therapy versus CRT overall (hazard ratio [HR] = 0.90; p = .66; 3-year OS = 86% and 87%) or within HPV-positive patients (HR = 0.89; p = .81; 3-year OS = 91% and 91%) or within HPV-negative patients (HR = 0.55; p = .32; 3-year OS = 85% and 75%).
CONCLUSION: Survival for all patients was high and notable for HPV-negative patients treated with sequential therapy. Further studies in this patient population are warranted. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26614576 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1OxQBZ0
via IFTTT

Quality assessment in head and neck oncologic surgery in a Brazilian cancer center compared with MD Anderson Cancer Center benchmarks.

Quality assessment in head and neck oncologic surgery in a Brazilian cancer center compared with MD Anderson Cancer Center benchmarks.

Head Neck. 2015 Nov 28;

Authors: Lira RB, de Carvalho AY, de Carvalho GB, Lewis CM, Weber RS, Kowalski LP

Abstract
BACKGROUND: Quality assessment is a major tool for evaluation of health care delivery. In head and neck surgery, the University of Texas MD Anderson Cancer Center (MD Anderson) has defined quality standards by publishing benchmarks.
METHODS: We conducted an analysis of 360 head and neck surgeries performed at the AC Camargo Cancer Center (AC Camargo). The procedures were stratified into low-acuity procedures (LAPs) or high-acuity procedures (HAPs) and outcome indicators where compared to MD Anderson benchmarks.
RESULTS: In the 360 cases, there were 332 LAPs (92.2%) and 28 HAPs (7.8%). Patients with any comorbid condition had a higher incidence of negative outcome indicators (p = .005). In the LAPs, we achieved the MD Anderson benchmarks in all outcome indicators. In HAPs, the rate of surgical site infection and length of hospital stay were higher than what is established by the benchmarks.
CONCLUSION: Quality assessment of head and neck surgery is possible and should be disseminated, improving effectiveness in health care delivery. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26614545 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1Q6dOmO
via IFTTT

Management of the cervico-petrous internal carotid artery in class C tympanojugular paragangliomas.

Management of the cervico-petrous internal carotid artery in class C tympanojugular paragangliomas.

Head Neck. 2015 Nov 28;

Authors: Bacciu A, Prasad SC, Sist N, Rossi G, Piazza P, Sanna M

Abstract
BACKGROUND: Management of the cervical and petrous internal carotid artery (ICA) is frequently required in Fisch class C tympanojugular paragangliomas (TJPs). The purpose of this study was to discuss the perioperative intervention of the ICA in patients who underwent surgical resection of a TJP.
METHODS: A retrospective study of 237 patients surgically treated for Fisch class C TJPs was done to identify cases that required ICA management.
RESULTS: Management of the ICA was required in 176 patients (74.2%). Forty-two patients required just an ICA decompression, 88 underwent a subperiosteal dissection, 19 underwent subadventitial dissection without intraluminal stenting, 17 underwent subadventitial dissection with intraluminal stenting, and 12 underwent arterial resection after permanent balloon occlusion. There were no complications associated with the endovascular procedures. Gross total tumor resection was achieved in 91.5% of the cases.
CONCLUSION: Preoperative endovascular intervention, in selected cases, facilitates gross total tumor removal and significantly reduces the risk of an intraoperative ICA injury. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26614405 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1OxQBIG
via IFTTT

Pretreatment serum xanthophyll concentrations as predictors of head and neck cancer recurrence and survival.

Pretreatment serum xanthophyll concentrations as predictors of head and neck cancer recurrence and survival.

Head Neck. 2015 Nov 28;

Authors: Arthur AE, Bellile EL, Rozek LS, Peterson KE, Ren J, Harris E, Mueller C, Jolly S, Peterson LA, Wolf GT, Djuric Z

Abstract
BACKGROUND: The purpose of this study was to examine associations of pretreatment serum carotenoids, tocopherols, and quercetin with prognosis in 154 patients newly diagnosed with head and neck cancer.
METHODS: Pretreatment blood and health surveys were collected. Serum micronutrients were measured by high performance liquid chromatography. Data on recurrence and death were collected annually. Cox proportional hazards models measured associations of serum nutrient concentrations with recurrence and overall survival.
RESULTS: During a median follow-up time of 37 months, there were 32 recurrences and 27 deaths. After controlling for covariates, subjects with high versus low serum xanthophyll and total carotenoid concentrations had significantly longer recurrence-free time (p = .002 and p = .02, respectively). Overall survival time was significantly longer in patients with high versus low serum xanthophyll concentrations (p = .02).
CONCLUSION: Future research should evaluate the possible benefits of interventions to increase intakes of rich food sources of xanthophylls in this patient population. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26614223 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1Q68csZ
via IFTTT

Impact of elective neck dissection on the outcome of oral squamous cell carcinomas arising in the maxillary alveolus and hard palate.

