bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human papillomavirus detection in head and neck squamous cell carcinoma in Turkey.
Authors: Kemal Yasemin , Kemal Ozgur , Kefeli Mehmet , Bel Ayse , Sahin Nilgun , Atmaca Sinan , Koyuncu Mehmet , Yucel Idris 
Published: September 2018

e17538 Background: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common type of cancer worldwide. In Turkey, 5538 new cases and 2340 deaths from head and neck cancer are estimated to occur every year. Tobacco and alcohol are the most important etiological risk factors but in the past three decads tobacco usage is decreased and Human Papilloma Virus (HPV) has changed HNSCC epidemiology. Many new reports suggests that almost 25% of all cases of HNSCC are related to HPV. But its prevelans shows a wide variation among different populations.Today in Turkey HPV positivity in HNSCC is currently not known and this retrospective study aimed to to evaluate the HPV infection in our HNSCC patients. Methods: We included 125 HNSCC patients diagnosed and treated in our hospital beween January 2010 and December 2016. Oral cavity, oropharyngeal, laryngeal and hypopharyngeal cancers were included. Nasopharyngeal and salivary gland cancers were exculuded. Head and neck cancer tissue samples fixed using 10% Neutral Buffered Formalin and embedded blocks were used. From an initial evaluation of 125 patients records 77 of the paients blocks could be adequate for the HPV testing. Detection and genotyping of HPV genotypes were done using a polymerase chain reaction (PCR) protocol. Results: PCR amplification was succesful in 61 of 77 patients. Among the 61 HNSCC patients only 3 patients were HPV positive(4.9 %). HPV 16 subtype was detected in one patient who was 70 years old male, stage III laryngeal cancer with a smoking history. The subtypes detected in other two patients were different from 16 and 18. One of these patients was 42 years old nonsmoker female stage IVa hypopharyngeal cancer and the other one was 56 years old smoker male with stage II oropharyngeal cancer. Conclusions: In Turkey, this is the first study that evaluated HPV positivity in HNSCC. Our results suggest a low prevelance of HPV in Turkish HNSCC patients; large scale population based studies are needed to confirm our findings.
Prognostic neutrophil-to-lymphocyte ratio in head and neck cancer: A single center experience.
Authors: Ziranu Pina , Massa Elena , Puzzoni Marco , Demurtas Laura , Madeddu Clelia , Pusole Grazia , Cubeddu Alessio , Astara Giorgio , Mascia Roberta , Pusceddu Valeria , Pretta Andrea , Dessi Mariele , Atzori Francesco , Lai Eleonora , Tolu Simona , Liscia Nicole , Pireddu Anna Grazia , Impera Valentino , Puxeddu Roberto , Scartozzi Mario 
Published: September 2018

e17540 Background: The Neutrophil-to-Lymphocytes ratio (NLR) represents a potential prognostic and predictive marker in a different tumor types. The purpose of our study was to investigate the prognostic value of the pretreatment inflammatory marker NLR in patients with head and neck squamous cell carcinoma (HNSCC). Methods: Pretreatment NLR were retrospectively investigated for correlation with overall survival (OS). Kaplan-Meier statistic and long rang test were used. Univariate analysis for categorical and descriptive variables were performed. Results: Thirty-nine patients, from local to advanced stage disease, were included in our analysis. At a median follow up of 9.44 months (2.04 – 30.3), of the total patients 30.7% died and 41.9% had progression of disease. The median PFS was 4.6 months (2.9 – 27.2) and the median OS (mOS) was 18.9 months. Following ROC curve analysis the optimum cut-off value of NLR was 3.93 (p = 0.017). Patient with NLR > 3.92 had a mOS of 11.9 months, whereas the mOS for NLR ≤ 3.92 was 30.3 months (Log-rank p = 0.189). The 1 year Kaplan-Meier estimates of OS for NLR ≤ 3.92 vs. >3.92 was 72% vs. 45% respectively (Log-rank p = 0.243). According to COX univariate analysis, the risk of death increases of 7.7% each unitary rise of NLR mean value (p = 0.3407). Conclusions: In our limited case series NLR was not significantly associated with clinical outcome. Therefore, multicenter studied are needed to determine an optimal NLR cutoff value. [Table: see text]
Immunologically relevant gene expression as prognostic biomarker in squamous cell carcinoma of the head and neck.
Authors: Pierce Andrew , Secrier Maria , Jones Emma V , Stokes Michael , Shire Norah , Barker Craig , Harrington Elizabeth A. , Barrett J Carl , Angell Helen 
Published: September 2018

e17542 Background: Expression of genes known to be integral to anti-tumour activity may be prognostic for patient outcomes in SCCHN. We hypothesized that broad categories of immune function would be responsible for anti-tumor activity. Methods: A study was conducted using data from patient medical records and analysis of archival tumour samples. Patients were ≥18 years old, diagnosed with SCCHN between 1989 and 2015 (n = 119). We quantified the expression of an annotated list of 71 aggregated genes selected to represent a variety of immunological activities: chemokines and receptors, interferon gamma stimulated genes, immunological checkpoints, HLA class I and II molecules, T cell activation, T cell surface markers, adhesion molecules, cytotoxic granules, immune suppression, inflammation, NK cell associated genes and ‘other functionality’. Results: Using a Cox proportional hazards model starting from consideration of the initial 71 genes and performing 10-fold cross-validation with 100 repetitions, several prognostic gene signatures were derived with overall survival hazard ratios > 2.8 and concordance indexes > 0.7, 95% confidence intervals ranging between [0.709, 0.805]. The signatures remained significantly predictive of outcome when accounting for tumour stage, sex and age of patients, HPV status and smoking habits. A cumulative score per sample taking into account the directionality of association of each gene with outcome and its corresponding expression was derived and this score outperformed tumour staging in distinguishing survival outcomes. The genes CD274 (PD-L1; checkpoints), CD8A (T cell surface markers), CCL11 (chemokines and receptors), GNLY (cytotoxic granules), TNFRSF10A (immune suppression), and EDN1 (other) appeared in all signatures, validating our approach of considering broad categories of functionality to represent the anti-tumor immune system response as an integrated whole. Conclusions: Identification of a prognostic gene signature may have additional utility for evaluating early response to therapy by assessing whether therapy has converted a patient tumour from a prognostically unfavourable to prognostically favourable gene signature status.
AUM voice prosthesis: A $1 novel modified tracheo-esophageal voice prosthesis for total laryngectomy patients (TEP).
Authors: Rao Vishal Uchila Shishir , Chatterjee Sataksi 
Published: September 2018

e17549 Background: Patients undergoing total laryngectomy require subsequent voice rehabilitation, which can be done by different modalities. The tracheo-esophageal voice prosthesis provides the clarity of speech and has a high rate of success in terms of acquisition of post laryngectomy speech.In this pilot study we evaluate the functionality of a modified trachea- oesophageal prosthesis to be used in primary and secondary trachea- esophageal puncture in 30 patients of total laryngectomy. Methods: This study was conducted at Health care Global Cancer Centre to evaluate the role of a novel trachea-oesophageal prosthesis for total laryngectomy +/- partial pharyngectomy patients from 2015-2016. 30 patients will be enrolled as an inpatient or outpatient. Post TEP insertion evaluation: Patients, who are undergoing primary TEP insertion, will be evaluated for speech/ voice interval of 6weeks, 12 weeks and 6 months. Objective assessment of speech Assessment of the incidence of TEP leak clinically after a test fluid feed. Through the prosthesis (intra TEP leak) Around the TEP leak (peri TEP leak) Assessment of the extrusion rate of the TEP device Assessment of the complication rate associated with the procedure/TEP Results: On objective assemsmsent of speech, all patients (100%) used prosthesis were able able to phonate and communicate using intelligible speech. 10% patients developed intra TEP leak immediately after insertion of prosthesis, 6% within 3 months of insertion, & 3% developed peri tep leak. All patients were immedaitely given a repalcement prosthesis and leaks corrected. Extrusion was seen in 3% of the patients. None reported any complications. Conclusions: Aum voice prosthesis is a excellent and affrodable tracheo oesophageal prosthetic device to enable and empower patients speeech rehabilitation. Clinical trial information: NCT03039465.
The influence of cisplatin de-escalation on survival outcomes in oropharyngeal head and neck squamous cell carcinoma (OPC).
Authors: Peters Geoffrey David , Milne Robin , Bernard Anne , Roberts Kate Elizabeth , Foote Matthew C , Panizza Benedict , Porceddu Sandro Virgilio , Coward Jermaine 
Published: September 2018

e17551 Background: Chemoradiotherapy (CRT) with 3 cycles (#) of high-dose cisplatin (HDC) (100mg/m2 weeks 1,4 & 7) and 70Gy over 7 weeks is associated with improved overall survival (OS) compared with radiotherapy (RT) alone in locally advanced OPC. Human Papilloma Virus (HPV) related tumours have superior outcomes and de-escalating treatment is a contemporary issue. Our study objectives were to determine if 2# HDC were non-inferior to 3#, how this was influenced by prognostic factors including stage, smoking history and p16 status, and to explore toxicity attributed to HDC. Methods: A single centre, retrospective analysis was undertaken for OPC patients who received CRT with HDC between Oct 2009 -Dec 2012. Those with distant metastatic disease or receiving induction chemotherapy were excluded. Data extracted included HPV and smoking status, tumour stage by 7thEd AJCC TNM and ICON-S classification, # HDC completed, toxicity and OS. Log-rank test was used for OS analysis. Results: 63, 96 and 4 patients received 3, 2 and 1 # HDC respectively. Median RT dose was 70Gy (range 66-70). 110 (67.5%) were p16 +, 28 (17.2%) were p16 negative and 25 (15.3%) unknown. 52 had omission of #3 HDC predominantly due to neutropenia (33%), nephrotoxicity (23%) and ototoxicity (12%). 19 had delays in #2 HDC resulting in omission of #3 due to completion of RT. There was no difference in OS between 3 #(mean OS (yrs)+/- SEM: 6.05+/- 0.22) or 2# HDC (5.70+/- 0.21) in all comers (p = 0.255). For RTOG0129 low risk p16+ patients, there was no significant difference (p = 0.896) between 3# (6.33+/- 0.24; n = 24) and 2# (6.18+/- 0.25; n = 44) HDC. Similar results were evident for ICON-S stage I for 3# (6.36+/-0.19; n = 25) vs 2# (6.30+/- 0.19; n = 42) HDC (p = 0.932). For RTOG 0129 intermediate risk p16 + OPC there was a significant difference (p = 0.017) in OS favouring 3# (6.29+/-0.22; n = 20) versus 2# (4.81+/-0.67; n = 10) HDC. For p16 negative patients there was no difference (p = 0.265) in OS between 3# (4.06+/-0.94; n = 9) and 2# (5.17+/-0.48; n = 22) HDC. Conclusions: This data suggests that cisplatin de-escalation does not confer inferior OS in low risk HPV related OPC. Significant toxicities with HDC influenced the ability to complete prescribed treatment.
Neoadjuvant chemotherapy plus concomitant chemoradiation versus concomitant chemoradiation for locoregionally advanced nasopharyngeal carcinoma: A systematic review and meta-analysis of comparative studies.
Authors: Tan Teng Hwee , Soon Yu Yang , Cheo Timothy , Tey Jeremy Chee Seong , Tham Ivan Weng Keong 
Published: September 2018

