Publications by authors named "Cheng-Ping Wang"

Article Synopsis
  • Extranodal extension (ENE) is included in the cancer staging for hypopharyngeal squamous cell carcinoma (HypoSCC), but its effects on survival rates and treatment effectiveness are not fully understood.
  • A study of 388 HypoSCC patients revealed that those with ENE had much lower 5-year overall survival rates (22.9% with radiological ENE and 40.3% with pathological ENE) compared to those without ENE (55.5%).
  • The research suggests that ENE is a significant risk factor for poorer survival outcomes, and that upfront neck dissection can improve disease-free survival and control in both ENE+ and ENE- patients.
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Background: The prognostic significance of margin-to-depth ratio (MDR) in oral cavity squamous cell carcinoma (OCSCC) remains unclear, particularly in comparison to traditional margin status. We aimed to examine the association between MDR and clinical outcomes in a large Taiwanese cohort.

Methods: A total of 18,324 patients with first primary OCSCC were categorized by margin status: positive (1013), <5 mm (8371), and ≥ 5 mm (8940).

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Background: The evidence for adjuvant chemoradiotherapy (CRT) of oral cavity squamous cell carcinoma (OCSCC) with extra-nodal extension (ENE) in National Comprehensive Cancer Network (NCCN) guidelines is derived from patients with head and neck cancer. The guidelines further suggest a radiation dose ranging from 6000 to 6600 cGy. In this nationwide study, we sought to evaluate the prognostic significance of adjuvant therapy and the specific radiation dosage in Taiwanese patients with pure OCSCC and ENE.

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Immunotherapy has revolutionized cancer treatment, but the lack of a reliable predictive biomarker for treatment response remains a challenge. Alpha-1,6-Mannosylglycoprotein 6-β-N-Acetylglucosaminyltransferase 5 (MGAT5) is a key regulator of complex N-glycan synthesis, and its dysregulation is associated with cancer progression. The lectin Phaseolus vulgaris leukoagglutinin (PHA-L) specifically binds to mature MGAT5 products.

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Elevated levels of Epstein-Barr virus (EBV) gp350 and gH/gL antibodies have been associated with a lower risk of developing nasopharyngeal carcinoma (NPC), although the evidence remains inconclusive and unexplained. We conducted a longitudinal study within a high-risk Taiwanese cohort, analyzing total immunoglobulin against EBV-gp350 and -gH/gL in blood and EBV DNA shedding in saliva. Contrary to our hypothesis-that elevated levels of antibodies previously shown to be associated with a lower NPC risk should result in a decrease in EBV shedding in saliva-higher anti-gp350 antibodies at baseline were significantly associated with detectable EBV DNA in saliva at follow-up (odds ratio [OR], 1.

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Background: Human papillomavirus (HPV) is a crucial prognostic factor in oropharyngeal cancer (OPC). p16 is a surrogate marker for diagnosing HPV+ OPC, however it is not direct evidence of HPV existence.

Objective: The purpose of our study was to evaluate an HPV DNA test-Cobas HPV assay-in diagnosing HPV+ OPC through neck lymph node aspiration.

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Article Synopsis
  • Induction chemotherapy (IC) is used as a treatment prior to surgery for oral squamous cell carcinoma (OCSCC), and this study analyzes its impact on patient survival in Taiwan.
  • A total of 29,891 OCSCC patients were examined, comparing those who had surgery only to those who received IC before surgery, with a focus on survival outcomes through matched analysis.
  • The results show that while overall survival rates were similar for both groups, patients with aggressive pT4a tumors had better outcomes with surgery alone compared to those who received IC before surgery.
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  • Elective tracheotomy is often performed on patients with resected oral squamous cell carcinoma (OCSCC) to help keep their airways open, but its necessity varies among surgeons.
  • A large study including over 18,000 OCSCC patients found that those who had tracheotomies had lower 5-year disease-specific and overall survival rates compared to those who didn't, even after adjusting for other factors.
  • Despite the survival rates being similar after matching groups for other variables, patients with tracheotomies generally experienced longer hospital stays, indicating the procedure may be associated with more complications or extended recovery times.
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Nasopharyngeal carcinoma (NPC) risk prediction models based on Epstein-Barr virus (EBV)-antibody testing have shown potential for screening of NPC; however, the long-term stability is unclear. Here, we investigated the kinetics of two EBV-antibody NPC risk scores within the Taiwan NPC Multiplex Family Study. Among 545 participants with multiple blood samples, we evaluated the stability of a 2-marker enzyme-linked immunosorbent assay score and 13-marker multiplex serology score using the intra-class correlation coefficient (ICC) by fitting a linear mixed model that accounted for the clustering effect of multiple measurements per subject and age.

