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Objectives: Laryngeal squamous cell carcinoma (SCC) is a predominantly male illness. Although the rate of female patients increased, a knowledge gap exists in the medical literature regarding gender‐based differences. Design: Retrospective cohort study. Setting: Adult patients treated for laryngeal SCC in a tertiary medical centre between 2006 and 2020. Data were collected on demographics, clinical presentation, treatment modalities, disease recurrence and survival status. Participants: Two hundred ninety‐one patients with laryngeal SCC, 50 (17.2%) females and 241 (82.8%) males. Main Outcome Measures: Disease‐specific survival (DSS), overall survival (OS) and disease‐free survival (DFS), as well as differences in disease characteristics and treatment modalities. Results: Tumour subsites differed significantly between females and males (36% vs. 19.5% supraglottic, 62% vs. 80.5% glottic and 2% vs. 0% subglottic, respectively; p = 0.006). Females were diagnosed at younger ages (61.7 ± 10.58 vs. 65.87 ± 11.11 years, p = 0.016) and advanced‐stage disease (58% vs. 39.4%, p = 0.018). Females were treated with combined modalities at higher rates (36% vs. 54.8% for single modality, p = 0.031). DSS rates did not differ between genders (log‐rank p = 0.12). Despite being diagnosed at more advanced disease stages, females demonstrated prolonged median OS compared to males (130.17 vs. 106.17 months, log‐rank p = 0.017). No significant differences in DFS were observed (log‐rank p = 0.32). In a multivariate Cox proportional hazards model, male gender remained an independent negative OS predictor (HR = 2.08; CI, 1.10–3.96; p = 0.025), along with increasing age (HR = 1.06; CI, 1.04–1.09; p < 0.001) and advanced disease stage (HR = 1.7; CI, 1.08–2.67; p = 0.023). Conclusions: Our findings suggest the importance of considering gender‐specific factors in the management of laryngeal SCC. [ABSTRACT FROM AUTHOR]

Objectives: Oral lichen planus (OLP) is a chronic inflammatory disorder involving epithelia with squamous differentiation. Although described as a potential malignant precursor, the characteristics of malignancies arising among these patients are not widely described. Our goal was to describe the patterns of disease recurrence of patients with oral cavity squamous cell carcinoma (OSCC) arising on the background of OLP. Methods: A retrospective analysis of all surgically treated patients with OSCC at a university‐affiliated tertiary care center between 2000 and 2020. Results: Two hundred seventy‐nine patients with OSCC treated surgically were included. Forty (14.3%) had OLP. The mean age of patients with OLP was 70.9 years compared with 64.3 years for non‐OLP patients (p = 0.03). OLP patients had a significantly higher rate of disease recurrence, persistence, or multiple primary disease (70% vs. 33.9%, p < 0.001). The mean number of sequential oncologic events for each patient with recurrence was also significantly higher among OLP patients (1.86 vs. 1.36, p = 0.03), a difference explained by a higher rate of multiple primary presentations (0.71 vs. 0.28, p = 0.008). A significant difference in disease‐free survival (DFS) was demonstrated between the groups as patients with OLP had a lower 5‐year DFS (34.7% vs. 61.3%, log‐rank p value <0.001). On multivariate analysis, OLP was significantly associated with multiple primary events (p < 0.001, Odds ratio = 7.42, 95% confidence interval 2.9–19). Conclusions: OSCC patients with OLP background demand close clinical follow‐up, as multiple primary disease is significantly more common and the DFS is significantly lower among these patients. A thorough clinical evaluation for all oral cavity subsites is mandatory. Level of Evidence: 3 Laryngoscope, 134:3146–3151, 2024 [ABSTRACT FROM AUTHOR]

Background: Regional metastases are considered the most important prognostic factor in OSCC patients. We aimed to investigate the impact of regional disease among different age groups with OSCC. Methods: A retrospective comparison between patients 40 years old or younger, 41–69 years old, and 70 years or older treated for OSCC between 2000 and 2020 in a tertiary‐care center. Results: 279 patients were included. The mean age was 65 ± 17.7 and 133 were male (47.7%). Thirty‐six (12.9%) were 40 years old or younger, 101 (36.2%) were 41–69 years and 142 (50.9%) were 70 years or older. Five‐year overall survival and disease‐specific survival (DSS) were significantly better among patients younger than 40 compared to the mid‐age group and patients 70 years or older (76.7% vs. 69.4% vs.48.2%, Log‐rank p < 0.001, and 76.7% vs. 75.3% vs. 46.5%, Log‐rank p < 0.001, respectively). While an association between regional spread and overall survival and DSS was demonstrated among all age groups, the odds ratio (OR) for death of any cause and death of disease regarding cervical metastasis was much higher among patients younger than 40 compared with the 41–69 and 70+ age groups (death of any cause‐OR = 23, p‐value = 0.008, OR = 2.6, p‐value = 0.026, OR = 2.4, p‐value = 0.13, respectively. Death of disease‐OR = 23, p‐value = 0.008, OR = 2.3, p‐value = 0.082, OR = 4.1, p‐value = 0.001, respectively). In univariate analysis, regional metastasis was associated with disease‐free survival only among patients younger than 40 (p‐value = 0.04). Conclusions: Regional metastases correspond with worse prognosis in young patients compared to older patients. These patients may benefit from a comprehensive treatment approach with close post‐treatment follow‐up. Level of Evidence: 3 Laryngoscope, 134:2212–2220, 2024 [ABSTRACT FROM AUTHOR]

