• Journal of Chest Surgery
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• v.27 no.2
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• pp.140-147
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• 1994

Reconstruction of the pharynx and cervical esophagus presents a tremendous challenges to surgeons. Over the past 2 years[1990, Dec.-1993, Jun], the free jejunal graft has been performed in 17 cases in Korea Cancer Center Hospital.The indications of this procedures were almost malignant neoplasms involving neck and upper aero-digestive tract; Hypopharyngeal cancer[12 cases, including 2 recurrent cases], laryngeal cancer[2 cases], thyroid cancer[2 cases, including 1 recurrent case], cervical esophageal cancer[1 case]. There were fifteen men and two women, and the mean age was 59.6 years. The anastomosis site of jejunal artery were common carotid artery[16 cases] or external carotid artery[1 case] and that of jejunal vein were internal jegular [15 cases] or facial[1 case] and superior thyroid vein[1 case]. The length of jejunal graft was from 9 cm to 17 cm[mean 13 cm] and the mean ischemic time was 68 minutes. There was one hospital mortality which was irrelevant to procedures[variceal bleeding] and one graft failure[1/16]. Other postoperative complications were neck bleeding or hematoma[3 cases], abdominal wound infection or disruption[5 cases], anastomosis site leakage[1 case], pneumonia[2 cases], graft vein thrombosis[1 case], and food aspiration[1 case]. The function of conduit was excellent and ingestion of food was possible in nearly all cases. Postoperative adjuvant radiation therapy was also applicable without problem in 7 cases. During follow-up periods, the anastomosis site stenosis developed in four patients, and the tracheal stoma was narrowed in one case but easily overcome with dilation. In conclusion, we think that the free jejunal graft is one of the excellent reconstruction methods of upper digestive tract, especially after radical resection of malignant neoplasm in neck with a high success rate and low mortality and morbidity rate.

• Journal of Chest Surgery
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• v.34 no.12
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• pp.930-936
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• 2001

Background: The origin site of carcinoma invading esophagogastric junction is variable. It may arise from squamous cell carcinoma of low esophagus, adenocarcinoma arising from Barrett's esophagus, adenocarcinoma of gastric cardia, or extension from proximal stomach cancer. In Korea, the majority of adenocarcinoma invading esophago-gastric junction seems to arise from proximal gastric carcinoma. Material and Method: We reviewed the data of surgically-resected gastric adenocarcinoma involving esophagogastric junction in KCCH between 1988 and 1999. Result: There were 212 cases. Male to female ratio was 156 to 56. Age distribution was between 22 and 78. Variable surgical approaches including median laparotomy, laparotomy with left or right thoracotomy, left thoracotomy, and thoracoabdominal approach were used. Postoperative pathologic stages were : Stage IA-7, IB-11, Ⅱ-25, ⅢA-73, ⅢB-34, and Ⅳ-57. Curative resection was performed in 199 patients, and total gastrectomy was performed in 200 patients. There were 77.4%(164 cases) with esophageal involvement, 74.1％(157 cases) with tumor involvement in the abdominal LN, and 8%(17 cases) with mediastinal LN metastasis. Operative mortality was 3.3%, and over-all 5 year survival rate was 35%. Conclusion: There are various surgical approaches and many things to consider for surgical resection, thoracic and abdominal approach may need for obtain proper resection margin and adequate lymph node dissection in stomach cancer invading esophagogastric junction.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8657-8660
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• 2014

Background: Yanting is one of high risk areas for esophageal cancer and the screening program was therefore initiated there. This study was aimed to investigate the dietary behaviors on the risk of esophageal squamous cell carcinoma (ESCC), among the individuals with normal and abnormal esophagus mucosa. Materials and Methods: A frequency matched case-controls study was proposed to estimate the different distribution of dietary behavior between individuals of control, esophagitis and cancer groups. Cancer cases were selected from hospitals. Esophagitis cases and controls were selected from screening population for ESCC. Health workers collected data for 1 year prior to interview, in terms of length of finishing a meal, temperature of eaten food and interval between water boiling and drinking. Chi-square, Kruskal-Wallis tests and unconditional logistic regression model were used to estimate differences and associations between groups. Results: Compared with controls, length of finishing a meal ${\geq}15mins$ was related to a reduced OR for cancer (OR=0.46, 95%CI, 0.22-0.97) and even compared with cases of esophagitis, the OR of cancer was reduced to 0.30 (95%CI, 0.13-0.72). The OR for often eating food at a high temperature was 2.48 (95%CI 1.06, 5.82) for ESCC as compared with controls. Interval between water boiling and drinking of ${\geq}10mins$ was associated with lower risk of cancer: the OR was 0.18 compared with controls and 0.49 with esophagitis cases (p<0.05). Conclusions: Length of eating food ${\geq}15mins$ and interval between water boiling and drinking ${\geq}10mins$ are potentially related to reduced risk of esophageal SCC, compared with individuals with normal and abnormal esophageal mucosa. Recommendations to Yanting residents to change their dietary behaviors should be made in order to reduce cancer risk.

