• Archives of Craniofacial Surgery
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• v.24 no.5
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• pp.244-249
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• 2023

Fibrous dysplasia (FD) is a rare skeletal disorder characterized by abnormal fibro-osseous connective tissue replacing normal bone. Despite its benign behavior, craniofacial FD can cause morphological disfigurement, headache, and even blindness as a result of the produced mass effect. Surgical resection is recommended when the patient shows apparent clinical symptoms or aggravating facial asymmetry. Postoperative complications have been reported, such as hematoma, surgical site infection, abscess formation, resorption of the bone graft used for reconstruction, and recurrence. An aneurysmal bone cyst (ABC) is a rare benign bony lesion that can occur secondary to preexisting bone tumor. Secondary ABCs in craniofacial FD are extremely rare in the literature, accounting for less than 30, all of which are either case reports or series. We report an extremely rare case of symptomatic secondary ABC arising from craniofacial FD that had been misdiagnosed with abscess formation or recurrence and was surgically removed. Notably, 17 years elapsed between the primary surgery and the complication of secondary ABC. The patient underwent total removal of secondary ABC. After surgery, symptoms were relieved, with no recurrence observed during a 6-month follow-up.

• Journal of Chest Surgery
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• v.51 no.1
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• pp.41-52
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• 2018

Background: Few studies have evaluated the long-term impact of postoperative infectious complications in patients with non-small cell lung cancer (NSCLC). We aimed to determine the impact of infectious complications on long-term outcomes after surgical resection for NSCLC. Methods: We performed a retrospective study of 1,380 eligible patients who underwent pulmonary resection for NSCLC from 2003 to 2012. Complications were divided into infectious complications and non-infectious complications. Kaplan-Meier survival analysis was used to compare unadjusted 5-year cancer-specific survival (CSS) rates and recurrence-free survival (RFS) rates. Cox regression was used to determine the impact of infectious complications on 5-year CSS and RFS. Results: The rate of total complications and infectious complications was 24.3% and 4.3%, respectively. In the node-negative subgroup, the 5-year CSS and RFS rates were 75.9% and 57.1% in patients who had infectious complications, compared to 87.9% and 78.4% in patients who had no complications. Infectious complications were a negative prognostic factor for 5-year RFS (hazard ratio, 1.92; 95% confidence interval, 1.00-3.69; p=0.049). In the node-positive subgroup, the 5-year CSS rate and RFS were 44.6% and 48.4% in patients who had infectious complications, compared to 70.5% and 48.4% for patients who had no complications. Conclusion: Postoperative infectious complications had a negative impact on CSS and RFS in node-negative NSCLC. Our findings may help improve risk assessment for tumor recurrence after pulmonary resection for node-negative NSCLC.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.2049-2053
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• 2016

Background: The LigaSure vessel sealing system has been proposed to save operation time and reduce intraoperative blood loss for various surgeries. However, its usage for gastric cancer is still controversial. The aim of the present meta-analysis was to compare the effectiveness of LigaSure with conventional surgery in gastrectomy. Materials and Methods: Sources were retrieved from the Cochrane Library, MEDLINE, EMBASE, SCOPUS and Google Scholar until February, 2015. All randomized controlled trials comparing LigaSure with conventional surgery in curative gastric cancer resection were selected. After data extraction, statistics were performed by Review Manager 5.1 software. Results: Three eligible randomized controlled trials were evaluated, with a total of 335 patients. The quality of the included trials was good, yet some methodological and clinical heterogeneity existed. There were no significant differences between the LigaSure and conventional groups in operative time (weighted mean difference [WMD], -22.95 minutes; 95% confidence interval [CI], [-59.75, 13.85]; P = 0.22), blood loss (WMD, -45.8 ml; 95% CI, [-134.5, 42.90]; P = 0.31), nor the incidence of surgical complications (odds ratio, 1.18; 95% CI, [0.68, 2.05]; P = 0.54). But there was a longer duration of hospital stay in LigaSure group (WMD, 1.41 days; 95% CI, [0.14, 2.68]; P = 0.03). Conclusions: All available randomized evidence has been summarized. LigaSure does not confer significant advantage over conventional surgery for curative gastric cancer resection. The usefulness of the device may be limited in gastrectomy. But, more trials are needed for further assessment of the LigaSure system for gastric cancer.

