OBJECTIVE:To study the clinical characters, management and the prognosis of patients with adenoid cystic carcinoma of the maxillary sinus.METHODS:The clinical data were analyzed retrospectively for 36 patients with adenoid cystic carcinoma of the maxillary sinus to evaluate the treatment results of different modalities. The contribution of every factors influencing on survival were also analyzed. Survival analysis was performed by life table method, comparison among/between groups was performed using log-rank test, and multivariate analysis was carried out using Cox proportional hazard model.RESULTS:The 5-year survival rate was 58.33% in all patients, while they were only 75.0% and 42.9% in stage III and stage IV lesions respectively. The 5-year survival rate of 66.7% was obtained in patients who received surgery combined with radiotherapy,71.4% and 12.5% respectively in those treated by surgery and by radiotherapy alone. Multivariate analysis indicated that stage, treatment modality, and the tumour residues in the primary treatment were the predict factors for the prognosis.CONCLUSIONS:Advanced adenoid cystic carcinoma should be treated by combined surgery and radiotherapy. Stage, treatment approach and short-term therapeutic response are the most important factors affecting the prognosis of the patients with adenoid cystic carcinoma of the maxillary sinus.

OBJECTIVE:To investigate the feasibility of submandibular gland transfer in preventing radiation-induced xerostomia in rabbits. METHODS: The left submandibular salivary gland was transferred to the submental space by operation in 7 New Zealand rabbits. Eight days after operation, the rabbits were given different doses (2-14 Gy) irradiation with the transferred one outside the irradiation scope. As the control group, the left submandibular gland was transferred to the submental space by operation in another 7 New Zealand rabbits that were not irradiated after the operation. Twenty weeks after the irradiation, the untransferred and transferred submandibular glands were removed to observe the late morphologic changes. RESULTS: The histopathology of the untransferred rabbit submandibular glands in the experimental group: Twenty weeks after the radiation, doses of 6 and 8 Gy caused wideness of some spaces between acni, decrease of seromucous acini, apparent atrophy of seromucous acini, the fibrous tissue thickened; 20 weeks after radiation, doses of 10-14 Gy causes apparent wideness of the spaces between acni, local necrosis of acini, apparent atrophy of acini, pronounced reduction of serous granules in the cell of serous ducts, necrotic cell segments in the ducts. The fibrous tissue increased and thickened, especially around the striated ducts. The histopathology of the transferred rabbit submandibular glands in the experimental group: No significant difference was found in any histologic parameter between the transferred (shielded) submandibular glands in the experimental group and the untransferred submandibular glands in the control group. CONCLUSION: The rabbit's submandibular gland transferres to the submental space is protected successfully by avoiding direct radiation.

BACKGROUND & OBJECTIVE:The early diagnosis of head and neck squamous cell carcinoma (HNSCC) is the key factor that affecting the treatment result. We performed surface-enhanced desorption ionization time-of-flight mass spectrometry (SELDI-TOF-MS) using a multi-layer artificial neural network (ANN) to develop and evaluate a proteomic diagnosis approach for HNSCC.METHODS:Serum samples from 74 HNSCC patients and 146 healthy individuals were randomized into training set (148 samples) and test set (72 samples). At first, we detected the training set of samples using SELDI mass spectrometry and WCX2 (weak cation-exchange) chips. Using a multi-layer ANN with a back propagation algorithm, we identified a proteomic pattern that could discriminate cancer from control samples in the training set. The discovered pattern was then used to determine the accuracy of the classification system in the test set.RESULTS:Four top-scored peaks, at m/z (mass/charge) ratio of 4 469 u, 5 924 u, 8 926 u, and 16 697 u, were finally selected as the potential biomarkers for detection of HNSCC with both sensitivity and specificity of 100.0% in the training set. The classifier predicted the HNSCC with sensitivity of 85.7%(18/21) and specificity of 96.1%(49/51) in the test set.CONCLUSION:SELDI profiling is a useful tool to accurately identify patients with HNSCC.

