• Title/Summary/Keyword: stagings

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Comparison of Nodal Staging, of UICC TNM and Japanese Classification, and Prognostic Nodal Grouping of UICC N3M0 in Advanced Gastric Cancer (진행 위암의 UICC와 일본식 림프절 병기의 비교 및 UICC N3M0 병기의 문제점)

  • Han, Sang-Jun;Yang, Dae-Hyun
    • Journal of Gastric Cancer
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    • v.5 no.3 s.19
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    • pp.163-168
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    • 2005
  • Purpose: We analyzed cases of advanced gastric cancer (AGC) by using two nodal stagings, UICC and Japanese systems. We also analyzed cases of UICC N3M0 by different ways to see which nodal system or group had better prognostic power. Materials and Methods: From Feb. 1990 to May 2000, 197 UICC M0 patients of AGC who had undergone curative resection were analyzed by using the nodal stagings of the UICC and the Japanese systems. Also, 58 patients with UICC N3M0 gastric cancer were analyzed by using the Japanese n-staging, metastatic ratio and the metastatic number Results: The 5-year survival rates were 62.9%, 33.0% and 21.2% for UICC N1, N2 and N3, and 61.2% and 25.3% for Japanese n1 and n2, respectively in patients of N3M0 AGC, the 5-year survival rates were 62.5% for Japanese n1, and 33.0% and 22.9% for metastatic ratios of less than 0.5 and metastatic numbers below 26, respectively significantly better than the 5-year survival rates for higher ratios and numbers (P=0.018, 0.021). Conclusion: UICC N staging of gastric cancer has better prognostic power with differentiation between stages than Japanese n staging. In patients with UICC N3M0 gastric cancer, the metastatic ratio and the metastatic number, as well as the Japanese n staging, were valuable prognostic factors.

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Surgical Treatment For Primary Non-Small Cell Lung Cancer (원발성 비소세포성 폐암의 외과적 치료)

  • 최준영;김병균
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.908-913
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    • 1997
  • From May 1988 to December 1995, 77 patients underwent surgical re ection for primary non-small cell lung cancer at GNUH, and were evaluated clinically. There were 65 males and 12 females(M:P=5.4:1), and the peak incidence of age was 6th decade of life(44.5%). The major symptoms were cough, hemoptysis and chest pain due to anatomical effects of the mass. Histopathologically, squamous cell carcinoma was 81.8%, adenocarcinoma 14.3%, and adenosquamous carcinoma 3.9% . There was no significant difference in survival among three groups. The pneumonectomy was performed in 26 cases(33.8%), lobectomy 30 cases(38.9%), bilobectomy 9 cases(11.7%), and overall resectability was 84.4%. The postoperative official stagings were as follows ; 26 patients of stage I(34%), 14 patients of stage II(18%), 22 patients of stage IIIa(29%), 14 patients of stage IIIb(18%), and one patients of stage IV(1%). In all cases, 3 year survival rate are showed stage 183%, stage II 26%, stage IIIa 17%, and stage IIIb 0%.

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Surgical Treatment of Lung Cancer (폐암의 외과적 치료)

  • 신현종
    • Journal of Chest Surgery
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    • v.20 no.3
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    • pp.473-482
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    • 1987
  • The records of 65 patients with a confirmed diagnosis of primary lung cancer who underwent surgical therapy at the Department of Thoracic and Cardiovascular Surgery of the Keimyung University Hospital were analyzed during the period of 8 years and 4 months, from August, 1978 to December, 1986. The peak incidence was observed in the 5th decade of life and the mean age was 52.9 years old. Male versus female ratio was 8.3:1 Cough was the most frequent presenting symptom, 76.9% then chest discomfort, hemoptysis and dyspnea followed in order. 44.6% of the patient had 2 months of prediagnostic symptomatic period, 72.3% had 5 months, and the mean was 5.7 months. As for preoperative diagnosis, 62 of total 65 patients revealed the mass lesion on simple chest x-ray, and 56 of 65 patients on bronchoscopic biopsy, 10 of 37 patients on sputum cytology and 15 of 15 patients on computerized tomography of the chest were positive. Of the 65 patients, 35 [53.9%] had squamous cell carcinoma, 18 [27.7%] adenocarcinoma, 3 [4.6%] large cell carcinoma, and 3 [4.6%] small cell carcinoma all which was oat cell carcinoma. 83.1% of the total patient was resectable, and 34 underwent pneumonectomy and 20 lobectomy. Of these 65 operations, 29 was radical resection, 25 palliative, and 11 exploratory thoracotomy. As for clinical stagings, 23 patients were in Stage, I, another 23 in Stage II and 19 in Stage III, while 16 was in stage, I, 14 in stage ll and 35 in stage III in postoperative staging evaluation. In correlation of postoperative TNM classification and radical resection, those patients who had lung cancer of stage I [14/16] and stage II [9/13] had more radical resection. As postoperative complications, one patient had massive bleeding, two empyema, one empyema with bronchopulmonary fistula, and one cardiac herniation. Operative mortality rate was 1.5% [1 patient]. Mean duration between 1st operation and discovering recurrence in 18 patients was 12.7 months.

