Pharyngeal Cancer Research Articles

Prevalence of smoking in the students of English medium private schools in Tripura, India

Introduction: Globally, smoking related diseases kill an estimated four million people every year. This number is predicted to rise to a staggering 10 million a year over the next two decades. Smoking leads, indeed, to a higher risk of cardiovascular disease, lung disorders as well as several malignancies, including lung, throat, stomach, and bladder cancers. Early identifying smokers in this group and the associated determinants of smoking behavior can help reduce or stop cigarette consumption. The Objective of this study is to find out prevalence of smoking among adolescents aged 13 to 18 years studying in class 9th to 11th in English medium private schools in Tripura, India. Materials and methods: A cross sectional descriptive study was carried out during November- December 2021 in faith based English medium private schools of Udaipur and Bishramganj subdivision of Tripura, India. A total of 565 students aged 13 to 18 years participated in this study from four schools. Results: The number of students participating from class 9th, 10th and 11th standard were 375 (66.4%), 85 (15%) and 105 (18.6%) respectively. The overall prevalence of ever smoker was 24.7% (95% CI 21.3 to 28.4%) among adolescents. The prevalence of ever smokers in male (38.6%) adolescents was more than female (7.7%) and differences between the male and female adolescents were significantly different (p value <0.05). Conclusion: Around one-fourth of the students studying in class 9th, 10th and 11th standard were ever smoked cigarettes or chewing guthka or pan masala.

Primary tracheobronchial necrosis after esophagectomy: A nationwide multicenter retrospective study in Japan.

The clinical features of postoperative primary tracheobronchial necrosis (P-TBN; the necrosis without anastomotic leakage or other cervical and mediastinal abscess) remains unclear. This nationwide multicenter retrospective study first investigated the clinical features of P-TBN after esophagectomy for upper aerodigestive tract cancer with a large cohort. As a study of the Japan Broncho-Esophagological Society, a nationwide questionnaire survey was conducted in 67 institutions. The clinical data of 6370 patients who underwent esophagectomy for laryngeal, pharyngeal, and esophageal cancer between 2010 and 2019 were collected. Grades of P-TBN were defined as follows: Grade 1, mucosal necrosis; Grade 2, transmural bronchial wall necrosis without fistula or perforation; Grade 3, transmural bronchial wall necrosis with fistula or perforation. P-TBN was observed in 48 (0.75%) of 6370 patients. The incidences of P-TBN for pharyngo-laryngo-cervical esophagectomy (PLCE; n=1650), total pharyngo-laryngo-esophagectomy (TPLE; n=205), and subtotal esophagectomy (SE; n=4515) were 2.0%, 5.4%, and 0.1%, respectively. The upper mediastinal LN dissection (P=0.016) and the higher level of the tracheal resection (P=0.039) were significantly associated with a higher grade of necrosis in PLCE and TPLE. Overall survival rates were significantly lower in patients with Grade 2 (P=0.009) and Grade 3 (P=0.004) than in those with Grade 1. The incidence of TBN restricted to P-TBN was lower than previously reported. Maintaining the tracheal blood flow is essential to prevent worsening P-TBN, especially in PLCE and TPLE. Our new P-TBN severity grade may predict the outcome of patients with P-TBN.

Stark differences in cancer epidemiological data between GLOBOCAN and GBD: Emphasis on oral cancer and wider implications.

