Upper Aerodigestive Tract Research Articles

Papillary Carcinoma Thyroid Co-existing with Upper Aerodigestive Tract Squamous Cell Carcinoma: Case Series

Papillary Carcinoma Thyroid Co-existing with Upper Aerodigestive Tract Squamous Cell Carcinoma: Case Series

Long-term exposure to several constituents and sources of PM2.5 is associated with incidence of upper aerodigestive tract cancers but not gastric cancer: Results from the large pooled European cohort of the ELAPSE project

It is unclear whether cancers of the upper aerodigestive tract (UADT) and gastric cancer are related to air pollution, due to few studies with inconsistent results. The effects of particulate matter (PM) may vary across locations due to different source contributions and related PM compositions, and it is not clear which PM constituents/sources are most relevant from a consideration of overall mass concentration alone. We therefore investigated the association of UADT and gastric cancers with PM2.5 elemental constituents and sources components indicative of different sources within a large multicentre population based epidemiological study.Cohorts with at least 10 cases per cohort led to ten and eight cohorts from five countries contributing to UADT- and gastric cancer analysis, respectively. Outcome ascertainment was based on cancer registry data or data of comparable quality.We assigned home address exposure to eight elemental constituents (Cu, Fe, K, Ni, S, Si, V and Zn) estimated from Europe-wide exposure models, and five source components identified by absolute principal component analysis (APCA). Cox regression models were run with age as time scale, stratified for sex and cohort and adjusted for relevant individual and neighbourhood level confounders.We observed 1139 UADT and 872 gastric cancer cases during a mean follow-up of 18.3 and 18.5 years, respectively. UADT cancer incidence was associated with all constituents except K in single element analyses. After adjustment for NO2, only Ni and V remained associated with UADT. Residual oil combustion and traffic source components were associated with UADT cancer persisting in the multiple source model. No associations were found for any of the elements or source components and gastric cancer incidence.Our results indicate an association of several PM constituents indicative of different sources with UADT but not gastric cancer incidence with the most robust evidence for traffic and residual oil combustion.

The Dubai Definition and Diagnostic Criteria of Laryngopharyngeal Reflux: The IFOS Consensus.

The objective of this work was to gather an international consensus group to propose a global definition and diagnostic approach of laryngopharyngeal reflux (LPR) to guide primary care and specialist physicians in the management of LPR. Forty-eight international experts (otolaryngologists, gastroenterologists, surgeons, and physiologists) were included in a modified Delphi process to revise 48 statements about definition, clinical presentation, and diagnostic approaches to LPR. Three voting rounds determined a consensus statement to be acceptable when 80% of experts agreed with a rating of at least 8/10. Votes were anonymous and the analyses of voting rounds were performed by an independent statistician. After the third round, 79.2% of statements (N = 38/48) were approved. LPR was defined as a disease of the upper aerodigestive tract resulting from the direct and/or indirect effects of gastroduodenal content reflux, inducing morphological and/or neurological changes in the upper aerodigestive tract. LPR is associated with recognized non-specific laryngeal and extra-laryngeal symptoms and signs that can be evaluated with validated patient-reported outcome questionnaires and clinical instruments. The hypopharyngeal-esophageal multichannel intraluminal impedance-pH testing can suggest the diagnosis of LPR when there is >1 acid, weakly acid or nonacid hypopharyngeal reflux event in 24 h. A global consensus definition for LPR is presented to improve detection and diagnosis of the disease for otolaryngologists, pulmonologists, gastroenterologists, surgeons, and primary care practitioners. The approved statements are offered to improve collaborative research by adopting common and validated diagnostic approaches to LPR. 5 Laryngoscope, 134:1614-1624, 2024.

“Scrutinizing Under the Green and Blue Filters” - Narrow Band Imaging as a Tool in the Otorhinolaryngologist’s Arsenal to Combat Upper Aerodigestive Tract Tumors

“Scrutinizing Under the Green and Blue Filters” - Narrow Band Imaging as a Tool in the Otorhinolaryngologist’s Arsenal to Combat Upper Aerodigestive Tract Tumors

Association Between Chronic Rhinosinusitis and Reflux Diseases in Adults: A Systematic Review and Meta-Analysis.

