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509/InvasionFront_CD8_block11_x6_y9_patient509_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 21036.3,
+    "Centroid Y µm": 32842.3,
+    "Num Detections": 20699,
+    "Num Negative": 18365,
+    "Num Positive": 2334,
+    "Positive %": 11.28,
+    "Num Positive per mm^2": 1074.0
+  }
+}

509/TumorCenter_CD3_block11_x5_y9_patient509_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18851.0,
+    "Centroid Y µm": 22485.0,
+    "Num Detections": 0,
+    "Num Negative": 0,
+    "Num Positive": 0,
+    "Positive %": NaN,
+    "Num Positive per mm^2": NaN
+  }
+}

509/TumorCenter_CD8_block11_x5_y9_patient509_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 16478.8,
+    "Centroid Y µm": 22225.7,
+    "Num Detections": 0,
+    "Num Negative": 0,
+    "Num Positive": 0,
+    "Positive %": NaN,
+    "Num Positive per mm^2": NaN
+  }
+}

509/TumorCenter_CD8_block11_x6_y9_patient509_1.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18927.5,
+    "Centroid Y µm": 22325.7,
+    "Num Detections": 15635,
+    "Num Negative": 12625,
+    "Num Positive": 3010,
+    "Positive %": 19.25,
+    "Num Positive per mm^2": 1486.4
+  }
+}

509/icd_codes.txt

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+Karzinom Oropharynx mehrere Teilbereiche überlappend[C10.8 ]

509/ops_codes.txt

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+Partielle Resektion des Pharynx [Pharynxteilresektion]: Transoral: Rekonstruktion mit freiem mikrovaskulär-anastomosierten Transplantat[5-295.04 ] Transplantat[5-296.14 ] Radikale zervikale Lymphadenektomie [Neck dissection] radikal modifiziert 5 Regionen[5-403.21 B] Entnahme sonstiges Transplantat mit mikrovaskulärer Anastomosierung Unterarm[5-858.43 L] Entnahme von Vollhaut aus der Leistenregion[5-901.1c ] Vollhaut großflächig Empfängerstelle Unterarm[5-902.68 L] Perkutane [endoskopische] Gastrostomie [PEG][5-431.2 ] Permanente Tracheotomie mit mukokutaner Anastomose[5-312.2 ] Direkte diagnostische Pharyngoskopie[1-611.0 ] Direkte diagnostische Laryngoskopie[1-610.0 ] Kontinuierliche Sogbehandlung bei einer Vakuumversiegelung an bis zu 7 Tagen[8-190.10 ] Wechsel Implantat Gefäße Kopf und Hals extrakraniell[5-394.3 ]

509/patient_clinical_data.json

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+{
+  "year_of_initial_diagnosis": 2012,
+  "age_at_initial_diagnosis": 61,
+  "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": 26,
+  "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"
+}

509/patient_pathological_data.json

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+{
+  "patient_id": "509",
+  "primary_tumor_site": "Oral_Cavity",
+  "pT_stage": "pT4a",
+  "pN_stage": "pN2b",
+  "grading": "G2",
+  "hpv_association_p16": "not_tested",
+  "number_of_positive_lymph_nodes": 3.0,
+  "number_of_resected_lymph_nodes": 40,
+  "perinodal_invasion": "yes",
+  "lymphovascular_invasion_L": "no",
+  "vascular_invasion_V": "yes",
+  "perineural_invasion_Pn": "yes",
+  "resection_status": "R0",
+  "resection_status_carcinoma_in_situ": "CIS Absent",
+  "carcinoma_in_situ": "no",
+  "closest_resection_margin_in_cm": "0.4",
+  "histologic_type": "SCC_Conventional-Keratinizing",
+  "infiltration_depth_in_mm": 16.0
+}

509/surgery_description.txt

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+Kombiniert transoral transzervikale En-bloc-Resektion, Freier Lappen (Radialis)

