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Tsai T, Chiang P, Yap W, Huang Y, See A, Hung S, Lu C, Lin C, Chang TJ, Kao H, Chang K. Postoperative radiotherapy versus surgery alone in pN1 oral cavity cancer patients: A meta-analysis. Laryngoscope Investig Otolaryngol 2024; 9:e1260. [PMID: 38751691 PMCID: PMC11094775 DOI: 10.1002/lio2.1260] [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] [Received: 12/30/2023] [Revised: 02/13/2024] [Accepted: 04/28/2024] [Indexed: 05/18/2024] Open
Abstract
Objectives The aim of this meta-analysis is to evaluate the potential benefits of postoperative radiotherapy (PORT) in patients with pN1 oral cavity squamous cell carcinoma. Methods A literature search through major databases was conducted until January 2023. The adjusted hazard ratio (aHR) or risk ratio (RR) with 95% confidence intervals (CIs) of different survival outcomes were extracted and pooled. Results Ten studies published between 2005 and 2022, with a pooled patient population of 2888, were included in this meta-analysis. Due to differences in study design and reported outcomes, the studies were categorized into distinct groups. In pN1 patients without extranodal extension (ENE), PORT was associated with a significant improvement in overall survival (OS) (aHR 0.76, 95% CI: 0.61-0.94). In pN1 patients without ENE and positive margins, PORT improved OS (aHR 0.71, 95% CI: 0.56-0.89) and was associated with a lower regional recurrence rate (RR 0.35, 95% CI: 0.15-0.83). However, in pN1 patients without ENE, positive margins, perineural invasion, and lymphovascular invasion, there were no significant differences observed between the PORT and observation groups in either 5-year OS (RR 0.48, 95% CI: 0.07-3.41) or 5-year disease-free survival (RR 0.37, 95% CI: 0.07-2.06). Conclusions The current study demonstrated that PORT has the potential to improve OS in pN1 disease. However, the decision of whether to administer PORT still hinges on diverse clinical scenarios, and additional research is necessary to furnish a more conclusive resolution. Level of Evidence 2.
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Affiliation(s)
- Tsung‐You Tsai
- Department of Otolaryngology—Head and Neck SurgeryChang Gung Memorial HospitalTaoyuanTaiwan
| | - Pin‐Chun Chiang
- Department of Otolaryngology—Head and Neck SurgeryChang Gung Memorial HospitalTaoyuanTaiwan
- College of MedicineChang Gung UniversityTaoyuanTaiwan
| | - Wing‐Keen Yap
- Proton and Radiation Therapy Center, Chang Gung Memorial Hospital‐Linkou Medical Center, Department of Radiation OncologyChang Gung UniversityTaoyuanTaiwan
| | - Yenlin Huang
- Department of Anatomic PathologyChang Gung Memorial Hospital at Linkou BranchTaoyuanTaiwan
- Institute of Stem Cell and Translation Cancer ResearchChang Gung Memorial Hospital at Linkou BranchTaoyuanTaiwan
- School of MedicineNational Tsing‐Hua UniversityHsinchuTaiwan
| | - Anna See
- Department of Otolaryngology—Head and Neck SurgeryChang Gung Memorial HospitalTaoyuanTaiwan
- Department of Otorhinolaryngology—Head and Neck SurgerySingapore General HospitalSingapore
| | - Shao‐Yu Hung
- Department of Plastic and Reconstructive SurgeryChang Gung Memorial Hospital at Linkou BranchTaoyuanTaiwan
| | - Chuieng‐Yi Lu
- Department of Plastic and Reconstructive SurgeryChang Gung Memorial Hospital at Linkou BranchTaoyuanTaiwan
| | - Chien‐Yu Lin
- Proton and Radiation Therapy Center, Chang Gung Memorial Hospital‐Linkou Medical Center, Department of Radiation OncologyChang Gung UniversityTaoyuanTaiwan
- Department of Medical Imaging and Radiological Sciences, College of MedicineChang Gung UniversityTaoyuanTaiwan
| | - Tung‐Chieh Joseph Chang
- College of MedicineChang Gung UniversityTaoyuanTaiwan
- Proton and Radiation Therapy Center, Chang Gung Memorial Hospital‐Linkou Medical Center, Department of Radiation OncologyChang Gung UniversityTaoyuanTaiwan
| | - Huang‐Kai Kao
- College of MedicineChang Gung UniversityTaoyuanTaiwan
- Department of Plastic and Reconstructive SurgeryChang Gung Memorial Hospital at Linkou BranchTaoyuanTaiwan
| | - Kai‐Ping Chang
- Department of Otolaryngology—Head and Neck SurgeryChang Gung Memorial HospitalTaoyuanTaiwan
- College of MedicineChang Gung UniversityTaoyuanTaiwan
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2
