Immunosuppression and Cancer: Importance in Head and Neck Surgery

Penn, Israel

doi:10.1001/archotol.1975.00780400025007

Cited by 11 publications

(8 citation statements)

References 21 publications

(1 reference statement)

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“…Many conditions included in the Charlson-Deyo score are immunosuppressed states, including AIDS and liver disease. Immunosuppressed patients 29 and patients with human immunodeficiency virus (HIV)/AIDS 30,31 are at increased risk of H&N cancers, and immunosuppression is a permissive factor in the H&N squamous cell carcinoma microenvironment. 32,33 Patients with diabetes also have an increased risk of H&N cancers 34,35 and an increased risk of complications after free flap reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Clinicopathologic Stage Discrepancy in Oropharyngeal Squamous Cell Carcinoma: A National Cancer Database Study

Kılıç

Kilic

Shah

et al. 2017

Otolaryngol.--head neck surg.

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Objective To determine the frequency, associated factors, and prognosis of clinicopathologic stage discrepancy in oropharyngeal squamous cell carcinoma (OPSCC). Study Design Retrospective study using a national database. Setting National Cancer Database. Subjects and Methods Cases of OPSCC diagnosed between January 1, 2004, and December 31, 2013, with full clinical and pathologic staging information available were identified. Demographic, clinicopathologic, and treatment variables associated with overall stage discrepancy were identified by multivariate logistic regression analysis. Results In total, 7731 cases of OPSCC were identified. Overall stage discrepancy was present in 30.2% of cases (21.9% upstaging, 8.2% downstaging). A total of 13.1% of cases were T-upstaged, and 10.5% of cases were T-downstaged; 22.9% of cases were N-upstaged, and 8.6% of cases were N-downstaged. Upstaging by overall stage was associated with a high Charlson-Deyo score, high tumor grade, number of lymph nodes examined, and increasing tumor size. No factors were positively associated with downstaging. High tumor grade was negatively associated with downstaging. For stage II, III, and IVA tumors, upstaging was associated with poorer OS. Conclusion Clinicopathologic stage discrepancy is common in OPSCC and is likely attributable to insensitive clinical staging techniques as well as to intrinsic tumor biologic properties. Upstaging is associated with poorer prognosis, which is likely due to advancement of disease.

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Section: Discussionmentioning

confidence: 99%

Predictors of Clinicopathologic Stage Discrepancy in Oropharyngeal Squamous Cell Carcinoma: A National Cancer Database Study

Kılıç

Kilic

Shah

et al. 2017

Otolaryngol.--head neck surg.

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Section: Immunosuppression-reducing Treatmentsmentioning

confidence: 99%

“…Most of the drugs used in the cancer chemotherapy have immunosuppressive effect (66,67). Moreover, it has been noticed nearly 50 years ago that some patients have manifested new tumors in different locations while their original neoplasm have been treated (66). Furthermore, increased incidence of cancer is observed in immunosuppressed patients, what at least partially had been attributed to the actions of Tregs in 1995 (57,68).…”

Section: Immunosuppression-reducing Treatmentsmentioning

confidence: 99%

The Intriguing History of Cancer Immunotherapy

2019

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Immunotherapy is often perceived as a relatively recent advance. In reality, however, one should be looking for the beginnings of cancer immunotherapy under different names as far as in the Antiquity. The first scientific attempts to modulate patients' immune systems to cure cancer can be attributed to two German physicians, Fehleisen and Busch, who independently noticed significant tumor regression after erysipelas infection. The next significant advances came from William Bradley Coley who is known today as the Father of Immunotherapy. It was Coley who first attempted to harness the immune system for treating bone cancer in 1891. His achievements were largely unnoticed for over fifty years, and several seminal discoveries in the field of Immunology, such as the existence of T cells and their crucial role in immunity in 1967, stepped up the research toward cancer immunotherapy known today. The following paper tracks cancer immunotherapy from its known beginnings up until recent events, including the 2018 Nobel Prize award to James Allison and Tasuku Honjo for their meticulous work on checkpoint molecules as potential therapeutic targets. That work has led to the successful development of new checkpoint inhibitors, CAR T-cells and oncolytic viruses and the pace of such advances brings the highest hope for the future of cancer treatment.

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“…Several studies have found significant associations between malnutrition indicators, such as weight loss, cachexia, and a worse perioperative and survival outcomes 3,43–45 . Moreover, malnutritional status is related to impaired immune system function, as cell‐mediated immunity and occurrence of immunosuppression, thus justifying the poorer oncological outcomes observed for malnourished patients 46–48 . This observation supports the rationale of active nutritional interventions in patients affected by HNSCC and the investigation of alternative medical interventions, such as immune‐enhancing nutrients, whose effectiveness in this specific oncological setting is not yet demonstrated 9,43 …”

Section: Discussionmentioning

confidence: 83%

Immunonutrition in major oncologic head and neck surgery: Analysis of complications, plasmatic equilibrium, and costs

et al. 2022

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Background Malnutrition, in patients with solid tumors, is associated with a worse clinical outcome and about 40% of patients affected by head and neck cancers (HNC) are malnourished at the time of cancer diagnosis. We investigated the potential benefit of a standardized immunonutritional protocol (INP) to patients with HNC receiving major ablative surgery. Methods An observational study was conducted enrolling 199 patients: 50 treated with the INP and 149 with standard enteral nutrition. Complication rates, need for medications, and costs were considered as outcomes. Results INP played a protective role in development of major surgical complications (OR 0.23, p = 0.023), albumin administration (RR 0.38, p = 0.018), and antibiotic duration (p < 0.001) and is cost‐effective in patients with moderate or severe malnutrition (−6083€ and −11 988€, p < 0.05). Conclusions Our study supports the utility of INP, and accurate nutritional screening can help to identify malnourished patients who would receive the most benefits from this protocol.

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Immunosuppression and Cancer: Importance in Head and Neck Surgery

Cited by 11 publications

References 21 publications

Predictors of Clinicopathologic Stage Discrepancy in Oropharyngeal Squamous Cell Carcinoma: A National Cancer Database Study

Predictors of Clinicopathologic Stage Discrepancy in Oropharyngeal Squamous Cell Carcinoma: A National Cancer Database Study

The Intriguing History of Cancer Immunotherapy

Immunonutrition in major oncologic head and neck surgery: Analysis of complications, plasmatic equilibrium, and costs

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