Survival and Prognostic Analysis after Pulmonary Metastasectomy for Head and Neck Cancer

2020 ◽  
Author(s):  
Wojciech Dudek ◽  
Emad AlMoussa ◽  
Waldemar Schreiner ◽  
Konstantinos Mantsopoulos ◽  
Horia Sirbu
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Primary Tumor ◽  
Lung Metastases ◽  
Therapeutic Option ◽  
Pulmonary Metastasectomy ◽  
Continuous Variables ◽  
Characteristic Analysis ◽  
The Impact

Abstract Background There is no consensus on the value of pulmonary metastasectomy (PM) for head and neck cancer (HNC). The aim of our single-institution study was to evaluate outcomes and to examine factors influencing 5-year survival of patients undergoing resections for HNC lung metastases. Methods All HNC patients undergoing curative-intent PM between January 2008 and December 2018 were retrospectively analyzed. The impact of factors related to primary tumor, metastases, and associated therapy on patient survival was evaluated using the univariable Cox proportional hazard model. Cutoff values of continuous variables were determined by a receiver operating characteristic analysis. Results In total, 44 patients (32 males and 12 females, with a median age of 65 years) underwent PM for metastatic HNC. There was one perioperative death, and major complications occurred in 2 (4.5%) patients. The median interval between the treatment of primary tumor and PM was 19.4 months (range: 0–151 months). Median size of the largest resected pulmonary lesion was 1.3 cm (range: 0.3–6.9 cm). Mean follow-up was 21 months (range: 0–123 months), and 5-year overall survival (OS) rate after the first PM was 41%. Resection was complete (R0) in all patients. Larger size of pulmonary metastasis (≥1.4 cm; hazard ratio: 4.49; 95% confidence interval: 1.79–11.27) was a significantly negative prognostic factor. Conclusion Despite the lack of randomized controlled trials, PM for HNC is a reasonable therapeutic option with favorable survival in a selected population. In patients with larger pulmonary lesions, shorter OS after PM is to be expected.

Surgery for Pulmonary Metastases: Long-Term Survival in 281 Patients

2021 ◽  
Author(s):  
Wojciech Dudek ◽  
Waldemar Schreiner ◽  
Mohamed Haj Khalaf ◽  
Horia Sirbu
Keyword(s):  
Primary Tumor ◽  
Multivariable Analysis ◽  
Pulmonary Metastasectomy ◽  
Incomplete Resection ◽  
Continuous Variables ◽  
Characteristic Analysis ◽  
Term Survival ◽  
Primary Tumors ◽  
Wide Range ◽  
The Impact

Abstract Background Despite weak evidence, pulmonary metastasectomy (PM) is widely performed with intent to improve patient survival. Our single-institution analysis aims to evaluate outcomes and to identify factors influencing survival of patients undergoing PM for metastases from wide range of primary tumors. Materials and Methods All patients undergoing curative-intent PM between 2008 and 2018 were retrospectively analyzed. The impact of factors related to primary tumor, metastases, and associated therapy on overall survival (OS) was evaluated using univariable and multivariable Cox proportional hazard models. Cutoff values of continuous variables were determined by a receiver operating characteristic analysis. Results In this study, 281 patients (178 male, median age 61 years) underwent PM. Two (0.7%) perioperative deaths and 23 (8.2%) major complications occurred. Median interval between the treatment of primary tumor and PM was 21 months. Median size of largest metastasis was 1.4 cm. After the median follow-up of 29 months, 134 patients (47.7%) had died. Five-year OS rate after first PM was 47.1%. Complete resection was achieved in 274 (97.5%) patients. Multivariable analysis identified genitourinary origin (hazard ratio [HR]: 0.30, 95% confidence interval [CI]: 0.15–0.60, p = 0.0008) as independent positive survival prognosticator; incomplete resection (HR: 3.53, 95% CI: 1.40–8.91, p = 0.0077) and age at PM of ≥66 years (HR: 1.97, 95% CI: 1.36–2.85, p = 0.0003) were negative prognosticators. Conclusion The use of PM as a part of multimodal treatment is in selected population justified. Our analysis identified age, primary tumor origin, and completeness of resection as independent survival prognosticators.

The impact of coronavirus disease 2019 on suspected head and neck cancer two-week-wait referrals

2021 ◽  
pp. 1-10
Author(s):  
N Bhamra ◽  
B Gorman ◽  
W Arnold ◽  
A Rajah ◽  
K Jolly ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
The Impact

scholarly journals Increasing Mean Age of Head and Neck Cancer Patients at a German Tertiary Referral Center

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 832
Author(s):  
Julius M. Vahl ◽  
Marlene C. Wigand ◽  
Michael Denkinger ◽  
Dhayana Dallmeier ◽  
Chiara Steiger ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Catchment Area ◽  
Incidence Rates ◽  
Cancer Center ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Referral Center ◽  
The Impact

Background: The impact of demographic change on the age at diagnosis in German head and neck cancer (HNC) patients is unclear. Here we present an evaluation of aging trends in HNC at a tertiary referral center. Methods: Retrospective cohort study on aging trends at the initial diagnosis of newly diagnosed patients with HNC between 2004 and 2018 at the head and neck cancer center Ulm in relation to demographic data of the catchment area. Results: The study population consisted of 2450 individuals diagnosed with HNC with a mean age of 62.84 (±11.67) years. We observed a significant increase in annual incidence rates and mean age over time. Mean age among HNC patients increased significantly more than among the population in the catchment area. Whereas the incidence rate of patients <50 years did not change, the incidence of HNC patients aged ≥70 years increased the most. The mean patient age in the main tumor sites increased significantly. Surprisingly, HPV-positive patients were not younger than HPV-negative patients, but showed a non-significant trend towards a higher mean age (63.0 vs. 60.7 years). Conclusions: Increasing incidence rates in older patients pose a challenge for health care systems. A nationwide study is needed to assess the dynamics and impact of aging on the incidence of HNC.

