Capacidad predictiva de la expresión transcripcional de FAT1 en pacientes con carcinomas escamosos de cabeza y cuello tratados con radioterapia / Predictive capacity of FAT1 transcriptional expression in patients with head and neck squamous cell carcinomas treated with radiotherapy

Objetivo Analizar la capacidad predictiva de la respuesta a nivel local de la expresión transcripcional de FAT1 en pacientes con carcinomas escamosos de cabeza y cuello tratados con radioterapia.Material y métodosLlevamos a cabo un estudio retrospectivo realizado a partir de biopsias de la localización primaria del tumor en 82 pacientes con carcinomas escamosos de cabeza y cuello tratados con radioterapia. Se determinó la expresión transcripcional de FAT1 mediante RT-PCR. Se categorizó el nivel de expresión transcripcional de FAT1 en función del control local tras el tratamiento con radioterapia mediante un análisis de partición recursiva.ResultadosLa expresión transcripcional elevada de FAT1 se relacionó con un incremento en el riesgo de recidiva local tras el tratamiento con radioterapia. Los pacientes con unos niveles de expresión elevada de FAT1 (n=18; 22,0%) tuvieron una supervivencia libre de recidiva local a los 5 años del 42,1% (IC 95%: 18,6-65,6%), en tanto que para los pacientes con una expresión baja (n=64; 78,0%) fue del 72,4% (IC 95%: 61,5-83,3%) (p=0,002). De acuerdo con el resultado de un análisis multivariante, los pacientes con una categoría de expresión elevada de FAT1 tuvieron un riesgo 2,3 veces superior de recidiva local (IC 95%: 1,0-5,2; p=0,043).ConclusionesLa expresión transcripcional elevada de FAT1 se relacionó con un incremento significativo del riesgo de recidiva local en los pacientes con carcinomas escamosos de cabeza y cuello tratados con radioterapia. (AU)

Objective To analyze the predictive capacity at the primary location of the tumor of the FAT1 transcriptional expression in patients with head and neck squamous cell carcinoma treated with radiotherapy.Material and methodsWe conducted a retrospective study from biopsies of the primary location of the tumor in 82 patients with head and neck squamous cell carcinoma treated with radiotherapy. The transcriptional expression of FAT1 was determined by RT-PCR. The level of FAT1 transcriptional expression was categorized according to the local control after radiotherapy using a recursive partitioning analysis.ResultsElevated FAT1 transcriptional expression was associated with an increased risk of local recurrence after radiotherapy. Patients with a high expression level of FAT1 (n=18; 22.0%) had a 5-year local recurrence-free survival of 42.1% (95% CI: 18.6–65.6%), whereas for patients with a low expression (n=64; 78.0%) it was 72.4% (95% CI: 61.5%–83.3%) (P=0.002). According to the result of a multivariate analysis, patients with a high FAT1 expression category had a 2.3-fold increased risk of local recurrence (95% CI: 1.0–5.2; P=0.043).ConclusionsElevated FAT1 transcriptional expression was associated with a significantly increased risk of local recurrence in patients with head and neck squamous cell carcinoma treated with radiotherapy. (AU)

Predictive capacity of FAT1 transcriptional expression in patients with head and neck squamous cell carcinomas treated with radiotherapy.

OBJECTIVE: To analyze the predictive capacity at the primary location of the tumor of the FAT1 transcriptional expression in patients with head and neck squamous cell carcinoma treated with radiotherapy. MATERIAL AND METHODS: We conducted a retrospective study from biopsies of the primary location of the tumor in 82 patients with head and neck squamous cell carcinoma treated with radiotherapy. The transcriptional expression of FAT1 was determined by RT-PCR. The level of FAT1 transcriptional expression was categorized according to the local control after radiotherapy using a recursive partitioning analysis. RESULTS: Elevated FAT1 transcriptional expression was associated with an increased risk of local recurrence after radiotherapy. Patients with a high expression level of FAT1 (n=18; 22.0%) had a 5-year local recurrence-free survival of 42.1% (95% CI: 18.6%-65.6%), whereas for patients with a low expression (n=64; 78.0%) it was 72.4% (95% CI: 61.5%-83.3%) (p=0.002). According to the result of a multivariate analysis, patients with a high FAT1 expression category had a 2.3-fold increased risk of local recurrence (95% CI: 1.0-5.2; p=0.043). CONCLUSIONS: Elevated FAT1 transcriptional expression was associated with a significantly increased risk of local recurrence in patients with head and neck squamous cell carcinoma treated with radiotherapy.

