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Shofoluwe NA, Aliyu HO, Kabir B, Mohammed IB, Hamza MA, Abdullahi AM, Yahaya ST. Metachronous Tumours in the Head and Neck in a Retroviral Disease Positive Patient: A Case Report and Review of Literature. JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS 2024; 14:417-420. [PMID: 39309385 PMCID: PMC11412586 DOI: 10.4103/jwas.jwas_141_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/02/2023] [Indexed: 09/25/2024]
Abstract
Patients diagnosed with head and neck squamous cell carcinoma (HNSCC), particularly those seropositive for human immunodeficiency virus (HIV), face a heightened risk of second primary malignancies (SPMs), with common regions being the head, neck, lung, and oesophagus. This risk amplifies the severity of their clinical condition, as these SPMs contribute significantly to the mortality rates in patients with HNSCC. We detail a case of a young woman, seropositive for HIV, who developed a second squamous cancer in the nasopharynx after achieving remission from her initial oropharyngeal squamous cell carcinoma through chemo-radiotherapy. This case study highlights the increased vulnerability of HIV-positive HNSCC patients to SPMs, with an observed association of HIV infection leading to a lower overall survival rate. As a result, we recommend long-term follow-up in HNSCC patients with HIV for early detection of SPMs. Our findings emphasize the importance of regular screening for HNSCC, particularly in people living with HIV, to ensure timely detection and treatment, which can significantly improve their prognosis.
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Affiliation(s)
- Nurudeen Adebola Shofoluwe
- Division of Ear-Nose and Throat, Department of Surgery, Faculty of Clinical Science, College of Medical Sciences Ahmadu Bello University and Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - Halima Oziohu Aliyu
- Department of Pathology and Morbid Anatomy, Faculty of Basic Clinical Sciences, College of Medical Sciences, Ahmadu Bello University and Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - Balarabe Kabir
- Department of Pathology and Morbid Anatomy, Faculty of Basic Clinical Sciences, College of Medical Sciences, Ahmadu Bello University and Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - Ibrahim Babatunde Mohammed
- Division of Ear-Nose and Throat, Department of Surgery, Faculty of Clinical Science, College of Medical Sciences Ahmadu Bello University and Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - Manir Anka Hamza
- Department of Otorhinolaryngology, Aminu Kano Teaching Hospital Kano, Kano, Kano State, Nigeria
| | | | - Saadat Titilayo Yahaya
- Department of Ear, Nose and Throat, Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria
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Spoerl S, Gerken M, Chamilos C, Spoerl S, Fischer R, Vielsmeier V, Künzel J, Bohr C, Meier JK, Ettl T, Reichert TE, Spanier G. Clinical significance of panendoscopy in initial staging of oral squamous cell carcinoma and detection of synchronous second malignancies of the upper aerodigestive tract — Insights from a retrospective population-based cohort study. J Craniomaxillofac Surg 2022; 50:515-522. [DOI: 10.1016/j.jcms.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 03/15/2022] [Accepted: 04/26/2022] [Indexed: 11/27/2022] Open
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Frequency and Localization of Second Primary Tumors in Patients with Oropharyngeal Carcinoma-The Influence of the Human Papilloma Virus. Cancers (Basel) 2021; 13:cancers13081755. [PMID: 33916999 PMCID: PMC8067739 DOI: 10.3390/cancers13081755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/25/2021] [Accepted: 04/03/2021] [Indexed: 12/29/2022] Open
Abstract
Simple Summary Human papillomavirus (HPV) infection, smoking, and excessive alcohol consumption have been established as risk factors for the development of oropharyngeal squamous cell carcinoma (OPSCC). While the HPV epidemic has led to an increasing incidence of OPSCC, HPV-negative OPSCC cases associated with smoking and alcohol remain stable. As HPV-positive and -negative OPSCC present two distinct etiological, clinical, and prognostic entities, different treatment and follow-up strategies are being discussed. Still, specific surveillance strategies for HPV-positive OPSCC are lacking, as the risk of second primary tumors (SPT) in the era of HPV-associated OPSCC has not been comprehensively assessed. Our study investigated the frequency and localization of SPT of HPV-positive OPSCC, as well as their prognostic impact. We find that the SPT of HPV-positive OPSCC are less frequent than those of HPV-negative OPSCC, and they are also associated with higher survival rates. The localization of SPT of HPV-positive OPSCC did not differ from the localization of SPT of HPV-negative OPSCC. Abstract Purpose: To investigate the frequency, localization, and survival of second primary tumors (SPT) of oropharyngeal squamous cell carcinoma (OPSCC) depending on human papillomavirus (HPV) status. Methods: We performed a retrospective chart analysis of 107 OPSCC patients treated at the Zurich University Hospital from 2001 to 2010. Rate and localization of SPT after an index OPSCC were stratified according to smoking and HPV infection status. Results: In total, 57/91 (63%) included patients showed an HPV-associated OPSCC. Of these, 37/57 (64.9%) patients with an HPV-positive and 32/34 (94.1%) patients with an HPV-negative OPSCC were smokers. The median age at diagnosis of the SPT was 59.54 years (interquartile range 52.7–65.6). In addition, 8/57 (14%) HPV-positive and 13/34 (38.2%) HPV-negative patients developed SPT. The rate of SPT in patients with HPV-positive index tumors was significantly lower than in patients with HPV-negative OPSCC (p-value 0.01). Smokers showed significantly more SPT in the head and neck area than outside. The development of an SPT led to a significantly lower survival time in HPV-negative patients, while it did not significantly affect the survival time of HPV-positive patients. Conclusions: Patients with HPV-positive index tumors had a significantly lower risk of developing SPT than patients with HPV-negative tumors. If SPT developed, survival was significantly shorter in patients with HPV-negative tumors than with HPV-positive tumors.
