Publications by authors named "Tuan Jen Fang"
Background: The question as to whether prolonged diagnosis-to-surgery intervals (DSIs) may compromise survival outcomes in patients with oral cavity squamous cell carcinoma (OCSCC) remains unanswered. This nationwide study was designed to address this issue.
Methods: We analyzed data from 26,214 patients with first primary OCSCC identified in the Taiwanese Cancer Registry Database between 2011 and 2021.
Introduction: Obstructive sleep apnoea (OSA) in children is associated with numerous adverse outcomes, including elevated blood pressure. While the associations between OSA, obesity, and autonomic dysfunction are recognised, the precise mechanisms linking these factors and their relationship with elevated blood pressure in children remain unclear.
Methods: This retrospective case series included 76 children with OSA.
Emerging evidence underscores the pivotal role of the gut microbiota in regulating emotional and behavioral responses via the microbiota-gut-brain axis. This study explores associations between pediatric obstructive sleep apnea (OSA), emotional distress (ED), and gut microbiome alterations before and after OSA treatment. Sixty-six children diagnosed with OSA via polysomnography participated, undergoing adenotonsillectomy alongside routine educational sessions.
View Article and Find Full Text PDFObstructive sleep apnea syndrome (OSAS) is prevalent among children and is associated with elevated blood pressure (BP), posing a risk for future hypertension and cardiovascular diseases. While the roles of gut microbiota and systemic inflammation in OSAS pathogenesis are recognized in adults and animal models, their impact on pediatric BP remains less understood. This cross-sectional study explored the relationships between polysomnographic parameters, gut microbiota, systemic inflammation, and BP in 60 children with OSAS.
View Article and Find Full Text PDFBackground: Advances in technology have enabled neck dissection techniques that reduce aesthetic impact while maintaining oncological safety. This study compares perioperative outcomes between robotic neck dissection via retroauricular/modified facelift incision (RNDRM) and conventional neck dissection via anterolateral cervical incision (CND).
Methods: Studies were selected from PubMed, Embase, and Cochrane Library.
Objectives: A novel J-shaped anterolateral thigh (ALT) flap reconstruction technique was developed to simultaneously restore swallowing and speech functions in patients following total laryngopharyngectomy. This study aimed to assess the outcomes and surgical complications in patients who underwent J-flap reconstruction over time.
Methods: Patients who underwent J-shaped ALT flap phonatory tube reconstruction were enrolled.
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).
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.
View Article and Find Full Text PDF: 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.
View Article and Find Full Text PDFImportance: Pregnancy may contribute to the development or exacerbation of obstructive sleep apnea (OSA) and increase the risk of gestational complications. Continuous positive airway pressure (CPAP) is the first-line and criterion standard treatment for OSA and is regarded as the most feasible choice during pregnancy. However, the association between CPAP therapy in pregnant women with OSA and reduced gestational complications remains inconclusive.
View Article and Find Full Text PDFArticle 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.
Background: Surgery for oesophageal squamous cell carcinoma involves dissecting lymph nodes along the recurrent laryngeal nerve. This is technically challenging and injury to the recurrent laryngeal nerve may lead to vocal cord palsy, which increases the risk of pulmonary complications. The aim of this study was to compare the efficacy and safety of robot-assisted oesophagectomy (RAO) versus video-assisted thoracoscopic oesophagectomy (VAO) for dissection of lymph nodes along the left RLN.
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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.
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.
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,
Article Synopsis
- 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.
Background: Recurrent laryngeal nerve (RLN) palsy is a serious complication of esophagectomy that affects the patient's phonation and the ability to prevent life-threatening aspiration events. The aim of this single-center, retrospective study was to investigate the clinical course of left RLN palsy and to identify the main prognostic factors for recovery.
Methods: The study cohort consisted of 85 patients who had developed left RLN palsy after minimally invasive McKeown esophagectomy.
Pathophysiological Mechanisms Underlying Unilateral Vocal Fold Paralysis in Female Patients: An Ultrasonographic Study.
Clin Exp Otorhinolaryngol
November 2023
Objectives: Laryngeal ultrasonography (LUS) has been suggested as an alternative diagnostic tool for unilateral vocal fold paralysis (UVFP). The present study applied LUS and quantitative laryngeal electromyography (LEMG) in female UVFP patients to investigate the pathophysiologic mechanisms of UVFP.
Methods: In this cross-sectional study, vocal fold (VF) length parameters included resting and phonating VF length measured using B-mode LUS, and color Doppler vibrating length (CDVL) measured using the color Doppler mode.
Continuous positive airway pressure is the first-line and gold-standard treatment for obstructive sleep apnea (OSA). Pharmacotherapy is not commonly used in treating OSA until recently. Combined noradrenergic and antimuscarinic agents have been clinically applied for OSA patients with variable results.
View Article and Find Full Text PDFBackground: Dietary behavior is a main contributing yet modifiable factor to the body weight status of children and may be involved in the pathophysiology of childhood obstructive sleep apnea (OSA). This study aimed to investigate the dietary profile of pediatric OSA patients, effects of educational counseling after adenotonsillectomy, and predictor for disease resolution.
Methods: This observational study included 50 pediatric OSA patients undergoing adenotonsillectomy with routine educational counseling (Group 1), 50 pediatric OSA patients undergoing adenotonsillectomy without formal educational counseling (Group 2), and 303 healthy children without OSA (Control).
Background: Adenotonsillar hypertrophy is the most common cause of pediatric obstructive sleep apnea (OSA). Although adenotonsillectomy considerably reduces OSA and systemic inflammation, whether and how systemic inflammation influences the effects of adenotonsillectomy on OSA has yet to be determined.
Methods: This study investigated the associations between changes in anatomical variables, % changes in subjective OSA-18 questionnaire scores, % changes in 11 polysomnographic parameters, and % changes in 27 systemic inflammatory biomarkers in 74 children with OSA.
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
Objective: To investigate the risk factors of postoperative elevated blood pressure (BP) in children with childhood obstructive sleep apnea syndrome (OSAS) after adenotonsillectomy (AT).
Study Design: Case series with planned data collection.
Setting: Tertiary referral center.
Background: Obstructive sleep apnea (OSA) is associated with impaired sleep quality and autonomic dysfunction. Adenotonsillectomy significantly improves subjective and objective sleep quality in children with OSA. However, the postoperative changes in heart rate variability (HRV) indices (indicators of cardiac autonomic function) and their importance remain inconclusive in childhood OSA.
View Article and Find Full Text PDFBackground: The prognostic significance of the relapse interval in patients with resected oral cavity squamous cell carcinoma (OCSCC) is a matter of ongoing debate. In this large-scale, registry-based, nationwide study, we examined whether the time interval between surgery and the first disease relapse may affect survival outcomes in Taiwanese patients with OCSCC.
Methods: Data made available by the Taiwan Health Promotion Administration as of 2004 were obtained.