scholarly journals Current Role of Surgery in the Management of Oropharyngeal Cancer

2016 ◽  
Vol 12 (11) ◽  
pp. 1176-1183 ◽  
Author(s):  
Meghan T. Turner ◽  
J. Kenneth Byrd ◽  
Robert L. Ferris
Keyword(s):  
Human Papillomavirus ◽  
Oropharyngeal Cancer ◽  
Functional Outcomes ◽  
Surgical Techniques ◽  
Oncologic Outcomes ◽  
Oropharyngeal Carcinoma ◽  
The Past ◽  
Minimally Invasive Surgical ◽  
Improved Outcomes

The 1990s saw an increased use of chemoradiotherapy protocols, commonly referred to as organ-sparing therapy, for the treatment of oropharyngeal cancer after the Groupe d'Oncologie Radiothérapie Tête et Cou trial. Since that time, human papillomavirus–associated oropharyngeal squamous cell carcinoma has been identified as a unique disease, with improved survival regardless of treatment modality. The improved outcomes of this population has led to re-evaluation of treatment paradigms in the past decade, with a desire to spare young, human papillomavirus–positive patients the treatment-related toxicities of chemoradiotherapy and to use new minimally invasive surgical techniques to improve outcomes. Numerous retrospective and prospective studies have investigated the role of surgery in treatment of oropharyngeal carcinoma and have demonstrated equivalent oncologic outcomes and improved functional outcomes compared with chemoradiotherapy protocols. Ongoing and future clinical trials may help delineate the role of surgery in the future.

scholarly journals Pathogenic Role of Immune Evasion and Integration of Human Papillomavirus in Oropharyngeal Cancer

2021 ◽  
Vol 9 (5) ◽  
pp. 891
Author(s):  
Takashi Hatano ◽  
Daisuke Sano ◽  
Hideaki Takahashi ◽  
Nobuhiko Oridate
Keyword(s):  
Human Papillomavirus ◽  
Immune Evasion ◽  
Oropharyngeal Cancer ◽  
Current Knowledge ◽  
Immune Evasion Mechanism ◽  
Cell Cycle Activation ◽  
Genome Integration ◽  
Integration Mechanisms ◽  
E6 And E7

The incidence of oropharyngeal cancer (OPC) is increasing remarkably among all head and neck cancers, mainly due to its association with the human papillomavirus (HPV). Most HPVs are eliminated by the host’s immune system; however, because HPV has developed an effective immune evasion mechanism to complete its replication cycle, a small number of HPVs are not eliminated, leading to persistent infection. Moreover, during the oncogenic process, the extrachromosomal HPV genome often becomes integrated into the host genome. Integration involves the induction and high expression of E6 and E7, leading to cell cycle activation and increased genomic instability in the host. Therefore, integration is an important event in oncogenesis, although the associated mechanism remains unclear, especially in HPV-OPC. In this review, we summarize the current knowledge on HPV-mediated carcinogenesis, with special emphasis on immune evasion and integration mechanisms, which are crucial for oncogenesis.

scholarly journals Nutritional and Pharmacological Enhancement of the Gut-Associated Lymphoid Tissue

2000 ◽  
Vol 14 (suppl d) ◽  
pp. 145D-151D ◽  
Author(s):  
M Keith Hanna ◽  
Kenneth A Kudsk
Keyword(s):  
Enteral Nutrition ◽  
Mucosal Immunity ◽  
Lymphoid Tissue ◽  
Severely Injured Patients ◽  
Quarter Century ◽  
The Past ◽  
Improved Outcomes ◽  
Injured Patients ◽  
Lower Morbidity

There has been an explosion of research in the field of nutrition over the past quarter century. Clinical studies have demonstrated the effectiveness of providing nutrition by the enteral route in reducing septic morbidity in critically ill patients. These improved outcomes have been substantiated by animal models that show that enteral nutrition decreases gut permeability while maintaining the gut-associated lymphoid tissue (GALT) in mucosal immunity. Evidence points to the important immunological role of the gut in the maintenance of mucosal immunity at both intestinal and extraintestinal sites. The preservation of this mucosal immunity by enteral nutrition is consistent with the lower morbidity seen in severely injured patients who receive nutrition via the gastrointestinal tract. For patients who are unable to be fed by the enteral route and who require parenteral nutrition, several supplements show promise in enhancing the mucosal immune system defenses. The nutritional and pharmacological tactics that may enhance the GALT and thereby maintain mucosal immunity are examined.

Survival impact of treatment delays in surgically managed oropharyngeal cancer and the role of human papillomavirus status

Head & Neck ◽  
2019 ◽  
Vol 41 (6) ◽  
pp. 1756-1769 ◽  
Author(s):  
Alexander N. Goel ◽  
Mariana Frangos ◽  
Govind Raghavan ◽  
Sophia Sangar ◽  
Stephanie Lazaro ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Oropharyngeal Cancer ◽  
Treatment Delays

scholarly journals Oncologic Outcomes Following Transoral Robotic Surgery for Human Papillomavirus–Associated Oropharyngeal Carcinoma in Older Patients

2020 ◽  
Vol 146 (12) ◽  
pp. 1167
Author(s):  
Harman S. Parhar ◽  
David Shimunov ◽  
Jason G. Newman ◽  
Steven B. Cannady ◽  
Karthik Rajasekaran ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Robotic Surgery ◽  
Older Patients ◽  
Transoral Robotic Surgery ◽  
Oncologic Outcomes ◽  
Oropharyngeal Carcinoma

scholarly journals Association of Salivary Human Papillomavirus Infection and Oral and Oropharyngeal Cancer: A Meta-Analysis

