• Title/Summary/Keyword: 근치적 절제술

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Two Cases of Repeated Pancreatectomy for Pancreatic Cancer Developing in the Remnant Pancreas after a Resection of Pancreatic Cancer - Repeated Pancreatectomy of Pancreatic Cancer - (췌장암 절제 후 잔여췌장에 발생한 췌장암에 대한 반복절제를 시행한 2례 - 췌장암의 반복절제 -)

  • Young-Il Kim;Sang Myung Woo;Woo Jin Lee
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.43-47
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    • 2013
  • There have been very few reports related to pancreatic cancer developing in the remnant pancreas after a resection for pancreatic cancer. We report two cases of repeated pancreatectomy for second primary pancreatic cancer. A 58-year-old man with a 2.3 cm sized low attenuated pancreatic tail mass on abdomen CT scan, received a distal pancreatectomy (adenosquamous carcinoma, stage IIB) and adjuvant chemoradiotherapy. A follow-up abdomen CT scan revealed a 2.0 cm sized pancreatic head mass in the remnant pancreas at 35 months after the distal pancreatectomy. He received a pancreaticoduodenectomy and diagnosed as ductal adenocarcinoma (stage IIA). Another 62-year-old female was declared pancreatic head mass on a regular health examination. An abdomen CT scan revealed a 3.6 cm sized mixed solid and cystic mass. She received a pylorus-preserving pancreaticoduodenectomy (ductal adenocarcinoma, stage IB) and adjuvant chemoradiation therapy. At 20 months after the resection, a 1.8 cm sized ill-defined low attenuated mass developing in the tail of remnant pancreas was detected on a follow-up abdomen CT scan. The patient received a distal pancreatectomy and diagnosed as ductal adenocarcinoma (stage IIA).

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Surgical Treatment of Synchronous Double Cancer of the Lung and Esophagus - A case report- (폐와 식도에서 동시에 발견된 중복암의 수술적 치료 -1예 보고-)

  • 이재익;우종수;이길수;노미숙;박미경
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.866-869
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    • 2003
  • Less than 2% of patients with primary esophageal cancers have synchronous primary lung cancers and many patients with these synchronous tumors are deemed ineligible for radical resection by surgeons due to the poor prognoses of both the diseases. However, we believe that carefully selected patients could benefit from one stage curative resection for these synchronous tumors. We experienced a case of synchronous double cancer of the lung and esophagus and performed bilobectomy and Ivor Lewis operation simultaneously. To the best of our knowledge, this is the first report on the good result of one stage curative resection for these synchronous serious tumors in Korea.

Curative Resection of Inoperable, Locally Advanced Gastric Cancer after Neoadjuvant Chemotherapy with Taxotere and Cisplatin (절제 불가능한 국소 진행성 위암 환자에서 Taxotere 및 Cisplatin을 이용한 선행 화학 요법제의 투여 후 근치적 절제가 가능했던 2예)

  • Lee, Han-Hong;Hur, Hoon;Chae, Byung-Joo;Kim, Wook;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.57-64
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    • 2005
  • At diagnosis, the majority of patients with gastric cancer are found to have local invasion or distant organ metastasis, even though the sole measure for a complete cure is a curative resection. A curative resection is hardly applicable for those with invasion and metastasis; thus, trials with neoadjuvant chemotherapy for downstaging the cancer should be considered. Docetaxel is a semisynthetic taxane that promotes tubulin polymerization and inhibits microtubule depolymerization. In recent studies, many metastatic gastric cancers were treated using neoadjuvant chemotherapy with docetaxel, and the response rates were reported. We report here two cases of locally advanced, non-resectable gastric cancer that were candidates for a curative resection after induction chemotherapy with docetaxel and cisplatin.

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Use of the Stomach as an Esophageal Substitute after Total Pharyngolaryngoesophagectomy for Treating Cervical Esophageal Cancer or Hypopharyngeal Cancer (경부식도암 및 하부인두암에서 근치적 전후두인두식도절제술 후 위를 이용한 재건술의 의의)

  • Lee, Sang-Hyuk;Lee, Sang-Hoon;Yoon, Ho-Young;Kim, Choong-Bai
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.200-205
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    • 2007
  • Purpose: The aim of this study was to analyze the post operative outcome of reconstruction with using the stomach after performing total pharyngolaryngoesophagectomy in patients with hypopharyngeal cancer or cervical esophageal cancer. Materials and Methods: We conducted a retrospective chart review of 23 patients who underwent gastric pull up for esophageal substitution at the Department of Surgery, Yonsei University College of Medicine, between January 1991 and December 2006. All the patients had transhiatal esophagectomy performed without thoracotomy. Results: There were seventeen males and six females with a median age of 58.1 years (range: 40-70 years). 19 cases were hypopharyngeal cancer, 13 cases had cancer in the pyriform sinus, 15 cases had cancer in the postcricoid area and one case had cancer in the glottic area. The rest were cervical esophageal cancers. The pathologic result was squamous cell carcinoma in all cases. The median total follow-up period was 33 months (range: 1-62 months) and there were two (8.6%) postoperative deaths: one was due to carotid rupture and the other was due to hepatic failure with liver metastasis. The complications were leakage in 1 patient (4.4%), pneumothorax in 1 patient (4.4%) and pneumonia in 1 patient (4.4%). Conclusion: The use of stomach for esophageal reconstruction has many benefits for treating hypopharyngeal cancer or cervical esophageal cancer, So, we made sure there was a sufficient length for the anastomosis after pharyngolaryngoesophagectomy and a rich blood supply from the stomach. There was a low incidence of the leakage at the anastomotic site, along with a low incidence of stenosis and bleeding.

