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Head and Neck Oncologic Surgery: Clinical Updates and New Perspectives in Precision Medicine Era

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Clinical Medicine, Cell, and Organism Physiology".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 4140

Special Issue Editors


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Guest Editor
Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, 09100 Cagliari, Italy
Interests: head and neck oncology; middle ear surgery; laryngology; cochlear implant; microvascular reconstruction

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Guest Editor
1. Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, 09100 Cagliari, Italy
2. Unit of Otorhinolaryngology, King’s College Hospital London-Dubai, Dubai P.O. Box 340901, United Arab Emirates
Interests: head and neck oncology; middle ear surgery; laryngology; cochlear implant; pediatric otorhinolaryngology; microvascular reconstruction

Special Issue Information

Dear Colleagues,

Head and neck cancer (HNC) is the seventh most common cancer globally, accounting for more than 660,000 new cases and 325,000 deaths annually. Approximately 90% of head and neck cancers are squamous cell carcinomas, which arise from the epithelial lining of the oral cavity, pharynx, and larynx.

The main treatment modalities for head and neck cancers include surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy. The size, location, and stage of the tumor, as well as metastasis status, are factors to be considered when determining operability and outcomes. Surgery is often the first-line treatment for localized head and neck cancers, and it may be used alone or in combination with other treatment modalities.

Multiple surgical approaches have been developed (such as transoral surgeries, open partial laryngectomies, tailored technology-assisted microvascular reconstruction, chemoradiotherapy protocols) with the aim of improving the survival of these patients and preserving or restoring their facial appearance, residual voice, ability to swallow and, consequently, quality of life to the best possible degree.

Surgical treatment may not be of benefit in patients with metastatic lesions, while radiotherapy and systemic therapy with pharmacologic agents may be better treatment options in these cases.

Precision medicine represents an emerging therapeutic approach focused on tailoring treatment for each individual patient. Despite the recent improvements in knowledge within this field, precision medicine-based therapies currently have a limited role in clinical practice. Clinical trials and studies based on precision medicine could improve the selection of the best treatment option for each patient and help to develop panels of markers that help to identify patients with high or low risks of recurrence or metastasis.

This Special Issue will focus on the functional and oncological outcomes of surgical strategies (with major interest in precision medicine trials) and organ preservation, as well as the reconstructive protocols applied to personalized medicine.

The following types of papers are welcome, including, but not limited to:

  • Original articles;
  • Clinical studies;
  • Review articles;
  • Translational research.

We are looking forward to receiving your manuscripts.

Dr. Filippo Carta
Prof. Dr. Roberto Puxeddu
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • head and neck cancer
  • squamous cell carcinoma
  • free flap
  • microsurgery
  • oral cancer
  • laryngeal cancer
  • pharyngeal cancer
  • skin cancer
  • salivary gland cancer
  • precision medicine
  • personalized medicine

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Published Papers (3 papers)

