• Journal of Gastric Cancer
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• v.20 no.4
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• pp.345-354
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• 2020

Early detection of gastric cancer is crucial because the survival rate can be improved through curative treatment. Although surgery and gastrectomy with lymph node dissection remain as the gold standard for curative treatment, early gastric cancer (EGC) with negligible risk of lymph node metastasis can be treated with endoscopic resection (ER), such as endoscopic submucosal dissection. Among gastric cancers, undifferentiated-type cancer is distinguished from differentiated-type cancer in various aspects in terms of clinical features and pathophysiology. The undifferentiated-type cancer is also known to be associated with an aggressive behavior and a poor prognosis. Therefore, the indication of ER for undifferentiated EGC is limited compared with differentiated-type. Recent studies have reported that ER for undifferentiated EGC is safe and shows favorable short- and long-term outcomes. However, it is necessary to understand the details of the research results and to selectively accept them. In this review, we aimed to evaluate the current practice guidelines and the short-term and long-term outcomes of ER for undifferentiated type EGC.

• Journal of Gastric Cancer
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• v.23 no.1
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• pp.171-181
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• 2023

Currently, the prevalence of gastroesophageal junction adenocarcinoma (GEJAC) is increasing in both Asian and Western countries, although the increasing rate in Asian countries is much slower than in Western countries. With these current trends, concerns regarding the surgical treatment method are also increasing among gastrointestinal surgeons. However, the surgical treatment for GEJAC has been a controversial issue for a long time due to the relative scarcity of this tumor and its characteristics from its borderline location. Recently, a large-scale prospective study of this tumor has been conducted in Japan, and the results are now available. The results of this study will be helpful for understanding this tumor. In this article, the pattern of lymph node metastasis of GEJAC is reviewed, and the extent and method of lymph node dissection for this tumor are discussed and proposed based on the review.

• Journal of Digestive Cancer Research
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• v.11 no.1
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• pp.15-20
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• 2023

Endoscopic submucosal dissection (ESD) is a minimally invasive and effective treatment for early gastric cancer. The criteria for determining the suitability and success of ESD have expanded, with changes in the histopathological classification of gastric carcinoma, including results from molecular research. Treatment methods have also diversified to include targeted therapies and immuno-oncology agents. To improve communication between clinicians and pathologists, it is crucial to understand the standardized diagnostic forms of gastric cancer. This study aims to examine the handling method of ESD specimens and describe the pathological findings of gastric tumors.

• Journal of Chest Surgery
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• v.57 no.1
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• pp.99-102
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• 2024

This article presents a straightforward hybrid arch technique for treating residual type B aortic dissecting aneurysms following type A repair (replacement of the ascending aorta) that employs a frozen elephant trunk (FET) straight vascular prosthesis. The debranch-first method involves only cutting and sewing the previous ascending graft, inserting the FET from zone 0, and debranching the arch vessels using a trifurcated graft. This technique is less invasive as it eliminates the need to manipulate the dissected distal arch aneurysm. We successfully applied this technique to 3 patients, with no instances of in-hospital death, stroke, or paraplegia. The debranch-first technique, combined with zone-0 FET insertion, simplifies the redo repair of residual type B aortic dissection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.6
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• pp.490-496
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• 2010

Introduction: This study examined the effect of a conservative neck dissection in patients with head and neck cancer. Materials and Methods: A total of 24 patients, who underwent a conservative neck dissection for the treatment of oral cancer from January 2002 to December 2007, were included. All procedures were performed by one oral and maxillofacial surgeon. The mean age was 58.2 years (range, 19 to 79 years). The medical recordings, pathologic findings, and radiographic findings were evaluated. The mean follow up period was 41.1 months (range, 4 to 88 months). Results: 1. Oral cancer was more common in men than women with a 3:1 ratio. 2. Histopathologically, squamous cell carcinoma(83%) was the most prevalent oral cancer in this study. 3. The most common primary site was the tongue(6 cases, 25%) followed by the mouth floor (5 cases, 21%), buccal mucosa (3 cases, 13%), lower lip, mandible, palate (2 cases, respectively) and salivary gland, retromolar area, oropharynx, alveolus (1 case, each). 4. Three out of the 24 (13%) subjects had a recurrence at the primary sites. 5. Two out of 24 (8%) subjects had a distant metastasis. 6. All 24 patients survived and there were eleven patients who passed 5 years postoperatively. Conclusion: A conservative neck dissection is a reliable and effective method for controlling neck node metastases in patients with oral cancer of the N0 or N1 neck node without serious complications.

