• Journal of Chest Surgery
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• v.33 no.1
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• pp.68-72
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• 2000

Background: The resection of recurrent non-small cell lung cancer can be performed very rarely. There has been many arguments for longterm result and therapeutic role in surgical management of recurrent non-small cell lung cancer(NSCLC). We analyze our result of surgical re-resection of recurrent NSCLC for 10 years retrospectively. Material and Method: In the period from 1987 to 1997, 702 patients who had been confirmed for NSCLC had undergone complete resection in Seoul National University Hospital. As December 1997, 22 of these patients have been operated on the diagnosis of recurrent lung cancer. In these patients one has revealed for benign nodule at postoperative pathologic pathologic was unresectable. and two had revealed other cell type on postoperative pathologic examination. Analysis about postoperative survival rate and the factors that influence postoperative survival rate - sex, age, pathologic stage, cell type, operation adjuvant therapy after first and second operation location of recurrence disease free survival-was 59.1$\pm$10.9 year. There were 14 men and 3 women. Four patients was received radiation therpy after first opration and two patients was received postoperative chemotherapy. At first operation 2 patients was stage Ia, 8 was stage Ib, 1 was stage IIa 6 was stage IIb. Eleven patients had squamous. cell carcinoma at postoperatrive pathologic examination five had adenocarcinoma and one had bronchioalveolar carcinoma. In second operation 8 patients were received limited resection. 9 were received lobectomy or pneumonectomy. One-year survival rate was 82.4% and five-year survival rate was 58.2% Non-adjuvant therapy group after initial operation was more survived than adjuvant therapy group statistically. Conclusion: operation was more survived than adjuvant therapy group statistically. Conclusion : Operation was feasible treatment modality for re-resectable non-small cell lung cancer. But we cannot rule out possibility of double primary lung cancer for them. Postoperative prognostic factor was adjuvant therapy or nor after first oepration but further study of large scale is needed for stastically more valuable result.

• Radiation Oncology Journal
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• v.12 no.1
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• pp.91-98
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• 1994

Purpose: Despite apparently complete resection of cancer of the rectum, local recurrence rate was high. Radiation therapy has been used either alone or in combination with chemotherapy as an adjunct to surgery to reduce the risk of recurrence. This study was designed to evaluate the prognostic factors, survival rate and local recurrence rate of the rectal cancer who had received postoperative radiation therapy by retrospective analysis. Method: From 1982 to 1990, 63 patients with cancer of the rectum surgically staged as B2 or C disease received postoperative adjuvant radiation therapy after curative resection of tumor for cure. Postoperative radiation therapy was given to the whole pelvis(mean dose: 5040 cGy in 5-6weets) and perineum was included in irradiated field in case of abdominoperineal resection. Results: Three-year actuarial survival rate was 73.2$ \% $ overall, 87.7$ \% $ in stage B2+3 and 62.9$ \% $ in stage C2+3. Three-year disease-free survival rate was 69.5$ \% $ overall, 87.7$ \% $ in stage B2+3 and 56.8$ \% $ in stage C2+3, Three-year disease-free survival rate in anterior resection was 77.8$ \% $ and 44.4$ \% $ in abdominoperineal resection. The local recurrence rate was 15.9$ \% $ and distant failure rate was 20.6$ \% $. Severe late complication was small bowel obstruction in 6 patients and surgery was required in 4 patients(6.3$ \% $). The prognostic factors were stage(p=0.0221) and method of surgery(p= 0.0414) (anterior resection vs abdominoperineal resection). Conclusion: This study provides evidence supporting the use of postoperative radiation therapy for reducing the local recurrence rate in patients who have had curative resection of rectal cancer with involvement of perirectal fat or regional nodes or both(stage B2 and C).

