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Head and Neck Cancer—Updates in Research and Treatment

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Otolaryngology".

Deadline for manuscript submissions: closed (20 July 2022) | Viewed by 9268

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Dr. Gunnar Wichmann

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Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
Interests: head and neck cancer (HNC); head and neck squamous cell carcinoma (HNSCC); human papillomavirus (HPV); immuno-oncology; biomarker; prognostic factor; genetic risk factors; outcome research
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Dear Colleagues,

The history of human papillomavirus (HPV) in the head and neck region starts in 1901 when the contagious transmission of warty lesions into the mouth via oral sex was described. Strong evidence has accumulated since 1983 about the etiological involvement of HPV in a subset of head and neck cancers (HNC) and substantial differences between HPV-associated and HPV-negative HNC have been observed establishing HPV as a prognostic factor especially in oropharyngeal squamous cell carcinoma (OPSCC). As the neoplastic transformation of epithelial cells by high-risk HPV subtypes was found to be linked to the overexpression of p16, immunohistochemical p16 detection is routinely used as a surrogate for HPV-related HNC. Despite good reasons to supplement p16 with HPV genotyping, we are now in an era of separate tumor-staging of OPSCC based on p16-positivity. There is increasing knowledge about some pitfalls whenever p16 is solely used, and discrimination between HPV-driven HNC from other HNC and clear identification of prognostic subgroups are more desired than ever. Therefore, we invite authors working in the field to submit contributions of original research and state-of-the-art reviews related to the epidemiology and molecular biology of HPV-positive HNC, the immune response to HPV, HPV-testing and genotyping, predictive factors for outcomes, and quality of life in HPV-positive versus HPV-negative HNC, as well as reports of clinical trials and other areas of research dealing with HPV in HNC for this Special Issue.

Dr. Gunnar Wichmann
Guest Editor

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Keywords

head and neck cancer (HNC)
head and neck squamous cell carcinoma (HNSCC)
human papillomavirus (HPV)
HPV-driven oropharynx cancer
biomarker
prognostic factor
outcome research

Published Papers (5 papers)

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Research

11 pages, 288 KiB

Open AccessArticle

The Assessment of Serum Cytokines in Oral Squamous Cell Carcinoma Patients: An Observational Prospective Controlled Study

by Ana Caruntu, Cristian Scheau, Elena Codrici, Ionela Daniela Popescu, Bogdan Calenic, Constantin Caruntu and Cristiana Tanase

J. Clin. Med. 2022, 11(18), 5398; https://doi.org/10.3390/jcm11185398 - 14 Sep 2022

Cited by 4 | Viewed by 1215

Abstract

Background: The oral squamous cell carcinoma (OSCC) tumor microenvironment (TME) is a complex interweb of cells and mediators balancing carcinogenesis, inflammation, and the immune response. However, cytokines are not only secreted within the TME but also released by a variety of other cells that do not comprise the TME; therefore, a thorough assessment of humoral changes in OSCC should include the measurement of serum cytokines. Methods: We assessed the role of various serum cytokines in the evolution of OSCC, before and after treatment, versus a control group. We measured the serum concentrations of MIP-1α, IL-1β, IL-4, IL-6, IL-8, IL-10, and TNF-α. Results: Significantly higher values (p < 0.01) were noted for IL-1β, IL-6, IL-8, IL-10, and TNF-α in the OSCC group before treatment (n = 13) compared with the control group (n = 14), and the increased concentrations persisted after treatment (n = 11). Furthermore, the variations in the values of MIP-1α, IL-1β, IL-10, and TNF-α are correlated both before and after treatment (p < 0.01). In the pretherapeutic group, IL-6 and IL-8 concentrations also correlate with IL-1β and IL-10 serum levels (p < 0.01), while in the posttherapeutic group, IL-4 varies with MIP-1α and TNF-α (p < 0.01). Conclusion: In OSCC patients, serum cytokine levels are significantly higher compared with control, but they are not significantly altered by treatment, therefore implying that they are also influenced by systemic factors. The interactions between all involved cytokines and the various pathways they regulate warrant further studies to clarify their definitive roles. Full article