SummaryBackgroundGLOBOCAN 2020 and Global Burden of Disease (GBD) 2019 are the two most established global online cancer databases. It is important to examine the differences between the two platforms, to attempt to explain these differences, and to appraise the quality of the data. There are stark differences for lip and oral cancers (LOC) and we attempt to explain these by detailed analysis of ten countries at the extremes of differences.MethodsAge-standardised incidence rates (ASIR) of LOC were obtained from GLOBOCAN 2020 and GBD 2019. Five countries with the greatest and smallest fold differences were selected. A systematic search of PubMed and Embase electronic databases was then performed to identify publications reporting the incidence of LOC in the selected countries between 2015 and 2022. Specifically, data sources of the articles were examined and evaluated.FindingsFor LOC, greatest differences were found in Papua New Guinea, Vietnam, China, Pakistan, and Indonesia (group A). In contrast, the United States of America (USA), Brazil, France, Germany, and India (group B) had the least differences between the two databases.InterpretationIt is not surprising that when GLOBOCAN and GBD could not obtain high-quality or accessible LOC data from national or local cancer registries, as in group A, discrepancies would be seen between the two online databases. In contrast, where only minor differences were seen between GLOBOCAN and GBD, as in group B, presumptively due to those countries having well-established cancer registries and healthcare administrative systems, the literature is more consistent. Moreover, many studies have grouped lip and oral cavity with pharynx and categorised outputs as “oral and oropharyngeal cancer” or “oral cavity and pharynx cancer”. Those categorisations lacked subsite accuracy and failed to realise that oral cancer and oropharyngeal cancer have completely different etiological factors, pathogeneses, prognosis, and treatment outcomes.FundingThis research received no specific grant or funding from any funding agency in the public, commercial, or not-for-profit sectors, and the authors received no financial support for the research, authorship, and/or publication of this article.

Association of the Affordable Care Act Medicaid expansion and receipt of palliative care among individuals newly diagnosed with advanced stage cancers.

73 Background: Receipt of palliative care is a guideline-based practice but is low among patients with advanced cancer is low in the U.S. Lack of insurance is a major barrier to accessing palliative care. It is unknown, however, whether Medicaid expansion under the Affordable Care Act (ACA) and the associated increase in insurance coverage among individuals diagnosed with cancer has led to increased palliative care. We use a nationwide dataset to examine the association between Medicaid expansion and receipt of palliative care among individuals newly diagnosed with advanced stage cancers. Methods: Individuals aged 18-64 years with newly diagnosed stage-IV solid cancers pre- (2010-2013) and post- (2014-2019) ACA Medicaid expansion were identified from the National Cancer Database. We used difference-in-differences (DD) analyses to estimate the association between Medicaid expansion and changes in receipt of palliative care as part of first-line therapy, adjusting for age group, sex, race/ethnicity, area-level poverty, metropolitan status, comorbidity, facility type, palliative care specialist availability, diagnosis year and state of residence. Stratified analyses were conducted by cancer type and sociodemographic factors. Results: A total of 685,781 individuals diagnosed with stage IV cancers were included from Medicaid expansion (N = 439,142) and non-expansion (N = 246,639) states. The percentage of eligible patients who received palliative care as part of first-line therapy increased from 17.0% pre-ACA to 18.9% post-ACA in Medicaid expansion states and from 15.7% to 16.7% in non-expansion states, resulting in a net increase (DD) of 1.4 (95%CI = 1.0-1.8) percentage points in expansion states after adjusting for sociodemographic and clinical factors. The increase in receipt of palliative care in expansion states compared to non-expansion states was greater for patients with advanced pancreatic (DD = 2.5; 95%CI = 0.8-4.3), colorectal (DD = 2.2; 95%CI = 1.1-3.3), female breast (DD = 1.9; 95%CI = 0.1-3.7), lung (DD = 1.6; 95%CI = 0.7-2.5), oral cavity and pharynx (DD = 1.1;95%CI = 0.5-1.6) cancers, and non-Hodgkin lymphoma (DD = 0.9; 95%CI = 0.2-1.5). The improvement in receipt of palliative care was larger among individuals aged 55-64 years, non-Hispanic White patients, and patients residing in middle-income areas and nonmetropolitan areas. Conclusions: Among individuals newly diagnosed with stage-IV cancer, Medicaid expansion was associated with increases in receipt of palliative care, although overall use was low. Furthermore, the increase varied by cancer type and sociodemographic factors. Improving access to insurance can facilitate access to guideline-based palliative care.

Effect of Maitake D-fraction in advanced laryngeal and pharyngeal cancers during concurrent chemoradiotherapy: A randomized clinical trial.