BACKGROUND & OBJECTIVE:Vascular endothelial growth factor-C (VEGF-C) could induce lymphangiogenesis in or around solid tumor, and is closely related with lymphatic metastasis. This study was to investigate the expression and clinical significance of VEGF-C and its receptor fms-like tyrosine kinase-4 (Flt-4) in tongue squamous cell carcinoma (TSCC).METHODS:The expression of VEGF-C and Flt-4 in 99 specimens of TSCC and 17 specimens of benign tongue epithelial lesions was detected by LSAB immunohistochemistry. The correlations of expression of VEGF-C and Flt-4 to the clinicopathologic features and prognosis of TSCC were analyzed.RESULTS:The positive rates of VEGF-C and Flt-4 were significantly higher in TSCC than in benign tongue epithelial lesion (35.35% vs. 5.88%, and 40.40% vs. 5.88%, P<0.05). The positive rate of VEGF-C was significantly higher in TSCC with cervical lymph node metastasis than in TSCC without metastasis (43.75% vs. 20%, P<0.05), and significantly lower in stage I-II TSCC than in stage III-IV TSCC (18.52% vs. 41.67%, P<0.05). The cumulative 5-year survival rates of the patients with positive expression of either VEGF-C or Flt-4 were significantly lower than those of the patients with negative expression of either VEGF-C or Flt-4 (45.08% vs. 68.25%, and 38.03% vs. 75.46%, P<0.05).CONCLUSIONS:The positive rates of VEGF-C and Flt-4 are significantly higher in TSCC than in benign tongue epithelial lesions. The expression of VEGF-C is correlated with cervical lymph node metastasis and clinical stage. The prognosis of TSCC patients with high expression of VEGF-C and Flt-4 is poor.

OBJECTIVE:To explore the clinical characteristics and the survival status of the patients with laryngeal squamous cell carcinoma in the multiple primary cancers (MPC).METHODS:Follow-up and clinical data were analyzed retrospectively in 81 laryngeal squamous cell cancer patients with MPC among 1101 patients with laryngeal carcinoma. Survival analysis and every influencing factor on survival rate were performed by Kaplan-Meier method.RESULTS:The occurrence rate of MPC in the patients with laryngeal squamous cell cancer was 7.4% (81/1101) in this report. Oral cavity carcinoma and nasopharyngeal carcinoma were the most common MPC in 29 cases (35.8%) in head and neck regions. MPC in head and neck regions were more often seen among patients who had treated with radiotherapy (chi2 = 5.7, P = 0.017). Lung carcinoma (25.9%, 21/81) and esophageal carcinoma (22.2%, 18/81) were the most common MPC in remote organs in 52 cases (64.2%). Thirty seven MPC cases (45.7%) were occurred in aerodigestive tract and 32 cases(39.5%) in respiratory tract in this series. Fourteen cases (17.3%) were synchronous MPC, the median time interval was 2 months. Other 67 cases (82.7%) were metachronous MPC, the median time interval was 28 months. The squamous cell carcinoma (66.7%) was the most common pathologic type among all MPC in 81 cases, which was more often seen among patients who had smoked and drunk (P = 0.007). The MPC of esophageal carcinoma and oropharyngeal carcinoma were more often seen among patients of supraglottic index cancer presentation (P = 0.04). The MPC of oral cavity cancers and nasopharyngeal carcinoma and lung carcinoma were more often seen among patients of glottic index cancer presentation (P = 0.006). The total three-and five-year survival rates were 45.2% and 29.7% respectively of all MPC patients, the five-year survival rate for patients (53 cases) who received actively different therapies for their MPC was 45.5%, obviously higher than that of untreated patients (28 cases) whose three-year survival rate was zero (P = 0.000).CONCLUSIONS:Lung carcinoma and esophageal carcinoma were the most common multiple primary cancers among MPC of the laryngeal cancer. MPC of the laryngeal cancer in head and neck regions were more often seen among patients who had treated with radiotherapy. The pathologic type of squamous carcinomas of MPC was more often seen among patients who had smoked and drunk. MPC affected the prognosis of patients in laryngeal cancer largely. Treating effectively and in time could help to improve the survival rate of patients with MPC in laryngeal squamous cell carcinomas.

