• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.40 no.3
• /
• pp.101-102
• /
• 2014

• 대한두경부종양학회:학술대회논문집
• /
• 2003.11a
• /
• pp.231-231
• /
• 2003

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.44 no.1
• /
• pp.34-36
• /
• 2018

• Radiation Oncology Journal
• /
• v.34 no.4
• /
• pp.280-289
• /
• 2016

Purpose: Early hypopharyngeal squamous cell carcinoma (HPSCC) is a rarely diagnosed disease, for which the optimal treatment has not been defined yet. We assessed patterns of failure and outcomes in early HPSCC treated with various therapeutic approaches to identify its optimal treatment. Materials and Methods: Thirty-six patients with stage I (n = 10) and II (n = 26) treated between January 1992 and March 2014 were reviewed. Patients received definitive radiotherapy (RT) (R group, n = 10), surgery only (S group, n = 19), or postoperative RT (PORT group, n = 7). All patients in both the R and PORT groups received elective bilateral neck irradiation. In the S group, 7 patients had ipsilateral and 8 had bilateral dissection, while 4 patients had no elective dissection. Results: At a median follow-up of 48 months, the 5-year locoregional control (LRC) rate was 65%. Six patients had local failure, 1 regional failure (RF), 3 combined locoregional failures, and 2 distant failures. There was no difference in 5-year LRC among the R, S, and PORT groups (p = 0.17). The presence with a pyriform sinus apex extension was a prognosticator related to LRC (p = 0.01) in the multivariate analysis. Patients with a bilaterally treated neck showed a trend toward a lower RF rate (p = 0.08). Conclusion: This study shows that patients with early stage HPSCC involving the pyriform sinus apex might need a tailored approach to improve LRC. Additionally, our study confirms elective neck treatment might have an efficacious role in regional control.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.46 no.2
• /
• pp.99-107
• /
• 2020

Objectives: We accessed the various clinico-histopathological factors, and their association with occult metastasis (OM) in oral tongue squamous cell carcinoma (OTSCC). Materials and Methods: One hundred-nine patients with OTSCC were divided into the elective neck dissection (END) group and the watchful waiting (WW) group. Age, sex, T-stage, depth of invasion and differentiation were evaluated to determine the correlation between clinico-histopathological factors and OM. For immunohistochemical analysis, paraffin-embedded blocks of 41 OTSCC specimens were examined with antibodies (VEGF-c, c-Met, and ROR1). Results: The group with tumor thickness of oral tongue cancer ≥3 mm had higher incidence of OM than those with a thickness of <3 mm. The depth of invasion was statistically correlated with OM (P=0.022). Immunohistochemical analysis showed that high expression of VEGF-c (P=0.043), c-Met (P=0.009), and ROR-1 (P=0.003) were statistically correlated with OM. Conclusion: The analysis of these clinico-histopathological and immunohistochemical factors can help to determine neck dissection in clinically negative (cN0) patients.

• Korean Journal of Head & Neck Oncology
• /
• v.21 no.2
• /
• pp.196-200
• /
• 2005

Objectives: The purpose of this study was to evaluate the incidence and predictive factors of contralateral occult lymph node metastasis in oral cavity squamous cell carcinomas to form a rational basis for elective contralateral neck management. Materials and Methods: We performed a retrospective analysis of 66 N0-2 oral cavity cancer patients undergoing elective neck dissection for contralateral clinically negative necks from 1991 to 2003. Results: Clinically negative but pathologically positive contralateral lymph nodes occurred in 11%(7 of 66) . Of the 11 cases with a clinically ipsilateral node positive neck, contralateral occult lymph node metastases developed in 36%(4 of 10, in contrast with 5%(3/55) in the cases with clinically ipsilateral node negative necks(p<0.05). Based on the clinical staging of the tumor, 8%(3 of 37) of the cases showed lymph node metastases in T2 tumors, 25%(2 of 8) in T3, and 18%(2 of 11) in T4. None of the T1 tumors(10 cases) had pathologically positive lymph nodes. The rate of contralateral occult neck metastasis was significantly higher in advanced stage cases and those crossing the midline, compared to early stage or unilateral lesions(p<0.05). Patients with no evidence of contralateral nodal cancer had significantly improved disease-specific survival over patients with any pathologically positive nodes(5-year disease-specific survival rate was 79% vs. 43%, p<0.05). Conclusion: The risk of contralateral occult neck involvement in the oral cavity squamous cell carcinomas above the T3 stage or those crossing the midline with unilateral metastases was high. Therefore, we advocate an elective contralateral neck treatment with surgery or radiotherapy in oral cavity squamous cell carcinoma patients with ipsilateral node metastases or tumors that are greater than stage T3 or crossing the midline.

• Radiation Oncology Journal
• /
• v.36 no.4
• /
• pp.304-316
• /
• 2018

Purpose: The indication of elective neck treatment (ENT) for clinically N0 (cN0) paranasal sinus (PNS) carcinoma remains unclear. We aimed to investigate different treatment outcomes regarding ENT and propose optimal recommendations for ENT. Materials and Methods: We identified patients with cN0 PNS carcinoma who underwent curative-intent treatment between 1992 and 2015. Survival outcomes and pattern of failure were compared between patients who received ENT and those who did not. We sought to identify significant patient or pathologic factors regarding treatment outcomes. Results: Among 124 patients meeting the inclusion criteria, 40 (32%) received ENT ('ENT (+) group') and 84 (68%) did not ('ENT (-) group'). With a median follow-up of 54 months, the 5-year overall survival (OS) was 67%, and the 5-year progression-free survival (PFS) was 45%. There was no significant difference between the ENT (+) and ENT (-) groups regarding OS (p = 0.67) and PFS (p = 0.50). Neither group showed a significantly different pattern of failure, including regional failure (p = 0.91). There was no specific benefit, even in the subgroups analysis by tumor site, histologic type, and T stage. Nevertheless, patients who ever had regional and/or distant failure showed significantly worse prognosis. Conclusion: ENT did not significantly affect the survival outcome or pattern of failure in patients with cN0 PNS carcinomas, showing that ENT should not be generalized in this group. However, further discussion on the optimal strategy for ENT should continue because of the non-negligible regional failure rates and significantly worse prognosis after regional failure events.

• Korean Journal of Head & Neck Oncology
• /
• v.23 no.1
• /
• pp.15-20
• /
• 2007

Background and Objectives：Supraglottic partial laryngectomy is oncologically sound surgical procedure for selected cases of laryngeal cancer which maintains physiologic speech and swallowing without permanent tracheostoma. The purpose of this study is to evaluate the oncologic and functional results of supraglottic partial laryngectomy and neck dissection for supraglottic cancer. Materials and Methods：Between 1991-2005, Twenty-three supraglottic cancer patients, underwent supraglottic partial laryngectomy, were studied retrospectively. There were 5 patients with cT1, 14 with cT2, 4 with cT3 and 11 patients with cN0, 1 with cN1, 10 with cN2, 1 with cN3. All patients underwent neck dissection and postoperative radiotherapy was added to twenty patients. They were reviewed with respect to primary subsites, extended subsites, treatment result, survival rate, factors affecting the prognosis, postoperative complication, time of decannulation and oral diet, and postoperative voice. Results：Among eleven patients with clinically negative node, six patients had pathologically positive nodes. So occult metastasis was 54.5%. Two patients recurred at cervical lymph node and one had distant metastasis to lung. Local and regional control were 100% and 91.3%. The overall 3-year and 5-year survival rate were 84%, 78%, respectively. Nineteen cases were squamous cell carcinomas and four were basaloid squamous cell carcinomas. Basaloid subtype was significantly affected to survival. Decannulation and oral feeding were possible in 100%. Conclusions：Supraglottic partial laryngectomy is oncologically safe and functionally good procedure in supraglottic cancers. Elective neck dissection is beneficial in management of occult cervical metastasis.

• Korean Journal of Head & Neck Oncology
• /
• v.21 no.1
• /
• pp.26-31
• /
• 2005

Backgrounds and Objectives: Squamous cell carcinomas of the oral cavity(SCOC) in TNM stage I & II have relatively high chance to be cured compared to those in the advanced stage, but sometimes result in the treatment failure with poor prognosis. There have been few reports on the patterns of failure and the clinical courses for SCOC in stage I & II after the failure of initial treatment. This study is directed at identifying the clinical outcomes of stage I & II SCOC and the salvage rate after initial treatment and suggesting an optimal level of treatment by analyzing the patterns of failure. Material and Methods: The medical records of 36 patients with SCOC, initially diagnosed between 1995 and 2001 as TNM stage I & II were reviewed retrospectively. The patterns of failure, salvage treatment, clinical courses, and the survival of these subjects were analyzed. The minimum follow-up period of no-evidence of disease(NED) was 12 months with an average of 32.2 months. Results: Overall rate of the treatment failure in SCOC of stage I & II was 41. 7%(15/36 cases). Most of the treatment failure in the subjects with stage I tumors occurred in regional lymph node. Local failure was the most frequent form of failure in the subjects with stage II tumors after wide excision of primary tumor with elective neck dissection and/or radiation therapy. No significant correlation was noted between the safety margin and the local failure. Elective neck dissections in stage I & II SCOC had a tendency to reduce regional failure (p=0.055). The salvage rates at 24 months were 85.7% in stage I, and 37.5% in stage II. The 3-year survival rate after the failure of initial treatment was 55.0%. Conclusion: SCOC of stage I & II after the failure of initial treatment showed poor prognosis despite of the salvage treatments. This study implies that the elective neck dissections for regional lymph node should be required for SCOC of stage I & II to reduce the treatment failure.

• Korean Journal of Head & Neck Oncology
• /
• v.16 no.2
• /
• pp.220-223
• /
• 2000

Mucosal melanoma of the head and neck is a rare and usually lethal disease. Primary laryngeal malignant melanoma(LMM) are exceedingly rare tumors that morphologically are readily confused with more common types of laryngeal cancer. Treatment of choice for LMM is complete surgical excision and elective lymph node dissection is usually not recommended. The use of radiation or chemotherapy is generally thought to have no effect on local or distant disease and currently used as adjuvant therapy. The prognosis is extremely poor. We have experienced a 61 year old male patient with symptoms of foreign body and lump sense in throat. A dark pigmented polypoid mass was found on the right aryepiglottic folds with normal mobility of vocal cord. Total laryngectomy was performed under the diagnosis of malignant melanoma. Bone scan revealed multiple bony metastasis on ribs and lumbar vertebrae after 5 months of operation. There have been no evidence of recurrence at primary area. The patient died after 8 months of operation.