Laryngeal Cancer Research Articles

Demographic Characteristics of Locally Advanced Laryngeal Cancer with Concurrent Chemo Radiotherapy along with Weekly Paclitaxel versus Weekly Cisplatin in Rajshahi Medical College

Modern multi-modality approaches using definitive concurrent chemoradiation has shown promising results in the treatment of locally advanced laryngeal cancer with intact cartilage and functional larynx. The aim of this study to estimate demographic Characteristics of Locally Advanced Laryngeal Cancer with Concurrent Chemo Radiotherapy along with Weekly Paclitaxel versus Weekly Cisplatin. This quasi-experimental study was conducted at the Department of Radiotherapy, Rajshahi Medical College Hospital, from January 2021 – June 2022 following ethical approval. Total 60 patients with locally advanced squamous cell carcinoma of larynx were included and divided into Arm-A (n=30) and Arm-B (n=30). After taking informed written consent, patients were given injection paclitaxel 30mg/m2 (Arm-A) or injection cisplatin 40mg/m2 (Arm-B) along with radiotherapy 66Gy in 33 fractions over 6.5 weeks. In this study, mean age of all study patients was 56.03±8.88 (SD) years with male predominance (88.3%). Demographic characteristics were similar across the two arms regarding age, gender, and tobacco history (p>0.05). Treatment response was evaluated at 6, 12 and 24 weeks after the completion of treatment. In Arm- A 80.00% showed complete response whereas in Arm- B showed 70.00%. Partial response was 20.00% and 30.00% in Arm-A and Arm-B respectively. Both Arm-A and Arm-B had similar rate of treatment response at each follow up (p>0.05).

Racial Disparities in 30 Day Outcomes Following Total Laryngectomy.

Despite the growing literature on racial disparities in the utilization of total laryngectomy (TL), and survival following the treatment of laryngeal cancers, there is a paucity of research in TL cohorts evaluating disparities in the immediate postoperative setting. In a national multi-institutional cohort, TL cases between 2010 and 2021 were identified using relevant Current Procedural Terminology (CPT) codes. Logistic regression analyses investigated the association between race/ethnicity and adverse outcomes within 30 days postoperatively. This study consisted of 1493 patients who underwent TL with or without radical neck dissection. Black patients underwent free flap and pedicled flap reconstruction more frequently than their counterparts (P = .023) and exhibited a 1.532 times higher odds of surgical complications (P < .001). There are increased rates of surgical complications in Black patients undergoing TL. Given the limited oncologic and socioeconomic variables available through National Surgical Quality Improvement Program, future study of disparate postoperative outcomes in this population is recommended.

The Association of TP53, BCL2, BAX and NOXA SNPs and Laryngeal Squamous Cell Carcinoma Development.

Head and neck cancer is the seventh leading cancer diagnosis worldwide. One of the most common cancers in the head and neck region is laryngeal cancer. In past years, the incidence of laryngeal squamous cell carcinoma has risen by 23%, and despite progress in treatment modalities, the survival rate has not changed. It is well known that genetic alterations may contribute to individuals' susceptibility to cancer. Research of genetic alterations, such as single nucleotide polymorphisms, is essential to understanding carcinogenesis and susceptibility of laryngeal squamous cell carcinoma. A total of 200 LSCC patients and 200 controls were included in this retrospective case-control study; both groups were matched by age and sex. In the present study, we analyzed six SNPs in genes essential for apoptosis regulation: TP53 (rs9895829, rs17884306), BCL2 (rs1564483, rs4987855), BAX (rs704243), NOXA (PMAIP1) (rs1041978, rs78800940). We evaluated their associations with the risk of LSCC development, its pathomorphological manifestation, and patients' overall survival rate. Genotyping was carried out using RT-PCR. The AG genotype of rs9895829 was more prevalent in controls than in cancer patients, leading to lower susceptibility to LSCC (OR = 0.301; 95%CI 0.096-0.940; p = 0.039). None of the analyzed SNPs showed an association with pathomorphological features of LSCC, but NOXA rs1041978 T allele carriers were found to be diagnosed with LSCC at an older age (OR = 1.962; 95%CI 1.072-3.592; p = 0.031). There was no statistically significant association between investigated SNPs and patient OS. The present study indicates that the AG genotype of rs9895829 provides a protective effect against LSCC development.

