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European Journal of Cancer (Oxford,... May 2024Uncertainty persists regarding clinical and treatment variations crucial to consider when comparing high human papillomavirus (HPV)-prevalence oropharyngeal squamous...
BACKGROUND
Uncertainty persists regarding clinical and treatment variations crucial to consider when comparing high human papillomavirus (HPV)-prevalence oropharyngeal squamous cell carcinoma (OPSCC) cohorts for accurate patient stratification and replicability of clinical trials across different geographical areas.
METHODS
OPSCC patients were included from The University of Texas MD Anderson Cancer Center (UTMDACC), USA and from The University Hospital of Copenhagen, Denmark from 2015-2020, (n = 2484). Outcomes were 3-year overall survival (OS) and recurrence-free interval (RFI). Subgroup analyses were made for low-risk OPSCC patients (T1-2N0M0) and high-risk patients (UICC8 III-IV).
RESULTS
There were significantly more HPV-positive (88.2 % vs. 63.1 %), males (89.4 % vs. 74.1 %), never-smokers (52.1 % vs. 23.7 %), lower UICC8-stage (I/II: 79.3 % vs. 68 %), and fewer patients treated with radiotherapy (RT) alone (14.8 % vs. 30.3 %) in the UTMDACC cohort. No difference in the adjusted OS was observed (hazard ratio [HR] 1.21, p = 0.23), but a significantly increased RFI HR was observed for the Copenhagen cohort (HR: 1.74, p = 0.003). Subgroup analyses of low- and high-risk patients revealed significant clinical and treatment differences. No difference in prognosis was observed for low-risk patients, but the prognosis for high-risk patients in the Copenhagen cohort was worse (OS HR 2.20, p = 0.004, RFI HR 2.80, p = 0.002).
CONCLUSIONS
We identified significant differences in clinical characteristics, treatment modalities, and prognosis between a Northern European and Northern American OPSCC population. These differences are important to consider when comparing outcomes and for patient stratification in clinical trials, as reproducibility might be challenging.
Topics: Male; Humans; Squamous Cell Carcinoma of Head and Neck; Prognosis; Carcinoma, Squamous Cell; Human Papillomavirus Viruses; Oropharyngeal Neoplasms; Papillomavirus Infections; Prevalence; Reproducibility of Results; Head and Neck Neoplasms; Denmark; Papillomaviridae
PubMed: 38452723
DOI: 10.1016/j.ejca.2024.113983 -
Otolaryngology--head and Neck Surgery :... Mar 2021To determine how communicative participation is affected in patients with oral and oropharyngeal head and neck cancers (HNCs) pretreatment and whether communication...
OBJECTIVE
To determine how communicative participation is affected in patients with oral and oropharyngeal head and neck cancers (HNCs) pretreatment and whether communication function predicts HNC-specific quality of life (QOL) before treatment, beyond known demographic, medical, psychosocial, and swallowing predictors.
STUDY DESIGN
Cross-sectional study.
SETTING
Tertiary care academic medical center.
METHODS
Eighty-seven patients with primary oral (40.2%) or oropharyngeal (59.8%) HNC were recruited prior to treatment. T stage, tumor site, and p16 status were extracted from medical records. Demographic and patient-reported measures were obtained. Communicative participation was measured using the Communicative Participation Item Bank (CPIB) General short form. A hierarchical regression analysis included demographic, medical, psychosocial, and functional measures of swallowing and communication as predictors; the University of Washington Quality of Life (UW-QOL v4) composite score was the predicted variable.
RESULTS
Median (SD) baseline CPIB scores were 71.0 (11.83); patients with oral cancers reported worse scores. A final sequential hierarchical regression model that included all variables explained 71% of variance in QOL scores. Tumor site, T stage, and p16 status accounted for 28% of variance ( < .001). Perceived depression predicted an additional 28% of the variance ( < .001). Swallowing and communicative participation together predicted an additional 12% of variance ( = .005). Tumor site, perceived depression, swallowing, and communication measures were unique predictors in the final model. Finally, communicative participation uniquely predicted QOL, above and beyond other predictors.
CONCLUSION
Pretreatment communication predicted QOL and was negatively affected in some oral and oropharyngeal patients with HNC.