(This article belongs to the Special Issue Head and Neck Cancer—Updates in Research and Treatment)

11 pages, 701 KiB

Open AccessArticle

Frailty Assessed with FRAIL Scale and G8 Questionnaire Predicts Severe Postoperative Complications in Patients Receiving Major Head and Neck Surgery

by Viktor Kunz, Gunnar Wichmann, Theresa Wald, Markus Pirlich, Veit Zebralla, Andreas Dietz and Susanne Wiegand

J. Clin. Med. 2022, 11(16), 4714; https://doi.org/10.3390/jcm11164714 - 12 Aug 2022

Cited by 3 | Viewed by 1211

Abstract

Introduction: Frailty represents a complex geriatric syndrome associated with elevated rates of postoperative complications as shown for several malignant entities, including head and neck cancer. A specific screening instrument to assess frailty in head and neck patients does not exist. Both the FRAIL Scale and the G8 questionnaire are well-established and easy to use as screening tools. The present study’s aim was to assess the potential of frailty screening to predict postoperative complications in head and neck patients prior to surgery. Patients and methods: We recorded demographic data, pre-existing medical conditions and clinical characteristics in a prospective cohort of 104 head and neck cancer patients undergoing major head and neck surgery and assessed frailty prospectively on the day of admission utilizing the G8 questionnaire and the FRAIL Scale. We analyzed the link between occurrence of postoperative complications up to the twenty-first postoperative day and age, frailty and other covariates using χ² tests and receiver operating characteristic (ROC) curves. Results: There was no significant correlation between patients’ pre-existing medical conditions and postoperative complications. Whereas chronological age alone did not predict the occurrence of postoperative complications, frailty posed the highest risk for complications. Frailty according to either the G8 questionnaire or the FRAIL Scale predicted occurrence of complications with an area under the curve (AUC) of 0.64 (p = 0.018) and 0.62 (p = 0.039) and severe complications with an AUC of 0.72 (p = 0.014) and 0.69 (p=0.031), respectively. Neither frailty score correlated with age or with each other. Conclusion: Prospective screening using the FRAIL Scale or the G8 questionnaire reliably detected frailty in our sample group. Frailty is linked to increased risk of postoperative complications. The correct prediction of severe postoperative complications as shown identifies vulnerable cases and triggers awareness of potential complications. Anticipating risk allows for a more comprehensive view of the patient and triggers decision making towards risk adjustment, and therefore a selective view of alternative treatment modalities. Full article

(This article belongs to the Special Issue Head and Neck Cancer—Updates in Research and Treatment)

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16 pages, 1095 KiB

Open AccessArticle

Sex-Specific Cut-Off Values for Low Skeletal Muscle Mass to Identify Patients at Risk for Treatment-Related Adverse Events in Head and Neck Cancer

by Aniek T. Zwart, Wolf Pörtzgen, Irene van Rijn-Dekker, Grigory A. Sidorenkov, Rudi A. J. O. Dierckx, Roel J. H. M. Steenbakkers, Inge Wegner, Anouk van der Hoorn, Geertruida H. de Bock and Gyorgy B. Halmos

J. Clin. Med. 2022, 11(16), 4650; https://doi.org/10.3390/jcm11164650 - 9 Aug 2022

Cited by 7 | Viewed by 1916

Abstract

A low skeletal muscle index (SMI), defined with cut-off values, is a promising predictor for adverse events (AEs) in head and neck squamous cell cancer (HNSCC) patients. The aim was to generate sex-specific SMI cut-off values based on AE to diagnose low SMI and to analyse the relationship between low SMI and AEs in HNSCC patients. In this present study, HNSCC patients were prospectively included in a large oncological data-biobank and SMI was retrospectively measured using baseline neck scans. In total, 193 patients were included and were stratified according to treatment modality: (chemo-)radiotherapy ((C)RT) (n = 135) and surgery (n = 61). AE endpoints were based on the occurrence of clinically relevant toxicities (Common Terminology Criteria for Adverse Events grade ≥ III) and postoperative complications (Clavien–Dindo Classification grade ≥ II). Sex-specific SMI cut-off values were generated with receiver operating characteristic curves, based on the AE endpoints. The relationship of the baseline characteristics and AEs was analysed with logistic regression analysis, with AEs as the endpoint. Multivariable logistic analysis showed that low SMI (OR 3.33, 95%CI 1.41–7.85) and tumour stage (OR 3.45, 95%CI 1.28–9.29) were significantly and independently associated to (C)RT toxicity. Low SMI was not related to postoperative complications. To conclude, sex-specific SMI cut-off values, were generated based on the occurrence of AEs. Low SMI and tumour stage were independently related to (C)RT toxicity in HNSCC patients. Full article

