An Kui Yang

Endoscopic nasopharyngectomy for locally recurrent nasopharyngeal carcinoma.

Nasopharyngectomy is the primary treatment for locally recurrent nasopharyngeal carcinoma (rNPC). However, oncological nasopharyngectomy is difficult to achieve, even using extranasal surgical approaches, with potential risks of severe functional disabilities and serious complications. This report introduces an innovative, minimally invasive, oncological, endoscopic nasopharyngectomy.

Treatment and prognosis in sinonasal mucosal melanoma: A retrospective analysis of 65 patients from a single cancer center

The purpose of this study was to evaluate the outcome in sinonasal mucosal melanoma (SMM).

Adenoid Cystic Carcinoma of the Nasopharynx: 27-Year Experience

Objective/Hypothesis: Nasopharyngeal adenoid cystic carcinoma (NACC) is a rare malignancy with special biological features. Clear consensus is not available regarding the clinical characters, management approaches, and prognostic factors. We presented one institutions experience with this tumor and the outcomes of treatment.

Treatment and prognosis of oral mucosal melanoma

To evaluate the treatment and prognosis of oral mucosal melanoma (OMM) and provide basic data for clinical treatment. Retrospective analysis of clinicopathological data on OMM from January 1976 to December 2005. Survival analysis was performed and Kaplan-Meier analysis was used to compare the effects of clinicopathological factors on survival using SPSS 18.0 software. A Cox model was applied for multivariate analysis. The 3-year and 5-year overall survival (OS) rates of 51 cases of OMM were 35.0% and 20.7%, respectively. Lymph node metastatic sites were predominantly at levels Ib-III (29/31, 93.5%). Patients of age ≥55 years and size ≥4 cm had a lower survival rate than those of aged <55 years and size <4 cm. The 3-year OS and 5-year OS of patients who underwent surgery combined with biotherapy or biochemotherapy (70.1% and 58.4%, respectively) were significantly higher than that of patients who underwent other therapeutic regimens (including surgery, chemotherapy, surgery combined with radiotherapy or surgery combined with chemotherapy) (25.0% and 12.5%, respectively). Multivariate analysis showed that surgery combined with biotherapy or biochemotherapy and neck dissection were effective treatments for OMM. Patients aged ≥55 years had a worse prognosis than those aged <55 years. OMM has a poor prognosis, but multimodality treatment including surgery combined with biotherapy may improve the prognosis. In patients aged ≥55 years with tumor size ≥4 cm, increasing the scope of resection may be effective. Elective levels I-III neck dissection should be considered in TanyNOMO cases.

Decreased expression of SATB2: A novel independent prognostic marker of worse outcome in laryngeal carcinoma patients

Background To investigate the expression and role of special AT-rich sequence-binding protein-2 (SATB2) in laryngeal squamous cell carcinoma (LSCC) tissue and cell line (HEp2), and to evaluate the clinical and prognostic significance of SATB2 protein in patients with LSCC. Methods The expression of SATB2 was examined in LSCC tissue and HEp2 cells by Western-blotting, Real-time PCR and immunohistochemical staining. Cell growth curve assay and colony formation assay were used to verify the effect of SATB2 on the proliferation and tumor progression ability of HEp2 cells. Tumor formation assay in nude mice was used to analyze the effect of SATB2 on the tumorigenicity of HEp2 cells. Results The status of SATB2 protein in carcinoma tissues is much lower than that in paracarcinoma tissues. The overall survival of the patients with high SATB2 expression was significantly higher than the low SATB2 expression group. Lower or negative SATB2 expression was significantly correlated with advanced clinical staging, histological grade and tumor recurrence. In vitro experiments demonstrated that over-expression of SATB2 in HEp2 cells inhibited cell proliferation and tumor progression ability, and down-regulation of SATB2 showed the opposite effects. Over-expression of SATB2 repressed the tumorigenicity of HEp2 cells by in vivo experiments. Moreover, multivariate analysis suggested that SATB2 expression might be an independent prognostic indicator for the survival of LSCC patients after curative surgery. Conclusions SATB2 might involve in the development and progression of LSCC as a tumor suppressor, and thereby may be a valuable prognostic marker for LSCC patients.

COX-2 Gene increases tongue cancer cell proliferation and invasion through VEGF-C pathway

COX-2 induces the proliferation and invasion of oral squamous cell carcinoma. In the present study, the role of the COX-2 gene in the tongue cancer cell proliferation and invasion was investigated. A short hairpin RNA (shRNA)method was used to knock down COX-2 gene expression and investigate the relationship between COX-2 and VEGF-C, and the role of the COX-2 gene for proliferation and invasion was also investigated in the tongue cancer cell Tca8113. COX-2 gene overexpressed in tongue cancer cell line. Suppressing the expression of COX-2 by shRNA could decrease cell proliferation comparing with control shRNA. Nevertheless, depressing COX-2 gene expression by shRNA reduced VEGF-C expression on both mRNA and protein levels. VEGF-C gene expression could be regulated by COX-2 gene. Our results suggested that COX-2 played essential roles in the proliferation and metastasis of tongue cancer, and COX-2 could serve as a potential chemotherapy target for tongue cancer.

