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Objective: To investigate the effect of local prilocaine infiltration on postoperative pain in patients undergoing percutaneous nephrolithotomy (PCNL). Materials and Methods: The case-control study enrolled 137 patients who underwent PCNL at Çukurova University Balcalı Hospital from April 2022 to December 2022. These patients were categorized into two distinct groups: The case and control groups. While peritubal 2% 10 cc prilocaine local anesthetic infiltration was applied to the cases, local anesthetic was not applied to the control group. Pain was evaluated using an analog scale after surgery. Results: In the study, which included 137 patients, local anesthesia was administered to 46 patients. Receiving local anesthesia was associated with the pain score (p<0.001). Pain scores were lower at the beginning and at the 4th minute in patients receiving local anesthesia (p<0.001 and p=0.004, respectively). Conclusion: Infiltration of peritubal prilocaine has been shown to notably diminish pain following PCNL. Our hypothesis suggests that local anesthetic infiltration into the nephrostomy tract could present a superior alternative for postoperative pain control. Nevertheless, extensive and prolonged follow-up studies are imperative for advancing research in this domain. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV)-associated head and neck squamous cell carcinoma (HNSCC), particularly oropharyngeal squamous cell carcinoma (OPSCC), is an increasingly prevalent pathology worldwide, especially in developed countries. For diagnosing HPV in HNSCC, the combination of p16 immunohistochemistry (IHC) and polymerase chain reaction (PCR) offers high sensitivity and specificity, with p16 IHC being a reliable initial screen and PCR confirming HPV presence. Advanced techniques like next-generation sequencing (NGS) and RNA-based assays provide detailed insights but are primarily used in research settings. Regardless of HPV status, standard oncological treatments currently include surgery, radiation, and/or chemotherapy. This conventional approach does not account for the typically better prognosis of HPV-positive HNSCC patients, leading to increased chemo/radiation-induced secondary morbidities and reduced quality of life. Therefore, it is crucial to identify and detect HPV positivity and other molecular characteristics of HNSCC to personalize treatment strategies. This comprehensive review aims to summarize current knowledge on various HPV detection techniques and evaluate their advantages and disadvantages, with a focus on developing methodologies to identify new biomarkers in HPV-positive HNSCC. The review discusses direct and indirect HPV examination in tumor tissue, DNA- and RNA-based detection techniques, protein-based markers, liquid biopsy potentials, immune-related markers, epigenetic markers, novel biomarkers, and emerging technologies, providing an overall insight into the current state of knowledge. [ABSTRACT FROM AUTHOR]

Purpose: Head and Neck squamous cell carcinoma (HNSCC) is the seventh most common cancer in the world. The prognosis of patients with HNSCC remains unsatisfactory, with a 5-years survival rate of only approximately 50%. In western Uganda, the 1-year survival rate is only 1%. Programmed cell death ligand 1 (PD-L1) and p16 have been shown to predict the progression of HNSCC lesions, prognosticate survival, reveal new therapeutic targets, and predict response to therapeutic agents. HNSCC patients with positive PD-L1 expression have been reported to benefit from immunotherapy; however, data on PD-L1 expression in HNSCC in Uganda and Africa are still lacking. This study aimed to determine the expression of PD-L1 in HNSCC and its association with p16 expression in Southwestern Uganda. Patients and Methods: We retrospectively studied 165 formalin-fixed paraffin-embedded specimens from the head and neck region with a previous histological diagnosis of squamous cell carcinoma (SCC). The specimens were retrieved from June 2012 to June 2022. Hematoxylin and eosin (H&E) staining was performed to confirm the diagnosis, followed by immunohistochemical (IHC) staining for PD-L1 and p16 using the laboratory developed technique. Results: Of the 165 specimens included in the study, 80% of source patients were male and the majority (51.5%) were older than 60 years. The oral cavity was the predominant site (51.52%). PD-L1 was expressed in 32.1% (95% C.l: 25.4– 39.68) of the specimens, whereas p16 was expressed in 16.36% (95% C.l: 11.4– 22.9). There was a statistically significant association between PD-L1 and p16 expression. Conclusion: The prevalence of PD-L1 expression in HNSCC in southwestern Uganda is low, implying that a number of patients with HNSCC can benefit from immunotherapy. PD-L1 expression may predict p16 expression and therefore HPV infection in HNSCC. [ABSTRACT FROM AUTHOR]

