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1.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 104-113, 2020.
Article | WPRIM | ID: wpr-835290

Résumé

Background@#Accurate intraoperative assessment of mediastinal lymph nodes is a critical aspect of lung cancer surgery. The efficacy and potential for upstaging implicit in these dissections must therefore be revisited in the current era of uniportal video-assisted thoracoscopic surgery (VATS). @*Methods@#A retrospective study was conducted in which 544 patients with stage I (T1abc–T2a, N0, M0) primary lung cancer were analyzed. To assess risk factors for nodal upstaging and to limit any imbalance imposed by surgical choices, we constructed an inverse probability of treatment-weighted (IPTW) logistic regression model (in addition to non-weighted logistic models). We also evaluated risk factors for early locoregional recurrence using IPTW logistic regression analysis. @*Results@#In the comparison of uniportal and multiportal VATS, the resected lymph node count (14.03±8.02 vs. 14.41±7.41, respectively; p=0.48) and rate of nodal upstaging (6.5% vs. 8.7%, respectively; p=0.51) appeared similar. Predictors of nodal upstaging included tumor size (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.12–2.70), carcinoembryonic antigen level (OR, 1.11; 95% CI, 1.04–1.18), and histologically confirmed pleural invasion (OR, 3.97; 95% CI, 1.89–8.34). The risk factors for locoregional recurrence within 1 year were found to be number of resected N2 nodes, age, and nodal upstaging. @*Conclusion@#Uniportal and multiportal VATS appear similar with regard to accuracy and thoroughness, showing no significant difference in the extent of nodal dissection.

2.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 131-140, 2019.
Article Dans Anglais | WPRIM | ID: wpr-761856

Résumé

BACKGROUND: The purposes of this study were to evaluate the appropriateness of the stage migration of stage IIA non-small cell lung cancer (NSCLC) in the seventh edition of the tumor, node, and metastasis classification for lung cancer to stage IIB lung cancer in the eighth edition, and to identify prognostic factors in patients with eighth-edition stage IIB disease. METHODS: Patients with eighth-edition stage IIB disease were subclassified into those with seventh-edition stage IIA disease and those with seventh-edition stage IIB disease, and their recurrence-free survival and disease-specific survival rates were compared. Risk factors for recurrence after curative resection were identified in all included patients. RESULTS: Of 122 patients with eighth-edition stage IIB NSCLC, 101 (82.8%) had seventh-edition stage IIA disease and 21 (17.2%) had seventh-edition stage IIB disease. Nonsignificant differences were observed in the 5-year recurrence-free survival rate and the 5-year disease-specific survival rate between the patients with seventh-edition stage IIA disease and those with seventh-edition stage IIB disease. Visceral pleural invasion was a significant risk factor for recurrence in patients with eighth-edition stage IIB NSCLC. CONCLUSION: The stage migration from seventh-edition stage IIA NSCLC to eighth-edition stage IIB NSCLC was appropriate in terms of oncological outcomes. Visceral pleural invasion was the only prognostic factor in patients with eighth-edition stage IIB NSCLC.


Sujets)
Humains , Carcinome pulmonaire non à petites cellules , Classification , Tumeurs du poumon , Métastase tumorale , Stadification tumorale , Pronostic , Récidive , Facteurs de risque , Taux de survie
3.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 131-140, 2019.
Article Dans Anglais | WPRIM | ID: wpr-939222

Résumé

BACKGROUND@#The purposes of this study were to evaluate the appropriateness of the stage migration of stage IIA non-small cell lung cancer (NSCLC) in the seventh edition of the tumor, node, and metastasis classification for lung cancer to stage IIB lung cancer in the eighth edition, and to identify prognostic factors in patients with eighth-edition stage IIB disease.@*METHODS@#Patients with eighth-edition stage IIB disease were subclassified into those with seventh-edition stage IIA disease and those with seventh-edition stage IIB disease, and their recurrence-free survival and disease-specific survival rates were compared. Risk factors for recurrence after curative resection were identified in all included patients.@*RESULTS@#Of 122 patients with eighth-edition stage IIB NSCLC, 101 (82.8%) had seventh-edition stage IIA disease and 21 (17.2%) had seventh-edition stage IIB disease. Nonsignificant differences were observed in the 5-year recurrence-free survival rate and the 5-year disease-specific survival rate between the patients with seventh-edition stage IIA disease and those with seventh-edition stage IIB disease. Visceral pleural invasion was a significant risk factor for recurrence in patients with eighth-edition stage IIB NSCLC.@*CONCLUSION@#The stage migration from seventh-edition stage IIA NSCLC to eighth-edition stage IIB NSCLC was appropriate in terms of oncological outcomes. Visceral pleural invasion was the only prognostic factor in patients with eighth-edition stage IIB NSCLC.