Over the last few decades, reflux diseases, such as laryngopharyngeal reflux (LPR) and gastroesophageal reflux disease (GERD), have been identified as significant contributors to inflammatory upper aerodigestive tract diseases. Establishing a direct relationship between reflux disease and chronic rhinosinusitis (CRS) is challenging due to the high prevalence of both diseases and their potential for independent coexistence. The purpose of this study is to review the existing literature and evaluate the evidence of an association between reflux diseases and CRS. A comprehensive electronic search was conducted across multiple databases to identify all studies that investigated the relationship between LPR, GERD, and CRS from January 1, 1950, to June 16, 2022. Only studies with English manuscripts involving adult populations were included, while case series, case reports, and in vitro studies were excluded. The risk of bias was evaluated using The Newcastle-Ottawa Scale for case-control studies and the NIH quality assessment tool for observational cohort and cross-sectional studies. The search strategy yielded a total of 427 articles, out of which 25 studies examined the correlation between reflux diseases and CRS. The meta-analysis indicated a significant association between the presence of GERD and CRS compared to control groups (P < .001; CI 3.56 [2.25, 5.65]), as well as significantly higher pH values and pepsin detection in CRS patients when compared to healthy individuals (P = .003). Furthermore, all studies that evaluated proton pump inhibitor (PPI) therapy in CRS patients reported positive outcomes, with 93% of CRS patients showing improvement on PPIs. The existing literature provides suggestive evidence of an association between reflux diseases and CRS, with regards to both prevalence and treatment. Nonetheless, further studies are required to confirm this relationship.

The tumor microenvironment state associates with response to HPV therapeutic vaccination in patients with respiratory papillomatosis.

Recurrent respiratory papillomatosis (RRP) is a rare, debilitating neoplastic disorder caused by chronic infection with human papillomavirus (HPV) type 6 or 11 and characterized by growth of papillomas in the upper aerodigestive tract. There is no approved medical therapy, and patients require repeated debulking procedures to maintain voice and airway function. PRGN-2012 is a gorilla adenovirus immune-therapeutic capable of enhancing HPV 6/11-specific T cell immunity. This first-in-human, phase 1 study (NCT04724980) of adjuvant PRGN-2012 treatment in adult patients with severe, aggressive RRP demonstrates the overall safety and clinically meaningful benefit observed with PRGN-2012, with a 50% complete response rate in patients treated at the highest dose. Responders demonstrate greater expansion of peripheral HPV-specific T cells compared with nonresponders. Additional correlative studies identify an association between reduced baseline papilloma HPV gene expression, greater interferon responses and expression of CXCL9 and CXCL10, and greater papilloma T cell infiltration in responders. Conversely, nonresponders were characterized by greater HPV and CXCL8 gene expression, increased neutrophilic cell infiltration, and reduced T cell papilloma infiltration. These results suggest that papilloma HPV gene expression may regulate interferon signaling and chemokine expression profiles within the tumor microenvironment that cooperate to govern clinical response to therapeutic HPV vaccination in patients with respiratory papillomatosis.

Total Number of Lymph Nodes in Neck Dissection and Its Relation to Cancer-Positive Lymph Nodes as a Prognostic Indicator in Aerodigestive Tract Cancers: A Multi-Center Study.

