Toukeibu Gan
Online ISSN : 1881-8382
Print ISSN : 1349-5747
ISSN-L : 1349-5747
Current issue
Displaying 1-8 of 8 articles from this issue
  • Masaaki Higashino, Tomoko Yamazaki
    2024 Volume 50 Issue 4 Pages 273-279
    Published: 2024
    Released on J-STAGE: January 21, 2025
    JOURNAL FREE ACCESS
    Objective: To investigate the current status of end-of-life care for patients with head and neck cancer and to identify problems.
    Methods: A nationwide survey was conducted by questionnaire to representatives of facilities participating in the head and neck malignancy registry project.
    Results: Responses were obtained from 168 of 199 facilities (84%). The number of acceptable home health care clinics within the medical area was 3 to 4. The rate of relocation to the home and the rate of end-of-life care at home increased until the number of home care clinics reached 5 to 6, and plateaued at higher numbers. Thirty-one percent of the facilities had their own palliative care units. The number of facilities with acceptable palliative care units within the medical area was 3 to 4. Head and neck cancer physicians identified the following problems as obstacles to home healthcare: pharyngocutaneous fistula, tumor bleeding, tracheotomy, risk of aspiration, absence of a key person, dementia, mental instability, and financial instability.
    Discussion: End-of-life care for head and neck cancer can be improved if physicians involved in head and neck cancer actively disseminate information and strengthen cooperation with home physicians and physicians at facilities with palliative care units.
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  • Kotaro Maeda, Takeshi Shinozaki, Kazuto Matsuura
    2024 Volume 50 Issue 4 Pages 280-284
    Published: 2024
    Released on J-STAGE: January 21, 2025
    JOURNAL FREE ACCESS
    Background: Olfactory neuroblastoma (ONB) is rare, and there is no clear consensus regarding the treatment of cervical lymph node metastasis. In this study, we investigated cervical lymph node metastasis in ONB.
    Methods: Of 59 ONB patients treated at our hospital between September 1996 and April 2022, 17 were treated for cervical lymph node metastasis (6 Kadish stage D patients with cervical lymph node metastasis at the time of initial treatment and 11 Kadish stage C and below patients with late cervical lymph node metastasis after initial treatment). The clinical study was conducted on 17 subjects.
    Results: Of the 6 Kadish stage D patients, 3 (50%) underwent neck dissection and 3 (50%) irradiation, and no death due to lymph node metastasis was observed in Kadish stage D patients. Among Kadish stage C and below patients with late cervical metastases, 9 (81.8%) underwent neck dissection, and the remaining 2 patients underwent radiation therapy. There were no deaths due to cervical lymph node metastases.
    One case was observed in which more than 20 years had elapsed between the initial treatment and the manifestation of cervical lymph node metastasis. The primary tumor control rate was 72.7% (8/11), which was better in the Kadish stage C and below group than in the Kadish stage D group.
    Conclusion: There were no deaths due to cervical lymph node metastases in patients with both initial and subsequent disease. Cervical lymph node involvement should be considered in patients with cervical lymph node involvement, and treatment should be considered in the cervical region if possible, based on the patient’s general condition and other factors, including involvement of the cervical region.
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  • Ryohei Mikami, Mihoko Mine, Hajime Fujiwara, Hikari Shimoda, Masanori ...
    2024 Volume 50 Issue 4 Pages 285-290
    Published: 2024
    Released on J-STAGE: January 21, 2025
    JOURNAL FREE ACCESS
    Introduction
    T-classification and histological grade are risk factors for cervical lymph node metastasis of parotid carcinoma, but preoperative diagnosis of histological grade is often difficult. We retrospectively reviewed cases of parotid carcinoma who were operated in our hospital and discussed cervical control.
    Subjects and Methods
    Seventy eight cases of parotid carcinoma without distant metastasis who underwent surgery as initial treatment between April 2008 and December 2021 were included. 47 males, 31 females. cT1, 2, 3, 4=11, 27, 17, 23 cases. cN+, N−: 18, 60 cases.
