The role of frozen section biopsy for parotid gland tumour with benign fine-needle aspiration cytology.

OBJECTIVES: This study focused on parotid gland tumours diagnosed as benign by fine-needle aspiration cytology and investigated the necessity of frozen section biopsy. METHODS: There were 104 cases of parotid gland tumour where fine-needle aspiration cytology was benign and frozen section biopsy was subsequently performed, between April 2006 and June 2016. In this retrospective study, the results of frozen section biopsy were analysed and compared with the final histological diagnosis. RESULTS: Among the 104 cases diagnosed as benign by fine-needle aspiration cytology, 102 cases and 2 cases were diagnosed as benign and malignant, respectively, by frozen section biopsy. The final histological diagnoses showed that 98 cases were benign and 6 cases were malignant. The sensitivity and specificity values of frozen section biopsy in detecting malignant tumours were 33 per cent and 100 per cent, respectively. CONCLUSION: The necessity of frozen section biopsy in cases with benign fine-needle aspiration cytology may be low in parotid gland surgery.

Long-term outcomes of alternating chemoradiotherapy in patients with advanced nasopharyngeal cancer: a single-centre experience over the last decade.

SUMMARY: We assessed the long-term outcomes of alternating chemoradiotherapy (ACRT) using 5-fluorouracil and cisplatin (FP) in 25 patients with stage II or advanced nasopharyngeal cancer treated at our institution between April 1999 and April 2010. Median follow-up duration was 87 months (range 2-189). According to the 2009 TNM classification (UICC), six patients were in stage II, nine in stage III, and 10 in stage IV. Treatment completion, response and five-year survival rates were retrospectively assessed. ACRT was performed with a first course of chemotherapy administered followed by the initial round of radiotherapy (36 Gy). Then, a second course of chemotherapy with additional radiotherapy (20-30 Gy) was administered, followed by a final third course of chemotherapy. For chemotherapy, 5-fluorouracil (5-FU, 800 mg/m2/24 h) was intravenously administered for five days, and cisplatin (CDDP, 50 mg/m2/24 h) was administered on the last two days. Treatment completion rate was 96% (24 of 25 cases), and the response rate was 100% (CR: 24 cases and PR: 1 case). Additionally, the five-year overall survival rate was 89.3%. We have demonstrated that ACRT is an effective regimen to treat nasopharyngeal cancer, revealing higher treatment completion, response, and five-year overall survival rates compared with other combinatorial radiotherapy and chemotherapy treatment regimens.

[Distribution of intraglandular metastatic foci in the contralateral lobe of papillary thyroid carcinoma].

The distribution of metastatic foci in the opposite lobe has not been studied in detail despite of several reports on the high incidence of contralateral metastasis. Whether foci spread to the upper one-third of the contralateral lobe influences the choice of total or subtotal thyroidectomy. Metastasis was studied in 66 patients 11 men and 55 women aged 24-73 years (mean; 51.3), undergoing primary total thyroidectomy from 1988 to 1996. Serial blocks of the opposite lobe, approximately 5 mm thick were sliced and stained by hematoxylin-eosin. Metastases were found in 44 patients (67%). Based on the size of the primary focus, these patients were divided into group A (smaller than one-third of the lobe) and group B (greater than that of group A). The average size of the primary focus was 21 mm in group A and 36 mm in group B. The contralateral metastatic rate was 64% (14/22) in group A and 68% (30/44) in group B. The distribution of metastatic foci in the opposite lobe was studied in 44 positive patients. The spread to the upper one third occurred in 61% (27/44); 29% (4/14) in group A and 76% (23/30) in group B a significant difference (p < .003). We thus concluded that the larger the primary focus, the wider the spread of metastatic foci to the opposite lobe.

[Retropharyngeal node metastasis in cancer of the oropharynx and hypopharynx: analysis of retropharyngeal node dissection regarding preoperative radiographic diagnosis].

In our department, all patients with advanced carcinoma of the oropharynx and hypopharynx are treated by retropharyngeal (RP) node dissection in addition to primary resection and standard neck dissection. Records of 42 patients (11 oropharynx, 29 hypopharynx and 2 retromandibula) who received RP node dissection from 1992 to 1996 in our department were examined for metastasis to RP nodes and for preoperative radiographic diagnosis (MRI or CT). The criteria for radiographic involvement of RP nodes are as follows: a diameter greater than 10mm on axial images or central necrosis within the nodal substance. Of the 42 patients, 6 (14.3%) had pathologically positive RP nodes and of those 6 patients, 5 were able to be diagnosed preoperatively by either CT scan or MRI. Results of radiographic diagnosis (MRI or CT) were as follows: by CT scan the sensitivity, specificity and accuracy were all 100% and by MRI the sensitivity, specificity and accuracy were 83.3%, 100% and 97.0% respectively. It is our conclusion that preoperative radiographic diagnosis (MRI or CT) is very useful and effective for diagnosis of metastasis to RP nodes.