호르몬 불응성 전립선암 환자의 생존율 및 예후인자

하홍구,윤창진,이승수,이완,이정주,정문기,신동길 대한비뇨의학회 2009 Investigative and Clinical Urology Vol.50 No.7

Purpose: We evaluated survival rate in patients with hormone-refractory prostate cancer (HRPC) and the clinical factors that influenced survival rate and time. Materials and Methods: The medical records of 96 patients who had HRPC and were not treated with chemotherapy from 2000 to 2008 were reviewed. We evaluated the survival rates at the 1st, 3rd, and 5th year by using Kaplan-Meier survival curves. We also evaluated survival differences according to clinical variables (clinical T stage, Gleason score, nadir prostate-specific antigen [PSA], PSA doubling time, and PSA velocity) by using the log-rank test and the relations between survival rates and these variables by using Cox proportional hazards models. Results: The mean age of the patients was 67.8±7.5 years and the mean follow-up period was 23.3±13.7 months. Cancer-specific survival rates at the 1st, 3rd, and 5th year were 57.8%, 16.8%, and 10.1%, respectively, and survival differences were significantly related to nadir PSA (p=0.002) and PSA velocity (p=0.019). In the univariate analysis, nadir PSA (p=0.004) and PSA velocity (p=0.024) were related to survival rate, but only nadir PSA remained as a significant variable for survival rate in patients with HRPC in the multivariate analysis (p=0.044). Conclusions: Cancer-specific survival rates in patients with HRPC at the 1st, 3rd, and 5th year were 57.8%, 16.8%, and 10.1%, respectively, and they were related to nadir PSA. These results may be useful in determining a therapeutic approach in patients with HRPC. Purpose: We evaluated survival rate in patients with hormone-refractory prostate cancer (HRPC) and the clinical factors that influenced survival rate and time. Materials and Methods: The medical records of 96 patients who had HRPC and were not treated with chemotherapy from 2000 to 2008 were reviewed. We evaluated the survival rates at the 1st, 3rd, and 5th year by using Kaplan-Meier survival curves. We also evaluated survival differences according to clinical variables (clinical T stage, Gleason score, nadir prostate-specific antigen [PSA], PSA doubling time, and PSA velocity) by using the log-rank test and the relations between survival rates and these variables by using Cox proportional hazards models. Results: The mean age of the patients was 67.8±7.5 years and the mean follow-up period was 23.3±13.7 months. Cancer-specific survival rates at the 1st, 3rd, and 5th year were 57.8%, 16.8%, and 10.1%, respectively, and survival differences were significantly related to nadir PSA (p=0.002) and PSA velocity (p=0.019). In the univariate analysis, nadir PSA (p=0.004) and PSA velocity (p=0.024) were related to survival rate, but only nadir PSA remained as a significant variable for survival rate in patients with HRPC in the multivariate analysis (p=0.044). Conclusions: Cancer-specific survival rates in patients with HRPC at the 1st, 3rd, and 5th year were 57.8%, 16.8%, and 10.1%, respectively, and they were related to nadir PSA. These results may be useful in determining a therapeutic approach in patients with HRPC.

인체 방광이행상피암에서 Hypoxia Inducibale Factor-1alpha 및 Vascular Endothelial Growth Factor 발현과 병리학적 특징과의 관계

하홍구,이상돈,정문기 대한비뇨의학회 2004 Investigative and Clinical Urology Vol.45 No.1

Purpose: HIF-1α(Hypoxia inducible factor-1α) and VEGF(vascular endothelial growth factor) have been reported to be involved in tumor growth and metastasis but little data concerning their role in transitional bladder cancer is available and few studies have yet evaluated their prognostic values. The aim of the present study was to assess HIF-1α and VEGF expression and to evaluate the relationship between HIF-1α/ VEGF and histopathologic characteristics in bladder tumors. Materials and Methods: HIF-1α and VEGF immunohistochemical stainings were performed on formalin-fixed, paraffin-embedded archival tissues from 27 transitional bladder cancer tissues and from 4 normal bladder tissues as a control group. Interpretation of immunohistochemical staining was performed semi-quantitatively by one pathologist. Results: Expressions of HIF-1α and VEGF tended to be higher in the patient group than in the control group. HIF-1α expression was correlated with VEGF expression. HIF-1α and VEGF tended to be positively correlated with pathologic stage and grade of transitional bladder cancer. Conclusions: HIF-1α and VEGF expression might be independent predictors of outcome, as well as stage and grade of transitional bladder cancer. This study suggests that HIF-1α and VEGF may be potential prognostic factors in bladder cancer. (Korean J Urol 2004;45:7-13)

인체 신세포암에서 Hypoxia Inducible Factor-1α 및 Vascular Endothelial Growth Factor 발현과 병리학적 특징과의 관계

