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442/history_text.txt

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+Patient with post attempted enoral tumor resection with extended tonsillectomy. The final specimen shows R1 on all sides, therefore the above-mentioned operation with flap coverage of an expected defect is now planned. CT also shows extension of the tumor into the pharyngeal wall.

442/ops_codes.txt

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+Diagnostische Ösophagogastroduodenoskopie bei normalem Situs[1-632.0 ] Perkutan-endoskopische Gastrostomie durch Fadendurchzugsmethode[5-431.20 ] Direkte diagnostische Pharyngoskopie[1-611.0 ] Radikale zervikale Lymphadenektomie [Neck dissection] radikal modifiziert 4 Regionen[5-403.20 R] Radikale zervikale Lymphadenektomie [Neck dissection] selektiv [funktionell] 3 Regionen[5-403.02 L] Entnahme von Spalthaut an Oberschenkel und Knie[5-901.0e R] Großflächige freie Spalthauttransplantation am Unterarm[5-902.48 L] Mikrochirurgische Technik (Zusatzkode)[5-984 ] Temporäre Tracheotomie[5-311.0 ] Transplantat[5-295.14 ] Entnahme fasziokutaner Lappen mit mikrovaskulärer Anastomosierung Unterarm[5-858.03 L]

442/surgery_description.txt

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+Tumor resection, Neck dissection (Level II-IV bilaterally), Defect coverage (Radial), Tracheostomy, PEG placement

