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

{"title":"Sinonasal Intestinal-Type Adenocarcinoma in the Netherlands: A Nationwide Study (2008-2022).","authors":"Lise J van de Velde, Gerben E Breimer, W F Julius Scheurleer, Mischa de Ridder, Lot A Devriese, Weibel W Braunius, Remco de Bree, Boukje A C van Dijk, Johannes A Rijken","doi":"10.1002/hed.28171","DOIUrl":"https://doi.org/10.1002/hed.28171","url":null,"abstract":"<p><strong>Background: </strong>Intestinal-type adenocarcinoma (ITAC) is a rare sinonasal malignancy with poor survival. By creating a clinical and epidemiological overview of the Dutch ITAC population between 2008 and 2022, this study aims to identify areas for improvement in ITAC management.</p><p><strong>Methods: </strong>A systematic query within the Netherlands Cancer Registry (NCR) was performed to assemble the nationwide ITAC cohort. Incidence calculations were performed alongside overall survival (OS) and relative survival (RS) estimations.</p><p><strong>Results: </strong>171 patients were included. Yearly incidence was low (0.04-0.12 per 100 000 person-years) and showed a non-significant, slight upward tendency. The population was predominantly male (92.5%), diagnosed at advanced stages (55% ≥ cT3) and sparsely presented with regional (4.7%) and/or distant metastases (5.9%). The 5-year OS (47.8%, 95% CI: 39.4%-55.6%) and RS (55.5%, 95% CI: 45.8%-64.6%) rates were poor. The addition of radiotherapy to surgery yielded better OS and RS compared to surgery alone.</p><p><strong>Conclusion: </strong>ITAC incidence shows a minimal upward tendency in the Netherlands, and survival chances remain poor. Ongoing vigilance in high-risk industries and the further implementation of adjuvant radiotherapy may lead to improved outcomes in the future. Biology-driven research is warranted to additionally tailor treatment strategies.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060345","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":"Patterns of Initial Lymph Node Involvement and Recurrence in Patients With Maxillary Sinus Squamous Cell Carcinoma.","authors":"Jina Kim, Chan Woo Wee, Chang Geol Lee, Ki Chang Keum, Kyung Hwan Kim","doi":"10.1002/hed.28170","DOIUrl":"https://doi.org/10.1002/hed.28170","url":null,"abstract":"<p><strong>Background: </strong>Determining whether to treat the elective cervical lymph node (LN) area remains a dilemma in maxillary sinus squamous cell carcinoma (SCC). This study analyzed the patterns of initial LN involvement and recurrence to guide treatment strategies.</p><p><strong>Methods: </strong>We retrospectively reviewed 119 patients with maxillary sinus SCC treated between 2005 and 2023. Patients received definitive concurrent chemoradiotherapy, neoadjuvant therapy followed by local treatment, or upfront surgery with or without adjuvant radiotherapy.</p><p><strong>Results: </strong>Among 119 patients, 28 (23.5%) had clinical LN involvement at diagnosis, primarily at ipsilateral neck levels I and II. Regional failure occurred in 18 (19.8%) cN0 and 9 (32.1%) cN+ patients, with ipsilateral level II being the most common site. Contralateral failures were frequent in cN+ patients. Distant metastases occurred in 17 patients (14.3%), predominantly in the lungs.</p><p><strong>Conclusion: </strong>Understanding LN involvement and recurrence patterns can refine radiation field design and follow-up strategies in maxillary sinus SCC.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056215","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":"Evaluating Diversity in Thyroid Cancer Clinical Trials: Application of the Clinical Diversity Rating Framework.","authors":"Ethan Wood, Ryan Sherry, Garrett Jones, J Tyler Babek, Haley Howard, Christian Hemmerich, Alexandra Koontz, Jean-Maria Langley, Alicia Ito Ford, Matt Vassar","doi":"10.1002/hed.28173","DOIUrl":"https://doi.org/10.1002/hed.28173","url":null,"abstract":"<p><strong>Background: </strong>Despite progress in recruiting representative patient samples for clinical trials, disparities persist. This study quantifies the representation of historically marginalized groups-female patients, members of racial/ethnic minority groups, and older patients-in thyroid cancer clinical trials and proposes strategies for improving their participation.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of thyroid cancer treatment studies conducted in the United States and published between January 2018 and December 2023, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines. Studies were sourced from EMBASE and PubMed. Independent and duplicate screening and data extraction were conducted to ensure accuracy. Extracted data included trial interventions, clinical phases, sample sizes, demographic characteristics of participants, and funding sources. Studies were evaluated using the Clinical Trial Diversity Rating framework to assess the inclusion rates of diverse participant groups compared to their prevalence rates for thyroid cancer.