Oral oncology最新文献

英文中文

Evaluating CD103+ intratumoral immune cell abundance and PD-L1 CPS in primary tumors versus lymph nodes in Human papillomavirus associated oropharyngeal Cancer 评估人乳头瘤病毒相关口咽癌原发肿瘤与淋巴结中CD103+瘤内免疫细胞丰度和PD-L1 CPS

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

Oral oncology

Pub Date : 2025-11-21 DOI: 10.1016/j.oraloncology.2025.107792

Chia Yuen Chong , Richard J. Young , Annette M. Lim , Angela Pizzolla , Christopher M. Angel , Mathias Bressel , Matthew Magarey , Benjamin Dixon , Benjamin Solomon , Danny Rischin

Background

CD103⁺ intratumoral immune cell (ITIC) abundance in Human Papillomavirus associated Oropharyngeal Cancer (HPVOPC) primary tumors in patients treated with chemoradiation conveys an excellent prognosis, but data is lacking for nodal expression and surgical cohorts. High programmed death-ligand 1 (PD-L1) expression predicts immunotherapy response, but its prognostic significance and correlation with CD103⁺ expression in HPVOPC is unknown.

Methods

Immunohistochemistry to evaluate CD103⁺ ITIC abundance > 30 % and PD-L1 Combined Positive Score (CPS) > 20 % in primary tumors and lymph nodes in 114 surgically treated HPVOPC patients. Findings were correlated with clinicopathological and outcome data.

Results

High CD103⁺ ITIC abundance (>30 %) in 14.5 % of primary tumors (16/110) and 14.3 % (11/77) of lymph nodes. High PD-L1 CPS (>20 %) in 38.3 % (41/107) of primaries, and 36.3 % (28/77) of nodes. Discordant rates between primaries and nodes for CD103⁺ ITIC and PD-L1 CPS were 15 % and 29 % respectively. 5-year failure free survival (FFS) was 100 % and 83 % in patients with high and low CD103⁺ ITIC abundance primary tumors, (95 % CI: 72–91; p = 0.161). 5-year FFS was 98 % and 79 % (p = 0.033) in patients with high and low PD-L1 CPS primary tumors. Lymph node CD103⁺ ITIC abundance and PD-L1 CPS did not appear to be prognostic for survival.

Conclusions

This study highlights the discordance in CD103⁺ ITIC and PD-L1 expression between primaries and nodes, favorable results in high CD103⁺ ITIC abundance HPVOPC in a surgical cohort consistent with outcomes in chemoradiation cohorts, and promising results suggesting that high PD-L1 CPS in HPVOPC also identifies patients with an excellent prognosis.

背景：在接受放化疗的人乳头瘤病毒相关口咽癌（HPVOPC）原发性肿瘤患者中，cd103 +瘤内免疫细胞（ITIC）丰度预示着良好的预后，但缺乏淋巴结表达和手术队列的数据。程序性死亡配体1 （PD-L1）的高表达可预测免疫治疗反应，但其在HPVOPC中的预后意义及其与CD103+表达的相关性尚不清楚。方法采用免疫组化方法评价114例手术治疗的HPVOPC患者原发肿瘤和淋巴结中CD103+ ITIC丰度>； 30%， PD-L1联合阳性评分（CPS） > 20%。结果与临床病理和预后数据相关。结果CD103+ ITIC在14.5%的原发肿瘤（16/110）和14.3%的淋巴结（11/77）中有较高的丰度（30%）。原发性肿瘤38.3%（41/107）、淋巴结36.3%（28/77）的PD-L1 CPS较高（> 20%）。CD103+ ITIC和PD-L1 CPS的原发和结间不一致率分别为15%和29%。CD103+ ITIC高、低丰度原发肿瘤患者的5年无失败生存率分别为100%和83% （95% CI: 72-91; p = 0.161）。高、低PD-L1 CPS原发肿瘤患者的5年FFS分别为98%和79% （p = 0.033）。淋巴结CD103+ ITIC丰度和PD-L1 CPS似乎不是生存的预后因素。本研究强调了CD103+ ITIC和PD-L1表达在原发和淋巴结之间的不一致性，高CD103+ ITIC丰度的HPVOPC在手术队列中的有利结果与放化疗队列的结果一致，并且令人鼓舞的结果表明，HPVOPC中高PD-L1 CPS也可以识别出预后良好的患者。

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引用次数: 0

From peripheral tolerance to combination therapy: The translational legacy of the 2025 Nobel Prize 从外周耐受到联合治疗：2025年诺贝尔奖的转化遗产

