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Stepan KO, Mazul AL, Larson J, Shah P, Jackson RS, Pipkorn P, Kang SY, Puram SV. Changing Epidemiology of Oral Cavity Cancer in the United States. Otolaryngol Head Neck Surg 2023; 168:761-768. [PMID: 35503657 PMCID: PMC10154079 DOI: 10.1177/01945998221098011] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/14/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We aim to more accurately characterize the current distribution and rates of squamous cell carcinoma (SCC) cases across various oral cavity subsites in the United States. STUDY DESIGN Retrospective cohort. SETTING Database study evaluating cancer incidence in the United States from 2001 to 2017. METHODS We utilized the US Cancer Statistics Public Use Database, which includes deidentified cancer data reported to the Centers for Disease Control and Prevention's National Program of Cancer Registries and the National Cancer Institute's SEER (Surveillance, Epidemiology, and End Results), capturing 97% of newly diagnosed cancers. We restricted our analysis to SCC arising from oral cavity subsites from 2001 to 2017. We calculated trends in annual cancer incidence rates using SEER*Stat, as well as annual and average annual percentage change and joinpoints with the National Cancer Institute's Joinpoint program. RESULTS Most oral cavity SCC cases arise from the oral tongue (41.7%), followed equally by lip and floor of mouth (each 16.5%), gingival (10.6%), buccal (6.7%), retromolar trigone (5.6%), and hard palate (2.3%) involvement. The overall incidence of oral tongue SCC continues to rise with an average annual percentage change of 1.8% (95% CI, 1.6%-2.1%; P < .001), with a 2.3% increase among women. This increase is seen among males and females of all age groups. Cancers involving the gum, buccal mucosa, and hard palate were also found to be increasing in rate, albeit to a lesser degree and with substantially lower incidence. CONCLUSIONS The tongue is the most frequently involved subsite of oral cavity SCC and is increasing in incidence among males and females of all ages.
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Affiliation(s)
- Katelyn O. Stepan
- Department of Otolaryngology–Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Angela L. Mazul
- Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Missouri, USA
| | - Jeffrey Larson
- Department of Otolaryngology–Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Parth Shah
- Department of Otolaryngology–Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Ryan S. Jackson
- Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Patrik Pipkorn
- Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Stephen Y. Kang
- Department of Otolaryngology–Head and Neck Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Sidharth V. Puram
- Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
- Department of Genetics, Washington University School of Medicine, St Louis, Missouri, USA
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da Silva Souto AC, Vieira Heimlich F, Lima de Oliveira L, Bergmann A, Dias FL, Spíndola Antunes H, de Melo AC, Thuler LCS, Cohen Goldemberg D. Epidemiology of tongue squamous cell carcinoma: A retrospective cohort study. Oral Dis 2023; 29:402-410. [PMID: 33964106 DOI: 10.1111/odi.13897] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/31/2021] [Accepted: 04/30/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To analyze the epidemiological profile and the specific survival of patients diagnosed with tongue squamous cell carcinoma at the National Cancer Institute (INCA). MATERIALS AND METHODS Hospital Cancer Registry System Data and Mortality Information from 2007 to 2009 were retrieved in a retrospective cohort study of patients diagnosed with tongue squamous cell carcinoma. Specific survival was estimated using the Kaplan-Meier method. The association between independent variables and the risk of death was explored in a Cox proportional hazards regression model. RESULTS A total of 346 patients were eligible, mostly male (77.5%), smokers (87.6%), with alcohol consumption (80.9%), with low education (65.6%), advanced staging at the time of diagnosis (71.1%), and presenting a high mortality rate (72.5%). In total, 44.5% of patients underwent a surgical approach alone or associated with another treatment modality, of which 85.1% of patients underwent neck dissection and 90.1% had free surgical margins. Specific survival was 40.6% in two years and 31.2% in five years. CONCLUSION The 5-year specific survival was considered worse in individuals over 60 years, and who did not undergo surgical treatment or had surgery associated with another treatment, compared to patients undergoing isolated surgery.
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Affiliation(s)
| | | | - Leticia Lima de Oliveira
- Brazilian National Cancer Institute (INCA) and Federal University of Rio de Janeiro State (UNIRIO), Rio de Janeiro, Brazil
| | - Anke Bergmann
- Clinical Research Division, National Cancer Institute, Rio de Janeiro, Brazil
| | - Fernando Luiz Dias
- Head and Neck Surgery Service, National Cancer Institute (INCA), Rio de Janeiro, Brazil
| | | | | | - Luiz Claudio Santos Thuler
- Brazilian National Cancer Institute (INCA) and Federal University of Rio de Janeiro State (UNIRIO), Rio de Janeiro, Brazil
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Tranby EP, Heaton LJ, Tomar SL, Kelly AL, Fager GL, Backley M, Frantsve-Hawley J. Oral Cancer Prevalence, Mortality, and Costs in Medicaid and Commercial Insurance Claims Data. Cancer Epidemiol Biomarkers Prev 2022; 31:1849-1857. [PMID: 35732291 PMCID: PMC9437560 DOI: 10.1158/1055-9965.epi-22-0114] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/17/2022] [Accepted: 06/16/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND This study compared prevalence, incidence, mortality rates, treatment costs, and risk factors for oral and oropharyngeal cancer (OC/OPC) between two large United States adult cohorts in 2012-2019. METHODS Medicaid and commercial claims data came from the IBM Watson Health MarketScan Database. Logistic regression analyses estimated incidence and risk factors for OC/OPC. Mortality was calculated by merging deceased individuals' files with those of the existing cancer cohort. Summing costs of outpatient and inpatient services determined costs. RESULTS Prevalence of OC/OPC in Medicaid enrollees decreased each year (129.8 cases per 100,000 enrollees in 2012 to 88.5 in 2019); commercial enrollees showed a lower, more stable prevalence (64.7 per 100,000 in 2012 and 2019). Incidence trended downward in both cohorts, with higher incidence in the Medicaid (51.4-37.6 cases per 100,000) than the commercial cohort (31.9-31.0 per 100,000). Mortality rates decreased for Medicaid enrollees during 2012-2014 but increased in the commercial cohort. OC/OPC treatment costs were higher for commercial enrollees by $8.6 million during 2016-2019. OC/OPC incidence was higher among adults who were older, male, and white; used tobacco or alcohol; or had prior human immunodeficiency virus/acquired immune deficiency syndrome diagnosis and lower among those who had seen a dentist the prior year. CONCLUSIONS Medicaid enrollees experienced higher OC/OPC incidence, prevalence, and mortality compared with commercially insured adults. Having seen a dentist within the prior year was associated with a lower risk of OC/OPC diagnosis. IMPACT Expanding Medicaid dental benefits may allow OC/OPC to be diagnosed at earlier stages through regular dental visits.
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Affiliation(s)
- Eric P. Tranby
- Analytics and Evaluation, CareQuest Institute for Oral Health, Boston, Massachusetts
| | - Lisa J. Heaton
- Analytics and Evaluation, CareQuest Institute for Oral Health, Boston, Massachusetts.,Corresponding Author: Lisa J. Heaton, Science Writer, Analytics and Evaluation, CareQuest Institute for Oral Health, 465 Medford Street, Boston, MA 02129. Phone: 617-886-1047; E-mail:
| | - Scott L. Tomar
- Division of Prevention and Public Health Sciences, College of Dentistry, University of Illinois, Chicago, Illinois
| | | | | | - Mary Backley
- Maryland Dental Action Coalition, Columbia, Maryland
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Xu Z, Wang J, Cai H, Qi F, Zou Q. Second primary malignancies in oral tongue cancer: A Surveillance, Epidemiology, and End Result–based analysis evaluating the basic characteristics, survival outcomes, and predictive factors. PRECISION MEDICAL SCIENCES 2022. [DOI: 10.1002/prm2.12056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Affiliation(s)
- Zicheng Xu
- Department of Urologic Surgery Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Jianxing Wang
- Department of Head and Neck Surgery Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Hongzhou Cai
- Department of Urologic Surgery Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Feng Qi
- Department of Urologic Surgery Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Qing Zou
- Department of Urologic Surgery Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
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Giraldi L, Collatuzzo G, Hashim D, Franceschi S, Herrero R, Chen C, Schwartz SM, Smith E, Kelsey K, McClean M, Gillison M, Boccia S, Hashibe M, Amy Lee YC, Boffetta P. Infection with Human Papilloma Virus (HPV) and risk of subsites within the oral cancer. Cancer Epidemiol 2021; 75:102020. [PMID: 34509873 DOI: 10.1016/j.canep.2021.102020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this study was to investigate the relationship between high-risk genotypes of Human Papilloma Virus (HPV) and cancer of different subsites of the oral cavity. MATERIAL AND METHODS A pooled analysis of five studies included on the International Head and Neck Cancer Epidemiology (INHANCE) Consortium was conducted. HPV 16 and HPV 18 were considered. Adjusted odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) for HPV and each oral cavity subsites were simultaneously estimated using multinomial logistic regression models. RESULTS The analysis included 1157 cases and 3272 controls. This study showed a slightly higher prevalence of HPV infection among oral cancer cases than controls. In particular, an increased risk of other and not otherwise specified (NOS) sites within the oral cavity, oral tongue, palate and floor of mouth cancer was observed for overall HPV16 positivity (OR = 1.66, 95 % CI: 1.01-2.72; OR = 1.97, 95 % CI: 1.36-2.85; OR = 2.48, 95 % CI: 1.50-4.11; OR = 2.71, 95 % CI: 1.06-6.95, respectively). In particular, HPV16E7 was related to cancer of floor of mouth, oral cavity NOS and palate (OR = 2.71, 95 % CI: 1.06-6.95; OR = 3.32, 95 % CI:1.53-7.19; OR = 3.34, 95 % CI:1.38-8.06). Results were inconsistent for HPV18 due to low prevalence of infection. CONCLUSION Our study suggests that HPV16 infection may increase the risk of developing floor of mouth, gum, tongue, and palate cancers. CLINICAL RELEVANCE Subjects with HPV infection have a higher risk of cancer from all sites of the oral cavity.
