• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.133-137
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• 2013

Background: To investigate the impact of ovarian transposition (OT) on survival rates of the patients with stage Ib squamous cell cervical cancer. Materials and Methods: Ninety-two subjects who underwent a radical hysterectomy including oophorectomy were evaluated. For nineteen (20.7%), OT was performed. Patients were divided into two groups, OT versus oophorectomy alone. The primary end-point of this study was to investigate the impact of OT on tumor recurrence rate and time, 5-year disease-free survival (DFS) and overall survival (OS). These comparisons were performed for subgroups including patients who received radiotherapy versus who did not. Statistical analyses were conducted using the Chi-square test, T-test and Mann-Whitney test. OS was examined using the Kaplan-Meier method. $P{\leq}0.05$ was considered to be statistically significant. Results: The median follow-up period was 89 months for OT and 81 months for the oophorectomy group (p>0.05). Both groups experienced similar recurrence rates (31.6% vs. 26.4%, p=0.181). The median duration from surgery to recurrence, and surgery to death were also similar between the groups (p>0.05). The 5-year DFS and OS rates were both 68.4% for the OT group, and 73.6% and 77.8% for the oophorectomy group (p=0.457 and p=0.307, respectively). While the 5-year DFS rate was not statistically significant between the OT and oophorectomy groups who did not receive radiotherapy (p=0.148), the 5-year OS rate was significantly higher in the oophorectomy group (95.4% vs 66.7%, respectively) without radiotherapy (p=0.05). The 5-year DFS and OS rates were statistically similar between the groups who received adjuvant radiotherapy (p>0.05). Conclusions: Ovarian transposition has not significantly negative effect on the survival rates when adjuvant radiotherapy will be applied, while 5-year OS may be less in OT group if radiotherapy is not mandatory.

• Journal of Korean Neurosurgical Society
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• 제30권11호
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• pp.1278-1283
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• 2001

Objective : Transsphenoidal approach(TSA) has been used as useful operative method for pituitary tumor but is still controversal in case of cavernous sinus invasion or severe suprasellar extension. This study was performed to evaluate the surgical result, recurrence, effect of adjuvant treatment, especially in cases of suprasellar extension or cavernous sinus invasion. Material and Methods : We studied 56 cases of surgically treated pituitary adenoma that we were able to follow up, treated by TSA from 1993 to 1998. There were 24 cases of suprasellar extension and 11 cases of cavernous sinus invasion. The medical records and radiological findings were reviewed. Surgical results including hormonal function and recurrence rates were analyzed according to extent of tumor invasion. Mean follow-up period was 19.1 months. Results : Tumors with suprasellar extension were removed totally in 54%, whereas total tumor removal was possible only in 38% with cavernous sinus invasion. Overall of recurrence rate was 14% and recurrence rate was 25% in suprasellar extension and 9% in cavernous sinus invasion. In cases of both suprasellar extension and cavernous sinus invasion, tumors that were treated by TSA and radiation showed recurrence rate of 7%, whereas those treated by surgery alone showed 28% of recurrence. Conclusion : Transsphenoidal approach is safe and useful operative method for pituitary adenoma and adjuvant therapy including radiation therapy is effective means to decrease the recurrence in cases of suprasellar extension or cavernous sinus invasion.

• 대한골관절종양학회지
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• 제2권1호
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• pp.78-87
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• 1996

The results of treatment of eighteen lesions of fibrous dysplasia which of them seventeen lesions were treated with surgery were reviewed at the Department of Orthopedic Surgery, College of Medicine, Hanyang University Hospital. We studied to evaluate the functional clinical results and the recurrence according to the type of disease, grafted bone, methods of treatment and location of lesion. We treated sixteen patients(five males and eleven females) and their mean age was 22.6 years. There was no association with skin pigmentation or dysfunction of endocrine system. Twelve patients had a monostotic pattern and four patients had a polyostotic pattern. Twelve lesions were treated with curettage and bone grafting and four lesions in the proximal femur were treated by internal fixation with curettage and bone grafting. One lesion was treated by en-bloc resection. There were eleven satisfactory results in twelve monostotic lesions and there were four satisfactory results in five polyostotic lesions, but the recurrence were four cases, respectively. The two unsatisfactory results were seen in two patients treated by autografting, but there were three recurrence of four lesions in autografting only, one of five in autografting and allografting, four of eight in allgrafting or xenografting. Four of six lesions in upper extremity were recurred after curettage and bone grafting and five of them showed satisfactory results. In pelvic and lower extremity lesions, the recurrence were occurred in two lesions after curettage and bone grafting and in two lesions after internal fixation and bone grafting. The recurrence does not always provide an unsatisfactory functional results and the recurrence showed higher rate in radiologic pattern of ground glass appearance with-out marginal sclerotic rim, but the recurrence according to grafted bone showed similar rates. Curettage and bone grafting is adequate for a symptomatic lesion and firm internal fixation is needed for a lesion in proximal femur. In use of grafted bone, xenograft or allograft may be preferable to autograft because of the disadvantage of autografting like a increased blood loss, prolonged operation times, etc.

