자동봉합기르를 이용한 위전절제술에 대한 임상적 고찰

송선교(Sun Kyo Song),손수상(Soo Sang Sohn),강중신(Joong Shin Kang) 대한외과학회 1985 Annals of Surgical Treatment and Research Vol.28 No.2

자동봉합기를 이용한 위장관수술의 임상적 고찰

송선교(Sun Kyo Song),손수상(Soo Sang Sohn),강중신(Joong Shin Kang) 대한외과학회 1984 Annals of Surgical Treatment and Research Vol.27 No.1

위암조직의 Vascular Endothelial Growth Factor(VEGF) mRNA 발현양상과 혈관형성능

이상춘(Sang Choon Lee),송석훈(Seok Hun Song),김상운(Sang Woon Kim),김재황(Jae Hwang Kim),윤성수(Sung Su Yun),최준혁(Joon Hyuk Choi),송선교(Sun Kyo Song) 대한외과학회 2001 Annals of Surgical Treatment and Research(ASRT) Vol.60 No.3

신장의 허혈 및 재관류 손상방지에 관한 연구

윤성수(Sung Su Yun),신명준(Myeong Jun Shin),송선교(Sun Kyo Song),김홍진(Hong Jin Kim),심민철(Minn Chul Shim),권굉보(Koing Bo Kwun) 대한외과학회 1991 Annals of Surgical Treatment and Research(ASRT) Vol.41 No.5

림프절 전이가 없는 진행성 위암의 예후 인자

강상윤,김세원,송선교,김상운,Kang, Sang-Yoon,Kim, Se-Won,Song, Sun-Kyo,Kim, Sang-Woon 대한위암학회 2007 대한위암학회지 Vol.7 No.3

목적: 진행성 위암환자의 예후인자에서 림프절 전이와 침윤깊이 등이 중요한 예후인자로 여겨지고 있지만, 림프절 전이가 없는 진행성 위암환자의 침윤깊이에 따른 예후인자에 관해서는 정립이 되지 않고 있다. 본 연구에서는 림프절 전이가 없는 진행성 위암 환자의 생존율에 관계된 예후 인자를 확인하고 침윤깊이에 따른 예후 인자의 변화를 확인하고자 한다. 대상 및 방법: 본 교실에서 진행성 위암으로 1990년 1월부터 1999년 12월까지 수술 받은 1,761명 중 의무기록을 후향적으로 검토하여 림프절 전이 및 원격전이가 없는 진행성 위암 환자 268명을 대상으로 하였다. 나이, 성별, 종양의 위치, 종양의 크기, 종양의 위벽침윤도, 조직학적 분화도, 림프관 침윤, 신경침윤, 혈관 침윤 등을 토대로 생존율에 대한 단변량 및 다변량 분석을 시행하였고 침윤 깊이(T2, T3, T4)에 따라 대상 환자를 아그룹으로 분류하여 침윤 깊이에 따르는 예후인자를 조사 하였다. T4 군은 제한된 개체 수 때문에 분석에서 제외 시켰다. 결과: 생존율과 관계된 통계적으로 의미있는 예후 인자는 단변량 분석에서는 나이, 종양의 위벽침윤도, 조직학적 분화도, Borrmann 형, Lauren 분류이고 다변량 분석에서는 나이, 침윤도, Lauren 분류였다. 침윤 깊이에 따른 아그룹의 다변량 분석에서 의미있는 예후 인자는 T2 군에서는 나이와 Borrmann 형, Lauren 분류이며 T3 군에서는 나이와 Lauren 분류, 혈관 침윤이었다. 결론: 림프절 전이 없는 진행성 위암에서 나이와 Lauren 분류, 침윤 깊이가 생존율의 영향을 미치는 독립적인 예후 인자라고 볼 수 있다. 단 T2 군에서는 Borrmann 형 또한 생존율에 영향을 미치는 예후 인자로써 검토해 볼 필요가 있다. Purpose: This study was conducted to identify prognostic factors in gastric cancer without lymph node metastasis and to specifiy which prognostic factors can be available in detail according to the depth of invasion. Materials and Methods: This retrospective study was based on the medial records of 268 gastric cancer patients who received resectional therapy from 1990 to 1999. The patients who revealed pT2NOMO, pT3NOMO, pT4NOMO on postoperative pathologic reports were enrolled. The survival rate was analyzed according to clinicopathologic and therapeutic factors. Results: According to the depth of invasion, the number of patients with pT2a, pT2b, pT3 and pT4 were 86 (32.1%), 56 (20.9%), 108 (40.3%), and 18 (6.7%) respectively. Age, depth of invasion, histological type, Borrmann type, and Lauren classification were statistically significant in the univariate analysis, and the age, the depth of invasion, and Lauren classification were independent prognostic factors identified by multivariate analysis. On multivariate analysis of subgroups according to the depth of invasion, the independent prognostic factors were age, Borrmann type, and Lauren classification in pT2, and age, Lauren classification, and vascular invasion in pT3. The prognostic factors of pT4 patients could not be analyzed due to limited sample size. Conclusion: In advanced gastric cancer patients without lymph node metastasis, age, the depth of invasion, and Lauren classification should be checked to predict prognosis. In patients with pT2 lesion among the above patients, the Borrmann type should be added in check-list.

