ROLE OF ACCESS OSTEOTOMY IN HEAD AND NECK LESIONS – A REVIEW

The surgical resection of the head and neck lesions summarizes the principles, classifications, applications, complications, and post-operative care of osteotomy with the standard protocols performed safely. It often poses a great surgical challenge due to the anatomical complexity, difficulty in accessibility, and proximity of vital structures. A multidisciplinary approach is often required in these situations for their better exposure to provide surgical access. Access osteotomy is the choice and type for these head and neck lesions, which are most often based on the anatomic extent of the lesion, vascularity of the lesion, and involvement of neurovascular structures in and around it. The literature search using Medline from the year 1986 to 2019 were performed and textbooks were also collected by hand search from the same period. The role of aggressive surgical resection has not been established for malignant head and neck lesions with the technical feasibility and its efficacy for specific tumor types must be defined by the future studies. Thus, we would like to conclude that access osteotomy allows the surgeon a better view and an access of the surgical field to resect the tumor completely with safer margins, preserving the vital structures, pre-operative functions, and reducing post-operative complications.

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The Role of Non-Coding RNAs in the Regulation of the Proto-Oncogene MYC in Different Types of Cancer

Biomedicines ◽

10.3390/biomedicines9080921 ◽

2021 ◽

Vol 9 (8) ◽

pp. 921

Author(s):

Ekaterina Mikhailovna Stasevich ◽

Matvey Mikhailovich Murashko ◽

Lyudmila Sergeevna Zinevich ◽

Denis Eriksonovich Demin ◽

Anton Markovich Schwartz

Keyword(s):

Malignant Tumors ◽

Current Data ◽

Cellular Processes ◽

Cell Divisions ◽

Specific Tumor ◽

Different Types ◽

Myc Gene ◽

Non Coding Rnas ◽

Tumor Types

Alterations in the expression level of the MYC gene are often found in the cells of various malignant tumors. Overexpressed MYC has been shown to stimulate the main processes of oncogenesis: uncontrolled growth, unlimited cell divisions, avoidance of apoptosis and immune response, changes in cellular metabolism, genomic instability, metastasis, and angiogenesis. Thus, controlling the expression of MYC is considered as an approach for targeted cancer treatment. Since c-Myc is also a crucial regulator of many cellular processes in healthy cells, it is necessary to find ways for selective regulation of MYC expression in tumor cells. Many recent studies have demonstrated that non-coding RNAs play an important role in the regulation of the transcription and translation of this gene and some RNAs directly interact with the c-Myc protein, affecting its stability. In this review, we summarize current data on the regulation of MYC by various non-coding RNAs that can potentially be targeted in specific tumor types.

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Glutamine-Derived Aspartate Biosynthesis in Cancer Cells: Role of Mitochondrial Transporters and New Therapeutic Perspectives

Cancers ◽

10.3390/cancers14010245 ◽

2022 ◽

Vol 14 (1) ◽

pp. 245

Author(s):

Ruggiero Gorgoglione ◽

Valeria Impedovo ◽

Christopher L. Riley ◽

Deborah Fratantonio ◽

Stefano Tiziani ◽

...

Keyword(s):

Uncoupling Protein ◽

Cell Metabolism ◽

Redox Homeostasis ◽

Nucleotide Biosynthesis ◽

Specific Tumor ◽

Mitochondrial Carrier Family ◽

Cancer Types ◽

Cancer Cell Metabolism ◽

Tumor Types

Aspartate has a central role in cancer cell metabolism. Aspartate cytosolic availability is crucial for protein and nucleotide biosynthesis as well as for redox homeostasis. Since tumor cells display poor aspartate uptake from the external environment, most of the cellular pool of aspartate derives from mitochondrial catabolism of glutamine. At least four transporters are involved in this metabolic pathway: the glutamine (SLC1A5_var), the aspartate/glutamate (AGC), the aspartate/phosphate (uncoupling protein 2, UCP2), and the glutamate (GC) carriers, the last three belonging to the mitochondrial carrier family (MCF). The loss of one of these transporters causes a paucity of cytosolic aspartate and an arrest of cell proliferation in many different cancer types. The aim of this review is to clarify why different cancers have varying dependencies on metabolite transporters to support cytosolic glutamine-derived aspartate availability. Dissecting the precise metabolic routes that glutamine undergoes in specific tumor types is of upmost importance as it promises to unveil the best metabolic target for therapeutic intervention.

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NKL-Code in Normal and Aberrant Hematopoiesis

Cancers ◽

10.3390/cancers13081961 ◽

2021 ◽

Vol 13 (8) ◽

pp. 1961

Author(s):

Stefan Nagel

Keyword(s):

Blood Cells ◽

Myeloid Leukemia ◽

Expression Patterns ◽

Homeobox Genes ◽

Hematopoietic Differentiation ◽

Oncogenic Potential ◽

Specific Tumor ◽

Tumor Types ◽

Hematopoietic Cell Lines

We have recently described physiological expression patterns of NKL homeobox genes in early hematopoiesis and in subsequent lymphopoiesis and myelopoiesis, including terminally differentiated blood cells. We thereby systematized differential expression patterns of eleven such genes which form the so-called NKL-code. Due to the developmental impact of NKL homeobox genes, these data suggest a key role for their activity in normal hematopoietic differentiation processes. On the other hand, the aberrant overexpression of NKL-code-members or the ectopical activation of non-code members have been frequently reported in lymphoid and myeloid leukemia/lymphoma, revealing the oncogenic potential of these genes in the hematopoietic compartment. Here, I provide an overview of the NKL-code in normal hematopoiesis and instance mechanisms of deregulation and oncogenic functions of selected NKL genes in hematologic cancers. As well as published clinical studies, our conclusions are based on experimental work using hematopoietic cell lines which represent useful models to characterize the role of NKL homeobox genes in specific tumor types.

