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Nassar SI, Suk A, Nguyen SA, Adilbay D, Pang J, Nathan CAO. The Role of ctDNA and Liquid Biopsy in the Diagnosis and Monitoring of Head and Neck Cancer: Towards Precision Medicine. Cancers (Basel) 2024; 16:3129. [PMID: 39335101 PMCID: PMC11430155 DOI: 10.3390/cancers16183129] [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: 08/20/2024] [Revised: 09/08/2024] [Accepted: 09/10/2024] [Indexed: 09/30/2024] Open
Abstract
Recent data have shown a continued rise in the worldwide annual incidence and mortality rates of head and neck cancers. The present standard for diagnosis and monitoring for disease recurrence or progression involves clinical examination, imaging, and invasive biopsy techniques of lesions suspected of being malignant. In addition to limitations relating to cost, time, and patient discomfort, these methodologies have inherent inaccuracies for detecting recurrence. In view of these limitations, the analysis of patient bodily fluid samples via liquid biopsy proposes a cost-effective and convenient alternative, which provides insight on the biogenetic and biomolecular underpinnings of oncologic disease processes. The monitoring of biomarkers for head and neck cancer via liquid biopsy, including circulating tumor DNA, circulating tumor cells, and circulating cell-free RNA, has shown clinical utility in the screening, diagnosis, prognostication, and monitoring of patients with various forms of head and neck cancer. The present review will provide an update on the current literature examining the use of liquid biopsy in head and neck cancer care and the clinical applicability of potential biomarkers, with a focus on viral and non-viral circulating tumor DNA. Possible future avenues for research to address specific shortcomings of liquid biopsy will be discussed.
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Affiliation(s)
- Sami I. Nassar
- Department of Otolaryngology—Head and Neck Surgery, Medical University of South Carolina, Charleston, SC 29425, USA; (S.I.N.); (S.A.N.); (D.A.)
| | - Amber Suk
- Department of Otolaryngology—Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA; (A.S.); (J.P.)
| | - Shaun A. Nguyen
- Department of Otolaryngology—Head and Neck Surgery, Medical University of South Carolina, Charleston, SC 29425, USA; (S.I.N.); (S.A.N.); (D.A.)
| | - Dauren Adilbay
- Department of Otolaryngology—Head and Neck Surgery, Medical University of South Carolina, Charleston, SC 29425, USA; (S.I.N.); (S.A.N.); (D.A.)
| | - John Pang
- Department of Otolaryngology—Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA; (A.S.); (J.P.)
| | - Cherie-Ann O. Nathan
- Department of Otolaryngology—Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA; (A.S.); (J.P.)
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Agarwal A, Bhatt A, Patel S, Bathla G, Murray J, Rhyner P. Preliminary Results from Retrospective Correlation of Circulating Tumor DNA (ct-DNA) with Imaging for HPV-Positive Oropharyngeal Squamous Cell Carcinoma. AJNR Am J Neuroradiol 2024; 45:1135-1140. [PMID: 38471786 PMCID: PMC11383412 DOI: 10.3174/ajnr.a8242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/08/2024] [Indexed: 03/14/2024]
Abstract
The role of molecular markers is increasingly being recognized for head and neck tumors, ranging from benign lesions like paragangliomas to malignancies like squamous cell carcinomas. Multiple studies have recently validated blood tests for circulating tumor tissue-modified viral human papillomavirus DNA (HPV ct-DNA) for posttreatment surveillance of HPV-driven oropharyngeal squamous cell carcinomas. This technology quantifies fragments of circulating DNA that are shed into the blood stream with very high (>95%) positive and negative predictive values and are also highly sensitive in distinguishing tumor HPV-DNA from a noncancerous source. This study has a cohort of 34 patients with HPV-driven oropharyngeal squamous cell carcinomas, having at least 3 sequential imaging studies and ct-DNA values. The study showed a strong positive correlation between the imaging findings and the ct-DNA level in recurrent HPV-positive oropharyngeal squamous cell carcinomas. Findings also include the 100% negative predictive value of HPV ct-DNA tests to rule out tumor recurrence. At our institution, we are now routinely performing the ct-DNA assay for surveillance of treated HPV oropharyngeal squamous cell carcinomas. Correlation among clinical, radiologic, and biomarker findings are now part of routine discussions during the multidisciplinary tumor boards.
