• Asian Pacific Journal of Cancer Prevention
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• 제13권6호
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• pp.2639-2642
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• 2012

Background: The patterns of gastric cancer recurrence vary across societies. We designed the current study in an attempt to evaluate and reveal the outbreak of the recurrence patterns of gastric cancer and also prediction of time to recurrence and its effected factors in Iran. Materials and Methods: This research was performed from March 2003 to February 2007. Demographic characteristics, clinical and pathological diagnosis and classification including pathologic stage, tumor grade, tumor site and tumor size in of patients with GC recurrent were collected from patients' data files. To evaluate of factors affected on the relapse of the GC patients, gender, age at diagnosis, treatment type and Hgb were included in the research. Data were analyzed using Kaplan-Meier and logistic regression models. Results: After treatment, 82 patients suffered recurrence, 42, 33 and 17 by the ends of first, second and third years. The mean ( SD) and median ( IQR) time to recurrence in patients with GC were 25.5 (20.6-30.1) and 21.5 (15.6-27.1) months, respectively. The results of multivariate analysis logistic regression showed that only pathologic stage, tumor grade and tumor site significantly affected the recurrence. Conclusions: We found that pathologic stage, tumor grade and tumor site significantly affect on the recurrence of GC which has a high positive prognostic value and might be functional for better follow-up and selecting the patients at risk. We also showed time to recurrence to be an important factor for follow-up of patients.

• Journal of Korean Neurosurgical Society
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• 제60권6호
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• pp.661-666
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• 2017

Objective : Atypical meningioma is rare tumor and there is no accurate guide line for optimal treatment. This retrospective study analyzed the prognostic factors, the effect of different methods of treatments and the behavior of atypical meningioma. Methods : Thirty six patients were diagnosed as atypical meningioma, among 273 patients who were given a diagnosis of meningioma in the period of 2002 to 2015. Age, gender, tumor location, Ki 67, Simpson grade and treatment received were analyzed. We studied the correlation between these factors with recurrence, overall survival rate and progression free survival. Results : Median overall survival time and progression free survival time are 60 and 53 (months). Better survival rate was observed for patients less than 50 years old but with no statistical significance (p=0.322). And patients with total resection compared with subtotal resection also showed better survival rate but no statistical significance (p=0.744). Patients with a tumor located in skull base compared with patients with a tumor located in brain convexity and parasagittal showed better progression free survival (p=0.048). Total resection is associated with longer progression-free survival than incomplete resection (p=0.018). Conclusion : We confirmed that Simpson grade was significant factor for statistically affect to progression free survival in univariate analysis. In case of skull base atypical tumor, it is analyzed that it has more recurrence than tumor located elsewhere. Overall survival was not affected statistically by patient age, gender, tumor location, Ki 67, Simpson grade and treatment received in this study.

• Brain Tumor Research and Treatment
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• 제6권2호
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• pp.47-53
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• 2018

Brain tumors represent a diverse spectrum of histology, biology, prognosis, and treatment options. Although MRI remains the gold standard for morphological tumor characterization, positron emission tomography (PET) can play a critical role in evaluating disease status. This article focuses on the use of PET with radiolabeled glucose and amino acid analogs to aid in the diagnosis of tumors and differentiate between recurrent tumors and radiation necrosis. The most widely used tracer is $^{18}F$-fluorodeoxyglucose (FDG). Although the intensity of FDG uptake is clearly associated with tumor grade, the exact role of FDG PET imaging remains debatable. Additionally, high uptake of FDG in normal grey matter limits its use in some low-grade tumors that may not be visualized. Because of their potential to overcome the limitation of FDG PET of brain tumors, $^{11}C$-methionine and $^{18}F$-3,4-dihydroxyphenylalanine (FDOPA) have been proposed. Low accumulation of amino acid tracers in normal brains allows the detection of low-grade gliomas and facilitates more precise tumor delineation. These amino acid tracers have higher sensitivity and specificity for detecting brain tumors and differentiating recurrent tumors from post-therapeutic changes. FDG and amino acid tracers may be complementary, and both may be required for assessment of an individual patient. Additional tracers for brain tumor imaging are currently under development. Combinations of different tracers might provide more in-depth information about tumor characteristics, and current limitations may thus be overcome in the near future. PET with various tracers including FDG, $^{11}C$-methionine, and FDOPA has improved the management of patients with brain tumors. To evaluate the exact value of PET, however, additional prospective large sample studies are needed.

