Background: With the coming of the aging society, the incidence of elderly nasopharyngeal carcinoma (NPC) has been increasing which may result in considerable disease burden; however, the optimal treatment strategy for elderly patients is still debatable.Methods and Results: Clinical data on 294 elderly NPC patients aged ≥70 treated between 2009 and 2019 was analyzed. Kaplan–Meier method was used to estimate overall survival (OS) and cancer‐specific survival (CSS) rates. With a median follow‐up of 53.25 months, the 5‐year estimated OS and CSS for the entire group were 59.5% and 69.8%, respectively. 146 patients died within the follow‐up period, of which recurrence + metastasis (48%) and internal medical disease unrelated to NPC (32%) are the primary causes of death. On univariable analysis, (IMRT vs. 3D‐CRT) (p = 0.001; p = 0.000), T stage (p = 0.001; p = 0.000), N stage (p = 0.013; p = 0.000) and clinical stage (p = 0.000; p = 0.000) were associated with OS and CSS; Charlson Comorbidity Index (CCI) (p = 0.016) was associated with OS. The addition of chemotherapy (CT) correlated with better CSS (p = 0.039), but did not improve OS (p = 0.056) for stage III–IV subgroup. On multivariate analysis, advanced clinical stage independently predicted poorer OS (p = 0.002) and CSS (p = 0.000). In addition, the application of IMRT was an independent protective factor on both OS (p = 0.028) and CSS (p = 0.030).Conclusion: IMRT is a reasonable treatment strategy to improve survival for elderly NPC patients aged over 70 years; consideration of adding chemotherapy for elderly population should be weighed carefully.

Aims: Primary mucoepidermoid carcinomas (MECs) of the sinonasal tract and nasopharynx are rare entities that represent a diagnostic challenge, especially in biopsy samples. Herein, we present a case series of MECs of the sinonasal and skull base and its mimics to evaluate the clinicopathological and molecular characteristics in order to avoid misdiagnosis. Methods: We reviewed the pathology records of patients diagnosed from 2014 to 2022. Thirty MECs were consecutively diagnosed during that period. Results: Based on morphological and fluorescence in situ hybridization (FISH) analyses, 30 tumors originally diagnosed as MECs were separated into MAML2 fusion-positive (7 cases) and MAML2 fusion-negative groups (23 cases), in which 14 tumors were positive for the EWSR1::ATF1 fusion; these tumors were reclassified to have hyalinizing clear cell carcinoma (HCCC). The remaining nine MAML2 FISH negative cases were reconfirmed as squamous cell carcinoma (SCC, 3 cases) which showed keratinization and high Ki-67 expression; DEK::AFF2 carcinomas (2 cases), in which DEK gene rearrangement was detected by FISH; and MECs as previously described (4 cases) with typical morphological features. Including 7 MAML2 rearrangements tumors, 11 MEC cases had a male-to-female ratio of 4.5:1, and 6 tumors arose from the nasopharyngeal region, while 5 tumors arose from the sinonasal region. The prognosis of this series of salivary gland-type MECs was favorable. Conclusions: Our study confirmed that HCCC runs the risk of being misdiagnosed as MEC in the sinonasal tract and nasopharynx, particularly with biopsy specimens. Careful histological evaluation with supporting molecular testing can facilitate pathological diagnoses.

Laryngeal squamous cell carcinoma (LSCC) presents significant treatment challenges, especially regarding recurrence after larynx-preservation therapy. We identified distinct microbial community structures between recurrence and non-recurrence groups, particularly highlighting the genera abundance of Fusobacterium and Serratia. However, larynx-preserving therapy did not significantly alter microbial diversity in recurrent patients. Survival analysis identified Fusobacterium and Serratia as independent prognostic factors for recurrence, leading to the development of a Serratia-Fusobacterium (SF) prognostic scoring model. The SF model achieved an AUC of 81.37% for predicting recurrence, outperforming the TNM staging system. LSCC patients classified as high-risk by the SF model exhibited significantly shorter disease-free survival (DFS) compared to low-risk patients in the LSCC cohort. Furthermore, the SF model demonstrated an AUC of 78.48% in the multi-center cohort for predicting recurrence. In conclusion, the Serratia-Fusobacterium prognostic scoring model can predict LSCC recurrence after larynx-preserving therapy and provide valuable insights to inform recommendations for LSCC surveillance.