Search Results (1,447)

Background: Head and neck carcinosarcoma (HNCS) is a rare and highly aggressive malignancy with limited research, resulting in an incomplete understanding of disease progression and a lack of reliable prognostic tools. This study aimed to retrospectively analyze the clinical characteristics and outcomes of HNCS patients using data from the Surveillance, Epidemiology, and End Results (SEER) database and to develop a nomogram to predict overall survival (OS) and cancer-specific survival (CSS). Methods: Patients diagnosed with HNCS from 1975 to 2020 were identified in the SEER database. Univariate and multivariate Cox regression analyses were conducted to identify independent prognostic indicators, with the optimal model selected using the minimal Akaike Information Criterion (AIC). The identified prognostic factors were incorporated into nomograms to predict OS and CSS. Model performance was assessed using the concordance index (C-index), area under the curve (AUC), calibration curves, and decision curve analysis (DCA). Survival curves were generated using Kaplan–Meier analysis and compared via the log-rank test. Results: A total of 152 HNCS patients were included, with 108 assigned to the training cohort and 44 to the validation cohort in a 7:3 ratio. Prognostic factors including age, primary tumor site, marital status, radiotherapy, chemotherapy, tumor size, pathological grade, and tumor stage were incorporated into the nomogram models. The models demonstrated strong predictive performance, with C-index values for OS and CSS of 0.757 and 0.779 in the training group, and 0.777 and 0.776 in the validation group, respectively. AUC values for predicting 3-, 5-, and 10-year OS were 0.662, 0.713, and 0.761, and for CSS the values were 0.726, 0.703, and 0.693. Kaplan–Meier analysis indicated significantly improved survival for patients with lower risk scores. The 3-, 5-, and 10-year OS rates for the entire cohort were 54.1%, 45.6%, and 35.1%, respectively, and the CSS rates were 62.9%, 57.5%, and 52.2%, respectively. Conclusions: This study provides validated nomograms for predicting OS and CSS in HNCS patients, offering a reliable tool to support clinical decision-making for this challenging malignancy. These nomograms enhance the ability to predict patient prognosis and personalize treatment strategies. Full article

Background/Objectives: This retrospective observational study aimed to investigate the perioperative outcome in Malignant Peripheral Nerve Sheath Tumors (MPNSTs) with and without relation to Neurofibromatosis Type 1 (NF1) and to detect possible influencing factors. Methods: Clinical reports, histopathological evaluations, imaging, and treatment characteristics were reviewed in 35 operated MPNSTs in 33 patients. Possible predictive valuables included disease type, preoperative tumor volume, SUV and MIB-1 proliferation index, resection margins, the presence of metastasis, and whether radio-/chemotherapy was received. Results: Patients with NF1 were younger (mean age: 29 ± 13, 8–54 years) than sporadic cases (mean age: 45 ± 13, 24–67 years) and exhibited significantly larger preoperative tumor volumes (mean 299 vs. 18 cm³, p = 0.048). Most tumors were located in the facial/cervical/neck area (34%, n = 12), followed by the trunk (31%, n = 11), lower extremity (17%, n = 6), upper extremity (14%, n = 5), and intraspinal area (3%, n = 1). NF1-associated MPNSTs appeared predominantly on the trunk (39%) and sporadically in the facial/cervical/neck area (50%). Complete resection was possible in 66% and an improvement in or stability of function was achieved in most cases (motor 69%, sensory 74%), as well as a decrease in pain intensity (63%). NF1-associated MPNSTs exhibited more severe pain scores (median VRS scale 2, p = 0.002) compared to sporadic tumors (median VRS scale 0.5). Sporadic MPNSTs located at the head/facial/brachial plexus and upper extremities exhibited better preoperative functions compared to those on the lower extremities. In 12 cases with available [¹⁸F]FDG PET, the mean preoperative SUV (9.8 ± 7.2) positively correlated with the mean maximum MIB-1 index (34 ± 26%, p = 0.005) and the mean preoperative tumor volume (474.7 ± 68.6 cm³, p = 0.047). The overall survival (OS) was significantly longer in tumors with higher resection extents (R0, p = 0.01) and without accompanying metastasis (p = 0.046), and tended to be longer, but not significantly so, in sporadic MPNSTs. In six and seven tumors, with R1/R2 resection margins and present metastasis, respectively, solid or combined neo-/adjuvant radio-/chemotherapy led to a significantly shorter OS (p = 0.014). Conclusions: NF1-associated MPNSTs have larger tumor volumes, higher SUVs and MIB-1 proliferation indices, and a shorter overall survival period. Nevertheless, surgery can improve symptoms, particularly medication-resistant pain, and should also be considered in advanced disease for symptom control/improvement. Full article