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Affiliation(s)
- Luca Giraldi
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Dana Hashim
- Norwegian Institute of Public Health, Department of Genetics and Bioinformatics, Oslo, Norway; Norwegian Institute of Public Health, Center of Fertility and Health, Oslo, Norway
| | - Silvia Franceschi
- Scientific Directorate, Aviano Oncologic Center (CRO) IRCCS, Aviano, Italy
| | | | - Chu Chen
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Elaine Smith
- College of Public Health, University of Iowa, Iowa City, IA, USA
| | | | | | - Maura Gillison
- Thoracic/Head and Neck Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Stefania Boccia
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - Mia Hashibe
- Division of Public Health, Department of Family and Preventive Medicine, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Yuan-Chin Amy Lee
- Division of Public Health, Department of Family and Preventive Medicine, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA.
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Lee DS, Ramirez RJ, Lee JJ, Valenzuela CV, Zevallos JP, Mazul AL, Puram SV, Doering MM, Pipkorn P, Jackson RS. Survival of Young Versus Old Patients With Oral Cavity Squamous Cell Carcinoma: A Meta-Analysis. Laryngoscope 2021; 131:1310-1319. [PMID: 33264444 PMCID: PMC8106620 DOI: 10.1002/lary.29260] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE/HYPOTHESIS To assess whether young patients with oral cavity squamous cell carcinoma (OCSCC) demonstrate worse oncologic outcomes than older patients after definitive therapy. STUDY DESIGN Systematic review and meta-analysis. METHODS A medical librarian composed a search strategy to identify relevant studies in Medline, Embase, Scopus, and other major databases (Prospero registration number CRD42019127974). Inclusion criteria were adults with histologically diagnosed OCSCC that underwent treatment, comparator groups with an age cutoff of 40 years old, and reported survival outcomes. Articles were excluded if they contained patients with oropharyngeal squamous cell carcinoma or patients treated for palliative intent. Overall survival hazard ratios were analyzed with a meta-analysis. RESULTS There were 23,382 patients with OCSCC that were treated with definitive therapy from 22 included studies. The pooled cohort contained 2,238 (10%) patients ≤40 years of age. Oral tongue was the most common subsite in both the younger (n = 1,961, 91%) and older (n = 18,047, 88%) cohorts. The majority of OCSCCs were either T1 or T2, representing 859 (80%) malignancies in younger patients and 8,126 (77%) malignancies in older patients. A meta-analysis of nine studies demonstrated that younger patients did not experience worse survival outcomes than older patients (hazard ratio = 0.97, 95% confidence interval = 0.66-1.41). CONCLUSIONS Young adults with OCSCC experienced similar oncologic outcomes as older patients with OCSCC after definitive treatment. Until compelling evidence demonstrates clinically relevant differences between these two cohorts, their approach to management should be similar. Future studies should consider comorbidities and using age 40 as a standard age cutoff to provide more uniform data moving forward. Laryngoscope, 131:1310-1319, 2021.
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Affiliation(s)
- David S. Lee
- Department of Otolaryngology- Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ricardo J. Ramirez
- Department of Otolaryngology- Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jake J. Lee
- Department of Otolaryngology- Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Carla V. Valenzuela
- Department of Otolaryngology- Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jose P. Zevallos
- Department of Otolaryngology- Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Angela L. Mazul
- Department of Otolaryngology- Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sidharth V. Puram
- Department of Otolaryngology- Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Michelle M. Doering
- Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Patrik Pipkorn
- Department of Otolaryngology- Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ryan S. Jackson
- Department of Otolaryngology- Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
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van der Kamp MF, van Dijk BAC, Plaat BEC, van der Laan BFAM, Halmos GB. To what extent has the last two decades seen significant progress in the management of older patients with head and neck cancer? Eur J Surg Oncol 2021; 47:1398-1405. [PMID: 33648773 DOI: 10.1016/j.ejso.2021.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/05/2021] [Accepted: 01/18/2021] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Life expectancy is rising and consequently also the number of older patients with head and neck cancer. Different treatment regimens are often applied for older patients. The aim of this study is to investigate how treatment patterns and survival rates have changed over the past 20 years in older patients with head and neck squamous cell carcinoma (HNSCC). MATERIALS Patient and tumour characteristics, treatment and 5-year survival data from the Netherlands Cancer Registry of patients aged ≥60 years diagnosed with HNSCC in 1990-1995 and 2010-2015 were compared using chi-square test and relative survival analysis. RESULTS Data of 14,114 patients were analyzed. Oral cavity cancer treatment did not change over time, while survival improved from 54% to 58% (p = 0.03). Oropharyngeal and hypopharyngeal cancer treatment shifted towards non-surgical, with survival improving from 31% to 51% (p < 0.01) and 26% to 34% (p < 0.01), respectively. Laryngeal cancer treatment changed towards surgery in stage I and non-surgical treatment in stage III and IV disease. Survival in laryngeal cancer stage I remained stable and favorable at a relative survival rate of around 90%. Survival non-significantly changed from 54% to 49% for stage III disease and from 37% to 33% for disease. CONCLUSION Relative survival increased for all head and neck cancer sites in older patients, except for laryngeal cancer. For oropharyngeal, hypopharyngeal and advanced laryngeal cancer, a shift towards non-surgical treatment modalities was observed.
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Affiliation(s)
- Martine F van der Kamp
- University of Groningen, University Medical Centre Groningen, Department of Otorhinolaryngology, Head & Neck Surgery, Groningen, the Netherlands.
| | - Boukje A C van Dijk
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands; University of Groningen, University Medical Centre Groningen, Department of Epidemiology, Groningen, the Netherlands
| | - Boudewijn E C Plaat
- University of Groningen, University Medical Centre Groningen, Department of Otorhinolaryngology, Head & Neck Surgery, Groningen, the Netherlands
| | - Bernard F A M van der Laan
- University of Groningen, University Medical Centre Groningen, Department of Otorhinolaryngology, Head & Neck Surgery, Groningen, the Netherlands
| | - Gyorgy B Halmos
- University of Groningen, University Medical Centre Groningen, Department of Otorhinolaryngology, Head & Neck Surgery, Groningen, the Netherlands
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Deregulation of extracellular matrix modeling with molecular prognostic markers revealed by transcriptome sequencing and validations in Oral Tongue squamous cell carcinoma. Sci Rep 2021; 11:250. [PMID: 33420101 PMCID: PMC7794513 DOI: 10.1038/s41598-020-78624-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 11/05/2020] [Indexed: 02/07/2023] Open
Abstract
Oral Tongue Squamous Cell Carcinoma (OTSCC), a distinct sub-group of head and neck cancers, is characteristically aggressive in nature with a higher incidence of recurrence and metastasis. Recent advances in therapeutics have not improved patient survival. The phenomenon of occult node metastasis, even among the purportedly good prognosis group of early-stage and node-negative tongue tumors, leads to a high incidence of locoregional failure in OTSCC which needs to be addressed. In the current study, transcriptome analysis of OTSCC patients identified the key genes and deregulated pathways. A panel of 26 marker genes was shortlisted and validated using real-time PCR in a prospective cohort of 100 patients. The gene expression was correlated with clinicopathological features including occult node metastasis, survival, and therapeutic outcome. The up-regulation of a panel of 6 genes namely, matrix metalloproteinase 9 (MMP9), Laminin subunit Gamma 2 (LAMC2), Desmoglein 2 (DSG2), Plasminogen Activator Urokinase (PLAU), Forkhead Box M1 (FOXM1), and Myosin 1B (MYO1B) was associated with failure of treatment in the early stage (T1, T2). Up-regulation of Tenacin C (TNC) and Podoplanin (PDPN) was significantly correlated with occult node positivity. Immunohistochemical analysis of LAMC2, MMP9, and E-Cadherin (ECAD) confirmed these markers to be indicators of poor prognosis. We propose this panel of valuable prognostic markers can be clinically useful to identify poor prognosis and occult node metastasis in OTSCC patients.
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Harris JA, Hunter WP, Hanna GJ, Treister NS, Menon RS. Rural patients with oral squamous cell carcinoma experience better prognosis and long-term survival. Oral Oncol 2020; 111:105037. [DOI: 10.1016/j.oraloncology.2020.105037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
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Bahethi RR, Stepan KO, Pinotti R, Li R, Agrawal N, Puram SV, Miles BA, Barber B. Genetic Mutations in Young Nonsmoking Patients With Oral Cavity Cancer: A Systematic Review. OTO Open 2020; 4:2473974X20970181. [PMID: 33210069 PMCID: PMC7643225 DOI: 10.1177/2473974x20970181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/27/2020] [Indexed: 12/15/2022] Open
Abstract
Objective This investigation aims to review the known genetic mutations associated with oral cavity squamous cell carcinoma (OCSCC) in young adults with limited environmental risk factors (YLERs). Data Sources A comprehensive search strategy was designed to identify studies in MEDLINE (Ovid), Embase (Ovid), and Scopus from database inception to May 2017 that included adults ≤50 years of age with OCSCC and minimal tobacco use history (≤10 pack-years) who had their tumors genetically sequenced or mutational profiles analyzed. Review Methods Identified articles were screened by 2 reviewers. Quality of evidence was graded by the MINORS criteria for case-control studies; other studies were graded by assigning a level of evidence for gene mutation literature. Results Thirteen studies met our inclusion criteria, and 130 patients met our criteria for age and tobacco history. TP53 was the most commonly evaluated gene (10 of 13 studies) and the most frequently observed mutation. One study reported that nonsmokers had significantly fewer TP53 mutations, while 9 studies found no difference in the prevalence of TP53 mutations. No other mutations were found specific to this cohort. Conclusions TP53 mutations may occur at a similar rate in YLERs with OCSCC as compared with older patients or those with risk factors. However, few studies have aimed to characterize the genetic landscape of oral cavity tumors in this population, often with small sample sizes. Future studies are needed to explore unidentified genetic alterations leading to tumor susceptibility or alternative mechanisms of carcinogenesis.