MiR-525-5p modulates cell proliferation, cell cycle, and apoptosis in Burkitt's lymphoma by targeting MyD88 and regulating the NF-κB signaling pathway.

MiR-525-5p functions as an oncomiRNA or tumor suppressor, and has been reported in various cancer types, including laryngeal squamous cell carcinoma, glioma, breast cancer, and cervical cancer. However, the biological functions and precise mechanisms of miR-525-5p remain unclarified in Burkitt's lymphoma (BL). This study aimed to explore the roles of miR-525-5p in BL, with the goal of ascertaining its regulatory effects on the nuclear factor-kappaB (NF-κB) signaling pathway by targeting Myeloid differentiation factor 88 (MyD88). The expression levels of miR-525-5p and MyD88 were measured by quantitative real-time PCR and immunohistochemical staining, respectively. The effects of miR-525-5p overexpression on BL cell proliferation, colony-forming, and migration were evaluated by cell counting kit-8, soft agar colony-forming, and transwell assays, while cell cycle and cell apoptosis were analyzed by flow cytometry. Possible interactions between miR-525-5p and MyD88 was examined via luciferase reporter assay. The expression of MyD88 and NF-κB signaling pathway-related proteins, including p65, p-p65, IκBa, and p-ΙκBa was determined by western blotting. BL cells overexpressing miR-525-5p were treated with phorbol 12-myristate 13-acetate (PMA), and Hoechst 33258 staining and Calcein AM/EthD-I staining were used to analyze the changes in chemotherapy sensitivity of BL cells to doxorubicin (DOX). Compared with reactive lymphoid hyperplasia, miR-525-5p was dramatically downregulated in BL tissues, while the rate of MyD88 protein positivity was significantly increased. Upregulation of miR-525-5p suppressed cell proliferation, colony-forming, and migration, induced cell cycle arrest and apoptosis, and enhanced the chemosensitivity to DOX in BL cells. MiR-525-5p targeted MyD88 to inhibit the activation of NF-κB signaling pathway. PMA treatment reactivated the NF-κB pathway and reversed apoptosis mediated by miR-525-5p overexpression. These findings revealed that miR-525-5p acts as a tumor suppressor, targeting MyD88 to modulate proliferation, cell cycle progression, and apoptosis in BL cells by regulation of NF-κB signaling pathway.

Long-term trends and future projections of larynx cancer burden in China: a comprehensive analysis from 1990 to 2030 using GBD data

Larynx cancer poses a significant public health challenge in China, with rising incidence and mortality rates over the past decades. Understanding the long-term trends and underlying factors is crucial for effective intervention and policy formulation. Data were utilized from the global burden of disease (GBD) Study 2021 to analyze the incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) due to larynx cancer in China from 1990 to 2021. Joinpoint regression analysis identified key changes in trends, while age-period-cohort (APC) analysis and decomposition analysis quantified the contributions of aging, epidemiological changes, and population growth to these trends. Our study found a significant increase in the incidence and prevalence of larynx cancer in China, particularly among males. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for males were substantially higher than those for females. Decomposition analysis revealed that aging was the primary driver of increasing incidence and mortality rates, while epidemiological changes had a mitigating effect. Joinpoint analysis identified periods of rapid urbanization and economic growth as key turning points for increased incidence. Bayesian APC models projected a continued upward trend in incidence rates up to 2030. The rising burden of larynx cancer in China underscores the need for targeted public health interventions, including smoking cessation programs, environmental pollution control, and early detection strategies. Addressing gender disparities and implementing effective prevention measures are crucial to mitigating the impact of larynx cancer in China.

