• Journal of Gastric Cancer
• /
• v.8 no.2
• /
• pp.104-109
• /
• 2008

Purpose: To investigate the clinicopathlogical characteristics and the surgical methods for gastric submucosal tumors in Korea, the Information Committee of the Korean Gastric Cancer Association performed a nationwide survey. Materials and Methods: Data on 878 patients who underwent resection from 2005 to 2006 were collected from medical records obtained from 47 institutes. Diagnosis, demographics, symptoms, tumor factors (location, size, degree of malignancy) and operative factors (surgicalmethod and approach, mortality) were analyzed. Results: Gastrointestinal stromal tumors (GISTs) were the most common cancers (n=586, 66.8%), followed by leiomyomas (n=97, 11.1%), schwannomas (n=70, 8.0%), ectopic pancreas (n=67, 7.8%) and carcinoids (n=16, 1.8%). The mean age of patients was 56.0 years and the male to female ratio was 1:1.18. Only 40.9% of the patients had symptoms at the time of diagnosis, such as abdominal pain, dyspepsia and bleeding. Gastric submucosal tumors were most frequently located in the upper third of the stomach and 55.4% of the GISTs (n=319) and 84.5% of the leiomyomas (n=84.5%) were located in the upper third of the stomach. Wedge resection (n=726, 82.8%) was the most common operative method, and laparoscopic surgery was performed in 388 patients (44.2%). Only one patient (0.1%) died within 30 days of surgery. A total of 115 patients withGISTs (21.1%, 115/544) had a high risk of malignancy and 41 patients (8.3%, 45/495) received adjuvant imatinib mesylate therapy. Conclusion: The survey showed that about two-thirds of the patients with a gastric submuscoal tumor (SMT) had a GIST, and about one-half of the patients underwent laparoscopic resection. These data presented in the nationwide survey could be used as a fundamental resource for gastric submucosal tumors in Korea.

• The Journal of the Korea Contents Association
• /
• v.18 no.6
• /
• pp.652-666
• /
• 2018

The purpose of this study was to investigate systematic review and meta-analysisto identify exercise intervention effect applied to patients who underwent lung resection with lung cancer. A total of 1,322 publications were searched from 1990 to 2016 through domestic and foreign electronic databases, and the final 13 publications were selected through literature selection process. Finally, eight RCT (randomized controlled trial) and five NRCT (non-randomized controlled trial) were identified, including 925 participants. The results of the meta-analysis of the effect sizes of the intervention on the outcome variables showed that the health-related quality of life EORTC QOL-C13/30 (the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire) (MD-0.50 95 % CI -0.83-0.18) and SF-36 PCS (the Medical Outcomes 36-Item Short Form Health Survey PCS) (MD 0.75, 95 % CI 0.41-1.10) in the intervention group were significantly higher than the control group. The results of this study suggest that exercise interventions can potentially improve the quality of life of patients who underwent lung resection with lung cancer.

