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

{"title":"Frailty and the Survival Outcomes of Patients With Laryngeal Squamous Cell Cancer.","authors":"Cameron McCann, Rhona Hurley, Josh McGovern, Katrina Knight, Nicholas J W Rattray, Catriona M Douglas","doi":"10.1002/hed.27951","DOIUrl":"https://doi.org/10.1002/hed.27951","url":null,"abstract":"<p><strong>Background: </strong>Frailty increases the risk of mortality in the head and neck cancer population. This study examines the association between frailty and survival outcomes in patients with laryngeal squamous cell cancer (LSCC).</p><p><strong>Method: </strong>Retrospective data collection from patients in the West of Scotland diagnosed with LSCC between 2014 and 2020. The Modified Five Item Frailty Index (mFI-5) measures frailty and categorizes patients according to their level of frailty. Statistical tests used were the Mann-Whitney U-test or ANOVA for differences in means and survival analyses for overall survival time.</p><p><strong>Results: </strong>There were 867 patients included. Seventy-eight percent (n = 676) of patients were deemed frail. Median survival for \"not frail\" patients was 78 months and \"severely frail\" was 23 months. The palliative treatment group had worse overall survival outcomes compared to curative (hazard ratio (HR) of 7.96, p < 0.001).</p><p><strong>Conclusion: </strong>This study demonstrates frailty is common in patients with LSCC and leads to worse mortality and survival outcomes.</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":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693790","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":"Contrast-Enhanced Computed Tomography (CT) With Concordant Sonography as Sufficient Early Detection Tools for Recurrent and Persistent Cervical Metastases After (Chemo)radiotherapy (CRT).","authors":"Carl Stöcker, Jens Greve, Meinrad Beer, Beate Hosch, Thomas F E Barth, Thomas K Hoffmann, Adrian von Witzleben","doi":"10.1002/hed.28008","DOIUrl":"10.1002/hed.28008","url":null,"abstract":"<p><strong>Background: </strong>Most challenging treatment needs are in recurrent or persisting head and neck squamous cell carcinoma (HNSCC) patients after (((chemo-)radiotherapy) (C)RT).</p><p><strong>Materials and methods: </strong>This 10-year retrospective study included 100 patients, who initially received (C)RT followed by neck dissection (ND). The results of computed tomography (CT) and sonography were evaluated for residual/recurrent cervical lymph nodes and compared to the histopathology. On this basis we calculate the sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV).</p><p><strong>Results: </strong>A total of 144 ND specimens were analyzed. The combination of CT and sonography (n = 103) reached values 97% sensitivity, 71% specificity, 98% NPV, 66% PPV, and 81% overall accuracy. For patients who received as primary treatment CRT the values for the combined imaging were: 100.0%, 73.5%, 100.0%, 66.7% and 82.7% respectively.</p><p><strong>Conclusion: </strong>Our study demonstrates that the combined use of CT and sonography reliably detects lymph node metastases, particularly in patients previously treated with CRT, even after a long time after treatment.</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":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669721","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":"Hardware Complication Risks in Head and Neck Cancer Patients Undergoing Reconstructive Surgery With Segmental Mandibulectomy.","authors":"Kevin Yu-Ting Chen, Angela Chien-Yu Chen, Chung-Kan Tsao, Shao-Yu Hung, David Chon-Fok Cheong, Huang-Kai Kao","doi":"10.1002/hed.28000","DOIUrl":"https://doi.org/10.1002/hed.28000","url":null,"abstract":"<p><strong>Background: </strong>The primary objective of this study was to ascertain the risk factors associated with hardware complications following segmental mandibular reconstruction in head and neck cancer patients. Additionally, we sought to develop a nomogram model that enables accurate risk prediction.</p><p><strong>Methods: </strong>Patients who underwent segmental mandibulectomy with immediate free or local regional tissue transfer between January 2016 and December 2020 were reviewed. Hardware complications were defined. Patient demographics and perioperative parameters were analyzed.