BACKGROUND Evaluate long-term outcomes after initial definitive or adjuvant radiotherapy for T3-larynx cancers. METHODS We reviewed 412 patients treated for T3 laryngeal squamous cell cancer 1985–2011. RESULTS 10-year OS was 35%; disease-specific-survival (DSS), 61%; locoregional control (LRC), 76%; freedom from distant metastasis, 83%. Chemotherapy, age, performance status <2, node-negative status, and glottic sub-site were associated with improved survival (all P<0.03). Larynx preservation with induction and/or concurrent chemoradiotherapy (LP-CRT) had better laryngectomy-free survival (LFS) than radiotherapy alone (LP-RT) (HR, 0.62; 95% CI, 0.47–0.81; P=0.0005); 10-year LFS rates of the LP-CRT cohort (37%) were higher than those of the LP-RT cohort (18%). 5-year DSS and OS rates of the LP-CRT cohort (79% and 67%) were better laryngectomy with post-operative radiotherapy (TL-PORT) (61% and 50%) and LP-RT (64% and 46%; P<0.006 for all). CONCLUSIONS In patients with T3-larynx cancers, LP-CRT provides better functional, oncologic, and survival outcomes than historical TL-PORT or LP-RT does.

Oropharyngeal squamous cell carcinoma (OPSCC) has historically been attributable to tobacco and alcohol exposure and saw a decline in incidence after societal norms shifted away from smoking. In recent decades, this disease has had a re-emergence due to human papillomavirus (HPV) infection, now surpassing cervical cancer as the number 1 cause of HPV-related cancer in the United States. HPVpositive OPSCC differs from HPV-negative disease in epidemiology, prognosis, treatment, and prevention. Additionally, there is a deficit in awareness of the causal relationship between HPV and OPSCC. This, coupled with low vaccination rates, puts primary care providers in a unique position to play a vital role in prevention and early diagnosis. In this review, we highlight the epidemiology, screening, patient presentation, diagnosis, prognosis, and prevention of HPV-positive OPSCC, with a focus on the primary care provider's role.

Background Optimal treatment and prognostic factors affecting long‐term survival in patients with sinonasal adenoid cystic carcinoma (ACC) have yet to be clearly defined. Methods We conducted a retrospective review of patients treated with curative intent from 1980‐2015 at MD Anderson Cancer Center. Results One hundred sixty patients met inclusion criteria, including 8 who were treated with radiotherapy alone. Median follow‐up time was 55 months. The 5‐year overall survival (OS) and disease‐free survival (DFS) rates were 67.0% and 49.0%, respectively. The 10‐year OS and DFS rates were 44.8% and 25.4%, respectively. Factors that portended for poor survival on multivariate analysis were recurrent disease, any solid type histology, epicenter in the sinus cavity, the presence of facial symptoms, or the original disease not treated with surgery. There was no association between surgical margin status or nodal status and survival. Conclusion In this large cohort of patients with sinonasal ACC with extended follow‐up, long‐term survival is better than reported in prior literature. Future research should target patients with adverse risk factors.

The age-adjusted CCI is a significant predictor of noncancer CSS and OS for patients with locally advanced laryngeal cancer but is not associated with DSS.

Objectives: Recently, the decision was made to transition the United States Medical Licensing Examination (USMLE) Step 1 score from a three-digit numerical score to a pass/fail system. Historically, Step 1 scores have been important for otolaryngology resident applicant selection. The purpose of this study was to understand and evaluate otolaryngology residency program directors’ (OPDs) opinions on the impact following the change in Step 1 score reporting. Methods: A 22-question survey administered through Qualtrics was sent to 113 academic otolaryngology residency program directors in April 2020. Information about demographics, impressions on the new Step 1 score format, anticipated changes in applicant selection, impact on mental health, and importance of various other factors in selecting applicants were queried. Descriptive statistics were used to analyze survey results. Results: A total of 41 out of 113 (36.3%) OPDs completed this survey. A majority of surveyed OPDs (80.5%) do not support the decision to change Step 1 to a pass/fail system. In the absence of a three digit numeric USMLE Step 1 score, OPDs indicated prioritization of away rotations, letters of recommendation (LORs), personal prior knowledge of the applicant, grades in required clerkship, and class ranking or quartile. 53.7% of OPDs anticipate requiring USMLE Step 2 Clinical Knowledge for interview consideration following this change. Conclusion: OPDs believe a pass/fail Step 1 score will decrease the importance of this exam and that this change will lead to the implementation and evaluation of additional metrics such as a required Step 2 CK score.