Topics: Adolescent; Adult; Aged; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Mouth Neoplasms; Oropharyngeal Neoplasms; Prospective Studies; Quality of Life; Speech; Speech Disorders; Voice; Voice Disorders; Young Adult
PubMed: 32928035
DOI: 10.1177/0194599820950718 -
Nutrients Sep 2021Oral cancer is the most common tumor of the head and neck region. Its management is based on surgical and systemic therapies. Taste disorders represent the most common... (Review)
Review
Oral cancer is the most common tumor of the head and neck region. Its management is based on surgical and systemic therapies. Taste disorders represent the most common side effect of these treatments; indeed, dysgeusia is noted by 70% of oral cancer patients. Despite survival remaining the primary endpoint of cancer patients, taste impairments can cause psychological distress. This comprehensive review describes the last decade's knowledge from the literature regarding taste alterations in patients with oral and oropharyngeal squamous cell carcinoma. A total of 26 articles in English, including prospective, cross-sectional, and case-control studies, and clinical trials were evaluated. Literature analysis shows that anti-cancer treatments can destroy taste cells, decrease and alter their receptors, and interrupt nerve transmission. Furthermore, the tumour itself can destroy the oral mucosal lining, which encloses the taste buds. Dysgeusia typically occurs in 3-4 weeks of treatments, and usually taste sensation is recovered within 3-12 months. However, some patients exhibit incomplete or no recovery, even several years later. Thus, dysgeusia can become a chronic issue and negatively influence patients' quality of life, worsening their dysphagia and their nutritional status. Physicians should be focused on preventing oncological treatment-related symptoms, offering the most suitable personalized support during therapy.
Topics: Dysgeusia; Humans; Mouth Neoplasms; Oropharyngeal Neoplasms
PubMed: 34684326
DOI: 10.3390/nu13103325 -
International Journal of Molecular... Nov 2022Biomarkers are crucial in oncology, from detection and monitoring to guiding management and predicting treatment outcomes. Histological assessment of tissue biopsies is... (Review)
Review
Biomarkers are crucial in oncology, from detection and monitoring to guiding management and predicting treatment outcomes. Histological assessment of tissue biopsies is currently the gold standard for oropharyngeal cancers, but is technically demanding, invasive, and expensive. This systematic review aims to review current markers that are detectable in biofluids, which offer promising non-invasive alternatives in oropharyngeal carcinomas (OPCs). A total of 174 clinical trials from the PubMed search engine in the last 5 years were identified and screened by 4 independent reviewers. From these, 38 eligible clinical trials were found and subsequently reviewed. The biomarkers involved, categorized by human papillomavirus (HPV)-status, were further divided according to molecular and cellular levels. Recent trials investigating biomarkers for both HPV-positive and HPV-negative OPCs have approaches from various levels and different biofluids including plasma, oropharyngeal swabs, and oral rinse. Promising candidates have been found to aid in detection, staging, and predicting prognosis, in addition to well-established factors including HPV-status, drinking and smoking status. These studies also emphasize the possibility of enhancing prediction results and increasing statistical significance by multivariate analyses. Liquid biopsies offer promising assistance in enhancing personalized medicine for cancer treatment, from lowering barriers towards early screening, to facilitating de-escalation of treatment. However, further research is needed, and the combination of liquid biopsies with pre-existing methods, including in vivo imaging and invasive techniques such as neck dissections, could also be explored in future trials.
Topics: Humans; Alphapapillomavirus; Papillomaviridae; Oropharyngeal Neoplasms; Biomarkers; Carcinoma
PubMed: 36430813
DOI: 10.3390/ijms232214336 -
Journal (Canadian Dental Association) Dec 2022The aims of this study were to determine demographic profiles, tumour characteristics and treatment factors related to oral cavity and oropharyngeal cancer (OCC and OPC)...
OBJECTIVES
The aims of this study were to determine demographic profiles, tumour characteristics and treatment factors related to oral cavity and oropharyngeal cancer (OCC and OPC) and comparatively analyze these cancers in the adult population of Alberta, Canada, over 12 years.
METHODS
Demographic, tumour characteristics and treatment data regarding OCC and OPC incidence in Alberta residents ≥18 years in 2005-2017 were extracted from the Alberta Cancer Registry database. Age-standardized incidence and mortality rates (ASIR and ASMR) were computed.
RESULTS
Among 3448 OCC and OPC cases, mean (standard deviation) age at diagnosis was 63.9 (14.4) and 60.1 (10.2) years, respectively. There was a male predilection for both OCC (58.2%) and OPC (81.7%). With some fluctuations, ASIR remained the same for OCC but increased for OPC. ASMR increased for both. The most common site for OCC was tongue and for OPC tonsil. Squamous cell carcinoma was the most common diagnosis for OCC and OPC. Involvement of at least 1 lymph node was observed in 38.5% of OCC and 85.8% of OPC cases. For 45.2% of OCC and 82.3% of OPC cases, diagnosis occurred at stage IV. The most common initial treatments for OCC were surgery, alone or combined with radiation, whereas radiation with chemotherapy was the main treatment modality for OPC.
