• Title/Summary/Keyword: Stomach neoplasm

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Long-Term Oncological Outcomes of Reduced Three-Port Laparoscopic Gastrectomy for Early-Stage Gastric Carcinoma: a Retrospective Large-Scale Multi-Institutional Study

  • Lee, Han Hong;Jeong, Oh;Seo, Ho Seok;Choi, Min Gew;Ryu, Seong Yeob;Sohn, Tae Sung;Bae, Jae Moon;Kim, Sung;Lee, Jun Ho
    • Journal of Gastric Cancer
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    • v.21 no.1
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    • pp.93-102
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    • 2021
  • Purpose: With advances in surgical techniques, reduced-port laparoscopic surgery is increasingly being performed for the treatment of gastric carcinoma. Many studies have reported satisfactory short-term outcomes after reduced 3-port laparoscopic gastrectomy (LG). The aim of this study was to investigate the long-term oncological outcomes of 3-port LG in patients with gastric carcinoma. Materials and Methods: We reviewed the medical records of 1,117 patients who underwent LG for gastric carcinoma in three major institutions between 2012 and 2015. The data showed that 460 patients underwent 3-port LG without assistance, and 657 underwent conventional 5-port LG. We compared the overall and disease-free survival rates between the 2 groups. Results: There were 642 male and 475 female patients with a mean age of 56.1 years. Among them, 1,028 (92.0%) underwent distal gastrectomy and 89 (8.0%) underwent total gastrectomy. In the final pathologic examination, 1,027 patients (91.9%) were stage I, 73 (6.5%) were stage II, and 17 (1.5%) were stage III, and there were no significant difference in the pathologic stage between groups. The 3- and 5-port LG groups showed no significant differences in the 5-year overall survival (94.3% vs. 96.7%, P=0.138) or disease-free survival (94.3% vs. 95.9%, P=0.231). Stratified analyses according to pT and pN stages also showed no significant differences in overall or disease-free survival between the two groups. Conclusions: Long-term survival after 3- and 5-port LG was comparable in patients with early-stage gastric carcinoma. The 3-port technique requiring limited surgical assistance may be an appropriate surgical option for this patient population.

Imaging and Clinical Findings of Xanthogranulomatous Inflammatory Disease of Various Abdominal and Pelvic Organs: A Pictorial Essay (복부와 골반의 다양한 장기에서 발생한 황색육아종성 염증 질환의 영상 및 임상 소견: 임상화보)

  • Se Jin Lee;Dal Mo Yang;Hyun Cheol Kim;Sang Won Kim;Kyu Yeoun Won;So Hyun Park;Woo Kyoung Jeong
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.109-123
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    • 2024
  • Xanthogranulomatous (XG) inflammatory disease is a rare benign disease involving various organs, including the gallbladder, bile duct, pancreas, spleen, stomach, small bowel, colon, appendix, kidney, adrenal gland, urachus, urinary bladder, retroperitoneum, and female genital organs. The imaging features of XG inflammatory disease are nonspecific, usually presenting as a heterogeneous solid or cystic mass. The disease may also extend to adjacent structures. Due to its aggressive nature, it is occasionally misdiagnosed as a malignant neoplasm. Herein, we review the radiological features and clinical manifestations of XG inflammatory diseases in various organs of the abdomen and pelvis.

Detection of Spinal Metastases: Comparison of Bone Scan and MR Imaging (전이성 척추 악성 종양의 진단 : 골스캔과 자기공명영상의 비교)

  • Kim, Ki-Jun;Sohn, Hyung-Sun;Park, Jeong-Mi;Chung, Soo-Kyo;Lee, Jae-Moon;Kim, Choon-Yul;Bahk, Yong-Whee;Shinn, Kyung-Sub
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.384-390
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    • 1994
  • Authors retrospectively compared the 99mTc MDP bone scans and corresponding MR imagings in 20 patients with histologically proven malignancy, Mean interval of the two studies was 16.6 days, Cancer diagnosis Included 8 lung, 2 each of colon, breast, stomach, 1 each of prostate, thyroid, malignant lymphoma and 3 adenocarcinoma of unknown primary site. Of the 105 regions compared, :t6 regions were positive for metastases in bone scans or MR imagings. 30 regions(65.2%) were positive by bone scan and 44 regions(95.7%) by MR imaging. 87 regions(82.9%) were concordantly positive or negative by bone scan and MR imaging, but 18 regions(17.1%) were discordant. In the discordant regions, 16 regions positive in MR imaging were negative in bone scan. The greatest number of discordant findings occured in the cervical region and in the patient with stomach cancer. Our results suggest that the sensitivity of MR Imaging is greater than that of bone scan in detecting spinal metastases. And bone scan is useful screening test of metastasis for evaluating entire skeleton including spine.

