With the increasing proportion of human papilloma virus(HPV)infection in the pathogenic factors of oro-pharyngeal cancer,a series of changes have occurred in the surgical treatment.While the treatment mode has been im-proved,there are still many problems,including the inconsistency between diagnosis and treatment modes,the lack of popularization of reconstruction technology,the imperfect post-treatment rehabilitation system,and the lack of effective preventive measures.Especially in terms of treatment mode for early oropharyngeal cancer,there is no unified conclu-sion whether it is surgery alone or radiotherapy alone,and whether robotic minimally invasive surgery has better func-tional protection than radiotherapy.For advanced oropharyngeal cancer,there is greater controversy over the treatment mode.It is still unclear whether to adopt a non-surgical treatment mode of synchronous chemoradiotherapy or induction chemotherapy combined with synchronous chemoradiotherapy,or a treatment mode of surgery combined with postopera-tive chemoradiotherapy.In order to standardize the surgical treatment of oropharyngeal cancer in China and clarify the indications for surgical treatment of oropharyngeal cancer,this expert consensus,based on the characteristics and treat-ment status of oropharyngeal cancer in China and combined with the international latest theories and practices,forms consensus opinions in multiple aspects of preoperative evaluation,surgical indication determination,primary tumor re-section,neck lymph node dissection,postoperative defect repair,postoperative complication management prognosis and follow-up of oropharyngeal cancer patients.The key points include:① Before the treatment of oropharyngeal cancer,the expression of P16 protein should be detected to clarify HPV status;② Perform enhanced magnetic resonance imaging of the maxillofacial region before surgery to evaluate the invasion of oropharyngeal cancer and guide precise surgical resec-tion of oropharyngeal cancer.Evaluating mouth opening and airway status is crucial for surgical approach decisions and postoperative risk prediction;③ For oropharyngeal cancer patients who have to undergo major surgery and cannot eat for one to two months,it is recommended to undergo percutaneous endoscopic gastrostomy before surgery to effectively improve their nutritional intake during treatment;④ Early-stage oropharyngeal cancer patients may opt for either sur-gery alone or radiation therapy alone.For intermediate and advanced stages,HPV-related oropharyngeal cancer general-ly prioritizes radiation therapy,with concurrent chemotherapy considered based on tumor staging.Surgical treatment is recommended as the first choice for HPV unrelated oropharyngeal squamous cell carcinoma(including primary and re-current)and recurrent HPV related oropharyngeal squamous cell carcinoma after radiotherapy and chemotherapy;⑤ For primary exogenous T1-2 oropharyngeal cancer,direct surgery through the oral approach or da Vinci robotic sur-gery is preferred.For T3-4 patients with advanced oropharyngeal cancer,it is recommended to use temporary mandibu-lectomy approach and lateral pharyngotomy approach for surgery as appropriate;⑥ For cT1-2N0 oropharyngeal cancer patients with tumor invasion depth＞3 mm and cT3-4N0 HPV unrelated oropharyngeal cancer patients,selective neck dissection of levels ⅠB to Ⅳ is recommended.For cN+HPV unrelated oropharyngeal cancer patients,therapeutic neck dissection in regions Ⅰ-Ⅴ is advised;⑦ If PET-CT scan at 12 or more weeks after completion of radiation shows intense FDG uptake in any node,or imaging suggests continuous enlargement of lymph nodes,the patient should undergo neck dissection;⑧ For patients with suspected extracapsular invasion preoperatively,lymph node dissection should include removal of surrounding muscle and adipose connective tissue;⑨ The reconstruction of oropharyngeal cancer defects should follow the principle of reconstruction steps,with priority given to adjacent flaps,followed by distal pedicled flaps,and finally free flaps.The anterolateral thigh flap with abundant tissue can be used as the preferred flap for large-scale postoperative defects.

