• Journal of Gastric Cancer
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• v.12 no.1
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• pp.7-12
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• 2012

More than ten years have passed since the sentinel node (SN) concept for gastric cancer surgery was first discussed. Less invasive modified surgical approaches based on the SN concept have already been put into practice for malignant melanoma and breast cancer, however the SN concept is not yet placed in a standard position in gastric cancer surgery even after two multi-institutional prospective clinical trials, the Japan Clinical Oncology Group trial (JCOG0302) and the Japanese Society for Sentinel Node Navigation Surgery (SNNS) trial. What is the problem in the clinical application of the SN concept to gastric cancer surgery? There is no doubt that we need reliable indicator(s) to determine with certainty the absence of metastasis in the lymph nodes in order to avoid unnecessary lymphadenectomy. There are several matters of debate in performing the actual procedure, such as the type of tracer, the site of injection, how to detect and harvest, how to detect metastases of SNs, and learning period. These issues have to be addressed further to establish the most suitable procedure. Novel technologies such as indocyanine green (ICG) fluorescence imaging and one-step nucleic acid amplification (OSNA) may overcome the current difficulties. Once we know what the problems are and how to tackle them, we can pursue the goal.

• Journal of Breast Disease
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• v.6 no.2
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• pp.46-51
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• 2018

Purpose: Endocrine therapy is the preferred treatment for hormone receptor (HR)-positive metastatic breast cancer (MBC). We investigated the efficacy of combined aromatase inhibitor (AI) and luteinizing hormone-releasing hormone (LHRH) agonist in premenopausal patients with HR-positive MBC. Methods: We retrospectively analyzed the medical records of 21 HR-positive premenopausal MBC patients treated with combined AI and LHRH agonist therapy. Results: The median follow-up period was 32.9 months. The overall response rate was 47.6%, with three complete responses (14.3%) and seven partial responses (33.3%). Nine patients (42.9%) achieved stable disease lasting more than 6 months; thus, the clinical benefit rate was 90.4%. The median time to progression was 45.4 months. No patients experienced grade 3 or 4 toxicity. Conclusion: Combined AI and LHRH agonist treatment safely and effectively induced remission or prolonged disease stabilization, suggesting that this could be a promising treatment option for HR-positive premenopausal patients with MBC.

• Journal of Gastric Cancer
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• v.10 no.4
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• pp.219-225
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• 2010

Purpose: The long-term survival rate of gastric cancer patients after surgery has recently increased as a result of making an early diagnosis of gastric cancer. Therefore, the incidence of remnant gastric cancer is increasing. This study was performed to evaluate the clinicopathological characteristics and prognosis of patients with remnant gastric cancer. Materials and Methods: From January 2005 to December 2009, twenty-nine patients with remnant gastric cancer and who underwent surgery at Pusan National University Hospital were enrolled in this study. We retrospectively reviewed and analyzed their medical records. We also divided them into two groups: the remnant gastric cancer (RGC)-B group (first operation for benign disease) and the RGC-M group (first operation for malignant disease). Results: The RGC-B group included ten patients and the RGC-M group included nineteen patients. The mean interval between the first and second operations was 17 years. The curative resection rate was 93.1% (27/29). The postoperative complication rate was 20.7% (6/29) and there was no perioperative mortality. Ten (37%) of twenty-seven patients experienced recurrence after curative resection and eight patients (27.6%) expired due to aggravation of remnant stomach cancer. An advanced TNM stage and non-curative resection were the negative prognostic factors for survival for patients with remnant stomach cancer (P=0.0453 and P<0.001). The RGC-M group showed a shorter interval (P<0.001) and the RGC-B group had more advanced TNM stage (P=0.003). Conclusions: Long-term follow-up should be considered not only for patients who undergo an operation for malignant disease, but also for the patients who underwent an operation for benign disease. When remnant gastric cancer is diagnosed, curative resection is essential to improve the survival.

