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

{"title":"Robotic Surgical Assist Arm for Head and Neck Reconstructive Surgery.","authors":"Sofia Torres-Small, Daron B Harrison, Camron Davies, Tate Naylor, Anas Eid, C Burton Wood, John P Gleysteen","doi":"10.1002/hed.28102","DOIUrl":"https://doi.org/10.1002/hed.28102","url":null,"abstract":"<p><p>This video demonstrates the use of a robotic surgical assist arm, specifically the Zimmer Biomet WalterLorenz arm, in a complex head and neck reconstructive surgery involving a scapular tip/latissimus dorsi free flap for a 67-year-old patient with advanced squamous cell carcinoma of the oral cavity. The key objective is to showcase how the robotic arm enhances surgical precision and efficiency by providing stable retraction, reducing the need for additional assistants, and minimizing fatigue-related challenges during prolonged procedures. The video highlights the setup, positioning, and intraoperative use of the robotic arm, including its role in maintaining optimal visualization and facilitating delicate dissections and osteotomies. The clinical significance of this technology lies in its ability to improve surgical ergonomics and outcomes by enabling the surgical team to focus more effectively on the intricate aspects of the procedure. This video serves as a valuable resource for surgeons interested in integrating robotic assist technology into head and neck reconstructive surgeries.</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":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484616","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":"Biochemical Markers of Sarcopenia as Predictors of Outcomes Among Patients Undergoing Laryngectomy.","authors":"Marianne Abouyared, Angela A Colback, Alexander Jones, Michael G Moore, Matthew Mifsud, Bailin Alexander, Sidharth Puram, Joseph Roh, Akina Tamaki, Andrea Ziegler, Eric Thorpe, Sean Abbott, Rusha Patel","doi":"10.1002/hed.28110","DOIUrl":"https://doi.org/10.1002/hed.28110","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia, the systemic loss of skeletal muscle mass and function, is prevalent and particularly detrimental to head and neck cancer (HNC) patients. Cancer-associated sarcopenia involves complex mechanisms of poor nutrition and inflammation, highlighting the necessity for preoperative identification of these high-risk patients.</p><p><strong>Methods: </strong>A multi-site retrospective chart review (2016-2021) was performed on HNC patients undergoing total laryngectomy with or without reconstruction. Preoperative lab values were utilized to calculate markers of sarcopenia including systemic immune inflammation index (SII), nutrition-related index (NRI), geriatric NRI (GNRI), and neutrophil-to-lymphocyte ratio (NLR). Comparative analyses, ROC curves, and logistic regressions were conducted to evaluate the predictive value of these indices on 30-day postoperative outcomes.</p><p><strong>Results: </strong>In a cohort of 520 laryngectomy patients (75.8% salvage), postoperative fistula, major complication, and prolonged PO intake > 30 days were recorded in 22.7%, 25.4%, and 26.2% of patients, respectively. NLR was higher in patients with prolonged PO intake, while the NRI/GNRI was lower in patients with delayed PO intake. There were no significant differences in patient indices with or without fistula and major complications. All nutritional indices on ROC curves had areas under the curve < 0.600. After adjusting for confounding on multivariate logistic regression, the NLR (OR = 0.95) and SII (OR = 0.98) were predictive of major postoperative complications, while the NRI/GNRI (OR = 0.96) was predictive of delayed PO intake.</p><p><strong>Conclusions: </strong>Nutritional indices may be valuable to predict adverse postoperative laryngectomy outcomes. Prospective studies are needed to validate these findings.