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For deep learning-based machine learning, not only are large and sufficiently diverse data crucial but their good qualities are equally important. However, in real-world applications, it is very common that raw source data may contain incorrect, noisy, inconsistent, improperly formatted and sometimes missing elements, particularly, when the datasets are large and sourced from many sites. In this paper, we present our work towards preparing and making image data ready for the development of AI-driven approaches for studying various aspects of the natural history of oral cancer.

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Article Synopsis
  • This study compared clinical outcomes between initial surgery and primary definitive radiotherapy (RT) for Taiwanese patients with cT1-2N0M0 oral cavity squamous cell carcinoma (OCSCC) between 2011 and 2019.
  • After analyzing data from over 13,500 patients and matching groups for fairness, the results showed much higher 5-year disease-specific survival rates (DSS) for the surgery group compared to the RT group (86% vs. 58%).
  • The findings suggest that initial surgery significantly improves survival outcomes in these patients, highlighting a notable survival gap of 30% between the two treatment modalities.
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Article Synopsis
  • * A matched analysis revealed that patients with margins < 1 mm had better disease-specific survival (DSS) and overall survival (OS) rates compared to those with positive margins, with 5-year DSS rates at 71% vs 59% and OS rates at 60% vs 48%.
  • * The findings suggest that OCSCC patients with < 1 mm margins have better prognostic outcomes and different clinical characteristics compared to those with positive margins,
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Objectives: In early-stage oral squamous cell carcinoma (OSCC) patients, whether the margin-to-depth-of-invasion ratio (MDR) can assist in stratifying the prognosis remains unclear.

Methods: Patients diagnosed with early stage OSCC at National Taiwan University Hospital between January 2007 and December 2021 were reviewed. Patients with margin > 1 mm were classified into two groups: MDR < 0.

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  • The study evaluates the effectiveness of elective neck dissection (END) versus neck observation (NO) in patients with early-stage oral cavity squamous cell carcinoma (OCSCC) where the depth of invasion (DOI) exceeds 3 mm, as per current NCCN guidelines.
  • An analysis of 4,723 patients revealed that those who underwent END had significantly better survival rates and neck control compared to those monitored without surgery.
  • Through risk stratification, researchers identified distinct subgroups within the NO group, finding that 26% of low-risk patients achieved positive outcomes comparable to the END group, suggesting some patients might not require immediate surgery.
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Purpose: Two Epstein-Barr virus (EBV)-based testing approaches have shown promise for early detection of nasopharyngeal carcinoma (NPC). Neither has been independently validated nor their performance compared. We compared their diagnostic performance in an independent population.

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Article Synopsis
  • The study focused on oral squamous cell carcinoma (OSCC) patients with single-node metastasis (Ns) and how the presence of extranodal extension (ENE) affects their survival outcomes.
  • Among 311 reviewed patients, those with ENE had worse survival rates than those without, but larger lymph nodes (LN >3 cm) significantly increased the likelihood of having ENE.
  • Postoperative radiotherapy (PORT) was found to improve regional control in both Ns patient groups, and after accounting for ENE status, the survival chances became more aligned between N category and N/N category patients.
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Article Synopsis
  • The study investigates the necessity of elective neck dissection (END) for patients with early-stage oral cavity squamous cell carcinoma (OCSCC) classified as cT1N0M0, given that evidence supporting it is weak.
  • It analyzes 3886 patients, with 2065 undergoing END and 1821 under neck observation, showing that while END improves neck control and disease-specific survival rates, the outcomes are similar for patients with low-risk scores (0 or 1).
  • The conclusion recommends performing END when the depth of invasion exceeds 2.5 mm or when tumors are poorly differentiated, suggesting that nearly half of the cT1N0M0 patients may be able to avoid unnecessary surgery without negatively impacting
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  • A study enrolled 28 patients with stage IEI/IIE1 extragastric MALT lymphoma who received first-line antibiotic treatment, while 64 patients receiving conventional treatment served as a control group.
  • The antibiotic treatment resulted in a 57.1% overall response rate, with 12 patients achieving complete remission and four achieving partial remission, while monoclonal gammopathy was more common in those who did not respond to antibiotics.
  • After a median follow-up of 7 years, patients who achieved complete remission remained lymphoma-free, with 7-year event-free survival and overall survival rates of 62.7% and 96.4%, respectively, indicating that antibiotics were effective for some patients compared to conventional treatments.
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Background: Oral cancer causes significant morbidity and mortality. Chemoprevention utilizes medication or natural compounds to reverse oral premalignant lesions and to prevent second primary tumors.

