한국 소아 고환종양 등록현황: 1997-2001

대한소아비뇨기과학회,이상돈,김경도 대한비뇨의학회 2004 Investigative and Clinical Urology Vol.45 No.6

The rare incidence of pediatric testicular tumors makes it difficult for any single institution to gain enough information about the tumor’s biological behavior. To date, there are no multi-institutional reports on pediatric testicular tumors in Korea. Our study was undertaken to obtain the valuable demographic data for the better understanding of the biological behavior and optimal management for these tumors. Materials and Methods: A pediatric testicular tumor registry form was mailed to all 87 hospitals registered in the Korean Urology Association. 249 medical records that were five years old were retrospectively reviewed, with the exception of 15 which had no histopathologic records. Results: According to the 249 patients who were enrolled in this registry, the incidence was 0.65 per 100,000 children. The distribution of age ranged from 1 to 240 months (mean 57.6). Most of the patients were diagnosed with a scrotal mass before the age of 4. Serum AFP and β-hCG increased to as much as 64.1% (92.9% in yolk sac tumor, 32.9% in teratoma) and 13.1% (5.3% in yolk sac tumor, 5.0% in teratoma) of patients, respectively. Preoperative diagnosis was featured as malignant tumors (67.9%), benign tumors (20.9%), and hydrocele (5.2%). Germ cell tumors were the most common (88.7%) mainly with either the yolk sac tumor (41.8%) or teratoma (35.7%). Primary management was as follows: radical (96%), simple (3.6%), and partial orchiectomy (0.4%). Management after surgery included: 64.3% surveillance, 12.4% chemotherapy, 4% combination therapy, and 19.3% other methods. The metastasis rate, as a whole, was 16.8% (18.3% in yolk sac tumor, 2.2% in teratoma). The final results of the treatment were as follows: complete remission (63.9%), incomplete remission (4.4%), no response or disease progression (1.2%), and unknown (30.5%). Outcomes at the last follow up (mean of 24.5 months) were 75.9% alive, 0.8% deceased, and 23.3% unknown status. Conclusions: The demographic data of pediatric testicular tumors in Korea will lead to a better understanding of these rare tumors and to the development of an optimal therapy for these children. (Korean J Urol 2004;45:563-572)

국내 20세 이하 연령에서의 신종양 등록현황: 1997-2001

대한소아비뇨기과학회,이상돈,김경도 대한비뇨의학회 2004 Investigative and Clinical Urology Vol.45 No.4

Purpose: To date, there has been no multi-institutional report on pediatric renal tumors in Korea. Our study was undertaken to obtain valuable demographic data for a better understanding of the biological behavior and optimal management for these tumors in patients under the age of 20 years. Materials and Methods: The testicular tumor registry form was mailed to all 87 hospitals registered in the Korean Urology Association. The five-year medical records at each hospital were retrospectively reviewed, which included age, presentation, evaluation, treatment and outcome. Results: 240 patients(0.1-19.7 years; ave. 3.6) were enrolled in this registry; the incidence of renal tumors was 0.33 per 100,000 population under the age of 20 years. Most patients were diagnosed with an abdominal mass before the age of 4 years. The pathological diagnoses were malignant and benign tumors in 90.4 and 9.6%, respectively. A Wilms' tumor was the most common(77.9%) malignant tumor, with a multilocular cystic nephroma(4.2%) in the most common benign tumor. 20.2% of patients were accompanied by other diseases, such as hypertension, hemihypertrophy, cryptorchidism and aniridia. The managements were as follows: surgery (16.3%), chemotherapy and/or radiotherapy after surgery(61.6%), surgery after biopsy and chemotherapy(18.7%) and others(12.5%). The results of treatment included; complete or incomplete remission(72.5%), no response or aggravation(9.6%) and unknown(16.7%). The overall metastasis rate was 24.7%. The outcomes at the last follow up(ave. 33.2 mos.) were alive, dead and unknown due to follow up loss, in 72.1, 6.7 and 21.2%, respectively. Conclusions: These demographic data and biological behaviors for renal tumors in Korea under the age of 20 years will lead to a better understanding of these rare tumors and to the optimal therapy for these young peoples. (Korean J Urol 2004;45:315-323)

소아 수신증에 대한 한국 비뇨기과 봉직의의 진료의식 조사

백민기,손동완,오경진,이택,장혁수,한상원,이상돈,대한소아비뇨기과학회 대한비뇨의학회 2009 Investigative and Clinical Urology Vol.50 No.12

