Oral oncology最新文献

{"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}

{"title":"Prognostic significance of extranodal extension in cervical lymph node metastases of head and neck squamous cell carcinoma: A systematic review and meta-analysis with bibliometric overview","authors":"Sachender Pal Singh ,&nbsp;Supriya Prasad ,&nbsp;Purnima Maggi Dean ,&nbsp;Asha Lata Kujur ,&nbsp;Gagan Jaiswal","doi":"10.1016/j.oraloncology.2026.107862","DOIUrl":"10.1016/j.oraloncology.2026.107862","url":null,"abstract":"<div><h3>Objective</h3><div>Extranodal extension (ENE) of cervical lymph node metastases is a key prognostic factor in head and neck squamous cell carcinoma (HNSCC). This systematic review and meta-analysis evaluated the survival impact of ENE in HNSCC and identified global research trends relevant to this research field through a complementary bibliometric analysis.</div></div><div><h3>Materials and methods</h3><div>ScienceDirect, PubMed, and Scopus were systematically searched during 2000–2025. A systematic review and a meta-analysis were conducted in accordance with the PRISMA 2020 guidelines. A Scopus-based bibliometric analysis was conducted using the Biblioshiny package of R to identify and map the publication trends, influential authors, and major institutional contributions between 2010 and 2025.</div></div><div><h3>Results</h3><div>Of the 839 retrieved records, 711 studies were screened, and 16 studies comprising approximately 3900 patients met all inclusion criteria. The bibliometric analysis of 120 Scopus-indexed publications demonstrated a marked increase in ENE-related research from 2015 onward, driven primarily by institutions in Australia, Taiwan, and South Korea. Keyword mapping indicated expanding intersections of ENE research with radiomics, prognostic modelling, and refinement of staging systems. Meta-analysis confirmed a significant association between ENE and adverse survival outcomes. Subgroup analyses showed consistently poor prognostic implications across both pathologic and radiologic ENE assessments.</div></div><div><h3>Conclusion</h3><div>ENE in cervical lymph node metastases is an independent and strong predictor of adverse survival in HNSCC. The increasing global attention to ENE highlights its crucial role in multidisciplinary oncologic management. Therefore, standardized pathological and imaging-based assessment of ENE is essential for developing superior prognostic models and optimizing future treatment planning strategies.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"174 ","pages":"Article 107862"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143146","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":"Cervical lymph node metastasis in oral squamous cell carcinoma: From metastatic patterns and risk factors to the development and validation of a predictive model","authors":"Xiao-Hu Wang ,&nbsp;Lei-Ming Cao ,&nbsp;Zhao-Qi Zhu ,&nbsp;Yao Xiao ,&nbsp;Han-Yue Luo ,&nbsp;Guang-Rui Wang ,&nbsp;Kan Zhou ,&nbsp;Yi-Fu Yu ,&nbsp;Jun Jia ,&nbsp;Bing Liu ,&nbsp;Lin-Lin Bu","doi":"10.1016/j.oraloncology.2026.107860","DOIUrl":"10.1016/j.oraloncology.2026.107860","url":null,"abstract":"<div><div>Cervical lymph node metastasis (CLNM) is the most critical prognostic factor in oral squamous cell carcinoma (OSCC). To facilitate individualized risk assessment, this study aimed to develop and internally validate a novel prediction model. We retrospectively analyzed 3723 patients with OSCC from a single center (2012–2023), with 2792 eligible patients randomly allocated to a training (n = 1954) and a validation set (n = 838). A rigorous variable selection process was employed, where predictors significant in univariable analysis were entered into a multivariable logistic regression model that utilized a stepwise forward and backward elimination procedure to identify the final set of predictors. Six factors were ultimately incorporated into the nomogram: clinical T stage, clinical N stage, histological grade, perineural invasion, time from onset to treatment, and alcohol consumption. The model demonstrated good discrimination in both training (AUC = 0.780) and validation (AUC = 0.744), excellent calibration, and clinical utility. In conclusion, this internally validated nomogram accurately predicts CLNM risk and can aid in tailoring neck management, pending external validation.