442/surgery_report.txt

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+First, pharyngoscopy and laryngoscopy again, showing the fibrin-covered area where the tumor was resected. Tumor is visible in the direction of the hypopharynx. Confirmation of the indication. Initial PEG placement using the thread pull-through method. With very good diaphanoscopy, this is successful without any problems. Then skin disinfection of all relevant surgical areas and sterile draping. Then start with neck dissection on both sides: Neck dissection on the right (<CLINICIAN_NAME>): Skin incision and dissection through the subcutaneous fatty tissue. Separation of the platysma and subplatysmal dissection. Exposure of the anterior border of the MSCM and identification and preservation of the accessory nerve. Tracing of the omohyoid muscle and visualization of the. Gl. submandibularis. Visualization of the posterior venter of the digastric muscle. A large metastasis is seen in region Ib/II, which is located directly on the internal jugular vein. Dissection of the VJI and careful dissection of the metastasis. Ligation of a large branch of the VJI in order to be able to use it later for the venous anastomosis. Ligation of the V. Facialis for the same reason, exposure and preservation of the ACI, ACC and ACE as well as the vagus nerve and the cervical artery. Exposure and preservation of the hypoglossal nerve. Now successive removal of the lateral and medial neck preparation, i.e. from region Ib to V while preserving the plexus branches. Dissection of the superior thyroid artery and the facial artery in order to be able to use them later for the microvascular anastomosis Neck dissection on the left: Sharp dissection of the skin, subcutaneous tissue and platysma. Exposure of the anterior border of the sternocleidomastoid muscle, the digaster muscle, the accessorius nerve and the omohyoid muscle. Exposure of the cervical vascular sheath with the internal jugular vein and facial vein, ACC, ACI, ACE, vagus nerve, cervical plexus and subsequent removal of the neck preparation from level II to IV without complications and with preservation of all the structures mentioned. Insertion of a Redon drain. Two-layer wound closure, first of the platysma and then of the skin. Subsequent combined transcervical, transoral tumor resection: First dissection of the large neck vessels from the pharyngeal tube. Small outgoing vessels are ligated or treated. Snaring of the internal carotid artery, external carotid artery and common carotid artery as well as snaring of the hypoglossal nerve. V. facialis is placed cranially. The lingual artery is ligated and double ligated in the direction of the external carotid artery. Pharyngeal tube is dissected free towards the base of the skull. Border cord is preserved. Subsequent resection of the tumor with a safety margin of at least 1.5 to 2 cm on all sides, whereby the entire pharyngeal wall is resected in each case. The uvula with soft and hard palate on the right, the entire tonsil lobe, the mucosa at the transition to the base of the tongue, a lateral part of the base of the tongue to the medial side and the posterior palatal arch of the medial pharyngeal wall are resected. The resection is then completed from the outside, whereby both parts of the base of the tongue, the vallecula, upper parts of the arytenoid fold and the medial and anterior as well as small parts of the lateral piriform sinus wall must also be resected. The tumor is marked using sutures. In addition, marginal samples are taken from the lateral pharyngeal wall caudal to the right of the piriform sinus, from the lateral right arytenoid area and from the medial arytenoid area to the edge of the epiglottis. In the frozen section, all marginal samples were tumor-free as well as the specimen. In the cranial area, a resection is recommended again for safety reasons, therefore a strip several mm in size is taken from the soft palate to hard palate area up to the lateral alveolar ridge, here a thread-marked specimen is taken and sent for frozen section. There were no tumor infiltrates either in the mucosa or in the soft tissue, not even in the additional soft tissue removed. So now R0 resection. Defect size is measured at 12 to 13 x 8 to 9 cm. Marking on the forearm according to the required three-dimensional configuration. Subsequent removal of the radial artery flap <CLINICIAN_NAME>: skin incision and dissection through the subcutaneous fatty tissue. Locate and expose the cephalic vein and small venous anastomoses. Preparation of the pedicle between the brachioradialis muscle and the flexor carpi radialis muscle. Exposure of the venous star. Now successive further dissection of the pedicle and clipping of perforating vessels. Trimming of the 14x8cm graft. Ulnar subfascial dissection with identification and preservation of the ulnar artery and nerve. Now radial incision and radial dissection of the cephalic vein. Separation of several venous outlets by means of ligation. Separation of the cephalic vein distally. Locate the radial nerve R superficialis and preserve it. A small branch is pulled into the flap and removed. Careful further preparation of the remaining graft. After the R0 tumor has been resected, the graft is removed. Subsequent insertion of the radial flap into the defect and vascular suture: After the radial flap has been removed, rinse thoroughly with plenty of heparin. Insertion of the flap into the defect. Successive suturing of the flap with 3-0 Vicryl single-button sutures, partly with caudal and then cranial exposure. The flap fits very well into the defect and fulfills the three-dimensional requirement. The flap is then connected to the vessels. The superior thyroid artery is selected as the arterial vessel. After conditioning the vessels, suture with 9-0 Ethilon single-button sutures. Subsequent dissection of the V. thyroidea media and a branch of the V. facialis. The V. thyroidea media is anastomosed to the one outlet in the area of the V. cephalica using a 2.5 mm coupler after conditioning the vessels. Good venous return after opening the clips, positive smear phenomenon. The other outlet from the cephalic vein is then anastomosed with an outlet from the facial vein. Here too, after opening the clamps, the smear phenomenon is positive. Then clip all other available venous outlets. Careful hemostasis and irrigation. Wound closure in layers on both sides of the neck, on the right with insertion of a Redon drain, on the left with insertion of 2 flaps. Thorough inspection of the flap, which is vital. Removal of split skin + wound closure of the forearm: At the same time, large areas of split skin are removed from the right thigh in the usual manner. Application of sterile wound dressing in the area of the donor site. Two-layer wound closure in the area of the proximal forearm. Application of a wound dressing and a forearm splint. Completion of graft elevation without complications. Tracheostoma creation: A horizontal incision of about 4 cm 2 QF is made above the jugulum, sharply cutting through the skin, subcutaneous tissue and the platysma. The prelaryngeal musculature or infrahyoid musculature is exposed, entered in the midline and the thyroid gland is exposed. Dissection of the trachea between the cricoid cartilage and isthmus. The isthmus is cut and stitched on both sides. No major bleeding. Between the 2nd and 3rd tracheal cartilage clasp, the trachea is entered and a visor tracheotomy is created. The mucocutaneous anastomosis is created cranially and caudally. The patient is then intubated using an 8-gauge cannula. Completion of the procedure without complications. Then reintubation and insertion of an 8-gauge tracheostomy tube. The procedure is completed without complications. Patient goes to the intensive care unit for monitoring. Please leave heparin perfusor running at 1 ml/h for a further 5 days. Flap control via enoral inspection for 5 days according to schedule. Feeding via the inserted PEG tube for 10-12 days, then X-ray pre-swallow and, if necessary, diet build-up. However, swallowing training should always be planned due to the size and extent of the defect. Aspiration initially likely here. Overall cT3, more likely cT4 oropharyngeal carcinoma right cN2b. After receiving the final histology, please present at the interdisciplinary tumor conference.