Methods: A comprehensive PubMed database and Cochrane Library search from 1980 to 2021 was performed using the keywords "leukoplakia," "oral premalignant lesion," and "chemoprevention.

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Background: Epstein-Barr virus (EBV) is linked to multiple cancers, including classical Hodgkin lymphoma (cHL), endemic Burkitt lymphoma (eBL), nasopharyngeal carcinoma (NPC), and extranodal natural killer/T-cell lymphoma (NKTCL).

Methods: Anti-EBV IgG and IgA antibody responses targeting 202 sequences from 86 EBV proteins were measured using the same EBV whole proteome array across four case-control studies investigating EBV-positive cHL, eBL, NPC, and NKTCL (407 cases/620 controls). We grouped EBV-targeted antibodies into pathways by immunoglobulin type (IgA and IgG) and life-cycle stage (latent, immediate early lytic, early lytic, late lytic, and glycoprotein) and evaluated their association with each cancer type.

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Article Synopsis
  • Radiation-induced sarcoma of the head and neck (RISHN) is a rare but serious complication following radiotherapy for head and neck cancer, prompting a study to analyze its characteristics and molecular traits.
  • The study examined 24 patients treated between 1994 and 2019, assessing demographics, tumor staging, risk factors, and survival rates, with whole-exome sequencing (WES) conducted on select samples.
  • Findings revealed a median RISHN diagnosis age of 54 years, with risk factors including oral cavity primary cancer and certain lifestyle choices; insights from WES highlighted key genetic pathways linked to the disease, emphasizing the need for awareness and early detection to improve patient outcomes.
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Small ruler tapes are commonly placed on the surface of the human body as a simple and efficient reference for capturing on images the physical size of a lesion. In this paper, we describe our proposed approach for automatically extracting the measurement information from a ruler in oral cavity images which are taken during oral cancer screening and follow up. The images were taken during a study that aims to investigate the natural history of histologically defined oral cancer precursor lesions and identify epidemiologic factors and molecular markers associated with disease progression.

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Article Synopsis
  • The study compared treatment outcomes for oral cavity squamous cell carcinoma (OCSCC) at two high-volume hospitals in Taiwan, focusing on surgical margins and patient survival rates.
  • Hospital 1 had significantly better outcomes, with lower rates of pathological margins less than 5 mm (34.5%) compared to Hospital 2 (65.2%), despite treating more severe cases.
  • Patients treated at Hospital 1 exhibited better 5-year disease-specific survival and overall survival rates, underscoring the importance of surgical quality and hospital choice in OCSCC outcomes.
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  • Spindle cell carcinoma of the head and neck (HNSpCC) is a rare and aggressive variant of head and neck squamous cell carcinoma, with a study analyzing 71 patients showing a high rate of local recurrence and distant metastasis.
  • Most tumors occurred in males and the oral cavity, with 1-, 3-, and 5-year disease-specific survival rates of 64.6%, 49.5%, and 43.9%, respectively; those with previous head and neck cancers had worse outcomes.
  • Whole exome sequencing indicated that post-radiotherapy HNSpCC shared mutations with prior cancers but also developed new genetic traits that may support survival in irradiated environments, highlighting the tumor's unique characteristics and
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The present study aimed to evaluate the impact of proactive swallowing rehabilitation on swallowing function and quality of life in patients with recurrent oral cancer in the first 2 years after salvage treatment. Consecutive adult patients with recurrent oral cancer who received salvage surgery and free flap reconstruction were recruited prospectively, to whom proactive swallowing rehabilitation was provided. Body weight (BW); fiberoptic endoscopic evaluation of swallowing (FEES), functional oral intake scale (FOIS), and diet level; 10-item eating assessment tool (EAT-10), and MD Anderson Dysphagia Inventory (MDADI); and adherence at baseline, 1, 3, 6, 12, 18 and 24 months were evaluated.

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