Objectives Few studies have been conducted on the total number of lymph nodes (LNs) in neck dissection and the lymph node ratio (LNR; number of positive lymph nodes divided by number of excised lymph nodes), or their potential use as a prognostic indicator for cancers of the upper aerodigestive tract (UADT) and its treatment. We aimed to measure the number of lymph nodesdissected and the LNR to assess their prognostic value for cancers of the UADT, as well as their effect on overall survival and disease-free survival. Methods We performed a retrospective study of patients diagnosed with cancer of the UADT who underwent neck dissection as the primary or secondary modality of their treatment plan at King Abdulaziz University Hospital and the National Guard Hospital, Jeddah, Saudi Arabia. Data were collected through medical records and analyzed to assess prognosis and calculate survival rates in relation to the number of lymph nodes and LNR. Results A total of 121 patients were included: 14 women (11.57%) and 107 men (88.43%). The median age was 60 years and the mean follow-up period was 2.7 years. Of the malignancies, 44.63% were of the oral tongue and 35.54% were laryngeal. A median of 38 lymph nodes were dissected during neck dissections. The distribution of the individual LNRs was characterized by mean values. A mean LNR of 0.04 was considered the cutoff value, an LNR of > 0.04 a high LNR, and an LNR of < 0.04 a low LNR. Kaplan-Meier survival estimates for the cohort showed a three-year overall survival rate of 88% (95% confidence interval [CI]: 77% to 94%) for patients with a low LNR, but 71% (95% CI: 47% to 85%) for patients with a high LNR, which was statistically significant. A similar significant decreasing trend persisted at the four-year follow-up, where the disease-free survival rate was 73% (95% CI: 61% to 82%) for patients with a low LNR compared with 56% (95% CI: 35% to 72%) for patients with a high LNR. Conclusion The number of excised lymph nodes in neck dissections and the LNR might be a good prognostic indicator for overall survival and disease-free survival in patients with cancers of the UADT and may serve as a valuable tool in deciding on different treatment plans.

Fatal upper aerodigestive tract obstruction in an East Asian finless porpoise (Neophocaena asiaeorientalis sunameri): findings in post-mortem computed tomography.

The present case report aims to outline the post-mortem findings of an East Asian finless porpoise with upper aerodigestive tract obstruction using different post-mortem computed tomography (PMCT) visualization techniques and discusses the potential cause of death of this individual. A dead-stranded adult male East Asian finless porpoise was recovered from the Northern coast of Jeju Island, Republic of Korea. The carcass was frozen in Jeju National University within 2h upon first reported. The PMCT examinations were performed at 120 kVp, 200 mAs with a section thickness of 1mm. The scan field of view (sFOV) was set to 400mm. Four image rendering techniques, including multi-planar reconstruction, three-dimensional volume rendering, perspective volume rendering, and minimum intensity projection technique, were used to aid the diagnosis of upper aerodigestive tract obstruction in the stranded finless porpoise. Conventional necropsy was performed to provide a complete necropsy report. Using PMCT, a Sebastidae of 24cm measured length was found to be lodged in the left pharyngeal food channel and esophagus of the finless porpoise. Hard rays of the pectoral fin of the lodged fish have impaled the esophageal mucosa. Fishing gear was found to embed at the dorsal side of the lodged fish. The trachea was compressed ventrally and the arytenoepiglottic tube opening has been narrowed, which may precipitate to the finless porpoise difficult breathing. Pulmonary hyperinflation, pulmonary edema, pneumothorax, pneumopericardium, and pneumorrhachis were observed. This case report represents the first documentation of potential radiological indicators of upper aerodigestive tract obstruction in the East Asian finless porpoise using PMCT. Spatial location of the lodged item could be rendered in situ as the time of death. It has demonstrated that PMCT could provide objective measurements to adjunct the necropsy findings in diagnosis of fatal aerodigestive tract obstruction in stranded cetaceans.

Trans-Nasal Endoscopic Repair of CSF Rhinorrhea: An Institutional Experience.

Cerebrospinal Fluid (CSF) rhinorrhea results from breakdown in the integrity of structures separating the subarachnoid space and nasal cavity, namely subarachnoid space and dura mater, the bony skull base and periostea alongside the upper aerodigestive tract mucosa. Endoscopic repair is considered the treatment of choice for CSF rhinorrhea. Our aim of study was to analyze the etiopathogenesis and outcomes of treatment. A retrospective study review of patients treated with endoscopic repair of CSF rhinorrhea at tertiary care hospital in ENT Department Benazir Bhutto hospital Rawalpindi from august 2013 to September 2017 identified 25 patients. Majority of them were male. The defects were closed in three layers using fat, fascia lata and nasal mucosa along with fibrin sealant in majority of patients. Pre operatively subarachnoid drain was placed in all patients. Patients were followed up to 3 months. Forty-four patients underwent endoscopic repair of CSF rhinorrhea. The age group ranged from 16 to 55 years. Of the total of 44 patients 26 (59%) were males and 18(41%) females. The mean age of the patients in our study was 32.8 ± 9.7. Post trauma CSF leak was seen up to 52.3% of the patients. The most common site of leakage was identified Cribriform plate area. Our success rate of endoscopic repair was 88.6%. The most commonly observed complication was meningitis that was observed in 2 (4.5%) of the patients that too were managed conservatively. Accurate localization of site of leakage appears to be essential for successful endoscopic repair of CSF rhinorrhea. In our study cribriform plate area was commonly observed area of CSF leak. In our study, the success rate was 88.6% and low complication rate 4.5%.