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Ho SY, Tsang RKY. Value of oesophagoscopy and bronchoscopy in diagnosis of synchronous malignancies in patients with head and neck squamous cell carcinomas. BMC Cancer 2020; 20:1172. [PMID: 33256662 PMCID: PMC7706228 DOI: 10.1186/s12885-020-07681-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 11/23/2020] [Indexed: 11/22/2022] Open
Abstract
Background Routine screening of patients with head and neck squamous cell carcinomas (HNSCCs) for synchronous malignancies using oesophagoscopy and bronchoscopy had been controversial. The aim of this study is therefore to find out the rate of synchronous malignancies in patients with primary HNSCCs, the risk factors for its occurrence and the effectiveness of oesophagoscopy and bronchoscopy from a 10-year experience in a single centre. Methods A retrospective review of medical records was conducted from July 2008 to June 2018 in a tertiary referral centre in Hong Kong. All patients with newly diagnosed HNSCCs were screened with oesophagoscopy and bronchoscopy at the time of diagnosis and therefore all patients were included in the study. The incidence of synchronous malignancies along the aerodigestive tract and the yield of oesophagoscopy and bronchoscopy were studied. Results Of the 702 patients included in the study, the overall rate of synchronous malignancies was 8.3% (58/702), with the rate of synchronous oesophageal and lung malignancies being 5.8% (41/702) and 0.85% (6/702) respectively. Fourteen out of the 41 oesophageal malignancies were only detectable with oesophagoscopy. Only one of the synchronous lung malignancies was detectable by bronchoscopy. Risk factors for synchronous malignancies include male gender, smokers, drinkers and primary hypopharyngeal cancer. Conclusions Oesophagoscopy is essential for detecting synchronous oesophageal malignancies in patients with HNSCCs especially in male patients, smokers and drinkers, and it is most valuable in primary hypopharyngeal cancer patients among all primary subsites. Bronchoscopy had a low yield for synchronous lung malignancies and can be potentially replaced by imaging techniques.
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Affiliation(s)
- Shi Yeung Ho
- Department of Ear, Nose and Throat, Queen Mary Hospital, 102, Pokfulam Road, Hong Kong
| | - Raymond King Yin Tsang
- Division of Otorhinolaryngology, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, 102, Pokfulam Road, Hong Kong.
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Asarkar A, Flores JM, Nathan CAO. Comparison of Survival Estimates Following Recurrence, Persistence, or Second Primary Malignancy in Oropharyngeal Squamous Cell Carcinoma. Otolaryngol Head Neck Surg 2020; 163:1209-1217. [PMID: 32633195 DOI: 10.1177/0194599820932872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study investigated survival among patients with oropharyngeal squamous cell carcinoma (OPSCC) after recurrence, persistence, and second primary malignancies (SPMs). STUDY DESIGN Retrospective cohort study. SETTING Patients were treated at a tertiary cancer center. SUBJECTS AND METHODS Patients with OPSCC who had completed treatment between 2001 and 2017 were included. Survival estimates of 4 groups of patients were calculated: (1) patients who were disease free after initial treatment, (2) patients who had persistent disease, (3) those with recurrent disease, and (4) patients with SPMs. Cox proportional hazard models and parametric survival analyses (using Weibull distributions) were used to obtain hazard ratios (HRs) and time ratios (TRs). RESULTS The cohort included 364 patients. The crude overall SPM prevalence was 8.2%. Mean overall survival (OS) time in years for patients who remained disease free after treatment was 4.02 years. Among patients who experienced recurrence, the recurrence-free survival (RFS) was 2.58 years while their mean (SD) OS was 3.67 (2.7) years. Participants who experienced persistence had a mean (SD) OS of 1.67 (1.68) years. Patients with observed SPMs had a mean (SD) OS of 6.39 (4.06) years since their primary cancer but shortened survivals of 1.75 (2.34) years since the secondary diagnosis. Differences were present even after accounting for human papillomavirus (HPV) and smoking status. CONCLUSIONS Our findings stress the importance of active surveillance as per current National Comprehensive Cancer Network guidelines, irrespective of the HPV status or smoking status. Prospective studies with a larger number of SPM cases and longer follow-up are needed to validate survival trends even beyond 5 years.
