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1.
Article in English | WPRIM | ID: wpr-763307

ABSTRACT

Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to provide guidance on the implementation of a surgical treatment of oral cancer. MEDLINE databases were searched for articles on subjects related to “surgical management of oral cancer” published in English. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. The quality of evidence was rated with use RoBANS (Risk of Bias Assessment Tool for Nonrandomized Studies) and AMSTAR (A Measurement Tool to Assess the Methodological Quality of Systematic Reviews). Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. Additional directives are provided as expert opinions and Delphi questionnaire when insufficient evidence existed. The Committee developed 68 evidence-based recommendations in 34 categories intended to assist clinicians and patients and counselors, and health policy-makers. Proper surgical treatment selection for oral cancer, which is directed by patient- and subsite-specific factors, remains the greatest predictor of successful treatment outcomes. These guidelines are intended for use in conjunction with the individual patient's treatment goals.


Subject(s)
Advisory Committees , Bias , Carcinoma, Squamous Cell , Counseling , Expert Testimony , Humans , Mouth Neoplasms , Neck , Republic of Korea
2.
Article in English | WPRIM | ID: wpr-786128

ABSTRACT

BACKGROUND: The worldwide incidence of squamous cell carcinoma of the tongue (SCCOT) in young patients has been increasing. We investigated clinicopathologic features of this unique population and compared them with those of SCCOT in the elderly to delineate its pathogenesis.METHODS: We compared clinicopathological parameters between patients under and over 45 years old. Immunohistochemical assays of estrogen receptor, progesterone receptor, androgen receptor, p53, p16, mdm2, cyclin D1, and glutathione S-transferase P1 were also compared between them.RESULTS: Among 189 cases, 51 patients (27.0%) were under 45 years of age. A higher proportion of women was seen in the young group, but was not statistically significant. Smoking and drinking behaviors between age groups were similar. Histopathological and immunohistochemical analysis showed no significant difference by age and sex other than higher histologic grades observed in young patients.CONCLUSIONS: SCCOT in young adults has similar clinicopathological features to that in the elderly, suggesting that both progress via similar pathogenetic pathways.


Subject(s)
Aged , Carcinoma, Squamous Cell , Cyclin D1 , Drinking , Drinking Behavior , Epithelial Cells , Estrogens , Female , Glutathione Transferase , Humans , Immunohistochemistry , Incidence , Mouth Neoplasms , Receptors, Androgen , Receptors, Progesterone , Smoke , Smoking , Tongue , Young Adult
3.
Article in English | WPRIM | ID: wpr-719565

ABSTRACT

OBJECTIVE: To evaluate the swallowing problems after a primary resection in patients with tongue cancer. METHODS: Thirty-eight patients with primary tongue cancer, who underwent a glossectomy and had undergone a Video Fluoroscopic Swallowing Study (VFSS) prior to surgery in a university hospital between January 2010 and May 2015, were included retrospectively. The clinical and swallowing features, including the VFSS parameters before and after surgery, were analyzed. RESULTS: Among the 38 patients, 33 patients were T1 and T2 stage. Thirty-one, six and one patient underwent a partial glossectomy, hemiglossectomy, and total glossectomy, respectively. More than ninety percent of the patients had a selective neck dissection. All the patients were on a regular diet before surgery and showed no penetration or aspiration on the VFSS. Immediately after surgery, 33 patients (87%) had to change to non-oral feeding. At discharge, 8 patients (21%) maintained non-oral feeding, and 30 patients ate a limited diet. In a telephone survey (mean 19 months after surgery), among the 25 survey participants, 24 patients (96%) reported no problems with their regular diet. CONCLUSION: In tongue cancer patients with low Tumor-Node-Metastasis (TNM), American Joint Committee on Cancer (AJCC) stages, a primary resection of tongue cancer did not cause statistically significant dysphagia after surgery. Although many patients had to change their diet to limited or non-oral feeding immediately after surgery, almost all patients improved and could eat a regular diet after the long term follow up.


