1
|
Kim JM, Kim JY, Jung EJ, Kwag SJ, Park JH, Cho JK, Kim HG, Jeong CY, Ju YT, Lee YJ. The prognostic impact of body mass index in breast cancer according to tumor subtype. Korean J Clin Oncol 2023; 19:52-59. [PMID: 38229489 DOI: 10.14216/kjco.23010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/29/2023] [Indexed: 01/18/2024]
Abstract
PURPOSE Several studies demonstrated that obesity and underweight were negatively associated with outcomes of breast cancer. However, the results are still controversial, and the impact of body mass index (BMI) on distant metastasis-free survival (MFS), which might directly affect mortality, was less well evaluated. Our study aimed to verify the prognostic effect of BMI in breast cancer. METHODS A retrospective analysis of 504 patients with stage I-III breast cancer who underwent surgery from January 2005 to December 2013 was performed. The patients were divided into three groups according to preoperative BMI: underweight <18.5 kg/m2, normal weight 18.5-24.9 kg/m2, and overweight ≥25 kg/m2. The association between body weight status and breast cancer recurrence was analyzed. Subgroup analysis by tumor subtype according to receptor status was also performed. RESULTS The median follow-up period was 88 months. For disease recurrence, histologic grade and human epidermal growth factor receptor 2 (HER2)-positivity were independent prognostic factors in multivariate analysis. Stage, histologic grade, HER2-positivity, and BMI status were independent prognostic factors for distant metastasis. In survival analysis, overweight and underweight were significant predisposing factors for MFS, but not for disease-free survival (DFS). In the estrogen receptor (ER)-positive group, overweight and underweight patients had significantly worse DFS and MFS than normal weight patients. In the ER-negative or HER2-positive group, BMI status had no significant association with DFS and MFS. CONCLUSION The prognostic role of BMI on the survival outcomes of patients with breast cancer was different by tumor subtype. In ER-positive patients, overweight and underweight statuses had a negative prognostic effect on DFS and MFS, respectively.
Collapse
Affiliation(s)
- Jae-Myung Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Ju-Yeon Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Eun Jung Jung
- Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Seung-Jin Kwag
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Ji-Ho Park
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jin-Kyu Cho
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Han-Gil Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Chi-Young Jeong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Young-Tae Ju
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Young-Joon Lee
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| |
Collapse
|
2
|
Kim IK, Ju YT, Kim HG, Lee JK, Kim DC, Kim JM, Cho JK, Park JH, Kim JY, Jeong CY, Hong SC, Kwag SJ. Experience of surgical treatment in a granular cell tumor in the ascending colon: a case report. Ann Coloproctol 2023; 39:275-279. [PMID: 34228911 PMCID: PMC10338165 DOI: 10.3393/ac.2020.00836.0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 05/06/2021] [Accepted: 05/08/2021] [Indexed: 10/20/2022] Open
Abstract
We report a case about successful surgical treatment of a granular cell tumor in the ascending colon. A 36-year-old man underwent screening colonoscopy. An endoscopic examination revealed a 10-mm yellowish and hemispheric mass in the ascending colon, and lower endoscopic ultrasonography revealed a hypoechoic-to-isoechoic mass invaded the submucosal layer. The mass was suspected to be a colonic carcinoid tumor. Based on the preoperative evaluation, endoscopic complete resection was considered difficult. Therefore, the lesion was removed via laparoscopic right hemicolectomy. Histological examination revealed that the tumor consisted of nests of polygonal cells with abundant granular eosinophilic cytoplasm. Immunohistochemical staining revealed diffuse positivity for S100 and CD68. Therefore, the tumor was diagnosed as a granular cell tumor. We suggest that surgical resection should be considered if it is located in the thin-walled ascending colon prone to perforation, difficult to rule out malignant tumor due to submucosal invasion, or to remove endoscopically.
Collapse
Affiliation(s)
- In-Kyeong Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Young-Tae Ju
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Han-Gil Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Jin-Kwon Lee
- Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Dong-Chul Kim
- Department of Pathology, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Jae-Myung Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Jin Kyu Cho
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Ji-Ho Park
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Ju-Yeon Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Chi-Young Jeong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Soon-Chan Hong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Seung-Jin Kwag
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| |
Collapse
|
3
|
Kim JY, Jung EJ, Kim JM, Son Y, Lee HS, Kwag SJ, Park JH, Cho JK, Kim HG, Park T, Jeong SH, Jeong CY, Ju YT. MiR‑221 and miR‑222 regulate cell cycle progression and affect chemosensitivity in breast cancer by targeting ANXA3. Exp Ther Med 2023; 25:127. [PMID: 36845963 PMCID: PMC9947582 DOI: 10.3892/etm.2023.11826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 12/15/2022] [Indexed: 02/10/2023] Open
Abstract
Breast malignancy remains one of the most common causes of cancer-associated mortalities among women. MicroRNA (miR)-221 and miR-222 are homologous miRs and have a substantial impact on cancer progression. In the present study, the regulatory mechanisms of miR-221/222 and its target annexin A3 (ANXA3) in breast cancer cells were investigated. Breast tissue samples were collected to evaluate the expression patterns of miR-221/222 levels in breast cancer cell lines and cancer tissues according to clinical characteristics. The levels of miR-221/222 were increased or decreased in cancer cell lines compared with normal breast cell lines according to cell line subtype. Subsequently, the changes in the progression and invasion of breast cancer cells were investigated using cell proliferation, invasion assay, gap closure and colony formation assays. Western blotting of cell cycle proteins and flow cytometry were performed to evaluate the possible pathway of miR-221/222 and ANXA3 axis. Chemosensitivity tests were performed to explore the suitability of the miR-221/222 and ANXA3 axis as a therapeutic target in breast cancer. The expression levels of miR-221/222 were associated with aggressive characteristics of breast cancer subtypes. Cell transfection assay demonstrated the regulation of breast cancer proliferation and invasiveness by miR-221/222. MiR-221/222 directly targeted the 3'-untranslated region of ANXA3 and suppressed the expression of ANXA3 at the mRNA and protein levels. In addition, miR-221/222 negatively regulated cell proliferation and the cell cycle pathway in breast cancer cells by targeting ANXA3. In combination with adriamycin, downregulation of ANXA3 may sensitize adriamycin-induced cell death to induction of persistent G2/M and G0/G1 arrest. Decreased expression of ANXA3 through increased expression of miR-221/222 reduced breast cancer progression and increased the effectiveness of the chemotherapy drug. The present results indicated the miR-221/222 and ANXA3 axis to be a possible novel therapeutic target for the treatment of breast cancer.
