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194/InvasionFront_CD8_block9_x4_y6_patient194_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 15216.9,
+    "Centroid Y µm": 19639.6,
+    "Num Detections": 20921,
+    "Num Negative": 19376,
+    "Num Positive": 1545,
+    "Positive %": 7.385,
+    "Num Positive per mm^2": 610.18
+  }
+}

194/TumorCenter_CD3_block9_x4_y6_patient194_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 13917.6,
+    "Centroid Y µm": 20739.0,
+    "Num Detections": 18012,
+    "Num Negative": 16338,
+    "Num Positive": 1674,
+    "Positive %": 9.294,
+    "Num Positive per mm^2": 698.02
+  }
+}

194/TumorCenter_CD8_block9_x3_y6_patient194_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 11344.0,
+    "Centroid Y µm": 15966.5,
+    "Num Detections": 18747,
+    "Num Negative": 17515,
+    "Num Positive": 1232,
+    "Positive %": 6.572,
+    "Num Positive per mm^2": 545.04
+  }
+}

194/TumorCenter_CD8_block9_x4_y6_patient194_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 13917.6,
+    "Centroid Y µm": 15854.1,
+    "Num Detections": 17219,
+    "Num Negative": 16619,
+    "Num Positive": 600,
+    "Positive %": 3.485,
+    "Num Positive per mm^2": 287.46
+  }
+}

194/history_text.txt

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+Patient with post-treatment rhabdomyosarcoma in childhood including radiochemotherapy, radiation dose up to 71 Gy. Now tongue base carcinoma, histologically squamous cell carcinoma on the left, extending to the midline. Second tumor after radiotherapy in childhood. Therefore above mentioned surgery indicated.

194/icd_codes.txt

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+Neubildung unsicheren oder unbekannten Verhaltens: Lippe, Mundhöhle und Pharynx[D37.0 ] Bösartige Neubildung Lippe Mundhöhle Pharynx mehrere Teilbereiche überlappend[C14.8 ] Bösartige Neubildung der Übergangsregion des Oropharynx[C10.8 L]

194/ops_codes.txt

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+Direkte diagnostische Pharyngoskopie[1-611.0 ] Sonstige radikale Resektion des Pharynx [Pharyngektomie] mit Rekonstruktion mit freiem mikrovaskulär-anastomosierten Transplantat[5-296.x4 ] Radikale zervikale Lymphadenektomie [Neck dissection] selektiv [funktionell] 4 Regionen[5-403.03 B] Entnahme fasziokutaner Lappen mit mikrovaskulärer Anastomosierung Unterarm[5-858.03 L] Pharyngoplastik mit mikrovaskulär anastomosiertem Transplantat[5-293.2 ] Partielle Resektion der Zunge durch Pharyngotomie mit Rekonstruktion mit nicht vaskularisiertem Transplantat[5-251.21 ] Temporäre Tracheotomie[5-311.0 ] Entnahme von Spalthaut des Oberschenkels[5-901.0e R] Spalthaut großflächig Empfängerstelle Unterarm[5-902.48 L] Wechsel vaskuläres Implantat Gefäße onA[5-394.3 ] Sonstige partielle Laryngektomie[5-302.x ]

194/patient_clinical_data.json

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+{
+  "year_of_initial_diagnosis": 2014,
+  "age_at_initial_diagnosis": 34,
+  "sex": "female",
+  "smoking_status": "smoker",
+  "primarily_metastasis": "no",
+  "survival_status": "living",
+  "survival_status_with_cause": "living",
+  "first_treatment_intent": "curative",
+  "first_treatment_modality": "local surgery",
+  "days_to_first_treatment": 53,
+  "adjuvant_treatment_intent": null,
+  "adjuvant_radiotherapy": "no",
+  "adjuvant_radiotherapy_modality": null,
+  "adjuvant_systemic_therapy": "no",
+  "adjuvant_systemic_therapy_modality": null,
+  "adjuvant_radiochemotherapy": "no"
+}

