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308/surgery_description.txt

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+Frontolateral laryngeal partial resection/Chordectomy

308/surgery_report.txt

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+After appropriate preparation, first perform the microlaryngoscopy. Adjustment of the endolarynx with the Kleinsasser B and JA tube. Demonstration of the findings on <CLINICIAN_NAME>. This shows tumor growth in the area of the right vocal fold, which occupies the entire right vocal fold and extends to the vocal process. Towards the anterior commissure, this appears to be reached. Laterally, the tumor is palpable in the area of the ventricle. Subsequently, a decision was made to perform an open partial laryngectomy. Subsequent sterile washing and draping. Serrated vertical skin incision with exposure of the prelaryngeal musculature, which is pushed apart along the linea alba. Then expose the laryngeal skeleton by pushing the cricothyroid muscle from the lower edge of the cricoid cartilage to the thyrohyoid membrane. Incision of the periosteum or perichondrium so that a right pedicled perichondrium flap of the thyroid cartilage is formed. Enter the subperichondrial layer in the area of the thyroid incisura and dissect caudally. Then pass through the thyrofissure in the median plane so that the thyroid cartilage can be pushed apart. There is no clinical evidence of infiltration in the area of the anterior commissure. Entry into the interior of the larynx in the area of the thyroid incisura. From here, the incision is first made caudally in a vertical direction and the anterior commissure is included in the resection. In this way, the tumour can be successively visualized. The resection proceeds to the right, including the perichondrium in the area of the medial half of the right half of the thyroid cartilage. The tumor is then removed caudally in the area of the subglottis as well as cranially, whereby the resection includes parts of the ventriculus laryngeus. Finally, the tumor and thus the entire vocal fold is removed dorsally using the Kittel scissors with resection of the vocal process on the arytenoid cartilage. Macroscopically, the resection margins are not suspicious. The entire specimen is then thread-marked and mounted on cork for a frozen section histological examination. The dorsal part of the subglottic resection margin still shows carcinoma extensions. A subglottic dorsal resection is therefore performed. Lateral to this resection, further marginal samples are taken as well as a further marginal sample in the area of the remaining arytenoid cartilage. These proved to be free of tumor and dysplasia in the frozen section histological examination, so that an R0 resection can be assumed here. Finally, careful hemostasis by bipolar coagulation. Sealing of the wound surface on the right side with fibrin glue. Drill holes are made for readaptation of the thyroid cartilage. Insertion of a Keel after appropriate individual modeling. Readaptation of the thyroid cartilage skeleton at the previously created cranial and caudal drill holes. Refixation of the ligamentum conicum to the caudal edge of the thyroid cartilage. Knock-back of the perichondrium flap, which is additionally fixed with fibrin glue. Multi-layer wound closure of the straight prelaryngeal musculature after insertion of a drainage flap. Finally, multi-layer skin suture. Sterile wound dressing. End of the operation and transfer of the patient to anesthesia after placement of a nasogastric feeding tube and microlaryngoscopic control of the dry wound bed endolaryngeally. Conclusion: Complete right chordectomy for right vocal fold carcinoma via thyrofissure. Inclusion of the anterior commissure as well as the vocal process of the arytenoid cartilage. Control microlaryngoscopy in 8 weeks.

309/InvasionFront_CD8_block21_x1_y11_patient309_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 3423.2,
+    "Centroid Y µm": 27035.7,
+    "Num Detections": 16318,
+    "Num Negative": 16298,
+    "Num Positive": 20,
+    "Positive %": 0.1226,
+    "Num Positive per mm^2": 9.649
+  }
+}

309/InvasionFront_CD8_block21_x2_y11_patient309_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 6021.8,
+    "Centroid Y µm": 27035.7,
+    "Num Detections": 17234,
+    "Num Negative": 17037,
+    "Num Positive": 197,
+    "Positive %": 1.143,
+    "Num Positive per mm^2": 90.27
+  }
+}

309/TumorCenter_CD3_block21_x1_y11_patient309_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 3873.0,
+    "Centroid Y µm": 30170.6,
+    "Num Detections": 0,
+    "Num Negative": 0,
+    "Num Positive": 0,
+    "Positive %": NaN,
+    "Num Positive per mm^2": NaN
+  }
+}