</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":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484615","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":"Crossing the Boundaries of Conflict: Analyzing Epidemiology & Outcomes of Afghan Oral Squamous Cell Carcinoma Patients at a Pakistani Cancer Hospital.","authors":"Hasnain Haider, Muhammad Awais Kanwal, Muhammad Mohaymin Ali, Afshan Khanum, Shayan Khalid, Kashif Iqbal Malik, Syed Raza Hussain, Muhammad Faisal","doi":"10.1002/hed.28118","DOIUrl":"https://doi.org/10.1002/hed.28118","url":null,"abstract":"<p><strong>Background: </strong>This study investigates oral cavity squamous cell carcinoma (OSCC) among Afghan patients treated at a Pakistani cancer center, focusing on epidemiology, tumor characteristics, outcomes, and healthcare challenges faced by patients from conflict-affected regions.</p><p><strong>Methods: </strong>A retrospective analysis of Afghan OSCC patients (2010-2023) was conducted. Demographic, clinical, and treatment data were evaluated, with survival outcomes analyzed using Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>Of the 117 patients, 47.1% had risk factors, predominantly smokeless tobacco use (61.8%). Tumors were common in oral subsites, especially the tongue (47.86%), with advanced-stage disease (Stage IV) in 34.2%. Mean overall survival was 56.29 months, and mean disease-free survival was 45.54 months. The 5-year overall and disease-free survival rates were 57.7% and 56.5%, respectively.</p><p><strong>Conclusion: </strong>The study highlights a high prevalence of advanced OSCC, underscoring the need for early detection, public health initiatives, and enhanced cancer care in Afghanistan. International collaboration is essential to improve healthcare access and reduce regional healthcare burdens.</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":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476943","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":"Aggressive Head and Neck Squamous Cell Carcinoma in the Setting of GATA2 Deficiency.","authors":"Brejjette Aljabi, James A Stewart, Kirk Withrow, Carissa M Thomas","doi":"10.1002/hed.28117","DOIUrl":"https://doi.org/10.1002/hed.28117","url":null,"abstract":"<p><strong>Background: </strong>GATA2 deficiency is a rare genetic disorder associated with hematologic, infectious, and neoplastic complications. We report a case of a patient with GATA2 deficiency who developed aggressive squamous cell carcinoma (SCC) of the head and neck, an atypical manifestation of this condition.</p><p><strong>Methods: </strong>A 34-year-old Hispanic male, a nonsmoker, presented with a large, exophytic right facial mass. Biopsy revealed HPV-negative SCC. Computed tomography (CT) showed a right periorbital mass invading the nasal cavity and a contralateral mass in the left parotid extending into the masticator space. The patient underwent extensive surgery, including right orbital exenteration, total rhinectomy, partial glossectomy, left radical parotidectomy, excision of the left mandibular condyle, and bilateral neck dissections. Reconstruction included a left temporalis muscle flap, internal fixation of the left zygoma, intermaxillary fixation, and a staged anterolateral thigh (ALT) free flap for the right facial defect. He developed postoperative Pseudomonas surgical site infections in the left face and ALT donor site and was treated with antibiotics and antifungals based on intraoperative culture results. The patient's postoperative course involved multiple interventions to address complications and support recovery. He developed bilateral local and regional recurrences rapidly after surgery and ultimately elected for palliative care.</p><p><strong>Results: </strong>Due to the aggressive nature of this case in a young, nonsmoking patient, combined with the atypical infections, genetic testing was performed for immunodeficiency syndromes. He was ultimately diagnosed with GATA2 deficiency.</p><p><strong>Conclusion: </strong>This case highlights the aggressive nature of SCC in the context of GATA2 deficiency and underscores the importance of genetic testing in patients with unusual malignancy presentations and suspected immunodeficiency. Genetic testing in the patient's children allows for early diagnosis of GATA2 deficiency and provides an opportunity for curative intervention through hematopoietic stem cell transplantation.