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Fisher MD, Fernandes AW, Olufade TO, Miller PJ, Walker MS, Fenton M. Patient Characteristics and Costs in Recurrent or Refractory Head and Neck Cancer: Retrospective Analysis of a Community Oncology Database. Clin Ther 2018. [PMID: 29530457 DOI: 10.1016/j.clinthera.2018.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE The goal of this study was to describe patient characteristics, health resource utilization (HRU), and costs associated with treating recurrent or refractory head and neck cancer (HNC) among patients with disease progression in the community oncology setting. METHODS This retrospective observational study was conducted by using data from the Vector Oncology Data Warehouse. Patients had been diagnosed with locally advanced or metastatic (stage III-IVc) HNC between January 1, 2007, and October 1, 2015. Patients also had evidence of at least 1 systemic anticancer therapy regimen following the diagnosis of advanced HNC, with at least 1 disease progression. Costs, treatment patterns, and HRU were evaluated beginning with diagnosis of advanced HNC through 3 lines of therapy. Costs of surgery or radiation were not available for inclusion in the analysis. Total cost for the study period and cost per month were analyzed by using a generalized linear regression model. FINDINGS The study included 462 patients (median age, 61 years; range, 26-99 years); of these, 81% were male, 77% were white, and 21% were black. At initial diagnosis, the most frequent tumor locations were the hypopharynx/larynx (31%) and the oropharynx (31%). Human papilloma virus testing was most frequent among the oropharynx group (22% tested, 52% positive). Overall, 42% were current tobacco users and 22% were current or past alcohol abusers/excessive users. Platinum-based combination therapies were the most frequently administered chemotherapy in both first (42%) and second (40%) lines of treatment. Through the overall study period (mean, 20.5 months), 74% of patients were hospitalized, 19% had an emergency department visit, and 100% had an office visit. The overall mean (SD) duration of hospital stay was 12.6 days, and the median number of office visits per patient was 35. The mean monthly health care cost for the overall study period was $14,391 (95% CI, 12,739-16,044). Hospitalization costs represented ~57% of the total expenditures. Statistically significant predictors of higher overall cost included primary tumor location in the oral cavity, history of alcohol abuse/excess use, use of cetuximab, and higher comorbidity index. Older age and being stage IV versus other stages of disease at diagnosis were associated with lower overall cost. IMPLICATIONS These data suggest that costs of care in patients with recurrent or refractory HNC are related to patient characteristics and treatment patterns. Identification of factors contributing to the costs of care in HNC may provide a useful foundation for developing strategies to control rising costs.
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102
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Moore A. Observer variation in the delineation of organs at risk for head and neck radiation therapy treatment planning: a systematic review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2018; 16:50-56. [PMID: 29324556 DOI: 10.11124/jbisrir-2016-003250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTION The objective of this review is to examine inter- and intra-observer agreement and reliability in the delineation of head and neck organs at risk (OAR) as part of the radiation therapy treatment planning process.More specifically, the objectives are to identify.
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Affiliation(s)
- Alisha Moore
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Newcastle, Australia
- Trans-Tasman Radiation Oncology Group (TROG) Cancer Research, Newcastle, Australia
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103
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Lim Y, Totsika M, Morrison M, Punyadeera C. Oral Microbiome: A New Biomarker Reservoir for Oral and Oropharyngeal Cancers. Theranostics 2017; 7:4313-4321. [PMID: 29158828 PMCID: PMC5695015 DOI: 10.7150/thno.21804] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 08/23/2017] [Indexed: 12/29/2022] Open
Abstract
Current biomarkers (DNA, RNA and protein) for oral cavity and oropharyngeal cancers demonstrate biological variations between individuals, rendering them impractical for clinical translation. Whilst these biomarkers originate from the host, there is not much information in the literature about the influence of oral microbiota on cancer pathogenesis, especially in oral cancers. Oral microbiotas are known to participate in disease initiation and progression not only limited to the oral cavity, but also at other distant sites. Due to the close proximity of oral microbiota and oral cavity and oropharyngeal tumours, abundance changes in oral microbiota may provide useful information on tumourigenesis. This review aims to highlight information on the role of oral microbiota in oral cavity and oropharyngeal cancers. An in-depth analysis into the oral microbiota may provide a new avenue to diagnose and treat these patients.
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Affiliation(s)
- Yenkai Lim
- The School of Biomedical Sciences, Institute of Health and Biomedical Innovations, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia
- The Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane, QLD, 4102, Australia
| | - Makrina Totsika
- The School of Biomedical Sciences, Institute of Health and Biomedical Innovations, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia
| | - Mark Morrison
- The University of Queensland Diamantina Institute, The University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane, QLD, 4102, Australia
| | - Chamindie Punyadeera
- The School of Biomedical Sciences, Institute of Health and Biomedical Innovations, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4059, Australia
- The Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane, QLD, 4102, Australia
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104
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Ward MC, Shah C, Adelstein DJ, Geiger JL, Miller JA, Koyfman SA, Singer ME. Cost-effectiveness of nivolumab for recurrent or metastatic head and neck cancer☆. Oral Oncol 2017; 74:49-55. [PMID: 29103751 DOI: 10.1016/j.oraloncology.2017.09.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 09/05/2017] [Accepted: 09/17/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Nivolumab is the first drug to demonstrate a survival benefit for platinum-refractory recurrent or metastatic head and neck cancer. We performed a cost-utility analysis to assess the economic value of nivolumab as compared to alternative standard agents in this context. MATERIALS AND METHODS Using data from the CheckMate 141 trial, we constructed a Markov simulation model from the US payer's perspective to evaluate the cost-effectiveness of nivolumab compared to physician choice of either cetuximab, methotrexate or docetaxel. Alternative strategies considered included: single-agent cetuximab, methotrexate or docetaxel, or first testing for PD-L1 to select for nivolumab. Costs were extracted from Medicare and utilities from the literature and CheckMate. Probabilistic sensitivity analysis (PSA) was used to evaluate parameter uncertainty. $100,000/QALY was the primary threshold for cost-effectiveness. RESULTS When comparing nivolumab to the standard arm of CheckMate, nivolumab demonstrated an incremental cost-effectiveness ratio (ICER) of $140,672/QALY. When comparing standard therapies, methotrexate was the most cost-effective with similar results for docetaxel. Nivolumab was cost-effective compared to single-agent cetuximab (ICER $89,786/QALY). Treatment selection by PD-L1 immunohistochemistry did not markedly improve the cost-effectiveness of nivolumab. Factors likely to positively impact the cost-effectiveness of nivolumab include better baseline quality-of-life, poor tolerability of standard treatments and/or a lower cost of nivolumab. CONCLUSIONS Nivolumab is preferred to single-agent cetuximab but requires a willingness-to-pay of at least $150,000/QALY to be considered cost-effective when compared to docetaxel or methotrexate. Selection by PD-L1 does not markedly improve the cost-effectiveness of nivolumab. This informs patient selection and clinical care-path development.