Prognostic value of transcriptional expression of fibronectin type III domain-containing 4 (FNDC4) in head and neck carcinoma patients treated with chemoradiotherapy

FNDC4 gene encodes the fibronectin type III domain-containing 4 protein. Elevated expression of FNDC4 has been associated with poor prognosis in several types of cancer. There are no studies that have evaluated the prognostic capacity of FNDC4 in patients with head and neck cancer (HNSCC). The aim of our study was to analyze the relationship between the transcriptional expression of FNDC4 and prognosis in HNSCC patients.MethodsWe determined the transcriptional expression of FNDC4 in 67 patients with advanced-stage HNSCC (III–IV) treated with chemoradiotherapy. The FNDC4 expression was categorized according to the disease-specific survival with a recursive partitioning analysis.ResultsThere were significant differences in disease-specific survival as a function of the level of FNDC4 transcriptional expression. The 5-year disease-specific survival for patients with high FNDC4 expression (n = 44, 65.7%) was 32.9% (95% CI: 16.5–49.3%), and for patients with low expression (n = 23, 34.3%) it was 85.4% (95% CI: 70.2–100%) (P = 0.0001). Patients with a high FNDC4 expression had poorer local (P = 0.097), regional (P = 0.008), and distant (0.034) recurrence-free survival. The results of a multivariate analysis showed that patients with a high FNDC4 expression had a 6.15-fold increased risk of death as a consequence of the HNSCC (95% CI: 1.71–22.06).ConclusionFNCF4 transcriptional expression was significantly related to the disease-specific survival of HNSCC patients treated with chemoradiotherapy. Patients with elevated FNDC4 expression had a significant decrease in disease-specific survival. (AU)

Prognostic value of transcriptional expression of fibronectin type III domain-containing 4 (FNDC4) in head and neck carcinoma patients treated with chemoradiotherapy.

PURPOSE: FNDC4 gene encodes the fibronectin type III domain-containing 4 protein. Elevated expression of FNDC4 has been associated with poor prognosis in several types of cancer. There are no studies that have evaluated the prognostic capacity of FNDC4 in patients with head and neck cancer (HNSCC). The aim of our study was to analyze the relationship between the transcriptional expression of FNDC4 and prognosis in HNSCC patients. METHODS: We determined the transcriptional expression of FNDC4 in 67 patients with advanced-stage HNSCC (III-IV) treated with chemoradiotherapy. The FNDC4 expression was categorized according to the disease-specific survival with a recursive partitioning analysis. RESULTS: There were significant differences in disease-specific survival as a function of the level of FNDC4 transcriptional expression. The 5-year disease-specific survival for patients with high FNDC4 expression (n = 44, 65.7%) was 32.9% (95% CI: 16.5-49.3%), and for patients with low expression (n = 23, 34.3%) it was 85.4% (95% CI: 70.2-100%) (P = 0.0001). Patients with a high FNDC4 expression had poorer local (P = 0.097), regional (P = 0.008), and distant (0.034) recurrence-free survival. The results of a multivariate analysis showed that patients with a high FNDC4 expression had a 6.15-fold increased risk of death as a consequence of the HNSCC (95% CI: 1.71-22.06). CONCLUSION: FNCF4 transcriptional expression was significantly related to the disease-specific survival of HNSCC patients treated with chemoradiotherapy. Patients with elevated FNDC4 expression had a significant decrease in disease-specific survival.

Limitations of Molecular and Antigen Test Performance for SARS-CoV-2 in Symptomatic and Asymptomatic COVID-19 Contacts.

COVID-19 has brought unprecedented attention to the crucial role of diagnostics in pandemic control. We compared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test performance by sample type and modality in close contacts of SARS-CoV-2 cases. Close contacts of SARS-CoV-2-positive individuals were enrolled after informed consent. Clinician-collected nasopharyngeal (NP) swabs in viral transport media (VTM) were tested with a routine clinical reference nucleic acid test (NAT) and PerkinElmer real-time reverse transcription-PCR (RT-PCR) assay; positive samples were tested for infectivity using a VeroE6TMPRSS2 cell culture model. Self-collected passive drool was also tested using the PerkinElmer RT-PCR assay. For the first 4 months of study, midturbinate swabs were tested using the BD Veritor rapid antigen test. Between 17 November 2020 and 1 October 2021, 235 close contacts of SARS-CoV-2 cases were recruited, including 95 with symptoms (82% symptomatic for ≤5 days) and 140 asymptomatic individuals. Reference NATs were positive for 53 (22.6%) participants; 24/50 (48%) were culture positive. PerkinElmer testing of NP and saliva samples identified an additional 28 (11.9%) SARS-CoV-2 cases who tested negative by reference NAT. Antigen tests performed for 99 close contacts showed 83% positive percent agreement (PPA) with reference NAT among early symptomatic persons, but 18% PPA in others; antigen tests in 8 of 11 (72.7%) culture-positive participants were positive. Contacts of SARS-CoV-2 cases may be falsely negative early after contact, but more sensitive platforms may identify these cases. Repeat or serial SARS-CoV-2 testing with both antigen and molecular assays may be warranted for individuals with high pretest probability for infection.

Relationship between the transcriptional expression of PIM1 and local control in patients with head and neck squamous cell carcinomas treated with radiotherapy.

PURPOSE: Proviral integration site for Moloney murine leukemia virus (PIMs) are proto-oncogenes encoding serine/threonine kinases that phosphorylate a variety of substrates involved in the regulation of cellular processes. Elevated expression of PIM-1 has been associated with poor prognosis in several types of cancer. There are no studies that have analyzed the response to radiotherapy in patients with head and neck squamous cell carcinoma (HNSCC) according to the expression of PIM-1. The aim of our study was to analyze the relationship between the transcriptional expression of PIM-1 and local response to radiotherapy in HNSCC patients. METHODS: We determined the transcriptional expression of PIM-1 in 135 HNSCC patients treated with radiotherapy, including patients treated with chemoradiotherapy (n = 65) and bioradiotherapy (n = 15). RESULTS: During the follow-up, 48 patients (35.6%) had a local recurrence of the tumor. Patients with local recurrence had a higher level of PIM-1 expression than those who achieved local control of the disease (P = 0.017). Five-year local recurrence-free survival for patients with a high expression of PIM-1 (n = 43) was 44.6% (95% CI 29.2-60.0%), and for patients with low expression (n = 92) it was 71.9% (95% CI 62.5-81.3%) (P = 0.007). According to the results of multivariate analysis, patients with a high PIM-1 expression had a 2.2-fold increased risk of local recurrence (95% CI 1.22-4.10, P = 0.009). CONCLUSION: Patients with elevated transcriptional expression levels of PIM-1 had a significantly higher risk of local recurrence after radiotherapy.