Prophylactic Swallowing Exercises in Patients with Laryngeal Cancer Who Underwent Total Laryngectomy-A Randomized Trial.

This study aims to determine the efficacy of prophylactic swallowing exercises on swallowing function in patients undergoing total laryngectomy for laryngeal cancer. The design was a randomized controlled trial set in one tertiary care academic medical center. A total of 92 patients undergoing total laryngectomy for stages III and IV laryngeal cancer performed five targeted swallowing exercises for a period of three months after their surgery, starting two weeks after the surgery. Weekly swallowing therapy sessions were held with the patients in order to encourage adherence and proper technique. The controls received no preventive exercise and were referred for swallowing treatment following the surgery, as well as radiation therapy if necessary. The Functional Oral Intake Scale (FOIS) and the Performance Status Scale for Head and Neck Cancer Patients (PSS-H&N) were used to measure swallowing function at the baseline, one week following the surgery, and three, six, nine, and twelve months following the surgery. Right after the surgery, there were no statistically significant variations between the intervention and control groups in the FOIS scores (p value = 0.64), the Eating in Public subscale scores (p value = 1) and Normalcy of Diet subscale scores (p = 0.33) of the PSS-H&N. The scores were significantly better among the intervention patients at months 3, 6, 9, and 12 for all the scores, with p values smaller than 0.000. Although not immediately following the surgery, the patients who engaged in prophylactic swallowing exercises showed improvements in their ability to swallow at 3, 6, 9, and 12 months following their procedure.

Laryngeal Disease Classification using Voice Data: Octave-band vs. Mel-Frequency Filters

IntroductionLaryngeal cancer diagnosis relies on specialist examinations, but non-invasive methods using voice data are emerging with artificial intelligence (AI) advancements. Mel Frequency Cepstral Coefficients (MFCCs) are widely used for voice analysis, but Octave Frequency Spectrum Energy (OFSE) may offer better accuracy in detecting subtle voice changes. Problem StatementAccurate early diagnosis of laryngeal cancer through voice data is challenging with current methods like MFCC. ObjectivesThis study compares the effectiveness of MFCC and OFSE in classifying voice data into healthy, laryngeal cancer, benign mucosal disease, and vocal fold paralysis categories. MethodsVoice samples from 363 patients were analyzed using CNN models, employing MFCC and OFSE with 1/3 octave band filters. Grad-Class Activation Mapping (Grad-CAM) was used to visualize key voice features. ResultsOFSE with 1/3 octave band filters outperformed MFCC in classification accuracy, especially in multi-class classification including laryngeal cancer, benign mucosal disease, and vocal fold paralysis groups (0.9398 ± 0.0232 vs. 0.7061 ± 0.0561). Grad-CAM analysis revealed that OFSE with 1/3 octave band filters effectively distinguished laryngeal cancer from healthy voices by focusing on increased noise in the over-formant area and changes in the fundamental frequency. The analysis also highlighted that specific narrow frequency areas, particularly in vocal fold paralysis, were critical for classification, and benign mucosal diseases occasionally resembled healthy voices, making AI differentiation between benign conditions and laryngeal cancer a significant challenge. ConclusionOFSE with 1/3 octave band filters provides superior accuracy in diagnosing laryngeal diseases including laryngeal cancer, showing potential for non-invasive, AI-driven early detection.

The Influence of the Microbiome on the Complications of Radiotherapy and Its Effectiveness in Patients with Laryngeal Cancer.

