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Ranganathan K, Kavitha L. Clinical aspects of oral cancer and potentially malignant disorders in South and Southeast Asia. Oral Dis 2024. [PMID: 38817004 DOI: 10.1111/odi.15008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/29/2024] [Accepted: 05/08/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Oral cancer and Oral Potentially Malignant Disorders (OPMD) are major health problems in South and Southeast Asia. AIMS To describe and discuss the clinical aspects of Oral Cancer and OPMD in South and Southeast Asia. MATERIALS AND METHODS Literature review of concepts and data over the last four decades. DISCUSSION Asian countries account for about two-thirds of new cases of oral cancer (OC) globally, with the highest burden in the South and Southeast Asian countries, including Pakistan and India. Habits, dietary patterns, socioeconomic status, and access to routine dental care play a crucial role in defining the demographics and clinical presentation of OC in these regions and significantly influence the morbidity and mortality of the disease. This region sees the use of different types of tobacco with or without areca nut (AN), such as pan masala, gutka, gul, snuff, mawa, and mishri. Tobacco use is high among men in Sri Lanka, Myanmar, Maldives, Bangladesh, Nepal, India and Bhutan. Areca nut is the fourth most common addictive substance globally and is frequently used in South and Southeast Asian countries, including Southeast China, Hainan Island, India, Taiwan, and the Pacific Islands, and immigrants from these regions in Africa, Europe, and North America. The use of these products results in mucosal alterations with varied clinical presentation of Oral Potentially Malignant Disorders (OPMDs) and OC. We discuss here the different types of OPMD and OC, the diagnostic aids and their relevance in clinical practice, and factors that influence their prognosis.
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Affiliation(s)
- Kannan Ranganathan
- Ragas Dental College and Hospital, Affiliated to The Tamil Nadu Dr. M.G.R. Medical University, Chennai, Tamil Nadu, India
| | - Loganathan Kavitha
- Ragas Dental College and Hospital, Affiliated to The Tamil Nadu Dr. M.G.R. Medical University, Chennai, Tamil Nadu, India
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Lal B, Thakur D, Gupta P, Dadwal M, Singh M. The Significance of Systemic Inflammatory Markers in Prognosis of Head and Neck Squamous Cell Cancers. Indian J Otolaryngol Head Neck Surg 2024; 76:41-47. [PMID: 38440621 PMCID: PMC10908702 DOI: 10.1007/s12070-023-04070-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/08/2023] [Indexed: 03/06/2024] Open
Abstract
This present study aimed to assess the predictive significance of two systemic inflammatory markers, the neutrophilic to lymphocytic ratio (NLR) and platelet to lymphocytic ratio (PLR), in evaluating the prognosis of individuals. The research involved 47 patients diagnosed with head and neck squamous cell carcinoma, all of whom were histo-pathologically confirmed and aged over 18 years. The patients were monitored every 6 months for a period of 18 months. The average age of the study participants was 57.66 ± 13.5 years, with 42 (89.36%) being male and 5 (10.64%) female. After 6 months, the mean PLR in patients with residual/recurrence was 161.5 ± 8.5, which was significantly, exceeded that of patients without residual/recurrence (109.07 ± 36.29; p value < 0.0001). However, no significant correlation was seen between the NLR (p value = 0.822) and residual/recurrence after 6 months. After 12 months, the mean NLR in patients with recurrence was 4.89 ± 0.69, which was significantly higher compared to patients without recurrence (3.48 ± 1.01; p value = 0.025). Conversely, no significant association was found between the PLR (p value = 0.751) and recurrence after 12 months. Notably, there were no significant associations observed in NLR and PLR at the 18-month mark. Elevated levels of the NLR and PLR can serve as indicators of poor prognosis and the presence of residual/recurrent disease in head and neck malignancies.