CONCLUSION
The incidence of OPC in younger males was higher than that of OCC. Although incidence of OPC per 100 000 population increased over the 12-year study period, it remained largely unchanged for OCC. For both cancers, initial diagnoses were made at advanced stages, with almost twice as many stage IV OPC cases than OCC cases.
Topics: Adult; Male; Humans; Mouth Neoplasms; Alberta; Oropharyngeal Neoplasms; Incidence
PubMed: 37098276
DOI: No ID Found -
Medicina (Kaunas, Lithuania) Feb 2023: to describe current scientific knowledge regarding the treatment options in advanced oropharyngeal cancer. The standard care for advanced oropharyngeal cancer (OPSCC)... (Review)
Review
: to describe current scientific knowledge regarding the treatment options in advanced oropharyngeal cancer. The standard care for advanced oropharyngeal cancer (OPSCC) has been chemoradiotherapy, although surgical approaches followed by adjuvant treatment have been proposed. The best therapy for each patient should be decided by an interdisciplinary tumour-board. Different strategies should be considered for the specific patient's treatment: surgery, chemotherapy and radiation therapy or combinations of them. The treatment choice is influenced by tumour variability and prognostic factors, but it also depends on cancer extension, extranodal extension, nervous invasion, human papilloma virus (HPV) presence, making the decisional algorithm not always clear. HPV-related OPSCC is strongly associated with a favourable overall survival (OS) and disease-free survival rate (DSS); by contrast, HPV-negative OPSCC often flags a worse prognosis. Consequently, the American Joint Committee on Cancer (AJCC) differentiates OPSCC treatment and prognosis based on HPV status. : we carried out a review of current scientific literature to analyze the different indications and limitations of surgical treatment options in OPSCC stage III and IV. : robotic surgery or open approaches with reconstructive flaps can be considered in advanced stages, resulting in the de-intensification of subsequent systemic therapy and fewer related side effects. Furthermore, in the event of the primary failure of systemic therapy or disease recurrence, the surgical approach constitutes an additional therapeutic option which lengthens patient survival functions.
Topics: Humans; Carcinoma, Squamous Cell; Papillomavirus Infections; Neoplasm Staging; Neoplasm Recurrence, Local; Oropharyngeal Neoplasms; Prognosis; Retrospective Studies
PubMed: 36837506
DOI: 10.3390/medicina59020304 -
Asian Pacific Journal of Cancer... Aug 2022The incidence of Head and neck (HN) cancers in Thailand is rising and survival rates not improving. Variations of its incidence among geographical areas may due to...
BACKGROUND
The incidence of Head and neck (HN) cancers in Thailand is rising and survival rates not improving. Variations of its incidence among geographical areas may due to various contributing factors.
METHODS
We focused on data from 25 districts within Chiang Mai province, Thailand. The temporal change was described separately into two periods, 2007-2012 and 2013-2018. The OpenBUGS and the Quantum Geographic Information System were utilized to determine the geographical patterns in the incidence of HN cancer and focus on oropharynx.
RESULTS
The number of new cases of HN cancer was 1,186, of which 835 cases (70%) were male. Among those patients 548 diagnosed in 2007-2012 and 638 diagnose in 2013-2018. High risk patterns of both overall HN and oropharyngeal cancer incidences were found in the central and southern areas of the province in 2007-2013. However, the geographical patterns of the incidence of oropharyngeal cancer showed the changed pattern, with high RR in central and northern areas in more recent period. Over two periods, the RR of the cancers incidence decrease. The RR of oropharyngeal increased in Fang district and it remained high in Mueang district.
CONCLUSION
This study have highlighted specific areas with a high risk of head and neck cancer and oropharyngeal cancer incidences in Chiang Mai province, along with the spatial inequalities in their distributions, with cluster formation. These results may be helpful in guiding any strategy put in place to respond to the high risk incidence of the cancers in specific areas.
