• 대한두경부종양학회지
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• 제9권1호
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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.

• Nuclear Medicine and Molecular Imaging
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• 제40권3호
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• pp.141-147
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• 2006

PET detects only less than 50% of early gastric cancer and 62-98% of advanced gastric cancer. Therefore, mass screening programs are recommended for all adults over the age of 40 for early detection and early treatment of gastric cancer through endoscopy or various radiological tests. The most important step after being diagnosed with gastric cancer is accurate staging, which mainly evaluates tumor resectability to avoid unnecessary surgery. Important factors that affect tumor resectability are whether the tumor can be separated from adjacent organs or important blood vessels, the extent of lymph node metastasis, presence of peritoneal metastasis, or distant organ metastasis. To evaluate the extent of local tumor invasion, anatomical imaging that has superior spatial resolution is essential. There are a few studies on prognostic significance of FDG uptake with inconsistent results between them. In spite of lower sensitivities for lymph node staging, the specificities of CT and PET are very high, and the specificity for PET tends to be higher than that for CT. Limited data published so far show that PET seems less useful in the detection of lung and bone metastasis. In the evaluation of pleural or peritoneal metastasis, PET seems very specific but insensitive as well. When FDG uptake of the primary tumor is low, the distant metastasis is also known to show low FDG uptake reducing its detection. There are only a few data available in the evaluation of recurrence detection and treatment response using FDG PET.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권6호
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• pp.529-539
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• 2008

Background and Purpose : Oral squamous cell carcinoma (OSCC) is one of the most aggressive tumors of the head and neck area. OSCC is known to preferentially metastasize via lymphatic system, and resulting cervical lymph node metastasis is the most reliable of treatment failure. But the biological mechanism of the regional nodal metastasis is not clear. So, we determined metastasis-related factors in orthotopic nude mouse models of OSCC. Experimental Design : Two cell lines-KB and YD-10B cells, established from human oral mucosal squamous cell carcinoma, were xenografted into the tissue space of athymic murine mouth floor. The mice were followed for tumor development and growth, the murine tumors were examined histopathologically for local invasion or regional or distant metastasis. Finally, we performed immunohistochemical assays with antiepithelial growth factor (EGF), EGF receptor (EGFR), phosphorylated EGFR (pEGFR), and anti-vascular endothelial growth factor (VEGF), VEGF receptor (VEGFR)-2, phosphorylated VEGFR-2/3 (pVEGFR-2/3) antibodies. We also determined the microvessel density. Results : Transplantation of human OSCC tumor cells into the mouth floor successfully resulted in the formation of orthotopic tumors. KB cell line showed significantly higher tumor proliferation and higher nodal metastatic potential than YD-10B cell line. Furthermore, immunohistochemical staining demonstrated higher expression of EGFR/pEGFR, VEGF, and pVEGFR-2/3 as well as higher microvessel density in KB murine tumors than in YD-10B murine tumors. Conclusion : An orthotopic model of OSCC in athymic mice was established which copies the cervical lymph nodal metastasis of human OSCC. Our mouth floor model should facillitate the understanding of the molecular pathogenesis of cervical nodal metastasis of OSCC.

• 대한두경부종양학회지
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• 제20권1호
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• pp.13-18
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• 2004

Objectives: Cancer lethality is usually the result of local invasion and metastasis of neoplastic cell from the primary tumor. Because of their ability to degrade extracellular matrix components, matrix metalloproteinases (MMPs) and basic fibroblast growth factor (bFGF) have been implicated in the breakdown of basement membrane and underlying stroma, thereby facilitating tumor growth and invasion. It has been well established that MMPs and bFGF expression correlate with cervical lymph node metastasis, but studies on expression in the metastatic cervical lymph node itself are not enough. We have analyzed matrix metalloproteinases (MMPs) and basic fibroblast growth factor (bFGF) in squamous cell carcinoma of the head and neck and metastatic cervical lymph node, and evaluated their relationship and clinicophathologic significance. Material and Methods: 20 cases of squamous cell carcinoma of the head and neck were entered on the study of immunohistochemical stains for MMP-9 and bFGF in the obtained tissue from primary tumor and metastatic cervical lymph node. We analyzed the relationship between MMP-9, bFGF expression of the primary tumor and metastatic node with age, sex, T-stage, N-stage, histologic grade, pathologic stage and disease free survival. Results: Expression of MMP-9 and bFGF in cancer cell and metastatic lymph node was higher than that in normal cell and lymph node. According to histologic differentiation, expression of MMP-9 of the metastatic cervical lymph node was higher than primary tumor. Considering to other clinicopathologic factor, no statistical significance was seen in MMP-9 and bFGF. Conclusion: We found that expression of MMP-9 is higher in the metastatic lymph node than primary tumor in the poorly differentiated squamous cell carcinoma. But we don't find out the statistical significance in relation between bFGF and clinical factors. So we guess that some different mechanism of MMP-9 and bFGF in Head & Neck squamous cell carcinoma exist. Further studies will be necessary to establish their pathogenesis in the Head and Neck cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제13권11호
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• pp.5385-5389
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• 2012