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

Oral oncology

Pub Date : 2025-11-21 DOI: 10.1016/j.oraloncology.2025.107793

Fábio Muradás Girardi , Manoela Domingues Martins , Lauren Frenzel Schuch

引用次数: 0

Learning process of transoral robotic surgery for head and neck cancers: a scoping review 头颈部肿瘤经口机器人手术的学习过程：范围综述

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

Oral oncology

Pub Date : 2025-11-20 DOI: 10.1016/j.oraloncology.2025.107788

Jérôme R. Lechien

Background

The learning curve for Transoral Robotic Surgery (TORS) in head and neck cancer (HNC) management remains incompletely characterized despite its increasing adoption. This systematic review evaluated the learning curves and required case volume for achieving proficiency and identified factors influencing the learning process.

Methods

Two investigators conducted a PubMed, Scopus, and Cochrane Library systematic review for studies investigating the surgical, functional, oncological and learning curve outcomes related to the implementation of TORS in HNC surgery using the PRISMA statement. The bias analysis was conducted with the MINORS.

Results

Of the 102 identified studies, 9 studies met our inclusion criteria, including 792 (82.1 %) male patients. TORS learning curve was primarily investigated on cT2N1 oropharyngeal cancer. The number of requested cases to achieve inflexion point in performing TORS varied by outcome measures but globally ranges from 25 to 50 cases. The mean MINORS was 8.8 ± 1.8 There was substantial heterogeneity across studies for the definition and criteria used to determine the learning process/inflexion point. No study detailed the surgeon experience and features. Two studies described the training program applied to surgeons before starting the study.

Conclusion

TORS proficiency case numbers remain unclear due to study heterogeneity, non-standardized endpoints, and variable definitions. Estimates range 20–50 cases for operative outcomes; long-term results require higher volumes. Future prospective studies are needed to standardize learning definitions and analyze how surgeon-specific factors (experience, age, prior training) impact TORS learning curves.

背景：尽管经口机器人手术（TORS）在头颈癌（HNC）治疗中的应用越来越广泛，但其学习曲线仍不完全明确。本系统综述评估了学习曲线和达到熟练程度所需的病例量，并确定了影响学习过程的因素。方法两名研究者使用PRISMA声明，对与在HNC手术中实施TORS相关的外科、功能、肿瘤和学习曲线结果进行了PubMed、Scopus和Cochrane图书馆系统评价。偏倚分析是在未成年人中进行的。结果在102项研究中，9项研究符合我们的纳入标准，包括792例（82.1%）男性患者。主要研究cT2N1口咽癌的TORS学习曲线。执行托尔疗法时要求达到拐点的病例数因结果指标而异，但全球范围为25至50例。平均未成年人为8.8±1.8，研究中用于确定学习过程/拐点的定义和标准存在很大的异质性。没有研究详细说明外科医生的经验和特点。两项研究描述了在研究开始前应用于外科医生的培训计划。结论：由于研究异质性、非标准化终点和变量定义，熟练病例数仍不清楚。估计手术结果为20-50例；长期业绩需要更高的销量。未来的前瞻性研究需要标准化学习定义，并分析外科医生特定因素（经验、年龄、先前培训）如何影响tor学习曲线。

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引用次数: 0

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 给编辑的信：紫杉醇卡铂作为局部晚期头颈部鳞状细胞癌患者手术后的新辅助治疗的II期临床试验

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

Oral oncology

Pub Date : 2025-11-13 DOI: 10.1016/j.oraloncology.2025.107784

Min Li, Yingchun Zhou, Ming Cai

引用次数: 0

Letter to the Editor: Neoadjuvant chemotherapy combined with anti-PD-1 monoclonal antibody in locally advanced resectable oral squamous cell carcinoma: Efficacy evaluation and prediction 致编辑：新辅助化疗联合抗pd -1单克隆抗体治疗局部晚期可切除口腔鳞状细胞癌：疗效评价与预测

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

Oral oncology

Pub Date : 2025-11-13 DOI: 10.1016/j.oraloncology.2025.107783

Yan Liu, Yingchun Zhou, Ming Cai

引用次数: 0

T4a classification for oral cancer using mandibular canal invasion instead of bone marrow invasion in the TNM staging system TNM分期系统中以下颌管侵袭代替骨髓侵袭进行口腔癌T4a分型。

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

Oral oncology

Pub Date : 2025-11-11 DOI: 10.1016/j.oraloncology.2025.107771

Masaya Okura , Nobuhiro Yamakawa , Mitsunobu Otsuru , Takumi Hasegawa , Yusuke Yokota , Shin Rin , Hironori Sakai , Shin-ichi Yamada , Eiji Hirai , Yuichi Ashikaga , Kozo Yamamoto , Michihiro Ueda , Tadaaki Kirita , Masahiro Umeda , Masaya Akashi , Hiroshi Kurita , Yoichi Ohiro , Tomofumi Naruse , Souichi Yanamoto , Japan Oral Oncology Group JOOG

Background and purpose

In oral cavity cancers, tumors invading the bone marrow of the mandible or maxilla have traditionally been classified as T4a in the TNM staging system. This study evaluated the impact of bone invasion on T classification and survival in patients with squamous cell carcinoma of the oral cavity.

