• Title/Summary/Keyword: 수술 전 항암화학요법

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A Case of Recurred Pseudomyxoma Peritonei Identified by Serially Elevated Serum CEA Levels after Cytoreductive Surgery and Intraperitoneal Chemotherapy (수술과 항암치료 후 종양표지자 검사의 상승으로 복막 가성점액종의 재발을 확인한 1례)

  • In Sub Han;Geun Am Song;Kwang Ha Kim;Bong Eun Lee;Dong Hoon Baek;Seong Jun Lee;Moon Won Lee;Sung Yong Han
    • Journal of Digestive Cancer Research
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    • v.4 no.1
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    • pp.32-35
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    • 2016
  • Pseudomyxoma peritonei (PMP) is a rare clinical syndrome characterized by profuse jelatinous materials in the abdominal cavity and pelvis with mucinous implants on the peritoneal surface. There are some studies for serum tumor markers, including carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 125 (CA125), to assess the risk of recurrence following cytoreductive surgery and intraperitoneal chemotherapy. However, rare cases were reported about recurrence with increasing serum CEA levels. Herein, we report a case of recurrence of PMP according to serially elevated serum CEA.

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Primary Melanoma of the Stomach at Cardia (위 분문부에 발생한 원발성 흑색종)

  • Park, Jong-Ik;Kang, Sung-Gu;Park, Sang-Su;Yoon, Jin;Kim, Il-Myung;Shin, Dong-Gue
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.193-197
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    • 2006
  • Melanoma is a malignant neoplasm of melanocytes most frequently arising from the skin, but primary melanoma can also arise from the mucosa of the gastrointestinal tract. Gastrointestinal melanomas are most commonly metastases from a cutaneous melanoma. Primary melanoma of the stomach is rare and carries a poor prognosis. Reported here is the case of a 75-year-old man with a primary gastric melanoma who presented with a melena, abdominal pain, and weight loss. Most cases of melanoma are treated by excision of the primary tumor. Patients with melanoma have been treated with adjuvant chemotherapy, radiation therapy, and immunotherapy. None of these modalities has been demonstrated to prolong the survival rate. To improve long-term disease-free survival, early diagnosis and surgical intervention are very important.

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Surgical Treatment of Pulmonary Mucormycosis (폐 모균증의 외과적 치료)

  • Kim, Ju-Hyeon;Park, Seong-Sik;Sin, Yun-Cheol;Seong, Suk-Hwan
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.350-354
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    • 1996
  • Pulmonary mucormycosis is a very rare but often fatal opportunistic fungal infection caused by the order Mucorales in class Zygomycetes. Reported overall mortality exceeds 70% and the diagnosis is often made post-mortem. We experienced 2 cases of typical form of pulmonary mucormycosis. One patient was a poorly controlled diabetic and the other suffered from acute Iymphocytic leukemia (ALL). The former was diagnosed by a bronchoscopic biopsy and the latter by a pathologic examination from the percutaneous drain of a subphrenic abscess. Both of them underwent a surgical excision of the involved lung tissue. The patient with diabetes mellitus was successfully treated by surgical resection and discharged without complications. The other with ALL underwent a second operation and was transferred to the department of internal medicine for further management of his relapse of lettkemia. Recent literat re suggests that early aggressive diagnostic effort and treatment including surgical resection in the case of localized forms of the disease results in a good prognosis.

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TRAIL and Effect of Irradiation on Apoptosis of Cancer Cells (TRAIL과 방사선 조사가 암세포의 사멸에 미치는 효과)

  • Lee, Jaeseob;Jang, Seongjoo
    • Journal of the Korean Society of Radiology
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    • v.10 no.6
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    • pp.387-393
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    • 2016
  • Tumor using the efficient concomitant radiotherapy and chemotherapy to remove, prior to surgery and, either reduce the size of the tumor after surgery, or was can be made smaller, Or excised tumor, in a way to be removed, most conventional surgical method is surgical excision surgery therapy. And methods reduce or tumor size, or smaller, chemotherapy can kill tumor is administered selectively anticancer agent which increases the radioactive susceptible to tumor cells, sensitive to susceptibility to radiation are those which make it possible to respond to, either TRAIL methods of various biological cytostatic can deform the protein, by deforming the structure of the protein help to cell death it is known. In this paper, the HCT-116 cells thought to be a cancer cell to analyze the interaction of TRAIL and radiation. Experimental results, single use of TRAIL and radiation, results were compared with the control group, it was found to have no significant effect on each cell proliferation and apoptosis. Conversely treated with TRAIL, when treated in parallel radiation, it was possible to know that the HCT-116 cells significantly apoptosis occurs, The proportion of G1 ratio G0 also was found to have increased. TRAIL conclusion is increased apoptosis radiation defensive cells can know that increased radiosensitivity, also possible to alter the cell cycle, reduce cell proliferation ability stepwise it was possible. TRAIL is increased apoptosis, decreased cell proliferative capacity, it is considered to be possible to use as a radiation sensitizer.