Head and Neck Squamous Cell Carcinoma (HNSCC) is one of the most common malignancies worldwide with most of the patients presenting in advanced stage. The associated high mortality and poor prognosis of the tumour has rendered the search for better therapeutic options than the traditional modalities of surgery, radiotherapy and chemotherapy. Immunotherapy targeting Programmed Cell Death Protein 1 / Programmed Cell Death Ligand 1 (PD-1/PD-L1) has been approved in recurrent/ metastatic HNSCC cases. PD-L1 expressing HNSCCs are likely to respond to immunotherapy. PD-L1 expression has been studied in peripheral blood utilising Circulating Tumour Cells (CTC) and soluble exosomes. Despite these non invasive techniques, PD-L1 expression has been most frequently assessed by immunohistochemistry (IHC) application on the Formalin Fixed Paraffin Embedded (FFPE) tissue of the tumour. Currently, many antibody clones and various IHC platforms are available for PD-L1, but only 22c3 has been approved by the Food and Drug Administration (FDA). Although, the availability of multiple options has made PD-L1 assessment possible and affordable at many centres worldwide, but various procedural, pre-analytical, and analytic issues have to be considered prior to the interpretation of immunoexpression of PD-L1. In this review, the authors aim to highlight the problem areas, and to understand the implications of PD-L1 expression in HNSCC. The authors propose recommendations for the optimal assessment of PD-L1 expression in HNSCC on IHC. [ABSTRACT FROM AUTHOR]

Head and neck cancers (HNC) are a biologically diverse set of cancers that are responsible for over 660,000 new diagnoses each year. Current therapies for HNC require a comprehensive, multimodal approach encompassing resection, radiation therapy, and systemic therapy. With an increased understanding of the mechanisms behind HNC, there has been growing interest in more accurate prognostic indicators of disease, effective post-treatment surveillance, and individualized treatments. This chapter will highlight the commonly used and studied biomarkers in head and neck squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

Simple Summary: The tumor microenvironment (TME) of HNSCC is heterogeneous and complex, and it plays a crucial role in achieving effective cancer therapy. To develop effective cancer therapies, it is important to understand the crosstalk between cancer inflammation and immunity, as well as oncogenes and tumor suppressor genes. In this study, we aimed to gain a more comprehensive understanding of the transcriptomes of the TME in HPV-associated and HPV-non-associated TSCC by studying the gene expression profiles of 168 genes linked to various cellular mediators and factors involved in inflammation, immune crosstalk, transcription, signal transduction, oncogenesis, tumor suppression, angiogenesis, and apoptosis. We found that the TME of HPV-associated and HPV-non-associated TSCC exhibited a remarkable heterogeneity of gene expression associated with cellular mediators and factors involved in inflammation, immune crosstalk, transcription factors, immune signaling pathways, signal transduction, oncogenesis, tumor suppression, angiogenesis, and apoptosis. Head and neck squamous cell carcinomas (HNSCCs) are a common type of cancer, ranking as the sixth most prevalent cancer worldwide and having a high morbidity and mortality rate. Among oropharyngeal squamous cell carcinoma (OPSCC) cancers, tonsillar squamous cell carcinoma (TSCC) is the most prevalent and has a particularly aggressive clinical course with poor disease outcomes. The tumor microenvironment (TME) of HNSCC is complex and heterogeneous, playing a crucial role in effective cancer therapy. Understanding the interaction between cancer inflammation, immunity, oncogenes, and tumor suppressor genes is essential for developing effective cancer treatments. This study aimed to gain a comprehensive understanding of the transcriptomes of the TME in TSCC, both associated with human papillomavirus (HPV) and not associated with HPV. The gene expression profiles of 168 genes linked to various cellular mediators and factors involved in inflammation, immunity crosstalk, transcription, signal transduction, oncogenesis, tumor suppression, angiogenesis, and apoptosis were analyzed. We identified 40 differentially expressed genes related to the communication between tumor cells and the cellular mediators of inflammation and immunity crosstalk. In HPV-positive TSCC patients, 33 genes were over-expressed with a fold change greater than 1.5, and 26 of these genes were unique to this group. In contrast, HPV-negative TSCC patients had 11 up-regulated genes. The results further showed that 48 gene transcripts related to oncogenesis, tumor suppression, angiogenesis, and apoptosis were up-regulated in both HPV-positive and HPV-negative TSCC patients. Among the HPV-positive TSCC patients, 37 genes were over-expressed, while the HPV-negative TSCC patients had 11 up-regulated genes. The tumor microenvironment (TME) of HPV-associated and HPV-non-associated TSCC exhibited distinct characteristics, including the dysregulation of various genes involved in cellular mediators, inflammation, immunity crosstalk, transcription factors, immune signaling pathways, signal transduction, oncogenesis, tumor suppression, angiogenesis, and apoptosis. Additionally, we detected six Hr-HPV genotypes in 81% of the TSCC patients, with HPV-16 and HPV-35 being the most common types, followed by HPV-45 and HPV-18. HPV-39 and 31 were also identified. The presence of Hr-HPV genotypes in TSCC patients varied from single to multiple infections. In conclusion, we observed distinct heterogeneity in the transcriptome of the microenvironment in HPV-associated and non-associated TSCC. Further in vitro and in vivo studies are needed to investigate the functional implications of the identified over-expressed genes. Also, deeper molecular pathways and immunological studies on the TME are required to determine the potential of targeting genes for cancer therapy. [ABSTRACT FROM AUTHOR]

