• Title/Summary/Keyword: Pathologic factors

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Pathologic Risk Factors and Oncologic Outcomes in Early-stage Cervical Cancer Patients Treated by Radical Hysterectomy and Pelvic Lymphadenectomy at a Thai University Hospital: A 7 year Retrospective Review

  • Ruengkhachorn, Irene;Therasakvichya, Suwanit;Warnnissorn, Malee;Leelaphatanadit, Chairat;Sangkarat, Suthi;Srisombat, Jutatip
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5951-5956
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    • 2015
  • Background: To evaluate the rate of pathologic high-risk factors, intermediate-risk factors, and treatment outcomes in early-stage cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy (RHPL). Materials and Methods: Medical records of stage IA-IIA1 cervical cancer patients who underwent RHPL during the 2006 to 2012 time period and patient follow-up data until December 2013 were reviewed. Results: Of 331 patients, 52 women (15.7%) had pathologic high-risk factors and 59 women (17.8%) had intermediate-risk factors without high-risk factors. All studied patients had an initial complete response. At median follow-up time of 40.9 months (range 1-103.3 months) and mean follow-up time of$ 43.3{\pm}25.3$ months, 37 women had disease recurrence and 4 women had died of disease. The most common site of recurrence was the pelvis (64.8%). Five-year and 10-year disease free survival rates were 96.1% and 91.5%, respectively. Five-year and 10-year overall survival rates were 100% and 99.4%, respectively. Independent factors related to recurrence were pelvic node metastasis (odds ratio [OR], 2.670; 95%CI, 1.001-7.119), and >1/3 cervical stromal invasion (OR, 3.763; 95%CI, 1.483-9.549). Conclusions: The rates of pathologic high-risk and intermediate-risk factors should be considered and disclosed when counseling patients regarding primary treatment by RHPL. Oncologic outcomes of primary surgical treatment for early-stage cervical carcinoma were found to be excellent.

The Prognosis According to Patterns of Mediastinal Lymph Node Metastasis in Pathologic Stage IIIA/N2 Non-Small Cell Lung Cancer

  • Kim, Do Wan;Yun, Ju Sik;Song, Sang Yun;Na, Kook Joo
    • Journal of Chest Surgery
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    • v.47 no.1
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    • pp.13-19
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    • 2014
  • Background: The aim of this study is to evaluate prognostic factors for survival in pathologic stage IIIA/N2 non-small-cell lung cancer (NSCLC), to identify the prognostic significance of the metastatic patterns of mediastinal lymph nodes (MLNs) relating to survival and to recurrence and metastasis. Methods: A total of 129 patients who underwent radical resection for pathologic stage IIIA-N2 NSCLC from July 1998 to April 2011 were retrospectively reviewed. The end points of this study were rates of loco-regional recurrence and distant metastasis, and survival. Results: The overall 5-year survival rate was 47.4%. A univariate analysis showed that age, pathologic T stage, and adjuvant chemotherapy were significant prognostic factors, while in multivariate analysis, pathologic T stage and adjuvant chemotherapy were significant prognostic factors. The metastasis rate was higher in patients with multi-station N2 involvement and with more than 3 positive MLNs. Further, non-regional MLN metastasis was associated with a higher loco-regional recurrence rate. Conclusion: Pathologic T stage and adjuvant chemotherapy were independent prognostic factors for long-term survival in pathologic stage IIIA/N2 NSCLC. The recurrence and the metastasis rate were affected by the metastatic patterns of MLNs. These results may be helpful for planning postoperative therapeutic strategies and predicting outcomes.

Clinical predictive factors of pathologic tumor response after preoperative chemoradiotherapy in rectal cancer

  • Choi, Chi Hwan;Kim, Won Dong;Lee, Sang Jeon;Park, Woo-Yoon
    • Radiation Oncology Journal
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    • v.30 no.3
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    • pp.99-107
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    • 2012
  • Purpose: The aim of this study was to identify clinical predictive factors for tumor response after preoperative chemoradiotherapy (CRT) in rectal cancer. Materials and Methods: The study involved 51 patients who underwent preoperative CRT followed by surgery between January 2005 and February 2012. Radiotherapy was delivered to the whole pelvis at a dose of 45 Gy in 25 fractions, followed by a boost of 5.4 Gy in 3 fractions to the primary tumor with 5 fractions per week. Three different chemotherapy regimens were used (5-fluorouracil and leucovorin, capecitabine, or tegafur/uracil). Tumor responses to preoperative CRT were assessed in terms of tumor downstaging and pathologic complete response (ypCR). Statistical analyses were performed to identify clinical factors associated with pathologic tumor response. Results: Tumor downstaging was observed in 28 patients (54.9%), whereas ypCR was observed in 6 patients (11.8%). Multivariate analysis found that predictors of downstaging was pretreatment relative lymphocyte count (p = 0.023) and that none of clinical factors was significantly associated with ypCR. Conclusion: Pretreatment relative lymphocyte count (%) has a significant impact on the pathologic tumor response (tumor downstaging) after preoperative CRT for locally advanced rectal cancer. Enhancement of lymphocyte-mediated immune reactions may improve the effect of preoperative CRT for rectal cancer.

