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Biomedical subjects

K C Soo

Publications and source records attributed to K C Soo.

At least 73 records · Page 4Linked to original sources
PubMed1994

Reconstruction of moderate sized intra-oral defects using the nasolabial flap.

The nasolabial flap was used in 11 patients for reconstruction of moderate sized intra-oral defects. There was minimal morbidity of donor and recipient sites in terms of function and cosmesis. The flap was easily harvested, with a reduction in operating time. The superb vascularity and reliability of the flap was demonstrated by the fact that it was possible to use this flap even after a radical neck dissection had been performed on the same side or after radiotherapy. This article describes the authors' experience with the use of the subcutaneously-pedicled, inferiorly-based, double-staged nasolabial flap for intra-oral reconstruction.

Adult↗
PubMed1993

Alveolar soft part sarcoma of the tongue: a case report.

Alveolar soft part sarcoma of the tongue is a rare malignancy. Until 1988, only 23 cases have been documented in the English literature. In this report, a 21 year old man with typical features of alveolar soft part sarcoma of the tongue is presented. Treatment was wide surgical resection with reconstruction using a pectoralis major myocutaneous flap.

Adult↗
PubMed1993

Primary reconstruction after chest wall resection in breast cancer.

Breast cancer patients with chest wall recurrence or patients with advanced breast cancer pose a difficult challenge to surgeons. Surgical ablation results in not only a large soft tissue defect that needs cover but often, in addition, a significant bony chest wall defect. The majority of these patients would have already received irradiation or chemotherapy or both. Thus, wound healing is significantly impaired. For these reasons, surgery was previously not attractive as an alternative in the palliation of these patients. Over a one-year period, seven breast cancer patients had chest wall resection. Six patients had recurrent tumours and one had advanced primary breast cancer. Two of these patients required only extensive resection of soft tissue of the anterior chest wall. The other five patients required, in addition, resection of the bony chest wall. Myocutaneous flaps were used to repair the surgical defects in six of these patients. Five were rectus abdominis myocutaneous flaps and one a pectoralis major myocutaneous flap. In one patient, a deltovertebral skin flap, which is an axial pattern skin flap was used. Primary wound healing was achieved in five of six patients (83%). One patient died immediately post-operatively, the cause of which is unknown. One of the rectus abdominis flap needed an exploration but was ultimately salvaged. This paper demonstrates the usefulness of the myocutaneous flap in enabling surgery to become a modality for palliation of patients with recurrent and advanced breast cancer.

Adult↗
PubMed1992

Tracheo-oesophageal groove clearance in well differentiated thyroid carcinoma.

Papillary carcinoma of the thyroid has a propensity for spread to the regional lymph nodes, in particular those along the recurrent laryngeal nerve. Twenty cases of papillary carcinoma of the thyroid had prophylactic clearance of the lymph nodes along the tracheo-oesophageal groove, and one patient had removal of recurrent disease in the groove. Eleven of the twenty patients had, in addition, some form of cervical lymph node clearance for clinically palpable ipsilateral cervical lymph nodes. Metastases to the tracheo-oesophageal groove lymph nodes was seen in seven of the twenty patients (35%). Tumour size, age, sex, race and cervical lymph node involvement did not appear to predict involvement of the tracheo-oesophageal groove lymph nodes. Clearance of the lymph nodes along the tracheo-oesophageal groove at the time of resection of primary disease is worthwhile for thyroid papillary carcinoma, because of the high incidence rate (35%) and also clearance for subsequent recurrence will be more difficult with a higher risk of damage to the recurrent laryngeal nerve and parathyroids.

Adult↗
PubMed1992

Breast carcinoma-in-situ: an emerging problem in Singapore.

Breast carcinoma-in-situ constitutes 4.1% of 707 breast cancers diagnosed between 1988 and 1990. Among these 30 patients, intraductal carcinoma-in-situ (DCIS) outnumbers lobular carcinoma-in-situ (LCIS) by 9-fold. They are mostly symptomatic - 87% present as breast lumps and/or nipple discharge, with 52% of lumps exceeding 2cm size. Three patients were detected by screening mammography and it is expected that more breast carcinoma-in-situ will be detected through mammographic screening. Two-thirds of the patients had mastectomy while the rest had lesser procedures. The different surgical procedures and adjuvant therapy instituted for the patients are reflections of the differing opinions regarding optimum therapy for carcinoma-in-situ and the differing rationale for DCIS and LCIS lesions.

Adult↗
PubMed1992

Calcifying epithelioma of Malherbe--a case report of a large preauricular tumour.

