• Journal of Gynecologic Oncology
• /
• 제29권6호
• /
• pp.94.1-94.10
• /
• 2018

Endometrial cancer (EC) represents the most common gynecological neoplasm in developed countries. Surgery is the mainstay of treatment for EC. Although EC is characterized by a high prevalence several features regarding its management are still unclear. In particular the execution of lymphadenectomy is controversial. The recent introduction of sentinel node mapping represents the mid-way between the execution and omission of node dissection in EC patients. In the present review we discuss the emerging role of sentinel node mapping in EC. In addition, we discussed how type of tracers utilized and site of injection impacted on sentinel node detection rates. Future perspective regarding EC management are also discussed.

• Radiation Oncology Journal
• /
• 제36권4호
• /
• pp.341-347
• /
• 2018

Surgical excision along with use of postoperative radiotherapy forms an integral management of sinonasal teratocarcinosarcoma (SNTCS). However, given the rarity of the tumor, no standardised guidelines, dose, technique and target delineation exist especially in the era of modern radiation delivery techniques. This is a case of 55-year-old male diagnosed as SNTCS treated with radical ethmoidectomy followed by volumetric modulated radiotherapy, showing good local control and acceptable toxicity profile.

• 대한두경부종양학회지
• /
• 제18권2호
• /
• pp.192-196
• /
• 2002

Objectives: Tuberculous cervical lymphadenitis is a frequently recurring disease when treated with chemotherapy alone without enough surgical removal of the tuberculous lesions. Authors reviewed retrospectively the treatment result of antituberculous chemotherapy following almost complete surgical removal of tuberculous foci in the neck. Materials and Methods: A retrospective clinical review and analysis was made in 127 cases of tuberculous cervical lymphadenitis patients treated during the past 10 years from 1989 to 1998 at the Department of General Surgery, Inje University Paik Hospital, Pusan. Results: 1) The peak age incidence was the 2nd decade(37.8%), and female was predominated over male by 2.3:1. 2) The time interval from the onset of symptoms to the first visit was less than 3 months in 60.6% of the patient. 3) The location of lymphadenitis was the right neck in 60%, the left neck 34%, and bilateral in 6% of the patient. 4) Signs on the first visit showed solitary masses(60%), abscess(25%) and both mixed(15%). 5) 25 patients(19%) had present or past history of tuberculosis; pulmonary tuberculosis 12 patients, tuberculous lymphadenitis 10 patients, and others 3 patients. 6) Locations of tuberculous lymphadenitis were posterior cervical triangle 70, supraclavicular 51, submandibular 19, anterior triangle 16 and others 4 cases. 7) The principle of treatment of cervical lymphadenitis was surgical management followed by chemotherapy. Surgical procedures were excision(s), curettage and drainage of abscess, combination of both, and biopsy in 60%, 22%, 12% and 6% respectively. Mean duration of antituberculous medication was 9 months after surgery. 8) The rate of recurrent and persistent tuberculous lymphadenitis was 9% in 4 years follow up. Conclusion: Tuberculous cervical lymphadenitis is a frequently recurring disease in young adult when only antituberculous chemotherapy was employed without almost complete removal of the lesions. It is considered that antituberculous medications for 6-9 months after removing the foci at a maximal extent by surgical excision and curettage will reduce the recurrence rate or persistence of tuberculous lymphadenitis.

• 대한두경부종양학회지
• /
• 제22권2호
• /
• pp.175-178
• /
• 2006

Pulsed dye laser(PDL) is originally designed for the treatment of vascular lesions but also effective in improving the quality and appearance of surgical scars. Recently, 595nm Pulsed dye laser(V-beam laser), which has the advantage of deeper tissue penetration and lesser amount of purpura, is spotlighted as a new option for the treatment of surgical scar. The authors treated a surgical scar of a female patient with V-beam laser for 3 times between 4 and 12 weeks after surgery. Subjective satisfaction was improved with visual analogue scale (VAS) and objective improvements were found in parameters of vascularity, pliability and height with Vancouver Scar Scale(VSS). We report the effectiveness of V-beam laser in surgical scar of Asian patient and plan the prospective study with larger scale.

