• Radiation Oncology Journal
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• v.17 no.1
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• pp.36-41
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• 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 Gastric Cancer
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• v.6 no.4
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• pp.244-249
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• 2006

Purpose: Tumor size has been reported to be one of the prognostic factors in the preoperative setting and 8 cm has been confirmed as a cut-off value for large gastric tumors with respect to postoperative complications. The aim of this study was to investigate the clinicopathologic features and the prognosis in patients with tumors larger than 8 cm in diameter. Materials and Methods: We retrospectively studied 2,260 patients with gastric cancer who underwent a gastrectomy from 1983 to 2001 at the Department of Surgery, Korea University College of Medicine. For a comparative analysis we divided the cases into the large and the small groups according to tumor size. The clinicopathological factors associated with large gastric tumors were analyzed by using univariate and multivariate analyses. To determine which variables were independent prognostic factors for overall survival, we applied the Cox proportional hazards model and we used P<0.05 as the cutoff value for statistical significance. Results: Univariate and multivariate analyses disclosed that tumor location (P<0.001), resection type (P<0.001), curability (P<0.001), depth of invasion (P<0.001), number of metastatic lymph nodes (P<0.001), differentiation (P<0.001) and combined resection (P<0.001) were significantly different between the two groups. The independent factors for survival identified by using the Cox proportional hazards model for large gastric tumors were nodal status (P<0.001), curative resection (P<0.001), depth of invasion (P=0.010), type of resection (P=0.018) and age (P=0.033). Conclusion: Large gastric tumors showed more aggressive local findings than their smaller counterparts. In patients with large gastric tumors, a curative resection was the most important factor for the prognosis. Therefore, we suggest that every effort should be made to do a curative gastrectomy and an accurate preoperative examination. (J Korean Gastric Cancer Assoc 2006;6:244-249)

• Tuberculosis and Respiratory Diseases
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• v.43 no.5
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• pp.709-719
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• 1996

Background: Surgical resection is the only way to cure non-small cell lung cancer(NSCLC) and the prognosis of NSCLC in patients who undergo a complete resection is largely influenced by the pathologic stage. After surgical resection, recurrences in distant sites is more common than local recurrences. An effective postoperative adjuvant therapy which can prevent recurrences is necessary to improve long tenn survival Although chemotherapy and radiotherapy are still the mainstay in adjuvant therapy, the benefits of such therapies are still controversial. We initiated this retrospective study to evaluate the effects of adjuvant therapies and analyze the prognostic factors for survival after curative resection. Method: From 1990 to 1995, curative resection was perfomled in 282 NSCLC patients with stage I, II, IIIa, Survival analysis of 282 patients was perfonned by Kaplan-Meier method. The prognostic factors, affecting survival of patients were analyzed by Cox regression model. Results: Squamous cell carcinoma was present in 166 patients(59%) ; adenocarcinoma in 86 pmients(30%) ; adenosquamous carcinoma in II parients(3.9%); and large cell undifferentiated carcinoma in 19 patients(7.1%). By TNM staging system, 93 patients were in stage I; 58 patients in stage II ; and 131 patients in stage rna. There were 139 postoperative recurrences which include 28 local and 111 distant failures(20.1% vs 79.9%). The five year survival rate was 50.1% in stage I ; 31.3% in stage II ; and 24.1% in stage IIIa(p <0.0001). The median survival duration was 55 months in stage I ; 27 months in stage II ; and 16 months in stage rna. Among 131 patients with stage rna, the median survival duration was 19 months for 81 patients who received postoperative adjuvant chemotherapy only or cherne-radiotherapy and 14 months for the other 50 patients who received surgery only or surgery with adjuvant radiotherapy(p=0.2982). Among 131 patients with stage IIIa, the median disease free survival duration was 16 months for 21 patients who received postop. adjuvant chemotherapy only and 4 months for 11 patients who received surgery only(p=0.0494). In 131 patients with stage IIIa, 92 cases were in N2 stage. The five year survival rate of the 92 patients with N2 was 25% and their median survival duration was 15 months. The median survival duration in patients with N2 stage was 18 months for those 62 patients who received adjuvant chemotherapy and 14 months for the other 30 patients who did not(p=0.3988). The median survival duration was 16 months for those 66 patients who received irradiation and 14 months for the other 26 patients who did not(p=0.6588). We performed multivariate analysis to identify the factors affecting prognosis after complete surgical resection, using the Cox multiple regression model. Only age(p=0.0093) and the pathologic stage(p<0.0001) were significam prognostic indicators. Conclusion: The age and pathologic stage of the NSCLC parients are the significant prognostic factors in our study. Disease free survival duration was prolonged with statistical significance in patients who received postoperative adjuvant chemotherapy but overall survival duration was not affected according to adjuvant therapy after surgical resection.

