Oral oncology最新文献

英文中文

Frozen section analysis in HPV-associated squamous cell carcinoma of unknown primary: Clinical and pathological considerations 原发不明的hpv相关鳞状细胞癌的冷冻切片分析：临床和病理考虑。

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-03-01 Epub Date: 2026-02-02 DOI: 10.1016/j.oraloncology.2026.107878

Carlos M. Ardila , Anny Marcela Vivares-Builes , Eliana Pineda-Vélez

引用次数: 0

Analysis of osteotomy distance and other predictors of osseous union following mandibular reconstruction with fibula free flap 腓骨游离瓣下颌骨重建术后骨愈合的截骨距离及其他预测因素分析。

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-03-01 Epub Date: 2026-02-06 DOI: 10.1016/j.oraloncology.2026.107883

Maged Ali Al-Aroomi , Yiheng Feng , Naseem Ali Al-Worafi , Jie Chen , Ning Li , Canhua Jiang , Ye Liang

Objectives

Optimal contouring of fibula free flaps (FFF) for mandibulectomy often requires osteotomies. This study aimed to define criteria for initial gap width by evaluating whether postoperative gap size and other factors influence long-term osseous union on CBCT, and to identify key determinants of bone healing.

Methods

This retrospective study included 75 patients who underwent segmental mandibulectomy with FFF reconstruction from 2017 to 2024. Initial osteotomy gaps were measured at four points on postoperative CBCT scans. Osseous union was assessed using a callus scale. Demographic, anatomical, and surgical variables—including 3D-assisted planning, fibula morphology, osteotomy location, systemic comorbidities, and segment number —were analyzed using uni- and multivariate regression models.

Results

A total of 202 osteotomy sites were evaluated. The mean initial gap was 1.68 ± 0.97 mm, and gap size did not significantly predict long-term union. Complete union occurred in 50.0% of sites, partial union in 36.6%, and nonunion in 13.4%. Fibula–fibula interfaces showed significantly better healing than fibula–mandible interfaces (p < 0.001). Symphyseal osteotomies demonstrated superior union compared with body and angle regions. Systemic vascular comorbidities were strong negative predictors of union, whereas reconstructions using more than two segments showed improved outcomes (p < 0.001). Alcohol consumption negatively affected both initial gap formation and union.

Conclusions

Long-term osseous union after FFF reconstruction is influenced mainly by systemic vascular health, osteotomy location, interface type, and fibula morphology rather than initial gap width.

目的：最佳轮廓的腓骨游离皮瓣（FFF）下颌骨切除术往往需要截骨。本研究旨在通过评估术后间隙大小和其他因素是否影响CBCT上的长期骨愈合来确定初始间隙宽度的标准，并确定骨愈合的关键决定因素。方法：本回顾性研究包括2017年至2024年接受下颌节段切除术并进行FFF重建的75例患者。术后CBCT扫描在四个点测量初始截骨间隙。骨愈合用愈伤组织量表评估。人口统计学、解剖学和外科变量——包括3d辅助规划、腓骨形态、截骨位置、全身合并症和节段数量——使用单变量和多变量回归模型进行分析。结果：共评估202个截骨部位。平均初始间隙为1.68±0.97 mm，间隙大小对长期愈合无显著影响。50.0%的位点完全愈合，36.6%的位点部分愈合，13.4%的位点不愈合。结论：FFF重建后的长期骨愈合主要受全身血管健康、截骨位置、界面类型和腓骨形态的影响，而不是初始间隙宽度的影响。

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引用次数: 0

Carcinoma of the parotid Gland: A Population-Based study of incidence and treatment outcomes in 1018 patients 腮腺癌：1018例患者发病率和治疗结果的基于人群的研究

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-03-01 Epub Date: 2026-01-23 DOI: 10.1016/j.oraloncology.2026.107863

K. Sandström , L. Farnebo , A. Hafström , A. Westerborn , M. Olin , E. Hammerlid , L. Hammarstedt-Nordenvall , M. Gebre-Medhin , B. Granström , T. Andersson-Säll , G. Laurell

Intro

Population-based studies predominantly focused on carcinoma of the parotid gland (CPG) are rare. The study aims were to analyze the incidence of CPG and to assess treatment outcomes in relation to histopathology, preoperative diagnosis and adjuvant radiotherapy.

