• Radiation Oncology Journal
• /
• v.17 no.1
• /
• pp.36-41
• /
• 1999

Purpose : We reviewed the treatment results for the patients with locally recurrent rectal carcinoma. The object was to evaluate the treatment outcome and to identify the prognostic factors influencing the survival. Methods and Materials: Twenty-eight patients with locally recurrent rectal carcinoma treated principally with external-beam radiation therapy between 1982 to 1996 in the Department of Radiation Oncology at Paik and Hanyang Hospital were reviewed retrospectively Of these, 17 patients had initially abdominoperineal resection, 9 had low anterior resection, and 2 had local excision. No patients had received adjuvant radiation therapy for the primary disease. There were 14 men and 14 women whose ages ranged from 31 to 72 years (median age:54.5). Median time from initial surgery to the start of radiation therapy for local recurrence was 11 months (4~47 months). Radiation therapy was given with total doses ranging from 27 to 64.8 Gy (median=51.2 Gy). Results : The median survival was 16.7 months. The 2-year and 5-year survival rates were 20.1%, 4.1% respectively. Upon multivariate analysis, overall survival was positively correlated with duration of intervals from initial surgery to local recurrence (P=0.039). Relief of pelvic symptoms was achieved in 17 of 28 patients (60.7%). Pain and bleeding responded in 40% and 100% of patients, respectively Conclusions : Patients with locally recurrent rectal carcinoma treated with radiotherapy have benefited symptomatically, and might have increased survivals with a small chance of cure. But, patient were rarely cured (median survival : 10 months, 5-year survival : less than 5%). Overall survival was positively correlated with long intervals from initial surgery to local recurrence. Future efforts should be directed to the use of effective therapy for patients with locally recurrent rectal carcinoma and adjuvant therapy for patients with rectal cancer to reduce the incidence of pelvic recurrence.

• Journal of the Korean Society of Radiology
• /
• v.81 no.3
• /
• pp.620-631
• /
• 2020

Purpose We aimed to assess local tumor progression (LTP) rate and associated prognostic factors in 92 patients who underwent radiofrequency ablation (RFA) using saline-perfused electrodes to treat hepatocellular carcinoma (HCC) (≤ 5 cm). Materials and Methods Total 92 patients with 148 HCCs were treated with RFA using saline-perfused electrodes, from 2009 to 2015. We retrospectively evaluated technical success, technique efficacy, and LTP rates. Potential prognostic factors for LTP were perivascular tumor, subphrenic tumor, artificial ascites, tumor size (≥ 2 cm), and previous treatment of transarterial chemoembolization. Analysis was performed by lesion, rather than by person. Results During follow-up period from 1 to 97.4 months, total cumulative LTP rates were 7.9%, 11.4%, and 14.6% at 1, 3, and 5 years, respectively. These values were significantly higher in the perivascular (35.1%; p = 0.009) and subphrenic group (38.9%; p = 0.002) at 5-year. We did not observe any significant difference in LTP according to other prognostic factors (p > 0.05). Conclusion RFA with saline-perfused electrode is a safe and effective treatment modality for HCC (≤ 5 cm), with lower LTP rates. Nevertheless, perivascular and subphrenic HCCs demonstrated higher LTP rate than other sites. It is imperative to note that perivascular and subphrenic location of HCC are associated with a high risk of local recurrence, despite the use of saline-perfused electrodes.

• The Journal of the Korean bone and joint tumor society
• /
• v.19 no.1
• /
• pp.20-27
• /
• 2013

Purpose: The purpose of this study was to evaluate the oncologic outcomes of parosteal osteosarcoma (POS) and to ascertain the fates of patients after local recurrence (LR). Materials and Methods: The authors retrospectively reviewed 22 POS patients with an average follow-up of 114 months (range: 36-235 months). Seven of the 22 patients were referred after LR. There were 17 Stage IB and 5 Stage IIB (G2, 2; dedifferentiation, 3). Tumors were located in the femur (11) and in other locations (11). Initial surgical margins were wide in 10, marginal in 5, and intralesional in 7. Correlations between clinico-pathologic variables and LR and clinical courses after LR were evaluated. Results: The 10-year overall survival rate was 85.7%. Three (14%) patients developed distant metastasis and all of them succumbed to the disease. Nine (41%) patients developed LR. Tumor location, resection type, and surgical margin were found to be correlated with LR. At final follow-up, 7 of the 9 patients that experienced local failure achieved no evidence of disease. Conclusion: A substantial risk of misdiagnosis exists, especially for POS in other than a femoral location. Recurrent tumor re-excision is possible in most cases; however, patients with an aggressive recurrence pattern deserve special attention.

