destruction releases several immunogenic antigens that indirectly activate an immune response against the disease. 4This case report describes a remarkable response to ECT in a patient with advanced oropharyngeal cancer. 5 The main benefits are temporary improvement of quality of life and reduction in the need for medical assistance and use of analgesic drugs. 6 More research is needed to develop ECT and assess its efficacy in the palliative setting. The unexpected response observed in this patient suggests the need for further investigation into the role of ECT for different localizations and histotypes.

Prior studies have shown that treatment of head and neck squamous cell carcinoma (HNSCC) patients with 1α,25-dihydroxyvitamin D3 [1,25(OH)2D3] reduced intratumoral levels of immune inhibitory CD34+ progenitor cells while increasing levels of mature progeny dendritic cells. This finding was extended to a pilot study to determine whether 1,25(OH)2D3 treatment concurrently increases levels of intratumoral CD4+ and CD8+ T cells, increases intratumoral levels of immune cells expressing the early activation marker CD69, and prolongs time to HNSCC recurrence. The clinical trial comprised 16 patients with newly diagnosed HNSCC being untreated and 16 patients being treated with 1,25(OH)2D3 during the 3-week interval between cancer diagnosis and surgical treatment. Immunologic effects of treatment were monitored by immunohistochemical analyses of surgically removed HNSCC. Clinical effectiveness of 1,25(OH)2D3 treatment in this study was measured by the time to HNSCC recurrence. HNSCC tissues of patients who received treatment with 1,25(OH)2D3 contained increased levels of CD4+ cells and, more significantly, CD8+ T cells. Also prominent was an increase in cells expressing the lymphoid activation marker CD69. Results of this pilot study suggest that patients treated with 1,25(OH)2D3 had a lengthier time to tumor recurrence compared with patients who were not treated before surgery.

Objectives To examine trend, prevalence, and outcomes of surgical site infection (SSI) in head and neck surgery. Study Design Retrospective cross-sectional analysis. Setting The Nationwide Readmissions Database (2010-2014), which represents 56.6% of all US hospitalization. Subjects Adult patients (≥18 years) who underwent head and neck surgery. Patients with SSI were compared with controls. Methods Analysis included chi-square test and multivariate logistic and linear regression models. Results A total of 427 cases and 116,921 controls were identified. SSI prevalence among patients who underwent head and neck surgery was 0.37%, of which 41.0% was reported within the initial admission while the remaining 59.0% was reported on readmission within 30 days of first surgery. SSI was associated with a higher mortality risk (odds ratio, 3.95; 95% CI, 1.25-12.50; P = .019). Multivariate analysis demonstrated that a higher risk of SSI was associated with major surgery of the ear, nose and paranasal sinuses, mouth and tonsil, salivary glands and ducts, maxillofacial bones and mandible, and pharynx and larynx ( P < .05 each). However, a lower risk of SSI was reported in thyroid and parathyroid and nonmajor procedures ( P < .05 each). Other factors associated with a higher risk of SSI included multiple comorbidities, smoking, cancer diagnosis, concomitant neck dissection, and tracheostomy ( P < .05 each). SSI was associated with a mean ± SE additional hospital stay of 8.1 ± 0.8 days per case ( P < .001) and an additional cost on the health system of $20,953.00 ± $186.3 per case ( P < .001). Conclusions SSI is associated with a significant mortality risk and burden on the health system. More than half of SSI cases were identified on readmission.

Background: examine presentation and outcomes of sinonasal squamous cell carcinoma (SCC). Methods: A retrospective study utilizing the National Cancer Database, 2004 to 2015. The study population included adult patients diagnosed with primary sinonasal SCC. Results: A total of 537 patients were included. The mean age of the study population was 62.6 ± 12.7 years. The median follow-up time was 35.6 months (interquartile range: 8.6-55.9). The histological variants identified are: (i) 66.7% keratinizing SCC, (ii) 21.6% non-keratinizing SCC, (iii) 8.0% papillary SCC, and (iv) 3.7% spindle cell carcinoma. Stage at presentation was: (i) 33.3% T1-2, N0, (ii) 31.8% T3-4a, N0, (iii) 13.8% T1-4a, N+, (iv) 17.0% T4b,N0-3, (v) 4.1% M1. Human papilloma virus (HPV) status was available for 96 patients and tested positive in 24 (25.0%) patients. By histological variants, 5-year survival was lowest for spindle cell carcinoma (40.0%), and highest for papillary SCC (70.1%). HPV negative tumors had a 5-year survival of 26.4%, while HPV positive tumors had a 5-year survival of 57.1% ( P = <.001). Of the 255 patients with T1-4a, N0-3, M0 who had surgery of the primary site, 31 (12.2%) patients underwent endoscopic approach. The risk of positive postsurgical margins was not significantly different comparing endoscopic to open approach (23.8% vs 24.1%, P >.99). Conclusions: Sinonasal SCC could present at advanced stages in two-thirds of the population and exhibit a variety of histological subtypes. Like other sites of head and neck, HPV positive tumors are associated with a favorable prognosis. Endoscopic approach is comparable to open approach in terms of post-surgical margins.