Purpose: To evaluate practice patterns for pediatric hydronephrosis of Korean urologists practicing at secondary or university hospitals.Materials and Methods: The subjects were asked to complete questionnaires sent by postal mail or e-mail that explored practicing diagnostic and therapeutic strategies in the management of pediatric hydronephrosis and ureteropelvic junction obstruction. The questionnaires of those responding were analyzed according to whether the respondent practiced at a secondary or university hospital, how long they had been urologists, and whether they specialized in pediatric urology or other specific field of urology.Results: Of the 354 questionnaires sent, 97 were returned (response rate 27.4%). Voiding cystourethrography was not routinely recommended by 95.7% of respondents, and diuretic renal scanning was considered necessary for postnatal evaluation of prenatal hydronephrosis by 78.5%. In addition, 72.2% of these doctors did not routinely recommend antibiotic prophylaxis. Follow-up ultrasonography was recommended at 3 to 6 months (61.1%), and follow-up diuretic renal scanning was recommended at 3 to 6 months (38.6%) or 6 to 12 months (32.7%). The reported length of time it took to deem an operation as a success was 3 to 6 months (49.5% and 60.7%) and within 3 months (34.1% and 19.1%) by ultrasonography and diuretic renal scanning, respectively.Conclusions: This survey documented a certain degree of variability among Korean urologists concerning standard practices of the assessment, follow-up, and treatment for pediatric hydronephrosis. Results from this survey might contribute useful data for establishing proper guidelines for the management of pediatric hydronephrosis.

잠복고환증에 대한 국내 비뇨기과 전문의의 인식도와 진료 형태

이상욱,김건석,장혁수,류동수,대한소아비뇨기과학회 대한비뇨의학회 2009 Investigative and Clinical Urology Vol.50 No.2

Purpose: We evaluated the practice patterns of urologists in Korea regarding the diagnosis and management of cryptorchidism. Materials and Methods: Self-completed questionnaires that consisted of 15 items concerning the diagnosis and treatment of cryptorchidism were distributed via letters or e-mail to 167 urologists who practiced in training hospitals in Korea. Responses were collected and analyzed statistically. Results: Responses were received from 89 urologists (response rate was 53.5%). Most of the urologists (96%) recommended that cryptorchidism be treated at the age of 1 year or before. In the case of postpubertal cryptorchidism, 72% of Korean urologists preferred orchiopexy first because of cosmesis (42%) and early detection of testicular cancer (38%). Sixty-five percent of all urologists preferred surgical correction of a retractile testis at the time of diagnosis or when the condition persisted until school age or puberty. Pediatric urologists were more conservative in terms of management of a retractile testis than were general urologists (p=0.009). To detect hidden testes in nonpalpable cryptorchidism, most urologists (92%) performed imaging studies, whereas only 39% of urologists performed laparoscopy. Conclusions: Korean urologists who practice in the training hospitals have a high level of understanding of the management of cryptorchidism. However, some differences of opinion exist in the diagnosis and treatment of nonpalpable undescended testis and retractile testis. These results can be used as baseline data for establishing future diagnosis and treatment guidelines for cryptorchidism. Purpose: We evaluated the practice patterns of urologists in Korea regarding the diagnosis and management of cryptorchidism. Materials and Methods: Self-completed questionnaires that consisted of 15 items concerning the diagnosis and treatment of cryptorchidism were distributed via letters or e-mail to 167 urologists who practiced in training hospitals in Korea. Responses were collected and analyzed statistically. Results: Responses were received from 89 urologists (response rate was 53.5%). Most of the urologists (96%) recommended that cryptorchidism be treated at the age of 1 year or before. In the case of postpubertal cryptorchidism, 72% of Korean urologists preferred orchiopexy first because of cosmesis (42%) and early detection of testicular cancer (38%). Sixty-five percent of all urologists preferred surgical correction of a retractile testis at the time of diagnosis or when the condition persisted until school age or puberty. Pediatric urologists were more conservative in terms of management of a retractile testis than were general urologists (p=0.009). To detect hidden testes in nonpalpable cryptorchidism, most urologists (92%) performed imaging studies, whereas only 39% of urologists performed laparoscopy. Conclusions: Korean urologists who practice in the training hospitals have a high level of understanding of the management of cryptorchidism. However, some differences of opinion exist in the diagnosis and treatment of nonpalpable undescended testis and retractile testis. These results can be used as baseline data for establishing future diagnosis and treatment guidelines for cryptorchidism.