American Head & Neck Society

Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.

Published on by AHNS Webmaster

AHNS 2021 International Conference

AHNS Call For Abstracts is Now Open

Submission Deadline: 

December 4, 2020 – 5:00 PM PT

You are invited to submit abstracts to the AHNS 10th International Conference on Head and Neck Cancer: “Survivorship through Quality and Innovation” taking place on July 22-25, 2021 at the Hyatt Regency Chicago in Chicago, Illinois.

All abstracts, even if previously submitted and accepted will undergo the standard peer review process. Please submit new or previously submitted abstracts for the conference next summer, as long as it complies with the following paragraph. 

No Previously Published/Presented Submissions (Encore Abstracts): The abstract submitted must present original work that has not and will not be published or presented prior to the AHNS 10th International Conference on Head and Neck Cancer, and shall not be under review for publication prior to the AHNS 10th International Conference on Head and Neck Cancer except by permission from the AHNS Program Chair. The exception to this rule is that a manuscript may be submitted to JAMA Otolaryngology – Head & Neck Surgery for special meeting related consideration only after the abstract has been accepted by AHNS for presentation. 

To submit your abstracts, please click this link.

NOTE: ALL content authors are required to disclose any financial relationship(s) with an ACCME-defined commercial interest(“industry”). AHNS considers the presenter of a proffered paper to be in control of the content. Thus, employees of commercial interests may not be the presenter for abstracts submitted to AHNS meetings.

If you have any questions, please contact the AHNS office at 310-437-0559 x 118 or by email at [email protected]. 

Sincerely,

AHNS Abstract Services

Published on by AHNS Office

World Robotic Symposium 2020

This 4-day virtual event will bring together the world’s most innovative leaders in robotic surgery from all corners of the globe. Medical experts and academics across 14 different specialties will present talks on the latest ground-breaking robotic surgery techniques, tools, and technology.

Drs. Umamaheswar Duvvuri and J. Scott Magnuson, are co-chairing the Head & Neck concurrent sessions at the World Robotic Symposium on Saturday, August 1st. Click the banners above for more information, the full schedule and registration.

Published on by Cherie-Ann Nathan

AHNS Leadership

AHNS Leadership Convenes Via Zoom

In a parallel universe, we would have just concluded our 10th International Conference in Chicago. As you are all aware, this conference is postponed until next summer, where hopefully we will meet in person.  However, conducting the business of the society is still a priority of many of the AHNS leaders and even the global pandemic did not stop the AHNS Council from meeting and discussing the initiatives and action items our services and sections have been working on (please click here to see the AHNS Council donning our fashionable masks).

I wanted to briefly update you on the work and progress of our leaders, as it’s vast and impressive! It wouldn’t be possible without their dedication and commitment to the mission of our society.

Some of the AHNS initiatives include:

  • Advanced Training Council continuation of curriculum education for our fellows
  • Upcoming webinars from various sections and services, including potential CME credits, to help provide education for our members
  • Special symposium on Ethics and COVID-19 during COSM
  • Abstract opening (part 2!) for our International Conference next summer
  • A renewed patient education initiative that will involve all six sections
  • Increased social media campaigns
  • Special forums and bulletin board on COVID-19
  • An increased number of guidelines and position statements, endorsed by the AHNS
  • Awarding of research grants, awards and mentoring partnerships
  • And more international collaboration!

As it turns out, and as no surprise, surgeons are even more productive during a global crisis.  Thank you to the AHNS Council, Service Chairs, Section Leaders and Representatives and to all members who are coming together to produce impactful work for our specialty. If you have any suggestions for the society or would like to become more involved, please reach out to our Executive Director, Christina Kasendorf, at [email protected].