Subject(s)
Deglutition , Deglutition Disorders , Diet , Follow-Up Studies , Glossectomy , Head and Neck Neoplasms , Humans , Joints , Neck Dissection , Retrospective Studies , Telephone , Tongue Neoplasms , Tongue
4.
Article in English | WPRIM | ID: wpr-718721

ABSTRACT

OBJECTIVES: The current study aims to determine the correlation between nutritional status upon presentation and disease severity, as well as treatment and survival outcomes. METHODS: Patients who were diagnosed with deep neck infection, underwent at least one surgical drainage/debridement, and had more than 1 week of hospitalization at a tertiary medical center from 2007 to 2015 were retrospectively included. Thereafter, initial serum albumin, C-reactive protein (CRP), and body mass index (BMI) were reviewed. RESULTS: A total of 135 patients were included in the final analysis. Accordingly, the proportion of patients with simultaneous mediastinitis (21.0%), necrotizing fasciitis (12.9%), disease extent >1 cervical level (72.6%), mean CRP (22.4 mg/dL), mean length of hospitalization (25.0 days), and mean 1-week follow-up CRP (7.2 mg/dL) was significantly higher in the hypoalbuminemia group (initial serum albumin 1 cervical level (2.12), initial serum CRP over 20 mg/dL (3.79), hospitalization of more than 14 days (4.10), 1-week follow-up CRP over 5 mg/dL (3.78), and increased duration for an over 50% decrease in initial CRP (2.70) (all P < 0.05). Although intravascular albumin replenishment decreased the proportion of patients with hypoalbuminemia after 2 weeks (P < 0.05), it did not significantly predict better treatment outcomes. CONCLUSION: Among the markers reflecting an individual's nutritional state, an initial serum albumin of less than 3.0 g/dL was an independent serologic marker predicting increased disease severity and complications in patients with deep neck infection.


Subject(s)
Body Mass Index , C-Reactive Protein , Comorbidity , Drainage , Fasciitis , Fasciitis, Necrotizing , Follow-Up Studies , Hospitalization , Humans , Hypoalbuminemia , Malnutrition , Mediastinitis , Neck , Nutritional Status , Odds Ratio , Retrospective Studies , Serum Albumin
5.
Article in English | WPRIM | ID: wpr-766395

ABSTRACT

OBJECTIVE: To evaluate the factors affecting long-term prognosis for dysphagia in tonsil cancer patients, after treatment. METHOD: This was a retrospective study of subjects who underwent a videofluoroscopic swallowing study (VFSS) following treatment for stage 3 or 4 tonsil cancer. Data including sex, age, cancer characteristics, and methods of cancer treatment were collected. To evaluate the swallowing-related outcome, we collected data including findings regarding the last VFSS, method of feeding, and history of aspiration pneumonia requiring in-patient care. We evaluated the correlation between these data and the characteristics of cancer and treatment methods. RESULT: Among 32 subjects included in this study, eight had aspiration or penetration confirmed by the last VFSS. There were no significant differences in swallowing-related factors according to the presence of aspiration or penetration in the last VFSS. Patients who underwent curative tonsillectomy retained more residues on the last VFSS than those who did not. CONCLUSION: Among subjects with tonsil cancer, history of curative tonsillectomy was correlated with more pharyngeal residue. However, other cancer- or treatment-related factors did not affect the outcome of swallowing.


Subject(s)
Deglutition , Deglutition Disorders , Humans , Methods , Palatine Tonsil , Pneumonia, Aspiration , Prognosis , Retrospective Studies , Tonsillar Neoplasms , Tonsillectomy
6.
Article in English | WPRIM | ID: wpr-165881

ABSTRACT

Primary airway tumors are rare in children and no literature reviewed their characteristics each location. We evaluate the clinical characteristics and outcomes of Korean children with primary airway tumors, from the larynx to bronchi. A retrospective chart review of children with primary tumors of the larynx, trachea, and bronchi at Asan Medical Center from January 2000 to July 2016 was conducted. Nineteen children were diagnosed with primary airway tumors of the larynx (47.4%), trachea (10.5%), and bronchi (42.1%). Median follow-up duration was 2.8 years and there were recurrences in 21.1%. Laryngeal tumors were associated with a younger median age at onset (2 months) and diagnosis (4 months), and most were relatively small (median size = 5.3 mm) and symptomatic. Tracheal and bronchial tumors were found in older children (age at onset and diagnosis > 11 years) and large (> 15.0 mm). Most (75%) patients with bronchial tumors were asymptomatic and all the patients with tracheal tumors were symptomatic. This study suggests that we should consider different the locations in primary airway tumor based on the age at onset and diagnosis, initial symptoms or signs, and size of tumor.


