Sarcomatoid squamous cell carcinoma of the uterine cervix successfully treated by Laparoscopic radical hysterectomy(초)

공태욱,이경미,김장희,유승철,장석준,유희석 대한산부인과학회 2009 대한산부인과학회 학술대회 Vol.95 No.-

Comparison of laparoscopic versus conventional open surgical staging procedure for endometrial cancer

공태욱,이경미,정지윤,김우영,장석준,유승철,윤종혁,장기홍,유희석 대한부인종양학회 2010 Journal of Gynecologic Oncology Vol.21 No.2

Objective: The aim of this study was to compare the surgical outcomes of laparoscopic surgery and conventional laparotomy for endometrial cancer. Methods: A total of 104 consecutive patients were non-randomly assigned to either laparoscopic surgery or laparotomy. All patients underwent comprehensive surgical staging procedures including total hysterectomy, bilateral salpingo-oophorectomy, and pelvic/para-aortic lymphadenectomy. The safety, morbidity, and survival rates of the two groups were compared, and the data was retrospectively analyzed. Results: Thirty-four patients received laparoscopic surgery and 70 underwent laparotomy. Operation time for the laparoscopic procedure was 227.0±28.8 minutes, which showed significant difference from the 208.1±46.4 minutes (p=0.032) of the laparotomy group. The estimated blood loss of patients undergoing laparoscopic surgery was 230.3±92.4 mL. This was significantly less than that of the laparotomy group (301.9±156.3 mL, p=0.015). The laparoscopic group had an average of 20.8 pelvic and 9.1 para-aortic nodes retrieved, as compared to 17.2 pelvic and 8.5 para-aortic nodes retrieved in the laparotomy group. There was no significant difference (p=0.062, p=0.554). The mean hospitalization duration was significantly greater in the laparotomy group than the laparoscopic group (23.3and 16.4 days, p<0.001). The incidence of postoperative complications was 15.7% and 11.8% in the laparotomy and laparoscopic groups respectively. No statistically significant difference was found between the two groups in the survival rate. Conclusion: Laparoscopic surgical staging operation is a safe and effective therapeutic procedure for management of endometrial cancer with an acceptable morbidity compared to the laparotomic approach, and is characterized by far less blood loss and shorter postoperative hospitalization.

Risk group criteria for tailoring adjuvant treatment in patients with endometrial cancer: a validation study of the Gynecologic Oncology Group criteria

공태욱,장석준,백지흠,이용희,전미선,유희석 대한부인종양학회 2015 Journal of Gynecologic Oncology Vol.26 No.1

Objective: The purpose of this study is to validate the Gynecologic Oncology Group (GOG) criteria for adjuvant treatment in a different cohort of patients and to evaluate the simplified risk criteria predicting the prognosis and tailoring adjuvant treatment in patients with surgically staged endometrial cancer. Methods: We performed a retrospective analysis of 261 consecutive patients with surgically staged endometrial cancer between January 2000 and February 2013. All patients had complete staging procedures and were surgically staged according to the 2009 International Federation of Gynecology and Obstetrics staging system. Clinical and pathologic data were obtained from medical records. We designed the simplified risk criteria for adjuvant treatment according to the risk factors associated with survival. The patients were divided into low and low-intermediate, high-intermediate, and high-risk groups according to the GOG criteria and simplified criteria and their survivals were compared. Receiver-operating characteristic curve analysis was used to evaluate the prognostic significance of both criteria. Results: Median follow-up time was 48 months (range, 10 to 122 months). According to the GOG criteria, we identified 197 low and low-intermediate risk patients, 20 high-intermediate risk patients, and 44 high-risk patients. There were significant differences in disease-free (p<0.001) and overall survival (p<0.001) among the three groups. Using the simplified risk criteria, we identified 189 low and low-intermediate risk patients, 28 high-intermediate risk patients, and 44 high-risk patients. There were significant differences in disease-free (p<0.001) and overall survival (p<0.001) among the three groups. The performance of the simplified criteria (area under the curve [AUC]=0.829 and 0.916 for disease recurrences and deaths, respectively) was as good as the GOG criteria (AUC=0.836 and 0.921 for disease recurrences and deaths, respectively). Conclusion: The simplified criteria may be easily applicable and offer useful information for planning strategy of adjuvant treatment in patients with surgically staged endometrial cancer as the GOG criteria.

