J Voice. 2019 Oct 22. pii: S0892-1997(19)30323-6. doi: 10.1016/j.jvoice.2019.09.010. ,
Compensatory Movement of Contralateral Vocal Folds in Patients With Unilateral Vocal Fold Paralysis.
Xu X1, Zhuang P2, Wilson A3, Jiang JJ4.
Author information
1
Division of Otolaryngology, Xiamen University Zhongshan Hospital, Xiamen, Fujian, China.
2
Division of Otolaryngology, Xiamen University Zhongshan Hospital, Xiamen, Fujian, China. Electronic address: peiyun_zhuang@yahoo.com.
3
Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania.
4
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin.
Abstract
OBJECTIVES:
Previous studies of subjects with unilateral vocal fold paralysis (UVFP) as observed in a positron emission tomography-computed tomography (PET-CT) examination have demonstrated false positive results in the contralateral cricoarytenoid, in which the metabolism may be higher. This area may also be the site of contralateral compensatory movement in these patients. In this study, we compared the adduction speed of the contralateral vocal folds in patients with UVFP and in healthy subjects as measured by the stroboscopic laryngoscope frame rate. This study aimed to explore the contralateral compensatory movement of the vocal folds in subjects with UVFP.

METHODS:
(1) We collected visual data from 14 patients with UVFP and 14 healthy subjects through a stroboscopic laryngoscope. These subjects were divided into a vocal fold paralysis group and a control group, and we analyzed the excessive adduction of the contralateral vocal folds in the vocal fold paralysis group by examining vocal fold movement speed (pixels/s) as featured in a stroboscopic laryngoscope video. (2) We analyzed the uptake of 18-FDG in the posterior vocal fold from positron emission tomography-computed tomography imaging from four subjects with UVFP and 12 healthy subjects. An independent sample t test and a χ2 test were used to compare data.

RESULTS:
Four subjects with UVFP had a higher metabolic rate in the contralateral cricoarytenoid joints, with a significant difference between the two groups, P < 0.05. Fifty percent of the cases of contralateral adduction of the vocal folds in the subjects with UVFP adducted past the midline, with a significant difference between the two groups, P < 0.05. The contralateral adduction of the vocal folds in subjects with UVFP had shorter video frames and higher adduction speed than the control group, and the difference was statistically significant, P < 0.05. There were fewer vocal fold abduction video frames and higher abduction speed of the healthy side of the vocal fold in subjects with UVFP than the control group, but there was no statistically significant difference, P > 0.05.

CONCLUSION:
Subjects with UVFP exhibited faster adduction compensation in the contralateral vocal folds, and the contralateral cricoarytenoid joint's metabolism in subjects with UVFP was higher. These data may help clarify the diagnostic criteria for laryngeal nerve damage.

Copyright © 2019 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

KEYWORDS:
PET CT; Vocal fold; Vocal fold compensatory movement; Vocal fold movement; Vocal fold paralysis

PMID: 31653598 DOI: 10.1016/j.jvoice.2019.09.010
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Select item 31653573
42.
Radiother Oncol. 2019 Oct 22. pii: S0167-8140(19)33111-1. doi: 10.1016/j.radonc.2019.09.022. [Epub ahead of print]
Improving automatic delineation for head and neck organs at risk by Deep Learning Contouring.
van Dijk LV1, Van den Bosch L2, Aljabar P3, Peressutti D3, Both S2, J H M Steenbakkers R2, Langendijk JA2, Gooding MJ3, Brouwer CL2.
Author information
1
Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands. Electronic address: l.v.van.dijk@umcg.nl.
2
Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands.
3
Mirada Medical Ltd, Oxford Centre for Innovation, UK.
Abstract
INTRODUCTION:
Adequate head and neck (HN) organ-at-risk (OAR) delineation is crucial for HN radiotherapy and for investigating the relationships between radiation dose to OARs and radiation-induced side effects. The automatic contouring algorithms that are currently in clinical use, such as atlas-based contouring (ABAS), leave room for improvement. The aim of this study was to use a comprehensive evaluation methodology to investigate the performance of HN OAR auto-contouring when using deep learning contouring (DLC), compared to ABAS.

METHODS:
The DLC neural network was trained on 589 HN cancer patients. DLC was compared to ABAS by providing each method with an independent validation cohort of 104 patients, which had also been manually contoured. For each of the 22 OAR contours - glandular, upper digestive tract and central nervous system (CNS)-related structures - the dice similarity coefficient (DICE), and absolute mean and max dose differences (|Δmean-dose| and |Δmax-dose|) performance measures were obtained. For a subset of 7 OARs, an evaluation of contouring time, inter-observer variation and subjective judgement was performed.

RESULTS:
DLC resulted in equal or significantly improved quantitative performance measures in 19 out of 22 OARs, compared to the ABAS (DICE/|Δmean dose|/|Δmax dose|: 0.59/4.2/4.1 Gy (ABAS); 0.74/1.1/0.8 Gy (DLC)). The improvements were mainly for the glandular and upper digestive tract OARs. DLC significantly reduced the delineation time for the inexperienced observer. The subjective evaluation showed that DLC contours were more often preferable to the ABAS contours overall, were considered to be more precise, and more often confused with manual contours. Manual contours still outperformed both DLC and ABAS; however, DLC results were within or bordering the inter-observer variability for the manual edited contours in this cohort.

