• Journal of Chest Surgery
• /
• 제54권6호
• /
• pp.454-459
• /
• 2021

According to statistics from 2017, esophageal cancer is the fifteenth most common cancer and the eleventh most common cause of cancer-related death in Korea. The most common pathology is esophageal squamous cell carcinoma. Moreover, the incidence of esophageal cancer has been gradually decreasing in Korea, and the percentage of early-stage cases has gradually increased to the point that it is higher than that of other countries. The 5-year relative survival rate has improved over time. Approximately 800 esophagectomy procedures are performed annually. Using a cut-off number of 21 cases per 2 years to define high-volume centers, it was found that 70% of esophagectomies were performed by a few high-volume centers. Unfortunately, there is no nationwide registry or database on esophageal cancer and esophagectomy in Korea. Efforts to establish a nationwide database on esophageal cancer and esophagectomy should be made.

• Journal of Digestive Cancer Research
• /
• 제5권1호
• /
• pp.32-36
• /
• 2017

In unresectable stage IV colorectal cancer, the role of palliative surgery is not defined clearly. The palliative surgery can be categorized into two surgeries; first, palliative primary tumor resection; second, palliative metastatectomy. Several retrospective studies reported initial palliative systemic chemotherapy in unresectable stage IV colorectal cancer did not increase primary tumor related complications such as obstruction, perforation and hemorrhage, so they insisted that primary tumor resection in asymptomatic stage IV colorectal cancer should be preserved. However, in terms of overall survival and cancer-specific or progression-free survival, several retrospective studies, especially using population-based big data, reported favored survivals in palliative primary tumor resection group. And also several studies reported that palliative metastatectomy such as liver resection without resection of lung metastasis showed better overall survivals. But those results from those studies came from retrospective studies and are likely to be affected by selection bias. Prospective randomized studies are needed to define the benefit of palliative primary tumor resection and metastatectomy in unresectable stage IV colorectal cancer. However, based on the updated evidences, the dogma that palliative primary tumor resection should be preserved in asymptomatic unresectable stage IV colorectal cancer should be questioned.

• Journal of Gastric Cancer
• /
• 제20권1호
• /
• pp.41-49
• /
• 2020

Purpose: Patients with pathological stage T1N+ or T2-3N0 gastric cancer may experience disease recurrence following curative gastrectomy. However, the current Japanese Gastric Cancer Treatment Guidelines do not recommend postoperative adjuvant chemotherapy for such patients. This study aimed to identify the prognostic factors for patients with pT1N+ or pT2-3N0 gastric cancer using a multi-institutional dataset. Materials and Methods: We retrospectively analyzed the data obtained from 401 patients with pT1N+ or pT2-3N0 gastric cancer who underwent curative gastrectomy at 9 institutions between 2010 and 2014. Results: Of the 401 patients assessed, 24 (6.0%) experienced postoperative disease recurrence. Multivariate analysis revealed that age ≥70 years (hazard ratio [HR], 2.62; 95% confidence interval [CI], 1.09-7.23; P=0.030) and lymphatic and/or venous invasion (lymphovascular invasion (LVI): HR, 7.88; 95% CI, 1.66-140.9; P=0.005) were independent prognostic factors for poor recurrence-free survival. There was no significant association between LVI and the site of initial recurrence. Conclusions: LVI is an indicator of poor prognosis in patients with pT1N+ or pT2-3N0 gastric cancer.

• Journal of Gastric Cancer
• /
• 제13권2호
• /
• pp.98-105
• /
• 2013

Purpose: The aim of this study is to investigate the clinical factors affecting on the cure rate by invasive and open surgery for gastric cancer and to establish a subgroup of patients who can be applied by the early recovery after surgery program through this retrospective analysis. Materials and Methods: In this retrospective study, we analyzed 425 patients who underwent gastric cancer surgery between January 2011 and December 2011 and were managed with conventional clinical therapies. This clinical algorithm was made when the patient was in minimally invasive surgery group and discharged from hospital one day faster than them in open surgery group. Results: The completion rate of the clinical pathway was 62.4%. Despite the different applications of clinical pathway, completion rate in minimally invasive surgery group was significantly higher than that of open group (P<0.001). In multivariate analysis, the surgical procedure of minimally invasive surgery (odds ratio=4.281) was the most predictable factor to complete clinical pathway. Additionally, younger patients (odds ratio=1.933) who underwent distal gastrectomy (odds ratio=1.999) without combined resection (odds ratio=3.069) were predicted to accomplish the clinical pathway without any modifications. Conclusions: We concluded that high efficacy of the clinical pathway for gastric cancer surgery was expected to selected patients through retrospective analysis (expected completion rate=85.4%). In addition, these patients would become enrolled criteria for early recovery program in gastric cancer surgery.

• Clinical Endoscopy
• /
• 제57권4호
• /
• pp.424-433
• /
• 2024

Colonic stent placement is a commonly used bridging strategy for surgery in patients with obstructive colorectal cancer. The procedure involves the placement of a self-expandable metallic stent (SEMS) across the obstructive lesion to restore intestinal patency and alleviate the symptoms of obstruction. By allowing patients to receive surgery in a planned and staged manner with time for preoperative optimization and bowel preparation, stent placement may reduce the need for emergency surgery, which is associated with higher complication rates and poorer outcomes. This review focuses on the role of colon stenting as a bridge to surgery in the management of obstructive colorectal cancer. SEMS as a bridge to surgery for left-sided colon cancer has been demonstrated to be particularly useful; however, further research is needed for its application in cases of right-sided colon cancer. Colon stent placement also has limitations and potential complications including stent migration, re-obstruction, and perforation. However, the timing of curative surgery after SEMS placement remains inconclusive. Considering the literature to date, performing surgery at an interval of approximately 2 weeks is considered appropriate. Therefore, colonic stent placement may be an effective strategy as a bridge to surgery in patients with obstructive colorectal cancer.

