• Asian Pacific Journal of Cancer Prevention
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• 제16권11호
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• pp.4777-4780
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• 2015

Objective: To analyze clinicopathological characteristics, prognostic factors and survival rates of the patients with urological soft tissue sarcomas treated and followed up in Turkey. Materials and Methods: For overall survival analyses the Kaplan-Meier method was used. From medical records, nine prognostic factors on overall survival were analysed. Results: For the 53 patients (34 males, 19 females) whose charts were reviewed, the median age was 53 (range 22 to 83) years. Most frequently renal location (n=30; 56.6%) was evident and leiomyosarcoma (n=20, 37.7%) was the most frequently encountered histological type. Median survival time of all patients was 40.3 (95% CI, 14.2-66.3) months. In univariate analysis, male gender, advanced age (${\geq}50years$), metastatic stage, unresectability, grade 3, renal location were determined as worse prognostic factors. In multivariate analysis, metastatic stage, unresectability and grade 3 were determined as indicators of worse prognosis. Conclusions: Urological soft tissue sarcomas are rarely seen tumours in adults. The most important factors in survival are surgical resection, stage of the tumour at onset, grade and location of the tumour, gender and age of the patients.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1935-1941
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• 2012

Introduction: Uterine sarcomas are a group of heterogenous and rare malignancies of the female genital tract and there is a lack of consensus on prognostic factors and optimal treatment. Objective and Methodology: To perform a retrospective evaluation of clinicopathological characteristics, prognostic factors and treatment outcomes of 93 patients with uterine sarcomas who were diagnosed and treated at 4 different centers from November 2000 to October 2010. Results: Of the 93 patients, 58.0% had leiomyosarcomas, 26.9% malignant mixed Mullerian tumors, 9.7% endometrial stromal sarcomas, and 5.4% other histological types. According to the last International Federation of Gynecology and Obstetrics (FIGO) staging, 43.0% were stage I, 20.4% were stage II, 22.6% were stage III and 14.0 % were stage IV. Median relapse free survival (RFS) was 20 months (95% confidence interval (CI), 12.4-27.6 months), RFS after 1, 2, 5 years were 66.6%, 44.1%, 16.5% respectively. Median overall survival (OS) was 56 months (95% CI, 22.5-89.5 months), and OS after 1, 2, 5 years was 84.7%, 78%, 49.4% respectively. Multivariate analysis showed that age ${\geq}60$ years and high grade tumor were significantly associated with poor OS and RFS; patients administered adjuvant treatment with sequential chemotherapy and radiotherapy had longer RFS time. Among patients with leiomyosarcoma, in addition to age and grade, adjuvant treatment with sequential chemotherapy and radiotherapy after surgery had significant effects on OS. Conclusion: Uterine sarcomas have poor progrosis even at early stages. Prognostic factors affecting OS were found to be age and grade.

• Journal of Gastric Cancer
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• 제10권4호
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• pp.162-167
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• 2010

Purpose: The incidence of lymph node metastasis has been reported to range from 2.6 to 4.8% in early stage gastric cancer with mucosal invasion (T1a cancer). Lymph node metastasis in early stage gastric cancer is known as an important predictive factor. We analyzed the prediction factors of lymph node metastasis in T1a cancer. Materials and Methods: A total of 9,912 patients underwent radical gastrectomy due to gastric cancer from October 1994 to July 2006 in the Department Of Surgery at Samsung Medical Center. We did a retrospective analysis of 2,524 patients of these patients, ones for whom the cancer was confined within the mucosa. Results: Among the 2,524 patients, 57 (2.2%) were diagnosed with lymph node metastasis, and of these, cancer staging was as follows: 41 were N1, 8 were N2, and 8 were N3a. Univariate analysis of clinicopathological factors showed that the following factors were significant predictors of metastasis: tumor size larger than 4 cm, the presence of middle and lower stomach cancer, poorly differentiated adenocarcinoma and signet-ring cell carcinoma, diffuse type cancer (by the Lauren classification), and lymphatic invasion. Multivariate analysis showed that lymphatic invasion and tumor larger than 4 cm were significant factors with P<0.001 and P=0.024, respectively. Conclusions: The frequency of lymph node metastasis is extremely low in early gastric cancer with mucosal invasion. However, when lymphatic invasion is present or the tumor is larger than 4 cm, there is a greater likelihood of lymph node metastasis. In such cases, surgical treatments should be done to prevent disease recurrence.