Background/Objectives: Head and neck squamous cell carcinoma (HNSCC) is a prevalent and aggressive cancer with high rates of metastasis and poor prognosis. Recent research highlights the role of 5-methylcytosine (m⁵C) in cancer progression. NSUN2, an m⁵C methyltransferase, has been implicated in various cancers, but its role in HNSCC remains elusive. Methods: NSUN2 expression and its impact on HNSCC were analyzed by using clinical samples and bioinformatic analysis. m⁵C-Bis-Seq was used to assess changes in mRNA m⁵C modification and identify downstream targets. Both in vitro and vivo studies were performed to evaluate the impact of NSUN2 manipulation on tumor growth and metastasis. Results: Results indicated that NSUN2 was significantly upregulated in HNSCC tissues compared to normal tissues and was associated with poor prognosis. NSUN2 knockdown led to decreased cell proliferation, migration, and invasion in vitro and reduced tumorigenicity and lymph node metastasis in vivo. m⁵C-Bis-Seq revealed altered m⁵C-modification patterns upon NSUN2 knockdown, with LAMC2 identified as a key downstream target. Conclusions: NSUN2-mediated m⁵C-modification enhanced LAMC2 stability, promoting epithelial–mesenchymal transition (EMT) signaling pathways. These findings demonstrate that NSUN2 promotes the initiation and progression of HNSCC by stabilizing the LAMC2 transcript through m⁵C-dependent mechanisms, offering a promising epitranscriptomic-targeted therapeutic approach for HNSCC. Full article

Nasopharyngeal carcinoma (NPC) is a tumor of the head and neck, with a higher incidence in southern China and Southeast Asia. Radiotherapy and chemotherapy are the main treatments; however, metastasis and recurrence remain the main causes of treatment failure. Further, the majority of patients are diagnosed in the late stage due to lack of tumor-specific biomarker for early diagnosis. Therefore, an effective treatment and early detection can improve the outcome of patient with NPC. Axl and EGFR are co-expressed in NPC tissues and play key roles in tumor proliferation, migration, and invasion, which are often correlated with poor prognosis and therapy resistance. In this study, we generated a novel bispecific affibody (Z_239-1907) for the dual targeting and inhibition of Axl and EGFR expression in NPC-positive cells both in vitro and in vivo. The in vitro experiments demonstrated that Z_239-1907 had more pronounced antitumor effects than either modality alone (Z_AXL239 or Z_EGFR1907) in NPC-positive cells. Further, mice bearing NPC-positive tumors showed significant inhibition in tumor growth after treatment with Z_239-1907 compared to Z_AXL239 and Z_EGFR1907. The in vivo tumor targeting ability and imaging also showed that Z_239-1907 specifically and selectively targeted NPC xenograft mice models and accumulate at tumor site as early as 30 min and disappeared within 24 h post-injection. Collectively, these results suggest that Z_239-1907 dual-target affibody is a promising therapeutic agent and a molecular imaging probe for early diagnosis in NPC. Full article

