• Journal of Gynecologic Oncology
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• 제29권6호
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• pp.91.1-91.12
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• 2018

Objective: To examine the association between tumor grade and survival for women with squamous cervical cancer. Methods: This retrospective observational study utilized the Surveillance, Epidemiology, and End Result program data between 1983 and 2013 to examine women with squamous cervical cancer with known tumor differentiation grade. Multivariable analyses were performed to assess independent associations between tumor differentiation grade and survival. Results: A total of 31,536 women were identified including 15,175 (48.1%) with grade 3 tumors, 14,084 (44.7%) with grade 2 neoplasms and 2,277 (7.2%) with grade 1 tumors. Higher tumor grade was significantly associated with older age, higher stage disease, larger tumor size, and lymph node metastasis (all, p<0.001). In a multivariable analysis, grade 2 tumors (adjusted-hazard ratio [HR]=1.21; p<0.001) and grade 3 tumors (adjusted-HR=1.45; p<0.001) were independently associated with decreased cause-specific survival (CSS) compared to grade 1 tumors. Among the 7,429 women with stage II-III disease who received radiotherapy without surgical treatment, grade 3 tumors were independently associated with decreased CSS compared to grade 2 tumors (adjusted-HR=1.16; p<0.001). Among 4,045 women with node-negative stage I disease and tumor size ${\leq}4cm$ who underwent surgical treatment without radiotherapy, grade 2 tumors (adjusted-HR=2.54; p=0.028) and grade 3 tumors (adjusted-HR=4.48; p<0.001) were independently associated with decreased CSS compared to grade 1 tumors. Conclusion: Our study suggests that tumor differentiation grade may be a prognostic factor in women with squamous cervical cancer, particularly in early-stage disease. Higher tumor grade was associated with poorer survival.

• 한국노년학
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• 제32권2호
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• pp.447-465
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• 2012

본 연구는 국민기초생활수급 여성독거노인의 생애 경험을, 사회구조의 힘이 작용하는 사회적 배제의 관점과 이에 대응하는 여성 행위자(agent)의 구체적 삶을 통해 살펴봄으로써, 적절한 실천적 함의를 제공하는데 그 목적을 두고 있다. 연구는 질적연구방법 중 하나인 생애사 연구로 진행되었다. 4명의 국민기초생활수급 여성독거노인이 참여했으며, 일대일 심층면접을 통해 자료는 수집했다. 수집된 자료는 Mandelbaum(1973)이 제안한 삶의 영역(dimension), 전환점(turnings), 적응(adaptation)의 세 가지 개념 틀을 활용하였다. 연구결과를 살펴보면, 참여자들의 유년기는 '유랑(流浪)의 시작'이었고, 결혼이후는 여전히 '부유(浮游)하는 삶'이었다. 하지만 사별·결별 이후 '실존적 삶'을 지향하고 있었다. 이상의 결과에 근거해, 국민기초생활수급 여성독거노인의 자존(自存) 능력을 강화하고 본성(本性)에 따라 사는 삶의 필요성을 제안했다.