1
|
Jana BK, Singh M, Dutta RS, Mazumder B. Current Drug Delivery Strategies for Buccal Cavity Ailments using Mouth Dissolving Wafer Technology: A Comprehensive Review on the Present State of the Art. Curr Drug Deliv 2024; 21:339-359. [PMID: 36443976 DOI: 10.2174/1567201820666221128152010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/02/2022] [Accepted: 08/31/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Mouth-dissolving wafer is polymer-based matrice that incorporates various pharmaceutical agents for oral drug delivery. This polymeric wafer is ingenious in the way that it needs not be administered with water, like in conventional tablet dosage form. It has better compliance among the pediatric and geriatric groups owing to its ease of administration. OBJECTIVE The polymeric wafer dissolves quickly in the oral cavity and is highly effective for a targeted local effect in buccal-specific ailments. It is a safe, effective, and versatile drug delivery carrier for a range of drugs used to treat a plethora of oral cavity-specific ailments that inflict common people, like thrush, canker sores, periodontal disease, benign oral cavity tumors, buccal neoplasm, and malignancies. This review paper focuses thoroughly on the present state of the art in mouth-dissolving wafer technology for buccal drug delivery and targeting. Moreover, we have also addressed present-time limitations associated with wafer technology to aid researchers in future developments in the arena of buccal drug delivery. CONCLUSION This dynamic novel formulation has tremendous future implications for designing drug delivery systems to target pernicious ailments and diseases specific to the buccal mucosa. In a nutshell, this review paper aims to summarize the present state of the art in buccal targeted drug delivery.
Collapse
Affiliation(s)
- Bani Kumar Jana
- Department of Pharmaceutical sciences, Dibrugarh University, Dibrugarh-786004, Assam, India
| | - Mohini Singh
- Department of Pharmaceutical sciences, Dibrugarh University, Dibrugarh-786004, Assam, India
| | - Rajat Subhra Dutta
- Department of Pharmaceutical sciences, Dibrugarh University, Dibrugarh-786004, Assam, India
| | - Bhaskar Mazumder
- Department of Pharmaceutical sciences, Dibrugarh University, Dibrugarh-786004, Assam, India
| |
Collapse
|
2
|
Worthington HV, Bulsara VM, Glenny AM, Clarkson JE, Conway DI, Macluskey M. Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment. Cochrane Database Syst Rev 2023; 8:CD006205. [PMID: 37650478 PMCID: PMC10476948 DOI: 10.1002/14651858.cd006205.pub5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
BACKGROUND Surgery is a common treatment option in oral cavity cancer (and less frequently in oropharyngeal cancer) to remove the primary tumour and sometimes neck lymph nodes. People with early-stage disease may undergo surgery alone or surgery plus radiotherapy, chemotherapy, immunotherapy/biotherapy, or a combination of these. Timing and extent of surgery varies. This is the third update of a review originally published in 2007. OBJECTIVES To evaluate the relative benefits and harms of different surgical treatment modalities for oral cavity and oropharyngeal cancers. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was 9 February 2022. SELECTION CRITERIA Randomised controlled trials (RCTs) that compared two or more surgical treatment modalities, or surgery versus other treatment modalities, for primary tumours of the oral cavity or oropharynx. DATA COLLECTION AND ANALYSIS Our primary outcomes were overall survival, disease-free survival, locoregional recurrence, and recurrence; and our secondary outcomes were adverse effects of treatment, quality of life, direct and indirect costs to patients and health services, and participant satisfaction. We used standard Cochrane methods. We reported survival data as hazard ratios (HRs). For overall survival, we reported the HR of mortality, and for disease-free survival, we reported the combined HR of new disease, progression, and mortality; therefore, HRs below 1 indicated improvement in these outcomes. We used GRADE to assess certainty of evidence for each outcome. MAIN RESULTS We identified four new trials, bringing the total number of included trials to 15 (2820 participants randomised, 2583 participants analysed). For objective outcomes, we assessed four trials at high risk of bias, three at low risk, and eight at unclear risk. The trials evaluated nine comparisons; none compared different surgical approaches for excision of the primary tumour. Five trials evaluated elective neck dissection (ND) versus therapeutic (delayed) ND in people with oral cavity cancer and clinically negative neck nodes. Elective ND compared with therapeutic ND probably improves overall survival (HR 0.64, 95% confidence interval (CI) 0.50 to 0.83; I2 = 0%; 4 trials, 883 participants; moderate certainty) and disease-free survival (HR 0.56, 95% CI 0.45 to 0.70; I2 = 12%; 5 trials, 954 participants; moderate certainty), and probably reduces locoregional recurrence (HR 0.58, 95% CI 0.43 to 0.78; I2 = 0%; 4 trials, 458 participants; moderate certainty) and recurrence (RR 0.58, 95% CI 0.48 to 0.70; I2 = 0%; 3 trials, 633 participants; moderate certainty). Elective ND is probably associated with more adverse events (risk ratio (RR) 1.31, 95% CI 1.11 to 1.54; I2 = 0%; 2 trials, 746 participants; moderate certainty). Two trials evaluated elective radical ND versus elective selective ND in people with oral cavity cancer, but we were unable to pool the data as the trials used different surgical procedures. Neither study found evidence of a difference in overall survival (pooled measure not estimable; very low certainty). We are unsure if there is a difference in effect on disease-free survival (HR 0.57, 95% CI 0.29 to 1.11; 1 trial, 104 participants; very low certainty) or recurrence (RR 1.21, 95% CI 0.63 to 2.33; 1 trial, 143 participants; very low certainty). There may be no difference between the interventions in terms of adverse events (1 trial, 148 participants; low certainty). Two trials evaluated superselective ND versus selective ND, but we were unable to use the data. One trial evaluated supraomohyoid ND versus modified radical ND in 332 participants. We were unable to use any of the primary outcome data. The evidence on adverse events was very uncertain, with more complications, pain, and poorer shoulder function in the modified radical ND group. One trial evaluated sentinel node biopsy versus elective ND in 279 participants. There may be little or no difference between the interventions in overall survival (HR 1.00, 95% CI 0.90 to 1.11; low certainty), disease-free survival (HR 0.98, 95% CI 0.90 to 1.07; low certainty), or locoregional recurrence (HR 1.04, 95% CI 0.91 to 1.19; low certainty). The trial provided no usable data for recurrence, and reported no adverse events (very low certainty). One trial evaluated positron emission tomography-computed tomography (PET-CT) following chemoradiotherapy (with ND only if no or incomplete response) versus planned ND (before or after chemoradiotherapy) in 564 participants. There is probably no difference between the interventions in overall survival (HR 0.92, 95% CI 0.65 to 1.31; moderate certainty) or locoregional recurrence (HR 1.00, 95% CI 0.94 to 1.06; moderate certainty). One trial evaluated surgery plus radiotherapy versus radiotherapy alone and provided very low-certainty evidence of better overall survival in the surgery plus radiotherapy group (HR 0.24, 95% CI 0.10 to 0.59; 35 participants). The data were unreliable because the trial stopped early and had multiple protocol violations. In terms of adverse events, subcutaneous fibrosis was more frequent in the surgery plus radiotherapy group, but there were no differences in other adverse events (very low certainty). One trial evaluated surgery versus radiotherapy alone for oropharyngeal cancer in 68 participants. There may be little or no difference between the interventions for overall survival (HR 0.83, 95% CI 0.09 to 7.46; low certainty) or disease-free survival (HR 1.07, 95% CI 0.27 to 4.22; low certainty). For adverse events, there were too many outcomes to draw reliable conclusions. One trial evaluated surgery plus adjuvant radiotherapy versus chemotherapy. We were unable to use the data for any of the outcomes reported (very low certainty). AUTHORS' CONCLUSIONS We found moderate-certainty evidence based on five trials that elective neck dissection of clinically negative neck nodes at the time of removal of the primary oral cavity tumour is superior to therapeutic neck dissection, with increased survival and disease-free survival, and reduced locoregional recurrence. There was moderate-certainty evidence from one trial of no difference between positron emission tomography (PET-CT) following chemoradiotherapy versus planned neck dissection in terms of overall survival or locoregional recurrence. The evidence for each of the other seven comparisons came from only one or two studies and was assessed as low or very low-certainty.
Collapse
Affiliation(s)
- Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Vishal M Bulsara
- School of Medicine, The University of Adelaide, Adelaide, Australia
- Oral and Maxillofacial Surgery, Central Adelaide Local Health Network, SA Health, Adelaide, Australia
| | - Anne-Marie Glenny
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Janet E Clarkson
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - David I Conway
- Glasgow Dental School, University of Glasgow, Glasgow, UK
| | | |
Collapse
|
3
|
Polz A, Morshed K, Bibik R, Drop B, Drop A, Polz-Dacewicz M. Serum and Saliva Level of miR-31-5p and miR-let 7a in EBV Associated Oropharyngeal Cancer. Int J Mol Sci 2023; 24:11965. [PMID: 37569339 PMCID: PMC10418762 DOI: 10.3390/ijms241511965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Epstein-Barr virus (EBV) has a well-documented association with head and neck neoplasms, including nasopharyngeal carcinoma (NPC). In the last few years, research aimed at elucidating the role of the miRs in the pathogenesis of head and neck cancer (HNC) has gained importance. The study of miRs expression has set new directions in the search for biomarkers with diagnostic and prognostic value, and even in the search for new therapeutic targets for various tumors, including HNC. The aim of current study was to approximate the importance of miR-31-5p and miR-let 7a in the pathogenesis of EBV associated oropharyngeal cancer. For this purpose, experiments were carried out to determine the level of mentioned miRs in serum among patients diagnosed with oropharyngeal cancer linked to EBV infection, depending on histological differentiation-grading (G1-G3) and TNM classification. All clinical specimens stratified by HPV status were HPV negative. The level of antibodies EBNA and EBVCA was also assessed. The obtained results showed a significantly increased serum level of miR-31-5p but decreased level of miR-let 7a in EBV positive oropharyngeal cancer patients. We demonstrated association between the level of tested miRs and clinical stage. Our findings showed that miR-31-5p and miR-let-7a may be involved in development and progression of EBV associated oropharyngeal cancer. Therefore, it seems important to further study these molecules, as well as to determine whether they could be important biomarkers in the diagnosis of oropharyngeal cancer associated with EBV infection.
Collapse
Affiliation(s)
- Anna Polz
- Synevo Poland, 80-180 Gdańsk, Poland;
| | - Kamal Morshed
- Department of Otolaryngology Head and Neck Cancer, University of Technology and Humanities in Radom, 26-600 Radom, Poland;
| | - Robert Bibik
- Department of Radiation Oncology, Oncology Center of Radom, 26-600 Radom, Poland;
| | - Bartłomiej Drop
- Department of Computer Science and Medical Statistics with the e-Health Laboratory, 20-090 Lublin, Poland;
| | - Andrzej Drop
- 1st Department of Medical Radiology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Małgorzata Polz-Dacewicz
- Department of Virology with Viral Diagnostics Laboratory, Medical University of Lublin, 20-093 Lublin, Poland
| |
Collapse
|
4
|
Boccellino M, De Rosa A, Di Domenico M. An ELISA Test Able to Predict the Development of Oral Cancer: The Significance of the Interplay between Steroid Receptors and the EGF Receptor for Early Diagnosis. Diagnostics (Basel) 2023; 13:2001. [PMID: 37370896 DOI: 10.3390/diagnostics13122001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/14/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Oral disorders including non-homogeneous leukoplakia, erythroplakia, erosive lichen planus, and many others can potentially progress to oral squamous cell carcinoma (OSCC). Currently, the late diagnosis of OSCC contributes to high mortality rates, emphasizing the need for specific markers and early intervention. In this study, we present a novel, quick, sensitive, and non-invasive method for the early detection and screening of oral cancer, enabling the qualitative assessment of neoplastic forms even before the onset of symptoms. Our method directly examines the expression of oral cancer biomarkers, such as the epithelial growth factor receptor (EGFR), and steroid receptors, including the androgen receptor (AR) and the estrogen receptor (ER). The crosstalk between sexual hormones and the EGF receptor plays a crucial role in the progression of different types of cancers, including head and neck squamous cell carcinoma. To implement our method, we developed a kit box comprising nine wells or stations, each containing buffers, lysis systems, and dried/lyophilized antibodies stored at room temperature. The kit includes instruments for sample collection and a PVDF strip (Immobilon) with specific primary antibodies immobilized on it. These antibodies capture the target proteins from cytological samples. Additionally, complementary tools are provided to ensure efficient utilization and optimal test performance. The technique can be performed outside the laboratory, either "patient side" with an instant chemocolorimetric response or with a digital reader utilizing the enzyme-linked immunosorbent assay (ELISA) method.
Collapse
Affiliation(s)
- Mariarosaria Boccellino
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Alfredo De Rosa
- Multidisciplinary Medical-Surgical Department, Odontostomatology Section, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Marina Di Domenico
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
- Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA 19140, USA
| |
Collapse
|
5
|
Cao Y, Liu W, Gu D. A nomogram for predicting overall survival of patients with squamous cell carcinoma of the floor of the mouth: a population-based study. Eur Arch Otorhinolaryngol 2023:10.1007/s00405-023-07971-5. [PMID: 37071145 DOI: 10.1007/s00405-023-07971-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 04/06/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND Floor of mouth squamous cell carcinoma (SCCFOM) is a rare but aggressive malignancy with 5-year overall survival (OS) rates below 40% in published studies. However, the clinicopathological predictors of the prognosis of SCCFOM remain undefined. We aimed to establish a model to predict the survival outcomes of SCCFOM. METHODS We searched the Surveillance, Epidemiology, and End Results (SEER) database for patients diagnosed with SCCFOM between 2000 and 2017. Data on patient demographics, treatment modalities, and survival outcomes were retrieved. Risk factors for OS were evaluated by survival and Cox regression analyses. A nomogram for OS was developed based on the multivariate model and split the patients into high- and low-risk cohorts based on cutoff values. RESULTS Overall, 2014 SCCFOM patients were included in this population-based study. Multivariate Cox regression showed that age, married status, grade, American Joint Committee on Cancer stage, radiotherapy, chemotherapy, and surgery were significant risk factors for survival. A nomogram was established using the regression model. The C-indices, areas under the receiver operating characteristic curves, and calibration plots demonstrated the reliable performance of the nomogram. Patients assigned to the high-risk group had a significantly lower survival rate. CONCLUSIONS The nomogram predicting survival outcomes of SCCFOM patients based on clinical information showed good discriminative ability and prognostic accuracy. Our nomogram could be used to predict the survival probabilities for SCCFOM patients at different timepoints.
Collapse
Affiliation(s)
- Yuxiao Cao
- School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
- The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, People's Republic of China
| | - Wenyi Liu
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Shanghai Bluecross Medical Science Institute, Shanghai, People's Republic of China
- Institute for Hospital Management, Tsing Hua University, Shenzhen Campus, Beijing, People's Republic of China
| | - Dantong Gu
- Institute of Otolaryngology, Clinical Research Center, Eye and ENT Hospital, Fudan University, Shanghai, 200031, People's Republic of China.
| |
Collapse
|
6
|
Zhang C, Cai Q, Ke J. Poor Prognosis of Oral Squamous Cell Carcinoma Correlates With ITGA6. Int Dent J 2023; 73:178-185. [PMID: 35820930 PMCID: PMC10023534 DOI: 10.1016/j.identj.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Oral cancer is the ninth most common cancer worldwide and a leading cause of cancer-related death. Oral squamous cell carcinoma (OSCC) accounts for 90% of all oral cancers. Autophagy is a conserved essential catabolic process related to OSCC. The aim of this study was to elucidate diagnostic and prognostic autophagy-related biomarkers in OSCC. METHODS The OSCC gene expression data set was obtained from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) between the OSCC samples and adjacent healthy tissues were identified by R software. The Human Autophagy Database was screened, which revealed 222 autophagy-related genes. The autophagy-related DEGs were identified. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were applied. Protein-protein interaction network analysis was performed in the STRING database. cytoHubba in the Cytoscape software was applied to determine the top 10 hub genes. The data set of patients with OSCC from The Cancer Genome Atlas (TCGA) was used to evaluate the prognostic value of the 10 hub genes. The association between prognosis-related hub genes and immune infiltrates was explored. RESULTS Twenty-seven autophagy-related DEGs were identified. The top 10 hub genes were CCL2, CDKN2A, CTSB, CTSD, CXCR4, ITGA6, MAP1LC3A, MAPK3, PARP1, and RAB11A. ITGA6 was identified as the most efficient biomarker. Receiver operating characteristic curve analysis indicated that ITGA6 had the highest diagnostic accuracy for OSCC (area under the curve = 0.925). ITGA6 expression was significantly related to immune infiltrates. CONCLUSIONS The autophagy-related gene ITGA6 might be an efficient diagnostic and prognostic biomarker in OSCC.
