• 제목/요약/키워드: Joint location

검색결과 434건 처리시간 0.025초

Treatment and Survial Rate of Malignant Peripheral Nerve Sheath Tumors (악성 말초신경막 종양의 치료와 생존율)

  • Lee, Jong-Seok;Jeon, Dae-Geun;Cho, Wan-Hyung;Lee, Soo-Yong;Oh, Jung-Moon;Kim, Jin-Wook
    • The Journal of the Korean bone and joint tumor society
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    • 제9권2호
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    • pp.131-138
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    • 2003
  • Purpose: We analyzed our malignant peripheral nerve sheath tumor (MPNST) cases to find out their oncologic results following by each treatment modalities. Materials and Methods: Thirty four patients with MPNST were registered in Korea Cancer Center Hospital from Feb. 1986 to Nov. 1996. Seventeen cases were male and 17, female. Average age was 41 years (range 18 to 74). Location of the tumor was as follows; 17 in lower extremity, 11 upper extremity, 4 trunk, and 2 retroperitoneum. Following the AJC classification, stage IA were 2 cases, stage IIA 2, stage IIB 6, stage III 16 and stage IV 8. Twenty six patients took operations and adjuvant chemotherapy and/or radiation therapy, 3 operation only and 3 adjuvant chemotherapy or radiation therapy. Average follow up period was 33.5 months (5.6 to 146.1). Kaplan-Meiyer method was done for survival curve, and log rank test for comparison analysis. Results: Fourteen cases were continuous disease free, 2 no evidence of disease, 2 alive with disease and 14 dead of disease states at final follow up. Actual 5-year and 10-year survival rates were 53.5%, 35.7%. Local recurrence rate after operation was 24.1%. 5-year survival rates of stage I/II/III were 100/85.7/55.9% and 2-year survival rate of stage IV was 14.3% (p=0.04). In 21 cases operated with stage II-III, wide margin (15cases) had 76.0% 5-year survival rate, and marginal or intralesional marigin (6cases) had 40.0%. The actual 5-year survival rate of the group which were done 4 or more cycles chemotherapy (8cases) was 71.4% and the actual 3-year survival rate less than 4cycles chemotherapy (6cases) was 83.3% (p=0.96). In 19 cases operated with stage II-III and which had no radiotherapy, marginal or intralesional margin (5cases) had 3 cases of local recurrences (60.0%), though wide margin (14cases) had 4 cases recurrences (28.6%). There was no local recurrence in 8cases which had pre-or post-operative radiotherapy. Conclusions: Surgical margin is an important factor in local recurrence. Resection margin has a tendency to influence the survival despite insufficient statistical significance. Conventional chemotherapy has no defnite statistical sigficance in the effect on local control and survival. Preoperative and postoperative radiotherapy has some positive effect on local control.

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The Reconstruction with Extracorporeal Irradiated Autograft for Osteosarcoma of Extremities (사지 골육종에서 체외 방사선 조사를 이용한 재건술)

  • Kim, Jae-Do;Lee, Gun-Woo;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • 제16권1호
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    • pp.1-7
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    • 2010
  • Purpose: With advances in various treatment modalities, limb salvage surgery has been commonly used in osteosarcoma of extremities. An alternative method for skeletal reconstruction is reimplantation of the tumor bearing bone following extracorporeal irradiation (ECI). We report the long-term results of ECI autograft in aspect of the oncological and functional outcomes, and complications. Materials and Methods: We retrospectively reviewed 31 osteosarcoma patients who underwent reconstruction with ECI between July 1995 and January 2006. There were 24 males and 7 females with a mean age of 24 (7-74 years) and a mean follow-up of 117 months (17-177 months). Twenty-five cases were reconstructed with ECI autograft, 6 cases with ECI autograft-prosthesis composite. The pathologic subtypes were conventional in 29 cases, periosteal in 1 case, and parosteal in 1 case. The most common location of tumor was distal femur (15 cases) followed by humerus (3), proximal fibula (3) and proximal tibia (3). Musculoskeletal Tumor Society (MSTS) score was used for functional evaluation. The overall survival rate, local recurrence, complications were analyzed. Results: The overall survival rate was 80.6% and the disease-free survival rate was 64.5%. Five patients died of distant metastasis. One patient required above-knee amputation due to local recurrence. All of them, twenty-three complications occurred, which included nonunion in 7 cases, deep infection in 5 cases, joint instability in 4 cases, metal failure in 2 cases, Limb-length discrepancy (LLD) in 2 cases, periprosthetic fracture in 1 case, epiphyseal collapse in 1, local recurrence in 1 case. The mean MSTS functional score was 62.5%. Conclusion: Extracorporeal irradiated autograft can be achieved relatively good result in aspect of oncological and functional aspect, but is needed to be additional research about occurring many complications. The reconstruction with ECI after intercalary or fragmentary resection is effective reconstruction in aspect of oncological and functional result, complications.

