Objective To compare the epidemiology, local and regional invasion and prognosis of head and neck malignant fibrous histiocytoma (MFH) and extremity MFH Methods Between January 1, 1972 and December 31, 1993, 173 pa...Objective To compare the epidemiology, local and regional invasion and prognosis of head and neck malignant fibrous histiocytoma (MFH) and extremity MFH Methods Between January 1, 1972 and December 31, 1993, 173 patients with MFH (71 head and neck, 102 extremities and trunk) were referred to the Cancer Hospital for surgical treatment They were 101 men and 72 women, with age ranging from 13 to 83 years (median: 45 years) The extent of surgery was classified into radical, wide and local resection Results For head and neck, local recurrence of MFH after wide resection was 80 4% (37/46), compared with 36.4% (8/22) after radical surgery ( P =0 000) The five year survival was 50 79% in all the head and neck patients (74 75% in patients free of local recurrence, 37 74% in patients with local recurrence; P =0 0181), compared with 70 71% in extremity patients ( P =0 0005) Repeated surgery after recurrence of MFH could cure 40 9% of the head and neck patients and 80 7% of the extremity patients Conclusion Inadequate resection of head and neck MFH in initial surgery is associated with a high incidence of local recurrence, which is always correlated with worse prognosis Repeated surgery for recurrent head and neck MFH is not as effective as for recurrent extremity MFH Therefore, we suggest that the initial surgery for head and neck MFH should be as radical as allowed to avoid a possible local recurrence展开更多
We reviewed retrospectively 139 patients with squamous cell carcinoma of the maxillary sinus who were treated with planned combinations of preoperative radiotherapy and maxillectomy between 1958 and 1987. The 5-year s...We reviewed retrospectively 139 patients with squamous cell carcinoma of the maxillary sinus who were treated with planned combinations of preoperative radiotherapy and maxillectomy between 1958 and 1987. The 5-year survival rate of these patients was 30%. In 111 patients who had tumor invasion of the orbital floor 88 underwent radical surgery with orbital exenteration and 23 had their orbital contents preserved. If orbital exenteration was performed, the 5-year survival rate was 27.3% (24 / 88) and the rate of recurrence within the orbit was 12.5%. In patients with preservation of the orbital contents, the corresponding rates were 34.8% (8 / 23) and 8.6% respectively (P = 0.65). Histological study af ter maxillectomy with orbital exenteration showed that in 95% of 65 specimens (62 / 65) invasion of the orbit was limited. These tumors could be completely resected by total maxillectomy with limited removal of the periorbital tissues after preoperative radiotherapy. We conclude that after preoperative radiation, the eyeball could be safely preserved in most selected patients with maxillary sinus carcinoma invading the orbital floor.展开更多
Objective To discuss treatment options for tonsillar squamous cell carcinoma.Methods A total of 108 patients with biopsy-proven tonsillar squamous cell carcinoma, treated between 1984 and 2000, were reviewed, includin...Objective To discuss treatment options for tonsillar squamous cell carcinoma.Methods A total of 108 patients with biopsy-proven tonsillar squamous cell carcinoma, treated between 1984 and 2000, were reviewed, including 82 men and 26 women, with ages ranging from 19 to 70 years. Treatments consisted of either radiotherapy and surgery reserved as salvage treatment (Salvage Surgery, 83 patients), or planned surgery with preoperative radiation (Planned Surgery, 25 patients). Radiotherapy was delivered primarily in a dosage of 60 -70 Gy for Salvage Surgery patients and 40 -50 Gy for Planned Surgery patients. Both salvage and planned surgeries were radical, with resection of the lateral oropharyngeal wall, segmental resection of the mandible and neck dissection. The pectoralis major myocutaneous flaps were used to repair surgical defects.Results The percentages of radical surgery used in the Salvage Surgery and Planned Surgery groups were 24. 1% (20/83) and 88. 0% (22/25), respectively ( P = 0. 000). The local recurrence rates were 28. 9% (24/83) and 20. 0% (5/25) in the Salvage Surgery and Planned Surgery groups, respectively ( P = 0. 378). The neck recurrence rates were 9. 6% (8/83) and 8. 0% (2/25) in the Salvage Surgery and Planned Surgery groups respeatively ( P = 0. 804) . The 5-year survival rates were 59. 3% and 55.3% in the Salvage Surgery and Planned Surgery groups, respeatively (P= 0.7056).Conclusions Although the two treatments had a similar survival rate, Salvage Surgery avoided 60% commando operations compared with the Planned Surgery group, which benefits to recovery of oral functions. Primary radiotherapy is recommended as the treatment of choice for tonsillar squamous cell carcinoma. After radical radiotherapy, salvage surgery should be undertaken in the case of tumor remnants or recurrences.展开更多
