Chuan-zheng Sun

Kunming Medical College, Yün-nan, Yunnan, China

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Publications (12)9.8 Total impact

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    ABSTRACT: Background: To evaluate outcome in sinonasal mucosal melanoma (SMM). Methods: A retrospective analysis of clinicopathological data from January 1976 to December 2005 was performed. Survival curve, univariate and multivariate analyses were undertaken. Results: Sixty-eight patients with SMM were enrolled, three patients refused treatment. The 3-year and 5-year overall survival (OS) rates in the remaining 65 cases of SMM were 36.5% and 29.7%, respectively. Patients who underwent surgery had better 3- and 5-year OS rates than those treated without surgery (40.7% & 34.1% vs. 21.4% & 14.3%), and the same was true for patients treated with and without biotherapy (58.2% & 50.9% vs. 30.0% & 23.4%). Distant metastasis at presentation was associated with a worse prognosis. Those patients managed with multimodality treatment had better OS rates. Conclusions: The prognosis in SMM is poor, particularly for those with distant metastasis or without surgery. Multimodality treatment may improve survival. Head Neck, 2013.
    Head & Neck 04/2013; · 2.83 Impact Factor
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    ABSTRACT: To evaluate the treatment and prognosis of oral mucosal melanoma (OMM) and provide basic data for clinical treatment. Retrospective analysis of clinicopathological data on OMM from January 1976 to December 2005. Survival analysis was performed and Kaplan-Meier analysis was used to compare the effects of clinicopathological factors on survival using SPSS 18.0 software. A Cox model was applied for multivariate analysis. The 3-year and 5-year overall survival (OS) rates of 51 cases of OMM were 35.0% and 20.7%, respectively. Lymph node metastatic sites were predominantly at levels Ib-III (29/31, 93.5%). Patients of age ≥55 years and size ≥4 cm had a lower survival rate than those of aged <55 years and size <4 cm. The 3-year OS and 5-year OS of patients who underwent surgery combined with biotherapy or biochemotherapy (70.1% and 58.4%, respectively) were significantly higher than that of patients who underwent other therapeutic regimens (including surgery, chemotherapy, surgery combined with radiotherapy or surgery combined with chemotherapy) (25.0% and 12.5%, respectively). Multivariate analysis showed that surgery combined with biotherapy or biochemotherapy and neck dissection were effective treatments for OMM. Patients aged ≥55 years had a worse prognosis than those aged <55 years. OMM has a poor prognosis, but multimodality treatment including surgery combined with biotherapy may improve the prognosis. In patients aged ≥55 years with tumor size ≥4 cm, increasing the scope of resection may be effective. Elective levels I-III neck dissection should be considered in TanyNOMO cases.
    Oral Oncology 02/2012; 48(7):647-52. · 2.70 Impact Factor
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    ABSTRACT: To increase the understanding of head and neck Castleman disease (CD) and to improve its diagnosis and management. A retrospective study was performed on the medical records of 14 patients with cervical CD treated at the Sun Yat-sen University Cancer Center from January 2000 through December 2009. The predictor variables were age, gender, site, size, and treatment modality. The outcome variables were survival time and recurrence. Neck level II (9/14) was the most common site for CD. On computed tomogram, all 14 cases appeared as nodular and cylindrical-shaped lesions growing along the neck. Computed tomogram showed a uniform density and clear margins of the lesions. Thirteen cases with hyaline-vascular type CD showed significant enhancement on enhancing computed tomographic scans. One case with plasma-cell type CD accompanied by Hodgkin lymphoma showed mild heterogeneous enhancement and a strong vascular shadow inside the lesion. Thirteen patients with unicentric CD underwent regional resection. Follow-up time ranged from 14 to 132 months, during which none of the patients relapsed. The results of this study suggest that head and neck CD has a low incidence and that the most common site is unilateral level II. Regional resection was the first choice for the treatment of unicentric CD. Overall, chemotherapy was associated with a poor prognosis in patients with multicentric CD. Future studies will focus on the early diagnosis and treatment of multicentric CD. Long-term follow-up is also necessary.
