• Asian Pacific Journal of Cancer Prevention
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• 제13권2호
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• pp.725-729
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• 2012

Background: The management of hepatolithiasis combined with intrahepatic cholangicarcinoma (IHHCC) remains a challenge due to poor prognosis. The aim of this study was to summarize our diagnosis and cure experience of IHHCC over the recent 10 years. Methods: From January 1996 to January 2006, 66 patients with IHHCC were reviewed retrospectively. Results: Of the 66 patients, 52 underwent surgical resection (radical resection in 38 and palliative in 14) and 8 patients abdominal exploration, while the other 6 cases received endoscopic retrograde biliary internal drainage and stent implantation. In this series, correct diagnosis of advanced stage was made during operation in 8 cases (8/60, 13.3%) and all of them (underwent unnecessary abdominal exploration, among them the positive rate of CA19-9 was 100%, and the positive rate of CEA was 87.6% (7/8), incidence rate of ascites was 100% and short-term significant weight loss was 100%, with median overall survival of only 4 months. Conclusion: Radical resection is mandatory for IHHCC patient to achieve long-term survival, the CT and MR imaging features of IHHCC being concentric enhancement. Patients with IHHCC have significant higher CA199 and significant higher CEA and short-term significant weight loss and ascites should be considered with advanced stage of IHHCC and unnecessary non-therapeutic laparotomies should be avoided.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제14권1_2호
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• pp.97-104
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• 1992

본 경북대학교 치과대학 구강외과학 교실 및 대구 가톨릭대학병원 구강악안면외과학 교실에서는 3명의 구강암 환자에서 각각의 상태에 따라 국소적 경부곽청술, 양측성 보존적 경부곽청술, 고전적 경부곽청술 및 술후 방사선요법을 시행하여 다소의 지견을 얻었기에 보고하는 바이다. 1. 국소적 경부곽청술을 시행한 증례 1($T2_N0_M0$)의 경우에는 아주 만족한 결과를 나타내었다. 2. 양측성 보존적 경부곽청술을 시행한 증례 2($_T3_N1_M0$)에서는 거의 전이가 일어나지 않는다고 알려진 후경삼각부위에서 술후 약 8개월만에 전이가 관찰되어 화학적 항암요법을 시행하였으나 술후 13개월 만에 사망하였음. 3. 고전적 경부곽청술을 시행한 증례 3($_T2_N1_M0$)에서는 현재 아주 양호한 예후를 보이고 있다.

• 대한기관식도과학회지
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• 제3권2호
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• pp.287-292
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• 1997

We report 22 cases of well -differentiated thyroid carcinoma infiltrating the upper airway tract. This retrospective study was undertaken to evaluate the prognosis md to determine optimal therapy for thyroid carcinoma adhering to or invading the trachea or larynx from 1984.3 to 1996.12. The treatment was individualized depending on the extent of the cancer. There were 12 cases dissected free by an laryngotracheal shaving, 7 cases removed by an tracheal resection with end to end anastomosis, 3 cases removed by an total laryngectomy. In all of these cases, we performed a total thyroidectomy with an accompanying neck dissection. There were no major complications during the operation. Over the 5-years observation period, 11 patients are alive without a sign of recurrence, 4 Patients are alive with recurrence, 7 died of thyroid carcinoma; 2 of 12 in an laryngotracheal shaving cases, 2 of 7 in an tracheal resection with end to end anastomosis case, 3 of 3 in an total laryngectomy case. The result showed an radical operation for thyroid carcinoma invading the laryngotrachea improves the survival rate, but limits improving the cure rate, and the invasion of the thrchea or larynx must be treated whenever possible by an total resection followed by radioiodine and external beam radiation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권2호
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• pp.112-119
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• 2021

Objectives: Myxomatous odontogenic tumors (MOTs) are the third most common odontogenic tumors in the oral and maxillofacial region. Due to its slow-growing, but locally invasive nature, the tumor is usually detected by accident or only when it becomes a large mass, which causes facial deformity. Materials and Methods: Current study reports three unusual cases of MOT including huge myxoma involve the mandible in middle-aged man, MOT with ossifying fibroma pattern in mandible, and MOT in maxilla of young female patient. The diagnosis and treatment strategy of MOTs was also summarized and updated. Results: In reported three cases of patients with large MOTs, surgical treatment was indicated with fibular free flap reconstruction in the mandible and plate reconstruction in the maxilla. The tumors were successfully treated with radical resection and did not show signs of recurrence during the follow-up period. Conclusion: Surgical treatment indication depends on size, the position of the lesion, patient systemic condition and surgeon individual experience. In the case of a large tumor, radical resection and reconstruction is the standard surgical strategy. The conservative surgical treatment including enucleation with wide curettage is still under controversy. The recurrence rate for MOTs is significantly high, up to 30%, therefore long-term follow-up is essential.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2211-2215
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• 2014

