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

{"title":"Lipoblastoma-Like Tumor of the Tongue With IDH1 Mutation: A Case Report and Literature Review.","authors":"Dongpo Li, Guangqi Li, Ye Wang, Hailei Shi, Shuangyi Wang, Xiaohong Zhan","doi":"10.1002/hed.28104","DOIUrl":"https://doi.org/10.1002/hed.28104","url":null,"abstract":"<p><strong>Background: </strong>Lipoblastoma-like tumors (LLTs) are uncommon lipogenic neoplasms that predominantly occur in the vulva of female individuals. This study presents a novel case of LLT located on the tongue with an IDH1 mutation. Both the site of occurrence and molecular alterations are reported for the first time.</p><p><strong>Case presentation: </strong>A 65-year-old female patient presented to the hospital 1 month ago with an incidental finding of a multinodular mass at the right lingual margin. We performed an incision along the outer edge of the mass and completely excised it 0.5 cm beyond its periphery. The final pathological diagnosis after routine examination confirmed a lipoblastoma-like tumor. Furthermore, Next-generation sequencing revealed the presence of mutations in IDH1.</p><p><strong>Conclusions: </strong>This study presents the first documented case of LLT, thereby expanding its anatomical site of tongue and confirming the presence of a significant IDH1 mutation, thus enhancing our understanding of the molecular alterations in LLT.</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":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384149","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":"Medial-to-Lateral Approach in Neck Dissection","authors":"Keigo Honda,&nbsp;Koichi Omori,&nbsp;Atsushi Suehiro,&nbsp;Yo Kishimoto,&nbsp;Tsuyoshi Kojima,&nbsp;Kiyomi Hamaguchi,&nbsp;Yoshitaka Kawai,&nbsp;Shintaro Fujimura,&nbsp;Ken Iwanaga,&nbsp;Yuji Kitada","doi":"10.1002/hed.28105","DOIUrl":"10.1002/hed.28105","url":null,"abstract":"<p>This video introduces a medial-to-lateral neck dissection technique in the management of head and neck cancer, emphasizing the importance of the middle layer of the deep cervical fascia as a key surgical landmark. The technique involves systematic dissection from superficial lymphatic tissue (Paddle 1) to deeper structures (Paddles 2 and 3), offering better visualization and preservation of functionally important structures, such as the cervical nerves. This approach enhances surgical precision, minimizes nerve damage, and optimizes lymphatic tissue removal.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":"47 4","pages":"1306-1310"},"PeriodicalIF":2.3,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hed.28105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transoral Surgery Versus Radiotherapy as Primary Treatment for HPV-Related Oropharyngeal Cancer in the Elderly.","authors":"Andrea Costantino, Bruce Haughey, Jianbin Zhu, Uthman Alamoudi, J Scott Magnuson","doi":"10.1002/hed.28097","DOIUrl":"https://doi.org/10.1002/hed.28097","url":null,"abstract":"<p><strong>Background: </strong>This study compares the oncological outcomes of primary transoral surgery (TOS) and primary radiotherapy (RT) in elderly patients with HPV-related oropharyngeal squamous cell carcinoma (OPSCC).</p><p><strong>Methods: </strong>This retrospective cohort study included patients with cT1-2 HPV-related OPSCC from the National Cancer Database (NCDB).</p><p><strong>Results: </strong>A total of 2566 patients were included, with 73.9% receiving primary RT and 22.3% undergoing primary TOS. Subgroup analysis showed a higher 5-year overall survival (OS) rate for primary TOS (81.6%; 95% CI: 79.6%-83.6%) compared to primary RT (70.7%; 95% CI: 68.3%-73.1%), with an adjusted hazard ratio (HR) of 0.64 (95% CI: 0.50-0.81; p < 0.001) after propensity score matching. Notably, only (13.6%) of patients diagnosed in 2020 underwent primary TOS, with a significant decline over the study period.</p><p><strong>Conclusions: </strong>This study suggests that primary TOS may offer better survival outcomes for elderly patients with HPV-related OPSCC compared to primary RT.</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":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366816","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":"Prognostic Factors for Free Flap Failure in Head and Neck Reconstruction.","authors":"Quentin Hennocq, Jean-Baptiste Caruhel, Mourad Benassarou, Jebrane Bouaoud, André Chaine, Angélique Girod, Nicolas Graillon, Sylvie Testelin, Mélika Amor-Sahli, Jean-Philippe Foy, Chloé Bertolus","doi":"10.1002/hed.28095","DOIUrl":"https://doi.org/10.1002/hed.28095","url":null,"abstract":"<p><strong>Background: </strong>The failure rate of free flaps varies from 0.8% to 10.6% in the literature in head and neck reconstruction. The primary objective was to identify prognostic factors for free flap failure.