194/patient_pathological_data.json

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+{
+  "patient_id": "194",
+  "primary_tumor_site": "Oropharynx",
+  "pT_stage": "pT1",
+  "pN_stage": "pN0",
+  "grading": "G3",
+  "hpv_association_p16": "negative",
+  "number_of_positive_lymph_nodes": 0.0,
+  "number_of_resected_lymph_nodes": 36,
+  "perinodal_invasion": null,
+  "lymphovascular_invasion_L": "no",
+  "vascular_invasion_V": "no",
+  "perineural_invasion_Pn": "yes",
+  "resection_status": "R0",
+  "resection_status_carcinoma_in_situ": "Ris0",
+  "carcinoma_in_situ": "yes",
+  "closest_resection_margin_in_cm": "<0.1",
+  "histologic_type": "SCC_Conventional-Keratinizing",
+  "infiltration_depth_in_mm": 11.0
+}

194/surgery_description.txt

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+Laryngectomy, Neck dissection, Free flap (Radial), Tracheotomy

194/surgery_report.txt

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+First, pharyngoscopy/laryngoscopy again and confirmation of the extent. The tumor is located in the base of the tongue on the left, reaching at least to the midline. The tumor extends to the glossotonsillar groove or the tonsil. This confirms the indication for surgery with flap coverage. First PEG placement: insertion of the flexible esophagoscope into the stomach. There, after creating the diaphanoscopy, insertion of a 15 mm stomach wall tube without complications. Sterile dressing. Subsequent repositioning for tumor resection and flap covering: First skin disinfection and injection of a total of 15 ml Ultracaine with adrenaline into the area of the planned apron flap and sterile covering of all surgical areas. Start with dissection of the apron flap: This is performed via the typical skin incision and by elevating the tissue subplatysmal to the level of the hyoid bone or submandibular gland. Subsequent neck dissection on the left: Exposure of the sternocleidomastoid muscle, digastric muscle and omohyoid muscle. Exposure of the infrahyoid muscles. Depiction of the common, internal and external carotid artery, internal jugular vein and facial vein. An external jugular vein is only very thin and is coagulated. The auricular nerve is exposed and preserved. Exposure of the hypoglossal nerve, vagus nerve, cervical nerve and accessorius nerve. Clearing level II to V a, with preservation of the cervical plexus. Subsequent combined tumor resection: start transorally. Tumor is palpated. Cut around the tumor with a distance of at least 1.5 cm on all sides. Resection extends beyond the midline. Resection includes the floor of the mouth, the lingual nerve is initially exposed, but must be resected later due to its proximity to the tumor. Mucosa is resected up to the alveolar ridge along the glossoalveolar groove. Lower parts of the tonsil are resected together with parts of the caudal palatal arch. Counter-operation from the transcervical side to resect the tumor in the base of the tongue while sparing the lingualis on the opposite side. Resection is performed with exposure of the lingual artery on the right side. Resection is performed in the vallecula to the left, taking the mucosa of the lingual epiglottis with it. Resection extends to the piriform sinus entrance. Cranially again up to the lower part of the palatal arch. The specimen is removed and thread-marked. An additional marginal sample is taken from the glossotonsillar groove from the floor of the mouth to the alveolar ridge to the lower edge of the tonsil. This is also thread-marked for the frozen section. In the frozen section, the tumor is basically removed on all sides in healthy tissue, but slightly higher-grade, approximately medium-grade dysplasia caudally in the direction of the vallecula, higher-grade dysplasia cannot be ruled out with certainty. Therefore resection is recommended again. An approx. 1 cm wide strip is resected, including the lateral parts of the epiglottis, the entrance of the piriform sinus up to the posterior pharyngeal wall. This goes to the frozen section marked with a thread remote from the tumor. Confirmation that this marginal sample is tumor-free at the markings remote from the tumor. Thus overall R0 resection with regard to the primary. There is now a defect in the area of the vallecula and pharyngeal side wall up to the tonsil lobe as well as in the floor of the mouth and in particular in the body and base of the tongue. Radial flap is planned after measuring the required three-dimensional dimensions. Neck dissection on the right: This neck dissection is performed in the same way as on the left side. Here too, clearing of levels II to V a. Then tracheotomy: After cutting through the thyroid isthmus and supplying it with puncture ligatures, visualization of the trachea. Entry into the trachea and creation of a broadly pedicled, visor-like, modified Björk flap. This is initially epithelized caudally. Insertion of a laryngectomy tube. Now remove the radial flap from the left forearm: mark the flap in the required three-dimensional size. Maximum length 11 cm, maximum width 7 ˝ cm. First cut around the flap ulnarly and lift subfascially. Then extend the incision into the crook of the elbow. Exposure of the superficial venous system. Only obliterated residual veins are visible here, with an insignificant volume, but still connected to the deep venous system. Visualization of the vascular pedicle. This shows a larger radial vein after confluence. Now first elevation of the superficial venous system from subfascial. Dissection of the radialis flap now from the radial side and elevation from the radial side. Exposure and preservation of the lateral antebrachial cutaneous nerve. Caudal exposure of the radial artery. After clamping and sufficient waiting time, always 100% saturation. Deposition of the radial artery. The artery is treated with 4-0 Prolene stitches. Lift the radial artery flap with the pedicle