• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4693-4697
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• 2016

Aim: The objective of this study is to investigate prognostic factors affecting survival of patients undergoing concurrent or sequential chemoradiotherapy (CRT) for stage III non-small-cell lung cancer (NSCL). Methods and materials: We retrospectively reviewed the clinical records of 148 patients with advanced, inoperable stage III NSCLC, who were treated between 2007 and 2015. Results: The median survival was found to be 19 months and 3-year overall survival was 27%. Age (<65 vs ${\geq}65years$, p=0.026), stage (IIIA vs IIIB, p=0.033), dose of radiotherapy (RT) (<60 vs ${\geq}60Gy$, p=0.024) and treatment method (sequential chemotherapy+RT vs concurrent CRT, p=0.023) were found to be factors affecting survival in univariate analyses. Gender, histological subtype, weight loss during CRT, performance status, induction/consolidation chemotherapy and presence of comorbidities did not affect survival (p>0.050). Conclusion: Young age, stage IIIA, radiotherapy dose and concurrent chemoradiotherapy may positively affect survival in stage III NSCL cases.

• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.322-332
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• 1998

Background: Accurate staging is important to determine treatment modalities and to predict prognosis for the patients with lung cancer. The simple two-stage system of the Veteran's Administration Lung Cancer study Group has been used for staging of small cell lung cancer(SCLC) because treatment usually consists of chemotherapy with or without radiotherapy. However, this system does not accurately reflect segregation of patients into homogenous prognostic groups. Therefore, a variety of new staging system have been proposed as more intensive treatments including either intensive radiotherapy or surgery enter clinical trials. We evaluate the prognostic importance of TNM staging, which has the advantage of providing a uniform detailed classification of tumor spread, in patients with SCLC. Methods: The medical records of 166 patients diagnosed with SCLC between January 1989 and December 1996 were reviewed retrospectively. The influence of TNM stage on survival was analyzed in 147 patients, among 166 patients, who had complete TNM staging data. Results: Three patients were classified in stage I / II, 15 in stage III a, 78 in stage IIIb and 48 in stage IV. Survival rate at 1 and 2 years for these patients were as follows: stage I / II, 75% and 37.5% ; stage IIIa, 46.7% and 25.0% ; stage III b, 34.3% and 11.3% ; and stage IV, 2.6% and 0%. The 2-year survival rates for 84 patients who received chemotherapy(more than 2 cycles) with or without radiotherapy were as follows: stage I / II, 37.5% ; stage rna, 31.3% ; stage IIIb 13.5% ; and stage IV 0%. Overall outcome according to TNM staging was significantly different whether or not received treatment. However, there was no significant difference between stage IIIa and stage IIIb though median survival and 2-year survival rate were higher in stage IIIa than stage IIIb. Conclusion: These results suggest that the TNM staging system may be helpful for predicting the prognosis of patients with SCLC.

• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.339-346
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• 1999

Background : Non-small cell lung carcinoma is a common tumor with a poor prognosis. Of all malignancies, it is the main cause of death for male and female patients in the Western world. Resection remains the most effective treatment when feasible. Accurate description and classification of the extent of cancer growth are important in planning treatment, estimating prognosis, evaluating end results of therapy, and exchanging information on human cancer research. Until effective systemic therapy is available for non-small cell lung cancer, development of new treatment strategies depends on knowledge of the end results achieved for carefully staged groups of patients in the lung cancer populations. For these reasons, we investigated the survival rate in radically resected non-small cell lung cancer patients by newly revised staging system adopted by the American Joint Committee on Cancer and the Union Internationale Contre le Cancer. Methods: Clinical, surgical-pathologic and follow-up informations on 84 consecutive, previously untreated, patients who received their primary treatment for non-small cell lung cancer were investigated. Staging definitions for the T(primary tumor), N(reginal lymph node), and M(distant metastasis) components were according to the International Staging System for Lung Cancer. Death from any causes was the primary target of the evaluation. Results: The median survival rates were as follows; stage I ;79.1 months, stage II ;47.3 months, stage IIIa; 22.7 months, stage IIIb; 16.1 months, and stage IV;15.2 months versus newly revised stage Ia;58.5 months, stage I b;76.0 months, stage IIa; not available, stage IIb;43.0 months, stage IIIa;22.5 months, stage IIIb; 16.1 months, and stage IV;15.2 months. The survival rates were not significantly different between old and newly revised staging system. Cumulative percent survival at 36months after treatment was 100% in stage Ia, 80% in stage Ib, not available in stage IIa, 26 % in stage IIb, and 21 % in stage m a respectively. Conclusions: Although these data were not significantly different statistically, the newly revised lung cancer staging system might be more promising for the accurate evaluation of the prognosis in the non-small cell lung caner patients.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 1995.05a
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• pp.13-13
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• 1995