Background: While miRNAs are increasingly recognized for their role in tumorigenesis, their involvement in head and neck cancer (HNC) remains insufficiently explored. Additionally, the carcinogenic mechanisms of areca nut, a major habitual carcinogen in Southeast Asia, are not well understood. Methods and results: This study adopts a systematic approach to identify miRNA profiles associated with areca nut-induced HNC. Using miRNA microarray analysis, we identified 292 miRNAs dysregulated in areca nut-treated HNC cells, with 136 upregulated and 156 downregulated. Bioinformatic analysis of the TCGA-HNSC dataset uncovered a set of 692 miRNAs relevant to HNC development, comprising 449 overexpressed and 243 underexpressed in tumor tissues. Integrating these datasets, we defined a signature of 84 miRNAs, including 39 oncogenic miRNAs (OncomiRs) and 45 tumor-suppressive miRNAs (TsmiRs), highlighting their pivotal role in areca nut-induced carcinogenesis. MultiMiR analysis identified 740 genes cross-regulated by eight hub TsmiRs, significantly impacting key cancer-related pathways (p53, PI3K-AKT, MAPK, and Ras) and critical oncogenic processes. Moreover, we validated miR-499a-5p as a vital regulator, demonstrating its ability to mitigate areca nut-induced cancer progression by reducing cell migration, invasion, and chemoresistance. Conclusions: Thus, this miRNA signature addresses a crucial gap in understanding the molecular underpinnings of areca nut-induced carcinogenesis and offers a promising platform for clinical applications in risk assessment, diagnosis, and prognosis of areca nut-associated malignancies. Full article

Background: CD59, a GPI-anchored membrane protein, protects cancer cells from complement-dependent cytotoxicity (CDC) by inhibiting the formation of the membrane attack complex (MAC). It has been demonstrated to be overexpressed in most solid tumors, where it facilitates tumor cell escape from complement surveillance. The role of CD59 in cancer growth and interactions between CD59 and immune cells that modulate immune evasion has not been well explored. Methods: Using cancer patient database from The Cancer Genome Atlas (TCGA) and other public databases, we analyzed CD59 expression, its prognostic significance, and its association with immune cell infiltration in the tumor microenvironment, identifying associated genomic and functional networks and validating findings with invitro cell-line experimental data. Results: This article describes the abundant expression of CD59 in multiple tumors such as cervical squamous cell carcinoma (CESC), kidney renal cell carcinoma (KIRC), glioblastoma multiforme (GBM), head and neck squamous cell carcinoma (HNSC), and stomach adenocarcinoma (STAD), as well as in pan-cancer, using The Cancer Genome Atlas (TCGA) database and confirmed using multiple cancer cell lines. The expression of CD59 significantly alters the overall survival (OS) of patients with multiple malignancies such as CESC, GBM, HNSC, and STAD. Further, the correlation between CD59 and Treg and/or MDSC in the tumor microenvironment (TME) has shown to be strongly associated with poor outcomes in CESC, GBM, HNSC, and STAD as these tumors express high FOXP3 compared to KIRC. Moreover, unfavorable outcomes were strongly associated with the expression of CD59 and M2 tumor-associated macrophage infiltration in the TME via the IL10/pSTAT3 pathway in CESC and GBM but not in KIRC. In addition, TGFβ1-dominant cancers such as CESC, GBM, and HNSC showed a high correlation between CD59 and TGFβ1, leading to suppression of cytotoxic T cell activity. Conclusion: Overall, the correlation between CD59 and immune cells predicts its prognosis as unfavorable in CESC, GBM, HNSC, and STAD while being favorable in KIRC. Full article

Having suitable animal models is crucial to mimic human disease states and for the successful transfer of experimental data into clinical practice. In the field of papillomavirus research, the domestic rabbit (Oryctolagus cuniculus) has served as an indispensable model organism for almost 100 years. The identification and characterization of the first papillomaviruses in rabbits, their carcinogenic potential and their immunogenicity have contributed significantly to the state of knowledge on the genetics and life cycle of papillomaviruses in general, as well as the development of antiviral strategies such as vaccination procedures. Due to the high species specificity of papillomaviruses, only rabbit papillomaviruses (RPVs) can be used for animal studies on papilloma-based tumor diseases in the rabbit. The major focus of this article is on cottontail rabbit papillomavirus (CRPV)-related rabbit squamous cell carcinoma (RSCC). A brief history outlines the discovery and generation of experimentally used RSCC tumors. A comprehensive overview of the current CRPV-associated VX2 carcinoma-based tumor models with a major focus on human head and neck squamous cell carcinoma (HNSCC) tumor models is provided, and their strengths in terms of transferability to human HNSCC are discussed. Full article

