Biomedical subjects

Zhengang Xu

Publications and source records attributed to Zhengang Xu.

8 recordsLinked to original sources

PubMed2003

[Study of the causes of recurrence of patients with glottic cancer after partial laryngectomy].

OBJECTIVE: To study the causes of recurrence of patients with glottic cancer after partial laryngectomy and to propose some possible measures for the prevention of glottic cancer postoperative recurrence. METHOD: A retrospective review of consecutive 46 patients with recurrent glottic cancer after partial laryngectomy was conducted. The sites of primary tumors, the ways of operations and the sites of tumor recurrence were investigated. RESULT: Among 46 patients diagnosed with glottic cancer recurrence after partial laryngectomy, 32 cases were local recurrences and 14 were regional metastasis or local-regional recurrences. 13 cases of the second primary lesions in larynx were the cause of the failure and occupied 40.6% of all cases of local recurrences (13/32). In the regional metastasis, the commonest recurrent site was encountered in the upper neck. The upper neck metastasis or local recurrences were common in local recurrent cases treated by salvage surgery. CONCLUSION: It is very important for the prevention of glottic cancer recurrence after partial laryngectomy to properly manage the upper cervical lymph node in the advanced glottic cancers and the local recurrences in larynx and to know the relation of the postoperative recurrence of glottic cancer and the second primary lesions in larynx and carry out corresponding management.

Adult↗

PubMed2003

Management of tonsillar squamous cell carcinoma.

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 respectively (P = 0.804). The 5-year survival rates were 59.3% and 55.3% in the Salvage Surgery and Planned Surgery groups, respectively (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.

Adult↗

PubMed2002

[Diagnosis and therapy of carotid body tumors].

OBJECTIVE: To summarize the experience in diagnosis and therapy of carotid body tumor. METHODS: A retrospective review was performed of 46 patients with carotid body tumors diagnosed and treated between February 1968 and March 2001. RESULTS: Fine-needle aspiration was performed in 2 cases with the the aspirate consisted of blood cells to undergo cytological examination. Blood pool imaging was performed in 12 cases, among which 10 cases (83%) were considered as carotid body tumor. Digital subtraction angiography was performed in 5 cases, all of which were correctly diagnosed. Fifteen cases underwent ultrasound examination, 14 of which (93%) were considered as carotid body tumor. Seven cases underwent computed tomography, among which 5 cases (71%) were considered as carotid body tumor. Four cases underwent magnetic resonance imaging, all of which were correctly diagnosed and 2 of which underwent magnetic resonance angiography. All 46 cases accepted surgical operation, five of them accepted radiotherapy too. The tumors didn't recur during the follow-up period. CONCLUSION: Ultrasonography is sufficient for the diagnosis of carotid body tumors. MRI/MRA help to draw out reasonable treatment fashion. Surgery is the first choice among treatments for carotid body tumors. Radiotherapy helps control effectively the aggression of tumors. Intraoperative meticulous dissection may decrease the incidence of postoperative complications.

Adult↗

PubMed2002

[Evaluation for submental island flap].

OBJECTIVE: To evaluate the clinical effect of submental island flap. METHODS: The influence of head and neck radiotherapy and neck lymph node metastasis on the flap was analysed. The clinical effect in the near future and longterm of submental island flap for defects repair was evaluated. RESULTS: Thirty-eight submental island flap were applied for reconstruction of head and neck defects following cancer ablation between July of 1997 to December of 1999. 16 of these had preoperative radiotherapy at both donor site and receive site, and neck dissections with resection of primary lesions were simultaneously performed in 18 patients. The success rate was 89.5% (34 of 38). All repaired cases had well matched skin with facial surface and excellent texture for intraoral function. CONCLUSIONS: Routine preoperative radiation does do not influence the success and healing of the flap. For tumor complete resection, appropriate cases should be chosen. We believe this flap is worthwhile in addition to the existing armamentarium of reconstruction options both facially and intraorally.

Adolescent↗

PubMed2002

[Election for surgery access to skull base].

