• Title/Summary/Keyword: Curative surgery

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Clinical Application of $^{18}F-FDG$ PET in Esophageal Cancer (식도암에서의 $^{18}F-FDG$ PET의 임상 이용)

  • Choi, Joon-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.32-38
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    • 2008
  • This review focuses on the clinical use of $^{18}F-FDG$ PET in esophageal cancer. For initial staging of esophageal cancer, $^{18}F-FDG$ PET is better than chest CT and is complementary to endoscopic ultrasound. Due to its good results for detecting distant metastasis, $^{18}F-FDG$ PET evades unnecessary curative surgery. Also, PET findings are associated with prognosis in esophageal cancer. $^{18}F-FDG$ PET seems to be useful for detecting recurrence and restaging in esophageal cancer. For therapy response assessment, $^{18}F-FDG$ PET is effective after chemotherapy or radiation therapy. $^{18}F-FDG$ PET is useful to predict pathological response after neoadjuvant therapy in esophageal cancer, which is better than chest CT and endoscopic ultrasound. For radiation therapy planning, $^{18}F-FDG$ PET may be helpful, but requires further investigations.

Radiation Therapy for Loco regional Recurrence of Adenocarcinoma of The Rectum (국소재발 직장암의 방사선 치료)

  • Cho K. H.;Seong J. S.;Suh C. O.;Kim G. E.
    • Radiation Oncology Journal
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    • v.2 no.2
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    • pp.237-243
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    • 1984
  • Thirty Patients with loco-regional recurrence following curative surgery for adenocarcinoma of the rectum were retrospectively evaluated to determine factors influencing survival and the efficacy of radiation therapy. In this review of 30 patients undergoing radiation therapy, more than 50 percent(17/30) had definite symptomatic and objective response. Ninety percent of patients(27/30) received significant palliation. Over all 2 year survival rate was $7.4\%$ and their median survival was 13.0 months. Grade of response and Sex were statistically related to survival.

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Sinonasal Undifferentiated Carcinoma of Sphenoid Sinus Invading Cavernous Sinus and Optic Nerve: A Case Report and Review of Literature (해면정맥동 및 시신경을 침범한 접형동 기원의 비부비동 미분화암 1예)

  • Park, Taejung;Jung, Taeyoung;Noh, Woongjae
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.2
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    • pp.41-46
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    • 2016
  • Sinonasal undifferentiated carcinoma (SNUC) is an extremely rare, highly aggressive malignancy of the nasal cavity and paranasal sinuses. Patients with SNUC usually being asymptomatic until the tumor has extensively progressed therefore frequently present with invasion of the orbit or cranial vault. Most case series of SNUC report very poor prognosis despite aggressive multimodality therapy. We recently experienced a 78-year-old male patient diagnosed as SNUC occurred from the left sphenoid sinus with invasion to the cavernous sinus and orbital content, which was treated intranasal endoscopic debulking surgery combined with curative radiation therapy successfully, and report this case with a review of literature.

Current status of stereotactic body radiotherapy for the treatment of hepatocellular carcinoma

  • Park, Jongmoo;Park, Jae Won;Kang, Min Kyu
    • Journal of Yeungnam Medical Science
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    • v.36 no.3
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    • pp.192-200
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    • 2019
  • Stereotactic body radiotherapy (SBRT) is an advanced form of radiotherapy (RT) with a growing interest on its application in the treatment of hepatocellular carcinoma (HCC). It can deliver ablative radiation doses to tumors in a few fractions without excessive doses to normal tissues, with the help of advanced modern RT and imaging technologies. Currently, SBRT is recommended as an alternative to curative treatments, such as surgery and radiofrequency ablation. This review discusses the current status of SBRT to aid in the decision making on how it is incorporated into the HCC management.

