Chris O’Brien Lifehouse’s head and neck cancer research programme helps our patients to access cutting edge treatments that deliver the best possible outcomes.
Head and neck research cancer research overview
The Lifehouse Head and Neck cancer unit undertakes a broad range of head and neck cancer research including disease outcomes (recurrence and survival) following surgery and radiotherapy, clinicopathological prognostic markers, patient reported outcomes (QoL), patient education and reconstructive techniques. The Sydney Head and Neck Cancer Institute (SHNCI) head and neck database brings together data from collaborators across Sydney and has been the cornerstone to facilitate these studies. In addition, collaborations with Royal Prince Alfred Hospital department of pathology, the University of Sydney, the University of Wollongong, the University of NSW and University of Technology have facilitated a rapidly growing basic science and translational research program. The unit continues to undertake a variety of head and neck cancer research projects and support individuals with particular interests, however there are four areas of focus:
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- Advanced cutaneous squamous cell carcinoma (cSCC)
The focus of this work is the identification of molecular prognostic markers to assist in identifying potentially lethal cSCC. The SHNCI continues to run a prospective sentinel node study for high risk cutaneous SCC and the interim results of this study (the largest of its kind) were published in 2015. Accrual now approaches 100 patients and these specimens have been used for several molecular studies looking for predictors of metastases in high risk cutaneous SCC.
- Aggressive salivary gland cancers (SGC)
A review was undertaken into the pathology and clinical follow-up of aggressive salivary gland cancers treated at the SHNCI. This included analysis of two potential biomarkers, Mammary analogue salivary cancer (MASC) and MAML2 translocation in mucoepidermoid cancer and salivary duct cancer.
- Oral squamous cell cancer (OSCC)
Several large multi-institutional studies were published by the ICOR group (international consortium oral cancer research) incorporating data from the SHCNI. The effect of p16 expression and human papilloma virus (HPV) status was explored in a collaborative study with A/Prof Iyer (NCI Singapore) examining differences in p16 expression between institutions including the effect of ethnic differences.
- Patient education – the Comprehensive Head and Neck Education and Support (CHANCES) program
The CHANCES program is a web based resource to support patients with head and neck cancer and their carers. A body of research underpins the program to provide an evidence based approach to head and neck education resources. The first step is determining what are the deficiencies in head and neck education and how they can be addressed. Two multicenter studies have been initiated to determine both the clinician perspective and the patient perspective on education resources in head and neck cancer.
- Thyroid cancer
A/Prof Michael Elliot leads the thyroid translational research program in conjunction with Dr Elizabeth Chua and A/Prof Sue Mclennan (USyd). This group is examining differential miRNA expression profiling in thyroid cancer and is also focussing on investigating miRNA expression in the serum to identify an alternative marker of recurrent/persistent disease.
Publications
1 Ebrahimi, A.; Gil, Z.; Amit, M.; Yen, T. C.; Liao, C. T.; Chatturvedi, P.; Agarwal, J.; Kowalski, L.; Kreppel, M.; Cernea, C.; Brandao, J.; Bachar, G.; Villaret, A. B.; Fliss, D.; Fridman, E.; Robbins, K. T.; Shah, J.; Patel, S.; Clark, J.; International Consortium for Outcome Research in, Head; Neck, Cancer Comparison of the American Joint Committee on Cancer N1 versus N2a nodal categories for predicting survival and recurrence in patients with oral cancer: Time to acknowledge an arbitrary distinction and modify the system Head Neck (2016) 38 1 135-9 PMID: 25227311 DOI: http://dx.doi.org/10.1002/hed.23871 RGMS ID P13296697