Collapse
Affiliation(s)
- Ju-Yeon Kim
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsang 52727, Republic of Korea
| | - Eun Jung Jung
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Gyeongsang 51472, Republic of Korea,Correspondence to: Professor Eun Jung Jung, Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 11 Samjeongja-ro, Seongsan, Changwon, Gyeongsang 51472, Republic of Korea
| | - Jae-Myung Kim
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsang 52727, Republic of Korea
| | - Youngsim Son
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsang 52727, Republic of Korea
| | - Han Shine Lee
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Gyeongsang 51472, Republic of Korea
| | - Seung-Jin Kwag
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsang 52727, Republic of Korea
| | - Ji-Ho Park
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsang 52727, Republic of Korea
| | - Jin-Kyu Cho
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsang 52727, Republic of Korea
| | - Han-Gil Kim
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsang 52727, Republic of Korea
| | - Taejin Park
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Gyeongsang 51472, Republic of Korea
| | - Sang-Ho Jeong
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Gyeongsang 51472, Republic of Korea
| | - Chi-Young Jeong
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsang 52727, Republic of Korea
| | - Young-Tae Ju
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsang 52727, Republic of Korea
| |
Collapse
|
4
|
Chun SH, Kim JH, Kwag SJ, Kang MH, Park JH, Lee GW, Kang JH. Second-line bevacizumab plus FOLFOX in patients with metastatic colorectal cancer previously treated with adjuvant oxaliplatin-based chemotherapy. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
157 Background: There is a rarity of evidence for retreatment with oxaliplatin for metastatic colorectal cancer (mCRC), especially in combination with bevacizumab. This is a retrospective study of second line bevacizumab (Bev) plus FOLFOX (oxaliplatin, 5-fluorouracil, and leucovorin) in patients with metastatic colorectal cancer previously treated with adjuvant oxaliplatin-containing chemotherapy. Methods: Patients with age older than 18 and histologically confirmed metastatic colorectal cancer treated with second line bevacizumab plus FOLFOX in a single institute between 2015 and 2020 were enrolled. History of previous adjuvant chemotherapy regimens in patients with metachronous metastatic colorectal cancer was analyzed. Progression-free survival (PFS) and overall survival (OS) of the second line treatment were calculated using Kaplan-Meier method and compared between patients pretreated with adjuvant oxaliplatin (ReOx) and oxaliplatin-naive patients (control) with the log rank test. Results: A total of 72 patients were included. 23 patients (ReOx) were pretreated with adjuvant oxaliplatin and 49 patients (control) were oxaliplatin-naive before the second line treatment. There was a tendency of younger age in the ReOx group, but not statistically significant. Liver metastasis was significantly more frequent in the control group. The median PFS and OS in the ReOx group and the control group were 4.3 months (95% confidence interval [CI], 3.67–21.50) versus 5.5 months (95% CI, 4.23–8.20, hazard ratio [HR] = 0.84), and 10.5 months (95% CI, 5.40–30.37) versus 9.4 months (95% CI, 6.00–14.9, HR = 1.01) respectively. There was no significant difference of PFS ( p= 0.523) and OS ( p= 0.9745) between two groups. Conclusions: This study suggests a potential survival benefit of bevacizumab plus FOLFOX for mCRC patients previously treated with adjuvant oxaliplatin-containing treatment comparable to oxaliplatin-naive patients. [Table: see text]
Collapse
Affiliation(s)
- Sang Hoon Chun
- Division of Hematology/Oncology, Department of Internal Medicine, Bucheon St.Mary's hospital, Catholic University of Korea, Bucheon-Si, South Korea
| | - Jung Hoon Kim
- Division of Hematology/Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju-Si, South Korea
| | - Seung-Jin Kwag
- Gyeonsang National University Hospital, Jinju-Si, South Korea
| | - Myoung Hee Kang
- Gyeongsang National University, School of Medicine, Jinju-Si, South Korea
| | - Ji-Ho Park
- Gyeongsang National University, Jinju-Si, South Korea
| | - Gyeong-Won Lee
- Division of Hematology and Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicin, Jinju, Korea, Republic of (South)
| | - Jung Hun Kang
- Gyeongsang National University, School of Medicine, Jinju-Si, South Korea
| |
Collapse
|
5
|
Cho JK, Kim JR, Jang JY, Kim HG, Kim JM, Kwag SJ, Park JH, Kim JY, Ju YT, Jeong CY. Comparison of the Oncological Outcomes of Open versus Laparoscopic Surgery for T2 Gallbladder Cancer: A Propensity-Score-Matched Analysis. J Clin Med 2022; 11:jcm11092644. [PMID: 35566770 PMCID: PMC9099510 DOI: 10.3390/jcm11092644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/25/2022] [Accepted: 05/06/2022] [Indexed: 02/01/2023] Open
Abstract
Although laparoscopic treatment for T1 gallbladder cancer (GBC) has been described previously, the differences in oncologic outcomes between laparoscopic and conventional open surgery for T2 GBC have not been investigated. We aimed to assess the role of laparoscopic surgery using retrospectively collected data for 81 patients with T2 GBC who underwent surgical resection between January 2010 and December 2017. Eligible patients were classified into “laparoscopic” and “open” groups. Propensity-score matching was performed in a 1:1 ratio. The effects of surgery type on surgical and oncological outcomes were investigated. After propensity-score matching, 19 patients were included in the open and laparoscopic surgery groups. The median follow-up durations were 70 and 26 months in the open and laparoscopic groups, respectively. The operative time (316.8 ± 80.3 vs. 218.9 ± 145.0 min, p = 0.016) and length of postoperative hospital stay (14.4 ± 6.0 vs. 8.4 ± 5.9 days, p = 0.004) were significantly shorter in the laparoscopic group. The three-year overall (86.3% vs. 88.9%, p = 0.660) and disease-free (76.4% vs. 60.2%, p = 0.448) survival rates were similar between the groups. Propensity-score matching showed that laparoscopic surgery for T2 GBC yielded similar long-term oncological outcomes and favorable short-term outcomes in comparison with open surgery. Laparoscopic treatment should be considered in patients with T2 GBC.
Collapse
Affiliation(s)
- Jin-Kyu Cho
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, 79, Gangnam-ro, Jinju 52727, Korea; (J.-K.C.); (H.-G.K.); (J.-M.K.); (S.-J.K.); (J.-H.P.); (J.-Y.K.); (Y.-T.J.)
| | - Jae-Ri Kim
- Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, 11, Samjeongja-ro, Changwon-si 51472, Korea; (J.-R.K.); (J.-Y.J.)
| | - Jae-Yool Jang
- Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, 11, Samjeongja-ro, Changwon-si 51472, Korea; (J.-R.K.); (J.-Y.J.)
| | - Han-Gil Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, 79, Gangnam-ro, Jinju 52727, Korea; (J.-K.C.); (H.-G.K.); (J.-M.K.); (S.-J.K.); (J.-H.P.); (J.-Y.K.); (Y.-T.J.)
| | - Jae-Myung Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, 79, Gangnam-ro, Jinju 52727, Korea; (J.-K.C.); (H.-G.K.); (J.-M.K.); (S.-J.K.); (J.-H.P.); (J.-Y.K.); (Y.-T.J.)
| | - Seung-Jin Kwag
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, 79, Gangnam-ro, Jinju 52727, Korea; (J.-K.C.); (H.-G.K.); (J.-M.K.); (S.-J.K.); (J.-H.P.); (J.-Y.K.); (Y.-T.J.)
| | - Ji-Ho Park
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, 79, Gangnam-ro, Jinju 52727, Korea; (J.-K.C.); (H.-G.K.); (J.-M.K.); (S.-J.K.); (J.-H.P.); (J.-Y.K.); (Y.-T.J.)
| | - Ju-Yeon Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, 79, Gangnam-ro, Jinju 52727, Korea; (J.-K.C.); (H.-G.K.); (J.-M.K.); (S.-J.K.); (J.-H.P.); (J.-Y.K.); (Y.-T.J.)
| | - Young-Tae Ju
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, 79, Gangnam-ro, Jinju 52727, Korea; (J.-K.C.); (H.-G.K.); (J.-M.K.); (S.-J.K.); (J.-H.P.); (J.-Y.K.); (Y.-T.J.)
| | - Chi-Young Jeong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, 79, Gangnam-ro, Jinju 52727, Korea; (J.-K.C.); (H.-G.K.); (J.-M.K.); (S.-J.K.); (J.-H.P.); (J.-Y.K.); (Y.-T.J.)
