margins – Oral Cancer News

Prognostic factors linked with poor locoregional control in tongue cancer

Source: www.cancernetwork.com Author: Gina Mauro Depth of invasion, lymphovascular space invasion, and positive glossectomy specimen margins were all found to be linked with inferior locoregional control (LRC) in patients with pT1-2N0 oral tongue squamous cell carcinoma who were treated with partial glossectomy and elective neck dissection alone. The retrospective findings, which were presented during the 2024 ASTRO Multidisciplinary Head and Neck Cancers Symposium, were seen even with final negative tumor bed margins. Results showed that, at a median follow-up of 45.6 months, the 3-year LRC and overall survival (OS) rates were 88.0% and 92.5%, respectively, in the all-comer patient population. In patients with pT1 disease, these rates were 92.0% and 95.2%, respectively; they were 85.0% and 90.5% in those with pT2 disease. However, upon the multivariate analysis, those with positive glossectomy margins had worse LRC (HR, 6.66; 95% CI, 1.60-27.78; P = .009). Lymphovascular space invasion (HR, 6.90; 95% CI, 1.42-33.65; P = .02) and depth of invasion (HR, 1.31; 95% CI, 1.06-1.63; P = .01) were also associated with inferior LRC. “Patients with these risk factors may be considered for adjuvant radiotherapy to optimize disease control,” lead study author Michael Modzelewski, MD, of Kaiser Permanente Bernard J. Tyson School of Medicine, in Pasadena, California, and coinvestigators wrote in a poster presented at the meeting. Patients who have early-stage tongue squamous cell carcinoma do not typically receive adjuvant radiation because they are often at low risk for recurrence. Following surgery, the status of main glossectomy specimen margin has been shown [...]

Oral Cancer Foundation News Team - A2024-03-06T20:42:18-07:00March, 2024|Oral Cancer News|

Risk factors for positive surgical margins in salivary gland cancers

Source: www.physiciansweekly.com Author: Craig Bollig, MD An analysis of patients with salivary gland cancers shows that risk factors for positive surgical margins include age, tumor stage, and treatment center. “Salivary gland cancers are rare malignancies in the oropharynx that are primarily treated with surgery because they are relatively resistant to other therapies, such as radiation, chemotherapy, and immunotherapy,” Craig Bollig, MD, explains. “Surgical margins have been associated with cancer recurrence rates and survival in previous studies. However, because these tumors are so rare, there was not much information on risk factors for positive margins in this population prior to this study. Additionally, one of my primary clinical interests is transoral robotic surgery (TORS), which involves using a surgical robot to remove tumors located deep in the throat in a minimally invasive fashion through a patient’s mouth.” According to Dr. Bollig, previous research on the use of TORS in this population was limited, as were data on whether it was associated with similar positive margin rates compared with traditional surgical approaches. For a study published in American Journal of Otolaryngology—Head and Neck Medicine and Surgery, Dr. Bollig and colleagues obtained data from the National Cancer Database on patients with oropharyngeal salivary gland malignancies (OPSGM) from clinical T stages 1 to 4a who underwent surgical resection between 2010 and 2017. The researchers analyzed risk factors for positive surgical margins (PSM) using logistic regression and overall survival (OS) using Kaplan-Meier and Cox proportional hazards models. “Our objectives were to determine the clinical factors [...]

Oral Cancer Foundation News Team - A2022-09-06T09:55:57-07:00September, 2022|Oral Cancer News|

