Pub Date : 2026-01-07DOI: 10.1016/j.oraloncology.2026.107850
Chengwei Xing , Siyuan Xu , Ruiying Liu , Qiuju Wang , Jie Liu
Background
Super-selective neck dissection which declining level II and V for better neck function preservation remains controversial in the treatment of papillary thyroid carcinoma (PTC). This study aims to explore association between occult lymph node metastasis (OLNM) in level II and preoperative clinical characteristics.
Methods
This retrospective study reviewed unilateral cN1b PTC patients who underwent surgery (2000–2017), with clinical lateral neck metastasis limiting in level III and IV. The OLNM in level II was assessed with preoperative clinical characteristics using logistic regression model; its association with pathological nodes distribution was examined with restricted cubic spline; the prognosis value of level II OLNM was evaluated using Kaplan–Meier method and Cox regression model.
Results
A total of 640 patients (mean [SD] age, 41[11.3] years; 440[68.8 %] female individuals; 307[48.0 %] with OLNM in level II) were analyzed. Primary tumor size (>1.5 cm, OR, 1.625[1.174–2.252]; P = 0.003) and clinical positive lymph nodes (multiple, OR, 4.241 [2.283–8.506]; P < 0.001) are associated with elevated risk of level II OLNM. A non-linear relationship was found between level II OLNM and metastatic lymph nodes number in levels III and IV. No significant difference in all-site recurrence-free survival (RFS) or regional RFS was found between patients with or without level II OLNM, even after adjusting other potential risk factors.
Conclusion
The primary tumor size and metastatic burden in adjacent cervical compartments are associated with risk of level II OLNM, super-selective neck dissection could be considered in patients with small primary tumor cancer and low metastatic burden.
{"title":"Predicting occult lymph node metastasis in level II using preoperative factors","authors":"Chengwei Xing , Siyuan Xu , Ruiying Liu , Qiuju Wang , Jie Liu","doi":"10.1016/j.oraloncology.2026.107850","DOIUrl":"10.1016/j.oraloncology.2026.107850","url":null,"abstract":"<div><h3>Background</h3><div>Super-selective neck dissection which declining level II and V for better neck function preservation remains controversial in the treatment of papillary thyroid carcinoma (PTC). This study aims to explore association between occult lymph node metastasis (OLNM) in level II and preoperative clinical characteristics.</div></div><div><h3>Methods</h3><div>This retrospective study reviewed unilateral cN1b PTC patients who underwent surgery (2000–2017), with clinical lateral neck metastasis limiting in level III and IV. The OLNM in level II was assessed with preoperative clinical characteristics using logistic regression model; its association with pathological nodes distribution was examined with restricted cubic spline; the prognosis value of level II OLNM was evaluated using Kaplan–Meier method and Cox regression model.</div></div><div><h3>Results</h3><div>A total of 640 patients (mean [SD] age, 41[11.3] years; 440[68.8 %] female individuals; 307[48.0 %] with OLNM in level II) were analyzed. Primary tumor size (>1.5 cm, OR, 1.625[1.174–2.252]; P = 0.003) and clinical positive lymph nodes (multiple, OR, 4.241 [2.283–8.506]; P < 0.001) are associated with elevated risk of level II OLNM. A non-linear relationship was found between level II OLNM and metastatic lymph nodes number in levels III and IV. No significant difference in all-site recurrence-free survival (RFS) or regional RFS was found between patients with or without level II OLNM, even after adjusting other potential risk factors.</div></div><div><h3>Conclusion</h3><div>The primary tumor size and metastatic burden in adjacent cervical compartments are associated with risk of level II OLNM, super-selective neck dissection could be considered in patients with small primary tumor cancer and low metastatic burden.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"173 ","pages":"Article 107850"},"PeriodicalIF":3.9,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-03DOI: 10.1016/j.oraloncology.2025.107828
Yoko Takahashi , Diana Bell , Arnoldo Corona , Shirely Y Su , Renata Ferrarotto , Brandon Gunn , Franco DeMonte , Shaan Raza , Ehab Y Hanna
Purpose
NUT carcinoma is a rare and aggressive malignancy defined by NUTM1 gene rearrangements, with no standard treatment approaches and limited preclinical models, especially for tumors arising in the sinonasal tract. We aimed to establish and characterize novel, stable sinonasal NUT carcinoma cell lines derived from the primary disease site to contribute to therapeutic development.
Experimental design
Tumor specimens from a sinonasal NUT carcinoma patient were cultured to establish two cell lines, MDA-NUT87 and MDA-NUT88. Cytogenetic analysis, immunohistochemistry, RT-PCR, and Sanger sequencing confirmed the presence of the BRD4::NUTM1 fusion. Sensitivity to a BET inhibitor, OTX-015, was assessed via dose–response assays. In vivo tumorigenicity was evaluated using subcutaneous xenografts in nude mice.
