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Cancers
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Advances in Diagnostics and Treatment of Head and Neck Cancer
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Advances in Diagnostics and Treatment of Head and Neck Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 4943

Special Issue Editor

Dr. Wenko Smolka

E-Mail Website
Guest Editor
Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU Munich, 80337 Munich, Germany
Interests: head and neck cancer; surgical treatment; new therapeutic targets; molecular diagnosis; rehabilitation; quality of life

Special Issue Information

Dear Colleagues,

Head and neck cancer is the seventh most common cancer worldwide. Overall, the 5-year survival rate has substantially improved for head and neck cancer patients over the past decade. Among other factors, this is also due to new treatment options such as PD-1–directed immune-checkpoint inhibitor therapy. However, only a small group of patients currently benefit from immune-checkpoint inhibitor therapy. Furthermore, a 5-year survival rate of 65% for head and neck cancer may still be considered relatively low. Advances in diagnostics and treatment of head and neck cancer are necessary to improve the survival rate as well as the patient’s quality of life further.

This special Issue aims to provide an overview of new knowledge and research fields in head and neck cancer therapy and diagnostics. In addition, it is intended to give an overview of prevention and rehabilitation programs and the impact of treatment on patients’ quality of life.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: clinical and radiological as well as molecular diagnosis and classification, surgical treatment, chemotherapy, radiotherapy, tumor-treating fields, immunotherapy, novel drug development, clinical trials, rehabilitation, sociopsychological aspects of oncological patients, cognition and quality of life.

Dr. Wenko Smolka
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • head and neck cancer
  • surgical treatment
  • radiotherapy
  • chemotherapy
  • immunotherapy
  • molecular diagnosis
  • rehabilitation
  • quality of life

Published Papers (5 papers)

