ABSTRACT
BACKGROUND AND OBJECTIVES: Minor salivary gland tumors vary in their primary sites, histopathology and biological behavior. Therefore, various factors are considered in selecting the treatment modality and predicting the prognosis. Generally, it is reported that the prognosis of malignant tumors of minor salivary glands are worse than that of such lesions of major salivary glands. We performed this study to find out the clinical features and determine the prognostic factors of minor salivary gland tumors. MATERIALS AND METHODS: We analyzed retrospectively, 83 cases of minor salivary gland tumor and the 10 year survival rates using the Kaplan-Meier method. RESULTS: We found 16 benign tumors and 67 malignant tumors. Among the patients, 43 were males and 40 were females. The most common age group was the sixties, with the mean age of 50. The most common site of benign tumor was the palate, whereas malignant tumors were most commonly found in the maxillary sinus, palate, and floor of mouth, etc. Histopathologically, 14 patients with benign tumor had pleomorphic adenoma, and 39 patients with malignant tumor had adenoid cystic carcinoma. According to the criteria set by the AJCC on staging, the most common stage found for the subjects were the stage IV. Overall, the 5 year and 10 year survival rates were 56.1% and 46.9%, respectively. Histopathologic type had no effect on 10 year survival rates. The clinical stage had a significant impact on survival. CONCLUSION: In minor salivary gland tumor, the most significant prognostic factor was its clinical stage. Considering the frequent local recurrence and distant metastasis, long term follow ups will be needed.
Subject(s)
Female , Humans , Male , Adenoma, Pleomorphic , Carcinoma, Adenoid Cystic , Follow-Up Studies , Maxillary Sinus , Mouth Floor , Neoplasm Metastasis , Palate , Prognosis , Recurrence , Retrospective Studies , Salivary Glands , Salivary Glands, Minor , Survival RateABSTRACT
OBJECTIVES: We analyzed the outcome of trachea shaving in 20 patients with locally invasive thyroid papillary carcinoma. MATERIALS AND METHODS: From Jan. 1992 to Jun. 1994, we treated surgically 205 patients with papillary thyroid carcinoma, of whom 41 revealed upper airway invasion and 20 were treated with the shaving method. The others were treated with window resection, circumferential resection, and total laryngopharyngectomy with free jejunal graft. Twenty patients who underwent the shaving procedure were followed up for 28 to 59 months (mean of 49.5 months) and were examined for the incidence of recurrence by way of physical examinations, elevated serum thyroglobulin, despite of the TSH suppression therapy, iodine whole body scan, and the endoscopic examination. RESULTS: The rate of recurrence was 5% (one patient), and it was detected by the iodine whole body scan. The site of recurrence was the pyriform sinus and paraglottic space, so we performed partial laryngopharyngectomy. CONCLUSION: In thyroid papillary carcinoma invading the upper airway, the extent of resection should be determined individually according to the extent of tumor invasion. If the adventitia of the trachea is only the invasion site, and a grossly complete resection is performed, the 'shaving' method may be sufficient. However, the window resection or the circumferential resection should be performed in more invasive cases. Our data suggest that the surgical method of resection may be determined individually, and surgeons who have flexible attitudes may have good results.
Subject(s)
Humans , Adventitia , Carcinoma, Papillary , Incidence , Iodine , Physical Examination , Pyriform Sinus , Recurrence , Thyroglobulin , Thyroid Gland , Thyroid Neoplasms , Trachea , Transplants , Whole Body ImagingABSTRACT
BACKGROUND: Tumors developing in the parotid gland tend to be of a large variety of histopathologic types. The relative rarity of parotid gland tumors makes epidemiologic study more difficult. To develop a rational therapeutic plan for tumors of the parotid gland, the surgeon must be fully cognizant of the factors that may affect survival. MATERIALS AND METHOD: The authors retrospectively studied 110 patients with histologically confirmed salivary gland tumor in the parotid glands at Korea Cancer Center between 1986 and 1995. We analyzed the histopatologic type and 5-year survival rate according to the some prognostic factors. RESULTS: Among the 110 patients, 39 had malignant parotid tumors. There were no recurtence in those who had parotid tumors. The overall 5-year survival rate was 62.4%. We observed statistically significant differences for patients of different clinical stages and histological grade. CONCLUSION: In summary, the clinical stage and histological grade are the significant prognostic factors, and these factors need to be considered in the treatment of parotid gland tumors.
