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Cancers
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Emerging Technologies in Head and Neck Cancer Surgery
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Emerging Technologies in Head and Neck Cancer Surgery

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: closed (31 July 2024) | Viewed by 4730

Special Issue Editors

Dr. Filippo Marchi

E-Mail Website
Guest Editor
Department of Internal Medicine and Medical Specialties, University of Genova, 16100 Genova, Italy
Interests: head and neck surgery
Dr. Vittorio Rampinelli

E-Mail Website
Guest Editor
Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
Interests: head and neck cancer
Dr. Pierluigi Bonomo

E-Mail Website
Guest Editor
Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Interests: head and neck cancer; gastrointestinal cancer; radiotherapy; supportive care

Special Issue Information

Dear Colleagues,

This Special Issue focuses on the advent of new technologies in the field of head and neck surgery. The quest for uniform protocols has remained a persistent focus in head and neck surgery. However, individualization has surfaced as an option for tailoring standardized protocols to each individual patient. This adaptability in treatments has long been a staple in medical disciplines and, in recent years, has found its way into surgery.

Recently, innovative tools have been emerging for preoperative and surgical management of head and neck oncologic patients and have contributed to fewer complications and improved surgical accuracy, bringing therapeutic personalization into our routine clinical and surgical practice.

We are pleased to invite you to submit your work to enrich the panorama of cutting-edge advancements. Therefore, in this Special Issue we welcome papers outlining how innovative technologies and novel applications may improve the diagnostic and therapeutic planning for head and neck patients.

Original research articles and reviews are welcome. Research areas may include, but are not limited, to the following fields of interest: innovation in robotic-assisted surgery, minimally invasive endoscopic/microscopic/exoscopic surgery,  virtual surgical planning, the use of artificial intelligence, videomics and radiomics during pre-operative diagnosis, 3D-printed devices, tissue engineering, computer-aided designing, dynamic navigation, high-definition ultrasound, bioendoscopy and novel immunohistochemical markers in pre-operative and definitive diagnosis.

We look forward to receiving your contributions.

Dr. Filippo Marchi
Dr. Vittorio Rampinelli
Dr. Pierluigi Bonomo
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 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. Cancers is an international peer-reviewed open access semimonthly 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 2900 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
  • robotics
  • 3D printing
  • computer-assisted surgery
  • virtual surgical planning
  • videomics
  • radiomics
  • artificial intelligence
  • early detection
  • minimally invasive surgery

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Published Papers (4 papers)