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Affiliation(s)
- Rohini R Bahethi
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Katelyn O Stepan
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Rachel Pinotti
- Gustave L. and Janet W. Levy Library, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ryan Li
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Oregon, USA
| | | | - Sidharth V Puram
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Brett A Miles
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Brittany Barber
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
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Change in Age at Diagnosis of Oropharyngeal Cancer in the United States, 1975-2016. Cancers (Basel) 2020; 12:cancers12113191. [PMID: 33143031 PMCID: PMC7693134 DOI: 10.3390/cancers12113191] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 12/14/2022] Open
Abstract
Simple Summary While previous studies have suggested that HPV-associated head and neck cancer (HNC) is mostly in the younger population, we found that in the last 40 years, the mean age at diagnosis of oropharyngeal cancer has been 60.3 years. We found that after an initially decrease leading up to the early 2000s, there has been a steady increase in age at diagnosis of oropharyngeal cancer since 2002. For non-oropharyngeal HNC, mean age at diagnosis has steadily increased throughout the last four decades. Finally, we found that age at diagnosis of HNC is higher among females in general, and lowest among blacks. Abstract The emergence of the human papillomavirus (HPV) as the primary etiology of oropharyngeal cancer has changed head and neck cancer (HNC) epidemiology. This study described change in the age at diagnosis of oropharyngeal and non-oropharyngeal HNC in the United States in the last four decades. Using a retrospective cohort analysis, the Surveillance, Epidemiology, and End Results dataset from 1975 to 2016 was queried for eligible adult cases of HNC, grouped as oropharyngeal (n = 31,702) versus non-oropharyngeal (n = 87,108). Age at diagnosis was compared by gender (female, male) using independent t-test, and by race/ethnicity (Hispanic, non-Hispanic black, non-Hispanic white, non-Hispanic other) using analysis of variance. Joinpoint regression estimated yearly increases/decreases in age of diagnosis by sex and race/ethnicity through annual percent changes (APC), which were summarized with average annual percent changes (AAPC). Mean age at diagnosis for oropharyngeal cancer was 60.3 years. While there was initially a decrease in age at diagnosis, a 0.37% annual increase occurred from 2002 to 2016 (APC = 0.37, 95% confidence interval (CI) 0.28, 0.45). For non-oropharyngeal cancer, mean age at diagnosis was 63.2 years, with a continuous increase in age at diagnosis throughout the study period (1975–2016 AAPC = 0.08, 95% CI 0.04, 0.12). Females had higher average age at diagnosis than males for both sites, while blacks (57.4 years for oropharyngeal cancer; 59.0 years for non-oropharyngeal) had the lowest age at diagnosis of all races/ethnicity. Age at diagnosis of oropharyngeal cancer has increased significantly since 2002, while non-oropharyngeal HNC has increased significantly in the last four decades.
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Jassal JS, Cramer JD. Explaining Racial Disparities in Surgically Treated Head and Neck Cancer. Laryngoscope 2020; 131:1053-1059. [PMID: 33107610 DOI: 10.1002/lary.29197] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 09/29/2020] [Accepted: 10/04/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVES/HYPOTHESIS To assess the causative factors that contribute to racial disparities in head and neck squamous cell carcinoma (HNSCC) and establish the role of hospital factors in racial disparities. STUDY DESIGN Retrospective database analysis. METHODS Patients with surgically treated HNSCC were identified using the National Cancer Database (2004-2014). Logistic and proportional-hazard regression models were used to characterize the factors that contribute to racial disparities. Differences in quality of care received were compared among black and white patients using previously validated metrics. RESULTS We identified 69,186 eligible patients. Black patients had a 48% higher mortality than white patients (HR 1.48; 95% confidence interval [CI], 1.41-1.54). Black patients had a lower mean quality score (67.6%; 95% CI, 66.8%-69.4%) compared with white patients (71.2%: 95% CI, 71.0%-71.4%) for five quality metrics. After adjusting for differences in patient, oncologic, and hospital factors we were able to explain 60% of the excess mortality for black patients. Oncologic factors at presentation accounted for 57.7% of observed mortality differences, whereas hospital characteristics and quality of care accounted for 11.5%. After adjusting for these factors, black patients still had a 19% higher mortality (HR 1.19; 95% CI, 1.14-1.24). CONCLUSIONS Oncologic factors at presentation are a major contributor to racial disparities in outcomes for HNSCC. Hospital factors, such as quality, volume, and safety-net status, constitute a minor factor in the mortality difference. Resolving existing disparities will require detecting head and neck cancer at an earlier stage and improving the quality of care for black patients. LEVEL OF EVIDENCE 3. Laryngoscope, 131:1053-1059, 2021.
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Affiliation(s)
- Japnam S Jassal
- Wayne State University School of Medicine, Detroit, Michigan, U.S.A
| | - John D Cramer
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A
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13
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Kim YJ, Kim JH. Increasing incidence and improving survival of oral tongue squamous cell carcinoma. Sci Rep 2020; 10:7877. [PMID: 32398670 PMCID: PMC7217912 DOI: 10.1038/s41598-020-64748-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 04/16/2020] [Indexed: 11/18/2022] Open
Abstract
We evaluated changes in incidence, relative survival (RS), and conditional survival (CS) of head and neck squamous cell carcinoma (HNSCC), focusing on oral tongue squamous cell carcinoma (OTSCC). Data of 74 680 HNSCC patients from 1976 to 2015 were obtained from the Surveillance, Epidemiology, and End Results database. Five anatomical sites and their subsites were analyzed. Annual percent change (APC) of incidence was calculated. RS and CS were compared across the four decades. Adjusted hazard ratios (aHRs) of RS were evaluated using multivariate regression. OTSCC incidence decreased from 1976 (APC = −0.76, P < 0.05) but has increased since 1999 (APC = 2.36, P < 0.05). During 2006–2015, the 5-year CS exceeded 90% only for OTSCC and oropharyngeal squamous cell carcinoma (OPSCC). RS improved in OTSCC (aHR = 0.697, 95% confidence interval [CI] 0.642–0.757, P < 0.001) and OPSCC (aHR = 0.669, 95% CI 0.633–0.706, P < 0.001) during the last two decades. For both OTSCC and OPSCC, improved survival was observed regardless of treatment. Incidence and survival remained unchanged for nasopharyngeal, hypopharyngeal, and laryngeal cancers during this period. In conclusion, OTSCC incidence has been increasing since the 2000s, with improving prognosis irrespective of treatment. Given its similarity to OPSCC, OTSCC may represent an emerging HNSCC, warranting further research and clinical recognition.
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Affiliation(s)
- Yi-Jun Kim
- Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.,Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Jin Ho Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.
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14
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Mukherjee A, Idigo AJ, Ye Y, Wiener HW, Paluri R, Nabell LM, Shrestha S. Geographical and Racial Disparities in Head and Neck Cancer Diagnosis in South-Eastern United States: Using Real-World Electronic Medical Records Data. Health Equity 2020; 4:43-51. [PMID: 32219195 PMCID: PMC7097706 DOI: 10.1089/heq.2019.0092] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background: Rurality, race, and age at diagnosis are important predictors in head and neck cancer (HNC) prognosis. However, literature on the associations of rurality and race with age at HNC diagnosis is limited. Data on geographical, racial, and gender disparities in young HNC patients (diagnosed ≤45 years) are also scarce. Materials and Methods: This retrospective study assesses rural–urban, racial, and gender disparities in age at HNC diagnosis, using electronic medical records (Cerner) data of 4258 HNC patients (1538 residing in rural counties and 2720 in urban counties) from National Cancer Institute-designated cancer center in Alabama. Rurality was defined based on 2010 U.S. Census Bureau's rural–urban classification. Logistic regression was used to assess the association of young HNC diagnosis with demographical, behavioral, and clinical variables. ArcGIS 10.2 was used to map geospatial distribution of age and population-adjusted HNC case across rural and urban counties. Results: Patients from rural counties were less likely to be diagnosed at younger age (≤45 years) compared with urban counties (odds ratio [OR] [95% confidence interval (CI)]: 0.74 [0.58–0.93]). Most patients present at stage III/IV (64.9% in rural and 60.2% in urban). Compared with white patients, black patients were 70% more likely to get diagnosed at a young age (95% CI: 1.23–2.35). Young patients were more likely to be females and blacks compared with older patients (p<0.0001). Among oral cavity cancer patients, rural patients were 51% less likely to get diagnosed at young age compared with urban patients (95% CI: 0.27–0.89). Conclusions: Head and neck cancer screening is not routinely conducted so most show up at later stage of cancer. There is also evidence of disparities in age at HNC diagnosis based on rurality, race, and gender; targeted screening can help in reducing these disparities.
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Affiliation(s)
- Amrita Mukherjee
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Adeniyi J Idigo
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Yuanfan Ye
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Howard W Wiener
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ravi Paluri
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Lisle M Nabell
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Sadeep Shrestha
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
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15
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Segel JE, Lengerich EJ. Rural-urban differences in the association between individual, facility, and clinical characteristics and travel time for cancer treatment. BMC Public Health 2020; 20:196. [PMID: 32028942 PMCID: PMC7006189 DOI: 10.1186/s12889-020-8282-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 01/27/2020] [Indexed: 11/25/2022] Open
Abstract
Background Greater travel time to cancer care has been identified as a potential barrier to care as well as associated with worse health outcomes. While rural cancer patients have been shown to travel farther for care, it is not known what patient, facility, and clinical characteristics may differentially be associated with greater roundtrip travel times for cancer patients by rurality of residence. Identifying these factors will help providers understand which patients may be most in need of resources to assist with travel. Methods Using 2010–2014 Pennsylvania Cancer Registry data, we examined the association between patient, facility, and clinical characteristics with roundtrip patient travel time using multivariate linear regression models. We then estimated separate models by rural residence based on the Rural-Urban Continuum Code (RUCC) of a patient’s county of residence at diagnosis to understand how the association of each factor with travel time may vary for patients separated into metro residents (RUCC 1–3); and two categories of non-metro residents (RUCC 4–6) and (RUCC 7–9). Results In our sample (n = 197,498), we document large differences in mean roundtrip travel time—mean 41.5 min for RUCC 1–3 patients vs. 128.9 min for RUCC 7–9 patients. We show cervical/uterine and ovarian cancer patients travel significantly farther; as do patients traveling to higher volume and higher-ranked hospitals. Conclusions To better understand patient travel burden, providers need to understand that factors predicting longer travel time may vary by rurality of patient residence and cancer type.
