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SHINOMIYA HirotakaGraduate School of Medicine / Faculty of Medical SciencesProfessor
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■ Paper- Non-recurrent inferior laryngeal nerve (NRILN) is rare but one of the important anatomical variations in thyroid and parathyroid surgery. Almost all cases were observed on the right side with aberrant right subclavian artery and left NRILN have been reported in only five cases so far. Here, we reported a 38 year-old Japanese male with left NRILN accompanying adenomatous goiter. He was referred to our hospital for the surgical treatment of left thyroid goiter. Preoperative computed tomography revealed right-sided aortic arch and aberrant left subclavian artery with no signs of complete situs inversus viscerum, suggesting possible left NRLN. Left hemithyroidectomy was performed using nerve monitoring system. Intraoperatively, left recurrent laryngeal nerve was not identified along tracheoesophageal groove, but directly originated from vagal nerve and was running horizontally to larynx. Mobility of vocal cords were not impaired and postoperative course was uneventful. During thyroid surgery for the patients with right-sided aortic arch, meticulous care should be taken using nerve monitoring system to avoid nerve injury.Mar. 2020, Auris, nasus, larynx, English, International magazine[Refereed]
- BACKGROUND: No clear consensus has been reached on the indication of supraomohyoid neck dissection (SOHND) for clinically positive lymph-node metastasis. PATIENTS: Consecutive 100 patients with previously untreated oral cancer treated at Kobe University Hospital were included in this study. All patients were clinically staged as anyTN1M0 and underwent radical dissection of the primary site and level I-V neck dissection as the initial treatment. RESULTS: None of the 100 patients had pathological lymph-node metastasis (pLN) to level V. pLN to level IV was observed in two patients with tongue cancer in whom clinical lymph-node metastasis was preoperatively observed at level II. CONCLUSIONS: Level V may be excluded in the neck dissection for patients with N1 oral cancers. Level IV dissection should be considered in the patient with tongue cancer and clinical lymph-node metastasis at level II.Mar. 2020, International Journal of Clinical Oncology, English, Domestic magazine[Refereed]Scientific journal
- Feb. 2020, Cancer Reports[Refereed]Scientific journal
- OBJECTIVE: Free flap reconstruction in elderly patients is one of the most challenging surgeries in the treatment of head and neck cancers. The aim of this study was to examine the oncological and functional outcomes of free flap reconstruction for elderly patients with head and neck cancer. METHODS: We retrospectively reviewed elderly patients who underwent free flap reconstruction for the treatment of head and neck cancers. All patients were 80 years or older. Clinicopathologic features, surgical procedures, oncological and functional outcomes were obtained from medical records. RESULTS: Free flap reconstructions were performed in 13 patients (3 female, 10 male). The mean age was 82.6 ± 3.4 years (range: 80-91). The mean follow-up period was 23.3 months (range 4-41 months). The mean disease-free survival was 49 ± 6 months (range 4-60 months). All patients had been alive more than one year after surgery. Reconstruction was performed using free jejunum in 10 patients and radial forearm flap in 3 patients. Graft necrosis occurred in 2 patients. Other two patients experienced major postoperative medical complications. CONCLUSION: Free flap reconstruction in well-selected older adults is safe and effective. Advanced age should not preclude consideration of free flap reconstruction in those patients.Feb. 2020, Auris, nasus, larynx, 47(1) (1), 123 - 127, English, International magazine[Refereed]Scientific journal
- Dec. 2019, Auris, nasus, larynx, 46(6) (6), 960 - 960, English, International magazine
- (株)医学書院, Dec. 2019, 耳鼻咽喉科・頭頸部外科, 91(13) (13), 1094 - 1097, Japanese【舌がん・口腔がん治療の最前線】診断 診断の進め方 新しいTNM分類では,何をどのように明らかにする必要があるのか[Refereed]
- (一社)日本耳鼻咽喉科学会, Dec. 2019, 日本耳鼻咽喉科学会会報, 122(12) (12), 1561 - 1562, JapaneseANL Secondary Publication 甲状腺癌に対する甲状腺全摘後の術後副甲状腺機能低下症について[Refereed]
- Cardiac metastasis from head and neck cancers are very rare. Metastases to heart are mostly diagnosed at autopsy, and seldom found while patients are alive. Patients with cardiac metastasis do not present with specific symptoms in the early stages, and diagnosis is often delayed until the disease has advanced significantly. Here, we report a 66-year-old lady who was diagnosed with cardiac metastasis 10 months after surgical resection of oral cancer. She died one month following the discovery of cardiac metastasis. Cardiac metastasis should be considered when unexplained and progressive decline of general health is observed, even in the absence of abnormalities on the electrocardiogram. Early diagnosis may be made by analyzing the chronological changes in the cardiac accumulation of fluorodeoxyglucose during positron emission tomography-computed tomography scan.Dec. 2019, Auris, nasus, larynx, 46(6) (6), 902 - 906, English, International magazine[Refereed]Scientific journal