Evaluating and Handling the Pain of People With Intellectual Disability.

Anecdotal reports have suggested people with intellectual disabilities experience more pain than the general population due to additional co-morbidities and secondary conditions. This multicenter comparative cross-sectional study aimed to evaluate the prevalence, factors, and treatment modalities in people with intellectual disabilities (PID) as observed by their caregivers and reported through distributed questionnaires. The study sample included 130 PID users of centers in Ciudad Real (Spain). Variables related to sociodemographic characteristics, health problems, problem behaviors, and pain were collected. Among participants, 78 (60%) of PID were males, and their mean age was 43.8 years (SD = 13.57). Pain was identified in 29 PID (22.3%; 95% confidence interval [CI] 14.99-29.81), and drugs for pain were administered to 33 PID (26.4%; 95%CI 19-34). The prevalence of pain in the sampled PID, its severity, and the analgesic administration rate were lower than those in the general population. This situation may be aggravated for PID with communication problems.

Differential Characteristics of Patients With Squamous Cell Carcinoma of the Head and Neck According to Gender.

OBJECTIVE: To analyse the trend in the percentage of patients with squamous cell carcinoma of the head and neck (SCCHN) of female gender over the last decades, and differences in survival according to gender. MATERIAL AND METHODS: Retrospective study of 5828 SCCHN diagnosed during the period 1985-2019. In the survival analysis we only included only patients with more than two years of follow-up. RESULTS: The proportion of tumours in female patients increased significantly over the study period. There was greater increase of tumours located in the oral cavity, oropharynx and larynx in the percentage of female patients. When considering the total number of patients, there were no significant differences in disease-specific survival according to gender. We observed a variable behaviour of disease-specific survival according to gender depending on the primary location of the tumour. For tumours of the larynx and oropharynx the female patients had a disease-specific survival significantly higher than that of men, while for tumours of the oral cavity, the female patients had a significant reduction of disease-specific survival. CONCLUSIONS: In our setting, the percentage of female patients with HNSCC has been increasing steadily over recent decades. There were differences in disease-specific survival according to gender depending on the location of the primary tumour.

Predictive capacity of IL-8 expression in head and neck squamous carcinoma patients treated with radiotherapy or chemoradiotherapy.

OBJECTIVE: To analyse the relationship between the transcriptional expression of interleukin-8 (IL-8) and response to treatment with radiotherapy or chemo-radiotherapy in patients with squamous cell carcinoma of the head and neck (SCCHN). MATERIAL AND METHODS: Retrospective study from tumour biopsies obtained before a treatment with radiotherapy or chemo-radiotherapy in 87 patients with SCCHN. We had a sample of healthy mucosa in 35 cases. We determined the transcriptional expression of IL-8 with RT-PCR. The transcriptional expression of IL-8 was categorized according to the local control of the disease with a recursive partitioning analysis. RESULTS: The transcriptional expression of IL-8 in tumour tissue was about 50 times higher than that in the samples of healthy mucosa. Patients with a high transcriptional expression of IL-8 (n = 56) had a 5-year local recurrence-free survival of 65.6%, and for patients with low expression (n = 31) it was 90.2% (P = 0.017). According to the results of a multivariate analysis, patients with high expression of IL-8 had a 4.1 higher risk of local recurrence of the tumour. CONCLUSIONS: SCCHN have a significant increase in transcriptional expression of IL-8 in relation to non-tumour tissue. Tumours with high IL-8 expression have an increased risk of local recurrence after treatment with radiotherapy or chemo-radiotherapy.

Capacidad predictiva de la expresión de IL-8 en pacientes con carcinomas escamosos de cabeza y cuello tratados con radioterapia o quimio-radioterapia / Predictive capacity of IL-8 expression in head and neck squamous carcinoma patients treated with radiotherapy or chemoradiotherapy