509/surgery_report.txt

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+First deepening of the anesthesia. After intubation through the anesthesia, pharyngoscopy and confirmation of an oropharyngeal carcinoma measuring at least cT2 on the left side, which just reaches the posterior wall of the oropharynx and extends caudally and medially into the base of the tongue. On palpation, the tumor is slightly larger in comparison with the computer tomography and is difficult to move laterally. Initially under strict diaphanoscopic control and after administration of 3 g Unacid, after skin disinfection and abjodation, placement of a 15 Charričre PEG tube using the thread pull-through technique. Strict diaphanoscopic conditions on all sides. The gastric mucosa is unremarkable. Sterile dressing. Then insertion of the tonsil plug. Inspection of the tumor tissue again. Then, using the electric needle of the bipolar forceps under visualization, start resection of the tumour from cranial to caudal, taking parts of the base of the tongue with it. The tumor is not visible at any time and is released at a wide macroscopic distance. However, it becomes apparent that the tumor has grown laterally into the pterygoid musculature and the palpatory distance of the lateral tumor border lies in depth up to the immediate vicinity of the carotid flow area. It was therefore decided to continue the tumor resection transcervically; 2 cranial margin samples were tumor-free. Skin disinfection and infiltration anesthesia with a total of 18 ml Ultracaine with added adrenaline on both cervical and median sides. Start with neck dissection on the left side: skin incision on the anterior edge of the sternocleidomastoid. Dissection of a subplatysmal portion of connective tissue. Release of the connective tissue sheath ventrally. Identification of the internal jugular vein, the omohyoid muscle and the digastric muscle. Remove the entire soft tissue mantle from the medial neck preparation, identify the superior thyroid artery and the hypoglossal nerve. Now release from caudal to cranial. Dissection of the internal jugular vein, the vagus nerve and the cervical nerve. Level III and II show large, conglomerate-like lymph node metastases through which the accessorius nerve runs. It was therefore decided to resect the nerve. The internal jugular vein, which also runs through the metastasis, is then removed together with the metastatic conglomerate. The external jugular vein is preserved. After releasing and removing the submandibular gland, access is gained through level I b into the oropharynx. The en bloc resection of the tumor is now completed. Basally in the wound area to the lateral side, the pathology still describes an R1 situation, which is why selective resection is performed again at this point; the other marginal samples were tumor-free. Dissection of the external and internal carotid artery. Ligation of the left lingual artery. Identification of the vascular nerve bundle of the superior pharyngeal artery. Subtle hemostasis and neck dissection on the right side: Here too, 2 to 3 oval lymph nodes are visible in levels II and III, but overall they are also to be classified as suspicious. Neck dissection levels I b, II, III and IV and partial V are now performed. The submandibular gland is preserved, as are the external jugular vein, vagus nerve, cervical nerve, accessorius and hypoglossus. The internal jugular vein is also preserved on this side; the submandibular gland, removal of 2 inconspicuous lymph nodes from level I b. After a door-like incision, cut the cutaneous and subcutaneous tissue to create a plastic tracheotomy. Blunt separation of the infrahyoid musculature. Identification of the anterior tracheal surface after transection of the isthmus of the thyroid gland. Visualization of the anterior surface of the trachea caudally. Incision between the 2nd and 3rd tracheal clasp area. Formation of a Björk flap. Re-intubation. After ethibond suture fixation at 6 points on a 9 mm Rügheimer cannula and problem-free ventilation. Suture fixation of the cannula edges with an Ethibond suture. Then removal of an area of inguinal skin measuring 12 x 6 cm and placement of a Redon drain. At the same time, the radial flap on the left side of the forearm is removed. After placing the tourniquet, the oropharyngeal defect region is marked. This is now adapted to the forearm. Skin incision, cut in an S-shape, from the crook of the elbow into the flap area. Starting radially, detachment of the myofascial tissue portion, release of the flap with identification of the antebrachial cutaneous nerve and the parallel vein. Identification of the radial artery-venous bundle and consecutive release from distal to proximal with multiple clip ligation and bipolar coagulation of the draining and feeding branches. It is thus possible to develop a wide stalk which, however, consists of 2 small caliber veins. Removal of the tourniquet and further hemostasis and preparation of the left cervical vascular area. Removal of the pedicle and primary closure of the defect with the inguinally removed full-thickness skin and application of a VAC dressing. Please leave this in place for 7 days. Suture removal on the 7th day. Please take photo documentation, several times intraoperatively. Then also dissect the stalk of the arterio-venous vascular bundle. Now primary suture of the artery or connection to the superior thyroid artery using 8.0 Ethilon. After dissection, the external jugular vein is first recruited and supplied with a 2.0 mm coupler. The second vein is supplied with a 1.0 coupler from a venous vessel in the area of the superior or middle thyroid vein. Overall, this is very difficult to achieve, but a dense vascular anastomosis is created in both the arterial and venous areas. After placement of a Redon drain on both cervical sides, the wound is closed in two layers and a dressing is applied. Discrete signs of congestion enorally at the end of the operation but good perfusion. Cannula change on day 3 to 5; suture removal on the neck on day 7.  