• Journal of Chest Surgery
• /
• v.30 no.4
• /
• pp.363-372
• /
• 1997

One hundred forty-four patients underwent operation for coarctation of the aorta at Seoul National University Children's Hospital between June 1986 and Decembsr 1995. Age ranged 0.1 to 191 months. Of these 78.5%(113) were infants. We classified the patients in terms of the anatomic location of coarctatiln and the associatCd anomalies(I[401= primary coarctation, 11(741=isthmic hypoplasia, lIIf30)=tubular hypoplasia involving transverse arch, Ar63 =with ventricular septal defect, B(28)=with other major cardiac defects). Subcalvian flap coarctoplasty(60), resection & anastomosis(44), extended aortoplasty(26), and onlay patch(14) were used as surgical methods. Overall operative mortality was 16.0(23/144)%. The hospital mortality was signific'antly higher in patheints with type 111, subtype B, younger age(under 3 months), extended aortoplasty(p(0.01). However, one-stage total repair in patients with subtype A or B were not found to be a predictor of hospital death. Restenosis had occured in 18 patients among 121 survivals(14. 9%). The mean follow-up period was 29.1 $\pm$28.8(0~129.2) months. Preoperative, immediate postoperative(within 3 months after operation) and postoperative(later than 6 months after operation) echocardiographic data on the dimensions of ascending aorta(AA), transverse arch(TA), an4 aortic isthmus(Al) were available in 77 patients(I=20, ll=42, 111= 15). Preoperative and postoperative aortic isthmus(All) and tra sverse arch indices(TAI), defined as TAIAA & AIIAA respectively, were compared. Immediate postoperative All in type 1, II and TAI in type 111 were significantly smaller in stenotic than non-stenotic group suggesting incomplete relieves of stenotic segment Younger age, subclavian coarctoplasty in patient under 3 months of age were round to be the risk factors for restenosis in this series. In conclusion, We found that aortic arch index and transverse arch index can be a useful tool to figure out the anatomic and clinical characteristics of the patients with aortic coarctation, and that anatomy, associated anomalies, age, and surgical methods may influence the surgical outcome of the coarctation repair.

• Radiation Oncology Journal
• /
• v.19 no.1
• /
• pp.16-20
• /
• 2001

Purpose : To evaluate the effectiveness and tolerance of the postoperative radiation therapy for patients with Stage III thymoma and to define the optimal radiotherapeutic regimen Materials and Methods : We retrospectively analyzed the records of 24 patients with Stage III thymoma who were referred for postoperative radiation therapy in our institution from June, 1987 to May, 1999. Surgical therapy consisted of total resection in one patient, subtotal resection in seventeen, and biopsy alone in six patients. Age of the patients was ranged from 20 to 62 years with mean age of 47 years. Male to female ratio was 14 to 10. Radiation therapy was delivered with linear accelerator producing either 6 MeV or 10 MeV photons. The irradiated volume included anterior mediastinum and known residual disease. The supraclavicular fossae were not irradiated. The delivered total dose was ranged from 30 to 56 Gy. One patient received 30 Gy and eighteen patients received minimum of 50 Gy. Follow up period was ranged from 12 months to 8 years with median follow up of 40 months. Results : The overall local control rate for entire group of patients was $67\%$ at 5 years. The cumulative local failure rates at one, three and five year were $18\%,\;28\%\;and\;33\%$, respectively. In patients treated with subtotal resection and biopsy alone, local control rate was $76\%\;and\;33\%$, respectively. The actuarial observed survival rate at 5 years was $57\%$, and actuarial adjusted survival at 5 years was $72\%$. The difference between 5 year survival rates for patients treated with subtotal resection and biopsy alone was not statistically significant $(62\%\;vs\;30\%)$. Conclusion : We might conclude that postoperative radiation therapy was safe and effective treatment for patients with Stage III thymoma. Postoperative radiation therapy is recommended in cases where tumor margin is close or incomplete resection is accomplished.

• Radiation Oncology Journal
• /
• v.22 no.2
• /
• pp.91-97
• /
• 2004

Propose: To Analyze the survival outcomes and prognostic factors In glioblastoma patients treated with surgery and radiation therapy. Materials and Methods : One hundred twenty glloblastoma patients treated with postoperative radiation therapy from 1994 to 2003 at Samsung Medical Center were retrospectively reviewed. Surgical extents were gross total resection in 22 patients (18$\%$), subtotal resection in 69 (58$\%$), and biopsy only in 29 (24$\%$). The median radiation dose was 50 Gy, ranging from 45 Gy to 72 Gy The median follow-up period was 12 months ranging from 2 to 52 months. Results The overall 1- and 2-year survival rates were 52$\%$ and 14$\%$, respectively, and the median survival duration was 13 months. Favorable prognostic factors by Uunivarlate analyses of prognostic factors on 1-year survival rate were revealed that age under 50 (p<0.01), ECOG performance status 0 or 1 (p=0.03), single lesion (p=0.02), and gross total resection (p=0.04), were the favorable prognostic (actors. and by Mmultlvarlate analyses were revealed that female (p<0.01), age under 50 (p<0.01), ECOG performance status 0 or 1 (p=0.05) and gross total resection (p=0.05) were the favorable prognostic factors. Conclusions : The results of our study were comparable with those previously reported. To Improve treatment outcome, various modifications, Including radiation dose escalation through newer radiation therapy techniques and use of effective chemotherapy regimen, should be further Investigated. Investigated. Also Furthermore, the application of Individualized treatment strategy based on 4he patient's prognostic factors might be needed.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.8
• /
• pp.1037-1041
• /
• 2001

