• Title/Summary/Keyword: Nodal Patterns

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Outcome of Surgery and Post-Operative Radiotherapy for Major Salivary Gland Carcinoma: Ten Year Experience from a Single Institute

  • Kaur, Jaspreet;Goyal, Shikha;Muzumder, Sandeep;Bhasker, Suman;Mohanti, Bidhu Kalyan;Rath, Goura Kishore
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8259-8263
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    • 2014
  • Aims: To determine the clinical characteristics, pathological features, local and distant failure patterns in patients with carcinoma of major salivary glands treated with surgery and postoperative radiotherapy (PORT). Materials and Methods: We retrospectively reviewed 106 cases of major salivary gland tumor seen at our centre (1998-2008). Sixty five cases of major salivary gland carcinoma were selected for analysis (exclusions: benign, palliative, non-carcinomas). The patient population treated by surgery and PORT was divided into two groups: 1) Patients who underwent surgery and immediate PORT (Primary PORT); 2) Patients with recurrent carcinoma who underwent at least two surgeries and received PORT in the immediate post-operative period of the last performed surgery (Recurrent PORT). Recurrence free survival (RFS) was assessed using the Kaplan-Meier method. Results: Median age was 35 years with a male: female ratio of 1.3:1. The majority of cancers were located in the parotid gland (86.2%) and the most common histology was mucoepidermoid carcinoma (43%). Thirty nine cases (60%) were primary while 26 (40%) were recurrent. Optimal surgery was performed in 59/65 patients (90.8%). 43 patients (66.2%) underwent neck dissection, of which 14 (32.5%) had nodal metastasis. Overall, 61 (93.8%) patients complied with the prescribed radiotherapy. Median dose of PORT was 60 Gy. Median follow-up was 13.1 months (range 2-70). Relapse free survival was 50.4% at 60 months. Some 12 cases (18.5%) recurred with a median time to recurrence of 16.9 months. Conclusions: Surgery and PORT is an effective treatment for major salivary gland carcinoma with over 90% compliance and <20% recurrence. Early treatment with postoperative radiotherapy may increase the survival rate in major salivary gland carcinoma patients.

Variation of Peroxidase 8 in Maize, Zea mays, L. (옥수수에 있어서 Peroxidase 8의 변이)

  • Bong Ho, Choe
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.28 no.3
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    • pp.374-378
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    • 1983
  • As one way of evaluating polymorphism in maize, variation of peroxidase 8 (Px.8) in maize plants was investigated by means of horizontal acrylomide electrophoresis. The specific part of maize plants was stele and other parts of plants were also studied for 34 different maize lines and hybrids. The results obtained indicate that Px.8 has three distinct migrating patterns on gel such as fast, slow and fast-slow. The band pattern varied with materials used. Most hybrids were showing fast-slow band, indicating that those hybrids are heterozygous at least for Px.8 allele. Variation of band pattern was obseerved within a single inbred line. The Px.8 in stele tissue and in young leaf and nodal tissue was found to be identical, indicating the possible use of those tissues as an alternative tissue for Px.8 study. It was also found that there might be some definite relationship between Px.8 and Px.3 activities in the same tissue.

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Risk Factors and Tumor Recurrence in pT1N0M0 Gastric Cancer after Surgical Treatment

  • Choi, Hee Jun;Kim, Su Mi;An, Ji Yeong;Choi, Min-Gew;Lee, Jun Ho;Sohn, Tae Sung;Bae, Jae Moon;Kim, Sung
    • Journal of Gastric Cancer
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    • v.16 no.4
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    • pp.215-220
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    • 2016
  • Purpose: This study aimed to evaluate the rate, patterns, and risk factors associated with tumor recurrence in patients with T1N0 gastric cancer. Materials and Methods: The medical records of 8,753 patients with pathological T1N0M0 gastric cancer who underwent gastrectomy between 1994 and 2014 at Sungkyunkwan University School of Medicine were examined. Results: Among the 8,753 patients, 95 patients (1.1%) experienced tumor recurrence; this included 31 remnant, 27 hematogenous, 9 lymph nodal, 5 peritoneal, and 23 multiple-site recurrences. When patients were divided into two groups according to the presence of tumor recurrence, the following characteristics were higher in the recurrence group than in the non-recurrence group: older age (${\geq}65years$), male gender, undifferentiated histology, submucosal invasion, and venous invasion. In multivariate analysis, older age, male gender, tumor depth (sm2 and sm3 invasion), and venous invasion were independent risk factors for tumor recurrence. The recurrence rates were 0.7% in patients with less than two risk factors, 1.7% in those with two risk factors, 3.0% in those with three risk factors, and 6.3% in those with four risk factors (P<0.001). Conclusions: Although tumor recurrence is rare in pT1N0M0 gastric cancer, some patients with certain risk factors demonstrate an increased rate of tumor recurrence. Careful follow-up is required for patients with three or four risk factors.