• 한국수의병리학회:학술대회논문집
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• 한국수의병리학회 2003년도 추계학술대회초록집
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• pp.54-54
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• 2003

Malignant fibrous histiocytomas (MFHs) is the most common type of soft tissue sarcoma in the old animal with a aggressiveness, a high local recurrence rate and significant metastatic rate, which associated with a poor prognosis. In most histologic and immunohistological studies, the tumor cells raised from a fibroblastic and/or myofibroblastic phenotype, presumably from undifferentiated mesenchymal cell origin. MFHs are usually firm and invasive, arising in the subcutis; metastasis depends on tumor grade (many are grade 3) [1,2]. The primary tumor cells are pleomorphic, varying in appearance from fusiform to round. Often nucleoli are prominent and irregular [5]. Extracellular amorphous eosinophilic material may be prominent and likely represents reactive collagen production by the tumor [5]. (omitted)

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3945-3951
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• 2016

Background: Whether concurrent chemotherapy treatment is superior to radiotherapy alone as an adjuvant regimen for postoperative cervical carcinoma with risk factors remains controversial. Materials and Methods: A literature search strategy examined Pubmed, Embase, the Cochrane Library, the China National Knowledge Internet Web, the Chinese Biomedical Database and the Wanfang Database. Article reference lists and scientific meeting abstracts were also screened. Controlled trials comparing concurrent chemoradiotherapy versus radiotherapy alone in postoperative cervical cancer were included. The methodological quality of non-randomized controlled trials was evaluated using the Newcastle-Ottawa Scale. Randomized controlled studies were evaluated with the Cochrane handbook. A meta-analysis was performed with RevMan 5.3. Results: A total of 1,073 patients from 11 clinical trials were analysed, with 582 patients in the concurrent chemoradiotherapy group and 491 patients in the radiotherapy group. Hazard ratios (HR) of 0.47 (95% CI 0.31-0.72) and 0.50 (95% CI 0.35-0.72) were observed for overall survival and progression-free survival, indicating a benefit from the additional use of concurrent chemotherapy. Subgroup analyses demonstrated that cervical cancer with high risk factors significantly benefitted from concurrent chemotherapy when examining overall survival (HR 0.44, 95% CI 0.28-0.67) and progression-free survival (HR 0.48, 95% CI 0.33-0.70), but patients with intermediate risk factors showed no benefit from concurrent chemotherapy in overall survival (HR 1.72, 95% CI 0.28-10.41) and progression-free survival (HR 1.09, 95% CI 0.19-6.14). No significant differences were observed for grade 3-4 anaemia (risk ratio (RR) 3.87, 95% CI 0.69-21.84), grade 3-4 thrombocytopenia (RR 3.04, 95% CI 0.88-10.58), grade 3-4 vomiting or nausea (RR 1.71, 95% CI 0.27-10.96), or grade 3-4 diarrhoea (RR 1.40, 95% CI 0.69-2.83). Significant differences were observed for grade 3-4 neutropenia in favour of the radiotherapy group (RR 7.23, 95% CI 3.94-13.26). Conclusions: In conclusion, concurrent chemoradiotherapy improves survival in postoperative cervical cancer with high risk factors but not in those with intermediate risk factors.

• 대한골관절종양학회지
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• 제16권2호
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• pp.51-54
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• 2010

목적: 골 거대세포종 환자들의 치료결과 및 재발률을 평가하여 보고하고자 하였다. 대상 및 방법: 1980년 3월부터 2008년 12월까지 본원에서 치료 받은 거대세포종 환자 중 최소 12개월 이상 추적관찰이 가능하였던 54예에 대하여 후향적으로 조사하였다. 54예 중 남자 27예, 여자 27예로 평균 나이는 33.1세(13-67세)였다. 평균 추시 기간은 67개월(12-104개월)이었다. 결과: 54예 중 21예(38.9%)에서 국소재발이 발생하였으며 술 후 재발까지의 기간은 평균 21.5개월이었다. 국소재발에 통계적으로 유의한 영향을 가진 인자로는 해부학적 위치와 임상적 병기로 하지에서 상지보다 낮은 재발률을 보였으며(p=0.032), Campanacci 분류 grade I이 grade II와 grade III보다 재발률이 낮았다. 소파술 후 골시멘트 충진을 시행한 군(28예)과 동종골 이식을 시행한 군(18예) 사이에도 국소 재발률에 대해 통계적으로 유의한 차이를 보이지 않았고, 소파술 후 국소 보조요법으로 냉동을 시행한 군과 시행하지 않은 군에서도 통계적 유의성은 없었다. 결론: 골 거대세포종의 국소 재발을 방지하기 위해서는 종양세포의 철저한 제거가 여러 부가적인 처치보다 더 중요하다고 판단된다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권2호
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• pp.519-522
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• 2015