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Affiliation(s)
- Amit Agarwal
- From the Department of Radiology (A.A., A.B., J.M., P.R.). Mayo Clinic, Jacksonville, Florida
| | - Alok Bhatt
- From the Department of Radiology (A.A., A.B., J.M., P.R.). Mayo Clinic, Jacksonville, Florida
| | - Samip Patel
- Department of Otolaryngology (S.P.), Mayo Clinic, Jacksonville, Florida
| | - Girish Bathla
- Department of Radiology (G.B.), Mayo Clinic, Rochester, Minnesota
| | - John Murray
- From the Department of Radiology (A.A., A.B., J.M., P.R.). Mayo Clinic, Jacksonville, Florida
| | - Patricia Rhyner
- From the Department of Radiology (A.A., A.B., J.M., P.R.). Mayo Clinic, Jacksonville, Florida
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Zhang X, Weeramange CE, Hughes BGM, Vasani S, Liu ZY, Warkiani M, Hartel G, Ladwa R, Thiery JP, Kenny L, Breik O, Punyadeera C. Circulating tumour cells predict recurrences and survival in head and neck squamous cell carcinoma patients. Cell Mol Life Sci 2024; 81:233. [PMID: 38780775 PMCID: PMC11116312 DOI: 10.1007/s00018-024-05269-1] [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: 10/22/2023] [Revised: 03/31/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024]
Abstract
Patients with head and neck squamous cell carcinoma (HNSCC) are at a high risk of developing recurrence and secondary cancers. This study evaluates the prognostic and surveillance utilities of circulating tumour cells (CTCs) in HNSCC. A total of 154 HNSCC patients were recruited and followed up for 4.5 years. Blood samples were collected at baseline and follow-up. CTCs were isolated using a spiral microfluid device. Recurrence and death due to cancer were assessed during the follow-up period. In patients with HNSCC, the presence of CTCs at baseline was a predictor of recurrence (OR = 8.40, p < 0.0001) and death (OR= ∞, p < 0.0001). Patients with CTCs at baseline had poor survival outcomes (p < 0.0001). Additionally, our study found that patients with CTCs in a follow-up appointment were 2.5 times more likely to experience recurrence or death from HNSCC (p < 0.05) prior to their next clinical visit. Our study highlights the prognostic and monitoring utilities of CTCs' in HNSCC patients. Early identification of CTCs facilitates precise risk assessment, guiding treatment choices and ultimately enhancing patient outcomes.
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Affiliation(s)
- Xi Zhang
- Saliva & Liquid Biopsy Translational Laboratory, Griffith Institute for Drug Discovery, Griffith University, 46, Don Young Rd, Queensland, QLD, 4111, Australia
- Menzies Health Institute Queensland, School of Medical Science, Griffith University, Gold Coast Campus, Gold coast, QLD, Australia
| | - Chameera Ekanayake Weeramange
- Saliva & Liquid Biopsy Translational Laboratory, Griffith Institute for Drug Discovery, Griffith University, 46, Don Young Rd, Queensland, QLD, 4111, Australia
- Menzies Health Institute Queensland, School of Medical Science, Griffith University, Gold Coast Campus, Gold coast, QLD, Australia
| | - Brett G M Hughes
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
- School of Medicine, University of Queensland, St Lucia, QLD, Australia
| | - Sarju Vasani
- School of Medicine, University of Queensland, St Lucia, QLD, Australia
- Department of Otolaryngology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Zhen Yu Liu
- Saliva & Liquid Biopsy Translational Laboratory, Griffith Institute for Drug Discovery, Griffith University, 46, Don Young Rd, Queensland, QLD, 4111, Australia
- School of Medicine, University of Queensland, St Lucia, QLD, Australia
- Department of Otolaryngology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Majid Warkiani
- School of Biomedical Engineering, Center for Health Technologies (CHT) & Institute for Biomedical Materials & Devices (IBMD), University of Technology Sydney, Sydney, Australia
| | - Gunter Hartel
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Rahul Ladwa
- School of Medicine, University of Queensland, St Lucia, QLD, Australia
- Dept of medical oncology, Princess Alexandra Hospital, Woolloongabba, Australia
| | - Jean Paul Thiery
- Guangzhou Laboratory, Guangzhou International Bio Island, No. 9 XingDaoHuanBei Road, Guangzhou, 510005, Guangdong Province, China
| | - Liz Kenny
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
- School of Medicine, University of Queensland, St Lucia, QLD, Australia
| | - Omar Breik
- School of Medicine, University of Queensland, St Lucia, QLD, Australia
| | - Chamindie Punyadeera
- Saliva & Liquid Biopsy Translational Laboratory, Griffith Institute for Drug Discovery, Griffith University, 46, Don Young Rd, Queensland, QLD, 4111, Australia.