A Study of the Capsuloligamentous Anatomy of the Glenohumeral Joint Using Magnetic Resonance Imaging and Three-Dimensional Imaging. Dynamic In Vivo Study (자기공명 영상 및 3차원 영상을 이용한 견관절 관절낭-인대의 해부학적 연구. 역동학적 생체연구)

  • Park Tae-Soo;Choi Il-Yong;Joo Kyung-Bin;Kim Sun-Il;Kim Jun-Sic;Paik Doo-Jin
    • Journal of the Korean Arthroscopy Society
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    • 제4권2호
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    • pp.154-158
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    • 2000
  • Purpose : The purpose of this study is to demonstrate changes in the orientation ortho glenohumeral ligaments(GHL) in different degrees of abduction and rotation of the normal healthy individuals. Materials and Methods : Saline Magnetic Resonance(MR) arthrography of nine consecutive shoulders of normal healthy adults were checked. At that time, MR images were obtained in three different positions of abduction and external rotation($0^{\circ}C\;and\;0^{\circ},\;45^{\circ}C\;and\;25^{\circ}C,\;90^{\circ}$ and maximum, respectively). From a series of consecutive MRI, three-dimensional images were reconstructed after detecting the location of the middle glenohumeral ligament(MGHL) and the inferior glenohumeral ligament(IGHL) using workstation computer. Results : The shape of the MGHL was taken in double curved, and straight, and finally curved again in three different positions of the shoulder in sequence. On the other hand, the shape of the IGHL was obliquely positioned, and curvilinear, and finally straight and extended at lower part of the anterior surface of the humeral head. Conclusions : At $45^{\circ}$ of abduction and $25^{\circ}$ of external rotation, and at $90^{\circ}$ of abduction and maximal external rotation of the shoulder, the MGHL and the IGHL had the role of the most important static stabilizer of the glenohumeral joint repectively.

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A Study on Detection Methodology for Influential Areas in Social Network using Spatial Statistical Analysis Methods (공간통계분석기법을 이용한 소셜 네트워크 유력지역 탐색기법 연구)

  • Lee, Young Min;Park, Woo Jin;Yu, Ki Yun
    • Journal of Korean Society for Geospatial Information Science
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    • 제22권4호
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    • pp.21-30
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    • 2014
  • Lately, new influentials have secured a large number of volunteers on social networks due to vitalization of various social media. There has been considerable research on these influential people in social networks but the research has limitations on location information of Location Based Social Network Service(LBSNS). Therefore, the purpose of this study is to propose a spatial detection methodology and application plan for influentials who make comments about diverse social and cultural issues in LBSNS using spatial statistical analysis methods. Twitter was used to collect analysis object data and 168,040 Twitter messages were collected in Seoul over a month-long period. In addition, 'politics,' 'economy,' and 'IT' were set as categories and hot issue keywords as given categories. Therefore, it was possible to come up with an exposure index for searching influentials in respect to hot issue keywords, and exposure index by administrative units of Seoul was calculated through a spatial joint operation. Moreover, an influential index that considers the spatial dependence of the exposure index was drawn to extract information on the influential areas at the top 5% of the influential index and analyze the spatial distribution characteristics and spatial correlation. The experimental results demonstrated that spatial correlation coefficient was relatively high at more than 0.3 in same categories, and correlation coefficient between politics category and economy category was also more than 0.3. On the other hand, correlation coefficient between politics category and IT category was very low at 0.18, and between economy category and IT category was also very weak at 0.15. This study has a significance for materialization of influentials from spatial information perspective, and can be usefully utilized in the field of gCRM in the future.

Surgical Treatment for Subungual Exostosis in the foot (족부에 발생한 조갑하 외골증에 대한 수술적 치료)

  • Lee, Kee-Haeng;Kim, Hyoung-Min;Moon, Chan-Woong;Lee, Bum-Seong;Kim, Youn-Soo
    • The Journal of the Korean bone and joint tumor society
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    • 제10권2호
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    • pp.107-112
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    • 2004
  • Purpose: We described our experience with subungual exostosis in the foot for which we used different surgical technique according as location and size of lesion and revealed excellent results. Materials and Methods: We experienced 12 cases of subungual exostosis that were treated surgically and followed them more than one year between October 1995 and July 2003. There were nine females and three males. The average age of patients at surgery was 13.4 years. Duration of symptoms was 20.3 months on average. The lesion involved the hallux in nine cases; eight dorsomedial and one dorsolateral aspect of distal phalangeal bone. It involved the second, the third, and the fifth toe in one each; all central aspect of dorsum of distal phalanx. We used surgical technique that involves approaching the exostosis under the nail to preserve nail coverage for lesion in the hallux. The nails were extracted totally but preserved nail bed as much as possible in other toes. Results were based on appearance of the regenerated nail and presence of recurrence. Excellent results were those in which the nail appeared nearly normal and there was no clinical or radiographic evidence of recurrence. Good results were associated with a minor nail deformity such as ridging, and no evidence of recurrence. Fair results had obvious nail deformity or a minimal asymptomatic recurrence that was discernable only on radiograph. Poor results were associated with a clinically evident symptomatic recurrence. Results: When the lesion involved hallux, there were six excellent and two good results, and one poor result. All cases that involved other toes revealed good results. Conclusion: We suggest that different surgical technique might be applied according as location and size of the lesion to achieve satisfactory results for subungual exostosis in the foot.

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Biomechanical Comparative Analysis of Two Goal-kick Motion in Soccer (두 가지 축구 골킥 동작의 운동역학적 비교 분석)

  • Jin, Young-Wan;Shin, Je-Min
    • Korean Journal of Applied Biomechanics
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    • 제15권1호
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    • pp.29-44
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    • 2005
  • The purpose of this study is to reveal the effects of two different kicks, the drop kick and the punt kick, into the kicking motion, through the kinetic comparative analysis of the kicking motion, which is conducted when one kicks a soccer goal. To grasp kinetic changing factors, which is performed by individual's each body segment, I connected kicking motions, which were analyzed by a two dimension co-ordination, into the personal computer to concrete the digits of it and smoothed by 10Hz. Using the smoothed data, I found a needed kinematical data by inputting an analytical program into the computer. The result of comparative analysis of two kicking motions can be summarized as below. 1. There was not a big difference between the time of the loading phase and the time of the swing phase, which can affect the exact impact and the angle of balls aviation direction. 2. The two kicks were not affected the timing and the velocity of the kicking leg's segment. 3. In the goal kick motion, the maximum velocity timing of the kicking leg's lower segment showed the following orders: the thigh(-0.06sec), the lower leg(-0.05sec), the foot(-0.018sec) in the drop kick, and the thigh(-0.06sec), the lower leg(-0.05sec), the foot(-0.015sec) in the punt kick. It showed that whipping motion increases the velocity of the foot at the time of impact. 4. At the time of impact, there was not a significant difference in the supporting leg's knee and ankle. When one does the punt kick, the subject spreads out his hip joint more at the time of impact. 5. When the impact performed, kicking leg's every segment was similar. Because the height of the ball is higher in the punt kick than in the drop kick, the subject has to stretch the knees more when he kicks a ball, so there is a significant affect on the angle and the distance of the ball's flying. 6. When one performs the drop kick, the stride is 0.02m shorter than the punt kick, and the ratio of height of the drop kick is 0.05 smaller than the punt kick. This difference greatly affects the center of the ball, the supporting leg's location, and the location of the center of gravity with the center of the ball at the time of impact. 7. Right before the moment of the impact, the center of gravity was located from the center of the ball, the height of the drop kick was 0.67m ratio of height was 0.37, and the height of the punt kick was 0.65m ratio of height was 0.36. The drop kick was located more to the back 0.21m ratio of height was 0.12, the punt kick was located more to the back 0.28m ratio of height was 0.16. 8. There was not a significant difference in the absolute angle of incidence and the maximum distance, but the absolute velocity of incidence showed a significant difference. This difference is caused from that whether players have the time to perform of not; the drop kick is used when the players have time to perform, and punt kick is used when the players launch a shifting attack. 9. The surface reaction force of the supporting leg had some relation with the approaching angle. Vertical reaction force (Fz) showed some differences in the two movements(p<0.05). The maximum force of the right and left surface reaction force (Fx) didn't have much differences (p<0.05), but it showed the tendency that the maximum force occurs before the peak force of the front and back surface (Fy) occurs.

Nodal Status of the Head and Neck Cancer Patients (두경부 암 환자의 경부 림프절 전이 분석)

  • Yang, Dae-Sik;Choi, Myung-Sun;Choi, Jong-Ouck
    • Radiation Oncology Journal
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    • 제15권4호
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    • pp.321-329
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    • 1997
  • Purpose : It is well known that the risk of lymph nodes metastases to head and neck cancers are influenced by the location and size of the Primary tumor. as well as the degree and types of histological differentiation. However, data on the statistical analyses of lymph node metastases from the head and neck cancers among Korean Population are not available at present. In order to obtain current status of such data, we have analyzed cancer patients at the department of radiation oncology, korea universityhospital for radiation treatment. Materials and Methods : We have evaluated nine-hundred and ninetyseven (997) head and neck cancer Patients who visited to the Department of radiation oncology, between November 1981 to December 1995. After careful physical examinations and CAT scan, Patients were divided into two groups, those with positive lymph node metastases and with negative lymph node metastases. The nodal status were classified according to the TNM system of American Joint Committee on Cancer (AJCC) Besults : Four-hundred and sixteen Patients out of the 997 patients were lymph node positive $(42\%)$ and 581 patients were lymph node negative $(58\%)$ when they were first presented at the department of radiation oncelogy. According to the AJCC classification, the distribution of positive lymph node is as follow: Nl:106 $(25.5\%),\;N2a:100\;(24\%),\;N2b:68\;(16.4\%),\;N2c:69\;(16.6\%),\;3:73\;(15\%).$ respectively. The frequency of lymph node metastases according to the primary sites is as follow : larynx 283 $(28.5\%)$, paranasal sinuses: 182 $(18\%),\;oropharynx:144\;(14.5\%)\;nasopharynx:122(12\%),\;oral\;cavity\;92\;(9\%),\;hypopharynx:71\;(7\%),\;falivary\;gland:58\;(6\%)$ unknown primary:31 $(3\%),\;skin:\;14(2\%)$,. The most frequent Primary site for the positive Iymph node metastases was nasopharynx $(71\%)$ followed by hypopharynx $(69\%),\;oropharynx\;(64\%),\;oral\;cavity\;(39\%)$ The most common histologic type was squamous cell carcinoma (652/997: $65.4\%$). followed by malignant lymphoma $(109/997:11\%)$. Conclusion : Statistical results of lymph node metastases from head and neck cancer at our department were very similar to those obtained from other countries. It is concluded that the location of Primary cancer influences sites of metastases on head and neck, and stage of the primary cancer also influences the development of metastatic lesions. Since the present study is limited on the data collected from one institute. further statistical analyses on Korean cancer Patients are warrented.

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Treatment of Squamous Cell Carcinoma in Extremity & Trunk (사지와 체부에 발생한 편평상피 세포암의 치료)

  • Shin, Duk-Seop;Kim, Beom-Jung
    • The Journal of the Korean bone and joint tumor society
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    • 제18권1호
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    • pp.7-13
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    • 2012
  • Purpose: The purpose of this study is to compare general survival rate and survival rate according to expectable prognostic factors by analyzing the result of treating a patient of squamous cell carcinoma. Materials and Methods: From Mar. 1999 to Feb. 2011, 151 patients were pathologically confirmed as squamous cell carcinoma of limbs and body in our hospital, and among those patients, 51 patients underwent the surgical treatment. This study included 41 patients who underwent the surgical treatment and were followed-up for more than 12 months. The mean age of population was 64.4 years. 31 males and 10 females were included. Wide excision with following skin grafts or flaps for reconstruction (29 cases) was mostly performed, but amputation (12 cases) was also performed for cases with extremities where resection margin was difficult to obtain and cases with neural or vascular invasion. 8 patients underwent chemotherapy or radiotherapy after resection, and 33 underwent the operation only. Stages were classified by AJCC Classification, survival rate was calculated by Kaplan-Meier method and survival rate of groups was compared by Log-rank test. For the expectable prognostic factors related to survival rate, location of primary lesion, cause of disease, pathologic grade, staging, surgical method, additional anticancer therapy were examined and each survival rate was compared. Results: The average follow-up period was 65.2 (12-132) months. Thirty patients survived out of 41 patients till last follow up. The overall survival rate in 5 years was 77%. Three cases (7.3%) had local recurrence, and 7 cases (17.0%) had metastasis. The average period of recurrence from operation was 27 (18-43) months. Possible prognostic factors such as location of primary lesion, cause of disease, pathologic grade, staging, additional anticancer therapy showed no significant difference in survival rates. However, patients with amputation showed significantly lower survival rate than those with wide excision. Conclusion: In analysis the results of treating 41 cases of squamous cell carcinoma, the overall 5-year survival rate was 77%. And, among the several prognostic factors, only the surgical method was significant statistically.

Treatment and Prognosis of Chondroblastoma (연골모세포종의 치료 결과)

  • Lee, Young-Kyun;Han, Il-kyu;Oh, Joo-Han;Lee, Sang-Hoon;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • 제13권2호
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    • pp.81-87
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    • 2007
  • Purpose: Chondroblastoma of bone is rare with the potential for local recurrence and metastasis. A retrospective review of 30 patients with chondroblastoma of bone treated at a single institution during a 24-year period was conducted to determine the clinical outcome and relevant prognostic factors. Materials and Methods: Thirty patients with biopsy-proven chondroblastoma of bone, treated between September of 1981 and September of 2005, were retrospectively reviewed. There were 16 men and 14 women with an average follow-up period of 7.2 years (range, 1.6~21.2). The most common sites were the distal femur (n=7), proximal humerus (n=6), proximal tibia (n=6) and proximal femur (n=4). The average age of the patients was 20 years (range, 12~47) with closed physes in 20 patients(67%.) Twenty-seven patients(90%) were treated by curettage of the tumor with or without bone grafting or cementing. Three patients(10%) were treated with en bloc resection. Clinical and pathological factors reported to be associated with poor outcome were analyzed. Results: Four local recurrences(13%) developed in postoperative 4, 6, 7 and 16 months. These patients underwent further curettage (once in 2 patients and twice 2) and had no further recurrence. All patients showed no evidence of disease at the final follow-up. Local recurrence developed in the two cases which removal of the tumor was incomplete. Curettage and bone-grafting (1) and cementing (1) were performed in the two other cases with local recurrences. In contrast, no local recurrences were observed in the 3 cases treated with en-bloc resection. The status of physes or the histologic presence of aneurysmal bone cyst, the anatomic location of the tumor did not affect local recurrence. Conclusion: Adequate removal of the tumor with aggressive curettage or en bloc resection seems to be necessary to prevent local recurrence in chondroblastoma. The status of physes, the histologic presence of aneurysmal bone cyst or the anatomic location of the tumor was not related with local recurrence.

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Suggestion of Optimal Radiation Fields in Rectal Cancer Patients after Surgical Resection for the Development of the Patterns of Care Study (Patterns of Care 연구 개발을 위한 직장암의 수술 후 방사선치료 시 적정 방사선치료 조사영역 제안)

  • Kim, Jong-Hoon;Park, Jin-Hong;Kim, Dae-Yong;Kim, Woo-Cheol;Seong, JinSil;Ahn, Yong-Chan;Ryu, Mi-Ryeong;Chun, Mison;Hong, Seong-Eon;Oh, Do-Hoon;Kim, Il-Han
    • Radiation Oncology Journal
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    • 제21권3호
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    • pp.183-191
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    • 2003
  • Purpose: To suggest the optimal radiation fields after a surgical resection based on a nationwide survey on the principles of radiotherapy for rectal cancer in the Korean Patterns on Care Study. Materials and method: A consensus committee, composed of radiation oncologists from 18 hospitals in Seoul Metropolitan area, developed a survey format to analyze radiation oncologist's treatment principles for rectal cancer after a surgical resection. The survey format included 19 questions on the principles of defining field margins, and was sent to the radiation oncologists in charge of gastrointestinal malignancies in all korean hospitals (48 hospitals). Thirty three ($69\%$) oncologists replied. On the basis of the replies and literature review, the committee developed guidelines for the optimal radiation fields nor rectal cancer Results: The following guidelines were developed: superior border between the lower tip on the L5 vertebral body and upper sacroiliac joint; inferior border $2\~3$ cm distal to the anastomosis in patient whose sphincter was saved, and $2\~3$ cm distal to the perineal scar In patients whose anal sphincter was sacrificed; anterior margin at the posterior lip of the symphysis pubis or $2\~3$ cm anterior to the vertebral body, to include the internal iliac lymph node and posterior margin $1.5\~2$ cm posterior to the anterior surface of the surface, to include the presacral space with enough margin. Comparison with the guidelines, the replies on the superior margin coincided in 23 cases ($70\%$), the inferior margin after sphincter saving surgery in 13 ($39\%$), the inferior margin after adbominoperineal resection in 32 ($97\%$), the lateral margin in 32 ($97\%$), the posterior margins in 32 ($97\%$) and the anterior margin in 16 ($45\%$). Conclusion: These recommendations should be tailored to each patient according to the clinical characteristics such as tumor location, pathological and operative findings, for the optimal treatment. The adequacy of these guidelines should be proved be following the Korean Patterns of Care Study.