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Lee J, Yoon N, Choi SY, Moon JH, Chung MK, Son YI, Ko YH, Jeong HS, Baek CH. Extent of local invasion and safe resection in cT1-2 tonsil cancer. J Surg Oncol 2012; 107:469-73. [DOI: 10.1002/jso.23286] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 10/02/2012] [Indexed: 11/11/2022]
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Lee SJ, Choi JY, Lee HJ, Baek CH, Son YI, Hyun SH, Moon SH, Kim BT. Prognostic value of volume-based (18)F-fluorodeoxyglucose PET/CT parameters in patients with clinically node-negative oral tongue squamous cell carcinoma. Korean J Radiol 2012; 13:752-9. [PMID: 23118574 PMCID: PMC3484296 DOI: 10.3348/kjr.2012.13.6.752] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Accepted: 04/13/2012] [Indexed: 12/22/2022] Open
Abstract
Objective To evaluate the prognostic value of volume-based metabolic parameters measured with 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in patients with clinically node-negative (cN0) oral tongue squamous cell carcinoma (OTSCC) as compared with other prognostic factors. Materials and Methods In this study, we included a total of 57 patients who had been diagnosed with cN0 tongue cancer by radiologic, 18F-FDG PET/CT, and physical examinations. The maximum standardized uptake value (SUVmax), average SUV (SUVavg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for primary tumors were measured with 18F-FDG PET. The prognostic significances of these parameters and other clinical variables were assessed by Cox proportional hazards regression analysis. Results In the univariate analysis, pathological node (pN) stage, American Joint Committee on Cancer (AJCC) stage, SUVmax, SUVavg, MTV, and TLG were significant predictors for survival. On a multivariate analysis, pN stage (hazard ratio = 10.555, p = 0.049), AJCC stage (hazard ratio = 13.220, p = 0.045), and MTV (hazard ratio = 2.698, p = 0.033) were significant prognostic factors in cN0 OTSCC patients. The patients with MTV ≥ 7.78 cm3 showed a worse prognosis than those with MTV < 7.78 cm3 (p = 0.037). Conclusion The MTV of primary tumor as a volumetric parameter of 18F-FDG PET, in addition to pN stage and AJCC stage, is an independent prognostic factor for survival in cN0 OTSCC.
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Moon SH, Choi JY, Lee HJ, Son YI, Baek CH, Ahn YC, Park K, Lee KH, Kim BT. Prognostic value of 18F-FDG PET/CT in patients with squamous cell carcinoma of the tonsil: comparisons of volume-based metabolic parameters. Head Neck 2012; 35:15-22. [PMID: 22307893 DOI: 10.1002/hed.22904] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 09/10/2011] [Accepted: 11/02/2011] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The prognostic significance of volume-based metabolic parameters measured by (18)F-fluorodeoxyglucose positron emission tomography/CT ((18) F-FDG PET/CT) is not established. We evaluated the prognostic value of metabolic parameters in patients with squamous cell carcinoma (SCC) of the tonsil. METHODS We enrolled a total of 69 patients with SCC of the tonsil who underwent pretreatment (18)F-FDG PET/CT. We measured maximum standardized uptake value (SUV(max)), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and asymmetry indices (of SUV(max), MTV, and TLG). The prognostic significance of these parameters and clinical variables was assessed by Cox proportional hazards regression analysis. RESULTS Multivariate analyses with adjustments for age, sex, and American Joint Committee on Cancer stage showed that only TLG (hazard ratio = 1.020, 95% confidence interval 1.003-1.037, p = .023) was an independent predictive factor associated with decreased overall survival. CONCLUSION TLG is a significant independent metabolic prognostic factor for overall survival in patients with SCC of the tonsil.