</p><p><strong>Results: </strong>A total of 510 patients were analyzed. Postoperative radiation therapy (OR = 2.296, 95% CI = 1.339-3.938, p = 0.003), postoperative wound infection (OR = 2.367, 95% CI = 1.472-3.806, p < 0.001), and debridement for flap-related complications (OR = 5.484, 95% CI = 3.269-9.199, p < 0.001) were identified as independent risk factors. The nomogram model demonstrated good discriminatory ability.</p><p><strong>Conclusion: </strong>This comprehensive analysis identified three independent risk factors, and the nomogram provides a valuable tool for predicting the risks. Further research is needed to validate these findings and explore preventive 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":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649888","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":"Recommendations for Research to Develop a Patient-Centered Clinical Follow-Up Protocol for Oral Epithelial Dysplasia","authors":"Pelin Güneri,&nbsp;Gaye Bolukbasi,&nbsp;Betul Ilhan,&nbsp;Joel B. Epstein,&nbsp;Saman Warnakulasuriya","doi":"10.1002/hed.28001","DOIUrl":"10.1002/hed.28001","url":null,"abstract":"<div>\u0000 \u0000 <p>Oral epithelial dysplasia (OED) is the primary histological marker for assessing the progression of oral potentially malignant disorders (OPMDs) to cancer. Despite challenges in grading and low inter-pathologist reproducibility, OED severity remains the key predictor of malignant transformation. However, globally accepted guidelines for OED monitoring are lacking, despite calls for individualized management based on host and lesion characteristics. The proposed research protocol involves acquiring high-quality intraoral images, assessing oral hygiene and periodontal status, eliminating chronic mechanical irritation and Candida infections, and applying adjunctive diagnostic methods like toluidine blue staining, optical evaluation, and brush cytology. Tailored follow-up regimens based on individual risk assessments are emphasized, with frequent monitoring for high-grade dysplasia or patients at higher risk of progression. Therefore, effective OED management should consider the patient's immune status, dietary habits, and oral microbiota, aiming to develop personalized treatment strategies that optimize patient-centered care.</p>\u0000 </div>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":"47 1","pages":"7-13"},"PeriodicalIF":2.3,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649892","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":"Outcome Analysis of Solitary Extramedullary Plasmacytoma in the Head and Neck: A Clinical Perspective.","authors":"Po-Wen Chuang, Wen-Yu Chuang, Ta-Jen Lee, Po-Hung Chang, Yi-Wei Chen, Chia-Hsiang Fu","doi":"10.1002/hed.27998","DOIUrl":"https://doi.org/10.1002/hed.27998","url":null,"abstract":"<p><strong>Introduction: </strong>Solitary extramedullary plasmacytomas (SEP) of the head and neck are rare and pose unique challenges. This study aimed to explore the clinical spectrum and treatment outcomes of these neoplasms using multimodal management.</p><p><strong>Methods: </strong>A retrospective review of 13 patients with SEP of the head and neck. Data on demographics, clinical presentation, diagnostics, treatment, and survival outcomes were analyzed.</p><p><strong>Results: </strong>One patient refused the treatment and was lost to follow-up. Another one received operation alone. The other 11 patients underwent surgical resection when feasible and showed favorable responses to radiation. Two of them (16.7%) experienced local recurrence, and another two patients (16.7%) progressed to multiple myeloma (MM) within the first 2 years following the initial treatment. Tumor > 2.6 cm significantly affected the post-radiation prognosis.</p><p><strong>Conclusion: </strong>Although radiotherapy yields favorable immediate outcomes in our limited case series, a subset of cases progresses to MM within the initial 2 years. Despite all tumors being categorized as Stage I, tumor size may still influence prognosis.