• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.9-15
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• 2017

The recently released the $8^{th}$ edition of the American Joint Committee on Cancer (AJCC) Staging Manual introduces significant modifications from the prior $7^{th}$ edition. In this paper, the contents of the new changes in the decision of cancer of the head and neck is summarized except changes in staging of skin and thyroid cancer. In addition to the 8th edition, 1) Addition of extracapsular involvement in metastatic lymph nodes (N category) 2) Oral cancer T classification change, 3) Staging of the pharyngeal cancer was divided into 3 chapters: high-risk human papilloma virus (HR-HPV) associated oropharyngeal cancer (OPC), non HR-HPV associated OPC and hypopharynx cancer (HPC), and nasopharynx cancer (NPC) 4) Changes in T and N classification in NPC, 5) In the case of cancer of unknown primary, P16-positive case is defined as HR-HPV related OPC, and EBV-positive case is defined as NPC. The process that led to these changes highlights the need to collect high-fidelity cancer registry-level data that can be used to confirm prognostic observations identified in institutional data sets. Clinicians will continue to use the latest information for patient care, including scientific content of the 8th Edition Manual. All newly diagnosed cases through December $31^{st}$ 2017 should be staged with the 7th edition. The time extension will allow all partners to develop and update protocols and guidelines and for software vendors to develop, test, and deploy their products in time for the data collection and implementation of the 8th edition in 2018. The 8th edition strikes a balance between a personalized, complex system and a more general, simpler one that maintains the user-friendliness and worldwide acceptability of the traditional TNM staging paradigm.

• Radiation Oncology Journal
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• v.10 no.2
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• pp.227-236
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• 1992

From March 1979 through December 1986, 232 previously untreated patients with invasive carcinoma of the uterine cervix stage IIB were treated at the Department of Therapeutic Radiology, Seoul National University Hospital. The patients studied were staged according to the FIGO recommendations and the majority of patients were treated with external beam whole pelvis radiation and intracavitary radiation. Pretreatment parameters, including physical examination findings, blood parameters, prior medical illnesses, histology and abdomino-pelvic CT findings were studied, employing univariate and multivariate analyses to identify the potentially significant prognostic factors on locoregional control, disease free survival and overall survival. Histology, extent of parametrial involvement on physical examination and paraaortic lymph node metastasis on CT were found to have prognostic significance in the carcinoma of uterine cervix stage IIB.

• Journal of Gastric Cancer
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• v.9 no.3
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• pp.104-109
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• 2009

Purpose: The aim of this study is to evaluate the accuracy of surgically diagnosing early gastric cancer (EGC) and lymph node metastasis, and to determine its role for performing limited surgery for EGC. Materials and Methods: We reviewed 369 patients who underwent gastrectomy for primary gastric carcinoma. The surgical diagnosis was evaluated by determining its sensitivity, specificity and accuracy, and this was compared with the preoperative examinations. Results: The sensitivity, specificity, and accuracy of the intraoperative diagnosis for EGC were 74.5%, 95.7% and 83.7%, respectively. The predictive value for EGC according to the intraoperative diagnosis was 95.7%. The surgical diagnosis of EGC showed higher specificity and a higher predictive value than preoperative examinations, which significantly reduced the risk of underestimating advanced gastric cancer (AGC) to EGC. The sensitivity, specificity, and accuracy for lymph node metastasis according to the surgical diagnosis were 73.2%, 78.1% and 76.4%, respectively. For 70 patients with a discrepancy in the diagnosis of EGC between the pre- and intra-operative diagnosis, the surgical diagnosis was correct in 63 (90%) patients, but the preoperative examinations were correct in only 7 (10%) patients. Conclusion: The surgical diagnosis showed better accuracy than the preoperative examinations for detecting EGC and lymph node metastasis. Our results suggest that the decision for conducting limited surgery based on the surgical diagnosis might reduce the risk of under-treatment of AGC to EGC better than the preoperative examinations.

