• 제목/요약/키워드: Recurrence

검색결과 4,372건 처리시간 0.037초

Differences in Prognostic Factors between Early and Late Recurrence Breast Cancers

  • Payandeh, Mehrdad;Sadeghi, Masoud;Sadeghi, Edris
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6575-6579
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    • 2015
  • Background: Breast cancer (BC) is the most frequent malignancy among females and is a leading cause of death of middle-aged women. Herein, we evaluated baseline characteristics for BC patients and also compared these variables across ealry and late recurrence groups. Materials and Methods: Between 1995 to 2014, among female breast cancer patients referred to our oncology clinic, eighty-six were entered into our study. All had distant metastasis. Early recurrence was defined as initial recurrence within 5 years following curative surgery irrespective of site. Likewise, late recurrence was defined as initial recurrence after 5 years. No recurrence was defined for survivors to a complete minimum of 10 years follow-up. Significant prognostic factors associated with early or late recurrence were selected according to the Akaike Information Criterion. Results: The median follow-up was 9 years (range, 1-18 years). During follow-up period, 51 recurrences occurred (distant metastasis), 31 early and 20 late. According to the site of recurrence, there were 51 distant. In this follow-up period, 19 patients died. Compared with the early recurrence group, the no recurrence group had lower lymph node involvement and more p53 positive lesions but the late recurrence group had lower tumor size. In comparison to no recurrence, p53 (odds ratio [OR] 6.94, 95% CI 1.49-32.16) was a significant prognostic factor for early recurrence within 5 years. Conclusions: Tumor size, p53 and LN metastasis are the most important risk factors for distance recurrence especially in early recurrence and also between of them, p53 is significant prognostic factor for early recurrence.

고분화성 갑상선 암종의 재발과 관련된 위험인자 분석 (Analysis of Risk Factors Related to the Recurrence of well Differentiated Thyroid Carcinoma)

  • 이상준;정필상;김영생;윤경섭
    • 대한두경부종양학회지
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    • 제23권2호
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    • pp.138-141
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    • 2007
  • Objectives : Well differentiated thyroid carcinoma(WDTC) has relatively good prognosis. But recurrence is associated with increased morbidity and mortality, and always results in reoperation. So it is important to evaluate the risk factors relative to the recurrence. The aim of this study is to evaluate the risk factors of recurrence. Materials and Method : Two hundred seventeen patients who had undergone thyroidectomy and proved as WDTC from January 1999 to December 2004 was included in the study. We reviewed patient-related and tumorrelated factors respectively and analyzed the correlation with tumor recurrence. Results : Fourteen patients from two hundreds seventeen had recurred. Recurrence rate was 6.5%, and average interval of recurrence was 28 month. Male, age over 45, multiple mass, and advanced TMN stage patient group show higher recurrence rate, but no statistical significance. However, the recurrence rate of lymph node metastasis, tumor size>1.5cm, and extracapsular invasion group were statistically high. Conclusion : Lymph node metastasis, tumor size and extracapsular invasion are significant risk factors related to the recurrence of WDTC.

The Prognostic Value of Oligo-Recurrence Following Esophagectomy for Esophageal Cancer

  • Minsang Kang;Woojung Kim;Chang Hyun Kang;Kwon Joong Na;Samina Park;Hyun Joo Lee;In Kyu Park;Young Tae Kim
    • Journal of Chest Surgery
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    • 제56권6호
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    • pp.403-411
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    • 2023
  • Background: The concept of oligo-recurrence has not been generally applied in esophageal cancer. This study aimed to determine the prognostic significance of the number of recurrences in esophageal cancer. Methods: Patients with squamous cell carcinoma who underwent curative esophagectomy with R0 or R1 resection and who experienced a confirmed recurrence were included. The study included 321 eligible participants from March 2001 to December 2019. The relationship between the number of recurrences and post-recurrence survival was investigated. Results: The mean age was 63.8±8.1 years, and the majority of the participants (97.5%) were men. The median time to recurrence was 10.7 months, and the median survival time after recurrence was 8.8 months. Multiple recurrences with simultaneous local, regional, and distant locations were common (38%). In terms of the number of recurrences, single recurrences were the most common (38.3%) and had the best post-recurrence survival rate (median, 17.1 months; p<0.001). Patients with 2 or 3 recurrences showed equivalent survival to each other and longer survival than those with 4 or more (median, 9.4 months; p<0.001). In the multivariable analysis, the significant predictors of post-recurrence survival were body mass index, minimally invasive esophagectomy, N stage, R0 resection, post-recurrence treatment, and the number of recurrences (p<0.05). Conclusion: After esophagectomy, the number of recurrences was the most significant risk factor influencing post-recurrence survival in patients with esophageal cancer. In esophageal cancer, oligo-recurrence can be defined as a recurrence with three or fewer metastases. More intensive treatment might be recommended if oligo-recurrence occurs.