Simple Summary: There is often a mismatch between the chronological and biological age of head and neck cancer patients. Treatment is based on chronological age, while biological age seems to be a better predictor for treatment toleration. The aim of this study was to assess whether tumor characteristics are associated with chronological and biological age, and the relation with survival. We observed that, in biologically old patients, a lower infiltration of CD163+ macrophages as well as CD4+ and CD8+ lymphocytes was found in the tumor microenvironment. Chronological older patients showed significantly lower PD-L1 combined positive scores. It can be concluded from these data that biological age might have a stronger influence on tumor microenvironment than chronological age. This emphasizes the need for studies investigating the response to specific treatment regimens (e.g., immunotherapy) according to biological age. There is often a mismatch between the chronological and biological age of head and neck squamous cell carcinoma (HNSCC) patients. Treatment is based on chronological age, while biological age seems to be a better prognosticator for treatment toleration. This study investigated whether tumor characteristics are associated with chronological and biological age. The relation with survival was also assessed. Prospectively collected data from 164 newly diagnosed HNSCC patients enrolled in the OncoLifeS database were analyzed. Biological age was assessed by a multidomain geriatric assessment. Several immunological markers were tested by immunohistochemistry on tissue microarray sections from the tumor. Disease-free survival (DFS), adjusted for chronological- and biological age, was assessed by univariable and bivariable analyses. In biologically old patients, a lower infiltration of CD163+ macrophages (p = 0.036) as well as CD4+ (p = 0.019) and CD8+ (p = 0.026) lymphocytes was found in the tumor microenvironment. Chronological older patients showed significantly lower PD-L1 combined positive scores (p = 0.030). Advanced tumor stage and perineural growth were related to a worse DFS. None of the immunological markers showed a significant association with DFS. Biological age might have a stronger influence on tumor microenvironment than chronological age. These findings should initiate clinical studies investigating the response to specific treatment regimens (e.g., immunotherapy) according to the biological age. [ABSTRACT FROM AUTHOR]

