Pub Date : 2026-01-01Epub Date: 2025-12-06DOI: 10.1016/j.oraloncology.2025.107811
Beniamino Vincenzoni Padovan , Marleen Beenker , Johannes A. Langendijk , Hans Paul van der Laan , Boukje A.C. van Dijk , Geertrudia H. de Bock , Boudewijn E.C. Plaat , Pauline de Graeff , Suzanne Festen , Gyorgy B. Halmos
Objective
The number of older/frail patients with head and neck cancer (HNC) is increasing. They are more frail compared to patients with other malignancies. Therefore, geriatric care is increasingly integrated into the HNC care pathway. The aim of this study was to investigate how integrated geriatric care affects treatment outcomes in HNC patients irrespective of treatment intention.
Methods
This retrospective study compared treatment-related adverse outcomes (grade ≥ 2 Clavien-Dindo surgical complications and grade ≥ 2 CTCAE (chemo)radiotoxicity), and one-year mortality in two patient cohorts. In the first cohort (2014–2016), geriatric screening was only observational i.e. without intervention. In the second cohort (2019–2020), a complete geriatric pathway was integrated into the oncological care pathway, including an onco-geriatric MDT (multidisciplinary team meeting), referral to the geriatrician with intervention, if needed. Multivariable logistic regression analysis was performed to identify factors associated with adverse events and one-year mortality, including the cohort period.
Results
This study included 640 patients; 369 from the first cohort and 271 from the second cohort. The second cohort showed significantly fewer adverse events (34.6 %) compared to the first (65.4 %) (OR 0.41; 95 % CI 0.27–0.63: p < 0.001). Reductions were seen in surgical complications (OR 0.57; 95 % CI 0.32–1.01) as well as (chemo)radiotoxicity (OR 0.39; 95 % CI 0.20–0.76). No significant differences were observed in one-year mortality (OR 0.88; CI 0.59–1.48). Adverse events were significantly linked to malnutrition, advanced tumor stage and concomitant radiotherapy treatment.
Conclusion
Integration of geriatric care in the HNC pathway reduces treatment-related adverse events, without altering one-year mortality.
目的:老年/体弱头颈癌(HNC)患者数量呈上升趋势。与其他恶性肿瘤患者相比,他们更加虚弱。因此,老年护理越来越多地纳入HNC护理途径。本研究的目的是调查综合老年护理如何影响HNC患者的治疗结果,而不考虑治疗意图。方法:本回顾性研究比较了两个患者队列中治疗相关不良结局(≥2级Clavien-Dindo手术并发症和≥2级CTCAE(化疗)放射毒性)和一年死亡率。在第一个队列(2014-2016)中,老年筛查仅为观察性筛查,即没有干预。在第二队列(2019-2020)中,一个完整的老年医学途径被整合到肿瘤治疗途径中,包括肿瘤-老年医学MDT(多学科团队会议),如果需要,转诊给老年医学专家并进行干预。进行多变量logistic回归分析,以确定与不良事件和一年内死亡率相关的因素,包括队列期。结果:本研究纳入640例患者;第一组369人第二组271人。与第一组(65.4%)相比,第二组的不良事件显著减少(34.6%)(OR 0.41; 95% CI 0.27-0.63: p)。结论:在HNC途径中整合老年护理减少了治疗相关的不良事件,没有改变一年的死亡率。
{"title":"Integrated geriatric assessment and intervention in the head and neck oncology care pathway reduces adverse events and does not affect survival","authors":"Beniamino Vincenzoni Padovan , Marleen Beenker , Johannes A. Langendijk , Hans Paul van der Laan , Boukje A.C. van Dijk , Geertrudia H. de Bock , Boudewijn E.C. Plaat , Pauline de Graeff , Suzanne Festen , Gyorgy B. Halmos","doi":"10.1016/j.oraloncology.2025.107811","DOIUrl":"10.1016/j.oraloncology.2025.107811","url":null,"abstract":"<div><h3>Objective</h3><div>The number of older/frail patients with head and neck cancer (HNC) is increasing. They are more frail compared to patients with other malignancies. Therefore, geriatric care is increasingly integrated into the HNC care pathway. The aim of this study was to investigate how integrated geriatric care affects treatment outcomes in HNC patients irrespective of treatment intention.