• Journal of Gastric Cancer
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• v.16 no.1
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• pp.14-20
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• 2016

Purpose: Early diagnosis of gastric cancer is still the exception in Western countries. In the East, as in Japan and Korea, this disease is an endemic disorder. More conservative surgical procedures are frequently performed in early gastric cancer cases in these countries where sentinel lymph node navigation surgery is becoming a safe option for some patients. This study aims to evaluate preliminary outcomes of patients with early gastric cancer who underwent sentinel node navigation surgeries in Brazil, a country with non-endemic gastric cancer levels. Materials and Methods: From September 2008 to March 2014, 14 out of 205 gastric cancer patients underwent sentinel lymph node navigation surgeries, which were performed using intraoperative, endoscopic, and peritumoral injection of patent blue dye. Results: Antrectomies with Billroth I gastroduodenostomies were performed in seven patients with distal tumors. The other seven patients underwent wedge resections. Sentinel basin resections were performed in four patients, and lymphadenectomies were extended to stations 7, 8, and 9 in the other 10. Two patients received false-negative results from sentinel node biopsies, and one of those patients had micrometastasis. There was one postoperative death from liver failure in a cirrhotic patient. Another cirrhotic patient died after two years without recurrence of gastric cancer, also from liver failure. All other patients were followed-up for 13 to 79 months with no evidence of recurrence. Conclusions: Sentinel lymph node navigation surgery appears to be a safe procedure in a country with non-endemic levels of gastric cancer.

• Radiation Oncology Journal
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• v.34 no.2
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• pp.128-134
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• 2016

Purpose: To evaluate the clinical outcomes of patients who underwent radiation therapy with or without targeted molecular therapy for the treatment of spinal metastasis from renal cell carcinoma (RCC). Materials and Methods: A total of 28 spinal metastatic lesions from RCC patients treated with radiotherapy between June 2009 and June 2015 were retrospectively reviewed. Thirteen lesions were treated concurrently with targeted molecular therapy (concurrent group) and 15 lesions were not (nonconcurrent group). Local control was defined as lack of radiographically evident local progression and neurological deterioration. Results: At a median follow-up of 11 months (range, 2 to 58 months), the 1-year local progression-free rate (LPFR) was 67.0%. The patients with concurrent targeted molecular therapy showed significantly higher LPFR than those without (p = 0.019). After multivariate analysis, use of concurrent targeted molecular therapy showed a tendency towards improved LPFR (hazard ratio, 0.13; 95% confidence interval, 0.01 to 1.16). There was no difference in the incidence of systemic progression between concurrent and nonconcurrent groups. No grade ${\geq}2$ toxicities were observed during or after radiotherapy. Conclusion: Our study suggests the possibility that concurrent use of targeted molecular therapy during radiotherapy may improve LPFR. Further study with a large population is required to confirm these results.

• Journal of Korean Neurosurgical Society
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• v.38 no.3
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• pp.184-189
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• 2005

Objective : Hemangioblastomas are highly vascular and benign neoplasm of the central nervous system[CNS]. They can often be found as multiple lesions, as is commonly observed in von Hippel-Lindau[VHL] disease. The aim of this study is to determine the proper management for multiple hemangioblastomas. Methods : Since 1990, 78cases of hemangioblastoma have been encountered. Among these, 9cases were multiple hemangioblastomas that were treated with surgical resection with or without radiosurgery. The medical, radiological, surgical and histological records were reviewed retrospectively and analyzed statistically. Results : Nine patients presented with multiple hemangioblastomas and were diagnosed as VHL disease. The mean follow-up duration was 75.7months [$6.6{\sim}159.2months$] after the first surgical treatment. Three patients were treated with surgical resection alone and six patients were treated by both surgical resection and radiosurgery. Twenty-one surgical procedures [13 surgical resections and 8 radiosurgery] were performed. One patient required ventriculoperitoneal shunt and a posterior fossa decompressive craniectomy because of post-radiation brain swelling. Another patient refused additional treatment for the newly developed lesions after the successful treatment of initial lesions. The other patient who presented with numerous lesions in the whole brain and spine underwent cranio-spinal irradiation. Remaining patients showed good results. Conclusion : The surgical outcomes for the patients with a single lesion of the CNS hemangioblastoma are favorable. However. the treatment of multiple hemangioblastoma is more difficult, and should be treated by surgical resection and radiosurgery with careful consideration.

