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1.
Anticancer Res ; 42(3): 1653-1657, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1716348

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, pedicle flaps instead of free flap transfer were recommended for head and neck reconstruction to reduce infection risk. Boron neutron-capture therapy in Japan was clinically approved in 2020 as a salvage radiotherapy for recurrent head and neck cancer following chemoradiotherapy. The efficacy and safety of salvage surgery following boron neutron-capture therapy remain unclear. CASE REPORT: We describe a 57-year-old male with crT4aN0M0 oral cancer after three different forms of radiotherapy including boron neutron-capture therapy, treated by salvage partial maxillectomy with both buccal fat pad and nasoseptal flaps. His postsurgical course was successful, without tracheostomy, and he had no Clavien- Dindo grade 3 or 4 complications. The pathological diagnosis was T4a squamous cell carcinoma with a negative surgical margin. No recurrence or metastasis had occurred at 113 days postoperatively. No opioid consumption was needed postoperatively. CONCLUSION: Pathological negative margins were achieved in this case and there were no severe complications. Further accrual of cases salvage surgery following boron neutron-capture therapy is required to clarify treatment strategies for recurrent head and neck cancer.


Subject(s)
COVID-19/epidemiology , Mouth Neoplasms/surgery , Neoplasm Recurrence, Local , Salvage Therapy , Squamous Cell Carcinoma of Head and Neck/surgery , Boron Neutron Capture Therapy , Humans , Japan/epidemiology , Male , Margins of Excision , Middle Aged , Mouth Neoplasms/pathology , Mouth Neoplasms/radiotherapy , Orthognathic Surgical Procedures , SARS-CoV-2 , Squamous Cell Carcinoma of Head and Neck/pathology , Squamous Cell Carcinoma of Head and Neck/radiotherapy , Surgical Flaps , Treatment Outcome
2.
Clin Exp Dent Res ; 8(1): 117-122, 2022 02.
Article in English | MEDLINE | ID: covidwho-1490746

ABSTRACT

OBJECTIVE: Besides angiotensin converting enzyme 2 (ACE2), an active involvement of proteases (FURIN and/or TMPRSS2) is important for cellular entry of SARS-CoV-2. Therefore, a simultaneous expression profiling of entry proteins in a tissue might provide a better risk assessment of SARS-CoV-2 infection as compared to individual proteins. In an attempt to understand the relative susceptibility of oral squamous cell carcinoma (OSCC) lesions as compared to the normal oral mucosa (NOM) for SARS-CoV-2 attachment/entry, this study examined the mRNA and protein expression profiles of ACE2, FURIN, and TMPRSS2 in the corresponding tissues using public transcriptomic and proteomics datasets. METHODS AND METHODS: Public transcriptomic and proteomics datasets (the Cancer Genome Atlas (TCGA)/the Genotype-Tissue Expression (GTEx), the Human Protein Atlas (HPA), and two independent microarray datasets) were used to examine the expression profiles of ACE2, TMPRSS2 and FURIN in NOM and OSCC. RESULTS: ACE2, TMPRSS2, and FURIN mRNAs were detected in NOM, however, at lower levels as compared to other body tissues. Except for moderate up-regulation of FURIN, expression levels of ACE2 and TMPRSS2 mRNA were unchanged/down-regulated in OSCC as compared to the NOM. CONCLUSIONS: These results indicate that NOM may serve as a possible site for SARS-CoV-2 attachment, however, to a lesser extent as compared to organs with higher expression levels of the SARS-CoV-2 entry proteins. However, the evidence is lacking to suggest that expression status of entry proteins predisposes OSCC lesions to additional risk for SARS-CoV-2 attachment/entry as compared to NOM.


Subject(s)
Angiotensin-Converting Enzyme 2/genetics , COVID-19/pathology , Furin/genetics , Gene Expression/genetics , Mouth Neoplasms/pathology , RNA, Messenger/genetics , SARS-CoV-2/genetics , Serine Endopeptidases/genetics , COVID-19/genetics , Carcinoma, Squamous Cell/genetics , Furin/metabolism , Head and Neck Neoplasms , Humans , Mouth Mucosa , Mouth Neoplasms/genetics , Mucous Membrane/pathology , Squamous Cell Carcinoma of Head and Neck , Tongue/metabolism
3.
Virchows Arch ; 479(3): 585-595, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1130775