CONCLUSION:
The DLC, trained on a large HN cancer patient cohort, outperformed the ABAS for the majority of HN OARs.

Copyright © 2019. Published by Elsevier B.V.

KEYWORDS:
Artificial intelligent; Auto segmentation; Contouring; Deep learning; Head and neck; Organs at risks

PMID: 31653573 DOI: 10.1016/j.radonc.2019.09.022
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Select item 31653566
43.
Brachytherapy. 2019 Oct 22. pii: S1538-4721(19)30584-7. doi: 10.1016/j.brachy.2019.09.006. [Epub ahead of print]
Efficacy and safety of CT-guided 125I seed implantation as a salvage treatment for locally recurrent head and neck soft tissue sarcoma after surgery and external beam radiotherapy: A 12-year study at a single institution.
Chen Y1, Jiang Y1, Ji Z1, Jiang P1, Xu F1, Zhang Y2, Guo F1, Peng R1, Li X1, Sun H1, Lei R1, Fan J1, Li W1, Wang J3.
Author information
1
Department of Radiation Oncology, Peking University Third Hospital, Beijing, China.
2
Department of Radiotherapy, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.
3
Department of Radiation Oncology, Peking University Third Hospital, Beijing, China. Electronic address: junjiewang_edu@sina.cn.
Abstract
OBJECTIVES:
The objective of this study was to evaluate the efficacy and safety of CT-guided radioactive 125I seed implantation as a salvage treatment for locally recurrent head and neck soft tissue sarcoma (HNSTS) after surgery and external beam radiotherapy.

METHODS AND MATERIALS:
From December 2006 to February 2018, 25 patients with locally recurrent HNSTS after surgery and external beam radiotherapy were enrolled. All the patients successfully underwent CT-guided 125I seed implantation. The primary end points included the objective response rate (ORR) and local progression-free survival (LPFS). The secondary end points were survival (OS) and safety profiles.

RESULTS:
After 125I seed implantation, the ORR was 76.0%. The 1-, 3-, and 5-year LPFS rates were 65.6%, 34.4%, and 22.9%, respectively, with the median LPFS of 16.0 months. The 1-, 3-, and 5-year OS rates were 70.8%, 46.6%, and 34.0%, respectively, with the median OS of 28.0 months. Furthermore, univariate analyses showed that the recurrent T stage and histological grade were prognostic factors of LPFS, whereas only the histological grade was a predictor of OS. The major adverse events were skin/mucosal toxicities, which were generally of lower grade (≤Grade 2) and were well tolerated.

CONCLUSIONS:
Radioactive 125I seed implantation could be an effective and safe alternative treatment for locally recurrent HNSTS after failure of surgery and radiotherapy. Recurrent T stage and histological grade were the main factors influencing the efficacy.

Copyright © 2019 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

KEYWORDS:
Brachytherapy; CT-guided radiotherapy; Head and neck soft tissue sarcoma; Iodine-125; Recurrent cancer

PMID: 31653566 DOI: 10.1016/j.brachy.2019.09.006
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Select item 31653434
44.
Br J Oral Maxillofac Surg. 2019 Oct 22. pii: S0266-4356(19)30317-1. doi: 10.1016/j.bjoms.2019.08.002. [Epub ahead of print]
Immunotherapy in the management of squamous cell carcinoma of the head and neck.
Subramaniam SS1, Paterson C2, McCaul JA3.
Author information
1
Department of Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, UK. Electronic address: shivassubramaniam@gmail.com.
2
Beaston West of Scotland Cancer Centre, 1053 Great Western Rd, Glasgow, UK. Electronic address: Claire.paterson2@ggc.scot.nhs.uk.
3
Department of Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, UK. Electronic address: mccaulsurgery@gmail.com.
Abstract
Despite many advances in surgery, radiotherapy, and systemic treatments, only modest improvements in survival, function, and quality of life have been achieved after treatment of squamous cell carcinoma (SCC) of the head and neck. With a better understanding of the biology and genetics of tumours, the emergence of a paradigm shift towards the further development of non-surgical treatments may result in less morbidity and better outcomes than are seen currently. SCC of the head and neck is known to be a complex disease that has a sophisticated interaction with the human immune system. At the forefront of emerging treatments is immunotherapy, which has already been established in many other areas of oncology. The rapidly evolving nature of immunotherapeutic agents and, sometimes, their complex mechanisms can make the understanding of these concepts challenging, and could discourage clinicians from engaging in clinical trials. The aim of this paper therefore was to review the current premise for immunotherapeutic approaches, and to provide a contemporary evidence-based rationale for their use.

Copyright © 2019 The British Association of Oral and Maxillofacial Surgeons. All rights reserved.