4.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 420-424, 2019.
Article Dans Anglais | WPRIM | ID: wpr-939193

Résumé

Atypical thymic carcinoid is an extremely rare tumor with a poor prognosis. In addition to its known association with multiple endocrine neoplasia type 1, its hallmark characteristics include local invasion and early distant metastasis. In this report, we share our experience treating atypical thymic carcinoid in a patient with Zollinger-Ellison syndrome.

5.
The Korean Journal of Internal Medicine ; : 401-408, 2019.
Article Dans Anglais | WPRIM | ID: wpr-919056

Résumé

BACKGROUND/AIMS@#The outcome of local treatment for advanced non-small cell lung cancer (NSCLC) remains poor, with therapies such as induction chemotherapy (IC) yielding conflicting results. This study aimed to assess the clinicopathologic and prognostic significance of the excision repair cross-complementation group 1 (ERCC1), beclin-1, and glucose-regulated protein of molecular mass 78 (GRP78) in patients with locally advanced NSCLC receiving docetaxel-platinum IC, along with efficacy and safety.@*METHODS@#This is a retrospective observational cohort study. We reviewed medical records of 31 NSCLC patients receiving docetaxel-platinum IC, and conducted immunohistochemical staining of ERCC1, beclin-1, and GRP78.@*RESULTS@#Response rate was 67.8% with 10.7 months of median relapse-free survival (RFS) and 23.1 months of median overall survival (OS), and no treatment-related death was reported. High expression of ERCC1, beclin-1, and GRP78 was identified in 67.7%, 87.1%, and 67.7%, respectively. Expression of ERCC1 and GRP78 did not reveal statistical significance in survival, whereas high beclin-1 expression revealed longer OS (7.6 months vs. 23.2 months; log-rank p = 0.024). In multivariate analysis, histologic differentiation (hazard ratio [HR], 3.48; p < 0.001), stage (HR, 8.5; p = 0.024), and adjuvant treatment (HR, 16.1; p = 0.001) were related to RFS, and in OS, stage (HR, 5.4; p = 0.037), adjuvant treatment (HR, 8.6; p = 0.004), and beclin-1 expression (HR, 8.2; p = 0.011) were identified as significant prognostic factors.@*CONCLUSIONS@#Our findings suggest that high beclin-1 expression predicts longer survival in locally advanced NSCLC and docetaxel-platinum IC is a treatment option that deserves consideration.

6.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 420-424, 2019.
Article Dans Anglais | WPRIM | ID: wpr-786664

Résumé

Atypical thymic carcinoid is an extremely rare tumor with a poor prognosis. In addition to its known association with multiple endocrine neoplasia type 1, its hallmark characteristics include local invasion and early distant metastasis. In this report, we share our experience treating atypical thymic carcinoid in a patient with Zollinger-Ellison syndrome.


Sujets)
Humains , Tumeur carcinoïde , Néoplasie endocrinienne multiple de type 1 , Métastase tumorale , Tumeurs neuroendocrines , Pronostic , Syndrome de Zollinger-Ellison
7.
Tuberculosis and Respiratory Diseases ; : 339-346, 2018.
Article Dans Anglais | WPRIM | ID: wpr-717906

Résumé

BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard procedure to evaluate suspicious lymph node involvement of lung cancer because computed tomography (CT) and 18F-fluorodeoxyglucose positron emission tomography-CT (PET-CT) have limitations in their sensitivity and specificity. There are a number of benign causes of false positive lymph node such as anthracosis or anthracofibrosis, pneumoconiosis, old or active tuberculosis, interstitial lung disease, and other infectious conditions including pneumonia. The purpose of this study was to evaluate possible causes of false positive lymph node detected in chest CT or PET-CT. METHODS: Two hundred forty-seven patients who were initially diagnosed with lung cancer between May 2009 and December 2012, and underwent EBUS-TBNA to confirm suspicious lymph node involvement by chest CT or PET-CT were analyzed for the study. RESULTS: Of 247 cases, EBUS-TBNA confirmed malignancy in at least one lymph node in 189. The remaining 58 patients whose EBUS-TBNA results were negative were analyzed. Age ≥65, squamous cell carcinoma as the histologic type, and pneumoconiosis were related with false-positive lymph node involvement on imaging studies such as chest CT and PET-CT. CONCLUSION: These findings suggest that lung cancer staging should be done more carefully when a patient has clinically benign lymph node characteristics including older age, squamous cell carcinoma, and benign lung conditions.