</div></div><div><h3>Methods</h3><div>This retrospective study compared treatment-related adverse outcomes (grade ≥ 2 Clavien-Dindo surgical complications and grade ≥ 2 CTCAE (chemo)radiotoxicity), and one-year mortality in two patient cohorts. In the first cohort (2014–2016), geriatric screening was only observational i.e. without intervention. In the second cohort (2019–2020), a complete geriatric pathway was integrated into the oncological care pathway, including an onco-geriatric MDT (multidisciplinary team meeting), referral to the geriatrician with intervention, if needed. Multivariable logistic regression analysis was performed to identify factors associated with adverse events and one-year mortality, including the cohort period.</div></div><div><h3>Results</h3><div>This study included 640 patients; 369 from the first cohort and 271 from the second cohort. The second cohort showed significantly fewer adverse events (34.6 %) compared to the first (65.4 %) (OR 0.41; 95 % CI 0.27–0.63: p < 0.001). Reductions were seen in surgical complications (OR 0.57; 95 % CI 0.32–1.01) as well as (chemo)radiotoxicity (OR 0.39; 95 % CI 0.20–0.76). No significant differences were observed in one-year mortality (OR 0.88; CI 0.59–1.48). Adverse events were significantly linked to malnutrition, advanced tumor stage and concomitant radiotherapy treatment.</div></div><div><h3>Conclusion</h3><div>Integration of geriatric care in the HNC pathway reduces treatment-related adverse events, without altering one-year mortality.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107811"},"PeriodicalIF":3.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701447","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 : 2026-01-01Epub Date: 2025-12-08DOI: 10.1016/j.oraloncology.2025.107815
Mushfiq H. Shaikh , Walid Gazala , Cindy Zeng , Mahdi Farzad Naimi , Matthew Cecchini , Amir Karimi , Halema Khan , Krista Joris , Shengjie Ying , Harrison Pan , Mohd Wessam Al Jawhri , David A. Palma , Joe S. Mymryk , Peter YF. Zeng , John W. Barrett , Anthony C. Nichols
Introduction
Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide, with over 700,000 new cases diagnosed annually. HPV-associated HNSCC patients generally respond well to standard therapies; however, about 15–20 % experience recurrence, while the rate is approximately 50 % in non-HPV-associated HNSCC. Identifying biomarkers for treatment failure is crucial for optimizing treatment strategies. Our lab’s whole genome sequencing (WGS) data has identified NOTCH1 mutations as enriched in recurrent HPV-positive HNSCC cases. This study investigates whether NOTCH1 deletion confers treatment resistance in both HPV-positive and HPV-negative HNSCC models.
Methods
Four HPV-positive (HPV+) HNSCC cell lines (UWO23, UWO37, UMSCC47, and 93VU147) and two HPV-negative (HPV−) HNSCC cell lines (FaDu and Cal27) were examined. We used siRNA to knock down NOTCH1 expression, confirmed by qPCR, and then used CRISPR editing to generate stable NOTCH1 knockout (KO) cells. The knockout was validated by real-time qPCR and western blotting. Cell viability, clonogenicity, and invasiveness were then evaluated through viability, colony formation, and invasion assays.
Results
The siRNA-mediated NOTCH1 knockdown increased cellular proliferation in both HPV+ and HPV− HNSCC lines, with similar effects observed in CRISPR-edited NOTCH1-KO cells. Colony formation and invasion assays demonstrated higher aggression and invasiveness in NOTCH1-KO cells compared to non-targeting controls (NTC). IC50 analysis showed that NOTCH1-KO cells exhibited enhanced cisplatin resistance in both HPV+ and HPV− lines, with increased radiation resistance also observed in NOTCH1-KO cells.
Conclusion
Our findings indicate that NOTCH1 loss in both HPV+ and HPV− HNSCC cell lines leads to increased aggressiveness, clonogenicity, invasiveness, and resistance to chemotherapy and radiation. This suggests that NOTCH1 loss may be a potential biomarker for identifying HNSCC patients at higher risk of treatment failure, supporting a more personalized, intensive therapeutic approach.