Subject(s)
Age of Onset , Bronchi , Child , Diagnosis , Follow-Up Studies , Humans , Larynx , Pediatrics , Recurrence , Retrospective Studies , Trachea
7.
Article in English | WPRIM | ID: wpr-66664

ABSTRACT

Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to develop clinical practice guidelines for the surgical treatment of laryngeal cancer. This Task Force conducted a systematic search of the EMBASE, MEDLINE, Cochrane Library, and KoreaMed databases to identify relevant articles, using search terms selected according to the key questions. Evidence-based recommendations were then created on the basis of these articles. An external expert review and Delphi questionnaire were applied to reach consensus regarding the recommendations. The resulting guidelines focus on the surgical treatment of laryngeal cancer with the assumption that surgery is the selected treatment modality after a multidisciplinary discussion in any context. These guidelines do not, therefore, address non-surgical treatment such as radiation therapy or chemotherapy. The committee developed 62 evidence-based recommendations in 32 categories intended to assist clinicians during management of patients with laryngeal cancer and patients with laryngeal cancer, and counselors and health policy-makers.


Subject(s)
Advisory Committees , Consensus , Counseling , Drug Therapy , Glottis , Humans , Laryngeal Neoplasms , Neck
8.
Article in English | WPRIM | ID: wpr-101082

ABSTRACT

BACKGROUND: Core needle biopsy is a relatively new technique used to diagnose salivary gland lesions, and its role in comparison with fine needle aspiration cytology needs to be refined. METHODS: We compared the results of 228 ultrasound-guided core needle biopsy and 371 fine needle aspiration procedures performed on major salivary gland tumors with their postoperative histological diagnoses. RESULTS: Core needle biopsy resulted in significantly higher sensitivity and more accurate tumor subtyping, especially for malignant tumors, than fine needle aspiration. No patient developed major complications after core needle biopsy. CONCLUSIONS: We recommend ultrasoundguided core needle biopsy as the primary diagnostic tool for the preoperative evaluation of patients with salivary gland lesions, especially when malignancy is suspected.


Subject(s)
Biopsy, Fine-Needle , Biopsy, Large-Core Needle , Diagnosis , Humans , Parotid Gland , Salivary Gland Neoplasms , Salivary Glands , Submandibular Gland
9.
Article in English | WPRIM | ID: wpr-188406

ABSTRACT

BACKGROUND: The pathogenesis of radiation-induced sarcomas (RISs) is not well known. In RIS, TP53 mutations are frequent, but little is known about Mdm2-p53 interaction, which is a recent therapeutic target of sarcomas. METHODS: We studied the immunohistochemical expression of Mdm2 and p53 of 8 RISs. The intervals between radiation therapy and diagnosis of secondary sarcomas ranged from 3 to 17 years. RESULTS: Mdm2 expression was more common in de novo sarcomas than RISs (75% vs 37.5%), and p53 expression was more common in RISs than in de novo cases (75% vs 37.5%). While half of the RISs were Mdm2(-)/p53(+), none of de novo cases showed such combination; while half of de novo sarcomas were Mdm2(+)/p53(-), which are a candidate group of Mdm2 inhibitors, only 1 RIS showed such a combination. Variable immunoprofiles observed in both groups did not correlate with tumor types, except that all of 2 myxofibrosarcomas were Mdm2(+)/p53(+). CONCLUSIONS: In conclusion, we speculated that both radiation-induced and de novo sarcomagenesis are not due to a unique genetic mechanism. Mdm2-expression without p53 overexpression in 1 case of RIS decreases the future possibility of applying Mdm2 inhibitors on a subset of these difficult tumors.


