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Gule-Monroe MK, Calle S, Policeni B, Juliano AF, Agarwal M, Chow LQM, Dubey P, Friedman ER, Hagiwara M, Hanrahan KD, Jain V, Rath TJ, Smith RB, Subramaniam RM, Taheri MR, Yom SS, Zander D, Burns J. ACR Appropriateness Criteria® Staging and Post-Therapy Assessment of Head and Neck Cancer. J Am Coll Radiol 2023; 20:S521-S564. [PMID: 38040469 DOI: 10.1016/j.jacr.2023.08.008] [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: 08/15/2023] [Accepted: 08/22/2023] [Indexed: 12/03/2023]
Abstract
Imaging of head and neck cancer at initial staging and as part of post-treatment surveillance is a key component of patient care as it guides treatment strategy and aids determination of prognosis. Head and neck cancer includes a heterogenous group of malignancies encompassing several anatomic sites and histologies, with squamous cell carcinoma the most common. Together this comprises the seventh most common cancer worldwide. At initial staging comprehensive imaging delineating the anatomic extent of the primary site, while also assessing the nodal involvement of the neck is necessary. The treatment of head and neck cancer often includes a combination of surgery, radiation, and chemotherapy. Post-treatment imaging is tailored for the evaluation of treatment response and early detection of local, locoregional, and distant recurrent tumor. Cross-sectional imaging with CT or MRI is recommended for the detailed anatomic delineation of the primary site. PET/CT provides complementary metabolic information and can map systemic involvement. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
| | - Susana Calle
- Research Author, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Bruno Policeni
- Panel Chair, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Amy F Juliano
- Panel Vice-Chair, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Mohit Agarwal
- Froedtert Memorial Lutheran Hospital Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Laura Q M Chow
- University of Texas at Austin, Dell Medical School, Austin, Texas; American Society of Clinical Oncology
| | | | | | - Mari Hagiwara
- New York University Langone Health, New York, New York
| | | | - Vikas Jain
- MetroHealth Medical Center, Cleveland, Ohio
| | | | - Russell B Smith
- Baptist Medical Center, Jacksonville, Florida; American Academy of Otolaryngology-Head and Neck Surgery
| | - Rathan M Subramaniam
- University of Otago, Dunedin, Otepoti, New Zealand; Commission on Nuclear Medicine and Molecular Imaging
| | - M Reza Taheri
- George Washington University Hospital, Washington, District of Columbia
| | - Sue S Yom
- University of California, San Francisco, San Francisco, California
| | | | - Judah Burns
- Specialty Chair, Montefiore Medical Center, Bronx, New York
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2
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Usman N, Shetty PS, Dikhit PS, Dinker D, Kumar NAN, Palod A, Prakashini K, Sankaran PP, Somu G. To CT or not to CT: Questioning the Cost-Effectiveness of CT Thorax in Head and Neck Cancers. Indian J Surg Oncol 2023; 14:28-33. [PMID: 36891447 PMCID: PMC9986160 DOI: 10.1007/s13193-022-01608-5] [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: 05/17/2022] [Accepted: 07/22/2022] [Indexed: 10/16/2022] Open
Abstract
Computed tomography (CT) scan has been an integral part of the diagnostic workup for patients with head and neck squamous cell carcinoma. Our study was designed to find out the incidence of distant metastasis and second primary tumor and to correlate the cost-effectiveness of CT thorax in detecting the same. This study was conducted among 326 cancer patients who visited our center with curative intent in the year 2021, with lesions in various head and neck subsites. Data were collected based on their pathological TNM staging and the presence of distant metastasis as evident on their CT thorax imaging with various variables related to the disease. Incremental cost-effectiveness ratio (ICER) was calculated for detecting a single metastatic deposit and second primary tumor in terms of Indian currency and was correlated to each subsite and stage of disease at presentation. Out of these 326 patients, 281 patients were included in our study after considering the inclusion criteria, and among these 281 patients, 235 of them underwent CT thorax for metastatic workup. No patient was found to have a second primary. Metastases were found in 12 patients. The site of primary lesion and clinical tumor (cT) staging were found to be significantly influencing the incidence of metastasis on CT thorax. ICER was least for larynx, pharynx, and paranasal sinuses and was highest for oral cavity primaries and early-stage disease. As per our observations and results of ICER, CT thorax is indeed a valuable modality but should be used judiciously when it comes to initial diagnostic workup.
