PURPOSE: The purpose of this study is to determine the status of nodal disease, including the right paraesophageal node, in papillary thyroid carcinoma (PTC). METHODS: A total of 116 patients with PTC underwent total thyroidectomy and prophylactic central node dissection, including right paraesophageal lymph nodes (RPE LNs). Metastases to RPELNs were analyzed by site and clinicopathologic variables. Recurrence rate and post-operative complications were also evaluated by comparing the right paraesophageal lymph node dissection (RPE LND) with the non-RPE LND group. RESULTS: Central node metastases were detected in 57 (49.1%) patients; paratracheal and pre-tracheal lymph node metastases, total RPE LN metastases, and metastases only in RPE LN occurred in 50 (43.1%), 18 (15.5%), and 5 (4.3%) patients, respectively. Age, tumor size, tumor longitudinal location, extrathyroidal extension, and multicentricity were insignificant in RPE LN metastasis (P>.05). Although there was no significant statistical difference, tumors with lymphatic invasion and larger tumors (>1 cm) had more frequent RPE LN metastases. RPE LN metastases were frequent in deeply located tumors instead of superficially located tumors (P=0.015). Compared with the non-RPE LND group, the incidence of post-operative complications (transient hypocalcemia and vocal cord palsy) was not significantly different and there was no recurrence in both groups during the follow up period. CONCLUSION: The metastatic rate of the right paraesophageal lymph nodes was 15.5%; 83.3% of these were macrometastatic. Prophylactic RPE dissection compared with the non-RPE LND group, however, did not show a survival difference for 5 years.
Follow-Up Studies ; Humans ; Hypocalcemia ; Incidence ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis* ; Recurrence ; Retrospective Studies* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Vocal Cords

A 76 year-old female who was diagnosed with multiple myeloma (IgG, lambda) had received bortezomib, melphalan and prednisolone as first-line treatment. After completing six cycles of chemotherapy, her serum monoclonal protein level decreased from 7.28 g/dL to 0.65 g/dL, indicating a partial response. However, at the next scheduled visit she complained of slowly progressing dyspnea. On chest X-ray, newly developed pleural effusion was found, and rapidly progressing extramedullary plasmacytoma was detected in the anterior mediastinum on chest computerized tomography. However, there was no change in her serum monoclonal protein level. In Korea, extramedullary involvement is encountered in 5% of patients with multiple myeloma. However, evaluation of treatment response using solely the serum monoclonal protein level may not accurately reflect disease status in these patients.
Drug Therapy ; Dyspnea ; Female ; Humans ; Korea ; Mediastinum ; Melphalan ; Multiple Myeloma* ; Plasmacytoma* ; Pleural Effusion ; Prednisolone ; Thorax ; Bortezomib

We compared the production of three chemokines; interferon-gamma-inducible protein-10 (IP-10), monocyte chemoattractant protein-1 (MCP-1) and growth-related onco-gene-alpha(Gro-alpha) that attracts monocytes or neutrophils, or both, in peripheral blood at acute stage of Kawasaki disease (n=29), Henoch-Schonlein purpura (n=15) and acute febrile illnesses (n=12). The production of the chemokines was assayed by ELISA. The plasma levels of IP-10 were markedly elevated in Kawasaki disease (538.6 +/-336.4 pg/mL) and acute febrile illnesses (417.1 +/-262.2 pg/mL) compared with in Henoch-Schonlein purpura (58.7 +/-95.7 pg/mL) (p<0.05). The MCP-1 levels were elevated in Kawasaki disease (443.0 +/-473.1 pg/mL) and acute febrile illnesses (328.6 +/-261.1 pg/mL) compared with in Henoch-Schonlein purpura (82.9 +/-79.0 pg/mL) (p<0.05). The Gro- levels were elevated only in acute febrile illnesses (134.3 +/-153.6 pg/mL) compared with in Kawasaki disease (31.8 +/-22.1 pg/mL) or Henoch-Schonlein purpura (29.4 +/-53.3 pg/mL) (p<0.05). According to these results, monocytes may play an important role in Kawasaki disease. In acute febrile illness-es, both monocytes and neutrophils may play an important role. By contrast, Henoch-Schonlein purpura may not be associated with the role of monocytes and neutrophils. Further studies using a larger number of cases are needed.
Acute Disease ; Adolescent ; Chemokines/*blood ; Child ; Child, Preschool ; Comparative Study ; Female ; Fever/*blood/*epidemiology ; Humans ; Infant, Newborn ; Korea/epidemiology ; Male ; Mucocutaneous Lymph Node Syndrome/*blood/*epidemiology ; Purpura, Schoenlein-Henoch/*blood/*epidemiology ; Research Support, Non-U.S. Gov't ; Risk Assessment/methods ; Risk Factors