309/TumorCenter_CD3_block21_x2_y11_patient309_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 6361.9,
+    "Centroid Y µm": 29834.7,
+    "Num Detections": 0,
+    "Num Negative": 0,
+    "Num Positive": 0,
+    "Positive %": NaN,
+    "Num Positive per mm^2": NaN
+  }
+}

309/TumorCenter_CD8_block21_x1_y11_patient309_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 5647.0,
+    "Centroid Y µm": 42059.2,
+    "Num Detections": 0,
+    "Num Negative": 0,
+    "Num Positive": 0,
+    "Positive %": NaN,
+    "Num Positive per mm^2": NaN
+  }
+}

309/TumorCenter_CD8_block21_x2_y11_patient309_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 8245.6,
+    "Centroid Y µm": 41984.3,
+    "Num Detections": 0,
+    "Num Negative": 0,
+    "Num Positive": 0,
+    "Positive %": NaN,
+    "Num Positive per mm^2": NaN
+  }
+}

309/icd_codes.txt

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+Bösartige Neubildung: Glottis[C32.0 ]

309/ops_codes.txt

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+Andere partielle Laryngektomie: Endoskopische Laserresektion[5-302.5 ]

309/patient_clinical_data.json

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+{
+  "year_of_initial_diagnosis": 2011,
+  "age_at_initial_diagnosis": 68,
+  "sex": "male",
+  "smoking_status": "former",
+  "primarily_metastasis": "no",
+  "survival_status": "deceased",
+  "survival_status_with_cause": "deceased not tumor specific",
+  "first_treatment_intent": "curative",
+  "first_treatment_modality": "local surgery",
+  "days_to_first_treatment": 0,
+  "adjuvant_treatment_intent": null,
+  "adjuvant_radiotherapy": "no",
+  "adjuvant_radiotherapy_modality": null,
+  "adjuvant_systemic_therapy": "no",
+  "adjuvant_systemic_therapy_modality": null,
+  "adjuvant_radiochemotherapy": "no"
+}

309/patient_pathological_data.json

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+{
+  "patient_id": "309",
+  "primary_tumor_site": "Larynx",
+  "pT_stage": "pT1a",
+  "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": "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": 3.0
+}

309/surgery_description.txt

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+Partial laryngectomy

309/surgery_report.txt

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+First, advance the O° optic through the glottic plane into the trachea. Inconspicuous mucosal conditions in the area of the trachea. Further advancement of the endoscope into the bronchial system, inconspicuous conditions on both sides. Now intubation of the patient. Then inspection of the hypopharynx on both sides, the postcricoid region, the oropharynx, the oral cavity and the nasopharynx. All mucosal conditions were unremarkable. All inspections with the aid of the endoscope or microscope. Now inspection of the larynx. A tumor was found in the area of the left vocal fold, extending from the tip of the arytenoid cartilage to just before the anterior commissure, occupying the entire vocal cord and extending to just before the morgue sinus. The tumor is located strictly on the left side. Beyond that, there are no special features in the subglottis and supraglottis. First, a sample is obtained and sent for frozen section histology. Here the diagnosis of squamous cell carcinoma is made. As a result, the process is resected with a laser from the tip of the arytenoid cartilage to the anterior commissure, including the largest parts of the vocalis muscle. The tumor is removed in the area of the anterior commissure together with the perichondrium, the thyroid cartilage. Deposition of the tumor, careful hemostasis. Obtain two representative marginal samples. Termination of the procedure if conditions are dry overall. A control endoscopy in 6-8 weeks is absolutely indicated.

