• Journal of Chest Surgery
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• 제55권6호
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• pp.470-477
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• 2022

Background: Upfront surgery followed by systemic treatment is recommended to treat clinical stage I-IIA small cell lung cancer (SCLC), but data on the clinical outcomes are sparse. Thus, this study evaluated the stage migration and long-term prognosis of surgically treated clinical stage I-IIA SCLC. Methods: We retrospectively reviewed 49 patients with clinical stage I-IIA SCLC who underwent upfront surgery between 2000 and 2020. Additionally, we re-evaluated the TNM (tumor-node-metastasis) staging according to the eighth edition of the American Joint Committee on Cancer staging system for lung cancer. Results: The clinical stages of SCLC were cIA in 75.5%, cIB in 18.4%, and cIIA in 6.1% of patients. A preoperative histologic diagnosis was made in 65.3% of patients. Lobectomy and systematic lymph node dissection were performed in 77.6% and 83.7% of patients, respectively. The pathological stages were pI in 67.3%, pII in 24.5%, pIII in 4.1%, and pIV in 4.1% of patients. The concordance rate between clinical and pathological stages was 44.9%, and the upstaging rate was 49.0%. The 5-year overall survival (OS) rate was 67.8%. No significant difference in OS was found between stages pI and pII. However, the OS for stages pIII/IV was significantly worse than for stages pI/II (p<0.001). Conclusion: In clinical stage I-IIA SCLC, approximately half of the patients were pathologically upstaged, and OS was favorable after upfront surgery, particularly in pI/II patients. The poor prognosis of pIII/IV patients indicates the necessity of intensive preoperative pathologic mediastinal staging.

• 대한기계학회논문집B
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• 제23권11호
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• pp.1464-1472
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• 1999

Design and operation of $1MW_{th}$ pulverized coal combustion testing facility are described. Also the influence of air staging on NOx emission and burnout of coal flames was investigated in this facility. The test facility consisted of coal feeding system, firing system and flue gas treatment system. A top-fired externally air staging burner was adopted in order to avoid influence of gravity on the coal particles and for easy maintenance. Distribution of temperature and chemical species concentration of coal flames could be measured in vertical pass of furnace. Main fuel was pulverized (83.4% less than $80{\mu}m$) Australian high bituminous coal. From variety of test conditions, overall excess air ratio was selected at 1.2(20% excess air). Tho study showed that increasing the staged air resulted in lower NOx omission, and it was suggested to be more than 40% of the total combustion air for the substantial NOx reduction. Sufficient burnout was not achievable when NOx emission was less than 500ppm. Also, the amount of core air did not influence tho NOx reduction.

• Journal of Gastric Cancer
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• 제11권2호
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• pp.78-85
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• 2011

Since January of 2010, the seventh edition of UICC tumor node metastasis (TNM) Classification, which has recently been revised, has been applied to almost all cases of malignant tumors. Compared to previous editions, the merits and demerits of the current revisions were analyzed. Many revisions have been made for criteria for the classification of lymph nodes. In particular, all the cases in whom the number of lymph nodes is more than 7 were classified as N3 without being differentiated. Therefore, the coverage of the N3 was broad. Owing to this, there was no consistency in predicting the prognosis of the N3 group. By determining the positive cases to a distant metastasis as TNM stage IV, the discrepancy in the TNM stage IV compared to the sixth edition was resolved. In regard to the classification system for an esophagogastric (EG) junction carcinoma, it was declared that cases of an invasion to the EG junction should follow the classification system for esophageal cancer. A review of clinical cases reported from Asian patients suggests that it would be more appropriate to follow the previous editions of the classification system for gastric cancer. In addition, in the classification of the TNM stages in the overall cases, the discrepancy in the prognosis between the different stages and the consistency in the prognosis between the same TNM stages were achieved to a lesser extent as compared to that previously. Accordingly, further revisions are needed to develop a purposive classification method where the prognosis can be predicted specifically to each variable and the mode of the overall classification can be simplified.

• Korean Journal of Radiology
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• 제21권12호
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• pp.1326-1333
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• 2020

