Prognostic Indicators in Head and Neck Oncology Including the New 7th Edition of the AJCC Staging System

Brandwein-Gensler, Margaret; Smith, Richard V.

doi:10.1007/s12105-010-0161-y

Cited by 75 publications

(54 citation statements)

References 61 publications

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“…31,32 It has become essential to reclassify the head and neck squamous cell carcinomas based on their association with HPV for determining the prognosis and patient management, instead of using the purely morphological classification. 33 In conclusion, we confirm in this study that highrisk HPV are etiologically involved in 20% of squamous cell carcinomas of the sinonasal tract. P16 immunostaining must be considered a surrogate marker in identifying these tumors.…”

Section: Discussionsupporting

confidence: 81%

High-risk human papillomavirus is transcriptionally active in a subset of sinonasal squamous cell carcinomas

et al. 2014

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It has been reported that high-risk human papillomavirus (HPV) is a causative agent of a subgroup of oropharyngeal carcinomas. In these tumors, the presence of the transcriptionally active HPV has been proved through the identification of HPV E6 or E7 messenger RNA (mRNA) transcripts. The aim of the study was to assess the HPV-active transcription in a series of sinonasal carcinomas, in correlation with the HPV DNA identification and the p16 immunohistochemistry. Seventy patients with squamous cell carcinomas of the sinonasal tract were included in the survey. The main clinicopathological characteristics were recorded. All tumors were investigated for HPV through the HPV DNA detection by PCR, using the SPF10 primers and by in situ hybridization, using the high-risk GenPoint probe (Dako, Glostrup, Denmark). HPV16 E7 mRNA transcripts detection was performed by RT-PCR in 27 cases. The immunostaining for p16 was performed in all cases. Fourteen carcinomas (20%) were positive for high-risk HPV by PCR: 13 HPV16 and one HPV35. In situ hybridization showed a dotted nuclear positivity in all these cases. HPV16 E7 mRNA was detected in seven tumors harboring HPV16; in the remaining HPV-positive cases, RNA did not reach the quality for analysis. Strong, diffuse positivity for p16 was observed only in the HPV-positive cases. The 14 HPV-positive squamous cell carcinomas were non-keratinizing or scarcely keratinizing tumors. No significant differences were found in terms of gender, age, or staging at diagnosis between HPV-positive and HPV-negative tumors. However, differences in disease-free survival and overall survival between both groups of patients were significant (P=0.004 and P=0.028, respectively). In conclusion, we have shown that HPV is the etiological agent of a subset of sinonasal carcinomas demonstrating the transcriptionally active HPV in these tumors. Immunostaining for p16 can be used as a surrogate marker to identify these tumors.

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Section: Discussionsupporting

confidence: 81%

High-risk human papillomavirus is transcriptionally active in a subset of sinonasal squamous cell carcinomas

et al. 2014

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“…For instance, a biological factor with prognostic value is the human papillomavirus (HPV) status. A positive HPV status is associated with a better prognosis and clinical outcome [39].…”

Section: Prognostic Factors-measurement and Choosing Optimal Cutpointsmentioning

confidence: 99%

Endpoints and cutpoints in head and neck oncology trials: methodical background, challenges, current practice and perspectives

Hezel

Usslar

Kurzweg

et al. 2015

Eur Arch Otorhinolaryngol

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This article reviews the methodical and statistical basics of designing a trial, with a special focus on the process of defining and choosing endpoints and cutpoints as the foundations of clinical research, and ultimately that of evidence-based medicine. There has been a significant progress in the treatment of head and neck cancer in the past few decades. Currently available treatment options can have a variety of different goals, depending e.g. on tumor stage, among other factors. The outcome of a specific treatment in clinical trials is measured using endpoints. Besides classical endpoints, such as overall survival or organ preservation, other endpoints like quality of life are becoming increasingly important in designing and conducting a trial. The present work is based on electronic research and focuses on the solid methodical and statistical basics of a clinical trial, on the structure of study designs and on the presentation of various endpoints.

