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Using salivary DNA methylation to predict aging, cell changes, and protein levels for assessing oral mucositis severity and survival in head and neck cancer patients 利用唾液 DNA 甲基化预测衰老、细胞变化和蛋白质水平,评估头颈部癌症患者口腔黏膜炎的严重程度和存活率。
IF 4 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-11 DOI: 10.1016/j.oraloncology.2024.107086
Gayathri Rengasamy, Vishnu Priya Veeraraghavan
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引用次数: 0
Robot-assisted versus conventional neck dissection in head and neck cancers: A systematic review and meta-analysis 头颈部癌症的机器人辅助颈部切除术与传统颈部切除术:系统综述和荟萃分析。
IF 4 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-09 DOI: 10.1016/j.oraloncology.2024.107101
Yi-Chan Lee , Li-Jen Hsin , Wan-Ni Lin , Tuan-Jen Fang , Yao-Te Tsai , Ming-Shao Tsai , Cheng-Ming Luo , Shih-Wei Yang

Background

Advances in technology have enabled neck dissection techniques that reduce aesthetic impact while maintaining oncological safety. This study compares perioperative outcomes between robotic neck dissection via retroauricular/modified facelift incision (RNDRM) and conventional neck dissection via anterolateral cervical incision (CND).

Methods

Studies were selected from PubMed, Embase, and Cochrane Library. Data from studies comparing RNDRM and CND were extracted and analyzed using a random-effects model.

Results

The meta-analysis included eight studies with 421 cases. The RNDRM group had a longer operative time (mean difference [MD], 69.11; 95 % confidence interval [CI] 37.92 to 100.30) and higher cosmetic satisfaction (MD, 2.03; 95 % CI, 1.48 to 2.57), along with a higher risk of marginal mandibular nerve injury (risk difference [RD], 0.08; 95 % CI 0.01 to 0.15). No significant differences were found in operative blood loss (MD, 15.35; 95 % CI − 7.39 to 38.10), days of drain placement (MD, 0.49; 95 % CI, −0.02 to 1.00), drainage volume (MD, 15.29; 95 % CI, −45.22 to 75.79), overall lymph node yield (MD, −1.09; 95 % CI, −3.18 to 1.00), positive lymph node yield (MD, −0.61; 95 % CI, −2.20 to 0.98), length of hospital stay (MD, 1.07; 95 % CI −0.06 to 2.20), or regional recurrence (RD, 0.00; 95 % CI −0.05 to 0.05), with similar rates of other complications.