Methods

A retrospective analysis was conducted on data from the Swedish Head and Neck Cancer Register (SweHNCR), including 1,018 patients diagnosed with CPG between 2008 and 2019.

Results

The age-adjusted incidence remained stable with a mean of 0.9 (range 0.65–1.08) cases per 100,000 person-years (ASR-Europe). Curative treatment was administered to 90 % of the patients, with a recurrence rate of 9 % within 3 years. The highest recurrence rates were observed in patients with salivary duct carcinoma and adenocarcinoma, while patients with acinic cell and mucoepidermoid carcinomas had lower recurrence rates. For stage I–II tumors, the 5-year relative survival was unaffected by whether the malignant diagnosis was known preoperatively. Male sex, increasing age, stage III–IV disease, and a World Health Organization/ Eastern Cooperative Oncology Group (WHO/ECOG) performance status 2–4 was independently associated with increased overall mortality risk, whereas the timing of adjuvant radiotherapy was not.

Conclusion

This study contributes to establishing the incidence and treatment outcomes of CPG in Sweden and highlights the diverse histopathological diagnoses of these tumors. Notably, unknown malignancy at the time of surgery did not impact survival in early-stage disease, and the timing of postoperative radiotherapy was not associated with overall survival.

以人群为基础的研究主要集中在腮腺癌（CPG）是罕见的。本研究的目的是分析CPG的发生率，并评估与组织病理学、术前诊断和辅助放疗相关的治疗结果。方法回顾性分析瑞典头颈癌登记处（SweHNCR）的数据，包括2008年至2019年诊断为CPG的1018例患者。结果年龄调整后的发病率保持稳定，平均为每10万人年0.9例（范围0.65-1.08）（ASR-Europe）。90%的患者得到根治，3年内复发率为9%。涎腺管癌和腺癌复发率最高，腺泡细胞癌和黏液表皮样癌复发率较低。对于I-II期肿瘤，5年相对生存率不受术前是否知道恶性诊断的影响。男性、年龄增长、III-IV期疾病和世界卫生组织/东方肿瘤合作组织（WHO/ECOG）的表现状况2-4与总体死亡风险增加独立相关，而辅助放疗的时机则无关。结论本研究有助于确定瑞典CPG的发病率和治疗结果，并强调了这些肿瘤的多种组织病理学诊断。值得注意的是，手术时未知的恶性肿瘤不影响早期疾病的生存，术后放疗的时间与总生存无关。

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引用次数: 0

Integrating betel nut control into routine health management strategies 将槟榔控制纳入日常健康管理策略

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-03-01 Epub Date: 2026-01-30 DOI: 10.1016/j.oraloncology.2026.107875

Xinjia Cai , Saman Warnakulasuriya

引用次数: 0

Prognostic associations of systemic inflammation response index (SIRI) in patients with head and neck cancer: a systematic review and meta-analysis 头颈癌患者全身炎症反应指数（SIRI）与预后的相关性：一项系统综述和荟萃分析

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-03-01 Epub Date: 2026-01-23 DOI: 10.1016/j.oraloncology.2026.107859

Neil D. Almeida , Tyler V. Schrand , Daniel Sullivan , Han Yu , Song Yao , Sung Jun Ma , Andrew Koempel , Dukagjin Blakaj , Elizabeth A. Repasky , Craig M. Brackett , David W. Goodrich , Elizabeth G. Bouchard , Mukund Seshadri , Mark K. Farrugia , Anurag K. Singh

