Clinical analysis of level II occult metastasis of papillary thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the relevant factors occult II lymph node metastases in papillary thyroid carcinoma (PTC) with clinical factors.</p><p><b>METHODS</b>The medical records of 213 PTC patients with clinically positive neck lymph nodes in level III and IV, and/or V based on preoperative ultrasonography, treated between January 2003 and December 2009 were retrospectively reviewed. All patients had no suspicion of clinical positive neck nodes in level II. Univariate and Multivariate analysis were performed using the Pearson chi-square test or Fisher's exact test and a binary logistic regression test, respectively.</p><p><b>RESULTS</b>The rate of metastasis at levels III, IV, V and VI was 83.6% (178/213), 75.1% (160/213), 13.1% (28/213) and 79.3% (169/213), respectively. The rate of occult metastasis at level II were observed in 16.0% (34/213). In univariate analysis, lymph node metastasis in level II was statistically significantly more frequent in patients with positive level III lymph node and positive lymph node throughout the lateral neck (level III + IV, χ(2) were 11.120 and 5.614 respectively, P < 0.05). Multivariate analysis showed that positive lymph node involvement in all lateral neck (level III + IV) was an independent predictive factor of level II lymph node metastasis (P = 0.033, OR = 3.846).</p><p><b>CONCLUSION</b>In PTC patients without suspicious lymph node in neck level II and III by preoperative US, prophylactic level II lymph node dissection may not be considered.</p>

Treatment and prognosis analysis of primary parotid squamous cell carcinoma / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the prognosis-related factors and treatment strategy of primary parotid squamous cell carcinoma.</p><p><b>METHODS</b>Forty-nine primary parotid squamous cell carcinoma treated from 1970 to 2005 were retrospectively analyzed. The follow up data were analyzed by SPSS 13.0 software.</p><p><b>RESULTS</b>Integrated follow up data were obtained from 44 patients with a median follow up time of 38 months (5 - 215 months). Recurrence or distant metastasis of the carcinoma occurred in 21 patients, including 13 local recurrence in parotid or neck and 8 distant metastasis. Local recurrence was the main reason of treatment failure. The 3-year and 5-year survival rate and disease-free survival rate was 52%, 27% and 34%, 16%. Kaplan-Meier and log-rank analysis indicated that age, tumor size, distant metastasis, postoperative radiotherapy, facial nerve dysfunction, neck dissection, skin invasion, and surgical margins were prognosis-related factors. Cox analysis showed that age, facial nerve dysfunction, distant metastasis and surgical margins were the important factors that influenced the prognosis.</p><p><b>CONCLUSIONS</b>Primary parotid gland squamous cell carcinoma is an uncommon tumor, surgery and postoperative radiotherapy are the optimal treatment, which can improve the prognosis of the patients and decrease recurrence of the tumor.</p>