</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":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470020","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 Management Following Endoscopic Skull Base Reconstruction: A Multidisciplinary Cross-Sectional Survey.","authors":"Khodayar Goshtasbi, Arash Abiri, Vidit Talati, Jagatkumar A Patel, Theodore V Nguyen, Jonathan C Pang, John R Craig, Peter Papagiannopoulos, Katie M Phillips, Bobby A Tajudeen, Nithin D Adappa, James N Palmer, Ahmad R Sedaghat, Eric W Wang, Shirley Y Su, Edward C Kuan","doi":"10.1002/hed.28116","DOIUrl":"https://doi.org/10.1002/hed.28116","url":null,"abstract":"<p><strong>Background: </strong>There is limited consensus on management protocols and practice patterns following endoscopic skull base surgery (ESBS).</p><p><strong>Methods: </strong>An online-based survey focusing on ESBS practice patterns was anonymously distributed to the American Rhinologic Society, North American Skull Base Society, and American Head and Neck Society Skull Base Section membership.</p><p><strong>Results: </strong>A total of 130 surgeons (81.5% in academic positions) completed the survey. Regarding reconstructive materials, 36.9% always used autologous as opposed to synthetic materials, with variation in specific materials used. Lumbar drain was never used by 22.3% of respondents, while high BMI or suspected intracranial hypertension (43.1%) and high-flow leak or large dural defects (50.0%) were indications for lumbar drain usage. There was significant variation in types of nasal packing, type, and duration of postoperative activity restrictions, antibiotic use, and debridement protocols.</p><p><strong>Conclusion: </strong>Postoperative management following endoscopic skull base reconstruction is highly complex, with a wide variety of practice patterns.</p><p><strong>Level of evidence: </strong>N/A.</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":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442965","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":"Upper Aerodigestive Tract Liposarcoma: Four Cases of a Rare Entity and a Review of the Literature.","authors":"Uma Ramesh, Antonio Bon Nieves, Maria Feucht, Naomi Wang, Rahul Alapati, Chelsea S Hamill, Shannon Kraft, James Garnett, Devin Shrock, Omar Karadaghy, Ethan Craig, Andrés M Bur","doi":"10.1002/hed.28114","DOIUrl":"https://doi.org/10.1002/hed.28114","url":null,"abstract":"<p><strong>Background: </strong>Liposarcomas involving the upper aerodigestive tract (UADT) are extremely rare. Consequently, consensus regarding the treatment approach and surveillance is not well established.</p><p><strong>Methods: </strong>We present four cases of UADT liposarcoma. All patients presented with either dysphagia or respiratory difficulty and underwent endoscopic examination as part of their diagnostic workup. Surgical excision, either endoscopic or open resection, was performed for all patients.</p><p><strong>Results: </strong>All patients had a pathologic diagnosis of well-differentiated liposarcoma without nodal or distant disease involvement. One patient underwent complete resection with no recurrences. Another patient experienced several recurrences, and his tumor ultimately underwent rapid disease progression and pathologic transformation into dedifferentiated liposarcoma, necessitating total laryngectomy. Of the two patients with positive surgical margins at their initial resections, one was lost to follow-up from our institution. The other three patients, including the second patient with positive margins, continue to follow up with endoscopic surveillance at our institution with no evidence of residual disease.</p><p><strong>Conclusions: </strong>UADT liposarcoma is a locally aggressive tumor that may frequently recur. Stringent surveillance is necessary to monitor disease progression, particularly if positive margins are noted during surgical excision. The role of adjuvant therapy has yet to be established.</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":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442978","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":"Neutrophil-to-Lymphocyte Ratio as a Predictor for PD-L1 Inhibitor Treatment in Recurrent or Metastatic Nasopharyngeal Carcinoma.","authors":"Kun Gao, Zhigong Wei, Zheran Liu, Yiyan Pei, Huilin Li, Ge Song, Jin Xiang, Junyou Ge, Yan Qing, Youneng Wei, Ping Ai, Ye Chen, Xingchen Peng","doi":"10.1002/hed.28101","DOIUrl":"https://doi.org/10.1002/hed.28101","url":null,"abstract":"<p><strong>Background: </strong>Neutrophil-to-lymphocyte ratio (NLR) can be treated as a simple indicator of patients' immune status by representing the state of the systemic inflammatory response. Immunotherapy now is the accepted second-line treatment for recurrent or metastatic nasopharyngeal carcinoma (R/M NPC). However, the significance of NLR in patients with R/M NPC undergoing treatment with PD-L1 (programmed cell death-ligand 1) inhibitors is still uncertain.