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A comparative Study of Changing Pattern of Cause of Death Analysis of Korean, Korean in Japan and Japanese (재일한국인의 생활문화의 이질화와 적응과정에 관한 보건학적 연구(제 1보 한국, 재일한국인, 일본의 사인구조분석)

  • 김정근;장창곡;임달오;김무채;이주열
    • Korea journal of population studies
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    • v.15 no.2
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    • pp.15-59
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    • 1992
  • After world war II Japanese life expectancy has been improved remarkably, and reached the highest level in the world around late 1970's. The life expectancy of Korean has also shown tremendous improvement in recent years with about 20 year's gap from the Japanese. The reason of rapid improvement of life expectancy can be explained by changes in the structure of cause of death due to health system, living standard, social welfare, health behavior of individuals and so on. Korean in Japan is placed under different situations from both Korean in Korea and Japanese in these regards, and expected to show different picture of cause of death pattern. The objective of this study is the comparision of changing patterns of cause of death of three population groups, Korean in Japan, Korean in Korea and Japanese, and to investigate the reasons which effect to the structural difference of mortality cause with special emphasis on health ecological aspects. One of the major limitations of the Korean causes of death statistics is the under-registration which ranges about 10% of the total events, and inaccuracy of the exact cause of death. Some 20% of registered deaths were unable to classify by ICD. However, it is concluded that the Korean data are evaluated as sufficient to stand for over-viewing of trends of cause of death pattern. The evaluation is done by comparing data from registration and field survey over the same population sample. Population data of Korean in Japan differ between two sources of data; census and foreigner's registration. Correction is done by life table method under the assumption that age-specific mortality pattern would accord with that of the Japanese. The crude death rate was lowest among Korean in Japan, 5.7 deaths per 1,000 population in 1965. The crude death rates of Korean in Japan and Japanese are increasing recently influenced by age structure while Korean in Korea still shows decreasing tendency. The adjusted death rate is lowest among Japanese, followed by Korean in Japan, and Korean in Korea. The leading causes of death of Korean in Korea until 1960's was infectious diseases including pneumonia and tuberculosis. The causes of death structure changed gradually to accidents, neoplasm, hypertensive disease, cerebro-vascular disease in order. The main difference in cause of death between Korean and Japanese if high rate of liver diseases and diabetes for both Korean in Japan and Korea. A special feature of cause of death among Korean in Korea is remakably high rate of hypertensive disease, which is assumed to be caused by physicians tendency in choosing diagnostic categories. The low ischemic heart disease and high vasculo-cerebral disease are the distinctive characteristic of the three population groups compared to western countries. Specific causes of death were selected for detailed sex, age and ethnic group comparisons based on their high death rates. Cancer is the cause of death which showed most dramatical increase in all three population groups. In Korea 20.1% of all death were caused by cancer in 1990 compared with 10.5% in 1981. Cancer of the liver is the leading cause of cancer death among Korean in Japan for both sexes, followed by cancer of the lung and cancer of the stomach, while that of Korean in Korea is cancer of the stomach, followed by cancer of the liver and cancer of the lung for male. Causes of infant mortality were examined among the three population groups since 1980 on yearly bases. For both Japanese and Korean in Japan, leading cause of death ranks as conditions originating in the perinatal period, congenital anomalies, accidents and other violent causes. Trends since 1980 for these two population groups in the leading cause of infant mortality showed no changes. On the contrary, significant changes in leading cause of death structure in Korea were observed : the ranking of leading cause of death in 1981 were congenital asnomalies, pneumonia bronchitis, infectious disease, heart disease, conditions originating in the perinatal period, accident and other violent causes ; in 1990 the ranking shifted to congenital anomalies, accident, pneumonia bronchities, conditions originating in the perinatal period, infectious disease. The mortality rate by congenital anomalies in Korea continuously grew than any other causes. Larger increase ocurred during the 1990's

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A Randomized Phase III Study of Patients With Advanced Gastric Adenocarcinoma Without Progression After Six Cycles of XELOX (Capecitabine Plus Oxaliplatin) Followed by Capecitabine Maintenance or Clinical Observation

