• Journal of Gastric Cancer
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• 제7권3호
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• pp.174-179
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• 2007

진단의 발달과 치료의 발전으로 위암의 치료 성적은 괄목한 성장이 이루어졌으나 근치적 위전절제술 후 암의 발생, 즉 문합부 재발암과 전이 그리고 이시성암이 발생되었을때 외과적 치료에 대한 보고와 결과는 많지 않으며, 특히 문합부에만 국소적으로 발생된 암은 흔치 않다. 근치적 위전절제술 후 문합부에만 국소적으로 발생된 암에 대하여 적극적인 수술을 함으로써 생존이 연장되었다는 보고가 있다. 연구자들은 위선암으로 근치적 위전절제술 후 발생한 문합부 국소재발 1예, 이시성 편평상피암 1예, 림프종 1예에 대하여 원격전이가 없음을 확인한 후 수술을 시행하여 모두 좋은 결과를 얻어 이에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제55권5호
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• pp.397-404
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• 2022

Background: Distant recurrence of esophageal cancer (EC), even after radical resection, is common, and the most frequent site of EC metastasis is the liver. However, a multidisciplinary treatment strategy for postoperative liver metastasis (LM) from EC has yet to be established; in particular, the role of liver-directed therapy (LDT) remains uncertain. We investigated the clinicopathological features and outcomes of patients undergoing post-esophagectomy LM with versus without LDT to explore its therapeutic implications. Methods: Among 624 consecutive patients undergoing R0/R1 esophagectomy for EC, 30 were identified in whom LM had developed as the initial recurrence. Their characteristics were retrospectively reviewed. Results: Six of the 30 subjects underwent LDT for metachronous LM. Five of those 6 also received systemic chemotherapy. A comparison between the 6 LDT and 24 non-LDT cases revealed no significant differences in major clinicopathological and operative factors, except for concurrent metastasis to extrahepatic organs (1/6 vs. 15/24, p=0.044). Twenty-nine of the 30 patients died during the study period, whereas 1 who had received multimodal treatment with LDT remained alive more than 200 months after multiple LM had been detected. Kaplan-Meier analysis for survival after LM demonstrated significantly prolonged survival in LDT cases compared to non-LDT cases treated with systemic chemotherapy alone (p=0.014). Even when the analysis was limited to patients without extrahepatic metastasis, this significant prognostic advantage of LDT was maintained (p=0.047). Conclusion: Multimodal treatment combined with LDT might be beneficial for patients with metachronous LM from EC and should therefore be considered a potential treatment option.

• 대한기관식도과학회지
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• 제5권2호
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• pp.212-216
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• 1999

Renal cell carcinoma is the third most common metastatic tumor to the bone and soft tissues of the head and neck. The common sites of metastatic renal cell carcinoma in head and neck region are nasal cavity, paranasal sinuses, oral mucosa, gingiva, tongue, palate, lip as the favored site. The present paper deals with one patient with metachronous oral tongue, nasal cavity and suspicious brain metastases after 2 years of renal cell carcinoma nephrectomy. Also, the patient had history of total thyroidectomy for thyroid follicular carcinoma. Total excision of nasal cavity and tongue mass were performed. Therapeutic aspects are briefly reviewed in literature.

• Journal of Gastric Cancer
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• 제15권2호
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• pp.139-142
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• 2015

Hepatic metastasis of early gastric cancer (EGC) following subtotal gastrectomy with lymphadenectomy is rare. We report the case of a 61-year-old male patient who was diagnosed with EGC that was initially treated using endoscopic submucosal dissection (ESD) and subsequently underwent laparoscopic subtotal gastrectomy. Histopathological examination of the patient's ESD specimen showed a moderately differentiated tubular adenocarcinoma invading the submucosa without lymphatic invasion. The deep margin of the specimen was positive for adenocarcinoma, and he subsequently underwent laparoscopic distal gastrectomy. The patient developed liver metastasis 15 months after the operation and then underwent liver resection. Histology of the resected specimen confirmed the diagnosis of two foci of metastatic adenocarcinoma originating from stomach cancer. Immunohistochemical analysis of the specimen demonstrated overexpression of human epidermal growth factor receptor 2. The patient was treated with trastuzumab in combination with chemotherapy consisting of capecitabine and cisplatin. Twenty-four months after the operation, the patient remained free of recurrence.

• 대한기관식도과학회지
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• 제7권1호
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• pp.54-58
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• 2001

Granular cell tumor or also called Abrikossoff's tumor, is a rare benign tumor that can occur anywhere in the body. Granular cell tumor may single or multiple (synchronous or metachronous). Approximately half of all granular cell tumors occur in the head and neck. most commonly in the tongue. But granular cell tumors of the larynx are rare, accounting for only 7 to 10% of all reported cases. Laryngeal tumors are usually small and men are more frequently affected than women. The exact histogenesis is still not known but most recent data support the neurogenic Schwann cell origin. The preferred treatment is local excision using cold knife or laser. Radiation therapy is of little benefit. We report a case of granular cell tumor of the larynx which was confirmed by histopathology.

