Precision Medicine for Head and Neck Surgery

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Personalized Therapy and Drug Delivery".

Deadline for manuscript submissions: 10 September 2024 | Viewed by 1999

Special Issue Editor


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Guest Editor
Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua—“Azienda Ospedale Università di Padova”, 35129 Padua, Italy
Interests: skull base; head and neck cancer; sinonasal malignancies; thyoid cancer; endoscopic surgery; regenerative medicine
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Special Issue Information

Dear Colleagues,

Head and neck cancers are rare and characterized by heterogeneous histotypes with a considerably variable behavior.

So far, the gold standard treatment for most of the tumors of head and neck region is surgery-including protocol. Furthermore, advance head and neck malignancies require a multimodal treatment, encompassing surgery, radiotherapy and chemoterapy in different combinations.

The field of precision medicine has been providing an increasing number of evidences during the last decades. The possibility of tailoring disease treatment by taking into account variability in people's genes, environments, and lifestyles is arousing a particular interest in several medical and surgical specialties, including head and neck surgery. As a matter of fact, advances in precision medicine have already led to powerful new discoveries and treatments that are tailored to specific characteristics of individuals, such as the genetic profile of an individual's tumor. Nowadays, in the head and neck oncology evidences are still poor. For example, neoadjuvant chemotherapy prior to definitive local therapy is more frequently used in some poorly differentiated and locally advanced cancers, but reliable predictive biomarkers of response to chemotherapy are lacking.

This Special Issue, entitled “Precision Medicine for Head and Neck Surgery”, aims to explore innovations regarding precision medicine approach in head and neck cancer treatment.

Dr. Stefano Taboni
Guest Editor

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Keywords

  • ablation margins
  • head and neck cancer
  • skull base tumor
  • endoscopic surgery
  • intraoperative navigation
  • new technologies in surgery
  • biomarkers
  • regenerative medicine in head and neck

Published Papers (2 papers)

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Research

11 pages, 1751 KiB  
Article
Evaluation of a 3D Printed Silicone Oral Cavity Cancer Model for Surgical Simulations
by Donovan Eu, Michael J. Daly, Stefano Taboni, Axel Sahovaler, Ashley N. Gilbank and Jonathan C. Irish
J. Pers. Med. 2024, 14(5), 450; https://doi.org/10.3390/jpm14050450 - 25 Apr 2024
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Abstract
Adequate surgical margins are essential in oral cancer treatment, this is, however, difficult to appreciate during training. With advances in training aids, we propose a silicone-based surgical simulator to improve training proficiency for the ablation of oral cavity cancers. A silicone-based tongue cancer [...] Read more.
Adequate surgical margins are essential in oral cancer treatment, this is, however, difficult to appreciate during training. With advances in training aids, we propose a silicone-based surgical simulator to improve training proficiency for the ablation of oral cavity cancers. A silicone-based tongue cancer model constructed via a 3D mold was compared to a porcine tongue model used as a training model. Participants of varying surgical experience were then asked to resect the tumors with clear margins, and thereafter asked to fill out a questionnaire to evaluate the face and content validity of the models as a training tool. Eleven participants from the Otolaryngology-Head and Neck Surgery unit were included in this pilot study. In comparison to the porcine model, the silicone model attained a higher face (4 vs. 3.6) and content validity (4.4 vs. 4.1). Tumor consistency was far superior in the silicone model compared to the porcine model (4.1 vs. 2.8, p = 0.0042). Fellows and staff demonstrated a better margin clearance compared to residents (median 3.5 mm vs. 1.0 mm), and unlike the resident group, there was no incidence of positive margins. The surgical simulation was overall useful for trainees to appreciate the nature of margin clearance in oral cavity cancer ablation. Full article
(This article belongs to the Special Issue Precision Medicine for Head and Neck Surgery)
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11 pages, 1574 KiB  
Article
Preoperative Diagnosis of Warthin Tumors Combining Cytological, Clinical and Ultrasonographic Information within a Multidisciplinary Approach in a Lump Clinic
by Paolo Fois, Luca Mureddu, Alessandra Manca, Simona Varrucciu, Claudia Crescio, Roberto Gallus, Davide Rizzo, Antonio Cossu and Francesco Bussu
J. Pers. Med. 2023, 13(7), 1075; https://doi.org/10.3390/jpm13071075 - 29 Jun 2023
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Abstract
(1) Background: Warthin tumors account for about 20% of all benign salivary tumors, approaching 50% if we consider only the parotid gland. Wait and see is considered a reasonable option, but the diagnosis should be certain. Diagnosis can be based on morphological and [...] Read more.
(1) Background: Warthin tumors account for about 20% of all benign salivary tumors, approaching 50% if we consider only the parotid gland. Wait and see is considered a reasonable option, but the diagnosis should be certain. Diagnosis can be based on morphological and cytological data, but the sensitivity of the fine needle aspiration cytology (FNAC) is not absolute, with a high rate of non-diagnostic findings in the event of a Warthin tumor, hindering the counseling and therapeutic decisions. The aim of the study is to evaluate the reliability of FNAC and its combination with anamnestic, clinical, and ultrasonographic data in diagnosing Warthin tumors. (2) Methods: A total of 413 patients affected by masses within the major salivary gland and managed between 2017 and 2022 at our institution have been included in the present retrospective study. Each patient underwent fine needle aspiration biopsy (FNAB) with a subsequent cytological diagnosis; successively, for each patient, the clinician (otolaryngologist) and the histopathologist discussed the combination of cytological (even non-diagnostic), clinical, and ultrasonographic data in order to make a “multiparametric” diagnosis. A total of 214 cases were subsequently submitted to surgical resection and had a final histopathology report, to which the cytological and the multiparametric diagnoses can be compared. We extracted all the patients with a cytological, multiparametric, and/or histological diagnosis of Warthin tumors in order to assess the sensitivity and specificity of FNAC and of multiparametric analysis in diagnosing Warthin tumors in case of a major salivary gland mass. (3) Results: One hundred thirty-two cases had a cytological, multiparametric, and/or histological diagnosis of Warthin tumors. FNAC displays a sensitivity of 68.4% and a specificity of 98.7% in diagnosing Warthin tumors. The multiparametric evaluation allowed a considerable improvement in sensitivity (92.9% vs. 68.4%), minimizing the number of non-diagnostic results and preserving at the same time a similar value of specificity (95.5% vs. 98.7%). Notably, none of the patients with a cytological or multiparametric diagnosis of Warthin were affected by a malignant lesion in the final histopathological report. (4) Conclusions: In the case of Warthin tumors, a multiparametric evaluation encompassing anamnestic, clinical, and cytological data is effective in reducing the number of non-diagnostic reports and can safely guide the management of a tumor (e.g., antibiotic treatment of infectious complications, assign a low priority to surgery, even consider observation avoiding surgery) which is absolutely benign and can be associated with no clinically relevant issues. Full article
(This article belongs to the Special Issue Precision Medicine for Head and Neck Surgery)
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