Sujets)
Humains , Anthracose , Carcinome épidermoïde , Électrons , Pneumopathies interstitielles , Tumeurs du poumon , Poumon , Noeuds lymphatiques , Aiguilles , Pneumoconiose , Pneumopathie infectieuse , Sensibilité et spécificité , Thorax , Tomodensitométrie , Tuberculose
8.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 312-321, 2018.
Article Dans Anglais | WPRIM | ID: wpr-717311

Résumé

BACKGROUND: Treatment strategies for octogenarians with lung cancer remain controversial. The purpose of this study was to compare surgical outcomes and survival between octogenarians and younger patients with stage IA and IB lung cancer. METHODS: We reviewed the medical records of 34 consecutive octogenarians and 457 younger patients ( < 70 years) with stage I lung cancer who underwent surgical resection from January 2007 to December 2015. We analyzed the survival and surgical outcomes of the 2 groups according to the lung cancer stage (IA and IB). RESULTS: The only significant differences in the clinicopathological features between the groups were the higher proportion of sublobar resection (56.3% vs. 18.9%) and the smaller number of dissected lymph nodes (LNs) in octogenarians. There was no significant difference in hospital stay (11 days vs. 9 days), pneumonia (5.8% vs 1.9%), or operative mortality (0% vs 0.6%) between the 2 groups. Among patients with stage IA lung cancer, 5-year recurrence-free survival was not significantly different between the octogenarians (n=16) and younger patients (n=318) (86.2% vs. 89.1%, p=0.548). However, 5-year overall survival was significantly lower in octogenarians than in younger patients (79.4% vs. 93.4%, p=0.009). Among patients with stage IB lung cancer, there was no significant difference in 5-year recurrence-free survival (62.1% vs. 73.5%, p=0.55) or overall survival (77.0% vs 85.0%, p=0.75) between octogenarians (n=18) and younger patients (n=139). In multivariable analysis, male sex, the number of dissected LNs, and tumor size were factors related to survival (hazard ratio [HR], 5.795; p=0.017; HR, 0.346, p=0.025; and HR, 1.699; p=0.035, respectively). CONCLUSION: Surgical outcomes and survival after pulmonary resection for stage I lung cancer were comparable in octogenarians and younger patients. Continued careful selection of octogenarians for pulmonary resection is important to achieve good results.


Sujets)
Sujet âgé de 80 ans ou plus , Humains , Mâle , Carcinome pulmonaire non à petites cellules , Durée du séjour , Tumeurs du poumon , Poumon , Noeuds lymphatiques , Dossiers médicaux , Mortalité , Pneumopathie infectieuse
9.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 415-423, 2017.
Article Dans Anglais | WPRIM | ID: wpr-90003

Résumé

BACKGROUND: Recently, many surgeons have chosen sublobar resection for the curative treatment of lung tumors with ground-glass opacity, which is a hallmark of lepidic lung cancer. The purpose of this study was to evaluate the oncological results of sublobar resection for non-lepidic lung cancer in comparison with lobectomy. METHODS: We conducted a retrospective chart review of 328 patients with clinical N0 non-small cell lung cancer sized ≤2 cm who underwent curative surgical resection from January 2009 to December 2014. The patients were classified on the basis of their lesions into non-lepidic and lepidic groups. The survival rates following lobectomy and sublobar resection were compared within each of these 2 groups. RESULTS: The non-lepidic group contained a total of 191 patients. The 5-year recurrence-free survival rate was not significantly different between patients who received sublobar resection or lobectomy in the non-lepidic group (80.1% vs. 79.2%, p=0.822) or in the lepidic group (100% vs. 97.4%, p=0.283). Multivariate analysis indicated that only lymphatic invasion was a significant risk factor for recurrence in the non-lepidic group. Sublobar resection was not a risk factor for recurrence in the non-lepidic group. CONCLUSION: The oncological outcomes of sublobar resection and lobectomy in small-sized non-small cell lung cancer did not significantly differ according to histological type.