Postoperative Course and Recurrence of Chronic Subdural Hematoma

  • Oh, Hyuck-Jin;Lee, Kyeong-Seok;Shim, Jae-Jun;Yoon, Seok-Mann;Yun, Il-Gyu;Bae, Hack-Gun
    • Journal of Korean Neurosurgical Society
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    • 제48권6호
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    • pp.518-523
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    • 2010
  • Objective : Chronic subdural hematoma (CSDH) is known to have a significant recurrence rate. There are different criteria defining the recurrence of CSDH. We evaluated the postoperative course of CSDH and tried to propose the reasonable criteria of recurrence. Methods : We retrospectively examined the medical records and pre- and postoperative CT scans of 149 consecutive patients who underwent surgery from January 2005 to December 2009. Diagnosis was confirmed by CT scanning or MRI. The postoperative courses were either resolved or recurrent. The resolved CSDH was one of the three types; early resolution, delayed resolution, or late resolution. The recurrent CSDH was one of the four types; recurrence without resolution, early recurrence after resolution, late recurrence after resolution, or recurrent-and-resolved type. Results : The CSDH was resolved within 30 days after surgery in 58 (39%) patients, between 1 to 3 months in 62 (42%), and after 3 months in 11 (7%) patients. The CSDH was recurred in 18 (12%) patients. Late resolution or recurrence was more common in the aged. The recurrent hematoma was seen on the same side in 11 patients, on the different side in 7 patients. Recurrence was significantly more common in the thick hematomas. Conclusion : For a working criteria of the recurrence of CSDH, we propose the early recurrence as return of symptoms or reaccumulation of the hematoma after a surgery within 3 months regardless of the location, amount or repeated operations. The late recurrence can be defined as reappearance or enlargement of a liquefied hematoma within the cranial cavity surrounded by the membranes or persistent CSDH beyond 3 months after surgery.

술 후 재발한 염증성 성대 병변의 임상 양상 (Clinical Analysis of Recurrence in Inflammatory Laryngeal Disease after Laryngomicrosurgery)

  • 김영선;김진호;박문규;유홍균;오준환;최종욱
    • 대한후두음성언어의학회지
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    • 제11권1호
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    • pp.28-31
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    • 2000
  • Microscopic surgery of the larynx normally have a low recurrence rate. However, once they do recur, it is uneasy to manage recurrent diseases. Recurrence is often the result of inappropriate postoperative care and voice management. Out of the 764 patients operated for benign inflammatory laryngeal diseases, we have conducted a clinical analysis of 54 cases who have had at least one episode of recurrence after the initial treatment with laryngomicrosurgery (7.1% of recurrence rate). High risk groups for recurrence were determined, and they were related to cigarette smoking, alcohol intake, laryngopharyngeal reflux. From our experience and literature review, we conclude that pre- and postoperative patient education concerning these risk factors and voice usage Is of critical need to prevent recurrence of inflammatory laryngeal lesions after laryngomicrosurgery.

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위암환자의 재발유형에 따른 임상병리학적 특성 (Clinicopathologic Characteristics according to the Type of Recurrence in Curatively-resected Gastric Cancer Patients)

