• 대한두경부종양학회지
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• 제27권1호
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• pp.59-65
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• 2011

Background and Objectives : Papillary thyroid carcinoma(PTC) frequently metastasize to the regional neck, however, lateral neck lymph node metastasis is less common. The aim of this study is to investigate clinical and immunohistochemical features of PTC with lateral LN metastasis, and determine the predictive factors for lateral LN metastases. Material and Methods : We undertook a retrospective study of 83 patients treated between January 2007 and December 2009 for PTC by thyroidectomy with or without lateral neck dissection. The following criteria were used to study the clinical predictive value of lateral LN. metastases : sex, age, tumor size, multifocality, extracapsular spread(ECS) and lymphovascular emboli. Immunohistochemical staining for VEGF-A, VEGF-C, Bax, Bcl-2, Cyclin D1, Cyclin E, $p27^{kip1}$ and $p57^{kip2}$ was performed, and quantified blindly by three pathologists who had no clinical information of the patients. Immunohistochemical expression was scored as high(>50% of cells stained) or low(0-49%). Results : With use of univariate and multivariate analysis, tumor size(>2cm) and ECS were independent correlates of lateral LN metastasis in PTC. Expression of VEGF-C, Bax, and Cyclin D1 in the PTC with lateral LN metastasis was scored higher than in PTC without lateral LN metastasis(p<0.05). Conclusion : The important risk factors for lateral LN metastasis in PTC are primary tumor size and the presence of ECS. And expression of VEGF-C, Bax and cyclin D1 may be considered of lateral LN metastatic potential in PTC.

• Radiation Oncology Journal
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• 제37권1호
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• pp.51-59
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• 2019

Purpose: We evaluated failure pattern and treatment outcomes of observational approach on regional lymph node (LN) in cutaneous melanoma of extremities and sought to find clinico-pathologic factors related to LN metastases. Material and Methods: We retrospectively reviewed 73 patients with cutaneous melanoma of extremities between 2005 and 2016. If preoperative 18-F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) findings were non-specific for regional LNs, surgical resection of primary tumors with adequate margins was performed without sentinel lymph node biopsy (SLNB) and/or complete lymph node dissection (CLND), irrespective of tumor thickness or size. In patients with suspicious or positive findings on PET/CT or CT, SLNB followed by CLND or CLND was performed at the discretion of the surgeon. We defined LN dissection (LND) as SLNB and/or CLND. Results: With a median follow-up of 38 months (range, 6 to 138 months), the dominant pattern of failure was regional failure (17 of total 23 events, 74%) in the observation group (n = 56). Pathologic LN metastases were significant factor for poor regional failure-free survival (hazard ration [HR] = 3.21; 95% confidence interval [CI], 1.03-10.33; p = 0.044) and overall survival (HR = 3.62; 95% CI, 1.02-12.94; p = 0.047) in multivariate analysis. In subgroup analysis for cN0 patients according to the preoperative PET/CT findings, LND group showed the better trend of LRFFS (log rank test, p = 0.192) and RFFS (p = 0.310), although which is not statistically significant. Conclusion: Observational approach on regional LNs on the basis of the PET/CT in patients with cutaneous melanoma of extremities showed the dominant regional failure pattern compared to upfront LND approach. To reveal regional lymph node status, SLND for cN0 patients may of importance in managing cutaneous melanoma patients.

• Radiation Oncology Journal
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• 제3권2호
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• pp.113-121
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• 1985

1979년 2월부터 1982년 9월까지 서울대학교병원 치료방사선과에서 두경부에 국한된 Non-Hodgkin's Lymphoma환자중 근치적 방사선치료를 받은 54예를 대상으로 다음과 같은 결론을 얻었다. 1. 원발병소의 관해율은 완전관해가 $81\%$, 부분관해가 $19\%$이었다. 2. 2년 생존을 및 무병 생존율은 각각 $57\%,\;45\%$, 이었으며 병기별, 발생부위별, 임파절 종대의 앙측성 여부, 조직아형에 따라 생존율에 통제학적으로 유의한 차이가 있었다. 3. 재발율은 $54.5\%$(24예/44예)로 국소재발이 $29\%$, 원격전이가 $54\%$, 원격전이와 국소재발이 공존했던 경우가 $17\%$로 $92\%$가 2년이내에 재발하였다. 4. 원발병소의 크기가 6cm이상이지나 다발성인 경우, 원발병소가 임파절외 장기 또는 조직아형이 미만성이거나 대세포형인 경우 원격전이율이 높아 국소방사선치료후 전신적 항암요법의 추가치료가 고러되어야 한다.