Radiotherapy is an effective method of treating cancer and affects 50% of patients. Intensity-modulated radiotherapy (IMRT) is a modernized method of classical radiation used in the treatment of laryngeal cancer. Treatment with intent to preserve the larynx is not always safe or complication-free. The microbiome may significantly influence the effectiveness of oncological treatment, especially radiotherapy, and may also be modified by the toxic response to radiation. The aim of the study was to prospectively assess the microbiome and its influence on radiotherapy toxicity in patients with laryngeal cancer. Statistically significant risk factors for complications after radiotherapy were the percentage of Porphyromonas of at least 6.7%, the percentage of Fusobacterium of at least 2.6% and the percentage of Catonella of at least 2.6%. The importance of the microbiome in oncology has been confirmed in many studies. Effective radiotherapy treatment and the prevention of radiation-induced oral mucositis is a challenge in oncology. The microbiome may be an important part of personalized cancer treatment. The assessment of the microbiome of patients diagnosed with cancer may provide the opportunity to predict the response to treatment and its effectiveness. The influence of the microbiome may be important in predicting the risk group for radiotherapy treatment failure. The possibility of modifying the microbiome may become a goal to improve the prognosis of patients with laryngeal cancer. Fusobacterium, Porphyromonas and Catonella are important risk factors for radiation-induced oral mucositis in patients with laryngeal cancer.

Berberine inhibits the malignant cell phenotype by inactivating PI3K/AKT/mTOR signaling in laryngeal squamous cell carcinoma.

Berberine is an active compound found in different herbs used in Chinese medicine and is well-known for its potential anticancer properties. The study aimed to figure out the role of berberine in regulating the malignant behavior of laryngeal squamous cell carcinoma (LSCC) cells. LSCC cell lines (SNU-899 and AMC-HN-8) were treated with different concentrations of berberine (0-200 μM) to determine its cytotoxicity. The migration, invasion, and apoptosis of LSCC cells were measured by wound healing assays, Transwell assays, and flow cytometry. Western blot was performed for the quantification of proteins involved in PI3K/AKT/mTOR signaling. The viability of LSCC cells was dose-dependently reduced by berberine. Berberine dampened LSCC cell migration and invasion while augmenting cell apoptosis, as evidenced by a reduced wound closure rate, a decrease in invaded cell number, and a surge in cell apoptosis in the context of berberine stimulation. Importantly, the effects of berberine on the cancer cell process were enhanced by LY294002 (an inhibitor for PI3K) treatment. Moreover, the protein levels of phosphorylated PI3K, AKT, and mTOR were markedly reduced in response to berberine treatment. Berberine inhibits cell viability, migration, and invasion but augments cell apoptosis by inactivating PI3K/AKT/mTOR signaling in LSCC.

The Prognostic Significance of Tumor Budding and Cell Nest Size in Laryngeal Squamous Cell Carcinoma.

Laryngeal squamous cell carcinoma (LSCC) is a commonly occurring malignancy in the head and neck region. However, due to the heterogeneity of primary tumor sites, tumor behavior, and molecular mechanisms, there is currently no consensus on the accuracy of clinicopathological prognostic factors for individual cases. Tumor histopathologic behavior remains a crucial factor in predicting aggressiveness. Recent studies have shown that peritumoral tumor budding (TB) combined with cell nest size (CNS) is a reliable marker for predicting lymph node metastasis, advanced cancer prognosis, and therapeutic response in SCCs of different origins. This study aims to investigate the relationship between TB and CNS in the context of nodal metastasis and overall prognosis in patients diagnosed with LSCC. Our objective is to establish the significance of TB and CNS status as a cost-effective, easily assessed, and highly reliable prognostic factor among this patient population. In this retrospective cross-sectional study, we analyzed 128 LSCC cases that underwent total laryngectomy at Amir Alam Hospital. We evaluated TB and CNS based on the Boxberg etal. Our study demonstrated a significant correlation between TB, and nodal involvement (p = 0.015), vascular invasion (p = 0.035), and mortality rate (p = 0.001), as well as a significant statistical correlation between high TB and extra-laryngeal extension (p = 0.006), clinical stage (p = 0.011), and mortality rate (p = 0.001). Moreover, small nest size was also associated with the clinical stage (p = 0.047), extra-laryngeal extension (p = 0.015), and mortality rate (p < 0.001). Based on our results, TB, CNS, and clinical stage are independent prognostic factors for mortality rate and are correlated with disease-specific survival. Given the effect of TB and CNS on the overall prognosis and survival of patients with LSCC, evaluating these two factors on routine H&E microscopic examination of LSCC specimens is recommended to facilitate individualized risk assessment and treatment planning.