Introduction: Sentinel lymph node biopsy (SLNB) is a precise procedure for lymphatic staging in early breast cancer. In a valid SLNB procedure, axillary lymph node dissection (ALND) can be omitted in nodenegative cases without compromising patient safety. In this study, detection rate, accuracy and false negative rate of SLNB for breast cancer was evaluated in a setting with simple modified conventional pathology facilities without any serial sectioning or immunohistochemistry. Material and Medthod: Patients with confirmed breast cancer were enrolled in the study. SLNB and ALND were performed in all cases. Lymph node metastasis was evaluated in SLN and in nodes removed by ALND to determine the false negative rate. Pathologic assessment was carried out only by modified conventional technique with only 3 sections. Detection rate was determined either by lymphoscintigraphy or during surgery. Results: 78 patients with 79 breast units were evaluated. SLN was detected in 75 of 79 cases (95%) in lymphoscintigraphy and 76 of 79 cases (96%) during surgery. SLN metastases was detected in 30 of 75 (40%) cases either in SLNB and ALND groups. Accuracy of SLNB method for detecting LN metastases was 92%. False negative rate was 3 of 30 of positive cases: 10%. In 7 of 10 cases with axillary lymphadenopathy, LN metastastates was detected. Conclusion: SLNB is recommended for patients with various tumor sizes without palpable lymph nodes. In modified conventional pathologic examination of SLNs, at least macrometastases and some micrometastases could be detected similar to ALND. Consequently, ALND could be omitted in node-negative cases with removal of all palpable LNs. We conclude that SLNB, as one of the most important developments in breast cancer surgery, could be expanded even in areas without sophisticated pathology facilities.

• 대한두경부종양학회지
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• 제13권2호
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• pp.187-199
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• 1997

Thyroid carcinoma ranks low in incidence and as a cause of death when compared to carcinomas arising in the other site. With adequate surgical treatment, the prognosis of operable thyroid carcinoma is good. However, the extent of surgical resection in treatment of thyroid cancer remains still controversy. The aim of this study was to assess the results of thyroid cancer patients treated surgically and to analyze the prognostic factors affecting survival and to improve the survival rate. We retrospectively analyzed the outcome of a total of 278 thyroid cancer patients treated surgically at Inje University Paik Hospital from 1980 to 1995 and followed for 1 to 16 years. There were man in 47 and woman in 231 patients with age range of 14 to 79 years(mean 42 years). Histopathologic findings were papillary carcinoma in 233, follicular carcinoma in 33, mixed carcinoma in 7, medullary carcinoma in 2, and undifferentiated carcinoma in 3 patients, respectively. Operative procedures were unilateral lobectomy in 111, subtotal thyroidectomy in 100, and total thyroidectomy in 67 patients. Central node dissection was performed in 92, modified neck disseciton in 62, radical neck dissection in 28, and no node dissection in 96 patients. Thyroid hormone was administered for the period of 3 to 5 years to suppress endogenous TSH production. Overall 5-year survival rate according to Kaplan-Meier method was 91.1%. Independently, significant factors affecting the prognosis were age at diagnosis, tumor size, pathologic type, tumor stage, lymph node metastasis, angioinvasion, extrathyroidal extension, and 'risk' group category. but, the prognosis were not influenced by sex and capsular invasion. Patients at low risk or with small size carcinomas had long survival over 5 years with only lobectomy. Lymph node dissection was carried out with a limited type in no jugular metastasis, radical neck dissection was performed only therapeutically in proved jugular node metastasis. Fifteen patients were dead of tumor recurrence after surviving for three months to two and half years, and the cause of death was local recurrence in nine, bone metastasis in four and lung metastasis in two patients. In conclusion, more extensive surgery including total thyroidecotmy and systematic compartment-oriented dissection of the lymph node metastases in patient at high-risk group will results in better survival and lower recurrence rate.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10509-10512
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• 2015