Stay safe and well,
Cherie-Ann Nathan, MD
AHNS President

Cherie-Ann Nathan

Cherie-Ann Nathan

Dr. Cherie-Ann Nathan is a leading head and neck cancer surgeon. She is Prof. & Chair of the Dept. of Oto/HNS &the Director of Head and Neck Surgical Oncology and Cancer Research, Feist-Weiller Cancer Center Louisiana State University Health - Shreveport (LSU Health Shreveport). The National Cancer Institute has funded her translational research since 2000 and her focus is on targeted therapy for head and neck patients. Dr. Nathan is recognized nationally and internationally for her seminal work on molecular analysis of surgical margins. She has pioneered multi-institutional clinical trials using mTOR inhibitors in HNSCC patients. She has also received NIH funding for chemoprevention of cancer with curcumin and has a patent for a curcumin chewing gum. More recently she also received an NCI grant on cutaneous Squamous cell cancer.  She serves on the NCI head and neck steering committee and the American Cancer Society HPV steering committee. Dr. Nathan has published extensively, has over 180 publications in peer-reviewed journals, and has authored multiple textbooks and encyclopedia chapters. She is married to Dr. Raghu Nathan, a pulmonary and critical eye care specialist with whom she has two boys.
Cherie-Ann Nathan

Latest posts by Cherie-Ann Nathan (see all)

Published on by Stephen Lai

NRG-HN006 Trial

Sentinel Lymph Node Biopsy versus Elective Neck Dissection for Early-Stage Oral Cavity Cancer: Activation of the NRG-HN006 Trial

For patients with early-stage oral cavity squamous cell carcinoma (OCSCC), there is a 20-30% risk for occult metastatic cervical disease despite clinical and radiographic ima Tirging. The debate surrounding management of the node-negative neck has spanned multiple decades initially centered around elective neck dissection (END) versus “watchful waiting” with subsequent therapeutic neck dissection. Recently, sentinel lymph node biopsy (SLN Bx) has emerged as a viable option for active management of the node-negative neck in these patients.

NRG Oncology has just activated a National Cancer Institute (NCI)-approved international, multi-institutional prospective trial comparing SLN Bx versus END for early-stage oral cavity cancer. The study is NRG-HN006 “Randomized Phase II/III Trial of Sentinel Lymph Node Biopsy Versus Elective Neck Dissection for Early-Stage Oral Cavity Cancer.” (Clinicaltrials.gov: NCT04333537)

The trial divides patients to two surgical arms, SLN Bx and END, following a PET/CT scan with a central reading as an integral biomarker supported by the NCI. The trial builds upon the recent results of the ACRIN 6685 trial, which demonstrated the relatively high negative predictive value of PET/CT for neck disease in patients with T2-4N0 head and neck cancers. Patients with a positive central read of their PET/CT for neck disease will still have their neck pathology results recorded to understand the functional performance of PET/CT in accurately assessing neck nodal status.

Patients with a negative central read of their PET/CT for neck disease will be randomized to the two surgical arms with stratification based on T-stage and performance status (Zubrod). The Phase II portion of the trial will test the hypothesis that SLN biopsy will have superior patient-reported neck and shoulder function and quality of life (QOL), as measured by the Neck Dissection Impairment Index (NDII), compared to END at 6 months post-surgery. Comparing the difference in the two arms from baseline and 6 months will serve to determine the “Go/No-Go” decision to proceed to Phase III. Phase III has co-primary endpoints and will test the hypothesis that SLN Bx will achieve non-inferior disease-free survival (DFS) compared to END, and that SLN Bx will have superior patient-reported neck and shoulder function and QOL, as measured by the NDII.

NRG-HN006 has an ambitious patient accrual target of 224 patients for Phase II who will be included as part of the 618 patients total for Phase III. The trial represents an opportunity to address the performance of SLN Bx and END in a definitive manner relative to QOL and patient survival. The collection of high-quality prospective data in this study will also permit the assessment of issues that continue to be raised with regard to extent of treatment for early-stage OCSCC, including extent of END, distribution of occult metastatic disease, and practice variations in adjuvant radiation therapy.

Site activation is currently in process and additional details, including the complete protocol, can be obtained here: CTSU website. Surgeon credentialing will require completion of an education course and case review. Please feel free to contact the study PI at [email protected] if you have additional questions and/or issues.

