• 제목/요약/키워드: local recurrence

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연부조직에 발생한 평활 근육종의 임상양상 및 치료 결과 (Leiomyosarcoma of the Somatic Soft Tissue: Clinical Manifestation and Treatment Results)

  • 김용성;공창배;조완형;전대근;김경훈;송원석
    • 대한정형외과학회지
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    • 제55권5호
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    • pp.397-404
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    • 2020
  • 목적: 본 연구의 목적은 연부조직에 발생한 평활 근육종 환자의 치료 결과를 후향적으로 분석하여 생존율과 재발 및 전이의 양상 등 치료 결과를 알아보고 예후에 영향을 미치는 인자를 분석하고자 한다. 대상 및 방법: 2001년 1월부터 2017년 12월까지 본원에서 연부조직에 발생한(사지 및 체간) 평활 근육종으로 치료 받은 72명의 환자를 대상으로 하였다. 치료 후 재발, 전이 발생, 생존율 및 생존의 예후 인자를 조사하였다. 생존자 중 1년 이상 추시되지 않은 증례는 제외하였다. 평균 추시 기간은 41개월(범위, 7-163개월)이었다. 결과: 전체 환자의 5년 생존율은 73.6%, 10년 생존율은 66.2%였다. 생존율에 영향을 미치는 인자는 종양의 크기(p=0.018), 병리학적 등급(p=0.017), 국소재발(p=0.04)이었다. 전이성 병변은 72명의 환자 중 23명(31.9%)의 환자에서 발생하였으며 전이 후 사망까지의 중간값은 15.6개월(범위, 3-78개월)이었다. 결론: 연부조직에 발생하는 평활 근육종은 주로 하지에 발생하며 종양의 크기, 병리학적 등급, 국소재발이 생존율에 영향을 미치고, 전이 후 생존율은 치료에도 불구하고 불량하였다.

점액성 지방육종: 단일기관 치료 결과 (Myxoid Liposarcoma: A Single Institute Experience)

  • 조완형;송원석;한강희;전대근;공창배;남희승
    • 대한정형외과학회지
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    • 제54권5호
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    • pp.440-446
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    • 2019
  • 목적: 본 연구의 목적은 사지에 발생한 점액성 지방육종 환자의 치료 결과를 후향적으로 분석하여 생존율과 재발 및 전이의 양상 등 치료 결과를 알아보고, 예후에 영향을 미치는 인자를 분석하고자 한다. 대상 및 방법: 2001년 1월부터 2015년 12월까지 원자력병원에서 점액성 지방육종으로 치료 받은 91명의 환자(일차성 83명, 재발성 8명)를 대상으로 하였다. 치료 후 재발 및 전이 발생 및 생존율 및 생존의 예후 인자를 조사하였다. 평균 추시 기간은 84개월(범위, 5-196)개월이었다. 결과: 전체 환자의 5년 및 10년 생존율은 82%, 10년 생존율은 74%였다. 일차성 환자에서 생존율에 영향을 미치는 인자는 종양의 크기(p=0.04), 원형 세포 분포 정도(p<0.0001), 병리적 등급(p=0.0002), 국소 재발(p=0.006)이었다. 폐외 전이는 전이 환자의 75.0%(18/24)에서 나타났으며 전이 후 평균 생존 기간은 26개월(범위, 2-72개월)이었다. 결론: 점액성 지방육종은 주로 하지에 발생하며 종양의 크기, 병리적 등급, 원형 세포의 분포, 국소 재발 여부가 예후에 영향을 미치고, 다른 일반적인 육종과 달리 폐 이외의 전이를 많이 하는 특징이 있음을 치료 또는 추시중 유의해야 할 것이다.

