Oral squamous cell carcinoma is characterized by high rate of recessive lymph gland metastasis. However, the treatment of early stage of neck lymph gland metastasis still remains large controversial. In this review, we were undertaken to assess the predictability of lymph node metastases by analyzing tumor thickness or depth and imaging. It is suggested that combined with imaging examination, elective neck dissection is a suitable choice for patient with > 4mm of primary tumor filtration.

Objective To analyze the treatment effect and factors affecting the prognosis in young people of papillary thyroid carcinoma (PTC).Methods A total of 69 PTC patients were reviewed retrospectively in Sun Yatsen University Cancer Center from Dec 1996 to Oct 2005.The prognostic status were compared using the Kaplan-Meier methods,the factors were analyzed by Log-rank test and the multiple factors were estimated by the Cox regression models.Results There were 26 males and 43 females.The median age was 24 years (mean:23.1 years).The average follow-up time was 113 months ranging from 73 to 174 months.20.3％ patients (14/69) experienced recurrence during follow-up time and 1.4％ patient (1/69) died.All the patients received levothyroxine after operation.The 10 year disease-free survival (DFS) rate of patients with or without extra thyroidal extension (ETE) of PTC was 29.6％ and 80.1％,respectively (P ＜ 0.01).Multivariate analysis showed that young PTC people with ETE had a worse prognosis (P =0.004).Conclusions Young papillary thyroid carcinoma patients had a favorable outcome.Surgical procedure was the first choice for this kind of patients.ETE was an independent factor for the recurrence of young PTC patients.

Power analyses(samples size calculation)is critical in protocol design for clinical trials.Adequate power ensures the credibility and reliability of the clinical trial results.In this article,omega-3 fatty acid supplementation study is chosen as an example to explain the power analysis in practice during the study design.First,obtaine the parameter estimates from the high-quality literature review and relevant systematic review(meta analyses)results.Then,calculate the sample size under different parameter settings and select the final patient number according to the clinical practice.Based on the above information,statistical simulation is performed to assume diverse possible combination of the outcome in real clinical trial.Further,under the specific determined sample size,the simulation pointing out the different positive or negative results when the real clinical trial is conducted.The determination of sample size of a clinical trial should be based on both the clinical and statistical considerations.

Objective: To investigate the long-term effect of submandibular salivary gland transfer on xerostomia induced by radiation in patients with nasopharyngeal carcinoma (NPC). Methods: A total of 70 eligible patients with NPC were divided into the test group (36 cases) and the control group (34 cases). In the test group, the submandibular salivary glands were transferred to the submental space before conventional radiotherapy (XRT) and shielded during XRT. Submandibular gland function and salivary fluid before and after radiotherapy, questionnaire of xerostomia at 60 months after XRT, and 5-year survival rate were compared between the two groups. Results: At 5 years after XRT, the trapping and excretion function of submandibular glands were significantly better in the test group (P=0.000 and P=0.000, respectively). The mean weight of saliva after XRT was greater in the test group than in the control group (1.65gvs.0.73g, P=0.000). Incidence of moderate to severe degree of xerostomia was significantly lower in the test group than in the control group (12.9%vs.78.6%, P=0.000). No significant difference was found in 5 year survival rate between the two groups (86.1%vs.82.4%, P＞0.05). Conclusion: Submandibular gland transfer procedure is safe for NPC patients. It can prevent XRT induced xerostomia and improve the quality of life of NPC patients.

OBJECTIVE To investigate the use ofultrasonically activated scalpel (UAS) in open thyroid surgery. METHODS From February 2004 to March 2005, thyroidectomy were performed in 77 cases by the same operation team. Forty seven cases received UAS thyroidectomy and 30 cases underwent conventional thyroidectomy. The operation time, estimated blood loss in operation, postoperative draining volume within the 24 hours, the length of hospitalization and postoperative complications between two groups were compared. RESULTS The average operation time of lobectomy and total/subtotal thyroidectomy in the UAS group were 61?4.34 and 85?3.02 minutes, and in conventional group were 82?3.37 and 121? 2.51 minutes. There was a significant difference in average operation time (P0.05). CONCLUSION The use of UAS in thyroid surgery was safe and can reduce the operation time.

Objective To study the short-term results and technological improvement of free anterolateral thigh (ALT) flaps in the reconstruction of circumferential hypopharyngeal defects.Methods The free ALT flap with a reporter skin paddle was used in 22 cases with circumferential hypopharyngeal defects.The short-term results of reconstructive surgeries and key points,advantages and complications of this technique were summarized.Results The length of circumferential hypopharyngeal defects ranged from 7 to 9 cm.ALT flap with an area of (8-9) cm × (11-18)cm was harvested.A reporter skin island with the skin area of (2.0-3.0) cm× (2.5-4.0) cm was designed.91％ (20/22) of ALT flaps survived.Two cases with flap necrosis underwent second reconstruction with a pedicled pectoralis major flap.All the patients had patent anastomotic lumen.Good postoperative subjective swallowing evaluation was obtained in 59％ (13/22) of patients;41％ (9/22)of patients had acceptable swallowing results.Three patients (14％) presented with postoperative pharyngocutaneous fistula.One case recovered spontaneously in short-term and other two cases received the second reconstructive surgery.Conclusions The application of free ALT flap with a reporter skin paddle in the reconstruction of circumferential hypopharyngeal defect is technologically easy and reliable,with satisfying swallowing function and limited trauma.

Background: The increasing incidence of radiation?induced osteosarcoma of the maxilla and mandible (RIOSM) has become a signiifcant problem that can limit long?term survival. The purpose of this study was to analyze the associa?tion of clinicopathologic characteristics with treatment outcomes and prognostic factors of patients who developed RIOSM after undergoing radiotherapy for nasopharyngeal carcinoma (NPC). Methods: We reviewed the medical records of 53,760 NPC patients admitted to Sun Yat?sen University Cancer Center during the period August 1964 to August 2012. Of these patients, 47 who developed RISOM and met inclusion criteria were included in this study. Two of these 47 patients refused treatment and were then excluded. Results: For all patients treated for NPC at Sun Yat?sen University Cancer Center during the study period, the total incidence of RIOSM after radiotherapy was 0.084% (47/53,760). Two patients (4.4%) had metastases at the diagnosis of RIOSM. Thirty?nine of the 45 (86.7%) patients underwent surgery for RIOSM; most patients (24/39; 61.5%) who under?went resection had gross clear margins, with 15 patients (38.5%) having either a gross or microscopic positive margin. All patients died. The 1?, 2?, and 3?year overall survival (OS) rates for the entire cohort of 45 patients were 53.3%, 35.6% and 13.5%, respectively. The independent prognostic factors associated with high OS rate were tumor size and treat?ment type. Conclusions: RISOM after radiotherapy for NPC is aggressive and often eludes early detection and timely inter?vention. Surgery combined with postoperative chemotherapy might be an effective treatment to improve patient survival.