Objective: To evaluate urologist satisfaction on structured prostate MRI reports, including report with tumor-node-metastasis (TNM) staging (report B) and with Prostate Imaging Reporting and Data System (PI-RADS) score with/without TNM staging (report C, report with PI-RADS score only [report C-a] and report with PI-RADS score and TNM staging [C-b]) compared with conventional free-text report (report A). Materials and Methods: This was a prospective comparative study. Altogether, 3015 prostate MRI reports including reports A, B, C-a, and C-b were rated by 13 urologists using a 5-point Likert Scale. A questionnaire was used to assess urologist satisfaction based on the following parameters: correctness, practicality, and urologist subjectivity. Kruskal-Wallis H-test followed by Nemenyi test was used to compare urologists' satisfaction parameters for each report type. The rate of urologist-radiologist recalls for each report type was calculated. Results: Reports B and C including its subtypes had higher ratings of satisfaction than report A for overall satisfaction degree, and parameters of correctness, practicality, and subjectivity (p < 0.05). There was a significant difference between report B and C (p < 0.05) in practicality score, but no statistical difference was found in overall satisfaction degree, and correctness and subjectivity scores (p > 0.05). Compared with report C-b (p > 0.05), report B and C-a (p < 0.05) showed a significant difference in overall satisfaction degree and parameters of practicality and subjectivity. In terms of correctness score, neither report C-a nor C-b had a significant difference with report B (p > 0.05). No statistical difference was found between report C-a and C-b in overall satisfaction degree and all three parameters (p > 0.05). The rate of urologist-radiologist recalls for reports A, B, C-a and C-b were 29.1%, 10.8%, 18.1% and 11.2%, respectively. Conclusion: Structured reports, either using TNM or PI-RADS are highly preferred over conventional free-text reports and lead to fewer report-related post-hoc inquiries from urologists.

• Genomics & Informatics
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• 제17권3호
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• pp.30.1-30.4
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• 2019

Neuroblastoma is a major cause of cancer death in early childhood, and its timely and correct diagnosis is critical. Gene expression datasets have recently been considered as a powerful tool for cancer diagnosis and subtype classification. However, no attempts have yet been made to apply deep learning using gene expression to neuroblastoma classification, although deep learning has been applied to cancer diagnosis using image data. Taking the International Neuroblastoma Staging System stages as multiple classes, we designed a deep neural network using the gene expression patterns and stages of neuroblastoma patients. Despite a small patient population (n = 280), stage 1 and 4 patients were well distinguished. If it is possible to replicate this approach in a larger population, deep learning could play an important role in neuroblastoma staging.

• Bulletin of the Korean Chemical Society
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• 제17권10호
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• pp.885-892
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• 1996

The effects of NOx reduction by advanced fuel staging in a small scale combustor (6.6 kWT) have been investigated using propane gas flames laden with ammonia as fuel-nitrogen. The variables which had the greatest influence on NOx reduction were temperature, reducing stoichiometry (relate to main combustion zone stoichiometry, air fraction and reburning fuel fraction) and residence time of reducing zone. NOx reduction was best at the reburning zone temperature of above 1,000 ℃ and reburning zone stoichiometry was 0.85. In terms of residence time of the reburning zone, NOx reduction was effective when burnout air was injected at the point where the reburning zone had been already established. In the advanced fuel staging NOx reduction was relatively large at the burning of higher Fuel-N concentration in the fuel. Under optimum reburning conditions, fuel nitrogen content had a relatively minor impact on reburning efficiency.

• Journal of Gastric Cancer
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• 제5권3호
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• pp.163-168
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• 2005

목적: 본 연구에서는 제5판 UICC (International Union Against Cancer) 림프절 병기와 일본 위암 학회 림프절 병기를 분석하여 병기별 분포와 예후의 차이점을 알아보고자 하였다. 그리고 UICC N3M0 위암 환자들을 여러 림프절 전이군으로 분류하여 예후 예측에서 효용성을 알아보고자 하였다. 대상 및 방법: 1990년 2월부터 2000년 5월까지 지방공사 서울 의료원 및 한림대학교 성심병원에서 진행 위암으로 근치적 절제 수술을 받은 환자 197예를 대상으로 하여 두 가지 병기의 연관성 및 예후 예측의 차이를 분석하였다. 그리고 UICC N3M0군으로 분류된 58예를 세 가지의 림프절 병기 분류 방법으로 분석하였다. 결과: UICC 림프절 병기 N1, N2, N3의 5년 생존율은 각각 62.9%, 33.0%, 21.2%였다. 일본 위암 학회 림프절 병기 n1, n2의 5년 생존율은 각각 61.2%, 25.3%였다 N3M0군에서 일본 위암 학회 병기 n1의 5년 생존율이 각각 62.5%였고, 전이 림프절 비율 0.5 미만, 전이 림프절 수 26개 미만인 군에서는 각각 33.0%, 22.9%로 통계학적으로 의미 있게 0.5이상, 26개 이상의 군보다 좋은 예후를 보였다(P=0.018, 0.021). 결론: UICC 림프절 병기 체계는 예후 예측 능력에서 일본식 림프절 병기보다 더 우수했다. N3M0 병기 위암환자에서 전이 림프절 비율, 전이 림프절 수는 의미 있는 예후 인자였다.