Association between obesity and local control of advanced rectal cancer after combined surgery and radiotherapy

  • Choi, Yunseon;Lee, Yun-Han;Park, Sung Kwang;Cho, Heunglae;Ahn, Ki Jung
    • Radiation Oncology Journal
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    • 제34권2호
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    • pp.113-120
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    • 2016
  • Purpose: The association between metabolism and cancer has been recently emphasized. This study aimed to find the prognostic significance of obesity in advanced stage rectal cancer patients treated with surgery and radiotherapy (RT). Materials and Methods: We retrospectively reviewed the medical records of 111 patients who were treated with combined surgery and RT for clinical stage 2-3 (T3 or N+) rectal cancer between 2008 and 2014. The prognostic significance of obesity (body mass index [BMI] ${\geq}25kg/m^2$) in local control was evaluated. Results: The median follow-up was 31.2 months (range, 4.1 to 85.7 months). Twenty-five patients (22.5%) were classified as obese. Treatment failure occurred in 33 patients (29.7%), including local failures in 13 patients (11.7%), regional lymph node failures in 5, and distant metastases in 24. The 3-year local control, recurrence-free survival, and overall survival rates were 88.7%, 73.6%, and 87.7%, respectively. Obesity (n = 25) significantly reduced the local control rate (p = 0.045; 3-year local control, 76.2%), especially in women (n = 37, p = 0.021). Segregation of local control was best achieved by BMI of $25.6kg/m^2$ as a cutoff value. Conclusion: Obese rectal cancer patients showed poor local control after combined surgery and RT. More effective local treatment strategies for obese patients are warranted.

The location of locoregional recurrence in pathologic T3N0, non-irradiated lower rectal cancer

  • Kim, Mi Sun;Keum, Ki Chang;Rhee, Woo Joong;Kim, Hyunju;Kim, Minji;Choi, Seohee;Nam, Ki Chang;Koom, Woong Sub
    • Radiation Oncology Journal
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    • 제31권2호
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    • pp.97-103
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    • 2013
  • Purpose: To investigate the patterns of locoregional recurrence of pathologic T3N0 (pT3N0) lower rectal cancer omitting postoperative radiotherapy (RT) and explore the potential of modification of a RT field. Materials and Methods: From Jan 2003 to Nov 2011, 35 patients omitting preoperative or postoperative RT for pT3N0 lower rectal cancer were included. We defined the lower rectal cancer as the tumor with the inferior margin located below the virtual line-a convergent level between rectal wall and levator ani muscle. All patients had radiologic examinations for recurrence evaluation during the follow-up duration. Results: The median follow-up duration was 66.4 months (range, 1.4 to 126.1 months). Eight (22.9%) of the 35 patients had recurrence. Three (8.6%) was local recurrence (LR) only, 3 (8.6%) was distant metastasis (DM) only, and 2 (5.7%) was LR with DM. All LR were located at primary tumor sites. The overall survival rate, LR-free survival rate, and DM-free survival rate at 5 years was 79.8%, 83%, and 87%, respectively. All LR developed from tumors over 5 cm. However, there was no statistical significance (p = 0.065). There was no other risk factor for LR. Conclusion: Even though the patients included in this study had pathologically favorable pT3N0 rectal cancer, LR developed in 14.3% of patients. Most of the LR was located at primary tumor sites prior to surgery. Based on these findings, it might seem reasonable to consider postoperative RT with a smaller radiation field to the primary tumor site rather than the conventional whole pelvic irradiation.

사지에 발생한 악성섬유조직구종의 치료 경험 (Treatment of MFH(Malignant fibrous histiocytoma) in Extremity)