KEYWORDS:
head and neck squamous cell carcinoma; immunotherapy; oral squamous cell carcinoma

PMID: 31653434 DOI: 10.1016/j.bjoms.2019.08.002
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Select item 31653276
45.
J Otolaryngol Head Neck Surg. 2019 Oct 25;48(1):55. doi: 10.1186/s40463-019-0374-3.
Pathological margins and advanced cutaneous squamous cell carcinoma of the head and neck.
Phillips TJ1,2, Harris BN3, Moore MG3, Farwell DG3, Bewley AF3.
Author information
1
Department of Otolaryngology-Head and Neck Surgery, UC Davis, Sacramento, California, USA. tjphilli@dal.ca.
2
Division of Head and Neck Surgery, Kingston Health Science Center, Queen's University, 2nd Floor Murray Building, Hotel Dieu Hospital, Bagot Street, Kingston, Ontario, Canada. tjphilli@dal.ca.
3
Department of Otolaryngology-Head and Neck Surgery, UC Davis, Sacramento, California, USA.
Abstract
OBJECTIVE:
The recommended treatment for cutaneous squamous cell cancer (CuSCC) of the head and neck is Mohs surgical excision or wide local excision. Excision is recommended to a gross surgical margin of 4-6 mm however this is based on limited evidence and specify a goal histologic margin. The objective of this study was therefore to examine the reported histological margin distance following WLE of advanced CuSCC and its association with recurrence and survival.

STUDY DESIGN:
Retrospective database review.

SETTING:
All patients included received treatment at UC Davis Department of Otolaryngology-Head and Neck Surgery and/or Radiation Oncology in Sacramento, California.

SUBJECTS AND METHODS:
The patients included were treated for advanced CuSCC with primary surgery with or without adjuvant therapy. Kaplan Meier survival curves with log rank analysis were then performed to compare 5-year recurrence free survival, and disease-specific survival for patients with different margin distances.

RESULTS:
Total number of subjects was 92. The overall 5-year DSS and RFS was 68.8 and 51.0% respectively. When the pathological margin distance was ≥5 mm, 5-year disease specific survival was improved when compared to margin distance less than 5 mm (94.7 vs 60.7 p = 0.034).

CONCLUSION:
The findings of this study suggest that a histologic margin of at least 5 mm may increase survival in advanced head and neck CuSCC patients.

PMID: 31653276 DOI: 10.1186/s40463-019-0374-3
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Select item 31653164
46.
Asian Pac J Cancer Prev. 2019 Oct 1;20(10):3129-3136. doi: 10.31557/APJCP.2019.20.10.3129.
Acute Stage Longitudinal Change of Quality of Life from Pre- to 3 Months after Surgical Treatment in Head and Neck Cancer Patients.
Tashimo Y1, Ihara Y1, Yuasa K1, Nozue S1, Saito Y2, Katsuta H2, Shimane T2, Takahashi K1.
Author information
1
Division of Oral Rehabilitation Medicine, Department of Special Needs Dentistry, Showa University, School of Dentistry, Tokyo, Japan.
2
Head and Neck Oncology Center, Showa University Hospital, Tokyo, Japan.
Abstract
PURPOSE:
Head and neck cancer (HNC) patients experience various posttreatment side effects that decrease quality of life (QOL). Some previous study reported that QOL of HHC patients were returned baseline (before treatment) after a year post treatment. However, acute stage longitudinal changes of QOL in HNC patients remains unclear. This point might be important for early reintegration of HNC patients. This study aimed to investigate the acute stage longitudinal change of the relationship between QOL and oral function in HNC patients had surgery.

METHODS:
45 HNC patients (23 men) scheduled for surgical treatment were enrolled in this study. Primary tumor sites were 22 tongue, 5 maxilla, 4 mandible, 3 pharynx and others. Weight, body mass index (BMI), whole body soft lean mass (SLM), and skeletal muscle mass (SMM) were evaluated as muscle mass-related measurements. Lip closure force (LC) and tongue pressure (TP) were evaluated as oral function measurements. Feeding function was evaluated using the Functional Oral Intake Scale (FOIS). QOL was assessed using the European Organization for Research and Treatment of Cancer QOL Questionnaire QLQ-C30 and H&N 35. Measures were evaluated at pre-surgical treatment (PT), and 1 month (1M) and 3 months (3M) after surgery. The change of QOL parameters and relationships between measurements were assessed.

RESULTS:
For QOL assessments, role functioning, fatigue, speech problems, trouble with social eating, trouble with social contact, and opening mouth significantly decreased from PT to 1M, but significantly increased from 1M to 3M. Weight, BMI, SLM, SMM, LC, TP, and FOIS demonstrated significant relationships with QOL from PT to 1M. Meanwhile, from 1M to 3M, weight, BMI, SLM, SMM, LC, and FOIS showed significant relationships with QOL assessments.

CONCLUSIONS:
Both oral function and muscle mass-related measurements significantly affected QOL in HNC patients.

KEYWORDS:
Feeding function; Muscle mass; Oral function; Quality of Life; head and neck cancer

