Our molecular and clinical results are in agreement with previous findings but provide additional information into the biologic mechanisms involved in HR-HPV oropharyngeal cancer in comparison to HPV-negative tumors. According to the reduced risk of relapse and second tumors associated with HR-HPV positivity of oropharyngeal cancer, the therapeutic strategy and follow-up procedures should be reviewed.

Lymph node metastases are a poor prognostic factor for patients with malignant tumors of the paranasal sinuses. The incidence of these metastases is low, particularly in ethmoid sinus tumors. A prophylactic treatment of the neck in patients with N0 tumors (surgery or radiotherapy) might be considered in T2 squamous cell carcinoma of the maxillary sinus and in undifferentiated carcinoma of the ethmoid sinus.

Purpose:The aim of this study was to acquire further insights into the pathogenetic pathways of head and neck squamous cell carcinomas (HNSCC) that may be useful for identifying new biomarkers instrumental in developing more specific treatment approaches. Experimental Design: Cell cycle regulators and epidermal growth factor receptor (EGFR) and BRAF genes were analyzed in a series of 90 oropharyngeal SCCs of a cohort of surgically treated patients from a single institution, and the results were matched with the presence of high-risk human papillomavirus (HR-HPV) DNA and theTP53 status. Results: At least four distinct groups of tumors were identified sharing a common histology but displaying different molecular/cytogenetic patterns: (a) 19% were HPV-positive SCCs whose lack of alterations of the investigated genes could explain their particular natural history, which requires less aggressive treatment; (b) 37% were HPV-negative SCCs carryingTP53 mutations, which may be more effectively treated by drugs acting through p53-independent apoptosis; (c) 34% were HPV-negative SCCs carrying wild-typeTP53 and loss of 9p21 (p16 INK4a and p15 INK4b) and/or cyclin D1overexpression that justify treatment with DNA-damaging drugs followed by cell cycle inhibitors; and (d) 10% were HPV-negative lacking tumor suppressor genes and cell cycle alterations.The second, third, and fourth groups also showed an increased copy number of EGFR and chromosome 7 (43%) that might justify the additional or alternative use of EGFR inhibitors. Conclusions: Our findings suggest that assessing HPV, TP53, 9p21, and EGFR status may be crucial to finding more tailored and beneficial treatments for oropharyngeal SCCs.Head and neck squamous cell carcinomas (HNSCC) are usually treated with surgery and/or radiotherapy, and advanced cases may be also treated with concomitant chemotherapy and radiotherapy. However, a greater understanding of the complex process leading to the transformation and maintenance of the malignant phenotype of HNSCC might help in the identification of diagnostic, prognostic, or predictive markers as well as of new therapeutic targets.Despite their shared histology, the presence or absence of high-risk human papillomavirus (HR-HPV) identifies two distinct HNSCC entities with different clinical properties and genetic-molecular patterns. Clinically, the tumors with integrated viral DNA show a more favorable outcome than those that are HR-HPV negative (1). At molecular level, the HR-HPVpositive HNSCCs are characterized by the lack of p16INK4a gene deletion coupled with p16 protein expression (2) and a unique gene expression profile (3), with a decreased occurrence of TP53 mutations, cyclin D up-regulation/amplification, 14-3-3j and RASSF1A promoter methylation (4), and loss of heterozygosity at 17p, 9p, and 3p (5, 6). These latter are common alterations in patients with HPV-negative HNSCCs.Clinical behavior of HPV-negative HNSCCs is heterogeneous, and it is warranted to better characterized this gray zone. The most frequent mo...

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Ethmoid malignant tumours are rare, but nearly all at least approach or involve the lamina cribrosa. An anterior craniofacial resection is almost always mandatory for a radical resection. While almost everything has been written about technical details, few studies reported meaningful analysis about prognostic factors and long-term results, for a series of reasons: the infrequency of these tumours, the variety of histologies, small patients cohorts presented by each author, a medley of untreated and pre-treated patients, the lack of a universally accepted classification. We perform a review of the literature in the light of our experience of 330 anterior craniofacial resections for ethmoid malignant tumours. We present our classification of ethmoid malignant tumours (called INT, Istituto Nazionale Tumori). It turned out to be more prognostic than AJCC-UICC classification.