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Multidisciplinary approach for treatment of primary hepatic choriocarcinoma in adult male patient
Yongchel Ahn,Ji-Hoon Kim,Cheon-Soo Park,Tae-Eun Kim,Shin-Hwang,Sung-Gyu Lee 한국간담췌외과학회 2018 Annals of hepato-biliary-pancreatic surgery Vol.22 No.2
Choriocarcinoma is a rare malignant germ cell tumor and it usually occurs in the gonads (ovary or testis) and uterus. Primary hepatic choriocarcinoma (PHC) is a variant of choriocarcinoma featuring sole liver presentation without any evidence of gonodal involvements. Adult male patients with PHC carry dismal prognosis and their median survival period was less than 5 months. We herein present a first Korean case of a 54-year-old male patient with adult PHC, who was treated by surgical resection and chemotherapy through a multidisciplinary approach.
Incidental gallbladder cancer after routine cholecystectomy
Yongchel Ahn,Cheon-Soo Park,Shin Hwang,Hyuk-Jai Jang,Kun-Moo Choi,Sung-Gyu Lee 대한외과학회 2016 Annals of Surgical Treatment and Research(ASRT) Vol.90 No.3
Purpose: In about 1% of cases, incidental gallbladder cancers (iGBC) are found after routine cholecystectomy. The aim of this study is to compare clinical features of iGBC with benign GB disease and to evaluate factors affecting recurrence and survival. Methods: Between January 1998 and March 2014, 4,629 patients received cholecystectomy and 73 iGBC patients (1.6%) were identified. We compared clinical features of 4,556 benign GB disease patients with 73 iGBC patients, and evaluated operative outcomes and prognostic factors in 56 eligible patients. Results: The iGBC patients were older and concomitant diseases such as hypertension and anemia were more common than benign ones. And an age of more than 65 years was the only risk factor of iGBC. Adverse prognostic factors affecting patients’ survival were age over 65, advanced histology, lymph node metastasis, and lymphovascular invasion on multivariate analysis. Age over 65 years, lymph node involvement, and lymphovascular invasion were identified as unfavorable factors affecting survival in subgroup analysis of extended cholecystectomy with bile duct resection (EC with BDR, n = 22). Conclusion: Prior to routine cholecystectomy, incidental GB cancer should be suspected especially in elderly patients. And advanced age, lymph node metastasis, and lymphovascular invasion are important prognostic factors in EC with BDR cohorts.
( Moon Ho Kim ),( Heui June Ahn ),( Hyun Joong Kim ),( So Young Park ),( Su Jung Jung ),( Yongchel Ahn ),( Ho Suk Oh ),( Heui June Ahn ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Prophylactic cranial irradiation (PCI) is an essential treatment in limited- stage small cell lung cancer (SCLC) for reducing the incidence of brain metastasis (BM) and improving overall survival rates. In extensive stages, PCI is also recommended for those who show good performance. However, PCI is optional for elderly patients with SCLC due to its toxicity, and there is no specific upper age limit for the use of PCI. In this study, we performed an observational study in elderly SCLC patients above the age of 60 who were not receiving PCI. Methods: In total, 156 elderly patients (aged 60 or above) were diagnosed with SCLC between 2001 and 2009 from GangNeung Asan Medical Center. Of them, 104 were included and investigated retrospectively. Forty-Seven were lost to follow-up, two had BM at the time of initial diagnosis, and three had PCI. The median age of the patients at the time of diagnosis was 70.01 years. Of the patients, 91 (87.5%) were male and 13 (12.5%) were female. Results: Symptomatic BM was detected in 14 out of the 104 (13.5%). When analyzed by age group at diagnosis, the incidence of BM in the age ranges 60-64, 65-69, 70-74, and 75 and older were 23.8% (five out of 21), 17.6% (Six out of 34), 8.0% (Two out of 25), and 4.2% (One out of 24), respectively. Conclusions: This study shows that the incidence of BM in SCLC patients aged 60 and above was 13.5%, which is lower than among the whole SCLC population compared to previous studies. This study implies that there is a lesser incidence of BM as age increases. Therefore, when performing PCI, practitioners should be more concerned with elderly SCLC patients.
Changhoon Yoo,Sung Bae Kim,Jin Hee Ahn,Kyung Hae Jung,Yongchel Ahn,Gyungyub Gong,Hak-Hee Kim,Hee-Jung Kim,손병호,Sei-Hyun Ahn 한국유방암학회 2011 Journal of breast cancer Vol.14 No.2
Purpose: Fulvestrant, a potent estrogen receptor (ER) antagonist with a novel mechanism of action, has shown efficacy in pretreated patients with advanced breast cancer. We assessed the efficacy and tolerability of fulvestrant in Korean postmenopausal women. Methods: Of the 25 candidates identified at Asan Medical Center, Seoul, Korea, six were deemed ineligible due to inadequate baseline and follow-up imaging. The 19 patients included in this retrospective analysis received the approved dose of fulvestrant (250 mg intramuscular injection, once per month) as second- (n=8), third- (n=7), or fourth-line (n=4) endocrine therapy. Results: At a median follow-up of 7.4 months (range, 1.2-34.8 months), the 19 patients received a median of four cycles (range, 1-34 cycles) of fulvestrant. Median time to progression was 5.5 months (95% confidence interval [CI], 0.4-10.7 months), and median overall survival was 17.9 months (95% CI, 2.7-33.1 months). Among 17 evaluable patients, one (5.3%) achieved a partial response, 10 (52.6%) showed stable disease, and six (31.6%) showed progressive disease. The clinical benefit rate was 26.3%. Four patients (21.1%) reported adverse events, but all were grade 1 or 2. Conclusion: Fulvestrant was effective and well tolerated in patients with advanced breast cancer who had been previously treated with several lines of endocrine and chemotherapeutic agents.