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709/surgery_description.txt

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+Tongue partial resection, Floor of mouth partial resection, Bilateral neck dissection, Defect coverage (Radial), Endoscopy

709/surgery_report.txt

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+First, after insertion of the mouth guard, re-inspection of the tumor region with the Kleinsasser microlaryngoscope. Now resection of the tongue tumor from the enoral side after insertion of the mouth guard, starting at the tip of the tongue, almost in the median line dorsally with the monopolar. The mass, which on the surface only appears as a small ulcer on the left side between the edge of the tongue and the floor of the mouth, shows extensive infiltrative growth in depth and spherical growth towards the body of the tongue. The tumor is now gradually bypassed dorsally towards the base of the tongue and resection is now performed in the area of the base of the tongue towards the floor of the mouth. Here, the tumor is also bypassed with an appropriate safety margin. The tumor also shows a cone-like growth in depth, which is carefully bypassed and lifted accordingly. The neck is now dissected, first on the left side. To do this, make a skin incision along the anterior edge of the sternocleidomastoid, ending in a skin fold. Dissection of the platysmal flap and dissection of the sternocleidomastoid anterior edge. Exposure of the vascular nerve sheath and further dissection along the omohyoid muscle to the hyoid bone. Dissection along the digastric muscle towards the base of the skull and removal of levels II, III and IV. Level V is then removed, as there are two macroscopically conspicuous lymph nodes in level IIa. All vascular and nerve structures in the neck area are spared after exposure and re-embedding of nerves X, XI, XII. This is followed by exposure and re-embedding of the marginal ramus and mandibular nerve and dissection and removal of level Ib, including the submandibular gland. This results in a thorough effect in the complete removal of the basal margin of the tumor. The large penetrating defect is used in the further course of the reconstruction, the pedicle pull-through. This is followed by neck dissection on the right side. The skin incision is the same as on the left. Dissection of the platysmal flap and exposure of the vascular nerve sheath. Careful evacuation of level II, III and IV without evidence of macroscopically conspicuous lymph nodes. Redon drainage is inserted here, subcutaneous and skin sutures are used. N. hypoglossus, N. accessorius and N. vagus are exposed and re-embedded. The next step is to lift the forearm graft after carefully measuring the tissue to be lifted. The graft is marked accordingly on the forearm, prepared and lifted from distal to proximal. The lifting ends in the area of the crook of the elbow and the superficial and deep venous system is taken along. The radial ramus superficial nerve is exposed and spared during dissection. The tourniquet is opened and careful hemostasis is performed. The graft is then removed and incorporated enorally to reconstruct the tongue and floor of the mouth. After appropriate incorporation, the vessels are anastomosed in the sense of an end-to-end anastomosis of the superior thyroid artery with the radial artery and end-to-end anastomosis of the flap vein with a branch of the facial vein using a size 3.0 coupler. Checking the vascular flows, which are excellent, and finally subcutaneous sutures and skin sutures here too. The lifting defect in the area of the right forearm is covered with full-thickness skin, which is lifted in the area of the right groin, and partially closed primarily. Application of a vacuum dressing and a Kramer splint to immobilize the forearm. The groin wound is treated with a Redon drain and closed primarily with subcutaneous sutures and skin sutures. After re-inspection of the findings, minimal swelling and a completely clear airway, a tracheostomy is not performed at this stage. This may have to be done secondarily. The vascular signals to be duplicated are drawn in the neck area.

710/history_text.txt

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+Patient with histologically confirmed hypopharyngeal carcinoma on the left in the anterior and lateral wall area. The above procedure was therefore indicated. Histologically squamous cell carcinoma. Previous panendoscopy without further findings.