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 01/2012; 70(10):2466-79. · 1.58 Impact Factor
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    ABSTRACT: To investigate the treatment and prognosis of the patients with oral mucosal melanoma (OMM). The clinicopathological and follow-up data of patients with OMM in Sun Yat-sen University Cancer Center from January 1976 to December 2005 were analyzed retrospectively. Fifty-one cases were analyzed. The pathological lymph node metastasis rate was 61% (31/51) and the affected sites were confined to level I(b)-III (94%). The overall three year and five yearsurvival rates were 35% and 21% respectively. No significant difference of three year and five year survival rates were found between the group of incisional biopsy and the group of excisional biopsy. The prognosis was not affected by pigmentation. The survival rate of the patients receiving surgery combined with biotherapy or biochemotherapy was significantly higher than that of the patients treated by other modalities (P = 0.003). In patients with OMM, lymph node metastasis was mostly confined to level I(b)-III. Incisional biopsy and pigmentation were not associated with an unfavorable prognosis. The prognosis of the patients with OMM was poor and the patients may get a better prognosis by receiving surgery combined with biotherapy or biochemotherapy.
    Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 09/2011; 46(9):528-30.
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    ABSTRACT: Our investigation aims to evaluate the significance of TRB3, an endoplasmic reticulum stress (ERS)-inducible gene, and explore its relationship with AKT in oral tongue squamous cell carcinoma (OTSCC). Expression of TRB3 and phosphorylated AKT (p-AKT) in OTSCC tissues and adjacent normal tissues were assessed by RT-PCR, Western blot and immunohistochemistry assay. Correlation of TRB3 and AKT was validated by TRB3 adenovirus plasmid (Ad-TRB3) transfection and short hairpin RNA (shRNA) inhibition. The mRNA expression of TRB3 was significantly higher than adjacent noncancerous tissues by RT-PCR in 15 of 18 specimens of OTSCC (83.3%, P<0.01). Both of TRB3 and AKT were highly expressed in 13 of 18 (72.2%) specimens of OTSCC comparing with adjacent noncancerous tissues by Western blot assay (P<0.05). TRB3 was significantly elevated in 49.2% (63/128) of pathologically confirmed specimens and 13.3% (4/30) of adjacent noncancerous specimens by immunohistochemical analysis (P<0.01). TRB3 overexpression was closely correlated with tumor pathological T stage, lymph node metastasis and tumor recurrence. In addition, both mRNA and protein expression of TRB3 was increased under thapsigargin (TG) or tunicmycin (TU)-induced ERS in Tca8113 and CAL-27 cells. Moreover, expression of p-AKT protein decreased when Ad-TRB3 was transected with OTSCC Tca8113 cells. However, expression of p-AKT protein increased when TRB3 was inhibited by TRB3 shRNA inhibition. TRB3 expression was closely correlated with OTSCC prognosis. Under ERS, TRB3 was up-regulated, resulting in inhibiting the activation of AKT in OTSCC.