• Radiation Oncology Journal
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• 제35권1호
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• pp.71-77
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• 2017

Purpose: Although the technical developments of radiotherapy have been remarkable, there are currently few reports on the treatment results of radiotherapy for local recurrence of rectal cancer treated with surgery alone as initial treatment in this three-dimensional conformal radiotherapy era. Thus, we retrospectively evaluated the treatment results of radiotherapy for local recurrence of rectal cancer treated with surgery alone as the initial treatment. Materials and Methods: Thirty-two patients who underwent radiotherapy were enrolled in this study. The dose per fraction was 2.0-3.5 Gy. Because the treatment schedule was variable, the biological effective dose (BED) was calculated. Results: Local control (LC) and overall survival (OS) rates from the completion of radiotherapy were calculated. The 1-, 2-, 3-, 4-, and 5-year LC rates were 51.5%, 24.5%, 19.6%, 19.6%, and 13.1%, respectively. LC rates were significantly higher for the high BED group (${\geq}75Gy_{10}$) than for the lower BED group (<$75Gy_{10}$). All patients who reported pain achieved pain relief. The duration of pain relief was significantly higher for the high BED group than for the lower BED group. The 1-, 2-, 3-, 4-, and 5-year OS rates were 82.6%, 56.5%, 45.2%, 38.7%, and 23.2%, respectively. There was a trend toward higher OS rates in with higher BED group compared to lower BED group. Conclusion: For patients with unresectable locally recurrent rectal cancer treated with surgery alone, radiotherapy is effective treatment. The prescribed BED should be more than $75Gy_{10}$, if the dose to the organ at risk is within acceptable levels.

• Journal of Korean Neurosurgical Society
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• 제30권3호
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• pp.349-357
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• 2001

목 적 : 높은 재발율과 전이 가능성의 특징을 갖고 있는 수막 혈관외세포종은 perivascular pericytes에서 기원하는 드문 종양으로, 저자들이 경험한 수막 혈관외세포종에 있어서 종양의 재발 및 신경계외 전이에 대하여 알아 보고자 한다. 연구 대상 및 방법 : 1982년부터 1999년까지 수술을 시행하여 수막 혈관외세포종으로 진단받은 31명의 환자를 대상으로 후향적 연구를 시행하였다. 진단 후 재발까지의 기간, 재발에 영향을 미칠 수 있는 여러 가지 인자들, 그리고 신경계외 전이의 기간 및 부위 등을 분석하였다. 결 과 : 총 31명의 환자들 중 12명의 환자들에서 원발성 부위에 종양이 재발하였다(38.7%). 전체의 환자들에서 재발이 발생하지 않았던 평균 기간(recurrence-free period : RFP)은 104개월이었으며 처음 수술 후 5년, 그리고 10년의 재발이 발생하지 않았던 율(recurrence free period : RFP)은 각각 59.2%, 33.6% 이었다. 원발성 부위에 종양의 재발을 보였던 12명의 환자들 중 4명의 환자들에서 첫 수술 후 5년 이후에 재발을 관찰 할 수 있었다. 처음 수술시의 절제 정도가 재발에 가장 큰 영향을 미쳤다. 처음 수술시에 완전 절제한 군의 RFP는 111 개월이었으며, 추적 관찰 5년째 RFR는 완전 절제한 경우 72.7%, 불완전 절제한 경우 20.8%로 그 차이는 통계 적으로 유의하였다(p=0.0060). 통계적으로 유의성은 없었지만 완전 절제 후 부가적인 방사선 치료를 시행하였을 경우가 완전 절제만을 시행한 경우보다 RFR가 높아 추적 관찰 5년째의 RFR는 각각 100%, 그리고 70.3% 이었다(p=0.3359). 4명의 환자들(12.9%)에서 수막 혈관외세포종의 신경계외 전이가 발생하였으며, 이 경우 신경계 외 전이의 평균 기간은 107개월, 그리고 추적 관찰 5년, 10년째의 신경계외 전이율은 각각 4.4%, 24.9% 이었다. 결 론 : 수막 혈관외세포종은 수술적 제거 후 원발성 부위에 또는 원발성 부위에서 멀리 떨어진 부위에 재발의 가능성이 무척 높은 종양이다. 이러한 재발의 가능성을 줄이는 가장 중요한 인자는 수술적 제거 정도로 처음 수술시에 가능한 완전 절제를 시도하여야 한다. 그리고 처음 수술시에 완전 절제가 가능하였다고 하여도 완전 절제 후 부가적인 방사선 치료를 시행하는 것이 재발의 위험성을 낮출 수 있을 것으로 생각한다. 원발성 부위의 재발 또는 신경계외 전이는 오랜 시간이 지난 후에도 가능할 수 있으므로 장기간의 추적 관찰이 필요하다고 생각한다.