Calcifying epithelioma of Malherbe (pilomatrixoma) is a relatively uncommon benign skin tumour of hair follicle origin. It usually presents in the face and upper extremities of young adults as an asymptomatic subcutaneous or dermal tumour. Treatment is surgical excision. This paper presents a case of a large tumour in the preauricular region with difficulty in diagnosis preoperatively and required a superficial parotidectomy to clear the tumour from the facial nerve.

Adult↗
PubMed1991

Oestrogen receptors in well differentiated thyroid cancers.

Oestrogen receptor (ER) monoclonal antibody, H222 was used to study ER expression in forty-seven paraffin embedded blocks of well differentiated thyroid cancers. Trypsinisation, DNase I digestion, together with the use of labelled streptavidin biotin immuno-histochemical staining kit were adopted to increase the sensitivity of the immunoreaction. One out of twenty-seven papillary carcinomas and one out of twenty follicular carcinomas were immunoreactive. Thus, 4.3% of the well differentiated thyroid cancers were noted to express ER. The increased incidence and the better prognosis in females with well differentiated thyroid cancers is unlikely to be explained on the presence or absence of ER.

Adenocarcinoma↗
PubMed1989

Squamous carcinoma of the nasal cavity and paranasal sinuses.

This study retrospectively analyzed 105 patients with squamous carcinoma of the nasal cavity and paranasal sinuses. The primary tumor was located in the maxillary sinus in 65 patients (62 percent), the nasal cavity in 27 (26 percent), the ethmoid sinus in 11 (10 percent), and the sphenoid sinus in 2 (2 percent). Over half of the patients with antral cancer were treated with surgery and radiotherapy, whereas one-third of the remaining patients received combination therapy. Most procedures were radical, including sacrifice of the orbital contents in half of the surgically treated patients. The 5-year determinate cure rate was 45 percent for patients with nasal cavity tumors, 38 percent for those with maxillary sinus lesions, and 13 percent for those with ethmoid tumors. Local recurrence remains a major problem despite aggressive surgery and increased use of adjunctive radiotherapy.

Actuarial Analysis↗
PubMed1988

Squamous carcinoma of the gums.

We reviewed a 20-year experience with squamous carcinoma of the gums in 347 patients who received definitive therapy. More than three-quarters of the lesions involved the lower gum and all but 37 patients were previously untreated. The proportion of patients with localized tumors (N0) remained the same (64 percent). Surgery continued to be the treatment of choice in 97 percent of patients, but proportionately more patients had a more conservative procedure which preserved lower jaw continuity. The 5-year determinate survival rate was little changed (54 percent). Advanced clinical stage (stages III and IV), prior dental extraction, bone invasion, and involvement of surgical margins were predictive of a lower survival rate on univariate analysis. Clinical stage was the only significant predictor of survival on multivariate analysis. The impact of adjunctive radiotherapy could not be assessed.

Adult↗
PubMed1988

Intestinal obstruction in patients with gynaecological malignancies.

Bowel obstruction developing in patients with gynaecological malignancies may present as a therapeutic dilemma. The causes, and results of surgical and conservative management of 92 patients are analysed. The causes of obstruction in the 64 patients who were treated surgically were: tumour recurrence in 42, adhesions in 12, radiation stricture in 9 and pelvic abscess in 1. Surgical palliation was effective in 45 patients in this group, with another 12 patients being palliated initially but subsequently developing further obstructive symptoms. Surgical palliation was ineffective in 7. Conservative management was effective only in 12 of the 41 patients, and even in this group 8 developed further obstructive episodes within the first month of discharge. The median survival in the surgically treated group for benign and malignant causes is 57 and 10 weeks respectively; while it is 4 weeks for those treated conservatively.

Female↗
PubMed1988

Head and neck cancer 1987--a review.

Significant advances in head and neck oncology are reviewed in this article. Tumour biology and pathology are outlined in some detail. Multidisciplinary management is emphasised. Conservatism in surgical treatment and the roles of radiotherapy, chemotherapy and other modalities are discussed. The alteration in the natural history of head and neck cancers with effective local and regional control is mentioned.

Alcohol Drinking↗
PubMed1988

Analysis of prognostic variables and results after vertical partial laryngectomy.

A consecutive series of 197 patients who underwent conservation surgery for squamous cell carcinoma of the glottic larynx was analyzed. The majority of patients were male. One hundred forty-one had stage I disease, 44 had stage II, and 12 had stage III disease at the time of treatment. Partial laryngectomy was performed in 25 patients who had recurrent cancer after previous definitive radiotherapy and in 5 patients who had previously undergone cordectomy. There was no operative mortality and postoperative morbidity was low. Local recurrence developed in 32 patients (17 percent); cervical metastasis developed in 8 patients. The determinate survival rates at 3 and 5 years were 92 percent and 87 percent, respectively. Multivariate analysis showed soft-tissue margins and tumor differentiation as the two significant covariates in predicting survival. Positive surgical margins were also significant covariates affecting local recurrence. These data suggest that conservation surgery is an effective treatment for early vocal cord carcinoma. Adequate surgical margins are essential. Postoperative irradiation should be considered in patients with inadequate margins.