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Affiliation(s)
- Matthew C Ward
- Southeast Radiation Oncology Group, PA, Charlotte, NC, USA.
| | - Chirag Shah
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - David J Adelstein
- Department of Hematology Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jessica L Geiger
- Department of Hematology Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jacob A Miller
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Shlomo A Koyfman
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Mendel E Singer
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA.
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105
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Han P, Gao F, Liu H, Liu Z, Shi Q, Troy JD, Owzar K, Lee W, Zevallos JP, Sturgis EM, Wei Q. Reduced mRNA expression of nucleotide excision repair genes in lymphocytes and risk of squamous cell carcinoma of the head and neck. Carcinogenesis 2017; 38:504-510. [PMID: 28379545 DOI: 10.1093/carcin/bgx028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 03/15/2017] [Indexed: 12/31/2022] Open
Abstract
Nucleotide excision repair (NER) plays a critical role in the development of smoking-related cancers. We hypothesize that mRNA expression levels of NER genes are associated with risk of the squamous cell carcinoma of head and neck (SCCHN). To test this hypothesis, we conducted a case-control study of 260 SCCHN patients and 246 cancer-free controls by measuring the mRNA expression levels of eight core NER genes in cultured peripheral lymphocytes. Compared with the controls, cases had statistically significantly lower expression levels of DDB1 and ERCC3 (P = 0.015 and 0.041, respectively). Because DDB1 and ERCC3 expression levels were highly correlated, we used DDB1 for further multivariate analyses and modeling. After dividing the subjects by controls' quartiles of expression levels, we found an association between an increased risk of SCCHN and low DDB1 expression levels [adjusted ORs and 95% CIs: 1.92 and 1.11-3.32, 1.48 and 0.85-2.59, 2.00 and 1.15-3.45 for the 2nd-4th quartiles, respectively, compared with the 1st quartile; Ptrend = 0.026]. We also identified a multiplicative interaction between sex and DDB1 expression levels (P = 0.007). Finally, the expanded model with gene expression levels, in addition to demographic and clinical variables, on SCCHN risk was significantly improved, especially among men. In conclusion, reduced DDB1 expression levels were associated with an increased risk of SCCHN. However, these results need to be validated in larger studies.
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Affiliation(s)
- Peng Han
- Duke Cancer Institute, Duke University Medical Center and.,Department of Medicine, Duke University School of Medicine, Durham, NC, 27710, USA.,Department of Otorhinolaryngology-Head and Neck Surgery, Second Affiliated Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, 710004, PR China
| | - Fengqin Gao
- Duke Cancer Institute, Duke University Medical Center and.,Department of Medicine, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Hongliang Liu
- Duke Cancer Institute, Duke University Medical Center and.,Department of Medicine, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Zhensheng Liu
- Duke Cancer Institute, Duke University Medical Center and.,Department of Medicine, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Qiong Shi
- Duke Cancer Institute, Duke University Medical Center and.,Department of Medicine, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Jesse D Troy
- Duke Cancer Institute, Duke University Medical Center and.,Division of Blood and Marrow Transplantation and
| | - Kouros Owzar
- Duke Cancer Institute, Duke University Medical Center and.,Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, 27710, USA
| | - Walter Lee
- Duke Cancer Institute, Duke University Medical Center and.,Division of Head and Neck Surgery Communications Science, Department of Surgery, Duke University Medical Center, Durham, NC, 27710, USA
| | - Jose P Zevallos
- Department of Otolaryngology-Head and Neck Surgery and.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA and
| | - Erich M Sturgis
- Departments of Head and Neck Surgery and.,Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, 77030, USA
| | - Qingyi Wei
- Duke Cancer Institute, Duke University Medical Center and.,Department of Medicine, Duke University School of Medicine, Durham, NC, 27710, USA
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Giacalone NJ, Qureshi MM, Mak KS, Kirke D, Patel SA, Shah BA, Salama AR, Jalisi S, Truong MT. Adjuvant chemoradiation does not improve survival in elderly patients with high-risk resected head and neck cancer. Laryngoscope 2017; 128:831-840. [PMID: 28833217 DOI: 10.1002/lary.26798] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/06/2017] [Accepted: 06/21/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Randomized trials have demonstrated that adjuvant chemoradiotherapy (CRT) confers an overall survival (OS) benefit over adjuvant radiation therapy (RT) alone in patients with resected head and neck squamous cell carcinoma (HNSCC) with adverse pathologic features (positive surgical margins [SM+] and/or extracapsular extension [ECE]). Whether this OS benefit exists in an elderly population remains unknown. STUDY DESIGN Retrospective database study. METHODS Using the National Cancer Database, we identified 1,686 elderly patients (age ≥70 years) with resected HNSCC with SM+ and/or ECE, who received adjuvant CRT (491 patients, 29%) or adjuvant RT alone (1,195 patients, 71%) between 1998 and 2011. Three-year survival rates were estimated using the Kaplan-Meier method both before and after propensity score matching (PSM). Crude and adjusted hazard ratios (HR) with 95% confidence intervals (CI) were computed using Cox regression modeling. RESULTS Median follow-up was 23.5 and 42.8 months for all and surviving patients, respectively. Three-year OS was 50.7% and 44.4% among patients receiving adjuvant CRT and RT alone, respectively (P = .002). On multivariate analysis, there was no significant improvement in OS with adjuvant CRT relative to adjuvant RT alone (HR: 0.88, 95% CI: 0.73-1.06). Similarly, a PSM cohort showed no significant difference in the 3-year OS for patients receiving adjuvant CRT versus adjuvant RT alone (48.8% and 50.9%, respectively; P = .839). CONCLUSIONS Although the addition of chemotherapy to adjuvant RT has been proven effective in randomized trials of patients with resected HNSCC with SM+ or ECE, it may be less efficacious in an elderly patient population treated outside of a controlled trial setting. LEVEL OF EVIDENCE 2c. Laryngoscope, 128:831-840, 2018.
