Hyeong Ryul Kim

University of Ulsan, Ulsan, Ulsan, South Korea

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Publications (46)159.8 Total impact

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    ABSTRACT: Peroxiredoxin 4 (Prx 4) is a newly emerging antioxidant protein that has been studied in several human cancers. Recently, it was revealed that Prx 4 is highly expressed in human lung cancer and is needed for the promotion of lung cancer progression in vitro. However, there are no clinical data regarding the association of Prx 4 and prognosis in lung cancer. The Prx 4 expression state as a prognostic indicator was assessed by immunohistochemical staining in 142 patients with stage II non-small cell lung cancer (NSCLC) who had undergone curative surgery between 2006 and 2010. The association between the degree of Prx 4 expression and several clinicopathologic parameters was then evaluated by statistical analyses. The degree of Prx 4 expression was associated with histology and recurrence in the overall NSCLC patient group, with the proportion of patients with positive Prx 4 expression significantly higher for the adenocarcinoma subtype (39/70, 56%) than the squamous cell carcinoma subtype (23/72, 32%) (P = 0.004). However, when subgroup analyses according to histopathology were performed in terms of recurrence, positive Prx 4 expression was significantly correlated with higher recurrence rates (P = 0.003) and shorter disease-free survival (DFS) (P = 0.003, hazard ratio = 3.910) in patients with squamous cell carcinoma. In contrast, no meaningful relationship was observed between the level of Prx 4 expression and DFS in the adenocarcinoma subgroup. Positive Prx 4 expression is significantly correlated with recurrence and shorter DFS in patients with early-stage lung squamous cell carcinoma.
    International journal of clinical and experimental pathology 08/2015; 8(6):6627-35. · 1.89 Impact Factor
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    ABSTRACT: Infections are major causes of both early and late death after lung transplantation (LT). The development of prophylaxis strategies has altered the epidemiology of post-LT infections; however, recent epidemiological data are limited. We evaluated infections after LT at our institution by time of occurrence, site of infections, and microbiologic etiologies. All consecutive patients undergoing lung or heart-lung transplantation between October 2008 and August 2014 at our institution were enrolled. Cases of infections after LT were initially identified from the prospective registry database, which was followed by a detailed review of the patients' medical records. A total of 108 episodes of post-LT infections (56 bacterial, 43 viral, and nine fungal infections) were observed in 34 LT recipients. Within 1 month after LT, the most common bacterial infections were catheter-related bloodstream infections (42%). Pneumonia was the most common site of bacterial infection in the 2- to 6-month period (28%) and after 6 months (47%). Cytomegalovirus was the most common viral infection within 1 month (75%) and in the 2- to 6-month period (80%). Respiratory viruses were the most common viruses after 6 months (48%). Catheter-related candidemia was the most common fungal infection. Invasive pulmonary aspergillosis developed after 6 months. Survival rates at the first and third years were 79% and 73%, respectively. Although this study was performed in a single center, we provide valuable and recent detailed epidemiology data for post-LT infections. A further multicenter study is required to properly evaluate the epidemiology of post-LT infections in Korea.
    The Korean Journal of Internal Medicine 07/2015; 30(4):506. DOI:10.3904/kjim.2015.30.4.506 · 1.43 Impact Factor
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    ABSTRACT: There have been controversies regarding the prognostic relevance of the number of positive N2 nodes in pathologic stage IIIA-N2 non-small-cell lung cancer (NSCLC). We examine prognosis of patients with pathologic stage IIIA-N2 with classifying the number of positive N2 nodes into subgroups. From January 1997 to December 2004, 250 patients were diagnosed with pathologic stage IIIA-N2 disease. All patients underwent mediastinal lymph node dissection. After excluding 44 patients with preoperative chemotherapy, incomplete resection, and postsurgical mortality, 206 patients were included in the analysis. Patients were classified according to the number of positive N2 lymph nodes (N2a: 1 [n = 83], N2b: 2-4 [n = 82], N2c: ≥ 5 [n = 41]), and its correlation with survival outcomes were investigated. With a median follow-up of 96.3 months, 5-year disease-free survival (DFS) was 27.2% (95% confidence interval [CI], 21.6-33.7), and 5-year overall survival (OS) was 37.7% (95% CI, 31.5-44.7) in all patients. The number of metastatic N2 lymph nodes was associated with DFS (P < .001) and OS (P = .01). In the N2a, N2b, and N2c groups, 5-year DFS rates were 38%, 24%, and 5%, respectively, and 5-year OS rates were 47%, 35%, and 24%, respectively. In a multivariate analysis, the number of metastatic N2 lymph nodes was an independent prognostic factor for DFS and OS. Stratification of patients according to the number of metastatic N2 lymph nodes may improve the accuracy of prognostic prediction among patients with curatively resected stage IIIA-N2 NSCLC. Copyright © 2015 Elsevier Inc. All rights reserved.