Adult↗
PubMed1988

Analysis of prognostic variables and results after supraglottic partial laryngectomy.

A consecutive series of 78 patients who underwent conservation surgery for squamous cell carcinoma of the supraglottic larynx is analyzed. The majority of the patients were middle-aged men who had early-stage disease, with only 18 patients in stage III and 6 in stage IV. The epiglottis was the most frequent site, followed by the aryepiglottic fold and other sites in the supraglottic larynx. There was no operative mortality and the complication rate was low. Univariate analysis showed no influence of tumor stage, tumor differentiation, or involved surgical margins on survival. Determinate survival rates of 85 percent at 3 years and 72 percent at 5 years were observed. Local recurrences took place in 12 patients, 4 of whom were salvaged by total laryngectomy; neck failure occurred in 13 patients, 7 of whom were salvaged after further treatment; and 1 of the 2 patients with distant metastasis was salvaged after further treatment. We believe that every patient with a favorable lesion of the supraglottic larynx should be considered for conservation surgery, specifically, supraglottic partial laryngectomy, adhering to the criteria mentioned. Initial surgical treatment offers excellent local control and 5 year survival. Adjuvant postoperative radiotherapy may be considered in those patients with bulky primary tumors, positive surgical margins, and histologically confirmed cervical lymph node metastases.

Adolescent↗
PubMed1987

Total glossectomy.

Total glossectomy is a procedure based on sound oncologic principles, and its usefulness may not be fully appreciated. Given the dimensions of the tongue and the need to obtain a wide margin of resection, this procedure may be indicated in selected T3 lesions and recurrences after irradiation. The procedure offers excellent palliation of pain, and form and function may be preserved by rim mandibulectomy when indicated. New reconstructive techniques allow for speedier recovery. Aspiration need not be a complication of total glossectomy if care is taken to preserve the superior laryngeal nerve. Speech rehabilitation plays an important role in returning these patients to their normal environment. Overall 1 and 3 year disease-free survival rates have been encouraging.

Adolescent↗
PubMed1987

Radical neck dissections for squamous carcinomas: pathological findings and their clinical implications with particular reference to transcapsular spread.

Two hundred fifty radical neck dissections, undertaken for mucosal squamous carcinomas of the head and neck, were reviewed with reference to pathological findings and their clinical implications. No major differences in descriptive surgical pathology were established between irradiated and non-irradiated resections. In general, irradiated dissections had lower total node counts and somewhat fewer nodal metastases involving a smaller number of different nodal groups. The topography of nodal deposits was similar in irradiated and non-irradiated resections. Palpable keratin granulomas (without intact tumor) were almost confined to irradiated patients. Transcapsular spread of tumor from involved lymph nodes was common: it was demonstrated in 160/188 'positive' dissections (85%) and was subclassified as 'macroscopic' in 90 and 'microscopic' in 70. The incidence and extent of transcapsular spread was similar in irradiated and nonirradiated resections. It was more frequently observed in association with large nodal masses but it was also regularly found with small nodal deposits less than 3 cm in diameter. Statistical analyses showed strong associations (p less than 0.0005) between the presence and/or extent of transcapsular spread and subsequent recurrence in the operated neck and overall survival. The predictive value of other clinical and pathological features vis-a-vis local neck recurrence such as numbers of involved nodal groups was weaker. Macroscopic transcapsulr spread emerges as the major prognostic factor for recurrent disease in the neck (p less than 0.0001). Attention is drawn to the advantages of accurate descriptive categories ('macroscopic', 'microscopic') for this critical prognostic feature.

Carcinoma, Squamous Cell↗
PubMed1986

Prognostic implications of perineural spread in squamous carcinomas of the head and neck.

The occurrence and prognostic implications of perineural spread were examined in 239 patients with mucosal squamous carcinomas of the head and neck. Perineural spread was demonstrated in resections from 64 patients (27%), the majority having primary tumors at one of three sites: buccal cavity, larynx, and pharynx. Perineural spread near nodal metastases was uncommon. There was no evidence that perineural involvement was more commonly associated with large tumors or less differentiated ones. No association was established between perineural spread and coexistent lymph node deposits in the surgical resections. Perineural spread was, however, shown to be a statistically significant prognostic factor for an increased incidence of subsequent locoregional recurrence and for decreased survival.

Adult↗