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Li J, Rao Y, Wang X, Yu L, Qiu K, Mao M, Song Y, Pang W, Cheng D, Zhang Y, Feng L, Wang X, Shao X, Luo Y, Zheng Y, Li X, Xu Y, Xu W, Zhao Y, Ren J. Prognostic effects of previous cancer history on patients with major salivary gland cancer. Oral Dis 2024; 30:492-503. [PMID: 36740958 DOI: 10.1111/odi.14530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/23/2023] [Accepted: 02/02/2023] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To explore the prognostic effects of previous cancer history on patients with major salivary gland cancer (SGC). SUBJECTS AND METHODS SGC patients with (sec-SGC) and without (one-SGC) a previous cancer from the SEER database were identified. Cox proportional hazards regression (CoxPH) models were used to compare the prognosis between sec-SGC and one-SGC patients. Subgroup analyses for sec-SGC patients by gender, previous cancer types, previous cancer histology, and cancer diagnosis interval (CDI) were performed. Two CoxPH models were constructed to distinguish sec-SGC patients with different prognostic risks. RESULTS 9098 SGC patients were enrolled. Overall, sec-SGC patients (adjusted HR [aHR] = 1.26, p < 0.001), especially those with a CDI ≤ 5 years (aHR = 1.47, p < 0.001), had worse overall survival (OS) than one-SGC patients. In subgroup analysis, only sec-SGC patients with a previous head and neck cancer who were female (aHR = 2.38, p = 0.005), with a CDI ≤ 5 years (aHR = 1.65, p = 0.007) or with a previous squamous cell carcinoma (aHR = 6.52, p < 0.001) had worse OS. Our models successfully differentiated all sec-SGC patients into high-, intermediate- and low-risk groups with different prognosis. CONCLUSIONS Sec-SGC patients with different previous cancer types, gender, CDI and previous cancer histology had varied prognosis. The models we constructed could help differentiate the prognosis of sec-SGC patients with different risks.
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Affiliation(s)
- Junhong Li
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
| | - Yufang Rao
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyu Wang
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
| | - Libo Yu
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
| | - Ke Qiu
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
| | - Minzi Mao
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
| | - Yao Song
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
| | - Wendu Pang
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
| | - Danni Cheng
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
| | - Yuyang Zhang
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
| | - Lan Feng
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
| | - Xinyi Wang
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiuli Shao
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
| | - Yaxin Luo
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yongbo Zheng
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
| | | | | | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Yu Zhao
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jianjun Ren
- Department of Oto-Rhino-Laryngology, West China Hospital, Sichuan University, Chengdu, China
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Department of Oto-Rhino-Laryngology, Langzhong People's Hospital, Langzhong, China
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Patel AM, Haleem A, Maxwell R, Lukens JN, Lin A, Brody RM, Brant JA, Carey RM. Choice of Adjuvant Radiotherapy Facility in Major Salivary Gland Cancer. Laryngoscope 2024. [PMID: 38400788 DOI: 10.1002/lary.31352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/16/2024] [Accepted: 02/05/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVE Undergoing surgery and adjuvant radiotherapy (aRT) at the same facility has been associated with higher overall survival (OS) in head and neck squamous cell carcinoma. Our study investigates whether undergoing surgery and aRT at the same academic facility is associated with higher OS in major salivary gland cancer (MSGC). METHODS The 2006-2018 National Cancer Database was queried for patients with MSGC undergoing surgery at an academic facility and then aRT. Multivariable binary logistic and Cox proportional hazards regression models were implemented. RESULTS Of 2801 patients satisfying inclusion criteria, 2130 (76.0%) underwent surgery and aRT at the same academic facility. Residence in a less populated area (adjusted odds ratio [aOR] 1.69, 95% confidence interval [CI] 1.16-2.45), treatment without adjuvant chemotherapy (aOR 1.97, 95% CI 1.41-2.76), and aRT duration (aOR 1.02, 95% CI 1.01-1.04) were associated with undergoing surgery and aRT at different facilities on multivariable logistic regression adjusting for patient demographics, clinicopathologic features, and adjuvant therapy (p < 0.01). Five-year OS was higher in patients undergoing surgery and aRT at the same academic facility (68.8% vs. 61.9%, p < 0.001). Undergoing surgery and aRT at different facilities remained associated with worse OS on multivariable Cox regression (aHR 1.41, 95% CI 1.10-1.81, p = 0.007). CONCLUSION Undergoing surgery and aRT at the same academic facility is associated with higher OS in MSGC. Although undergoing surgery and aRT at the same academic facility is impractical for all patients, academic physicians should consider same-facility treatment for complex patients who would most benefit from clear multidisciplinary communication. LEVEL OF EVIDENCE 4 Laryngoscope, 2024.