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Affiliation(s)
- Joel E Segel
- Department of Health Policy and Administration, Pennsylvania State University, 504 S Ford Building, University Park, PA, 16802, USA. .,Penn State Cancer Institute, Hershey, PA, USA. .,Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA.
| | - Eugene J Lengerich
- Penn State Cancer Institute, Hershey, PA, USA.,Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
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16
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Halicek M, Shahedi M, Little JV, Chen AY, Myers LL, Sumer BD, Fei B. Head and Neck Cancer Detection in Digitized Whole-Slide Histology Using Convolutional Neural Networks. Sci Rep 2019; 9:14043. [PMID: 31575946 PMCID: PMC6773771 DOI: 10.1038/s41598-019-50313-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 09/10/2019] [Indexed: 01/01/2023] Open
Abstract
Primary management for head and neck cancers, including squamous cell carcinoma (SCC), involves surgical resection with negative cancer margins. Pathologists guide surgeons during these operations by detecting cancer in histology slides made from the excised tissue. In this study, 381 digitized, histological whole-slide images (WSI) from 156 patients with head and neck cancer were used to train, validate, and test an inception-v4 convolutional neural network. The proposed method is able to detect and localize primary head and neck SCC on WSI with an AUC of 0.916 for patients in the SCC testing group and 0.954 for patients in the thyroid carcinoma testing group. Moreover, the proposed method is able to diagnose WSI with cancer versus normal slides with an AUC of 0.944 and 0.995 for the SCC and thyroid carcinoma testing groups, respectively. For comparison, we tested the proposed, diagnostic method on an open-source dataset of WSI from sentinel lymph nodes with breast cancer metastases, CAMELYON 2016, to obtain patch-based cancer localization and slide-level cancer diagnoses. The experimental design yields a robust method with potential to help create a tool to increase efficiency and accuracy of pathologists detecting head and neck cancers in histological images.
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Affiliation(s)
- Martin Halicek
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, USA.,Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Maysam Shahedi
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, USA
| | - James V Little
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Amy Y Chen
- Department of Otolaryngology, Emory University School of Medicine, Atlanta, GA, USA
| | - Larry L Myers
- Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Baran D Sumer
- Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Baowei Fei
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, USA. .,Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA. .,Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
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17
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Halicek M, Dormer JD, Little JV, Chen AY, Myers L, Sumer BD, Fei B. Hyperspectral Imaging of Head and Neck Squamous Cell Carcinoma for Cancer Margin Detection in Surgical Specimens from 102 Patients Using Deep Learning. Cancers (Basel) 2019; 11:E1367. [PMID: 31540063 PMCID: PMC6769839 DOI: 10.3390/cancers11091367] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/04/2019] [Accepted: 09/12/2019] [Indexed: 01/27/2023] Open
Abstract
Surgical resection of head and neck (H and N) squamous cell carcinoma (SCC) may yield inadequate surgical cancer margins in 10 to 20% of cases. This study investigates the performance of label-free, reflectance-based hyperspectral imaging (HSI) and autofluorescence imaging for SCC detection at the cancer margin in excised tissue specimens from 102 patients and uses fluorescent dyes for comparison. Fresh surgical specimens (n = 293) were collected during H and N SCC resections (n = 102). The tissue specimens were imaged with reflectance-based HSI and autofluorescence imaging and afterwards with two fluorescent dyes for comparison. A histopathological ground truth was made. Deep learning tools were developed to detect SCC with new patient samples (inter-patient) and machine learning for intra-patient tissue samples. Area under the curve (AUC) of the receiver-operator characteristic was used as the main evaluation metric. Additionally, the performance was estimated in mm increments circumferentially from the tumor-normal margin. In intra-patient experiments, HSI classified conventional SCC with an AUC of 0.82 up to 3 mm from the cancer margin, which was more accurate than proflavin dye and autofluorescence (both p < 0.05). Intra-patient autofluorescence imaging detected human papilloma virus positive (HPV+) SCC with an AUC of 0.99 at 3 mm and greater accuracy than proflavin dye (p < 0.05). The inter-patient results showed that reflectance-based HSI and autofluorescence imaging outperformed proflavin dye and standard red, green, and blue (RGB) images (p < 0.05). In new patients, HSI detected conventional SCC in the larynx, oropharynx, and nasal cavity with 0.85-0.95 AUC score, and autofluorescence imaging detected HPV+ SCC in tonsillar tissue with 0.91 AUC score. This study demonstrates that label-free, reflectance-based HSI and autofluorescence imaging methods can accurately detect the cancer margin in ex-vivo specimens within minutes. This non-ionizing optical imaging modality could aid surgeons and reduce inadequate surgical margins during SCC resections.
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Affiliation(s)
- Martin Halicek
- Department of Bioengineering, The University of Texas at Dallas, Richardson, TX 75080, USA
- Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA 30329, USA
| | - James D Dormer
- Department of Bioengineering, The University of Texas at Dallas, Richardson, TX 75080, USA
| | - James V Little
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Amy Y Chen
- Department of Otolaryngology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Larry Myers
- Department of Otolaryngology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Baran D Sumer
- Department of Otolaryngology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Baowei Fei
- Department of Bioengineering, The University of Texas at Dallas, Richardson, TX 75080, USA.
- Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
- Department of Radiology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
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18
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Halicek M, Fabelo H, Ortega S, Little JV, Wang X, Chen AY, Callico GM, Myers L, Sumer BD, Fei B. Hyperspectral imaging for head and neck cancer detection: specular glare and variance of the tumor margin in surgical specimens. J Med Imaging (Bellingham) 2019; 6:035004. [PMID: 31528662 DOI: 10.1117/1.jmi.6.3.035004] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 08/06/2019] [Indexed: 12/19/2022] Open
Abstract
Head and neck squamous cell carcinoma (SCC) is primarily managed by surgical cancer resection. Recurrence rates after surgery can be as high as 55%, if residual cancer is present. Hyperspectral imaging (HSI) is evaluated for detection of SCC in ex-vivo surgical specimens. Several machine learning methods are investigated, including convolutional neural networks (CNNs) and a spectral-spatial classification framework based on support vector machines. Quantitative results demonstrate that additional data preprocessing and unsupervised segmentation can improve CNN results to achieve optimal performance. The methods are trained in two paradigms, with and without specular glare. Classifying regions that include specular glare degrade the overall results, but the combination of the CNN probability maps and unsupervised segmentation using a majority voting method produces an area under the curve value of 0.81 [0.80, 0.83]. As the wavelengths of light used in HSI can penetrate different depths into biological tissue, cancer margins may change with depth and create uncertainty in the ground truth. Through serial histological sectioning, the variance in the cancer margin with depth is investigated and paired with qualitative classification heat maps using the methods proposed for the testing group of SCC patients. The results determined that the validity of the top section alone as the ground truth may be limited to 1 to 2 mm. The study of specular glare and margin variation provided better understanding of the potential of HSI for the use in the operating room.
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Affiliation(s)
- Martin Halicek
- University of Texas at Dallas, Department of Bioengineering, Dallas, Texas, United States.,Emory University and Georgia Institute of Technology, Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Himar Fabelo
- University of Texas at Dallas, Department of Bioengineering, Dallas, Texas, United States.,University of Las Palmas de Gran Canaria, Institute for Applied Microelectronics, Las Palmas, Spain
| | - Samuel Ortega
- University of Las Palmas de Gran Canaria, Institute for Applied Microelectronics, Las Palmas, Spain
| | - James V Little
- Emory University School of Medicine, Department of Pathology and Laboratory Medicine, Atlanta, Georgia, United States
| | - Xu Wang
- Emory University School of Medicine, Department of Hematology and Medical Oncology, Atlanta, Georgia, United States
| | - Amy Y Chen
- Emory University School of Medicine, Department of Otolaryngology, Atlanta, Georgia, United States
| | - Gustavo Marrero Callico
- University of Las Palmas de Gran Canaria, Institute for Applied Microelectronics, Las Palmas, Spain
| | - Larry Myers
- University of Texas Southwestern Medical Center, Department of Otolaryngology, Dallas, Texas, United States
| | - Baran D Sumer
- University of Texas Southwestern Medical Center, Department of Otolaryngology, Dallas, Texas, United States
| | - Baowei Fei
- University of Texas at Dallas, Department of Bioengineering, Dallas, Texas, United States.,University of Texas Southwestern Medical Center, Advanced Imaging Research Center, Dallas, Texas, United States.,University of Texas Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States
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19
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Oliver JR, Wu SP, Chang CM, Roden DF, Wang B, Hu KS, Schreiber D, Givi B. Survival of oral tongue squamous cell carcinoma in young adults. Head Neck 2019; 41:2960-2968. [DOI: 10.1002/hed.25772] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 03/02/2019] [Accepted: 04/02/2019] [Indexed: 01/09/2023] Open
Affiliation(s)
- Jamie R. Oliver
- Department of Otolaryngology, NYU School of Medicine New York New York
| | - S. Peter Wu
- Department of Radiation OncologyNYU Langone Health New York New York
| | - Clifford M. Chang
- Department of Otolaryngology, NYU School of Medicine New York New York
| | - Dylan F. Roden
- Department of OtolaryngologyThomas Jefferson University Philadelphia Pennsylvania
| | - Binhuan Wang
- Department of Population HealthNYU Langone Health New York New York
| | - Kenneth S. Hu
- Department of Radiation OncologyNYU Langone Health New York New York
| | - David Schreiber
- Department of Radiation OncologySUNY Downstate Medical Center Brooklyn New York
| | - Babak Givi
- Department of OtolaryngologyNYU Langone Health New York New York
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20
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Halicek M, Little JV, Wang X, Chen AY, Fei B. Optical biopsy of head and neck cancer using hyperspectral imaging and convolutional neural networks. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-9. [PMID: 30891966 PMCID: PMC6975184 DOI: 10.1117/1.jbo.24.3.036007] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 01/14/2019] [Indexed: 05/21/2023]
Abstract
For patients undergoing surgical cancer resection of squamous cell carcinoma (SCCa), cancer-free surgical margins are essential for good prognosis. We developed a method to use hyperspectral imaging (HSI), a noncontact optical imaging modality, and convolutional neural networks (CNNs) to perform an optical biopsy of ex-vivo, surgical gross-tissue specimens, collected from 21 patients undergoing surgical cancer resection. Using a cross-validation paradigm with data from different patients, the CNN can distinguish SCCa from normal aerodigestive tract tissues with an area under the receiver operator curve (AUC) of 0.82. Additionally, normal tissue from the upper aerodigestive tract can be subclassified into squamous epithelium, muscle, and gland with an average AUC of 0.94. After separately training on thyroid tissue, the CNN can differentiate between thyroid carcinoma and normal thyroid with an AUC of 0.95, 92% accuracy, 92% sensitivity, and 92% specificity. Moreover, the CNN can discriminate medullary thyroid carcinoma from benign multinodular goiter (MNG) with an AUC of 0.93. Classical-type papillary thyroid carcinoma is differentiated from MNG with an AUC of 0.91. Our preliminary results demonstrate that an HSI-based optical biopsy method using CNNs can provide multicategory diagnostic information for normal and cancerous head-and-neck tissue, and more patient data are needed to fully investigate the potential and reliability of the proposed technique.