Results
MDA-NUT87 and MDA-NUT88 maintained stable morphology and harbored the characteristic t(15;19) translocation and BRD4::NUTM1 (exon 11: exon 2) fusion. The cells expressed nuclear NUT protein and responded to OTX-015 with IC50 values in the low nanomolar range. Tumorigenicity was observed in vivo, albeit with modest efficiency, suggesting a contributing role of the tumor microenvironment in disease progression.
Conclusions
MDA-NUT87 and MDA-NUT88 are the first stable human sinonasal NUT carcinoma cell lines established from the primary tumor site. They preserve the hallmark genetic and phenotypic characteristics of NUT carcinoma and show sensitivity to BET inhibition. These models represent valuable tools for mechanistic studies and high-throughput drug screening in sinonasal NUT carcinoma.
{"title":"Establishment of novel stable human sinonasal NUT carcinoma cell lines","authors":"Yoko Takahashi , Diana Bell , Arnoldo Corona , Shirely Y Su , Renata Ferrarotto , Brandon Gunn , Franco DeMonte , Shaan Raza , Ehab Y Hanna","doi":"10.1016/j.oraloncology.2025.107828","DOIUrl":"10.1016/j.oraloncology.2025.107828","url":null,"abstract":"<div><h3>Purpose</h3><div>NUT carcinoma is a rare and aggressive malignancy defined by <em>NUTM1</em> gene rearrangements, with no standard treatment approaches and limited preclinical models, especially for tumors arising in the sinonasal tract. We aimed to establish and characterize novel, stable sinonasal NUT carcinoma cell lines derived from the primary disease site to contribute to therapeutic development.</div></div><div><h3>Experimental design</h3><div>Tumor specimens from a sinonasal NUT carcinoma patient were cultured to establish two cell lines, MDA-NUT87 and MDA-NUT88. Cytogenetic analysis, immunohistochemistry, RT-PCR, and Sanger sequencing confirmed the presence of the <em>BRD4::NUTM1</em> fusion. Sensitivity to a BET inhibitor, OTX-015, was assessed via dose–response assays. In vivo tumorigenicity was evaluated using subcutaneous xenografts in nude mice.</div></div><div><h3>Results</h3><div>MDA-NUT87 and MDA-NUT88 maintained stable morphology and harbored the characteristic t(15;19) translocation and <em>BRD4::NUTM1</em> (exon 11: exon 2) fusion. The cells expressed nuclear NUT protein and responded to OTX-015 with IC<sub>50</sub> values in the low nanomolar range. Tumorigenicity was observed in vivo, albeit with modest efficiency, suggesting a contributing role of the tumor microenvironment in disease progression.</div></div><div><h3>Conclusions</h3><div>MDA-NUT87 and MDA-NUT88 are the first stable human sinonasal NUT carcinoma cell lines established from the primary tumor site. They preserve the hallmark genetic and phenotypic characteristics of NUT carcinoma and show sensitivity to BET inhibition. These models represent valuable tools for mechanistic studies and high-throughput drug screening in sinonasal NUT carcinoma.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"173 ","pages":"Article 107828"},"PeriodicalIF":3.9,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-02DOI: 10.1016/j.oraloncology.2025.107846
Angeliki Margoni , Kostas A. Papavassiliou , Athanasios G. Papavassiliou
{"title":"Harnessing TP53 mutational status to enhance prognostic precision and therapeutic effectiveness in head and neck squamous cell carcinoma","authors":"Angeliki Margoni , Kostas A. Papavassiliou , Athanasios G. Papavassiliou","doi":"10.1016/j.oraloncology.2025.107846","DOIUrl":"10.1016/j.oraloncology.2025.107846","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"173 ","pages":"Article 107846"},"PeriodicalIF":3.9,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to develop a radiomics-based framework for quantifying intratumoral heterogeneity (ITH) in nasopharyngeal carcinoma (NPC) using three-dimensional tumor subregions. The goal was to enhance conventional clinical risk stratification and investigate the biological basis of ITH.
Methods
This multicenter retrospective study included PET scans from 760 treatment-naïve NPC patients. Radiomics features were extracted from the whole tumor (WT), and the intratumoral spatial diversity score (ITSDS) was simultaneously quantified through subregion analysis. After a multi-step feature selection process, both WT and ITH models were developed. Finally, a nomogram was constructed by integrating ITSDS with clinical factors. All models were evaluated using the C-index, AUC, and calibration curves, and their performance was interpreted using SHAP. Additionally, the biological characteristics of the ITH model were analyzed using tissue proteomics.