</p><p><strong>Methods: </strong>We prospectively included all consecutive free flaps performed between August 2021 and January 2024, and used a multivariate Cox proportional hazard model.</p><p><strong>Results: </strong>We included 307 free flaps, performed on 274 patients. Age, cardiovascular risk, radiotherapy history, type of flap, type of arterial anastomosis, and ischemia duration were not statistically linked to the risk of flap failure. In multivariate analysis, a venous anastomosis to the anterior jugular vein or to the superior thyroid vein were associated with an increased risk of flap failure, such as per- or postoperative revision of the anastomoses.</p><p><strong>Conclusions: </strong>The choice of venous anastomosis, appear to have a greater influence on the success or failure of a microvascularized transfer than patient characteristics.</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":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257184","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":"Resectable Sinonasal Mucosal Melanoma in the Immunotherapy Era: Upfront Surgery vs. Neoadjuvant Therapy.","authors":"Aya F Salem, Melissa M Chen, Michelle D Williams, David M Swanson, Jennifer L McQuade, Rodabe N Amaria, Ehab Y Hanna, Andrew J Bishop, Ahsan S Farooqi, B Ashleigh Guadagnolo, Shirley Y Su, Devarati Mitra","doi":"10.1002/hed.28098","DOIUrl":"https://doi.org/10.1002/hed.28098","url":null,"abstract":"<p><strong>Objective: </strong>We aim to evaluate outcomes for patients with resectable SNMM treated in the immunotherapy era.</p><p><strong>Methods: </strong>Thirty-seven patients with resectable SNM were identified using our institutional database between 2016 and 2023.</p><p><strong>Results: </strong>Patients receiving neoadjuvant Ipi/Nivo (46%, n = 17) were more likely to have disease involving the sinuses and/or the skull base (71% vs. 35%, p = 0.05). The overall response rate to Ipi/Nivo was 24%. Two-year LRFS from the start of therapy was 63%, and from the end of local therapy was 78%. Two-year PFS was 49%. The patients who received Ipi/Nivo with evidence of response (n = 4, 24%) had better PFS (2-year PFS 100% vs. 15%, p = 0.02) and LRFS (2-year LRFS 100% vs. 31%, p = 0.08).</p><p><strong>Conclusions: </strong>Outcomes for resectable SNMM patients continue to be poor in the immunotherapy era. In the context of selection bias, neoadjuvant Ipi/Nivo was not associated with better outcomes in all-comers. However, those with evidence of response to Ipi/Nivo had better 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":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191180","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":"Laryngeal Squamous Cell Carcinoma Incidence and Survival Trends in the United States: A Population-Based Analysis of Two Decades.","authors":"Neel R Sangal, Katherine Xu, Praneet Kaki, Steven Cannady, Robert M Brody","doi":"10.1002/hed.28077","DOIUrl":"https://doi.org/10.1002/hed.28077","url":null,"abstract":"<p><strong>Importance: </strong>Laryngeal cancer has undergone a complex evolution in incidence, management, and standards of care over the past 20 years. Disease-wide demographic and survival risk factors have yet to be elucidated.</p><p><strong>Objective: </strong>Examine incidence, management, and survival trends in laryngeal cancer from 2000 to 2019.</p><p><strong>Design, setting, and participants: </strong>The Surveillance, Epidemiology, and End Results database was utilized to identify age-adjusted incidence rates (AAIRs) of laryngeal squamous cell carcinoma (LSCCa) from 2000 to 2019. Joinpoint regression was conducted to identify annual percentage changes (APCs). Chi-squared analysis was used to find changes in demographic, clinicopathologic, and treatment changes over the study period. Finally, univariate Kaplan-Meier and COX multivariate regressions were conducted to identify survival differences.