Objetivo: Analizar la relación entre la expresión transcripcional de interleucina-8 (IL-8) y la respuesta al tratamiento con radioterapia o quimio-radioterapia en pacientes con carcinoma escamoso de cabeza y cuello (CECC).Material y métodosEstudio retrospectivo realizado a partir de biopsias de tumor obtenidas de forma previa a un tratamiento con radioterapia o quimio-radioterapia en 87 pacientes con CECC. Se dispuso de una muestra de mucosa sana en 35 ocasiones. Se determinó la expresión transcripcional de la IL-8 mediante RT-PCR. Se categorizó el nivel de expresión transcripcional de IL-8 en función del control local de la enfermedad mediante un análisis de partición recursiva.ResultadosLa expresión transcripcional de IL-8 en el tejido tumoral fue unas 50 veces superior al de las muestras de mucosa sana. La supervivencia libre de recidiva local a los 5años para los pacientes con una expresión transcripcional elevada de IL-8 (n=56) fue del 65,6%, y para los pacientes con una expresión baja (n=31) del 90,2% (p=0,017). De acuerdo con los resultados de un análisis multivariante, los pacientes con unos niveles de expresión elevada de IL-8 contaron con un riesgo 4,1 veces superior de recidiva local de la enfermedad.ConclusionesLos CECC cuentan con un incremento significativo en los niveles de expresión transcripcional de la IL-8 en relación con el tejido no tumoral. Los tumores con unos niveles de expresión elevados de IL-8 tienen un incremento en el riesgo de sufrir una recidiva local del tumor tras un tratamiento con radioterapia o quimio-radioterapia. (AU)

Objective: To analyse the relationship between the transcriptional expression of interleukin-8 (IL-8) and response to treatment with radiotherapy or chemo-radiotherapy in patients with squamous cell carcinoma of the head and neck (SCCHN).Material and methodsRetrospective study from tumour biopsies obtained before a treatment with radiotherapy or chemo-radiotherapy in 87 patients with SCCHN. We had a sample of healthy mucosa in 35 cases. We determined the transcriptional expression of IL-8 with RT-PCR. The transcriptional expression of IL-8 was categorized according to the local control of the disease with a recursive partitioning analysis.ResultsThe transcriptional expression of IL-8 in tumour tissue was about 50 times higher than that in the samples of healthy mucosa. Patients with a high transcriptional expression of IL-8 (n=56) had a 5-year local recurrence-free survival of 65.6%, and for patients with low expression (n=31) it was 90.2% (P=.017). According to the results of a multivariate analysis, patients with high expression of IL-8 had a 4.1 higher risk of local recurrence of the tumour.ConclusionsSCCHN have a significant increase in transcriptional expression of IL-8 in relation to non-tumour tissue. Tumours with high IL-8 expression have an increased risk of local recurrence after treatment with radiotherapy or chemo-radiotherapy. (AU)

Características diferenciales de los pacientes con carcinomas escamosos de cabeza y cuello en función del género / Differential characteristics of patients with squamous cell carcinoma of the head and neck according to gender

Objetivo: Analizar la evolución en el porcentaje de pacientes con carcinoma escamoso de cabeza y cuello de género femenino a lo largo de las últimas décadas, así como la existencia de diferencias en la supervivencia en función del género.Material y métodosEstudio retrospectivo de 5.828 carcinomas escamosos de cabeza y cuello diagnosticados durante el periodo 1985-2019. En el análisis de supervivencia se incluyeron solo pacientes con más de dos años de seguimiento.ResultadosLa proporción de tumores en pacientes de género femenino aumentó de forma significativa a lo largo del periodo de estudio. Los tumores localizados en la cavidad oral, orofaringe y laringe fueron los que tuvieron un mayor incremento en el porcentaje de pacientes de género femenino. Al considerar el total de pacientes, no aparecieron diferencias significativas en la supervivencia específica en función del género. Observamos un comportamiento variable de la supervivencia específica en función del género dependiendo de la localización primaria del tumor. Para los tumores de laringe y la orofaringe las pacientes de género femenino tuvieron una supervivencia específica significativamente superior a la de los varones, en tanto que para los tumores de cavidad oral, las pacientes de género femenino contaron con una reducción significativa de la supervivencia específica.ConclusionesEn nuestro entorno, el porcentaje de pacientes de género femenino con carcinoma escamoso de cabeza y cuello se ha venido incrementando de forma progresiva a lo largo de las últimas décadas. Existen diferencias en la supervivencia específica en función del género dependiendo de la localización del tumor primario. (AU)

Objective: To analyse the trend in the percentage of patients with squamous cell carcinoma of the head and neck of female gender over the last decades, and differences in survival according to gender.Material and methodsRetrospective study of 5,828 squamous cell carcinoma of the head and neck diagnosed during the period 1985-2019. In the survival analysis we only included only patients with more than two years of follow-up.ResultsThe proportion of tumours in female patients increased significantly over the study period. There was greater increase of tumours located in the oral cavity, oropharynx and larynx in the percentage of female patients. When considering the total number of patients, there were no significant differences in disease-specific survival according to gender. We observed a variable behaviour of disease-specific survival according to gender depending on the primary location of the tumour. For tumours of the larynx and oropharynx the female patients had a disease-specific survival significantly higher than that of men, while for tumours of the oral cavity, the female patients had a significant reduction of disease-specific survival.ConclusionsIn our setting, the percentage of female patients with squamous cell carcinoma of the head and neck has been increasing steadily over recent decades. There were differences in disease-specific survival according to gender depending on the location of the primary tumour. (AU)

Head and neck squamous cell carcinoma in cigar smokers. Distinctive epidemiological and prognostic characteristics.

