1.Treatment outcome and prognosis of head and neck hemangiopericytoma.
Alimujiang WUSHOU ; Xinchao MIAO ; Yajun ZHAO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(23):1855-1859
OBJECTIVE:
Aim of the study is to report the unique clinicopathologic feature, treatment outcome and prognostic factors of head and neck hemangiopericytoma (HNHPC).
METHOD:
A retrospective data collection of reported HNHPC cases, in which therapy, follow-up and outcome data were available, was performed from the electronic database of PubMed, Embase, Google scholar, China National Knowledge Infrastructure, Wan Fang and Wei Pu until on December 31, 2013.
RESULT:
A total of 213 HNHPC cases were identified from 122 peer-reviewed articles. The recurrence rate was 24.4% (51/209). The positive surgical margin (OR= 3. 977, P<0. 01) and poor pathologic differentiation (OR=l. 890, P<0. 01) were associated with increased local recurrence. The metastasis rate was 15.8% (22/139). The positive surgical margin (OR=13. 833, P<0. 01), poor pathologic differentiation (OR=4. 661, P<0. 01) and non-surgical treatment (OR=2. 000, P<0. 01) were associated with increased distant metastasis. The mortality rate was 15. 0% (32/213). The tumor size >5. 0 cm in diameter (OR= 2. 860, P<0. 05), positive surgical margin (OR=9. 833, P<0. 01), poor pathologic differentiation (OR=4. 061, P<0. 01) and non-surgical treatment (OR=2. 032, P<0. 01) were associated with worse mortality. The treatment included surgery alone 139 cases, multiple treatments 64 cases and non-surgical treatment 10 cases. The overall survival (OS) of the 213 cases was 85%, and the 3-year, 5-year and 10-year OS were 86%, 78% and 74%, respectively. The 3-year, 5-year and 10-year OS for surgery alone were 95%, 88% and 84%, respectively. The 3- year, 5-year and 10-year OS for surgery plus radiotherapy were 90%, 80% and 80%, respectively. The 3-year, 5- year and 10-year OS for surgery plus chemotherapy were 75%, 25% and 25%, respectively. The 3-year, 5-year and 10-year OS for surgery plus radio-chemotherapy were 67%, 58% and 46%, respectively. There were signifi- cant survival difference in recurrence-free survival (RFS), metastasis free survival (MFS) and OS depending on surgical margins (P<0. 01). RFS, MFS and OS difference were identified depending on pathologic differentiation (P<0. 01). MFS and OS differences were observed on the different treatment modality (P<0. 01). OS differences was observed on the different tumor sizes (P<0. 05). Positive surgical margins was correlated with disease recurrence (HR= 3. 680, P<0.01), while poor pathologic differentiation was correlated with metastasis and death (HR=2. 619, P<0. 05 and HR=3. 188, P<0. 05). The tumor size >5. 0 cm in diameter and non-surgical treatment was correlated with death (HR= 5. 461, P<0. 01 and HR= 8. 563, P<0. 01, respectively).
CONCLUSION
The surgical resection was the mainstream treatment and it was superior to multiple treatments. The tumor size, surgical margins, pathological differentiation and non-surgical treatment were independent prognostic factors.
Head and Neck Neoplasms
;
mortality
;
pathology
;
therapy
;
Hemangiopericytoma
;
mortality
;
pathology
;
therapy
;
Humans
;
Neoplasm Recurrence, Local
;
Prognosis
;
Retrospective Studies
;
Treatment Outcome
2.Concordant Surgical Treatment: Non-melanocytic Skin Cancer of the Head and Neck.
Wan Cheol RYU ; In Chang KOH ; Yong Hae LEE ; Jong Hyun CHA ; Sang Il KIM ; Chang Gyun KIM
Archives of Craniofacial Surgery 2017;18(1):37-43
BACKGROUND: Skin cancer is the most common type of cancer. Of the 4 million skin lesions excised annually worldwide, approximately 2 million are considered cancerous. In this study, we aimed to describe a regional experience with skin cancers treated by a single senior surgeon and to provide a treatment algorithm. METHODS: The medical records of 176 patients with head and neck non-melanocytic skin cancer (NMSC) who were treated by a single surgeon at our institution between January 2010 and May 2016 were retrospectively reviewed, and their data (age, sex, pathological type, tumor location/size, treatment modality) were analyzed. Patients with cutaneous squamous cell carcinoma (cSCC) who were classified as a high-risk group for nodal metastasis underwent sentinel node mapping according to the National Comprehensive Cancer Network guidelines. RESULTS: Among the patients with NMSC who were treated during this period, basal cell carcinoma (BCC; n=102, 57.9%) was the most common pathological type, followed by cSCC (n=66, 37.5%). Most lesions were treated by complete excision, with tumor-free surgical margins determined via frozen section pathology. Thirty-one patients with high-metastasis-risk cSCC underwent sentinel node mapping, and 17 (54.8%) exhibited radiologically positive sentinel nodes. Although these nodes were pathologically negative for metastasis, 2 patients (6.5%) later developed lymph node metastases. CONCLUSION: In our experience, BCC treatment should comprise wide excision with tumor-free surgical margins and proper reconstruction. In contrast, patients with cSCC should undergo lymphoscintigraphy, as nodal metastases are a possibility. Proper diagnosis and treatment could reduce the undesirably high morbidity and mortality rates.