• Advances in pediatric surgery
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• v.9 no.1
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• pp.12-18
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• 2003

The purpose of this study is to evaluate children who underwent hepatic resection for primary malignant hepatic tumor in the period from January 1994 to December 2001. A total of 8 patients, seven with hepatoblastoma (HB) and one with hepatocellular carcinoma (HCC), were studied. One HCC was resectable at the initial diagnosis, but five cases of unresectable HB received two cycles of transarterial chemoembolization (TACE) before operation. One patient with an unresectable HB with bone marrow metastasis was operated after one cycle of TACE and one cycle of systemic chemotherapy based on CCG-823F protocol. Another unresectable HB patient received systemic chemotherapy instead of TACE before operation. Postoperative chemotherapy was administered to all of the patients after complete surgical resection on CCG-823F protocol. All 6 patients who underwent TACE and neoadjuvant chemotherapy showed marked reduction in tumor volume and a clear outline of the lesion. Major complication was not noticed. Mean alpha-fetoprotein (${\alpha}$-FP) level at diagnosis, after neoadjuvant chemotherapy and after postoperative chemotherapy was 9,818 (42-35,350), 664, and 10.1 ng/mL, respectively. Half life of the ${\alpha}$-FP after complete resection was 5.1 days (3.0-8.7 days). Median follow up period was 57.1 months (10-97 months) and all the patients are alive with NED. In conclusion, preoperative chemotherapy, especially TACE, is effective, safe, and useful to treat initially unresectable hepatoblastoma, and serial level of the serum ${\alpha}$-FP is a useful tumor marker for diagnosis and monitoring therapeutic responses.

• Korean Journal of Radiology
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• v.21 no.7
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• pp.829-837
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• 2020

Objective: The aim of this study was to investigate the prognostic value of the maximum standardized uptake value (SUV_max) measured while restaging with F-18 fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) to predict the 3-year post-recurrence survival (PRS) in patients with recurrent gastric cancer after curative surgical resection. Materials and Methods: In total, 47 patients with recurrent gastric cancer after curative resection who underwent restaging with ¹⁸F-FDG PET/CT were included. For the semiquantitative analysis, SUV_max was measured over the visually discernable ¹⁸F-FDG-avid recurrent lesions. Cox proportional-hazards regression models were used to predict the 3-year PRS. Differences in 3-year PRS were assessed with the Kaplan-Meier analysis. Results: Thirty-nine of the 47 patients (83%) expired within 3 years after recurrence in the median follow-up period of 30.3 months. In the multivariate analysis, SUV_max (p = 0.012), weight loss (p = 0.025), and neutrophil count (p = 0.006) were significant prognostic factors for 3-year PRS. The Kaplan-Meier curves demonstrated significantly poor 3-year PRS in patients with SUV_max > 5.1 than in those with SUV_max ≤ 5.1 (3-year PRS rate, 3.5% vs. 38.9%, p < 0.001). Conclusion: High SUV_max on restaging with ¹⁸F-FDG PET/CT is a poor prognostic factor for 3-year PRS. It may strengthen the role of ¹⁸F-FDG PET/CT in further stratifying the prognosis of recurrent gastric cancer.

• Journal of Gastric Cancer
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• v.23 no.4
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• pp.535-548
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• 2023

Purpose: This study evaluated real-world compliance with surgical treatment according to Korea's gastric cancer treatment guidelines. Materials and Methods: The 2018 Korean Gastric Cancer Treatment Guidelines were evaluated using the 2019 national survey data for surgically treated gastric cancer based on postoperative pathological results in Korea. In addition, the changes in surgical treatments in 2019 were compared with those in the 2014 national survey data implemented before the publication of the guidelines in 2018. The compliance rate was evaluated according to the algorithm recommended in the 2018 Korean guidelines. Results: The overall compliance rates in 2019 were 83% for gastric resection extent, 87% for lymph node dissection, 100% for surgical approach, and 83% for adjuvant chemotherapy, similar to 2014. Among patients with pathologic stages IB, II, and III disease who underwent total gastrectomy, the incidence of splenectomy was 8.08%, a practice not recommended by the guidelines. The survey findings revealed that 48.66% of the patients who underwent gastrectomy had pathological stage IV disease, which was not recommended by the 2019 guidelines. Compared to that in 2014, the rate of gastrectomy in stage IV patients was 54.53% in 2014. Compliance rates were similar across all regions of Korea, except for gastrectomy in patients with stage IV disease. Conclusions: Real-world compliance with gastric cancer treatment guidelines was relatively high in Korea.

• Radiation Oncology Journal
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• v.25 no.1
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• pp.34-42
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• 2007