Collapse
Affiliation(s)
- Churen Zhang
- Department of Stomatology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, China.
| | - Qiaoling Cai
- Department of Stomatology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, China.
| | - Jianguo Ke
- Department of Stomatology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, China.
| |
Collapse
|
7
|
Renou A, Guizard AV, Chabrillac E, Defossez G, Grosclaude P, Deneuve S, Vergez S, Lapotre-Ledoux B, Plouvier SD, Dupret-Bories A. Evolution of the Incidence of Oral Cavity Cancers in the Elderly from 1990 to 2018. J Clin Med 2023; 12:jcm12031071. [PMID: 36769722 PMCID: PMC9917397 DOI: 10.3390/jcm12031071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES To describe the evolution of the incidence of oral cavity cancers (OCC) among elderly patients in France between 1990 and 2018 and to compare it to the incidence of other cancers sharing the same main risk factors. MATERIAL AND METHODS The incidence of cancers in mainland France from 1990 to 2018 was estimated from incidence data observed in every cancer registry of the Francim network. Incidence was modeled by a 2-dimensional penalized spline of age and year of diagnosis, associated with a random effect corresponding to the registry. The elderly population was divided into two groups: 70-79 years old and ≥80 years old. RESULTS There was a 72% increase in the number of OCC cases in women over 70 years of age between the periods 1990-1999 and 2010-2018. As for men, there was a stabilization in the number of cases (+2%). Over the same period, for laryngeal and hypopharyngeal cancers, there was a decrease in incidence in elderly men and an increase in elderly women, although less marked than for OCC. CONCLUSIONS Since the 1990s, the incidence of OCC has been increasing in elderly subjects in France, particularly in women. Population aging and growth or alcohol and tobacco consumption alone do not seem to explain this increase, which is not observed in the same proportions for other upper aerodigestive tract cancer subsites sharing the same main risk factors.
Collapse
Affiliation(s)
- Alice Renou
- Department of Surgery, University Cancer Institute Toulouse—Oncopole, Hôpitaux Universitaires de Toulouse, 31009 Toulouse, France
| | - Anne-Valérie Guizard
- French Network of Cancer Registries, 31073 Toulouse, France
- General Tumor Registry of Calvados, Centre François Baclesse, 14000 Caen, France
- ANTICIPE U 1086 Inserm-UCN, 14000 Caen, France
| | - Emilien Chabrillac
- Department of Surgery, Institut Claudius Regaud, University Cancer Institute Toulouse—Oncopole, 31009 Toulouse, France
| | - Gautier Defossez
- French Network of Cancer Registries, 31073 Toulouse, France
- General Cancer Registry of Poitou-Charentes, Pôle Biologie, Pharmacie et Santé Publique, CHU/Université de Poitiers, 86000 Poitiers, France
| | - Pascale Grosclaude
- French Network of Cancer Registries, 31073 Toulouse, France
- Tarn Cancer Registry, Claudius Regaud Institute, University Cancer Institute Toulouse—Oncopole, 31009 Toulouse, France
- CERPOP, UMR 1295 Inserm Toulouse III University, 31000 Toulouse, France
| | - Sophie Deneuve
- Department of ENT, Rouen University Hospital, 76000 Rouen, France
- Quantification en Imagerie Fonctionnelle-Laboratoire d’Informatique, du Traitement de l’Information et des Systèmes Equipe d’Accueil 4108 (QuantIF-LITIS EA4108), University of Rouen, 76000 Rouen, France
| | - Sébastien Vergez
- Department of Surgery, University Cancer Institute Toulouse—Oncopole, Hôpitaux Universitaires de Toulouse, 31009 Toulouse, France
| | - Bénédicte Lapotre-Ledoux
- French Network of Cancer Registries, 31073 Toulouse, France
- Somme Cancer Registry, CHU Amiens, CEDEX 1, 80054 Amiens, France
- CHIMERE, Surgery, Imaging and Tissue REgeneration of the Cephalic Extremity-Morphological and Functional Characterization, 7516 UR UPJV, CHU-Amiens Picardie, 1 Rond Point du Professeur Cabrol, 80000 Amiens, France
| | - Sandrine D Plouvier
- French Network of Cancer Registries, 31073 Toulouse, France
- General Cancer Registry of Lille Area, GCS-C2RC, 59000 Lille, France
| | - Agnès Dupret-Bories
- Department of Surgery, University Cancer Institute Toulouse—Oncopole, Hôpitaux Universitaires de Toulouse, 31009 Toulouse, France
- Correspondence: ; Tel.: +33-53-1155-373
| | | |
Collapse
|
8
|
Pastorino R, Sassano M, Danilo Tiziano F, Giraldi L, Amore R, Arzani D, Abiusi E, Ahrens W, Vilches LA, Canova C, Healy CM, Holcatova I, Lagiou P, Polesel J, Popovic M, Nygård S, Cadoni G, Znaor A, Boffetta P, Matsuo K, Oze I, Brennan P, Boccia S. Plasma miR-151-3p as a Candidate Diagnostic Biomarker for Head and Neck Cancer: A Cross-sectional Study within the INHANCE Consortium. Cancer Epidemiol Biomarkers Prev 2022; 31:2237-2243. [PMID: 36126276 PMCID: PMC9720423 DOI: 10.1158/1055-9965.epi-22-0376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/24/2022] [Accepted: 09/19/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Identification of screening tests for the detection of head and neck cancer (HNC) at an early stage is an important strategy to improving prognosis. Our objective was to identify plasma circulating miRNAs for the diagnosis of HNC (oral and laryngeal subsites), within a multicenter International Head and Neck Cancer Epidemiology consortium. METHODS A high-throughput screening phase with 754 miRNAs was performed in plasma samples of 88 cases and 88 controls, followed by a validation phase of the differentially expressed miRNAs, identified in the screening, in samples of 396 cases and 396 controls. Comparison of the fold changes (FC) was carried out using the Wilcoxon rank-sum test and the Dunn multiple comparison test. RESULTS We identified miR-151-3p (FC = 1.73, P = 0.007) as differentially expressed miRNAs in the screening and validation phase. The miR-151-3p was the only overexpressed miRNA in validation sample of patients with HNC with early stage at diagnosis (FC = 1.81, P = 0.008) and it was confirmed upregulated both in smoker early-stage cases (FC = 3.52, P = 0.024) and in nonsmoker early-stage cases (FC = 1.60, P = 0.025) compared with controls. CONCLUSIONS We identified miR-151-3p as an early marker of HNC. This miRNA was the only upregulated in patients at early stages of the disease, independently of the smoking status. IMPACT The prognosis for HNC is still poor. The discovery of a new diagnostic biomarker could lead to an earlier tumor discovery and therefore to an improvement in patient prognosis.
Collapse
Affiliation(s)
- Roberta Pastorino
- Department of Woman and Child Health and Public Health—Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Michele Sassano
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Francesco Danilo Tiziano
- Department of Life Sciences and Public Health, Section of Genomic Medicine, Università Cattolica del Sacro Cuore, Roma, Italia
- Unit of Medical Genetics, Department of Laboratory Science and Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Luca Giraldi
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Rosarita Amore
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Dario Arzani
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Emanuela Abiusi
- Department of Life Sciences and Public Health, Section of Genomic Medicine, Università Cattolica del Sacro Cuore, Roma, Italia
- Unit of Medical Genetics, Department of Laboratory Science and Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, and University of Bremen, Faculty of Mathematics and Computer Science, Institute of Statistics, Bremen, Germany
| | - Laia Alemany Vilches
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Cristina Canova
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Università di Padova, Padova, Italia
| | | | - Ivana Holcatova
- Institute of Hygiene & Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Jerry Polesel
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO) Aviano, IRCCS, Aviano, Italia
| | - Maja Popovic
- Cancer Epidemiology Unit, Department of Medical Sciences, Università di Torino, Torino, Italia
| | | | - Gabriella Cadoni
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Dipartimento Patologia Testa Collo e Organi di Senso, Facoltà Medicina e Chirurgia Università Cattolica Sacro Cuore, Roma, Italia
| | - Ariana Znaor
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center, Nagoya, Japan
- Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center, Nagoya, Japan
| | - Paul Brennan
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Stefania Boccia
- Department of Woman and Child Health and Public Health—Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
| |
Collapse
|
9
|
Smith CDL, McMahon AD, Ross A, Inman GJ, Conway DI. Risk prediction models for head and neck cancer: A rapid review. Laryngoscope Investig Otolaryngol 2022; 7:1893-1908. [PMID: 36544947 PMCID: PMC9764804 DOI: 10.1002/lio2.982] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/26/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022] Open
Abstract
Background Cancer risk assessment models are used to support prevention and early detection. However, few models have been developed for head and neck cancer (HNC). Methods A rapid review of Embase and MEDLINE identified n = 3045 articles. Following dual screening, n = 14 studies were included. Quality appraisal using the PROBAST (risk of bias) instrument was conducted, and a narrative synthesis was performed to identify the best performing models in terms of risk factors and designs. Results Six of the 14 models were assessed as "high" quality. Of these, three had high predictive performance achieving area under curve values over 0.8 (0.87-0.89). The common features of these models were their inclusion of predictors carefully tailored to the target population/anatomical subsite and development with external validation. Conclusions Some existing models do possess the potential to identify and stratify those at risk of HNC but there is scope for improvement.
Collapse
Affiliation(s)
- Craig D. L. Smith
- School of Medicine, Dentistry, and NursingUniversity of GlasgowGlasgowUK
- Institute of Cancer SciencesUniversity of GlasgowGlasgowUK
| | - Alex D. McMahon
- School of Medicine, Dentistry, and NursingUniversity of GlasgowGlasgowUK
| | - Alastair Ross
- School of Medicine, Dentistry, and NursingUniversity of GlasgowGlasgowUK
| | - Gareth J. Inman
- Institute of Cancer SciencesUniversity of GlasgowGlasgowUK
- Cancer Research UK Beatson InstituteGlasgowUK
| | - David I. Conway
- School of Medicine, Dentistry, and NursingUniversity of GlasgowGlasgowUK
- Institute of Cancer SciencesUniversity of GlasgowGlasgowUK
| |
Collapse
|
10
|
Perim Galvão De Podestá O, Salaroli LB, Cattafesta M, Peres SV, De Podestá JRV, von Zeidler SLV, de Oliveira JC, Kowalski LP, Ikeda MK, Brennan P, Curado MP. Changes in Body Mass Index Are Associated with Squamous Cell Carcinomas of Oral Cavity, Oropharynx and Larynx: A Case-Control Study in Brazil. Nutr Cancer 2022; 75:599-609. [PMID: 36426640 DOI: 10.1080/01635581.2022.2143535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 10/28/2022] [Indexed: 11/27/2022]
Abstract
Head and neck cancer (HNC) significantly impacts nutritional status because the tumor limits swallowing function. In this sense, it is important to monitor the nutritional status throughout the life of any individual. A multicenter case-control study was carried out to analyze the BMI at 30 years of age, two years before diagnosis and at the time of diagnosis of individuals with oral cavity, oropharynx, and larynx cancers. It was observed that a 5% reduction in BMI during the two years before enrollment was associated with an increased risk of the oral cavity (OR = 3.73), oropharyngeal OR = 5.25), and laryngeal (OR = 5.22). Reduced BMI of more than 5% over two years before diagnosis was associated with HNC. Weight loss remained significant at diagnosis, but it is not possible to exclude reverse causality since most cases are at an advanced stage. BMI monitoring of individuals at potential risk for HNC can promote early diagnosis and nutritional interventions for HNC.
Collapse
Affiliation(s)
- Olívia Perim Galvão De Podestá
- Research Group on Epidemiology, Healf and Nutrition, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
- Sciences of Fundacion Antonio Prudente, A C Camargo Cancer Center, São Paulo, São paulo, Brazil
| | - Luciane Bresciani Salaroli
- Graduate Program in Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
- Graduate Program in Nutrition and Health, Vitória, Espírito Santo, Brazil
| | - Mônica Cattafesta
- Research Group on Epidemiology, Healf and Nutrition, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Stela Verzinhasse Peres
- Onconcenter Foundation of São Paulo - Deputy Director of Information and Epidemiology, São paulo, Brazil
| | | | | | | | - Luiz Paulo Kowalski
- Sciences of Fundacion Antonio Prudente, A C Camargo Cancer Center, São Paulo, São paulo, Brazil
| | - Mauro Kasuo Ikeda
- Sciences of Fundacion Antonio Prudente, A C Camargo Cancer Center, São Paulo, São paulo, Brazil
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Maria Paula Curado
- Sciences of Fundacion Antonio Prudente, A C Camargo Cancer Center, São Paulo, São paulo, Brazil
| |
Collapse
|
11
|
Reviewing the epidemiology of head and neck cancer: definitions, trends and risk factors. Br Dent J 2022; 233:780-786. [PMID: 36369568 PMCID: PMC9652141 DOI: 10.1038/s41415-022-5166-x] [Citation(s) in RCA: 126] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022]
Abstract
Introduction Head and neck cancer appears to be increasing in incidence, with potential changes in aetiology proposed. This paper aims to provide a narrative overview of the epidemiological literature to describe the disease burden and trends in terms of incidence and mortality both in the UK and globally and to review the evidence on current risk factors. Methods A search was performed on multiple databases (PubMed and Epistemonikos), applying filters to identify systematic reviews and meta-analyses which investigated head and neck cancer incidence, mortality and risk factors. International and UK cancer registries and sources were searched for incidence and mortality data. Results Multiple definitions of head and neck cancer are employed in epidemiology. Globally, incidence rates have increased in recent decades, largely driven by oropharyngeal cancer. Mortality rates over the last decade have also started to rise, reflecting the disease incidence and static survival rates. Major risk factors include tobacco smoking alone and in combination with alcohol consumption, betel chewing (particularly in Southeast Asian populations) and the human papillomavirus in oropharyngeal cancer. Conclusions These epidemiological data can inform clinical and preventive service planning for head and neck cancer. Head and neck cancer incidence is increasing and is projected to continue to rise, largely driven by increases in oropharyngeal cancer. Mortality rates have started to increase within the last decade, reflecting a rising incidence and static survival rates. Major risk factors that are associated with the risk of head and neck cancer are tobacco smoking and tobacco used in combination with alcohol consumption. Human papillomavirus is an additional major risk factor for oropharyngeal cancer. Cancers of the head and neck are clearly socioeconomically patterned but this socioeconomic risk is not entirely explained by smoking and alcohol behaviours.
Collapse
|
12
|
Ben-Arie E, Lottering B, Inprasit C, Yip HT, Ho WC, Ton G, Lee YC, Kao PY. Traditional Chinese medicine use in patients with oral cancer: A retrospective longitudinal cohort study in Taiwan. Medicine (Baltimore) 2022; 101:e30716. [PMID: 36197175 PMCID: PMC9509120 DOI: 10.1097/md.0000000000030716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Oral cancer is frequently associated with smoking, alcohol consumption, and betel quid chewing, which are common harmful behaviors observed in certain cohorts of the Taiwanese population. Some reports have explored the potential therapeutic effect of certain herbal remedies on cancer treatments and the outcomes thereof. However, supportive evidence regarding the specific use of traditional Chinese medicine (TCM) in oral cancer treatment is lacking and deserves further investigation. This study measured the use of TCM therapies for oral cancer in a Taiwanese population-based retrospective longitudinal cohort study. The Taiwan National Health Insurance Research Database was utilized to conduct this study. The study population was limited to oral cancer patients diagnosed between 2000 and 2009, which were followed up for at least 5 years. Therapeutic strategies investigated included acupuncture and the Chinese herbs and formula used. Additionally, the frequency of TCM treatment visits, total medical costs, and all-cause mortality were also analyzed. Between 2000 and 2009, a total of 951 patients were diagnosed with various oral cancers. 13.7% of the diagnosed patients utilized TCM treatment measures. The majority of the patients were males. The top 3 common single herbs used were Xuán shēn (Radix Scrophulariae), Shí hú (Herba Dendrobii), and Mài mén dōng (Ophiopogon Japonicus). Then, Gān lù yǐn, Zhī bǎi dì huáng wán, and Sàn zhǒng kuì jiān tāng were the most frequently used herbal formulas. The survival probability was higher in TCM users when compared to non-TCM users in 5- and 12-year all-cause mortality (P < .05). This study explored the use of TCM therapies in oral cancer patients and identified essential information regarding the specifics of conventional herbal medicine used, affiliated medical costs, survival probability, and common symptoms observed in Taiwanese oral cancer patients.
