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Laryngo- Rhino- Otologie May 2022Near-infrared fluorescence (NIR) imaging is a new technique for intraoperative identification of sentinel lymph nodes (SLN). It has shown promising results in several...
BACKGROUND
Near-infrared fluorescence (NIR) imaging is a new technique for intraoperative identification of sentinel lymph nodes (SLN). It has shown promising results in several surgical specialties. This article reviews the current study situation of NIR SLN diagnosis of head and neck malignancy.
MATERIAL AND METHODS
Systematic literature search in the following online databases: PubMed, MEDLINE, Thompson Reuters Web of Science, SPIE for the search terms: sentinel node, sentinel node biopsy, head and neck squamous cell carcinoma, near-infrared imaging, indocyanine green, icg. Evaluation of scientific relevance of papers according to established criteria.
RESULTS
Studies were analyzed in terms of clinical application, clinical reporting, identification rate, and false-negative rate. The identification rate of SLN is 97-100 %, with an average of 1.2-3.4 fluorescence positive lymph nodes per examination. The overall false-negative rate varies between 0 and 20 %.
CONCLUSIONS
In the synopsis of the currently published results, NIR imaging promises the great potential to improve the diagnosis of SLN in carcinomas of the oral cavity and pharynx. A simple and fast procedure with high spatial resolution and without radiation exposure is beneficial.
Topics: Head and Neck Neoplasms; Humans; Indocyanine Green; Sentinel Lymph Node; Sentinel Lymph Node Biopsy; Squamous Cell Carcinoma of Head and Neck
PubMed: 34049415
DOI: 10.1055/a-1507-5492 -
BMC Cancer Apr 2021The clinical significance of tumor-stroma ratio (TSR) has been examined in many tumors. Here we systematically reviewed all studies that evaluated TSR in head and neck... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The clinical significance of tumor-stroma ratio (TSR) has been examined in many tumors. Here we systematically reviewed all studies that evaluated TSR in head and neck cancer.
METHODS
Four databases (Scopus, Medline, PubMed and Web of Science) were searched using the term tumo(u)r-stroma ratio. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) were followed.
RESULTS
TSR was studied in nine studies of different subsites (including cohorts of nasopharyngeal, oral, laryngeal and pharyngeal carcinomas). In all studies, TSR was evaluated using hematoxylin and eosin staining. Classifying tumors based on TSR seems to allow for identification of high-risk cases. In oral cancer, specifically, our meta-analysis showed that TSR is significantly associated with both cancer-related mortality (HR 2.10, 95%CI 1.56-2.84) and disease-free survival (HR 1.84, 95%CI 1.38-2.46).
CONCLUSIONS
The assessment of TSR has a promising prognostic value and can be implemented with minimum efforts in routine head and neck pathology.
Topics: Carcinoma, Squamous Cell; Disease-Free Survival; Head and Neck Neoplasms; Humans; Laryngeal Neoplasms; Nasopharyngeal Neoplasms; Pharyngeal Neoplasms; Stromal Cells
PubMed: 33931044
DOI: 10.1186/s12885-021-08222-8 -
Oral Oncology Mar 2021To present an up to date systematic review and meta-analysis evaluating the diagnostic accuracy of the most used imaging modalities in detection of histopathological... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To present an up to date systematic review and meta-analysis evaluating the diagnostic accuracy of the most used imaging modalities in detection of histopathological extra nodal extension (ENE) in head and neck squamous cell carcinoma.
MATERIALS AND METHODS
Medline, Embase, and Cochrane databases were systematically searched on March 27th 2020. Screening, inclusion, quality assessment, and data extraction were done by two reviewers. Meta-analysis was conducted using the bivariate model approach after pooling the studies according to imaging modality. Heterogeneity was explored by meta-regression. Comparison was done by meta-regression and sub-group analyses.
RESULTS
Out of 476 initial hits, 25 studies were included for analysis. Of these, 14 dealt with CT, nine with PET/CT, four with MRI, two with ultrasound, and none with PET/MRI. Meta-analysis based on a total sample size of 3391 showed that CT had a sensitivity of 76% [67-82%] and specificity of 77% [69-83%], MRI a sensitivity of 72% [64-79%] and specificity of 78% [57-90%], and PET/CT a sensitivity of 80% [76-84%] and specificity of 83% [74-90%] in the ability to predict ENE. No meta-analysis could be done on ultrasound. There were no significant differences between modalities in overall accuracy; however, PET/CT had significantly higher sensitivity than CT and MRI.
CONCLUSION
There was no significant difference in the ability of CT, MRI, and PET/CT to diagnose histopathological ENE, except that PET/CT had a significantly higher sensitivity than CT and MRI.