Objective·To explore the expression of sorting nexin 1(SNX1)in colorectal cancer(CRC)and its impact on the proliferation and migration of CRC cells.Methods·Transcriptomic data and clinical pathological information of CRC were obtained from The Cancer Genome Atlas(TCGA),Genotype-Tissue Expression(GTEx),and Gene Expression Omnibus(GEO)databases for enrichment analysis with Gene Set Enrichment Analysis(GSEA)software.The expression of SNX1 in CRC tissues and cells was detected by quantitative real-time polymerase chain reaction(qPCR),Western blotting,and immunohistochemistry staining(IHC).Small interfering RNA(siRNA)was used to knock down the expression of SNX1 to observe its effect on tumor cell proliferation and migration.Correlation analysis was conducted to explore the potential molecular mechanisms underlying SNX1-mediated CRC cell migration,and mRNA level validation was performed in SNX1 knockdown cell lines.Results·Analysis of CRC patients data in TCGA and tissue microarrays revealed that SNX1 expression was downregulated in CRC tissues and correlated with tumor diameter and distant metastasis.Knockdown of SNX1 enhanced tumor cell proliferation and migration.The expression of SNX1 was negatively correlated with metastasis associated in colon cancer 1(MACC1),mesenchymal to epithelial transition factor(MET),and Notch;knockdown of SNX1 led to upregulation of these genes.Silencing SNX1 resulted in the downregulation of the epithelial marker cadherin 1(CDH1)and the upregulation of vimentin(VIM)and Snail family transcriptional repressor 1(SNAI1).Conclusion·SNX1 expression was significantly downregulated in CRC tissues and correlated with patient prognosis.Low expression of SNX1 enhanced the proliferation and migration of CRC cells and was associated with the MACC1-MET pathway and EMT.SNX1 may serve as a potential biomarker for poor prognosis and a novel therapeutic target in CRC.

Objective:To compare the efficacy and safety of low-dose and standard-dose radiotherapy (LD-RT vs. SD-RT) in the treatment of oropharyngeal cancer patients with positive human papillomavirus (HPV). Methods:All comparative studies of low-dose versus standard-dose radiotherapy in the treatment of HPV-positive oropharyngeal cancer were searched from PubMed, Web of Science, Cochrane Library, EMbase, Chinese Biomedical Literature Database (CBM), CNKI, Chongqing VIP, and Wanfang databases from January 1, 2000 to February 9, 2023. According to the inclusion and exclusion criteria, the data were strictly screened, and the RevMan 5.4 software was used for meta-analysis.Results:A total of 8 studies were included. The pooled results showed that the overall survival (OS) and progression-free survival (PFS) of patients in the LD-RT group were similar to those in the SD-RT group ( HR=0.83, 95% CI=0.59-1.18, P=0.31; HR=0.97, 95% CI=0.53-1.78, P=0.92), but the rate of percutaneous endoscopic gastrostomy (PEG) insertion was significantly reduced ( RR=0.45, 95% CI=0.28-0.72, P=0.001). Conclusion:LD-RT yields similar efficacy and lower rate of PEG insertion compared with SD-RT in HPV-positive oropharyngeal neoplasm patients.

As the primary surgical procedure of treating and preventing cervical lymph node metastasis in head and neck cancers, neck dissection (ND) have increasingly becoming standardized and reasonable since the past hundred years. However, the preoperative uncertainty of cervical lymph node metastasis for patient with head neck cancer, whether perform ND and the dissection region often confuse the surgeons. Provide a currently standardized ND operation manner according to the metastatic characteristics and operative wound degree as a reference to surgeons may facilitate the therapeutic and prevent effects on patients with head and neck cancer.

As the primary surgical procedure of treating and preventing cervical lymph node metastasis in head and neck cancers, neck dissection (ND) have increasingly becoming standardized and reasonable since the past hundred years. However, the preoperative uncertainty of cervical lymph node metastasis for patient with head neck cancer, whether perform ND and the dissection region often confuse the surgeons. Provide a currently standardized ND operation manner according to the metastatic characteristics and operative wound degree as a reference to surgeons may facilitate the therapeutic and prevent effects on patients with head and neck cancer.