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Affiliation(s)
- Nawaz Usman
- Department of Surgical Oncology, Manipal Academy of Higher Education (MAHE), Manipal Comprehensive Cancer Care Centre, Kasturba Medical College, Manipal, Karnataka 576401 India
| | - Preethi S Shetty
- Department of Surgical Oncology, Manipal Academy of Higher Education (MAHE), Manipal Comprehensive Cancer Care Centre, Kasturba Medical College, Manipal, Karnataka 576401 India
| | - Punit Singh Dikhit
- Department of Surgical Oncology, Manipal Academy of Higher Education (MAHE), Manipal Comprehensive Cancer Care Centre, Kasturba Medical College, Manipal, Karnataka 576401 India
| | - Diksha Dinker
- Department of Surgical Oncology, Manipal Academy of Higher Education (MAHE), Manipal Comprehensive Cancer Care Centre, Kasturba Medical College, Manipal, Karnataka 576401 India
| | - Naveena A N Kumar
- Department of Surgical Oncology, Manipal Academy of Higher Education (MAHE), Manipal Comprehensive Cancer Care Centre, Kasturba Medical College, Manipal, Karnataka 576401 India
| | - Akhil Palod
- Department of Surgical Oncology, Manipal Academy of Higher Education (MAHE), Manipal Comprehensive Cancer Care Centre, Kasturba Medical College, Manipal, Karnataka 576401 India
| | - Koteshwara Prakashini
- Department of Radiodiagnosis and Imaging, Manipal Academy of Higher Education (MAHE), Kasturba Medical College Manipal, Manipal, Karnataka 576104 India
| | - Priya P Sankaran
- Department of Radiodiagnosis and Imaging, Manipal Academy of Higher Education (MAHE), Kasturba Medical College Manipal, Manipal, Karnataka 576104 India
| | - G Somu
- Department of Hospital Administration, Kasturba Medical College Manipal, Manipal, Karnataka 576104 India
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3
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Macmillan MT, Hopkins M, Gomati A, Subedi D, Reid H, Bruce L, Murchison JT, Nixon IJ. Analysis of the interactions between small pulmonary nodules, clinical factors and the risk of malignancy in the chest following diagnosis of head and neck cancer. Clin Otolaryngol 2022; 47:455-463. [PMID: 35212150 DOI: 10.1111/coa.13922] [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: 09/30/2021] [Revised: 01/18/2022] [Accepted: 02/13/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study aims to investigate radiological and clinical factors which predict malignancy in indeterminate pulmonary nodules in patients with head and neck cancer (HNC). METHODS Prospective data was collected in 424 patients who were reviewed in the NHS Lothian HNC multi-disciplinary meeting from May 2016 to May 2018. Staging and follow up CT chest imaging was reviewed to identify and assess pulmonary nodules in all patients. RESULTS 61.8% of patients had at least one pulmonary nodule at staging CT. In total 25 patients developed malignancy in the chest. Metastatic disease in the chest was significantly associated with unknown or negative p16 status (p<0.0005). Pleural indentation and spiculation were associated with indeterminate nodules, subsequently being shown to represent metastatic disease (p>0.0005 and p=0.046 respectively). CONCLUSION Negative or unknown p16 status was associated with an increased propensity to develop metastatic disease in the chest in patients with HNC.