2020 ◽  
Vol 9 (5) ◽  
pp. 1305 ◽  
Author(s):  
Óscar Rapado-González ◽  
Cristina Martínez-Reglero ◽  
Ángel Salgado-Barreira ◽  
Almudena Rodríguez-Fernández ◽  
Santiago Aguín-Losada ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Oral Cancer ◽  
Oropharyngeal Cancer ◽  
Meta Analysis ◽  
Hpv Infection ◽  
Cochrane Library ◽  
Oropharyngeal Carcinoma ◽  
Hpv Dna ◽  
Start Date ◽  
Oral And Oropharyngeal Cancer

Background. Human papillomavirus (HPV) infection has been recognized as an important risk factor in cancer. The purpose of this systematic review and meta-analysis was to determine the prevalence and effect size of association between salivary HPV DNA and the risk of developing oral and oropharyngeal cancer. Methods. A systematic literature search of PubMed, EMBASE, Web of Science, LILACS, Scopus and the Cochrane Library was performed, without language restrictions or specified start date. Pooled data were analyzed by calculating odds ratios (ORs) and 95% confidence intervals (CIs). Quality assessment was performed using the Newcastle–Ottawa Scale (NOS). Results. A total of 1672 studies were screened and 14 met inclusion criteria for the meta-analysis. The overall prevalence of salivary HPV DNA for oral and oropharyngeal carcinoma was 43.2%, and the prevalence of salivary HPV16 genotype was 27.5%. Pooled results showed a significant association between salivary HPV and oral and oropharyngeal cancer (OR = 4.94; 2.82−8.67), oral cancer (OR = 2.58; 1.67−3.99) and oropharyngeal cancer (OR = 17.71; 6.42−48.84). Significant associations were also found between salivary HPV16 and oral and oropharyngeal cancer (OR = 10.07; 3.65−27.82), oral cancer (OR = 2.95; 1.23−7.08) and oropharyngeal cancer (OR = 38.50; 22.43−66.07). Conclusions. Our meta-analysis demonstrated the association between salivary HPV infection and the incidence of oral and oropharyngeal cancer indicating its value as a predictive indicator.

Energy Sources for the Surgical Treatment of Atrial Fibrillation

2019 ◽  
Vol 14 (6) ◽  
pp. 503-508
Author(s):  
Robert M. MacGregor ◽  
Spencer J. Melby ◽  
Richard B. Schuessler ◽  
Ralph J. Damiano
Keyword(s):  
Atrial Fibrillation ◽  
Surgical Treatment ◽  
Tissue Injury ◽  
Surgical Techniques ◽  
Maze Procedure ◽  
Energy Sources ◽  
Surgical Approaches ◽  
Surgical Ablation ◽  
The Past ◽  
Minimally Invasive Surgical

The surgical treatment of atrial fibrillation has evolved over the past 2 decades due to the advent of ablation technology, and the introduction of less invasive surgical approaches. Current devices produce ablation lines that aim to replace the incisions of traditional surgical ablation strategies, such as the Cox-Maze procedure. This has helped to simplify and shorten surgical ablation procedures and has allowed for the development of minimally invasive surgical techniques. This review discusses surgical ablation energy sources and devices, providing background on device characteristics, mechanism of tissue injury, and success in creating transmural lesions.

The role of concomitant chemoradiotherapy in AJCC 7th edition T1-2N1 oropharyngeal carcinoma in the human papillomavirus era

Oral Oncology ◽  
2020 ◽  
Vol 110 ◽  
pp. 104882
Author(s):  
Diana J. Lu ◽  
Michael Luu ◽  
Anthony T. Nguyen ◽  
Stephen L. Shiao ◽  
Kevin Scher ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Oropharyngeal Carcinoma ◽  
Concomitant Chemoradiotherapy ◽  
7Th Edition

scholarly journals Systemic Inflammatory Response Based on Neutrophil-to-Lymphocyte Ratio as a Prognostic Marker in Bladder Cancer

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Hyung Suk Kim ◽  
Ja Hyeon Ku
Keyword(s):  
Inflammatory Response ◽  
Cancer Patients ◽  
Systemic Inflammatory Response ◽  
Neutrophil To Lymphocyte Ratio ◽  
Oncologic Outcomes ◽  
Survival Outcomes ◽  
Lymphocyte Ratio ◽  
The Past ◽  
Differential White Blood Cell

A growing body of evidence suggests that systemic inflammatory response (SIR) in the tumor microenvironment is closely related to poor oncologic outcomes in cancer patients. Over the past decade, several SIR-related hematological factors have been extensively investigated in an effort to risk-stratify cancer patients to improve treatment selection and to predict posttreatment survival outcomes in various types of cancers. In particular, one readily available marker of SIR is neutrophil-to-lymphocyte ratio (NLR), which can easily be measured on the basis of absolute neutrophils and absolute lymphocytes in a differential white blood cell count performed in the clinical setting. Many investigators have vigorously assessed NLR as a potential prognostic biomarker predicting pathological and survival outcomes in patients with urothelial carcinoma (UC) of the bladder. In this paper, we aim to present the prognostic role of NLR in patients with UC of the bladder through a thorough review of the literature.

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