Topics: Female; Geographic Information Systems; Head and Neck Neoplasms; Humans; Incidence; Male; Oropharyngeal Neoplasms; Thailand
PubMed: 36037110
DOI: 10.31557/APJCP.2022.23.8.2583 -
Bioscience Reports Dec 2019The present meta-analysis was conducted to explore the role of milk and dairy products consumption on oral or oropharyngeal cancer risk. PubMed, Embase and Chinese... (Meta-Analysis)
Meta-Analysis
The present meta-analysis was conducted to explore the role of milk and dairy products consumption on oral or oropharyngeal cancer risk. PubMed, Embase and Chinese Wanfang databases were investigated until 30 June 2019. The overall and subgroup associations were pooled with odds ratios (ORs) and 95% confidence intervals (CIs). As a result, the present study involving 4635 cases and 50777 participants from 12 publications suggested that an inverse association was found between milk and dairy products consumption and oral or oropharyngeal cancer risk (OR = 0.74, 95% CI = 0.59-0.92; I2 = 65.9%, Pfor heterogeneity=0.001). Four studies reported milk consumption on oral cancer risk, but no significant association was found (OR = 0.91, 95% CI = 0.61-1.37). Six studies about milk consumption and oropharyngeal cancer risk found that there was a positive association between them (OR = 0.63, 95% CI = 0.44-0.90). In conclusion, findings from our meta-analysis indicated that milk and dairy products consumption may be associated with decreased risk of oral or oropharyngeal cancer.
Topics: Adult; Dairy Products; Female; Humans; Male; Oropharyngeal Neoplasms; Risk Factors
PubMed: 31789344
DOI: 10.1042/BSR20193526 -
Cancer Medicine Dec 2020People living with HIV/AIDS (PLWH) have an excess risk for head and neck squamous cell carcinoma (HNSCC) compared to the general U.S. population, but little is known...
BACKGROUND
People living with HIV/AIDS (PLWH) have an excess risk for head and neck squamous cell carcinoma (HNSCC) compared to the general U.S. population, but little is known about HIV-specific risk factors associated with the incidence and outcomes HNSCC. We aim to identify clinical and HIV-specific risk factors associated with oropharyngeal and non-oropharyngeal HNSCC incidence and outcomes separately.
METHODS
We constructed a retrospective cohort study of 45,052 PLWH aged 18 or above from the national Veteran Affairs (VA) Corporate Data from 1999 to 2015. We extracted demographic data and risk factor information, including history of alcohol abuse, smoking, CD4 count (cells/μl), and percent of follow-up time with undetectable HIV viral load as time-updated variables. We calculated the age-standardized incidence rates of oropharyngeal and non-oropharyngeal HNSCC and estimated adjusted hazard ratios (HR). We also examined overall survival using Kaplan-Meier curves and adjusted HR.
RESULTS
The standardized incidence rate of oropharyngeal and non-oropharyngeal HNSCC in this veteran cohort of PLWH is 23.0 (95% confidence intervals (CIs): 17.1-28.9) and 55.4 (95% CI: 46.5-64.3) per 100,000 person-years, respectively. Nadir CD4 count ≤200 was associated with an increased risk of non-oropharyngeal HNSCC (HR: 1.78; 95% CI: 1.31-2.30 vs >200). Five-year overall survival of OPSCC (37.0%) was significantly lower than non-oropharyngeal HNSCC (49.1%).
CONCLUSIONS
PLWH who receive care in the VA had higher age-adjusted HNSCC incidence rates than reported in the general population, suggesting that HIV and immunosuppression play a role. Additional studies should be conducted to study the interaction between HPV and HIV.
Topics: Adult; CD4 Lymphocyte Count; Cohort Studies; Databases, Factual; HIV; HIV Infections; Head and Neck Neoplasms; Humans; Male; Middle Aged; Oropharyngeal Neoplasms; Retrospective Studies; Risk Factors; SEER Program; Survival Rate; United States; Veterans
PubMed: 33094910
DOI: 10.1002/cam4.3539 -
Ugeskrift For Laeger Sep 2022Transoral robotic surgery (TORS) has been utilized in the head and neck field for more than a decade. It is a minimally invasive technique which ensures flexible... (Review)
Review
Transoral robotic surgery (TORS) has been utilized in the head and neck field for more than a decade. It is a minimally invasive technique which ensures flexible instrumentation and 3D visualization of the oropharynx. This has led to a paradigm shift in the treatment of early-stage oropharyngeal cancer and in the diagnostic management of unknown primary of the head and neck. Over time, the indications for TORS have broadened. This review discusses the development, current indications, and future perspectives of TORS within head and neck surgery.
Topics: Head; Head and Neck Neoplasms; Humans; Neck; Oropharyngeal Neoplasms; Robotic Surgical Procedures
PubMed: 36065869
DOI: No ID Found