Background/Objectives: Inflammation and immune evasion are linked to tumor progression. This cancer-related inflammatory response is reflected by a biomarker named the systemic inflammatory response (SIRI). SIRI is calculated by multiplying the peripheral blood neutrophil and monocyte counts and dividing by the lymphocyte count is a biomarker that has shown prognostic capacity in squamous cell head and neck cancer. We sought to perform a meta-analysis of SIRI data for head and neck cancer. Methods: A meta-analysis using a mixed-effects model was performed to estimate the overall effect size of prognostic capacity. The primary outcomes of interest were overall survival and progression-free survival, with effect sizes measured as log hazard ratios (HR). Results: Ten studies reporting data on overall survival revealed a pooled HR of 2.4 (p < 0.0001). This indicates higher SIRI patients are at greater risk of mortality relative to lower SIRI patients. Additionally, 3 studies reported metrics on progression-free survival, with a pooled HR of 2.32 (1.72, 3.13) (p < 0.0001). Minimal heterogeneity was observed for progression-free survival (I2 = 0%, p< 0.74). Conclusions: High SIRI portends worse overall survival. Since SIRI correlates to immune function and demonstrated minimal heterogeneity, these factors are among those most likely to be impacted by altered SIRI parameters.

背景/目的：炎症和免疫逃避与肿瘤进展有关。这种与癌症相关的炎症反应由一种名为全身炎症反应（SIRI）的生物标志物反映。SIRI是通过将外周血中性粒细胞和单核细胞计数相乘并除以淋巴细胞计数来计算的，这是一种生物标志物，已显示出鳞状细胞头颈癌的预后能力。我们试图对头颈癌的SIRI数据进行荟萃分析。方法：采用混合效应模型进行meta分析，估计预后能力的总体效应大小。研究的主要结局是总生存期和无进展生存期，效应量以对数风险比（HR）衡量。结果：10项报告总生存数据的研究显示，总风险比为2.4 （p < 0.0001）。这表明，相对于低SIRI患者，高SIRI患者的死亡风险更大。此外，3项研究报告了无进展生存指标，总风险比为2.32 (1.72,3.13)（p < 0.0001）。无进展生存期的异质性最小（I2 = 0%, p< 0.74）。结论：高SIRI预示着较差的总生存率。由于SIRI与免疫功能相关，且表现出最小的异质性，因此这些因素最有可能受到SIRI参数改变的影响。

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引用次数: 0

Economic evaluation of microvascular reconstruction of the jaw: A micro-costing analysis and identification of key cost-drivers 颌骨微血管重建的经济评估：微观成本分析和关键成本驱动因素的识别。

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-03-01 Epub Date: 2026-02-07 DOI: 10.1016/j.oraloncology.2026.107885

George A. Petrides , Masako Dunn , Ashleigh R. Sharman , Catriona Froggat , Timothy G.H. Manzie , Blaise Agresta , David Beard , Hansoo Kim , Michael Boyer , Rebecca L. Venchiarutti , Tsu-Hui (Hubert) Low , David Leinkram , Sydney Ch’ng , James Wykes , Carsten Palme , Jonathan R. Clark

Purpose

Efficient resource allocation in surgery requires thorough economic evaluation that reflects the true costs of a procedure, with micro-costing being a primary method. Existing economic studies on microvascular jaw reconstruction of the jaw often exclude or estimate key cost-drivers. The aim of this study was to estimate the direct financial costs and cost-drivers associated with surgical reconstruction of the jaw from the perspective of the healthcare provider.

Methods

A retrospective micro-costing study from the perspective of the healthcare provider was performed on 100 patients who underwent mandibular or maxillary free flap reconstruction. Direct financial costs of activities (in USD) from admission to discharge were examined, and classified into operative and perioperative admission periods.

Results

The mean cost for the entire admission was $36,415.95 ± 14,246.56 comprising 57.7% from the operative period and 42.3% from the perioperative admission period. Ward staffing and consumables (35.7%), prostheses (25.0%), and operating room staffing (21.0%) were the largest cost contributors. In adjusted analyses, higher costs were associated with vasculopathy (+$9142.02, p = 0.044), ASA IV ($19,495.93, p = 0.023), tracheostomy (+$10,445.81, p = 0.012), return to the operating room (+$19,920.22, p = 0.005), and return to the intensive care unit (+$25,316.26, p = 0.014).

Conclusion

Jaw reconstruction is associated with considerable direct financial costs to the healthcare provider with complications requiring return to the operating room and/or return to the intensive care unit the critical key cost-drivers. These insights will support future health technology assessments focused on jaw reconstruction to assist decision-makers in implementing or reimbursing these procedures.

