JAMA otolaryngology-- head & neck surgery最新文献

{"title":"Insights on Distress Measurement in Head and Neck Cancer.","authors":"Ching-Nung Wu, Wei-Chih Chen, Sheng-Dean Luo","doi":"10.1001/jamaoto.2025.0888","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.0888","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative ctHPVDNA Kinetics in Patients With HPV-Related Oropharyngeal Cancer.","authors":"Linda X Yin, Cecelia M Hidalgo, Aaron W Bogan, Danielle E Hunter, Kathleen R Bartemes, Kendall K Tasche, Eric J Moore, Daniel L Price, Daniel J Ma, Michelle A Neben-Wittich, Scott C Lester, Katharine A Price, Patrick W McGarrah, Harry E Fuentes Bayne, David M Routman, Kathryn M Van Abel","doi":"10.1001/jamaoto.2025.1606","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.1606","url":null,"abstract":"<p><strong>Importance: </strong>Circulating tumor human papillomavirus DNA (ctHPVDNA) is an important biomarker for the presence of HPV-associated oropharyngeal squamous cell carcinoma (OPSCC), but little is known about early postoperative kinetics of ctHPVDNA clearance.</p><p><strong>Objective: </strong>To investigate early postoperative kinetics of ctHPVDNA in patients with HPV-associated OPSCC.</p><p><strong>Design, setting, and participants: </strong>This prospective cohort study was conducted at a single tertiary care center from January 4, 2020, to January 26, 2023. Patients with newly diagnosed HPV-associated OPSCC undergoing surgical management were enrolled. HPV status was defined as positive if findings of p16 immunohistochemistry and/or HPV DNA in situ hybridization and/or E6/E7 RNA in situ hybridization were positive. Exclusion criteria included history of prior head and neck cancer and metastatic disease at presentation. Data were analyzed from September 1, 2024, to April 25, 2025.</p><p><strong>Exposures: </strong>Transoral robotic surgery with concurrent neck dissection.</p><p><strong>Main outcomes and measures: </strong>Blood was drawn prior to surgery (pretreatment), 1 to 2 days after surgery (postoperative days 1 to 2), and approximately 2 weeks after surgery (postoperative week 2; range, 8 to 20 days). ctHPVDNA was quantified by a tumor tissue-modified viral (TTMV) HPV DNA test. Correlations were tested between the pretreatment and postoperative day 1 to 2 TTMV HPV DNA levels using Gaussian regression. Concordance between detectability at postoperative day 1 to 2 and postoperative week 2 was explored using negative predictive value and positive predictive value.</p><p><strong>Results: </strong>Of 57 included patients with detectable pretreatment TTMV HPV DNA, 51 (89%) were male, and the median (IQR) age was 59 (54-66) years. A total of 35 patients (61%) had blood draws at all 3 time points; 16 (28%) had detectable TTMV HPV DNA on postoperative day 1 to 2. Pretreatment and postoperative day 1 to 2 TTMV HPV DNA levels had a medium positive linear correlation (r = 0.31; 95% CI, 0.04-0.54). Undetectable TTMV HPV DNA on postoperative day 1 to 2 blood draw had a negative predictive value of 0.95 (95% CI, 0.74-1.00) for an undetectable level on postoperative week 2 blood draw, but a detectable level on postoperative day 1 to 2 blood draw only had a positive predictive value of 0.19 (95% CI, 0.04-0.46). Of the 16 patients with detectable TTMV HPV DNA pretreatment and at postoperative day 1 to 2, only 3 (19%) continued to have detectable TTMV HPV DNA at postoperative week 2. One patient had undetectable levels at postoperative day 1 to 2 and detectable levels at postoperative week 2.