710/icd_codes.txt

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+ND 2-zeitig[C13.2 ]

710/ops_codes.txt

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+Direkte diagnostische Pharyngoskopie[1-611.0 ] Direkte diagnostische Laryngoskopie[1-610.0 ] Permanente Tracheotomie[5-312.0 ] Transorale radikale Resektion des Pharynx [Pharyngektomie] sonstige[5-296.0x ]

710/patient_pathological_data.json

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+{
+  "patient_id": "710",
+  "primary_tumor_site": "Hypopharynx",
+  "pT_stage": "pT1",
+  "pN_stage": "pN3b",
+  "grading": "G3",
+  "hpv_association_p16": "not_tested",
+  "number_of_positive_lymph_nodes": 1.0,
+  "number_of_resected_lymph_nodes": 35,
+  "perinodal_invasion": "yes",
+  "lymphovascular_invasion_L": "no",
+  "vascular_invasion_V": "no",
+  "perineural_invasion_Pn": "no",
+  "resection_status": "R0",
+  "resection_status_carcinoma_in_situ": "CIS Absent",
+  "carcinoma_in_situ": "no",
+  "closest_resection_margin_in_cm": "0.5",
+  "histologic_type": "SCC_Conventional-NonKeratinizing",
+  "infiltration_depth_in_mm": 1.0
+}

710/surgery_description.txt

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+Laser resection, Tracheotomy

710/surgery_report.txt

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+First position the patient after intubation. Insertion of mouth guard. Entry with the spreading laryngoscope. Positioning of the tumor. This appears slightly larger than described with slightly flatter extensions downwards and also medially. Endoscopically controlled laser resection of the tumor is now performed. The tumor is incised on all sides with a safety margin of at least 10 mm and removed macroscopically and microscopically in the healthy tissue. Resection includes the lateral arytenoid fold, anterior piriform sinus wall and lateral piriform sinus wall up to the tip, the piriform sinus caudally and the beginning of the base of the tongue cranially. The tumor is removed in several sections. Subsequently, edge samples are taken caudally from the adjacent piriform sinus, from the arytenoid fold on the left, from the piriform sinus entrance cranially as well as laterally from the area of the pharyngeal wall and laterobasally from the area of the still existing muscular pharyngeal wall. All marginal samples were tumor-free in the frozen section. Thus R0 status. Careful hemostasis is now performed. The operation is completed when the site is free of bleeding. Due to the patient's overall situation, a tracheostomy is initially not performed. The patient should be transferred to intensive care and extubated the next day in a controlled manner; if complications arise here, a tracheostomy is probably unavoidable. Neck dissection necessary on both sides at intervals with N+ status. Feeding via the inserted gastric tube and diet build-up after 5 to 7 days or swallowing training. Tracheotomy by <CLINICIAN_NAME> and <CLINICIAN_NAME>. Marking of the landmarks, sterile abjodation. Skin incision and dissection through the subcutaneous fatty tissue. Now strict perforation in the midline down to the prelaryngeal musculature, where a larger vein is ligated on both sides. Cut through the prelaryngeal muscles and push them aside. Now locate the cricoid cartilage and dissect the thyroid gland below the cricoid cartilage. Careful dissection of the trachea and undermining of the thyroid gland. Bipolar coagulation of the thyroid gland and transection of the thyroid gland. Exposure of the trachea using pedicle swabs. The trachea is now exposed in a clearly visible area. After consultation with the anaesthetist, enter the trachea between the 2nd and 3rd tracheal cartilage and create a visor tracheotomy. Suturing of the tracheostoma in the usual manner. Problem-free reintubation blocked on an 8 mm cannula.

