30-Second Takeaway
- Machine-learning risk models may refine adjuvant therapy decisions after oral cavity cancer surgery.
- Proton therapy reduces pharyngeal constrictor dose and early weight loss in nasopharyngeal cancer without clear QoL gain at one year.
- Single-stage TLM can safely diagnose and treat selected early glottic lesions, despite frequent biopsy underdiagnosis.
- Serum Aspergillus IgG aids staging and treatment monitoring in chronic invasive Aspergillus rhinosinusitis.
- Routine confirmatory HPV mRNA testing adds little to p16 in surgically treated oropharyngeal cancer and can misclassify cases.
Week ending March 7, 2026
Targeted therapy, risk stratification, and functional outcomes in contemporary head and neck practice
DeepSurv-based risk groups identify who benefits from adjuvant therapy in oral cavity SCC
Using 35,625 NCDB oral cavity SCC cases, DeepSurv achieved a C-index of 0.73 for postoperative survival prediction. The model defined low-, intermediate-, and high-risk groups with 5-year OS of 77.6%, 53.0%, and 29.3%, respectively. In low-risk patients, adjuvant RT or CRT did not improve overall survival versus surgery alone. In intermediate- and high-risk groups, both adjuvant RT and CRT significantly improved survival, with CRT providing modest additional benefit over RT. Key prognostic features included pT4a stage, age ≥70 years, and extranodal extension, supporting intensified adjuvant therapy for higher-risk strata.
IMPT lowers constrictor doses and early weight loss in nasopharyngeal cancer
Among 104 nasopharyngeal carcinoma patients receiving chemoradiotherapy, IMPT reduced mean doses to oral cavity and mid/inferior pharyngeal constrictors versus VMAT. IMPT patients had less acute weight loss and lower odds of >10% loss at end of radiotherapy. Despite dosimetric advantages, MDADI swallowing-related quality-of-life scores at one year did not differ between IMPT and VMAT. Higher superior constrictor dose consistently correlated with worse MDADI scores, while mid-constrictor dose related to acute swallowing decline. These data support prioritizing pharyngeal constrictor sparing, particularly the superior constrictor, when planning NPC radiotherapy.
Single-stage TLM safely replaces biopsy-plus-TLM for many early glottic lesions
In 128 patients with early glottic cancer, CIS, or severe dysplasia, outcomes were compared between single-stage and two-stage TLM approaches. Biopsy underestimated final pathology in 25% of two-stage patients, and overall biopsy–TLM pathology discordance reached 33%. Single-stage TLM patients were older, had smaller T stages, and received smaller cordectomies. Five-year overall survival, local control, margin status, and repeat TLM rates were similar between strategies. Carefully selected patients with limited lesions may undergo single-stage TLM, avoiding a potentially misleading initial biopsy.
Global review clarifies subtype patterns and outcomes in fungal rhinosinusitis
This meta-analysis pooled 40,860 fungal rhinosinusitis cases from 77 countries across seven subtypes. Non-invasive disease comprised 60% of cases, mainly fungal ball and allergic fungal rhinosinusitis, with high surgical cure rates. Invasive forms clustered in tropical climates, with hyperacute rhino-orbito-cerebral mucormycosis predominating and causing major morbidity and mortality. Aspergillus species were identified in about 60% of cases, with A. fumigatus common in temperate climates and A. flavus in dry/tropical regions. The climatic and geographic preferences of subtypes and species support climate-informed diagnostic and surveillance strategies.
References
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Additional Reads
Optional additional studies from this edition.