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ABSTRACT: Ameloblastoma (AM) is the most common, locally aggressive odontogenic tumor. It comprises about 1% of all head and neck neoplasms. It occurs mainly in young adults in their 3rd and 4th decade of life. It localizes in the mandible in about 80% of the cases. According to the 2017 WHO classification, 4 types of ameloblastoma can be distinguished: ameloblastoma (previously referred to as solid/multicystic-SMA; the "conventional type" AM), unicystic (AM-UA), extraosseous/peripheral (AM-PA), and malignant/metastatic (AM-MA). Solid, multicystic is the most common type. It is characteristic for its aggressiveness and high risk of recurrence. Radical resection with consecutive reconstruction is the treatment of choice of mandibular ameloblastomas.In this study, the authors present their experience in the surgical treatment of mandibular ameloblastomas with vascularized free flap reconstructions. They discuss new technological possibilities that could improve the precision of the reconstructive procedure and therefore result in the better aesthetic outcome.The retrospective study of a group of 21 patients suffering from mandibular ameloblastoma who underwent segmental man-dibulectomy with simultaneous microvascular free flap reconstruction was conducted. A thorough clinical analysis with various aspects was performed. Tumors resected before 2017 were double checked patomorphologically and assigned to the corrected subtype group.Seven patients were admitted to the department due to recurrent ameloblastoma. The most common localization of the tumor was the mandibular body ( n = 6) andbodywith ramus of the mandible ( n = 6). A total amount of 10 iliac crest free flaps and 12 fibular free flaps were performed. Complications were reported in 4 patients. A purulent oro-cutaneus fistula occurred in 3 patients. There was a flap failure in each reconstructive group. The virtual surgical planning with intraoperative cone-beam computed tomography was used in 3 patients. Dentition implantation was conducted in 4 patients (3 simultaneously, 1 postponed). The mean follow-up was 5 years and 8 months.Radical resection that covers radical segmental mandibulect-omy with immediate microvascular free flap reconstruction is a first-line and only effective treatment of mandibular ameloblas-tomas, that eliminates the risk of recurrence. The extent of surgical margins seems not to influence the recurrence rate, yet further investigation with statistical analysis should be performed. The choice of the adequate free flap must be adapted to dimensions and localization of the tumor and to each patient individually.New technologies such as virtual surgical planning with 3D models and intraoperative cone-beam computed tomography can make the reconstruction more accurate, improving patient's quality of life.
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Ameloblastoma , Colgajos Tisulares Libres , Neoplasias Mandibulares , Reconstrucción Mandibular , Procedimientos de Cirugía Plástica , Ameloblastoma/diagnóstico por imagen , Ameloblastoma/patología , Ameloblastoma/cirugía , Trasplante Óseo/métodos , Estética Dental , Peroné/cirugía , Colgajos Tisulares Libres/cirugía , Humanos , Masculino , Mandíbula/cirugía , Neoplasias Mandibulares/patología , Neoplasias Mandibulares/cirugía , Reconstrucción Mandibular/métodos , Calidad de Vida , Procedimientos de Cirugía Plástica/métodos , Estudios Retrospectivos , Adulto JovenRESUMEN
ABSTRACT: The restoration of large full-thickness lip defects still remains a formidable challenge for the reconstructive surgeons. Traumatic injuries, infections and tumors (primarily squamous cell carcinoma) are the most common source of the lip defects. Lower lips are more important in providing oral competence, unfortunately throughout the life-time they are significantly more exposed to ultraviolet radiation and thus are the most common site for the lip cancers (89%). This type of defect requires a complex reconstruction of an adequate sphincter function, defined vermilion, proper oral lining and sufficient mouth opening. To maintain the oral competence, it is of paramount importance to restore the function of orbicularis oris, which principally composes the body of the lip. Currently, the dynamic reconstructions are gaining considerable interest. They enables not only improvement of appearance but also a restoration of function and preservation of health-related quality of life. The use of the free gracilis muscle transfer to reconstruct the lower lip and its dynamic character in contrast to other, static reconstructions can provide the sufficient movement of the lower lip, which does not depend on function of other mimic muscles as it becomes an independent motor unit with its own neurotization. In our opinion the free functioning gracilis muscle flap, due to its anatomic and functional features as well as low-rate donor-site morbidity is the worth considering option for a lower lip reconstruction.