Collapse
Affiliation(s)
- Eyal Ben-Arie
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan
| | - Bernice Lottering
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan
| | - Chanya Inprasit
- Suphanburi Campus Establishment Project, Kasetsart University, Suphan Buri, Thailand
| | - Hei-Tung Yip
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Wen-Chao Ho
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Gil Ton
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan
| | - Yu-Chen Lee
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan
- Department of Acupuncture, China Medical University Hospital, Taichung, Taiwan
- Chinese Medicine Research Center, China Medical University, Taichung, Taiwan
- *Correspondence: Yu-Chen Lee, Graduate Institute of Acupuncture Science, China Medical University, 2 Yuh-Der Road, Taichung City 40402, Taiwan (e-mail: ) and Pei-Yu Kao, Division of Thoracic Surgery, Department of Surgery, China Medical University Hospital, 2 Yuh-Der Road, Taichung City 40402, Taiwan (e-mail: )
| | - Pei-Yu Kao
- Division of Thoracic Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan
- Surgical Intensive Care Unit, China Medical University Hospital, Taichung, Taiwan
- *Correspondence: Yu-Chen Lee, Graduate Institute of Acupuncture Science, China Medical University, 2 Yuh-Der Road, Taichung City 40402, Taiwan (e-mail: ) and Pei-Yu Kao, Division of Thoracic Surgery, Department of Surgery, China Medical University Hospital, 2 Yuh-Der Road, Taichung City 40402, Taiwan (e-mail: )
| |
Collapse
|
13
|
Juszczak HM, Rosenfeld RM. Diet and Health in Otolaryngology. Otolaryngol Clin North Am 2022; 55:909-927. [PMID: 36088162 DOI: 10.1016/j.otc.2022.06.001] [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: 11/30/2022]
Abstract
Diet is essential to health and can modulate inflammatory markers, the microbiota, and epigenetic outcomes. Proper nutrition is also key to good postsurgical outcomes. Diet is challenging to study, resulting in a relative dearth of influential studies. There is substantial evidence regarding the benefits of a whole food plant-predominant diet on health and longevity, in general, but limited evidence regarding otolaryngologic disorders. Diet may be associated with the risk of head and neck cancer, hearing loss, laryngopharyngeal reflux, and sinonasal symptoms. Evidence, however, is heterogenous and often insufficient for treatment recommendations. Many opportunities exist for future research and expansion..
Collapse
Affiliation(s)
- Hailey M Juszczak
- Department of Otolaryngology-Head and Neck Surgery, State University of New York Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
| | - Richard M Rosenfeld
- Department of Otolaryngology-Head and Neck Surgery, State University of New York Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| |
Collapse
|
14
|
Lip and Oral Cavity Cancer Burden and Related Risk Factors in China: Estimates and Forecasts from 1990 to 2049. Healthcare (Basel) 2022; 10:healthcare10091611. [PMID: 36141223 PMCID: PMC9498681 DOI: 10.3390/healthcare10091611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/18/2022] [Accepted: 08/21/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary China’s lip and oral cavity cancer burden is rising. The elderly have a relatively heavy disease burden, mainly due to poor oral health awareness, the side effects of other diseases and delayed treatment. Moreover, the incidence of the elderly over 50 years old is predicted to increase further from 2020 to 2049 in China. Males have a heavier disease burden, mainly due to their smoking, drinking and work exposure. Early screening and health intervention policies incorporating key populations and risk factors may deserve the consideration of policy makers to reduce the disease burden. Abstract Lip and oral cavity cancer is a common malignancy faced by many developing countries, and the disease burden is high in China. This study explored this cancer burden and its risk factors using data from China in the GBD 2019, along with predicting the incidence trends in 2020–2049. Data on age-standardized rates (ASR), incidence, death and disability-adjusted life years (DALY), by sex, age and risk factors were collected from the Institute for Health Metrics and Evaluation (IHME). Joinpoint regression and Age–Period–Cohort (APC) models were selected to analyze the epidemic trend of this cancer in China, and descriptive analysis was used for the time trend and age distribution of risk factors. The Bayesian APC model was selected to foresee the incidence trend in 2020–2049. This cancer burden was found to be in an upward trend in China in 1990–2019. The upward trend was more pronounced among men than among women. These cancer deaths and DALYs are overwhelmingly attributable to smoking and drinking. On APC analysis, the younger generation in China demonstrated a lower cancer risk. In 2049, the incidence of this cancer is projected to be 3.99/100,000, 6.07/100,000, 7.37/100,000, 10.49/100,000, 14.82/100,000, 19.19/100,000, 20.71/100,000, 23.64/100,000, 16.42/100,000 and 9.91/100,000 among those aged 50–54, 55–59, 60–64, 65–69, 70–74, 75–79, 80–84, 85–89, 85–89 and over 95 years, respectively. Disease control policies and early screening should focus on men and the elderly and target different risk factors.
Collapse
|
15
|
Gislon LC, Curado MP, López RVM, de Oliveira JC, Vasconcelos de Podestá JR, Ventorin von Zeidler S, Brennan P, Kowalski LP. Risk factors associated with head and neck cancer in former smokers: A Brazilian multicentric study. Cancer Epidemiol 2022; 78:102143. [PMID: 35378425 DOI: 10.1016/j.canep.2022.102143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/19/2022] [Accepted: 03/09/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Reduced tobacco consumption in the population has not been associated with reduced incidence rates of head and neck cancer in several countries. OBJECTIVE To explore the associations between HNC and sociodemographic characteristics and lifestyle of former smokers from three Brazilian cancer centers. METHODS A multicenter case-control study was conducted with 229 former smokers diagnosed with squamous cell carcinoma of the oral cavity, oropharynx, larynx, and 318 controls (former smokers without head and neck cancer). Bivariate and multiple logistic regression analyses were conducted to estimate odds ratios (ORs) with a 95% confidence interval (CI). RESULTS 11-20 years after smoking cessation showed significant impact on HNC reduction (OR 0.22, 95% CI, 0.12-0.39), which reached 82% (95% CI, 0.09-0.35) among 20 + former smokers when compared to individuals who had stopped smoking for up to 5 years. A history of high-intensity smoking (>40 pack-years) increased HNC risk by 2.09 times (95% CI 1.13-3.89) when compared to subjects who smoked up to 20 pack-years. Past alcohol consumption (OR 1.99, 95% CI, 1.06-3.82) was also associated with head and neck cancer risk in former smokers when compared to no alcohol consumption. There was a decreased head and neck cancer risk in former smokers who had high school level of education (OR 0.38, 95% CI, 0.16-0.91) compared to illiterate former smokers; and former smokers with moderate intake of vegetables (OR 0.49, 95% CI, 0.28-0.85) and fruits (OR 0.43, 95% CI, 0.25-0.73) compared to those with low intake. CONCLUSION Head and neck cancer risk in former smokers decreases after 11 years after smoking cessation, former smokers with past alcohol consumption showed an increased risk of HNC. High school level of education and moderate intake of vegetables and fruits reduced HNC risk among former smokers.
Collapse
Affiliation(s)
- Luciane Campos Gislon
- Antônio Prudente Foundation, A.C.Camargo Cancer Center, Rua Professor Antônio Prudente, 211, São Paulo, Brazil; University of Vale of Itajaí, 88302-901, Itajaí, Brazil.
| | - Maria Paula Curado
- Antônio Prudente Foundation, A.C.Camargo Cancer Center, Rua Professor Antônio Prudente, 211, São Paulo, Brazil.
| | - Rossana Verónica Mendoza López
- Center for Translational Research in Oncology. São Paulo State Cancer Institute, Avenida Dr. Arnaldo, 251, São Paulo, Brazil.
| | | | | | - Sandra Ventorin von Zeidler
- Pathology Department, Postgraduate Program in Biotechnology, Federal University of Espírito Santo, Avenida Marechal Campos, 1468 Vitória, Espírito Santo, Brazil.
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France.
| | - Luiz Paulo Kowalski
- Antônio Prudente Foundation, A.C.Camargo Cancer Center, Rua Professor Antônio Prudente, 211, São Paulo, Brazil; Department of Head and Neck Surgery, University of São Paulo Medical School, São Paulo, Brazil.
| |
Collapse
|
16
|
Woodley N, Slim MAM, Ton T, Montgomery J, Douglas C. Does recreational drug use influence survival and morbidity associated with laryngeal cancer. ADDICTION & HEALTH 2022; 14:115-126. [PMID: 36544516 PMCID: PMC9743818 DOI: 10.22122/ahj.2022.196452.1287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/07/2021] [Indexed: 12/24/2022]
Abstract
Background The use of opioids is considered a risk factor for laryngeal cancer. A retrospective study was performed to explore the relationship between recreational drug exposure and laryngeal cancer. Methods Patients diagnosed between the 1st of January 2013 and the 31st of December 2017 using ICD-10 CD-32 coding were identified from the Head and Neck Multidisciplinary Team database. We divided the study population into two cohorts (RD and non-RD) and compared the demographics, morbidity, and outcomes of these two populations. In addition, we performed case-matched analysis to control for potential confounding factors including gender, alcohol use and cigarette smoking. Findings 329 patients in Glasgow, Scotland were included with a mean age of 64.96 ± 10.94 and a follow-up of 24 ± 13.91 months. Of these, 39 reported recreational drug use (RD). RD was associated with younger age (53.0 vs. 66.6, p<0.001) at diagnosis with laryngeal cancer. A greater proportion of tumours occurred in the supraglottic subsite (p=0.041). Furthermore, these patients were more likely to undergo tracheostomy (RR=2.50, 95% CI: 1.41-4.44, p=0.008) and laryngectomy (RR=2.25, 95% CI: 1.57-3.21, p<0.001). Recreational drug users were more likely to require enteral feeding support (RR= 1.44, 95% CI: 1.13-1.84, p=0.02) during oncological treatment. No survival differences were noted at 1, 2, or 3-years (plog-rank=0.83). Case matched analysis correcting for smoking, alcohol and gender confirmed that recreational drug users were younger at diagnosis with a predilection for the supraglottic subsite. Conclusion Recreational drug use is associated with an increased burden of disease and morbidity in laryngeal cancer. We suggest that clinicians view recreational drug exposure as a red flag in those with suspected laryngeal cancer regardless of patient age.
Collapse
Affiliation(s)
- Niall Woodley
- ENT Department, Queen Elizabeth University Hospital, Glasgow, G51 4TF,Correspondence to: Niall Woodley; ENT Department, Queen Elizabeth University Hospital, Glasgow, G51 4TF
| | | | - Trung Ton
- ENT Department, Queen Elizabeth University Hospital, Glasgow, G51 4TF
| | - Jenny Montgomery
- ENT Department, Queen Elizabeth University Hospital, Glasgow, G51 4TF
| | - Catriona Douglas
- ENT Department, Queen Elizabeth University Hospital, Glasgow, G51 4TF
| |
Collapse
|
17
|
Bandeira CM, Almeida AÁ, Alves MGO, Pascoal MBN, Chagas JFS, Neto MB, de Barros PP, Nunes FD, Carta CFL, Almeida JD. The Fagerström and AUDIT Tests as Probable Screening Tools in Oral Cancer and Their Correlation with CYP1A1, GSTM1, GSTP1, and GSTT1 Gene Expression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3991. [PMID: 35409669 PMCID: PMC8997590 DOI: 10.3390/ijerph19073991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/26/2022] [Accepted: 03/01/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Cancer is currently a major public health problem worldwide, with a marked increase of about 70% in the number of expected diagnosed cases over the next two decades. The amount of tobacco and alcohol consumed is calculated based on the subjective information provided by the user. Tobacco exposure can be assessed using the Fagerström Test for Cigarette Dependence (FTCD) and alcohol consumption by the Alcohol Use Disorder Identification Test (AUDIT). MATERIALS AND METHODS Forty-eight subjects answered the Fagerström, and AUDIT tests and we studied them as likely screening tools for oral cancer and their correlation with the expression of CYP1A1, GSTM1, GSTP1, and GSTT1 genes by the RT-qPCR method. RESULTS There were significant differences in the AUDIT score and CYP1A1 expression between cancer and control groups. Participants in advanced stages, whether due to tumor size or regional metastasis, showed significant differences in the duration of tobacco use, FTCD, AUDIT score, and CYP1A1 expression when compared to patients in early stages. Among subjects without cancer, we found a significant correlation between participant age and GSTP1 expression. Furthermore, the expression of GSTP1 was significantly correlated with the number of cigarettes smoked per day, duration of tobacco use, and FTCD. CONCLUSIONS Questionnaires designed to evaluate the degree of tobacco and alcohol exposure and dependence combined with gene expression tests can be useful to assess the risk of developing oral cancer. Furthermore, raising the awareness of individuals regarding their degree of dependence and encouraging them to participate in cessation programs are important educational measures for the prevention of tobacco-related malignancies.
Collapse
Affiliation(s)
- Celso Muller Bandeira
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology of São José dos Campos, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (C.M.B.); (A.Á.A.); (P.P.d.B.); (C.F.L.C.)
- Faculdade de Ciências Médicas de São José dos Campos—Humanitas, São José dos Campos 12220-061, Brazil
| | - Adriana Ávila Almeida
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology of São José dos Campos, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (C.M.B.); (A.Á.A.); (P.P.d.B.); (C.F.L.C.)
| | - Mônica Ghislaine Oliveira Alves
- School of Medicine, Anhembi Morumbi University, São José dos Campos 12230-002, Brazil;
- Technology Research Center (NPT), Universidade Mogi das Cruzes, Mogi das Cruzes 08780-911, Brazil
| | - Maria Beatriz Nogueira Pascoal
- Department of Head and Neck Surgery, São Leopoldo Mandic College, Campinas 13045-755, Brazil; (M.B.N.P.); (J.F.S.C.)
- Department of Head and Neck Surgery, Hospital Municipal Doutor Mário Gatti, Campinas 13036-902, Brazil
| | - José Francisco Sales Chagas
- Department of Head and Neck Surgery, São Leopoldo Mandic College, Campinas 13045-755, Brazil; (M.B.N.P.); (J.F.S.C.)
| | - Morun Bernardino Neto
- Department of Basic Sciences and Environment, São Paulo University, São Paulo 12602-810, Brazil;
| | - Patrícia Pimentel de Barros
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology of São José dos Campos, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (C.M.B.); (A.Á.A.); (P.P.d.B.); (C.F.L.C.)
| | - Fábio Daumas Nunes
- Department of Oral Pathology, School of Dentistry, São Paulo University, São Paulo 05508-000, Brazil;
| | - Celina Faig Lima Carta
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology of São José dos Campos, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (C.M.B.); (A.Á.A.); (P.P.d.B.); (C.F.L.C.)
| | - Janete Dias Almeida
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology of São José dos Campos, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil; (C.M.B.); (A.Á.A.); (P.P.d.B.); (C.F.L.C.)
| |
Collapse
|
18
|
Wang Z, Zhang H, Zhai Y, Li F, Shi X, Ying M. Single-Cell Profiling Reveals Heterogeneity of Primary and Lymph Node Metastatic Tumors and Immune Cell Populations and Discovers Important Prognostic Significance of CCDC43 in Oral Squamous Cell Carcinoma. Front Immunol 2022; 13:843322. [PMID: 35401551 PMCID: PMC8986980 DOI: 10.3389/fimmu.2022.843322] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 02/28/2022] [Indexed: 12/24/2022] Open
Abstract
Although substantial progress has been made in biological research and clinical treatment in recent years, the clinical prognosis of oral squamous cell carcinoma (OSCC) is still not satisfactory. Tumor immune microenvironment (TIME) is a potential target, which plays an essential role in the response of anti-tumor immunity and immunotherapy. In this study, we used scRNA-seq data, revealing the heterogeneity of TIME between metastatic and primary site. We found that in the metastatic site, the content of cytotoxic T cells and classical activated macrophages (M1 macrophages) increases significantly, while alternately activated macrophages (M2 macrophages) and inflammatory cancer-associated fibroblasts (iCAFs) decrease, which may be due to the increased immunogenicity of OSCC cells in the metastatic site and the changes in some signal pathways. We also found that iCAFs may recruit alternately activated macrophages (M2 macrophages) by secreting CXCL12. Then, we described a regulatory network for communication between various TIME cells centered on OSCC cells, which can help to clarify the possible mechanism of lymph node metastasis in OSCC cells. By performing pseudotime trajectory analysis, we found that the expression CCDC43 is upregulated in more advanced OSCC cells and is an independent prognostic factor for poor living conditions. Other than this, the high expression of CCDC43 may impair the antitumor immunity of the human body and promote the metastasis of OSCC cells. Our research provides a profound insight into the immunological study of OSCC and an essential resource for future drug discovery.
