• 대한골관절종양학회지
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• 제1권2호
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• pp.194-199
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• 1995

To evaluate the role of post-operative irradiation in reducing local recurrence after surgical treatment of liposarcoma, 19 patients who were treated between July 1988 and June 1994 at Department of Orthopedic Surgery, Catholic University were studied retrospectively. The average follow up was 31 months. 1. There were 14 males and 5 females and an average age was 51 years old. 2. Thirteen cases were in extremities and buttock, 3 in neck, 2 in retroperitoneum and 1 in back. 3. Histologic types were 16 cases of myxoid type and 3 cases of well differentiated type. 4. Ten cases were achieved with wide margin and 9 with inadequate(intralesional or marginal) margin. 5. There were no local recurrence in 10 cases with wide margin, whereas 6(67%) local recurrences in 9 cases with inadequate margin. 6. Among 6 cases of local recurrence, 5 cases had been treated with post-operative irradiation. In conclusion, post-operative irradiation for inadequate margin(intralesional or marginal margin) was not sufficient to reducing local recurrence.

• Journal of Chest Surgery
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• 제48권5호
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• pp.335-344
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• 2015

Background: A raised carcinoembryonic antigen (CEA) may be associated with significant pathology during the postoperative follow-up of lung adenocarcinoma. Methods: We reviewed the medical records of 305 patients who underwent surgical resections for primary lung adenocarcinoma at a single institution between April 2006 and February 2013. Results: Preoperative CEA levels were significantly associated with age, smoking history, pathologic stage including pT (pathologic tumor stge), pN (pathologic nodal stage) and overall pathological stage, tumor size and differentiation, pathologically positive total lymph node, N1 and N2 lymph node, N2 nodal station (0/1/2=1.83/2.94/7.21 ng/mL, p=0.019), and 5-year disease-free survival (0.591 in group with normal preoperative CEA levels vs. 0.40 in group with high preoperative CEA levels, p=0.001). Preoperative CEA levels were significantly higher than postoperative CEA levels (p<0.001, Wilcoxon signed-rank test). Postoperative CEA level was also significantly associated with disease-free survival (p<0.001). A follow-up serum CEA value of >2.57 ng/mL was found to be the appropriate cutoff value for the prediction of cancer recurrence with sensitivity and specificity of 71.4% and 72.3%, respectively. Twenty percent of patients who had recurrence of disease had a CEA level elevated above this cutoff value prior to radiographic evidence of recurrence. Postoperative CEA, pathologic stage, differentiation, vascular invasion, and neoadjuvant therapy were identified as independent predictors of 5-year disease-free survival in a multivariate analysis. Conclusion: The follow-up CEA level can be a useful tool for detecting early recurrence undetected by postoperative imaging studies. The perioperative follow-up CEA levels may be helpful for providing personalized evaluation of lung adenocarcinoma.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5133-5139
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• 2013

Background: Perineural invasion (PNI) has been reported as one of the sources of locoregional recurrence in resected pancreatic cancer (PC). However the impact of PNI in resected pancreatic cancer remains controversial. The purpose of this study was to determine the association between PNI status and clinical outcomes. Methods: Publications were identified which assessed prognostic significance of PNI status in resected pancreatic cancer up to February 2013. A meta-analysis was performed to clarify the association between PNI status and clinical outcomes. Results: A total of 21 studies met the inclusion criteria, covering 4,459 cases. Analysis of these data showed that intrapancreatic PNI was correlated with reduced overall survival only in resected pancreatic ductal adenocarcinoma (PDAC) patients (HR=1.982, 95%CI: 1.526-2.574, p=0.000). Extrapancreatic PNI was correlated with reduced overall survival in all resected pancreatic cancer patients (HR=1.748, 95%CI: 1.372-2.228, p=0.000). Moreover, intrapancreatic PNI status may be associated with tumor recurrence in all resected pancreatic cancer patients (HR=2.714, 95%CI: 1.885-3.906, p=0.000). Conclusion: PNI was an independent and poor prognostic factor in resected PDAC patients. Moreover, intrapancreatic PNI status may be associated with tumor recurrence.

• Radiation Oncology Journal
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• 제37권3호
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• pp.193-200
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• 2019