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Affiliation(s)
- Nicholas J Giacalone
- Harvard Radiation Oncology Program, Boston, Massachusetts, U.S.A.,Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, U.S.A
| | - Muhammad M Qureshi
- Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, U.S.A
| | - Kimberley S Mak
- Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, U.S.A
| | - Diana Kirke
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, U.S.A
| | - Sagar A Patel
- Harvard Radiation Oncology Program, Boston, Massachusetts, U.S.A.,Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, U.S.A
| | - Bhartesh A Shah
- Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, U.S.A
| | - Andrew R Salama
- Department of Oral and Maxillofacial Surgery, Boston Medical Center, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, U.S.A
| | - Scharukh Jalisi
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, U.S.A
| | - Minh Tam Truong
- Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, U.S.A
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107
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Keeping ST, Tempest MJ, Stephens SJ, Carroll SM, Simcock R, Jones TM, Shaw R. The cost of oropharyngeal cancer in England: A retrospective hospital data analysis. Clin Otolaryngol 2017; 43:223-229. [PMID: 28734109 DOI: 10.1111/coa.12944] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To estimate the total costs of treating head and neck cancers, specifically oropharyngeal, laryngeal and oral cavity cancer, in secondary care facilities in England during the period 2006/2007 to 2010/2011. DESIGN Patient records were extracted from an English hospital database to estimate the number of patients treated for oropharyngeal, laryngeal and oral cavity cancer in England. Identified resource use was linked to published United Kingdom cost estimates to quantify the reimbursement of treatment through the Payment by Results system. SETTING Retrospective hospital data analysis. PARTICIPANTS From the hospital data, patient records of patients treated for oropharyngeal, laryngeal and oral cavity cancer were selected. MAIN OUTCOME MEASURES Annual total costs of treatment, stratified by inpatient and outpatient setting and by male and female patients. RESULTS From 2006/2007 to 2010/2011, total costs of treatment across the three head and neck cancer sites were estimated to be approximately £309 million, with 90% attributable to inpatient care (bundled costs). Oropharyngeal cancer accounted for 37% of total costs. Costs and patient numbers increased over time, largely due to a rise in oropharyngeal cancer, where total costs increased from £17.21 million to £30.32 million, with over 1400 (52%) more inpatients treated in 2010/11 compared to 2006/07. CONCLUSIONS In 4 years, the number of patients with oropharyngeal cancer receiving some form of inpatient care increased by more than half, and associated costs increased by three quarters. This reinforces the case for prevention and early detection strategies to help contain this epidemiological and economic burden.
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Affiliation(s)
- S T Keeping
- Sanofi Pasteur MSD, Mallards Reach, Maidenhead, UK
| | | | | | - S M Carroll
- Sanofi Pasteur MSD, Mallards Reach, Maidenhead, UK
| | - R Simcock
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - T M Jones
- University of Liverpool, Aintree University Hospitals NHS Foundation Trust, Liverpool, UK
| | - R Shaw
- University of Liverpool, Aintree University Hospitals NHS Foundation Trust, Liverpool, UK
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108
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Bossi P, Alfieri S. The Benefit of a Multidisciplinary Approach to the Patient Treated with (Chemo) Radiation for Head and Neck Cancer. Curr Treat Options Oncol 2017; 17:53. [PMID: 27520784 DOI: 10.1007/s11864-016-0431-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OPINION STATEMENT In the past two decades, multidisciplinary care has emerged as new way to manage cancer given the need to gather together specific areas of expertise and to discuss the variety of treatment approaches available for each patient. Of all the cancer subtypes, head and neck cancer might be considered one of the most valid areas, from an oncological point of view, for a multidisciplinary approach to be applied. Head and Neck Cancer is a complex disease area due to its varied histology and subsites, its numerous feasible treatments, its multiple typical comorbidities, and its treatment-induced toxicities whose management requires the simultaneous involvement of several professionals as part of the same health care team. However, the benefits of a multidisciplinary team approach in this particular area have not yet been properly documented in terms of survival outcomes. Moreover, there are some concerns and the limitations of a multidisciplinary team approach for Head and Neck Cancer patients are still open to question: cost-efficiency, the implications from a medical law perspective, the level of expertise required and the timing of each intervention (fixed or as required; before, during or after oncological treatment), and the role of the leader with other interested specialists to optimize all multidisciplinary care mechanisms.
