• 대한두경부종양학회지
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• 제11권2호
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• pp.173-177
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• 1995

Multiple primary malignant neoplasms occur relatively frequently today and are important especially in the head and neck area for they usually carry a bad prognosis. Detection of a synchronous primary tumor at the time of initial work-up is crucial both for management and final outcome. The first case was a T1 hypopharyngeal cancer with a mid-esophageal second primary who complained of a huge neck node. The second case was a T3 hypopharyngeal cancer who was initially seen by the chest surgeons for a large lower esophageal tumor. The third case was a patient previously operated for stomach adenocarcinoma three years ago, who had newly developed symptoms like dysphagia and hoarseness, and was diagnosed as hypopharyngeal T3 with oropharyngeal second primary cancer. Three cases were all heavy smokers and had histories of heavy alcohol consumption. They were all treated at the same sitting by en-block resection of the involved organs and postoperative radiation therapy. The authors have recently experienced 3 cases of synchronous second primary cancers in association with hypopharyngeal cancer and a report is made.

• Radiation Oncology Journal
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• 제34권4호
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• pp.280-289
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• 2016

Purpose: Early hypopharyngeal squamous cell carcinoma (HPSCC) is a rarely diagnosed disease, for which the optimal treatment has not been defined yet. We assessed patterns of failure and outcomes in early HPSCC treated with various therapeutic approaches to identify its optimal treatment. Materials and Methods: Thirty-six patients with stage I (n = 10) and II (n = 26) treated between January 1992 and March 2014 were reviewed. Patients received definitive radiotherapy (RT) (R group, n = 10), surgery only (S group, n = 19), or postoperative RT (PORT group, n = 7). All patients in both the R and PORT groups received elective bilateral neck irradiation. In the S group, 7 patients had ipsilateral and 8 had bilateral dissection, while 4 patients had no elective dissection. Results: At a median follow-up of 48 months, the 5-year locoregional control (LRC) rate was 65%. Six patients had local failure, 1 regional failure (RF), 3 combined locoregional failures, and 2 distant failures. There was no difference in 5-year LRC among the R, S, and PORT groups (p = 0.17). The presence with a pyriform sinus apex extension was a prognosticator related to LRC (p = 0.01) in the multivariate analysis. Patients with a bilaterally treated neck showed a trend toward a lower RF rate (p = 0.08). Conclusion: This study shows that patients with early stage HPSCC involving the pyriform sinus apex might need a tailored approach to improve LRC. Additionally, our study confirms elective neck treatment might have an efficacious role in regional control.

• International Journal of Oral Biology
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• 제47권3호
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• pp.41-48
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• 2022

Ulva compressa Linnaeus (UCL) is a green algae seaweed that performs photosynthesis and is used as a food material in some Asian regions including Korea. It is known to be the dominant species in copper ion-contaminated seas, and many studies on copper ion resistant mechanisms have been reported. UCL is known to have an excellent antioxidant effect, but limited information is available regarding its other physiological activities. In this study, we investigated the anticancer activity of 30% prethanol extracts of Ulva compressa Linnaeus (30% PeUCL) and the underlying mechanisms of its activity on human FaDu hypopharyngeal squamous carcinoma cells. The 30% PeUCL extracts suppressed FaDu cell viability without affecting normal cells (L929), as determined by MTT and viability assays. Furthermore, the 30% PeUCL extracts induced apoptosis, as determined by DAPI staining. The 30% PeUCL extracts inhibited colony formation effectively as well as wound-healing of FaDu cells, even at noncytotoxic concentrations. In addition, 30% PeUCL extracts induced apoptosis significantly through proteolytic cleavage of caspase-3, -7, and -9, and poly (ADP-ribose) polymerase, and by downregulation of Bcl-2 and upregulation of Bax in FaDu cells, as determined by Western blot analysis. Collectively, these results suggest that the inhibitory effect of 30% PeUCL extracts on the growth of oral cancer cells, colony formation and wound-healing may be mediated by caspase- and mitochondrial-dependent apoptotic pathways in human FaDu hypopharyngeal squamous carcinoma cells. Therefore, 30% PeUCL extracts can be administered as a natural chemotherapeutic drug for the treatment of human oral cancers.