Concurrent chemo-radiotherapy (CCRT) is an ideal treatment for advanced head and neck squamous cell carcinoma (HNSCC). The performance of CCRT induces severe toxicities in HNSCC patients and decreases the quality of life (QOL). Maitake D-Fraction is proteoglycan which has anti-tumor function associated with its immunomodulatory capacity. The polysaccharides of Maitake also have anti-radiation effect in radiation therapy during cancer treatment. This research aimed to illustrate Maitake D-Fraction effects on CCRT-associated adverse events and QOL. During CCRT, Maitake capsules were taken orally 3 times a day, each time 4 capsules, one hour before meals. QOL were analyzed by EORTC QLQ-C30-Chinese version and EORTC QLQ-HandN-35-Chinese version. 141 patients were recruited and divided into an intervention group and a placebo group. Frequencies of severe CCRT-associated adverse events in intervention group were less than in placebo group. Global QOL score in intervention group was higher than in placebo group 5 weeks post treatment. The proportion of patients returning to baseline global QOL score at 6-month was increased by Maitake D-Fraction administration. In conclusion, this randomized clinical trial demonstrated that in advanced laryngeal and pharyngeal cancer patients, the oral administration of Maitake D-Fraction alleviated CCRT-related adverse events and deterioration in QOL.

Trends in lip, oral cavity, and pharyngeal cancer mortality in the United States, 1999–2019

Changes in the epidemiology of lip, oral cavity, and pharyngeal (LOCP) cancers have been reported in the United States. This study aimed to examine recent trends in LOCP cancer mortality in the United States from 1999 to 2019. National mortality data were extracted from CDC WONDER, 1999-2019. International Classification of Diseases Codes, 10th Revision-C00-C14, were used to identify decedents of malignant neoplasms of the lip, oral cavity, and pharynx. LOCP cancer mortality trends were assessed by fitting a Joinpoint regression model overall, and by race/ethnicity, sex, age, and US Census Region. Annual Percentage Changes (APC) were derived to estimate variations in mortality trends over time. The age-adjusted mortality rate (AAMR) for LOCP cancers was 2.5 per 100 000 (95% CI: 2.5-2.5), equivalent to 180 532 deaths during 1999-2019. Overall mortality trends have stabilized since 2009 (APC=0.3; 95% CI: -0.1, 0.7), but an examination by subtype revealed rising mortality trends from cancers of the lip and oral cavity (APC=1.2; 95% CI: 0.7, 1.6) and pharynx (APC=3.2; 95% CI: 1.7, 4.8), and declining trends in malignancies of other and ill-defined areas of the lip, oral cavity, and pharynx (APC=-2.7; 95% CI: -3.4, -2.0). Trend variations were also noted by sex, age, US Census Region, and race/ethnicity. There are differential trends in mortality from LOCP cancers in the United States. Investigating the biological, individual, and contextual factors related to LOCP cancers would guide effective public health intervention efforts.

Attributable fraction of tobacco smoking on selected cancer deaths in the past decade using mortality case-control study in Tianjin, China.

INTRODUCTIONThis study aims to estimate the impact of smoking-attributable mortality of selected cancers, in the period 2010–2019 in Tianjin, China.METHODSA case-control study was conducted to assess the smoking-attributed major causes of cancer deaths. Unmatched multiple logistic regression was used to calculate mortality risk ratios.RESULTSSmoking-attributable cancer deaths were 23709 (28.87%) among adult males and 8648 (13.37%) among adult females in the period 2010–2019 in Tianjin, China. Lung cancer remains the largest cause of smoking-attributable deaths; among men, the death rates were 49.06% of lung cancers, 27.55% of mouth, pharynx, larynx, or esophagus cancers, 13.56% of kidney and other urinary cancers, and 10.11% of liver cancers; among women the corresponding death rates were 31.56% of lung cancers and 10.59% of the mouth, pharynx, larynx, or esophagus cancer, 10.56% of bladder cancers. Smoking-attributed cancer deaths in men increased from 1817 in 2010 to 2695 in 2019; for women, the number remained stable at just over 800 per year during the past decade.CONCLUSIONSAt least one in three cancer deaths in men and one in six in women would be potentially preventable through appropriate control of tobacco smoking in Tianjin, China. Effective control programs against tobacco smoking should be further implemented.

