Current Issue Volume 8, Number 2 , April-June 2017

EDITORIAL
Pankaj Chaturvedi

Editorial

[Year:2017] [Month:April-June] [Volumn:8 ] [Number:2] [Pages:51] [Pages No:iv]



It is indeed an honor to write an editorial for the special issue of our journal dedicated to Dr Jatin Shah. Dr Shah is truly a living legend who has inspired several generations of head neck surgeons in his illustrious career spanning over almost 5 decades. He completed his postgraduation in general surgery from the Medical College of Maharaja Sayajirao University in Baroda, India. Starting with his fellowship at Memorial Sloan Kettering Cancer Centre he continues to be the integral part of this premium institute since 42 years. He was the chief of the coveted Head and Neck Disease Management Team in MSKCC in New York. Dr Shah is one of the most renowned personalities in Head and Neck community all over the world.


INVITED REVIEW
C Fitzgerald, James Paul O'Neill

High-risk Cutaneous Squamous Cell Carcinoma

[Year:2017] [Month:April-June] [Volumn:8 ] [Number:2] [Pages:51] [Pages No:37-44]



Cutaneous squamous cell carcinoma (cSCC) is the second most common nonmelanoma skin cancer worldwide. Cutaneous squamous cell carcinoma can potentially be treated fully with minimal morbidity when detected early; however, certain subtypes of cSCC have been shown to confer a poorer prognosis for patients. In these high-risk tumors, increased incidence of recurrence, as well as metastasis to local lymph nodes and distant sites, is seen as a result of certain patient characteristics and pathological features. While guidelines regarding the management of high-risk cSCC have been produced, no clear consensus management or prognostic algorithms exist. In this review, we discuss current definitions of high-risk cSCC, recommendations regarding the management of cSCC, and current guidelines.

Keywords: Clinical guidelines, High-risk, Oncology, Squamous cell carcinoma.

How to cite this article: Fitzgerald C, O'Neill JP. High-risk Cutaneous Squamous Cell Carcinoma. Int J Head Neck Surg 2017;8(2):37-44.

Source of support: Nil

Conflict of interest: None


REVIEW ARTICLE
Evangelia Katsoulakis, Natalya Chernichenko, David Schreiber

Proton Therapy in the Treatment of Head and Neck Cancer

[Year:2017] [Month:April-June] [Volumn:8 ] [Number:2] [Pages:51] [Pages No:45-48]



Aim: To examine the value of proton therapy in relation to other treatment modalities in head and neck cancer.

Review: Proton therapy has evolved into more sophisticated and costly intensity-modulated proton therapy and has resulted in even greater dose reduction to normal critical structures at risk as compared with photon therapy. Early clinical studies in head and neck cancers, especially for tumors of the skull base and paranasal sinuses, suggest that proton therapy is excellent in terms of local control and is comparable to intensity-modulated radiation therapy photons but with lower rates of morbidity.

Results: There are many potential advantages to radiation therapy with protons. While there are many single institution studies examining the added value of protons to photon therapy, the value of proton therapy must be examined in prospective randomized clinical studies and across many subsites of head and neck cancer. Additional evidence is necessary to guide efficient clinical practice, patient selection, and tumors that are most likely to benefit from this treatment modality and justify proton therapy use given its significant cost.

Keywords: Head and neck cancer, Proton therapy, Radiation therapy.

How to cite this article: Katsoulakis E, Chernichenko N, Schreiber D. Proton Therapy in the Treatment of Head and Neck Cancer. Int J Head Neck Surg 2017;8(2):45-48.

Source of support: Nil

Conflict of interest: None


REVIEW ARTICLE
Joshua D Smith, Kayte Spector-Bagdady, Andrew G Shuman

Head and Neck Cancer Research Ethics: A Primer.

[Year:2017] [Month:April-June] [Volumn:8 ] [Number:2] [Pages:51] [Pages No:49-56]



The rapidly evolving landscape of clinical research in head and neck cancer promises scientific discovery that will benefit patients and stand to improve the human condition for years to come. However, it is imperative that the head and neck oncology research community remains cognizant of the ethical conundrums posed by novel clinical investigation and respects and honors the primacy of the patients and participants upon whom such discoveries depend. It is as vital as ever to revisit the ethical debates of the past, the novel issues of the present, and potential ethical concerns of the future, to ensure research subject protection and respect evolves at the same pace as the research enterprise itself. Herein, we review the basic ethical principles required of human subjects research, the regulatory landscape, and selected emerging debates with relevant examples for head and neck providers and researchers.

Keywords: Clinical research, Head & neck cancer, IRBs, Research eithics.

How to cite this article: Smith JD, Spector-Bagdady K, Shuman AG. Head and Neck Cancer Research Ethics: A Primer. Int J Head Neck Surg 2017;8(2):49-56.

Source of support: Nil

Conflict of interest: None


REVIEW ARTICLE
Mina N Le, Erica Lee, Bhuvanesh Singh

The Evolution of Staging of Cutaneous Squamous, Cell Carcinomas: A Structured Review

[Year:2017] [Month:April-June] [Volumn:8 ] [Number:2] [Pages:51] [Pages No:57-63]



Among non-melanoma skin cancers, cutaneous squamous cell carcinoma entails the highest morbidity and mortality, and yet there is little guidance on how to identify the subset of cutaneous squamous cell carcinomas that behave aggressively. The staging of non-melanoma skin cancers is meant to provide this guidance, by dividing patients into groups for which survival differs between groups, is similar within each group, and consistently decreases with each increasing stage group. In the present review, we explore the history of how the staging of nonmelanoma skin cancers, focusing on cutaneous squamous cell carcinomas, has evolved over time. We describe the common criticisms leveled at the American Joint Committee on Cancer (AJCC) staging rubric. We discuss alternative staging systems that have recently been proposed, and how they have stood up to validation. Finally, we preview the AJCC staging changes that will go into effect next year and lay out some future directions for the improvement of skin cancer staging.