Collapse
Affiliation(s)
- Zhenyu Wang
- Department of Molecular Biology and Biochemistry, Basic Medical College of Nanchang University, Nanchang, China
- Medical College of Nanchang University, Nanchang, China
| | - Hongbo Zhang
- Medical College of Nanchang University, Nanchang, China
| | - Yanan Zhai
- Medical College of Nanchang University, Nanchang, China
| | - Fengtong Li
- Medical College of Nanchang University, Nanchang, China
| | - Xueying Shi
- Medical College of Nanchang University, Nanchang, China
| | - Muying Ying
- Department of Molecular Biology and Biochemistry, Basic Medical College of Nanchang University, Nanchang, China
- *Correspondence: Muying Ying,
| |
Collapse
|
19
|
Mathur S, Conway DI, Macpherson LMD, Ross AJ. Systematic overview of systematic reviews and clinical guidelines: assessment and prevention of behavioural risk factors associated with oral cancer to inform dental professionals in primary care dental practices. Evid Based Dent 2022:10.1038/s41432-022-0235-1. [PMID: 35256757 DOI: 10.1038/s41432-022-0235-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Abstract
Aims/objectives Tobacco and alcohol are recognised as the major modifiable risk factors for oral cancer, the incidence of which is rising globally and predicted to increase. This paper aimed to: 1) appraise and synthesise best practice evidence for assessing the major behavioural risk factors for oral cancer and delivering behaviour change interventions (for example, advice, counselling, signposting/referral to preventive services); and 2) assess appropriateness for implementation by dental professionals in primary care.Methods A systematic overview was undertaken of systematic reviews and international clinical guidelines. This involved: systematically searching and collating the international literature on assessing oral cancer risk and delivering preventive interventions within primary care; quality appraising and assessing the risk of bias using validated tools; synthesising the evidence for best practice; and assessing application of key findings to the dental setting.Results and conclusions There is clear evidence for the effectiveness of a 'brief', in-person, motivational intervention for sustained tobacco abstinence or reduced alcohol consumption, following risk factor assessment. Evidence for combined behavioural interventions is lacking. There is no firm conclusion with regards to optimal duration of brief interventions (range 5-20 minutes). For tobacco users, longer (10-20 minutes) and intensive (more than 20 minutes, with follow-up visits) interventions are more effective in increasing quit rates compared to no intervention; very brief (less than five minutes) interventions in a single session show comparable effectiveness to the longer/more intensive interventions. For alcohol users, 10-15-minute multi-contact interventions were most effective, compared to no intervention or very brief (less than five minutes) intervention or intensive intervention; brief interventions of five-minute duration were equally effective. There is limited direct evidence from the dental practice setting (one high-quality systematic review relating to tobacco prevention and none relating to alcohol). Thus, very brief, or brief advice of up to five minutes, should be trialled for tobacco and alcohol respectively in a dental practice setting, after risk assessment tailored to patient motivational status. Exploring delivery by the dental team is supported, as effectiveness was generally independent of primary care provider.
Collapse
Affiliation(s)
- Sweta Mathur
- Kaiser Permanente Centre for Health Research, Portland, OR, USA.
| | - David I Conway
- School of Medicine, Dentistry and Nursing, University of Glasgow, UK
| | | | - Alastair J Ross
- School of Medicine, Dentistry and Nursing, University of Glasgow, UK
| |
Collapse
|
20
|
Mortensen A, Wessel I, Rogers SN, Tolver A, Jarden M. Needs assessment in patients surgically treated for head and neck cancer-a randomized controlled trial. Support Care Cancer 2022; 30:4201-4218. [PMID: 35083545 DOI: 10.1007/s00520-021-06759-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 12/13/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate the effect and feasibility of a head and neck cancer-specific needs assessment tool integrated into nursing rehabilitation consultations early in the post-surgical period on quality of life, symptom burden, and referrals for multidisciplinary follow-up. METHODS Ninety-two surgically treated patients with head and neck cancer were enrolled in a two-arm randomized controlled trial. All participants received nursing rehabilitation consultations prior to discharge, and two weeks and two months post-operative. The intervention group had their needs assessed using Patient Concerns Inventory, while standard care used a systematic questioning approach. Primary outcome was quality of life. Secondary outcomes were symptom burden and referrals for multidisciplinary rehabilitation follow-up. RESULTS No significant differences were found in quality of life or symptom burden between groups. However, 35% more patients in the intervention group were referred for rehabilitation. The attrition rate was similar in both groups, with a dropout rate of six in each group. No patients declined using the Patient Concerns Inventory. CONCLUSION The intervention showed no improvement in QoL or symptom burden compared to standard care. However, the results suggest that important needs were identified and addressed. Especially emotional and existential needs, which were accommodated through referrals and professional advice. Nursing rehabilitation consultations using the Patient Concerns Inventory are feasible and may ensure that patient preferences and priorities are incorporated in their care. TRIAL REGISTRATION ClinicalTrials.com (NCT03443258). Date of registration: May 31st, 2018.
Collapse
Affiliation(s)
- Annelise Mortensen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
| | - Irene Wessel
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark
| | - Simon N Rogers
- Faculty of Health and Social Care, Edge Hill University, Ormskirk, L39 4QP and Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, Great Britain, UK
| | - Anders Tolver
- Data Science Lab, Department of Mathematical Sciences, University of Copenhagen, Universitetsparken 5, 2200, Copenhagen N, Denmark
| | - Mary Jarden
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University and Department of Hematology, Center for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark
| |
Collapse
|
21
|
Peres KG, Nascimento GG, Gupta A, Singh A, Cassiano LS, Rugg-Gunn AJ. Scoping Review of Oral Health-Related Birth Cohort Studies: Toward a Global Consortium. J Dent Res 2022; 101:632-646. [PMID: 35012400 PMCID: PMC9125142 DOI: 10.1177/00220345211062475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The multidisciplinary nature and long duration of birth cohort studies allow investigation of the relationship between general and oral health and indicate the most appropriate stages in life to intervene. To date, the worldwide distribution of oral health-related birth cohort studies (OHRBCSs) has not been mapped, and a synthesis of information on methodological characteristics and outcomes is not available. We mapped published literature on OHRBCSs, describing their oral health-related data and methodological aspects. A 3-step search strategy was adopted to identify published studies using PubMed, Embase, Web of Science, and OVID databases. Studies with baseline data collection during pregnancy or within the first year of life or linked future oral health data to exposures during either of these 2 life stages were included. Studies examining only mothers' oral health and specific populations were excluded. In total, 1,721 articles were suitable for initial screening of titles and abstracts, and 528 articles were included in the review, identifying 120 unique OHRBCSs from 34 countries in all continents. The review comprised literature from the mid-1940s to the 21st century. Fifty-four percent of the OHRBCSs started from 2000 onward, and 75% of the cohorts were from high-income and only 2 from low-income countries. The participation rate between the baseline and the last oral health follow-up varied between 7% and 93%. Ten cohorts that included interventions were mostly from 2000 and with fewer than 1,000 participants. Seven data-linkage cohorts focused mostly on upstream characteristics and biological aspects. The most frequent clinical assessment was dental caries, widely presented as decayed, missing, and filled teeth (DMFT/dmft). Periodontal conditions were primarily applied as isolated outcomes or as part of a classification system. Socioeconomic classification, ethnicity, and country- or language-specific assessment tools varied across countries. Harmonizing definitions will allow combining data from different studies, adding considerable strength to data analyses; this will be facilitated by forming a global consortium.
Collapse
Affiliation(s)
- K G Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme Duke-NUS Medical School, Singapore
| | - G G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - A Gupta
- Deakin University, Geelong, Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Australia
| | - A Singh
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - L Schertel Cassiano
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - A J Rugg-Gunn
- The Borrow Foundation, Waterlooville, UK.,School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
22
|
Sichero L, Tagliabue M, Mota G, Ferreira S, Nunes RAL, Castañeda CA, Castillo M, Correa RM, Perdomo S, Rodríguez-Urrego PA, Matos LL, Mohssen A, Gheit T, Tommasino M, Chiocca S, Villa LL. Biomarkers of human papillomavirus (HPV)-driven head and neck cancer in Latin America and Europe study: Study design and HPV DNA/p16 INK4a status. Head Neck 2022; 44:122-133. [PMID: 34726297 DOI: 10.1002/hed.26912] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/02/2021] [Accepted: 10/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV)-driven head/neck squamous cell carcinomas (HNSCC) prevalence varies globally. We evaluated HPV DNA and p16INK4a in formalin fixed paraffin embedded (FFPE) HNSCC from Argentina, Brazil, Colombia, and Peru. METHODS HPV was genotyped by PCR-hybridization. All HPV DNA positive and some HPV DNA negative cases underwent p16INK4a immunohistochemistry. RESULTS HPV DNA was detected in 32.8%, 11.1%, and 17.8% of oropharyngeal (OPC), oral cavity (OCC) and laryngeal (LC) cancers, respectively. OPC HPV prevalence was higher in Colombia (94.7%), and Argentina (42.6%) compared to Brazil (10.6%) and Peru (0.0%). HPV-16 was the most detected. Other HPVs were found in LC. Higher rates of p16INK4a positivity were observed among HPV positive OPC/OCC cases compared to LC cases. CONCLUSIONS Our results support a role for HPV-16 in a subset of HNSCC, corroborate the heterogeneity observed in samples from different countries, and contribute additional etiological and biomarkers information in tumors of significant impact worldwide.
Collapse
Affiliation(s)
- Laura Sichero
- Center for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo ICESP, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo FMUSP HC, Sao Paulo, Brazil
| | - Marta Tagliabue
- Division of Otolaryngology - Head and Neck Surgery, IRCCS European Institute of Oncology, Milan, Italy
| | - Giana Mota
- Center for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo ICESP, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo FMUSP HC, Sao Paulo, Brazil
| | - Silvaneide Ferreira
- Center for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo ICESP, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo FMUSP HC, Sao Paulo, Brazil
| | - Rafaella A L Nunes
- Center for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo ICESP, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo FMUSP HC, Sao Paulo, Brazil
| | - Carlos Arturo Castañeda
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Universidad Cientifica del Sur, Lima, Peru
| | - Miluska Castillo
- Department of Research, Instituto Nacional de Enfermedades Neoplásicas, Universidad Cientifica del Sur, Lima, Peru
| | - Rita Mariel Correa
- Servicio Virus Oncogénicos, Instituto Nacional de Enfermedades Infecciosas-ANLIS "Dr. Malbrán", Buenos Aires, Argentina
| | - Sandra Perdomo
- University Hospital Foundation Santa Fe de Bogotá, Bogotá, Colombia
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | | | - Leandro Luongo Matos
- Department of Head and Neck Surgery, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Ansarin Mohssen
- Division of Otolaryngology - Head and Neck Surgery, IRCCS European Institute of Oncology, Milan, Italy
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), Lyon, France
| | - Susanna Chiocca
- Department of Experimental Oncology, IRCCS European Institute of Oncology, Milan, Italy
| | - Luisa Lina Villa
- Center for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo ICESP, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo FMUSP HC, Sao Paulo, Brazil
- Department of Radiology and Oncology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
23
|
Fantozzi PJ, Bavarian R, Tamayo I, Bind MA, Woo SB, Villa A. The role of family history of Cancer in Oral Cavity Cancer. Head Face Med 2021; 17:48. [PMID: 34809651 PMCID: PMC8607727 DOI: 10.1186/s13005-021-00298-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/27/2021] [Indexed: 11/15/2022] Open
Abstract
Objectives Oral and oropharyngeal squamous cell carcinoma (SCC) is the 10th most common cancer in the United States (8th in males, 13th in females), with an estimated 54,010 new cases expected in 2021, and is primarily associated with smoked tobacco, heavy alcohol consumption, areca nut use and persistent high-risk human papillomavirus (HPV). Family history of cancer (FHC) and family history of head and neck cancer (FHHNC) have been reported to play an important role in the development of OSCC. We aimed to investigate the role of FHC, FHHNC and personal history of cancer in first/second degree-relatives as co-risk factors for oral cancer. Methods This was a retrospective study of patients diagnosed with OSCC at the Division of Oral Medicine and Dentistry at Brigham and Women’s Hospital and at the Division of Head and Neck Oncology at Dana Farber Cancer Institute. Conditional logistic regressions were performed to examine whether OSCC was associated with FHC and FHHNC of FDRs and SDRs, personal history of cancer and secondary risk factors. Results Overall, we did not find an association between FHC, FHHNC and OSCC risk, whereas patients with a cancer history in one of their siblings were 1.6-times more likely to present with an OSCC. When secondary risk factors were considered, patients with a history of oral leukoplakia and dysplasia had a 16-times higher risk of having an OSCC. Conclusions Our study confirmed that a previous history of oral leukoplakia or dysplasia was an independent risk factor for OSCC. A positive family history of cancer in one or more siblings may be an additional risk factor for OSCC.
Collapse
Affiliation(s)
- Paolo Junior Fantozzi
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA.
| | - Roxanne Bavarian
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.,Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Ibon Tamayo
- Department of Statistics, Faculty of Arts and Sciences, Harvard University, Cambridge, MA, USA
| | - Marie-Abele Bind
- Department of Statistics, Faculty of Arts and Sciences, Harvard University, Cambridge, MA, USA
| | - Sook-Bin Woo
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.,Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Alessandro Villa
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
24
|
Conway DI, Hovanec J, Ahrens W, Ross A, Holcatova I, Lagiou P, Serraino D, Canova C, Richiardi L, Healy C, Kjaerheim K, Macfarlane GJ, Thomson P, Agudo A, Znaor A, Brennan P, Luce D, Menvielle G, Stucker I, Benhamou S, Ramroth H, Boffetta P, Vilensky M, Fernandez L, Curado MP, Menezes A, Daudt A, Koifman R, Wunsch-Filho V, Yuan-Chin AL, Hashibe M, Behrens T, McMahon AD. Occupational socioeconomic risk associations for head and neck cancer in Europe and South America: individual participant data analysis of pooled case-control studies within the INHANCE Consortium. J Epidemiol Community Health 2021; 75:779-787. [PMID: 33622804 PMCID: PMC8292575 DOI: 10.1136/jech-2020-214913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/22/2020] [Accepted: 01/04/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND The association between socioeconomic disadvantage (low education and/or income) and head and neck cancer is well established, with smoking and alcohol consumption explaining up to three-quarters of the risk. We aimed to investigate the nature of and explanations for head and neck cancer risk associated with occupational socioeconomic prestige (a perceptual measure of psychosocial status), occupational socioeconomic position and manual-work experience, and to assess the potential explanatory role of occupational exposures. METHODS Pooled analysis included 5818 patients with head and neck cancer (and 7326 control participants) from five studies in Europe and South America. Lifetime job histories were coded to: (1) occupational social prestige-Treiman's Standard International Occupational Prestige Scale (SIOPS); (2) occupational socioeconomic position-International Socio-Economic Index (ISEI); and (3) manual/non-manual jobs. RESULTS For the longest held job, adjusting for smoking, alcohol and nature of occupation, increased head and neck cancer risk estimates were observed for low SIOPS OR=1.88 (95% CI: 1.64 to 2.17), low ISEI OR=1.74 (95% CI: 1.51 to 1.99) and manual occupations OR=1.49 (95% CI: 1.35 to 1.64). Following mutual adjustment by socioeconomic exposures, risk associated with low SIOPS remained OR=1.59 (95% CI: 1.30 to 1.94). CONCLUSIONS These findings indicate that low occupational socioeconomic prestige, position and manual work are associated with head and neck cancer, and such risks are only partly explained by smoking, alcohol and occupational exposures. Perceptual occupational psychosocial status (SIOPS) appears to be the strongest socioeconomic factor, relative to socioeconomic position and manual/non-manual work.
