• 제목/요약/키워드: disease stage

검색결과 2,600건 처리시간 0.029초

Midline Involvement as a Risk Factor for Vulvar Cancer Recurrence

  • Stankevica, Jekaterina;Macuks, Ronalds;Baidekalna, Ieva;Donina, Simona
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권10호
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    • pp.5237-5240
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    • 2012
  • Objective: This observational study was to identify risk factors for vulvar cancer recurrence. Materials and Methods: In the study 107 patients with primary vulvar cancer were analyzed. Surgical treatment consisted of radical excision of the primary tumor in combination with unilateral or bilateral superficial and deep inguinofemoral lymphadenectomy through separate incisions. Patients with deeper tumor invasion >1 mm or wider than 2 cm and/or groin lymphnode metastases were referred for adjuvant radiotherapy. Those with large privary vulvar tumors received neoadjuvant radiotherapy of 30Gy followed by surgical treatment and adjuvant radiotherapy. Results: Most of patients had only primary radiotherapy to the vulva and inguinal lymph nodes and only 34.5% of patients were eligible for surgical treatment. In 5 year follow-up period 25.2% (27) patients were alive without the disease, 15.0% (16) were alive with the disease and 59.8% (64) were dead. 60.7% (65) patients experienced local recurrence and 2.8% (3) patients had distant metastases. Median survival for patients without recurrent disease was $38.9{\pm}3.2$ months and $36.0{\pm}2.6$ months with no statistically significant difference. Patients with early stage vulvar cancer had longer mean survival rates-for stage I $53.1{\pm}3.4$ months, $38.4{\pm}4.4$ months for stage II and $33.4{\pm}2.6$ and $15.6{\pm}5.2$ months for patients with stage III and stage IV vulvar cancer, respectively. The only signifficant prognostic factor predicting vulvar cancer recurrence was involvement of the midline. Conclusions: Patients having midline involvement of vulvar cancer has lower recurrence risk, probably because of receiving more aggressive treatment. There is a tendency for lower vulvar cancer recurrence risk for patients over 70 years of age and patients who are receiving radiotherapy as an only treatment without surgery, but tendency for higher risk of recurrence in patients with multifocal vulvar cancer.

Treatment Outcome for Nasopharyngeal Carcinoma in University Malaya Medical Centre from 2004-2008

  • Ee Phua, Vincent Chee;Loo, Wei Hoong;Yusof, Mastura Md;Ishak, Wan Zamaniah Wan;Tho, Lye Mun;Ung, Ngie Min
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권8호
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    • pp.4567-4570
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    • 2013
  • Background: Nasopharyngeal carcinoma (NPC) is the commonest radiocurable cancer in Malaysia. This study aimed to determine the treatment outcomes and late effects of radiotherapy for NPC patients treated in University Malaya Medical Centre (UMMC). Materials and Methods: All newly diagnosed patients with NPC referred for treatment to the Oncology unit at UMMC from 2004-2008 were retrospectively analyzed. Treatment outcomes were 5 years overall survival (OS), disease free survival (DFS), cause-specific survival (CSS), locoregional control (LRC) and radiotherapy-related late effects. The Kaplan-Meier method was used for survival analysis and differences in survival according to AJCC stage was compared using the log-rank test. Results: A total of 176 patients with newly diagnosed NPC were treated in UMMC during this period. Late presentation was common, with 33.5% presenting with T3-4 disease, 84.7% with N1-3 disease and 75.6% with AJCC stage 3-4 disease. Radical RT was given to 162 patients with 22.7% having RT alone and 69.3% having CCRT. The stipulated OTT was 7 weeks and 72.2% managed to complete their RT within this time period. Neoadjuvant chemotherapy was given to 14.8% while adjuvant chemotherapy was administered to 16.5%. The 5 years OS was 51.6% with a median follow up of 58 months. The 5 years OS according to stage were 81.8% for stage I, 77.9% for stage II, 47.4% for stage III and 25.9% for stage IV. The 5 years overall CSS, DFS and LRC were 54.4%, 48.4% and 70.6%, respectively. RT related late effects were documented in 80.2%. The commonest was xerostomia (66.7%). Other documented late effects were hearing deficit (17.3%), visual deficit (3.1%), neck stiffness (3.1%), dysphagia (3.4%), cranial nerve palsy (2.5%), pneumonitis (0.6%) and hypothyroidism (1.2%). Conclusions: The 5 years OS and LRC in this study are low compared to the latest studies especially those utilizing IMRT. Implementation of IMRT for NPC treatment should be strongly encouraged.

