Oral oncology最新文献

{"title":"Frozen section analysis in HPV-associated squamous cell carcinoma of unknown primary: Clinical and pathological considerations","authors":"Carlos M. Ardila , Anny Marcela Vivares-Builes , Eliana Pineda-Vélez","doi":"10.1016/j.oraloncology.2026.107878","DOIUrl":"10.1016/j.oraloncology.2026.107878","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"174 ","pages":"Article 107878"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of osteotomy distance and other predictors of osseous union following mandibular reconstruction with fibula free flap","authors":"Maged Ali Al-Aroomi ,&nbsp;Yiheng Feng ,&nbsp;Naseem Ali Al-Worafi ,&nbsp;Jie Chen ,&nbsp;Ning Li ,&nbsp;Canhua Jiang ,&nbsp;Ye Liang","doi":"10.1016/j.oraloncology.2026.107883","DOIUrl":"10.1016/j.oraloncology.2026.107883","url":null,"abstract":"<div><h3>Objectives</h3><div>Optimal contouring of fibula free flaps (FFF) for mandibulectomy often requires osteotomies. This study aimed to define criteria for initial gap width by evaluating whether postoperative gap size and other factors influence long-term osseous union on CBCT, and to identify key determinants of bone healing.</div></div><div><h3>Methods</h3><div>This retrospective study included 75 patients who underwent segmental mandibulectomy with FFF reconstruction from 2017 to 2024. Initial osteotomy gaps were measured at four points on postoperative CBCT scans. Osseous union was assessed using a callus scale. Demographic, anatomical, and surgical variables—including 3D-assisted planning, fibula morphology, osteotomy location, systemic comorbidities, and segment number —were analyzed using uni- and multivariate regression models.</div></div><div><h3>Results</h3><div>A total of 202 osteotomy sites were evaluated. The mean initial gap was 1.68 ± 0.97 mm, and gap size did not significantly predict long-term union. Complete union occurred in 50.0% of sites, partial union in 36.6%, and nonunion in 13.4%. Fibula–fibula interfaces showed significantly better healing than fibula–mandible interfaces (p &lt; 0.001). Symphyseal osteotomies demonstrated superior union compared with body and angle regions. Systemic vascular comorbidities were strong negative predictors of union, whereas reconstructions using more than two segments showed improved outcomes (p &lt; 0.001). Alcohol consumption negatively affected both initial gap formation and union.</div></div><div><h3>Conclusions</h3><div>Long-term osseous union after FFF reconstruction is influenced mainly by systemic vascular health, osteotomy location, interface type, and fibula morphology rather than initial gap width.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"174 ","pages":"Article 107883"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating betel nut control into routine health management strategies","authors":"Xinjia Cai ,&nbsp;Saman Warnakulasuriya","doi":"10.1016/j.oraloncology.2026.107875","DOIUrl":"10.1016/j.oraloncology.2026.107875","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"174 ","pages":"Article 107875"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic evaluation of microvascular reconstruction of the jaw: A micro-costing analysis and identification of key cost-drivers","authors":"George A. Petrides ,&nbsp;Masako Dunn ,&nbsp;Ashleigh R. Sharman ,&nbsp;Catriona Froggat ,&nbsp;Timothy G.H. Manzie ,&nbsp;Blaise Agresta ,&nbsp;David Beard ,&nbsp;Hansoo Kim ,&nbsp;Michael Boyer ,&nbsp;Rebecca L. Venchiarutti ,&nbsp;Tsu-Hui (Hubert) Low ,&nbsp;David Leinkram ,&nbsp;Sydney Ch’ng ,&nbsp;James Wykes ,&nbsp;Carsten Palme ,&nbsp;Jonathan R. Clark","doi":"10.1016/j.oraloncology.2026.107885","DOIUrl":"10.1016/j.oraloncology.2026.107885","url":null,"abstract":"<div><h3>Purpose</h3><div>Efficient resource allocation in surgery requires thorough economic evaluation that reflects the true costs of a procedure, with micro-costing being a primary method. Existing economic studies on microvascular jaw reconstruction of the jaw often exclude or estimate key cost-drivers. The aim of this study was to estimate the direct financial costs and cost-drivers associated with surgical reconstruction of the jaw from the perspective of the healthcare provider.