310/InvasionFront_CD3_block7_x5_y1_patient310_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 16816.1,
+    "Centroid Y µm": 2273.8,
+    "Num Detections": 18293,
+    "Num Negative": 17301,
+    "Num Positive": 992,
+    "Positive %": 5.423,
+    "Num Positive per mm^2": 428.79
+  }
+}

310/InvasionFront_CD3_block7_x6_y1_patient310_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 19323.1,
+    "Centroid Y µm": 2178.1,
+    "Num Detections": 15039,
+    "Num Negative": 12633,
+    "Num Positive": 2406,
+    "Positive %": 16.0,
+    "Num Positive per mm^2": 1313.6
+  }
+}

310/InvasionFront_CD8_block7_x5_y1_patient310_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18815.0,
+    "Centroid Y µm": 3573.1,
+    "Num Detections": 16366,
+    "Num Negative": 15849,
+    "Num Positive": 517,
+    "Positive %": 3.159,
+    "Num Positive per mm^2": 242.89
+  }
+}

310/InvasionFront_CD8_block7_x6_y1_patient310_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 21338.7,
+    "Centroid Y µm": 3823.0,
+    "Num Detections": 13265,
+    "Num Negative": 12037,
+    "Num Positive": 1228,
+    "Positive %": 9.257,
+    "Num Positive per mm^2": 762.61
+  }
+}

310/TumorCenter_CD3_block7_x5_y1_patient310_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 16216.4,
+    "Centroid Y µm": 2873.5,
+    "Num Detections": 10893,
+    "Num Negative": 10160,
+    "Num Positive": 733,
+    "Positive %": 6.729,
+    "Num Positive per mm^2": 564.3
+  }
+}

310/TumorCenter_CD3_block7_x6_y1_patient310_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18765.1,
+    "Centroid Y µm": 2923.5,
+    "Num Detections": 18300,
+    "Num Negative": 17630,
+    "Num Positive": 670,
+    "Positive %": 3.661,
+    "Num Positive per mm^2": 298.29
+  }
+}

310/TumorCenter_CD8_block7_x5_y1_patient310_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 16141.5,
+    "Centroid Y µm": 3273.3,
+    "Num Detections": 16096,
+    "Num Negative": 15744,
+    "Num Positive": 352,
+    "Positive %": 2.187,
+    "Num Positive per mm^2": 220.26
+  }
+}

310/TumorCenter_CD8_block7_x6_y1_patient310_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18590.2,
+    "Centroid Y µm": 3498.1,
+    "Num Detections": 20580,
+    "Num Negative": 20447,
+    "Num Positive": 133,
+    "Positive %": 0.6463,
+    "Num Positive per mm^2": 57.51
+  }
+}

310/icd_codes.txt

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+Bösartige Neubildung: Tonsille, mehrere Teilbereiche überlappend[C09.8 ]

310/ops_codes.txt

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+Direkte diagnostische Pharyngoskopie[1-611.0 ] Direkte diagnostische Laryngoskopie[1-610.0 ] Perkutan-endoskopische Gastrostomie durch Fadendurchzugsmethode[5-431.20 ] Temporäre Tracheotomie[5-311.0 ] Radikale zervikale Lymphadenektomie [Neck dissection] selektiv [funktionell] 5 Regionen[5-403.04 B] Lokale Exzision erkranktes Gewebe Pharynx[5-292.0 ] Entnahme freier Radialis-Lappen[5-858.23 L] Deckung mit freiem Radialis-Lappen Kopf und Hals[5-858.70 R] Großflächige freie Spalthauttransplantation auf granulierendes Hautareal am Unterarm[5-902.58 L] Entnahme von Spalthaut an Oberschenkel und Knie[5-901.0e R]

310/patient_clinical_data.json

@@ -0,0 +1,18 @@
+{
+  "year_of_initial_diagnosis": 2019,
+  "age_at_initial_diagnosis": 47,
+  "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": 32,
+  "adjuvant_treatment_intent": "curative",
+  "adjuvant_radiotherapy": "yes",
+  "adjuvant_radiotherapy_modality": "percutaneous radiotherapy",
+  "adjuvant_systemic_therapy": "no",
+  "adjuvant_systemic_therapy_modality": null,
+  "adjuvant_radiochemotherapy": "no"
+}