2 Luk, Peter P.; Wykes, James; Selinger, Christina I.; Ekmejian, Rafael; Tay, Jessica; Gao, Kan; Eviston, Timothy J.; Lum, Trina; O’Toole, Sandra A.; Clark, Jonathan R.; Gupta, Ruta Diagnostic and prognostic utility of Mastermind-like 2 (MAML2) gene rearrangement detection by fluorescent in-situ hybridization (FISH) in mucoepidermoid carcinoma of the salivary glands Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology (2016) DOI: http://dx.doi.org/10.1016/j.oooo.2016.01.003 RGMS ID P13296647
3 Heiduschka, G.; Virk, S. A.; Palme, C. E.; Ch’ng, S.; Elliot, M.; Gupta, R.; Clark, J. Margin to tumor thickness ratio – A predictor of local recurrence and survival in oral squamous cell carcinoma Oral Oncol (2016) PMID: 26861256 DOI: http://dx.doi.org/10.1016/j.oraloncology.2016.01.010 RGMS ID P13296678
4 Buckley, Lisa; Gupta, Ruta; Ashford, Bruce; Jabbour, Joe; Clark, Jonathan R. Oropharyngeal cancer and human papilloma virus: evolving diagnostic and management paradigms ANZ Journal of Surgery (2016) n/a-n/a DOI: http://dx.doi.org/10.1111/ans.13417 RGMS ID P13296735
5 Burgess, M; Leung, M; Chellapah, A; Crombie, A; Clark, J; Batstone, M A retrospective analysis of osseo-integrated implants placed into vascularised free-flaps of the head and neck–a multicentre analysis International Journal of Oral and Maxillofacial Surgery (2015) 44 e98 RGMS ID P13296734
6 McAndrew, Darryl; Buckley, Lisa; Ashford, Bruce; Clark, Jonathan Anatomical Mapping of the Omental Vasculature to Refine its Optimal Use in Free Flap Transfer The FASEB Journal (2015) 29 1 Supplement 544.3 RGMS ID P13296645
7 Brunner, M.; Ng, B. C.; Veness, M. J.; Clark, J. R. Assessment of the new nodal classification for cutaneous squamous cell carcinoma and its effect on patient stratification Head Neck (2015) 37 3 336-9 PMID: 24415458 DOI: http://dx.doi.org/10.1002/hed.23602 RGMS ID P13296737
8 Gore, S. M.; Crombie, A. K.; Batstone, M. D.; Clark, J. R. Concurrent chemoradiotherapy compared with surgery and adjuvant radiotherapy for oral cavity squamous cell carcinoma Head Neck (2015) 37 4 518-23 PMID: 24532246 DOI: http://dx.doi.org/10.1002/hed.23626 RGMS ID P13296684
9 Habib, M.; Murgasen, J.; Gao, K.; Ashford, B.; Shannon, K.; Ebrahimi, A.; Clark, J. R. Contralateral neck failure in lateralized oral squamous cell carcinoma ANZ J Surg (2015) PMID: 26138827 DOI: http://dx.doi.org/10.1111/ans.13206 RGMS ID P13296682
10 Hasmat, Shaheen; Lovell, Nigel H; Eviston, Timothy; Ekmejian, Rafael; Suaning, Gregg J; Clark, Jonathan Creating eye closure in patients with facial nerve paralysis using an implantable solenoid actuator Engineering in Medicine and Biology Society (EMBC), 2015 37th Annual International Conference of the IEEE (2015) 1357-1360 RGMS ID P13296679
11 Luk, Peter P.; Selinger, Christina; Wykes, James; Eviston, Tim; Ekmejian, Rafael; Tay, Jess; Lum, Trina; O’Toole, Sandra A.; Clark, Jonathan R.; Gupta, Ruta DIAGNOSTIC AND PROGNOSTIC UTILITY OF MASTERMIND-LIKE 2 (MAML2) GENE REARRANGEMENT DETECTED BY FLUORESCENT IN-SITU HYBRIDISATION (FISH) IN MUCOEPIDERMOID CARCINOMA Pathology – Journal of the RCPA (2015) 47 S69 DOI: http://dx.doi.org/10.1097/01.pat.0000461507.93729.63 RGMS ID P13296651
12 Luk, Peter P; Weston, Jared; Selinger, Christina; Eviston, Tim; Lum, Trina; O’Toole, Sandra A; Clark, Jonathan R; Gupta, Ruta EXPLORING SALIVARY DUCT CARCINOMA: CLINICOPATHOLOGIC FEATURES, MORPHOLOGIC SPECTRUM AND GENETIC CHANGES Pathology-Journal of the RCPA (2015) 47 S68 RGMS ID P13296649