I, II기 악성 림프종 환자의 방사선 치료 성적 (Result of Radiation Therapy for Stage I, II Non-Hodgkin's Lymphoma)

  • 이규찬;김철용;최명선
    • Radiation Oncology Journal
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    • 제11권1호
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    • pp.159-166
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    • 1993
  • A retrospective analysis was done for 69 patients with Stage I and II non-Hodgkin's lymphoma who were treated from May 1981 to December 1990, in the Department of Radiadtion Oncology, Korea University Hospital. We used Ann Arbor Staging system and Working Formulation for histological classification. Forty-three patients (43/69, $62.3{\%}$) were Stage I and 26 patients (26/69, $37.7{\%}$) were Stage II, and B symptom was found in $10.1{\%}$ (7/69). Nodal lymphoma was $21.7{\%}$ (15/69); 14 patients with supradiaphragmatic disease and 1 patient with infradiaphragmatic disease. Extranodal lymphoma was $78.3{\%}$ (54/69): $64.8{\%}$ (35/54) for head and neck, $25.9{\%}$ (14/54) for gastrointestinal tract. Histologically, low grade consists of $8.7{\%}$ (6/69), intermediate grade $84.2{\%}$ (56/69), high grade $10.1{\%}$ (7/69), and diffuse large cell type was the most frequent form with 36 patients (36/69, $52.2{\%}$). Eighteen patients ($26.1{\%}$) were treated with radiation therapy alone,20 patients ($29.0{\%}$) with radiation therapy combined with chemotherapy, 15 patients ($21.7{\%}$) with radiation therapy combined with surgery and chemotherapy, Median survival duration was 28 months, and the range of survival time was from 1 month to 134 months. Overall five-year survival rate for Stage I and II disease was $54.2{\%}$, with $64.5{\%}$ for Stage I and $37.1{\%}$ for Stage II. For nodal lymphoma,5-year survival rate was $45.9{\%}$, and $56.5{\%}$ for extranodal lymphoma; $60.6{\%}$ for head and neck, $52.9{\%}$ for GI tract primary disease. Local control rate for all patients was $88.4{\%}$ (61/69), with $80{\%}$ (12/15) for nodal lymphoma and $90.7{\%}$ (49/54) for extranodal lymphoma. The total failure rate was $34.8{\%}$ (24/69). Five of 24 ($20.8{\%}$) patients who were failed developed local failure only, $12.5{\%}$ (3/24) local failure with distant failure, and distant failure only were found in $66.7{\%}$ (16/24). Between nodal lymphoma and extranodal lymphoma, there was no significant survival difference, but extranodal lymphoma showed higher incidence.

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특발성 파킨슨병 환자의 임상척도에 따른 심박변이도의 변화에 대한 연구 (Clinical Study of Heart Rate Variability on Patients with Idiopathic Parkinson's Disease according to Clinical Scale(Hoehn-Yahr stage, UPDRS))