Conclusion

RNDRM offers better cosmetic outcomes but requires longer operative time and has a higher risk of marginal mandibular nerve injury than CND. It may be an alternative for selected patients, with surgery choice needing discussion between patient and surgeon.
背景:技术的进步使得颈部解剖技术在保持肿瘤安全性的同时减少了对美观的影响。本研究比较了通过耳后/改良拉皮切口(RNDRM)进行机器人颈部解剖与通过颈前侧切口(CND)进行传统颈部解剖的围手术期结果:研究选自 PubMed、Embase 和 Cochrane 图书馆。从比较 RNDRM 和 CND 的研究中提取数据,并使用随机效应模型进行分析:荟萃分析包括 8 项研究,共 421 个病例。RNDRM组的手术时间更长(平均差异[MD],69.11;95%置信区间[CI],37.92~100.30),美容满意度更高(MD,2.03;95%置信区间[CI],1.48~2.57),下颌神经边缘损伤的风险更高(风险差异[RD],0.08;95%置信区间[CI],0.01~0.15)。在手术失血量(MD,15.35;95 % CI - 7.39 至 38.10)、引流管放置天数(MD,0.49;95 % CI,-0.02 至 1.00)、引流量(MD,15.29;95 % CI,-45.22 至 75.79)、总体淋巴结产量(MD,-1.09;95 % CI,-3.18 至 1.00)、淋巴结阳性率(MD,-0.61;95 % CI,-2.20 至 0.98)、住院时间(MD,1.07;95 % CI,-0.06 至 2.20)或区域复发(RD,0.00;95 % CI,-0.05 至 0.05),其他并发症发生率相似:结论:与 CND 相比,RNDRM 具有更好的美容效果,但需要更长的手术时间,而且下颌神经边缘损伤的风险更高。对于选定的患者来说,RNDRM 可能是一种替代方案,但手术方式的选择需要患者和外科医生进行讨论。
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引用次数: 0
Letter to the editor regarding, “Impact of post-operative transoral robotic surgery hemorrhage on adjuvant treatment delays in patients with oropharyngeal squamous cell carcinoma” 致编辑的信,内容涉及 "口咽鳞癌患者术后经口机器人手术出血对辅助治疗延迟的影响"。
IF 4 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-08 DOI: 10.1016/j.oraloncology.2024.107091
Pitchaipillai Sankar Ganesh, Naji Naseef Pathoor, Rajesh Kanna Gopal
The study finds no significant difference in the timing of radiation therapy initiation between bleeding and non-bleeding cohorts, ensuring that timely adjuvant care is achievable without compromising survival. Feeding tube dependency and dysphagia outcomes are also explored to enhance understanding of post-surgical morbidity and quality of life. With a multi-institutional design, the study strengthens the generalizability of its findings and addresses limitations inherent in retrospective data collection. Future research could use validated patient-reported outcomes to refine swallowing assessments and investigate novel hemostatic techniques as alternatives to transcervical arterial ligation. Additionally, exploring HPV-related prognostic subgroups will provide further clarity on oncological outcomes. This study paves the way for optimizing TORS protocols to improve patient care and long-term survival.
研究发现,出血队列和非出血队列在开始放射治疗的时间上没有明显差异,从而确保了在不影响生存的情况下实现及时的辅助治疗。研究还探讨了喂食管依赖性和吞咽困难的结果,以加深对手术后发病率和生活质量的了解。该研究采用多机构设计,加强了研究结果的可推广性,并解决了回顾性数据收集固有的局限性。未来的研究可以使用经过验证的患者报告结果来完善吞咽评估,并研究新型止血技术作为经宫颈动脉结扎的替代方法。此外,探索与 HPV 相关的预后亚组将进一步明确肿瘤结果。这项研究为优化 TORS 方案以改善患者护理和长期生存铺平了道路。
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引用次数: 0
Metastasis to the ciliary body and iris from a parotid carcinoma 腮腺癌转移至睫状体和虹膜。
IF 4 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-07 DOI: 10.1016/j.oraloncology.2024.107098
Suellen Hornos Vieira , André Alexis Corazza Vidoris , Leandro Luongo Matos
Adenoid cystic carcinoma (ACC) of the parotid gland is a relatively rare neoplasm, accounting for 10–15 % of all salivary gland tumors. Metastasis to the uveal region, particularly to the ciliary body and iris, is extremely uncommon, with the first case reported in 2011. This case report describes a 32-year-old woman with a history of ACC of the parotid gland. Despite radical surgery, radiotherapy, and facial nerve reconstruction, the patient developed metastasis to the ciliary body and iris one year after treatment. Ultrasonography revealed a solid iridociliary mass, and radiotherapy was administered. The patient later developed meningeal, hepatic, and bone metastases, leading to her death four years after diagnosis. This report highlights the rarity of uveal metastasis from ACC and the importance of considering metastatic disease in oncology patients presenting with ocular symptoms, as early diagnosis and intervention may improve outcomes and quality of life.
腮腺腺样囊性癌(ACC)是一种相对罕见的肿瘤,占所有唾液腺肿瘤的10-15%。转移到葡萄膜区域,尤其是睫状体和虹膜的病例极为罕见,首例病例报告于 2011 年。本病例报告描述了一名 32 岁女性的腮腺 ACC 病史。尽管患者接受了根治性手术、放疗和面神经重建,但治疗一年后睫状体和虹膜出现转移。超声波检查发现虹膜睫状体实性肿块,于是进行了放疗。患者后来出现脑膜、肝脏和骨转移,最终在确诊四年后死亡。本报告强调了 ACC 葡萄膜转移的罕见性,以及在肿瘤患者出现眼部症状时考虑转移性疾病的重要性,因为早期诊断和干预可改善预后和生活质量。
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引用次数: 0
Innovative use of radial artery retrograde forearm flap for oral and maxillofacial reconstruction 桡动脉逆行前臂皮瓣在口腔颌面部重建中的创新应用。
IF 4 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-06 DOI: 10.1016/j.oraloncology.2024.107084
Hui Peng, Li Y. Zhang, Wei Z. Zhu, Yu Zhou

Introduction

The purpose of this study is to present a novel method of reconstructing oral and maxillofacial defects using the Radial Artery Retrograde Proximal Forearm Flap (RARPFF) and to evaluate the efficacy and safety of the forearm flap for direct closure of the donor site and its effect on hand function in the donor area.

Methods

A prospective study of 30 patients who underwent oral and maxillofacial reconstruction with RARPFF between June 2021 and April 2024 was conducted to evaluate the safety and efficacy of the flap and its influence on hand function in the donor area.

