Luiz Paulo Kowalski

• Hospital A. C. Camargo

Objective This study aimed to integrate the available data published in the literature to identify and elucidate the impact of targeted therapy for oral potentially malignant disorders (OPMDs). Material and Methods This systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta‐anal...

Background: The current American Joint Committee on Cancer 8th edition staging system on thyroid cancer describes outcomes for populations of patients with well-differentiated thyroid cancer (WDTC) and not individual patients. The aim of this study was to create a clinical nomogram that can be used to predict survival in individual patients with WD...

Sinonasal tumors with orbital involvement present significant management challenges due to the complex anatomy of the orbital and sinonasal complex and the potential for severe tumor-and treatment-related morbidities. This comprehensive review examines evidence-based decision-making guidelines in the context of treating sinonasal malignancies invol...

Background Radiofrequency ablation guided by ultrasound (RFA‐USG) is an alternative treatment for primary hyperparathyroidism (PHPT) patients. Despite showing accurate precision and minimal invasion, its efficacy remains questionable. Methods We searched PubMed, Embase, Scopus, Cochrane Library, Portal Regional da Biblioteca Virtual em Saúde (BVS)...

Post/Long COVID (syndrome) is defined as a condition with symptoms persisting for more than 12 weeks after the onset of SARS-CoV-2 infection that cannot be explained otherwise. The prevalence of self-reported otorhinolaryngological Post/Long COVID symptoms is high. The aim of this review was to analyze the current literature regarding the actual pr...

Objective Evaluate the sociodemographic, clinical, and lifestyle characteristics at head and neck squamous cell carcinoma (HNSCC) diagnosis and their impact on overall survival (OS) across different anatomical sites. Materials and Methods A retrospective cohort study (2011–2021) at Instituto do Câncer do Estado de São Paulo , involving 3052 HNSCC...

Objective: To evaluate the rates of permanent hypoparathyroidism based on demographic variables, patient comorbidities, clinical staging of the disease, surgery performed, and severity of transient hypoparathyroidism. Subjects and methods: This is a retrospective cohort study with patients who underwent total thyroidectomy with or without neck diss...

Emerging evidence suggests that aberrant expression levels of Sigma1 (SIGMAR1, also known as sigma-1 receptor) have been implicated in the progression of various diseases, including cancer. However, its significance in oral cancer (OC) has not been thoroughly explored. To advance in this field, the present study aimed to investigate the impact of S...

Objectives Several studies have evaluated the prognostic significance of Perineural Invasion (IPN) in laryngeal cancer; however, the results are non-conclusive. Therefore, we conducted a meta-analysis aiming to identify the prognostic value of IPN in laryngeal cancer. Methods A literature review was performed, searching MedLine via PubMed, Scielo,...

Objective This study aimed to implement and evaluate a Deep Convolutional Neural Network for classifying myofibroblastic lesions into benign and malignant categories based on patch-based images. Methods A Residual Neural Network (ResNet50) model, pre-trained with weights from ImageNet, was fine-tuned to classify a cohort of 20 patients (11 benign...

Aims To develop a model capable of distinguishing carcinoma ex‐pleomorphic adenoma from pleomorphic adenoma using a convolutional neural network architecture. Methods and Results A cohort of 83 Brazilian patients, divided into carcinoma ex‐pleomorphic adenoma ( n = 42) and pleomorphic adenoma ( n = 41), was used for training a convolutional neural...

Head and neck cancers are a growing global health concern, with oral squamous cell carcinoma (OSCC) accounting for 90-95% of all cases within this region. OSCC near dental implants can resemble benign inflammatory lesions, posing diagnosis challenging. A 74-year-old man presented with an ulcerated, asymptomatic lesion in the upper right alveolar mu...