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Músculo Grácil , Neoplasias de los Labios , Procedimientos de Cirugía Plástica , Músculo Grácil/cirugía , Humanos , Labio/cirugía , Neoplasias de los Labios/cirugía , Calidad de Vida , Rayos UltravioletaRESUMEN
<b>Introduction:</b> The nose is the central and probably the most important organ of the face. In view of the three-dimensional shape and variety of tissues, reconstructive surgery after tumor resection in this anatomical region requires the surgeon's knowledge of anatomy. <br><b>Materials and Method:</b> In the years 2010-2019, 48 patients were treated in the Oncological and Reconstructive Surgery Clinic for extended nasal tumors, which required the use of free microvascular flaps after resection for functional and aesthetic supply of anatomical structures of the nose. <br><b>Results:</b> In 48 patients, a total of 92 free microvascular flaps were used for nasal reconstruction including: radial forearm free flap in 24 patients, radial forearm free flap with radial bone in 14 patients, auricular free flap in 16 patients, radial forearm free flap in combination with auricle free flap in 7 patients, double auricular free flap in 6 patients, radial forearm free flap in combination with double auricular free flap in 4 patients. Total necrosis of the free flap was noted in 4 cases, partial in 6 patients. <br><b>Conclusions:</b> The presented surgical techniques using microvascular free flaps constitute a recognized method of treatment and should be used in everyday surgeon practice. The results demonstrated in this article allow to obtain optimal functional and aesthetic effects.
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Neoplasias Nasales/cirugía , Nariz/cirugía , Rinoplastia/métodos , Colgajos Quirúrgicos/irrigación sanguínea , Expansión de Tejido/métodos , Adulto , Femenino , Antebrazo , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Nariz/patología , Neoplasias Nasales/patología , Procedimientos de Cirugía Plástica/métodosRESUMEN
<b>Introduction:</b> The aim of the study was to prove that a combination of visual surgical planning (VSP) and cone beam computed tomography (CBCT) is an optimal technique in fibular free flap reconstructions after complex tumor resections in the head and neck region and that it leads to better functional and aesthetic outcomes. <br><b>Material and method:</b> Six patients (3 females, 3 males) with head and neck tumors were included in the study. The region concerned midface in 2 cases and mandible in 4 patients. On the basis of computed tomography of the head, fibular free flap (FFF) reconstruction was planned with the VSP technique. The 3D-printed models were prepared. At the beginning of the operation and a few minutes after the reconstruction, an xCAT CBCT by XORAN was performed. Minor corrections of the angles of the reconstructed bony parts were made where needed. The time of the operation was assessed for each case. Functional and cosmetic results were evaluated in a 1-year follow-up. <br><b>Results:</b> The mean time of operation was 6 hours and 48 minutes, which was approximately 1hour and 40 minutes less than standard reconstructive surgery. Functional recovery was achieved in all patients. Aesthetic result was unsatisfactory for 2 patients due to insufficient soft tissue masses of FFF. <br><b>Conclusions:</b> The authors claim that intraoperative CBCT imaging, regardless of the cost, improves the accuracy of aesthetic outcome of reconstructive surgeries based on VSP, especially in the region of the midface and the mandible. Further studies on a higher number of subjects are required.
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Colgajos Tisulares Libres , Neoplasias de Cabeza y Cuello , Cirugía Asistida por Computador , Tomografía Computarizada de Haz Cónico , Femenino , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Masculino , Proyectos Piloto , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: Evaluate the possibility of performing a complex vascular allotransplant of all neck organs including skin. SUMMARY BACKGROUND DATA: There are 2 previous attempts described in the literature, none of them being that complex. The first one is nonfunctional due to chronic rejection, the second one is viable yet considerably limited in complexity (no parathyroids, no skin). METHODS: The allotransplantation was performed simultaneously on 2 adjacent operating rooms, using microsurgical techniques. RESULTS: The patient's voice, breathing through mouth, swallowing, and endocrinal functions have been fully restored. CONCLUSIONS: Achieved results show clearly that such operations performed in selected patients can nearly fully restore functional and aesthetic effects in 1 single procedure.
