Yong-xia Zhang

Peking Union Medical College Hospital, Peping, Beijing, China

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Publications (7)1.27 Total impact

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    ABSTRACT: To investigate the clinicopathological features, treatment outcomes and prognosis of patients with oropharyngeal squamous cell carcinoma (OSCC). Retrospective review of 318 consecutive cases with OSCC treated from January 1999 to December 2011. Survival rates and prognostic factors were calculated using the Kaplan-Meier method and multivariate Cox model survival analysis respectively. There were 281 males and 37 females, with a median age of 56 years. Of the 318 cases, 163 carcinomas were from tonsil, 108 from tongue base and 47 from soft palate-uvula. The presenting symptoms were pharyngalgia (128 cases, 40.3%), neck masses (71 cases, 22.3%), foreign body sensation in the pharynx (63 cases, 19.8%) and dental ulcer (44 cases, 13.8%). The median time from onset of the first symptoms until diagnosis of OSCC was 3 months. Of the 318 OSCC, 75 were with high grade, 110 with intermediate grade and 133 with low grade, including 10 patients at stageI, 39 at stage II, 68 at stage III and 201 at stage IV. The rates of lymph node metastasis, distant metastasis and second primary carcinoma were 72.3%, 13.2% and 7.9%, respectively. Of 318 patients, 117 received radiotherapy alone, 66 underwent surgery plus postoperative radiotherapy, 59 underwent preoperative radiotherapy plus surgery, 33 received concomitant chemotherapy and radiotherapy, 20 received concomitant molecular targeted therapy and radiotherapy, 16 underwent surgery alone and 7 received induction chemotherapy plus radiotherapy. The 3-, 5-year overall survival (OS) rates were 58.4%, 50.7%, respectively, and the median overall survival time was 60.1 months. Ages (P = 0.034), gender(P = 0.024), smoking and alcohol consumptions(P = 0.008), doses of radiotherapy(P = 0.046) and clinic stages(P = 0.001) were independent factors for OS. OSCC is poor in prognosis, with a high incidence of cervical lymph node metastasis. Radiotherapy and salvage surgery are the main treatments for OSCC.
    Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 05/2013; 48(5):398-404.
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    ABSTRACT: OBJECTIVE: To investigate the clinicopathological features, treatment outcomes and prognosis of patients with squamous cell carcinoma of the thyroid (SCCT). METHODS: Retrospective review of SCCT cases in our hospital from January 1999 to May 2012. Demographic data and clinical charts, including presenting symptoms, histologic grade of tumor, treatment, and outcome of 28 consecutive patients were obtained. Survival rates and prognostic factors were calculated with SPSS 13.0 software using the Kaplan-Meier method and multivariate Cox model survival analysis. RESULTS: SCCT accounted for only 0.36% of all types of thyroid malignancy. There were 15 males and 13 females, and the median age was 63 years. The presenting symptoms were neck masses (26/28) and hoarse voice (18/28). The 28 SCCTs included 15 high grade tumors, eight intermediate grade tumors and five low grade tumors. According to the UICC 2002 staging criteria, 16 patients were stage IVa, and 12 were stage IVb. Of the 28 patients, 19 underwent surgery plus postoperative radiotherapy, seven underwent surgery alone, and two received radiotherapy alone. The rates of lymph node metastasis and distant metastasis were 60.7% and 25.0%, respectively. The 1-year, 2-year and 5-year overall survival (OS) rate were 50.4%, 25.8% and 19.3%, respectively, and the median overall survival time was 12.2 months. Kaplan-Meier univariate survival analyses indicated that the sizes of the tumors, esophageal invasions and treatment policies are prognostic factors, and multivariate Cox model survival analyses confirmed that the sizes of the tumors and treatment policies were independent factors for OS. Multivariate survival analyses confirmed that the sizes of the tumors and treatment policies were independent factors for OS. CONCLUSIONS: SCCT is a rare malignant tumor with strong invasive ability, high malignancy and poor prognosis. Combined modality therapy was strongly recommended, and surgical resection plus postoperative radiotherapy may be the main treatment protocol for patients with SCCT.
    Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 02/2013; 48(2):143-147.
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    ABSTRACT: To analyze the relationship between the prognosis of patients with oropharyngeal squamous cell carcinoma (OSCC) and human papillomavirus (HPV) infection in OSCC. Sixty-six patients with oropharyngeal carcinoma who met the enrollment criteria during the period from January 1999 to December 2009 were retrospectively reviewed. The presence or absence of HPV oncogenic types in OSCC specimen was determined by multiplex polymerase chain reaction (PCR). Overall survival (OS) and disease specific survival (DSS) for HPV-positive and HPV-negative patients were estimated by Kaplan-Meier analysis. Cox regression model was used for multivariate analysis. HPV-DNA was detected in 11(16.7%) of all specimens. Among them, 7 were positive for HPV-16, 1 for HPV-16/11, 1 for HPV-35, 1 for HPV-58/52, and 1 for HPV-33/52/54. With the follow-up of 3-78 months (a median of 24.5 months), patients with HPV-positive tumors had significantly better overall survival (χ2=5.792, P=0.016) and disease specific survival (χ2=4.721, P=0.030), the 3-year OS and DSS were 90.0% vs 52.4% and 90.0% vs 56.4%, respectively. Multivariate analysis by Cox regression model showed that HPV infection and nodal status were both independent prognostic factors for patients with OSCC (P<0.05). Patients with HPV-positive OSCC have significantly better prognosis than patients with HPV-negative tumors. HPV infection is an independent prognostic factor.
    Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 03/2012; 47(3):207-11.
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    ABSTRACT: This study focused on infection rates and subtypes of human papillomavirus (HPV) in patients with oropharyngeal squamous cell carcinoma (OSCC), and the relationship between HPV status and prognosis of the disease. We evaluated sixty-six OSCC patients who met the enrollment criteria during the period from January 1999 to December 2009. The presence or absence of oncogenic HPV types in tumors was determined using the SPF10 LiPA25 assay. Overall survival (OS) and disease specific survival (DSS) for HPV positive and HPV negative patients were estimated using Kaplan-Meier analysis. The Cox regression model was applied for multivariate analysis. HPV-DNA was detected in 11(16.7%) of all specimens. Among them, 7 were type HPV-16, while other types were HPV-16/11, HPV-35, HPV-58/52, and HPV-33/52/54. Patients with HPV positive tumors were more likely to be female, non-smokers and non-drinkers (p=0.002, 0.001 and 0.001, respectively). After a median follow-up of 24.5 months, patients with HPV positive tumors had significantly better overall survival (HR=0.106[95%CI=0.014-0.787], p=0.016,) and disease specific survival (HR=0.121[95%CI=0.016-0.906], p=0.030). Patients with HPV positive OSCC have significantly better prognosis than patients with HPV negative tumors. HPV infection is an independent prognostic factor.
    Asian Pacific journal of cancer prevention: APJCP 01/2012; 13(3):891-6. · 1.27 Impact Factor
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    ABSTRACT: To investigate the clinical application of fine needle aspiration (FNA) cytology of thyroid nodules. A retrospective review was performed of 474 consecutive cases of FNA cytology of thyroid nodules from October 2005 to January 2011. Two hundred and eighteen patients underwent ultrasound-guided FNA, and 256 patients experienced palpation-guided FNA. Cytologic diagnoses were classified as unsatisfactory, benign, atypical cellular lesion, follicular neoplasm, suspicious for malignancy, and positive for malignancy. The discrepancies between initial cytologic diagnoses and histologic diagnoses were evaluated in 157 surgical specimens. According to the cytological categories, the rates for histologically confirmed malignancy in the 157 patients were as follows: 2/7 of unsatisfactory results, 16.7% (9/54) of benign lesion, 3/9 of atypical cellular lesion, 1/3 of follicular neoplasm, 83.3% (35/42) of suspicious for malignancies, and 97.6% (41/42) of positive for malignancies. The sensitivity, specificity and positive predictive value of thyroid FNA for the diagnosis of malignancy were 85.4%, 86.9% and 90.5%, respectively. FNA can provide an accurate diagnosis of thyroid malignancy preoperatively. The 6 diagnostic categories were beneficial for either clinical follow-up or surgical management of the patients with thyroid nodules.
    Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 11/2011; 46(11):892-6.
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    ABSTRACT: To evaluate the efficacy of the distinct free flaps in reconstruction of different types of maxillectomy defects. A retrospective reviews was performed of in 66 consecutive cases of reconstructions with free flaps for maxillary tumor ablation defects from October 1997 to June 2010. There were 43 patients who had recurrences after previous operations and 46 patients had accepted radiation therapy before. According to the classification of Brown's maxilla defect:10 cases were in class I, 13 in class II, 23 in class III and 20 in class IV. The reconstructive free flaps included 26 fibula flaps, 10 radial forearm flaps, 7 latissimus dorsi flaps, 7 rectus abdominis flaps, 7 anterolateral thigh perforator flaps, 5 deep inferior epigastric artery perforators, 2 latissimus dorsi/rib flaps and 2 iliac crest flaps. Postoperative features and functions were assessed in 29 patients. The overall free flap success rate was 93.9% (62/66). Three rectus abdominis flaps and one fibula flap failed. There were 29 patients who received postoperative function assessment. Sixty-two percent of the patients restored to taking regular diets, 24 (82.8%) patients had normal language communication ability, and 25 (86.2%) patients were satisfied with their feature. Radial forearm flap was recommended to reconstruct the class 1 defect, fibula flap to class 2 or class 3 and preformatted flap to class 4.
    Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 05/2011; 46(5):368-72.
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    ABSTRACT: To analyze the results and the indications of free flaps in the skull base reconstruction. A retrospective review was performed of 25 free flaps reconstructions for skull base tumor ablation defects between March of 1999 and March of 2009. There were 9 latissimus dorsi flaps, 6 rectus abdominis flaps, 4 deep inferior epigastric artery perforator flaps, 3 anterolateral thigh flaps, 2 radial forearm flaps and 1 fibular flap. The defects were classified as cranial bone (100%), dura (40%), brain (12%), sino-nasal cavity (52%), mucosa (56%) and skin (80%). Twenty-three of 25(92%) free flaps survived. One total flap failure and 1 partial flap failure occurred. Five patients (20%) had central nervous system related postoperative complications which including 1 mortality, 2 central nerve system infection and 2 cerebrospinal fluid fistula. Free flaps transfer is a reliable reconstruction technique for cranial base surgery. This provides a solution to the select advances disease otherwise surgical contraindications. Free flap is the choice for reconstruction of advanced oncological defects, especially when skin and mucosa are violated.
    Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 05/2010; 45(5):406-9.

Publication Stats

3 Citations
1.27 Total Impact Points

Institutions

  • 2010–2013
    • Peking Union Medical College Hospital
      Peping, Beijing, China