  • 하태경;권성준
    • Journal of Gastric Cancer
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    • 제7권1호
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    • pp.23-30
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    • 2007
  • 목적: 위암 환자 수술 후 재발의 임상병리학적 특성에 대한 이해는 재발의 조기 발견과 이에 따른 보다 나은 치료 성적을 얻기 위하여 필수적인 정보이다. 즉 종양의 특성에 따른 재발의 유형, 재발시기, 재발 이후의 경과 등을 이해하고자 본 연구를 시행하였다. 대상 및 방법: 1992년 6월부터 2005년 12월까지 본원 외과에서 위암으로 근치적수술을 시행 받은 1,338명의 환자 가운데 재발 유형을 모르는 경우(n=60), 사고사 및 타 질환으로 사망한 경우(n=55)를 제외한 1,223명을 연구 대상자로 하였다. 재발예(n=241)와 비재발예(n=982) 사이의 임상병리학적 특성 및 재발예 가운데 재발의 유형에 따른 임상병리학적 특성을 비교 분석하였다. 결과: 재발예는 비재발예에 비하여 위전절제술, 진행된 병기, 림프관이나 혈관 침윤예, 위전벽암, 크기가 큰 암, 미분화암, 미만형, Borrmann 4형이 의미 있게 많았다. 복막파종은 여성, stage III, 위상부 및 위전벽암, 미분화암, 미만형, Borrmann 4형이 의미 있게 많았고, 혈행성전이는 조기위암, stage I, 국소전이는 Borrmann 1, 2, 3형이 의미 있게 많았다. 복막파종의 경우 혈행성전이나 국소전이에 비하여 재발 후 생존기간이 짧았다(7.0개월, 9.5개월, 12.5개월). 조기재발군은 병기3, 4기, N3, 림프관침윤율이 높았고, 후기재발군은 병기3기, N1이 조기재발군에 비해 의미 있게 많았다. 결론: 위암의 임상병리학적 특성에 대한 이해가 위암수술 후 재발을 조기에 발견하는 데 중요할 것으로 판단된다.

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갑상선 재발암의 진단과 치료에 대한 고찰 (Diagnosis and Treatment of the Recurrent Thyroid Cancer)

  • 권오경;박성길;오성수
    • 대한두경부종양학회지
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    • 제16권1호
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    • pp.58-63
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    • 2000
  • Objectives: To demonstrate effective diagnostic method and proper management of recurrent thyroid cancer through to compare treatment and surveillance of $I^{131}$ scanning detected recurrence and clinically detected recurrence. Material and Methods: We retrospectively analyzed clinical information about 46 patients who has recurrent thyroid cancer of 298 patients who have been primarily operated due to thyroid cancer in PMC at the over 10 years between 1986 and 1995. We examine incidence of recurrence due to pathologic types, site of recurrence, disease free interval, detection method of recurrence, and also treatment and progression of recurrence. A patients in which the clinical examination was entirely negative and the $I^{131}$ scan demonstrated either a new area of $I^{131}$ uptake or an increased area of concentration, compared to the previous scan, was designated as a recurrence detected by $I^{131}$ scan only. Recurrences that were obviously by physical examination or chest x-ray, etc were considered clinically detected recurrence, regardless of the the results of the thyroid scan. Results: Mean of disease tree interval(DFI) is 36months. When mean DFI of $I^{131}$ scan detected recurrence is 28months, whereas mean DFI of clinically detected recurrence is 47months. In statiscal analysis, p-value is 0.043 as significantly. In progression of recurrent patient, NED is 28case, AWD is Sease, DOD is 13case. Among the 13case, scan detected recurrence is lease of 20 patients(5%), whereas clinically detected recurrence is l2case of 26 patient(46%). In statiscal analysis, p-value is 0.003 as significantly. Conclusion: Early detection of the recurrent thyroid cancer by $I^{131}$ scanning leads to good progress compare with detection by clinical examination. NED: No Evidence of Disease AWD : Alive With Disease DOD : Dead Of Disease DOC: Dead of Other Cause

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Long-Term Outcomes in Stage I Lung Cancer After Segmentectomy with a Close Resection Margin

  • Kim, Dae Hyeon;Na, Kwon Joong;Park, In Kyu;Kang, Chang Hyun;Kim, Young Tae;Park, Samina
    • Journal of Chest Surgery
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    • 제54권5호
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    • pp.361-368
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    • 2021
  • Background: In general, a 2-cm surgical margin is recommended for limited resection to obtain equivalent oncologic outcomes to lobectomy for lung cancer. This study aimed to examine the patterns of recurrence and prognostic factors for recurrence in patients with a close parenchymal resection margin. Methods: From January 2009 to April 2017, 156 patients with stage I lung cancer who underwent segmentectomy with a close resection margin (<2 cm) were enrolled. Recurrence-free survival and overall survival were assessed. In addition, predisposing factors for recurrence were evaluated. Results: The mean tumor size was 1.7±0.8 cm and the parenchymal resection margin was 1.1±0.6 cm. Recurrence developed in 17 (10.7%) of the 156 patients, and the 5-year recurrence-free survival rate was 88.9%. Distant metastasis (7.7%) was the predominant recurrence pattern. The isolated local recurrence rate was 1.9%. Multivariate Cox regression analysis revealed that age, tumor size, mediastinal lymph node dissection, postoperative complications, and histologic type were significant predisposing factors for recurrence. However, parenchymal margin distance did not significantly affect the long-term prognosis. Conclusion: Segmentectomy with a close resection margin for early-stage lung cancer in selected patients resulted in acceptable recurrence and survival. However, patients with tumors larger than 2 cm, squamous cell carcinoma histology, and insufficient mediastinal evaluation should be carefully followed up for recurrence.