Objectives: Secretory Carcinoma is a malignant salivary gland tumor, initially described in 2010. This rare tumor is associated with the translocation t(12;15) (p13;q25), resulting in the fusion gene ETV6‐NTRK3. Since this tumor is quite rare, most publications describe only small cohorts of patients. We aimed to investigate the clinical, pathological, and prognostic features of this newly defined malignant entity. Data Sources: Pubmed, Google Scholar, and Web of Science databases. Review Methods: All published articles between 2010 and 2023 were reviewed. Search terms included the terms "Mammary Analogue Secretory Carcinoma" and "Secretory Carcinoma". All articles published in English reporting on Secretory Carcinoma of salivary glands were retrieved. Results: One‐hundred and 12 retrospective articles reporting a total of 674 patients were included, with 52% males and a mean age of 44.9 ± 18.9. The event rate for patients with advanced‐stage disease (Stage 3/4) at presentation was 24.1% (95% CI 17.6%–31.9%, I2 = 9.2%), 14.6% for regional metastases (95% CI 10.5%–20%, I2 = 12%), and the event rate of distant metastasis was 8.4% (95% CI 5.5%–12.7%, I2 = 4.2%). Adjuvant radiotherapy was administered for 30.3% of patients (95% CI 24.1%–37.2%, I2 = 21.5%). The recurrence rate was 19% (95% CI 15.1%–23.8%, I2 = 5%). Survival outcomes showed a 17.2% death of disease rate for Secretory Carcinoma patients (95% CI 13.5%–21.8%, I2 = 7.3%). Conclusions: Secretory Carcinoma is a rare and relatively newly defined entity arising in the parotid gland most commonly. Characterized as a low‐grade tumor, the majority of patients are diagnosed at an early stage, without regional or distant disease, and the prognosis is relatively good. Level of Evidence: NA Laryngoscope, 134:1716–1724, 2024 [ABSTRACT FROM AUTHOR]

Background: While almost one-third of patients treated for laryngeal cancer will experience disease recurrence, the current National Comprehensive Cancer Network guidelines do not recommend routine post-treatment imaging follow-up. We aimed to examine the yield of post-treatment imaging surveillance among patients with primary advanced laryngeal cancer. Methods: Patients treated for advanced-stage laryngeal carcinoma between 2000 and 2020 in a tertiary care medical center were retrospectively reviewed. Data collected included demographics, clinical and pathological features, treatment modalities, tumor recurrence data including the diagnostic modality (patient's symptoms, physical examination, or imaging), and outcome. Results: The cohort included 123 patients with advanced-stage laryngeal cancer. Thirty-five (28.7%) patients experienced disease recurrence with fourteen recurrences (40%) diagnosed by imaging. Patients diagnosed by imaging had a shorter time to recurrence diagnosis (23.8 vs. 45.9 months, p-value = 0.016), with similar 5-year overall and disease-specific survival (20.6% vs. 26.6%, log-rank p-value = 0.53 and 62.1% vs. 59.7%, log-rank p-value = 0.87, respectively). Conclusions: Performance of routine post-treatment imaging follow-up in patients with advanced laryngeal cancer was associated with a shorter time to diagnosis of recurrence and similar survival rates. Imaging follow-up should be considered in cases where clinical follow-up is limited and according to the judgment of the treating physician. [ABSTRACT FROM AUTHOR]

Objective: Elective neck dissection (END) improves outcomes among clinically node‐negative patients with oral cavity squamous cell carcinoma (OCSCC). However, END is of questionable value, considering the potentially higher comorbidities and operative risks in elderly patients. Methods: A retrospective review of all patients older than 65 years of age who were treated for OCSCC at a tertiary care centre between 2005 and 2020 was conducted. Results: Fifty‐three patients underwent primary tumour resection alone, and 71 had simultaneous END. Most primary tumours were located on the mobile tongue. The patients who did not undergo END had a higher mean age (81.2 vs. 75.1 years, P < 0.00001), significantly shorter surgeries, and shorter hospitalizations. Occult cervical metastases were found in 24% of the patients who underwent END. The two groups showed no significant differences in overall survival or recurrence rates. Similar results were shown in a subpopulation analysis of patients older than 75 years. Conclusion: Foregoing END in elderly patients with no clinical evidence of neck metastases did not result in lower survival rates or higher recurrence rates. [ABSTRACT FROM AUTHOR]

