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박정열,조준식,김대연,이동헌,김종혁,김용만,김영탁,목정은,남주현 대한부인종양 콜포스코피학회 2002 Journal of Gynecologic Oncology Vol.13 No.3
횡문근육종은 소아와 청소년기에 가장 흔한 연부조직 육종이다. 발생 부위는 일반적으로 두부 및 경부, 그 다음으로 비뇨생식계이다 조직학적으로 배아성 횡문근육종, 국화상 육종, 폐포성 횡문근육종, 다형성 횡문근육종으로 나누어진다. 횡문근육종의 약 20%가 비뇨생식기에서 발생하고, 50% 이상이 배아성 횡문근육종이다. 여성 생식기의 배아성 횡문근육종은 드문 악성 종양으로,주로 유소아의 질에서 발생하며, 자궁경부에서 발생하는 횡문근육종은 청소년기에 흔하고, 질에서 기원하는 횡문근육종이 자궁경부에 기원하는 경우보다 5배 정도 많다. 폐경기여성에서는 자궁체부에서 가장 흔히 발생한다. 비뇨생식기의 횡문근육종의 치료는 과거에는 골반장기 적출술만으로 치료를 시도하였으나. 서서히 다중 항암화학요법, 방사선요법, 근치적 절제술을 포함한 병합요법으로 바뀌어가고 있으며, 이에 따라 생존율이 현저하게 향상되었다. 이에 저자들은 최근 본원 산부인과에서 자궁경부에 발생한 배아성 횡문근육종 2예를 경험하였기에 문헌 고찰과 아울러 보고하는 바이다. Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood and young adult. Genitourinary tract is the econd most common site of rhabdomyosarcoma. Rhabdomyosarcoma can be classified into one of four major types; embryonal, alveolar, pleomorphic and undifferentiated. Embryonal rhabdomyosarcoma of the female genital tract is rare malignant tumor and usually occurs during childhood in the vagina. In rare cases, rhabdomyosarcoma can originate in the uterine cervix, with a peak incidence in the second decade. Recently we have experienced two cases of embryonal rhabdomyosarcoma of the uterine cervix. These cases are presented with a brief review of the literature.
( Jeong Yeol Park ),( Jae Hyun Cho ),( Jin Young Min ),( Dae Yeon Kim ),( Jong Hyeok Kim ),( Yong Man Kim ),( Young Tak Kim ),( Joo Hyun Nam ) 대한산부인과학회 2014 Obstetrics & Gynecology Science Vol.57 No.2
Objective To analyze how pretreatment body mass index relates to known endometrial cancer prognostic factors and how it impacts the disease-free survival and cause-specific survival of Korean women with endometrial cancer. Methods The patients were divided into the non-obese (<25 kg/m2) and obese groups (≥25 kg/m2) according to their pretreatment body mass index. The 25 kg/m2 body mass index cut-off was based on the World Health Organization criteria for Asian people. The two groups were compared in terms of their clinicopathological characteristics and survival outcomes. Results A total of 213 consecutive patients with endometrioid adenocarcinoma of the uterus met the eligibility criteria of this study and were included in the analysis. Of these patients, 105 patients had a body mass index less than 25 kg/ m2 (non-obese group) and 108 patients had a body mass index equal to or more than 25 kg/m2 (obese group). The two groups did not differ in terms of age, menopause, parity, height, FIGO (International Federation of Obstetrics and Gynecology) stage, tumor grade, tumor size, myometrial invasion, lymphovascular space invasion, cytology, and lymph node metastasis. Body mass index was not a significant factor for disease-free and cause-specific survival in univariate analysis, and after adjusting for all prognostic factors that were significant in univariate analysis, it did not associate significantly with disease-free and cause-specific survival. Conclusion In Korean women with endometrioid adenocarcinoma of the uterus, a high pretreatment body mass index did not associate with other prognostic factors and had little impact on the disease-free survival and cause-specific survival of these women.
( Young-jae Lee ),( Yong-man Kim ),( Shin-wha Lee ),( Jeong-yeol Park ),( Dae-yeon Kim ),( Dae-shik Suh ),( Jong-hyeok Kim ),( Young-tak Kim ),( Joo-hyun Nam ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.5
Objective This study aimed to evaluate the efficacy and safety of pegylated liposomal doxorubicin (PLD) with or without carboplatin in Korean patients with recurrent ovarian cancer (ROC), fallopian tube, or primary peritoneal cancer. Methods This retrospective study included 52 patients with ROC, fallopian tube, or primary peritoneal cancer who received PLD (50 mg/m<sup>2</sup>) between 1<sup>st</sup> December 2014 and 31<sup>th</sup> July 2016. Results The mean number of chemotherapy cycles was 3.8 (range, 2 to 9) in the PLD monotherapy group and 7 (range, 2 to 13) in the PLD combined with carboplatin (PLD-C) group. In overall response rates and clinical beneficial rates, PLD monotherapy group shows 5.0% and 17.5%, and PLD-C group shows 33.3% and 75.0%. The mean progression-free survival (PFS) was 5 and 13 months in the PLD monotherapy and PLD-C groups, respectively. At 6 months after treatment initiation, absence of disease progression was confirmed in 6 (15%) and 10 (83.3%) patients in the PLD monotherapy and PLD-C groups. Hematological adverse events (e.g., neutropenia and thrombocytopenia) were more common in the PLD-C group (P <0.001, P =0.004). The incidence of anemia and non-hematological adverse events, including mucositis, hand-foot syndrome, and allergic reactions, was similar in both groups. Conclusion This study demonstrated the efficacy and safety of PLD monotherapy and PLD-C combination in Korean patients with ROC. This study would be helpful to consider the degree of worry about side effects and treatment expectations after treatment. Further retrospective studies with larger samples are required to confirm the efficacy of PLD monotherapy in Asian patients with platinum-resistant ROC.