    23 cN− cases had level Ⅱ lymph nodes with frozen section, and all 23 were negative for cancer. In cN− cases, the potential cervical lymph node metastasis rate was 7% (4/60). Seven cases with cT1-3 or preoperatively diagnosed as low or intermediate grade were diagnosed as high grade postoperatively. None of them developed neck lymph node recurrence.
    Discussion
    Although prophylactic neck dissection is recommended for cN− cases with T4 or higher grade, preoperative diagnosis of histological grade is often difficult. Even in cases where the grading was wrong, there was no cervical recurrence, and so this was considered an acceptable treatment strategy.
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  • Masaaki Higashino, Ryo Kawata, Tsuyoshi Jinnin, Teruhito Aihara, Tetsu ...
    2024 Volume 50 Issue 4 Pages 291-297
    Published: 2024
    Released on J-STAGE: January 21, 2025
    JOURNAL FREE ACCESS
    Objective: The purpose of this study was to examine the prognostic impact of HER2 expression and anti-HER2 therapy in parotid salivary duct carcinoma (SDC) and invasive carcinoma ex-pleomorphic adenoma (iCXPA).
    Subjects and Methods: The subjects of this study were 25 SDC and 15 iCXPA patients initially treated between 2002 and 2022 at the Department of Otorhinolaryngology and Head and Neck Surgery, Osaka Medical and Pharmaceutical University. The study included HER2 expression and clinical background, recurrence rate, clinical course of 9 patients treated with anti-HER2 therapy at the time of recurrent metastasis, and adverse events.
    Results: HER2-positive cases had more lymph node metastases than negative cases. Twenty-one of 34 patients who underwent initial radical surgery relapsed. The response rate to anti-HER2 therapy was 66.7%, CR rate was 33.3%, 1-year disease control rate was 76.2%, and 5-year disease-specific survival rate was 87.5%. The median progression-free survival was 18 months. Among HER2-positive patients, those treated with anti-HER2 therapy had a significantly better prognosis than those not treated with anti-HER2 therapy (p=0.01).
    Discussion: HER2-positive patients with unresectable or distant parotid adenocarcinoma may have a good chance of long-term survival with anti-HER2 therapy. However, anti-HER2 therapy is less effective for intracranial metastases and requires periodic imaging evaluation. Further investigation of the efficacy of adjuvant anti-HER2 therapy for HER2-positive parotid cancer is warranted.
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  • Mari Kyono, Kazuki Hashimoto, Mioko Matsuo, Ryunosuke Kogo, Rina Jirom ...
    2024 Volume 50 Issue 4 Pages 298-303
    Published: 2024
    Released on J-STAGE: January 21, 2025
    JOURNAL FREE ACCESS
    Patients with advanced pharyngeal carcinoma often develop metastasis to the lateral retropharyngeal lymph node (RLN; Rouvière lymph node), but there are few reports on the treatment of RLN metastatic lesions, and no unified opinion has been reached. In this study, we reviewed 22 cases of squamous cell carcinoma of the oropharyngeal and hypopharynx that had RLN metastasis at the time of initial treatment at our hospital. Initial treatment included 11 cases of surgery and 11 cases of chemoradiotherapy. Of the patients who underwent surgery, 3 patients had RLN metastatic lesions resected and in the remaining 8 patients, RLN metastatic lesions were not resected and postoperative radiation therapy was administered. The recurrence rate of RLN was 18.2% of all cases, and the control of RLN lesions was relatively good even in cases treated with chemoradiotherapy alone. Regardless of whether the RLN was controlled after treatment, the distant metastasis rate was especially high for hypopharyngeal cancer at 66.7%, indicating a poor prognosis. Therefore, more rigorous metastatic follow-up is required after treatment in cases of hypopharyngeal cancer.