Associations Between Diet Quality and Proinflammatory Cytokines in Newly Diagnosed Head and Neck Cancer Survivors

BackgroundHead and neck squamous cell carcinoma (HNSCC) is a class of heterogenous cancers involving the upper aerodigestive tract. We previously demonstrated the utility of a priori diet quality indices for predicting survival after an HNSCC diagnosis. The aim of this analysis was to evaluate the role of those a priori diet quality indices and proinflammatory cytokines in newly diagnosed HNSCC survivors. MethodsWe analyzed cross-sectional data from a sample (n = 146; mean age 59.6 y; 79.3% male) from the University of Michigan Head and Neck Specialized Program of Research Excellence prospective longitudinal cohort study. Dietary intake was measured at pretreatment using a food frequency questionnaire. Serum samples were also collected at pretreatment. Covariate-adjusted proportional odds and logistic regression models were used to assess the relationship between 6 diet quality indices (Alternative Healthy Eating Index [AHEI]-2010, Alternate Mediterranean Diet, Dietary Approaches to Stop Hypertension [DASH], and 3 low-carbohydrate indices) and serum measures of a panel of 10 inflammatory cytokines and a cytokine summary composite score. ResultsHigher scores on the AHEI-2010 and DASH diet quality indices were associated with higher odds of lower cytokine value scores for several cytokines and for the cytokine summary composite score (AHEI-2010—odds ratio [OR]: 1.55; 95% confidence interval [CI]: 1.10, 2.20; DASH—OR: 1.65; 95% CI 1.15, 2.36). ConclusionsHigher scores on the AHEI-2010 and DASH diet quality indices may be associated with lower proinflammatory cytokine levels in HNSCC survivors.

Elaboración de una escala de puntuación predictiva de infección periamigdalina basada en signos y síntomas

BackgroundPeritonsillar infection (PTI) is a reason for urgent consultation due to intense throat discomfort. A delayed or inaccurate diagnosis can jeopardize the upper aerodigestive tract and be fatal in its evolution. Our objective was to develop a predictive model for the presence of IPA helping in its rapid detection. Patients and methodsA 66-month retrospective observational study from 2017 was carried out in a county and tertiary referral hospitals, registering data from all patients diagnosed with PTI and a proportional volume of subjects with pharyngeal symptoms without PTI. Collection of clinical, exploratory and demographic data among participants. Their higher relative risk of PTI presence allowed them to be considered as variables to be tested. Development of a scoring scale for the probability of suffering from it and logistic regression analysis, obtaining the ROC curve with the best diagnostic correlation. Internal validation and estimation of the predictive values of the model. ResultsOn 348 cases of PTI, the assessment scale scored the presence of six variables: trismus (3), unilateral dysphagia-odynophagia (2), velar bulging (2), reflex otalgia (1), pharyngolalia (1) and age between 16 and 46 years (1). With a range of 0-10, a cut-off ≥6 offered a sensitivity of 96.1%, a specificity of 93.9%, and an efficiency of 94.9%. The area under the ROC curve was 0.979. ConclusionsThe internal validation of this model based on signs and symptoms makes it a very useful tool for early detection of PTI in otorhinolaryngology and primary care.

Applications of electrothermal bipolar vessel sealing devices in transoral head and neck surgery

AbstractObjectiveElectrothermal bipolar vessel sealing devices are electrosurgical devices that seal tissues and blood vessels up to 7 mm in diameter. This paper discusses our experience using electrothermal bipolar vessel sealing devices in transoral head and neck surgery.MethodsElectrothermal bipolar vessel sealing devices were used in five patients with lesions of varying size and type within the pharyngo-larynx. These were treated transorally by the otolaryngology department at the Royal Adelaide Hospital. Either the Medtronic LigaSure or BiZact devices were used for transoral resection, debulking or division of these lesions.ResultsElectrothermal bipolar vessel sealing devices were considered helpful in four out of the five cases. Success was dependent on suitable transoral access. A single unsuccessful case reflected the LigaSure jaw's inability to engage a large tumour effectively.ConclusionElectrothermal bipolar vessel sealing devices can be safely deployed transorally to treat lesions of the upper aero-digestive tract in selected patients. Further studies investigating additional indications would broaden applications of this approach.