PMID: 31653164 DOI: 10.31557/APJCP.2019.20.10.3129
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Select item 31653019
47.
Nutrients. 2019 Oct 24;11(11). pii: E2570. doi: 10.3390/nu11112570.
Patients Discharged with Home Enteral Nutrition from a Third-Level Hospital in 2018.
Campos-Martín C1, García-Torres MD2, Castillo-Martín C3, Domínguez-Rabadán R4, Rabat-Restrepo JM5.
Author information
1
Endocrinology and Nutrition Department, Universitary Hospital Virgen Macarena, 41009 Seville, Spain. smaradigna@hotmail.com.
2
Endocrinology and Nutrition Department, Universitary Hospital Virgen Macarena, 41009 Seville, Spain. m_doloresgt@hotmail.com.
3
Hospital Pharmacy Department, Universitary Hospital Virgen Macarena, 41009 Seville, Spain. christinacm93@hotmail.com.
4
Endocrinology and Nutrition Department, Universitary Hospital Virgen Macarena, 41009 Seville, Spain. rociodr91@hotmail.com.
5
Endocrinology and Nutrition Department, Universitary Hospital Virgen Macarena, 41009 Seville, Spain. rabat@us.es.
Abstract
Patients who, during admission, begin to use enteral nutrition (EN) and do not recover adequate oral intake need proper planning prior to discharge. The present study is a descriptive analysis of patients discharged with EN from our hospital in 2018. In all, the study included 141 patients (50.3% male) with an average age of 76.18 ± 14 years with the most frequent reasons for enteral support being neurological disease (71.3%) and ear, nose, and throat (ENT) and maxillofacial surgery (17.02%) (others accounted for 11.68%). In these two groups, differences were observed in both the average age (77 vs. 70.5 years) and sex of patients-mostly women (58%) in the first group and men (70%) in the second. Overall, the access routes used were nasogastric tube (76.4%), and percutaneous endoscopic gastrostomy (18.4%); 67.1% of the episodes ended by 30 June, 60.6% of patients died (47% of neurological patients), and 39.3% patients recovered function of the oral passage (85% of surgical/head and neck tumor). The duration of support was as follows: 1-3 months, 32%; 6-12 months, 26.9%; more than 12 months, 18.5%. This indicated some frequent and clearly differentiated profiles in the patients studied, which may contribute to better care and support in order to maintain long-term treatment.

KEYWORDS:
dysphagia; head and neck tumor; home enteral nutrition; nutritional support; stroke

PMID: 31653019 DOI: 10.3390/nu11112570
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Select item 31652973
48.
Cancers (Basel). 2019 Oct 24;11(11). pii: E1633. doi: 10.3390/cancers11111633.
The Role of Merlin/NF2 Loss in Meningioma Biology.
Lee S1, Karas PJ2, Hadley CC3, Bayley V JC4, Khan AB5, Jalali A6, Sweeney AD7, Klisch TJ8,9, Patel AJ10,11,12.
Author information
1
Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA. sungho.lee@bcm.edu.
2
Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA. patrick.karas@bcm.edu.
3
Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA. caroline.hadley@bcm.edu.
4
Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA. james.bayley@bcm.edu.
5
Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA. abdul.khan@bcm.edu.
6
Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA. ali.jalali@bcm.edu.
7
Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX 77030, USA. alex.sweeney@bcm.edu.
8
Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX 77030, USA. tiemo.klisch@bcm.edu.
9
Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA. tiemo.klisch@bcm.edu.
10
Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA. Akash.Patel@bcm.edu.
11
Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX 77030, USA. Akash.Patel@bcm.edu.
12
Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX 77030, USA. Akash.Patel@bcm.edu.
Abstract
Mutations in the neurofibromin 2 (NF2) gene were among the first genetic alterations implicated in meningioma tumorigenesis, based on analysis of neurofibromatosis type 2 (NF2) patients who not only develop vestibular schwannomas but later have a high incidence of meningiomas. The NF2 gene product, merlin, is a tumor suppressor that is thought to link the actin cytoskeleton with plasma membrane proteins and mediate contact-dependent inhibition of proliferation. However, the early recognition of the crucial role of NF2 mutations in the pathogenesis of the majority of meningiomas has not yet translated into useful clinical insights, due to the complexity of merlin's many interacting partners and signaling pathways. Next-generation sequencing studies and increasingly sophisticated NF2-deletion-based in vitro and in vivo models have helped elucidate the consequences of merlin loss in meningioma pathogenesis. In this review, we seek to summarize recent findings and provide future directions toward potential therapeutics for this tumor.

KEYWORDS:
DREAM complex; meningioma; merlin; neurofibromin 2; next-generation sequencing

PMID: 31652973 DOI: 10.3390/cancers11111633
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Select item 31652949
49.
Int J Mol Sci. 2019 Oct 24;20(21). pii: E5276. doi: 10.3390/ijms20215276.
Role of Matrix Metalloproteinases 7 in the Pathogenesis of Laryngopharyngeal Reflux: Decreased E-cadherin in Acid exposed Primary Human Pharyngeal Epithelial Cells.
Im NR1, Lee DY2, Kim B3,4, Kim J5, Jung KY6, Kim TH7, Baek SK8.
Author information
1
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 02841, Korea. snwksnwksnwk@hanmail.net.
2
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Boramae Medical Center, Seoul 07061, Korea. gedo0212@naver.com.
3
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 02841, Korea. autru222@gmail.com.
4
Neuroscience research institute, College of Medicine, Korea University, Seoul 02841, Korea. autru222@gmail.com.
5
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 02841, Korea. 1023kdh@naver.com.
6
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 02841, Korea. kyjungmd@gmail.com.
7
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 02841, Korea. doctorthk@gmail.com.
8
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 02841, Korea. mdskbaek@gmail.com.
Abstract
Cleavage of E-cadherin and the resultant weakness in the cell-cell links in the laryngeal epithelium lining is induced by exposure to acidic contents of the refluxate. Herein, we aimed to evaluate the role of matrix metalloproteinases (MMPs) in inducing E-cadherin level changes following acid exposure to the human pharyngeal mucosal cells. E-cadherin levels were inversely correlated with the duration of acid exposure. Treatment with actinonin, a broad MMP inhibitor, inhibited this change. Immunocytochemical staining and transepithelial permeability test revealed that the cell surface staining of E-cadherin decreased and transepithelial permeability increased after acid exposure, which was significantly inhibited by the MMP inhibitor. Among the various MMPs analyzed, the mRNA for MMP-7 in the cellular component was upregulated, and the secretion and enzymatic activity of MMP-7 in the culture media increased with the acid treatment. Consequently, MMP-7 plays a significant role in the degradation of E-cadherin after exposure to a relatively weak acidic condition that would be similar to the physiologic condition that occurs in Laryngopharyngeal reflux disease patients.