The authors performed the arthroscopic decompression and cuff debridement on 47 cases in 45 consecutive patients with either stage II or stage III impingement syndrome from July 1990 to January 1994. The summarized results are as follows. 1. 47 cases in 45 consecutive patients had arthroscopic decompression for the subacromial impingement syndrome. 2. There were 31 males and 14 females and the mean age was 40 years for men and 46years for women. 3. The follow up duration was from 3 years 9 months to 1 year (average 2 years 1month). 4. Among 47 cases, 19 cases were found to have no cuff tear (stageII) 13 cases partial thickness cuff tear (stage IIIa) 10 cases complete tear on cuff less than 3 cm long (stage IIIb) and 5 cases complete tear on cuff more than 3 em in length (stage IIIc). 5. The arthroscopic subacromial decompression and rotator cuff debridement was a good treatment method in stage II and stage IIIa and stage IIIb. in the case of stage IIIc rotator cuff tear, it was useful for pain relief and improvement of shoulder function.

• Radiation Oncology Journal
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• v.13 no.4
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• pp.359-368
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• 1995

Purpose : This is a retrospective analysis for pattern of failure, survival rate and prognostic factors of 114 patients with histologically proven invasive cancer of the uterine cervix treated with definitive irradiation. Materials and Methods : One hundred fourteen patients with invasive carcinoma of the cervix were treated with a combination of intracavitary irradiation using Fletcher-Suit applicator and external beam irradiation by 6MV X-ray at the Ewha Womans University Hospital between March 1982 and Mar 1990. The median age was 53 years(range:30-77 years). FIGO stage distribution was 19 for IB, 23 for IIA, 42 for IIB, 12 for IIIA and 18 for IIIB. Summation dose of external beam and intracavitary irradiation to point A was 80-90 Gy(median:8580 cGy) in early stage(IB-IIA) and 85-100 Gy(median:8850 cGy) in advanced stage(IIB-IIIB). Kaplan-Meier method was used to estimate the survival rate and multivariate analysis for progrostic factors was performed using the Log likelihood for Weibull Results : The pelvic failure rates by stage were $10.5{\%}$ for IB. $8.7{\%}$ for IIA, $23.8{\%}$ for IIB, $50.0{\%}$ for IIIA and $38.9{\%}$ for IIIB. The rate of distant metastasis by stage were $0{\%}$ for IB, $8.7{\%}$ for IIA, $4.8{\%}$ for IIB. $0{\%}$ for IIIA and $11.1{\%}$ for IIIB. The time of failure was from 3 to 50 months and with median of 15 months after completion of radiation therapy. There was no significant coorelation between dose to point A($\leq$90 Gy vs >90 Gy) and pelvic tumor control(P>0.05). Incidence rates of grade 2 rectal and bladder complications were $3.5{\%}$(4/114) and $7{\%}$(8/114), respectively and 1 patient had sigmoid colon obstruction and 1 patient had severe cystitis. Overall 5-year survival rate was $70.5{\%}$ and disease-free survival rate was $53.6{\%}$. Overall 5-year survival rate by stage was $100{\%}$ for IB, $76.9{\%}$ for IIA, $77.6{\%}$ for IIB $87.5{\%}$ for IIIA and $69.1{\%}$ for IIIB. Five-rear disease-free survival rate by stage was $81.3{\%}$ for IB, $67.9{\%}$ for IIA, $46.8{\%}$ for IIB, $45.4{\%}$ for IIIA and $34.4{\%}$ for IIIB. The prognostic factors for disease-free survival rate by multivariate analysis was performance status(p= 0.0063) and response rate after completion of radiation therapy(p= 0.0026) but stage, age and radiation dose to point A were not siginificant. Conclusion : The result of radiation therapy for early stage of the uterine cervix cancer was relatively good but local control rate and survival rate in advanced stage were poor inspite of high dose irradiation to point A above 90 Gy. Prospective randomized studies are recommended to establish optimal tumor doses for various stages and volume of carcinoma of uterine cervix, And ajuvant chemotherapy or radiation-sensitizing agents must be considered to increase the pelvic control and survival rate in advanced cancer of uterine cervix.

