Elective neck dissection for carcinomas of the oral cavity: occult metastases, neck recurrences, and adjuvant treatment of pathologically positive necks

BACKGROUND: Supraomohyoid neck dissection (SOHND) is currently performed in patients with carcinoma of the oral cavity with clinically negative neck. Most investigators consider SOHND as a staging procedure. METHODS: Records of 100 patients with cancer of the oral cavity and clinically negative neck undergoing SOHND were reviewed. The rate and significance of occult metastases are evaluated, the neck recurrences are analyzed and the indication of adjuvant radiation of pN+ necks is discussed. RESULTS: In 34 of 1814 of analyzed lymph nodes, metastatic disease was detected as follows: 30 macrometastases and 4 micrometastases. In 13 of 34 metastases (38%), extracapsular spread was observed. Twenty of 100 patients (20%) had to be upstaged. In 9 of 87 (10%) patients without local recurrence and with a minimal follow-up of 24 months, 5 ipsilateral (4 within the dissection field) and 5 contralateral neck recurrences were observed. Regional recurrence developed in 4% and 35% of patients with pN0 and pN+ necks, respectively. CONCLUSIONS: In 20% of patients with oral cavity tumors and pN0 neck, occult metastases were disclosed. Neck recurrences developed significantly more often in patients with pN+ than in those with pN0 necks. To evaluate the exact indication for an adjuvant treatment of patients with cN0/pN+ necks, prospective studies should be performed.

The story of Community preference for food security

"Préférence communautaire" is an in-built notion of the CAP since its inception with the Treaty of Rome (1957). Its’ simple objective laid down at the Stresa Conference in 1958 is to prefer community produce over imports wherever possible, while at the same time promoting agricultural exports and FDI (“vocation exportatrice de l’Europe”). Does this contrast or correlate with the notion of “food sovereignty” which originated in 1996 as a notion of small farmer self-sufficiency (Via Campesina), and which now has found its way into the official EC discourse? Recent CAP reforms indeed seem to continue banking on border protection and on the occasional export subsidy. Nonetheless, coming together with claims to mitigate climate change, “food sovereignty” à la CAP fails to acknowledge efficiency losses at home and negative spillover effects on the right to food of food exporting developing countries. This chapter asks whether new non-tariff and domestic support measures are just new wine in the old cask of fortress Europe, together with the FDI promotion instruments of the FED and others. Might the increasing dynamics and new challenges of agricultural trade and investment lead to lower market and production shares for European farms? It concludes that in the medium term the WTO Green Box has the only legal and effective tools to promote EU agriculture and food.

Minority Rights and Humanitarianism: The international campaign for the Ukrainians in Poland, 1930-31

In October 1930, violent action of the Polish security forces against the Ukrainian population in Eastern Galicia resulted in an international campaign for the Ukrainians in Poland. Its central claim was the condemnation of these incidents as a violation of the Minorities Treaty of the League of Nations. The article focuses on the involved British extra-parliamentary groups and their international federations as well as leftist intellectuals, socialist parties and the Labour and Socialist International. In most cases, the commitment of the activists was motivated by the desire to expose a humanitarian scandal while the implementation of minority rights played a minor role. When it turned out that the first reports had presented an exaggerated version of the events, they shifted their focus to the Polish opposition whose persecution started in November 1930.

The Hidden World of Multilateralism? Treaty Commitments of Newly Democratized States in Europe

Why do new EU democracies engage in multilateralism? The dominant explanation proposes that new democracies use international treaties to lock in domestic reforms. This article offers a novel explanation as to why new EU democracies participate in multilateral treaties. We argue that ratifying a treaty serves three external signaling purposes (addressing recognition concerns; increasing strategic autonomy, and pleasing the EU). We test our argument through a mix of quantitative and qualitative methods. First, we apply event history analysis. Drawing on a new ratification data set comprising 76 multilateral treaties, we illustrate the prominent role of new EU democracies in multilateralism as compared to other new democracies. Second, to assess the importance of external signaling in the decision to ratify multilateral treaties, we examine parliamentary ratification debates in selected Central and Eastern European countries. Third, we compare parliamentary discussions across European and non-European new democracies to demonstrate the different motives driving their approaches toward multilateralism.