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Affiliation(s)
- Ameya Asarkar
- Department of Otolaryngology-Head and Neck Surgery, LSU Health, Shreveport, Louisiana, USA.,Surgical Service, Otolaryngology Section, Overton Brooks Veterans Affairs Medical Center, Shreveport, Louisiana, USA
| | | | - Cherie-Ann O Nathan
- Department of Otolaryngology-Head and Neck Surgery, LSU Health, Shreveport, Louisiana, USA.,Surgical Service, Otolaryngology Section, Overton Brooks Veterans Affairs Medical Center, Shreveport, Louisiana, USA
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The contribution of second primary cancers to the mortality of patients with a gastric first primary cancer. Eur J Gastroenterol Hepatol 2019; 31:471-477. [PMID: 30601339 DOI: 10.1097/meg.0000000000001348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Gastric first primary cancers (FPCs) have an increased risk of developing second primary cancers (SPCs). However, their effect on mortality remains poorly understood. Thus, we aimed to estimate the contribution of SPCs to the mortality of gastric FPCs. PATIENTS AND METHODS A population-based cohort of gastric FPCs diagnosed in 2000-2006 was followed for SPCs (31 December 2012) and vital status (31 December 2017). SPCs (138 synchronous and 205 metachronous, ≤1 and >1 year after the FPC, respectively) were matched (1 : 3, by sex, 5-year age group, and year of FPC diagnosis) with those without an SPC and alive when the corresponding SPC was diagnosed. RESULTS In synchronous SPCs, the hazard ratio (95% confidence interval) for death was 1.07 (0.81-1.40) in males and 0.86 (0.58-1.28) in females; the corresponding estimates for metachronous SPCs were 1.89 (1.49-2.41) and 2.08 (1.42-3.05). In synchronous SPCs, the 10-year cumulative mortality was similar to that of FPCs only; the estimates were higher in lung SPCs. The 10-year cumulative mortality was 75.5% in males and 65.5% in females with metachronous SPCs, which is more than 20% higher than for FPCs only. CONCLUSION Among patients with gastric FPCs who survive long enough for metachronous SPCs, the latter substantially increases mortality over 10 years, whereas the effect of synchronous SPCs is generally smaller.
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Seeburg DP, Baer AH, Aygun N. Imaging of Patients with Head and Neck Cancer. Oral Maxillofac Surg Clin North Am 2018; 30:421-433. [DOI: 10.1016/j.coms.2018.06.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Dezube AR, Lee A, Rebeiz E. The role of esophagoscopy and imaging in the detection of second esophageal primary carcinomas in mucosal head and neck malignancy. INTERNATIONAL JOURNAL OF SURGERY OPEN 2017. [DOI: 10.1016/j.ijso.2017.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Bhattacharyya N, Chien W. Risk of Second Primary Malignancy after Radioactive Iodine Treatment for Differentiated Thyroid Carcinoma. Ann Otol Rhinol Laryngol 2016; 115:607-10. [PMID: 16944659 DOI: 10.1177/000348940611500806] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: The association between second primary malignancy (SPM) and radioactive iodine (RAI) is controversial. We examined the association between RAI and SPM after treatment of differentiated thyroid carcinoma (DTC) using a large cohort from a national cancer database. Methods: From the Surveillance, Epidemiology and End Results (SEER) database, all index cases of DTC (papillary or follicular) were extracted for the years 1988 to 2001. Two cohorts were constructed: 1) patients with DTC who were not treated with RAI, and 2) patients with DTC who were treated with RAI. For each cohort, we tabulated all subsequent malignancies for each patient, identifying patients in each group with 1 or more SPMs. Results: According to inclusion criteria, 18,882 cases of DTC treated without RAI (mean follow-up, 55.5 months) and 10,349 cases treated with RAI (mean follow-up, 61.8 months) were identified. The most common SPM sites were breast or prostate followed by colon or lung for both groups. On univariate analysis, SPMs developed in 6.7% of patients without RAI versus 4.8% of those with RAI (p > .001, univariate χ2). However, on multivariate analysis, only age and male gender had statistically significant hazard ratios (1.052 and 1.438, respectively; p > .001); follicular carcinoma histology and use of RAI did not influence occurrence of SPM after DTC (p = .180 and p = .789, respectively). Conclusions: Use of RAI does not elevate the risk of SPM. Concern about SPM induction should not adversely affect the decision to administer RAI for DTC.