- Menzies Health Institute Queensland, School of Medical Science, Griffith University, Gold Coast Campus, Gold coast, QLD, Australia.
- Translational Research Institute, Woolloongabba, Brisbane, Australia.
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Akhtar A, Akhtar R. Response to " impact of tumor subsite on survival outcomes in oral squamous cell carcinoma: A retrospective cohort study from 2000 to 2019″. Oral Oncol 2024; 152:106777. [PMID: 38552468 DOI: 10.1016/j.oraloncology.2024.106777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 03/24/2024] [Indexed: 05/01/2024]
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Cavalieri S, Bruno E, Serafini MS, Lenoci D, Canevari S, Lopez-Perez L, Hernandez L, Mariani L, Miceli R, Gavazzi C, Pasanisi P, Rosso E, Cordero F, Bossi P, Golusinski W, Dietz A, Strojan P, Fuereder T, De Cecco L, Licitra L. Dietary intervention for tertiary prevention in head and neck squamous cell carcinoma survivors: clinical and translational results of a randomized phase II trial. Front Oncol 2024; 13:1321174. [PMID: 38239654 PMCID: PMC10794719 DOI: 10.3389/fonc.2023.1321174] [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: 10/13/2023] [Accepted: 12/04/2023] [Indexed: 01/22/2024] Open
Abstract
Background There is a strong need for preventive approaches to reduce the incidence of recurrence, second cancers, and late toxicities in head and neck squamous cell carcinoma (HNSCC) survivors. We conducted a randomized controlled trial (RCT) to assess a dietary intervention as a non-expensive and non-toxic method of tertiary prevention in HNSCC survivors. Methods Eligible participants were disease-free patients with HNSCC in follow-up after curative treatments. Subjects were randomized 1:1 to receive a highly monitored dietary intervention plus the Word Cancer Research Fund/American Institute for Cancer Research recommendations for cancer prevention (intervention arm) or standard-of-care recommendations (control arm). The planned sample size for the event-free survival evaluation (primary endpoint) was not reached, and the protocol was amended in order to investigate the clinical (nutritional and quality-of-life questionnaires) and translational study [plasma-circulating food-related microRNAs (miRNAs)] as main endpoints, the results of which are reported herein. Results One hundred patients were screened, 94 were randomized, and 89 were eligible for intention-to-treat analysis. Median event-free survival was not reached in both arms. After 18 months, nutritional questionnaires showed a significant increase in Recommended Food Score (p = 0.04) in the intervention arm vs. control arm. The frequency of patients with and without a clinically meaningful deterioration or improvement of the C30 global health status in the two study arms was similar. Food-derived circulating miRNAs were identified in plasma samples at baseline, with a significant difference among countries. Conclusion This RCT represented the first proof-of-principle study, indicating the feasibility of a clinical study based on nutritional and lifestyle interventions in HNSCC survivors. Subjects receiving specific counseling increased the consumption of the recommended foods, but no relevant changes in quality of life were recorded between the two study arms. Food-derived plasma miRNA might be considered promising circulating dietary biomarkers.
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Affiliation(s)
- Stefano Cavalieri
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Eleonora Bruno
- Nutrition Research and Metabolomics, Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Mara Serena Serafini
- Integrated Biology of Rare Tumors Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Deborah Lenoci
- Integrated Biology of Rare Tumors Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Laura Lopez-Perez
- Universidad Politecnica de Madrid-Life Supporting Technologies Research Group, ETSIT, Madrid, Spain
| | - Liss Hernandez
- Universidad Politecnica de Madrid-Life Supporting Technologies Research Group, ETSIT, Madrid, Spain
| | - Luigi Mariani
- Biostatistics for Clinical Research Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Rosalba Miceli
- Biostatistics for Clinical Research Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Cecilia Gavazzi
- Clinical Nutrition Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Patrizia Pasanisi
- Nutrition Research and Metabolomics, Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Elena Rosso
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Computer Science, University of Torino, Torino, Italy
| | | | - Paolo Bossi
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Wojciech Golusinski
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Andreas Dietz
- Department of Otolaryngology, Head and Neck Surgery, Universitätsklinikum, Leipzig, Germany
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Thorsten Fuereder
- Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Loris De Cecco