subfascially along the course of the pedicle. Outgoing, smaller vessels are clipped or treated with bipolar coagulation. In the antecubital fossa, the relatively small radial artery is exposed as far as the entrance to the brachial artery. The confluence can be followed a little further into the antecubital fossa. The flap is then removed. The small, rudimentary cephalic veins are also removed and ligated proximally. The relatively thin radial artery is supplied twice using a clip. The confluent radial vein is ligated after removal. Flush the flap with heparin solution. Subsequent insertion of the flap. This is generally very difficult due to the very narrow mouth opening. The flap is successively worked into the defect with 3-0 Vicryl single button sutures according to the preforming. Difficult suturing due to the limited space available. Finally, the flap is sutured in all dimensions sufficiently. Tension-free, complete closure. The stalk is carried forward into the left side of the neck. The connecting vessels are then shown here. The superior artery and the facial vein are selected first. Conditioning of the superior thyroid artery and the radial artery. Suture with 9-0 Ethilon single-button sutures. After opening the clamp, initially very good blood flow and good venous return. Insufficient pulsation in the course, possible vascular spasm or thrombosis. Therefore opening of the superior thyroid artery. No blood flow recognizable here, even after dilatation. Either spasm or thrombosis near the outlet. Closure of the superior thyroid artery with clips, as was previously done in the distal area of this artery. Additional ligation. Subsequent exploration of the linguofacial trunk. The facial artery, which was previously preserved, is already thrombosed. Overall, the relatively poor vascular status after chemotherapy was confirmed. The lingual artery can be visualized, the ligature is removed and the artery is shortened. Afterwards, there is good blood flow from this artery. Therefore, the radial artery is now reapproximated to the lingual artery. This is done with 9-0 Ethilon single button sutures. Again, good arterial flow and also good venous return. Therefore, the veins are now conditioned. The facial vein is conditioned with confluence of the radial vein. Selection of a coupler size 2.5 and anastomosis of the veins without any problems. Good venous return. Subsequent irrigation of the entire wound area. Careful hemostasis. Successive wound closure with insertion of a flap on the left and a Redon drainage on the right and epithelialization of the tracheostoma. Suture marking in the area of the vascular pedicle for sonographic Doppler control. The flap is then checked again. This shows that there is no blood flow after the puncture. This means that there is again insufficient perfusion via the arterial vessel. The wound must therefore be reopened on the left side. Visualization of the pedicle. Here, too, there is no longer any continuous pulsation, which means that there is another thrombosis. Opening of the artery. No sufficient blood flow recognizable here, similar to the superior thyroid artery previously. Thus, again suspected thrombosis or vasospasm. Even after dilatation, there is no longer sufficient blood flow from this vessel. The flap is flushed with heparin solution until it comes out of the venous vascular system and is recognizable again. Shortening of the vessel in the area of the linguofacial trunk. Very good blood flow here again. The radial artery is dissected like a fish mouth and anastomosed again with the now significantly larger lumen using 9-0 Ethilon single button sutures. Again, after opening the clamp, good blood flow, good venous return. Now follow the perfusion for approx. 1 hour. Here finally permanent arterial pulsation, which also provides signals with the Doppler, in contrast to the previous anastomoses. Puncture of the flap shows good perfusion. This time the anastomosis appears to remain permanently open. Therefore, wound irrigation, careful hemostasis and closure, with insertion of a new flap on the left side. Suturing of the cannula. Flap check again after skin closure. Now good blood circulation. Insertion of a 7 mm tracheostomy tube. The forearm was closed with a split-thickness skin graft taken from the right thigh. A 0.7 mm thick split-thickness skin graft was first removed from the right thigh. Hydrogel or hydrocholoid dressing is then applied here. The arm is then primarily closed in the proximal area and the split skin is successively incorporated into the defect in the area of the forearm. Care is taken to protect the lateral antebrachial cutaneous nerve of the median nerve and also to protect the ulnar artery. Octenidine-Mepilex dressing is then applied. Loose compresses are placed over this and fixed in place with absorbent cotton. Application or adjustment of a Cramer splint and fixation with a bandage. Positioning of the arm. Arm always well perfused with 100% saturation until the end of the procedure. Patient goes to the intensive care unit for postoperative monitoring. Heparin perfusor 500 units/hour must be continued postoperatively. Additionally aspirin 50 mg i.v., please repeat this the next day. Flap check every ˝ hour for the first 1 to 2 days, then according to the schedule for a total of 5 days. Antibiotics given intraoperatively should be continued for 1 week with Unacid. Nutrition via the inserted PEG tube. On the 12th day, approx. gruel swallow and then, depending on the gruel swallow or swallowing function, diet build-up or initiation of swallowing rehabilitation. Overall, in the case of radiochemotherapy for rhabdomyosarcoma, difficult situation with regard to the arterial anastomosis. Overall tongue base tumor cT2 to 3, defect coverage by radial flap. Please present at the interdisciplinary tumor conference after receiving the final histology.