The mechanisms involved with the pathogenesis of carcinoma ex pleomorphic adenoma (CXPA) seem to be associated with the accumulation of molecular alterations in the pleomorphic adenoma (PA). In this sense, using array-based comparative genomic hybridization (aCGH) a rare series of 27 cases of CXPA and 14 residual PA (rPA) adjacent to the transforma...

Objective To determine the effectiveness of surgical loupes in reducing postoperative RLN palsy and hypocalcemia following thyroidectomy. Data sources PubMed, Scopus and Google Scholar databases were searched between 2000 and 2024. Review methods Studies were included if they reported at least one complication outcome following thyroidectomy usin...

Background: The study of notable people as advocates for raising cancer awareness began in the latter decades of the 20th century. This research aimed to identify Pan-American notable people with head and neck cancer (HNC) and to explore senior health professionals’ perspectives on communicating stories of notable patients with HNC to promote preve...

The risk of hypoparathyroidism and hypocalcemia is a critical concern in thyroid surgery. Preserving parathyroid gland vascularization during surgery is essential for effective prevention. Preoperative and postoperative management, including calcium and Vitamin D supplementation, is paramount. Measurement of parathyroid hormone levels after surgery...

Introduction Subtotal Parathyroidectomy (S-PTx) and total Parathyroidectomy with immediate Autograft (PTx-AG) are well-established techniques for the treatment of refractory Secondary Hyperparathyroidism (SHPT), with comparable improvements in patients' quality of life and survival. However, the long-term costs after these operations may impact the...

Objectives The present study aims to characterize immunohistochemical features of markers associated with Epithelial–Mesenchymal Transition (EMT) and proliferative activity that could lead to death in Papillary Thyroid Cancer (PTC). Methods Clinical data and tumor material were retrospectively collected. The patients were separated into death from...

Purpose Oral alterations are frequently observed in patients undergoing palliative care and are linked to the direct or indirect effects of the primary medical condition, comorbidities and medical management, leading to oral pain, impacting oral intake, and affecting quality of life. This systematic review aims to assess the prevalence of oral dise...

Objective This systematic review and meta‐analysis aimed to compare the risk of recurrence and cancer progression after surgical treatment for oral potentially malignant disorders (OPMD) and precancerous lesions in different anatomical sites. Materials and Methods A comprehensive search was conducted in nine databases and grey literature. We inclu...

Background: Oral cancer (OC) and oral potentially malignant disorders (OPMD) pose significant challenges to public health in Brazil. This study aimed to estimate the prevalence of oral cancer (OC) and oral potentially malignant disorders (OPMD) among patients who would be treated by Brazilian dentists during their careers. Material and Methods: Dat...

Background Neural tumors are difficult to distinguish based solely on cellularity and often require immunohistochemical staining to aid in identifying the cell lineage. This article investigates the potential of a Convolutional Neural Network for the histopathological classification of the three most prevalent benign neural tumor types: neurofibrom...

e18030 Background: Smoking and alcohol abuse are the main risk factors for head and neck squamous cell carcinoma. However, some patients do not present clear risk factors. We are studying a cohort of Brazilian patients that are non-smokers and alcoholic beverage abstainers. Brazilian people have peculiar ethnic characteristics, reflecting a miscege...

Background The purpose of this systematic review (SR) is to gather evidence on the use of machine learning (ML) models in the diagnosis of intraosseous lesions in gnathic bones and to analyze the reliability, impact, and usefulness of such models. This SR was performed in accordance with the PRISMA 2022 guidelines and was registered in the PROSPERO...

Background The current study presents the effort of a global collaborative group to review the management and outcomes of malignant tumors of the skull base worldwide. Patients and methods A total of 28 institutions contributed data on 3061 patients. Analysis evaluated clinical variables, survival outcomes, and multivariable factors associated wit...

Background/Objectives: Positive margins are associated with locoregional recurrence in early laryngeal cancer. The aim of this study was to evaluate the impacts of specimen-driven (ex vivo) positive margins on patients with early-stage laryngeal cancer whose tumor bed (defect-driven) margins had been negative. Methods: A retrospective study was per...

