• 대한두경부종양학회지
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• 제33권1호
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• pp.57-59
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• 2017

A non-recurrent laryngeal nerve on the left side is a rare anomaly which is reported in 0.04% and it is associated with abnormal developments of the aortic arch during embryogenesis. Although the possibility is extremely low, it is important to consider the possible existence of a non-recurrent laryngeal nerve to prevent a nerve injury during thyroidectomy. We experienced a 42 year-old male with left thyroid papillary cancer who had right side aortic arch and aberrant left subclavian artery. Even though we found that this patient had a recurrent laryngeal nerve, we present this case of the right aortic arch with an aberrant left subclavian artery variation with a brief review of literature.

• 대한두개안면성형외과학회지
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• 제21권1호
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• pp.27-34
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• 2020

Background: Free-flap reconstruction for recurrent head and neck cancer may be challenging depending on the previous treatments, those are, chemotherapy, radiotherapy, and surgery, including neck dissection or free tissue transfer. Specifically, the previous treatment could compromise the neck vessels, thereby making free-flap reconstruction more difficult. This study aimed to investigate the correlation between previous treatments and vascular compromise of the free flap. Methods: In this retrospective study, 124 free-flap reconstructions in 116 patients for recurrent head and neck cancer between 1993 and 2017 were investigated. The demographic characteristics, previous treatments, flap choices, infections, recipient vessels, and vascular crises were evaluated. Results: Of the 124 reconstruction cases, 10 had vascular crises. There were six revisions, totaling six flap failures. The success rate of free-flap reconstruction for recurrent cancer was 95.2%, which significantly differed from that for primary cancer (98.8%, p= 0.006). Moreover, in the recurrent cancer group, no correlation was found between previous treatments and vascular crises (p> 0.05). Increased rates of contralateral or uncommon anastomoses were found following neck dissection (p< 0.05). Conclusion: Previous neck dissection or radiotherapy could lead to scarring and tissue damage, which could in turn make microvascular reconstruction more challenging; however, the effect was not definite in this study. Approximately 60% of patients with previous neck dissection had compromised ipsilateral recipient vessels, which resulted in contralateral or uncommon anastomoses. In this study, free-flap reconstruction seems to be quite safe and preferable in patients with recurrent head and neck cancer based on the overall survival rate.

• Archives of Plastic Surgery
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• 제46권5호
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• pp.449-454
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• 2019

Background Most patients with head and neck cancer successfully undergo oncologic resection followed by free or local flap reconstruction, depending on the tumor's size and location. Despite effective curative resection and reconstruction, head and neck cancer patients still face a high risk of recurrence and the possibility of a second primary cancer. Moreover, surgeons hesitate to perform sequential reconstruction following curative resection for several reasons. Few large-scale studies on this subject are available. Therefore, we retrospectively evaluated the outcome of sequential head and neck reconstruction to determine the possible risks. Methods In total, 467 patients underwent head and neck reconstruction following cancer resection at our center from 2008 to 2017. Of these cases, we retrospectively reviewed the demographic and clinical features of 58 who had sequential head and neck reconstruction following resection of recurrent cancer. Results Our study included 43 males (74.1%) and 15 females (25.9%). The mean age at the initial operation was $55.4{\pm}15.3years$, while the mean age at the most recent operation was $59.0{\pm}14.3years$. The interval between the first and second operations was $49.2{\pm}62.4months$. Twelve patients (20.7%) underwent surgery on the tongue, and 12 (20.7%) had procedures on the oropharynx. Thirty-four patients (58.6%) received a sequential free flap reconstruction, and 24 patients (41.4%) were treated using locoregional flaps. No cases of flap failure occurred. Conclusions Our findings suggest that patients who need additional operations with recurrent head and neck cancer could optimally benefit from sequential curative resections and reconstructions.