KEYWORDS:
E-cadherin; acid; laryngopharyngeal reflux; matrix metalloproteinase; permeability

PMID: 31652949 DOI: 10.3390/ijms20215276
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Select item 31652939
50.
Cancers (Basel). 2019 Oct 24;11(11). pii: E1630. doi: 10.3390/cancers11111630.
Applications of Bioinformatics in Cancer.
Brenner C1,2,3.
Author information
1
Department of Otolaryngology-Head and Neck Surgery, Michigan Otolaryngology and Translational Oncology Laboratory, University of Michigan Health Systems, Ann Arbor, MI 48109-0602, USA. chadbren@umich.edu.
2
Department of Pharmacology, Michigan Otolaryngology and Translational Oncology Laboratory, University of Michigan Health Systems, Ann Arbor, MI 48109-0602, USA. chadbren@umich.edu.
3
Rogel Cancer Center, University of Michigan Medical School, 1150 E. Medical Center Dr., 9301B MSRB3, Ann Arbor, MI 48109-0602, USA. chadbren@umich.edu.
Abstract
This series of 25 articles (22 original articles, 3 reviews) is presented by international leaders in bioinformatics and biostatistics [...].

KEYWORDS:
Computational Immunology; Neoantigen Prediction; Network Analysis; artificial intelligence; bioinformatics; circulating tumor DNA (ctDNA); machine learning; precision medicine; single-cell sequencing

PMID: 31652939 DOI: 10.3390/cancers11111630
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Select item 31652840
51.
J Clin Med. 2019 Oct 23;8(11). pii: E1767. doi: 10.3390/jcm8111767.
Texture Analysis of Multi-Shot Echo-planar Diffusion-Weighted Imaging in Head and Neck Squamous Cell Carcinoma: The Diagnostic Value for Nodal Metastasis.
Park JH1,2, Bae YJ3, Choi BS4, Jung YH5, Jeong WJ6, Kim H7, Sunwoo L8, Jung C9, Kim JH10.
Author information
1
Department of Radiology, Ajou University School of Medicine, Ajou University Medical Center, Suwon 443-380, Korea. nadine16jhp@gmail.com.
2
Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea. nadine16jhp@gmail.com.
3
Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea. bae729@gmail.com.
4
Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea. byungse.choi@gmail.com.
5
Department of Otolaryngology-Head&Neck Surgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea. entist@naver.com.
6
Department of Otolaryngology-Head&Neck Surgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea. safar@snubh.org.
7
Department of Pathology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea. hyojinkim7137@gmail.com.
8
Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea. leonard.sunwoo@gmail.com.
9
Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea. jck0097@gmail.com.
10
Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea. jaehkim@snu.ac.kr.
Abstract
Accurate assessment of nodal metastasis in head and neck squamous cell carcinoma (SCC) is important, and diffusion-weighted imaging (DWI) has emerged as a potential technique in differentiating benign from malignant lymph nodes (LNs). This study aims to evaluate the diagnostic performance of texture analysis using apparent diffusion coefficient (ADC) data of multi-shot echo-planar imaging-based DWI (msEPI-DWI) in predicting metastatic LNs of head and neck SCC. 36 patients with pathologically proven head and neck SCC were included in this study. A total of 204 MRI-detected LNs, including 176 subcentimeter-sized LNs, were assigned to metastatic or benign groups. Texture features of LNs were compared using independent t-test. Hierarchical cluster analysis was performed to exclude redundant features. Multivariate logistic regression and receiver operating characteristic analysis were performed to assess the diagnostic performance. The discriminative texture features for predicting metastatic LNs were complexity, energy and roundness. Areas under the curves (AUCs) for diagnosing metastasis in all/subcentimeter-sized LNs were 0.829/0.767 using complexity, 0.699/0.685 using energy and 0.671/0.638 using roundness, respectively. The combination of three features resulted in higher AUC values of 0.836/0.781. In conclusion, texture analysis of ADC data using msEPI-DWI could be a useful tool for nodal staging in head and neck SCC.

KEYWORDS:
apparent diffusion coefficient; diffusion-weighted imaging; lymph node; squamous cell carcinoma; texture analysis