Subject(s)
Diagnosis , Head and Neck Neoplasms , Head , Neck , Neoplasms, Radiation-Induced , Sarcoma , Tumor Suppressor Protein p53
10.
Article in English | WPRIM | ID: wpr-50491

ABSTRACT

OBJECTIVES: This study evaluated the risk factors for anastomotic leakage (AL) and survival outcomes in patients with head and neck squamous cell carcinoma (HNSCC). METHODS: Patients with HNSCC who underwent surgery carrying potential AL from 2003 through 2009 were included in this study. Univariate and multivariate analyses were performed and patient survival was calculated by the Kaplan-Meier method. RESULTS: Of 232 eligible patients, 25 (10.8%) developed AL. Univariate analyses revealed that primary tumor site, salvage surgery, perineural invasion, radiotherapy, chemotherapy, and blood transfusion were significantly associated with the occurrence of AL (P0.1). CONCLUSION: Patients who received salvage surgery and blood transfusion may require careful surveillance for development of AL, which has a tendency toward decreased survival.


Subject(s)
Anastomotic Leak , Blood Transfusion , Carcinoma, Squamous Cell , Disease-Free Survival , Drug Therapy , Head , Humans , Methods , Multivariate Analysis , Neck , Radiotherapy , Risk Factors
11.
12.
Article in Korean | WPRIM | ID: wpr-649311

ABSTRACT

BACKGROUND AND OBJECTIVES: Fibromatosis is an uncommon soft tissue mass lesion that can occur in all anatomic sites. Fibromatoses arising in the head and neck region comprises of approximately 5% of all fibromatoses, which is associated with an infiltrative growth pattern and thus results in difficulty in complete excision. The authors investigate the clinical characteristics of head and neck fibromatoses. SUBJECTS AND METHOD: Six cases of head and neck fibromatoses were analyzed from 1989 to 2011. The imaging and pathologicfindings, surgical management, and clinicaloutcomes were evaluated. RESULTS: Painless mass effect was the most common symptom. The accuracy of diagnostic tools including computed tomography, magnetic resonance imaging and fine needle aspiration biopsy were under 50%. Recurrence was observed in two patients who had undergone surgical excision during follow-up. Salvage surgery was performed in these patients. CONCLUSION: The aggressive excision of head and neck fibromatosis cannot be achieved easily. Vigilant follow-up with or without conservative surgical excision results in good disease control. Radiotherapy can be applied for inoperable or margin positive cases considering age or performance of patient.


Subject(s)
Biopsy , Biopsy, Fine-Needle , Fibroma , Follow-Up Studies , Head , Humans , Magnetic Resonance Imaging , Neck , Recurrence
13.
Article in English | WPRIM | ID: wpr-65411

ABSTRACT

BACKGROUND: A new tumor entity of the salivary glands, mammary analogue secretory carcinoma (MASC) with ETV6-NTRK3 translocation, has recently been proposed. MASC was originally diagnosed as adenocarcinoma, not otherwise specified (ANOS), or acinic cell carcinoma (AciCC) by the current World Health Organization classification. We aimed to identify MASC cases by molecular tests, and to characterize their clinical, histological, and immunohistochemical features. METHODS: Thirty cases of MASC candidates were selected after review of 196 salivary gland tumors, and subjected to break-apart ETV6 fluorescence in situ hybridization (FISH), and immunohistochemical study for S100 protein, gross cystic disease fluid protein 15, DOG1, estrogen receptor, and progesterone receptor. RESULTS: Valid FISH results were obtained in 23 cases, and 13 positive cases were retrieved. MASCs were histologically varied, and the most frequent features observed in 10 cases were low-grade papillary/cystic/glandular patterns, intraluminal secretory materials, ovoid/wrinkled nuclei, and relatively abundant granular eosinophilic cytoplasms, corresponding to papillary-cystic or follicular types of AciCC. All cases showed diffuse immunopositivity for S100 protein. Three cases developed recurrences, but all patients remained alive. CONCLUSIONS: MASC could be a molecularly well-defined salivary gland neoplasm, encompassing some portions of AciCC and ANOS, but its histological spectrum and clinical implication require further investigation.