443/InvasionFront_CD3_block10_x1_y5_patient443_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 5896.9,
+    "Centroid Y µm": 17515.7,
+    "Num Detections": 25168,
+    "Num Negative": 23909,
+    "Num Positive": 1259,
+    "Positive %": 5.002,
+    "Num Positive per mm^2": 481.15
+  }
+}

443/InvasionFront_CD3_block10_x2_y5_patient443_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 8720.4,
+    "Centroid Y µm": 17540.7,
+    "Num Detections": 23799,
+    "Num Negative": 21974,
+    "Num Positive": 1825,
+    "Positive %": 7.668,
+    "Num Positive per mm^2": 717.74
+  }
+}

443/InvasionFront_CD8_block10_x1_y5_patient443_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 5047.3,
+    "Centroid Y µm": 18440.2,
+    "Num Detections": 25218,
+    "Num Negative": 21880,
+    "Num Positive": 3338,
+    "Positive %": 13.24,
+    "Num Positive per mm^2": 1309.0
+  }
+}

443/InvasionFront_CD8_block10_x2_y5_patient443_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 7920.8,
+    "Centroid Y µm": 18115.4,
+    "Num Detections": 23769,
+    "Num Negative": 20329,
+    "Num Positive": 3440,
+    "Positive %": 14.47,
+    "Num Positive per mm^2": 1366.5
+  }
+}

443/TumorCenter_CD3_block10_x1_y5_patient443_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 6571.5,
+    "Centroid Y µm": 12618.3,
+    "Num Detections": 18830,
+    "Num Negative": 16559,
+    "Num Positive": 2271,
+    "Positive %": 12.06,
+    "Num Positive per mm^2": 1028.5
+  }
+}

443/TumorCenter_CD3_block10_x2_y5_patient443_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 9070.2,
+    "Centroid Y µm": 12568.3,
+    "Num Detections": 23640,
+    "Num Negative": 18691,
+    "Num Positive": 4949,
+    "Positive %": 20.93,
+    "Num Positive per mm^2": 1952.6
+  }
+}

443/TumorCenter_CD8_block10_x1_y5_patient443_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 3748.0,
+    "Centroid Y µm": 13392.9,
+    "Num Detections": 21869,
+    "Num Negative": 20456,
+    "Num Positive": 1413,
+    "Positive %": 6.461,
+    "Num Positive per mm^2": 598.42
+  }
+}

443/TumorCenter_CD8_block10_x2_y5_patient443_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 6221.7,
+    "Centroid Y µm": 13367.9,
+    "Num Detections": 23384,
+    "Num Negative": 19459,
+    "Num Positive": 3925,
+    "Positive %": 16.78,
+    "Num Positive per mm^2": 1539.4
+  }
+}

443/history_text.txt

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+Suspected cT2 cN2a tonsillar carcinoma on the left in the preoperative CT neck/thorax. Overall indication for the above-mentioned procedure.