Perfil epidemiológico de la salud bucodental de estudiantes de la FES Iztacala

Introducción: La Organización Mundial para la Salud (OMS) afirma que la caries dental, la enfermedad periodontal y el cáncer oral y faríngeo se consideran los mayores problemas globales que afectan la salud bucal en países industrializados y en las comunidades más pobres de los países en desarrollo. El incremento de enfermedades bucales indica la necesidad de un acercamiento integral a la promoción de la salud bucal. Objetivo: Determinar el estado de salud bucodental y necesidades de tratamiento de estudiantes de la carrera de Cirujano Dentista de la FES Iztacala, UNAM. Material y métodos: Estudio no experimental, comparativo y transversal sobre el total de la generación 2005-1. Se utilizó la Encuesta de Salud Bucodental (OMS). Resultados: 536 sujetos, con edades entre 17 y 44 años (media 19.15); 30% hombres y 70% mujeres. La mayoría presentó tejidos extraorales y mucosa sanos. La caries se presentó en 98.6% de sujetos. El CPO fue de 2.28, con valor mínimo de 0 y máximo de 6.25. Se encontraron diferencias significativas por sexo en el CPO, número de dientes sanos, obturados y perdidos, en favor de los hombres. Conclusiones: Se observa disminución del CPO, sin embargo la mayoría presenta dientes con caries y un incremento en la prevalencia de fluorosis dental y maloclusiones en relación a las encuestas anteriores.

Detection Ability of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography for Clinical T Classification of Synchronous Esophageal Cancer in Pharyngeal Cancer.

The utility of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) for clinical T classification of synchronous esophageal cancer (SEC) in pharyngeal cancer has not been fully elucidated. We investigated the association between 18F-FDG-PET/CT and clinical T classification for SEC. We retrospectively enrolled 90 patients with pharyngeal cancer having both Lugol chromoendoscopy and 18F-FDG-PET/CT at pretreatment. The association between 18F-FDG-PET/CT and pathological examination was compared by the Fisher's exact test. Pathologically, 12 patients with SEC were diagnosed. The number of locations for SEC with cT1a, cT1b, and cT3 was 20, 1, and 1, respectively. Sensitivity for cT1a-cT3, cT1b-cT3, and cT3 was 9.1%, 100%, and 100%, respectively. Locations of SEC with cT1b-cT3 were significantly detected. The locations of SEC with cT1b-cT3 were more frequently detected than those without cT1b-cT3 by 18F-FDG-PET/CT (p<0.01). Detection of SEC with clinical T1b-T3 in comparison to clinical T1a on pretreatment 18F-FDG-PET/CT for patients with pharyngeal cancer, was achieved with high sensitivity.

Predicting Pathologic Lymph Node Positivity in cN0 Pharynx and Larynx Cancers.

Elective neck dissection is a standard of care for pharynx and most larynx cancer patients undergoing surgery, based largely on historical series. It is unclear if this is necessary for all patients in the modern era. Patients with cN0 oropharynx, larynx, and hypopharynx cancers diagnosed from 2010-2015 undergoing primary surgery were identified in the National Cancer Data Base. Inclusion criteria were met by 4117 cN0 patients. The presence of lymphovascular invasion (LVI) was the strongest independent predictor of pN+ (odds ratio [OR]=4.19, 95% confidence interval [CI] 3.56-4.93, p < 0.001). Histologic grade strongly predicted pN+ (OR 2.58, 95% CI 1.88-3.59, p < 0.001). A nomogram predicted less than 10% of cN0 patients had pN+ risk <15%. LVI and grade are the strongest predictors of pN+ among patients with cN0 pharynx and larynx cancer. Even in the modern era, pN+ rates warrant neck dissection for cN0 patients. 3 Laryngoscope, 2022.

Distinct sociodemographic differences in incidence and survival rates for human papillomavirus (HPV)-like, non-HPV-like, and "other"-like oral cavity and pharynx cancers: An analysis of Surveillance, Epidemiology and End Results (SEER) Program data.

