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Maglitto F, Copelli C, Manfuso A, Cocis S, Salzano G. Special Issue "New Updates in Oral and Maxillofacial Surgery". J Pers Med 2024; 14:705. [PMID: 39063959 PMCID: PMC11277887 DOI: 10.3390/jpm14070705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Accepted: 06/29/2024] [Indexed: 07/28/2024] Open
Abstract
In the ever-evolving landscape of medical science, few fields have witnessed as profound a transformation as oral and maxillofacial surgery [...].
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Affiliation(s)
- Fabio Maglitto
- Maxillo-Facial Surgery, Interdisciplinary Department of Medicine, University of Bari, 70100 Bari, Italy; (C.C.); (A.M.); (S.C.)
| | - Chiara Copelli
- Maxillo-Facial Surgery, Interdisciplinary Department of Medicine, University of Bari, 70100 Bari, Italy; (C.C.); (A.M.); (S.C.)
| | - Alfonso Manfuso
- Maxillo-Facial Surgery, Interdisciplinary Department of Medicine, University of Bari, 70100 Bari, Italy; (C.C.); (A.M.); (S.C.)
| | - Stefan Cocis
- Maxillo-Facial Surgery, Interdisciplinary Department of Medicine, University of Bari, 70100 Bari, Italy; (C.C.); (A.M.); (S.C.)
| | - Giovanni Salzano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy;
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Seretis K, Sfaelos K, Boptsi E, Gaitanis G, Bassukas ID. The Neutrophil-to-Lymphocyte Ratio as a Biomarker in Cutaneous Oncology: A Systematic Review of Evidence beyond Malignant Melanoma. Cancers (Basel) 2024; 16:1044. [PMID: 38473401 DOI: 10.3390/cancers16051044] [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: 02/14/2024] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
With the ongoing progress of basic research along with the introduction of new pharmaceutical options spanning almost all therapeutic areas, the need for biomarkers that will be implemented into the personalized medical approach is higher than ever. Their use can be incorporated into clinical practice and can be applied to the classification of disorders and the evaluation of disease severity but also to the monitoring of the progress of therapeutic/pharmaceutical interventions. This systematic review collects the findings of hematologic biomarkers in various cutaneous malignancies, excluding malignant melanoma, to support their potential use in the prognosis but also in the assessment of therapeutic strategies for the specific category of skin disorders.
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Affiliation(s)
- Konstantinos Seretis
- Department of Plastic Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece
| | - Konstantinos Sfaelos
- Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece
| | - Elena Boptsi
- Department of Plastic Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece
| | - Georgios Gaitanis
- Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece
| | - Ioannis D Bassukas
- Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece
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Yeh TJ, Wang HC, Cho SF, Wu CC, Hsieh TY, Huang CT, Wang MH, Chuang TM, Gau YC, Du JS, Liu YC, Hsiao HH, Pan MR, Chen LT, Moi SH. The Prognosis Performance of a Neutrophil- and Lymphocyte-Associated Gene Mutation Score in a Head and Neck Cancer Cohort. Biomedicines 2023; 11:3113. [PMID: 38137334 PMCID: PMC10741104 DOI: 10.3390/biomedicines11123113] [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: 05/08/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
The treatment of head and neck squamous cell carcinomas (HNSCCs) is multimodal, and chemoradiotherapy (CRT) is a critical component. However, the availability of predictive or prognostic markers in patients with HNSCC is limited. Inflammation is a well-documented factor in cancer, and several parameters have been studied, with the neutrophil-to-lymphocyte ratio (NLR) being the most promising. The NLR is the most extensively researched clinical biomarker in various solid tumors, including HNSCC. In our study, we collected clinical and next-generation sequencing (NGS) data with targeted sequencing information from 107 patients with HNSCC who underwent CRT. The difference in the NLR between the good response group and the poor response group was significant, with more patients having a high NLR in the poor response group. We also examined the genetic alterations linked to the NLR and found a total of 41 associated genes across eight common pathways searched from the KEGG database. The overall mutation rate was low, and there was no significant mutation difference between the low- and high-NLR groups. Using a multivariate binomial generalized linear model, we identified three candidate genes (MAP2K2, MAP2K4, and ABL1) that showed significant results and were used to create a gene mutation score (GMS). Using the NLR-GMS category, we noticed that the high-NLR-GMS group had significantly shorter relapse-free survival compared to the intermediate- or low-NLR-GMS groups.
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Affiliation(s)
- Tsung-Jang Yeh
- Division of Hematology & Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (T.-J.Y.); (H.-C.W.); (S.-F.C.); (T.-Y.H.); (C.-T.H.); (M.-H.W.); (T.-M.C.); (Y.-C.G.); (J.-S.D.); (Y.-C.L.); (H.-H.H.)
