• The Journal of the Korean bone and joint tumor society
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• v.11 no.1
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• pp.71-81
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• 2005

Purpose: Due to local recurrence of tumor, metal failure usually develops in patients who underwent internal fixation or hip joint arthroplasty after curettage in the case of metastatic tumor of proximal femur. The aim of this study is to find out the appropriateness of reconstruction using recycling autograft after wide excision in the case of metastatic bone tumor by performing recycling autograft and hip joint arthroplasty after wide excision, and through presence or absence of local recurrence, functions of lower limbs and occurrence of complications. Materials and Methods: Five patients, in 6 cases, who had undergone reconstruction using recycling autograft prosthetic composite after wide excision in the metastatic tumor from May 2000 to May 2003 were included in this study. The average age of the patients was 60.8 years of age with male to female ratio of 3:2. Average duration of lives following surgery was 23.3 month (7-57 months). Primary lesion included 2 cases of lung cancer, and 1 each of stomach cancer, renal cancer and multiple myeloma. After wide excision, the hip joint was reconstructed with recycling autograft prosthetic composite ; 4 cases of extracorporeal irradiation and 2 cases of pasteurization. Musculoskeletal Tumor Society (MSTS) score(1993) for 6-month period after surgery, as well as presence of complication and local recurrence during the rest of their lives, were studied. Results: Average Musculoskeletal Tumor Society (MSTS) score over the 6-month period after surgery was 63.3% and 1 case of dislocation of hip joint, as a complication following surgery, was discovered. Local recurrence during the lives of the patients was not observed. Conclusion: In the case of metastatic tumor of proximal femur, in which the life span following surgery is expected to be more than 6 months, undergoing reconstruction using recycling autograft after wide excision, in comparison to internal fixation or hip joint arthroplasty after curettage, is deemed to have better results in prevention of local recurrence, and preservation of the functions of all limbs during the life span of the patient.

• Journal of Gastric Cancer
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• v.7 no.2
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• pp.74-81
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• 2007

Purpose: Routine pancreatico-splenectomy with total gastrectomy should no longer be considered as the standard surgical procedure for gastric cancer because of the lack of proven surgical benefit for survival. The aim of this study is to evaluate the clinicopathologic factors and the survival of patients with locally advanced gastric cancer and they had undergone combined pancreatico-splenectomy with a curative intent. Material and Methods: We retrospectively reviewed a total of 118 patients who had undergone total gastrectomy with distal pancreatico-splenectomy from 1990 to 2001. The patients were divided into 2 groups: 90 patients who were free from cancer invasion (group I), and 28 patients with histologically proven cancer invasion into the pancreas (group II). The various clinicopathologic factors that were presumed to influence survival and the survival rates were analyzed. Results: The rate of pathological pancreatic invasion was 23.7%. The tumor stage, depth of invasion, pancreas invasion, lymph node metastasis, lymph node ratio, curability and the hepatic and peritoneal metastasis were statistically significance on univariate analysis. Among these factors, the tumor stage, lymph node ratio and curability were found to be independent prognostic factor on multivariate analysis. The 5-years survival rates were 36.2% for group I and 13.9% for group II. The morbidity rate was 22.1%, and this included pancreatic fistula (5.1%), intra-abdominal abscess (4.2%) and bleeding (4.2%). The overall mortality rate was 0.8%. Conclusion: Combined distal pancreatico-splenectomy with total gastrectomy with a curative intent was selectively indicated for those patients with visible tumor invasion to the pancreas, a difficult complete lymph node dissection around the distal pancreas and spleen, and no evidence of liver metastasis or peritoneal dissemination.

• Tuberculosis and Respiratory Diseases
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• v.57 no.5
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• pp.443-448
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• 2004

Background : Small-cell carcinomas of lung have a tendency for rapid growth and early wide metastasis. Despite the high response rates of combination chemotherapy alone or with radiotherapy, the overall long-term survival rate is very disappointing. According to autopsy findings, the common cause of failure is local recurrence in the primary cancer site. Therefore, surgical resection with combined chemotherapy has recently been attempted for very early stage small-cell carcinomas of the lung. Methods : 10 patients (TNM I & II: 5 cases each) undergoing surgical resection for small-cell carcinomas of the lung were treated with adjuvant chemotherapy in an attempt to prolong survival. Of these, 9 patients received chemotherapy, and a retrospective study for survival undertaken (Kaplan-Meier analysis). Results : The median survival time was 26 months, and the 2- and 5-year survival rates were 68.6 and 46.7%, respectively. If the 1 patient not having undergone chemotherapy was excluded, the 2-, 5-year survival rates were 76.2 and 50.8%, respectively? No difference in the survival rate was seen between patients with TNM stages I and II. Conclusion : Adjuvant chemotherapy after surgical resection results in prolonged survival for patients with TNM stages I and II small-cell carcinomas of the lung.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.2
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• pp.69-76
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• 2000

