Prognostic factors in oral cancer surgery - results from a UK tertiary centre

Introduction Oral cancer surgery is complicated by the diverse nature of clinical and histopathological presentations that occur. Current National guidance recognises the significant role that surgical margin status plays in the overall survival of patients. Many other histopathological factors influence patient survival, the importance of which varies between the literature. Materials and methods In this prospective longitudinal study, all patients diagnosed with squamous cell carcinoma who had primary surgical treatment under general anaesthesia were included. Surgery was performed by one surgical team within this tertiary referral centre. Patients were followed up for a maximum of 7 years following their surgery. Results A total of 250 patients were included from 2015 to 2022. Patients were 61.44 years old (SD 13.23) at diagnosis, and 56.4% were male (n = 141). Pathology was mainly pT1 (39.1%) and the most common sites were the border of tongue (31.2%) and floor of mouth (18.8%). 43.4% of patients had clear surgical margins, with overall survival being significantly associated with margin status (p = 0.0079). Extra-capsular spread was significantly associated with higher risk of death from metastatic head and neck cancer (p = 0.014), whereas presence of high-grade dysplasia at surgical margins and depth of invasion of tumour were not. Conclusion This study has reinforced the importance of surgical margin clearance and as such the development of intra-operative techniques to ensure this is imperative. The significance of extra-capsular spread in survival has also been demonstrated. Discussion regarding the current deficiency in accurate pre-operative diagnostic methods for extra capsular spread is covered

Systematic review of health-related quality of life following thyroid cancer.

This systematic review provides a summary of all studies published between 2000 and 2019 using a health-related quality of life (HRQOL) patient-completed questionnaire to report outcomes following diagnosis and treatment of thyroid cancer. The search terms were "thyroid cancer" or "thyroid carcinoma," "quality of life" or "health related quality of life," and "questionnaire" or "patient reported outcome." EMBASE, PubMed, Medline, PsycINFO, CINAHL, and HaNDLE-On-QOL search engines were searched between 2 February and 23 February 2020. A total of 811 identified articles were reduced to 314 when duplicates were removed. After exclusion criteria (not thyroid specific, no quality of life questionnaires, and conference abstracts) were applied, 92 remained. Hand searching identified a further 2 articles. Of the 94 included, 16 had a surgical, 26 a primarily medical, and 52 a general focus. There were articles from 27 countries. A total of 49 articles were published from 2015 through 2019 inclusive. A total of 72 questionnaires were used among the articles and a range of 7 to 2215 participants were included within each article. This review demonstrated an increasing number of publications annually. The scope of enquiry into aspects of HRQOL following thyroid cancer is broad, with relatively few addressing surgical aspects and many focusing on the impact of radio-iodine. More research is required into shared decision-making in initial management decisions and HRQOL and interventions aimed specifically at addressing long-term HRQOL difficulties

Novel artificial eye service evaluation using patient reported outcome measures

Background This service evaluation explores patient reported outcomes from patients provided with high definition ocular prostheses (artificial eyes). Methods Validated patient questionnaires (FACE-Q, DAS24 and HADS) were utilised to evaluate patient experiences of their new ocular prosthesis. 10 patients were included in the service evaluation, which was conducted between December 2018 and September 2019. Descriptive analysis of the mean and 95% CI was undertaken for all questionnaires. Statistical analysis was performed using SPSS 21 Principal Component Analysis (PCA) for FACE-Q questionnaires. Correlations were significant when factor loading is at α > 0.4. Results A questionnaire response rate of 80% was achieved (n = 8). PCA analysis showed the number of variables tested could be reduced. Two principal components (PC1 and PC2) had very good to excellent internal consistency between variables with factor loading (α = 0.7–0.9). PC1 contained questionnaires 1–7, all of which were highly correlated. PC2 contained question number 8 with a factor loading of α = 0.8. This indicates good reliability, validity and responsiveness. Conclusions We hope to demonstrate the importance of service evaluations with respect to rapidly evolving technological advances in medical devices, pharmaceuticals and imaging modalities. Further feasibility and full clinical studies are required to confirm the positive results of the novel artificial eye service we have evaluated with respect to the traditional approach

Handle-On-QOL: a dedicated quality of life resource following the diagnosis and treatment of head and neck cancer

Measuring quality of life (QOL) after head and neck cancer (HNC), is rapidly becoming the standard of care. The Head and Neck Database Listing Evidence on QOL (Handle-On-QOL) is a dedicated QOL resource that includes articles published from 1982 onwards. The aim of this study was to assess the completeness of Handle-On-QOL, when compared with other non-specific search engines. Six years were selected at random; 1982, 1990, 1998, 2003, 2006, 2016. Four search engines were used (Medline, EMBASE, CINAHL, PsycINFO). Reporting followed PRISMA methodology. A total of 595 papers were assessed, of which 200 met the inclusion criteria. 186 papers were present on Handle-On-QOL, 243 were found on Handle-On-QOL for these six years, but not identified in the other searches, and 14 were missing from Handle-On-QOL. A search using standard engines generated a large number of irrelevant papers. Handle-On-QOL provides a comprehensive and accurate reflection of articles published using questionnaires to report QOL following HNC. This web-based repository (http://www.handle-on-qol.com) acts as a quick reference point for clinicians and researchers

Analytical Methods for Multilevel Graph-Partitioning

he multilevel strategy is widely used for graph partitioning. We discuss analytical methods for the central parts of this approach, i.e. for the graph coarsening and the local improvement