Anatomy and three-dimensional reconstruction study of SSL area / 中国实用妇科与产科杂志

OBJECTIVE: Use cadavers and three-dimensional MRA models to study the anatomical relationship between the sacrospinous ligament(SSL)and its adjacent vessels and nerves.METHODS: Totally 24 female cadavers provided by Anatomy Department of Southern Medical University from September 2017 to September 2018 were dissected,and 30 MRA data collected by Gynecology Department of Nanfang Hospital of Southern Medical University from January 2015 to December 2018 were selected to reconstruct to measure the relevant application parameters.RESULTS: The medial structure of the pudendal canal was the pudendal nerve,and the horizontal distance between the right pudendal nerve and the sciatic spine was(1.51 ± 0.35)cm. The thickness of the thickest point of the right coccygeus-sacrospinousligament(CSSL)was(1.03±0.23)cm and the horizontal distance between the point and the right sciatic spine was(2.81±0.55)cm;the vertical distance from where the right inferior gluteal artery is out of pelvis cavity to the horizontal line of sciatic spine was(2.43±0.95)cm,and the distance between the vertical point and the sciatic spine was(1.83±0.83)cm. In anatomy and MRA model,none of the inferior gluteal artery went dorsally through the SSL,and the sciatic nerve was away from the SSL.There was no obvious vascular nerve traveling on the pelvic surface of SSL.CONCLUSION: The point which is 2.81 cm away from the right sciatic spine of the SSL at the horizonal level may be the best suspension point for SSLF.

Prognostic analysis of 76 cases with adenoid cystic carcinoma in salivary gland / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the prognosis of adenoid cystic carcinoma (ACC) in salivary gland and its influencing factors.</p><p><b>METHODS</b>Clinical and following-up data of 76 patients with ACC in salivary glands were reviewed. Major gland tumors represented 35.5% whereas minor gland tumors comprised 64.5% of the cohort, with 8 cases (10.5%) in stage I, 23 (30.3%) in stage II, 18 (23.7%) in stage III and 27(35.5%) in stage IV. Survival rates were calculated by Kaplan-Merier method. Cumulative survival curves were evaluated using the Log-rank test. Multivariate analysis was performed by Cox proportional hazard model.</p><p><b>RESULTS</b>The regional recurrence rate was 28.9% and distant metastasis rate was 21.1%. The overall 5-year survival rate, tumor-free survival rate and tumor-related survival rate were 73.7%, 61.8% and 74.9% respectively. The overall 10-year survival rate, tumor-free survival rate and tumor-related survival rate were 48.2%, 39.8% and 56.2% respectively. Univariate survival analysis showed pathological type, clinical stage and perineural invasion were relevant to the prognosis of ACC and multivariate analysis showed they were the independent prognostic factors of ACC in salivary gland.</p><p><b>CONCLUSIONS</b>Clinical stage, pathological type and perineural invasion were the independent prognostic factors for adenoid cystic carcinoma in salivary gland. Surgery was the first choice for the treatment of adenoid cystic carcinoma in salivary gland, and postoperative radiotherapy may prolong the tumor-free survival time of patients in stage III and IV.</p>

Clinical analysis of 52 cases of adenoid cystic carcinoma in minor salivary gland / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the prognosis of adenoid cystic carcinoma (ACC) in minor salivary glands and its influencing factors.</p><p><b>METHODS</b>Clinical data of 52 patients with ACC in minor salivary glands were reviewed. The distribution of stage was as follows: stage I (6%), stage II (21%), stage III (27%) and stage IV (46%). Counting data was analyzed by χ(2) test or Fisher's exact. Survival rates were calculated by Kaplan-Merier method. Statistical significance of differences in the cumulative survival curves was evaluated using the Log-rank test. Multivariate analysis was performed by Cox proportional hazard model.</p><p><b>RESULTS</b>All patients underwent primary tumor radical resection, 39 patients (75%) received postoperative radiation. The regional recurrence rate was 37% and distant metastasis rate was 21%. The 5-, 10-year cumulative local control rate were 68% and 63% respectively. The 5-, 10-year cumulative distant control rate were 86%, 68% respectively. The 5-, 10-year tumor specific survival rates were 70% and 54% respectively. Multivariate analysis showed that T stage, lymph node metastasis and perineural invasion were relevant to the tumor specific survival of ACC in minor salivary glands.</p><p><b>CONCLUSIONS</b>Recurrence and metastasis were the main cause of treatment failure of ACC in minor salivary glands. T stage, lymph node metastasis and perineural invasion were the independent prognostic factors of ACC in minor salivary glands. Radical surgery and reasonably postoperative radiotherapy were the main treatment strategy.</p>