443/icd_codes.txt

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+V.a. cT2 cN1 Tonsillen-CA links[C09.0 ]

443/ops_codes.txt

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+Diagnostische ÖGD[1-632 ] Sonstige diagnostische Pharyngoskopie[1-611.x ] Direkte diagnostische Laryngoskopie[1-610.0 ] Transorale Tumortonsillektomie[5-281.2 ]

443/patient_clinical_data.json

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+{
+  "year_of_initial_diagnosis": 2013,
+  "age_at_initial_diagnosis": 62,
+  "sex": "male",
+  "smoking_status": "non-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": 1,
+  "adjuvant_treatment_intent": "curative",
+  "adjuvant_radiotherapy": "yes",
+  "adjuvant_radiotherapy_modality": "percutaneous radiotherapy",
+  "adjuvant_systemic_therapy": "no",
+  "adjuvant_systemic_therapy_modality": null,
+  "adjuvant_radiochemotherapy": "no"
+}

443/patient_pathological_data.json

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+{
+  "patient_id": "443",
+  "primary_tumor_site": "Oropharynx",
+  "pT_stage": "pT2",
+  "pN_stage": "pN1",
+  "grading": "hpv_association_p16",
+  "hpv_association_p16": "positive",
+  "number_of_positive_lymph_nodes": 1.0,
+  "number_of_resected_lymph_nodes": 29,
+  "perinodal_invasion": "no",
+  "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-Keratinizing",
+  "infiltration_depth_in_mm": 18.0
+}

443/surgery_description.txt

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+Tonsillectomy and Panendoscopy

443/surgery_report.txt

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+After team time-out, induction of anesthesia by the anesthesia colleagues. Then direct tracheoscopy by the surgeon. Abnormal mucosal conditions down to the carina. Then intubation by the surgeon. This is successful without any problems. The surgeon now positions the patient's head. Now perform the gastroscopy. Enter with the flexible esophagoscope and advance into the stomach. Typical gastric mucosal folds without further abnormalities. Even after inversion, the gastroesophageal junction is unremarkable. No abnormalities in the esophagus on reflection. Then, insertion with the Kleinsasser C-tube and inspection of the hypopharynx on both sides. Here the mucosal conditions were unremarkable down to the esophageal entrance as well as in the postcricoid area. Now, if the larynx is difficult to adjust, change to Kleinsasser D-tube. Inconspicuous mucosa in the area of the endolarynx and the epiglottis as well as the interary area. Now insertion of the Mc Ivor oral spatula and demonstration of findings on <CLINICIAN_NAME>. A rough mass was found in the area of the left tonsil, which, however, remained limited to the tonsil lobe. The anterior and posterior palatal arch do not appear to be infiltrated, nor does the base of the tongue. In the rest of the oropharynx and in the oral cavity, inconspicuous mucosal conditions. The tumor is now macroscopically excised in toto in the sense of an extended tonsillectomy using a dissection technique with a sufficient safety margin while sparing the posterior palatal arch. The tumor specimen is thread-marked for histology. A resection is then taken in the area of the wound bed and the entire area is covered with margin samples. These are sent separately for final histology. Finally, subtle hemostasis using H2O2-soaked swabs and bipolar coagulation. Finally, dry mucosal conditions and completion of the procedure without complications. Repositioning of the patient by the surgeon. Conclusion: Overall macroscopic in sano resection of a cT2 tonsillar carcinoma on the left. There is a very small defect in the left oropharyngeal side wall. Waiting for the histology and planning a neck dissection of the left side.

444/InvasionFront_CD3_block12_x5_y9_patient444_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 15891.6,
+    "Centroid Y µm": 27485.4,
+    "Num Detections": 17344,
+    "Num Negative": 15299,
+    "Num Positive": 2045,
+    "Positive %": 11.79,
+    "Num Positive per mm^2": 918.99
+  }
+}

444/InvasionFront_CD3_block12_x6_y9_patient444_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18440.2,
+    "Centroid Y µm": 27710.3,
+    "Num Detections": 18292,
+    "Num Negative": 16625,
+    "Num Positive": 1667,
+    "Positive %": 9.113,
+    "Num Positive per mm^2": 709.86
+  }
+}