Surgical Treatment for T4 Non-small Cell Lung Cancer Invading Mediastinal Structures (종격동 구조물을 침범한 T4 비소세포폐암의 수술적 치료)

  • 황은구;이해원;정진행;박종호;조재일;심영목;백희종
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.349-355
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    • 2004
  • Non-small cell lung cancer (NSCLC) with invasion of mediastinal structures is classified as stage IIIB, and has been considered surgically unresectable However, in a selected group of these patients, better results after surgical resection compared to non-surgical group have been reported. The aim of this study is to evaluate the role of surgical resection in treatment of mediastinal T4 NSCLC. Material and Method: Among 1067 patients who underwent surgical intervention for non-small cell lung cancer from Aug 1987 to Dec 2001 in Korea cancer center hospital, 82 patients had an invasion of T4 mediastinal structures (7.7%). Resection was possible in 63patients (63/82 resectability 76.8%). Their medical records in Data Base were reviewed, and they were followed up completely until Jun 2002. Surgical results and prognostic factors of NSCLC invading mediastinal structures were evaluated retrospectively. Result Lung cancer was resected completely in 52 patients (63.4%, 52/82). Lung resection was lobectomy (or more) in 14, pneumonectomy in 49. The mediastinal structures invaded by primary tumor were great vessel (61.9%), heart (19%), vagus nerve (9.5%), esophagus (7.9%), and vertebral body (7.9%). Nodal status was N0 in 11, N1 in 24, and N2 in 28 (44.4%). Neoadjuvant therapy was done in 6 (9.5%, 5 chemotherapy, 1 radiotherapy), and adjuvant therapy was added in 44 (69.8%, 15 chemotherapy, 29 radiotherapy) in resection group (n=63). Complication was occurred in 23 (31.7%), and operative mortality was 9.5% in resection group. Median and 5 year overall survival including operative mortality was 18.1 months and 21.7% in resection group (n=63), 6.2months and 0% in exploration only group (n=19, p=.001), 39 months and 32.9% in N2 (-) resection group (n=35), and 8.8 months and 8.6% in N2 (+) resection group (n=28, p=.007). The difference of overall survival by mediastinal structure was not significant. Conclusion: The operative risk of NSCLC invading mediastinal structures was high but acceptable, and long-term result of resection was favorable in selected group. Aggressive resection is recommended in well selected pateints with good performace and especially N2 (-) NSCLC with mediastinal invasion.

The Results of the ATP Based Chemotherapy Response Assay in Gastric Cancer Tissues (ATP-CRA 방법을 이용한 위암조직의 항암제 감수성 검사결과)

  • Lee, Je-Hyung
    • Journal of Gastric Cancer
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    • v.7 no.3
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    • pp.160-166
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    • 2007
  • Purpose: Recently, chemosensitivity tests have become widely used for the selection of effective drugs in gastric cancer patients. In this study, a chemosensitivity test was performed to select agents to increase the effectiveness of adjuvant chemotherapy. Materials and Methods: Chemosensitivity testing was performed in 81 gastric cancer patients that received a gastrectomy at the Yeungnam University Hospital. An ATP (adenosine triphosphate) based chemotherapy response assay was used. Clinicopatholgical factors such as sex, age, expression of tumor markers (CEA and CA19-9 levels), location of the tumor, morphology of advanced cancer, histological type, cell differentiation, depth of invasion, Lauren classification, Ming classification, lymphatic invasion, vascular invasion, neural invasion, lymph node metastasis and TNM stage were used to correlate the chemosensitivity and clinicopathological factors. Results: The most effective antitumor agents in gastric cancer patients were (in order of effectiveness) 5-FU, Epirubicin, lrinotecan and Oxaliplatin in our series. The chemosensitivity test showed a significant difference in susceptibility according to clinicopathological factors. Conclusion: Further studies on multidrug therapy are needed to evaluate synergistic effects of drugs. Therefore, for effective chemotherapy, it is more efficacious to select a chemosensitive drug than continue to use the same drug regimen.