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Affiliation(s)
- Paolo Bossi
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milano, Italy.
| | - Salvatore Alfieri
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milano, Italy
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109
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Flores B, Price GW, Rayl JD. Systems Automation for Cancer Surveillance: A Lean Six Sigma Project for Tracking Care of Patients With Head and Neck Cancer. Fed Pract 2017; 34:S62-S68. [PMID: 30766311 PMCID: PMC6375471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
An automated tracking system was devised to identify new patients with head and neck cancer and to track follow-up tests and surveillance appointments after treatment.
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Affiliation(s)
- Barbara Flores
- is a cancer care coordinator and is Lean Green Belt certified; is a nurse practitioner; and is an IT specialist in the Office of Information and Technology, all at the Raymond G. Murphy VAMC in Albuquerque, New Mexico
| | - Gregory W Price
- is a cancer care coordinator and is Lean Green Belt certified; is a nurse practitioner; and is an IT specialist in the Office of Information and Technology, all at the Raymond G. Murphy VAMC in Albuquerque, New Mexico
| | - James D Rayl
- is a cancer care coordinator and is Lean Green Belt certified; is a nurse practitioner; and is an IT specialist in the Office of Information and Technology, all at the Raymond G. Murphy VAMC in Albuquerque, New Mexico
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110
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Bossi P, Cossu Rocca M, Corvò R, Depenni R, Guardamagna V, Marinangeli F, Miccichè F, Trippa F. The vicious circle of treatment-induced toxicities in locally advanced head and neck cancer and the impact on treatment intensity. Crit Rev Oncol Hematol 2017; 116:82-88. [DOI: 10.1016/j.critrevonc.2017.05.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 05/22/2017] [Accepted: 05/30/2017] [Indexed: 10/19/2022] Open
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111
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Worry in Head and Neck Cancer Caregivers: The Role of Survivor Factors, Care-Related Stressors, and Loneliness in Predicting Fear of Recurrence. Nurs Res 2017; 66:295-303. [PMID: 28654567 DOI: 10.1097/nnr.0000000000000223] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Fear of recurrence (FOR) is a primary concern for both cancer survivors and their caregivers, yet little is known about what care-related factors exacerbate this worry. OBJECTIVES This study aimed to establish the role of care-related stressors-as distinct from survivor characteristics-in predicting FOR in head and neck cancer caregivers. METHODS HNC survivor-caregiver dyads took part in a mailed survey. Survivors provided information on health and quality of life (using the Functional Assessment of Cancer Therapy Questionnaire). Caregivers provided sociodemographic information, impact of caring on their time and finances, as well as their level of social support (Oslo Support Scale), loneliness (3-point loneliness scale), and completed the Worry of Cancer Scale (to measure FOR). RESULTS Data from 180 dyads were available for analysis. Multiple regression analysis was used to examine the role of caregiver stressors, social support, and loneliness while controlling for caregiver and survivor characteristics. The model explained 28% of the variance in Worry of Cancer scores (FOR). Caregivers who reported more loneliness, spent more time caring, and had greater financial stress from caring had higher scores on Worry of Cancer (FOR). Female caregivers, those caring for younger survivors, and those with survivors who had undergone less extensive forms of surgery also reported higher FOR. DISCUSSION A combination of factors place caregivers at greater risk of cancer-related worry, paving the way for designing interventions aimed at reducing FOR in caregivers of patients with head and neck cancers.
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112
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Djordjevic G, Dagovic A, Ristic V, Kanjevac T, Brajkovic D, Popovic M. Trends and Patterns of Disparities in Oral Cavity and Pharyngeal Cancer in Serbia: Prevalence and Economic Consequences in a Transitional Country. Front Pharmacol 2017; 8:385. [PMID: 28670280 PMCID: PMC5472664 DOI: 10.3389/fphar.2017.00385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 06/01/2017] [Indexed: 01/27/2023] Open
Affiliation(s)
| | - Aleksandar Dagovic
- Department of Clinical Oncology, Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
| | - Vladimir Ristic
- Department of Orthodontics, Faculty of Dentistry, University of BelgradeBeograd, Serbia
| | - Tatjana Kanjevac
- Department of Dentistry, Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
| | - Denis Brajkovic
- Department of Dentistry, Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
| | - Milica Popovic
- Department of Dentistry, Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
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113
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Lu G, Little JV, Wang X, Zhang H, Patel MR, Griffith CC, El-Deiry MW, Chen AY, Fei B. Detection of Head and Neck Cancer in Surgical Specimens Using Quantitative Hyperspectral Imaging. Clin Cancer Res 2017; 23:5426-5436. [PMID: 28611203 DOI: 10.1158/1078-0432.ccr-17-0906] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 05/07/2017] [Accepted: 06/09/2017] [Indexed: 01/09/2023]
Abstract
Purpose: This study intends to investigate the feasibility of using hyperspectral imaging (HSI) to detect and delineate cancers in fresh, surgical specimens of patients with head and neck cancers.Experimental Design: A clinical study was conducted in order to collect and image fresh, surgical specimens from patients (N = 36) with head and neck cancers undergoing surgical resection. A set of machine-learning tools were developed to quantify hyperspectral images of the resected tissue in order to detect and delineate cancerous regions which were validated by histopathologic diagnosis. More than two million reflectance spectral signatures were obtained by HSI and analyzed using machine-learning methods. The detection results of HSI were compared with autofluorescence imaging and fluorescence imaging of two vital-dyes of the same specimens.Results: Quantitative HSI differentiated cancerous tissue from normal tissue in ex vivo surgical specimens with a sensitivity and specificity of 91% and 91%, respectively, and which was more accurate than autofluorescence imaging (P < 0.05) or fluorescence imaging of 2-NBDG (P < 0.05) and proflavine (P < 0.05). The proposed quantification tools also generated cancer probability maps with the tumor border demarcated and which could provide real-time guidance for surgeons regarding optimal tumor resection.Conclusions: This study highlights the feasibility of using quantitative HSI as a diagnostic tool to delineate the cancer boundaries in surgical specimens, and which could be translated into the clinic application with the hope of improving clinical outcomes in the future. Clin Cancer Res; 23(18); 5426-36. ©2017 AACR.