Results

Flap survival was 93.3 %. The donor site defect in 28 out of 30 patients healed primarily. All donor sites were directly closed without complications such as splitting, tendon exposure, or numbness in the thumb or thenar region. Statistically significant differences were observed in grip strength (MD = 4.56, p < 0.001) and elbow extension (MD = 2.78, p < 0.001) at 3 months, as well as in grip strength (MD = 2.20, p < 0.001) and elbow extension (MD = 1.67, p < 0.001) at 1 year, compared to the contralateral hand. Wrist flexion, extension, radial deviation, ulnar deviation, elbow flexion, pronation, and supination did not exhibit statistically significant differences from the contralateral hand at both 3 months and 1 year. The Michigan Hand Questionnaire (MHQ) revealed a statistically significant difference in aesthetics compared to the contralateral hand (p < 0.001), along with satisfactory overall hand function, activities of daily living (ADL), work performance, pain levels, and patient satisfaction with hand function.

Conclusions

The reverse radial artery proximal forearm flap is a dependable and secure technique for head and neck reconstruction. This method can effectively reduce donor site complications while preserving hand function.
简介:本研究旨在介绍一种使用桡动脉逆行前臂近端皮瓣(RARPFF)重建口腔颌面部缺损的新方法,并评估前臂皮瓣直接闭合供区的有效性和安全性及其对供区手功能的影响:对2021年6月至2024年4月期间接受RARPFF口腔颌面重建术的30名患者进行前瞻性研究,评估皮瓣的安全性和有效性及其对供区手功能的影响:皮瓣存活率为 93.3%。结果:皮瓣存活率为 93.3%,30 例患者中有 28 例的供区缺损基本愈合。所有供体部位均可直接缝合,未出现拇指或腕部分裂、肌腱外露或麻木等并发症。在握力方面观察到了明显的统计学差异(MD = 4.56,P 结论):反向桡动脉前臂近端皮瓣是一种可靠、安全的头颈部重建技术。这种方法能有效减少供体部位的并发症,同时保留手部功能。
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引用次数: 0
Can we safely de-escalate HPV+ oropharyngeal cancers? – A review of current practices and novel approaches 我们能否安全地消除 HPV+ 口咽癌?- 回顾当前做法和新方法。
IF 4 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-06 DOI: 10.1016/j.oraloncology.2024.107089
Janis Morgenthaler , Maike Trommer , Richard Khor , Morikatsu Wada , Houda Bahig , Adam S. Garden , Alesha Thai , Hui Gan , Emmanouil Fokas , Sweet Ping Ng
Oropharyngeal carcinomas linked to high-risk types of human papillomavirus (HPV+OPC) as a distinct tumor entity, have a better prognosis than HPV-OPC. Current treatment approaches do not differentiate between HPV-positive and negative disease, but ongoing studies are exploring de-escalation strategies, aiming to reduce therapy-related morbidity and improve patient quality of life, particularly focusing on reducing late effects from radiotherapy.We performed a literature search for both published and ongoing clinical trials and critically discussed the presented concepts and results. Those include reduction in radiotherapy dose or volume, omission or modification of concomitant chemotherapy/immunotherapy, usage of induction chemotherapy and utilization of advanced molecular and imaging biomarkers and radiomics for selected subgroups of HPV+OPC patients. While promising data have been reported from various Phase II trials, evidence from Phase III de-escalation trials has failed to demonstrate improved outcomes. Therefore, further data and an improved risk stratification are required before de-escalated radiation treatments can be recommended outside of clinical trials.The review aims to outline current de-escalation strategies and future possibilities for enhancing patient outcomes in HPV+OPC.
与高危型人类乳头状瘤病毒(HPV+OPC)相关的口咽癌是一种独特的肿瘤实体,其预后优于HPV-OPC。目前的治疗方法并不区分HPV阳性和阴性疾病,但正在进行的研究正在探索降级策略,旨在降低与治疗相关的发病率并改善患者的生活质量,特别是侧重于减少放疗的晚期影响。我们对已发表和正在进行的临床试验进行了文献检索,并对提出的概念和结果进行了批判性讨论。我们对已发表和正在进行的临床试验进行了文献检索,并对所提出的概念和结果进行了批判性讨论,这些概念和结果包括减少放疗剂量或放疗量、省略或调整伴随化疗/免疫治疗、使用诱导化疗以及针对特定亚组的 HPV+OPC 患者使用先进的分子和成像生物标记物及放射组学。虽然各种 II 期试验已报告了令人鼓舞的数据,但 III 期降级试验的证据未能证明疗效有所改善。因此,在临床试验之外推荐降级放射治疗之前,需要更多的数据和更好的风险分层。本综述旨在概述目前的降级策略和未来提高HPV+OPC患者预后的可能性。
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引用次数: 0
