{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:20:46Z","timestamp":1791235246378,"version":"4.1.0"},"reference-count":87,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T00:00:00Z","timestamp":1725235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Oropharyngeal squamous-cell carcinoma (OPSCC) poses significant challenges in diagnosis, treatment, and management and has important medico-legal and forensic implications. In particular, the management of OPSCC and its treatment-related complications can often be challenging. In cases with advanced OPSCC, a loco-regional extension of the tumor can contribute to the destruction of oral cavity tissues, while the radiotherapy treatment can induce profound changes in tissue morphology and structure. These changes, which resemble tumor neoplasms and endovascular effects, are related to a higher risk of fatal bleeding, as reported in the case study illustrated, in which a hemorrhage occurred from a lingual artery, originating from an ulcerative, necrotic, hemorrhagic lesion on the tongue. Bleeding complications in OPSCC and prolonged radiotherapy are associated with high mortality and require comprehensive management strategies to improve survival and quality of life. Autopsy investigations, contributing to the definition of post-mortem diagnosis, can provide valuable insights into the pathogenetic mechanisms underlying bleeding and guide therapeutic decisions and preventive measures. The integration of autopsy and histopathological investigation into clinical practice should be considered as a necessary support to optimize the management of complications in advanced OPSCC patients, emphasizing the importance of a patient-centered approach and continued research.<\/jats:p>","DOI":"10.3390\/jcm13175198","type":"journal-article","created":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T10:07:35Z","timestamp":1725271655000},"page":"5198","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Challenges and Complications in the Management of Advanced Oropharyngeal Carcinoma: Role of Post-Mortem Diagnosis and Future Perspectives"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8467-249X","authenticated-orcid":false,"given":"Francesca","family":"Consalvo","sequence":"first","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy"},{"name":"BrainLab s.r.l., Mercato San Severino, 84085 Salerno, Italy"},{"name":"Unit of Legal Medicine, University Hospital \u201cSan Giovanni di Dio e Ruggi D\u2019Aragona\u201d, 84081 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8172-6134","authenticated-orcid":false,"given":"Matteo","family":"De Simone","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy"},{"name":"BrainLab s.r.l., Mercato San Severino, 84085 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9219-6175","authenticated-orcid":false,"given":"Alfonso","family":"Scarpa","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Acerra","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy"},{"name":"Unit of Otolaryngology, University Hospital \u201cSan Giovanni di Dio e Ruggi, D\u2019Aragona\u201d, 84081 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4090-8120","authenticated-orcid":false,"given":"Francesco Antonio","family":"Salzano","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy"},{"name":"Unit of Otolaryngology, University Hospital \u201cSan Giovanni di Dio e Ruggi, D\u2019Aragona\u201d, 84081 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1686-3236","authenticated-orcid":false,"given":"Vittorio","family":"Fineschi","sequence":"additional","affiliation":[{"name":"Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5491-3719","authenticated-orcid":false,"given":"Alessandro","family":"Santurro","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy"},{"name":"Unit of Legal Medicine, University Hospital \u201cSan Giovanni di Dio e Ruggi D\u2019Aragona\u201d, 84081 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.oraloncology.2008.06.002","article-title":"Global epidemiology of oral and oropharyngeal cancer","volume":"45","author":"Warnakulasuriya","year":"2009","journal-title":"Oral Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1002\/hed.26019","article-title":"Anatomical subsite modifies survival in oropharyngeal squamous cell carcinoma: National Cancer Database study","volume":"42","author":"Tham","year":"2020","journal-title":"Head Neck"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1038\/s41571-022-00603-7","article-title":"HPV-associated oropharyngeal cancer: Epidemiology, molecular biology and clinical management","volume":"19","author":"Lechner","year":"2022","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3235","DOI":"10.1200\/JCO.2015.61.6995","article-title":"Epidemiology of Human Papillomavirus-Positive Head and Neck Squamous Cell Carcinoma","volume":"33","author":"Gillison","year":"2015","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"724","DOI":"10.15585\/mmwr.mm6833a3","article-title":"Human Papillomavirus-Attributable Cancers\u2014United States, 2012\u20132016","volume":"68","author":"Senkomago","year":"2019","journal-title":"MMWR. Morb. Mortal. Wkly. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3322\/caac.21763","article-title":"Cancer statistics, 2023","volume":"73","author":"Siegel","year":"2023","journal-title":"CA A Cancer J. Clin."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"6598","DOI":"10.1158\/0008-5472.CAN-16-0633","article-title":"HPV-Related Oropharynx Cancer in the United Kingdom: An Evolution in the Understanding of Disease Etiology","volume":"76","author":"Schache","year":"2016","journal-title":"Cancer Res."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Don\u00e0, M.G., Rollo, F., Pichi, B., Spriano, G., Moretto, S., Covello, R., Pellini, R., and Benevolo, M. (2020). Evolving Profile of HPV-Driven Oropharyngeal Squamous Cell Carcinoma in a National Cancer Institute in Italy: A 10-Year Retrospective Study. Microorganisms, 8.","DOI":"10.3390\/microorganisms8101498"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1038\/s41416-019-0414-9","article-title":"Recommendations for determining HPV status in patients with oropharyngeal cancers under TNM8 guidelines: A two-tier approach","volume":"120","author":"Craig","year":"2019","journal-title":"Br. J. Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.oraloncology.2018.11.020","article-title":"Evidence for the approach to the diagnostic evaluation of squamous cell carcinoma occult primary tumors of the head and neck","volume":"88","author":"Golusinski","year":"2019","journal-title":"Oral Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1001\/jamaoto.2014.141","article-title":"Initial symptoms in patients with HPV-positive and HPV-negative oropharyngeal cancer","volume":"140","author":"McIlwain","year":"2014","journal-title":"JAMA Otolaryngol Head Neck Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1001\/jamaoto.2017.2019","article-title":"Defining the Prevalence and Prognostic Value of Perineural Invasion and Angiolymphatic Invasion in Human Papillomavirus-Positive Oropharyngeal Carcinoma","volume":"143","author":"Albergotti","year":"2017","journal-title":"JAMA Otolaryngol Head Neck Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.oraloncology.2017.09.007","article-title":"Tumor thickness versus depth of invasion\u2014Analysis of the 8th edition American Joint Committee on Cancer Staging for oral cancer","volume":"74","author":"Dirven","year":"2017","journal-title":"Oral Oncol."},{"key":"ref_14","first-page":"267","article-title":"Review of the complications associated with treatment of oropharyngeal cancer: A guide for the dental practitioner","volume":"44","author":"Turner","year":"2013","journal-title":"Quintessence Int."},{"key":"ref_15","first-page":"721","article-title":"Oral Complications of The Oromaxillofacial Area Radiotherapy","volume":"18","author":"Ahadian","year":"2017","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"625","DOI":"10.2174\/1389201020666190408095050","article-title":"Advanced Loss Eventuality Assessment and Technical Estimates: An Integrated Approach for Management of Healthcare-Associated Infections","volume":"20","author":"Gatto","year":"2019","journal-title":"Curr. Pharm. Biotechnol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.gien.2013.09.002","article-title":"Cyst-like periapical lesion healing in an orthodontic patient: A case report with five-year follow-up","volume":"27","author":"Paduano","year":"2013","journal-title":"G. Ital. Di Endod."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"D\u2019Errico, S., Zanon, M., Radaelli, D., Padovano, M., Santurro, A., Scopetti, M., Frati, P., and Fineschi, V. (2022). Medication Errors in Pediatrics: Proposals to Improve the Quality and Safety of Care Through Clinical Risk Management. Front. Med., 8.","DOI":"10.3389\/fmed.2021.814100"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"242","DOI":"10.2174\/1389201018666170208125131","article-title":"Personalised Healthcare: The DiMA Clinical Model","volume":"18","author":"Borro","year":"2017","journal-title":"Curr. Pharm. Biotechnol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Hargreaves, S., Beasley, M., Hurt, C., Jones, T.M., and Evans, M. (2019). Deintensification of Adjuvant Treatment After Transoral Surgery in Patients with Human Papillomavirus-Positive Oropharyngeal Cancer: The