• Archives of Plastic Surgery
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• 제49권3호
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• pp.378-396
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• 2022

Several reconstructive methods have been reported to restore the continuity of the aerodigestive tract following resection of pharyngeal and hypopharyngeal cancers. However, high complication rates have been reported after voice prosthesis insertion. In this setting, the ileocolon free flap (ICFF) offers a tubularized flap for reconstruction of the hypopharynx while providing a natural phonation tube. Herein, we systematically reviewed the current evidence on the use of the ICFF for reconstruction of the aerodigestive tract. A systematic literature search was conducted across PubMed MEDLINE, Web of Science, ScienceDirect, Scopus, and Ovid MEDLINE(R). Data on the technical considerations and surgical and functional outcomes were extracted. Twenty-one studies were included. The mean age and follow-up were 54.65 years and 24.72 months, respectively. An isoperistaltic or antiperistaltic standard ICFF, patch flap, or chimeric seromuscular-ICFF can be used depending on the patients' needs. The seromuscular chimeric flap is useful to augment the closure of the distal anastomotic site. The maximum phonation time, frequency, and sound pressure level (dB) were higher with ileal segments of 7 to 15 cm. The incidence of postoperative leakage ranged from 0 to 13.3%, and the majority was occurring at the coloesophageal junction. The revision rate of the microanastomosis ranged from 0 to 16.6%. The ICFF provides a reliable and versatile alternative for reconstruction of middle-size defects of the aerodigestive tract. Its three-dimensional configuration and functional anatomy encourage early speech and deglutition without a prosthetic valve and minimal donor-site morbidity.

• Radiation Oncology Journal
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• 제36권3호
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• pp.192-199
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• 2018

Purpose: Use of radiotherapy combined with chemotherapy is increasing in hypopharyngeal cancer. However, many show residual tumor after radiotherapy. Timing for treatment evaluation and salvage therapy is essential. However, optimal timing for salvage surgery has not been suggested. In this study, we tried to evaluate optimal timing for salvage surgery. Methods and Materials: Patients who were diagnosed with hypopharyngeal squamous cell carcinoma between 2006 and 2015 were retrospectively analyzed. All patients received definitive radiotherapy with or without chemotherapy. Response of all treated patients were analyzed at 1, 3, and 6 months after radiotherapy. Any patients with progression before 6 months were excluded. Results: A total of 54 patients were analyzed. Complete remission (CR) rates at 1 month (CR₁), 3 months (CR₃) and 6 months (CR₆) were 66.7%, 81.5%, and 90.7%, respectively. Non-CR at 1 month (NCR₁), 3 months (NCR₃), and 6 months (NCR₆) showed poor locoregional recurrence-free survival rates (1-year rates of 63.7%, 66.7%, and 0.0%, respectively) compared to CR₁, CR₃, and CR₆ (1-year rates 94.3%, 88.0%, and 91.5%, respectively). Particularly significant differences were seen between CR₆ and NCR₆ (p < 0.001). Of 10 patients with NCR₃, 5 showed CR at 6 months (NCR₃/CR₆). There was no statistical difference in locoregional recurrence-free survival between CR₃ and NCR₃/CR₆ group (p = 0.990). Conclusion: Our data suggest half of patients who did not show CR at 3 months eventually achieved CR at 6 months. Waiting until 6 months after radiotherapy may be appropriate for avoiding additional salvage therapy.

• Journal of Digestive Cancer Research
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• 제6권1호
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• pp.36-39
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• 2018

여러 가지 원인으로 인해 다발성 원발암은 증가하고 있으며, 발생 가능성을 염두에 두고 필요한 선별 검사를 시행하여야 적절한 치료가 이루어질 수 있다. 저자들은 국내에서는 보고된 적이 없고 전세계적으로도 희귀한 5중 원발암의 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Radiation Oncology Journal
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• 제36권2호
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• pp.95-102
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• 2018