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Nodal Station as a Prognostic Factor in Resected Stage IIIA N2 Non-Small Cell Lung Cancer (절제된 IIIA N2 병기 비소세포형 폐암에 있어서 Nodal Station의 의의)

  • 김대준;김길동;김치영;정경영
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.489-496
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    • 2003
  • To clarify the prognostic implication of the location and number of the metastatic mediastinal nodes in resected stage IIIA N2 non-small cell lung cancer. Material and Method: One hundred and seventy-four patients with resected non-small cell lung cancer who eventually proved to have pathologic stage IIIA N2 disease were studied. Patients who received preoperative induction therapy, non-curative operation or defined as operative mortality were excluded from this study. Result: In upper lobe tumors, there was no difference in 5-year survival according to the involvement of lower mediastinal nodes (32.3% vs 25.6%, p=0.86). In lower lobe tumors, no difference was found in 5-year survival according to the involvement of upper mediastinal nodes (25.1% vs 14.1%, p=0.33). There was no significant difference in 5-year survival between patients with or without metastatic subcarinal node (20.9% vs 25.6%, p=0.364). In terms of the number of metastatic mediastinal nodes, 5-year survival was better in single station group (26.3%) than multiple station group (18.3%) (p=0.048). In multiple station N2 group, the patients who received postoperative chemotherapy and radiation therapy had better 5-year survival (34.2%) (p=0.01). Cox's proportional hazards model revealed that the age $\geq$60 (O.R: 1.682, p=.006), multiple station N2 (O.R: 1.503. p=0.021), pneumonectomy (O.R: 1.562, p=0.018), postoperative chemotherapy and radiation therapy (O.R: 0.625, p=0.012) were the factors affecting the postoperative survival. Conclusion: Multiple station N2 disease was the important prognostic factor for postoperative survival in resected stage IIIA N2 non-small cell lung cancer. Postoperative chemotherapy and radiotherapy were thought to improve the survival in case of multiple station N2 disease.

A Case of Wilms Tumor with Thrombi which Invaded the Right Ventricule (종양색전이 우심실까지 침범한 Wilms 종양 1례)

  • Uhm, Ji Hyun;Won, Sung Chul;Lyu, Chuhl Joo;Yang, Chang Hyun;Kim, Byung Soo;Hwang, Eui Ho;Park, Young Hwan;Seo, Chang Ok
    • Clinical and Experimental Pediatrics
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    • v.45 no.3
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    • pp.390-394
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    • 2002
  • Wilms tumor is the second most common malignant retroperitoneal tumor. Inferior vena cava and right atrial involvement is found in about 4-10% and 0.5-3% of cases, respectively. But, right ventricular involvement has not been reported. We experienced a case of Wilms tumor with right ventricular invasion in a 2 year-old male who presented intermittent hematuria and abdominal pain. Computed tomogram and echocardiogram showed a homogeneous mass extended to right ventricle via inferior vena cava. He received pre-operative chemotherapy followed by operation, radiation therapy including heart, and post-operative chemotherapy.

Current Status and Consensus on Esophageal Cancer Management (식도암의 치료, 어디까지 와 있는가?)

  • Joon Han Jeon;Dae Young Cheung
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.17-23
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    • 2013
  • Over the decades, the treatment of the esophageal cancer has been debated. Multimodal therapy is a important keystone in advanced esophageal cancer. Neoadjuvant chemoradiation therapy is now known to provide advantages for treating stage II and stage III esophageal squamous cell cancer and can also be considered for the esophageal adenocarcinoma. Definitive chemoradiation therapy results in long-term survival compared with surgery alone. This review aims to provide recent consensus recommendations based on the data and literatures.

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Psychological Systematic Consideration of Breast Cancer Radiotherapy (유방암 방사선 치료 환자의 심리의 체계적 분석)

  • Yang, Eun-Ju;Kim, Young-Jae
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.629-635
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    • 2019
  • In term of the factors affecting psychosocial adjustment of breast cancer patients, their quality of life after surgical operation, radiation, and chemotherapy were systematically meta-analyzed. As a result, their qualities of life of the patients that had radiation therapy was the lowest right after the therapy, and gradually increased after the end of the therapy. However, after six months, their quality of life failed to reach the same level before the therapy. They had depression and side effects the most right after the therapy, and somewhat reduced them after the end of the therapy. In case of surgical operation, the more they were educated, the more they had psychosocial adjustment, and the more they had a medical examination and took out an insurance policy, the more they had psychosocial adjustment. In case of chemotherapy, their cognitive function is influenced so that they have impairments in memory, learning, and thinking stages. Since subjective cognitive impairment has a relationship with depression, it is necessary to monitor depression of chemotherapy patients. Given the results of this systematic meta-analysis, when three types of therapies (surgical operation, radiation therapy, and chemotherapy) are applied to patients with breast cancer, it is necessary to recognize their psychosocial adjustment, depression, anxiety, and quality of life in the nursing and radiation therapy fields and thereby to introduce an intervention program for a holistic approach.