• 제목/요약/키워드: Recurrence

검색결과 4,570건 처리시간 0.028초

Clinical Outcomes of Differentiated Thyroid Cancer Patients with Local Recurrence or Distant Metastasis Detected in Old Age

  • Han, Ji Min;Bae, Ji Cheol;Kim, Hye In;Kwon, Sam;Jeon, Min Ji;Kim, Won Gu;Kim, Tae Yong;Shong, Young Kee;Kim, Won Bae
    • Endocrinology and Metabolism
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    • 제33권4호
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    • pp.459-465
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    • 2018
  • Background: Differentiated thyroid carcinoma (DTC) shows a very good prognosis, but older patients have a higher recurrence rate and those show poor prognosis than younger patients. The aim of this study was to determine the clinical outcomes of thyroid cancer patients who experienced recurrence in old age according to the treatment strategy used. Methods: This retrospective observational cohort study was conducted at Asan Medical Center, Seoul, Korea. Among DTC patients with no evidence of disease after initial treatment, we enrolled 86 patients who experienced recurrence at an age >65 years from 1994 to 2012. Sixty-nine patients had local recurrence and 17 patients showed distant metastasis. Results: The mean age of patients at recurrence was 72 years. Patients were followed up for a median of 4.1 years after recurrence. Sixty-three of the 69 patients with local recurrence received additional treatment, while the other six received conservative care. The cancer-specific mortality rate was 15.5% in the local recurrence group. Airway problems were the main cause of death in patients who did not receive further treatment for local recurrence. Among the 17 patients with distant metastasis, 10 underwent specific treatment for metastasis and seven received only supportive management. Seven of those 17 patients died, and the cancer-specific mortality rate was 35% in the distant metastasis group. Conclusion: The overall cancer-specific mortality rate was 20% in DTC patients in whom recurrence was first detected at an age >65 years. Mortality due to uncontrolled local disease occurred frequently in patients who did not receive definitive management for recurrence.

Isolated Supratentorial Intraventricular Recurrence of Medulloblastoma

  • Abode-Iyamah, Kingsley O.;Winslow, Nolan;Flouty, Oliver;Kirby, Patricia
    • Journal of Korean Neurosurgical Society
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    • 제58권6호
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    • pp.557-559
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    • 2015
  • Medulloblastoma is a common pediatric tumor typically diagnosed before the age of fifteen. Initial therapy includes surgical resection and radiation of the entire neuro-axis. Recurrence is common and typically occurs within 2 years of initial diagnosis. Those fitting Collin's Law is considered tumor-free. We report a case of single supratentorial recurrence 13 years after initial diagnosis. Here we present a 22 year old male presenting 13 years after initial diagnosis with isolated septum pellucidum recurrence. He underwent complete resection of the tumor. Medulloblastoma is a common in the pediatric population. Late recurrence to the ventricular system is uncommon. Long term follow-up is recommended in these patients.

연대측정자료를 이용한 단층활동주기 산정 방법 (Method of Recurrence Interval Estimation for Fault Activity from Age Dating Data)

  • 최원학
    • 한국지진공학회:학술대회논문집
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    • 한국지진공학회 2001년도 춘계학술대회 논문집
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    • pp.74-80
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    • 2001
  • The estimation of recurrence interval for fault activity and earthquake is an important input parameter for seismic hazard assessment. In this study, the methods of recurrences interval estimation were reviewed and tentative calculation was performed for age dating data which have uncertainty. Age dating data come from previous studies of Ulsan fault system which is a well developed lineament in the southeastern part of korean Peninsula. Age dating for fault gouges, parent rocks, Quaternary sediments and veins were carried out by several researchers through various methods. Recurrence interval for fault activity was estimated on the basis of the age dating data of minor fault gouge and sediments during past 3Ma. The estimated recurrence interval was about 430-500 ka. Exact estimation of recurrence interval for fault activity need to compile more geological data and fault characteristics such as fault length, amount of displacement, slip rate and accurate fault movement age. In the future, the methods and results of fault recurrence interval estimation should be considered for establishing the criteria for domestic active fault definition.

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Tumor Diameter for Prediction of Recurrence, Disease Free and Overall Survival in Endometrial Cancer Cases

