Zong Yuan Zeng

Overexpression of MMP-2 in laryngeal squamous cell carcinoma: a potential indicator for poor prognosis.

OBJECTIVES: To investigate the expression and clinical significance of gelatinases (MMP-2 and MMP-9) in patients with laryngeal squamous cell carcinoma (LSCC). STUDY DESIGN AND SETTING: In a retrospective study of 72 consecutive patients with LSCC hospitalized in a single cancer center, immunohisto-chemistry was used to examine the expression of MMP-2 and MMP-9 in surgical samples. The results were compared to clinicopathological features and prognosis. RESULTS: The positive expression of MMP-2 and MMP-9 in patients with LSCC was 50% (36/72) and 73.6% (53/72), respectively. According to the expression scale, there were 36 patients of -, 26 patients of +, 7 patients of + +, and 3 patients of + + + expression of MMP-2; 19 patients of -, 26 patients of +,16 patients of ++, and 11 patients of + + + expression of MMP-9. There was no significant relationship found between the expression of MMP-2 or MMP-9 and clinicopathological features of LSCC, such as histological grade, primary site, T stage, N stage, and clinical stage. The 5-year overall survival (OS) and disease-free survival (DFS) rate calculated by Kaplan-Meier method in patients with negative and positive expression of MMP-9 and MMP-2 was 73.68%, 50.94%, 73.68%, and 49.06% in MMP-9 and 72.22%, 41.67%, 72.22%, and 38.89% in MMP-2, respectively. Significant 5-year survival difference was found between patients with negative and positive expression of MMP-2 (log rank = 6.74, P = 0.0094). There was significant lower survival rate in patients with higher positive expression of MMP-2 (log rank = 11.77, P = 0.0028). In glottic laryngeal cancer, positive expression of MMP-2 could predict poor survival and was more likely to present primary recurrence. CONCLUSION: The expression of MMP-2 could be used as a potential predictor for poor prognosis in patients with LSCC.

Elevated plasma big ET-1 is associated with distant failure in patients with advanced-stage nasopharyngeal carcinoma†

Endothelin‐1 (ET‐1) is a potent vasoactive peptide and a hypoxia‐inducible angiogenic growth factor associated with the development and spread of solid tumors. The clinical significance of plasma big ET‐1 in patients with advanced‐stage nasopharyngeal carcinoma (NPC) is not known.

Submandibular salivary gland transfer for the prevention of radiation‐induced xerostomia in patients with nasopharyngeal carcinoma: 5‐Year outcomes

Our aim in this study was to investigate the value of the submandibular salivary gland transfer procedure in prevention of radiation‐induced xerostomia in patients with nasopharyngeal carcinoma (NPC).

Therapeutic targeting of the endothelin a receptor in human nasopharyngeal carcinoma

The endothelin A receptor (ETAR) autocrine pathway is overexpressed in many malignancies, including nasopharyngeal carcinoma (NPC). In this tumor, ETAR expression is an independent determinant of survival and a robust independent predictor of distant metastasis. To evaluate whether ETAR represents a new target in NPC treatment, we tested the therapeutic role of ETAR in NPC. Cell proliferation was inhibited by the ETAR‐selective antagonist ABT‐627 in two ETAR‐positive NPC cells in a dose‐dependent manner. Proliferation of ETAR‐negative NPC cells was not decreased. ETAR blockade also resulted in sensitization to cisplatin and 5‐fluorouracil‐induced apoptosis. In nude mice, ABT‐627 inhibited the growth of NPC cell xenografts. Combined treatment of ABT‐627 with the cytotoxic drug cisplatin or 5‐fluorouracil produced additive antitumor effects. The antitumor activity of ABT‐627 was demonstrated finally on an experimental lung metastasis by a reduction in the number of tumors. These results support the rationale of combining ABT‐627 with current standard chemotherapy to further improve the therapeutic ratio in the treatment of NPC. (Cancer Sci 2006; 97: 1388–1395)

Sentinel lymph node biopsy versus elective neck dissection in patients with cT1-2N0 oral tongue squamous cell carcinoma

OBJECTIVE This study aimed to compare the value of sentinel lymph node biopsy (SLNB) with that of elective neck dissection (END) for the prediction of cervical lymph node metastasis in patients with clinically diagnosed T1-2N0 (cT1-2N0) oral tongue squamous cell carcinoma (OTSCC), and it aimed to examine the prognostic value of individualized treatment in sentinel lymph node (SLN)-negative patients. STUDY DESIGN The study entailed a retrospective review of 82 patients with cT1-2N0 OTSCC. Thirty patients underwent SLNB, and 52 patients underwent END. RESULTS There was a significant difference between the SLNB and END groups in the incidence of occult cervical lymph node metastasis in initial specimens (30% vs 11.5%; P = .037). However, there were no significant differences between the groups for 10-year overall and cervical recurrence-free survival rates and 10-year overall survival rate. CONCLUSIONS SLNB is superior to END for the prediction of cervical lymph node metastasis in patients with cT1-2N0 OTSCC. Neck dissection may be reduced for SLN-negative patients, owing to the comparable prognosis of SLNB.