• Clinical and Experimental Reproductive Medicine
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• 제49권2호
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• pp.76-86
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• 2022

Ovarian cystectomy is the preferred technique for the surgical management of ovarian endometrioma. However, other techniques such as ablation or sclerotherapy are also commonly used. The aim of this review is to summarize information regarding the efficacy of ablation and sclerotherapy compared to cystectomy in terms of ovarian reserve, the recurrence rate, and the pregnancy rate. Several studies comparing ablation versus cystectomy or sclerotherapy versus cystectomy in terms of the serum anti-Müllerian hormone (AMH) decrement, endometrioma recurrence, or the pregnancy rate were identified and summarized. Both ablation and cystectomy have a negative impact on ovarian reserve, but ablation results in a smaller serum AMH decrement than cystectomy. Nonetheless, the recurrence rate is higher after ablation than after cystectomy. More studies are needed to demonstrate whether the pregnancy rate is different according to whether patients undergo ablation or cystectomy. The evidence remains inconclusive regarding whether sclerotherapy is better than cystectomy in terms of ovarian reserve. The recurrence rates appear to be similar between sclerotherapy and cystectomy. There is not yet concrete evidence that sclerotherapy helps to improve the pregnancy rate via in vitro fertilization in comparison to cystectomy or no sclerotherapy.

• Journal of Medicine and Life Science
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• 제19권3호
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• pp.116-120
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• 2022

Objective: To estimate the efficacy of sequential treatment of bladder endometriosis (BE) of the vesicoureteric junction using transurethral resection (TUR) and hormonal therapy. Design: Case report. Setting: Private multispecialty hospital. Patient: A multiparous woman presented with perimenstrual lower urinary tract symptoms, cyclic chronic pelvic pain, and left loin pain. Intervention[s]: Ultrasonography revealed marked left renal dilatation. Computed tomography confirmed the presence of a bladder mass. A diagnostic cystoscopy revealed compression of the left vesicoureteral junction. Complete TUR BE with release of chocolate material during resection, followed by ureteric double J stent insertion for 3 months, was performed. Histopathology confirmed the diagnosis of BE, followed by adjuvant hormonal therapy (dienogest) for 3 months. Follow-up for about 2 years revealed complete relief of the symptoms without any recurrence. Main Outcome Measure[s]. Success and recurrence rates of sequential TUR and hormonal therapy of BE of the vesicoureteric junction. Result[s]. TUR BE followed by adjuvant hormonal therapy was very effective in eradicating BE of the vesicoureteric junction in a safe manner without recurrence on follow-up for 2 years. Conclusion[s]. BE of the vesicoureteric junction can be properly treated by sequential TUR and hormonal therapy without recurrence over a 2-year follow-up.