Robotics surgery may improve outcomes in mouth and throat cancer

Source: eandt.theiet.org Author: E&T editorial staff Robotic surgery may improve the health outcomes in mouth and throat cancer patients, including better long-term survival, new research suggests. The method used for the study focused on oropharyngeal cancer that occurs in the back of the throat and includes the base of the tongue and tonsils. In transoral robotic surgery, a surgeon uses a computer-enhanced system to guide an endoscope – a flexible tube with a light and camera attached to it – to provide high-resolution, 3D images of the back of the mouth and throat. Naturally, this is an area that is difficult to reach with conventional tools; therefore, robots can be used during this procedure. Here, two robotically guided instruments, acting as a surgeon’s arms, work around corners to safely remove tumours from surrounding tissue. The observational study, conducted by non-profit Los Angeles hospital Cedars-Sinai, used data from the US National Cancer Database and included 9,745 surgical patients – 2,694 of whom underwent transoral robotic surgery between 2010 and 2015. “At a minimum, robotic surgery for oropharyngeal cancer patients seems safe and effective compared to what’s been the standard of care for many years,” said Zachary S Zumsteg, assistant professor of Radiation Oncology at Cedars-Sinai, referring to standard surgery, radiation therapy, and chemotherapy. The researchers found that the five-year overall survival rate for patients with early-stage disease who underwent robotic surgery was 84.5 per cent, compared with 80.3 per cent for patients who had non-robotic surgery. They adjusted for differences in [...]

Oral Cancer Foundation News Team - A2020-08-22T12:27:13-07:00August, 2020|Oral Cancer News|

Hopkins team shows methylation-specific ddPCR may help predict head and neck cancer recurrence

Source: www.genomeweb.com Author: Madeleine Johnson Oncologists probe the margins of surgical sites to detect epigenetic indicators that can anticipate cancer recurrence. But deep surgical margin analysis with biopsy can alter the site making it challenging to return to the exact spot if there is a problem. It also takes only a few rogue cancer cells to cause a recurrence and these may be missed by histological techniques. Researchers at Johns Hopkins University School of Medicine have now developed a method using Bio-Rad's Droplet Digital PCR platform that is amenable to molecular methods and only requires a tiny sample from the surgical margin. Specifically, in a study published this week in Cancer Prevention Research, scientists examined an epigenetic signature of PAX5 gene methlyation previously determined to be specific to cancer, and found that it could be used to predict local cancer recurrence after tumor removal for head and neck squamous cell carcinoma, or HNSCC. In a prospective study of 82 patients, if the tumors had methylated PAX5 then the presence of residual methylated cells in the surgical margins was a predictor of poor locoregional recurrence-free survival. And among patients on subgroup of patients who did not receive radiation treatment after surgery, the ddPCR method increased detection of the PAX5 maker from 29 percent to 71 percent. Compared to conventional methylation analysis, the ddPCR method also reduced the number of false negatives. Importantly, the authors noted in the study that the method can be performed within three hours by one person. Thus, [...]

Oral Cancer Foundation News Team - A2015-08-27T14:39:59-07:00August, 2015|Oral Cancer News|

Cisplatin aids survival of high-risk head and neck cancer

Source: www.oncologyreport.com Author: Miriam E. Tucker Adding chemotherapy to radiotherapy improved 10-year survival of resectable head and neck carcinomas among high-risk patients who had microscopically involved resection margins and/or extracapsular spread of disease – but not in high-risk patients who only had tumor in multiple lymph nodes. The findings come from a long-term update and unplanned subset analysis of 410 evaluable patients from the RTOG (Radiation Therapy Oncology Group) 9501 phase III study, which previously showed no overall survival advantage from the addition of cisplatin chemotherapy to radiation. The new data are "good news," according to lead author Dr. Jay Cooper, director of Maimonides Cancer Center in Brooklyn, N.Y. "We now can eradicate some advanced head and neck tumors that we couldn’t before by adding chemotherapy to radiation therapy. At the same time, we can spare other patients who would not do better with the addition of chemotherapy from its side effects," he said at a head and neck cancer symposium sponsored by the American Society for Radiation Therapy. The RTOG 9501 study randomized 459 patients with high-risk, resected head and neck cancers to receive either radiation therapy of 60 Gy in 6 weeks (RT), or identical radiotherapy plus cisplatin at 100 mg/m2 IV on days 1, 22, and 43 (RT+CT). When reported at a median follow-up of 45.9 months, the locoregional control rate was significantly higher in the combined-therapy group than in the group given radiotherapy alone (hazard ratio for locoregional recurrence, 0.61); disease-free survival was significantly longer with [...]

Oral Cancer Foundation News Team - A2012-02-03T19:44:50-07:00February, 2012|Oral Cancer News|