Topics: Aged, 80 and over; Diagnostic Imaging; Extranodal Extension; Humans
PubMed: 33493691
DOI: 10.1016/j.oraloncology.2020.105169 -
Medicine Oct 2020Hypopharyngeal and esophageal squamous cell carcinoma (ESCC) are the most common double primary tumors with poor prognosis. Intensive work has been made to illuminate... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Hypopharyngeal and esophageal squamous cell carcinoma (ESCC) are the most common double primary tumors with poor prognosis. Intensive work has been made to illuminate the etiology, but the common carcinogenic mechanism remains unclear. Thus, we conducted the study to seek to find the common gene signatures and key functional pathways associated with oncogenesis and treatment in hypopharyngeal squamous cell carcinoma (HSCC) and ESCC by bioinformatic analysis.
METHODS
Three independent datasets (GSE2379, GSE20347, and GSE75241) were screened out from the Gene Expression Omnibus (GEO) database and the overlapping differentially expressed genes (DEGs) were identified using GEO2R online platform. Subsequently, the Gene Ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways enrichment analysis of DEGs were conducted using database for annotation, visualization and integrated discovery (DAVID). Meanwhile, the protein-protein interaction network (PPI) constructed by search tool for the retrieval of interacting genes (STRING) was visualized using Cytoscape. Afterwards, the most key module and hub genes were extracted from the PPI network using the Molecular Complex Detection plugin. Moreover, the gene expression profiling interactive analysis (GEPIA) was applied to verify the expression differences and conduct the survival analyses of hub genes. Finally, the interaction network of miRNAs and hub genes constructed by encyclopedia of RNA interactomes (ENCORI) was visualized using Cytoscape.
RESULTS
A total of 43 DEGs were identified, comprising 25 upregulated genes and 18 downregulated genes, which were mainly involved in the extracellular matrix-receptor interaction, collagen metabolic, epidermis development, cell adhesion, and PI3K/Akt signaling pathways. Subsequently, 12 hub genes were obtained and survival analysis demonstrated SERPINE1 and SPP1 were closely related to poor prognosis of patients with HSCC and ESCC. Finally, hsa-miR-29c-3p, hsa-miR-29a-3p, and hsa-miR-29b-3p were confirmed as the top 3 interactive miRNAs that target the most hub genes according to the interaction network of miRNAs and hub genes.
CONCLUSION
The common gene signatures and functional pathways identified in the study may contribute to understanding the molecular mechanisms involved in the carcinogenesis and progression of HSCC and ESCC, and provide potential diagnostic and therapeutic targets.
Topics: Biomarkers, Tumor; Carcinoma, Squamous Cell; Computational Biology; Databases, Genetic; Esophageal Neoplasms; Gene Expression Profiling; Gene Expression Regulation, Neoplastic; Gene Ontology; Humans; Pharyngeal Neoplasms; Prognosis
PubMed: 33080677
DOI: 10.1097/MD.0000000000022434 -
European Archives of... Oct 2020To perform a systematic review of the literature available about the posterior pharyngeal wall squamous cell carcinomas, with a special focus on oncologic outcomes. (Review)
Review
OBJECTIVE
To perform a systematic review of the literature available about the posterior pharyngeal wall squamous cell carcinomas, with a special focus on oncologic outcomes.
METHODS
A comprehensive research was performed on PubMed/MEDLINE, Google Scholar, and Cochrane Library datasets for published studies meeting the established criteria. The last search was conducted on December 8, 2019.
RESULTS
Eleven studies were included in the review, for a total of 534 patients (median age 60.4; male: n = 359, 67.2%). Six of the studies evaluated the oncologic outcomes of primary surgery, while three studies focused on results achieved through primary radiotherapy. Two studies evaluated both surgery and radiotherapy outcomes for the treatment of early or advanced posterior pharyngeal wall carcinoma.
CONCLUSIONS
Primary surgery associated with adjuvant radiotherapy would seem to ensure better oncologic outcomes, especially for locally advanced tumors. Moreover, this systematic review showed that oro- and hypo-pharyngeal wall tumors are similar in terms of clinical and biological behavior.