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"174 ","pages":"Article 107860"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019157","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":"Comment on “Risk factors and a risk assessment model for venous thromboembolism in head and neck cancer surgery”","authors":"Ling Zhang","doi":"10.1016/j.oraloncology.2026.107881","DOIUrl":"10.1016/j.oraloncology.2026.107881","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"174 ","pages":"Article 107881"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125732","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":"Tumour microenvironment diversity of HNSCC and the molecular landscape of recurrent disease","authors":"Katelyn Steele ,&nbsp;Catherine Barnett ,&nbsp;Rahul Ladwa ,&nbsp;Meg L Donovan ,&nbsp;Clara Lawler ,&nbsp;Arutha Kulasinghe","doi":"10.1016/j.oraloncology.2026.107864","DOIUrl":"10.1016/j.oraloncology.2026.107864","url":null,"abstract":"<div><div>Head and neck squamous cell carcinoma (HNSCC) represents a biologically diverse group of malignancies within the upper aerodigestive tract and oral cavity and remains a significant cause of global morbidity and mortality. Increasing evidence highlights that the tumour microenvironment (TME) plays a central role in disease progression and therapeutic response. Distinct immune and stromal profiles have been observed between HPV positive (HPV+) and HPV negative (HPV-) HNSCC, underpinning their differing natural history and responses to immunotherapy. Despite advances, only 15–20% of patients with recurrent or metastatic HNSCC (RMHNSCC) respond to immunotherapy, with no difference in response being seen between HPV+ and HPV- disease. This may reflect the complexity and heterogeneity of the TME. This review explores how emerging spatial omics technologies, combining molecular, and spatial context, are reshaping our understanding of the HNSCC microenvironment, with emphasis on recurrent and/or metastatic disease. By delineating the spatial organisation of immune, stromal, and metabolic features, these approaches provide new insights into mechanisms of treatment resistance, prognostic biomarkers, and therapeutic vulnerabilities. Understanding spatial TME dynamics across HPV-related subtypes may ultimately guide more precise and effective treatment strategies for HNSCC.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"174 ","pages":"Article 107864"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079496","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 first report of contralateral parapharyngeal space metastasis of papillary thyroid carcinoma: report of a case","authors":"Nan Wang ,&nbsp;Haotian Gao ,&nbsp;Shuai-xia Yu ,&nbsp;Jiangang Fan ,&nbsp;Bin Li ,&nbsp;Xiaolong Zhao","doi":"10.1016/j.oraloncology.2026.107865","DOIUrl":"10.1016/j.oraloncology.2026.107865","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"174 ","pages":"Article 107865"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079560","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 swallowing outcomes following transoral robotic surgery for oropharyngeal cancer – Five years and beyond","authors":"Bartosz P. Wojtera ,&nbsp;Avinash Beharry ,&nbsp;Victoria Salati ,&nbsp;Karma Lambercy ,&nbsp;Nina Wahler ,&nbsp;Edouard Romano ,&nbsp;Wojciech Golusinski ,&nbsp;Christian Simon","doi":"10.1016/j.oraloncology.2026.107876","DOIUrl":"10.1016/j.oraloncology.2026.107876","url":null,"abstract":"<div><div>Objective: Transoral robotic surgery (TORS), either used alone or combined with radiotherapy, is a common treatment for operable T-stage oropharyngeal squamous cell carcinoma (OPSCC). Due to high survival rates, maintaining quality of life—especially swallowing function—is an important long-term consideration. This study aimed to assess swallowing outcomes five years and beyond following TORS in patients with primary OPSCC.</div><div>Methods: “Functional outcome swallowing scale” (FOSS) was used to retrospectively assess long-term dysphagia in 47 OPSCC patients, with a median follow-up of 6.8 years. All patients had a minimum follow-up of five years.</div><div>Results: The FOSS scores remained stable at five years compared to 1–4 years post-TORS (all p &gt; 0.99). Furthermore, there were no significant differences in FOSS from 1 to 10 years post-TORS compared to preoperative score. Adjuvant therapy was a univariate predictor of worse swallowing outcomes (OR: 17.46, 95% CrI: 2.94–121.51); however, this effect was limited to the short-term postoperative period (≤ 2 years after TORS). In contrast, subsequent major surgery after TORS and treatment of more advanced tumors (pT2–pT3 vs. pTis–pT1) were associated with persistently worse swallowing outcomes, including long-term follow-up (OR: 23.81, 95% CrI: 4.48–142.59; OR: 15.03, 95% CrI: 3.06–81.45, respectively).</div><div>Conclusions: TORS offers excellent and stable long-term swallowing outcomes when used as a single-modality treatment for OPSCC. While outcomes remain satisfactory with additional therapies, swallowing results are influenced by tumor stage, adjuvant treatment, and further major surgery.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"174 ","pages":"Article 107876"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100556","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}