Objective: Meta-analysis was used to compare the long-term efficacy and laryngeal function preservation rate of patients with advanced hypopharyngeal cancer treated with surgery plus radio(chemo)therapy (SRT) or non-surgery chemoradiotherapy (CRT). Methods: We searched publicly published articles on case-control studies of surgical and non-surgical comprehensive treatment of advanced hypopharyngeal cancer in PubMed, the Cochrane Library, Wanfang Database, Chinese Journal Full-text Database, and Chinese Science and Technology Periodical Database. The search language was limited to Chinese and English, and the period was from 1990 to 2018. These literatures were rigorously screened by inclusion and exclusion criteria. The data needed for this study were extracted and the Meta analysis was performed using RevMan 5.3 software. Results: A total of 13 literatures were included, and the overall quality of the literature was relatively high, and no significant publication bias was suggested. A total of 1 994 subjects, including 720 in the SRT group and 1 274 in the CRT group. The average 3-year overall survival rates were 42.9% in SRT group and 44.8% in CRT group,with no significant difference (OR=1.14, 95%CI: 0.62-2.06, P=0.68). The average 5-year overall survival rate (OR=1.42, 95%CI: 1.10-1.84, P<0.01), 5-year local recurrence-free survival rate (OR=1.68, 95%CI: 1.11-2.55, P=0.01) and 5-year local control rate (OR=2.17, 95%CI: 1.52-3.12, P<0.01) of SRT group were 46.4%, 47.4% and 71.2%, respectively, which were higher than those of non-surgical group (37.9%, 32.0%, and 52.2% respectively). The average laryngeal function preservation rate was 19.8%,being significantly lower than 80.6% of the non-surgical group(OR=0.03, 95%CI: 0.01-0.07, P<0.01). Conclusions SRT has better long-term efficacy, while CRT has better preservation of laryngeal function.

Surgical margin principle is one of the central surgical principles for head and neck cancers. Negative surgical margin is the primary purpose of surgery for head and neck cancers. This paper is based on the current clinical application of surgical margins of head and neck cancers, and it is proposed that surgical margins of head and neck cancers may be classified into three types: surface margin, deep margin, and tissue interface margin in consideration of surgical exposure of tumors. The classification of surgical margins can make the clinical application and the research of surgical margins of head and neck cancers more systematic and clear.

OBJECTIVETo investigate the effects of -260C>T and -651C>T genetic variants in the promoter region of CD14 on the susceptibility to laryngeal cancer.

METHODSA total of 163 patients with laryngeal cancer and 326 healthy subjects as controls were included. Genotypes of CD14 -260C>T (rs2569190) and -651C>T (rs5744455) variants were determined by polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP). Odd ratios (OR) and 95% confidence intervals (95%CI) were calculated with logistic regression analysis.

RESULTSCompared with CD14 -651CC genotype carriers, -651TT genotype carriers had the increased risk of laryngeal cancer with the OR (95%CI) of 5.79 (2.38-14.11). When the -651TT genotype carriers were stratified by smoking status, the OR (95%CI) for laryngeal cancer was 8.64 (1.88-39.77) in nonsmokers and 4.74 (1.69-13.25) in smokers; the OR (95%CI) was 5.40 (1.10-26.45) in the light smokers and 4.30 (1.10-16.75) in the hevey smokers. When the -651TT genotype carriers were stratified by drinking status, the OR (95%CI) for laryngeal cancer was 6.48 (2.81-14.95) in nondrinkers and 2.01 (0.65-6.26) in drinkers. There was no significant difference in CD14 -260C>T genotype distribution between patients and controls.

CONCLUSIONPolymorphisms of -651C>T in CD14 promoter contribute to the susceptibility to laryngeal cancer in Chinese population.

Asian Continental Ancestry Group ; Case-Control Studies ; Genetic Predisposition to Disease ; Genotype ; Humans ; Laryngeal Neoplasms ; genetics ; Lipopolysaccharide Receptors ; genetics ; Odds Ratio ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic

To report one case of postoperative reconstruction of facial squamous cell carcinoma by cervicotho-racic flap and temporal flap in our hospital. Clinical symptoms of the patient are facial mass and tumor ulceration.The patient had chronic bronchitis. On admission, the right side of the patient face was found to have a mass of about 6. 5 cm X 5. 0 cm, and the middle is about 2. 5 cm X 2. 5 cm X 1. 0cm ulcer, the neck has no swollen lymphnodes by palpation. After imaging and pathological examination,the patient was diagnosed as right facial squamouscell carcinoma and chronic bronchitis.
Carcinoma, Squamous Cell ; surgery ; Face ; pathology ; surgery ; Humans ; Postoperative Period ; Reconstructive Surgical Procedures ; Surgical Flaps