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Affiliation(s)
- Guolan Lu
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia
| | - James V Little
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Xu Wang
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia
| | - Hongzheng Zhang
- Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia
| | - Mihir R Patel
- Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia.,Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Christopher C Griffith
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Mark W El-Deiry
- Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia.,Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Amy Y Chen
- Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia.,Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Baowei Fei
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia. .,Winship Cancer Institute of Emory University, Atlanta, Georgia.,Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
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Meregaglia M, Cairns J, Alfieri S, Favales F, Mazzitelli D, Orlandi E, Licitra L, Bossi P. Eliciting Preferences for Clinical Follow-Up in Patients with Head and Neck Cancer Using Best-Worst Scaling. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2017; 20:799-808. [PMID: 28577698 DOI: 10.1016/j.jval.2017.01.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 11/07/2016] [Accepted: 01/27/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES There are no commonly accepted standards for monitoring patients treated for head and neck cancer. The aim of this study was to assess patients' preferences for different aspects of follow-up. METHODS A best-worst survey was conducted in a sample of head and neck cancer patients in clinical follow-up at the National Cancer Institute (Milan, Italy). Conditional logit regression with choice as the dependent variable was run to analyse the data. A covariate-adjusted analysis was performed in order to identify socio-demographic and clinical factors related to the selection of best-worst items. The participants were asked to report any difficulties encountered during the survey. RESULTS A total of 143 patients, predominantly male (74%) and with a mean age of 58 years were enrolled in the survey. The strongest positive preference was expressed for a hospital-based program of physical examinations with frequency decreasing over time. Conversely, the lowest valued item was not performing any positron emission tomography (PET) scan during follow-up. Patients with high educational levels were more likely to value attending a primary care-based program and undergoing intensive radiological investigations. Other patient-specific variables significantly associated with the choice of items were employment and living status, time already spent in follow-up and number of treatments received. CONCLUSIONS Overall, patients were more likely to choose an intensive follow-up scheme broadly consistent with the program currently administered by the hospital. There is little evidence of preference heterogeneity that might justify customized programs based on demographics. The best-worst scaling task appeared feasible for most participants.
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Affiliation(s)
- Michela Meregaglia
- Faculty of Public Health and Policy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK; Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy.
| | - John Cairns
- Faculty of Public Health and Policy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK; CCBIO, University of Bergen, Bergen, Norway
| | - Salvatore Alfieri
- Head and Neck Medical Oncology Department, IRCCS Foundation National Cancer Institute, Milan, Italy
| | - Federica Favales
- Head and Neck Medical Oncology Department, IRCCS Foundation National Cancer Institute, Milan, Italy
| | | | - Ester Orlandi
- Radiation Therapy Department, IRCCS Foundation National Cancer Institute, Milan, Italy
| | - Lisa Licitra
- Head and Neck Medical Oncology Department, IRCCS Foundation National Cancer Institute, Milan, Italy
| | - Paolo Bossi
- Head and Neck Medical Oncology Department, IRCCS Foundation National Cancer Institute, Milan, Italy
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Rodin D, Caulley L, Burger E, Kim J, Johnson-Obaseki S, Palma D, Louie AV, Hansen A, O'Sullivan B. Cost-Effectiveness Analysis of Radiation Therapy Versus Transoral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2017; 97:709-717. [DOI: 10.1016/j.ijrobp.2016.11.029] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 11/09/2016] [Accepted: 11/19/2016] [Indexed: 12/31/2022]
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Ahn SH, Hong HJ, Kwon SY, Kwon KH, Roh JL, Ryu J, Park JH, Baek SK, Lee GH, Lee SY, Lee JC, Chung MK, Joo YH, Ji YB, Hah JH, Kwon M, Park YM, Song CM, Shin SC, Ryu CH, Lee DY, Lee YC, Chang JW, Jeong HM, Cho JK, Cha W, Chun BJ, Choi IJ, Choi HG, Lee KD. Guidelines for the Surgical Management of Laryngeal Cancer: Korean Society of Thyroid-Head and Neck Surgery. Clin Exp Otorhinolaryngol 2017; 10:1-43. [PMID: 28043099 PMCID: PMC5327593 DOI: 10.21053/ceo.2016.01389] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 10/24/2016] [Indexed: 01/08/2023] Open
Abstract
Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to develop clinical practice guidelines for the surgical treatment of laryngeal cancer. This Task Force conducted a systematic search of the EMBASE, MEDLINE, Cochrane Library, and KoreaMed databases to identify relevant articles, using search terms selected according to the key questions. Evidence-based recommendations were then created on the basis of these articles. An external expert review and Delphi questionnaire were applied to reach consensus regarding the recommendations. The resulting guidelines focus on the surgical treatment of laryngeal cancer with the assumption that surgery is the selected treatment modality after a multidisciplinary discussion in any context. These guidelines do not, therefore, address non-surgical treatment such as radiation therapy or chemotherapy. The committee developed 62 evidence-based recommendations in 32 categories intended to assist clinicians during management of patients with laryngeal cancer and patients with laryngeal cancer, and counselors and health policy-makers.