Identifying Predictive Factors for the Recurrence of Pediatric Intussusception

  • Lee, Dong Hyun;Kim, Se Jin;Lee, Hee Jung;Jang, Hyo-Jeong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권2호
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    • pp.142-151
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    • 2019
  • Purpose: The aim of the study was to identify factors related to the recurrence of intussusception in pediatric patients. Methods: The medical charts of patients diagnosed with intussusception and treated at Dongsan Medical Center, between March 2015 to June 2017, were retrospectively reviewed. Univariate and multivariate analyses were performed. Results: Among 137 patients, 23 patients (16.8%) had a recurrent intussusception and 8 of these patients (6%) had more than 2 episodes of recurrence. The age at diagnosis was significantly different between the non-recurrence and recurrence group (p=0.026), with age >1 year at the time of diagnosis associated with a greater rate of recurrence (p=0.002). The time interval from symptom onset to the initial reduction (<48 vs. ${\geq}48$ hours) was significantly longer in the recurrence group (p=0.034) and patients in the recurrence group had higher levels of C-reactive protein (CRP) (p=0.024). Bloody stools and a history of infection were significantly more frequent in the non-recurrence group (p=0.001 and p<0.001, respectively). On stepwise regression analysis, age >1 year at the time of presentation (odds ratio [OR], 4.79; 95% confidence interval [CI], 1.56-14.06; p=0.016) and no history of infection (OR, 0.18; 95% CI, 0.06-0.58; p=0.004) were retained as predictors of recurrence. Conclusion: Patients with intussusception who are older than 1 year at diagnosis, have an elevated CRP level, a delay of ${\geq}48$ hours between symptom onset and the initial reduction, an absence of bloody stools, and no history of infection should be closely monitoring for symptoms and signs of a possible recurrence.

Chemical Pleurodesis Using Tetracycline for the Management of Postoperative Pneumothorax Recurrence

  • Jun Tae Yang;Sahri Kim;Hyoung Soo Kim;Hee Sung Lee;Yong Joon Ra;Hong Kyu Lee
    • Journal of Chest Surgery
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    • 제56권4호
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    • pp.240-243
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    • 2023
  • Background: Although there is no obvious recommendation for the management of pneumothorax recurrence after surgery, chemical pleurodesis with tetracycline has been applied as a significant treatment approach. The objective of this study was to evaluate the effectiveness of chemical pleurodesis with tetracycline for the management of postoperative recurrence of primary spontaneous pneumothorax (PSP). Methods: We retrospectively analyzed patients who underwent video-assisted thoracic surgery (VATS) as therapy for PSP at Hallym University Sacred Heart Hospital from January 2010 to December 2016. Patients who had ipsilateral recurrence after surgery were included in this study. Patients who underwent pleural drainage with chemical pleurodesis were compared with patients who only underwent pleural drainage. Results: In total, 932 patients who underwent VATS for PSP were analyzed, and ipsilateral recurrence after surgery occurred in 67 patients (7.1%). The treatment modalities for recurrence after surgery were observation (n=12), pleural drainage alone (n=16), pleural drainage with chemical pleurodesis (n=34), and repeated VATS (n=5). Eight of the 16 patients (50 %) treated with pleural drainage alone had recurrence again, while 15 of the 34 patients (44.1%) treated with pleural drainage and chemical pleurodesis experienced further recurrence. Chemical pleurodesis with tetracycline did not show a meaningful difference in the re-recurrence rate in comparison with pleural drainage alone (p=0.332). Conclusion: Chemical pleurodesis with tetracycline for the management of postoperative recurrence of PSP was not effective. Further research is required to identify alternative drugs that can significantly decrease the re-recurrence rate.