Materials and methods

We retrospectively reviewed and restaged 2,143 patients treated between 2001 and 2019. Bone invasion was categorized as no bone invasion, non-mandibular canal (MC) bone marrow invasion, or MC invasion. Disease-specific survival (DSS) was the primary endpoint. Prognostic performance was assessed using Kaplan–Meier analysis and Cox proportional hazards models. Discriminative ability was evaluated with Harrell’s concordance index (C-index) and calibration analysis.

Results

Among 505 T4a tumors, 271 (53.7%) were classified as T4a solely due to bone marrow invasion, and their survival outcomes were comparable to those of T3 tumors. In multivariate analysis, MC invasion was independently associated with worse DSS, whereas non-MC bone marrow invasion was not. Based on these findings, we developed two revised versions of the MC-T classification for oral tumors, replacing bone marrow invasion with MC invasion as a T4a criterion in the 8th edition UICC/AJCC T classification. Both MC-T classifications showed superior prognostic discrimination, with higher C-indices than the original system.

Conclusions

Patients with T4a oral tumors classified solely by bone marrow invasion had survival outcomes similar to those with T3 tumors. The proposed MC-T classification improves prognostic accuracy by more effectively stratifying T4a tumors.

背景与目的：在口腔癌中，侵袭下颌骨或上颌骨髓的肿瘤在TNM分期系统中传统上被归类为T4a。本研究评估骨浸润对口腔鳞状细胞癌患者T分类和生存的影响。材料和方法：我们对2001年至2019年期间接受治疗的2143例患者进行了回顾性研究和再治疗。骨侵犯分为无骨侵犯、非下颌管（MC）骨髓侵犯和下颌管侵犯。疾病特异性生存（DSS）是主要终点。采用Kaplan-Meier分析和Cox比例风险模型评估预后。采用Harrell’s concordance index （C-index）和校正分析评价辨别力。结果505例T4a肿瘤中有271例（53.7%）仅因骨髓侵袭被归为T4a，其生存结局与T3肿瘤相当。在多变量分析中，MC侵袭与DSS恶化独立相关，而非MC骨髓侵袭与DSS恶化无关。基于这些发现，我们制定了两个修订版本的口腔肿瘤MC-T分类，在第8版UICC/AJCC T分类中以MC侵袭取代骨髓侵袭作为T4a标准。两种MC-T分类均具有较好的预后判别能力，其c指数均高于原分类系统。结论：单纯以骨髓侵袭分类的T4a口腔肿瘤患者的生存结局与T3肿瘤相似。提出的MC-T分类通过更有效地对T4a肿瘤进行分层，提高了预后准确性。

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引用次数: 0

Reply to the comment on “Osteoradionecrosis as a complication following post-operative intensity-modulated radiation therapy or proton therapy for oral cavity cancers 回复关于“骨放射性坏死作为口腔癌术后调强放疗或质子治疗的并发症”的评论。

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

Oral oncology

Pub Date : 2025-11-10 DOI: 10.1016/j.oraloncology.2025.107775

Annu Singh , Teeradon Treechairusame , Edward Christopher Dee , Joseph M. Huryn , Cherry L. Estilo , Nancy Y. Lee

引用次数: 0

Access to surgery and high-quality radiotherapy for human papillomavirus related oropharynx cancer 人乳头瘤病毒相关口咽癌手术和高质量放疗的可及性

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

Oral oncology

Pub Date : 2025-11-10 DOI: 10.1016/j.oraloncology.2025.107768

Cecelia M. Hidalgo , Gabriel A. Hernandez-Herrera , Courtney N. Day , Felicia Olawuni , Chadi N. Abdel-Halim , Kathryn M. Van Abel , David M. Routman , Linda X. Yin

Purpose

De-escalation trials in human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPV + OPSCC) have led to variable institutional treatment algorithms. It is unclear whether treatment options are offered equally throughout the United States. This study assesses how social determinants of health (SDOH), and treatment facility type impact access to surgery and/or high-quality radiotherapy (RT) for HPV + OPSCC.