- Papillary thyroid carcinoma (PTC) occasionally invades tracheal cartilages. We adapted a reconstructive procedure "modified spiral tracheoplasty" to extensive tracheal defect after resection of locally advanced thyroid cancer. Extensive window resection of tracheal wall was performed in a 72-year-old woman and a 48-year-old man with PTC invading intraluminal trachea. Remaining stumps of trachea were separated from the esophageal wall and were rotated by 90 degrees in opposite directions. Posterior and lateral walls were anastomosed and tracheocutaneous fistula was created to prevent postoperative airway obstruction. Postoperative course was uneventful in both cases. Tracheocutaneous fistula was successfully closed 3 to 4 months after the initial surgery. Modified spiral tracheoplasty is a safe and useful method to recreate a framework of trachea after extensive window resection for advanced thyroid cancer.Dec. 2019, Auris, nasus, larynx, 46(6) (6), 946 - 951, English, International magazine[Refereed]Scientific journal
- OBJECTIVE: The purpose of this study was to clarify the impact of superficial parotidectomy and postoperative radiotherapy (PORT) for the surgical treatment of early stage squamous cell carcinoma (SCC) in external auditory canal (EAC). MATERIALS AND METHODS: Thirty-seven patients with T1 (n = 14) or T2 (n = 19) SCC in EAC treated between 2000 and 2016 at Kobe University Hospital were enrolled in this study. Thirty-three patients were operated with sleeve resection or lateral temporal bone resection. RESULTS: The 5-year overall survival and disease-specific survival rates were 95% and 100%, respectively. Surgical margin was positive in 4 patients, who were treated by PORT and have been alive without disease. Prophylactic superficial parotidectomy was simultaneously performed at the time of initial surgery in 15 patients, in whom no lymph node (LN) metastasis was observed. Among the other 22 patients, regional recurrence in parotid LN was observed in one patient, who was successfully salvaged by total parotidectomy. Potential parotid lymph node metastasis rates of T1 and T2 SCC in EAC was 0% (0/14) and 5% (1/19) respectively. CONCLUSIONS: Complete resection without positive surgical margins is essential for the treatment of the patients with T1 and T2 ear cancers. Prophylactic superficial parotidectomy or neck dissection is not mandatory for T1 and T2 diseases, as long as precisely extent of disease is assessed preoperatively. PORT should be performed for the patients with positive surgical margins. LEVELS OF EVIDENCE: 4.Oct. 2019, Auris, nasus, larynx, 46(5) (5), 785 - 789, English, International magazine[Refereed]Scientific journal
- OBJECTIVE: To investigate the oncological and functional outcomes of the patients treated with transoral CO2 laser cordectomy for early glottic cancer. PATIENTS AND METHODS: Fifty-five consecutive patients who underwent CO2 laser cordectomy for early glottic cancer were retrospectively reviewed. RESULTS: Overall survival, larynx preservation, and relapse free local control rates were 96%, 100%, and 91%, respectively. Five patients with local recurrences were salvaged with re-cordectomy and/or radiotherapy. In type I cordectomy, VHI-10 consistently improved during postoperative course and VHI-10 at postoperative 12months was significantly better than preoperative value (2.3 vs. 9.4, p=0.02). Perceptual grading, MPT, MFR and AC/DC also improved and were better than preoperative values. In type III cordectomy, shimmer at 12months after cordectomy was significantly better than preoperative value (14.7 vs. 9.3, p=0.007). CONCLUSIONS: These results further support the rationale of CO2 cordectomy as initial and salvage surgery for early glottic cancer.Sep. 2019, Auris, nasus, larynx, English, International magazine[Refereed]
- BACKGROUND: The purpose of this study was to investigate the effectiveness of dental intervention before and after radiation therapy (RT) for head and neck malignancy on prevention of osteoradionecrosis (ORN) of the jaws. METHODS: This is a single-arm prospective study according to intervention protocol of prophylactic dental extraction before RT and routine follow-up after RT. The primary endpoint was the occurrence of jawbone exposure during the first 2 years after RT. RESULTS: Sixty-seven patients were assessed. Before RT, 144 teeth among 39 patients (58%) were prophylactically extracted. The occurrence of transient jawbone exposure during the first 2 years after RT was 7%. Because those jawbone exposures healed with intervention after RT, no jawbone exposure was found at 2 years after RT. CONCLUSIONS: Dental intervention both before and after RT seemed to be important to prevent ORN development. Further studies in larger cohorts are necessary.Sep. 2019, Oral and maxillofacial surgery, 23(3) (3), 297 - 305, English, International magazine[Refereed]Scientific journal
- BACKGROUND: Papillary thyroid carcinoma frequently metastasizes to central and lateral neck lymph nodes, but metastasis to retropharyngeal lymph nodes (RPLN) is rare. PATIENTS AND METHODS: We retrospectively reviewed 16 patients with RPLN metastasis of PTC who underwent therapeutic dissection of RPLN metastases. RESULTS: Among 16 patients, 7 patients underwent RPLN dissection with initial surgery and remaining 9 patients as salvage surgery. RPLN metastasis arose unilaterally in 15 patients and bilaterally in 1 patient. Eleven patients showed temporal dysphagia and four patients showed temporal vocal cord paralysis, but both symptoms eventually recovered in all cases. Two patients with salvage RPLN dissection died of distant metastasis and six patients survived with distant metastasis and/or persistent loco-regional disease. Other eight patients have been alive without disease. CONCLUSIONS: Although transcervical approach for RPLN metastases of PTC provided acceptable functional and oncological outcomes, half of the patients with RPLN metastasis have had distant metastasis and/or persistent locoregional disease. Indications of surgery for patients with RPLN metastasis need to be performed carefully in consideration of patients' prognosis and quality of life.Jun. 2019, European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 276(6) (6), 1809 - 1814, English, International magazine[Refereed]Scientific journal