OBJECTIVE: The objective of this study is to assess the existence of differences in the epidemiological characteristics and prognosis of patients with head and neck squamous cell carcinoma (HNSCC) who smoke cigars. MATERIAL AND METHODS: We carried out a retrospective study of a cohort of 4500 patients with HNSCC treated during the period 1985-2017. RESULT: The proportion of cigar smokers was 2.4%, compared with 88.3% of cigarette smokers and 9.3% of non-smokers. There was an increase in the proportion of cigar smokers throughout the study period. With respect to cigarette smokers, cigar smokers had a higher proportion of male patients, a higher average age at diagnosis, and they had a higher frequency of tumours located in the oral cavity and hypopharynx. The results of a univariate analysis showed that the disease-specific survival of cigar smokers was lower than that of the other patients. Five-year disease-specific survival of cigar smokers was 60.9%, compared to 69.0% for non-smokers, 72.8% for smokers of less than 20 cigarettes/day, and 67.2% for smokers of more than 20 cigarettes/day. There were differences in the pattern of survival depending on tobacco consumption based on the location of the primary tumour. CONCLUSIONS: A 2.4% of patients with HNSCC had a history of regular consumption of cigars. Disease-specific survival of cigar smokers was lower than that of other patients.

High-Risk Clinicopathological and Genetic Features and Outcomes in Patients Receiving Neoadjuvant Radiochemotherapy for Locally Advanced Rectal Cancer.

Administering preoperative radiochemotherapy (RCT) in stage II-III tumors to locally advanced rectal carcinoma patients has proved to be effective in a high percentage of cases. Despite this, 20-30% of patients show no response or even disease progression. At present, preoperative response is assessed by a combination of imaging and tumor regression on histopathology, but recent studies suggest that various genetic abnormalities may be associated with the sensitivity or resistance of rectal cancer tumor cells to neoadjuvant therapy. In the present study we investigated the relationship between genetic lesions detected by high-density single-nucleotide polymorphisms (SNP) arrays 6.0 and response to neoadjuvant RCT, evaluated according to Dworak criteria in 39 rectal cancer tumors before treatment. The highest frequency of copy-number (CN) losses detected corresponded to chromosomes 18q (n = 27; 69%), 1p (n = 22; 56%), 15q (n = 19; 49%), 8p (n = 18; 48%), 4q (n = 17; 46%), and 22q (n = 17; 46%); in turn, CN gains more frequently involved chromosomes 20p (n = 22; 56%), 8p (n = 20; 51%), and 15q (n = 16; 41%). There was a significant association between alterations in the 1p, 3q, 7q, 12p, 17q, 20p, and 22q chromosomal regions and the degree of response to therapy prior to surgery. However, 4q, 15q11.1, and 15q14 chromosomal region alterations were identified as important by five prediction algorithms, i.e., those with the greatest influence on predicting the tumor response to treatment with preoperative RCT. Multivariate analysis of prognostic factors showed that gains on 15q11.1 and carcinoembryonic antigen (CEA) levels serum at diagnosis were the only independent variables predicting disease-free survival (DFS). Lymph node involvement also showed a prognostic impact on overall survival (OS) in the multivariate analysis. A deep-learning-based algorithm showed a 100% success rate in predicting both DFS and OS at 60 months after diagnosis of the disease. In summary, our results indicate the existence of an association between tumor genetic abnormalities at diagnosis, response to neoadjuvant therapy, and survival of patients with locally advanced rectal cancer. In addition to the clinical and biological characteristics of locally advanced rectal cancer patients, these could be used in the future as therapeutic and prognostic biomarkers, to identify patients sensitive or resistant to preoperative treatment, helping guide therapeutic decision-making. Additional prospective studies in larger series of patients are required to confirm the clinical utility of the newly identified biomarkers.

Pacientes fumadores de cigarros con carcinomas escamosos de cabeza y cuello. Características epidemiológicas y pronósticas diferenciales / Head and neck squamous cell carcinoma in cigar smokers. Distinctive epidemiological and prognostic characteristics

Objetivo: El objetivo del presente estudio es evaluar la existencia de diferencias en las características epidemiológicas y el pronóstico de los pacientes fumadores de cigarros con carcinomas escamosos de cabeza y cuello (CECC).Material y métodosEstudio retrospectivo de una cohorte de 4.500 pacientes con CECC tratados durante el periodo 1985-2017.ResultadoLa proporción de fumadores de cigarros fue del 2,4%, frente a un 88,3% de fumadores de cigarrillos y 9,3% de no fumadores. Se observó un incremento en la proporción de fumadores de cigarros a lo largo del periodo de estudio. En relación con los fumadores de cigarrillos, los fumadores de cigarros contaron con una mayor proporción de pacientes varones, una edad media de diagnóstico más avanzada, y una mayor frecuencia de tumores localizados en cavidad oral e hipofaringe. El resultado de un estudio univariante mostró que la supervivencia específica de los fumadores de cigarros fue inferior a la del resto de pacientes. La supervivencia específica a los cinco años fue del 60.9% para los fumadores de cigarros, del 69,0% para los no fumadores, del 72,8% para los fumadores de menos de 20 cigarrillos/día, y del 67,2% para los fumadores de más de 20 cigarrillos/día. Existieron diferencias en el patrón de supervivencia, dependiendo del consumo de tabaco en función de la localización del tumor primario.ConclusionesUn 2,4% de los pacientes con CECC contaron como antecedente el consumo habitual de cigarros. La supervivencia específica de los pacientes fumadores de cigarros fue inferior a la del resto de pacientes. (AU)