 

 

Published on by AHNS Office

AHNS Journal Club – July 2020

Volume 32 – July, 2020

The AHNS Journal Club reviews the leading head and neck cancer-related journals, sharing with AHNS members some of the most relevant and important manuscripts, and providing summaries and critiques of the work.

The Journal Club for the July issue: AHNS Skull Base Surgery Edition

This Issue of the AHNS Journal Club has been compiled and reviewed by members of the

AHNS Skull Base Surgery Section (Ivan El-Sayed, Chair; Ian Witterick, Co-Chair)

 Meghan Turner
Marilene Wang
Shirley Su
Harishanker Jeyarajan

Dear Colleagues,

The AHNS Skull Base Surgery Section is very pleased to present its first AHNS Journal Club Issue.  Our ultimate goal for the Skull Base Surgery Section issues will be to provide insight into contemporary management of skull base tumors through themed issues.  This particular issue will address controversies in the recently published literature on nodal metastases in olfactory neuroblastoma (ONB) by reviewing the recently published literature.

Traditionally, elective treatment of cervical nodal metastases for head and neck primaries is advocated when the risk of occult metastases reaches > 20%.  However, sinonasal malignancy (as a group) has been shown to have a lower incidence of cervical metastases on presentation making elective treatment of the neck in sinonasal malignancy controversial and somewhat rare. With respect to ONB, the incidence of nodal metastases at the time of diagnosis (modified Kadish stage D) is low, approximately 8%.1,2  In spite of this rare incidence at diagnosis, up to 20.2% of patients with ONB will develop nodal disease within 5 years of diagnosis.3

Single institution studies have tried to identify risk factors for nodal recurrence (positive margins, modified Kadish C Staging, Hyam’s grade, the presence of dural invasion) and identify patients who might benefit from elective treatment of the neck.4-6  This has led to more recent studies examining elective treatment of high-risk nodal basins including retropharyngeal, level IB and level II lymph nodes.7  Elective neck irradiation provides 100% locoregional control in small, single-institution series, but was associated with worse overall survival in patients over 50.  Salvage treatment of the delayed nodal recurrence has 5-year LRC rates of 30-80% and is highest when both surgery and radiation are used.3,6  It remains unclear whether or not elective treatment of the neck reduces distant metastasis or has meaningful impact on survival as metastases are largely found in the brain, leptomeningeal spine, or the spinal skeleton.6,7

In this issue, we present recent evidence regarding nodal metastases in ONB.  It is suggested you read them in the order presented.  We believe this evidence may impact future trends in the treatment of ENB and hope you enjoy this issue.  Comments are welcome and can be sent to [email protected].

Sincerely,

Meghan T. Turner, MD
Assistant Professor of Head and Neck Surgery
West Virginia University Health Sciences Center

Marilene Wang, MD
Professor of Head and Neck Surgery
Ronald Reagan UCLA Medical Center

Harishanker Jeyarajan, MD
Assistant Professor of Head and Neck Surgery
University of Alabama Birmingham School of Medicine

Shirley Y. Su, MBBS
Associate Professor of Head and Neck Surgery
Associate Professor of Neurosurgery
The University of Texas M.D. Anderson Cancer Center

  1. Kuan EC, Nasser HB, Carey RMet al. A Population-Based Analysis of Nodal Metastases in Esthesioneuroblastomas of the Sinonasal Tract. Laryngoscope 2019; 129:1025-1029.
  2. Konuthula N, Iloreta AM, Miles Bet al. Prognostic significance of Kadish staging in esthesioneuroblastoma: An analysis of the National Cancer Database. Head Neck 2017; 39:1962-1968.
  3. Gore MR, Zanation AM. Salvage treatment of late neck metastasis in esthesioneuroblastoma: a meta-analysis. Arch Otolaryngol Head Neck Surg 2009; 135:1030-1034.
  4. Marinelli JP, Janus JR, Van Gompel JJet al. Dural Invasion Predicts the Laterality and Development of Neck Metastases in Esthesioneuroblastoma. J Neurol Surg B Skull Base 2018; 79:495-500.
  5. Nalavenkata SB, Sacks R, Adappa NDet al. Olfactory Neuroblastoma: Fate of the Neck–A Long-term Multicenter Retrospective Study. Otolaryngol Head Neck Surg 2016; 154:383-389.
  6. Banuchi VE, Dooley L, Lee NYet al. Patterns of regional and distant metastasis in esthesioneuroblastoma. Laryngoscope 2016; 126:1556-1561.
  7. Jiang W, Mohamed ASR, Fuller CDet al. The role of elective nodal irradiation for esthesioneuroblastoma patients with clinically negative neck. Pract Radiat Oncol 2016; 6:241-247.