Introduction Locally advanced oral cavity carcinoma (LAOCSCC) is primarily treated with surgery followed by radiotherapy with or without chemotherapy. Methods A review of literature using PubMED was performed for studies reporting the management of LAOCSCC. Based on the reviewed literature and opinions of experts in the field, recommendations were...

Tobacco smoke, alone or combined with alcohol, is the predominant cause of head and neck cancer (HNC). Here, we further explore how tobacco exposure contributes to cancer development by mutational signature analysis of 265 whole-genome sequenced HNC from eight countries. Six tobacco-associated mutational signatures were detected, including some not...

Head and neck squamous cell carcinoma (HNSCC) is well known as a serious health problem worldwide, especially in low-income countries or those with limited resources, such as most countries in Latin America. International guidelines cannot always be applied to a population from a large region with specific conditions. This study established a Latin...

Introperative nerve monitoring (IONM) of the recurrent laryngeal nerve (RLN) is a well-established technique to aid in thyroid/parathyroid surgery. However, there is little evidence to support its use in non-thyroid or non-parathyroid surgery. The aim of this paper was to review the current evidence regarding the use of IONM in non-thyroid/non-para...

Objective Despite a favorable prognosis, some patients with papillary thyroid carcinoma (PTC) develop recurrence. The objective of this study was to examine the impact of the combination of initial American Thyroid Association (ATA) risk stratification with serum level of postoperative stimulated thyroglobulin (s-Tg) in predicting recurrence in pat...

Background: The SIGMAR1 receptor is a regulator of immunity and inflammation. Together, these key processes can support or restrain cancer progression and response to therapy. Nevertheless, the effect of SIGMAR1 on the modulation of oral cancer (OC) immunity is largely unknown. Here, we investigated not only the prognostic value of SIGMAR1 in OC bu...

Salivary gland tumors are a heterogeneous group of lesions, being mucoepidermoid carcinoma (MEC) the malignant neoplasm with the highest incidence, occurring mainly in the parotid gland. Characterization of its histological grade (high, intermediate, and low) is important for determining patient prognosis. Metastasis is more common high-grade tumor...

Objective This study used array comparative genomic hybridization to assess copy number alterations (CNAs) involving miRNA genes in pleomorphic adenoma (PA), recurrent pleomorphic adenoma (RPA), residual PA, and carcinoma ex pleomorphic adenoma (CXPA). Materials and Methods We analyzed 13 PA, 4 RPA, 29 CXPA, and 14 residual PA using Nexus Copy Num...

Objective We investigated motivation levels across the general Brazilian population and subgroups and their willingness to spend for surgery without a cervical scar. Methods This random‐sample survey was performed by a specialized third‐party research institute. In this study, we created a hypothetical thyroidectomy scenario, and the transcervical...

Poorly differentiated thyroid carcinomas (PDTC) are rare diseases; nevertheless, they account for the majority of deaths from non-anaplastic follicular cell-derived thyroid carcinomas. Establishing the diagnosis and treatment of PDTC is challenging given the low incidence and the lack of standardization of diagnostic criteria. These limitations ham...

Background Salivary gland carcinomas (SGCs) are a rare group of malignant neoplasms of the head and neck region. MicroRNAs (miRNAs) are a class of small non-coding RNAs that have been associated with the control biological process and oncogenic mechanism by the regulation of gene expression at the post-transcriptional level. Recent evidence has sug...

Background: HOXA1 is a prognostic marker and a potential predictive biomarker for radioresistance in head and neck tumors. Its overexpression has been associated with promoter methylation and a worse prognosis in oral squamous cell carcinoma (OSCC) patients. However, opposite outcomes are also described. The effect of the methylation of this gene o...

