Oral oncology最新文献

英文中文

PD-L1 testing patterns in recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) in the U.S. 美国复发/转移性头颈部鳞状细胞癌（R/M HNSCC）的PD-L1检测模式

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2024.107146

Glenn J. Hanna , Dandan Zheng , Wei Gao , Gleicy M. Hair , Lei Ai , Yan Song , Nati Lerman , Behzad Bidadi , Abigail Zion , Lin Zou , Yuexin Tang , Liya Wang , Sanjay Merchant , Christopher M. Black

Background

Pembrolizumab with/without platinum + 5-FU is approved for the first-line (1L) treatment of R/M HNSCC, and its monotherapy use requires PD-L1 Combined Positive Score (CPS) ≥ 1. We aimed to understand PD-L1 testing patterns and associations with patient characteristics and treatment choice in R/M HNSCC.

Methods

Adults with R/M HNSCC initiating 1L systemic therapy were included from a U.S. nationwide database primarily compromised of community practices (07/01/2019–12/31/2023). PD-L1 testing patterns, treatment sequence, and time gaps related to testing and treatment initiation were summarized. Logistic regression was used to test associations between patient characteristics and PD-L1 testing patterns, and between CPS scores and 1L pembrolizumab monotherapy use.

Results

Of 2,207 patients, 32.7 % received PD-L1 testing before 1L therapy initiation, 17.4 % after 1L therapy initiation, and 50.0 % were never tested. Most patients (55.9 %) who tested positive before 1L therapy received pembrolizumab monotherapy while those who tested negative received pembrolizumab + platinum + 5-FU most commonly (31.6 %). Among patients untested before 1L therapy, the most common 1L treatment was pembrolizumab monotherapy (24.3 %). Patients with an ECOG ≥ 2 had higher odds of being tested before 1L therapy (OR: 1.42, p < 0.01). CPS scores were associated with higher odds of receiving 1L pembrolizumab monotherapy (OR: 4.11 and 4.96 for CPS 1–19 and ≥ 20, respectively; both p < 0.0001).

Conclusions

This study revealed low utilization of PD-L1 testing to guide treatment choice and impactful gaps between specimen collection, the receipt of results, and 1L therapy initiation. There is a need to improve clinician awareness of the importance of PD-L1 testing and an opportunity for updated guidelines on testing.

背景：派姆单抗联合/不联合铂+ 5-FU被批准用于R/M型HNSCC的一线（1L）治疗，其单药治疗要求PD-L1联合阳性评分(CPS)≥1。我们旨在了解PD-L1检测模式及其与R/M型HNSCC患者特征和治疗选择的关系。方法：从美国全国数据库（2019年7月1日- 2023年12月31日）中纳入了接受1L全身治疗的R/M HNSCC成人患者。总结了PD-L1检测模式、治疗顺序以及与检测和治疗开始相关的时间间隔。Logistic回归用于检测患者特征与PD-L1检测模式之间的相关性，以及CPS评分与1L派姆单抗单药治疗使用之间的相关性。结果：2207例患者中，32.7%的患者在1L治疗开始前接受了PD-L1检测，17.4%的患者在1L治疗开始后接受了PD-L1检测，50.0%的患者从未接受过检测。大多数在1L治疗前检测呈阳性的患者（55.9%）接受了派姆单抗单药治疗，而检测呈阴性的患者最常接受派姆单抗+铂+ 5-FU治疗（31.6%）。在未接受1L治疗的患者中，最常见的1L治疗是派姆单抗单药治疗（24.3%）。ECOG≥2的患者在1L治疗前接受检测的几率更高（OR: 1.42, p）。结论：本研究揭示了PD-L1检测在指导治疗选择方面的低利用率，以及标本采集、结果接收和1L治疗开始之间的影响间隔。有必要提高临床医生对PD-L1检测重要性的认识，并有机会更新检测指南。

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引用次数: 0

From infection to immortality: The role of HPV and telomerase in head and neck cancer 从感染到不朽：HPV和端粒酶在头颈癌中的作用。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2024.107169

Silvia Giunco , Annarosa Del Mistro , Marzia Morello , Jacopo Lidonnici , Helena Frayle , Silvia Gori , Anita De Rossi , Paolo Boscolo-Rizzo