Subject(s)
Adenocarcinoma , Carcinoma, Acinar Cell , Cytoplasm , Eosinophils , Estrogens , Fluorescence , Humans , In Situ Hybridization , In Situ Hybridization, Fluorescence , Oncogene Proteins, Fusion , Progesterone , Recurrence , Salivary Gland Neoplasms , Salivary Glands , World Health Organization
14.
Article in English | WPRIM | ID: wpr-56548

ABSTRACT

BACKGROUND: Human papillomavirus (HPV)-related tonsillar squamous cell carcinoma (TSCC) has recently been characterized as a distinct subset with a favorable prognosis. The prevalence and clinicopathologic significance of HPV-related TSCC in Koreans are not well known. METHODS: HPV in situ hybridization (ISH) accompanied by p53, p16, pRb, and cyclin D1 immunohistochemical staining were performed on 89 resection cases of TSCC from 2000 through 2010. RESULTS: HPV was detected by ISH in 59 of 89 cases (66.3%). HPV-positive TSCCs were more common in younger ages (p=0.005), and tumor sizes were smaller in the HPV-positive compared to the HPV-negative group (p=0.040). Positive HPV staining was significantly correlated with p16 expression (p<0.001), pRb inactivation (p=0.003), and cyclin D1 down-regulation (p<0.001) but not with p53 expression (p=0.334). Seventeen cases that showed p16-immunopositivity with HPV-negativity by ISH were retested by HPV typing; HPV DNA was not detected in all cases. There was no significant difference between HPV-positive and HPV-negative patients either in the disease-specific survival (DSS, p=0.857) or overall survival (p=0.910). Furthermore, pRb-inactivated cases showed better DSS (p=0.023), and p53-positive cases showed worse DSS (p=0.001). CONCLUSIONS: Although high HPV prevalence was noted, it was not correlated with histopathologic findings or survival benefit. In addition to p53 expression, pRb inactivation along with p16 overexpression and down-regulation of cyclin D1 are thought to be important pathogenetic steps for developing TSCCs.


Subject(s)
Carcinoma, Squamous Cell , Cell Cycle , Cyclin D1 , Cyclin-Dependent Kinase Inhibitor p16 , DNA , Down-Regulation , Humans , In Situ Hybridization , Prevalence , Prognosis , Tonsillar Neoplasms , Tumor Suppressor Protein p53
15.
Article in English | WPRIM | ID: wpr-138607

ABSTRACT

BACKGROUND: Metastases to the oral/oropharynx are very rare and their diagnosis is challenging. METHODS: We reviewed pathologic data for malignant tumors of the oral/oropharynx that were diagnosed at the Asan Medical Center, Seoul, Korea from 1995 until 2010. RESULTS: Twenty-nine cases of oral/oropharyngeal metastases were retrieved, comprising 2.0% of 1,445 malignancies. The most common primary sites were the liver and lung, followed by the stomach, colon, breast, prostate, and kidney. The gingiva was the most common metastatic site, followed by the tonsil/pillar, mandible, tongue, tongue base, palate mucosa, mouth floor, and buccal mucosa. Intervals between detection of primary tumors and metastases were variable, from -1 month to 104 months. Ten patients with lung (7 cases), liver, stomach, and kidney carcinomas manifested with oral/oropharyngeal metastases as the first sign of systemic metastases. The majority of patients had died within one year of the onset of an oral/oropharyngeal metastasis, but exceptionally long-lived cases were also present. The survival periods of patients with lung cancers were longer than those of patients with non-pulmonary tumors. CONCLUSIONS: An awareness of the incidence, common primary sites, metastatic subsites, and metastatic courses or patterns of oral/oropharyngeal metastases is helpful in the diagnosis of metastatic carcinomas.