  • 강종화;이원재;유대현;나동균;탁관철
    • Archives of Plastic Surgery
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    • 제35권4호
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    • pp.439-445
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    • 2008
  • Purpose: Malignant fibrous histiocytoma(MFH) is the most common soft tissue sarcoma in adult. As to this date, tissue development, treatment and prognosis of the tumor has not been definitely clarified, however, it has been reported that wide surgical resection of the tumor along with the radiotheraphy and chemotheraphy is needed for treatment. In MFH with high recurrence rate, the reconstruction method and points to be considered for reconstruction in recurrent case were studied in 10 patients who were treated in our hospital. Methods: From August of 1991 to August 2007, location of tumor, initial mass size, 1st recurred period, lymph node metastasis, recurrence rate, treatment modality, complication, reconstruction in recurrent defect, and follow up period was studied in 10 patients who underwent reconstruction at our Plastic surgery department following wide excision. Results: The average age was 62.8(46 - 73) years old, average follow up period was 7.7(1 - 17) years. Various reconstructions has been performed for recurrent cases and postoperative chemotheraphy and radiotheraphy was done. As for reconstruction in recurrent cases, After wide excision, local flap was performed in 6 cases, and free flap in 2 cases. After radiotherapy, osteoradionecrosis was occurred in 4 cases. Recurrence rate was 1 - 5(2.6) times and reconstruction due to recurrence was 7 out of 10 cases(70%). Conclusion: The treatment modality of MFH is not yet defined. Due to it's high recurrence rate, radiotherapy and chemotherapy is commonly combined with surgery. Even still, additional excision and reconstruction may be required. Therefore, possibility of re-operation must be considered when performing every excision and reconstruction; in case a recurrence or osteoradionecrosis occurs. Free flap coverage should be left as the last resort, according to the principle of reconstruction. Nevertheless, if the defect is large or osteoradionecrosis is present, it will benefit greatly to the patient's quality of life.

경상남도 해안 지역에서의 태풍에 의한 극한 풍속 추정 (Estimation of Typhoon-induced Extreme Wind Speeds over Coastal region of Gyeongsangnam-do Province)

  • 이영규;이승수;김학선
    • 한국방재학회:학술대회논문집
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    • 한국방재학회 2007년도 정기총회 및 학술발표대회
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    • pp.85-89
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    • 2007
  • Data of the typhoon affecting Korean peninsula from 1951 to 2005 are obtained from the RSMC best track and six climatological characteristics of the typhoons are examined. Local wind speeds are obtained by the physical model for wind fields. Typhoons are generated by the Monte Carlo simulation and their wind speeds are distributed using Weibull CDF. Simulated typhoon wind speeds are used to obtain different wind speeds corresponding their mean recurrence intervals.

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폐에서 발생한 악성 혈관외피세포종 1례 보고 (Malignant Hemangiopericytoma of the lung)

  • 김승철
    • Journal of Chest Surgery
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    • 제18권3호
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    • pp.513-516
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    • 1985
  • Hemangiopericytoma is a rare tumor of vascular origin, first described by Stout and Murray in 1942. It is characterized by proliferation of capillaries surrounded by pericytes. There is no characteristic clinical or radiological finding. Wide excision is the treatment of choice. A 21 year-old man was admitted with one year history of productive cough. On admission, chest film showed large lobulated mass and Right lower lobe atelectasis. Rt. pneumonectomy was performed and the tumor was confirmed as malignant hemangiopericytoma of the lung. Local recurrence didn`t occur until now.

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Extensive Adenomatoid Odontogenic Tumor of the Maxilla: A Case Report of Conservative Surgical Excision and Orthodontic Alignment of Impacted Canine

  • Moon, Jee-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제36권4호
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    • pp.173-177
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    • 2014
  • The present report describe the surgical therapy, clinical course, orthodontic treatment and morphological characteristics of an adenomatoid odontogenic tumor in the maxilla of an 11-year-old patient. The cystic tumor filled the maxillary sinus and involved a tooth. Marsupialization was accompanied by partial enucleation and applied traction to the affected tooth by a fixed orthodontic appliance. Healing was uneventful and no local recurrence was observed during a 1-year period of follow-up control.

폐에 발생한 고립성 형질세포종 1례 보고 (Solitary Plasmacytoma of the Lung - Report of a Case -)

  • 박만실
    • Journal of Chest Surgery
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    • 제19권1호
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    • pp.148-152
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    • 1986
  • Solitary plasmacytoma of the lung are extremely rare, and are sorts of plasma cell dyscrasia which are characterized by the elaboration of excessive amount of immunoglobulin or their constituent units. We experienced one case of plasmacytoma on the left lower lobe which was treated by left pneumonectomy. It was proven that the plasmacytoma produced immunoglobulin M and kappa chain by immunofluorescent technique. During the follow up period, 2 1/2 years after surgical removal of tumor mass, there were no local recurrence and dissemination.

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