Impact of elective neck dissection on the outcome of oral squamous cell carcinomas arising in the maxillary alveolus and hard palate.

Head Neck. 2015 Nov 28;

Authors: Givi B, Eskander A, Awad MI, Kong Q, Montero PH, Palmer FL, Xu W, De Almeida JR, Lee N, O'Sullivan B, Irish JC, Gilbert R, Ganly I, Patel SG, Goldstein DP, Morris LG

Abstract
BACKGROUND: Whether elective lymph neck dissection (ELND) is associated with improved survival in oral squamous cell carcinomas (SCC) of the maxillary alveolus/hard palate is not known.
METHODS: One hundred ninety-nine patients presenting de novo and receiving treatment for clinically node negative SCC of the maxillary alveolus/hard palate at 2 cancer centers between 1985 and 2011 were analyzed.
RESULTS: Forty-two patients (21%) received ELND. Occult nodal metastases were present in 29% of the dissected necks. The ELND group had more T3 to T4 status tumors (62% vs 34%; p < .001) and positive-margin resections (59% vs 38%; p = .019). Patients undergoing ELND experienced lower rates of neck recurrence (6% vs 21%; p = .031), superior 5-year recurrence-free survival (68% vs 45%; p = .026), and overall survival (86% vs 62%; p = .043). ELND was associated with a 2-fold decrease in risk of recurrence in multivariable analysis.
CONCLUSION: ELND was associated with lower rates of recurrence and improved survival in SCC of the maxillary alveolus/hard palate. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26614119 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1Q6dO6w
via IFTTT

Degree of nephrotoxicity after intermediate- or high-dose cisplatin-based chemoradiotherapy in patients with locally advanced head and neck cancer.

Degree of nephrotoxicity after intermediate- or high-dose cisplatin-based chemoradiotherapy in patients with locally advanced head and neck cancer.

Head Neck. 2015 Nov 28;

Authors: Driessen CM, Uijen MJ, van der Graaf WT, van Opstal CC, Kaanders JH, Nijenhuis T, van Herpen CM

Abstract
BACKGROUND: The purpose of this study was to compare the occurrence of cisplatin-induced nephrotoxicity between concomitant chemoradiotherapy with high versus intermediate-dose cisplatin.
METHODS: One hundred forty-four patients with locally advanced head and neck or nasopharyngeal cancer (NPC) were included; 40 patients received cisplatin 100 mg/m(2) (high dose) on days 1, 22, and 43, and 104 patients received cisplatin 40 mg/m(2) weekly (intermediate dose) during 6 weeks in combination with radiotherapy.
RESULTS: During treatment with intermediate-dose cisplatin, 6.7% developed an increase of ≥50% serum creatinine versus 60.0% treated with high-dose cisplatin (p < .05). Nephrotoxicity (all grades) scored by Common Toxicity Criteria for Adverse Events (CTCAE) version 3.0 or CTCAE version 4.03 was 53% and 100% in the high-dose group and 4.8% and 68% in the intermediate-dose group, respectively.
CONCLUSION: Significantly less nephrotoxicity occurs during chemoradiotherapy with intermediate-dose cisplatin compared with high-dose cisplatin. The CTCAE version 4.03 seems to be more appropriate in scoring nephrotoxicity than the CTCAE version 3.0. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26614010 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1OxQE77
via IFTTT

Adjuvant radiotherapy for early head and neck squamous cell carcinoma with perineural invasion: A systematic review.

Adjuvant radiotherapy for early head and neck squamous cell carcinoma with perineural invasion: A systematic review.