• Radiation Oncology Journal
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• v.10 no.1
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• pp.69-76
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• 1992

To identify pretreatment prognostic factors in locally advanced carcinoma of the uterine cervix, retrospective analysis was undertaken of 154 patients treated with curative radiation therapy at Seoul National University Hospital, from March 1979 through December 1986. According to FIGO classification, eight patients were stage IIIA, 134 were stage IIIB, and 12 were stage IVA. Five year locoregional control rate was $58\%$, $51\%$, and $27\%$ in stage IIIA, IIIB, and IVA, respectively. Five year disease free survival was $57\%$, $40\%$, and $25\%$ for each stage respectively. Five year overall survival was $67\%$, $51\%$, and $33\%$ in stage IIIA, IIIB, and IVA, respectively. In univariate analysis, fewer than or equal to four of pregnancies, initial hemoglobin of lower than $10\;g\%$, and pelvic sidewall invasion on CT were associated with poor locoregional control. Number of pregnancies, initial hemoglobin level, obstructive uropathy on intavenous pyelography (IVP), pelvic lymph node (LN) status on CT, and pelvic sidewall invasion on CT were significant factors in disease free survival. In terms of overall survival, pelvic sidewall invasion on CT and bladder invasion on CT were prognostically significant. In multivariate analysis, no factor was found to affect locoregional control and pelvic LN status was a sole significant factor affecting disease free survival. in terms of overall survival, the size.

• Journal of Chest Surgery
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• v.32 no.2
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• pp.144-150
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• 1999

Background: Surgery has been considered the most effective and standard treatment modality in non-small cell lung cancer(NSCLC). However in stage IIIA lung cancer, the role of surgery is still controversial. To evaluate the role of surgery for stage IIIA NSCLC, we investigated the survival after surgery and the prognostic factors. Material and Method: We evaluated 158 consecutive cases of stage IIIA NSCLC patients operated on between 1990 and 1996. There were 130 male patients and 28 female patients, and the mean age was 58.5 years. All patients except one underwent lung resection beyond lobectomy and extended mediastinal dissection. Postoperative adjuvant therapy were undertaken in 145(94.8%) patients. All patients(153) were followed and the mean follow-up period was 21.4months. Result: Twenty nine cases of the postoperative complications developed in 25 patients (15.8%). There were 5 operative mortality cases(3.2%) and the main cause of death was acute respiratory distress syndrome (ARDS). Local or distant recurrences developed in 84 patients(54.9%). The 5-year survival of 153 patients was 29.6% and the median survival time was 18.0 months. The 5-year survival of non N2 disease group(36.8%) was better than that of N2 disease group(26.6%)(p=0.35) and the 5-year survival of squamous cell carcinoma (38.1%) was better than that of adenocarcinoma(25.7%)(p=0.39) however there were no significant differences. Regarding the postoperative adjuvant therapy, in combined therapy group(84 patients), radiotherapy group(37 patients) and chemotherapy group(24 patients), the 5-year survival were 31.3%, 32.4%, and 14.6% respectively. There was no difference of survival between radiotherapy and combined therapy group(p=0.31), however the survival of the combined therapy group was better than the chemotherapy group(p=0.005). The survival of the complete resection group(31.9%) was better than the incomplete resection group(16.6%) however there was no significant difference(p=0.19). Conclusion: These observations indicate that the good 5-year survival(29.6%) in patients with stage IIIA NSCLC result from the agressive surgical treatment including extensive mediastinal nodes dissection.