- Integrated Biology of Rare Tumors Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lisa Licitra
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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van de Weerd C, Geurts SME, Vercoulen RJMT, van Veggel IHF, Brands MT, Marres HAM, Hermens RPMG, van Tol-Geerdink JJ, Kaanders JHAM, Takes RP. Value of routine follow-up for recurrence detection after treatment with curative intent for laryngeal squamous cell carcinoma. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:107304. [PMID: 38043360 DOI: 10.1016/j.ejso.2023.107304] [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: 07/25/2023] [Revised: 10/30/2023] [Accepted: 11/24/2023] [Indexed: 12/05/2023]
Abstract
INTRODUCTION The benefits of routine follow-up after treatment of primary laryngeal squamous cell carcinoma (LSCC) remain disputed. Guidelines worldwide are consensus-based, and evidence for specific subgroups is lacking. This study evaluates routine LSCC follow-up including flexible endoscopy for detecting locoregional recurrence (LRR). METHODS A retrospective cohort of 413 LSCC patients treated between 2006 and 2012 was analysed. The cumulative risk of LRR was calculated. Routine follow-up was evaluated by follow-up visit (routine or interval) at which LRR was detected, LRR treatment intent, and overall survival (OS). Analyses were stratified by early (I-II) and advanced (III-IV) TNM-stage. RESULTS There were 263 (64 %) patients with early-stage and 132 (32 %) patients with advanced-stage LSCC. One-, two- and five-year cumulative risks for LRR after early-stage LSCC were 8 %, 18 %, and 26 %. For advanced-stage LSCC, cumulative risks of LRR were 20 %, 30 %, and 35 %. Of all 69 LRRs after early-stage LSCC, 72 % were routine-detected, 81 % were symptomatic, and 90 % received curative-intent treatment. Of all 45 LRRs following advanced-stage LSCC, 42 % were routine-detected, 84 % were symptomatic, and 62 % received curative-intent treatment. Five-year OS of early-stage LSCC with routine-detected LRR was 70 %, and 72 % for interval-detection (log-rank-p = 0.91). Five-year OS of advanced-stage LSCC with routine-detected LRR was 37 %, and 18 % for interval-detection (log-rank-p = 0.06). CONCLUSIONS Routine follow-up for detecting asymptomatic recurrences seems redundant for early-stage LSCC. After advanced-stage LSCC, no asymptomatic recurrences were detected beyond one year posttreatment despite regular follow-up. Emphasis should be on other follow-up aspects, such as psychosocial support, especially after one year posttreatment.
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Affiliation(s)
- Cecile van de Weerd
- Radboud University Medical Center, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, the Netherlands.
| | - Sandra M E Geurts
- Maastricht University Medical Center, Department of Medical Oncology, GROW School for Oncology and Reproduction, Maastricht, the Netherlands
| | - Richard J M T Vercoulen
- Radboud University Medical Center, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, the Netherlands
| | - Inge H F van Veggel
- Radboud University Medical Center, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, the Netherlands
| | - Maria T Brands
- Hospital Network Antwerp, Middelheim Medical Center, Department of Oral and Maxillofacial Surgery, Antwerp, Belgium
| | - Henri A M Marres
- Radboud University Medical Center, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, the Netherlands
| | - Rosella P M G Hermens
- Radboud University Medical Center, Department of IQ Healthcare, Nijmegen, the Netherlands
| | | | - Johannes H A M Kaanders
- Radboud University Medical Center, Department of Radiation Oncology, Nijmegen, the Netherlands
| | - Robert P Takes
- Radboud University Medical Center, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, the Netherlands
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Gaffney J, Ramzan A, Dinizulu T, Maley C, Onamusi O, Motamedi-Ghahfarokhi G, Price G, Metcalf R, Garcez K, Hughes C, Lee L, Thomson D, Price J, Jain Y, McPartlin A. Association of follow-up imaging frequency with temporal incidence and patterns of distant failure following (chemo) radiotherapy for HPV related oropharyngeal cancer. Oral Oncol 2024; 148:106645. [PMID: 37992488 DOI: 10.1016/j.oraloncology.2023.106645] [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: 07/24/2023] [Revised: 11/17/2023] [Accepted: 11/19/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVES Emerging data supports radical intent therapy for oligometastatic (OM) relapsed human papilloma virus (HPV+) related oropharyngeal cancer (OPC). We assess the association of follow-up imaging frequency amongst HPV + OPC, with temporal and spatial patterns of distant relapse, to inform rationalisation of routine post-treatment imaging. MATERIALS AND METHODS A retrospective single centre cohort study was carried out of consecutive HPV + OPC patients treated with radical intent (chemo)radiotherapy ((CT)RT) between 2011 and 2019. OM state was defined as ≤ 5 metastasis, none larger than 3 cm (OMs) or, if interval from last negative surveillance imaging > 6-months, then ≤ 10 metastasis, none larger than 5 cm, (OMp). Patients not meeting OMs / OMp criteria were deemed to have incurable diffuse metastatic disease (DMdiffuse). RESULTS 793 HPV-OPC patients were identified with median follow-up 3.15years (range 0.2-8.9). 