Collapse
Affiliation(s)
- David I Conway
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Jan Hovanec
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Alastair Ross
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Ivana Holcatova
- Institute of Hygiene and Epidemiology, Charles University First Faculty of Medicine, Praha, Czech Republic
| | - Pagona Lagiou
- School of Medicine, National and Kapodistrian University of Athens, Athens, Attica, Greece
| | - Diego Serraino
- Oncology Reference Center, Aviano, Friuli-Venezia Giulia, Italy
| | - Cristina Canova
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padova, Veneto, Italy
| | - Lorenzo Richiardi
- Department of Medical Sciences, University of Turin, Torino, Piemonte, Italy
| | - Claire Healy
- School of Dental Science, Trinity College Dublin, Dublin, Ireland
| | | | | | - Peter Thomson
- Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Hospitalet de Llobregat, Catalunya, Spain
| | - Ariana Znaor
- International Agency for Research on Cancer, Lyon, Rhône-Alpes, France
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, Rhône-Alpes, France
| | - Danièle Luce
- University of Rennes 1-Health Sciences Campus Villejean, Rennes, Bretagne, France
- Institute for Research in Health, Environment and Work, National Institute of Health and Medical Research, Rennes, Bretagne, France
- School of Advanced Studies in Public Health, Rennes, Bretagne, France
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Isabelle Stucker
- Paris-Sud University, Saint-Aubin, Île-de-France, France
- Environmental Epidemiology of Cancer, Centre for Research in Epidemiology and Population Health, National Institute of Health and Medical Research, Villejuif, Île-de-France, France
| | | | - Heribert Ramroth
- Institute of Public Health, University of Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | - Paolo Boffetta
- The Tisch Cancer Institute and Institute for Translational Epidemiology, Mount Sinai School of Medicine, New York, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Marta Vilensky
- Institute of Oncology Angel H Roffo, University of Buenos Aires, Buenos Aires, Argentina
| | | | - Maria Paula Curado
- Epidemiology, AC Camargo Cancer Center International Research Center, Sao Paulo, Brazil
| | - Ana Menezes
- Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Alexander Daudt
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rosalina Koifman
- Fundacao Oswaldo Cruz, National School of Public Health, Rio de Janeiro, Brazil
| | | | - Amy Lee Yuan-Chin
- Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Mia Hashibe
- Division of Public Health, Department of Family and Preventive Medicine, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
| | - Alex D McMahon
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| |
Collapse
|
25
|
Wagner VP, Spuldaro TR, Nör F, Gaio EJ, Castilho RM, Carrard VC, Rösing CK. Can propranolol act as a chemopreventive agent during oral carcinogenesis? An experimental animal study. Eur J Cancer Prev 2021; 30:315-321. [PMID: 33136608 DOI: 10.1097/cej.0000000000000626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The multistep process of oral carcinogenesis provides a biological rationale for the use of chemoprevention in individuals at increased risk of developing oral cancer. We aimed to determine if low doses of propranolol can prevent the development of oral cancer using a tobacco-relevant and p53-associated animal model of cancer initiation. Twenty-six Wistar rats were randomly allocated into two groups, vehicle, and propranolol. All animals received 4-nitroquinoline N-oxide (4NQO) at 25 ppm diluted in the drinking water for 20 weeks. Animals from the propranolol group received propranolol (0.1 mg/kg) 5 days per week by gavage for 18 weeks. The clinical analysis was performed by measuring the area of the lesion and assessment of scores based on lesion appearance (papule; plaque; nodule or ulcerated). Histopathological analysis was performed to determine the presence of epithelial dysplasia or invasive squamous cell carcinoma (SCC). The average lesion area in 4NQO + vehicle and in 4NQO + propranolol groups were 0.20 and 0.28 mm2, respectively (P = 0.53). The percentage of cases clinically graded as papules, thick plaques, nodular areas, and ulcerated lesions was similar between groups (P = 0.94). Histopathological diagnosis also did not differ between groups (P = 0.65), with 54.5 and 70% of cases being diagnosed as SCC in 4NQO and in 4NQO + propranolol groups, respectively. In conclusion, daily doses propranolol at 0.1 mg/kg were not as effective as a chemopreventive therapy in an animal model of 4NQO-induced carcinogenesis.
Collapse
Affiliation(s)
- Vivian P Wagner
- Department of Oral Pathology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul
- Department of Oral Diagnosis, University of Campinas, Piracicaba, São Paulo
| | - Tobias R Spuldaro
- Department of Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Nör
- Department of Oral Pathology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul
- Department of Oral Pathology, Radiology and Medicine, University of Iowa College of Dentistry, Iowa City, Iowa
| | - Eduardo J Gaio
- Department of Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rogerio M Castilho
- Department of Periodontics and Oral Medicine, Laboratory of Epithelial Biology, University of Michigan School of Dentistry; Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Vinicius C Carrard
- Department of Oral Pathology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul
| | - Cassiano K Rösing
- Department of Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
26
|
Diet Quality as Measured by the Healthy Eating Index 2015 and Oral and Pharyngeal Cancer Risk. J Acad Nutr Diet 2021; 122:1677-1687.e5. [PMID: 34127426 DOI: 10.1016/j.jand.2021.04.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 04/06/2021] [Accepted: 04/26/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Alcohol and tobacco are the major risk factors for oral and pharyngeal cancer, but diet is likely to have a role, too. OBJECTIVE The objective was to analyze the relationship between adherence to the 2015-2020 Dietary Guidelines for Americans (DGA), as measured by the Healthy Eating Index 2015 (HEI-2015), and oral and pharyngeal cancer risk. Moreover, this work aimed to quantify the number of avoidable cases under different scenarios of increased adherence to the DGA, with the use of the potential impact fraction. This estimates the proportion of cases that would occur if the distribution of the risk factor in the population followed an alternative distribution. DESIGN A multicenter, case-control study was conducted in Italy between 1991 and 2009. Participants' usual diet for the 2 years preceding study enrolment was assessed using a food frequency questionnaire. PARTICIPANTS AND SETTING Cases were 946 patients admitted to major hospitals with incident, histologically confirmed oral and pharyngeal cancer. Controls were 2,492 patients admitted to the same hospitals for acute non neoplastic conditions. MAIN OUTCOME MEASURES The adherence to the DGA was assessed using the HEI-2015 score (range = 0 to 100), based on 13 components. The outcome was oral and pharyngeal cancer. STATISTICAL ANALYSES PERFORMED Odds ratios and the corresponding 95% CIs were estimated using multiple logistic regression models adjusted for tobacco, alcohol, and other relevant covariates. The potential impact fraction was estimated under different scenarios of adherence to the DGA. RESULTS In this Italian population the HEI-2015 score ranged from 33.4 to 97.5. A higher HEI-2015 score was associated with a lower risk of oral and pharyngeal cancer, with an odds ratio of 0.70 (95% CI 0.62 to 0.79) for a 10-point increment of the score. The estimated potential impact fraction was 64.8% under the maximum achievable reduction scenario, and it ranged from 9% to 27% following other more feasible scenarios. CONCLUSIONS The HEI-2015 score was inversely related to oral and pharyngeal cancer risk in this Italian population. This analysis allowed for the estimation of the fraction of preventable cases, under different feasible scenarios. A share of 9% to 27% of avoidable cases of oral and pharyngeal cancer might be obtained across real-world scenarios of adherence to the DGA as measured by the HEI-2015 score.
Collapse
|
27
|
Incidence of squamous cell carcinomas of the head and neck following prolonged pegylated liposomal doxorubicin. Anticancer Drugs 2021; 31:747-750. [PMID: 32697468 DOI: 10.1097/cad.0000000000000950] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Despite numerous case reports, the incidence of a secondary diagnosis of head and neck squamous cell carcinoma (HNC) following pegylated liposomal doxorubicin (PLD) treatment is unknown. Computerized pharmacy records were searched at a large, multi-center healthcare system for patients who received PLD. Electronic medical records were searched to identify the patient's age at treatment initiation of PLD, diagnosis for which they were treated with PLD, number of courses and total cumulative dose of PLD (TCDPLD) and secondary malignancies. Published PLD associated HNC was utilized to determine the lowest and median TCDPLD doses associated with HNC. One thousand two hundred ninety eligible patients who had been treated with PLD were identified. The lowest TCDPLD associated HNC in the literature is 405 mg/m2. In our healthcare system, 275 patients received more than 400 mg/m2 yielding a risk of 0.004%. One hundred fifty-one patients received the lowest TCDPLD associated with HNC cancer in our series which was 640 mg/m2 yielding a risk of 0.007%. Four of 30 patients (13.3%) developed HNC who received the median TCDPLD associated with HNC in the literature of 1440 mg/m2. Five of 20 patients (25%) receiving 1650 mg/m2 developed HNC in our healthcare system. Prolonged therapy with PLD is associated with an increased risk of HNC. This risk appears to be related to the cumulative dose varying from 0.004 to 13.3% at the lowest and median TCDPLD of reported cases in the literature, respectively. Oncologists need to be aware of this risk and to screen patients appropriately.
Collapse
|
28
|
He S, Lian C, Thorstad W, Gay H, Zhao Y, Ruan S, Wang X, Li H. A novel systematic approach for cancer treatment prognosis and its applications in oropharyngeal cancer with microRNA biomarkers. Bioinformatics 2021; 37:3106-3114. [PMID: 34237137 DOI: 10.1093/bioinformatics/btab242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 03/10/2021] [Accepted: 04/12/2021] [Indexed: 01/31/2023] Open
Abstract
MOTIVATION Predicting early in treatment whether a tumor is likely to respond to treatment is one of the most difficult yet important tasks in providing personalized cancer care. Most oropharyngeal squamous cell carcinoma (OPSCC) patients receive standard cancer therapy. However, the treatment outcomes vary significantly and are difficult to predict. Multiple studies indicate that microRNAs (miRNAs) are promising cancer biomarkers for the prognosis of oropharyngeal cancer. The reliable and efficient use of miRNAs for patient stratification and treatment outcome prognosis is still a very challenging task, mainly due to the relatively high dimensionality of miRNAs compared to the small number of observation sets; the redundancy, irrelevancy and uncertainty in the large amount of miRNAs; and the imbalanced observation patient samples. RESULTS In this study, a new machine learning-based prognosis model was proposed to stratify subsets of OPSCC patients with low and high risks for treatment failure. The model cascaded a two-stage prognostic biomarker selection method and an evidential K-nearest neighbors (EK-NN) classifier to address the challenges and improve the accuracy of patient stratification. The model has been evaluated on miRNA expression profiling of 150 oropharyngeal tumors by use of overall survival and disease-specific survival as the end points of disease treatment outcomes, respectively. The proposed method showed superior performance compared to other advanced machine-learning methods in terms of common performance quantification metrics. The proposed prognosis model can be employed as a supporting tool to identify patients who are likely to fail standard therapy and potentially benefit from alternative targeted treatments.
Collapse
Affiliation(s)
- Shenghua He
- Department of Computer Science and Engineering, Washington University in Saint Louis, St. Louis, MO, USA
| | - Chunfeng Lian
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Wade Thorstad
- Department of Radiation Oncology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Hiram Gay
- Department of Radiation Oncology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Yujie Zhao
- Carle Cancer Center, Carle Foundation Hospital, Urbana, IL, USA
| | - Su Ruan
- Laboratoire LITIS (EA 4108), Equipe Quantif, University of Rouen, Rouen, France
| | - Xiaowei Wang
- Department of Radiation Oncology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Hua Li
- Carle Cancer Center, Carle Foundation Hospital, Urbana, IL, USA.,Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| |
Collapse
|
29
|
A roadmap of six different pathways to improve survival in laryngeal cancer patients. Curr Opin Otolaryngol Head Neck Surg 2021; 29:65-78. [PMID: 33337612 DOI: 10.1097/moo.0000000000000684] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Laryngeal cancer continues to require improvement in earlier stage diagnosis and better imaging delineation of disease, and hence 'more evidence-based' selection of treatment, as recent evidence suggests that related mortality, in the last decades, has not significantly decreased worldwide. Even though the reasons are not fully understood, there persists an urgency for a review and development of future strategies to embrace such clinical and diagnostic challenges from a political, societal, as well as scientific and clinical points of view. RECENT FINDINGS This review of the published literature suggests that survival improvement in laryngeal cancer may be achieved by fuelling and combining at least some or all of six targeted agendas: documentation of disease global incidence and national burden monitoring; development and implementation of high-quality cancer registries; education on risk factors and hazardous habits associated with laryngeal cancer for the general population; active modification of proven at-risk population lifestyles; centralization of treatment; and use of machine learning of gathered 'big data' and their integration into approaches for the optimization of prevention and treatments strategies. SUMMARY Laryngeal cancer should be tackled on several fronts, commencing with disease monitoring and prevention, up to treatment optimisation. Available modern resources offer the possibility to generate significant advances in laryngeal cancer management. However, each nation needs to develop a comprehensive approach, which is an essential prerequisite to obtain meaningful improvement on results.
Collapse
|
30
|
Preclinical Evaluation of the Association of the Cyclin-Dependent Kinase 4/6 Inhibitor, Ribociclib, and Cetuximab in Squamous Cell Carcinoma of the Head and Neck. Cancers (Basel) 2021; 13:cancers13061251. [PMID: 33809148 PMCID: PMC7998503 DOI: 10.3390/cancers13061251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/04/2021] [Accepted: 03/09/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary We previously showed that ribociclib induces cell cycle arrest in some human papillomavirus (HPV)-negative squamous cell carcinomas of the head and neck (SCCHN) models. However, in vivo, ribociclib has only a cytostatic effect, suggesting that its activity needs to be optimized in combination with other treatments. We investigated the activity of ribociclib in combination with cetuximab in several HPV-negative SCCHN patient-derived tumor xenograft (PDTX) models. We found that the combination of cetuximab and ribociclib was not significantly more active than cetuximab monotherapy. In addition, our observations also suggest that the combination of cetuximab with a cyclin-dependent kinase (CDK) 4/6 inhibitor may reduce the activity of the CDK4/6 inhibitor in some cetuximab-resistant models. Our work has significant clinical implications since combinations of anti-epidermal growth factor receptor (EGFR) therapy and CDK4/6 inhibitors are currently being investigated in clinical trials. Abstract Epidermal growth factor receptor (EGFR) overexpression is observed in 90% of human papillomavirus (HPV)-negative squamous cell carcinomas of the head and neck (SCCHN). Cell cycle pathway impairments resulting in cyclin-dependent kinase (CDK) 4 and 6 activation, are frequently observed in SCCHN. We investigated the efficacy of ribociclib, a CDK4/6 inhibitor, in combination with cetuximab, a monoclonal antibody targeting the EGFR, in HPV-negative SCCHN patient-derived tumor xenograft (PDTX) models. The combination of cetuximab and ribociclib was not significantly more active than cetuximab monotherapy in all models investigated. In addition, the combination of cetuximab and ribociclib was less active than ribociclib monotherapy in the cetuximab-resistant PDTX models. In these models, a significant downregulation of the retinoblastoma (Rb) protein was observed in cetuximab-treated mice. We also observed Rb downregulation in the SCCHN cell lines chronically exposed and resistant to cetuximab. In addition, Rb downregulation induced interleukin 6 (Il-6) secretion and the Janus kinase family member/signal transducer and activator of transcription (JAK/STAT) pathway activation that might be implicated in the cetuximab resistance of these cell lines. To conclude, cetuximab is not an appropriate partner for ribociclib in cetuximab-resistant SCCHN models. Our work has significant clinical implications since the combination of anti-EGFR therapy with CDK4/6 inhibitors is currently being investigated in clinical trials.
Collapse
|
31
|
Bravi F, Lee YCA, Hashibe M, Boffetta P, Conway DI, Ferraroni M, La Vecchia C, Edefonti V. Lessons learned from the INHANCE consortium: An overview of recent results on head and neck cancer. Oral Dis 2021; 27:73-93. [PMID: 32569410 PMCID: PMC7752834 DOI: 10.1111/odi.13502] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/04/2020] [Accepted: 06/06/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To summarize the latest evidence on head and neck cancer epidemiology from the International Head and Neck Cancer Epidemiology (INHANCE) consortium. SUBJECTS AND METHODS INHANCE was established in 2004 to elucidate the etiology of head and neck cancer through pooled analyses of individual-level data on a large scale. We summarize results from recent INHANCE-based publications updating our 2015 overview. RESULTS Seventeen papers were published between 2015 and May 2020. These studies further define the nature of risks associated with tobacco and alcohol, and occupational exposures on head and neck cancer. The beneficial effects on incidence of head and neck cancer were identified for good oral health, endogenous and exogenous hormonal factors, and selected aspects of diet related to fruit and vegetables. INHANCE has begun to develop risk prediction models and to pool follow-up data on their studies, finding that ~30% of cases had cancer recurrence and 9% second primary cancers, with overall- and disease-specific 5-year-survival of 51% and 57%, respectively. CONCLUSIONS The number and importance of INHANCE scientific findings provides further evidence of the advantages of large-scale internationally collaborative projects and will support the development of prevention strategies.
Collapse
Affiliation(s)
- Francesca Bravi
- Branch of Medical Statistics, Biometry, and Epidemiology “G. A. Maccacaro”, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
| | - Yuan-Chin Amy Lee
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Mia Hashibe
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - David I. Conway
- School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, UK
| | - Monica Ferraroni
- Branch of Medical Statistics, Biometry, and Epidemiology “G. A. Maccacaro”, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
| | - Carlo La Vecchia
- Branch of Medical Statistics, Biometry, and Epidemiology “G. A. Maccacaro”, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
| | - Valeria Edefonti
- Branch of Medical Statistics, Biometry, and Epidemiology “G. A. Maccacaro”, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
| |
Collapse
|
32
|
Ferenczi Ö, Major T, Akiyama H, Fröhlich G, Oberna F, Révész M, Poósz M, Polgár C, Takácsi-Nagy Z. Results of postoperative interstitial brachytherapy of resectable floor of mouth tumors. Brachytherapy 2020; 20:376-382. [PMID: 33250304 DOI: 10.1016/j.brachy.2020.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/29/2020] [Accepted: 10/22/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study was to describe the results of postoperative sole interstitial brachytherapy (BT) in patients with resectable floor of mouth tumors. METHODS AND MATERIALS Between January 1998 and December 2017, 44 patients with squamous cell histology, stage T1-3N0-1M0 floor of mouth tumor were treated by excision of the primary lesion with or without neck dissection followed by sole high-dose-rate tumor bed BT with an average dose of 22.7 Gy (10-45 Gy) using rigid metal needles (n = 14; 32%) or flexible plastic catheters (n = 30; 68%). RESULTS During a median followup time of 122 months for surviving patients, the probability of 5- and 10-year local and regional tumor control, overall survival (OS), and disease-specific survival (DSS) was 89% and 89%, 73% and 67%, 52% and 32%, 66% and 54%, respectively. In univariate analysis, lymphovascular invasion was a negative predictor of regional tumor control (p = 0.0062), DSS (p = 0.0056), and OS (p = 0.0325), whereas cervical recurrence was associated with worse DSS (p < 0.0001) and OS (p < 0.0001). The incidence of local Grade 1, 2, and 3 mucositis was 25%, 64%, and 11%, respectively. Grade 4 side effect, that is soft tissue necrosis occurred in four cases (9%). CONCLUSIONS Results of postoperative sole high-dose-rate BT of floor of mouth tumors are comparable with those reported with low-dose-rate BT, and this method could improve local tumor control and DSS compared with exclusive surgical treatment.