e17552 Background: To determine if addition of neoadjuvant chemotherapy (NACT) to concomitant chemoradiation (CCRT) for patients with locoregionally advanced nasopharyngeal carcinoma (NPC) improves overall survival. Methods: We searched MEDLINE for eligible studies comparing NACT plus CCRT versus (vs) CCRT alone for locoregionally advanced NPC. We assessed the methodological quality of the included studies using the MERGE criteria. We performed the meta-analysis with random effects model using Revman 5.3 to estimate the pooled hazard ratios (HR), confidence intervals (CI), P values (P) and I squared statistic (I2). The primary outcome was overall survival (OS); secondary outcomes include progression-free survival (PFS) and adverse events (AE). We used the GRADE approach to appraise the quality of evidence from randomized trials. Results: We found four randomized and five retrospective comparative studies including 2178 patients with low to moderate risk of bias in their methodologic quality. Pooled estimates from both randomized and retrospective studies demonstrated a benefit in PFS (HR 0.78, 95% CI 0.66 to 0.93, P = 0.006, I2 = 0%) and OS (HR 0.77, 95% CI 0.61 to 0.96, P = 0.02, I2 = 0%) with NACT. In the randomized trials, there was moderate quality evidence that NACT improved PFS significantly (HR 0.73, 95% CI 0.57 to 0.93, P = 0.01, I2 = 0%); trend towards OS benefit (HR 0.76, 95% CI 0.56 to 1.03, P = 0.08, I2= 0%) and was associated with more frequent AE. There were no significant differences in the results between the randomized and retrospective comparative studies (PFS HR 0.73 vs 0.82, interaction P (IP) = 0.58; OS HR 0.76 vs 0.78, IP = 0.93). Conclusions: Neoadjuvant chemotherapy delays disease progression substantially and may improve survival for locoregionally advanced nasopharyngeal carcinoma. There were no divergent results between randomized and retrospective comparative studies. Future trials should test more effective and/or better tolerated agents during the neoadjuvant therapy phase.
Randomized controlled trial to test the efficacy of trans-tympanic injections of a sodium thiosulfate gel to prevent cisplatin-induced ototoxicity.
Authors: Meyer Francois , Rolland Viannique , Bairati Isabelle , Guitton Matthieu , Fortin André , Côté Mathieu 
Published: September 2018

e17560 Background: The hearing loss due to cisplatin cochlear damage is frequent and severe. Antioxidants, such as sodium thiosulfate (STS), can neutralize the effects of cisplatin, but, when administered systemically, they decrease its efficacy. In animal experiments, STS deposited in the middle ear reached the cochlea and reduced cisplatin ototoxicity. We conducted a randomized controlled trial to test the efficacy of trans-tympanic injections of a STS gel to prevent cisplatin-induced ototoxicity. Methods: Eligible participants were patients with symmetrical hearing treated for a locally advanced head and neck cancer with chemoradiation including 3 cisplatin cycles (100 mg/m2). For each participant, one randomly selected ear received the injections while the other ear did not. On the eve of each cisplatin treatment, a trans-tympanic injection deposited 0.1 ml of an immediately prepared STS-hyaluronate gel (0.5 M) on the round window. The main outcome was assessed blindly using the shift of hearing threshold in decibels (dB) from before chemoradiation to one month thereafter for pure-tone air conduction at 0.5-14 kHz frequencies. Adverse effects were noted according to CTCAE. Assuming a lower hearing loss of 7.0 dB for the treated ears, 0.90 power and 0.05 two-sided statistical significance, 25 patients were needed. The main outcome was assessed in a mixed linear model with hearing threshold shift as dependent variable and intervention, frequency and radiation dose to the cochlea as independent variables. Results: From January to December 2015, 13 patients were randomized. The trial was stopped in June 2016 for poor accrual. The average loss of hearing over all frequencies was 1.5 dB less for the treated ears than for the control ears. The difference was not statistically (p = 0.56) nor clinically significant, but was consistently in favor of the treated ears for all frequencies between 3 and 10 kHz. The intervention adverse effects were mild. Conclusions: Our trial suggests that STS deposited in the middle ear reached the cochlea but was not clinically effective. More work is needed to improve the efficacy of trans-tympanic administration of cisplatin antidotes. Clinical trial information: NTC02281006.
Global history and clinical experiences of gene therapy: A brief review.
Authors: Li Yi 
Published: September 2018

e17562 Background: Based on the theoretic and clinical development of modern medicine, gene therapy has been a promising treatment strategy for cancer and other patients. Methods: In the present paper, we reviewed the history and clinical experiences of gene therapy from the aspects of treatment protocol, administration cycle, dosage calculation and evaluation of therapeutic effects, in order to provide more information for the further development of this promising treatment. Results: although the development of gene therapy has not gone smoothly since the beginning of the clinical trials, the results showed that this was a promising treatment for the cancer patients. There are still a lot of researches needed to be done to further solve the theoretic and clinical issues, and to improve the therapeutic effects. Conclusions: In conclusion, although the development of gene therapy has not gone smoothly since the beginning of the clinical trials, the results showed that this was a promising treatment for the cancer patients. There are still a lot of researches needed to be done to further solve the theoretic and clinical issues, and to improve the therapeutic effects. But the future of the gene therapy will be bright, and it will become a new basic strategy to help more patients.
Rate of false-negative findings in sentinel lymph node biopsy in patients with head and neck malignant melanoma.
Authors: Rahimi-Nedjat Roman , Sagheb Keyvan , Hormes Maike , Tuettenberg Andrea , Al-Nawas Bilal , Walter Christian 
Published: September 2018

