• Korean Journal of Radiology
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• v.25 no.7
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• pp.644-655
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• 2024

Objective: To develop and validate a preoperative risk score incorporating carbohydrate antigen (CA) 19-9, CT, and fluorine18-fluorodeoxyglucose (¹⁸F-FDG) PET/CT variables to predict recurrence-free survival (RFS) after upfront surgery in patients with resectable pancreatic ductal adenocarcinoma (PDAC). Materials and Methods: Patients with resectable PDAC who underwent upfront surgery between 2014 and 2017 (development set) or between 2018 and 2019 (test set) were retrospectively evaluated. In the development set, a risk-scoring system was developed using the multivariable Cox proportional hazards model, including variables associated with RFS. In the test set, the performance of the risk score was evaluated using the Harrell C-index and compared with that of the postoperative pathological tumor stage. Results: A total of 529 patients, including 335 (198 male; mean age ± standard deviation, 64 ± 9 years) and 194 (103 male; mean age, 66 ± 9 years) patients in the development and test sets, respectively, were evaluated. The risk score included five variables predicting RFS: tumor size (hazard ratio [HR], 1.29 per 1 cm increment; P < 0.001), maximal standardized uptake values of tumor ≥ 5.2 (HR, 1.29; P = 0.06), suspicious regional lymph nodes (HR, 1.43; P = 0.02), possible distant metastasis on ¹⁸F-FDG PET/CT (HR, 2.32; P = 0.03), and CA 19-9 (HR, 1.02 per 100 U/mL increment; P = 0.002). In the test set, the risk score showed good performance in predicting RFS (C-index, 0.61), similar to that of the pathologic tumor stage (C-index, 0.64; P = 0.17). Conclusion: The proposed risk score based on preoperative CA 19-9, CT, and ¹⁸F-FDG PET/CT variables may have clinical utility in selecting high-risk patients with resectable PDAC.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.sup1
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• pp.52-59
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• 2008

In the management of colo-retal and anal cancer, accurate staging, treatment evaluation, early detection of recurrence are main clinical problems. F-18 FDG PET (PET/CT) has been reported as useful in the management of colo-rectal and anal cancer because that PET has high diagnostic performance comparing to conventional studies. In case of liver metastases, for confirmation of no extrahepatic metastases, in case of high risk of metastasis, for avoiding unnecessary operation, PET (PET/CT) is expected more useful. In anal cancer, PET is expected useful in lymph node staging. For the early prediction of chemotherapy or radiation therapy effect PET has been reported as useful, also. In early detection of recurrence by PET, cost-benefit advantages has been suggested, also. PET/CT is expected to have higher diagnostic performance than PET alone.

• The Korean Journal of Nuclear Medicine
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• v.35 no.4
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• pp.213-223
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• 2001

Breast cancer accounts for the higher proportion of cancer related deaths among women, and the incidence of this malignant disease is still increasing. The commonly used screening method is mammography. However, mammography has the drawback of low specificity in differentiating malignant and benign breast diseases. To overcome this low specificity of mammography, scintimammography using various radiopharmaceuticals such as Thallium-201, Tc-99m MIBI, Tc-99m tetrofosmin and Tc-99m MDP was introduced and now actively under the investigation. Several studios have shown that high sensitivity and specificity in detection of primary breast cancer and axillary lymph node metastases using these radiopharmaceuticals. Scintimammography may play important roles in the diagnosis of primary breast cancer, evaluation of the patients with high risk, determining axillary lymph node metastasis, evaluation of the response to chemotherapy, determining the extent of disease, and surveillance of local recurrence. In the future, we should investigate the prognostic role of scintimammography after treatment of breast cancer patients and cost-effectiveness of scintimammography in the detection of primary breast cancer.

• Journal of Gastric Cancer
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• v.14 no.1
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• pp.7-14
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• 2014

Endoscopic resection is the established treatment for early gastric cancer in selected patients with negligible risk of lymph node metastasis ('absolute indication'). Based on clinical observations and large pathological databases, expanding indications for endoscopic resection beyond absolute indication has been tried in Japan and Korea. However, controversies exist regarding the safety of treating early gastric cancer beyond absolute indication in terms of pathological evaluation of the resected specimen, definition of expanded indication, discrepancy between pre-endoscopic resection and post-endoscopic resection diagnoses of gastric neoplasm, and the best strategy for cases with non-curative resection. In this brief review, current evidence and clinical experience regarding issues of endoscopic resection beyond absolute indication will be summarized.