Conception of the PATHOS Study and Its Development. Front. Oncol., 9.","DOI":"10.3389\/fonc.2019.00936"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"263","DOI":"10.2174\/1389201018666170207141525","article-title":"Personalized Medicine Applied to Forensic Sciences: New Advances and Perspectives for a Tailored Forensic Approach","volume":"18","author":"Santurro","year":"2017","journal-title":"Curr. Pharm. Biotechnol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"274","DOI":"10.2174\/1389201018666170207124835","article-title":"Personalized Medicine and Adverse Drug Reactions: The Experience of An Italian Teaching Hospital","volume":"18","author":"Fineschi","year":"2017","journal-title":"Curr. Pharm. Biotechnol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1007\/s11547-015-0561-x","article-title":"Errors and malpractice lawsuits in radiology: What the radiologist needs to know","volume":"120","author":"Frati","year":"2015","journal-title":"La Radiol. Medica"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Klasen, C., Wuerdemann, N., Rothbart, P., Prinz, J., Eckel, H.N.C., Suchan, M., Kopp, C., Johannsen, J., Ziogas, M., and Charpentier, A. (2023). Sex-specific aspects in patients with oropharyngeal squamous cell carcinoma: A bicentric cohort study. BMC Cancer, 23.","DOI":"10.1186\/s12885-023-11526-6"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA A Cancer J. Clin."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2468","DOI":"10.1158\/0008-5472.CAN-14-2843","article-title":"NHANES 2009-2012 Findings: Association of Sexual Behaviors with Higher Prevalence of Oral Oncogenic Human Papillomavirus Infections in U.S. Men","volume":"75","author":"Chaturvedi","year":"2015","journal-title":"Cancer Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.ijwd.2019.10.003","article-title":"Dermatologic conditions in women receiving systemic cancer therapy","volume":"5","author":"Ferreira","year":"2019","journal-title":"Int. J. Women\u2019s Dermatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1016\/j.ijom.2015.04.015","article-title":"Gender differences in prognostic factors for oral cancer","volume":"44","author":"Honorato","year":"2015","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1007\/s11864-022-00941-9","article-title":"Induction Chemotherapy in Low-Risk HPV+ Oropharyngeal Cancer","volume":"23","author":"Dolezal","year":"2022","journal-title":"Curr. Treat. Options Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.21037\/atm-20-2984","article-title":"De-intensification strategies in HPV-related oropharyngeal squamous cell carcinoma-a narrative review","volume":"8","author":"Strohl","year":"2020","journal-title":"Ann. Transl. Med."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Fasano, M., D\u2019Onofrio, I., Belfiore, M.P., Angrisani, A., Caliendo, V., Della Corte, C.M., Pirozzi, M., Facchini, S., Caterino, M., and Guida, C. (2022). Head and Neck Squamous Cell Carcinoma in Elderly Patients: Role of Radiotherapy and Chemotherapy. Cancers, 14.","DOI":"10.3390\/cancers14030472"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1001\/jamaoto.2018.0310","article-title":"Age Profile of Patients with Oropharyngeal Squamous Cell Carcinoma","volume":"144","author":"Rettig","year":"2018","journal-title":"JAMA Otolaryngol.\u2014Head Neck Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"105330","DOI":"10.1016\/j.oraloncology.2021.105330","article-title":"The role of age in treatment decisions for oral cavity squamous cell carcinoma: Analysis of the National Cancer Database","volume":"118","author":"Barrett","year":"2021","journal-title":"Oral Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Dickstein, D.R., Lehrer, E.J., Hsieh, K., Hotca, A., Jones, B.M., Powers, A., Sharma, S., Liu, J., Gupta, V., and Mell, L. (2022). Management of Older Adults with Locally Advanced Head and Neck Cancer. Cancers, 14.","DOI":"10.3390\/cancers14112809"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Bozec, A., Culi\u00e9, D., Poissonnet, G., Demard, F., and Dassonville, O. (2021). Current Therapeutic Strategies in Patients with Oropharyngeal Squamous Cell Carcinoma: Impact of the Tumor HPV Status. Cancers, 13.","DOI":"10.3390\/cancers13215456"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Meccariello, G., Catalano, A., Cammaroto, G., Iannella, G., Vicini, C., Hao, S.P., and De Vito, A. (2022). Treatment Options in Early Stage (Stage I and II) of Oropharyngeal Cancer: A Narrative Review. Medicina, 58.","DOI":"10.3390\/medicina58081050"},{"key":"ref_37","first-page":"CD010963","article-title":"Minimally invasive surgery versus radiotherapy\/chemoradiotherapy for small-volume primary oropharyngeal