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Chung MK, Do IG, Jung E, Son YI, Jeong HS, Baek CH. Lymphatic vessels and high endothelial venules are increased in the sentinel lymph nodes of patients with oral squamous cell carcinoma before the arrival of tumor cells. Ann Surg Oncol 2011; 19:1595-601. [PMID: 22124758 DOI: 10.1245/s10434-011-2154-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Indexed: 01/08/2023]
Abstract
PURPOSE To investigate the change of vasculature in the sentinel lymph node (SLN) of patients with oral squamous cell carcinoma. METHODS Immunohistochemical staining of SLNs in 58 patients was performed with two monoclonal antibodies (MAb): anti-D2-40 MAb for lymphatic endothelial cells, and anti-MECA-79 MAb for high endothelial venules (HEV). Twelve metastatically involved (m(+)) SLNs, 120 uninvolved (m(-)) SLNs, and 35 non-SLNs (control) were available for analyses. Vessel densities were measured by computer-assisted analyses in the entire region of SLN. Correlations were assessed between vessel density and clinicopathologic variables, including vascular endothelial growth factor C of primary tumor. RESULTS Lymphatic vessel density (LVD) in SLNs was higher than that in control LNs [2361.8 μm(2)/high-power field (HPF) (624.3-4758.5) vs. 1621.9 μm(2)/HPF (465.3-3453.5), P = 0.005]. LVD of m(-) SLNs [2662.4 μm(2)/HPF (624.3-4758.5)] and m(±) SLNs [4946.6 μm(2)/HPF (2009.3-8698.8)] were both statistically significantly higher compared to control. HEV densities in m(-) SLNs [14029.7 μm(2)/HPF (10465.7-17927.1)] as well as m(±) SLNs [18258.5 μm(2)/HPF (8408.9-27706.0)] were also significantly higher than those in control [10350.5 μm(2)/HPF (7807.8-12541.1)]. By multivariate analysis, the degree of vascular endothelial growth factor C expression of primary tumor showed significant correlation with LVD of SLNs (odds ratio 9.46, 95% confidence interval 1.73-51.5, P = 0.009), which was not the case in HEV. CONCLUSIONS Lymphatic vessels and HEVs were increased in SLNs, regardless of metastatic status of SLNs. Vascular endothelial growth factor C expression of primary tumor may contribute to the premetastatic change within SLNs of oral squamous cell carcinoma.
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Kim TW, Chung MK, Youm HY, Jeong JI, Son YI, Jeong HS, Baek CH. Bilateral neck metastases in upper aero-digestive tract cancer: emphasis on the distribution of lymphatic metastases and prognostic implications. J Surg Oncol 2011; 105:553-8. [PMID: 22095558 DOI: 10.1002/jso.22145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 10/24/2011] [Indexed: 02/06/2023]
Abstract
BACKGROUND Bilateral neck metastases (BNM) in patients with upper aero-digestive tract cancer (UADTC) indicate a poor prognosis. However, the prognostic significance of involved neck node levels has not been determined clearly. In this study, the distribution of neck nodal metastasis and its impact on prognosis were investigated. METHODS Eighty-two previously untreated UADTC patients with BNM from 2000 to 2007 were included in these analyses. The pathology was mainly squamous cell carcinomas, including nasopharynx undifferentiated carcinoma and excluding salivary and thyroid carcinomas. The distribution and pattern of neck metastases and their prognostic significance were assessed, along with other clinical variables. RESULTS BNM confined to the upper neck level (I-III) showed a lower rate of distant metastasis compared to BNM beyond I-III levels (13.6% vs. 47.4%, P = 0.001). There was a significant reduction in survival among patients with bilateral lower neck (IV-V) metastases on multivariate analysis (HR: 5.95, 95%CI: 1.51-23.43). However, multi-level involvement itself did not correlate with survival. Subgroup analysis (according to nasopharynx and non-nasopharynx cancer) also confirmed the strong trends of lower neck nodal involvement for poorer survival in both groups. CONCLUSION BNM at lower neck nodes can be a significant prognostic factor for early systemic dissemination and worse prognosis in UADTC patients.
