Duanshu Li

Clinicopathologic study of 1176 salivary gland tumors in a Chinese population: experience of one cancer center 1997-2007.

Abstract Conclusion: Chinese patients have a higher rate of lymphoepithelial carcinoma (LEC) and salivary duct carcinoma (SDC). Comprehensive use of diagnostic modalities, neck dissection, and postoperative radiation will improve the treatment results for salivary gland tumors (SGTs). Objectives: To study the clinicopathological characteristics of SGTs in a Chinese population. Methods: The records of SGT patients operated in a tertiary cancer hospital of China were retrieved. Results: From December 1997 to December 2007, 289 malignant and 887 benign SGTs were operated at Cancer Hospital, Shanghai, China. Pleomorphic adenoma and Warthins tumor were the most common types of SGT. Mucoepidermoid carcinoma (24.6% of malignant cases) and adenoid cystic carcinoma (18.0%) were the most frequent malignant cases, followed by acinic cell carcinoma (12.1%), LEC (9.7%), and SDC (9.3%). The sensitivity and specificity of ultrasound scan, fine needle aspiration biopsy, and frozen section were 58.3 and 88.6%, 87.2 and 96.7%, 86.9 and 99.6%, respectively. Neck dissections and postoperative radiation were carried out for 48.6 and 48.0% of carcinomas, respectively. The percentage of tumors by pathologic TNM stage were 23.7% for stage I, 32.9% for stage II, 17.3% for stage III, and 26.1% for stage IV. The 5-year overall survival rate was 88.0%.

Preoperative CT diagnosis of right nonrecurrent inferior laryngeal nerve

The nonrecurrent inferior laryngeal nerve is an anomaly associated with the absence of the brachiocephalic artery (BCA) and the presence of arteria lusoria.

New clinical features of thyroid cancer in eastern China

OBJECTIVEnAnalyze recent clinical features of thyroid cancer in eastern China.nnnMETHODSnInvestigation and comparison of clinical data of thyroid cancer patients from 1996 to 2006 from the Department of Head and Neck Surgery in the Cancer Hospital of Fudan University, Shanghai, China.nnnRESULTSnThe number of patients with thyroid cancer rose from 148 in the year 1996 to 572 in the year 2006, a 3.9-fold increase. Routine ultrasound survey during physical examination revealed four cases (2.7%) in 1996 and 285 cases (49.8%) in 2006. The sensitivity of the ultrasound survey in thyroid cancer diagnosis was 86.66% in 1996 and 88.20% in 2006 (P>0.05). Papillary carcinoma was most prevalent (87.8% in 1996 and 92.8% in 2006). An increasing proportion of small tumors was found. The incidence of microcarcinoma was 35.7% in 2006 in contrast with 20.3% in 1996 (P<0.01). Moreover, tumors with diameter from 1 to 2 cm were found in 38.5% patients in 2006 as opposed to 27.0% in 1996 (P<0.01). Extrathyroid extension was reported in 46 (31.1%) patients in 1996, but only in 39 (6.8%) in 2006 (P<0.01). Central cervical lymph node metastases were found in 98 (66.2%) patients in 1996, contrasting with 301 (52.6%) in 2006 (P<0.05). Thirty-seven (25.0%) patients had lateral cervical lymph node metastasis in 1996 compared with 117 (20.5%) in 2006 (P>0.05). Last, the proportion of stage I cancers in 2006 was higher than that in 1996.nnnCONCLUSIONnWith the increasing incidence of thyroid cancer, cancer was discovered at an earlier stage. This is due to new clinical features of thyroid cancer, such as the decrease in tumor diameter, the lower rate of extrathyroid extension and of cervical lymph node metastasis. Routine ultrasound survey during physical examination has become the most common way to detect thyroid cancer. Increasing usage of diagnostic scrutiny, including the ultrasound survey, has most likely contributed to the increased incidence through detection of small thyroid cancers. Increased use of ultrasound to screen thyroid cancer in early stages should lead to better therapeutic outcome.

Outcome after intensity modulated radiotherapy for anaplastic thyroid carcinoma

BackgroundAnaplastic thyroid carcinoma (ATC) is a malignancy with one of the highest fatality rates. We reviewed our recent clinical experience with intensity modulated radiotherapy (IMRT) combined with surgery and chemotherapy for the management of ATC.Methods13 patients with ATC who were treated by IMRT in our institution between October 2008 and February 2011, have been analyzed. The target volume for IMRT was planned to include Gross tumor volume (GTV): primary tumor plus any Nu2009+u2009disease (66 Gy/33 F/6.6xa0W), with elective irradiation of thyroid bed, bilateral level II through VI and mediastinal lymph nodes to the level of the carina (54-60 Gy). Seven patients received surgical intervention and eleven patients had chemotherapy.ResultsThe median radiotherapy dose to GTV was 60xa0Gy/30 fractions/6xa0weeks. The median survival time of the 13 patients was 9xa0months. The direct causes of death were distant metastases (75%) and progression of the locoregional disease (25%). Ten patients were spared dyspnea and tracheostomy because their primary neck lesion did not progress.ConclusionThe results showed that IMRT combined by surgery and chemotherapy for ATC might be beneficial to improve locoregional control. Further new therapies are needed to control metastases.