</div></div><div><h3>Methods</h3><div>A retrospective micro-costing study from the perspective of the healthcare provider was performed on 100 patients who underwent mandibular or maxillary free flap reconstruction. Direct financial costs of activities (in USD) from admission to discharge were examined, and classified into operative and perioperative admission periods.</div></div><div><h3>Results</h3><div>The mean cost for the entire admission was $36,415.95 ± 14,246.56 comprising 57.7% from the operative period and 42.3% from the perioperative admission period. Ward staffing and consumables (35.7%), prostheses (25.0%), and operating room staffing (21.0%) were the largest cost contributors. In adjusted analyses, higher costs were associated with vasculopathy (+$9142.02, p = 0.044), ASA IV ($19,495.93, p = 0.023), tracheostomy (+$10,445.81, p = 0.012), return to the operating room (+$19,920.22, p = 0.005), and return to the intensive care unit (+$25,316.26, p = 0.014).</div></div><div><h3>Conclusion</h3><div>Jaw reconstruction is associated with considerable direct financial costs to the healthcare provider with complications requiring return to the operating room and/or return to the intensive care unit the critical key cost-drivers. These insights will support future health technology assessments focused on jaw reconstruction to assist decision-makers in implementing or reimbursing these procedures.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"174 ","pages":"Article 107885"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De-escalation in high-risk HPV-positive OPC: critical appraisal of methodology and inference","authors":"Shu’ang Shu","doi":"10.1016/j.oraloncology.2026.107880","DOIUrl":"10.1016/j.oraloncology.2026.107880","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"174 ","pages":"Article 107880"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic associations of systemic inflammation response index (SIRI) in patients with head and neck cancer: a systematic review and meta-analysis","authors":"Neil D. Almeida ,&nbsp;Tyler V. Schrand ,&nbsp;Daniel Sullivan ,&nbsp;Han Yu ,&nbsp;Song Yao ,&nbsp;Sung Jun Ma ,&nbsp;Andrew Koempel ,&nbsp;Dukagjin Blakaj ,&nbsp;Elizabeth A. Repasky ,&nbsp;Craig M. Brackett ,&nbsp;David W. Goodrich ,&nbsp;Elizabeth G. Bouchard ,&nbsp;Mukund Seshadri ,&nbsp;Mark K. Farrugia ,&nbsp;Anurag K. Singh","doi":"10.1016/j.oraloncology.2026.107859","DOIUrl":"10.1016/j.oraloncology.2026.107859","url":null,"abstract":"<div><div>Background/Objectives: Inflammation and immune evasion are linked to tumor progression. This cancer-related inflammatory response is reflected by a biomarker named the systemic inflammatory response (SIRI). SIRI is calculated by multiplying the peripheral blood neutrophil and monocyte counts and dividing by the lymphocyte count is a biomarker that has shown prognostic capacity in squamous cell head and neck cancer. We sought to perform a <em>meta</em>-analysis of SIRI data for head and neck cancer. Methods: A <em>meta</em>-analysis using a mixed-effects model was performed to estimate the overall effect size of prognostic capacity. The primary outcomes of interest were overall survival and progression-free survival, with effect sizes measured as log hazard ratios (HR). Results: Ten studies reporting data on overall survival revealed a pooled HR of 2.4 (p &lt; 0.0001). This indicates higher SIRI patients are at greater risk of mortality relative to lower SIRI patients. Additionally, 3 studies reported metrics on progression-free survival, with a pooled HR of 2.32 (1.72, 3.13) (p &lt; 0.0001). Minimal heterogeneity was observed for progression-free survival (I2 = 0%, p&lt; 0.74). Conclusions: High SIRI portends worse overall survival. Since SIRI correlates to immune function and demonstrated minimal heterogeneity, these factors are among those most likely to be impacted by altered SIRI parameters.