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Research

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11 pages, 373 KiB  
Article
Temporal Variability in the Incidence and Risk Factors for Pharyngocutaneous Fistula Development after Total Laryngectomy
by Robert Šifrer, Maja Dolenc, Sara Bitenc Zore, Simon Fugina, Luka Jesenko and Primož Strojan
Cancers 2024, 16(20), 3486; https://doi.org/10.3390/cancers16203486 - 15 Oct 2024
Viewed by 484
Abstract
Background: This study aimed to analyse the variability in the incidence of the pharyngocutaneous fistula (PCF), the most common complication following a total laryngectomy (TLE), and to identify the underlying causes for fluctuations in incidence rates. Methods: In the retrospective study, the annual [...] Read more.
Background: This study aimed to analyse the variability in the incidence of the pharyngocutaneous fistula (PCF), the most common complication following a total laryngectomy (TLE), and to identify the underlying causes for fluctuations in incidence rates. Methods: In the retrospective study, the annual PCF incidence data and comprehensive clinicopathologic data from 540 patients who underwent TLE between January 2004 and December 2022 were reviewed. Distinct peri ods of both high and low PCF incidence were identified. Within these periods, patients were categorized into groups with PCF (study groups) and without it (control groups). These groups were statistically compared based on potential risk factors for PCF development. The high-incidence periods were specially analysed for recurring risk factors and the corresponding corrective measures were reviewed. Results: The analysis revealed four high-incidence periods with an overall PCF incidence of 37.61%, along with three low-incidence periods in between with an overall incidence of 19.38%. Surgical wound infection (SWI) and a history of head and neck cancer alongside their related treatments were repeatedly identified as independent risk factors during high-incidence periods, with SWI being the most consistent predictor of PCF development. Conclusions: Continuous monitoring of PCF incidence is crucial, as it allows for the identification of emerging risk factors and the immediate implementation of corrective measures to mitigate these newly identified risk factors. Full article
(This article belongs to the Special Issue Emerging Technologies in Head and Neck Cancer Surgery)
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15 pages, 1840 KiB  
Article
Transoral Robotic Surgery for Oral Cancer: Evaluating Surgical Outcomes in the Presence of Trismus
by Ting-Shen Lin, Ci-Wen Luo, Tsai-Ling Hsieh, Frank Cheau-Feng Lin and Stella Chin-Shaw Tsai
Cancers 2024, 16(6), 1111; https://doi.org/10.3390/cancers16061111 - 10 Mar 2024
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Abstract
Trismus, defined as restricted mouth opening, is a common complication among Taiwanese oral cancer patients, especially those who chew betel quid. However, the impact of trismus on survival outcomes in oral cancer patients undergoing transoral robotic surgery (TORS) is unclear. This study aimed [...] Read more.
Trismus, defined as restricted mouth opening, is a common complication among Taiwanese oral cancer patients, especially those who chew betel quid. However, the impact of trismus on survival outcomes in oral cancer patients undergoing transoral robotic surgery (TORS) is unclear. This study aimed to investigate the associations between trismus and surgical outcomes in Taiwanese male oral cancer patients treated with TORS. We conducted a retrospective propensity score-matched cohort study of 40 Taiwanese male oral cancer patients who underwent TORS between 2016 and 2022. Overall, 20 patients with trismus were matched to 20 patients without trismus. TORS achieved similar operative and short-term clinical outcomes in trismus patients to non-trismus patients. There were no significant differences between groups in operation time, blood loss, margin status, flap reconstruction rates, duration of nasogastric tube feeding, or length of hospital stay. Kaplan–Meier and Cox proportional hazard regression analyses were performed to compare overall survival (OS) and disease-free survival (DFS) between the two groups. The overall survival (OS) rate at three years was significantly lower in patients with trismus than those without trismus (27.1% vs. 95.0%, log-rank p = 0.02). However, there was no significant difference in disease-free survival (DFS) rates between the trismus and non-trismus groups (36.6% vs. 62.7%, log-rank p = 0.87). After adjusting for confounders, trismus was independently associated with a 13-fold increased risk of mortality (adjusted HR 12.87, 95% CI 1.55–106.50, p < 0.05). In conclusion, trismus appears to be an independent prognostic factor for reduced long-term OS in Taiwanese male oral cancer patients undergoing TORS, though short-term surgical outcomes were non-inferior in the trismus patients. Further research is warranted to clarify the mechanisms linking trismus and survival in this population. Full article
(This article belongs to the Special Issue Emerging Technologies in Head and Neck Cancer Surgery)
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13 pages, 4235 KiB  
Article
Scalp Irradiation with 3D-Milled Bolus: Initial Dosimetric and Clinical Experience
by Khaled Dibs, Emile Gogineni, Sachin M. Jhawar, Sujith Baliga, John C. Grecula, Darrion L. Mitchell, Joshua Palmer, Karl Haglund, Therese Youssef Andraos, Wesley Zoller, Ashlee Ewing, Marcelo Bonomi, Priyanka Bhateja, Gabriel Tinoco, David Liebner, James W. Rocco, Matthew Old, Mauricio E. Gamez, Arnab Chakravarti, David J. Konieczkowski and Dukagjin M. Blakajadd Show full author list remove Hide full author list
Cancers 2024, 16(4), 688; https://doi.org/10.3390/cancers16040688 - 6 Feb 2024
Cited by 1 | Viewed by 1186
Abstract
Background and purpose: A bolus is required when treating scalp lesions with photon radiation therapy. Traditional bolus materials face several issues, including air gaps and setup difficulty due to irregular, convex scalp geometry. A 3D-milled bolus is custom-formed to match individual patient anatomy, [...] Read more.
Background and purpose: A bolus is required when treating scalp lesions with photon radiation therapy. Traditional bolus materials face several issues, including air gaps and setup difficulty due to irregular, convex scalp geometry. A 3D-milled bolus is custom-formed to match individual patient anatomy, allowing improved dose coverage and homogeneity. Here, we describe the creation process of a 3D-milled bolus and report the outcomes for patients with scalp malignancies treated with Volumetric Modulated Arc Therapy (VMAT) utilizing a 3D-milled bolus. Materials and methods: Twenty-two patients treated from 2016 to 2022 using a 3D-milled bolus and VMAT were included. Histologies included squamous cell carcinoma (n = 14, 64%) and angiosarcoma (n = 8, 36%). A total of 7 (32%) patients were treated in the intact and 15 (68%) in the postoperative setting. The median prescription dose was 66.0 Gy (range: 60.0–69.96). Results: The target included the entire scalp for 8 (36%) patients; in the remaining 14 (64%), the median ratio of planning target volume to scalp volume was 35% (range: 25–90%). The median dose homogeneity index was 1.07 (range: 1.03–1.15). Six (27%) patients experienced acute grade 3 dermatitis and one (5%) patient experienced late grade 3 skin ulceration. With a median follow-up of 21.4 months (range: 4.0–75.4), the 18-month rates of locoregional control and overall survival were 75% and 79%, respectively. Conclusions: To our knowledge, this is the first study to report the clinical outcomes for patients with scalp malignancies treated with the combination of VMAT and a 3D-milled bolus. This technique resulted in favorable clinical outcomes and an acceptable toxicity profile in comparison with historic controls and warrants further investigation in a larger prospective study. Full article
(This article belongs to the Special Issue Emerging Technologies in Head and Neck Cancer Surgery)
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Review