    Clinical Lung Cancer 04/2015; DOI:10.1016/j.cllc.2015.04.004 · 3.10 Impact Factor
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    ABSTRACT: Several new classifications have been proposed for revision of the N descriptors for non-small-cell lung cancer (NSCLC), but external validation is required. The aim of this study was to validate various newly proposed nodal classifications and to compare the discrimination abilities of these classifications. A retrospective analysis was conducted of 1487 patients who underwent complete resection with systematic lymph node dissection for NSCLC between 2000 and 2008. Four nodal classifications based on the following categories were analysed: zone-based classification (single-zone N1, multiple-zone N1, single-zone N2 and multiple-zone N2), number-based classification (the number of metastatic lymph nodes; 1-2, 3-6 and ≥7), rate-based classification (ratio of the number of metastatic lymph nodes to the total number of resected lymph nodes; ≤15, 15-40 and >40%) and the combination of location- and number-based classification (N1: 1-3, N1: ≥4, N2: 1-3 and N2: ≥4). Concordance (C)-index and net reclassification improvement (NRI) index were used to assess the discrimination abilities of the models. In multivariate analysis, all of the newly proposed classifications were independent predictors (P< 0.001) of overall survival (OS) after adjustment for significant variables (age, tumour histology and pathological T status). The C-indices of the classifications based on the nodal zone, nodal number, rate and location alongside the number of metastatic lymph nodes were 0.6179, 0.6280, 0.6203 and 0.6221, respectively; however, the differences in the C-indices were statistically insignificant. Compared with the zone-based classification, the NRI for OS of classifications based on the nodal number, rate and location with number were 0.1101, 0.0972 and 0.0416, respectively. All four proposed classifications based on the nodal zone, nodal number, rate and the combination of location and number are prognostically valid and could serve as future N descriptors after complete resection of NSCLC. The discrimination ability was not significantly different among the four proposed classifications, although the number-based classification tended to have a higher predictive ability compared with the zone-based classification. Future studies with an in-depth discussion are needed to clarify optimal future N descriptors for NSCLC. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
    European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 04/2015; DOI:10.1093/ejcts/ezv134 · 3.30 Impact Factor
  • Eun Shin · Chang Min Choi · Hyeong Ryul Kim · Se Jin Jang · Young Soo Park
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    ABSTRACT: Dysregulation of mammalian target of rapamycin (mTOR) pathway has been linked with malignant tumorigenesis. This study explored the expression profiles of proteins involved in the mTOR pathway and their relationships with clinicopathologic characteristics in stage-I non-small-cell lung carcinoma (NSCLC). The protein expression profiles of PTEN, p-Akt, p-mTOR, p-S6, and eIF4E were examined using immunohistochemical staining and tissue microarray method in 408 patients with stage-I NSCLC (250 adenocarcinomas [ADC] and 158 squamous cell carcinomas). Retained PTEN expression (P<0.001), p-mTOR expression (P<0.001), and p-S6 expression (P=0.007) were associated with ADC histology. Expression of PTEN (P=0.001), p-Akt (P=0.005), p-mTOR (P=0.007), p-S6 (P<0.001) were correlated with lower pathologic T stage. PTEN loss was correlated with male gender and smoking history and p-mTOR expression was inversely correlated with these factors (P<0.001). Subgroup analysis of ADCs indicated that male gender, high pT stage, lymphovascular invasion, and PTEN loss were poor prognostic factors. Multivariate analysis revealed that the PTEN(-)/p-Akt(+)/p-mTOR(+) combination more effectively determined the prognosis of ADC (hazard ratio=2.2, P=0.004) than PTEN alone. Activation of the mTOR pathway in early-stage ADCs suggests a significant role for the mTOR axis in early carcinogenesis. The combination of PTEN(-)/p-Akt(+)/p-mTOR(+) expression was correlated with poor overall survival in patients with stage-I lung ADC. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Lung Cancer 04/2015; 89(1). DOI:10.1016/j.lungcan.2015.04.003 · 3.96 Impact Factor