- Correspondence: ; Tel.: +82-10-9360-8294
| |
Collapse
|
6
|
Bae SH, Kim JY, Jung EJ, Lee HS, Choi BH, Kwag SJ, Park JH, Cho JK, Kim HG, Ju YT, Jeong CY, Lee YJ, Hong SC, Kim JM. The role of fluorodeoxyglucose-PET/computed tomography as a predictor of breast cancer characteristics and prognosis. Nucl Med Commun 2022; 43:108-113. [PMID: 34419988 DOI: 10.1097/mnm.0000000000001476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Fluorodeoxyglucose-PET/computed tomography (FDG-PET/CT) affects the management of patients with breast cancer. Our study aimed to determine the predictive ability of characteristics such as lymph node involvement or subtype and the prognostic value of pretreatment FDG-PET/CT in breast cancer. METHOD A total of 270 patients who were confirmed with breast cancer histopathologically and underwent pretreatment FDG-PET/CT were enrolled in the study. Nuclear medicine specialists obtained the readings and measured the maximum standardized uptake value (SUVmax) of the images. Tumor and lymph node SUVmax were evaluated according to lymph node metastasis and subtype status. Survival outcomes were analyzed by the Kaplan-Meier method. RESULTS The lymph node SUVmax and the lymph node/tumor SUVmax ratio were significantly higher in the subgroup of patients with lymph node metastasis than in those without lymph node metastasis. High cutoff lymph node SUVmax value and lymph node/tumor SUVmax ratio were confirmed as significant predictive factors in multivariate analysis. In a comparison of the tumor SUVmax values, the more biological aggressive subtype showed higher tumor SUVmax values. In survival analysis, tumor SUVmax and lymph node SUVmax were significant predisposing factors for disease-free survival in breast cancer. In subgroup analysis, tumor SUVmax was a more significant prognostic factor in patients who had breast cancer with tumor sizes of ≤2 cm. The lymph node SUVmax was more a significant prognostic factor in patients who had breast cancer with lymph node metastasis. CONCLUSION In this study, we showed that the SUVmax of FDG-PET/CT was a useful predictor of lymph node metastasis and breast cancer prognosis.
Collapse
Affiliation(s)
- Sung Hun Bae
- Surgery, Gyeongsang National University Hospital, Jinju
| | - Ju-Yeon Kim
- Surgery, Gyeongsang National University Hospital, Jinju
| | - Eun Jung Jung
- Surgery, Changwon Gyeongsang National University Hospital, Changwon
| | - Han Shin Lee
- Surgery, Changwon Gyeongsang National University Hospital, Changwon
| | - Bong-Hoi Choi
- Neuclear Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | | | - Ji-Ho Park
- Surgery, Gyeongsang National University Hospital, Jinju
| | - Jin-Kyu Cho
- Surgery, Gyeongsang National University Hospital, Jinju
| | - Han-Gil Kim
- Surgery, Gyeongsang National University Hospital, Jinju
| | - Young-Tae Ju
- Surgery, Gyeongsang National University Hospital, Jinju
| | | | - Young-Joon Lee
- Surgery, Changwon Gyeongsang National University Hospital, Changwon
| | | | - Jae-Myung Kim
- Surgery, Gyeongsang National University Hospital, Jinju
| |
Collapse
|
7
|
Kim HG, Yang JW, Hong SC, Ju YT, Jeong CY, Kim JY, Park JH, Lee JK, Kim JM, Cho JK, Kwag SJ. Ileocolonic Intussusception Caused by Epithelioid Leiomyosarcoma of the Ileum: A Report of Case and Review of the Literature. Ann Coloproctol 2021; 38:176-180. [PMID: 34044504 PMCID: PMC9021852 DOI: 10.3393/ac.2020.12.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/08/2020] [Indexed: 11/02/2022] Open
Abstract
Small intestinal malignant tumor accounts for about 3% of all malignant tumors in the gastrointestinal tract, among which 13% are leiomyosarcoma (LMS). In addition, epithelioid LMS is of very rare occurrence. As small intestinal malignant tumors are initially asymptomatic and nonspecific, diagnosis is often delayed, and this can lead to large tumor at the time of detection and lead to intussusception. We observed ileocolonic intussusception in an 80-year-old male patient who was admitted to the hospital with a complaint of abdominal pain and palpable mass on right lower quadrant. The laparoscopic ileocecectomy was performed by the emergency operation because of obstruction. The pathologic examination revealed that the epithelioid LMS developed in the terminal ileum was the leading point of intussusception. To the best of our knowledge, laparoscopic surgery for ileocolonic intussusception with epithelioid LMS has not yet been reported.
Collapse
Affiliation(s)
- Han-Gil Kim
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jung Wook Yang
- Department of Pathology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Soon-Chan Hong
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Young-Tae Ju
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Chi-Young Jeong
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Ju-Yeon Kim
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Ji-Ho Park
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jin-Kwon Lee
- Department of General Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Jae-Myung Kim
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jin-Kyu Cho
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Seung-Jin Kwag
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| |
Collapse
|
8
|
Jung EJ, Kim JY, Kim JM, Lee HS, Kwag SJ, Park JH, Park T, Jeong SH, Jeong CY, Ju YT, Lee YJ, Hong SC. Positive estrogen receptor status is a poor prognostic factor in node-negative breast cancer: An observational study in Asian patients. Medicine (Baltimore) 2021; 100:e25000. [PMID: 33725973 PMCID: PMC7982180 DOI: 10.1097/md.0000000000025000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 02/10/2021] [Indexed: 01/05/2023] Open
Abstract
This study evaluated the outcomes and prognostic factors for breast cancer according to initial lymph node (LN) status. Among patients with LN-negative breast cancer, we also focused on the prognostic value of estrogen receptor (ER) status.Medical records were retrospectively reviewed for 715 patients who underwent curative surgery for breast cancer between January 2005 and December 2015 at a single Korean institution. We evaluated factors that were associated with metastasis-free survival (MFS) according to LN status.Among the 715 patients (age: 28-87 years), 458 patients (64.1%) did not have axillary LN metastasis. Relative to patients without LN metastasis, patients with LN metastasis had larger tumor sizes and higher histological grades. Among patients with no LN metastasis, ER positivity was associated with non-significantly poorer MFS than ER negativity (mean survival: 138.90 months vs. 146.99 months, p = .17), and patients with LN-negative ER-positive disease had MFS rates of 91.7% at 5 years and 74.5% at 10 years. Among patients with LN-negative ER-positive disease, a poor prognosis was significantly associated with larger tumor size (≥2 cm, P = .03) and older age (≥50 years, P = .03).These results indicate that the risk of metastasis increases over time for patients with LN-negative ER-positive breast cancer, and especially for older patients or patients with larger tumors.
Collapse
Affiliation(s)
- Eun Jung Jung
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon
| | - Ju-Yeon Kim
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Jae-Myung Kim
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Han Shin Lee
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon
| | - Seung-Jin Kwag
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Ji-Ho Park
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Taejin Park
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon
| | - Sang-Ho Jeong
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon
| | - Chi-Young Jeong
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Young-Tae Ju
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Young-Joon Lee
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon
| | - Soon-Chang Hong
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| |
Collapse
|
9
|
Kim JY, Jung EJ, Kim JM, Lee HS, Kwag SJ, Park JH, Park T, Jeong SH, Jeong CY, Ju YT. Dynamic changes of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio predicts breast cancer prognosis. BMC Cancer 2020; 20:1206. [PMID: 33287745 PMCID: PMC7720486 DOI: 10.1186/s12885-020-07700-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/30/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND We aimed to identify whether neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are more useful predictors after initial intention to treat than at the time of diagnosis. METHODS We collected the medical data of 533 patients. The results of the peripheral blood sampling before the primary treatments were labeled as initial cohort, and those obtained between 24 and 36 months after initial treatment were defined as the 2nd cohort. Delayed metastasis has been defined as distant metastasis 2 years after treatment, and survival outcome was estimated and compared across groups. RESULTS Median follow-up duration was 74 months (24-162 months), and 53 patients experienced delayed metastasis. In univariate analysis, metastasis-free survival, patient age at diagnosis, tumor size, axillary lymph node metastasis, HER-2 status, initial NLR and PLR, and 2nd NLR and PLR were found to be significantly associated with delayed metastasis. However, in multivariate analysis, only the 2nd NLR and PLR were found to be significantly associated with delayed metastasis, excluding initial NLR and PLR. Metastasis-free survival was analyzed through the pattern changes of NLR or PLR. The results revealed that patients with continued low NLR and PLR values at pre- and post-treatment (low initial values and 2nd values) showed a significantly better prognosis than those with a change in value or continued high NLR and PLR. CONCLUSIONS We identified that patients with persistent high NLR and PLR after initial treatment have significant worse prognosis in terms of late metastasis. Therefore, these results suggest that NLR and PLR are more useful in predicting prognosis post-treatment.