Background/Objectives: Head and neck free-flap reconstructions are often required to treat tumors or extensive post-traumatic jaw defects. The facial artery is the standard receiving vessel for intraoral microvascular anastomoses. However, its use is associated with several disadvantages, such as lesions of buccal nerve branches of the facial nerve or the parotid duct, as well as variability in course and diameter. The aim of this study is to investigate whether branches of the sublingual artery can be considered as an alternative intraoral supply vessel to the facial artery to avoid these drawbacks. Methods: Twelve formalin-fixed cadaveric heads with 24 sides (n = 24) were dissected. The origin, course, branching pattern, and distribution of the sublingual artery were examined. In addition, the diameters of the branches of the sublingual artery were assessed to identify potential supply vessels for anastomoses. Results: In ten of the twenty-four cases (41.7%), the sublingual artery originated from the lingual artery, and in nine cases (37.5%), the lingual artery originated from the facial artery. The main trunk of the sublingual artery was present in the floor of the mouth in all cases (100%), with a diameter of ≥0.9 mm in vitro (1 mm in vivo). In 15 of the 24 half heads (62.5%), branches of the sublingual artery with ≥0.9 mm were identified in this space, with the main branch being considerably stronger. Conclusions: The large diameter of the sublingual artery in the floor of the mandible suggests that this vessel or its branches could be considered as alternative pedicles for intraoral anastomoses in mandibular microvascular free-flap grafts. Full article

Background: Accurate delineation of tumors and organs at risk (OARs) is crucial for intensity-modulated radiation therapy. This study aimed to evaluate the performance of OncoStudio, an AI-based auto-segmentation tool developed for Korean patients, compared with Protégé AI, a globally developed tool that uses data from Korean cancer patients. Methods: A retrospective analysis of 1200 Korean cancer patients treated with radiotherapy was conducted. Auto-contours generated via OncoStudio and Protégé AI were compared with manual contours across the head and neck and thoracic, abdominal, and pelvic organs. Accuracy was assessed using the Dice similarity coefficient (DSC), mean surface distance (MSD), and 95% Hausdorff distance (HD). Feedback was obtained from 10 participants, including radiation oncologists, residents, and radiation therapists, via an online survey with a Turing test component. Results: OncoStudio outperformed Protégé AI in 85% of the evaluated OARs (p < 0.001). For head and neck organs, OncoStudio achieved a similar DSC (0.70 vs. 0.70, p = 0.637) but significantly lower MSD and 95% HD values (p < 0.001). In thoracic organs, OncoStudio performed excellently in 90% of cases, with a significantly greater DSC (male: 0.87 vs. 0.82, p < 0.001; female: 0.95 vs. 0.87, p < 0.001). OncoStudio also demonstrated superior accuracy in abdominal (DSC 0.88 vs. 0.81, p < 0.001) and pelvic organs (male: DSC 0.95 vs. 0.85, p < 0.001; female: DSC 0.82 vs. 0.73, p < 0.001). Clinicians favored OncoStudio in 70% of cases, with 90% endorsing its clinical suitability for Korean patients. Conclusions: OncoStudio, which is tailored for Korean patients, demonstrated superior segmentation accuracy across multiple anatomical regions, suggesting its suitability for radiotherapy planning in this population. Full article

