Submit to Special Issue Submit Abstract to Special Issue Review for JCM Propose a Special Issue

Journal Menu

Journal Browser

Diagnosis, Treatment and Prognosis of Head and Neck Cancer

Print Special Issue Flyer
Editors
Special Issue Information
Keywords
Benefits of Publishing in a Special Issue
Published Papers

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: 20 July 2026 | Viewed by 1982

Share This Special Issue

Editors

Dr. Armando De Virgilio

E-Mail Website
Guest Editor

Dipartimento di Organi di Senso, Sapienza Università di Roma, Rome, Italy
Interests: head and neck surgery; minimally invasive surgery; reconstructive surgery; head and neck oncology; robotic surgery
Special Issues, Collections and Topics in MDPI journals

Dr. Elena Russo

E-Mail Website
Guest Editor

Dipartimento di Organi di Senso, Sapienza Università di Roma, Rome, Italy
Interests: head and neck cancer; chronic rhinosinusitis; salivary gland tumors; squamous-cell carcinoma; robotic surgery

Special Issue Information

Dear Colleagues,

Head and neck cancer (HNC) comprises a biologically diverse group of malignancies, presenting complex diagnostic and therapeutic challenges. Recent advances in molecular profiling, imaging technologies, and minimally invasive surgical and therapeutic techniques are transforming the clinical landscape, allowing for more precise and personalized care. Early detection and accurate staging are critical to improving outcomes, while functional preservation and quality of life are increasingly prioritized treatment objectives. This Special Issue aims to showcase current evidence and emerging perspectives related to the diagnosis, treatment, and prognosis of HNC. In this Special Issue, original research articles and reviews are welcome. Topics of interest may include (but are not limited to) the following:

Innovations in surgical and non-surgical management;
Biomarkers for risk stratification and therapeutic response;
Strategies for surveillance and survivorship care.

Dr. Armando De Virgilio
Dr. Elena Russo
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 short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

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-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine 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 2600 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 neoplasms
surgical procedures
minimally invasive surgical procedures
radiotherapy
immunotherapy
biomarkers
treatment outcome
early diagnosis
prognosis
quality of life

Benefits of Publishing in a Special Issue

Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Research

Jump to: Review, Other

15 pages, 756 KB

Open AccessArticle

Automated Pretreatment Thoracic CT-Based Body Composition Analysis Predicts Progression-Free Survival in Head and Neck Cancer

by Frederic Jungbauer, Clara Arndt, Lena Huber, Anne Lammert, Nicole Rotter, Claudia Scherl, Elena Seiz, Farroch Vahidi Noghani, Stefan O. Schoenberg, Johannes Haubold, Sonja Ludwig, Annette Affolter, Fabian Tollens, Dominik Nörenberg and Johannes M. Ludwig

J. Clin. Med. 2026, 15(11), 4169; https://doi.org/10.3390/jcm15114169 - 28 May 2026

Viewed by 242

Abstract

Background/Objectives: To evaluate the prognostic significance of automated, volumetric body composition analysis (BCA) derived from pretreatment thoracic computed tomography (CT) scans in patients with head and neck cancer (HNC). Methods: We retrospectively assessed 160 patients (median age: 63 years; 26.9% women) undergoing primary treatment. BCA quantified various tissue volumes, including bone (B), skeletal muscle (SM), and subcutaneous adipose tissue (SAT). Optimal sex-specific cutoffs for BCA metrics were established via maximally selected log-rank tests. Internal validation of BCA cutoffs was conducted via bootstrap resampling. Kaplan–Meier survival analysis and Cox proportional hazards modeling were used to investigate progression-free survival (PFS). Results: The median PFS for all patients was 51.7 months (95% confidence interval (CI): 31.4–68.8). Among the continuous BCA parameters, only SM/B was significant across the total cohort (hazard ratio (HR): 0.23; 95%CI: 0.12–0.46; p < 0.0001, males (p = 0.0009), females (p = 0.004)). Internal validation of gender-specific cutoffs demonstrated strong-to-intermediate stability for SM/B across both sexes and for SAT/B in males. In contrast, SAT/B exhibited only weak stability among female participants. In univariate PFS analysis, dichotomized SM/B, SAT/B, Union for International Cancer Control (UICC) stage, Eastern Cooperative Oncology Group (ECOG) status, higher body mass index (BMI), normal albumin, and Charlson Comorbidity Index were identified as significant predictors of PFS. Multivariable analysis identified high SM/B (HR: 0.53; 95% CI: 0.3–0.93; p = 0.026) and high SAT/B (HR: 0.58; 95% CI: 0.35–0.95; p = 0.029) as independent prognostic factors, alongside lower UICC stage (p = 0.045) and lower Charlson Comorbidity Index (p = 0.038). Patients with high SM/B and SAT/B ratios had the longest median PFS (65.9 months, 95%CI: 51.7–.), compared to 36.4 months (95%CI: 19.4–.) for high SM/B or SAT/B and 12.6 months (95%CI: 4.2–25.1) for low SM/B and SAT/B (p < 0.0001). Conclusions: Although the BCA parameters SM/B and, to a lesser extent, SAT/B appear to be promising biomarkers, external validation and investigation within well-defined patient subgroups are warranted to establish their generalizability in clinical practice. Full article