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Sung JY, Ahn HK, Kwon JE, Jeong H, Baek CH, Son YI, Ahn YC, Park K, Ahn MJ, Ko YH. Reappraisal of KIT mutation in adenoid cystic carcinomas of the salivary gland. J Oral Pathol Med 2011; 41:415-23. [PMID: 22077630 DOI: 10.1111/j.1600-0714.2011.01105.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND While overexpression of KIT protein has been well documented in adenoid cystic carcinomas (ACCs), mutation of KIT gene has been a controversial issue. We wanted to evaluate clinical value of the KIT mutation and protein expression in ACC. METHODS We analyzed 33 cases of ACC. Gene mutations in KIT exons 9, 11, 13, and 17 were analyzed using paraffin-embedded tissue, and two different sets of primers with direct sequencing after polymerase chain reaction (PCR) for exon 9, 11, 13, and 17, and cloning of PCR products for exon 11. KIT protein expression was assessed by immunohistochemistry. The correlation between clinicopathological findings and these biomarkers was analyzed. RESULTS No KIT mutation was observed in all of the 33 cases. With one primer set, KIT mutation was found in nine of 33 cases (27.3%). However, these mutations were not reproducible in the experiment using another primer set. KIT protein overexpression was detected in 22 of 33 patients (66.7%). KIT protein expression was not statistically correlated with either clinicopathological factors or survival. Patients with metastasis showed a tendency of longer progression-free survival (P = 0.052) and overall survival (P = 0.080) when the tumor overexpressed KIT protein. CONCLUSION This study supports that mutational study using paraffin-embedded tissue should be interpreted with great caution. KIT gene mutation is very rare in ACC, and gene mutation is not the cause of protein overexpression. KIT protein expression may have a potential value for better prognostic factor in patients with metastasis.
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Baek CH, Lee WY, Choi SY, Chung MK. Minimal incision technique for harvesting of the vascular pedicle of the radial forearm free flap by ultrasonically activated shears (Harmonic Scalpel®). J Plast Reconstr Aesthet Surg 2011; 64:e285-6. [DOI: 10.1016/j.bjps.2011.06.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Revised: 06/08/2011] [Accepted: 06/21/2011] [Indexed: 10/17/2022]
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So YK, Son YI, Baek CH, Jeong HS, Chung MK, Ko YH. Expression of Sodium–Iodide Symporter and TSH Receptor in Subclinical Metastatic Lymph Nodes of Papillary Thyroid Microcarcinoma. Ann Surg Oncol 2011; 19:990-5. [DOI: 10.1245/s10434-011-2047-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Indexed: 12/22/2022]
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So YK, Son YI, Park JY, Baek CH, Jeong HS, Chung MK. Preoperative BRAF Mutation Has Different Predictive Values for Lymph Node Metastasis according to Tumor Size. Otolaryngol Head Neck Surg 2011; 145:422-7. [DOI: 10.1177/0194599811404649] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective. To investigate whether BRAF mutation of papillary thyroid carcinoma (PTC) has different predictive values for regional lymph node (LN) metastasis according to tumor size. Study Design. Prospective cohort study. Setting. A tertiary hospital. Subjects and Methods. From January 2009 to August 2009, the authors prospectively enrolled 102 consecutive patients with unifocal PTC based on the findings of ultrasonography-guided fine-needle aspiration biopsy (FNAB). BRAF mutation was tested on preoperative FNAB specimens. Total thyroidectomy and bilateral central neck dissection (± lateral neck dissection) was performed for all patients. Among 102 patients, 71 who were confirmed to have unifocal PTC by the surgical pathology were finally selected. The 71 patients were classified into 3 groups according to their tumor size: group I, ≤0.5 cm; group II, >0.5 cm and ≤1 cm; and group III, >1 cm. LN metastasis was evaluated in the surgical specimen as a dependent variable. The authors investigated whether BRAF mutation is predictive of LN metastasis in each group. Results. Overall, BRAF mutation was a significant predictor of LN metastasis ( P = .045). When patients were classified into 3 groups, frequency of LN metastasis increased with tumor size: 4.8%, 50.0%, and 66.7% ( P < .001). However, the frequency of BRAF mutation was not different among 3 groups: 61.9%, 56.3%, and 72.2% ( P = .536). BRAF mutation was predictive of LN metastasis only in group II ( P = .026). Conclusion. BRAF mutation of PTC may have differential predictive values for LN metastasis, according to tumor size.