444/InvasionFront_CD8_block12_x5_y9_patient444_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 17565.7,
+    "Centroid Y µm": 26086.2,
+    "Num Detections": 17629,
+    "Num Negative": 15519,
+    "Num Positive": 2110,
+    "Positive %": 11.97,
+    "Num Positive per mm^2": 925.79
+  }
+}

444/InvasionFront_CD8_block12_x6_y9_patient444_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 20139.3,
+    "Centroid Y µm": 26036.2,
+    "Num Detections": 18655,
+    "Num Negative": 17828,
+    "Num Positive": 827,
+    "Positive %": 4.433,
+    "Num Positive per mm^2": 358.1
+  }
+}

444/TumorCenter_CD3_block12_x5_y9_patient444_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 15541.8,
+    "Centroid Y µm": 22563.1,
+    "Num Detections": 17111,
+    "Num Negative": 15618,
+    "Num Positive": 1493,
+    "Positive %": 8.725,
+    "Num Positive per mm^2": 674.06
+  }
+}

444/TumorCenter_CD3_block12_x6_y9_patient444_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18015.5,
+    "Centroid Y µm": 22638.0,
+    "Num Detections": 18233,
+    "Num Negative": 15317,
+    "Num Positive": 2916,
+    "Positive %": 15.99,
+    "Num Positive per mm^2": 1320.9
+  }
+}

444/TumorCenter_CD8_block12_x5_y9_patient444_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18615.1,
+    "Centroid Y µm": 32058.0,
+    "Num Detections": 12770,
+    "Num Negative": 12118,
+    "Num Positive": 652,
+    "Positive %": 5.106,
+    "Num Positive per mm^2": 302.84
+  }
+}

444/TumorCenter_CD8_block12_x6_y9_patient444_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 21088.8,
+    "Centroid Y µm": 32232.9,
+    "Num Detections": 15701,
+    "Num Negative": 13763,
+    "Num Positive": 1938,
+    "Positive %": 12.34,
+    "Num Positive per mm^2": 894.26
+  }
+}

444/patient_clinical_data.json

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+{
+  "year_of_initial_diagnosis": 2006,
+  "age_at_initial_diagnosis": 63,
+  "sex": "male",
+  "smoking_status": null,
+  "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": 25,
+  "adjuvant_treatment_intent": "curative",
+  "adjuvant_radiotherapy": "yes",
+  "adjuvant_radiotherapy_modality": "brachytherapy",
+  "adjuvant_systemic_therapy": "no",
+  "adjuvant_systemic_therapy_modality": null,
+  "adjuvant_radiochemotherapy": "no"
+}

444/patient_pathological_data.json

@@ -0,0 +1,20 @@
+{
+  "patient_id": "444",
+  "primary_tumor_site": "Oral_Cavity",
+  "pT_stage": "pT2",
+  "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": "0.2",
+  "histologic_type": "SCC_Conventional-Keratinizing",
+  "infiltration_depth_in_mm": 13.0
+}

444/surgery_description.txt

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+Panendoscopy, Tumor resection, Left neck dissection, Possibly PEG (according to the surgical protocol)

445/InvasionFront_CD3_block16_x5_y12_patient445_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 16591.2,
+    "Centroid Y µm": 34281.8,
+    "Num Detections": 20767,
+    "Num Negative": 18375,
+    "Num Positive": 2392,
+    "Positive %": 11.52,
+    "Num Positive per mm^2": 1004.6
+  }
+}

445/InvasionFront_CD3_block16_x6_y12_patient445_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18989.9,
+    "Centroid Y µm": 34281.8,
+    "Num Detections": 18852,
+    "Num Negative": 18029,
+    "Num Positive": 823,
+    "Positive %": 4.366,
+    "Num Positive per mm^2": 346.82
+  }
+}