- OBJECTIVES: To evaluate the impact of retropharyngeal lymph node (RPLN) dissection in the surgical treatment of hypopharyngeal cancer. METHODS: Between 2007 and 2016, 98 previously untreated patients with pathological diagnosed hypopharyngeal squamous cell carcinoma underwent total pharyngolaryngectomy and bilateral neck dissection at Kobe University Hospital. Bilateral dissection of RPLN was simultaneously performed in all patients. Pharynx was reconstructed with free jejunal transfer in 94 patients and primarily closed in 4 patients. Postoperative chemoradiotherapy was performed in patients with high risk factors including metastasis to RPLN, multiple lymph node metastasis, extranodal invasion, and/or positive/close surgical margins. RESULTS: The median follow-up period was 25 months ranging from 1 to 105 months. RPLN adenopathy was preoperatively identified in 9 patients in FDG-positron emission tomography. All of them had pathologically diagnosed RPLN metastases, which had been controlled in all patients during the observation periods. Among the other 89 patients, 7 patients had RPLN metastasis. The 2-year overall survival rates of the patients with and without RPLN metastasis were 65.7% and 69.8% (P = .61), respectively. CONCLUSIONS: In the present study, patients with RPLN metastasis showed equally favorable oncological outcome compared with patients without RPLN metastasis. At least, ipsilateral RPLN dissection should be considered in the surgical treatment of advanced hypopharyngeal cancer and multiple neck lymph node metastasis regardless of primary subsite.Jun. 2019, Head & neck, 41(6) (6), 1738 - 1744, English, International magazine[Refereed]Scientific journal
- Background: In 2008, Kano developed a new laryngeal closure technique (Kano's method) for the treatment of severe aspiration. The aim of this study was to evaluate the safety and efficacy of this technique in patients with head and neck cancer. Methods: Since June 2014 until March 2018, six patients underwent Kano's method for management of severe aspiration after the treatment of head and neck cancers. The anterior parts of the thyroid and the cricoid cartilages were excised widely. The glottis was closed by suturing bilateral vocal folds and reinforced by the sternohyoid muscle. A tracheostoma was created with skin flaps, subglottic mucosal flaps, and stumps of cricoid and trachea cartilages. Results: No severe complications were observed after the surgery. Oral intake improved without developing aspiration. Conclusions: Kano's method can provide satisfactory functional results with minimal invasion for treating severe aspiration after advanced surgery, chemotherapy, and/or chemoradiotherapy, in patients with head and neck cancer. Level of Evidence: 4.Apr. 2019, Laryngoscope investigative otolaryngology, 4(2) (2), 246 - 249, English, International magazine[Refereed]Scientific journal
- BACKGROUND: Fine-needle aspiration (FNA) is the most reliable method for diagnosing thyroid nodules; however, some features such as atypia of undetermined significance or follicular lesion of undetermined significance can confound efforts to identify malignancies. Similar to BRAF, cyclin D1 may be a strong marker of cell proliferation. METHODS: One hundred two patients with thyroidal nodule were enrolled in this prospective study. Expression of cyclin D1 in thyroid nodules was determined by immunohistochemistry using both surgical specimens and their cytological specimens. The identification of the optimal cut off points for the diagnosis of malignancy were evaluated using the receiver operating characteristic (ROC) curves and the assessment of the area under the ROC curve (AUC). The specificity, sensitivity, positive predictive value (PPV) of markers were evaluated from crosstabs based on cut off points and significance were calculated. We also analyzed genetic variants by target NGS for thyroid nodule samples. RESULTS: The positive predictive value (PPV) and median stain ratio (MSR) of cyclin D1 nuclear staining was determined in papillary thyroid carcinoma (PPV = 91.5%, MSR = 48.5%), follicular adenoma (PPV = 66.7%, MSR = 13.1%), and adenomatous goiter and inflammation controls (MSR = 3.4%). In FNA samples, a threshold of 46% of immunolabelled cells allows to discriminate malignant lesions from benign ones (P < 0.0001), with 81% sensitivity and 100% specificity. A 46% cutoff value for positive cyclin D1 immunostaining in thyroid cells demonstrated 81% sensitivity and 100% specificity. In surgical specimens, ROC curve analysis showed a 5.8% cyclin D1 immunostaining score predicted thyroid neoplasms at 94.4% sensitivity and 92.3% specificity (P = 0.003), while a 15.7% score predicted malignancy at 86.4% sensitivity and 80.5% specificity (P < 0.0001). Finally, three tested clinico-pathological variables (extra thyroidal extension, intraglandular metastasis, and lymph node metastasis) were significant predictors of cyclin D1 immunostaining (P < 0.001). CONCLUSION: Our cytological cyclin D1 screening system provides a simple, accurate, and convenient diagnostic method in precision medicine enabling ready determination of personalized treatment strategies for patients by next generation sequencing using cytological sample.Mar. 2019, BMC cancer, 19(1) (1), 245 - 245, English, International magazine[Refereed]Scientific journal