• 대한의사협회지
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• 제61권11호
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• pp.662-669
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• 2018

The cutaneous melanoma has been regarded as rare disease entity in Korea for long time but it shows a silent growth recently. Furthermore the management of cutaneous melanoma including staging system, surgical principle, sentinel lymph node biopsy and subsequent complete node dissection and, most importantly, immunotherapy and target therapy against cutaneous melanoma recently. The incidence of cutaneous melanoma is steadily increasing in Korea but its increase is rapid recent 2 decades to 4.3 times and should be greater soon according to the steeper increase of life expectancy. New staging system proposed by American Joint Committee on Cancer (2017) includes changes in individual TNM category and stage groups, particularly from a prognostic viewpoint. Dermoscopy has been successfully introduced in the differential diagnosis of pigmented skin lesion focusing on cutaneous melanoma by non-invasive simple diagnostic tool. Sentinel lymph node biopsy was a issue of long debate whether survival benefit is real or not. Temporary conclusion about this question is reached after two large scale studies and immediate complete node dissection should be performed in a certain situations. Most important change is drug therapy focusing on immunotherapy and target therapy. Braf- and MEK-inhibitor, immune checkpoint inhibitor and PD-1 blocker has been proved to be effective as a sole or combination regimen against advanced and/or high-risk adjuvant setting of cutaneous melanoma. In conclusion, these remarkable changes will be reviewed shortly here.

• Radiation Oncology Journal
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• 제35권3호
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• pp.233-240
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• 2017

Purpose: To validate the 8th edition of the American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) TNM staging system for human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) and investigate whether a modified classification better reflects the prognosis. Materials and Methods: Medical records of patients diagnosed with non-metastatic HPV-related OPSCC between 2010 and 2016 at a single institution were retrospectively reviewed. HPV status was determined by immunohistochemical analysis of p16 and/or HPV DNA polymerase chain reaction (PCR). We reclassified TNM stage T0-1 and N0-1 as group A, T2-3 or N2 as B, and T4 or N3 as C. Survival analysis according to 8th AJCC/UICC TNM staging and the modified classification was performed. Results: Of 383 OPSCC patients, 211 were positive for HPV DNA PCR or p16. After exclusion, 184 patients were included in this analysis. Median age was 56 years (range, 31 to 81 years). Most primary tumors were in the palatine tonsil (148 tumors, 80%). The eighth AJCC/UICC TNM classification could not differentiate between stage I and II (p = 0.470) or II and III (p = 0.209). Applying modified grouping, the 3-year overall survival rate of group A was significantly higher than that of group B and C (98% vs. 91%, p = 0.039 and 98% vs. 78%, p < 0.001, respectively). Differentiation between group B and C was marginally significant (p = 0.053). Conclusion: The 8th AJCC/UICC TNM staging system did not clearly distinguish the prognosis of stage II from that of other stages. Including the T2N0-1 group in stage II may improve prognostic stratification.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.4119-4123
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• 2012

Background: Neoadjuvant systemic chemotherapy is the accepted approach for women with locally advanced breast cancer. Anthracycline- and taxane-based regimens have been extensively studied in clinical trials and consequently are widely used. In this study aimed to research the complete response (pCR) rates in different regimens for neoadjuvant setting and determine associated clinical and biological factors. Methods: This study included 63 patients diagnosed with breast carcinoma among 95 patients that had been treated with neoadjuvant chemotherapy between 2007 and 2010. TNM staging system was used for staging. The histologic response to neoadjuvant chemotherapy was characterized as a pCR when there was no evidence of residual invasive tumor in the breast or axillary lymph nodes. Biologic subclassification using estrogen receptor (ER), progesterone receptor (PR), HER2 were performed. Luminal A was defined as ER+, PR+, HER2-; Luminal B tumor was defined as ER+, PR-, HER2-; ER+, PR-, HER2+; ER-, PR+, HER2-; ER+, PR+, HER2+; HER2 like tumor ER-, PR+, HER2+; and triple negative tumor ER, PR, HER2 negative. Results: Patients median age was 54.14 (min-max: 30-75). Thirty-two patients (50.8%) were premenapousal and 31 (49.2%) were postmenapousal. Staging was performed postoperatively based on the pathology report and appropriated imaging modalities The TNM (tumor, lymph node, metastasis) system was used for clinical and pathological staging. Fifty-seven (90.5%) were invasive ductal carcinomas, 6 (9.5%) were other subtypes. Thirty nine (61.9%) were grade II and 24 (38.1%) were grade III. Seven (11.1%) patients were stage II and 56 (88.9) patients were stage III. The patients were classified for ER, PR receptor and HER2 positivity. Seventeen patients had complete response to chemotherapy. Forty patients (63.5%) were treated with dose dense regimen (cyclophosphamide 600 mg/m2 and doxorubicine 60 mg/m every two weeks than paclitaxel 175 mg/m2 every two weeks with filgrastim support) 40 patients (48%) were treated anthracycline and taxane containing regimens. Thirteen patients (76%) from 17 patients with pCR were treated with the dose dense regimen but without statistical significance (p=0.06). pCR was higher in HER2(-), ER(-), grade III, premenopausal patients. Conclusion: pCR rate was higher in the group that treated with dose dense regimen, which should thus be the selected regimen in neoadjuvant setting. Some other factors can predict pCR in Turkish patients, like grade, menopausal status, triple negativity, percentage of ER positivity, and HER2 expression.