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A Clinical Use of CT Scan in Rectal Cancer (직장암 단층촬영(CT)의 임상적 이용)

  • Suh, Bo-Yang;Chung, Yong-Sik;Lee, Su-Jeung;Shim, Min-Chul;Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.67-72
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    • 1986
  • Authors evaluated the accuracy of preoperative pelvic CT scan staging and its effects on management in 12 biopsy proved rectal cancer patients. Authors also studied postoperative CT in 5 patients to detect disease recurrence and metastasis. Preoperative CT staging was identical to surgical and/or pathological staging in 9 patients(75%), but it was underestimated in two cases and overstimated in one instance than in surgical stagings. In 7 cases, CT scan didnot alter original choice of procedures. However, preoperative CT staging gave definitive informations to change management plans in 5 cases otherwise the treatment would be difficult and inadequate. Postoperative CT showed local recurrence in one and liver metastases in 2 cases. One of them was not detected at exploratory laparotomy.

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Seismic torsional vibration in elevated tanks

  • Dutta, Sekhar Chandra;Murty, C.V.R.;Jain, Sudhir K.
    • Structural Engineering and Mechanics
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    • v.9 no.6
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    • pp.615-636
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    • 2000
  • Some elevated water tanks have failed due to torsional vibrations in past earthquakes. The overall axisymmetric structural geometry and mass distribution of such structures may leave only a small accidental eccentricity between centre of stiffness and centre of mass. Such a small accidental eccentricity is not expected to cause a torsional failure. This paper studies the possibility of amplified torsional behaviour of elevated water tanks due to such small accidental eccentricity in the elastic as well as inelastic range; using two simple idealized systems with two coupled lateral-torsional degrees of freedom. The systems are capable of retaining the characteristics of two extreme categories of water tanks namely, a) tanks on staging with less number of columns and panels and b) tanks on staging with large number of columns and panels. The study shows that the presence of a small eccentricity may lead to large displacement of the staging edge in the elastic range, if the torsional-to-lateral time period ratio $({\tau})$ of the elevated tanks lies within a critical range of 0.7< ${\tau}$ <1.25. Inelastic behaviour study reveals that such excessive displacement in some of the reinforced concrete staging elements may cause unsymmetric yielding. This may lead to progressive strength deterioration through successive yielding in same elements under cyclic loading during earthquakes. Such localized strength drop progressively develop large strength eccentricity resulting in large localized inelastic displacement and ductility demand, leading to failure. So, elevated water tanks should have ${\tau}$ outside the said critical range to avoid amplified torsional response. The tanks supported on staging with less number of columns and panels are found to have greater torsional vulnerability. Tanks located near faults seem to have torsional vulnerability for large ${\tau}$.

A Clinical Study of prophylactic Neck Dissection in Supraglottic Cancer Patients (성문상부암 환자에서 예방적 경부곽청술의 임상적 연구)

  • 이석우;나종원;이윤세;유승주;남순열;김상윤
    • Korean Journal of Bronchoesophagology
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    • v.8 no.1
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    • pp.81-86
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    • 2002
  • Background and objectives : There may be frequent lymphatic neck metastasis among supraglottic cancer patients after their primary surgery. The aim of this study was to evaluate the effectiveness of prophylactic neck dissections in supraglottic cancer patients to lower the neck metastasis. Material and method : The authors retrospectively reviewed medical records of 52 patients (7 females. 45 males) who had received the operations for the supraglottic cancer from 1995 to 2000. They were preoperatively examined with Computer Tomographic images, and also examined by the cervical neck palpations. Postoperative pathologic specimens were reviewed and the Pathologic stagings were confirmed by the pathologist. Results : Among 52 patients who received surgery for supraglottic carcinoma, 5 patients received ipsilateral neck dissection, 12 patients received ipsilateral neck dissection with postoperative radiation therapy, 10 Patients received bilateral neck dissection and 25 patients received bilateral neck dissection with postoperative radiation treatment. In comparison of the data of N0 to N+ conversion rate of neck, there were 11 ipsilateral T3 N0 patients and 2 patients(18%) were converted to N+ status, and there were 8 Patients with T4 N0 stages, and 3 patients(38%) were converted to N+ status. In comparing the data of contralateral neck dissection on N0 patient, there were 8 patients of T3 N0 patients, and there was 1 patient (13%) who showed recurrence. There were 5 patients of T4 N0 stages and there was 1(20%) patient with recurrences. When the ipsilateral N stages were N2a, and N2b, there 1 case of contraleral N+ conversions, respectively. In recurrences, there were 2 patients of N2b staged patients and 1 patient of N2c patient that showed recurrence during the follow up period. Conclusion : This data shows that at least an ipsilateral neck dissection is necessary in order to prevent the recurrences, and also suggests that bilateral neck dissection is necessary for the higher T stage. Since the higher N staged patients showed higher rate of recurrence, so that neck dissection is mandatory for the higher N staged patients.

