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      • 구강 편평세포암종의 반대측 예방적 경부치료

        구본석(Bon Seok Koo),이욱진(Wook Jin Lee),나경원(Keong Won Rha),정의석(Eui sok Jung),김유석(Yoo Suk Kim),이진석(Jin Seok Lee),임영창(Young Chang Lim),최은창(Eun Chang Choi) 대한두경부종양학회 2005 대한두경부 종양학회지 Vol.21 No.2

        Objectives: The purpose of this study was to evaluate the incidence and predictive factors of contralateral occult lymph node metastasis in oral cavity squamous cell carcinomas to form a rational basis for elective contralateral neck management. Materials and Methods: We performed a retrospective analysis of 66 N0-2 oral cavity cancer patients undergoing elective neck dissection for contralateral clinically negative necks from 1991 to 2003. Results: Clinically negative but pathologically positive contralateral lymph nodes occurred in 11%(7 of 66) . Of the 11 cases with a clinically ipsilateral node positive neck, contralateral occult lymph node metastases developed in 36%(4 of 10, in contrast with 5%(3/55) in the cases with clinically ipsilateral node negative necks(p<0.05). Based on the clinical staging of the tumor, 8%(3 of 37) of the cases showed lymph node metastases in T2 tumors, 25%(2 of 8) in T3, and 18%(2 of 11) in T4. None of the T1 tumors(10 cases) had pathologically positive lymph nodes. The rate of contralateral occult neck metastasis was significantly higher in advanced stage cases and those crossing the midline, compared to early stage or unilateral lesions(p<0.05). Patients with no evidence of contralateral nodal cancer had significantly improved disease-specific survival over patients with any pathologically positive nodes(5-year disease-specific survival rate was 79% vs. 43%, p<0.05). Conclusion: The risk of contralateral occult neck involvement in the oral cavity squamous cell carcinomas above the T3 stage or those crossing the midline with unilateral metastases was high. Therefore, we advocate an elective contralateral neck treatment with surgery or radiotherapy in oral cavity squamous cell carcinoma patients with ipsilateral node metastases or tumors that are greater than stage T3 or crossing the midline.

      • 후구치삼각암의 수술적 치료

        이세영(Sei Young Lee),최영춘(Young Choon Choi),정의석(Eui Sok Jung),권순호(Soon Ho Kwon),유대현(Dae Hyun Lew),이원재(Won Jae Lee),최은창(Eun Chang Choi) 대한두경부종양학회 2004 대한두경부 종양학회지 Vol.20 No.2

        Background and Objectives: Squamous cell carcinoma of retromolar tringone (RMT) is an uncommon head and neck tumor. RMT cancer has unique clinical feature and specific considerations for surgical treatment are needed but, reports on the treatment of RMT cancer are still lacking. Patients and Methods: From May 1997 to July 2004, 8 patients with histologically proven squamous cell carcinoma of the RMT were treated in Severance Hospital. Surgical excision of the primary lesion and neck dissection were performed in all patients. Reconstruction was accomplishing using several methods. Charts and other medical records were reviewed. Results: In early cases, lower cheek flap was appropriate but, mandibular swing or madibulectomy approach was appropriate in advanced cases. Reconstruction was needed in all patients and excision of mandible was needed in majority of patients. 6 patients were disease free status and one died from recurrence and one was lost to follow up. Conclusion: In treatment of RMT cancer, several surgical approach methods and reconstruction should be considered before treatment. Surgical treatment of RMT cancer may be one of a useful primary treatment modality.

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