BACKGROUND & OBJECTIVE:Laryngeal squamous cell carcinoma (LSCC) is a common malignancy of the head and neck. Stage I-II LSCC patients have a favorable prognosis after operation or radiotherapy, but the curative effect and prognosis of stage III-IV LSCC are not satisfying, and its treatment is also controversial. This study was to summarize our experience in treating stage III-IV LSCC patients, evaluate the treatment results, and seek more reasonable therapeutic modality.METHODS:Records of 202 stage III-IV LSCC patients, treated in Cancer Center of Sun Yat-sen University from Jan. 1, 1991 to Jan. 1, 2000, were retrospectively analyzed. Of the 202 patients, 64 received surgery alone, 83 received surgery and preoperative or postoperative radiotherapy, 41 received radiotherapy, and 14 received chemotherapy. The overall survival rate was estimated using life table method by SPSS10.0 software. Survival curves were compared with Wilcoxon method; relapse statuses were compared with Chi(2) test.RESULTS:The 5- and 10-year overall survival rates of the 202 patients was (42.12+/-3.62)% and (33.20+/-4.32)%, and the median survival time was 48.5 months. The 5-year survival rates were 61.07% in glottic carcinoma group and 26.07% in supraglottic carcinoma group, and were 53.41% in surgery alone group, 51.04% in surgery plus radiotherapy group, 18.33% in radiotherapy group and 7.14% in chemotherapy group. There was no significant difference between surgery alone group and surgery plus radiotherapy group (P>0.05). Of the 147 patients received surgery, the 5-year survival rates were 56.15% for the 31 patients received partial laryngectomy and 52.08% for the 116 patients received total laryngectomy. Eleven patients had tumor relapsed after total laryngectomy within 5 years.CONCLUSIONS:Surgery, especially total laryngectomy, is the major treatment modality for stage III-IV LSCC. Partial laryngectomy may be performed with strict selection. Postoperative radiotherapy may be preformed on the patients with suspect of tumor residue or positive margin.

BACKGROUND & OBJECTIVE:The most challenging problem in diagnosing thyroid nodules is to distinguish benign disease from malignant disease. Although fine-needle aspiration cytology (FNAC) is an important diagnostic procedure, its inherent limitations affect the diagnostic accuracy. Therefore, this study was designed to search for biological markers which can distinguish benign lesion from malignant lesion of thyroid.METHODS:The expression of galectin-3 in 30 specimens of thyroid cancer, 10 specimens of thyroid adenoma, and 10 specimens of nodular thyroid goiter were detected by LSAB immunocytochemistry. The results of routine pathologic examination of gland species were set as golden standard.RESULTS:The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate of impression immunocytochemistry in detecting galectin-3 were 96.66%, 100.00%, 100.00%, 95.23%, and 98.00%, respectively; those of routine impression cytology were 86.66%, 100.00%, 100.00%, 83.33%, and 92.00%, respectively; those of fine-needle aspiration biopsy (FNAB) were 86.66%, 100.00%, 100.00%, 83.33%, and 92.00%, respectively; those of FNAC were 76.66%, 100.00%, 100.00%, 74.07%, and 86.00%, respectively. Galectin-3 was commonly expressed in well-differentiated thyroid carcinoma, but didn't express in thyroid adenoma and nodular thyroid goiter.CONCLUSIONS:Galectin-3 is commonly expressed in thyroid malignant lesions, but not in benign lesions. Immunocytochemistry assay can distinguish well-differentiated thyroid carcinoma from thyroid adnoma and nodular thyroid goiter.