Desmoplastic fibroma(DF) is a rare neoplasm of the bone, and is histologically benign but locally aggressive disease. A total of nine cases of DF involving skull have been reported in the literature, and among these eight are females. In this report, the clinical findings and histopathology of a case with DF of the skull in a male patient is presented with a review of the literature with an emphasis on treatment modalities. A 21-year-old man presented with headache. CT scan revealed a solitary and lytic skull lesion without brain invasion. DF was confirmed by histological evaluation. On immunohistochemical staining of the tumor was negative for estrogen or progesterone receptors. After total resection of tumor with wide surgical margin, there was no recurrence during the 35 months of follow-up period. Although longer follow up period maybe needed, treatment of this type of tumor with complete resection of tumor tissue along with a wide margin may provide long disease-free state compare to the high recurrence rates in DF of other sites.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.37
• /
• pp.19.1-19.7
• /
• 2015

Background: The purpose of this retrospective study was to investigate the usefulness of tracheostomy scoring system in the decision of postoperative airway management in oral cancer patients. Materials and methods: A total of 104 patients were reviewed in this retrospective study, who underwent radical resection with or without neck dissection and free flap reconstruction due to oral cancer. The patients were classified into three groups according to the timing of the extubation; extubated groups (n = 51), overnight intubation group (n = 45), and tracheostomy group (n = 8). Cameron's score was used to evaluate the relation between the state of the patient's airway and the type of the operation. Results: Tracheostomy was performed in eight patients (8/104, 7.7 %). A total of 22 patients (21.2 %) had more than 5 points of which 17 patients (77.3 %) did not have a tracheostomy and any postoperative emergency airway problems. The tracheostomy scores were significantly different among the three groups. Hospital stay showed a significant correlation with the tracheostomy score. Conclusions: The scoring system did not quite agree with the airway management of the authors' clinic; however, it can be one of the clinical factors predicting the degree of the postoperative airway obstruction and surgical aggressiveness for recovery. The further studies are needed for clinically more reliable scoring systems.

• Radiation Oncology Journal
• /
• v.24 no.3
• /
• pp.157-163
• /
• 2006

[ $\underline{Purpose}$ ]: To evaluate the role of postoperative adjuvant chemoradiotherapy in rectal cancer, we retrospectively analyzed the treatment outcome of patients with rectal cancer taken curative surgical resection and postoperative adjuvant chemoradiotherapy. $\underline{Materials\;and\;Methods}$: A total 46 patients with AJCC stage II and III carcinoma of rectum were treated with curative surgical resection and postoperative adjuvant chemoradiotherapy. T3 and T4 stage were 38 and 8 patients, respectively. N0, N1, and N2 stage were 12, 16, 18 patients, respectively. Forty patients received bolus infusions of 5-fluorouracil ($500\;mg/m^2/day$) with leucovorin ($20\;mg/m^2/day$), every 4 weeks interval for 6 cycles. Oral Uracil/Tegafur on a daily basis for $6{\sim}12$ months was given in 6 patients. Radiotherapy with 45 Gy was delivered to the surgical bed and regional pelvic lymph node area, followed by $5.4{\sim}9\;Gy$ boost to the surgical bed. The follow up period ranged from 8 to 75 months with a median 35 months. $\underline{Results}$: Treatment failure occurred in 17 patients (37%). Locoregional failure occurred in 4 patients (8.7%) and distant failure in 16 patients (34.8%). There was no local failure only. Five year actuarial overall survival (OS) was 51.5% and relapse free survival (RFS) was 58.7%. The OS and RFS were 100%, 100% in stage N0 patients, 53.7%, 47.6% in N1 patients, and 0%, 41.2% in N2 patients (p=0.012, p=0.009). The RFS was 55%, 78.5%, and 31.2% in upper, middle, and lower rectal cancer patients, respectively (p=0.006). Multivariate analysis showed that N stage (p=0.012) was significant prognostic factor for OS and that N stage (p=0.001) and location of tumor (p=0.006) were for RFS. Bowel complications requiring surgery occurred in 3 patients. $\underline{Conclusion}$: Postoperative adjuvant chemoradiotherapy was an effective modality for locoregional control of rectal cancer. But further investigations for reducing the distant failure rate are necessary because distant failure rate is still high.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.22
• /
• pp.9949-9953
• /
• 2014