Do revised resection margins for early-stage oral tongue squamous cell carcinoma require adjuvant therapy? 早期口腔舌鳞状细胞癌的修正切除边缘是否需要辅助治疗?
IF 4 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-05 DOI: 10.1016/j.oraloncology.2024.107100
Bhargav Ram, Josephine Joy, Shelly sharma, Shalini Thakur, Anand Subash, Vishal U S Rao
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引用次数: 0
In reply to “Risk of cardiovascular disease among head and neck cancer survivors: A population-based matched cohort study” 回复 "头颈癌幸存者患心血管疾病的风险:基于人群的匹配队列研究"
IF 4 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-04 DOI: 10.1016/j.oraloncology.2024.107096
John Lennon Silva Cunha
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引用次数: 0
Changes of immune function mediated by Gasdermin-E in the immune microenvironment of primary oral squamous cell carcinoma 原发性口腔鳞状细胞癌免疫微环境中Gasdermin-E介导的免疫功能变化
IF 4 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-04 DOI: 10.1016/j.oraloncology.2024.107088
Xiangjun Wang , Xingyu Chen , Zi Mei
In primary oral squamous cell carcinoma (OSCC), the tumor microenvironment (TME) constitutes a highly intricate ecosystem comprised of cellular and acellular elements. The tumor immune microenvironment (TIME) is characterized by the presence of a broad of immune cells, while there is a scarcity of cytotoxic lymphocytes (CTLs) intratumorally. Consequently, the recruitment of a larger cohort of CTLs to infiltrate the tumor core has emerged as a pressing scientific challenge. Gasdermin E (GSDME), as a pivotal effector protein in pyroptosis, plays a significant role in anti-tumor therapy. Here, primary OSCC was induced by Gsdme knockout (KO) mice and wild type (WT) mice of the same strain respectively, using the chemical mutagen 4-Nitroquinoline N-oxide (4-NQO). Through comparative analysis of immune function between the two kinds of mice, intriguing observations have been elucidated, the presence of GSDME was instrumental in augmenting the infiltration of lymphocytes towards the neoplastic site, effectively ameliorating the TIME. Our findings elucidated that the absence of GSDME promotes the development of primary OSCC, accompanied by a notable increase in malignancy. Furthermore, our data delineated a positive inter-relationship between the presence of GSDME and the host organism’s immunological reactivity, which enhances the TIME in primary OSCC.
在原发性口腔鳞状细胞癌(OSCC)中,肿瘤微环境(TME)是一个由细胞和细胞元素组成的高度复杂的生态系统。肿瘤免疫微环境(TIME)的特点是存在大量免疫细胞,而肿瘤内的细胞毒性淋巴细胞(CTL)却很少。因此,如何招募更多的细胞毒性淋巴细胞浸润肿瘤核心已成为一项紧迫的科学挑战。Gasdermin E (GSDME)作为热蛋白沉积过程中的关键效应蛋白,在抗肿瘤治疗中发挥着重要作用。本文利用化学诱变剂4-硝基喹啉N-氧化物(4-NQO)分别诱导Gsdme基因敲除(KO)小鼠和同一品系的野生型(WT)小鼠发生原发性OSCC。通过对两种小鼠的免疫功能进行比较分析,我们发现了一些耐人寻味的现象:GSDME的存在有助于增加淋巴细胞向肿瘤部位的浸润,从而有效地改善TIME。我们的研究结果阐明,GSDME的缺失会促进原发性OSCC的发展,并伴随着恶性程度的显著增加。此外,我们的数据还描述了GSDME的存在与宿主机体免疫反应性之间的正向相互关系,而宿主机体免疫反应性会延长原发性OSCC的发病时间。
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引用次数: 0
Commentary on “Effect analysis of 847 nasopharyngeal carcinoma cases treated with intensity modulated radiation: Experience and suggestions” 关于 "采用调强放射治疗的 847 例鼻咽癌的疗效分析:经验与建议"
IF 4 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-04 DOI: 10.1016/j.oraloncology.2024.107099
Erkan Topkan , Efsun Somay , Duriye Ozturk , Ugur Selek
{"title":"Commentary on “Effect analysis of 847 nasopharyngeal carcinoma cases treated with intensity modulated radiation: Experience and suggestions”","authors":"Erkan Topkan ,&nbsp;Efsun Somay ,&nbsp;Duriye Ozturk ,&nbsp;Ugur Selek","doi":"10.1016/j.oraloncology.2024.107099","DOIUrl":"10.1016/j.oraloncology.2024.107099","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"159 ","pages":"Article 107099"},"PeriodicalIF":4.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578352","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
期刊
Oral oncology
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