Indian clinical practice consensus guidelines for the management of locoregional laryngeal cancer - Update 2023

ABSTRACT Laryngeal cancer typically presents at a nonmetastatic stage, and the majority of patients are treated with curative intent. Due to the functional and cosmetic morbidities associated with surgical approaches, nonsurgical modalities are increasingly favored. This update to the guidelines emphasizes a multidisciplinary approach tailored to the Indian healthcare context, enhancing treatment strategies and optimizing patient outcomes. Key recommendations include the use of concurrent chemoradiotherapy and induction chemotherapy regimens, with a focus on organ preservation whenever feasible.

The Diagnostic And Prognostic Role Of Immunohistochemistry In Head &amp; Neck Tumours Along With Radiological &amp; Histopathological Study

Background: Head &amp; neck tumors are defined as benign, premalignant &amp; malignant tumors above the clavicles, except the tumors of brain, spinal cord and esophagus. This includes tumors of paranasal sinus, nasal cavity, salivary glands, thyroid and upper aerodigestive tract, lymph nodes of neck, skin &amp; its appendages, soft tissue tumors, midline carcinomas &amp; metastatic tumors. Ultrasonography, computed tomography, magnetic resonance imaging were the modalities for initial evaluation. Histopathology was the GOLD standard for diagnosis followed by IHC for confirmation because correct diagnosis &amp; cancer subtyping of the neoplasia is essential for successful therapy and prognosis. Materials &amp; Methods: Study was conducted for 2 years with 100 specimens of head &amp; neck tumors. Thorough Radiological investigation was done followed by Histopathological examination including biopsy &amp; whole resected specimens. IHC markers appropriate to the histopathological diagnosis was done. Results: Among 100 patients of head &amp; neck tumors, most belonged to 5th decade with male: female ratio of 2.3:1. Squamous cell carcinoma (66%) followed by Lymphoma(11%), tumors of salivary glands(8%), metastatic lymphadenopathy(7%) were the lesions present. SCC was most common carcinoma in oral cavity, larynx, nasopharynx and ear with positive p63 marker. 1 case of Basal cell carcinoma with positive BerEP4 &amp; in NHL, salivary gland tumors &amp; Metastatic lymphadenopathy panel of IHC were included for confirmation. Conclusion: Immunohistochemistry has a diagnostic &amp; prognostic role in Head &amp; Neck tumors along with Radiological &amp; histopathological examination.

XCT as a Predictor for Survival in a Population-Based Cohort of Head and Neck Squamous Cell Carcinoma.

xCT, also known as SLC7A11 (solute carrier Family 7 Member 11), is a cystine/glutamate antiporter protein that mediates regulated cell death and antioxidant defense. The aim of this study was to investigate the effect of xCT on the outcome of patients diagnosed with new head and neck squamous cell carcinoma (HNSCC). This retrospective cohort study utilized a population-based dataset, comprising all patients (n = 1033) diagnosed with new HNSCC during 2005-2015 in a population of 697,000 people. All patients (n = 585) with a tumor tissue sample available for immunohistochemical (IHC) staining were included. The follow-up rates were 97% and 81% at 3 and 5 years, respectively. Also, the specificity of the anti-xCT antibody was validated. The expression level and prognostic significance of xCT were strongly dependent on tumor location. In oropharyngeal squamous cell carcinoma (OPSCC) patients, xCT expression was a significant prognostic factor for 5-year overall survival (OAS) (HR: 2.71; 95% CI 1.67-4.39; p < 0.001), disease-specific survival (DSS) (HR: 2.58; 95% CI 1.47-4.54; p = 0.001), and disease-free survival (DFS) (HR: 2.69; 95% CI 1.55-4.64; p < 0.001). Five-year survival rates for OPSCC patients with high and low levels of xCT were OAS 34% versus 62%; DSS 51% versus 73%; DFS 43% versus 73%, respectively. According to a multivariate model adjusted for age, T-class, nodal positivity, and tobacco consumption, xCT was an independent prognostic factor for 3-year survival, in which it outperformed p16 IHC. Similar associations were not observed in squamous cell carcinomas of oral cavity or larynx. Regarding treatment modalities, xCT was most predictive in HNSCC patients who received radiotherapy. High xCT expression was associated with poor prognosis in OPSCC. Our findings suggest that joint analysis of xCT and p16 may add significant value in OPSCC treatment stratification.