Exposure to pesticide residues in honey and its potential cancer risk assessment.

Honey is the most recognized natural food by-product of flower nectar and the upper aero-digestive tract of the honeybees. Significance of honey for its medicinal importance are well-documented in the world's oldest medical literatures. However, the current urbanization, environmental contaminations and changes in agricultural, as well as apiculture practices has led to various types of contaminations in honey. Among all, pesticide contamination has become one of the major issues worldwide. This review focuses on the recent updates concerning pesticides occurrence in honey, as well as how the repeated use and long-term exposure to honey contaminated with pesticide residues could affect the human physiological functions, possibly leading to the development of various cancers. Our findings suggests that uncontrolled use of pesticides in farming and apiculture practices leads to the occurrence of pesticides residues in honey. Therefore, regular consumption of such honey will pose a serious threat to human health, since most of the pesticides has been reported as potential carcinogens. This review will draw the attention of honey consumers, scientific communities, apiculture farmers, as well as governing bodies to strictly monitor the pesticide usage in floriculture, agriculture as well as other related practices.

Warthinův tumor nosohltanu – kazuistika a přehled literatury

Papillary cystic adenolymphoma, usually called Warthin’s tumour (WT), is the second most common benign salivary gland tumour with a relative incidence of up to 25%. Typically, it is localized in the parotid gland or in its proximity where it arises from salivary inclusions entrapped in the intra- and paraparotic lymph nodes. In the upper aerodigestive tract, the WT occurs very rarely. In the postnasal space, only 11 cases have been published in the literature so far. In this case, we bring a case report of a 61-year-old woman, a smoker, in whom the tumour was located at the nasopharyngeal ostium of the left Eustachian tube. Based on our case and review of relevant literature, we discuss clinical aspects of this extraordinary rare neoplasia. Key words Warthin’s tumour – nasopharynx – head and neck neoplasms

A Rare Otological Presentation of Squamous Papilloma

Introduction:&#x0D; Squamous papillomas (SPs) are benign epithelial neoplastic lesions commonly found in skin, oral mucosa, upper aerodigestive tract and genitals. Involvement of external auditory canal (EAC) by SP is extremely rare and whatever scarce literature is available is in the form of case reports. The exact incidence of this entity is still unknown. Consequently, its etiology, histopathological features, differential diagnoses and optimal management merit a better understanding by the Otolaryngologists.&#x0D; Case report: We present a case of EAC SP in a 15 year old girl hailing from north-eastern India who presented to us with a mass in the EAC which was acutely painful. Contrast Enhanced Computed Tomography remained the gold standard and imaging study of choice for evaluation. However, the diagnosis was clinched only by histopathology. We also discuss our strategy of management along with a brief review of literature.&#x0D; Conclusion:&#x0D; Squamous papilloma has rarely been reported to affect the EAC. Human papilloma virus remains the most consistent etiological agent. Advanced imaging like contrast enhanced high resolution computed tomogram remains gold standard to evaluate any mass seen in EAC. Complete excision with cold steel technique or coblation with good post-operative care and follow up is the standard of care.

Diagnostic Accuracy Of Barium Swallow For Dysphagia, Keeping Rigid Esophagoscopy As The Gold Standard