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Robertson IJ, Robbins QC, Li PC. Case of metastatic clear cell odontogenic carcinoma with response to chemoimmunotherapy. BMJ Case Rep 2024; 17:e259568. [PMID: 38684356 PMCID: PMC11146348 DOI: 10.1136/bcr-2023-259568] [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] [Accepted: 04/18/2024] [Indexed: 05/02/2024] Open
Abstract
Our patient initially presented with 6 months of left jaw pain and gingival bleeding, leading to the discovery of a radiolucent left maxillary mass on dental evaluation. A biopsy confirmed clear cell odontogenic carcinoma, and the patient was treated with definitive surgery and radiation for localised disease. Unfortunately, the patient was found to have pulmonary metastases 3 months after initial management and was subsequently treated with a combination of cytotoxic chemotherapy and immunotherapy with a partial response. To our knowledge, this is the first case demonstrating the successful use of chemoimmunotherapy in metastatic clear cell odontogenic carcinoma.
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Affiliation(s)
- Ian J Robertson
- Internal Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Quinn C Robbins
- Oral and Maxillofacial Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Peter C Li
- Hematology/Oncology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
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Su MJ, Ho CH, Yeh CC. Association of alcohol consumption, betel nut chewing, and cigarette smoking with mortality in patients with head and neck cancer among the Taiwanese population: A nationwide population-based cohort study. Cancer Epidemiol 2024; 89:102526. [PMID: 38266595 DOI: 10.1016/j.canep.2024.102526] [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: 09/23/2023] [Revised: 12/26/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVES This study investigated the association of alcohol consumption, betel nut chewing, and cigarette smoking (ABC) with mortality in patients with head and neck cancer (HNC). This nationwide population-based cohort study determined whether ABC habits were associated with overall or cancer-specific mortality in patients with HNC in Taiwan. METHODS Data from the Taiwan Cancer Registry and Taiwan's National Health Insurance Research Database were used to identify patients with HNC from 2011 to 2017. All the identified patients were monitored until the date of death or the end of 2017. Poisson regression models were employed to estimate the incidence rate ratios (IRRs) and 95% confidence intervals (CIs) associated with the effect of ABC habits on mortality. RESULTS A total of 31,246 patients with HNC were analyzed in this study. The results revealed that betel nut chewing alone exhibited the strongest effect, significantly increasing the risk of overall mortality (adjusted IRR = 1.44, 95% CI = 1.27-1.63). Additionally, betel nut chewing alone was significantly associated with cancer-specific mortality (adjusted IRR = 1.51, 95% CI = 1.30-1.44). Stratified analyses by sex and tumor location indicated that the effect of betel nut chewing alone on overall or cancer-specific mortality remained significant across both sexes, and among patients with oral cancer and patients with oropharyngeal cancer. CONCLUSIONS ABC habits, particularly betel nut chewing, are significantly associated with diminished survival rates in patients with HNC. Accordingly, the implementation of an integrated campaign targeting the prevention of betel nut chewing would be one of the effective public health strategies for improving outcomes for HNC patients.
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Affiliation(s)
- Ming-Jang Su
- School of Public Health, College of Public Health, Taipei Medical University, New Taipei City, Taiwan; Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan; Department of Clinical Pathology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, Tainan City, Taiwan; Department of Information Management, Southern Taiwan University of Science and Technology, Tainan City, Taiwan
| | - Chih-Ching Yeh
- School of Public Health, College of Public Health, Taipei Medical University, New Taipei City, Taiwan; Cancer Center, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung City, Taiwan; Master Program in Applied Epidemiology, College of Public Health, Taipei Medical University, New Taipei City, Taiwan.