Maximum standardized uptake value at pre-treatment PET in estimating lung cancer progression after stereotactic body radiotherapy

  • Park, Jisun;Choi, Yunseon;Ahn, Ki Jung;Park, Sung Kwang;Cho, Heunglae;Lee, Ji Young
    • Radiation Oncology Journal
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    • v.37 no.1
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    • pp.30-36
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    • 2019
  • Purpose: This study aimed to identify the feasibility of the maximum standardized uptake value (SUVmax) on baseline 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) as a predictive factor for prognosis in early stage primary lung cancer treated with stereotactic body radiotherapy (SBRT). Materials and Methods: Twenty-seven T1-3N0M0 primary lung cancer patients treated with curative SBRT between 2010 and 2018 were retrospectively evaluated. Four patients (14.8%) treated with SBRT to address residual tumor after wedge resection and one patient (3.7%) with local recurrence after resection were included. The SUVmax at baseline PET/CT was assessed to determine its relationship with prognosis after SBRT. Patients were divided into two groups based on maximum SUVmax on pre-treatment FDG PET/CT, estimated by receiver operating characteristic curve. Results: The median follow-up period was 17.7 months (range, 2.3 to 60.0 months). The actuarial 2-year local control, progression-free survival (PFS), and overall survival were 80.4%, 66.0%, and 78.2%, respectively. With regard to failure patterns, 5 patients exhibited local failure (in-field failure, 18.5%), 1 (3.7%) experienced regional nodal relapse, and other 2 (7.4%) developed distant failure. SUVmax was significantly correlated with progression (p = 0.08, optimal cut-off point SUVmax > 5.1). PFS was significantly influenced by pretreatment SUVmax (SUVmax > 5.1 vs. SUVmax ≤ 5.1; p = 0.012) and T stage (T1 vs. T2-3; p = 0.012). Conclusion: SUVmax at pre-treatment FDG PET/CT demonstrated a predictive value for PFS after SBRT for lung cancer.

Nomenclature and Lymphatic Drainage Patterns of Abdominal Lymph Nodes (복부 림프절의 명명법 및 림프 배액 패턴)

  • Hyun Seok Cho;Jhii-Hyun Ahn
    • Journal of the Korean Society of Radiology
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    • v.83 no.6
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    • pp.1240-1258
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    • 2022
  • The lymphatic system provides a route for the spread of inflammation and malignancies. The identification of nodal stations and lymphatic pathways of tumor spread is important for tumor staging, choice of therapy, and the prediction of the prognosis of patients with malignant diseases. Because lymph node metastasis is common in primary intra-abdominal malignant tumors, its detection is essential for radiologists to understand the pattern of disease spread. Using schematic pictures and color-coded CT images, this pictorial essay describes the locations and nomenclature of the abdominal lymph nodes. Furthermore, the lymphatic drainage pathways of the upper and lower gastrointestinal tracts, liver, gallbladder, bile duct, and pancreas have been highlighted. In addition, lymph nodes belonging to the regional lymph nodes in malignant tumors arising from each organ are described, and certain cases are presented with images from patients.

