Head and neck cancer research

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:

    1. 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.

    1. 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.

    1. 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.

    1. 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.

    1. 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.



    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


    1. 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


    1. 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


    1. 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


    1. 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


    1. 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)


    1. 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)


    1. 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


    1. 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



    1. 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


    1. 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.




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