• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.4061-4063
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• 2015

Background: To evaluate pathological features of head and neck squamous cell carcinoma (HNSCC) and to compare these pathological features in patients younger and older than 40 years. Materials and Methods: All resection specimens of HNSCC between 2010 and 2013 evaluated. Tumor characteristics - grade, location (site) cervical node status, alongwith presence or absence of extranodal extension, lymphovascular invasion, gender and age - were extracted from surgical pathology reports. Results: Among these n=19 patients (21.8%) were 40 years or younger and n=68 patients (78.2%) were above 40 years of age. The mean age was 34 (20-40 years) in the younger group and 56 (42-86) in the older group. The most common location of HNSCC in both groups was the oral cavity. The analysis of histopathological features including grade of tumor, tumor size, extranodal extension and comparison between two groups do not show any significant difference. Conclusions: There are no specific pathological characteristics of HNSCC in young patients. An interesting observation is that exposure to expected risk factors is similar in both groups, in younger patients they have less time to act and yet tumors are the same in terms of tumor size, lymph node status and lymphovascular invasion. Therefore further research is recommended to look for potentiating factors.

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.2935-2940
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• 2016

Breast cancer is the most frequent type of cancer diagnosed among women worldwide and also in Thailand. Estrogen and estrogen receptors exert important roles in its genesis and progression. Several cytokines have been reported to be involved in the microenvironment that promotes distant metastasis via modulation of immune and inflammatory responses to tumor cells. Estrogen receptor genetic polymorphisms and several cytokines have been reported to be associated with breast cancer susceptibility and aggressiveness. To investigate roles of genetic polymorphisms in estrogen receptor alpha (ESR1) and interleukin 6 (IL6), breast cancer patients and control subjects were recruited from the Division of Head, Neck and Breast Surgery (Siriraj Hospital, Bangkok, Thailand). Polymorphisms in ESR1 (rs3798577) and IL6 (rs1800795 and rs1800797) were evaluated by real-time PCR in 391 breast cancer patients and 79 healthy controls. Associations between genetic polymorphisms and clinicopathological data were determined. There was no association between genetic polymorphisms and breast cancer susceptibility. However the ESR1 rs3798577 CT genotype was associated with presence of lymphovascular invasion (OR=2.07, 95%CI 1.20-3.56, p=0.009) when compared to the TT genotype. IL6 rs1800795 CC genotype was associated with presence of extranodal extension (OR= 2.30, 95%CI 1.23-4.31, p=0.009) when compared to the GG genotype. Survival analysis showed that IL6 rs1800797 AG or AA genotypes were associated with lower disease-free survival. These findings indicate that polymorphisms in ESR1 and IL6 contribute to aggressiveness of breast cancer and may be used to identify high risk patients.

• 대한두경부종양학회지
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• 제37권2호
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• pp.33-41
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• 2021

Background/Objectives: Extra-nodal extension (ENE) is one of the strongest prognosticators in oral cancers. Here we tried to evaluate clinicopathological factors associated with the presence of ENE. Materials & Methods: We retrospectively analyzed clinical information of 120 patients who diagnosed with oral cancer and received curative surgery at our hospital from Mar 2012 to Apr 2020. We comparatively analyzed clinicopathological factors associated with the presence of lymph node (LN) metastasis and ENE, respectively. Results: Variable factors of primary tumor characteristics such as lymphovascular invasion, perineural invasion, largest diameter of tumor, depth of invasion and maximum standardized uptake value were significantly associated with the presence of cervical LN metastasis. The largest diameter of tumor was statistically significant also in multivariate analysis for predicting the LN metastasis. Meanwhile, the association between primary tumor characteristics and the presence of ENE were not statistically significant except the primary tumor size. Importantly, factors associated with LN characteristics including the maximum diameter and number of metastatic LNs were significantly associated with ENE. Conclusion: In this study, several factors affecting cervical LN metastasis and ENE in oral cancer patients were identified. The ENE seems to be influenced by the status of the metastatic LNs, such as the number of metastatic LNs, rather than the characteristics of the primary tumor itself.

