The Discriminating Ability of a Prognosis According to the TNM, Okuda, CLIP, JIS, and BCLC Staging Systems for Hepatocellular Carcinoma

PURPOSE: There is yet no ideal single staging system for hepatocellular carcinoma (HCC). The aim of this study was to analyze HCC survival times according to the TNM, Okuda, CLIP, JIS, and BCLC staging systems and their prognostic discrimination ability. METHODS: A retrospective analysis of medical records and statistical data from the Korean statistical information service was done for HCC patients diagnosed at Bundang CHA hospital between June, 1992 and February, 2009. RESULTS: During follow-up, 121 (72%) of 168 people died and 1, 3 and 5 year overall survival rates were, respectively, 58%, 35% and 25%. In the analysis of discriminative ability of each staging system, the CLIP staging system showed the highest LR chi-square value, and the lowest AIC value (p<0.05). Therefore, the CLIP staging system appears to be superior to the other systems. CONCLUSION: Of the 5 staging systems in this study, the CLIP staging system was superior to the other systems, but the results of many other studies from different countries have varied. It is necessary to establish the staging system suitable for each country's actual circumstances.

A case of leiomyosarcoma arising from the posterior mediastinum / 대한내과학회지

Primary mediastinal leiomyosarcoma is an extremely rare neoplasm that arises from smooth muscle, usually in the esophagus or main vessels, but rarely from small vessels in the soft tissues of the mediastinum. The clinical findings depend mostly on its size and the subsequent compression of neighboring structures. The treatment of choice is surgical removal. We report the case of a 78-year-old female who presented with esophageal compression symptoms due to a 9-cm inhomogeneous mass in the posterior mediastinum. A computed tomography (CT)-guided gun biopsy and immunohistochemistry established the pathological diagnosis of leiomyosarcoma with a high grade of malignancy. Surgery was performed because of local invasion involving the aorta and diaphragm. The literature is reviewed and the pathology discussed

Incidence of Proximal Colon Adenoma According to Distal Colon Adenoma Characteristics / 대한소화기내시경학회지

BACKGROUND/AIMS: The aim of this study was to examine the incidence of proximal colon adenoma according to characteristics of distal colon adenoma. METHODS: Ninety-two colon adenoma patients who underwent total colonoscopy and endoscopic polypectomy were analyzed retrospectively. Adenoma was classified as proximal when located in proximal to splenic flexure. The advanced adenoma was defined as an adenoma larger than 10 mm or any size with a villous component or severe dysplasia. RESULTS: The incidence of proximal adenoma was increased significantly in those with old age (odds ratio (OR)=3.3), villous (OR=5.3) or dysplastic histology (OR=8.1) or the presence of advanced distal adenoma (OR=3.4). However, the incidence of advanced proximal adenoma was increased only in those with old age (OR=11.2). Nineteen in thirty-nine (48.7%) patients with proximal colon adenoma did not have distal colon adenoma. CONCLUSIONS: Various characteristics of distal colon adenoma couldn't exactly predict the presence of synchronous proximal adenoma and a greater percentage of subjects with proximal adenoma didn't have distal adenoma. So, colonoscopy could be a standard method for colon cancer screening in Korea.