T2 위암환자의 침윤깊이에 따른 병리소견 및 예후의 차이

김세원 ( Se Won Kim ),송선교 ( Sun Kyo Song ),김상운 ( Sang Woon Kim ) 영남대학교 기초/임상의학연구소 2007 Yeungnam University Journal of Medicine Vol.24 No.2S

Purpose:A difference of a pathologic characteristic in proportion to depth of invasion analyzed in T2 gastric cancer and a difference of depth of invasion examined an influence to lymph node metastasis and prognosis. Materials and Methods:The clinicopathologic outcomes of 432 patients who underwent curative resection for pT2 stage gastric cancers from 1995 to 1999 were reviewed retrospectively. We are compared on lymphatic metastasis, stage distribution, histologic classification, Bormann`s classification, Lauren classification, vessel invasion, lymphatic invasion, neural invasion and 5-year survival rate of pT2 groups(mp vs. ss). 1) Results:pT2b(ss) group compare to pT2a(mp) in Lauren classification, ratio of diffused type was higher(p<0.05) and in Bormann classification, infiltration type was higher (p<0.01). Vessel and lymphatic invasion, neural invasion showed significant difference between pT2a(mp) and pT2b(ss) (p<0.01). Difference noted between pT2a(mp) and pT2b(ss) group in a lymph node metastatic rate, degree of a metastasis and stage distribution (p<0.01). On stratifying patients according to depth of invasion, 5-year suvival rate for those with pT2a(mp) group was significantly greater than those with pT2b(ss) group(82.4% vs. 47.4%, respectively: P<0.01). In this study, appeared with the significant prognostic factor in 5-year suvival rate which multivariate analysis, depth of invasion(P<0.05) and lymph node metastasis (P<0.01) that enforced the total gastric cancer patient who had T2 gastric cancer with the object noted, but for patients with accurately staged pN0 group, suvival characteristics were similar for pT2a (mp) and pT2b(ss) gastric cancer (P=0.97). Conclusion:The subclassification of pT2 gastric cancer into pT2a(mp) and pT2b(ss) is necessary to demonstrate their different prognosis.

위암에서 종양맥관형성능의 임상적 의의

송석훈(Seok Hun Song),박기혁(Ki Hyuk Park),주대현(Dae Hyun Joo),이한일(Han Il Lee),박성환(Sung Hwan Park),유용운(Yong Oon Yoo),박기호(Ki Ho Park),송선교(Sun Kyo Song),김동석(Dong Seok Kim) 대한외과학회 1999 Annals of Surgical Treatment and Research(ASRT) Vol.56 No.1

절제불가능 혹은 전이성 위암환자들에게 일차 화학요법으로 시행한 TS-1/Cisplatin 병합요법의 결과

송정현(Jung Hyun Song),김상운(Sang Woon Kim),송선교(Sun Kyo Song),김세원(Se Won Kim) 대한종양외과학회 2014 Korean Journal of Clinical Oncology Vol.10 No.1

Purpose: This study was conducted to evaluate the response rate, side effect and resection rate after primary chemotherapy of TS-1/cisplatin regimen in unresectable or metastatic gastric cancer patients. Methods: From January 2005 to December 2012, 44 patients with unresectable or metastatic gastric cancer were enrolled onto the study. The regimen of primary chemotherapy was TS-1/cisplatin. Results: Unresectable or metastatic lesions were ascertained abdominal computed tomography (CT), positron emission tomography/CT and diagnostic laparoscopy. The factors of inoperability were 26 patients of peritoneal seeding, 8 tumor fixation, 7 mutiple liver metastasis, 15 multiple lymph node metastasis. They received TS-1/cisplatin regimen for primary chemotherapy. The response rates was 40.9% (18/44). The resection rate was 27.2% (12/44). Among 8 patients received curative resection and 4 received palliative resection. Median survival time were 41 months in cutative resection group, 21 months in palliative resection group and 8 months in non-resection group respectively (P=0.000). Conclusion: The response rates was 40.9% (18/44) and the resection rate was 27.2% (12/44). Resection group had longer survival than non-rescetion group. So aggressive treatment was needed to improve survival.