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Chung MK, Son YI, Cho JK, So YK, Woo SH, Jeong HS, Baek CH. Therapeutic options in patients with early T stage and advanced N stage of tonsillar squamous cell carcinomas. Otolaryngol Head Neck Surg 2010; 143:808-14. [DOI: 10.1016/j.otohns.2010.06.914] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Revised: 05/16/2010] [Accepted: 06/18/2010] [Indexed: 01/22/2023]
Abstract
OBJECTIVE: To compare the therapeutic role of surgery followed by radiotherapy (OPRT) and concurrent chemoradiotherapy (CCRT) in patients with early T (T1/T2) and advanced N (N2/N3) stage tonsillar squamous cell carcinoma. STUDY DESIGN: Historical cohort study. SETTING: A tertiary hospital. SUBJECTS AND METHODS: The medical records of 42 patients who met the eligible criteria (24 patients were treated by OPRT, 18 patients by CCRT) were reviewed. RESULTS: Mean overall survival (OS) and disease-free survival (DFS) were 49.0 months and 43.0 months in OPRT group, respectively, and 39.6 months and 35.0 months in CCRT group, respectively ( P = 0.18 for OS, P = 0.29 fr DFS between the two groups). There was also no significant difference in survival estimates between OPRT and CCRT group in terms of two-year OS ( P = 0.18) and two-year DFS ( P = 0.45). In the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, the scores for global health status and symptom scales did not differ between the two groups. However, the OPRT group reported better functional scales and significantly higher scores for cognitive ( P = 0.008) and social function ( P = 0.03). Among single items, a significantly lower score for insomnia ( P = 0.007) was noted in the OPRT group. In EORTC QLQ-H&N35 modules, there were no significantly different scales between the two groups except scores for nutritional supplements, in which the OPRT group presented lower symptom scores ( P = 0.02). CONCLUSION: OPRT could be still a viable option for managing selected cases of advanced oropharyngeal cancer because one can expect comparable therapeutic outcome as well as quality of life.
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Youm HY, Kim TW, Son YI, Baek CH, Chung MK. Treatment Outcome of Oropharynx Cancer. Otolaryngol Head Neck Surg 2010. [DOI: 10.1016/j.otohns.2010.06.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Chung MK, Min JY, So YK, Ko YH, Jeong HS, Son YI, Baek CH. Correlation between lymphatic vessel density and regional metastasis in squamous cell carcinoma of the tongue. Head Neck 2010; 32:445-51. [PMID: 19672869 DOI: 10.1002/hed.21202] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate the correlation between lymphatic vessel density in squamous cell carcinoma of the tongue and regional metastasis. METHODS Intratumoral and peritumoral lymphatic densities (ILDs and PLDs, respectively) were determined by immunohistochemical staining of lymphatic endothelial cells with podoplanin in 62 patients surgically treated for tongue cancer. Clinicopathological variables were quantified, and their correlations with regional metastasis were assessed. RESULTS The rate of regional metastasis was significantly higher in patients with high ILD than that in those with low ILD (21/33, 63.6% vs 8/29, 27.5%; p = .006). Perineural invasion and lymphovascular invasion were also significantly correlated with regional metastasis. By multivariate analyses, ILD was the only variable identified to be significantly correlated with regional metastasis (p = .009). On the other hand, PLD showed no correlation with regional metastasis. CONCLUSIONS ILD showed a strong correlation with regional metastasis in patients with squamous cell carcinoma of the tongue.
