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Medicina
Special Issues
Metastatic Head and Neck Malignancy
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Metastatic Head and Neck Malignancy

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

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 10539

Special Issue Editor

Dr. Shogo Shinohara

E-Mail Website
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
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Head and neck carcinoma (HNC) accounts for approximately 550,000 cases annually in the whole world. In the United States, it has been reported that about 3% of all cancers are head and neck origin, and approximately 63,000 Americans develop HNC annually. While the incidence of HNC has been declining in advanced nations due to the decrease in smokers, a rise in HPV-related HNC has been attracting attention.

The initial manifestations of HNC are often yielded by cervical metastases, and patients are often unaware of the primary site, something which has been well documented in cases with nasopharyngeal carcinoma. Thyroid cancer, which is a more prevalent type of cancer especially among women, is often found by cervical metastases, and it has been called occult thyroid carcinoma. The swelling of the left subclavian lymph node (the Virchow node) sometimes proceeds the detection of primary intra-abdominal cancers. Moreover, approximately 10% of head and neck malignancies are reported to be malignant lymphoma. As in the ‘Clinical Practice Guideline: Evaluation of the Neck Mass in Adults’, clinicians have to list tons of differential diagnoses in treating patients with neck masses.

In dealing with metastatic cervical carcinomas, we have traditionally utilized the surgical approach, so-called neck dissection. Recently, from the point of view of quality of life, several modified procedures have been invented, called selective neck dissections. Thanks to the advances of anticancer drugs, radiotherapy, and diagnostic imaging, neck dissection can be replaced by chemoradiotherapy and follow-up imaging strategies in some cases. In 2016, Mehanna et al. reported that PET-CT surveillance could do away with the necessity of planned neck dissection in advanced head and neck cancer, something which can occur sooner than we think based on the rapid progress of immune checkpoint inhibitors.

This Special Issue of Medicina entitled “Metastatic Head and Neck Malignancy” welcomes submissions of clinical original articles, as well as systematic reviews, meta-analyses, and overviews related to head and neck cancer or thyroid cancer with cervical and/or distant metastasis, cervical metastasis from the distant organ, and cervical carcinomas with unknown primary (CUP) and malignant lymphoma with an initial symptom in a head and neck lesion. This issue also invites articles about diagnostic assessment of the etiology unknown neck masses.

Dr. Shogo Shinohara
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. Medicina is an international peer-reviewed open access monthly 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 1800 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

  • Cervical metastasis
  • Distant metastasis
  • Neck mass
  • Oral cancer
  • Nasopharyngeal cancer
  • Hypopharyngeal cancer
  • Oropharyngeal cancer
  • Laryngeal cancer
  • Esophageal cancer
  • Thyroid cancer
  • Carcinoma with an unknown primary
  • Malignant lymphoma
  • Neck dissection
  • Chemoradiotherapy
  • Immune checkpoint inhibitor

Published Papers (4 papers)

