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방승민,문도창,이희승,이용일,정문재,박정엽,박승우,송시영,정재복 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.5
Purpose: Erlotinib-gemcitabine combined chemotherapy is considered as the standard treatment for unresectable pancreaticcancer. This study aimed to determine the clinical factors associated with response to this treatment. Materials and Methods: This retrospective study included 180 patients with unresectable pancreatic cancer who received ≥2 cyclesof gemcitabine-erlotinib combination therapy as first-line palliative chemotherapy between 2006 and 2014. “Long-term response”was defined as tumor stabilization after >6 chemotherapy cycles. Results: The median progression-free survival (PFS) and overall survival (OS) were 3.9 and 8.1 months, respectively. On univariateanalysis, liver metastasis (p=0.023) was negatively correlated with long-term response. Locally advanced stage (p=0.017), a history ofstatin treatment (p=0.01), and carcinoembryonic antigen levels <4.5 (p=0.029) had a favorable effect on long-term response. Onmultivariate analysis, a history of statin treatment was the only independent favorable factor for long-term response (p=0.017). Prognosticfactors for OS and PFS were significantly correlated with liver metastasis (p=0.031 and 0.013, respectively). A history of statintreatment was also significantly associated with OS after adjusting for all potential confounders (hazard ratio, 0.48; 95% confidenceinterval, 0.26–0.92; p=0.026). Conclusion: These results suggest that statins have a favorable effect on “long-term response” to gemcitabine-erlotinib chemotherapyin unresectable pancreatic cancer patients. Statins may have a chemoadjuvant role in stabilizing long-term tumor growth.
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Multicentric Type 3 Gastric Neuroendocrine Tumors
이상훈,문도창,이희승,이충건,전용덕,박지혜,김현기,이상길 대한소화기내시경학회 2015 Clinical Endoscopy Vol.48 No.5
A 50-year-old woman with incidentally detected multiple gastric polyps and biopsy-proven neuroendocrine tumor (NET) was referred to our hospital. More than 10 polypoid lesions (less than 15 mm) with normal gastric mucosa were detected from the gastric body to the fundus. The serum level of gastrin was within the normal limits. There was no evidence of atrophic changes on endoscopy and serologic marker as pepsinogen I/II ratio. Computed tomography of the abdomen and pelvis revealed no evidence of metastatic lesions. She refused surgery, and we performed endoscopic polypectomy for almost all the gastric polyps that were greater than 5 mm. Although the histological examination revealed that all the removed polys were diagnosed as NET G1, three of them extended to the lateral or vertical resection margins, while two exhibited lymphovascular invasion. A follow-up upper endoscopy that was performed 6 months after the diagnosis showed multiple remnant gastric polyps that were suggestive of remnant gastric NET.
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