Background: We aimed to investigate whether the tumor free distance (the distance between the uterine serosa and the tumor at its deepest point) is useful in surgical staging and in predicting prognosis. Materials and Methods: Data from patients who underwent complete surgical staging for endometrial cancer between January 2006 and June 2011 were reviewed retrospectively. All demographic findings, surgical stages, histological type and grade, myometrial invasion, lymphovascular space invasion as well as abdominal cytology, cervical, adnexal, and omental involvement, and lymph node metastasis were recorded. The relations between myometrial invasion and tumor free distance from uterine serosa with prognostic factors were investigated. Results: Seventy patients were included in the study. Sixty-four (91.5%) had endometrioid type cancers and forty-four (62.9%) were grade 1. The deepest myometrial invasion was less than 1/2 in 42 patients (60%). In 18 patients (25.8%) lymphovascular invasion was noted. Eight (11.4%) were found to have cervical involvement, five (7.1%) had adnexal involvement and in 4 cases (5.7%) the peritoneal washings included malignant cells. Four patients had pelvic and one para-aortic node metastasis. We recognized that an invasion of more than 1/2 was correlated significantly with lymphovascular space involvement, histological grade, positive abdominal washing cytology, nodal and cervical involvement, but not with adnexal involvement. Tumor-free myometrial thickness was negative and statistically significant correlated with surgical stage, histological grade, lymphovascular space involvement, positive abdominal washing cytology, cervical and adnexal involvement. The importance of tumor-free myometrial thickness in determinating the lymphovascular space invasion was found to be highest in terms of sensitivity and specificity when crossing the ROC curve at 11 millimeters. Conclusions: Depth of myometrial invasion is more valuable for predicting lymph node metastasis than tumor-free myometrial thickness. The tumor-free myometrial thickness provides a better prediction for adnexal involvement.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7463-7466
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• 2015

Aims: To analyse the predictors of recurrence, disease free survival and overall survival in cases with endometrial cancer. Materials and Methods: A total of 152 women diagnosed with endometrial cancer were screened using a prospectively collected database including age, smoking history, menopausal status, body mass index, CA125, systemic disorders, tumor histology, tumor grade, lymphovascular space invasion, tumor diameter, cervical involvement, myometrial invasion, adnexal metastases, positive cytology, serosal involvement, other pelvic metastases, type of surgery, fertility sparing approach to assess their ability to predict recurrence, disease free survival and overall survival. Results: In ROC analyses tumor diameter was a significant predictor of recurrence (AUC:0.771, P<0.001). The optimal cut off value was 3.75 with 82% sensitivity and 63% specificity. In correlation analyses tumor grade (r=0.267, p=0.001), tumor diameter (r=0.297, p<0.001) and the serosal involvement (r=0.464, p<0.001) were found to significantly correlate with the recurrence. In Cox regression analyses when some different combinations of variables included in the model which are found to be significantly associated with the presence of recurrence, tumor diameter was found to be a significant confounder for disease free survival (OR=1.2(95 CI,1.016-1.394, P=0.031). On Cox regression for overall survival only serosal involvement was found to be a significant predictor (OR=20.8 (95 % CI 2.4-179.2, P=0.006). In univariate analysis of tumor diameter > 3.75 cm and the recurrence, there was 14 (21.9 %) cases with recurrence in group with high tumor diameter where as only 3 (3.4 %) cases group with smaller tumor size (Odds ratio:7.9 (95 %CI 2.2-28.9, p<0.001). Conclusions: Although most of the significantly correlated variables are part of the FIGO staging, tumor diameter was also found to be predictor for recurrence with higher values than generally accepted.