• 대한생식의학회:학술대회논문집
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• 1995.12a
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• pp.40-41
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• 1995

• 대한두경부종양학회:학술대회논문집
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• 2001.11a
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• pp.266-266
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• 2001

• 대한두경부종양학회:학술대회논문집
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• 1995.11a
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• pp.215-215
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• 1995

• Journal of Yeungnam Medical Science
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• v.8 no.1
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• pp.1-11
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• 1991

족부의 교정을 위해서는 비정상적인 상태 및 원인 그 치료법에 대해서 충분히 이해해야 할 것으로 생각되며, 비 척행족에 대해서는 먼저 정확한 원인 인자의 파악과 수술전 평가, 수술의 선택, 수술의 범위등을 정해야 한다. 이렇게 함으로써 변형에 대한 충분한 교정이 가능하며, 수술후 예후가 좋은 척행족으로 될 것이다. 그리고 위에서 밝힌 치료의 원칙은 변하지 않겠지만, 관절 고정술을 대체하여 다른 남은 관절에 영향을 주지 않으면서 더 많은 유연성을 가질 수 있는 기능있는 족부를 만들 수 있는 새로운 수술방법이(관절 치환술등) 더 개발되어 져야할 것으로 생각된다.

• Journal of Gastric Cancer
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• v.9 no.1
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• pp.26-30
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• 2009

Purpose: The aim of this study was to evaluate the prognostic value of the peripheral blood lymphocyte count before surgery in those patients with gastric cancer. Materials and Methods: The study group was comprised of a series of 1,054 patients who underwent curative gastrectomy. The appropriate lymphocyte count cutoff value was determined. The prognostic factors were evaluated by univariate and multivariate analyses. Results: The lymphocyte count cutoff value was 1,500/ul. The patients were classified into two groups: Group A had a lymphocyte count $\geq$ 1,500/ul (n=765) and Group B had a lymphocyte count <1,500/ul (n=289). There were statistically significant differences between the groups according to their age (P<0.001), the tumor stage (P=0.038) and the tumor size (P<0.001). The 5- and 10-year survival rates of Group A were 80.1% and 76.6%, respectively and those of Group B were 72.4% and 63.5%, respectively (P=0.002). When multivariate analysis was performed by the Cox proportional hazards model, the lymphocyte count was not an independent prognostic factor. Conclusion: Although the prognosis of patients with a high lymphocyte count was better than that of the patients with a low lymphocyte count, our results did not support using the preoperative peripheral blood lymphocyte count as an independent prognostic factor for patients with gastric cancer.

• Journal of Chest Surgery
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• v.41 no.4
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• pp.447-456
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• 2008

Background: Caspase-3 is a cysteine protease that plays a major role in the process of apoptotic cell death. The dysregulated expression of c-myc contributes to the tumorigenesis in a variety of human cancers. The aim of this study was to investigate the expressions of caspase-3 and c-myc and their significances as prognosis markers in patients with completely resected non-small cell lung cancer (NSCLC). Material and Method: A total 130 consecutive patients who had undergone complete resection without pre-operative radio-therapy or chemotherapy between May 1996 and December 2003 for NSCLC were retrospectively reviewed. The median follow-up period of the patients was 50 months (range: $3{\sim}128$ months). The expressions of caspase-3 and c-myc were immuno-histochemically examined, and these were correlated with the clinico-pathologic data. Result: The prevalence of caspase-3 and c-myc expressions in the patients was 68% (88/130) and 59% (77/130), respectively. Significant association was found between the frequency of the expressions of caspase-3 and c-myc (p=0.025). The caspase-3 and c-myc expressions were not significantly associated with the prognosis in all the patients. However, according to stages, a positive caspase-3 expression was significantly correlated with a favorable prognosis for patients with stage IIIa disease (median survival period: 35 months vs. 10 months, p=0.021). Multivariate analysis showed the pathologic stage to be significantly correlated with a good prognosis in all the patients (p=0.024), and with a positive caspase-3 expression, well differentiated tumor and negative neuronal invasion in the patients with stage llla disease (p=0.005, p=0.003, p=0.004, respectively). Conclusion: Caspase-3 and c-myc were frequently expressed in NSCLC, suggesting its possible involvement in tumor development. The caspase-3 expression, as determined with performing immunohistochemical staining, may be a favorable prognostic indicator in patients with completely resected NSCLC an advanced stage (IIIa).

• Journal of Chest Surgery
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• v.29 no.7
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• pp.734-740
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• 1996

The relative importance of various factors influencing the prognosis and survival in the treatment of thymoma is still controversial. Sixty ave patients operated on for thymoma from Jan. 1981 to Dec. 1994 were evaluated, 28 patients (43.1 %) with myasthenia gravis and 37 patients (56.9%) without. Masaoka staging revealed stage I disease in 28 patie ts(4).1%) , stage ll in 1) patients(20.0%), stage 111 In 22 patients(33.8%), stage IVa in 1 patients(1.5%), and stage IVb in 1 patient(1.5%). There was no operative mortality. A complete resection was performed in 48 patients (73.8%) patients, associated in 10 patients (15.4%) with postoperative adjuvant treatment(radiotherapy 5; chemotherapy 1: radio- and chemotherapy 4). Thymomas were found to be predominantly of the epithelial type in 16 patients(24.6%), predominantly Iymphocytic type in 18 patients(27.7%), and mlxed in 22 patients (33.9%). The overall 5- and 10-year survival rates were 87% and 82%, respectively, Factors indicating a poor prognosis included local invasion, incomplete excision, thymic carcinoma, advanced staging and myasthenia gravis. The de- gree of tumor invasion turned out to be the main prognostic factor, and treatment should be planned ac- cordingly. The prognosis is best predicted by the stage of the tumor as determined intraoperatively and is poorer in patie ts with incomplete resection than in those with complete resection of the thynoma. No recurrence developed In patients with stage I disease.