• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6889-6892
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• 2013

Background: Testicular germ cell tumors (TGCTs) are a relatively common malignancy in young men. The aim of this study was to investigate the clinicopathological features and survival of young Turkish patients with TGCT. Materials and Methods: In this retrospective study, the clinical and pathological characteristics of young Turkish patients with TGCT who were monitored by the Department of Medical Oncology of a military hospital between 2008 and 2013 were investigated. Overall survival data were analyzed. Results: Ninety-six patients were included in the study. The mean age was 26.4 years. Among the patients, 17.7% had seminoma and 43.8% had mixed non-seminomatous germ cell tumors. Some 46.9% were Stage I, 30.2% were Stage II, and 22.9 were Stage III. Of the patients, 83.3% received chemotherapy, 25% underwent retroperitoneal lymph node dissection (RPLND), 3.1% received radiotherapy, and 12.5% were followed-up without treatment. In addition, 18.8% of the patients were administered salvage chemotherapy due to relapse or progression. The 5-year overall survival rate was 90.2% for all patients. The 2-year overall survival rate was 100% for Stage I patients, 94% for Stage II patients, and 70.2% for Stage III patients. The difference between the survival curves of stages was statistically significant (p=0.029). Conclusions: In young Turkish patients with TGCT, good results were obtained with appropriate treatment, most receiving chemotherapy. The prognosis of the disease was good even in the advanced stage.

• Advances in pediatric surgery
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• 제11권2호
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• pp.107-114
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• 2005

Primary liver tumors are uncommon in childhood, with a relative frequency of 3 % of all childhood tumors. Seventy-three cases of pediatric primary liver tumors operated on at single institution between 1986 and 2002 were reviewed. Malignant tumors included 37 cases of hepatoblastoma, 11 hepatocellular carcinomas, 6 undifferentiated (embryonal) sarcomas, and 1 mixed germ-cell tumor. Benign tumors constitute only 24.6 % of liver tumors, including 7 hemangioendotheliomas, 5 mesenchymal hamartomas, 3 congenital cysts, and one each with focal nodular hyperplasia and hemangioma. The common presenting clinical features were abdominal mass or abdominal distension. Anatomical hepatic resections were carried out in 38 cases, and nonanatomical resections in 34 cases. One patient died of a direct result of hepatic resection (1.4 %). The complication rate was 16.4 %.

• Advances in pediatric surgery
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• 제16권2호
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• pp.134-142
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• 2010

Malignant ovarian tumors in children are very rare, and consist of about 1 % of all childhood malignant tumors. The purpose of this study is to examine the clinical characteristics, treatment, and prognosis for children with malignant ovarian tumors. We retrospectively reviewed the medical records of children under 15 years of age with malignant ovarian tumors who had been treated surgically at Asan Medical Center between 1989 and March 2009. There were 32 patients, ranged in age at surgery from 2 to 15 years (mean; 10.4 years). The median follow-up period was 64.7 months (from 1 month to 188 months). Pathologic diagnosis were; immature teratoma (n=10), mixed germ cell tumor (n=10), and dysgerminoma (n=6). Tumor stage was classified by the staging system of the International Federation of Gynecology and Obstetrics (FIGO). The number of patients in stage I, II, III, and IV were 24 (75 %), 2 (6.2 %), 4 (12.5 %), and 2 (6.1 %), respectively. The tumor recurred in 4 patients. Seven patients of group 1 did not receive postoperative adjuvant chemotherapy, and in three of them, the tumor recurred. Twenty-five patients (group 2) underwent postoperative adjuvant chemotherapy, and there was only one recurrence. One patient who did not receive postoperative adjuvant chemotherapy and expired 10 months after operation because of tumor recurrence and distant metastasis. The overall 5-year event free survival (EFS) was 84.2 %: group 1 in 44.4 %, and group 2 in 95.7 %. Tumor recurrence was related to the postoperative adjuvant chemotherapy (p=0.004). In conclusion, proper surgical procedures with relevant postoperative adjuvant chemotherapy might improve clinical results in children with malignant ovarian tumors.

• Journal of Korean Neurosurgical Society
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• 제30권5호
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• pp.575-580
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• 2001