Head and neck squamous cell carcinomas (HNSCCs) represent a heterogeneous group of malignancies with multifactorial aetiologies. High-risk human papillomavirus (hrHPV) infections, particularly HPV16, and the dysregulation of telomerase activity, specifically through its catalytic subunit, telomerase reverse transcriptase (TERT) are among the key contributors to HNSCC development and progression. HPV promotes oncogenesis via the E6 and E7 oncoproteins, which inactivate tumour suppressors TP53 and RB1, leading to unchecked cellular proliferation. Concurrently, telomerase activation plays a critical role in HNSCC by maintaining telomere length, thus enabling cellular immortality, and facilitating tumour development and progression. The interplay between HPV and telomerase is significant; HPV oncoprotein E6 enhances telomerase activity through multiple regulatory mechanisms, including upregulating TERT expression. Beyond telomere maintenance, TERT influences signalling pathways, cellular metabolism, and the tumour microenvironment, contributing to aggressive tumour behaviour and poor prognosis. This review integrates the roles of HPV and telomerase in HNSCC, focusing on their molecular mechanisms and interactions that drive carcinogenesis and influence disease progression. Understanding the synergistic effects of HPV and TERT in HNSCC may be crucial for risk stratification, prognostic assessment, and the development of novel therapeutic strategies targeting these specific molecular pathways.

头颈部鳞状细胞癌（HNSCCs）是一种异质性的恶性肿瘤，具有多因素的病因。高危人乳头瘤病毒（hrHPV）感染，特别是HPV16，以及端粒酶活性失调，特别是通过其催化亚基，端粒酶逆转录酶（TERT）是HNSCC发展和进展的关键因素之一。HPV通过E6和E7癌蛋白促进肿瘤发生，使肿瘤抑制因子TP53和RB1失活，导致不受控制的细胞增殖。同时，端粒酶激活在HNSCC中发挥关键作用，维持端粒长度，从而使细胞不朽，促进肿瘤的发展和进展。HPV与端粒酶之间的相互作用是显著的；HPV癌蛋白E6通过多种调控机制增强端粒酶活性，包括上调TERT表达。除了端粒维持外，TERT还影响信号通路、细胞代谢和肿瘤微环境，导致肿瘤的侵袭性行为和不良预后。这篇综述整合了HPV和端粒酶在HNSCC中的作用，重点关注它们的分子机制和相互作用，驱动癌变和影响疾病进展。了解HPV和TERT在HNSCC中的协同作用可能对风险分层、预后评估和针对这些特定分子途径开发新的治疗策略至关重要。

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引用次数: 0

Comment on “The effect of time from surgery to commencing adjuvant radiotherapy for patients with head and neck squamous cell carcinoma” 评议“头颈部鳞状细胞癌患者手术至开始辅助放疗时间的影响”。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2025.107177

Sukran Senyurek , Nulifer Kilic Durankus , Ugur Selek , Erkan Topkan

引用次数: 0

Anaplastic thyroid carcinoma in a 43-year-old female confirmed by metastatic lymph node pathology: A case report 43岁女性甲状腺间变性癌经淋巴结转移病理证实1例。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2025.107192

Huanyu Jiang, Lijuan Zhou, Teng Zhao, Gang Zou, Lili Lv, Zhenkun Yu

引用次数: 0

Do we recognize oral oncology with accuracy? AI-driven models serve in the diagnosis of oral squamous cell carcinoma 我们能准确地识别口腔肿瘤吗？人工智能驱动模型用于口腔鳞状细胞癌的诊断。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2025.107194

Jiayi Chen

引用次数: 0

A rare case of extracranial schwannoma in the masticator space removed by endoscopic assisted transoral approach (EATA) 经鼻内镜辅助经口入路（EATA）切除咀嚼间隙颅外神经鞘瘤一例。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2024.107164

Giovanni Motta , Pasquale Puzone , Gino Latini , Arianna Di Stadio , Luca D’Ascanio

Background

Extracranial schwannomas, particularly those arising from the masticator space, are rare entities. Given the challenges in pre-operative diagnosis and the potential for misdiagnosis, accurate localization and differential diagnosis are crucial for optimal surgical planning.

Case Report

A 42-year-old woman underwent a head and neck MRI for unrelated reasons and was incidentally found to have a mass in the left masticator space. Radiological findings were suggestive of a schwannoma. An endoscopic-assisted transoral approach was adopted for the resection of the lesion. Histopathological examination confirmed the diagnosis of schwannoma. The patient had an uneventful postoperative recovery.

Conclusion

This case report highlights the feasibility of an endoscopic-assisted transoral approach for the resection of rare masticator space schwannomas. This minimally invasive technique offers potential benefits in terms of reduced morbidity and improved cosmetic outcomes.