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Affiliation(s)
- Mark T Macmillan
- Department of Radiology Edinburgh Royal Infirmary, Edinburgh, UK.,Centre for Regenerative medicine, University of Edinburgh, Edinburgh, UK
| | - Michael Hopkins
- Edinburgh Ear, Nose, and Throat Department, Edinburgh Royal Infirmary, Edinburgh, UK
| | - Anas Gomati
- Edinburgh Ear, Nose, and Throat Department, Edinburgh Royal Infirmary, Edinburgh, UK
| | - Deepak Subedi
- Department of Radiology Western General Hospital, Edinburgh, UK
| | - Helen Reid
- Department of Radiology Western General Hospital, Edinburgh, UK
| | - Lorna Bruce
- South East Scotland Cancer Network (SCAN) Cancer Audit Edinburgh, Scotland, UK
| | - John T Murchison
- Department of Radiology Edinburgh Royal Infirmary, Edinburgh, UK
| | - Iain J Nixon
- Edinburgh Ear, Nose, and Throat Department, Edinburgh Royal Infirmary, Edinburgh, UK
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4
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Matsuyama R, Maeda K, Yamanaka Y, Ishida Y, Kato R, Nonogaki T, Shimizu A, Ueshima J, Kazaoka Y, Hayashi T, Ito K, Furuhashi A, Ono T, Mori N. Assessing skeletal muscle mass based on the cross-sectional area of muscles at the 12th thoracic vertebra level on computed tomography in patients with oral squamous cell carcinoma. Oral Oncol 2020; 113:105126. [PMID: 33388617 DOI: 10.1016/j.oraloncology.2020.105126] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/11/2020] [Accepted: 11/30/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This study aimed to create a formula to estimate the third lumbar vertebra (L3)1 level skeletal muscle cross-sectional area (CSA), known as a standard value to evaluate skeletal muscle mass on computed tomography (CT), using the twelfth thoracic vertebra (Th12) level skeletal muscle CSA on chest CT. MATERIALS AND METHODS This retrospective observational study included patients aged 40 + years with a diagnosis of oral squamous cell carcinoma (n = 164). Skeletal muscle CSA on CT images was measured using the Th12 and the L3 levels of pretreatment CT scans. The predictive formula was created based on the five-fold cross-validation method with a linear regression model. Correlations between the predicted L3-level CSA and the actual L3-level CSA were evaluated using r and Intraclass Correlation Coefficients (ICC). RESULTS The predictive formula for L3-level CSA from Th12-level CSA was: CSA at L3 (cm2) = 14.143 + 0.779 * CSA at Th12 (cm2) - 0.212 * Age (y) + 0.502 * Weight (kg) + 13.763 * Sex. Correlations between the predicted and measured L3-level CSA were r = 0.915 [0.886-0.937] and ICC = 0.911 [0.881-0.934]. CONCLUSION We developed a formula for predicting skeletal muscle mass from the Th12-level CT slice. The predicted L3-level CSA correlated with the measured L3-level CSA.
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Affiliation(s)
- Remi Matsuyama
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Keisuke Maeda
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan; Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Yosuke Yamanaka
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yuria Ishida
- Department of Nutrition, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Ryoko Kato
- Department of Pharmacy, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Tomoyuki Nonogaki
- Department of Pharmacy, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Akio Shimizu
- Department of Nutrition, Hamamatsu City Rehabilitation Hospital, 1-6-1 Wagokita, Naka-Ku, Hamamatsu, Shizuoka 433-8511 Japan
| | - Junko Ueshima
- Department of Clinical Nutrition and Food Service, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-Ku, Tokyo 141-0022, Japan
| | - Yoshiaki Kazaoka
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Tomio Hayashi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Kunihiro Ito
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Akifumi Furuhashi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Takayuki Ono
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Naoharu Mori
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Nutritional Therapy Support Center, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
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5
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Nasry WHS, Wang H, Jones K, Tesch M, Rodriguez-Lecompte JC, Martin CK. Cyclooxygenase and CD147 expression in oral squamous cell carcinoma patient samples and cell lines. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:400-410.e3. [PMID: 31350224 DOI: 10.1016/j.oooo.2019.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 05/09/2019] [Accepted: 06/05/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES In oral squamous cell carcinoma (OSCC), cyclooxygenases (COX-1 and COX-2) contribute to inflammation, and cluster of differentiation factor 147 (CD147) contributes to invasiveness, but their relationship has not been previously examined within a cohort of patients with OSCC or OSCC cell lines. STUDY DESIGN COX-2 and CD147 expression was determined by using immunohistochemistry on 39 surgical biopsy specimens of OSCC. Expression in tumor cells, stroma, and adjacent oral epithelium was characterized by using a visual grading system. COX-1, COX-2, and CD147 expression was determined in vitro by using OSCC cell lines (SCC25, BHY, and HN) and reverse transcriptase-quantitative polymerase chain reaction. Secretion of prostagladin E2 (PGE2) from OSCC cell lines was determined by using PGE2 enzyme-linked immunosorbent assay. RESULTS Biopsy specimens showed higher COX-2 expression in tumor cells compared with stroma and adjacent epithelium (P < .05). There was no difference in CD147 expression among the tumor cells, stroma, and adjacent epithelium. In OSCC cell lines, there was a trend for COX-2 and CD147 gene expression to be coordinated. Interestingly, PGE2 secretion was more closely related to COX-1 expression than to COX-2 expression. CONCLUSIONS COX-1, COX-2, and CD147 appear to be independently regulated in OSCC, potentially representing 2 therapeutic targets for future investigation. COX-1 expression in OSCC deserves further study because it may be an important determinant of PGE2 secretion from OSCC cells.
