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Purpose: HPV-associated cancer in the head-neck region has been reported at high frequencies in certain countries and is considered a separate entity. Since the prevalence of HPV positivity in oropharyngeal squamous cell carcinomas is currently not known in the Northern part of the Netherlands, the aim was to analyze HPV prevalence in oropharyngeal tumours treated at our centre. Material and methods: Based on the Dutch cancer registration, we collected clinical, pathological, and follow-up data and formalin-fixed paraffin embedded samples of a complete cohort of 125 tonsillar and base-of-tongue oropharyngeal tumours treated in our centre from 1997 to 2009. HPV testing was performed using an established algorithm of p16 immunohistochemistry, followed by HPV-PCR of the positive cases. HPV-BRISH was performed as extra control of p16 negative cases. Results: p16 staining could be assessed on 109 cases. 32/109 (29%) were p16+ of these 32 cases 21/32 (66%) were HPV-GP+, 16 cases were found HPV16+ and one HPV18+, three were HPV33+ and one HPV35+. HPV-BRISH showed 83/102 (81%) negativity and 19/102 (19%) positivity. BRISH had a sensitivity of 85% and a specificity of 98%, as only two p16- cases were positive for BRISH. HPV prevalence increased from 11% between 1997 and 2002, to 27% between 2003 and 2009. Conclusions: In the period 1997–2009, 19% of the tonsillar and base-of-tongue tumours in the Northern Netherlands was HPV+. This prevalence is lower than in other regions in the Netherlands (33%) and in Europe (40%). Remarkably, a large increase in prevalence was observed in the more recent years. The relative low incidence in our region might be due to the relative high percentage of smokers, associated with non-HPV related oropharyngeal tumours. Currently HPV testing of a series of 200 oral squamous cell carcinomas from our centre is in progress. [Copyright &y& Elsevier]

Background: There is resistance to routine intraoperative cholangiography (IOC) during cholecystectomy because it prolongs surgery and may be experienced as cumbersome. An alternative instrument may help to reduce these drawbacks and lower the threshold for IOC. This trial compared the Kumar cannulation technique to the more commonly used Olsen clamp for IOC (KOALA trial; Dutch Trial Register NTR2582). Methods: Patients undergoing elective laparoscopic cholecystectomy were randomized between IOC using the Kumar clamp and the Olsen clamp. Primary end points were the time that the IOC procedure took and its perceived ease as measured on a visual analog scale from 0 (impossible) to 10 (effortless). To detect a difference of 33 % in IOC time, a total sample size of 40 patients was required. Results: Fifty-nine patients were randomized. Nine were excluded because of conversion to open cholecystectomy before the IOC procedure. Twenty-eight patients underwent IOC with the Kumar clamp and 22 with the Olsen clamp. The success rate was 23 (82.1 %) of 28 for the Kumar clamp and 19 (86.4 %) of 22 for the Olsen clamp ( p > 0.999). The mean IOC time was 10 min 27 s ± 6 min 17 s using the Kumar clamp and 11 min 34 s ± 7 min 27 s using the Olsen clamp ( p = 0.537). Surgeons graded the ease of the Kumar clamp as 6.8 ± 2.7 and the Olsen clamp as 6.8 ± 2.1 ( p = 0.977). Conclusions: IOC using the Kumar clamp was neither faster nor easier than using the Olsen clamp. Both clamps facilitated IOC in just over 10 min. Individual surgeon preference should dictate which clamp is used. [ABSTRACT FROM AUTHOR]