Malignant minor salivary gland tumors of the larynx / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the clinical features, treatment and prognosis of malignant minor salivary gland tumors of the larynx.</p><p><b>METHODS</b>Treatment and outcome were retrospectively analyzed in a consecutive series of 15 patients with malignant minor salivary gland tumors of the larynx treated in this hospital from 1959 to 2005. Ten patients (66.7%) had adenoid cystic carcinoma and 2 (13.3%) had adenocarcinoma. The other three patients had mucoepidermoid carcinomas, polymorphic adenocarcinoma and base cell carcinoma respectively. Eleven (73.3%) were located in the supraglottis and 4 (26.7%) in the subglottis. Fourteen had surgery (7 with adjuvant radiotherapy) and one was treated with radiotherapy plus chemotherapy. Five patients were found to have recurrent disease, 4 of whom underwent salvage surgery, 1 of whom had palliation radiotherapy.</p><p><b>RESULTS</b>With a median follow-up of 8 years (ranging from 2 to 16 years), 7 patients are alive. Five patients have no evidence of disease, 1 of whom had surgery alone, 4 of whom were treated with surgery plus radiotherapy. Four patients died of distant metastases in a range of 2 to 10 years. The other 4 patients were lost to follow-up after treatment (ranging from 2 years to 16 years). Seven patients developed recurrent disease, 1 of whom had local recurrence alone, 1 had regional recurrence alone, 2 had distant metastases alone, and 3 had local and distant metastases.</p><p><b>CONCLUSIONS</b>Minor salivary gland carcinomas of the larynx are rare and they are prone to the local recurrence and the distant metastasis in advanced stage. Distant metastases remain the principal cause of treatment failure. Surgery is the primary treatment modality used in most cases and the radiotherapy combining surgery has better local and regional control rate.</p>

Reconstruction with free jejunal interposition for defect after tumor resection of hypopharyngeal and cervical esophageal cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the use of free jejunal flap in reconstruction for circumferential defect after tumor resection of hypopharyngeal and cervical esophageal cancer.</p><p><b>METHODS</b>Retrospective review of 51 patients who underwent circumferential pharyngoesophageal reconstruction with free jejunal flap after tumor ablation.</p><p><b>RESULTS</b>In 51 patients, 5 had flap failure and the flap success rate was 90% (46/51). Forty-five patients had oral intake after operation excluding one who had anastomosis stenosis and 5 who had flap failure. The 1-year and 3-year survival rate was 62% and 48% respectively. Positive surgical marginal status and external invasion including thyroid gland, carotid artery, skin and pre-vertebral area were indicators for bad prognosis. Except 5 patients who had flap failure, one of which died from mediastinal infection, no other severe complications occurred.</p><p><b>CONCLUSIONS</b>Patients reconstructed with free jejunal flap after resection of hypopharyngeal and cervical esophageal cancer had low mortality and few complications. Those without positive surgical margin and external invasion including thyroid gland, carotid artery, skin and pre-vertebral area had higher survival rate. Most of them had good quality of life. The choice of free jejunal flap for reconstruction of hypopharyngoesophageal defect was appropriate in selected patients who had guarantee of negative surgical margin and no external invasion.</p>

Surgical treatment for 27 cases of malignant fibrous histiocytoma in the soft tissue of the neck / 中国癌症杂志

Purpose:An analysis of 27 patients who underwent surgery for their malignant fibrous histiocytoma in the soft tissue of the neck was done to show that compartment dissection of the neck should be the optimal choices of treatment. Methods:From 1 st Jan 1972 through 31 st Dec 1993,27 patients who were referred to the Cancer Hospital for surgical treat- ment were reviewed,including 19 males and 8 females in the age range from 15 to 67,with a mean of 44 years.Surgery was classified as wide resection and compartment dissection of the neck.The two groups were compared for local recurrence and 5 years survival rates.Results:Of the 27 operations,21 were wide resections and 6 compartment dissection of the necks.The average tumor diameter was6 millimeters in patients with compartment dissection of the neck.Local recurrence was encountered in 16 of 21 wide resections (76.2%),and in 1 of 6 compartment dissection of the necks (16.7%).The difference between the two groups was statistically significant (P= 0.015).The 5 years survival was 89% for patients without local recurrence and 52% for patients with local recurrence. The difference between them was significant statistically (Log Rank,P=0.0264).Conclusions:For malignant fibrous his- tiocytoma in the soft tissue of the neck,compartment dissection of the neck is recommended as the optimal operation for its ability to the local control of the disease locally.