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Affiliation(s)
- Aman M Patel
- Department of Otolaryngology, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A
| | - Afash Haleem
- Department of Otolaryngology, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A
| | - Russell Maxwell
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - John N Lukens
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Alexander Lin
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Robert M Brody
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
- Department of Otolaryngology, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, U.S.A
| | - Jason A Brant
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
- Department of Otolaryngology, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, U.S.A
| | - Ryan M Carey
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
- Department of Otolaryngology, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, U.S.A
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Hanania AN, Zhang X, Gunn GB, Rosenthal DI, Garden AS, Fuller CD, Phan J, Reddy JP, Moreno A, Chronowski G, Shah S, Ausat N, Hanna E, Ferrarotto R, Frank SJ. Proton Therapy for Major Salivary Gland Cancer: Clinical Outcomes. Int J Part Ther 2021; 8:261-272. [PMID: 34285952 PMCID: PMC8270094 DOI: 10.14338/ijpt-20-00044.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/23/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose To report clinical outcomes in terms of disease control and toxicity in patients with major salivary gland cancers (SGCs) treated with proton beam therapy. Materials and Methods Clinical and dosimetric characteristics of patients with SGCs treated from August 2011 to February 2020 on an observational, prospective, single-institution protocol were abstracted. Local control and overall survival were calculated by the Kaplan-Meier method. During radiation, weekly assessments of toxicity were obtained, and for patients with ≥ 90 days of follow-up, late toxicity was assessed. Results Seventy-two patients were identified. Median age was 54 years (range, 23-87 years). Sixty-three patients (88%) received postoperative therapy, and nine patients (12%) were treated definitively. Twenty-six patients (36%) received concurrent chemotherapy. Nine patients (12%) had received prior radiation. All (99%) but one patient received unilateral treatment with a median dose of 64 GyRBE (relative biological effectiveness) (interquartile range [IQR], 60-66), and 53 patients (74%) received intensity-modulated proton therapy with either single-field or multifield optimization. The median follow-up time was 30 months. Two-year local control and overall survival rates were 96% (95% confidence interval [CI] 85%-99%) and 89% (95% CI 76%-95%], respectively. Radiation dermatitis was the predominant grade-3 toxicity (seen in 21% [n = 15] of the patients), and grade ≥ 2 mucositis was rare (14%; n = 10 patients). No late-grade ≥ 3 toxicities were reported. Conclusion Proton beam therapy for treatment of major SGCs manifests in low rates of acute mucosal toxicity. In addition, the current data suggest a high rate of local control and minimal late toxicity.
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Affiliation(s)
- Alexander N Hanania
- Department of Radiation Oncology, Baylor College of Medicine, Houston, TX, USA.,Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xiaodong Zhang
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - G Brandon Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David I Rosenthal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Adam S Garden
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C David Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jack Phan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jay P Reddy
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Amy Moreno
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gregory Chronowski
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shalin Shah
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Noveen Ausat
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ehab Hanna
- Department of Head and Neck Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Renata Ferrarotto
- Department of Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Steven J Frank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Li Y, Ju J, Liu X, Gao T, Wang Z, Ni Q, Ma C, Zhao Z, Ren Y, Sun M. Nomograms for predicting long-term overall survival and cancer-specific survival in patients with major salivary gland cancer: a population-based study. Oncotarget 2018; 8:24469-24482. [PMID: 28160551 PMCID: PMC5421863 DOI: 10.18632/oncotarget.14905] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 01/04/2017] [Indexed: 12/22/2022] Open
Abstract
In this study, we aimed to develop and validate nomograms for predicting long-term overall survival (OS) and cancer-specific survival (CSS) in major salivary gland cancer (MSGC) patients. These nomograms were developed using a retrospective cohort (N=4218) from the Surveillance, Epidemiology, and End Results (SEER) database, and externally validated using an independent data cohort (N=244). We used univariate, and multivariate analyses, and cumulative incidence function to select the independent prognostic factors of OS and CSS. Index of concordance (c-index) and calibration plots were used to estimate the nomograms’ predictive accuracy. The median follow-up period was 34 months (1–119 months). Of 4218 MSGC patients, 1320 (31.3%) died by the end of the follow-up; of these 1320 patients, 883 (20.9%) died of MSGC. The OS nomogram, which had a c-index of 0.817, was based on nine variables: age, sex, tumor site, tumor grade, surgery performed, radiation therapy and TNM classifications. The CSS nomogram, which had a c-index of 0.829, was based on the same nine variables plus race. External validation c-indexes were 0.829 and 0.807 for OS and CSS, respectively. Based on SEER database, we have developed nomograms predicting five- and eight-years OS and CSS for MSGC patients with perfect accuracy. These nomograms will help clinicians customize treatment and monitoring strategies in MSGC patients.
