• Korean Journal of Head & Neck Oncology
• /
• v.34 no.2
• /
• pp.53-56
• /
• 2018

Despite adequate diagnostic work-up, unknown primary carcinoma(UPC) of the head and neck cannot be detected in approximately 2- 3% of patients.(1,2) There are several explanations for a cervical metastasis in the absence of a primary tumor. Here in, we report 2 patients, who were diagnosed with nasopharyngeal cancer after treatment of unknown primary cancer of the neck. Both patients had radical neck dissections and chemoradiation therapy, but 1 patient showed nasopharyngeal cancers 4 years after treatment and the other patient at 9 months after treatment for the unknown primary cancer. Therefore, we report 2 cases of nasopharyngeal cancer, which were diagnosed after treatment of unknown head and neck primary site.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.26 no.2
• /
• pp.154-163
• /
• 2000

Growth factors and the receptors play an important role in the regulation of the growth and development of mammalian cells. In particular, epidermal growth factor is a polypeptide with potent mitogenic activity that stimulates proliferation of various normal and neoplastic cells through the interaction with its specific receptor(EGFR). EGFR has been described as a parameter of poor prognosis in many human neoplasms such as breast, bladder, and vulvar cancers. The objectives of this study are the evaluation of the expression of EGFR and cell cycle analysis in the head and neck squamous cell carcinomas(SCC), and the evaluation of the correlation between clinico-patholgic features and expression of EGFR and S-phase fraction. 37 head and neck squamous cell carcinoma specimens were evaluated for expression of EGFR by Western blot analysis and S-phase fraction by cell cycle analysis using the flow cytometry. The obtained results were as follows : 1. The expressions of EGFR were observed in 20 specimens(54%) among 37 head and neck SCC specimens. In case of oral SCC, 15 specimens(56%) out of 27 specimens were observed, and in case of nasopharyngeal SCC 5 specimens(50%) out of 10 specimens. 2. There was no correlation between clinical features(location, stage) of head and neck SCC and expression of EGFR (p>0.05). 3. There was a significant correlation between histo-pathological differentiation of head and neck SCC and expression of EGFR (p<0.02). 4. There was a significant correlation between expression of EGFR and S-phase fraction of cell cycle in the head and neck SCC (p<0.05). The above results suggest that expression of EGFR and S-phase fraction of cell cycle are adjunctive prognostic marker in the head and neck squamous cell carcinomas.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.3
• /
• pp.885-890
• /
• 2012

Background: Head and neck cancers are prevalent in Thailand, in particular in the southern region of the country. However, survival with a large data set has not been reported. The purpose of the present study was to evaluate the survival figures and the prognostic factors in a cohort of patients treated in a university hospital located in the south of Thailand. Patients and Methods: Consecutive new cases of primary carcinoma of the oral cavity, oropharyx, hypopharynx and larynx, treated at Songklanagarind Hospital during 2002 to 2004, were analyzed. The 5-year overall survival rates were obtained by the Kaplan-Meier method. Prognostic factors were identified through multivariate Cox regression analysis. Results: A total 1,186 cases were analyzed. Two-thirds (66.6%) of the cases were at advanced stage (stage III & IV) at presentation. The five-year overall survivals for the whole cohort, oral cavity, oropharynx, hypopharynx and larynx were 24.1%, 25.91%, 19.2%, 13.4%, 38.0% respectively. Stage and treatment type were strong prognostic factors for all sites. An age ${\geq}$ 80 years was associated with poor survival in oral cavity and larynx cancer. Conclusions: The results revealed remarkably poor outcomes of the patients in the series, indicating a strong need to increase the proportion of early stage presentations and maximize the treatment efficacy to improving outcomes. Very old patients are of particular concern for treatment care of oral cavity and larynx cancer.