    Oral Oncology 08/2011; 47(10):934-9. · 2.70 Impact Factor
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    ABSTRACT: The treatment pattern for cT1-2N0 squamous cell carcinoma (SCC) of the oral tongue is controversial; the postoperative recurrence rate of the disease is high and the salvage effect is poor. This study was to explore the postoperative recurrence-related factors of cT1-2N0 SCC of the oral tongue, to analyze their effects on the survival, and to seek more reasonable therapeutic modality. Clinical data of 125 patients with cT1-2N0 SCC of the oral tongue, treated in Cancer Center of Sun Yat-sen University from Jan. 1992 to Dec. 2000, were reviewed. Of the 125 patients, 58 were at stage T1, 67 were at stage T2; 17 (13.6%) were treated with local operation alone, 53 (42.4%) were treated with both local operation and selective neck dissection, and 55 (44.0%) were treated with operation and chemotherapy and/or radiotherapy. The correlations of disease duration, tumor growth pattern, clinical TNM stage, pathologic grade, occult cervical lymphatic metastasis, tumor invasion depth, treatment methods and neck management to tumor recurrence and prognosis were analyzed. Forty-one (32.8%) patients had recurrence; the overall 5-year survival rate was 62.59%. The 5-year survival rate was significantly lower in recurrent group than in non-recurrent group (38.74% vs. 74.69%, log-rank=19.27, P<0.001). Disease duration (Chi(2) test, P=0.002), tumor growth pattern (Chi(2) test, P<0.001), neck management (Chi(2) test, P<0.001) and occult cervical lymphatic metastasis (Cox regression, P=0.001) were significantly related to the recurrence of cT1-2N0 SCC of the oral tongue. Tumor invasion depth (Cox regression, P=0.005) and the site of recurrent tumor (Cox regression, P<0.001) were significantly related to the prognosis of cT1-2N0 SCC of the oral tongue. Disease duration, tumor growth pattern, neck management, and occult cervical lymphatic metastasis are main recurrent factors of cT1-2N0 SCC of the oral tongue; tumor invasion depth and the site of recurrent tumor are important prognostic factors.
    Ai zheng = Aizheng = Chinese journal of cancer 06/2007; 26(6):661-5.
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    ABSTRACT: To evaluate the effect of induction chemotherapy on the patients with moderate tongue squamous cell carcinoma and to investigate the factors that influence prognosis of these patients. One hundred and twenty two patients with moderate tongue squamous cell carcinoma (stage II-III, T2-3 N0/T1-3N1), treated from Jan. 1990 to Dec. 1999 were retrospectively reviewed. Among them, 69 and 53 patients were received operation alone and operation after induction chemotherapy respectively [cisplatin + 5-fluorouracil + bleomycin-A5 (PBF), 17 cases; bleomycin-A5, 36 cases]. Survival rate was estimated by Kaplan-Meier method. Multivariate analysis by the Cox proportional hazard model. The mean follow-time of all patients were (79.9 +/- 49.8) (x +/- s) months (range: 7 to 177 months), and 45 patients died (including 5 lost to follow up) , 66 of 77 patients alive followed more than 5 years. The overall 3-year and 5-year survival rate were 79.4% and 69. 0% respectively. The overall 3-year and 5-year free-disease survival rate were 71.7% and 66. 3% respectively. The survival rate of 3-year and 5-year was 82.5% and 73.1% respectively for the group of operation alone; 82.4% and 70.1% respectively for the group of operation after induction chemotherapy with PBF, 72.2% and 61.1% respectively for the group of operation after induction chemotherapy with bleomycin-A5; and there were no significant difference between the above three groups (chi2 = 0.42, P = 0.8106). The locoregional recurrence rate were 30.4%, 41.2% and 38.9% for the operation alone group, operation after PBF induction chemotherapy group and operation after bleomycin-A5 induction chemotherapy group respectively. No significant benefit on decreasing locoregional recurrence (chi2 = 1.148, P = 0.563) or distant metastasis rate (chi2 = 2.305, P = 0.316) were found by induction chemotherapy by univariate analysis. Using multivariate analysis, risk factor that independently influence survival was the recurrence. Risk factors that independently influence survival of moderate tongue squamous cell carcinoma was the locoregional recurrence. No significant benefit on improving survival rate or decreasing locoregional recurrence or metastasis rate were found by induction chemotherapy, there was no difference between the two induction chemotherapy schemes on the survival rate or locoregional recurrence or metastasis rate of these patients.
    Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 05/2007; 42(4):273-6.
