• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1683-1686
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• 2012

In the present case control study mRNA expression of the GSTP1 gene, encoding a phase II enzyme that detoxifies via glutathione conjugation, was investigated using semiquantitative PCR followed by SSCP for 49 confirmed head and neck (HN) cancer and 49 control samples. It was found that GSTP1 was upregulated in significantly higher number of cancers (OR 4.2, 95% CI 1.2-15.3). Grade wise correlation was also observed with more up regulation in patients with more advanced grades of HN carcinomas. We also found that 5 patients showed variation in mRNA with a larger product size than expected. Sequencing revealed insertion of an intronic segment between the $6^{th}$ and $7^{th}$ exon of the GSTP1 gene. Germline screening was performed showing mobility shifts which suggested mutation at the DNA level resulting in intronic portion retention. This study is of prime importance for drug design and treatment selection to overcome increased resistance of HN cancers to drugs due to alteration in the GSTP1 gene.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5645-5651
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• 2014

Whether cyclin D1 (CCND1) gene variants increase susceptibility to head and neck cancer (HNC) is undetermined. Therefore, we performed the present meta-analysis to systematically assess any possible association between CCND1 variants (G870A and G1722C) and HNC risk. Seventeen studies for CCND1 G870A and three studies for CCND1 G1722C were included. Overall, CCND1 polymorphisms (G870A and G1722C) had no association with increased HNC risk (p>0.05). In the subgroup analysis by smoking status, significantly increased HNC risk was found among smokers under allele contrast, homozygous comparison and recessive models (p<0.05), smoking carriers of A allele and AA genotype appearing at elevated risk. In conclusion, while there was overall a lack of any association between CCND1 polymorphisms (G870A and G1722C) and HNC risk, smokers carrying the A allele and AA genotype of the CCND1 G870A polymorphism may be susceptible to HNC development.

• Korean Journal of Head & Neck Oncology
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• v.38 no.1
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• pp.11-16
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• 2022

HHPV (Human Papillomavirus) is a DNA virus that can cause benign lesions, genitourinary cancer, and oropharyngeal cancer by penetrating the mucous membrane and skin. It is widely known to be transmitted mainly through sexual contact. As with many viral infections, vaccines have been developed to prevent infection with HPV. Currently, in many countries, HPV vaccines are mainly used for national immunization for women to prevent diseases that traditionally occur frequently in women, especially cervical cancer. However, since the vaccination rate is relatively low, many countries are struggling with ways to increase the vaccination rate. Meanwhile, the incidence of oropharyngeal cancer caused by HPV in men has been increasing recently. In the United States, the annual number of oropharyngeal cancers in men already exceeds the number of cervical cancers in women, so HPV infection in men has emerged as a major problem. Accordingly, interest in HPV vaccination in men has also increased, and studies on the effectiveness and necessity of vaccination of both women and men compared to women alone are being actively conducted. In this paper, the evidence of HPV vaccination for men will be reviewed through previous studies, and its validity and cost-effectiveness will be analyzed to bolster the clinical usefulness of HPV vaccination for men.

• Archives of Reconstructive Microsurgery
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• v.15 no.2
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• pp.92-100
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• 2006