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Research

13 pages, 1026 KiB  
Article
Impact of Changing Surgical Strategies on Clinical Outcomes in Patients with Parotid Carcinoma: A 53-Year Single-Institution Experience
by Hirotaka Yamamoto, Tsuyoshi Kojima, Yusuke Okanoue, Shuya Otsuki, Koki Hasebe, Ryohei Yuki and Ryusuke Hori
Medicina 2021, 57(8), 745; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57080745 - 23 Jul 2021
Viewed by 1321
Abstract
Background and Objectives: We investigated the clinical outcomes of patients who underwent surgery for parotid carcinoma in a single institution during a 53-year period. This study aimed to estimate the impact of changing the surgical approach to parotid carcinoma on clinical outcomes [...] Read more.
Background and Objectives: We investigated the clinical outcomes of patients who underwent surgery for parotid carcinoma in a single institution during a 53-year period. This study aimed to estimate the impact of changing the surgical approach to parotid carcinoma on clinical outcomes including the incidence rate of the facial nerve palsy. Materials and Methods: Sixty-seven patients with parotid carcinoma who underwent surgery between 1966 and 2018 were retrospectively reviewed. Group A consisted of 29 patients who underwent surgery from 1966 to 2002, and Group B consisted of 38 patients from 2002 to 2018. Treatment outcomes were estimated. Additionally, candidate prognostic factors of Group B, the current surgical approach group, were evaluated. Results: Partial parotidectomy and total parotidectomy were performed in 35 and 32 patients, respectively. Partial parotidectomy was performed in 4 patients in Group A and 31 patients in Group B, with a predominant increase in Group B. The facial nerve was preserved in 43 patients, among whom 8 in Group A (8/17; 47.1%) and 7 in Group B (7/26; 26.9%) had temporary postoperative facial nerve palsy. Postoperative radiotherapy was performed on 35 patients. The 5-year OS, DSS, and DFS rates for Group A were 77.1%, 79.9%, and 71.5%, respectively. The 5-year OS, DSS, and DFS rates for Group B were 77.1%, 77.1%, and 72.4%, respectively. Clinical T4 stage, clinical N+ stage, stage IV disease, and tumor invasion of the facial nerve were independent prognostic factors in Group B. Conclusions: The incidence of facial nerve palsy in the current surgical approach group decreased compared with that in the previous surgical approach group. The current surgical management and treatment policies for parotid carcinoma have led to improved outcomes. Full article
(This article belongs to the Special Issue Metastatic Head and Neck Malignancy)
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12 pages, 2779 KiB  
Article
The Utility of Ultrasonography in the Diagnosis of Cervical Lymph Nodes after Chemoradiotherapy for Head and Neck Squamous Cell Carcinoma
by Hoshino Terada, Yuzo Shimode, Madoka Furukawa, Yuichiro Sato and Nobuhiro Hanai
Medicina 2021, 57(5), 407; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57050407 - 23 Apr 2021
Cited by 3 | Viewed by 4270
Abstract
Background and Objectives: There is evidence or consensus on the use of 18F-2-fluorodeoxyglucose-positron emission tomography with computed tomography (PET-CT) in evaluating the effects of treatment at 12 weeks after chemoradiotherapy for head and neck squamous cell carcinoma with cervical lymph node metastasis. [...] Read more.
Background and Objectives: There is evidence or consensus on the use of 18F-2-fluorodeoxyglucose-positron emission tomography with computed tomography (PET-CT) in evaluating the effects of treatment at 12 weeks after chemoradiotherapy for head and neck squamous cell carcinoma with cervical lymph node metastasis. However, the use of imaging to evaluate the effects of treatment within 12 weeks after chemoradiotherapy is controversial. The aim of this study was to evaluate the usefulness of ultrasonography in the diagnosis of lymph nodes metastasis after chemoradiotherapy according to the criteria of the “Evaluation of the effects of treatment on metastatic cervical lymph nodes using ultrasonography”, which evaluated lymph nodes metastasis based on size change and presence of degeneration. Materials and methods: This prospective study included 34 head and neck squamous cell carcinoma patients with cervical lymph nodes metastasis. Thirty-two patients who completed treatment were analyzed. Ultrasonography was performed at 4 and 8 weeks after chemoradiotherapy and we judged whether a favorable prognosis could be expected or whether additional treatments should be considered. Ultrasonography and PET-CT were performed at 12 weeks after chemoradiotherapy. Neck dissection was performed if residual disease was suspected based on the PET-CT findings. Results: The accuracy and negative predictive value of ultrasonography were 81.3% and 96.3%, respectively. According to the Ultrasonography findings, the size of lymph nodes metastasis after chemoradiotherapy was significantly smaller than those before chemoradiotherapy (p < 0.05). The fluid and blood flow of lymph nodes metastasis showed a significantly reduced at 12 weeks after chemoradiotherapy (p < 0.05, p < 0.05, respectively). The echo density significantly changed from low to high echoic density after chemoradiotherapy (p < 0.05). Conclusions: Ultrasonography was useful for evaluating cervical lymph nodes metastasis after chemoradiotherapy for head and neck squamous cell carcinoma. Full article