Purpose: To explore the role of salvage radiotherapy (RT) for recurrent thymoma as an alternative to surgery. Materials and Methods: Between 2007 and 2015, 47 patients who received salvage RT for recurrent thymoma at Yonsei Cancer Center were included in this study. Recurrent sites included initial tumor bed (n = 4), pleura (n = 19), lung parenchyma (n = 10), distant (n = 9), and multiple regions (n = 5). Three-dimensional conformal and intensity-modulated RT were used in 29 and 18 patients, respectively. Median prescribed dose to gross tumor was 52 Gy (range, 30 to 70 Gy), with equivalent doses in 2-Gy fractions (EQD₂). We investigated overall survival (OS), progression-free survival (PFS), and patterns of failure. Local failure after salvage RT was defined as recurrence at the target volume receiving >50% of the prescription dose. Results: Median follow-up time was 83 months (range, 8 to 299 months). Five-year OS and PFS were 70% and 22%, respectively. The overall response rate was 97.9%; complete response, 34%; partial response, 44.7%; and stable disease, 19.1%. In multivariate analysis, histologic type and salvage RT dose (≥52 Gy, EQD₂) were significantly associated with OS. The high dose group (≥52 Gy, EQD₂) had significantly better outcomes than the low dose group (5-year OS: 80% vs. 59%, p = 0.046; 5-year PFS: 30% vs. 14%, p=0.002). Treatment failure occurred in 34 patients; out-of-field failure was dominant (intra-thoracic recurrence 35.3%; extrathoracic recurrence 11.8%), while local failure rate was 5.8%. Conclusion: Salvage RT for recurrent thymoma using high doses and advanced precision techniques produced favorable outcomes, providing evidence that recurrent thymoma is radiosensitive.

• Radiation Oncology Journal
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• 제38권1호
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• pp.26-34
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• 2020

Purpose: Intensity-modulated radiotherapy (IMRT) allows for more precise treatment, reducing unwanted radiation to nearby structures. We investigated the safety and feasibility of IMRT for anaplastic ependymoma patients below 3 years of age. Materials and Methods: A total of 9 anaplastic ependymoma patients below 3 years of age, who received IMRT between October 2011 and December 2017 were retrospectively reviewed. The median equivalent dose in 2 Gy fractions was 52.0 Gy (range, 48.0 to 60.0 Gy). Treatment outcomes and neurologic morbidities were reviewed in detail. Results: The median patient age was 20.9 months (range, 12.1 to 31.2 months). All patients underwent surgery. The rates of 5-year overall survival, freedom from local recurrence, and progression-free survival were 40.6%, 53.3%, and 26.7%, respectively. Of the 9 patients, 5 experienced recurrences (3 had local recurrence, 1 had both local recurrence and cerebrospinal fluid [CSF] seeding, and 1 had CSF seeding alone). Five patients died because of disease progression. Assessment of neurologic morbidity revealed motor dysfunction in 3 patients, all of whom presented with hydrocephalus at initial diagnosis because of the location of the tumor and already had neurologic deficits before radiotherapy (RT). Conclusion: Neurologic morbidity is not caused by RT alone but may result from mass effects of the tumor and surgical sequelae. Administration of IMRT to anaplastic ependymoma patients below 3 years of age yielded encouraging local control and tolerable morbidities. High-precision modern RT such as IMRT can be considered for very young patients with anaplastic ependymoma.

• Journal of Microbiology and Biotechnology
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• 제31권12호
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• pp.1643-1655
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• 2021

Recent studies have reported dysbiosis of the microbiome in breast tissue collected from patients with breast cancer and the association between the microbiota and disease progression. However, the role of the microbiota in breast tissue remains unclear, possibly due to the complexity of breast cancer and various factors, including racial and geographical differences, influencing microbiota in breast tissue. Here, to determine the potential role of microbiota in breast tumor tissue, we analyzed 141 tissue samples based on three different tissue types (tumor, adjacent normal, and lymph node tissues) from the same patients with breast cancer in Korea. The microbiota was not simply distinguishable based on tissue types. However, the microbiota could be divided into two cluster types, even within the same tissue type, and the clinicopathologic factors were differently correlated in the two cluster types. Risk of regional recurrence was also significantly different between the microbiota cluster types (p = 0.014). In predicted function analysis, the pentose and glucuronate interconversions were significantly different between the cluster types (q < 0.001), and Enterococcus was the main genus contributing to these differences (q < 0.01). Results showed that the microbiota of breast tissue could interact with the host and influence the risk of regional recurrence. Although further studies would be recommended to validate our results, this study could expand our understanding on the breast tissue microbiota, and the results might be applied to develop novel prediction methods and treatments for patients with breast cancer.

• Journal of Korean Neurosurgical Society
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• 제29권6호
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• pp.744-747
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• 2000

Objectives : The purpose of this study was to evaluate the clinical features of the epidermoid tumor of posterior fossa and to assess the surgical outcome. Methods : We reviewed the clinicoradiological records of 10 epidermoid tumor of posterior fossa, treated surgically at our hospital between 1991 and 1996. Results : The mean age of onset was 36 years old and mean duration of symptom was 5.2 years. Six were men and four were women. The location of tumors were cerebellopontine angle(CPA) 5 cases, cerebellum(Cbll)& 4th ventricle 3 cases, foramen magnum 1 case, and pineal region extended to Cbll and 4th ventricle 1 case. Common clinical features were trigeminal neuralgia in 3 cases, cerebellar signs 2 case, headache 2 cases, hemifacial spasm with deafness 1 case, cbll signs and multiple cranial nerve dysfunctions 1 case. One CPA epidermoid had no clinical symptom and sign associated with the tumor. The surgical approaches were suboccipital approach in 9 cases and one transcallosal approach to the tumor of pineal region. The extent of surgical removal was gross total resection in 5 cases and near total or subtotal resection in 5. Two patients with CPA tumor were complicated with facial paresis. One patient with tumor located in cerebellum extended into cisterna magna had postoperative vocal cord paresis. All complicated cases had severe adhesion of tumor capsule with brainstem or cranial nerve. The mean duration of follow up was 26 months. The overall outcome was improvement of symptoms and signs in 6 cases and stationary 4 cases. During follow up, imaging study was done in 7 patients and none of them had finding of tumor recurrence. Conclusion : We conclude that recurrence of tumor is rare in both total and subtotal resected cases, but long-term follow-up is required. Aggressive removal of tumor capsule that adhesed to brianstem or cranial nerve is avoided for preventing severe postoperative complication.

