European white paper: oropharyngeal dysphagia in head and neck cancer

Purpose To develop a European White Paper document on oropharyngeal dysphagia (OD) in head and neck cancer (HNC). There are wide variations in the management of OD associated with HNC across Europe. Methods Experts in the management of specific aspects of OD in HNC across Europe were delegated by their professional medical and multidisciplinary societies to contribute to this document. Evidence is based on systematic reviews, consensus-based position statements, and expert opinion. Results Twenty-four sections on HNC-specific OD topics. Conclusion This European White Paper summarizes current best practice on management of OD in HNC, providing recommendations to support patients and health professionals. The body of literature and its level of evidence on diagnostics and treatment for OD in HNC remain poor. This is in the context of an expected increase in the prevalence of OD due to HNC in the near future. Contributing factors to increased prevalence include aging of our European population (including HNC patients) and an increase in human papillomavirus (HPV) related cancer, despite the introduction of HPV vaccination in various countries. We recommend timely implementation of OD screening in HNC patients while emphasizing the need for robust scientific research on the treatment of OD in HNC. Meanwhile, its management remains a challenge for European professional associations and policymakers.Otorhinolaryngolog

Prognostic Significance of Pcna Expression in Laryngeal Cancer

Objective: To assess the prognostic value of proliferating cell nuclear antigen (PCNA) in laryngeal carcinoma and its relation with other known prognostic clinicopathologic variables. Design: A retrospective cohort study of 92 patients chosen randomly from patients treated between 1964 and 1993 with the diagnosis of laryngeal cancer. Prognostic factors including PCNA expression, grade, lymphovascular invasion, depth of tumor margins, neck metastasis, and clinical outcome were evaluated. Setting: Hacettepe University Medical Faculty, Ankara, Turkey. Patients: Eighty-five men and 7 women operated on for squamous cell carcinoma of the larynx were studied. Sixty-nine patients had total and 20 patients had partial laryngectomy with neck dissection, and 3 patients had endolaryngeal tumor excision. Intervention: Hematoxylin and eosin-stained sections were reevaluated for grade, lymphovascular invasion, and depth of tumor margins; sections stained with monoclonal antibody against PC10 were examined for PCNA expression. Results: The PCNA index correlated with grade, lymphovascular invasion, depth of tumor margins, neck metastasis, and local-regional recurrence. The PCNA index values of patients with occult metastasis were significantly higher than those of patients without metastasis (P=.006). Conclusions: The PCNA index is a more sensitive variable than grade in predicting tumor proliferation, occult lymph node metastasis, and prognosis. These re suits suggest that the PCNA index can be used in decision making for treatment and assessment of prognosis in laryngeal carcinomas.WoSScopu

A European survey on the practice of nutritional interventions in head–neck cancer patients undergoing curative treatment with radio(chemo)therapy

Purpose: As the practice of nutritional support in patients with head and neck cancer (HNC) during curative radio(chemo)therapy is quite heterogeneous, we carried out a survey among European specialists. Methods: A 19-item questionnaire was drawn up and disseminated via the web by European scientific societies involved in HNC and nutrition. Results: Among 220 responses, the first choice was always for the enteral route; naso-enteral tube feeding was preferred to gastrostomy in the short term, while the opposite for period longer than 1 month. Indications were not solely related to the patient’s nutritional status, but also to the potential burden of the therapy. Conclusion: European HNC specialists contextualize the use of the nutritional support in a comprehensive plan of therapy. There is still uncertainty relating to the role of naso-enteral feeding versus gastrostomy feeding in patients requiring < 1 month nutritional support, an issue that should be further investigated

A European survey on the practice of nutritional interventions in head-neck cancer patients undergoing curative treatment with radio(chemo)therapy

PURPOSE: As the practice of nutritional support in patients with head and neck cancer (HNC) during curative radio(chemo)therapy is quite heterogeneous, we carried out a survey among European specialists. METHODS: A 19-item questionnaire was drawn up and disseminated via the web by European scientific societies involved in HNC and nutrition. RESULTS: Among 220 responses, the first choice was always for the enteral route; naso-enteral tube feeding was preferred to gastrostomy in the short term, while the opposite for period longer than 1 month. Indications were not solely related to the patient's nutritional status, but also to the potential burden of the therapy. CONCLUSION: European HNC specialists contextualize the use of the nutritional support in a comprehensive plan of therapy. There is still uncertainty relating to the role of naso-enteral feeding versus gastrostomy feeding in patients requiring < 1 month nutritional support, an issue that should be further investigated

European Head and Neck Society recommendations for head and neck cancer survivorship care

© 2022 The AuthorsSurvivors of head and neck cancer can experience long-term consequences of the cancer and subsequent treatments even after the cancer has resolved. Increasingly clinicians are aware of the social, psychological, financial, and emotional impacts of these cancers, in addition to the support required for the physical symptoms. This review provides recommendations on the long-term management and support required for survivors of head and neck cancer in the European healthcare setting