</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":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649890","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":"Cervical Lymph Nodes Metastasis From Non-head and Neck Primary Carcinomas: A Retrospective Analysis of 1448 Patients","authors":"Jin-Hui Rao,&nbsp;Cheng-Peng Zha,&nbsp;Wen-Da Zhang,&nbsp;Liu-Han Cheng,&nbsp;Qian Lei,&nbsp;Tao Xie,&nbsp;Wen Peng,&nbsp;Pei-Jing Ye,&nbsp;Min-Yue Zhang,&nbsp;Yu-Jie Xing,&nbsp;Chuan-Zheng Sun,&nbsp;Lei Li","doi":"10.1002/hed.28002","DOIUrl":"10.1002/hed.28002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the clinicopathological features of individuals who have cervical lymph node metastasis (CLNM) from non-head and neck primary carcinomas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data of 1448 patients diagnosed with CLNM from non-head and neck primary carcinomas at the Yunnan Cancer Hospital, Third Affiliated Hospital of Kunming Medical University, China, from January 2013 to December 2023 were collected. The patients' general information, imaging data, and pathological information were retrospectively analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 780 men and 668 women among the 1448 patients, for a male-to-female ratio of 1.17:1. The median age was 56 years (range 21–81 years). The most prevalent primary sites in males were the lung (<i>n</i> = 508, 65.1%) and, in females, the breast (<i>n</i> = 276, 41.3%). The most prevalent pathological kind (<i>n</i> = 949), or 65.5% of cases, was adenocarcinoma. There was a significant difference in the proportion of adenocarcinoma between males (<i>n</i> = 385, 49.4%) and females (<i>n</i> = 564, 84.4%). The common sites of CLNM from non-head and neck primary carcinomas were level V (1,236 cases, 85.4%). In a subgroup of 1133 patients with primary cancer located in symmetrical or unilateral organs, 60.3% exhibited ipsilateral lymph node metastasis, 27.6% had bilateral lymph node metastasis, and 12.1% showed contralateral lymph node metastasis exclusively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>For patients with CLNM, especially those with metastasis to cervical areas IV-V and those with adenocarcinoma pathology, it is particularly important to screen for primary foci in the lungs, breast, urogenital system, and digestive system after excluding head and neck primary cancers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":"47 1","pages":"400-409"},"PeriodicalIF":2.3,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632566","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":"Parameningeal Rhabdomyosarcoma: Results of the European Pediatric Soft Tissue Sarcoma Study Group RMS 2005 Study.","authors":"Reineke A Schoot, Pieter Taselaar, Giovanni Scarzello, Frederic Kolb, Beatrice Coppadoro, Simone Ter Horst, Henry Mandeville, Andrea Ferrari, Raquel Hladun, Sylvie Helfre, Sima Ferman, Anna Kelsey, Marinka L F Hol, Christine Devalck, Myriam Ben-Arush, Daniel Orbach, Julia Chisholm, Meriel Jenney, Veronique Minard-Colin, Gianni Bisogno, Johannes H M Merks","doi":"10.1002/hed.27994","DOIUrl":"https://doi.org/10.1002/hed.27994","url":null,"abstract":"<p><strong>Background: </strong>Parameningeal (PM) site is an unfavorable characteristic in rhabdomyosarcoma (RMS). We described the treatment and outcome for patients with PM RMS and investigated the prognostic value of risk factors. We scored PM site by originating site and by highest risk extension.</p><p><strong>Methods: </strong>Patients with PM RMS were treated within the European pediatric Soft tissue sarcoma Study Group (EpSSG) RMS 2005 study with risk-adapted, multi-modal treatment.</p><p><strong>Results: </strong>Three-hundred-eighty-one patients with PM RMS were included. Radiotherapy was administered in 359 patients (77 with surgery). After a median follow-up of 75 months, 5-year event-free survival was 60% (95% confidence interval (CI) 55%-65%), 5-year overall survival was 65% (95% CI 60%-70%).</p><p><strong>Conclusions: </strong>The outcome for patients with PM RMS has not improved in comparison to previous historical studies, despite the more rigorous application of radiotherapy (94% of patients). Signs of meningeal involvement, PM site, and age at diagnosis remained prognostic risk factors.</p><p><strong>Trial registration: </strong>EudraCT number 2005-000217-35.</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":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640346","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":"Initial Proof-of-Concept Study on Immediate Effects of External Advanced Pneumatic Compression on Pharyngeal and Laryngeal Internal Lymphedema Using a Fluoroscopic Measurement Tool.","authors":"Jessica W Gregor, Brent Chang, Nandita Keole, Alyssa McGary, Samir Patel","doi":"10.1002/hed.27983","DOIUrl":"https://doi.org/10.1002/hed.27983","url":null,"abstract":"<p><strong>Background: </strong>External and internal head and neck cancer related lymphedema (HNCRL) is a common consequence of radiation treatment (RT). Currently, internal HNCRL can be clinically assessed endoscopically using a visuoperceptual, ordinal rating scale. Use of fluoroscopy to identify and measure internal HNCRL has been explored but is not widely used in clinical practice. Advanced Pneumatic Compression (APC) has shown external HNCRL reduction after a single treatment, whereas internal HNCRL reduction has not yet been assessed.