Role of Adjuvant Radiotherapy in Gastric Cancer

  • Jeong Il Yu
    • Journal of Gastric Cancer
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    • v.23 no.1
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    • pp.194-206
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    • 2023
  • Although continuous improvement in the treatment outcome of localized gastric cancer has been achieved through early screening, diagnosis, and treatment and the active application of surgery and adjuvant chemotherapy, the necessity of adjuvant radiotherapy (RT) remains controversial. In this review, based on the results of two recently published randomized phase III studies (Adjuvant Chemoradiation Therapy In Stomach Cancer 2 and ChemoRadiotherapy after Induction chemoTherapy of Cancer in the Stomach) and a meta-analysis of six randomized trials including these two studies, the role of adjuvant RT in gastric cancer was evaluated and discussed, especially in patients who underwent curative gastrectomy with D2 lymphadenectomy. This article also reported the possible indications for adjuvant RT in the current clinical situation and in future research to enable patientspecific treatments according to the risk of recurrence.

Self-expandable Metal Stents for Malignant Colorectal Obstruction (악성 대장 폐색에서의 자가팽창형 스텐트 삽입술)

  • Jae Jun Park
    • Journal of Digestive Cancer Research
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    • v.12 no.1
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    • pp.15-22
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    • 2024
  • Malignant colorectal obstructions urgently require decompression therapy to prevent the severe risks of intestinal ischemia and bowel perforation. In managing malignant colonic strictures endoscopically, the use of self-expandable metal stents (SEMS) is the predominant approach. Colonic SEMs are primarily used in preoperative decompression therapy before curative surgery and palliative treatment in patients with advanced disease stages. Furthermore, the stenting process, which requires rigorous clinical supervision, can lead to complications. This review endeavors to concisely review the clinical considerations associated with the SEMS procedure, with a focus on its indications, technical aspects, and potential complications that may arise during the procedure.

Role of radiofrequency ablation in advanced malignant hilar biliary obstruction

  • Mamoru Takenaka;Tae Hoon Lee
    • Clinical Endoscopy
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    • v.56 no.2
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    • pp.155-163
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    • 2023
  • Malignant hilar biliary obstruction (MHO), an aggressive perihilar biliary obstruction caused by cholangiocarcinoma, gallbladder cancer, or other metastatic malignancies, has a poor prognosis. Surgical resection is the only curative treatment for biliary malignancies. However, the majority of patients with MHO cannot undergo surgery on presentation because of an advanced inoperable state or a poor performance state due to old age or comorbid diseases. Therefore, palliative biliary drainage is mandatory to improve symptomatic jaundice and the quality of life. Among the drainage methods, endoscopic biliary drainage is the current standard for palliation of unresectable advanced MHO. In addition, combined with endoscopic drainage, additional local ablation therapies, such as photodynamic therapy or radiofrequency ablation (RFA), have been introduced to prolong stent patency and survival. Currently, RFA is commonly used as palliative therapy, even for advanced MHO. This literature review summarizes recent studies on RFA for advanced MHO.

Factors Affecting Prognosis in Early Gastric Cancer (조기위암 환자의 예후에 영향을 주는 인자)

  • Han, Ki-Bin;Jang, You-Jin;Kim, Jong-Han;Park, Sung-Soo;Park, Seong-Heum;Kim, Seung-Ju;Mok, Young-Jae;Kim, Chong-Suk
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.238-245
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    • 2009
  • Purpose: Treatment strategies for early gastric carcinoma (EGC) should be based on achieving a complete cure, but clear indications for limited surgery have not been established. We investigated surgical outcomes for early gastric cancer to determine the optimal? treatment strategy for EGC. Materials and Methods: Subjects included 881 patients who underwent curative surgery for EGC between 1986 and 2003. Retrospective uni & multi-variate analysis for prognostic factors, factors affecting lymph node metastasis, and risk factors for cancer recurrence were analyzed. Results: In multivariate survival analyses, age, operation method, macroscopic appearance and lymph node stage proved to be independent prognostic factors. Lymph node metastasis, depth of tumor invasion, tumor size, lymphatic and venous invasion were also significant risk factors in multivariate analyses. In multivariate analyses for cancer recurrence, depth of tumor invasion and lymph node metastasis proved to be significant risk factors. Conclusion: Appropriate surgical treatment with lymph node dissection is necessary for EGC patients with risk factors for lymph node metastasis.

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The Surgical Treatment of Malignant Bowel Obstruction Caused by Recurrent Gastric Cancer (재발된 위암 환자에서 발생한 악성 장폐쇄증의 수술적 치료)

  • Yoo, Byung-Eun;Park, Joong-Min;Jang, You-Jin;Kim, Jong-Han;Park, Sung-Soo;Park, Seong-Heum;Kim, Seong-Ju;Mok, Young-Jae;Kim, Chong-Suk
    • Journal of Gastric Cancer
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    • v.8 no.3
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    • pp.148-153
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    • 2008
  • Purpose: Malignant bowel obstruction caused by recurrent gastric cancer must be treated appropriately to improve the effects of treatment and to prolong survival. We reviewed the surgical treatments for malignant bowel obstruction caused by recurrent gastric cancer. Materials and Methods: The subjects were patients with malignant bowel obstruction caused by recurrent gastric cancer and these patients were treated by surgical procedures at our hospital from 1998 to 2008. The patients were treated by resection, ostomy or bypass. The success of treatment was decided when the patients were able to tolerate more than a liquid diet. Results: 42 patients were treated 46 times by surgical procedures. Resection was done12 times, ostomy was done 24 times and bypass was done 10 times. The hospital stay and the period to liquid diet after the operation were shorter in the ostomy group. The post operative morbidity rate was 21.7% and the post operative death rate was 8.7%. There was no significant difference in survival according to the type of surgery. Conclusion: Ostomy is good choice for selected patients because it has a shorter hospital stay and period to liquid diet. There was no significant difference in survival according to the type of surgery because curative resection is difficult to perform in patients with malignant bowel obstruction.

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Surgical Results for Perforated Gastric Cancer (천공성 위암의 수술 방법과 치료 결과)

  • Lee, Moon-Soo;Chae, Man-Kyu;Kim, Tae-Yun;Cho, Gyu-Seok;Kim, Sung-Yong;Baek-Moo-Jun;Chung-Il-Kwon;Park, Kyung-Kyu;Kim, Chang-Ho;Song-Ok-Pyung;Cho, Moo-Sik
    • Journal of Gastric Cancer
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    • v.2 no.2
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    • pp.85-90
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    • 2002
  • Purpose: Perforated gastric cancer (PGC) is rare and occurs in $1\∼4\%$ of all gastric cancers. Possible dissemination of tumor cells at the time of perforation of the gastric carcinoma has been a matter of concern. The intraoperative determination of what kind of operation should be done and how extensive the lymphnode dissection should be still remains controversial. The purpose of this study is to evaluate the factors influencing the survival and to determine the optimal treatment for PGC. Materials and Methods: A total of 42 patients were operated on for a perforated gastric carcinoma at Soonchunhyang University Chunan Hospital from 1983 to 2000. the age and the sexes of the patients, the location of perforation, the diameter of perforation, the histologic type of the tumor, the depth of wall invasion, the absence or presence of lymph node metastasis / distant metastasis, the stage of disease, the type of operation, and the outcomes were examined. Statistically significant differences were analyzed by using Fisher's exact test. Results: The stage distributions according to the UICC classification were 1 case of stage I, 6 cases of stage II, 17 cases of stage III, and 11 cases of stage IV. An emergency gastrectomy was done in 26 patients ($61.9\%$), with a 5-yr survival rate of $44\%$. The survival of patients was significantly influenced by the depth of wall invasion, the lymphnode metastasis, distant metastasis, the stage of disease, and the type of operation. Conclusions: an emergency gastrectomy is the treatment of choice for most patients with resectable PGC. Choosing more a optimistic surgical approach for potentially curative cases of PGC should be one way to increase the patient's survival rate.

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