Collapse
Affiliation(s)
- Örs Ferenczi
- Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary.
| | - Tibor Major
- Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary; Department of Oncology, Semmelweis University, Budapest, Hungary
| | - Hironori Akiyama
- Department of Oral Radiology, Osaka Dental University, Osaka, Japan
| | - Georgina Fröhlich
- Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary
| | - Ferenc Oberna
- Multidisciplinary Center of Head and Neck Tumours, National Institute of Oncology, Budapest, Hungary
| | - Mónika Révész
- Multidisciplinary Center of Head and Neck Tumours, National Institute of Oncology, Budapest, Hungary
| | - Márton Poósz
- Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary
| | - Csaba Polgár
- Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary; Department of Oncology, Semmelweis University, Budapest, Hungary
| | - Zoltán Takácsi-Nagy
- Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary; Department of Oncology, Semmelweis University, Budapest, Hungary
| |
Collapse
|
33
|
Zhao XT, Zhu Y, Zhou JF, Gao YJ, Liu FZ. Development of a novel 7 immune-related genes prognostic model for oral cancer: A study based on TCGA database. Oral Oncol 2020; 112:105088. [PMID: 33220636 DOI: 10.1016/j.oraloncology.2020.105088] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/16/2020] [Accepted: 10/31/2020] [Indexed: 12/24/2022]
Abstract
Oral squamous cell carcinoma (OSCC) is an aggressive tumor whose prognosis has little improvement in the last three decades. Various immune-related genes have been suggested as significant roles in the development and progression of malignant cancers. In this study, we acquired and integrated differentially expressed genes of OSCC patients, including immune-related genes and transcription factors (TFs), from The Cancer Genome Atlas (TCGA) database. TF-mediated network was established to exploring the regulatory mechanisms of prognostic immune-related genes. A 7 immune-related genes prognostic model for OSCC was obtained, including CGB8, CTLA4, TNFRSF19, CCL26, NRG1, TPM2 and PLAU, which was further proved to be an independent prognostic indicator after adjusting for other clinical factors. The immune-related genes prognostic index was significantly negatively correlated to the infiltration abundances of B cells (P < 0.05) and CD8+ T cells (P < 0.05). The novel proposed immune-based prognostic model not only provided a promising biomarker and a way to monitor the long-term treatment of OSCC, but also gave a new insight into a potential immunotherapy strategy.
Collapse
Affiliation(s)
- Xiao-Tong Zhao
- Department of Otorhinolaryngology and Head and Neck Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, China
| | - Yan Zhu
- Department of Pathology, the People's Hospital of Jiangsu Province (The First Affiliated Hospital of Nanjing Medial University), Nanjing, Jiangsu 210029, China
| | | | | | - Fang-Zhou Liu
- Department of Head & Neck Surgery, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210029, China.
| |
Collapse
|
34
|
Hou C, Cai H, Zhu Y, Huang S, Song F, Hou J. Development and Validation of Autophagy-Related Gene Signature and Nomogram for Predicting Survival in Oral Squamous Cell Carcinoma. Front Oncol 2020; 10:558596. [PMID: 33178587 PMCID: PMC7596585 DOI: 10.3389/fonc.2020.558596] [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] [Received: 05/03/2020] [Accepted: 09/24/2020] [Indexed: 12/19/2022] Open
Abstract
Background Autophagy, a highly conserved self-digesting process, has been deeply involved in the development and progression of oral squamous cell carcinoma (OSCC). However, the prognostic value of autophagy-related genes (ARGs) for OSCC still remains unclear. Our study set out to develop a multigene expression signature based on ARGs for individualized prognosis assessment in OSCC patients. Methods Based on The Cancer Genome Atlas (TCGA) database, we identified prognosis-related ARGs through univariate COX regression analysis. Then we performed the least absolute shrinkage and selection operator (LASSO) regression analysis to identify an optimal autophagy-related multigene signature with the subsequent validation in testing set, GSE41613 and GSE42743 datasets. Results We identified 36 prognosis-related ARGs for OSCC. Subsequently, the multigene signature based on 13 prognostic ARGs was constructed and successfully divided OSCC patients into low and high-risk groups with significantly different overall survival in TCGA training set (p < 0.0001). The autophagy signature remained as an independent prognostic factor for OSCC in univariate and multivariate Cox regression analyses. The area under the curve (AUC) values of the receiver operating characteristic (ROC) curves for 1, 3, and 5-year survival were 0.758, 0.810, 0.798, respectively. Then the gene signature was validated in TCGA testing set, GSE41613 and GSE42743 datasets. Moreover, Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, and single-sample gene set enrichment analysis (ssGSEA) revealed the underlying biological characteristics and signaling pathways associated with this signature in OSCC. Finally, we constructed a nomogram by combining the gene signature with multiple clinical parameters (age, gender, TNM-stage, tobacco, and alcohol history). The concordance index (C-index) and calibration plots demonstrated favorable predictive performance of our nomogram. Conclusion In summary, we identified and verified a 13-ARGs prognostic signature and nomogram, which provide individualized prognosis evaluation and show insight for potential therapeutic targets for OSCC.
Collapse
Affiliation(s)
- Chen Hou
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Hongshi Cai
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Yue Zhu
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Shuojin Huang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Fan Song
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Jinsong Hou
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
35
|
Di Credico G, Polesel J, Dal Maso L, Pauli F, Torelli N, Luce D, Radoï L, Matsuo K, Serraino D, Brennan P, Holcatova I, Ahrens W, Lagiou P, Canova C, Richiardi L, Healy CM, Kjaerheim K, Conway DI, Macfarlane GJ, Thomson P, Agudo A, Znaor A, Franceschi S, Herrero R, Toporcov TN, Moyses RA, Muscat J, Negri E, Vilensky M, Fernandez L, Curado MP, Menezes A, Daudt AW, Koifman R, Wunsch-Filho V, Olshan AF, Zevallos JP, Sturgis EM, Li G, Levi F, Zhang ZF, Morgenstern H, Smith E, Lazarus P, La Vecchia C, Garavello W, Chen C, Schwartz SM, Zheng T, Vaughan TL, Kelsey K, McClean M, Benhamou S, Hayes RB, Purdue MP, Gillison M, Schantz S, Yu GP, Chuang SC, Boffetta P, Hashibe M, Yuan-Chin AL, Edefonti V. Alcohol drinking and head and neck cancer risk: the joint effect of intensity and duration. Br J Cancer 2020; 123:1456-1463. [PMID: 32830199 PMCID: PMC7592048 DOI: 10.1038/s41416-020-01031-z] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 07/27/2020] [Accepted: 07/30/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Alcohol is a well-established risk factor for head and neck cancer (HNC). This study aims to explore the effect of alcohol intensity and duration, as joint continuous exposures, on HNC risk. METHODS Data from 26 case-control studies in the INHANCE Consortium were used, including never and current drinkers who drunk ≤10 drinks/day for ≤54 years (24234 controls, 4085 oral cavity, 3359 oropharyngeal, 983 hypopharyngeal and 3340 laryngeal cancers). The dose-response relationship between the risk and the joint exposure to drinking intensity and duration was investigated through bivariate regression spline models, adjusting for potential confounders, including tobacco smoking. RESULTS For all subsites, cancer risk steeply increased with increasing drinks/day, with no appreciable threshold effect at lower intensities. For each intensity level, the risk of oral cavity, hypopharyngeal and laryngeal cancers did not vary according to years of drinking, suggesting no effect of duration. For oropharyngeal cancer, the risk increased with durations up to 28 years, flattening thereafter. The risk peaked at the higher levels of intensity and duration for all subsites (odds ratio = 7.95 for oral cavity, 12.86 for oropharynx, 24.96 for hypopharynx and 6.60 for larynx). CONCLUSIONS Present results further encourage the reduction of alcohol intensity to mitigate HNC risk.
Collapse
Affiliation(s)
- Gioia Di Credico
- Department of Economics, Business, Mathematics and Statistics, University of Trieste, Trieste, Italy
| | - Jerry Polesel
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.
| | - Francesco Pauli
- Department of Economics, Business, Mathematics and Statistics, University of Trieste, Trieste, Italy
| | - Nicola Torelli
- Department of Economics, Business, Mathematics and Statistics, University of Trieste, Trieste, Italy
| | - Daniele Luce
- Université de Rennes, INSERM, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, Pointe-à-Pitre, France
| | - Loredana Radoï
- INSERM UMR 1018, Centre for Research in Epidemiology and Population Health (CESP), Cancer Epidemiology, Genes and Environment Team, Villejuif, France
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Ivana Holcatova
- Institute of Hygiene & Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
- University of Bremen, Faculty of Mathematics and Computer Science, Bremen, Germany
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Claire M Healy
- Trinity College School of Dental Science, Dublin, Ireland
| | | | - David I Conway
- School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, UK
| | - Gary J Macfarlane
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | | | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, Nutrition and Cancer Group, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, 08908, Spain
| | - Ariana Znaor
- International Agency for Research on Cancer, Lyon, France
| | - Silvia Franceschi
- Scientific Directorate, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | | | - Tatiana N Toporcov
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Raquel A Moyses
- Head and Neck Surgery, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Eva Negri
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Marta Vilensky
- Instituto de Oncología Ángel H. Roffo, Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | | | - Ana Menezes
- Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Rosalina Koifman
- Escola Nacional de Saude Publica, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Victor Wunsch-Filho
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Jose P Zevallos
- Division of Head and Neck Surgical Oncology in the Department of Otolaryngology/Head and Neck Surgery at Washington University School of Medicine, St Louis, MO, USA
| | - Erich M Sturgis
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Guojun Li
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Fabio Levi
- Institut Universitaire de Médecine Sociale et Préventive (IUMSP), Unisanté, University of Lausanne, Lausanne, Switzerland
| | | | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Department of Urology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Elaine Smith
- College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Philip Lazarus
- Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA, USA
| | - Carlo La Vecchia
- Branch of Medical Statistics, Biometry and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
| | - Werner Garavello
- Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Chu Chen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Stephen M Schwartz
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Tongzhang Zheng
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Thomas L Vaughan
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Karl Kelsey
- Brown University, Providence, Rhode Island, RI, USA
| | | | - Simone Benhamou
- National Institute of Health and Medical Research, INSERM U1018, Villejuif, France
| | - Richard B Hayes
- Division of Epidemiology, New York University School Of Medicine, New York, NY, USA
| | - Mark P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Maura Gillison
- "Thoracic/Head and Neck Medical Oncology", The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Beijing, China
| | - Shu-Chun Chuang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mia Hashibe
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Amy Lee Yuan-Chin
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Valeria Edefonti
- Branch of Medical Statistics, Biometry and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
| |
Collapse
|
36
|
do Nascimento Santos Lima E, Ferreira IB, Lajolo PP, Paiva CE, de Paiva Maia YC, das Graças Pena G. Health-related quality of life became worse in short-term during treatment in head and neck cancer patients: a prospective study. Health Qual Life Outcomes 2020; 18:307. [PMID: 32938480 PMCID: PMC7493852 DOI: 10.1186/s12955-020-01543-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 08/26/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Quality of life (QoL) is influenced in head and neck cancer (HNC) patients by a set of factors related to diagnosis, treatment and tumor impacts. The aim of this study was to evaluate the Quality of Life (QoL) changes in Head and Neck cancer (HNC) patients during treatment (radiotherapy and/or chemoradiotherapy). METHODS QoL was evaluated prospectively in 63 HNC patients during radiotherapy and/or chemoradiotherapy at three moments: before or at beginning (T0), in the middle (T1 ~ four weeks) and immediately at the end (T2 ~ eight weeks) of treatment. The differences between the scores at different time points was verified using Friedman's non-parametric test. Negative changes between time points were evaluated, with differences (delta) of ±10 points being considered to be clinically significant. RESULTS The total mean age was 59.1 ± 9.5y, and 82.5% were male. The oral cavity and larynx were more frequent tumors. The functional score for 'role' was decreased at time points T1 and T2 as compared to T0, while an improvement in scores was observed for cognitive function. Several physical symptoms also worsened over time, such as: fatigue, nausea and vomiting, dry mouth and sticky saliva, swallowing and skin symptoms, senses and teeth problems. A high frequency of altered and clinically meaningful values were observed for most of domains, ranging from 6 to 74%. CONCLUSIONS The QoL became worse at approximately one month after treatment beginning in HNC patients, and this remained until the end of therapy. Protocols directing to early nutritional counseling and management of symptoms of nutritional impact are important to improve clinical outcomes. This is part of preventive actions aiming to make the exhausting treatment process less traumatic and easier to complete.
Collapse
Affiliation(s)
- Emanuelle do Nascimento Santos Lima
- Graduate Program in Health Sciences, Federal University of Uberlandia, Pará Av, 1720 / 2U, Campus Umuarama, Uberlandia, Minas Gerais 38400-902 Brazil
| | - Isabela Borges Ferreira
- Graduate Program in Health Sciences, Federal University of Uberlandia, Pará Av, 1720 / 2U, Campus Umuarama, Uberlandia, Minas Gerais 38400-902 Brazil
| | - Paula Philbert Lajolo
- Department of Clinical Oncology, Clinical Hospital, Federal University of Uberlandia, Pará Av, 1720 / sala 9, Campus Umuarama, Uberlandia, Minas Gerais 38.405-320 Brazil
| | - Carlos Eduardo Paiva
- Department of Clinical Oncology and Research Group on Palliative Care and Health-Related Quality of Life (GPQual), Barretos Cancer Hospital, Barretos, Antenor Duarte Viléla St, 1331, Dr. Paulo Prata, Barretos, SP 14784-400 Brazil
| | - Yara Cristina de Paiva Maia
- School of Medicine; Nutrition Course, Federal University of Uberlandia, Pará Av, 1720 / 2U, Campus Umuarama, Uberlandia, Minas Gerais 38400-902 Brazil
| | - Geórgia das Graças Pena
- School of Medicine; Nutrition Course, Federal University of Uberlandia, Pará Av, 1720 / 2U, Campus Umuarama, Uberlandia, Minas Gerais 38400-902 Brazil
| |
Collapse
|
37
|
Wen L, Mu W, Lu H, Wang X, Fang J, Jia Y, Li Q, Wang D, Wen S, Guo J, Dai W, Ren X, Cui J, Zeng G, Gao J, Wang Z, Cheng B. Porphyromonas gingivalis Promotes Oral Squamous Cell Carcinoma Progression in an Immune Microenvironment. J Dent Res 2020; 99:666-675. [PMID: 32298192 DOI: 10.1177/0022034520909312] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Increasing evidence has revealed a significant association between microorganisms and oral squamous cell carcinoma (OSCC). Porphyromonas gingivalis, the keystone pathogen in chronic periodontitis, is considered an important potential etiologic agent of OSCC, but the underlying immune mechanisms through which P. gingivalis mediates tumor progression of the oral cancer remain poorly understood. Our cohort study showed that the localization of P. gingivalis in tumor tissues was related to poor survival of patients with OSCC. Moreover, P. gingivalis infection increased oral lesion multiplicity and size and promoted tumor progression in a 4-nitroquinoline-1 oxide (4NQO)–induced carcinogenesis mouse model by invading the oral lesions. In addition, CD11b+ myeloid cells and myeloid-derived suppressor cells (MDSCs) showed increased infiltration of oral lesions. Furthermore, in vitro observations showed that MDSCs accumulated when human-derived dysplastic oral keratinocytes (DOKs) were exposed to P. gingivalis, and CXCL2, CCL2, interleukin (IL)–6, and IL-8 may be potential candidate genes that facilitate the recruitment of MDSCs. Taken together, our findings suggest that P. gingivalis promotes tumor progression by generating a cancer-promoting microenvironment, indicating a close relationship among P. gingivalis, tumor progression of the oral cancer, and immune responses.