</p><p><strong>Conclusions and relevance: </strong>In this study, ctHPVDNA detectability early after surgery did not predict detectability at 2 weeks after surgery. ctHPVDNA clearance early after surgery could predict a negative test at 2 weeks. A negative b","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations and Cautions in Postoperative HPV Circulating Tumor DNA Kinetics.","authors":"Molly E Heft Neal, Richard L Bakst, Raymond L Chai","doi":"10.1001/jamaoto.2025.1612","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.1612","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of a Brief Cognitive Behavioral Treatment Across Body Image Distress Domains: Secondary Outcomes of the BRIGHT Randomized Clinical Trial.","authors":"Haley Hullfish, Emily Kistner-Griffin, Stacey Maurer, Wendy Balliet, Jessica Vanderlan, Olga Slavin-Spenny, Lynne Padgett, Angie Rush, Brad Johnson, Taylor McLeod, Ella J Starr, Kenneth J Ruggiero, Katherine R Sterba, Evan M Graboyes","doi":"10.1001/jamaoto.2025.0965","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.0965","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Proposal for HPV-Associated Oropharyngeal Carcinoma in the Ninth Edition Clinical TNM Classification.","authors":"Shao Hui Huang, Jie Su, Shlomo A Koyfman, David Routman, Frank Hoebers, Houda Bahig, Eugene Yu, Eric Bartlett, Anna Spreafico, Jonathan Lee, Sarah Stock, Robin Davis, Neil M Woody, Kristoff Nelson, Danny Lavigne, Phuc Felix Nguyen-Tan, Laurent Létourneau-Guillon, Edith Filion, Alex A Nagelschneider, Daniel Ma, Kathryn M Van Abel, Alida A Postma, Walter M Palm, Ann Hoeben, William Lydiatt, Snehal G Patel, Melvin L K Chua, Wei Xu, Brian O'Sullivan","doi":"10.1001/jamaoto.2025.0848","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.0848","url":null,"abstract":"<p><strong>Importance: </strong>A subset of Union for International Cancer Control (UICC)/American Joint Committee on Cancer (AJCC) eighth edition TNM stage I and II human papillomavirus-positive oropharyngeal carcinoma has undesirable outcomes, which might have contributed to a lack of success in phase III deintensification trials. Refining clinical stage groups, especially in the overabundant cN1/stage I group, has become important for treatment selection.</p><p><strong>Objective: </strong>To assess the prognostic importance of pretreatment lymph node (LN) characteristics to optimize case distribution and outcome homogeneity within the N classification system.</p><p><strong>Design, setting, and participants: </strong>This is an international multi-institutional retrospective prognostic cohort study. Analysis of human papillomavirus-positive oropharyngeal carcinoma treated curatively from 4 institutions (International Collaboration of Oropharyngeal Cancer Network for N-Classification [ICON-N] dataset) provided a refined clinical staging proposal; an independent dataset (Centre Hospitalier de l'Université de Montréal [CHUM] dataset) validated the proposal. Neuroradiologists reviewed pretreatment computed tomography and/or magnetic resonance imaging for nodal features, including presence or absence of abnormal LN(s), retropharyngeal LN, laterality, number of abnormal LN, and imaging-detected extranodal extension (iENE). Data were collected from February to May 2023, and data were analyzed from June to July 2023.</p><p><strong>Exposures: </strong>Definitive chemoradiotherapy/radiotherapy or definitive surgery with or without postoperative chemoradiotherapy/radiotherapy.</p><p><strong>Main outcomes and measures: </strong>The primary end point was overall survival. A Cox proportional hazards multivariable model was used to estimate adjusted hazard ratios (AHRs) and to derive an optimal clinical TNM stage classification (AHR-stage schema) incorporating the strongest prognostic nodal features within the UICC/AJCC eighth edition TNM framework after confirming the prognostication of iENE status. The performance (according to overall normalized scores and ranking) of the AHR-stage schema against the current UICC/AJCC eighth edition TNM staging system was evaluated for hazard consistency, hazard discrimination, prognostic importance, and sample size balance. Validation was performed in the CHUM dataset.