STC2 promotes head and neck squamous cell carcinoma metastasis through modulating the PI3K/AKT/Snail signaling

The mammalian peptide hormone stanniocalcin 2 (STC2) plays an oncogenic role in many human cancers. However, the exact function of STC2 in human head and neck squamous cell carcinoma (HNSCC) is unclear. We aimed to examine the function and clinical significance of STC2 in HNSCC. Using in vitro and in vivo assays, we show that overexpression of STC2 suppressed cell apoptosis, promoted cell proliferation, migration, invasion, and cell cycle arrest at the G1/S transition. By contrast, silencing of STC2 inhibited these activities. We further show that STC2 upregulated the phosphorylation of AKT and enhanced HNSCC metastasis via Snail-mediated increase of vimentin and decrease of E-cadherin. These responses were blocked by silencing of STC2/Snail expression or inhibition of pAKT activity. Furthermore, clinical data indicate that high STC2 expression was associated with high levels of pAKT and Snail in tumor samples from HNSCC patients with regional lymph node metastasis (P < 0.01). Thus, we conclude that STC2 controls HNSCC metastasis via the PI3K/AKT/Snail signaling axis and that targeted therapy against STC2 may be a novel strategy to effectively treat patients with metastatic HNSCC.

Selective neck dissection for neck residue of nasopharyngeal carcinoma: A prospective study

PURPOSEnCervical residue or recurrence of nasopharyngeal carcinoma (NPC) is traditionally treated with radical neck dissection (RND). Because cervical residue patients with NPC exhibit better prognoses than patients with neck recurrence, selective neck dissection (SND) rather than RND may be the optimal treatment for these patients. This study was designed to evaluate the efficacy of SND for the management of neck residue of NPC.nnnMATERIAL AND METHODSnBetween January 2008 and July 2013, a total of 69 patients were assigned to undergo either RND or SND in the Department of Head and Neck Surgery at Fudan University Cancer Center. The patients clinical and pathological characteristics, complications, and treatment outcomes were evaluated and analyzed.nnnRESULTSnOur study consisted of 69 patients, including 51 in the RND group and 18 in the SND group. There was no significant difference in any clinical or pathological characteristic between the two groups. The overall survival (OS), disease-free survival (DFS), and regional-free survival of all the patients were 79.70%, 61.43%, and 83.30%, respectively, at 3 years and 66.81%, 47.43%, and 78.67%, respectively, at 5 years. No statistically significant difference was found in the OS, DFS, or regional-free survival between the RND and SND groups. The total complication rate was much lower in the SND group (11.11%) than in the RND group. The patients in the RND group experienced longer hospitalization and postoperative hospitalization than those in the SND group.nnnCONCLUSIONnSND was demonstrated to be safe and effective for the treatment of neck residue of NPC. The results indicated that patients with neck residue disease who are at stage II to III with a single enlarged lymph node (<1xa0cm) and only one positive pathological lymph node may benefit the most from SND.

Extracranial schwannoma in the carotid space: A retrospective review of 91 cases

Schwannomas of the vagus nerve and cervical sympathetic nerve are rare; hence, only limited information exists regarding their diagnosis and clinical management.

Clinicopathologic features and prognostic factors of diffuse sclerosing variant of papillary thyroid carcinoma: a populationbased analysis

Background: The diffuse sclerosing variant (DSV) is an aggressive and rare subtype of papillary thyroid carcinoma (PTC). The present study aims to analyze its clinicopathological features and prognosis and compare these findings with classical PTCs. Methods: Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database (2004–2013), and were retrospectively analyzed to compare clinicopathological characteristics between DSVPTCs and classical PTCs. Survival was analyzed using the Kaplan-Meier method, and the log-rank test was used to determine if differences in survival were statistically significant. n Results: In total, 331 cases of DSVPTC and 63,659 cases of classical PTC were included. DSVPTCs had a higher proportion of women and young patients, and presented higher rates of larger tumor size, multifocality, extrathyroidal extension (ETE) and lymph node metastasis than classical PTCs. Total thyroidectomy, neck dissection and radioiodine therapy were more frequently conducted in DSV patients. The 5-year and 10-year cancer-specific survival rates were significantly lower in the DSV group (97.6% and 97.6%, respectively). DSV patients with risk factors including ≥55 years of age, lateral neck metastasis, tumor diameter ≥2 cm, ETE and distant metastasis developed a poorer prognosis. The rate of lateral neck metastasis (28.7%) was significantly higher in the DSV group, and DSV patients with lateral neck metastasis suffered a worse prognosis. n Conclusions: DSVPTC is an aggressive subtype with a worse prognosis. Total thyroidectomy and prophylactic central neck dissection followed by radioiodine therapy are more likely to be performed in patients with DSV. Lateral neck dissection should be given full consideration in DSVPTC patients with such predictors as ≥55 years of age, male, ≥2 cm tumor size and ETE.

Cost-effectiveness analysis in papillary thyroid carcinoma patients with different neck dissection strategy: A retrospective cohort study

BACKGROUNDnThere are two surgical strategies for bilateral neck dissection (BND), simultaneous and two-stage operations. The aim of the study was to compare the cost-effectiveness BND with this two operations in papillary thyroid carcinoma (PTC) patients.nnnMATERIALS AND METHODSnConsecutive PTC patients undergoing BND were studied retrospectively, and were classified into simultaneous group (Group A) and two-stage group (Group B). Demographic, medical costs, complication and surgical variables were recorded.nnnRESULTSnThis study included 256 PTC patients, of which 175 (68.4%) underwent simultaneous BND and 81 (31.6%) patients underwent two-stage. Patients in Group B spent almost twice as much on medical costs as patients in Group A (

Contrastive study of two screening criteria for active surveillance in patients with low-risk papillary thyroid microcarcinoma: a retrospective analysis of 1001 patients

4145.3 vs.