BACKGROUND & OBJECTIVE:Cervical lymph node metastasis and recurrence are the most common causes of treatment failure to patients with oral tongue carcinoma. The neck management for oral tongue carcinoma of early stages remains controversial. This study was to evaluate the effectiveness of elective neck dissection (END) in treating oral tongue squamous cell carcinoma (SCC) of stage I.METHODS:A retrospective analysis of 95 patients with oral tongue SCC of stage I, undergone surgical treatment from 1988 through 1997, was performed to determine the impact of END on patients' outcomes,such as regional recurrence,and overall survival. Of the 95 patients, 24 (observation group) did not undergo END, while the rest 71 (END group) underwent END.RESULTS:In observation group, the regional recurrence rate was 25.0% (6/24), and the recurrence-related mortality was 20.8% (5/24). END significantly reduced both the regional recurrence rate and the recurrence-related mortality to 7.0% (5/71) and 4.2% (3/71) respectively (Chi(2) test, P < 0.05). The overall survival rate of END group was also significantly higher than that of observation group (log-rank test, P < 0.05).CONCLUSION:END may improve the neck control rate of oral tongue SCC of stage I, reduce the recurrence-related mortality, and increase the overall survival rate of patients.

Objective: To analyze the patterns of relapse and management options in unknown primarycervical metastatic carcinoma (UPCMC) as well as to discuss its treatment strategies. Methods: Clinicaldata of 111 cases of eligible UPCMC were retrospectively studied. Neck control, primary relapse and long-term survival were compared among different groups. Results: Primary carcinomas ultimately appearedin 12 cases (10.8%, 12/111). Neck control rate was 36.9%. Overall 5-year survival rate was 41.4%. Neckcontrol, N stage and primary control were prognostic factors for UPCMC. Neck control was affected byN stage and whether or not comprehensive radiotherapy was administered. Conclusion: UPCMC shouldprimarily be treated by radiotherapy except for cases with N1 or N2 insensitive to radiation. Bilateral necksradiotherapy is the optimal choice in terms of neck radiotherapy. Selective total pharyngeal irradiation isrecommended for potential primary treatment.

Objective Functional neck dissection was first described by Bocca and Pignataro in 1967. It has been used in clinical practice for years, but remains controversial among neck-surgery experts. This study was designed to evaluate indications and curative effects of functional-neck dissection (FND). Methods One hundred and fifty-two cases which underwent FND were reviewed with an analysis of pathological specimens and follow-up datas. Results The series of FND included 20 cases of tongue carcinoma, 23 cases of larynx carcinoma, 96 cases of thyroid papillary adenocarcinoma, 9 cases of follicular adenocarcinoma and 4 cases of medullary adenocarcinoma; the five-year recurrence rate for tongue carcinoma was 12.5%, 14.3%, 40.0% and for a larynx carcinoma was 20.0%, 16.7%, 50.0% in N 0 stage, N 1 stage, N 2a stage, respectively. The 5-year recurrence rate of thyroid papillary adenocarcinoma was 6.5%, 7.1% in N 1a , N 1b , respectively. Conclusion Functional neck dissection is indicated in early and low malignant head and neck neoplasms and results in satisfactory curative effects.

BACKGROUND & OBJECTIVE Few research of surgery for superior mediastinal metastasis from thyroid carcinoma has been reported. Previous surgical approach from neck had the problems of easy damage of nerve and vessels and the difficulty of clearance of lymph nodes. This study was designed to assess the value of systemic superior mediastinal lymph node dissection via sternotomy for superior mediastinal metastasis from differentiated thyroid carcinoma. METHOD A retrospective study was performed to analyze the clinical pathologic data as well as the outcome of 12 cases of differentiated thyroid carcinoma treated with systemic superior mediastinal lymph node dissection via sternotomy approach from April 1995 to April 2002, including 7 cases of papillary adenocarcinoma and 5 cases of medullary carcinoma. RESULTS Pathologically, the incidence rates of metastasis to anteriotracheal lymph node, paratracheal lymph node, anterior superior vena cava, and anterior innominate artery lymph nodes were 55.6% (25/45), 57.1% (36/63), 42.1% (8/19) and 30% (3/10), respectively. All cases are still alive in one to seven years follow-up period. The median follow-up was 32 months. Upper mediastinal lymph nodes were recurrent in one case; distant metastasis occurred in two cases. CONCLUSION Systemic superior mediastinal lymph node dissection via sternotomy approach can be employed in treating superior mediastinal lymph node metastasis from differentiated thyroid carcinoma due to its safety and relatively satisfactory outcome.