Division of the N2 Stage According to the Multiplicity of the Involved Nodal Stations May be Necessary in the N2-NSCLC Patients Who are Treated with Postoperative Radiotherapy (비소세포성 폐암으로 수술 후 방사선치료가 시행된 N2병기 환자들에서 다발 부위 종격동 림프절 전이 여부에 따른 N2병기 구분의 임상적 의미)

  • Yoon, Hong-In;Kim, Yong-Bae;Lee, Chang-Geol;Lee, Ik-Jae;Kim, Song-Yih;Kim, Jun-Won;Kim, Joo-Hang;Cho, Byung-Chul;Lee, Jin-Gu;Chung, Kyung-Young
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.126-132
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    • 2009
  • Purpose: We wanted to evaluate the prognostic factors for the pathologic N2 non-small cell lung cancer (NSCLC) patients who were treated by postoperative radiotherapy. Materials and Methods: We retrospectively reviewed 112 pN2 NSCLC patients who underwent surgery and postoperative radiotherapy (PORT) From January 1999 to February 2008. Seventy-five (67%) patients received segmentectomy or lobectomy and 37 (33%) patients received pneumonectomy. The resection margin was negative in 94 patients, and it was positive or close in 18 patients. Chemotherapy was administered to 103 (92%) patients. Nine (8%) patients received PORT alone. The median radiation dose was 54 Gy (range, 45 to 66), and the fraction size was 1.8~2 Gy. Results: The 2-year overall survival (OS) rate was 60.2% and the disease free survival (DFS) rate was 44.7% for all the patients. Univariate analysis showed that the patients with multiple-station N2 disease had significantly reduced OS and DFS (p=0.047, p=0.007) and the patients with an advanced T stage ($\geq$T3) had significantly reduced OS and DFS (p<0.001, p=0.025). A large tumor size ($\geq$5 cm) and positive lymphovascular invasion reduced the OS (p=0.035, 0.034). Using multivariate analysis, we found that multiple-station N2 disease and an advanced T stage ($\geq$T3) significantly reduced the OS and DFS. Seventy one patients (63.4%) had recurrence of disease. The patterns of failure were loco-regional in 23 (20.5%) patients, distant failure in 62 (55.4%) and combined loco-regional and distant failure in 14 (12.5%) patients. Conclusion: Multiple involvement of mediastinal nodal stations for the pN2 NSCLC patients with PORT was a poor prognostic factor in this study. A prospective study is necessary to evaluate the N2 subclassification and to optimize the adjuvant treatment.

Significance of Supraclavicular Lymph Node Involvement on Determination of Clinical Staging for Thoracic Esophageal Carcinoma (흉부 식도암의 병기 결정에 있어서 채골상 림프절 전이의 의미)

  • Wu Hong-Gyun;Park Chan Il;Ha Sung Whan;Kim Il Han
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.108-112
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    • 1999
  • Background and Purpose : Involvement of supraclavicular Iymph nodes (SCL) is considered distant metastasis for thoracic esophageal carcinoma in AJCC staging system revised in 1997. We investigated significance of SCL involvement compared to other regional Iymph node involvement. Materials and Methods : Two-hundred eighty-nine patients with unresectable esophageal carcinoma were treated with radiation therapy from June of 1979 through December 1992. Of these patients, 25 were identified having SCL involvement. Survival rate and relapse patterns were compared with that of mediastinal and perigastric Iymph node positive patients to evaluate prognostic significance of SCL involvement. Results : Median survival for patients with SCL involvement was 7 months and 2- and 5-year overall survival rates were 12.0$\%$ and 4.0$\%$ respectably. Corresponding features for regional node positive patients were 9 month, 17.0$\%$ and 3.8$\%$. There was no significant difference between two groups. There was also no difference in patterns of recurrence. Conclusions : Results of this analysis showed that SCL involvement should be staged as nodal disease in contrast to present classification of metastatic disease.

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Patterns of Failure after Combined Surgery and Radiation Therapy for Malignant Tumors of the Parotid Gland - Analysis of Treatment Results According to Pathologic Type - (근치적수술과 술후방사선치료를 받은 이하선 악성종양 환자의 치료실패 양상 - 병리학적 유형에 따른 결과를 중심으로 -)