</p><p><strong>Results: </strong>The ICON-N dataset comprised 2053 patients, including 1898 (92.5%) with cN-positive disease and 155 (7.5%) with cN0 disease; a total of 298 (14.5%) were female, and the mean (SD) age was 60.6 (9.3) years. iENE-positive disease was identified in 710 of 1898 patients with cN-positive disease (37.4%). The median (range) follow-up was 5.1 (0.1-14.7) years. iENE was the strongest prognostic nodal feature in multivariable analysis; the AHR for iENE-positive vs iENE-positive disease was 2.43 (95% CI, 1.96-3.03) in the ICON-N dataset","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error in Author Affiliation.","authors":"","doi":"10.1001/jamaoto.2025.1314","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.1314","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving Intersystem Medical Error Reporting Into a New Era of Accountability and Duty.","authors":"G Richard Holt","doi":"10.1001/jamaoto.2025.0596","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.0596","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intersystem Medical Error Discovery in Otolaryngology-Head and Neck Surgery.","authors":"Ruby J Kazemi, Alexis G Antunez, Nicholas R Lenze, Norman D Hogikyan, Andrew G Shuman, Lesly Dossett, Michael J Brenner","doi":"10.1001/jamaoto.2025.0541","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.0541","url":null,"abstract":"<p><strong>Importance: </strong>Intersystem medical error discovery (IMED) involves clinicians identifying errors that occurred outside of their facility while a patient was under another clinician's care. Despite its major implications for safety and quality of care, explicit guidance is limited. Given the complexity of disorders and specialization within otolaryngology, IMED is a considerable concern, yet little is known about current practices or management strategies.</p><p><strong>Objective: </strong>To explore otolaryngologists' perceptions and practices around feedback and reporting of IMED and to identify strategies for preventing or responding to these errors.</p><p><strong>Design, setting, and participants: </strong>This qualitative study used semistructured, virtual interviews of 24 otolaryngologists with expertise in patient safety and quality improvement across the US from July to October of 2023. Purposive sampling ensured diversity in subspecialty, career stage, geography, practice context, and demographics.</p><p><strong>Main outcomes and measures: </strong>Otolaryngologist perceptions of IMED, encompassing barriers and facilitators to providing feedback or reporting IMED, and strategies for improving practices. Analysis followed an iterative inductive approach of interpretive description.</p><p><strong>Results: </strong>Among the 24 participants (median [IQR] age, 51 [43-59] years; 13 [54%] female), several barriers, facilitators, and strategies emerged. Barriers included logistical (eg, lack of proximity, unavailable contact information, time constraints), psychosocial (eg, interpersonal discomfort, fear of retaliation, burnout), and structural factors (eg, fragmented systems, lack of incentives, leadership modeling, perceived conflict of interest). Facilitators that were associated with increased feedback or reporting included severe, egregious, fraudulent, or repetitive errors and preexisting relationships with the involved clinician. Most participants believed that IMED was inadequately addressed, with proposed strategies encompassing feedback training, standardized guidelines, interoperable medical records, oversight by national or state bodies, and intersystem safety reporting mechanisms.</p><p><strong>Conclusions and relevance: </strong>This qualitative study shows that the absence of standardized processes and resources hampers effective responses to IMED, such as feedback and reporting. While egregious errors or preexisting relationships may trigger action, opportunities exist to enhance clinical practice and policies across health systems.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presbycusis and Age-Related Hearing Loss are Really Sociocusis and Noise-Induced Hearing Loss in Elderly Individuals.","authors":"Daniel Fink","doi":"10.1001/jamaoto.2025.0784","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.0784","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency-to-Place Mismatch and Cochlear Implant Outcomes-Beyond Electrode Type.","authors":"Xiaohui Zhu, Yuan Ren, Kai Wang","doi":"10.1001/jamaoto.2025.0102","DOIUrl":"10.1001/jamaoto.2025.0102","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"532"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}