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Affiliation(s)
- Korean Society of Thyroid-Head and Neck Surgery Guideline Task Force
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Catholic Kwandong University College of Medicine, Incheon, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, University of Ulsan College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, National Cancer Center, Goyang, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Korea Cancer Center Hospital, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Daejin Medical Center, Bundang Jesaeng Hospital, Seongnam, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Wonkwang University School of Medicine, Iksan, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Inje University College of Medicine, Busan, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Seonam University College of Medicine, Goyang, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea
| | - Soon-Hyun Ahn
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Jun Hong
- Department of Otorhinolaryngology Head and Neck Surgery, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Soon Young Kwon
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Kee Hwan Kwon
- Department of Otorhinolaryngology Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
| | - Jong-Lyel Roh
- Department of Otorhinolaryngology Head and Neck Surgery, University of Ulsan College of Medicine, Seoul, Korea
| | - Junsun Ryu
- Department of Otorhinolaryngology Head and Neck Surgery, National Cancer Center, Goyang, Korea
| | - Jun Hee Park
- Department of Otorhinolaryngology Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Korea
| | - Seung-Kuk Baek
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Guk Haeng Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Korea Cancer Center Hospital, Seoul, Korea
| | - Sei Young Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jin Choon Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Man Ki Chung
- Department of Otorhinolaryngology Head and Neck Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Hoon Joo
- Department of Otorhinolaryngology Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Bae Ji
- Department of Otorhinolaryngology Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Jeong Hun Hah
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Minsu Kwon
- Department of Otorhinolaryngology Head and Neck Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Young Min Park
- Department of Otorhinolaryngology Head and Neck Surgery, Daejin Medical Center, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Chang Myeon Song
- Department of Otorhinolaryngology Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Sung-Chan Shin
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Chang Hwan Ryu
- Department of Otorhinolaryngology Head and Neck Surgery, National Cancer Center, Goyang, Korea
| | - Doh Young Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Young Chan Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jae Won Chang
- Department of Otorhinolaryngology Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
| | - Ha Min Jeong
- Department of Otorhinolaryngology Head and Neck Surgery, Wonkwang University School of Medicine, Iksan, Korea
| | - Jae-Keun Cho
- Department of Otorhinolaryngology Head and Neck Surgery, Inje University College of Medicine, Busan, Korea
| | - Wonjae Cha
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Byung Joon Chun
- Department of Otorhinolaryngology Head and Neck Surgery, Seonam University College of Medicine, Goyang, Korea
| | - Ik Joon Choi
- Department of Otorhinolaryngology Head and Neck Surgery, Korea Cancer Center Hospital, Seoul, Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
| | - Kang Dae Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea
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Vahabzadeh-Hagh AM, Zipser BD, Tan HT, Hong AY, Clair JMS, Armin BB. More than just tissue diagnosis in a patient with maxillofacial bony lesions and hypercalcemia. Laryngoscope 2016; 127:1318-1321. [PMID: 27641155 DOI: 10.1002/lary.26300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2016] [Indexed: 12/19/2022]
Abstract
Brown tumors are a definitive feature of hyperparathyroidism. They are well-demarcated osteolytic lesions commonly in the appendicular skeleton. Primary hyperparathyroidism is typically suggested by hypercalcemia and hypophosphatemia on routine labs. Much more rarely do these cases present with a craniofacial mass. Here we investigate a unique presentation of terminal stage primary hyperparathyroidism with a growing maxillary mass emphasizing the importance of a broad differential diagnosis and key diagnostic studies. Hyperparathyroidism can present in very unique ways. As otolaryngologists in the frontline, we must think beyond just tissue diagnoses so that appropriate and expedited care may be implemented. Laryngoscope, 127:1318-1321, 2017.
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Affiliation(s)
- Andrew M Vahabzadeh-Hagh
- Department of Head and Neck Surgery , University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California, U.S.A
| | - Brian D Zipser
- Department of Radiology , Olive-View University of California Los Angeles Medical Center, Sylmar, California, U.S.A
| | - Hongying T Tan
- Department of Pathology and Clinic Labs , Olive-View University of California Los Angeles Medical Center, Sylmar, California, U.S.A
| | - Austin Y Hong
- Department of Head and Neck Surgery , University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California, U.S.A
| | - Jon Mallen-St Clair
- Department of Head and Neck Surgery , University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California, U.S.A
| | - Bob B Armin
- Department of Head and Neck Surgery , University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California, U.S.A
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Guthrie S, Bienkowska-Gibbs T, Manville C, Pollitt A, Kirtley A, Wooding S. The impact of the National Institute for Health Research Health Technology Assessment programme, 2003-13: a multimethod evaluation. Health Technol Assess 2016; 19:1-291. [PMID: 26307643 DOI: 10.3310/hta19670] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme supports research tailored to the needs of NHS decision-makers, patients and clinicians. This study reviewed the impact of the programme, from 2003 to 2013, on health, clinical practice, health policy, the economy and academia. It also considered how HTA could maintain and increase its impact. METHODS Interviews (n = 20): senior stakeholders from academia, policy-making organisations and the HTA programme. Bibliometric analysis: citation analysis of publications arising from HTA programme-funded research. Researchfish survey: electronic survey of all HTA grant holders. Payback case studies (n = 12): in-depth case studies of HTA programme-funded research. RESULTS We make the following observations about the impact, and routes to impact, of the HTA programme: it has had an impact on patients, primarily through changes in guidelines, but also directly (e.g. changing clinical practice); it has had an impact on UK health policy, through providing high-quality scientific evidence - its close relationships with the National Institute for Health and Care Excellence (NICE) and the National Screening Committee (NSC) contributed to the observed impact on health policy, although in some instances other organisations may better facilitate impact; HTA research is used outside the UK by other HTA organisations and systematic reviewers - the programme has an impact on HTA practice internationally as a leader in HTA research methods and the funding of HTA research; the work of the programme is of high academic quality - the Health Technology Assessment journal ensures that the vast majority of HTA programme-funded research is published in full, while the HTA programme still encourages publication in other peer-reviewed journals; academics agree that the programme has played an important role in building and retaining HTA research capacity in the UK; the HTA programme has played a role in increasing the focus on effectiveness and cost-effectiveness in medicine - it has also contributed to increasingly positive attitudes towards HTA research both within the research community and the NHS; and the HTA focuses resources on research that is of value to patients and the UK NHS, which would not otherwise be funded (e.g. where there is no commercial incentive to undertake research). The programme should consider the following to maintain and increase its impact: providing targeted support for dissemination, focusing resources when important results are unlikely to be implemented by other stakeholders, particularly when findings challenge vested interests; maintaining close relationships with NICE and the NSC, but also considering other potential users of HTA research; maintaining flexibility and good relationships with researchers, giving particular consideration to the Technology Assessment Report (TAR) programme and the potential for learning between TAR centres; maintaining the academic quality of the work and the focus on NHS need; considering funding research on the short-term costs of the implementation of new health technologies; improving the monitoring and evaluation of whether or not patient and public involvement influences research; improve the transparency of the priority-setting process; and continuing to monitor the impact and value of the programme to inform its future scientific and administrative development.