e17566 Background: Sentinel Lymph Node Biopsy (SLNB) is the standard procedure for malignant melanoma with a thicknes above 1mm. However, the benefits of this procedure have recently been questioned because of a high number of false negative findings. The aim of our study was to investigate the number of early recurrence in patients with negative SLNB. Methods: All patients with malignant melanoma of the head and neck region who underwent SLNB between 2010 and 2016 in our department were included and data reviewed retrospectively. Recurrence in the same cervical lymph node region of the previously extirpated sentinel lymph node (SLN) within one year was defined as primary false-negative. Results: Allover 101 patients were investigated (mean age 62.48 years (±17.66; 73.3% ♂, 26.7% ♀). Most frequent location of the primary melanoma were the cheeks and ears (each 18.8%), followed by the hair bearing region (13.9%). Superficial Spreading Melanoma and Nodular Melanoma were the most frequently seen subtypes (each 23.8%), followed by Lentigo maligna Melanoma (19.8%). Median thickness of all patients was 2.5mm (min: 0.15 – max: 10.0 mm). In average 3 SLN were removed during operation (min: 1 – max 16). In 79.2% of the cases the SLN was negative. 13% showed one metastasis, 5.2% showed two and 1.6% three metastases. Positive findings in the SLN were significantly correlated with T-classification. Ulceration and tumor thickness showed significant tendencies in Χ2-Test and Mann-Whitney-Test. Out of the patients with negative SLN 13.1% had at least one metastasis in a cervical lymph node of the same region within one year. Mean duration until recurrence was 6.5 months. 75.0% of the metastases in our study were diagnosed within this period. 62.5% of the patients with secondary positive SLN had a tumor of intermediate thickness (between 1mm and 4mm). Conclusions: With 13.1 % secondary positive SLN this study shows that SLNB has a high rate of false-negative findings. However, SLNB has lower complication rates compared to traditional lymph node extirpation. This study shows that patients with negative SLN especially with intermediate tumor thickness should be controlled by ultrasound or computer tomography in short intervals.
Carotid body tumors in Japan: A multi-institutional study.
Authors: Shiga Kiyoto , Ikeda Aya , Saitoh Daisuke , Katagiri Katsunori , Oikawa Shin-ichi 
Published: September 2018

e17574 Background: Carotid body tumor (CBT) is thought to be a rare disease derived from carotid body paraganglion cells. It is well known that this tumor is related to some hereditary tendencies that linked to such as SDH gene mutations. CBTs have rich vascular contents and capsules supplied by many feeding arteries. When we head and neck surgeons perform resection sugery, we sometimes encounter much blood loss or injuries of carotid arteries. There has been no study to reveal the characteristic features of CBT patients in Japan because of lack of registration and survey system for them. Methods: We attempted to analyze CBT patients all over Japan by integrating information of CBT patients from institutions which had head and neck surgeries. Results: 399 patients were referred to 112 institutes for past 20 years. Among these patients, 150 were registered to our study. There were 87 female and 63 male patients and their mean and median age were 48.0 years old and 49 years old, respectively, ranging from 8 to 78 years old. Eighteen patients had family history of paragangliomas. 15 patients had bilateral CBTs. Among 94 patients who underwent surgery to remove CBT, 23 patients had tumors classified as Shamblin type I, 59 as type II and 12 as type III. Mean operation time of the surgery and the mean amount of blood loss were calculated to compare. Angiography revealed that most frequent feeding artery of these CBTs was ascending pharyngeal artery followed by superior thyroid artery and occipital artery. Preoperative embolization of these arteries was effective to reduce the blood loss but operation time in Shamblin type I and II tumors. Conclusions: Further investigation will be needed to clarify gene mutations for hereditary paragangliomas including CBTs in Japan.