-
Pathogens (Basel, Switzerland) Jul 2023Oropharyngeal squamous cell carcinoma (OPSCC) development is strongly associated with risk factors like smoking, chronic alcohol consumption, and the living environment,...
Oropharyngeal squamous cell carcinoma (OPSCC) development is strongly associated with risk factors like smoking, chronic alcohol consumption, and the living environment, but also chronic human papilloma virus (HPV) infection, which can trigger cascade cellular changes leading to a neoplastic transformation. The prevalence of these factors differs among different world regions, and the prevention, diagnosis, and prognosis of OPSCC are highly dependent on them. We performed a retrospective study on 406 patients diagnosed with OPSCC in our region that were classified according to the tumor type, localization and diagnosis stage, demographic characteristics, risk factors, and histological and immunohistochemical features. We found that most of the patients were men from urban areas with a smoking habit, while most of the women in our study were diagnosed with tonsillar OPSCC and had a history of chronic alcoholism. During the immunohistochemical study, we analyzed the tumor immunoreactivity against anti-p16 and anti-HPV antibodies as markers of HPV involvement in tumor progression, as well as the correlation with the percentage of intratumoral nuclei immunomarked with the anti-Ki 67 antibody in serial samples. We observed that the percentage of Ki67-positive nuclei increased proportionally with the presence of intratumoral HPV; thus, active HPV infection leads to an increase in the rate of tumor progression. Our results support the implementation of strategies for OPSCC prevention and early diagnosis and can be a starting point for future studies aiming at adapting surgical and oncological treatment according to the HPV stage for better therapeutic results.
PubMed: 37623944
DOI: 10.3390/pathogens12080984 -
Alternative Therapies in Health and... Nov 2023Nasopharyngeal carcinoma (NPC) is a malignant tumor with a high incidence. Regional lymph node metastasis (RLNM) affects the benefits to and prognosis of patients after...
CONTEXT
Nasopharyngeal carcinoma (NPC) is a malignant tumor with a high incidence. Regional lymph node metastasis (RLNM) affects the benefits to and prognosis of patients after treatment. Researchers speculate that CRNDE expression might have a correlation with NPC lymph node metastasis (LNM), but studies on the subject are relatively few.
OBJECTIVE
The study intended to explore the predictive value of the level of serum colorectal neoplasia differentially expressed (CRNDE) for RLNM in NPC patients and to analyze the effects of RLNM on their long-term prognosis after radiotherapy and chemotherapy, to provide a reference for early prediction, diagnosis, and treatment of RLNM in NPC.
DESIGN
The research team performed a retrospective case-control study.
SETTING
The study took place at Taizhou People's Hospital in Taizhou, China.
PARTICIPANTS
Participants were 80 NPC patients who received treatment using radiotherapy and chemotherapy at the hospital between January 2014 and December 2017.
GROUPS
The research team divided participants into two groups: (1) an observation group diagnosed with RLNM, with 52 participants, and a control group that had no RLNM, with 28 participants.
OUTCOME MEASURES
The research team: (1) determined the level of colorectal neoplasia differentially expressed (CRNDE) in participants' serum to predict the risk of RLNM, (2) compared clinical total response rates (TRRs) between the groups, and (3) analyzed the five-year overall survival (OS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS).
RESULTS
Compared with control group, the observation group's CRNDE level was significantly higher, and its five-year OS and DMFS rates were significantly lower (all P < .01). No significant differences existed in the TRR and five-year LRFS rate between the observation and control groups (P > .05). The cut-off value for serum CRNDE was set at 3.540, the area under curve (AUC) value for the observation group was 0.805, and the 95% confidence interval (CI) was 0.715-0.889. In addition, the sensitivity was 88.5%, specificity was 57.1%, and Yoden index was 0.463. The five-year OS rates were significant lower in the observation group patients with metastatic lymph nodes > 2 in number (P = .025) and > 6 cm in diameter (P = .002) and with posterior pharyngeal LNM (P = .049).
