Treatment Strategies for Recurrent Cancers in Head and Neck Oncology

A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: closed (25 June 2023) | Viewed by 6739

Special Issue Editors


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Guest Editor
Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Interests: head and neck oncology; geriatric oncology; sarcopenia; health care pathway

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Co-Guest Editor
Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
Interests: clinical applications and improvements of diagnostic imaging techniques; sentinel node procedure; quality of life; reconstructive surgery in head and neck cancer patients

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Co-Guest Editor
Coordinator of the International Head and Neck Scientific Group, Padua, Italy
Interests: head and neck cancer; neuroendocrine carcinoma

Special Issue Information

Dear Colleagues, 

Annually, head and neck cancer affects around 700,000 new patients and causes around 350,000 deaths worldwide. Most patients present with advanced disease, and despite the existence of highly intensive treatment protocols, recurrence occurs in almost half of the cases among these patients. Moreover, new technological developments, such as the introduction of robotic surgery and proton therapy, have not resulted in significant survival benefits, and immunotherapy has only been approved for palliative treatment thus far. There are evidence-based treatment guidelines for the treatment of primary tumors; however, the treatment of recurrent disease is not straightforward. Patients with recurrent head and neck cancer have a very poor prognosis, and salvage treatment often further deteriorates their quality of life. Salvage surgery and re-irradiation are challenging procedures, which are often associated with adverse events and cause significant morbidity.

This Special Issue aims to summarize the current evidence regarding the treatment of recurrent head and neck cancer, including both surgical and non-surgical options. The possibilities of salvage surgery, (re-)irradiation treatment options, and new systemic treatment opportunities, such as immunotherapy, all fall within the scope of the topics discussed in this issue.

Dr. G. B. Halmos
Prof. Dr. Remco De Bree
Prof. Dr. Alfio Ferlito
Guest Editors

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Keywords

  • head and neck cancer
  • recurrence
  • salvage surgery
  • re-irradiation
  • systemic treatment

Published Papers (3 papers)

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Research

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11 pages, 2138 KiB  
Article
Recurrence of Basal Cell Carcinoma Treated with Surgical Excision and Histopathological Analysis with Frozen Section Technique with Complete Margin Control (CMC-FS): A 15-Year Experience of a Reference Center
by Alessandra Di Maria, Gianmaria Barone, Vanessa Ferraro, Costanza Tredici, Sofia Manara, Camilla De Carlo, Alessandro Gaeta and Filippo Confalonieri
Cancers 2023, 15(15), 3840; https://doi.org/10.3390/cancers15153840 - 28 Jul 2023
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Abstract
Background: Basal cell carcinoma (BCC) is the most common type of eyelid malignancy and it is considered to be dangerous due to its proximity to functionally essential organs. Early diagnosis and complete excision of the primary lesion are crucial to prevent infiltration and [...] Read more.
Background: Basal cell carcinoma (BCC) is the most common type of eyelid malignancy and it is considered to be dangerous due to its proximity to functionally essential organs. Early diagnosis and complete excision of the primary lesion are crucial to prevent infiltration and metastasis. The study aims to evaluate the extent of recurrence in subjects affected by BCC of the upper third of the face treated with surgical eradication and the frozen section technique with complete margin control (CMC-FS), in comparison with the gold standard Mohs micrographic surgery (MMS). Materials and Methods: The study included 111 patients with 111 biopsy-proven eyelid BCCs. On clinical examination, all lesions were removed with 2 mm margins clinically free of neoplasm. Prior to reconstruction, CMC-FS analysis of all surgical margins was performed on each tumor for histopathologic confirmation. Subsequently, all margins were presented for the permanent paraffin sections. Results: There were 69 primary carcinomas and 42 secondary carcinomas among the 111 samples. No recurrence occurred in 109 tumors followed-up for at least 5 years, with a total recurrence rate of 1.8%. The median time between lesion excision and diagnosis of recurrence was 20 months. Conclusions: at 5-year follow-up, CMC-FS guided excision of BCCs of the eyelids resulted in recurrence rates equivalent to MMS. Intraoperative microscopic control of all margins reduced the recurrence rate of the upper third of the facial BCCs, correlating with easier reconstruction with better esthetic and functional outcome. Full article
(This article belongs to the Special Issue Treatment Strategies for Recurrent Cancers in Head and Neck Oncology)
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Review

