Tong Ji

Shanghai Jiao Tong University, Shanghai, Shanghai Shi, China

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Publications (39)61.44 Total impact

  • H S Ong, X D Fan, T Ji
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    ABSTRACT: The surgical resection of a large unfavourable Shamblin type III carotid body tumour (CBT) can be very challenging technically, with many potential significant complications. Preoperative embolization aids in shrinking the lesion, reducing intraoperative blood loss, and improving visualization of the surgical field. Preoperative internal carotid artery (ICA) stenting aids in reinforcing the arterial wall, thereby providing a better dissection plane. A woman presented to our institution with a large right-sided CBT. Failure of the preoperative temporary balloon occlusion (TBO) test emphasized the importance of intraoperative preservation of the ipsilateral ICA. A combination of both preoperative embolization and carotid stenting allowed a less hazardous radical resection of the CBT. An almost bloodless surgical field permitted meticulous dissection, hence reducing the risk of intraoperative vascular and nerve injury. Embolization and carotid stenting prior to surgical resection should be considered in cases with bilateral CBT or a skull base orientated high CBT, and for those with intracranial extension and patients who have failed the TBO test.
    International Journal of Oral and Maxillofacial Surgery 08/2014; · 1.52 Impact Factor
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    ABSTRACT: Malignant peripheral nerve sheath tumours (MPNST) are rare soft tissue sarcomas. The aim of this study was to assess clinicopathological characteristics and prognostic factors in order to improve the treatment of such tumours in the head and neck region. We performed a retrospective analysis of head and neck MPNST patients in our hospital between 1996 and 2012. Clinical features and pathological findings of these cases (n = 43) were summarized. In addition, prognostic variables were evaluated by univariate and multivariate analyses. The median age of the patients at presentation was 41 years. Surgery was the main treatment approach. Pertinent information regarding the presence of neurofibromatosis type 1 was found in 13 patients (30.2%). Two-thirds of these patients were admitted for a primary tumour (n = 27, 62.8%), while one-third (n = 16, 37.2%) were treated for recurrent neoplasms. The overall survival rate was 46.5%. Multivariable analysis identified tumour size, surgical margins, and postoperative radiotherapy to be independent prognostic factors. MPNST of the head and neck is extremely difficult to manage. Surgery with postoperative radiation may be the optimum choice of treatment for primary head and neck MPNST.
    International Journal of Oral and Maxillofacial Surgery 08/2014; · 1.52 Impact Factor
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    ABSTRACT: Tendon sheath giant cell tumor is an idiopathic proliferative and destructive disease of the synovium. It is rare and tends to arise in large joints, for example, knee and ankle, but it can also arise in temporomandibular joints (TMJs). Because of its destructive nature, immediate treatment upon diagnosis is recommended. Radical resection proved to be an excellent choice for superior local control. However, the unfavorable anatomic location of TMJ and infratemporal fossa tumor with intradural extension make such a resection impractical. Hereby, we reported a case of resection of a TMJ tendon sheath giant cell tumor with intradural extension using a transcranial approach. This involves a complex radical resection with subsequent reconstruction. Transposition of temporal bone flap is a novel state-of-the-art technique in reconstructing the middle fossa floor defect by providing a three-dimensional rigid architecture to support the brain. Temporal bone flap is a reliable plug for rigid support in preventing brain hernia and cerebrospinal fluid leak. Despite its complexity, this cost-effective technique is relatively straightforward to learn and is applicable across all socioeconomic groups.
    The Journal of craniofacial surgery. 07/2014;
  • Tong Ji
    07/2014; 49(7):440-3.
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    ABSTRACT: The pedicled latissimus dorsi myocutaneous flap (PLDMF) is not the first-line reconstructive option for most clinicians; however, when treating salvage patients or those with depleted neck vessels, the PLDMF provides a valuable armamentarium. Unlike the pectoralis major myocutaneous flap or the lower island trapezius flap, the PLDMF has greater versatility in soft tissue design and a longer arc of rotation. These advantages are of great importance in managing advanced reconstructive cases.
    Oral and maxillofacial surgery clinics of North America. 06/2014;
  • Journal of Reconstructive Microsurgery 04/2014; · 1.00 Impact Factor
  • International Journal of Oral and Maxillofacial Surgery 01/2014; · 1.52 Impact Factor
  • T Ji, H S Ong
    International Journal of Oral and Maxillofacial Surgery 07/2013; · 1.52 Impact Factor