711/InvasionFront_CD3_block19_x1_y10_patient711_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 3997.9,
+    "Centroid Y µm": 26585.9,
+    "Num Detections": 0,
+    "Num Negative": 0,
+    "Num Positive": 0,
+    "Positive %": NaN,
+    "Num Positive per mm^2": NaN
+  }
+}

711/InvasionFront_CD8_block19_x1_y10_patient711_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 4147.8,
+    "Centroid Y µm": 34781.6,
+    "Num Detections": 11235,
+    "Num Negative": 10874,
+    "Num Positive": 361,
+    "Positive %": 3.213,
+    "Num Positive per mm^2": 251.06
+  }
+}

711/InvasionFront_CD8_block19_x2_y10_patient711_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 6521.5,
+    "Centroid Y µm": 34756.6,
+    "Num Detections": 16341,
+    "Num Negative": 16268,
+    "Num Positive": 73,
+    "Positive %": 0.4467,
+    "Num Positive per mm^2": 39.39
+  }
+}

711/TumorCenter_CD3_block19_x1_y10_patient711_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 6244.0,
+    "Centroid Y µm": 27138.6,
+    "Num Detections": 5387,
+    "Num Negative": 5086,
+    "Num Positive": 301,
+    "Positive %": 5.588,
+    "Num Positive per mm^2": 176.74
+  }
+}

711/TumorCenter_CD3_block19_x2_y10_patient711_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 8799.4,
+    "Centroid Y µm": 26681.1,
+    "Num Detections": 8698,
+    "Num Negative": 8006,
+    "Num Positive": 692,
+    "Positive %": 7.956,
+    "Num Positive per mm^2": 403.24
+  }
+}

711/TumorCenter_CD8_block19_x2_y10_patient711_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 9145.2,
+    "Centroid Y µm": 36255.8,
+    "Num Detections": 17560,
+    "Num Negative": 17126,
+    "Num Positive": 434,
+    "Positive %": 2.472,
+    "Num Positive per mm^2": 223.12
+  }
+}

711/icd_codes.txt

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+Karzinom Hypopharynx mehrere Teilbereiche überlappend[C13.8 R] Halslymphknotenmetastasen[C77.0 R]

711/ops_codes.txt

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+Laryngopharyngektomie mit Rekonstruktion mit lokaler Schleimhaut[5-303.11 ] Partielle Resektion des Pharynx [Pharynxteilresektion] durch Pharyngotomie mit Rekonstruktion mit lokaler Schleimhaut[5-295.11 ] Radikale zervikale Lymphadenektomie [Neck dissection] radikal modifiziert 5 Regionen[5-403.21 B] Sonstige permanente Tracheostomie[5-312.x ] Inzision Zungengrund[5-250.x ]

711/patient_clinical_data.json

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+{
+  "year_of_initial_diagnosis": 2016,
+  "age_at_initial_diagnosis": 68,
+  "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": 49,
+  "adjuvant_treatment_intent": null,
+  "adjuvant_radiotherapy": "yes",
+  "adjuvant_radiotherapy_modality": null,
+  "adjuvant_systemic_therapy": "yes",
+  "adjuvant_systemic_therapy_modality": null,
+  "adjuvant_radiochemotherapy": "yes"
+}

711/patient_pathological_data.json

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+{
+  "patient_id": "711",
+  "primary_tumor_site": "Larynx",
+  "pT_stage": "pT3",
+  "pN_stage": "pN3b",
+  "grading": "G3",
+  "hpv_association_p16": "not_tested",
+  "number_of_positive_lymph_nodes": 1.0,
+  "number_of_resected_lymph_nodes": 18,
+  "perinodal_invasion": "yes",
+  "lymphovascular_invasion_L": "no",
+  "vascular_invasion_V": "no",
+  "perineural_invasion_Pn": "no",
+  "resection_status": "R0",
+  "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": 5.0
+}

711/surgery_description.txt

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+Laryngectomy, Partial pharyngectomy, Neck dissection

