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Cancer Imaging : the Official... Nov 2005Imaging studies have an important role in defining the extent of oropharyngeal neoplasms and coming to an accurate staging of these lesions. Besides influencing...
Imaging studies have an important role in defining the extent of oropharyngeal neoplasms and coming to an accurate staging of these lesions. Besides influencing treatment choice, imaging studies can also be used to monitor tumour response to treatment, and as an adjunct to clinical follow-up in order to detect treatment failure as early as possible.
Topics: Carcinoma, Squamous Cell; Humans; Lymphatic Metastasis; Magnetic Resonance Imaging; Neoplasm Staging; Oropharyngeal Neoplasms; Tomography, X-Ray Computed
PubMed: 16361137
DOI: 10.1102/1470-7330.2005.0030 -
Otolaryngology--head and Neck Surgery :... Sep 2018
Topics: Adalimumab; Adult; Autoimmune Diseases; Biopsy, Needle; Carcinoma, Squamous Cell; Chemoradiotherapy; Female; Humans; Immunocompromised Host; Immunohistochemistry; Male; Middle Aged; Oropharyngeal Neoplasms; Papillomavirus Infections; Positron-Emission Tomography; Prognosis; Risk Assessment; Sampling Studies; Treatment Outcome
PubMed: 29734877
DOI: 10.1177/0194599818774756 -
Cancer May 1998
Topics: Carcinoma; Humans; Neoplasm Staging; Oropharyngeal Neoplasms
PubMed: 9576277
DOI: 10.1002/(sici)1097-0142(19980501)82:9<1611::aid-cncr2>3.0.co;2-d -
Pathology, Research and Practice Dec 2020In a retrospective review, we identified 332 patients with 338 pathologically diagnosed primary oropharyngeal carcinomas (OPC) between January 2013 and March 2020 with...
In a retrospective review, we identified 332 patients with 338 pathologically diagnosed primary oropharyngeal carcinomas (OPC) between January 2013 and March 2020 with known p16/HPV status from a tumor registry at Northwestern Memorial Hospital. The tumors predominantly involved the palatine tonsil (51 %) and the base of the tongue/lingual tonsil (38 %). The most common type of cancer was non-keratinizing squamous cell carcinoma (60 %), and the majority of primaries were p16 positive/HPV-mediated (86 %). A cohort of p16 positive/HPV mediated OPC (27/283, 9.5 %) presented with aggressive clinical behavior, including multiple distant metastases at unusual sites. Tumor size >2 cm and the presence of tumor anaplasia/multinucleation were significantly associated with an increased rate of distant metastases in p16 positive/HPV mediated cases, both in unadjusted and adjusted analyses (all P < 0.05). Of the 332 individuals in the overall cohort, 38 individuals died due to their disease within the observed follow-up time. Among the 283 patients with p16 positive/HPV mediated tumors, survival was estimated at 97 % (95 % CI 95 %, 100 %) at 1 year, 95 % (95 % CI 92 %, 98 %) at 2 years, and 80 % (95 % CI 72 %, 89 %) at 5 years. The presence of tumor anaplasia/multinucleation and distant metastasis were both significantly associated with poorer disease-specific survival in p16 positive/HPV mediated cases (both P < 0.05), with the survival effect of tumor anaplasia/multinucleation likely mediated in part through its association with distant metastasis. For p16 positive/HPV-mediated OPC, age, smoking status, tumor status, and lymph node status were not significantly associated with disease-specific survival in our study.
Topics: Aged; Aged, 80 and over; Biomarkers, Tumor; Carcinoma, Squamous Cell; Cell Nucleus; Cyclin-Dependent Kinase Inhibitor p16; Disease Progression; Female; Humans; Illinois; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Oropharyngeal Neoplasms; Papillomaviridae; Papillomavirus Infections; Progression-Free Survival; Registries; Retrospective Studies; Tumor Burden
PubMed: 33113454
DOI: 10.1016/j.prp.2020.153243 -
European Archives of... Jun 2017Surgery for early-intermediate oropharyngeal squamous cell carcinoma (OPSCC) may involve using transoral endoscopic approaches or open surgical procedures. "Lateral...
