JAMA otolaryngology-- head & neck surgery最新文献

{"title":"Imaging-Detected Extranodal Extension in p16-Positive Oropharyngeal Cancer: Secondary Analysis of RTOG 1016.","authors":"Christopher W Fleming, Chandana A Reddy, Sarah Stock, Jonathan Lee, Maura Gillison, Jimmy J Caudell, Jessica L Geiger, Dukagjin M Blakaj, Greg A Krempl, A Dimitrios Colevas, Christopher U Jones, Nabil F Saba, Jack Phan, Thomas J Galloway, Samantha Seaward, Sharon Spencer, Pedro Torres-Saavedra, Sue S Yom, Quynh-Thu Le, Shlomo A Koyfman","doi":"10.1001/jamaoto.2026.0932","DOIUrl":"10.1001/jamaoto.2026.0932","url":null,"abstract":"<p><strong>Importance: </strong>Imaging-detected extranodal extension (iENE) has been included in the American Joint Committee on Cancer (AJCC) and Union for International Cancer Control (UICC) protocol tumor-node-metastasis 9th edition staging system (TNM9) for human papillomavirus (HPV)-mediated (p16-positive) oropharyngeal cancer (HPV-positive OPC).</p><p><strong>Objective: </strong>To confirm the new TNM9 staging system on a prospective dataset.</p><p><strong>Design, setting, and participants: </strong>This prognostic study included patients with HPV-positive OPC with clinically node-positive disease treated at 182 health care centers in the US and Canada and enrolled in the NRG Radiation Therapy Oncology Group (RTOG) 1016 trial between 2011 and 2014 were included. Deidentified images were reviewed between September and December 2021. Data were analyzed between May and September 2023.</p><p><strong>Exposure: </strong>Computed tomography simulation scans were reviewed by 2 expert head and neck radiologists documenting the presence of iENE.</p><p><strong>Main outcomes and measures: </strong>Kaplan-Meier analysis was used to estimate overall survival (OS) and progression-free survival (PFS). Cumulative incidence curves were generated for locoregional failure (LRF) and distant metastasis. Univariate (UVA) and multivariate analyses (MVA) were performed incorporating iENE with other known prognostic factors. The TNM9 clinical nodal schema incorporating iENE was compared with the previous TNM8. Model goodness of fit and comparison of models was done using Akaike information criterion (AIC) and Harrell concordance statistic (C index).</p><p><strong>Results: </strong>Of the 987 patients enrolled in NRG RTOG 1016, 586 met inclusion criteria (median age, 58 years [range, 33-83 years]; 534 male [91.1%]), 350 (60%) of whom had iENE. Median (IQR) follow-up was 4.2 (3.3-5.0) years. Patients with iENE had inferior 5-year OS (79.2% vs 87.0%; difference, 7.8% [95% CI, 1.2%-14.4%]) and 5-year PFS (68.8% vs 80.4%; difference, 11.6% [95% CI, 4.1%-19.2%]) compared with those without iENE. On MVA, iENE was independently associated with inferior OS (HR, 1.63; 95% CI, 1.04-2.56) and PFS (HR, 1.78; 95% CI, 1.24-2.57). TNM9 and TNM8 clinical nodal schemas had similar performance in terms of C index and AIC (TNM8: C, 0.73 [95% CI, 0.68-0.78]; AIC = 1109.34 vs TNM9: C, 0.72 [95% CI, 0.67-0.77]; AIC = 1112.70).</p><p><strong>Conclusions and relevance: </strong>This study showed that the updated TNM9 clinical nodal schema, in which patients with iENE-positive disease are upstaged 1 stratum from their TNM8 clinical N category, discriminates better than the TNM8 category between patients.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT01302834.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"981-988"},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840228","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":"Sinonasal Obstruction Secondary to Mass With Palatal Erosion.","authors":"Stephanie Provenzano, Mackenzie Latour, Michael T Yim","doi":"10.1001/jamaoto.2026.2941","DOIUrl":"https://doi.org/10.1001/jamaoto.2026.2941","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109741","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":"Pollutant-Specific Inflammatory Signatures in Sinonasal Tissue.","authors":"Hyun Jin Min","doi":"10.1001/jamaoto.2026.2987","DOIUrl":"https://doi.org/10.1001/jamaoto.2026.2987","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109726","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":"Between-Regimen Claims in a Single-Arm Meta-Analysis-Reply.","authors":"Linda X Yin","doi":"10.1001/jamaoto.2026.2114","DOIUrl":"10.1001/jamaoto.2026.2114","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1010-1011"},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620087","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":"Between-Regimen Claims in a Single-Arm Meta-Analysis.","authors":"Chang Yue","doi":"10.1001/jamaoto.2026.2111","DOIUrl":"10.1001/jamaoto.2026.2111","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1010"},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620136","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":"Serum and Tumor PD-L1 Expression and Aggressive