Ten-Year Outcome After Supracricoid Partial Laryngectomy in cT3M0 Laryngeal Squamous Cell Carcinoma-A STROBE Analysis.

The aim of this study was to document 10-year outcomes after supracricoid partial laryngectomy (SCPL) in selected cT3M0 laryngeal squamous cell carcinoma (SCC) patients. This real-life retrospective observational study analyzed an inception cohort of 168 patients with isolated, untreated, selected cT3M0 laryngeal SCC, that were consecutively managed by SCPL during the period 1973-2013, and followed up until death or for a minimum of 10 years in 92% of cases at a single French academic and tertiary referral care center. Prior induction chemotherapy, arytenoid cartilage removal, level II-IV neck dissection, and postoperative radiation therapy were performed on 148, 77, 136, and 27 patients, respectively. The main objective was to determine 10-year actuarial local control and laryngeal preservation estimates. Secondary objectives included 10-year actuarial survival and cause-of-death analysis, and assessment of correlations between endpoints and clinical variables. The significance threshold was set at p < 0.005. Ten-year actuarial local control, laryngeal preservation, and survival estimates were 90%, 85%, and 52%, respectively. Salvage treatment resulted in an overall 99% local control rate. Metachronous second primary cancer, intercurrent disease without evidence of SCC, SCPL-related death, and uncontrolled local recurrence accounted for 31%, 26%, 7%, and 2% of causes of death. On univariate analysis, overall local recurrence and laryngeal preservation rates varied significantly, from 5% to 54% and 90% to 46% when resection margins were R0 and R1, respectively. The present study highlighted successful 10-year outcomes after SCPL, providing further evidence in favor of its integration into the conservative armamentarium for endolaryngeal cT3 SCC. 4 Laryngoscope, 134:4557-4563, 2024.

Tissue-Engineered Implant for Hemilaryngectomy Reconstruction with Recurrent Laryngeal Nerve Injury.

Laryngeal cancer resections often require excision of portions of the larynx along with sacrifice of the ipsilateral recurrent laryngeal nerve (RLN). In such cases, there are no reconstructive options that reliably restore laryngeal function, rendering patients with severe functional impairment. To address this unmet clinical need, we extend our evaluation of a 3-implant mucosal, muscle, cartilage reconstruction approach aimed at promoting functional laryngeal restoration in a porcine hemilaryngectomy model with ipsilateral RLN transection. Six Yucatan mini-pigs underwent full-thickness hemilaryngectomies with RLN transection followed by transmural reconstruction using fabricated collagen polymeric mucosal, muscle, and cartilage replacements. To determine the effect of adding therapeutic cell populations, subsets of animals received collagen muscle implants containing motor-endplate-expressing muscle progenitor cells (MEEs) and/or collagen cartilage implants containing adipose stem cell (ASC)-derived chondrocyte-like cells. Acoustic vocalization and laryngeal electromyography (L-EMG) provided functional assessments and histopathological analysis with immunostaining was used to characterize the tissue response. Five of six animals survived the 4-week postoperative period with weight gain, airway maintenance, and audible phonation. No tracheostomy or feeding tube was required. Gross and histological assessments of all animals revealed implant integration and regenerative remodeling of airway mucosa epithelium, muscle, and cartilage in the absence of a material-mediated foreign body reaction or biodegradation. Early voice and L-EMG data were suggestive of positive functional outcomes. Laryngeal reconstruction with collagen polymeric mucosa, muscle, and cartilage replacements may provide effective restoration of function after hemilaryngectomy with RLN transection. Future preclinical studies should focus on long-term functional outcomes. NA Laryngoscope, 134:4604-4613, 2024.