510/InvasionFront_CD3_block9_x5_y9_patient510_0.json

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+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 17066.0,
+    "Centroid Y µm": 23662.5,
+    "Num Detections": 21810,
+    "Num Negative": 21013,
+    "Num Positive": 797,
+    "Positive %": 3.654,
+    "Num Positive per mm^2": 323.22
+  }
+}

510/InvasionFront_CD3_block9_x6_y9_patient510_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 19814.5,
+    "Centroid Y µm": 23937.3,
+    "Num Detections": 22698,
+    "Num Negative": 22233,
+    "Num Positive": 465,
+    "Positive %": 2.049,
+    "Num Positive per mm^2": 191.05
+  }
+}

510/InvasionFront_CD8_block9_x5_y9_patient510_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 17165.9,
+    "Centroid Y µm": 27185.6,
+    "Num Detections": 22706,
+    "Num Negative": 21369,
+    "Num Positive": 1337,
+    "Positive %": 5.888,
+    "Num Positive per mm^2": 549.67
+  }
+}

510/InvasionFront_CD8_block9_x6_y9_patient510_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 19814.5,
+    "Centroid Y µm": 27360.5,
+    "Num Detections": 22930,
+    "Num Negative": 22413,
+    "Num Positive": 517,
+    "Positive %": 2.255,
+    "Num Positive per mm^2": 219.89
+  }
+}

510/TumorCenter_CD3_block9_x5_y9_patient510_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 16266.4,
+    "Centroid Y µm": 28260.0,
+    "Num Detections": 0,
+    "Num Negative": 0,
+    "Num Positive": 0,
+    "Positive %": NaN,
+    "Num Positive per mm^2": NaN
+  }
+}

510/TumorCenter_CD3_block9_x6_y9_patient510_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 18440.2,
+    "Centroid Y µm": 28584.9,
+    "Num Detections": 12300,
+    "Num Negative": 11001,
+    "Num Positive": 1299,
+    "Positive %": 10.56,
+    "Num Positive per mm^2": 924.11
+  }
+}

510/TumorCenter_CD8_block9_x5_y9_patient510_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 17057.4,
+    "Centroid Y µm": 23887.8,
+    "Num Detections": 0,
+    "Num Negative": 0,
+    "Num Positive": 0,
+    "Positive %": NaN,
+    "Num Positive per mm^2": NaN
+  }
+}

510/TumorCenter_CD8_block9_x6_y9_patient510_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 19078.8,
+    "Centroid Y µm": 23939.0,
+    "Num Detections": 0,
+    "Num Negative": 0,
+    "Num Positive": 0,
+    "Positive %": NaN,
+    "Num Positive per mm^2": NaN
+  }
+}

510/history_text.txt

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+There is morphological and clinical evidence of a high-grade hypopharyngeal carcinoma with an exuding large cervical lymph node metastasis on the right side. After exclusion of distant metastasis, indication for the above-mentioned procedure.