Objective: To determine the diagnostic accuracy of Barium Swallow in detection of patients presenting with dysphagia.&#x0D; Study Design: Cross-sectional validation study.&#x0D; Study Setting &amp; Duration: Department of Otorhinolaryngology, Head &amp; Neck Surgery, District Headquarter Hospital Rawalpindi from 01-09- 2022 to 01-03-2023.&#x0D; Materials and Methods: Approval of the study was obtained from the Hospital Ethical Committee. A total of 111 patients both male and female patients were selected. The patients suffering from dysphagia as per operational definitions and who have reported for work-up to the Department of ENT, District Headquarters Hospital, Rawalpindi, and fulfill the complete inclusion and exclusion criteria, were selected. Informed consent was obtained from all the patients. Patients were selected by consecutive non-probability sampling technique. The data was analyzed using SPSS 24.&#x0D; Results: A total of 111 patients were included in this study. The mean age of these patients was 50.79 ± 13.01 years, ranging from 28 to 70 years. The frequency distribution of females 70.27 % was found to be more than that of males 29.73 %. Majority of patients' barium swallow (74.77%) revealed pathologies, while only a small percentage of patients (25.23%) had normal barium swallow. Most of patients (87.39%) had pathologies found during rigid esophagoscopy, while just a small number (12.61%) had normal rigid esophagoscopy. Comparing both investigating tools, esophagoscopy discovered 87.39% of pathologies while Barium swallow detected 74.77%, indicating that esophagoscopy was a more accurate procedure. Patients had esophageal web 55 (25.2%) on barium swallow and 69 (62.2%) on the Rigid esophagoscopy. Barium Swallow had esophageal stricture 28 (52.2) and no Pathology was detected in 28 (25.2 %) patients. As well as Rigid esophagoscopy had esophageal growth13 (11.7), esophageal stricture 15 (13.5), and no Pathology was detected in 14 (12.6 %). Rigid esophagoscopy is more efficient in detecting esophageal pathology than Barium Swallow. In Barium swallows most patients had esophageal web 55 (25.2%) than the esophageal stricture 28 (52.2) and no pathology was detected 28 (25.2). In rigid esophagoscopy most patients had esophageal web 69 (62.2%) than the esophageal growth13 (11.7), esophageal stricture 15 (13.5) and no pathology detected 14 (12.6).&#x0D; Conclusion: A range of diseases are associated with dysphagia can be found in patients. Two often used diagnostic methods are barium swallow and rigid esophagoscopy. Both Barium swallow and Rigid esophagoscopy are successful in the diagnosis of esophageal cancer. The use of a Rigid esophagoscopy is still a gold standard diagnostic and therapeutic tool for upper aerodigestive tract pathologies.

Papillary Thyroid Carcinoma with Tracheal Invasion

Papillary thyroid carcinoma (PTC) is commonly associated with praising survivaland less recurrence rate compared with other malignancy. The prognosis of PTC depends on age, sex, size of tumor, lymphadenopathy, and extrathyroidal extension. PTC which invade upper aerodigestive tract (ADT) is more aggressive tumor that signify the patients at a greater risk of recurrence and death. Bangladesh J Otorhinolaryngol 2023; 29(1): 45-48

Abstract PO-070: New patient-derived head and neck cancer xenograft (PDX) panel for drug development, immuno-oncology and translational research