Objective This study aimed to explore perceived barriers to early diagnosis and management of oral cancer, as well as potential pathways for improvement in Latin America and the Caribbean (LAC). Methods This cross‐sectional study used a self‐administered online questionnaire created via the Research Electronic Data Capture platform. The survey was...

Background The clinical significance of single cell invasion and large nuclear diameter is not well documented in early-stage oral tongue squamous cell carcinoma (OTSCC). Methods We used hematoxylin and eosin-stained sections to evaluate the presence of single cell invasion and large nuclei in a multicenter cohort of 311 cases treated for early-st...

Colonialism’s enduring impact on Brazil has had significant implications for health and oncology outcomes. This historical essay delves into the profound changes brought about by the transatlantic slave trade from Africa to the Americas, particularly in terms of its influence on the economy, sociocultural habits, and health outcomes. This essay exp...

Introduction The harmonic scalpel (HS) is a technique introduced to reduce blood loss and intraoperative time during neck dissection (ND). Objective To compare the results of HS with traditional hemostasis in ND through a systematic review and metanalysis. Methods A computer-based strategy of systematic literature survey included research in the ME...

Large-scale biorepositories and databases are essential to generate equitable, effective, and sustainable advances in cancer prevention, early detection, cancer therapy, cancer care, and surveillance. The Mutographs project has created a large genomic dataset and biorepository of over 7,800 cancer cases from 30 countries across five continents with...

Objective To compare the oncological results and the functional outcomes of patients undergoing Total Laryngectomy (TL) with the non-surgical treatment (organ preservation protocol) in the treatment of advanced laryngeal carcinomas through systematic review and meta-analysis. Methods A literature survey strategy was employed in order to perform a...

Malignant carotid body tumors (MCBT) are rare and diagnosed after detection of nodal or distant metastases. This systematic review (SR) focuses on MCBT initially approached by surgery. Preferred Reporting Items for SR and Meta‐Analysis (MA) guided the articles search from 2000 to 2023 on PubMed, Scopus, and Web of Science. Among 3548 papers, 132 (3...

In the modern world, cancer is a growing cause of mortality, but archeological studies have shown that it is not exclusive to modern populations. The aim of this study is to examine the epidemiologic, social, and clinicopathologic features of head and neck cancers in ancient populations. To do this, we extracted all records that described malignant...

Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive cutaneous sarcoma with a propensity for recurrence. Its management, particularly in the head and neck (H&N) region, presents unique challenges. This study aimed to evaluate the effectiveness of Mohs micrographic surgery (MMS) compared to wide local excision (WLE) in treating H&N D...

Objective To evaluate the preoperative muscle mass of patients with head and neck cancer (HNC) with computed tomography (CT), comparing the results obtained through analysis of cross-sectional areas at the level of the third lumbar vertebra (L3) with those obtained through analysis of cross-sectional areas at the levels of the third cervical and fo...

The objective of this study was to assess the remodeling-associated gene expression in the mandible of patients diagnosed with oral squamous cell carcinoma (OSCC), investigating the cortical microarchitecture, and their influence on disease-free survival (DFS) and overall survival (OS) rates. A total of twenty-four patients who underwent mandibulec...

Simple Summary Oral squamous cell carcinoma is a challenging mouth cancer, with roughly half of those diagnosed succumbing to it, often due to it recurring or spreading to other body parts. Although some factors like tumor size, invasiveness, lymph node involvement, and specific characteristics when examining tissue samples are known to influence t...

Objective: To determine the overall surgical outcomes of infranotch T4b oral cancers and compare them with T4a oral cancers. Methods: PubMed, EMBASE and Cochrane databases from 2000 to 2022 were systematically searched. Clinical studies reporting at least one outcome following curative surgery and adjuvant therapy for comparison of patients with e...

Simple Summary Local recurrences, isolated regional recurrences, and loco-regional recurrences are frequent after treatment for advanced stage head and neck squamous cell carcinoma. Salvage surgery may be possible in selected patients, taking into account the location and stage of the recurrent disease, patient age and comorbidities, tumor HPV stat...