Sujets)
Humains , Carcinome pulmonaire non à petites cellules , Poumon , Tumeurs du poumon , Analyse multifactorielle , Anatomopathologie , Récidive , Études rétrospectives , Facteurs de risque , Chirurgiens , Taux de survie , Chirurgie thoracique
10.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 435-438, 2015.
Article Dans Anglais | WPRIM | ID: wpr-95465

Résumé

Gestational trophoblastic disease (GTD) is a condition of uncertain etiology, choriocarcioma, or placental-site hydatidiform moles, invasive moles, choriocarcinoma, and placental-site trophoblastic tumors. It arises from the abnormal proliferation of trophoblastic tissue and spreads beyond the uterus hematogenously. The early diagnosis of GTD is important to ensure timely and successful management and the preservation of fertility. We report the unusual case of a metastatic choriocarcinoma that formed bullae on the lung surface and presented as recurrent pneumothorax in a 38-year-old woman with elevated beta-human chorionic gonadotropin (hCG) levels. She underwent thoracoscopic wedge resection of the involved lung and four subsequent cycles of consolidation chemotherapy. No other evidence of metastatic disease or recurrent pneumothorax was noted during 22 months of follow-up. GTD should be considered in the differential diagnosis of spontaneous pneumothorax in reproductive-age women with an antecedent pregnancy and abnormal beta-hCG levels.


Sujets)
Adulte , Femelle , Humains , Grossesse , Choriocarcinome , Gonadotrophine chorionique , Chimiothérapie de consolidation , Diagnostic différentiel , Traitement médicamenteux , Diagnostic précoce , Fécondité , Études de suivi , Maladie trophoblastique gestationnelle , Môle invasive , Poumon , Métastase tumorale , Pneumothorax , Tumeur trophoblastique du site d'implantation placentaire , Trophoblastes , Utérus
11.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 335-344, 2015.
Article Dans Anglais | WPRIM | ID: wpr-81058

Résumé

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 (p2.57 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.


Sujets)
Humains , Adénocarcinome , Antigène carcinoembryonnaire , Survie sans rechute , Études de suivi , Poumon , Noeuds lymphatiques , Dossiers médicaux , Analyse multifactorielle , Traitement néoadjuvant , Anatomopathologie , Pronostic , Récidive , Sensibilité et spécificité , Fumée , Fumer
12.
Annals of Surgical Treatment and Research ; : 117-123, 2015.
Article Dans Anglais | WPRIM | ID: wpr-26228

Résumé

PURPOSE: To analyze the benefit and feasibility of this procedure compared with those of open method. METHODS: Abdominal procedure includes laparoscopic gastric mobilization, celiac axis lymph node dissection, formation of the gastric tube, and pyloromyotomy. The actual procedure performed during open surgery is the same as those of laparoscopic surgery except for the main incision. Minimally invasive esophagectomy (MIE) was performed on 54 patients with esophageal cancer. The short-term outcomes, including postoperative complications were analyzed and compared with 44 cases of open method. RESULTS: Although the total operative time was not different between 2 groups (349.8 minutes vs. 374.8 minutes, P = 0.153), the operation time of abdominal procedure was shorter in laparoscopic group (90.6 minutes vs. 162.1 minutes, P < 0.001). Operation related complications and hospital stay were not significantly different between the 2 groups. The number of transfused patients was significantly smaller in laparoscopic group (11.1% vs. 27.9%, P = 0.030). CONCLUSION: Laparoscopic gastric tubing with pyloromyotomy is a feasible and safe treatment option for patients with esophageal cancer.


Sujets)
Humains , Axis , Tumeurs de l'oesophage , Oesophagectomie , Études de faisabilité , Laparoscopie , Durée du séjour , Lymphadénectomie , Durée opératoire , Complications postopératoires , Interventions chirurgicales mini-invasives
13.
Radiation Oncology Journal ; : 147-155, 2014.
Article Dans Anglais | WPRIM | ID: wpr-209404