PMID: 31652840 DOI: 10.3390/jcm8111767
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Conflict of interest statement
Grant support
Select item 31652413
52.
J Speech Lang Hear Res. 2019 Oct 25:1-15. doi: 10.1044/2019_JSLHR-S-19-0144. [Epub ahead of print]
Categorical and Dimensional Ratings of Emotional Speech: Behavioral Findings From the Morgan Emotional Speech Set.
Morgan SD1,2.
Author information
1
Program in Audiology, Department of Otolaryngology Head and Neck Surgery and Communicative Disorders, School of Medicine, University of Louisville, KY.
2
Department of Communication Sciences and Disorders, University of Utah, Salt Lake City.
Abstract
Purpose Emotion classification for auditory stimuli typically employs 1 of 2 approaches (discrete categories or emotional dimensions). This work presents a new emotional speech set, compares these 2 classification methods for emotional speech stimuli, and emphasizes the need to consider the entire communication model (i.e., the talker, message, and listener) when studying auditory emotion portrayal and perception. Method Emotional speech from male and female talkers was evaluated using both categorical and dimensional rating methods. Ten young adult listeners (ages 19-28 years) evaluated stimuli recorded in 4 emotional speaking styles (Angry, Calm, Happy, and Sad). Talker and listener factors were examined for potential influences on emotional ratings using categorical and dimensional rating methods. Listeners rated stimuli by selecting an emotion category, rating the activation and pleasantness, and indicating goodness of category fit. Results Discrete ratings were generally consistent with dimensional ratings for speech, with accuracy for emotion recognition well above chance. As stimuli approached dimensional extremes of activation and pleasantness, listeners were more confident in their category selection, indicative of a hybrid approach to emotion classification. Female talkers were rated as more activated than male talkers, and female listeners gave higher ratings of activation compared to male listeners, confirming gender differences in emotion perception. Conclusion A hybrid model for auditory emotion classification is supported by the data. Talker and listener factors, such as gender, were found to impact the ratings of emotional speech and must be considered alongside stimulus factors in the design of future studies of emotion.

PMID: 31652413 DOI: 10.1044/2019_JSLHR-S-19-0144
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Select item 31652350
53.
Clin Exp Immunol. 2019 Oct 25. doi: 10.1111/cei.13389. [Epub ahead of print]
Oral Cancer-associated Tertiary Lymphoid Structures: Gene-Expression Profile and Prognostic Value.
Li K1,2,3, Guo Q4, Zhang X5, Dong X5, Liu W6, Zhang A6, Li Y5, Yan J5, Jia G5, Zheng Z5, Tang W6, Pan L6, An M7, Zhang B2,3, Liu S1, Fu B6.
Author information
1
Department of Human Anatomy, Histology and Embryology, Shandong University School of Medicine, Jinan, P.R, China.
2
Department of Stomatology, Liaocheng People's Hospital, Liaocheng, P.R, China.
3
Shandong Province Key Laboratory of Oral and Maxillofacial-Head and Neck Medicine, Liaocheng, P.R, China.
4
Department of Clinical Laboratory, Yidu Central Hospital of Weifang, Weifang, P.R, China.
5
Department of Pathology, Liaocheng People's Hospital, Liaocheng, P.R, China.
6
Department of Central Laboratory, Liaocheng People's Hospital, Liaocheng, P.R, China.
7
Department of Clinical Laboratory, Liaocheng People's Hospital, Liaocheng, P.R, China.
Abstract
Tertiary lymphoid structure (TLS) provides a local and critical microenvironment for both cellular and humoral immunity and supports effective antigen presentation and lymphocyte activation. However, the gene expression profile and prognostic significance of TLS in oral cancer remain largely unrevealed. In this study, we found the presence of both intratumoral and peritumoral TLSs in a series of 65 patients with oral cancer treated by surgical resection, with the positive detection rates of 33.8% and 75.4%, respectively. The presence of intratumoral TLSs, but not peritumoral TLSs, was significantly associated with decreased P53 and Ki67 scores (P = 0.027 and 0.047, respectively). The survival analyses revealed that oral cancer patients with higher grade of TLSs was associated with improved disease-free survival (DFS) and overall survival (OS) (P = 0.037 and 0.031, respectively). Gene expression profiling analysis of the cytokines and chemokines responsible for lymph-node neogenesis identified a 3-upregulated-gene set, i.e. IL7, LTB and CXCL13, which was indicated correlated with human oral cancer-associated TLSs. This study provides a framework for better understanding of oral cancer-associated TLSs, and for delineating future innovative prognostic biomarkers and immune therapeutic strategies for oral cancer.

© 2019 British Society for Immunology.

KEYWORDS:
oral cancer; prognostic biomarker; tertiary lymphoid structure; therapeutic target

PMID: 31652350 DOI: 10.1111/cei.13389
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54.
Dermatol Surg. 2019 Oct 24. doi: 10.1097/DSS.0000000000002162. [Epub ahead of print]
Superficial Basal Cell Cancers Demonstrate Higher Rates of Mixed Histology on High-Risk Anatomical Sites.
Petersen ET1, Ahmed SR1, Pradhan D2, MacFarlane DF1,3.
Author information
1
Departments of Dermatology.
2
Anatomical Pathology, and.
3
Plastic Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas.
Abstract
BACKGROUND:
The Mohs Appropriate Use Criteria (MAUC) have come into question recently regarding the most appropriate treatment for superficial basal cell carcinoma (sBCC). At the heart of this debate is the limited body of evidence describing tumor behavior of sBCC based on clinical factors relevant to the MAUC.

OBJECTIVE:
To determine whether sBCC is more likely to harbor aggressive subtypes in high-risk anatomical locations and in immunocompromised patients.

MATERIALS AND METHODS:
A single institution retrospective review produced 133 evaluable Mohs cases performed on sBCC over a 10-year period. All slides from the respective cases were reviewed for the presence of histologic patterns other than known sBCC. Cases were then grouped by both MAUC anatomical zone (H, M, and L) and patient immune status for statistical analysis.