3기 위암 환자의 술 후 생존율 및 예후 인자 분석

장석원,김치호,김상운,송선교,Jang Seok-Won,Kim Chi-Ho,Kim Sang-Woon,Song Sun-Kyo 대한위암학회 2004 대한위암학회지 Vol.4 No.3

Purpose: There have been some controversies over the therapeutic principles of advanced gastric cancer, and the results of treatment have been variable, especially for stage III disease. This study was conducted to define the prognostic factors of stage III gastric cancer. Materials and Methods: This retrospective study was based on the medical records of 179 patients with stage III disease who received a gastrectomy from January 1990 to December 1994. The 5-year survival rate was analyzed according to the age, sex, tumor location, tumor size, Borrmann's type, depth of invasion, lymph-node metastasis, ratio of metastatic lymph nodes, type of surgical resection, extent of lymphnode dissection, curability of resection, postoperative chemotherapy, and pathological stage. The statistical analysis was done by using the Kaplan-Meier method, the log-rank test, and the Cox proportional hazards model. Results: The overall 5-year survival rate was $61.6\%$ the 5-year survival rates according to subgroup were $69.7\%$ for stage IIIa ($100\%$ for $T_{2}N_{2}$, $70.0\%$ for $T_{3}N_{1}$, $68.6\%$ for $T_{4}N_{0}$), and $54.1\%$ for stage IIIb ($T_{3}N_{2}$) (P<0.05). Among various clinicopathologic factors of stage III gastric cancer, the age of the patient, the tumor location, the gross type of tumor, the type of gastric resection, the extent of lymph-node dissection, the curability of resection, and the subgroups of stage III were statistically significant in the univariate survival analysis. The multivariate analysis defined the curability of resection, the extent of lymph-node dissection, the type of operation, the stage of disease, and the age of the patient as independent prognostic factors. Conclusion: A curative surgical resection and an extended lymph-node dissection are thought to be most important for improving the survival rate in stage III gastric cancer patients.

위암 환자의 예후인자로서 림프관 정맥 및 신경 침범의 의의

김치호,장석원,강수환,김상운,송선교,Kim Chi-Ho,Jang Seok-Won,Kang Su-Hwan,Kim Sang-Woon,Song Sun-Kyo 대한위암학회 2005 대한위암학회지 Vol.5 No.2

목적: 표준화된 술식으로 위절제술을 시행한 위암 환자를 대상으로 임상병리학적 특성, 특히 암세포의 림프관, 정맥 및 신경 침범 유무가 환자의 예후에 미치는 영향을 확인 하고자 하였다. 대상 및 방법: 1995년 1월부터 1999년 12월까진 만 5년간 영남대학교 의과대학 부속병원 외과에서 위암으로 진단되어 위절제를 시행받은 1,018명의 의무기록을 토대로 후향적 연구를 시행하였다. 통계는 chi-dquare test를 이용하고 예후 인자들은 Cox proportional hazards regression model을 사용한 다변량 분석을 통해 분석하였다. 생존율은 Kaplan-Meier 방법으로 5년 생존율을 구하고 log-rank test로 검정하였다. 유의 수준은 P < 0.05를 기준으로 하였다. 통계처리는 SPSS for Windows (Version 10.0, SPSS lnc, USA) 프로그램을 이용하였다. 결과: 각 임상병리학적 특성에 대한 단변량 분석 결과, 환자의 연령, 종양의 크기 및 위치, Borrmann형, 조직 분화도, 위절제술의 범위, 암의 위벽 침윤도, 림프절 전이 정도, 병기, 원격 전이 유무, 수술의 근치도 등이 유의하였으며, 이상의 유의한 인다들을 다변량 분석한 결과 암의 위벽 침윤도, 림프절 전이, 림프관 침범, 신경 침범 및 수술의 근치도가 독립적 예후 인자로서 유의하였다. 결론: 기존의 TNM 병기 분류법이 병의 진행 상태를 객관적으로 표현할 수 있고 기본적인 예후 인자로서 역할을 하지만, 병리조직학적 검사 소견에서 림프관 및 신경 침범 유무를 확인하는 것은 위암의 예후 판정에 추가적인 정보를 제공할 수 있을 것으로 기대한다. Purpose: Some controversies exist over the prognostic values of lymphatic, venous, and neural invasion in patients with gastric cancer. This study was conducted to confirm the prognostic values of these histopathologic factors in gastric cancer patients who received a gastrectomy. Materials and Methods: Data for clinicopathologic factors and clinical outcomes were collected retrospectively from the medical records of 1,018 gastric cancer patients who received a gastrectomy at Yeungnam University Medical Center between January 1995 and December 1999. A statistical analysis was done using the SPSS program for Windows (Version 10.0, SPSS Inc., USA). The Kaplan-Meier method was used for the survival analysis. Prognostic factors were analyzed by using a multivariate analysis with Cox proportional hazard regression model. Results: Ages ranged from 21 to 79 (median age, 56). A univariate analysis revealed that age, tumor size, location, gross type, depth of invasion, extent of gastrectomy or lymph node dissection, lymph node metastasis, distant metastasis, lymphatic invasion, venous invasion, neural invasion, pathologic stage, histologic type, and curability of surgery had statistical significance. Among these factors, lymph node metastasis, curability of surgery, neural invasion, lymphatic invasion, and depth of invasion were found to be independent prognostic factors by using a multivariate analysis. Venous invasion showed no prognostic value in the multivariate analysis. Conclusion: Neural invasion and lymphatic invasion are useful parameters in determining a prognosis for gastric cancer patients.