310/patient_pathological_data.json

@@ -0,0 +1,20 @@
+{
+  "patient_id": "310",
+  "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": 31,
+  "perinodal_invasion": null,
+  "lymphovascular_invasion_L": "no",
+  "vascular_invasion_V": "no",
+  "perineural_invasion_Pn": "yes",
+  "resection_status": "R0",
+  "resection_status_carcinoma_in_situ": "CIS Absent",
+  "carcinoma_in_situ": "no",
+  "closest_resection_margin_in_cm": "0.2",
+  "histologic_type": "SCC_Conventional-Keratinizing",
+  "infiltration_depth_in_mm": 5.0
+}

310/surgery_description.txt

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

310/surgery_report.txt

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+After appropriate preparation by the anesthesia department, the PEG is first inserted by <CLINICIAN_NAME>. The PEG is inserted and secured using the usual technique. Then transition to tracheostoma placement. After skin disinfection, infiltration with local anesthetic containing adrenaline in the area of the subsequent skin incision as well as the tracheostoma. Sterile washing and draping. Skin incision approx. 2 QF above the jugulum. Sharp dissection through the subcutaneous fatty tissue down to the prelaryngeal musculature. This is divided along the linea alba. Exposure of the very strong isthmus of the thyroid gland. The isthmus is then passed under the pretracheal lamina, clamped and repositioned. This clearly exposes the upper trachea and the cricoid cartilage. The visor tracheotomy is then performed between the 2nd and 3rd tracheal cartilage. Creation of the mucocutaneous anastomosis with 2 sutures each cranially and caudally. Problem-free reintubation of the patient. Then transition to tumor resection. Here, the tumor is positioned with the tonsil retractor. The ulcerative tumor in the area of the right oropharynx, dorsal to the posterior mandibular molar, is not very well defined. First start with caudal tumor resection. The adjacent base of the tongue is biopsied first, which is found to be tumor-free on frozen section histology, as is the adjacent maxilla. Now first cut around the resection margins caudally in the area of the medial base of the tongue in a lateral direction towards the mandible. The mucosa of the lateral floor of the mouth is incised up to the penultimate premolar. The resection is then guided laterally over the gingiva between the last and penultimate molars and continues in an arc over the adjacent buccal mucosa cranially to the maxilla. From there, the right soft palate is parauvularly incised almost to the midline. The resection then proceeds, including the posterior palatal arch, to the back wall of the pharynx, where it is then rejoined at the lower pole of the tonsil or base of the tongue. During resection, the last morale on the right side is then removed. The tumor is then successively resected along these borders together with the surrounding soft tissue. The posterior part of the lingual nerve is exposed and must also be resected in order to maintain an appropriate safety distance. Finally, the tumor can be completely removed by pushing the periosteum away from the mandible and thus completely exposing the mandibular angle from the medial side down to the bare bone. Multiple frozen section histological samples are taken from the surrounding resection margin as well as from the base of the tumor, all of which prove to be tumor-free. The last molar on the right side is then extracted and the adjacent mandible is ground out with the drill and smoothed. Also the root canals. After tumor resection, measurement of a 9 x 6.5 cm long radial flap graft, which will be lifted from the left forearm by <CLINICIAN_NAME>. Distal skin incision and dissection through the subcutaneous fatty tissue. Expose the cephalic vein and dissect radially from it. Exposure of the muscle bellies of the flexor carpi radialis and brachioradialis muscles and exposure of the venous star as well as exposure of the pedicle in depth. Now free dissection of the muscle bellies distally and exposure of the complete pedicle. Dissection of the cephalic vein and the radial vein as potential connecting vessels. Exposure of the brachial and ulnar arteries and exposure of the proximal end of the radial artery. Clipping of small perforator vessels and ligation of larger veins and arteries. Now ulnar recutting of the flap while sparing the ulnar artery and dissection up to the flexor carpi radialis tendon. Now also radially recut the flap and follow the cephalic artery distally. This is included in the subcutaneous fatty tissue of the graft. The R. superficialis of the radial nerve can be preserved with its two branches. Separation of the cephalic vein distally. Complete removal of the transplant. Finally, removal of the radial artery distally and proximally and removal of the two venous outlets. Ligation of the vascular stumps. Arm closure after careful hemostasis using a split-thigh skin graft of the right thigh, which was obtained in the usual manner. Application of a plaster splint. Good recapillarization time after removal of the flap. Subsequent transition to neck dissection on the right side. After skin incision, dissection and skeletonization of the sternocleidomastoid muscle. Then expose the cervical vascular nerve sheath caudally and dissect cranially, sparing all non-lymphatic structures. Regions II to V are thus completely cleared out first. Submandibulectomy and removal of region I are then performed. In the area of the submandibular lobe, the pharyngeal passage into the defect is also found. Insertion of a Redon suction drainage. Subsequently, transition to neck dissection on the left side. Here, regions II to V are completely evacuated while preserving all non-lymphatic structures. After placement of the radial lobe graft, it is then inserted into the oropharyngeal defect from the lateral side via the previously created access and initially fixed to its cranial attachment site with several sutures. Then suture via the transcervical access of the caudal flap edge. Finally, the flap is fixed in position with the remaining sutures from the transoral side. The microvascular anastomosis is then performed. The arterial anastomosis is performed with the ascending pharyngeal artery, as both the superior thyroid artery and the facial artery are extremely small in caliber. The venous anastomoses are performed in the usual manner via 2 veins to the internal jugular vein using the end-to-side technique. Finally, insertion of a drainage flap in the right side of the neck. Two-layer wound closure. End of the operation, transfer of the patient to the anesthesia department after the patient has been reintubated onto an 8-gauge tracheostomy tube, which is sutured to the skin. Prior to this, wound closure on the left side after insertion of a Redon suction drain. End of the operation, transfer of the patient to anesthesia. Conclusion: Transoral tumor resection of a cT3 oropharyngeal carcinoma on the right side in the region of the mandibular angle with extraction of the last molar from the right mandible and corresponding grinding of the adjacent bone. Microvascular reconstruction with a radial flap graft from the left forearm and defect coverage on the left forearm with split skin from the right thigh, creation of a tracheostoma and a PEG.