• 대한두경부종양학회지
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• 제33권2호
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• pp.9-15
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• 2017

The recently released the $8^{th}$ edition of the American Joint Committee on Cancer (AJCC) Staging Manual introduces significant modifications from the prior $7^{th}$ edition. In this paper, the contents of the new changes in the decision of cancer of the head and neck is summarized except changes in staging of skin and thyroid cancer. In addition to the 8th edition, 1) Addition of extracapsular involvement in metastatic lymph nodes (N category) 2) Oral cancer T classification change, 3) Staging of the pharyngeal cancer was divided into 3 chapters: high-risk human papilloma virus (HR-HPV) associated oropharyngeal cancer (OPC), non HR-HPV associated OPC and hypopharynx cancer (HPC), and nasopharynx cancer (NPC) 4) Changes in T and N classification in NPC, 5) In the case of cancer of unknown primary, P16-positive case is defined as HR-HPV related OPC, and EBV-positive case is defined as NPC. The process that led to these changes highlights the need to collect high-fidelity cancer registry-level data that can be used to confirm prognostic observations identified in institutional data sets. Clinicians will continue to use the latest information for patient care, including scientific content of the 8th Edition Manual. All newly diagnosed cases through December $31^{st}$ 2017 should be staged with the 7th edition. The time extension will allow all partners to develop and update protocols and guidelines and for software vendors to develop, test, and deploy their products in time for the data collection and implementation of the 8th edition in 2018. The 8th edition strikes a balance between a personalized, complex system and a more general, simpler one that maintains the user-friendliness and worldwide acceptability of the traditional TNM staging paradigm.

• Asian Pacific Journal of Cancer Prevention
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• 제15권3호
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• pp.1481-1488
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• 2014

Background: To avoid performing axillary lymph node dissection (ALND) for non-sentinel lymph node (SLN)-negative patients with-SLN positive axilla, nomograms for predicting the status have been developed in many centers. We created a new nomogram predicting non-SLN metastasis in SLN-positive patients with invasive breast cancer and evaluated 14 existing breast cancer models in our patient group. Materials and Methods: Two hundred and thirty seven invasive breast cancer patients with SLN metastases who underwent ALND were included in the study. Based on independent predictive factors for non-SLN metastasis identified by logistic regression analysis, we developed a new nomogram. Receiver operating characteristics (ROC) curves for the models were created and the areas under the curves (AUC) were computed. Results: In a multivariate analysis, tumor size, presence of lymphovascular invasion, extranodal extension of SLN, large size of metastatic SLN, the number of negative SLNs, and multifocality were found to be independent predictive factors for non-SLN metastasis. The AUC was found to be 0.87, and calibration was good for the present Ondokuz Mayis nomogram. Among the 14 validated models, the MSKCC, Stanford, Turkish, MD Anderson, MOU (Masaryk), Ljubljana, and DEU models yielded excellent AUC values of > 0.80. Conclusions: We present a new model to predict the likelihood of non-SLN metastasis. Each clinic should determine and use the most suitable nomogram or should create their own nomograms for the prediction of non- SLN metastasis.

• 대한두경부종양학회지
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• 제38권1호
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• pp.17-24
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• 2022

Background/Objectives: This study analyzed the prognostic significance of clinico-pathologic factors including comprehensive nodal factors in parotid gland cancers (PGCs) patients and constructed a survival prediction model for PGCs patients using machine learning techniques. Materials & Methods: A total of 131 PGCs patients were enrolled in the study. Results: There were 19 cases (14.5%) of lymph nodes (LNs) at the lower neck level and 43 cases (32.8%) involved multiple level LNs metastases. There were 2 cases (1.5%) of metastases to the contralateral LNs. Intraparotid LNs metastasis was observed in 6 cases (4.6%) and extranodal extension (ENE) findings were observed in 35 cases (26.7%). Lymphovascular invasion (LVI) and perineural invasion findings were observed in 42 cases (32.1%) and 49 cases (37.4%), respectively. Machine learning prediction models were constructed using clinico-pathologic factors including comprehensive nodal factors and Decision Tree and Stacking model showed the highest accuracy at 74% and 70% for predicting patient's survival. Conclusion: Lower level LNs metastasis and LNR have important prognostic significance for predicting disease recurrence and survival in PGCs patients. These two factors were used as important features for constructing machine learning prediction model. Our machine learning model could predict PGCs patient's survival with a considerable level of accuracy.