Objective: The objective of this study is to assess the existence of differences in the epidemiological characteristics and prognosis of patients with head and neck squamous cell carcinoma (HNSCC) who smoke cigars.Material and methodsWe carried out a retrospective study of a cohort of 4,500 patients with HNSCC treated during the period 1985-2017.ResultThe proportion of cigar smokers was 2.4%, compared with 88.3% of cigarette smokers and 9.3% of non-smokers. There was an increase in the proportion of cigar smokers throughout the study period. With respect to cigarette smokers, cigar smokers had a higher proportion of male patients, a higher average age at diagnosis, and they had a higher frequency of tumours located in the oral cavity and hypopharynx. The results of a univariate analysis showed that the disease-specific survival of cigar smokers was lower than that of the other patients. Five-year disease-specific survival of cigar smokers was 60.9%, compared to 69.0% for non-smokers, 72.8% for smokers of less than 20 cigarettes/day, and 67.2% for smokers of more than 20 cigarettes/day. There were differences in the pattern of survival depending on tobacco consumption based on the location of the primary tumour.ConclusionsA 2.4% of patients with HNSCC had a history of regular consumption of cigars. Disease-specific survival of cigar smokers was lower than that of other patients. (AU)

Tracking the Antibody Immunome in Sporadic Colorectal Cancer by Using Antigen Self-Assembled Protein Arrays.

Sporadic Colorectal Cancer (sCRC) is the third leading cause of cancer death in the Western world, and the sCRC patients presenting with synchronic metastasis have the poorest prognosis. Genetic alterations accumulated in sCRC tumor cells translate into mutated proteins and/or abnormal protein expression levels, which contribute to the development of sCRC. Then, the tumor-associated proteins (TAAs) might induce the production of auto-antibodies (aAb) via humoral immune response. Here, Nucleic Acid Programmable Protein Arrays (NAPPArray) are employed to identify aAb in plasma samples from a set of 50 sCRC patients compared to seven healthy donors. Our goal was to establish a systematic workflow based on NAPPArray to define differential aAb profiles between healthy individuals and sCRC patients as well as between non-metastatic (n = 38) and metastatic (n = 12) sCRC, in order to gain insight into the role of the humoral immune system in controlling the development and progression of sCRC. Our results showed aAb profile based on 141 TAA including TAAs associated with biological cellular processes altered in genesis and progress of sCRC (e.g., FSCN1, VTI2 and RPS28) that discriminated healthy donors vs. sCRC patients. In addition, the potential capacity of discrimination (between non-metastatic vs. metastatic sCRC) of 7 TAAs (USP5, ML4, MARCKSL1, CKMT1B, HMOX2, VTI2, TP53) have been analyzed individually in an independent cohort of sCRC patients, where two of them (VTI2 and TP53) were validated (AUC ~75%). In turn, these findings provided novel insights into the immunome of sCRC, in combination with transcriptomics profiles and protein antigenicity characterizations, wich might lead to the identification of novel sCRC biomarkers that might be of clinical utility for early diagnosis of the tumor. These results explore the immunomic analysis as potent source for biomarkers with diagnostic and prognostic value in CRC. Additional prospective studies in larger series of patients are required to confirm the clinical utility of these novel sCRC immunomic biomarkers.

Preservación de órgano en pacientes con tumores avanzados de laringe. Resultados de la quimioterapia de inducción versus quimio-radioterapia en la práctica clínica real / Organ preservation in patients with advanced laryngeal tumours. Results of induction chemotherapy versus chemoradiotherapy in actual clinical practice

Introducción y objetivos: Un porcentaje elevado de pacientes con carcinomas localmente avanzados de laringe son candidatos a ser incluidos en protocolos de preservación de órgano. El objetivo del presente estudio es comparar los resultados de dos esquemas de preservación, quimioterapia de inducción versus quimio-radioterapia, en pacientes con carcinomas de laringe localmente avanzados en un contexto de práctica clínica real.MétodosEstudio retrospectivo realizado en 157 pacientes con tumores localmente avanzados de laringe (T3-T4) tratados con quimioterapia de inducción (n = 121) o quimio-radioterapia (n = 36).ResultadosDe los 121 pacientes que iniciaron tratamiento con quimioterapia de inducción, seis fallecieron como consecuencia de toxicidad, 37 fueron tratados con cirugía y 78 completaron el esquema de preservación; 36 pacientes recibieron un tratamiento inicial con quimio-radioterapia. No existieron diferencias significativas en la supervivencia específica a los cinco años en función de que los pacientes iniciasen un tratamiento con quimioterapia de inducción o quimio-radioterapia (68,9% versus 75,7%, p = 0,259). Un 45,9% de los pacientes consiguió una preservación de la función laríngea. Los pacientes tratados con quimio-radioterapia tuvieron una tendencia a conseguir una supervivencia libre de pérdida de la función laríngea a los cinco años superior a la de los pacientes tratados con quimioterapia de inducción (55,6% versus 44,8%, p = 0,079).ConclusiónLos pacientes incluidos en un protocolo de preservación consiguieron una supervivencia libre de disfunción laríngea a los cinco años del 45,9%. No se observaron diferencias significativas en la supervivencia específica entre los pacientes tratados con quimioterapia de inducción o quimio-radioterapia. (AU)