  • 박상민;이상훈;정지철;김건형;박히준;임사비나;장대일;이윤호
    • Journal of Acupuncture Research
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    • 제22권3호
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    • pp.137-144
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    • 2005
  • 본 저자는 2004년 3월 9일부터 2004년 5월15일까지 경희의료원 침구과 외래를 내원한 특발성 파킨슨병 환자를 대상으로 하여 파킨슨병 증상의 호전도를 판단하는 임상척도인 H-Y stage에 따른 HRV를 관찰한 결과 다음과 같은 결론을 얻었다. 1. 시간영역분석에서 H-Y stage I, II, III 그룹의 SDNN은 $28.21{\pm}10.10$, $22.25{\pm}11.26$, $14.57{\pm}5.31$으로 그룹 I과 그룹III 간에는 유의한 차이가 있었다(P<0.05). RMS-SD는 $19.23{\pm}13.27$, $14.63{\pm}6.44$, $6.44{\pm}2.32$ 으로 역시 그룹 I과 그룹III 간에는 유의한 차이가 있었 다(p<0.05). 2. 주파수영역분석에서 TP는 H-Y stage Ⅰ, II, III 그룹에서 각각 $499.86{\pm}345.45$, $243.72{\pm}212.22$, $99.44{\pm}51.01$로 ANOYA 검정결과 p-value가 0.007로 매우 유의 있었으며, 사후 검정에서는 그룹 I과 II, 그룹 II와 III에서는 유의한 차이가 없었으나 그룹 I과 III에서는 매우 유의한 차이가 있었다(p<0.01). LF는 H-Y stage I과 III 그룹에서 유의한 차이가 있었으나(p<0.05) VLF, HF, LF norm HF nonm LF norm, LF/HF ratio에서는 각 그룹 간 유의한 차이가 없었다. 3. SDNN, RMS-SD, TP가 UPDRS 총점이 증가함에 따라 유의성 있게 감소하는 경향 (p<0.05)을 보이는 것으로 보아 파킨슨병이 진행함에 따라 자율신경계의 활동성이 저하될 것으로 보인다.

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Survival Analysis of Oral Squamous Cell Carcinoma in a Subgroup of Young Patients

  • Fan, Yi;Zheng, Lei;Mao, Ming-Hui;Huang, Ming-Wei;Liu, Shu-Ming;Zhang, Jie;Li, Sheng-Lin;Zheng, Lei;Zhang, Jian-Guo
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권20호
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    • pp.8887-8891
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    • 2014
  • Oral squamous cell carcinoma (OSCC) is predominantly a disease of middle-aged men with long-term exposure to tobacco and alcohol. An increasing trend has been reported at a younger age worldwide. Clinical records of 100 patients under the age of 45 years treated specifically for oral cavity SCC in our hospital during a 10-year period were retrospectively analyzed to calculate the survival rates. An obvious male predominance coincided with smoking trend among Chinese young individuals and female patients were more likely to have no traditional risk factors such as smoking or drinking. The 5-year overall survival rate and disease-free survival rate were 61.0% and 75.5%, respectively, consistent with other published series over the decade showing a relatively better survival among the young. No significant differences clearly correlated with outcome when comparing non-smokers non-drinkers to ever-smokers and ever drinkers (P>0.05). Overall survival rate and disease free survival rate was found to be significantly higher in patients with early-stage disease than with advanced stage disease (P=0.001, P=0.009 respectively). The strong influence of clinical stage on prognosis emphasizes the importance of early diagnosis and treatment of oral malignancies for this unique clinical subgroup.

Freiberg병에서 시행한 Weil 절골술 (Weil Osteotomy for Freiberg's Disease)

  • 이화성;권순용;김동욱;정진화
    • 대한족부족관절학회지
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    • 제15권4호
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    • pp.217-222
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    • 2011
  • Purpose: The aim of this study was to evaluate the result of combined Weil and dorsal closing wedge osteotomy for Freiberg's disease. Materials and Methods: We performed combined Weil and dorsal closing wedge osteotomy of the second metatarsal under the diagnosis of Freiberg's disease in 7 patients, 7 feet (2 male and 5 female). The mean age at the time of operation was 29 years and the mean follow-up period was 31 months. Patients had no trauma history and no combined deformity of the foot. The surgical results were evaluated by VAS and weight bearing radiographs in antero-posterior and oblique projection. Results: According to Smillie staging system, there were 1 of stage II, 2 of stage III and 4 of stage IV patients. The osteotomy site was united at 8 weeks and the second metatarsal was shortened in length of average 2.8 mm. Remodeling of the metatarsal head was observed at 24 months. The mean VAS was decreased from 8.2 points preoperatively to 2.7 points at follow-up. And average range of motion of second metatarso-phalangeal joint was increased from 30o preoperatively to 45o at follow-up. There was no transfer metatarsalgia or arthritis of the metatarsal head during follow-up. Conclusion: Combined Weil and dorsal closing wedge osteotomy of the metatarsal appears to be an effective procedure for the treatment of Freiberg's disease with a view to shortening of metatarsal length and elevation of metatarsal head.

