Publications by authors named "Chung Jan Kang"

Background: This study evaluates the impact of maxillary sinus mucosa preservation on radiographic outcomes after an inferior maxillectomy and soft-tissue free flap reconstruction.

Methods: A total of 90 patients in two cohorts (mucosal sacrifice versus mucosa preservation) were evaluated from an institutional dataset. Imaging was reviewed at set time points and sinus scores were allotted based on a modification of the Lund-MacKay system.

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Background: The prognostic significance of margin-to-depth ratio (MDR) in oral cavity squamous cell carcinoma (OCSCC) remains unclear, particularly in comparison to traditional margin status. We aimed to examine the association between MDR and clinical outcomes in a large Taiwanese cohort.

Methods: A total of 18,324 patients with first primary OCSCC were categorized by margin status: positive (1013), <5 mm (8371), and ≥ 5 mm (8940).

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Aims: Social culture concerns and betel quid (BQ) dependence may be the potential reasons for BQ chewing. This study's purpose was to identify the correlates of reasons for male BQ chewing.

Methods: We adopted a mixed-methods design.

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Background: The evidence for adjuvant chemoradiotherapy (CRT) of oral cavity squamous cell carcinoma (OCSCC) with extra-nodal extension (ENE) in National Comprehensive Cancer Network (NCCN) guidelines is derived from patients with head and neck cancer. The guidelines further suggest a radiation dose ranging from 6000 to 6600 cGy. In this nationwide study, we sought to evaluate the prognostic significance of adjuvant therapy and the specific radiation dosage in Taiwanese patients with pure OCSCC and ENE.

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Purpose: The aim of this was to evaluate the prognostic significance of the nodal-to-primary tumor SUV max ratio (NTR) in patients with node-positive hypopharyngeal squamous cell carcinoma (HPSCC) treated with radiotherapy with or without concurrent chemotherapy. The study aims to enhance prognostic accuracy by incorporating NTR into the American Joint Committee on Cancer (AJCC) staging system.

Patients And Methods: This retrospective study included 191 patients with biopsy-proven node-positive HPSCC treated from 2005 to 2013.

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: This study aimed to examine the relationship between health-related quality of life (HRQoL) and sociodemographic and clinical variables in survivors of head and neck cancer (HNC) treated with radiotherapy, with or without surgery. : HRQoL was measured using the functional assessment of cancer therapy-head and neck (FACT-H&N) in a cross-sectional survey involving 150 patients. Of these, 60 had nasopharyngeal cancer (NPC), treated exclusively with radiotherapy, while 90 had oral cavity squamous cell cancer (OSCC), undergoing radical surgery followed by adjuvant radiotherapy.

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Article Synopsis
  • Induction chemotherapy (IC) is used as a treatment prior to surgery for oral squamous cell carcinoma (OCSCC), and this study analyzes its impact on patient survival in Taiwan.
  • A total of 29,891 OCSCC patients were examined, comparing those who had surgery only to those who received IC before surgery, with a focus on survival outcomes through matched analysis.
  • The results show that while overall survival rates were similar for both groups, patients with aggressive pT4a tumors had better outcomes with surgery alone compared to those who received IC before surgery.
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  • Elective tracheotomy is often performed on patients with resected oral squamous cell carcinoma (OCSCC) to help keep their airways open, but its necessity varies among surgeons.
  • A large study including over 18,000 OCSCC patients found that those who had tracheotomies had lower 5-year disease-specific and overall survival rates compared to those who didn't, even after adjusting for other factors.
  • Despite the survival rates being similar after matching groups for other variables, patients with tracheotomies generally experienced longer hospital stays, indicating the procedure may be associated with more complications or extended recovery times.
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We probed the associations of preoperative modified geriatric nutritional risk index (mGNRI) values with prognosis in patients receiving surgery for oral cavity squamous cell carcinoma (OCSCC). This retrospective study analyzed the clinical data of 333 patients with OCSCC and undergoing surgery between 2008 and 2017. The preoperative mGNRI was calculated using the following formula: (14.

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For deep learning-based machine learning, not only are large and sufficiently diverse data crucial but their good qualities are equally important. However, in real-world applications, it is very common that raw source data may contain incorrect, noisy, inconsistent, improperly formatted and sometimes missing elements, particularly, when the datasets are large and sourced from many sites. In this paper, we present our work towards preparing and making image data ready for the development of AI-driven approaches for studying various aspects of the natural history of oral cancer.

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Article Synopsis
  • This study compared clinical outcomes between initial surgery and primary definitive radiotherapy (RT) for Taiwanese patients with cT1-2N0M0 oral cavity squamous cell carcinoma (OCSCC) between 2011 and 2019.
  • After analyzing data from over 13,500 patients and matching groups for fairness, the results showed much higher 5-year disease-specific survival rates (DSS) for the surgery group compared to the RT group (86% vs. 58%).
  • The findings suggest that initial surgery significantly improves survival outcomes in these patients, highlighting a notable survival gap of 30% between the two treatment modalities.
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Objective: The lymph node to primary tumor standardized uptake value ratio (NTR) is an innovative parameter derived from positron emission tomography/computed tomography (PET/CT) scans that captures the intricate relationship between primary tumors and associated lymph nodes. This meta-analysis aimed to investigate the prognostic value of NTR in cancer patients.

Methods: A systematic search of PubMed, Cochrane, and Embase databases was conducted to identify studies investigating the association between NTR and survival outcomes in cancer patients.