Radial forearm free flap (RFFF) has been established itself as a versatile and widely used method for reconstruction of the head and neck, although it is still criticized for high mortality of donor site. Delayed wound healing, cosmetic deformity, vascular compromise and potentially reduced wrist function have many plastic surgeons hesitate to adapt it as a first choice in micro-reconstruction. To overcome these drawbacks, some techniques for donor-site repair such as V-Y advancement with full thickness skin graft (FTSG), application of artificial dermis ($Terudermis^{(R)}$) or acellular dermal matrix ($AlloDerm^{(R)}$), and double-opposing rhomboid transposition flap have been reported. Authors performed 4 cases of RFFF in old-aged patients of the head and neck cancer from April 2005 to February 2006. We compared the outcomes of donor site of RFFF which were resurfaced with split thickness skin graft (STSG) only and STSG overlying an $AlloDerm^{(R)}$. Patients were all males ranging from 59 to 74 years old (mean, 67.5). Three of them had tongue cancers, and the other showed hypopharyngeal cancer. All cases were pathologically confirmed as squamous cell carcinomas. We included the deep fascia into the flap, so called subfascially elevated RFFF in three cases, and in the other one, we dissected the RFFF suprafascially leaving the fascia intact. The donor site of the suprafascially elevated RFFF was resurfaced with STSG only. Among three of subfascially elevated RFFFs, donor-sites were covered with thin STSG only in one case, and STSG overlying $AlloDerm^{(R)}$ in two cases. All RFFFs were survived completely without any complication. The donor site of the suprafascially elevated RFFF was taken well with STSG only. But, the partial graft loss exposing brachioradialis and flexor carpi radialis muscle was unavoidable in all the subfascially elevated RFFFs irregardless of $AlloDerm^{(R)}$ application. Considering that many patients of the head and neck cancer are in old ages, we believe the RFFF is still a useful and versatile choice for resurfacing the head and neck region after cancer ablation. Its reliability and functional characteristics could override its criticism for donor site in old-aged cancer patients.

• Journal of the Korean Society of Radiology
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• v.82 no.5
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• pp.1246-1257
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• 2021

Purpose To assess the predictive factors and describe the imaging features of mediastinal lymph node (MLN) metastases in patients with head and neck cancer. Materials and Methods We compared the clinical features and disease characteristics (sex, age, site of primary tumor, histologic type, history of prior treatments, TNM stages, and metastasis in cervical LNs) of patients with head and neck cancers between the MLN metastasis and no MLN metastasis groups. We also evaluated the chest CT (distribution and maximum dimension of the largest LN) and PET/CT (maximum standardized uptake value) features of MLN metastases based on the MLN classification. Results Of the 470 patients with head and neck cancer, 55 (11.7%) had MLN metastasis, involving 150 mediastinal stations. Hypopharynx cancer, recurrent tumor, T4 stage, N2/N3 stages, and M1 stage were found to be significant predicting factors for MLN metastasis. The most common location of MLN metastasis was ipsilateral station 2 (upper paratracheal LNs, 36.4%), followed by ipsilateral station 11 (interlobar LNs, 27.3%) and ipsilateral station 10 (hilar LNs, 25.5%). Conclusion Metastasis to MLNs should be considered in patients with head and neck cancer, especially in cases that are associated with a hypopharyngeal cancer, recurrent tumor, and high TNM stages.

• Korean Journal of Head & Neck Oncology
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• v.28 no.1
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• pp.50-53
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• 2012

Advanced cancer of the oral cavity has been treated with wide excision in conjunction with mandibulectomy and neck dissection. This has resulted in significant mandibulofacial defects with functional and cosmetic significance. Therefore, proper mandibular reconstruction is very important for physiologic and esthetic restoration. The risk factors of free flap reconstruction have been reported including obesity, age, smoking, previous irradiation, and systemic vascular disease. We recently experienced a case of donor site necrosis after fibular osteocutaneous free flap in oral cavity cancer.

• Korean Journal of Head & Neck Oncology
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• v.11 no.2
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• pp.167-172
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• 1995

Pharyngocutaneous fistula(PCF) is one of the complications following total laryngectomy in laryngeal and hypopharyngeal cancer. Fistula lead to delayed wound healing, more serious complications such as carotid blow-out, prolonged hospitalization, significant patient morbidity and occasional mortality. Identification of patients at high risk for fistula formation, appropriate preventive measures, and appropriate management are the head and neck surgeon's responsibility. So we analyzed the clinical data of pharyngocutaneous fistula which was developed after total laryngectomy. Following results were obtained: 1) Occurrence of PCF increases with salvage surgery compared to curative surgery. 2) Early detection and effective management of PCF are the key factors to decreasing the hospitalization period. 3) Constructing a pharyngostoma seems to be an ideal method of preventing dangerous complications and ultimately closing the fistula. 4) Simultaneous reconstruction is necessary in the high risk group.

• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.169-174
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• 1998

Background: To avoid the major mobidity associated with bilateral radical neck dissection, modified radical neck dissection has become established as an effective adjunctive procedure in the management of head and neck cancer. But several studies reported early postoperative internal jugular vein(IJV) occlusion in patients who underwent modified radical neck dissection. Objectives: To determine internal jugular vein patency following modified radical neck dessection performed in various head and neck cancer and to identify factors associated with venous occlusion. Materials and Methods: From Aug. 1996 to Oct. 1997, twenty three patients underwent either unilateral or bilateral modified radical neck dissection; 19 males and 4 females, ranging in age from 28 to 75 were retrospectively examined. All patients had a preoperative doppler imaging or CT or both for their initial evaluation. A follow-up examination was obtained(after a minimum postoperative period of 2 months and a maximum one of 4 months). Results: Thirty-four IJVs were examined. All but six IJVs examined were found patent postoperatively. The preservation rate of patency of the IJV in modified radical neck dissection was found to be high(28 of 34 IJVs or 82%). Conclusion: The preservation rate of patency of the IJV in modified radical neck dissection was found to be high. These results favor the use of modified radical neck dissection for IJV preservation, particularly in bilateral neck dissection. A retrospective chart review revealed that trauma of the vessel and extrinsic compression of the vein by the musculocutaneous flap or recurrent carcinoma in the neck may be the cause of the vein occlusion.

• Korean Journal of Head & Neck Oncology
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• v.33 no.1
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• pp.21-29
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• 2017

Methylation of CpG islands in the promoter region of genes acts as a significant mechanism of epigenetic gene silencing in head and neck squamous cell carcinoma (HNSCC). DNA methylation markers are particularly advantageous because DNA methylation is an early event in tumorigenesis, and the epigenetic modification, 5-methylcytosine, is a stable mark. In the present study, we assessed the genome-wide preliminary screening and were to identify novel methylation biomarker candidate in HNSCC. Genome-wide methylation analysis was performed on 10 HNSCC tumors using the Methylated DNA Isolation Assay (MeDIA) CpG island microarray. Validation was done using immunohistochemistry using tissue microarray of 135 independent HNSCC tumors. In addition, in vitro proliferation, migration/invasion assays, RT-PCR and immunoblotting were performed to elucidate molecular regulating mechanisms. Our preliminary validation using CpG microarray data set, immunohisto-chemistry for HNSCC tumor tissues and in vitro functional assays revealed that methylation of the Homeobox B5 (HOXB5) and H6 Family Homeobox 2 (HMX2) could be possible novel methylation biomarkers in HNSCC.

• Korean Journal of Head & Neck Oncology
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• v.34 no.2
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• pp.23-28
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• 2018

Background/Objectives: Adenoid cystic carcinoma is the second most common salivary carcinoma. It occurs commonly in the submandibular gland, sublingual gland and minor salivary gland. Local recurrence and distant metastasis are the leading cause of death. The aim of this study was to evaluate long-term oncologic outcomes of patients with head and neck adenoid cystic carcinoma focusing on distant metastasis. Materials & Methods: We retrospectively studied 39 patients who were diagnosed with and treated for adenoid cystic carcinoma of the head and neck from December 1996 to May 2018. The clinicopathologic characteristics of patients such as age, sex, primary site and TNM stage, and treatment methods, recurrence and distant metastasis after treatment, survival rate, and treatment method for recurrence were analyzed. Results: Of 39 patients, 18 were males and 21 were females, and the mean age was $5.9{\pm}14.4$ (28-89) years. The most common primary site was oral cavity (12 cases), and followed by sino-nasal cavity (11 cases), parotid gland (5 cases), and etc. For treatment, 17 patients underwent surgery alone, 16 received surgery with postoperative radiation therapy, and 3 patients received radiation therapy only. Three patients refused any further treatments. Recurrence occurred in 15 patients. The most common site of recurrence was the lung. The mean time to recurrence was 31.7 months. The 5 and 10 years' overall survival rate was 79.3% and 74%, respectively. The 2 and 5 years' overall survival rate was 69.6% and 62.6% in patients with distant metastasis. Conclusion: Distant metastasis is an important prognostic factor in adenoid cystic carcinoma, and eventually one third of patients have distant metastasis, especially in the lung. An appropriate treatment for lung metastasis is necessary because some patients with pulmonary metastasis survive for a quite long time.