CONCLUSIONS
An abnormal increase in serum CRNDE can be a basis to diagnose RLNM in NPC patients. RLNM affected the long-term prognosis of NPC patients, and the number and diameter of lymph nodes and posterior pharyngeal metastasis were the factors affecting patients' long-term. The current study's findings can provide a reference for the realization of the early diagnosis of NPC RLNM, formulating the treatment schemes and improving the long-term survival outcome of NPC patients.
PubMed: 37944952
DOI: No ID Found -
Ear, Nose, & Throat Journal Sep 2023We explored the value of supraclavicular flaps in repairing pharyngeal fistula. Patients treated with supraclavicular flaps were included. Data on preoperative...
We explored the value of supraclavicular flaps in repairing pharyngeal fistula. Patients treated with supraclavicular flaps were included. Data on preoperative radiotherapy, surgical modality, flap size, postoperative healing, and other clinical outcomes were collected. Techniques, indications, and postoperative complications after repairing with supraclavicular flaps were described. A total of 16 male patients aged 58 to 79 years were involved, including 10 cases of postoperative pharyngeal fistula after hypopharyngeal cancer, 5 cases of postoperative pharyngeal fistula after laryngeal cancer, and 1 case of postoperative pharyngeal fistula after laryngeal and esophageal cancer. In 12 patients, the pharyngeal fistula was repaired by double island folding of the supraclavicular flap; in the remaining 4 patients, the pharyngeal fistula was repaired by the supraclavicular flaps combined with the pectoralis major flaps. The supraclavicular flap was 6 to 8 cm in width and 6 to 15 cm in length. One patient developed partial necrosis at the distal end of the flap, which was successfully treated with debridement and dressing. The flaps grew well in the remaining 15 patients. Among them, a patient with a postoperative pharyngeal fistula after hypopharyngeal carcinoma was implanted with radioactive particles for tumor recurrence at the esophageal entrance, and died in the 11th month after surgery. The supraclavicular flap can achieve excellent results in the repair of pharyngeal fistula.
PubMed: 37705336
DOI: 10.1177/01455613231196667 -
Frontiers in Oncology 2023The global incidence of lip and oral cavity cancers (OCCs) and oropharyngeal cancers (OPCs) is steadily increasing. While tobacco and alcohol consumption are established...
BACKGROUND
The global incidence of lip and oral cavity cancers (OCCs) and oropharyngeal cancers (OPCs) is steadily increasing. While tobacco and alcohol consumption are established risk factors, a considerable proportion of these cancers has become attributed to human papilloma virus (HPV) infection. We aimed to describe the occurrence and identify potential risk factors of OCCs and OPCs across the Russian Federation during 2007-2018.
METHODS
We conducted an ecological analysis using publicly accessible data from the P.A. Herzen Moscow Oncology Research Institute. Incidence and mortality rates by jurisdiction were mapped for geospatial analysis. We pre-defined 11 potential contributing risk factors and used univariable and multivariable Poisson regression model with backwards stepwise variable selection to identify associated factors with OCC and OPC.
RESULTS
A total of 190,585 individuals were diagnosed with OCCs and OPCs in Russia between 2007-2018. Non-uniform geographic distribution of cancer cases was noted where the Far Eastern Federal District had the highest rate of OCC and the Central Federal District of OPCs. Districts with high weekly alcohol consumption had significantly higher incidence and mortality rates in both sexes. Districts with high rates of daily smoking had higher incidence of OCC among females, and those with low smoking trends had lower mortality rates for OCCs and OPCs.
CONCLUSION
We detail the burden of OCCs and OPCs across Russia, with the aim of elucidating modifiable risk factors and proposing evidence-based prevention strategies. Tobacco/alcohol sales control measures and smoking/drinking cessation programs should continue to be prioritized as public health measures, especially for females.