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17 pages, 1242 KiB  
Review
Open-Face Masks in Radiotherapy: Enhancing Therapeutic Strategies for Head and Neck and Brain Cancer Patients—A Comprehensive Scoping Review
by Andrea Lastrucci, Ilaria Morelli, Claudio Votta, Irene Maran, Nicola Iosca, Ilaria Pia Monaco, Viola Salvestrini, Isacco Desideri, Livia Marrazzo, Yannick Wandael, Patrizia Cornacchione, Stefania Pallotta, Daniele Giansanti, Renzo Ricci, Lorenzo Livi and Pierluigi Bonomo
Cancers 2024, 16(16), 2899; https://doi.org/10.3390/cancers16162899 - 21 Aug 2024
Viewed by 1251
Abstract
Introduction: The main goal of radiotherapy (RT) is to deliver a precise dose to the target while sparing the surrounding normal tissue and minimizing side effects. Appropriate patient immobilization is crucial, especially for head and neck cancer (HNC) and Brain Cancer (BC). [...] Read more.
Introduction: The main goal of radiotherapy (RT) is to deliver a precise dose to the target while sparing the surrounding normal tissue and minimizing side effects. Appropriate patient immobilization is crucial, especially for head and neck cancer (HNC) and Brain Cancer (BC). Conventional closed-face masks (CFMs), while effective in minimizing head motion, can cause significant discomfort, anxiety, and claustrophobia. Open-face masks (OFMs) have been developed to increase patient comfort while providing precise immobilization. Methods: Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) extension for scoping reviews and the Arskey and O’Malley framework, an electronic search of EMBASE, PubMed, SCOPUS, and Web of Science was conducted to identify original studies reporting the use and description of OFMs in clinical practice up to April 2024. The inclusion criteria were English-language articles focusing on OFMs for HNC and BC patients undergoing RT. Results: Of 618 titles, 19 articles fulfilled the selection criteria. Most studies were comparative (n = 13) or observational (n = 6). The articles were categorized by treatment site, resulting in three groups: BC (n = 14, 68.4%), HNC (n = 4, 21.4%), and mixed (n = 2, 10.5%), which includes both BC and HNC. Of note, 82.4% (n = 16) of the included studies were published from 2020 onwards, emphasizing the recent adoption of OFM in clinical practice. Conclusions: The reviewed studies show that OFMs, in combination with SGRT, offer significant advantages in terms of patient comfort and positioning accuracy in HNC and BC treatments. Reproducibility in the sub-millimeter and sub-degree range can be achieved, which supports the use of OFMs in clinical practice. Future research should explore innovative combinations of immobilization and monitoring to further improve RT outcomes and ensure precise treatment while increasing patient comfort. Full article
(This article belongs to the Special Issue Emerging Technologies in Head and Neck Cancer Surgery)
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