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Affiliation(s)
- Bhushan Lal
- Department of Otorhinology, Indra Gandhi Medical College & Hospital, Shimla, Himachal Pradesh India
| | - Diksha Thakur
- Department of Otorhinology, Indra Gandhi Medical College & Hospital, Shimla, Himachal Pradesh India
| | - Payal Gupta
- Department of Otorhinology, Indra Gandhi Medical College & Hospital, Shimla, Himachal Pradesh India
| | - Madhuri Dadwal
- Department of Otorhinology, Indra Gandhi Medical College & Hospital, Shimla, Himachal Pradesh India
| | - Mahender Singh
- Department of Otorhinology, Indra Gandhi Medical College & Hospital, Shimla, Himachal Pradesh India
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Choi SY, Shim J, Gu DE, Kim SY, Kim HJ, Shin DY, Chung MK. Clonal evolution of long-term expanding head and neck cancer organoid: Impact on treatment response for personalized therapeutic screening. Oral Oncol 2023; 146:106571. [PMID: 37741019 DOI: 10.1016/j.oraloncology.2023.106571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/27/2023] [Accepted: 09/16/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVES In biobanking based on patient-derived organoids (PDO), the genetic stability of organoid lines is critical for the clinical relevance of PDO with parental tumors. However, data on mutational heterogeneity and clonal evolution of PDO and their effects on treatment response are insufficient. METHODS To investigate whether head and neck cancer organoids (HNCOs) could maintain the genetic characteristics of their original tumors and elucidate the clonal evolution process during a long-term passage, we performed targeted sequencing, covering 377 cancer-related genes and adopted a sub-clonal fraction model. To explore therapeutic response variability between an early and late passage (>passage 6), we generated dose-response curves for drugs and radiation using two HNCO lines. RESULTS Using 3D ex vivo organoid culture protocol, we successfully established 27 HNCOs from 39 patients with an overall success rate of 70% (27/39). Their mutational profiles were highly concordant, with three of the HNCOs analyzed showing greater than 70% concordance. Only one HNCO displayed less than 50% concordance. However, many of these organoid lines displayed clonal evolution during serial passaging, although major cancer driver genes and VAF distributions were shared between early and later passages. We also found that all late passages of HNCOs tended to be more sensitive to radiation than early passages, similar to drug response results. CONCLUSIONS We report the establishment of HNCO lines derived from 27 patients and demonstrate their genetic concordance with corresponding parental tumors. Furthermore, we show serial changes in mutational profiles of HNCO along with long passage culture and the impact of these clonal evolutions on response to radiotherapy.
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Affiliation(s)
- Sung Yong Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, National Cancer Center, Goyang, Republic of Korea
| | - Joonho Shim
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Do-Eon Gu
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Soo Yoon Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Hye Jin Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Da-Yong Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Man Ki Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
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Win Myint TT, McIvor N, Douglas R, Tin Tin S, Elwood M. Incidence, trends, and survival of oropharyngeal squamous cell cancer in Aotearoa New Zealand, 2006-2020. Cancer Epidemiol 2023; 85:102393. [PMID: 37267678 DOI: 10.1016/j.canep.2023.102393] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/07/2023] [Accepted: 05/19/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND An increasing trend of oropharyngeal cancer (OPC) has been reported in several countries with different demographic characteristics, and often attributed to increases in human papillomavirus (HPV) infection. The survival of patients with OPC has steadily improved, especially for those with positive HPV status. This study assessed the incidence, trends, and survival of OPC in Aotearoa New Zealand (NZ) by age at diagnosis, sex and ethnicity. METHODS The study included all 2109 patients resident in NZ with a primary diagnosis of oropharyngeal squamous cell carcinoma from 2006 to 2020, identified from the National Cancer Registry. We assessed age-standardised incidence rate (ASR), annual percent change (APC) and overall and relative survival rates. RESULTS The average annual incidence of OPC was 2.2 per 100,000 population. There was a steady increase of 4.9% per year over 15 years. Although the incidence rates were higher in males over the study period, the overall rate of increase was similar in males (4.9%) and in females (4.3%). The incidence was highest in the 50-69-year group (8.8/100,000 population). This age group had an incidence that increased by 7.5% per year to 2018, and then declined. The main increase in rates was seen between the birth cohort of 1946-50 and that of 1956-60. The increase in incidence was seen in Māori and Pākehā/European populations, but no increase was seen in Pacific or Asian populations. The 5-year overall relative survival rate improved from 69% in 2006-13 to 78% in 2014-20. Survival rates were lower in older patients, females, and Māori patients. CONCLUSION This study confirmed a substantial increase in OPC incidence in NZ, with some evidence to suggest a recent slowing in this increase. Māori and Pākehā/European had the highest incidence, while Pacific and Asian populations showed the lowest rates and no increase over the study period. Survival rates have improved over time, but remained lower in some demographic groups.