CLICK THE ARTICLES BELOW TO ACCESS THE CURRENT ISSUE

Patterns of Regional and Distant Metastasis in Esthesioneuroblastoma

Victoria E Banuchi, MD Laura Dooley, MD, Nancy Y Lee, MD, David G. Pfister, Sean McBride, MD MPH, Nadeem Riaz, MD, Mark H Bilsky, MD, Ian Ganly, MD, Jatin P Shah, MD, Dennis H Kraus, MD, and Luc GT Morris, MD MSc
From The Laryngoscope, July 2016

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A Population-Based Analysis of Nodal Metastases in Esthesioneuroblastomas of the Sinonasal Tract
Edward C Kuan, Hassan B Nasser, Ryan M Carey, Alan D Workman, Jose E Alonso, Marilene B Wang, Maie A St John, James N Palmer, Nithin D Adappa, Bobby A Tajudeen
 From The Laryngoscope, May 2019

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The Role of Elective Nodal Irradiation for Esthesioneuroblastoma Patients with Clinically Negative Neck
Wen Jiang, Abdallah S R Mohamed , Clifton David Fuller, Betty Y S Kim, Chad Tang , G Brandon Gunn, Ehab Y Hanna, Steven J Frank, Shirley Y Su, Eduardo Diaz, Michael E Kupferman, Beth M Beadle, William H Morrison, Heath Skinner, Stephen Y Lai , Adel K El-Naggar, Franco DeMonte, David I Rosenthal, Adam S Garden, Jack Phan 

From the Practical Radiation Oncology, July-August 2016

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Olfactory Neuroblastoma: Fate of the Neck–A Long-term Multicenter Retrospective Study

Sunny B Nalavenkata, Raymond Sacks, Nithin D Adappa, James N Palmer, Michael T Purkey, Michael D Feldman, Rodney J Schlosser, Carl H Snyderman, Eric W Wang, Bradford A Woodworth, Robert Smee, Thomas E Havas, Richard Gallagher, Richard J Harvey
From the Otolaryngology and head and neck surgery, February 2016

From the Practical Radiation Oncology, July-August 2016

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Neck Recurrence and Mortality in Esthesioneuroblastoma: Implications for Management of the NO Neck

James G Naples , Jeffrey Spiro, Belachew Tessema, Clinton Kuwada, Chia-Ling Kuo, Seth M Brown

From The Laryngoscope, June 2016

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Dural Invasion Predicts the Laterality and Development of Neck Metastases in Esthesioneuroblastoma

John P Marinelli, Jeffrey R Janus, Jamie J Van Gompel, Michael J Link, Eric J Moore, Kathryn M Van Abe, Brandon W Peck, Christine M Lohse, Daniel L Price

From the Journal of neurological surgery. Part B, Skull Base, October 2018.

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Olfactory Neuroblastoma: Fate of the Neck–A Long-term Multicenter Retrospective Study
Sunny B Nalavenkata, Raymond Sacks, Nithin D Adappa, James N Palmer, Michael T Purkey, Michael D Feldman, Rodney J Schlosser, Carl H Snyderman, Eric W Wang, Bradford A Woodworth, Robert Smee, Thomas E Havas, Richard Gallagher, Richard J Harvey

From the Otolaryngology and head and neck surgery, February 2016