• Journal of Korean Neurosurgical Society
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• 제55권6호
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• pp.321-330
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• 2014

Objective : Based on surgical outcomes of patients with infratentorial meningiomas surgically treated at our institution, we analyzed the predictors for surgical resection, recurrence, complication, and survival. Methods : Of surgically treated 782 patients with intracranial meningioma, 158 (20.2%) consecutive cases of infratentorial location operated on between April 1993 and May 2013 at out institute were reviewed retrospectively. The patients had a median age of 57.1 years (range, 16-77 years), a female predominance of 79.7%, and a mean follow-up duration of 48.4 months (range, 0.8-242.2 months). Results : Gross total resection (Simpson's grade I & II) was achieved in 81.6% (129/158) of patients. Non-skull base location was an independent factor for complete resection. The recurrence rate was 13.3% (21/158) and the 5-, 10-, and 15-year recurrence rates were 8.2%, 12.0%, and 13.3%, respectively. Benign pathology, postoperative KPS over than 90, low peritumoral edema, and complete resection were significantly associated with longer recurrence-free survival rate. The 5-, 10-, and 15-year survival rates were 96.2%, 94.9%, and 94.9%, respectively. Benign pathology, postoperative KPS over than 90 and complete resection were significantly associated with a longer survival rate. The permanent complication rate was 13% (21/158). Skull base location and postoperative KPS less than 90 were independent factors for the occurrence of permanent complication. Conclusion : Our experience shows that infratentorial meningiomas represent a continuing challenge for contemporary neurosurgeons. Various factors are related with resection degree, complications, recurrence and survival.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권1호
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• pp.48-54
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• 2015

Purpose: Metabolic liver disease (MLD) often progresses to life-threatening conditions. This study intends to describe the outcomes of liver transplantation (LTx) for MLD at a living donor-dominant transplantation center where potentially heterozygous carrier grafts are employed. Methods: We retrospectively evaluated the medical records of 54 patients with MLD who underwent LTx between November 1995 and February 2012 at Asan Medical Center in Seoul, Korea. The cumulative graft and patient survival rates were analyzed according to patient age, and living or deceased donor LTx. Recurrence of the original disease was also investigated. Results: The post-transplant cumulative patient survival rates at one, five, and 10 years were 90.7%, 87.5% and 87.5%, and the graft survival rates were 88.8%, 85.5%, and 85.5%, respectively. There were no differences in the patient survival rates according to the recipient age, human leukocyte antigen matching, and living or deceased donor LTx. There were also no differences in the patient survival rates between the MLD and the non-MLD groups for children. Recurrence of the original metabolic disease was not observed in any patient during the follow-up period. Conclusion: Our results suggest that the living donor-dominant transplantation program is well-tolerated in MLD without recurrence of the original MLD using all types of transplantation.

• Childhood Kidney Diseases
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• 제19권2호
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• pp.125-130
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• 2015

Introduction: This study investigated whether renal and bladder ultrasonography (RBUS) findings performed in children with the first incidence of febrile urinary tract infection (UTI) can predict UTI recurrence, high-grade vesicoureteral reflux (high-grade VUR), or acquired renal scarring (aRS). Methods: In all, 917 children who were admitted to our hospital from January 2001 to October 2010, owing to the first incidence of febrile UTI were enrolled in this study. All children underwent RBUS during admission. The mean follow-up was 7.9 months (standard deviation $[SD]{\pm}13.3$). UTI recurrence rates were calculated according to various clinical parameters. By using bivariate and multiple logistic regression analyses, we determined whether age, sex, abnormal RBUS findings, abnormal dimercaptosuccinic acid renal scan findings, or RBUS findings parameters were predictive of UTI recurrence, high-grade VUR, or aRS. Results: On RBUS, hydronephrosis and congenital anomaly of the kidney and urinary tract significantly predicted UTI recurrence. A small kidney, hydroureter, hydronephrosis, cortical thinning, and increased parenchymal echogenicity significantly predicted high-grade VUR. However, their odds ratios (OR) are low compared to normal RBUS findings (recurrent UTI: OR 0.432 and 0.354 vs. 0.934, respectively, high-grade VUR: .019, 0.329, 0.126, 0.058, and 0.188 vs. 2.082, respectively). No RBUS findings significantly predicted aRS. Recurrent UTI, high-grade VUR, and abnormal RBUS findings significantly predicted aRS (OR of 4.80, 4.61, and 2.58, respectively). Conclusion: RBUS is necessary to exclude severe congenital renal scarring, obstructive uropathy, and renal abscess at the first incidence of febrile UTI and is helpful in determining the need for subsequent clinical imaging.