13 Brunner, M.; Gore, S. M.; Read, R. L.; Alexander, A.; Mehta, A.; Elliot, M.; Milross, C.; Boyer, M.; Clark, J. R. Head and neck multidisciplinary team meetings: Effect on patient management Head Neck (2015) 37 7 1046-50 PMID: 24710807 DOI: http://dx.doi.org/10.1002/hed.23709 RGMS ID P13296740
14 Luk, Peter P; Selinger, Christina; Eviston, Tim; Lum, Trina; O’Toole, Sandra A; Clark, Jonathan R; Gupta, Ruta MAMMARY ANALOGUE SECRETORY CARCINOMA: AN EVALUATION OF ITS GENETIC AND CLINICAL CHARACTERISTICS Pathology-Journal of the RCPA (2015) 47 S69 RGMS ID P13296652
15 Luk, P. P.; Selinger, C. I.; Eviston, T. J.; Lum, T.; Yu, B.; O’Toole, S. A.; Clark, J. R.; Gupta, R. Mammary analogue secretory carcinoma: an evaluation of its clinicopathological and genetic characteristics Pathology (2015) 47 7 659-66 PMID: 26517645 DOI: http://dx.doi.org/10.1097/PAT.0000000000000322 RGMS ID P13296650
16 Eviston, Timothy J.; Yabe, Takako E.; Gupta, Ruta; Ebrahimi, Ardalan; Clark, Jonathan R. Parotidectomy: surgery in evolution ANZ Journal of Surgery (2015) n/a-n/a DOI: http://dx.doi.org/10.1111/ans.13212 RGMS ID P13296690
17 Aivazian, K.; Ebrahimi, A.; Low, T. H.; Gao, K.; Clifford, A.; Shannon, K.; Clark, J. R.; Gupta, R. Perineural invasion in oral squamous cell carcinoma: quantitative subcategorisation of perineural invasion and prognostication J Surg Oncol (2015) 111 3 352-8 PMID: 25363330 DOI: http://dx.doi.org/10.1002/jso.23821 RGMS ID P13296749
18 Amit, M.; Yen, T. C.; Liao, C. T.; Chaturvedi, P.; Agarwal, J. P.; Kowalski, L. P.; Kohler, H. F.; Ebrahimi, A.; Clark, J. R.; Cernea, C. R.; Brandao, S. J.; Kreppel, M.; Zoller, J.; Fliss, M. D.; Bachar, G.; Shpitzer, T.; Bolzoni, V. A.; Patel, P. R.; Jonnalagadda, S.; Robbins, K. T.; Iyer, N. G.; Skanthakumar, T.; Shah, J. P.; Patel, S. G.; Gil, Z. Prognostic Performance of Current Stage III Oral Cancer Patients After Curative Intent Resection: Evidence to Support a Revision of the American Joint Committee on Cancer Staging System Ann Surg Oncol (2015) 22 Suppl 3 3 985-91 PMID: 26314876 DOI: http://dx.doi.org/10.1245/s10434-015-4842-3 RGMS ID P13296744
19 Ong, W.; Zhao, R.; Lui, B.; Tan, W.; Ebrahimi, A.; Clark, J. R.; Soo, K. C.; Tan, N. C.; Tan, H. K.; Iyer, N. G. Prognostic significance of lymph node density in squamous cell carcinoma of the tongue Head Neck (2015) PMID: 25917601 DOI: http://dx.doi.org/10.1002/hed.24113 RGMS ID P13296636
20 Gore, S. M.; Shaw, D.; Martin, R. C.; Kelder, W.; Roth, K.; Uren, R.; Gao, K.; Davies, S.; Ashford, B. G.; Ngo, Q.; Shannon, K.; Clark, J. R. Prospective study of sentinel node biopsy for high-risk cutaneous squamous cell carcinoma of the head and neck Head Neck (2015) PMID: 25965008 DOI: http://dx.doi.org/10.1002/hed.24120 RGMS ID P13296683
21 Wang, Shu; Wykes, James; McKenzie, Paul R; Milross, Chris G; Boyer, Michael J; Clark, Jonathan R; Gupta, Ruta QUANTIFYING THE CONTRIBUTION OF PATHOLOGY TO PATIENT MANAGEMENT: A REVIEW OF PATHOLOGY CASES PRESENTED AT A HEAD AND NECK MULTIDISCIPLINARY MEETING Pathology-Journal of the RCPA (2015) 47 S79 RGMS ID P13296619
22 Low, T. H.; Lindsay, A.; Clark, J.; Chai, F.; Lewis, R. Reconstruction of maxillary defect with musculo-adipose rectus free flap Microsurgery (2015) PMID: 26109516 DOI: http://dx.doi.org/10.1002/micr.22439 RGMS ID P13296653
23 Zhang, X.; Gee, H.; Rose, B.; Lee, C. S.; Clark, J.; Elliott, M.; Gamble, J. R.; Cairns, M. J.; Harris, A.; Khoury, S.; Tran, N. Regulation of the tumour suppressor PDCD4 by miR-499 and miR-21 in oropharyngeal cancers BMC Cancer (2015) 16 1 86 PMID: 26867589 DOI: http://dx.doi.org/10.1186/s12885-016-2109-4 RGMS ID P13296613
24 Hong, Angela; Lee, C Soon; Jones, Deanna; Veillard, Anne‐Sophie; Zhang, Mei; Zhang, Xiaoying; Smee, Robert; Corry, June; Porceddu, Sandro; Milross, Christopher Rising prevalence of human papillomavirus–related oropharyngeal cancer in Australia over the last 2 decades Head & neck (2015) RGMS ID P13296674