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Bone Metastasis after a Curative Resection for Gastric Cancer (위암의 근치적 절제술 후 발생한 골 전이)

  • Kim Jin Jo;Song Kyo Young;Chin Hyung Min;Kim Wook;Chun Hae Myung;Park Cho Hyun;Park Seung Man;Park Woo Bae;Lim Keun Woo;Kim Seung Nam
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.23-28
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    • 2005
  • Purpose: Bone metastasis is not a common event in patients with gastric cancer. Therefore, most studies of bone metastasis in such patients have been in the form of case reports, so the clinical features of the bone metastasis are not well understood. To clarify metastatic patterns, the efficacy of radiation or chemotherapy, and the prognosis, we analyzed 29 cases of patients with bone metastases after curative surgery for gastric cancer. Materials and Methods: Twenty-nine (29) gastric cancer patients with bone metastasis who underwent curative resection from January 1989 to December 2002 at the Departments of Surgery, Kangnam St. Mary's Hospital and Our Lady of Mercy's Hospital, The Catholic University of Korea, were analyzed. Results: Nineteen (19) patients were males and, 10 patients were females. The mean age of the patients was $53\pm12$ years. There were more Borrmann type-3 and type-4 cancers and more undifferentiated histologic types. Most of the original cancers were stage III or IV. The most frequently involved bone was the spine. Treatment after recurrence was done in 16 patients ($55.2\%$). The median survival time after recurrence of the patients who received treatment was seven (7) months ($0\∼75$ months in range), which was significantly longer than that of the patients who did not received treatment (P=0.019). However, there was no difference according to the treatment modality (P=0.388). Conclusion: Bone metastasis after a curative resection of gastric cancer tends to occur in Borrmann type-3 and type-4 cancers, cancers with undifferentiated histology and, in stage III/IV disease. The prognosis of bone metastasis is dismal, and aggressive treatment is the only way to prolong survival.

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Nonfunctional Parathyroid Carcinoma: A Case Report (비기능성 부갑상선암: 증례 보고)

  • Choi, Sang-Gyu
    • Radiation Oncology Journal
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    • v.28 no.2
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    • pp.111-116
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    • 2010
  • Parathyroid carcinoma is a rare endocrine malignancy accounting for 0.5% to 4.0% of all cases of hyperparathyroidism and commonly present as hypercalcemia and parathyroid hormone (PTH) elevation. Nonfunctional parathyroid carcinoma does not show symptoms of hyperparathyroidism and only showed a vague indication of being pathologic, even when detected late. The optimal treatment is en bloc resection of the cancer, but frequent local recurrence after surgery has been reported. Adjuvant local treatment such as radiotherapy may improve the likelihood local control in cases with incompletely resected or microscopic residual tumor. The results of this study point to a case of nonfunctional parathyroid carcinoma treated by external beam radiotherapy after en-bloc resection of cancer.

Diagnosis and Treatment of Gastric Cancer (위암의 진단과 치료)

  • Song, S.K.
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.173-181
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    • 1996
  • 위암 환자의 수술후 5년 생존율은 조기암의 경우 90%이상으로 매우 좋으나 진행암의 경우 20~30%를 넘지 못한다. 위암의 예후에 영향을 주는 요인 중 조기 발견보다 더 중요한 것은 없으며, 조기암의 진단율에 노력을 기울이는 것이 현실적 타개책이라 하겠다. 현재 우리나라의 조기암 진단율은 16~22%로 일본의 40~45%보다 극히 저조하므로 소화기계 증상이 있는 경우 위내시경 검사를 적극 권고함이 바람직하다. 위암은 외과적 절제술이 유일한 근치치료법임은 주지의 사실이며 근래에는 위내시경 및 복강경을 이용하여 위장관 기능을 보존하는 술식도 시도되고 있어 바람직한 발전이라 사료되나, 림프절 곽청의 원칙을 훼손하지 않는 범위내에서 이루어져야할 것이다. 근치적 절제술의 정의에 합당한 외과적 치료법만이 5년 생존율 향상을 기대할 수 있으며, 보조적 항암화학요법과 면역요법은 대상 환자의 엄선으로 부분적 치료효과를 기대할 수 있다. 절제불능 위암이나 국소진행암에서 절제율을 높이기 위한 술전치료방법들의 적극적 도입이 바람직하다. 그러나 대상 환자의 선정에 있어 객관적 타당성이 있는 병기 결정 방법과 치료효과를 판정하는 방법의 혁신이 있어야 할 것으로 사료되며 현재의 부정확한 검사방법들의 대안으로 복강경의 이용이 바람직하리라 사료된다.

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Malignant Melanoma of the Vagina: A Report of 2 Cases (질의 원발성 악성 흑색종: 증례보고)

  • Kim, Ok-Bae;Kim, Jin-Hee;Jung, Young-Yeon;Cho, Chi-Heum;Choi, Tae-Jin
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.111-115
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    • 2005
  • Primary malignant melanoma of the vagina is an extremely rare genital neoplasm occurring mainly on postmenopausal women. It has a worse prognosis than cutaneous melanomas, because of the high rate of loco-regional recurrences and rapid systemic dissemination. In the past, radical surgical extirpation as the primary management had been recommended to improve loco-regional control, and possibly overall survival. However, the prognosis was poor In spite of such a radical approache. Recently, more conservative treatment such as wide local excision combined with adjuvant high-dose fraction radiotherapy seems to have premising results. Primary radiation therapy could be served as an alternative to surgery for patients with lesion less than 3 cm in diameter. We report 2 cases of primary vaginal malignant melanoma treated with radiotherapy.