• Radiation Oncology Journal
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• 제23권2호
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• pp.85-91
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• 2005

목적 : 본 연구는 흉선상피종의 수술 및 수술 후 방사선치료의 치료 성적과 예후 인자로서 WHO세포형의 중요성에 대하여 알아보고, 방사선 조사 범위를 종양이 있던 부위로 국한하였을 때 재발 양상을 분석하여 조사 범위의 적절성을 평가하였다. 대상 및 방법 : 1994년 12월부터 2004년 6월까지 흉선상피종으로 진단 받고 수술을 시행 받은 160명을 대상으로 하였다. 수술 및 병리조직 소견 상 (1) 종양의 완전 절제가 의심되는 경우, (2) 병리 검사결과 절제연이 양성인 경우, (3) 조직병리가 WHO 세포형 B2이상인 경우, (4) Masaoka 병기 2기 이상인 경우에 수술 후 방사선치료를 추가하도록 권유하였으며, 실제 99명이 수술 후 방사선치료를 시행받았다. 방사선치료의 표적 용적은 종양 원발 부위에서 $1.5\~2$ cm 여유를 두고 결정하였으며, 매일 1.8 Gy또는 2 Gy씩, 주 5회 조사하는 통상분할조사법으로 목표선량은 54 Gy였다. 결과 : 전체 환자의 5년 생존율은 $87.3\%$였다. 단변량 분석결과 5년 생존율에 유의한 영향을 미치는 인자는 연령(60세 이상 $77.8\%$, 60세 미만 $91.3\%$: p=0.03), Masaoka 병기(1기 $92.2\%$, 2기 $95.4\%$, 3기 $82.1\%$, 4기 $67.5\%$: p=0.001), WHO세포형(A-B1 $96.0\%$, B2-C $82.4\%$: p=0.001), 절제 정도(완전절제 $92.3\%$, 부분절제 및 조직검사 $72.3\%$: p=0.001)였다. 다변량 분석 결과는 WHO 세포형만이 유의한 차이(p=0.03)를 보였다. 육안적 완전 절제(R0-1 절제) 후 보조적 방사선 치료를 종양 원발 부위에만 시행 받았던 Masaoka 병기 1-3기 환자 71명 중 총 5명에서 재발이 확인되었고, 재발 부위는 늑막강 파종이 2명, 심장막강 파종 및 폐 전이 1명, 폐 전이 1명이었고, 단 1명만이 종격동 림프절 재발이었다. 모든 환자에서 방사선 조사범위 안에서 재발은 없었다. 결론 : WHO 세포형은 Masaoka 병기, 완전 절제 여부, 연령과 함께 흉선상피종 환자의 생존율에 영향을 미치는 중요한 예후인자로 확인되었다. 또한 수술 후 보조적 방사선치료는 조사범위를 종양 원발 부위에 국한하여 시행하는 것이 재발 양상 및 부작용을 고려할 때 안전하고 유효한 방법으로 판단되며, 늑막강 및 심장막강 파종에 의한 재발을 막기 위해서는 효과적인 보조적 항암화학요법에 대한 연구가 진행되어야 할 것이다.

• 대한기관식도과학회지
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• 제2권1호
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• pp.120-124
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• 1996

Nasopharyngeal angiofibroma is rare highly vascular tumor and occurs almost exclusively in adolescent boy. This tumor is histologically benign but clinically malignant because of massive bleeding, destruction of surrounding tissue, difficulty in surgical access and recurrence. Preoperative embolization is required to decrease bleeding during operation Surgical method varies according to staging of angiofibroma. Recently, we had experienced a case of angiofibroma that was resected by transmaxillary approach after preoperative embolization.

• Journal of Chest Surgery
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• 제18권3호
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• pp.513-516
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• 1985

Hemangiopericytoma is a rare tumor of vascular origin, first described by Stout and Murray in 1942. It is characterized by proliferation of capillaries surrounded by pericytes. There is no characteristic clinical or radiological finding. Wide excision is the treatment of choice. A 21 year-old man was admitted with one year history of productive cough. On admission, chest film showed large lobulated mass and Right lower lobe atelectasis. Rt. pneumonectomy was performed and the tumor was confirmed as malignant hemangiopericytoma of the lung. Local recurrence didn`t occur until now.