Results
The training, internal validation, and external validation cohorts included 480, 235, and 45 patients, respectively. The ITH model showed superior C-indexes of 0.852, 0.792, and 0.757 compared to the clinical and WT models. The nomogram demonstrated the best prognostic value, with C-indexes of 0.864, 0.817, and 0.772 in the three cohorts, respectively. The nomogram effectively classified patients into risk groups for progression-free survival (P < 0.01). Tissue proteomic analysis revealed upregulated ciliary movement, a more complex tumor microenvironment, and impaired immune function in the high-ITH group.
Conclusion
The nomogram integrating ITSDS biomarkers with clinical factors improved risk stratification accuracy and created a clinically translatable framework for NPC. This approach potentially offers mechanistic insights into ITH and holds promise for advancing precision oncology.
{"title":"Positron emission tomography-based intratumoral spatial diversity for prognosis in nasopharyngeal carcinoma","authors":"Shuxian Niu , Jianming Ding , Hanshen Chen , Zeyu Zhu , Xiyi Liao , Huiling Hong , Chuanben Chen , Jiyang Dong , Zhaodong Fei","doi":"10.1016/j.oraloncology.2025.107845","DOIUrl":"10.1016/j.oraloncology.2025.107845","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to develop a radiomics-based framework for quantifying intratumoral heterogeneity (ITH) in nasopharyngeal carcinoma (NPC) using three-dimensional tumor subregions. The goal was to enhance conventional clinical risk stratification and investigate the biological basis of ITH.</div></div><div><h3>Methods</h3><div>This multicenter retrospective study included PET scans from 760 treatment-naïve NPC patients. Radiomics features were extracted from the whole tumor (WT), and the intratumoral spatial diversity score (ITSDS) was simultaneously quantified through subregion analysis. After a multi-step feature selection process, both WT and ITH models were developed. Finally, a nomogram was constructed by integrating ITSDS with clinical factors. All models were evaluated using the C-index, AUC, and calibration curves, and their performance was interpreted using SHAP. Additionally, the biological characteristics of the ITH model were analyzed using tissue proteomics.</div></div><div><h3>Results</h3><div>The training, internal validation, and external validation cohorts included 480, 235, and 45 patients, respectively. The ITH model showed superior C-indexes of 0.852, 0.792, and 0.757 compared to the clinical and WT models. The nomogram demonstrated the best prognostic value, with C-indexes of 0.864, 0.817, and 0.772 in the three cohorts, respectively. The nomogram effectively classified patients into risk groups for progression-free survival (P < 0.01). Tissue proteomic analysis revealed upregulated ciliary movement, a more complex tumor microenvironment, and impaired immune function in the high-ITH group.</div></div><div><h3>Conclusion</h3><div>The nomogram integrating ITSDS biomarkers with clinical factors improved risk stratification accuracy and created a clinically translatable framework for NPC. This approach potentially offers mechanistic insights into ITH and holds promise for advancing precision oncology.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"173 ","pages":"Article 107845"},"PeriodicalIF":3.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The global incidence of papillary thyroid microcarcinoma (PTMC) continues to rise, and the optimal management strategy remains controversial due to its generally favorable prognosis. Central lymph node metastasis (CLNM) is an important predictor of recurrence and survival and therefore plays a critical role in guiding therapeutic decision-making. This study aimed to develop and validate a nomogram to preoperatively predict the risk of CLNM in PTMC patients.
Methods
Patients from ward A (n = 877) were assigned to the training cohort, and those from ward B (n = 637) formed the validation cohort. Clinical characteristics and ultrasonographic variables were evaluated. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of CLNM, which were subsequently incorporated into a predictive nomogram. Model performance was assessed using receiver operating characteristic (ROC) analysis, calibration curves, and decision curve analysis (DCA).
Results
Univariate analysis identified gender, age, maximum tumor diameter (MTD), multifocality, calcification and capsule status as significantly associated with CLNM (P < 0.05). Multivariate logistic regression analysis revealed gender, age, MTD, multifocality, and capsule status as independent predictors. The nomogram demonstrated good discriminative ability, with an area under the curve (AUC) of 0.724 in the training cohort and 0.708 in the validation cohort. Calibration curves showed excellent agreement between predicted and observed outcomes, and DCA confirmed favorable clinical utility.
Conclusion
We successfully developed and validated a clinically applicable nomogram that integrates preoperative clinical and ultrasonographic features to predict CLNM in PTMC patients. This model may assist clinicians in tailoring surgical strategies and optimizing individualized management.