Topics: Carcinoma, Squamous Cell; Head and Neck Neoplasms; Humans; Male; Middle Aged; Pharyngeal Neoplasms; Pharynx; Radiotherapy, Adjuvant
PubMed: 32361771
DOI: 10.1007/s00405-020-05990-0 -
Cancers Apr 2020Head and neck squamous cell carcinoma (HNSCC) is one of the main neoformations of the head-neck region and is characterized by the presence of squamous carcinomatous... (Review)
Review
Head and neck squamous cell carcinoma (HNSCC) is one of the main neoformations of the head-neck region and is characterized by the presence of squamous carcinomatous cells of the multi-layered epithelium lining the oral cavity, larynx, and pharynx. The annual incidence of squamous cell carcinoma of the head and neck (HNSCC) comprises approximately 600,000 new cases globally. Currently, the 5-year survival from HNSCC is less than 50%. Surgical, radiotherapy, and chemotherapy treatments strongly compromise patient quality of life. MicroRNAs (miRNAs) are a family of small noncoding endogenous RNAs that function in regulating gene expression by regulating several biological processes, including carcinogenesis. The main upregulated microRNAs associated with oral carcinoma are miR-21, miR-455-5p, miR-155-5p, miR-372, miR-373, miR-29b, miR-1246, miR-196a, and miR-181, while the main downregulated miRNAs are miR-204, miR-101, miR-32, miR-20a, miR-16, miR-17, and miR-125b. miR-21 represents one of the first oncomirs studied. The present systematic review work was performed based on the preferred reporting items for systematic review and meta-analysis (PRISMA) protocol. A search was carried out in the PubMed and Scopus databases with the use of keywords. This search produced 628 records which, after the elimination of duplicates and the application of the inclusion and exclusion criteria, led to 7 included articles. The heterogeneity of the studies according to the odds ratio was high, with a Q value of 26.616 ( < 0.001), and the was 77.457% for specificity. The heterogeneity was high, with a Q value of 25.243 ( < 0.001) and the was 76.231% for sensitivity. The heterogeneity of data showed a Q value of 27.815 ( < 0.001) and the was 78.429%. Therefore, the random-effects model was selected. The diagnostic odds ratio was 7.620 (95% CI 3.613-16.070). The results showed that the sensitivity was 0.771 (95% CI 0.680-0.842) ( < 0.001) while, for specificity, we found 0.663 (95% CI 0.538-0.770) ( < 0.001). The negative likelihood ratio (NLR) was 0.321 (95% CI 0.186-0.554), and the positive likelihood ratio (PLR) was 2.144 (95% CI 1.563-2.943). The summary ROC plot demonstrates that the diagnostic test presents good specificity and sensitivity, and the area under the curve (AUC), as calculated from the graph, was 0.79.
PubMed: 32290144
DOI: 10.3390/cancers12040936 -
Cells Sep 2019To review the current knowledge regarding the involvement of human papilloma virus (HPV) infection and the immune system in the development of head and neck squamous...
OBJECTIVES
To review the current knowledge regarding the involvement of human papilloma virus (HPV) infection and the immune system in the development of head and neck squamous cell carcinoma (HNSCC).
METHODS
An electronic literature search was conducted to identify articles published between 1990 and 2019 pertaining to tumor-infiltrating immune cells (TICs) in HNSCC using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Issues of clinical relevance, including tumor location, the number of tumor samples, the inclusion of additional specimens (dysplastic or normal mucosa), tumor size, methods used for HPV detection, relationship between antigen expression and patient characteristics (age, gender, smoking, alcohol consumption, etc.), and prognostic data (overall survival (OS) and recurrence-free survival (RFS)) were assessed by four blinded investigators.
RESULTS
The search identified 335 relevant studies, of which 41 met the inclusion criteria. Of these, 7 studies focused on the peripheral blood immune cell concentration in patients with HNSCC according to HPV status, and 36 studies investigated TICs in the intraepithelial and/or stromal compartment(s) according to HPV status. The immune cells studied were CD8+ T cells (N = 19), CD4+ T cells (N = 7), regulatory T cells (Tregs, N = 15), macrophages (N = 13), myeloid-derived suppressor cells (MDSCs, N = 4), and Langerhans cells (LCs, N = 2).
CONCLUSIONS
Irrespective of tumor location, CD8+ and CD4+ T cells appear to play a key role in the development of HPV-related HNSCC, and their infiltration is likely associated with a significant impact on OS and RFS. To date, the roles and prognostic value of Tregs, macrophages, DCs and MDSCs remain unclear.
Topics: Carcinoma, Squamous Cell; Female; Head and Neck Neoplasms; Humans; Langerhans Cells; Macrophages; Male; Myeloid-Derived Suppressor Cells; Oropharyngeal Neoplasms; Oropharynx; Papillomaviridae; Papillomavirus Infections; Squamous Cell Carcinoma of Head and Neck; T-Lymphocytes, Regulatory
PubMed: 31510065
DOI: 10.3390/cells8091061 -
Journal of Clinical Medicine Feb 2019The aim of this systematic review with meta-analysis was to investigate the available literature on transoral approaches in the treatment of hypopharyngeal squamous cell... (Review)
Review
The aim of this systematic review with meta-analysis was to investigate the available literature on transoral approaches in the treatment of hypopharyngeal squamous cell carcinoma, with a special focus on transoral robotic surgery (TORS). A systematic review was conducted according to the PRISMA (preferred reporting items for systematic reviews and meta-analyses) check-list, and 15 studies were included. Five of the included studies evaluated TORS, while ten studies focused on transoral laser microsurgery (TLM) for the treatment of early or advanced stage hypopharyngeal cancer. Overall, survival rates of TLM and TORS studies, analyzed together in the cumulative meta-analysis, were 66.4% (95% confidence interval (CI) 54.3%⁻76.7%) at 36+ months of follow up. The TORS subgroup showed a higher cumulative survival rate (85.5%, 95% CI 55.8%⁻96.5%) compared to TLM (58.5%, 95% CI 46.6%⁻69.6%). Cumulative data showed that 29.3% (95% CI 24.0%⁻35.3%) of deaths were attributable to cancer. The results were similar between TLM and TORS studies. The larynx function preservation cumulative rate was 94.3% (95% CI 91.8%⁻96.1%). The results were similar among the two subgroups. The present review supports the use of transoral approaches in the treatment of hypopharyngeal cancer. TORS is oncologically sound and provides excellent functional results with low complication rates.