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    ABSTRACT: To investigate the clinical characteristics and prognosis of second primary tumor of tongue (SPTr) after nasopharyngeal carcinoma (NPCR) treated with radiotherapy. Clinical data of 53 patients with SP7T after NPCR (group A) and 252 patients with primary tongue carcinoma (group B) were analyzed retrospectively with regard to clinical characteristics and survival rate (Kaplan-Meier); and multivariate analysis was performed using Cox proportional hazards model. There was no significant difference between group A and group B ( P > 0. 05) in the presenting age, sex, tumor size, cTNM stage, tumor differentiation and the rate of distant metastasis. The overall 5-year survival rates were 41.6% in group A and 56.3% in group B (chi2 = 4.40, P = 0.0359) with a statistically significant difference between two groups. The differences of tumor location (chi2 = 61.18, P = 0.000) and rate of clinical (cN+, chi2 = 6.846, P = 0.009) or pathological lymph node metastasis (pN+, X2 = 3.993, P = 0.046) were also statistically significant between group A and group B, respectively. Multivariate analysis showed that age at presence, cTNM stage and with or without neck lymph node dissection were independent risk factors affecting survival. Second primary tongue carcinoma after radiotherapy for nasopharyngeal carcinoma is likely to occur on the dorsal aspect of the tongue with worse prognosis but with a lower rate of lymph node metastasis than that of primary tongue carcinoma. However, radiotherapy history is not an independent influencing factor on prognosis. Surgical resection or combined modality therapy may give a better prognosis.
    Zhonghua zhong liu za zhi [Chinese journal of oncology] 01/2007; 28(12):938-41.
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    ABSTRACT: To compare the results of different treatment modalities for the advanced tongue squamous cell carcinoma and investigate the factors that influence its prognosis. Ninety-two patients with advanced tongue squamous cell carcinoma without distant metastasis, treated in our hospital from Jan. 1990 to Dec. 1999 were retrospectively reviewed. Survival rate was estimated by Kaplan-Meier method, and multivariate analysis was performed by the Cox Proportional hazard model. The overall 3-year and 5-year survival rates were 52.40% and 37.23% respectively. There was a significant difference in the overall between the two groups survival rate (chemotherapy only and radiotherapy after induced chemotherapy) and the three groups (operation only, operation after induced chemotherapy, radiotherapy after operation) cTNM stage, operation for the primary lesion and local recurrence were the independent factors that influenced the prognosis. Risk factors that independently influence the survival of patients with advanced tongue squamous cell carcinoma were the local recurrence, cTNM and receiving operation or not for the primary lesion. Operation only or comprehensive therapy including operation could give a better prognosis, but the results of chemotherapy only or radiotherapy after chemotherapy were poor.
    Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 12/2006; 41(11):650-3.
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    ABSTRACT: To investigate the treatment model and the factors that influence survival of the patients with anaplastic thyroid carcinoma (ATC). The clinical data of all patients with ATC in our hospital from May. 1970 to May. 2005 were analyzed retrospectively with regard to mortality and survival rate (Kaplan-Meier). Multivariate analysis was performed by the Cox proportional hazard model. Fifty cases together were analyzed. The overall 1-year, 3-year, 5-year survival rate were 39.4%, 29.6% and 20.7% respectively. The median survival time was 6 months. Univariate analysis showed the patients with their age < 55 years old, without distant metastasis, white blood cell count < 10.0 x 10(9)/L at presentation, without receiving chemotherapy, receiving radiotherapy with the dose no less than 40 Gy, receiving multiple modality therapy had a better prognosis. White blood cell count at presentation, the model of therapy were the risk factors independently influencing prognosis by multivariate analysis. White blood cell count at presentation, receiving surgery and postoperative radiotherapy or not were the risk factors independently influencing prognosis. The prognosis of anaplastic thyroid carcinoma was worse; the patients with ATC maybe get a better prognosis by receiving surgery and postoperative radiotherapy.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 11/2006; 44(21):1493-7.
