• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.997-1000
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• 2015

Esophageal cancer represents the fourth most common gastrointestinal cancer and generally confers a poor prognosis. Prostaglandin-producing cyclo-oxygenase has been implicated in the pathogenesis of esophageal cancer growth. Here we report that prostaglandin dehydrogenase, the major enzyme responsible for prostaglandin degradation, is significantly reduced in expression in esophageal cancer in comparison to normal esophageal tissue. Reconstitution of PGDH expression in esophageal cancer cells suppresses cancer cell growth, at least in part through preventing cell proliferation and promoting cell apoptosis. The tumor suppressive role of PGDH applies equally to both squamous cell carcinoma and adenocarcinoma, which enriches our understanding of the pathogenesis of esophageal cancer and may provide an important therapeutic target.

• Journal of Chest Surgery
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• 제54권6호
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• pp.454-459
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• 2021

According to statistics from 2017, esophageal cancer is the fifteenth most common cancer and the eleventh most common cause of cancer-related death in Korea. The most common pathology is esophageal squamous cell carcinoma. Moreover, the incidence of esophageal cancer has been gradually decreasing in Korea, and the percentage of early-stage cases has gradually increased to the point that it is higher than that of other countries. The 5-year relative survival rate has improved over time. Approximately 800 esophagectomy procedures are performed annually. Using a cut-off number of 21 cases per 2 years to define high-volume centers, it was found that 70% of esophagectomies were performed by a few high-volume centers. Unfortunately, there is no nationwide registry or database on esophageal cancer and esophagectomy in Korea. Efforts to establish a nationwide database on esophageal cancer and esophagectomy should be made.

• Journal of Chest Surgery
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• 제26권3호
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• pp.214-218
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• 1993

Extensive lymphnode dissection combined with thoracic esophagectomy improved prognosis of esophageal cancer, but there is still high postoperative recurrence rate. The immunologic capacity of esophageal cancer patients is compromised by surgery and adjuvant chemotherapy. Therefore immunological therapy for esophageal cancer patients seems rational. We have adopted postoperative immunochemotherapy since 1988. From 1988 to 1992, 31 patients with thoracic esophageal cancer underwent esophagectomy and radical lymphnode dissection, and selected patient with early esophageal cancer and unfit for thoracotomy underwent transhiatal esophagectomy in Korea University Hospital. Mean age of patients was 56 years. There were 28 squamous cell cancers, 2 adenocarcinomas and one mixed tumor. There were 4 stage I, 3 stage II, 18 stage III, and 6 stage IV cases. There were no opeartive death. Postoperative complications included anastomotic leakage in 9%, pneumonia 3 %, cylothorax 3%, recurrent laryngeal neve paresis in 3% of all patients. Curative resection group[n=19] received immunotherapy. Noncurative resection group[n=12] received postoperative immunochemotherapy, including PS-K, CDDP, and 5-FU. Operative survivors were followed from 4 months to 5 years. There were 3 lost of follow-up. Actuarial survival rate is 79% to one year, 54% to two years and 27% to five years.In conclusion, an transthoracic esophagectomy combined with systematic lymph node dissection and postoperative immunochemotherapy could improve survival rate for esophageal cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3379-3383
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• 2012

Objective: To investigate uPA and VEGF expression in esophageal cancer and relations with tumorous invasion and metastasis. Methods: Immunohistochemistry was used to detect uPA and VEGF expression in the normal epithelial tissue of esophageal mucosa and cancer tissue and detect CD34 labeled micrangium and analyze the relationships with clinical pathological features and tumor angiogenesis. Results: Positive rates for uPA and VEGF protein expression were significantly greater in esophageal cancer than normal epithelial tissue (P < 0.05), the two being linked (P <0.05). In addition, uPA and VEGF protein expression of the high microvessel density (MVD) group was significantly lower than in the low MVD group (P < 0.05), with relation to clinical pathological staging, differentiation and lymph node metastasis (P < 0.05). Conclusion: In esophageal cancer tissue, uPA and VEGF proteins are overexpressed and promote tumor angiogenesis, indicative of a poor prognosis.

