Pub Date : 2025-02-01DOI: 10.1016/j.oraloncology.2025.107194
Jiayi Chen
{"title":"Do we recognize oral oncology with accuracy? AI-driven models serve in the diagnosis of oral squamous cell carcinoma","authors":"Jiayi Chen","doi":"10.1016/j.oraloncology.2025.107194","DOIUrl":"10.1016/j.oraloncology.2025.107194","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"161 ","pages":"Article 107194"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009322","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 : 2025-02-01DOI: 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.
{"title":"A rare case of extracranial schwannoma in the masticator space removed by endoscopic assisted transoral approach (EATA)","authors":"Giovanni Motta , Pasquale Puzone , Gino Latini , Arianna Di Stadio , Luca D’Ascanio","doi":"10.1016/j.oraloncology.2024.107164","DOIUrl":"10.1016/j.oraloncology.2024.107164","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Case Report</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"161 ","pages":"Article 107164"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966392","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 : 2025-02-01DOI: 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.
{"title":"Functional and oncological outcomes of transoral laser versus robotic surgery in supraglottic squamous cell carcinoma","authors":"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","doi":"10.1016/j.oraloncology.2025.107178","DOIUrl":"10.1016/j.oraloncology.2025.107178","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div><div>Study Design:</div><div>Retrospective case series with prospective data.</div><div>Settings:</div><div>Tertiary Academic Medical Center.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>p</em> < 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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"161 ","pages":"Article 107178"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966394","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 : 2025-02-01DOI: 10.1016/j.oraloncology.2024.107163
Bacem K. Othman, Wafaey Badawy
{"title":"Hyalinising parotid adenoid cystic carcinoma with dystrophic calcification masquerading as a thyroid-like carcinoma","authors":"Bacem K. Othman, Wafaey Badawy","doi":"10.1016/j.oraloncology.2024.107163","DOIUrl":"10.1016/j.oraloncology.2024.107163","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"161 ","pages":"Article 107163"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104955","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 : 2025-01-30DOI: 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}
Pub Date : 2025-01-28DOI: 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}
Pub Date : 2025-01-27DOI: 10.1016/j.oraloncology.2025.107206
Na Sun , Long Huang , Hong-gang Xiong , Wei-ming Wang , Si-qi Hua , Fei-ya Zhu , Tong Su
Objective
To develop a nomogram prediction model for occult lymph node metastasis (LNM) in patients with cT1-2N0 buccal squamous cell carcinoma (BSCC), then to compare its predictive efficacy against depth of invasion (DOI).
Methods
Clinical data were retrieved for patients undergoing primary tumor resection and neck dissection from June 2020 to August 2024. Based on the risk factors screened by Lasso regression, we established four candidate models: logistic regression, random forest, support vector machine, and XGboost. The optimal model was determined by comparing the values of areas under the receiver-operating characteristic curve (AUC), then the nomogram was ultimately plotted accordingly to visualize the results.
Results
Two hundred and fifty patients were enrolled. The screened variables include Ki-67, tumor differentiation grade, surgical margin status, perineural invasion, DOI, and smoking. With similar good performance from both the training and test cohorts (AUC, 0.726 vs. 0.782) and good calibration, the logistic regression model performed the best overall, and was thus selected for creating a nomogram. The nomogram was superior to DOI cut-off values of 3 mm and 4 mm in predicting occult LNM, with a higher AUC (0.741 vs. 0.543 and 0.595) and more net benefits. Compared with DOI < 4 mm, at a 9.51 % risk of LNM, the nomogram identified an equivalent number of cases (n = 64) for not undergoing elective neck dissection (END), while successfully reducing 2 false-negative cases (2 vs. 4) with insufficient treatment.
Conclusions
The nomogram described here prevails over DOI in predicting occult LNM in early-stage BSCC, and provide effective guidance for END.