scholarly journals Impacts of Environmental Factors on Head and Neck Cancer Pathogenesis and Progression

Cells ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 389
Author(s):  
Marisol Miranda-Galvis ◽  
Reid Loveless ◽  
Luiz Paulo Kowalski ◽  
Yong Teng
Keyword(s):  
Head And Neck Cancer ◽  
Environmental Factors ◽  
Head And Neck ◽  
Neck Cancer ◽  
Molecular Mechanisms ◽  
Metastatic Cancer ◽  
Environmental Drivers ◽  
Cancer Pathogenesis ◽  
Gene Environment ◽  
The Impact

Epidemiological and clinical studies over the past two decades have provided strong evidence that genetic elements interacting with environmental components can individually and collectively influence one’s susceptibility to cancer. In addition to tumorigenic properties, numerous environmental factors, such as nutrition, chemical carcinogens, and tobacco/alcohol consumption, possess pro-invasive and pro-metastatic cancer features. In contrast to traditional cancer treatment, modern therapeutics not only take into account an individual’s genetic makeup but also consider gene–environment interactions. The current review sharpens the focus by elaborating on the impact that environmental factors have on the pathogenesis and progression of head and neck cancer and the underlying molecular mechanisms involved. Recent advances, challenges, and future perspectives in this area of research are also discussed. Inhibiting key environmental drivers of tumor progression should yield survival benefits for patients at any stage of head and neck cancer.

Lymphoedema after head and neck cancer treatment: an overview for clinical practice

2021 ◽  
Vol 26 (Sup4) ◽  
pp. S24-S29
Author(s):  
Claire Jeans ◽  
Bena Brown ◽  
Elizabeth C Ward ◽  
Anne E Vertigan
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Lymphatic System ◽  
Review Article ◽  
Psychological Issues ◽  
Wide Range ◽  
The Face ◽  
Protein Rich ◽  
The Impact

Lymphoedema is a disorder of the lymphatic system that presents as an atypical swelling and accumulation of protein-rich fluid within the interstitial spaces. Head and neck lymphoedema (HNL) is highly prevalent in patients who have been treated for head and neck cancer (HNC) and may manifest externally on the face and neck; internally within the oral cavity, pharynx or larynx; or as a combination of both. HNL is known to contribute to a wide range of physical, functional and psychological issues, and presents several unique challenges in terms of its management. This review article provides an overview of HNL for clinicians and aims to improve awareness of this condition and the impact it has on patients.

scholarly journals Adaptive radiotherapy for head and neck cancer

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Enis Tinjak ◽  
Velda Smajlbegović ◽  
Adnan Beganović ◽  
Mirjana Ristanić ◽  
Halil Ćorović ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Locally Advanced ◽  
Adaptive Radiotherapy ◽  
Tumor Control ◽  
Parotid Glands ◽  
Image Guided Radiotherapy ◽  
The Impact

Introduction: Radiation therapy has long played an integral role in the manage¬ment of locally advanced head and neck cancer (HNC), both for organ preservation and to improve tumor control in the postoperative setting. The aim of this research is to investigate the effects of adaptive radiotherapy on dosimetric, clinical, and toxicity outcomes for patients with head and neck cancer undergoing radiation therapy treatment. Many sources have reported volume reductions in the primary target, nodal volumes, and parotid glands over treatment, which may result in unintended dosimetric changes affecting the side effect profile and even efficacy of the treatment. Adaptive radiotherapy (ART) is an interesting treatment paradigm that has been developed to directly adjust to these changes.Material and methods: This research contains the results of 15 studies, including clinical trials, randomized prospective and retrospective studies. The researches analyze the impact of radiation therapy on changes in tumor volume and the relationship with planned radiation dose delivery, as well as the possibility of using adaptive radiotherapy in response to identified changes. Also, medical articles and abstracts that are closely related to the title of adaptive radiotherapy were researched.Results: The application of ART significantly improved the quality of life of patients with head and neck cancer, as well as two-year locoregional control of the disease. The average time to apply ART is the middle of the treatment course approximately 17 to 20 fractions of the treatment.Conclusion: Based on systematic review of the literature, evidence based changes in target volumes and dose reduction at OAR, adaptive radiotherapy is recommended treatment for most of the patients with head and neck cancer with the support of image-guided radiotherapy.

scholarly journals Current clinical immunotherapeutic approaches for head and neck cancer

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 803 ◽  
Author(s):  
Carolina Soto Chervin ◽  
Bruce Brockstein
Keyword(s):  
Head And Neck Cancer ◽  
Immune System ◽  
Head And Neck ◽  
Neck Cancer ◽  
Hematological Malignancies ◽  
Therapeutic Option ◽  
Specific Treatment ◽  
Clinical Development ◽  
The Us ◽  
The Status

It was estimated that 59,340 new cases of head and neck cancer would be diagnosed in the US alone in 2015 and that 12,290 deaths would be attributed to the disease. Local and regional recurrences may be treated with chemotherapy and radiation; however, metastatic head and neck cancer is fatal and is treated with chemotherapy for palliation. Recent successful treatment of a variety of solid and hematological malignancies by immunotherapeutic approaches (i.e. harnessing the body’s own immune system to combat disease) has added a fourth therapeutic option for the treatment of cancer. This commentary will review the status of immunotherapies in clinical development for the specific treatment of head and neck cancer.

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