Head and Neck-Journal for the Sciences and Specialties of the Head and Neck最新文献

{"title":"Tumoral Skin Invasion Is an Independent Predictor of Rapid Recurrence in Head and Neck Cancer.","authors":"Abdullah A Memon, Mohamed Khalil, Oscar Villarreal Espinosa, Imaad Said, Eric Yang, Jazzmyne A Adams, David R Friedland, Masoud Khani, Jake Luo, Rachel Kuehn, Anne Frei, Jamie Foeckler, Kenneth Akakpo, Becky Massey, Michael Stadler, Stuart Wong, Heather A Himburg, Musaddiq J Awan, Jennifer Bruening, Joseph Zenga","doi":"10.1002/hed.70066","DOIUrl":"https://doi.org/10.1002/hed.70066","url":null,"abstract":"<p><strong>Background: </strong>Head and neck squamous cell carcinoma (HNSCC) is an aggressive malignancy, with 50% of patients recurring. A subset of patients experience rapid recurrence (RR) postoperatively but prior to adjuvant therapy. This study identifies factors associated with RR and additional recurrence intervals: short-interval recurrence (SIR) and standard recurrence (SR).</p><p><strong>Methods: </strong>Retrospective 10-year review of 246 HNSCC patients undergoing surgery with adjuvant therapy. Recurrence was categorized as RR (prior to initiation of adjuvant therapy), SIR (≤ 6 months post-adjuvant therapy), and SR (> 6 months post-adjuvant therapy). Univariate analysis (UVA), multivariate analysis (MVA), and machine learning Random Forest models were employed to identify predictors of each recurrence interval.</p><p><strong>Results: </strong>Of the 246 patients, 89 recurred (45 SR, 27 SIR, 17 RR). On MVA, skin invasion (OR = 3.492, p = 0.039) was a unique predictor of RR. Random Forest feature importance also revealed skin invasion, along with nodal status, tobacco pack-years, and tumor size as predictors with strong performance (accuracy 93%, AUC 0.96, F1 0.93).</p><p><strong>Conclusion: </strong>Skin invasion is a unique independent predictor of RR, confirmed by two statistical models. These patients warrant further study.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of HPV Circulating Tumor DNA Following Non-Diagnostic FNA of a Cystic Lateral Neck Mass.","authors":"Michael R Papazian, Melanie D Hicks, Kyle Mannion, Meghan Turner, Michael C Topf","doi":"10.1002/hed.70060","DOIUrl":"https://doi.org/10.1002/hed.70060","url":null,"abstract":"<p><strong>Background: </strong>Cystic lateral neck masses in adults commonly represent nodal metastases from HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) or benign lesions. Because cystic lesions are relatively acellular, fine-needle aspiration (FNA) is often non-diagnostic. HPV circulating tumor DNA (ct-DNA) may aid diagnosis in these cases.</p><p><strong>Methods: </strong>We conducted a two-institution retrospective review of patients with cystic neck masses and non-diagnostic FNA who underwent pre-treatment HPV ct-DNA testing. Sensitivity, specificity, and predictive values were calculated based on final pathology.</p><p><strong>Results: </strong>Thirty-two patients were included. HPV ct-DNA was positive in 20/32 (62.5%) cases, all of which were HPV-associated OPSCC. Four patients with negative HPV ct-DNA were ultimately diagnosed with HPV-associated OPSCC (sensitivity: 83%, specificity: 100%, PPV: 100%, NPV: 67%).</p><p><strong>Conclusion: </strong>HPV ct-DNA demonstrated high specificity and may complement standard workup in adult cystic neck masses with non-diagnostic FNA. Positive HPV ct-DNA results should prompt further evaluation for HPV-associated OPSCC.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Assessment of Advanced Practice Provider-Led Head and Neck Cancer Survivorship Clinic: Quality-of-Care Metric Analysis and HOUSES Index Application.","authors":"Katey M Wert, Byron C May, Jeffrey R Janus, Samip Patel, Phillip Pirgousis, Yujie Zhao, Shenduo Li, Katharine A Price, Lisa A McGee, Daniel J Ma, David M Routman, Chung Il Wi, Sungjune Kim, Homan Mohammadi, Adam L Holtzman","doi":"10.1002/hed.70062","DOIUrl":"https://doi.org/10.1002/hed.70062","url":null,"abstract":"<p><strong>Background: </strong>As head and neck cancer survival rates improve, there is growing demand for quality survivorship care and tools to predict patient adherence; this study aims to evaluate an advanced practice provider (APP)-led survivorship clinic and assess these key metrics.