背景：颅外分裂瘤，尤其是咀嚼肌间隙产生的分裂瘤非常罕见。鉴于术前诊断的挑战性和误诊的可能性，准确定位和鉴别诊断对最佳手术计划至关重要：一名 42 岁的女性因无关原因接受了头颈部核磁共振检查，意外发现左侧咀嚼肌间隙有肿块。放射学检查结果提示为分裂瘤。医生采用内窥镜辅助经口方法切除了病灶。组织病理学检查确诊为分裂瘤。患者术后恢复顺利：本病例报告强调了经口内窥镜辅助方法切除罕见咀嚼肌间隙分裂瘤的可行性。这项微创技术具有降低发病率和改善美容效果的潜在优势。

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引用次数: 0

Functional and oncological outcomes of transoral laser versus robotic surgery in supraglottic squamous cell carcinoma 经口激光与机器人手术治疗声门上鳞状细胞癌的功能和肿瘤预后。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2025.107178

Charlotte Loubieres , Robin Baudouin , Marta Circiu , Florent Couineau , Lise Crevier-Buchman , Tiffany Rigal , Clémence Forges , Aude Julien-Laferriere , Grégoire Vialatte De Pemille , Jérôme R. Lechien , Stéphane Hans

Objective

To compare the surgical, functional and oncological outcomes of Transoral Laser Microsurgery (TLM) and Transoral Robotic Surgery (TORS) for the treatment of supraglottic squamous cell carcinoma.

Study Design:

Retrospective case series with prospective data.

Settings:

Tertiary Academic Medical Center.

Methods

A chart-review analysis, with prospective follow-up was performed on 122 patients treated for a supraglottic squamous cell carcinoma with either TLM or TORS between 2003 and 2019. Patients were grouped according to the surgical technique used. Clinical, surgical, functional and oncological outcomes were compared, including local and regional controls, DFS, and OS, and postoperative complications.

Results

A total of 122 patients, including 47 treated with TLM and 75 with TORS. Negative margins were observed in n = 12/47 (25.5 %) of TLM cases and n = 4/75 (5.3 %) of TORS cases (p < 0.05). There was no significant difference between the two techniques in terms of 5-year local and regional control, however a significant difference was found in disease-free survival and overall survival. The functional laryngeal preservation rate was 97.8 % in the TLM group and 100 % in the TORS group.

Conclusion

Both techniques appear to be safe and effective, though TORS shows superiority in achieving negative margins compared to TLM. Therefore, the choice of technique should be tailored to available resources, surgical team preferences, and experience, while also considering the learning curves associated with each approach.

目的：比较经口激光显微手术（TLM）与经口机器人手术（TORS）治疗声门上鳞癌的手术、功能和肿瘤预后。研究设计：具有前瞻性数据的回顾性病例系列。设置：三级学术医疗中心。方法：对2003年至2019年期间接受TLM或TORS治疗的122例声门上鳞状细胞癌患者进行回顾性分析和前瞻性随访。根据手术方法对患者进行分组。比较临床、手术、功能和肿瘤结果，包括局部和区域对照、DFS和OS以及术后并发症。结果：122例患者，TLM治疗47例，TORS治疗75例。在TLM病例中，n = 12/47（25.5%）和TORS病例中，n = 4/75（5.3%）观察到阴性边缘(p)。结论：两种技术都是安全有效的，尽管TORS在实现阴性边缘方面比TLM更有优势。因此，技术的选择应根据现有的资源、手术团队的偏好和经验进行调整，同时也要考虑与每种入路相关的学习曲线。

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引用次数: 0

Hyalinising parotid adenoid cystic carcinoma with dystrophic calcification masquerading as a thyroid-like carcinoma

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2024.107163

Bacem K. Othman, Wafaey Badawy

引用次数: 0

Scapula or Fibula?: Prospective data-driven decision criteria for flap selection in mandibular reconstruction planning

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-01-30 DOI: 10.1016/j.oraloncology.2025.107190

Maharshi Panchal , Katrina Zaraska , Thomas D. Milner , Khanh Linh Tran , Antony Hodgson , Sidney Fels , James Scott Durham , Eitan Prisman

Objectives

The objectives of the study are twofold: 1) to propose a set of criteria for virtually evaluating different types of reconstructions for mandibular defects during surgical planning, and 2) to prospectively apply the criteria to a series of mandibular reconstructions to select the optimal flap.