{"title":"Nomogram vs. Depth of invasion for predicting occult lymph node metastasis in cT1-2N0 buccal squamous cell carcinoma","authors":"Na Sun , Long Huang , Hong-gang Xiong , Wei-ming Wang , Si-qi Hua , Fei-ya Zhu , Tong Su","doi":"10.1016/j.oraloncology.2025.107206","DOIUrl":"10.1016/j.oraloncology.2025.107206","url":null,"abstract":"<div><h3>Objective</h3><div>To develop a nomogram prediction model for occult lymph node metastasis (LNM) in patients with cT1-2N0 buccal squamous cell carcinoma (BSCC), then to compare its predictive efficacy against depth of invasion (DOI).</div></div><div><h3>Methods</h3><div>Clinical data were retrieved for patients undergoing primary tumor resection and neck dissection from June 2020 to August 2024. Based on the risk factors screened by Lasso regression, we established four candidate models: logistic regression, random forest, support vector machine, and XGboost. The optimal model was determined by comparing the values of areas under the receiver-operating characteristic curve (AUC), then the nomogram was ultimately plotted accordingly to visualize the results.</div></div><div><h3>Results</h3><div>Two hundred and fifty patients were enrolled. The screened variables include Ki-67, tumor differentiation grade, surgical margin status, perineural invasion, DOI, and smoking. With similar good performance from both the training and test cohorts (AUC, 0.726 vs. 0.782) and good calibration, the logistic regression model performed the best overall, and was thus selected for creating a nomogram. The nomogram was superior to DOI cut-off values of 3 mm and 4 mm in predicting occult LNM, with a higher AUC (0.741 vs. 0.543 and 0.595) and more net benefits. Compared with DOI < 4 mm, at a 9.51 % risk of LNM, the nomogram identified an equivalent number of cases (n = 64) for not undergoing elective neck dissection (END), while successfully reducing 2 false-negative cases (2 vs. 4) with insufficient treatment.</div></div><div><h3>Conclusions</h3><div>The nomogram described here prevails over DOI in predicting occult LNM in early-stage BSCC, and provide effective guidance for END.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"162 ","pages":"Article 107206"},"PeriodicalIF":4.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059758","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 : 2025-01-27DOI: 10.1016/j.oraloncology.2025.107205
Talia A. Wenger , Jaynelle Gao , Margaret Nurimba , Peter G. Phung , Uttam K. Sinha
Purpose
Head and neck cancer (HNC) patients face substantial morbidity and mortality. Despite the potential benefits of palliative care (PC) in improving quality of life, many HNC patients do not receive these services. This study aimed to quantify the proportion of HNC patients receiving PC, the timing of PC referrals, and the mental health and clinical outcomes of this population.
Methods
A retrospective cohort study was conducted using the TriNetX database with de-identified electronic medical records. HNC patients were categorized based on whether they had at least one PC encounter. We examined time to first PC encounter, mortality rates, mental health diagnoses, and access to ACP and supportive care.
Results
Of 304,404 HNC patients, only 22,470 (7.4 %) had at least one PC encounter. The median time from cancer diagnosis to initial PC referral was 318 days. After propensity score matching, the cohorts consisted of 24,916 patients each. Those who received PC had a significantly higher risk of mortality (RR 3.05, 95 % CI 2.97–3.14), depression (RR 1.38, 95 % CI 1.33–1.45), anxiety (RR 1.47, 95 % CI 1.42–1.53), failure to thrive (RR 3.26, 95 % CI 3.03–3.51), and were more likely to engage in advance care planning (RR 4.97, 95 % CI 4.39–5.62) and access supportive care services compared to patients who did not receive PC.
Conclusions
PC utilization among HNC patients is low, with patients often waiting nearly a year before their first PC encounter. This delay highlights a significant unmet need for early integrated PC in this population.