Objective: To evaluate the long term results among patients with soft tissue sarcoma of the thoracic wall. Materials and Methods: Twenty-six patients who were treated with pre-or postoperative radiotherapy between December 1980-December 2007, with a diagnosis of soft tissue sarcoma of the thoracic wall were retrospectively evaluated. Results: The median age was 44 years (14-85 years) and 15 of them were male. A total of 50% of patients were grade 3. The most common histologic type of tumor was undifferentiated pleomorphic sarcoma (26.9%). Tumor size varied between 2-25 cm (median 6.5 cm). Seventeen of the cases had marginal and 9 had wide local resection. Four cases received preoperative radiotherapy and 22 postoperative radiotherapy. Six of the patients with large and high grade tumors received chemotherapy. Median follow-up time was 82 months (9-309 months). Local recurrence and metastasis was detected in 34.6% and 42.3% of patients, respectively. Five-year local control (LC), disease-free survival (DFS), overall survival (OS), and disease-specific survival (DSS) were 62%, 38%, 69%, and 76% respectively. On univariate analysis, the patients with positive surgical margins had a markedly lower 5-year LC rate than patients with negative surgical margin, but the difference was not significant (43% vs 78%, p=0.1). Five-year DFS (66% vs 17%) and DSS (92% vs 60%) rates were significantly worse for the patients who had high grade tumors (p=0.01, p=0.008 respectively). Conclusions: Tumor grade and surgical margin are essential parameters for determining the prognosis of thoracic wall soft tissue sarcoma both in our series and the literature.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.41
• /
• pp.43.1-43.5
• /
• 2019

Background: Reconstructive surgery is often required for tumors of the oral and maxillofacial region, irrespective of whether they are benign or malignant, the area involved, and the tumor size. Recently, three-dimensional (3D) models are increasingly used in reconstructive surgery. However, these models have rarely been adapted for the fabrication of custom-made reconstruction materials. In this report, we present a case of maxillary reconstruction using a laboratory-engineered, custom-made mesh plate from a 3D model. Case presentation: The patient was a 56-year-old female, who had undergone maxillary resection in 2011 for intraoral squamous cell carcinoma that presented as a swelling of the anterior maxillary gingiva. Five years later, there was no recurrence of the malignant tumor and a maxillary reconstruction was planned. Computed tomography (CT) revealed a large bony defect in the dental-alveolar area of the anterior maxilla. Using the CT data, a 3D model of the maxilla was prepared, and the site of reconstruction determined. A custom-made mesh plate was fabricated using the 3D model (Okada Medical Supply, Tokyo, Japan). We performed the reconstruction using the custom-made titanium mesh plate and the particulate cancellous bone and marrow graft from her iliac bone. We employed the tunneling flap technique without alveolar crest incision, to prevent surgical wound dehiscence, mesh exposure, and alveolar bone loss. Ten months later, three dental implants were inserted in the graft. Before the final crown setting, we performed a gingivoplasty with palate mucosal graft. The patient has expressed total satisfaction with both the functional and esthetic outcomes of the procedure. Conclusion: We have successfully performed a maxillary and dental reconstruction using a custom-made, pre-bent titanium mesh plate.