510/icd_codes.txt

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

510/ops_codes.txt

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+Direkte Hypopharyngoskopie[1-611.0 ] Direkte diagnostische Laryngoskopie[1-610.0 ] Laserkoagulation Pharynxgewebe[5-292.31 ] Transorale partielle Resektion des Pharynx [Pharynxteilresektion] mit Rekonstruktion mit gestieltem Fernlappen[5-295.05 ] Radikale Neck dissection in 4 Regionen[5-403.10 R] Radikal modifizierte Neck dissection in 4 Regionen[5-403.20 L] Permanente Tracheotomie[5-312.0 ] PEG-Sonde Anlage[5-431.2 ] Diagnostische Ösophagogastroskopie[1-631 ]

510/patient_clinical_data.json

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+{
+  "year_of_initial_diagnosis": 2014,
+  "age_at_initial_diagnosis": 52,
+  "sex": "male",
+  "smoking_status": "non-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": 73,
+  "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"
+}

510/patient_pathological_data.json

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+{
+  "patient_id": "510",
+  "primary_tumor_site": "Hypopharynx",
+  "pT_stage": "pT1",
+  "pN_stage": "pN2c",
+  "grading": "G3",
+  "hpv_association_p16": "not_tested",
+  "number_of_positive_lymph_nodes": 26.0,
+  "number_of_resected_lymph_nodes": 45,
+  "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": "0.5",
+  "histologic_type": "SCC_Conventional-Keratinizing",
+  "infiltration_depth_in_mm": 4.0
+}

510/surgery_description.txt

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+Laserresektion, Neck dissection sowie Tracheotomie, PEG-Anlage