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Laringe/trasplante , Glándulas Paratiroides/trasplante , Faringe/cirugía , Glándula Tiroides/trasplante , Tráquea/trasplante , Adulto , Carcinoma de Células Escamosas/cirugía , Estética , Humanos , Neoplasias Laríngeas/cirugía , Laringectomía/efectos adversos , Masculino , Complicaciones Posoperatorias , Recuperación de la Función , Trasplante HomólogoRESUMEN
Intra-tumor heterogeneity is a vivid problem of molecular oncology that could be addressed by imaging mass spectrometry. Here we aimed to assess molecular heterogeneity of oral squamous cell carcinoma and to detect signatures discriminating normal and cancerous epithelium. Tryptic peptides were analyzed by MALDI-IMS in tissue specimens from five patients with oral cancer. Novel algorithm of IMS data analysis was developed and implemented, which included Gaussian mixture modeling for detection of spectral components and iterative k-means algorithm for unsupervised spectra clustering performed in domain reduced to a subset of the most dispersed components. About 4% of the detected peptides showed significantly different abundances between normal epithelium and tumor, and could be considered as a molecular signature of oral cancer. Moreover, unsupervised clustering revealed two major sub-regions within expert-defined tumor areas. One of them showed molecular similarity with histologically normal epithelium. The other one showed similarity with connective tissue, yet was markedly different from normal epithelium. Pathologist's re-inspection of tissue specimens confirmed distinct features in both tumor sub-regions: foci of actual cancer cells or cancer microenvironment-related cells prevailed in corresponding areas. Hence, molecular differences detected during automated segmentation of IMS data had an apparent reflection in real structures present in tumor.
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Carcinoma de Células Escamosas/diagnóstico por imagen , Imagen Molecular/métodos , Neoplasias de la Boca/diagnóstico por imagen , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción/métodos , Adulto , Algoritmos , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patología , Análisis por Conglomerados , Epitelio/diagnóstico por imagen , Epitelio/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/diagnóstico , Neoplasias de la Boca/genética , Neoplasias de la Boca/patologíaRESUMEN
UNLABELLED: The use of microsurgery for oral reconstruction of cancer patients, has become standard treatment in restoring oral function. The free anterolateral thigh flap is one of the most preferred options in reconstruction after total, subtotal or hemiresection of the tonque due to squamous cell cancer. The aim of the study was to present the reconstructive method using anterolateral thigh free flap with evaluation of quality of live. MATERIAL AND METHODS: Clinical material includes 46 consecutive patients with tongue cancer, who underwent complex surgical treatment between 2009 and 2011. There were 36 males and 10 females and the M: F ratio was 3.6: 1. All of them were reconstructed using the anterolateral thigh free flap. The quality of life was evaluated 6 months after completing the treatment, based on postoperative functional and aesthetic status. RESULTS: The overall flap survival rate was 96%. Surgical complications were observed in 8 patients (17%). Donor site was closed primarly in 42 cases and in remaining 4 skin graft was required. In all 46 cases understandable speech and return to unrestricted diet mastication and swallowing were achieved. The mean follow-up period after treatment was 32 months. Analysis of aesthetic effects evaluated in 23 cases and shows generally very good results. According to average transformed scores the QOL can be characterized as excellent for >90, very good for 76-90, good for 51-75, moderate for 25-50 and bad for <25 points. CONCLUSIONS: Anterolateral thigh flap, with its versatility in design, long pedicle with a suitable vessel diameter, low donor site morbidity, and very good aesthetic effects, could be the ideal flap for functional tongue reconstruction.