</p><p><strong>Methods: </strong>We performed a retrospective review of 213 head and neck cancer patients treated with curative radiation therapy between 2016 and 2023, to assess follow-up adherence in an advanced practice provider-led survivorship clinic.</p><p><strong>Results: </strong>With a median follow-up of 2.4 years, follow-up care metrics identified high completion percentages (> 90%) for lung cancer screening, smoking cessation, thyroid screening, dental evaluation, xerostomia, dysphagia, and dysgeusia. The HOUsing-based SocioEconomic Status (HOUSES) index at diagnosis showed a significant adherence difference (median percentile, 78% vs. 55%, adherent vs. nonadherent; p = 0.03).</p><p><strong>Conclusions: </strong>High adherence rates with guideline-defined care metrics are achievable in an advanced practice provider-led head and neck cancer survivorship clinic. The HOUSES index may assist in predicting nonadherence; however, further studies are needed.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Quality of Life Outcomes After Head and Neck Cancer in New Zealand.","authors":"Anna Miles, Elizabeth Thompson-Williams, Ella Wilson, Jacqui Allen","doi":"10.1002/hed.70059","DOIUrl":"https://doi.org/10.1002/hed.70059","url":null,"abstract":"<p><strong>Background: </strong>Understanding quality of life (QOL) after head and neck cancer (HNC) is crucial for service planning. This study explored survivorship experiences in New Zealand.</p><p><strong>Methods: </strong>This study includes clinical records audit (n = 1277), cross-sectional online survey (n = 195), and semi-structured interviews (n = 22). Audit included all patients presenting to one tertiary cancer center (2012-2023). All 750 patients surviving > 12 months past primary treatment were invited to complete a survey. All survey respondents were offered follow-up interviews.</p><p><strong>Results: </strong>Patients (male: 72%, 51-70 years: 45%; oral cavity 32%, oropharynx 21%) were often diagnosed at advanced stages (T3-4: 45%) requiring multimodal treatment (71%). Survey respondents reported persisting voice difficulties (25% elevated VHI-10) and depression (18% elevated HADS). Fear of negative evaluation was evident in younger survey respondents. Psychological support was the most desired long-term service in surveys and interviews. Interviewees described a paucity of services post-treatment.</p><p><strong>Conclusions: </strong>This study describes challenges accessing long-term support after HNC. Advocating for long-term support may enhance survivorship experiences.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Plasmablastic Lymphoma: Case Series and Literature Review.","authors":"A Xu, J P Foy, P Reimbold, M Amor-Sahli, A Vozy, I Boussen, A Chaine, M Benassarou, C Bertolus, J Bouaoud","doi":"10.1002/hed.70053","DOIUrl":"https://doi.org/10.1002/hed.70053","url":null,"abstract":"<p><strong>Background: </strong>Plasmablastic lymphoma (PBL) of the oral cavity is a rare, aggressive subtype of Non-Hodgkin lymphoma, predominantly seen in immunocompromised patients, particularly those with chronic Human Immunodeficiency Virus (HIV) infection. This malignancy is closely associated with Epstein-Barr virus (EBV), highlighting its oncogenic role.</p><p><strong>Methods: </strong>We present 11 cases of oral cavity PBL (OPBL) managed at our institution, detailing clinical, radiological, pathological, and therapeutic features, as well as patient outcomes. We also conducted a comprehensive literature review to synthesize current evidence.</p><p><strong>Results: </strong>Since 2008, 645 OPBL cases have been reported. The disease primarily affects men with underlying immunodeficiency, particularly HIV. The maxillary alveolar ridge was the most frequent subsite, typically associated with osteolytic bone lesions. Most patients presented at a localized stage. Although chemotherapy remains the mainstay of treatment, novel targeted therapies are emerging. Prognosis, however, remains poor.</p><p><strong>Conclusions: </strong>OPBL should be systematically considered when evaluating oral cavity malignancy, especially in immunocompromised patients with submucosal lesion.