Otolaryngology (ENT)

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. 1

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. 2

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. 3

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. 4