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Calidad de Vida , Colgajos Quirúrgicos/irrigación sanguínea , Muslo/cirugía , Recolección de Tejidos y Órganos/métodos , Neoplasias de la Lengua/psicología , Neoplasias de la Lengua/cirugía , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Glosectomía/métodos , Humanos , Masculino , Persona de Mediana Edad , Recolección de Tejidos y Órganos/psicología , Lengua/cirugía , Neoplasias de la Lengua/rehabilitaciónRESUMEN
Advances in genomics, molecular pathology and metabolism have generated many candidate biomarkers of colorectal cancer with potential clinical value. Epidemiological and biological studies suggest a role for adiposity, dyslipidaemia, hyperinsulinemia, altered glucose homeostasis, and elevated expression of insulin-like growth factor (IGF) axis members in the risk and prognosis of cancer. This review discusses some recent past and current approaches being taken by researches in obesity and metabolic disorders. The authors describe three main systems as the most studied metabolic candidates of carcinogenesis: dyslipidemias, adipokines and insulin/IGF axis. However, each of these components is unsuccessful in defining the diseases risk and progression, while their co-occurrence increases cancer incidence and mortality in both men and women.
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Biomarcadores de Tumor/sangre , Neoplasias Colorrectales/sangre , Metabolómica , Adipoquinas/sangre , Animales , Neoplasias Colorrectales/etiología , Neoplasias Colorrectales/patología , Dislipidemias/sangre , Dislipidemias/complicaciones , Trastornos del Metabolismo de la Glucosa/sangre , Trastornos del Metabolismo de la Glucosa/complicaciones , Humanos , Lípidos/sangre , Metabolómica/métodos , Obesidad/sangre , Obesidad/complicaciones , Valor Predictivo de las Pruebas , Pronóstico , Factores de Riesgo , Somatomedinas/metabolismoRESUMEN
Vitamin D3 (1,25(OH)2D3 (1,25-dihydroxyvitamin D3)) is a hormone playing a crucial role in numerous biological processes in the human body, including induction and control of cell proliferation and differentiation. Numerous data relate the vitamin D3 level with various types of cancer. It has been suggested that SNPs in the vitamin D3 receptor (VDR) gene might influence both the risk of cancer occurrence and cancer progression. The aim of this study was to search for genetic correlations between individual SNPs in the VDR gene and the risk of oral cavity carcinoma. Two SNPs were selected based on the literature and our previous results. Seventy-three patients with squamous cell carcinoma of the head and neck and one hundred control subjects were investigated. Two SNPs in the VDR gene were genotyped in minisequencing reactions followed by capillary electrophoresis. Hardy-Weinberg equilibrium (HWE), the χ(2) test and logistic regression were used for statistical analysis. The SNP rs2238135 in the VDR gene displayed statistical differences in frequency between the tested groups (p=0,0007). Furthermore, the G/C genotype of the rs2238135 in the VDR gene was characterized by a 3.16 fold increased risk of oral cavity carcinoma. The obtained results provide evidence for a genetic association between rs2238135 in the VDR gene and the occurrence and risk of oral cavity cancer.
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Carcinoma de Células Escamosas , Neoplasias de la Boca/genética , Boca , Receptores de Calcitriol/genética , Adulto , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patología , Colecalciferol/genética , Colecalciferol/metabolismo , Femenino , Estudios de Asociación Genética , Genotipo , Humanos , Masculino , Boca/metabolismo , Boca/patología , Neoplasias de la Boca/patología , Polimorfismo de Nucleótido Simple , Factores de RiesgoRESUMEN
Preoperative preparation of working models of the skull and free bone flaps using the digital print technology and photocured polyacrylic resins may be of a great benefit to the patient, for whom a virtual resection and reconstruction procedure may be planned in detail and performed. The purpose of mid-facial reconstruction using 3D models is to plan a functional mid-facial reconstruction procedure in order to restore supportive function of intraorbital structures and to make placement of dental implants and further prosthetic rehabilitation possible.Maxillary and mid-facial reconstruction using a free fibula flap based on a three-dimensional working model was performed in a patient diagnosed with a squamous cell carcinoma of the left maxillary sinus penetrating to the orbit, the ethmoid complex, and the pterygopalatine fossa. The use of three-dimensional polyacrylic models allowed for detailed preoperative planning and a virtual resection and reconstruction procedure with a highly satisfying functional and cosmetic effect.A procedure based on methods discussed here may be significantly shorter and more precise.
