Tang Pingzhang

Management and outcome of cervical lymph node metastases of unknown primary sites: a retrospective study

Analysis of the case records of 114 patients with cervical lymph node metastases from unknown primary sites showed that management should be adapted according to the site of nodal disease and the histopathology. Poorly differentiated carcinoma was best treated with radiotherapy, squamous cell carcinoma with radiotherapy and excision, and non-papillary adenocarcinoma by radical thyroidectomy and neck dissection. The 5-year survival for each regimen alone, was 15/40 (38%), 7/13 (54%) and 5/8 (63%), respectively. For metastatic masses in the supraclavicular region, chemotherapy was the preferred treatment. The overall survival for the 107 patients who completed the follow up was 36%.

Surgical management of metastases that involve the carotid artery in cases of primary squamous cell carcinoma of the head and neck

The surgical management of advanced cervical metastases with carotid artery involvement in patients with primary squamous cell carcinoma of the head and neck can be difficult. The authors retrospectively reviewed 73 patients over a 15-year period comparing the outcomes of carotid artery resection versus peeling the tumour off the carotid artery. Based on these findings, the authors suggest that in the absence of carotid wall involvement, nodal metastatic tumour should be peeled off the carotid artery where possible. This practice appears to have a lower morbidity than that associated with arterial reconstruction. Steps to minimize cerebrovascular injury are discussed.

EXPRESSION OF c-erbB-2, p53, p16 IN SQUAMOUS CELL CARCINOMA OF ANTERIOR TONGUE IN CHINA POPULATION

Objective: Aberrant expression of c-erbB-2, p53, p16 has been found in oral squamous cell carcinoma. We therefore examined expression of these proteins in squamous cell carcinoma of the anterior tongue and compared their relationship with clinical stages and prognosis. Methods: Seventy-six patients with squamous cell carcinoma of the anterior tongue never treated before were obtained from Cancer Hospital, CAMS. Archive tissues of carcinoma and paracarcinoma were examined for c-erbB-2, p53 and p16 expression by immunohistochemistry. Results: The rates of immunopositive staining of c-erbB-2, p53 and p16 were 64.5%, 61.8% and 23.7% respectively; the positive rates in paracarcinoma mucosa were 19.7%, 22.6% and 55.3% respectively. Overexpression of c-erbB-2 was significantly correlated with short overall survival, metastasis and staging. Overexpression of paracarcinoma p53 was significantly correlated with local recurrence. Conclusion. c-erbB-2 may be used as a prognosis marker for the patients with squamous cell carcinoma of the anterior tongue and p53 as a recurrence marker.