{"title":"NOTCH1 loss promotes chemo and radio-resistance in head and neck cancer","authors":"Mushfiq H. Shaikh , Walid Gazala , Cindy Zeng , Mahdi Farzad Naimi , Matthew Cecchini , Amir Karimi , Halema Khan , Krista Joris , Shengjie Ying , Harrison Pan , Mohd Wessam Al Jawhri , David A. Palma , Joe S. Mymryk , Peter YF. Zeng , John W. Barrett , Anthony C. Nichols","doi":"10.1016/j.oraloncology.2025.107815","DOIUrl":"10.1016/j.oraloncology.2025.107815","url":null,"abstract":"<div><h3>Introduction</h3><div>Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide, with over 700,000 new cases diagnosed annually. HPV-associated HNSCC patients generally respond well to standard therapies; however, about 15–20 % experience recurrence, while the rate is approximately 50 % in non-HPV-associated HNSCC. Identifying biomarkers for treatment failure is crucial for optimizing treatment strategies. Our lab’s whole genome sequencing (WGS) data has identified <em>NOTCH1</em> mutations as enriched in recurrent HPV-positive HNSCC cases. This study investigates whether <em>NOTCH1</em> deletion confers treatment resistance in both HPV-positive and HPV-negative HNSCC models.</div></div><div><h3>Methods</h3><div>Four HPV-positive (HPV+) HNSCC cell lines (UWO23, UWO37, UMSCC47, and 93VU147) and two HPV-negative (HPV−) HNSCC cell lines (FaDu and Cal27) were examined. We used siRNA to knock down <em>NOTCH1</em> expression, confirmed by qPCR, and then used CRISPR editing to generate stable <em>NOTCH1</em> knockout (KO) cells. The knockout was validated by real-time qPCR and western blotting. Cell viability, clonogenicity, and invasiveness were then evaluated through viability, colony formation, and invasion assays.</div></div><div><h3>Results</h3><div>The siRNA-mediated <em>NOTCH1</em> knockdown increased cellular proliferation in both HPV+ and HPV− HNSCC lines, with similar effects observed in CRISPR-edited <em>NOTCH1</em>-KO cells. Colony formation and invasion assays demonstrated higher aggression and invasiveness in <em>NOTCH1</em>-KO cells compared to non-targeting controls (NTC). IC50 analysis showed that <em>NOTCH1</em>-KO cells exhibited enhanced cisplatin resistance in both HPV+ and HPV− lines, with increased radiation resistance also observed in <em>NOTCH1</em>-KO cells.</div></div><div><h3>Conclusion</h3><div>Our findings indicate that <em>NOTCH1</em> loss in both HPV+ and HPV− HNSCC cell lines leads to increased aggressiveness, clonogenicity, invasiveness, and resistance to chemotherapy and radiation. This suggests that <em>NOTCH1</em> loss may be a potential biomarker for identifying HNSCC patients at higher risk of treatment failure, supporting a more personalized, intensive therapeutic approach.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107815"},"PeriodicalIF":3.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145714937","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 : 2026-01-01Epub Date: 2025-12-15DOI: 10.1016/j.oraloncology.2025.107822
Shanshan Yuan, Jingjing Gao
{"title":"Methodological considerations in profiling the immune microenvironment and HPV status of oral multiple primary cancers","authors":"Shanshan Yuan, Jingjing Gao","doi":"10.1016/j.oraloncology.2025.107822","DOIUrl":"10.1016/j.oraloncology.2025.107822","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107822"},"PeriodicalIF":3.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768735","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 : 2026-01-01Epub Date: 2025-12-15DOI: 10.1016/j.oraloncology.2025.107816
Kripa Bajaj , Ramya Ramadoss , Sandhya Sundar , Suganya Panneer Selvam , Hema Shree K.
Background
Oral squamous cell carcinoma (OSCC) is a large source of cancer-related morbidity in India especially when it involves the tongue and the buccal mucosa. Despite the fact that TNM staging provides a global framework, regional patterns of metastasis, comorbidity interaction and concordance between imaging and pathology are not uniformly represented. This study will investigate nodal disease patterns in a group of people in the Delhi National Capital Region (NCR) and will suggest more specific treatments. The research aims to facilitate early diagnosis and intervention pathways and to reduce inequality in healthcare service provision.
Methods
Twenty patients with OSCC who had been diagnosed between 2023 and 2025 were the subjects of a retrospective study conducted on tertiary oncology centres in Delhi NCR. Inclusion criteria were confirmation of primary OSCC of the tongue or buccal mucosa, availability of PET −CT or MRI images, full TNM staging, and comorbidity information. Data visualization included heatmaps, scatter plot, cluster diagram and radar charts. Along with the imaging concordance, tumour site, the size of the lesion, nodal involvement, and the burden of comorbidity were evaluated.
