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Background: Fat grafting has become popular for repair of postsurgical/postradiation defects after head/neck cancers resection. Fat graft supplementation with adipose tissue-derived stromal/stem cells (ASCs) is proposed to improve graft viability/efficacy, although the impact of ASCs on head/neck cancer cells is unknown., Objectives: To determine whether ASCs affect growth, migration, and metastasis of human head/neck cancer., Methods: Human Cal-27 and SCC-4 head/neck cancer cells were co-cultured human ASCs, or treated with ASC conditioned medium (CM), and cancer cell growth/migration was assessed by MTT, cell count, and scratch/wound healing assays in vitro. Co-injection of 3 × 10(6) Cal-27/green fluorescent protein (GFP) cells and ASCs into the flank of NUDE mice assessed ASC effect on tumor growth/morphology. Quantitation of human chromosome 17 DNA in mouse organs assessed ASC effects on micrometastasis. Primary tumors were evaluated for markers of epithelial-to-mesenchymal transition, matrix metalloproteinases, and angiogenesis by immunohistochemistry., Results: Co-culture of Cal-27 or SCC-4 cells with ASCs from 2 different donors or ASC CM had no effect on cell growth in vitro. However, ASC CM stimulated Cal-27 and SCC-4 migration. Co-injection of ASCs from 2 different donors with Cal-27 cells did not affect tumor volume at 6 weeks, but increased Cal-27 micrometastasis to the brain. Evaluation of tumors sections from 1 ASC donor co-injection revealed that ASCs were viable and well integrated with Cal-27/GFP cells. These tumors exhibited increased MMP2, MMP9, IL-8, and microvessel density., Conclusions: Human ASCs did not alter growth of human head/neck cancer cells or tumor xenografts, but stimulated migration and early micrometastasis to mouse brain., (© 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.)

Objectives/hypothesis: To perform a subset analysis of faith- and community-based screening events to further identify at-risk populations for head and neck cancer in hopes of further focusing screening efforts., Study Design: Prospective cohort study., Methods: Three hundred fifty-three individuals (n=353) presented to community events and self-selected for head and neck cancer screenings. A subgroup analysis focusing on risk factors for the development of head and neck cancer and for poor overall prognosis was performed. Subgroups analyzed were individuals screened at church-affiliated events, social events, or community outreach events at homeless shelters. Statistical analysis was performed using one-tailed analysis of variance test., Results: The outreach group had more risk factors for development of cancer, and a significantly higher proportion who used tobacco (P<.05) and consumed >1 drink/day (P<.05). Those in the outreach and church groups had a greater number of risk factors for a poor prognosis with and neck cancer in comparison with the social group: number of uninsured subjects (P<.05), fewer subjects with private insurance (P<.05), fewer subjects with a primary care provider (P<.05), and more subjects with a reported barrier to care (P<.05)., Conclusions: Inhabitants of homeless shelters represent a particularly vulnerable population for both the development and poor prognosis of head and neck cancer. Members of urban church groups are also an at-risk subpopulation due to the prevalence of poor prognostic risk factors. These groups may benefit from future targeted screenings for head and neck cancer., (Copyright © 2012 The American Laryngological, Rhinological and Otological Society, Inc.)

Squamous cell carcinoma of the head and neck (SCCHN) has traditionally been treated with a combination of surgery, chemotherapy, and external beam radiotherapy. While cure is generally the goal of these therapeutic modalities, recurrence is an unfortunately common outcome. Salvage surgery often results in close or positive surgical margins and the patient is at high risk for recurrence. Cyberknife stereotactic radiosurgery is a novel treatment that may benefit this subset of patients. This targeted treatment has shown promise in improving local control rates of tumors at multiple sites; however, the data for recurrent SCCHN is limited. In this case series, we present our experience with Cyberknife therapy in SCCHN patients who have undergone salvage surgery with close or positive margins.

Background: The supraclavicular island flap has been used successfully for difficult facial reconstruction cases, providing acceptable results without using microsurgical techniques. The authors use this regional flap in reconstructing various head and neck oncologic defects that normally require traditional regional or free flaps to repair surgical wounds., Methods: A pedicled supraclavicular artery flap was used to reconstruct head/neck oncologic defects. Complications and functional outcomes were assessed., Results: Head and neck oncologic patients underwent tumor resection followed by immediate reconstruction using a supraclavicular artery island flap. Ablative defects included neck, tracheal-stomal, mandible, parotid, and pharyngeal walls. All flaps (n = 18) were harvested in less than 1 hour. All ablative wounds and donor sites were closed primarily and did not require additional surgery. Major complications included a complete flap loss when the vascular pedicle was inadvertently divided and pharyngeal leaks. The leaks resolved without surgical intervention, and both patients regained the ability to swallow using their neo-esophagus. Minor complications included donor-site wound dehiscence and cellulitis. None of the patients reported functional donor-site morbidity., Conclusions: This thin flap is easy and quick to harvest, has a reliable pedicle, and has minimal donor-site morbidity. It is now the authors' flap of choice for many common head and neck reconstructive problems. Early experience using the supraclavicular artery island flap suggests that it is an excellent flap option for head and neck oncologic disease patients.