Purpose : Tumors of the foot and ankle are uncommon compared with those arising in the other sites, and the malignant tumors are rare. We analyzed the data of patients who have been diagnosed as having a tumor of the foot and ankle. Materials and Methods : Between 1989 and 1998, we treated 72 patients and analyzed on their clinical characteristics retrospectively. Results : Fifty-three cases were benign. Included are 30 cases of soft tissue tumor and 23 cases of bone tumor. Malignant tumor was in 19 cases (26%), including 17 cases of soft tissue tumor, one cases of metastatic tumor. The most common benign tumor was fibroma in soft tissue and osteochondroma in bone. Malignant melanoma was the most common malignant tumor of the foot (7 cases). The predilection site for benign tumors was around toes while for the malignant tumor mostly arises in the heel. Among 19 malignant tumors, local recurrence developed in 3 cases and the distant metastasis occurred in 8 cases. Conclusion : The ratio of malignant tumor and metastasis was high. Therefore, when we faced with a tumor of the foot and ankle, the histopathologic confirmation is essential through biopsy before the definite initial treatment.

• The Journal of the Korean bone and joint tumor society
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• v.17 no.1
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• pp.30-35
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• 2011

Purpose: This study was designed to evaluate the treatment results of malignant melanoma and to analyze the factors influencing prognosis. Materials and Methods: Thirty one cases of malignant melanoma were included in this study. They were treated in our hospital surgically, medically and immunologically from January 1996 to December 2005, and were followed more than 5 years. We compared 5 year survival rate (5YSR) according to the age, gender, anatomical site, depth of tumor, TNM stage, involvement of lymph node and immuno-chemotherapy. Results: Overall 5YSR was 80.6%. 5YSR of the age group below 65 years was 89.7% and 66.7% for the age group over 65 (p=0.033). 5YSR for men was 75% and 90.9% for women. 5YSR according to the site of occurrence showed 66.7% in upper extremities, 89.5% in lower extremities, and 66.7% in other site. 5YSR was 100% for the Clark level below III and 62.5% for the level above IV (p=0.032). 5YSR was 53.8% for lymph node metastasis group and 100% for non-lymph node metastasis group (p=0.021). Conclusion: We concluded that early diagnosis and wide excision was the most important in treatment of malignant melanoma. The prognostic fractors of malignant melanoma were age, depth of tumor (Clark's stage) and metastasis of lymph node.

• Journal of Gastric Cancer
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• v.5 no.2
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• pp.127-132
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• 2005

A hepatoid adenocarcinoma of stomach, a subtype of gastric cancr, is characterized by a histologic resemblance to a hepatocellular carcinoma and $\alpha$-feto protein production. Another feature is early metastasis to the liver and lymph nodes, thus revealing a poor prognosis. We report a case of a hepatoid adenocarcinoma of the stomach with liver metastasis. A 52-year-old male visited our hospital with a chief complaint of indigestion. Gastroscopic examination showed a Borrmann type-II lesion on the lesser curvature of the antrum. The CT scan showed a suspected advanced gastric cancer with liver metastasis. The serum AFP level was 123 ng/ml. A radical subtotal gastrectomy and a right hemihepatectomy were performed simultaneously. Pathologic examination confirmed the lesion to be confined to the submucosa. The gastric lesion was a hepatoid adenocarcinoma, and the hepatic lesion was a metastatic adenocarcinoma from the stomach. Therefore, he was classified as having stage IV (T1N1M1) gastric cancer. In cases of a hepatoid adenocarcinoma of the stomach, even patients with early gastric cancer can be staged into the poor prognostic group.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.2
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• pp.169-177
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• 2003

Purpose: The purpose of the current study is to evaluate the correlation between the expressions of p21 and p27 in osteosarcoma, and prognostic impact such as local recurrence, distant metastasis and survival rate. Materials and methods: Between 1988 and 2001, forty patients who underwent surgery, followed more than 12 months, and whose pathologic blocks were available, were evaluated retrospectively. Their formalin-fixed and paraffin-embedded tumor specimens were investigated. The correlation between expressions of p21, p27, local recurrence, distant metastasis and survival rate was statistically evaluated. Results: p21 protein was expressed in 38 (95%) patients. p27 protein was expressed in 14 (35%) patients. Patients with high expression of p21 had more frequent metastasis and poorer results (p=0.024). In contrast with these findings, patients with positive staining of the p27 had the significant lower distant metastasis (p=0.028). Conclusion: The prognosis of the osteosarcoma according to the expression level of p21 and p27 had inverse relationship which had unknown mechanism. Further work will be needed to define the relationship between p21 and p27.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.1
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• pp.32-39
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• 2005