Impact of Multiprofessional Radiotherapy Peer Review on Multidisciplinary Team Meeting Staging in Head and Neck Cancer

BackgroundCancer staging is routinely done in a multidisciplinary team meeting (MDM). There is however no established quality assurance (QA) for MDM-recorded cancer staging. Conversely, radiotherapy peer review is a recommended QA process. This study aimed to compare the cancer staging of the multiprofessional radiotherapy peer review (with radiologists) against the referring MDMs. MethodsAll head and neck intensity-modulated radiotherapy (IMRT) cases discussed in peer review between May 2023 to April 2024 were prospectively evaluated. Any radiological disease progression (PD) on IMRT-planning scan since the diagnostic scans, and patients’ cancer staging, were prospectively recorded. These were compared with the MDM-recorded outcomes data. ResultsA total of 235 IMRT cases were peer-reviewed: 166 definitive, 63 post-operative and 6 palliative. Of the analysable definitive cases, 44/150 (29%) were found to have PD, with mean interval from diagnostic to IMRT-planning scan of 51 days (Standard Deviation SD=25), compared to 38 days (SD=21) in the cohort without PD (p<0.01). After exclusion of 28 patients with the most advanced non-metastatic stage, 35 (30%) were upstaged with mean interval from diagnostic to IMRT-planning of 49 days (SD=26), compared to 39 days (SD=23) in the cohort without upstage (p=0.05). Twenty (57%) upstaged patients had evidence of PD, while the other 15 (43%) were upstaged despite absence of PD. Two MDM-recorded T3-category larynx cancers were subsequently recommended for a primary laryngectomy due to T4a-category at peer review, and both were proven T4a pathologically. Three upstaged patients were recommended concomitant chemotherapy. The peer review recommended IMRT volume changes to 156 (66%) patients. ConclusionsDiscrepancies in MDM-staging can occur, and a protracted diagnosis and treatment pathway too can affect final cancer staging. Routine radiologist input in peer review can provide crucial post-MDM outcome assurance, and the recommended clinical management.

Evaluation of UCA1/miR-138/CDK6 Network in the Patients with Laryngeal Squamous Cell Carcinoma

Objective: Noncoding RNAs (ncRNAs) have the potential to be diagnostic and therapeutic targets, in many cancer types. miRNA ‐ mRNA ceRNA (competing endogenous RNA) network in cancer has been an interesting topic that has been studied in recent years. We aimed to investigate the relationship of UCA1/miR-138/CDK6 network with laryngeal squamous cell carcinoma (LSCC). Material and Methods: We studied with the cancerous tissue and as the control; neighboring normal tissue samples of the patients with diagnosis of LSCC. UCA1, miR-138 and CDK6 expression analysis was made by quantitative real-time PCR (qRT-PCR) method after RNA isolation of the samples. Results: Expressions of cancerous tissue samples and normal adjacent tissue samples as controls were compared. CDK6 and UCA1 levels were increased and miR-138 levels were found to be decreased in cancer tissues but not statistically significant. Conclusions: To the best of our knowledge there is no study to provide an expression profile of the UCA1/CDK6/miR-138 network for LSCC patients. Although we could not obtain statistically significant results, our results were similar with the UCA1, miR‐138, and CDK6 axis literature. Further studies with larger patient samples and LSCC cell lines may confirm the function of this axis, which might be a diagnostic and therapeutic target for LSCC.