25 Luk, P. P.; Weston, J. D.; Yu, B.; Selinger, C. I.; Ekmejian, R.; Eviston, T. J.; Lum, T.; Gao, K.; Boyer, M.; O’Toole, S. A.; Clark, J. R.; Gupta, R. Salivary duct carcinoma: Clinicopathologic features, morphologic spectrum, and somatic mutations Head Neck (2015) PMID: 26699379 DOI: http://dx.doi.org/10.1002/hed.24332 RGMS ID P13296648
26 Weston, J; Luk, P; Selinger, C; Ekmejian, R; Eviston, T; Lum, T; Gao, K; O’Toole, S; Clark, J; Yu, B Salivary duct carcinoma: clinicopathologic features, morphologic spectrum and genetic changes International Journal of Oral and Maxillofacial Surgery (2015) 44 e165 RGMS ID P13296618
27 Satgunaseelan, Laveniya; Virk, Sohaib; Lum, Trina; Gao, Kan; Clark, Jonathan; Gupta, Ruta THE ROLE OF p16 EXPRESSION IN ORAL SQUAMOUS CELL CARCINOMA Pathology-Journal of the RCPA (2015) 47 S53 RGMS ID P13296627
28 Weston, J; Wykes, J; Clark, J Treatment variations in patients discussed at head and neck multidisciplinary team meetings International Journal of Oral and Maxillofacial Surgery (2015) 44 e306 RGMS ID P13296617
29 Low, T. H.; Gao, K.; Elliott, M.; Clark, J. R. Tumor classification for early oral cancer: re-evaluate the current TNM classification Head Neck (2015) 37 2 223-8 PMID: 24375610 DOI: http://dx.doi.org/10.1002/hed.23581 RGMS ID P13296655
- Moloney, E. C.; Brunner, M.; Alexander, A. J.; Clark, J. Quantifying fibrosis in head and neck cancer treatment: An overview Head Neck (2015) 37 8 1225-31 PMID: 24797251 DOI: http://dx.doi.org/10.1002/hed.23722 RGMS ID P13296751
- Gupta, R.; Balasubramanian, D.; Clark, J. R. Salivary gland lesions: recent advances and evolving concepts Oral Surg Oral Med Oral Pathol Oral Radiol (2015) 119 6 661-74 PMID: 25840511 DOI: http://dx.doi.org/10.1016/j.oooo.2015.02.481 RGMS ID P13296753
- Clark, J.R.; Gupta, R Sidebar in: Goyal, G.; Mehdi, S. A.; Ganti, A. K.
Salivary Gland Cancers: Biology and Systemic Therapy Oncology (Williston Park) (2015) 29 10 773-80 PMID: 26470903 RGMS ID P13296755
- Maher NG, Collgros H, Uribe P, Ch’ng S, Rajadhyaksha M, Guitera P. In vivo confocal microscopy for the oral cavity: Current state of the field and future potential. Oral Oncol. 2016 Jan 16. pii: S1368-8375(16)00004-X. doi: 10.1016/j.oraloncology.2016.01.003. [Epub ahead of print]
Book Chapters 2015
- Ch’ng S, Low I, Alexander A, Clark JR
Merkel cell carcinoma and other rare skin cancers
In Sataloff’s Text Book of Otolaryngologic Surgery
Jp Medical Publishers (Nov. 30 2015)
- Ch’ng S, Low I, Alexander A, Clark JR
Non-melanoma skin cancer
In Sataloff’s Text Book of Otolaryngologic Surgery
Jp Medical Publishers (Nov. 30 2015)
- Wykes J, Clark JR, Niles N
The role of sentinel node biopsy in non-melanoma skin cancer
In Non-Melanoma skin cancer of the head and neck
2015 Head and Neck Cancer Clinics Springer
- Alexander A, Gore S, Clark RJ
Reconstructive Option for the Face
In Non-Melanoma skin cancer of the head and neck
2015 Head and Neck Cancer Clinics Springer
Grants:
- Measuring the genomic architecture and evolution of papillary thyroid cancer (PTC) by multi-regional sequencing $5000
Chief Investigator: Dr Joel Smith
Granting Body: The Midlands Institute of Otology 2015
- Genetic Stratification of tumours of the head, neck, pituitary and skull base – identifying prognostic and new therapeutic targets $360 000
Chief Investigator: A/Prof Marcel Dinger
Granting Body: Cancer Council NSW 2015 – 2017
3. Understanding the molecular and genetic changes that lead to metastasis in cutaneous squamous cell carcinoma (cSCC) $25 000 Chief Investigator: Dr Bruce Ashford
Granting Body: IMHRI 2015
4. Comprehensive Head and Neck Cancer Education and Support (CHANCES) program $1 000 000
Chief Investigator: Dr Jonathan Clark
Granting Body: Private donation to Lifehouse 2015
5. Isolated tumour cells in neck dissection for squamous cell carcinoma
$ 5000
Chief investigator: Simone Visage
Royal College of Pathologists of Australasia project support.