하홍구,예정우,이상돈,정문기 대한비뇨의학회 2004 Investigative and Clinical Urology Vol.45 No.4

Purpose: HIF-1α(Hypoxia inducible factor-1α) and VEGF(vascular endothelial growth factor) have been reported to be involved in tumor growth and metastasis, but only a little data on the roles of HIF-1α and VEGF in renal cell carcinomas are available, and few studies have yet evaluated their prognostic values. The aim of the present study was to assess the HIF-1α and VEGF expression and evaluate the relationships between HIF-1α/VEGF and the histopathological characteristics in renal cell carcinomas. Materials and Methods: HIF-1α and VEGF immunohistochemical stainings were performed on formalin-fixed, paraffin-embedded archival tissues from 22 renal cell carcinoma tissues and 13 normal kidney tissues, used as a control group. The interpretation of the immunohistochemical stainings were semi-quantitatively performed by one pathologist. Results: The expressions of HIF-1α and VEGF were significantly higher in the patient than the control group. The HIF-1α and VEGF expressions were correlated to each other, and inclined to be positively correlated with the pathological stage and grade of the renal cell carcinoma. Conclusions: The HIF-1α and VEGF expressions might be independent predictors of the outcome, as well as the stage and grade of renal cell carcinomas. This study suggests that HIF-1α and VEGF may be potential prognostic factors in renal cell carcinomas. (Korean J Urol 2004;45:303-308)

Learning Curve of Robot-Assisted Laparoscopic Radical Prostatectomy for a Single Experienced Surgeon: Comparison with Simultaneous Laparoscopic Radical Prostatectomy

하홍구,구자윤 대한남성과학회 2015 The World Journal of Men's Health Vol.33 No.1

Purpose: Despite the large number of analytical reports regarding the learning curve in the transition from open to robot-assisted radical prostatectomy (RARP), few comparative results with laparoscopic radical prostatectomy (LRP) have been reported. Thus, we evaluated operative and postoperative outcomes in RARP versus 100 simultaneously performed LRPs.Materials and Methods: A single surgeon had performed more than 1,000 laparoscopic operations, including 415 cases of radical nephrectomy, 85 radical cystectomies, 369 radical prostatectomies, and treatment of 212 other urological tumors, since 2009. We evaluated operative (operation time, intraoperative transfusion, complications, hospital stay, margin status, pathological stage, Gleason score) and postoperative (continence and erectile function) parameters in initial cases of RARP without tutoring compared with 100 recently performed LRPs.Results: Mean operation time and length of hospital stay for RARP and LRP were 145.5±43.6 minutes and 118.1±39.1 minutes, and 6.4±0.9 days and 6.6±1.1 days, respectively (p=0.003 and p=0.721). After 17 cases, the mean operation time for RARP was similar to LRP (less than 2 hours). Positive surgical margins in localized cancer were seen in 11.1% and 8.9% of cases in RARP and LRP, respectively (p=0.733). At postoperative 3 months, sexual intercourse was reported in 14.0% and 12.0%, and pad-free continence in 96.0% and 81.0% in patients with RARP and LRP, respectively (p=0.796 and p=0.012).Conclusions: Previous large-volume experience of LRPs may shorten the learning curve for RARP in terms of oncological outcome. Additionally, previous experience with laparoscopy may improve the functional outcomes of RARP.

Laparoscopic Radical Cystourethrectomy in a Patient with Adenocarcinoma of the Female Urethral Diverticulum

하홍구,이완,이상돈,이정주,정문기 대한비뇨의학회 2010 Investigative and Clinical Urology Vol.51 No.2

Adenocarcinomas arising in the female urethra have been rarely reported. Here we report a case of laparoscopic radical cystourethrectomy with incontinent urinary diversion in a patient with adenocarcinoma in the urethra and bladder. A 60-year-old female presenting with a history of recurrent cystitis and painless hematuria was referred to our facility with voiding difficulty and a urethral mass. Radiologic evaluation showed an enhanced mass in the urethra and bladder neck. Cystoscopic biopsy of the mass in the bladder neck revealed an adenocarcinoma. Laparoscopic radical cystourethrectomy with anterior vaginal wall excision followed by extracorporeal incontinent urinary diversion was performed.

Retroperitoneal Seminoma with the ‘Burned out’ Phenomenon in the Testis

하홍구,정석근,박성우,이완,이상돈,정문기 대한비뇨의학회 2009 Investigative and Clinical Urology Vol.50 No.5

The rare ‘burned out’ phenomenon in germ cell tumors is known as the presence of an extragonadal germ cell tumor with a spontaneously regressed testicular tumor found in common metastatic sites, including the retroperitoneal, mediastinal, supraclavicular, cervical, and axillary lymph nodes; lung; and liver. We report a patient who presented with a retroperitoneal extragonadal germ cell tumor with a spontaneously regressed testicular tumor.