{"title":"Development and validation of a risk nomogram for predicting central lymph node metastasis in papillary thyroid microcarcinoma","authors":"Weidong Zhang, Xianjiang Wu, Yingchun Wang, Qi Le, Yue Xie, Kejie Yu","doi":"10.1016/j.oraloncology.2025.107842","DOIUrl":"10.1016/j.oraloncology.2025.107842","url":null,"abstract":"<div><h3>Background</h3><div>The global incidence of papillary thyroid microcarcinoma (PTMC) continues to rise, and the optimal management strategy remains controversial due to its generally favorable prognosis. Central lymph node metastasis (CLNM) is an important predictor of recurrence and survival and therefore plays a critical role in guiding therapeutic decision-making. This study aimed to develop and validate a nomogram to preoperatively predict the risk of CLNM in PTMC patients.</div></div><div><h3>Methods</h3><div>Patients from ward A (n = 877) were assigned to the training cohort, and those from ward B (n = 637) formed the validation cohort. Clinical characteristics and ultrasonographic variables were evaluated. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of CLNM, which were subsequently incorporated into a predictive nomogram. Model performance was assessed using receiver operating characteristic (ROC) analysis, calibration curves, and decision curve analysis (DCA).</div></div><div><h3>Results</h3><div>Univariate analysis identified gender, age, maximum tumor diameter (MTD), multifocality, calcification and capsule status as significantly associated with CLNM (P < 0.05). Multivariate logistic regression analysis revealed gender, age, MTD, multifocality, and capsule status as independent predictors. The nomogram demonstrated good discriminative ability, with an area under the curve (AUC) of 0.724 in the training cohort and 0.708 in the validation cohort. Calibration curves showed excellent agreement between predicted and observed outcomes, and DCA confirmed favorable clinical utility.</div></div><div><h3>Conclusion</h3><div>We successfully developed and validated a clinically applicable nomogram that integrates preoperative clinical and ultrasonographic features to predict CLNM in PTMC patients. This model may assist clinicians in tailoring surgical strategies and optimizing individualized management.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"173 ","pages":"Article 107842"},"PeriodicalIF":3.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-31DOI: 10.1016/j.oraloncology.2025.107844
Guoming Xiao , Li Ning , Lihui Chen , Shu Zhang , Yingle Chen , Yanfeng Chen
Background
Head and neck squamous cell carcinoma (HNSCC) significantly impairs patients’ quality of life (QoL). While neoadjuvant immuno-chemotherapy offers potential survival benefits, it is associated with substantial treatment-related toxicities, including fatigue, sleep disturbances, and functional decline. Exercise therapy has shown promise in improving QoL in other cancers, but its role in HNSCC patients receiving neoadjuvant therapy remains underexplored.
Methods
This single-center, open-label, randomized phase II trial enrolled 114 HNSCC patients undergoing neoadjuvant immuno-chemotherapy. Participants were randomized 1:1 to an exercise group (personalized breathing and aerobic exercise program) or a control group (routine care). Outcomes were assessed using the BFI-C, EORTC QLQ-C30, QLQ-H&N35, and PSQI at baseline, after 2 cycles, and after 3 cycles of therapy.
Results
The exercise group demonstrated significantly lower fatigue scores (BFI) after 2 and 3 cycles compared to controls (P < 0.05). Sleep quality (PSQI) improved significantly in the exercise group and worsened in the control group. The exercise group also showed better outcomes in physical functioning, fatigue and insomnia.
Conclusion
Exercise therapy is feasible and effective in reducing fatigue and improving sleep quality in HNSCC patients receiving neoadjuvant immuno-chemotherapy. Early integration of exercise may mitigate treatment-related symptoms and improve tolerance and overall QoL.