Abstract Head and neck squamous cell carcinomas (HNSCC) represent a heterogeneous group of epithelial cell malignancies arising from the upper aerodigestive tract. Despite of improved therapies, HNSCC remain a devastating disease. Oropharynx cancers are mainly attributed to infection with human papillomavirus (HPV). Since 2017, HNSCC are classified into HPV-negative and HPV-positive HNSCC. Therapies in the clinic are surgery and/or radiotherapy (RT)/radiochemotherapy (RCT) with a recurrence of about 50%. Therefore, new approaches are needed to improve long-term remission and patient survival. Recent advances in high-throughput molecular profiling have helped to identify genetic dispositions (TP53, FAT1, CDKNA2, NOTCH1 etc.) for HNSCC. We have generated and characterized a diverse panel (n = 85) of patient-derived xenografts (PDX) of HNSCC for preclinical research and immuno-oncological approaches. We successfully established 85 HNSCC PDX from fresh surgery tissue of primary and recurrent carcinomas by direct subcutaneous transplantation into immune-deficient mice. 14 HNSCC PDX were derived from HPV-positive tumors. We treated 28 HNSCC PDX with radiotherapy alone or radiochemotherapy. Heterogeneous individual responses to treatments resemble the clinical situation. For characterization, the established HNSCC PDX were treated with standard of cares (SoC) such as docetaxel, platinum compounds, cetuximab, 5-fluorouracil and investigational drugs. No correlation was observed to mutations and drug response. Molecular subtypes were determined based on gene expression data. Cetuximab response was associated with basal subtype and inflamed/mesenchymal subtype was negative predictive for cetuximab response. Further, 30 HNSCC PDX were analyzed for PD-L1 expression as suitable candidates for the evaluation of checkpoints inhibitors such as nivolumab and pembrolizumab and other novel immunotherapy approaches on humanized mice. To gain a deeper insight into the molecular biology, RNA sequencing was performed for 46 HNSCC models. Based on RNASeq data, an individual Human Leucocyte Antigen (HLA) profile of each PDX was determined and a comprehensive HLA matching analysis of the HNSCC models and 9 peripheral blood mononuclear cell (PBMC) donors was performed to enable personalized, preclinical immuno-oncology studies. Our newly and comprehensively characterized HNSCC PDX panel enables the evaluation of new targeted and immunological therapies in preclinical phase II studies. It provides an exceptional platform for the identification and validation of new targets and enables the preclinical screening of new combinations in translational research. Citation Format: Bernadette Brzezicha, Theresia Conrad, Maria Stecklum, Michael Becker, Konrad Klinghammer, Jens Hoffmann. New patient-derived head and neck cancer xenograft (PDX) panel for drug development, immuno-oncology and translational research [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Innovating through Basic, Clinical, and Translational Research; 2023 Jul 7-8; Montreal, QC, Canada. Philadelphia (PA): AACR; Clin Cancer Res 2023;29(18_Suppl):Abstract nr PO-070.

Interdisciplinary defect reconstruction of upper aerodigestive fistulas-case series and treatment algorithm

Persistent complex defects and dysfunctions of the upper aerodigestive tract after tumor surgery represent amajor challenge. The aim of this study was to evaluate the effectiveness of an interdisciplinary approach using the free anterolateral thigh flap (ALT) as areconstruction option in the upper aerodigestive tract. The retrospective study identified 5patients with complex defects after laryngectomy/pharyngolaryngectomy (LE/PLE) and multiple revision surgeries between 2017 and 2023. The operations were performed by an interdisciplinary team from otolaryngology, plastic surgery, and visceral/thoracic surgery. The results of the microsurgical reconstruction were analyzed. There was an average of six previous operations. The defects included tracheoesophageal fistulas, pharyngocutaneous fistulas, neopharyngeal stenosis, and combinations thereof. Successful reconstruction was achieved in 100% of patients using the ALT flap. In 2patients, ALT flow-through flaps were used with an additional free jejunal interposition (JI) and in 3patients split-ALT flaps were used. The major complication rate was 40% and the minor complication rate was 20%. Complex defects of the upper aerodigestive tract with multiple previous operations can be successfully reconstructed. Because of its versatility, the ALT flap seems to be avery good option. Prerequisite for this is an interdisciplinary treatment approach with acritical assessment of patient- and disease-specific factors.

Cancer mortality associated with low education in Italy.

This study provides a nationwide representative quantification of the impact of educational inequalities on cancer mortality in Italy. The study is based on prevalence data and mortality rate ratios according to levels of education obtained from the Italian 2011 census cohort, including >35 million individuals aged 30-74. We estimated the population attributable fraction (PAF) and the number of cancer deaths associated with low education (below university degree) in Italy by sex. PAFs for low levels of education were 29.1% among men and 13.3% among women, corresponding to 22,271 cancer deaths associated with low education in men and 7456 in women in 2019. PAFs by cancer site in men were: 53.0% for upper aerodigestive tract (UADT), 44.6% for liver, 41.3% for stomach, 41.3% for lung, 37.0% for bladder, 18.5% for colorectal, 9.8% for prostate and 9.1% for pancreatic cancers. PAFs in women were: 44.5% for cervical, 36.1% for UADT, 34.9% for stomach and 13.9% for colorectal cancers. The cancer sites with the highest number of deaths associated with low education were lung among men (7902/22,271, 35.5%) and colorectum among women (780/7456, 10.5%). About a quarter of cancer deaths in 2019 in Italy may be prevented by reducing the socioeconomic determinants that contribute to educational disparities in cancer mortality.