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Introduction: Samples classified as indeterminate correspond to 10-20% of cytologies obtained by fine needle biopsy of thyroid nodules, preventing an adequate distinction between benign and malignant lesions and leading to diagnostic thyroidectomies that often prove unnecessary, as most cases are benign. Furthermore, although the vastmajority of patients with differentiated thyroid cancer (DTC) have such a good prognosis that active surveillance is permitted as an initial therapeutic option, relapses are not rare, and a non-negligible number of patients experience poor outcomes. MicroRNAs(miR)emergeaspotentialbio markers capable of helping to define more precise management of patients in all these situations. Methods: Aiming to investigate the clinical utility of miR-146b-5p in the diagnostic of thyroid nodules and evaluating its prognostic potential in a realworld setting, we studied 89 thyroid nodule samples, correlating miR-146b-5p expression with clinical tools such as the 8th edition from the American Joint Committee on Cancer (AJCC/UICC) and the American Thyroid Association Guideline Stratification Systems for the rate of recurrence (RR). Results: miR-146b-5p expression levels distinguished benign from malignant thyroid FNA samples (p< 0.0001). For indeterminate nodules, overexpression of miR-146b-5p with a cut-off of 0.497 was able to diagnose malignancy with a 90% accuracy; specificity=87.5%; sensitivity=100%. An increased expression of miR-146b-5p was associated with greater RR (p=0.015). A cut-off of 2.21 identified cases with more vascular involvement (p=0.013) and a cut-off of 2.420 was associated with a more advanced TNM stage (p-value=0.047). Discussion: We demonstrated that miR-146b5p expression in FNA samples is able to differentiate benign frommalignant indeterminate nodules and is associatedwith an increased risk of recurrence andmortality, suggesting that this single miRNAmay be a useful diagnostic and prognostic marker in the personalized management of DTC patients. [ABSTRACT FROM AUTHOR]

Introduction: Head and neck cancer is a highly relevant public health issue due to its high incidence and mortality rates. According to the National Cancer Institute (INCA) estimates for 2023, Brazil sees 15,100 cases of oral cavity cancer and 7,790 cases of laryngeal cancer, making these the fifth most frequent cancers in the country.(1) Among men, oral cavity cancer is the fifth most common, and laryngeal cancer is the eighth.(1) Notably, around 75% of these cases are diagnosed at advanced stages, complicating treatment and reducing survival rates. Early-stage diagnosis offers high cure rates, up to 80% for mouth cancer, (2) and disease-specific survival rates of over 90% and 80% for laryngeal cancer at stages I and II, respectively.(3) Objective: Understanding the demographic profile of patients with head and neck cancer is crucial for formulating effectiv e health policies, resource planning, and developing prevention and treatment strategies. Methods: This prospective study was conducted with data from 1,325 patients diagnosed with Head and Neck Squamous Cell Carcinoma (HNSCC). Data were collected at the outpatient clinic of a public tertiary hospital in São Paulo-SP, from an initial sample of 3,311 patients. The data collection included demographic information, medical history, lifestyle habits, tumor staging at diagnosis, and treatments administered. Results: Analysis of these data revealed that the mean age of the patients was 62.44 years (standard deviation of 12.77). The gender distribution was predominantly male (963, 73.6%), with females representing 26.1% (342). Regarding race, 49.9% (639) were white, 36.2% (464) mixed-race, 13.1% (168) black, 0.6% (8) yellow, and 0.2% (2) other. The majority of patients (63.4%) had a monthly family income of up to 2 minimum wages, representing a low income for national reality. A family history of cancer was positive in 33.4% of cases. Concerning risk factors, 44.2% were alcohol users, and 75.4% were smokers, with an average smoking load of 46.98 pack-years (standard deviation of 32.81). The most common symptoms were hoarseness (19.9%), mouth sore (20.2%), and neck lump (16.9%). The mean duration of symptoms was 13.68 months (standard deviation of 22.13). Clinical staging revealed that 51.7% of patients were in stage IV, 20.7% in stage III, 16.3% in stage II, and 11.0% in stage I. The main tumor sites were the larynx (25.5%), oropharynx (17.6%), and mouth (16.6%). Among patients who did not require further diagnostic workup, 47.39% underwent surgical treatment. Among those who received nonsurgical treatment, 86.8% were treated with combined radiotherapy and chemotherapy, 5.4% with exclusive radiotherapy, and 7.8% with other treatments. Conclusion: The results of this study indicate a considerable delay in the