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Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/cirugía , Imagenología Tridimensional/métodos , Neoplasias del Seno Maxilar/diagnóstico , Neoplasias del Seno Maxilar/cirugía , Modelos Dentales , Trasplante Óseo/métodos , Peroné , Colgajos Tisulares Libres , Humanos , Masculino , Maxilar/patología , Maxilar/cirugía , Persona de Mediana Edad , Cuidados PreoperatoriosRESUMEN
BACKGROUND: Reconstruction of the pharynx and cervical esophagus has significantly progressed in the last 2 decades. A revolution in microvascular surgery has provided numerous choices for primary restoration, or in secondary reconstructions necessary for recurrences or complications of primary surgery. The goals of reconstruction after laryngopharyngoesophagectomy are to provide continuity of the alimentary tract, to protect major blood vessels, to heal the primary wound, and to restore the swallowing and breathing functions with minimal donor site and neck morbidity and deformation. CASE REPORT: We present 3 cases with complex defects of the laryngopharynx, cervical esophagus and trachea and anterior neck skin following central neck exenteration safely reconstructed with a single anterolateral thigh flap. No postoperative complications occurred in any of the 3 cases of reconstructions, each using a single anterolateral thigh flap. CONCLUSIONS: This approach significantly simplified the reconstruction, with quick recovery, short hospital stay and excellent functional and aesthetic results.
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Colgajos Tisulares Libres , Laringectomía/métodos , Laringe/cirugía , Terapia Recuperativa , Anciano , Humanos , Laringe/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Radiografía , RecurrenciaRESUMEN
AIM OF THE STUDY: The aim of the study was to develop standards for the prefabrication of free microvascular flaps in an animal model, followed by their application in clinical practice, and quantitative/qualitative microscopic assessment of the extent of development of a new microvascular network. MATERIAL AND METHODS: The study was carried out in 10 experimental pigs. As the first stage, a total of 20 prefabricated flaps were created using polytetrafluoroethylene (PTFE) as a support material, placed horizontally over an isolated and distally closed vascular pedicle based on superficial abdominal vessels. After completing the animal model study, one patient was selected for the grafting of the prefabricated free flap. RESULTS: All 20 free flaps prefabricated in the animal model were analyzed microscopically, exhibiting connective tissue rich in fibroblasts and small blood vessels in the porous areas across the entire thickness of the PTFE element. CONCLUSIONS: Flap prefabrication is a new and fast developing reconstruction technique. The usefulness of prefabrication techniques and their status in reconstructive surgery still needs to be investigated experimentally and clinically. The method based on prefabricated free flaps is the first step towards anatomical bioengineering that will make it possible to replace missing organs with their anatomically perfect equivalents.
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PURPOSE: To evaluate the feasibility and preliminary results of intraoperative radiotherapy (IORT) with low-energy photons as a boost in patients with early-stage oral cancer with the indications for postoperative radiotherapy. PATIENTS AND METHODS: Between 2003 and 2006, 16 patients with early-stage cancer of mobile tongue (n = 10 [63%]) or floor of the mouth (n = 6 [37%]) treated at Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Poland, were evaluated for IORT boost with the INTRABEAM®System (Carl Zeiss Surgical GmbH; IORT-PRS) because of the high risk of local recurrence due to positive margins on frozen pathologic section. After tumor resection, the applicator was positioned in the tumor bed. The applicator's diameter (range: 1.5-5 cm) was selected to encompass high-risk area of tumor recurrence. The dose (5 Gy, 7 Gy, or 7.5 Gy) was applied according to tumor volume and bone proximity. External-beam radiotherapy (EBRT) was provided to the tumor bed in all patients (50 Gy) and to the nodal area, when needed. Toxicity and local tumor control were assessed. RESULTS: Median follow-up was 36 months. IORT did not increase acute mucosal reaction. Local tumor control was found in all cases. Early mucosal reaction did not exceed 3 according to the RTOG scale and healed in median time of 35 days after completion of EBRT. No late adverse effects were observed. CONCLUSION: This preliminary report has demonstrated the feasibility of IORT-PRS for patients with early oral cancer with the indications for postoperative radiotherapy. This method may be considered an alternative boost technique, although additional studies are needed to establish long-term results in a larger group of patients.