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Article Synopsis
  • * A matched analysis revealed that patients with margins < 1 mm had better disease-specific survival (DSS) and overall survival (OS) rates compared to those with positive margins, with 5-year DSS rates at 71% vs 59% and OS rates at 60% vs 48%.
  • * The findings suggest that OCSCC patients with < 1 mm margins have better prognostic outcomes and different clinical characteristics compared to those with positive margins,
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This study assessed functional outcomes and quality of life (QoL) in the long term in individuals treated for laryngohypopharyngeal cancer (LHC) by estimating their life expectancy (LE), survival-weighted psychometric scores (SWPSs), and quality-adjusted LE (QALE). To estimate survival outcomes, we retrospectively reviewed the data of 1576 patients treated for primary LHC between January 2010 and December 2018 and followed them until death or December 2020. We also prospectively collected QoL and functional data between October 2013 and November 2022 from 232 patients by administering the Taiwanese Chinese versions of the QoL Questionnaire Core 30, Head and Neck 35, and EQ-5D-3L.

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  • The study evaluates the effectiveness of elective neck dissection (END) versus neck observation (NO) in patients with early-stage oral cavity squamous cell carcinoma (OCSCC) where the depth of invasion (DOI) exceeds 3 mm, as per current NCCN guidelines.
  • An analysis of 4,723 patients revealed that those who underwent END had significantly better survival rates and neck control compared to those monitored without surgery.
  • Through risk stratification, researchers identified distinct subgroups within the NO group, finding that 26% of low-risk patients achieved positive outcomes comparable to the END group, suggesting some patients might not require immediate surgery.
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Background: This study aimed to explore the prognostic utility of the preoperative platelet-to-albumin ratio (PAR) among patients with oral cavity squamous cell carcinoma (OSCC).

Methods: We retrospectively reviewed of 355 patients with surgically-treated OSCC between 2008 and 2017. The optimal PAR cutoff for patient stratification was determined through X-tile analysis.

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Purpose: This study evaluates serial radiographic changes in the maxillary sinus of patients with oral cancer after an inferior maxillectomy and a soft tissue free flap reconstruction.

Methods: Fifty-six patients were evaluated between Oct 2005 and Mar 2017 from an institutional database. Preoperative and surveillance imaging was reviewed at set time-points.

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Background And Purpose: We aimed to investigate the prognostic value of peritumoral and intratumoral computed tomography (CT)-based radiomics during the course of radiotherapy (RT) in patients with laryngeal and hypopharyngeal cancer (LHC).

Materials And Methods: A total of 92 eligible patients were 1:1 randomly assigned into training and validation cohorts. Pre-RT and mid-RT radiomic features were extracted from pre-treatment and interim CT.

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Article Synopsis
  • The study aimed to determine if postoperative chemoradiotherapy (POCRT) leads to better outcomes than postoperative radiotherapy (PORT) alone for patients with high-risk salivary gland carcinoma (SGC).
  • A total of 411 patients were analyzed, with results showing that POCRT significantly improved overall survival (OS) and progression-free survival (PFS) for those with nodal metastasis, compared to PORT alone.
  • POCRT also improved locoregional control (LRC) rates in patients with residual tumors after surgery, highlighting its effectiveness for specific subgroups like those with adenoid cystic carcinoma (AdCC).
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We investigated the prognostic utility of preoperative neck lymph node-to-primary tumor maximum standardized uptake value ratios (NTRs) in oral cavity squamous cell carcinoma (OSCC). We retrospectively reviewed the medical records of 141 consecutive patients who were diagnosed as having OSCC and had received fluorodeoxyglucose-positron emission tomography within 2 weeks prior to radical surgery between 2009 and 2018. To determine the optimal NTR cutoff, receiver operating characteristic analysis for overall survival (OS) was executed.

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Perineural invasion (PNI) was quantitatively analyzed in oral squamous cell carcinoma (OSCC) specimens obtained by radical surgery to correlate with survival outcomes. This is a retrospective study that reviewed the Cancer registry data between 2009 and 2015. Inclusion criteria were oral cavity cancer, treatment by radical surgery, presence of PNI, and available pathologic samples for S100 staining.

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We introduced a novel squamous cell carcinoma inflammatory index (SCI) and explored its prognostic utility for individuals with operable oral cavity squamous cell carcinomas (OSCCs). We retrospectively analyzed data from 288 patients who were given a diagnosis of primary OSCC from January 2008 to December 2017. The SCI value was derived by multiplying the serum squamous cell carcinoma antigen and neutrophil-to-lymphocyte ratio values.

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Whether the modified Glasgow prognostic score (mGPS) is useful for patients with head and neck squamous cell carcinoma (HNSCC) remains controversial. An electronic database search on EMBASE, PubMed, and the Cochrane Library from inception to 30 June 2022 was performed for study selection and data extraction. The associations between the mGPS and survival outcomes were evaluated using a random-effects meta-analysis and expressed as pooled hazard ratios (HRs) and 95% CIs.

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Background: We aimed to probe the hemoglobin-albumin-lymphocyte-platelet (HALP) score's prognostic value in oral cavity squamous cell carcinoma (OSCC).

Methods: Medical data of 350 patients with primary operated OSCC were retrospectively reviewed. We derived the optimal HALP cutoff by executing receiver operating characteristic curve analysis, and patients were then grouped based on this cutoff value.

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Article Synopsis
  • The study investigates the necessity of elective neck dissection (END) for patients with early-stage oral cavity squamous cell carcinoma (OCSCC) classified as cT1N0M0, given that evidence supporting it is weak.
  • It analyzes 3886 patients, with 2065 undergoing END and 1821 under neck observation, showing that while END improves neck control and disease-specific survival rates, the outcomes are similar for patients with low-risk scores (0 or 1).
  • The conclusion recommends performing END when the depth of invasion exceeds 2.5 mm or when tumors are poorly differentiated, suggesting that nearly half of the cT1N0M0 patients may be able to avoid unnecessary surgery without negatively impacting
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