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Baek CH, Chung MK, Choi JY, So YK, Son YI, Jeong HS. Role of salivary function in patients with globus pharyngeus. Head Neck 2010; 32:244-52. [PMID: 19572282 DOI: 10.1002/hed.21176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Our aim was to investigate the prevalence and the clinical role of salivary hypofunction in patients with globus sensation. METHODS We conducted a prospective observational study in 340 patients with globus pharyngeus. A standard questionnaire and (99m)Tc-pertechnate salivary scintigraphy were used to evaluate salivary hypofunction, with a full examination from the nasal cavity to the larynx (N = 303). We also investigated the effect of xerostomia management on globus symptoms (N = 252). RESULTS The symptom scores for xerostomia were higher in patients with severe globus (p < .05). Objective salivary hypofunction was noted in 57.4% of the patients, based on the reference values from control groups. Globus symptoms were more severe in the subgroup with salivary hypofunction (p = .0447). Conservative management of xerostomia significantly reduced the severity of globus at 1 and 3 months (p = .0002) regardless of salivary function. CONCLUSIONS Salivary hypofunction seems to be an aggravating factor in globus pharyngeus, but not a direct cause. Conservative management of xerostomia improves globus symptoms.
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Chung MK, Baek CH, Choi JY. Correlation of Segmented Metabolic Tumor Volume with Outcome - Response. Clin Cancer Res 2010. [DOI: 10.1158/1078-0432.ccr-09-3335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ko YH, Roh JH, Son YI, Chung MK, Jang JY, Byun H, Baek CH, Jeong HS. Expression of mitotic checkpoint proteins BUB1B and MAD2L1 in salivary duct carcinomas. J Oral Pathol Med 2009; 39:349-55. [PMID: 20040022 DOI: 10.1111/j.1600-0714.2009.00835.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Defects in the mitotic checkpoint lead to aneuploidy and might facilitate tumorigenesis. However, the ploidy status in salivary duct carcinoma (SDC) has been reported to play limited role in prediction of prognosis. Thus, we need more reliable markers to reflect the rapid tumor progression in SDCs. We aimed here to investigate the expression of mitotic checkpoint proteins benzimidazole 1 homolog beta (BUB1B) and mitosis arrest-deficient 2 like 1 (MAD2L1) in SDCs and to determine their possible role as surrogate prognostic markers. METHODS We analyzed the clinical courses, pathologic findings and immunohistochemical profiles of mitotic checkpoint proteins (BUB1B and MAD2L1) in 27 pathologically confirmed SDCs. The expression status of BUB1B and MAD2L1 was compared with clinicopathologic factors and other molecular markers, such as TGF-beta, c-erb-B2, androgen receptor, vascular endothelial growth factor, and epidermal growth factor receptor, for prognostic significance. RESULTS High BUB1B expression was detected in 25.9% of subjects, and high MAD2L1 expression was in 55.6% of subjects. However, survival analysis revealed that mitotic checkpoint expression did not have prognostic significance in SDCs, nor did the other studied markers. Rather, the clinical variable of N classification at diagnosis (in N+ status, hazard ratio 5.19, 95% CI 1.26-21.32 for disease-free survival and hazard ratio 7.18, 95% CI 1.09-46.99 for overall survival) was strongly associated with survival and prognosis based on the Cox proportional hazard model. CONCLUSIONS Mitotic checkpoint proteins appeared to play a limited role in predicting prognosis in SDCs. Further study is required to elucidate the exact role of mitotic checkpoint proteins in SDCs.
