• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.3
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• pp.214-219
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• 1995

Free grafting of oral mucosa for minor oral reconstruction was first described by Propper in ridge extension surgery. Situation calling for mucosal grafting procedures may relate to periodontal surgery, minor and major preprosthetic surgery, implant surgery, reconstruction in deformity cases after trauma, congenital cleft, gross atrophy and ablative tumor surgery. In the cases of 9 patients with mucosal defect of intraoral or orbital cavity after wide excision of tumor, preprosthetic surgery, and orbitoplasty, full-thickness mucosal graft were used to close a large defect. Four patients received buccal mucosal graft for preprosthetic surgery or orbitoplasty, one patient had benign tumor and the others had malignant tumors located on the palate or upper alveolus. Buccal mucosal graft donor site morbidity and trismus were minimal and healing of surgical defect was satisfactory. So we present the case with review of literatures.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3741-3745
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• 2012

Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide and the most common form of liver cancer. However, while it is associated frequently with hepatitis C virus (HCV) there is only an elementary understanding of its molecular pathogenesis. Methods: To gain insight into the molecular mechanisms of HCV-induced hepatocarcinogenesis, we performed microarray analysis on 75 surgical liver samples from 48 HCV-infected patients. Results: There were 395 differentially expressed geness between cirrhotic samples and HCC samples. Of these, 125 genes were up-regulated and 270 genes were down-regulated. We performed pathway enrichment analysis and screened as described previously. Conclusions: The differentially expressed genes might be involved in hepatocarcinogenesis through upregulating the pathways of ECM-receptor interaction, focal adhesion, cell adhesion molecules and other cancer-related pathways, and downregulating the pathways of "complement and coagulation cascades". We hope our results could aid in seeking of therapeutic targets for HCV-induced hepatocellular carcinoma.

• Radiation Oncology Journal
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• v.37 no.1
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• pp.13-21
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• 2019

Purpose: Glioblastoma (GBM) carries a high propensity for in-field failure despite trimodality management. Past studies have failed to show outcome improvements with dose-escalation. Herein, we examined trends and outcomes associated with dose-escalation for GBM. Materials and Methods: The National Cancer Database was queried for GBM patients who underwent surgical resection and external-beam radiation with chemotherapy. Patients were excluded if doses were less than 59.4 Gy; dose-escalation referred to doses ≥66 Gy. Odds ratios identified predictors of dose-escalation. Univariable and multivariable Cox regressions determined potential predictors of overall survival (OS). Propensity-adjusted multivariable analysis better accounted for indication biases. Results: Of 33,991 patients, 1,223 patients received dose-escalation. Median dose in the escalation group was 70 Gy (range, 66 to 89.4 Gy). The use of dose-escalation decreased from 8% in 2004 to 2% in 2014. Predictors of escalated dose were African American race, lower comorbidity score, treatment at community centers, decreased income, and more remote treatment year. Median OS was 16.2 months and 15.8 months for the standard and dose-escalated cohorts, respectively (p = 0.35). On multivariable analysis, age >60 years, higher comorbidity score, treatment at community centers, decreased education, lower income, government insurance, Caucasian race, male gender, and more remote year of treatment predicted for worse OS. On propensity-adjusted multivariable analysis, age >60 years, distance from center >12 miles, decreased education, government insurance, and male gender predicted for worse outcome. Conclusion: Dose-escalated radiotherapy for GBM has decreased over time across the United States, in concordance with guidelines and the available evidence. Similarly, this large study did not discern survival improvements with dose-escalation.

• Korean Journal of Head & Neck Oncology
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• v.16 no.2
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• pp.196-200
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• 2000