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Affiliation(s)
- Yun Li
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Jun Ju
- Department of Otolaryngology Head and Neck Surgery, Navy General Hospital, Beijing, China
| | - Xiaoxiao Liu
- Department of Stomatology, Fengtai Hospital, Peking University First Hospital, Beijing, China
| | - Tao Gao
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China.,Department of Stomatology, The First Hospital of Yu Lin, Shaanxi, China
| | - Zhidong Wang
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, Xi'an, China
| | - Qianwei Ni
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Chao Ma
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Zhenyan Zhao
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Yixiong Ren
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Moyi Sun
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
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Lu CH, Liu CT, Chang PH, Hung CY, Li SH, Yeh TS, Hung YS, Chou WC. Develop and validation a nomogram to predict the recurrent probability in patients with major salivary gland cancer. J Cancer 2017; 8:2247-2255. [PMID: 28819427 PMCID: PMC5560142 DOI: 10.7150/jca.19461] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/18/2017] [Indexed: 12/26/2022] Open
Abstract
Objectives: Prediction of recurrent risk in patients with major salivary gland carcinoma (MSGC) after surgical treatment is an important but difficult task because of a broad spectrum of tumor histological subtypes and diverse clinical behaviors. This study aimed to develop and validate a nomogram to predict the recurrent probability in patients with MSGC. Methods: A total of 231 consecutive patients with MSGC received curative-intend surgery between 2002 and 2014 from one medical center were selected as the training set. Clinicopathologic variables with the most significant values in the multivariate Cox regression were selected to build into a nomogram to estimate the recurrence probability. An independent validation set of 139 patients treated at the same period from 3 other hospitals were selected for external validation and calibration. Results: The nomogram was developed on six significant predictive factors, including the smoking history, tumor grade, perineural invasion, lymphatic invasion, pathologic T- and N-classification, of tumor recurrence retained in the multivariate Cox model. The nomogram had a highly predictive performance, with a bootstrapped corrected concordance index of 0.82 for the training set and 0.78 for the validation set. The nomogram showed good calibration in predict 2-year and 5-year recurrence probability both in the training and validation set. Conclusions: We developed and externally validated an accurate nomogram for prediction the tumor recurrence probability of patients with MSGC after surgical treatment. This nomogram may be used to assist clinician and patient in elaborating the recurrent risk and making decision for appropriate adjuvant treatment.
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Affiliation(s)
- Chang-Hsien Lu
- Department of Hematology-Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chien-Ting Liu
- Department of Hematology-Oncology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Pei-Hung Chang
- Department of Hematology-Oncology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chia-Yen Hung
- Department of Hematology-Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Shau-Hsuan Li
- Department of Hematology-Oncology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Ta-Sen Yeh
- Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taiwan
| | - Yung-Shin Hung
- Department of Hematology-Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Wen-Chi Chou
- Department of Hematology-Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taiwan
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Xiao CC, Baker AB, White-Gilbertson SJ, Day TA. Prognostic Factors in Myoepithelial Carcinoma of the Major Salivary Glands. Otolaryngol Head Neck Surg 2016; 154:1047-53. [PMID: 27048677 DOI: 10.1177/0194599816637605] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 02/16/2016] [Indexed: 01/29/2023]
Abstract
OBJECTIVES (1) Identify all cases of myoepithelial carcinoma of the major salivary glands from the National Cancer Data Base (NCDB). (2) Analyze the effect of grade, stage, and regional nodal metastasis on survival in myoepithelial carcinoma of the major salivary glands. STUDY DESIGN Retrospective review of NCDB. SETTING Multicenter data pooled from 1998 to 2012 in the NCDB. METHODS We identified all reported cases of myoepithelial carcinomas of the major salivary glands from the United States from 1998 to 2012 in the NCDB. Clinical parameters were then examined and analyzed for predictors of survival. RESULTS A total of 473 cases of myoepithelial carcinoma were identified. Of the reported cases, 38.1% were low grade; 26.7%, intermediate grade; and 35.2%, high grade. When presenting stage was examined, 24.4% were stage I; 30.6%, stage II; 22.5%, stage III; 12.2%, stage IVa; 3.0%, stage IVb; and 4.1%, stage IVc. At presentation, 18.7% of patients had regional nodal disease, and 4.5% had distant metastases. The 3- and 5-year survival rates were 73% and 64%, respectively. The presence of nodal disease significantly reduced mean survival time versus those without (64 vs 108 months, P < .001), as did high-grade disease compared with low grade (67 vs 114 months, P < .001) and stage III/IV compared with stage I/II disease (61 vs 118 months, P < .001). CONCLUSIONS The presence of regional nodal disease, high-grade disease, and advanced stage are predictors of lower survival in myoepithelial carcinoma. Further studies based on types of treatment are warranted.
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Affiliation(s)
- Christopher C Xiao
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Andrew B Baker
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Shai J White-Gilbertson
- Cancer Registry, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Terry A Day
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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