510/surgery_report.txt

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+Dictation <CLINICIAN_NAME>: After induction of anesthesia and intubation by the anesthesia colleagues, entry with the small bore tube and inspection of the hypopharynx. An exophytic process measuring approx. 2-3 cm can be seen at the entrance to the piriform sinus on the medial and anterior side. The tip of the piriform sinus is free. This shows the exophytic mass measuring approx. 2-3 cm. It is located on the anterior and medial side wall of the piriform sinus. The tip is free. The lateral wall is also free. The process also extends into the postcricoid region. Adjustment of the process with the spread laryngoscope and activation of the laser and microscope. Start cutting around the tumor on the medial side wall and gradually remove it. Hemostasis is achieved using monopolar coagulation or vascular clips. To be on the safe side, another resection is performed on the medial wall, as the margin was relatively narrow after removal of the tumor in toto. Both are suture-marked for the frozen section. The frozen section still shows an invasive carcinoma in the mediocaudal area. A generous resection is performed here, including a margin sample, which is again sent to the frozen section. Final R0 situation. This results in a large wound area. Therefore decision to perform a tracheostomy. PEG placement using the thread pull-through method. Successful with good diaphanoscopy. Neck dissection on the right in the meantime. Externally a 5-6 cm metastasis breaking through the skin at level Va to b. Skin incision at the anterior edge of the sternocleidomastoid muscle and in the area of the metastasis around the mass. Exposure of the platysma in the anterior upper area. Formation of a platysma flap. Exposure of the submandibular gland. Exposure of the sternocleidomastoid muscle. This also shows that the metastasis under the skin also infiltrates the sternocleidomastoid muscle in the cranial region. For this reason, the sternocleidomastoid is deposited in the caudal region at the base and the metastasis is deposited from caudal to cranial, sparing the cervical vascular sheath. The metastasis also infiltrates the cervical plexus, which must be completely removed except for a few small branches. The vagus nerve remains intact as it can be pushed away by the tumor. The border cord cannot be completely spared from the tumor. The accessory nerve is also removed. Ultimately, the hypoglossus remains at the top. During dissection, the subclavian vein is torn in the caudal area. This resulted in severe bleeding, which could be sutured over. The result is an hourglass-shaped structure that leads to narrowing of the vein but is still pervious. During the treatment of the subclavian hemorrhage, the outlet of the internal jugular vein was also torn, which ultimately had to be removed. However, deeper accompanying veins could be preserved. V. Bezas: Neck dissection on the left: Skin disinfection on the left and injection of 6 ml mixed solution of Ultracaine with 2% Suprarenin added in the area of the anterior border of the sternocleidomastoid muscle. Sterile washing and draping. Creation of a skin incision on the anterior border of the sternocleidomastoid muscle. Dissection in depth and identification of the platysma. This is cut sharply. Now lift off a subplatysmal flap anteriorly and posteriorly. Further dissection in depth and identification of the superficial cervical fascia. Now identify the external jugular vein and auricular nerve. The great auricular nerve is completely spared and the external jugular vein is coagulated and cut. Now identify the sternocleidomastoid and dissect in depth along the muscles. First dissection in the level II b area until the digastric muscle is identified. Now dissect further along the digastric muscle until the accessor nerve is identified. Tissue above the accessorius nerve is sharply separated and the remaining tissue from level II b is pulled under the accessorius. Further dissection in the area of level II a up to the identification of the facial vein. Here a resection is performed below the submandibular gland. The marginal ramus nerve and facial nerve are not exposed during the preparation. Now clear Level II a until the hypoglossal nerve is identified. The hypoglossal nerve and internal carotid artery are exposed and spared. Now dissect further downwards along the sternocleidomastoid muscle to below the omohyoid muscle. Dissection further laterally up to the identification of the cervical plexus. Further dissection anteriorly above the cervical plexus and prevertebral cervical fascia. Sharp separation of the fatty tissue in level IV and dissection now along the common carotid artery. The fascia of the cervical vascular sheath is largely spared here. Now lift the preparation cranially and complete the dissection in level IV and level III above the internal jugular vein. Further dissection along the omohyoid muscle and infrahyoid muscles. The complete neck dissection is removed as one piece and sent for histological analysis. Careful hemostasis using ligatures and bipolar forceps. A size 10 Redon drain is placed and the wound is closed step by step once the bleeding has stopped completely. <CLINICIAN_NAME>: Lifting of the pectoralis major flap. Measurement of the defect. This results in a 5x7 cm defect that needs to be covered on the neck. The skin island medial to the nipple is configured accordingly. Creation of a skin bridge in the area of the theoretical delto-pectoral flap. Lifting of the skin island from the thoracic wall while protecting the pectoralis minor muscle. Locate and expose the vascular pedicle. Medial separation of the pectoralis major and lateral separation of the pectoralis major from the attachment to the humerus. Finally, most of the muscle is removed. The pedicle is palpable the entire time and the skin island is well supplied with blood. Pull the flap through the skin bridge and fit the graft so that a large muscle patch is positioned in the area of the pharynx. This muscle patch is fixed with sutures and the skin island can be inserted into the skin defect and sutured there. Two Redon drains were previously inserted in the chest area and one in the neck area. Two-layer wound closure in the neck and chest area. At the end, a tracheotomy was created using the visor technique. Insertion into the trachea between the 1st and 2nd tracheal cartilage and creation of a mucocutaneous anastomosis. Patient goes to the intensive care unit for postoperative monitoring. Please set up a diet on the 7th postoperative day without performing an X-ray pre-swallow. Presentation of the patient at the tumor conference to plan adjuvant radiochemotherapy.  

