F-NLR score was useful to stratify patients to extract poor prognostic characteristics in patients with advanced HPC.

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The JCOG1008 trial revealed non-inferiority of chemoradiotherapy with weekly cisplatin to that with tri-weekly cisplatin in terms of the overall survival in patients with postoperative high-risk locally advanced squamous cell carcinoma of the head and neck. We developed clinical pathways to standardize and optimize the weekly cisplatin treatment procedure, minimize adverse events, and promote the patients' understanding. The regimen ensures a sufficient amount of hydration during the short-term overnight hospitalization for the treatment. We retrospectively reviewed the medical records of patients treated at our department, which revealed that the weekly cisplatin treatment reduced the duration of hospitalization, but increased the DPC fee per night as compared with tri-weekly cisplatin therapy, without attenuating the safety or intensity of the treatment. These findings suggest that introduction of a weekly cisplatin regimen is beneficial for patients, caregivers, as well as medical institutions.

Background We had previously identified the following risk factors for insufficient control of early T-stage head and neck cancer by transoral surgery (TOS): (1) tumor thickness > 7 mm on enhanced computed tomography (CT), and (2) poor differentiation in pathological examination. We subsequently used a different patient cohort to validate the usefulness of these factors in determining the need for adaptation of TOS. Study setting A prospective observational study Methods Patients who received TOS as a definitive treatment between April 1, 2016 and September 30, 2020 were included. Primary control rates (by single TOS and TOS alone) in relation to the above-mentioned risk factors were calculated. Overall (O), recurrence-free (RF), and disease-free (DF) survival (S) outcomes were evaluated. A combination analysis based on the number of risk factors was also performed. Results Patients with tumor thickness > 7 mm had a 2.88-fold [95% confidence interval (CI) 1.01-8.51] higher risk of incomplete primary resection by single TOS, while patients who showed poor differentiation on pathological assessments had a 13.14-fold (95% CI 3.66-47.14) higher risk of insufficient primary control by TOS alone. The 3 year OS, RFS, and DFS rates were 99%, 83%, and 63%, respectively. Patients with both risk factors had a 93.00-fold (95% CI 4.99-1732.00) higher risk of incomplete primary control by TOS alone. Conclusions Among patients with early-stage laryngeal, oropharyngeal, and hypopharyngeal squamous cell carcinoma, primary control by TOS alone may not be achieved in patients with both risk factors, that is, tumor thickness > 7 mm as measured by enhanced CT and poor differentiation on pathological examination.

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