Anti‐programmed cell death 1 (anti‐PD‐1) therapy shows definite but modest activity in patients with advanced/metastatic head and neck squamous cell carcinoma (HNSCC). Preliminary evidence suggests that SN‐38, an activated form of irinotecan that increases expression of the transcription factor FoxO3a, can suppress programmed cell death ligand‐1 (PD‐L1) expression in breast and ovarian tumor models. We analyzed the SN‐38‐mediated activation of natural killer cells in vitro and explored the efficacy of SN‐38 in combination with anti‐PD‐1 for treatment in vivo. In vitro, SN‐38 enhanced the expression of FoxO3a and reduced the expression of c‐Myc and PD‐L1 dose‐dependently in tumor cells. Low‐dose SN‐38 increased interferon‐γ secretion by NK cells and promoted NK cell‐mediated cytotoxicity in tumor cells. In vivo studies revealed that at non‐cytotoxic drug concentrations, SN‐38 significantly enhanced anti‐PD‐1 activity in suppressing murine tumor growth. We found increased NK cell and CD8+ T‐cell infiltration in post‐treatment tumors. RNA‐seq analysis indicated that SN‐38 increased the enrichment of immune cells and biological function genes related to the immune responses. SN‐38 is a potentially beneficial adjunct to checkpoint inhibitor therapy in HNSCC. Further studies exploring its mechanism of action and possible applications are necessary. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland. [ABSTRACT FROM AUTHOR]

Background & Objective: Head and Neck Squamous Cell Carcinoma (HNSCC) is a highly frequent malignancy worldwide and is also the leading cause of death. The prognosis for individuals with HNSCC remains dismal, with a five-year survival rate of less than 50%. The novel anti-PD-L1 immunotherapy is found to be promising, and immunohistochemistry (IHC) has been established as a reliable method for patient stratification. We intend to evaluate the prognostic significance of the expression of programmed death ligand-1 (PD-L1) in HNSCC and determine its association with clinicopathological variables. Methods: A total of 50 cases of biopsy-confirmed HNSCC were studied in a tertiary hospital between Dec 2020 and June 2022. The specimens were tested for PD-L1 IHC expression with antibody clone CAL-10 (Biocare) and scored by Combined Positive Score (CPS). The association between PD-L1 expression and clinicopathological variables was evaluated. Results: PD-L1 was positive in 92% of the cases, and a significant association (P= 0.024) was seen between PD-L1 expression and tumor-infiltrating lymphocytes (TILs). PD-L1 did not show any significant association with patient demographics, tumor site, grade, or stage. Conclusion: In the present study, evaluation of the immunohistochemical expression of PD-L1 on the tumor cells and TILs in HNSCC revealed a high prevalence of PD-L1 expression. PD-L1 IHC studies for patient selection for immunotherapy would be a promising technique. Frequent PD-L1 expression in tumors with significant TILs may be useful in identifying patients who may benefit from anti-PD-1/PD-L1 therapy. [ABSTRACT FROM AUTHOR]

To evaluate the effect of quadratus lumborum block (QLB) for postoperative analgesia after percutaneous nephrolithotomy (PCNL), we searched Pubmed, Embase, Cochrane library, the Chinese Biomedical Literature Database, and randomized controlled trials (RCTs) assessing analgesic efficacy of QLB for PCNL are included in this meta-analysis. The related trials met the inclusion criteria were analyzed using RevMan 5.4 software, the weighted mean difference (WMD), with their corresponding 95% CI, was calculated to compare continuous variables. Nine RCTs are included in the meta-analysis showed that QLB group had significantly lower opioids consumption (WMD − 29.59 95% CI − 43.64 to − 15.55; P < 0.00001), lessen visual analog scale (VAS) after surgery 2 h (WMD − 1.35, 95% CI − 1.93 to − 0.76; P < 0.00001), 6 h (WMD − 1.47, 95% CI − 2.04 to − 0.91; P < 0.00001) 12 h (WMD − 1.75, 95% CI − 3.17 to − 0.32; P = 0.02) and 24 h (WMD − 1.4, 95% CI − 1.86 to − 0.94; P < 0.00001), shorter hospital stay(WMD − 0.7, 95% CI -1.26 to − 0.14, P < 0.00001) and reduce intestinal exhaust recovery time (WMD − 7.41, 95% CI − 9.36 to − 5.46, P < 0.00001) than in the control group. QLB offers some potential advantages in terms of opioids consumption, VAS, hospital stay and intestinal exhaust recovery time. However, good quality and large studies with long-term follow-up are warranted for further research. [ABSTRACT FROM AUTHOR]