PurposeOral cavity and pharynx cancer (OCPC) cases are traditionally dichotomized into human papillomavirus (HPV) and non-HPV types. Using a proxy for HPV status, the objective was to evaluate differences in incidence and survival rates of OCPC anatomic sub-sites identified as: 1) HPV-like; 2) non-HPV-like (i.e., tobacco/alcohol-related); and 3) “other”-like (i.e., not predominantly HPV-like nor tobacco/alcohol-like) OCPCs.MethodsData from the Surveillance, Epidemiology and End Results Program were used to examine incidence and survival rates for OCPC categories over time and according to age, sex, race, ethnicity, stage at diagnosis, neighborhood socioeconomic status (i.e., nSES or Yost Index), and rurality/urbanity (i.e., Rural Urban Commuting Area (RUCA) codes). Although HPV status was unavailable in this dataset, OCPC anatomies and histologies were classified into three sub-categories, based on potential risk factors. Frequencies, average annual, age-adjusted incidence rates, five-year relative survival rates, and 95% confidence intervals were examined across and within OCPC categories.ResultsHPV-like OCPC incidence rates sharply increased from 1975 through 2015 while non-HPV-like and “other”-like OCPC rates decreased, all converging to similar rates from 2016 through 2018. Increasing over time for both categories, survival was highest for HPV-like and lowest for non-HPV-like OCPCs; survival for “other”-like OCPCs remained stable. Generally, across OCPC categories, incidence and survival rates were significantly higher among males vs. females, Whites vs. African Americans, and non-Hispanics vs. Hispanics. “Other”-like OCPC incidence decreased with increasing nSES tertiles, while no nSES differences were observed for HPV-like and non-HPV-like OCPCs. Incidence rates were significantly lower among urban (vs. rural) residents. For all OCPC categories, survival rates were significantly higher with increasing nSES and variable across RUCA categories.Conclusion/ImpactHPV-like and non-HPV-like OCPC cases had distinct sociodemographic differences; “other”-like OCPC cases were a sociodemographic blend of HPV-like and non-HPV-like OCPC cases, resembling more of the sociodemographic makeup of non-HPV-like OCPC cases. To prevent new OCPCs, additional studies are needed to epidemiologically and clinically differentiate between OCPC categories so that high-risk groups can be better targeted in future public health interventions.

The In Vitro Impact of Two Scaffold-Type Structure Dental Ceramics on the Viability, Morphology, and Cellular Migration of Pharyngeal Cancer Cells

There is a growing trend with respect to the use of ceramic materials in dental practice. With an increase in the number of cases of head and neck cancer, the use of dental implants in these patients is subject to controversy. Consequently, the purpose of the present study was to evaluate the impact of two ceramic materials on the viability, proliferation, migration, and structure of the cytoskeleton and nuclei of pharyngeal cancer cells. Therefore, samples of the two ceramic were immersed in artificial saliva with three different pH values in order to better simulate the natural biological environment. A 21-day immersion period was followed by testing of the saliva on pharyngeal cancer cell line Detroit-562 for its viability, morphology, and migration, as well as its effects on the nucleus and cytoskeleton. The results of the study after stimulation of Detroit-562 cells for 72 h with the three types of artificial saliva in which the ceramic materials were immersed indicated the following: (i) viability of cells did not change significantly, with the percentage of viable cells not falling below 90%; (ii) no morphological changes were recorded, with the shape and number of cells being similar to that of the control cells; (iii) the scratch assay method indicated that the two types of ceramics do not stimulate cell migration; and (iv) fluorescence immunocytochemistry revealed that both the nucleus and the cytoskeleton distributions were unaltered, as they were observed in unstimulated cells. The preliminary results of the study indicate that the investigated ceramic materials did not interact unfavorably with tumor cells when immersed in artificial saliva, thereby supporting the possibility of their safe use in cancer patients.

The Evolving Epidemiology of Oral Cavity and Oropharyngeal Cancers.