ABSTRACT

The role of digital pathology in remote reporting has seen an increase during the COVID-19 pandemic. Recently, recommendations had been made regarding the urgent need of reorganizing head and neck cancer diagnostic services to provide a safe work environment for the staff. A total of 162 glass slides from 109 patients over a period of 5 weeks were included in this validation and were assessed by all pathologists in both analyses (digital and conventional) to allow intraobserver comparison. The intraobserver agreement between the digital method (DM) and conventional method (CM) was considered almost perfect (κ ranged from 0.85 to 0.98, with 95% CI, ranging from 0.81 to 1). The most significant and frequent disagreements within trainees encompassed epithelial dysplasia grading and differentiation among severe dysplasia (carcinoma in situ) and oral squamous cell carcinoma. The most frequent pitfall from DM was lag in screen mirroring. The lack of details of inflammatory cells and the need for a higher magnification to assess dysplasia were pointed in one case each. The COVID-19 crisis has accelerated and consolidated the use of online meeting tools, which would be a valuable resource even in the post-pandemic scenario. Adaptation in laboratory workflow, the advent of digital pathology and remote reporting can mitigate the impact of similar future disruptions to the oral and maxillofacial pathology laboratory workflow avoiding delays in diagnosis and report, to facilitate timely management of head and neck cancer patients. Graphical abstract.


Subject(s)
COVID-19 , Carcinoma in Situ/pathology , Digital Technology , Image Interpretation, Computer-Assisted , Maxillary Neoplasms/pathology , Microscopy , Mouth Neoplasms/pathology , Squamous Cell Carcinoma of Head and Neck/pathology , Telepathology , Biopsy , Diagnosis, Differential , Humans , Observer Variation , Predictive Value of Tests , Reproducibility of Results , Workflow
7.
Head Neck ; 42(6): 1173-1178, 2020 06.
Article in English | MEDLINE | ID: covidwho-116849

ABSTRACT

BACKGROUND: The coronavirus infection is rapidly spreading, putting a strain on health care services across the globe. Patients with oral cancer are susceptible often immunosuppressed due to the disease and/or the treatment received. METHODS: We performed a simulation of the currently available data using a multistate and hazards model to provide an objective model for counseling and decision making for health care workers. RESULTS: Stage IV patients with oral cancer who did not receive treatment had progression of disease and an increased mortality rate compared to patients who receive treatment but did not contract COVID-19. The patients who received treatment and got affected with COVID-19 had a far worse impact and higher mortality rate than all other groups. CONCLUSION: Isolation and deferring treatment for stage IV patients with oral cancer, so as to avoid hospital visits and contraction of COVID-19, is an advisable strategy based on this model.


Subject(s)
Cause of Death , Clinical Decision-Making/methods , Coronavirus Infections/epidemiology , Mouth Neoplasms/pathology , Mouth Neoplasms/surgery , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , COVID-19 , Computer Simulation , Coronavirus Infections/prevention & control , Disease Management , Disease-Free Survival , Female , Humans , Male , Mouth Neoplasms/mortality , Neoplasm Invasiveness/pathology , Neoplasm Staging , Patient Selection , Pneumonia, Viral/prevention & control , Proportional Hazards Models , Risk Assessment , Survival Analysis , United States
8.
Head Neck ; 42(6): 1131-1136, 2020 06.
Article in English | MEDLINE | ID: covidwho-66373

ABSTRACT

BACKGROUND AND METHODS: There is an added level of complexity in the management of head and neck cancer patients with underlying immunosuppressive disorders during the COVID-19 pandemic. Head and neck oncologists are tasked with balancing the dual risks of cancer progression in the setting of impaired tumor immunity and increased susceptibility to life-threatening complications from exposure to viral infection for patients and providers. Through two cases of immunocompromised patients with newly diagnosed head and neck malignancies, we aim to provide guidance to clinicians struggling with how to best counsel and manage this unique subset of patients under these difficult circumstances. RESULTS: After careful consideration of the options, we took different approaches in the care of these two patients. CONCLUSIONS: Ultimately, there is no uniform set of rules to apply to this heterogeneous group of immunocompromised patients. We provide some general principles to help guide patient management during the current pandemic.


Subject(s)
Conservative Treatment/methods , Coronavirus Infections/epidemiology , Head and Neck Neoplasms/therapy , Immunocompromised Host , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Time-to-Treatment/organization & administration , Adult , COVID-19 , Clinical Decision-Making , Communicable Disease Control/methods , Disease Management , Female , Follow-Up Studies , Head and Neck Neoplasms/pathology , Humans , Interdisciplinary Communication , Laryngeal Neoplasms/pathology , Laryngeal Neoplasms/surgery , Male , Middle Aged , Mouth Neoplasms/pathology , Mouth Neoplasms/surgery , Patient Safety , Risk Assessment , Sampling Studies , Time Factors , United States , Vocal Cords/pathology , Vocal Cords/surgery
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