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Neoplasias de la Boca/radioterapia , Neoplasias de la Boca/cirugía , Neoplasias de la Lengua/radioterapia , Neoplasias de la Lengua/cirugía , Anciano , Terapia Combinada , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Humanos , Periodo Intraoperatorio , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/patología , Estadificación de Neoplasias , Periodo Posoperatorio , Factores de Tiempo , Neoplasias de la Lengua/patologíaRESUMEN
BACKGROUND AND PURPOSE: The aim of the study was to present our results of the surgical treatment of subtemporal fossa tumours and surrounding regions using the extended subtemporal approach. MATERIAL AND METHODS: Twenty-five patients (10 women, 15 men) with subtemporal fossa tumours were included in the study. The neurological and performance status of the patients were assessed before and after surgery as well as at the conclu-sion of treatment. The approximate volume of the operated tumour, its relation to large blood vessels and cranial nerves, as well as consistency and vascularisation were assessed. RESULTS: The symptom duration ranged from 2 to 80 months (mean: 14 months). In 44% of patients, headache was the predominant symptom. Less frequent symptoms were: paralysis of the abducent nerve and disturbances of the trigeminal nerve. Approximate volume of the tumours ranged from 13 to 169 cm3 (mean: 66 cm3). The most frequent histological diagnosis was meningioma (16%), followed by angiofibroma, neurinoma and adenocystic carcinoma (12%). Total or subtotal resection was achieved in 80% of patients. CONCLUSIONS: The extended subtemporal approach allows for the removal of tumours of the subtemporal fossa and surrounding regions. This approach also allows one to remove tumours expanding in the regions surrounding the subtemporal fossa only. In such cases the subtemporal fossa constitutes the way of the surgical approach.
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Procedimientos Neuroquirúrgicos/estadística & datos numéricos , Neoplasias de la Base del Cráneo/cirugía , Adolescente , Adulto , Anciano , Angiofibroma/patología , Angiofibroma/cirugía , Carcinoma/patología , Carcinoma/cirugía , Niño , Cordoma/patología , Cordoma/cirugía , Femenino , Fibroma/patología , Fibroma/cirugía , Estudios de Seguimiento , Humanos , Masculino , Meningioma/cirugía , Persona de Mediana Edad , Neurilemoma/patología , Neurilemoma/cirugía , Examen Neurológico , Polonia , Base del Cráneo , Neoplasias de la Base del Cráneo/patología , Resultado del Tratamiento , Adulto JovenRESUMEN
Resections of malignant tumors involving the mandible and anterior tongue result in complex defects that are still real challenges for reconstructive surgeons. Whereas there are preferred methods for mandible reconstruction involving isolated or limited loss of soft tissues, there are no standards for extended bone-soft tissue intraoral defects. This article documents the modification of the fibula free flap where triple skin islands are used for reconstruction of anterior tongue and floor of the mouth. The technique also includes filing the submandibular space with an isolated part of the flexor hallucis longus muscle, based on individual perforator. The details of flap designing, harvesting, and insetting are also presented. Eight such reconstructions have been performed on patients who underwent complex resection of the anterior mandible together with the mobile part of the tongue. Flap survival rate was 100%. In all eight cases, understandable speech and return to unrestricted diet mastication and swallowing were achieved. Analysis of aesthetic effects showed generally very good results. The presented modification of fibula free flap can be an alternative to double flaps in complex reconstruction of the mandible and mobile tongue.