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Expression and Significance of TSGF, CEA and AFP in Patients Before and after Radical Surgery for Colon Cancer

  • Hu, Yi;Wang, Jing-Liang;Tao, Hai-Tao;Wu, Bai-Shou;Sun, Jin;Cheng, Yao;Dong, Wei-Wei;Li, Rui-Xin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3877-3880
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    • 2013
  • Objective: To explore the expression and significance of tumor specific growth factor (TSGF), carcinoembryonic antigen (CEA) and alpha fetoprotein (AFP) in cancer tissue and serum of patients with colon cancer. Materials and Methods: Radical surgery for colon cancer was performed on 43 patients with laparoscopu under conditions of general anesthesia. The Elisa method was used to detect the levels of serum TSGF, CEA and AFP before and after radical operation, and cancer tissue underwent TSGF, CEA and AFP immunohistochemistry staining after laparoscopic surgery. The decreased conditions of serum TSGF, CEA and AFP in patients with colon cancer at different levels of differentiation and clinical stagings were analyzed, and the relationships of expression rates between histological types, colon cancer morphology, lymph node metastasis and TSGF, CEA as well as AFP in cancer tissue were assessed. Results: Compared with before radical surgery, the levels of serum TSGF, CEA and AFP decreased notably in patients after operations (p<0.01). The decreased degree of TSGF and CEA was the largest in patients with poorly differentiated cancer tissue (p<0.01), while that of AFP was noted in patients with moderately differentiated cancer tissue (p<0.01). The decreased degree of TSGF and AFP was the largest in patients at phase Dukes A (p<0.01), while that of CEA in patients at phase Dukes C (p<0.01). There were no significant differences among the positive expression rates of TSGF, CEA and AFP with different histological types and colon cancer morphologies (p>0.05). The positive expression rates of TSGF and CEA in patients with lymph node metastasis were significantly higher than those without lymph node metastasis (p<0.01). Conclusions: TSGF, CEA and AFP can be used to evaluate the effect of radical operation for colon cancer, and the changed levels of different markers are associated with tumor differentiation, clinical stating and presence or absence of lymph node metastasis.

Long Term Result and Clinical Evaluation of Primary Non-Small Cell Lung Cancer (원발성 비소세포성 폐암의 임상적 고찰과 장기성적)

  • 김양원;김윤규
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.43-51
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    • 1996
  • From march 1989 to October 1993, 57 patients were diagnosed and operated for primary non-small cell lung cancer, and evaluated clinically. 1. There were 45 males and 12 females (M:F=3.8:1), and the peak incidence of age was 6th decade of life (45.6%). In the preoperative diagnostic methods and their positive rate, sputum cytology was 11%, bronchial washing cytology 50%, bronchoscopic biopsy 73%, and CT guided percutaneous needle aspiration biopsy 83%. 3. Histopathologically, squamous cell carcinoma was 56.1%, adenocarcinoma 22.8%, bronchioloal veolar cell carcinoma 1%, and undifferentiated large cell carcinoma 1.8%. 4. In the operation, pneumonectomy was 35.1%, lobectomy 38.6%, bilobectomy 3.5%, segmentec tony 7%, and exploratory thoracotomy 15.8%, and overall resectability was 84.2%. 5. In postoperative stagings, stage I was 28.1%, st ge II 22.8%, stage IIIa 31.6% and stage IIIb 17.5%. 6. Postoperative complications were developed in 11 cases (19.3%) and operative mortality was none. 7. One year survival rate in rejectable cases was 87.0%, 2 year 61.6% and 5 year 44.9%. According to stage, 3 year survival rate was 75.8% in stage I, 16.9% in stage II, 60.9% in stage IIIa, 50% in stage IIIb.