carcinoma","volume":"12","author":"Howard","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Maniaci, A., Hao, S.P., Cancemi, F., Giardini, D., Checcoli, E., Soprani, F., Iannella, G., Vicini, C., Cocuzza, S., and La Mantia, I. (2023). Surgical Treatment for Advanced Oropharyngeal Cancer: A Narrative Review. Medicina, 59.","DOI":"10.3390\/medicina59020304"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1002\/cncr.23142","article-title":"Salvage therapy in relapsed squamous cell carcinoma of the oral cavity: How and when?","volume":"112","author":"Liao","year":"2008","journal-title":"Cancer"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1002\/hed.21273","article-title":"Salvage treatment for recurrent oropharyngeal squamous cell carcinoma","volume":"32","author":"Studer","year":"2010","journal-title":"Head Neck"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Taniguchi, A.N., Sutton, S.R., Nguyen, S.A., Kejner, A.E., and Albergotti, W.G. (2023). The Lack of Standardized Outcomes for Surgical Salvage of HPV-Positive Recurrent Oropharyngeal Squamous Cell Carcinoma: A Systematic Scoping Review. Cancers, 15.","DOI":"10.3390\/cancers15102832"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.radonc.2019.01.016","article-title":"Radiation therapy dose de-escalation compared to standard dose radiation therapy in definitive treatment of HPV-positive oropharyngeal squamous cell carcinoma","volume":"134","author":"Gabani","year":"2019","journal-title":"Radiother. Oncol. J. Eur. Soc. Ther. Radiol. Oncol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1044\/2022_AJSLP-22-00196","article-title":"Temporal Trends in Clinician-Assessed and Patient-Reported Swallowing Outcomes in Oropharyngeal Cancer Patients","volume":"32","author":"Kabalan","year":"2023","journal-title":"Am. J. Speech-Lang. Pathol."},{"key":"ref_44","first-page":"CD011112","article-title":"Therapeutic exercises for affecting post-treatment swallowing in people treated for advanced-stage head and neck cancers","volume":"2016","author":"Perry","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Golusi\u0144ski, W., and Golusi\u0144ska-Kardach, E. (2019). Current Role of Surgery in the Management of Oropharyngeal Cancer. Front. Oncol., 9.","DOI":"10.3389\/fonc.2019.00388"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1001\/jamaoto.2013.2747","article-title":"Transoral robotic surgery for oropharyngeal cancer: Long-term quality of life and functional outcomes","volume":"139","author":"Dziegielewski","year":"2013","journal-title":"JAMA Otolaryngol.\u2014Head Neck Surg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1016\/j.ijrobp.2012.08.004","article-title":"Patterns of disease recurrence following treatment of oropharyngeal cancer with intensity modulated radiation therapy","volume":"85","author":"Garden","year":"2013","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s13193-020-01209-0","article-title":"Selective Neck Dissection in Oral Cavity Cancer Is Not Without Morbidity","volume":"12","author":"Anand","year":"2021","journal-title":"Indian J. Surg. Oncol."},{"key":"ref_49","first-page":"773","article-title":"Timing of neck dissection in patients undergoing transoral robotic surgery for head and neck cancer","volume":"41","author":"Busch","year":"2015","journal-title":"Eur. J. Surg. Oncol. J. Eur. Soc. Surg. Oncol. Br. Assoc. Surg. Oncol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/S0167-8140(02)00404-8","article-title":"Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: A systematic literature review","volume":"66","author":"Trotti","year":"2003","journal-title":"Radiother. Oncol. J. Eur. Soc. Ther. Radiol. Oncol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2918","DOI":"10.1002\/cam4.1221","article-title":"Common oral complications of head and neck cancer radiation therapy: Mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis","volume":"6","author":"Sroussi","year":"2017","journal-title":"Cancer Med."},{"key":"ref_52","first-page":"e770","article-title":"Impact of xerostomia on the quality of life of patients submitted to head and neck radiotherapy","volume":"24","author":"Nascimento","year":"2019","journal-title":"Med. Oral Patol. Oral Y Cir. Bucal"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/j.ijrobp.2010.06.052","article-title":"Clinical management of salivary gland hypofunction and xerostomia in head-and-neck cancer patients: Successes and barriers","volume":"78","author":"Vissink","year":"2010","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"84","DOI":"10.3857\/roj.2020.00213","article-title":"Late side effects of radiation treatment for head and neck cancer","volume":"38","author":"Brook","year":"2020","journal-title":"Radiat. Oncol. J."