Details

Autor(en) / Beteiligte

• Fearington, Forrest W.
• Zhao, Conan Y.
• Romero-Brufau, Santiago
• Moore, Eric J.
• Price, Daniel L.
• Tasche, Kendall K.
• Yin, Linda X.
• Kunkel, Elizabeth T.
• Kisiel, John B.
• Giridhar, Karthik V.
• Routman, David M.
• Van Abel, Kathryn M.

Titel

Addressing positive multi-cancer early detection tests in head and neck Surgery: Experience with head and neck work up for high-risk referrals

Ist Teil von

• Oral oncology, 2024-05, Vol.152, p.106809-106809, Article 106809

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2024

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• •Commercial multi-cancer early detection (MCED) tests can detect head and neck cancers.•False-positive MCED tests are possible.•MCED cancer tissue of origin indicators may not be accurate.•Guidelines for positive head and neck MCED tests are needed. Blood-based multi-cancer early detection (MCED) tests are now commercially available. However, there are currently no consensus guidelines available for head and neck cancer (HNC) providers to direct work up or surveillance for patients with a positive MCED test. We seek to describe cases of patients with positive MCED tests suggesting HNC and provide insights for their evaluation. Retrospective chart review of patients referred to Otolaryngology with an MCED result suggesting HNC. Patients enrolled in prospective MCED clinical trials were excluded. Cancer diagnoses were confirmed via frozen-section pathology. Five patients were included (mean age: 69.2 years, range 50–87; 4 male) with MCED-identified-high-risk for HNC or lymphoma. Only patient was symptomatic. After physical exam and follow-up head and neck imaging, circulating tumor HPV DNA testing, two patients were diagnosed with p16 + oropharyngeal squamous cell carcinomas and underwent appropriate therapy. A third patient had no evidence of head and neck cancer but was diagnosed with sarcoma of the thigh. The remaining two patients had no evidence of malignancy after in-depth workup. In this retrospective study, 2 of 5 patients referred to Otolaryngology with a positive MCED result were diagnosed with HPV + oropharyngeal squamous cell carcinoma. We recommend that positive HNC MCED work up include thorough head and neck examination with flexible laryngoscopy and focused CT or MRI imaging. Given the potential for inaccurate MCED tissue of origin classification, PET/CT may be useful in specific situations. For a patient with no cancer identified, development of clear guidelines is warranted.