Objectives: Submandibular gland tumors is rare. The aim of this study is to get a clinical feature of submandibular gland tumors and to apply a treatment of submandibular gland tumors of future patients. Methods: We analyzed retrospectively the 18 patients with submandibular gland tumors who were treated surgically at Presbyterian Medical Center(PMC), during the period of 8 years from 1992 to 1999. Analysis was performed regarding the incidence, classification, surgical treatment, surgical complication, recurrence and prognosis. Result : 1) Male to female sex ratio was 1:1.25, the most prevalent age group was the 5th decade. 2) Benign tumors were 12 cases(66.7%) and malignant tumors were 6 cases(33.3%). 3) Histopathologically, the most common benign submandibular gland tumor was pleomorphic adenoma, and the most malignant submandibular gland tumor was adenoid cystic carcinoma. 4) In pleomorphic adenoma, excision of submandibular gland was performed in all case(8case). In malignant tumors, excision and supraomohyoid node dissection was performed in 3cases, and modified-radical neck dissection(RND) was performed in 2cases, and than standard RND was performed in 1case. 5) In the malignant tumor, we choose a radiation therapy as adjuvant therapy. 6) In a surgical complication of submandibular gland tumor, we had a facial nerve injury(1case). 7) Recurrence rate of submandibular gland tumor was 22.2%, and than all case were malignant tumor. Overall 5-year survival rate of submandibular gland cancer was 50%. Conclusion: In above results, postoperative recurrence rate is low in benign, but high in malignant tumor of submandibular gland. Surgical procedure should not be aggressive in benign tumor, but should be aggressive in malignant tumor of submandibular gland and an adjuvant radiation therapy should be considered.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.9767-9771
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• 2014

Background: Social support is an important factor in psycho-social well-being of cancer survivors. There is little information about level of social support and its predictors among cancer survivors in Iran or other Middle Eastern countries. The aims of present study were to determine the social support and its prediction factors among Iranian cancer survivors. Materials and Methods: In this descriptive-correlational study 187 cancer patients in one educational center and one private oncology office in northwest of Iran participated using a convenient sampling method. The data collection tool consisted of a researcher-prepared checklist and the Multidimensional Scale of Perceived Social Support Assessment (MSPSS). Data analysis was performed using SPSS statistical software with descriptive statistics and multiple linear regression analysis. Results: The total score of MSPSS was 68 from a possible score between 7 and 84. Participants believed that they received a high level of support from their family members and significant others. Multiple linear regression analysis showed that single and depressed cancer survivors and participants with lower levels of physical activity believed that they received lower levels of social support. Conclusions: Iranian cancer survivors receive high levels of social support and family members are the most important source of this support. In planning any supportive care program for Iranian cancer survivors this strength should be considered. Especially, single and depressed and patients with lower levels of physical activity need more attention.

• Korean Journal of Head & Neck Oncology
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• v.3 no.1
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• pp.15-24
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• 1987

This study is limited to epidermoid carcinoma arising in the larynx. The 623 patients in this series comprised 1.6% of all malignant neoplasms seen during the 20-year period .from 1965 to 1984 ; it comprised 13.2% of all cancers of the head and neck registered during this period. The male: female ratio was 11:1, and the highest incidence was in the fifth decade of life. Analysis by anatomical site revealed that 51.7% were supraglottic, 36.1% glottic, and 6.8% subglottic in oriain. One-hundred eighty-nine(79%) were clinically Stage III or Stage IV lesions at the time of the first visit. Of the total of 263 cases, 113 refused treatment, 4 definite radiation for $T_1$. lesion,21 underwent palliative therapy only, and 125 underwent surgical management with intent to cure. This surgical category included 53 patients who had surgical treatment only and 72 who underwent combined therapy(preoperative radiation, postoperative radiation, or inductive chemotherapy followed by surgery and postoperative radiation). The surgical management varied from partial laryngectomy to widefield laryngectomy and ipsilateral neck dissection. In 14.4% pathologically positive node or nodes were found in the clinically negative contralateral neck nedes. Such contralateral spread was most common in supraglottic site of origin(222%). Combined modality of management was compared to single therapy. Although results at three years showed no difference in determinate disease-free survival between patients treated by surgery only and those treated by surgery followed by postoperative radiation therapy at 5 years a statistically significant difference emerged, only 36% of those receiving surgery alone surviving as compared to 65.4% in the surgery with radiation group.

• Korean Journal of Head & Neck Oncology
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• v.15 no.2
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• pp.172-176
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• 1999

Background: An increasing number of traumatic, infectious, degenerative, benign, and malignant lesions of the clivus and cervical spine are treated by head and neck surgeons. Surgical techniques vary according to the exact level of the lesion. Objectives: The purpose of this article are to introduce the surgical approach and to discript our experience and to analyze the advantage of the each methods. Materials and Methods: Transpalatal approach in clivus chordoma, transoral approach in C2 fibrous dysplasia, trans mandibular approach in clivus meningioma and transcervical approach in neulilemmoma were reviewed from the medical record. Results: Postoperative complications occured. Otitis media with effusion were observed in transoral and trans mandibular approach. Cranial nerve paralysis was observed in transcervical approach. But other complications such as swallowing difficulty persisting over 6 weeks, malunion of mandible, orocutaneous fistula, hemorrhage from major vessel were not observed. Conclusion: The various surgical techniques to be described herein serve to give the best exposure of each level of the lesions. Therefore head and neck surgeon plays a major role in the treatment of lesion in the clivus and anterior cervical spine according to the lower incidence of postoperative morbidity.