• Journal of Gastric Cancer
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• v.13 no.3
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• pp.164-171
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• 2013

Purpose: Laparoscopy-assisted distal gastrectomy for early gastric cancer has gained acceptance and popularity worldwide. However, laparoscopy-assisted distal gastrectomy for advanced gastric cancer is still controversial. Therefore, we propose this prospective randomized controlled multi-center trial in order to evaluate the safety and feasibility of laparoscopy assisted D2-gastrectomy for advanced stage gastric cancer. Materials and Methods: Patients undergoing distal gastrectomy for advanced gastric cancer staged cT2/3/4 cN0/1/2/3a cM0 by endoscopy and computed tomography are eligible for enrollment after giving their informed consent. Patients will be randomized either to laparoscopyassisted distal gastrectomy or open distal gastrectomy. Sample size calculation revealed that 102 patients are to be included per treatment arm. The primary endpoint is the non-compliance rate of D2 dissection; relevant secondary endpoints are three-year disease free survival, surgical and postoperative complications, hospital stay and unanimity rate of D2 dissection evaluated by reviewing the intraoperative video documentation. Discussion: Oncologic safety is the major concern regarding laparoscopy-assisted distal gastrectomy for advanced gastric cancer. Therefore, the non-compliance rate of clearing the N2 area was chosen as the most important parameter for the technical feasibility of the laparoscopic procedure. Furthermore, surgical quality will be carefully reviewed, that is, three independent experts will review the video records and score with a check list. For a long-term result, disease free survival is considered a secondary endpoint for this trial. This study will offer promising evidence of the feasibility and safety of Laparoscopy-assisted distal gastrectomy for advanced gastric cancer. Trial Registration: NCT01088204 (international), NCCCTS-09-448 (Korea).

• CELLMED
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• v.14 no.5
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• pp.79.1-79.4
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• 2024

Objective: To report a case of postoperative improvement in a uterine cancer patient using Ortho-Cellular Nutrition Therapy (OCNT). Methods: A Korean woman in her fifties suffering from postoperative complications associated with uterine cancer treatment. Results: Significant improvement in various indicators was noted following the administration of nutritional therapy after uterine cancer surgery. Conclusion: OCNT may aid in alleviating symptoms following uterine cancer surgery.

• Archives of Plastic Surgery
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• v.34 no.5
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• pp.617-621
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• 2007

Purpose: With the necessity of comprehensive care for the breast cancer patients, Breast Care Center of our hospital started to work in March 2004. This study examined the 3-year execution of Breast Care Center. The role of Breast Care Center was evaluated in aspect of clinical activities in quality and quantity. Methods: A retrospective review was carried out from 2001 to 2007 with breast cancer patients. The number and type of breast cancer surgery and breast reconstruction procedure were compared before and after Breast Care Center's foundation. Time required for the diagnosis and treatment was also compared. Regression analysis and T-test were used to identify the statistical significance. Results: The number of breast cancer surgery did not statistically increase compared with progressive increase of breast cancer. QUART(quadrantectomy, axillary dissection, radiotherapy) procedure statistically significantly increased and MRM(Modified Radical Mastectomy) procedure decreased for breast cancer surgery after foundation of Breast Care Center. The number of breast reconstruction procedures statistically significantly increased. The number of immediate TRAM free flap (Transverse Rectus Abdominal muscle free flap) procedures has grown 3.8 times after foundation of Breast Care Center. The time required for diagnosis and treatment was also shortened. Conclusion: After foundation of Breast Care Center, the number of breast reconstruction surgery increased, while the counselling time in breast reconstruction was reduced. Breast Care Center provided a prompt and comprehensive care to the breast cancer patients through the multidisciplinary therapeutic approaches.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.91-95
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• 1998