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Affiliation(s)
- Thu Thu Win Myint
- School of Population Health, The University of Auckland, Auckland, New Zealand; Department of Surgery, The University of Auckland, Auckland, New Zealand.
| | - Nick McIvor
- Department of Otorhinolaryngology, Head and Neck Surgery, Te Toka Tumai Auckland, Te Whatu Ora - Health, New Zealand
| | - Richard Douglas
- Department of Surgery, The University of Auckland, Auckland, New Zealand; Department of Otorhinolaryngology, Head and Neck Surgery, Te Toka Tumai Auckland, Te Whatu Ora - Health, New Zealand
| | - Sandar Tin Tin
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Mark Elwood
- School of Population Health, The University of Auckland, Auckland, New Zealand
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A novel 3D pillar/well array platform using patient-derived head and neck tumor to predict the individual radioresponse. Transl Oncol 2022; 24:101483. [PMID: 35850059 PMCID: PMC9294182 DOI: 10.1016/j.tranon.2022.101483] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/24/2022] [Accepted: 07/06/2022] [Indexed: 12/24/2022] Open
Abstract
Radiotherapy is a critical modality in head and neck cancer treatment. A novel 3D pillar/well array platform provides the individual radioresponse biomarker, RTauc. Poor and good radioresponse group by RTauc correlates with other clinical features. RTauc shows potential for radioresponse biomarker, useful in clinical decision-making.
Predicting individual radiotherapy (RT) response is valuable in managing head and neck squamous cell carcinoma (HNSCC). We assessed the feasibility of our novel 3D culture platform to measure radioresponse using patient-derived cells (PDCs) from HNSCC patients. Cells from the FaDu line and tumor samples from 39 HNSCC patients were cultivated serially in MatrigelTM on a 3D pillar/well array culture system. The 3D tumor models were exposed to 0 to 8 Gy of radiation dose, and the radioresponse index (RTauc, area under the dose-response curve) was measured quantitatively with Calcein AM staining of live tumor cells. Calcein AM fluorescence showed reduced density and the number of FaDu colonies as radiation increased, implying a dose-dependent effect on cell viability in the 3D pillar/well culture system. 3D tumor models using PDCs were established successfully from 39 HNSCC patient tumor samples, maintaining original genomic and pathological characteristics. These 3D tumor models were exposed to ionizing radiation on a 3D pillar/well array, with a mean period of 12 days from tumor harvest to the measurement of RTauc. The RTauc of all PDCs varied from 3.5 to 9.4, and the lower 40th percentile (Z-score = -0.26) was considered a good radioresponse group with a threshold RTauc of 4.6. The good radioresponse group showed fewer adverse features than others. As of the last follow-up, recurrence-free survival was better in the good radioresponse group (p = 0.037). 3D pillar/well array platforms using PDC could rapidly quantify radioresponse index in patients with HNSCC, showing potential as a novel prognosticator.