OBJECTIVE: To seek for a better approach for the resection of skull base tumors. METHODS: A review of 84 skull base tumors resection employed unlike operative approach in the Cancer Hospital of Chinese Academy of Medical Sciences was presented. Surgical approach feature of invaded the different position of skull base, selects the best operative access for safely removes the tumor, protects the critical structure of skull base as fully as possible, and decreases the complication were discussed in this article. RESULTS: Fourteen cases of benign and seventy cases of malignant underwent surgery. The tumor in 38 cases implicated parapharyngeal space and skull base. The lesion synchronously involved the anterior and middle cranial fossa in 7 cases, middle and posterior cranial fossa in 13 cases, lateral cranial base in 26 cases. The survival rate at 3 years was 68.5% (27/40) for malignant tumor. There was no operative death and severe complication in this series. CONCLUSION: To select the best operation access should think over following factors: 1. Tumor position and the scope implicated. 2. Safely and fully removal of the tumor. 3. The limited destroy to normal function structure and receivable cosmetic effect. 4. It is convenient to reliable reconstruction.

Adolescent↗

PubMed2002

[The management of stomal recurrence after laryngectomy].

OBJECTIVE: To study effective prevention and treatment of stoma recurrence after laryngectomy. METHODS: A retrospective review of 23 patients with stomal recurrence after laryngectomy was conducted. Among all 23 cases, 20 cases were referred to Cancer Hospital of Chinese Academy of Medical Science from other hospitals. The etiopathology of stomal recurrence after laryngectomy, feasibilities of various kinds of operative treatment and outcomes of clinical management in this series were analyzed. RESULTS: The subglottic extension and invasion of paraglottic portion of laryngeal cancer and peritreacheal metastasis may result in stomal recurrence. The survival period of 18 cases surgically treated was longer than that of 5 cases untreated or irradiated and/or chemotherapied. The 1- and 5-year survival rates were 40.7% and 20.4%, respectively. The common complication was pharyngeal fistula. Surgical treatment may relieve local pain, improve breathing, resume swallowing and decrease cancer ulcer bleeding. CONCLUSIONS: The overall prognosis of peristomal recurrence after laryngectomy was awful and dismal. Prevention should be stressed in surgical treatment of the subglottic extension, invasion of paraglottic portion and peritreacheal node metastasis. A proper surgical treatment in some cases of stomal recurrence would prolong the lifetime and advance the life quality of the patients.

Adult↗

PubMed2002

[Effect of salvagy surgeries for nasopharyngeal carcinoma].

OBJECTIVE: To explore a reasonable surgical method for improving salvagy surgery of nasopharyngeal carcinoma (NPC). METHOD: 25 cases of nasopharyngeal carcinoma with salvagy surgery were reviewed. Surgical accesses include the transcervico-mandibuio-palatal, the maxillary swing approach, the transpalatal approach for removing nasopharyngeal lesion. The pectoralis major muscle flap and galea aponeurotica flap were employed to repair operative defect and protect the critical structure of parapharyngeal space and the skull base. RESULT: The operative complication rate is 16% (4/25), which are local infection and flap putrescence. The postoperative sequela such as cleft palate is slight. 18 cases were followed-up over 3 year and 8 cases died. 2 cases were lost. The 3-year survival rate is 44% (8/18). CONCLUSION: The best operation access should be selected depending on the position and the implicated scope. Safely and fully removal of the tumor and reliably reconstruct are necessary. It is possible to improve salvage surgery effect for NPC patients.

Adult↗

PubMed2002

[Relation between vascular endothelial growth factor expression and clinical pathological character in laryngeal squamous cell carcinoma].

OBJECTIVE: To approach the relation between vascular endothelial growth factor (VEGF) expression and clinical pathological character in laryngeal squamous cell carcinoma. METHOD: Immunohistochemical staining (SP) was used to evaluated the expression of VEGF and microvessel count (MVC) in tumor tissues from 87 patients with laryngeal squamous cell carcinoma. RESULT: VEGF immune response was mainly localized to the tumor cell cytoplasm, positive rate was 77%. In laryngeal squamous cell carcinoma, the wider the tumor invaded, the stronger VEGF expressed, the fewer the tumor invaded, the weaker VEGF expressed (P < 0.05); The lower the tumor differentiated, the stronger VEGF expressed, the higher the tumor differentiated, the weaker VEGF expressed (P < 0.05); The stronger VEGF expressed, the more MVC were (P < 0.01); The mean MVC in tumor tissues was obviously higher than that in surgical margin tissues (P < 0.01). CONCLUSION: In laryngeal squamous cell carcinoma, the expression of VEGF was markedly correlated with tumor stage and differentiation, was positively correlated with MVC. As a result, VEGF may have an important role in the progression of laryngeal squamous the carcinoma.

Adult↗