Subject(s)
Humans , Epidemiologic Studies , Korea , Parotid Gland , Retrospective Studies , Salivary Glands , Survival RateABSTRACT
Recently, the 5-year survival rate of rhabdomyosarcoma has been greatly increased by combining therapy with radical surgery, radiation and chemotherapy. But it still has poor prognosis and there are few case reports of rhabdomyosarcoma of head and neck with long term survival rate. Here, we treated a rhabdomyosarcoma patient with radical surgery, radiation and chemotherpy. The patient visited our hospital in 1990 with a complaint of left facial protruding mass, diplopia and exopthalmos. She was diagnosed as rhabdomyosarcoma involving maxillary sinus and orbit. In september 1990, she received left total maxillectomy and eyeball exentration. After the surgery, we applied a 5000 cGy neutron therapy, 2000 cGy external radiation and 9 cycle pulse, along with VAC chemotherapy. She remains free of disease as of her last follow-up in February 1998.
Subject(s)
Humans , Diplopia , Drug Therapy , Follow-Up Studies , Head , Maxillary Sinus , Neck , Neutrons , Orbit , Prognosis , Rhabdomyosarcoma , Survival RateABSTRACT
BACKGROUND: Adenoid cystic carcinoma of the head and neck is relatively rare and is characterized by slow evolution, multiple recurrences, protracted clinical course, and distant metastases. OBJECTIVES: We performed this study for the purpose of determining the effect of age and sex distribution, site, treatment modality, distant metastasis and stage on survival in adenoid cystic carcinoma of the head and neck. MATERIALS AND METHOD: This article presents the age and sex distribution, primary sites, treatment modalities according to different clinical stages, recurrence patterns, and 5 year survival rates in each cases by analyzing 55 patients of adenoid cystic carcinoma of the head and neck treated from 1985 to 1995 at Korea Cancer Center Hospital. RESULTS: In 55 cases of adenoid cystic carcinomas, 27 were male and 28 were female. By age, 6th decades were most common. According to the primary site, major salivary gland origin were 20 cases and minor were 35 cases. 12 cases were stage 1, 18 cases were 2, 10 cases were 3, and 15 cases were 4. According to the treatment modality, 12 patients received surgery only, 31 patients received surgery and postoperative radiation therapy, and 9 patients received radiation therapy only. Among the 4 patients with distant metastases at diagnosis, 3 received chemotherapy. Local recurrence was identified in 12 cases, distant metastasis only was in 7 cases, and both were in 6 cases. Lung was the most common metastatic site. Overall 5 year survival rates were 77.1%. Age, sex, primary site, and treatment modality had no effect on 5 year survival rates. The clinical stage and distant metastasis had a significant impact on survival. CONCLUSION: In adenoid cystic carcinoma of the head and neck, the most significant prognostic factors are clinical stage and distant metastasis. But, considering the slow growing features of tumor, long term follow up will be needed for the more accurate evaluation.
Subject(s)
Female , Humans , Male , Adenoids , Carcinoma, Adenoid Cystic , Diagnosis , Drug Therapy , Follow-Up Studies , Head , Korea , Lung , Neck , Neoplasm Metastasis , Recurrence , Salivary Glands , Sex Distribution , Survival RateABSTRACT
BACKGROUND: Because the maxillary sinus is anatomically located adjacent to the orbit and skull base, it is difficult to remove the tumor completely with tumor-free margin in advanced maxillary cancer. Local recurrence is by far the most common cause of treatment failure and long-term survival rates are low. OBJECTIVES: By analyzing clinical status, treatment methods and results about squamous cell carcinoma of the maxillary sinus, the authors investigated local recurrences and survival rates by treatment and got helps from these evaluation and treatment. MATERIALS AND METHODS: Sixty-nine cases with squamous cell carcinomas of the maxillary sinus diagnosed at Department of Otolaryngology-Head and Neck Surgery, Korea Cancer Center Hospital from January 1989 to December 1995 were studied by chart review, telephone interview and letters retrospectively. RESULTS: The T-stages at presentation were T2 11.6%, T3 24.6%, T4 63.8% respectively, and overall neck node metastases were 8.7%. Thirty nine cases were treated with surgery at first choice of treatment and almost all cases were followed by adjunctive radiotherapy. Thirty cases were treated with radiotherapy at first choice of treatment. Overall recurrence rates were 75.4% and local recurrence rates were 72.4%. The sites of local recurrence treated by surgery were substantially higher in posterior wall of maxillary sinus, orbital floor, skull base and palate. The five-year survival rate by Kaplan-Meier method was 44.0% for surgery with radiotherapy and 16.8% for radiotherapy alone. CONCLUSION: Local recurrence was the major cause of treatment failure and the survival rates were poor. Therefore, early detection, aggressive local treatment and close follow up are desirable.