(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Head and Neck Cancer)

► Show Figures

Figure 1

13 pages, 525 KB

Open AccessArticle

Monocyte-to-Lymphocyte Ratio as New Prognostic Factor in Patients with Medullary Thyroid Carcinoma

by Luca Canali, Francesca Gaino, Claudia Valenziano, Giulio Sandri, Alberto Paderno, Fabio Ferreli, Luca Malvezzi, Gherardo Mazziotti, Andrea Lania, Giuseppe Spriano and Giuseppe Mercante

J. Clin. Med. 2026, 15(6), 2363; https://doi.org/10.3390/jcm15062363 - 19 Mar 2026

Viewed by 524

Abstract

Objectives: Medullary thyroid carcinoma (MTC) is a rare but biologically aggressive neuroendocrine tumor for which reliable preoperative prognostic biomarkers are still lacking. This study aimed to evaluate the association between preoperative blood immunological markers and disease recurrence in patients with MTC undergoing curative surgery. Methods: We conducted a retrospective cohort study at a single tertiary academic center including 52 consecutive patients who underwent curative surgery for MTC between January 1999 and December 2023. The study size was determined by including all eligible consecutive patients meeting predefined inclusion/exclusion criteria within the study period. Preoperative inflammatory indices (MLR, NLR, PLR, SII, SIRI) were calculated from standardized complete blood count tests performed within 30 days before surgery. Disease-free survival (DFS) was calculated using the Kaplan–Meier method. Cox proportional hazards regression analysis with a backward stepwise selection based on the Akaike Information Criterion was used to identify independent predictors of recurrence, adjusting for potential confounders. Results: The mean age was 55.0 years (range 31–75), and 73% of patients were female. The ROC-derived cut-off for preCT was 181 pg/mL. Locally advanced disease (T3-T4) was observed in 12% of cases, and cervical node metastases in 27%. With a mean follow-up of 75.48 months, the 3- and 5-year DFS rates were 91% and 86%, respectively. On multivariable Cox regression, a high monocyte-to-lymphocyte ratio (MLR ≥0.37), positive surgical margins, and pathological nodal involvement remained independently associated with worse DFS after confounder adjustment (HR 9.73, 10.78, and 17.71, respectively). Conclusions: Elevated MLR, histological node metastases, and positive surgical margins independently predict recurrence in MTC after curative treatment. Preoperative MLR may represent a simple, inexpensive, and reproducible biomarker to improve preoperative risk stratification and personalize surgical and follow-up strategies: patients with MLR ≥0.37 may benefit from more aggressive management and/or closer follow-up. Full article

(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Head and Neck Cancer)

► Show Figures

Figure 1

Review

Jump to: Research, Other

25 pages, 3265 KB

Open AccessReview

Radiotherapy-Associated Pain in Head and Neck Cancer: From Clinical Burden to Neuroimmune Modulator

by Wenjun Meng, Ruiyue Li, Manting Wang, Zilin Yue, Haoran Zhang, Xueliang Sun and Qing Li

J. Clin. Med. 2026, 15(13), 5040; https://doi.org/10.3390/jcm15135040 (registering DOI) - 28 Jun 2026

Abstract

Radiotherapy-associated pain is among the most common and debilitating complications in head and neck cancer. Although historically viewed primarily as a treatment-related adverse effect, growing evidence suggests that pain is deeply intertwined with tumor biology, immune remodeling, and therapeutic outcomes. At the same time, recent advances in cancer neuroscience have identified sensory nerves as active components of the tumor microenvironment (TME), capable of influencing antitumor immunity through complex neuroimmune crosstalk. These observations raise the possibility that radiotherapy-associated pain is not merely a clinical symptom but also a biological indicator of dynamic changes within the tumor immune microenvironment (TIME). In this review, we outline the major clinical manifestations of radiotherapy-associated pain in head and neck cancer, including inflammatory or mucositis-related pain, neuropathic pain, and long-term chronic pain, with emphasis on their underlying biological features and potential therapeutic relevance. Given that oral mucositis is the dominant source of acute radiotherapy-associated pain in head and neck cancer, we further summarize evidence-based preventive and supportive strategies, including photobiomodulation, mucosal barrier-forming agents, anti-inflammatory mouthwashes, nutritional interventions, pain control, and multidisciplinary oral care. We further discuss how radiotherapy reshapes the TIME through mechanisms such as immunogenic cell death, activation of the cGAS-STING pathway, vascular and stromal remodeling, and regulation of lymphoid compartments, while also triggering compensatory immunosuppressive responses. Preclinical and translational studies suggest that nociceptive signaling pathways may modulate T-cell function, myeloid-cell activity, and immune-evasive programs. Through these neuroimmune interactions, radiotherapy-induced neural injury and persistent pain may contribute to the establishment of an immunosuppressive, wound-like microenvironment that ultimately affects treatment response and tumor progression. Finally, we discuss the translational significance of incorporating pain phenotyping into combined radiotherapy and immunotherapy strategies for head and neck cancer. Opioid-sparing multimodal analgesia, neuromodulation, and neuroimmune-targeted interventions may represent promising approaches to simultaneously improve symptom control and antitumor immunity. We propose that radiotherapy-associated pain may be considered a candidate neuroimmune phenotype rather than a passive adverse event, providing a new conceptual framework for precision management and translational research in head and neck cancer. Full article