</p><p><strong>Results: </strong>We found that US-based clinical trials for thyroid cancer frequently underrepresented female and non-white individuals. In over half of studies, male participants outnumbered female participants. Reporting of race and ethnicity information was inadequate, with 9/13 studies failing to provide any demographic breakdown. Among the four studies that did report race and ethnicity data, none achieved adequate representation of minority patients. Additionally, there was a notable lack of reporting on participant age bands, despite the relatively high incidence of thyroid cancer in adults aged 60 and above.</p><p><strong>Conclusions: </strong>Our findings highlight the persistent underrepresentation of women, non-white racial/ethnic groups, and older adults in thyroid cancer trials. Urgent efforts are needed to address these disparities, particularly given the increasing rates of thyroid cancer among women and the healthcare access disparities in marginalized communities.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022948","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":"Accurate and Efficient Detection of Nasopharyngeal Carcinoma Using Multi-Dimensional Features of Plasma Cell-Free DNA.","authors":"Song Zhang, Jiahui Tang, Pin Cui, Weihuang He, Xiaohui Lin, Shubing Wang, Yuanxian Liu, Xiaohua Tan, Shu Xu, Mingji Feng, Hanming Lai","doi":"10.1002/hed.28154","DOIUrl":"https://doi.org/10.1002/hed.28154","url":null,"abstract":"<p><strong>Background: </strong>The incidence of Nasopharyngeal carcinoma (NPC) is rising in recent years, especially in some non-developed parts of the world. Hence, cost-efficient means for sensitive detection of NPC are vital.</p><p><strong>Methods: </strong>We recruited 646 participants, including healthy individuals, patients with benign nasopharyngeal diseases, and NPC patients for plasma cell-free DNA(cfDNA), which underwent low-depth whole-genome sequencing (WGS) to extract multi-dimensional molecular features, including fragmentation pattern, end motif, copy number variation(CNV), and transcription factors(TF). Based on these features, we employed a machine learning algorithm to build prediction models for NPC detection.</p><p><strong>Results: </strong>We achieved a sensitivity of 95.8% and a specificity of 99.4% to discriminate NPC patients from healthy individuals.</p><p><strong>Conclusions: </strong>This study can be a proof-of-concept for these multi-dimensional molecular features to be implemented as a noninvasive approach for the detection and even early detection of NPC.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052661","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":"Full Title: Surgical Versus Non-Surgical Treatment of Advanced Oropharyngeal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.","authors":"Megan K Scharner, Johnny M Owen, Shaun A Nguyen, Alexandra E Kejner, Jason G Newman, Emily Brennan, W Greer Albergotti","doi":"10.1002/hed.28167","DOIUrl":"https://doi.org/10.1002/hed.28167","url":null,"abstract":"<p><strong>Background: </strong>This review aims to compare survival outcomes of surgical versus non-surgical treatment of advanced-stage OPSCC.</p><p><strong>Methods: </strong>CINAHL, Cochrane Library, PubMed, and Scopus were searched. Studies comparing the survival of patients with advanced OPSCC treated surgically (±adjuvant therapy) or non-surgically were included. Meta-analyses hazard ratio (HR) and proportions (%) were performed for the outcomes of 2-, 3-, and 5-year overall (OS), disease-free (DFS), disease-specific (DSS), and relapse-free (RFS) survival.</p><p><strong>Results: </strong>Forty-four studies reporting on (N = 35 681) patients were included, with a mean age of 58.9. For advanced-stage disease, primary treatment with surgery and chemoradiotherapy (CRT) demonstrated the best 5-year OS, at 67.1% (95% CI 55.6-77.6). Survival outcomes favored Surgery + CRT over other primary treatment modalities.</p><p><strong>Conclusions: </strong>Surgical treatment with adjuvant CRT may be associated with better OS outcomes compared with non-surgical treatment. Further research is needed to determine superior treatment modalities in OPSCC subgroups, such as HPV+ tumors.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058663","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":"Acoustic Features of Airway Protective Maneuvers as Biomarkers of Radiation-Associated Dysphagia and Penetration/Aspiration in Head and Neck Cancer Patients.","authors":"Sofiana Mootassim-Billah, Jean Schoentgen, Marc De Bodt, Hichem Slama, Esther Willemse, Tatiana Dragan, Nicolas Roper, Mathilde Le Tensorer, Paulus Kristanto, Marianne Paesmans, Dirk Van Gestel, Gwen Van Nuffelen","doi":"10.1002/hed.28163","DOIUrl":"https://doi.org/10.1002/hed.28163","url":null,"abstract":"<p><strong>Background: </strong>This study aimed at identifying acoustic features of airway protective maneuvers as biomarkers of radiation-associated dysphagia, involving penetration/aspiration and pharyngeal residue.