• Clinical and Experimental Pediatrics
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• 제53권4호
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• pp.465-470
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• 2010

The number of long-term survivors is increasing in the western countries due to remarkable improvements in the treatment of childhood cancer. The long-term complications of childhood cancer survivors in these countries were brought to light by the childhood cancer survivor studies. In Korea, the 5-year survival rate of childhood cancer patients is approaching 70%; therefore, it is extremely important to undertake similar long-term follow-up studies and comprehensive long-term care for our population. On the basis of the experiences of childhood cancer survivorship care of the western countries and the current Korean status of childhood cancer survivors, long-term follow-up study and long-term care systems need to be established in Korea in the near future. This system might contribute to the improvement of the quality of life of childhood cancer survivors through effective intervention strategies.

• Asian Pacific Journal of Cancer Prevention
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• 제16권4호
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• pp.1415-1420
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• 2015

Background: We compared the health-promoting behavior of long-term cancer survivors with those of the general population to identify necessary behavioral interventions to reduce the health risk among cancer patients. Materials and Methods: We used data from the 2007 and 2012 Korea National Health and Nutrition Examination Surveys (KNHANES IV [2007~2009] and KNHANES V [2010~2012]) on smoking status, alcohol use, physical exercise, and disease screening. We compared long-term cancer survivors with members of the general population; the controls were matched by propensity score matching. A multiple logistic regression model was used to investigate the association between cancer status and health-promoting behavior. Results: Long-term cancer survivors had a lower risk of smoking than the general population controls (OR: 0.42, 95%CI: 0.25-0.71). In addition, the long-term cancer survivors had a lower risk of alcohol use than the general population controls (OR: 0.70, 95%CI: 0.50-0.98). However, in terms of physical exercise and disease screening, no statistically significant differences were detected (physical exercise OR: 1.01, 95%CI: 0.75-1.35; disease screening OR: 1.27, 95%CI: 0.93-1.74). All covariates were adjusted. Conclusions: The long-term cancer survivors had a much lower risk of smoking and alcohol use than the general population controls. However, almost no differences in physical exercise and screening for cancer recurrence or secondary disease were detected between the long-term cancer survivors and general population controls. To reduce the health risks and challenges facing long-term cancer survivors, interventions to encourage physical exercise and screening for cancer recurrence and secondary disease should be implemented.

• Investigative Magnetic Resonance Imaging
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• 제22권3호
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• pp.158-167
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• 2018

Purpose: To investigate the surgical, perfusion, and molecular characteristics of glioblastomas which influence long-term survival after treatment, and to explore the association between MR perfusion parameters and the presence of MGMT methylation and 1p/19q deletions. Materials and Methods: This retrospective study was approved by our institutional review board. A total 43 patients were included, all with pathologic diagnosis of glioblastoma with known MGMT methylation and 1p/19q deletion statuses. We divided these patients into long-term (${\geq}60\;months$, n = 7) and short-term (< 60 months, n = 36) survivors, then compared surgical extent, molecular status, and rCBV parameters between the two groups using Fisher's exact test or Mann-Whitney test. The rCBV parameters were analyzed according to the presence of MGMT methylation and 1p/19q deletions. We investigated the relationship between the mean rCBV and overall survival using linear correlation. Multivariable linear regression was performed in order to find the variables related to overall survival. Results: Long-term survivors (100% [7 of 7]) demonstrated a greater percentage of gross total or near total resection than short-term survivors (54.5% [18 of 33]). A higher prevalence of 1p/19q deletions was also noted among the long-term survivors (42.9% [3 of 7]) than the short-term survivors (0.0% [0 of 36]). The rCBV parameters did not differ between the long-term and short-term survivors. The rCBV values were marginally lower in patients with MGMT methylation and 1p/19q deletions. Despite no correlation found between overall survival and rCBV in the whole group, the short-term survivor group showed negative correlation ($R^2=0.181$, P = 0.025). Multivariable linear regression revealed that surgical extent and 1p/19q deletions, but not rCBV values, were associated with prolonged overall survival. Conclusion: While preoperative rCBV and 1p/19q deletion status are related to each other, only surgical extent and the presence of 1p/19q deletion in GBM patients may predict long-term survival.