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Affiliation(s)
- Neil Bhattacharyya
- Division of Otolaryngology, Brigham and Women's Hospital, Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts 02115, USA
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Muñoz AA, Haddad RI, Woo SB, Bhattacharyya N. Behavior of oral squamous cell carcinoma in subjects with prior lichen planus. Otolaryngol Head Neck Surg 2016; 136:401-4. [PMID: 17321867 DOI: 10.1016/j.otohns.2006.09.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2006] [Accepted: 09/26/2006] [Indexed: 11/16/2022]
Abstract
Objective To characterize the clinical behavior of oral squamous cell carcinomas (OSCCA) arising in patients with pre-existing oral lichen planus (OLP). Study Design and Setting Retrospective case-control study. Disease-free interval, time to first recurrence, subsequent therapy, and overall survival were calculated and compared between cases and controls matched for age, gender, primary site, and tumor stage. Results In 10 identified subjects with OLP/OSCCA, mean time from OLP diagnosis to OSCCA was 5.5 years. Three subjects suffered a local recurrence and two developed a second primary OSCCA. Mean actuarial survival for OLP patients was 119 months vs 42 months for the control patients, though this difference was not significant ( P = 0.201, log-rank). Conclusions OLP/SCCA subjects may exhibit better actuarial survival than SCCA patients despite a somewhat higher rate of local recurrence and second primary SCCA. Further study is required to characterize the behavior of OSCCA arising in pre-existing OLP.
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Affiliation(s)
- Amanda A Muñoz
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
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Birkeland AC, Rosko AJ, Chinn SB, Prince ME, Sun GH, Spector ME. Prevalence and Outcomes of Head and Neck versus Non-Head and Neck Second Primary Malignancies in Head and Neck Squamous Cell Carcinoma: An Analysis of the Surveillance, Epidemiology, and End Results Database. ORL J Otorhinolaryngol Relat Spec 2016; 78:61-9. [PMID: 26910465 PMCID: PMC4818170 DOI: 10.1159/000443768] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 01/04/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Patients with head and neck squamous cell carcinoma (HNSCC) are at risk for second primary malignancies (SPMs). The prevalence, distribution, and patient survival in head and neck versus non-head and neck SPMs are not fully elucidated. The objective of this study was to quantify the rate of SPMs in patients with HNSCC. METHODS This is a population-based cohort study using the Surveillance, Epidemiology, and End Results (SEER) database. Prevalence and location of SPMs, and survival data were analyzed. RESULTS There were 58,363 HNSCC patients, and the prevalence of HNSCC and non-HNSCC SPMs was 3.0% (1,746) and 8.8% (5,109), respectively. Overall survival (OS) was higher in patients with HNSCC SPMs compared to non-HNSCC SPMs (p < 0.001), with no difference in disease-specific survival. Patients with SPMs in the lung and esophagus had a worse OS (p < 0.001), and patients with SPMs in the prostate and breast had a better OS (p < 0.001). CONCLUSION In HNSCC patients who develop SPMs, nearly 75% are non-HNSCC SPMs. Patients with non-HNSCC SPMs have a lower OS. Future clinical practice guidelines should take the risks and locations of SPM development into consideration for screening.
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Affiliation(s)
- Andrew C. Birkeland
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan
| | - Andrew J. Rosko
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan
| | - Steven B. Chinn
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mark E. Prince
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan
| | - Gordon H. Sun
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan
- Division of Otolaryngology, Rancho Los Amigos National Rehabilitation Center, Downey, California
| | - Matthew E. Spector
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan
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Open questions and novel concepts in oral cancer surgery. Eur Arch Otorhinolaryngol 2015; 273:1975-85. [PMID: 26003319 DOI: 10.1007/s00405-015-3655-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 05/17/2015] [Indexed: 01/05/2023]
Abstract
The persistence of cancerous cells after surgery in oral squamous cell carcinoma (OSCC) represents a major challenge, as it often leads to local recurrences and secondary primary tumors, which are eventually responsible for a large proportion of deaths. This persistence is currently evaluated by histological analyses. In this review we discuss some important pitfalls of the histopathological analysis, such as margin evaluation, specimen shrinkage and T staging. In addition, we critically analyze the appropriateness of current surgical techniques in relation to the concept of field cancerization. Finally, we describe some novel imaging and molecular approaches, which might be useful in tailoring surgical resections and encourage the use of OSCC animal models to explore and provide proof of concept of the feasibility and potential clinical utility of innovative surgical protocols.