• Journal of Chest Surgery
• /
• v.37 no.11
• /
• pp.942-945
• /
• 2004

Primary pulmonary liposarcoma is extremely rare disease. It has poor prognosis with early multiple metastases and frequent local recurrences. Surgery is the choice of treatment for liposarcoma. Incomplete resection would result in rapid and aggressive growing of the tumor. We report a case of primary pulmonary liposarcoma which was successfully treated with complete resection without local recurrence and distant metastasis for 10 months.

• The Journal of the Korean bone and joint tumor society
• /
• v.16 no.2
• /
• pp.51-54
• /
• 2010

Purpose: This study was aimed to evaluate the recurrence rate of a giant cell tumor (GCT) of the bone. Materials and Methods: The medical records of fifty four patients who were diagnosed with a giant cell tumor of the bone between March 1980 and December 2008 were analysed retrospectively. Among 54 patients, 27 were men, remaining 27 were women with the mean age of 33.1 years (range, 13-67 years). The mean duration of follow-up was 67.1 months. Results: Twenty-one patients (38.9%) had a local recurrence. The mean time to recurrence was 21.5 months (range, 2-59 months). The local recurrence rate of the upper extremities was higher than that of lower extremities. According to Campanacci classification, patients with a grade I diseae had lower recurrence rate than those with grade II or III disease. There was no significant differences in the recurrence rates based on cryotherapy, the filling of bone cement or bone grafts and surgical margin. Conclusion: To prevent local recurrence of GCT of bone, curettage of the tumor and elimination of the remaining cells are more important than adjuvant therapy.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1991.06a
• /
• pp.42-42
• /
• 1991

부비동에 발생하는 악성종양은 자각증상이 비교적 늦게 나타나 병변이 많이 진행된 후에 발견되는 경우가 대부분이다. 진행된 부비동압의 치료는 수술, 화학요법, 방사선요법의 병용치료법이 종래부터 시도되어왔으며 대부분의 경우 광범위한 수술적 절제가 필요하여 이에 따른 후유증이 크고 치료결과는 아직 많은 논란이 있다. 저자들은 진행된 부비동암 (T4)환자 10명에서 유도화학요법 (Cisplatin, 5-FU)후 수술 (상악절제술 4예, 두개안면 절제술 1예 )과 방사선 치료 (약 7000 cGy)를 받은 5명과 유도화학요법후 방사선치료만 받은 5명을 비교하여 다음과 같은 결과를 얻었다. 1. 수술을 포함한 병용요법을 받은 환자 6명중 3명은 평균추적기간 28개월 동안 재발의 증거가 없었으나 2명에서 국소재발이 있었고 이들은 국소 절제술 및 방사선치료후 현재 1년 이상 무병상태이다. 2. 수술을 포함한 병용요법을 받은 환자 5명중 4명에서 초진시 안와내 종양침윤의 소견이 있었으나 수술시 안와를 보존하였고 그 후 안와 부위의 국소 재발은 없었다. 3. 유도화학요법과 방사선치료만을 받은 5명 모두 6개월 이내에 국소재발하였다. 4. 진행된 악성 부비동암은 수술을 포함한 병용요법으로 좀 더 좋은 치료성적을 얻을 수 있을 것으로 기대된다.

• Journal of Chest Surgery
• /
• v.30 no.4
• /
• pp.449-452
• /
• 1997

We managed surgically a case of local recurrence in esophageal cancer Twenty month after transthoracic subtotal esophagectomy and csophago-gastrostomy, he su(fared from dysphagia. Chest CT and percutaneous needle aspiration biopsy showed . Local recurrence involving residual esophagus, thyroid gland, posterior membraneous portion of trachea. We did cervical esophagectomy, laryngectomy thyroidectomy, partial resection of trachea and reconstruction with free jejunal antograft successfully.