- BACKGROUND: Concomitant chemoradiotherapy (CCRT) produces severe mucositis and swallowing dysfunction, often resulting in malnutrition. Intensive nutrition support (INS) in addition to percutaneous endoscopic gastrostomy (PEG) is reported to decrease adverse effects during CCRT. PATIENTS AND METHODS: Fifty-eight patients with oropharyngeal cancer treated by CDDP-based CCRT were retrospectively analyzed. Twenty-nine patients treated with INS in addition to PEG were classified as INS group, and other 29 patients treated with PEG but without INS were classified as control group. RESULTS: INS in addition to PEG significantly increased calorie intake in the second half of CCRT and reduced adverse events including mucositis (p = 0.0019), leukopenia (p = 0.04), and renal function (p = 0.006). Moreover, 21 out of 29 patients had successfully administration of 200 mg/m2 or more of CDDP, while only 10 out of 29 patients had enough amount of CDDP in control group. CONCLUSIONS: These results suggest that INS in addition to prophylactic PEG not only decreases adverse effects but also may potentially improve oncological outcome of the patients with oropharyngeal cancer treated by CCRT.Dec. 2018, International journal of clinical oncology, 23(6) (6), 1023 - 1028, English, Domestic magazine[Refereed]Scientific journal
- OBJECTIVES: Postoperative hypoparathyroidism (HPT) is one of the most common complications in total thyroidectomy for thyroid carcinoma. Parathyroid glands (PTGs) are at risk of being damaged during total thyroidectomy and central neck dissection mainly due to inadvertent removal, interruption of the blood supply or hematoma formation. The purpose of this study was to evaluate the efficacy of our surgical procedure to preserve for parathyroid function retrospectively and to clarify the risk factors of HPT after total thyroidectomy for thyroid cancer. PATIENTS AND METHODS: Sixty-five patients undergoing total thyroidectomy with central neck dissection for thyroid cancer were enrolled in this retrospective study. Cancers were diagnosed as stage I in 15 patients, stage II in 24 patients, stage III in 19 patients, and stage IV in 7 patients. Lateral neck dissection and upper mediastinal dissection were simultaneously performed in 47 patients and one patient, respectively. Parathyroid glands (PTGs) were preserved in situ in 34 patients. Among 31 patients in whom PTG could not be preserved in situ, two or more PTGs were autotransplanted in 9 patients and one PTG was autotransplanted in 18 patients. PTG was not autotransplanted in 4 patients, since it could not be identified during the surgery. RESULTS: Postoperative transient HPT and permanent HPT were observed in 44 (68%) patients and in 12 (18%) patients, respectively. Among 34 patients in whom PTGs were preserved in situ, transient HPT and permanent HPT were observed in 17 (50%) patients and in 6 (2%) patients, respectively. Among 31 patients in whom PTG were not preserved in situ, postoperative permanent HPT was observed in all 4 patients without PTG autotransplantation, and 6 (33%) out of the 18 patients who had one PTG autotransplantation. On the other hand, none of the 9 patients who had two or more PTG autotransplantation at the time of thyroidectomy developed permanent HPT (P=0.04). The patients with large tumor (≥40mm) and/or gross extra glandular invasion had a significantly higher risk of permanent postoperative HPT compared with the patients without these pathological features (P<0.01). CONCLUSIONS: Two or more PTG should be autotransplanted in case where PTG is not preserved in situ to prevent postoperative HPT after total thyroidectomy with central neck dissection, especially in cases of large tumor and/or gross extrathyroidal extension.Dec. 2018, Auris, nasus, larynx, 45(6) (6), 1233 - 1238, English, International magazine[Refereed]Scientific journal
- Carcinoma arising in lingual thyroid is an extremely rare entity accounting for only 1% of all reported ectopic thyroids. Here, we report a case of carcinoma arising in lingual thyroid, which has been successfully managed by transoral resection and bilateral neck dissections. A lingual mass 4-cm in diameter with calcification was incidentally detected by computed tomography at medical check-up. No thyroid tissue was observed in normal position. Ultrasound examination showed bilateral multiple lymphadenopathies. Fine needle aspiration biopsy from lymph node in his right neck was diagnosed as Class III and thyroglobulin level of the specimen was 459ng/ml. Due to the difficulty in performing FNA of the lingual masses, right neck dissection was performed in advance for diagnostic purpose. Pathological examination showed existence of large and small follicular thyroid tissues in several lymph nodes, suggesting lymph node metastasis from thyroid carcinoma. Two months after the initial surgery, video-assisted transoral resection of lingual thyroid with simultaneous left neck dissection was performed. Postoperative course was uneventful. Papillary carcinoma was found in the lingual thyroid and thyroid tissues were also found in left cervical lymph nodes. Video-assisted transoral resection was useful for the treatment of thyroid cancer arising in lingual thyroid.Oct. 2018, Auris, nasus, larynx, 45(5) (5), 1127 - 1129, English, International magazine[Refereed]Scientific journal