311/InvasionFront_CD3_block12_x3_y8_patient311_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 10994.2,
+    "Centroid Y µm": 24661.9,
+    "Num Detections": 18550,
+    "Num Negative": 18132,
+    "Num Positive": 418,
+    "Positive %": 2.253,
+    "Num Positive per mm^2": 192.07
+  }
+}

311/InvasionFront_CD3_block12_x4_y8_patient311_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 13642.8,
+    "Centroid Y µm": 24864.7,
+    "Num Detections": 20513,
+    "Num Negative": 18672,
+    "Num Positive": 1841,
+    "Positive %": 8.975,
+    "Num Positive per mm^2": 780.19
+  }
+}

311/InvasionFront_CD8_block12_x3_y8_patient311_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 12343.5,
+    "Centroid Y µm": 23912.3,
+    "Num Detections": 18571,
+    "Num Negative": 16277,
+    "Num Positive": 2294,
+    "Positive %": 12.35,
+    "Num Positive per mm^2": 1006.1
+  }
+}

311/InvasionFront_CD8_block12_x4_y8_patient311_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 14992.1,
+    "Centroid Y µm": 23787.4,
+    "Num Detections": 20871,
+    "Num Negative": 18362,
+    "Num Positive": 2509,
+    "Positive %": 12.02,
+    "Num Positive per mm^2": 1044.5
+  }
+}

311/TumorCenter_CD3_block12_x3_y8_patient311_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 10619.4,
+    "Centroid Y µm": 19939.4,
+    "Num Detections": 21392,
+    "Num Negative": 17107,
+    "Num Positive": 4285,
+    "Positive %": 20.03,
+    "Num Positive per mm^2": 1861.9
+  }
+}

311/TumorCenter_CD3_block12_x4_y8_patient311_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 13168.0,
+    "Centroid Y µm": 20014.4,
+    "Num Detections": 20299,
+    "Num Negative": 17343,
+    "Num Positive": 2956,
+    "Positive %": 14.56,
+    "Num Positive per mm^2": 1244.7
+  }
+}

311/TumorCenter_CD8_block12_x3_y8_patient311_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 13742.7,
+    "Centroid Y µm": 29234.5,
+    "Num Detections": 19849,
+    "Num Negative": 17013,
+    "Num Positive": 2836,
+    "Positive %": 14.29,
+    "Num Positive per mm^2": 1246.1
+  }
+}