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“…The new staging criteria reflect the aggressive nature of head neck mucosal melanoma. 46 The AJCC staging system for MM begins with stage T3 as the most limited form of disease (Table 1).…”

Section: Dermoscopy Of An Amalgam Tattoo Dermoscopy Image Showing a mentioning

confidence: 99%

Melanoma of the oral cavity: pathogenesis, dermoscopy, clinical features, staging and management

Warszawik-Hendzel

Słowińska²,

Olszewska

et al. 2014

J Dermatol Case Rep

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Primary mucosal melanoma of the oral cavity is an exceedingly rare neoplasm which is estimated to comprise 1-2% of all oral malignancies. In contrast to cutaneous melanomas, the risk factors and pathogenesis are poorly understood. The predominate localization of primary oral melanoma is hard palate and maxillary alveolus. Dermoscopy may be utilized as an adjunctive tool in the clinical differential diagnosis of oral mucosal melanoma whenever the lesion is accessible with a dermoscope. Surgery is the mainstay of treatment, but it may be challenging depending on the location of the tumor within the oral cavity and its size. Adjuvant therapy with dacarbazine, platinum analogs, nitrosoureas and interleukin-2 have been utilized with low response rates. Imatinib may be effective for patients with with c-Kit gene mutations. Sunitinib and dasatinib have been reported effective in selected cases. Vemurafenib and dabrafenib are targeted agents for patients with BRAF mutation-positive melanoma. Ipilimumab, an anti-cytotoxic T-lymphocyte antigen 4 antibody and pembrolizumab, a monoclonal antibody targeting programmed death 1 receptor may be a feasible treatment option in patients with metastatic mucosal melanoma. (J Dermatol Case Rep. 2014; 8(3) Melanoma is a malignant tumor that arises from melanocytes and is most commonly cutaneous in origin. Extracutaneous melanomas are known to be exceedingly rare and aggressive neoplasms that embrace ocular, mucosal and leptomeningeal melanomas. EpidemiologyMucosal melanomas are estimated to comprise 4-6.8 % of all primary melanomas. 1The incidence rate for mucosal melanoma (MM) is 2.3 per million. 1,2The incidence of MM increases with age. Older patients have tenfold higher incidence of MM compared to patients under the age of 60 years. 2Primary oral mucosal melanoma (POMM) is excessively uncommon in prepubertal children. 3Although there is a slight male preponderance (1.2:1), 1,4 some studies have been reported higher gender distribution of mucosal melanoma for women, 5,6 other indicate that there is no significant difference between sexes in the incidence of this tumor. 2,7The incidence rate of POMM is highest among Asian men. 3,6 Among the Japanese oral melanoma accounts for 7.5 % of all melanomas versus less than 1 % in Caucasians. 8,9Pathogenesis In contrast to cutaneous melanomas, the etiology and pathogenesis of POMM is poorly understood and no etiological and intraoral risk factors, other than preexisting pigmented nevi, have been identified. 10,11 POMM are believed to arise from pigmented nevi, pre-existing pigmented areas or de novo (30% cases) from apparently normal mucosa. 9,12 Although Kahn et al 13 described transformation of a benign oral pigmentation to primary oral melanoma, a definite precursor lesion has not been identified. 14,15 In the oral cavity, mechanical trauma including injury from ill-fitting prostheses, infection, tobacco use has been cited as possible causative factors, but its etiological role seems unlikely. 30Amelanotic oral melanoma is partic...

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Prognostic Indicators in Head and Neck Oncology Including the New 7th Edition of the AJCC Staging System

Cited by 75 publications

References 61 publications

High-risk human papillomavirus is transcriptionally active in a subset of sinonasal squamous cell carcinomas

High-risk human papillomavirus is transcriptionally active in a subset of sinonasal squamous cell carcinomas

Endpoints and cutpoints in head and neck oncology trials: methodical background, challenges, current practice and perspectives

Melanoma of the oral cavity: pathogenesis, dermoscopy, clinical features, staging and management

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