Korean journal of clinical oncology最新文献

{"title":"Suspicious T1 colon cancer with synchronous liver metastasis not detected by preoperative imaging study","authors":"C. Park, So Hyang Moon, H. Lee, S. Bae, W. Jeong, S. Baek","doi":"10.14216/kjco.19024","DOIUrl":"https://doi.org/10.14216/kjco.19024","url":null,"abstract":"Colorectal carcinoma invading the submucosa but not the muscularis propria (pT1) represents the earliest form of clinically relevant colorectal cancer in most patients. T1 colorectal cancer with synchronous liver metastasis is considered to be rare. We report a rare case of T1 colon cancer with synchronous liver metastasis not detected by preoperative imaging study. A 54-year-old male patient presented to our department for treatment of sigmoid colon cancer following an endoscopic submucosal dissection. Histopathological examination revealed the pedunculated mass was moderately differentiated adenocarcinoma without lymphovascular invasion and the depth of submucosal invasion was 2,000 μm, the resection margin was not involved. We performed a laparoscopic anterior resection with lymph node dissection. After the 3 months, the patient’s carcinoembryonic antigen level elevated from 1.4 to 7.26 ng/mL (normal level: <1.5 ng/mL) and the abdominal computed tomography and FDG-PET/CT (positron emission tomography-computed tomography) showed multiple hepatic metastases in both hepatic lobes (SUV-max: 5.6) without evidence of local recurrence or lymphadenopathy. We strongly suspected a synchronous liver metastasis not detected by imaging study as opposed to a systemic recurrence. Therefore, evaluation and follow-up protocol of T1 colorectal cancer should be changed for discovery and prediction of synchronous liver metastasis; because we cannot exclude the possibility of synchronous liver metastasis.","PeriodicalId":74045,"journal":{"name":"Korean journal of clinical oncology","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80810901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of subtotal or total colectomy with primary anastomosis compared to Hartmann procedure for left-sided colon cancer obstruction or perforation","authors":"Eun-Do Kim, Jinkwon Lee, Jin-Kyu Cho, Jae-Myung Kim, Ji-Ho Park, Ju-Yeon Kim, Sangho Jeong, Young-Tae Ju, C. Jeong, E. Jung, Young-Joon Lee, Soon-Chan Hong, Seung-Jin Kwag","doi":"10.14216/kjco.19019","DOIUrl":"https://doi.org/10.14216/kjco.19019","url":null,"abstract":"Approximately one-third of patients with colon cancer present to an emergency room because of obstruction or perforation. They have high postoperative mortality and poor survival [1]. Acute obstruction of the colon is an early symptom in 7%–29% of colorectal cancer patients. It often leads to emergency surgery. Acute symptoms are more common in advanced disease and elderly patients. Tumor-related left-sided colon obstruction is particularly difficult for surgery due to the risk of perforation in the enlarged colon near the tumor. Emergency surgery due to malignant obstruction of the left-sided colon is associated with frequent complications and poor survival [2]. Colon perforation is a life-threatening condition. If severe peritonitis occurs after colon perforation, emergency surgery is needed [3]. In the past, Hartmann procedure (HP) was recommended because it could prevent intra-abdominal sepsis associated with anastomotic dehiscence. However, subtotal or total colectomy with Original Article Korean Journal of Clinical Oncology 2019;15:106-111 https://doi.org/10.14216/kjco.19019 pISSN 1738-8082 ∙ eISSN 2288-4084","PeriodicalId":74045,"journal":{"name":"Korean journal of clinical oncology","volume":"61 1","pages":"106-111"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75792717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occult papillary thyroid carcinoma presenting with cervical neck lymph node metastasis","authors":"S. Han, S. Hong, Jong Eun Lee, Sungyong Kim, M. Baek","doi":"10.14216/kjco.19023","DOIUrl":"https://doi.org/10.14216/kjco.19023","url":null,"abstract":"Papillary thyroid cancer accounts for most cases of thyroid cancer. Although the prognosis is usually good, it often causes cervical neck lymph node metastasis. Cervical neck lymph node metastases have been reported even in the absence of a primary tumor in the thyroid glands, and these cases are referred to as occult thyroid cancer (OTC). The McGraw-Hill Concise Dictionary of Modern Medicine defines OTC as “unknown primary malignancy that is symptomless, which first manifests itself as metastases or secondary-paraneoplastic phenomena” [1]. Although the frequency of OTC has decreased owing to developments in cervical ultrasonography and improved accuracy of histological tests [2], rare cases are still reported. Due to the decreased frequency of OTC, a benign cervical neck lymph