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Gan SJ, Dahlstrom KR, Peck BW, Caywood W, Li G, Wei Q, Zafereo ME, Sturgis EM. Incidence and pattern of second primary malignancies in patients with index oropharyngeal cancers versus index nonoropharyngeal head and neck cancers. Cancer 2013; 119:2593-601. [PMID: 23605777 DOI: 10.1002/cncr.28107] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 03/08/2013] [Accepted: 03/13/2013] [Indexed: 12/17/2022]
Abstract
BACKGROUND A recent review of the Surveillance, Epidemiology, and End Results registry suggested that patients with index squamous cell carcinoma (SCC) of the oropharynx (SCCOP) are less likely to develop second primary malignancies (SPM) than patients with index SCC of nonoropharyngeal sites (oral cavity, larynx, hypopharynx). The objectives of this study were to determine the impact of index primary tumor site on SPM risk and to explore factors that potentially affect this risk within a large, prospectively accrued cohort of patients with index SCC of the head and neck (SCCHN). METHODS A cohort of 2230 patients with incident SCCHN was reviewed for development of SPM. Kaplan-Meier analysis, log-rank testing, and Cox proportional hazards models were used to detect the impact of various factors, including index tumor site, on SPM risk. RESULTS The SPM rate was lower for patients with index SCCOP than for patients with index nonoropharyngeal cancer (P < .001). Among patients with SCCOP, former smokers had a 50% greater risk of SPM, and current smokers had a 100% greater risk of SPM than never-smokers (Ptrend = .008). Also among patients with SCCOP, those with the classic SCCHN phenotype had an SPM risk similar to that of patients with index nonoropharyngeal cancers; those with a typical human papillomavirus phenotype had a very low SPM risk. SPM most commonly occurred at nontobacco-related sites in patients with index SCCOP and at tobacco-related sites in patients with index nonoropharyngeal cancers. CONCLUSIONS In patients with SCCHN, index cancer site and smoking status affect the risk and distribution of SPM.
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Affiliation(s)
- Samuel J Gan
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
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Peck BW, Dahlstrom KR, Gan SJ, Caywood W, Li G, Wei Q, Zafereo ME, Sturgis EM. Low risk of second primary malignancies among never smokers with human papillomavirus-associated index oropharyngeal cancers. Head Neck 2012; 35:794-9. [PMID: 22711172 DOI: 10.1002/hed.23033] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2012] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Among patients with index oropharyngeal cancer, second primary malignancies (SPMs) may be less common in cases of human papillomavirus (HPV)-associated tumors than HPV-negative tumors. Further modification of these SPM risks by smoking has not been reported. METHODS SPM outcomes of 356 patients with incident oropharyngeal cancer were analyzed using Cox proportional hazards and Kaplan-Meier models. SPM risk and SPM-free survival were compared in HPV-seronegative patients, HPV-seropositive never smokers, and HPV-seropositive ever smokers. RESULTS HPV-seropositive patients had a lower 5-year SPM rate than HPV-seronegative patients (5.6% vs 14.6%; p = .051). Compared to HPV-seronegative patients, HPV-seropositive never smokers had a 73% reduced SPM risk, and HPV-seropositive ever smokers had a 27% reduced SPM risk (trend p = .028). Although HPV-seronegative patients had SPMs in traditional locations, 70% of SPMs among HPV-seropositive patients were outside typical tobacco-related sites. CONCLUSION HPV serologic status and smoking may stratify patients with index oropharyngeal cancers in terms of risk and location of SPMs.
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Affiliation(s)
- Brandon W Peck
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Second course of radiation for new primary head-and-neck cancer: population-based study of survival. Am J Clin Oncol 2011; 34:367-71. [PMID: 20859195 DOI: 10.1097/coc.0b013e3181e84b7a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To analyze patient and tumor characteristics, and survival of patients who received 2 courses of radiotherapy for different primary head and neck cancers (HNCs). METHODS A total of 234 patients who underwent 2 courses of radiotherapy for different primary, localized, or regional HNCs registered in the population-based Surveillance, Epidemiology, and End Results database were identified. RESULTS The latency between first and second irradiated HNCs ranged from 0.3 to 28.8 years (median, 6.3 years). Only 22% of first irradiated HNCs were node positive, and only 22% of second irradiated HNCs were node positive. After the diagnosis of the second irradiated HNC, the 1-, 2-, and 5-year overall survivals were 68%, 40%, and 17%, respectively. The variables of gender, race, latency, and stage of second cancer did not significantly impact survival. At the time of diagnosis of second irradiated HNC, younger age (P = 0.026), later year of diagnosis (P = 0.005), and cancer-directed surgery (P = 0.032) were favorable predictors of improved survival. With Cox regression analyses, younger age (P = 0.060) and cancer-directed surgery for the second irradiated HNC (HR = 0.75, 95% CI: 0.55-1.01, P = 0.062) were borderline significantly favorable risk factors, whereas year of diagnosis (P = 0.13) was not. CONCLUSIONS From a population-based analysis, patients undergoing a second course of radiation for HNC appear to benefit from cancer-directed surgery, although this did not reach statistical significance with Cox regression analyses. The improved outcome after resection is perhaps attributable to a therapeutic benefit from surgery and/or more indolent disease among those amenable to resection.