Background： Laryngeal cancer, the most common malignancy of head and neck, is being detected and treated in earlier and more effectively due to introduction of endoscope, continuous development of radiographic technology, and advancement in new surgical techniques such as laser surgery and conservation laryngeal surgery Objectives To compare the different treatment results for early laryngeal cancer to determine which methos provides the good prognosis. Materials and Methods： Retrospective study was done for 135 patients with early laryngeal squamous cell carcinoma(Stage I or II) who were treated at our institute between 1989 to 1996. There were 105 patients with glottic cancer(Stage I: 68 patients, Stage II：37 Patients) and 30 patients with supraglottic cancer(Stage I: 12 patients, Stage II：18 patients) Initial treatment included radiation therapy for 54 patients, endoscopic laser surgery for 8 patients, laryngofissure and cordectomy for 8 patients, vertical partial laryngectomy for 37 patients, supraglottic laryngecomy for 14 patients and supracricoid laryngectomy for 5 patiens, and total laryngectomy for 9 patients. Results : Salvage treatments, such as total laryngectomy, conservation laryngeal surgery, radiation therapy and neck dissection were performed for initial treatment failure with 9 patients after radiation therapy, 8 patients after conservation laryngeal surgery, 2 patients after endoscopic laser and 3 patients after total laryngectomy. Overall 3-year survival rate for glottic 71 was 92.4%, glottic f 84.3%, supraglottic 7172.7%, and supraglottic f was 63.%%. However, survival rate of the same stage was variable according to the choice of initial treatment. Conclusion New classification of the early laryngeal cancer was necessary and helpful for the choice of the initial treatment.

• Journal of Breast Cancer
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• v.21 no.4
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• pp.447-452
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• 2018

Purpose: The recent trend in breast cancer treatment is to minimize axillary dissection. However, no pattern of axillary metastasis has been precisely established. The purpose of this study was to evaluate the metastatic lymphatic pattern using near-infrared fluorescence imaging with indocyanine green (ICG) in breast cancer with cytologically proven axillary metastasis. Methods: This was a prospective single-center study. We evaluated 147 patients with breast cancer involving cytologically proven axillary metastasis, and compared physiological and nonphysiological lymphatic metastasis. Results: We performed lymphatic mapping for 64 patients who exhibited level II lymphatic flow on near-infrared fluorescence imaging with ICG, and found that all had axillary metastasis: 51 patients who did not receive neoadjuvant chemotherapy (NAC) and 13 patients post-NAC. Of patients who did not receive NAC, 32 had physiological lymphatic metastasis and 19 had nonphysiological lymphatic metastasis. The risk factors for nonphysiological lymphatic metastasis were age ${\geq}55$ years, high Ki-67 index (>20%), and perinodal extension in both univariate and multivariate analysis (p<0.05). Conclusion: Patients with identified risk factors in cytologically-proven axillary metastasis who did not receive NAC may have nonphysiological lymphatic metastasis.

• Journal of Gastric Cancer
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• v.16 no.4
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• pp.254-259
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• 2016

Purpose: Owing to increased life expectancy, the number of elderly patients with gastric cancer has increased. This study aimed to identify the outcomes of gastric cancer patients aged 80 years or older through comparison of their clinicopathological characteristics, surgical outcomes, and oncologic outcomes. Materials and Methods: Between January 2006 and December 2013, the records of 478 patients who underwent surgery for gastric cancer were retrospectively evaluated. Patients were divided into two groups: patients <80 years old (n=446) and patients ${\geq}80$ years old (n=32). Results: There were no significant differences in sex, body mass index, length of hospital stay, duration of surgery, depth of invasion, nodal metastasis, histologic type, or tumor size between the two groups. However, significant differences were found for the American Society of Anesthesiologist score and the serum albumin level between the two groups. Postoperative morbidity, mortality, disease-free survival, and recurrence rate did not differ between curatively resected patients in the two groups. Conclusions: In elderly patients with gastric cancer, active treatment including radical gastrectomy is necessary.

• Journal of Gastric Cancer
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• v.23 no.4
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• pp.509-511
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• 2023