node mass is sometimes diagnosed, which can result in delays to more accurate diagnoses and appropriate treatment. Therefore, we report a case of OTC identified in a 74year-old male patient.","PeriodicalId":74045,"journal":{"name":"Korean journal of clinical oncology","volume":"2 1","pages":"132-134"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84722951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for atypical lymph node metastasis in gastric cancer","authors":"Ji-Woong Jung, Sang Il Yoon, Kanghaeng Lee, Yongjoon Won, Sahong Min, Young-Suk Park, Sang-Hoon Ahn, D. Park, Hyung-Ho Kim","doi":"10.14216/kjco.19018","DOIUrl":"https://doi.org/10.14216/kjco.19018","url":null,"abstract":"Lymph node (LN) metastasis is very important for the prognosis of gastric cancer, and topics surrounding the amount of LN dissection during surgery remain controversial. Nodal metastasis of gastric cancer cells is relatively more aggressive than other cancers and removal is necessary even for micrometastasis nodes [1]. Currently, D2 dissection is accepted as the gold standard of gastric cancer treatment. However, D1 dissection is also performed in early gastric cancer (EGC) without LN metastasis in Korea and Japan [2,3]. Endoscopic mucosal resection, endoscopic submucosal dissection, and sentinel node navigation surgery (SNNS) have been attempted to preserve gastric function and improve quality of life according to the recent minimal invasive tendency [4-8]. Gastric cancer has a relatively complex multidirectional lymphatic flow, and the rate of skip metastasis is not low, making it difficult to apply SNNS in the treatment of gastric cancer [9-11]. Therefore, if risk factors related to the possibility of atypical LN metastasis, such as skip metastasis, are identified, it is helpful to set an indication of minimally invasive surgery. To date, skip metastases have been studied several times; however, to the best of our knowledge, studies on transversal metastases are rare [12,13]. There were also only a few studies on atypical LN metastasis in advanced gastric cancer (AGC). The purpose of this study was to determine the distribution of atypical LN metastasis according to tumor location and depth. Original Article Korean Journal of Clinical Oncology 2019;15:100-105 https://doi.org/10.14216/kjco.19018 pISSN 1738-8082 ∙ eISSN 2288-4084","PeriodicalId":74045,"journal":{"name":"Korean journal of clinical oncology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81795954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative developed intra-abdominal desmoid tumor after surgical resection of gastrointestinal malignancy: A review of 10 cases","authors":"A. Sakr, Jong Min Lee, H. Alawfi, M. Alessa, N. Kim","doi":"10.14216/kjco.19016","DOIUrl":"https://doi.org/10.14216/kjco.19016","url":null,"abstract":"Desmoid tumors (fibromatosis), are rare locally aggressive tumors with less liability of metastasis. They have a high rate of recurrence even after complete excision. In patients with familial adenomatous polyposis (FAP; Gardner syndrome), desmoid tumors tend to be more aggressive and may result in vital organs destruction and can be fatal. They account for around 0.03% of all neoplasms. The incidence is 2–4 million population per year [1]. The age of presentation is between 15 and 60 with more females’ predilection [2]. Desmoid tumor occurs more frequently in FAP patients than other population with the majority of tumors being intra-abdomiOriginal Article Korean Journal of Clinical Oncology 2019;15:86-92 https://doi.org/10.14216/kjco.19016 pISSN 1738-8082 ∙ eISSN 2288-4084","PeriodicalId":74045,"journal":{"name":"Korean journal of clinical oncology","volume":"16 1","pages":"86-92"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87927502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of 18F-fluorodeoxyglucose positron emission tomography and carbohydrate antigen 19-9 in patients with periampullary tumors","authors":"H. Jung","doi":"10.14216/kjco.19009","DOIUrl":"https://doi.org/10.14216/kjco.19009","url":null,"abstract":"47 Periampullary tumors include neoplastic lesions of the pancreatic head, the ampulla of Vater, the duodenum, and the distal common bile duct. Although of different origins, these neoplasms are treated the same, with pancreaticoduodenectomy. Early and accurate diagnosis is extremely important to both the overall survival and the quality of life of patients with periampullary malignant tumors [1]. Unfortunately, until now, there has been no ideal imaging modality for the diagnosis of periampullary lesions. Since it is difficult to use biopsies to confirm the diagnosis because of the anatomical location of the tumors, many noninvasive tests, such as ultrasound, computed tomography (CT), and magnetic resonance imaging, have become important in diagnosing