• Journal of Chest Surgery
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• 제20권1호
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• pp.81-91
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• 1987

During the period of 10 years from July, 1976 to July, 1986, 154 cases of primary carcinoma of the lung - by the cell type, stage, operability, and survival rate in the resectable cases - are analyzed at the Dept. of Thoracic Surgery, Paik Hospital in Seoul. The results are as follows: 1] Histopathological types are squamous cell carcinoma 49% [76 cases], adenocarcinoma 25% [39 cases], undifferentiated large cell carcinoma 9% [14 cases], undifferentiated small cell carcinoma 6% [9 cases], bronchioloalveolar carcinoma 4% [6 cases] and adenosquamous carcinoma 3% [4 cases]. 2] Peak incidence is observed in the 4th decade of life [33%], then 5th [29%] and 3rd [21%] respectively. Male to female ratio is 4 to 1. 3] Evidence of inoperability is observed in 64% [99 cases] by clinical staging workup. Thirty six percent [55 cases] were operated. Of these, post-surgical stage I was 5% [3 cases], stage II, 64% [35 cases] and stage III, 31% [17 cases]. Among total 17 cases of stage III, 14 cases were unresectable with evidence of T2N2M0, while 3 cases were resectable. Resectability is 27%, [41 cases] from the total number of 154 cases. And the resectability for the ex 55 cases is 75% [41 cases]. 4] By cell type, highest resectabitity is the squamous cell carcinoma, 49% [20 cases]. Adenocarcinoma is 32% [13 cases] and bronchioloalveolar, 12% [5 cases]. 5] Survival rate is evaluated for 38 cases of 41 resectable stage I, II and III. Overall 5 year survival rate is 24%, 3 year 32% and 10 year 8%. Survival rate in stage II for 5 year is 25%. In squamous cell type for, 5 year is 42%. Authors believe when surgeons continuous effort of early detection is met with patients early visit, 5 year survival rate for the stage I K II resectable patients will improve more effectively. As well, When the efforts are added to combined modality with radiotherapy and chemotherapy for the stage III selected cases of non-small cell carcinoma patients, the enhancement in survival rate is expected.

• Journal of Chest Surgery
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• 제47권1호
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• pp.13-19
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• 2014

Background: The aim of this study is to evaluate prognostic factors for survival in pathologic stage IIIA/N2 non-small-cell lung cancer (NSCLC), to identify the prognostic significance of the metastatic patterns of mediastinal lymph nodes (MLNs) relating to survival and to recurrence and metastasis. Methods: A total of 129 patients who underwent radical resection for pathologic stage IIIA-N2 NSCLC from July 1998 to April 2011 were retrospectively reviewed. The end points of this study were rates of loco-regional recurrence and distant metastasis, and survival. Results: The overall 5-year survival rate was 47.4%. A univariate analysis showed that age, pathologic T stage, and adjuvant chemotherapy were significant prognostic factors, while in multivariate analysis, pathologic T stage and adjuvant chemotherapy were significant prognostic factors. The metastasis rate was higher in patients with multi-station N2 involvement and with more than 3 positive MLNs. Further, non-regional MLN metastasis was associated with a higher loco-regional recurrence rate. Conclusion: Pathologic T stage and adjuvant chemotherapy were independent prognostic factors for long-term survival in pathologic stage IIIA/N2 NSCLC. The recurrence and the metastasis rate were affected by the metastatic patterns of MLNs. These results may be helpful for planning postoperative therapeutic strategies and predicting outcomes.

• 대한두경부종양학회지
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• 제11권2호
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• pp.145-152
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• 1995

A retrospective analysis was performed to ascertain the relationship between the treatment modalities and their treatment results. From July 1980 to June 1993, 115 patients with squamous cell carcinoma of the maxillary sinus were: treated at the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University. There were 88 men and 27 women with median age of 57 years. According to AJCC TNM system of 1992. eight patients of T2, 54 patients of T3 and 53 patients of T4 were available, respectively. Cervical lymph node metastases at diagnosis was observed in 11 patients. 87 patients were treated with radiotherapy and 28 patients were treated with combination of surgery and radiotherapy. The overall 5 year survival rate was 32 %, patients that were treated with radiotherapy alone had a 5 year survival rate 24.3 % and patients who were treated with combination of surgery and radiation therapy had a 5 year survival rate of 52.8 % (p<0.05). Combination of surgery and radiotherapy resulted in a better treatment modality for squamous cell carcinoma of the maxillary sinus. Improved radiotherapy technique and development of multimodality treatment are needed to improve the local control and the survival rate in patients with advanced maxillary sinus carcinoma.