• Korean Journal of Head & Neck Oncology
• /
• v.12 no.2
• /
• pp.147-152
• /
• 1996

For advanced head and neck cancers that originate in midline structures, bilateral neck dissection should be considered even if the lymph nodes were negative clinically. But, many complications and mortalities may occur in synchronous bilateral neck dissection at sacrifing of both internal jugular vein. Therefore several types of bilateral neck dissection have been proposed, but the effective and safe methods were not determined yet. So, we have prefered the method of synchronous bilateral neck dissection with preserving one internal jugular vein at least. We operated 21 patients who might be expected high incidences of bilateral neck metastases with above type of neck dissection. We analyzed the data of 21 cases(42 sides) retrospectively. The results were as follows: 1) The primary sites were transglottic(33%), supraglottic(29%), hypopharynx(29%) and tongue base(9%). 2) Types of neck dissection were RND(4 sides), MND(7 sides), FND(16 sides), and SND (15 sides). 3) Postoperative complications were minimal and did not influenced morbidity. 4) Mean interval time of neck recurrence was 21 months. Overall neck recurrent rate after bilateral neck dissecton was 19%. In 19%, neck recurrence from positive lymph nodes was 63% and from negative lymph nodes was 37%. As a results, synchronous bilateral neck dissection with preservation of one internal jugular vein minimally should be done in cases which were suspected high incidence of bilateral lymph node metastases for cure and prevention of neck recurrence.

• Korean Journal of Head & Neck Oncology
• /
• v.13 no.1
• /
• pp.3-8
• /
• 1997

Malignant melanoma has a very poor prognosis compared to other cancers. There are no specific tumor markers other than clinical staging and depth of invasion to predict the prognosis of the malignant melanoma. The nm23 has been known to inhibit the metastasis of the malignant melanoma, some studies showed that it is highly expressed in the malignant melanoma cell line which has a relatively weak metastatic potential. In this study, we compared the expression of nm23 in mucosal type with that in cutaneous type of the malignant melanoma in the head and neck according to the stage and survival rate to identify the role of nm23 expression as a prognostic factor in mucosal melanoma of the head and neck. Six out of eight cases in mucosal type and seven out of 11 cases in cutaneous type expressed nm23, which showed no significant differences. Between the two groups there were no significant differences in expression of nm23 according to clinicopathologic staging or two year survival rate. However, in cases with low cliniopathological staging and those surviving more than two years the expression was significantly increased which suggests that expression of nm23 can be used as an aid in determining the prognosis of mucosal melanoma.

• Korean Journal of Head & Neck Oncology
• /
• v.13 no.1
• /
• pp.24-29
• /
• 1997

Background: Supraglottic and hypopharyngeal regions drain into the upper deep cervical lymph nodes. And bilateral neck node metastasis is frequently occured especially, in the early stage. It influences on the prognosis of above diseases. The prognosis for patients wih supraglottic and hypopharyngeal cancers, although usually poor, has improved by modern imaging technique, better application of treatment modalities, increasing assortment of reconstructive procedures and improved application of radiation therapy. Objectives: This study was designed to obtain objective data about the patterns of neck node metastasis and to identify the necessity of elective bilateral neck dissection. Material and Methods: Twenty four patients with supraglottic cancer and twenty six patients with hypopharyngeal cancer were investigated from the chart review. Results: In supraglottic cancer, the most frequent sites of neck metastasis is level II (52.9%) and level III (52.9%) in ipsilateral side, level II (29.4%) in contralateral side, in hypopharyngeal cancer, level II (73.7%) and III (52.6%) in ipsilateral side, level II (10.5%) in contralateral side. In elective neck dissection, the occult metastasis is about 50% in supraglottic cancer, but there is no occult metastasis in hypopharyngeal cancer. Conclusion: In supraglottic cancer, elective bilateral neck dissection is necessary because of early contralateral neck metastasis, but in hypopharyngeal cancer, elective contralateral neck dissection may not be always necessary because of rare occult metastasis and contralateral neck metastasis.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.1
• /
• pp.217-220
• /
• 2012

This prospective study records the tobacco related habits among the relatives of patients with advanced head and neck cancers who underwent both surgery and chemotherapy as part of their treatment from September 2009 to March 2010. A total of 200 relatives were interviewed (148 males and 52 females). 198 (99%) were aware of the fact that tobacco use can lead to cancer and 168 (84%) had any one of the habits. Smoking alone was reported in 36 (18%) individuals, pan chewing alone in 66 (33%) and multiple habits in 64 (32%). Alcohol and tobacco chewing alone was reported in one case each. There were change in habits following diagnosis of head and neck cancers among the relatives, 33 (16.5%) stopped their habits and smoking was reduced by 25% in 72 (36%)and by 50% in 63 (31.2%) individuals. However, 135 continued the habit even after the diagnosis of cancer in their relatives. Of note, 15 out of the 33 who quit the habit did it because of health advice given to them during the hospital visit.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.4
• /
• pp.1683-1686
• /
• 2012

