Recurrence Risk Factors after Radiotherapy in Early Glottic Cancer and Outcome of Salvage Treatment / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The aim of this study was to find risk factors for recurrence after curative radiotherapy in early glottic cancer and to analyze the result of treatment between salvage total laryngectomy and salvage conservation laryngectomy for recurrent glottic cancer. SUBJECTS AND METHOD: A retrospective analysis was performed for patients of 45 cases of early glottic cancer who were treated with curative radiotherapy from 1997 to 2004. The risk factors analyzed for recurrence in early glottic cancer were gender, age, anterior involvement, bilaterality, T stage and radiotherapy interruption. Fourteen patients who underwent salvage laryngectomy for recurrent glottic cancer were analyzed by Kaplan-Myer method to assess the results of salvage total laryngectomy and salvage conservation laryngectomy. RESULTS: Forty-two patients were male and only 3 patients were female, with the median age of 62.4 years. Radiotherapy interruption was found to be a risk factor significantly influencing recurrence in univariate and multivariate analyses. The 5-year overall survival rate in salvage total laryngectomy was 77% and that in salvage conservation laryngectomy was 75%. CONCLUSION: When a curative radiotherapy was interrupted in early glottic cancer before total dosage irradiation, the possibility of recurrence must be considered. In such cases, by choosing an adequate patient group combined with a proper surgical technique, optimal treatment results can be obtained by salvage conser-vation laryngectomy.

The Changes of Polysomnographic Indices after Adenotonsillectomy in Pediatric Obstructive Sleep Apnea Syndrome / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Adenotonsillar hypertrophy is one of the leading causes in pediatric obstructive sleep apnea syndrome. Because untreated obstructive sleep apnea syndrome in children is associated with various complications such as neurobehavioral and cardiovascular dysfunction, it is very important to exactly diagnose and properly treat those patients. This study evaluates the effectiveness of adenotonsillectomy by assessing polysomnographic indices in pediatric obstructive sleep apnea syndrome. SUBJECTS AND METHOD: We evaluated children aged 4 through 15 years old (mean age=8.14 years old), a total 19 (Male=11, Female=8) with obstructive sleep apnea syndrome using the laboratory based polysomnography before and after adenotonsillectomy. RESULTS: After surgical managements, such as adenoidectomy or adenotonsillectomy, 89% of pediatric obstructive sleep apnea syndrome were successfully treated. The apnea-hypopnea index (from 10.76/hour to 0.78/hour, p=0.001), apnea index (from 5.64/hour to 0.54/hour, p=0.027), snoring (from 27.74% to 5.71%, p=0.002), arousal index (from 21.31/hour to 9.43/hour, p=0.001), minimal SaO2 (from 83.53% to 92.47%, p=0.017) were improved significantly following surgery. CONCLUSION: In children with obstructive sleep apnea syndrome, we identified that various polysomnographic indices were significantly improved after surgical treatments.

Clinical Significance of c-kit Protein Expression and c-kit Gene Mutation in Nasopharyngeal Cancer / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The proto-oncogene c-kit is a receptor tyrosine kinase recognized to initiate essential signal transduction pathways that transmit biological signals for cellular proliferation, differentiation and metastasis. Aberrant expression or mutation of c-kit has been shown to be involved in the pathogenesis of many cancers. In this study, with the aim of identifying additional groups of tumors that may use the stem cell factor/c-kit pathway, we investigated the expression of c-kit in nasopharyngeal carcinoma. SUBJECTS AND METHOD: In this retrospective study, immunohistochemical stains for c-kit were performed on formalin-fixed paraffin embedded sections from 20 patients with nasopharyngeal carcinoma who were treated from 1996 to 2004. Gene mutation was analyzed by PCR-SSCP and direct sequencing. RESULTS: c-kit over-expression was found in 65% (13/20) of patients. Eight of the 13 samples (61.5%) exhibited strongly positive immunoreactivity for c-kit protein (staining of >50% of the tumor cells). c-kit gene mutation was found in 4 of 20 cases by the PCR-SSCP method. CONCLUSION: c-kit protein over-expre-ssion is found in 65% of the nasopharyngeal carcinoma patients. c-kit expression is correlated with c-kit DNA mutations and nasopharyngeal carcinoma may be potential targets for treatment with imatinib mesylate.