Subject(s)
Incidence , Neoplasm Metastasis , Lung Neoplasms
16.
Article in English | WPRIM | ID: wpr-138606

ABSTRACT

BACKGROUND: Metastases to the oral/oropharynx are very rare and their diagnosis is challenging. METHODS: We reviewed pathologic data for malignant tumors of the oral/oropharynx that were diagnosed at the Asan Medical Center, Seoul, Korea from 1995 until 2010. RESULTS: Twenty-nine cases of oral/oropharyngeal metastases were retrieved, comprising 2.0% of 1,445 malignancies. The most common primary sites were the liver and lung, followed by the stomach, colon, breast, prostate, and kidney. The gingiva was the most common metastatic site, followed by the tonsil/pillar, mandible, tongue, tongue base, palate mucosa, mouth floor, and buccal mucosa. Intervals between detection of primary tumors and metastases were variable, from -1 month to 104 months. Ten patients with lung (7 cases), liver, stomach, and kidney carcinomas manifested with oral/oropharyngeal metastases as the first sign of systemic metastases. The majority of patients had died within one year of the onset of an oral/oropharyngeal metastasis, but exceptionally long-lived cases were also present. The survival periods of patients with lung cancers were longer than those of patients with non-pulmonary tumors. CONCLUSIONS: An awareness of the incidence, common primary sites, metastatic subsites, and metastatic courses or patterns of oral/oropharyngeal metastases is helpful in the diagnosis of metastatic carcinomas.


Subject(s)
Incidence , Neoplasm Metastasis , Lung Neoplasms
17.
Article in Korean | WPRIM | ID: wpr-652114

ABSTRACT

Organ preservation strategy in treatment of the head and neck cancer (HNC) has led to an increase in the use of primary chemoradiation in both laryngeal and extralaryngeal sites for recent two decades. Primary non-surgical chemoradiotherpay has replaced the traditional gold standard of surgery followed by postoperative radiation with saving the organ and no compromising oncological outcomes. In accompany with wide clinical extension of primary chemoradiation, organ preservation surgery through open transcervical or transoral route has been increasingly used in the patients with HNC at both primary and salvage settings. Minimally invasive transoral approach using lasers or robots has been more spotlighted as a sensible strategy for organ preservation of the HNC patients. There is, however, a paucity of randomized controlled clinical trial data comparing primary organ-preserving chemoradiation to organ preservation surgery. Future direction leads to conduct well-designed clinical trials to establish the functional and oncological benefits of the organ preservation surgery. This article reviews the role of organ preservation surgery in head and neck cancer.


Subject(s)
Head , Head and Neck Neoplasms , Humans , Microsurgery , Organ Preservation , Robotics
18.
Article in Korean | WPRIM | ID: wpr-651067

ABSTRACT

BACKGROUND AND OBJECTIVES: We evaluated treatment outcomes of patients with advanced hypopharyngeal cancer for whom surgical salvage was attempted after primary concomitant chemoradiation therapy (CRT) had failed as a treatment. The pre-salvage factors were assess-ed to predict the prognosis of salvage surgery. SUBJECTS AND METHOD: A retrospective analysis was conducted from 1997 to 2006 for 22 patients with stage III-IV hypopharyngeal cancer who had undergone salvage surgery after local and/or regional CRT failures with no distant metastasis. RESULTS: Larynx-sacrificing pharyngectomy was performed in 12 (54.5%) of all patients. Postoperative complications occurred in 9 (40.9%), and carotid artery blowout occurred in two of these patients. After salvage surgery, the 2-year and 5-year overall survival rates were 52.8% and 28.9%, respectively. The 2-year disease specific survival rate and locoregional control rate were 45.5% and 60.0%, respectively. The initial N2-3 stage (p=0.038) and the concurrent local and regional failures (p=0.035) were independent predictors for decreased survival after salvage surgery. Two-year overall survival rates for patients with 2, 1, or none of these predictive factors were 23.3%, 66.7%, and 80.0%, respectively (p=0.027). CONCLUSION: Although salvage surgery after CRT has postoperative complications and unfavorable larynx preservation, it can be considered as a viable option with acceptable oncologic outcomes for advanced hypopharyngeal cancer. The initial N2-3 stage and concurrent local and regional failures were independent predictors that can stratify patients into distinct prognostic groups for postsalvage survival.


