Yasuhiro Ebihara

Quality of life after neck dissection: a multicenter longitudinal study by the Japanese Clinical Study Group on Standardization of Treatment for Lymph Node Metastasis of Head and Neck Cancer

BackgroundWe performed a multicenter longitudinal study using our neck dissection questionnaire (NDQ) and arm abduction test (AAT) to assess the impact of rehabilitation and surgical modification on postoperative quality of life (QOL).MethodsPatients who had undergone neck dissection for the treatment of head and neck cancer answered the NDQ and completed the AAT 1, 3, 6, and 12xa0months after surgery. All patients enrolled in this study underwent a rehabilitation program designed for neck dissection. The obtained data were statistically analyzed according to the types of neck dissection and compared with the data of patients who had undergone neck dissection but not rehabilitation.ResultsA total of 224 patients were enrolled in this study. Our findings revealed that resection of the sternocleidomastoid muscle (SCM) and spinal accessory nerve (SAN) resulted in shoulder drop. Lowering the dissection level and preservation of the SAN and SCM significantly reduced various sensory symptoms of the neck, such as stiffness, pain, numbness, and constriction, and improved shoulder function. Postoperative rehabilitation had a significant effect on arm abduction ability, particularly when the SCM and SAN were resected.ConclusionsThe study demonstrated that rehabilitation, in addition to modifications to radical neck dissection, contributed to the improvement of postoperative QOL after neck dissection.

Olfactory neuroblastoma: long-term clinical outcome at a single institute between 1979 and 2003

Conclusions. The progression of olfactory neuroblastoma showed a biphasic pattern. As well as Hyams’ histopathological grading and neck metastasis at presentation, early phase recurrence should be regarded as an important prognosticator. A high local failure rate suggests that craniofacial resection followed by postoperative radiotherapy should still be the standard treatment for olfactory neuroblastoma. Objective. The aim of this study was to evaluate factors associated with survival and local control of olfactory neuroblastoma in the long run and to estimate treatment strategies. Patients and methods. Twelve patients (seven men and five women) who had undergone initial curative treatment for olfactory neuroblastoma were retrospectively analyzed. Results. Cause-specific 10-year survival was 64.8%, while disease-free 10-year survival remained 28.6%. Local failure was found in half of the patients. All of the three patients who did not receive radiotherapy developed local failure. A biphasic pattern of recurrence was observed. The early phase recurrence group showed a significantly poorer survival than the late phase recurrence group. Hyams’ histopathological grading and neck metastasis at presentation were also correlated with survival.

A new aspect of tri-modal therapy with superselective intra-arterial chemotherapy in maxillary sinus carcinoma

Conclusion. This superselective intra-arterial intervention technique enabled us to administer a higher dose of cisplatinum to the local lesion with a lower incidence of adverse issues by use of neutralizer, compared with the conventional methods. Objective. A wide variety of modalities, including surgery, radiotherapy, and chemotherapy, alone or in combination, have been reported for the treatment of maxillary sinus cancer. However, there is still much controversy with regard to the optimum treatment to obtain better local control and acceptable preservation of shape and function. Since 2001, we have performed superselective intra-arterial infusion chemotherapy in combination with radiotherapy and surgery aiming at a higher local control rate. Patients and methods. This was a review of prospective collected data. The therapeutic design consisted of weekly intra-arterial infusion of high dose CDDP with concomitant radiotherapy and planned surgery performed during chemo-radiation therapy. From June 2001 to January 2004, 14 patients with squamous cell carcinoma of maxillary sinus underwent this treatment procedure at the University of Tokyo Hospital. Results. The local response rate with this combined therapy was 85.7%. Overall survival rates at 1 and 2 years were 78.6% and 56.2%, respectively, with median follow-up of 25.5 months.

A clinical study of post-cricoid carcinoma

Conclusion. The local control rate following surgery was very high in patients with post-cricoid carcinoma; however, many of the patients undergoing surgery later developed distant metastasis. Therefore, establishment of chemotherapeutic regimens for preventing distant metastasis is desirable. Objectives. To define the clinical course of the cancer, the problems that might be associated with its treatment, and the future course of treatment of this cancer at our hospital. Patients and methods. This study included 21 patients with post-cricoid carcinoma who had undergone primary treatment at our hospital between 1989 and 2004. The present study was designed to retrospectively investigate the therapeutic outcome of post-cricoid carcinoma at our hospital. Results. The 5-year cause-specific survival rate was 52%. All the patients who eventually died did so within 3 years of the treatment. Seven patients had distant metastases, representing a higher frequency as compared with that of patients with recurrence of the primary focus and cervical lymph node metastasis. All of these patients who had been treated by surgery died of the cancer.

Carcinoid tumor of the larynx: clinical analysis of 33 cases in Japan

Conclusion. In regard to the treatment of carcinoid tumor of the larynx, irradiation is not effective and tumor excision with a minimum surgical margin is associated with a high risk of local recurrence. Lymph node metastases to the neck are associated with worsening of the prognosis. To improve the survival rate, primary resection with a sufficient surgical margin (e.g. partial laryngectomy) and (elective) neck dissection is recommended, even for patients with early stage carcinoid tumors of the larynx. Objective. The objective of this study was to clarify the prognostic factors, modalities of treatment for the primary lesions, and importance of neck dissection in the treatment of carcinoid tumors of the larynx. Patients and methods. The data of 33 cases of carcinoid of the larynx reported from Japan (including 2 of our cases) were analyzed. Results. The distributions of the T and N classifications of the lesions were as follows T1, 50.0%; T2, 32.2%; T3, 14.3%; T4, 3.6%; N0, 57.1%; N1, 17.9%; N2, 25.0%; and N3, 0%. Fifteen patients underwent radiation therapy, of whom five underwent curative radiotherapy. While complete remission (CR) was maintained in one of these patients (T1N0), the remaining four patients developed recurrence. Five patients underwent preoperative radiation therapy. The response to the treatment was rated as no change in four patients and as progressive disease in the remaining one patient. Among the patients with N0 disease, seven patients (43.8%) developed lymph node metastases in the neck postoperatively. Distant metastases were the most frequent cause of death in the patients. The 3-year, 5-year, and 10-year survival rates of the patients were 58.5%, 36.5%, and 12.2%, respectively. Significant differences were recognized in the survival rates between patients with and without neck lymph node involvement at the first treatment (p=0.008), and between patients with and without postoperative lymph node recurrence in the neck (p=0.037).

4H-SiC Trench MOSFET with Ultra-Low On-Resistance by Using Miniaturization Technology

The authors have developed 4H-SiC trench MOSFETs with orthogonal Deep-P structures (ODSs) to improve the trade-off between the on-resistance and the gate oxide field. The conditions of photolithography to realize a miniaturized Deep-P pattern have been optimized. The fabricated MOSFETs with ODS have demonstrated a low on-resistance of 2 mΩcm2 and a high breakdown voltage of 1.8 kV.