Results

Among 6,458 patients, the median age was 62, 93.1 % were White, and 79.2 % had no significant comorbidities. Patients with the highest education, income, and private insurance (p ≤ 0.002 for all) underwent more surgery. Patients with lower education and income presented with more advanced disease (each p < 0.001). Care at academic facilities was the strongest predictor of surgery for early-stage disease (aOR:6.17, 95 % CI:3.74–10.18, p < 0.001) and was more likely to result in a margin-negative resection (p = 0.017). Delays in TTI were highest among Black patients, uninsured patients, patients with low socioeconomic status (SES), and patients receiving care at academic facilities (p ≤ 0.011 for all). Patients with significant comorbidities were more likely to experience delays in TTA (p = 0.018) and TTC (p = 0.036). There were no differences in delays in TTA or TTC based on treatment facility.

Conclusions

SDOH affect access to surgery for HPV + OPSCC, with patients of low SES presenting with more advanced disease. Among early-stage cases, access to surgery is significantly greater at academic facilities, which offer superior surgical outcomes. Treatment completion times are comparable between academic and community facilities, suggesting that poor surgical candidates should pursue care at the facility offering the fastest treatment initiation and completion.

目的：人乳头瘤病毒相关口咽鳞状细胞癌（HPV + OPSCC）的降级试验导致了不同的机构治疗算法。目前尚不清楚在美国是否提供平等的治疗方案。本研究评估了健康的社会决定因素（SDOH）和治疗设施类型如何影响HPV + OPSCC的手术和/或高质量放疗（RT）。结果：6458例患者中位年龄为62岁，93.1%为白种人，79.2%无明显合并症。受教育程度、收入和私人保险最高的患者（p≤0.002）接受手术的次数更多。结论：SDOH影响HPV + OPSCC手术的可及性，低社会经济地位的患者表现为更晚期的疾病。在早期病例中，在学术机构接受手术的机会明显更多，这可以提供更好的手术效果。治疗完成时间在学术机构和社区机构之间是相当的，这表明贫困的手术候选人应该在提供最快治疗开始和完成的机构寻求治疗。

{"title":"Access to surgery and high-quality radiotherapy for human papillomavirus related oropharynx cancer","authors":"Cecelia M. Hidalgo , Gabriel A. Hernandez-Herrera , Courtney N. Day , Felicia Olawuni , Chadi N. Abdel-Halim , Kathryn M. Van Abel , David M. Routman , Linda X. Yin","doi":"10.1016/j.oraloncology.2025.107768","DOIUrl":"10.1016/j.oraloncology.2025.107768","url":null,"abstract":"<div><h3>Purpose</h3><div>De-escalation trials in human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPV + OPSCC) have led to variable institutional treatment algorithms. It is unclear whether treatment options are offered equally throughout the United States. This study assesses how social determinants of health (SDOH), and treatment facility type impact access to surgery and/or high-quality radiotherapy (RT) for HPV + OPSCC.</div></div><div><h3>Results</h3><div>Among 6,458 patients, the median age was 62, 93.1 % were White, and 79.2 % had no significant comorbidities. Patients with the highest education, income, and private insurance (p ≤ 0.002 for all) underwent more surgery. Patients with lower education and income presented with more advanced disease (each p < 0.001). Care at academic facilities was the strongest predictor of surgery for early-stage disease (aOR:6.17, 95 % CI:3.74–10.18, p < 0.001) and was more likely to result in a margin-negative resection (p = 0.017). Delays in TTI were highest among Black patients, uninsured patients, patients with low socioeconomic status (SES), and patients receiving care at academic facilities (p ≤ 0.011 for all). Patients with significant comorbidities were more likely to experience delays in TTA (p = 0.018) and TTC (p = 0.036). There were no differences in delays in TTA or TTC based on treatment facility.</div></div><div><h3>Conclusions</h3><div>SDOH affect access to surgery for HPV + OPSCC, with patients of low SES presenting with more advanced disease. Among early-stage cases, access to surgery is significantly greater at academic facilities, which offer superior surgical outcomes. Treatment completion times are comparable between academic and community facilities, suggesting that poor surgical candidates should pursue care at the facility offering the fastest treatment initiation and completion.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"171 ","pages":"Article 107768"},"PeriodicalIF":3.9,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496177","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}

引用次数: 0

Integrating artificial intelligence-driven digital pathology and genomics to establish patient-derived organoids as new approach methodologies for drug response in head and neck cancer 整合人工智能驱动的数字病理学和基因组学，建立患者来源的类器官，作为头颈癌药物反应的新方法方法。