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Hui-Ching Wang
- Division of Hematology & Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (T.-J.Y.); (H.-C.W.); (S.-F.C.); (T.-Y.H.); (C.-T.H.); (M.-H.W.); (T.-M.C.); (Y.-C.G.); (J.-S.D.); (Y.-C.L.); (H.-H.H.)
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Shih-Feng Cho
- Division of Hematology & Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (T.-J.Y.); (H.-C.W.); (S.-F.C.); (T.-Y.H.); (C.-T.H.); (M.-H.W.); (T.-M.C.); (Y.-C.G.); (J.-S.D.); (Y.-C.L.); (H.-H.H.)
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Chun-Chieh Wu
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Tzu-Yu Hsieh
- Division of Hematology & Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (T.-J.Y.); (H.-C.W.); (S.-F.C.); (T.-Y.H.); (C.-T.H.); (M.-H.W.); (T.-M.C.); (Y.-C.G.); (J.-S.D.); (Y.-C.L.); (H.-H.H.)
| | - Chien-Tzu Huang
- Division of Hematology & Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (T.-J.Y.); (H.-C.W.); (S.-F.C.); (T.-Y.H.); (C.-T.H.); (M.-H.W.); (T.-M.C.); (Y.-C.G.); (J.-S.D.); (Y.-C.L.); (H.-H.H.)
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Min-Hong Wang
- Division of Hematology & Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (T.-J.Y.); (H.-C.W.); (S.-F.C.); (T.-Y.H.); (C.-T.H.); (M.-H.W.); (T.-M.C.); (Y.-C.G.); (J.-S.D.); (Y.-C.L.); (H.-H.H.)
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Tzer-Ming Chuang
- Division of Hematology & Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (T.-J.Y.); (H.-C.W.); (S.-F.C.); (T.-Y.H.); (C.-T.H.); (M.-H.W.); (T.-M.C.); (Y.-C.G.); (J.-S.D.); (Y.-C.L.); (H.-H.H.)
| | - Yuh-Ching Gau
- Division of Hematology & Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (T.-J.Y.); (H.-C.W.); (S.-F.C.); (T.-Y.H.); (C.-T.H.); (M.-H.W.); (T.-M.C.); (Y.-C.G.); (J.-S.D.); (Y.-C.L.); (H.-H.H.)
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Jeng-Shiun Du
- Division of Hematology & Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (T.-J.Y.); (H.-C.W.); (S.-F.C.); (T.-Y.H.); (C.-T.H.); (M.-H.W.); (T.-M.C.); (Y.-C.G.); (J.-S.D.); (Y.-C.L.); (H.-H.H.)
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Yi-Chang Liu
- Division of Hematology & Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (T.-J.Y.); (H.-C.W.); (S.-F.C.); (T.-Y.H.); (C.-T.H.); (M.-H.W.); (T.-M.C.); (Y.-C.G.); (J.-S.D.); (Y.-C.L.); (H.-H.H.)
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Hui-Hua Hsiao
- Division of Hematology & Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (T.-J.Y.); (H.-C.W.); (S.-F.C.); (T.-Y.H.); (C.-T.H.); (M.-H.W.); (T.-M.C.); (Y.-C.G.); (J.-S.D.); (Y.-C.L.); (H.-H.H.)
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Mei-Ren Pan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Li-Tzong Chen
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- National Institute of Cancer Research, National Health Research Institutes, Tainan 704, Taiwan
| | - Sin-Hua Moi
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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Committeri U, Barone S, Salzano G, Arena A, Borriello G, Giovacchini F, Fusco R, Vaira LA, Scarpa A, Abbate V, Ugga L, Piombino P, Ionna F, Califano L, Orabona GD. Support Tools in the Differential Diagnosis of Salivary Gland Tumors through Inflammatory Biomarkers and Radiomics Metrics: A Preliminary Study. Cancers (Basel) 2023; 15:cancers15061876. [PMID: 36980760 PMCID: PMC10047378 DOI: 10.3390/cancers15061876] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/03/2023] [Accepted: 03/12/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND The purpose of this study was to investigate how the systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), and radiomic metrics (quantitative descriptors of image content) extracted from MRI sequences by machine learning increase the efficacy of proper presurgical differentiation between benign and malignant salivary gland tumors. METHODS A retrospective study of 117 patients with salivary gland tumors was conducted between January 2015 and November 2022. Univariate analyses with nonparametric tests and multivariate analyses with machine learning approaches were used. RESULTS Inflammatory biomarkers showed statistically significant differences (p < 0.05) in the Kruskal-Wallis test based on median values in discriminating Warthin tumors from pleomorphic adenoma and malignancies. The accuracy of NLR, PLR, SII, and SIRI was 0.88, 0.74, 0.76, and 0.83, respectively. Analysis of radiomic metrics to discriminate Warthin tumors from pleomorphic adenoma and malignancies showed statistically significant differences (p < 0.05) in nine radiomic features. The best multivariate analysis result was obtained from an SVM model with 86% accuracy, 68% sensitivity, and 91% specificity for six features. CONCLUSIONS Inflammatory biomarkers and radiomic features can comparably support a pre-surgical differential diagnosis.