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Clinical Behaviors and Treatment Outcome of Papillary Thyroid Microcarcinomas:Tumor Size-Based Therapeutic Concept (미세 유두 갑상선암의 크기에 따른 임상상 및 단기간 치료 결과)

  • Lee, Jan-Dee;Oh, Dong-Kyu;Lim, Seung-Soo;Nam, Kee-Hyun;Chung, Woong-Youn;Soh, Euy-Yong;Park, Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.1
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    • pp.47-52
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    • 2008
  • Purpose:The incidence of papillary thyroid microcarcinoma(PTMC) has increased due to the widespread use of high resolution ultrasonography and fine-needle aspiration biopsy. However, the clinical and biologic behaviors of PTMC is debatable. The aim of this study was to describe clinicopathologic features of PTMC and to suggest whether tumor size(5mm) might prove the useful parameter for determining the surgical strategy in PTMC. Material and Methods:From Jan. 2000 to Dec. 2005, 1355 of 2678 patients with papillary thyroid carcinoma were identified as having PTMC, based on tumor size${\leq}$10mm(50.6%). Among patients with PTMC, we further separated tumors<5mm(minute group:group M) from those 5 to 10mm(tiny group:group T). We compared the clinicopathological characteristics and the TNM stagings between two groups. Results:There were 114(8.4%) men and 1241(91.6%) women with a median age of 47 years(range;13-79). During a mean follow-up of 47.3(range;22-93), 13 patients(1.0%) developed locoregional recurrences and 3 patients(0.2%) showed distant metastases at initial presentation. Statistical analysis revealed that the presence of extracapsular invasion(p<0.0001), invasion to adjacent structure(p<0.0001), multifocality(p<0.0001), central lymph node metastasis(p<0.0001), and lateral lymph node metastasis(p<0.0001) were all significantly higher in tiny group(tumor${\geq}$5mm). Furthermore, minute group demonstrated a significantly lower tumor stage(AJCC TNM classification) compared with tiny group(p<0.0001). Conclusion:Patients with PTMC have a favorable treatment outcomes, although the distinction needs to be made with reference to the clinicopathologic behaviors. It would be reasonable to consider that tumor size(5mm) would be useful parameter for the treatment strategy of PTMC.

The Result of the Surgical Treatment for Non-small Cell Lung Cancer (비소세포성 폐암의 외과적 치료에 대한 성적)

  • Park, Jin-Gyu;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.899-907
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    • 1997
  • Recently, primary lung cancer has increased markedly in incidence & prevalence in korea. Prom July 1979 to June 1996, 183 patients were diagnosed and operated for primary non-small cell lung cancer, and evaluated clinically. 1. There were 164 males and 19 females(M:P=8.6: 1), and the peak incidence of age was 50th and 60th decade of life(73.7%). 2. Most of symptoms were respiratory, whitch were cough(44.8%), chest pain(30.1%), dyspnea(20.8%), hemoptysis or blood tinged sputum(19.7%), sputum(15.3%), and asymptomatic cases were 12.0%. 3. Histopathologically, sguamous cell carcinoma was 68.9%, adenocarcinoma 19.7%, bronchioloalveol r cell carcinoma 2.2%, adenosguamous cell carcinoma 1.6%, and large cell carcinoma 7.7%. 4. In the operation, pneumonectomy was 41.0%, lobectomy 42.1%, bilobectomy 13.1%, stagmentectomy or wedge resection 1.6%, and explore tharacotomy 2.2%, and the overall resectability was 97.8%. 5. Postoperative complications were developed in 31.9%, and operative mortality was 1.6%. 6. In postoperative stagings, stage I was 38.3%, stage H 14.8%, stage llla 31.1%, and stage IIIb 15.8%. 7. The overall cumulative survival rates were 1 year 77.8%, 3 year 42.7%, and 5 year 39.5%. The 5 year survival rate according to stage were stage 153.0%, stage H 46.5%, stage I[la 28.2%, and stage IIIb 13.8%(p<0.05), according to operation method were lobectomy 45.0%, and pneumonectomy 30.3%(p<0.05), and according to mediastinal involvement were Nl 32.0%, and N2 11.1%(p<0.05). The 5 year survival rate according to histologic type were squamous cell carcinoma 43.1%, adenocarcinoma 23.3%, and large cell carcinoma 30.3 (p>0.05).

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