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    ABSTRACT: Dermatofibrosarcoma protuberans (DFSP) is an uncommon dermal soft tissue tumour of intermediate malignancy. A 44-year-old man presented to the hospital with a large lesion on the right upper chest and neck. Despite eight previous surgical excisions, the tumour had continued to recur. Contrast-enhanced computed tomography showed recurrence of the tumour, associated with superior vena cava (SVC) syndrome. He declined radical surgical resection of the recurrent tumour, which may have required right upper limb amputation. Targeted therapy with sunitinib malate was therefore introduced. This case demonstrates the recurrent nature of DFSP and the association of this lesion on the upper chest/neck with SVC syndrome. Primary wide radical resection is essential for better local control and to avoid the development of SVC syndrome.
    International Journal of Oral and Maxillofacial Surgery 03/2013; · 1.52 Impact Factor
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    ABSTRACT: PURPOSETo evaluate induction chemotherapy with docetaxel, cisplatin, and fluorouracil (TPF) followed by surgery and postoperative radiotherapy versus up-front surgery and postoperative radiotherapy in patients with locally advanced resectable oral squamous cell carcinoma (OSCC). PATIENTS AND METHODSA prospective open-label phase III trial was conducted. Eligibility criteria included untreated stage III or IVA locally advanced resectable OSCC. Patients received two cycles of TPF induction chemotherapy (docetaxel 75 mg/m(2) on day 1, cisplatin 75 mg/m(2) on day 1, and fluorouracil 750 mg/m(2) on days 1 to 5) followed by radical surgery and postoperative radiotherapy (54 to 66 Gy) versus up-front radical surgery and postoperative radiotherapy. The primary end point was overall survival (OS). Secondary end points included local control and safety.ResultsOf the 256 patients enrolled onto this trial, 222 completed the full treatment protocol. There were no unexpected toxicities, and induction chemotherapy did not increase perioperative morbidity. The clinical response rate to induction chemotherapy was 80.6%. After a median follow-up of 30 months, there was no significant difference in OS (hazard ratio [HR], 0.977; 95% CI, 0.634 to 1.507; P = .918) or disease-free survival (HR, 0.974; 95% CI, 0.654 to 1.45; P = .897) between patients treated with and without TPF induction. Patients in the induction chemotherapy arm with a clinical response or favorable pathologic response (≤ 10% viable tumor cells) had superior OS and locoregional and distant control. CONCLUSION Our study failed to demonstrate that TPF induction chemotherapy improves survival compared with up-front surgery in patients with resectable stage III or IVA OSCC.
    Journal of Clinical Oncology 11/2012; · 18.04 Impact Factor
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    ABSTRACT: The aim of this study was to examine our patients who underwent accurate mandibular reconstruction with vascularized iliac crest flap using computer simulation and stereomodel and assess the postoperative results. Fourteen patients were reviewed in this study. Bilateral iliac crests were automatically superimposed on the mandibular defects to select the optimal matching donor region in computer simulation. Operation was performed using stereomodels to replicate the preoperative planning. Actual reconstruction result was compared with computer simulation. The patients were asked to assess their satisfaction with facial appearance at 1 year after surgery. Bony unions and good occlusion were observed, and actual results were basically in accordance with computer simulation in 14 patients. Fourteen patients reported their facial appearance to be excellent or good at 1 year after surgery. Accurate mandibular reconstruction with vascularized iliac crest flap using computer simulation and stereomodel may achieve the ideal contour of neomandible and good function after dental rehabilitation.
    Oral surgery, oral medicine, oral pathology and oral radiology. 08/2012; 114(2):175-82.
  • Plastic and reconstructive surgery 03/2012; 129(3):565e-566e. · 2.74 Impact Factor
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    ABSTRACT: Owing to rarity and awareness deficiency towards inflammatory myofibroblastic tumor (IMT), we sought to review on its clinicopathological features; arising awareness to achieve early diagnosis; exploring prognostic factors and then establishing a treatment protocol. Retrospective study was performed on patients with histological proven IMT between January 2003 and December 2010. Their demographic data, clinical and histological presentations were recorded. Overall survival (OS) and progression-free-survival (PFS) were estimated via Kaplan-Meier method. Cox regression model was applied to determine the significant of prognostic factors. Logistic regression model was established to predict the probability of relapse. A total of 28 patients. Five-year PFS was 65%. Surgical margins primarily and independently determined the survival, followed by size, pseudocapsule of the lesion, intra-lesional necrosis and lastly Ki-67 and ALK overexpression. Logistic model in prediction of relapse was established, with the formula as probability of relapse = 1/(1 + e(-z)) where e = exponential function, z = constant value (3.9) + B*margin + B*size + B*immunohistochemical expression + B*pseudocapsule + B*intra-lesional necrosis. Immunohistochemical overexpression was significant if Ki-67 was strongly expressed with a conditioned ALK overexpression simultaneously. Staining intensity must be at least moderate for those ALK nuclear staining was less than 25%. Weak ALK staining intensity is only significant if nuclear staining was more than 25%. Diagnosis of IMT is achieved via exclusion. Radical resection and obtaining negative margins remains the mainstay of treatment. Both high and moderate-risk groups required post-operative radiotherapy. In low-risk group, post-operative radiotherapy was recommended if the lesion is larger than 5 cm in diameter with a conditioned ALK & Ki-67 overexpression.
