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Abstracts Explore Head and Neck Surgical Research

Scientific Oral Presentations: Head and Neck Surgery
10:00 am – 12:00 pm
Room E353B

Research into several topics will be examined Wednesday during “Scientific Oral Presentations: Head and Neck Surgery.” Following are summaries of four of the 17 five-minute presentations.

Sentinel Lymph Node Biopsy in Squamous Cell Carcinoma

Sentinel lymph node biopsy (SLNB) is well established for the staging and prognosis of melanoma. A new study showed that it also has the potential to fill the same role for cutaneous squamous cell carcinoma, but advances first need to be established in SLNB techniques and pathological analysis.

Data were collected from pathology reports of 22 patients in one institution who underwent SLNB for cutaneous squamous cell carcinoma. All but one of the patients had one or more high-risk features. Follow-up with the patients averaged eight months. Two of the 22 patients had positive SNLBs and one had local recurrence. In the study, SLNB-positive rates for high-risk cutaneous squamous cell carcinoma were greater than in the literature.

“Although promising, the utility of SLNB in squamous cell carcinoma has not been well defined due to small sample sizes and short follow-up,” said presenter Tom Shokri, MD. “Therefore, our results further reinforce the literature indicating that the technique for SLNB and pathologic analysis must be further standardized.”

Lung Malignancy Following Head and Neck Squamous Cell Cancer

Clinicians need to be aware of the risk of the development of secondary primary lung malignancies (SPLM) when treating patients with head and neck squamous cell cancer (HNSCC), according to conclusions of Surveillance, Epidemiology, and End Results (SEER) database query.

The study found 5,195 patients with SPLM out of 118,902 HNSCC patients. It was found that cancers originating from the floor of the mouth, pyriform sinus, glottis, and supraglottis were more likely to be followed by an SPLM than cancers originating from other sites in the head and neck.

“While these results are not necessarily surprising in their assessment of subsite-specific risk, they offer insight into the accuracy with which we determine SPLM versus metastasis to the lung,” said presenter Meghan Crippen, MS.

Diagnosis to Treatment Time in Head and Neck Cancer

The comprehensive care of patients with head and neck cancer can be performed as well in a resource-poor environment as in a tertiary cancer referral center, according to a prospective cohort study.

From October 2010 to June 2016, 287 patients were evaluated for head and neck cancer at a public, 230-bed safety-net hospital. The median time from diagnosis to treatment was 41 days, and less than 30 days for 34 percent of patients, a result that was surprising, said presenter Garren Low, MD.

“(There is a) persistent mistaken notion that healthcare processes at safety-net hospitals are inherently cumbersome and inefficient,” Dr. Low said. “Quality care can be provided to any patient population given appropriate coordination of leadership and resources.”

C-Reactive Protein in HPV-Positive and Negative Oropharyngeal Cancer

C-reactive protein (CRP) levels were examined as potential biomarkers to help determine if CRP could be used to determine the outcomes of patients with HPV oropharyngeal cancer (OPC). It also examined whether there were survival differences between patients with HPV-positive and HPV-negative OPC.

Kaplan Meier log-rank tests and Cox regression models determined that overall survival and recurrence-free survival are higher in HPV-positive patients. Of 113 HPV-positive and 110 HPV-negative patients, CRP was significantly higher in the HPV-positive group compared with the HPV-negative group. Higher CRP levels resulted in worsened overall survival in the HPV-positive group.

The study also concluded that in HPV-negative patients, higher CRP resulted in worsened survival. A similar but non-significant trend was found in HPV-positive patients.

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