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Research

11 pages, 955 KiB  
Article
Clinical Characteristics and Treatment Outcomes of Oral Cancers Using Transoral Robotic Surgery in an Endemic Region
by Chia-Chun Chang, Chung-Hsiung Chen, Tsai-Ling Hsieh, Kuang-Hsi Chang, Jing-Yang Huang, Frank Cheau-Feng Lin and Stella Chin-Shaw Tsai
Cancers 2023, 15(19), 4896; https://doi.org/10.3390/cancers15194896 - 9 Oct 2023
Cited by 1 | Viewed by 1009
Abstract
Oral cancer poses a major health challenge in Taiwan, consistently ranking among the highest globally in both incidence and cancer-related mortality. Transoral robotic surgery (TORS) has potential advantages over open surgery, but its long-term oncologic outcomes are not well established. In this study, [...] Read more.
Oral cancer poses a major health challenge in Taiwan, consistently ranking among the highest globally in both incidence and cancer-related mortality. Transoral robotic surgery (TORS) has potential advantages over open surgery, but its long-term oncologic outcomes are not well established. In this study, we sought to elucidate the role of TORS in improving treatment outcomes among oral cancer patients. A case–control study with propensity score matching was conducted in a single teaching hospital in Taiwan. It included 72 oral cancer patients in each group to analyze and compare survival outcomes between the surgical approaches. The TORS group demonstrated a higher negative resection margin rate, a lower mortality risk and better overall survival than the open-surgery group. Multivariate Cox regression analysis confirmed TORS’s association with a reduced risk of death. Kaplan–Meier survival analysis and log-rank tests indicated significantly better survival outcomes for the TORS group across all cancer stages. Moreover, the TORS group exhibited improved overall survival rates for stage III and IV patients compared to the conventional open-surgery group. In conclusion, this study suggests that TORS may offer better overall survival rates and potential advantages over conventional surgery for oral cancer treatment. Full article
(This article belongs to the Special Issue Advances in Diagnostics and Treatment of Head and Neck Cancer)
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16 pages, 775 KiB  
Article
Radiomic Assessment of Radiation-Induced Alterations of Skeletal Muscle Composition in Head and Neck Squamous Cell Carcinoma within the Currently Clinically Defined Optimal Time Window for Salvage Surgery—A Pilot Study
by Matthias Santer, Herbert Riechelmann, Benedikt Hofauer, Joachim Schmutzhard, Wolfgang Freysinger, Annette Runge, Timo Maria Gottfried, Philipp Zelger, Gerlig Widmann, Hanna Kranebitter, Stephanie Mangesius, Julian Mangesius, Florian Kocher and Daniel Dejaco
Cancers 2023, 15(18), 4650; https://doi.org/10.3390/cancers15184650 - 20 Sep 2023
Viewed by 936
Abstract
Patients with locally advanced head and neck squamous cell carcinoma (HNSCC) frequently require primary radiochemotherapy (RCT). Despite intensity modulation, the desired radiation-induced effects observed in HNSCC may also be observed as side effects in healthy tissue, e.g., the sternocleidomastoid muscle (SCM). These side [...] Read more.
Patients with locally advanced head and neck squamous cell carcinoma (HNSCC) frequently require primary radiochemotherapy (RCT). Despite intensity modulation, the desired radiation-induced effects observed in HNSCC may also be observed as side effects in healthy tissue, e.g., the sternocleidomastoid muscle (SCM). These side effects (e.g., tissue fibrosis) depend on the interval between the completion of RCT and restaging CT. For salvage surgery, the optimal time window for surgery is currently clinically postulated at between 6 and 12 weeks after completion of RCT. Thus, no extensive tissue fibrosis is to be expected. This interval is based on clinical studies exploring surgical complications. Studies directly exploring radiation-induced changes of the SCM in HNSCC patients are sparse. The present study quantified tissue alterations in the SCM and paravertebral musculature (PVM) after RCT, applying radiomics to determine the optimal time window for salvage surgery. Three radiomic key parameters, (1) volume, (2) mean positivity of pixels (MPP), and (3) uniformity, were extracted with mint LesionTM in the staging CTs and restaging CTs of 98 HNSCC patients. Of these, 25 were female, the mean age was 62 (±9.6) years, and 80.9% were UICC Stage IV. The mean restaging interval was 55 (±28; range 29–229) days. Only the mean volume significantly decreased after RCT, from 9.0 to 8.4 and 96.5 to 91.9 mL for the SCM and PVM, respectively (both p = 0.007, both Cohen’s d = 0.28). In addition, the mean body mass index (BMI) decreased from 23.9 (±4.2) to 21.0 (±3.6) kg/m² (p < 0.001; Cohen’s d = 0.9). The mean BMI decreased significantly and was correlated with the volume decrease for the SCM (r = 0.27; p = 0.007) and PVM (r = 0.41; p < 0.001). If t-test p-values were adjusted for the BMI decrease, no significant change in volumes for the SCM and PVM was observed (both p > 0.05). The present data support the clinically postulated optimal interval for salvage surgery of 6 to 12 weeks. Full article
(This article belongs to the Special Issue Advances in Diagnostics and Treatment of Head and Neck Cancer)
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11 pages, 453 KiB  
Article
Association between Metabolic Syndrome and Risk of Hypopharyngeal Cancer: A Nationwide Cohort Study from Korea
by Jeong Wook Kang, Hyeon-Kyoung Cheong, Su Il Kim, Min Kyeong Lee, Young Chan Lee, In-Hwan Oh and Young-Gyu Eun
Cancers 2023, 15(18), 4454; https://doi.org/10.3390/cancers15184454 - 7 Sep 2023
Viewed by 804
Abstract
This study evaluated the relationship between metabolic syndrome (MS) and the risk of hypopharyngeal cancer. This retrospective cohort study used data from the Korean National Health Insurance Research Database. A total of 4,567,890 participants who underwent a health checkup in 2008 were enrolled. [...] Read more.