  • Lee Sang-Wook;Chang Sei-Kyung;Kim Gwi-Eon;Suh Chang-Ok;Seong Jin-Sil;Lee Chang-Geol;Keum Ki-Chang;Park Cheong-Soo;Choi Eun-Chang
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.182-188
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    • 1999
  • Purpose: To investigate the treatment results' and patterns of failure according to the pathologic type of the parotid malignancy who were treated with radical sugery and postoperative radiation therapy. Materials and Methods: Fifty-two patients with various type of the parotid malignancy, who were treated with combined radical surgery and post-operative irradiation at Yonsei Cancer Center, between 1981 and 1995, were retrospectively reviewed after completion treatment, all but one patients were follow up with the median follow up period of 49 months. Results: We found that pathologically confirmed neck node metastasis rate was 28.8% all case and level II was most common site. Overall failure rate was 26.9%, local recurrence rate was 13.5%, node failure rate was 7.7%, and distant failure rate was 5.8%. Five-year disease free survival rate was 70.9%, and overall survival rate was 73.8%. Recurrence rate was low in adenoid cystic carcinoma and acinic cell carcinoma. However distant metastasis was very high in undifferentiated carcinoma. Local recurrence was main pattern of failure in mucoepidermoid carcinoma and nodal failure was frequently observed in adenocarcinoma. Conclusion: Individualized treatment plan may be required to improve a treatment outcome by pathologic subtype of the parotid malignancy.

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Accessibility Changes in the Metropolitan Seoul Subway System: Time-distance Algorithms based on the T-card Big Data and an Accessibility Measurement Model for Un-fixed Transportation Networks (수도권 광역철도망 확충에 따른 서울 대도시권 접근도 변화: 교통카드 빅데이터를 이용한 시간거리 산출 알고리즘 및 비고정성 교통망 접근도 산출 모형의 개발과 적용)

  • Lee, Keumsook;Park, Jong Soo;Jeong, Mi Seon
    • Journal of the Economic Geographical Society of Korea
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    • v.17 no.1
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    • pp.98-113
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    • 2014
  • The purpose of this study is to investigate the changes in the accessibility of the Metropolitan Seoul Transit systems since 2000, in which many new subway lines have been constructed as well as other urban transit lines have been connected to the systems. We suggest an accessibility measure model for Un-fixed Transportation Networks. In order to measure the nodal accessibility based on the mobility, we apply path-distance, physical-distance, and time-distance as the distance impedance measurement. Specifically, we develop time-distance algorithms to measure the time-distance between each pairs of transit stations based on the T-card transaction databases. We apply the model to the Metropolitan Seoul Transit systems in two time points(2005 and 2011). We examine the results in terms of three distance accessibility measures. Time-distance accessibility explains better the urban land use patterns in the Metropolitan Seoul area than the other two. We visualize the spatial patterns of time-distance accessibility by applying GIS, and analyze the spatial structures of accessibility in the Metrropolitan Seoul area between two time points.

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Radiotherapy Results of Midline Malignant Reticulosis (MMR) (중심선 악성 세망증의 방사선 치료 결과)

  • Yun, Sang-Mo;Kim, Jae-Cheol
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.291-297
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    • 1996
  • Purpose : This study was performed to evaluate survival, failure patterns, and prognostic factors of MMR patients after radiation therapy. We also discussed the need for chemotherapy. Materials and Methods : A retrospective analysis was done for 23 patients with MMR who were treated with radiation therapy from June 1985 to November 1992. There were 19 male and 4 female patients, The patients' age ranged from 17 to 71 years (median 39 years). Systemic symptoms including fever, weight loss, or malaise were found in $30\%$ of the patients. The nasal cavity was most frequently involved No patients had nodal involvement at diagnosis. There were 2 patients with distant metastasis at presentation. Radiation therapy was delivered five times a week, 1.8 Gy daily, total $45\~54$ Gy (median 50.4 Gy) using 6 MV X-ray No patients received chemotherapy as initial treatment. Results : Overall 5-year and 10-year survival rates were $52.4\%$ and $44.1\%$, respectively. Seventy Percent(12/17) of the patients achieved complete response to radiotherapy, and $29.4\%$ (5/17) achieved partial response. The Patients with complete response showed a better 5-year survival rate than those with partial response ($66.9\%$ vs. $20\%$. p=0.004). Symptom duration before diagnosis, the presence of systemic symptom, and the number of primary sites had no influence on survival. The patterns of failure were as follows: local failure(1), failure in adjacent site(1), local and distant failure(1) distant metastasis(2). and conversion to malignant lymphoma(1). We could not find factors associated with the patterns of failure. Conclusion : The most important facto associated with survival was the response to radiotherapy. Seventeen percent of the patients had distant metastasis, and the salvage after distant metastasis was not successful. However. about $50\%$ of the patients could achieve long-term survival with local radiation therapy alone. Therefore, chemotherapy of MMR should be done after a prospective randomized study for the factors associated with distant metastasis.

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