Prognostic factors in Osteosarcoma (골육종의 예후인자)

  • Jeon, Dae-Geun;Lee, Jong-Seok;Kim, Sug-Jun;Yang, Hyun-Seok;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.1
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    • pp.1-8
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    • 1997
  • Osteosarcoma is the most common primary bony malignancy and its survivorship has been progressed markedly through refined chemotherapy and surgery. But still there are many non-responders and analysis of prognostic factors may be helpful for them. Two hundred and sixty-six patients were enlisted between Mar, 1985 and Sep. 1994. Among them our inclusion criteria were: 1)primary, nonmetastatic classical osteosarcoma 2)extremity in location 3)no prior treatment at other institute and completed neoadjuvant chemotherapy and surgery according to our protocol. One hundred and eleven cases were eligible. Analyzed factors were:age, sex, location, tumor size, and pathologic response. Statistical methods were log-rank test for univariate and Cox's test for multivariate analysis. Male to female ratio was 69:42 with an average age of 17.2 years. Locations of tumor were distal femur 59, proximal tibia 29, and proximal humerus 8. Tumor size were measured by its maximal diameter and 48 cases were above 10cm and 47 cases were below 10cm. For pathologic response, 57 cases showed more than 90% and 54 cases were less than that. Limb salvage procedure was 101 cases and amputation was 10 cases and their local recurrence rate were 3.6%. Average follow-up period was 24(9-78.2) months and their final status was CDF 86, AWD 8, NED 5, and DOD 12 cases. In univariate study: type of operation(p=0.005), tumor size(p=0.005), and pathologic response(p=0.02) were significant variables. Pathologic response(p=0.03) and type of operation(p=0.01) were meaningful prognostic factors on multivariate analysis. But the latter result was interpreted as a bias, so pathologic response remained as a sole meaningful prognostic factor. More aggressive chemotherapy will be needed to improve the survival.

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Factors Influencing Axillary Lymph Node Metastasis in Invasive Breast Cancer

  • Li, Ling;Chen, Li-Zhang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.251-254
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    • 2012
  • Purpose: To explore the relationship between auxiliary lymph node metastasis and clinical features, and to identify the factors that affect metastasis occurrence. Methods: A total of 164 cases of primary breast cancer were selected to investigate features such as age, concomitant chronic disease and pathologic diagnosis. Immunohistochemistry was used to detect the expression of the estrogen receptor (ER) and CerbB-2. Logistic regression was employed to analyze the factors that affect the incidence of lymph node metastases. Results: The incidence of lymph node metastases was 46.3% among elderly patients with breast cancer. Based on logistic regression, chronic disease, scale of tumor, age, and ER expression affected the occurrence of lymph node metastases; the ORs were 3.05, 2.18, 0.34, and 3.83, respectively. Between different pathologic diagnoses and the risk factors, the OR scores were 12.7 and 8.02, respectively, for aggressive ductal carcinoma and aggressive lobular carcinoma auxiliary lymph node metastases. Conclusion: The incidence of lymph node metastases is affected by chronic disease, scale of tumor, age, ER expression and pathologic diagnosis.

Epidemiological investigation of equine hindlimb ataxia with Setaria digitata in South Korea

  • Hwang, Hyeshin;Ro, Younghye;Lee, Hyunkyoung;Kim, Jihyeon;Lee, Kyunghyun;Choi, Eun-Jin;Bae, You-Chan;So, ByungJae;Kwon, Dohoon;Kim, Ho;Lee, Inhyung
    • Journal of Veterinary Science
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    • v.23 no.5
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    • pp.75.1-75.7
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    • 2022
  • Background: Since 2013, the number of requests for diagnosis for horses based on neurological symptoms has increased rapidly in South Korea. The affected horses have commonly exhibited symptoms of acute seasonal hindlimb ataxia. A previous study from 2015-2016 identified Setaria digitata as the causative agent. Objectives: This study is an epidemiological investigation to find out risk factors related to the rapid increase in hindlimb ataxia of horses due to aberrant parasites in South Korea. Methods: An epidemiological investigation was conducted on 155 cohabiting horses in 41 horse ranches where the disease occurred. The surrounding environment was investigated at the disease-causing horse ranches (n = 41) and 20, randomly selected, non-infected ranches. Results: Hindlimb ataxia was confirmed in nine cohabiting horses; this was presumed to be caused by ectopic parasitism. Environments that mosquitoes inhabit, such as paddy fields within 2 km and less than 0.5 km from a river, had the greatest association with disease occurrence. Conclusions: Most horse ranches in South Korea are situated in favorable environments for mosquitoes. Moreover, the number of mosquitoes in the country has increased since 2013 due to climate change. Additional research is required; however, these data show that it is necessary to establish guidelines for the use of anthelmintic agents based on local factors in South Korea and disinfection of the environment to prevent disease outbreaks.