Materials and Methods

Clinically relevant assessment criteria were selected, including volumetric overlap, Haussdorf-95, bony contact, ramus/symphysis angles, and dental implantability. In 2021, 21 consecutive patients undergoing mandibular reconstructions were consented to the study. For each patient, seven virtual reconstructions were created: vertical scapula, horizontal scapula, 1-segment fibula, optimal fibula determined by the Ramer-Douglas-Peucker (RDP) algorithm, RDP + 1 fibula, and RDP-1 fibula. The surgeon selected the optimal reconstruction for each patient based on the objective criteria and clinical considerations.

Results

The vertical scapula was selected for 12 cases, the RDP fibula for 6 cases, and the horizontal scapula for 3 cases. For defects involving the symphysis, the horizontal scapula was the frequently selected as its geometry could be leveraged to recreate the symphysis angle. For the remaining defects, the RDP fibula optimizes the bony contact, performs well in volume overlap, and is the most implantable. The vertical scapula minimizes osteotomies while maximizing each criterion but results in low implantability. On average, the chosen reconstruction performed better on all criteria compared to the remaining proposed models.

Conclusion

The criteria proposed comprises of measurable and clinically important metrics that can serve as a useful tool for reconstructive surgeons in selecting the optimal flap for mandibular reconstruction.

{"title":"Scapula or Fibula?: Prospective data-driven decision criteria for flap selection in mandibular reconstruction planning","authors":"Maharshi Panchal , Katrina Zaraska , Thomas D. Milner , Khanh Linh Tran , Antony Hodgson , Sidney Fels , James Scott Durham , Eitan Prisman","doi":"10.1016/j.oraloncology.2025.107190","DOIUrl":"10.1016/j.oraloncology.2025.107190","url":null,"abstract":"<div><h3>Objectives</h3><div>The objectives of the study are twofold: 1) to propose a set of criteria for virtually evaluating different types of reconstructions for mandibular defects during surgical planning, and 2) to prospectively apply the criteria to a series of mandibular reconstructions to select the optimal flap.</div></div><div><h3>Materials and Methods</h3><div>Clinically relevant assessment criteria were selected, including volumetric overlap, Haussdorf-95, bony contact, ramus/symphysis angles, and dental implantability. In 2021, 21 consecutive patients undergoing mandibular reconstructions were consented to the study. For each patient, seven virtual reconstructions were created: vertical scapula, horizontal scapula, 1-segment fibula, optimal fibula determined by the Ramer-Douglas-Peucker (RDP) algorithm, RDP + 1 fibula, and RDP-1 fibula. The surgeon selected the optimal reconstruction for each patient based on the objective criteria and clinical considerations.</div></div><div><h3>Results</h3><div>The vertical scapula was selected for 12 cases, the RDP fibula for 6 cases, and the horizontal scapula for 3 cases. For defects involving the symphysis, the horizontal scapula was the frequently selected as its geometry could be leveraged to recreate the symphysis angle. For the remaining defects, the RDP fibula optimizes the bony contact, performs well in volume overlap, and is the most implantable. The vertical scapula minimizes osteotomies while maximizing each criterion but results in low implantability. On average, the chosen reconstruction performed better on all criteria compared to the remaining proposed models.</div></div><div><h3>Conclusion</h3><div>The criteria proposed comprises of measurable and clinically important metrics that can serve as a useful tool for reconstructive surgeons in selecting the optimal flap for mandibular reconstruction.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"162 ","pages":"Article 107190"},"PeriodicalIF":4.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Is postoperative adjuvant therapy necessary for pT3N0 oral cavity squamous cell carcinoma?

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-01-28 DOI: 10.1016/j.oraloncology.2025.107198

Chun-Hung Hua , Jin-Ching Lin , Yu-Wen Wen , Chung-Jan Kang , Chien-Yu Lin , Hsiu-Ying Ku , Kang-Hsing Fan , Shu-Hang Ng , Shu-Ru Lee , Yao-Te Tsai , Wen-Cheng Chen , Li-Yu Lee , Chih-Yen Chien , Cheng Ping Wang , Tsung-Ming Che , Shyuang-Der Terng , Chi-Ying Tsai , Hung-Ming Wang , Chia-Hsun Hsieh , Chih-Hua Yeh , Chun-Ta Liao

Background

The current NCCN guidelines advocate for the use of adjuvant radiotherapy (RT) or chemoradiotherapy (CRT) in pT3N0 oral cavity squamous cell carcinoma (OCSCC). Here, we sought to evaluate whether postoperative RT/CRT may confer a survival advantage in pT3N0 patients who lack adverse pathological features.