Selection criteria and colpotomic approach for safe minimally invasive radical hysterectomy in early-stage cervical cancer

공태욱,손주혁,백지흠,장석준,유희석 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.1

Objective: To evaluate oncologic outcomes of minimally invasive radical hysterectomy (RH) in early cervical cancer before and after the application of parametrial invasion (PMI) criterion on magnetic resonance imaging (MRI) and vaginal colpotomy (VC). Methods: A total of 216 International Federation of Gynecology and Obstetrics stage IB–IIA cervical cancer patients who underwent minimally invasive RH was identified between April 2006 and October 2018. Patients were classified into the pre-PMI intracorporeal or VC (IVC) (n=117) and post-PMI VC groups (n=99). In the pre-PMI IVC group, PMI criterion (intact stromal ring) on MRI was not applied and the patients received IVC. In the post-PMI VC group, surgical candidates were selected using the PMI criterion on MRI and all patients received VC only. Oncologic outcomes and prognostic factors associated with disease recurrence were analyzed. Results: The rate of positive vaginal cuff margins in the pre-PMI IVC group was higher than that in the post-PMI VC group (11.1% vs. 1.0%, p=0.003). Two-year disease-free survival was different between the 2 groups (84.5% in pre-PMI IVC vs. 98.0% in post-PMI VC groups, p=0.005). Disrupted stromal ring on MRI (hazard ratio [HR]=20.321; 95% confidence interval [CI]=4.903–84.218; p<0.001) and intracorporeal colpotomy (HR=3.059; 95% CI=1.176–7.958; p=0.022) were associated with recurrence. Conclusion: The intact cervical stromal ring on MRI might identify the low-risk group of patients in terms of PMI and lymphovascular/stromal invasion in early cervical cancer. Minimally invasive RH should be performed in optimal candidates with an intact stromal ring on MRI, using VC.

Comparison of concurrent chemoradiation therapy with weekly cisplatin versus monthly fluorouracil plus cisplatin in FIGO stage IIB-IVA cervical cancer

공태욱,장석준,백지흠,유승철,윤종혁,장기홍,전미선,유희석 대한부인종양학회 2012 Journal of Gynecologic Oncology Vol.23 No.4