비소세포성 폐암환자에서의 Docetaxel과 Cisplatin의 복합요법에 대한 효과 (Effects of the Combination Chemotherapy of Docetaxel and Cisplatin in Non-Small Cell Lung Cancer Patients)

  • 방은숙;오정미
    • 한국임상약학회지
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    • 제12권1호
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    • pp.1-6
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    • 2002
  • Central Cancer Registry of Korean National Cancer Center in 1999 reported that mortality from lung cancer is higher than mortality from stomach cancer or hepatocellular carcinoma in Korean male. Lung cancer is classified into small cell cancer and non-small cell lung cancer (NSCLC), and NSCLC patients account for $70\%$ of the whole lung cancer patients. The purpose of this study was to evaluate the efficacy and toxicity of docetaxel and cisplatin combination in Korean patients with NSCLC. All patients who had received the combination therapy of docetaxel and cisplatin for histologically confirmed NSCLC in Ajou University Hospital between 2000. $2\~2001$. 4 were retrospectively evaluated for the responses and toxicities of that combination therapy. Nineteen patients were treated with docetaxel 75 $mg/m^2$ on Day 1 and cisplatin 25 $mg/m^2$ on Day 1-3 every 4 weeks. The response for combination regimen was evaluated by CT scans after 2 or 3 cycles of treatments. Seventeen patients were evaluated for the responses and the 19 patients far the toxicities. Among the 19 patients (14 men and 5 women), there were one patient $(5.3\%)$ with stage I disease, 4 patients $(21.1\%)$ with stage III disease, and 14 patients $(73.1\%)$ with stage IV disease. Of the 17 patients who were evaluable for response, complete response (CR) was not observed in any patient while partial response (PR) was observed in 5 patients $(29.4\%)$. The overall response rate (CR+PR) was $29.4\%$. Stable disease (SD) was observed in 11 patients $(64.7\%)$ and progressive disease (PD) in 1 patient $(5.9\%)$. The toxicities were graded by NCI (National Cancer Institute) Common Toxicity Criteria for the evaluable 70 cycles. Grade 3 or 4 neutropenia occurred in 53 cycles $(76\%)$. Four patients were hospitalized due to febrile neutropenia. The combination chemotherapy of docetaxel and cisplatin was effective as NSCLC treatments, however, the regimen must be administered carefully due to its hematological side effects.

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무주 수왕광산에서 산출되는 섬아연석의 황동석 병변에 관한 연구 (Chalcopyrite Disease in Sphalerite: A Case of the Soowang Ore Deposits in Muju, Republic of Korea)

  • 윤석태
    • 한국지구과학회지
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    • 제29권7호
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    • pp.551-558
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    • 2008
  • 수왕광상은 중생대 백악기 중기의 반상화강암이나 선캄브리아기의 소백산 편마암 복합체에 발달한 열극을 충진한 석영맥에서 산출된다. 광물 공생군에 대한 연구 결과 광화작용은 4차례에 걸쳐 일어났다. 섬아연석은 광화작용이 진행되는 동안 광화 I, II, III기에 각각 정출하였다. 현미경 관찰과 전자현미분석 결과 섬아연석에서 나타나는 황동석 점적과 황동석 병변은 광화 III기 초에 열수용액의 교대작용에 의하여 생성되었을 것으로 생각된다. 황동석 병변의 생성과정은 아래와 같다. (1) Fe가 풍부한 용액이 Fe가 결핍된 섬아연석의 가장자리나 틈을 통해 Fe부화 (2)광화 II기에 Fe가 결핍된 섬아연석에 황동석 점적을 형성하고 Cu를 함유한 용액에 의해 황동석 점적 주변의 섬아연석에 Fe 감소 (3)광화 III기 초에 황동석 병변을 형성하였다.