RESULTS:
A significantly higher rate of mixed histology (MH) was observed when comparing Zone H with Zone L across all patients, healthy patients, and immunocompromised patients. The same was true when comparing Zone M with Zone L for all patients and healthy patients (immunocompromised did not reach significance).

CONCLUSION:
The authors' data very clearly demonstrate a higher rate of MH in sBCC of the head and neck which provides strong support to the current MAUC scoring.

PMID: 31652222 DOI: 10.1097/DSS.0000000000002162
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Select item 31652217
55.
J Craniofac Surg. 2019 Oct 24. doi: 10.1097/SCS.0000000000005929. [Epub ahead of print]
Intranasal Bolsters: A Novel Technique for Nasal Bone Stabilization.
Shokri T1, Hilger PA2, Lighthall JG1,3.
Author information
1
Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA.
2
Facial Plastic & Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery.
3
Department of Surgery, Director, Section of Facial Plastic and Reconstructive Surgery, Division of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA.
Abstract
Nasal bone stabilization, in the setting of comminuted nasal fracture or surgical osteotomy, represents a challenging surgical experience. Postoperative shifting of osseous fragments may result in compromised outcomes in an otherwise well-performed procedure. Although prior studies have reported nasal bone fixation with implementation of wires, plates, or halos, these techniques are often difficult to employ routinely. Herein, the authors describe a novel and facile technique for the maintenance of unstable nasal bones using customized intranasal bolsters.

PMID: 31652217 DOI: 10.1097/SCS.0000000000005929
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Select item 31651991
56.
J Forensic Sci. 2019 Oct 25. doi: 10.1111/1556-4029.14225. [Epub ahead of print]
Commentary on: Zhuo Y, Wang X, Wu J, Zhang S, Deng H, Liu W, et al. Simultaneous quantitative determination of amphetamines, opiates, ketamine, cocaine and metabolites in human hair: application to forensic cases of drug abuse. J Forensic Sci doi: 10.1111/1556-4029.14179. Epub 2019 Sep 9.
Hu J1, Zheng N2, Liang M3.
Author information
1
Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
2
Department of Pathology, Health Science Center, Shenzhen University, Shenzhen, 518066, Guangdong, China.
3
Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
PMID: 31651991 DOI: 10.1111/1556-4029.14225
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Publication type
Select item 31651887
57.
Medicine (Baltimore). 2019 Oct;98(43):e17651. doi: 10.1097/MD.0000000000017651.
A systematic review and meta-analysis approach on diagnostic value of MLH1 promoter methylation for head and neck squamous cell carcinoma.
Li Q1, Hong J2, Shen Z1, Deng H1, Shen Y1, Wu Z3, Zhou C1.
Author information
1
Department of Otorhinolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital (Lihuili Hospital of Ningbo University).
2
Department of Hand Surgery, Ningbo 6th Hospital, Ningbo University.
3
Department of Otorhinolaryngology Head and Neck Surgery, Ningbo Medical Center, Lihuili Eastern Hospital, Ningbo, Zhejiang, People's Republic of China.
Abstract
BACKGROUND:
Head and neck squamous cell carcinoma (HNSCC) is the leading histological type among head and neck cancers. Several studies have explored an association between aberrant methylation of MutL homolog-1 (MLH1) promoter and HNSCC risk. We aimed to explore the associations between MLH1 promoter methylation and HNSCC by using a meta-analysis.

METHODS:
Systematic literature search was conducted among PubMed, Google Scholar, Web of Science, and China National Knowledge Infrastructure, and Wanfang databases to retrieve relevant articles published up to June 30, 2018. A total of 12 studies were included in this meta-analysis (including 717 HNSCC and 609 controls).

RESULTS:
The results demonstrated that MLH1 promoter methylation was notably higher in patients with HNSCC than in controls (odds ratios [ORs] = 2.52, 95% confidence intervals [CIs] = 1.33-4.79). Besides, MLH1 promoter methylation was not associated with tumor stage, lymph node status, smoking behavior, age, clinical stage, gender, and differentiation grade (all P > .05). The pooled sensitivity and specificity rates of MLH1 methylation for HNSCC were 0.23 (95% CI = 0.12-0.38) and 0.95 (95% CI, 0.82-0.99), respectively. The area under the receiver operating characteristic (ROC) curve was presented as 0.64 (95% CI = 0.60-0.68).

CONCLUSION:
The results of this meta-analysis suggested that hypermethylation of MLH1 promoter was associated with HNSCC. Methylated MLH1 could be a potential diagnostic biomarker for diagnose of HNSCC.