Reinterpretation of Taeyang disease(太陽病) in "Shanghanlun(傷寒論)" Based on the Pathologic Perspective of Sasang Constitutional Medicine (사상체질의학적 병리관에 의한 "상한론(傷寒論)" 태양병(太陽病)의 재해석)

  • Lee, Ji-Won;Shin, Seung-Won;Kwak, Sang-Hyup;Kim, Yeong-Jun;Lee, Jun-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.22 no.3
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    • pp.18-28
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    • 2010
  • 1. Objectives: Purpose of this paper is to study the reinterpretation of Taeyang disease(太陽病) in "Shanghanlun(傷寒論)" based on the pathologic perspective of Sa-sang Constitutional Medicine by comparing factors as pathologic mechanisms, clinical symptoms, and remedies. 2. Methods: The texts referred to pathologic mechanisms, clinical symptoms, and remedies of Taeyang disease(太陽病) described in "Donguisusebowon Gabobon(東醫壽世保元 甲午本)", "Donguisusebowon Sinchookbon(東醫壽世保元 辛丑本)", and Shanghanlun(傷寒論)" in "Donguibogam(東醫寶鑑)" were analysed. 3. Results and Conclusions 1) Early phase of Ulgwang symptomatic pattern(鬱狂證 初證) and of Mangyang symptomatic pattern(亡陽證初證) of Kidney Heat-based Exterior Heat disease(腎受熱表熱病), a category of Soeumin(少陰人) diseases, were described by adopting pathologic models of Taeyang-sangpung symptomatic pattern(太陽傷風證) and Sanghan-hyeol symptomatic pattern(傷寒血證) from "Sanghanlun(傷寒論)". 2) Soyang-sangpung symptomatic pattern(少陽傷風證) of Spleen Cold-based Exterior Cold diseae (脾受寒表寒病) and Hyunggyeok-yeol symptomatic pattern(胸膈熱證) of Stomach Heat-based Interior Heat disease(胃受熱裏熱病), categories of Soyangin(少陽人) diseases, were described by adopting pathologic models of Taeyang-yangsangpunghan symptomatic pattern(太陽兩傷風寒證), Soyang-sangpung symptomatic pattern(少陽傷風證) and Tayangbyong-sahak symptomatic pattern(太陽病似瘧證) from "Sanghanlun(傷寒論)". 3) Baechu-pyo symptomatic pattern(背顀表病輕證) and Hangual symptomatic pattern(寒厥證) of Esophagus Cold-based Exterior Cold disease(胃脘受寒表寒病), a category of Taeeumin(太陰人) diseases, was described by adopting pathologic models of Taeyang-sanghan symptomatic pattern(太陽傷寒證) and Hangual symptomatic pattern(寒厥證) from "Sanghanlun(傷寒論)". 4) Je-Ma Lee reinterpreted various diseases classified as Taeyang disease(太陽病) with the pathologic perspective of Sa-sang Constitutional Medicine. Different from existing medicine, diseases were analysed and treated by the standard, constitution of the patient.

Treatment of pathologically migrated teeth via modified intentional replantation: cases report (변형된 의도적 재식술을 통한 병적 이동된 치아들의 치료: 증례보고)

  • Kim, Hyun-Soo;Lee, Won-Pyo;Yu, Sang-Joun;Kim, Byung-Ock
    • The Journal of the Korean dental association
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    • v.54 no.8
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    • pp.592-603
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    • 2016
  • Pathologic tooth migration (PTM) caused by periodontal disease is a relatively common disease with a prevalance rate of 30~55%. It is one of the reasons for periodontal treatment of patients. PTM occurs when various factors related to the position of the tooth are altered and clinical features of PTM include facial flaring, diastema, proximal tilting, rotation, and extrusion of teeth. The purpose of this study was to assess the treatment of teeth of hopeless prognosis through the practice of modified intentional replantation on pathologic migrated tooth. This study presents cases using modified intentional replantation for the treatment of pathologic tooth migration caused by severe periodontitis. Modified intentional replantation is a technique that prepares extraction socket by using an implant drill. Based on 3 cases performed with modified intentional replantation, an improvement of clinical periodontal indicators such as probing pocket depth, bleeding on probing, tooth mobility, and pathologic teeth migration was observed after surgery. Also, the patients were satisfied with the functional and esthetic improvement.