</p><p><strong>Results: </strong>There were 46 266 cases of LSCCa identified between 2000 and 2019 with AAIR of 2.7 per 100 000 person-years with APC of -2.6% [95% CI: -2.8% to 2.4%]. These rates have largely been down-trending among demographic substratifications. Age at initial diagnosis has been increasing (64.6 → 66.0, p < 0.001). Higher median household income was associated with lower AAIR (35 000 5.3; > $75 000 2.2) and increased annual percentage decrease (< $35 000, -1.1%*; > $75 000, -3.2%*). There were no other clinically significant differences in demographic and clinicopathologic trends although persistent demographic differences were noted. Late T-stage at diagnosis has increased over the study period (T3, 18% → 23%, p < 0.001). Treatment with primary chemoradiotherapy has increased significantly (20.0% → 27.0%, p < 0.001). On univariate analysis, there were no significant differences in survival; however, on multivariate analysis, there has been a progressive improvement in disease-specific and overall survival over 5-year bins. Late-stage disease had a progressive improvement in survival with each treatment period on both univariate and multivariate analysis.</p><p><strong>Conclusions and relevance: </strong>There has been a progressively significant decrease in age-adjusted incidence of LSCCa with increased utilization of primary chemoradiotherapy. When adjusted for associated characteristics, there has been a continuing improvement in survival over the study period, primarily in late-stage disease.</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":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076416","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":"Risk Stratification for Trial Enrichment Considering Loco-Regional Failure in Head and Neck Cancer: UICC8 Versus Purpose-Built Failure-Type Specific Risk Prediction Model.","authors":"Katrin Håkansson, Daha Hassan Muse, Anna Bäck, Jacob H Rasmussen, Anne Marie Lindegaard, Lena Specht, Jeppe Friborg, Hedda Haugen Cange, Ivan R Vogelius","doi":"10.1002/hed.28085","DOIUrl":"https://doi.org/10.1002/hed.28085","url":null,"abstract":"<p><strong>Background: </strong>A previously published failure-type specific risk model showed good performance in the original cohort.</p><p><strong>Aim: </strong>to validate the model and separate patients with high- and low-risk loco-regional failure (LRF).</p><p><strong>Goal: </strong>to identify patients potentially suitable for treatment intensification trials.</p><p><strong>Methods: </strong>Validation data: 756 patients from two institutions (different countries). Predictive performance was evaluated by Brier scores and AUCs. Discriminatory performance was compared to Union for International Cancer Control (UICC) staging (versions 7 and 8).</p><p><strong>Results: </strong>The model's 3-year AUC for LRF was 65%, significantly better than UICC7 staging, but no significant difference to UICC8. Model-based risk stratification and UICC8 both identified high-risk patient groups with 3-year LRF ≈30%. The population mean was 18%.</p><p><strong>Conclusions: </strong>The model performed well on a group level. UICC8 staging performed equally well. Although developed for the endpoint of OS, an improvement from UICC version 7 to version 8 was evident also for the prediction of LRF.</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":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076477","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":"The Role of Adjuvant Radiotherapy for Early-Stage Oral Cavity Cancer With Minor Adverse Features; A Single Institute Experience.","authors":"Eyal Yosefof, Nofar Edri, Noga Kurman, Gideon Bachar, Thomas Shpitzer, Aviram Mizrachi, Aron Popovtzer","doi":"10.1002/hed.28093","DOIUrl":"https://doi.org/10.1002/hed.28093","url":null,"abstract":"<p><strong>Background: </strong>The role of post-operative radiotherapy (PORT) in early-stage (T1-T2N0M0) oral tongue squamous cell carcinoma (OTSCC) with minor adverse features (MAF) including perineural invasion (PNI) and poorly differentiated carcinoma (PDC) is not well described. We aimed to study the role of PORT among these patients.</p><p><strong>Methods: </strong>A retrospective review of patients treated for early-stage OTSCC between 2000 and 2022 in a tertiary-care referral center while comparing patients treated by surgery and PORT with patients treated by surgery alone.</p><p><strong>Results: </strong>One hundred fifty-four patients were included and 36 (23.4%) received PORT. The PORT subgroup had a significantly higher rate of MAF. Survival rates were similar between the two sub-groups. PORT demonstrated a trend toward improved overall survival (odds ratio = 0.406, p = 0.07). Patients with PNI or PDC treated with PORT experienced improved survival rates.</p><p><strong>Conclusion: </strong>PORT has an important role when treating early-stage OTSCC with MAF. It should be considered especially among patients with PNI or PDC.