• Journal of Gastric Cancer
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• v.13 no.1
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• pp.69-72
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• 2013

Carcinosarcoma is a rare malignant, biphasic tumor comprised of carcinoma and sarcoma components. In the gastrointestinal tract, carcinosarcoma is most frequently seen in the esophagus and rarely in the stomach. We report a 51-year-old female patient with 2-month-history of epigastric pain and dyspepsia. Endoscopic finding revealed a huge ulcerative lesion that infiltrated from the antrum to the mid-body. An endoscopically taken biopsy revealed poorly differentiated malignant round cell neoplasm. After the palliative subtotal gastrectomy, immunohistochemical studies showed two positive reactions for the epithelial marker and mesenchymal marker. Based on the above findings, the patient was diagnosed with gastric carcinosarcoma. The immunohistochemical analysis is a critical method in making an accurate diagnosis of carcinosarcoma.

• Journal of Hospice and Palliative Care
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• v.12 no.1
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• pp.1-4
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• 2009

The aim of palliative radiotherapy (RT) is to control cancer-related local symptoms with minimal radiation reaction. About one third of all radiation treatments are given with palliative intent. Indications for RT in symptom palliation are as follows: Pain from bone metastasis, pressure symptom from brain and spinal cord, obstruction of bronchus, esophagus, superior vena cava and malignant cancer bleeding from bronchus, urinary tract, uterine cervix and rectum. In hospice palliative care, RT is very effective for symptom palliation and improvement of quality of life without influence on survival.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.419-422
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• 2014

Background: Lymphadenopathy is a common presentation in both benign and malignant diseases which need to be diagnosed without delay. Fine needle aspiration cytology (FNAC) helps us diagnose a disease and follow its course, including the response to therapy. Aim: This study aimed to analyze the clinicopathological features of metastatic lymphadenopathy and the diagnostic utility of FNAC in our setting. Materials and Methods: This two-year prospective study included all the patients with metastatic lymphadenopathy, diagnosed with FNAC. Results: A total of 412 cases (male:female ratio, 1.3:1; age range, 3 to 90 years) were studied. Supraclavicular lymph nodes were involved most commonly (50.5%). The commonest metastatic tumor was squamous cell carcinoma in general (30.1%) and in males (37.6%), and infiltrating ductal carcinoma (25.3%) in females. Lung, with 64 (15.5%) cases followed by esophagus, 60 (14.6%) cases; breast, 49 (11.9%) cases; skin, 32 (7.8%) cases; and stomach, 25 (6.1%) cases were the most common primary sites of malignancy. In 69 patients, excision biopsy was performed. Histopathological findings correlated well with that of cytology in all these cases. Conclusions: FNAC is an important tool in the diagnostic work up of metastatic lymphadenopathy, which in the hands of an experienced and skilful cytopathologist can avoid the need for excision biopsy.

• Journal of Chest Surgery
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• v.46 no.4
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• pp.241-248
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• 2013

Esophageal cancer has one of the highest malignant potentials of any type of tumor. The 3-field lymph node dissection is the standard procedure in Japan for surgically curable esophageal cancer in the middle or upper thoracic esophagus. Minimally invasive esophagectomy is being increasingly performed in many countries, and several studies report its feasibility and curability; further, the magnifying effect of the thoracoscope is another distinct advantage. However, few studies have reported that minimally invasive esophagectomy is more beneficial than open esophagectomy. A recent meta-analysis revealed that minimally invasive esophagectomy reduces blood loss, respiratory complications, the total morbidity rate, and hospitalization duration. A randomized study reported that the pulmonary infection rate, pain score, intraoperative blood loss, hospitalization duration, and postoperative 6-week quality of life were significantly better with the minimally invasive procedure than with other procedures. In the future, sentinel lymph node mapping might play a significant role by obtaining individualized information to customize the surgical procedure for individual patients' specific needs.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.1
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• pp.57-61
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• 2010