• Journal of Chest Surgery
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• v.51 no.1
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• pp.29-34
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• 2018

Background: We evaluated the feasibility and outcomes of pulmonary resection and mediastinal node dissection (MND) by video-assisted thoracoscopic surgery (VATS) following neoadjuvant therapy for stage IIIA N2 non-small cell lung cancer (NSCLC). Methods: From November 2009 to December 2013, a total of 35 consecutive patients with pathologically or radiologically confirmed stage IIIA N2 lung cancer underwent pulmonary resection and MND, performed by a single surgeon, following neoadjuvant chemoradiation. Preoperative patient characteristics, surgical outcomes, postoperative drainage, postoperative complications, and mortality were retrospectively analyzed. Results: VATS was completed in 17 patients. Thoracotomy was performed in 18 patients, with 13 planned thoracotomies and 5 conversions from the VATS approach. The median age was $62.7{\pm}7.9years$ in the VATS group and $60{\pm}8.7years$ in the thoracotomy group. The patients in the VATS group tended to have a lower diffusing capacity for carbon monoxide (p=0.077). There were no differences between the 2 groups in the method of diagnosing the N stage, tumor response and size after induction, tumor location, or histologic type. Complete resection was achieved in all patients. More total and mediastinal nodes were dissected in the VATS group than in the thoracotomy group (p<0.05). The median chest tube duration was 5.3 days (range, 1 to 33 days) for the VATS group and 7.2 days (range, 2 to 28 days) for the thoracotomy group. The median follow-up duration was 36.3 months. The 5-year survival rates were 76% in the VATS group and 57.8% in the thoracotomy group (p=0.39). The 5-year disease-free survival rates were 40.3% and 38.9% in the VATS and thoracotomy groups, respectively (p=0.8). Conclusion: The VATS approach following neoadjuvant treatment was safe and feasible in selected patients for the treatment of stage IIIA N2 NSCLC, with no compromise of oncologic efficacy.

• Proceedings of the Korean Society for Technology of Plasticity Conference
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• 2007.05a
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• pp.272-275
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• 2007

This paper is concerned with modified integration algorithm on the strain-space for rate and temperature dependent elasto-plastic constitutive relations in order to obtain more accurate results in numerical implementation. The proposed algorithm is integrated analytically using integration by part and chain rule and then is applied to the 2-stage Lobatto IIIA with second-order accuracy. It has advantage that is able to consider the convective stress rates on the yield surface of the strain-space. Also this paper is carried out the iteration procedure using the Newton-Raphson method to enforce consistency at the end of the step. And the performance of the proposed algorithm for rate and temperature dependent constitutive relation is illustrated by means of analysis of adiabatic shear bands.

• Journal of Chest Surgery
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• v.24 no.1
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• pp.72-82
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• 1991

From May 1978 to Sep. 1990, 106 patients who had been diagnosed as primary lung cancer and operated on at the Department of Thoracic & Cardiovascular Surgery, Han Yang University, were clinically evaluated. 1. The peak incidence of age was 5th decade of life[37.7%] and 6th decade[29.2%]. Male to female ratio was 3.8: l. 2. Most of symptoms were respiratory, which were cough, chest pain, hemoptysis, and asymptomatic cases were 2.9%. 3. Histopathologic classifications were squamous cell carcinoma[53.7%], adenocarcinoma [23.8%], bronchioloalveolar cell carcinoma[6.6%], undifferentiated large cell carcinoma[6.6%], small cell carcinoma[3.8%], adenosquamous carcinoma[3.8%] and others[1.8%]. 4. Methods of operation were pneumonectomy 49.1%[52cases], lobectomy 21%[22cases] bilobectomy[6cases], lobectomy with wedge resection[3cases], exploration 21.9%[23cases], and resectability was 78.3%. 5. Staging classifications were Stage I [22.6%], Stage II [11.3%], Stage IIIa[42.6%], Stage IIIb[21.7%] and Stage lV[1.6%]. Resectability by Stage; Stage I was 100%, II 100%, IIIa 84.4% and IIIb 30.4%. 6. Causes of most of inoperable cases were invasion of mediastinal structures and diffuse chest wall, and others were contralateral lymph node invasion and malignant pleural effusion. 7. Operative mortality was 6.7% which caused by arrhythmia, sepsis, pulmonary edema, and radiation pneumonitis. 8. On the long term follow up of the resectable cases, overall 1 year survival rate was 58.5 %, 2 year 39%, and 5 year 19.5%. Five year survival rate was 40% in Stage I, 25% in Stage II and 11.7% in Stage Illa. As for the method of operation, the higher 5 year survival rate was observed in lobectomies[33.3%] than in pneumonectomies[10.3%].