Background/Objectives: Pediatric parotid malignancies are rare but represent a critical subset of head and neck cancers. This study integrates nationwide incidence trends in Korea with detailed surgical outcomes from a single tertiary institution to better understand the characteristics and management of these tumors.Materials & Methods: Nationwide data from the Korea Central Cancer Registry (1999-2019) were analyzed to assess trends in pediatric parotid malignancy incidence. A retrospective review was conducted on 31 pediatric parotidectomy cases at a tertiary hospital from 2011 to 2024. Clinical data, surgical methods, pathology results, and follow-up outcomes were examined. Results: Nationwide analysis revealed an annual mean of 9.0 ± 4.0 cases of pediatric parotid malignancies, with a significant rise in incidence among patients aged 10-19 years (APC 5.4%, 95% CI 1.1-9.8, p=0.016). Institutional data showed that the median age of patients underwent parotidectomy was 15.0 years, with males comprising 67.7%. Among 31 cases, 19 (61.3%) were benign, primarily pleomorphic adenomas (68.4%), and 12 (38.7%) were malignant, predominantly mucoepidermoid carcinoma (87.5%). Superficial or partial parotidectomy was the most common surgical approach (71.0%), and no unexpected complications or recurrences were observed. Conclusion Pediatric parotid malignancies in Korea exhibit rising incidence rates, particularly among teenagers. Surgical outcomes confirm the predominance of pleomorphic adenomas and mucoepidermoid carcinomas. Pediatric parotid surgery is a procedure with minimized complications and a promising prognosis. Tailored treatment strategies adapted to the unique characteristics of pediatric patients are essential to optimize outcomes.

Background/Objectives: Pediatric parotid malignancies are rare but represent a critical subset of head and neck cancers. This study integrates nationwide incidence trends in Korea with detailed surgical outcomes from a single tertiary institution to better understand the characteristics and management of these tumors.Materials & Methods: Nationwide data from the Korea Central Cancer Registry (1999-2019) were analyzed to assess trends in pediatric parotid malignancy incidence. A retrospective review was conducted on 31 pediatric parotidectomy cases at a tertiary hospital from 2011 to 2024. Clinical data, surgical methods, pathology results, and follow-up outcomes were examined. Results: Nationwide analysis revealed an annual mean of 9.0 ± 4.0 cases of pediatric parotid malignancies, with a significant rise in incidence among patients aged 10-19 years (APC 5.4%, 95% CI 1.1-9.8, p=0.016). Institutional data showed that the median age of patients underwent parotidectomy was 15.0 years, with males comprising 67.7%. Among 31 cases, 19 (61.3%) were benign, primarily pleomorphic adenomas (68.4%), and 12 (38.7%) were malignant, predominantly mucoepidermoid carcinoma (87.5%). Superficial or partial parotidectomy was the most common surgical approach (71.0%), and no unexpected complications or recurrences were observed. Conclusion Pediatric parotid malignancies in Korea exhibit rising incidence rates, particularly among teenagers. Surgical outcomes confirm the predominance of pleomorphic adenomas and mucoepidermoid carcinomas. Pediatric parotid surgery is a procedure with minimized complications and a promising prognosis. Tailored treatment strategies adapted to the unique characteristics of pediatric patients are essential to optimize outcomes.

Background/Objectives: Pediatric parotid malignancies are rare but represent a critical subset of head and neck cancers. This study integrates nationwide incidence trends in Korea with detailed surgical outcomes from a single tertiary institution to better understand the characteristics and management of these tumors.Materials & Methods: Nationwide data from the Korea Central Cancer Registry (1999-2019) were analyzed to assess trends in pediatric parotid malignancy incidence. A retrospective review was conducted on 31 pediatric parotidectomy cases at a tertiary hospital from 2011 to 2024. Clinical data, surgical methods, pathology results, and follow-up outcomes were examined. Results: Nationwide analysis revealed an annual mean of 9.0 ± 4.0 cases of pediatric parotid malignancies, with a significant rise in incidence among patients aged 10-19 years (APC 5.4%, 95% CI 1.1-9.8, p=0.016). Institutional data showed that the median age of patients underwent parotidectomy was 15.0 years, with males comprising 67.7%. Among 31 cases, 19 (61.3%) were benign, primarily pleomorphic adenomas (68.4%), and 12 (38.7%) were malignant, predominantly mucoepidermoid carcinoma (87.5%). Superficial or partial parotidectomy was the most common surgical approach (71.0%), and no unexpected complications or recurrences were observed. Conclusion Pediatric parotid malignancies in Korea exhibit rising incidence rates, particularly among teenagers. Surgical outcomes confirm the predominance of pleomorphic adenomas and mucoepidermoid carcinomas. Pediatric parotid surgery is a procedure with minimized complications and a promising prognosis. Tailored treatment strategies adapted to the unique characteristics of pediatric patients are essential to optimize outcomes.

Background/Objectives: Pediatric parotid malignancies are rare but represent a critical subset of head and neck cancers. This study integrates nationwide incidence trends in Korea with detailed surgical outcomes from a single tertiary institution to better understand the characteristics and management of these tumors.Materials & Methods: Nationwide data from the Korea Central Cancer Registry (1999-2019) were analyzed to assess trends in pediatric parotid malignancy incidence. A retrospective review was conducted on 31 pediatric parotidectomy cases at a tertiary hospital from 2011 to 2024. Clinical data, surgical methods, pathology results, and follow-up outcomes were examined. Results: Nationwide analysis revealed an annual mean of 9.0 ± 4.0 cases of pediatric parotid malignancies, with a significant rise in incidence among patients aged 10-19 years (APC 5.4%, 95% CI 1.1-9.8, p=0.016). Institutional data showed that the median age of patients underwent parotidectomy was 15.0 years, with males comprising 67.7%. Among 31 cases, 19 (61.3%) were benign, primarily pleomorphic adenomas (68.4%), and 12 (38.7%) were malignant, predominantly mucoepidermoid carcinoma (87.5%). Superficial or partial parotidectomy was the most common surgical approach (71.0%), and no unexpected complications or recurrences were observed. Conclusion Pediatric parotid malignancies in Korea exhibit rising incidence rates, particularly among teenagers. Surgical outcomes confirm the predominance of pleomorphic adenomas and mucoepidermoid carcinomas. Pediatric parotid surgery is a procedure with minimized complications and a promising prognosis. Tailored treatment strategies adapted to the unique characteristics of pediatric patients are essential to optimize outcomes.

PURPOSE: The treatment strategy for elderly patients older than 80 years with diffuse large B-cell lymphoma (DLBCL) has not been established because of poor treatment tolerability and lack of data. MATERIALS AND METHODS: This multicenter retrospective study was conducted to investigate clinical characteristics, treatment patterns and outcomes of patients older than 80 years who were diagnosed with DLBCL at 19 institutions in Korea between 2005 and 2016. RESULTS: A total of 194 patients were identified (median age, 83.3 years). Of these, 114 patients had an age-adjusted International Prognostic Index (aaIPI) score of 2-3 and 48 had a Charlson index score of 4 or more. R-CHOP was given in 124 cases, R-CVP in 13 cases, other chemotherapy in 17 cases, radiation alone in nine cases, and surgery alone in two cases. Twenty-nine patients did not undergo any treatment. The median number of chemotherapy cycles was three. Only 37 patients completed the planned treatment cycles. The overall response rate from 105 evaluable patients was 90.5% (complete response, 41.9%). Twentynine patients died due to treatment-related toxicities (TRT). Thirteen patients died due to TRT after the first cycle. Median overall survival was 14.0 months. The main causes of death were disease progression (30.8%) and TRT (27.1%). In multivariate analysis, overall survival was affected by aaIPI, hypoalbuminemia, elevated creatinine, and treatment. CONCLUSION: Age itself should not be a contraindication to treatment. However, since elderly patients show higher rates of TRT due to infection, careful monitoring and dose modification of chemotherapeutic agents is needed.
Aged* ; B-Lymphocytes* ; Cause of Death ; Creatinine ; Disease Progression ; Drug Therapy ; Humans ; Hypoalbuminemia ; Korea ; Lymphoma, B-Cell* ; Multivariate Analysis ; Retrospective Studies*

Thyroid cancer is the most common malignancy in Korea; in 2012, about 44,000 new cases (19.6% of all malignancies) were registered and the estimated age-standardized incidence rate of thyroid cancer was 73.6 per 100,000 (17.3 and 88.6 per 100,000 in men and women, respectively). Despite the steep increase in its incidence, the age-standardized mortality rate of thyroid cancer has remained stable and 10-year relative survival rate is 99.2%. Increased detection using high-resolution ultrasonography may have contributed to the increased incidence of thyroid cancer if not all. However, the effectiveness of thyroid cancer screening using ultrasonography has not been fully evaluated as to whether screening and early diagnosis could decrease the morbidity or mortality of thyroid cancer. A multidisciplinary expert committee for developing a guideline for thyroid cancer screening was organized and established a recommendation for thyroid cancer screening using ultrasonography in Korea based on scientific evidence for the first time. In conclusion, the current evidence is insufficient to assess the balance of benefits and harms of the thyroid cancer screening by ultrasonography and the recommendation is that thyroid ultrasonography is not routinely recommended for healthy subjects.
Early Detection of Cancer ; Early Diagnosis ; Female ; Humans ; Incidence ; Korea ; Male ; Mass Screening* ; Mortality ; Survival Rate ; Thyroid Gland ; Thyroid Neoplasms* ; Ultrasonography

Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to provide guidance on the implementation of a surgical treatment of oral cancer. MEDLINE databases were searched for articles on subjects related to “surgical management of oral cancer” published in English. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. The quality of evidence was rated with use RoBANS (Risk of Bias Assessment Tool for Nonrandomized Studies) and AMSTAR (A Measurement Tool to Assess the Methodological Quality of Systematic Reviews). Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. Additional directives are provided as expert opinions and Delphi questionnaire when insufficient evidence existed. The Committee developed 68 evidence-based recommendations in 34 categories intended to assist clinicians and patients and counselors, and health policy-makers. Proper surgical treatment selection for oral cancer, which is directed by patient- and subsite-specific factors, remains the greatest predictor of successful treatment outcomes. These guidelines are intended for use in conjunction with the individual patient's treatment goals.
Advisory Committees ; Bias (Epidemiology) ; Carcinoma, Squamous Cell ; Counseling ; Expert Testimony ; Humans ; Mouth Neoplasms ; Neck ; Republic of Korea