Euractiv Croatia is hereby displaying the main conclusions of the conference.
We are delighted to inform you on behalf of Croatian Head and Neck Society, Croatian Society of Oto-Rhino-Laryngology, Head and Neck Surgery and partners, in historical momentum of Croatian Presidency of the EU Council, about conclusions of High Level Expert Digital MeetUp „ZOOM ON HEAD AND NECK CANCER - (R)Evolution of Care“, that was held on June 10th 2020, under the patronage of the Croatian Academy for Science and Arts - Department for Medical Sciences, supported by Croatian Ministry of Health and Central State Office for Development of Digital Society.
Under the EU2020HR and in expectation of EU Beating Cancer Plan, there was an opportunity for Croatia to connect scientific leaders and share global and European best practices on H&N cancer prevention, treatment and integrated care in an era of robotic surgery, artificial intelligence and immunooncology. Program will cover following topics: H&N cancer prevention, multidisciplinary approach, digital transformation and innovative treatments.
European Commissioner for Health and Food Safety Stella Kyriakides also made an important contribution to the conference, emphasizing that the European Union is strongly committed to finalizing the EU Beating Cancer Plan, which will higlight value of cancer prevention and equal opportunities for all European citizens. in terms of accessibility to oncology care, from diagnosis to treatment. We are looking forward that conclusions from this event will be a valuable contribution on the healthcare agenda of the Croatian Presidency of the EU Council.
Multidisciplinary approach in H&N cancer
The management of head and neck cancers is very complex.
Treatment is based on site of disease and degree of invasion and metastases.
We have to choose the best one for each patient
No one in any expertise or profession can make optimal treatment decisions individually.
The multidisciplinary team (MDT) is an essential part of the management of H&N cancer.
The core members include head and neck surgeons, radiation and medical oncologists, pathologists, radiologists, swallow and speech therapist, nurse specialists and also dieticians.
Benefits of MDT
Better quality of life.
Shorter waiting times between each stage of service (from first visit to the diagnosis and to treatment.
Patients and family satisfaction increase when they are in immersed in a good organization.
The newest treatments and protocols can be discussed and proposed to our patient.
Higher access to information and participation in clinical trials.
Higher possibility to implement clinical practice guidelines.
Reduction of cost in the treatment.
HPV and H&N cancer
• Tobacco and alcohol use have been reported to be associated with H&N cancer.
• Infection with high-risk human papillomaviruses (HPVs) has recently been implicated in the pathogenesis of H&N cancer.
• HPV-related H&N cancer are increasing.
• HPV-related H&N cancer are known to have a better prognosis response to treatment as compared with HPV-unrelated H&N cancer.
• However, randomized trials evaluating de-intensification strategies substituting cisplatin with cetuximab have failed to show non-inferiority in terms of outcome and current guidelines do not recommend a different treatment approach for HPV+ OSCC.
• Future studies are necessary to establish the role of de-escalation treatment approaches in HPV+ OSCC
Transoral robotic surgery (TORS) in H&N cancer
TORS provides superb three-dimensional visualisation and magnification in all directions, minimally invasive and less morbid access.
In patients undergoing TORS, shorter operative time and decreased hospital stay have been observed.
Excellent oncological and functional outcomes have been also reported.
Some trials highlight the potential of surgical de-intensification in treatment of OCC (radically reduce the toxicity of current treatments.
Immunotherapy of H&N cancer
Imunotherapy is based on the fact that tumor cells present changes in antigen structures or changes occur in tumor microenvironment.
These changes are also notes in H&N cancer.
Anti-programmed cell death 1 (PD-1) therapies, currently approved for platinum-refractory recurrent and/or metastatic H&N cancer, offer the prospect of long term remission.
In the near future immunotherapy might be used to enhance the efficacy of conventional treatments in the curative settings and expected to advance to earlier lines of therapy.
Contributors to conclusions:
SPEAKERS / PANELISTS
Jatin Shah, M.D., Ph.D, (Hon) FACS, FRCS (Hon), FDSRCS (Hon), FRACS (Hon), The Elliott W. Strong Chair in Head and Neck Oncology at Memorial Sloan-Kettering Cancer Center, New York. CEO of International Federation of Head and Neck Oncologic Societies (IFHNOS)
Wojciech Golusiński, M.D., Ph.D., Chair of the Department of Head and Neck Services of the Poznan University of Medical Sciences, President of European Head and Neck Society (EHNS)
Robert Ferris, M.D., Ph.D., FACS, Director, UPMC Hillman Cancer Center, Associate Vice Chancellor for Cancer Research, Co-Director, Tumor Microenvironment Center, Professor, Department of Otolaryngology, of Immunology, and of Radiation Oncology, University of Pittsburgh
Asit Arora, PhD, DIC, DOHNS, FRCS (ORL-HNS) ENT Airway Robotic Head & Neck Consultant Surgeon, Guy's and St Thomas' Hospitals
Zvonko Kusić, M.D., Ph.D., president of Croatian Academy of Science and Arts. Professor of Nuclear Medicine and Oncology, School of Medicine Zagreb, president of Croatian Thyroid Society
Miroslav Samaržija, M.D., Ph.D., full member of Croatian Academy of Science and Arts, Chair of The Department of Pulmonary Diseases, University Hospital Centre Zagreb, School of Medicine Zagreb, president of Croatian Thoracic Society
Zoran Rakušić, M.D., Ph.D., The Department for Oncology, Head of Division of Head and Nech Tumor, University Hospital Center Zagreb
Thomas Hoffmann, M.D., Ph.D., Head of The Department of Otorhinolaryngology, Head Neck Surgery, University Hospital Ulm
Roberto Persio, European Cancer Patient Coalition
Boštjan Lanišnik, M.D., Ph.D., chair of the Department of Otorhinolaryngology, Cervical and Maxillofacial Surgery University Medical Centre Maribor
Ricard Simo, M.D., Ph.D., FRCS, Head and Neck Center, Guy's and St Thomas' Hospital, London. Senior Lecturer at GKT Medical School.
Stjepko Pleština, M.D., Ph.D., chair of The Department for Oncology, University Hospital Center Zagreb, President of Croatian Society of Medical Oncology
Rene Leemans, M.D., Ph.D. Chair of the Department of ENT Head and Neck surgery VU University Medical Center, Amsterdam. President of the Netherlands Society of Otolaryngology-Head and Neck Surgery
Danko Velimir Vrdoljak, M.D., Ph.D., FACS, The Department for Oncology, Sisters of Charity Hospital, Zagreb. Special Hospital Radiochirurgia, President of Croatian Society of Surgical Oncology
Krešimir Gršić, MD, PhD, Chief of Division of Head & Neck Surgery, Department of ENT and Head and Neck Surgery, University Hospital Centre Zagreb, School of Medicine Zagreb
Ivica Lukšić, M.D., Ph.D. Chair of the Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb
Primož Strojan MD, PhD. Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
Drago Prgomet, M.D., Ph.D., president of Croatian Head and Neck Society, Chair of The Department of ENT and Head and Neck Surgery, School of Medicine, University Hospital Centre Zagreb