Rusana Bark

I am a senior consultant in head and neck surgery at Karolinska University Hospital and Associate Professor (Docent) in Otorhinolaryngology at Karolinska Institutet. My research is translational and clinically oriented, aiming to improve diagnostic precision and individualise treatment in head and neck cancer. Key areas are sentinel node techniques, HPV-based diagnostics in cystic neck metastases and cancer of unknown primary (CUP), and prognostic and predictive biomarkers.

H-index: 11

Number of completed supervisions as principal supervisor: 0

Ongoing supervisons as principal supervisor: Petronella Pettersson, Gabriel Johansson

Number of completed supervisions as co-supervisor: 1

Ongoing supervisons as co-supervisor: Evelina Jörtsö, Marcus Jansson

After a PhD in experimental inner ear research on the role of sex steroid hormones in hearing, I subspecialised in head and neck cancer surgery, which is now the main focus of my research. My overall goal is to translate new diagnostic methods and biomarkers into clinical practice, so that treatment can be better tailored to each patient and both over- and undertreatment can be avoided.

HPV, cystic neck lesions and cancer of unknown primary. We have shown that fine needle aspiration cytology combined with HPV DNA analysis of cyst fluid can reliably distinguish benign branchial cleft cysts from cystic metastases. These findings have led to revised national care guidelines, sparing patients unnecessary invasive procedures. Ongoing studies examine p16/HPV discordance in CUP neck metastases and its impact on tumour classification and survival, as well as a Nordic multicentre survival study.

Oropharyngeal cancer. Together with colleagues at Karolinska Institutet and Uppsala University, we study incidence trends and HPV/p16 status across oropharyngeal subsites, and biomarkers for prognosis, follow-up and treatment response, including circulating cell-free HPV DNA as a marker of recurrence. In a Nordic collaboration with centres in Copenhagen, Helsinki, Turku, Oslo and Reykjavik, we investigate long-term survival and late recurrence in the HPV era.

Sentinel node techniques. We were the first to apply sentinel node-assisted neck dissection in advanced oral cancer. Current studies explore whether neck treatment can be individualised based on lymphatic drainage patterns and micrometastases, and evaluate the sentinel node technique in salivary gland tumours. In collaboration with Professor Lars Olaf Cardell's group, we also study immune profiles in tumour-draining lymph nodes as prognostic markers in oral cancer.

Laryngeal cancer. This translational project combines epidemiological and molecular methods to identify risk factors, complications such as pharyngocutaneous fistula after laryngectomy, and predictive markers of tumour aggressiveness and radiosensitivity.

I also led a prospective randomised trial of ultrasound-guided hook-wire localisation for diagnostic excision of non-palpable neck lesions, which is now completed and under review. In addition, I have contributed to clinical studies on tracheostomy techniques and gastrostomy in head and neck cancer patients.

I lecture regularly on the medical programme at Karolinska Institutet. I also teach medical students, interns (AT), residents (ST) and junior ENT surgeons in head and neck cancer surgery.