Background: To examine the incidence of positive vaginal surgical margins and determine the predicting factors following radical hysterectomy for stage IB1 carcinoma of the cervix. Materials and Methods: The clinical and histological data of 656 FIGO stage IB1 cervical cancer patients who had radical hysterectomy with bilateral pelvic lymphadenectomy (RHPL) from January 2003 to December 2012 were retrospectively reviewed and were analyzed for their association with a positive vaginal surgical margin. A p-value of < 0.05 was considered significant. Results: Thirty-five patients (5.3%) had positive vaginal surgical margins following RHPL; 24 (3.7%) for intraepithelial lesions and 11 (1.7%) for carcinoma. On multivariate analysis, microscopic vaginal involvement by high-grade squamous intraepithelial lesion and/or carcinoma (adjusted odd ratio (OR) 186.8; 95% confidence interval (CI) 48.5-718.5) and squamous histology (OR 8.7; 95% CI 1.7-44.0), were significantly associated with positive vaginal surgical margin. Conclusions: Microscopic vaginal involvement by HSIL and/or carcinoma are strong predictors for positive vaginal surgical margins for stage IB1 cervical cancer patients undergoing radical hysterectomy. Preoperative 'mapping' colposcopy or other strategies should be considered to ensure optimal vaginal resection.

• Radiation Oncology Journal
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• 제15권4호
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• pp.357-367
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• 1997

목적 : 근치적 절제술과 골반림프절 절제술을 시행한 자궁경부암 환자 중에서 치료실패의 위험인자가 있어서 술후 방사선치료를 시행한 환자를 대상으로 치료성적, 예후인자, 실패양상을 알아보기 위하여 후향적 분석을 시행하였다. 대상 및 방법 : FIGO 병기 IB, IIA와 IIB 환자 중에서 근치적 수술과 방사선치료를 시행하고 추적조사가 가능하였던 124명을 대상으로 하였다. 환자들은 1985년 3월부터 1994년 3원까지 수술후 방사선치료를 시행하였으며 최소 추적기간은 24개월이었다. 모든 환자는 4-MV 선형가속기를 이용한 외부방사선치료를 전골반에 50-6OGy를 조사하였고 일부 환자는 코발트를 이용한 고선량율 강내치료를 추가하였다. 결과 : 전체 환자의 5년 생존율과 5년 무병 생존율은 각각 $75.4\%,\;73.5\%$였고, 단변수 분석상 5년 무병 생존율에 영향을 미치는 인자는 림프절 전이 유무, 개수와 위치, 종양의 크기, 자궁체부 침운, 자궁주위조직 침윤, 병기, 자궁경부벽 침윤정도, 질 절제면 양성, 그리고 치료 관계 인자로 방사선량, 강내치료, 항암제 등이 통계상 유의하였으며, 다변량 분석상 림프절 전이와 종양의 크기, 질 절제면 양성이 유의하였다. 치료 실패는 33명이었고 2명은 다른 원인으로 사망하였고 부위별로는 국소재발이 13명, 원격전이 13명 국소-원격 동시 실패가 7명이었고 추적 종료시점까지 5명이 생존하였다. 국소재발은 병기 IB, 림프절 전이 양성 또는 질 절제면 양성 환자에서 많이 발생하였으며 림프절 전이 음성환자에서는 빈도는 낮았으나 원격전이가 상대적으로 더 많았다. 그리고 병기 lIB에서 5년 생존율 은 $56\%$ 였고 22명 중에서 9명이 재발하였다. 결론 : 수술후 방사선치료는 비교적 효과적인 방법이지만 다수의 재발 위험인자들을 가진 환자에게 술후 방사선치료만으로는 재발을 막기가 충분하지 않으므로 방사선감작제의 추가나 동시방사선-항암치료 등의 보다 효과적인 방법이 필요할 것으로 성각되며, 술혹 방사선치료의 효율을 정하기 위하여 무작위 표본 추출에 의한 전향적 연구가 필오하다. 그리고 병기 IIB는 항암치료와 수술후 방사선치료를 시행해도 치료 성적이 나쁘므로 일차적으로 근치적 방사선치료를 시행해야한다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권4호
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• pp.287-294
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• 2011