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Affiliation(s)
- Walaa Hamed Shaker Nasry
- Department of Pathology and Microbiology, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Haili Wang
- Department of Pathology and Microbiology, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Kathleen Jones
- Diagnostic Services, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Marvin Tesch
- Provincial Health Services, Health PEI, Charlottetown, Prince Edward Island, Canada
| | - Juan Carlos Rodriguez-Lecompte
- Department of Pathology and Microbiology, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Chelsea K Martin
- Department of Pathology and Microbiology, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada.
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Sun XS, Michel C, Babin E, De Raucourt D, Péchery A, Gherga E, Géry B, Florescu C, Bourhis J, Thariat J. Approach to oligometastatic disease in head and neck cancer, on behalf of the GORTEC. Future Oncol 2018; 14:877-889. [DOI: 10.2217/fon-2017-0468] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Median survival for recurrent/metastatic head and neck squamous cell cancer (HNSCC) patients is about 10 months after first-line best systemic treatment. We aimed to assess current approaches of oligometastatic HNSCC patients by the analysis of current concept and published data (1995–2017) in this population. Five-year survival rates are over 20% in selected patients who undergo metastasis-directed therapy by either surgery or stereotactic irradiation. Human papillomavirus(+) HNSCC patients have more disseminated metastases but respond more favorably and also benefit from ablative treatments. Treatments of oligometastases are expanding rapidly. Unmet needs include revised imaging follow-up strategies to detect metastases earlier, identification of predictive noninvasive biomarkers for treatment guidance, assessment and corrections of biases in current studies and randomized clinical trials.
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Affiliation(s)
- Xu Shan Sun
- CH Belfort-Montbéliard, Department of Radiation Therapy, Boulevard du Maréchal Juin, 25209 Montbéliard, France
| | - Cécile Michel
- GORTEC, Hôpital Bretonneau, 2 Boulevard Tonnellé, 37044 Tours, France
| | - Emmanuel Babin
- CHU – Normandie Université, Department of Head & Neck Surgery, 14000 Caen, France
| | - Dominique De Raucourt
- Center François Baclesse – Normandie Université, Department of Head & Neck Surgery, 3 Avenue Général Harris, 14000 Caen, France
| | - Adeline Péchery
- CH Belfort-Montbéliard, Department of Radiation Therapy, Boulevard du Maréchal Juin, 25209 Montbéliard, France
| | - Elisabeta Gherga
- CH Belfort-Montbéliard, Department of Radiation Therapy, Boulevard du Maréchal Juin, 25209 Montbéliard, France
| | - Bernard Géry
- Center François Baclesse – Normandie Université, Department of Radiation Therapy, 3 Avenue Général Harris, 14000 Caen, France
| | - Carmen Florescu
- Center François Baclesse – Normandie Université, Department of Radiation Therapy, 3 Avenue Général Harris, 14000 Caen, France
| | - Jean Bourhis
- CHUV. Lausanne, Department of Radio-oncology, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland
| | - Juliette Thariat
- Center François Baclesse – Normandie Université, Department of Radiation Therapy, 3 Avenue Général Harris, 14000 Caen, France
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7
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Green R, Macmillan MT, Tikka T, Bruce L, Murchison JT, Nixon IJ. Analysis of the incidence and factors predictive of outcome in patients with head and neck cancer with pulmonary nodules. Head Neck 2017; 39:2241-2248. [PMID: 28741723 DOI: 10.1002/hed.24885] [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] [Received: 03/13/2017] [Revised: 04/17/2017] [Accepted: 06/15/2017] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The management of pulmonary nodules is challenging; unfortunately, little is known about the incidence and significance of pulmonary nodules in patients with head and neck cancer. METHODS A review was conducted of 400 consecutive patients with head and neck cancer. Imaging was reviewed to identify the incidence of nodules and patient, tumor, and radiological factors associated with the risk of malignancy. RESULTS Nodules were found in 58% of patients, with a malignant rate of 6%. Age was the only predictor of having a nodule and advanced-stage III + IV was a predictor of malignancy (P = .023; odds ratio [OR] 10.64; confidence interval 1.33-84.98). CONCLUSION Patients presenting with head and neck cancer have a higher incidence of pulmonary nodules and a higher risk of malignancy. In contrast to the British Thoracic Society (BTS) guidelines, which use size to guide the need for serial scans, we would recommend follow-up imaging in all patients with head and neck cancer with nodules, irrespective of size.