711/surgery_report.txt

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+Induction of anesthesia and intubation by the anesthesia colleagues. Sterile washing and draping. Creation of an apron flap and start of neck dissection on the right side. The skin over the metastases is dissected off for this purpose; the platysma cannot be spared in part as it is adherent to the metastases. Exposure of the sternocleidomastoid muscle in the caudal region. Separation of the sternocleidomastoid muscle. Exposure of the internal jugular vein. Dissection of the large metastases from the internal jugular vein in the caudal region. Then removal of the omohyoid muscle. Dissection of the common carotid artery. Dissection of the division into external and internal carotid artery. Both divisions can be preserved, but the facial artery runs directly into the tumor. The superior thyroid artery also enters the tumor. The hypoglossal nerve and the accessory nerve extend into this metastatic tumor, as do the plexus branches, all of which are completely resected. The submandibular gland is partially resected. The neck conglomerate is sent for final histology with suture marking. Level II b is then removed and sent for histology. Neck dissection on the left side is performed by <CLINICIAN_NAME>. After subplatysmal dissection of the apron flap up to the submandibular gland, the neck is dissected on the left side. Open the capsule of the submandibular gland and dissect in depth to expose the digastric muscle. Exposure of the accessorius nerve and exposure of the nerve. This can be completely preserved. Dissection of the neck specimen along the anterior venter of the digastric muscle and detachment of the specimen up to the hyoid bone. Exposure of the facial vein. Identification of the hypoglossal nerve. The facial vein can be preserved. Sharp dissection on the vein and lateral striking of the neck preparation. The vein can be completely detached from the neck specimen by inserting a .............................. The common carotid artery and vagus nerve are exposed. The neck preparation is now detached from the deep cervical fascia from cranial to caudal. Particular care is taken to spare the deep branches of the cervical plexus. The accessorius nerve is also not injured. After releasing the neck preparation, inspect the wound area. After hemostasis with the bipolar coagulation forceps, there is no further bleeding. After removal of the neck specimen at the level of the junction of the omohyoid muscle and the internal jugular vein, there is no evidence of a chyle fistula. Exposure of the outlets of the external carotid artery (the superior thyroid artery and the facial artery can be safely exposed and dissected). Completion of the neck dissection on the left side without complications. Now release of the larynx by <CLINICIAN_NAME>. Skeletonization of the hyoid bone. Removal of the hyoid bone. Release of the piriform sinus. Neck level VI was removed beforehand. Then entering the pharynx from the left side. It can be seen that the tumor grows very far into the base of the tongue. Tumor resection with a safety margin of 1 ˝ cm. Cut down towards the postcricoid region, first on the left side, then on the right side. Some of the pharynx must also be resected on the right side. Then place the larynx below the cricoid cartilage and send the specimen marked with a suture for frozen section. All frozen sections are designated as R0, but at one point with a safety margin of just under 0.2 cm. A resection of the pharyngeal mucosa on the left side is taken, which is then also designated as R0. Now insertion of a Provox Vega prosthesis size 10 in the usual manner. Mobilization of the base of the tongue and the pharynx in the cranial region. Pharyngeal suture in the usual manner in two layers. A T-shaped suture must be applied in the area of the base of the tongue, as otherwise there is too much tension due to the relatively large amount of mucosa missing here. However, due to the overall situation of the patient and the still sufficient mucosa for a primary closure, the decision is made against a free graft or a pedicled graft. Finally, a mucocutaneous anastomosis is created at the tracheostoma. Insertion of Redon drains. Two-layer wound closure and completion of the procedure without complications. The patient is ventilated and admitted to the intensive care unit. Please continue antibiotics for at least 24 hours. X-ray gruel swallow in this case only after the 14th postoperative day.

712/InvasionFront_CD3_block2_x3_y10_patient712_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 13392.9,
+    "Centroid Y µm": 38404.7,
+    "Num Detections": 23465,
+    "Num Negative": 20058,
+    "Num Positive": 3407,
+    "Positive %": 14.52,
+    "Num Positive per mm^2": 1312.4
+  }
+}

712/InvasionFront_CD3_block2_x4_y10_patient712_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 15841.6,
+    "Centroid Y µm": 38479.6,
+    "Num Detections": 23770,
+    "Num Negative": 20847,
+    "Num Positive": 2923,
+    "Positive %": 12.3,
+    "Num Positive per mm^2": 1131.5
+  }
+}