In the present case control study mRNA expression of the GSTP1 gene, encoding a phase II enzyme that detoxifies via glutathione conjugation, was investigated using semiquantitative PCR followed by SSCP for 49 confirmed head and neck (HN) cancer and 49 control samples. It was found that GSTP1 was upregulated in significantly higher number of cancers (OR 4.2, 95% CI 1.2-15.3). Grade wise correlation was also observed with more up regulation in patients with more advanced grades of HN carcinomas. We also found that 5 patients showed variation in mRNA with a larger product size than expected. Sequencing revealed insertion of an intronic segment between the $6^{th}$ and $7^{th}$ exon of the GSTP1 gene. Germline screening was performed showing mobility shifts which suggested mutation at the DNA level resulting in intronic portion retention. This study is of prime importance for drug design and treatment selection to overcome increased resistance of HN cancers to drugs due to alteration in the GSTP1 gene.

• Korean Journal of Head & Neck Oncology
• /
• v.38 no.1
• /
• pp.11-16
• /
• 2022

HHPV (Human Papillomavirus) is a DNA virus that can cause benign lesions, genitourinary cancer, and oropharyngeal cancer by penetrating the mucous membrane and skin. It is widely known to be transmitted mainly through sexual contact. As with many viral infections, vaccines have been developed to prevent infection with HPV. Currently, in many countries, HPV vaccines are mainly used for national immunization for women to prevent diseases that traditionally occur frequently in women, especially cervical cancer. However, since the vaccination rate is relatively low, many countries are struggling with ways to increase the vaccination rate. Meanwhile, the incidence of oropharyngeal cancer caused by HPV in men has been increasing recently. In the United States, the annual number of oropharyngeal cancers in men already exceeds the number of cervical cancers in women, so HPV infection in men has emerged as a major problem. Accordingly, interest in HPV vaccination in men has also increased, and studies on the effectiveness and necessity of vaccination of both women and men compared to women alone are being actively conducted. In this paper, the evidence of HPV vaccination for men will be reviewed through previous studies, and its validity and cost-effectiveness will be analyzed to bolster the clinical usefulness of HPV vaccination for men.

• Korean Journal of Head & Neck Oncology
• /
• v.15 no.2
• /
• pp.166-171
• /
• 1999

Background and Objectives: The aim of our study was to describe the appearance of recurrent and residual lesions in the head and neck tumors, and to evaluate the usefullness of CT and MRI. Materials and Methods: CT(n=42) and MRI(n=4) of 44 patients with recurrent head and neck tumors were reviewed retrospectively. Primary tumor sites were larynx/hypopharynx in 15, oral cavity/floor of mouth in 13, base of tongue/tonsil in 5, nasopharynx in 4, palate in 2, and others in 5 patients. Therapeutic modalities included sugery and radiotherapy in 23, radiotherapy in 11, surgery in 5, chemotherapy and radiotherapy in 4, and chemotherapy in 1 patient. Results: The patterns of tumor recurrence were nodal recurrence(n=17), primary tumor bed recurrence combined with nodal recurrence(n=12), primary tumor bed recurrence(n=10) and residual primary tumors(n=5). The most common appearance of residual/recurrent primary tumor on CT was focal or diffuse heterogenous mass with or without surrounding fat or muscle infiltration(25/27). On MRI, the recurrent lesions showed intermediate signal intensity on T1 weighted image and high signal intensity on T2 weighted image with heterogenous enhancement in the most cases(n=3). 38 out of 44 nodal recurrences(86%) which had been pathologically or clinically proved were more than 1 cm in diameter or contained central low density on CT scan. Conclusion: Although CT and MRI findings of recurrent and residual tumors of the head and neck were nonspecific, in the majority the lesions manifested as a mass at primary tumor bed and/or nodal disease including contralateral side of the neck. And CT and MRI are valuable for revealing above lesions.