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Affiliation(s)
- Richard Green
- Edinburgh Ear, Nose, and Throat Department, Edinburgh Royal Infirmary, Edinburgh, Scotland, UK
| | - Mark T Macmillan
- Radiology Department, Edinburgh Royal Infirmary, Edinburgh, Scotland, UK
| | - Theofano Tikka
- Glasgow Ear, Nose, and Throat Department, Glasgow, Scotland, UK.,School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Lorna Bruce
- South East Scotland Cancer Network (SCAN) Cancer Audit Edinburgh, Scotland, UK
| | - John T Murchison
- Radiology Department, Edinburgh Royal Infirmary, Edinburgh, Scotland, UK
| | - Iain J Nixon
- Edinburgh Ear, Nose, and Throat Department, Edinburgh Royal Infirmary, Edinburgh, Scotland, UK
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8
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Kwon M, Lee SH, Lee YS, Lee CW, Roh JL, Choi SH, Nam SY, Kim SY. Clinical implications of nonspecific pulmonary nodules identified during the initial evaluation of patients with head and neck squamous cell carcinoma. Eur Radiol 2017; 27:3725-3732. [PMID: 28168367 DOI: 10.1007/s00330-017-4750-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 11/29/2016] [Accepted: 01/16/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE We aimed to identify the clinical implications of nonspecific pulmonary nodules (NPNs) detected in the initial staging workup for patients with head and neck squamous cell carcinoma (HNSCC). METHODS Medical records of patients who had been diagnosed and treated in our hospital were retrospectively analysed. After definite treatment, changes of NPNs detected on initial evaluation were monitored via serial chest computed tomography. The associations between NPNs and the clinicopathological characteristics of primary HNSCC were evaluated. Survival analyses were performed according to the presence of NPNs. RESULTS The study consisted of 158 (49.4%) patients without NPNs and 162 (50.6%) patients with NPNs. The cumulative incidence of probabilities of pulmonary malignancy (PM) development at 2 years after treatment were 9.0% and 6.2% in NPN-negative and NPN-positive patients, respectively. Overall and PM-free survival rates were not significantly different according to NPN status. Cervical lymph node (LN) involvement and a platelet-lymphocyte ratio (PLR) ≥126 increased the risk of PMs (both P <0.05). CONCLUSIONS NPNs detected in the initial evaluation of patients with HNSCC did not predict the risk of pulmonary malignancies. Cervical LN involvement and PLR ≥126 may be independent prognostic factors affecting PM-free survival regardless of NPN status. KEY POINTS • We aimed to identify the clinical implications of nonspecific pulmonary nodules (NPNs). • NPNs in head and neck cancer patients do not lead to pulmonary malignancies (PMs). • NPNs are not associated with overall or PM-free survival (PMFS). • Cervical lymph node involvement is an independent prognostic factor affecting PMFS. • Platelet-lymphocyte ratio ≥126 is another predictor of PMFS regardless of NPN presence.
