Background: Dental prosthetic rehabilitation (DPR) plays a critical role in restoring function and quality of life following mandibular reconstruction. This study examines the rate of patients undergoing dental implants and DPR after reconstruction of a segmental jaw defect with a fibula free flap reconstruction. We identify factors associated with successful dental implants and DPR in this patient population.
View Article and Find Full Text PDFBackground: In the USA, the incidence of thyroid cancer increased rapidly for several decades, although some studies have suggested that it has now plateaued or even begun to decrease. We aimed to establish whether incidence in the USA has truly decreased or merely plateaued, and to understand some of the underlying factors driving these changes.
Methods: We conducted a retrospective, population-based study using the National Cancer Institute (NCI)'s Surveillance, Epidemiology, and End Results database and the National Center for Health Statistics database.
Background: The superior thyroid artery (STA) as a recipient vessel in free flap reconstruction may theoretically impact thyroid function. This study aimed to assess whether the use of the STA has an adverse effect on thyroid function.
Methods: Retrospective review of 101 head and neck reconstructive cases.
Background: As a surrogate of malnutrition, degree of weight loss and recovery from head and neck cancer (HNC) treatment is understudied. The influence of modifiable factors that affect weight, including speech/language pathology (SLP) and nutrition counseling, is also poorly defined. We characterize weight loss trends, baseline weight recovery (BWR), and the impact of interdisciplinary care on oncologic outcomes.
View Article and Find Full Text PDFObjective: Circulating tumor DNA assays have robust potential as molecular surveillance tools. They may also exacerbate patient distress without improving outcomes. We investigate patient acceptability of a validated ctHPVDNA assay (NavDx) during cancer surveillance for HPV(+) oropharyngeal cancer (OPC).
View Article and Find Full Text PDFJAMA Otolaryngol Head Neck Surg
December 2024
Squamous cell carcinomas (SCCs) are common and aggressive malignancies. Immune check point blockade (ICB) therapy using PD-1/PD-L1 antibodies has been approved in several types of advanced SCCs. However, low response rate and treatment resistance are common.
View Article and Find Full Text PDFObjective: To characterize malpractice trends related to active surveillance (AS) as a treatment strategy across cancers.
Background: Active surveillance is increasingly considered a viable management strategy for low-risk cancers. Since a subset of AS cases will progress, metastasize, or exhibit cancer-related mortality, a significant barrier to implementation is the perceived risk of litigation from missing the window for cure.
Substernal thyroid goiters can present with progressive symptoms involving compression of vital structures such as the esophagus, trachea, or large vessels. A multidisciplinary approach is critical when diagnosing and treating these patients. This article discusses patient presentation, workup, and management options for patients with substernal goiter as well as surgical pearls to minimize risk of complications.
View Article and Find Full Text PDFBackground: As one of the most common malignancies, esophageal cancer has two subtypes, squamous cell carcinoma and adenocarcinoma, arising from distinct cells-of-origin. Distinguishing cell-type-specific molecular features from cancer-specific characteristics is challenging.
Results: We analyze whole-genome bisulfite sequencing data on 45 esophageal tumor and nonmalignant samples from both subtypes.
Background: Elective lymph node dissection (ELND) is performed for many early-stage oral cavity squamous cell carcinomas (OCSCC) with clinically negative necks (cN0), often guided by depth of invasion (DOI). However, DOI is less validated in non-tongue OC sites, and often correlates with other adverse features. We sought to evaluate the utility of DOI versus other factors for independently predicting pathologic lymph node positivity (pN+) in patients with cN0 OCSCC.
View Article and Find Full Text PDFBackground: The comparative impact of histologic variants and grade has not been well described.
Methods: Salivary cancer histologies were profiled using hospital and population-based cancer registries. Multivariable models were employed to assess relationships between histology, grade, and survival.
Importance: Unlike for prostate cancer, active surveillance for thyroid cancer has not achieved wide adoption. The parameters by which this approach is feasible are also not well defined, nor is the effect of patient anxiety.
Objective: To determine if expanded size/growth parameters for patients with low-risk thyroid cancer are viable, as well as to assess for cohort differences in anxiety.
Background: Elective neck dissection is a standard of care for pharynx and most larynx cancer patients undergoing surgery, based largely on historical series. It is unclear if this is necessary for all patients in the modern era.
Methods: Patients with cN0 oropharynx, larynx, and hypopharynx cancers diagnosed from 2010-2015 undergoing primary surgery were identified in the National Cancer Data Base.
Curr Opin Endocrinol Diabetes Obes
October 2022
Cytopathological evaluation of thyroid fine-needle aspiration biopsy (FNAB) specimens can fail to raise preoperative suspicion of medullary thyroid carcinoma (MTC). The Afirma RNA-sequencing MTC classifier identifies MTC among FNA samples that are cytologically indeterminate, suspicious, or malignant (Bethesda categories III-VI). In this study we report the development and clinical performance of this MTC classifier.
View Article and Find Full Text PDFPurpose: A better understanding of the relationship between the spread of head and neck squamous cell carcinoma (HNSCC) to regional lymph nodes (LNs) and the frequency and manner of treatment failure should help design better treatment intensification strategies. In this study, we evaluated the relationship between recurrence patterns, mortality, and number of pathologically positive (+) LNs in HNSCC in 3 prospective randomized controlled trials.
Methods And Materials: We performed a secondary analysis of 947 patients with HNSCC enrolled in RTOG 9501 (n = 410), RTOG 0234 (n = 203), and EORTC 22931 (n = 334) undergoing surgery and postoperative radiation ± systemic therapy.
Background: Nodal staging systems vary substantially across solid tumors, implying heterogeneity in the behavior of nodal variables in various contexts. We hypothesized, in contradiction to this, that metastatic lymph node (LN) number is a universal and dominant predictor of outcome across solid tumors.
Methods: We performed a retrospective cohort analysis of 1 304 498 patients in the National Cancer Database undergoing surgery between 2004 and 2015 across 16 solid cancer sites.
JAMA Otolaryngol Head Neck Surg
April 2022