目的：外科手术中有效的资源分配需要全面的经济评估，以反映手术的真实成本，微观成本是主要方法。现有的关于下颌微血管重建的经济研究往往排除或估计了关键的成本驱动因素。本研究的目的是从医疗保健提供者的角度估计与颌骨手术重建相关的直接财务成本和成本驱动因素。方法：从医疗保健提供者的角度对100例接受下颌骨游离皮瓣重建的患者进行回顾性微观成本研究。检查从入院到出院的直接财务成本（以美元计），并将其分为手术期和围手术期。结果：整个住院期的平均费用为36,415.95±14,246.56美元，其中57.7%来自手术期，42.3%来自围手术期。病房人员和耗材（35.7%）、假体（25.0%）和手术室人员（21.0%）是最大的成本贡献者。在调整分析中，较高的费用与血管病变（+ 9142.02美元，p = 0.044）、ASA IV（+ 19,495.93美元，p = 0.023）、气管造口术（+ 10,445.81美元，p = 0.012）、返回手术室（+ 19,920.22美元，p = 0.005）和返回重症监护病房（+ 25,316.26美元，p = 0.014）相关。结论：颌骨重建与医疗保健提供者的直接经济成本相关，并发症需要返回手术室和/或返回重症监护病房是关键的关键成本驱动因素。这些见解将支持未来以颌骨重建为重点的卫生技术评估，以协助决策者实施或报销这些手术。

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引用次数: 0

De-escalation in high-risk HPV-positive OPC: critical appraisal of methodology and inference 高危hpv阳性OPC的降级：对方法和推断的关键评估。

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-03-01 Epub Date: 2026-02-04 DOI: 10.1016/j.oraloncology.2026.107880

Shu’ang Shu

引用次数: 0

The prognostic significance of the ‘Worst Pattern of Invasion’ in oral cancers−an international collaborative multicentre analysis 口腔癌“最坏侵袭模式”的预后意义——一项国际多中心合作分析

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-03-01 Epub Date: 2026-02-03 DOI: 10.1016/j.oraloncology.2026.107874

Paromita Roy , Margaret Brandwein Weber , Ruta Gupta , Aanchal Kakkar , Daphne Fonseca , Munita Bal , Meenakshi Kamboj , Nidhi Anand , K.R. Anila , Shanthi Velusamy , Megha Shantveer Uppin , Suvradeep Mitra , Meera Thomas , Poonam Abhay Elhence , Indu Arun , Sunil Pasricha , Nuzhat Husain , Rekha V. Kumar , Amanjit Bal , Asawari Patil , Indranil Mallick

Worst pattern of invasion (WPOI) has been evaluated in many single-institute cohorts. Our goal was to perform a large multicentre evaluation of WPOI as a prognostic marker in oral squamous cell carcinoma (OSCC). Retrospective pathology data was collated from 14 institutions and compared with clinical outcome in 1374 OSCC patients with upfront curative resection. Most cases were of oral tongue (n = 645, 47%); T2 (33%) and N0 (59%). WPOI 1–3 frequency was 29.4%, WPOI 4 47% and WPOI 5 22%. On univariable analysis, the 3-year disease free survival (DFS) was 54.2% for WPOI 5 vs. 69.7% for WPOI 1–4 (p < 0.001). The locoregional control (LRC) was 68.9% vs 79.2% (p = 0.001), and overall survival (OS) 68.4% vs 83.8% (p < 0.001). On multivariable Cox-regression in the entire cohort, WPOI 4 or 5 was strongly correlated with other known poor prognostic factors and not an independent predictor of OS (HR 1.10, 95% CI 0.92–1.52), LRC or DFS. However, in early-stage (pT1-2 N0) patients treated with surgery alone without adjuvant radiotherapy, WPOI 5 was a robust independent predictor of DFS (HR 4.36, 95% CI 1.54–12.32, p = 0.006), OS (HR 3.69, 95% CI 1.23–11.1, p = 0.020) and LRC (HR 3.52, 95% CI 2.13–5.82, p <0.001) after applying inverse probability weighting to correct for selection bias. Furthermore, in the entire cohort of early-stage patients, interaction modeling showed that adjuvant radiotherapy significantly reduces the risk for both DFS and LRC for those with WPOI-5 (Interaction p = 0.002). Therefore, it may act as a predictive biomarker for the benefit of adjuvant radiotherapy. The prognostic and predictive role of WPOI-5 should be validated in prospective trials.