• Korean Journal of Head & Neck Oncology
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• v.24 no.1
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• pp.9-14
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• 2008

The most important concern to do parotidectomy is correct identification of the facial nerve and preservation of the nerve function. Many descriptions for the localization and branching types of the facial nerve trunk have existed. During the parotid surgery, it is necessary to have knowledges about the incidence and prognostic aspect of a invasion of the facial nerve by the parotid tumors. The method of the dissection and the surgical extent of the parotid gland would be decided not only by the anatomic variation of the facial nerve. but also the size and location of the tumor. Invasion of the facial nerve in parotid malignancies is the most significant factors affecting the prognosis, so radical parotidectomy which consists of the total extirpation of the parotid gland in conjunction with resection of the facial nerve is often required for proper management. Radical parotidectomy is advocated for the surgical treatment of high grade malignancies and in selective recurrent benign tumors intimately involving the facial nerve. Unfortunately, the morphologic and functional deficits created by sacrificing the facial nerve can be emotionally and physically traumatizing to the patient. Therefore, when the facial nerve is sacrificed, immediate reconstruction of the facial nerve should be necessary. Immediate nerve repair with direct anastomosis of the resected nerve ends or placement of a cable nerve graft provides the better cosmetic and functional results. Surgical resection remains the mainstay of treatment for cancer of the parotid gland, and there is general agreement that facial nerve should not be sacrificed unless the tumor is adherent to, or surrounds the nerve. The following statement is described general principles of troublesome management of the facial nerve during surgery for parotid tumor.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.895-904
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• 2016

Breast cancer is the most commonly diagnosed invasive cancer among women. Many factors, both genetic and non-genetic, determine a woman's risk of developing breast cancer and several breast cancer risk prediction models have been proposed. It is vitally important to risk stratify patients as there are now effective preventive strategies available. All women need to be counseled regarding healthy lifestyle recommendations to decrease breast cancer risk. As such, management of these women requires healthcare professionals to be familiar with additional risk factors so that timely recommendations can be made on surveillance/risk-reducing strategies. Breast cancer risk reduction strategies can be better understood by encouraging the women at risk to participate in clinical trials to test new strategies for decreasing the risk. This article reviews the advances in the identification of women at high risk of developing breast cancer and also reviews the strategies available for breast cancer prevention.

• Journal of Gynecologic Oncology
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• v.29 no.6
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• pp.100.1-100.13
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• 2018

Objective: To investigate survival outcomes in endometrioid endometrial cancer (EEC) patients with single vs. multiple positive pelvic lymph nodes. Methods: We performed a retrospective evaluation of all consecutive patients with histologically proven International Federation of Gynecology and Obstetrics (FIGO) stage IIIC1 EEC who underwent primary surgical treatment between 2004 and 2014 at seven Italian gynecologic oncology referral centers. Patients with pre- or intra-operative evidence of extra-uterine disease (including the presence of bulky nodes) and patients with stage IIIC2 disease were excluded, in order to obtain a homogeneous population. Results: Overall 140 patients met the inclusion criteria. The presence of >1 metastatic pelvic node was significantly associated with an increased risk of recurrence and mortality, compared to only 1 metastatic node, at both univariate (recurrence: hazard ratio [HR]=2.19; 95% confidence interval [CI]=1.2-3.99; p=0.01; mortality: HR=2.8; 95% CI=1.24-6.29; p=0.01) and multivariable analysis (recurrence: HR=1.91; 95% CI=1.02-3.56; p=0.04; mortality: HR=2.62; 95% CI=1.13-6.05; p=0.02) and it was the only independent predictor of prognosis in this subset of patients. Disease-free survival (DFS) and disease-specific survival (DSS) were significantly longer in patients with only 1 metastatic node compared to those with more than 1 metastatic node (p=0.008 and 0.009, respectively). Conclusion: The presence of multiple metastatic nodes in stage IIIC1 EEC represents an independent predictor of worse survival, compared to only one positive node. Our data suggest that EEC patients may be categorized according to the number of positive nodes.