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Rodriguez-Bruno K, Ali MJ, Wang SJ. Role of panendoscopy to identify synchronous second primary malignancies in patients with oral cavity and oropharyngeal squamous cell carcinoma. Head Neck 2010; 33:949-53. [DOI: 10.1002/hed.21561] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2010] [Indexed: 11/10/2022] Open
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van der Waal I, de Bree R. Second primary tumours in oral cancer. Oral Oncol 2010; 46:426-8. [DOI: 10.1016/j.oraloncology.2010.02.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2010] [Accepted: 02/19/2010] [Indexed: 10/19/2022]
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González-García R, Naval-Gías L, Román-Romero L, Sastre-Pérez J, Rodríguez-Campo FJ. Local recurrences and second primary tumors from squamous cell carcinoma of the oral cavity: A retrospective analytic study of 500 patients. Head Neck 2009; 31:1168-80. [DOI: 10.1002/hed.21088] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Woolgar JA, Hall GL. Determinants of outcome following surgery for oral squamous cell carcinoma. Future Oncol 2009; 5:51-61. [PMID: 19243298 DOI: 10.2217/14796694.5.1.51] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The recent changes in incidence and prevalence of oral squamous cell carcinoma in relation to gender and age mirror the changing patterns of exposure to tobacco and alcohol, the main etiological agents. Most cases of oral cancer are managed by surgery, often combined with radiotherapy. Histopathological assessment of the resection specimen provides information vital for postoperative management and prognosis. This review considers the full range of histological determinants of outcome in relation to the primary oral tumor and any metastatic involvement of the cervical lymphatic system, together with an outline of more general patient factors that may also impact on morbidity and mortality rates.
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Affiliation(s)
- Julia A Woolgar
- Oral Pathology, University of Liverpool Dental Hospital, Liverpool, UK.
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van der Haring I, Schaapveld M, Roodenburg J, de Bock G. Second primary tumours after a squamous cell carcinoma of the oral cavity or oropharynx using the cumulative incidence method. Int J Oral Maxillofac Surg 2009; 38:332-8. [DOI: 10.1016/j.ijom.2008.12.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2007] [Revised: 05/28/2008] [Accepted: 12/16/2008] [Indexed: 01/05/2023]
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Moore MG, Bhattacharyya N. Survival outcomes for head and neck squamous cell carcinoma arising after lymphoma. Otolaryngol Head Neck Surg 2008; 138:388-93. [PMID: 18312890 DOI: 10.1016/j.otohns.2007.11.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Revised: 10/31/2007] [Accepted: 11/27/2007] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Determine onset and survival of head and neck squamous cell carcinoma (HNSCC) after lymphoma. STUDY DESIGN Case-control. METHODS Cases of HNSCC occurring as a second primary malignancy after prior diagnosis of lymphoma were extracted from the Surveillance, Epidemiology and End Results database. Survivals were compared with age- and stage-matched control cases of HNSCC. RESULTS A total of 333 cases of HNSCC after lymphoma (53 Hodgkin's and 280 non-Hodgkin's lymphomas) were identified as occurring on average 70.7 months after lymphoma. Post-lymphoma HNSCC cases exhibited poorer mean (median) Kaplan-Meier overall survival of 57.0 months (29.0 months) vs 84.2 months (42.0 months) for controls (P = 0.008). However, after exclusion of lymphoma-related deaths, post-lymphoma HNSCC survival improved to 63.9 (86.3) months (P = 0.191). HNSCC occurring after Hodgkin's disease exhibited better mean survival (92.5 months) than extranodal non-Hodgkin's (43.5 months) and nodal non-Hodgkin's (50.7 months) disease (P = 0.049). CONCLUSIONS Patients with HNSCC with prior lymphoma, especially non-Hodgkin's lymphoma, exhibit poorer survival than first primary HNSCC cases.