In 1988, Blot and colleagues reported results from a U.S. case-control study of oral cavity or pharyngeal (oropharyngeal and hypopharyngeal) cancers, with results showing independent associations of smoking and alcohol with increased risk, multiplicative interaction effects between smoking and alcohol, and that nearly three-quarters of these cancers are attributable to smoking and alcohol. The report by Blot and colleagues represents a landmark in oropharyngeal cancer epidemiology. This study, the largest at the time, introduced several novel concepts in oropharyngeal cancer epidemiology that remain relevant today-etiologic heterogeneity, statistical interaction effects, adjusted attributable fractions, and disparities by sex and race/ethnicity. Perhaps the most significant recognition in the field since 1988 is the etiologic association of human papillomavirus (HPV, primarily HPV16) with cancers arising in the oropharynx. Today, more than 80% of oropharyngeal cancers in the United States are caused by HPV while only approximately 3% of oral cavity cancers are caused by HPV. This etiologic heterogeneity across head and cancer subsites revealed by HPV is manifest at the genetic/genomic, epidemiologic, and clinical levels. Tobacco and alcohol remain the major etiologic factors for oral cavity cancers while HPV is the major cause of oropharyngeal cancers. Thus, tobacco and alcohol control and prophylactic HPV vaccination remain the most promising prevention tools for oral cavity and oropharyngeal cancers at this time. Importantly, the ever-emerging alternative tobacco products, such as smokeless tobacco/snus, hookah and water pipes, e-cigarettes, flavored cigars and cigarillos, and oral dissolvable products, represent a key public health concern and the carcinogenic effects of these products remains an active area of investigation. See related article by Blot and colleagues, Cancer Res 1988;48:3282-7.

Oligometastatic Head and Neck Cancer: Challenges and Perspectives.

Simple SummaryOligometastasis represents a disease state and an opportunity for cure when metastases emerge. Emerging evidence supports that most head and neck cancer patients with oligometastatic disease are likely to benefit from curative intent local ablative therapy if appropriate selection criteria are applied. Biomarkers to predict development of oligometastasis, as well as to identify which patients could benefit from a radical intent approach, are under investigation. This review summarizes recent knowledge about the characteristics, investigational efforts, and evidence for local ablation regarding oligometastasis in head and neck cancer. We also describe the challenges and opportunities in patient selection and discuss the role of radiotherapy and immunotherapy combinations to enhance anti-tumor immunity.A minority of patients with metastatic head and neck squamous cell carcinoma (HNSCC) present with oligometastatic disease. Oligometastasis not only reflects a disease state, but might also present an opportunity for cure in the metastatic setting. Radical ablation of all oligometastatic sites may confer prolonged survival and possibly achieve cure in some patients. However, substantial debate remains about whether patients with oligometastatic disease could benefit from curative intent therapy or whether aggressive treatments expose some patients to futile toxicity. Optimal selection of patients, carefully balancing the currently known prognostic factors against the risks of toxicity is critical. Emerging evidence suggests that patients with a limited burden of disease, viral-related pharyngeal cancer, metachronous metastasis and lung-only metastasis may benefit most from this approach. Efforts are underway to identify biomarkers that can detect oligometastasis and better select patients who would derive the maximum benefit from an aggressive radical approach. The combination of radiotherapy and immunotherapy promises to enhance the anti-tumoral immune response and help overcome resistance. However, optimization of management algorithms, including patient selection, radiation dose and sequencing, will be critical in upcoming clinical trials. This review summarizes recent knowledge about the characteristics and investigational efforts regarding oligometastasis in HNSCC.

INVESTIGATION OF CIRCULAR RNAs AS BIOMARKERS IN HEAD AND NECK CANCER CELLS AND THE EFFECTS OF RADIOTHERAPY ON CIRCULAR RNAs

Objective: The head and neck squamous cell carcinoma (HNSCC) is the sixth most common type of cancer worldwide and the 5-year survival rate of patients is by 40-50 %. Radiotherapy is one of the important treatments for HNSCC. circRNAs, which are much more stabil than other RNAs because of their circular structure, have the potential to be a biomarker for all types of cancer. Therefore, the alterations of circRNAs expression in HNSCC cells and after irradiation was investigated. Methods: Pharyngeal cancer (Detroit-562) and healthy fibroblast (WI-38) cell lines were used. After appropriate irradiation dose for Detroit-562 cells was determined by colony formation assay, Detroit-562 cells were irradiated with 4 grays. The expression levels of 122 circRNA molecules in all groups were examined by RT-qPCR. The results were evaluated using CircNet and TCGA platforms. Results: In this study, 60 circRNAs were not expressed in any cell line, whereas 62 were found to be expressed in at least one of the groups, including irradiated Detroit-562, Detroit-562, and WI-38 cell lines. Among them, seven circRNAs were detected in all groups and expressed higher in Detroit-562 than two groups. Interestingly, these circRNAs were significantly decreased in irradiated group, exhibiting similar expression levels with healthy group. Bioinformatics analyses showed that the host genes of these circRNAs was also higher expressed in HNSCC tissue. Conclusions: Differential expression of circRNAs in cancers and changes with treatment revealed that they could be potential diagnostic and monitoring biomarkers in cancer. However, further studies need in this regard.