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"174 ","pages":"Article 107859"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognostic significance of the ‘Worst Pattern of Invasion’ in oral cancers−an international collaborative multicentre analysis","authors":"Paromita Roy ,&nbsp;Margaret Brandwein Weber ,&nbsp;Ruta Gupta ,&nbsp;Aanchal Kakkar ,&nbsp;Daphne Fonseca ,&nbsp;Munita Bal ,&nbsp;Meenakshi Kamboj ,&nbsp;Nidhi Anand ,&nbsp;K.R. Anila ,&nbsp;Shanthi Velusamy ,&nbsp;Megha Shantveer Uppin ,&nbsp;Suvradeep Mitra ,&nbsp;Meera Thomas ,&nbsp;Poonam Abhay Elhence ,&nbsp;Indu Arun ,&nbsp;Sunil Pasricha ,&nbsp;Nuzhat Husain ,&nbsp;Rekha V. Kumar ,&nbsp;Amanjit Bal ,&nbsp;Asawari Patil ,&nbsp;Indranil Mallick","doi":"10.1016/j.oraloncology.2026.107874","DOIUrl":"10.1016/j.oraloncology.2026.107874","url":null,"abstract":"<div><div>Worst pattern of invasion (WPOI) has been evaluated in many single-institute cohorts. Our goal was to perform a large multicentre evaluation of WPOI as a prognostic marker in oral squamous cell carcinoma (OSCC). Retrospective pathology data was collated from 14 institutions and compared with clinical outcome in 1374 OSCC patients with upfront curative resection. Most cases were of oral tongue (n = 645, 47%); T2 (33%) and N0 (59%). WPOI 1–3 frequency was 29.4%, WPOI 4 47% and WPOI 5 22%. On univariable analysis, the 3-year disease free survival (DFS) was 54.2% for WPOI 5 vs. 69.7% for WPOI 1–4 (p &lt; 0.001). The locoregional control (LRC) was 68.9% vs 79.2% (p = 0.001), and overall survival (OS) 68.4% vs 83.8% (p &lt; 0.001). On multivariable Cox-regression in the entire cohort, WPOI 4 or 5 was strongly correlated with other known poor prognostic factors and not an independent predictor of OS (HR 1.10, 95% CI 0.92–1.52), LRC or DFS. However, in early-stage (pT1-2 N0) patients treated with surgery alone without adjuvant radiotherapy, WPOI 5 was a robust independent predictor of DFS (HR 4.36, 95% CI 1.54–12.32, p = 0.006), OS (HR 3.69, 95% CI 1.23–11.1, p = 0.020) and LRC (HR 3.52, 95% CI 2.13–5.82, p &lt;0.001) after applying inverse probability weighting to correct for selection bias. Furthermore, in the entire cohort of early-stage patients, interaction modeling showed that adjuvant radiotherapy significantly reduces the risk for both DFS and LRC for those with WPOI-5 (Interaction p = 0.002). Therefore, it may act as a predictive biomarker for the benefit of adjuvant radiotherapy. The prognostic and predictive role of WPOI-5 should be validated in prospective trials.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"174 ","pages":"Article 107874"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of large language models as decision support tools for head and neck cancer management: A blinded multidisciplinary simulation study","authors":"Sholem Hack ,&nbsp;Ron J. Karni ,&nbsp;Antonino Maniaci ,&nbsp;Christopher E. Fundakowski ,&nbsp;Luca Castellani ,&nbsp;Fabiola Incandela ,&nbsp;Remo Accorona ,&nbsp;Miguel Mayo-Yanez ,&nbsp;Martina Violati ,&nbsp;Lorenzo Giannini ,&nbsp;Niccolo’ Mevio ,&nbsp;Alberto Maria Saibene","doi":"10.1016/j.oraloncology.2026.107877","DOIUrl":"10.1016/j.oraloncology.2026.107877","url":null,"abstract":"<div><h3>Background</h3><div>The management of head and neck cancer relies on multidisciplinary expertise; however, access to tumor boards remains variable. Large language models (LLMs) may support guideline-based decision-making, although performance in complex oncologic scenarios is not well defined.</div></div><div><h3>Methods</h3><div>Fourteen synthetic cases based on real tumor board encounters were evaluated. Five blinded comparator arms produced recommendations: a human expert, Non-RAG-GPT-4, Non-RAG-GPT-5, RAG-GPT-4, and RAG-GPT-5. Eight head and neck oncologic surgeons scored each recommendation for appropriateness, clarity, specificity, and feasibility using 5-point Likert scales. Paired permutation testing and inter-rater reliability were assessed.</div></div><div><h3>Results</h3><div>LLM outputs showed close alignment with expert recommendations. RAG-based models achieved the highest mean scores across domains, with some statistically significant differences versus the expert comparator in appropriateness and clarity; however, absolute differences were modest. Inter-rater reliability was strong (ICC 0.73–0.87).