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    ABSTRACT: To investigate the clinical characteristics of second primary tumor of tongue after nasopharyngeal carcinoma (NPC) radiotherapy and the prognostic factors of patients. Fifty-three cases with second primary tumor of tongue after NPC radiotherapy, presenting to Cancer Centre, Sun Yat-sen University from Jan. 1st 1975 to Dec. 31st 2000 were analyzed retrospectively with regard to mortality and survival rate (Kaplan-Meier method); A multivariate analysis was performed in these patients with Cox proportional hazard model. Forty of 53 patients died. Among them,37 died of second primary tumor of tongue, 2 of recurrence of NPC, 1 of perioperative period. The overall 5-year and 10-year survival rate of 51 patients receiving therapy were 41.64% and 35.69% respectively. The subsites of tumor were: tip 0, margin 26 (49.06%), ventral lateral 8 (15.09%) and dorsal aspect 19 (35.85%). Eighteen cases had recurrence of second primary tumor of tongue (33.96%) ; Six (11.32%) cases had clinical lymph node metastasis from second primary tumor of tongue and 3 (5.66%) had pathological lymph node metastasis; The univariate analysis showed the major prognostic factors influencing survival of these patients were tumor size, clinical TNM stage at presentation; Using multivariate analysis, risk factors that independently influence survival were clinical and pathological stage and the interval between two tumors. The clinical and pathological stage and the interval between two tumors are the prognostic factors for second primary tumor of tongue after NPC radiotherapy.
    Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 12/2005; 40(11):819-23.
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    ABSTRACT: To investigate the factors that influence survival of the patients with differentiated thyroid carcinoma in young people and evaluate the efficiency of unilateral lobectomy plus isthmectomy with therapeutic cervical lymph node dissection and postoperative TSH (thyroid stimulating hormone) suppressive therapy. One hundred and thirty-one patients under 30 years old with differentiated thyroid carcinoma treated in this hospital (14 cases no more than and 117 cases more than 16 years) from Jan. 1st, 1985 to Dec. 31st, 1997 were retrospectively reviewed. One hundred and twenty-eight patients were received only surgery and TSH suppressive therapy, and 3 patients received chemotherapy or radiotherapy because of the progressive metastasis in necks or mediastina. A multivariate analysis was performed in these patients by the Cox proportional hazard model. The mean follow-time (x +/- s) of all patients were (140.86 +/- 43.76) months, with range from 20 to 229 months; Ninety-eight patients followed more than 10 years. Ten patients died of thyroid cancer. The overall 10-year survival rate was 97.18%. The 10-year survival rate for patients < or = 16 years of age and > 16 years were 75.97% and 96.57% respectively (P = 0. 0006). The 10-year survival rate for women and men were 94.91% and 93.69% respectively (P = 0.5261). The 10-year survival rates of patients with papillary thyroid carcinoma and follicular thyroid carcinoma were 93.77% and 96. 55% respectively (P = 0.8137). For patients with tumor size of < or = 1 cm, 1-4 cm and >4 cm the survival rate was 100.0%, 96.40%, and 80.67% respectively (P = 0. 0589). The 10-year survival rates of patients with or without lymph node metastasis were 88.37% and 100. 0% respectively (P = 0.0313). For patients of with or without distant metastasis, The survival rate was 96.64% or 60.00% (P = 0.0000). The 10-year survival rates with or without recurrence were 86. 67% and 95.48% respectively (P = 0. 5681). Using multivariate analysis, risk factors that independently influence survival were distant metastasis, tumor size and age. The distant metastasis, tumor size and age at diagnosis were the independent factors influencing survival significantly. The status of lymph node metastasis may have certain effect on the prognosis. Unilateral lobectomy plus isthmectomy with a therapeutic cervical lymph node dissection followed by postoperative TSH suppressive therapy is a favourable model to children and young adults with DTC without distant metastasis, but to the patients with distant metastasis, their prognosis of this therapy model is disappointing.
    Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 08/2005; 40(8):595-600.