</p><p><strong>Methods: </strong>Temporal and spectral acoustical analyses were carried out on voluntary coughs, voluntary throat clearings, and reflexive coughs. Head and neck cancer patients with and without penetration/aspiration were compared. The same was done for patients and healthy controls.</p><p><strong>Results: </strong>A decreased convexity of the amplitude contour and decreased salience of periodicity in the frequency band 0-400 Hz were observed in induced reflexive coughs of patients compared to healthy controls. A longer length and a less steep slope of the amplitude contour of voluntary throat clearings were observed in patients with penetration/aspiration versus those without.</p><p><strong>Conclusions: </strong>Acoustic features of induced reflexive cough discriminate between patients and healthy controls, but do not relate to penetration/aspiration. However, acoustic features of voluntary throat clearing are associated with penetration/aspiration in head and neck cancer patients.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058934","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":"Minimally Invasive Endoscopic Resection and Suture Ligation for Third Branchial Cleft Fistulas: Low Recurrence and Reduced Trauma.","authors":"Jiamei Wen, Min Pan, Guohua Hu, Quan Zeng, Zhihai Wang","doi":"10.1002/hed.28165","DOIUrl":"https://doi.org/10.1002/hed.28165","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate three surgical procedures for the treatment of third branchial cleft fistulas, focusing on recurrence rates and postoperative complications.</p><p><strong>Study design: </strong>A retrospective review of medical records was conducted for patients treated for third branchial cleft fistulas at the Department of Otorhinolaryngology-Head and Neck Surgery, First Affiliated Hospital of Chongqing Medical University, from January 2014 to October 2024.</p><p><strong>Setting: </strong>Tertiary care hospital.</p><p><strong>Methods: </strong>Patient demographics, clinical presentations, surgical details, complications, outcomes, and follow-up data were collected and analyzed.</p><p><strong>Results: </strong>The cohort consisted of 14 males and 15 females with a median age of 27 years. The left neck was affected in 82.76% of cases. The most frequent symptoms were neck swelling (89.66%) and pain (77.78%). No postoperative complications, particularly pharyngocutaneous fistulas or vocal cord paralysis, occurred. Overall, seven patients in our cohort had an internal fistula located in the piriform fossa found under preoperative fibrolaryngoscopy. Recurrence was observed in 17.6% of patients who underwent open surgery alone during a follow-up period ranging from 37 to 120 months, while no recurrence was noted in patients who had additional endoscopic resection plus suture ligation or endoscopic resection plus suture ligation alone. The three procedures showed significant differences in the operation time, blood loss, and postoperative hospital stay.</p><p><strong>Conclusion: </strong>The endoscopic resection plus suture ligation approach demonstrated a low recurrence rate and offered aesthetic and minimally invasive advantages in this study.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035886","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":"Using Nomograms to Predict Patient Tolerance to High-Dose Cisplatin During Concurrent Chemoradiotherapy in Locoregionally Advanced Head and Neck Cancer.","authors":"Ming-Yu Lien, Chia-Yu Chen, Ching-Yun Hsieh, Ming-Hsui Tsai, Chun-Hung Hua, Wen-Hui Chung, Ti-Hao Wang","doi":"10.1002/hed.28164","DOIUrl":"https://doi.org/10.1002/hed.28164","url":null,"abstract":"<p><strong>Background: </strong>Concurrent chemoradiotherapy (CCRT) with high-dose cisplatin is the standard treatment for locally advanced head and neck cancer (LA-HNC). However, some patients experience underdosing or severe side effects due to intolerance. That is, identifying patients who can tolerate high-dose cisplatin remains challenging.</p><p><strong>Methods: </strong>This study aims to develop a prediction nomogram to identify patients tolerating high cumulative cisplatin dose (CCD ≥ 200 mg/m²) during CCRT. The collected data of 1020 patients who received cisplatin-based definitive CCRT between 2010 and 2019 in a Taiwanese medical center were retrospectively reviewed.</p><p><strong>Results: </strong>A prediction model was developed using stepwise multivariable logistic regression and evaluated for accuracy. A nomogram was created to predict the likelihood of completing a CCD ≥ 200 mg/m², and its performance was assessed using various measures. The higher CCD group had better-experienced status and median body mass index than the lower CCD group (p < 0.001 for both comparisons). Univariate analysis identified several risk factors for high-dose cisplatin intolerance, including old age, tumor site, the nasopharynx, stage IV disease, Charlson Comorbidity Index (CCI) ≥ 3, and weekly cisplatin (p < 0.001 for all). Multivariate logistic regression analysis revealed that age, tumor site, stage IV disease, and hemoglobin level strongly predicted high-dose cisplatin intolerance. The nomogram showed good predictive accuracy with a Brier score of 0.18, C-index of 0.71, calibration curve slope of 0.95, and intercept of 0.2. Similar values were observed in the non-nasopharyngeal carcinoma subgroup.