BACKGROUND & OBJECTIVE:Survivin, a new described member of the family of apoptosis inhibitory proteins (IAP), is undetectable in normal tissue of adults, but abundantly expressed in a variety of human malignancies. This study was designed to examine the expression of Survivin in laryngeal squamous cell carcinoma, analyze the relationships between the expression of Survivin and prognostic factors including age, gender, clinical stage, T stage, N stage, classification, histology and recurrence, to investigate its significance on prognosis.METHODS:Clinical information and paraffin- embedded tumor samples of 81 cases laryngeal squamous cell carcinoma (LSCC) patients, who were treated at Cancer Center of Sun Yat-sen University between 1997 and 1998, were collected. Tissue chip was made, and SP method was performed to analyze Survivin expression in tumor tissue and adjacent normal laryngeal mucosa. SPSS 10.0 software was used. Kaplan-Meier method was used for survival analysis, and log-rank test was used for data analysis; multivariate analysis was carried out using Cox proportional hazard model.RESULTS:The overall 5-year survival rate for patients with laryngeal squamous cell carcinoma in this study was 58.33%. The over-expression rate of Survivin in tumor tissue and adjacent normal laryngeal tissue were 50.62%, 0%, respectively (P< 0.05). The positive Survivin expression group(5-year overall surivial rate: 22.06%) had a worse prognosis than that of negative group (5- year overall survival rate: 92.33%)(P< 0.05). The univariate analysis showed that clinical stage, T stage, N stage, histology grade, recurrence, and Survivin expression were the most important prognostic factors (P< 0.05). The Chi(2) test results showed that the expression of survivin was correlated with clinical stage, T stage, N stage, histology grade and recurrence (P< 0.05); Multivariate analysis results showed that clinical stage, survivin expression, and recurrence were independent prognosis factors on survival in LSCC patients.CONCLUSIONS:The expression of Survivin is an important biological factor affecting the prognosis; Tissue chip method can be simply and efficiently used in large scale of retrospective study in laryngeal squamous cell carcinoma.

BACKGROUND & OBJECTIVES:At present head and neck surgeons from many countries have different opinions on management of well-differentiated thyroid cancer (WDTC). We will discuss WDTC invading trachea surgical treatment and its clinical significance.METHODS:Retrospectively reviewed clinical data of 15 cases WDTC invading trachea, According to WDTC invading extent and grade, there were 3 kinds of surgical approaches: 1) end to end anastomosis; 2) tissue flap reconstruction; 3)larynx-tracheal dissociation.RESULTS:15 cases underwent radical resection and reconstruct the defect of tracheal or larynx-tracheal dissociation. 2 cases received directly suture, 5 cases received sternocleidomastoid muscle flap reconstruction, 2 cases received pectorlis major muscle flap reconstruction, 2 cases received platysma flap reconstruction, 2 cases received free forearm flap with muticore titanium-board reconstruction, 2 cases received larynx-tracheal dissociation with larynx block out and tracheal fistula. 10 cases (10/15, 66.7%) received decannulation postoperation. Patients who were success fully decannulated could recover phonation and maintain airway breath. In the 5 patients who couldn't decannulate, underwent sternocleidomastoid muscle flap reconstruction, 1 underwent free forearm flap with muticore titanium-board reconstruction, 1 underwent pectorlis major muscle flap reconstruction, 2 underwent larynx-tracheal dissociation, but all of them could hardly utter voice by compress tracheostoma and needed permanent tracheostoma due to collapse of trachea. The recurrence rate of our group is 33.33%, 5 years survival rate is 88.89%.CONCLUSIONS:WDTC with trachea invading easily cause dyspnea or emptysis influencing on 5 years survival rate. We should take more actively surgical approach to resect all the tumor and involved organ, thus improve survival rate and reduce recurrence postoperation.