Trends in hospitalization and death rates among patients with head and neck cancer in Spain, 2009 to 2019

ABSTRACT Background Head and neck squamous cell carcinoma (HNSCC) is the seventh most common cancer worldwide, and prevalence is still substantially higher in men than in women. Causative factors include smoking and alcohol use, while human papillomavirus (HPV) infection is causally related to a subset of oropharyngeal cancers. In this retrospective study, we aimed to provide estimates on the clinical and economic burden of HNSCC in Spain. Methods We used the discharge reports from the Spanish Minimum Basic Data Set (MBDS), to retrospectively analyze hospital discharge data in individuals with a diagnosis of HNSCC in any diagnostic position, based on the ICD coding system (ICD-9-CM and ICD10 CM), from 2009 to 2019. Results A total of 175,340 admissions and 14,498 deaths due to laryngeal, pharyngeal and oral cavity cancer were recorded in Spain, of which 85% occurred in men. The most prevalent diagnoses were laryngeal cancer in men (50.9%) and oral cavity cancer in women (49.1%). In general, the hospitalization and death rates for all major head and neck cancer sites decreased in men and increased or remained stable in women during the study period. However, the corresponding rates for tonsil cancer, strongly associated with HPV infection, increased significantly in men. Overall, the economic burden of HNSCC during the study period was estimated at 100 million euros per year on average. Conclusion HNSCC still places an important clinical and economic burden on the health system in Spain. Prevention strategies should be prioritized, and vaccination programs against HPV in both sexes should be reinforced.

Sexual Behavior and the Awareness Level of Common Risk Factors for the Development of Cervical, Anogenital and Oropharyngeal Cancer among Women Subjected to HR HPV DNA-Testing.

The human papillomavirus (HPV) is a significant health problem that increases the risk of developing precancerous lesions, cancer of the anogenital area, as well as mouth and throat cancers. The aim of the study was to analyze the awareness level of common risk factors and the preferred sexual behavior of women aged 18–68, who underwent a molecular evaluation of common HR-HPV from material collected from the cervix. The study was conducted at the Jan Kochanowski University in Kielce, Collegium Medicum, in the period from December 2019 to August 2020 on a group of 201 women. A diagnostic survey and the HR-HPV molecular test were used in the research. All of the obtained samples were subjected to identification of and testing for the presence of HR-HPV by the Cobas 4800 platform (Roche Diagnostic©, Basel, Switzerland). We presented the statistically significant relationships between the age of the respondents and the awareness of the impact. The women aged over 43 years old presented the widest spectrum of information concerning HPV-related lesions. Conclusion: Our study highlights the necessity of educating women about the prevention of sexually transmitted infections.

Comparative Analysis of the Quality of Life in the Pretreatment of Head and Neck Cancer Patients According to Tumor Site.

Introduction Head and neck cancer (HNC) and its treatment can cause physical, psychological, and quality of life (QoL) damage, because it can disturb the physiology of eating, breathing, speaking, and compromise self-image. Objective To evaluate the QoL of the pretreatment of patients diagnosed with head and neck cancer according to the anatomical location of the tumor. Methods A descriptive, cross-sectional study was performed on a sample of 144 patients undergoing pretreatment for cancer from February 2017 to July 2019. The University of Washington QoL Questionnaire (version 4) was used to assess the QoL. The anatomical location data were obtained from medical records. The ANOVA test was used to compare the differences in QoL according to tumor location. Results A total of 144 participants were included, 66 (45.5%) of whom had the primary tumor located in the mouth. The median age of the patients was 62 years, with a higher prevalence of male (75.7%), Black (78.5%), single/divorced/widowed people (59%), and illiterates (32.6%); most of them were smokers (84.7%) and alcohol drinkers (79.2%). The mean QoL score was 830 for mouth cancer, 858 for pharynx cancer, and 891 for laryngeal cancer patients. Conclusion Based on the results of this study, it can be concluded that the QoL of patients with head and neck cancer was not influenced by tumor location. The most affected domains in the three groups were pain, appearance, chewing, swallowing, and speech ( p < 0.05).