• 한국산학기술학회논문지
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• 제12권11호
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• pp.5094-5101
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• 2011

위암 완치수술을 받은 환자들의 재발수준과 재발에 미치는 영향을 파악하고자 2010년 9월부터 2011년 5월까지 한 대학병원에서 위암으로 진단받고 수술받은 환자 386명을 대상으로 조사하였다. 이들의 의무기록지와 병원암등록 자료에서 인구사회학적 특성, 생화학적 검사치, 임상병리학적 특성 등을 조사하였으며, 통계학적 검증으로 카이스퀘어 검정과 로지스틱 회귀분석을 실시하였다. 전체 조사대상자의 위암 재발률은 2.6%이었고, 성별 재발률은 남자에서 3.45%, 여자는 0.89%로 남자가 여자보다 약 4배정도 높았다. 단변량 로지스틱 회귀분석에서 재발이 발생할 위험은 림프전이가 있을수록 8.793배, 헬리코박터 파이로니균에 감염시 6.495배, 총콜레스테롤이 비정상일 때 14.333배 높았다. 다변량 로지스틱 회귀분석에서 림프전이와 헬리코박터 파이로니 감염이 재발에 중요한 요인으로 작용하였다. 결론적으로 위암의 재발에는 림프전이, 헬리코박터 파이로니 감염과 총콜레스테롤을 관리하고, CEA 및 CRP와 같은 생화학적 물질을 모니터링하여 재발을 조기에 발견하기 위한 노력이 함께 필요할 것으로 보인다.

• Childhood Kidney Diseases
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• 제8권2호
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• pp.176-185
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• 2004

목적: 급속 진행성 사구체신염은 병리조직학적으로 사구체가 광범위한 반월상을 형성하며 임상적으로는 수개월내에 급성 신부전에 빠지게 되는 신질환이다. 저자들은 이 질환의 임상 경과의 이해와 치료 방침의 결정에 도움을 주고자 소아급속 진행성 사구체 신염 환자들의 임상양상과 병리 소견을 후향적으로 고찰하였다. 방법: 1991년부터 2003년까지 소아과에 내원하여 임상 양상과 신생검 소견을 종합하여 급속 진행성 사구체 신염으로 진단 받고 추적 관찰이 가능하였던 12명을 대상으로 임상양상 및 병리소견에 대해 후향적으로 조사하였다. 신부전으로 진행한 군과 정상 신기능이 유지된 군으로 나누어 임상-병리학적 지표들을 비교하였다. 결과: 12명의 환자 중 남자는 4명, 여자는 8명이었다. 발병 당시 연령은 평균 11세 5개월이었고 경과 관찰 기간은 평균 25개월이었다. 신조직 검사 결과에 따라 분류하면 면역복합체 매개성 사구체 신염인 경우가 10예(83%), 무면역 침착 사구체 신염이 2예(17%)였고 항사구체 기저막 항체 신염인 경우는 없었다. 모든 환자가 경구 스테로이드 투여를 받았고 10명(83.3%)에서 methylprednisolone pulse therapy를 시행하였고 이중 8명(65.7%)은 cyclophosphamide 병합 투여도 시행하였고 4명(33.3%)은 혈장교환을 병행하였다. 경과 관찰하는 동안 1예에서 정상 신기능으로 회복되었고 7예는 정상 신기능은 유지되나 신증후군 범위 이하의 단백뇨가 지속되는 부분 회복을 보였다. 2예에서는 지속되는 단백뇨와 혈청 크레아티닌 상승을 보이는 만성 신부전 상태를 보였고 2예에서는 말기 신질환으로 진행하였다. 진단시 높은 혈청 크레아티닌과 낮은 헤모글로빈 수치를 보인 경우와 나이가 어린 경우 예후가 불량하였다. 결론: 소아에서 급속 진행성 사구체신염은 면역 복합체 신염이 대부분을 차지하고 조기 진단과 적극적인 치료를 시행하였을 때 대부분의 환자에서 신기능의 호전이 관찰되었다. 이 질환의 임상 경과와 치료 방침의 확립을 위하여 다기관의 전향적 연구가 필요하다.

• Journal of Gastric Cancer
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• 제6권4호
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• pp.270-276
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• 2006

목적 : Borrmann 제4형 위암은 일반적으로 다른 형의 위암에 비해 예후가 나쁜 것으로 알려져 있다. 이에 본 연구에서는 Borrmann 제4형 위암의 임상병리학적 특성 및 예후를 다른 형의 위암과 비교 분석하고, Borrmann 제4형 위암의 예후 인자로서의 의의를 알아보고자 한다. 대상 및 방법: 1995년 1월부터 2004년 12월까지 삼성서울병원에서 수술 받은 4,416명의 진행 위암 환자 중 Borrmann형 분류 및 생존여부의 추적이 가능하였던 4,389명의 환자를 대상으로 임상적 특징, TNM 병기 및 생존율을 후향적으로 분석하였다. 결과: Borrmann 제4형 위암은 다른 형의 위암에 비해 위벽침윤도, 림프절 전이, 원격 전이 모두 진행된 상태인 경우가 많았고, 근치적 절제술 비율이 낮았다. 5년 생존율은 Borrmann 제4형이 20.7%로 다른 형의 5년 생존율 53.7%에 비해 유의하게 낮았으며, 동일 병기에서도 낮은 생존율을 보이고 있었다. 단변량 및 다변량 분석에서 위벽침윤도, 림프절전이, 원격전이, 치유도 그리고 Borrmann 제4형이 위암의 독립적인 예후 인자였다. 결론: Borrmann 제4형 위암은 다른 형의 위암과 비교시 임상병리학적으로 구분되는 특성을 지니고 있으며 진행된 상태에서 진단되는 경우가 많았다. 동일 병기에서도 Borrmann 제4형 위암은 다른 형에 비해 낮은 생존율을 보이고 있어 이를 고려한 예후 판단과 보다 적극적인 치료가 필요하다.

• Journal of Gastric Cancer
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• 제1권3호
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• pp.180-186
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• 2001

Purpose: The prognosis for early gastric cancer (EGC) is favorable, and the 10-year disease-specific survival rate is reported to be around $90\%$. The absolute number of recurred EGC is too small to assess the risk factors, so recruitment of a large number of cases for statistical analysis is very difficult. We carried out this study to analyze the incidence and the patterns of recurrence of EGC and to identify the clinicopathological risk factors for recurrence of EGC. Materials and Methods: The authors retrospectively investigated the follow-up records of 1418 patients who underwent a curative resection for EGC from Jan. 1984 to Dec. 1999 at the Korea Cancer Center Hospital and analyzed them with special reference to cancer recurrence. Results: In this retrospective study of 1418 cases, 43 patients died of a recurrence of gastric cancer, and 105 patients died of unrelated causes. The five-year and the ten-year overall survival rates were $89.6\%$ and $81.7\%$, respectively, while the five-year and the ten-year diseasespecific survival rates were $96.5\%$ and $94.3\%$, respectively. The recurrence patterns of the 45 recurred EGC were hematogenous metastasis (19 cases), lymph node (L/N) metastasis (8 cases), locoregional recurrence (2 cases), peritoneal seeding (3 cases), and combined form (13 cases). The mean time interval to recurrence was 38.6 months, and the number of delayed recurred cases after 5 years was 10 ($22.2\%$). Of the clinicopathologic factors, depth of invasion, L/N metastasis, macroscopic type, lymphatic invasion, and vessel invasion, were significant risk factors in the univariate analysis. However, in the multivariate analysis, only L/N metastasis was an independent prognostic factor. Conclusion: Based on the results of this study, L/N metastasis is an independent prognostic factor. Thus, in patients with node-positive disease, adjuvant therapy might be considered, and long-term close follow-up might facilitate early detection and treatment of recurrent disease due to delayed recurrence.

• Journal of Gastric Cancer
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• 제5권4호
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• pp.266-272
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• 2005

목적: 위암의 근치적 절제술 후에 재발은 여러 형태로 발생한다. 특히 현행성 재발은 간 부위에서 주로 나타나는데 이러한 간계발의 임상병리학적 위험인자를 예측하기 위해 본 연구를 시행하였다. 대상 및 방법: 1992년 1월부터 1999년 12월까지 전북대학교병원에서 위암으로 근치적 수술치료를 받았던 838명의 환자 중 201명의 재발환자를 대상으로 간 재발과 관련된 임상병리학적 위험인자를 찾기 위해 후향적 연구를 하였다. 결과: 201명의 재발환자 중 59명이 간재발을 보였다. 로지스틱 회귀분석을 통한 다변량분석에서 간재발의 독립적인 위험인자로는 Lauren의 분류에서 장형인 경우(OR, 6.66; 95% Cl, 1.53 to 28.9; P=0.011), 근위부 절제연의 길이가 6cm 미만인 경우(OR, 3.76; 95% Cl, 1.03 to 13.67; P=0.045)가 관련되어 있었다. 결론: 위암의 수술 치료 후 간재발의 임상병리학적 위험인자들의 다양한 연구 조사와 더불어 분자생물학적인 연구가 더해진다면 간 재발에 대한 예측이 가능할 것이며 고위험 환자에게 적절한 치료법의 개발에도 도움이 될 수 있을 것이다.

• Journal of Gastric Cancer
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• 제13권2호
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• pp.93-97
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• 2013

Purpose: Endoscopic submucosal dissection has recently been practiced on a differentiated type of early gastric cancer. However, there is no clear evidence for endoscopic treatments of signet ring cell carcinoma. The aim of this study is to identify the predictive clinicopathological factors for lymph node metastasis in signet ring cell carcinoma for assisting endoscopic submucosal dissection trials. Materials and Methods: A total of 186 patients with early signet ring cell carcinoma who underwent radical curative gastrectomy between January 2001 and September 2009 were enrolled in this study. Retrospective reviews of their medical records are being conducted. Several clinicopathologic factors were being investigated in order to identify predictive factors for lymph nodes metastasis: age, gender, tumor size, type of operation, tumor location, gross type, ulceration, Lauren's classification, depth of invasion, and lymphatic invasion. Results: The lymph node metastasis rate for signet ring cell carcinoma was 4.3% (n=8). Of the 186 lesions with early signet ring cell carcinoma, 91 (48.9%) tumors were larger than 15 mm in size and 40 (21.5%) showed submucosal invasions in the resection specimens. In multivariate analysis, only the lymphatic invasion (P<0.0001) showed an association with lymph node metastasis. To evaluate cutoff values for tumor sizes in the presence of lymph node metastasis, early signet ring cell carcinomas with lymphatic invasions were excluded. In the absence of lymphatic invasion, mucosal cancer with tumor sizes <15 mm had no lymph node metastasis. Conclusions: Endoscopic submucosal dissection can be performed on patients with early signet ring cell carcinoma limited to the mucosa and less than 15 mm.

• Asian Pacific Journal of Cancer Prevention
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• 제15권7호
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• pp.3057-3063
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• 2014

Background: Anaplastic lymphoma kinase (ALK) gene rearrangement in non-small cell lung cancer (NSCLC) has been intensively studied. The gold standard for ALK detection is FISH, but this is not routinely conducted in clinical practice, so that the IHC method has a role. The aim of this study was to identify the incidence of ALK rearrangement and risk or prognostic factors for ALK positivity using both of IHC and FISH methods. Materials and Methods: From January 2008 to December 2012, 267 completely resected NSCLC patients in Chiang Mai University Hospital were enrolled in this study. Clinical and pathological variables and outcomes of treatment were retrospectively reviewed. IHC and FISH were used to evaluate ALK rearrangement. Sensitivity and specificity of IHC were analyzed. Multivariable analysis was used to identify clinico-pathological correlations with positive results of IHC and clinical outcomes. Results: Twenty-two (8.2%) of 267 specimens were IHC-positive for ALK with intense cytoplasmic staining, whereas only 10 (3.8%) were FISH-positive. Sensitivity, specificity and the positive likelihood ratio with IHC were 80.0%, 94.9%, and 15.8 respectively. Age less than 55 years (RR 4.4, 95%CI 1.78-10.73, p value=0.001) and presence of visceral pleural invasion (VPI) (RR 2.9, 95%CI 1.21-6.78, p value =0.017) were identified as risk factors for ALK rearrangement with FISH. There were no statistically significant differences in other clinical and pathological variables. ALK rearrangement was not a prognostic factor for tumor recurrence or overall survival. Conclusions: The incidences of ALK positivity in completely resected NSCLCs in northern Thailand were 8.2% by IHC and 3.8% by FISH. IHC with mouse monoclonal, Ventana D5F3 antibody can be used as a screening tool before FISH method because of high specificity and high positive likelihood ratio. Age less than 55 years and VPI are risk factors for ALK positivity.