The Therapeutic Landscape of Head and Neck Cancer

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (15 September 2022) | Viewed by 7857

Special Issue Editor


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Guest Editor
Department of Head and Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
Interests: head and neck neoplasms; thyroid neoplasms; PET/CT; imaging; magnetic resonance imaging
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Special Issue Information

Dear Colleagues,

Head and neck cancer (HNC) was reported to be the seventh most common cancer worldwide, accounting for approximately 8,900,000 new cases and 450,000 deaths in 2018. However, the incidence of HNC has been slowly declining globally due to the decrease in smokers, while cases of HPV-related oropharyngeal cancer induced by HPV type16 and 18 are increasing.

For the treatment of HNC, we have been utilizing “the triad of cancer treatment” (i.e., surgery, radiotherapy, and chemotherapy), or combinations of this triad. Preoperative evaluation for establishing a treatment strategy is very important in the choice of the piece of the triad for HNC, since treatment differs according to the stage of disease, anatomical site, and surgical accessibility. Both better survival outcome and structural/functional preservation should be carefully considered before treatment in accordance with the patient’s request as influenced by their daily life.

There have been several innovations in each area of the triad of HNC cancer treatments. In the area of surgery, the use of transoral resection robotic surgery (TORS) using the da Vinci surgical robot for the resection of oropharynx tumor is becoming a general procedure worldwide. This minimally invasive procedure is reported to decrease surgical morbidity and reduce the hospitalization period, with an almost identical survival outcome to traditional open surgery. Advances in radiation therapy have also been noted in the area of HNC. The use of intensity-modulated radiation therapy (IMRT) is the major innovation in this area over the last two decades, and it has been becoming a primary therapeutic strategy in treating HNC. Other innovations, such as proton therapy, carbon beam therapy, and boron neutron capture therapy, are also promising, but we are still awaiting the results of long-term morbidity and survival outcome. Finally, the area of medical oncology had a great progress with the emergence of immune-checkpoint inhibitors (ICIs). ICIs have been drastically changing the strategy for the treatment of recurrent/metastatic HNC, while we are acutely aware of the importance of multispecialty teams comprising surgeons, radiation oncologists, and medical oncologists. At present, precision medicine based on genomic profiling is becoming more common, and is a method used to investigate the genetic information related to individual patients or specific cancer cells and the way their genes interact with each other and with the environment. This method may provide more effective treatment strategies that are tailored to the genetic profile of each patient.

This Special Issue of Medicina entitled “The Therapeutic Landscape of Head and Neck Cancer” welcomes submissions of clinical original articles, as well as systematic reviews, meta-analyses, and overviews, related to head and neck cancer treatment, advances in surgery, radiologic oncology treating HNC, or treatment outcome of chemotherapy/chemoradiotherapy, as well as treatment outcomes of regimens including ICI. This Issue also invites new experimental results of basic science in the field of HNC.

Dr. Shogo Shinohara
Guest Editor

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Keywords

  • sinonasal cancer
  • oral cancer
  • nasopharyngeal cancer
  • oropharyngeal cancer
  • hypopharyngeal cancer
  • laryngeal cancer
  • minimally invasive surgery
  • chemoradiotherapy
  • immune checkpoint inhibitor
  • precision medicine

Published Papers (3 papers)