712/InvasionFront_CD8_block2_x3_y10_patient712_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 12243.5,
+    "Centroid Y µm": 26111.2,
+    "Num Detections": 22554,
+    "Num Negative": 20259,
+    "Num Positive": 2295,
+    "Positive %": 10.18,
+    "Num Positive per mm^2": 904.25
+  }
+}

712/InvasionFront_CD8_block2_x4_y10_patient712_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 14742.2,
+    "Centroid Y µm": 26236.1,
+    "Num Detections": 22862,
+    "Num Negative": 20649,
+    "Num Positive": 2213,
+    "Positive %": 9.68,
+    "Num Positive per mm^2": 881.66
+  }
+}

712/TumorCenter_CD3_block2_x3_y10_patient712_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 10794.3,
+    "Centroid Y µm": 24462.0,
+    "Num Detections": 21274,
+    "Num Negative": 16498,
+    "Num Positive": 4776,
+    "Positive %": 22.45,
+    "Num Positive per mm^2": 1941.6
+  }
+}

712/TumorCenter_CD3_block2_x4_y10_patient712_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 13342.9,
+    "Centroid Y µm": 24736.9,
+    "Num Detections": 18069,
+    "Num Negative": 15153,
+    "Num Positive": 2916,
+    "Positive %": 16.14,
+    "Num Positive per mm^2": 1466.2
+  }
+}

712/TumorCenter_CD8_block2_x3_y10_patient712_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 13118.1,
+    "Centroid Y µm": 24761.9,
+    "Num Detections": 12220,
+    "Num Negative": 8940,
+    "Num Positive": 3280,
+    "Positive %": 26.84,
+    "Num Positive per mm^2": 2282.1
+  }
+}

712/TumorCenter_CD8_block2_x4_y10_patient712_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 15791.6,
+    "Centroid Y µm": 24587.0,
+    "Num Detections": 0,
+    "Num Negative": 0,
+    "Num Positive": 0,
+    "Positive %": NaN,
+    "Num Positive per mm^2": NaN
+  }
+}

712/icd_codes.txt

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+Halslymphknotenmetastasen[C77.0 R]

712/ops_codes.txt

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+Transorale radikale Resektion des Pharynx mit Rekonstruktion mit freiem mikrovaskulär-anastomosierten Transplantat[5-296.04 ] Sonstige partielle Glossektomie Rekonstruktion mit freiem mikrovaskulär-anastomosierten Transplantat[5-251.x2 ] Selektive Neck dissection in 4 Regionen[5-403.03 B] Sonstige permanente Tracheostomie[5-312.x ] Sonstige perkutan-endoskopisch Gastrostomie (PEG)[5-431.2x ] Partielle Exzision [erkrankter] harter und weicher Gaumen[5-272.1 ] Extraktion mehrerer Zähne eines Quadranten[5-230.2 ] Wechsel eines vaskulären Implantates[5-394.3 ] Sonstige diagnostische Ösophagogastroskopie[1-631.x ] Deckung mit freiem Radialis-Lappen Kopf und Hals[5-858.70 L] Spalthaut Entnahmestelle sonstige[5-901.0x R] Spalthautdeckung auf granulierendes Hautareal großflächig Empfängerstelle Unterarm[5-902.58 L]

712/patient_clinical_data.json

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+{
+  "year_of_initial_diagnosis": 2015,
+  "age_at_initial_diagnosis": 58,
+  "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": 21,
+  "adjuvant_treatment_intent": "curative",
+  "adjuvant_radiotherapy": "yes",
+  "adjuvant_radiotherapy_modality": "percutaneous radiotherapy",
+  "adjuvant_systemic_therapy": "yes",
+  "adjuvant_systemic_therapy_modality": "fluorouracil + cisplatin",
+  "adjuvant_radiochemotherapy": "yes"
+}