Objective: Concurrent chemoradiation therapy (CCRT) is the standard treatment for locally advanced cervical cancer. Although the optimal chemotherapeutic regimen is not yet defined, previous randomized trials have demonstrated that 5-fluorouracil (5-FU) plus cisplatin every 3 weeks and weekly cisplatin are the most popular regimens. The purpose of this study was to compare the outcomes of weekly CCRT with cisplatin and monthly CCRT with 5-FU plus cisplatin for locally advanced cervical cancer. Methods: We retrospectively reviewed data from 255 patients with FIGO stage IIB-IVA cervical cancer. Patients were classified into two CCRT groups according to the concurrent chemotherapy: weekly CCRT group, consisted of CCRT with weekly cisplatin for six cycles; and monthly CCRT group, consisted of CCRT with cisplatin and 5-FU every 4 weeks for two cycles followed by additional consolidation chemotherapy for two cycles with the same regimen. Results: Of 255 patients, 152 (59.6%) patients received weekly CCRT and 103 (40.4%) received monthly CCRT. The mean follow-up period was 39 months (range, 1 to 186 months). Planned CCRT was given to 130 (85.5%) patients in weekly CCRT group and 84 (81.6%) patients in monthly CCRT group, respectively. Severe adverse effects were more common in the monthly CCRT group than in the weekly CCRT group. There were no statistically significant differences in progression-free survival and overall survival between the two groups (p=0.715 and p=0.237). Conclusion: Both weekly CCRT and monthly CCRT seem to have similar efficacy for patients with locally advanced cervical cancer, but the weekly cisplatin is better tolerated. Objective: Concurrent chemoradiation therapy (CCRT) is the standard treatment for locally advanced cervical cancer. Although the optimal chemotherapeutic regimen is not yet defined, previous randomized trials have demonstrated that 5-fluorouracil (5-FU) plus cisplatin every 3 weeks and weekly cisplatin are the most popular regimens. The purpose of this study was to compare the outcomes of weekly CCRT with cisplatin and monthly CCRT with 5-FU plus cisplatin for locally advanced cervical cancer. Methods: We retrospectively reviewed data from 255 patients with FIGO stage IIB-IVA cervical cancer. Patients were classified into two CCRT groups according to the concurrent chemotherapy: weekly CCRT group, consisted of CCRT with weekly cisplatin for six cycles; and monthly CCRT group, consisted of CCRT with cisplatin and 5-FU every 4 weeks for two cycles followed by additional consolidation chemotherapy for two cycles with the same regimen. Results: Of 255 patients, 152 (59.6%) patients received weekly CCRT and 103 (40.4%) received monthly CCRT. The mean follow-up period was 39 months (range, 1 to 186 months). Planned CCRT was given to 130 (85.5%) patients in weekly CCRT group and 84 (81.6%) patients in monthly CCRT group, respectively. Severe adverse effects were more common in the monthly CCRT group than in the weekly CCRT group. There were no statistically significant differences in progression-free survival and overall survival between the two groups (p=0.715 and p=0.237). Conclusion: Both weekly CCRT and monthly CCRT seem to have similar efficacy for patients with locally advanced cervical cancer, but the weekly cisplatin is better tolerated.

High-risk human papillomavirus testing as a primary screening for cervical cancer: position statement by the Korean Society of Obstetrics and Gynecology and the Korean Society of Gynecologic Oncology

공태욱,김미선,김영한,김용범,김자연,김재원,박미혜,박주현,이정호,임명철,홍준석 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.2

Based on emerging data and current knowledge regarding high-risk human papillomavirus (hrHPV) testing as aprimary screening for cervical cancer, the Korean Society of Obstetrics and Gynecology and the Korean Society ofGynecologic Oncology support the following scientific facts:• Compared to cytology, hrHPV screening has higher sensitivity and detects more cases of high-grade cervicalintraepithelial neoplasia. • Qualified hrHPV testing can be considered as an alternative primary screening for cervical cancer to the currentcytology method. • The starting age of primary hrHPV screening should not be before 25 years because of possible overtreatment in thisage, which has a high human papillomavirus (HPV) prevalence but rarely progresses to cancer. The screening intervalshould be no sooner than every 3 years and no longer than every 5 years. • Before the introduction of hrHPV screening in Korea, research into comparative effectiveness of primary hrHPVscreening for cervical cancer should be conducted to determine the appropriate HPV assay, starting age, andscreening interval.

Asian Society of Gynecologic Oncology International Workshop 2018

공태욱,유희석,김승철,Takayuki Enomoto,Jin Li,Kenneth H. Kim,심승혁,Peng-Hui Wang,Suwanit Therasakvichya,Yusuke Kobayashi,이마리아,Ting-Yan Shi,이신화,Mikio Mikami,Satoru Nagase,임명철,Jianliu Wang,Sarikapan Wilailak,김상운,홍숙 대한부인종양학회 2019 Journal of Gynecologic Oncology Vol.30 No.2

The Asian Society of Gynecologic Oncology International Workshop 2018 on gynecologic oncology was held in the Ajou University Hospital, Suwon, Korea on the 24th to 25th August 2018. The workshop was an opportunity for Asian doctors to discuss the latest findings of gynecologic cancer, including cervical, ovarian, and endometrial cancers, as well as the future of fertility-sparing treatments, minimally invasive/radical/debulking surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy. Clinical guidelines and position statement of Asian countries were presented by experts. Asian clinical trials for gynecologic cancers were reviewed and experts emphasized the point that original Asian study is beneficial for Asian patients. In Junior session, young gynecologic oncologists presented their latest research on gynecologic cancers.