  • Senol, Taylan;Polat, Mesut;Ozkaya, Enis;Karateke, Ates
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7463-7466
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    • 2015
  • Aims: To analyse the predictors of recurrence, disease free survival and overall survival in cases with endometrial cancer. Materials and Methods: A total of 152 women diagnosed with endometrial cancer were screened using a prospectively collected database including age, smoking history, menopausal status, body mass index, CA125, systemic disorders, tumor histology, tumor grade, lymphovascular space invasion, tumor diameter, cervical involvement, myometrial invasion, adnexal metastases, positive cytology, serosal involvement, other pelvic metastases, type of surgery, fertility sparing approach to assess their ability to predict recurrence, disease free survival and overall survival. Results: In ROC analyses tumor diameter was a significant predictor of recurrence (AUC:0.771, P<0.001). The optimal cut off value was 3.75 with 82% sensitivity and 63% specificity. In correlation analyses tumor grade (r=0.267, p=0.001), tumor diameter (r=0.297, p<0.001) and the serosal involvement (r=0.464, p<0.001) were found to significantly correlate with the recurrence. In Cox regression analyses when some different combinations of variables included in the model which are found to be significantly associated with the presence of recurrence, tumor diameter was found to be a significant confounder for disease free survival (OR=1.2(95 CI,1.016-1.394, P=0.031). On Cox regression for overall survival only serosal involvement was found to be a significant predictor (OR=20.8 (95 % CI 2.4-179.2, P=0.006). In univariate analysis of tumor diameter > 3.75 cm and the recurrence, there was 14 (21.9 %) cases with recurrence in group with high tumor diameter where as only 3 (3.4 %) cases group with smaller tumor size (Odds ratio:7.9 (95 %CI 2.2-28.9, p<0.001). Conclusions: Although most of the significantly correlated variables are part of the FIGO staging, tumor diameter was also found to be predictor for recurrence with higher values than generally accepted.

Risk Factors for Early and Late Intrahepatic Recurrence in Patients with Single Hepatocellular Carcinoma Without Macrovascular Invasion after Curative Resection

  • Li, Shu-Hong;Guo, Zhi-Xing;Xiao, Cheng-Zuo;Wei, Wei;Shi, Ming;Chen, Zhi-Yuan;Cai, Mu-Yan;Zheng, Lie;Guo, Rong-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권8호
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    • pp.4759-4763
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    • 2013
  • Background: Prognostic factors of postoperative early and late recurrence in patients with hepatocellular carcinoma (HCC) undergoing curative resection remain to be clarified. The aim of this study was to identify risk factors for postoperative early (${\leq}$ 2 year) and late (> 2 year) intrahepatic recurrences in patients with single HCCs without macrovascular invasion. Methods: A total of 280 patients from December 2004 to December 2007 were retrospectively included in this study. Intrahepatic recurrence was classified into early (${\leq}$ 2 year) and late (> 2 year) and the Chi-Square test or Fisher's exact test and multivariate logistic regression analysis were performed to determine significant risk factors. Results: During the follow-up, 124 patients had intrahepatic recurrence, early and late in 82 and 42 patients, respectively. Multivariate logistic regression analysis showed that microvascular invasion (p=0.006, HR: 2.397, 95% CI: 1.290-4.451) was the only independent risk factor for early recurrence, while being female (p = 0.031, HR: 0.326, 95% CI: 0.118-0.901), and having a high degree of cirrhosis (P=0.001, HR: 2.483, 95% CI: 1.417-4.349) were independent risk factors for late recurrence. Conclusions: Early and late recurrence of HCC is linked to different risk factors in patients with single HCC without macrovascular invasion. This results suggested different emphases of strategies for prevent of recurrence after curative resection, more active intervention including adjuvant therapy, anti-cirrhosis drugs and careful follow-up being necessary for patients with relevant risk factors.

치성 각화 낭종의 술후 재발양상과 추적관찰 기간의 제안 (POSTOPERATIVE RECURRENCES OF ODONTOGENIC KERATOCYST : THE BEHAVIOR AND PROPOSAL OF CRITICAL FOLLOW-UP PERIOD)

  • 박세현;김남균;김기호;강상훈;박형식;김형준;차인호;남웅
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권4호
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    • pp.456-459
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    • 2008
  • Post-operative recurrence of cystic lesion is a great concern for clinician, patients, and their family, especially in case of odontogenic keratocyst, which has aggressive behavior and high recurrence rate. The purpose of this study was to evaluation clinical characters of OKC, focusing of the recurrence rate and proposed critical follow-up period. 58 cases (aged 9 to 66, 33 males and 25 females) of OKC were reviewed for sex of patients, location, size, operative procedure type, radiographic findings, histopathologic findings, post-operative recurrence time, from 2000 to 2005 at Yonsei Medical Center, were selected. The computerized statistical analysis was carried out with SAS system. 18 of 58 cases (31.03%) were recurred and this study revealed no statistically significant difference in recurrence rate for sex, location, size, radiographic findings, histopatologic findings, operative procedure type, recurrence timing. 3 out of 18 cases (16.7%) showed one or more recurrence. This was statistically significant difference (P=.0264). In this study, 15 of 18 cases (83.3%) were observed recurrence during 4 years after removal of the OKCs, we suggest critical follow-up period during 4 years after operation.