Background: Worldwide prevalence of Oropharyngeal Squamous Cell Carcinoma (OPSCC) has increased, affecting mostly young males. OPSCC associated with Human Papillomavirus (HPV) infection exhibits particular characteristics in terms of response to treatment, hence HPV has been proposed as a prognostic factor. The impact of HPV positivity and associated biomarkers on OPSCC in the Mexican population has not been addressed. Therefore, the analysis of OPSCC prognostic markers in the Mexican population is necessary. Methods: Retrolective study in Mexican OPSCC patients, where HPV prevalence, p16 and EGFR levels were assessed using INNO-LiPA and immunohistochemistry. Results: We found an HPV prevalence of 57.6% in OPSCC cases treated at a reference center in Mexico. HPV and p16 positivity, as well as EGFR, associate with better outcomes in OPSCC patients, and they also promote reduced death risk. Notably, HPV presence and p16 positivity showed a significant association with disease-free survival (DFS), with a HR of 0.15 (p = 0.006) and a HR of 0.17 (p = 0.012), respectively, indicating a possible role as predictive biomarkers in Mexican OPSCC patients. Conclusions: Our results reflect the clinical utility of p16 analysis to improve overall survival (OS) and to predict recurrence in oropharyngeal cancer. These results position p16 and HPV as predictive biomarkers for OPSCC. [ABSTRACT FROM AUTHOR]

Head and neck cancer has high heterogeneity with poor prognosis, and emerging researches have been focusing on the prognostic markers of head and neck cancer. PD-L1 expression is an important basis for strategies of immunosuppressive treatment, but whether it has prognostic value is still controversial. Although meta-analysis on PD-L1 expression versus head and neck cancer prognosis has been performed, the conclusions are controversial. Since PD-L1 and PD-L2 are two receptors for PD-1, here we summarize and analyze the different prognostic values of PD-1, PD-L1, and PD-L2 in head and neck cancer in the context of different cell types, tissue localization and protein forms. We propose that for head and neck cancer, the risk warning value of PD-1/PD-L1 expression in precancerous lesions is worthy of attention, and the prognostic value of PD-L1 expression at different subcellular levels as well as the judgment convenience of prognostic value of PD-1, PD-L1, PD-L2 should be fully considered. The PD-L1 evaluation systems established based on immune checkpoint inhibitors (ICIs) are not fully suitable for the evaluation of PD-L1 prognosis in head and neck cancer. It is necessary to establish a new PD-L1 evaluation systembased on the prognosis for further explorations. The prognostic value of PD-L1, PD-L2 expression in head and neck cancer may be different for early-stage and late-stage samples, and further stratification is required. [ABSTRACT FROM AUTHOR]

The high prevalence of oral squamous cell carcinoma (OSCC) in South Asia is associated with habitual areca nut chewing. Arecoline, a primary active carcinogen within areca nut extract, is known to promote OSCC pathological development. Dysregulation of N6‐methyladenosine (m6A) modification has begun to emerge as a significant contributor to cancer development and progression. However, the biological effects and molecular mechanisms of m6A modification in arecoline‐promoted OSCC malignance remain elusive. We reveal that chronic arecoline exposure substantially induces upregulation of fat mass and obesity‐associated protein (FTO), MYC, and programmed cell death‐ligand 1 (PD‐L1) in OSCC cells. Moreover, upregulation of PD‐L1 is observed in OSCC cell lines and tissues and is associated with areca nut chewing in OSCC patients. We also demonstrate that arecoline‐induced FTO promotes the stability and expression levels of PD‐L1 transcripts through mediating m6A modification and MYC activity, respectively. PD‐L1 upregulation confers superior cell proliferation, migration, and resistance to T‐cell killing to OSCC cells. Blockage of PD‐L1 by administration of anti‐PD‐L1 antibody shrinks tumor size and improves mouse survival by elevating T‐cell‐mediated tumor cell killing. Therefore, targeting PD‐L1 might be a potential therapeutic strategy for treating PD‐L1‐positive OSCC patients, especially those with habitual areca nut chewing. [ABSTRACT FROM AUTHOR]