Background Dysplasia grading systems for oral epithelial dysplasia are a source of disagreement among pathologists. Therefore, machine learning approaches are being developed to mitigate this issue. Methods This cross‐sectional study included a cohort of 82 patients with oral potentially malignant disorders and correspondent 98 hematoxylin and eos...

Background Odontogenic tumors (OT) are composed of heterogeneous lesions, which can be benign or malignant, with different behavior and histology. Within this classification, ameloblastoma and ameloblastic carcinoma (AC) represent a diagnostic challenge in daily histopathological practice due to their similar characteristics and the limitations tha...

Simple Summary Treatment recommendations for head and neck cancer need to be disseminated worldwide becoming available through societies/authors scientific reports and websites with warning updates. This scoping review identifies and compares the worldwide clinical practice guidelines for treating oral, oropharynx, and larynx cancer. We verified th...

Simple Summary Skin cancer, particularly non-melanoma skin cancer, is the most common malignancy in the world. There are both common and uncommon types that receive treatment every day. Despite their commonality, the management of each is not perfectly defined in the scientific literature. Many require surgical removal, but the management of region...

Background: Compare outcomes after surgery (S) or radiotherapy (RT) for T1a-T1b glottic squamous cell carcinoma (T1GSCC) in a population-based cohort study. Methods: Patients diagnosed with T1GSCC from 1999 to 2020 were identified from a public database. Clinical, demographic, and social data were extracted. Treatment and patient groups and subg...

Background: The management of cT3 laryngeal cancers remains controversial, with studies recommending surgical or non-surgical approaches. Despite the many papers that have been published on the subject, there is a lack of studies showing which treatment has better results in terms of survival. Objective: To determine the difference in survival o...

Introduction: The aim of this study is to assess the impact of lymph node ratio (LNR) and number of positive lymph nodes (NPLN) on mortality and recurrence rates in patients with laryngeal squamous cell carcinoma. Materials and methods: We conducted a retrospective multicenter international study involving 24 Otorhinolaryngology-Head and Neck Su...

Background: We aimed to develop and validate a risk-scoring system for distant metastases (DM) in oral cavity carcinoma (OCC). Methods: OCC patients treated at 4 tertiary cancer institutions with curative surgery +/- postoperative radiation/chemo-radiation (PORT/PO-CRT) were randomly divided into discovery and validation cohorts (3:2 ratio). Cas...

The study of notable people as agents for increasing cancer awareness started just in the last decades of the 20th century. This study aimed to identify Pan-American notable people with head and neck cancer (HNC) and to assess HNC’s professional perspective on communicating stories of notable patients with HNC to promote prevention. Methods: This c...

Introduction: The most common early postoperative complication after total laryngectomy (TL) is pharyngocutaneous fistula (PCF). Rates of PCF are higher in patients who undergo salvage TL compared with primary TL. Published meta-analyses include heterogeneous studies making the conclusions difficult to interpret. The objectives of this scoping rev...

Sialoblastoma is a rare malignant salivary gland tumor. The aim of this study was to review the available published data on sialoblastoma in a comprehensive analysis of its clinicopathologic characteristics, treatment, and outcomes. An unrestricted electronic search was performed in the following databases: MEDLINE/PubMed, EMBASE, Scopus, Web of sc...

Actinic cheilitis is an inflammatory and potentially malignant condition that mainly affects the lower lip and is caused by long-term chronic sun exposure. Considering the well-established association between actinic cheilitis and the development of squamous cell carcinoma in the lower lip, in this chapter, we highlight the importance of early diag...

Leukoplakia and erythroplakia are the two most common potentially malignant disorders of the oral cavity. Both lesions in a small and significant proportion of cases, respectively, turn into cancer. Most lesions are asymptomatic, and the main objective of treatment is to prevent their malignant transformation. The role of the dentist in the diagnos...