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Cho U, Sung YE, Kim MS, Lee YS. Prognostic Role of Systemic Inflammatory Markers in Patients Undergoing Surgical Resection for Oral Squamous Cell Carcinoma. Biomedicines 2022; 10:biomedicines10061268. [PMID: 35740290 PMCID: PMC9220324 DOI: 10.3390/biomedicines10061268] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 02/06/2023] Open
Abstract
Background: A high platelet−lymphocyte ratio (PLR) is a marker of systemic inflammation and, together with the neutrophil−lymphocyte ratio (NLR), is associated with poor outcomes in several cancers. We investigated the prognostic value of PLR and other systemic inflammatory markers, such as NLR, systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI), in oral squamous cell carcinoma (OSCC) patients undergoing surgical resection. Methods: We derived PLR, NLR, SII, and SIRI from a retrospective chart review of 269 consecutive OSCC patients. The complete blood count examined in the immediate preoperative period was used to compute PLR, NLR, SII, and SIRI. We analyzed the relationship between these systemic inflammatory markers and the clinicopathologic characteristics, disease-specific survival (DSS), and progression-free survival (PFS) of patients. Results: In the univariate analysis, high PLR and SII were significantly associated with worse DSS and PFS (all p < 0.05). In the multivariate analysis, PLR (HR 2.36, 95% CI 1.28−4.36 for DSS; HR 1.80, 95% CI 1.06−3.06 for PFS) was an independent predictor of survival outcomes. When PLR was analyzed as a continuous variable, the relationship between the outcome and preoperative PLR was not monotonically linear. In the subgroup analysis, PLR was more strongly associated with DSS and PFS in patients who were male, had stage III/IV OSCC, or had lymph node metastasis. Conclusion: Our data suggest that in OSCC patients, the pretreatment PLR is an independent predictor of DSS and PFS. The PLR is a readily available biomarker that will improve prognostication and risk stratification in OSCC.
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Affiliation(s)
- Uiju Cho
- Department of Hospital Pathology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Yeoun-Eun Sung
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Min-Sik Kim
- Department of Otorhinolaryngology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Youn-Soo Lee
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
- Correspondence:
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Jun HW, Ji YB, Song CM, Myung JK, Park HJ, Tae K. Positive Rate of Human Papillomavirus and Its Trend in Head and Neck Cancer in South Korea. Front Surg 2022; 8:833048. [PMID: 35127812 PMCID: PMC8814325 DOI: 10.3389/fsurg.2021.833048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/29/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction This study aimed to investigate the positive rate of human papillomavirus (HPV) and its trend in head and neck squamous cell carcinoma (HNSCC) in South Korea and to evaluate the clinical differences between HPV-positive and -negative tumors. Methods We studied 300 patients with HNSCC arising in the oropharynx (n = 77), oral cavity (n = 65), larynx (n = 106), hypopharynx (n = 40), and sinonasal cavity (n = 12), treated in a tertiary university hospital in South Korea from January 2008 to July 2020. HPV status was determined using p16 immunohistochemical staining of formalin-fixed paraffin-embedded tissues. Results Of the 300 patients with HNSCC, the positive rate of p16 was 30.3% (91/300). The p16 positive rate was 70.1, 13.9, 20.8, 15, and 0% in the oropharynx, oral cavity, larynx, hypopharynx, and sinonasal cavity, respectively. HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) patients were significantly younger than HPV-negative OPSCC patients. The positive rate of HPV in OPSCC has increased over time from 2008 to 2020, but has not changed significantly in the other primary sites. The disease-free survival curve of HPV-positive OPSCC was significantly better than that of HPV-negative tumors. Conclusion The positive rate of HPV in Korean patients with OPSCC is significantly high (70.1%), similar to that in North America and Europe, and has increased abruptly in the past 12 years.
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Affiliation(s)
- Hyun Woong Jun
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea
| | - Yong Bae Ji
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea
| | - Chang Myeon Song
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea
| | - Jae Kyung Myung
- Department of Pathology, College of Medicine, Hanyang University, Seoul, South Korea
| | - Hae Jin Park
- Department of Radiation Oncology, College of Medicine, Hanyang University, Seoul, South Korea
| | - Kyung Tae
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea
- *Correspondence: Kyung Tae
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