{"title":"Exercise and quality of life in head and neck squamous cell carcinoma patients receiving neoadjuvant immuno-chemotherapy: A randomized, open-labeled phase II trial","authors":"Guoming Xiao , Li Ning , Lihui Chen , Shu Zhang , Yingle Chen , Yanfeng Chen","doi":"10.1016/j.oraloncology.2025.107844","DOIUrl":"10.1016/j.oraloncology.2025.107844","url":null,"abstract":"<div><h3>Background</h3><div>Head and neck squamous cell carcinoma (HNSCC) significantly impairs patients’ quality of life (QoL). While neoadjuvant immuno-chemotherapy offers potential survival benefits, it is associated with substantial treatment-related toxicities, including fatigue, sleep disturbances, and functional decline. Exercise therapy has shown promise in improving QoL in other cancers, but its role in HNSCC patients receiving neoadjuvant therapy remains underexplored.</div></div><div><h3>Methods</h3><div>This single-center, open-label, randomized phase II trial enrolled 114 HNSCC patients undergoing neoadjuvant immuno-chemotherapy. Participants were randomized 1:1 to an exercise group (personalized breathing and aerobic exercise program) or a control group (routine care). Outcomes were assessed using the BFI-C, EORTC QLQ-C30, QLQ-H&N35, and PSQI at baseline, after 2 cycles, and after 3 cycles of therapy.</div></div><div><h3>Results</h3><div>The exercise group demonstrated significantly lower fatigue scores (BFI) after 2 and 3 cycles compared to controls (P < 0.05). Sleep quality (PSQI) improved significantly in the exercise group and worsened in the control group. The exercise group also showed better outcomes in physical functioning, fatigue and insomnia.</div></div><div><h3>Conclusion</h3><div>Exercise therapy is feasible and effective in reducing fatigue and improving sleep quality in HNSCC patients receiving neoadjuvant immuno-chemotherapy. Early integration of exercise may mitigate treatment-related symptoms and improve tolerance and overall QoL.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"173 ","pages":"Article 107844"},"PeriodicalIF":3.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-30DOI: 10.1016/j.oraloncology.2025.107843
Kathrine K. Jakobsen , Jacob H. Rasmussen , Jacob Melchiors , Tina K. Agander , Christian von Buchwald , Christian Grønhøj
Background and purpose
Head and neck cancers (HNCs) encompass various malignancies with variation in anatomical site, histology, and survival outcomes. This study aims to describe HNC incidence and survival trends in Denmark from 1980 to 2021.
Patients/material and methods
This retrospective, cohort study used data from the Danish Cancer Registry and the Central Population Register to include all HNC cases in the upper aerodigestive tract from 1980 to 2021. Incidence rates were age-adjusted and survival analyzed as relative survival rates compared to the general population. Average Annual Percent Change (AAPC) in incidence was calculated using linear regression models.
Results
A total of 36,626 HNC cases were included. The age-adjusted incidence rate (AAIR) increased significantly from 7.1 in 1980 to 12.5 per 100,000 in 2021. From 2015 to 2021, oropharyngeal cancer was the most common HNC. Further, oropharyngeal cancer demonstrated the highest 5-year relative survival of 70.1 % [95 % CI: 67.9–72.4]. Hypopharyngeal cancer had the lowest survival (26.8 % [95 % CI: 25.1 to 28.7]). Overall, the 5-year relative survival improved during the study period from 46.9 % [95 % CI: 44.7–49.2] in 1980–1984 to 65.2 % [95 % CI: 63.8 to 66.6] in 2015–2019.
Interpretation
Our study showed a continued increase in incidence for HNC alongside an improvement in survival. The survival varied notably across different tumor subsite. Continued research is essential to address these variations and improve outcomes across cancer subsites. Exploring opportunities for treatment de-escalation to mitigate the toxicity associated with current therapies is essential to optimizing long-term quality of life for survivors.
{"title":"Head and neck cancer trends in Denmark: A nationwide, 40-Year data analysis","authors":"Kathrine K. Jakobsen , Jacob H. Rasmussen , Jacob Melchiors , Tina K. Agander , Christian von Buchwald , Christian Grønhøj","doi":"10.1016/j.oraloncology.2025.107843","DOIUrl":"10.1016/j.oraloncology.2025.107843","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Head and neck cancers (HNCs) encompass various malignancies with variation in anatomical site, histology, and survival outcomes. This study aims to describe HNC incidence and survival trends in Denmark from 1980 to 2021.</div></div><div><h3>Patients/material and methods</h3><div>This retrospective, cohort study used data from the Danish Cancer Registry and the Central Population Register to include all HNC cases in the upper aerodigestive tract from 1980 to 2021. Incidence rates were age-adjusted and survival analyzed as relative survival rates compared to the general population. Average Annual Percent Change (AAPC) in incidence was calculated using linear regression models.</div></div><div><h3>Results</h3><div>A total of 36,626 HNC cases were included. The age-adjusted incidence rate (AAIR) increased significantly from 7.1 in 1980 to 12.5 per 100,000 in 2021. From 2015 to 2021, oropharyngeal cancer was the most common HNC. Further, oropharyngeal cancer demonstrated the highest 5-year relative survival of 70.1 % [95 % CI: 67.9–72.4]. Hypopharyngeal cancer had the lowest survival (26.8 % [95 % CI: 25.1 to 28.7]). Overall, the 5-year relative survival improved during the study period from 46.9 % [95 % CI: 44.7–49.2] in 1980–1984 to 65.2 % [95 % CI: 63.8 to 66.6] in 2015–2019.</div></div><div><h3>Interpretation</h3><div>Our study showed a continued increase in incidence for HNC alongside an improvement in survival. The survival varied notably across different tumor subsite. Continued research is essential to address these variations and improve outcomes across cancer subsites. Exploring opportunities for treatment de-escalation to mitigate the toxicity associated with current therapies is essential to optimizing long-term quality of life for survivors.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"173 ","pages":"Article 107843"},"PeriodicalIF":3.9,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patients treated for head & neck cancer (HNC) are at risk of developing head and neck lymphedema (HNL) that may impact their functions and quality of life (QoL). This study aimed to assess the prevalence of HNL, its risk factors, and evaluate its impact on QoL.