</p><p><strong>Methods: </strong>Fluoroscopic lateral scouts and TIMS Review software (TIMS Medical) were used to assess immediate internal HNCRL measures of 30 HNC patients with RT history following a single APC treatment. Pre and post external measures were also obtained. Paired t-test was used to assess changes in pre and post measures. A post-treatment survey was completed.</p><p><strong>Results: </strong>All 30 patients had both immediate external and internal HNCRL reductions, and all reductions were statistically significant. All reported positive benefit.</p><p><strong>Conclusions: </strong>A single, external APC treatment immediately impacted the extent of pharyngeal and laryngeal edema in post-radiated HNC survivors. Fluoroscopy can be a clinically useful and complementary modality to detect, surveil, and measure internal HNCRL.</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":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632580","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":"A Rare Case of Ewing Sarcoma of the Left Ethmoid Sinus With Orbital Extension.","authors":"Xiaoxuan Chen, Kiran Abraham-Aggarwal, David I Kutler","doi":"10.1002/hed.27993","DOIUrl":"https://doi.org/10.1002/hed.27993","url":null,"abstract":"<p><strong>Background: </strong>Ewing sarcoma (ES) of the ethmoid sinus with orbital involvement in an adult is very rare, with 16 reported cases in the literature. Immunohistochemical studies show small blue round cells positive for CD99 and fluorescence in situ hybridization (FISH) testing reveals positivity for the EWSR1 gene.</p><p><strong>Methods: </strong>A 38-year-old male with a diagnosis of ES of the ethmoid sinus presented with left-sided periorbital pain and edema, rhinorrhea, and proptosis. The patient underwent neoadjuvant chemotherapy, surgical resection of the left skull base, and postoperative proton radiotherapy.</p><p><strong>Results: </strong>The patient tolerated chemotherapy, surgical resection, and adjuvant proton radiotherapy well with resolution of proptosis, diplopia, and pain. Due to local recurrence, he is currently undergoing adjuvant chemotherapy.</p><p><strong>Conclusion: </strong>Our findings provide insight on the clinical presentation and appropriate management of extraosseous ES, specifically in the ethmoid sinus in the adult population.</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":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632444","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":"Self-Attention Mechanisms-Based Laryngoscopy Image Classification Technique for Laryngeal Cancer Detection.","authors":"Yi-Fan Kang, Lie Yang, Yi-Fan Hu, Kai Xu, Lan-Jun Cai, Bin-Bin Hu, Xiang Lu","doi":"10.1002/hed.27999","DOIUrl":"https://doi.org/10.1002/hed.27999","url":null,"abstract":"<p><strong>Background: </strong>The early diagnosis of laryngeal cancer (LCA) is crucial for prognosis, driving our search for an accurate, precise, and sensitive deep learning model to assist in LCA detection.</p><p><strong>Methods: </strong>We collected 5768 laryngoscopic images from 1462 patients and created the intelligent laryngeal cancer detection system (ILCDS) based on Swin-Transformer. Following training and validation, we assessed the ILCDS performance on the internal and external test sets and compared it with previous convolutional neural network (CNN) models and three professional laryngologists.</p><p><strong>Results: </strong>The ILCDS outperformed the six CNNs, with the highest accuracy of 92.78% and an area under the curve (AUC) of 0.9732. Despite a slight drop in performance on external sets, the ILCDS maintained the best superiority, with 85.79% accuracy and an AUC of 0.9550. Surpassing professional laryngologists, the ILCDS achieved 92.00% accuracy.</p><p><strong>Conclusions: </strong>The ILCDS offers high accuracy and stability for LCA detection, reducing the burden on laryngologists.</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":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632585","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}