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Clinico-pathologic Factors and Machine Learning Algorithm for Survival Prediction in Parotid Gland Cancer (귀밑샘 암종에서 생존 예측을 위한 임상병리 인자 분석 및 머신러닝 모델의 구축)

  • Kwak, Seung Min;Kim, Se-Heon;Choi, Eun Chang;Lim, Jae-Yol;Koh, Yoon Woo;Park, Young Min
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.1
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    • pp.17-24
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    • 2022
  • Background/Objectives: This study analyzed the prognostic significance of clinico-pathologic factors including comprehensive nodal factors in parotid gland cancers (PGCs) patients and constructed a survival prediction model for PGCs patients using machine learning techniques. Materials & Methods: A total of 131 PGCs patients were enrolled in the study. Results: There were 19 cases (14.5%) of lymph nodes (LNs) at the lower neck level and 43 cases (32.8%) involved multiple level LNs metastases. There were 2 cases (1.5%) of metastases to the contralateral LNs. Intraparotid LNs metastasis was observed in 6 cases (4.6%) and extranodal extension (ENE) findings were observed in 35 cases (26.7%). Lymphovascular invasion (LVI) and perineural invasion findings were observed in 42 cases (32.1%) and 49 cases (37.4%), respectively. Machine learning prediction models were constructed using clinico-pathologic factors including comprehensive nodal factors and Decision Tree and Stacking model showed the highest accuracy at 74% and 70% for predicting patient's survival. Conclusion: Lower level LNs metastasis and LNR have important prognostic significance for predicting disease recurrence and survival in PGCs patients. These two factors were used as important features for constructing machine learning prediction model. Our machine learning model could predict PGCs patient's survival with a considerable level of accuracy.

A Comparative Study on the Theory of Lee jaema and Chang ts' ungcheng (이제마(李濟馬)와 장종정(張從正)의 학술사상(學術思想)에 대한 비교(比較) 연구(硏究))

  • Ch’ oi, yeikwen;Kim, kyungyo
    • Journal of Sasang Constitutional Medicine
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    • v.8 no.2
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    • pp.41-68
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    • 1996
  • This thesis is a try for examining the historical characteristics of Constiutional medicine. For this purpose, I have examined their theory, and made a comparison carefully. Through this study, I have obtained several results as following. Both Chang and Lee lived in the time of change, which was unstable and uncertain. Under the condition, they both rejected following the existing trends of learned circles, and developed new thoughts and clinical techniques. They rejected superstitious beliefs and fatalism, and conducted the pursuit of experimental knowledge and rationale idea. Clinical experience was the very base of their study. They both criticized the bad habits of abuse of tonifing medication and health seeking. Especially Lee regarded control of emotion and regulation of a way of life as the best way for preservation of one's health. Chang regarded pathogenic factors as the ultimate factor of diseases, and strived for eliminating pathogenic factors, but L brought to a conclusion that the final factor of diseases was what is called "heart" itself, and emotional changes were the most essential causes of disease. It can be said that the pathogenesis insisted by Chang can be called The insistence that pathologic factors are the very etiology of all the disease (邪氣致病論), or all the diseases result from pathologic factors. And his whole remedy can be summarized as following, A study on the method of eliminating pathogenic factors. But the purpose of Constitutional medicine is to correct imbalance intrinsic to one's internal organs. In this aspect, Constitutional medicine is a "regulatory medicine". Depending on the classification of six vital substances, Chang classified all disease into six categories. These were based on symptoms and sings represented. While classification of diseases made by Lee was likely to rely upon constitutional characteristics. Chang thought that the three remedies made up of perspiration, purgation, vomiting were the most efficient way of eliminating pathogenic factors. Lee, however, thought those weren't methods of eliminating pathogenic factors but the best ways restoring one's self-regulation power. Chang thought that all the febrile disease essentially has a tendency in properties to belong to "heat", but Lee pointed out that pathologic processes are variable in accordance with constitutional features. They both regarded pathogenesis of diabetes as fire. That is to say, fire is the most essential factor of diabetes. And there are many risk factors such as inappropriate foods, drugs, climate, etc., but Lee thought what is most important is heart. Putting all accounts together, medical characteristics of Chang are similar to those of T aiyinjen and Shaoyangjen, and have no relation to those of those of Shaoyinjen. Therefore we can conclude that Chang understood pathologic processes of disease of T aiyinjen and Shaoyangjen, whether he knew about constitutional features or not.

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