• Korean Journal of Head & Neck Oncology
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• v.37 no.2
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• pp.51-55
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• 2021

Background/Objectives: Extracapsular dissection has the advantage of reducing complications by minimizing tissue loss of the parotid without intentionally exposing the facial nerve in patients with benign parotid tumor. However, there has been controversy over the surgical results. Thus, the surgical outcomes of extracapsular dissection for benign parotid tumor was compared to those of superficial parotidectomy. Materials & Methods: A retrospective chart review was conducted with 132 patients who received surgery for benign parotid tumor in our center from January 2014 to December 2018 retrospectively. Results: A total of 132 people were enrolled, with 62 people receiving extracapsular dissection, 38 people receiving partial superficial parotidectomy and 32 people receiving superficial parotidectomy. No significant difference was found between the three groups regarding complications such as facial nerve palsy, Frey's syndrome, or first bite syndrome. Operation time and hospital stay was significantly short in extracapsular dissection group. Conclusion: For well-selected cases, extracapsular dissection can be considered as an option for surgery of benign parotid tumor.

• Korean Journal of Head & Neck Oncology
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• v.7 no.1
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• pp.10-16
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• 1991

Elective neck dissection (END), provide proper information on nodal status and stage which are significant prognosticator in head and neck cancers with clinically $N_{(0)}$ neck. But there are many controversies for the extents, methods of surgery, moreover, whether normal lymph nodes, local defencer, have to be removed or not. The authors performed 47 END in 39 patients of head and neck squamous cell carcinoma from 1984 to 1989 and a retrospective study of the cases was conducted. Eighteen percent of nodal metastasis and five percent of extracapsular spread were found in END specimens. We concluded that END provide significant information for the management and evaluation of prognosis in head and neck cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7049-7054
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• 2014

Background: Almost half of the breast cancer patients with positive sentinel lymph nodes have no additional disease in the remaining axillary lymph nodes. This group of patients do not benefit from complete axillary lymph node dissection. This study was designed to assess the clinicopathologic factors that predict non-sentinel lymph node metastasis in Iranian breast cancer patients with positive sentinel lymph nodes. Materials and Methods: The records of patients who underwent sentinel lymph node biopsy, between 2003 and 2012, were reviewed. Patients with at least one positive sentinel lymph node who underwent completion axillary lymph node dissection were enrolled in the present study. Demographic and clinicopathologic characteristics including age, primary tumor size, histological and nuclear grade, lymphovascular invasion, perineural invasion, extracapsular invasion, and number of harvested lymph nodes, were evaluated. Results: The data of 167 patients were analyzed. A total of 92 (55.1%) had non-sentinel lymph node metastasis. Univariate analysis of data revealed that age, primary tumor size, histological grade, lymphovascular invasion, perineural invasion, extracapsular invasion, and the number of positive sentinel lymph nodes to the total number of harvested sentinel lymph nodes ratio, were associated with non-sentinel lymph node metastasis. After logistic regression analysis, age (OR=0.13; 95% CI, 0.02-0.8), primary tumor size (OR=7.7; 95% CI, 1.4-42.2), lymphovascular invasion (OR=19.4; 95% CI, 1.4-268.6), extracapsular invasion (OR=13.3; 95% CI, 2.3-76), and the number of positive sentinel lymph nodes to the total number of harvested sentinel lymph nodes ratio (OR=20.2; 95% CI, 3.4-121.9), were significantly associated with non-sentinel lymph node metastasis. Conclusions: According to this study, age, primary tumor size, lymphovascular invasion, extracapsular invasion, and the ratio of positive sentinel lymph nodes to the total number of harvested sentinel lymph nodes, were found to be independent predictors of non-sentinel lymph node metastasis.