最坏侵袭模式（WPOI）已在许多单研究所队列中进行了评估。我们的目标是对WPOI作为口腔鳞状细胞癌（OSCC）预后标志物进行大型多中心评估。回顾性整理来自14家机构的病理资料，比较1374例OSCC患者的临床结果。多数病例为口腔舌部病变（645例，占47%）；T2（33%）和N0（59%）。WPOI 1-3占29.4%，WPOI 4占47%，WPOI 5占22%。在单变量分析中，WPOI 5组的3年无病生存率（DFS）为54.2%，而WPOI 1-4组为69.7%

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引用次数: 0

Evaluation of large language models as decision support tools for head and neck cancer management: A blinded multidisciplinary simulation study 大型语言模型作为头颈癌管理决策支持工具的评估：一项盲法多学科模拟研究

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-03-01 Epub Date: 2026-01-31 DOI: 10.1016/j.oraloncology.2026.107877

Sholem Hack , Ron J. Karni , Antonino Maniaci , Christopher E. Fundakowski , Luca Castellani , Fabiola Incandela , Remo Accorona , Miguel Mayo-Yanez , Martina Violati , Lorenzo Giannini , Niccolo’ Mevio , Alberto Maria Saibene

Background

The management of head and neck cancer relies on multidisciplinary expertise; however, access to tumor boards remains variable. Large language models (LLMs) may support guideline-based decision-making, although performance in complex oncologic scenarios is not well defined.

Methods

Fourteen synthetic cases based on real tumor board encounters were evaluated. Five blinded comparator arms produced recommendations: a human expert, Non-RAG-GPT-4, Non-RAG-GPT-5, RAG-GPT-4, and RAG-GPT-5. Eight head and neck oncologic surgeons scored each recommendation for appropriateness, clarity, specificity, and feasibility using 5-point Likert scales. Paired permutation testing and inter-rater reliability were assessed.

Results

LLM outputs showed close alignment with expert recommendations. RAG-based models achieved the highest mean scores across domains, with some statistically significant differences versus the expert comparator in appropriateness and clarity; however, absolute differences were modest. Inter-rater reliability was strong (ICC 0.73–0.87).

Conclusions

Advanced LLMs can generate guideline-concordant management recommendations in simulated head and neck cancer cases, supporting potential utility for decision support and education; prospective validation and expert oversight remain essential.

头颈癌的治疗依赖于多学科的专业知识；然而，进入肿瘤板的途径仍然是可变的。大型语言模型（llm）可能支持基于指南的决策，尽管在复杂的肿瘤场景中的表现尚未得到很好的定义。方法对14例基于真实肿瘤板接触的综合病例进行评价。五个盲法比较组提出了建议：人类专家、Non-RAG-GPT-4、Non-RAG-GPT-5、RAG-GPT-4和RAG-GPT-5。8名头颈部肿瘤外科医生采用李克特5分制对每项建议的适当性、清晰度、特异性和可行性进行评分。对配对排列检验和评分者间信度进行评估。结果sllm输出结果与专家建议一致。基于rag的模型在各个领域的平均得分最高，在适当性和清晰度方面与专家比较器存在统计学上的显着差异；然而，绝对差异并不大。量表间信度较强（ICC 0.73-0.87）。结论高级法学硕士可以在模拟头颈癌病例中产生与指南一致的管理建议，支持决策支持和教育的潜在效用；前瞻性验证和专家监督仍然至关重要。

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引用次数: 0

Mandibular canal invasion as a T4a criterion: a step forward with important caveats 下颌管侵犯作为T4a标准：向前迈出了重要的一步

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-03-01 Epub Date: 2026-01-16 DOI: 10.1016/j.oraloncology.2026.107856

Suhani Ghai

引用次数: 0

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