PubMed: 37601694
DOI: 10.3389/fonc.2023.1197287 -
Cancers Apr 2024Head and neck squamous cell carcinoma (HNSCC) is the most common histological form of head and neck tumors (HNTs), which originate from the epithelium of the lips and... (Review)
Review
Head and neck squamous cell carcinoma (HNSCC) is the most common histological form of head and neck tumors (HNTs), which originate from the epithelium of the lips and oral cavity, pharynx, larynx, salivary glands, nasal cavity, and sinuses. The main risk factors include consumption of tobacco in all forms and alcohol, as well as infections with high-risk human papillomaviruses or the Epstein-Barr virus. Regardless of the etiological agent, the risk of developing different types of HNTs is from two to more than six times higher in males than in females. The reason for such disparities probably lies in a combination of both biological and psychosocial factors. Therefore, it is hypothesized that exposure to female sex hormones, primarily estrogen, provides women with protection against the formation and metastasis of HNTs. In this review, we synthesized available knowledge on the role of estrogen and estrogen receptors (ERs) in the development and progression of HNTs, with special emphasis on membrane ERs, which are much less studied. We can summarize that in addition to epidemiologic studies unequivocally pointing to the protective effect of estrogen in women, an increased expression of both nuclear ERs, ERα, and ERβ, and membrane ERs, ERα36, GPER1, and NaV1.2, was present in different types of HNSCC, for which anti-estrogens could be used as an effective therapeutic approach.
PubMed: 38672656
DOI: 10.3390/cancers16081575 -
Cancers Jul 2023Head and neck squamous cell carcinoma (HNSCC), specifically in the oral cavity (oral squamous cell carcinoma, OSCC), is a common, complex cancer that significantly...
Head and neck squamous cell carcinoma (HNSCC), specifically in the oral cavity (oral squamous cell carcinoma, OSCC), is a common, complex cancer that significantly affects patients' quality of life. Early diagnosis typically improves prognoses yet relies on pathologist examination of histology images that exhibit high inter- and intra-observer variation. The advent of deep learning has automated this analysis, notably with object segmentation. However, techniques for automated oral dysplasia diagnosis have been limited to shape or cell stain information, without addressing the diagnostic potential in counting the number of cell layers in the oral epithelium. Our study attempts to address this gap by combining the existing U-Net and HD-Staining architectures for segmenting the oral epithelium and introducing a novel algorithm that we call Onion Peeling for counting the epithelium layer number. Experimental results show a close correlation between our algorithmic and expert manual layer counts, demonstrating the feasibility of automated layer counting. We also show the clinical relevance of oral epithelial layer number to grading oral dysplasia severity through survival analysis. Overall, our study shows that automated counting of oral epithelium layers can represent a potential addition to the digital pathology toolbox. Model generalizability and accuracy could be improved further with a larger training dataset.
PubMed: 37568707
DOI: 10.3390/cancers15153891 -
Iranian Journal of Public Health Jul 2023Cancer is the second most common cause of death worldwide. Economic evaluation of cancer treatment to reduce costs can save the health care system millions of dollars... (Review)
Review
BACKGROUND
Cancer is the second most common cause of death worldwide. Economic evaluation of cancer treatment to reduce costs can save the health care system millions of dollars while optimizing care. Therefore, this systematic review aimed to study the economic evaluation of cancer treatment using intermediate intensity radiation therapy (IMRT) compared to conventional 3D conformal radiation therapy (3D-CRT).
METHODS
Literatures from PubMed, Embase, Cochran Library, Google scholar, Scopus and Iranian databases were retrieved since Jan 2000 to Apr 2020 for eligible English studies. The quality of the studies was evaluated using Cheers' checklist and then the textual data were analyzed manually by content analysis method.
RESULTS
Overall, 1790 articles were retrieved, of which 12 studies were reviewed. The article quality score ranged from 14.5 to 23 out of a maximum of 24 points. Eleven studies referred to cost-effectiveness analysis and one study referred to cost-utility analysis. Studies have been conducted in the United States, Canada, Australia, Brazil, the Netherlands, the United Kingdom, and Hungary. IMRT appears to be a cost-effective treatment strategy for rectal cancer, soft tissue sarcoma, and localized carcinoma of the pharynx, and for prostate cancer in terms of prolonging survival, but it is a cost-effective treatment strategy for head cancer. In addition, the neck was not in India's cancer control program.
CONCLUSION
The results can help to decide whether to use radiation therapy and radiotherapy in the standard treatment path. Furthermore, they underline that IMRT treatment technique was cost effective for a long-time care service.