PMID: 31651887 DOI: 10.1097/MD.0000000000017651
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Select item 31651715
58.
Melanoma Res. 2019 Oct 22. doi: 10.1097/CMR.0000000000000643. [Epub ahead of print]
External validation of the American Joint Committee on Cancer 8th edition melanoma staging system: who needs adjuvant treatment?
Madu MF1, Franke V1, Van de Wiel BA2, Klop WMC3, Jóźwiak K4, van Houdt WJ1, Wouters MWJM1, van Akkooi ACJ1.
Author information
1
Departments of Surgical Oncology.
2
Pathology.
3
Head and Neck Surgery and Oncology and.
4
Epidemiology and Biostatistics, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
Abstract
Now effective adjuvant therapy has arrived in melanoma, accurate staging and patient selection to optimize its risk/benefit ratio is crucial. The American Joint Committee on Cancer staging system is the most widely used and validated melanoma staging system, which recently released its 8th edition. We aimed to externally validate the prognostic and discriminatory ability for survival of the 8th edition compared to the 7th edition and evaluate prognostic factors. Prospective database of stage III melanoma (2000-2016). Prognostic factors for melanoma-specific survival and distant metastasis-free survival were analyzed. Survival differentiation of the 7th and 8th edition was assessed with log-rank tests and Cox proportional hazards models. Discriminatory ability was compared using the receiver operating characteristic and Akaike's Information Criterion. Six hundred forty patients were included (median follow-up 59 months). Median melanoma-specific survival was 138 months, distant metastasis-free survival 96 months. Age, Breslow thickness, ulceration of the primary tumor and number of positive lymph nodes (N) were independent prognostic parameters for distant metastasis-free survival and melanoma-specific survival. The 8th edition performed slightly better than the 7th edition in terms of survival discrimination but showed slightly worse distant metastasis-free survival and melanoma-specific survival differentiation between stage IIIA and IIIB. Sentinel node (SN) metastasis size cutoff of 1 mm differentiated survival in both 7th and 8th edition stage IIIA, showing excellent distant metastasis-free survival and melanoma-specific survival for patients with a SN metastasis size <1 mm. The 8th edition performed at least comparably, if not better than the 7th in terms of survival discrimination. However, survival in both 7th and 8th edition stage IIIA melanoma remains heterogeneous. EORTC SN tumor burden criteria can further stratify survival and help patient selection for adjuvant therapy.

PMID: 31651715 DOI: 10.1097/CMR.0000000000000643
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Select item 31651462
59.
Cancer Nurs. 2019 Oct 23. doi: 10.1097/NCC.0000000000000772. [Epub ahead of print]
Chinese Version of the Psychological Inflexibility in Pain Scale for Cancer Patients Reporting Chronic Pain.
Xie CJ1, Xu XH, Ou MJ, Chen YY.
Author information
1
Author Affiliation: Department of Nursing (Ms Xie and Dr Chen) and Head and Neck Plastic Surgery Department (Dr Xu and Ms Ou), The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, People's Republic of China.
Abstract
BACKGROUND:
Cancer-related chronic pain is reported by many patients during treatment. There are very few Chinese tools for measuring psychological inflexibility caused by cancer pain, particularly with regard to psychological processes that might influence pain severity and function disorder during cancer treatment.

OBJECTIVE:
To culturally adapt the Psychological Inflexibility in Pain Scale (PIPS) to Chinese cancer patients experiencing chronic pain, including the determination of psychometric properties of the translated PIPS.

METHODS:
This cross-sectional study included 2 phases: (1) translation and cultural adaptation and (2) determination of psychometric properties of the translated PIPS. In total, 389 cancer patients with several types of cancer experiencing chronic pain enrolled from May to September 2018 at a tertiary cancer hospital in Yuelu District of Hunan Province, China.

RESULTS:
The Chinese PIPS version was semantically equivalent to the original. It had a 2-factor structure with satisfactory content validity (content validity index = 0.78-1.00), convergent and discriminant validity (composite reliability and average variance extracted at 0.41-0.89, P < .001), criterion-related validity (r = 0.54 and 0.41, P < .001), Cronbach's α coefficients (α = .87), and test-retest reliability (0.9 ≤ r ≤ 0.98).

CONCLUSIONS:
The Chinese PIPS version has been culturally adapted and has strong psychometric properties. The scale is a psychometrically sound assessment of psychological inflexibility that can be used for future studies of pain and pain management for cancer patients.

IMPLICATIONS FOR PRACTICE:
The study provides a vital tool for the psychological management of cancer patients with chronic pain.

PMID: 31651462 DOI: 10.1097/NCC.0000000000000772
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Select item 31651383
60.
AMA J Ethics. 2019 Oct 1;21(10):E844-851. doi: 10.1001/amajethics.2019.844.
How Should We Determine the Value of CAR T-Cell Therapy?
Silbert S1, Yanik GA2, Shuman AG3.
Author information
1
A fellow in hospice and palliative medicine and pediatric hematology/oncology in the Department of Pediatrics and Communicable Diseases at the University of Michigan Medical School in Ann Arbor.
2
A professor of pediatric hematology/oncology in the Department of Pediatrics and Communicable Diseases at the University of Michigan Medical School in Ann Arbor.
3
An assistant professor in the Department of Otolaryngology-Head and Neck Surgery and the co-chief of the clinical ethics service in the Center for Bioethics and Social Sciences in Medicine at the University of Michigan Medical School in Ann Arbor.
Abstract
In 2017, the US Food and Drug Administration approved the first chimeric antigen receptor (CAR) T-cell therapies for patients with relapsed or refractory B-cell leukemia and selected B-cell lymphomas. This novel form of cellular immunotherapy creates a "living drug" that effectively reprograms a patient's T cells to target specific antigens on the surface of a tumor. The therapy has high response rates in patients with refractory disease, although a single infusion of CAR T cells costs hundreds of thousands of dollars. A value analysis is required to determine whether and how to offer patients these expensive, customized drugs.

© 2019 American Medical Association. All Rights Reserved.

PMID: 31651383 DOI: 10.1001/amajethics.2019.844