Effect of intravenous lidocaine on pain after head and neck cancer surgery (ELICO trial): A randomised controlled trial.

Treatment of postoperative pain after ear, nose and throat (ENT) cancer surgery is mainly morphine administration. Additional systemic lidocaine has shown promising results in some surgical procedures. The main objective was to evaluate morphine consumption in the first 48 postoperative hours after intra-operative lidocaine infusion during major ENT cancer surgery. A randomised, double-blind, placebo-controlled trial. Bicentric study including a university hospital and a major cancer centre, conducted from December 2016 to December 2019. A total of 144 patients undergoing major ENT cancer surgery were included. The patients were randomly assigned to receive intravenous lidocaine or placebo during surgery and in the recovery room. Endpoints were postoperative morphine consumption in the first 24 and 48 h postoperatively, intra-operative remifentanil consumption, adverse events occurrence and assessment 3 to 6 months after surgery with the McGill pain questionnaire. A total of 118 patients were included (lidocaine n = 57; placebo n = 61, 26 patients were excluded). There was no significant difference in morphine consumption during the first 48 postoperative hours in the lidocaine group compared with the placebo group with a median [IQR] of 0.60 [0.30 to 1.03] mg kg -1 vs. 0.57 [0.37 to 0.96] mg kg -1 , total dose 44 [21 to 73.3] mg vs. 38 [23.3 to 56.5] mg, P = 0.92.There was no significant difference between the two groups in any of the other endpoints, including at follow up 3 to 6 months after surgery. Intravenous lidocaine in ENT cancer surgery did not show any additional analgesic or morphine-sparing effect 48 h after surgery. Three to six months after surgery, there was no significant difference in pain scores or consumption of analgesics. Patients treated pre-operatively with opioids were not evaluated in the study. Clinicaltrials.gov identifier: NCT02894710 and EUDRACT number 2015-005799-90.

Prediction of depth of invasion and lymph node metastasis in superficial pharyngeal cancer by magnifying endoscopy using the Japan Esophageal Society classification.

BackgroundsThe pharynx has no muscularis mucosae, so it is unclear whether diagnostic techniques used for the esophagus can be applied to the pharynx. This study investigated the usefulness of magnifying endoscopy with narrowband imaging using the Japan Esophageal Society (JES) classification for predicting the depth of invasion and lymph node metastasis (LNM) in pharyngeal cancer.MethodsA total of 123 superficial pharyngeal carcinoma lesions that had been observed preoperatively with magnifying endoscopy with narrowband imaging between January 2014 and June 2021 were analyzed. Predictors of subepithelial invasion (SEP) and LNM were sought based on endoscopic findings, including microvascular morphology, using the JES classification.ResultsThe lesions were divided into carcinoma in situ (n = 41) and SEP (n = 82). Multivariate analysis identified B2–B3 vessels (odds ratio [OR] 6.54, 95% confidence interval [CI] 1.74–24.61, p = 0.005) and a middle/large avascular area (OR 4.15, 95% CI 1.18–14.62, p = 0.027) as independent predictors of SEP. Significant predictors of LNM were protruding type, B2–B3 vessels, middle/large avascular area, SEP, venous invasion, lymphatic invasion, and tumor thickness > 1000 μm. Median tumor thickness increased significantly in the order of B1 < B2 < B3 vessels (B1, 305 μm; B2, 1045 μm; B3, 4043 μm; p < 0.001). The LNM rates for B1, B2, and B3 vessels were 1.6% (1/63), 4.8% (2/42), and 55.6% (10/18), respectively (p < 0.001).ConclusionsMagnifying endoscopy with narrowband imaging using the JES classification could predict the depth of invasion in superficial pharyngeal carcinoma. The JES classification may contribute to the prediction of LNM, suggesting that it could serve as an alternative to tumor thickness.