Head Neck. 2015 Nov 28;

Authors: Bur AM, Lin A, Weinstein GS

Abstract
Perineural invasion (PNI) is widely regarded as a negative prognostic factor in head and neck squamous cell carcinoma (HNSCC). Treatment guidelines recommend adjuvant radiotherapy (RT) for patients with adverse pathologic features, including PNI. The purpose of this study was to systematically review the literature to determine if patients with PNI as their only indication for adjuvant therapy benefit from adjuvant RT. In total, 339 abstracts were reviewed for relevance leaving 85 articles, which were evaluated in detail. Thirteen retrospective studies addressed the role of adjuvant RT for patients with PNI. Evidence is lacking to recommend adjuvant RT for all patients with HNSCC with PNI. However, the literature suggests that large nerve or multifocal PNI may predict worse outcome and may be a more appropriate indication for adjuvant therapy. We advocate that patients decide whether to undergo adjuvant therapy after a discussion of the limitations of current evidence. © 2015 Wiley Periodicals, Inc. Head Neck 00: 000-000, 2015.

PMID: 26613965 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1Q6dO6p
via IFTTT

Recent advances in optical diagnosis of oral cancers: Review and future perspectives.

Recent advances in optical diagnosis of oral cancers: Review and future perspectives.

Head Neck. 2015 Nov 28;

Authors: Singh SP, Ibrahim O, Byrne HJ, Mikkonen JW, Koistinen AP, Kullaa AM, Lyng FM

Abstract
Optical diagnosis techniques offer several advantages over traditional approaches, including objectivity, speed, and cost, and these label-free, noninvasive methods have the potential to change the future workflow of cancer management. The oral cavity is particularly accessible and, thus, such methods may serve as alternate/adjunct tools to traditional methods. Recently, in vivo human clinical studies have been initiated with a view to clinical translation of such technologies. A comprehensive review of optical methods in oral cancer diagnosis is presented. After an introduction to the epidemiology and etiological factors associated with oral cancers currently used, diagnostic methods and their limitations are presented. A thorough review of fluorescence, infrared absorption, and Raman spectroscopic methods in oral cancer diagnosis is presented. The applicability of minimally invasive methods based on serum/saliva is also discussed. The review concludes with a discussion on future demands and scope of developments from a clinical point of view. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26613806 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1Q6dN2e
via IFTTT

Treatment of squamous cell carcinoma of the posterior pharyngeal wall: Radiotherapy versus surgery.

Treatment of squamous cell carcinoma of the posterior pharyngeal wall: Radiotherapy versus surgery.

Head Neck. 2015 Nov 28;

Authors: De Felice F, Blanchard P, Levy A, Nguyen F, Gorphe P, Janot F, Temam S, Tao Y

Abstract
BACKGROUND: Treatment strategy in squamous cell carcinoma (SCC) of the posterior pharyngeal wall is still being debated.
METHODS: We performed a retrospective analysis according to delivered treatment.
RESULTS: One hundred eighty patients were treated between 1997 and 2011. Eighty-nine patients (49.4%) received surgery +/- radiotherapy (RT), whereas 91 (50.6%) received definitive RT +/- chemoradiotherapy (RT/CRT). Five-year overall survival (OS) was 33.4%. There was a significant 5-year OS benefit in surgical treatment versus RT/CRT (43% vs 24.1%; p = .002). Multivariate analysis showed that current smokers, T3 to T4 classification, well-differentiated SCC, and nonsurgical treatment were associated with reduced OS. Subgroup analysis showed significant survival benefit of surgical treatment compared with RT/CRT in patients with T1 to T2 but not in T3 to T4 disease.
CONCLUSION: Surgical management translated into a survival benefit, even in early T classification. These results should be interpreted with caution for selection bias. Surgery remains the standard of care in localized posterior pharyngeal wall SCC. Primary CRT should be considered for nonoperable disease. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26613802 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1OxQDQI
via IFTTT

Psychometric evaluation of the Swallowing Outcomes After Laryngectomy (SOAL) patient-reported outcome measure.

Psychometric evaluation of the Swallowing Outcomes After Laryngectomy (SOAL) patient-reported outcome measure.