Results
Bilateral nodal involvement was higher in the Tongue OSCC, mostly at Level II and III, but the tumours of the buccal mucosa were mostly limited to Level Ib unilateral. Nodal burden was much higher in lesions of around 3.5 cm. Comorbidities (diabetes and chronic kidney disease) were also related to higher FDG uptake and necrosis, but the relationships were not statistically significant. PET-CT had 85 percent agreement with the pathology of the surgery. The decision of treatment was based on the staging with surgery being the preferred treatment option in early disease and chemoradiation in advanced ones.
Conclusion
The site and size of tumour have a significant impact on nodal dissemination in OSCC. Bilateral neck dissection can be a wise option in case of early tongue lesions involving the midline but selective unilateral dissection is adequate in selecting cases involving the buccal lesions. It is necessary to couple comorbidity profiling with imaging results when planning pre-treatment. In this study, health systems, health equity, and collaborative oncology care are strengthened.
背景:口腔鳞状细胞癌(OSCC)是印度癌症相关发病率的一大来源,特别是当它累及舌头和颊粘膜时。尽管TNM分期提供了一个全球框架,但转移的区域模式、合并症的相互作用以及影像学和病理学之间的一致性并没有统一的代表。本研究将调查德里国家首都地区(NCR)一组人群的淋巴结疾病模式,并提出更具体的治疗方法。该研究旨在促进早期诊断和干预途径,并减少医疗服务提供中的不平等。方法:在德里NCR三级肿瘤中心对2023年至2025年间诊断的20例OSCC患者进行回顾性研究。纳入标准为确认舌头或颊粘膜原发OSCC, PET -CT或MRI图像的可用性,完整的TNM分期和合并症信息。数据可视化包括热图、散点图、聚类图和雷达图。随着影像学的一致性,肿瘤的位置,病变的大小,淋巴结的累及和合并症的负担进行评估。结果:舌头OSCC的双侧淋巴结受累较高,主要在II级和III级,但颊粘膜的肿瘤大多局限于单侧Ib级。在3.5 cm左右的病变中,淋巴结负担要高得多。合并症(糖尿病和慢性肾脏疾病)也与FDG摄取增加和坏死有关,但两者之间的关系无统计学意义。PET-CT与手术病理有85%的一致性。治疗的决定是基于分期,早期手术是首选的治疗方案,晚期放化疗。结论:肿瘤的部位和大小对OSCC淋巴结的播散有重要影响。在早期舌部病变累及中线的情况下,双侧颈部清扫是一个明智的选择,但在累及颊部病变的情况下,选择性单侧清扫是足够的。在计划术前治疗时,有必要将合并症分析与影像学结果相结合。在本研究中,卫生系统、卫生公平和协作肿瘤学护理得到加强。
{"title":"Patterns of metastasis and nodal disease in tongue and buccal carcinomas: Case-based reflections in Delhi NCR Region","authors":"Kripa Bajaj , Ramya Ramadoss , Sandhya Sundar , Suganya Panneer Selvam , Hema Shree K.","doi":"10.1016/j.oraloncology.2025.107816","DOIUrl":"10.1016/j.oraloncology.2025.107816","url":null,"abstract":"<div><h3>Background</h3><div>Oral squamous cell carcinoma (OSCC) is a large source of cancer-related morbidity in India especially when it involves the tongue and the buccal mucosa. Despite the fact that TNM staging provides a global framework, regional patterns of metastasis, comorbidity interaction and concordance between imaging and pathology are not uniformly represented. This study will investigate nodal disease patterns in a group of people in the Delhi National Capital Region (NCR) and will suggest more specific treatments. The research aims to facilitate early diagnosis and intervention pathways and to reduce inequality in healthcare service provision.</div></div><div><h3>Methods</h3><div>Twenty patients with OSCC who had been diagnosed between 2023 and 2025 were the subjects of a retrospective study conducted on tertiary oncology centres in Delhi NCR. Inclusion criteria were confirmation of primary OSCC of the tongue or buccal mucosa, availability of PET −CT or MRI images, full TNM staging, and comorbidity information. Data visualization included heatmaps, scatter plot, cluster diagram and radar charts. Along with the imaging concordance, tumour site, the size of the lesion, nodal involvement, and the burden of comorbidity were evaluated.</div></div><div><h3>Results</h3><div>Bilateral nodal involvement was higher in the Tongue OSCC, mostly at Level II and III, but the tumours of the buccal mucosa were mostly limited to Level Ib unilateral. Nodal burden was much higher in lesions of around 3.5 cm. Comorbidities (diabetes and chronic kidney disease) were also related to higher FDG uptake and necrosis, but the relationships were not statistically significant. PET-CT had 85 percent agreement with the pathology of the surgery. The decision of treatment was based on the staging with surgery being the preferred treatment option in early disease and chemoradiation in advanced ones.