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Heuke S, Chernavskaia O, Bocklitz T, Legesse FB, Meyer T, Akimov D, Dirsch O, Ernst G, von Eggeling F, Petersen I, Guntinas-Lichius O, Schmitt M, Popp J. Multimodal nonlinear microscopy of head and neck carcinoma - toward surgery assisting frozen section analysis. Head Neck 2016; 38:1545-52. [PMID: 27098552 DOI: 10.1002/hed.24477] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 01/06/2016] [Accepted: 03/16/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Treatment of early cancer stages is deeply connected to a good prognosis, a moderate reduction of the quality of life, and comparably low treatment costs. METHODS Head and neck squamous cell carcinomas were investigated using the multimodal combination of coherent anti-Stokes Raman scattering (CARS), two-photon excited fluorescence (TPEF), and second-harmonic generation (SHG) microscopy. RESULTS An increased median TPEF to CARS contrast was found comparing cancerous and healthy squamous epithelium with a p value of 1.8·10(-10) . A following comprehensive image analysis was able to predict the diagnosis of imaged tissue sections with an overall accuracy of 90% for a 4-class model. CONCLUSION Nonlinear multimodal imaging is verified objectively as a valuable diagnostic tool that complements conventional staining protocols and can serve as filter in future clinical routine reducing the pathologist's workload. © 2016 Wiley Periodicals, Inc. Head Neck 38: First-1552, 2016.
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Affiliation(s)
- Sandro Heuke
- Leibniz Institute of Photonic Technology, Jena, Germany.,Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller University, Jena, Germany
| | - Olga Chernavskaia
- Leibniz Institute of Photonic Technology, Jena, Germany.,Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller University, Jena, Germany
| | - Thomas Bocklitz
- Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller University, Jena, Germany
| | - Fisseha Bekele Legesse
- Leibniz Institute of Photonic Technology, Jena, Germany.,Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller University, Jena, Germany
| | - Tobias Meyer
- Leibniz Institute of Photonic Technology, Jena, Germany.,Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller University, Jena, Germany
| | - Denis Akimov
- Leibniz Institute of Photonic Technology, Jena, Germany
| | - Olaf Dirsch
- Institute of Pathology, Klinikum Chemnitz, Chemnitz, Germany
| | - Günther Ernst
- Leibniz Institute of Photonic Technology, Jena, Germany.,Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - Ferdinand von Eggeling
- Leibniz Institute of Photonic Technology, Jena, Germany.,Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller University, Jena, Germany.,Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - Iver Petersen
- Institute of Pathology, Jena University Hospital, Jena, Germany
| | | | - Michael Schmitt
- Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller University, Jena, Germany
| | - Jürgen Popp
- Leibniz Institute of Photonic Technology, Jena, Germany. .,Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich-Schiller University, Jena, Germany.
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Lim Y, Sun CX, Tran P, Punyadeera C. Salivary epigenetic biomarkers in head and neck squamous cell carcinomas. Biomark Med 2016; 10:301-13. [DOI: 10.2217/bmm.16.2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The early detection of head and neck squamous cell carcinoma (HNSCC) continues to be a challenge to the clinician. Saliva as a diagnostic medium carries significant advantages including its close proximity to the region of interest, ease of collection and noninvasive nature. While the identification of biomarkers continues to carry significant diagnostic and prognostic utility in HNSCC, epigenetic alterations present a novel opportunity to serve this purpose. With the developments of novel and innovative technologies, epigenetic alterations are now emerging as attractive candidates in HNSCC. As such, this review will focus on two commonly aberrant epigenetic alterations: DNA methylation and microRNA expression in HNSCC and their potential clinical utility. Identification and validation of these salivary epigenetic biomarkers would not only enable early diagnosis but will also facilitate in the clinical management.