文摘Objective To compare the epidemiology, local and regional invasion and prognosis of head and neck malignant fibrous histiocytoma (MFH) and extremity MFH Methods Between January 1, 1972 and December 31, 1993, 173 patients with MFH (71 head and neck, 102 extremities and trunk) were referred to the Cancer Hospital for surgical treatment They were 101 men and 72 women, with age ranging from 13 to 83 years (median: 45 years) The extent of surgery was classified into radical, wide and local resection Results For head and neck, local recurrence of MFH after wide resection was 80 4% (37/46), compared with 36.4% (8/22) after radical surgery ( P =0 000) The five year survival was 50 79% in all the head and neck patients (74 75% in patients free of local recurrence, 37 74% in patients with local recurrence; P =0 0181), compared with 70 71% in extremity patients ( P =0 0005) Repeated surgery after recurrence of MFH could cure 40 9% of the head and neck patients and 80 7% of the extremity patients Conclusion Inadequate resection of head and neck MFH in initial surgery is associated with a high incidence of local recurrence, which is always correlated with worse prognosis Repeated surgery for recurrent head and neck MFH is not as effective as for recurrent extremity MFH Therefore, we suggest that the initial surgery for head and neck MFH should be as radical as allowed to avoid a possible local recurrence
文摘We reviewed retrospectively 139 patients with squamous cell carcinoma of the maxillary sinus who were treated with planned combinations of preoperative radiotherapy and maxillectomy between 1958 and 1987. The 5-year survival rate of these patients was 30%. In 111 patients who had tumor invasion of the orbital floor 88 underwent radical surgery with orbital exenteration and 23 had their orbital contents preserved. If orbital exenteration was performed, the 5-year survival rate was 27.3% (24 / 88) and the rate of recurrence within the orbit was 12.5%. In patients with preservation of the orbital contents, the corresponding rates were 34.8% (8 / 23) and 8.6% respectively (P = 0.65). Histological study af ter maxillectomy with orbital exenteration showed that in 95% of 65 specimens (62 / 65) invasion of the orbit was limited. These tumors could be completely resected by total maxillectomy with limited removal of the periorbital tissues after preoperative radiotherapy. We conclude that after preoperative radiation, the eyeball could be safely preserved in most selected patients with maxillary sinus carcinoma invading the orbital floor.
文摘Objective To discuss treatment options for tonsillar squamous cell carcinoma.Methods A total of 108 patients with biopsy-proven tonsillar squamous cell carcinoma, treated between 1984 and 2000, were reviewed, including 82 men and 26 women, with ages ranging from 19 to 70 years. Treatments consisted of either radiotherapy and surgery reserved as salvage treatment (Salvage Surgery, 83 patients), or planned surgery with preoperative radiation (Planned Surgery, 25 patients). Radiotherapy was delivered primarily in a dosage of 60 -70 Gy for Salvage Surgery patients and 40 -50 Gy for Planned Surgery patients. Both salvage and planned surgeries were radical, with resection of the lateral oropharyngeal wall, segmental resection of the mandible and neck dissection. The pectoralis major myocutaneous flaps were used to repair surgical defects.Results The percentages of radical surgery used in the Salvage Surgery and Planned Surgery groups were 24. 1% (20/83) and 88. 0% (22/25), respectively ( P = 0. 000). The local recurrence rates were 28. 9% (24/83) and 20. 0% (5/25) in the Salvage Surgery and Planned Surgery groups, respectively ( P = 0. 378). The neck recurrence rates were 9. 6% (8/83) and 8. 0% (2/25) in the Salvage Surgery and Planned Surgery groups respeatively ( P = 0. 804) . The 5-year survival rates were 59. 3% and 55.3% in the Salvage Surgery and Planned Surgery groups, respeatively (P= 0.7056).Conclusions Although the two treatments had a similar survival rate, Salvage Surgery avoided 60% commando operations compared with the Planned Surgery group, which benefits to recovery of oral functions. Primary radiotherapy is recommended as the treatment of choice for tonsillar squamous cell carcinoma. After radical radiotherapy, salvage surgery should be undertaken in the case of tumor remnants or recurrences.
