Publications by authors named "Kunihiko Tokashiki"

4 Publications

  • Page 1 of 1

Postoperative Complications of Jejunal and Skin Valve Reconstruction in Free Reconstructive Surgery for Hypopharyngeal Carcinoma.

Anticancer Res 2021 Aug;41(8):4033-4038

Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan.

Background/aim: This study evaluated the incidence of perioperative complications in jejunal flap compared with the free tissue flap approach.

Patients And Methods: This study included 75 patients who underwent free flap reconstruction for hypopharyngeal carcinoma. The primary outcome was the incidence of pharyngocutaneous fistula, and the secondary outcomes were perioperative complications.

Results: Pharyngocutaneous fistula developed in 7% of patients who underwent jejunal flap procedures and 6% of patients who underwent free tissue flap procedure. Flap sampling site complications occurred in 23% of patients who underwent jejunal flap procedures and in none of the patients who underwent free tissue flap procedure.

Conclusion: No significant difference was observed in the incidence of pharyngocutaneous fistula between the two groups (p=0.99), but complications at the flap sampling site were significantly more common in jejunal flap procedures than in free tissue flap procedures (p=0.03). Free tissue flap procedures are potential reconstruction methods superior to jejunal flap methods.
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http://dx.doi.org/10.21873/anticanres.15203DOI Listing
August 2021

Pericardial metastasis of parotid mucoepidermoid carcinoma diagnosed by pericardial biopsy.

Auris Nasus Larynx 2021 Mar 6. Epub 2021 Mar 6.

Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, 6-7-1, Shinjuku-ku, Tokyo, Nishishinjuku 160-0023, Japan.

A 30-year-old man presented with swelling in the lower left ear. Close examination led to a diagnosis of parotid gland cancer, T4N0M0 Stage IVA, so total resection of the left parotid gland and left neck dissection were performed. Pathological examination led to a diagnosis of high-grade malignant-type mucoepidermoid, and chemoradiotherapy was performed as postoperative treatment. Fourteen days after completion of chemoradiotherapy, the patient was admitted to the hospital with headache and lack of appetite. Echocardiography showed a pericardial effusion and complete collapse of the right ventricle; cardiac tamponade was diagnosed, and pericardiocentesis was performed. The pericardial effusion was bloody, and a metastatic lesion was suspected, but cytological examination showed class IIIa. On day 33 of the illness, respiratory distress and hypotension were observed. A clot was seen covering the lower wall of the heart, and dilatation of the lower wall was significantly impaired. Pericardiotomy was performed on day 36. Pathological examination diagnosed cardiac metastasis of mucoepidermoid carcinoma of the parotid gland. Although only 4 cases of parotid cancer have been reported as primary lesions of metastatic heart tumors, this case represents the world's first description of isolated parenchymal metastasis of mucoepidermoid carcinoma of the parotid gland diagnosed by pericardial biopsy.
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http://dx.doi.org/10.1016/j.anl.2021.02.016DOI Listing
March 2021

Real-World, Long-Term Outcomes of Nivolumab Therapy for Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck and Impact of the Magnitude of Best Overall Response: A Retrospective Multicenter Study of 88 Patients.

Cancers (Basel) 2020 Nov 18;12(11). Epub 2020 Nov 18.

Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan.

No real-world, long-term outcomes of immunotherapy with nivolumab for recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) have yet been reported. Furthermore, the prognostic impact of the best overall response (BOR) of this therapy remains unclear. We conducted a multi-institutional cohort study of the long-term efficacy and safety of this therapy and investigated prognostic factors associated with survival. Further, we evaluated the relationship between BOR and survival. Median follow-up time was 25.9 months. Median overall survival (OS) was 9.6 months, and two-year survival rate was 25.0%. Median progression-free survival (PFS) was 3.7 months, and two-year PFS rate was 19.6%. BOR was assessed as complete response (CR) in 6%, partial response (PR) in 13%, stable disease (SD) in 30%, and progressive disease (PD) in 52% of the patients. Overall response rate was 18%, and disease control rate was 48%. For immune-related adverse events (irAEs), 38 irAEs were detected in 29 patients. On multivariate analysis, the development of irAEs was significantly associated with better OS and PFS. Better BOR was significantly associated with longer OS and PFS. These findings demonstrate the long-term efficacy and safety of nivolumab therapy for R/M SCCHN in a real-world setting. The magnitude of BOR and the development of irAEs might be useful surrogate markers of survival.
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http://dx.doi.org/10.3390/cancers12113427DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699139PMC
November 2020

A case of primary submandibular gland oncocytic carcinoma.

Case Rep Otolaryngol 2013 12;2013:384238. Epub 2013 Sep 12.

Otorhinolaryngology, Head & Neck Surgery, Tokyo Medical University Hachioji Medical Center, 403 La Conte Shinjuku, Nishi-Shinjuku 5-8-6, Shinjuku-ku, Tokyo 160-0023, Japan.

Primary submandibular gland oncocytic carcinoma is a rare pathology, with only 10 cases being reported to date. We encountered a case of primary submandibular gland oncocytic carcinoma and report it herein. The patient was a 69-year-old man who came to our hospital with right submandibular cancer as the main complaint. Based on the results of computed tomography and magnetic resonance imaging, submandibular gland tumor was diagnosed. Preoperative cytodiagnosis suggested class III oncocytic carcinoma. Resection of the right submandibular tumor was performed along with right neck dissection. Postoperative histopathological diagnosis was oncocytic carcinoma. As of 3 years following surgery, no recurrence has been identified.
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http://dx.doi.org/10.1155/2013/384238DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789408PMC
October 2013
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