[ $\underline{Purpose}$ ]: We performed a retrospective non-randomized clinical study of locally advanced rectal cancer, to evaluate the anal sphincter preservation rates, down staging rates and survival rates of preoperative chemoradiotherapy. $\underline{Materials\;and\;Methods}$: From January 2002 to December 2005, patients with pathologically confirmed rectal cancer with clinical stage T2 or higher, or patients with lymph node metastasis were enrolled in this study. A preoperative staging work-up was conducted in 36 patients. All patients were treated with preoperative chemoradiotherapy, and curative resection was performed for 26 patients at Hallym University Sacred Heart Hospital. Radiotherapy treatment planning was conducted with the use of planning CT for all patients. A total dose of $45.0{\sim}52.2\;Gy$ conventionally fractionated three-dimensional radiotherapy was delivered to the whole pelvis. Chemotherapy was given at the first and fifth week of radiation therapy with continuous infusion i.v. 5-FU (Fluorouracil) and LV (Leucovorine). Surgical resection was performed 2 to 4 weeks after the completion of the chemoradiotherapy regimen. $\underline{Results}$: The complete resection rate with negative resection margin was 100% (26/26). However, a pathologically complete response was not seen after curative resection. Surgery was done by LAR (low anterior resection) in 23 patients and APR (abdomino-perineal resection) in 3 patients. The sphincter preservation rate was 88.5% (23/26), down staging of the tumor occurred in 12 patients (46.2%) and down-sizing of the tumor occurred in 19 patients (73%). Local recurrence after surgical resection developed in 1 patient, and distant metastasis developed in 3 patients. The local recurrence free survival rate, distant metastasis free survival rate, and progression free survival rate were 96.7%, 87% and 83.1%, respectively. Treatment related toxicity was minimal except for one grade 3, one grade 4 anemia, one grade 3 leukopenia, and one grade 3 ileus. $\underline{Conclusion}$: Preoperative concurrent chmoradiotherapy for locally advanced rectal cancer seems to have some potential benefits: high sphincter preservation and down staging. Treatment related toxicity was minimal and a high compliance with treatment was seen in this study. Further long-term follow-up with a larger group of patients is required.

• Korean Journal of Head & Neck Oncology
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• v.10 no.2
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• pp.152-156
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• 1994

Stomal recurrence after total laryngectomy presents serious therapeutic problems despite aggressive treatment methods. The purpose of this study is to evaluate the critical analysis of etiology and treatment results and to clarify the treatment plans and prevention of stomal recurrence. Among 159 cases who had undergone total laryngectomy for cancers of larynx(135 cases) and hypopharynx(24 cases) during recent 10 years, stomal recurrence occured in 12 cases(1 case with type I, 2 cases with type II, 2 cases with type III, 3 cases of type IV and unclassified 4 cases according to Sisson's classification) and the retrospective analysis of results were as follows: 1) Average duration of stomal recurrence was $8.2{\pm}4.35$ months after cessation of primary treatment. 2) The overall incidence of stomal recurrence was 7.6%. 3) The suggested etiology in the pathogenesis of stomal recurrence could be inadequate surgical margin, delayed laryngectomy after initial tracheostomy and improper management of metastatic nodes. 4) Mean survival time was $7.3{\pm}5.61$ months and one case with type I underwent surgical salvage is still alive out of 7 cases with chemotherapy and radiotherapy and 5 cases with surgical salvage and adjacent therapy. In summary, aggressive surgical resection should be recommended in cases with high risks of stomal recurrence.

• Radiation Oncology Journal
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• v.24 no.3
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• pp.201-206
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• 2006

Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving synovial membranes. Natural history and etiology of PVNS are not well known. PVNS presents as localized or diffuse tumor like nodular lesion of the synovial lining of the joint and the synovial spaces adjacent to the joints. Though histologically benign, it is a very aggressive lesion, capable of bone destruction and widespread infiltration of surrounding tissues. Standard therapy is surgical resection, but due to the infiltrative growth, the recurrence rate is significantly high. After several relapses surgical treatment of diffuse PVNS becomes difficult and may require amputation of the involved limb. Radiotherapy can provide an effective treatment option for patients with large lesions or lesions which are not suitable for surgery, after incomplete resection to prevent relapses or to avoid amputation. We report 2 cases of diffuse PVNS in the knee joint treated with arthroscopic gross total synovectomy and radiotherapy.

• Archives of Craniofacial Surgery
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• v.23 no.1
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• pp.39-42
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• 2022

The reconstruction of total lower eyelid defects is challenging to plastic surgeons due to the complicated anatomical structure of the eyelid. In addition, in the setting of cancer excision, the resection is deep, which requires some volume augmentation. However, in some cases, free tissue transfer is not applicable. We report a case of using a temporoparietal fascia flap (TPFF) for reconstructing a total lower eyelid defect. A large erythematous mass in an 83-year-old woman was diagnosed as squamous cell carcinoma by biopsy. After wide excision, the defect size was about 8×6 cm. The lower eyelid structures including the tarsus were removed. The TPFF including the superficial temporal artery was elevated and inset to the defect area. After the flap inset, a split-thickness skin graft with an acellular dermal matrix was performed on the fascial flap. There were no wound problems such as infection, dehiscence, or necrosis. After the patient's discharge, partial skin graft loss and ectropion occurred. The complications resolved spontaneously during the postoperative period. We report a case of reconstructing a lower eyelid defect using a TPFF. A TPFF can be applied to patients with large defects for whom free tissue transfer surgery is not appropriate as in this case.