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Objective To explore the relationship between the status of the cervical lymphatic metastasis of papillary thyroid carcinoma(PTC)at cNo stage and tumor recurrence and the patient' s prognosis.Methods The clinical data of 498 cNo PTC patients admitted from 1986 to 1990 were retrospectively analyzed.Results All the patients were followed up for more than 10 years.16 patients died of PTC,among them 3 for metastasis,13 for local recurrence.The total cervical lymphatic metastasis rate in these 498 patients was 52.2％,in 260 cases in which detailed data were available: rate was 14.1％ in zone Ⅱ,27.1％ in zone Ⅲ,24.6％ in zone Ⅳ,12.5％ in zone Ⅴ,and 20.1％ in zone Ⅵ respectively.According to the appearances of microscopic pathology,the cervical lymphatic metastasis rates in 498 cases of cNo PTC were collected as following: uncapsuled group was 65.6％,extracapsular group was 64.5％,extralobal group was 56.5％,involved the surrounding tissue and structure group was 52.0％,focal cancerous focus group was 33.3％,latent sclerosis group was 26.9％,encapsuled and introcapsule group was 0.The cervical recurrence rate was only 2％ in the complete function neck dissection group and 9.9％ in the selective center neck dissection group.Conclusions In cNo PTC the most common cause of death was local recurrence.Prophylactic function complete neck dissection should be performed for cNo PTC cases of highly invasive type such as without tumor capsule,extracapsular,extralobal or surrounding tissue invasion.
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Objective To investigate clinical biologic characteristics and factors that impact prognosis of patients with follicular thyroid carcinoma(FTC).Method Clinical data of 105 FTC patients treated surgically in the Department of Head& Neck,Tianjin Cancer Hospital from 1970 to 1990 was analyzed retrospectively.Results The overall 5-year,10-year and 15-year survival rates of these patients were 85.3％,76.7％ and 72.9％ respectively.The overall 15-year survival rates of patients ≥45 years and those ＜ 45 years were 45.9％,89.8％ respectively.The overall 15-year survival rates of patients with unilateral and bilateral carcinoma was 50.0％,76.2％ respectively.The overall 15-year survival rates of patients with neck lymph node metastasis and without were 54.2％,79.2％ respectively.The overall 15-year survival rates of patients at stage Ⅰ,stage Ⅱ,stageⅢ and stageⅣ were 89.3％,70.0％,45.5％ and 35.3％respectively.During the follow-up period,11 patients were diagnosed with distant metastasis from 1 year to 33 years after surgical treatment and 9 died of cancer within 5 years after diagnosis.Seventeen patients had local recurrence from 3 months to 34 years after surgery and 10 of these patients died of local recurrence.Conclusions The factors influencing prognosis of patients with FTC were age,clinical stage,bilateral carcinoma and neck lymph node metastasis,therefore early treatment and close following-up are essential to improve the prognosis of patients with FTC.
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Objective To investigate the characteristic,diagnosis,clinical staging, treatment and clinical prognosis of occult breast carcinoma (OBC). Method Forty-six cases of OBC were analyzed retrospectively with the clinical and follow-up information that were confirmed by postoperative pathologic diagnosis from November 1981 to November 2005. Results All patients showed axillary node enlargement as the first sign and were operated.The operation included axillary node excision in 2 patients,radical mastec-tomy or modified radical mastectomy in 44 patients. Forty-five cases got follow-up for 1-22 years,33 cases had existed 3 years,18 cases had existed 5 years,8 cases had existed 10 years. Conclusions For axillary mass which causes are uncertain ,the possibility of OBC should be considered .Meanwhile excision and pathological examination is necessary.The metastatic histological structure and immunohistochemical index of the axillary nodes usually provide important clue for the source of this tumor.Radical or modified mastectomy is the best method, and pest-operative chemotherapy and/or radiotherapy should be done. It has been showed that targeted therapy is very important to breast cancer with C-erbB-2 positive recently.To the cases that neck lymphatic metastasis is M4G3 positive by immunohistochemical examination and no primary focus clinically, the diagnosis of OBC should be considered. The cases without primary focus have better prognosis than those with primary focus.
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OBJECTIVE To investigate the clinical and pathological characteristics and its diagnosis and treatment of the parotid gland tumor in children.METHODS The clinical data of 77 children with parotid gland tumor treated in Department of Head and Neck,Tianjin Cancer Hospital affiliated Tianjin Medical University from Dec.1985 to Dec.2007 were retrospectively studied.RESULTS Among the 77 cases,51 cases were benign tumor(66.2%),26 cases were malignant tumor(33.8%).Among the benign cases,hemangioma and lymphangioma were the most common diseases,which accounted for 37.3%(19/51).Mucoepidermoid carcinoma(34.6%, 9/26) was the most common malignancy.Sixty seven cases were treated surgically.Among 18 cases of the epithelial malignant tumors,7 cases treated combined with postoperative radiotherapy.During the period of following-up from 1 to 17 years,1 case of pleomorphic adenoma,1 case of malignant myoepithelioma and 1 case of mucoepidermoid carcinoma recurred. CONCLUSION The clinical and pathological features of parotid gland tumors in children were different from those in adults.The hemangioma,lymphangioma and teratoma are rare in adults but common in children.Half of the solid tumors of parotid gland in children are malignant,but only 23.7%in adults. The primary radical operation has great value to the prognosis of children parotid tumor.Although postoperative radiotherapy can reduce the risk of recurrence,oncogenesis in thyroid gland and the adverse effect on the orofacial development of radiotherapy in children need investigated clinically in future.
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OBJECTIVE To study the clinical manifestation and relationship of the pathologic type,clinical treatment and the prognosis of head and neck rhabdomyosarcoma. METHODS The clinical data of 28 cases with head and neck rhabdomyosarcoma were reviewed retrospectively. RESULTS Among these 28 cases, 10 cases were treated surgically accompanying with postoperative chemotherapy and radiotherapy, 6 cases were treated with operation and chemotherapy, 2 cases were treated with operation and radiotherapy, 2 cases were treated with radiotherapy and chemotherapy, 4 cases were treated with chemotherapy only, 2 cases were treated with radiotherapy only, and 2 cases were treated with palliative operation. The 3-year and 5-year total survival rates were 57.14 % and 28.57 % respectively.Two cases who were embryonal type in pathology and at stage Ⅰand treated with extensive dissection accompanied with chemotherapy survived more than 10 years. Among 8 cases survived more 5 years, 6 cases were embryonal type, one case was alveolar type, one case was pleomorphic type. CONCLUSION The combined treatment strategy can improve the survival rate of the patients.
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Purpose: To explore the prognostic factors of medullary thyroid carcinoma( MTC) . Methods: The current study was designed to collect and analyze the clinical and follow-up information of 73 cases of MTC treated in our hospital. Results: It was shown that 37 cases were patients aged 30-40 years, it was more common in female than male, 83. 6% of these cases were regarded as clinical stage Ⅰ toⅢ. After treatment, the survival rate for 5 years were 100% , 41. 5% and 0 in the group of clinical stage Ⅰ,Ⅲ and IV respectively. None of those 8 cases in which the masses were incompletely removed surgically combined with the postoperative radiotherapy survived up to 5 years. Conclusions: The clinical stage, the thoroughness of the remove of MTC and its metastasis were the significant prognostic factors in our patients. It should be recognized that in most cases of MTC, though the mass was huge, it could be removal completely because it has an incomplete capsule. Although a little cancerous tissue might be left after operation, the prognosis is good after the postoperative radiotherapy. Therefore attempts of surgical removal of the cancerous mass should not be given up easily.