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Affiliation(s)
- Martin Halicek
- University of Texas at Dallas, Department of Bioengineering, Richardson, Texas, United States
- Emory University and Georgia Institute of Technology, Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - James V. Little
- Emory University School of Medicine, Department of Pathology and Laboratory Medicine, Atlanta, Georgia, United States
| | - Xu Wang
- Emory University School of Medicine, Department of Hematology and Medical Oncology, Atlanta, Georgia, United States
| | - Amy Y. Chen
- Emory University School of Medicine, Department of Otolaryngology, Atlanta, Georgia, United States
| | - Baowei Fei
- University of Texas at Dallas, Department of Bioengineering, Richardson, Texas, United States
- Emory University School of Medicine, Department of Radiology and Imaging Sciences, Atlanta, Georgia, United States
- University of Texas Southwestern Medical Center, Advanced Imaging Research Center, Dallas, Texas, United States
- University of Texas Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States
- Address all correspondence to Baowei Fei, E-mail:
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21
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Halicek M, Fabelo H, Ortega S, Little JV, Wang X, Chen AY, Callico GM, Myers LL, Sumer BD, Fei B. Cancer Detection Using Hyperspectral Imaging and Evaluation of the Superficial Tumor Margin Variance with Depth. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2019; 10951:109511A. [PMID: 32489227 PMCID: PMC7265739 DOI: 10.1117/12.2512985] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Head and neck squamous cell carcinoma (SCCa) is primarily managed by surgical resection. Recurrence rates after surgery can be as high as 55% if residual cancer is present. In this study, hyperspectral imaging (HSI) is evaluated for detection of SCCa in ex-vivo surgical specimens. Several methods are investigated, including convolutional neural networks (CNNs) and a spectral-spatial variant of support vector machines. Quantitative results demonstrate that additional processing and unsupervised filtering can improve CNN results to achieve optimal performance. Classifying regions that include specular glare, the average AUC is increased from 0.73 [0.71, 0.75 (95% confidence interval)] to 0.81 [0.80, 0.83] through an unsupervised filtering and majority voting method described. The wavelengths of light used in HSI can penetrate different depths into biological tissue, while the cancer margin may change with depth and create uncertainty in the ground-truth. Through serial histological sectioning, the variance in cancer-margin with depth is also investigated and paired with qualitative classification heat maps using the methods proposed for the testing group SCC patients.
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Affiliation(s)
- Martin Halicek
- Department of Bioengineering, University of Texas at Dallas, Dallas, TX, USA
- Georgia Inst. of Tech. & Emory Univ., Dept. of Biomedical Engineering, Atlanta, GA
- Medical College of Georgia, Augusta University, Augusta, GA
| | - Himar Fabelo
- Department of Bioengineering, University of Texas at Dallas, Dallas, TX, USA
- Institute for Applied Microelectronics, University of Las Palmas de Gran Canaria, Spain
| | - Samuel Ortega
- Institute for Applied Microelectronics, University of Las Palmas de Gran Canaria, Spain
| | - James V Little
- Emory Univ. School of Medicine, Dept. of Pathology & Laboratory Medicine, Atlanta, GA
| | - Xu Wang
- Emory Univ. School of Medicine, Dept. of Hematology & Medical Oncology, Atlanta, GA
| | - Amy Y Chen
- Emory University School of Medicine, Dept. of Otolaryngology, Atlanta, GA
| | | | - Larry L Myers
- University of Texas Southwestern Medical Center, Dept. of Otolaryngology, Dallas, TX
| | - Baran D Sumer
- University of Texas Southwestern Medical Center, Dept. of Otolaryngology, Dallas, TX
| | - Baowei Fei
- Department of Bioengineering, University of Texas at Dallas, Dallas, TX, USA
- Univ. of Texas Southwestern Medical Center, Advanced Imaging Research Center, Dallas, TX
- University of Texas Southwestern Medical Center, Department of Radiology, Dallas, TX
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22
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Campbell BR, Netterville JL, Sinard RJ, Mannion K, Rohde SL, Langerman A, Kim YJ, Lewis JS, Lang Kuhs KA. Early onset oral tongue cancer in the United States: A literature review. Oral Oncol 2018; 87:1-7. [PMID: 30527223 PMCID: PMC7039330 DOI: 10.1016/j.oraloncology.2018.10.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/04/2018] [Accepted: 10/06/2018] [Indexed: 12/11/2022]
Abstract
The incidence of early onset oral tongue squamous cell carcinoma (OTC) has been increasing in the United States, and no clear etiology has been identified. Studies on this topic have generally been small and presented varied results. The goal of this review is to analyze and synthesize the literature regarding early onset OTC risk factors, outcomes, and molecular analyses within the US. To date, studies suggest that early onset OTC patients tend to have less heavy cigarette use than typical onset patients, but there may be an association between early onset OTC and smokeless tobacco (chewing tobacco and snuff) use. Early onset OTC is associated with similar or possibly improved survival compared to typical onset OTC. There has been no evidence to support a significant role for human papillomavirus in development of early onset OTC. Further research with larger cohorts of these patients is needed to better characterize this disease entity.
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Affiliation(s)
- Benjamin R Campbell
- Vanderbilt University School of Medicine, 1161 21st Ave S #D3300, Nashville, TN 37232, USA.
| | - James L Netterville
- Vanderbilt University Medical Center, Department of Otolaryngology, 1215 21st Ave S, Nashville, TN 37232, USA.
| | - Robert J Sinard
- Vanderbilt University Medical Center, Department of Otolaryngology, 1215 21st Ave S, Nashville, TN 37232, USA.
| | - Kyle Mannion
- Vanderbilt University Medical Center, Department of Otolaryngology, 1215 21st Ave S, Nashville, TN 37232, USA.
| | - Sarah L Rohde
- Vanderbilt University Medical Center, Department of Otolaryngology, 1215 21st Ave S, Nashville, TN 37232, USA.
| | - Alexander Langerman
- Vanderbilt University Medical Center, Department of Otolaryngology, 1215 21st Ave S, Nashville, TN 37232, USA.
| | - Young J Kim
- Vanderbilt University Medical Center, Department of Otolaryngology, 1215 21st Ave S, Nashville, TN 37232, USA.
| | - James S Lewis
- Vanderbilt University Medical Center, Department of Otolaryngology, 1215 21st Ave S, Nashville, TN 37232, USA; Vanderbilt University Medical Center, Department of Pathology, Microbiology, and Immunology, 1211 Medical Center Dr, Nashville, TN, 37232, USA.
| | - Krystle A Lang Kuhs
- Vanderbilt University Medical Center, Department of Otolaryngology, 1215 21st Ave S, Nashville, TN 37232, USA; Vanderbilt University Medical Center, 2525 West End Ave, Suite 300, Nashville, TN, 37203, USA.
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Abstract
BACKGROUND Skin cancer has traditionally been studied in Caucasian skin. Although it does occur with increased relative frequency in Caucasians, patients with skin of color suffer from elevated morbidity and mortality when diagnosed with skin cancer. OBJECTIVE To detail the unique demographic and clinical features of nonmelanoma skin cancer (NMSC) in patients with skin of color, including Hispanic, African American, and Asian patients. MATERIALS AND METHODS A complete PubMed search was conducted spanning dates from 1947 to June 2017 yielding a total of 185 manuscripts, from which 45 were included in this review. RESULTS Relative to Caucasians, NMSC, comprised squamous cell carcinoma and basal cell carcinoma, has unique demographic and clinical features in African Americans, Hispanics, and Asians. CONCLUSION Familiarization with these unique presentations of skin cancer in skin of color is imperative to accurate identification and treatment of cutaneous malignancies in these populations and ultimately to improved disease-related outcomes.
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Farquhar DR, Tanner AM, Masood MM, Patel SR, Hackman TG, Olshan AF, Mazul AL, Zevallos JP. Oral tongue carcinoma among young patients: An analysis of risk factors and survival. Oral Oncol 2018; 84:7-11. [PMID: 30115478 DOI: 10.1016/j.oraloncology.2018.06.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/14/2018] [Accepted: 06/16/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The incidence of oral tongue squamous cell carcinoma (OTSCC) in younger adults has rapidly increased over the past two decades. While tobacco and alcohol use may be less likely to cause these tumors, it remains controversial whether differences also exist in their prognosis. Our aim is to examine the risk factors for cancer among young (<45 years old) OTSCC patients at our institution, and to compare their recurrence and survival with older patients in a matched cohort. MATERIALS AND METHODS All OTSCC patients seen at our institution between 2000 and 2015 were reviewed. Patients under 45 who with sufficient treatment information were matched 1:1 on race, T-stage, and N-stage with patients 45 and older. Three-year recurrence and survival were determined in stratified and adjusted Cox regression models. RESULTS Of 397 OTSCC patients were seen at our institution, 117 (29%) were less than 45 years old. Younger patients were significantly more likely to be female, (50% vs. 39%; p = 0.04) and to abstain from tobacco (51% vs. 39%; p < 0.01). Young patients in the matched cohort were significantly more likely to have a recurrence (HR 3.9 95% CI 1.4-10.5). There was no difference in overall survival. CONCLUSION Younger OTSCC patients in a matched cohort were more likely to recur within 3 years, although there was no difference in overall mortality. Differences in risk factors and recurrence between older and younger patients suggest that some cancer among younger patients may be distinct from traditional OTSCC.