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  • Hisasi Kessoku, Taisuke Akutsu, Yosuke Mizunari, Eiji Shimura, Masato ...
    2024 Volume 50 Issue 4 Pages 304-309
    Published: 2024
    Released on J-STAGE: January 21, 2025
    JOURNAL FREE ACCESS
    The aim of this study was to clarify the impact of marital status (presence or absence of a spouse) on survival in elderly patients with head and neck cancer. We examined 258 head and neck cancer patients aged 65 years or older who underwent curative treatment at our hospital between 2015 and 2019. Marital status (presence or absence of a spouse), patient demographic information, and disease information were collected from medical records. Overall survival was calculated using the Kaplan-Meier method, and the impact of marital status on survival was estimated using the Cox proportional hazards model. The results indicated that the absence of a spouse was significantly associated with poorer prognosis, even after adjusting for patient demographics and disease information (hazard ratio:1.73, 95% confidence interval:1.08-2.76, P=0.022). These findings suggest the need to strengthen social support, especially for elderly head and neck cancer patients without a spouse, undergoing curative treatment.
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  • Masahiro Inada, Takuya Uehara, Yukinori Matsuo, Yasumasa Nishimura
    2024 Volume 50 Issue 4 Pages 310-315
    Published: 2024
    Released on J-STAGE: January 21, 2025
    JOURNAL FREE ACCESS
    We report a case of successful treatment with definitive chemoradiation therapy for axillary lymph node recurrence from nasopharyngeal carcinoma after chemoradiation therapy. The patient was a 77-year-old man with initially T1N3M0 nasopharyngeal carcinoma who was treated with concurrent chemoradiation therapy of 70Gy/35fr plus cisplatin followed by adjuvant chemotherapy with 5-FU plus cisplatin. Eleven months after completion of the initial therapy, the patient developed axillary lymph node recurrence without any local recurrence or distant organ metastases. After discussion with otorhinolaryngologists and medical oncologists, definitive chemoradiotherapy was recommended. Concurrent chemoradiation therapy of 66Gy/33fr plus nedaplatin for recurrent axillary lymph node was performed and a complete response was achieved. Five years after completion of the second treatment, the patient died of aspiration pneumonia without any clinical evidence of re-recurrence.
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  • Akihisa Tanaka, Shinji Mikami, Naomiki Kimura, Tadashi Kitahara
    2024 Volume 50 Issue 4 Pages 316-321
    Published: 2024
    Released on J-STAGE: January 21, 2025
    JOURNAL FREE ACCESS
    Parathyroid carcinoma is an exceedingly rare malignancy, accounting for approximately 0.005% of all cancers and 0.5-5% of cases with hyperparathyroidism. Biopsy is generally contraindicated due to the risk of tumor seeding; thus, preoperative diagnosis is challenging. Here, we report a case of parathyroid carcinoma with successful surgical intervention based on clinical suspicion of malignancy in a patient with primary hyperparathyroidism.
    The patient was a 50-year-old female. She was referred to our department following blood tests conducted in another department, which showed hypercalcemia and elevated intact-PTH levels. A cervical CT scan also revealed parathyroid enlargement. Upon examination, a palpable mass was detected in the right lower neck. Cervical ultrasound showed a parathyroid tumor with a depth-width ratio of 1.12 on transverse scan, with an indistinct boundary between the tumor and the right thyroid lobe. Additionally, 99mTc-MIBI scintigraphy displayed intense accumulation in the dorsal region of the lower pole of the right thyroid lobe. Based on these findings, parathyroid carcinoma without distant metastasis was suspected. We proceeded with surgery, performing a right inferior parathyroidectomy, partial thyroidectomy, and right paratracheal lymph node dissection.
    Postoperative histopathological examination confirmed the diagnosis of parathyroid carcinoma, as initially anticipated. Currently, 2 years and 3 months post-surgery, the patient remains well with no evidence of recurrence; serum calcium and intact-PTH levels have normalized.
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