Collapse
Affiliation(s)
- Ju-Yeon Kim
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, 11, Samjeongjaro, Seongsangu, Changwonsi, Republic of Korea, 51472
| | - Eun Jung Jung
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 11, Samjeongjaro, Seongsangui, Changwonsi, Republic of Korea.
| | - Jae-Myung Kim
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, 11, Samjeongjaro, Seongsangu, Changwonsi, Republic of Korea, 51472
| | - Han Shin Lee
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 11, Samjeongjaro, Seongsangui, Changwonsi, Republic of Korea
| | - Seung-Jin Kwag
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, 11, Samjeongjaro, Seongsangu, Changwonsi, Republic of Korea, 51472
| | - Ji-Ho Park
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, 11, Samjeongjaro, Seongsangu, Changwonsi, Republic of Korea, 51472
| | - Taejin Park
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 11, Samjeongjaro, Seongsangui, Changwonsi, Republic of Korea
| | - Sang-Ho Jeong
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 11, Samjeongjaro, Seongsangui, Changwonsi, Republic of Korea
| | - Chi-Young Jeong
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, 11, Samjeongjaro, Seongsangu, Changwonsi, Republic of Korea, 51472
| | - Young-Tae Ju
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, 11, Samjeongjaro, Seongsangu, Changwonsi, Republic of Korea, 51472
| |
Collapse
|
10
|
Kim DH, Hong SC, Jang JY, Cho JK, Ju YT, Lee YJ, Jung EJ, Jeong SH, Park TJ, Kim JY, Kwag SJ, Park JH, Jeong CY. Comparing the surgical outcomes of stapled anastomosis versus hand-sewn anastomosis of duodenojejunostomy in pylorus-preserving pancreaticoduodenectomy. Ann Hepatobiliary Pancreat Surg 2019; 23:245-251. [PMID: 31501813 PMCID: PMC6728254 DOI: 10.14701/ahbps.2019.23.3.245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/21/2019] [Accepted: 04/30/2019] [Indexed: 12/28/2022] Open
Abstract
Backgrounds/Aims This study is to evaluate the perioperative outcomes of the duodenojejunostomy (DJ) procedure in pylorus preserving pancreaticoduodenectomy (PPPD). Methods In this study, as noted between 2010 and 2018, there were 77 PPPDs which were performed at our hospital by one surgeon. We began the circular stapled method from 2014, and continue with this procedure for the aforementioned surgeries including and up to today. The clinical data for the study were collected retrospectively to compare clinical outcomes of the two methods, the circular stapled anastomosis and the hand - sewn anastomosis. Results There were 34 patients in a circular stapled group, and 43 in a hand-sewn group as identified for this study. The delayed gastric emptying (DGE) occurred in 6 (17.64%) patients in the circular stapled group, and 10 (23.3%) in the hand-sewn group (p=0.547). It is noted that there was a serum albumin level measured on the 14th day after the operation, which was significantly high in the circular stapled group (3.41±0.47 (g/dl) vs 2.92±0.39 (g/dl), p<0.001). There were no significant differences in terms of the incidence of postoperative complications (58.8% vs 58.1%, p=0.952) and mortality rates (5.9% vs 0, p=0.192) among the patient participants in this study. Conclusions We conclude that using a circular stapler for the DJ procedure in PPPDs do not increase the development of a DGE, and is also helpful for the benefit of the patient's nutritional status going forward during recovery from the operation.
Collapse
Affiliation(s)
- Dong-Hwan Kim
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Soon-Chan Hong
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jae-Yool Jang
- Department of General Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Jin-Kyu Cho
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Young-Tae Ju
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Young-Joon Lee
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Eun-Jung Jung
- Department of General Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Sang-Ho Jeong
- Department of General Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Tae-Jin Park
- Department of General Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Ju-Yeon Kim
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Seung-Jin Kwag
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Ji-Ho Park
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Chi-Young Jeong
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| |
Collapse
|
11
|
Cho JK, Lee W, Jang JY, Kim HG, Kim JM, Kwag SJ, Park JH, Kim JY, Park T, Jeong SH, Ju YT, Jung EJ, Lee YJ, Hong SC, Jeong CY. Validation of the oncologic effect of hepatic resection for T2 gallbladder cancer: a retrospective study. World J Surg Oncol 2019; 17:8. [PMID: 30616645 PMCID: PMC6323785 DOI: 10.1186/s12957-018-1556-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/27/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND While extended cholecystectomy is recommended for T2 gallbladder cancer (GBC), the role of hepatic resection for T2 GBC is unclear. This study aimed to identify the necessity of hepatic resection in patients with T2 GBC. METHODS Data of 81 patients with histopathologically proven T2 GBC who underwent surgical resection between January 1999 and December 2017 were enrolled from a retrospective database. Of these, 36 patients had peritoneal-side (T2a) tumors and 45 had hepatic-side (T2b) tumors. To identify the optimal surgical management method, T2 GBC patients were classified into the hepatic resection group (n = 44, T2a/T2b = 20/24) and non-hepatic resection group (n = 37, T2a/T2b = 16/21). The recurrence pattern and role of hepatic resection for T2 GBC were then investigated. RESULTS Mean age of the patients was 69 (range 36-88) years, and the male-to-female ratio was 42:39 (male, 51.9%; female, 48.1%). Hepatic-side GBC had a higher rate of recurrence than peritoneal-side GBC (44.4% vs. 8.3%, p = 0.006). The most common type of recurrence in T2a GBC was para-aortic lymph node recurrence (n = 2, 5.6%); the most common types of recurrence in T2b GBC were para-aortic lymph node recurrence (n = 7, 15.6%) and intrahepatic metastasis (n = 6, 13.3%). Hepatic-side GBC patients had worse survival outcomes than peritoneal-side GBC patients (76.0% vs. 96.6%, p = 0.041). Hepatic resection had no significant treatment effect in T2 GBC patients (p = 0.272). Multivariate analysis showed that lymph node metastasis was the only significant prognostic factor (p = 0.002). CONCLUSIONS Hepatic resection is not essential for curative treatment in T2 GBC, and more systemic treatments are needed for GBC patients, particularly for those with T2b GBC.