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Research

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11 pages, 1541 KiB  
Article
Role of Human Papilloma Virus and Lifestyle Factors in Overall Survival of Patients with Oropharyngeal Squamous Cell Carcinoma
by Daisuke Nishikawa, Nobuhiro Hanai, Taijiro Ozawa, Tadashi Kitahara and Yasuhisa Hasegawa
Medicina 2022, 58(4), 557; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58040557 - 18 Apr 2022
Cited by 2 | Viewed by 2123
Abstract
Background: Patients with human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) have a significantly better treatment response and overall survival (OS) rates than non-HPV-associated OPSCC. Objectives: We conducted the present study to further characterize the interplay between lifestyle risk factors, which are [...] Read more.
Background: Patients with human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) have a significantly better treatment response and overall survival (OS) rates than non-HPV-associated OPSCC. Objectives: We conducted the present study to further characterize the interplay between lifestyle risk factors, which are not only HPV status, but also smoking history and alcohol consumption, and the OS to optimize the treatment of patients with OPSCC. Materials and Methods: Between January 2006 and December 2013, 94 patients newly diagnosed with OPSCC were treated with curative intent at Aichi Cancer Center Hospital (Nagoya, Japan). To determine negative prognostic factors associated with the OS, univariate and multivariable Cox regression analyses were performed. Results: Of the 94 OPSCC patients, 53 (56.4%) were positive for HPV. The univariate analysis revealed that T classification, smoking history, alcohol consumption, and HPV status were significant determinants of the OS. In the multivariate analysis, adjusted for the clinical stage, smoking history, alcohol consumption, HPV status, and a smoking history of >10 pack-years was an independent negative prognostic factor for the OS among patients with OPSCC (HR: 10.4, 95 %CI: 1.34–80.6, p < 0.05). Conclusions: Smoking is a very important negative prognostic factor even in cases of HPV-associated OPSCC. The impact of smoking needs to be reaffirmed when deciding on treatment plans and de-escalation trials in OPSCC, even in cases of HPV-associated OPSCC. Full article
(This article belongs to the Special Issue The Therapeutic Landscape of Head and Neck Cancer)
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12 pages, 2865 KiB  
Article
Clinicopathological Characteristics and Survival Outcomes of Patients with Buccal Squamous Cell Carcinoma: Results of a Multi-Institutional Study
by Shogo Shinohara, Masahiro Kikuchi, Hiroyuki Harada, Kiyomi Hamaguchi, Ryo Asato, Hisanobu Tamaki, Masanobu Mizuta, Ryusuke Hori, Tsuyoshi Kojima, Keigo Honda, Takashi Tsujimura, Yohei Kumabe, Kazuyuki Ichimaru, Yoshiharu Kitani, Koji Ushiro and Koichi Omori
Medicina 2021, 57(12), 1361; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57121361 - 13 Dec 2021
Cited by 6 | Viewed by 2377
Abstract
Background and Objectives: To investigate clinicopathological characteristics and survival outcomes of patients with buccal cancer in Japan. Materials and Methods: This study was conducted using a database of 1055 patients with oral cancers treated between 2010 and 2017 at 12 institutions [...] Read more.
Background and Objectives: To investigate clinicopathological characteristics and survival outcomes of patients with buccal cancer in Japan. Materials and Methods: This study was conducted using a database of 1055 patients with oral cancers treated between 2010 and 2017 at 12 institutions in Japan. Ninety-two patients (8.7%) with primary buccal cancer were extracted and clinicopathological characteristics and survival outcomes were compared between patients with buccal cancers and patients with other oral cancers. Results: Ages were significantly higher in the patients with buccal cancer (73 years old vs. 69 years old). Buccal cancer had less advanced cT stage and cN stage than other oral cancers. Overall 5-year survival (OS) was 80.6%, and recurrence-free 5-year survival (RFS) of buccal cancers was 67.8%, and there were no significant differences in survival compared with other oral cancers in terms OS or RFS (5y-OS: 82.5%, 5y-RFS: 74.4%). However, patients with stage IV buccal cancer showed poorer prognosis in terms of OS and RFS compared with the same stage patients with other oral cancer. Advanced T stage was the only factor independently associated with both OS and RFS of patients with buccal cancer in this study. Conclusions: Postoperative radiotherapy or chemoradiotherapy should be considered to improve survival outcome of buccal cancer patients, especially for the patients with advanced primary site disease or a higher cancer stage. Full article
(This article belongs to the Special Issue The Therapeutic Landscape of Head and Neck Cancer)
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Review

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8 pages, 309 KiB  
Review
Obstructive Sleep Apnea in Patients with Head and Neck Cancer—More than Just a Comorbidity?
by Christopher Seifen, Tilman Huppertz, Christoph Matthias and Haralampos Gouveris
Medicina 2021, 57(11), 1174; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57111174 - 28 Oct 2021
Cited by 8 | Viewed by 2640
Abstract
Obstructive sleep apnea is the most common type of sleep-disordered breathing with growing prevalence. Its presence has been associated with poor quality of life and serious comorbidities. There is increasing evidence for coexisting obstructive sleep apnea in patients suffering from head and neck [...] Read more.
Obstructive sleep apnea is the most common type of sleep-disordered breathing with growing prevalence. Its presence has been associated with poor quality of life and serious comorbidities. There is increasing evidence for coexisting obstructive sleep apnea in patients suffering from head and neck cancer, a condition that ranks among the top ten most common types of cancer worldwide. Routinely, patients with head and neck cancer are treated with surgery, radiation therapy, chemotherapy, immunotherapy or a combination of these, all possibly interfering with the anatomy of the oral cavity, pharynx or larynx. Thus, cancer treatment might worsen already existing obstructive sleep apnea or trigger its occurrence. Hypoxia, the hallmark feature of obstructive sleep apnea, has an impact on cancer biology and its cure. Early diagnosis and sufficient treatment of coexisting obstructive sleep apnea in patients with head and neck cancer may improve quality of life and could also potentially improve oncological outcomes. Full article
(This article belongs to the Special Issue The Therapeutic Landscape of Head and Neck Cancer)
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