Surgery for early-intermediate oropharyngeal squamous cell carcinoma (OPSCC) may involve using transoral endoscopic approaches or open surgical procedures. "Lateral pharyngotomy" (LP) is an open surgical approach that improves exposure of the oropharyngeal region, while avoiding mandibulotomy. The aim of the present study was to retrospectively analyze our experience with the surgical treatment of early-intermediate OPSCC using the LP approach, and to investigate the potentially prognostic clinical and/or pathological factors that might identify patients at higher risk of recurrence after primary surgery. Sixty-four patients with previously untreated early-intermediate (pT1-T2-T3) OPSCC consecutively underwent partial pharyngectomy using a LP approach, performed by the same surgical team at a tertiary head and neck oncology center (Otolaryngology Unit, Vittorio Veneto Hospital, Italy). The 2-year disease-specific survival rates were 86% for stage I-II and 77% for stage III-IV disease. All patients who experienced locoregional or distant metastases died of their disease, while no patients died of any complications of the treatment. Postoperative complications occurred in 25 patients (39%), the most common being pharyngocutaneous fistula. All but one of the patients experienced a complete recovery of oral food intake. In conclusion, the LP approach to oropharyngeal cancer could be a valid open surgical alternative to oropharyngectomy with mandibulotomy for: (a) patients with early-intermediate OPSCC in whom oropharyngeal exposure proves difficult, and/or who are not eligible for transoral endoscopic surgery; (b) HPV-negative OPSCCs; and
Topics: Adult; Aged; Aged, 80 and over; Analysis of Variance; Carcinoma, Squamous Cell; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Minimally Invasive Surgical Procedures; Neck Dissection; Neoplasm Staging; Oral Surgical Procedures; Oropharyngeal Neoplasms; Pharynx; Prognosis; Retrospective Studies; Robotic Surgical Procedures; Survival Rate
PubMed: 28324180
DOI: 10.1007/s00405-017-4538-3 -
Otolaryngology--head and Neck Surgery :... Dec 2020Characterize the survival impact of smoking on HPV-related (human papillomavirus) oropharyngeal squamous cell carcinoma. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Characterize the survival impact of smoking on HPV-related (human papillomavirus) oropharyngeal squamous cell carcinoma.
DATA SOURCES
Articles from 2000 to 2019 in the PubMed, Embase, and Cochrane Library databases were systematically reviewed for content and inclusion/exclusion criteria.
REVIEW METHODS
Two reviewers independently analyzed the databases for eligibility and quality of the articles. Demographic data, smoking history, and survival outcomes were recorded. Hazard ratios and 95% CIs were collectively analyzed through a random effects meta-analysis model.
RESULTS
Fifteen articles were included in the meta-analysis for overall survival, disease-specific survival, disease-free survival, progression-free survival, and locoregional recurrence outcomes. The overall survival hazard ratio was 2.4 for ever having smoked (95% CI, 1.4-4.0; = .0006, = .384) and 3.2 for current smoking (95% CI, 2.2-4.6; < .0001, = 0). The hazard ratio for disease-specific survival in current smokers was 6.3 (95% CI, 1.3-29.3; = .0194, = 0). Ever smoking had a larger impact on overall survival and disease-specific survival than the 10-pack year smoking threshold.
CONCLUSION
Smoking negatively affects survival in patients with HPV-related oropharyngeal carcinoma across all outcomes. Current smoking during treatment is associated with the greatest reduction in survival, possibly secondary to diminished radiation therapy efficacy.
Topics: Carcinoma, Squamous Cell; Humans; Neoplasm Recurrence, Local; Oropharyngeal Neoplasms; Papillomavirus Infections; Risk Factors; Smoking; Survival Rate
PubMed: 32452741
DOI: 10.1177/0194599820931803 -
Otolaryngologic Clinics of North America Aug 2013The major benefits of modern radiation therapy (eg, intensity-modulated [x-ray] radiation therapy [IMRT]) for oropharyngeal cancer are reduced xerostomia and better... (Review)
Review
The major benefits of modern radiation therapy (eg, intensity-modulated [x-ray] radiation therapy [IMRT]) for oropharyngeal cancer are reduced xerostomia and better quality of life. Intensity-modulated proton therapy may provide additional advantages over IMRT by reducing radiation beam-path toxicities. Several acute and late treatment-related toxicities and symptom constellations must be kept in mind when designing and comparing future treatment strategies, particularly because currently most patients with oropharyngeal carcinoma present with human papillomavirus-positive disease and are expected to have a high probability of long-term survival after treatment.
Topics: Chemoradiotherapy; Dose Fractionation, Radiation; Humans; Oropharyngeal Neoplasms; Radiotherapy, Intensity-Modulated; Treatment Outcome
PubMed: 23910474
DOI: 10.1016/j.otc.2013.04.004 -
Oral Oncology Feb 2018To examine reader performance in evaluating oropharyngeal anatomy on ultrasonography.
OBJECTIVE
To examine reader performance in evaluating oropharyngeal anatomy on ultrasonography.