• Journal of Chest Surgery
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• 제40권10호
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• pp.685-690
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• 2007

배경: 상부 식도암에 대한 종래의 표준적 치료는 방사선 조사였으나 결과는 만족스럽지 않았으며, 아직도 수술적 치료를 적용하는 데에는 의견의 차이가 있다. 저자들은 상부식도암에 대하여 수술적 치료를 적극적으로 시행하여 왔으며, 그의 효과를 분석해 보고자 하였다. 대상 및 방법: 1995년부터 2005년까지 저자들이 수술을 시행한 식도암 증례는 모두 147예였으며, 이들을 상부 식도암(경부 및 상흉부 식도암) 23예와 하부 식도암(중, 하흉부 및 복부 식도암) 124예의 2군으로 구분하여, 수술의 완전 절제율과 수술의 합병증 및 사망률, 재발률,그리고 생존율 등을 비교함으로써 양군에서의 수술의 유용성을 비교해 보았다. 결과: 양 군 간에 병기 분포는 유사하였으며, 완전 절제율에서도 유의한 차이를 발견할 수 없었다. 수술의 합병증 발생률은 상부 식도암군에서 유의하게 높았으나(39.1% vs 16.9%, p<0.05), 수술 사망률이나 재발률 및 장기 생존율에서의 차이는 없었다. 결론: 양 군 간에 수술 사망률이나 수술의 효과 면에서 차이가 없어 상부 식도암에서도 수술적 치료는 유용하다고 판단되었으나, 향후 보다 많은 증례의 분석이 필요할 것이라고 생각한다.

• 대한기관식도과학회지
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• 제9권1호
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• pp.39-46
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• 2003

Surgery remains the standard treatment for resectable thoracic esophageal cancer but that is justified only when acceptably low morbidity and mortality rates can be achieved even for advanced disease. The appropriate extent of resection to achieve the best outcome is the most controversial aspect of treating esopahgeal cancer and the optimal excent of lymphadenectomy also remains controversial. Until data from prospective randomized trials showing a clear benefit using a particular approach are available, surgeons should perform their better judgement in individualizing and selecting the most appropriate surgical approach to provide the best chance of cure or lasting palliation for this disease that challanges both patient and surgeon. Further studies are necessary to examine the utility and efficacy of each approach in treating thoracic esophageal cancer either alone or in combination with other modalities.

• Journal of Chest Surgery
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• 제41권2호
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• pp.253-259
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• 2008

배경: 경부식도암은 흉부식도암에 비해 발생 빈도가 상대적으로 낮고 방사선치료나 항암 약물치료의 역할이 흉부식도암에서보다 상대적으로 높다. 따라서 경부식도암에 대한 수술적 치료의 역할이 흉부식도암에 비해 상대적으로 제한적이다. 저자들은 경부식도암에 대한 수술적 치료의 결과를 알아보기 위해 본 연구를 시행하였다. 대상 및 방법: 1989년 1월부터 2002년 12월까지 경부식도암(경흉부식도 암 포함 )으로 수술을 시행 받은 환자 43명의 결과를 후향적으로 분석하였다. 모든 환자에서 추적이 가능하였으며, 최종 추적일은 2004년 2월 28일이었다. 결과: 대상 환자의 평균 나이는 60세$(43{\sim}77)$였고, 남녀 비는 40:3이었다. 조직학적으로 편평상피세포암이 42명, 악성 흑색종이 1명이었다. 식도 재건 방법은 gastric pull-up 32명, 유리 공장 이식 7명, colon interposition 4명이었다. 전체 43명 중 31명(72%)의 환자에서 합병증이 발생하였고, 수술 사망자는 7명(16%)이었다. 수술 후 최종 병기는 I 3명, IIa 14 명, IIb 1명, III 19명, IVa 6명이었다. 수술 사망자를 제외한 36 명 중 16명(44%)에서 종양이 재발하였고, 수술 후 3년, 5년 생존율은 29.3% 와 20.9%이었다. 결론: 경부식도암에 대한 수술은 수술 사망률, 합병증 발생률, 재발률이 높고, 장기 생존율이 낮지만, 방사선치료나 항암약물치료 만으로는 연하곤란의 완전한 해소 및 종양의 완치가 어려우므로 수술이 포함되는 다방법 병합치료가 필요하다고 생각한다.