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Affiliation(s)
- Douglas R Farquhar
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States.
| | - April M Tanner
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States
| | - Maheer M Masood
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States
| | - Sagar R Patel
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States
| | - Trevor G Hackman
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Angela L Mazul
- Department of Otolaryngology-Head and Neck Surgery, Washington University, St. Louis, MO, United States
| | - Jose P Zevallos
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Otolaryngology-Head and Neck Surgery, Washington University, St. Louis, MO, United States
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Ibikunle AA, Taiwo AO, Braimah RO. A 5-year audit of major maxillofacial surgeries at Usmanu Danfodiyo university teaching hospital, Nigeria. BMC Health Serv Res 2018; 18:416. [PMID: 29879975 PMCID: PMC5992770 DOI: 10.1186/s12913-018-3236-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/25/2018] [Indexed: 11/10/2022] Open
Abstract
Background There is a paucity of data on the pattern of oral and maxillofacial surgeries done in Nigeria. Despite the rising prominence of oral and maxillofacial surgery as a specialty in our immediate environment, no published audit of the surgeries performed exist. This study aims to present the pattern and types of major surgeries done by oral and maxillofacial surgeons in our hospital as well as the indications for such surgeries. It is hoped that the findings will assist in formulating informed policies and improving healthcare delivery. Methods A review of hospital records of all patients who had major oral and maxillofacial surgeries at Usmanu Danfodiyo University Teaching Hospital from January, 2013 to August, 2017 was done. Descriptive statistics such biodata, indication for surgery and type of surgery were recorded and analyzed using the IBM SPSS statistics for windows version 20 (Armonk, NY: IBM Corp) software. Results One hundred and forty six individuals who underwent 158 major surgeries under general anaesthesia were included. There were 82 males and 64 females, giving a male/female ratio of 1.3: 1. The ages ranged from 3 months to 81 years [median of 33 years]. Tumours and tumour-like lesions were the major indications for surgery [85 (58.2%)]. The most commonly performed surgery was mandibulectomy [31 (19.6%)], followed by Open Reduction and Internal Fixation (ORIF) [29 (18.4%)]. Conclusion Major oral and maxillofacial surgeries are common in our environment. The frequencies of these surgeries can increase with better healthcare financing and universal availability of health insurance schemes. Efforts aimed at reducing the incidence of tumours should be instituted.
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Affiliation(s)
- Adebayo Aremu Ibikunle
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital Sokoto, PMB, Sokoto, 12003, Nigeria.
| | - Abdurrazaq Olanrewaju Taiwo
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital Sokoto, PMB, Sokoto, 12003, Nigeria
| | - Ramat Oyebunmi Braimah
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital Sokoto, PMB, Sokoto, 12003, Nigeria
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Fakhry C, Krapcho M, Eisele DW, D'Souza G. Head and neck squamous cell cancers in the United States are rare and the risk now is higher among white individuals compared with black individuals. Cancer 2018. [PMID: 29533459 DOI: 10.1002/cncr.31322] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The increasing incidence of oropharyngeal squamous cell cancer (OPSCC) is well established. However, up-to-date incidence estimates and trends for head and neck squamous cell cancers (HNSCCs) overall, including major anatomic sites, and nonoropharyngeal (non-OP) HNSCCs by sex, race, and age in the United States are not well described. METHODS A retrospective analysis of incident HNSCCs during 1992 through 2014 using the Surveillance, Epidemiology, and End Results database was performed to evaluate the incidence of HNSCCs overall, OPSCC, and non-OP HNSCC (those of the larynx, oral cavity, hypopharynx, nasopharynx, and nasal cavity). Incidence rates were calculated overall and by subgroups of interest, and incidence rate ratios were used to compare rates between groups. The incidence rates presented were per 100,000 population and were age adjusted to the 2000 US standard population (19 age groups; Census P25-1130). The annual percent change (APC) was modeled with and without joinpoints. RESULTS The incidence of HNSCC overall declined (average APC [aAPC], -0.8; P<.001) despite significant increases in the incidence of OPSCCs, most notably between 2000 and 2014 (APC, 2.1; P<.001). Significant declines in incidence were observed for all non-OP HNSCC sites for both women and men (P<.001 each). Among women, the risk of OPSCC also significantly decreased (aAPC, -0.8; P = .002), whereas the risk among men was stable during 1992 through 2001 (APC, 0.4; P = .42) and then significantly increased from 2001 to 2014 (APC, 2.7; P<.001). Decreases in the risk of non-OP HNSCC were especially large for black women (aAPC, -2.6; P<.001) and men (aAPC, -3.0; P<.001). Although the incidence of HNSCC previously was highest among black individuals, since 2009 its incidence has been higher among white compared with black individuals. CONCLUSIONS The incidence of HNSCC is declining, especially for non-OP HNSCC and among black individuals. Cancer 2018;124:2125-33. © 2018 American Cancer Society.
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Affiliation(s)
- Carole Fakhry
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, Baltimore, Maryland.,Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Medicine, Baltimore, Maryland.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - David W Eisele
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, Baltimore, Maryland
| | - Gypsyamber D'Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Halicek M, Little JV, Wang X, Chen ZG, Patel M, Griffith CC, El-Deiry MW, Saba NF, Chen AY, Fei B. Deformable Registration of Histological Cancer Margins to Gross Hyperspectral Images using Demons. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2018; 10581. [PMID: 30220773 DOI: 10.1117/12.2293165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Hyperspectral imaging (HSI), a non-contact optical imaging technique, has been recently used along with machine learning technique to provide diagnostic information about ex-vivo surgical specimens for optical biopsy. The computer-aided diagnostic approach requires accurate ground truths for both training and validation. This study details a processing pipeline for registering the cancer-normal margin from a digitized histological image to the gross-level HSI of a tissue specimen. Our work incorporates an initial affine and control-point registration followed by a deformable Demons-based registration of the moving mask obtained from the histological image to the fixed mask made from the HS image. To assess registration quality, Dice similarity coefficient (DSC) measures the image overlap, visual inspection is used to evaluate the margin, and average target registration error (TRE) of needle-bored holes measures the registration error between the histologic and HSI images. Excised tissue samples from seventeen patients, 11 head and neck squamous cell carcinoma (HNSCCa) and 6 thyroid carcinoma, were registered according to the proposed method. Three registered specimens are illustrated in this paper, which demonstrate the efficacy of the registration workflow. Further work is required to apply the technique to more patient data and investigate the ability of this procedure to produce suitable gold standards for machine learning validation.
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Affiliation(s)
- Martin Halicek
- Georgia Institute of Technology & Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, GA, USA.,Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - James V Little
- Emory University School of Medicine, Department of Pathology and Laboratory Medicine, Atlanta, GA, USA
| | - Xu Wang
- Emory University School of Medicine, Department of Hematology and Medical Oncology, Atlanta, GA, USA
| | - Zhuo Georgia Chen
- Emory University School of Medicine, Department of Hematology and Medical Oncology, Atlanta, GA, USA
| | - Mihir Patel
- Emory University School of Medicine, Department of Otolaryngology, Atlanta, GA, USA.,Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Christopher C Griffith
- Emory University School of Medicine, Department of Pathology and Laboratory Medicine, Atlanta, GA, USA
| | - Mark W El-Deiry
- Emory University School of Medicine, Department of Otolaryngology, Atlanta, GA, USA.,Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Nabil F Saba
- Emory University School of Medicine, Department of Hematology and Medical Oncology, Atlanta, GA, USA
| | - Amy Y Chen
- Emory University School of Medicine, Department of Otolaryngology, Atlanta, GA, USA.,Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Baowei Fei
- Georgia Institute of Technology & Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, GA, USA.,Winship Cancer Institute of Emory University, Atlanta, GA, USA.,Emory University, Department of Mathematics and Computer Science, Atlanta, GA, USA.,Emory University, Department of Radiology and Imaging Sciences, Atlanta, GA, USA
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Halicek M, Little JV, Wang X, Patel M, Griffith CC, Chen AY, Fei B. Tumor Margin Classification of Head and Neck Cancer Using Hyperspectral Imaging and Convolutional Neural Networks. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2018; 10576:1057605. [PMID: 30245540 PMCID: PMC6149520 DOI: 10.1117/12.2293167] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
One of the largest factors affecting disease recurrence after surgical cancer resection is negative surgical margins. Hyperspectral imaging (HSI) is an optical imaging technique with potential to serve as a computer aided diagnostic tool for identifying cancer in gross ex-vivo specimens. We developed a tissue classifier using three distinct convolutional neural network (CNN) architectures on HSI data to investigate the ability to classify the cancer margins from ex-vivo human surgical specimens, collected from 20 patients undergoing surgical cancer resection as a preliminary validation group. A new approach for generating the HSI ground truth using a registered histological cancer margin is applied in order to create a validation dataset. The CNN-based method classifies the tumor-normal margin of squamous cell carcinoma (SCCa) versus normal oral tissue with an area under the curve (AUC) of 0.86 for inter-patient validation, performing with 81% accuracy, 84% sensitivity, and 77% specificity. Thyroid carcinoma cancer-normal margins are classified with an AUC of 0.94 for inter-patient validation, performing with 90% accuracy, 91% sensitivity, and 88% specificity. Our preliminary results on a limited patient dataset demonstrate the predictive ability of HSI-based cancer margin detection, which warrants further investigation with more patient data and additional processing techniques to optimize the proposed deep learning method.