• 한국벤처창업학회:학술대회논문집
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• 2023.04a
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• pp.149-156
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• 2023

임팩트 투자(impact investment)는 사회적 가치와 재무적 이익을 동시에 추구하는 소셜벤처에 투자하는 행위이다. 그동안 국내에서는 정부 주도로 임팩트 투자 생태계가 조성되고 성장하였다. 선순환 투자 생태계를 위해서는 소셜벤처가 가지는 사회혁신의 가치와 임팩트 투자의 연계가 중요하다. 사회적 형평과 시장의 효율의 두 가치 중심으로 수요와 공급이 맞는 임팩트 투자에 대한 이해가 필수적이다. 특히, 임팩트 투자 지원정책과 투자가 공공에서 민간으로 확대되는 시점에서 임팩트 투자의사 결정요인을 규명하는 차별화된 접근이 필요하다. 이에 본 연구는 임팩트 투자의사 결정요인을 분석하고 우선순위를 도출하고자 하였다. 먼저 문헌분석을 통해 투자 결정에 영향을 미치는 요인을 확인하고 임팩트 투자 심사역을 대상으로 자문·설문조사를 수행한 뒤, 델파이 기법을 적용하여 주요 투자의사 결정요인을 도출하였다. 다음으로는 임팩트 투자 심사역 10명을 대상으로 AHP분석을 실시하여 투자의사 결정요인의 우선순위를 분석하였다. 분석 결과, 상위요인의 중요도는 시장-창업가(팀)-제품·서비스-재무의 순서로 확인되었으며, 세부요인의 중요도는 '시장의 경쟁강도 및 진입장벽-시장성장 및 확장 가능성-팀의 전문성 및 역량-신시장 창출 가능성-영업활동 및 고객관리-창업가의 신뢰성 및 진정성의 순서로 나타났다. 이러한 연구 결과는 임팩트 투자에 대한 지원정책과 투자가 공공에서 민간으로 확대되는 시점에서 고유한 투자의사 결정요인을 규명하여 투자를 희망하는 이해관계자들에게 기초 자료를 제시했다는 데 의의가 있다.

• Radiation Oncology Journal
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• v.24 no.1
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• pp.21-29
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• 2006

Purpose: This study explored the anal sphincter-saving rate and down-staging rate after preoperative chemoradiotherapy for treating lower rectal cancer. We also explored the prognosis of the patients who refused surgery after preoperative chemoradiotherapy. Materials and Methods: Thirty seven patients with histologically proven lower rectal cancer who underwent preoperative chemoradiotherapy were retrospectively analyzed. In each case, the tumor location was 0 to 5 em from the anal verge, and curative resection of the cancer with performing a sphincter-saving procedure was not feasible before chemoradiotherapy. In each case, the staging examinations, including biopsy, were done before starting radiotherapy and this was repeated at 1 month after radiation therapy. Results: After chemoradiotherapy, among the 37 included patients, 56.8% and 32.4% were downstaged to the T stage and N stage, respectively, when comparing the postradiotherapy stage with pre-radiotherapy stage. Twenty five patients underwent complete resection of cancer at 6 weeks after radiotherapy: eleven, eight and six patients underwent abdominoperineal resection, low anterior resection and local excision, respectively. The sphincter-saving rate among the 24 completely resected cases was 54.2%. Twelve patients refused surgery after radiotherapy. Among 6 patients who refused surgery with biopsy-proven complete remission after chemoradiotherapy, 5 patients were alive without disease at a median follow up period of 31 months, and only 1 patient had local failure. Conclusion: For lower rectal cancer, a high sphincter-saving rate was accomplished with preoperative chemoradiotherapy. The prognosis of the patients who refused surgery with biopsy proven complete remission after chemoradiotherapy was good and these patients need to be kept under close surveillance.