Subject(s)
Carcinoma, Squamous Cell , Follow-Up Studies , Interviews as Topic , Korea , Maxillary Sinus , Neck , Neoplasm Metastasis , Orbit , Palate , Radiotherapy , Recurrence , Retrospective Studies , Skull Base , Survival Rate , Treatment FailureABSTRACT
BACKGROUND: Follicular carcinoma of the thyroid is less common than papillary carcinoma and so with a few clinical data. OBJECTIVES: We performed this study for the purpose of getting further understanding and more supporting idea for diagnosis and treatment of follicular carcinoma. MATERIALS AND METHODS: Four hundred thirty patients with thyroid tumors were treated from 1991 to 1995. Twenty two patients were histopathologically proved as follicular carcinoma. All but one without treatment were reviewed retrospectively. RESULTS: Of the 430 patients, 382(88.8%) were malignant and 48(11.2%) were benign. In malignant tumors, 317(83.0%) were papillary carcinoma and 22(5.8%) were follicular carcinoma. Fine-needle aspiration cytology(FNAC) was performed in 17/21 which revealed malignancy only in 7 patients. Total thyroidectomies were performed in 18 patinets;12 patients had completion thyroidectomies. Cervical lymph node metastases presented in 3 patients and distant metastases were detected in 6 patients. According to the AMES risk group, 9 patients were in low and 12 patients were in high risk group. CONCLUSION: Follicular carcinoma of the thyroid reveals higher rate of distant metastases and lower accuracy of fine-needle aspiration cytology and frozen section biopsy. Therefore, the more aggressive treatment should be considered in high risk group after confirmation of distant metastases through careful evaluation.
Subject(s)
Humans , Biopsy , Biopsy, Fine-Needle , Carcinoma, Papillary , Diagnosis , Frozen Sections , Lymph Nodes , Neoplasm Metastasis , Retrospective Studies , Thyroid Gland , Thyroid Neoplasms , ThyroidectomyABSTRACT
OBJECTIVE: We studied the clinical manifestations and charicteristics of the neck masses for taking the correct diagnosis. MATERIALS AND METHODS: In 1995, 403 patients were admitted and treated with neck masses at department of otolaryngology-head and neck surgery, Korea Cancer Center Hospital and analyzed retrospectively. The diagnosis was confirmed by radiological(CT, MRI, Ultrasonograph, etc) and histopathological(fine-needle aspiration cytology, incisional or excisional biopsies, and surgical procedures) studies. RESULTS: Ten cases(2.5%) were below 15 year-old age group and there were 4 cases of congenital masses, 3 cases of inflammatory masses, 2 cases of benign neoplasia, and 1 cases of malignant neoplasm. One hundred thirty-one cases(32.5%) were between 16 and 40 year-old age group and there were 7 cases of congenital masses, 33 cases of inflammatory masses, 31 cases of benign neoplasia, and 60 cases of malignant neoplasia. Two hundred sixty-two cases(65.0%) were above 41 year-old age group and there were 6 cases of congenital masses, 16 cases of inflammatory masses, 31 cases of benign neoplasia, and 20 cases of malignant neoplasia. Above 41 year-old age group, the malignant neoplasia were frequent. In all cases, the malignant neoplasia were frequent(67.0%) and among these primary malignant neoplasia were 118 cases and metastatic malignant neoplasia were 152 cases. In 17 cases of congenital masses, thyroglossal duct cyst was 7 cases and branchial cleft cyst was followed. In 52 cases of inflammatory masses, tuberculous lymphadenitis was the most(27cases) and reactive lymphadenitis was followed. In benign neoplasia, adenomatous goiter was the most(47cases) among 64 cases. CONCLUSION: Malignant neoplasia was 67.0%(270/403) of the neck masses and among these metastatic tumors was 56.3%(152/270). In women congenital masses was the most and then inflammatory masses and benign tumors were followed but in men malignant tumors were the most. After 5th decade, malignant neoplasia were frequent(79.8%) and neck masses in old age-patients were suspicious for the malignancies.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Biopsy , Branchioma , Diagnosis , Goiter , Korea , Lymphadenitis , Magnetic Resonance Imaging , Neck , Retrospective Studies , Thyroglossal Cyst , Tuberculosis, Lymph NodeABSTRACT
No abstract available.