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Affiliation(s)
- Umberto Committeri
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Simona Barone
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Giovanni Salzano
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Antonio Arena
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Gerardo Borriello
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Francesco Giovacchini
- Department of Maxillo-Facial Medicine Surgery, Hospital of Perugia, 06132 Perugia, Italy
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Naples, Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | - Alfonso Scarpa
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Salerno, Italy
| | - Vincenzo Abbate
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131 Naples, Italy
| | - Pasquale Piombino
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Franco Ionna
- Otolaryngology and Maxillo-Facial Surgery Unit, Istituto Nazionale Tumori-IRCCS Fondazione G. Pascale, 80131 Naples, Italy
| | - Luigi Califano
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Giovanni Dell'Aversana Orabona
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy
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Morioka R, Matsuda Y, Kato A, Okui T, Okuma S, Tatsumi H, Kanno T. Oral functional impairment may cause malnutrition following oral cancer treatment in a single-center cross-sectional study. Sci Rep 2022; 12:14787. [PMID: 36042270 PMCID: PMC9428164 DOI: 10.1038/s41598-022-19177-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/25/2022] [Indexed: 11/23/2022] Open
Abstract
Oral dysfunction and dysphagia after oral cancer treatment are linked to altered nutritional status. We aimed to identify specific oral functions related to nutritional status. We conducted a cross-sectional study from September 2019 to December 2021, recruited 75 participants (median age: 72.0 years), including 52 males and 23 females, collected background data, and evaluated oral function. The Mini Nutritional Assessment-Short Form (MNA-SF) scores were divided into three groups (normal nutritional status, at risk of malnutrition, and malnourished), and a multi-group comparison was conducted for each oral function measurement (microorganisms, oral dryness, occlusal force, tongue pressure, masticatory function, and Eating Assessment Tool [EAT-10]). The primary tumor site was the tongue in 31 patients (41.3%), gingiva in 30 (40.0%), and others in 14 (18.7%). Multiple comparisons revealed significant differences in occlusal force, tongue pressure, masticatory function, and EAT-10 levels, categorized as Type I (Transport type) and Type III (Occlusion type) postoperative oral dysfunctions, between each MNA-SF group. Multiple regression analysis showed a statistically significant association with MNA-SF in terms of masticatory function and EAT-10 levels, categorized as Type I. Type I and Type III are risk factors for malnutrition, confirming that different types of postoperative oral dysfunction require unique nutritional guidance.
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Affiliation(s)
- Reon Morioka
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yuhei Matsuda
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Akira Kato
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Tatsuo Okui
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Satoe Okuma
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Hiroto Tatsumi
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Takahiro Kanno
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.
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Calabrese L, Nocini R, Spirito F, Gazzini L, Dallari V, Girolami I, Lo Muzio L. Response to the comment on "The role of the depth of invasion (DOI) in minor salivary glands tumors according to the 8th TNM classification: Pitfalls and potential misinterpretations". Oral Oncol 2022; 132:105984. [PMID: 35759859 DOI: 10.1016/j.oraloncology.2022.105984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 06/18/2022] [Indexed: 10/17/2022]
Affiliation(s)
- Luca Calabrese
- Division of Otorhinolaryngology, San Maurizio Hospital, Via Lorenz Böhler, 5, 39100 Bolzano, Italy
| | - Riccardo Nocini
- Section of Ear Nose and Throat (ENT), Department of Surgical Sciences, Dentistry, Gynecology and Pediatric, University of Verona, 37126 Verona, Italy
| | - Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy
| | - Luca Gazzini
- Division of Otorhinolaryngology, San Maurizio Hospital, Via Lorenz Böhler, 5, 39100 Bolzano, Italy.
| | - Virginia Dallari
- Division of Otorhinolaryngology, San Maurizio Hospital, Via Lorenz Böhler, 5, 39100 Bolzano, Italy
| | - Ilaria Girolami
- Division of Pathology, San Maurizio Hospital, Via Lorenz Böhler, 5, 39100 Bolzano, Italy.
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; C.I.N.B.O. (Consorzio Interuniversitario Nazionale per la Bio-Oncologia), Chieti, Italy.