</p><p><strong>Methods: </strong>We analyzed the relationship between baseline NLR with 153 patients' efficacy and survival from a multicenter, prospective, Phase 2 study. We employed restricted cubic spline plots to get the nonlinear relationship between NLR and progression-free survival (PFS) or overall survival (OS). We identified the ideal cut-off value through the analysis of the receiver operating characteristic curve (ROC curve). We used Logistic regression, Cox regression, Log-rank test, and Kaplan-Meier method to analyze the association between NLR and patients' disease control rate (DCR) and PFS or OS.</p><p><strong>Results: </strong>The ideal threshold value for NLR was 2.826. NLR was identified as a significant independent predictor of DCR (OR = 0.17, 95% CI = 0.05-0.48, p = 0.001), indicating that a higher NLR is associated with worse DCR. NLR (AUC = 0.634) showed superior predictive capability for DCR in comparison to lymphocytes (AUC = 0.602) and neutrophils (AUC = 0.593). High NLR values were risk factors both for poor PFS (HR = 2.53, 95% CI = 1.58-4.06, p < 0.001) and OS (HR = 3.89, 95% CI = 2.09-7.24, p < 0.001).</p><p><strong>Conclusion: </strong>Elevated NLR is strongly associated with lower response to treatment and reduced survival rates in patients with R/M NPC being treated with PD-L1 inhibitors. Patients with high NLR values have poor efficacy and survival.</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":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411448","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":"Factors Increasing the Likelihood of Postoperative Hematomas Following Thyroid Surgery.","authors":"Emily Ajit-Roger, Jessica Hier, Marco Mascarella, Koorosh Semsar-Kazerooni, Sabrina Daniela Silva Wurzba, Véronique-Isabelle Forest, Michael P Hier, Alex Mlynarek, Carmelina Mancini, Richard J Payne","doi":"10.1002/hed.28096","DOIUrl":"https://doi.org/10.1002/hed.28096","url":null,"abstract":"<p><strong>Background: </strong>Neck hematoma following thyroid surgery is a potentially life-threatening complication.</p><p><strong>Methods: </strong>This retrospective case-control study reviewed neck hematoma reoperations following thyroid surgery (2009-2024), using 3:1 matching. Univariable analysis identified hematoma and delayed onset (≥ 6 h) risk factors, with odds ratios (ORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Among 5502 surgeries, the hematoma incidence was 0.55% (n = 30). The mean age was 54 and the female-to-male ratio was 7:3. Key risk factors included pre-induction blood pressure > 160 mmHg (OR = 3.04 [95% CI = 1.25-7.39], p = 0.014) and limited blood pressure change postmedication (OR = 6.25 [95% CI = 1.03-38.08], p = 0.047). The hematoma group had higher rates of smoking, hypertension, diabetes, Graves' disease, and prior thyroid surgery, and, in delayed hematoma cases, larger nodules, total thyroidectomy, and central neck dissection, though not statistically significant.</p><p><strong>Conclusion: </strong>Patients with poorly controlled blood pressure may not be candidates for outpatient thyroidectomy.</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":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400774","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":"Global Incidence, Mortality, and Risk Factors of Stroke in Multi-Modality Head and Neck Cancer Treatment-A Systematic Review and Meta-Analysis.","authors":"Srivatsa Surya Vasudevan, Elise Ericksen, Victor Albornoz, Elizabeth Bryan, Lindsay Olinde, Cherie-Ann O Nathan","doi":"10.1002/hed.28109","DOIUrl":"https://doi.org/10.1002/hed.28109","url":null,"abstract":"<p><strong>Background: </strong>Head and neck cancer (HNC) due to its nature and proximity to essential vasculature, along with different treatments, can lead to stroke, significantly contributing to morbidity and mortality. Our aim is to systematically evaluate the association of stroke incidence, mortality, and predictors with HNC treatment.