    Oral Oncology 02/2012; 48(2):141-8. · 2.70 Impact Factor
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    ABSTRACT: This study was performed to gain some knowledge on the possible relation between surgical site infection (SSI) and geriatric patients who undergo surgical treatment of oral squamous cell carcinoma and to identify the risk factors in this specific population. A retrospective study from 2004 through 2010 at the Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine was conducted. The primary outcome variable was the presence of SSIs. Twenty-seven variables of the patients concerning general characteristics, comorbidities, disease information, and treatment options were investigated. A multivariate analysis using logistic regression was implemented to find SSI risk factors. The data of 376 patients (183 men, 48.7%; 193 women, 51.3%) older than 65 years with the diagnosis of oral squamous cell carcinoma were included in the present analysis. In multivariate logistic regression analysis, 6 parameters were identified for a significant and independent association with the development of SSI: body mass index (P = .0086); diabetes (P < .0001); American Society of Anesthesiologists score (P = .0127); Adult Comorbidity Evaluation-27 score (P = .0392); operation time (P = .0003); and reconstruction with pectoralis major myocutaneous flaps or free flaps (P < .0001). Special attention to SSIs should be given to elderly patients with oral squamous cell carcinoma. The authors advocate a preoperative evaluation of comorbidities and the selection of high-risk elderly patients for a more effective prevention of SSIs.
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 01/2012; · 1.58 Impact Factor
  • C Y Ma, T Ji, Y Q Wu, A Ow
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    ABSTRACT: Jugulotympanic paragangliomas (JTPs) are rarely encountered benign diseases derived embryonically from the autonomic nervous system. Although JTPs may originate extracranially or intracranially, little has been reported in the literature about large JTPs involving several anatomical structures in the craniofacial regions. Management of large JTPs is controversial. The authors describe a large JTP invading the cranial bones and extending through the neck to the left clavicle. Doppler sonography, computed tomography and magnetic resonance imaging were performed preoperatively to confirm the diagnosis. Combined therapeutic approaches were undertaken with preoperative selective embolization followed by craniofacial resection in cooperation with neurosurgeons.
    International Journal of Oral and Maxillofacial Surgery 11/2011; 41(2):221-4. · 1.52 Impact Factor
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    ABSTRACT: To investigate the subcellular expression of mammary serine proteinase inhibitor (Maspin) in oral squamous cell carcinoma and its relationship to the clinicopathological features. The Maspin protein subcellular expression was detected in 45 patients with oral squamous cell carcinoma by immunohistochemical staining. The relationship between the Maspin protein subcellular expression and the clinicopathological parameters was analyzed. The negative rate of nuclear maspin expression was 64% (29/45), and the weakly positive rate was 11% (5/45), and the strong positive rate was 24% (11/45). Nuclear maspin expression was negatively correlated with T stage (P = 0.019), lymph node metastasis (P = 0.038) and postoperative metastasis (P = 0.004), but positively correlated with the patients' survival rate (P = 0.014). The negative rate of cytoplasmatic maspin expression was 38% (17/45), and the weakly positive rate was 31% (14/45), and the strong positive rate was 31% (14/45). Cytoplasmatic maspin expression was negatively correlated with lymph node metastasis (P = 0.038) and postoperative metastasis (P = 0.004), but positively correlated with the patients' survival rate (P = 0.014). Maspin expression may be a significant marker in predicting prognosis of oral squamous cell carcinoma.
    Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 08/2011; 46(8):505-9.