</div></div><div><h3>Conclusion</h3><div>The site and size of tumour have a significant impact on nodal dissemination in OSCC. Bilateral neck dissection can be a wise option in case of early tongue lesions involving the midline but selective unilateral dissection is adequate in selecting cases involving the buccal lesions. It is necessary to couple comorbidity profiling with imaging results when planning pre-treatment. In this study, health systems, health equity, and collaborative oncology care are strengthened.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107816"},"PeriodicalIF":3.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768754","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 : 2026-01-01Epub Date: 2025-12-18DOI: 10.1016/j.oraloncology.2025.107824
Yiheng Feng , Maged Ali Al-Aroomi , Jie Chen , Saiwen Song , Canhua Jiang , Jie Wang
Objectives
Patients who undergo solid organ or hematopoietic stem cell transplantation are at an increased risk of developing oral squamous cell carcinoma (OSCC) due to prolonged immunosuppression. The specific characteristics and prognostic outcomes of OSCC in these post-transplant patients are not well understood. This study aims to investigate the risk, characteristics, and prognostic outcomes of OSCC in post-transplant patients.
Methods
This study analyzed the clinical baseline characteristics of OSCC patients with pathological confirmation who had undergone organ transplantation (study group) and non-transplant OSCC patients (control group), all of whom were monitored with comprehensive follow-up. Survival outcomes, including overall survival (OS) and disease-free survival (DFS), were assessed using the Kaplan-Meier method. The Cox proportional hazards model was used to evaluate whether organ transplantation status was an independent risk factor affecting survival.
Results
A total of 103 patients were enrolled (study group, n = 17; control group, n = 86). The median age at OSCC diagnosis for study group was 53 years, with tumors primarily located on the tongue (35.3 %), buccal (17.6 %), and gingiva (11.8 %). Control group had a similar median age, with tumors mostly located on the tongue (64.0 %), buccal (16.3 %), and gingiva (8.1 %). Except for one transplant recipient who received conservative management, all patients underwent surgical resection. Cox multivariate analysis identified tumor recurrence (p = 0.002), tumor size (p = 0.016), and vascular invasion (p = 0.006) as significant adverse factors affecting survival.
Conclusion
This study emphasizes the importance of organ transplantation history in managing OSCC. Regular screening is essential for early detection and improved survival, particularly under immunosuppressive conditions, in this high-risk group.
{"title":"Influencing factors on occurrence and prognosis of oral squamous cell carcinoma after organ transplantation","authors":"Yiheng Feng , Maged Ali Al-Aroomi , Jie Chen , Saiwen Song , Canhua Jiang , Jie Wang","doi":"10.1016/j.oraloncology.2025.107824","DOIUrl":"10.1016/j.oraloncology.2025.107824","url":null,"abstract":"<div><h3>Objectives</h3><div>Patients who undergo solid organ or hematopoietic stem cell transplantation are at an increased risk of developing oral squamous cell carcinoma (OSCC) due to prolonged immunosuppression. The specific characteristics and prognostic outcomes of OSCC in these post-transplant patients are not well understood. This study aims to investigate the risk, characteristics, and prognostic outcomes of OSCC in post-transplant patients.</div></div><div><h3>Methods</h3><div>This study analyzed the clinical baseline characteristics of OSCC patients with pathological confirmation who had undergone organ transplantation (study group) and non-transplant OSCC patients (control group), all of whom were monitored with comprehensive follow-up. Survival outcomes, including overall survival (OS) and disease-free survival (DFS), were assessed using the Kaplan-Meier method. The Cox proportional hazards model was used to evaluate whether organ transplantation status was an independent risk factor affecting survival.