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Committeri U, Fusco R, Di Bernardo E, Abbate V, Salzano G, Maglitto F, Dell’Aversana Orabona G, Piombino P, Bonavolontà P, Arena A, Perri F, Maglione MG, Setola SV, Granata V, Iaconetta G, Ionna F, Petrillo A, Califano L. Radiomics Metrics Combined with Clinical Data in the Surgical Management of Early-Stage (cT1-T2 N0) Tongue Squamous Cell Carcinomas: A Preliminary Study. BIOLOGY 2022; 11:biology11030468. [PMID: 35336841 PMCID: PMC8945467 DOI: 10.3390/biology11030468] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/08/2022] [Accepted: 03/16/2022] [Indexed: 11/16/2022]
Abstract
Objective: To predict the risk of metastatic lymph nodes and the tumor grading related to oral tongue squamous cell carcinoma (OTSCC) through the combination of clinical data with radiomics metrics by computed tomography, and to develop a supportive approach in the management of the lymphatic cervical areas, with particular attention to the early stages (T1−T2). Between March 2016 and February 2020, patients with histologically confirmed OTSCC, treated by partial glossectomy and ipsilateral laterocervical lymphadenectomy and subjected to computed tomography (CT) before surgery, were identified by two centers: 81 patients (49 female and 32 male) with 58 years as the median age (range 19−86 years). Univariate analysis with non-parametric tests and multivariate analysis with machine learning approaches were used. Clinical, hematological parameters and radiological features extracted by CT were considered individually and in combination. All clinical parameters showed statistically significant differences (p < 0.05) for the Kruskal−Wallis test when discriminating both the tumor grading and the metastatic lymph nodes. DOI, PLR, SII, and SIRI showed an accuracy of 0.70 (ROC analysis) when identifying the tumor grading, while an accuracy ≥ 0.78 was shown by DOI, NLR, PLR, SII, and SIRI when discriminating metastatic lymph nodes. In the context of the analysis of radiomics metrics, the original_glszm_HighGrayLevelZoneEmphasis feature was selected for identifying the tumor grading (accuracy of 0.70), while the wavelet_HHH_glrlm_LowGrayLevelRunEmphasis predictor was selected for determining metastatic lymph nodes (accuracy of 0.96). Remarkable findings were also obtained when classifying patients with a machine learning approach. Radiomics features alone can predict tumor grading with an accuracy of 0.76 using a logistic regression model, while an accuracy of 0.82 can be obtained by running a CART algorithm through a combination of three clinical parameters (SIRI, DOI, and PLR) with a radiomics feature (wavelet_LLL_glszm_SizeZoneNonUniformityNormalized). In the context of predicting metastatic lymph nodes, an accuracy of 0.94 was obtained using 15 radiomics features in a logistic regression model, while both CART and CIDT achieved an asymptotic accuracy value of 1.00 using only one radiomics feature. Radiomics features and clinical parameters have an important role in identifying tumor grading and metastatic lymph nodes. Machine learning approaches can be used as an easy-to-use tool to stratify patients with early-stage OTSCC, based on the identification of metastatic and non-metastatic lymph nodes.
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Affiliation(s)
- Umberto Committeri
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Naples, Italy; (R.F.); (E.D.B.)
| | - Elio Di Bernardo
- Medical Oncology Division, Igea SpA, 80013 Naples, Italy; (R.F.); (E.D.B.)
| | - Vincenzo Abbate
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
| | - Giovanni Salzano
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
| | - Fabio Maglitto
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
| | - Giovanni Dell’Aversana Orabona
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
| | - Pasquale Piombino
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
| | - Paola Bonavolontà
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
| | - Antonio Arena
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
| | - Francesco Perri
- Head and Neck Medical Oncology Unit, Istituto Nazionale dei Tumori IRCCS Fondazione G. Pascale, 80131 Naples, Italy;
| | - Maria Grazia Maglione
- Division of Surgical Oncology Maxillo-Facial Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via Mariano Semmola, 80131 Naples, Italy; (M.G.M.); (F.I.)
| | - Sergio Venanzio Setola
- Divisions of Radiology, Istituto Nazionale dei Tumori IRCCS Fondazione G. Pascale, 80131 Naples, Italy; (S.V.S.); (V.G.)
| | - Vincenza Granata
- Divisions of Radiology, Istituto Nazionale dei Tumori IRCCS Fondazione G. Pascale, 80131 Naples, Italy; (S.V.S.); (V.G.)
| | - Giorgio Iaconetta
- Department of Neurosurgery, University of Salerno, 84084 Salerno, Italy;
| | - Franco Ionna
- Division of Surgical Oncology Maxillo-Facial Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via Mariano Semmola, 80131 Naples, Italy; (M.G.M.); (F.I.)
| | - Antonella Petrillo
- Divisions of Radiology, Istituto Nazionale dei Tumori IRCCS Fondazione G. Pascale, 80131 Naples, Italy; (S.V.S.); (V.G.)
- Correspondence:
| | - Luigi Califano
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
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