Methods
In this observational (cross-sectional) study, we included adult HNC patients who had completed definitive treatment at least 6 months prior and who had received some part of their treatment at our institute. The external lymphedema was rated using the MD Anderson Cancer Centre (MDACC) HNL rating system, and internal lymphedema using Patterson’s scale. Health-related QoL was assessed using the University of Washington quality of life questionnaire.
Results
A total of 421 were enrolled, with a median duration post-treatment of 19 months. HNL was present in 190 patients (45.1 %), either internal or external lymphedema or both. Most of them had stage 1a HNL. Factors that predisposed to the development of HNL were age (>47 years) [p = 0.002, 1.993(1.279–2.935)], tobacco use [p = 0.025, 1.864(1.081–3.214)], and the type of treatment received, especially those who received definitive chemoradiotherapy [p < 0.001,9.750(4.063–23.395)]. Patients with HNL, especially internal lymphedema, reported significantly more QoL impairments, particularly related to swallowing, chewing, xerostomia, taste and mood.
Conclusion
HNL was present in 45.1% of the patients in our cohort, predominantly stage 1a. Age, tobacco use, and treatment received predisposed the patient to develop HNL. Patients with internal lymphedema particularly had swallowing-related QoL issues.
{"title":"Prevalence, risk Factors, and quality of life in patients with head and neck lymphedema following treatment for head and neck Cancer: The HeNLy-1 study","authors":"Shivakumar Thiagarajan , T Rukmangathan , Drub Sharma , Aniket Kakade , Arun Balaji , Marri Rebeka , Vanita Noronha , Kumar Prabhash , Sarbani Ghosh-Laskar , Gouri Pantvaidya","doi":"10.1016/j.oraloncology.2025.107838","DOIUrl":"10.1016/j.oraloncology.2025.107838","url":null,"abstract":"<div><h3>Background</h3><div>Patients treated for head & neck cancer (HNC) are at risk of developing head and neck lymphedema (HNL) that may impact their functions and quality of life (QoL). This study aimed to assess the prevalence of HNL, its risk factors, and evaluate its impact on QoL.</div></div><div><h3>Methods</h3><div>In this observational (cross-sectional) study, we included adult HNC patients who had completed definitive treatment at least 6 months prior and who had received some part of their treatment at our institute. The external lymphedema was rated using the MD Anderson Cancer Centre (MDACC) HNL rating system, and internal lymphedema using Patterson’s scale. Health-related QoL was assessed using the University of Washington quality of life questionnaire.</div></div><div><h3>Results</h3><div>A total of 421 were enrolled, with a median duration post-treatment of 19 months. HNL was present in 190 patients (45.1 %), either internal or external lymphedema or both. Most of them had stage 1a HNL. Factors that predisposed to the development of HNL were age (>47 years) [p = 0.002, 1.993(1.279–2.935)], tobacco use [p = 0.025, 1.864(1.081–3.214)], and the type of treatment received, especially those who received definitive chemoradiotherapy [p < 0.001,9.750(4.063–23.395)]. Patients with HNL, especially internal lymphedema, reported significantly more QoL impairments, particularly related to swallowing, chewing, xerostomia, taste and mood.</div></div><div><h3>Conclusion</h3><div>HNL was present in 45.1% of the patients in our cohort, predominantly stage 1a. Age, tobacco use, and treatment received predisposed the patient to develop HNL. Patients with internal lymphedema particularly had swallowing-related QoL issues.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"173 ","pages":"Article 107838"},"PeriodicalIF":3.9,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-26DOI: 10.1016/j.oraloncology.2025.107840
Mahad Chaudhry , Annes Elfar , Kaylyn Rowsey , Andrew Neel , Adam Khan , Ty Lutze , David Wenger , Matt Vassar
Introduction
Head and Neck Squamous Cell Carcinoma (HNSCC) is a debilitating malignancy that requires a multimodal approach in treatment, which is associated with a considerable burden of adverse events (AE). Since the 2007 FDA Amendments Act (FDAAA 801) mandates comprehensive AE reporting on ClinicalTrials.gov, the consistency of these data with corresponding peer‑reviewed publications remains unclear. This study examines the consistency of AE reporting between ClinicalTrials.gov and peer-reviewed publications for HNSCC randomized clinical trials (RCTs) conducted post-FDAAA implementation.