712/patient_pathological_data.json

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+{
+  "patient_id": "712",
+  "primary_tumor_site": "Oropharynx",
+  "pT_stage": "pT4a",
+  "pN_stage": "pN2",
+  "grading": "hpv_association_p16",
+  "hpv_association_p16": "positive",
+  "number_of_positive_lymph_nodes": 3.0,
+  "number_of_resected_lymph_nodes": 31,
+  "perinodal_invasion": "yes",
+  "lymphovascular_invasion_L": "yes",
+  "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": 14.0
+}

712/surgery_description.txt

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+Combined tumor resection, Bilateral neck dissection, Defect coverage, Free flap (Radial), PEG placement, Tracheotomy

712/surgery_report.txt

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+Induction of anesthesia and intubation by the anesthetist, then sterile washing and draping. Insertion of a covered retractor. Snare the tongue, then inspect the tumor region. The tumor extends from the base of the tongue to the tonsil region to the anterior and posterior palatal arch and passes over to the soft palate and extends to the base of the uvula, but does not infiltrate it. First transoral tumor resection using a monopolar needle, scissors and bipolar forceps so that the tumor is detached from the soft palate and the tonsil region as well as from the tongue margin. Then switch to the transcervical approach. To do this, make a skin incision in a transverse skin fold 2 ˝ cm below the lower jaw. Exposure of the sternocleidomastoid muscle. Exposure of the omohyoid muscle. Showing the submandibular gland. Exposure of the cervical vascular sheath. First resection of the submandibular gland. The lower part of the tumor is then immediately encountered. A pharyngotomy is performed here, then the tumor is dislocated transcervically and successively cut around. It can be removed en bloc. The entire tumor is then thread-marked and sent for frozen section. In the frozen section, all edges are tumor-free. Basally in the area of the tongue, the margins are only very narrowly resected. Therefore, a resection is made here again, which is sent for final histology. Now complete the neck dissection. For this, free preparation of the internal jugular vein. Exposure of the N. accessorius, the V. facialis, which must be removed, the A. thyroidea superior and removal of the neck IIa to Va while sparing the plexus branches. Measurement of the defect reveals a fairly large defect in the area of the edge of the tongue and the oropharynx. The flap is then configured so that one part can cover the posterior pharyngeal wall and one part goes to the tongue with a notch so that the tongue is not fixed later. This graft is drawn onto the forearm. Then cut around the skin. Exposure of the brachioradialis muscle. Exposure of the cephalic vein, exposure of the deep venous system in the crook of the elbow. The patient has no direct confluence in the crook of the elbow between the superficial and deep systems. The cephalic vein is therefore directly integrated with the graft. Exposure of the superficial ramus, radial nerve, this divides into 2 branches, unfortunately one branch cannot be preserved, but the larger main branch remains. Then visualization of the radial artery, clamping, ligation and repositioning of the radial artery. Detach the graft from the tendon bed, then dissect the pedicle in the usual way. Smaller vessels are clipped and bipolar coagulated. Then dissection of the vessel outlet in the elbow area. Exposure and identification of the ulnar and interosseous arteries. The radial artery is removed distally from its outlet. The cephalic vein and a larger accompanying vessel of the radial artery are dissected for the venous connection. The arm is then closed in the usual way using split skin. Neck dissection on the left side and tracheotomy by <CLINICIAN_NAME> are now performed in parallel with graft elevation. Now proceed to the tracheotomy: First mark the landmarks (jugulum, cricoid cartilage, thyroid incisura). Mark the skin incision. This is located at mid-height between the jugulum and the cricoid cartilage. Skin incision at a length of approx. 4 cm. Dissection through the subcutaneous tissue. Two larger veins must be ligated and cut. Then dissect the linea alba of the infrahyoid musculature. Spread the muscles apart. Finding the thyroid isthmus. This is now dissected along the trachea. Then insertion of the Pean clamps and transection of the isthmus after bipolar coagulation. Ligation of the left and right isthmus. Free preparation of the trachea. Entering the trachea after preoxygenation between the 2nd and 3rd tracheal cartilage. Formation of a Björk flap and tracheocutaneous anastomosis in the typical manner. Retubing of the patient to a 9-gauge cannula. Proceed to neck dissection on the left side. The incision is first made at a length of approx. 7 to 8 cm, approx. 2 transverse fingers below the mandible in a skin fold. Dissection through the subcutaneous tissue. Exposure and separation of the platysma and formation of a platysmal flap. This is exposed cranially and caudally. The anterior edge of the sternocleidomastoid muscle is then dissected caudally to the omohyoid muscle, which is then dissected cranially/medially. Further dissection of the anterior edge of the sternocleidomastoid muscle. Locate the submandibular gland. Dissection of the caudal glandular capsule and insertion into the anterior neck preparation. Locate the digaster venter muscle posteriorly and move along it anteriorly as far as the hyoid. Release the anterior neck preparation while protecting the hypoglossal nerve, which can be visualized and protected. Now dissect the cervical vascular sheath. The internal jugular vein and facial vein are exposed and spared. The common carotid artery and external carotid artery are exposed and spared, as are the vagus nerve and the cervical artery. The accessorius nerve is then explored. Dissection of level II b. Detachment of the fatty tissue with the lymph nodes along the sternocleidomastoid muscle and the internal jugular vein to level IV caudally, level V is also removed. The fatty tissue is ligated and removed caudally in level IV. Detachment of the lateral neck preparation. Subsequent insertion of an 8 Redon drain. Subcutaneous suture with 3.0 Vicryl and skin suture with 4.0 Ethilon. Now insertion of the graft, first transcervically, then transorally. This is relatively difficult as the uvula, tongue and the entire oral mucosa are very swollen. In the end, the graft can be inserted completely. The vessels for the anastomosis are now exposed. For this purpose, the superior thyroid artery and the facial vein as well as an outlet from the internal jugular vein are taken. Finally, an artery and two veins are connected, which is successful without any problems and ensures good perfusion in the graft area. Insertion of a flap and two-layer wound closure. Re-intubation to a 9 mm tracheostomy tube. The patient is ventilated and admitted to the intensive care unit. Please X-ray pre-swallow on the 10th postoperative day, until then nutrition via the previously inserted PEG tube. The PEG tube was inserted with good diaphanoscopy using the thread pull-through method.