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Affiliation(s)
- Michael G Moore
- Division of Otolaryngology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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Schairer C, Hisada M, Chen BE, Brown LM, Howard R, Fosså SD, Gail M, Travis LB. Comparative mortality for 621 second cancers in 29356 testicular cancer survivors and 12420 matched first cancers. J Natl Cancer Inst 2007; 99:1248-56. [PMID: 17686826 DOI: 10.1093/jnci/djm081] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Testicular cancer survivors, many of whom have undergone radiotherapy, are at substantial risk of second cancers. Treatment for testicular cancer may limit treatment options for second cancers, thereby adversely affecting survival after the second cancer. However, no data on outcomes of testicular cancer survivors with second cancers compared to patients with comparable first cancers exist. METHODS Among 29356 white testicular cancer patients reported to the Surveillance, Epidemiology, and End Results (SEER) program (1973-2002), 621 developed a second cancer with known stage and were matched to a random sample of 12420 white male first cancer patients in the SEER program by cancer site, stage, diagnosis year, and age at diagnosis. Mortality was ascertained through 2002. Cancer-specific and all-cause mortality following second cancers were compared with those of matched first cancers, and rate ratios (RRs) were estimated using proportional hazards analysis. Survival functions were calculated using product-limit estimates. RESULTS During the study period, 284 testicular cancer survivors with second cancers died, 191 from their second cancer; 5443 matched first cancer patients died, 3929 from their first cancer. Rate ratios for cancer-specific and all-cause mortality for second cancers compared with matched first cancers were 1.05 (95% confidence interval [CI] = 0.90 to 1.23) and 1.09 (95% CI = 0.96 to 1.23), respectively. However, among testicular cancer patients who were diagnosed during 1973-1979, an era in which radiation therapy was given at high doses and to the chest area, all-cause mortality following second cancers at sites below the diaphragm (79 deaths) and second lung cancers (29 deaths) was statistically significantly higher than that from matched first cancers (RR = 1.44, 95% CI = 1.13 to 1.83, and RR = 1.65, 95% CI = 1.12 to 2.42, respectively). CONCLUSIONS Mortality from second cancers following testicular cancer was similar to matched first cancers, except for selected tumors in the radiotherapy field among testicular cancer patients who were diagnosed during 1973-1979, a time when radiotherapy doses for treatment of testicular cancer were high and chest irradiation was an option in standard practice.
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Affiliation(s)
- Catherine Schairer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA.
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Copper MP, Triesscheijn M, Tan IB, Ruevekamp MC, Stewart FA. Photodynamic therapy in the treatment of multiple primary tumours in the head and neck, located to the oral cavity and oropharynx. Clin Otolaryngol 2007; 32:185-9. [PMID: 17550506 DOI: 10.1111/j.1365-2273.2007.01441.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Multiple primary tumours are a common problem in the head and neck cancer patients. Curative surgery or radiotherapy of these tumours can be very mutilating or even impossible. This study aims at evaluating meta-tetrahydroxy-phenyl chlorin-mediated photodynamic therapy for second or multiple primary tumours in the head and neck. DESIGN Retrospective study of all patients with second or multiple primary tumours treated by photodynamic therapy over a 10-year period. SETTING All patients were treated in the Netherlands Cancer Institute, a tertiary referral centre for the head and neck cancer patients. PARTICIPANTS A total of 27 patients with 42 the second or the multiple primary head and neck tumours were treated by photodynamic therapy (0.15 mg/kg meta-tetrahydroxy-phenyl chlorin). MAIN OUTCOMES MEASURES Cure rates. RESULTS Twenty-eight of 42 tumours were cured (67%). Cure rates for stage I or in situ disease were 85%versus 38% for stage II/III. CONCLUSIONS Cure rates for photodynamic therapy of the multiple primary head and neck tumours were lower than previously described for first primaries, but were still very encouraging for this difficult patient population. The high cure rate obtained in stage I multiple primaries emphasises the importance of a meticulous follow-up of patients treated for the head and neck cancer to detect new tumours at a curable stage.
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Affiliation(s)
- M P Copper
- Department of Head and Neck Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands.
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White JS, Weissfeld JL, Ragin CCR, Rossie KM, Martin CL, Shuster M, Ishwad CS, Law JC, Myers EN, Johnson JT, Gollin SM. The influence of clinical and demographic risk factors on the establishment of head and neck squamous cell carcinoma cell lines. Oral Oncol 2006; 43:701-12. [PMID: 17112776 PMCID: PMC2025692 DOI: 10.1016/j.oraloncology.2006.09.001] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2006] [Revised: 09/08/2006] [Accepted: 09/11/2006] [Indexed: 01/15/2023]
Abstract
The purpose of this study was to generate stable cell cultures from head and neck squamous cell carcinomas (HNSCC), and retrospectively analyze the factors associated with successful cell line establishment. Fifty-two HNSCC cell lines were isolated from a series of 199 tumors collected between 1992 and 1997 at the University of Pittsburgh Medical Center. Cell lines were characterized at the molecular and cellular level to determine the features associated with cell line formation. Successful cell line formation was dependent on multiple factors, including gene amplification involving chromosomal band 11q13, local and/or regional involvement of lymph nodes, and alcohol usage. The establishment of HNSCC cell lines enriches the resources available for cancer research. Our findings indicate that generation of stable cell lines from HNSCC is biased towards tumors with a poor prognosis. Our 52 stable lines comprise one of the largest series of HNSCC cell lines in the literature, with complete demographic, histopathologic, clinical, and survival data.