311/TumorCenter_CD8_block12_x4_y8_patient311_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 16166.4,
+    "Centroid Y µm": 29434.4,
+    "Num Detections": 17062,
+    "Num Negative": 15012,
+    "Num Positive": 2050,
+    "Positive %": 12.02,
+    "Num Positive per mm^2": 925.93
+  }
+}

311/patient_clinical_data.json

@@ -0,0 +1,18 @@
+{
+  "year_of_initial_diagnosis": 2007,
+  "age_at_initial_diagnosis": 52,
+  "sex": "female",
+  "smoking_status": "smoker",
+  "primarily_metastasis": "no",
+  "survival_status": "deceased",
+  "survival_status_with_cause": "deceased tumor specific",
+  "first_treatment_intent": "curative",
+  "first_treatment_modality": "local surgery",
+  "days_to_first_treatment": 45,
+  "adjuvant_treatment_intent": null,
+  "adjuvant_radiotherapy": "no",
+  "adjuvant_radiotherapy_modality": null,
+  "adjuvant_systemic_therapy": "no",
+  "adjuvant_systemic_therapy_modality": null,
+  "adjuvant_radiochemotherapy": "no"
+}

311/patient_pathological_data.json

@@ -0,0 +1,20 @@
+{
+  "patient_id": "311",
+  "primary_tumor_site": "Oral_Cavity",
+  "pT_stage": "pT2",
+  "pN_stage": "pN2c",
+  "grading": "G2",
+  "hpv_association_p16": "not_tested",
+  "number_of_positive_lymph_nodes": 2.0,
+  "number_of_resected_lymph_nodes": 26,
+  "perinodal_invasion": null,
+  "lymphovascular_invasion_L": "no",
+  "vascular_invasion_V": "no",
+  "perineural_invasion_Pn": "no",
+  "resection_status": "R1",
+  "resection_status_carcinoma_in_situ": "CIS Absent",
+  "carcinoma_in_situ": "no",
+  "closest_resection_margin_in_cm": "0",
+  "histologic_type": "SCC_Conventional-Keratinizing",
+  "infiltration_depth_in_mm": 9.0
+}

311/surgery_description.txt

@@ -0,0 +1 @@
+Resection of Tonsillar carcinoma, Bilateral neck dissection, Defect coverage, Free flap (Radial), Tracheotomy