Collapse
Affiliation(s)
- L. Wen
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - W. Mu
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - H. Lu
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - X. Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - J. Fang
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Y. Jia
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Q. Li
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - D. Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - S. Wen
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - J. Guo
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - W. Dai
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - X. Ren
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - J. Cui
- State Key Laboratory of Oncology in South China, MOE Key Laboratory of Gene Function and Regulation, School of Life Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - G. Zeng
- Department of Microbiology, Zhongshan School of Medicine, Key Laboratory for Tropical Diseases Control of the Ministry of Education, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - J. Gao
- Discipline of Oral Bioscience, Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Z. Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - B. Cheng
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| |
Collapse
|
38
|
Lee YCA, Al-Temimi M, Ying J, Muscat J, Olshan AF, Zevallos JP, Winn DM, Li G, Sturgis EM, Morgenstern H, Zhang ZF, Smith E, Kelsey K, McClean M, Vaughan TL, Lazarus P, Chen C, Schwartz SM, Gillison M, Schantz S, Yu GP, D'Souza G, Gross N, Monroe M, Kim J, Boffetta P, Hashibe M. Risk Prediction Models for Head and Neck Cancer in the US Population From the INHANCE Consortium. Am J Epidemiol 2020; 189:330-342. [PMID: 31781743 DOI: 10.1093/aje/kwz259] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 10/29/2019] [Accepted: 11/06/2019] [Indexed: 12/23/2022] Open
Abstract
Head and neck cancer (HNC) risk prediction models based on risk factor profiles have not yet been developed. We took advantage of the large database of the International Head and Neck Cancer Epidemiology (INHANCE) Consortium, including 14 US studies from 1981-2010, to develop HNC risk prediction models. Seventy percent of the data were used to develop the risk prediction models; the remaining 30% were used to validate the models. We used competing-risk models to calculate absolute risks. The predictors included age, sex, education, race/ethnicity, alcohol drinking intensity, cigarette smoking duration and intensity, and/or family history of HNC. The 20-year absolute risk of HNC was 7.61% for a 60-year-old woman who smoked more than 20 cigarettes per day for over 20 years, consumed 3 or more alcoholic drinks per day, was a high school graduate, had a family history of HNC, and was non-Hispanic white. The 20-year risk for men with a similar profile was 6.85%. The absolute risks of oropharyngeal and hypopharyngeal cancers were generally lower than those of oral cavity and laryngeal cancers. Statistics for the area under the receiver operating characteristic curve (AUC) were 0.70 or higher, except for oropharyngeal cancer in men. This HNC risk prediction model may be useful in promoting healthier behaviors such as smoking cessation or in aiding persons with a family history of HNC to evaluate their risks.
Collapse
|
39
|
Hall AL, Kromhout H, Schüz J, Peters S, Portengen L, Vermeulen R, Agudo A, Ahrens W, Boffetta P, Brennan P, Canova C, Conway DI, Curado MP, Daudt AW, Fernandez L, Hashibe M, Healy CM, Holcatova I, Kjaerheim K, Koifman R, Lagiou P, Luce D, Macfarlane GJ, Menezes A, Menvielle G, Polesel J, Ramroth H, Richiardi L, Stücker I, Thomson P, Vilensky M, Wunsch-Filho V, Yuan-Chin AL, Znaor A, Straif K, Olsson A. Laryngeal Cancer Risks in Workers Exposed to Lung Carcinogens: Exposure-Effect Analyses Using a Quantitative Job Exposure Matrix. Epidemiology 2020; 31:145-154. [PMID: 31577634 DOI: 10.1097/ede.0000000000001120] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Various established occupational lung carcinogens are also suspected risk factors for laryngeal cancer. However, individual studies are often inadequate in size to investigate this relatively rare outcome. Other limitations include imprecise exposure assessment and inadequate adjustment for confounders. METHODS This study applied a quantitative job exposure matrix (SYN-JEM) for four established occupational lung carcinogens to five case-control studies within the International Head and Neck Cancer Epidemiology Consortium. We used occupational histories for 2256 laryngeal cancer cases and 7857 controls recruited from 1989 to 2007. We assigned quantitative exposure levels for asbestos, respirable crystalline silica, chromium-VI, and chromium-VI and nickel combined (to address highly correlated exposures) via SYN-JEM. We assessed effects of occupational exposure on cancer risk for males (asbestos, respirable crystalline silica, chromium-VI, and chromium-VI and nickel combined) and females (asbestos and respirable crystalline silica), adjusting for age, study, tobacco smoking, alcohol consumption, and asbestos exposure where relevant. RESULTS Among females, odds ratios (ORs) were increased for ever versus never exposed. Among males, P values for linear trend were <0.05 for estimated cumulative exposure (all agents) and <0.05 for exposure duration (respirable crystalline silica, chromium-VI, and chromium-VI and nickel combined); strongest associations were for asbestos at >90th percentile cumulative exposure (OR = 1.3, 95% confidence interval [CI] = 1.0, 1.6), respirable crystalline silica at 30+ years duration (OR = 1.4, 95% CI = 1.2, 1.7) and 75th-90th percentile cumulative exposure (OR = 1.4, 95% CI = 1.1, 1.8), chromium-VI at >75th percentile cumulative exposure (OR = 1.9, 95% CI = 1.2, 3.0), and chromium-VI and nickel combined at 20-29 years duration (OR = 1.5, 95% CI = 1.1, 2.2). CONCLUSIONS These findings support hypotheses of causal links between four lung carcinogens (asbestos, respirable crystalline silica, chromium-VI, and nickel) and laryngeal cancer.
Collapse
Affiliation(s)
- Amy L Hall
- From the International Agency for Research on Cancer, Lyon, France
| | - Hans Kromhout
- Institute for Risk Assessment Sciences, Utrecht University, The Netherlands
| | - Joachim Schüz
- From the International Agency for Research on Cancer, Lyon, France
| | - Susan Peters
- Institute for Risk Assessment Sciences, Utrecht University, The Netherlands
| | - Lützen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, The Netherlands
| | - Roel Vermeulen
- From the International Agency for Research on Cancer, Lyon, France
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Faculty of Mathematics/Computer Science, Institute of Statistics, University of Bremen, Bremen, Germany
| | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paul Brennan
- From the International Agency for Research on Cancer, Lyon, France
| | | | - David I Conway
- School of Medicine, Dentistry, and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | | | | | | | - Claire M Healy
- Trinity College School of Dental Science, Dublin, Ireland
| | - Ivana Holcatova
- Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Kristina Kjaerheim
- Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
| | - Rosalina Koifman
- Escola Nacional de Saude Publica, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Pagona Lagiou
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Danièle Luce
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Pointe-à-Pitre, France
| | - Gary J Macfarlane
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, United Kingdom
| | - Ana Menezes
- Universidade Federal de Pelotas, Pelotas, Brazil
| | - Gwenn Menvielle
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Paris, France
| | | | | | | | - Isabelle Stücker
- University Paris Sud, Paris Saclay University, UVSQ, CESP, INSERM, Environmental Epidemiology of Cancer Team, Villejuif, France
| | | | - Marta Vilensky
- Institute of Oncology Angel H. Roffo, University of Buenos Aires, Argentina
| | | | | | - Ariana Znaor
- From the International Agency for Research on Cancer, Lyon, France
| | - Kurt Straif
- From the International Agency for Research on Cancer, Lyon, France
| | - Ann Olsson
- From the International Agency for Research on Cancer, Lyon, France
| |
Collapse
|
40
|
Nayar S. Current concepts and novel techniques in the prosthodontic management of head and neck cancer patients. Br Dent J 2019; 226:725-737. [PMID: 31127217 DOI: 10.1038/s41415-019-0318-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
'The face is the mirror of the mind', so said St Jerome. Patients affected by head and neck cancer have to deal not only with the effects of the disease but also with the effects of the treatment for the disease. This is one cancer which is literally and figuratively 'in your face'! And it is a disease which is difficult to hide. This article attempts to summarise head and neck cancer and its treatment modalities as well as the effects of treatment and the defects it creates. It will also attempt to explore and elaborate on the novel prosthodontic management techniques in advanced jaw reconstruction and extraoral anatomical defects. The concept of functional assessment and rehabilitation in head and neck cancer patient management will also be briefly explained.
Collapse
Affiliation(s)
- Suresh Nayar
- Maxillofacial Prosthodontist, Institute for Reconstructive Sciences in Medicine, 16940, 87 Avenue, Edmonton, Alberta, Canada; Associate Professor, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Canada.
| |
Collapse
|
41
|
Chang CP, Chang SC, Chuang SC, Berthiller J, Ferro G, Matsuo K, Wünsch-Filho V, Toporcov TN, de Carvalho MB, La Vecchia C, Olshan AF, Zevallos JP, Serraino D, Muscat J, Sturgis EM, Li G, Morgenstern H, Levi F, Dal Maso L, Smith E, Kelsey K, McClean M, Vaughan TL, Lazarus P, Ramroth H, Chen C, Schwartz SM, Winn DM, Bosetti C, Edefonti V, Garavello W, Negri E, Hayes RB, Purdue MP, Boccia S, Cadoni G, Shangina O, Koifman R, Curado MP, Vilensky M, Swiatkowska B, Herrero R, Franceschi S, Benhamou S, Fernandez L, Menezes AMB, Daudt AW, Mates D, Schantz S, Yu GP, Lissowska J, Brenner H, Fabianova E, Rudnai P, Brennan P, Boffetta P, Zhang ZF, Hashibe M, Lee YCA. Age at start of using tobacco on the risk of head and neck cancer: Pooled analysis in the International Head and Neck Cancer Epidemiology Consortium (INHANCE). Cancer Epidemiol 2019; 63:101615. [PMID: 31586822 PMCID: PMC10072232 DOI: 10.1016/j.canep.2019.101615] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Tobacco use is a well-established risk factor for head and neck cancer (HNC). However, less is known about the potential impact of exposure to tobacco at an early age on HNC risk. METHODS We analyzed individual-level data on ever tobacco smokers from 27 case-control studies (17,146 HNC cases and 17,449 controls) in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using random-effects logistic regression models. RESULTS Without adjusting for tobacco packyears, we observed that younger age at starting tobacco use was associated with an increased HNC risk for ever smokers (OR<10 years vs. ≥30 years: 1.64, 95% CI: 1.35, 1.97). However, the observed association between age at starting tobacco use and HNC risk became null after adjusting for tobacco packyears (OR<10 years vs. ≥30 years: 0.97, 95% CI: 0.80, 1.19). In the stratified analyses on HNC subsites by tobacco packyears or years since quitting, no difference in the association between age at start and HNC risk was observed. CONCLUSIONS Results from this pooled analysis suggest that increased HNC risks observed with earlier age at starting tobacco smoking are largely due to longer duration and higher cumulative tobacco exposures.
Collapse
Affiliation(s)
- Chun-Pin Chang
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Shen-Chih Chang
- International Agency for Research on Cancer, Lyon, France; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, United States
| | - Shu-Chun Chuang
- Institute of Population Health Sciences, National Health Research Institutes, Taiwan
| | - Julien Berthiller
- International Agency for Research on Cancer, Lyon, France; Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, France
| | - Gilles Ferro
- International Agency for Research on Cancer, Lyon, France
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan; Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Victor Wünsch-Filho
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Tatiana N Toporcov
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, NC, United States
| | - Jose P Zevallos
- Division of Head and Neck Surgical Oncology, Department of Otolaryngology/Head and Neck Surgery, Washington University School of Medicine, Saint Louis, MO, United States
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Joshua Muscat
- Penn State College of Medicine, Hershey, PA, United States
| | - Erich M Sturgis
- University of Texas M. D. Anderson Cancer Center, Houston, TX, United States
| | - Guojun Li
- University of Texas M. D. Anderson Cancer Center, Houston, TX, United States
| | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health, and Department of Urology, Medical School, University of Michigan, Ann Arbor, MI, United States
| | - Fabio Levi
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Elaine Smith
- College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Karl Kelsey
- Brown University, Providence, RI, United States
| | | | - Thomas L Vaughan
- Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Philip Lazarus
- Washington State University College of Pharmacy, Spokane, WA, United States
| | | | - Chu Chen
- Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | | | - Deborah M Winn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Valeria Edefonti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Werner Garavello
- Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, University of Milan, Italy
| | - Richard B Hayes
- Division of Epidemiology, New York University School of Medicine, New York, United States
| | - Mark P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Stefania Boccia
- Institute of Public Health, Section of Hygiene, Universita Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | - Gabriella Cadoni
- Department of Head and Neck Surgery, Institute of Clinical Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy; Istituto di Clinica Otorinolaringoiatrica, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | | | - Rosalina Koifman
- Escola Nacional de Suade Publica, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Marta Vilensky
- Institute of Oncology Angel H. Roffo, University of Buenos Aires, Argentina
| | | | | | - Silvia Franceschi
- Scientific Directorate, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Simone Benhamou
- National Institute of Health and Medical Research, Inserm U1018, Villejuif, France
| | | | | | | | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | | | - Guo-Pei Yu
- Department of Otolaryngology, School of Medicine, New York Medical College, Valhalla, NY, United States
| | - Jolanta Lissowska
- The M. Skasodowska-Curie Memorial Cancer Center and Institute of Oncology, Dept. of Cancer Epidemiology and Prevention, Warsaw, Poland
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Peter Rudnai
- National Institute of Environmental Health, Budapest, Hungary
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, United States
| | - Mia Hashibe
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Yuan-Chin Amy Lee
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT, United States.
| |
Collapse
|
42
|
Cosetti-Olivera ML, Cunha ARD, Prass TS, Martins MAT, Hugo FN, Martins MD. Mortality due to oral and oropharyngeal cancer in Uruguay from 1997 to 2014. J Appl Oral Sci 2019; 28:e20190166. [PMID: 31800875 PMCID: PMC6886395 DOI: 10.1590/1678-7757-2019-0166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 07/31/2019] [Indexed: 12/03/2022] Open
Abstract
Oral and oropharyngeal cancer is considered a public health problem in several countries due to its high incidence and mortality rate.
Collapse
Affiliation(s)
- Maria Laura Cosetti-Olivera
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Odontologia, Porto Alegre, Rio Grande do Sul, Brasil.,Universidad de la República, Facultad de Odontologia, Departamento del Patologia y Estomatologia, Montevideo, Uruguay
| | - Amanda Ramos da Cunha
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Odontologia, Porto Alegre, Rio Grande do Sul, Brasil
| | - Taiane Schaedler Prass
- Universidade Federal do Rio Grande do Sul, Departamento de Estatística, Porto Alegre, Rio Grande do Sul, Brasil
| | - Marco Antonio Trevizani Martins
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Odontologia, Porto Alegre, Rio Grande do Sul, Brasil
| | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Odontologia, Porto Alegre, Rio Grande do Sul, Brasil
| | - Manoela Domingues Martins
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Odontologia, Porto Alegre, Rio Grande do Sul, Brasil
| |
Collapse
|
43
|
The changing epidemiology of oral cancer: definitions, trends, and risk factors. Br Dent J 2019; 225:867-873. [PMID: 30412558 DOI: 10.1038/sj.bdj.2018.922] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2018] [Indexed: 02/06/2023]
Abstract
Objective This review has three objectives, namely: (i) to discuss how oral cancer is and ought to be defined and recorded; (ii) to present up-to-date data on the incidence burden of the disease in the four countries of the UK, and review recent analyses of trends in the disease; and (iii) to summarise recent evidence on risk factors of the disease. Methods Cancer definitions were clarified by the International Classification of Diseases accounting for anatomical and aetiological differences; descriptive epidemiology included international / UK literature review and information requests for incidence data from the UK cancer registries (2000-2016); analytical epidemiology focused on reviewing the findings of the International Head and Neck Cancer Epidemiology (INHANCE) consortium, which has pooled data from multiple case-control studies providing the best estimates of risk factors. Results Emerging evidence of the role played by risk factors in different anatomical sites means that oral cavity cancer and oropharynx cancer should be considered distinct disease entities – and a standardised attribution of anatomical subsites will be helpful in ensuring consistency in how data are presented. In 2016, over 3,700 people were diagnosed with oral cavity cancer and over 3,500 people were diagnosed with oropharyngeal cancer in the UK. Incidence of oropharyngeal cancer is rapidly rising across the UK. Rates of oral cavity cancer are higher in Northern Ireland and higher still (and relatively stable) in Scotland, but rising in England and Wales. INHANCE data show that while the consumption of alcohol and tobacco are the prime risk factors for oral cavity and oropharyngeal cancers, they provide greater certainty in the preventive benefits of reducing these risk factors. The role played by other factors such as low socioeconomic status, genetics, oral health, and human papillomavirus (only for oropharyngeal cancer) have become clearer. Conclusions This epidemiology provides a strong foundation for designing and managing both population and individual oral cavity and oropharyngeal cancer control strategies.