• Radiation Oncology Journal
• /
• v.22 no.1
• /
• pp.11-16
• /
• 2004

Purpose: To evaluate the survival rate, local failure rate and patterns of failure, and analyze the prognostic factors affecting local relapse of ductal carcinoma in situ treated with breast conserving surgery and radiotherapy Materials and Methods: From June 1995 to December 2001, 96 patients with ductal carcinoma in situ treated with breast conserving surgery and radiotherapy were retrospectively analyzed. The operations were either local or wide excision in all patients, with an axillary lymph node dissection performed in some patients. Radiation dose to the whole breast was 50.4 Gy, over 5 weeks, with 1.8 Gy daily fractions, with additional doses ($10\~14$ Gy) administered to the primary tumor bed in some patients with close ($\leq$2 mm) or positive resection margin. The median follow-up period was 43 months (range $10\~102$ months). Results: The 5-year local relapse free survival and overall survival rates were 91 and $100\%$ respectively. Local relapse occurred in 6 patients ($6.3\%$). Of the 6 recurrences, one was invasive ductal cell carcinoma. With the exception of one, all patients recurred 2 years after surgery. There was no regional recurrence or distant metastasis. Five patients with local recurrence were salvaged with total mastectomy, and are alive with no evidence of disease. One patient with recurrent invasive ductal cell carcinoma will receive salvage treatment. On analysis of the prognostic factors affecting local relapse, none of the factors among the age, status of resection margin, comedo type and nuclear grade affected local relapse. Operation extent also did not affect local control (p=0.30). In the patients with close resection margin, boost irradiation to the primary tumor bed did not affect local control (p=1.0). Conclusions: The survival rate and local control of the patients with ductal carcinoma in situ treated with breast conserving surgery and radiotherapy were excellent. Close resection margin and boost irradiation to the primary tumor bed did not affect local relapse, but further follow-up with much more patients is needed.

• Journal of Gastric Cancer
• /
• v.5 no.1
• /
• pp.52-56
• /
• 2005

Despite improvements in the surgical treatment of gastric adenocarcinomas, the recurrence rates remain high in patients with advanced-stage disease. Most of the recurrence occurs within 3 years of the surgical resection, and nearly $90\%$ of the patients with recurrence die within 2 years of the diagnosis of recurrence. A recent study analyzed recurrence patterns for patients who had undergone a potentially curative gastrectomy. For those patients, $33\%$ of the recurrences involved locoregional sites, $44\%$ the peritoneum, and $38\%$ distant sites. A 51-year-old female patient was diagnosed with stomach cancer and underwent a total gastrectomy with D2 lymph node dissection during Oct. 1999. The pathologic report indicated a T3N1M0 tumor. We performed immunochemotherapy for 2 years with regular follow up. A gastrofiberscopic examination done during sep. 2004, cancer recurrence was found at the Kim's tie site of the jejunual loop. We did an abdominal exploration and a segmental resection of cancer site with pathologically negative resection margins. After the operation, we started secondary chemotherapy with TS-1.

• Radiation Oncology Journal
• /
• v.20 no.4
• /
• pp.323-327
• /
• 2002

Purpose : To evaluate the outcome of early stage non-small cell lung cancer patients who were treated with radiation therapy alone and define the optimal radiotherapeutic regimen for these patients. Materials and Methods : A retrospective review was peformed on patients with sage I or II non-small cell carcinoma of the lung that were treated at our institution between June, 1987 and May, 2000. A total of 21 patients treated definitively with radiation therapy alone were included in this study. The age of the patients ranged from 53 to 81 years with a median of 66 years. All the patients were male. The medical reasons for inoperability were lack of pulmonary reserve, cardiovascular disease, poor performance status, old age, and patient refusal in the decreasing order. Pathological evidence was not adequate to characterize the non-small cell subtype in two patients. Of the remaining 19 patients, 16 had squamous cell carcinoma and 3 had adenocarcinoma. Treatment was given with conventional fractionation, once a day, five times a week. The doses to the primary site ranged from 56 Gy to 59 Gy. No patients were lost to follow-up. Results : The overall survival rates for the entire group at 2, 3 and 5 years were 41, 30 and $21\%$, respectively. The cause specific survivals at 2, 3 and 5 years were 55, 36 and $25\%$, respectively. An intercurrent disease was the cause of death in two patients. The cumulative local failure rate at 5 years was $43\%$. Nine of the 21 patients had treatment failures after the curative radiotherapy was attempted. Local recurrences as the first site of failure were documented in 7 patients. Therefore, local failure alone represented $78\%$ of the total failures. Those patients whose tumor sizes were less than 4 cm had a significantly better 5 year disease free survival than those with tumors greater than 4 cm $(0\%\;vs\;36\%)$. Those patients with a Karnofsky performance status less than 70 did not differ significantly with respect to actuarial survival when compared to those with a status greater than 70 $(25\%\;vs\;26\%,\;p>0.05)$. Conclusion : Radiation therapy 리one is an effective and safe treatment for early stage non-small ceil lung cancer patients who are medically inoperable or refuse surgery. Also we believe that a higher radiation dose to the primary site could improve the local control rate, and ultimately the overall survival rate.