Numerous papers report the occurrence of head and neck tumors in interventional radiology (IR) physicians. Recently, appropriate dosimetry and protection have become much more important. To accomplish these, first, we should accurately understand how the brain is exposed. We assessed the dose distribution of the head and clarified the relationship between head exposure and brain dose. We used eight radiophotoluminescence dosimeters (RPLDs), two at the surface of the eyes and six inside the phantom head. We conducted measurements with three kinds of irradiation fields: one irradiated the whole head, the second irradiated the brain region, and the third irradiated the soft tissue of the face. The cranial bone reduced the brain dose to less than half the skin dose: about 48% at the front and less than 9% at the back of the brain. Due to the brain exposure, the soft tissues were slightly exposed to the scatter radiation from the cranial bone. We revealed the dose distribution of the head and the influence of the scatter radiation from the cranial bone and the soft tissues of the face. There are two kinds of scatter radiation: from the cranial bone to the soft tissue of the face, and from the soft tissue to the brain. Although the influence of these sources of scatter radiation is not significant, the relationship between brain exposure and the occurrence of head and neck tumors is still unclear. Therefore, some IR physicians should keep this in mind if they receive high levels of exposure in their daily practice. Full article

Objectives: Head and neck squamous cell carcinoma (HNSCC) ranks sixth globally, with a 50% five-year survival rate. SAR1A exhibits high expression levels in various tumor types, yet its specific role in HNSCC remains to be clarified. Methods: In vitro assays, such as CCK8, EdU, colony formation, wound-healing, transwell, and Western blotting analyses, as well as in vivo assays, such as tumor xenografts and lung metastasis models, were conducted to evaluate the impacts of SAR1A on HNSCC proliferation, migration, and invasion. Transcriptome sequencing and KEGG enrichment pathway analysis revealed evident alterations in the PI3K/AKT/mTOR(PAM) pathways. LY294002 (a PI3K/AKT inhibitor) was used to investigate the role of the PAM pathway in proliferation, migration, and invasion in HNSCC. Results: Univariate and multivariate Cox regression were conducted to screen SAR1A as a gene prognostic biomarker in HNSCC, and it was validated in the Cancer Genome Atlas (TCGA) database. Functional assays demonstrated that the depletion of SAR1A leads to suppressed proliferation, migration, and invasion of HNSCC cells. This is accompanied by a decrease in the expression of epithelial–mesenchymal transition (EMT)-related markers in HNSCC cell lines. In addition, the diminished capacities of proliferation, migration, and invasion observed in SAR1A knockdown cells were reversed upon the overexpression of SAR1A. Furthermore, RNA-seq and KEGG enrichment analysis demonstrated a significant alteration in the PAM pathway following SAR1A knockdown. LY294002 effectively mitigated the increased proliferation, migration, and invasion induced by SAR1A overexpression. Conclusions: SAR1A facilitates HNSCC proliferation and EMT via the PI3K/AKT/mTOR pathway. Full article

Background and Objectives: Angiomatoid fibrous histiocytoma (AFH) is a rare soft-tissue tumor with a low-grade malignancy. It typically arises in superficial soft tissues of the extremities, head, neck and trunk in children or young adults. Because of its rare entity, it tends to be confused and misdiagnosed. Materials and Methods: A 12-year-old male presented with a painless mass located on his right upper back. The CT finding showed a 7.3 × 2.8 × 5.4 cm-sized, well-defined heterogeneous soft tissue mass in the right infrascapular area. We performed a complete excision, including the surrounding capsule. Result: The final pathology revealed an AFH of intermediate malignancy. On pathologic examination, the lesion was a 5.8 × 4.5 × 2.6 cm-sized mass with a mitotic count of 12/10 HPF, tumor necrosis of 0% and marked increased cellularity and spindle cell morphology. The immunohistochemical study showed negative for S100 and positive for SMA, focal positive for Ki-67, CD68 and positive for CD99, Desmin staining. During the five years of follow-up period, he did not show any evidence of recurrence. Conclusions: The result was satisfactory. We report a case of AFH of the back initially misdiagnosed as an elastofibroma dorsi (ED) with the review of the literature for this uncommon entity. Full article