Purpose: To evaluate the prognostic value of $^{18}F$-fluorodeoxyglucose positron-emission tomography (FDG PET) with computed tomography (CT) before and during radiotherapy (RT) in patients with head and neck cancer. Methods: Twenty patients with primary head and neck squamous cell carcinoma were enrolled in this study, of whom 6 had oropharyngeal cancer, 10 had hypopharyngeal cancer, and 4 had laryngeal cancer. Fifteen patients received concurrent cisplatin and 2 received concurrent cetuximab chemotherapy. FDG PET/CT was performed before RT and in the 4th week of RT. The parameters of maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) of the primary tumor were measured, and the prognostic significance of each was analyzed with the Cox proportional hazards model. Results: Higher TLG (>19.0) on FDG PET/CT during RT was a poor prognostic factor for overall survival (OS) (p = 0.001) and progression-free survival (PFS) (p = 0.007). In the multivariate analysis, TLG during RT as a continuous variable was significantly associated with OS and PFS rate (p = 0.023 and p = 0.016, respectively). Tumor response worse than partial remission at 1 month after RT was another independent prognostic factor for PFS (p = 0.024). Conclusions: Higher TLG of the primary tumor on FDG PET/CT during RT was a poor prognostic factor for OS and PFS in patients with head and neck cancer.

• Journal of Chest Surgery
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• 제27권2호
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• pp.140-147
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• 1994

Reconstruction of the pharynx and cervical esophagus presents a tremendous challenges to surgeons. Over the past 2 years[1990, Dec.-1993, Jun], the free jejunal graft has been performed in 17 cases in Korea Cancer Center Hospital.The indications of this procedures were almost malignant neoplasms involving neck and upper aero-digestive tract; Hypopharyngeal cancer[12 cases, including 2 recurrent cases], laryngeal cancer[2 cases], thyroid cancer[2 cases, including 1 recurrent case], cervical esophageal cancer[1 case]. There were fifteen men and two women, and the mean age was 59.6 years. The anastomosis site of jejunal artery were common carotid artery[16 cases] or external carotid artery[1 case] and that of jejunal vein were internal jegular [15 cases] or facial[1 case] and superior thyroid vein[1 case]. The length of jejunal graft was from 9 cm to 17 cm[mean 13 cm] and the mean ischemic time was 68 minutes. There was one hospital mortality which was irrelevant to procedures[variceal bleeding] and one graft failure[1/16]. Other postoperative complications were neck bleeding or hematoma[3 cases], abdominal wound infection or disruption[5 cases], anastomosis site leakage[1 case], pneumonia[2 cases], graft vein thrombosis[1 case], and food aspiration[1 case]. The function of conduit was excellent and ingestion of food was possible in nearly all cases. Postoperative adjuvant radiation therapy was also applicable without problem in 7 cases. During follow-up periods, the anastomosis site stenosis developed in four patients, and the tracheal stoma was narrowed in one case but easily overcome with dilation. In conclusion, we think that the free jejunal graft is one of the excellent reconstruction methods of upper digestive tract, especially after radical resection of malignant neoplasm in neck with a high success rate and low mortality and morbidity rate.

• 대한영상의학회지
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• 제82권5호
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• pp.1246-1257
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• 2021

목적 본 연구의 목적은 두경부암의 종격동 림프절 전이의 예측인자와 영상 소견을 알아보고자 함이다. 대상과 방법 이 연구에서 저자들은 두경부암 환자 중에서 종격동 림프절 전이그룹과 비전이 그룹 사이의 임상 소견 및 질병의 특성(성별, 연령, 원발성 종양 부위, 조직학적 유형, 악성종양에 대한 이전 치료이력, T-, N- 및 M- 단계, 경부 림프절 전이) 들을 비교하였다. 또한 저자들은 전이그룹에서 종격동 림프절 분류에 따라 림프절 전이의 흉부 전산화단층촬영(전이분포와 림프절 최대직경) 및 양전자방출단층촬영/전산화단층촬영(최대 표준섭취계수)의 소견을 평가하였다. 결과 두경부암 환자 470명 중 55명(11.7%)에서 150개의 종격동 station을 포함하는 종격동 림프절 전이가 발견되었다. 하인두암, 재발한 종양, T4, N2/N3, 및 M1 단계는 종격동 림프절 전이의 의미 있는 예측인자로 평가되었다. 종격동 림프절 전이의 가장 흔한 위치는 일측 station 2 (상부기관주위 림프절, 36.4%), 일측 station 11 (엽간 림프절, 27.3%), 일측 station 10(폐문 림프절, 25.5%) 순이었다. 결론 하인두암, 재발성 종양 및 높은 TNM 단계인 경우, 두경부암의 종격동 림프절 전이 가능성을 고려하여야 한다.