• Korean Journal of Head & Neck Oncology
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• v.27 no.1
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• pp.54-58
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• 2011

Objectives : There are many reports on attempts to minimize complications and recurrences of tumor by several techniques for benign parotid tumor resection. The purpose of our study is to find out meaning of procedure without identifying main trunk of facial nerve compared to conventional parotidectomy. Material and Methods : We classified 121 patients into two groups. Patients who were underwent superficial parotidectomy or partial superficial parotidectomy were included in idenitification group(IF group), and patients who were treated with conservative partial parotidectomy or extracapsular dissection without identification of main trunk of facial nerve were included in the non-identification group(NF group). We analyzed the location of tumor, operation time, mean drainage duration, complication, recurrence and cosmetic satisfaction in two groups. Results : NF group has shorter operation time and mean drainage duration than IF group, however there is no significant difference in complication and recurrence between two surgical techniques. The Cosmetic satisfaction was similar between two groups. Conclusion : Limited parotidectomy without finding main trunk of facial nerve may be reliable option for benign parotid tumors because it has advantages such as less operation time and mean drainage duration without increasing in recurrence or complication rate.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4273-4278
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• 2013

Objective: We aimed to define clinicopathologic risk factors associated with regional recurrence (RR) and thus the effectiveness of postoperative radiotherapy (PORT) for neck control for head and neck squamous cell carcinomas (HNSCCs) with differing cervical lymph node status. Methods: A retrospective study was performed in 196 HNSCC patients with pathologically positive neck node (N+) to evaluate the high-risk factors for RR and to define the role of PORT in control after neck dissection and postoperative radiotherapy (PORT). Results: Overall, the RR rate after neck dissection and PORT was 29%. Extracapsular spread (ECS) was confirmed to be the only independent risk factor for RR. There were no significant risk factors associated with RR in the ECS- group. The 5-year disease-specific survival rate was 45%, which descended to 10% with the emergence of RR. Conclusions: ECS remains a determined risk factor for RR after neck dissection and PORT in patients with N+. PORT alone is not adequate for preventing RR in the neck with ECS after neck dissection. More intensive postoperative adjuvant therapies, especially combined chemotherapy and radiotherapy, are needed to prevent regional failure in HNSCC patients with ECS.

• Archives of Craniofacial Surgery
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• v.18 no.2
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• pp.105-111
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• 2017

Background: The author analyse the impact of extracapsular lymph node spread and bone engagement in the ipsilateral neck of patients suffering squamous cell carcinoma (SCC) of the lower lip. Methods: The data of 56 neck dissections performed in patients suffering SCC of the lower lip between January 2000 and December 2008 were retrospectively analysed. Statistical analysis was performed with the Kaplan-Meier life table method, and the survival rate was investigated with the log rank statistic and significance test. The values were considered statistically significant at p<0.05. Results: Nine patients took advantage from simultaneous treatment of tumor and prophylactic neck dissection (level I-III), reaching 100% survival rate. Patients suffering metastasized disease, who received radical neck dissection at the time of tumor treatment, presented 83.3% survival rate. Patients who underwent previous surgery and radiotherapy presented worse prognosis although radical neck dissection in case of extra-capsular spread only (24.7%) and osseous engagement (22.2%). Conclusion: Prophylactic neck dissection (level I-III) is recommended in T3-T4 N0 SCC. Simultaneous treatment of tumor and cervical lymph nodes provides a better prognosis as respect to delayed nodal management. Extra-capsular spread with or without bone engagement represents independent risk factor responsible for high mortality rate of SCC of the lower lip.

• Korean Journal of Head & Neck Oncology
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• v.36 no.1
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• pp.45-47
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• 2020

Tuberculosis of parotid gland is extremely rare, even in countries where tuberculosis is endemic. It can occur by systemic dissemination from a distant focus or as primary involvement. Because of the clinical and radiological similarity, parotid tumor and parotid inflammatory disease take priority over the tuberculosis of parotid when it comes to differential diagnosis. As a result, clinicians often fail to make a timely diagnosis of tuberculosis of parotid gland in patient with a slowly growing parotid mass. However, its treatment is primarily medical if the positive diagnosis is well established. We have recently experienced a case of tuberculosis of parotid gland that was considered as the benign tumor preoperatively, but which was confirmed as tuberculosis of parotid gland after extracapsular dissection. We report it with a review of literature.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3361-3363
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• 2015