OBJECTIVE:This study was designed to evaluate whether sentinel node (SN) biopsy can accurately assess the cervical lymph node status of oral tongue carcinoma, as well to research the best method and indications of SN biopsy.METHODS:Preoperative lymphoscintigraphy with (99m)Tc-SC and intraoperative sentinel node mapping with methylene blue dye were administered on 20 cases of oral tongue carcinoma with cN(0) neck and 5 cases with cN(+) neck; routine pathological examination was used to assess the status of SNs. The results of routine pathological examination of cervical specimen were set as golden standard to assess the efficacy of SN biopsy in evaluating the cervical lymph node status.RESULTS:53 SNs were detected in 24 cases out of the total 25 cases (96%), averaging 2.2 SNs per case. SNs were detected in all 20 cases with cN(0) neck, in which 4 cases with occult cervical metastasis were detected by SN diopsy, without false negative case found in the procedure. In 5 cases with cN(+) neck, SNs were detected in 4 cases. In 4 cases whose SNs were detected, there were 5 cN(+) necks, out of which SNs were detected in 4 cN(+) necks but failed to predicted the cervical lymph node status in 2 necks. However, SNs were detected in 2 out of the other 3 cN(0) necks, both of which were diagnosed as SN(+)pN(+).CONCLUSIONS:Nuclear lymphoscintigraphy and blue dye mapping can be used to trace the SNs in cases with oral tongue carcinoma, with satisfactory detective rate. SN biopsy can accurately evaluate the cervical lymph node status in cases of oral tongue carcinoma with cN(0) neck. Whether it can be used to evaluate the lymph node status of the cN(0) neck in case with a contralateral cN(+) neck is worthy of further research.

BACKGROUND & OBJECTIVE:At present, whether neck dissection should be employed in squamous cell carcinoma (SCC) of the tongue with clinically node negative neck(cN0) is still controversial. This study was designed to explore the regularity of cervical lymph node metastasis in SCC of the mobile part of the tongue, and to discuss the theories and principles of employment of selective neck dissection in cN0 cases.METHODS:A retrospective research was performed on clinical data of 214 cases of SCC of the tongue treated with surgery from 1991 to 1997. Distribution of cervical lymph node metastasis of cN0 pN(+)= (pathologically node positive) and cN(+) (clinically node positive) pN(+)= cases were analyzed; the survival rates of different groups were compared; the factors that impact the survival of SCC of the tongue were screened out by Cox regression analysis.RESULTS:Cervical lymph node metastases were found in 69 cases. The metastatic rate was 32.2%. Metastases occurred in level I, II, III, IV, V of the ipsilateral neck were 22.3%, 33.5%, 22.3%, 4.6%, 1.0%, in level I,II,III, IV,V of the contralateral neck were 6.6%, 3.6%, 3.0%, 2.0%, 0.5%, respectively. The 5-year survival rates of the pN(+)= group and the pN0 group were 47% and 83%, respectively(P< 0.001). T stage and N stage were independent factors that impact the long-term outcome of SCC of the tongue.CONCLUSION:Level I,II,III of the ipsilateral neck tend to be involved when cervical lymph node metastases occur. Selective neck dissection can be used to treat the cervical metastasis in cN0 cases, as well as to evaluate the cervical lymph node status in order to determine whether comprehensive neck dissection should be employed.

