Survival outcomes following salvage surgery for oropharyngeal squamous cell carcinoma: systematic review

Kao, Shung‐Te; Ooi, Eng H.

doi:10.1017/s0022215117000998

Cited by 22 publications

(18 citation statements)

References 39 publications

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“…Thus, the miRNA content of circulating small extracellular vesicles has the potential to provide a unique molecular signature for multiple possibilities such as diagnosis, prognosis and surveillance of cancers [ 10 ]. In the event of recurrence, a systematic review found that success of salvage surgery in OPSCC recurrence is dependent on early recognition of such disease [ 11 ]. A biomarker that identifies the presence of residual or recurrent cancers prior to clinical evidence of such disease would facilitate early salvage options.…”

Section: Introductionmentioning

confidence: 99%

Cross validated serum small extracellular vesicle microRNAs for the detection of oropharyngeal squamous cell carcinoma

et al. 2020

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Background Oropharyngeal squamous cell carcinoma (OPSCC) is often diagnosed at an advanced stage because the disease often causes minimal symptoms other than metastasis to neck lymph nodes. Better tools are required to assist with the early detection of OPSCC. MicroRNAs (miRNAs, miRs) are potential biomarkers for early head and neck squamous cell cancer diagnosis, prognosis, recurrence, and presence of metastatic disease. However, there is no widespread agreement on a panel of miRNAs with clinically meaningful utility for head and neck squamous cell cancers. This could be due to variations in the collection, storage, pre-processing, and isolation of RNA, but several reports have indicated that the selection and reproducibility of biomarkers has been widely affected by the methods used for data analysis. The primary analysis issues appear to be model overfitting and the incorrect application of statistical techniques. The purpose of this study was to develop a robust statistical approach to identify a miRNA signature that can distinguish controls and patients with inflammatory disease from patients with human papilloma virus positive (HPV +) OPSCC. Methods Small extracellular vesicles were harvested from the serum of 20 control patients, 20 patients with gastroesophageal reflux disease (GORD), and 40 patients with locally advanced HPV + OPSCC. MicroRNAs were purified, and expression profiled on OpenArray™. A novel cross validation method, using lasso regression, was developed to stabilise selection of miRNAs for inclusion in a prediction model. The method, named StaVarSel (for Stable Variable Selection), was used to derive a diagnostic biomarker signature. Results A standard cross validation approach was unable to produce a biomarker signature with good cross validated predictive capacity. In contrast, StaVarSel produced a regression model containing 11 miRNA ratios with potential clinical utility. Sample permutations indicated that the estimated cross validated prediction accuracy of the 11-miR-ratio model was not due to chance alone. Conclusions We developed a novel method, StaVarSel, that was able to identify a panel of miRNAs, present in small extracellular vesicles derived from blood serum, that robustly cross validated as a biomarker for the detection of HPV + OPSCC. This approach could be used to derive diagnostic biomarkers of other head and neck cancers.

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Section: Introductionmentioning

confidence: 99%

Cross validated serum small extracellular vesicle microRNAs for the detection of oropharyngeal squamous cell carcinoma

et al. 2020

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“…These patients were almost exclusively treated with open surgery. A recent review of 18 articles showed similar results (45). Favorable results have also been reported using TORS for salvage surgery in a selected group of patients with early-stage recurrence.…”

Section: Surgerymentioning

confidence: 71%

Advances in Diagnosis and Multidisciplinary Management of Oropharyngeal Squamous Cell Carcinoma: State of the Art

2019

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During the past decade and a half, the most common cause of oropharyngeal squamous cell carcinoma (OPSCC) has shifted from tobacco and alcohol to the human papillomavirus (HPV). HPVdriven p16-positive OPSCC and tobacco-related OPSCC differ in their underlying molecular and genetic profiles, socioeconomic demographics, and response to treatment. HPV-related OPSCC tends to occur in younger patients and has a significantly better response to treatment and excellent prognosis. The stark contrast in prognosis-with around 90% overall 5-year survival for HPV-related p16-positive OPSCC and 40% for non-HPV-related p16-negative OPSCC-has prompted major changes in the eighth edition of the staging manual of the AJCC (American Joint Committee on Cancer). The past 10-15 years have also witnessed major advances in surgery, radiation therapy (RT), and systemic therapy. Minimally invasive surgery has come of age, with transoral robotic procedures and laser microsurgery. Intensity-modulated RT (IMRT) and more recently proton-beam RT have markedly improved the conformity of RT, with an ability to precisely target the cancer and cancer-bearing regions while sparing normal structures and significantly reducing long-term treatment-related morbidity. Progress in systemic therapy has come in the form of immunotherapy and targeted agents such as cetuximab. Owing to the better prognosis of HPV-driven OPSCC as well as the morbidity associated with treatment, de-escalation of therapy via multiple strategies is being explored. The article reviews the advances in diagnosis and multidisciplinary management of OPSCC in the HPV era. ©

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“…This consideration is especially important for patients with HPV-associated disease, a population with a favorable prognosis. Post-CRT neck dissection has important implications on long-term quality of life as it is associated with a higher rate of post-operative complications (17). Therefore, a literature review was performed with the PubMed Database to investigate potential strategies for improvement of post-CRT treatment assessment of the neck in patients with HPV-associated OPSCC.…”

Section: Introductionmentioning

confidence: 99%

Improving post‑CRT neck assessment in patients with HPV‑associated OPSCC (Review)

et al. 2020

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The positive predictive value (PPV) of 12-week post-therapy FDG-PET/CT is low in patients with Human Papillomavirus (HPV)-associated Oropharyngeal Squamous Cell Carcinoma (OPSCC) after treatment with definitive chemoradiation (CRT). Moreover, the diagnostic performance of post-CRT fine needle aspiration (FNA) in detecting persistent disease is unknown in this population. Given these important shortcomings in post-CRT treatment assessment, head and neck oncologists are limited in appropriately selecting patients for consolidative neck dissection, which results in over-treatment of a favorable risk population. Using the PubMed database, we performed a literature review of published series in HPV-associated OPSCC to investigate potential strategies for improvement of post-CRT neck assessment. Several different approaches were found, including continued surveillance with PET/CT, delayed timing of restaging PET/CT, initial response evaluation with multimodality or alternative imaging, and detection of circulating HPV DNA. At present, the optimal approach to post-CRT treatment assessment is unclear; further investigation and incorporation of new technologies and surveillance protocols will be highly beneficial for patients with HPV-associated OPSCC. Contents 1. Introduction 2. Strategies to improve post-CRT neck assessment 3. Conclusions and prospects

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Survival outcomes following salvage surgery for oropharyngeal squamous cell carcinoma: systematic review

Cited by 22 publications

References 39 publications

Cross validated serum small extracellular vesicle microRNAs for the detection of oropharyngeal squamous cell carcinoma

Cross validated serum small extracellular vesicle microRNAs for the detection of oropharyngeal squamous cell carcinoma

Advances in Diagnosis and Multidisciplinary Management of Oropharyngeal Squamous Cell Carcinoma: State of the Art

Improving post‑CRT neck assessment in patients with HPV‑associated OPSCC (Review)

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