</div></div><div><h3>Results</h3><div>A total of 103 patients were enrolled (study group, n = 17; control group, n = 86). The median age at OSCC diagnosis for study group was 53 years, with tumors primarily located on the tongue (35.3 %), buccal (17.6 %), and gingiva (11.8 %). Control group had a similar median age, with tumors mostly located on the tongue (64.0 %), buccal (16.3 %), and gingiva (8.1 %). Except for one transplant recipient who received conservative management, all patients underwent surgical resection. Cox multivariate analysis identified tumor recurrence (p = 0.002), tumor size (p = 0.016), and vascular invasion (p = 0.006) as significant adverse factors affecting survival.</div></div><div><h3>Conclusion</h3><div>This study emphasizes the importance of organ transplantation history in managing OSCC. Regular screening is essential for early detection and improved survival, particularly under immunosuppressive conditions, in this high-risk group.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107824"},"PeriodicalIF":3.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145787203","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 : 2026-01-01Epub Date: 2025-12-02DOI: 10.1016/j.oraloncology.2025.107790
Sarah C. Nyirjesy , Yana Al-Inaya , Selena Zhang , Omar A. Karadaghy , Derrick T. Lin , Daniel G. Deschler , Allen L. Feng , Mark A. Varvares , Adam S. Fisch , Daniel L. Faden , Jeremy D. Richmon
Second primary tumors after HPV-associated oropharyngeal squamous cell carcinoma (HPV + OPSCCa) are generally assumed to share the same HPV status as the index lesion, and current pathology guidelines discourage repeat HPV testing in recurrent disease. We retrospectively reviewed records from a tertiary academic center (2010–2024) to identify patients with a history of HPV + OPSCCa who subsequently developed an HPV-independent second primary head and neck squamous cell carcinoma. HPV status was determined by p16 immunohistochemistry, high-risk HPV DNA PCR, or RNA in situ hybridization. Eleven patients developed metachronous HPV-independent malignancies, representing an incidence of 2.5 %. The median interval between tumors was 8.8 years (range, 3.2–16.0 years). Second primaries most often arose in the contralateral base of tongue (55 %) or oral cavity (27 %). All patients had received definitive or adjuvant radiation for the initial tumor, and 73 % received concurrent chemotherapy. Four patients (36 %) reported a smoking history >10 pack-years. Most tumors at both time points were T1 or T2, but node-positive disease was more frequent in first primaries (82 % vs 18 %). Two patients developed a third HPV-independent primary tumor. These findings demonstrate that biologically discordant second primary head and neck cancers can emerge years after HPV + OPSCCa, challenging the assumption of HPV concordance and underscoring the need for long-term surveillance and reconsideration of repeat HPV testing in this population.
HPV相关口咽鳞状细胞癌(HPV + OPSCCa)后的第二原发肿瘤通常被认为与指数病变具有相同的HPV状态,目前的病理指南不鼓励在复发性疾病中重复HPV检测。我们回顾性地回顾了一个三级学术中心(2010-2024)的记录,以确定有HPV + OPSCCa病史的患者,这些患者随后发展为不依赖HPV的第二原发性头颈部鳞状细胞癌。通过p16免疫组织化学、高危HPV DNA PCR或RNA原位杂交检测HPV状态。11例患者发生异时性不依赖hpv的恶性肿瘤,发生率为2.5%。肿瘤之间的中位间隔为8.8年(范围3.2-16.0年)。第二原发牙最常发生在对侧舌根(55%)或口腔(27%)。所有患者都接受了初始肿瘤的最终或辅助放疗,73%的患者接受了同期化疗。4例患者(36%)报告吸烟史(10包年)。两个时间点的大多数肿瘤都是T1或T2,但淋巴结阳性疾病在首次原发时更为常见(82%对18%)。两名患者发展为第三个不依赖hpv的原发肿瘤。这些发现表明,生物学上不一致的第二原发性头颈癌可能在HPV + OPSCCa发生数年后出现,这挑战了HPV一致性的假设,并强调了在这一人群中进行长期监测和重新考虑重复HPV检测的必要性。
{"title":"Incidence of HPV-independent second primary malignancies following treatment of HPV-associated malignancy","authors":"Sarah C. Nyirjesy , Yana Al-Inaya , Selena Zhang , Omar A. Karadaghy , Derrick T. Lin , Daniel G. Deschler , Allen L. Feng , Mark A. Varvares , Adam S. Fisch , Daniel L. Faden , Jeremy D. Richmon","doi":"10.1016/j.oraloncology.2025.107790","DOIUrl":"10.1016/j.oraloncology.2025.107790","url":null,"abstract":"<div><div>Second primary tumors after HPV-associated oropharyngeal squamous cell carcinoma (HPV + OPSCCa) are generally assumed to share the same HPV status as the index lesion, and current pathology guidelines discourage repeat HPV testing in recurrent disease. We retrospectively reviewed records from a tertiary academic center (2010–2024) to identify patients with a history of HPV + OPSCCa