BACKGROUND & OBJECTIVE:Occult cervical lymph node metastasis in squamous cell carcinoma of tongue has regularity and influence on the prognosis of patients. This study was designed to investigate the characteristics of occult cervical lymph node metastasis in squamous cell carcinoma of tongue and their influence on the prognosis to provide clinical bases for elective supraomohyoid neck dissection. METHODS:The data of 164 patients with squamous cell carcinoma of tongue who were treated in cancer center, Sun Yat-sen University, from 1990 to 1996 were reviewed. The characteristics of occult cervical lymph node metastasis in squamous cell carcinoma of tongue and their influence on the prognosis were analyzed. RESULTS:The rate of occult cervical lymph node metastasis of squamous cell carcinoma of tongue was 25.71%. The most common site of occult cervical lymph node metastasis was ipsilateral level II, and followed by ipsilateral level I and III. 82.98% of the lymph nodes of occult metastasis occurred in the above three levels. Most cervical lymph nodes of occult metastasis were found within two years after the first operation (33/36). There was significant difference of the prognosis between the group of dominant or occult cervical lymph node metastasis and the group of without cervical lymph node metastasis in squamous cell carcinoma of tongue (log-rank,P< 0.01); whereas there was no significant difference of the prognosis between the group of dominant cervical lymph node metastasis and the group of occult cervical lymph node metastasis according to log-rank test (P >0.05). CONCLUSION:The ipsilateral level I to level III were the common regions where occult cervical lymph node metastasis occurred. The authors suggest that elective supraomohyoid neck dissection may be applied to clinically negative neck of the patients with squamous cell carcinoma of tongue who were prone to metastasize latently. Occult cervical lymph node metastasis influences the prognosis of patients with squamous cell carcinoma of tongue significantly.

BACKGROUND & OBJECTIVE:Some clinical and histopathological features of squamous cell carcinoma of tongue (TSCC) were closely associated with occult cervical lymph node metastasis (OCLNM). This study was designed to investigate the correlation between occult cervical lymph node metastasis in squamous cell carcinoma of tongue and the clinicopathological indexes of primary tumor tissue. METHODS:Thirty-five TSCC patients with OCLNM treated in Cancer Center, Sun Yat-sen University from 1988 to 1996 were enrolled. According to random principle, 35 TSCC patients without OCLNM at the same period were selected. Tumor deepness was measured and pathological parameters were assessed under microscope. RESULTS:The rates of OCLNM in group of infiltrative plus ulcerative type, group of infiltrative type, group of ulcerative type and group of exogenous type were 70.37%, 41.67%, 40.00%, and 27.27%, respectively; the rates of OCLNM in T1, T2, and T4 were 44.00%, 43.48%, and 62.64%, respectively. The rates of OCLNM in groups of tumor deepness < 4 mm, 4-7.9 mm, and > or = 8 mm were 14.29%, 61.54%, and 88.89%, respectively. The rates of OCLNM in groups of response of peritumoral lymphocyte +, ++ and +++ were 73.68%, 58.62%, and 18.18%, respectively. The rates of OCLNM in groups of with vascular invasion and without vascular invasion were 85.71% and 46.03%, respectively. The rates of OCLNM in groups of well, moderate, and poor differentiation were 52.63%, 42.31%, and 66.67%, respectively. The rates of OCLNM in groups of invasive patterns of type I, type II, type III, and type IV were 40.90%, 50.00%, 52.00%, and 80.00%, respectively. Univariate analysis indicated that OCLNM in TSCC was closely associated with gross appearance of primary tumor, tumor deepness, response degree of peritumoral lymphocyte and vascular invasion (P < 0.05), but was not associated with T stage, pathological differentiation, and invasion way (P > 0.05); Logistic multivariate analysis manifested that only tumor deepness and response degree of peritumoral lymphocyte significantly correlated with OCLNM in TSCC. CONCLUSION:There was significant correlation between gross appearance of primary tumor, tumor deepness, response degree of peritumoral lymphocyte and vascular invasion and OCLNM in TSCC. These parameters can be used to predict occult cervical lymph node metastasis in TSCC.