713/InvasionFront_CD3_block15_x5_y4_patient713_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18040.4,
+    "Centroid Y µm": 19864.5,
+    "Num Detections": 20199,
+    "Num Negative": 17185,
+    "Num Positive": 3014,
+    "Positive %": 14.92,
+    "Num Positive per mm^2": 1246.5
+  }
+}

713/InvasionFront_CD3_block15_x6_y4_patient713_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 20664.1,
+    "Centroid Y µm": 19589.6,
+    "Num Detections": 20088,
+    "Num Negative": 17650,
+    "Num Positive": 2438,
+    "Positive %": 12.14,
+    "Num Positive per mm^2": 954.01
+  }
+}

713/InvasionFront_CD8_block15_x5_y4_patient713_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 16194.7,
+    "Centroid Y µm": 9737.2,
+    "Num Detections": 17759,
+    "Num Negative": 16260,
+    "Num Positive": 1499,
+    "Positive %": 8.441,
+    "Num Positive per mm^2": 671.65
+  }
+}

713/InvasionFront_CD8_block15_x6_y4_patient713_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18853.6,
+    "Centroid Y µm": 9726.3,
+    "Num Detections": 17759,
+    "Num Negative": 16885,
+    "Num Positive": 874,
+    "Positive %": 4.921,
+    "Num Positive per mm^2": 400.78
+  }
+}