Introduction and objectives: A high percentage of patients with locally advanced larynx carcinomas are candidates for inclusion in organ preservation protocols. The objective of this study is to compare the results of two schemes of preservation, induction chemotherapy versus chemoradiotherapy, in patients with locally advanced larynx carcinomas in the context of actual clinical practice.MethodsOur retrospective study included 157 patients with locally advanced tumours of the larynx (T3-T4) treated with induction chemotherapy (n = 121) or chemoradiotherapy (n = 36).ResultsFrom 121 patients who began treatment with induction chemotherapy, 6 died due to toxicity, 37 were treated with surgery, and 78 completed the preservation scheme; 36 patients received treatment with chemoradiotherapy. There were no significant differences in 5-year disease-specific survival between both treatments: 68.9% in induction chemotherapy versus 75.7% in chemoradiotherapy (p = 0.259). In 45.9% of patients the laryngeal function was preserved. Patients treated with chemoradiotherapy had a tendency to have better 5-year laryngeal dysfunction-free survival than patients treated with induction chemotherapy (55.6% versus 44.8%, p = 0.079).ConclusionPatients included in a protocol of organ preservation achieved a 5-year laryngeal dysfunction-free survival of 45.9%. There were no significant differences in disease-specific survival among patients treated with induction chemotherapy or chemoradiotherapy. (AU)

Resultados oncológicos del tratamiento de rescate en pacientes con carcinomas de hipofaringe / Oncological results of salvage treatment in patients with hypopharyngeal carcinoma

INTRODUCCIÓN Y OBJETIVOS: El objetivo del presente estudio es analizar las variables relacionadas con la posibilidad de llevar a cabo una cirugía de rescate con intención radical en pacientes con carcinomas de hipofaringe con una recidiva local del tumor, así como evaluar el rendimiento oncológico de este tipo de cirugías. MÉTODOS: Estudio retrospectivo de 96 pacientes con carcinoma de hipofaringe con una recidiva local del tumor. RESULTADOS: Sólo 27 pacientes (28,1%) fueron considerados candidatos a cirugía de rescate. Las variables relacionadas con que el paciente fuese tratado con una cirugía de rescate fueron el tratamiento no quirúrgico inicial y un intervalo libre de enfermedad superior a los seis meses. Los 69 pacientes no candidatos a tratamiento quirúrgico de rescate fallecieron como consecuencia de la evolución del tumor en un periodo inferior a los 2,5 años. La supervivencia específica a los cinco años para los pacientes tratados con una cirugía de rescate fue del 39,5%. La única variable que se relacionó de forma significativa con la supervivencia específica fue el estatus de los márgenes de resección. Los pacientes con una recidiva tumoral extensa (rT3-4) o con una afectación ganglionar simultánea tuvieron una peor supervivencia, pero sin que las diferencias alcanzasen la significación estadística. CONCLUSIÓN: Sólo un 28,1% de los pacientes con carcinomas de hipofaringe con una recidiva local del tumor fueron considerados candidatos a tratamiento de rescate quirúrgico con intención radical. De los pacientes tratados con una cirugía de rescate, la supervivencia específica a los cinco años fue del 39,5%

INTRODUCTION AND OBJECTIVE: The aim of this study is to analyse the variables related to the feasibility of salvage surgery with radical intention in patients with a local recurrence of hypopharyngeal carcinoma, and to evaluate the oncological performance of this type of surgery. METHODS: Retrospective study of 96 patients with hypopharyngeal carcinoma with local tumour recurrence RESULT: Only 27 patients (28.1%) were considered for surgical salvage treatment. The variables related to feasibility of salvage surgery were non-surgical initial treatment of the tumour and a disease-free interval greater than 6 months. All 69 patients non-candidates for salvage surgery died as a result of tumour progression in a period of less than 2.5 years. The 5-year disease-specific survival rate for the patients treated with salvage surgery was 39.5%. The only variable significantly related to disease-specific survival was the status of the resection margins. Patients with extensive tumour recurrence (rT3-T4) or with simultaneous nodal involvement had a lower survival rate, but the differences did not reach statistical significance. CONCLUSION: Only 28% of the patients with hypopharyngeal carcinoma with local recurrence of the tumour were eligible for salvage surgery with radical intention. The patients treated with salvage surgery had a 5 -year disease-specific survival of 39.5%

Differential characteristics of patients with squamous cell carcinoma of the head and neck according to gender. / Características diferenciales de los pacientes con carcinomas escamosos de cabeza y cuello en función del género.

OBJECTIVE: To analyse the trend in the percentage of patients with squamous cell carcinoma of the head and neck of female gender over the last decades, and differences in survival according to gender. MATERIAL AND METHODS: Retrospective study of 5,828 squamous cell carcinoma of the head and neck diagnosed during the period 1985-2019. In the survival analysis we only included only patients with more than two years of follow-up. RESULTS: The proportion of tumours in female patients increased significantly over the study period. There was greater increase of tumours located in the oral cavity, oropharynx and larynx in the percentage of female patients. When considering the total number of patients, there were no significant differences in disease-specific survival according to gender. We observed a variable behaviour of disease-specific survival according to gender depending on the primary location of the tumour. For tumours of the larynx and oropharynx the female patients had a disease-specific survival significantly higher than that of men, while for tumours of the oral cavity, the female patients had a significant reduction of disease-specific survival. CONCLUSIONS: In our setting, the percentage of female patients with squamous cell carcinoma of the head and neck has been increasing steadily over recent decades. There were differences in disease-specific survival according to gender depending on the location of the primary tumour.