Head Neck. 2015 Nov 28;

Authors: Govender R, Lee MT, Drinnan M, Davies T, Twinn C, Hilari K

Abstract
BACKGROUND: The purpose of this study was to evaluate the psychometric properties of the Swallowing Outcomes After Laryngectomy (SOAL) in a large group of people who underwent a laryngectomy.
METHODS: We conducted a cross-sectional psychometric study of laryngectomy patients (minimum 3 months posttreatment) attending routine hospital follow-up for the psychometric evaluation of SOAL.
RESULTS: One hundred ten people participated in this study. Thirteen percent of the patients had a laryngectomy, 63% had laryngectomy with radiotherapy, and 24% had laryngectomy with chemoradiation therapy. The SOAL showed good quality of data (minimal missing data and floor effects); good internal consistency (α = 0.91); and adequate test-retest reliability (intra-class correlation coefficient = 0.73). In terms of validity, it differentiated people by treatment group (F(2,85) = 8.02; p = .001) and diet texture group (t(102) = -7.33; p < .001).
CONCLUSION: The SOAL demonstrates good validity and has potential for use in research. Further study is required to determine its clinical application. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26613682 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1Tl3B6d
via IFTTT

Influence of social factors on patient-reported late symptoms: Report from a controlled trial among long-term head and neck cancer survivors in Denmark.

Influence of social factors on patient-reported late symptoms: Report from a controlled trial among long-term head and neck cancer survivors in Denmark.

Head Neck. 2015 Nov 28;

Authors: Kjaer TK, Johansen C, Andersen E, Karlsen R, Nielsen AL, Frederiksen K, Rørth M, Ibfelt E, Dalton SO

Abstract
BACKGROUND: The incidence of head and neck cancer and morbidity and mortality after treatment are associated with social factors. Whether social factors also play a role in the prevalence of late-onset symptoms after treatment for head and neck cancer is not clear.
METHODS: Three hundred sixty-nine survivors completed questionnaires on late symptoms and functioning.
RESULTS: Survivors with short education were more likely to report severe problems than those with medium or long education. In the fully adjusted model, the risk for problems with opening the mouth remained significantly increased (odds ratio [OR] = 3.20; 95% confidence interval [CI] = 1.18-8.63). For survivors who lived alone, the adjusted ORs were significantly increased for physical functioning (2.17; 95% CI = 1.01-4.68) and trouble with social eating (OR = 2.26; 95% CI = 1.14-4.47).
CONCLUSION: Self-reported severe late symptoms were more prevalent in survivors with short education and in those living alone, suggesting differences in perception of late symptoms between social groups. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26613661 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1Xp4CzY
via IFTTT

Comprehensive Postoperative Management After Endoscopic Skull Base Surgery.

Comprehensive Postoperative Management After Endoscopic Skull Base Surgery.

Otolaryngol Clin North Am. 2016 Feb;49(1):253-263

Authors: Tien DA, Stokken JK, Recinos PF, Woodard TD, Sindwani R

Abstract
To maximize outcomes from endoscopic skull base surgery, careful early postoperative management is critically important. Standardized postoperative regimens are lacking. The type of reconstruction and presence and type of cerebrospinal fluid leak dictate management. If a leak is encountered intraoperatively, patients should avoid maneuvers that increase intracranial pressures for at least 1 month. Early postoperative care focuses on minimizing and managing nasal crusting. This article reviews the evidence in the literature on postoperative management, complications, and quality of life after surgery, and outlines our experience in the management of patients after endoscopic skull base surgery.

PMID: 26614842 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1ResYYc
via IFTTT

Cerebrospinal Fluid Diversion in Endoscopic Skull Base Reconstruction: An Evidence-Based Approach to the Use of Lumbar Drains.

Cerebrospinal Fluid Diversion in Endoscopic Skull Base Reconstruction: An Evidence-Based Approach to the Use of Lumbar Drains.

Otolaryngol Clin North Am. 2016 Feb;49(1):119-129

Authors: Tien DA, Stokken JK, Recinos PF, Woodard TD, Sindwani R

Abstract
Before the vascularized pedicled nasoseptal flap was popularized, lumbar drains (LDs) were routinely used for cerebral spinal fluid (CSF) diversion in endoscopic skull base reconstruction. LDs are not necessary in most CSF leaks encountered during skull base surgery. In this article, the use is considered of an LD in select high-risk settings in which a high-flow leak is anticipated and the patient has significant risk factors that make closure of the leak more challenging. Evidence for the use of LDs in preventing postoperative after endoscopic skull base reconstruction is reviewed and a rational framework for their use is proposed.

PMID: 26614832 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1ResVf4
via IFTTT