who subsequently developed an HPV-independent second primary head and neck squamous cell carcinoma. HPV status was determined by p16 immunohistochemistry, high-risk HPV DNA PCR, or RNA in situ hybridization. Eleven patients developed metachronous HPV-independent malignancies, representing an incidence of 2.5 %. The median interval between tumors was 8.8 years (range, 3.2–16.0 years). Second primaries most often arose in the contralateral base of tongue (55 %) or oral cavity (27 %). All patients had received definitive or adjuvant radiation for the initial tumor, and 73 % received concurrent chemotherapy. Four patients (36 %) reported a smoking history >10 pack-years. Most tumors at both time points were T1 or T2, but node-positive disease was more frequent in first primaries (82 % vs 18 %). Two patients developed a third HPV-independent primary tumor. These findings demonstrate that biologically discordant second primary head and neck cancers can emerge years after HPV + OPSCCa, challenging the assumption of HPV concordance and underscoring the need for long-term surveillance and reconsideration of repeat HPV testing in this population.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107790"},"PeriodicalIF":3.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669487","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 : 2026-01-01Epub Date: 2025-11-27DOI: 10.1016/j.oraloncology.2025.107789
Ying Li , Qianzi Kou , Chongyang Zheng , Pengkhun Nov, Changqian Wang, Peizan Ni, Lilin Li, Yangfeng Zhang, Duanyu Wang, Arzoo Prasai, Wen Fu, Jiqiang Li , Kunpeng Du
Purpose
Human papillomavirus (HPV) status is a key prognostic factor in head and neck squamous cell carcinoma (HNSCC), yet the precise immunological mechanisms and robust biomarkers for guiding personalized therapy remain elusive. This study aims to comprehensively delineate how HPV infection reprograms the tumor immune microenvironment (TIME) and to develop a novel prognostic model for stratifying patient outcomes and therapeutic responses.
Methods
Multi-omics data from TCGA and GEO databases were integrated. The immune landscape was compared between HPV+ and HPV- HNSCC using bulk transcriptomic deconvolution and single-cell RNA sequencing (scRNA-seq) profiling. A prognostic risk signature was constructed from HPV-associated genes via LASSO-COX regression and validated in independent cohorts. The model was evaluated for its association with immune infiltration, tumor mutational burden, and drug sensitivity. Cellular communication networks were deciphered using CellChat. Hub genes expression was confirmed by immunohistochemistry (IHC).
Results
Single-cell profiling revealed that HPV+ tumors were characterized by an immunologically active microenvironment with increased infiltration and enhanced crosstalk of cytotoxic CD8+ T cells, helper CD4+ T cells, and B cells. In contrast, HPV- tumors exhibited a stromal-rich, immunosuppressive niche. We developed and validated a prognostic model based on seven HPV-related genes (IER3, FHL2, MBOAT2, DSC3, IRAK3, RGMA, BARD1). This risk score robustly stratified patients into high- and low-risk groups with distinct overall survival (low-risk vs. high-risk, P < 0.0001) and was an independent prognostic factor. The low-risk group, mirroring the HPV+ phenotype, demonstrated an activated immune milieu, higher expression of immune checkpoints (e.g., PD-1, CTLA-4), and was predicted to be more responsive to both chemotherapy and immunotherapy. Conversely, the high-risk group displayed a barren immune landscape, enriched in stromal and pro-tumorigenic pathways (e.g., MIF, COLLAGEN), and heightened sensitivity to specific targeted agents (e.g., Dasatinib). IHC validation confirmed the tumor-promotive role of hub genes (IER3, FHL2).
Conclusion
Our study leverages single-cell profiling to elucidate HPV-driven immunological remodeling in HNSCC. The derived prognostic signature effectively captures the essence of the TIME, serving as a reliable biomarker for predicting patient survival and informing precision therapy, potentially bridging the gap between HPV status and clinical decision-making.