The present review discusses the transformative role of AI in the diagnosis and management of head and neck cancers (HNCs). Methods: It explores how AI technologies, including ML, DL, and CNNs, are applied in various diagnostic tasks, such as medical imaging, molecular profiling, and predictive modeling. Results: This review highlights AI’s ability to improve diagnostic accuracy and efficiency, particularly in analyzing medical images like CT, MRI, and PET scans, where AI sometimes outperforms human radiologists. This paper also emphasizes AI’s application in histopathology, where algorithms assist in whole-slide image (WSI) analysis, tumor-infiltrating lymphocytes (TILs) quantification, and tumor segmentation. AI shows promise in identifying subtle or rare histopathological patterns and enhancing the precision of tumor grading and treatment planning. Furthermore, the integration of AI with molecular and genomic data aids in mutation analysis, prognosis, and personalized treatment strategies. Conclusions: Despite these advancements, the review identifies challenges in AI adoption, such as data standardization and model interpretability, and calls for further research to fully integrate AI into clinical practice for improved patient outcomes. Full article

The management of head and neck squamous cell carcinoma (HNSCC) relies heavily on TNM staging and WHO histologic grading; however, in recent years, the analysis of prognostic markers expressed in the tumor stroma has gained attention. The tumor–stroma ratio (TSR) quantifies the proportion of tumor tissue relative to the surrounding stromal tissue; it is assessed with the percentage of stromal tissue within the tumor area, with a cutoff point of 50% being widely used to discriminate high-stroma cancer. In this systematic review and meta-analysis, we investigated the potential prognostic role of the TSR in HNSCC. After a literature screening, 24 studies dealing with the TSR and survival outcomes were included. The TSR showed a significant association with overall survival (OS) in both unadjusted and adjusted measures (RR 2.04, CI 1.57–2.65, p < 0.01; HR 2.36 CI 1.89–2.94, p < 0.00001), with an even stronger prognostic potential in oral cavity/oral tongue cancers (RR 2.44 CI 1.84–3.22, p < 0.00001). The TSR also showed prognostic value when dealing with cancer-specific survival and was associated with a reduction in disease-free survival (DFS). In particular, the TSR also retained its prognostic role in terms of DFS when specifically considering early-stage cancers in both unadjusted and adjusted analyses (RR 1.81 CI 1.57–2.10, p < 0.00001; HR 2.09 CI 1.58–2.76, p < 0.00001). Therefore, we conclude that the TSR is a reliable prognostic marker that is easy to assess in routine histological slides and can be effectively implemented in the routine evaluation of HNSCC. Full article

Objectives: This study used multilevel social determinants of health (SDoH) models to determine how SDoH influence different sexes of patients diagnosed with HPV-positive oropharyngeal squamous cell cancers (OPSCC) across the US. Methods: This was a retrospective cohort study assessing HPV-confirmed patients with oropharyngeal squamous cell cancers from 2010 to 2018 using census-level Yost Index socioeconomic status (SES) score and rurality–urbanicity measures alongside individual-level race–ethnicity while stratifying by biological sex. Age-adjusted multivariate regressions were performed for survival, treatment receipt, and delay of treatment initiation (of 3+ months). Results: Across 14,076 OPSCC-HPV-positive patients, delay of treatment uniquely featured positive predictors for males of black race–ethnicity (OR, 2.07; 95% CI, 1.68–2.54) and poor Yost SES (1.43; 1.24–1.65). Five-year all-cause mortality uniquely showed positive predictors of females of black race–ethnicity (2.74; 1.84–4.71) and of males with poor Yost SES (1.98; 1.79–2.19). Three-year all-cause mortality shared positive predictors across sexes but were exacerbated in females of black race–ethnicity (2.50; 1.82–3.44) compared to males (2.23; 1.91–2.60); this was reversed for poor Yost SES (male, 1.92, 1.76–2.10; female, 1.60, 1.32–1.95). Surgery showed negative predictors of black race–ethnicity that displayed worsened effects in females (0.60, 0.44–0.79) versus males (0.75, 0.66–0.86). First-line radiation receipt uniquely featured negative predictors for males of black race–ethnicity (0.73; 0.62–0.86) with poor Yost SES (0.74; 0.68–0.82). Conclusions: Comprehensive models of multilevel SDoH displayed exacerbated disparity effects of community-level SES in males and black race–ethnicity among female HPV-positive OPSCC patients. These objective comparisons of specific SDoH factors inform providers and policy direction on how to strategically target the most pertinent SDoH factors affecting a rapidly growing cancer population. Full article