• 동의생리병리학회지
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• 제23권3호
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• pp.710-714
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• 2009

Several studies showed that the survival rate of stage IIIB disease with malignant pleural effusion is worse than stage IIIB disease without malignant effusion. But, malignant pleural effusion was considered T4. To analyze changes the survival time for malignant pleural effusion, in the seventh revision of TNM classification for lung cancer. The records of all patients had to have either a histological or cytological diagnosis of non-small cell lung cancer (NSCLC), who were admitted to Wonkwang university hospital between January 2004 and December 2006 were reviewed retrospectively. We evaluated the survival time of 187 patients with advanced lung cancer with and without malignant pleural effusion. This included the pleural effusion or nodule M1 a (pleural dissemination, currently classified as T4), nodule(s) in the other lung M1 a (contralateral lung nodule, currently classified as M1), nodule(s) with the same lobe as the primary tumor T3 (currently classified as T4), other T4 factors T4 (T4 MO anyN), and extrathoracic sites of disease M1b (distant metastasis, currently classified M1). Among the 187 patients, T4anyNMO was 57 patients in the current TNM classification. In the next edition of the TNM classification, T4MOanyN-T4 (excluding same lobe nodules) was 12 patients, pleural dissemiantion-M1a was 45 patients, contralateral lung nodule(s)-M1a was 7 patients, and metastatic disease-M1b was 55 patients. We compared the survival time for these groups. Survival time was 11 months, 8 months, 11 months, and 4 months. The survival time of malignant pleural effusion was shorter than other T4 factors without pleural effusion. But, there was no remarkable difference in statistics due to small cases (p=0.23). We strongly suggest that malignant pleural effusion in advanced NSCLC will be categorized with metastatic disease.

• Radiation Oncology Journal
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• 제7권1호
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• pp.37-43
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• 1989

1979년 3월부터 1984년 2월까지 성문상부의 편평상피암으로 진단되어 근치적 방사선치료를 시행한 66명을 대상으로 치료성적을 분석하였다. 전체 환자군의 최소 추적기간은 4년이었다. 진단당시 전체 환자군의 $78\%$가 T3 T4 병변이었고 임파절 전이율은 $58\%$이었으며, 전체 환자군의 5년 생존율은 $31.3\%$, 병기에 따른 생존율은 병기 II, III, IV에서 각각 $60.7\%,\;46.7\%\;및\;13.5\%$이었다. 3명의 환자$(5\%)$에서 원격전이가 관찰되었으며 수술을 요하는 주부작용률은 $11\%$이었다. 방사선치료 후 잔유병변 또는 재발에 대한 구제수술 성공률은 $57\%$이었다. 병기 I, II및 병기 III 초기의 성문상부암은 방사선 단독 치료만으로도 높은 근치율과 생존자의 성대기능 보존이 가능 하나, 병기 III과 IV의 성문상부암 환자 중 경부에 전이된 임파절의 절제가 가능한 환자는 수술과 방사선치료의 병용이 권장된다.

• Journal of Ginseng Research
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• 제41권2호
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• pp.222-226
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• 2017

Background: Long-term ginseng intake can increase longevity in healthy individuals. Here, we examined if long-term treatment with Panax ginseng Meyer (Korean Red Ginseng, KRG) can also enhance survival duration (SD) in patients with human immunodeficiency virus type 1 (HIV-1) infection. Methods: We retrospectively analyzed 252 HIV-1 patients diagnosed from 1986 to 2013 prior to the initiation of antiretroviral therapy. Overall, 162 patients were treated with KRG ($3,947{\pm}4,943g$) for $86{\pm}63$ mo. The effects of KRG on SD were analyzed according to the KRG intake level and the length of the follow-up period. Results: There were significant correlations between the total amount of KRG and SD in the KRG intake group (r = 0.64, p < 0.0001) as well as between total amount of KRG and mean annual decrease in $CD4^+$ T-cell count in all 252 patients (r = -0.17, p < 0.01). The annual decrease in $CD4^+$ T-cell count (change in $cells/{\mu}L$) was significantly slower in KRG-treated patients than in patients receiving no KRG ($48{\pm}40$ vs. $106{\pm}162$; p < 0.001). The SD (in months) was also significantly longer in the KRG group than in the no-KRG group ($101{\pm}64$ vs. $59{\pm}40$, p < 0.01). Conclusion: KRG prolongs survival in HIV-1 patients, possibly by slowing the decrease in $CD4^+$ T-cell count.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권5호
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• pp.315-322
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• 2003

