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Volume 110, Issue 9
Displaying 1-4 of 4 articles from this issue
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Original article
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Katsuro Sato, Masahiko Tomita, Jun Watanabe, Hiroshi Matsuyama, Sugata ...2007 Volume 110 Issue 9 Pages 623-628
Published: September 20, 2007
Released on J-STAGE: December 25, 2008
JOURNAL FREE ACCESSThirteen patients with pyriform sinus fistula treated surgically at our department were clinically evaluated. Twelve (92%) fistulae occurred in the left pyriform sinus, and one (8%) in the right. There were a mean of 4 infectious episodes before the final diagnosis. The median age at the first infection was 5 years, and the median age at surgery was 13 years, although there were 2 elderly patients (over 60 years old) in this series. Association with pharyngeal foreign body was suspected in the case with onset at 81 years of age. There was a history of previous surgery for cervical disease in 54% of the patients. The final diagnosis was based on delineation of the fistula by hypopharyngography, although coronal section of CT and MRI were also useful for understanding the morphopathology. The surgical procedure consisted of identification and staining of the fistula under direct hypopharyngoscopy, followed by identification and extirpation of the fistula until the distal end via a cervical approach. There was no recurrence of infections, although resection of the thyroid gland and identification of the recurrent laryngeal nerve were not always performed. The most important surgical principle is considered to be complete disconnection of the lesion from the hypopharynx, and complete identification and extirpation of the fistula by the procedure used at our department is considered to be a useful surgical strategy.View full abstractDownload PDF (2004K) -
Hidenori Suzuki, Tetuya Ogawa, Akihiro Terada, Shinobu Arima, Taijiro ...2007 Volume 110 Issue 9 Pages 629-634
Published: September 20, 2007
Released on J-STAGE: December 25, 2008
JOURNAL FREE ACCESSWe evaluated the accuracy of staging in 159 patients with head and neck squamous cell carcinoma (HNSCC) scanned by FDG-PET and 116 patients with the same cancer scanned by FDG-PET/computed tomography (CT). The accuracy was measured by comparing the FDG-PET/FDG-PET/CT findings at the primary tumor site, cervical node sites and distant metastatic sites with the clinical diagnosis. Especially, accuracy at cervical sites was evaluated from the screening point of view. Both examinations yielded an accuracy rate of more than 80% for each site, and a negative predictive value of more than 90% for the cervical sites. For the cervical sites, the positive predictive value (PPV) of FDG-PET was 78% and of FDG-PET/CT was 82%. When one cervical lymph node metastasis was detected by FDG-PET, the PPV was 63%, which appears to be comparatively low. Both examinations showed high accuracy for staging of HNSCC. In the near future, excellent screening examination might become possible with the spread of FDG-PET/CT. However, both examinations do not yield the direct image of the carcinoma itself, but only the status of glucose metabolism in the carcinoma. Care must always be exercised in the interpretation, as there are not a few false negative and false positive cases.View full abstractDownload PDF (611K) -
Akira Kubota, Madoka Furukawa, Hideaki Hanamura, Yoshifumi Fujita, Mas ...2007 Volume 110 Issue 9 Pages 635-642
Published: September 20, 2007
Released on J-STAGE: December 25, 2008
JOURNAL FREE ACCESSSubjects were 34 patients, 32 men and 2 women, with squamous cell carcinoma of the oropharynx, with a median age of 63 years (range, 47 to 72 year). Subsites were the lateral wall in 18, anterior wall in 10, posterior wall in 5 and superior wall in 1. Nine had stage III disease and 25 had stage IV disease. Nineteen cases were resectable and 15 cases were unresectable. The patients were treated with concurrent chemoradiotherapy. The treatment regimen consisted of 5-fluorouracil (5-FU) and cisplatin (CDDP). 5-FU was given at 1000mg/m2 per day as a continuous infusion over 4 days, and CDDP was given at 60mg/m2 on day 4 after the start of 5-FU administration. Two courses of chemotherapy were administered, on day 1 and day 35. Radiation was given at a single daily fraction of 2Gy and 5 fractions per week were administered up to a total dose of 58 to 70Gy. Radiation break was scheduled from day 26 to 35. The median total delivered dose of radiation was 66Gy. Toxicities included mucositis (grade 3, 23.6%, grade 4, 38.2%), vomiting (grade 3, 14.7%) and leukopenia (grade 3, 20.6%). Twenty-eight patients (82.3%) received the treatment as scheduled. Seven (22.6%) showed a complete response and 22 (70.9%) showed partial response. The mean overall survival rate was 23 months (4.5-73.5) and progression-free survival (PFS) rate was 20 months (4.5-71.3). The two-year preservation rate of the oropharynx without recurrence was 45.0%. The two-year overall survival (OS) rate was 57.1% and PFS rate was 55.1%. Significant differences among groups were observed in the two-year overall survival and progression-free survival rate, as follows : 84.6% and 88.8%, respectively, in the resectable cases, and 33.3% and 26.7%, respectively, in the unresectable cases, and 60.6% and 63.2%, respectively, in the T2+3 cases and 40.0% and 0%, respectively in the T4 cases. Failure patterns were noted in 15 cases with locoregional recurrence in 14 and other disease in one. Based on the results it is concluded that concurrent chemoradiotherapy is effective for preserving the oropharynx in a high percentage of patients and for improving the two-year OS and PFS rates without compromising the QOL.View full abstractDownload PDF (739K)
Educational lecture
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[in Japanese]2007 Volume 110 Issue 9 Pages 646-649
Published: September 20, 2007
Released on J-STAGE: December 25, 2008
JOURNAL FREE ACCESSDownload PDF (2278K)
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