Objective/hypothesis: Infection with the hepatitis C virus (HCV) is a global problem with over 170 million people infected. Recently, we have noticed that a large number of patients diagnosed with squamous cell carcinoma of the head and neck (SCCHN) have also been diagnosed with HCV. A review of the literature reveals little information concerning this patient population. The objective of this study was to compare the outcome of SCCHN patients who have been exposed to HCV with naïve SCCHN patients., Study Design: Retrospective chart review., Methods: A retrospective chart review from June 1991 through December 2002 was performed to identify patients diagnosed with SCCHN who were screened for HCV. Patients were stratified into two groups (HCV positive and HCV negative). Data were recorded on patients for status of disease at last clinic visit, pretreatment serum albumin and hematocrit levels, and RNA quantities of HCV. Statistical analysis was performed using paired t test to compare serum albumin and hematocrit levels. Kaplan-Meier survival curves were used to compare outcomes. The log-rank test was used to determine significance. Cox regression was used to examine the association of prognostic predictor variables with overall survival and disease-free survival., Results: There was no difference noted in 5 year survival between hepatitis C positive and hepatitis C negative groups in overall outcomes (66.7% vs. 67.9%, P = 1.000) or 5 year disease-free survival (90.5% vs. 80.8%, P = .514). The two groups, HCV positive versus HCV negative, also had similar serum albumin levels (3.62 g/dL vs. 3.72 g/dL, P = .37) as well as serum hematocrit levels (42.9% vs. 41.0%, P = .12). Serum levels of hepatitis C RNA were obtained in seven patients, with only one being undetectable. The only prognostic predictor variable that was significantly associated with overall survival was age. None of the predictor variables were significantly associated with disease-free survival., Conclusion: Co-infection with HCV, although prevalent in the Veterans Administration Hospital population, did not affect patient outcome as defined by disease-free survival. Patients who were seropositive for HCV had comparable serum albumin levels as well as serum hematocrit when compared with HCV negative patients.

Objective: Recently, we have noticed that a large number of patients with squamous cell carcinoma of the head and neck (SCCHN) are also infected with the hepatitis C virus (HCV). A review of the literature has revealed no published studies examining this association. The objective of this study was to determine the incidence and epidemiology of HCV infection in patients with SCCHN., Study Design: A retrospective chart review., Methods: Patients diagnosed with SCCHN were analyzed to determine whether they were screened for HCV. Patients were then stratified into two groups (HCV positive and HCV negative). The patient's age at onset, site and stage of the tumor at presentation were determined, and statistical analysis was performed., Results: Ninety-nine (26%) patients were screened, and 21 (21.2%) were HCV positive. This incidence was increased when compared with previously published data (9.9%) (P < .0038). HCV-positive patients presented at an earlier age (51 years) versus the HCV-negative group (60 years) (P < .0002). There were no significant differences in the site or stage at presentation., Conclusions: In this study, 21% of patients diagnosed with SCCHN were found to be infected with HCV. These patients presented at an earlier age but had similar presentation with respect to site and stage. More research is needed to determine the significance of HCV infection in this patient population.

Introduction: Internalization of wild-type adenovirus is dependent on binding to a coxsackie-adenovirus receptor (CAR). Unfortunately, many tumors lack these receptors. We hypothesized that a novel RGD adenovirus, which binds by way of cellular integrins, would improve the transfection of head and neck cancers., Materials and Methods: Three squamous cell cancer lines were transfected with either the wild type or the novel RGD containing a luciferase reporter gene. After 48 hours, the transfection rate was determined. This was correlated with CAR and alphaVbeta3 and alphaVbeta5 integrin expression as determined by flow cytometry. A similar experiment was performed in a nude mouse model to determine in vivo differences of transfection rate., Results: Statistically significant increased rates of transfection were seen for the novel adenovirus at all multiplicities of infection (MOIs) in the CAL-27 and SCC-4 cell lines. Increased rates of transfection were seen at lower viral titers for the SCC-25 cells. Flow cytometry revealed low CAR expression in all cell lines but no consistent pattern of integrin expression. The nude mouse model demonstrated a 43-fold higher rate of transfection for the novel RGD adenovirus., Conclusions: A modified RGD adenovirus increased the efficacy of transfection in specific cell lines and in the nude mouse model. It is possible that modified adenoviruses may improve gene delivery to patients with advanced or recurrent head and neck cancers., (Copyright 2002 Wiley Periodicals, Inc.)