Objectives: Tumor satellites are defined as islands of tumor cells completely separated from the border of the main tumor. They are believed to be a sign of aggressive disease. Our goal was to investigate the association between tumor satellites and outcome in patients with oral squamous cell carcinoma. Materials and Methods: A retrospective analysis of all patients treated for oral squamous cell carcinoma at a university‐affiliated tertiary care center between 2010 and 2018 was performed. Data collected included demographics, clinical and pathological features including tumor satellites, staging, treatment modalities, and outcomes. Results: A total of 144 patients were included. The mean age of all patients was 63.5 and 50.7% were males. The mean follow‐up time was 40.5 months. Seventeen patients (11.8%) had tumor satellites. These patients had a higher rate of involved margins, peri‐neural invasion, lympho‐vascular invasion, and extra‐nodal extension. Tumor, nodal and overall classification were significantly more advanced in patients with satellites. Disease‐specific and overall survival rates were significantly lower among satellites patients (28.7% vs. 59.7% and 28.7% vs. 54.9%, respectively). Conclusions: Tumor satellites are associated with several adverse features and advanced locoregional disease. Patients with satellites should be treated aggressively with a combination of surgery aimed at achieving free surgical margins and adjuvant treatment, as they have a worse prognosis compared with patients without satellites. Further prospective studies are mandatory to consolidate the importance of adjuvant treatment in these patients. Level of Evidence: 3 Laryngoscope, 133:336–343, 2023 [ABSTRACT FROM AUTHOR]

Objectives: Regional failure after primary treatment for oral squamous cell carcinoma (OSCC) carries a dismal outcome. Our goal was to investigate the recurrence patterns and salvage treatment in patients with OSCC and regional failure. Study design: Retrospective chart review of all patients treated for OSCC in a university‐affiliated tertiary care center during 2000‐2018. Methods: Data collected from patients' medical charts included demographics, clinical and pathological features, staging, treatment modalities and outcomes. Patients with insufficient data or a follow‐up of less than 2 years were excluded. Results: Out of 266 surgically treated patients, 55 developed regional recurrence and were included in the study cohort. Forty patients received surgical salvage treatment followed by adjuvant chemo‐radiotherapy (CRT). Disease specific survival and overall survival were significantly higher in surgically treated patients compared to patients who received non‐surgical treatment (46.7% vs. 0%, log‐rank P value <.001 and 35.3% vs. 0%, log‐rank P value =.001, respectively) and in patients who recurred regionally more than 10 months following initial treatment (40.8% vs 10.7%, log‐rank P value =.065). Patients with early recurrence were older (73.6 vs. 61.3 years) and had a deeper invasion of the primary tumor (10.1 vs. 7 mm). Conclusions: Salvage neck dissection is feasible in most cases, providing the best outcomes in patients with OSCC who fail regionally. Close follow‐up during the first year after initial treatment is paramount as early recurrence carries a dismal prognosis. Specifically, elderly patients and patients with deeper primary tumor invasion should be closely monitored during the first post‐operative year. Level of Evidence: 4 Laryngoscope, 132:786–792, 2022 [ABSTRACT FROM AUTHOR]

Background: Depth of invasion (DOI) has a significant clinical impact on the staging system of oral squamous cell carcinoma (OSCC). We aimed to compare the prognostic impact of treating DOI as a continuous variable rather than a categorical one., Methods: A retrospective review of 277 OSCC patients surgically treated in a tertiary care center from 2000 to 2020, with a minimum 2-year follow-up. The analyses were performed using Cox and logistic regression., Results: DOI as a continuous variable significantly predicted mortality in both univariate (p < 0.001) and multivariate (p < 0.001) analyses. It was also a significant predictor of locoregional recurrence (multivariate p = 0.039) and occult lymph node metastasis (univariate p = 0.005, multivariate p = 0.04). Categorical analysis failed to demonstrate the same significance., Conclusions: DOI as a continuous factor rather than a categorical one is significantly associated with mortality, locoregional recurrence, and occult lymph node metastasis. This innovative approach promotes personalized risk stratification and better decision-making., (© 2024 The Author(s). Head & Neck published by Wiley Periodicals LLC.)

Objective: The traditional categorical division of surgical margins using a 5 mm cutoff in oral cavity squamous cell carcinoma (OCSCC) is controversial. The primary aim of this study was to investigate the presence of an optimal cutoff point or, alternatively, assess the potential improvement in predictive value by considering the surgical margins as a continuum., Methods: Retrospective analysis of OCSCC patients at a tertiary medical center in 1995-2020. Clinical, pathological, and surgical data were evaluated for effect on survivability by regression analyses., Results: The cohort included 266 patients (48.1% male, mean age 65.4 ± 17.7). Patient stratification by categorical margin status yielded no significant between-group differences in survival (p = 0.54). Significance was achieved when margin distance was reevaluated as a continuous variable (p = 0.0018). Similar results were shown in local control (categorical p = 0.59 vs. continuous p = 0.06). Multivariate model excluded possible confounders. A predictive model was created to provide a more accurate prediction of survival., Conclusions: The continuum spectrum of margin distance better predicts survival outcomes and locoregional control in OCSCC., Level of Evidence: 3 Laryngoscope, 2024., (© 2024 The Author(s). The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)