• 대한두개안면성형외과학회지
• /
• 제21권2호
• /
• pp.87-91
• /
• 2020

Background: The incidence of skin cancer, which is primarily caused by exposure to ultraviolet radiation, has steadily increased in recent years. The authors of the present study sought to investigate changes in the epidemiology of skin cancer by conducting a retrospective review of patients diagnosed with skin cancer who received related care at a single medical institution. Methods: The present study included patients who were diagnosed with skin cancer and received treatment at Gyeongsang National University Hospital from 2008 to 2018. The site and type of skin cancer, the number of patients with skin cancer each year, the sex and sex ratio of the patients, and changes in patients' age at first diagnosis were examined through retrospective chart reviews. Results: The number of patients with skin cancer significantly increased, but statistically significant changes were not found in patients' sex, skin cancer sites, or the types of skin cancer. However, patients' age at the first diagnosis of skin cancer showed a statistically significant decrease starting in 2015. Conclusion: In this study, the number of patients with skin cancer increased over time. However, patients' age at first diagnosis has decreased since 2015. Therefore, younger patients should take care to prevent skin cancer, and further research on the causes of skin cancer in younger patients is needed.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권17호
• /
• pp.7223-7228
• /
• 2014

The MYH11 gene may be related to cell migration and adhesion, intracellular transport, and signal transduction. However, its relationship with prognosis is still uncertain. The aim of this study was to investigate correlations between MYH11 gene expression and prognosis in 58 patients with stage II and III colorectal cancer. Quantitative real-time polymerase chain reaction was performed in fresh CRC tissues to examine mRNA expression, and immunohistochemistry was performed with paraffin-embedded specimens for protein expression. On univariate analysis, MYH11 expression at both mRNA and protein levels, perineural invasion and lymphovascular invasion were related to disease-free survival (p<0.05; log-rank test). Cancers with lower MYH11 expression were more likely to have a poor prognosis. Otherwise, MYH11 expression was unrelated to patient clinicopathological features. On multivariate analysis, low MYH11 expression proved to be an independent adverse prognosticator (p<0.05). These findings show that MYH11 can contribute to predicting prognosis in stage II and III colorectal cancers.

• 한국병원경영학회지
• /
• 제26권4호
• /
• pp.59-66
• /
• 2021

Purposes: This study aimed to identify relevant factors that determine cancer surgery at a medium-sized general hospital where patients are diagnosed with cancer. Methodology: The study subjects were 1,530 patients diagnosed with cancer between November 2013 and October 2019 at a 400-bed general hospital located in the metropolitan area. Multiple logistic regression analysis was performed to identify the patient characteristics, cancer types, and characteristics of treatment experience of the study subjects, in addition to the determinants of cancer surgery in the hospital. Findings: Among 1,530 cases diagnosed with cancer, 353 cases (23.1%) were operated at the hospital where the cancer diagnosis was made. As determinants of surgery after a fist-time diagnosis at a general hospital, the likelihood of having surgery at the hospital, for colorectal cancer patients compared to stomach cancer patients (Odds Ratio=2.38), bladder and kidney cancer patients (Odds Ratio=1.79). According to the results of an additional survey conducted, it was found that important determinants of decisions on a hospital to receive cancer surgery were the kindness of the staff including doctors and nurses, and the trust in the medical skills and technique of the doctor. Practical Implication: The management of general hospitals should take note of the fact that it is important to establish proactive strategies for hospital management including strengthening the rapport between patients and medical institutions based on the kindness of medical staff (doctors and nurses) and staff, in addition to promoting cancer adequacy evaluation results and introducing one-stop systems.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권1호
• /
• pp.377-381
• /
• 2012

The aim of this study was to screen for polypeptides binding specifically to LoVo human colorectal cancer cells using a phage-displayed peptide library as a targeting vector for colorectal cancer therapy. Human normal colorectal mucous epithelial cells were applied as absorber cells for subtraction biopanning with a c7c phage display peptide library. Positive phage clones were identified by enzyme-linked immunosorbent assay and immunofluorescence detection; amino acid sequences were deduced by DNA sequencing. After 3 rounds of screening, 5 of 20 phage clones screened positive, showing specific binding to LoVo cells and a conserved RPM motif. Specific peptides against colorectal cancer cells could be obtained from a phage display peptide library and may be used as potential vectors for targeting therapy for colorectal cancer.

• Journal of Gastric Cancer
• /
• 제15권3호
• /
• pp.214-217
• /
• 2015

Surgeons occasionally encounter a patient with a gastric cancer invading an adjacent organ, such as the pancreas, liver, or transverse colon. Although there is no established guideline for treatment of invasive gastric cancer, combined resection with radical gastrectomy is conventionally performed for curative purposes. We recently treated a patient with a large gastric cancer invading the abdominal wall, which was initially diagnosed as a simple abdominal wall abscess. Computed tomography showed that an abscess had formed adjacent to the greater curvature of the stomach. During surgery, we made an incision on the abdominal wall to drain the abscess, and performed curative total gastrectomy with partial excision of the involved abdominal wall. The patient received intensive treatment and wound management postoperatively with no surgery-related adverse events. However, the patient could not receive adjuvant chemotherapy and expired on the 82nd postoperative day.