• Advances in pediatric surgery
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• 제14권2호
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• pp.125-133
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• 2008

To evaluate the long-term prognosis of biliary atresia after Kasai operation, a total of 14 patients (of the 41 patients operated upon from 1982 to 1997), who had been followed up for more than 10 years, were included in this retrospective study. Eleven out of 14 patients survived with their native livers, and their data analyzed for age at operation, clearing time of jaundice, histological outcome, postoperative complications, effectiveness after the application of an intussusception anti-reflex valve, and quality of life. Average age at surgery was 62.8 days. Serum bilirubin was normalized within three months in all patients. Six among the eleven long-term survivors had ascending cholangitis as one of the postoperative complications. The application of an intussusception anti-reflux valve did not show any statistical significance in long-term survival. Most of long-term survivors appeared to enjoy good quality of life. Kasai operation might not be the definitive treatment for biliary atresia; however, Kasai operation made it possible to achieve long-term survival for patients with biliary atresia when the patients were detected and treated as early as possible.

• Clinical and Experimental Pediatrics
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• 제53권4호
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• pp.471-476
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• 2010

The majority of childhood cancer survivors and their families will be psychologically healthy, but may desire and benefit from preventive care. A significant portion of the survivor population will be psychosocially distressed in various aspects by their harsh experience of long cancer treatment, and may warrant professional intervention and treatment. Pediatricians should be aware of the late psychological effects that can occur a year or 2 after treatment, possibly in many aspects of a survivor's life. Not only the cancer diagnosis, but also treatments such as chemotherapy, irradiation, and surgical intervention may exert different long-term effects on the psychosocial outcomes of survivors. Pediatricians need to be more concerned with maintaining and improving the psychological health of this growing number of childhood cancer survivors through long-term follow-up clinics, community support, or self-help groups. Research on all of the psychosocial aspects of childhood cancer survivors is important to recognize the reality and problems they face in Korea.

• Communications for Statistical Applications and Methods
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• 제24권1호
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• pp.43-65
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• 2017

We propose a flexible cure rate survival model by assuming that the number of competing causes of the event of interest has the Poisson distribution and the time for the event follows the gamma-G family of distributions. The extended family of gamma-G failure-time models with long-term survivors is flexible enough to include many commonly used failure-time distributions as special cases. We consider a frequentist analysis for parameter estimation and derive appropriate matrices to assess local influence on the parameters. Further, various simulations are performed for different parameter settings, sample sizes and censoring percentages. We illustrate the performance of the proposed regression model by means of a data set from the medical area (gastric cancer).

• Journal of Gastric Cancer
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• 제2권3호
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• pp.157-162
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• 2002

Purpose: The prognosis of stage IV gastric cancer is very grave. However, some of these patients survive long periods after surgery. This study was undertaken to investigate various clinico-pathological profiles related to the prognosis for these long-term survivors. Materials and Methods: One hundred fifty-five patients with stage IV gastric cancer who underwent a gastric resection from 1992 to 1997 at Hanyang University Hospital were evaluated. Thirty-three patients who survived more than 5 years after surgery were designated as long-term survivors (LTS); on the other hand, one hundred twenty-two patients who died within 5 years after surgery were named as short-term survivors (STS). Results: The rate of the patients with T4, preoperative serum level of CA19-9 greater than 37 U/g protein, and peritoneal dissemination was lower for the LTS than in for the STS (P=0.002, P=0.045, and P=0.0000, respectively). Tumors were smaller (7.3 cm vs. 8.9 cm, P=0.030) and metastatic lymph node were fewer (19.7 vs. 28.8, P=0.019) for the LTS than for the STS. Curative surgery ($\76\%\;vs.\;\46\%$, P=0.002) and a subtotal gastrectomy ($\76\%\;vs.\;46\%$, P=0.026) were performed more frequently for the LTS than for the STS. From a univariate survival analysis, depth of invasion, distant metastasis, extent of gastric resection, postoperative chemotherapy, and curability were statistically significant factors. From a multivariate survival analysis, curability, depth of invasion, and extent of gastric resection were independent prognostic factors. Conclusions: If feasible, we have to exert our efforts to achieve curative surgery although the tumor is considered to be a stage IV gastric cancer. Thereafter, multi-modality treatments including chemotherapy can be considered to improve the prognosis.

