Head- and neck cancer

Characterization of salivary gland tumors 

Salivary gland tumors are a very heterogeneous group of tumors. The most recent WHO classification recognizes more than 40 different subtypes. These tumors are relatively rare with an incidence of 1-10 cases per 100,000 population. Although most tumors are benign, ca 5% of these tumors recur, posing considerable problems in clinical management. Until now, little is known about the oncogenesis of these tumors, and the characteristics associated with prognosis. In close collaborations with the department of Otorhinolaryngology and other Head and Neck centers in the Netherlands, we aim to improve classification of salivary gland tumors and to develop markers useful for prognostication.

Oral (potential) malignant lesions 

In close collaboration with the departments of Maxillofacial Surgery and of Otorhinolaryngology we focus on the characterization of oral (potential) malignant lesions. To this aim we develop methods to improve prediction of malignant transformation in (erythro)leukoplakia. In addition we develop molecular markers for early diagnosis of recurrence in squamous cell carcinoma of head and neck. 
After having elucidated the role of HPV in oropharyngeal cancer, we now focus on the incidence, epidemiology and genetics of HPV related non-oropharyngeal carcinomas
Periimplantitis and implant loss after irradiation
In HNSCC patients with postoperative irradiation, 50% of patients fail after oral rehabilitation with peri-implantitis This project aims to investigate the factors that determine this, both at the level of the inflammatory response in the mucosa and at the level of bone metabolism.
Placing dental implants in previously irradiated tissue is a clinical challenge: peri-implantitis and osteoradionecrosis (ORN) are frequently observed, resulting in implant loss in up to 22% of patients. Osteoradionecrosis is a severe complication from radiotherapy resulting in substantial morbidity, in advanced cases, large reconstructive surgical procedures are needed to maintain oral function. This study aims to investigate the process of irradiation-induced changes in jaw bone and oral (sub)mucosa on molecular and cellular level. By investigating the pathophysiological processes in the tissues, we hope to discover patterns that can be used to predict future peri-implantitis, implant loss and ORN. 

Staff   

Elisabeth Bloemena MD PhD - program leader 

Research projects :

- "Towards a model to predict malignant transformation in leukoplakia"
- "Early detection of (recurrence of) head and neck squamous cell carcinomas by tumor-educated thrombocytes" 
- "Peri-implantitis, implant loss and osteoradionecrosis due to irradiation in oral cancer patients"