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So YK, Yun YS, Baek CH, Jeong HS, Son YI. Speech Outcome of Supracricoid Partial Laryngectomy: Comparison with Total Laryngectomy and Anatomic Considerations. Otolaryngol Head Neck Surg 2009; 141:770-5. [DOI: 10.1016/j.otohns.2009.08.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2009] [Revised: 08/18/2009] [Accepted: 08/27/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE: We studied speech after a supracricoid partial laryngectomy (SCPL) and compared it to speech after a total laryngectomy and insertion of voice prosthesis (TL-VP). We also determined the anatomical factors related to speech after SCPL. STUDY DESIGN AND SETTING: Historic cohort study. Patients were recruited for data collection. SUBJECTS AND METHODS: We enrolled 28 patients who had undergone SCPL or TL-VP for laryngeal cancer from 1995 to 2005 (15 with SCPL and 13 with TL-VP). Patients had no recurrence, no respiratory problems, and were followed-up more than one year. Using sustained vowel phonation and standard paragraph reading, maximum phonation time, maximum loudness, total time for reading the paragraph, number of syllables per breath, and speech intelligibility were tested, and the patients' self satisfaction was evaluated using the Voice Handicap Index questionnaire. In addition, we performed stroboscopic examination for the SCPL group to study the configuration of the neoglottis during phonation. RESULTS: Maximum phonation time was longer in the TL-VP group than in the SCPL group ( P = 0.048). There was no significant difference in the other parameters between the groups. With stroboscopic examination, we observed widely variable findings with reference to arytenoid mobility, mucosal vibration, and neoglottic occlusion in the SCPL group. CONCLUSIONS: Speech after SCPL was not better than speech after TL-VP and was widely variable. The configuration of the neoglottis during phonation in the SCPL group was also variable. We believe that some technical refinement during the operation could improve speech outcome after SCPL.
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Chung MK, Jeong HS, Park SG, Jang JY, Son YI, Choi JY, Hyun SH, Park K, Ahn MJ, Ahn YC, Kim HJ, Ko YH, Baek CH. Metabolic Tumor Volume of [18F]-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Predicts Short-Term Outcome to Radiotherapy With or Without Chemotherapy in Pharyngeal Cancer. Clin Cancer Res 2009; 15:5861-8. [DOI: 10.1158/1078-0432.ccr-08-3290] [Citation(s) in RCA: 169] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chung MK, Jeong HS, Son YI, So YK, Park GY, Choi JY, Hyun SH, Kim HJ, Ko YH, Baek CH. Metabolic Tumor Volumes by [18F]-Fluorodeoxyglucose PET/CT Correlate with Occult Metastasis in Oral Squamous Cell Carcinoma of the Tongue. Ann Surg Oncol 2009; 16:3111-7. [DOI: 10.1245/s10434-009-0621-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Revised: 06/29/2009] [Accepted: 06/29/2009] [Indexed: 11/18/2022]
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Baek CH, Chung MK, Jeong HS, Son YI, Jung SC, Jeon HK, Ryu NG, Cho HJ, Cho JK, Jang JY. Questionnaire evaluation of sequelae over 5 years after parotidectomy for benign diseases. J Plast Reconstr Aesthet Surg 2009; 62:633-8. [DOI: 10.1016/j.bjps.2007.08.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2007] [Accepted: 08/28/2007] [Indexed: 10/22/2022]
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Chung IS, Son YI, Ko YJ, Baek CH, Cho JK, Jeong HS. Peritumor injections of purified tumstatin delay tumor growth and lymphatic metastasis in an orthotopic oral squamous cell carcinoma model. Oral Oncol 2008; 44:1118-26. [DOI: 10.1016/j.oraloncology.2008.01.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Revised: 01/09/2008] [Accepted: 01/09/2008] [Indexed: 10/22/2022]
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Baek CH, Son YI, Jeong HS, Chung MK, Park KN, Ko YH, Kim HJ. Intraoral Sonography–Assisted Resection of T1–2 tongue Cancer for Adequate deep Resection. Otolaryngol Head Neck Surg 2008; 139:805-10. [DOI: 10.1016/j.otohns.2008.09.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2008] [Revised: 06/12/2008] [Accepted: 09/17/2008] [Indexed: 11/26/2022]
Abstract
Objective To investigate the clinical usefulness of intraoral sonography-assisted resection for securing adequate deep resection margins in T1–2 tongue cancers. Study Design Prospective clinical trial. Materials and Methods Twenty consecutive patients with clinical T1–2 tongue cancers were enrolled and their lesions were removed by intraoral sonography-assisted resection. We then retrospectively collected data from 20 T stage-matched patients without intraoral sonography-assisted resection as the control group. All resections were performed with a goal of 15 mm margin. The mucosal and deep safety margins were compared between the two groups. Results Intraoral sonography could predict the paraffin-embedded tumor thickness with an error of 3.16 ± 2.24 mm. The deep safety margins were more adequate for intraoral sonography–assisted resection (9.8 ± 5.2 mm) than for conventional resection (4.0 ± 2.03 mm) ( P < 0.001), while the mucosal safety margins were not different Conclusion Intraoral sonography-assisted resection provides a more adequate deep resection margin for early T-stage tongue cancers.