Diagnosis and treatment of 11 cases with sinonasal neuroendocrine carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the diagnosis and treatment and prognosis of sinonasal neuroendocrine carcinoma.</p><p><b>METHODS</b>The clinical data of 11 cases with sinonasal neuroendocrine carcinoma treated in Zhejiang Cancer Hospital from 1998 to 2010 were analyzed retrospectively. Ten cases were small cell type and one case was atypical carcinoid. One case by only operation, one case by only radiotherapy, one case by only chemotherapy, two cases by radiotherapy and chemotherapy, 6 cases by combined treatment based on surgery (surgery combined with radiotherapy and chemotherapy).</p><p><b>RESULTS</b>All cases have been followed up for 2 months to 12 years. Six cases by combined treatment one case died in 3 years and one case died in 4 years after treatment, one case has survived without tumor for 12 years and two cases have survived without tumor for 8 years, one case was still in treatment. Five cases of other treatment programs, four cases died in 12 months, one case died in 18 months.</p><p><b>CONCLUSIONS</b>There's no standard treatment plan. Combined treatment based on surgery should be adopted to nasal neuroendocrine carcinoma. Reccurrence is frequent and the prognosis is poor. The key to improving the survival rate of the disease is early accurate diagnosis and combined treatment.</p>

Treatment for thyroid papillary cancer after nonstandard operation / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the disadvantage of nonstandard operation for thyroid papillary cancer, and the value of re-operation.</p><p><b>METHODS</b>Eight hundred and ninety three thyroid papillary cancer patients (332 patients who received nonstandard operation received re-operation and 561 patients who received first standard operation in Zhejiang Cancer Hospital from January 1990 to January 2000) were retrospectively reviewed.</p><p><b>RESULTS</b>Pathological results confirmed that there were 53.9% cases with residual cancer in re-operative specimen. The parathyroid was preserved in 74.1% cases in re-operation and 93.0% cases in standard operation (P < 0.01). The recurrent laryngeal nerve was injured in 3.3% cases in reoperation and 1.2% cases in standard operation (P < 0.05). The positive neck lymph node was 39.2% and 37.4% (P > 0.05), the 5-year local recurrence rate was 7.5% and 3.7% (P < 0.01), the total 5-year and 10-year cum-survival rates were 90.2%, 84.4% in patients with re-operation and 94.0%, 92.5% in patients with standard operation. The 10-year cum-survival rate were 67. 8% in patients with recurrence and 92. 9% in patients with non-recurrence in primary site respectively. Statistical analysis showed that the cancer recurrence influences the survival rate significantly (P < 0.01).</p><p><b>CONCLUSIONS</b>In consideration of the higher residual tumor rate in patients who received nonstandard operations, the re-operations were necessary. But the re-operation could also leads to higher recurrence rate and more functional injuries. The standardized primary operation should therefore be formulated and advocated.</p>

Treatment and survival analysis of pyriform sinus cancer / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of surgery for the patients with pyriform sinus carcinoma and analyze the prognostic factors related to the cancer.</p><p><b>METHODS</b>Between December 1995 and December 2002, 62 patients with pyriform sinus cancer were treated in Zhejiang Tumor Hospital. There were 13 patients staged T1, 17 T2, 12 T3, 20 T4. Four patients received preoperative radiation and 40 patients had post-operative radiation. Among 62 patients, 33 patients were treated by partial laryngectomy, 29 patients were treated by total laryngectomy.</p><p><b>RESULTS</b>The survival rate was calculated with Kaplan-Meier method. The overall 3- and 5-year survival rates were 42.3% and 27.8%, respectively. The 3-year survival rate between partial and total laryngectomy was 51.9% and 29.9%. The 5-year survival rate between partial and total laryngectomy was 39.5% and 11.2% (chi2 = 4.14, P<0.05). Early stage and combined modality therapy were the independent favorable prognostic factors.</p><p><b>CONCLUSIONS</b>Early diagnosis with treatment and combined treatment are the most important factors influencing the survival of patients with pyriform sinus carcinoma. Partial laryngopharyngectomy is a suitable treatment for early and selected advanced pyriform sinus carcinoma with a good function and oncologic outcome.</p>