• Korean Journal of Head & Neck Oncology
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• v.13 no.2
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• pp.187-199
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• 1997

Thyroid carcinoma ranks low in incidence and as a cause of death when compared to carcinomas arising in the other site. With adequate surgical treatment, the prognosis of operable thyroid carcinoma is good. However, the extent of surgical resection in treatment of thyroid cancer remains still controversy. The aim of this study was to assess the results of thyroid cancer patients treated surgically and to analyze the prognostic factors affecting survival and to improve the survival rate. We retrospectively analyzed the outcome of a total of 278 thyroid cancer patients treated surgically at Inje University Paik Hospital from 1980 to 1995 and followed for 1 to 16 years. There were man in 47 and woman in 231 patients with age range of 14 to 79 years(mean 42 years). Histopathologic findings were papillary carcinoma in 233, follicular carcinoma in 33, mixed carcinoma in 7, medullary carcinoma in 2, and undifferentiated carcinoma in 3 patients, respectively. Operative procedures were unilateral lobectomy in 111, subtotal thyroidectomy in 100, and total thyroidectomy in 67 patients. Central node dissection was performed in 92, modified neck disseciton in 62, radical neck dissection in 28, and no node dissection in 96 patients. Thyroid hormone was administered for the period of 3 to 5 years to suppress endogenous TSH production. Overall 5-year survival rate according to Kaplan-Meier method was 91.1%. Independently, significant factors affecting the prognosis were age at diagnosis, tumor size, pathologic type, tumor stage, lymph node metastasis, angioinvasion, extrathyroidal extension, and 'risk' group category. but, the prognosis were not influenced by sex and capsular invasion. Patients at low risk or with small size carcinomas had long survival over 5 years with only lobectomy. Lymph node dissection was carried out with a limited type in no jugular metastasis, radical neck dissection was performed only therapeutically in proved jugular node metastasis. Fifteen patients were dead of tumor recurrence after surviving for three months to two and half years, and the cause of death was local recurrence in nine, bone metastasis in four and lung metastasis in two patients. In conclusion, more extensive surgery including total thyroidecotmy and systematic compartment-oriented dissection of the lymph node metastases in patient at high-risk group will results in better survival and lower recurrence rate.

• Korean Journal of Head & Neck Oncology
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• v.13 no.2
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• pp.221-227
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• 1997

The authors reviewed 106 cases of parotid gland tumor at Presbyterian Medical Center seen during the past 10 years between January, 1986 and December, 1995. The results were obtained as follows; 1) 86 cases(81.1%) were benign tumors and 20 cases(18.9%) were malignant tumors. 2) Overall male and female sex ratio was 1 : 1.4. 3) For benign tumors, the mean age was 47.9 and for malignant tumors, the mean age was 43.4. 4) Clinical manifestations in benign tumors were palpable mass in 86 cases(100%), pain in 6 cases(6.9%), facial nerve palsy in 2 cases(2.3%), lymphadenopathy in 1 case(1.2%); and in malignant tumors, palpable mass in 20 cases(100%), pain in 7 cases(35%), facial nerve palsy in 2 cases(10%) and lymphadenopathy in 3 cases(15%). Thus, the presence of pain, facial nerve palsy and lymphadenopathy suggest malignant tumors. 5) Operative procedures in benign tumors included superficial parotidectomy in 53 cases(61.6%), total parotidectomy in 10 cases(11.6%), local excision in 23 cases(26.7%); and in malignant tumors, superficial parotidectomy in 3 cases, total parotidectomy in 1 case, local excision in 1 case, superficial parotidectomy with supraomohyoid neck dissection in 6 cases, total parotidectomy with supraomohyoid neck dissection in 8 cases, total parotidectomy with radical neck dissection in 1 case. 6) Postoperative complications in benign tumors were transient facial nerve palsy in 14 cases, Frey's syndrome in 2 cases. In malignant tumors complications included transient facial nerve palsy in 3 cases and permanent facial nerve palsy in 1 case. 7) Pleomorphic adenoma was the most common benign parotid tumor and mucoepidermoid carcinoma was the most common malignant tumor. 8) In our review of 20 patients with malignant parotid tumors, all patients who received supraomohyoid neck dissection and postoperative radiation therapy remain alive from 1986 to 1995 years. Two deaths in this series were adenoid cystic carcinoma patients who failed to receive postoperative radiation therapy. These series of cases have been studied in order to determine whether supraomohyoid neck dissection and postoperative radiation therapy may have further therapeutic effect.