</div></div><div><h3>Conclusions</h3><div>Advanced LLMs can generate guideline-concordant management recommendations in simulated head and neck cancer cases, supporting potential utility for decision support and education; prospective validation and expert oversight remain essential.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"174 ","pages":"Article 107877"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mandibular canal invasion as a T4a criterion: a step forward with important caveats","authors":"Suhani Ghai","doi":"10.1016/j.oraloncology.2026.107856","DOIUrl":"10.1016/j.oraloncology.2026.107856","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"174 ","pages":"Article 107856"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term outcomes of induction chemotherapy–guided reduced-dose chemoradiotherapy in poor-risk HPV-Positive oropharyngeal Cancer: Results from the sequential quarterback trials","authors":"J.T. Lovett ,&nbsp;M.T. Wotman ,&nbsp;W.H. Westra ,&nbsp;S. Ahn ,&nbsp;V. Gupta ,&nbsp;R.L. Bakst ,&nbsp;Scott Roof ,&nbsp;B.A. Miles ,&nbsp;E Genden ,&nbsp;K. Misiukiewicz ,&nbsp;L. Worona ,&nbsp;E. Ramos ,&nbsp;J. Botzler ,&nbsp;T. Chen ,&nbsp;M. Posner","doi":"10.1016/j.oraloncology.2026.107858","DOIUrl":"10.1016/j.oraloncology.2026.107858","url":null,"abstract":"<div><h3>Importance</h3><div>The rising incidence of HPV-positive oropharynx cancer (HPV-OPC) underscores the need for treatment strategies that maintain disease control while minimizing long-term toxicity. This study reports the long-term follow-up of de-escalation in poor prognosis HPV-OPC, providing critical data for future studies.</div></div><div><h3>Objective</h3><div>To evaluate long-term outcomes in patients with locally advanced HPV-OPC treated with induction chemotherapy (IC) followed by reduced-dose chemoradiation (rdCRT). We hypothesized that de-escalated radiation therapy after IC would be non-inferior to standard-dose CRT (sdCRT).</div><div>Design: Two sequential clinical trials; Quarterback (QB) 1: phase III randomized control trial, QB 2: phase II non-randomized trial; patient accrual conducted between December 2012 and February 2022; final data cutoff April 2025. Median follow-up (IQR): 88.5 (64.6–118.2) months.</div><div>Setting: Single-institution academic center.</div><div>Participants: 62 patients with HPV-OPC were screened. 47 patients received rdCRT after IC and were included in the primary analysis. Key eligibility: smoking history ≤20 pack-years, no active smoking, no distant metastases, molecularly confirmed HPV status.</div><div>Interventions: Three cycles of induction TPF (docetaxel, cisplatin, 5-fluorouracil) followed by rdCRT (5600 cGy) with weekly carboplatin in clinical responders; non-responders in both QB trials and responders in the control arm of QB1 received sdCRT (7000 cGy).</div><div>Main Outcomes and Measures: Primary endpoints: 3-year locoregional relapse-free survival (LRRFS) and 3-year progression-free survival (PFS). Secondary: overall survival (OS). Tertiary: disease-specific survival.</div></div><div><h3>Results</h3><div>Among 47 patients treated with rdCRT after IC, the 3-year and 5-year LRRFS were 89.3% and 86.6%. PFS was 87.2% and 84.6% at 3 and 5 years. OS was 91.5% and 89.1% at 3 and 5 years. Six patients (13%) experienced locoregional failure, and two (4%) developed distant metastases. 7/8 treatment failures (87.5%) occurred in patients with extracapsular extension.</div></div><div><h3>Conclusions and Relevance</h3><div>rdCRT following IC yields durable disease control in poor prognosis HPV-OPC, with outcomes comparable to historical benchmarks. Extended follow-up supports the safety and efficacy of this de-escalation strategy, even in patients with aggressive disease characteristics, but also underscores the need for careful patient selection, particularly in those with extracapsular extension.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"174 ","pages":"Article 107858"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}