Collapse
Affiliation(s)
- Jin-Kyu Cho
- 0000 0001 0661 1492grid.256681.eDepartment of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79, Gangnam-ro, Jinju, 660-702 South Korea
| | - Woohyung Lee
- 0000 0001 0661 1492grid.256681.eDepartment of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University Postgraduate School of Medicine, 11, Samjeongja-ro, Changwoun-si, 51472 South Korea
| | - Jae Yool Jang
- 0000 0001 0661 1492grid.256681.eDepartment of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79, Gangnam-ro, Jinju, 660-702 South Korea
| | - Han-Gil Kim
- 0000 0001 0661 1492grid.256681.eDepartment of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79, Gangnam-ro, Jinju, 660-702 South Korea
| | - Jae-Myung Kim
- 0000 0001 0661 1492grid.256681.eDepartment of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79, Gangnam-ro, Jinju, 660-702 South Korea
| | - Seung-Jin Kwag
- 0000 0001 0661 1492grid.256681.eDepartment of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79, Gangnam-ro, Jinju, 660-702 South Korea
| | - Ji-Ho Park
- 0000 0001 0661 1492grid.256681.eDepartment of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79, Gangnam-ro, Jinju, 660-702 South Korea
| | - Ju-Yeon Kim
- 0000 0001 0661 1492grid.256681.eDepartment of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79, Gangnam-ro, Jinju, 660-702 South Korea
| | - Taejin Park
- 0000 0001 0661 1492grid.256681.eDepartment of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University Postgraduate School of Medicine, 11, Samjeongja-ro, Changwoun-si, 51472 South Korea
| | - Sang-Ho Jeong
- 0000 0001 0661 1492grid.256681.eDepartment of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University Postgraduate School of Medicine, 11, Samjeongja-ro, Changwoun-si, 51472 South Korea
| | - Young-Tae Ju
- 0000 0001 0661 1492grid.256681.eDepartment of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79, Gangnam-ro, Jinju, 660-702 South Korea
| | - Eun-Jung Jung
- 0000 0001 0661 1492grid.256681.eDepartment of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University Postgraduate School of Medicine, 11, Samjeongja-ro, Changwoun-si, 51472 South Korea
| | - Young-Joon Lee
- 0000 0001 0661 1492grid.256681.eDepartment of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79, Gangnam-ro, Jinju, 660-702 South Korea
| | - Soon-Chan Hong
- 0000 0001 0661 1492grid.256681.eDepartment of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79, Gangnam-ro, Jinju, 660-702 South Korea
| | - Chi-Young Jeong
- 0000 0001 0661 1492grid.256681.eDepartment of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79, Gangnam-ro, Jinju, 660-702 South Korea
| |
Collapse
|
12
|
Kim HG, Ju YT, Lee JK, Hong SC, Lee YJ, Jeong CY, Kim JY, Park JH, Jang JY, Kwag SJ. Three-Port Laparoscopic Right Colectomy Versus Conventional Five-Port Laparoscopy for Right-Sided Colon Cancer. J Laparoendosc Adv Surg Tech A 2018; 29:465-470. [PMID: 30265591 DOI: 10.1089/lap.2018.0498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The purpose of the study was to evaluate the safety and effectiveness of three-port laparoscopic right colectomy (3-LRC) for right-sided colon cancer compared with conventional five-port laparoscopic right colectomy (5-LRC). MATERIALS AND METHODS One hundred sixty-three patients diagnosed with right-sided colon adenocarcinoma underwent laparoscopic right colectomy (LRC) between April 2011 and December 2017. Seventy-four of these patients underwent 3-LRC procedure and 89 patients underwent 5-LRC. Clinical characteristics, perioperative short-term outcomes, and pathologic data were analyzed. RESULTS There were no differences in TNM stage, tumor location, estimated blood loss, complications, and open conversion rates. The operation time was shorter in the 3-LRC group than in 5-LRC group (140.9 ± 27.5 minutes versus 178.2 ± 38.2 minutes; P = .001). The number of harvested lymph nodes (28.5 ± 13.9 versus 22.6 ± 11.7; P = .004) was also higher in the 3-LRC group. The first passage of flatus and first oral diet were significantly faster in the 3-LRC group than in the 5-LRC group (2.8 ± 1.0 days versus 4.0 ± 1.2 days; P = .001, 3.6 ± 2.9 days versus 5.0 ± 1.5 days; P = .001). The number of patients who required analgesics is less in the 3-LRC group (32.4% versus 43.8%; P = .583). CONCLUSION 3-LRC for right-sided colon cancer is technically feasible and is associated with a short operation time. We believe that 3-LRC effectively reduces the costs associated with equipment and manpower and represents a standard procedure.
Collapse
Affiliation(s)
- Han-Gil Kim
- 1 Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Young-Tae Ju
- 1 Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Jin-Kwon Lee
- 2 Department of General Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Republic of Korea
| | - Soon-Chan Hong
- 1 Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Young-Joon Lee
- 1 Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Chi-Young Jeong
- 1 Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Joo-Yeon Kim
- 1 Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Ji-Ho Park
- 1 Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Jae Yool Jang
- 1 Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Seung-Jin Kwag
- 1 Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| |
Collapse
|
13
|
Kim HG, Yang JW, Hong SC, Lee YJ, Ju YT, Jeong CY, Lee JK, Kwag SJ. Toxocara canis Mimicking a Metastatic Omental Mass from Sigmoid Colon Cancer: A Case Report. Ann Coloproctol 2018; 34:160-163. [PMID: 29991206 PMCID: PMC6046541 DOI: 10.3393/ac.2017.12.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 12/20/2017] [Indexed: 12/21/2022] Open
Abstract
Toxocara canis is an important roundworm of canids and a fearsome animal parasite of humans. Human infections can lead to syndromes called visceral larva migrans (VLM), ocular larva migrans, neurotoxocariasis, and covert toxocariasis. VLM is most commonly diagnosed in children younger than 8 years of age, but adult cases are relatively frequent among those infected by ingesting the raw tissue of paratenic hosts in East Asia. This research reports the case of a 59-year-old man with sigmoid colon cancer, who visited our institution for surgery. An intraperitoneal mass was found on preoperative computed tomography, and it was thought to be a metastatic mass from sigmoid colon cancer. A postoperative histologic examination and serum test showed eosinophilic granuloma due to toxocariasis. Diagnosis of VLM is often difficult and highly suspicious in adults. Researchers suggest, although rarely, that VLM be included in the differential diagnosis as a cause of intraperitoneal tumors.
Collapse
Affiliation(s)
- Han-Gil Kim
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jung-Wook Yang
- Department of Pathology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Soon-Chan Hong
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Young-Joon Lee
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Young-Tae Ju
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Chi-Young Jeong
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jin-Kwon Lee
- Department of General Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Seung-Jin Kwag
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| |
Collapse
|
14
|
Kim TH, Park JH, Jeong SH, Lee JK, Kwag SJ, Kim JY, Lee W, Woo JW, Jang JY, Song EJ, Park T, Jeong CY, Ju YT, Jung EJ, Hong SC, Choi SK, Ha WS, Lee YJ. Feasibility of a novel laparoscopic technique with unidirectional knotless barbed sutures for the primary closure of duodenal ulcer perforation. Surg Endosc 2018; 32:3667-3674. [PMID: 29470633 DOI: 10.1007/s00464-018-6099-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 02/07/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Laparoscopic primary repair is one of the main procedures used for perforated gastric ulcers, and this technique requires reproducible and secure suturing. The aim of this study was to investigate the safety and efficacy of a novel continuous suture method with barbed sutures during laparoscopic repair for perforated peptic ulcers. PATIENTS AND METHODS Clinical data from 116 consecutive patients undergoing laparoscopic repair for perforated peptic ulcers were collected between November 2009 and October 2015. Continuous suturing with 15-cm-long unidirectional absorbable barbed sutures was used for laparoscopic repair in the study group, termed group V (n = 51). Patients who underwent laparoscopic repair with conventional interrupted sutures were defined as group C (n = 65). The complication and operative data were compared between groups. RESULTS Although there was no difference between group V and group C in the overall complication rate (15.7% vs. 24.6%; p = 0.259), the complication rate related to suturing was lower (3.9% vs. 15.4%; p = 0.04) in group V. Group V showed rates of 0% for leakage, 2% for intra-abdominal fluid collection, and 2% for stricture; the corresponding rates in group C were 3.1, 7.7, and 4.6%, respectively. Regarding operative data, the total operation time (V vs. C, 87.7 min vs. 131.2 min), total suture time (7.1 min vs. 25.3 min), and suture time per stitch (1.2 min vs. 6.2 min) were significantly shorter in group V than in group C (p < 0.001). CONCLUSION The use of a continuous suture technique with unidirectional barbed sutures is as safe as the conventional suture technique and allows easier and faster suturing in the repair of perforated peptic ulcers.
