Surgeon-performed intraoperative transoral ultrasound improves the detection of human papillomavirus-positive head and neck cancers of unknown primary

IF 5.4 3区材料科学 Q2 CHEMISTRY, PHYSICAL

ACS Applied Energy Materials Pub Date : 2024-10-14 DOI:10.1016/j.oraloncology.2024.107073

Martin Garset-Zamani , Anne Fog Lomholt , Birgitte Wittenborg Charabi , Rikke Norling , Danijela Dejanovic , Johanna Maria Hall , Fatemeh Makouei , Tina Klitmøller Agander , Annette Kjær Ersbøll , Christian von Buchwald , Tobias Todsen

{"title":"Surgeon-performed intraoperative transoral ultrasound improves the detection of human papillomavirus-positive head and neck cancers of unknown primary","authors":"Martin Garset-Zamani , Anne Fog Lomholt , Birgitte Wittenborg Charabi , Rikke Norling , Danijela Dejanovic , Johanna Maria Hall , Fatemeh Makouei , Tina Klitmøller Agander , Annette Kjær Ersbøll , Christian von Buchwald , Tobias Todsen","doi":"10.1016/j.oraloncology.2024.107073","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Squamous cell carcinomas of unknown primary (SCCUP) are often Human Papillomavirus (HPV)-positive. Due to their small size, extensive surgical workup is required to locate the primary tumors. High-frequency transoral ultrasound (US) may provide improved visualization of these small tumors. Our study aimed to explore whether surgeon-performed intraoperative transoral US for patients with HPV-positiveSCCUP could improve primary tumor detection during panendoscopy.</div></div><div><h3>Methods</h3><div>This was a single-center, prospective diagnostic study including patients undergoing panendoscopy under general anesthesia with HPV-positive SCCUP. Preoperative MRIs, PET/CTs, and HPV DNA-testing of lymph node metastases were performed in all patients. Intraoperative transoral US was performed prior to panendoscopy. Frozen section biopsies were performed unblinded to US results, and transoral US-guided biopsies were attempted if initial biopsies were negative. Final histopathology was obtained with palatine- and/or lingual tonsillectomy if frozen section was negative. The main outcome was the primary tumor detection rate with intraoperative transoral US and panendoscopy.</div></div><div><h3>Results</h3><div>Thirty patients were included: 24 (80 %) were men, and the median age was 60 years [range 35–79 years]. Twenty-nine primary tumors (97 %) were confirmed; 18 (62 %) and 10 (34 %) in the lingual- and palatine tonsils, respectively, and one (3 %) in the posterior oropharynx. Transoral US had a significantly higher sensitivity than panendoscopy to locate the primary tumor (93 % vs 76 %, p = 0.02), and significantly higher than pre-operative PET/CT (62 %, p = 0.002), CT (45 %, p < 0.001), and MRI (28 %, p < 0.001).</div></div><div><h3>Conclusions</h3><div>Intraoperative transoral US during panendoscopy is a promising diagnostic tool that may improve the detection of HPV-positive SCCUP.</div></div>","PeriodicalId":4,"journal":{"name":"ACS Applied Energy Materials","volume":null,"pages":null},"PeriodicalIF":5.4000,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Energy Materials","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1368837524003919","RegionNum":3,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CHEMISTRY, PHYSICAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Squamous cell carcinomas of unknown primary (SCCUP) are often Human Papillomavirus (HPV)-positive. Due to their small size, extensive surgical workup is required to locate the primary tumors. High-frequency transoral ultrasound (US) may provide improved visualization of these small tumors. Our study aimed to explore whether surgeon-performed intraoperative transoral US for patients with HPV-positive SCCUP could improve primary tumor detection during panendoscopy.

Methods

This was a single-center, prospective diagnostic study including patients undergoing panendoscopy under general anesthesia with HPV-positive SCCUP. Preoperative MRIs, PET/CTs, and HPV DNA-testing of lymph node metastases were performed in all patients. Intraoperative transoral US was performed prior to panendoscopy. Frozen section biopsies were performed unblinded to US results, and transoral US-guided biopsies were attempted if initial biopsies were negative. Final histopathology was obtained with palatine- and/or lingual tonsillectomy if frozen section was negative. The main outcome was the primary tumor detection rate with intraoperative transoral US and panendoscopy.

Results

Thirty patients were included: 24 (80 %) were men, and the median age was 60 years [range 35–79 years]. Twenty-nine primary tumors (97 %) were confirmed; 18 (62 %) and 10 (34 %) in the lingual- and palatine tonsils, respectively, and one (3 %) in the posterior oropharynx. Transoral US had a significantly higher sensitivity than panendoscopy to locate the primary tumor (93 % vs 76 %, p = 0.02), and significantly higher than pre-operative PET/CT (62 %, p = 0.002), CT (45 %, p < 0.001), and MRI (28 %, p < 0.001).

Conclusions

Intraoperative transoral US during panendoscopy is a promising diagnostic tool that may improve the detection of HPV-positive SCCUP.

Abstract Image

查看原文本刊更多论文

外科医生在术中进行经口超声检查可提高对人类乳头瘤病毒阳性的不明原发性头颈部癌症的检测率

背景原发灶不明的鳞状细胞癌（SCCUP）通常是人乳头状瘤病毒（HPV）阳性。由于其体积较小，需要进行大量的手术检查才能确定原发肿瘤的位置。高频经口超声（US）可改善这些小肿瘤的可视化。我们的研究旨在探讨外科医生为HPV阳性SCCUP患者进行术中经口超声检查是否能提高全内镜检查时原发肿瘤的检测率。方法这是一项单中心、前瞻性诊断研究，包括在全身麻醉下接受全内镜检查的HPV阳性SCCUP患者。所有患者都进行了术前核磁共振成像、PET/CT 和淋巴结转移的 HPV DNA 检测。全腔镜检查前进行术中经口 US 检查。冷冻切片活检与 US 结果无关，如果最初的活检结果为阴性，则尝试在 US 引导下进行经口活检。如果冷冻切片呈阴性，则通过腭和/或舌扁桃体切除术获得最终组织病理学结果。主要结果是术中经口 US 和全内镜检查的原发肿瘤检出率：其中 24 例（80%）为男性，中位年龄为 60 岁[35-79 岁]。确诊原发性肿瘤 29 例（97%），其中 18 例（62%）和 10 例（34%）分别位于舌扁桃体和腭扁桃体，1 例（3%）位于口咽后部。经口 US 定位原发肿瘤的灵敏度明显高于全内镜检查（93 % vs 76 %，p = 0.02），明显高于术前 PET/CT（62 %，p = 0.002）、CT（45 %，p < 0.001）和 MRI（28 %，p < 0.001）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

ACS Applied Energy Materials Materials Science-Materials Chemistry

CiteScore

10.30

自引率

6.20%

发文量

1368

期刊介绍： ACS Applied Energy Materials is an interdisciplinary journal publishing original research covering all aspects of materials, engineering, chemistry, physics and biology relevant to energy conversion and storage. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important energy applications.