Reconstruction of Through-and-Through Cheek Defects With Folded Free Anterolateral Thigh Flaps

PURPOSE The purpose of this study was to assess the clinical application and therapeutic efficacy of through-and-through cheek defects reconstructed with folded anterolateral thigh (ALT) flaps. PATIENTS AND METHODS From January 2009 to May 2012, 10 patients with through-and-through cheek defects resulting from resection of cheek tumor underwent reconstruction with the folded ALT flap at Sun Yat-Sen University Cancer Center, Guangzhou, China. Surgical procedures in harvesting the ALT flap, as well as the surgical anatomy, are described, and the success rate is reported. RESULTS All ALT flaps were fasciocutaneous flaps. One patient with a thrombotic event required operative exploration in the perioperative period. All 10 flaps were based on a single perforator for reconstruction of defects. In all 10 cases, the donor site was closed primarily for the ALT flap, leaving only a linear scar that was inconspicuous with normal clothing, and the thigh had no functional deficit. CONCLUSIONS The free ALT flap has good pliability and can be folded for the reconstruction of both the inner and outer lining of through-and-through cheek defects. This flap presents good functional results at the recipient site with the additional advantages of minimal donor-site morbidity, a very acceptable esthetic result, and a high level of patient satisfaction.

Influence of pathologic complete response to neoadjuvant chemotherapy on long-term survival of patients with advanced head and neck squamous cell carcinoma

OBJECTIVE The aim of this study was to analyze whether pathologic complete response (PCR) to neoadjuvant chemotherapy (NAC) affected long-term survival in advanced head and neck squamous cell carcinoma (HNSCC) patients. MATERIALS All patients with advanced HNSCC were previously untreated and underwent NAC followed by surgery. The 5-year overall survival, disease-free survival, local control rate, and reasons for treatment failure were analyzed. RESULTS A total of 101 cases were included, and the response rate to NAC was 67.3%, including 17 patients (16.8%) who achieved PCR. The 5-year overall survival (OS) of the PCR group (82.4%; histologically complete response group [HCG]) was higher than that of the pathologic incomplete responder group (45.4%; histologically incomplete response group [HICG]) (P = 0.045). No statistically significant difference was noted between the two groups in terms of local recurrence and nodal recurrence, but the local control rate in HCG (88.2%) was higher than that in HICG (62.7%) (P = 0.034). CONCLUSIONS Achieving PCR could improve locoregional control and long-term survival in patients with advanced HNSCC.

Radiation-induced osteosarcoma of the maxilla and mandible after radiotherapy for nasopharyngeal carcinoma

BackgroundThe increasing incidence of radiation-induced osteosarcoma of the maxilla and mandible (RIOSM) has become a significant problem that can limit long-term survival. The purpose of this study was to analyze the association of clinicopathologic characteristics with treatment outcomes and prognostic factors of patients who developed RIOSM after undergoing radiotherapy for nasopharyngeal carcinoma (NPC).MethodsWe reviewed the medical records of 53,760 NPC patients admitted to Sun Yat-sen University Cancer Center during the period August 1964 to August 2012. Of these patients, 47 who developed RISOM and met inclusion criteria were included in this study. Two of these 47 patients refused treatment and were then excluded.ResultsFor all patients treated for NPC at Sun Yat-sen University Cancer Center during the study period, the total incidence of RIOSM after radiotherapy was 0.084% (47/53,760). Two patients (4.4%) had metastases at the diagnosis of RIOSM. Thirty-nine of the 45 (86.7%) patients underwent surgery for RIOSM; most patients (24/39; 61.5%) who underwent resection had gross clear margins, with 15 patients (38.5%) having either a gross or microscopic positive margin. All patients died. The 1-, 2-, and 3-year overall survival (OS) rates for the entire cohort of 45 patients were 53.3%, 35.6% and 13.5%, respectively. The independent prognostic factors associated with high OS rate were tumor size and treatment type.ConclusionsRISOM after radiotherapy for NPC is aggressive and often eludes early detection and timely intervention. Surgery combined with postoperative chemotherapy might be an effective treatment to improve patient survival.

Laryngeal framework reconstruction using titanium mesh in glottic cancer after frontolateral vertical partial laryngectomy

To investigate the feasibility and efficacy of laryngeal framework reconstruction using titanium mesh in patients with glottic cancer after frontolateral vertical partial laryngectomy.