• Annals of Surgical Treatment and Research
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• v.96 no.2
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• pp.78-85
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• 2019

Purpose: Insistence that total regression of primary tumor would not represent long-term oncologic outcomes has been raised. Therefore, this study aimed to evaluate the outcomes of these patients after preoperative chemoradiotherapy (PCRT) and radical surgery and to evaluate the associated risk factors. Methods: We included 189 patients with rectal cancer who showed total regression of the primary tumor after PCRT, followed by radical resection, between 2001 and 2012. Recurrence-free survival (RFS) was calculated using the Kaplan-Meier method, and the results were compared with 77 patients with Tis rectal cancer who received only radical resection. Factors associated with RFS were evaluated using Cox regression analysis. Results: Sphincter-saving resection was performed for 146 patients (77.2%). Adjuvant chemotherapy was administered to 168 patients (88.9%). During the follow-up period, recurrence occurred in 17 patients (9%). The 5-year RFS was 91.3%, which was significantly lower than that of patients with Tis rectal cancer without PCRT (P = 0.005). In univariate analysis, preoperative CEA and histologic differentiation were associated with RFS. However, no factors were found to be associated with RFS. Conclusion: RFS was lower in patients with total regression of primary rectal cancer after PCRT than in those with Tis rectal cancer without PCRT, and it would not be considered as the same entity with early rectal cancer or "disappeared tumor" status.

• Korean Journal of Social Welfare Studies
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• v.45 no.2
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• pp.123-146
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• 2014

This study aims to investigate the employment duration and the probability of quitting the job at first return-to-work of injured workers. This study collected data with structured questionnaires and finally included 515 injured workers. The Kaplan-Meier method is used for describing the employment duration, and the Cox regression is used to identify significant factors on the probability of quitting the job at first return-to-work. The results show that among the all respondents, the 5.65% quitted the job within 1 month, 14.14% within 3 months, 23.7% within 6 months, and 32.81% within 1 years. The Cox regression results show that the probability of quitting the job at first return-to-work is significantly affected by age, marital status, education, employment period when happened the accident, job retention, income change, and classification of diseases. As a result, some implication and policies are suggested for the return-to-work and employment durability of injured workers.

• Korean Journal of Clinical Oncology
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• v.14 no.2
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• pp.128-134
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• 2018

Purpose: Previous studies have addressed the role of the hypercoagulable state in the pathogenesis of cancer progression and metastasis. In this study, we investigated the association between coagulation factors, including tissue factor (TF) expression, platelet count, and fibrinogen level, and disease recurrence in patients with non-metastatic colorectal cancer. Methods: Patients who underwent curative resection for stage II or III colorectal cancer between 2000 and 2007 were included in this study. Data from a prospectively maintained database were retrospectively reviewed. TF expression was determined by immunohistochemistry using an anti-TF monoclonal antibody. The Kaplan-Meier method was used to estimate 5-year disease-free survival. Results: TF was highly expressed in 257 of 297 patients (86.5%). TF expression was not significantly associated with the platelet counts (P=0.180) or fibrinogen level (P=0.281). The 5-year disease-free survival rate was lower in patients with high TF expression than in patients with low TF expression (72.3% vs. 83.9%, P=0.074). In Cox hazard analysis, high TF expression was an independent risk factor for tumor recurrence (hazard ratio [HR] 2.446; 95% confidence interval [CI], 1.054-5.674; P=0.037). Undifferentiated histologic type (HR, 2.911; 95% CI, 1.308-6.481; P=0.009), venous invasion (HR, 2.784; 95% CI, 1.431-5.417; P=0.003), and lymph node metastasis (HR, 2.497; 95% CI, 1.499-4.158; P<0.001), were also significantly associated with disease recurrence. Conclusion: TF expression is associated with a recurrence in patients with non-metastatic colorectal cancer. However, further studies are required to clarify the underlying mechanisms relating TF expression with oncologic outcomes and its potential role as a therapeutic target.