195/InvasionFront_CD3_block6_x5_y11_patient195_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 16391.3,
+    "Centroid Y µm": 29059.6,
+    "Num Detections": 23342,
+    "Num Negative": 19474,
+    "Num Positive": 3868,
+    "Positive %": 16.57,
+    "Num Positive per mm^2": 1546.1
+  }
+}

195/InvasionFront_CD3_block6_x6_y11_patient195_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18989.9,
+    "Centroid Y µm": 29184.5,
+    "Num Detections": 0,
+    "Num Negative": 0,
+    "Num Positive": 0,
+    "Positive %": NaN,
+    "Num Positive per mm^2": NaN
+  }
+}

195/InvasionFront_CD8_block6_x5_y9_patient195_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 16866.1,
+    "Centroid Y µm": 23037.8,
+    "Num Detections": 22597,
+    "Num Negative": 21634,
+    "Num Positive": 963,
+    "Positive %": 4.262,
+    "Num Positive per mm^2": 372.03
+  }
+}

195/InvasionFront_CD8_block6_x6_y9_patient195_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 19464.7,
+    "Centroid Y µm": 23337.6,
+    "Num Detections": 19435,
+    "Num Negative": 19376,
+    "Num Positive": 59,
+    "Positive %": 0.3036,
+    "Num Positive per mm^2": 29.16
+  }
+}

195/TumorCenter_CD3_block6_x5_y9_patient195_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 16141.5,
+    "Centroid Y µm": 22912.9,
+    "Num Detections": 12032,
+    "Num Negative": 9837,
+    "Num Positive": 2195,
+    "Positive %": 18.24,
+    "Num Positive per mm^2": 1563.7
+  }
+}

195/TumorCenter_CD3_block6_x6_y9_patient195_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18815.0,
+    "Centroid Y µm": 22688.0,
+    "Num Detections": 24449,
+    "Num Negative": 21516,
+    "Num Positive": 2933,
+    "Positive %": 12.0,
+    "Num Positive per mm^2": 1105.4
+  }
+}

195/TumorCenter_CD8_block6_x5_y9_patient195_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 16191.4,
+    "Centroid Y µm": 23262.7,
+    "Num Detections": 14100,
+    "Num Negative": 12324,
+    "Num Positive": 1776,
+    "Positive %": 12.6,
+    "Num Positive per mm^2": 1134.2
+  }
+}

195/TumorCenter_CD8_block6_x6_y9_patient195_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18915.0,
+    "Centroid Y µm": 23162.7,
+    "Num Detections": 26751,
+    "Num Negative": 24630,
+    "Num Positive": 2121,
+    "Positive %": 7.929,
+    "Num Positive per mm^2": 784.08
+  }
+}

195/icd_codes.txt

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+Karzinom der Plica aryepiglottica[C13.1 L]

195/ops_codes.txt

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+Direkte diagnostische Pharyngoskopie[1-611.0 ] Direkte diagnostische Laryngoskopie[1-610.0 ] Diagnostische Ösophagogastroskopie bei normalem Situs[1-631.0 ] Perkutan-endoskopische Gastrostomie durch Fadendurchzugsmethode[5-431.20 ] Radikale zervikale Lymphadenektomie [Neck dissection] radikal erweitert 6 Regionen[5-403.32 L] Radikale zervikale Lymphadenektomie [Neck dissection] radikal modifiziert 5 Regionen[5-403.21 R] Deckung mit freiem Radialis-Lappen Kopf und Hals[5-858.70 L] Entnahme freier Radialis-Lappen[5-858.23 L] Entnahme von Spalthaut an Oberschenkel und Knie[5-901.0e R] Großflächige freie Spalthauttransplantation am Unterarm[5-902.48 L] Transplantat[5-295.14 ] Mikrochirurgische Technik (Zusatzkode)[5-984 ]

