• Title/Summary/Keyword: 두경부암 환자

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The Surgical Treatment of Choice for Patients with Differentiated Thyroid Cancer(DTC) (분화성 갑상선암 환자에서 수술범위의 선택)

  • Cha Seong-Jae;Park Sung-Jun;Lim Hyen-Muck
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.200-205
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    • 1997
  • Background: There is considerable controversy concerning the most appropriate surgical treatment of patients with DTC. Objectives: In order to selection of the appropriate surgical treatment for DTC, we have analyzed the outcome of the different types of surgical treatment in low and high risk groups of DTC. Materials and Methods: From January 1968 through december 1980, a total of 71 patients with DTC were treated surgically at our institution. According to Cady and Rossi's scoring system, the patients were divided into low risk and high risk groups. Results: Seventy percent of patients were defined as low risk group with a 4% death rate whereas 30% of patients at high risk with a death caused by thyroid cancer in 38%(p<0.05). There was no difference in mortality between ipsilateral lobectomy and total thyroidectomy in both low and high risk groups(p>0.1). Conclusion: In our study, total thyroidectomy was not benefit in high risk group. These results suggested that total thyroidectomy must be selected carefully and based on clear evidence of major improvement in outcome or absence of other suitable surgical approaches. However, follow up study of more cases will be needed for accurate determination of the efficacy of total thyroidectomy in high risk group.

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Two Cases of Stomach Cancer in Patients with Head and Neck Cancer (두경부암 환자에 병발된 위암 2예)

  • Kang Jin-Hyoung;Moon Chan-Soo;Kim Hoon-Kyo;Lee Kyung-Shik;Kim Dong-Jip;Yoon Sei-Chul;Cho Seung-Ho;Suh Byung-Do
    • Korean Journal of Head & Neck Oncology
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    • v.8 no.1
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    • pp.25-30
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    • 1992
  • The causes of treatment failure in head and neck cancer are locoregional recurrence, distant metastasis and second primary cancer. The favorite sites of second primary cancer are head and neck, lung and esophagus. But, the incidence of stomach cancer in Korea is the highest of all, high incidence of stomach cancer is expected in head and neck cancer patients. We experienced 2 cases of stomach cancer after successful treatment of primary head and neck cancer at Kang Nam St. Mary's hospital. The first case was a 60-year-old male with nasopharyngeal non-keratinizing carcinoma(stage III, T1N1M0). He received three cycles of induction chemotherapy including cisplatin and 5-fluorouracil followed by radiotherapy which resulted in complete response. Five months after completion of radiotherapy. stomach adenocarcinoma(stage IV, T4N2M1) was diagnosed. He received one cycle of FAM chemotherapy and died 4 months after diagnosis of stomach cancer. The second case was a 50-year-old male with pyriform sinus squamous cell carcinoma(stage II, T2N0M0). He received curative partial pharyngolaryngectomy followed by radiotherapy which result in free of disease. Four months after completion of radiotherapy. stomach adenocarcinoma(stage IV, T4N2M1) was diagnosed. Bypass gastrojejunostomy was performed. The screening test for stomach cancer including upper gastrointestinal X-xay series and/or endoscope of the stomach should be performed periodically for the patients with head and neck cancer in Korea.

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Chromosome 3p Deletions in Korean Head and Neck Carcinomas (한국인 두경부암 환자에서 제3번 염색체 단완의 결손)

  • Son Mi-Na;Yoo Young-A;Cho Zeung-Keun;Choi Kun;Choi Jong-Wook;Kim Yeul-Hong;Kim Jun-Suk
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.1
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    • pp.20-26
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    • 1998
  • Objectives: Deletion in the short arm of chromosome 3 is common in many human cancers, including sporadic and hereditary renal carcinomas, small cell lung carcinomas, non-small cell lung carcinomas, and carcinomas of the ovary, breast, and cervix. A high frequency of chromosomal aberrations in head and neck cancers involving chromosome 3p has also been reported. These findings suggest that multiple tumor suppressor genes may be present on the short arm of chromosome 3. Materials and Methods: To investigate the possibility of chromosome 3p deletions in the Korean head and neck cancer patients, we applied a polymerase chain reaction(PCR)-based Restriction Fragment Length Polymorphism analysis to the DNA samples of matched normal mucosa and head and neck squamous cell carcinomas from 19 patients. Results: In the 19 normal samples heterozygosity at the polymorphic loci varied: 6 at the D3F15S2 locus(on telomeric 3p21), 2 at the D3S32 locus(on centromeric 3p21), and 4 at the THRB locus(on centromeric 3p24). In 12 matched carcinoma specimens, LOH(loss of heterozygosity) was observed at D3F15S2 in 1 of 6(17%), D3S32 in 1 of 2(50%), and at THRB in 2 of 4 cases(50%). Conclusion: The frequency of chromosome 3p deletion in the Korean head and neck carcinomas appear as other country did.

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Clinical Significance of FDG PET-CT Scan at 12 Weeks after Curative Radiation Therapy in Patients with Head and Neck Cancer (두경부암 환자에서 근치적 방사선치료 후 12주 시행한 양전자방출촬영의 임상적 중요성에 대한 연구)

  • Kim, Young-il;Kim, Jun-sang;Kwon, Jeanny;Kim, Sup;Seo, Youngduk;Koo, Bon-seok;Chang, Jae-won;Cho, Moon-June
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.1
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    • pp.17-22
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    • 2021
  • Background/Objectives: To evaluate clinical significance of FDG PET-CT for detection of residual cancer cells after curative radiation therapy or chemoradiotherapy for patients with squamous cell carcinoma (SCC) of Head and Neck Materials & Methods: A retrospective analysis of patients with SCC of Head and neck with curative radiotherapy or chemoradiotherpy between June 2011 and Jan. 2019 was performed. Sixty patients were treated with Intensity-modulated radiotherapy (IMRT). The Metabolic responses were evaluated on the post-treatment FDG PET-CT at 12 weeks after curative radiotherapy completion. Results: Median follow up was 51.5 months (3-102). The overall survival (OS), disease free survival (DFS), local control rate (LCR), and Distant metastasis free survival (DMFS) at 5 years were 80.5%, 80.1%, 87.7% and 89.1%. Metabolic CR was found in 43 (71.7%) and partial metabolic response (PR) was noted in 17 (14.6%). Metabolic CR was significantly correlated with OS, DFS, LCR, and DMFS. On multivariate analysis, Metabolic CR remained significant for DFS and LCR. Conclusion: Metabolic CR on post-radiotherapy FDG PET-CT is highly predictive of increased DFS and LCR in patients with head and neck cancer.

Clinical Studies on Locally Invasive Thyroid Cancer (국소침범한 갑상선암의 임상적 고찰)

  • Kim Young-Min;Lee Chang-Yun;Yang Kyung-Hun;Rho Young-Soo;Park Young-Min;Lim Hyun-Jun
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.236-243
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    • 1998
  • Objectives: Local invasion of the thyroid cancer that is invasion of the upper aerodigestive tract, neurovascular structures of the neck and superior mediastinum, is infrequent and comprises of 1-16% of well-differentiated thyroid cancer. However the proximity of the thyroid gland to these structures provides the means for an invasive cancer to gain ready access into theses structures and when invasion occurs, it is the source of significant morbidity and mortality. So locally invasive thyroid cancer should be removed as much as possible, but still much debates have been exist whether the surgical method should be radical or conservative. This study was desinged to evaluate the clinical characteristics and the surgical treatment of the locally invasive thyroid cancer. Material and Methods: At the department of otorhinolaryngology of Hallym university, 10 patients diagnosed as locally invasive thyroid cancer among the 81 patients treated for thyroid cancer between 1991 to 1997 were retrospectively evaluated. Results: Of the 10 patients, 3 patients had histories of previous surgical treatment with or without radiation or radioactive iodine therapy. The site of invasion of thyroid cancer were trachea(7 cases), recurrent laryngeal nerve(5 cases), mediastinal node(5 cases), esophagus(3cases), larynx(3cases), carotid artery(3 cases), pharynx(l case), and other sites(4 cases). The operation techniques included 1 partial laryngectomy and 1 partial cricoid resection, 2 shavings and 3 window resections of the trachea, 1 sleeve resection of the trachea with end-to-end anastomosis and 1 cricotracheoplasty for tracheal invasion, 2 shavings and 1 partial esophagectomies for esophageal invasion, and 1 wall shaving and 2 partial resections with $Gortex^{\circledR}$ tube reconstruction for carotid artery invasion, and so on. Conclusions: These data and review of literature suggest that the surgical method should be perfomed on the basis of individual condition and complete removal of all gross tumor with preservation of vital structures whenever possible will offer a good result.

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The Results of Conservation Surgery in Laryngeal Cancer (보존적 수술을 시행받은 후두암 환자의 치료성적)

  • Lee Soon-Young;Choi Jong-Ouck;Jung Kwang-Yoon;Yoo Hong-Kyun
    • Korean Journal of Head & Neck Oncology
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    • v.7 no.1
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    • pp.17-23
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    • 1991
  • The purpose of conservation surgery is complete eradication of the lesion with maximal maintenance of the proper function of the larynx. But the re are various methods of conservation surgery for the laryngeal cancer because of the unique embriological and anatomical characteristics of the larynx, which is the narrowest portion of the upper airway. The authors experienced 24 cases of conservation surgery for laryngeal cancer(7 in supraglottie cancer, 13 in glottic cancer, 4 in transglottic cancer) during recent 5 years and performed retrospective analysis of the cases. The result shows 91.6% of overall 3 years survival rate(87.5% of disease free 3 year survival rate). The authors concluded that conservation surgery for the laryngeal cancer preserve the function of larynx as possible and high cure rates were achieved by postoperative radiation therapy for the incomplete resection margin.

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Pharyngocutaneous Fistula which Occurred During Postoperative Radiotherapy in Larynx Cancer Patient with Dementia (치매가 있는 후두암 환자에서 술 후 방사선치료 중 발생한 인두피부누공)

  • Kim, Jung Jun;Kang, Ju Yong;Choi, Ik Joon;Lee, Myung-Chul
    • Korean Journal of Head & Neck Oncology
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    • v.35 no.2
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    • pp.51-55
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    • 2019
  • Pharyngocutaneous fistula is a relatively common, but serious complication after pharyngeal or laryngeal cancer surgery. It can cause wound infection, longer hospitalization period and sometimes carotid artery rupture which can be fatal. Recently, we experienced a 63-year-old larynx cancer patient who had dementia and alcoholic liver cirrhosis for underlying diseases. He underwent total laryngectomy and both neck dissection, and pharyngocutaneous fistula occurred during postoperative radiotherapy. Pharyngocutaneous fistula during postoperative radiotherapy has not yet reported in the literature, and there are few reports about pre and postoperative management of dementia patient after head and neck cancer surgery. Therefore, we report this case with a brief review of literature.

A Case of Squamous Cell Carcinoma arising from an Odontogenic Keratocyst (우측 하악의 치성 각화성 낭종 수술 후 발견된 암으로 내원한 63세 환자 1예)

  • Jae Eun, Oh;Chan Yeong, Lee;Kyeong Min, Kim;Min Sung, Tak;Hyung Kwon, Byeon
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.2
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    • pp.37-41
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    • 2022
  • Odontogenic keratocyst (OKC) accounts for 3-11% of all odontogenic cysts. OKC is a benign intra-osseous odontogenic tumor, but what makes this cyst special is its aggressive behavior and high recurrence rate. OKC is relatively aggressive compared to other odontogenic cysts, but its malignant transformation is considered extremely rare. Squamous cell carcinoma associated with odontogenic keratocysts have rarely been reported in the medical literature. We recently experienced a case of a 63-year-old man finally confirmed with squamous cell carcinoma of the mandible, which was initially diagnosed as a benign odontogenic keratocyst. Surgical resection was performed as definitive treatment. Therefore, we present this unique case with a review of the literature.

The Change of Tumor Interstitial Fluid Pressure by Radiation Therapy in Patients with Metastatic Lymph Node in Head and Neck Area (방사선치료시 두경부 림파절 종양내 간질액 압력의 변화 양상)

  • Cho Moon-June;Kim Jae-Sung;Lee Intae;Kim Jun-Sang;Kim Ki-Hwan;Jang Ji-Young
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.127-132
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    • 2000
  • Purpose : To determine if the tumor intersitial fluid pressure (TIFP) and/or its change in patients with metastatic Iymph node in head and neck area can predict radiotherapy outcome. Materials and Methods : In 26 biopsy Proven metastatic Iymph node Patients in head and neck area with accessible by direct inspection and palpation, and of sufficient thickness (>1 cm) to permit accurate needle placement, we measured TIFP at cervical Iymph node before and during radiotherapy. Tumor size was measured clinically and radiologically. Results : The mean preradiotherapy TIFP was 24.7 mmHg. Preradiotherapy TIFP had marginally significant relationship with tumor size (p=0.06). Preradiotherapy TIFP significantly decreased when tumor size decreased (p=0.009). Preradiotherapy TIFP was not different between complete response group and group with partial or less response (p=0.75). Radiotherapy outcome was not different between group with above and group with below than average TIFP (p=0.229). TIFP decreased 36mmHg in complete response group and 29.7 mmHg in group with partial or less response. Conclusion :The mean TIFP was elevated with 24.7 mmHg. Preradiotherapy TIFP had marginally significant relationship with tumor size (p=0.06). TIFP decreased 36 mmHg in complete response group and 29.7 mmHg in group with partial or less respone but there was no statistically significant relationship in two groups.

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Prosthetic rehabilitation for patient with hemi-maxillectomy: Obturator combined with a hybrid telescopic double crown using friction pin (편측 절제된 상악골 환자에서 하이브리드 텔레스코픽 이중관 의치를 이용한 구강 폐색기 수복 증례)

  • Seo, Jeong-Gyo;Cho, Jin-Hyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.4
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    • pp.317-323
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    • 2018
  • When oral cancer develops in the maxilla, oro-nasal communication occurs after surgical treatment including removal of the primary site. Restoration through an obturator is necessary to prevent food from storing due to non-oral opening, and to ensure proper pronunciation and aesthetic restoration. In this case, the patient was treated with right hemi-maxillectomy due to oral cancer and has residual abutment and poor periodontal support due to the effect of head and neck radiotherapy. The obturator was treated with a hybrid telescopic double crown denture. Reporting a successful prognosis in 18 months of follow-up.