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Chang CC, Wu YT, Lu HH, Cheng YJ, Tsai MH. The role of postoperative radiotherapy or chemoradiation in pT1-2N1M0 oral squamous cell carcinoma. J Formos Med Assoc 2024:S0929-6646(24)00150-5. [PMID: 38514372 DOI: 10.1016/j.jfma.2024.03.005] [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: 06/06/2023] [Revised: 02/29/2024] [Accepted: 03/10/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Postoperative radiotherapy (PORT) and concurrent chemoradiation (CCRT) are indicated for patients with advanced oral cancer. However, the benefits for pT1-2N1 disease without adverse pathological features are controversial. METHODS This retrospective study using the Taiwan Cancer Registry database included patients with pT1-2N1 oral cancer from January 1, 2011, to December 31, 2017. Overall survival was analyzed in patients receiving surgery alone, PORT, or CCRT. RESULTS Among the 862 patients, the five-year overall survival rate in patients receiving surgery alone, PORT, and CCRT was 62.2%, 58.7%, and 71.1% (P = 0.03), respectively. CCRT was associated with longer survival than PORT (P = 0.008). Survival in patients with pT2 disease was significantly higher with CCRT than PORT (P = 0.001), but no difference was observed in pT1 disease. CONCLUSION CCRT demonstrated a favorable impact on survival outcomes in patients diagnosed with pT2N1 oral cancer when compared to PORT. However, no significant survival benefits were observed for patients with pT1 disease.
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Affiliation(s)
- Chan-Chi Chang
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yin-Ting Wu
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsi-Huei Lu
- Division of Nuclear Medicine, Department of Medical Imaging, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yung-Jen Cheng
- Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mu-Hung Tsai
- Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan.
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Wang W, Wang Y, Zeng W, Xie X, Li C, Zhou Q, Shen L. Prognostic factors in surgically treated tongue squamous cell carcinoma in stage T1-2N0-1M0: A retrospective analysis. Cancer Med 2024; 13:e7016. [PMID: 38400675 PMCID: PMC10891452 DOI: 10.1002/cam4.7016] [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: 08/22/2023] [Revised: 11/20/2023] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
PURPOSE The study aimed to retrospectively identify the prognostic factors of surgically treated primary tongue squamous cell carcinoma (TSCC) cases and assess the benefits of surgical neck lymph node dissection (LND) in early-stage cancer. METHODS Patients with primary TSCC with pT1-2N0-1M0 stage without distant metastasis who were treated with surgery during 2014-2016 at Xiangya Hospital, Central South University were included. Univariate and multivariate Cox models were constructed to explore prognostic factors of overall survival (OS), disease-free survival (DFS), and local recurrence-free survival (LRFS). Sub-group analysis was used to assess the effect of adjuvant therapy and the prognostic value of LND for the early-stage patients. RESULTS In total, 440 patients met the inclusion criteria. During the follow-up period, the 5-year OS, DFS, were 84.4% and 70.0%, respectively. Univariate analysis showed that TNM stage, lymphovascular invasion (LVI), and/or perineural invasion (PNI), pathological differentiation, etc. were significant predictors of OS and DFS. Multivariate analysis showed that TNM stage and the degree of pathological differentiation were independent prognostic factors for all outcomes. Besides, the number of cervical LND could independently predict both DFS and LRFS while LVI/PNI were associated with DFS. And high-quality neck LND (≥30) significantly improved DFS and LRFS for patients of pT1cN0M0 or stage I as compared to those without LND. CONCLUSIONS TNM stage and pathological differentiation were crucial prognostic factors for postoperative patients with TSCC. Notably, high-quality cervical LND was beneficial for the improvement of DFS and LRFS for patients of pT1cN0M0 or stage I.