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Affiliation(s)
- Minsu Kwon
- Department of Otorhinolaryngology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Republic of Korea
| | - Sang Hoon Lee
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Yoon Se Lee
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
| | - Choong Wook Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jong-Lyel Roh
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Seung-Ho Choi
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Soon Yuhl Nam
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Sang Yoon Kim
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
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9
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Chai H, Tang X, Ni M, Chen F, Zhang Y, Chen D, Qiu Y. Preparation and properties of novel, flexible, lead-free X-ray-shielding materials containing tungsten and bismuth(III) oxide. J Appl Polym Sci 2015. [DOI: 10.1002/app.43012] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Hao Chai
- Department of Nuclear Science and Engineering; Nanjing University of Aeronautics and Astronautics; Nanjing 211100 China
| | - Xiaobin Tang
- Department of Nuclear Science and Engineering; Nanjing University of Aeronautics and Astronautics; Nanjing 211100 China
- Jiangsu Key Laboratory of Nuclear Energy Equipment Materials Engineering; Nanjing 211100 China
| | - Minxuan Ni
- Department of Nuclear Science and Engineering; Nanjing University of Aeronautics and Astronautics; Nanjing 211100 China
| | - Feida Chen
- Department of Nuclear Science and Engineering; Nanjing University of Aeronautics and Astronautics; Nanjing 211100 China
| | - Yun Zhang
- Department of Nuclear Science and Engineering; Nanjing University of Aeronautics and Astronautics; Nanjing 211100 China
| | - Da Chen
- Department of Nuclear Science and Engineering; Nanjing University of Aeronautics and Astronautics; Nanjing 211100 China
- Jiangsu Key Laboratory of Nuclear Energy Equipment Materials Engineering; Nanjing 211100 China
| | - Yunlong Qiu
- ZhongXing Energy Equipment Company, Limited; Haimen Nantong 226100 China
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10
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Lee KD, Lee HS, Kim SW, Park T, Hong JC, Chang HK, Jung SB, Jeon CH, Park JW. Clinical significance of melanoma-associated antigen A1-6 expression in sputum of patients with squamous cell carcinoma of the larynx and hypopharynx. Head Neck 2015; 38 Suppl 1:E736-40. [PMID: 25900108 DOI: 10.1002/hed.24081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2015] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Several studies have reported the expression of the melanoma-associated antigen (MAGE) gene in head and neck squamous cell carcinoma (HNSCC). In this study, we evaluated the correlations between MAGE expression in sputum and the clinical features and oncologic outcomes of SCC of the larynx and hypopharynx. METHODS We performed a retrospective review of 119 patients treated for SCC of the larynx and hypopharynx and analysis of their induced sputum by nested reverse transcription-polymerase chain reaction (RT-PCR) to detect the MAGE-A1-6 gene. The associations between MAGE expression and clinical characteristics were analyzed. RESULTS Expression of MAGE-A1-6 in sputum was identified in 57 of 119 patients (47.9%), and was independently correlated to double primary cancer (p = .024; odds ratio [OR] = 4.135). Expression of MAGE-A1-6 in sputum was correlated to poor survival. CONCLUSION Expression of MAGE-A1-6 in sputum predicts poor oncologic outcome in patients with SCC of the larynx and hypopharynx. © 2015 Wiley Periodicals, Inc. Head Neck 38: E736-E740, 2016.
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Affiliation(s)
- Kang Dae Lee
- Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, Republic of South Korea
| | - Hyoung Shin Lee
- Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, Republic of South Korea
| | - Sung Won Kim
- Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, Republic of South Korea
| | - Taejung Park
- Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, Republic of South Korea
| | - Jong Chul Hong
- Department of Otolaryngology-Head and Neck Surgery, Dong-A University College of Medicine, Busan, Republic of South Korea
| | - Hee Kyung Chang
- Department of Pathology, Kosin University College of Medicine, Busan, Republic of South Korea
| | - Sang Bong Jung
- Department of Clinical Pathology, Gimhae College, Busan, Republic of South Korea
| | - Chang-Ho Jeon
- Department of Laboratory Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of South Korea
| | - Jong Wook Park
- Department of Immunology, School of Medicine, Keimyung University, Daegu, Republic of South Korea
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