• Journal of Gastric Cancer
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• v.19 no.1
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• pp.92-101
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• 2019

Purpose: The aim of this study was to evaluate the trend of non-compliance with treatment (NCT) among gastric cancer patients in the Korean population. Materials and Methods: Using data from the Korea Central Cancer Registry from 1999 to 2015, patients who did not receive any treatment for gastric cancer within 4 months after diagnosis were defined as the NCT group. The annual incidence rate, distributions according to age group and stage, and 5-year relative survival of the patients exhibiting NCT were analyzed. Results: The number of NCT patients was 5,871 (30.6%) in 1999 and continuously decreased to 4,434 (15.3%) in 2015. Between 2006 and 2015, the proportions of NCT patients decreased from 72.9% to 55.0% among those 80 years old or older and from 9.2% to 5.4% among patients younger than 40 years. In patients with distant metastases, this proportion decreased from 35.5% to 32.7%, and this proportion also decreased from 17.6% to 8.2% among those with localized disease. The 5-year relative survival rates of NCT patients between 2011 and 2015 were significantly lower than those of the treated patients in each stage (60.2% vs. 99.7%, 13.8% vs. 67.1%, and 2.0% vs. 8.3% among those with localized, regional, and distant disease, respectively). Conclusions: The proportion of NCT gastric cancer patients has decreased during the last 16 years. However, considerable numbers of elderly patients are still NCT. There must be a strategy to decrease NCT and improve the nationwide survival rate of patients with gastric cancer.

• The Journal of Korean Medicine
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• v.40 no.2
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• pp.119-132
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• 2019

Purpose: This study was conducted to collect and analyze real world data to evaluate the effectiveness and safety of comprehensive traditional Korean Medicine treatment on quality of life, anorexia and cachexia of cancer patients. Methods: We analyzed medical records of 62 cancer patients admitted to O-I Dang Korean Medicine Hospital from February 2018 to February 2019. The primary outcome was a change score in the Anorexia/Cachexia Subscale of Functional Assessment of Anorexia/Cachexia Therapy (FAACT). The secondary outcomes were Functional Assessment of Cancer Therapy-General (FACT-G), Trial Outcome Index(TOI) of FAACT, 11 point Pain Intensity Numeric Rating Score (11 PI-NRS) and Patient Global Impression of Change (PGIC) and adverse event. Results: Cachexia and quality of life in cancer patients assessed by FAACT, increased by $5.59{\pm}14.83$ (p=0.004) after treatment. PI-NRS was reduced by $2.10{\pm}1.81$ (p<0.001) and TOI and FACT-G total scores were increased by $5.17{\pm}11.70$ (p=0.001) and $3.59{\pm}10.94$ (p=0.012), respectively. These results were also clinically meaningful assessed via minimal clinically important difference (MCID). There was no severe adverse event. Conclusion: These findings suggest that comprehensive traditional Korean Medicine treatment might be effective and safe strategy for improving quality of life, anorexia, cachexia and pain of cancer patients. Further advanced studies with controlled group and more participants with rigorous design are needed to ensure these findings.

• Journal of Korean Neurosurgical Society
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• v.62 no.4
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• pp.467-475
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• 2019

Objective : There is a lack of knowledge regarding whether decompression is necessary in treating patients with epidural spinal cord compression (ESCC) grade 2. The purpose of this study was to compare the outcomes of minimally invasive surgery (MIS) without decompression and conventional open surgery (palliative laminectomy) for patients with hepatocellular carcinoma (HCC) spinal metastasis of ESCC grade 2. Methods : Patients with HCC spinal metastasis requiring surgery were retrospectively reviewed. Patients with ESCC grade 2, medically intractable mechanical back pain, a Nurick grade better than 3, 3-6 months of life expectancy, Tomita score ${\geq}5$, and Spinal Instability Neoplastic Score ${\geq}7$ were included. Patients with neurological deficits, other systemic illnesses and less than 1 month of life expectancy were excluded. Thirty patients were included in the study, including 17 in the open surgery group (until 2008) and 13 in the MIS group (since 2009). Results : The MIS group had a significantly shorter operative time ($94.2{\pm}48.2minutes$ vs. $162.9{\pm}52.3minutes$, p=0.001), less blood loss ($140.0{\pm}182.9mL$ vs. $1534.4{\pm}1484.2mL$, p=0.002), and less post-operative intensive care unit transfer (one patient vs. eight patients, p=0.042) than the open surgery group. The visual analogue scale for back pain at 3 months post-operation was significantly improved in the MIS group than in the open surgery group ($3.0{\pm}1.2$ vs. $4.3{\pm}1.2$, p=0.042). The MIS group had longer ambulation time ($183{\pm}33days$ vs. $166{\pm}36days$) and survival time ($216{\pm}38days$ vs. $204{\pm}43days$) than the open surgery group without significant difference (p=0.814 and 0.959, respectively). Conclusion : MIS without decompression would be a good choice for patients with HCC spinal metastasis of ESCC grade 2, especially those with limited prognosis, mechanical instability and no neurologic deficit.