( Young-jae Lee ),( Shin-wha Lee ),( Jeong-yeol Park ),( Dae-shik Suh ),( Jong-hyeok Kim ),( Yong-man Kim ),( Young-tak Kim ),( Joo-hyun Nam ),( Dae-yeon Kim ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-
목적: To identify the risk factors for distant recurrence in node-positive cervical cancer patients who underwent radical hysterectomy (RH) and pelvic lymph node dissection (PLND) with or without para-aortic lymph node sampling (PALNS) or para-aortic lymph node dissection (PALND). 방법: The clinicopathologic data of 299 patients who confirmed lymph node metastasis after radical surgery at Asan Medical Center for stage IA2 to IIB cervical cancer from February 2001 to December 2012 were retrospectively analyzed. 결과: The patients who underwent PLND only were 72 (24.1%) and PLND with PALNS or PALND were 227 (75.9%). The mean number of positive lymph nodes and largest lymph node metastasis were 4.46 and 11.13mm. Univariate analysis showed that histologic types, parametrial involvement, lymphovascular space invasion (LVSI), bilaterality of lymph node metastasis, number of positive lymph node, number of total removed para-aortic lymph node, and largest diameter of lymph node metastasis were significantly associated with distant recurrence of cervical cancer. Multivariate analysis showed that only histologic types (HR=3.338, p=<0.001 for adenocarcinoma, HR=14.518, p=<0.001 for small cell carcinoma), number of positive lymph node (HR=1.060, p=<0.001), largest lymph node metastasis (HR=1.039, p=0.011) were independent risk factors for distant recurrence of cervical cancer. The total number of removed lymph node is not significantly associated with distant recurrence, recurrence-free survival (RFS) and overall survival (OS). 결론: Histologic types (adenocarcinoma, small cell carcinoma), number of positive lymph node, largest diameter of lymph node metastasis are significant risk factors for distant recurrence in node-positive cervical cancer patients after RH. Further clinical trials are required to set up a group of patients who required extended field radiation therapy or adjuvant chemotherapy after RH and chemoradiation therapy.
( Min Hyun Baek ),( Shin Wha Lee ),( Dae Yeon Kim ),( Jong Hyeok Kim ),( Yong Man Kim ),( Young Tak Kim ),( Joo Hyun Nam ),( Jeong Yeol Park ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-
The aim of this study was to assess the distribution of HPV genotypes in high-grade cervical intraepithelial neoplasia (CIN) in Korea. This prospective study included consecutive 1009 patients who referred for cervical biopsy due to abnormal cytology. HPV genotyping was performed on the cervical smear using PCR-based DNA chip test for 21 high-risk HPV types. Histologic diagnosis was chronic cervicitis (CC), CIN 1, CIN 2, CIN3, and invasive carcinoma (IC) in 332 (32.9 %), 143 (14.1 %), 104 (10.3 %), 351 (34.7 %), and 79 (7.8 %) patients, respectively. High-risk HPV DNA was detected in 591 (58.7 %) patients and multiple HPV types were identified in 181 (17.9 %) patients. High-risk HPV DNA was detected in 41.5 %, 50.3 %, 63.4 %, 72.3 %, and 77.2% of patients with CC, CIN 1, CIN 2, CIN 3, and IC, respectively. The leading HPV types were HPV 16 (31.0 %), HPV 58 (12.9 %), HPV 18 (8.9 %), HPV 52 (7.4 %), HPV 31 (5.6 %), and HPV 33 (5.2%) for patients with high-grade lesions (CIN 2/3 and IC). The overall positivity rate of HPV 16 (odds ratio [OR], 6.83; 95 % confidence interval [CI], 4.54-10.29; p<0.001), HPV 18 (OR, 2.04; 95% CI, 1.20-3.45; p=0.008), HPV 31 (OR, 5.09; 95 % CI, 2.22-11.71; p=0.001), HPV 33 (OR, 3.19; 95% CI, 1.53-6.64; p=0.002), HPV 52 (OR, 2.56; 95% CI, 1.46-4.50; p=0.001), and HPV 58 (OR, 2.16; 95% CI, 1.65-4.13; p<0.001) was significantly higher in high-grade lesions than in low-grade lesions. HPV 30, 35, and 45 were overrepresented in high-grade lesions than in low-grade lesions, but the differences were not statistically significant. HPV 16, 58, 18, 52, 31, and 33 were the most common genotypes which are represented in high-grade CIN and these were significantly associated with development of high-grade CIN. The development of vaccines against these HPV types is required in Korea.