{"title":"Palliative care utilization among head and neck cancer patients: A population-based analysis","authors":"Talia A. Wenger , Jaynelle Gao , Margaret Nurimba , Peter G. Phung , Uttam K. Sinha","doi":"10.1016/j.oraloncology.2025.107205","DOIUrl":"10.1016/j.oraloncology.2025.107205","url":null,"abstract":"<div><h3>Purpose</h3><div>Head and neck cancer (HNC) patients face substantial morbidity and mortality. Despite the potential benefits of palliative care (PC) in improving quality of life, many HNC patients do not receive these services. This study aimed to quantify the proportion of HNC patients receiving PC, the timing of PC referrals, and the mental health and clinical outcomes of this population.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using the TriNetX database with de-identified electronic medical records. HNC patients were categorized based on whether they had at least one PC encounter. We examined time to first PC encounter, mortality rates, mental health diagnoses, and access to ACP and supportive care.</div></div><div><h3>Results</h3><div>Of 304,404 HNC patients, only 22,470 (7.4 %) had at least one PC encounter. The median time from cancer diagnosis to initial PC referral was 318 days. After propensity score matching, the cohorts consisted of 24,916 patients each. Those who received PC had a significantly higher risk of mortality (RR 3.05, 95 % CI 2.97–3.14), depression (RR 1.38, 95 % CI 1.33–1.45), anxiety (RR 1.47, 95 % CI 1.42–1.53), failure to thrive (RR 3.26, 95 % CI 3.03–3.51), and were more likely to engage in advance care planning (RR 4.97, 95 % CI 4.39–5.62) and access supportive care services compared to patients who did not receive PC.</div></div><div><h3>Conclusions</h3><div>PC utilization among HNC patients is low, with patients often waiting nearly a year before their first PC encounter. This delay highlights a significant unmet need for early integrated PC in this population.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"162 ","pages":"Article 107205"},"PeriodicalIF":4.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059961","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 : 2025-01-27DOI: 10.1016/j.oraloncology.2025.107182
Selvam Thavaraj , Rhonda Henley-Smith , Harry Gregson-Williams , Sangeetha Yogarajah , Edward W. Odell , Hans Sathasivam
Background
Human papillomavirus-associated oral epithelial dysplasia (HPV-OED) has been recently recognised by the World Health Organisation (WHO) as a distinct type of oral epithelial dysplasia. The rarity of HPV-OED, together with gaps in the current understanding of risk factors and clinical behaviour raise the risk of under-recognition and misdiagnosis. To address this, we describe the clinico-pathological features of a consecutive series of HPV-OED from a single institution to provide additional insight into the presentation and behaviour of this disease.
Methods
Consecutive cases of HPV-OED were identified over a 20-year period from the pathology routine diagnostic archives of a single centre. Cases with features of viral cytopathic changes in a background of OED underwent HPV-specific testing in addition to p16 immunohistochemistry to confirm HPV positivity.
Results
Fifty-three consecutive patients with HPV-OED were identified. The mean age at diagnosis was 55 years-old and there was a strong male predilection (83 %). Most patients were smokers or former smokers, and almost a fifth of individuals were Human Immunodeficiency Virus (HIV)-positive. The latero-ventral tongue was the most common index site. Twenty-eight percent of cases were associated with invasive oral squamous cell carcinoma. There was a statistically significant association between with patient’s HIV status and malignant transformation (p = 0.022).
Conclusions
Findings from our cohort of HPV-OED patients suggests that malignant transformation is relatively frequent and associated with the HIV status of patients.
{"title":"Clinico-pathological characterisation of human papillomavirus-associated oral epithelial dysplasia","authors":"Selvam Thavaraj , Rhonda Henley-Smith , Harry Gregson-Williams , Sangeetha Yogarajah , Edward W. Odell , Hans Sathasivam","doi":"10.1016/j.oraloncology.2025.107182","DOIUrl":"10.1016/j.oraloncology.2025.107182","url":null,"abstract":"<div><h3>Background</h3><div>Human papillomavirus-associated oral epithelial dysplasia (HPV-OED) has been recently recognised by the World Health Organisation (WHO) as a distinct type of oral epithelial dysplasia. The rarity of HPV-OED, together with gaps in the current understanding of risk factors and clinical behaviour raise the risk of under-recognition and misdiagnosis. To address this, we describe the clinico-pathological features of a consecutive series of HPV-OED from a single institution to provide additional insight into the presentation and behaviour of this disease.</div></div><div><h3>Methods</h3><div>Consecutive cases of HPV-OED were identified over a 20-year period from the pathology routine diagnostic archives of a single centre. Cases with features of viral cytopathic changes in a background of OED underwent HPV-specific testing in addition to p16 immunohistochemistry to confirm HPV positivity.</div></div><div><h3>Results</h3><div>Fifty-three consecutive patients with HPV-OED were identified. The mean age at diagnosis was 55 years-old and there was a strong male predilection (83 %). Most patients were smokers or former smokers, and almost a fifth of individuals were Human Immunodeficiency Virus (HIV)-positive. The latero-ventral tongue was the most common index site. Twenty-eight percent of cases were associated with invasive oral squamous cell carcinoma. There was a statistically significant association between with patient’s HIV status and malignant transformation (p = 0.022).</div></div><div><h3>Conclusions</h3><div>Findings from our cohort of HPV-OED patients suggests that malignant transformation is relatively frequent and associated with the HIV status of patients.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"162 ","pages":"Article 107182"},"PeriodicalIF":4.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059722","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 : 2025-01-25DOI: 10.1016/j.oraloncology.2024.107168
Tao Xie , Yuqi Shu , Wei Huang , Anbang Ren , Jie Lin , Yujing Tan , Shufen Zhao , Junguo Bu
Background
Chemoresistance is one of the main challenges for advanced NPC treatment. We previously proved LHX2 transcriptionally regulates FGF1 and promotes cancer progression through activating FGF1/FGFR axis,which prompted us to explore the potential inhibitors for FGFR to improve the therapy response.