Subject(s)
Carotid Arteries , Humans , Hypopharyngeal Neoplasms , Larynx , Pharyngectomy , Postoperative Complications , Prognosis , Retrospective Studies , Salvage Therapy , Survival Rate , Treatment Failure
19.
Article in Korean | WPRIM | ID: wpr-651063

ABSTRACT

BACKGROUND AND OBJECTIVES: Primary subglottic cancer is uncommon, so our understanding of primary subglottic cancer is limited. The purpose of this study is to review the clinical characteristics and treatment result of primary subglottic cancer from our experience. SUBJECTS AND METHOD: During the period from Nov. 1996 to Nov. 2010, patients with primary subglottic cancer were reviewed retrospectively. The mean follow up period was 46.1+/-40.9 months. We analyzed its clinical characteristics, stage, treatment results and survival rate. RESULTS: Of 824 patients with diagnosed laryngeal cancer, 8 (0.97%) had primary subglottic cancer and hoarseness (50.0%) is the most common initial presenting symptom. The symptom of dyspnea was found in 25.0% (2/8) of the patients and squamous cell carcinoma in 75% (6/8). At the time of diagnosis, the four clinical stages of TNM, T1, T2, T3 and T4, had 1 (12.5%), 2 (25.0%), 1 (12.5%) and 4 (50.0%) patients, respectively. There were two cases of cervical lymph node metastases, N1 and N2c. No distant metastasis was found. Two groups of patients comprising of two patients each received surgery alone or radiation alone as an initial treatment; another two groups of patients comprising of two patients each received concurrent chemoradiation or surgery plus radiation therapy alone. The overall 2-year survival rate was 80.0% and 2-year disease free survival rate was 51.7% in patients with squamous cell carcinoma. CONCLUSION: Despite the infrequency of primary subglottic cancer, it is important to understand its clinical characteristics and treatment results during the early diagnosis to make the prognosis better.


Subject(s)
Carcinoma, Squamous Cell , Disease-Free Survival , Dyspnea , Early Diagnosis , Follow-Up Studies , Hoarseness , Humans , Laryngeal Neoplasms , Lymph Nodes , Neoplasm Metastasis , Prognosis , Retrospective Studies , Survival Rate
20.
Article in English | WPRIM | ID: wpr-127700

ABSTRACT

In carcinoma ex pleomorphic adenoma (CXPA), pleomorphic adenoma (PA) and diverse carcinoma components showing luminal (ductal) or non-luminal (myoepithelial) differentiation coexist. To elucidate the clinicopathological implications of cellular differentiation in CXPA and the potential role of p53, vascular endothelial growth factor (VEGF), c-erbB-2, c-kit, and glucose transporter 1 (Glut-1) in carcinogenesis, we analyzed 11 CXPAs with luminal differentiation (CXPAs-LD) and 6 CXPAs with non-luminal differentiation (CXPAs-NLD) and compared protein expressions in residual PAs and carcinomas by immunohistochemistry. Among the CXPAs-LD, 5 were invasive and 8 were histologically high-grade tumors. The 5-year survival rate was 72.7%. P53, c-erbB-2, VEGF, and Glut-1 were more immunoreactive in carcinoma components than in PAs (P = 0.008, 0.004, 0.002, and 0.024, respectively); c-erbB-2 overexpression was associated with high histological grade (P = 0.024). Carcinoma components frequently lacked c-kit expression (P = 0.009). CXPAs-NLD were all low-grade and invasive with a larger mean tumor size (5.2 cm) than CXPAs-LD (3.3 cm) (P = 0.040). The patients remained disease-free without significant immunohistochemical expression. The immunoprofiles and clinical course of CXPA differed according to cellular differentiation. Therefore, it is important to report the histological subtype and to assess potential biomarkers in diagnostic and therapeutic trials.


Subject(s)
Adenoma, Pleomorphic/immunology , Adult , Aged , Carcinoma/immunology , Cell Differentiation , Female , Glucose Transport Proteins, Facilitative/metabolism , Humans , Male , Middle Aged , Proto-Oncogene Proteins c-kit/metabolism , Receptor, ErbB-2/metabolism , Salivary Gland Neoplasms/immunology , Biomarkers, Tumor/analysis , Tumor Suppressor Protein p53/metabolism , Vascular Endothelial Growth Factor A/metabolism
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