Résumé

PURPOSE: This study was conducted to observe the outcomes of postoperative radiotherapy (PORT) with or without concurrent chemotherapy in resected non-small cell lung cancer (NSCLC) in single institution. MATERIALS AND METHODS: From 2002 to 2013, 78 patients diagnosed with NSCLC after curative resection were treated with radiotherapy alone (RT, n = 48) or concurrent chemoradiation (CCRT, n = 30). The indications of adjuvant radiation therapy were N2 node positive (n = 31), close or involved resection margin (n = 28), or gross residual disease due to incomplete resection (n = 19). The median radiation dose was 57.6 Gy (range, 29.9 to 66 Gy). RESULTS: Median survival time was 33.7 months (range, 4.4 to 140.3 months). The 5-year overall survival (OS) rate was 49.5% (RT 46% vs. CCRT 55.2%; p = 0.731). The 3-year disease-free survival rate was 45.5% (RT 39.4% vs. CCRT 55.3%; p = 0.130). The 3-year local control rate was 68.1% (RT 64.4% vs. CCRT 77.7%; p = 0.165). The 3-year DMFS rate was 56.1% (RT 52.6% vs. CCRT 61.7%; p = 0.314). In multivariate analysis, age > or =66 years and pathologic stage III were significant poor prognostic factors for OS. Treatment failure occurred in 40 patients. Four patients had radiologically confirmed grade 3 radiation pneumonitis. CONCLUSION: In NSCLC, adjuvant RT or CCRT after curative surgery is a safe and feasible modality of treatment. OS gain was seen in patients less than 66 years. Postoperative CCRT showed a propensity of achieving better local control and improved disease-free survival compared to RT alone according to our data.


Sujets)
Humains , Carcinome pulmonaire non à petites cellules , Chimioradiothérapie , Survie sans rechute , Traitement médicamenteux , Analyse multifactorielle , Poumon radique , Radiothérapie , Échec thérapeutique
14.
Journal of Minimally Invasive Surgery ; : 21-25, 2014.
Article Dans Anglais | WPRIM | ID: wpr-65828

Résumé

PURPOSE: We report on a novel method and outcomes of laparoscopic gastric tubing with pyloromyotomy. METHODS: The abdominal procedure includes laparoscopic gastric mobilization, celiac axis lymph node dissection, formation of the gastric tube, and pyloromyotomy. Between January 2009 and April 2013, our minimally invasive esophagectomy (MIE) was performed on 54 patients with esophageal cancer. The short-term outcomes, including postoperative complications, were analyzed. RESULTS: There were no cases of conversion to open surgery. Of 54 patients, 52 patients had squamous cell carcinoma (SCC) and two had adenocarcinoma. The total operative time was 349.8+/-77.4 minutes, of which 90.6+/-27.6 minutes was required for the abdominal procedure. The mean estimated operative blood loss during the abdominal procedure was 40.0+/-355.5 ml. The postoperative complication rate was 24.1%; three patients died of pneumonia. CONCLUSION: Laparoscopic gastric tubing with pyloromyotomy is a feasible and safe treatm ent option for patients with esophageal cancer.


Sujets)
Humains , Adénocarcinome , Axis , Carcinome épidermoïde , Conversion en chirurgie ouverte , Tumeurs de l'oesophage , Oesophagectomie , Laparoscopie , Lymphadénectomie , Durée opératoire , Pneumopathie infectieuse , Complications postopératoires
15.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 494-496, 2014.
Article Dans Anglais | WPRIM | ID: wpr-45095

Résumé

The granular cell tumor (GCT) occurs extremely rarely in the mediastinum. Few mediastinal GCT cases have been reported in Japan or other countries. Here, we report a case of a 24-year-old man with superior mediastinal GCT. The mass was located just above the aortic arch. It was firm, oval in shape, and well encapsulated. The tumor was removed completely with video-assisted thoracoscopic surgery, but we had to resect the vagus nerve, which was already included in the tumor, along with the tumor. After the operation, the patient recovered without any specific complications except for a mild degree of hoarseness.


Sujets)
Humains , Jeune adulte , Aorte thoracique , Tumeur à cellules granuleuses , Enrouement , Japon , Médiastin , Chirurgie thoracique vidéoassistée , Nerf vague
16.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 51-54, 2014.
Article Dans Anglais | WPRIM | ID: wpr-29890

Résumé

Primary tumors of the lung are uncommon in pediatric patients, particularly bronchioloalveolar carcinoma (BAC). An 11-year-old female suffering from back pain for 1 month was referred to Seoul St. Mary's Hospital for treatment of a pathologic fracture of the lumbar spine. Comprehensive evaluation disclosed numerous pulmonary metastases of rhabdomyosarcoma (stage IV). During chemotherapy, most of the lung lesions regressed, with the exception of two nodules. Wedge resections, intended for diagnosis and cure, yielded a histologic diagnosis of BAC.