Objectives: Percutaneous nephrolithotomy and placement of nephrostomy tube are performed for renal stones >2 cm in diameter. Attempts have been made to infiltrate local anesthetics with or without adjuvants into the surgical site to reduce pain. We hypothesized that there would be a significant prolongation of the analgesic effect of local anesthetic instillation along the nephrostomy tube due to the adjuvant dexamethasone. Methods: After ethical approval and Clinical Trials Registry ‐ India registration (CTRI/2020/03/024332), 64 American Society of Anesthesiologists classification 1 and 2 adult patients were enrolled in this randomized double‐blinded prospective study divided into Group R—received 20 mL 0.2% Ropivacaine and Group R + D—received 20 mL 0.2% Ropivacaine with dexamethasone 8 mg, injected through a multi‐lumen wound infiltration catheter. Results: The demographic profile of patients was similar in both groups. The mean duration of analgesia was longer in Group R + D (21.3 ± 2.1 hrs) versus Group R (10 ± 1.9 hrs, P = 0.001). The mean numeric rating scale scores of Group R + D were significantly lower at all time intervals (P = 0.001). Also, the cumulative dose of ropivacaine and the total use of fentanyl postoperatively in Group R was much higher (70 ± 10.4 vs 56 ± 8.9 μg, P = 0.02). The C‐reactive protein levels were significantly lower in Group R + D (13.8 ± 1.5 vs 23.1 ± 1.2 mg/L, P = 0.001 and 16.5 ± 1.3 vs 28.5 ± 1.7 mg/L, P = 0.001, at 24 and 48 hrs, respectively). Conclusion: We conclude that dexamethasone can be used as a suitable adjuvant to intermittent local anesthetic infiltration after percutaneous nephrolithotomy with a nephrostomy tube for the prolongation of analgesia. [ABSTRACT FROM AUTHOR]

Background: In recent clinical practice, an increasing number of elderly patients suffering from head and neck squamous cell carcinoma (HNSCC) of unknown pathophysiology is observed. The majority of HNSCC patients can roughly be divided into three subcategories. First, a small group of young patients who present with variants of genomic aberrations and inheritable diseases like Fanconi anaemia. Second, an increasing population of HPV-related HNSCCs that are regarded as genomic stable tumours with a more favourable prognosis. Though HPV-related tumours used to be more common among younger males, a notable rise in the elderly population is observed. The third subcategory, that of HPV-negative tumours, has been shown to be more heterogeneous with involvement of a variety of oncogenic pathways related to lifestyle factors like smoking and alcohol consumption, often seen in middle-aged males. Some of these pathways could be related to age, such as TP53 alterations, EGFR activation, apoptotic pathway alterations and field cancerization. Conclusions: In this narrative review, we provide an overview of established and newly discovered age-specific pathophysiological mechanisms underlying HNSCC. We propose a fourth subcategory of patients with a suspected different pathophysiology: elderly (HPV-negative) HNSCC patients without a history of tobacco and alcohol consumption. In this subcategory, carcinogenesis seems to be a multi-step process based on genomic instability, immunosenescence, cell cycle disruption and telomere shortening. To conclude, we discuss suggestions for future research to fill the knowledge gap about age-dependent HNSCC carcinogenesis. [ABSTRACT FROM AUTHOR]