- Objective Nasal and paranasal malignant tumors invading the skull base are rare and poorly studied. We evaluated postoperative complications in patients undergoing salvage surgery for such tumors. Design Retrospective study. Setting Kobe University Hospital. Participants Among 48 patients who underwent surgery for tumors involving the skull base between 1993 and 2015, 21 patients had squamous cell carcinoma, 13 had olfactory neuroblastoma, 5 had adenocarcinoma, 2 had sarcoma, 2 had adenoid cystic carcinoma, and 1 each had malignant melanoma, poorly differentiated carcinoma, undifferentiated carcinoma, myoepithelial carcinoma, and malignant peripheral nerve sheath tumor. Prior to skull base surgery, radiotherapy, chemoradiotherapy (CRT), particle radiotherapy, chemotherapy, or surgery were applied in 3, 15, 4, 5, and 3 patients, respectively. Main Outcome Measures Main outcome measures were postoperative complications in patients who underwent skull base surgery after concomitant CRT and/or particle therapy. Results Major postoperative complications were observed in 14 surgical procedures (29%; 2 patients with cerebral herniation, 3 with cerebrospinal fluid leakages, 3 with meningitis, 1 with hydrocephalus, 6 with epidural abscesses, 2 with local infections, and 2 with partial flap necrosis). Four patients developed ≥2 complications. One patient died of postoperative lung infarction. Three (16.7%) of 18 patients without prior treatment and 9 (50%) of 18 patients who underwent preoperative radiotherapy/CRT had severe postoperative complications. Two (50%) of four patients treated with particle radiotherapy had postoperative complications. Conclusions CRT or particle radiotherapy were significantly associated with a high risk of severe postoperative complications after skull base surgery. Meticulous care should be taken in patients treated with radiotherapy/particle therapy prior to skull base surgery.Jun. 2018, Journal of neurological surgery. Part B, Skull base, 79(3) (3), 224 - 228, English, International magazine[Refereed]Scientific journal
- Background: Aggressive fibromatoses are histologically benign fibrous neoplasms originating from musculoaponeurotic structures throughout the body. They are locally invasive and erode adjacent vital structures. The head and neck region constitutes 7-25% of all extra-abdominal cases. Case Report: Here, we report the case of a patient with aggressive fibromatosis in the left side of the neck. While the tumor deeply invaded the scalene muscles, the lesion was successfully treated by surgery followed by radiotherapy. The patient has been disease free for the last 7 years following treatment. Conclusion: Due to its unusual location in the head and neck region, aggressive fibromatosis should be considered in the differential diagnosis of invading lesions of the neck.May 2018, Balkan medical journal, 35(3) (3), 278 - 281, English, International magazine[Refereed]Scientific journal
- BACKGROUND: The purpose of this research was to investigate the association between alcohol dehydrogenase 1B (ADH1B) and aldehyde dehydrogenase 2 (ALDH2) polymorphisms and hypopharyngeal squamous cell carcinoma (SCC) survival. METHODS: We genotyped ADH1B (rs1229984) and ALDH2 (rs671) single nucleotide polymorphisms (SNPs) in 85 Japanese male patients with hypopharyngeal SCC. The independent prognostic values of ADH1B-ALDH2 genotypes were analyzed by univariate and multivariate proportional hazard Cox regression, taking well-known clinical risk factors into account. RESULTS: Heavy drinkers with ALDH2*2 allele resulted in significantly worse overall survival (OS; P = .028) and disease-free survival (DFS; P = .029) compared with other patients. Heavy drinkers with ALDH2*2 allele remained statistically significant in multivariate analysis for OS and DFS, indicating independent poor prognostic factor (hazard ratio [HR] 2.251; 95% confidence interval [CI] 1.018-4.975 and HR 2.261; 95% CI 1.021-5.006, respectively). CONCLUSION: We conclude that heavy drinkers with the ALDH2*2 allele are associated with poor outcome in hypopharyngeal SCC.Apr. 2018, Head & neck, 40(4) (4), 770 - 777, English, International magazine[Refereed]Scientific journal
- AIMS: We recently reported that a small subset (7%) of oesophageal squamous cell carcinomas completely lacking SOX2 expression had unique clinicopathological features and a dismal prognosis. The aim of the present study was to elucidate whether the findings obtained in oesophageal cancers are applicable to hypopharyngeal squamous cell carcinomas (HPSCCs) or oropharyngeal squamous cell carcinomas (OPSCCs). METHODS AND RESULTS: The study cohort consisted of consecutive patients with HPSCC (n = 130) and OPSCC (n = 65) who underwent surgery without preoperative therapy. On immunostaining, SOX2 was almost entirely negative in 10 of 130 HPSCCs (8%) and seven of 65 OPSCCs (11%). No significant differences were observed in clinicopathological features, including p16 status, between SOX2-positive and SOX2-negative cancers. However, patients with SOX2-negative HPSCC had significantly worse overall and recurrence-free survival than those with SOX2-positive HPSCC, whereas such a prognostic relationship was not confirmed in patients with OPSCC. In a multivariate analysis, the loss of SOX2 expression appeared to be an independent poor prognostic factor for patients with HPSCC. In a sequencing analysis, no mutation was found in SOX2. As SOX2 is known to contain an extensive CpG island before the transcription start site, methylation-specific polymerase chain reaction for the SOX2 promoter was performed. Methylated alleles were found in nine of 10 SOX2-negative HPSCCs but in none of SOX2-positive HPSCCs. CONCLUSIONS: Similarly to oesophageal cancers, a small subset (8%) of HPSCCs characteristically almost completely lacking SOX2 expression appeared to be aggressive neoplasms with high recurrence rates. Promoter hypermethylation was determined to be a major mechanism underlying epigenetic SOX2 silencing.Apr. 2018, Histopathology, 72(5) (5), 826 - 837, English, International magazine[Refereed]Scientific journal