511/InvasionFront_CD3_block5_x1_y5_patient511_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 3972.9,
+    "Centroid Y µm": 12518.4,
+    "Num Detections": 20039,
+    "Num Negative": 16914,
+    "Num Positive": 3125,
+    "Positive %": 15.59,
+    "Num Positive per mm^2": 1283.5
+  }
+}

511/InvasionFront_CD3_block5_x2_y5_patient511_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 6596.5,
+    "Centroid Y µm": 12643.3,
+    "Num Detections": 21127,
+    "Num Negative": 17085,
+    "Num Positive": 4042,
+    "Positive %": 19.13,
+    "Num Positive per mm^2": 1569.2
+  }
+}

511/InvasionFront_CD8_block5_x1_y4_patient511_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 4034.4,
+    "Centroid Y µm": 10221.5,
+    "Num Detections": 8522,
+    "Num Negative": 8395,
+    "Num Positive": 127,
+    "Positive %": 1.49,
+    "Num Positive per mm^2": 108.44
+  }
+}

511/InvasionFront_CD8_block5_x2_y4_patient511_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 6647.1,
+    "Centroid Y µm": 10113.4,
+    "Num Detections": 11035,
+    "Num Negative": 10503,
+    "Num Positive": 532,
+    "Positive %": 4.821,
+    "Num Positive per mm^2": 363.74
+  }
+}

511/TumorCenter_CD3_block5_x1_y4_patient511_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 5122.3,
+    "Centroid Y µm": 9145.2,
+    "Num Detections": 23301,
+    "Num Negative": 19005,
+    "Num Positive": 4296,
+    "Positive %": 18.44,
+    "Num Positive per mm^2": 1629.3
+  }
+}

511/TumorCenter_CD3_block5_x2_y4_patient511_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 7820.9,
+    "Centroid Y µm": 9569.9,
+    "Num Detections": 13983,
+    "Num Negative": 13075,
+    "Num Positive": 908,
+    "Positive %": 6.494,
+    "Num Positive per mm^2": 505.28
+  }
+}

511/TumorCenter_CD8_block5_x1_y4_patient511_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 3773.0,
+    "Centroid Y µm": 9794.8,
+    "Num Detections": 23683,
+    "Num Negative": 20532,
+    "Num Positive": 3151,
+    "Positive %": 13.3,
+    "Num Positive per mm^2": 1201.8
+  }
+}

511/TumorCenter_CD8_block5_x2_y4_patient511_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 6507.1,
+    "Centroid Y µm": 9825.4,
+    "Num Detections": 14334,
+    "Num Negative": 13705,
+    "Num Positive": 629,
+    "Positive %": 4.388,
+    "Num Positive per mm^2": 362.9
+  }
+}

511/icd_codes.txt

@@ -0,0 +1 @@
+Bösartige Neubildung: Gaumen, mehrere Teilbereiche überlappend[C05.8 ]

511/ops_codes.txt

@@ -0,0 +1 @@
+Radikale zervikale Lymphadenektomie [Neck dissection] radikal modifiziert 6 Regionen[5-403.22 B] Resektion Glandula submandibularis mit intraoperativem Monitoring des Ramus marginalis N. facialis[5-262.41 B] Direkte diagnostische Pharyngoskopie[1-611.0 ] Direkte diagnostische Laryngoskopie[1-610.0 ] Sonstige radikale Resektion des Pharynx [Pharyngektomie][5-296.xx ] Gaumenbogenkarzinom-Resektion[5-272.1 ]

511/patient_clinical_data.json

@@ -0,0 +1,18 @@
+{
+  "year_of_initial_diagnosis": 2018,
+  "age_at_initial_diagnosis": 67,
+  "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": 29,
+  "adjuvant_treatment_intent": "curative",
+  "adjuvant_radiotherapy": "yes",
+  "adjuvant_radiotherapy_modality": "percutaneous radiotherapy",
+  "adjuvant_systemic_therapy": "yes",
+  "adjuvant_systemic_therapy_modality": "cisplatin",
+  "adjuvant_radiochemotherapy": "yes"
+}

511/patient_pathological_data.json

@@ -0,0 +1,20 @@
+{
+  "patient_id": "511",
+  "primary_tumor_site": "Oropharynx",
+  "pT_stage": "pT1",
+  "pN_stage": "pN3b",
+  "grading": "G3",
+  "hpv_association_p16": "negative",
+  "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": "Ris0",
+  "carcinoma_in_situ": "yes",
+  "closest_resection_margin_in_cm": "0.5",
+  "histologic_type": "SCC_Conventional-Keratinizing",
+  "infiltration_depth_in_mm": 3.0
+}