713/TumorCenter_CD3_block15_x5_y4_patient713_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 16491.3,
+    "Centroid Y µm": 13293.0,
+    "Num Detections": 17843,
+    "Num Negative": 13601,
+    "Num Positive": 4242,
+    "Positive %": 23.77,
+    "Num Positive per mm^2": 1887.0
+  }
+}

713/TumorCenter_CD3_block15_x6_y4_patient713_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18989.9,
+    "Centroid Y µm": 13317.9,
+    "Num Detections": 18702,
+    "Num Negative": 16655,
+    "Num Positive": 2047,
+    "Positive %": 10.95,
+    "Num Positive per mm^2": 953.41
+  }
+}

713/TumorCenter_CD8_block15_x5_y4_patient713_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18940.0,
+    "Centroid Y µm": 9919.7,
+    "Num Detections": 17854,
+    "Num Negative": 15701,
+    "Num Positive": 2153,
+    "Positive %": 12.06,
+    "Num Positive per mm^2": 976.28
+  }
+}

713/TumorCenter_CD8_block15_x6_y4_patient713_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 21438.6,
+    "Centroid Y µm": 9894.8,
+    "Num Detections": 19887,
+    "Num Negative": 19088,
+    "Num Positive": 799,
+    "Positive %": 4.018,
+    "Num Positive per mm^2": 348.02
+  }
+}

713/history_text.txt

@@ -0,0 +1 @@
+Patient with histologically confirmed tongue margin carcinoma on the right. Extension to the midline and cones in the direction of the external musculature or floor of mouth muscles. Therefore, the above-mentioned surgery is indicated.

713/icd_codes.txt

@@ -0,0 +1 @@
+Zungenrandkrebs[C02.1 R]

713/ops_codes.txt

@@ -0,0 +1 @@
+Transorale partielle Resektion der Zunge mit Rekonstruktion mit freiem mikrovaskulär-anastomosiertem Transplantat[5-251.02 ] Transplantat[5-295.14 ] Selektive Neck dissection in 4 Regionen[5-403.03 B] Permanente Tracheotomie[5-312.0 ] Entnahme von Spalthaut des Oberschenkels[5-901.0e R] Diagnostische Ösophagogastroskopie: Bei normalem Situs[1-631.0 ] Perkutan-endoskopische Gastrostomie durch Fadendurchzugsmethode[5-431.20 ] Zirkuläres Klammernahtgerät für die Anwendung bei Gefäßanastomosen (Zusatzkode)[5-98c.3 ]

713/patient_clinical_data.json

@@ -0,0 +1,18 @@
+{
+  "year_of_initial_diagnosis": 2015,
+  "age_at_initial_diagnosis": 57,
+  "sex": "male",
+  "smoking_status": "smoker",
+  "primarily_metastasis": "yes",
+  "survival_status": "living",
+  "survival_status_with_cause": "living",
+  "first_treatment_intent": "curative",
+  "first_treatment_modality": "local surgery",
+  "days_to_first_treatment": 49,
+  "adjuvant_treatment_intent": null,
+  "adjuvant_radiotherapy": "yes",
+  "adjuvant_radiotherapy_modality": null,
+  "adjuvant_systemic_therapy": "yes",
+  "adjuvant_systemic_therapy_modality": null,
+  "adjuvant_radiochemotherapy": "yes"
+}

713/patient_pathological_data.json

@@ -0,0 +1,20 @@
+{
+  "patient_id": "713",
+  "primary_tumor_site": "Oral_Cavity",
+  "pT_stage": "pT2",
+  "pN_stage": "pN2b",
+  "grading": "G2",
+  "hpv_association_p16": "not_tested",
+  "number_of_positive_lymph_nodes": 2.0,
+  "number_of_resected_lymph_nodes": 41,
+  "perinodal_invasion": "yes",
+  "lymphovascular_invasion_L": "no",
+  "vascular_invasion_V": "no",
+  "perineural_invasion_Pn": "no",
+  "resection_status": "R0",
+  "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": 14.0
+}