Primary salivary gland type carcinoma of the nasopharynx: Therapeutic outcomes and prognostic factors

Primary salivary gland type nasopharyngeal carcinoma (SNPC) is a rare malignancy with diverse clinical behavior and different prognoses. Previous studies have reported on limited patient populations, and few long‐term studies have outlined outcomes and prognostic factors. Furthermore, controversy exists as to the treatment policy of SNPC. The aim of this study was to define management approaches, therapeutic outcomes, and prognostic factors of SNPC.

Elective neck dissection in clinical stage I squamous cell carcinoma of the tongue: Does it improve regional control or survival time?

The objective of this study was to evaluate whether elective neck dissection could improve regional control or survival time in clinical stage I squamous cell carcinoma of the oral tongue (OTSCC). This was a retrospective study of patients with surgical treatment between January 1991 and December 2003. A total of 131 patients were included in the study, and all of them received operation of the primary site, while 88 cases underwent selective neck dissection simultaneously including level I-III neck dissection in 49 patients and level I-V neck dissection in 39 patients. In all these cases, the rate of occult neck metastases was 23.7%. The 4-year local control rates in patients with only primary site treatment, patients with level I-III neck dissection and patients with level I-V neck dissection were 81.0%, 83.6% and 89.1%, respectively. By univariate analyse, neck dissection did not increase regional control rate, disease free survival (DFS) or overall survival (OS). Multivariate analyses showed that neck dissection was not an independent factor for DFS or OS. This study showed that the occult neck metastases rate was 23.7% in clinical stage I OTSCC. Elective neck dissection did not significantly improve regional control, DFS and OS in clinical stage I patients. There is a need for accurate and valid methods to select the patients who would benefit from elective neck treatment.

External monitoring of buried radial forearm free flaps in hypopharyngeal reconstruction

Abstract Conclusion: The radial forearm free flap (RFFF) is one of the optimal choices for hypopharyngeal reconstruction. Our series demonstrates that the technique of an indicator flap for the monitoring of the buried flap is simple, reliable, and inexpensive. The condition of the indicator flap can be easily interpreted by the physicians and the nursing staff. Therefore, the success rate of this microsurgical reconstruction may be improved. Objectives: The RFFF is increasingly applied in reconstruction of the hypopharynx after radical resection for advanced hypopharyngeal cancer. However, postoperative monitoring of the buried free flap is extremely difficult. We designed a small external component as an indicator flap to monitor the perfusion of the buried vascular pedicle. Methods: Eight consecutive patients with hypopharyngeal cancer underwent radical surgery and hypopharyngeal reconstruction using RFFF at the Sun Yat-sen University Cancer Center between January 2005 and January 2007. The indicator flap was sutured to the surface of the neck for postoperative monitoring. Results: All of the indicator flaps remained viable. One patient experienced vascular compromise and was successfully salvaged. The success rate of the buried flaps was 100%. Pharyngocutaneous fistula occurred in one patient. All patients resumed an oral diet eventually.

Anatomical study and modified incision of the infrahyoid myocutaneous flap

Skin paddle necrosis and neck function damage, particularly rotation, are two problems associated with the infrahyoid myocutaneous flap clinical application. The aim of this study was to investigate vessel supply and drainage of the skin paddle and to report our modified flap incision technique. In this work, we conducted a cadaveric study and reviewed our experience with the modified incision and describe the surgical procedure. We confirmed the platysma muscle branch feeds the skin paddle overlying the infrahyoid myocutaneous flap. The length between the platysma muscle branch entry point and its originating point measured 3.38 (min 2.51, max 4.52) cm. The flap has two drainage systems. The skin paddle of the flap was drained by the anterior jugular vein and external jugular vein, respectively, or both. The infrahyoid muscles were drained by the superior thyroid vein. In the early four cases, where the platysma muscle branch was not protected, skin paddle necrosis appeared in two cases. In the later seven cases, which involved preservation of the platysma muscle branch, all flaps successfully survived. Patients in whom a modified incision was used all achieved both satisfactory rehabilitation of neck function and an adequate esthetic result. We conclude that the necrosis rate of the skin paddle of the flap can be reduced by carefully protecting its supply and drainage vessels. The modified incision can improve neck function postoperatively.