Treatment of 570 cases of oral squamous cell carcinoma

This paper presents results of treatment in 570 cases with oral cancers. The overall 5-year survival rate was 64.5% and 92.8%, 84.9%, 50.2% and 16.4%, respectively for Stages I, II, III and IV. Five kinds of therapy have been used and discussed. The mortality rate of operation was 0.35%. The 5-year survival rate of 127 and 443 cases with and without cervical node metastases was 28.3% and 74.7% respectively. The 5-year survival rates of 81, 30 and 16 cases with involvement of 1, 2 and more than 3 nodes were 33.6%, 27.9% and 6.3% respectively. The 5-year survival rates were 35.5%, 14.4% and 0% when upper, middle and lower cervical nodes were respectively involved. Forty-six cases recurred and were operated on again, their 5-year survival rate was 23%.

[The value of sialography in the differential diagnosis of parotid masses]

Sialographic manifestations of 82 patients with parotid masses were studied to determine the value of sialography in the differential diagnosis. Multiple filling defects indicate metastatic tumor, tuberculosis and sarcoidosis. The occurrence of calcification suggests tuberculosis or sarcoidosis. The parotid cyst may show the sialographic appearance similar to that of adenolymphoma. The appearance of adenitis of parotid lymph nodes may be similar to that of malignant tumor when the inflammation extends into the parenchyma. Sometimes the appearance of eosinophilic lymphatic granuloma may be similar to that of malignant tumor, but the former is more extensive. The displacement of entire gland suggests extrinsic lesion. Although the displacement of branch ducts may occur in the hypertrophy of parotid, there is no defect in acinar filling. At times it is not easy to differentiate the parotid masses by sialography alone Case histories, results of laboratory and other examines, such as gray scale ultrasound, should be combined to improve the diagnosis.

Computed tomography of parotid masses

Fifty-six patients with parotid masses, benign tumors in 22, malignant tumors 26 and other diseases 8, were examined by CT scan, which can differentiate intrinsic from extrinsic parotid lesions, especially deep lobe from parapharyngeal tumors and typical benign tumors from malignant ones, but may fail to differentiate aggressive benign tumors from low-grade malignant ones. CT sialography was done to detect the relation between the trunk of the facial nerves and tumor according to the band of normal parotid tissue between the tumor and posterior border of the mandibular ramus, and incremental dynamic CT with intravenous bolus injection of contrast medium to detect the relation between the tumor and carotid sheath. We conclude that the images of CT sialography are much better than those of plain CT and intravenous enhancement CT.

[The value of sialography in the diagnosis of parotid tumors]

Sialographic manifestations of 442 patients with primary parotid tumors, 336 benign and 106 malignant, were studied. The sialographic appearance were divided into five types: benign, aggressive benign, low-grade malignant, malignant, and adenolymphoma. The overall corresponding rate between roentgenographic and histologic diagnosis was 81.9%, benign tumors was 89.3, malignant tumors 58.5%, and adenolymphoma 88.9%. Irregular-arrangement, dilation and narrow of branch ducts were the characteristics of adenolymphoma. Extension of main duct, smooth defect of posterior border of mandibular ramus, posterior displace of styloid process, and filling defect of branch ducts and acini in the pterygomandibular space were seen in deep lobe parotid tumors. The causes of mistaken, and the value of sialography were discussed.

Tumours of the minor salivary glands. A clinicopathologic study of 243 cases

243 patients with tumours of the minor salivary glands were analysed clinicopathologically. The palate was the most common location for the lesions. Mixed tumours (pleomorphic adenomas) were the most common benign tumour type. Muco-epidermoid carcinoma and adenoid cystic carcinoma were the dominant types of malignant tumours. For malignant tumours, the overall 3-year survival rate was 84.0%, 5-year 80.2%, 10-year 66.7% and 15-year 53.6%. The overall recurrency rate was 38.9%. The rate of cervical lymph node metastases and distant metastases rate were both 9.2%.