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Affiliation(s)
- Yenkai Lim
- The School of Biomedical Sciences, Institute of Health & Biomedical Innovations, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4001, Australia
| | - Charles Xiaohang Sun
- The School of Biomedical Sciences, Institute of Health & Biomedical Innovations, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4001, Australia
- School of Dentistry, The University of Queensland, 288 Herston Rd, Herston, Brisbane, QLD 4006, Australia
| | - Peter Tran
- The School of Biomedical Sciences, Institute of Health & Biomedical Innovations, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4001, Australia
- School of Dentistry, The University of Queensland, 288 Herston Rd, Herston, Brisbane, QLD 4006, Australia
| | - Chamindie Punyadeera
- The School of Biomedical Sciences, Institute of Health & Biomedical Innovations, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD 4001, Australia
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Individualised quality of life as a measure to guide treatment choices in squamous cell carcinoma of the head and neck. Oral Oncol 2016; 52:18-23. [DOI: 10.1016/j.oraloncology.2015.10.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 10/19/2015] [Accepted: 10/26/2015] [Indexed: 11/30/2022]
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Kim SY, Park JH, Kang KH, Hwang I, Yang HK, Won YJ, Seo HG, Lee D, Yoon SJ. The economic burden of cancer in Korea in 2009. Asian Pac J Cancer Prev 2015; 16:1295-301. [PMID: 25735370 DOI: 10.7314/apjcp.2015.16.3.1295] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer imposes a significant economic burden on individuals, families and society. The purpose of this study was to estimate the economic burden of cancer using the healthcare claims and cancer registry data in Korea in 2009. MATERIALS AND METHODS The economic burden of cancer was estimated using the prevalence data where patients were identified in the Korean Central Cancer Registry. We estimated the medical, non-medical, morbidity and mortality cost due to lost productivity. Medical costs were calculated using the healthcare claims data obtained from the Korean National Health Insurance (KNHI) Corporation. Non-medical costs included the cost of transportation to visit health providers, costs associated with caregiving for cancer patients, and costs for complementary and alternative medicine (CAM). Data acquired from the Korean National Statistics Office and Ministry of Labor were used to calculate the life expectancy at the time of death, age- and gender-specific wages on average, adjusted for unemployment and labor force participation rate. Sensitivity analysis was performed to derive the current value of foregone future earnings due to premature death, discounted at 3% and 5%. RESULTS In 2009, estimated total economic cost of cancer amounted to $17.3 billion at a 3% discount rate. Medical care accounted for 28.3% of total costs, followed by non-medical (17.2%), morbidity (24.2%) and mortality (30.3%) costs. CONCLUSIONS Given that the direct medical cost sharply increased over the last decade, we must strive to construct a sustainable health care system that provides better care while lowering the cost. In addition, a comprehensive cancer survivorship policy aimed at lower caregiving cost and higher rate of return to work has become more important than previously considered.
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Affiliation(s)
- So Young Kim
- Office for Public Healthcare, Chungbuk National University Hospital, Chungbuk National University, Cheong- ju, Korea E-mail : ,
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XPD, APE1, and MUTYH polymorphisms increase head and neck cancer risk: effect of gene-gene and gene-environment interactions. Tumour Biol 2015; 36:7569-79. [PMID: 25916209 DOI: 10.1007/s13277-015-3472-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 04/15/2015] [Indexed: 01/11/2023] Open
Abstract
In the present study, we investigated the effect of the DNA repair gene polymorphisms XPD Asp312Asn (G>A), APE1 Asp148Glu (T>G), and MUTYH Tyr165Cys (G>A) on the risk for head and neck cancer (HNC) in association with tobacco use in a population of Northeast India. The study subjects comprised of 80 HNC patients and 92 healthy controls. Genotyping was performed using amplification refractory mutation system-PCR (ARMS-PCR) for XPD Asp312Asn (G>A) and PCR using confronting two-pair primers (PCR-CTPP) for APE1 Asp148Glu (T>G) and MUTYH Tyr165Cys (G>A). The XPD Asp/Asn genotype increased the risk for HNC by 2-fold (odds ratio, OR = 2.072; 95 % CI, 1.025-4.190; p < 0.05). Interaction between APE1 Asp/Asp and XPD Asp/Asn as well as MUTYH Tyr/Tyr and XPD Asp/Asn genotypes further increased the risk by 2.9 (OR = 2.97; 95 % CI, 1.16-7.61; p < 0.05) and 2.3 (OR = 2.37; 95 % CI, 1.11-5.10; p < 0.05) folds, respectively. The risk was further increased in heavy smokers with the XPD Asp/Asn genotype and heavy tobacco chewers with XPD Asn/Asn genotype by 7.7-fold (OR = 7.749; 95 % CI, 2.53-23.70; p < 0.05) and 10-fold (OR = 10; 95 % CI, 1.26-79.13; p < 0.05), respectively. We thus conclude that the XPD Asp312Asn and APE1 Asp148Glu polymorphisms increase the risk for HNC in association with smoking and/or tobacco chewing in the population under study.
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Egestad H, Nieder C. Undesirable financial effects of head and neck cancer radiotherapy during the initial treatment period. Int J Circumpolar Health 2015; 74:26686. [PMID: 25623815 PMCID: PMC4306757 DOI: 10.3402/ijch.v74.26686] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 12/15/2014] [Accepted: 12/16/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Healthcare cost and reforms are at the forefront of international debates. One of the current discussion themes in oncology is whether and how patients' life changes due to costs of cancer care. In Norway, the main part of the treatment costs is supported by general taxpayer revenues. OBJECTIVES The objective of this study was to clarify whether head and neck cancer patients (n=67) in northern Norway experienced financial health-related quality of life (HRQOL) deterioration due to costs associated with treatment. DESIGN HRQOL was examined by the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 in the beginning and in the end of radiation treatment in patients treated at the University Hospital in Northern Norway. Changes in financial HRQOL were calculated and compared by paired sample T-tests. Multiple regression analyses were used to examine correlations among gender, marital status, age and treatment with or without additional chemotherapy and changes in the HRQOL domain of financial difficulties. RESULTS The majority of score results at both time points were in the lower range (mean 15-25), indicating limited financial difficulties. We observed no statistically significant differences by gender, marital status and age. Increasing financial difficulties during treatment were reported by male patients and those younger than 65, that is, patients who were younger than retirement age. The largest effect was seen in singles. However, differences were not statistically significant. CONCLUSIONS During the initial phase of the disease trajectory, no significant increase in financial difficulties was found. This is in line with the aims of the Norwegian public healthcare model. However, long-term longitudinal studies should be performed, especially with regard to the trends we observed in single, male and younger patients.
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Affiliation(s)
- Helen Egestad
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT, The Arctic University of Norway, Tromsø, Norway;
| | - Carsten Nieder
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT, The Arctic University of Norway, Tromsø, Norway; Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway
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