(This article belongs to the Special Issue Metastatic Head and Neck Malignancy)
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12 pages, 1464 KiB  
Article
Lingual Lymph Node Metastases as a Prognostic Factor in Oral Squamous Cell Carcinoma—A Retrospective Multicenter Study
by Masahiro Kikuchi, Hiroyuki Harada, Ryo Asato, Kiyomi Hamaguchi, Hisanobu Tamaki, Masanobu Mizuta, Ryusuke Hori, Tsuyoshi Kojima, Keigo Honda, Takashi Tsujimura, Yohei Kumabe, Kazuyuki Ichimaru, Yoshiharu Kitani, Koji Ushiro, Morimasa Kitamura, Shogo Shinohara and Koichi Omori
Medicina 2021, 57(4), 374; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57040374 - 12 Apr 2021
Cited by 8 | Viewed by 2537
Abstract
Backgrounds and Objectives: The epidemiology and prognostic role of lingual lymph node (LLN) metastasis in patients with oral squamous cell carcinoma (OSCC) remain unclear. Here, we aimed to analyze the clinicopathological features, risk factors, and prognostic role of LLN metastasis in patients with [...] Read more.
Backgrounds and Objectives: The epidemiology and prognostic role of lingual lymph node (LLN) metastasis in patients with oral squamous cell carcinoma (OSCC) remain unclear. Here, we aimed to analyze the clinicopathological features, risk factors, and prognostic role of LLN metastasis in patients with OSCC. Materials and Methods: In total, 945 patients with OSCC were retrospectively analyzed. Clinicopathological features were compared between patients with and without LLN metastasis. The risk factors of LLN metastasis and its effects on survival outcomes were evaluated using multi-variate analysis. Results: LLN metastasis was noted in 67 patients (7.1%). Habitual alcohol consumption and clinical neck node metastasis were independent risk factors for LLN metastasis. LLN metastasis was an independent prognostic factor for disease-free and overall survival, although LLN dissection did not improve survival outcomes. Conclusion: LLN metastasis is an independent adverse prognostic factor. Further prospective studies are needed to fully assess the extent of LLN dissection required in OSCC patients. Full article
(This article belongs to the Special Issue Metastatic Head and Neck Malignancy)
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11 pages, 878 KiB  
Article
Neck Dissection for Cervical Lymph Node Metastases from Remote Primary Malignancies
by Shogo Shinohara, Hiroyuki Harada, Masahiro Kikuchi, Shinji Takebayashi and Kiyomi Hamaguchi
Medicina 2020, 56(7), 343; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56070343 - 10 Jul 2020
Cited by 2 | Viewed by 1955
Abstract
Background and Objectives: Patients with cervical lymph node metastases from remote primary tumours have poor prognoses because of the advanced stage of their cancer. Owing to recent progress in the nonsurgical management of various cancer types, options for surgical treatment to reduce [...] Read more.
Background and Objectives: Patients with cervical lymph node metastases from remote primary tumours have poor prognoses because of the advanced stage of their cancer. Owing to recent progress in the nonsurgical management of various cancer types, options for surgical treatment to reduce tumour volume are increasing, and may help improve survival rates. For example, neck dissection may be a good option as a definitive therapy for some patients with resectable cervical metastases. We assessed patients who underwent neck dissection with curative intent and discuss the effectiveness of this approach for cervical metastases from remote malignancies. Material and Methods: We retrospectively reviewed the data of 18 patients (10 males and 8 females in an age range of 30–79 years) who underwent neck dissections for neck lymph node metastases from a remote primary tumour between 2010 and 2019. Patient clinical characteristics, preoperative accuracy of positive node localisation using fluorodeoxyglucose positron emission tomography–computed tomography (FDG/PET-CT), and patient survival rates were estimated. Results: Primary sites included ten lungs, two mammary glands, one thymus, one thoracic oesophagus, one stomach, one uterine cervix, one ovary, and one testis per patient. There were 19 levels with FDG/PET-CT positive nodes in 17 out of 18 patients. Conversely, there were 28 pathological positive levels out of 50 dissected levels. The sensitivity, specificity, positive and negative predictive values, and accuracy of FDG-PET/CT in predicting positive nodes were 69%, 88%, 95%, 47%, and 74%, respectively. The three-year overall survival (OS) rate for all patients was 70%. The three-year OS rate of the group with zero or one pathological positive nodes was 81%, which was significantly higher than that of the group with more than two positive nodes (51%) (p = 0.03). Conclusions: Neck dissection for cervical lymph node metastases from remote primary malignancies may improve prognoses, especially considering anticancer agents and radiotherapy advancements. Full article
(This article belongs to the Special Issue Metastatic Head and Neck Malignancy)
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