Keywords: Cutaneous squamous cell carcinoma, Non-melanoma skin cancer, Prognostic factors, TNM staging.

How to cite this article: Le MN, Lee E, Singh B. The Evolution of Staging of Cutaneous Squamous Cell Carcinomas: A Structured Review. Int J Head Neck Surg 2017;8(2):57-63.

Source of support: Nil

Conflict of interest: None


REVIEW ARTICLE
Christopher Thompson, Iain J Nixon

Our Understanding of Well-differentiated Thyroid Cancer

[Year:2017] [Month:April-June] [Volumn:8 ] [Number:2] [Pages:51] [Pages No:64-70]



Through significant contributions to our understanding of risk factors, prognostic indicators and management of welldifferentiated thyroid cancer (WDTC), Prof Jatin Shah has contributed much to the field of thyroid cancer in recent times. Many of the guidelines used in WDTC management today are a testament to his less-aggressive, dedicated and individualised approach. This article seeks to both review the current understanding of WDTC and to outline these contributions in a special issue dedicated to the career of Prof Shah.

Keywords: Lymph nodes, Risk stratification, Thyroidectomy, Well-differentiated thyroid cancer.

How to cite this article: Thompson C, Nixon IJ. Our Understanding of Well-differentiated Thyroid Cancer. Int J Head Neck Surg 2017;8(2):64-70.

Source of support: Nil

Conflict of interest: None


REVIEW ARTICLE
Natalya Chernichenko

Critical Update on Malignant Salivary Gland Neoplasms

[Year:2017] [Month:April-June] [Volumn:8 ] [Number:2] [Pages:51] [Pages No:71-75]



Salivary gland neoplasms are relatively rare tumors with a wide range of biologic behavior. Early low-grade malignancies could be adequately treated with surgery alone, while larger locally advanced tumors will require adjuvant radiation therapy. The role of chemotherapy remains palliative. The goal of this article is to provide a critical review of recent literature on diagnosis and management of salivary neoplasms.

Keywords: Head and neck cancer, Perineural invasion, Salivary neoplasm.

How to cite this article: Chernichenko N. Critical Update on Malignant Salivary Gland Neoplasms. Int J Head Neck Surg 2017;8(2):71-75.

Source of support: Nil

Conflict of interest: None


REVIEW ARTICLE
Volkert B Wreesmann

Role of Extracapsular Nodal Spread and Surgical Margin Status in defining High-risk Head and Neck Squamous Cell Carcinoma and its Treatment Intensity

[Year:2017] [Month:April-June] [Volumn:8 ] [Number:2] [Pages:51] [Pages No:76-83]



High-risk head and neck squamous cell carcinoma (HNSCC) includes an ill-defined collection of tumors that share an extremely poor outcome after seemingly appropriate multimodality treatment. Accumulating evidence suggests that extracapsular nodal spread and suboptimal surgical margins may be markers of high-risk HNSCC, but their utility is limited by ambiguous pathological criteria and unsatisfactory establishment of independent prognostic value. Inaccurate definition of high-risk HNSCC continues to obscure the scientific basis of treatment intensification protocols that have been proposed for high-risk HNSCC. Recent studies propose a more objective definition of clinically relevant extracapsular nodal spread (ECS) and surgical margins, which may contribute to improved staging and treatment selection.

Keywords: Extracapsular nodal spread, Head and neck squamous cell carcinoma, Margins, Outcome, Treatment.

How to cite this article: Wreesmann VB. Role of Extracapsular Nodal Spread and Surgical Margin Status in defining High-risk Head and Neck Squamous Cell Carcinoma and its Treatment Intensity. Int J Head Neck Surg 2017;8(2):76-83.

Source of support: Nil

Conflict of interest: None


LITERATURE REVIEW
Bahbak Shariat-Madar, Jeffrey C Liu

Role of Depth of Invasion in Evaluation and Management of Early-stage Oral Cavity Squamous Cell Carcinoma

[Year:2017] [Month:April-June] [Volumn:8 ] [Number:2] [Pages:51] [Pages No:84-88]



Aim: To evaluate the existing body of literature and impact of depth of invasion (DOI) in early-stage oral cavity squamous cell carcinoma (OCSCC) and its role in predicting occult cervical lymph node metastases.

Background: The prognosis for early-stage T1 to T2 disease OCSCC is relatively poor compared with other mucosal subsites within the head and neck. Primary tumor DOI can help prognosticate high-risk tumors for additional treatment.

Review results: There are unequivocal management implications in the literature demonstrating a role for elective neck dissection in early-stage OCSCC based on DOI. Following appropriate patient selection, there may be a role for sentinel lymph node biopsy in regional lymph node staging in earlystage OCSCC.

Conclusion: There are a multitude of studies demonstrating novel strategies to appropriately treat early-stage OCSCC, which are increasingly becoming standard of care. These strategies are altering the overall and disease-free survival of early-stage OCSCC. Despite advances, locoregional recurrence remains a challenge in this disease.

Clinical significance: Herein, the authors highlight a number of advances in the management of early-stage OCSCC as described in the literature, which are having an impact on disease-free and overall survival.

Keywords: Carcinoma, Cavity, Cell, Cervical, Depth, Invasion, Lymphatic, Metastases, Oral, Squamous.

How to cite this article: Shariat-Madar B, Liu JC. Role of Depth of Invasion in Evaluation and Management of Early-stage Oral Cavity Squamous Cell Carcinoma. Int J Head Neck Surg 2017;8(2):84-88.

Source of support: Nil

Conflict of interest: None


© JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD.