• 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.

• 대한핵의학회지
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• 제33권3호
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• pp.243-246
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• 1999

Currently, dissection of the axillary or regional lymph nodes is considered the standard staging procedure in breast cancer. However, accumulating evidence is becoming available that the sentinel node concept may provide the same or even better staging information. In the case of melanoma, it is proven that the histological characteristics of the sentinel node reflect the histological characteristics of the distal part of the lymphatic basin. Morbidity can be reduced significantly by the use of sentinel node dissection as several authors have reported successful introduction of this technique into clinical practice. But in breast cancer patients, there are signigicant differences in practice relating to the technology, such as radiopharmaceuticals, injection sites, volume of injectate, combination with vital blue dye, preoperative lymphoscintigraphy, etc. Valuable reports on these topics appeared in recent journals. This review is a summary of those reports for nuclear physicians interested in sentinel node detection by lymphoscintigraphy in breast cancer patients.

• 대한기관식도과학회지
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• 제6권2호
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• pp.147-151
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• 2000

Background and Objectives： Metastasis to the submental and submandibular lymph nodes rarely occurs in squamous cell carcinoma of the larynx and hypopharynx. The aim of this study is to evaluate the effectiveness of level I neck dissection in squamous cell carcinoma of larynx and hypopharynx. Materials and Methods : Forty-three patients with pathologically positive cervical nodal involvement in squamous cell carcinoma of larynx and hypopharynx treated between 1989 to 1998 were reviewed. Fifteen patients were treated with neck dissection including level 1,28 patients were treated with neck dissection excluding the level 1. Results : The regional recurrence at the level I in patients treated with neck dissection excluding the level I, was shown in only one case (recurrence rate 3.6%), but this patient was efficiently managed with salvage operation and adjuvant radiotherapy. No recurrence was shown in patients treated with neck dissection including the level I. So, total recurrence rate at the level I was 2.3%. Conclusion : This study suggests that dissection of the level I is not justified in squamous cell carcinoma of larynx and hypopharynx even if metastasis to cervical lymph node was confirmed preoperatively (cN+).

• Journal of Chest Surgery
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• 제31권11호
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• pp.1081-1084
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• 1998

연구배경 : 식도암은 근치율이 낮고, 광범위 림프절 절제후에도 그 성적이 나쁜 편이다. 따라서 경부 림프절 절제가 식도수술결과에 미치는 효과를 알아보고자 식도수술 환자에서 경부림프절 전이가 된 환자를 조사하였다 대상 및 방법 : 1994년부터 1996년 6월까지 본원에서 흉부식도암 수술을 받은 32명의 환자 중 고식적 수술을 시행받은 25명의 환자를 대상으로 하여 경부림프절 절제의 유무를 기준으로 두 그룹으로 나뉘어 연구하였다. 두 그룹 모두 흉부식도 전절제술과 동반하여 종격림프절과 복부림프절 절제를 시행하였으나 B그룹은 양측 경부림프절 절제를 추가하여 시행하였다. 결과 : 수술합병증은 두 그룹 사이에서 의미있게 차이가 나지않았다. t수술사망과 병원사망은 두 그룹 모두에서 보이지 않았다. 그러나 평균 마취시간은 B그룹에서 의밌게 더 길었다.(평균 마취시간 90분). B그룹에서 27%가 경부림프절 전이를 보였다 결론 : 그러므로 경부림프절 절제는 흉부식도암 수술에서 의미있는 수술방법이라고 할 수 있다. 장기생존율의 비교가 더 필요하리라고 생각한다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권5호
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• pp.267-275
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• 2019

Objectives: Metastasis in oral squamous cell carcinoma (OSCC) can occur in a variety of ways, and draining lymphatics and lymph nodes serve as a common route. Prior to metastasis, lymph nodes elicit an immune response to either wall off or create a favorable environment for homing of tumor cells. This immune response to tumor stimuli is visualized by recognizing various immunoreactive patterns exhibited by the lymph node. The present study aims to evaluate the role of immuno-morphologic patterns of the lymph node in neck dissection for cases of OSCC. Materials and Methods: Our retrospective study included 50 neck dissection cases of OSCC and a total of 1,078 lymph nodes. The grades of primary tumors with eight different immunoreactive patterns were compared. Vascularity and metastasis in lymph nodes were also evaluated. Results: The lymphocyte predominant pattern was the most common immunoreactive pattern found in 396 of 1,078 lymph nodes. Patterns of lymphocyte predominant (P=0.0005), sinus histiocytosis (P=0.0500), paracortical hyperplasia (P=0.0001), cortical hyperplasia (P=0.0001), and increased vascularity (P=0.0190) were significantly associated with tumor grade. Conclusion: The present study adds to the understanding of lymph node immunoreactivity patterns and their correlation with tumor grade. We recommend further study of lymph node patterns for all sentinel lymph node biopsies and routine neck dissections for OSCCs.

• 대한한의정보학회지
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• 제14권2호
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• pp.95-103
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• 2008

Objectives : The purpose of this case is to report the improvement of a patient with lymphedema due to axillary lymph node dissection after acupuncture therapy and herbal medicine. Methods : We treated the patient with Dong-Qi acupuncture, herbal medication(木通大安湯), lymph absorption massage, compresses, abdominal breathing. We measured the circumference of the patient's elbow and wrist every day at 6pm. Results : Since being hospitalized, the circumference of the patient' elbow and wrist has been decreased and VAS score has gotten lower gradually. Conclusions : We considered Dong-Qi acupuncture, herbal medication had a useful effect on lymphedema due to axillary lymph node dissection with lymph absorption massage, compresses, abdominal breathing.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권1호
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• pp.73-81
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• 1995

The poor survival rates of patients with carcinoma of a tongue, despite of modern therapy, is well recognized. One of the most important prognostic factors is status of the cervical lymph nodes. There have been a long-standing debate about the treatment of cervical lymph nodes in early-stage tongue cancer. There are two major treatment opinion. The one is surgical excision of primary tumor with prophylactic neck dissection, simultaneously, and the other is to delay the cervical therapy until cervical lymph node is palpable. Recently we have experienced the early cervical metastasis in three patients who had been diagnosed as a carcinoma of the tongue. They were T1, T2 lesion and no palpable node was found. But histopathologic examination showed the occult metastasis or delayed cervical metastasis was occured. By the review of literature and clinical experience, we could conclude the prophylactic neck dissection offers a better chance for success than therapeutic neck dissection of palpable lymph nodes, in case of oral tongue cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1181-1185
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• 2016

Background: The aim of this study is to compare the numbers of axillary lymph nodes (ALN) taken out by dissection between patients with breast cancer operated on after having neoadjuvant chemotherapy (NAC) treatment and otherswithout having neoadjuvant chemotherapy, and to investigate factors affecting lymph node positivity. Materials and Methods: A total of 49 patients operated due to advanced breast cancer after neoadjuvant chemotherapy and 144 patients with a similar stage of the cancer having primary surgical treatment without chemotherapy at the general surgery clinic of Ondokuz Mayis University Medicine Faculty between the dates 01.01.2006 and 31.10.2012 were included in the study. The total number of lymph nodes taken out by axillary dissection (ALND) was categorized as the number of positive lymph nodes and divided into <10 and ${\geq}10$. The variables to be compared were analysed using the program SPSS 15.0 with P<0.05 accepted as significant. Results: Median number of dissected lymph nodes from the patient group having neoadjuvant chemotherapy was 16 (16-33) while it was 20 (5-55) without chemotherapy. The respective median numbers of positive lymph nodes were 5 (0-19) and 10 (0-51). In 8 out of 49 neoadjuvant chemotherapy patients (16.3%), the number of dissected lymph nodes was below 10, and it was below 10 in 17 out of 144 primary surgery patients. Differences in numbers of dissected total and positive lymph nodes between two groups were significant, but this was not the case for numbers of <10 lymph nodes. Conclusions: The number of dissected lymph nodes from the patients with breast cancer having neoadjuvant chemotherapy may be less than without chemotherapy. This may not always be attributed to an inadequate axillary dissection. More research to evaluate the numbers of positive lymph nodes are required in order to increase the reliability of staging in the patients with breast cancer undergoing neoadjuvant chemotherapy.

• Journal of Gastric Cancer
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• 제11권2호
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• pp.86-93
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• 2011

Purpose: When performing a laparoscopic assisted gastrectomy, a function-preserving gastrectomy is performed depending on the location of the primary gastric cancer. This study examined the incidence of lymph node metastasis by the lymph node station number by tumor location to determine the optimal extent of the lymph node dissection. Materials and Methods: The subjects consisted of 1,510 patients diagnosed with gastric cancer who underwent a gastrectomy between 1996 and 2005. The patients were divided into three groups: upper, middle and lower third, depending on the location of the primary tumor. The lymph node metastasis patterns were analyzed in the total and early gastric cancer patients. Results: In all patients, lymph node station numbers 1, 2, 3, 7, 10 and 11 metastases were dominant in the cancer originating in the upper third, whereas station numbers 4, 5, 6 and 8 were dominant in the lower third. In early gastric cancer patients, the station number of lymph nodes with a metastasis did not show a significant difference in stage pT1a disease. On the other hand, a metastasis in lymph node station number 6 was dominant in stage pT1b disease that originated in the lower third of the stomach. Conclusions: When performing a laparoscopic-assisted gastrectomy for early gastric cancer, a limited lymphadenectomy is considered adequate during a function-preserving gastrectomy in mucosal (T1a) cancer. On the other hand, for submucosal (T1b) cancer, a number 6 node dissection should be performed when performing a pylorus preserving gastrectomy.

• Asian Pacific Journal of Cancer Prevention
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• 제16권8호
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• pp.3361-3363
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• 2015

Background: Despite the majority of papillary thyroid microcarcinoma (PTMC) patients having an excellent prognosis, cervical lymph node metastases are common. The purpose of this study was to investigate the incidence and the predictive risk factors for occult central compartment lymph node metastasis (CLNM) in PTMC patients. Materials and Methods: 178 patients with clinically node-negative (cN0) PTMC undergoing prophylactic central compartment neck dissection in our hospital from January 2008 to Jun 2010 were enrolled. The relationship between CLNM and the clinical and pathological factors such as gender, age, tumor size, tumor number, tumor location, extracapsular spread (ECS), and coexistance of chronic lymphocytic thyroiditis was analyzed. Results: Occult CLNM was observed in 41% (73/178) of PTMC patients. Multivariate analysis showed that male gender, tumor size (${\geq}6mm$) and ECS were independent variables predictive of CLNM in PTMC patients. Conclusions: Male gender, tumor size (${\geq}6mm$) and ECS were risk factors of CLNM. We recommend a prophylactic central lymph node dissection (CLND) should be considered in PTMC patients with such risk factors.