Association between PD-L1 expression combined with tumor-infiltrating lymphocytes and the prognosis of patients with advanced hypopharyngeal squamous cell carcinoma.

Limited information is available regarding the immune-related prognostic factors of patients with advanced hypopharyngeal squamous cell carcinoma (HPSCC). The expression of programmed cell death-ligand 1 (PD-L1) in tumor cells contributes to a mechanism that allows cancer cells to escape immune surveillance. We investigated whether PD-L1 or human leukocyte antigen (HLA) class I expression in tumor cells and the tumor-infiltrating lymphocyte (TIL) density were associated with the tumor response to neoadjuvant chemotherapy (NAC) and survival in patients with advanced HPSCC. We retrospectively reviewed 83 consecutive patients with stage III or IV HPSCC who received NAC. We evaluated PD-L1 and HLA class I expression and TIL density using immunohistochemistry. Univariate and multivariate analyses demonstrated that CD8+ TIL density was an independent and significant predictive factor for the response to NAC, progression-free survival (PFS) and overall survival (OS), whereas PD-L1 or HLA class I expression did not significantly correlate. The subgroup analysis revealed that a higher CD8+ TIL density without detectable PD-L1 expression tended to be associated with longer patient survival. These results suggest that PD-L1 expression levels combined with CD8+ TIL density may serve as a predictive biomarker for patients with stage III or IV HPSCC receiving NAC.

Transcutaneous Intrafold Injection for Unilataeral Recurrent Nerve Paralysis in Terminal Cancer Patients

<b>Purpose</b>; Recurrent laryngeal nerve paralysis (RLNP) is often observed in terminal cancer patients. It causes hoarseness of voice, and this interferes with a patient's communication skills. Moreover, RLNP causes aspiration, which decreases the joy of eating, and pneumonia. Although it is important to control the symptoms of RLNP in terminal cancer patients, there are few methods for their control. In this study, 3 terminal cancer patients suffering from RLNP were treated using percutaneous intrafold silicon injection. <b>Methods</b>; The injection was administered under local anesthesia through cricothyroid membrane monitoring fiberscopy. The amount of silicon to be injected was determined on the basis of fiberscopic findings; 0.4 to 2.0 ml of silicon was injected. <b>Results</b>; As a result of this treatment, a marked improvement in voice hoarseness and swallowing ability was observed in all 3 cases. No complications were observed during and after treatment. <b>Conclusion</b>; Thus, percutaneous intrafold silicon injection is a very useful and safe treatment for RLNP in terminal cancer patients.