Background : Important factors to determine treatment method and prognosis of oral cancer are anatomical site, tumor size, metastatic lesion, histologic cell differenciation and microvascular invasion. Anatomical site has great effect to oral cancer patient's survival rate because each site's accessibility and lymph node metastasis is different but this factor was't studied much than other factors. Patients and Methods : 228 patients with squamous cell carcinoma of common primary sites(Mandible, Maxilla, Floor of Mouth and Tongue) in oral cavity who were diagnosed in the Korea Cancer Center Hospital from January 1989 to December 1999, were clinically studied and analyzed on survival rate. Results : 1. Survival rates of each anatomical sites were Tongue(36.8%), Mandible(33.3%), Maxilla(28.7%) and Floor of Mouth(24.5%). Survival rates difference between Tongue and Floor of Mouth has significance(p<0.05). 2. Survival rates for early cancer of each site were Maxilla(100%), Mandible(57.1%), Tongue(54.2%) and Floor of Mouth(46.7%). Survival rates difference between Maxilla and Floor of Mouth has significance(p<0.05). 3. Survival rates by surgery method of each site were Maxilla(60.6%), Tongue(56.9%), Mandible(44.8%) and Floor of Mouth(26.3%). Survival rates difference between Maxilla and Floor of Mouth has significance(p<0.05). 4. Survival rates by radiation or chemo method of each site were Floor of Mouth(23.5%), Mandible(20.0%), Maxilla(9.5%), and Tongue(9.1%). Survival rates difference between each site doesn't have significance(p>0.05). 5. In advance stage, Survival rates by single therapy of each site were Tongue(33.6%), Mandible(23.5%), Floor of Mouth(16.7%), Maxilla(0%), and Survival rates difference between Maxilla and Tongue has significance (p<0.05). Survival rates by combination therapy of each site were Mandible(38.1%), Maxilla(30.0%), Floor of mouth(18.2%), Tongue(12.5%), and Survival rates difference between Mandible and Tongue has significance(p<0.05). Conclusion : Survival rate of tongue is higher than the other sites, early detection of oral cancer can increase survival rate at any site and combination therapy is the most effetive method, especially at maxilla.

• Journal of Chest Surgery
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• 제27권11호
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• pp.922-929
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• 1994

This research represents an attempt to study the postoperative results among 32 patients who underwent complete resections of primary lung and involved mediastinal lymph nodes between January 1988 and June 1993. Ages ranged from 34 to 73 years with a mean age of 51.31 $\pm$ 8.17 years. There were 29 male patients[90.6%]. Left lung cancers were more frequent than right lung cancers. There were 19 cases of left lung cancers accounting for 59.4% of the total lung cancers. The difference, however, was insignificant. There was no T1 lesion. T2 and T3 lesions were 21[65.6%] and 11 cases[34.4%], respectively. As for cell type, squamous cell carcinomas were reported in 25 cases making up 78.1% of the cell types. Pneumonectomy was conducted on 20[62.5%] cases. Lobectomy and sleeve lobectomy were conducted on 12[37.5%] cases respectively. Mediastinal lymph node involvemednts were most frequent in subcarinal lymph node[9/13] among right lung cancers, while subaortic lymph noce[12/19] was most frequent among left lung cancers. Postoperative complications were reported in 18.9% of the total cases, including 2 cases each of paralysis of the recurrent laryngeal nerve and 1 case each of chylothorax and pyothorax. They were more frequent among patients who underwent pneumonectomy. The operative mortality stood at 3.1% with 1 patient who underwent pneumonectomy dying of pulmonary edema. The 1-year and 5-year survival rates were 50.8% and 30.1%, respectively. Patients treated with squamous cell carcinoma, involvement of single level mediastinal lymph node and lobectomy showed a higher level of survival. These fidings suggest that a long-term survival can be expected of a considerable number of N2 non-small cell lung cancer patients with a selective complete surgical resection of primary lung cancers involved mediastinal lymph nodes.