Background and Aims: Erector spinae plane (ESP) block is a simple and safe interfascial plane block reported to provide good analgesia after thoracolumbar surgeries. We compared its efficacy with conventional peritubal local anesthetic infiltration following percutaneous nephrolithotomy (PCNL). Material and Methods: A total of 60 adult patients posted for elective PCNL were randomly allocated into two groups. Postoperatively, Group I received ultrasound (US) guided peritubular infiltration block with 20 ml of 0.25% levobupivacaine and Group II received US guided ESP block with 20 ml of 0.25% levobupivacaine. The two groups were compared for the time to first rescue analgesic (Injection tramadol), number of rescue analgesic demands, total analgesic consumption in first 24 hours, VAS (rest and dynamic) scores and the adverse effects. The data were analyzed by unpaired t-test and Mann Whitney U test. Results: The time to first rescue analgesic demand was significantly longer in Group II (6.93 ± 2.15 h vs. 16.21 ± 7.53 h). The VAS scores (rest and dynamic) at eight and twelve hours of measurement were significantly lower in Group II (P < 0.05). The number of analgesic demands were less in group II (2.97 ± 0.49 vs. 1.00 ± 1.05). The total analgesic consumption in first 24 hours was less in Group II (148.33 ± 24.51 mg vs. 51.92 ± 45.78 mg). Conclusion: ESP block is a very effective and safe technique to provide prolonged duration of postoperative analgesia following PCNL. Peritubal local anesthetic infiltration is also a reliable technique for postoperative analgesia. [ABSTRACT FROM AUTHOR]

To evaluate the effect of quadratus lumborum block (QLB) for postoperative analgesia after percutaneous nephrolithotomy (PCNL), we searched Pubmed, Embase, Cochrane library, the Chinese Biomedical Literature Database, and randomized controlled trials (RCTs) assessing analgesic efficacy of QLB for PCNL are included in this meta-analysis. The related trials met the inclusion criteria were analyzed using RevMan 5.4 software, the weighted mean difference (WMD), with their corresponding 95% CI, was calculated to compare continuous variables. Nine RCTs are included in the meta-analysis showed that QLB group had significantly lower opioids consumption (WMD - 29.59 95% CI - 43.64 to - 15.55; P < 0.00001), lessen visual analog scale (VAS) after surgery 2 h (WMD - 1.35, 95% CI - 1.93 to - 0.76; P < 0.00001), 6 h (WMD - 1.47, 95% CI - 2.04 to - 0.91; P < 0.00001) 12 h (WMD - 1.75, 95% CI - 3.17 to - 0.32; P = 0.02) and 24 h (WMD - 1.4, 95% CI - 1.86 to - 0.94; P < 0.00001), shorter hospital stay(WMD - 0.7, 95% CI -1.26 to - 0.14, P < 0.00001) and reduce intestinal exhaust recovery time (WMD - 7.41, 95% CI - 9.36 to - 5.46, P < 0.00001) than in the control group. QLB offers some potential advantages in terms of opioids consumption, VAS, hospital stay and intestinal exhaust recovery time. However, good quality and large studies with long-term follow-up are warranted for further research., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Simple Summary: Head and neck cancer (HNC) is the sixth most common cancer, causing almost half a million deaths worldwide every year. The two subtypes of HNC are distinctly associated with smoking/drinking and/or human papillomavirus (HPV) infection. While the incidence of non-viral HNC is decreasing, HPV-positive HNC incidence has dramatically increased in the last few decades. Accumulating evidence from numerous studies shows molecular and clinical differences in mutations, gene expression regulation, treatment responses, and patient survival rates between HPV-positive and HPV-negative HNC. Here, we discuss the current status of HNC research and clinical approaches and suggest unanswered questions and future directions. Head and neck squamous cell carcinoma (HNSCC) is a unique malignancy associated with two distinct risk factors: exposure to typical carcinogens and infection of human papillomavirus (HPV). HPV encodes the potent oncoproteins E6 and E7, which bypass many important oncogenic processes and result in cancer development. In contrast, HPV-negative HNSCC is developed through multiple mutations in diverse oncogenic driver genes. While the risk factors associated with HPV-positive and HPV-negative HNSCCs are discrete, HNSCC patients still show highly complex molecular signatures, immune infiltrations, and treatment responses even within the same anatomical subtypes. Here, we summarize the current understanding of biological mechanisms, treatment approaches, and clinical outcomes in comparison between HPV-positive and -negative HNSCCs. [ABSTRACT FROM AUTHOR]

Byline: Prabha. Mishra, Avnit. Sidhu, Gunjan. Dwivedi, Deepak. Mulajker, Shivali. Awasthi Background: Advanced head and neck squamous cell carcinoma (HNSCC) has limited treatment options. Programmed death-ligand1 (PD-L1) expressed by tumor [...]