Subject(s)
Carotid Arteries , Head and Neck Neoplasms , Head , Ligation , RuptureABSTRACT
No abstract available.
ABSTRACT
Total of 154 patients of pathologically proven and previously untreated nasopharyngeal carcinoma who were treated in the Department of Therapeutic Radiology, Korea Cancer Center Hospital during the period from 1964 to 1984 were analyzed. Minimal follow-up period of survivors was 3 years. Thirteen percent of the patients had T4 primary lesions and 65% had stage IV disease. Total radiation dose to the primary site was 1550~1750 ret in 82 and above 1750 ret in 72 patients. Local control was obtained in 79% of patients. Significant prognostic factors for the survival were tumor dose (above vs. below 1750 ret), age (below vs. above 30 years), stage (AJCC I-III vs IV), T stage (T1 vs. T2-4), and N stage (NO vs. N+).
Subject(s)
Humans , Follow-Up Studies , Korea , Radiation Oncology , SurvivorsABSTRACT
Retrospective analysis of survival rates was undertaken in the patients of 58 cases treated with conventional radiation therapy for malignant salivary gland tumors between January 1975 and December 1984 in Korea Cancer Center Hospital (KCCH). They were patients whose long-term follow-up was possible and who had refused surgery or had had recurrences postoperatively. Out of 58 patients, 25 patients (43.1%) had mucoepidermoid carcinomas and 24 patients (41.3%) adenoid cystic carcinoma. Total actuarial survival rates at 5 years and 10 years were 68.2% and 31.8% respectively, but disease-free survival rates, 43.2% and 13.0%, respectively. According to TNM stage, the survival rates at 5 years were 86.5% in T1, 40.0% in T2 + T3, and 0% in T4. In terms of histologic types, 5 years disease-free survival rate of adenoid cystic carcinomas (40.1%) was lower than that of mucoepidermoid carcinomas (49.8%) but overall survival rate (77.3%) was much higher than that of mucoepidermoid carcinomas (51.5%). Therefore, we concluded that the patients, who had had disease after failure of treatment, could survive during a certain period of time and their alive times were 2 years on the average. There was a difference in survival rates in the mucoepidermoid carcinomas in terms of histological grade of differentiation and it was a arbiter in prognosis: 5 YSR of low-grade was 78.8% and higher 2 times than that of high-grade. There was no difference in survival rates according to location and sex. The number of patients having minor salivary gland tumors was 6 cases and their actuarial 5 YSR was 32.3%. Consequently, prognostic factors which influence the survival rates of patients with malignant salivary gland tumors are thought to be 1) histological ubtypes 2) T and N staging (AJCC) 3) histological grade, especially in mucoepidermoids.
Subject(s)
Humans , Carcinoma, Adenoid Cystic , Carcinoma, Mucoepidermoid , Disease-Free Survival , Follow-Up Studies , Korea , Prognosis , Recurrence , Retrospective Studies , Salivary Glands , Salivary Glands, Minor , Survival RateABSTRACT
To determine the correlation between the response to induction chemotherapy and subsequent radiotherapy we analyzed the clinical records of 60 patients with locally advanced carcinoma of the head and neck retrospectively who had completed a full course (2~3 cycle) of induction chemotherapy and curative radiotherapy in Korea Cancer Center Hospital between 1986 and 1989. Chemotherapy was administered with CDDP+Bleomycin (BP) in 20, CDDP+5-FU (FP) in 37, and hybrid of BP and FP in three patients. Radiotherapy was given conventionally with a dose of 65 to 75 gy or more over seven to eight weeks according to the size of lesion. Response rates following induction chemotherapy were 80% for the tumors and 79% for the nodes whereas complete response rates were 12% and 13%, respectively. Six months after radiotherapy 67% of the tumors and 77% of the nodes achieved a complete response. Among the 48 tumor responders and the 31 nodal responders to chemotherapy, 39 (81%) and 28 (90%), respectively, achieved complete response after radiotherapy. Thus, whether or not the tumor and node respond to induction chemotherapy was predictive of the response to subsequent radiotherapy (p0.3). Therefore the tumor or node's response to induction chemotherapy is a predictor for subsequent radiotherapy except in T1-T2 tumors, and complete response to radiotherapy can be expected despite the failure of induction chemotherapy in T1-T2 tumors.