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Cho YS, So YK, Park K, Baek CH, Jeong HS, Hong SH, Chung WH. Surgical outcomes of lateral approach for jugular foramen schwannoma: postoperative facial nerve and lower cranial nerve functions. Neurosurg Rev 2008; 32:61-6; discussion 66. [PMID: 18779983 DOI: 10.1007/s10143-008-0165-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2007] [Revised: 01/22/2008] [Accepted: 08/09/2008] [Indexed: 10/21/2022]
Abstract
The lateral surgical approach to jugular foramen schwannomas (JFS) may result in complications such as temporary facial nerve palsy (FNP) and hearing loss due to the complicated anatomical location. Ten patients with JFS surgically treated by variable methods of lateral approach were retrospectively reviewed with emphasis on surgical methods, postoperative FNP, and lower cranial nerve status. Gross total removal of the tumors was achieved in eight patients. Facial nerves were rerouted at the first genu (1G) in six patients and at the second genu in four patients. FNP of House-Brackmann (HB) grade III or worse developed immediately postoperatively in six patients regardless of the extent of rerouting. The FNP of HB grade III persisted for more than a year in one patient managed with rerouting at 1G. Among the lower cranial nerves, the vagus nerve was most frequently paralyzed preoperatively and lower cranial nerve palsies were newly developed in two patients. The methods of the surgical approach to JFS can be modified depending on the size and location of tumors to reduce injury of the facial nerve and loss of hearing. Careful manipulation and caution are also required for short facial nerve rerouting as well as for long rerouting to avoid immediately postoperative FNP.
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Baek CH, Chung MK, Son YI, Choi JY, Kim HJ, Yim YJ, Ko YH, Choi J, Cho JK, Jeong HS. Tumor volume assessment by 18F-FDG PET/CT in patients with oral cavity cancer with dental artifacts on CT or MR images. J Nucl Med 2008; 49:1422-8. [PMID: 18703597 DOI: 10.2967/jnumed.108.051649] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
UNLABELLED The purpose of this study was to investigate the clinical usefulness of PET/CT or CT-attenuated PET in the evaluation of patients with oral cavity cancer (OCC) in whom dental artifacts distorted the conventional CT or MR images of the oral cavity. METHODS A PET/CT scan, in addition to a CT or MRI scan, was performed in 69 patients with OCC who had dentures or dental implants. A total of 64 PET/CT, 64 CT, and 27 MR images were analyzed including images from scans performed on 40 patients with OCC without dental artifacts on the conventional images; these were used for comparison. The CT-attenuated PET scan for the detection of primary tumors was compared with the CT or MRI scan. We also evaluated the correlation between the PET/CT volume and the pathologic volume using a regression analysis. In addition, subgroup analysis was performed to determine what proportion of subjects benefited most from the PET/CT. RESULTS CT-attenuated PET detected more primary tumors than did CT in patients with OCC with dental artifacts (95.3% vs. 75.0%, respectively; P=0.0016). PET/CT volume with a standardized uptake value (SUV) cutoff point of 3.5 predicted the pathologic volume more accurately than did the other cutoff points in patients with OCC with or without artifacts. After comparing pathologic volume and PET/CT(SUV 3.5) volume, the following regression equation was developed: log (pathologic volume)=0.6 x log (PET/CT(SUV 3.5) volume) + 1.3 (R(2) = 0.42, P<0.0001). Subgroup analysis showed that the prediction of the pathologic volume from the PET/CT images was more reliable for tumors that were more than 2 cm in depth (R(2)=0.72). CONCLUSION For patients with OCC with dental artifacts on the conventional imaging, PET/CT could provide useful clinical information about the primary tumors, particularly in cases with advanced tumors.