Contribution of Imagery in Larynx Cancer: About 61 Cases

Extensional imaging of laryngeal tumors relies on multi-bar helical CT scans. This examination requires compliance with a few simple rules in its preparation and performance. The protocol for performing cervico-mediastinal CT scans will be developed. Imaging must take into account not only the initial tumor pathology, but also the entire upper aero-digestive tract and lymph node areas, i.e. acquisition must extend from the base of the skull to the cervico-mediastinal orifice. Thoracic imaging should be performed as a matter of course for overall patient management. Certain deep extensions, only accessible by imaging, are decisive in the choice of treatment: surgery or radio-chemotherapy. In the case of surgery, imaging is a key factor in the choice of total or partial surgery. A complete lymph node survey is also essential in the management of these lymphophilic tumors.

Passive smoking and risk of head and neck cancer: a systematic review and meta-analysis.

Studies on the association between passive smoking and head and neck cancer (HNC) are controversial. This meta-analysis aimed to explore this association. A systematic search of the PubMed, Embase, Web of Science, and Cochrane Library databases was conducted up to July 2024 to identify relevant studies. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using the DerSimonian-Laird random-effects model. Heterogeneity among studies was assessed, and the risk of bias was evaluated. A total of 1036 records were identified, of which 17 studies were included. Passive smoking was significantly associated with an increased risk of HNC overall (OR = 1.70, 95% CI: 1.27-2.28, P < 0.001). The association was particularly strong for oral cancer (OR = 1.85, 95% CI: 1.07-3.17, P = 0.026), oropharyngeal cancer (OR = 2.78, 95% CI: 1.29-5.98, P = 0.009), laryngeal cancer (OR = 1.60, 95% CI: 1.24-2.06, P < 0.001), and hypopharyngeal cancer (OR = 2.60, 95% CI: 1.45-4.66, P = 0.001). No significant association was observed for nasopharyngeal carcinoma (OR = 1.14, 95% CI: 0.78-1.66, P = 0.498). Geographically, the risk was elevated among both Asian and European populations. Passive smoking is associated with an increased risk of HNC, particularly for subtypes such as oral, oropharyngeal, laryngeal, and hypopharyngeal cancers. These findings underscore the importance of mitigating exposure to passive smoking as a public health measure.

Usefulness of Upfront Neck Dissection Before Chemoradiation Therapy for Head and Neck Squamous Cell Carcinoma.

Locally advanced squamous cell carcinoma of the head and neck (L/A SCCHN) is typically treated with surgery or chemoradiation therapy (CRT), whereas salvage surgery is considered for residual disease post-CRT. However, salvage surgery after radiation therapy presents challenges due to tissue fibrosis. Planned neck dissection (ND) combined with CRT, as well as positron emission tomography after CRT, have been proposed strategies, but no definitive consensus has been reached. Therefore, this study aimed to investigate the utility of "upfront ND" performed prior to CRT to enhance local control and reduce complications. We retrospectively reviewed 121 patients who underwent primary CRT for oropharyngeal, hypopharyngeal, or laryngeal cancer at Tokyo Medical University Hospital from January 2015 to September 2021. Patients without cervical lymph node metastasis or with unresectable nodes were excluded. All patients underwent pre-treatment imaging and staging. CRT consisted of intensity-modulated radiation therapy (IMRT) and cisplatin-based chemotherapy. Selective ND or modified radical neck dissection was performed based on lymph node involvement. Overall, 35 patients underwent upfront ND, whereas 54 did not. The upfront ND group exhibited significantly better 2-year locoregional recurrence-free survival than the group without upfront ND (93.7% vs. 71.0%). No significant differences were noted in adverse events between groups. The findings highlight upfront ND before CRT as a viable option for locally advanced head and neck cancer, particularly beneficial in cases with extranodal extension. This approach enhances local control and may reduce the need for salvage surgery, thus improving patient outcomes.