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Affiliation(s)
- Martin Halicek
- Georgia Institute of Technology & Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, GA, USA
- Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - James V Little
- Emory University School of Medicine, Department of Pathology and Laboratory Medicine, Atlanta, GA, USA
| | - Xu Wang
- Emory University School of Medicine, Department of Hematology and Medical Oncology, Atlanta, GA, USA
| | - Mihir Patel
- Emory University School of Medicine, Department of Otolaryngology, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Christopher C Griffith
- Emory University School of Medicine, Department of Pathology and Laboratory Medicine, Atlanta, GA, USA
| | - Amy Y Chen
- Emory University School of Medicine, Department of Otolaryngology, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Baowei Fei
- Georgia Institute of Technology & Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Emory University, Department of Mathematics and Computer Science, Atlanta, GA, USA
- Emory University, Department of Radiology and Imaging Sciences, Atlanta, GA, USA
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29
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Halicek M, Little JV, Wang X, Patel M, Griffith CC, El-Deiry MW, Chen AY, Fei B. Optical Biopsy of Head and Neck Cancer Using Hyperspectral Imaging and Convolutional Neural Networks. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2018; 10469:104690X. [PMID: 30197462 PMCID: PMC6123819 DOI: 10.1117/12.2289023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Successful outcomes of surgical cancer resection necessitate negative, cancer-free surgical margins. Currently, tissue samples are sent to pathology for diagnostic confirmation. Hyperspectral imaging (HSI) is an emerging, non-contact optical imaging technique. A reliable optical method could serve to diagnose and biopsy specimens in real-time. Using convolutional neural networks (CNNs) as a tissue classifier, we developed a method to use HSI to perform an optical biopsy of ex-vivo surgical specimens, collected from 21 patients undergoing surgical cancer resection. Training and testing on samples from different patients, the CNN can distinguish squamous cell carcinoma (SCCa) from normal aerodigestive tract tissues with an area under the curve (AUC) of 0.82, 81% accuracy, 81% sensitivity, and 80% specificity. Additionally, normal oral tissues can be sub-classified into epithelium, muscle, and glandular mucosa using a decision tree method, with an average AUC of 0.94, 90% accuracy, 93% sensitivity, and 89% specificity. After separately training on thyroid tissue, the CNN differentiates between thyroid carcinoma and normal thyroid with an AUC of 0.95, 92% accuracy, 92% sensitivity, and 92% specificity. Moreover, the CNN can discriminate medullary thyroid carcinoma from benign multi-nodular goiter (MNG) with an AUC of 0.93, 87% accuracy, 88% sensitivity, and 85% specificity. Classical-type papillary thyroid carcinoma is differentiated from benign MNG with an AUC of 0.91, 86% accuracy, 86% sensitivity, and 86% specificity. Our preliminary results demonstrate that an HSI-based optical biopsy method using CNNs can provide multi-category diagnostic information for normal head-and-neck tissue, SCCa, and thyroid carcinomas. More patient data are needed in order to fully investigate the proposed technique to establish reliability and generalizability of the work.
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Affiliation(s)
- Martin Halicek
- Georgia Institute of Technology & Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, GA, USA
- Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - James V Little
- Emory University School of Medicine, Department of Pathology and Laboratory Medicine, Atlanta, GA, USA
| | - Xu Wang
- Emory University School of Medicine, Department of Hematology and Medical Oncology, Atlanta, GA, USA
| | - Mihir Patel
- Emory University School of Medicine, Department of Otolaryngology, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Christopher C Griffith
- Emory University School of Medicine, Department of Pathology and Laboratory Medicine, Atlanta, GA, USA
| | - Mark W El-Deiry
- Emory University School of Medicine, Department of Otolaryngology, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Amy Y Chen
- Emory University School of Medicine, Department of Otolaryngology, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Baowei Fei
- Georgia Institute of Technology & Emory University, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, GA, USA
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
- Emory University, Department of Mathematics and Computer Science, Atlanta, GA, USA
- Emory University, Department of Radiology and Imaging Sciences, Atlanta, GA, USA
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30
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de Morais EF, Mafra RP, Gonzaga AKG, de Souza DLB, Pinto LP, da Silveira ÉJD. Prognostic Factors of Oral Squamous Cell Carcinoma in Young Patients: A Systematic Review. J Oral Maxillofac Surg 2017; 75:1555-1566. [DOI: 10.1016/j.joms.2016.12.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 12/09/2016] [Accepted: 12/09/2016] [Indexed: 10/24/2022]
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31
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Silva LP, Gonzaga AKG, Serpa MS, Nascimento GJF, Sobral APV. Immunohistochemical expression of cyclooxygenase-2 and cyclin-D1 in oral squamous cell carcinoma. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2017. [DOI: 10.1016/j.ajoms.2016.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Tota JE, Anderson WF, Coffey C, Califano J, Cozen W, Ferris RL, St John M, Cohen EEW, Chaturvedi AK. Rising incidence of oral tongue cancer among white men and women in the United States, 1973-2012. Oral Oncol 2017; 67:146-152. [PMID: 28351569 DOI: 10.1016/j.oraloncology.2017.02.019] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 02/18/2017] [Accepted: 02/20/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Despite significant reductions in tobacco use in the US, oral tongue cancer incidence has reportedly increased in recent years, particularly in young white women. We conducted age-period-cohort analyses to identify birth cohorts that have experienced increased oral tongue cancer incidence, and compared these with trends for oropharyngeal cancer, a cancer caused by human papillomavirus (HPV) that has also recently increased. METHODS We utilized cancer incidence data (1973-2012) from 18 registries maintained by the NCI SEER Program. Incidence trends were evaluated using log-linear joinpoint regression and age-period-cohort modeling was utilized to simultaneously evaluate effects of age, calendar year, and birth year on incidence trends. RESULTS Incidence of oral tongue cancer increased significantly among white women during 1973-2012 (0.6% annual increase, p<0.001) and white men during 2008-2012 (5.1% annual increase, p=0.004). The increase was most apparent among younger white individuals (<50years; annual increase of 0.7% for men [p=0.02] and 1.7% for women [p<0.001] during 1973-2012). Furthermore, the magnitude of the increase during 1973-2012 was similar between young white men and women (2.3 vs. 1.8 cases per million, respectively). Incidence trends for oropharyngeal cancer were similar to trends for oral tongue cancer and similar birth cohorts (born after the 1940s) experienced rising incidence of these cancers (p-value: white men=0.12, white women=0.42), although the magnitude of increase was greater for oropharyngeal cancer. CONCLUSIONS The incidence of oral tongue and oropharyngeal cancer has significantly increased among young white men and women within the same birth cohorts in the US.
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Affiliation(s)
- Joseph E Tota
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Rockville, MD, USA.
| | - William F Anderson
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Rockville, MD, USA
| | | | | | - Wendy Cozen
- University of Southern California, Departments of Preventive Medicine and Pathology, Los Angeles, CA, USA
| | - Robert L Ferris
- University of Pittsburgh, Department of Otolaryngology, Pittsburgh, PA, USA
| | - Maie St John
- UCLA, Department of Head and Neck Surgery, UCLA Head and Neck Cancer Program, Los Angeles, CA, USA
| | | | - Anil K Chaturvedi
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Rockville, MD, USA
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Sher DJ, Rusthoven CG, Khan SA, Fidler MJ, Zhu H, Koshy M. National patterns of care and predictors of neoadjuvant and concurrent chemotherapy use with definitive radiotherapy in the treatment of patients with oropharyngeal squamous cell carcinoma. Cancer 2016; 123:273-282. [PMID: 27649421 DOI: 10.1002/cncr.30255] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 07/07/2016] [Accepted: 07/14/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND To the authors' knowledge, the patterns of care for the radiotherapy-based treatment of patients with stage III to IVB oropharyngeal squamous cell carcinoma (OPSCC) are poorly defined. The objective of the current study was to characterize the use and predictors of chemotherapy with radiotherapy for this population using the National Cancer Database. METHODS Patients in the National Cancer Database with AJCC (American Joint Committee on Cancer) stage III to IV OPSCC who were treated with radiotherapy between 2003 and 2012 were eligible for analysis. Treatment was defined as radiotherapy alone, concurrent chemoradiotherapy, or induction chemotherapy (IC). Multivariable regression with multilevel modeling was used to determine predictors of any chemotherapy use and, among patients receiving chemotherapy, the predictors of IC. RESULTS The majority (90%) of the 30,875 eligible patients received chemotherapy, the majority of whom (71% of the total) were treated with definitive chemoradiotherapy; a sizeable percentage of patients received IC (19% of total). On multivariable regression, younger age, favorable comorbidity status, and more advanced tumor and lymph node disease were found to be independent predictors of any chemotherapy and IC use. Nonwhite patients (odds ratio [OR], 0.71; P<.0001), women (OR, 0.74; P<.0001), and individuals without private insurance were found to be significantly less likely to receive chemotherapy. Patients treated at higher-volume institutions were significantly less likely to receive IC (OR, 0.69; P = .0006). Human papillomavirus status did not appear to independently influence treatment choice. CONCLUSIONS The vast majority of patients with stage III to IVB OPSCC who were treated with definitive radiotherapy received chemotherapy, which is consistent with high-level data and national recommendations. However, disparities with regard to race, sex, and insurance status emerged thereby requiring additional investigation. The frequent use of IC despite limited supportive evidence warrants research on physician and patient decision making and presents an opportunity to improve evidence-based treatment delivery. Cancer 2017;123:273-282. © 2016 American Cancer Society.
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Affiliation(s)
- David J Sher
- Division of Outcomes and Health Services Research, Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Chad G Rusthoven
- Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado
| | - Saad A Khan
- Department of Medical Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Mary Jo Fidler
- Department of Medical Oncology, Rush University Medical Center, Chicago, Illinois
| | - Hong Zhu
- Department of Clinical Sciences, Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Matthew Koshy
- Department of Radiation Oncology, University of Chicago, Chicago, Illinois
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Cannon RB, Sowder JC, Buchmann LO, Hunt JP, Hitchcock YJ, Lloyd S, Grossman KF, Monroe MM. Increasing use of nonsurgical therapy in advanced-stage oral cavity cancer: A population-based study. Head Neck 2016; 39:82-91. [PMID: 27641220 DOI: 10.1002/hed.24542] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 04/22/2016] [Accepted: 05/17/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND National guidelines support surgical-based treatment and offer nonsurgical therapy as an alternative for advanced-stage oral cavity squamous cell carcinoma (SCC). There are limited data evaluating current utilization of these therapies and their survival outcomes. METHODS A total of 5856 patients were found in the Surveillance, Epidemiology, and End Results (SEER) database from 1988 to 2008 with resectable advanced-stage oral cavity SCC tumors. Outcomes were disease-specific survival (DSS) and overall survival (OS). RESULTS Surgical therapy had significantly improved mean DSS and OS (115 and 71 months, respectively) compared to nonsurgical therapy (63 and 35 months, respectively; p < .001). The use of nonsurgical therapy was significantly associated with the hard palate, and patients who were single, divorced, and black, with T3, T4, and N3 tumors, and the percent utilization has significantly increased from 12% to 20% (p < .05). CONCLUSION Utilization of nonsurgical therapy for advanced-stage oral cavity SCC is increasing and is independently associated with a reduction in survival, as well as patient factors traditionally associated with reduced access to medical care and advanced T and N classifications. © 2016 Wiley Periodicals, Inc. Head Neck 39: 82-91, 2017.