• Journal of Chest Surgery
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• 제39권3호
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• pp.255-259
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• 2006

식도암의 수술은 일반적으로 개흉술과 개복술이 동시에 시행되며 경우에 따라 경부절개까지 추가되므로 다른 수술에 비해 이환율과 사망률이 상대적으로 높다. 수술에 따른 합병증을 최소화하고 빠른 회복을 유도하기 위하여 최근에는 양성 질환뿐만 아니라 악성 종양의 수술에도 저 침습적인 방법이 많이 시행되고 있으나, 식도암에는 적극적으로 적용되고 있지는 않으며 아직 국내보고도 없다. 최근 저자들은 8예의 식도암 환자에게 저 침습 수술을 적용하였기에 수술 기법을 중심으로 보고하는 바이다.

• Journal of Chest Surgery
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• 제56권6호
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• pp.403-411
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• 2023

Background: The concept of oligo-recurrence has not been generally applied in esophageal cancer. This study aimed to determine the prognostic significance of the number of recurrences in esophageal cancer. Methods: Patients with squamous cell carcinoma who underwent curative esophagectomy with R0 or R1 resection and who experienced a confirmed recurrence were included. The study included 321 eligible participants from March 2001 to December 2019. The relationship between the number of recurrences and post-recurrence survival was investigated. Results: The mean age was 63.8±8.1 years, and the majority of the participants (97.5%) were men. The median time to recurrence was 10.7 months, and the median survival time after recurrence was 8.8 months. Multiple recurrences with simultaneous local, regional, and distant locations were common (38%). In terms of the number of recurrences, single recurrences were the most common (38.3%) and had the best post-recurrence survival rate (median, 17.1 months; p<0.001). Patients with 2 or 3 recurrences showed equivalent survival to each other and longer survival than those with 4 or more (median, 9.4 months; p<0.001). In the multivariable analysis, the significant predictors of post-recurrence survival were body mass index, minimally invasive esophagectomy, N stage, R0 resection, post-recurrence treatment, and the number of recurrences (p<0.05). Conclusion: After esophagectomy, the number of recurrences was the most significant risk factor influencing post-recurrence survival in patients with esophageal cancer. In esophageal cancer, oligo-recurrence can be defined as a recurrence with three or fewer metastases. More intensive treatment might be recommended if oligo-recurrence occurs.

• 한국전문물리치료학회지
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• 제27권3호
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• pp.220-226
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• 2020

Esophageal cancer is a representative cancer that occur physical deterioration but, physical problems after surgery were not well reported. The purpose of this study is to report on the long thoracic neuropathy after surgery, and to identify the symptoms and effects of physical therapy after esophageal cancer surgery. This is a case of a 61-year-old man who showed winging of the scapula with long thoracic nerve injury on the results of electromyography after an esophageal cancer surgery. Physical therapy programs were implemented 8 sessions during hospitalization. The quality of life, fatigue, shoulder range of motion (ROM), numeric rating scale (NRS), 6-minute walk test, and 30-second chair stand test were assessed. The quality of life, fatigue, shoulder ROM, NRS (pain), 6-minute walk test, and 30-second chair stand test were improved. However, the esophageal-specific symptom was not different after physical therapy program. As esophageal cancer suffers from physical difficulties after surgery, physical therapy programs are thought to be helpful.