• Journal of Chest Surgery
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• v.32 no.4
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• pp.388-393
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• 1999

Background: Correct preoperative staging of esophageal cancer is a prerequisite for adequate treatment. We prospectively compared the accuracy of positron emission tomography (PET) with [fluorine-18]FDG in the staging of esophageal cancer to that of computed tomography (CT). Material and Method: The findings of FDG PET and of chest CT including lower neck and the upper abdomen of 20 biopsy-proven squamous cell carcinoma patients (male, 19; female, 1; mean age, 61) were compared with the pathologic findings obtained from a curative esophagectomy with lymph node dissection. Result: The sensitivities of FDG PET and CT for diagnosis of primary tumor were the same, 90.0% (18/20). Both FDG PET and CT failed to show the primary tumor in 2 of 20 patients; one had a 1cm sized carcinoma in situ and the other had T1 stage cancer. By using the results of the pathologic examinations of 193 removed lymph node groups, we calculated the diagnostic sensitivities, specificities and accuracies of PET and CT (*$\chi$2 p < 0.005). Sensitivity** Specificity Accuracy* PET 55.6%(30/54) 97.1%(135/139) 85.5%(165/193) CT 13.0%(7/54) 98.6%(137/139) 74.6%(144/193) One of four patients with a false-positive for PEThad had active pulmonary tuberculosis. Among the 24 tumor involved lymph node groups, PET failed to show tumor metastasis in 5 lymph node groups abutting the tumor and in 14 lymph node groups located where the decay correction was not performed. Conclusion: Based on the above findings, it is suggested that [F-18]FDG-PET is superior to CT in the detection of nodal metastases and in the staging of patients with esophageal cancer.

• Proceedings of the Korea Information Processing Society Conference
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• 2002.11c
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• pp.1925-1928
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• 2002

소프트웨어에 대한 고객의 요구수준이 점점 높아지고 복잡, 대형화됨에 따라 개발인력, 예산, 기간 등 많은 개발 자원이 소요되는 추세이지만, 개발자 직관에 의한 정성적인 판단으로 소요자원의 과부족을 초래하는 원인이 되고 있다. 본 논문에서는 요구분석 단계에서 기존의 정성적 판단에 따른 문제점을 보완하기 위해 요구분석 프로세스를 수정/제안하고, 의사결정기법을 이용하여 요구사항을 정량적으로 분석하고 식별할 수 있는 방법을 제안하였다. 이를 위해 사용자 요구분석 프로세스 검증단계에서 요구사항 평가활동을 추가하고, 의사결정 모델을 이용한 요구사항 가중치 계산, 시스템 기능과의 관련성 평가, 중요도 가중치를 계산하여 요구사항에 대한 식별의 기준으로 삼는다.

• Journal of Gastric Cancer
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• v.9 no.4
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• pp.246-255
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• 2009

Purpose: The objectives of this study were to investigate the impact of the number of resected lymph nodes on the survival of gastric cancer patients who underwent curative resection, and to evaluate the cut-off values that can have an influence on survival on the tumor stage-stratified analysis. Materials and Methods: The subjects were 949 gastric cancer patients who underwent curative resection at Korea University Medical Center from 1992 to 2002. They were classified according to the depth of tumor invasion, and the influence of the number of resected lymph nodes on survival was investigated. The cut-off value for the number of resected lymph nodes was determined as the smallest value that showed a significant survival difference. Results: The tumor size, location, lymph node stage, the number of metastatic lymph nodes and the number of resected lymph nodes were significantly different according to the tumor stage. The average number of resected lymph nodes was about 39, and it showed linear correlation with the number of metastatic lymph nodes. On the Cox proportional hazard model, the cut-off values of the number of resected lymph nodes, as corrected by the number of metastatic lymph nodes, was 14 for all the patients, 15 for the pT1 patients, 28 for the pT2 patients and 37 for the pT3 patients, respectively. Conclusion: Retrieving a number of lymph nodes that is more than the cut-off value could improve the survival of gastric cancer patients. Surgeons should also make efforts to perform an exact and thorough D2 lymph node dissection. Therefore, we urge surgeons to perform D2 dissection and pathologists should examine an certain exact number of lymph nodes.

• 대한핵의학회:학술대회논문집
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• 2002.11a
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• pp.31.1-31.1
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• 2002

• 대한핵의학회:학술대회논문집
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• 2002.11a
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• pp.31.2-31.2
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• 2002