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Carcinoma de Células Escamosas/cirugía , Mandíbula/cirugía , Neoplasias Mandibulares/cirugía , Procedimientos de Cirugía Plástica/métodos , Colgajos Quirúrgicos , Neoplasias de la Lengua/cirugía , Lengua/cirugía , Adulto , Anciano , Femenino , Supervivencia de Injerto , Humanos , Masculino , Persona de Mediana Edad , Suelo de la Boca/cirugíaRESUMEN
BACKGROUND: Extended supraomohyoid neck nodes dissection (ESOHND) involves surgical resection of nodal levels from I to IV. The incidence of occult metastases in level V is rare and mainly depends of the location and size of the primary tumour in oral cavity and oropharynx squamous cell cancer. AIM: The aim of this study was to present the results of treatment with extended supraomohyoid neck dissection. METHODS: The records of 72 patients with cancer of the oral cavity undergoing extended supraomohyoid neck dissection (ESOHND) during the period 15.12.2003 - 13.06.2005 were reviewed. RESULTS: Tumor and nodal stage were: T2-9(13%), T3-39(54%), T4-24(33%), N0-14(19%), N1-31(43%), N2-25(35%), N3-2(3%). 64 patients were treated with surgery and postoperative adjuvant radiotherapy. The follow-up period ranged from 11 to 27 months. The surgical failure rate was 8% (occurred in 6 of 72 patients). CONCLUSIONS: Preliminary analysis suggests extended supraomohyoid neck nodes dissection to be considered as a therapeutic and diagnostic procedure in patients with squamous cell cancer of oral cavity and oropharynx.
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Carcinoma de Células Escamosas/secundario , Carcinoma de Células Escamosas/cirugía , Neoplasias de la Boca/cirugía , Disección del Cuello/métodos , Neoplasias Orofaríngeas/cirugía , Adulto , Carcinoma de Células Escamosas/patología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/patología , Invasividad Neoplásica , Estadificación de Neoplasias , Neoplasias Orofaríngeas/patología , Polonia , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
82 patients with adenolymphoma of parotid gland treated with surgery in Department of Oncological Surgery Cancer Center, Gliwice in the period of 1986-2004 were retrospectively analyzed. They were about 22% of all patients with parotid gland tumors operated in that period. In almost 70% of cases partial parotidectomy with facial nerve preservation was performed as a treatment of choice. In that group DFS was over 95%. Local recurrence occurred in less then 5%, only in cases with multiple tumor in histopathological examinations. Quality of life parameters were also analyzed. In the analysis complications rate increased with the extension of surgical treatment. It revealed in the postoperative cosmetic defect evaluation. Partial resection of the parotid gland could be useful method of surgical treatment of adenolymphoma selected cases. It allows to achieve the same results as classic parotidectomy with lower risk of significant complications. In analyzed group the local recurrence was always combined with multi lesional growth of the tumor.
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Adenolinfoma/cirugía , Neoplasias de la Parótida/cirugía , Adenolinfoma/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Supervivencia sin Enfermedad , Nervio Facial/fisiopatología , Parálisis Facial/etiología , Parálisis Facial/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Neoplasias de la Parótida/patología , Complicaciones Posoperatorias/mortalidad , Calidad de Vida , Estudios Retrospectivos , Procedimientos Quirúrgicos Operativos/métodos , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
The expression of the genes coding TNFalpha and TNF RII receptors (TNF RII: TNFR2 membrane and soluble domain, TNFR2/R7 soluble domain) was analysed in colon cancer at the II and III stage of disease, by estimation of mRNA expression. The study included 80 patients with histopathologically confirmed adenocarcinoma. The number of TNFalpha mRNA, TNFR2 mRNA and TNFR2/R7 mRNA copies were estimated in tumour and healthy tissue. The highest number of mRNA TNF-alpha copies were investigated in all samples of tissue and independently of the stage of disease. Simultaneously, we noticed the largest number of mRNA copies for TNFalpha and TNF R2/R7 in healthy cells at stage III of the disease. It is possible to draw a hypothetical line separating the anti-cancer activity of TNFalpha and its influence on cancer progression.
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Neoplasias del Colon/genética , Neoplasias del Colon/patología , Regulación Neoplásica de la Expresión Génica/genética , Receptores Tipo II del Factor de Necrosis Tumoral/genética , Factor de Necrosis Tumoral alfa/genética , Humanos , Estadificación de Neoplasias , ARN Mensajero/genética , ARN Mensajero/metabolismoRESUMEN
In 1974 Karapandzic described reconstruction technique of the lower lip resection defects by using neuro-vascular flap of the upper lip. In this paper authors present six cases of this reconstruction, were defect after resection was in the range of 50-80% of lower lip. In all cases the result was excellent, comparing to other plastic techniques. Based on the authors scale, functional and aesthetic result was scored. Authors suggest that this reconstruction can be an alternative to other methods using rotation flaps in particular cases of lower lip cancer.