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.anl.2008.04.006","article-title":"Late complications of radiotherapy for nasopharyngeal carcinoma","volume":"36","author":"Sumitsawan","year":"2009","journal-title":"Auris Nasus Larynx"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"4322","DOI":"10.1002\/cncr.31740","article-title":"Comparing outcomes of concurrent chemotherapy regimens in patients 65 years old or older with locally advanced oropharyngeal carcinoma","volume":"124","author":"Amini","year":"2018","journal-title":"Cancer"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1097\/SPC.0b013e32833575fd","article-title":"Management of gastrointestinal symptoms in advanced cancer patients: The rapid learning cancer clinic model","volume":"4","author":"Abernethy","year":"2010","journal-title":"Curr. Opin. Support. Palliat. Care"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/j.pain.0000000000001540","article-title":"Chemotherapy-induced peripheral neuropathy: Where are we now?","volume":"160","author":"Colvin","year":"2019","journal-title":"Pain"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Chitsike, L., and Duerksen-Hughes, P.J. (2021). Targeted Therapy as a Potential De-Escalation Strategy in Locally Advanced HPV-Associated Oropharyngeal Cancer: A Literature Review. Front. Oncol., 11.","DOI":"10.3389\/fonc.2021.730412"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Huang, Y., Lan, Y., Zhang, Z., Xiao, X., and Huang, T. (2022). An Update on the Immunotherapy for Oropharyngeal Squamous Cell Carcinoma. Front. Oncol., 12.","DOI":"10.3389\/fonc.2022.800315"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1038\/nrclinonc.2017.88","article-title":"Monitoring immune-checkpoint blockade: Response evaluation and biomarker development","volume":"14","author":"Nishino","year":"2017","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2443","DOI":"10.1056\/NEJMoa1200690","article-title":"Safety, activity, and immune correlates of anti-PD-1 antibody in cancer","volume":"366","author":"Topalian","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1001\/archotol.1974.00780030245001","article-title":"An experimental analysis of causative factors and protective methods in carotid artery rupture","volume":"99","author":"Swain","year":"1974","journal-title":"Arch. Otolaryngol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1001\/jamaoto.2013.103","article-title":"Risk factors for hemorrhage after chemoradiation for oropharyngeal squamous cell carcinoma","volume":"139","author":"Self","year":"2013","journal-title":"JAMA Otolaryngol.\u2014Head Neck Surg."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1017\/S0022215122001918","article-title":"Major haemorrhage after non-surgical management of oropharyngeal squamous cell carcinoma","volume":"137","author":"Leedman","year":"2023","journal-title":"J. Laryngol. Otol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2653","DOI":"10.1200\/JCO.2005.05.3850","article-title":"Locally recurrent, previously irradiated head and neck cancer: Concurrent re-irradiation and chemotherapy, or chemotherapy alone?","volume":"24","author":"Wong","year":"2006","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1002\/lary.29167","article-title":"Catastrophic Hemorrhage After Chemoradiation for Advanced Stage Oropharyngeal Carcinoma: A Case Series","volume":"131","author":"Chou","year":"2021","journal-title":"Laryngoscope"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1002\/hed.27632","article-title":"Acute and definitive management of oropharyngeal hemorrhage in patients with squamous cell carcinoma of the oropharynx","volume":"46","author":"Araujo","year":"2024","journal-title":"Head Neck"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"265","DOI":"10.21037\/apm.2017.11.01","article-title":"Bleeding in cancer patients and its treatment: A review","volume":"7","author":"Johnstone","year":"2018","journal-title":"Ann. Palliat. Med."},{"key":"ref_70","first-page":"1185","article-title":"Transcutaneous arterial embolization to control massive tumor bleeding in head and neck cancer: 63 patients\u2019 experiences from a single medical center","volume":"15","author":"Chou","year":"2007","journal-title":"Support. Care Cancer Off. J. Multinatl. Assoc. Support. Care Cancer"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.wneu.2011.08.024","article-title":"Endovascular management of carotid blowout","volume":"78","author":"Zussman","year":"2012","journal-title":"World Neurosurg."