Collapse
Affiliation(s)
- Tae-Han Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Ji-Ho Park
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Sang-Ho Jeong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Jin-Kwon Lee
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Seung-Jin Kwag
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Ju-Yeon Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Woohyung Lee
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Jung-Woo Woo
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Jae Yool Jang
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Eun-Jin Song
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Taejin Park
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Chi-Young Jeong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Young-Tae Ju
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Eun-Jung Jung
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Soon-Chan Hong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Sang-Kyung Choi
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Woo-Song Ha
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Young-Joon Lee
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79 Gangnam-ro, Jinju, 52727, Republic of Korea.
| |
Collapse
|
15
|
Kim JY, Jung EJ, Park HJ, Lee JH, Song EJ, Kwag SJ, Park JH, Park T, Jeong SH, Jeong CY, Ju YT, Lee YJ, Hong SC. Tumor-Suppressing Effect of Silencing of Annexin A3 Expression in Breast Cancer. Clin Breast Cancer 2017; 18:e713-e719. [PMID: 29217453 DOI: 10.1016/j.clbc.2017.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 10/30/2017] [Accepted: 11/13/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Annexin A3 (ANXA3) participates in various tumor-associated biological processes, including tumor initiation, progression, and metastasis. The present study was designed to investigate the expression and function of ANXA3 in breast cancer cells. MATERIALS AND METHODS Annexin A3 protein expression in breast cancer cell lines was evaluated using Western blot analysis. ANXA3 expression in MDA-MB 231 breast cancer cells was silenced by RNA interference, and the effects of RNA silencing on cell proliferation, colony forming ability, wound-healing, and invasiveness were evaluated. Levels of ANXA3 expression in 30 primary breast cancers were assayed using immunohistochemistry and correlated with patient survival. RESULTS Levels of ANXA3 expression were higher in the basal subtype of breast cancer cells, such as MDA-MB 231, HCC-70, and HCC-1954 cells, than in other subtypes. ANXA3 silencing inhibited the activities of MDA-MB 231 and HCC-1954 cells, including their proliferation, invasion across transwell membranes, and wound-healing and colony forming abilities. ANXA3 small interfering RNA (siRNA) also reduced the expression of cycle-dependent kinase protein and increased the expression of E2F1 and p27 proteins compared with control siRNA. Expression of ANXA3 was closely correlated with tumor size, with higher ANXA3 expression associated with reduced disease-free survival in breast cancer patients. CONCLUSION These findings indicate that ANXA3 is associated with the natural progression of breast cancer and might be a potential prognostic marker of patient survival.
Collapse
Affiliation(s)
- Ju-Yeon Kim
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Eun Jung Jung
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
| | - Hee Jin Park
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Jeong-Hee Lee
- Department of Pathology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Eun Jin Song
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Seung-Jin Kwag
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Ji-Ho Park
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Taejin Park
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Sang-Ho Jeong
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Chi-Young Jeong
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Young-Tae Ju
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Young-Joon Lee
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Soon-Chan Hong
- Department of Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| |
Collapse
|
16
|
Lee W, Woo JW, Lee JK, Park JH, Kim JY, Kwag SJ, Park T, Jeong SH, Ju YT, Jeong EJ, Lee YJ, Choi SK, Hong SC, Jeong CY. Comparison of Learning Curves for Major and Minor Laparoscopic Liver Resection. J Laparoendosc Adv Surg Tech A 2016; 26:457-64. [PMID: 27120254 DOI: 10.1089/lap.2016.0063] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Because laparoscopic liver resection (LLR) has a steep learning curve, analyzing experience is important for trainees. Several authors have described the learning curve of LLR, without comparing the learning curves between major and minor LLR. METHODS Perioperative data were retrieved from the medical records of 170 consecutive patients who underwent LLR by a single surgeon at a tertiary hospital. Learning curves were generated and compared between major and minor LLR using cumulative sum control charts and the moving average. RESULTS Major and minor LLR was performed in 96 and 74 patients, respectively. The learning curves showed a steady state after case 50 for major LLR. Because of discordant results in minor LLR, subgroup analyses were performed, showing competency in LLR after cases 25 and 35 for left lateral sectionectomy and tumorectomy, respectively. Transfused red blood cell volume (0.6 versus 2.2 packs, P < .001) decreased after achievement of competence in major LLR. Blood loss exceeding 500 mL (odds ratio 2.395, 95% confidence interval 1.096-5.233, P = .028) was independently associated with LLR failure. CONCLUSIONS The number of cases required to accomplish LLR differed according to the extent of resection. Extensive blood loss was independently associated with LLR failure.
Collapse
Affiliation(s)
- Woohyung Lee
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine , Jinju, Korea
| | - Jung-Woo Woo
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine , Jinju, Korea
| | - Jin-Kwon Lee
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine , Jinju, Korea
| | - Ji-Ho Park
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine , Jinju, Korea
| | - Ju-Yeon Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine , Jinju, Korea
| | - Seung-Jin Kwag
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine , Jinju, Korea
| | - Taejin Park
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine , Jinju, Korea
| | - Sang-Ho Jeong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine , Jinju, Korea
| | - Young-Tae Ju
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine , Jinju, Korea
| | - Eun-Jung Jeong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine , Jinju, Korea
| | - Young-Joon Lee
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine , Jinju, Korea
| | - Sang-Kyung Choi
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine , Jinju, Korea
| | - Soon-Chan Hong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine , Jinju, Korea
| | - Chi-Young Jeong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine , Jinju, Korea
| |
Collapse
|
17
|
Lee W, Park JH, Kim JY, Kwag SJ, Park T, Jeong SH, Ju YT, Jung EJ, Lee YJ, Choi SK, Hong SC, Jeong CY. A case of gallbladder cancer combined with ectopic individual opening of pancreatic and bile ducts to the duodenal bulb. Korean J Hepatobiliary Pancreat Surg 2015; 19:121-4. [PMID: 26379734 PMCID: PMC4568595 DOI: 10.14701/kjhbps.2015.19.3.121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 08/18/2015] [Accepted: 08/21/2015] [Indexed: 12/30/2022]
Abstract
Ectopic opening of the pancreatic and bile ducts (EOPBD) into the duodenal bulb is an extremely rare congenital anomaly with unknown clinical implications. We presented a case of gallbladder cancer with EOPBD into the duodenal bulb. A 57-year-old male was referred to our hospital with intermittent right upper abdominal pain. Endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography showed individual EOPBD into the duodenal bulb with no papillary structure, and a focal nodular lesion in the gallbladder. A follow-up abdominal computed tomography scan 9 months later revealed a slight increase in the size of the fundal nodule, which was suspected as gallbladder cancer. An intraoperative frozen biopsy identified the nodular lesion as adenocarcinoma involving the cystic duct, and the patient underwent radical cholecystectomy including bile duct resection with hepaticojejunostomy. EOPBD is an extremely rare condition that can be associated with gallbladder malignancy as well as benign disease. Clinicians should follow up carefully and consider surgical treatment for suspected malignant lesions.