• Korean Journal of Head & Neck Oncology
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• v.34 no.1
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• pp.21-27
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• 2018

Background/Objectives: This study aimed to evaluate the changes of uptake around the sternoclavicular joint (SCJ) according to 18F-FDG PET images in patients with head and neck cancer who underwent neck dissection. Materials & Methods: Retrospectively, the medical records of patients who received selective or comprehensive neck dissection were reviewed. Preoperative and 1-year postoperative 18F-FDG PET images, if available, were analyzed by nuclear medicine physicians in both qualitative and quantitative manners. Correlation between the changes of uptake around SCJ and perioperative data were statistically analyzed. Results: Thirty-seven patients satisfying the inclusion criteria were enrolled. Seven patients with increased uptake around SCJ on 1-year postoperative 18F-FDG PET showed a correlation with radical or comprehensive neck dissection, accessory nerve sacrifice, and high postoperative SUVmax. When 20 patients with increased uptake around SCJ according to quantitative measurement were compared with other patients without increased uptake, no parameter was significantly different, except postoperative SUVmax. Bivariate logistic regression analysis revealed that the clinical symptom (shoulder or sternal pain) was significantly correlated with the extent of neck dissection (OR 0.227, CI 0.053-0.966, p=0.045) and spinal accessory nerve sacrifice (OR 13.500, CI 1.189-153.331, p=0.036). Conclusions: Increased uptake around SCJ on 1-year postoperative 18 F-FDG PET was correlated with either the radical or comprehensive procedure, as well as with accessory nerve sacrifice. This suggests that subjective analysis of 18F-FDG PET can be used to detect subclinical shoulder instability.

• Journal of Chest Surgery
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• v.26 no.5
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• pp.403-408
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• 1993

The atrioventricular node reentrant tachycardia[AVNRT] is a common type of supraventricular tachycardias. Recently we experienced two cases of AVNRT. One is AVNRT with severe aortic regurgitation[grade IV] and the other is AVNRT with patent ductus arteriosus. Dissection of perinodal tissue has been successfully carried out in the beating heart under the normothermic cardiopulmonary bypass, and aortic valve replacement and ligation of patent ductus arteriosus were also performed, respectively. Postoperatively, permanent atrioventricular block was not occured and AVNRT was not developed during the follow up. We propose that the surgical dissection of perinodal tissue is a simple and effective treatment for the patient with refractory AVNRT.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.687-690
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• 1984

Aortic dissection, a condition characterized by hemorrhage into the media and variable extension along the length of the aorta, has long been recognized as a catastrophic Cardiovascular event. Recent developments in diagnostic and therapeutic skills have improved the prognosis considerably, but there is still controversy as to how cases should be managed. We experienced a case of dissecting aortic aneurysm [DeBakey Type III ], which were managed using intensive medical treatment. The period of follow up was about 11 years. At last, patient was died by progression of dissection into proximal aorta and resulted in aortic insufficiency and congestive heart failure.