This study evaluated the relationship between metabolic syndrome (MS) and the risk of hypopharyngeal cancer. This retrospective cohort study used data from the Korean National Health Insurance Research Database. A total of 4,567,890 participants who underwent a health checkup in 2008 were enrolled. The participants were followed until 2019, and the incidence of hypopharyngeal cancer was analyzed. We evaluated the risk of hypopharyngeal cancer according to the presence of MS, including obesity, dyslipidemia, hypertension, and diabetes, using a multivariate Cox proportional hazards model adjusted for age, sex, alcohol consumption, and smoking. During the follow-up period, 821 were newly diagnosed with hypopharyngeal cancer. MS was inversely associated with the risk of hypopharyngeal cancer (hazard ratio (HR), 0.83 [95% confidence interval (CI), 0.708–0.971]). Large waist circumference and high triglyceride levels among MS elements were both inversely related to the risk of hypopharyngeal cancer (HR: 0.82 [95% CI, 0.711–0.945] and 0.83 [95% CI, 0.703–0.978], respectively). The risk of hypopharyngeal cancer decreased with increasing comorbidity of MS in women (N = 0 vs. N = 1–2 vs. N ≥ 3; HR = 1 vs. HR = 0.511 [95% CI, 0.274–0.952] vs. HR = 0.295 [95% CI, 0.132–0.66]), but not in men. This study may improve our etiological understanding of hypopharyngeal cancer. Full article
(This article belongs to the Special Issue Advances in Diagnostics and Treatment of Head and Neck Cancer)
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8 pages, 1477 KiB  
Article
Metastases of OSCC Based on Oral Lichen Ruber Planus
by Katharina Theresa Obermeier, Sabina Noreen Wuersching, Paris Liokatis, Wenko Smolka, Philipp Poxleitner, Christin Kleye, Michael Ehrenfeld, Maximilian Kollmuss and Sven Otto
Cancers 2023, 15(16), 4092; https://doi.org/10.3390/cancers15164092 - 14 Aug 2023
Cited by 2 | Viewed by 961
Abstract
Oral lichen ruber planus (OLP) is a poorly understood chronically inflammatory disease of the oral mucosa. Malignant transformation into oral squamous cell carcinoma (OSCC) is reported in between 1–2% of cases in the literature. After malignant transformation, surgical treatment—meaning tumor resection combined with [...] Read more.
Oral lichen ruber planus (OLP) is a poorly understood chronically inflammatory disease of the oral mucosa. Malignant transformation into oral squamous cell carcinoma (OSCC) is reported in between 1–2% of cases in the literature. After malignant transformation, surgical treatment—meaning tumor resection combined with neck dissection—is recommended. The recommended extent of treatment is controversial in the literature because this kind of OSCC is often a highly differentiated tumor with a lower risk for lymph nodal spreading. This study aims to overview 103 patients treated in our department due to OLP. The primary outcome parameter was the development of metastases in OLP patients compared to a group of OSCC patients without OLP and the comparison of survival in between both groups. Statistical analysis showed a significantly lower risk for patients with OSCC and with OLP for lymph nodal spreading (p = 0.013). Patients with OSCC and without OLP had a 4.76-higher risk for lymph nodal spreading. On the other hand, second metachronous tumor occurred more often in patients with OSCC and OLP. Overall, OSCC based on OLP occurs more often in female patients, is more highly differentiated and comes with a lower risk for metastases but has a higher risk for second metachronous tumors. Therefore, special attention should be paid to patients with OSCC based on OLP when planning adjuvant therapy and clinical follow-up. The indication for postoperative radiation should be made cautiously in this case, and clinical controls should be performed more closely due to the risk of recurrent disease or tumors at different locations. Full article
(This article belongs to the Special Issue Advances in Diagnostics and Treatment of Head and Neck Cancer)
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16 pages, 1228 KiB  
Article
Postoperative Changes in Systemic Immune Tolerance Following Major Oncologic versus Minor Maxillofacial Surgery
by Leah Trumet, Jutta Ries, Philip Sobl, Niclas Ivenz, Falk Wehrhan, Rainer Lutz, Marco Kesting and Manuel Weber
Cancers 2023, 15(15), 3755; https://doi.org/10.3390/cancers15153755 - 25 Jul 2023
Cited by 1 | Viewed by 823
Abstract
Background: There is increasing evidence of the benefits of adjuvant and neoadjuvant immunotherapy in the treatment of solid malignancies like oral squamous cell carcinoma (OSCC). To optimize (neo-)adjuvant treatment, the systemic immunomodulatory effects of tumor surgery itself need to be considered. Currently, there [...] Read more.
Background: There is increasing evidence of the benefits of adjuvant and neoadjuvant immunotherapy in the treatment of solid malignancies like oral squamous cell carcinoma (OSCC). To optimize (neo-)adjuvant treatment, the systemic immunomodulatory effects of tumor surgery itself need to be considered. Currently, there is little evidence on the immunological effects of major surgery, such as free microvascular flap reconstruction. The current study aims to analyze how and to what extent maxillofacial surgery affects systemic parameters of immune tolerance. Methods: A total of 50 peripheral whole blood samples from patients (Group 1 (G1) = extensive OSCC surgery; Group 2 (G2) = free flap reconstruction without persistent malignant disease; Group 3 (G3) = minor maxillofacial surgery) undergoing surgery were included for real-time quantitative polymerase chain reaction (RT-qPCR) to examine changes in mRNA expression of the biomarkers IL-6, IL-10, FOXP3, and PD-L1. Blood samples were taken immediately before and after surgery as well as on the second, fourth, and tenth postoperative days. Differences in mRNA expression between groups and time points were calculated using statistical tests, including Mann–Whitney U-test and Pearson correlation analysis. Results: Comparing postoperative expression of G1 and G3, there was a significantly higher PD-L1 expression (p = 0.015) in G1 compared to G3 and a significantly lower IL-6 (p = 0.001) and FOXP3 (p = 0.016) expression. Interestingly, IL-10 expression was higher pre- (0.05) and postoperative (p < 0.001) in G1 compared to G3. Additionally, in G1, there was a significant overexpression of IL-10 post-surgery compared to the preoperative value (p = 0.03) and a downregulated expression of FOXP3 between pre- and 2 d post-surgery (p = 0.04). Furthermore, there was a significant correlation between the duration of surgery and the perioperative expression changes of the analyzed biomarkers. As the duration of surgery increased, the expression of IL-10 and PD-L1 increased, and the expression of IL-6 and FOXP3 decreased. Conclusion: Extensive surgery in OSCC patients is associated with a transient shift toward postoperative systemic immune tolerance compared with patients undergoing minor surgery. However, even extensive surgery causes no signs of long-lasting systemic immunosuppression. The degree of immune tolerance that occurred was associated with the duration of surgery. This supports efforts to minimize the duration of surgery. Full article
(This article belongs to the Special Issue Advances in Diagnostics and Treatment of Head and Neck Cancer)
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