195/patient_clinical_data.json

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+{
+  "year_of_initial_diagnosis": 2018,
+  "age_at_initial_diagnosis": 48,
+  "sex": "male",
+  "smoking_status": "former",
+  "primarily_metastasis": "no",
+  "survival_status": "living",
+  "survival_status_with_cause": "living",
+  "first_treatment_intent": "curative",
+  "first_treatment_modality": "local surgery",
+  "days_to_first_treatment": 63,
+  "adjuvant_treatment_intent": "curative",
+  "adjuvant_radiotherapy": "yes",
+  "adjuvant_radiotherapy_modality": "percutaneous radiotherapy",
+  "adjuvant_systemic_therapy": "yes",
+  "adjuvant_systemic_therapy_modality": "cisplatin",
+  "adjuvant_radiochemotherapy": "yes"
+}

195/patient_pathological_data.json

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+{
+  "patient_id": "195",
+  "primary_tumor_site": "Hypopharynx",
+  "pT_stage": "pT1",
+  "pN_stage": "pN3b",
+  "grading": "G3",
+  "hpv_association_p16": "not_tested",
+  "number_of_positive_lymph_nodes": 6.0,
+  "number_of_resected_lymph_nodes": 17,
+  "perinodal_invasion": "no",
+  "lymphovascular_invasion_L": "yes",
+  "vascular_invasion_V": "no",
+  "perineural_invasion_Pn": "no",
+  "resection_status": "R0",
+  "resection_status_carcinoma_in_situ": "Ris0",
+  "carcinoma_in_situ": "no",
+  "closest_resection_margin_in_cm": "0.5",
+  "histologic_type": "SCC_Basaloid",
+  "infiltration_depth_in_mm": 6.0
+}

195/surgery_description.txt

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+TU resection, Bilateral neck dissection, Defect coverage, Free flap (Radial), Tracheostomy, PEG placement