• Radiation Oncology Journal
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• v.12 no.2
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• pp.185-190
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• 1994

Purpose : Patients with esophageal cancer treated with surgery plus postoperative radiotherapy or radiation alone were retrospectively analyzed. Method : From August 1980 to June 1992, 93 patients who were treated with 30 Gy or more in the Department of Therapeutic Radiology were evaluated. Median age was 59 years. Ninety one were male and remaining 2 were female. Patients with stage II, III and IV disease were 25, 62 and 6 respectively. Thirteen of the tumor were located in upper one third, 56 in middle one third and 24 in lower one third. Forty three patients had tumors 5cm or less in size and remaining 50 had greater than 5cm. Of those 93 patients, 41 were treated with surgery plus postoperative radiotherapy and 52 with radiation alone. Dose of radiation ranged from 34 to 66.6 Gy. Follow up period was 12 to 61 months. Results : Stage of the tumor was the most important prognostic factor of the evaluated factors. Median survival for entire group of patients was 12 months. Median survival for patients treated with surgery plus postoperative radiotherapy and radiation alone were 15 and 10 months, respectively. There was no difference of 2 year survival. Median survival was 21 months for Stage II and 10 months for Stage m disease. In Stage II disease, that was 21 months for postoperative group and 17.5 months for radiation alone group. Five year survival were $27.5\%$ and $9\%$, respectively. Conclusion : This study showed that the result of surgery plus postoperative radiotherapy was not different from that of radiation alone despite of slightly longer median survival in postoperative group. Also stage of the disease was the most important prognostic factor.

• Journal of Gastric Cancer
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• v.12 no.4
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• pp.205-209
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• 2012

In gastric adenocarcinoma, high rates of loco-regional recurrences have been reported even after complete resection, and various studies have been tried to find the role of postoperative adjuvant therapy. Among them, Intergroup 0116 trial was a landmark trial, and demonstrated the definite survival benefit in adjuvant chemoradiotherapy, compared with surgery alone. However, the INT 0116 trial had major limitation for global acceptance of the INT 0116 regimen as an adjuvant treatment modality because of the limited lymph node dissection. Lately, several randomized studies that were performed to patients with D2-dissected gastric cancer were published. This review summarizes the data about patterns of failure after surgical resection and the earlier prospective studies, including INT 0116 study. Author will introduce the latest studies, including ARTIST trial and discuss whether external beam radiotherapy should be applied to patients receiving extended lymph node dissection and adjuvant chemotherapy.

• Journal of Chest Surgery
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• v.21 no.5
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• pp.863-870
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• 1988

Many varieties of space-occupying lesions can occur in the mediastinum. During the twenty-three-year period 1966-1988, we had experienced the 151 cases of primary mediastinal tumors and cysts at the Thoracic k Cardiovascular Dept., CUMC. The most common histologic types were thymomas and germ cell tumors, followed by neurogenic tumors and lymphomas. Most non-neoplastic lesions were granulomatous lesions and cysts. The mediastinal tumors were often asymptomatic, the malignant tumors in 35.4%, the benign tumors and cysts in 72.8% of the cases. The most common symptom was pain, which occurred in one-fourth of the patients. The most useful diagnostic method was X-ray examination of the chest. However, a final diagnosis could usually be made only at operation. Nine malignant tumors[30.0%] were excised radically, 17[56.7%] palliatively and 4[13.3%] were only biopsied. Almost all benign tumors except tuberculous lymphadenitis were radically excised. Fourteen patients received postoperative radiation therapy and 17 received chemotherapy. The postoperative complications were developed in 15[11.7%] and hospital mortality was 0.8%.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1269-1272
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• 1992

Benign cardiac tumors are almost uniformly curable, but malignant cardiac tumors are almost always fatal despite of modern techniques of diagnosis and surgical treatment Resection of malignant tumors of heart is occasionally feasible and can result in prolonged survival, although cure is unlikely. Survival may be enhanced by postoperative irradiation in selected patients, but chemotherapy does not appear to be beneficial. Fibromyxosarocoma of the left atrium is a primary malignant tumor of the heart which is extremely rare and has a poor prognosis and rapid recurrence. It is important to differentiate the uniformly fatal fibromyxosarcoma from the more common benign atrial myxoma. A 19-year-old woman with a fibromyxosarcoma of the left atrium which was extirpated surgically, and postoperative irradiation was given[totally 4,500 rads]. She is still alive 9 months postoperatively without recurrence.