- Dec. 2017, PLOS ONE, 12(12) (12), e0187992, English[Refereed]Scientific journal
- Jun. 2017, AURIS NASUS LARYNX, 44(3) (3), 302 - 305, English[Refereed]Scientific journal
- OBJECTIVE: First bite syndrome is the development of pain in the ipsilateral parotid region after the first few bites of food and can be seen after surgery of the upper cervical region. The aim of this study is to highlight the etiology of this potentially debilitating chronic pain syndrome. MATERIALS AND METHODS: Retrospective review of 53 patients undergoing surgery of the upper neck between 2002 and 2013. RESULTS: FBS developed in 16 patients (30%). Partial resolution of FBS symptoms occurred in 69% and complete resolution in 12%, whereas 15% had no change. FBS was most common in the patients who had tumor arising from deep lobe of parotid gland in comparison with other sites (50% vs 18%, p=0.017). FBS developed in 57% of patients undergoing external carotid artery (ECA) ligation and in 12.5% of patients in whom ECA was preserved (p=0.0008). Among the patients in whom ECA was preserved, FBS developed in 43% of the patients in whom sympathetic chain was sacrificed and in 4% of the patients in whom sympathetic chain was preserved. CONCLUSION: Present results further support the role of sympathetic chain in the development of FBS.Jun. 2017, Auris, nasus, larynx, 44(3) (3), 302 - 305, English, International magazine[Refereed]
- Mar. 2017, Head & neck, 39(3) (3), 427 - 431, English, International magazine[Refereed]Scientific journal
- Feb. 2017, Frontiers in aging neuroscience, 9, 19[Refereed]
- Japan Society of Logopedics and Phoniatrics, 2017, Japan Journal of Logopedics and Phoniatrics, 58(2) (2), 152 - 158, JapaneseScientific journal
- BACKGROUND: Extirpation of tumors arising in the pterygopalatine fossa is challenging because of its anatomic complexity. METHODS AND RESULTS: A 67-year-old man was referred to our department with a diagnosis of a tumor in his left pterygoid fossa. An incisional biopsy through the canine fossa was diagnosed as myxofibrosarcoma. The upper part of the maxilla was swung laterally to remove the tumor while the hard plate was preserved. The defect was reconstructed using rectus abdominis musculocutaneous free and ipsilateral temporal. The postoperative course was uneventful, without facial palsy or mastication disorders. CONCLUSION: Our experience with this case suggests that the modified partial maxillary swing approach with preservation of the hard palate and orbital floor in combination with infratemporal and cervical approaches is useful for lesions in the pterygoid process without causing severe complications. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2519-E2522, 2016.Dec. 2016, Head & neck, 38(12) (12), E2519-E2522 - E2522, English, International magazine[Refereed]Scientific journal
- PURPOSE: This retrospective study aimed to analyze the relationship between tooth extraction and osteoradionecrosis (ORN) occurrence. The irradiation field, dose, and time interval between radiotherapy (RT) and ORN were reviewed. We also discuss appropriate guidelines for prophylactic tooth extraction. METHODS: A total of 33 patients treated for grade ≥2 (clinical) ORN in our department from 2002 to 2014 were enrolled. The following epidemiological data were retrospectively gathered: age, sex, histological diagnosis, primary tumor sites, radiation dose, chemotherapy, site of ORN, relationship between tooth extraction and ORN occurrence, and time interval between tooth extraction and the initiation or end of RT. RESULTS: Twenty-one percent of ORN cases resulted from tooth extraction. The most common site of ORN (82 %) was the mandibular molar region. About half of ORN cases (49 %) occurred within 2 years after RT. All patients who received tooth extraction after RT developed ORN (100 %) independently of time interval between tooth extraction and the end of RT (median interval, 37.5 months; range, 27-120 months). In contrast, only 50 % of patients who received tooth extraction before RT developed ORN. There may have been an association between the irradiation field and the site of ORN development CONCLUSIONS: ORN occurrence due to tooth extraction was 21 %. Occurrence timing of ORN did not depend on time interval between tooth extraction and the end of RT. The irradiation field is certainly related to the site of ORN; therefore, prophylactic tooth extraction should be performed in consideration of the proposed radiation field and dose.Dec. 2016, Oral and maxillofacial surgery, 20(4) (4), 337 - 342, English, International magazine[Refereed]Scientific journal
- Dec. 2016, 頭頸部癌, 42(4号) (4号), 432 - 437, Japanese当院における再発転移頭頸部扁平上皮癌に対する初回化学療法としてのセツキシマブ併用療法の遡及的検討[Refereed]Scientific journal
- May 2016, 頭頸部癌, 42(2号) (2号), 181, Japanese当科で放射線治療を施行した下咽頭癌T1・T2症例の検討Research society
- May 2016, 頭頸部癌, 42(2号) (2号), 211, Japaneseセツキシマブ追加の有無による、再発性/転移性頭頸部癌の第一選択治療の比較(First-line Treatment of Recurrent/Metastatic Head and Neck Cancer with or without Cetuximab)(英語)Research society
- BACKGROUND: The purpose of this study was to analyze outcomes for the treatment of locally advanced temporal bone cancer by means of concomitant chemoradiotherapy (CCRT) with a combination of cisplatin (CDDP), 5-fluorouracil (5-FU), and docetaxel (TPF). METHODS: Between 2006 and 2011, 34 patients with squamous cell carcinoma of the temporal bone were treated at Kobe University Hospital. Medical records were retrospectively reviewed to obtain information concerning patient characteristics, extent of disease, treatment, adverse events, and oncologic results. RESULTS: Ten patients were treated with CCRT using TPF regimen. The 5-year overall survival rate and disease-free survival rate were both 60%. Of special interest is that even for patients with unresectable T4 disease, the 5-year overall survival rate was 56%. CONCLUSION: The results of our study indicate that CCRT with TPF for locally advanced temporal bone cancer is an effective and promising regimen. © 2015 Wiley Periodicals, Inc. Head Neck 38: E949-E953, 2016.Apr. 2016, Head & neck, 38 Suppl 1, E949-53 - 53, English, International magazine[Refereed]Scientific journal