195/surgery_report.txt

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+After appropriate preparation, first perform a diagnostic hypopharyngoscopy. There is no macroscopic evidence of a tumor, so several tissue samples are taken. From these, the PE from the piriform sinus is found to be infiltrated by tumor. Start of surgery after appropriate preparation. After sharp transection of the cutis, the subcutaneous cutis and the platysma as well as the subcutaneous fatty tissue and the platysma, the large metastasis is exposed. Exposure of the vascular nerve sheath caudally and ligation of the internal jugular vein. Dissection of the sternocleidomstoideus muscle caudally. Expose the digastric muscle starting at the posterior abdomen. From there, follow ventrally to the omohyodeus muscle. Locate and ligate the internal jugular vein cranially under the digastric muscle. Then dissect the common carotid artery starting from caudal to cranial. Contrary to the radiological report, the carotid artery is not infiltrated. Therefore, the bifurcation together with the internal and external carotid artery can be dissected away from the metastasis in a healthy layer. Exposure and preservation of the hypoglossal nerve on the left side until the end. The sternocleidomastoid muscle is then removed together with the cranial accessorius nerve. The metastasis is then mobilized laterally, including resection of the cervical plexus and parts of the underlying musculature. The phrenic nerve is exposed and spared until the end. However, the vagus nerve runs through the metastasis and is separated from it caudally and cranially. The large metastasis is then resected with the surrounding fatty tissue in the form of a radical neck dissection. Metastases extend caudally to the clavicle. It is assumed that the thoracic duct is also injured here. The surrounding connective tissue is therefore grasped and ligated. In addition, the caudal stump of the sternocleidomastoid muscle is further exposed and sutured onto the suspected defect site. The upper horn of the thyroid cartilage and the lateral part of the hyoid bone are then exposed. Complete mobilization of the hypoglossal nerve, which is turned upwards. Separation of the digastric muscle. Exposing the hypopharyngeal side wall and performing the lateral pharyngotomy. Enter the pharynx at approximately the level of the upper edge of the epiglottis. From there, the tumor is explored in the direction of the piriform sinus. This is about the size of a pea and is hard to the touch. Triggering of the piriform sinus so that the tumor can be successively excised under vision. The resection covers the entire piriform sinus on the left side and extends to the arytenoid cartilage on the left side. The specimen is then mounted on a cork plate with corresponding markings. The frozen section histology shows that there is still some CIS in the area of the medial margin, i.e. towards the posterior wall of the hypopharynx. Therefore, a resection is performed at this site and another frozen section is made at the margin, which then proves to be free of tumor and CIS. The defect measures approximately 5 1/2 x 5 cm, so that the corresponding radial lobe of <CLINICIAN_NAME> is elevated. Elevation of the radial forearm flap on the left (<CLINICIAN_NAME>/PJ): Palpatory identification of the distal radial artery. Marking of the flap borders (6 x 4 cm) on the distal forearm, proximal to the flexor retinaculum, with an S-shaped incision running proximally into the cubital fossa. Incision of cutaneous and subcutaneous tissue starting proximally. Identification and visualization of the venous confluence in the cubital fossa. Identification of the cephalic vein and dissection of the vein distally with integration into the radial graft margin. Identification of the ramus externus of the radial nerve and elevation of the radial portion, leaving the peritendineum of the tendons of the brachioradialis muscle intact. Subsequent ulnar incision down to the forearm fascia. Incision of the fascia and subsequent subfascial elevation of the ulnar edge of the graft up to the tendon of the flexor carpi radialis muscle. Care is taken to leave the peritendineum on the flexor tendons and to spare the ulnar artery. Identification of the distal radial artery and trial clamping with a vascular clamp. After 5 minutes with good oxygen saturation measured by pulse oximetry (measured on the index finger), the vessels are removed with subsequent ligation (Prolene 6.0). Successive detachment of the flap pedicle from the M. pronator quadratus and M. flexor pollicis longus with ligation of the outgoing perforators using a vessel clip into the cubital fossa. Exposure and protection of the radial nerve on the medial side of the brachioradialis muscle. Exposure of the brachial artery, V. mediana cubiti, A. ulnaris. First removal of the radial artery, then of two veins of the superficial venous system. Vascular ligation by means of a bypass ligature (artery) and vascular clip (veins). Subtle hemostasis in the area of the wound bed using bipolar coagulation forceps. Two-layer wound closure in the area of the proximal forearm. Defect coverage of the graft bed with split skin from the right thigh in the usual manner. Suturing of preparation swabs. Application of a wound dressing and a forearm splint. Completion of graft elevation without complications. PEG placement (<CLINICIAN_NAME>/<CLINICIAN_NAME>): Entering with the gastroesophagoscope under air insufflation, pre-scanning into the stomach. After spontaneous diaphanoscopy, insertion of a PEG in the typical manner using the thread pull-through method. Neck dissection is then performed on the right side. All non-lymphatic structures in regions II to V are removed while sparing them. The facial artery is then traced up to the lower jaw and deposited there so that it can be used for subsequent anastomosis. A breakthrough is then created via the supralaryngeal muscles to the opposite side for insertion of the flap pedicle. After lifting the radial flap, it is sutured into the hypopharyngeal defect. The pedicle is then passed over the entire transition to the opposite side and arterially connected to the facial artery there. The venous anastomosis is made with 2 veins to the internal jugular vein. The lifting defect is then treated with split skin from the right thigh of <CLINICIAN_NAME>. Subsequently reintubation onto an 8 . cannula. Complete wound closure after insertion of Redon drains and 2 drainage flaps in the neck. End of the operation, transfer of the patient to anesthesia. Conclusion: Resection of a small piriform sinus carcinoma on the left side via lateral pharyngectomy with a large metastasis on the left side. Contrary to the radiological findings, the common carotid artery was not infiltrated by the tumor. Radical neck dissection on the left side and selective neck dissection on the right side. Defect coverage with radial lobe graft from the left forearm. Due to the extensive metastasis, adjuvant radiochemotherapy is recommended.