• 한국노년학
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• 제30권4호
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• pp.1239-1261
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• 2010

본 연구는 장기간 노인(전문)병원 및 요양시설에서 생활하고 있는 뇌졸중 생존 노인들의 건강관련 삶의 질에 미치는 요인들이 무엇인지 규명함으로써 대상자들의 삶의 질 증진을 위한 사회복지 실천 방안들을 제언하고자 시행되었다. 연구 대상자는 충청지역 및 D 광역시 소재 노인(전문)병원 18곳과 요양시설 13곳에서 장기 입원(입소)하고 있는 55세 이상의 뇌졸중 생존 노인들이며 서베이 방법을 사용하여 직접면담조사를 실시하였다. 조사는 2008년 12월 16일부터 2009년 1월 17일까지 실시되었고, 총 328부의 설문지가 통계분석에 이용되었다. 연구결과 대상자들이 인지하고 있는 건강관련 삶의 질은 비교적 낮게 나타났고, 특히 건강관련 삶의 질을 구성하고 있는 하위 영역 중 사회적 관계 영역이 가장 낮게 나타났다. 투입된 독립변수들이 건강관련 삶의 질에 미치는 상대적 영향력은 '우울', '향후 경제적 부담감', '일상생활수행능력', '장애수용', '중복질환', '경제적 주부양자가 배우자인 경우'순으로 나타났다. 본 연구를 통해 장기재활 및 요양서비스를 이용하고 있는 뇌졸중 생존 노인들의 건강관련 삶의 질에 질병관련 요인뿐만 아니라 심리사회적 요인, 환경적 요인 모두 중요한 영향을 미치고 있다는 것이 규명되었고, 그 가운데서도 심리사회적 요인의 영향력이 제일 큰 것으로 밝혀졌다. 이를 바탕으로 노인의료복지시설에서 생활하고 있는 뇌졸중 생존 노인들의 삶의 질을 향상시키고 더 나아가 사회복지사들의 역량을 고취시킬 수 있는 사회복지 방안들이 논의되었다.

• 고려인삼학회:학술대회논문집
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• 고려인삼학회 2007년도 춘계 학술대회
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• pp.17-17
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• 2007

• 종양간호연구
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• 제10권1호
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• pp.19-29
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• 2010

Purpose: The purpose of this article was to review and discuss the current status, issues, and nursing perspectives of cancer survivorship. Methods: A comprehensive literature review was conducted. Results: The major areas of concern for the survivors included recurrence, secondary malignancies, and long-term treatment sequalae which affect their quality of life. The four essential components of survivorship are prevention, surveillance, intervention, and coordination. Cancer survivorship care plan should address survivor's long-term care, such as types of cancer, treatment modalities, potential side effects, and recommendations for follow-up. It also needs to include preventive practices, health maintenance and well-being, information on legal protections regarding employment and health insurance, as well as psychosocial services in the community. Survivorship care for cancer patients requires multidisciplinary efforts and team approach. Conclusion: Nurses are uniquely positioned to play a key role in ensuring quality services for cancer survivors and family members. Nurses should review the care plans for cancer survivorship with patients and families by instructing them when to seek medical treatment, promoting any recommended surveillance protocols, and encouraging healthy life styles for health promotion and quality of life.