• Journal of Chest Surgery
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• v.25 no.5
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• pp.555-561
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• 1992

Endodermal sinus tumor[EST] of the mediastinum is a rare germ cell neoplasm. It usually arises from the ovaries and testes but also arises from multiple extragonadal site including the mediastinum. Characteristically, alpha feto protein level is high and used for monitoring the clinical course. EST of the mediastinum is poor prognosis because of its direct invasion. The patient was 18 month old female with chief complaints of cough and fever. In the chest X-ray and CT, large encapsulated, 7x6cm sized, mass of anterior med-iastinum was found, and we could excise it completely because it was well encapsulated and not invaded but only adhered to aortic arch, pericardium and left upper lung. And confirmed it as EST by histopathology. Pre-operative alpha feto protein[AFP] level as 41,748ng/ml and decreased to 2, 663ng /ml at 14th postoperative day, 644ng /ml at 31th postoperative day. From 17th post-operative day, chemotherapy was started and keep going now.

• Journal of Chest Surgery
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• v.27 no.8
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• pp.689-694
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• 1994

A retrospective analysis was performed on 36 patients with primary cysts and tumors of the mediastinum seen at the Department of Thoracic and Cardiovascular Surgery of Maryknoll Hospital from January 1983 to December 1993. There were 21 female and 15 male patients in the study. Ages ranges from 2 years to 72 years, with a mean of 34.7. There were 9 malignant tumors and 27 benign tumors.Thymic neoplasms were the most common. For the whole series, 29 of the patients had tumors in the anterior mediastinum. There appears to be an in6rease in tumors in the anterior compartment. There were 30 symptomatic patients in our series. Of the patients with malignant disease, 89 % were symptomatic. All of benign tumors were completely removed and malignant tumors were treated with chemotherapy and radiotherapy after operation. There were 9[27.3 %] postoperative complications. There was no postoperative mortality. Follow-up was available on 27 patients. There was no recurrence, malignant degeneration, or growth of any tumor. It is hoped that careful evaluation and aggressive treatment of mediastinal tumors will continue to provide improvement in the prognosis for these patients.

• Korean Journal of Head & Neck Oncology
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• v.37 no.2
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• pp.91-95
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• 2021

Primary squamous cell carcinoma of thyroid is a very rare malignant tumor with poor prognosis. It is usually diagnosed as an advanced disease infiltrating adjacent organs, and characterized by aggressive clinical course with an average postoperative survival time of less than 1 year. Recently, we had a 79- year-old woman with a painful neck mass who was diagnosed as primary squamous cell carcinoma of thyroid gland. She underwent total thyroidectomy and selective neck dissection(level III, VI) with no further postoperative managements such as radiation therapy or chemotherapy; she died of poor general condition and pneumonia resulting from rapid progression of the lesion on the 38^th day after surgery. We report this case with a review of relevant literatures.

• Journal of Chest Surgery
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• v.23 no.2
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• pp.366-369
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• 1990

Primary choriocarcinoma of the lung is extremely rare. The patient was 28-year-old female and had no specific signs and symptoms except right chest pain for 5 years. On simple chest film, 8X8 cm sized, well demarcated, homogeneous ovoid mass was found on right lower lung field. The qualitative urine \ulcorner-HCG was 17140 mIU/ml. The result of percutaneous needle biopsy highly suggested choriocarcinoma. Under the impression of primary choriocarcinoma of the lung, right middle and lower lobectomy was done. On 33 postoperative days, serum \ulcorner-HCG level was within normal limit, the patient was discharged without complications after one-cycle chemotherapy.