MATERIALS AND METHODS
Ultrasound images of the oropharynx comprising normal and malignant anatomic variants were organized into slideshows. Slideshows were administered to 6 readers blinded to participant tumor status and with varying experience reading oropharyngeal sonograms. A training slideshow oriented readers to images of the oropharynx with and without malignant lesions. Readers then evaluated images in a test slideshow for tumor presence and marked orthogonal long and short dimensions of the tumor. Results were analyzed for accuracy, sensitivity, specificity, inter-reader agreement, and measurement error relative to prospectively-identified reference measurements.
RESULTS
Eighty-seven percent of base of tongue (BOT) sonograms were identified correctly by a majority of readers. In identifying BOT tumors, median accuracy, sensitivity, specificity, and Fleiss's kappa were 79%, 73%, 85%, and 0.51, respectively. Median measurement error in the long and short axes for BOT tumors was -2.6% (range: -40% to 29%) and -2.6% (range: -56% to 156%), respectively. Eighty-four percent of palatine tonsil sonograms were identified correctly by a majority of readers. In identifying tonsil tumors, median accuracy, sensitivity, specificity, and Fleiss's kappa were 77%, 74%, 78%, and 0.41, respectively. Median measurement error in the long and short axes for tonsil tumors was 3.8% (range: -45% to 32%) and -6.5% (range: -83% to 42%), respectively.
CONCLUSIONS
Overall, US has clinically useful sensitivity for identification of oropharyngeal carcinoma among readers of diverse clinical backgrounds and experience. US may be useful for the evaluation of features such as tumor dimensions.
Topics: Adult; Aged; Aged, 80 and over; Alphapapillomavirus; Carcinoma, Squamous Cell; Female; Humans; Male; Middle Aged; Oropharyngeal Neoplasms; Sensitivity and Specificity; Tongue; Ultrasonography
PubMed: 29362115
DOI: 10.1016/j.oraloncology.2017.12.012 -
European Archives of... Feb 2022The objective was to assess swallowing, mouth opening and speech function during the first year after radiation-based treatment (RT(+)) after introduction of a dedicated...
OBJECTIVE
The objective was to assess swallowing, mouth opening and speech function during the first year after radiation-based treatment (RT(+)) after introduction of a dedicated preventive rehabilitation program for stage III-IV oropharyngeal carcinoma (OPC).
METHODS
Swallowing, mouth opening and speech function were collected before and at six- and twelve-month follow-up after RT(+) for OPC as part of ongoing prospective assessments by speech-language pathologists .
RESULTS
Objective and patient-perceived function deteriorated until 6 months and improved until 12 months after treatment, but did not return to baseline levels with 25%, 20% and 58% of the patients with objective dysphagia, trismus and speech problems, respectively. Feeding tube dependency and pneumonia prevalence was low.
CONCLUSION
Despite successful implementation, a substantial proportion of patients still experience functional limitations after RT(+) for OPC, suggesting room for improvement of the current rehabilitation program. Pretreatment sarcopenia seems associated with worse functional outcomes and might be a relevant new target for rehabilitation strategies.
Topics: Carcinoma; Deglutition Disorders; Humans; Oropharyngeal Neoplasms; Speech; Trismus
PubMed: 34043065
DOI: 10.1007/s00405-021-06870-x -
Journal of B.U.ON. : Official Journal... 2018Human papillomavirus (HPV)-mediated cervical carcinogenesis represents a well analyzed model of viral implication in epithelial malignant transformation. Mechanisms of...
Human papillomavirus (HPV)-mediated cervical carcinogenesis represents a well analyzed model of viral implication in epithelial malignant transformation. Mechanisms of high risk (HR) HPV-related infection seem to demonstrate a similar action regarding its implication in head and neck (HN) carcinomas, predominantly in squamous cell carcinoma (SCC) histological type. The prevalence of HR HPV subtypes - mainly HPV16 - is characterized by a broad geographic heterogeneity. Furthermore, HPV-associated HNSCCs demonstrate differences regarding sexual, molecular, epidemiological, and prognostic features compared to alcohol and tobacco dependent ones. Based on these differences, HPV-derived HNSCC appear to be a specific well-defined entity mostly affecting young to middle-aged - male mainly - non-smokers. This is a strong reason of detecting an increased HR-HPV DNA levels -due to viral transmission - in oropharyngeal and laryngeal anatomic regions. Additionally, different response rates to chemoradiation and targeted therapeutic regimens are another significant field for handling these SCC malignancies in the corresponding patients. In the current special article we explored the role of HPV-related carcinogenesis in oropharyngeal and laryngeal SCC focused on the latest molecular aspects.
Topics: Carcinoma, Squamous Cell; DNA, Viral; Head and Neck Neoplasms; Humans; Male; Middle Aged; Oropharyngeal Neoplasms; Papillomaviridae; Papillomavirus Infections
PubMed: 29552754
DOI: No ID Found