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Affiliation(s)
- Jason S. White
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, School of Medicine and School of Dental Medicine, Pittsburgh, Pennsylvania
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, School of Medicine and School of Dental Medicine, Pittsburgh, Pennsylvania
- University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Joel L. Weissfeld
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, School of Medicine and School of Dental Medicine, Pittsburgh, Pennsylvania
- University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Camille C. R. Ragin
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, School of Medicine and School of Dental Medicine, Pittsburgh, Pennsylvania
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, School of Medicine and School of Dental Medicine, Pittsburgh, Pennsylvania
- University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Karen M. Rossie
- Department of Oral Medicine and Pathology, University of Pittsburgh Graduate School of Public Health, School of Medicine and School of Dental Medicine, Pittsburgh, Pennsylvania
| | - Christa Lese Martin
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, School of Medicine and School of Dental Medicine, Pittsburgh, Pennsylvania
| | - Michele Shuster
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, School of Medicine and School of Dental Medicine, Pittsburgh, Pennsylvania
| | - Chandramohan S. Ishwad
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, School of Medicine and School of Dental Medicine, Pittsburgh, Pennsylvania
| | - John C. Law
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, School of Medicine and School of Dental Medicine, Pittsburgh, Pennsylvania
| | - Eugene N. Myers
- Department of Otolaryngology, University of Pittsburgh Graduate School of Public Health, School of Medicine and School of Dental Medicine, Pittsburgh, Pennsylvania
| | - Jonas T. Johnson
- Department of Otolaryngology, University of Pittsburgh Graduate School of Public Health, School of Medicine and School of Dental Medicine, Pittsburgh, Pennsylvania
| | - Susanne M. Gollin
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, School of Medicine and School of Dental Medicine, Pittsburgh, Pennsylvania
- University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
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Taioli E, Piselli P, Arbustini E, Boschiero L, Burra P, Busnach G, Caldara R, Citterio F, De Juli E, Dissegna D, Gotti E, Marchini F, Maresca MC, Marsano L, Montagnino G, Montanaro D, Sandrini S, Pedotti P, Scalamogna M, Serraino D. Incidence of Second Primary Cancer in Transplanted Patients. Transplantation 2006; 81:982-5. [PMID: 16612272 DOI: 10.1097/01.tp.0000203321.42121.14] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Solid organ transplanted patients have a three- to fourfold higher lifetime risk of developing a cancer than the general population. However, the incidence of a second primary cancer in transplanted patients has never been studied, despite the fact that the presence of regular follow-ups and the increased survival of these patients make them a very attractive model. METHODS We investigated the incidence of a second primary cancer (SPC) in 7,636 patients who underwent a kidney, liver, lung or heart transplant between 1970 and 2004, and were followed-up for 51,819 person-years. RESULTS During the follow-up, 499 subjects developed a first cancer (annual incidence: 98.6 x 10,000 PY), and 22 of them developed a SPC (annual incidence: 3.9 x 10,000 PY). The annual incidence of a SPC in the transplanted patients who developed a first cancer was 107.8 x 10,000 PY, giving a standardized incidence ratio of 1.1 (95% CI: 0.83-1.41). CONCLUSIONS This result shows that the incidence of the SPC was the same as the incidence of a first cancer. Our study does not indicate an increased risk of SPC in transplanted subjects who already suffered a first malignancy.
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Abstract
Oral cavity cancers represent an area of head and neck oncology with some unique and interesting management themes. In spite of a significant paradigm shift in the treatment of many head and neck cancers toward us-ing primary chemoradiation, this treatment is not frequently applied to the oral cavity. Small cancers of the oral cavity are usually managed by surgery alone. Larger cancers are usually treated with primary surgery followed by chemoradiation. Neck treatment is offered to patients who have a greater than 20% chance of having lymph node metastasis or who have neck disease at the time of presentation. Neck treatment may involve surgery, radiation therapy, or both. Reconstruction of surgical defects of the oral cavity runs the gamut of techniques from the most simple to the most complex three-dimensional microvascular composite flaps. A multidisciplinary setting with a tumor board and multiple supportive services provides the best care for patients who have advanced-stage cancers.
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Affiliation(s)
- John P Campana
- Department of Otolaryngology, B-205, University of Colorado Health Sciences Center, 4200 East 9th Avenue, Denver, CO 80262, USA.
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