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    ABSTRACT: To retrospectively review the diagnosis and treatment outcomes of 21 diagnosed with synovial sarcoma (SS) extending to skull base region and identify prognostic factors for local recurrence and distant metastasis. The clinical and pathological records of 21 synovial sarcoma cases involving skull base treated at Department of Oral and Maxillofacial Surgery, Affiliated to Ninth People's Hospital, Shanghai Jiao Tong University, from 2003 to 2008 were reviewed. Parameters including clinical, radiographic, histological findings, and treatment modalities were analyzed. Prognostic factors influencing overall survival, local recurrence, and metastasis were identified. Categorical variables were compared between groups for local recurrence and distant metastasis by using 2-tailed Fisher exact test. The sample consisted of 8 males and 13 females with a median age of 23. 42.9% of cases showed skull base bone erosion with 9.5% of cases presenting intracranial tumor extension. 52.4% of cases died from recurrence or metastasis with a median survival time of 11 months. Orbital involvement, perineural and cranial invasion along with other factors were statistically significant for their impact on overall survival. Local recurrence was associated with tumors located in the infratemporal space (p=0.01), perineural invasion (p=0.001), pathological grade 3 (p=0.005), and tumor size >5 cm (p=0.008). The aggressive behavior of skull base SS and its close proximity to vital structures make the diagnosis and management a challenge. The study reported high local recurrence rates despite surgical and postoperative radiotherapy. Adjuvant chemotherapy did not seem to affect distant metastasis rates.
    Oral Oncology 07/2011; 47(7):671-6. · 2.70 Impact Factor
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    ABSTRACT: Profilins are small proteins essential for many normal cellular dynamics and constitute one of the crucial components of actin-based cellular motility. Several recent studies have implicated a role for the profilin (PFN) family in cancer pathogenesis and progression. However, their expression and promising functions are largely unknown in oral squamous cell carcinoma (OSCC). In this study, we analyzed the correlation between PFN1 and PFN2 expression in vitro and in vivo. The protein expression levels were roughly compared between cell lines (HIOEC, HB96) with the employment of mass spectrometry. PFN2 was singled out as one of the significantly down-regulated genes in the cancerous HB96 cells. The expression levels of PFN1 and PFN2 in vitro were validated by RT-PCR, real-time PCR and Western blotting. Laser scanning confocal microscopy was used for the first time to assess the localization of PFN2 expression. In subsequent experiments, we observed the relationship between PFN2 expression levels and the proliferation of transfected HB96 cancer cells. VASP, N-WASP and P27 expression was also examined in the PFN2-transfected or non-transfected HB96 cells. In vivo, antigen expression was determined by immunohistochemical analyses in 88 paired tissue specimens. Decreased protein expression was confirmed in cancerous tissues from 88 OSCC patients compared with paracancerous normal mucous epithelia. Tumors with weak PFN2 expression were associated with a significantly worse prognosis than strongly expressed tumours (P<0.001). Other statistical analyses were performed to assess the differences in expression and their clinical and pathological significance. In conclusion, PFN2 can be utilized as both a potential suppressor marker and a prognostic protein for OSCC. The function of PFN2 may be to regulate the N-WASP/Arp2/3 signaling pathway.
    Oncology Reports 06/2011; 26(4):813-23. · 2.30 Impact Factor
  • Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 05/2011; 69(5):1390-7. · 1.58 Impact Factor
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    ABSTRACT: Accessory parotid lesions are clinically rare and its management remains poorly understood. The aim of this study was to analyze the clinical management of accessory parotid lesions. From April 1999 to November 2008, a retrospective analysis of 32 patients with accessory parotid lesions was performed. The preoperative examinations, surgical treatment, and prognosis were recorded and analyzed. Among the 32 patients, there were 8 men and 24 women with an overall average age of 45 years. These patients always presented without obvious symptoms, and the masses were moderate to hard in hardness without tenderness, mobile, and with clear boundary. The pathologic diagnoses were 24 benign and 8 malignant lesions. Surgery and surgery plus radiotherapy were performed in the patients with benign and malignant lesions, respectively, with good prognosis. Accessory parotid lesions are rare, and the clinical manifestation is always the same for benign tumors. Surgical resection and surgical resection plus radiotherapy are the primary choices of treatment for benign and malignant lesions, respectively. The prognosis is always good.
    Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 02/2011; 112(3):290-7. · 1.50 Impact Factor

Publication Stats

100 Citations
61.44 Total Impact Points

Institutions

  • 2007–2014
    • Shanghai Jiao Tong University
      • • Department of Oral and Maxillofacial Surgery
      • • School of Medicine
      Shanghai, Shanghai Shi, China
  • 2009–2013
    • Shanghai Putuo District People's Hospital
      Shanghai, Shanghai Shi, China
  • 2006
    • Shanghai University
      Shanghai, Shanghai Shi, China
  • 2003–2004
    • Second Military Medical University, Shanghai
      Shanghai, Shanghai Shi, China