196/InvasionFront_CD3_block14_x3_y7_patient196_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 11768.8,
+    "Centroid Y µm": 21413.7,
+    "Num Detections": 15677,
+    "Num Negative": 15433,
+    "Num Positive": 244,
+    "Positive %": 1.556,
+    "Num Positive per mm^2": 137.69
+  }
+}

196/InvasionFront_CD3_block14_x4_y7_patient196_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 14417.4,
+    "Centroid Y µm": 21438.6,
+    "Num Detections": 19692,
+    "Num Negative": 18792,
+    "Num Positive": 900,
+    "Positive %": 4.57,
+    "Num Positive per mm^2": 399.42
+  }
+}

196/InvasionFront_CD8_block14_x3_y7_patient196_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 11918.7,
+    "Centroid Y µm": 17115.9,
+    "Num Detections": 16978,
+    "Num Negative": 16824,
+    "Num Positive": 154,
+    "Positive %": 0.9071,
+    "Num Positive per mm^2": 84.48
+  }
+}

196/InvasionFront_CD8_block14_x4_y7_patient196_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 14417.4,
+    "Centroid Y µm": 17140.9,
+    "Num Detections": 20396,
+    "Num Negative": 19749,
+    "Num Positive": 647,
+    "Positive %": 3.172,
+    "Num Positive per mm^2": 280.35
+  }
+}

196/TumorCenter_CD3_block14_x3_y7_patient196_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 11468.9,
+    "Centroid Y µm": 17765.6,
+    "Num Detections": 16693,
+    "Num Negative": 15581,
+    "Num Positive": 1112,
+    "Positive %": 6.661,
+    "Num Positive per mm^2": 522.03
+  }
+}

196/TumorCenter_CD3_block14_x4_y7_patient196_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 13942.6,
+    "Centroid Y µm": 17915.5,
+    "Num Detections": 15739,
+    "Num Negative": 15131,
+    "Num Positive": 608,
+    "Positive %": 3.863,
+    "Num Positive per mm^2": 257.71
+  }
+}

196/TumorCenter_CD8_block14_x3_y7_patient196_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 10794.3,
+    "Centroid Y µm": 17990.5,
+    "Num Detections": 18275,
+    "Num Negative": 17007,
+    "Num Positive": 1268,
+    "Positive %": 6.938,
+    "Num Positive per mm^2": 604.27
+  }
+}

196/TumorCenter_CD8_block14_x4_y7_patient196_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 13243.0,
+    "Centroid Y µm": 17990.5,
+    "Num Detections": 17836,
+    "Num Negative": 17271,
+    "Num Positive": 565,
+    "Positive %": 3.168,
+    "Num Positive per mm^2": 242.74
+  }
+}

196/icd_codes.txt

@@ -0,0 +1 @@
+Bösartige Neubildung: Glottis[C32.0 ]

196/ops_codes.txt

@@ -0,0 +1 @@
+Diagnostische Mikrolaryngoskopie[1-610.2 ] Sonstige diagnostische Pharyngoskopie[1-611.x ] Endoskopische Laserresektion am Larynx[5-302.5 ]

196/patient_clinical_data.json

@@ -0,0 +1,18 @@
+{
+  "year_of_initial_diagnosis": 2015,
+  "age_at_initial_diagnosis": 65,
+  "sex": "male",
+  "smoking_status": "smoker",
+  "primarily_metastasis": "no",
+  "survival_status": "living",
+  "survival_status_with_cause": "living",
+  "first_treatment_intent": "curative",
+  "first_treatment_modality": "local surgery",
+  "days_to_first_treatment": 28,
+  "adjuvant_treatment_intent": null,
+  "adjuvant_radiotherapy": "no",
+  "adjuvant_radiotherapy_modality": null,
+  "adjuvant_systemic_therapy": "no",
+  "adjuvant_systemic_therapy_modality": null,
+  "adjuvant_radiochemotherapy": "no"
+}

196/patient_pathological_data.json

@@ -0,0 +1,20 @@
+{
+  "patient_id": "196",
+  "primary_tumor_site": "Larynx",
+  "pT_stage": "pT1",
+  "pN_stage": "NX",
+  "grading": "G2",
+  "hpv_association_p16": "not_tested",
+  "number_of_positive_lymph_nodes": NaN,
+  "number_of_resected_lymph_nodes": 0,
+  "perinodal_invasion": null,
+  "lymphovascular_invasion_L": "no",
+  "vascular_invasion_V": "no",
+  "perineural_invasion_Pn": "no",
+  "resection_status": "RX",
+  "resection_status_carcinoma_in_situ": "CIS Absent",
+  "carcinoma_in_situ": "no",
+  "closest_resection_margin_in_cm": null,
+  "histologic_type": "SCC_Conventional-Keratinizing",
+  "infiltration_depth_in_mm": NaN
+}