periampullary tumors. Even though there are some diagnostic inaccuracies in these noninvasive tests, invasive procedures, such as endoscopic retrograde cholangiopancreatography or endoscopic ultrasound, also carry risks of complications, such as bleeding, perforation, and the spreading of tumors [2]. Several studies have reported the clinical utility of carbohydrate antigen 19-9 (CA19-9) levels and positron emission tomography-CT (PET/CT) in the diagnosis and management of periampullary tumors [3,4]. Serum CA19-9 is an extensively studied and validated biomarker of pancreatic cancer that has also been used for the diagnosis and surveillance of periampullary tumors. It has well-known roles in predicting prognosis, overall survival, response to chemotherapy, and postoperative recurrence [3,5-7]. 18F-fluorodeoxyglucose PET/CT (FDG-PET/CT) is a metabolic imaging system based on glucose uptake capacity [3,6-8]. The accumulation of FDG reflects the rate of carbohydrate metabolism, which is an index of the metabolic activity of the cells. Carbohydrate metabolism is more active in malignant cells, resulting in a significant accumulation of FDG [6]. This examination has been well investigated in the field of esophageal, rectal, and some other cancers for detecting residual, viable cancer after anticancer treatment [5]. The maximum standardized uptake value (SUVmax marker of tumor glucose metabolism detected by [18F]) is a FDGPET/CT value. The SUVmax reflects tumor aggressiveness and is an independent prognostic factor in pancreatic cancer. The evaluation of SUVmax offers an advanced method of detecting small solid lesions, based on the focal uptake of FDG-labeled glucose in malignant tumor cell populations [3,7]. The authors aimed to determine the preoperative predictive value of the FDG-PET and CA19-9 diagnostic tools for periampullary tumors [9]. They found that elevated CA19-9 levels and the SUVmax of PET/CT were associated with malignancy in periampullary tumors. And thus, normal CA19-9 and no uptake of FDGPET were correlated with benign lesions. However, there were some limitations to this study due to the small numbers of benign lesions (n = 17) and the heterogenicity of the periampullary tumors, in w","PeriodicalId":74045,"journal":{"name":"Korean journal of clinical oncology","volume":"54 1","pages":"47-48"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84838359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mucinous carcinoma is a predictive factor for the risk of open conversion from laparoscopic colectomy in colorectal cancer","authors":"Ah Jung Seo, J. Shin, Y. Park, J. Huh, Y. Cho, H. Kim, S. Yun, W. Lee","doi":"10.14216/kjco.19014","DOIUrl":"https://doi.org/10.14216/kjco.19014","url":null,"abstract":"laparoscopic is widely in the of colorectal conversion to open surgery is associated with the rate of unfavorable outcomes. The aim of this study was to determine the factors associated with open conversion from laparoscopic surgery for colorectal cancer. Methods: A total of 3,002 patients who underwent laparoscopic colectomy as an initial plan for the treatment of colorectal cancer located from the sigmoid colon to the rectum were retrospectively evaluated between January 2009 and December 2018 at Samsung Medical Center in Korea. Risk factors significantly associated with open conversion were determined using univariate and multivariate regression models. Results: Among the 3,002 patients, open conversion was performed in 120 patients (4%). Age >60 years (adjusted odds ratio [AOR], 2.370), preoperative bowel obstruction (AOR, 2.348), clinical T4 stage (AOR, 2.201), and serum carcinoembryonic antigen level >5 ng/mL (AOR, 2.289) were significantly associated with open conversion. Moreover, mucinous carcinoma was a significantly more frequent histopathologic type than adenocarcinoma (10.0% vs. 3.2%, P<0.001) in the open conversion group with an AOR of 2.549 (confidence interval, 1.259–5.159; P=0.009). Conclusion: The present study presented a novel finding, i.e. mucinous carcinoma as the histopathologic type could be an independent predictive factor for conversion from laparoscopic colectomy to open surgery. Identifying patients with mucinous carcinoma will help stratify the risk of open conversion preoperatively.","PeriodicalId":74045,"journal":{"name":"Korean journal of clinical oncology","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84390989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic resection for isolated stomach cancer liver metastases: A single-center experience","authors":"Hyunyou Kim, H. Seo","doi":"10.14216/kjco.19013","DOIUrl":"https://doi.org/10.14216/kjco.19013","url":null,"abstract":"Stomach cancer is the second most common cause of cancer related death worldwide. The liver is the major site of metastases in 