• The Journal of the Korean bone and joint tumor society
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• v.4 no.1
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• pp.59-64
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• 1998

Parosteal osteosarcoma is characterized as a densely ossifying lesion, usually occurring on the surface near the metaphyses of a long bone. The histological pattern is a well- differentiated mature bone trabeculae with a hypocellular spindle-cell stroma. The cytological details are those of a low-grade malignant lesion. The natural history of this lesion is indolent local growth, late invasion of the underlying bone, and infrequently, distant metastasis. However, there is a significant risk of eventual dedifferentiation into a high-grade lesion. We report here-a case of parosteal osteosarcoma dedifferentiated into a high-grade lesion, which occurred in the left distal femur of a 40-years-old woman, and discuss the experience in detail.

• Journal of Chest Surgery
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• v.23 no.3
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• pp.537-541
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• 1990

Early esophageal carcinoma is defined as a lesion wherein invasion is confined to the mucosa and submucosa without metastasis to lymph node or other organs. Postoperative 5-year survival rate for early esophageal carcinoma is much superior than advanced carcinoma. Unfortunately, because of the anatomic characteristic of esophagus and absence of specific early symptoms, detection is frequently belated, and advanced disease is present at the time of the initial diagnosis. We experienced 2 cases of early esophageal carcinoma. They complained no specific symptoms. The diagnosis was made by barium esophagogram, esophagofiberscopy with dye staining and endoscopic biopsy. We performed esophagectomy with esophagogastrostomy. All had good postoperative course without any complication. We concluded that the combined use of double contrast radiography, esopagofiberscopy aided by intraluminal staining with Toluidine blue or Lugol`s solution, and endoscopic biopsy is very important in the diagnosis of early esophageal carcinoma in high risk patient group.

• Journal of Chest Surgery
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• v.53 no.4
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• pp.191-199
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• 2020

Surgeons recommend dissecting lymph nodes in the thorax, abdomen, and neck during surgery for esophageal cancer because of the possibility of metastasis to the lymph nodes in those areas through the lymphatic plexus of the esophageal submucosal layer. Extensive lymph node dissection is essential for accurate staging and is thought to improve survival. However, it can result in several complications, including chyle leakage, which refers to continuous lymphatic fluid leakage and can occur in the thorax, abdomen, and neck. Malnutrition, fluid imbalance, and immune compromise may result from chyle leakage, which can be potentially life-threatening if it persists. Therefore, various treatment methods, including conservative treatment, pharmacological treatment such as octreotide infusion, and interventions such as thoracic duct embolization and surgical thoracic duct ligation, have been applied. In this article, the risk factors, diagnosis, and treatment methods of chyle leakage after esophagectomy are reviewed.

• Journal of Rhinology
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• v.25 no.2
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• pp.118-122
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• 2018

Epithelioid hemangioendothelioma is a rare vascular tumor with intermediate malignity and metastasis risk. It presents epithelioid cells with intracytoplasmic vacuoles and low mitotic activity. Its vascular nature can be confirmed by immunohistochemical studies (vimentin, CD31, CD34, and factor VIII). It is extremely rare in the nasal cavity, with only one case reported on the middle turbinate in Korea. The authors present a case of epithelioid hemangioendothelioma on the choana with a size of 2mm, which easily coult have been misdiagnosed as a blood clot.

• 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 Digestive Cancer Research
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• v.4 no.2
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• pp.88-91
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• 2016

Pancreatic cancer is the lethal disease and the prognosis of pancreatic cancer has remained largely unchanged over the past years. Borderline advanced pancreatic cancer is a biological different from resectable pancreatic cancer due to higher risk of early recurrence because of artery/vein abutment. Therefore this unique subset of pancreatic cancer has a controversial issue with regard to their treatment policy. Some institutes managed borderline advanced pancreatic cancer by up-front neoadhuvant chemotherapy because neoadjuvant chemotherapy provide the opportunity to treat early micro-metastasis with unfavorable tumor biology. But, some institutes try aggressive up-front surgical procedures to provide a chance of long-term survival in highly selected patients. Therefore this unique subset of pancreatic cancer has a controversial issue with regard to their treatment policy. This review address recent treatment trend for patients with borderline advanced pancreatic cancer.