(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Head and Neck Cancer)

► Show Figures

Graphical abstract

16 pages, 613 KB

Open AccessReview

Transoral Robotic Surgery for Elderly Patients with Oropharyngeal and Laryngeal Cancer: A Comprehensive Review

by Elena Russo, David Virós Porcuna, Philippe Gorphe, Vinidh Paleri, Raul Pellini, Andrea Costantino, Remo Accorona and Armando De Virgilio

J. Clin. Med. 2026, 15(4), 1586; https://doi.org/10.3390/jcm15041586 - 18 Feb 2026

Viewed by 600

Abstract

Background/Objectives: Head and neck squamous cell carcinoma (HNSCC) poses a significant health challenge, especially among elderly patients, who are often underrepresented in clinical trials. Transoral robotic surgery (TORS) has emerged as a promising alternative to non-surgical strategies such as chemoradiotherapy (CRT), but its effectiveness in older adults is not well-studied. Methods: A structured narrative review of studies on TORS for elderly HNSCC patients was conducted using the PubMed/MEDLINE database. Studies were selected according to predefined eligibility criteria based on the PICOS framework. PRISMA reporting principles were applied to document study identification and selection. Results: The available evidence suggests that, in carefully selected elderly patients, TORS is associated with disease-specific (DSS) and disease-free survival (DFS) outcomes comparable to those reported in younger cohorts, while overall survival (OS) appears more strongly influenced by comorbidities than chronological age. TORS may facilitate treatment de-escalation in selected cases, potentially reducing exposure to adjuvant therapies and limiting treatment-related toxicity. Functional outcomes, particularly swallowing function and long-term gastrostomy dependence, may be favorable in selected elderly patients; however, comparative data with non-surgical approaches remain limited, heterogeneous, and are partly derived from mixed-age cohorts. Conclusions: TORS represents a viable treatment option for selected elderly HNSCC patients, providing encouraging oncologic outcomes and potential functional advantages. Nevertheless, the current evidence base is predominantly retrospective and heterogeneous. Careful patient selection is essential, and further prospective elderly-specific studies are needed to better define functional and oncologic benefits. Full article

(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Head and Neck Cancer)

► Show Figures

Figure 1

Other

Jump to: Research, Review

16 pages, 28903 KB

Open AccessCase Report

An Aggressive Neoplasm with Mixed Epithelial and Sarcoma-like Features, of Uncertain Primary Origin, Presenting as an Upper Lip Mass: A Case Report

by Ha Eun Park and Chongsoo Park

J. Clin. Med. 2026, 15(11), 4331; https://doi.org/10.3390/jcm15114331 - 3 Jun 2026

Viewed by 220

Abstract

Carcinosarcoma is a rare and aggressive malignancy characterized by both epithelial and mesenchymal components. It most commonly arises in the uterus, lung, or gastrointestinal tract, whereas occurrence in the oral cavity is exceptionally rare. Here, we report a rare case of an aggressive neoplasm with mixed epithelial and sarcoma-like features that initially presented as a benign-appearing upper lip lesion. A 47-year-old male first presented in March 2025 with a painless upper lip mass that had persisted for two months. The lesion appeared clinically benign, and an excisional biopsy was performed. However, during surgery, intraoperative frozen section analysis revealed features highly suspicious for malignancy. Following surgery, systemic imaging demonstrated multiple hypermetabolic lesions in the lung, colon, liver, pancreas, adrenal glands, and lymph nodes. Biopsies from the lip, colon, and lung revealed a high-grade malignant tumor with variable epithelioid and sarcomatoid features across sampled sites. Immunohistochemistry showed co-expression of cytokeratin and vimentin, supporting mixed epithelial and sarcoma-like features. As no primary tumor was identified despite extensive work-up, the available findings favored an aggressive malignant neoplasm of uncertain primary origin with mixed epithelial and sarcoma-like features, although the final histologic sub-classification remained uncertain due to incomplete original pathology information. The patient subsequently received palliative systemic chemotherapy with an alectinib-based targeted regimen starting in April 2025, but showed progressive disease on follow-up, even with additional second-line gemcitabine/cisplatin and third-line pembrolizumab therapy. The patient ultimately succumbed in September 2025. This case highlights that even relatively subtle-appearing lesions require a high index of suspicion for malignancy, emphasizing the importance of early biopsy and comprehensive systemic evaluation. Carcinosarcoma, though rare, should be considered in the differential diagnosis of aggressive tumors arising in atypical locations. Full article

(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Head and Neck Cancer)

► Show Figures

Journal Menu

Journal Browser

Diagnosis, Treatment and Prognosis of Head and Neck Cancer

Share This Special Issue

Editors

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (5 papers)

Research

Review

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI