• Title/Summary/Keyword: Cervical lymph node

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Prognostic Value of HPV18 DNA Viral Load in Patients with Early-Stage Neuroendocrine Carcinoma of the Uterine Cervix

  • Siriaunkgul, Sumalee;Utaipat, Utaiwan;Suwiwat, Supaporn;Settakorn, Jongkolnee;Sukpan, Kornkanok;Srisomboon, Jatupol;Khunamornpong, Surapan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3281-3285
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    • 2012
  • Objectives: To evaluate the clinicopathologic correlation and prognostic value of HPV18 DNA viral load in patients with early-stage cervical neuroendocrine carcinoma (NECA). Methods: Formalin-fixed, paraffin-embedded tissue of cervical NECA patients with known HPV18 infection and clinicopathologic data including follow-up results were collected. The HPV18 DNA load was assessed with quantitative PCR targeting the HPV18 E6E7 region. Results: Twenty-one patients with early-stage (IB-IIA) cervical NECA were identified. HPV18 DNA viral load ranged from 0.83 to 55,174 copies/cell (median 5.90). Disease progression, observed in 10 cases (48%), was not significantly associated with any clinicopathologic variables. However, the group of patients with progressive disease tended to have a higher rate of pelvic lymph node metastasis (50% versus 9%, p=0.063) and a lower median value of HPV18 DNA viral load (4.37 versus 8.17 copies/cell, p=0.198) compared to the non-recurrent group. When stratified by a cut-off viral load value of 5.00 copies/cell, the group of patients with viral load ${\leq}5.00$ copies/cell had a significantly shorter disease-free survival than the group with viral load >5.00 copies/cell (p=0.028). The group with a lower viral load also tended to have a higher rate of disease progression (75% versus 31%, p=0.080). No significant difference in the other clinicopathologic variables between the lower and higher viral load groups was identified. Conclusion: HPV18 DNA viral load may have a prognostic value in patients with early-stage NECA of the cervix. A low viral load may be predictive of shortened disease-free survival in these patients.

Results of Postoperative Irradiation in Patients with Carcinoma of Uterine Cervix Stage IB and IIA (자궁경부암 IB와 IIA 환자의 수술후 방사선치료 결과)

  • Ahn Sung Ja;Nam Taek Keun;Chung Woong Ki;Nah Byung Sik;Choi Ho Sun;Byun Ji Soo
    • Radiation Oncology Journal
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    • v.13 no.1
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    • pp.41-48
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    • 1995
  • Purpose : The adjuvant postoperative radiotherapy has been usually applied to the patients with unfavorable prognostic factors after radical operation in early cervical cancer. We focused on the evaluation of the survival status and failure patterns of the patients with postoperative radiotherapy. Materials and Methods : We retrospectively analyzed ninety patients with FIGO stage IB and IIA cervix cancer who received postoperative pelvic irradiation at Chonnam University Hospital between August 1985 and December 1988, Seventy-eight patients had adequate follow-up information for survival analysis. Median follow-up time of these patients was 64 months. Results : The 5 year overall and disease free survival rate of ninety patients was $80.0\%$ and $80.2\%$, respectively. The prognostic significance to the survival was determined by multivariate analysis. Adequacy of resection margin(p=0.005) and lymph node status(p=0.005) appeared to be independent prognostic factors. Recurrence occurred in 13 patients, 5 in the pelvis and 8 at distant sites. The median time to recurrence was 19 months(range:3-39 months). The pelvic recurrence was more prevalent in the group of patients with adenocarcinoma, depth of stromal invasion more than 10mm and use of chemotherapy. The distant failure was more prevalent in the group of positive resection margin or positive lymph node with statistical significance. Conclusion : Patients with pelvic lymph node or surgical margin involvement clearly constitute a high risk group in this analysis and should be considered as candidates for some form of adjuvant therapy.

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Tumor Interstitial Fluid Pressure in Patients with Head and Neck Cancer (두경부 악성 종양 조직내 간질액 압력)

  • Cho Moon-June;Kim Jae-Sung;Lee In-Tae;Kim Jun-Sang;Jang Ji-Young;Kim Ki-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.9-13
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    • 2000
  • Objectives: To determine the tumor interstitial fluid pressure(TIFP) in patients with head and neck cancerand predict radiotherapy outcome.Materials and Methods: In 12 biopsy proven primary head and neck cancer patients with accessible by direct inspection and palpation, and of sufficient thickness(>1cm) to permit accurate needle placement, we measured TIFP at cervical lymph node before and during radiotherapy using a modified wick-in-needle technique. Tumor size was measured clinically and radiologically. Results: The mean preradiotherapy TIFP was 23.4mmHg. Preradiotherapy TIFP had significant relationship with tumor size(p=0.0009). Preradiotherapy TIFP was not different between complete response group and partial or less response group(p=0.114). Radiotherapy outcome was not different between group with above and group with below average TIFP(p=0.09). Conclusion: The mean TIFP was elevated with 23.4mmHg before radiation therapy. Preradiotherapy TIFP had significant relationship with tumor size. It is not definitive that TIFP could be prognostic indicator of radiation response.

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A CLINICOPATHOLOGIC STUDY ON MUCOEPIDERMOID CARCINOMA OF SALIVARY GLANDS (타액선의 점액유상피암에 관한 임상병리학적 연구)

  • Kim, Jong-Ryoul;Chung, In-Kyo;Sung, Iel-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.2
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    • pp.174-179
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    • 2001
  • The authors analyzed retrospectively the 19 patients with mucoepidermoid carcinoma of salivary glands who were treated at Department of Oral and Maxillofacial Surgery, Pusan National University Hospital from June, 1986 to September, 1998. The results obtained were as follows: 1. There were 4 males(21%) and 15 females(79%). Age distribution was wide and the mean age was 45.2. 2. Of all mucoepidermoid carcinomas of salivary gonads, 4 cases arose in the major salivary glands and 15 cases in the minor salivary glands. The incidence according to the anatomic primary site for minor salivary glands was 8 cases in the palate, 2 cases each arising in the tongue and floor of mouth and 1 case each arising in the mandible, buccal mucosa and the lower lip. 3. In histopathological classification of mucoepidermoid carcinoma, 5 cases were low grade. 9 cases, intermediate grade and 5 cases, high grade. 4. Perineural invasion was observed 40%(2/5) in high grade and 22%(2/9) in the intermediate grade of mucoepidermoid carcinoma. 5. The incidence of cervical lymph node metastasis according to histopathologic grade was 40% (2/5) in high grade and 11%(1/9) in intermediate grade of mucoepidermoid carcinoma. 6. The lung was the commonest site for metastasis comprising 3 cases among 3 cases of distant spread of which 2 cases in high grade and 1 case in intermediate grade of mucoepidermoid carcinoma.

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Radiation Therapy of Squamous Cell Carcinoma of the Maxillary Sinus (상악동 편평상피암의 방사선치료)

  • Chung Eun-Ji;Kim Gwi-Eon;Lee Chang-Geol;Kim Woo-Cheol
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.2
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    • pp.145-152
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    • 1995
  • A retrospective analysis was performed to ascertain the relationship between the treatment modalities and their treatment results. From July 1980 to June 1993, 115 patients with squamous cell carcinoma of the maxillary sinus were: treated at the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University. There were 88 men and 27 women with median age of 57 years. According to AJCC TNM system of 1992. eight patients of T2, 54 patients of T3 and 53 patients of T4 were available, respectively. Cervical lymph node metastases at diagnosis was observed in 11 patients. 87 patients were treated with radiotherapy and 28 patients were treated with combination of surgery and radiotherapy. The overall 5 year survival rate was 32 %, patients that were treated with radiotherapy alone had a 5 year survival rate 24.3 % and patients who were treated with combination of surgery and radiation therapy had a 5 year survival rate of 52.8 % (p<0.05). Combination of surgery and radiotherapy resulted in a better treatment modality for squamous cell carcinoma of the maxillary sinus. Improved radiotherapy technique and development of multimodality treatment are needed to improve the local control and the survival rate in patients with advanced maxillary sinus carcinoma.

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Anticancer and Related Immunomodulatory and Anticachexic Effects of Insamyangyoung-tang Extracts on Non Small Cell Lung Carcinoma, NCI-H520, Xenograft Mice (인삼양영탕(人蔘養榮湯)이 비소세포 폐암세포 이식 마우스에서 항암, 면역활성 및 악액질 억제에 미치는 영향)

  • Song, Kwang Kyu;Park, Mee Yeon;Choi, Hae Yun;Kim, Jong Dae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.1
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    • pp.63-77
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    • 2013
  • The object of this study was to observe anticancer and related immunomodulatory and anticachexic effects of Insamyangyoung-tang aqueous extracts (ISYYTe) on non-small cell lung carcinoma (squamous epithelial carcinoma), NCI-H520, xenograft Balb/c nu-nu nude mice. Changes on the tumor volume and weights, lymphatic organ(spleen and popliteal lymph node), serum interferon (IFN)-${\gamma}$ levels, splenocytes and peritoneal macrophage activities (NK cell activity), splenic tumor necrosis factor (TNF)-${\alpha}$, interleukin (IL)-$1{\beta}$ and IL-10 contents, splenic T-lymphocyte subsets (CD3+, CD4+ and CD8+) and TNF-${\alpha}+$ cells were observed with tumor mass and lymphatic organ histopathology to detect anticancer and immunomodulatory effects. In addition, changes on the body weights, epididymal fat weights and serum IL-6 levels were also detected with the thicknesses of deposited cervical brown adipose tissue and their mean diameters to monitor the tumor-related anticachexic effects. The results obtained in this study suggest that over 50 mg/kg of ISYYTe showed favorable anticancer effects on the NCI-H520 cell xenograft with immunomodulatory and anticachexic effects. However, detail mechanism studies should be conducted in future with the screening of the biological active compounds in this herb.

Formidable Angiosarcoma of the Scalp (두피에 발생한 혈관 육종)

  • Cha, Jeong-Ho;Oh, Suk-Joon;Moon, Min-Cheol;Koh, Sung-Hoon
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.583-588
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    • 2010
  • Purpose: Angiosarcoma is a tumor of mesenchymal origin with an extremely high rate of metastasis and invasiveness. This tumor is notorious for its very poor prognosis, although surgical excision followed by radiation therapy is considered to be effective by many. The authors experienced three angiosarcoma patients with their tumors removed and wounds covered with split-thickness skin grafts and/or latissimus dorsi free flaps. Methods: Three patients were admitted to our hospital showed plaques of different morphology. Based on their medical records, these patients were classified by sex, age, type of reconstruction, recurrence, and further treatment after surgical removal. Results: All patients were male, with a mean age of 72 years (range, 66 to 77 years). Split-thickness skin grafts with latissimus dorsi free flaps were performed on two cases, and of these two cases, cervical lymph node biopsy was done in one case, and radical neck dissection was done in the other. In all cases, radiation therapy was done within two weeks of tumor removal. Distant metastasis occurred without local recurrence in two of the cases. Lung was the first organ affected by metastasis. In the remaining case, the tumor recurred locally 6 times, and additional excision was necessary. All patients died due to local recurrence and lung metastasis. Conclusion: Irregular margins and high recurrence and metastasis rates cause a poor prognosis in large angiosarcoma of the scalp. Radiotherapy and chemotherapy should be strongly considered in large angiosarcomas.

New formulated "DOX-MTX-loaded Nanoparticles" Down-regulate HER2 Gene Expression and Improve the Clinical Outcome in OSCCs Model in Rat: the Effect of IV and Oral Modalities

  • Abbasi, Mehran Mesgari;Monfaredan, Amir;Hamishehkar, Hamed;Jahanban-Esfahlan, Rana
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9355-9360
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    • 2014
  • Background: Oral squamous cell carcinoma (OSCC) remains as one of the most difficult malignancies to control because of its high propensity for local invasion and cervical lymph node dissemination. In this study, we evaluate the efficacy of our novel pH and temperature sensitive doxorubicin-methotrexate-loaded nanoparticles (DOX-MTX NP) in affecting HER2 expression profile in OSCC model in rat. Results: DOX-MTX- nanoparticle complexes caused significant decrease in mRNA level of HER2 compared to untreated cancers (p<0.05) and this finding was more pronounced with the IV mode (p<0.000). Surprisingly, HER2 mRNA was not affected in DOX treated as compared to the control group (p>0.05). On the other hand, in the DOX-MTX NP treated group, fewer tumors characterized with advanced stage and decreased HER2 paralleled improved clinical outcome (P<0.05). Moreover, the effectiveness of the oral route in the group treated with nanodrug accounted for the enhanced bioavailability of nanoparticulated DOX-MTX compared to free DOX. Furthermore, there was no significant difference in mRNA level of HER2 (p>0.05). Conclusions: Influence of HER2 gene expression is a new feature and mechanism of action observed only in dual action DOX-MTX-NPs treated groups. Down-regulation of HER2 mRNA as a promising marker and prognosticator of OSCC adds to the cytotoxic benefits of DOX in its new formulation. Both oral and IV application of this nanodrug could be used, with no preferences in term of their safety or toxicity. As HER2 is expressed abundantly by a wide spectrum of tumors, i DOX-MTX NPs may be useful for a wide-spectrum of lesions. However, molecular mechanisms underlying HER2 down regulation induced by DOX-MTX NPs remain to be addressed.

A Clinical Analysis of Second Primary Malignancy in Head and Neck Cancer Patients (두경부 이차암의 임상적 고찰)

  • Chung Keun;Kim Jeong-Bae;Min Hun-Ki;Kim Young-Min;Rho Young-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.1
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    • pp.35-39
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    • 1998
  • Objectives: Minimal improvement in the long-term survival of head and neck cancer(HNC) patients has occurred despite a multitude of advances in the control of loco regional disease and a second primary malignancy(SPM) contribute to the continued poor prognosis for the HNC patients. This study was performed in order to identify the clinical characteristics of SPM in the HNC patients. Materials and Methods: The medical records of 354 patients of head and neck squamous cell carcinoma that were followed up after initial treatment during the period of 1987 through 1994 were reviewed. This study examines the medical records of 354 patients with squamous cell carcinoma of the head and neck, of whom 26 subsequently developed a second neoplasm. Results: The actuarial SPM rate was 7.3%, and median time to presentation for the SPM was 26.8 months. The SPM were more likely to occur in male patients who had oral cavity index tumors. Patient whose index tumor was small at diagnosis had a greater chance of developing a second tumor as did those with no cervical lymph node metastases to the neck. Initial treatment modality was not associated with an increased risk of developing a second tumor. The commonest sites for the SPM were the lung and other head and neck area. The 3-year survival for patients who developed a secondary tumor from the time of its diagnosis was 27.8%. Conclusion: The SPM in the head and neck cancer patients are not uncommon and early detection of the SPM will contribute to increase the long-term survival of HNC patients.

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Clinical Analysis of Completion Thyroidectomy (완료적 갑상선 전 절제술의 임상분석)

  • Lee Sang-Su;Kim Jung-Gyu
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.1
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    • pp.94-98
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    • 1998
  • Background: Completion thyroidectomy can most accurately be described as reexploration of the neck to remove the contralateral thyroid lobe. This procedure has commonly been performed when the histopatholoic condition of the ipsilateral thyroid lobe reveals papillary or follicular carcinoma of the thyroid. Because of a definitely increased risk of complications with completion thyroidectomy, avoiding its routine use is important. But this operation is safe procedure with minimal morbidity by coinsidering interval, surgical approach, surgeon's experience. The purpose of this review is to define the indication, and the safety of completion thyroidectomy. Materials & Methods: Recent 2 years(1995. 1 to 1996. 12), we have performed 161 thyroid operations. Fourteen of these patients were treated by completion thyroidectomy. The patients ranged in age from 21 to 66 years. We have routinely used ultrasound guided needle biopsy and intraoperative frozen section. Result: The completion thyroidectomized specimen contained papillary carcinoma in 12 (86%), follicular carcinoma in 1(7%) and follicular adenoma(no residual tumor) in 1(7%). The complication of completion thyroicetomy was absent, although case number was a few. The indication of completion thyroidectomy in our study was defined recurrence in 9 and staging in 5. The site of recurrence consists of residual thyroid in 7 and residual thyroid added cervical lymph node in 2. The staging consists of incomplete thyroidectomy 3, questionable frozen biopsy 1, and huge follicular carcinoma. Conclusion: The incidence of completion thyroidectomy appear to be increasing by application of ultrasonogram in follow-up of thyroidectomized patients, especially, for the improving of well differentiated thyroid carcinoma. Experience suggests that the morbidity of completion thyroidectomy is low, so we recommend completion thyroidectomy as an efficient and safe method of surgical treatment.

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