• 대한두경부종양학회:학술대회논문집
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• 대한두경부종양학회 2002년도 제19차 학술대회
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• pp.269-274
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• 2002

• 대한두경부종양학회지
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• 제37권2호
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• pp.11-17
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• 2021

Head and neck cancer is the 6^th most frequently diagnosed solid tumor in the world. Alcohol consumption, smoking, and HPV infection are associated with the incidence of head and neck squamous cell carcinoma (HNSCC). Although a multidisciplinary approach is a key strategy for the treatment of locally advanced HNSCC, systemic therapy is the mainstream of recurrent or metastatic HNSCC treatment. Stage IV HNSCC has a relatively poor prognosis with median overall survival of around one year. There have been many clinical trials to investigate the efficacy of target agents in the treatment of HNSCC. In the HPV-negative HNSCC, TP53 and CDKN2A are the most commonly mutated genes. In the HPV-positive HNSCC, the PI3K pathway is frequently altered. EGFR, PI3K, cell cycle pathway, MET, HRAS, and IL6/JAK/STAT pathway are explored targets in HNSCC. In this study, we review the target pathways and agents under research. We also introduce here umbrella trials of recurrent or metastatic HNSCC conducted by the Korea Cancer Study Group. The combination of target agents with immune checkpoint inhibitors or cytotoxic chemotherapies would be a future step in the precision medicine of HNSCC treatment.

• 대한두경부종양학회지
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• 제3권1호
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• pp.107-114
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• 1987

Clinical application of hyperthermia using 8 MHz radiofrequency(capacitive type THERMOTRON RF-8) in cancer treatment was begun at Yonsei Cancer Center in 1985. From April 1985 to April 1986, 23 patients with loco-regionally advanced and persistent or recurrent carcinomas of the head and neck were treated with hyperthermia at the Department of Radiation Oncology, Yonsei University College of Medicine. Radiation therapy and/or chemotherapy were combined with hyperthermia to improve the tumor response. The response rate of 23 patients was 52%, 4 had complete response, and 7 had partial response. The factors affecting the tumor response were dose of irradiation(P=0.009). Complications related to treatment were found in 8 patients and all of them were self-limited. The result of this study indicates that localized hyperthermia as a combined modality has a significant role in palliation of advanced and recurrent head and neck cancer.

• Nuclear Medicine and Molecular Imaging
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• 제42권sup1호
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• pp.6-13
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• 2008

Head and neck cancer is the sixth most common type of human cancer worldwide. Squamous cell carcinoma is the most common cancer of the head and neck. Since $^{18}F-FDG$ PET is very sensitive to detecting squamous cell carcinoma, it has been widely used in patients with head and neck cancers for initial staging, management of recurrent cancers, and therapeutic monitoring. According to clinical research data, $^{18}F-FDG$ PET is expected to be a very helpful diagnostic tool in the management of head and neck cancer.

• 대한두경부종양학회지
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• 제33권1호
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• pp.7-13
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• 2017

Despite improved treatment outcomes of locally advanced disease over the last 2 decades, the survival of patients with recurrent and/or metastatic head and neck squamous cell carcinoma (HNSCC) remains dismal. There is a clear need for development of novel therapeutic strategies for recurrent and/or metastatic HNSCC. Recent advances in understanding tumor immunology have been directly and rapidly translated into clinical success of T cell-directed immunotherapeutic approach in the treatment of several types of solid cancers. Among them, impact of immune checkpoint inhibition using neutralizing antibodies is the most striking. A variety of immunotherapeutic strategies targeting T cells have been also studied in HNSCC, especially in recurrent and/or metastatic setting even with significant survival benefit. The present article reviews the basic concept of T cell-directed immunotherapy and the current status of such approaches in the treatment of HNSCC.

• 대한두경부종양학회지
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• 제29권2호
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• pp.58-61
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• 2013

Early glottic cancer can be effectively treated with surgery or radiotherapy showing the comparable treatment results. Since radiation therapy may be better in terms of voice preservation, it tends to be preferred in early glottic cancer. Most common recurrence site is glottis after radiation therapy and complete remission of glottic primary site followed by local recurrence limited to neck is very rare. The authors are reporting a patient with regional recurrence of central neck lymph nodes after radiation therapy for T1a glottic cancer.

• 대한두개안면성형외과학회지
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• 제20권6호
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• pp.416-420
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• 2019

Reconstruction method choice in recurrent head and neck cancer depends on surgical history, radiation therapy dosage, conditions of recipient vessels, and general patient condition. Furthermore, when defects are multiple or three dimensional in nature, reconstruction and flap choice aimed at rebuilding the functional structure of the head and neck are difficult. We experienced successful reconstruction of recurrent laryngeal cancer requiring reconstruction of esophageal and tracheostomy stroma defects using a chimeric two-skin anterolateral thigh flap with a single pedicle.