Methods

A dataset of 852 pT3N0 OCSCC patients treated between 2018 and 2021 was analyzed. Patients with adverse pathological features (i.e., positive margins, margins <5 mm, lymphovascular invasion, or perineural invasion) were excluded, leaving 235 eligible patients. The cohort was further refined by omitting 12 patients who received surgery plus chemotherapy and two cases who received RT doses <5000 cGy, resulting in two study groups: surgery alone (n = 131) and surgery plus RT/CRT (n = 90).

Results

Baseline characteristics were comparable between groups, except for a higher proportion of buccal subsite (p = 0.0063) and female patients (p = 0.0495) in the surgery alone group. Kaplan-Meier analyses revealed no significant differences in 4-year disease-specific survival (DSS) (84.2 % versus 85.9 %, p = 0.8834) or overall survival (OS) (75.6 % versus 84.8 %, p = 0.2376). These findings were confirmed by multivariable analyses and remained consistent after propensity score matching (n = 74 per group), with similar survival outcomes between groups (4-year DSS, 90.7 % versus 83.2 %, p = 0.4020; 4-year OS, 87.0 % versus 81.9 %, p = 0.6121)

Conclusions

For patients with pT3N0 OCSCC lacking adverse pathological features, the addition of adjuvant RT/CRT does not appear to confer a survival benefit over surgery alone.

{"title":"Is postoperative adjuvant therapy necessary for pT3N0 oral cavity squamous cell carcinoma?","authors":"Chun-Hung Hua , Jin-Ching Lin , Yu-Wen Wen , Chung-Jan Kang , Chien-Yu Lin , Hsiu-Ying Ku , Kang-Hsing Fan , Shu-Hang Ng , Shu-Ru Lee , Yao-Te Tsai , Wen-Cheng Chen , Li-Yu Lee , Chih-Yen Chien , Cheng Ping Wang , Tsung-Ming Che , Shyuang-Der Terng , Chi-Ying Tsai , Hung-Ming Wang , Chia-Hsun Hsieh , Chih-Hua Yeh , Chun-Ta Liao","doi":"10.1016/j.oraloncology.2025.107198","DOIUrl":"10.1016/j.oraloncology.2025.107198","url":null,"abstract":"<div><h3>Background</h3><div>The current NCCN guidelines advocate for the use of adjuvant radiotherapy (RT) or chemoradiotherapy (CRT) in pT3N0 oral cavity squamous cell carcinoma (OCSCC). Here, we sought to evaluate whether postoperative RT/CRT may confer a survival advantage in pT3N0 patients who lack adverse pathological features.</div></div><div><h3>Methods</h3><div>A dataset of 852 pT3N0 OCSCC patients treated between 2018 and 2021 was analyzed. Patients with adverse pathological features (i.e., positive margins, margins <5 mm, lymphovascular invasion, or perineural invasion) were excluded, leaving 235 eligible patients. The cohort was further refined by omitting 12 patients who received surgery plus chemotherapy and two cases who received RT doses <5000 cGy, resulting in two study groups: surgery alone (n = 131) and surgery plus RT/CRT (n = 90).</div></div><div><h3>Results</h3><div>Baseline characteristics were comparable between groups, except for a higher proportion of buccal subsite (<em>p</em> = 0.0063) and female patients (<em>p</em> = 0.0495) in the surgery alone group. Kaplan-Meier analyses revealed no significant differences in 4-year disease-specific survival (DSS) (84.2 % <em>versus</em> 85.9 %, <em>p</em> = 0.8834) or overall survival (OS) (75.6 % <em>versus</em> 84.8 %, <em>p</em> = 0.2376). These findings were confirmed by multivariable analyses and remained consistent after propensity score matching (n = 74 per group), with similar survival outcomes between groups (4-year DSS, 90.7 % <em>versus</em> 83.2 %, <em>p</em> = 0.4020; 4-year OS, 87.0 % <em>versus</em> 81.9 %, <em>p</em> = 0.6121)</div></div><div><h3>Conclusions</h3><div>For patients with pT3N0 OCSCC lacking adverse pathological features, the addition of adjuvant RT/CRT does not appear to confer a survival benefit over surgery alone.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"162 ","pages":"Article 107198"},"PeriodicalIF":4.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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