Methods
RT-qPCR, immunohistochemistry, western blot assay and immunofluorescence were applied to verify the gene expression levels. Xenograft model as well as lung metastasis model was performed for in vitro assays. Flow cytometry and Tunel staining were used to determine the apoptosis of NPC cells.The interaction between β-eudesmol and FGFR1/2 was analyzed by Autodock software.
Results
β-eudesmol inhibited the growth and metastasis of NPC in vivo and in vitro. In addition, β-eudesmol treatment promoted NPC apoptosis and sensitized NPC to cisplatin. β-eudesmol putatively bound to FGFR and blocked the Akt signaling, STAT3 signaling and ERK signaling, which in turn restrained ABCC1 transcription.
Conclusion
β-eudesmol suppressed cell growth, metastasis and chemoresistance in NPC through targeting FGF1/FGFR signaling, thereby blocking the Akt signaling, STAT3 signaling and ERK signaling, as well as down-regulating ABCC1 expression. Our findings provided a novel potential drug for NPC treatment.
{"title":"β-eudesmol inhibits cell growth and enhances cell chemosensitivity of NPC through targeting FGF1/FGFR signaling","authors":"Tao Xie , Yuqi Shu , Wei Huang , Anbang Ren , Jie Lin , Yujing Tan , Shufen Zhao , Junguo Bu","doi":"10.1016/j.oraloncology.2024.107168","DOIUrl":"10.1016/j.oraloncology.2024.107168","url":null,"abstract":"<div><h3>Background</h3><div>Chemoresistance is one of<!--> <!-->the main challenges for advanced NPC<!--> <!-->treatment.<!--> <!-->We previously<!--> <!-->proved LHX2 transcriptionally regulates FGF1 and promotes cancer progression through activating FGF1/FGFR axis,which prompted us to<!--> <!-->explore the potential inhibitors for FGFR to improve the therapy response.</div></div><div><h3>Methods</h3><div>RT-qPCR, immunohistochemistry, western blot assay<!--> <!-->and immunofluorescence<!--> <!-->were applied to verify the gene expression levels. Xenograft<!--> <!-->model as well as lung metastasis model was performed for<!--> <!-->in vitro<!--> <!-->assays. Flow cytometry and Tunel staining<!--> <!-->were used to determine the apoptosis of NPC cells.The interaction between β-eudesmol and FGFR1/2 was analyzed by Autodock software.</div></div><div><h3>Results</h3><div> <!-->β-eudesmol inhibited the growth and metastasis<!--> <!-->of NPC<!--> <em>in vivo</em> <!-->and<!--> <!-->in vitro.<!--> <!-->In addition,<!--> <!-->β-eudesmol treatment promoted NPC apoptosis and sensitized NPC to cisplatin. β-eudesmol putatively bound to FGFR and blocked the Akt signaling, STAT3 signaling<!--> <!-->and<!--> <!-->ERK<!--> <!-->signaling,<!--> <!-->which in turn restrained<!--> <!-->ABCC1 transcription.</div></div><div><h3>Conclusion</h3><div> <!-->β-eudesmol suppressed cell growth, metastasis and chemoresistance in NPC through targeting<!--> <!-->FGF1/FGFR signaling, thereby blocking the Akt signaling, STAT3 signaling and<!--> <!-->ERK<!--> <!-->signaling, as well as down-regulating ABCC1 expression. Our findings provided a novel potential drug for NPC treatment.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"162 ","pages":"Article 107168"},"PeriodicalIF":4.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047427","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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