• Radiation Oncology Journal
• /
• 제34권4호
• /
• pp.297-304
• /
• 2016

Purpose: To investigate the outcomes of postoperative radiotherapy (RT), in patients with extrahepatic bile duct (EHBD) cancer by comparing the survival rate between patients undergoing surgery alone or surgery plus postoperative RT, and to identify the prognostic factors affecting survival. Materials and Methods: Between 2000 and 2013, 52 patients with EHBD cancer underwent surgical resection. Of these, 33 patients did not receive postoperative RT (group I), and 19 patients did (group II). R1 resection was significantly more frequent in group II. The median radiation dose was 5,040 cGy. Results: The 3-year overall survival (OS) rate for group I and group II was 38% and 56%, respectively (p = 0.274). The 3-year disease free survival (DFS) rate for group I and group II was 20% and 31%, respectively (p = 0.049), and the 3-year loco-regional recurrence free survival (LRFS) rates were 19% and 58%, respectively (p = 0.002). Multivariate analyses showed that postoperative RT and lymphovascular invasion were independent prognostic factors for DFS and LRFS. Overall, 42 patients (80%) experienced treatment failure. Distant metastasis was the predominant pattern of failure in group II. Conclusion: Postoperative RT after surgical resection appeared to improve the loco-regional control and DFS rate. More effort is needed to reduce distant metastasis, the major pattern of failure, in patients who receive postoperative RT.

• Journal of Yeungnam Medical Science
• /
• 제33권2호
• /
• pp.166-169
• /
• 2016

Afferent loop obstruction following gastrectomy is a rare but fatal complication. Clinical features of afferent loop obstruction are mainly gastrointestinal symptoms. A 56-year-old female underwent radical total gastrectomy with Roux-en-Y esophagojejunostomy for treatment of advanced gastric cancer. After fourteen months postoperatively, she showed gradual development of edema of both legs. Computed tomography (CT) scan showed disease progression at the jejunojejunostomy site and consequent dilated afferent loop, which resulted in inferior vena cava (IVC) compression. A drainage catheter was placed percutaneously into the afferent loop through the intrahepatic duct and an IVC filter was placed at the suprarenal IVC, and self-expanding metal stents were inserted into bilateral common iliac veins. With these procedures, sympotms related with afferent loop obstruction and deep vein thrombosis were improved dramatically. The follow-up abdominal CT scan was taken 3 weeks later and revealed the completely decompressed afferent loop and improved IVC patency. Surgical treatment should be considered as the first choice for afferent loop obstruction; however, because it is more immediate and less invasive, non-surgical modalities, such as percutaneous catheter drainage or stent placement, can be effective alternatives for inoperable cases or risky patients who have severe medical comorbidities.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권17호
• /
• pp.7683-7688
• /
• 2015

Background: The study evaluated the patient, lifestyle and tumor profile in patients undergoing upfront surgery for sporadic colorectal cancer (CRC) in Indian population. Materials and Methods: One hundred consecutive patients were included. Details related to their demographic profile, habits, signs and symptoms, tumor profile, further treatment and follow up were recorded. Results: The majority of the patients had colonic cancer (68%), advanced tumor stage 3 & 4 (46%), moderately differentiated tumors (70%) with absence of lymphatic invasion (60%) and metastasis (90%). Correlations between tumor location and abdominal pain (p-value 0.002), bleeding per rectum (p-value <0.001), difficulty in micturition (p-value 0.012) and constipation (p-value 0.007) were found to be statistically significant. Abdominal pain was more frequently reported in patients with metastasis (p-value 0.031). Loss of weight statistically correlated with absence of lymphatic invasion (p-value 0.047). Associations between tumor stage and alcohol intake (p-value 0.050) and non vegetarian diet (p-value 0.006); lymphatic invasion and intake of spicy food (p-value 0.040) and non vegetarian diet (p-value 0.001) and metastasis and alcohol intake (p-value 0.041) were also observed. Age and tumor grade were also correlated (p-value 0.020). Conclusions: Minimizing the adverse lifestyle factors can help in reducing the overall incidence of CRC in the Indian population.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권4호
• /
• pp.1487-1489
• /
• 2012