• 대한골관절종양학회지
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• 제15권2호
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• pp.122-129
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• 2009

목적: 최근 발생빈도가 증가하고 있는 악성 흑색종의 치료 결과를 분석하여 장기 예후에 영향을 미치는 인자를 알아보고자 하였다. 대상 및 방법: 1997년 3월부터 2004년 3월까지 악성 흑색종으로 진단 받았고 5년 이상 추시가 가능하였던 51예를 대상으로 후향성 연구를 하였으며, 평균연령은 49.4세였다. 연구 방법으로는 나이, 성별, 발생 부위, 종양의 두께, 주위 림프절 전이여부, 면역화학 요법의 시행 유무에 따른 5년 생존율을 비교하였고, 전이 및 국소재발 유무를 조사하였다. 결과: 발병 연령이 65세 미만인 경우 5년 생존율은 88.5%였고, 65세 이상에서는 88.0%였다. 남자의 5년 생존율은 62.5%였으며, 여자는 100%였다. 발생 부위에 따른 5년 생존율은 상지가 100%, 하지가 80.0%, 기타 부위가 100%였다. Clark stage III이하에서는 100% 5년 생존율을 보였고, IV이상에서는 79.3%였다. 주위 림프절로의 전이가 있었던 경우 5년 생존율은 66.7%였고, 림프절 전이가 없었던 경우는 94.9%였다. 결론: 악성흑색종의 예후에 영향을 미치는 인자로 성별(남자), 발생 부위(하지), 종양의 두께(Clark's stage IV이상), 주위 림프절 전이가 있는 경우에 나쁜 예후를 보였으나, 다른 연구와는 다르게 발병 연령은 예후에 큰 영향을 미치지 않는 것으로 조사되었다.

• Radiation Oncology Journal
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• 제29권4호
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• pp.228-235
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• 2011

Purpose: To evaluate the impact of postoperative radiotherapy (PORT) on patterns of failure and survivals in uterine carcinosarcoma patients treated with radical surgery. Materials and Methods: Between October 1998 and August 2010, 19 patients with stage I-III uterine carcinosarcoma received curative hysterectomy and bilateral salpingo-oophorectomy with or without PORT at Seoul National University Hospital. Their hospital medical records were retrospectively reviewed. PORT and non-PORT groups included 11 and 8 patients, respectively. They were followed for a mean of 22.7 months (range, 7.8 to 126.6 months). Results: At 5 years, the overall survival rates were 51.9% for entire, 61.4% for PORT, and 41.7% for non-PORT groups, respectively. There was no statistical difference between PORT and non-PORT groups with regard to overall survival (p = 0.682). Seven out of 19 (36.8%) patients showed treatment failures, which all happened within 12 months. Although the predominant failures were distant metastasis in PORT group and loco-regional recurrence in non-PORT group, there was no statistically significant difference in locoregional recurrence-free survival (LRRFS) (p = 0.362) or distant metastasis-free survival (DMFS) (p = 0.548). Lymph node metastasis was found to be a significant prognostic factor in predicting poor LRRFS (p = 0.013) and DMFS (p = 0.021), while the International Federation Gynecology and Obstetrics (FIGO) stage (p = 0.043) was associated with LRRFS. Conclusion: Considering that adjuvant radiotherapy after surgical resection was effective to decrease loco-regional recurrence and most treatment failures were distant metastasis, multimodal therapy including surgery, radiotherapy, and chemotherapy might be an optimal treatment for uterine carcinosarcoma patients.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7277-7281
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• 2013

Background: Globally, there have been important changes in trends amongst gender, histology and smoking patterns of lung cancer cases. Materials and Methods: This retrospective study was conducted on 466 patients with lung cancer who were registered in Regional Cancer Center, Regional Institute of Medical Sciences, Manipur from January 2008 to December 2012. Results: Most were more than 60 years of age (67.8%) with a male: female ratio of 1.09:1. Some 78.8% of patients were chronic smokers with male smoker to female smoker ratio of 1.43:1. Consumption of alcohol was found in 29.4%, both smoking and alcohol in 27.5%, betel nut chewing in 37.9% and tobacco chewing in 25.3%. A history of tuberculosis was present in 16.3% of patients. The most frequent symptom was coughing (36.6%) and most common radiological presentation was a mass lesion (70%). Most of the patients had primary lung cancer in the right lung (60.3%). The most common histological subtype was squamous cell carcinoma (49.1%), also in the 40-60 year age group (45.9%), more than 60 year age group (51.6%), males (58.1%) and females (41.8%). As many as 91.9% of squamous cell carcinoma patients had a history of smoking. About 32.5% of patients had distant metastasis at presentation with brain (23.8%) and positive malignant cells in pleural effusions (23.1%) as common sites. The majority of patients were in stage III (34.4%), stage IV (32.5%) and stage II (30.2%). Conclusions: Our analysis suggests that the gender gap has been narrowed such that about half of the patients diagnosed with lung cancer are women in this part of India. This alarming rise in female incidence is mainly attributed to an increased smoking pattern. Squamous cell carcinoma still remains the commonest histological subtype. Most of the patients were elderly aged and presented at locally or distantly advanced stages.