{"title":"Hpv-driven rewiring of the tumor immune microenvironment through single-cell profiling informs prognosis and therapy in HNSCC","authors":"Ying Li , Qianzi Kou , Chongyang Zheng , Pengkhun Nov, Changqian Wang, Peizan Ni, Lilin Li, Yangfeng Zhang, Duanyu Wang, Arzoo Prasai, Wen Fu, Jiqiang Li , Kunpeng Du","doi":"10.1016/j.oraloncology.2025.107789","DOIUrl":"10.1016/j.oraloncology.2025.107789","url":null,"abstract":"<div><h3>Purpose</h3><div>Human papillomavirus (HPV) status is a key prognostic factor in head and neck squamous cell carcinoma (HNSCC), yet the precise immunological mechanisms and robust biomarkers for guiding personalized therapy remain elusive. This study aims to comprehensively delineate how HPV infection reprograms the tumor immune microenvironment (TIME) and to develop a novel prognostic model for stratifying patient outcomes and therapeutic responses.</div></div><div><h3>Methods</h3><div>Multi-omics data from TCGA and GEO databases were integrated. The immune landscape was compared between HPV<sup>+</sup> and HPV<sup>-</sup> HNSCC using bulk transcriptomic deconvolution and single-cell RNA sequencing (scRNA-seq) profiling. A prognostic risk signature was constructed from HPV-associated genes via LASSO-COX regression and validated in independent cohorts. The model was evaluated for its association with immune infiltration, tumor mutational burden, and drug sensitivity. Cellular communication networks were deciphered using CellChat. Hub genes expression was confirmed by immunohistochemistry (IHC).</div></div><div><h3>Results</h3><div>Single-cell profiling revealed that HPV<sup>+</sup> tumors were characterized by an immunologically active microenvironment with increased infiltration and enhanced crosstalk of cytotoxic CD8<sup>+</sup> T cells, helper CD4<sup>+</sup> T cells, and B cells. In contrast, HPV<sup>-</sup> tumors exhibited a stromal-rich, immunosuppressive niche. We developed and validated a prognostic model based on seven HPV-related genes (IER3, FHL2, MBOAT2, DSC3, IRAK3, RGMA, BARD1). This risk score robustly stratified patients into high- and low-risk groups with distinct overall survival (low-risk vs. high-risk, P < 0.0001) and was an independent prognostic factor. The low-risk group, mirroring the HPV<sup>+</sup> phenotype, demonstrated an activated immune milieu, higher expression of immune checkpoints (e.g., PD-1, CTLA-4), and was predicted to be more responsive to both chemotherapy and immunotherapy. Conversely, the high-risk group displayed a barren immune landscape, enriched in stromal and pro-tumorigenic pathways (e.g., MIF, COLLAGEN), and heightened sensitivity to specific targeted agents (e.g., Dasatinib). IHC validation confirmed the tumor-promotive role of hub genes (IER3, FHL2).</div></div><div><h3>Conclusion</h3><div>Our study leverages single-cell profiling to elucidate HPV-driven immunological remodeling in HNSCC. The derived prognostic signature effectively captures the essence of the TIME, serving as a reliable biomarker for predicting patient survival and informing precision therapy, potentially bridging the gap between HPV status and clinical decision-making.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107789"},"PeriodicalIF":3.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145600471","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 : 2026-01-01Epub Date: 2025-12-15DOI: 10.1016/j.oraloncology.2025.107705
Cunxi Zou
{"title":"Letter to the editor: Stroke risk after head and neck cancer diagnosis and treatment in a Real-World clinical cohort","authors":"Cunxi Zou","doi":"10.1016/j.oraloncology.2025.107705","DOIUrl":"10.1016/j.oraloncology.2025.107705","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107705"},"PeriodicalIF":3.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768751","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 : 2025-12-01Epub Date: 2025-11-05DOI: 10.1016/j.oraloncology.2025.107770
Giancarlo Tirelli, Paolo Boscolo-Rizzo
{"title":"Perioperative pembrolizumab and the changing paradigm of adjuvant therapy in head and neck squamous cell carcinoma: the case of T1-2, pN1","authors":"Giancarlo Tirelli, Paolo Boscolo-Rizzo","doi":"10.1016/j.oraloncology.2025.107770","DOIUrl":"10.1016/j.oraloncology.2025.107770","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"171 ","pages":"Article 107770"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459374","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 : 2025-12-01Epub Date: 2025-11-13DOI: 10.1016/j.oraloncology.2025.107784
Min Li, Yingchun Zhou, Ming Cai
{"title":"Letter to the Editor: A phase II clinical trial of paclitaxel-carboplatin as neoadjuvant therapy followed by surgery in patients with locally advanced head and neck squamous cell carcinoma","authors":"Min Li, Yingchun Zhou, Ming Cai","doi":"10.1016/j.oraloncology.2025.107784","DOIUrl":"10.1016/j.oraloncology.2025.107784","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"171 ","pages":"Article 107784"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518017","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}