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The Mechanical Spread of Viable Tumor during Surgery

Otolaryngology ◽

10.1177/019459988609400303 ◽

1986 ◽

Vol 94 (3) ◽

pp. 278-281 ◽

Cited By ~ 13

Author(s):

Raja A. Atiyah ◽

Yosef P. Krespi ◽

Denise Hidvegi ◽

George A. Sisson

Keyword(s):

Stem Cell ◽

Head And Neck ◽

Tumor Cells ◽

Surgical Resection ◽

Tumor Stem Cell ◽

Physical Trauma ◽

The Past ◽

Viable Tumor ◽

Surgical Field ◽

Tumor Stem Cell Assay

The “mechanical” spread of tumor is that which occurs through physical trauma, such as during surgical resection. There has been a waxing and waning of interest in this concept over the past 70 years. We have collected the blood that comes off the surgical field during major head and neck resections and separated and plated all nucleated cells in the tumor stem cell assay of Hamburger and Salmon. In one of six such preparations, we demonstrated the presence of viable, colony-forming tumor cells. Two were contaminated and three did not grow. We demonstrated, therefore, that the blood that bathes the raw open surgical field contains tumor cells that are viable and potentially capable of producing new foci of tumor.

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Immunotherapy Approaches in HPV-Associated Head and Neck Cancer

Cancers ◽

10.3390/cancers13235889 ◽

2021 ◽

Vol 13 (23) ◽

pp. 5889

Author(s):

Ricklie Julian ◽

Malvi Savani ◽

Julie E. Bauman

Keyword(s):

Head And Neck ◽

Clinical Evidence ◽

Tumor Antigens ◽

Checkpoint Inhibitors ◽

Therapeutic Approaches ◽

Improved Outcomes ◽

Hpv Status ◽

Management Of Hpv ◽

Tumor Types

Immunotherapy approaches for head and neck squamous cell carcinoma (HNSCC) are rapidly advancing. Human papillomavirus (HPV) has been identified as a causative agent in a subset of oropharyngeal cancers (OPC). HPV-positive OPC comprises a distinct clinical and pathologic disease entity and has a unique immunophenotype. Immunotherapy with anti-PD1 checkpoint inhibitors has exhibited improved outcomes for patients with advanced HNSCC, irrespective of HPV status. To date, the clinical management of HPV-positive HNSCC and HPV-negative HNSCC has been identical, despite differences in the tumor antigens, immune microenvironment, and immune signatures of these two biologically distinct tumor types. Numerous clinical trials are underway to further refine the application of immunotherapy and develop new immunotherapy approaches. The aim of this review is to highlight the developing role of immunotherapy in HPV-positive HNSCC along with the clinical evidence and preclinical scientific rationale behind emerging therapeutic approaches, with emphasis on promising HPV-specific immune activators that exploit the universal presence of foreign, non-self tumor antigens.

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The role of surgery and radiotherapy in treatment of soft tissue sarcomas of the head and neck region: Review of 30 cases

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.20507 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 20507-20507

Author(s):

F. Tas ◽

M. Fayda ◽

G. Aksu ◽

F. Y. Agaoglu ◽

A. Karadeniz ◽

...

Keyword(s):

Soft Tissue ◽

Head And Neck ◽

Surgical Resection ◽

Local Control ◽

Residual Disease ◽

Postoperative Radiotherapy ◽

Soft Tissue Sarcomas ◽

Neck Region ◽

Head And Neck Region

20507 Background: To evaluate the role of surgery and radiotherapy in the treatment of soft tissue sarcomas of the head and neck region Methods: Thirty adult patients with head and neck soft tissue sarcoma were retrospectively analyzed. The most frequent histopathologic subtypes were chondrosarcomas (27%) and malignant fibrous histiocytoma (20%). The surgical resection was performed in 25 of the 30 patients (83%). Negative surgical margins could be achieved only in 9 of 25 patients (36%). Ten patients had marginal resection (40%) and 6 patients (24%) had gross residual disease after the surgery. All patients in the surgical resection arm received postoperative radiotherapy except two patients. Results: Five-year local control rates for patients with negative surgical margins (n=9), microscopically positives (n=10), gross residual disease (n=6) and inoperable (n=5) cases were 64%, 70%, 20% and 0% respectively. The median disease free survivals were 26.6 months, 17.7 months, 8.4 and 5.5 months. However, there was no significant difference in local control between patients with negative or microscopically positive disease who receive postoperative radiotherapy (71% vs 70%). The higher dose of radiotherapy (= 60Gy) was found to be associated with a longer local control (p=0.048). The local control rates were lower in patients with grade 2–3 tumors as compared with grade 1 tumors (44% vs. 83%). The median overall survival of whole group was 31 months. Median survivals of patients receiving both surgery and radiotherapy with negative and microscopically positive margins were significantly better than patients who were not treated with surgery (34.8 and 36 months vs. 13.3 months). In univariate analysis grade 1–2 vs. 3, had statistically significant 5-year survival difference (64% vs. 14%, p=0.003). The presence of local relapse had clear negative effect on survival (absent vs. present 66% vs. 7%, p=0.0003). Conclusions: Our results and the findings in the literature confirm that the optimal treatment of head and neck soft tissue sarcomas is complete surgical excision. Postoperative adjuvant radiotherapy clearly improves local control however the high locoregional failure rates still indicate the need for improved treatment strategies. No significant financial relationships to disclose.

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