Objective: Second primary malignancy (SPM) that occur in various period and region are important factors that deteriorate long-term survival rate in patients who recovered from oral cancer. Researches such as chemoprevention are being tried to reduce occurrence of SPMs. Only if analysis of clinical features of patients who develop SPM such as period, region and factors precedes, adequate prevention and treatment of SPM is possible. But, there are few researches about clinical features of SPMs that have primary lesion in oral cavity. In this study, we analysis that occurrence rates, regions that happen, risk factors and effect to survival rates of 2nd primary malignancies in oral cancer patients. From this survey, we willing to collect basic data for prevention and early diagnosis of SPMs. Methods: The medical records of 139 patients of oral oncology clinic of National Cancer Center who had up to 2-years follow up records after surgical or radiological treatment due to squamus cell carcinoma of oral cavity were reviewed. In these patients, survey of occurrence rate of SPMs, duration, survival rate and risk factors about occurrence of SPMs such as history of smoking, body mass index, age, sex, stage of primary lesion and history of radiologic treatment were achieved. Results: There are 15 patients who developed SPM in 139 cases. The actual occurrence rate of SPM was 10.79% and SPM were more likely to occur in male patients with 11 male Vs 4 female patients. Median age of these patient is 61.47 within 32 to 74 range. The regions that develop SPM are oral cavities (2 cases), stomach (4 cases), esophagus (2 cases), lung (2 cases) and others (1 case each breast, larynx, cervix, liver and kidney). In addition, metachronous cancers were 11 cases which happened more common than 4cases of synchronous cancers. Surveys of risk factors that relate to development of SPMs, such as sex, age, history of radiologic treatment, body mass index, history of smoking and stage of primary disease were done. Among them, factor of sex is only appear statistically significant (P=0.001), but rest are not significant in statistically. Conclusion: Occurrence rates of SPMs were reported from 10% to 20% by precede study. In this study, occurrence rate of SPMs is 10.79% that is similar to results of precede research. In comparison of 5-yr survival rates of groups that develop SPMs or not, there is statistically significance between two groups. Present treatment modalities of SPMs are surgical operation, radiotherapy, chemotherapy and combination of these modalities. In choosing the treatment modality, we must consider the first treatment modality, region of primary disease, region of SPMs and general conditions of patient. Because development of SPMs have big effect on prognosis, prevention of SPMs must regard to important objective of treatments in patients of SCCa in oral cavity.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9107-9112
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• 2014

Purpose: To investigate and study the relationship between the PLCE1 rs2274223 gene polymorphism and susceptibility to esophageal cancer by meta-analysis. Materials and Methods: The literature was searched in Wanfang, CNKI, PubMed, CBM, Web of Science, MEDLINE, EMBASE, Springer, Elsevier and Cochrane databases from the date of January $1^{st}$ 2004 to April $1^{st}$ 2014 to collect case-control studies on the PLCE1 polymorphism and susceptibility to esophageal cancer. For the population genotype distributions of both esophagus cancer and control groups, their odds ratios (ORs) and 95% confidence intervals (CIs) were taken as effect indexes. Disqualified studies were excluded. Odds ratios of PLCE1 rs2274223 genotype distributions in the group of patients with esophageal cancer and the group of healthy control were calculated. The metaanalysis software, RevMan5.0, was applied for heterogeneity test, pooled OR and 95% confidence intervals. Sensitivity analysis and publication bias were also explored. Results: A total of twelve case-control studies were included, covering a total of 9, 912 esophageal cancer cases and 13, 023 controls were included. The pooled odds ratio of PLCE1 rs2274223 genotype GA vs AA was 1.29 (95%CI=1.17~1.43), p<0.01, GG vs AA was 1.65 (95%CI=1.32~2.05), p<0.01, GG/GA vs AA was 1.30 (95%CI=1.16~1.46), p<0.01 and GG vs GA/AA was 1.48 (95%CI=1.22~1.80), p<0.01. The PLCE1 rs2274223 polymorphism was thus associated with risk of esophageal cancer in all genetic models. In the stratified analysis by ethnicity, and source of controls, no significantly increased risk was observed for white persons. There was no obvious publication bias detected. Conclusions: This meta-analysis showed there was a significantly association between PLCE1 rs2274223 polymorphism and esophageal cancer in yellow race populations. Due to some minor limitations, our findings should be confirmed in further studies.

• Journal of Ginseng Research
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• v.34 no.2
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• pp.77-88
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• 2010

Ginseng has been reported to reduce the risk of cancer in diverse organs, including the lip, oral cavity, pharynx, larynx, esophagus, lung, liver, pancreas, ovary, colon, rectum, and stomach, as demonstrated in clinical and epidemiological studies. studies, base on which findings, Panax ginseng has been classified as a "non-organ-specific cancer preventive." However, the recent keen interest in traditional medicinal herbs has been frequently questioned, about exact mode of action and the use of panaceic compounds has been a prime issue discussed in terms of complementary and alternative medicine. Several in vitro and in vivo studies have shown the mitigating effects of Korean red ginseng on Helicobacter pylori (H. pylori)-associated atrophic changes and carcinogenesis; However, evidence-based medicine, consisting of large-scale or well designed clinical studies, is still warranted whether Korean red ginseng is to be recognized as an essential therapeutic strategy regarding a "H. pylori-associated gastric cancer preventive." Specifically, comprehensive clinical trials of Korean red ginseng are needed to demonstrate that mucosal regeneration in patients with atrophic gastritis is feasible using Korean red ginseng supplements after the eradication of H. pylori infection. Ginseng is a good example of a natural herb and its ubiquitous properties may include the reduction or delay of inflammation carcinogenesis. Korean red ginseng contains ample amounts of active ginsenosides and we have demonstrated their effects in in vitro and in vivo studies with positive outcomes. In this review, the quantitative and qualitative benefits of Korean red ginseng in the treatment of H. pylori infection are described.