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Son YI, Jeong HS, Baek CH, Chung MK, Ryu J, Chung JH, So YK, Jang JY, Choi J. Extent of prophylactic lymph node dissection in the central neck area of the patients with papillary thyroid carcinoma: comparison of limited versus comprehensive lymph node dissection in a 2-year safety study. Ann Surg Oncol 2008; 15:2020-6. [PMID: 18459004 DOI: 10.1245/s10434-008-9928-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2008] [Revised: 03/18/2008] [Accepted: 03/18/2008] [Indexed: 11/18/2022]
Abstract
BACKGROUND To compare the "comprehensive" (including bilateral paratracheal, pretracheal, prelaryngeal lymph nodes) (CCND) with "limited" (saving contralateral paratracheal lymph nodes) central node dissection (LCND) for postoperative complications and disease recurrence rate in sonographically node-negative papillary thyroid carcinomas. MATERIALS AND METHODS From 2003 to 2005, 114 consecutive patients, diagnosed as sonographically node-negative thyroid papillary carcinomas, were included retrospectively. Among them, the LCND was performed in 56 patients and CCND in 58 patients, in combination with total thyroidectomy, based on the operator-dependent decision. We compared the complication rates and the recurrence rates between these two groups with a mean follow-up duration of 2 years. RESULTS Transient hypocalcemia was more frequent in the CCND group than in the LCND group (48.3% vs 26.8%, P = .02, odds ratio [OR] = 2.55). However, the other complication rates were similar in the two groups. In addition, the immediate postoperative reduction of parathyroid hormone (PTH) was more evident in the CCND group. The postoperative PTH levels increased up to a similar level (12.4 vs 11.8 pg/mL) over 6 months. The incidence of permanent hypocalcemia did not differ significantly between the two groups. Four (7.1%) and five recurrences (8.6%) were found in two groups, respectively, implying similar oncological safety during the 2-year follow-up. CONCLUSION The LCND with total thyroidectomy could be an alternative treatment option for node-negative papillary thyroid carcinomas, because LCND had fewer short-term hypocalcemia and similar oncological outcomes during the 2-year follow-up. Further study enrolling a large number of patients with long-term follow-up is needed.
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Jeong HS, Chung MK, Son YI, Choi JY, Kim HJ, Ko YH, Baek CH. Role of 18F-FDG PET/CT in Management of High-Grade Salivary Gland Malignancies. J Nucl Med 2007; 48:1237-44. [PMID: 17631549 DOI: 10.2967/jnumed.107.041350] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED The role of 18F-FDG PET/CT for planning the treatment of high-grade salivary gland malignancies was investigated and was compared with that with using contrast-enhanced CT. METHODS The subjects chosen for the study had high-grade cancer of the salivary gland, as confirmed by surgical pathology. The diagnostic values from 37 CT and PET/CT scans of 33 subjects were compared. The ability to predict the extent of the disease was compared by performing a subsite-based analysis for the primary lesions and a level-by-level analysis for the neck node levels as well as for the final TNM staging. The surgical pathology (67.6%) and clinical follow-up examinations (32.4%) were used as the reference standards. Furthermore, the changes made in each subject's care, based on a PET/CT examination, were compared with the treatment received without using the PET/CT data. RESULTS Using a primary subsite-based analysis, the diagnostic accuracy for predicting the pathologic tumor extent was significantly higher for PET/CT (91.0%) compared with that using CT alone (70.1%, P < 0.001). For the neck nodes on a level-by-level analysis, the metastasis could be predicted more accurately on the basis of a PET/CT examination (97.6%) than with using only CT (86.0%, P = 0.01). PET/CT was also far superior to CT in terms of the TNM staging (83.7% vs. 62.1%, P = 0.03). For 43.2% of the subjects, changes in the clinical decision making were made as a result of the PET/CT scan data over what was previously determined by using the CT scans alone. CONCLUSION PET/CT provides more accurate diagnostic information for the evaluation of high-grade salivary cancer than does CT and it has a major impact on making treatment decisions for patients with a high-grade salivary malignancy.
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