Purpose : In general, pineal region tumors are managed by using microsurgical approach or stereoctactic biopsy. However, in selected cases endoscopic approach to pineal lesions might prove to be as effective as microsurgery and less invasive. We report an alternative surgical strategy for managing certain patients with pineal neoplasms that allows treatment of the symptomatic hydrocephalus as well as tumor biopsy under direct vision in the same sitting. Materials and Methods : Twenty-two patients with pineal region tumors with associated hydrocephalus were treated in one session by endoscopic third ventriculostomy and endoscopic tumor biopsy at our institution from October 1996 to January 2000. All patients were retrospectively evaluated. Results : There was no operative mortality. There was one cause of significant bleeding during biopsy, but was controlled endoscopically, and the patient recovered completely without neurologic deficit resulting from intra-operative bleeding. The symptoms related to increased intracranial pressure(ICP) have resolved in all patients, and the need for a shunt is completely eliminated. Histological diagnosis was achieved in 21 of the 22 patients by this procedure. A biopsy was not obtained in one patient. Although this pineal region tumor was seen endoscopically, this could not be biopsied because of technical difficulties in working around an enlarged massa intermedia. The lesions included fourteen germinomas, three mixed germ cell tumors, and one each of the followings: pineocytoma, pineoblastoma, pineocytoma/pineoblastoma(intermediate type), meningioma, and low grade glioma. Five of the 22 patients subsequently underwent formal microsurgical tumor removal. Additional chemotherapy or radiotherapy could then be initiated according to the histological diagnosis. Conclusion : We consider that endoscopy affords a minimally invasive way of reaching three objectives by one-step surgery in the management of pineal region tumors with associated hydrocephalus : 1) cerebrospinal fluid(CSF) sample for analysis of tumour markers and cytology, 2) treatment of hydrocephalus by third ventriculostomy, and 3) several biopsy specimens can be obtained identifying tumors which will require further open surgery or adjuvant radiation and/or chemotherapy. However, complications and morbidities should be emphasized so as to be avoided with further technical experience.

• Radiation Oncology Journal
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• 제14권3호
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• pp.221-228
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• 1996

목적 : 난소 미분화세포종의 임상적 특징과 치료 방법, 국소 제어율, 치료 실패 양상, 생존율 등 치료 성적을 분석해 보고, 가임력을 보존하기 원하는 병기 13 환자들에서의 적절한 치료 방침을 찾아보고자 본 연구를 시행하였다. 대상 및 방법 : 1975년 1월부터 1990년 12월까지 연세 의대 신촌 세브란스병원, 연세암센터에서 진단 및 치료를 받은 34명의 난소 미분화세포종 환자를 대상으로 하였다. 이중 2예의 gonadoblastoma(46,XY)와 3예의 혼합 배세포종(mixed germ cell tumor)을 제외하고 나머지 순수 미분화세포종(pure dysgermlnoma) 환자 29예만을 연구 대상으로 하여 치료 방법에 따라 두군으로 나누어 성적을 분석하였다. 1군은 수술후 보조적 방사선치료를 받은 환자로 21예였고, 2군은 수술후 보조적 방사선치료를 하지 않은 군으로 8예였다. 대상 환자의 연령 분포는 8-39세였고 중앙치는 23세였다. 진단 시 임상 증상은 촉지되는 복부 골반부 종괴가 가장 호발하였다. 병기는 I이 23명으로 $89.3\%$로 다수를 차지하였다. 방사선치료는 병기 I, II에서는 전복부조사 20-25 Gy, 골반부에 축소하여 10-15 Gy 추가 조사하였고 종격동과 쇄골 상부의 방사선치료는 대부분 II기 이상의 진행된 병기에서 20-26 Gy 조사하였다. 환자들의 추적 관찰 중앙치는 80개월(13-201개월)이었다. 결과 : 수술후 보조적 방사선치료를 받은 환자인 1군(21예)은 전원 국소제어 및 무병 생존중이었다. 2군은 수술후 보조적 방사선치료를 하지 않은 8예인데 이중 6예에서 국소 재발지 발생하여 4예는 구제 목적의 방사선치료를 받았고 1예는 항암화학요법을 1예는 재수술만 시행 받았다. 구제 치료 결과 방사선치료를 받은 4예중 3예, 항암화학요법 받은 1예 및 재수술을 받은 1예는 완치되었으나, 1예만 암종증(carcinomatosis)으로 진행되어 방사선치료후 11개월에 사망하였다. 그러므로 29예 전체의 5년 국소 제어율 및 5년 생존율은 $96.6\%$(28/29)였다. 일측 난소에 국한된 병기 la 환자 13예 중 7예는 수술 및 수술후 방사선치료를 받았고 이들은 전원 국소제어 되어 20-201개월간(중앙치 80개월) 무병 추적 관찰 중이나, 수술로 일측 난소난 관절제술 후 방사선치료 없이 지내던 6예의 환자 중 5예에서 재발하였으나 이들 모두 방사선치료, 항암화학요법, 재수술 등의 구제치료에 성공하였다. 즉 13예의 병기 la 환자 전원이 20-201개월간 무병 생존 중이다. 결론 : 난소 미분화세포종의 치료에 있어서 수술후 보조적 방사선치료를 부가함으로 종양의 크기, 병기, 수술법에 관계없이 $100\%$ 국소 제어율 및 $100\%$ 5년 생존율을 획득하였다. 수술후 재발한 경우라도 암종증(carclnomatosis)이나 복부 이외의 장기에 원격 전이가 없다면 방사선치료, 항암화학요법 또는 재수술로 구제될 가능성이 매우 높다. 그러므로 가임력을 보존하기 원하는 병기 la 환자에서는 보존적 수술인 일측 난관난소절제술만 시행하고 추적 관찰하는 것도 치료 방법으로 고려될 수 있겠다.