Objective: To investigate the differential features of CT images in children with neuroblastomas (N) and ganglioneuroblastomas (G). Materials and Methods: Clinical data of 12 children in group G and 15 in group N undergoing CT examination and definitely diagnosed by pathology were retrospectively analyzed. The focal conditions were observed and compared in the two groups, including location, size, boundaries, morphology, enhanced degree and mode, abdominal vascular involvement, presence or absence of spanning the midline, infiltration of peripheral organs, angiography manifestations in tumors or surroundings, presence or absence of calcification and vascular tumor emboli as well as metastases of distal organs and lymph nodes. Results: In group N, the incidence of tumors in the adrenal area was conspicuously higher than in group G (P<0.05), while that of tumors with regular morphology and clear boundaries was significantly lower than in group G (P<0.01); Angiography manifestation rate and incidences of vascular embedding, lymph node metastasis, infiltration and organic metastasis in group N were all markedly higher than in group G (P<0.05). There was no statistical significance between the two groups in terms of focal size, presence or absence of calcification and spanning the midline, and enhanced degree and mode, as well as vascular tumor emboli (P>0.05). Conclusions: Mostly located in adrenal areas and with vascular embedding as a primary manifestation, the neuroblastoma extremely readily metastases to lymph nodes and other organs as well as infiltrating local tissues, with dilation on angiography frequent in or around the tumors. With vascular displacement as a primary manifestation, ganglioneuroblastoma has a regular morphology and clear boundaries.

• 대한두경부종양학회지
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• 제7권1호
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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.

• Nuclear Medicine and Molecular Imaging
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• 제42권sup1호
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• pp.39-45
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• 2008

PET or PET/CT detects only less than 50% of early gastric cancer and 62-98% of advanced gastric cancer. Therefore, mass screening programs are recommended for all adults over the age of 40 for early detection and early treatment of gastric cancer through endoscopy or various radiological tests. The most important step after diagnosis of gastric cancer is accurate staging, which mainly evaluates tumor resectability to avoid unnecessary surgery. Important factors that affect tumor resectability are whether the tumor can be separated from adjacent organs or important blood vessels, the extent of lymph node metastasis, presence of peritoneal metastasis, or distant organ metastasis. To evaluate the extent of local tumor invasion, anatomical imaging that has superior spatial resolution is essential. There are a few studies on prognostic significance of FDG uptake with inconsistent results between them. In spite of lower sensitivity for lymph node staging, the specificity of CT and PET are very high, and the specificity for PET tends to be higher than that for CT. Limited data published so far show that PET seems less useful in the detection of lung and bone metastasis. In the evaluation of pleural or peritoneal metastasis, PET seems very specific but insensitive as well. When FOG uptake of primary tumor is low, distant metastasis also tends to show low FDG uptake reducing its detection on PET. There are only a few data available in the evaluation of recurrence detection and treatment response using FDG PET or PET/CT.

• 대한두경부종양학회지
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• 제31권2호
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• pp.39-42
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• 2015

Warthin's tumor is the second most common salivary gland benign tumor, typically occurring in the fifth to seventh decades of life which shows an indolent feature. It is usually found in the parotid gland but occasionally in extra-parotid locations such as peri-parotid lymph node. However, Report of solitary Warthin's tumor in cervical lymph node is unusual. We here report a case of 72-year-old male with simultaneous malignant melanoma on eyelid and cervical lymph node enlargement in cervical level II area thus mimicking malignancy metastasis. After excisional biopsy under the local anesthesia, pathology was reported as papillary cystadenoma lymphomatosum, which is a histologically pathognomic finding of Warthin's tumor. However, there was no suspicious tumorous lesion in major or minor salivary glands. This case suggests that Warthin's tumor should be considered as a possible pathology in solitary lymph node lesion of neck.