- Feb. 2016, 頭頸部外科, 25(3号) (3号), 269 - 274, Japanese[Refereed]Scientific journal
- Oct. 2015, 耳鼻咽喉科・頭頸部外科, 87(11号) (11号), 915 - 919, Japanese非特異的喉頭肉芽腫症38例の検討[Refereed]Scientific journal
- Japan Society for Head and Neck Cancer, Jan. 2015, Japanese Journal of Head and Neck Cancer, 40(4) (4), 406 - 411, Japanese[Refereed]Scientific journal
- Oct. 2014, 耳鼻咽喉科・頭頸部外科, 86(11号) (11号), 943 - 948, Japanese腺腫様甲状腺腫と診断され遠隔およびリンパ節転移をきたした1例[Refereed]Scientific journal
- Dec. 2013, 耳鼻咽喉科・頭頸部外科, 85(13号) (13号), 1093 - 1097, Japanese耳下腺に発症したメトトレキサート関連リンパ増殖性疾患の2例[Refereed]Scientific journal
- (一社)日本内分泌外科学会, Sep. 2019, 日本内分泌外科学会雑誌, 36(Suppl.3) (Suppl.3), S310 - S310, Japanese甲状腺結節の診断を目的としたCyclinD1免疫染色とゲノム解析を用いた細胞学的スクリーニングシステム
- (一社)日本内分泌外科学会, Sep. 2019, 日本内分泌外科学会雑誌, 36(Suppl.3) (Suppl.3), S343 - S343, Japanese上腕骨転移を来した副甲状腺癌の1例
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 138 - 138, Japanese進行聴器癌に対するTPF併用化学放射線治療の治療成績
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 132 - 132, Japanese再発転移頭頸部扁平上皮癌 ニボルマブ投与例におけるmodified Glasgow Prognostic Scoreの予後予測性
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 134 - 134, Japanese当科における甲状腺手術後の反回神経麻痺の検討
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 142 - 142, Japanese頭頸部外科医からみた嗅神経芽細胞腫の病理診断に関する検討
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 149 - 149, Japanese下咽頭癌外側咽頭後リンパ節転移症例の検討
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 162 - 162, Japanese再発転移鼻副鼻腔原発粘膜悪性黒色腫に対するニボルマブの後方視的検討
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 168 - 168, Japanese頭頸部扁平上皮癌術後の再発高リスク症例に対する放射線療法の治療成績の検討
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 169 - 169, Japanese中咽頭癌に対する化学放射線療法による摂食・嚥下に関するQOLの変化
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 201 - 201, JapaneseT4下咽頭癌に対する根治的(化学)放射線療法の後方視的検討
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 221 - 221, Japanese甲状腺癌術後の音声障害に対して音声治療を行った3例
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 223 - 223, Japanese下咽頭癌に対する化学放射線治療により下咽頭閉鎖、声門狭窄を生じた2例
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 132 - 132, Japanese再発転移頭頸部扁平上皮癌 ニボルマブ投与例におけるmodified Glasgow Prognostic Scoreの予後予測性
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 149 - 149, Japanese下咽頭癌外側咽頭後リンパ節転移症例の検討
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 162 - 162, Japanese再発転移鼻副鼻腔原発粘膜悪性黒色腫に対するニボルマブの後方視的検討
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 168 - 168, Japanese頭頸部扁平上皮癌術後の再発高リスク症例に対する放射線療法の治療成績の検討
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 169 - 169, Japanese中咽頭癌に対する化学放射線療法による摂食・嚥下に関するQOLの変化
- (一社)日本頭頸部癌学会, May 2019, 頭頸部癌, 45(2) (2), 201 - 201, JapaneseT4下咽頭癌に対する根治的(化学)放射線療法の後方視的検討
- 日本内分泌外科学会・日本甲状腺外科学会, Oct. 2018, 日本内分泌・甲状腺外科学会雑誌, 35(Suppl.2) (Suppl.2), S313 - S313, Japanese片側反回神経麻痺を伴う甲状腺乳頭癌症例の検討
- (一社)日本頭頸部癌学会, May 2018, 頭頸部癌, 44(2) (2), 180 - 180, Japanese聴器原発悪性腫瘍の予後因子に関する検討
- (一社)日本耳鼻咽喉科学会, Apr. 2018, 日本耳鼻咽喉科学会会報, 121(4) (4), 608 - 608, Japanese口腔底癌心臓転移の一例
- Jun. 2017, 耳鼻咽喉科臨床, 110(6) (6), 367 - 374, Japanese頭頸部癌に対する遺伝子診断Introduction scientific journal
- (一社)日本頭頸部癌学会, May 2017, 頭頸部癌, 43(2) (2), 206 - 206, Japanese当科における聴器原発悪性腫瘍T1、T2例37例の臨床的検討
- (一社)日本頭頸部癌学会, May 2017, 頭頸部癌, 43(2) (2), 177 - 177, Japanese局所進行頭頸部扁平上皮癌における導入化学療法TPFの安全性と有効性の検討
- (一社)日本頭頸部癌学会, May 2017, 頭頸部癌, 43(2) (2), 205 - 205, Japanese当院における嗅神経芽細胞腫症例の検討
- Society of Practical Otolaryngology, 2017, Practica Oto-Rhino-Laryngologica, 110(6) (6), 367 - 374, Japanese[Refereed]Book review
- Oct. 2016, 耳鼻咽喉科・頭頸部外科, 88(11号) (11号), 852 - 856, Japanese【頸部郭清術のNew Concept】 手術手技 咽頭後リンパ節郭清[Invited]Introduction commerce magazine
- Jul. 2015, JOHNS, 31(7号) (7号), 827 - 830, Japanese【頭蓋底外科の進歩-オープンサージェリーと内視鏡下手術】 頭蓋底外科の歴史 オープンサージェリーから内視鏡手術まで[Invited]Introduction commerce magazine
- Apr. 2015, 耳鼻咽喉科・頭頸部外科, 87(5号) (5号), 264 - 267, Japanese【こんなときの対応法がわかる 耳鼻咽喉科手術ガイド】 頸部の手術 副咽頭間隙腫瘍に対する手術[Invited]Introduction scientific journal
- (一社)日本頭頸部癌学会, Dec. 2014, 頭頸部癌, 40(4) (4), 406 - 411, Japanese頭頸部進行がんに対する治療戦略 進行期(Stage III/IV)喉頭癌・下咽頭癌の治療戦略
- (一社)日本頭頸部癌学会, May 2014, 頭頸部癌, 40(2) (2), 148 - 148, Japanese頭頸部進行がんに対する治療戦略 進行期喉頭癌・下咽頭癌に対する治療戦略
- (一社)日本頭頸部癌学会, May 2014, 頭頸部癌, 40(2) (2), 155 - 155, JapaneseT3N0-1声門癌に対する喉頭温存を目的とした根治的化学放射線治療の検討
- (一社)日本頭頸部癌学会, May 2014, 頭頸部癌, 40(2) (2), 195 - 195, Japanese当科における中咽頭癌症例の臨床的検討
- (一社)日本頭頸部癌学会, May 2014, 頭頸部癌, 40(2) (2), 264 - 264, Japanese上顎洞扁平上皮癌に対する放射線治療成績
- (一社)日本頭頸部癌学会, May 2014, 頭頸部癌, 40(2) (2), 265 - 265, Japanese頭頸部癌に対するセツキシマブ併用放射線治療の初期経験
- Apr. 2014, 耳鼻咽喉科・頭頸部外科, 86(5号) (5号), 296 - 301, Japanese【画像診断パーフェクトガイド 読影のポイントとピットフォール】 部位別診断法 頭頸部 副咽頭間隙腫瘍Introduction scientific journal
- 第42回日本嚥下医学会, Mar. 2019, Japanese, 久留米, Domestic conference当科における内視鏡下輪状咽頭筋切断術の経験Oral presentation
- 第31回喉頭科学会, Mar. 2019, Japanese, 久留米, Domestic conference当科における声帯麻痺症例の検討Oral presentation
- 第29回 日本頭頸部外科学会, Jan. 2019, Japanese, 仙台, Domestic conference施行しHRMで評価した1例Oral presentation
- 第29回 日本頭頸部外科学会, Jan. 2019, Japanese, 仙台, Domestic conference外耳道癌術後の嚥下障害に段階的に嚥下機能改善手術をOral presentation
- 日本甲状腺外科学会, Oct. 2018, Japanese, 横浜, Domestic conference片側反回神経麻痺を伴う甲状腺乳頭癌症例の検討Oral presentation
- 第51回日本甲状腺外科学会, Oct. 2018, Japanese, 横浜, Domestic conference片側反回神経麻痺を伴う甲状腺乳頭癌症例の検討Oral presentation