9%–40% of cases, though the metastatic pattern in most cases is diffuse, involving both the peritoneum and distant lymph nodes [1-4]. In contrast to the well-described guidelines for hepatic resection of colorectal cancer and neuroendocrine liver metastases, surgical resection of stomach cancer liver metastases (SCLMs) is only considered in a select few patients. Treatment for SCLM is mainly based on the physician’s experience because of the limited clinical benefit of hepatic resection. In general, surgical resection is not commonly performed in patients with hepatic metastases from gastric cancers, because of poor long-term outcomes. However, recent studies suggest that hepatic resection for SCLM showed improved outcomes in select patients, with a 5-year survival ranging from 23% to 42% [3-6]. Yet, the effectiveness of liver resection in the treatment of SCLM is still controversial. The aim of this paper was to review the outcomes of select patients with SCLM after hepatic resection at a single center.","PeriodicalId":74045,"journal":{"name":"Korean journal of clinical oncology","volume":"102 1","pages":"68-71"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78160515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic delay and treatment outcome of Clostridium difficile infection in the patients who underwent rectal surgery","authors":"Jaram Lee, Seung-Seop Yeom, Soo-Young Lee, C. Kim, Hyeong-Rok Kim, Y. J. Kim","doi":"10.14216/KJCO.19007","DOIUrl":"https://doi.org/10.14216/KJCO.19007","url":null,"abstract":"Purpose: The bowel frequency of patients who had undergone rectal resection might be difficult to distinguish from the diarrhea of Clostridium difficile infection (CDI). The change of bowel movement following rectal surgery has been a challenge for the diagnosis of CDI and scarce studies discussed this diagnostic difficulty. Methods: a total of 8,327 patients in a single colorectal was evaluated for CDI, and their medical records were ret rospectively reviewed. Bowel frequency and treatment outcomes were compared between the rectal resection group (RG) and colectomy group (CG). Diagnostic time was defined as the time interval between first diarrhea (more than three times a day) and pathologic confirmation date of CDI. Results: CDI incidence was 2.3% (17/752) vs. 0.41% (31/7,575) between RG and CG (P<0.001). RG had frequent bowel movements than CG (RG: 13.56±6.16/day vs. CG: 8.39±6.23/day; P=0.010), but the interval between the time of symptom and the time of CDI diagnosis was longer in the RG than in CG (RG: 1.38±3.34 days vs. CG: 0.39±1.16 days). A total of three mortalities has been occurred (RG: 2 vs. CG: 1), and the reasons were delayed diagnosis and omitted treatment. Conclusion: Patients experienced significant bowel frequency after rectal surgery than after colectomy, and the delayed diagnosis was associated with mortality. Active surveillance for CDI should be performed for the patients who underwent rectal surgery to prevent morbidity and mortality from delayed diagnosis of CDI, but sophisticated guideline also should be evaluated to reduce over-examinations.","PeriodicalId":74045,"journal":{"name":"Korean journal of clinical oncology","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79287517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study of Watson for Oncology and tumor boards in breast cancer treatment","authors":"Do-Hoon Kim, Y. Kim, Joon-Hyop Lee, Y. Chung, S. Choi, J. Kang, H. Park, Y. Chun","doi":"10.14216/KJCO.19002","DOIUrl":"https://doi.org/10.14216/KJCO.19002","url":null,"abstract":"The treatment methods for breast cancer are evolving rapidly. New therapies such as radiation therapy, chemotherapy, and endocrine therapy, have been developed with the improvements in science and technology, and now molecular genetic methods have been developed to greatly affect the treatment and prognosis of breast cancer. As of October 2017, there were 69 drugs approved by the Food and Drug Administration for breast cancer treatment [1]. In a situation where technology in various fields is developed [2], the guidelines for the diagnosis and treatment of breast cancer and the development of treatment plans are improving at an accelerating rate [3]. Therefore, it is necessary to choose a treatment that suits the individual characteristics of a patient, but there are too many factors for a physician to synthesize and determine the knowledge in all fields. Clinical decision-support systems can be a great solution to Original Article Korean Journal of Clinical Oncology 2019;15:3-6 https://doi.org/10.14216/kjco.19002 pISSN 1738-8082 ∙ eISSN 2288-4084","PeriodicalId":74045,"journal":{"name":"Korean journal of clinical oncology","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81195666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}