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13 pages, 2120 KiB  
Review
Recurrent Differentiated Thyroid Cancer: The Current Treatment Options
by Andrés Coca-Pelaz, Juan Pablo Rodrigo, Jatin P. Shah, Iain J. Nixon, Dana M. Hartl, K. Thomas Robbins, Luiz P. Kowalski, Antti A. Mäkitie, Marc Hamoir, Fernando López, Nabil F. Saba, Sandra Nuyts, Alessandra Rinaldo and Alfio Ferlito
Cancers 2023, 15(10), 2692; https://doi.org/10.3390/cancers15102692 - 10 May 2023
Cited by 2 | Viewed by 2618
Abstract
Differentiated thyroid carcinomas (DTC) have an excellent prognosis, but this is sometimes overshadowed by tumor recurrences following initial treatment (approximately 15% of cases during follow-up), due to unrecognized disease extent at initial diagnosis or a more aggressive tumor biology, which are the usual [...] Read more.
Differentiated thyroid carcinomas (DTC) have an excellent prognosis, but this is sometimes overshadowed by tumor recurrences following initial treatment (approximately 15% of cases during follow-up), due to unrecognized disease extent at initial diagnosis or a more aggressive tumor biology, which are the usual risk factors. The possible sites of recurrence are local, regional, or distant. Local and regional recurrences can usually be successfully managed with surgery and radioiodine therapy, as are some isolated distant recurrences, such as bone metastases. If these treatments are not possible, other therapeutic options such as external beam radiation therapy or systemic treatments should be considered. Major advances in systemic treatments have led to improved progression-free survival in patients previously considered for palliative treatments; among these treatments, the most promising results have been achieved with tyrosine kinase inhibitors (TKI). This review attempts to give a comprehensive overview of the current treatment options suited for recurrences and the new treatments that are available in cases where salvage surgery is not possible or in cases resistant to radioiodine. Full article
(This article belongs to the Special Issue Treatment Strategies for Recurrent Cancers in Head and Neck Oncology)
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20 pages, 868 KiB  
Review
Novel Immunotherapeutic Approaches to Treating HPV-Related Head and Neck Cancer
by Nabil F. Saba, Saagar Pamulapati, Bhamini Patel, Mayur Mody, Primož Strojan, Robert Takes, Antti A. Mäkitie, Oded Cohen, Pia Pace-Asciak, Jan B. Vermorken, Carol Bradford, Arlene Forastiere, Yong Teng, Andreas Wieland and Alfio Ferlito
Cancers 2023, 15(7), 1959; https://doi.org/10.3390/cancers15071959 - 24 Mar 2023
Cited by 5 | Viewed by 2556
Abstract
Head and neck cancer (HNC) is the seventh most common malignancy, with oropharyngeal squamous cell carcinoma (OPSCC) accounting for a majority of cases in the western world. While HNC accounts for only 5% of all cancers in the United States, the incidence of [...] Read more.
Head and neck cancer (HNC) is the seventh most common malignancy, with oropharyngeal squamous cell carcinoma (OPSCC) accounting for a majority of cases in the western world. While HNC accounts for only 5% of all cancers in the United States, the incidence of a subset of OPSCC caused by human papillomavirus (HPV) is increasing rapidly. The treatment for OPSCC is multifaceted, with a recently emerging focus on immunotherapeutic approaches. With the increased incidence of HPV-related OPSCC and the approval of immunotherapy in the management of recurrent and metastatic HNC, there has been rising interest in exploring the role of immunotherapy in the treatment of HPV-related OPSCC specifically. The immune microenvironment in HPV-related disease is distinct from that in HPV-negative OPSCC, which has prompted further research into various immunotherapeutics. This review focuses on HPV-related OPSCC, its immune characteristics, and current challenges and future opportunities for immunotherapeutic applications in this virus-driven cancer. Full article
(This article belongs to the Special Issue Treatment Strategies for Recurrent Cancers in Head and Neck Oncology)
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