Materials and Methods
We retrospectively analyzed AE reporting on Phase II-IV HNSCC RCTs registered on clinicaltrials.gov between September 27, 2009, and January 15, 2025. Data was extracted on participant counts and total events for serious adverse events (SAEs), other adverse events (OAEs), all-cause mortality (ACM), and treatment discontinuation. Discrepancies were defined as any mismatch in counts or reporting. Chi-square and Mann-Whitney U tests assessed differences in reporting frequencies and publication delays between trial and publication data.
Results
Overall, 60 trials met inclusion criteria. All 60/60 (100 %) trials reported participants affected by SAEs versus 43/60 (71.7 %) publications (p < 0.05), of which 33/43 (76.7 %) showed discrepant counts. Likewise, 60/60 (100 %) trials versus 22/60 (36.7 %) publications reported participants affected by OAEs (p < 0.05), with 18/22 (81.8 %) mismatches. Among 24/24 (100 %) trials completed post‑2017, ACM was reported on ClinicalTrials.gov versus 15/24 (62.5 %) publications, and 22/24 (91.7 %) of those pairs differed. Participant discontinuations due to AEs appeared in 17/60 (28.3 %) registries versus 39/60 (65.0 %) publications (p < 0.05); of the 15/17 (88.2 %) with both sources reporting, 9/15 (60.0 %) had discordant counts.
Conclusion
Substantial inconsistencies in AE, mortality, and discontinuation reporting persist between ClinicalTrials.gov and peer‑reviewed publications of HNSCC RCTs. To uphold transparency and patient safety, enhanced technical safeguards on registry platforms and stricter journal policies, such as mandatory discrepancy checklists, are urgently needed.
{"title":"Safety reporting in head and neck squamous cell carcinoma clinical Trials: A comparative analysis of ClinicalTrials.gov data and published research","authors":"Mahad Chaudhry , Annes Elfar , Kaylyn Rowsey , Andrew Neel , Adam Khan , Ty Lutze , David Wenger , Matt Vassar","doi":"10.1016/j.oraloncology.2025.107840","DOIUrl":"10.1016/j.oraloncology.2025.107840","url":null,"abstract":"<div><h3>Introduction</h3><div>Head and Neck Squamous Cell Carcinoma (HNSCC) is a debilitating malignancy that requires a multimodal approach in treatment, which is associated with a considerable burden of adverse events (AE). Since the 2007 FDA Amendments Act (FDAAA 801) mandates comprehensive AE reporting on ClinicalTrials.gov, the consistency of these data with corresponding peer‑reviewed publications remains unclear. This study examines the consistency of AE reporting between ClinicalTrials.gov and peer-reviewed publications for HNSCC randomized clinical trials (RCTs) conducted post-FDAAA implementation.</div></div><div><h3>Materials and Methods</h3><div>We retrospectively analyzed AE reporting on Phase II-IV HNSCC RCTs registered on clinicaltrials.gov between September 27, 2009, and January 15, 2025. Data was extracted on participant counts and total events for serious adverse events (SAEs), other adverse events (OAEs), all-cause mortality (ACM), and treatment discontinuation. Discrepancies were defined as any mismatch in counts or reporting. Chi-square and Mann-Whitney U tests assessed differences in reporting frequencies and publication delays between trial and publication data.</div></div><div><h3>Results</h3><div>Overall, 60 trials met inclusion criteria. All 60/60 (100 %) trials reported participants affected by SAEs versus 43/60 (71.7 %) publications (p < 0.05), of which 33/43 (76.7 %) showed discrepant counts. Likewise, 60/60 (100 %) trials versus 22/60 (36.7 %) publications reported participants affected by OAEs (p < 0.05), with 18/22 (81.8 %) mismatches. Among 24/24 (100 %) trials completed post‑2017, ACM was reported on ClinicalTrials.gov versus 15/24 (62.5 %) publications, and 22/24 (91.7 %) of those pairs differed. Participant discontinuations due to AEs appeared in 17/60 (28.3 %) registries versus 39/60 (65.0 %) publications (p < 0.05); of the 15/17 (88.2 %) with both sources reporting, 9/15 (60.0 %) had discordant counts.</div></div><div><h3>Conclusion</h3><div>Substantial inconsistencies in AE, mortality, and discontinuation reporting persist between ClinicalTrials.gov and peer‑reviewed publications of HNSCC RCTs. To uphold transparency and patient safety, enhanced technical safeguards on registry platforms and stricter journal policies, such as mandatory discrepancy checklists, are urgently needed.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"173 ","pages":"Article 107840"},"PeriodicalIF":3.9,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-26DOI: 10.1016/j.oraloncology.2025.107826
Jérôme R. Lechien , Vinidh Paleri , Robin Baudouin , Aina Brunet , Carlos M. Chiesa-Estomba , Erika Crosetti , Andrea De Vito , Giovanni Cammaroto , Armando De Virgilio , Nicolas Fakhry , Wojciech Golusinski , Heikki Irjala , Stefan Lang , C.Rene Leemans , Sylvain Moriniere , Alberto M. Saibene , Claudio Sampieri , Somiah Siddiq , Vincent Vander Poorten , David Viros Porcuna , Stéphane Hans
Background
Substantial heterogeneity in practice exists across centers regarding the indications and perioperative care for patients undergoing transoral robotic surgery (TORS) for head and neck cancer. This consensus paper aims to propose a European surgical practice guideline in this setting.
