Background:Lymph node density (LND) has previously been reported to reliably predict recurrence risk and survival in oral cavity squamous cell carcinoma (OSCC). This multicenter international study was designed to validate the concept of LND in OSCC.Methods:The study included 4254 patients diagnosed as having OSCC. The median follow-up was 41 months. Five-year overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), locoregional control and distant metastasis rates were calculated using the Kaplan–Meier method. Lymph node density (number of positive lymph nodes/total number of excised lymph nodes) was subjected to multivariate analysis.Results:The OS was 49% for patients with LND⩽0.07 compared with 35% for patients with LND>0.07 (P<0.001). Similarly, the DSS was 60% for patients with LND⩽0.07 compared with 41% for those with LND>0.07 (P<0.001). Lymph node density reliably stratified patients according to their risk of failure within the individual N subgroups (P=0.03). A modified TNM staging system based on LND ratio was consistently superior to the traditional system in estimating survival measures.Conclusion:This multi-institutional study validates the reliability and applicability of LND as a predictor of outcomes in OSCC. Lymph node density can potentially assist in identifying patients with poor outcomes and therefore for whom more aggressive adjuvant treatment is needed.

Endoscopic transnasal ET balloon dilation is a novel approach to treating ET dysfunction. Benefits can be durable up to 3 years. This technique holds much promise and merits further investigation.

Through careful selection, some patients with locally advanced laryngeal cancer can be offered chemoradiation (organ preservation) without compromising survival. However, the patients selected to receive chemoradiation have a high rate of laryngeal and esophageal dysfunction.

Patients with stage I to II OCSCC and positive/close margins have poor long-term outcomes. For this population, adjuvant treatment may be associated with improved survival. Cancer 2018;124:2948-55. © 2018 American Cancer Society.

In a number of additive layer manufacturing processes, particularly for metals, additional support structure is required during the build process to act as scaffolding for overhanging features and to dissipate process heat. Such structures use valuable raw materials and their removal adds to post processing time. The objective of this study was to investigate whether a simple, single objective optimisation technique could be used to find the best orientation of the part, that would minimise the volume of support needed during the build. Not only reducing waste but potentially providing an effective and consistent approach for inexperienced users to orient components during manufacture. Software was developed using MatLab with an unconstrained optimisation algorithm implemented to search the different rotations of the part and identify the configuration with the least requirement for support volume. The algorithm was gradient based, and so multiple starting points were used to identify a global minimum. The efficacy of the algorithm is illustrated with three different case studies of increasing complexity. Additionally, the component of the final study was manufactured, which allowed a comparison between the algorithm's results and the orientations chosen by experienced operatives. In two of the three case studies, the software was able to find good solutions for the support volume minimisation. For the manufactured part, only one of the results matched the orientation chosen by the operators, the other was orientated in a similar way but the difference added significantly to the required support volume. Future developments of the software would benefit from incorporating the expertise of the manufacturing operative.