• 대한두개안면성형외과학회지
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• 제24권5호
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• pp.211-217
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• 2023

Background: Oral cavity cancers, the second most common type in India, are responsible for 10% of the overall cancer burden. With a recurrence rate of 30% to 40% and a 5-year survival rate of 50%, these malignancies account for substantial morbidity and mortality. Despite advances in treatment modalities, survival rates following treatment completion have not improved significantly. The present study aimed to establish specific epidemiological and pathological factors responsible for recurrence after treatment completion in buccal mucosa cancers. Methods: A retrospective analysis of the data of 116 patients treated for biopsy-proven cancers of the buccal mucosa was undertaken 1 year after treatment completion. Factors such as age, sex, education, lymphovascular invasion, extranodal extension (ENE), perineural invasion, depth of invasion, and pathological margin status were compared between patients who presented with recurrence and those who did not. Statistical significance was set at p< 0.05. Results: Of the 116 patients, 40 (34.5%) developed a recurrent disease within 1 year. The mean age of the study population was 43.3 years, and males constituted 91.4% of the included patients. Ipsilateral buccal mucosa was the commonest site of disease recurrence. Neck node metastasis, ENE, and margins of resection < 5 mm were significantly related to the recurrence of disease. However, surprisingly, lymphovascular invasion, perineural invasion, and depth of invasion > 10 mm did not show statistically significant associations. Conclusion: Neck node metastasis, ENE, and margins of resection < 5 mm were the histopathological factors associated with recurrence in cancers of the buccal mucosa.

• Journal of Chest Surgery
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• 제32권6호
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• pp.536-542
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• 1999

배경: 비소세포성 폐암의 치료방법 중에서 아직까지 장기 생존을 기대할 수 있는 가장 좋은 방법은 수술적 완전 절제술이지만, 그 때문에 불필요한 시험적 개흉술을 시행받는 환자도 해마다 상당한 수에서 보고되고 있다. 본 연구에서는 비소세포성 폐암에서 시행된 개흉술에서 수술적 절제가 불가능하였던 원인을 분석하여 불필요한 개흉술을 줄이는데 일조하고자 한다. 대상 및 방법: 1990년 1월부터 1996년 12월까지 본원에서 원발성 폐암으로 개흉술을 시행받은 616명의 환자중에서 시험적 개흉술을 시행받은 59명(9.6%)을 대상으로 하여 그 임상기록을 관찰하여 기관지 내시경 소견, 조직 진단 방법, 컴퓨터 단층 촬영 결과, 페기능 검사 및 폐관류 스캔, 절제가 불가능했던 원인, 수술후 보조요법 여부 등을 분석하였고, 수술후 생존기간을 추적하였다. 결과: 폐암종의 세포 유형은 편평세포암종 38명, 선암종 15명, 대세포암종 3명, 기타 3명이었고 원발부위는 우상엽 20명, 우중엽 6명, 우하엽 8명, 좌상엽 13명, 좌하엽 4명, 기타 8명이었다. 절제가 불가능했던 원인으로는 종격동내 인근조직이나 기관으로의 암세포 침윤이 41명으로 가장 많았으며, 흉강내 암세포 파종 8명, 광범위한 흉벽 침윤 3명, 피막을 포함한 림프절 암전이 2명, 기타 5명 등이었다. 추적관찰이 가능했던 58명에서 시험적 개흉술후 생존율은 12개월 생존율이 55.2%, 24 개월 생존율이 17.2% 이었고, 평균 생존기간은 14개월이었다. 폐암종의 세포유형이나 수술후 보조치료 요법에 따른 생존율의 차이는 없었다. 세포유형에 따른 특성은 편평세포암종의 경우 기관지 폐색과 무기폐를 잘 동반하였으며 종격동내 구조물로의 암세포 침윤이 시험적 개흉술을 시행한 주된 이유였다. 선암종에서는 흉강내 암세포 파종이 편평세포암종에서보다 의미있게 많았다. 결론: 본 연구의 자료분석을 통하여 시험적 개흉술을 시행받은 환자중 일부는 시험적 개흉술을 피하거나 수술적 절제를 할수도 있었을 것으로 생각되었다. 선암종으로 흉막 삼출액, 흉막내 암세포 파종이 의심되는 환자에서는 개흉술전 흉강경술을 도입하고, 편평세포암종의 종격동 침윤이 의심되는 환자에서는 MRI, 개흉술전 흉강경술의 도입등으로 수술전에 수술적 절제 가능성을 면밀히 판단하고 일단 개흉시에는 보다 적극적인 수술적 절제를 시행하는 것이 비소세포성 폐암의 시험적 개흉술을 줄이는데 필요할 것으로 사료되었다.