Methods
Twenty-two experts from European and International scientific societies participated in a modified Delphi process for rating and validating statements about indications, contraindications, surgical outcomes, and pre- and postoperative care associated with TORS for head and neck cancer care. Consensus was deemed to have been achieved when two-thirds of experts agreed or strongly agreed with the statement; those with fewer than one-third agreement were improved and resubmitted for voting until final validation or rejection.
Results
Of the initial 41 statements, 38 reached consensus after three voting rounds. Statements propose recommendations for the preoperative assessment (n = 7), indications and contraindications for TORS in oropharyngeal, laryngeal, and hypopharyngeal primaries (n = 10), surgical outcomes to be reported (n = 7), postoperative care (n = 8), and clinical research (n = 6). TORS is appropriate for small, accessible oropharyngeal and supraglottic tumors with favorable exposure. The contraindications set out in detail for oropharyngeal, laryngeal and hypopharyngeal lesions will assist in decision-making, especially when presented with a controversial clinical scenario. Standardized reporting of surgical, functional, and oncological outcomes, including swallowing, voice quality, and survival rates, is essential for evidence-based practice. TORS represents a promising avenue for therapeutic de-escalation in HPV-positive oropharyngeal cancers.
Conclusion
The European TORS surgical consensus provides clinical recommendations for the indications, contraindications, surgical and perioperative care for TORS management of head and neck malignancies.
{"title":"European surgical guidelines: transoral robotic surgery for head and neck cancers","authors":"Jérôme R. Lechien , Vinidh Paleri , Robin Baudouin , Aina Brunet , Carlos M. Chiesa-Estomba , Erika Crosetti , Andrea De Vito , Giovanni Cammaroto , Armando De Virgilio , Nicolas Fakhry , Wojciech Golusinski , Heikki Irjala , Stefan Lang , C.Rene Leemans , Sylvain Moriniere , Alberto M. Saibene , Claudio Sampieri , Somiah Siddiq , Vincent Vander Poorten , David Viros Porcuna , Stéphane Hans","doi":"10.1016/j.oraloncology.2025.107826","DOIUrl":"10.1016/j.oraloncology.2025.107826","url":null,"abstract":"<div><h3>Background</h3><div>Substantial heterogeneity in practice exists across centers regarding the indications and perioperative care for patients undergoing transoral robotic surgery (TORS) for head and neck cancer. This consensus paper aims to propose a European surgical practice guideline in this setting.</div></div><div><h3>Methods</h3><div>Twenty-two experts from European and International scientific societies participated in a modified Delphi process for rating and validating statements about indications, contraindications, surgical outcomes, and pre- and postoperative care associated with TORS for head and neck cancer care. Consensus was deemed to have been achieved when two-thirds of experts agreed or strongly agreed with the statement; those with fewer than one-third agreement were improved and resubmitted for voting until final validation or rejection.</div></div><div><h3>Results</h3><div>Of the initial 41 statements, 38 reached consensus after three voting rounds. Statements propose recommendations for the preoperative assessment (n = 7), indications and contraindications for TORS in oropharyngeal, laryngeal, and hypopharyngeal primaries (n = 10), surgical outcomes to be reported (n = 7), postoperative care (n = 8), and clinical research (n = 6). TORS is appropriate for small, accessible oropharyngeal and supraglottic tumors with favorable exposure. The contraindications set out in detail for oropharyngeal, laryngeal and hypopharyngeal lesions will assist in decision-making, especially when presented with a controversial clinical scenario. Standardized reporting of surgical, functional, and oncological outcomes, including swallowing, voice quality, and survival rates, is essential for evidence-based practice. TORS represents a promising avenue for therapeutic de-escalation in HPV-positive oropharyngeal cancers.</div></div><div><h3>Conclusion</h3><div>The European TORS surgical consensus provides clinical recommendations for the indications, contraindications, surgical and perioperative care for TORS management of head and neck malignancies.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"173 ","pages":"Article 107826"},"PeriodicalIF":3.9,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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