• Radiation Oncology Journal
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• 제33권2호
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• pp.75-82
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• 2015

Purpose: We evaluated the prognostic significance of T3 subtypes and the role of adjuvant radiotherapy in patients with resected the American Joint Committee on Cancer stage IIB T3N0M0 non-small cell lung cancer (NSCLC). Materials and Methods: T3N0 NSCLC patients who underwent resection from January 1990 to October 2009 (n = 102) were enrolled and categorized into 6 subgroups according to the extent of invasion: parietal pleura chest wall invasion, mediastinal pleural invasion, diaphragm invasion, separated tumor nodules in the same lobe, endobronchial tumor <2 cm distal to the carina, and tumor-associated collapse. Results: The median overall survival (OS) and disease-free survival (DFS) were 55.3 months and 51.2 months, respectively. In postoperative T3N0M0 patients, the tumor size was a significant prognostic factor for survival (OS, p = 0.035 and DFS, p = 0.035, respectively). Patients with endobronchial tumors within 2 cm of the carina also showed better OS and DFS than those in the other T3 subtypes (p = 0.018 and p = 0.016, respectively). However, adjuvant radiotherapy did not cause any improvement in survival (OS, p = 0.518 and DFS, p = 0.463, respectively). Only patients with mediastinal pleural invasion (n = 25) demonstrated improved OS and DFS after adjuvant radiotherapy (n = 18) (p = 0.012 and p = 0.040, respectively). Conclusion: The T3N0 NSCLC subtype that showed the most favorable prognosis is the one with endobronchial tumors within 2 cm of the carina. Adjuvant radiotherapy is not effective in improving survival outcome in resected T3N0 NSCLC.

• Radiation Oncology Journal
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• 제18권4호
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• pp.257-264
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• 2000

목적 : 조기 비소세포성 폐암의 경우 수술이 최선의 치료법으로 생각 되고있다. 환자가 내과적인 질환으로 수술이 불가능한 경우, 혹은 수술을 거부한 경우 방사선치료가 수술의 대체적 치료로 사용 가능하다. 근치적방사선치료를 시행 받은 환자에서의 치료성적 및 이에 영향을 미치는 요인의 분석을 통하여 향후 치료에 도움을 얻고자 본 연구를 시행하였다. 대상 및 방법 : 서울대학교병원 치료방사선과에서 1987년 6월부터 1997년 6월 사이에 치료를 시행 받은 조직학적으로 진단된 조기 비소세포성 폐암 환자 32명을 대상으로 하였다. 수술이 불가능했던 이유로는 폐질환이 21명으로 가장 많았다. 대상환자의 중간 연령은 68세였으며, 조직학적으로는 편평상피암이 24명으로 가장 많았다. 임상 병기는 T1, T2, T3가 각각 5명, 25명, 2명이었으며, 진단시의 종양의 크기는 3$\~$5 cm가 13명으로 가장 많았다. 방사선치료는 6 MV또는 10 MV 선형가속기를 이용하여, 종양부위에 54.0$\~$68.8 Gy (중앙값; 61.2 Gy)를 조사하였고 12명의 환자에서는 동시분할조사를 시행하였다. 추적관찰기간은 2개월에서 93개월 (중앙값; 23개월)이었고, 생존기간은 치료개시일을 기준으로 산정하였다. 결과 : 전체생존률은 코년, 5년이 각각 44.6$\%$, 24.5$\%$이었으며, 무병생존률은 38.9$\%$, 28.3$\%$, 중앙생존기간은 23개월이었다. 전체환자 32명중 최종 추적관찰 시 25명이 사망하였으며, 이중 7명이 페암이외의 질환으로 사망하였다. 단변량분석 상 종양의 크기는 전체생존률과 무병생존률에 통계적으로 유의한 영향을 주는 요인으로 판정되었고 (p=0.0015, p=0.0022), T 병기는 전체생존률에 의미있는 요인으로 판정되었다(p=0.0395). 다변량분석 상 종양의 크기는 무병생존률에 통계적으로 의미있는 요인으로 판정되었으며(p=0.0317), 전체생존률에 영향을 주는 경향을 보였다 (p=0.0649). 종격동의 방사선조사 여부는 생존률에 영향을 주지 않았다. 결론 : 근치적방사선치료는 조기 비소세포성 폐암 환자로 내과적인 질환으로 수술 불가능한 경우나 환자가 수술을 거부한 경우, 특히 T1 또는 3 cm 이하의 종양에서는 수술적치료를 대치할 수 있는 치료법이다. 그러나 종양의 크기가 5 cm를 넘는 경우에는 방사선치료만으로는 장기생존자가 거의 없었으며, 따라서 이러한 환자의 치료에 있어 과분할조사나 기관지내 추가조사, 방사선감작제의 사용, 입체조형방사선치료, 강도변조방사선치료 등의 이용을 고려해야 할 것이다.