Collapse
Affiliation(s)
- Woohyung Lee
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, Jinju, Korea
| | - Ji-Ho Park
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, Jinju, Korea
| | - Ju-Yeon Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, Jinju, Korea
| | - Seung-Jin Kwag
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, Jinju, Korea
| | - Taejin Park
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, Jinju, Korea
| | - Sang-Ho Jeong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, Jinju, Korea
| | - Young-Tae Ju
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, Jinju, Korea
| | - Eun-Jung Jung
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, Jinju, Korea
| | - Young-Joon Lee
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, Jinju, Korea
| | - Sang-Kyung Choi
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, Jinju, Korea
| | - Soon-Chan Hong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, Jinju, Korea
| | - Chi-Young Jeong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, Jinju, Korea
| |
Collapse
|
18
|
Ju YT, Kwag SJ, Park HJ, Jung EJ, Jeong CY, Jeong SH, Lee YJ, Choi SK, Kang KR, Hah YS, Hong SC. Decreased expression of heat shock protein 20 in colorectal cancer and its implication in tumorigenesis. J Cell Biochem 2015; 116:277-86. [PMID: 25187324 DOI: 10.1002/jcb.24966] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 08/29/2014] [Indexed: 12/11/2022]
Abstract
Heat shock protein 20 (HSP20), which is a member of the small heat shock protein family, is known to participate in many pathological processes, such as asthma, intimal hyperplasia, and insulin resistance. However, the function of HSP20 in cancer development is not yet fully understood. In this study, we identified HSP20 as a down-regulated protein in 20 resected colorectal cancer (CRC) specimens compared with their paired normal tissues. Because HSP20 proteins were barely detectable in HCT-116 cells (a human colorectal cancer cell line), recombinant adenovirus encoding HSP20 (Ad-HSP20) was used to induce HSP20 overexpression in HCT-116 cells. Infection of Ad-HSP20, but not control adenovirus (Ad-GFP), reduced viability, and induced massive apoptosis in a time-dependent manner. The forced expression of HSP20 enhanced caspase-3/7 activity and down-regulated the anti-apoptotic Bcl-xL and Bcl-2 mRNA and protein levels. In addition, immunohistochemical analysis of 94 CRC specimens for HSP20 protein showed that reduced HSP20 expression was related to advanced TNM stage, lymph node metastasis, and tumor recurrence. Our study shows, for the first time, that expression of the HSP20 protein has a pro-death role in colorectal cancer cells. Therefore, HSP20 may have value as a prognostic tumor marker and its overexpression might be a novel strategy for CRC therapy.
Collapse
Affiliation(s)
- Young-Tae Ju
- Department of Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Lee YJ, Park JH, Jeong SH, Ha CY, Kwag SJ, Kim JY, Park T, Jeong CY, Ju YT, Jung EJ, Hong SC, Choi SK, Ha WS. A noble method for intraoperative fine localization during laparoscopic gastric local resection: endoscopic submucosal cutting and light transmission. Surg Endosc 2014; 29:2456-61. [PMID: 25277479 DOI: 10.1007/s00464-014-3858-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 08/15/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND The main requirements when performing laparoscopic local resection for early mucosal tumors of the stomach are a clearly defined cancer-free margin and precise tumor localization. In this study, a novel method for precise intraoperative tumor localization and appropriate resection in a porcine model is introduced: endoscopic submucosal cutting and light transmission (ESCLT). METHODS A total of 15 cases of laparoscopic local resection were performed in 6 pigs. The size of the target lesions was approximately 20 mm. The imaginary lesions were located in the high body anterior wall, posterior wall, lower body posterior wall, angle, and antrum anterior wall of the stomach. Mucosal marking around the lesions, mucosal precutting surrounding the marking, and submucosal cutting along the precutting line using white light endoscopy were sequentially performed. Next, an endoscopic light source was placed directly in front of the lesion. Exact oval-shaped submucosal cutting margins were identified via laparoscopy. Laparoscopic local resection was performed after the minimal distance from the stapler line to the submucosal cutting line was confirmed. The sizes of the mucosal marking, submucosal cutting line, and the entire resected mucosa and serosa were measured. RESULTS The procedure was completed successfully in all pigs. Local resection was completed on all of the lesions. The mean endoscopic and laparoscopic procedure times were 26.1 and 12.7 min, respectively. The mean size of the resected specimens was: (i) marking lesion, 22 × 19.5 mm; (ii) submucosal cutting line, 26.7 × 23.2 mm; (iii) entire resected mucosa, 37 × 31 mm; and (iv) entire resected serosa, 41.7 × 33.1 mm. There was no intraoperative morbidity. CONCLUSION ESCLT provides a precise and useful method of intraoperative tumor localization during laparoscopic local resection of the stomach in terms of minimizing the resection of normal stomach tissue and guaranteeing adequate mucosal safety margins.
Collapse
Affiliation(s)
- Young-Joon Lee
- Department of Surgery, Postgraduate School of Medicine, Gyeongsang National University, 79 Gangnam-ro, Jinju, Gyeongsang South Province, 660-702, South Korea
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Kwag SJ, Choi SK, Jung EJ, Jung CY, Jung SH, Park TJ, Ju YT. Surgical strategy for colonic intussusception caused by a giant colonic lipoma: a report of two cases and a review of the literature. Ann Coloproctol 2014; 30:147-50. [PMID: 24999467 PMCID: PMC4079814 DOI: 10.3393/ac.2014.30.3.147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 11/05/2013] [Indexed: 12/21/2022] Open
Abstract
A colon lipoma is a remarkably rare tumor. In most cases, the tumors are asymptomatic and small in size, need to be differentiated from malignant tumors, and do not need any special treatment. Selection of the right surgical strategy depends on the status of bowel, as well as the size and the location of tumor. We encountered two patients with giant submucosal lipomas that had induced intussusceptions: one with a lipoma in the transverse colon and the other with a lipoma in the ascending colon. The diagnoses were made by using histological examinations. We report the clinical features, diagnoses, and treatments of, as well as our experience with, these two uncommon cases, and we present a review of the literature on this subject.
Collapse
Affiliation(s)
- Seung-Jin Kwag
- Department of Surgery, Gyeongsang National University Postgraduate School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Sang-Kyung Choi
- Department of Surgery, Gyeongsang National University Postgraduate School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Eun-Jung Jung
- Department of Surgery, Gyeongsang National University Postgraduate School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Chi-Young Jung
- Department of Surgery, Gyeongsang National University Postgraduate School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Sang-Ho Jung
- Department of Surgery, Gyeongsang National University Postgraduate School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Tae-Jin Park
- Department of Surgery, Gyeongsang National University Postgraduate School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Young-Tae Ju
- Department of Surgery, Gyeongsang National University Postgraduate School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| |
Collapse
|
21
|
Kwag SJ, Kim JG, Kang WK, Lee JK, Oh ST. Niti CAR 27 Versus a Conventional End-to-End Anastomosis Stapler in a Laparoscopic Anterior Resection for Sigmoid Colon Cancer. Ann Coloproctol 2014; 30:77-82. [PMID: 24851217 PMCID: PMC4022756 DOI: 10.3393/ac.2014.30.2.77] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 07/24/2013] [Indexed: 01/04/2023] Open
Abstract
PURPOSE The Niti CAR 27 (ColonRing) uses compression to create an anastomosis. This study aimed to investigate the safety and the effectiveness of the anastomosis created with the Niti CAR 27 in a laparoscopic anterior resection for sigmoid colon cancer. METHODS In a single-center study, 157 consecutive patients who received an operation between March 2010 and December 2011 were retrospectively assessed. The Niti CAR 27 (CAR group, 63 patients) colorectal anastomoses were compared with the conventional double-stapled (CDS group, 94 patients) colorectal anastomoses. Intraoperative, immediate postoperative and 6-month follow-up data were recorded. RESULTS There were no statistically significant differences between the two groups in terms of age, gender, tumor location and other clinical characteristics. One patient (1.6%) in the CAR group and 2 patients (2.1%) in the CDS group experienced complications of anastomotic leakage (P = 0.647). These three patients underwent a diverting loop ileostomy. There were 2 cases (2.1%) of bleeding at the anastomosis site in the CDS group. All patients underwent a follow-up colonoscopy (median, 6 months). One patient in the CAR group experienced anastomotic stricture (1.6% vs. 0%; P = 0.401). This complication was solved by using balloon dilatation. CONCLUSION Anastomosis using the Niti CAR 27 device in a laparoscopic anterior resection for sigmoid colon cancer is safe and feasible. Its use is equivalent to that of the conventional double-stapler.