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Affiliation(s)
- Richard B Cannon
- Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah
| | - Justin C Sowder
- Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah
| | - Luke O Buchmann
- Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah.,Huntsman Cancer Hospital, Salt Lake City, Utah.,Department of Surgery, Division Otolaryngology, George E. Whalen VAMC, Salt Lake City, Utah
| | - Jason P Hunt
- Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah.,Huntsman Cancer Hospital, Salt Lake City, Utah
| | | | - Shane Lloyd
- Huntsman Cancer Hospital, Salt Lake City, Utah
| | | | - Marcus M Monroe
- Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah.,Huntsman Cancer Hospital, Salt Lake City, Utah.,Department of Surgery, Division Otolaryngology, George E. Whalen VAMC, Salt Lake City, Utah
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Lai Y, Wang C, Civan JM, Palazzo JP, Ye Z, Hyslop T, Lin J, Myers RE, Li B, Jiang BH, Sama A, Xing J, Yang H. Effects of Cancer Stage and Treatment Differences on Racial Disparities in Survival From Colon Cancer: A United States Population-Based Study. Gastroenterology 2016; 150:1135-1146. [PMID: 26836586 PMCID: PMC4842115 DOI: 10.1053/j.gastro.2016.01.030] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 01/20/2016] [Accepted: 01/24/2016] [Indexed: 12/02/2022]
Abstract
BACKGROUND & AIMS We evaluated differences in treatment of black vs white patients with colon cancer and assessed their effects on survival, based on cancer stage. METHODS We collected data from the Surveillance, Epidemiology, and End Results-Medicare database and identified 6190 black and 61,951 white patients with colon cancer diagnosed from 1998 through 2009 and followed up through 2011. Three sets of 6190 white patients were matched sequentially, using a minimum distance strategy, to the same set of 6190 black patients based on demographic (age; sex; diagnosis year; and Surveillance, Epidemiology, and End Results registry), tumor presentation (demographic plus comorbidities, tumor stage, grade, and size), and treatment (presentation plus therapies) variables. We conducted sensitivity analyses to explore the effects of socioeconomic status in a subcohort that included 2000 randomly selected black patients. Racial differences in treatment were assessed using a logistic regression model; their effects on racial survival disparity were evaluated using the Kaplan-Meier method and the Cox proportional hazards model. RESULTS After patients were matched for demographic variables, the absolute 5-year difference in survival between black and white patients was 8.3% (white, 59.2% 5-y survival; blacks, 50.9% 5-y survival) (P < .0001); this value decreased significantly, to 5.0% (P < .0001), after patients were matched for tumor presentation, and decreased to 4.9% (P < .0001) when patients were matched for treatment. Differences in treatment therefore accounted for 0.1% of the 8.3% difference in survival between black and white patients. After patients were matched for tumor presentation, racial disparities were observed in almost all types of treatment; the disparities were most prominent for patients with advanced-stage cancer (stages III or IV, up to an 11.1% difference) vs early stage cancer (stages I or II, up to a 4.3% difference). After patients were matched for treatment, there was a greater reduction in disparity for black vs white patients with advanced-stage compared with early-stage cancer. In sensitivity analyses, the 5-year racial survival disparity was 7.7% after demographic match, which was less than the 8.3% observed in the complete cohort. This reduction likely was owing to the differences between the subcohort and the complete cohort in those variables that were not included in the demographic match. This value was reduced to 6.5% (P = .0001) after socioeconomic status was included in the demographic match. The difference decreased significantly to 2.8% (P = .090) after tumor presentation match, but was not reduced further after treatment match. CONCLUSIONS We observed significant disparities in treatment and survival of black vs white patients with colon cancer. The disparity in survival appears to have been affected more strongly by tumor presentation at diagnosis than treatment. The effects of treatment differences on disparities in survival were greater for patients with advanced-stage vs early-stage cancer.
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Affiliation(s)
- Yinzhi Lai
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Chun Wang
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Jesse M. Civan
- Division of Gastroenterology and Hepatology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Juan P. Palazzo
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Zhong Ye
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Terry Hyslop
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC 27710, USA
| | - Jianqing Lin
- Division of Solid Tumor Oncology, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Ronald E. Myers
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Bingshan Li
- Center for Human Genetics Research, Department of Molecular Physiology & Biophysics, Vanderbilt University, Nashville, TN 37232, USA
| | - Bing-Hua Jiang
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Ashwin Sama
- Division of Solid Tumor Oncology, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Jinliang Xing
- Experimental Teaching Center, School of Basic Medicine, Fourth Military Medical University, Xi’an, 710032, China
| | - Hushan Yang
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania.
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Patel MA, Blackford AL, Rettig EM, Richmon JD, Eisele DW, Fakhry C. Rising population of survivors of oral squamous cell cancer in the United States. Cancer 2016; 122:1380-7. [PMID: 26950886 DOI: 10.1002/cncr.29921] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 01/13/2016] [Accepted: 01/15/2016] [Indexed: 11/12/2022]
Abstract
BACKGROUND The incidence of oropharyngeal cancer (OPC) and a subset of oral cavity cancer (OCC) is increasing in the United States. To the authors' knowledge, the presumed growing prevalence of survivors of OPC and OCC has not been investigated to date. METHODS Retrospective analysis of Surveillance, Epidemiology, and End Results data (1975-2012) estimated changes in incidence, 5-year cause-specific survival, and prevalence for OPC and OCC. Changes in incidence, cause-specific survival and prevalence were estimated by linear regression and expressed as the percentage change (B). Differences in incidence trends over time were determined by joinpoint analysis. RESULTS The incidence of OPC increased by 62.6% from 1975 through 2012. Notable increases in OPC incidence were observed among men, white individuals, and those of younger ages. The 5-year survival for OPC increased significantly for all sexes, races, and individuals aged >30 years, with white individuals and males experiencing the largest increase in survival. By contrast, the incidence of OCC declined by 22.3% during the same time period. OCC incidence decreased across all groups but increased among individuals aged 30 to 39 years. Significant increases in survival were observed for OCC, except for those who were female, black, and aged <40 years. The prevalence of survivors of OPC increased from 2000 to 2012 (B, 115.1 per 100,000 individuals per year; P<.0001), whereas the prevalence of survivors of OCC significantly decreased (B, -15.8 per 100,000 individuals per year; P<.0001). CONCLUSIONS The prevalence of survivors of OPC is increasing, whereas the prevalence of survivors of OCC is declining. These data portend significant implications for long-term care planning for survivors of OPC and OCC. Cancer 2016;122:1380-1387. © 2016 American Cancer Society.
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Affiliation(s)
- Mira A Patel
- Department of Otolaryngology, Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Amanda L Blackford
- Division of Oncology Biostatistics and Bioinformatics, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Eleni M Rettig
- Department of Otolaryngology, Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jeremy D Richmon
- Department of Otolaryngology, Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - David W Eisele
- Department of Otolaryngology, Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Carole Fakhry
- Department of Otolaryngology, Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
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Pan ST, Qin Y, Zhou ZW, He ZX, Zhang X, Yang T, Yang YX, Wang D, Zhou SF, Qiu JX. Plumbagin suppresses epithelial to mesenchymal transition and stemness via inhibiting Nrf2-mediated signaling pathway in human tongue squamous cell carcinoma cells. Drug Des Devel Ther 2015; 9:5511-51. [PMID: 26491260 PMCID: PMC4599573 DOI: 10.2147/dddt.s89621] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Tongue squamous cell carcinoma (TSCC) is the most common malignancy in oral and maxillofacial tumors with highly metastatic characteristics. Plumbagin (5-hydroxy-2-methyl-1, 4-naphthoquinone; PLB), a natural naphthoquinone derived from the roots of Plumbaginaceae plants, exhibits various bioactivities, including anticancer effects. However, the potential molecular targets and underlying mechanisms of PLB in the treatment of TSCC remain elusive. This study employed stable isotope labeling by amino acids in cell culture (SILAC)-based quantitative proteomic approach to investigate the molecular interactome of PLB in human TSCC cell line SCC25 and elucidate the molecular mechanisms. The proteomic data indicated that PLB inhibited cell proliferation, activated death receptor-mediated apoptotic pathway, remodeled epithelial adherens junctions pathway, and manipulated nuclear factor erythroid 2-related factor 2 (Nrf2)-mediated oxidative stress response signaling pathway in SCC25 cells with the involvement of a number of key functional proteins. Furthermore, we verified these protein targets using Western blotting assay. The verification results showed that PLB markedly induced cell cycle arrest at G2/M phase and extrinsic apoptosis, and inhibited epithelial to mesenchymal transition (EMT) and stemness in SCC25 cells. Of note, N-acetyl-l-cysteine (NAC) and l-glutathione (GSH) abolished the effects of PLB on cell cycle arrest, apoptosis induction, EMT inhibition, and stemness attenuation in SCC25 cells. Importantly, PLB suppressed the translocation of Nrf2 from cytosol to nucleus, resulting in an inhibition in the expression of downstream targets. Taken together, these results suggest that PLB may act as a promising anticancer compound via inhibiting Nrf2-mediated oxidative stress signaling pathway in SCC25 cells. This study provides a clue to fully identify the molecular targets and decipher the underlying mechanisms of PLB in the treatment of TSCC.
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Affiliation(s)
- Shu-Ting Pan
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
| | - Yiru Qin
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, USA
| | - Zhi-Wei Zhou
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, USA
- Guizhou Provincial Key Laboratory for Regenerative Medicine, Stem Cell and Tissue Engineering Research Center and Sino-US Joint Laboratory for Medical Sciences, Guiyang Medical University, Guiyang, Guizhou, People’s Republic of China
| | - Zhi-Xu He
- Guizhou Provincial Key Laboratory for Regenerative Medicine, Stem Cell and Tissue Engineering Research Center and Sino-US Joint Laboratory for Medical Sciences, Guiyang Medical University, Guiyang, Guizhou, People’s Republic of China
| | - Xueji Zhang
- Research Center for Bioengineering and Sensing Technology, University of Science and Technology Beijing, Beijing, People’s Republic of China
| | - Tianxin Yang
- Department of Internal Medicine, University of Utah and Salt Lake Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Yin-Xue Yang
- Department of Colorectal Surgery, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| | - Dong Wang
- Cancer Center, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, People’s Republic of China
| | - Shu-Feng Zhou
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, USA
| | - Jia-Xuan Qiu
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
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