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

Oral oncology

Pub Date : 2025-11-09 DOI: 10.1016/j.oraloncology.2025.107742

Rose Doerfler , Jie Chen , Carl Kim , Joshua D. Smith , Micah Harris , Krishna B. Singh , Brian Isett , Rebekah E. Dadey , Daniel D. Brown , Adrian V. Lee , Xuefeng Wang , Matthew E. Spector , Seungwon Kim , Shaum Sridharan , Kevin Contrera , Katelyn Smith , Carly Reeder , Maureen Lyons , Jianhua Luo , Silvia Liu , Riyue Bao

Patient-derived organoids (PDOs) emerge as advanced 3D ex vivo New Approach Methodologies (NAM) preclinical models, offering significant advantages over traditional cell lines and monolayer cultures for therapeutic development. In this study, we established PDOs from surgically resected fresh tissues of human papillomavirus (HPV)-negative head and neck squamous cell carcinoma (HNSCC) across anatomical sites, tumor T-categories, and sample types. These PDOs faithfully recapitulate the tumor’s pathology, mutational profile, and drug response. To enable rapid classification of PDO identity, we developed a new convolutional neural network (CNN) model, TransferNet-PDO, which accurately distinguished tumor versus normal PDOs in culture using digital histopathology images (AUC ≥ 0.88). PDOs maintained stable cultures and were cryopreserved between passages 5 and 12. Immunohistochemistry (IHC) staining (PanCK, p63, Cytokeratin 13, Ki67) confirmed squamous phenotype and histologic aggression of the original tumor. For tumors harboring TP53 mutations by whole-exome sequencing (WES), PDOs retained the corresponding p53 functional status as confirmed by IHC (enhanced or loss of protein expression). Somatic mutational landscape revealed that PDOs preserved driver somatic mutations, copy number variations (CNVs), and clonal architecture including low-prevalence subclones. Drug sensitivity assessment of PDOs showed that cisplatin reduced cell viability, whereas cetuximab and lenvatinib had minimal effects. Chemoradiation led to greater tumor organoid killing compared to radiation or chemotherapy alone. This study presents an integrated HNSCC PDO platform combining tissue biobanking, organoid establishment, multiomics characterization, functional drug screening, and AI-driven histopathologic classification, providing a comprehensive and scalable system for translational cancer research.

患者源性类器官（PDOs）作为先进的3D离体新方法（NAM）临床前模型出现，与传统细胞系和单层培养物相比，在治疗开发方面具有显著优势。在这项研究中，我们从手术切除的人乳头瘤病毒（HPV）阴性头颈部鳞状细胞癌（HNSCC）的新鲜组织中建立了跨解剖部位、肿瘤t分类和样本类型的PDOs。这些PDOs忠实地概括了肿瘤的病理、突变特征和药物反应。为了实现PDO身份的快速分类，我们开发了一种新的卷积神经网络（CNN）模型TransferNet-PDO，该模型使用数字组织病理学图像（AUC≥0.88）准确区分培养中的肿瘤与正常PDO。pdo保持稳定的培养，并在传代5和12之间冷冻保存。免疫组化（IHC）染色（PanCK, p63, Cytokeratin 13, Ki67）证实原肿瘤呈鳞状表型和组织学侵袭性。对于携带TP53突变的肿瘤，通过全外显子组测序（WES）， PDOs保留了相应的p53功能状态，IHC证实了这一点（蛋白质表达增强或丧失）。体细胞突变景观揭示了PDOs保留了驱动体细胞突变、拷贝数变异（CNVs）和包括低流行亚克隆在内的克隆结构。PDOs的药物敏感性评估显示，顺铂降低了细胞活力，而西妥昔单抗和lenvatinib的影响最小。与单独放疗或化疗相比，放化疗导致更大的肿瘤类器官杀伤。本研究提出了一个集组织生物库、类器官建立、多组学表征、功能药物筛选和人工智能驱动的组织病理学分类为一体的HNSCC PDO集成平台，为转化性癌症研究提供了一个全面、可扩展的系统。

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引用次数: 0

Age and surgical complexity outperform preoperative Geriatric-8 for 30-day major complications in older head and neck cancer 年龄和手术复杂性优于术前老年头颈癌30天主要并发症

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

Oral oncology

Pub Date : 2025-11-08 DOI: 10.1016/j.oraloncology.2025.107774

Araceli Diez-Fraile , Lies Pottel , Philippe Lamoral , Tom De Backer , Christophe Spaas , Raf Van Hoeyweghen , Tom Vauterin , Catherine Dick , Johan Abeloos , Joke De Ceulaer

引用次数: 0

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