Objective: To compare the clinical efficacy of concurrent chemoradiotherapy, neoadjuvant chemotherapy, and intracavity brachytherapy in comprehensive treatment for young patients with stage Ib2 cervical cancer. Methods: One hundred and twelve young patients with stage Ib2 cervical cancer were enrolled retrospectively in our hospital from January 2003 to June 2005. They were categorized into three groups according to preoperative regimens, including the concurrent chemoradiotherapy group (Group 1, n=38), the neoadjuvant chemotherapy (Group 2, n=49), and the intracavity brachytherapy group (Group 3, n=25). Radical hysterectomy was performed following these regimens. Chemotherapy and radiotherapy were given according to pelvic lymph node metastasis, deep cervical stromal invasion, intravascular cancer emboli, histological grading, vaginal stump and positive surgical margin. Results: The cancer disappearance and superficial muscle invasion rates were statistically significantly better in the concurrent chemoradiotherapy group than in the other two groups (P<0.01). No statistically significant difference was noted in the deep muscle invasion rate, surgical time and intraoperative blood loss among three groups, but significantly more postoperative complications occurred in the concurrent chemoradiotherapy group. The 2-year pelvic recurrence was statistically significantly lower in the concurrent chemoradiotherapy group compared to other two groups, while the 5-year survival was higher. Conclusion: Concurrent chemoradiotherapy is efficacious for young patients with stage Ib2 cervical cancer.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권9호
• /
• pp.5403-5408
• /
• 2013

Objective: CXCL12 exerts a wide variety of chemotactic effects on cells. Evidence indicates that CXCL12, in conjunction with its receptor, CXCR4, promotes invasion and metastasis of tumor cells. Our objective was to explore whether the CXCL12-CXCR4 biological axis might influence biological behavior of pancreatic cancer cells. Methods: Miapaca-2 human pancreatic cancer cells were cultured under three different conditions: normal medium (control), medium + recombinant CXCL12 (CXCL12 group), or medium + CXCR4-inhibitor AMD3100 (AMD3100 group). RT-PCR was applied to detect mRNA expression levels of CXCL12, CXCR4, matrix metalloproteinase 2 (MMP-2), MMP-9, and human urokinase plasminogen activator (uPA). Additionally, cell proliferation and invasion were performed using CCK-8 colorimetry and transwell invasion assays, respectively. Results: CXCL12 was not expressed in Miapaca-2 cells, but CXCR4 was detected, indicating that these cells are capable of receiving signals from CXCL12. Expression of extracellular matrix-degrading enzymes MMP-2, MMP-9, and uPA was upregulated in cells exposed to exogenous CXCL12 (P<0.05). Additionally, both proliferation and invasion of pancreatic cancer cells were enhanced in the presence of exogenous CXCL12, but AMD3100 intervention effectively inhibited these processes (P<0.05). Conclusions: The CXCL12-CXCR4 biological axis plays an important role in promoting proliferation and invasion of pancreatic cancer cells.

• Radiation Oncology Journal
• /
• 제31권3호
• /
• pp.131-137
• /
• 2013

Purpose: We evaluated treatment outcomes of thymic carcinomas to determine prognostic factors for survival. Materials and Methods: Between May 1988 and May 2009, 41 patients had pathologic diagnosis of thymic carcinoma in Seoul National University Hospital, Seoul, Korea. Of these, 40 patients were followed up to 188 months after treatment. The mean age of all patients was 58.3 years and male to female ratio was 23 to 17. Results: Among 30 patients who underwent surgical resection, 26 achieved R0 resection and postoperative radiotherapy (PORT) was performed in 22 patients (73%). Various chemotherapeutic regimens were given with local treatment modalities, surgery and/or radiotherapy, in 12 patients. The 5-year locoregional control (LRC), distant metastasis-free survival, progression-free survival (PFS), and overall survival were 79.4%, 53.0%, 42.6%, and 63.6%, respectively. Patients with Masaoka stage I or II showed excellent prognosis of 5-year PFS around 90%. In advanced stages, invasion of the great vessels or atrium by thymic carcinomas was negative prognostic factor for PFS in univariate analysis. Lymph node involvement was statistically significant factor for LRC and PFS. Local or regional recurrence was infrequent after surgical resection followed by PORT, while distant metastasis was the major component of treatment failure. Conclusion: Complete resection followed by PORT provided remarkable local control without severe acute toxicities in patients with stage II and favorable stage III thymic carcinoma. Invasion of the great vessels or atrium was statistically significant prognostic factor for PFS.