Indicators for secondary carcinoma in head and neck cancer patients following curative therapy: A retrospective clinical study.

Patients with head and neck squamous cell carcinoma (HNSCC) are at risk for local and regional relapse, as well as for occurrence of synchronous or metachronous secondary carcinoma. The aim of this retrospective study was to evaluate the frequency of secondary malignancies amongst HNSCC patients and their association with age, sex and TNM classification, as well as smoking and alcohol abuse. Data from 394 patients with HNSCC who were treated at the Department of Otorhinolaryngology-Head and Neck Surgery of the University Hospital Mannheim between 2011 and 2015 were retrieved and analyzed using t-tests and P≤0.05 was considered statistically significant. Of the 394 patients, 50 (12.7%) developed a secondary carcinoma. In this cohort, >70% of secondary malignancies were diagnosed using clinical inspection or microlaryngoscopy. The majority of secondary malignancies were identified in the oropharynx, with men being more often affected overall. Continued abuse of carcinogenic substances appeared to increase the incidence of secondary carcinoma, whereas the localization of the primary tumor, age, sex or TNM classification were not identified as significant indicators of the occurrence of a secondary carcinoma. The purpose of the present study was to emphasize the importance of intensive follow-up to ensure early detection of secondary malignancies. The aim was to help predict numbers and occurrence within smaller cohorts, and to evaluate the quality of data collected during the establishment of a certified tumor center. To fully evaluate the role of continued exposure to noxious substances and other possible contributing factors, and in order to improve the rate of early diagnosis and establish preventive strategies, multicentered studies with larger cohorts are required.

Metastasis of pulmonary adenocarcinoma to the palatine tonsil.

Lung cancer rarely metastasizes to the palatine tonsil. There have only been a few cases that have reported on palatine tonsillar metastases of pulmonary adenocarcinoma. In the majority of these cases the primary diagnosis is a small cell lung cancer. The present case report resents an unusual case of a 66-year-old woman with a multiple metastasized lung adenocarcinoma, which was finally detected by tonsillectomy. The present case report and review of the literature revealed the importance of complete and systematic tumor staging, including the examination of the oral cavity in case of lung cancer and that the evident tentative diagnosis is not always the right one.

Intracranial arterial calcifications as a prognostic factor for subsequent major adverse cardiovascular events (MACE).

BACKGROUND: Intracranial arterial calcifications (ICAC) are often detected on unenhanced CT of patients with an age > 60. However, association with the subsequent occurrence of major adverse cardiovascular events (MACE) has not yet been evaluated. PURPOSE: This study aimed at evaluating the association of ICAC with subsequent MACE and overall mortality. METHODS: In this retrospective, IRB approved study, we included 175 consecutive patients (89 males, mean age 78.3 ± 8.5 years) of age > 60 years who underwent an unenhanced CT of the head due to minor trauma or neurological disorders. Presence of ICAC was determined in seven intracranial arteries using a semi-quantitative scale, which resulted in the calcified plaque score (CPS). Clinical follow-up information was obtained by questionnaires and telephone interviews. MACE was defined as myocardial infarction or revascularization, stroke or death due to cardiovascular event. RESULTS: Mean follow-up time was 39.8 ± 7.8 months, resulting in 579.7 patient-years of follow-up. Overall, 36 MACE occurred during follow-up (annual event rate = 6.2%/year). Mean CPS was significantly higher in subjects with MACE during follow-up compared to subjects without MACE (p < 0.01). In 15 patients CPS was 0; in none of these patients MACE was registered. Kaplan-Meier-analysis revealed that patients with a low plaque burden (CPS < 5) had a significant longer MACE-free and overall survival than patients with a high plaque burden (CPS ≥ 5) (p < 0.01). CONCLUSION: Patients with ICAC have an increased risk for future cardio- or cerebrovascular events. Therefore, ICAC might be a prognostic factor to determine the risk for these events in older patients.

Communicate or Die - A Model for HPV+ and HPV- CSCs and Their Interactions with SDF-1α.

BACKGROUND/AIM: Cancer stem cells (CSCs) are suspected of being a reason for limited therapy in head and neck squamous cell carcinoma (HNSCC). Stromal cell-derived factor-1α (SDF-1α) plays a critical role in the communication between CSCs and their microenvironment. We investigated the influence of SDF-1α on HPV+/HPV- SCC cell lines to find an approach of explanation for the superior prognosis of HPV+ HNSCCs. MATERIALS AND METHODS: We evaluated the expression of CD44/CXCR4 on HPV+/HPV- SCC cell lines and monitored the influence of SDF-1α on proliferation, morphology and migration of HPV+/HPV- SCCs. RESULTS: HPV- SCCs showed a significant increase of podia formation and an intensified migration towards SDF-1α. HPV+ SCCs rested nearly unaffected by SDF-1α. CONCLUSION: Weakened reaction to SDF-1α in HPV+ SCC could lead to an impaired communication between CSCs and their niche, that would result in an increased exposure of CSCs to the harming influence of e.g. chemotherapeutic agents.

Impact of Small Molecules on ß-Catenin and E-Cadherin Expression in HPV16-positive and -negative Squamous Cell Carcinomas.

BACKGROUND: The validation of potential molecular targets in head and neck squamous cell carcinoma (SCC) is mandatory. ß-Catenin and E-cadherin are crucial for cancer progression through epithelial-mesenchymal transition. We analyzed the effect of the tyrosine kinase inhibitors nilotinib, dasatinib, erlotinib and gefitinib on ß-catenin and E-cadherin expression in SCC with respect to human papillomavirus (HPV) status. MATERIALS AND METHODS: Expression of ß-catenin and E-cadherin in cell lines UMSCC 11A, UMSCC 14C and CERV196 under the influence of tyrosine kinase inhibitors were analyzed by enzyme-linked immunosorbent assay. RESULTS: All agents reduced ß-catenin and E-cadherin expression of HPV16-negative cells. Increased E-cadherin expression was observed after treatment with gefitinib and dasatinib in HPV16-positive cells. CONCLUSION: All substances, nilotinib, dasatinib, erlotinib and gefitinib have a significant impact on ß-catenin and E-cadherin expression in both HPV16-positive and HPV16-negative cells in vitro. Alterations of ß-catenin and E-cadherin could provide novel insights for future targeted therapies of head and neck SCC.