Collapse
Affiliation(s)
- Seung-Jin Kwag
- Department of Surgery, Gyeongsang National University, Postgraduate School of Medicine, Jinju, Korea
| | - Jun-Gi Kim
- Department of Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | - Won-Kyung Kang
- Department of Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | - Jin-Kwon Lee
- Department of Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | - Seong-Taek Oh
- Department of Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| |
Collapse
|
22
|
Kwag SJ, Kim JG, Kang WK, Lee JK, Oh ST. The nutritional risk is a independent factor for postoperative morbidity in surgery for colorectal cancer. Ann Surg Treat Res 2014; 86:206-11. [PMID: 24783180 PMCID: PMC3996723 DOI: 10.4174/astr.2014.86.4.206] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 11/18/2013] [Accepted: 11/20/2013] [Indexed: 01/10/2023] Open
Abstract
Purpose The authors evaluate the prevalence of malnutrition and its effect on the postoperative morbidity of patients after surgery for colorectal cancer. Methods Three hundred fifty-two patients were enrolled prospectively. Nutritional risk screening 2002 (NRS 2002) score was calculated through interview with patient on admission. Clinical characteristics, tumor status and surgical procedure were recorded. Results The prevalence of patients at nutritional risk was 28.1 per cent according to the NRS 2002. The rate of postoperative complication was 27%. There was a significant difference in postoperative complication rates between patients at nutritional risk and those not at risk (37.4% vs. 22.9%, P = 0.006). Nutritional risk was identified as an independent predictor of postoperative complications (odds ratio, 3.05; P = 0.045). Nutritional risk increased the rate of anastomotic leakage (P = 0.027) and wound infection (P = 0.01). Conclusion NRS may be a prognostic factor for postoperative complication after surgery for colorectal cancer. A large scaled prospective study is needed to confirm whether supplementing nutritional deficits reduces postoperative complication rates.
Collapse
Affiliation(s)
- Seung-Jin Kwag
- Department of Surgery, Gyeongsang National University, Postgraduate School of Medicine, Jinju, Korea
| | - Jun-Gi Kim
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Won-Kyung Kang
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jin-Kwon Lee
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Seong-Taek Oh
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| |
Collapse
|
23
|
Abstract
A stercoral perforation of the rectum due to a fecaloma is a rare disease with a high mortality rate. Although multiple case reports of colonic perforations have been published, the data regarding rectal perforations are limited. This case report will highlight one such case of a stercoral rectal perforation that was successfully treated with a laparoscopic operation.
Collapse
Affiliation(s)
- Seung-Jin Kwag
- Department of Surgery, Gyeongsang National University Hospital, Postgraduate School of Medicine, Gyeongsang National University, Jinju, Korea
| | | | | | | | | | | | | |
Collapse
|
24
|
Kwag SJ, Kim JG, Oh ST, Kang WK. Single incision vs conventional laparoscopic anterior resection for sigmoid colon cancer: a case-matched study. Am J Surg 2013; 206:320-5. [PMID: 23570738 DOI: 10.1016/j.amjsurg.2012.11.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Revised: 09/17/2012] [Accepted: 11/05/2012] [Indexed: 12/17/2022]
Abstract
BACKGROUND The purpose of the study was to evaluate the safety and effects of single-incision laparoscopic anterior resection (SILAR) for sigmoid colon cancer by comparing it with conventional laparoscopic anterior resection (CLAR). METHODS Twenty-four patients who underwent SILAR between April 2010 and July 2011 were case matched 1:2 with patients who underwent CLAR, with respect to age, sex, body mass index, tumor location, and history of abdominal surgery. RESULTS Two patients in the SILAR group and 1 patient in the CLAR group experienced anastomotic leakage. The operative time was longer in the SILAR group than in the CLAR group (251 ± 50 vs 237 ± 49 minutes; P = .253). The number of harvested lymph nodes (19.6 ± 10.7 vs 20.8 ± 7.7; P = .630) was not different. The postoperative hospital stay was shorter in the SILAR group (7.1 ± 3.4 days) than in the CLAR group (8.1 ± 3.5 days) (P = .234). CONCLUSIONS On the basis of the early outcomes, we conclude that SILAR is feasible and safe. Moreover, the adequate lymph node harvest and free margins support the use of this procedure.
Collapse
Affiliation(s)
- Seung-Jin Kwag
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Korea
| | | | | | | |
Collapse
|
25
|
Kwag SJ, Jung SH, Lee YJ, Jung CY, Park ST, Choi SK, Hong SC, Jung EJ, Joo YT, Ha WS. The Risk Factors of Reflux Complication after Gastrectomy for Proximal Gastric Cancer. J Korean Surg Soc 2010. [DOI: 10.4174/jkss.2010.79.4.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Seung-Jin Kwag
- Department of Surgery, Gyeongsang National University Hospital, Jinju, Korea
- Gyeongnam Regional Cancer Center, Jinju, Korea
- Gyeongsang Institute of Health Sciences, Jinju, Korea
| | - Sang-Ho Jung
- Department of Surgery, Gyeongsang National University Hospital, Jinju, Korea
- Gyeongnam Regional Cancer Center, Jinju, Korea
- Gyeongsang Institute of Health Sciences, Jinju, Korea
| | - Young-Jun Lee
- Department of Surgery, Gyeongsang National University Hospital, Jinju, Korea
- Gyeongnam Regional Cancer Center, Jinju, Korea
- Gyeongsang Institute of Health Sciences, Jinju, Korea
| | - Chi-Young Jung
- Department of Surgery, Gyeongsang National University Hospital, Jinju, Korea
- Gyeongnam Regional Cancer Center, Jinju, Korea
- Gyeongsang Institute of Health Sciences, Jinju, Korea
| | - Soon-Tae Park
- Department of Surgery, Gyeongsang National University Hospital, Jinju, Korea
- Gyeongnam Regional Cancer Center, Jinju, Korea
- Gyeongsang Institute of Health Sciences, Jinju, Korea
| | - Sang-kyeong Choi
- Department of Surgery, Gyeongsang National University Hospital, Jinju, Korea
- Gyeongnam Regional Cancer Center, Jinju, Korea
- Gyeongsang Institute of Health Sciences, Jinju, Korea
| | - Soon-Chan Hong
- Department of Surgery, Gyeongsang National University Hospital, Jinju, Korea
- Gyeongnam Regional Cancer Center, Jinju, Korea
- Gyeongsang Institute of Health Sciences, Jinju, Korea
| | - Eun-Jung Jung
- Department of Surgery, Gyeongsang National University Hospital, Jinju, Korea
- Gyeongnam Regional Cancer Center, Jinju, Korea
- Gyeongsang Institute of Health Sciences, Jinju, Korea
| | - Young-Tae Joo
- Department of Surgery, Gyeongsang National University Hospital, Jinju, Korea
- Gyeongnam Regional Cancer Center, Jinju, Korea
- Gyeongsang Institute of Health Sciences, Jinju, Korea
| | - Woo-Song Ha
- Department of Surgery, Gyeongsang National University Hospital, Jinju, Korea
- Gyeongnam Regional Cancer Center, Jinju, Korea
- Gyeongsang Institute of Health Sciences, Jinju, Korea
| |
Collapse
|