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Cosmetic Outcomes and Quality of Life After Thyroidectomy: A Systematic Review and Network Meta-Analysis.","authors":"Van Cuong Nguyen, Chang Myeon Song, Yong Bae Ji, Jin Hyeok Jeong, Jonathon O Russell, Feng-Yu Chiang, Gregory W Randolph, Kyung Tae","doi":"10.1002/hed.70052","DOIUrl":"https://doi.org/10.1002/hed.70052","url":null,"abstract":"<p><strong>Background: </strong>Remote-access thyroidectomy and minimally invasive video-assisted thyroidectomy (MIVAT) were developed to improve cosmesis over the conventional transcervical approach (CTA). However, comparative data on cosmetic and quality of life (QOL) outcomes remain limited.</p><p><strong>Methods: </strong>A systematic review and random-effects network meta-analysis was performed to compare MIVAT, five remote-access approaches-breast approach (BA), bilateral axillo-breast approach (BABA), gasless transaxillary approach (GTAA), retroauricular approach (RA), and transoral approach (TOA)-with CTA.</p><p><strong>Results: </strong>Fifty-seven studies (9206 patients) were included. All remote-access techniques and MIVAT showed superior cosmetic outcomes versus CTA. TOA and BABA ranked highest. Remote-access approaches, particularly TOA, BABA, and GTAA, demonstrated generally better QOL outcomes than CTA and MIVAT.</p><p><strong>Conclusions: </strong>Remote-access approaches and MIVAT offer superior cosmesis over CTA. TOA and BABA generally rank highest in both cosmesis and QOL, although evidence on QOL remains limited. These approaches may be considered for patients prioritizing aesthetic and psychosocial outcomes.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Vismodegib and Sonidegib in Advanced Basal Cell Carcinoma of the Head and Neck: A Systematic Review and Meta-Analysis.","authors":"Cindy M Doyle, Jevan Cevik, Anand Ramakrishnan","doi":"10.1002/hed.70056","DOIUrl":"https://doi.org/10.1002/hed.70056","url":null,"abstract":"<p><strong>Importance: </strong>Basal cell carcinoma (BCC) is the most prevalent malignancy globally, with 75% occurring in the head and neck. Hedgehog pathway inhibitors (HHIs) may provide a treatment for locally advanced BCC (laBCC) and metastatic BCC (mBCC) of the head and neck.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to evaluate the safety and efficacy of these treatments specifically in the head and neck region.</p><p><strong>Data sources: </strong>An electronic database search was conducted in June 2024 across Embase, MEDLINE, CINAHL, and ClinicalTrials.gov. There were no date limits applied, with search constraints consisting of the English language.</p><p><strong>Study selection: </strong>Included were studies involving adults with confirmed laBCC or mBCC of the head and neck treated with either vismodegib or sonidegib, with histological or radiological confirmation. Studies were excluded if they involved concurrent treatments or lacked quantitative measures. After full text review was completed, there were 17 studies for inclusion.</p><p><strong>Data extraction and synthesis: </strong>This systematic review and meta-analysis were conducted in accordance with PRISMA guidelines using two independent observers. Data extraction was performed using a standardized Microsoft Excel Form. Statistical analyses were conducted using meta-analysis software on jamovi using a random effects model.</p><p><strong>Main outcome(s) and measure(s): </strong>This study initially aimed to investigate both systemic immunotherapies and targeted therapies, but no articles were identified for systemic immunotherapies for laBCC or mBCC of the head and neck region. Thus, the sole focus of this article became targeted therapies. Primary outcomes assessed were overall response rate (ORR), complete response (CR), and partial response (PR), alongside the prevalence of adverse effects.</p><p><strong>Findings: </strong>Seventeen studies involving 522 patients were analyzed, revealing a pooled ORR of 84.2% (95% CI: 77.1-91.3), CR of 33.8%, and PR of 47.7%. Common adverse effects included muscle spasms, dysgeusia, and fatigue, with a discontinuation rate of 13.2% due to adverse events.</p><p><strong>Conclusions and relevance: </strong>This systematic review and meta-analysis demonstrated a high efficacy of vismodegib and sonidegib for treating advanced BCCs in the head and neck region, suggesting a viable option when surgery is not feasible. Further high-quality research is necessary to optimize treatment outcomes for this patient population.