</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":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076480","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":"Clinicopathological Significance of Extranodal Extension in Hypopharyngeal and Laryngeal Squamous Cell Carcinoma.","authors":"Natsumi Kijima, Yui Uzawa, Yuri Hirai, Yusuke Nojima, Jun Aoyama, Hideaki Takahashi, Yasuhiro Arai, Daisuke Sano, Goshi Nishimura, Nobuhiko Oridate, Satoshi Fujii","doi":"10.1002/hed.28090","DOIUrl":"https://doi.org/10.1002/hed.28090","url":null,"abstract":"<p><strong>Background: </strong>The AJCC cutoff value of 2 mm for the extranodal extension (ENE) distance was determined from an analysis of patients with or without adjuvant therapy. The purpose of this study was to find out the ENE distance that reflects prognosis only in patients with head and neck squamous cell carcinoma (SCC) who received adjuvant therapy.</p><p><strong>Methods: </strong>The ENE distance was defined for 109 patients who underwent surgery for SCC of larynx or hypopharynx as a primary tumor.</p><p><strong>Results: </strong>To standardize patient conditions, only 26 patients who received additional postoperative treatment were analyzed. Receiver operating characteristic analysis of the ENE distance for overall survival (OS) and recurrence-free survival (RFS) yielded a cutoff value of 4250 μm. Multivariate analysis showed that the ENE distance was an independent poor prognostic factor for OS and RFS.</p><p><strong>Conclusion: </strong>The optimal ENE distance cutoff for OS and RFS in postoperatively treated patients was 4250 μm.</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":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076435","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 Pilot Trial of Tongue Reconstruction Using the Chimeric Innervated Vastus Lateralis Muscle and Antero-Lateral Thigh Free Flap.","authors":"Emma Charters, Jessica Boehm, Anita Macdonald D'Silva, Raymond Wu, Simon A Mueller, Tsu-Hui Hubert Low, Jonathan R Clark, James Wykes","doi":"10.1002/hed.28087","DOIUrl":"https://doi.org/10.1002/hed.28087","url":null,"abstract":"<p><strong>Background: </strong>Subtotal and total glossectomies for advanced tongue cancer result in significant speech- and swallow-related morbidity, impairing quality of life. This prospective pilot study compares the safety and functional outcomes associated with using a chimeric innervated muscle and fasciocutaneous flap for soft tissue reconstruction.</p><p><strong>Materials and methods: </strong>A prospective, non-randomized controlled pilot study evaluated a standardized technique for tongue reconstruction using a chimeric innervated vastus lateralis muscle and anterolateral thigh fasciocutaneous flap. Inclusion criteria were ≥ 50% resection of the oral tongue. Participants were followed longitudinally, with measures recorded at baseline, 6-8 weeks, 6 months, and 12 months after surgery. The primary endpoints were post-operative complications, time to radiotherapy, operative time, and locoregional failure, videofluoroscopy swallow studies (dynamic imaging grade of swallowing toxicity (DIGEST), penetration and aspiration score, performance status scale for head and neck). Secondary endpoints were patient-rated outcomes.</p><p><strong>Results: </strong>Eighteen participants were recruited (10 intervention: 8 controls). Fourteen (78%) experienced complications, only one of which was related to the innervated flap. DIGEST scores deteriorated post-operatively across all participants but did not differ significantly between the intervention and control groups (p = 0.4) at any point post-surgery, despite more extensive resections in the intervention group. Those in the intervention group had better patient-rated intelligibility (p = 0.04). Multimodality treatment was associated with worse speech (p = 0.03) and normalcy of diet (p = 0.02). Less extensive resections were associated with better scores in eating in public (p = 0.005), tongue range of movement (p = 0.0008), intelligibility (p = 0.006), and diet (p = 0.001).</p><p><strong>Conclusions: </strong>The innervated vastus lateralis and antero-lateral thigh free-flap technique is safe and improves speech intelligibility for patients with subtotal and total glossectomy defects. However, the technique requires refinement to optimize functional and quality-of-life 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":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061563","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}