FXYD-3 expression in relation to local recurrence of rectal cancer

  • Loftas, Per;Arbman, Gunnar;Sun, Xiao-Feng;Edler, David;Syk, Erik;Hallbook, Olof
    • Radiation Oncology Journal
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    • 제34권1호
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    • pp.52-58
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    • 2016
  • Purpose: In a previous study, the transmembrane protein FXYD-3 was suggested as a biomarker for a lower survival rate and reduced radiosensitivity in rectal cancer patients receiving preoperative radiotherapy. The purpose of preoperative irradiation in rectal cancer is to reduce local recurrence. The aim of this study was to investigate the potential role of FXYD-3 as a biomarker for increased risk for local recurrence of rectal cancer. Materials and Methods: FXYD-3 expression was immunohistochemically examined in surgical specimens from a cohort of patients with rectal cancer who developed local recurrence (n = 48). The cohort was compared to a matched control group without recurrence (n = 81). Results: Weak FXYD-3 expression was found in 106/129 (82%) of the rectal tumors and strong expression in 23/129 (18%). There was no difference in the expression of FXYD-3 between the patients with local recurrence and the control group. Furthermore there was no difference in FXYD-3 expression and time to diagnosis of local recurrence between patients who received preoperative radiotherapy and those without. Conclusion: Previous findings indicated that FXYD-3 expression may be used as a marker of decreased sensitivity to radiotherapy or even overall survival. We were unable to confirm this in a cohort of rectal cancer patients who developed local recurrence.

아동보호서비스 개입사례의 재학대 특성 연구: 생존분석의 적용 (The Characteristics of Recurrence on Intervention Cases of Child Protective Services: Application of Survival Analysis)

  • 장희선;김기현;김경희
    • 한국가족복지학
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    • 제54호
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    • pp.225-262
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    • 2016
  • 본 연구의 목적은 아동보호서비스 개입사례의 재학대 특성을 확인하는 것이다. 이를 위해 국가아동학대정보시스템에 접근하여 2012년에 신고 접수된 전수를 추출하였고 이들 사례 중 아동학대로 판정된 사례를 중심으로 2014년까지 총 3년간의 데이터를 수집하여 해당기간 내 재학대가 발생한 사례들의 특성을 확인하였다. 재학대 특성은 생존분석을 통해 재학대 발생 시점 및 빈도를 중심으로 살펴보았다. 분석결과, 2012년에 학대판정을 받은 5,542사례 중 323사례가 이후 3년 이내에 재학대를 기록하였다. 대부분의 사례(93.5%)가 1회의 재학대를 기록하였지만 2회의 재학대를 기록한 사례도 21사례로 확인되었다. 또한 학대로 판정된 이후 1개월 이내에 가장 많은 재학대가 발생하였고, 이전 아동보호서비스 연루 유무, 중복학대 유무, 신체학대 포함 여부, 서비스 제공 유형 등에 따라 재학대 발생 시기 및 빈도가 다르게 나타났다. 아동의 연령 및 문제행동 수, 학대행위자의 스트레스 및 사회적 고립, 가족구성원인 학대행위자, 이전 아동보호서비스 연루 기록, 재신고 총 횟수 증가 등은 이후의 재학대 발생과 관련되었다. 본 연구는 이러한 분석결과를 토대로 아동학대의 재학대 예방을 위한 정책적, 실천적 함의를 논하고 관련 제언을 제시하였다.

Incidence and Risk Factors of Recurrent Venous Thromboembolism after Pulmonary Embolism

  • Hwang, Hun-Gyu;Choi, Won-Il;Lee, Bora;Lee, Choong Won
    • Tuberculosis and Respiratory Diseases
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    • 제82권4호
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    • pp.341-347
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    • 2019
  • Background: Information about the epidemiology of venous thromboembolism (VTE) recurrence in Korea is lacking. The purpose of this study was to investigate VTE cumulative recurrence rates and identify risk factors for VTE recurrence among Korean adults. Methods: A retrospective cohort study was conducted on adult patients (${\geq}18years$) admitted to a university teaching hospital for pulmonary embolism (PE) from 2005 to 2013. The main outcome of interest was a recurrence of VTE. We used Cox proportional hazard regression analyses to calculate the relative risk of VTE recurrence. Results: Five-year cumulative incidence of recurrent VTE events was 21.5% (95% confidence interval [CI], 17.7-25.4) in all cases of PE; 17% after provoked and 27% after unprovoked PE. Multivariate analysis showed that body mass index (BMI) of ${\geq}25$ (hazard ratio [HR], 2.02; 95% CI, 1.17-3.46; p=0.01) and longer anticoagulation therapy duration (HR, 0.90; 95% CI, 0.84-0.96; p<0.01) were independently associated with risk of VTE recurrence. Risk factors not found to be statistically significant at the <0.05 level included history of VTE (HR, 1.81; 95% CI, 0.84-3.88; p=0.12), unprovoked PE (HR, 1.70; 95% CI, 0.89-3.25; p=0.10), symptomatic deep vein thrombosis (HR, 1.62; 95% CI, 0.89-2.94; p=0.10), and female sex (HR, 1.42; 95% CI, 0.78-2.55; p=0.24). We found that age, history of cancer, and other co-morbidities did not significantly affect the risk of VTE recurrence. Conclusion: Recurrence of VTE after PE is high. Patients with BMI ${\geq}25$ or reduced anticoagulation therapy duration have a higher risk of recurrent VTE.