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- 저자 : 이건욱(Khun Uk Lee) (검색결과 3 건)
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밀란 기준 내의 간세포암 환자의 이식 전 비수술적 치료 유무 및 기간에 따른 이식 후 성적
김지선(Ji Sun Kim),이건욱(Khun Uk Lee),신우영(Woo Young Shin),전영민(Young-Min Jeon),김태훈(Tae-Hoon Kim),이남준(Nam-Joon Yi),서경석(Kyung-Suk Suh) 한국간담췌외과학회 2009 한국간담췌외과학회지 Vol.13 No.4
Purpose: We wanted to evaluate the influence of preoperative non-surgical treatment and its duration for hepatocellular carcinoma (HCC) patients who underwent liver transplantation (LT). Methods: We analyzed 75 patients with HCC who underwent living donor liver transplantation from January 1999 to December 2005. The median follow-up was 40.2 months. The patients were divided into the not treated group (26 patients) and non-surgically treated group (49 patients). We compared the overall survival (OS) and disease-free survival (DFS) rates of the 24 not treated patients with that of the 33 treated patients within the Milan criteria. The treated group was divided to 39 short-term (<3 years) treated patients and 10 long-term (≥3 years)treated patients by the preoperative treatment duration. The OS and DFS rates were analyzed. Results: For 57 patients within the Milan criteria, the 1-, 3- and 5-year OS rates and the 1-, 3- and 5-year DFS rates were 80.0%, 68.5%, 64.8%, 82.0%, 77.2% and 75.1%, respectively. There were no different characteristic between the not treated group and the treated group, except for the mean age and the Child-Turcotte-Pugh score. Compared to the treated group, the OS and DFS rates were slightly better in the not treated group (p=0.053). There were more patients who underwent transcatheter arterial chemoembolization only in the short-term treated group and there were more patients who had microvascular invasion in the long-term treated group. The OS and DFS rates showed no significant difference between the two groups. Conclusion: It is possible that LT is a first treatment for HCC patients. If the patients’ response to preoperative treatment was good, then their prognosis may be same regardless of the treatment duration.
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안혜성(Hye Seong Ahn),장진영(Jin-Young Jang),이승은(Seung Eun Lee),양성훈(Sung Hoon Yang),이건욱(Khun Uk Lee),김선회(Sun Whe Kim) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.72 No.1
Purpose: Because of the rarity of primary duodenal adenocarcinomas, the factors affecting the management and survival of patients with this disease remain controversial. This study analyzed the nineteen-years of experience gained at one institution to define the surgical management and outcomes of patients with primary duodenal adenocarcinomas. Methods: A retrospective review of 77 patients, who underwent surgery for a primary duodenal adenocarcinoma at Seoul National University Hospital, between May 1985 and April 2004, was undertaken. The dermographics symptoms, operative variables, surgical pathology and survival data were analyzed. Results: A curative resection was performed in 40 patients (51.9%); a pancreaticoduodenectomies and/or resection of other organs, pancreas head resection with a duodenal segmentectomy and a segmental duodenectomy and resection of another organ in 37, 2 and 1, respectively. The remaining 37 patients underwent a palliative resection or bypass. The hospital mortality and complication rates were 2.6% (2 patients) and 42.9% (33 patients), respectively. The overall 5-year survival was 26.8%. The 5-year survival for the curative resection group was 42.7%, whereas that for the palliative surgery group was 0%. In a univariate analysis, nodal metastasis was found to have a significant negative impact on survival after a curative resection (P=0.028). The patients’ age, sex, operative procedure, tumor size, histologic type, differentiation and tumor depth had no influence on survival. Conclusion: A curative resection is associated with increased survival in patients with a duodenal adenocarcinoma. Following a curative resection, nodal metastasis is an independent prognostic factor. Therefore, the early diagnosis should be sought to achieve a curative resection and increased survival. As a curative resection, a pancreati-coduodenectomy is usually required, and a segmental duodenal resection may be appropriate in selected patients, especially in early duodenum cancers.
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