</p><p><strong>Conclusions: </strong>Our nomogram model identified patients who can tolerate higher cisplatin doses, showing predictive accuracy after internal validation. Developed using pretreatment characteristics like age, clinical stage, tumor size, and hemoglobin level, it predicts tolerability for CCD ≥ 200 mg/m². This method helps select patients for high-dose cisplatin, enabling confident prescription of three-weekly or weekly dosing to improve survival outcomes. Further prospective research is needed for a comprehensive nomogram.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046591","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":"Bilateral Neck Dissection in cN0 Supraglottic Squamous Cell Carcinoma: Essential or Not?","authors":"Jiamei Wen, Chuan Liu, Min Pan, Yanshi Li, Min Wang, Lin Chen, Mengna Wang, Zhaobo Cheng, Guohua Hu","doi":"10.1002/hed.28140","DOIUrl":"https://doi.org/10.1002/hed.28140","url":null,"abstract":"<p><strong>Objective: </strong>There is controversy regarding bilateral neck dissection for cN0 supraglottic squamous cell carcinoma. This study aimed to explore the risk factor of occult isolated contralateral/bilateral metastasis in cN0 supraglottic squamous cell carcinoma and help clinicians better make assessments for these patients.</p><p><strong>Method: </strong>PubMed, the Cochrane Library, CNKI, and CBM were systematically searched for studies on occult lymph node metastasis in cN0 supraglottic squamous cell carcinoma from the inception of each database to May 30, 2024. All patients with supraglottic squamous cell carcinoma and a clinical N0 neck, who had complete records of neck lymph node metastasis, were included in the study. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline was followed to extract data. Data were pooled using a random-effects generalized linear mixed model with 95% confidence intervals (CIs). The risk of occult isolated contralateral/bilateral metastatic lymph nodes was analyzed.</p><p><strong>Results: </strong>Fifteen studies including 1609 patients with cN0 supraglottic squamous cell carcinoma were analyzed. The pooled risk of occult isolated contralateral/bilateral metastasis was 7.49% (95% CI: 5.65%-9.87%; I² = 57%). For Type A tumors, the risk was 4.14% (95% CI: 2%-64%; I² = 81%), 6.74% for Type B (95% CI: 2.27%-18.33%, I² = 82%), and 13.62% for Type C (95% CI: 5.82%-28.66%, I² = 69%). For T1-T2 patients, the risk was 5.18% (95% CI: 2%-64%; I² = 81%), and 8.73% (95% CI: 5.92%-12.69%, I² = 0%)for T3-T4 patients. When ipsilateral pN+ was present, the risk increased to 20.97% (95% CI: 16.09%-26.85%, I² = 29%).</p><p><strong>Conclusions: </strong>Contralateral neck dissection is recommended for Type C patients. Pathologically ipsilateral metastasis confirmed patients should receive contralateral neck dissection, radiotherapy, or even active surveillance follow-up.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058909","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 Pneumonia in Major Head and Neck Cancer Surgery.","authors":"Grant Borne, Mark Knackstedt, Isabella Fabian, Ivan Alvarez, Liam Ordoyne, Rema A Kandula, Ameya Asarkar, Cherie-Ann Nathan, John Pang","doi":"10.1002/hed.28160","DOIUrl":"https://doi.org/10.1002/hed.28160","url":null,"abstract":"<p><strong>Background: </strong>The incidence of postoperative pneumonia (PPNA) in patients undergoing major head and neck cancer surgery has not been well established.</p><p><strong>Methods: </strong>Patients who developed PPNA undergoing major head and neck cancer (HNC) surgery from the Nationwide Inpatient Sample (NIS) from the years 2017 to 2019 (n = 10 037) were analyzed using ICD-10 codes.</p><p><strong>Results: </strong>PPNA developed in 2.8% (n = 285) of patients undergoing major HNC surgery. PPNA patients had longer hospitalizations (15 [10-24] vs. 6 [3-9] days, p < 0.001; median, IQR) and had greater hospital charges (241 308 [166 976-382 982] vs. 104 697 [59 640-181 760], p < 0.001; USD; median, IQR). Regression models revealed that anemia was the greatest predisposing factor for PPNA (OR: 3.3, 95% CI: 2.6-4.2) among other comorbidities such as COPD (OR: 2.0, 95% CI: 1.6-2.7), hypertension (OR: 1.3, 95% CI: 1.0-1.7), and dementia (OR: 1.4, 95% CI: 1.0-1.9).</p><p><strong>Conclusions: </strong>In one of the population's largest data sets, anemia and COPD were the strongest contributing factors to developing PPNA for HNC patients. PPNA was the strongest predictor of increased length of stay and hospital charges in patients undergoing major HNC surgery. Surgical pathways should directly target decreasing PPNA rates to improve outcomes and lower costs.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019411","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}