311/surgery_report.txt

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+At the beginning of the operation, the surgeon positions the patient. After induction of anesthesia, the tumor is inspected again. This extends from the soft palate close to the uvula down to the lower tonsillar pole with transition via the glossotonsillar groove to the base of the tongue. Laterally, the tumor appears to extend to the posterior molars. After insertion of the tonsil retractor and insertion of the monopolar electric needle, the tumor is cut around far into the healthy tissue and removed, taking the uvula, the soft palate on the left up to the hard palate border and the upper alveolar ridge, from here to the lower alveolar ridge. Removal of the last molar and preparation via the glossotonsillar groove to the base of the tongue. Removal of the tonsil in its capsule. Mucosa up to the buccal mucosa and the floor of the mouth as a post-resection. Then take lateral and medial edge samples. These are now found to be tumor-free. To confirm the R0 situation, the bed of the two extracted molars is now removed from the medial side to the lateral corticalis with the rose bur, taking the corticalis with it, so that a safe R0 resection appears to be given. Intraoperative demonstration on <CLINICIAN_NAME> and <CLINICIAN_NAME>. Removal of the tonsil plug. The bridge of the maxilla breaks out at the front. It becomes apparent that the tooth roots could not be preserved, so these are also removed. A residual root may have remained on the left paramedian side. Therefore, request a postoperative maxillofacial consultation. In the further course, repositioning for neck dissection, starting on the left side: skin incision along the anterior edge of the sternocleidomastoid. Exposure of the cervical vascular sheath. Laborious exploration of the neck vessels and preservation of the same for later defect coverage. Dissection in the accessorius triangle and exploration of the accessorius, the hypoglossus and the cervical sinus. Dissection from the digaster to the caudal omohyoid. Removal of the lateral neck preparation while sparing the above-mentioned structures and the main plexus branches. Then dissect the capsule of the submandibular gland in the midline. Dissect caudally, preserving the above-mentioned structures and remove the medial neck preparation. Careful hemostasis and H2O2 irrigation. Now dissection on the right side, essentially identical. Here too, the accessorius nerve, the hypoglossal nerve, the cervical sinus and the cervical vascular sheath can be located and spared. After removal of the lateral and medial neck specimen in regions I to V, careful hemostasis, H2O2 irrigation and insertion of a Redon drain are performed. Subsequently, two-layer wound closure. Now perform the tracheotomy. Skin incision. Subcutaneous preparation of the prelaryngeal musculature. Push them apart in the midline. Dissection of the thyroid gland. Undermining of the thyroid gland, clamping, severing and repositioning of both thyroid globules. Now locate the 2nd and 3rd tracheal cartilage. Creation of a Björk flap with the 3rd tracheal cartilage. Epithelialization of the stoma. Now the intubation is transferred to an LE tube. Then lift the radial flap by cutting around the skin island. Locate the radial artery. Clamp it with the bulldog and observe the saturation while the flap pedicle is dissected from caudal to cranial. Locate the flap pedicle in the crook of the elbow. A relatively small artery and even finer veins can be seen. Therefore, renewed demonstration on <CLINICIAN_NAME> and <CLINICIAN_NAME>. Decision to lift and use the flap despite difficult conditions. Separation of the radial artery caudally and cranially. Subsequent transection of the same. Now separation of the vein. Dissection of the same. Now lift the split skin from the right groin. This is primarily closed by inserting a Redon drain. The split skin is sutured into the lifting defect of the forearm, the rest of the forearm is closed in two layers accordingly. The flap is then fitted into the lifting defect orally. Suturing in the area of the soft palate and the tonsil and caudally with covering of the exposed bone. Passing the flap pedicle through an artificial fistula between the mandible and the submandibular gland. Then dissection of the superior thyroid artery and the internal jugular vein in preparation for anastomization. The thyroid artery is then removed and an end-to-end anastomosis of the superior thyroid artery to the radial artery is performed. Then end-to-side anastomosis of the accompanying veins in their confluence with the internal jugular vein. This is achieved without any problems using 9/0 sutures as microsurgical re-anastomization. Finally, two-layer wound closure with insertion of a Redon drain on the left side of the neck and completion of the procedure with a vital flap and no indication of complications.

312/InvasionFront_CD3_block19_x5_y11_patient312_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 15816.6,
+    "Centroid Y µm": 29709.3,
+    "Num Detections": 21402,
+    "Num Negative": 21186,
+    "Num Positive": 216,
+    "Positive %": 1.009,
+    "Num Positive per mm^2": 110.27
+  }
+}

312/InvasionFront_CD3_block19_x6_y11_patient312_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18240.3,
+    "Centroid Y µm": 29984.1,
+    "Num Detections": 23782,
+    "Num Negative": 23539,
+    "Num Positive": 243,
+    "Positive %": 1.022,
+    "Num Positive per mm^2": 115.99
+  }
+}

312/InvasionFront_CD8_block19_x5_y11_patient312_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 16116.5,
+    "Centroid Y µm": 37580.1,
+    "Num Detections": 16737,
+    "Num Negative": 16545,
+    "Num Positive": 192,
+    "Positive %": 1.147,
+    "Num Positive per mm^2": 107.27
+  }
+}

312/InvasionFront_CD8_block19_x6_y11_patient312_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18565.2,
+    "Centroid Y µm": 37730.0,
+    "Num Detections": 17284,
+    "Num Negative": 17074,
+    "Num Positive": 210,
+    "Positive %": 1.215,
+    "Num Positive per mm^2": 114.53
+  }
+}

312/TumorCenter_CD3_block19_x5_y11_patient312_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18573.5,
+    "Centroid Y µm": 27872.5,
+    "Num Detections": 10352,
+    "Num Negative": 9989,
+    "Num Positive": 363,
+    "Positive %": 3.507,
+    "Num Positive per mm^2": 235.55
+  }
+}