Impact of HPV-associated p16-expression on radiotherapy outcome in advanced oropharynx and non-oropharynx cancer

AbstractBackground and purposeHPV is found in head and neck cancer from all sites with a higher prevalence in oropharynx cancer (OPC) compared to non-OPC. HPV/p16-status has a significant impact on radiotherapy (RT) outcome in advanced OPC, but less is known about the influence in non-OPC. We analyzed HPV-associated p16-expression in a cohort of patients with stage III–IV pharynx and larynx cancer treated with primary, curatively intended (chemo-)RT, aiming to test the hypothesis that the impact of HPV/p16 also extends to tumors of non-oropharyngeal origin.Material and methods1294 patients enrolled in previously conducted DAHANCA-trials between 1992 and 2012 were identified. Tumors were evaluated by p16-immunohistochemistry and classified as positive in case of staining in >70% of tumors cells.ResultsThirty-eight percent (490/1294) of the tumors were p16-positive with a significantly higher frequency in OPC (425/815) than in non-OPC (65/479), p<.0001. In OPC p16-positivity significantly improved loco-regional control (LRC) (adjusted HR [95% CI]: 0.43 [0.32–0.57]), event-free survival (EFS) (HR 0.44 [0.35–0.56]), and overall survival (OS) (HR: 0.38 [0.29–0.49]), respectively, compared with p16-negativity. In non-OPC no prognostic impact of p16-status was found for either endpoint: LRC (HR: 1.13 [0.75–1.70]), EFS (HR: 1.06 [0.76–1.47]), and OS (HR: 0.82 [0.59–1.16]).ConclusionsThe independent influence of HPV-associated p16-expression in advanced OPC treated with primary RT was confirmed. However, RT-outcome in the group of non-OPC did not differ by tumor p16-status, indicating that the prognostic impact may be restricted to OPC only

Listeria monocytogenes

Listeriosis is a foodborne infection caused by Listeria monocytogenes. The clinical spectrum of listeriosis ranges from mild to invasive disease including bacteraemia or meningitis. Listeria monocytogenes can also be transmitted from mother to fetus in utero or to the neonate during birth. Risk factors for invasive disease include immunosuppression, advanced age, and pregnancy. The incubation is longer than for most foodborne pathogens, usually a few weeks. In Denmark, invasive forms of listerioses in humans are monitored in the Danish surveillance system. The 30-day mortality of registered cases of listeriosis is about 25% [1]

National clinical Genetic Networks - GENets - Establishment of expert collaborations in Denmark

Genetic conditions are often familial, but not all relatives receive counseling from the same institution. It is therefore necessary to ensure consistency in variant interpretation, counseling practices, and clinical follow up across health care providers. Furthermore, as new possibilities for gene-specific treatments emerge and whole genome sequencing becomes more widely available, efficient data handling and knowledge sharing between clinical laboratory geneticists and medical specialists in clinical genetics are increasingly important. In Denmark, these needs have been addressed through the establishment of collaborative national networks called Genetic Expert Networks or "GENets". These networks have enhanced patient and family care significantly by bringing together groups of experts in national collaborations. This promotes coordinated clinical care, the dissemination of best clinical practices, and facilitates the exchange of new knowledge.</p

Study Protocol for a Scoping Review of Systematic Reviews, Reviews of Clinical Guidelines and Consensus Papers on Educational Messages for People with Chronic Musculoskeletal Pain Conditions

Patient education is consistently promoted in clinical guidelines for management of musculoskeletal (MSK) pain conditions. Despite these recommendations, there is a significant gap in fulfilling the informational needs of individuals affected by MSK pain. People seeking care for MSK pain report that their needs for understanding their condition and available management option are unmet. Moreover, healthcare professionals face challenges in explaining the complexities of MSK pain, often struggling to move beyond structural or biomechanical/functional explanations. This fosters a situation where patients encounter a plethora of different, and sometimes conflicting, explanations regarding their condition, leading to confusion and dissatisfaction. To facilitate people with chronic MSK pain receiving the same key messages, irrespective of where they seek care, we have initiated a collaborative process aimed at the development of standardized educational content for MSK pain. This scoping review is the first step of this development process