Hemodynamic findings during sinus rhythm, atrial and AV sequential pacing compared to ventricular pacing in a dog model

The hemodynamic responses of atrial (AP), atrioventricular sequential (AVP) and ventricular pacing (VP) were compared to sinus rhythm (SR) in seventeen anesthetized dogs with intact AV conduction. The atrium and/or ventricle were paced at fixed rates above the control sinus rate. An AV interval shorter than normal conduction was selected to capture the ventricle. The changes of pulmonary capillary wedge pressure (PCWP, mmHg), mean aortic pressure (MAP, mmHg), cardiac output (CO, L/min), systemic vascular resistance (SVR, dynes/s/cm-5), left ventricular stroke work index (SWI) and mean systolic ejection rate (MSER, ml/s) during sinus rhythm, atrial pacing and atrioventricular sequential pacing (expressed in percentages of the individual values during ventricular pacing) were: (Chart: See text) The importance of atrial systole for cardiac performance was clearly demonstrated in dogs with normally compliant hearts. In both atrial and atrioventricular sequential pacing compared to ventricular pacing there was a reduction of pulmonary capillary wedge pressure (PCWP) (p less than 0.01) and systemic vascular resistance (SVR) (p less than 0.01) despite an increase in cardiac output (CO). The lesser mean systolic ejection rate (MSER) found during atrioventricular sequential pacing compared to sinus rhythm and atrial pacing may be explained by the abnormal ventricular depolarization in this pacing mode; nevertheless, the mean systolic ejection rate was still greater than that found during ventricular pacing (p less than 0.05).

Carcinoma of the salivary gland: a clinicopathologic study of 405 cases

Four hundred five cases with carcinoma of salivary glands were analyzed clinicopathologically; 181 tumors were located in parotid, 52 were in submandibular, 21 were in sublingual, and 151 were in minor salivary glands. Mucoepidermoid carcinoma and adenoid cystic carcinoma were the most common histologic types. The overall 3-, 5-, 10-, and 15-year survival rates were 77.8%, 69.6%, 55.8%, and 36.7%, respectively. The difference between survival and recurrence-free survival rate was 9%. The prognosis of acinic cell carcinoma and mucoepidermoid carcinoma was much better than that of squamous cell carcinoma, adenocarcinoma, and undifferentiated carcinoma. The survival rates of minor salivary gland tumors was the highest, and those of submandibular gland tumors were the lowest. Postoperative radiotherapy improved the prognosis of adenoid cystic carcinoma. The overall recurrence rate was 40.2%; the cervical lymph node metastases rate was 15.3%, and the distant metastases rate was 11.1%.

[Carcinoma of salivary glands--a clinical analysis of 342 cases]

342 cases with carcinoma of salivary glands were analysed. 152 tumors were located in parotid, 42 in submaxillary, 17 in sublingual and 131 in minor salivary glands. Pathological diagnosis were 106 mucoepidermoid carcinoma, 80 adenoid cystic carcinoma, 54 malignant mixed tumor, 40 adenocarcinoma, 38 papillary cystadenocarcinoma, 17 acinic cell carcinoma, 5 squamous cell carcinoma, and 2 undifferentiated carcinoma. The 3, 5, 10 and 15 year survival rates of these 342 cases were 76.6%, 65.9%, 48% and 29%, respectively. The difference between survival rate and relapse-free survival rate was about 8%. The prognosis of acinic cell carcinoma and mucoepidermoid carcinoma was much better than that of squamous cell carcinoma, adenocarcinoma and undifferentiated carcinoma. The survival rates, according to location, were: minor salivary gland tumors the highest, and those of submaxillary gland tumors the lowest. Postoperative radiotherapy improved the survival rate of adenoid cystic carcinoma. The overall recurrence rate was 37.4%, the neck lymph node metastasis rate 14.3% and the distant metastasis rate 9.1%.