Lymph-Vascular Space Invasion as a Significant Risk Factor for Isolated Para-aortic Lymph Node Metastasis in Endometrial Cancer (초)

공태욱,장석준,김우영,유승철,윤종혁,장기홍,유희석 대한산부인과학회 2010 대한산부인과학회 학술대회 Vol.96 No.-

낙동강 하구둑 방류량이 하구지역 지형 변화에 미치는 영향 분석

공태욱,김성보 한국산업융합학회 2023 한국산업융합학회 논문집 Vol.26 No.1

In this study, topographic change analysis was performed on the Nak-dong River estuary area. The factors affecting the changes in the bathymetry of the Nak-dong River estuary were analyzed using data from the discharge, suspended sediments, and rainfall of the Nak-dong River barrier as analysis data. As a result, erosion and sedimentation are judged to appear repeatedly due to complex effects such as discharge of the estuary barrier of the Nak-dong River and invasion of the open sea waves, and it is judged that there is no one-sided tendency. However, as a result of checking the data in the second half of 2020, it was possible to confirm a large amount of erosion, which is different from the past data. It is clear that this is a result beyond the trend of erosion in the first half and sedimentation in the second half. In the summer of 2020, the rainy season lasted for more than a month and torrential rains occurred, which seems to be due to about three times higher rainfall than other periods, and erosion is believed to have occurred as the discharge increased rapidly compared to the time deposited by river water outflow. In addition, compared to other times, the influence of many typhoons in the summer of 2020 is believed to have affected the topographical change at the mouth of the Nak-dong River.

<千金要方>에 記載된 <傷寒論>의 考察

孔兌旭,嚴賢燮 동의대학교 한의학연구소 1998 동의한의연구 Vol.2 No.-

This study is to compare the text of Sanghan(傷寒)'s section (9 and 10th volume) in Chungumyobang(千金要方) with the text of Sanghanron(傷寒論). The conclusion obtained as follows; 1. Sanghan(傷寒) of Chungumyobang(千金要方) is made up of 201 prescription and 43 symptoms and Sanghanron(傷寒論) is composed of 113 prescription and 398 text. 58 text and 22 prescription in Sanghanron(傷寒論) is found at contents of Chungumyobang(千金要方). 2. The three puts of Sanghanron(傷寒論)-Byunsoyangbyungmaekjungbyungchi(少陽病脈證幷治), Byuntaeeumbyungmaekjungbyungchi(辨太陰病脈證幷治) and Byungwaknan byungmaekjungbyungchi(辨證亂病脈證幷治)- were not found at Chungumyobang(千金要方). 3. Chungumyobang(千金要方) used different name as compared with Sanghanron(傷寒論). For example, Gejitang(桂柱湯) is Yangdantang(陽且湯) at Guemgueyoyak(金??要略), Sosihotang(小柴胡湯) is Hwangryongtang(黃龍湯), Hyunmutang(玄武湯) is Jinmutang(眞武湯). 4. Due to different number of text and content of composition, can infer that Sonsamak(孫思邈), the writer of Chungumyobang(千金要方), didn't read Sanghanron(傷寒論) when he edit his book. 5. With Chungumikbang(千金要方), Chungumyobang(千金要方) is a very important literary work that collect and adjust Sanghanron(傷寒論) or Wangsukhwa(王叔和). Chungumyobang(千金要方), rare material, is help to suppose and make a study of the original of Sanghanron(傷寒論).