445/InvasionFront_CD8_block16_x5_y12_patient445_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 15541.6,
+    "Centroid Y µm": 28956.2,
+    "Num Detections": 19728,
+    "Num Negative": 16905,
+    "Num Positive": 2823,
+    "Positive %": 14.31,
+    "Num Positive per mm^2": 1190.0
+  }
+}

445/InvasionFront_CD8_block16_x6_y12_patient445_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 17939.2,
+    "Centroid Y µm": 29123.8,
+    "Num Detections": 16845,
+    "Num Negative": 15608,
+    "Num Positive": 1237,
+    "Positive %": 7.343,
+    "Num Positive per mm^2": 563.21
+  }
+}

445/TumorCenter_CD8_block16_x5_y12_patient445_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 15766.7,
+    "Centroid Y µm": 30483.9,
+    "Num Detections": 21292,
+    "Num Negative": 17445,
+    "Num Positive": 3847,
+    "Positive %": 18.07,
+    "Num Positive per mm^2": 1571.3
+  }
+}

445/TumorCenter_CD8_block16_x6_y12_patient445_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18340.3,
+    "Centroid Y µm": 30458.9,
+    "Num Detections": 21051,
+    "Num Negative": 18571,
+    "Num Positive": 2480,
+    "Positive %": 11.78,
+    "Num Positive per mm^2": 998.17
+  }
+}

445/history_text.txt

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+Patient with multiple endoscopies and sampling as well as decortication twice on the right side for dysplasia in the laryngeal region. Now presentation with suspected carcinoma. At the last MLE, a squamous cell carcinoma of the right vocal fold was confirmed. This was described as being located in the anterior part of the right vocal cord up to the anterior commissure.

445/icd_codes.txt

@@ -0,0 +1 @@
+Glottiskarzinom[C32.0 R]

445/ops_codes.txt

@@ -0,0 +1 @@
+Sonstige Hemilaryngektomie[5-301.x ] Temporäre Tracheotomie[5-311.0 ]

445/patient_clinical_data.json

@@ -0,0 +1,18 @@
+{
+  "year_of_initial_diagnosis": 2019,
+  "age_at_initial_diagnosis": 72,
+  "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": 42,
+  "adjuvant_treatment_intent": null,
+  "adjuvant_radiotherapy": "yes",
+  "adjuvant_radiotherapy_modality": null,
+  "adjuvant_systemic_therapy": "no",
+  "adjuvant_systemic_therapy_modality": "pembrolizumab",
+  "adjuvant_radiochemotherapy": "no"
+}

445/patient_pathological_data.json

@@ -0,0 +1,20 @@
+{
+  "patient_id": "445",
+  "primary_tumor_site": "Larynx",
+  "pT_stage": "pT2",
+  "pN_stage": "pN0",
+  "grading": "G3",
+  "hpv_association_p16": "not_tested",
+  "number_of_positive_lymph_nodes": 0.0,
+  "number_of_resected_lymph_nodes": 47,
+  "perinodal_invasion": null,
+  "lymphovascular_invasion_L": "no",
+  "vascular_invasion_V": "no",
+  "perineural_invasion_Pn": "no",
+  "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": 8.0
+}

445/surgery_description.txt

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+Partial laryngeal resection according to Leroux-Robert, Tracheostomy, MLE (Microlaryngoscopy and Endoscopy)