511/surgery_description.txt

@@ -0,0 +1 @@
+enorale TU-Resektion, Neck diss bds., Submandibulektomie

511/surgery_report.txt

@@ -0,0 +1 @@
+Transfer of the patient to the operating theater and positioning of the patient. Introductory consultation with the anesthesia department. Carrying out the team time-out. Sterile ablation and draping. Start of enoral tumor resection: insertion of a McIvor spatula. There is an ulcerous-appearing mass on the anterior palatal arch on the left side with a diameter of approx. 2.5 cm. Boundaries can be defined directly. The central ulcer is approx. 1 cm in diameter and hard on palpation. The tumor is carefully and successively removed with the ultrasonic knife under palpatory and inspector control. Both the uvula and the posterior palatal arch can be preserved. The tonsil lobe with the lower part of the tonsil is also preserved. The tumor is placed in the muscles of the palatal arch in such a way that sufficient closure is still possible and regurgitation should be avoided. Marking of the specimen after successive hemostasis. The specimen goes to the frozen section. This is R0-resected on the specimen. The penetration depth of the tumor is 3 mm. Laterally, the tumor is resected over 1 cm, basally 3 mm. As a further resection in depth would result in a large defect with subsequent flap coverage and the patient has a history of internal diseases, it is decided to leave the distance of 3 mm in depth for R0 resection. Repositioning and performing the neck dissection on the left side: skin incision and dissection through the subcutaneous fatty tissue. Splitting of the platysma and exposure of the anterior border of the sternocleidomastoid muscle. Dissection along the omohyoid muscle and finding the submandibular gland. Pulling up the submandibular glanula and exposing the posterior digastric venter. Trace it in the direction of level II b. Several metastasis-related masses can be seen here, including an approx. 4 cm mass above the accessorius nerve. This can be carefully pushed away from the accessorius nerve as well as from the internal jugular vein and the facial vein. The accessory nerve and the hypoglossal nerve can be spared. Further free preparation of the internal jugular vein and successive removal of the lateral neck preparation while sparing the brachial plexus. Successive removal of the medial neck preparation. The cervical nerve and hypoglossal nerve are exposed and preserved. The vagus nerve is also identified and can be preserved. A metastasis is palpated above the submandibular gland at level I b. This was also visualized sonographically. For this reason, successive removal of the submandibular gland on the left side. Ligation of the excretory duct. The lingual nerve with its loop was identified and spared. Successive removal of level I b. For this purpose, the marginal ramus of the facial nerve above the facial vein is first exposed and followed. A total of 6 small branches can be exposed. Ligation and removal of the facial vein and folding it upwards. Successive removal of region I a and I b so that the mandible is subsequently exposed and can be seen. Also removal of level I a. Successive hemostasis. Insertion of a Redon drain and two-layer wound closure. Neck dissection on the right: The incision is made in a curved line at the front edge of the sternocleidomastoid muscle. Use the 15 mm scalpel to sharply cut through the skin and subcutaneous tissue and platysma. Dissection of the subplatysmal flap. Dissection of the anterior margin of the sternocleidomastoid muscle. Dissection of the omohyoid muscle. Exposure of the submandibular gland, the accessorius nerve and the posterior belly of the digaster. Now the anterior neck preparation is also removed at the jugulofacial angle and medial to the cervical vascular sheath. The hypoglossal nerve is exposed and spared as well as the external and internal carotid arteries. The lateral preparation is now resected, starting with level II b to V b on the right side. There is an anastomosis between the accessorius nerve and the deep cervical plexus on the right side. No chyle fistula, no injury to the surrounding structures. Dissection of the internal jugular vein leads to a small tear in the vein, which is treated with 6-0 Vascufil. The submandibular gland to the right of the gland is then dissected out after the facial vein has been cut, ligated and folded up in order to protect the oral branch of the facial nerve. The gland is dissected and the mylohyoid muscle is exposed. Exposure of the lingual nerve. The duct is severed and ligated. Also the facial artery. Removal of the gland and complete evacuation of levels I b and I a. Punctual hemostasis. Insertion of a 10-gauge Redon drain and two-layer wound closure using 4-0 Vicryl and 5-0 Ethilon.