diagnosis of patients with malignant head and neck neoplasms. This late-stage presentation significantly reduces the likelihood of successful treatment outcomes and contributes to a poorer prognosis for the patients. The advanced stage at diagnosis also implies that the disease has had more time to progress, making it more difficult to treat effectively and requiring more intensive and costly therapeutic interventions. These statistics highlight the importance of early detection in improving patient outcomes and reducing the burden on healthcare systems. Considering these findings, it is evident that public health strategies must prioritize prevention, early detection, and risk factor reduction to combat head and neck cancer more effectively. [ABSTRACT FROM AUTHOR]

Introduction: Any surgical resection of the oral cavity and pharynx can lead to serious impairments affecting swallowing, chewing, breathing, and speech. Early-stage tumors of the oral cavity and oropharynx are generally accessed via the transoral approach.(1) Resections using an electronic scalpel can create complex defects, with the exposed area causing intense pain and bleeding in the postoperative period. Consequently, reconstruction with flaps (local or free flaps) is usually indicated and is important for achieving better functional outcomes.(2) The Diode LASER is not a new tool for the treatment of Head and Neck (H&N) tumors, and its use in the treatment of early glottic cancer is well established, (3) but the CO2 LASER has been more widely adopted worldwide.(4) Objective: Therefore, this study aims to evaluate hospital stay duration and postoperative complications in the transoral surgical resection of early-stage malignant neoplasms of the oral cavity and oropharynx, comparing Diode LASER surgery with conventional electrosurgical resection.(5) Methods: This is a retrospective cohort study that includes all patients with early-stage malignant neoplasms of the oral cavity and oropharynx treated with transoral surgical resection using a Diode LASER compared to patients who underwent conventional electrosurgical resection between August 2019 and August 2022 at a Head and Neck Cancer Center. A total of 21 patients were initially selected using inclusion criteria. Two patients were excluded because they had T3 and T4 tumors after pathological staging (AJCC 8th ed.). Finally, this study included 19 patients: 10 underwent transoral resection with Diode LASER (DLG) and 9 underwent electrosurgical resection (ESG). The outcomes evaluated were hospital stay duration, postoperative complications, enteral feeding tube, tracheostomy, and oncological outcomes (recurrence rate and margins). Results: The average hospital stay duration was shorter in the Diode LASER group (3.2 days versus 4.8 days / p=0.01). Postoperative complication rates were similar in both groups. None of the patients presented local or regional recurrence during follow-up. The average follow-up duration was 23 months. Conclusion: Diode LASER surgery is associated with reduced hospital stay duration for early-stage carcinomas of the oral cavity and oropharynx. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate vocal, swallowing and respiratory rehabilitation of patients undergoing supracricoid laryngectomy; evaluate the impact of voice changes and global quality of life., Methods: It is a prospective cohort study where voice, swallowing and respiratory rehabilitation where evaluated. Quality of life was assessed using EORTC QLQ-C30 and H&N35 questionnaires., Results: 31 patients were included in the study. 70.4% of patients were T3. In swallowing assessment, two patients (6.4%) were considered non-rehabilitated. Ten patients (32.2%) were considered partially rehabilitated and 19 (61.3%) fully rehabilitated. Sensitivity was abnormal at 74.2%. Penetration occurred in 58.1% of patients with 29% experiencing aspiration. In voice assessment, 19 (61.3%) patients were considered rehabilitated. 77.41% had a calculated voice handicap index considered abnormal. When assessing breathing, eight patients (25.8%) were considered non-rehabilitated. Disease-free survival was 87.1% in follow-up of 5.77 years. When subjected to specific exams and evaluations, only 38.7% were completely rehabilitated. When comparing results of EORTC-C30 and H&N35 questionnaires with the reference values, global score and domain scores are better on the patients of the study, as well as some of the symptoms., Conclusion: Partial supracricoid laryngectomy remains an option in patients with laryngeal tumors, especially in the most advanced ones, with a survival rate around 90%. Quality of life is impacted after surgery, but with few symptoms., Level of Evidence: Level 3. 1 ., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2024 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier España S.L.U. All rights reserved.)