BACKGROUND & OBJECTIVE:Minor salivary gland carcinoma of the hard palate is rare, and its long-term survival rate is high, making it difficult to evaluate the prognostic factors and the efficacy of treatment. This study was designed to evaluate the efficacy of treatment and investigate the prognostic factors of minor salivary gland carcinoma of the hard palate. METHODS:Ninety-six cases of minor salivary gland carcinoma of the hard palate hospitalized in Cancer Center, Sun Yat-sen University, from 1964 to 2001 were reviewed retrospectively. The cumulative survival rate was analyzed by Kaplan-Meier method. The factors were compared using the log-rank test. The influencing factors were screened by Cox proportional hazards model. RESULTS:The 5- and 10-year overall survival rates were 65.60% and 47.90%, respectively. The 5- and 10-year disease-specific survival rates for the patients treated with surgery (53 cases) and surgery + radiotherapy (35 cases) were 73.14%, 67.40% and 66.58%,46.60%,respectively. Multivariate analysis showed that age >or=50 years old,tumor size >or=3 cm,surgical margin status,and recurrence were independently associated with decreased survival rates (P< 0.05). CONCLUSION:Surgery or surgery dominated multi-modality therapy was the principal treatment modality for minor salivary gland carcinoma of the hard palate. Age >or=50 years old, tumor size >or=3 cm, surgical margin status, and recurrence are independent factors affecting the prognosis.

BACKGROUND & OBJECTIVE:There is controversy in therapy strategy for the cN0 squamous cell carcinoma of the tongue. The aim of this study was to explore the relative factors of prognosis for the cN0 squamous cell carcinoma of the tongue and to identify the risk population.METHODS:Cox regression model was used to analyze the clinical data of 109 patients with cN0 tongue cancer treated in Cancer Center, Sun Yat-sen University from January 1990 to March 1998. The prognostic index (PI) of the patients was calculated on basis of the results of multivariate analysis. According to the individualized PI, the patients were classified to different hazard groups.RESULTS:The 3, 5 years survival rates were 74.40%and 69.31%, respectively. Multivariate analysis showed the prognosis statistically correlated with T grade, therapy manner of primary tumor, differentiation grade, age, and occult neck lymph node metastasis. T stage was found to be the most important prognostic factor. The prognosis of the patients in comprehensive therapy group is better than that in surgery alone group, chemotherapy alone,or radiotherapy alone group. The patients with tongue carcinoma in low differentiation group, the older group, or occult neck lymph node metastasis group showed a poor prognosis. The patients were divided into high-risk group,moderate-risk group, and low-risk group according to the PI value and there was significant difference in the survival rates between each two groups of the three groups (P< 0.05), and the 5-year survival rates were 83.33%, 64.12%, and 27.65%, respectively.CONCLUSION:The prognosis of cN0 squamous cell carcinoma of the tongue is associated with T grade, therapy manner of primary tumor, differentiation grade, age, and occult neck lymph node metastasis. PI value could be used to predict the prognosis of the patients with the cN0 squamous cell carcinoma of the tongue.

OBJECTIVETo study the diagnosis and treatment of a second primary malignant tumor induced by previous radiotherapy.METHODSFrom March 1970 to March 1997, 108 nasopharyngeal cancer (NPC) patients who developed a second primary malignant tumor induced by radiotherapy were treated. There were squamous carcinoma 43 (39.8%), sarcoma 26 (24.1%), malignant fibrous histiocytoma 14 (13.0%), adenoid cystic carcinoma 12 (11.1%), thyroid papillary adenocarcinoma 8 (7.4%) and malignant melanoma 5 (4.6%). Fifty patients underwent operation, 32 received radiotherapy, 18 received chemotherapy and 8 received operation combined with chemotherapy.RESULTSThe 3- and 5-year tumor-free survival rates were 64.0% and 36.0% in the operation group. They were 34.4% and 18.8% in the radiotherapy group.CONCLUSIONSurgery, if not contra-indicated, is the first choice for the second primary malignant tumor induced by radiotherapy. Aggressive treatment for these patients is, hence, indicated clinically.