요도하열 재수술 환자에서 Tubularized Incised Plate 요도성형술의 성적 및 영향 인자들

하홍구,이상돈 대한비뇨의학회 2009 Investigative and Clinical Urology Vol.50 No.1

Purpose: We retrospectively evaluated the outcome and risk factors of tubularized incised plate(TIP) urethroplasty in patients with reoperative hypospadias repairs. Materials and Methods: Thirty-nine patients with reoperative hypospadias repairs by the TIP method were evaluated. The meatal location, interval between prior urethroplasty and reoperation, length from meatus to penile tip, coexistence of chordee, type of prior urethroplasty, shape of glans, scarring on urethral plate, times of prior urethroplasty, and complications were reviewed. We also evaluated the outcome of reoperative hypospadias repairs and the relationships between these factors and outcomes. Results: The mean age of the patients was 47.7±77.9 months(range: 5-384 months) at prior urethroplasty and 92.7±115.6 months(12-480 months) at reoperative urethroplasty, and the mean follow-up duration was 54.2±90.5 months(6-443 months). Complications at prior urethroplasty included urethrocutaneous fistula in 18 patients, wound dehiscence in 9, meatal stenosis in 5, persistent chordee in 5, and urethral diverticulum in 3. Complications at TIP reoperation were urethrocutaneous fistula and wound dehiscence in 11 and 4 patients, respectively(complication rate: 38.5%). Older age at the time of the repeat urethroplasty, long urethral defect, and scarring in the urethral plate at reoperation were related with poor outcomes in reoperative urethroplasty. Conclusions: TIP urethroplasty for reoperative hypospadias repair can result in good cosmetic and functional outcomes. However, caution is necessary in patients of old age or with a long urethral defect and scarring at the urethral plate at reoperation. Purpose: We retrospectively evaluated the outcome and risk factors of tubularized incised plate(TIP) urethroplasty in patients with reoperative hypospadias repairs. Materials and Methods: Thirty-nine patients with reoperative hypospadias repairs by the TIP method were evaluated. The meatal location, interval between prior urethroplasty and reoperation, length from meatus to penile tip, coexistence of chordee, type of prior urethroplasty, shape of glans, scarring on urethral plate, times of prior urethroplasty, and complications were reviewed. We also evaluated the outcome of reoperative hypospadias repairs and the relationships between these factors and outcomes. Results: The mean age of the patients was 47.7±77.9 months(range: 5-384 months) at prior urethroplasty and 92.7±115.6 months(12-480 months) at reoperative urethroplasty, and the mean follow-up duration was 54.2±90.5 months(6-443 months). Complications at prior urethroplasty included urethrocutaneous fistula in 18 patients, wound dehiscence in 9, meatal stenosis in 5, persistent chordee in 5, and urethral diverticulum in 3. Complications at TIP reoperation were urethrocutaneous fistula and wound dehiscence in 11 and 4 patients, respectively(complication rate: 38.5%). Older age at the time of the repeat urethroplasty, long urethral defect, and scarring in the urethral plate at reoperation were related with poor outcomes in reoperative urethroplasty. Conclusions: TIP urethroplasty for reoperative hypospadias repair can result in good cosmetic and functional outcomes. However, caution is necessary in patients of old age or with a long urethral defect and scarring at the urethral plate at reoperation.

소량의 지방을 포함한 신혈관근육지방종의 방사선학적 특징

하홍구,서호경,정문기 대한비뇨의학회 2004 Investigative and Clinical Urology Vol.45 No.2

농촌 거주 노령 부부의 성생활 양상에 대한 지역중심연구

박남철; 하홍구 부산대학교 병원 암연구소 2002 부산대병원학술지 Vol.- No.12

Androgen Receptor-dependent Expression of Low-density Lipoprotein Receptor-related Protein 6 is Necessary for Prostate Cancer Cell Proliferation

박은,하홍구,김영환,김은경,신화경,김민경,하정민,배순식,진세연,이정주 대한약리학회 2015 The Korean Journal of Physiology & Pharmacology Vol.19 No.3

Androgen receptor (AR) signaling is important for prostate cancer (PCa) cell proliferation. Here, we showed that proliferation of hormone-sensitive prostate cancer cells such as LNCaP was significantly enhanced by testosterone stimulation whereas hormone-insensitive prostate cancer cells such as PC3 and VCaP did not respond to testosterone stimulation. Blocking of AR using bicalutamide abolished testosterone-induced proliferation of LNCaP cells. In addition, knockdown of AR blocked testosterone-induced proliferation of LNCaP cells. Basal expression of low-density lipoprotein receptor-related protein 6 (LRP6) was elevated in VCaP cells whereas stimulation of testosterone did not affect the expression of LRP6. However, expression of LRP6 in LNCaP cells was increased by testosterone stimulation. In addition, knockdown of LRP6 abrogated testosterone-induced proliferation of LNCaP cells. Given these results, we suggest that androgen-dependent expression of LRP6 plays a crucial role in hormone-sensitive prostate cancer cell proliferation.