Collapse
|
44
|
Moraes JKD, Wagner VP, Fonseca FP, Amaral‐Silva GKD, de Farias CB, Pilar EFS, Gregianin L, Roesler R, Vargas PA, Martins MD. Activation of BDNF/TrkB/Akt pathway is associated with aggressiveness and unfavorable survival in oral squamous cell carcinoma. Oral Dis 2019; 25:1925-1936. [DOI: 10.1111/odi.13190] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/14/2019] [Accepted: 09/04/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Juliana Kern de Moraes
- Department of Oral Diagnosis Piracicaba Dental School University of Campinas Piracicaba Brazil
| | - Vivian Petersen Wagner
- Department of Oral Diagnosis Piracicaba Dental School University of Campinas Piracicaba Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology School of Dentistry Federal University of Minas Gerais Belo Horizonte Brazil
| | | | - Caroline Brunetto de Farias
- Cancer and Neurobiology Laboratory Experimental Research Center Porto Alegre Clinical Hospital Federal University of Rio Grande do Sul Porto Alegre Brazil
- Children’s Cancer Institute Porto Alegre Brazil
| | - Emily Ferreira Salles Pilar
- Experimental Pathology Unit Clinics Hospital of Porto Alegre Federal University of Rio Grande do Sul Porto Alegre Brazil
| | - Lauro Gregianin
- Children’s Cancer Institute Porto Alegre Brazil
- Pediatric Oncology Service Clinical Hospital Federal University of Rio Grande do Sul Porto Alegre Brazil
| | - Rafael Roesler
- Cancer and Neurobiology Laboratory Experimental Research Center Porto Alegre Clinical Hospital Federal University of Rio Grande do Sul Porto Alegre Brazil
- Children’s Cancer Institute Porto Alegre Brazil
- Department of Pharmacology Institute for Basic Health Sciences Federal University of Rio Grande do Sul Porto Alegre Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis Piracicaba Dental School University of Campinas Piracicaba Brazil
| | - Manoela Domingues Martins
- Department of Oral Diagnosis Piracicaba Dental School University of Campinas Piracicaba Brazil
- Experimental Pathology Unit Clinics Hospital of Porto Alegre Federal University of Rio Grande do Sul Porto Alegre Brazil
- Department of Oral Pathology School of Dentistry Federal University of Rio Grande do Sul Porto Alegre Brazil
| |
Collapse
|
45
|
Galvão De Podestá OP, Peres SV, Salaroli LB, Cattafesta M, De Podestá JRV, von Zeidler SLV, de Oliveira JC, Kowalski LP, Ikeda MK, Brennan P, Curado MP. Consumption of minimally processed foods as protective factors in the genesis of squamous cell carcinoma of the head and neck in Brazil. PLoS One 2019; 14:e0220067. [PMID: 31344089 PMCID: PMC6657870 DOI: 10.1371/journal.pone.0220067] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 07/08/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Head and neck cancer (HNC) is the sixth most common cancer, and two-fifths of cases could be avoided by changing lifestyle and eating habits. METHODS This multicenter case-control study was conducted under the International Consortium on Head and Neck Cancer and Genetic Epidemiology, coordinated by the International Agency for Research on Cancer. This consortium evaluated associations between minimally processed food consumption and the risk of HNC in three Brazilian states. RESULTS We evaluated 1740 subjects (847 cases and 893 controls). In multiple analyses including recognized risk factors for HNC, the consumption of apples and pears was associated with reduced risks of oral cavity and laryngeal cancers; the consumption of citrus fruits and fresh tomatoes was associated with a reduced risk of oral cavity cancer; the consumption of bananas was associated with a reduced risk of oropharynx cancer; the consumption of broccoli, cabbage, and collard greens was associated with reduced risks of laryngeal and hypopharyngeal cancers; and the consumption of carrots and fresh fruits was associated with a reduced risk of hypopharyngeal cancer. CONCLUSIONS The consumption of a heathy diet rich in fruits and vegetables was associated with a reduced risk of HNC. Public policies, including government subsidies, are essential to facilitate logistical and financial access to minimally processed foods, thereby strengthening environments that promote healthy behavior.
Collapse
Affiliation(s)
| | - Stela Verzinhasse Peres
- Postgraduate Program in Sciences of Fundação Antônio Prudente, Cancer Center of A.C.Camargo, São Paulo—SP / BR
| | | | - Monica Cattafesta
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória—ES / BR
| | | | | | | | - Luiz Paulo Kowalski
- Postgraduate Program in Sciences of Fundação Antônio Prudente, Cancer Center of A.C.Camargo, São Paulo—SP / BR
| | - Mauro Kasuo Ikeda
- Postgraduate Program in Sciences of Fundação Antônio Prudente, Cancer Center of A.C.Camargo, São Paulo—SP / BR
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Maria Paula Curado
- Postgraduate Program in Sciences of Fundação Antônio Prudente, Cancer Center of A.C.Camargo, São Paulo—SP / BR
| |
Collapse
|
46
|
Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR, Listl S, Celeste RK, Guarnizo-Herreño CC, Kearns C, Benzian H, Allison P, Watt RG. Oral diseases: a global public health challenge. Lancet 2019; 394:249-260. [PMID: 31327369 DOI: 10.1016/s0140-6736(19)31146-8] [Citation(s) in RCA: 1434] [Impact Index Per Article: 286.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/12/2019] [Accepted: 04/26/2019] [Indexed: 02/08/2023]
Abstract
Oral diseases are among the most prevalent diseases globally and have serious health and economic burdens, greatly reducing quality of life for those affected. The most prevalent and consequential oral diseases globally are dental caries (tooth decay), periodontal disease, tooth loss, and cancers of the lips and oral cavity. In this first of two papers in a Series on oral health, we describe the scope of the global oral disease epidemic, its origins in terms of social and commercial determinants, and its costs in terms of population wellbeing and societal impact. Although oral diseases are largely preventable, they persist with high prevalence, reflecting widespread social and economic inequalities and inadequate funding for prevention and treatment, particularly in low-income and middle-income countries (LMICs). As with most non-communicable diseases (NCDs), oral conditions are chronic and strongly socially patterned. Children living in poverty, socially marginalised groups, and older people are the most affected by oral diseases, and have poor access to dental care. In many LMICs, oral diseases remain largely untreated because the treatment costs exceed available resources. The personal consequences of chronic untreated oral diseases are often severe and can include unremitting pain, sepsis, reduced quality of life, lost school days, disruption to family life, and decreased work productivity. The costs of treating oral diseases impose large economic burdens to families and health-care systems. Oral diseases are undoubtedly a global public health problem, with particular concern over their rising prevalence in many LMICs linked to wider social, economic, and commercial changes. By describing the extent and consequences of oral diseases, their social and commercial determinants, and their ongoing neglect in global health policy, we aim to highlight the urgent need to address oral diseases among other NCDs as a global health priority.
Collapse
Affiliation(s)
- Marco A Peres
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia
| | - Lorna M D Macpherson
- Department of Dental Public Health, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Robert J Weyant
- Department of Dental Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Blánaid Daly
- Division of Child and Public Dental Health, Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Renato Venturelli
- WHO Collaborating Centre in Oral Health Inequalities and Public Health, Department of Epidemiology and Public Health, University College London, London, UK
| | | | - Stefan Listl
- Quality and Safety of Oral Healthcare, Department of Dentistry, Radboud University Medical Center, Radboud University, Nijmegen, Netherlands; Section for Translational Health Economics, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Roger Keller Celeste
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Carol C Guarnizo-Herreño
- Departamento de Salud Colectiva, Facultad de Odontología, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Cristin Kearns
- Department of Preventive and Restorative Dental Sciences and Philip R Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Habib Benzian
- WHO Collaborating Centre for Quality-Improvement, Evidence-Based Dentistry, Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY, USA; New York University College of Global Public Health, New York, NY, USA
| | - Paul Allison
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Richard G Watt
- WHO Collaborating Centre in Oral Health Inequalities and Public Health, Department of Epidemiology and Public Health, University College London, London, UK.
| |
Collapse
|
47
|
A Prospective Cohort Study of Human Papillomavirus-Driven Oropharyngeal Cancers: Implications for Prognosis and Immunisation. Clin Oncol (R Coll Radiol) 2019; 31:e132-e142. [PMID: 31248692 DOI: 10.1016/j.clon.2019.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 02/26/2019] [Accepted: 04/12/2019] [Indexed: 12/29/2022]
Abstract
AIMS Oropharyngeal cancer (OPC) is increasing on a global scale, including the component driven by high-risk human papillomavirus (HR-HPV); contemporary data that provides insight into the prognosis of this disease in addition to the fraction attributable to HR-HPV are essential to inform primary and secondary disease management strategies. MATERIALS AND METHODS A population-based cohort of 235 patients diagnosed with OPC between 2013 and 2015 in Scotland was assessed for HPV status using molecular genotyping. Associations between HR-HPV status and key clinical and demographic variables were estimated using the Pearson chi-squared test. Rates of overall survival and progression-free survival were estimated and visualised using Kaplan-Meier curves. RESULTS HPV DNA (largely HPV 16) was identified in 60% of cases. After adjustment for age, gender, deprivation, smoking, alcohol consumption and tumour stage, patients with HR-HPV-positive OPC had an 89% reduction in the risk of death (hazard ratio = 0.11, 95% confidence interval 0.05-0.25) and an 85% reduction in the risk of disease progression (hazard ratio = 0.15, 95% confidence interval 0.07-0.30). HPV positivity was not associated with age, deprivation or smoking status, whereas those who reported excess alcohol consumption were less likely to be positive for HR-HPV. CONCLUSIONS The prevalence of HR-HPV-associated OPC is high in Scotland and strongly associated with dramatically improved clinical outcomes, including survival. Demographic/behavioural variables did not reliably predict HPV positivity in this cohort, which underlines the importance of laboratory confirmation. Finally, the dominance of HPV 16 in OPC indicates the significant impact of prophylactic immunisation on this disease.
Collapse
|
48
|
Byrne K, Zanotti G, Hallworth P, Roughley A, Martini JF, Uehara R, Iyer S. Real-world treatment patterns and outcomes of patients with stage IV squamous cell carcinoma of the head and neck. Future Oncol 2019; 15:611-623. [DOI: 10.2217/fon-2018-0484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Aim: To understand the treatment patterns and outcomes for stage IV squamous cell carcinoma of the head and neck, patients receiving second-line or later drug therapy. Materials & methods: Real-world data were collected from 1152 patients in the USA, France, Germany and the UK through a retrospective chart analysis and patient-reported outcomes were collected using validated questionnaires in a subgroup of patients. Results: Forty-four percent of patients had stage IVA/B disease. A total of 77, 19 and 3% of patients had received two, three and four plus lines of active drug treatment. Platinum- and cetuximab-based regimens were common at early treatment lines. Time to progression was short (5.2 months post first line), survival rates low and patient-reported health status poor. Conclusion: Novel therapies that could improve clinical and patient-reported outcomes would address a significant unmet need.
Collapse
|
49
|
Mirza AH, Aylin P, Middleton S, King EV, Nouraei RAR, Repanos C. Impact of social deprivation on the outcome of major head and neck cancer surgery in England: A national analysis. Head Neck 2018; 41:692-700. [DOI: 10.1002/hed.25461] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 05/23/2018] [Accepted: 08/22/2018] [Indexed: 12/25/2022] Open
Affiliation(s)
- Adal H. Mirza
- University Hospital Southampton; Southampton United Kingdom
| | - Paul Aylin
- Dr Foster Unit, Department of Primary Care and Public Health; Imperial College; London United Kingdom
| | | | - Emma V. King
- University Hospital Southampton; Southampton United Kingdom
| | - Reza A. R. Nouraei
- Centre for Airway, Voice and Swallowing, Department of Ear, Nose, and Throat Surgery; Poole Hospital, NHS Foundation Trust; Poole United Kingdom
| | - Costa Repanos
- Department of Head and Neck Surgery; Queen Alexandra Hospital; Portsmouth United Kingdom
| |
Collapse
|
50
|
Bulsara VM, Worthington HV, Glenny A, Clarkson JE, Conway DI, Macluskey M. Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment. Cochrane Database Syst Rev 2018; 12:CD006205. [PMID: 30582609 PMCID: PMC6517307 DOI: 10.1002/14651858.cd006205.pub4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Surgery is an important part of the management of oral cavity cancer with regard to both the removal of the primary tumour and removal of lymph nodes in the neck. Surgery is less frequently used in oropharyngeal cancer. Surgery alone may be treatment for early-stage disease or surgery may be used in combination with radiotherapy, chemotherapy and immunotherapy/biotherapy. There is variation in the recommended timing and extent of surgery in the overall treatment regimens of people with these cancers. This is an update of a review originally published in 2007 and first updated in 2011. OBJECTIVES To determine which surgical treatment modalities for oral and oropharyngeal cancers result in increased overall survival, disease-free survival and locoregional control and reduced recurrence. To determine the implication of treatment modalities in terms of morbidity, quality of life, costs, hospital days of treatment, complications and harms. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 20 December 2017), the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 11), MEDLINE Ovid (1946 to 20 December 2017) and Embase Ovid (1980 to 20 December 2017). We searched the US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. There were no restrictions on the language or date of publication. SELECTION CRITERIA Randomised controlled trials where more than 50% of participants had primary tumours of the oral cavity or oropharynx, or where separate data could be extracted for these participants, and that compared two or more surgical treatment modalities, or surgery versus other treatment modalities. DATA COLLECTION AND ANALYSIS Two or more review authors independently extracted data and assessed risk of bias. We contacted study authors for additional information as required. We collected adverse events data from included studies. MAIN RESULTS We identified five new trials in this update, bringing the total number of included trials to 12 (2300 participants; 2148 with cancers of the oral cavity). We assessed four trials at high risk of bias, and eight at unclear. None of the included trials compared different surgical approaches for the excision of the primary tumour. We grouped the trials into seven main comparisons.Future research may change the findings as there is only very low-certainty evidence available for all results.Five trials compared elective neck dissection (ND) with therapeutic (delayed) ND in participants with oral cavity cancer and clinically negative neck nodes, but differences in type of surgery and duration of follow-up made meta-analysis inappropriate in most cases. Four of these trials reported overall and disease-free survival. The meta-analyses of two trials found no evidence of either intervention leading to greater overall survival (hazard ratio (HR) 0.84, 95% confidence interval (CI) 0.41 to 1.72; 571 participants), or disease-free survival (HR 0.73, 95% CI 0.25 to 2.11; 571 participants), but one trial found a benefit for elective supraomohyoid ND compared to therapeutic ND in overall survival (RR 0.40, 95% CI 0.19 to 0.84; 67 participants) and disease-free survival (HR 0.32, 95% CI 0.12 to 0.84; 67 participants). Four individual trials assessed locoregional recurrence, but could not be meta-analysed; one trial favoured elective ND over therapeutic delayed ND, while the others were inconclusive.Two trials compared elective radical ND with elective selective ND, but we were unable to pool the data for two outcomes. Neither study found evidence of a difference in overall survival or disease-free survival. A single trial found no evidence of a difference in recurrence.One trial compared surgery plus radiotherapy with radiotherapy alone, but data were unreliable because the trial stopped early and there were multiple protocol violations.One trial comparing positron-emission tomography-computed tomography (PET-CT) following chemoradiotherapy (with ND only if no or incomplete response) versus planned ND (either before or after chemoradiotherapy), showed no evidence of a difference in mortality (HR 0.92, 95% CI 0.65 to 1.31; 564 participants). The trial did not provide usable data for the other outcomes.Three single trials compared: surgery plus adjunctive radiotherapy versus chemoradiotherapy; supraomohyoid ND versus modified radical ND; and super selective ND versus selective ND. There were no useable data from these trials.The reporting of adverse events was poor. Four trials measured adverse events. Only one of the trials reported quality of life as an outcome. AUTHORS' CONCLUSIONS Twelve randomised controlled trials evaluated ND surgery in people with oral cavity cancers; however, the evidence available for all comparisons and outcomes is very low certainty, therefore we cannot rely on the findings. The evidence is insufficient to draw conclusions about elective ND of clinically negative neck nodes at the time of removal of the primary tumour compared to therapeutic (delayed) ND. Two trials combined in meta-analysis suggested there is no difference between these interventions, while one trial (which evaluated elective supraomohyoid ND) found that it may be associated with increased overall and disease-free survival. One trial found elective ND reduced locoregional recurrence, while three were inconclusive. There is no evidence that radical ND increases overall or disease-free survival compared to more conservative ND surgery, or that there is a difference in mortality between PET-CT surveillance following chemoradiotherapy versus planned ND (before or after chemoradiotherapy). Reporting of adverse events in all trials was poor and it was not possible to compare the quality of life of people undergoing different surgical treatments.
Collapse
Affiliation(s)
- Vishal M Bulsara
- The University of Western AustraliaSchool of Dentistry17 Monash AvenueNedlandsWestern AustraliaAustralia6009
| | - Helen V Worthington
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | - Anne‐Marie Glenny
- The University of ManchesterDivision of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and HealthCoupland Building 3, Oxford RoadManchesterUKM13 9PL
| | - Janet E Clarkson
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | - David I Conway
- University of GlasgowGlasgow Dental School378 Sauchiehall StreetGlasgowUKG2 3JZ
| | - Michaelina Macluskey
- University of DundeeUnit of Oral Surgery and MedicineUniversity of Dundee Dental Hospital and SchoolPark PlaceDundeeScotlandUKDD1 4NR
| | | |
Collapse
|