Publications by authors named "Li-Yu Lee"
Background: The current NCCN guidelines advocate for the use of adjuvant radiotherapy (RT) or chemoradiotherapy (CRT) in pT3N0 oral cavity squamous cell carcinoma (OCSCC). Here, we sought to evaluate whether postoperative RT/CRT may confer a survival advantage in pT3N0 patients who lack adverse pathological features.
Methods: A dataset of 852 pT3N0 OCSCC patients treated between 2018 and 2021 was analyzed.
Background: The question as to whether prolonged diagnosis-to-surgery intervals (DSIs) may compromise survival outcomes in patients with oral cavity squamous cell carcinoma (OCSCC) remains unanswered. This nationwide study was designed to address this issue.
Methods: We analyzed data from 26,214 patients with first primary OCSCC identified in the Taiwanese Cancer Registry Database between 2011 and 2021.
Nasopharyngeal carcinoma (NPC) is an Epstein-Barr virus (EBV)-associated cancer, and immune checkpoint inhibitors (ICIs) have shown efficacy in its treatment. The combination of chemotherapy and ICIs represents a new trend in the standard care for metastatic NPC. In this study, we aim to clarify the immune cell profile and related prognostic factors in the ICI-based treatment of metastatic NPC.
View Article and Find Full Text PDFBackground: 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).
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.
View Article and Find Full Text PDFArticle Synopsis
- Paraneoplastic leukocytosis (PNL) in genitourinary cancer may signal aggressive disease and poor prognosis, potentially linked to G-CSF and GM-CSF expression in tumors.
- The study created four patient-derived xenograft lines from urothelial cancer, finding that one line (UC-PDX-LN1) had two effective druggable targets and correlated PNL with the patient’s original tumor, suggesting a mechanism of enhanced tumor growth through secreted growth factors.
- The research indicates that combining chemotherapy with interventions targeting neutrophil activity and thrombosis may improve treatment outcomes for bladder cancer patients with PNL.
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.
Article Synopsis
- 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.
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.
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,
Article Synopsis
- 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.
Comparison between a novel salivary marker and several clinical prognosticators in oral cavity cancer.
Laryngoscope Investig Otolaryngol
December 2023
Article Synopsis
- This study explored how salivary matrix metalloproteinase-1 (MMP-1) relates to various clinical characteristics of oral cavity squamous cell carcinoma (OSCC) and compared its effectiveness as a prognostic marker to other established markers.
- A total of 479 saliva samples from OSCC patients were analyzed using specific testing methods, which revealed that salivary MMP-1 is a strong indicator of overall survival outcomes.
- The findings showed that higher levels of salivary MMP-1 correlate with worse clinicopathological features and are an independent predictor of poor survival in OSCC patients.
Patient With Unilateral Nasal Obstruction and a Nasal Mass.
JAMA Otolaryngol Head Neck Surg
February 2024
Background: Nasopharyngeal carcinoma (NPC) is associated with Epstein-Barr virus (EBV) infection. To test preclinical NPC drugs, we established two patient-derived xenograft (PDX) mouse models, EBV-positive PDX-B13 and EBV-negative PDX-Li41, for drug screening.
Methods: Based on next generation sequencing (NGS) studies, PDX-B13 had CCND1 copy number (CN) gain but CDKN2A CN loss, whereas PDX-Li41 had CDKN2A and RB1 CN loss, TSC1 (negative regulator of mTOR) frameshift deletion mutation, and increased activation of mTOR, a serine/threonine kinase that governs metabolism, autophagy, and apoptosis.
Article Synopsis
- The study aimed to determine if postoperative chemoradiotherapy (POCRT) leads to better outcomes than postoperative radiotherapy (PORT) alone for patients with high-risk salivary gland carcinoma (SGC).
- A total of 411 patients were analyzed, with results showing that POCRT significantly improved overall survival (OS) and progression-free survival (PFS) for those with nodal metastasis, compared to PORT alone.
- POCRT also improved locoregional control (LRC) rates in patients with residual tumors after surgery, highlighting its effectiveness for specific subgroups like those with adenoid cystic carcinoma (AdCC).
Kimura's disease (KD) is an immune-mediated disorder which mainly affects Asian men. It appears as head and neck subcutaneous masses, with inflammatory infiltrate and elevated serum immunoglobulin E levels. The clinical presentation of KD resembles that of various diseases.
View Article and Find Full Text PDFPerineural invasion (PNI) was quantitatively analyzed in oral squamous cell carcinoma (OSCC) specimens obtained by radical surgery to correlate with survival outcomes. This is a retrospective study that reviewed the Cancer registry data between 2009 and 2015. Inclusion criteria were oral cavity cancer, treatment by radical surgery, presence of PNI, and available pathologic samples for S100 staining.
View Article and Find Full Text PDFArticle 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
Background: The prognostic significance of the relapse interval in patients with resected oral cavity squamous cell carcinoma (OCSCC) is a matter of ongoing debate. In this large-scale, registry-based, nationwide study, we examined whether the time interval between surgery and the first disease relapse may affect survival outcomes in Taiwanese patients with OCSCC.
Methods: Data made available by the Taiwan Health Promotion Administration as of 2004 were obtained.
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.
Background: Perineural invasion (PNI), a form of local invasion defined as the ability of cancer cells to invade in, around, and through nerves, has a negative prognostic impact in oral cavity squamous cell carcinoma (OCSCC). Unfortunately, the diagnosis of PNI suffers from a significant degree of intra- and interobserver variability. The aim of this pilot study was to develop a deep learning-based human-enhanced tool, termed domain knowledge enhanced yield (Domain-KEY) algorithm, for identifying PNI in digital slides.
View Article and Find Full Text PDFObjectives: To evaluate whether tegafur-uracil maintenance (UFTm) following postoperation adjuvant cisplatin-based concurrent chemoradiotherapy (CCRT) may reduce distant metastasis in patients with resected oral cavity squamous cell carcinoma (OSCC) with pathologic extranodal extension (pENE+).
Methods: A retrospective comparison was conducted between two cohorts of patients with resected pENE+ OSCC who completed adjuvant CCRT between March 2015 and December 2017, including one cohort of a phase II trial using UFTm and a trial-eligible but off-protocol cohort without using UFTm (non-UFTm) after their adjuvant CCRT. The UFTm trial enrolled patients without relapse within 2 months after the end of adjuvant CCRT and administered UFT 400 mg/day for 1 year.
We developed a hybrid platform using a negative combined with a positive selection strategy to capture circulating tumor cells (CTCs) and detect epidermal growth factor receptor () mutations in patients with metastatic lung adenocarcinoma. Blood samples were collected from patients with pathology-proven treatment-naïve stage IV lung adenocarcinoma. Genomic DNA was extracted from CTCs collected for mutational tests.
View Article and Find Full Text PDFBackground: Breast cancer in silicone-injected breasts is often obscured in conventional mammography and sonography. Contrast-enhanced magnetic resonance imaging (CE-MRI) is an optimal modality for cancer detection. This case report demonstrates the use of contrast-enhanced spectral mammography (CESM) and CESM-guided biopsy (CESM-Bx) to diagnose breast cancer in silicone-injected breasts.
View Article and Find Full Text PDF