• Tuberculosis and Respiratory Diseases
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• 제45권2호
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• pp.311-321
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• 1998

연구배경: 기관지 점액상피암은 기관지의 점액선세포에서 기인한 악성 종양으로 세포들의 구성비와 mitosis정도에 따라 저등급 몇 고등급 종양으로 구분되며 저등급의 종양은 예후가 양호한 반면 고등급의 종양은 선종편평상피암과 조직학적으로 감별이 어렵고 악성 임상경과를 보인다. 기관지 점액상피암은 폐종양의 0.1~0.2%, 그리고 기관지선종의 1~5%를 차지한다고 알려져 있으나 국내에는 소수의 증례보고만 있었다. 저자들은 문헌으로 확인된 예를 포함하여 경북대학교 병원에서 기관 및 기관지 정액상피암으로 진단된 예에 대하여 임상고찰을 하였다. 방 법: 1990년 1월부터 1996년 12월까지 점액상피암으로 진단받았던 9예와 국내에 보고된 증례가운데 문헌으로 확인할 수 있었던 8예를 포함한 17예를 대상으로 임상상, 방사선 및 기관지내시경소견, 그리고 조직학적소견과 임상경과 등을 후향적으로 분석하였다. 결 과: 남자 12예와 여자 5예였으며, 평균나이는 42 세였다. 흡연력은 17예 가운데 5예에서 있었으며 평균 흡연력은 11인년이었다. 내원당시 주요 증상은 호흡곤란 9예, 기침 7예, 객혈 6예, 자각적 천명음 3예였으며, 증상이 없는 경우가 2 예였다. 단순 흉부 X-선 사진상 폐허탈소견이 8예, 종괴양 음영 5예, 폐렴양침윤소견이 2예, 다발성결절소견이 1예였으며. 1예는 정상이었다. 17예 가운데 16예는 중심형으로 발생부위는 좌주기관지가 5예, 우주기관지가 4예, 우중엽기관지가 2예였고, 그외 기관, 우중간간기관지, 우상엽기관지 및 좌상엽기관지가 각각 1예였으며, 1예는 양측 기관지에 병변이 있었다. 중심형 16예의 기관지 내시경소견은 외장형 종과 12예와 결절성 침윤소견 4 예였다. 우폐하야에 위치한 말초형 1예는 정상기관지 내시경소견이었다. 조직소견상 10예가 저등급이었고 7예는 고등급이었다. 10예의 저등급가운데 9예는 수술을 시행하였으며 종양이 상부기관에 있었던 l예는 레이저요법 및 방사선치료를 받았으나 사망하였다. 고등급암종 7예의 경우 2예는 전폐절제술을 시행하였고 종격동임파절, 심낭 및 흉막의 전이가 있었던 4 예와 폐결핵이 동반되어 전신상태가 불량하였던 1예는 항암화학요법과 방사선요법 또는 보존적치료를 하였다. 결 론: 점액상피암은 다양한 연령층에서 발생하고 대부분 중심기도에 위치하여 기도 자극증상과 함께 폐허탈, 종괴양음영 및 폐쇄성폐렴 등과 같은 방사선소견을 보인다. 병리조직학적인 등급과 주위장기로의 전이유무 등이 치료 및 예후판정에 있어 중요하다.

• 대한골관절종양학회지
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• 제15권2호
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• pp.171-177
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• 2009

저등급 골육종은 전형적 골육종에 비해 발생 빈도가 훨씬 드물고, 호발 연령도 전형적 골육종에 비해 높은 것으로 나타나 있다. 본 교실에서는 12세 여아에서 좌측 경골, 대퇴골 경부 및 간부, 그리고 좌측 비구에 발생한 다발성 저급성 골육종 1예를 경험하였다. 본 증례는 예외적으로 소아에 발생하였고, 그리고 다발성 소견을 나타내어 동시성(synchronous) 혹은 이시성(metachronous) 전이의 양상을 띠고 있었다. 더욱이 저급성 골육종은 일반적으로 느린 성장 과정을 보이기 때문에, 본 증례에서 보이는 전이의 양상에 대해서는 희귀하여 문헌고찰과 함께 보고하는 바이다.