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s00066-010-2114-5","article-title":"Acute arterial hemorrhage following radiotherapy of oropharyngeal squamous cell carcinoma","volume":"186","author":"Greve","year":"2010","journal-title":"Strahlenther Onkol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1016\/j.jvs.2015.12.047","article-title":"Outcomes of interventions for carotid blowout syndrome in patients with head and neck cancer","volume":"63","author":"Liang","year":"2016","journal-title":"J. Vasc. Surg."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1159\/000058030","article-title":"Histopathological examination of ruptured carotid artery after irradiation","volume":"64","author":"Okamura","year":"2002","journal-title":"ORL J. Oto-Rhino-Laryngol. Its Relat. Spec."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1038\/s41568-019-0199-4","article-title":"Cancer biology as revealed by the research autopsy","volume":"19","author":"Michael","year":"2019","journal-title":"Nat. Rev. Cancer"},{"key":"ref_76","first-page":"PO.16.00038","article-title":"Next-Generation Rapid Autopsies Enable Tumor Evolution Tracking and Generation of Preclinical Models","volume":"2017","author":"Pisapia","year":"2017","journal-title":"JCO Precis. Oncol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1080\/0036554021000001349","article-title":"A head and neck cancer patient dies! Why perform an autopsy: For the relatives, for the clinicians or for the pathologists?","volume":"123","author":"Bradley","year":"2003","journal-title":"Acta Oto-Laryngol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"45","DOI":"10.23907\/2016.005","article-title":"Pitfalls and Artifacts in the Neck at Autopsy","volume":"6","author":"Pollanen","year":"2016","journal-title":"Acad. Forensic Pathol."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Cartocci, G., Santurro, A., Frati, P., La Russa, R., and Fineschi, V. (2019). Imaging Techniques for Postmortem Forensic Radiology. Radiology in Forensic Medicine: From Identification to Post-mortem Imaging, Springer.","DOI":"10.1007\/978-3-319-96737-0_5"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1136\/jcp-2021-207946","article-title":"Efficacy of postmortem CT and tissue sampling in establishing the cause of death in clinical practice: A prospective observational study","volume":"77","author":"Mentink","year":"2024","journal-title":"J. Clin. Pathol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1007\/s11547-019-01052-6","article-title":"Post-mortem computed tomography (PMCT) radiological findings and assessment in advanced decomposed bodies","volume":"124","author":"Cartocci","year":"2019","journal-title":"La Radiol. Medica"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s11547-016-0672-z","article-title":"Post-mortem magnetic resonance foetal imaging: A study of morphological correlation with conventional autopsy and histopathological findings","volume":"121","author":"Vullo","year":"2016","journal-title":"La Radiol. Medica"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s11547-018-0943-y","article-title":"Postmortem computed tomography angiography (PMCTA) and traditional autopsy in cases of sudden cardiac death due to coronary artery disease: A systematic review and meta-analysis","volume":"124","author":"Catalano","year":"2019","journal-title":"La Radiol. Medica"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1055\/s-0040-1721378","article-title":"Tumor-like Lesions of Bone and Soft Tissues and Imaging Tips for Differential Diagnosis","volume":"24","author":"Arkun","year":"2020","journal-title":"Semin. Musculoskelet. Radiol."},{"key":"ref_85","first-page":"285","article-title":"Necrosis of the Tongue as a Late Complication of Radiotherapy","volume":"35","author":"Aguiar","year":"2023","journal-title":"Iran. J. Otorhinolaryngol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"e28","DOI":"10.1016\/j.oooo.2016.10.010","article-title":"Delayed tongue necrosis simultaneous with bilateral osteoradionecrosis of the jaw secondary to head and neck irradiation","volume":"123","author":"Curi","year":"2017","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1962","DOI":"10.2174\/138920102215210928154236","article-title":"Risk Management, Patient Safety and Quality in Health Care","volume":"22","author":"Santurro","year":"2021","journal-title":"Curr. Pharm. Biotechnol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/17\/5198\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:47:13Z","timestamp":1760111233000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/17\/5198"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,2]]},"references-count":87,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["jcm13175198"],"URL":"https:\/\/doi.org\/10.3390\/jcm13175198","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,2]]}}}