The 2019 novel coronavirus disease (COVID-19) is a highly contagious zoonosis produced by SARS-CoV-2 that is spread human-to-human by respiratory secretions. It was declared by the WHO as a public health emergency. The most susceptible populations, needing mechanical ventilation, are the elderly and people with associated comorbidities. There is an important risk of contagion for anesthetists, dentists, head and neck surgeons, maxillofacial surgeons, ophthalmologists, and otolaryngologists. Health workers represent between
Previous studies have described that tumor organoids can capture the diversity of defined human carcinoma types. Here, we describe conditions for long-term culture of human mucosal organoids. Using this protocol, a panel of 31 head and neck squamous cell carcinoma (HNSCC)-derived organoid lines was established. This panel recapitulates genetic and molecular characteristics previously described for HNSCC. Organoids retain their tumorigenic potential upon xenotransplantation. We observe differential responses to a panel of drugs including cisplatin, carboplatin, cetuximab, and radiotherapy in vitro. Additionally, drug screens reveal selective sensitivity to targeted drugs that are not normally used in the treatment of patients with HNSCC. These observations may inspire a personalized approach to the management of HNSCC and expand the repertoire of HNSCC drugs. SIGNIFICANCE: This work describes the culture of organoids derived from HNSCC and corresponding normal epithelium. These tumoroids recapitulate the disease genetically, histologically, and functionally. In vitro drug screening of tumoroids reveals responses to therapies both currently used in the treatment of HNSCC and those not (yet) used in clinical practice.
Background Low skeletal muscle mass (SMM) is associated with postoperative complications, prolonged hospital stay, and short overall survival (OS) in surgical oncology. We aimed to investigate this association in patients undergoing total laryngectomy (TL). Methods A retrospective study was performed of patients undergoing TL. SMM was measured using CT or MRI scans at the level of the third cervical vertebra (C3). Results In all, 235 patients were included. Low SMM was observed in 109 patients (46.4%). Patients with low SMM had more pharyngocutaneous fistulas (PCFs) than patients with normal SMM (34.9% vs 20.6%; P = .02) and prolonged hospital stay (median, 17 vs 14 days; P < .001). In multivariate analysis, low SMM (hazards ratio, 1.849; 95% confidence interval, 1.202‐2.843) and high N stage were significant prognosticators of decreased OS. Conclusion Low SMM is associated with PCF and prolonged hospital stay in patients undergoing TL. Low SMM is an independent prognostic factor for shorter OS.
Objectives Sarcopenia is known as a geriatric syndrome associated with increased disability and decreased survival in elderly patients. In oncological patients, pretreatment low skeletal muscle mass (SMM), sometimes referred to as sarcopenia, is an emerging negative prognostic factor. Commonly, only SMM is assessed in cancer patients. Sarcopenia is defined as the combination of low SMM and low muscle function (MF). We investigated the relation between SMM, MF, sarcopenia (SMM and MF combined), and overall survival (OS) in a group of elderly patients with head-and-neck squamous cell carcinoma (HNSCC). Patients and methods A retrospective study in elderly HNSCC patients treated between 2015 and 2018 was performed. The prognostic value of SMM and MF seperately, and sarcopenia was investigated. Results Eighty-five patients were included of whom 48.2% had sarcopenia. The median OS was significantly worse for patients treated with curative intent with sarcopenia (12.07 months; IQR 3.64–21.82) compared to patients without sarcopenia (13.60 months; IQR 5.98-27.00) (HR 2.80; 95% CI 1.14–6.88; p = 0.03). SMM and MF seperately were not significant predictors of OS. Conclusion Sarcopenia is associated with impaired OS in elderly HNSCC patients. Sarcopenia, defined as the combination of low SMM and low MF, appears to be a better predictor of OS than low SMM or low MF separately.
Background The eighth international symposium for sentinel node biopsy (SNB) in head and neck cancer was held in 2018. This consensus conference aimed to deliver current multidisciplinary guidelines. This document focuses on the surgical aspects of SNB for oral cancer. Method Invited expert faculty selected topics requiring guidelines. Topics were reviewed and evidence evaluated where available. Data were presented at the consensus meeting, with live debate from panels comprising expert, nonexpert, and patient representatives followed by voting to assess the level of support for proposed recommendations. Evidence review, debate, and voting results were all considered in constructing these guidelines. Results/Conclusion A range of topics were considered, from patient selection to surgical technique and follow‐up schedule. Consensus was not achieved in all areas, highlighting potential issues that would benefit from prospective studies. Nevertheless these guidelines represent an up‐to‐date pragmatic recommendation based on current evidence and expert opinion.
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