Preservación de órgano tras un tratamiento con quimioterapia de inducción en pacientes con carcinomas localmente avanzados (T3-T4) de cavidad oral y orofaringe / Organ preservation after treatment with induction chemotherapy in patients with locally advanced carcinomas (T3-T4) of oral cavity and oropharynx

INTRODUCCIÓN Y OBJETIVOS: Con el objetivo de conseguir la preservación funcional, una de las estrategias de tratamiento para los pacientes con carcinomas localmente avanzados de cabeza y cuello consiste en iniciar el tratamiento con quimioterapia (QT) de inducción y decidir la segunda maniobra terapéutica en función de la respuesta. El objetivo del presente estudio es evaluar la capacidad de preservación de órgano basada en esta estrategia terapéutica en pacientes con tumores de cavidad oral y orofaringe. MÉTODOS: Estudio retrospectivo de 246 pacientes con carcinomas de cavidad oral u orofaringe localmente avanzados (cT3-T4) tratados inicialmente con QT de inducción. RESULTADOS: Tras la QT de inducción el 28% de los pacientes consiguieron una respuesta completa de la localización primaria del tumor, el 43,1% una respuesta parcial superior al 50% y el 28,9% una reducción inferior al 50% o persistencia. Tras el tratamiento de QT de inducción 70 pacientes (28,5%) recibieron tratamiento quirúrgico y 176 (71,5%) radioterapia (RT) o quimiorradioterapia (QRT). Considerando a los pacientes tratados de forma no quirúrgica (n = 176), la preservación de órgano para los pacientes con una respuesta completa (n = 66) fue del 65,2%, para los pacientes con una respuesta parcial superior al 50% (n = 75) fue del 30,7% y para los pacientes con una respuesta inferior al 50% o persistencia (n = 35) fue del 14,3%. CONCLUSIÓN: La respuesta al tratamiento con QT de inducción cuenta con capacidad pronóstica en los pacientes con carcinomas localmente avanzados de cavidad oral y orofaringe. Los pacientes candidatos a tratamiento conservador con RT o QRT serían aquellos que consiguen una respuesta completa tras la administración del tratamiento de inducción

INTRODUCTION AND OBJECTIVES: With the goal of achieving functional preservation, one of the treatment strategies for patients with locally advanced squamous cell carcinomas of the head and neck is to initiate treatment with induction chemotherapy (CT) and decide the second therapeutic manoeuvre depending on the response. The objective of this study is to evaluate organ preservation capacity based on this therapeutic approach in patients with tumours of the oral cavity and oropharynx. METHODS: A retrospective study of 246 patients with locally advanced carcinomas of the oral cavity or oropharynx (cT3-T4) initially treated with induction CT. RESULTS: After induction CT 28% of patients achieved a complete response of the primary location of the tumour, 43.1% a partial response greater than 50%, and 28.9% a reduction less than 50% or persistence. After the induction CT treatment 70 patients (28.5%) underwent surgical treatment, and 176 (71.5%) radiotherapy (RT) or chemoradiotherapy (CRT). Considering the patients treated non-surgically (n = 176), organ preservation for patients with a complete response (n = 66) was 65.2%, for those patients with a partial response greater than 50% (n = 75) it was 30.7%, and for patients with a partial response less than 50% or persistence (n = 35) it was 14.3%. CONCLUSION: The response to treatment with induction CT has prognostic value in patients with locally advanced carcinomas of the oral cavity and oropharynx. Patients who are candidates for conservative treatment with RT or CRT would be those who achieve a complete response after induction treatment

Organ preservation after treatment with induction chemotherapy in patients with locally advanced carcinomas (T3-T4) of oral cavity and oropharynx. / Preservación de órgano tras un tratamiento con quimioterapia de inducción en pacientes con carcinomas localmente avanzados (T3-T4) de cavidad oral y orofaringe.

INTRODUCTION AND OBJECTIVES: With the goal of achieving functional preservation, one of the treatment strategies for patients with locally advanced squamous cell carcinomas of the head and neck is to initiate treatment with induction chemotherapy (CT) and decide the second therapeutic manoeuvre depending on the response. The objective of this study is to evaluate organ preservation capacity based on this therapeutic approach in patients with tumours of the oral cavity and oropharynx. METHODS: A retrospective study of 246 patients with locally advanced carcinomas of the oral cavity or oropharynx (cT3-T4) initially treated with induction CT. RESULTS: After induction CT 28% of patients achieved a complete response of the primary location of the tumour, 43.1% a partial response greater than 50%, and 28.9% a reduction less than 50% or persistence. After the induction CT treatment 70 patients (28.5%) underwent surgical treatment, and 176 (71.5%) radiotherapy (RT) or chemoradiotherapy (CRT). Considering the patients treated non-surgically (n=176), organ preservation for patients with a complete response (n=66) was 65.2%, for those patients with a partial response greater than 50% (n=75) it was 30.7%, and for patients with a partial response less than 50% or persistence (n=35) it was 14.3%. CONCLUSION: The response to treatment with induction CT has prognostic value in patients with locally advanced carcinomas of the oral cavity and oropharynx. Patients who are candidates for conservative treatment with RT or CRT would be those who achieve a complete response after induction treatment.