- 第63回音声言語医学会, Oct. 2018, Japanese, 久留米, Domestic conference喉頭全摘後のシャント発声の音声評価Oral presentation
- 第189回日耳鼻兵庫県地方部会, Jul. 2018, Japanese, 神戸, Domestic conference当科における内視鏡下輪状咽頭筋切断術の経験Oral presentation
- 第30回日本頭蓋底外科学会, Jul. 2018, Japanese, 東京, Domestic conference当院における聴器癌に対する側頭骨亜全摘術の手術手技と治療成績-脳神経外科からの視点 –Oral presentation
- 頭頸部癌学会, Jun. 2018, Japanese, 東京, Domestic conference頭頸部癌治療後の嚥下障害に対して施行した声門閉鎖術Oral presentation
- 第42回日本頭頸部癌学会, Jun. 2018, Japanese, 東京, Domestic conference頭頸部癌治療後の嚥下障害に対してPoster presentation
- 頭頸部癌学会, Jun. 2018, Japanese, 東京, Domestic conference頭蓋底進展眼窩悪性腫瘍の臨床的検討Oral presentation
- 第30回日本頭蓋底外科学会, Jun. 2018, Japanese, 東京, Domestic conference当科における頭蓋底進展眼窩悪性腫瘍の検討Oral presentation
- 第42回日本頭頸部癌学会, Jun. 2018, Japanese, 東京, Domestic conference当科における頭蓋底進展眼窩悪性腫瘍の検討Oral presentation
- 第42回頭頸部癌学会, Jun. 2018, Japanese, 東京, Domestic conference聴器原発悪性腫瘍の予後因子に関する検討Oral presentation
- 頭頸部癌学会, Jun. 2018, Japanese, 東京, Domestic conference聴器原発悪性腫瘍の予後因子に関する検討Oral presentation
- 第42回日本頭頸部癌学会, Jun. 2018, Japanese, 東京, Domestic conference声門閉鎖術を施行した6例Poster presentation
- 日本耳鼻咽喉科学会, May 2018, Japanese, 東京, Domestic conference口腔底癌心臓転移の一例Oral presentation
- 第30回日本喉頭科学会, Mar. 2018, Japanese, 日本喉頭科学会, 高知, Domestic conference当科における声門閉鎖術Poster presentation
- 第41回日本嚥下医学会, Feb. 2018, Japanese, 日本嚥下医学会, 仙台, Domestic conference当院における食道癌術後摂食嚥下障害の検討Oral presentation
- 第28回日本頭頸部外科学会, Jan. 2018, Japanese, 日本頭頸部外科学会, 宇都宮, Domestic conference進行下咽頭癌手術例における外側咽頭後リンパ節郭清の意義についてOral presentation
- 2nd Congress of Asia-Pacific Society of Thyroid Surgery, Nov. 2017, English, Asia-Pacific Society of Thyroid Surgery, 那覇, International conferenceParathyroid function after total thyroidectomy for thyroid carcinomaOral presentation
- 2nd Congress of Asia-Pacific Society of Thyroid Surgery, Nov. 2017, English, 2nd Congress of Asia-Pacific Society of Thyroid Surgery, Okinawa, Japan, International conferenceA case of left non-recurrent inferior laryngeal nerve with right-sided aortic archOral presentation
- 日耳鼻地方部会, Jul. 2017, Japanese, 神戸, Domestic conference当科における声門閉鎖術Oral presentation
- 第41回日本頭頸部癌学会, Jun. 2017, Japanese, 日本頭頸部癌学会, 京都, Domestic conference当科における 頭頸部腺様嚢胞癌の検討Oral presentation
- 第41回日本頭頸部癌学会, Jun. 2017, Japanese, 京都, Domestic conference当院における 嗅神経芽細胞腫の検討Oral presentation
- 第41回日本頭頸部癌学会, Jun. 2017, Japanese, 日本頭頸部癌学会, 京都, Domestic conferenceInduction chemotherapy of TPF for locally advanced head and neck squamous cell carcinoma (LA-HNSCC) - A retrospective safety analysis at our institution -Oral presentation
- 第29回日本喉頭科学会, Apr. 2017, Japanese, 日本喉頭科学会, 盛岡, Domestic conference診断に苦慮した 喉頭アレルギーの1例Oral presentation
- 5th Congress of Asian Society of Head and Neck Oncology, Mar. 2017, English, Congress of Asian Society of Head and Neck Oncology, Bali, インドネシア, International conferenceTreatment outcome of transoral Resection against Hypopharyngeal CancersPublic symposium
- 5th congress of Asian Sosiety of Head and Neck oncology, Mar. 2017, English, ASHNO congress, Bali, Indonesia, International conferenceSuperselective intra-arterial infusion of high-dose cisplatin with radiotherapy (RADPLAT) for patients with locally advanced maxillary sinus carcinomasPublic symposium
- 5th congress of Asian Society of Head and Neck Oncology, Mar. 2017, English, Asian Society of Head and Neck Oncology, bali, インドネシア, International conferenceSafety laryngeal closure after treatment of head and neck cancerPublic symposium
- 5th congress of asia head and neck oncology, Mar. 2017, English, Asian society of head and neck oncology, バリ, インドネシア, International conferenceRADPLAT for advanced maxillary Ca[Invited]Nominated symposium
- 5th congress of asia head and neck oncology, Mar. 2017, English, Asian society of head and neck oncology, バリ, インドネシア, International conferencecomplihensive management of temporal bone malignancies[Invited]Nominated symposium
- 第27回日本頭頸部外科学会総会ならびに学術講演会, Feb. 2017, Japanese, JAPAN SOCIETY FOR HEAD AND NECK SURGERY, 東京, Domestic conference当科における頭蓋底進展眼窩悪性腫瘍の臨床的検討Oral presentation
- 第9回喉頭機能温存治療研究会, Nov. 2016, Japanese, 喉頭機能温存研究会, 東京, Domestic conference早期声門癌に対する経口的CO2レーザー切除術の治療成績[Invited]Nominated symposium
- 第9回喉頭機能温存治療研究会, Oct. 2016, Japanese, 喉頭機能温存研究会, 東京, Domestic conference当科におけるシャント発声の現状と課題[Invited]Nominated symposium
- The 40th Annual Meeting of Japan Society for Head and Neck Cancer, Jun. 2016, Japanese, Japan Society for Head and Neck Cancer, Saitama, Japan, 埼玉、ソニックシティー, Domestic conference当科で放射線治療を施行した下咽頭癌T1・T2症例の検討Oral presentation
- 7th international congress of the world federation of the skull base society, Jun. 2016, English, world federation of the skull base society, 大阪, International conferencePartial maxillary swing approach and Infratemporal approach for three malignant tumors inpterygopalatine fossaPoster presentation
- 第40回日本頭頸部癌学会, Jun. 2016, English, 日本頭頸部癌学会, 埼玉, Domestic conferenceFirst-Line treatment with Cetuximab-based Combination Therapy for Recurrent/Metastatic Head and Neck Cancer: A single institution experienceOral presentation
- The 40th Annual Meeting of Japan Society for Head and Neck Cancer, Jun. 2016, Japanese, Japan Society for Head and Neck Cancer, Saitama, Japan, 埼玉、ソニックシティー, Domestic conferenceFirst-line Treatment of Recurrent/Metastatic Head and Neck Cancer with or without CetuximabOral presentation
- 117th Annual Meeting of ORL Society of Japan, May 2016, Japanese, ORL Society of Japan, 名古屋, Domestic conference喉頭蓋病変に対する経口切除後の摂食・嚥下状態についての臨床検討Oral presentation
- 16thJapan- Korea joint meeting of otorhinolaryngology head and neck surgery, Mar. 2016, English, 日本韓国耳鼻咽喉科学会, 東京, International conferencePrognostic value of ALDH polymorphism in Japanese patients with oropharyngeal cancerPoster presentation