In the present study we could confirm the role of CRP as an independent prognostic marker in patients with tongue carcinoma. Incorporating this marker in prognostication could represent a valuable and moreover inexpensive tool for improved decisions making concerning therapy in the future.

Background: To date, no studies have successfully shown that a highly specific, blood-based tumour marker to detect clinically relevant HPV-induced disease could be used for screening, monitoring therapy response or early detection of recurrence. This study aims to assess the clinical performance of a newly developed HPV16-L1 DRH1 epitope-specific serological assay. Methods: In a multi-centre study sera of 1486 patients (301 Head and Neck Squamous Cell Carcinoma (HNSCC) patients, 12 HIV+ anal cancer patients, 80 HIV-positive patients, 29 Gardasil-9-vaccinees, 1064 healthy controls) were tested for human HPV16-L1 DRH1 antibodies. Analytical specificity was determined using WHO reference-sera for HPV16/18 and 29 pre-and post-immune sera of Gardasil-9-vaccinees. Tumour-tissue was immunochemically stained for HPV-L1-capsidprotein-expression. Findings: The DRH1-competitive-serological-assay showed a sensitivity of 95% (95% CI, 77 . 2À99 . 9%) for HPV16-driven HNSCC, and 90% (95% CI, 55 . 5À99 . 7%) for HPV16-induced anal cancer in HIV-positives. Overall diagnostic specificity was 99 . 46% for men and 99 . 29% for women 30 years. After vaccination, antibody level increased from average 364 ng/ml to 37,500 ng/ml. During post-therapy-monitoring, HNSCC patients showing an antibody decrease in the range of 30À100% lived disease free over a period of up to 26 months. The increase of antibodies from 2750 to 12,000 ng/ml mirrored recurrent disease. We can also show that the L1-capsidprotein is expressed in HPV16-DNA positive tumour-tissue. Interpretation: HPV16-L1 DRH1 epitope-specific antibodies are linked to HPV16-induced malignant disease. As post-treatment biomarker, the assay allows independent post-therapy monitoring as well as early diagnosis of tumour recurrence. An AUC of 0 . 96 indicates high sensitivity and specificity for early detection of HPV16-induced disease. Funding: The manufacturer provided assays free of charge.

Purpose Radiochemotherapy (RCT) is an effective standard therapy for locally advanced head and neck squamous cell carcinoma (LA-HNSCC). Nonetheless, toxicity is common, with patients often requiring dose modifications. Methods To investigate associations of RCT toxicities according to CTCAE version 5.0 and subsequent therapy modifications with short-and long-term treatment outcomes, we studied all 193 patients with HNSCC who received RCT (70 Gy + platinum agent) at an academic center between 03/2010 and 04/2018. Results During RCT, 77 (41%, 95% CI 34-49) patients developed at least one ≥ grade 3 toxicity, including seven grade 4 and 3 fatal grade 5 toxicities. The most frequent any-grade toxicities were xerostomia (n = 187), stomatitis (n = 181), dermatitis (n = 174), and leucopenia (n = 98). Eleven patients (6%) had their radiotherapy schedule modified (mean radiotherapy dose reduction = 12 Gy), and 120 patients (64%) had chemotherapy modifications (permanent discontinuation: n = 67, pause: n = 34, dose reduction: n = 7, change to other chemotherapy: n = 10). Objective response rates to RCT were 55% and 88% in patients with and without radiotherapy modifications (p = 0.003), and 84% and 88% in patients with and without chemotherapy modifications (p = 0.468), respectively. Five-year progression-free survival estimates were 20% and 50% in patients with and without radiotherapy modifications (p = < 0.001), and 53% and 40% in patients with and without chemotherapy modifications (p = 0.88), respectively. Conclusions Reductions of radiotherapy dose were associated with impaired long-term outcomes, whereas reductions in chemotherapy intensity were not. This suggests that toxicities during RCT should be primarily managed by modifying chemotherapy rather than radiotherapy.

Background Generally, it is known that men are affected more frequently by nonmelanoma skin cancer (NMSC) than women. The aim of our study was to investigate the effect of sex on the characteristics of NMSCs of the pinna at the population that our center serves and to compare it with the international data. Methods We analyzed retrospectively the data of 225 patients with NMSC of the pinna. Sex‐specific differences were investigated for basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) subgroups. Results The ratio of BCC to cSCC was determined in male patients at 1:1.3, in contrast in females it was identified at 4:1 (P = .001). Conclusion In our study, a new aspect of the sex‐dependent distribution of cSCC and BCC of the pinna was demonstrated. Women are affected four times more frequently by BCC than by cSCC, whereas in men this ratio is approximately equal.

Introduction: Late outcome of repaired TOF is driven by the impact of residual lesions. We shifted strategy from liberal transannular patch (TAP) use to aggressive valve and annulus preservation (AP) hypothesizing that for equivalent anatomy, AP would leave a mixed stenosis regurgitation lesion that would lead to a healthier right ventricle (RV). Methods: Between 1996 and 2002, 185 children underwent TOF repair (median age 7.7 m). A regression equation for predicting annulus preservation, in the AP group, was derived from preoperative anatomic parameters and applied to all. Patients were identified (n=107) that could have had either AP or TAP on the basis of anatomical equivalency (subgroup validation with propensity matching) with 52 having a TAP and 55 having AP. These are the primary study group. Results: Cardiac MRI at mean age 13.1±2.3 yrs (TAP n=28, AP n=23) showed AP was associated with significantly lower indexed RV end diastolic vol (AP: 120±29; TAP: 181±35 mL - Fig. 1), RV end systolic vol (AP: 57±23; TAP: 95±25 mL), RV stroke volume (AP: 64±15; TAP: 86±15 mL), MPA regurgitant fraction (AP: 28±11; TAP: 45±9 %), all p<0.0001, and LV mass (AP: 46±6; TAP: 54±8 gm/m2); p=0.001). Echo RVOT gradient was no different (AP 31 Vs TAP 25 mmHg (p=ns). MRI LVEF (AP: 57±4; TAP: 55±4 %; P=0.031) and RVEF (AP: 54±7; TAP: 48±6 %; p=0.004) was higher after AP. Freedom from surgical reintervention at 15 years was 89.3% (TAP) and 71.7% (AP , P=0.048) (Fig.2) with early reoperation for RVOTO predominating in AP and late pulmonary valve replacement most frequent in TAP. VO2 max for all AP vs TAP was higher in AP (p<0.05). Conclusion: This is the first long-term follow-up study demonstrating that, for equivalent anatomy, an aggressive AP strategy leads to a lower reoperative incidence, less pulmonary insufficiency, smaller indexed RV volumes and better LV function as compared to a standard TAP. Surgical strategy directly impacts ventricular health and should be reflected in practice.