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Use of Nonvascularized Iliac Crest Bone Graft and Submental Island Flap in Mandibular Reconstruction: A Technical Note.","authors":"Remzi Dogan, Ramazan Bahadır Küçük, Alper Yenigun, Orhan Ozturan","doi":"10.1002/hed.70055","DOIUrl":"https://doi.org/10.1002/hed.70055","url":null,"abstract":"<p><p>Reconstruction following segmental resection of the mandible due to tumors poses significant aesthetic and functional challenges. While vascularized free tissue flaps remain the gold standard, they are associated with prolonged operative time, high cost, requirement for microsurgical expertise, and donor site morbidity. We present a novel technique combining a nonvascularized iliac crest bone graft (NVICBG) with a submental island flap (SIF) for mandibular reconstruction. Between February 2024 and May 2025, three patients underwent this procedure. Graft and flap survival was achieved in all cases, with satisfactory functional and aesthetic outcomes based on clinical evaluation. Despite the limited sample size, this technique demonstrates promise as a practical and effective alternative, offering a short learning curve, high feasibility, and low complication rates. To our knowledge, this is the first report describing the combined use of NVICBG and SIF for mandibular reconstruction.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Outcomes Between Free Ileocolonic and Tube-Shaped ALT Fasciocutaneous Flaps in Total Hypopharyngeal Defect Reconstruction.","authors":"Jian-Xun Chen, Ta-I Wang, Shane D Morrison, Mei-Chen Lin, Pin-Keng Shih","doi":"10.1002/hed.70051","DOIUrl":"https://doi.org/10.1002/hed.70051","url":null,"abstract":"<p><strong>Objectives: </strong>This study compares the outcomes of free ileocolonic and tube-shaped anterolateral thigh (ALT) fasciocutaneous flaps in reconstructing total hypopharyngeal defects.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 76 patients who underwent reconstruction with either an ileocolonic flap (n = 20) or a tube-shaped ALT flap (n = 56) between 2011 and 2021. Primary outcomes included dietary tolerance at 1 and 3 years, pharyngocutaneous fistula rates, and survival. Statistical analyses assessed group differences in complications and dietary restrictions.</p><p><strong>Results: </strong>The ileocolonic flap group demonstrated superior dietary outcomes at 1 and 3 years (90% vs. 62.5% and 90% vs. 51.4%, respectively) but had a higher fistula rate (25% vs. 7.1%, p = 0.048). No significant differences in survival were observed between the groups.</p><p><strong>Conclusion: </strong>The ileocolonic flap offers better long-term dietary outcomes despite higher early fistula rates. Further research is recommended to optimize flap selection for hypopharyngeal reconstruction.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Merkel Cell Carcinoma: Evolving Therapeutics, Continued Challenges.","authors":"Hunter A Holley, Maria Lyons, Barry O'Sullivan, Neville Shine, Robbie Woods, Orla McArdle, James Paul O'Neill","doi":"10.1002/hed.70054","DOIUrl":"https://doi.org/10.1002/hed.70054","url":null,"abstract":"<p><strong>Background: </strong>Merkel Cell Carcinoma (MCC) is a rare, aggressive neuroendocrine malignancy with rising incidence, influenced by ultraviolet (UV) radiation and Merkel cell polyomavirus (MCPyV).</p><p><strong>Methods: </strong>This review summarizes recent advances in MCC management, based on an analysis of current literature, focusing on immune checkpoint inhibitors (ICIs), viral status implications, and evolving multimodal treatment strategies.</p><p><strong>Results: </strong>MCPyV-positive MCC has a median overall survival (OS) of 6.6 years compared to 1.2 years for virus-negative cases. The 5-year OS rate for localized MCC is approximately 50%. Historically, the 5-year OS for metastatic MCC was ~14%, but has significantly improved with ICIs. First-line treatment with avelumab achieved a median OS of 20.3 months and a 5-year OS of approximately 26%. Pembrolizumab demonstrated a median OS of 24.3 months, a median progression-free survival (PFS) of 9.3 months, and a durable response with a median duration of response (DOR) of 39.8 months.</p><p><strong>Conclusion: </strong>Despite advances, MCC recurrence rates remain high (16.4% local, 32.1% regional, 9.5% distant), necessitating vigilant long-term surveillance. Future research should focus on optimizing combination therapies, identifying predictive biomarkers, and refining treatment sequencing to further improve survival and quality of life.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}