PubMed: 37593521
DOI: 10.18502/ijph.v52i7.13237 -
BMC Cancer May 2024This study aimed to assess the long-term effect of level IIb clinical target volume (CTV) optimisation on survival, xerostomia, and dysphagia in patients with...
Long-term follow-up of protective effects on salivary and swallowing structures and improvement of late xerostomia and dysphagia by level IIb optimisation in clinical target volume of nasopharyngeal carcinoma.
BACKGROUND
This study aimed to assess the long-term effect of level IIb clinical target volume (CTV) optimisation on survival, xerostomia, and dysphagia in patients with nasopharyngeal carcinoma (NPC).
METHODS
Clinical data of 415 patients with NPC treated with intensity-modulated radiotherapy between December 2014 and October 2018 were retrospectively analysed. The patients were categorised into modified and comparison groups. Late xerostomia and dysphagia were evaluated using Radiation Therapy Oncology Group/European Organisation for Research and Treatment of Cancer scoring. Survival analysis was performed using the Kaplan-Meier method. Differences in late toxicity and dose parameters between both groups were compared. Prognostic factors for survival and late toxicity were assessed using regression analyses.
RESULTS
Patients in the modified group developed late xerostomia and dysphagia less frequently than those in the comparison group did (P < 0.001). The mean dose (D) and V of parotid glands; D and V of submandibular glands; and D of sublingual glands, oral cavity, larynx, and superior, middle, and lower pharyngeal constrictor muscles were lower in the modified group than those in the comparison group (all P < 0.001). Both groups had no significant differences in overall, local recurrence-free, distant metastasis-free, or progression-free survival. The D of the parotid and sublingual glands was a risk factor for xerostomia. The D of the parotid and sublingual glands and middle pharyngeal constrictor muscle was a risk factor for dysphagia.
CONCLUSIONS
Level IIb optimisation in NPC patients who meet certain criteria specially the exclusion of positive retropharyngeal nodes treated with intensity-modulated radiotherapy has the potential to better protect the salivary and swallowing structures, decreasing the development of late radiation-induced xerostomia and dysphagia while maintaining long-term survival.
Topics: Humans; Deglutition Disorders; Male; Xerostomia; Female; Nasopharyngeal Carcinoma; Middle Aged; Radiotherapy, Intensity-Modulated; Retrospective Studies; Follow-Up Studies; Nasopharyngeal Neoplasms; Adult; Aged; Radiation Injuries; Deglutition; Salivary Glands; Radiotherapy Dosage; Prognosis; Young Adult
PubMed: 38802747
DOI: 10.1186/s12885-024-12391-7 -
Medicine Oct 2023Head and neck squamous cell carcinoma (HNSCC) develops from the mucosal epithelium of the oral cavity, pharynx, and larynx, and is the most common malignancy of the head... (Review)
Review
Head and neck squamous cell carcinoma (HNSCC) develops from the mucosal epithelium of the oral cavity, pharynx, and larynx, and is the most common malignancy of the head and neck, the incidence of which continues to rise. The epidermal growth factor receptor is thought to play a key role in the pathogenesis of HNSCC. Inhibition of epidermal growth factor receptor has been identified as an effective target for the treatment of HNSCC. Many phytochemicals have emerged as potential new drugs for the treatment of HNSCC. A systematic search was conducted for research articles published in PubMed, and Medline on relevant aspects. This review provides an overview of the available literature and reports highlighting the in vitro effects of phytochemicals on epidermal growth factor in various HNSCC cell models and in vivo in animal models and emphasizes the importance of epidermal growth factor as a current therapeutic target for HNSCC. Based on our review, we conclude that phytochemicals targeting the epidermal growth factor receptor are potentially effective candidates for the development of new drugs for the treatment of HNSCC. It provides an idea for further development and application of herbal medicines for cancer treatment.
Topics: Animals; Squamous Cell Carcinoma of Head and Neck; Carcinoma, Squamous Cell; Head and Neck Neoplasms; ErbB Receptors; Epidermal Growth Factor; Phytochemicals; Cell Line, Tumor
PubMed: 37800790
DOI: 10.1097/MD.0000000000034439