445/surgery_report.txt

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+After intubation of the patient, MLE is now performed: the thickened vocal fold is visible, especially on the right, up to the anterior commissure. Overall, the tumor also appears to be growing into the ventriculus laryngeus. Overview difficult due to the poor adjustability, therefore, due to the overall situation, the decision was made to perform the operation by means of partial laryngeal resection from the outside. Therefore now repositioning. Injection of a total of 8 ml Ultracaine 1% with adrenaline. Sterile draping. Zigzag skin incision. Exposure of the larynx. Creation of a perichondrium flap from the left side. Then opening of the larynx, whereby a triangle is cut out more on the right than on the left with the wheel. The larynx is then opened. Entering the larynx from the supraglottic side. Now inspect the tumor. Cut around the tumor or the visible thickenings and palpable thickenings with a safety margin of at least 4 mm on all sides. The entire vocal fold up to the arytenoid area on the right, the mucosa up to the upper edge of the cricoid cartilage, the entire area of the pouch ligament. The tumor, including the perichondrium, is removed from the right side after it has been dissected away from the cartilage, as well as from the front left side, whereby the anterior vocal fold is also resected macroscopically in the anterior part of the healthy area. Resection caudally up to the ligamentum conicum. Tumor is marked with sutures. Samples are taken from the supraglottic margin and the basal anterior margin. In the frozen section at the border of the supraglottic to the arytenoid region or the arytenoid region to the subglottic region, the tumor forms a margin. Also in the area of the vocal fold on the front left. A resection is performed on the left side, which includes the supraglottic, glottic and subglottic areas and is sent in marked with sutures. The sutures are all remote from the tumor. Also post-resection dorsal right and subglottic right. A marginal sample is then taken from subglottic and dorsal in the arytenoid region. Here in the first post-resection supraglottic left still clear carcinoma infiltrates, glottic and subglottic none. In the direction of the arytenoid region, there is a tumor, although metaplasia is also possible. Post-resection is therefore also recommended here. Overall, the resection in the arytenoid region on the right has already progressed to the interary area. Further massive removal of the mucosa is not possible without functional damage. Therefore, mucosa is removed from the arytenoid region in the dorsal area and subglottically only as a resection. In addition, an extensive resection is performed in the glottic and supraglottic area on the left, whereby the sutures are placed remote from the tumor. Ultimately, a vocal fold remnant remains on the left, supraglottic mucosal remnant on the left. Overall, the situation is now borderline. In principle, there is also a suspicion of field carcinomatization with an overall macroscopically invisible tumour extension. Now laryngeal closure. Creation of drill holes and 2 Vicryl sutures, which adapt the cartilage. Perichondrium is sutured over the laryngeal cartilage defect or over the laryngeal cartilage. The muscle layer is sutured over this. A further layer of soft tissue is then applied. The skin is then closed in layers with the insertion of a flap. A tracheostoma was also created via a slightly deeper, small Kocher collar incision. The trachea was first exposed by dissecting through the subcutaneous tissue. The thyroid isthmus was cut and ligated beforehand. A modified Björk flap is then created, which has a wide stalk. The tracheostoma is then epithelialized in the typical manner. An 8 mm tracheostomy tube is then inserted. Overall, the procedure is completed without complications. Patient goes to the intensive care unit for monitoring. Overall borderline situation as far as partial laryngeal resection is concerned. No further resection can be performed, particularly in the direction of the interary space, without the interary region shrinking and leading to respiratory distress. If tumor residues are still present, a laryngectomy should be discussed in any case. Even in an R0 situation, the situation is borderline, so that a laryngectomy would ultimately be the safest option for long-term survival. Postoperative nutrition via a nasogastric tube if necessary.

446/InvasionFront_CD3_block22_x5_y3_patient446_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 17016.0,
+    "Centroid Y µm": 19264.8,
+    "Num Detections": 19436,
+    "Num Negative": 18677,
+    "Num Positive": 759,
+    "Positive %": 3.905,
+    "Num Positive per mm^2": 315.26
+  }
+}

446/InvasionFront_CD3_block22_x6_y3_patient446_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 19664.6,
+    "Centroid Y µm": 19489.7,
+    "Num Detections": 19696,
+    "Num Negative": 18135,
+    "Num Positive": 1561,
+    "Positive %": 7.925,
+    "Num Positive per mm^2": 699.11
+  }
+}

446/InvasionFront_CD8_block22_x5_y3_patient446_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18715.1,
+    "Centroid Y µm": 7745.9,
+    "Num Detections": 16916,
+    "Num Negative": 16455,
+    "Num Positive": 461,
+    "Positive %": 2.725,
+    "Num Positive per mm^2": 202.4
+  }
+}