PubMed: 30781660
DOI: 10.3390/jcm8020256 -
PloS One 2019Nasopharyngeal cancer (NPC), despite being one of the most malignant head and neck carcinomas (HNC), lacks comprehensive prognostic biomarkers that predict patient... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Nasopharyngeal cancer (NPC), despite being one of the most malignant head and neck carcinomas (HNC), lacks comprehensive prognostic biomarkers that predict patient survival. Therefore, this systematic review and meta-analysis is aimed to evaluate the potential prognostic value of miRNAs as prognostic biomarkers in NPC.
METHODS
PRISMA guidelines were used to conduct this systematic review and meta-analysis study. Permutations of multiple "search key-words" were used for the search strategy, which was limited to articles published between January 2012 and March 2018. The retrieved articles were meticulously searched with multi-level screening by two reviewers and confirmed by other reviewers. Meta-analysis was performed using Hazard Ratios (HR) and associated 95% Confidence Interval (CI) of survival obtained from previously published studies. Publication bias was assessed by Egger's bias indicator test and funnel plot symmetry.
RESULTS
A total of 5069 patients across 21 studies were considered eligible for inclusion in the systematic review, with 65 miRNAs being evaluated in the subsequent meta-analysis. Most articles included in this study originated from China and one study from North Africa. The forest plot was generated using cumulated survival data, resulting in a pooled HR value of 1.196 (95% CI: 0.893-1.601) indicating that the upregulated miRNAs increased the likelihood of death of NPC patients by 19%.
CONCLUSION
To our knowledge, this is the first meta-analysis that examines the prognostic effectiveness of miRNAs as biomarkers in NPC patients. We noted that the combined effect estimate of HR across multiple studies indicated that increased miRNA expression in NPC potentially leads to poor overall survival. However, further large-scale prospective studies on the clinical significance of the miRNAs, with sizable cohorts are necessary in order to obtain conclusive results.
Topics: Biomarkers, Tumor; Humans; MicroRNAs; Nasopharyngeal Neoplasms; Nasopharynx; Prognosis; Survival Analysis
PubMed: 30735523
DOI: 10.1371/journal.pone.0209760 -
Head & Neck Apr 2019This systematic review and meta-analysis aims to evaluate the effectiveness of palatine tonsillectomy in patients with cervical metastasis from squamous cell carcinoma... (Meta-Analysis)
Meta-Analysis
BACKGROUND
This systematic review and meta-analysis aims to evaluate the effectiveness of palatine tonsillectomy in patients with cervical metastasis from squamous cell carcinoma of unknown primary (SCCUP) origin.
METHODS
A systematic review including studies that encompassed palatine tonsillectomy in the SSCUP diagnostic evaluation was conducted. A single arm meta-analysis was then made to obtain the overall identification rate of tonsillectomy.
RESULTS
Fourteen studies were included, comprising 673 patients who underwent 416 palatine tonsillectomies, 338 preformed during examination under anesthesia (EUA) and 78 managed with transoral robotic surgery (TORS). A total of 140 occult tonsillar malignancies were identified; of these, 124 (89%) were ipsilateral, 2 (1%) contralateral, and 14 (10%) synchronous bilateral. Meta-analysis of 11 studies showed an overall detection rate of tonsillectomy of 0.34 (99% confidence interval 0.23-0.46).
CONCLUSION
Palatine tonsillectomy is a valuable diagnostic tool in the management of patients with head and neck SCCUP. Bilaterality of tonsillectomy should be taken into consideration.
Topics: Aged; Disease-Free Survival; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Neoplasms, Unknown Primary; Palatine Tonsil; Prognosis; Risk Assessment; Role; Squamous Cell Carcinoma of Head and Neck; Survival Analysis; Tonsillar Neoplasms; Tonsillectomy; Treatment Outcome
PubMed: 30575162
DOI: 10.1002/hed.25522