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Affiliation(s)
- Wenxi Wang
- Department of Oncology, Xiangya HospitalCentral South UniversityChangshaHunan ProvinceChina
| | - Yuxiang Wang
- Department of Radiation OncologyFourth Hospital of Hebei Medical UniversityShijiazhuangHebei ProvinceChina
| | - Wenhui Zeng
- Department of Oncology, Xiangya HospitalCentral South UniversityChangshaHunan ProvinceChina
| | - Xubin Xie
- Department of Oncology, Xiangya HospitalCentral South UniversityChangshaHunan ProvinceChina
| | - Chen Li
- Department of Oncology, Xiangya HospitalCentral South UniversityChangshaHunan ProvinceChina
| | - Qin Zhou
- Department of Oncology, Xiangya HospitalCentral South UniversityChangshaHunan ProvinceChina
| | - Liangfang Shen
- Department of Oncology, Xiangya HospitalCentral South UniversityChangshaHunan ProvinceChina
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Kämmerer PW, Tribius S, Cohrs L, Engler G, Ettl T, Freier K, Frerich B, Ghanaati S, Gosau M, Haim D, Hartmann S, Heiland M, Herbst M, Hoefert S, Hoffmann J, Hölzle F, Howaldt HP, Kreutzer K, Leonhardt H, Lutz R, Moergel M, Modabber A, Neff A, Pietzka S, Rau A, Reichert TE, Smeets R, Sproll C, Steller D, Wiltfang J, Wolff KD, Kronfeld K, Al-Nawas B. Adjuvant Radiotherapy in Patients with Squamous Cell Carcinoma of the Oral Cavity or Oropharynx and Solitary Ipsilateral Lymph Node Metastasis (pN1)—A Prospective Multicentric Cohort Study. Cancers (Basel) 2023; 15:cancers15061833. [PMID: 36980719 PMCID: PMC10047283 DOI: 10.3390/cancers15061833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 03/22/2023] Open
Abstract
(1) Background: Evaluation of impact of adjuvant radiation therapy (RT) in patients with oral squamous cell carcinoma of the oral cavity/oropharynx (OSCC) of up to 4 cm (pT1/pT2) and solitary ipsilateral lymph node metastasis (pN1). A non-irradiated group with clinical follow-up was chosen for control, and survival and quality of life (QL) were compared; (2) Methods: This prospective multicentric comprehensive cohort study included patients with resected OSCC (pT1/pT2, pN1, and cM0) who were allocated into adjuvant radiation therapy (RT) or observation. The primary endpoint was overall survival. Secondary endpoints were progression-free survival and QL after surgery; (3) Results: Out of 27 centers, 209 patients were enrolled with a median follow-up of 3.4 years. An amount of 137 patients were in the observation arm, and 72 received adjuvant irradiation. Overall survival did not differ between groups (hazard ratio (HR) 0.98 [0.55–1.73], p = 0.94). There were fewer neck metastases (HR 0.34 [0.15–0.77]; p = 0.01), as well as fewer local recurrences (HR 0.41 [0.19–0.89]; p = 0.02) under adjuvant RT. For QL, irradiated patients showed higher values for the symptom scale pain after 0.5, two, and three years (all p < 0.05). After six months and three years, irradiated patients reported higher symptom burdens (impaired swallowing, speech, as well as teeth-related problems (all p < 0.05)). Patients in the RT group had significantly more problems with mouth opening after six months, one, and two years (p < 0.05); (4) Conclusions: Adjuvant RT in patients with early SCC of the oral cavity and oropharynx does not seem to influence overall survival, but it positively affects progression-free survival. However, irradiated patients report a significantly decreased QL up to three years after therapy compared to the observation group.