</p><p><strong>Methods: </strong>Pubmed, Web of Science, Embase, and ScienceDirect were searched from inception to July 2024 for articles reporting stroke incidences, mortality, or associated risk factors following treatment in HNC patients. A random-effects meta-analysis assessed cumulative incidence and mortality rates with proportional analysis and risk factors using hazard ratios (HRs) associated with HNC treatment. Subgroup analyses of incidence and mortality were conducted for pre- and post-2010 periods, reflecting changes in stroke protocols.</p><p><strong>Results: </strong>Out of 1561 studies, 69 studies with 258 850 HNC patients were included. The global cumulative incidence of stroke in HNC was 4.1% (95% CI: 3.3%-5.0%), with similar rates before and after 2010 (4.4% vs. 4.0%). In patients undergoing chemoradiotherapy (CRT), stroke incidence was 4.9% (95% CI: 3.5%-6.7%) with a median time to first stroke of 45 months (range: 14-51.7 months). Following radiation therapy (RT), stroke incidence was 3.8% (95% CI: 2.7%-5.3%) with a median time to stroke of 36 months (range: 6.8-130 months). The incidence rates of stroke in HNC patients were higher compared to the general population (HR: 1.69, 95% CI: 1.24-2.31, p = 0.001). Stroke mortality decreased from 28.5% (95% CI: 11.6%-54.9%) pre-2010 to 14.5% (95% CI: 11.6%-17.9%) 2010-2024. Stroke mortality was 39.3% (95% CI: 17.8%-66.0%) post-CRT and 21% (95% CI: 7.2%-47.7%) post-RT. Hypertension (HR = 1.75), diabetes (HR = 1.71), and age > 65 (HR = 2.17) increased stroke risk (p < 0.0001 for all). Geographically, South Korea (6.6%) had the highest incidence of stroke.</p><p><strong>Conclusion: </strong>This is the first systematic review to analyze the association between stroke and HNC treatment. Stroke mortality decreased from 28.5% to 14.5% (pre-2010 vs. 2010-2024), with the highest mortality in the CRT group (39.3%). Given that stroke occurs 36-45 months after CRT, a screening protocol within 3-4 years is crucial.</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":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411443","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":"Genomic Differences in Thyroid Cancers From Primary Sites Versus Distant Metastases in Individual Patients: A Clinical Perspective and Preliminary Report.","authors":"Yen-Bo Lin, Hsiang-Wei Hu, An-Ko Chung, Jin-Ying Lu, Wan-Chen Wu, I-Hsuan Chiu, I Chu, Chia-Chi Lin, Jih-Hsiang Lee, Feng-Jung Nien, Kuen-Yuan Chen, Ming-Hsun Wu, Chun-Nan Chen, Chun-Wei Wang, Ting-Chun Kuo, Chia-Hung Lin, Mei-Fang Cheng, Wei-Yih Chiu, Shuenn-Wen Kuo, Wen-Hui Hsih, Chih-Yuan Wang, Wei-Shiung Yang, Pei-Lung Chen, Shyang-Rong Shih","doi":"10.1002/hed.28100","DOIUrl":"https://doi.org/10.1002/hed.28100","url":null,"abstract":"<p><strong>Background: </strong>Distant metastasis is a leading cause of thyroid cancer (TC)-related deaths. Genetic profiling is typically limited to one sample per patient due to cost and sampling-risk concerns. Differences between samples from thyroid and distant metastasis within individual patients are unclear.</p><p><strong>Methods: </strong>Patients with TC and distant metastasis were recruited for genetic analysis.</p><p><strong>Results: </strong>Using a TC-specific NGS panel, 66 specimens from 29 patients were analyzed, identifying 16 mutations and 4 fusions, including two novel fusions (FGFR2-SHTN1 and RFTN1-BRAF). Genetic alterations differed between primary and metastatic sites in nine patients (31%), predominantly in additional oncogenic alterations (89%). More genetic alterations were found at the primary site in three patients and metastatic sites in four. Distinct mutations were found in two patients. A longer time interval between specimen acquisitions was significantly associated with genetic discrepancies (p = 0.032).</p><p><strong>Conclusion: </strong>Patterns of genetic discrepancies between primary and metastatic TC vary, offering valuable insights for clinical practice.</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":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400775","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}