• Archives of Plastic Surgery
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• v.48 no.1
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• pp.49-54
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• 2021

Background Reconstruction after removal of a malignant tumor in the head and neck region is crucial for restoring tissue integrity, function, and aesthetics. We retrospectively analyzed patients who underwent intraoral reconstruction surgery using radial forearm free flaps (RFFF) and anterolateral thigh free flaps (ALT) at a single institution to provide more information supporting the choice of a reconstruction method after removal of head and neck cancer. Methods The charts of 708 patients who underwent head and neck reconstruction between 1998 and 2018 at the Department of Plastic and Reconstructive Surgery at our institution were retrospectively reviewed. Patients' age, sex, and history of radiation therapy, diabetes mellitus, and smoking were retrieved. The primary cancer site, types of defects, and complications were investigated. Results Overall, 473 and 95 patients underwent reconstruction surgery with RFFF and ALT, respectively. RFFF was more often used in patients with cancers of the pharynx, larynx, esophagus, or tonsil, while ALT was more frequently used in patients with cancers of the mouth floor with tonsil or tongue involvement. The proportion of patients undergoing ALT increased gradually. Flap failure and donor site morbidities did not show significant differences between the two groups. Conclusions RFFF and ALT flaps resulted in similar outcomes in terms of flap survival and donor site morbidity. ALT can be an option for head and neck reconstruction surgery in patients with large and complex defects or for young patients who want to hide their donor site scars.

• Journal of Digestive Cancer Research
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• v.4 no.2
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• pp.51-57
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• 2016

The epidemiology of pancreatic neuroendocrine neoplasms (PNENs) in Asia has been clarified through epidemiological studies, including one conducted in Japan, and subsequently another in South Korea. As endoscopic ultrasonography (EUS) has become more widely accessible, endoscopic ultrasound-fine needle aspiration (EUS-FNA) has been performed in pancreatic tumors for which the clinical course was only monitored previously. This has enabled accurate diagnosis of pancreatic tumors based on the 2010 WHO classification; as a result, the number of patients with an accurate diagnosis has increased. Although surgery has been the standard therapy for PNENs, new treatment options have become available in Japan for the treatment of advanced or inoperable PNENs; of particular note is the recent introduction of molecular target drugs (such as everolimus and sunitinib) and streptozocin. Treatment for progressive PNENs needs to be selected for each patient with consideration of the performance status, degree of tumor differentiation, tumor mass, and proliferation rate. Somatostatin receptor (SSTR)-2 is expressed in many patients with neuroendocrine tumor. Somatostatin receptor scintigraphy (SRS), which can visualize SSTR-2 expression, has been approved in Japan. The SRS will be a useful diagnostic tool for locating neuroendocrine neoplasms, detecting distant metastasis, and evaluating therapy outcomes. In this manuscript, we review the latest diagnostic methods and treatments for PNENs.

• The Journal of Korean Medicine
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• v.44 no.4
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• pp.26-40
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• 2023

Objectives: This study was to evaluate the effectiveness and safety of Bojungikgi-tang for lung cancer patients with anorexia. Methods: This was a single-arm, open-label, and single-center trial, and suitable participants took Bojungikgi-tang (Buzhongyiqi-tang in Chinese, Hochuekki-to in Japanese) three times a day before or between meals for six weeks (42 days). After registration of clinical trials (visit 2), they visited the hospital every three weeks (visits 3 and 4) and measured or tested the effectiveness or safety evaluation variables to analyze the results. The primary outcome was the anorexia/cachexia subscale (A/CS) of functional assessment of anorexia/cachexia therapy (FAACT) score. Results: Seventeen lung cancer patients were included in the intention-to-treat (ITT) analysis. Lung cancer patients had higher A/CS of FAACT scores after six weeks of Bojungikgi-tang administration compared to that at the baseline. This was not significant four lung cancer (p=0.1668). In the secondary outcomes, the visual analog scale (VAS) score of anorexia decreased significantly (p=0.0009), and the CD4/CD8 ratio (p=0.0396) and CD4 levels (p=0.0345) significantly increased after six weeks of treatment. No serious adverse events were reported with Bojungikgi-tang in lung cancer patients. Conclusions: Bojungikgi-tang can be an effective and safe treatment for anorexia in lung cancer patients undergoing chemotherapy.

• Journal of the Korean Society of Radiology
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• v.84 no.5
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• pp.999-1008
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• 2023

Thyroid cancer, characterized by high incidence rates, good prognosis, and frequent recurrence, is typically treated surgically. However, since the early 2000s, radiofrequency ablation, which is commonly utilized in liver, lung, and kidney cancers, is being performed for management of primary and recurrent thyroid cancers. Many studies have focused on inoperable cases of low-risk papillary microcarcinoma (≤ 1 cm) and some have investigated its role in larger lesions (up to 4 cm). Overall, these studies have reported positive results. Radiofrequency ablation for recurrent cancer has primarily been performed for locally recurrent cervical cancer, and this therapeutic approach has been attempted for treatment of distant metastases in lungs and bones, with encouraging outcomes. A growing global trend, particularly in South Korea, the United States, and Europe supports radiofrequency ablation for thyroid cancer. However, this therapy is currently not recognized as a treatment option recommended by universally accepted clinical guidelines such as those established by the National Comprehensive Cancer Network. Based on past efforts and future research, radiofrequency ablation is expected to play a key role in thyroid cancer treatment in the near future.