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Affiliation(s)
- Peer W. Kämmerer
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
- Correspondence:
| | - Silke Tribius
- Hermann-Holthusen-Institute for Radiation Oncology, Asklepios Hospital St. Georg, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Lena Cohrs
- Department of Oral & Cranio-Maxillofacial Surgery, University Hospital of Luebeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Gabriel Engler
- Department of Oral and Craniomaxillofacial Plastic Surgery, University of Giessen and Marburg, UKGM, Campus Marburg, Faculty of Medicine, Philipps-University of Marburg, Baldingerstrasse, 35043 Marburg, Germany
| | - Tobias Ettl
- Department of Cranio- and Maxillofacial Surgery, Hospital of the University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Kolja Freier
- Department of Oral and Maxillofacial Surgery, Saarland University Medical Center, Kirrberger Str., 66424 Homburg, Germany
| | - Bernhard Frerich
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Rostock University Medical Center, Schillingallee 35, 18057 Rostock, Germany
| | - Shahram Ghanaati
- Clinic for Maxillofacial and Plastic Surgery, University Hospital Frankfurt, Goethe University, Marienburgstraße 2, 60528 Frankfurt am Main, Germany
| | - Martin Gosau
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251 Hamburg, Germany
| | - Dominik Haim
- Department of Oral and Maxillofacial Surgery, University Hospital Carl Gustav Carus, Fetscherstr. 74, 01307 Dresden, Germany
| | - Stefan Hartmann
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Manuel Herbst
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Rhabanusstraße 4, 55118 Mainz, Germany
| | - Sebastian Hoefert
- Department of Oral and Maxillofacial Surgery, University Hospital of Tübingen, Osianderstraße 2-8, 72076 Tübingen, Germany
| | - Jürgen Hoffmann
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Hans-Peter Howaldt
- Department of Oral and Maxillofacial Surgery, Justus-Liebig-University, Klinikstraße 33, 35392 Gießen, Germany
| | - Kilian Kreutzer
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Henry Leonhardt
- Department of Oral and Maxillofacial Surgery, University Hospital Carl Gustav Carus, Fetscherstr. 74, 01307 Dresden, Germany
| | - Rainer Lutz
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg, Glückstraße 11, 91054 Erlangen, Germany
| | - Maximilian Moergel
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Andreas Neff
- Department of Oral and Craniomaxillofacial Plastic Surgery, University of Giessen and Marburg, UKGM, Campus Marburg, Faculty of Medicine, Philipps-University of Marburg, Baldingerstrasse, 35043 Marburg, Germany
| | - Sebastian Pietzka
- Department of Oral and Maxillofacial Surgery, University Hospital Ulm, Albert-Einstein-Allee 11, 89081 Ulm, Germany
| | - Andrea Rau
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, Fleischmannstraße 8, 17489 Greifswald, Germany
| | - Torsten E. Reichert
- Department of Cranio- and Maxillofacial Surgery, Hospital of the University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251 Hamburg, Germany
| | - Christoph Sproll
- Department of Oral and Maxillofacial Surgery, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Daniel Steller
- Department of Oral & Cranio-Maxillofacial Surgery, University Hospital of Luebeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany
| | - Klaus-Dietrich Wolff
- Department of Oro-Maxillofacial Surgery, University Hospital Rechts der Isar, Technical University of Munich, Langerstraße 3, 81675 München, Germany
| | - Kai Kronfeld
- Interdisciplinary Center for Clinical Trials, University Medical Center of the Johannes Gutenberg University, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
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He L, Guo J, Fan Z, Yang S, Zhang C, Cheng B, Xia J. Exosomal miR-146b-5p derived from cancer-associated fibroblasts promotes progression of oral squamous cell carcinoma by downregulating HIPK3. Cell Signal 2023; 106:110635. [PMID: 36813147 DOI: 10.1016/j.cellsig.2023.110635] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVES Cancer-associated fibroblasts (CAFs) are vital constituents of the tumor microenvironment (TME) and play a predominant role in oral squamous cell carcinoma (OSCC) progression. We aimed to investigate the effect and mechanism of exosomal miR-146b-5p derived from CAFs on the malignant biological behavior of OSCC. MATERIALS AND METHODS Illumina small RNA (sRNA) sequencing was conducted to determine the differential expression patterns of microRNAs (miRNAs) in exosomes derived from CAFs and normal fibroblasts (NFs). Transwell and cell counting kit-8 (CCK-8) assays and xenograft tumor models in nude mice were used to investigate the effect of CAF exosomes and miR-146b-p on the malignant biological behavior of OSCC. Reverse