Sujets)
Enfant , Femelle , Humains , Adénocarcinome bronchioloalvéolaire , Dorsalgie , Diagnostic , Traitement médicamenteux , Fractures spontanées , Poumon , Tumeurs du poumon , Métastase tumorale , Rhabdomyosarcome , Séoul , Rachis
17.
Journal of the Korean Surgical Society ; : 393-396, 2012.
Article Dans Anglais | WPRIM | ID: wpr-209285

Résumé

We experienced a case of wide necrosis of the cervical gastric conduit during esophageal cancer surgery. We attempted to repair this defect with various methods including conservative care, stents two times, and sternocleidomastoid muscle flap without successful results. Finally, we were able to reconstruct the gastric conduit defect with rotational pectoralis major musculocutaneous (PMM) flap. PMM flap is thought to be a reconstruction method applicable to the intractable gastric conduit defect.


Sujets)
Tumeurs de l'oesophage , Muscles , Nécrose , Endoprothèses
18.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 53-55, 2012.
Article Dans Anglais | WPRIM | ID: wpr-28666

Résumé

We report a very rare case of surgery on gastric conduit cancer. A 67-year-old male patient underwent esophagectomy and intrathoracic esophagogastrostomy for squamous cell carcinoma of the lower thoracic esophagus 27 months ago. Upon follow-up, a gastric carcinoma at the intra-abdominal part of the gastric conduit was found on an esophagogastroduodenoscopy. We performed total gastrectomy and esophagocolonojejunostomy in the manner of Roux-en-Y anastomosis. The postoperative course was not eventful and an esophagogram on the 10th postoperative day showed no leakage or stenosis of the passage. The patient was discharged on the 17th day with no complications.


Sujets)
Sujet âgé , Humains , Mâle , Anastomose de Roux-en-Y , Carcinome épidermoïde , Sténose pathologique , Endoscopie digestive , Tumeurs de l'oesophage , Oesophagectomie , Oesophage , Études de suivi , Gastrectomie
19.
Cancer Research and Treatment ; : 217-224, 2011.
Article Dans Anglais | WPRIM | ID: wpr-34651

Résumé

PURPOSE: This study aimed to analyze the efficacy and toxicity of gemcitabine plus platinum chemotherapy for patients aged 70 years or older with advanced non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: We reviewed the records of stage IIIB, IV NSCLC patients or surgically inoperable stage II, IIIA NSCLC patients who were aged 70 years or older when treated with gemcitabine (1,250 mg/m2) plus cisplatin (75 mg/m2) or carboplatin (AUC5) chemotherapy from 2001 to 2010 at Seoul St. Mary's Hospital, Uijeongbu St. Mary's Hospital and St. Vincent's Hospital. Gemcitabine was administered on days 1 and 8, and cisplatin or carboplatin was administered on day 1. Treatments were repeated every 3 weeks for a maximum of 4 cycles. RESULTS: The median age of the 62 patients was 73.5 years (range, 70 to 84 years). Forty-one (66%) patients exhibited comorbidity. The mean number of treatment cycles was 3.9. The compared average relative dose intensity of gemcitabine plus platinum chemotherapy was 84.8%. The median progression-free survival and overall survival (OS) were 5.0 months and 9.4 months, respectively. Reduced Eastern Cooperative Oncology Group (ECOG) performance status (none vs. > or =1) and weight loss ( or =5%) after treatment were found to have a significant effect on OS (p=0.01). CONCLUSION: Gemcitabine plus platinum chemotherapy is an effective treatment option with an acceptable level of toxicity in patients aged 70 years or older with good performance status in advanced NSCLC.


Sujets)
Sujet âgé , Humains , Carboplatine , Carcinome pulmonaire non à petites cellules , Cisplatine , Comorbidité , Désoxycytidine , Survie sans rechute , Association de médicaments , Poumon , Tumeurs du poumon , Platine , Études rétrospectives , Perte de poids
20.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 448-451, 2011.
Article Dans Anglais | WPRIM | ID: wpr-19759

Résumé

Microscopic polyangiitis (MPA) is a necrotizing vasculitis involving the small vessels without granulomatous inflammation. Most MPA initially presents with renal involvement without pulmonary involvement. Isolated and initially presenting alveolar hemorrhage is very rare. The patient was a 39-year-old female with a progressive cough, dyspnea, and blood-tinged sputum for the previous 5 days. We determined that her condition was MPA though VATS lung biopsy and renal biopsy. After 2 months of steroid therapy, the chest lesions had improved. We report here a rare case of MPA with isolated and initial involvement of the lung with a review of the literature.


Sujets)
Adulte , Femelle , Humains , Biopsie , Toux , Dyspnée , Hémoptysie , Hémorragie , Inflammation , Poumon , Polyangéite microscopique , Expectoration , Chirurgie thoracique vidéoassistée , Thorax , Maladies vasculaires , Vascularite
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