• Journal of Gastric Cancer
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• v.19 no.1
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• pp.102-110
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• 2019

Purpose: Despite an increased acceptance of laparoscopic gastrectomy (LG) in early gastric cancer (EGC), there is insufficient evidence for its oncological safety in advanced gastric cancer (AGC). This is a prospective phase II clinical trial to evaluate the feasibility of LG with D2 lymph node dissection (LND) in AGC. Materials and Methods: The primary endpoint was set as 3-year disease-free survival (DFS). The eligibility criteria were as follows: 20-80 years of age, cT2N0-cT4aN3, American Society of Anesthesiologists score of 3 or less, and no other malignancy. Patients were enrolled in this single-arm study between November 2008 and May 2012. Exclusion criteria included cT4b or M1, or having final pathologic results as EGC. All patients underwent D2 lymphadenectomy. Three-year DFS rates were estimated by the Kaplan-Meier method. Results: A total of 157 patients were enrolled. The overall local complication rate was 10.2%. Conversion to open surgery occurred in 11 patients (7.0%). The mean follow-up period was $55.0{\pm}20.4months$ (1-81 months). The cumulative 3-year DFS rates were 76.3% for all stages, and 100%, 89.3%, 100%, 88.0%, 71.4%, and 35.3% for stage IB, IIA, IIB, IIIA, IIIB, and IIIC, respectively. Recurrence was observed in 37 patients (23.6%), including hematogenous (n=6), peritoneal (n=13), locoregional (n=1), distant node (n=8), and mixed recurrence (n=9). Conclusions: In addition to being technically feasible for treatment of AGC in terms of morbidity, LG with D2 LND for locally advanced gastric cancer showed acceptable 3-year DFS outcomes.

• The Korean Journal of Urological Oncology
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• v.16 no.3
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• pp.126-134
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• 2018

Purpose: The purpose of this study is to compare the radiation therapy (RT) and radical prostatectomy (RP) of high-risk or locally advanced prostate cancer (PC) patients after neoadjuvant hormonal therapy (NHT). Materials and Methods: This retrospective study evaluated patients underwent RT (42 patients) or RP (152 patients) after NHT at a single center during 2003-2014. Times to biochemical recurrence (BCR), pelvic local recurrence (PLR), metastasis, clinical painful symptom progression (CPSP), castration-resistant PC (CRPC), and overall survival were compared between the RT and RP groups, after adjustment for TN stage, using the Kaplan-Meier method and log-rank test. Results: Significant inter-group differences were observed for age, Gleason score, initial PSA, and clinical and pathological T stages (all p<0.05). During a median follow-up of 71.7 months, the overall incidences of BCR, PLR, metastasis, CPSP, CRPC, and death were 49.5%, 16.5%, 8.3%, 7.7%, 7.7%, and 17.5%, respectively. The median times to BCR were 100 months for RT and 36.2 months for RP (p=0.004), although the median times were not reached for the other outcomes (all p>0.05). The independent predictor of CPSP was RP (hazard ratio, 0.291; p=0.013). Conclusions: Despite significantly different baseline parameters, RP provided better CPSP-free survival than RT among patients with localized high-risk or locally advanced PC.

• Implantology
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• v.22 no.4
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• pp.196-209
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• 2018

Purpose: The purpose of this study was to analyze the cumulative survival rate of dental implants installed with guided bone regeneration (GBR), and also elucidate the factors related with the survival of dental implants. Material and Methods: This retrospective study was conducted on 148 dental implants installed in 76 patients by one specialist (Y.K.) at the Department of Periodontology and Implant Center, Seoul National University Dental Hospital from 2001 to 2010. The cumulative survival rates were obtained by the Kaplan-Meier method. The correlations between various factors and dental implant survival were analyzed by using the log-rank test and Cox proportional hazards model. Results: Among 148 dental implants installed in 76 patients, 8 implants in 7 patients were lost and the cumulative survival rates up to 5-years and 10-years were 97% and 89%, respectively. Gender, smoking status and location of implant were significantly associated with the cumulative survival rate of implants (p < 0.05). Age, history of hypertension and diabetes were not significantly associated with the cumulative survival rate of implants (p > 0.05). Conclusion: The dental implants installed with guided bone regeneration is predictable technique according to the results of cumulative survival rate over 10 years.

• Journal of Chest Surgery
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• v.52 no.3
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• pp.148-154
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• 2019

Background: This study investigated the clinical outcomes of surgical treatment of primary chest wall soft tissue sarcoma (CW-STS). Methods: Thirty-one patients who underwent surgery for CW-STS between 2000 and 2015 were retrospectively reviewed. The disease-free and overall survival rates were estimated using the Kaplan-Meier method, and prognostic factors were analyzed using a Cox proportional hazards model. Results: The median follow-up duration was 65.6 months. The most common histologic type of tumor was malignant fibrous histiocytoma (29%). The resection extended to the soft tissue in 14 patients, while it reached full thickness in 17 patients. Complete resection was achieved in 27 patients (87.1%). There were 5 cases of local recurrence, 3 cases of distant metastasis, and 5 cases of combined recurrence. The 5-year disease-free rate was 49%. Univariate analysis indicated that incomplete resection (p<0.001) and stage (p=0.062) were possible risk factors for recurrence. Multivariate analysis determined that incomplete resection (p=0.013) and stage (p=0.05) were significantly associated with recurrence. The overall 5- and 10-year survival rates were 86.8% and 64.3%, respectively. No prognostic factor for survival was identified. Conclusion: Long-term primary CW-STS surgery outcomes were found to be favorable. Incomplete microscopic resection and stage were risk factors for recurrence.