(This article belongs to the Special Issue Head and Neck Cancer—Updates in Research and Treatment)

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12 pages, 1057 KiB

Open AccessArticle

Nurse-Led Counseling Intervention of Postoperative Home-Based Exercise Training Improves Shoulder Pain, Shoulder Disability, and Quality of Life in Newly Diagnosed Head and Neck Cancer Patients

by Yu-Long Hong, Tsung-Cheng Hsieh, Peir-Rong Chen and Shu-Chuan Chang

J. Clin. Med. 2022, 11(14), 4032; https://doi.org/10.3390/jcm11144032 - 12 Jul 2022

Cited by 2 | Viewed by 2061

Abstract

This randomized controlled trial investigated the effectiveness of the nurse-led counseling intervention (NLCI) of postoperative home-based exercise training (HBET) on functional outcomes in patients with newly diagnosed head and neck cancer (NDHNC). Forty NDHNC patients were randomly and equally divided into the control and intervention groups. Both groups received routine care, and were instructed to undergo a HBET program with 40 min moderate-intensity exercise 3–4 times per day for 12 weeks after their surgery. Only the intervention group received the NLCI with a bedside demonstration, coaching, consultation, and a weekly telephone follow-up. Shoulder pain (SP), shoulder disability (SD), and quality of life (QOL) scores were assessed using questionnaires at 2 weeks presurgery and at several timepoints postsurgery. Over the 12-week study period, all three scores remained relatively stable in the control group. By contrast, the SP, SD, and QOL scores significantly improved in the intervention group. The generalized estimating equation analysis revealed a significant time effect, group effect, and group–time interaction. The analysis of covariance revealed that all three scores significantly improved in the intervention group compared with those in the control group at 12 weeks postsurgery. We concluded that the NLCI of postoperative HBET improved the SP, SD, and QOL of NDHNC patients. Full article

(This article belongs to the Special Issue Head and Neck Cancer—Updates in Research and Treatment)

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19 pages, 286 KiB

Open AccessArticle

Awareness of Head and Neck Cancers: A 2021 Nationwide Cross-Sectional Survey in Poland

by Wojciech Pinkas, Mateusz Jankowski and Waldemar Wierzba

J. Clin. Med. 2022, 11(3), 538; https://doi.org/10.3390/jcm11030538 - 21 Jan 2022

Cited by 11 | Viewed by 1974

Abstract

Head and neck cancers (HNC) are the seventh most common cancers worldwide. Early diagnosis of HNC is associated with better outcomes. This study aimed to assess public awareness of HNC among adults in Poland, with particular emphasis on awareness of HNC symptoms and risk factors for HNC. This cross-sectional study was carried out in November 2021 on a nationwide, representative sample of 1082 inhabitants of Poland aged 18 years and over. The computer-assisted web interview (CAWI) technique was used. Most of the respondents rated their knowledge of head and neck cancers as “a little” (40.8%) or “nothing at all” (30%). The most identified symptoms were a lump in the neck (57.9%) and swelling or a lump in the throat (51.8%). The most identified risk factor for HNC was smoking cigarettes/tobacco (63.1%). Excessive alcohol consumption and HPV infection were correctly identified as risk factors by about one-third of respondents. Public awareness of selected symptoms of HNC and risk factors for HNC differed by sociodemographic factors, of which the educational level was the most important factor associated with awareness of head and neck cancers (p < 0.05). This study demonstrated low public awareness of head and neck cancers among adults in Poland. Full article

(This article belongs to the Special Issue Head and Neck Cancer—Updates in Research and Treatment)

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