Clinicopathologic Features in Papillary Thyroid Carcinoma.","authors":"Srivatsa Surya Vasudevan, Janmaris Marin Fermin, Lindsay Boven, Abhijit Gundale, Tara Moore-Medlin, Alok R Khandelwal, Xin Gu, Cherie-Ann O Nathan","doi":"10.1001/jamaoto.2026.2200","DOIUrl":"10.1001/jamaoto.2026.2200","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Aggressive variants of papillary thyroid carcinoma (PTC) represent a small but clinically consequential subset and may become radioactive iodine refractory, limiting treatment options. Programmed cell death 1 ligand 1 (PD-L1) has been evaluated in tumor tissue as a potential biomarker in PTC, but evidence for serum PD-L1, particularly in aggressive PTC, is limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To determine whether serum PD-L1 levels and tumor PD-L1 expression are associated with aggressive clinicopathologic features of PTC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This retrospective cohort study included patients with PTC undergoing serum PD-L1 measurement by enzyme-linked immunosorbent assay and tumor PD-L1 by immunohistochemistry (E1L3N) at the Louisiana State University Health Shreveport and Overton Brooks Veterans Affairs Medical Center. Healthy controls, patients with benign thyroid disease, and patients with PTC (including aggressive and nonaggressive disease) were included. Statistical comparisons were performed using linear and logistic regression. Data were collected from January 2009 to December 2024, and data were analyzed from February to August 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposures: &lt;/strong&gt;PTC was classified as aggressive if it demonstrated 1 or more of the following, defined a priori per the 2025 American Thyroid Association Risk of Recurrence framework: (1) macroscopic extrathyroidal extension, (2) bulky or invasive lymphadenopathy, (3) aggressive histology (tall cell, columnar cell, solid, or diffuse sclerosing variant), or (4) distant metastases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Differences in serum PD-L1 levels and tumor PD-L1 expression between aggressive and nonaggressive PTC; associations between serum PD-L1 and specific aggressive features; and correlation between serum PD-L1 levels and tumor PD-L1 expression. Disease-free survival (DFS) was analyzed using Kaplan-Meier estimator and Cox proportional hazards regression to evaluate the prognostic value of tumor and serum PD-L1 on recurrence outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 156 included patients, 116 (74.4%) were female and 40 (25.6%) were male, with a mean (SD) age of 49.2 (15.6) years. A total of 45 patients were healthy controls, 49 had benign thyroid disease, and 62 had PTC, including 31 with aggressive disease and 31 with nonaggressive disease. Serum PD-L1 levels were markedly higher in patients with aggressive PTC compared with healthy controls (β = 23.40; 95% CI, 9.12-37.67), benign thyroid disease (β = 20.78; 95% CI, 6.80-34.77), and nonaggressive PTC (β = 24.92; 95% CI, 8.95-40.88). On adjusted linear analysis of aggressive features, macroscopic extrathyroidal extension (β = 42.07; 95% CI, 23.04-61.10) and aggressive histology (β = 181.15; 95% CI, 126.08-236.23) were associated with higher serum PD-L1 levels but not bulky/invasive lymphadenopathy and distant metastasis. Tumor PD-L1 positivity","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"935-943"},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759080","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":"Necrotic Nasal Lesion in a Woman Without a History of Immunodeficiency.","authors":"Jun Yun, Alice C Yu, Chau T Nguyen","doi":"10.1001/jamaoto.2026.2325","DOIUrl":"10.1001/jamaoto.2026.2325","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1005-1006"},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840254","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":"Treating Hearing Loss and Improved Mild Cognitive Impairment.","authors":"Ruiyan M Wang, Victoria A Sanchez, Justin S Golub","doi":"10.1001/jamaoto.2026.3413","DOIUrl":"https://doi.org/10.1001/jamaoto.2026.3413","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074438","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":"Odynophagia With a Glottic Mass and Diffuse Lymphadenopathy.","authors":"Rishi N Modi, Nanki Kaur, Tanya K Meyer","doi":"10.1001/jamaoto.2026.2847","DOIUrl":"https://doi.org/10.1001/jamaoto.2026.2847","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038565","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":"Null Findings in the Era of Large Administrative Databases.","authors":"Mishek Thapa, Carlos X Castellanos, Matthew E Lin, Peter S Han","doi":"10.1001/jamaoto.2026.2826","DOIUrl":"https://doi.org/10.1001/jamaoto.2026.2826","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038617","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}