Dartmouth Atlas Takes Aim at Excess Utilization of Medical Resources

Researchers from Henry Ford Hospital in Detroit, led by Seema Sethi, MD, took saliva samples from 27 patients with HNSCC and 10 healthy controls. They analyzed DNA from the saliva with a multiplex ligation-dependent probe amplification assay and examined 82 genes with known associations to HNSCC.

They found that 11 genes showed a high individual predictive ability for HNSCC. In particular, the researchers found that an increase in PMAIP1, a tumor suppression gene on chromosome 18, either alone or with an increase in PTPN1, an oncogene on chromosome 20, identified all subjects with HNSCC with 100% sensitivity and 100% specificity. Further validation results showed a sensitivity of 96% and a specificity of 90%.

Dr. Sethi emphasized that the results of the study are preliminary, but she hopes that this could lead to HNSCC detection at its earliest stage. HNSCC affects more than 40,000 Americans, and approximately 12,000 die of it annually.

Scalp/Neck Melanomas Seem More Lethal than Other Melanomas

People with scalp or neck melanomas die at nearly twice the rate of people with melanoma elsewhere on the body, including the face and ears, according to a study in the April issue of the Archives of Dermatology.

Researchers from the University of North Carolina at Chapel Hill, led by Anne Lachiewicz, a student in the School of Medicine, and Nancy Thomas, MD, PhD, Associate Professor of Dermatology and a member of the Lineberger Comprehensive Cancer Center, analyzed 51,704 melanoma cases in the United States. They used data from 13 National Cancer Institute Surveillance Epidemiology and End Results (SEER) registries in nine states.

The researchers found that individuals with scalp or neck melanomas die at a rate 1.84 times higher than those with melanomas on the extremities, after controlling for age, gender, tumor thickness, and ulceration. The five-year melanoma-specific survival rate for patients with scalp or neck melanoma was 83%, compared with 92% for patients with melanomas at other sites. The 10-year survival rate was 76% for scalp or neck melanomas, compared with 89% for other melanomas.

Laryngoscope Highlights

Conservative Strategy for Management of Vestibular Schwannoma

Surgery has traditionally been the treatment of choice for vestibular schwannoma (VS), with the goal being complete removal of the tumor and, where possible, preserving hearing and facial nerve integrity. However, because the surgery is highly challenging and the tumors tend to grow very slowly, conservative management of VS is being proposed more frequently today as a primary therapeutic option. Gian Gaetano Ferri, MD, and associates found that in 47 nonsurgically treated patients, no growth at all was observed in 30 patients during the entire follow-up period. This report is an update on their experience, with a larger group of patients and a longer follow-up period.