Oral squamous cell carcinoma is the most common malignant epithelial neoplasm affecting the oral cavity, accounting for more than 90% of cases. Most patients smoke tobacco, drink alcohol, or both. Since the time of diagnosis is the most important prognostic factor for the patient’s affected, this chapter overviews the essential clinical aspects of...

Background The treatment of glottic cancer remains challenging, especially with regard to morbidity reduction and larynx preservation rates. The National Comprehensive Cancer Network (NCCN) has published guidelines to aid decision‐making about this treatment according to the tumor site, clinical stage, and patient medical status. Aim The present r...

While altered protein glycosylation is regarded a trait of oral squamous cell carcinoma (OSCC), the heterogeneous and dynamic glycoproteome of tumour tissues from OSCC patients remain unmapped. To this end, we here employ an integrated multi-omics approach comprising unbiased and quantitative glycomics and glycoproteomics applied to a cohort of res...

e23550 Background: Head and neck soft-tissue sarcoma (HN-STS) is a rare entity for which a new prognostic risk stratification has been proposed in the 8th AJCC. The tumor size 2cm and 4cm have been adopted as cutoffs for T1 to T3 classification and the invasion of surrounding structures denotes T4. In opposite, in the 7th edition the primary tumor...

Backgroud Parathyroid carcinoma (PC) is a rare and challenging disease without clearly understood prognostic factors. Adequate management can improve outcomes. Characteristics of patients treated for PC over time and factors affecting prognosis were analyzed. Methods Retrospective cohort study including surgically treated patients for PC between 2...

Objective: The purpose of these guidelines is to provide specific recommendations for the surgical treatment of neck metastases in patients with papillary, follicular, and medullary thyroid carcinomas. Materials and methods: Recommendations were developed based on research of scientific articles (preferentially meta-analyses) and guidelines issu...

Simple Summary The most appropriate treatment for local/regional recurrent differentiated thyroid cancers (DTC) is surgical excision if feasible, followed by adjuvant radioiodine administration. However, depending on the location or extent of the recurrence, surgical excision may not be possible, thus creating a need for alternative therapeutic int...

Summary Background: Since its outbreak in early 2020, the COVID-19 pandemic has diverted resources from non-urgent and elective procedures, leading to diagnosis and treatment delays, with an increased number of neoplasms at advanced stages worldwide. The aims of this study were to quantify the reduction in surgical activity for indeterminate thyr...

Drug resistance remains a major obstacle in the treatment of mucoepidermoid carcinomas (MEC) leading to tumor recurrence, disease progression, and metastasis. Emerging evidence suggests that drug resistance is mediated by the presence of a highly adaptative subpopulation of cancer cells known as cancer stem cells (CSC). We have previously reported...

Mucoepidermoid carcinoma (MEC) is the most common malignant tumor of the salivary glands. Metastatic spread occurs in up to 80% of high-grade tumors and it is a strong predictor of poor outcome, however, the mechanisms underlying this process are largely unknown. Large-scale microRNA expression profiling studies of human cancers have demonstrated t...

Introduction: The aim of the present systematic review (SR) is to summarize Machine Learning (ML) models currently used to predict head and neck cancer (HNC) treatment-related toxicities, and to understand the impact of image biomarkers (IBMs) in prediction models (PMs). The present SR was conducted following the guidelines of the PRISMA 2022 and...

The projected increase in life expectancy over the next few decades is expected to result in a rise in age-related diseases, including cancer. Head and neck cancer (HNC) is a worldwide health problem with high rates of morbidity and mortality. In this report, we have critically reviewed the literature reporting the management of older patients with...

Objective: The present study aims to quantify clinicians' perceptions of oral potentially malignant disorders (OPMDs) when evaluating, classifying, and manually annotating clinical images, as well as to understand the source of inter-observer variability when assessing these lesions. The hypothesis was that different interpretations could affect t...