Fecal Calprotectin Assay at an Early Stage of Treatment Can Be Used as a Surrogate Marker to Predict Clinical Remission and Mucosal Healing in Pediatric Crohn's Disease

  • Lee, Yeoun Joo;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제25권5호
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    • pp.396-405
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    • 2022
  • Purpose: This study evaluated the predictive role of fecal calprotectin (FC) measured at an early stage of treatment for monitoring clinical remission (CR) after six months and endoscopic remission (ER) after one year of treatment in pediatric Crohn's disease (CD). Methods: This retrospective study included 45 patients who simultaneously underwent ileocolonoscopy and FC testing during follow-up. FC levels were measured before and after six weeks of treatment. CR was assessed after six months of treatment using Pediatric Crohn' s Disease Activity Index and acute-phase reactants. ER was assessed after one year using the Simple Endoscopic Score for Crohn's Disease. Results: Twenty-nine (64.4%) patients used oral prednisolone for remission induction and 16 (35.6%) patients used anti-tumor necrosis factor-alpha. Thirty (66.7%) patients achieved CR, while 24 (53.3%) achieved ER. The FC level measured after six weeks of treatment could predict CR (χ2=9.15, p=0.0025) and ER (χ2=12.31, p=0.0004). The δFC could predict CR (χ2=7.91, p=0.0049), but not ER (χ2=1.85, p=0.1738). With a threshold of ≤950.4 ㎍/g, FC at week six could predict CR with 76.7% sensitivity and 73.3% specificity. The area under the curve (AUC) was 0.769 (standard error 0.0773, p=0.0005). The same threshold predicted ER with 87.5% sensitivity and 71.4% specificity. The AUC was 0.774 (standard error 0.074, p=0.0002). Conclusion: FC assay at an early stage of treatment can be used as a surrogate marker to predict CR and mucosal healing in pediatric CD.

A retrospective study of age-specific disease incidence in major popular breed dogs in Republic of Korea

  • Seung-Won Yi;Sang-Ik Oh;Yoon Jung Do;Jae Gyu Yoo;Eunju Kim
    • 대한수의학회지
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    • 제63권4호
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    • pp.34.1-34.9
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    • 2023
  • Dogs exhibit patterns of health issues that vary by life stage. An understanding of disease incidence with respect to breed and age/life stage could be an important component of canine health management and welfare. This study aimed to describe the age-specific disease incidence of 3 small dog breeds that attended veterinary clinics in the Republic of Korea, based on data from electronic veterinary medical records (EVMRs). A total of 40,785 EVMRs from Maltese (n = 21,355), Miniature Poodle (n = 11,658) and Shih Tzu dogs (n = 7,772) were analyzed. Common health problems in 3 small dog breeds were 'diseases of the skin' and 'diseases of the ear,' respectively. Among dogs aged ≤ 3 years, 'preventive medicine' was the most common cause cited for veterinary clinic visits. Among dogs aged 4 to 8 years, the most frequent health problems were 'diseases of the skin.' Among dogs aged 9 to 13 years, 'heart diseases,' 'kidney diseases,' 'mammary gland tumor,' and 'neoplasia (unspecified)' were considerably more frequent, compared to the rates in dogs ≤3 years. Among dogs aged ≥ 14 years, 'heart diseases' and 'sneezing/cough' were the main health problems. In all breeds, the frequencies of 'diseases of circulatory system,' 'diseases of respiratory system,' 'diseases of the nervous system,' 'endocrine' and 'neoplasia' increased rapidly with aging. This surveillance could inform strategies for disease screening tests and management based on life stage in these dog breeds and enable more effective health management.