  • Guk Jin Lee;Hyunho Kim;Sung Shim Cho;Hyung Soon Park;Ho Jung An;In Sook Woo;Jae Ho Byun;Ji Hyung Hong;Yoon Ho Ko;Der Sheng Sun;Hye Sung Won;Jong Youl Jin;Ji Chan Park ;In-Ho Kim;Sang Young Roh;Byoung Yong Shim
    • Journal of Gastric Cancer
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    • v.23 no.2
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    • pp.315-327
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    • 2023
  • Purpose: Oxaliplatin, a component of the capecitabine plus oxaliplatin (XELOX) regimen, has a more favorable toxicity profile than cisplatin in patients with advanced gastric cancer (GC). However, oxaliplatin can induce sensory neuropathy and cumulative, dose-related toxicities. Thus, the capecitabine maintenance regimen may achieve the maximum treatment effect while reducing the cumulative neurotoxicity of oxaliplatin. This study aimed to compare the survival of patients with advanced GC between capecitabine maintenance and observation after 1st line XELOX chemotherapy. Materials and Methods: Sixty-three patients treated with six cycles of XELOX for advanced GC in six hospitals of the Catholic University of Korea were randomized 1:1 to receive capecitabine maintenance or observation. The primary endpoint was progression-free survival (PFS), analyzed using a two-sided log-rank test stratified at a 5% significance level. Results: Between 2015 and 2020, 32 and 31 patients were randomized into the maintenance and observation groups, respectively. After randomization, the median number of capecitabine maintenance cycles was 6. The PFS was significantly higher in the maintenance group than the observation group (6.3 vs. 4.1 months, P=0.010). Overall survival was not significantly different between the 2 groups (18.2 vs. 16.5 months, P=0.624). Toxicities, such as hand-foot syndrome, were reported in some maintenance group patients. Maintenance treatment was a significant factor associated with PFS in multivariate analysis (hazard ratio, 0.472; 95% confidence interval, 0.250-0.890; P=0.020). Conclusions: After 6 cycles of XELOX chemotherapy, capecitabine maintenance significantly prolonged PFS compared with observation, and toxicity was manageable. Maintenance treatment was a significant prognostic factor associated with PFS.

Clinical Outcomes of Corrective Surgical Treatment for Esophageal Cancer (식도암의 외과적 근치 절제술에 대한 임상적 고찰)

  • Ryu Se Min;Jo Won Min;Mok Young Jae;Kim Hyun Koo;Cho Yang Hyun;Sohn Young-sang;Kim Hark Jei;Choi Young Ho
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.157-163
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    • 2005
  • Background: Clinical outcomes of esophageal cancer have not been satisfactory in spite of the development of surgical skills and protocols of adjuvant therapy. We analyzed the results of corrective surgical patients for esophageal cancer from January 1992 to July 2002. Material and Method: Among 129 patients with esophageal cancer, this study was performed in 68 patients who received corrective surgery. The ratio of sex was 59 : 9 (male : female) and mean age was $61.07\pm7.36$ years old. Chief complaints of this patients were dysphagia, epigastric pain and weight loss, etc. The locations of esophageal cancer were 4 in upper esophagus, 36 in middle, 20 in lower, 8 in esophagogastric junction. 60 patients had squamous cell cancer and 7 had adenocarcinoma, and 1 had malignant melanoma. Five patients had neoadjuvant chemotherapy. Result: The postoperative stage I, IIA, IIB, III, IV patients were 7, 25, 12, 17 and 7, respectively. The conduit for replacement of esophagus were stomach (62 patients) and colon (6 patients). The neck anastomosis was performed in 28 patients and intrathoracic anastomosis in 40 patients. The technique of anastomosis were hand sewing method (44 patients) and stapling method (24 patients). One of the early complications was anastomosis leakage (3 patients) which had only radiologic leakage that recovered spontaneously. The anastomosis technique had no correlation with postoperative leakage, which stapling method (2 patients) and hand sewing method (1 patient). There were 3 respiratory failures, 6 pneumonia, 1 fulminant hepatitis, 1 bleeding and 1 sepsis. The 2 early postoperative deaths were fulminant hepatitis and sepsis. Among 68 patients, 23 patients had postoperative adjuvant therapy and 55 paitents were followed up. The follow up period was $23.73\pm22.18$ months ($1\~76$ month). There were 5 patients in stage I, 21 in stage 2A, 9 in stage IIB, 15 in stage III and 5 in stage IV. The 1, 3, 5 year survival rates of the patients who could be followed up completely was $58.43\pm6.5\%,\;35.48\pm7.5\%\;and\;18.81\pm7.7\%$, respectively. Statistical analysis showed that long-term survival difference was associated with a stage, T stage, and N stage (p<0.05) but not associated with histology, sex, anastomosis location, tumor location, and pre and postoperative adjuvant therapy. Conclusion: The early diagnosis, aggressive operative resection, and adequate postoperative treatment may have contributed to the observed increase in survival for esophageal cancer patients.