52 (6.6 %) patients had radiologically identified DM at first failure and were considered for analysis. The median time to recurrence was 15.1 months (range: 2.6-63 months). 87 % of distant metastasis (DM) occurred in the first two years after treatment. Twenty-seven (52 %) patients had OM (OMs or OMp) at time of failure, with 31 % having OMs. The median time from completion of treatment to diagnosis of DMdiffuse vs OM was 22.2 months (range: 2.6-63.1 months) vs 11.6 months (range: 3.5-32.5 months). The probability of being diagnosed with OM vs DMdiffuse increased with reducing interval from last negative surveillance scan to imaging identifying DM (≤6 months 88.9 %, 7-12 months 71.4 %, 13-24 months 35 %, > 24 months 22.2 %). CONCLUSION We demonstrate that a reduced interval between last negative imaging and subsequent radiological diagnosis of DM is associated with increased likelihood of identification of OM disease. Consideration of increased frequency of surveillance imaging during the first two years of follow up is supported, particularly for patients at high risk of distant failure.
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Affiliation(s)
- John Gaffney
- The Christie NHS Foundation Trust, Manchester, UK.
| | | | | | | | | | | | - Gareth Price
- The Christie NHS Foundation Trust, Manchester, UK; The University of Manchester, Manchester, UK
| | | | - Kate Garcez
- The Christie NHS Foundation Trust, Manchester, UK
| | | | - Lip Lee
- The Christie NHS Foundation Trust, Manchester, UK
| | | | - James Price
- The Christie NHS Foundation Trust, Manchester, UK; The University of Manchester, Manchester, UK
| | - Yatin Jain
- The Christie NHS Foundation Trust, Manchester, UK
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Newman S, Cowart JH, Omar N, Martin E, Byrd JK. HPV-associated oropharyngeal Adenosquamous carcinoma with early metastatic disease detected by ctDNA. Oral Oncol 2023; 145:106526. [PMID: 37482044 DOI: 10.1016/j.oraloncology.2023.106526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/25/2023]
Abstract
Adenosquamous Carcinoma is a rare, aggresssive variant of squamous cell carcinoma that may HPV-driven in the oropharynx. Although it is reported to behave similar to HPV-related squamous cell carcinoma, the literature is very limited for this disease. We present a case of early T and N stage HPV + adenosquamous carcinoma of the tonsil that metastasized immediately following surgery and adjuvant therapy despite only having microscopic nodal burden. Circulating tumor DNA (ctDNA) was instrumental in recognizing and salvaging metastatic disease early with radiation.
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Affiliation(s)
- Samantha Newman
- Department of Otolaryngology Head and Neck Surgery, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - J Harrison Cowart
- Department of Otolaryngology Head and Neck Surgery, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Nivin Omar
- Department of Pathology, Medical College of Georgia at Augusta University, Augusta GA, United States
| | - Elizabeth Martin
- Department of Pathology and Lab Medicine, West Virginia University Health Sciences Center, Morgantown, WV, United States
| | - J Kenneth Byrd
- Department of Otolaryngology Head and Neck Surgery, Medical College of Georgia at Augusta University, Augusta, GA, United States.
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Sankar V, Xu Y. Oral Complications from Oropharyngeal Cancer Therapy. Cancers (Basel) 2023; 15:4548. [PMID: 37760517 PMCID: PMC10526346 DOI: 10.3390/cancers15184548] [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: 08/15/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Post-oropharyngeal cancer treatment complications include a multitude of oral side effects that impact overall survival and quality of life. These include acute and chronic conditions affecting the oral cavity and head and neck, such as mucositis, infection, xerostomia, dysgeusia, radiation caries, osteonecrosis, and trismus. This review will summarize the most common oral complications from oropharyngeal cancer therapy. The authors would like to point out that the literature cited frequently combines oropharyngeal and head and neck cancer results. If recommendations are made strictly related to oropharyngeal cancers, this will be highlighted.
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Affiliation(s)
- Vidya Sankar
- Department of Diagnostic Sciences, Tufts University School of Dental Medicine, Boston, MA 02111, USA;
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