• Smart Media Journal
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• v.9 no.4
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• pp.126-133
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• 2020

The treatment policy and prognosis are determined based on the final stage of lung cancer patients. The final stage of lung cancer patients is determined based on the T, N, and M stage classification table provided by the American Cancer Society (AJCC). However, the final stage of AJCC has limitations in its use for various fields such as patient treatment, prognosis and survival days prediction. In this paper, clustering algorithm which is one of non-supervised learning algorithms was assessed in order to check whether using only T, N, M stages with a data science method is effective for classifying the group of patients in the aspect of survival days. The final stage groups and T, N, M stage clustering groups of lung cancer patients were compared by using the cox proportional hazard model. It is confirmed that the accuracy of prediction of survival days with only T, N, M stages becomes higher than the accuracy with the final stages of patients. Especially, the accuracy of prediction of survival days with clustering of T, N, M stages improves when more or less clusters are analyzed than the seven clusters which is same to the number of final stage of AJCC.

• Journal of Gastric Cancer
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• v.21 no.2
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• pp.155-168
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• 2021

Purpose: Previous studies have demonstrated the usefulness of the controlling nutritional status (CONUT) score in nutritional assessment and survival prediction of patients with various malignancies. However, its value in advanced gastric cancer (GC) treated with neoadjuvant chemotherapy and curative gastrectomy remains unclear. Materials and Methods: The CONUT score at different time points (pretreatment, preoperative, and postoperative) of 272 patients with advanced GC were retrospectively calculated from August 2004 to October 2015. The χ² test or Mann-Whitney U test was used to estimate the relationships between the CONUT score and clinical characteristics as well as short-term outcomes, while the Cox proportional hazard model was used to estimate long-term outcomes. Survival curves were estimated by using the Kaplan-Meier method and log-rank test. Results: The proportion of moderate or severe malnutrition among all patients was not significantly changed from pretreatment (13.5%) to pre-operation (11.7%) but increased dramatically postoperatively (47.5%). The pretreatment CONUT-high score (≥4) was significantly associated with older age (P=0.010), deeper tumor invasion (P=0.025), and lower pathological complete response rate (CONUT-high vs. CONUT-low: 1.2% vs. 6.6%, P=0.107). Pretreatment CONUT-high score patients had worse progression-free survival (P=0.032) and overall survival (OS) (P=0.026). Adjusted for pathologic node status, the pretreatment CONUT-high score was strongly associated with worse OS in pathologic node-positive patients (P=0.039). Conclusions: The pretreatment CONUT score might be a straightforward index for immune-nutritional status assessment, while being a reliable prognostic indicator in patients with advanced GC receiving neoadjuvant chemotherapy and curative gastrectomy. Moreover, lower pretreatment CONUT scores might indicate better chemotherapy responses.

• Journal of Korean Academy of Nursing
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• v.50 no.6
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• pp.837-847
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• 2020

Purpose: The purpose of this study was to investigate the effects of hospital characteristics on employment rate, working period, and retirement of ward nurses in Korea through a retrospective cohort study based on HIRAS data. Methods: Data were obtained from a report on medical care institutions of Health Insurance Review & Assessment Service (HIRAS). Data from 259,941 nurses who were working for a day or more from January 1, 2012, to December 31, 2016, at 2,942 medical care institutions were analyzed. Life table method analysis, Kaplan-Meier analysis, and Cox proportional hazard regression analysis were conducted. Results: The employment rates of 5 yeas and 10 years for the total sample were 38% and 28%, respectively. The estimated mean value of the working period was 3,642.7 days (SE: 17.4 days). Cox proportional hazard regression analyses revealed that nurses who were working at the general hospital/hospital, clinic, and nursing hospital were more likely to leave the hospital compared to those who were working at the 3rd general hospital. Nurses who were working at the medical institutions which were located in cities and countries, established by the private foundation, rated lower levels of nursing, and owned an insufficient number of beds, nurses and doctors were more likely to leave their workplace compared to those of the counterparts. Conclusion: This study indicates that hospital characteristics may play a significant role in retirement and working period of ward nurses in Korea. The improvement of hospital conditions to reduce ward nurses' retirement are needed.