512/InvasionFront_CD3_block12_x3_y12_patient512_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 10219.6,
+    "Centroid Y µm": 34306.8,
+    "Num Detections": 8580,
+    "Num Negative": 8573,
+    "Num Positive": 7,
+    "Positive %": 0.0816,
+    "Num Positive per mm^2": 6.259
+  }
+}

512/InvasionFront_CD3_block12_x4_y12_patient512_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 12768.2,
+    "Centroid Y µm": 34556.7,
+    "Num Detections": 18047,
+    "Num Negative": 17900,
+    "Num Positive": 147,
+    "Positive %": 0.8145,
+    "Num Positive per mm^2": 78.74
+  }
+}

512/InvasionFront_CD8_block12_x3_y12_patient512_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 12668.3,
+    "Centroid Y µm": 33457.8,
+    "Num Detections": 8637,
+    "Num Negative": 8629,
+    "Num Positive": 8,
+    "Positive %": 0.0926,
+    "Num Positive per mm^2": 7.435
+  }
+}

512/InvasionFront_CD8_block12_x4_y12_patient512_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 15391.9,
+    "Centroid Y µm": 33461.4,
+    "Num Detections": 17320,
+    "Num Negative": 17182,
+    "Num Positive": 138,
+    "Positive %": 0.7968,
+    "Num Positive per mm^2": 77.02
+  }
+}

512/TumorCenter_CD3_block12_x3_y12_patient512_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 10394.5,
+    "Centroid Y µm": 29484.4,
+    "Num Detections": 10761,
+    "Num Negative": 10528,
+    "Num Positive": 233,
+    "Positive %": 2.165,
+    "Num Positive per mm^2": 166.56
+  }
+}

512/TumorCenter_CD3_block12_x4_y12_patient512_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 12768.2,
+    "Centroid Y µm": 29709.3,
+    "Num Detections": 10615,
+    "Num Negative": 10459,
+    "Num Positive": 156,
+    "Positive %": 1.47,
+    "Num Positive per mm^2": 89.22
+  }
+}

512/TumorCenter_CD8_block12_x3_y12_patient512_0.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 13018.1,
+    "Centroid Y µm": 38929.4,
+    "Num Detections": 14298,
+    "Num Negative": 14163,
+    "Num Positive": 135,
+    "Positive %": 0.9442,
+    "Num Positive per mm^2": 72.49
+  }
+}

512/TumorCenter_CD8_block12_x4_y12_patient512_1.json

@@ -0,0 +1,11 @@
+{
+  "patient_tma_measurements": {
+    "Centroid X µm": 15566.8,
+    "Centroid Y µm": 39104.3,
+    "Num Detections": 14855,
+    "Num Negative": 14434,
+    "Num Positive": 421,
+    "Positive %": 2.834,
+    "Num Positive per mm^2": 219.17
+  }
+}

512/history_text.txt

@@ -0,0 +1 @@
+In the patient, an extensive hypopharyngeal carcinoma with laryngeal infiltration was histologically confirmed as a squamous cell carcinoma during a panendoscopy, and a tracheotomy was performed in the presence of extensive edema. Overall difficult visualization of the tumor borders. CT showed hypopharyngeal carcinoma with extensive destruction of the larynx on the left side and also cN3 metastasis with a long wall around the ACC without definite signs of infiltration. A preoperative occlusion test showed a regular and sufficient collateral circulation. After extensive internal clarification and therapy optimization in the multimorbid patient as well as after detailed explanatory discussions with reduced therapy options, the decision was made to perform primary radical surgery.