196/surgery_description.txt

@@ -0,0 +1 @@
+Laser resection

196/surgery_report.txt

@@ -0,0 +1 @@
+Initially induction of anesthesia and transoral and tracheal intubation using a laser tube by the anesthesia colleagues and positioning of the patient by the surgeon. Adjustment of the endolaryngeal findings. This revealed a pronounced exophytic mass starting from the area of the vocal process of the left arytenoid cartilage, growing anteriorly into the anterior commissure, growing laterally into the pocket fold, thus T2 glottic laryngeal carcinoma. With good adjustability, decision to attempt transoral laser resection. Setting the laser beam to continuous mode 6 watts. The laser moves around the mass. It is then possible to remove the mass macroscopically in toto using the piecemeal technique. Three marginal samples are then taken (supraglottis, anterior commissure, vocal process). All three marginal samples were found to be tumor-free by the pathology colleague <CLINICIAN_NAME>. An R0 resection can therefore be assumed. Repeated inspection. Hemostasis using monopolar coagulation and swabs soaked in suprarenin. Dry conditions. Removal of the Kleinsasser tube. Completion of the procedure without complications. Transoral laser resection of an R0 resection of a cT2 glottic laryngeal carcinoma on the left. Please schedule follow-up MLE in 8 weeks.

197/InvasionFront_CD3_block12_x1_y2_patient197_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 4772.5,
+    "Centroid Y µm": 9445.0,
+    "Num Detections": 19177,
+    "Num Negative": 18961,
+    "Num Positive": 216,
+    "Positive %": 1.126,
+    "Num Positive per mm^2": 126.55
+  }
+}

197/InvasionFront_CD3_block12_x2_y2_patient197_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 7272.7,
+    "Centroid Y µm": 9857.6,
+    "Num Detections": 14069,
+    "Num Negative": 13440,
+    "Num Positive": 629,
+    "Positive %": 4.471,
+    "Num Positive per mm^2": 452.57
+  }
+}

197/InvasionFront_CD8_block12_x1_y2_patient197_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 4047.9,
+    "Centroid Y µm": 9245.1,
+    "Num Detections": 17113,
+    "Num Negative": 16920,
+    "Num Positive": 193,
+    "Positive %": 1.128,
+    "Num Positive per mm^2": 114.65
+  }
+}

197/InvasionFront_CD8_block12_x2_y2_patient197_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 6611.4,
+    "Centroid Y µm": 9255.9,
+    "Num Detections": 11737,
+    "Num Negative": 11332,
+    "Num Positive": 405,
+    "Positive %": 3.451,
+    "Num Positive per mm^2": 320.09
+  }
+}

197/TumorCenter_CD3_block12_x1_y2_patient197_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 3848.0,
+    "Centroid Y µm": 5547.1,
+    "Num Detections": 14010,
+    "Num Negative": 13810,
+    "Num Positive": 200,
+    "Positive %": 1.428,
+    "Num Positive per mm^2": 128.15
+  }
+}

197/TumorCenter_CD3_block12_x2_y2_patient197_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 6346.6,
+    "Centroid Y µm": 5272.2,
+    "Num Detections": 16995,
+    "Num Negative": 16475,
+    "Num Positive": 520,
+    "Positive %": 3.06,
+    "Num Positive per mm^2": 287.93
+  }
+}

197/TumorCenter_CD8_block12_x1_y2_patient197_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 7321.1,
+    "Centroid Y µm": 14292.4,
+    "Num Detections": 9611,
+    "Num Negative": 9527,
+    "Num Positive": 84,
+    "Positive %": 0.874,
+    "Num Positive per mm^2": 59.87
+  }
+}

197/TumorCenter_CD8_block12_x2_y2_patient197_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 9919.7,
+    "Centroid Y µm": 14342.4,
+    "Num Detections": 16140,
+    "Num Negative": 16044,
+    "Num Positive": 96,
+    "Positive %": 0.5948,
+    "Num Positive per mm^2": 52.04
+  }
+}

197/history_text.txt

@@ -0,0 +1 @@
+The patient was diagnosed with an extensive, suspicious mass with cT4a cN2c oropharyngeal carcinoma as part of a panendoscopy. No malignancy could be detected in the sample taken. Due to the clinically and radiologically clearly malignant tumor formation, indication for resection with partial pharyngectomy and laryngectomy. Sonographic cN2c neck status without infiltration of neck structures,