• 대한두경부종양학회지
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• 제11권2호
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• pp.125-131
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• 1995

The authors present 15 cases in which the diagnosis of thyroid cancer was established pathologically among 300 cases of Graves' disease diagnosed clinically at Chosun University Hospital, from January 1982 to December 1994. These cases were analyzed in order to establish guidelines for prophylactic node dissection as part of the initial management of thyroid cancer in patients with Graves' disease. The analysis revealed the following: 1) The average age of the 15 patients was 34.5 years and the male: female ratio was 1 : 4.0. 2) In 8 of the 15 cases(53.5 %) the occult thyroid carcinoma measured less than 1.5cm. 3) The degree of invasivensess manifested in these fifteen cases may be summarized as follows: In Group 1(6 cases) there was absence of microscopic capsular invasion and of lymphnode metastasis. In Group 11(4 cases) threre was microscopic capsular invasion but absence of lymphnode metastasis: In Group III(4 cases) there was either extrathyrodal soft tissue invasion or regional lymph node metastasis: and in Group IV(1 case) there was lymphnode invasion and distant metastasis. 4) Thirteen patients underwent either subtotal or near total thyroidectomy, and 2 patients underwent total thyroidectomy. Seven patients underwent some type of neck dissection, as follows: anterior compartment dissection in one of the cases in Group I; functional neck dissection in two cases and jugular node dissection in one case in Group II; and anterior compartment dissection in one case and modified radical neck dissection in two cases in Group III. 5) The author propose the following guidelines for prophylactic initial node dissection when a unexpected coexisting thyroid carcinoma in encountered on the frozen section during the surgical management of Graves' disease; Group I cases do not require initial neck dissection in group II, anterior compartment dissection in sufficient. In Group III, either jugular node dissection or functional neck dissection should be performed, and followed by postoperative Ra$^{131}$I therapy, Group IV requires Ra$^{131}$I therapy with or without modified radical neck dissection depending in the patient's condition.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권4호
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• pp.339-342
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• 2009

Adenoid cystic carcinoma(ACC) is the second most common malignant neoplasm in the salivary gland. In spite of ACC shows slowly growing nature, it is sometimes highly detrimental that it readily invades adjacent tissues and metastasize to distant organs at the early stage of disease. Hence, treatment outcome may be misfortunate due to wide regional infiltration, pathognomonic perineural spread and the tendency of hematogenous metastasis. We present a unusal case of ACC of the scalp in which the patient initially presented with bumpy mass of the scalp who had been diagnosed as the primarily developed ACC of the right hard palate that extended to infratemporal fossa, nasal cavity, and paranasal sinuses and had been treated by total excision and post-operative chemotherapy and radiation therapy for 10 years ago. Although this lesion occured at the scalp, which is a frequent site of primary dermatologic ACC, its histomorphology was the same with that of previous tumor. Complete clinical examination showed no recurrence sign at the primary site and suggested the scalp as a sole treatment failure site. Accordingly, it would be reasonable to consider the present case as either a scalp metastasis or a second primary lesion of salivary gland ACC.

• 대한골관절종양학회지
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• 제11권1호
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• pp.94-99
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• 2005

부신경절종은, 신경외배엽 기원의 교감신경 신경내분비 세포로 이루어져 있는, 부신 이외의 부신경절에서 생긴 종양으로, 주로 갑상선, 목동맥체, 종격동, 폐, 십이지장, 대동맥 주변 부위와 후복막 부위에 잘 생긴다. 악성도는 조직학적인 진단에 의한 것이 아니라, 국소 림프절 재발과 원격 전이에 의하여 판별되며, 골 전이가 드물지만 전이가 일어나면 주로 두개골 기저, 척추에 생기며, 드물게 골반골, 대퇴골로 전이한다. 저자들은 대퇴부 피하층에 발생하여 혈관 기원성의 종양과 감별되었던 부신경절종과 조기 골 전이를 보인 후복막에 발생한 부신경 절종을 경험하여 문헌고찰과 함께 보고하고자 한다.

• Journal of Chest Surgery
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• 제32권11호
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• pp.1052-1056
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• 1999

The pulmonary sarcomatoid carcinoma is a rare malignant tumor, which is composed of an admixture of carcinomatous and sarcomatous components, and accounts for 0.3% of all pulmonary neoplasms. Clinicopathological features are often related to anatomical location: central endobronchial type and peripheral parenchymal type. Noninvasive diagnostic test had a low yield in detection sarcomatoid carcinoma. Metastasis to the regional lymph nodes and to distant organ is common. The prognosis is poor and the median survival is about 15 months. We report two cases of pulmonary sarcomatoid carcinoma with review of literatures.