Carcinoma, Basal Cell
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Carcinoma, Squamous Cell
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Diagnosis
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Frozen Sections
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Head*
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Humans
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Lymph Nodes
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Lymphoscintigraphy
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Medical Records
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Mortality
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Neck*
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Neoplasm Metastasis
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Pathology
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Retrospective Studies
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Skin Neoplasms*
;
Skin*
3.Prognostic significance of NADPH quinine oxidoreductase 1 overexpression in head and neck squamous cell carcinoma.
Yang YANG ; Tiefeng JIN ; Shuangping LIU ; Liyan CHEN ; Lijuan LIN ; Hongxiu HAN ; Longshan LI ; Zhenhua LIN
Chinese Journal of Pathology 2014;43(7):463-467
OBJECTIVETo investigate the significance of NADPH quinine oxidoreductase 1 (NQO1) protein overexpression on prognostic evaluation of head and neck squamous cell carcinoma (HNSCC).
METHODSNQO1 protein was detected in 162 of HNSCC, 45 cases of adjacent nontumor tissues and 26 samples of normal head and neck epithelia using EnVision immunohistochemical. Correlation between NQO1 overexpression and patients prognosis was also analyzed.
RESULTSThe positive rate and strongly positive rate of NQO1 protein were 84.0% (136/162) and 69.8% (113/162) in HNSCC, respectively, and both of which were significantly higher than either those in adjacent nontumor tissues and normal head and neck epithelia (both P < 0.01). NQO1 expression was significantly correlated with the clinical stage, pT and chemoradiotherapy of HNSCC (P < 0.01). Kaplan-Meier survival analysis showed that overall survival and disease-free survival rates were significantly higher in HNSCC patients with high level NQO1 expression than that those with low level of NQO1 expression (Log-rank = 6.625 , P = 0.010;Log-rank = 6.234 , P = 0.013). Additional analysis by Cox proportional hazard regression model showed that high level of NQO1 expression was an independent hazard predictor for overall survival of patients with HNSCC (Wald = 6.626, P = 0.008).
CONCLUSIONSNQO1 expression level is closely correlated with the progression and prognosis of patients with HNSCC. High level of NQO1 expression may be used as an important indicator for patients with poor prognostic HNSCC.
Breast ; enzymology ; Carcinoma, Squamous Cell ; enzymology ; mortality ; pathology ; Disease-Free Survival ; Female ; Head and Neck Neoplasms ; enzymology ; mortality ; pathology ; Humans ; Kaplan-Meier Estimate ; NAD(P)H Dehydrogenase (Quinone) ; metabolism ; NADH, NADPH Oxidoreductases ; metabolism ; Prognosis ; Proportional Hazards Models
4.Clinical Significance of Early Detection of Esophageal Cancer in Patients with Head and Neck Cancer.
Hyun LIM ; Do Hoon KIM ; Hwoon Yong JUNG ; Eun Jeong GONG ; Hee Kyong NA ; Ji Yong AHN ; Mi Young KIM ; Jeong Hoon LEE ; Kwi Sook CHOI ; Kee Don CHOI ; Ho June SONG ; Gin Hyug LEE ; Jin Ho KIM
Gut and Liver 2015;9(2):159-166
BACKGROUND/AIMS: The efficacy of surveillance for esophageal squamous cell neoplasia (ESCN) in patients with head and neck squamous cell carcinoma (HNSCC) remains controversial. Our study aimed to provide clinical data concerning the necessity of surveillance for detecting early ESCN in patients with HNSCC. METHODS: We retrospectively reviewed the data from 714 patients who were pathologically confirmed as having HNSCC (n=236 oral cavity cancers, 137 oropharyngeal cancers, 87 hypopharyngeal cancers, and 254 laryngeal cancers). RESULTS: Of 714 patients, during a median follow-up of 31 months, 48 ESCNs (37 synchronous and 11 metachronous) were detected in 36 patients (5%). Fifteen synchronous lesions (40.3%) were early ESCN, whereas nine metachronous lesions (81.8%) were early ESCN. The 3-year survival rates of HNSCC only and HNSCC combined with ESCN were 71.2% and 48.2%, respectively (p<0.001). Among 36 patients with ESCN, the 3-year survival rates for early and advanced ESCN were 77.7% and 21.7%, respectively (p=0.01). In the multivariate analysis, alcohol consumption and hypopharyngeal cancer were significant factors associated with the development of ESCN. CONCLUSIONS: HNSCC patients with early ESCN were similar in prognosis with patients without ESCN, in contrast to patients with advanced ESCN. Therefore, surveillance for the early detection of ESCN in patients with HNSCC, especially in alcohol drinkers and those with hypopharyngeal cancer, is warranted.
Adolescent
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Adult
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Aged
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Aged, 80 and over
;
Alcohol Drinking/adverse effects
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Carcinoma, Squamous Cell/*diagnosis/mortality/*pathology/*secondary
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Early Detection of Cancer/*statistics & numerical data
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Esophageal Neoplasms/*diagnosis/mortality/*secondary
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Female
;
Head and Neck Neoplasms/mortality/*pathology
;
Humans
;
Male
;
Middle Aged
;
Multivariate Analysis
;
Prognosis
;
Retrospective Studies
;
Risk Factors
;
Survival Rate
;
Young Adult
5.Clinical Significance of Early Detection of Esophageal Cancer in Patients with Head and Neck Cancer.
Hyun LIM ; Do Hoon KIM ; Hwoon Yong JUNG ; Eun Jeong GONG ; Hee Kyong NA ; Ji Yong AHN ; Mi Young KIM ; Jeong Hoon LEE ; Kwi Sook CHOI ; Kee Don CHOI ; Ho June SONG ; Gin Hyug LEE ; Jin Ho KIM
Gut and Liver 2015;9(2):159-166
BACKGROUND/AIMS: The efficacy of surveillance for esophageal squamous cell neoplasia (ESCN) in patients with head and neck squamous cell carcinoma (HNSCC) remains controversial. Our study aimed to provide clinical data concerning the necessity of surveillance for detecting early ESCN in patients with HNSCC. METHODS: We retrospectively reviewed the data from 714 patients who were pathologically confirmed as having HNSCC (n=236 oral cavity cancers, 137 oropharyngeal cancers, 87 hypopharyngeal cancers, and 254 laryngeal cancers). RESULTS: Of 714 patients, during a median follow-up of 31 months, 48 ESCNs (37 synchronous and 11 metachronous) were detected in 36 patients (5%). Fifteen synchronous lesions (40.3%) were early ESCN, whereas nine metachronous lesions (81.8%) were early ESCN. The 3-year survival rates of HNSCC only and HNSCC combined with ESCN were 71.2% and 48.2%, respectively (p<0.001). Among 36 patients with ESCN, the 3-year survival rates for early and advanced ESCN were 77.7% and 21.7%, respectively (p=0.01). In the multivariate analysis, alcohol consumption and hypopharyngeal cancer were significant factors associated with the development of ESCN. CONCLUSIONS: HNSCC patients with early ESCN were similar in prognosis with patients without ESCN, in contrast to patients with advanced ESCN. Therefore, surveillance for the early detection of ESCN in patients with HNSCC, especially in alcohol drinkers and those with hypopharyngeal cancer, is warranted.
Adolescent
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Adult
;
Aged
;
Aged, 80 and over
;
Alcohol Drinking/adverse effects
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Carcinoma, Squamous Cell/*diagnosis/mortality/*pathology/*secondary
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Early Detection of Cancer/*statistics & numerical data
;
Esophageal Neoplasms/*diagnosis/mortality/*secondary
;
Female
;
Head and Neck Neoplasms/mortality/*pathology
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Humans
;
Male
;
Middle Aged
;
Multivariate Analysis
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Prognosis
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Retrospective Studies
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Risk Factors
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Survival Rate
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Young Adult
6.Effect of human papilloma virus infection status on the prognosis of localized stage head and neck squamous cell carcinomas in different ethnic groups of Xinjiang.
Yang ZHANG ; Songan ZHANG ; Tu-er-xun A ER-ZI-GI ; Huarong ZHAO ; Ni-ya-zi Hu ER-XIDAN ; Yongxing BAO
Chinese Journal of Stomatology 2015;50(12):742-745
OBJECTIVETo discuss the effect of limited head and neck squamous cell carcinomas human papillomavirus(HPV) infection status on the prognosis in different nationalities of Xinjiang.
METHODSThe clinical data of 149 cases of head and neck squamous cell carcinoma from Uighur, Han and Kazak was analyzed. The HPV16/18 infection and viral load was examined.The prognosis was analyzed by cox multiIvar-Iate model. The effect of HPV infection status on prognosis was evaluated.
RESULTSIn this study, Oropharyngeal HPV infection rate was 35.0%, followed by hypopharynx 30.0%, oropharyx was 16.0%. The overall survival rate of 3 years and 5 years was 66.4%, and 39.2% respectively. The clinical stage,N stage and HPV were influencing factors for the prognosis of patients with head and neck squamous cell carcinoma (P< 0.05). N stage and HPV were independent prognostic factors for the prognosis of patients with head and neck squamous cell carcinoma (P< 0.05).
CONCLUSIONSThere is a high rate of HPV infection in oropharynx in head and neck cancer. HPV positive is a protective factor for the prognosis of head and neck cancer, and the risk of death in patients with HPV was 3/5 lower than that of HPV negative patients. HPV viral load may be positively related to the total survival rate. N stage is a risk factor for the prognosis of head and neck cancer. Different nationalities have little influence on prognosis.
Carcinoma, Squamous Cell ; ethnology ; mortality ; pathology ; virology ; China ; Ethnic Groups ; Head and Neck Neoplasms ; ethnology ; mortality ; pathology ; virology ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans ; Neoplasm Staging ; Papillomavirus Infections ; diagnosis ; mortality ; virology ; Prognosis ; Proportional Hazards Models ; Survival Rate ; Time Factors ; Viral Load
7.Clinical characteristics, pathological distribution, and prognostic factors in non-Hodgkin lymphoma of Waldeyer's ring: nationwide Korean study.
Seong Jun LEE ; Cheol Won SUH ; Soon Il LEE ; Won Seog KIM ; Won Sik LEE ; Hyo Jung KIM ; Chul Won CHOI ; Jin Seok KIM ; Ho Jin SHIN
The Korean Journal of Internal Medicine 2014;29(3):352-360
BACKGROUND/AIMS: In Asia, the incidence of non-Hodgkin lymphoma (NHL) has increased in recent decades. Waldeyer's ring (WR) is the most common site of NHL involving the head and neck. In this study, the pathological distribution of WR-NHL and its clinical features were analyzed retrospectively. METHODS: From January 2000 through December 2010, we analyzed the medical records of 328 patients from nine Korean institutions who were diagnosed with WR-NHL. RESULTS: The study group comprised 197 male and 131 female patients with a median age of 58 years (range, 14 to 89). The rate of localized disease (stage I/II) was 64.9%, and that of low-risk disease (low/low-intermediate, as defined by the International Prognostic Index) was 76.8%. Diffuse large B-cell lymphoma (DLBCL; 240 patients, 73.2%) was the most common pathologic subtype, followed by peripheral T-cell lymphoma (14 patients, 4.3%) and nasal NK/T-cell lymphoma (14 patients, 4.3%). WR-NHL occurred most frequently in the tonsils (199 patients, 60.6%). Extranodal involvement was greater with the T-cell subtype (20 patients, 42.5%) compared with the B-cell subtype (69 patients, 24.5%). Multivariate analyses showed that age > or = 62 years, T-cell subtype, and failure to achieve complete remission were significant risk factors for overall survival. CONCLUSIONS: DLBCL was found to have a higher incidence in Korea than those incidences reported by other WR-NHL studies. T-cell lymphoma occurred more frequently than did follicular lymphoma. T-cell subtype, age > or = 62 years, and complete remission failure after first-line treatment were significant poor prognostic factors for overall survival according to the multivariate analysis.
Adolescent
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Adult
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Age Factors
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Aged
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Aged, 80 and over
;
Disease-Free Survival
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Female
;
Head and Neck Neoplasms/mortality/*pathology/therapy
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Humans
;
Incidence
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Kaplan-Meier Estimate
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Lymphoma, Extranodal NK-T-Cell/pathology
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Lymphoma, Large B-Cell, Diffuse/pathology
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Lymphoma, Non-Hodgkin/mortality/*pathology/therapy
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Lymphoma, T-Cell, Peripheral/pathology
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Male
;
Middle Aged
;
Multivariate Analysis
;
Neoplasm Staging
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Proportional Hazards Models
;
Recurrence
;
Remission Induction
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Republic of Korea
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Retrospective Studies
;
Risk Factors
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Time Factors
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Treatment Outcome
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Young Adult