transcription quantitative real-time PCR (qRT-PCR), luciferase reporter, western blotting (WB) and immunohistochemistry assays were employed to investigate the underlying mechanisms involved in CAF exosomes that promote OSCC progression. RESULTS We demonstrated that CAF-derived exosomes were taken up by OSCC cells and enhanced the proliferation, migration, and invasion ability of OSCC. Compared with NFs, the expression of miR-146b-5p was increased in exosomes and their parent CAFs. Further studies showed that the decreased expression of miR-146b-5p inhibited the proliferation, migration and invasion ability of OSCC cells in vitro and the growth of OSCC cells in vivo. Mechanistically, miR-146b-5p overexpression led to the suppression of HIKP3 by directly targeting the 3'-UTR of HIPK3, as confirmed by luciferase assay. Reciprocally, HIPK3 knockdown partially reversed the inhibitory effect of the miR-146b-5p inhibitor on the proliferation, migration, and invasion ability of OSCC cells and restored their malignant phenotype. CONCLUSIONS Our results revealed that CAF-derived exosomes contained higher levels of miR-146b-5p than NFs, and miR-146b-5p overexpression in exosomes promoted the malignant phenotype of OSCC by targeting HIPK3. Therefore, inhibiting exosomal miR-146b-5p secretion may be a promising therapeutic modality for OSCC.
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Affiliation(s)
- Lihong He
- Department of Oral Medicine, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, PR China; Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, PR China
| | - Jiaxin Guo
- Department of Oral Medicine, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, PR China; Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, PR China
| | - Zhaona Fan
- Department of Oral Medicine, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, PR China; Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, PR China
| | - Shiwen Yang
- Department of Oral Medicine, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, PR China; Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, PR China
| | - Chi Zhang
- Department of Oral Medicine, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, PR China; Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, PR China
| | - Bin Cheng
- Department of Oral Medicine, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, PR China; Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, PR China.
| | - Juan Xia
- Department of Oral Medicine, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, PR China; Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, PR China.
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Zhang J, Tan Y, Shou Y, Fang L, Li X, Lai J. The relationship between adjuvant radiotherapy and survival of osteosarcoma: a case-control study. Biotechnol Genet Eng Rev 2023:1-14. [PMID: 36596221 DOI: 10.1080/02648725.2022.2163805] [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: 11/14/2022] [Accepted: 12/23/2022] [Indexed: 01/04/2023]
Abstract
To investigate whether adjuvant radiotherapy (RT) is associated with survival rate of osteosarcoma patients. A total of 3938 osteosarcoma patients between 1975 and 2016 from Surveillance, Epidemiology, and End Results (SEER) database were enrolled in this study. Survival rate was obtained by Kaplan-Meier method, with log-rank test identifying the difference. Multivariate Cox regression analysis was used to explore independent prognostic factors. The 5-year overall survival (OS) and cancer-specific survival (CSS) rates in surgery plus adjuvant RT group and surgery alone group were 38.2%, 66.3% (OS), and 41.6%, 68% (CSS), respectively. Multivariate analysis showed that adjuvant RT served as the independent unfavorable prognostic factor for OS and CSS. Based on the propensity score matching (PSM) method, the patients who received adjuvant RT had a poorer prognosis. Adjuvant RT showed an association with survival of osteosarcoma. Patients who received adjuvant RT had poorer survival. In the clinical use of adjuvant RT for osteosarcoma, the potential for reduced survival should be considered.
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Affiliation(s)
- Jiefeng Zhang
- Department of Orthopaedics, 72nd Group Army Hospital, Huzhou University, Huzhou, China
| | - YiXuan Tan
- Department of Orthopedics, Shanghai Changzheng Hospital, Shanghai, China
| | - Yanwei Shou
- The Third People's Hospital of Yuhang District, Hangzhou, Zhejiang Province, China
| | - Liangqin Fang
- Department of Orthopaedics, 72nd Group Army Hospital, Huzhou University, Huzhou, China
| | - Xiaoming Li
- Department of Orthopaedics, 72nd Group Army Hospital, Huzhou University, Huzhou, China
| | - Jin Lai
- Department of Orthopaedics, 72nd Group Army Hospital, Huzhou University, Huzhou, China
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