Introduction: Ameloblastoma is a benign but locally invasive tumor with a high recurrence rate. The aim of this study was to make an easier diagnosis and treatment planning of ameloblastoma. Materials and Methods: From January 1993 to October 2009, 139 cases from 123 patients, who had been diagnosed with ameloblastoma through radiologic and biopsy in the department of oral and maxillofacial surgery of Kyunpook National University, were selected as the subjects in this study. According to the medical charts, 9 factors (age, gender, location, chief complaints, duration, radiographic findings, size and recurrence) concerned in deciding the treatment method and the relevance between each factor and the treatment methods were examined.(Conservative treatments were marsu-pialization, enucleation, curettage and lateral decortication. Radical treatments included block excision, resection and hemisection) Results: In the patients under the age of 20, 77.14% had conservative treatments, whereas 22.86% underwent radical treatments. In the patients over the age of 20, 44.23% were treated conservatively treatments, and 55.77% underwent radical treatments. For unilocular types, 28.57% had conservative treatments, whereas 71.43% had radical treatments. For the multilocular types, 66.67% underwent conservative treatments, and 33.33% had radical treatments. For the primary cases, 58.68% were treated conservatively and 41.32% had radical treatments. For the recurrent cases, 16.67% and 83.33% underwent conservative and radical treatments, respectively. Conclusion: There was statistical significance in the factors affecting the treatment methods, such as age, radiographic findings and recurrence.

• 대한기관식도과학회지
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• 제9권1호
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• pp.30-38
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• 2003

Cancers of the cervical esophagus occur uncommonly, but treatment is remaining a challenging problem and surgery demands special knowledge of abdominal, thoracic, and neck surgery. The primary risk factor is chronic heartburn, leading to a sequence of esophagitis, Barrett's esophagus, reflux esophagitis and etc. Among the various treatment modalities, Surgery is still a mainstay of treatment. The main aim of surgery is not only oncologically adequate resection but also preservation or restoration of physiologic functions, such as deglutition and phonation. Surgical treatment of cervical esophageal cancer is influenced by special problems arising from tumor factors, patient factors and surgeon factors. Complete clearance of loco-regional disease and prevention of postoperative complications are of particular importance for the improvement of long-term survival in patients with these cancers. So the cervical and thoracic extension of these tumors usually required an extensive lymphadenectomy with primary resection. Radical resection of the primary site almostly include sacrifice of the larynx, but the voice could be rehabilitated with various methods, such as tracheoesophageal prosthesis or tracheoesophageal shunts, etc. Restoration of the esophageal conduit can be performed using gastric or colon interposition, radial forearm free flap or jejunum free flap, etc. Recently, the advances of radiation therapy and chemotherapy will enable less extended resections with greater rates of laryngeal preservation. At initial presentation, up to 50％ to 70％ of patients will have advanced locoregional or distant disease with virtually no chance for cure. Patients with advanced but potentially resectable esophageal cancer are generally treated by surgery with some form of neoadjuvant chemotherapy, radiotherapy, or both, with 5-year survivals in the 20％ to 30％ range. So the significant adverse factors affecting survival should be taken into account to select the candidates for surgery.

• Journal of Chest Surgery
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• 제36권11호
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• pp.866-869
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• 2003

식도암 환자에서 동시에 일차성 폐암이 발견되는 빈도는 2% 미만에 불과하며, 특히 두 질환 모두 예후가 나쁨으로 인해서 환자들이 근치적 절제술을 받을 기회를 놓치게 되는 경우가 많다. 그러나 환자를 신중히 선택한다면 폐와 식도의 중복암을 동시에 절제함으로써 좋은 결과를 가져올 수 있다고 생각한다. 저자들은 최근 식도와 폐의 일차성 중복암 환자 1예를 경험하였고, 쌍폐엽절제술과 Ivor Lewis 술식으로 일차성 근치적 절제술을 시행하여 좋은 결과를 얻었기에 국내 문헌상으로는 최초로 이를 보고하는 바이다.

• Journal of Chest Surgery
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• 제27권5호
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• pp.413-417
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• 1994

Adenoid cystic carcinoma usually grows in the trachea or near its bifurcation and causes obstruction of the air way. We recently experienced a 33 year-old male patient who had adenoid cystic carcinoma in the left main bronchus with the chief complaint of productive cough. On the bronchoscopy, the mass obstructed the left main bronchus completely and had nodularity and increased vascularity.The trachea was shifted to the left side and the lower lobe of the left lung was atelectatic on chest X-ray and computed axial tomogram.He underwent left tracheal sleeve pneumonectomy and lymph node dissection through bilateral thoracotomy. At first,we attempted left tracheal sleeve pneumonectomy through the left thoracotomy,however, it was very difficult to perform carinoplastic procedure after sleeve resection of 2.5cm of distal trachea and 1cm of proximal right main bronchus including whole left lung because of poor operative field and difficulty in the anastomosis of the right main bronchus to the distal end of the trachea without tension.Therefore after radical resection of the left lung we made right thoracotomy,through which we could anastomosed the distal trachea and right main bronchus with 4-0 PDS interrupted suture after mobilization of the right hilum without difficulty. The tumor was confirmed to be adenoid cystic carcinoma with metastasis to subcarinal lymph node histopathologically. Postoperative course was uneventful but he needed two bronchoscopic procedure to clear distal airway of the retained bronchial secretion. He was discharged at 14 days after operation with complete recovery.