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Research

10 pages, 803 KiB  
Article
Changes in Clinical Practice in Adherence to the 2014 American Thyroid Association Guidelines on Thyroid Cancer: A Retrospective Study from a Tertiary Referral Center
by Federico Cappellacci, Gian Luigi Canu, Eleonora Noli, Alessandro Argiolas, Giulia Peis, Maria Letizia Lai, Pietro Giorgio Calò and Fabio Medas
J. Pers. Med. 2024, 14(7), 727; https://doi.org/10.3390/jpm14070727 - 5 Jul 2024
Viewed by 1008
Abstract
Thyroidectomy, a pivotal treatment for various thyroid disorders, has seen its indications evolve, particularly with the 2014 American Thyroid Association (ATA) Guidelines advocating for conservative surgical approaches like lobectomy. This retrospective study analyzes thyroidectomy practices at a high-volume center from January 2014 to [...] Read more.
Thyroidectomy, a pivotal treatment for various thyroid disorders, has seen its indications evolve, particularly with the 2014 American Thyroid Association (ATA) Guidelines advocating for conservative surgical approaches like lobectomy. This retrospective study analyzes thyroidectomy practices at a high-volume center from January 2014 to December 2023, focusing on patients potentially eligible for lobectomy per ATA guidelines. The inclusion criteria were tumors < 4 cm, indeterminate thyroid nodules, or differentiated thyroid carcinoma with clinically uninvolved lymph nodes (cN0). This study analyzed the proportion of patients undergoing lobectomy versus total thyroidectomy (TT) and the oncological outcomes. Of 357 patients, 243 underwent TT and 114 underwent lobectomy. The prevalence of lobectomies rose markedly, comprising 73.9% of surgeries in 2023. TT patients were predominantly female (83.5%) and had higher rates of autoimmune thyroiditis (67.5%) and malignancy (89.7%). Lobectomy patients had larger nodules and more indeterminate cytology. Among 301 malignant cases, TT was associated with higher lymph node metastasis, but similar recurrence rates, compared to lobectomy. This study underscores a shift towards lobectomy, reflecting adherence to ATA guidelines and suggesting conservative surgery is feasible without compromising outcomes. Further research on long-term outcomes and refined patient selection criteria is needed to optimize surgical approaches. Full article
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13 pages, 1852 KiB  
Article
Segmental Mandibulectomy and Mandibular Reconstruction with Fibula-Free Flap Using a 3D Template
by Melania Tatti, Filippo Carta, Mauro Bontempi, Sara Deriu, Cinzia Mariani, Valeria Marrosu, Emanuele Foddis, Clara Gerosa, Giuseppe Marongiu, Luca Saba, Andrea Figus, Massimiliano Pau, Bruno Leban and Roberto Puxeddu
J. Pers. Med. 2024, 14(5), 512; https://doi.org/10.3390/jpm14050512 - 11 May 2024
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Abstract
Introduction: The present study evaluates the influence of virtual surgical planning with a preoperative 3D resin model on aesthetic and functional outcomes in patients treated by segmental mandibulectomy and reconstruction with fibula-free flap for oral cancer. Methods: All consecutive patients who underwent segmental [...] Read more.
Introduction: The present study evaluates the influence of virtual surgical planning with a preoperative 3D resin model on aesthetic and functional outcomes in patients treated by segmental mandibulectomy and reconstruction with fibula-free flap for oral cancer. Methods: All consecutive patients who underwent segmental mandibulectomy and mandibular reconstruction with a fibula-free flap using a 3D template at our department from January 2021 to January 2023 were included in the study. “Patients control” were patients treated by reconstruction with a fibula-free flap without using a 3D template. Three-dimensional modeling was performed by converting from preoperative computed tomography to a stereolithography format to obtain the resin 3D models. Qualitative analysis of anatomical and aesthetic results consisted of the evaluation of the patients’ aesthetic and functional satisfaction and the symmetry of the mandibular contour observed at clinical examination. Quantitative analysis was based on the assessment of the accuracy and precision of the reconstruction by comparing preoperative and postoperative computed tomograms as objective indicators. Results: Seven patients (five males and two females, mean age of 65.1 years) were included in the study. All patients showed a symmetric mandibular contour based on the clinical examination. After recovery, six patients (85.7%) considered themselves aesthetically satisfied. The quantitative analysis (assessed in six/seven patients) showed that the mean difference between preoperative and postoperative intercondylar distance, intergonial angle distance, anteroposterior dimension, and gonial angle improved in the 3D template-assisted group. Conclusion: The 3D-printed template for mandibular reconstruction with microvascular fibula-free flap can improve aesthetic outcomes in comparison with standard approaches. Full article
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13 pages, 2438 KiB  
Article
The Use of Artificial Intelligence in Head and Neck Cancers: A Multidisciplinary Survey
by Caterina Giannitto, Giorgia Carnicelli, Stefano Lusi, Angela Ammirabile, Elena Casiraghi, Armando De Virgilio, Andrea Alessandro Esposito, Davide Farina, Fabio Ferreli, Ciro Franzese, Gian Marco Frigerio, Antonio Lo Casto, Luca Malvezzi, Luigi Lorini, Ahmed E. Othman, Lorenzo Preda, Marta Scorsetti, Paolo Bossi, Giuseppe Mercante, Giuseppe Spriano, Luca Balzarini and Marco Franconeadd Show full author list remove Hide full author list
J. Pers. Med. 2024, 14(4), 341; https://doi.org/10.3390/jpm14040341 - 25 Mar 2024
Viewed by 1528
Abstract
 Artificial intelligence (AI) approaches have been introduced in various disciplines but remain rather unused in head and neck (H&N) cancers. This survey aimed to infer the current applications of and attitudes toward AI in the multidisciplinary care of H&N cancers. From November 2020 [...] Read more.
 Artificial intelligence (AI) approaches have been introduced in various disciplines but remain rather unused in head and neck (H&N) cancers. This survey aimed to infer the current applications of and attitudes toward AI in the multidisciplinary care of H&N cancers. From November 2020 to June 2022, a web-based questionnaire examining the relationship between AI usage and professionals’ demographics and attitudes was delivered to different professionals involved in H&N cancers through social media and mailing lists. A total of 139 professionals completed the questionnaire. Only 49.7% of the respondents reported having experience with AI. The most frequent AI users were radiologists (66.2%). Significant predictors of AI use were primary specialty (V = 0.455; p < 0.001), academic qualification and age. AI’s potential was seen in the improvement of diagnostic accuracy (72%), surgical planning (64.7%), treatment selection (57.6%), risk assessment (50.4%) and the prediction of complications (45.3%). Among participants, 42.7% had significant concerns over AI use, with the most frequent being the ‘loss of control’ (27.6%) and ‘diagnostic errors’ (57.0%). This survey reveals limited engagement with AI in multidisciplinary H&N cancer care, highlighting the need for broader implementation and further studies to explore its acceptance and benefits.  Full article
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