Introduction: Currently, F-18 fluorodeoxyglucose positron emission tomography scans (FDG-PET) has been investigated in soft tissue tumor especially for tumor detection and noninvasive grading. However, the validity and the efficacy of FDG-PET are still unclear in clinical evaluation. The purpose of this study is to determine the efficacy of FDG-PET in compared to conventional diagnostic imaging studies currently used in the soft tissue tumor. Methods: Between March 2001 and March 2002, 29 patients (sixteen males, thirteen females, mean age, 47 years; a range from 4 to 73) diagnosed with soft tissue tumor were evaluated by both conventional diagnostic imaging and FDG-PET. Valid reference test of the local lesion was the histopathologic diagnosis, which was measured in all patients. The suspecting metastasis in the imaging studies was validated by pathology or follow up imaging for at least 6 months. Each imaging diagnosis was made independently. The accuracy of each diagnostic method was evaluated. The incremental cost accuracy ratio was determined in each diagnostic method. Results: For detection of local lesion, sensitivity, specificity, and accuracy for MRI and FDGPET scans were 91%, 57%, 83% and 95%, 43%, 83% respectively. For detection of distant lesion, sensitivity, specificity, accuracy for conventional diagnostic methods and FDG-PET scans were 77%, 89%, 87% and 92%, 94%, 93% respectively. The incremental cost accuracy ratio (ICAR) of FDG-PET for detection of distant lesion was 145,000won/%. According to ICAR for each tumor grade, PET strategy is most cost-effective at high grade tumors. Conclusions: For detection of local lesion such as recurrence or remnant tumor, FDG-PET scan was not more accurate than MRI. However, It was more accurate for detection of metastatic lesion than conventional methods. For detection of high grade tumor, PET was most costeffective than for detection of lower grade tumor.

• The Journal of the Korean bone and joint tumor society
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• v.18 no.1
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• pp.1-6
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• 2012

Purpose: The purpose of this study was to analyze the results of treatment and prognosis of Marjolin's ulcer compared with primary squamous cell carcinoma. Materials and Methods: Fourteen patients treated for Marjolin's ulcer were analyzed. Twenty patients with primary squamous cell carcinoma treated during the same time period was the control group. Mean age was 61.2 years. There were 24 males and 10 females. The locations, TNM stages, histological grades, recurrence, metastasis, and survival rate were analyzed and compared between two groups. Results: The mean follow-up period was 54.8 months (range, 12-168 months). Local recurrences were found in 6 cases, 5 ones in Marjolin's ulcer patients, and one case in primary squamous cell carcinoma patients. The mean time interval between the initial presentation and occurrence of local recurrences was 9 months (range, 2-20 months). There were 6 metastases. 2 (14.3%) metastases were found in Marjolin's ulcer patients, and 4 (20.0%) metastases in primary squamous cell carcinoma patients. Total events (metastasis or local recurrence) were found in 10 pateients, 6 of them in Marjolin's ulcer group, and the remaining four in primary group. 5-year disease-free survival rate was 64.3% in Marjolin's ulcer group and 95.0% in primary squamous cell carcinoma group. Conclusion: Squamous cell carcinomas originating as Marjolin's ulcers revealed higher recurrence rate and lower survival rate despite of aggressive treatment. Therefore, new treatment modalities should be developed for improving outcomes.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.1
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• pp.26-33
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• 2009

Purpose: This study was performed to investigate the maspin gene expression from osteosarcoma and to determine whether its expression correlates with clinical course of the cancer. Materials and Methods: Between 2001 and 2006, 39 patients who were diagnosed and treated surgically for osteosarcoma were included in the present study. We estimated the maspin gene expression from osteosarcoma tissue samples using RT-PCR. And we examined the correlations between the maspin expression and clinical data (post-chemotherapeutic response, local relapse or metastases). Results: Maspin was over expressed in 21 cases of 39 osteosarcoma tissues. There were significant correlations between maspin expression and the response to neoadjuvant chemotherapy, distant metastases & metastasis-free survival. In multivariate analysis, maspin low-expression was significant risk factor for distant metastases. Also, there was significant difference in metastasis-free survivals between maspin hi- expression group ($69.0{\pm}10.5%$) and low-expression group ($25.4{\pm}13.0%$). Conclusion: The degree of maspin expression in osteosarcoma was significant risk factor for distant metastases and predictive factor for metastasis-free of overall survivals. Maspin may be a useful biologic marker in evaluating the prognosis in patients with osteosarcoma and could be used as a therapeutic target clinically.