Background: Despite the majority of papillary thyroid microcarcinoma (PTMC) patients having an excellent prognosis, cervical lymph node metastases are common. The purpose of this study was to investigate the incidence and the predictive risk factors for occult central compartment lymph node metastasis (CLNM) in PTMC patients. Materials and Methods: 178 patients with clinically node-negative (cN0) PTMC undergoing prophylactic central compartment neck dissection in our hospital from January 2008 to Jun 2010 were enrolled. The relationship between CLNM and the clinical and pathological factors such as gender, age, tumor size, tumor number, tumor location, extracapsular spread (ECS), and coexistance of chronic lymphocytic thyroiditis was analyzed. Results: Occult CLNM was observed in 41% (73/178) of PTMC patients. Multivariate analysis showed that male gender, tumor size (${\geq}6mm$) and ECS were independent variables predictive of CLNM in PTMC patients. Conclusions: Male gender, tumor size (${\geq}6mm$) and ECS were risk factors of CLNM. We recommend a prophylactic central lymph node dissection (CLND) should be considered in PTMC patients with such risk factors.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6181-6185
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• 2012

Background: The aim of the study was to evaluate the available breast nomograms (MSKCC, Stanford, Tenon) to predict non-sentinel lymph node metastasis (NSLNM) and to determine variables for NSLNM in SLN positive breast cancer patients in our population. Materials and Methods: We retrospectively reviewed 170 patients who underwent completion axillary lymph node dissection between Jul 2008 and Aug 2010 in our hospital. We validated three nomograms (MSKCC, Stanford, Tenon). The likelihood of having positive NSLNM based on various factors was evaluated by use of univariate analysis. Stepwise multivariate analysis was applied to estimate a predictive model for NSLNM. Four factors were found to contribute significantly to the logistic regression model, allowing design of a new formula to predict non-sentinel lymph node metastasis. The AUCs of the ROCs were used to describe the performance of the diagnostic value of MSKCC, Stanford, Tenon nomograms and our new nomogram. Results: After stepwise multiple logistic regression analysis, multifocality, proportion of positive SLN to total SLN, LVI, SLN extracapsular extention were found to be statistically significant. AUC results were MSKCC: 0.713/Tenon: 0.671/Stanford: 0.534/DEU: 0.814. Conclusions: The MSKCC nomogram proved to be a good discriminator of NSLN metastasis in SLN positive BC patients for our population. Stanford and Tenon nomograms were not as predictive of NSLN metastasis. Our newly created formula was the best prediction tool for discriminate of NSLN metastasis in SLN positive BC patients for our population. We recommend that nomograms be validated before use in specific populations, and more than one validated nomogram may be used together while consulting patients.

• Korean Journal of Head & Neck Oncology
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• v.9 no.1
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• pp.33-41
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• 1993

A multivariate analysis of the prognostic factors and five year survival rate was carried out on a series of 72 thyroid cancers treated surgically from 1980 to 1987 and followed for 1 to 11 years. The prognosis of the disease was significantly influenced by age at diagnosis, extracapsular invasion, angioinvasion and pathologic type, but the disease was not influenced by sex, lymph node metastasis, and 'risk' category. The overall five year survival rate was 89.7%. Six patients were dead of tumor after surviving for six months to two and half years, and the cause of death was local recurrence in three, lung metastasis in two and bone metastasis in one patient. Five year survival rate in age above fifty, presence of capsule and angioinvasion, follicular carcinoma, and extrathyroidal lesion was significantly shorter than that of patients with age below fifty, absence of capsule and angioinvasion, papillary carcinoma, and intrathyroidal lesion. Patients at low risk or with small carcinomas had long survival over 5 years with only lobectomy. Lymph node dissection was done with a limited type in no jugular metastasis, radical neck disscetion was performed only therapeutically in proved jugular node metastasis. Thyroid hormone was administered for the period of 3 to 5 years to suppress endogenous TSH production.