• Journal of Genetic Medicine
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• 제4권1호
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• pp.15-21
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• 2007

Hereditary syndromes cause approximately 5 to 10% of overall cancer cases. Cancer related with genetic syndromes are found elsewhere, including stomach, breast, colorectum, ovary, brain and so on. Because hereditary cancers are due to germline mutations, these patients have unique clinical features distinct from sporadic cancer. Generally these features include (i) early age-of onset of cancer, (ii) frequent association with synchronous or metachronous tumors, (iii) frequent bilateral involvement in paired organs (iv) frequent association with other site tumors or characteristic clinical manifestation specific to each genetic syndrome. Due to these differences, the management strategy for patients with hereditary cancer is quite different from that for sporadic cancer. Additionally, there are important screening and surveillance implications for family members. Genetic counselling is prerequisite to these families for risk assessment by pedigree analysis, and guidance to clinical or genetic testing. The genes responsible for these syndromes has recently identified, as a result, genetic testing has become important determining factor in clinical decisions.

• 대한기관식도과학회지
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• 제3권1호
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• pp.164-168
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• 1997

Multiple primary tumors in the head and neck are not uncommon, however those in the thyroid and the larynx are known to be very rare. In most cases of multiple primary tumors involving the thyroid and the larynx, lesions are observed usually simultaneously and thyroid tumors are found incidentally during the laryngeal tumor surgery. In rare cases, thyroid tumors are found metachronously after radiation therapy of laryngeal cancer. The authors recently experienced a case of multiple primary tumor involving the thyroid and the larynx, in which thyroid papillary carcinoma was the index tumor and the laryngeal squamous carcinoma was the meatachronous second tumor. Both tumors showed aggressive local extension and regional nodal meatastasis with tumor collision in the same node. The patient died of recurrent or of residual squamous carcinoma shortly after main surgical treatment index thyroid cancer.

• 대한소화기학회지
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• 제72권5호
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• pp.245-251
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• 2018

Gastric cancer is the most common cancer in Korea and the fifth most common cancer globally. Helicobacter pylori (H. pylori) infection is considered the main etiologic agent for gastric cancer development. Most regional guidelines for H. pylori treatment recommend treating the organism to prevent gastric cancer in the high-risk group. However, evidence that such a strategy can also be applied to the general population, especially in terms of the preventive effect and safety, has not been adequately presented yet. Although a meta-analysis in the general population suggested effectiveness in decreasing gastric cancer incidence, individual studies should be critically reviewed to evaluate the soundness of the evidence. Recently published, long-term, Korean studies on metachronous gastric cancer prevention ended the controversies from previous short-term studies and confirmed the effectiveness. Currently, further prospective, large, randomized studies are ongoing in the general population and will provide more definitive, high-level evidence on this gastric cancer prevention strategy in the next decade.

• Journal of Digestive Cancer Research
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• 제3권1호
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• pp.42-44
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• 2015

Anomalous union of the pancreaticobiliary duct (AUPBD) has been shown to predispose to carcinomas of the biliary tract (bile duct and gallbladder) and pancreatic cancer because of chronic recurrent inflammatory reaction due to pancreatic or bile juice refluxes. However, pancreatic duct would be less affected by the bile because of the relatively higher intraductal pressure of the pancreatic duct. We report a case of metachronous pancreatic cancer in AUPBD patient without choledochal cyst who underwent cholecystectomy because of gallbladder cancer.

• Journal of Korean Neurosurgical Society
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• 제54권2호
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• pp.107-111
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• 2013

Objective : We investigated the effectiveness of stereotactic gamma knife Radiosurgery (GKR) for radioresistant brain metastases with the impact upon histology. Methods : Between April 2004 and May 2011, a total of 23 patients underwent GKR for 67 metastatic brain tumors from 12 renal cell cancers, 5 sarcomas and 6 melanomas. The mean age was 56 years (range, 18 to 79 years). Most of the patients were classified as the Radiation Therapy Oncology Group recursive partitioning analysis class II (91.3%). The synchronous metastasis was found in 6 patients (26.1%) and metachronous metastasis in 17 patients (73.9%). We analyzed the local control rate, intracranial progression-free survival (PFS) and overall survival (OS). Results : The mean tumor volume for GKR was 2.24 cc and the mean prescription dose was 19.4 Gy (range, 10 to 24) to the tumor margin. Out of metachronous metastases, the median duration to intracranial metastasis was 3.3 years in renal cell cancer (RCC), 2.4 years in melanoma and 1.1 years in sarcoma (p=0.012). The total local control rate was 89.6% during the mean 12.4 months follow-up. The six-month and one-year local control rate was 90.2% and 83% respectively. Depending on the pathology, the control rate of RCC was 95.7%, sarcoma 91.3% and melanoma 80.5% during the follow-up. The common cause of local failure was the tumor bleeding in melanoma. The median PFS and OS were 5.2 and 8.4 months in RCC patients, 6.5 and 9.8 months in sarcoma, and 3.8 and 5.1 months in melanoma. Conclusion : The GKR can be one of the effective management options for the intracranial metastatic tumors from the radioresistant tumors. The melanoma showed a poor local control rate compared to other pathologies because of the hemorrhage.