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    ABSTRACT: The aim of this retrospective, multicenter study was to develop a recurrence risk-scoring model in patients with curatively resected stage I lung adenocarcinoma (ADC). Clinicopathologic and outcome data for a development cohort of 1,700 patients with pathologic stage I ADC from four institutions resected between January 2000 and December 2009 were evaluated. A phantom study was performed for correction of inter-institutional differences in positron emission tomography-standardized uptake value (PET-SUV). A nomogram for recurrence prediction was developed using Cox proportional hazards regression. This model was validated in a cohort of 460 patients in two other hospitals. The recurrence rate was 21.0 % for the development cohort and 22.1 % for the validation cohort. In multivariable analysis, three independent predictors for recurrence were identified: pathologic tumor size (hazard ratio [HR] 1.03, 95 % CI 1.017-1.048; p < 0.001), corrected PET-SUV (HR 1.08, 95 % CI 1.051-1.105; p < 0.001), and lymphovascular invasion (HR 1.65, 95 % CI 1.17-2.33; p = 0.004). The nomogram was made based on these factors and a calculated risk score was accorded to each patient. Kaplan-Meier analysis of the development cohort showed a 5-year recurrence-free survival (RFS) of 83 % (95 % CI 0.80-0.86) in low-risk patients and 59 % (95 % CI 0.54-0.66) in high-risk patients with the highest 30 percentile scores. The concordance index was 0.632 by external validation. This recurrence risk-scoring model can be used to predict the RFS for pathologic stage I ADC patients using the above three easily measurable factors. High-risk patients need close follow-up and can be candidates for adjuvant chemotherapy.
    Annals of Surgical Oncology 03/2015; DOI:10.1245/s10434-015-4411-9 · 3.93 Impact Factor
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    ABSTRACT: Although video-assisted mediastinoscopic lymphadenectomy (VAMLA) has greatly increased the accuracy of mediastinal staging, its clinical value as a therapeutic tool for complete mediastinal lymph node dissection in the treatment of left-sided lung cancer is not well elucidated. We identified the consecutive 649 patients with left-sided lung cancer undergoing minimally invasive pulmonary resection between July 2002 and June 2013. Among them, 225 patients underwent VAMLA combined with pulmonary resection (VAMLA + VATS group), while the remaining 424 patients underwent VATS procedure only (VATS group). Operative outcomes including procedural time, removed lymph nodes and node stations, complications and the final pathological mediastinal staging in the both groups were evaluated and compared. There was no significant difference in the baseline profiles between the two groups. The patients in the VATS + VAMLA group showed significantly shorter operative time (116.8 ± 39.8 vs 159.8 ± 44 .0 min; P < 0.001), more extensive lymph node dissection (total number of removed lymph nodes, 29.7 ± 10.8 vs 23.0 ± 8.6; P < 0.001) and the higher rates of patients with mediastinal lymph nodes removed: Station 2 on the right (12.4 vs 0.2%), Station 2 on the left (15.1 vs 0.2%), Station 4 on the right (42.7 vs 0.9%), Station 4 on the left (87.6 vs 57.3%) and Station 7 (100 vs 99.3%), while maintaining comparable surgical morbidities compared with the VATS group. Also, the patients in the VATS + VAMLA group tended to have higher rates of being upstaged with mediastinal involvement (8.0 vs 5.7%; P = 0.31). VAMLA is a clinically feasible procedure safely performed as a therapeutic tool for complete mediastinal lymph node dissection (MLND), and can be a good complement to minimally invasive pulmonary resection in left-sided lung cancer, where optimal MLND is not always feasible with VATS approach. Further studies are required to investigate the long-term clinical impacts of VAMLA with regard to survival and tumour recurrence. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
    European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 03/2015; DOI:10.1093/ejcts/ezv077 · 3.30 Impact Factor
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    ABSTRACT: To assess, in a randomized, phase 2 trial, the efficacy and safety of chemoradiotherapy with or without induction chemotherapy (ICT) of S1 and oxaliplatin for esophageal cancer. Patients with stage II, III, or IVA esophageal cancer were randomly allocated to either 2 cycles of ICT (oxaliplatin 130 mg/m(2) on day 1 and S1 at 40 mg/m(2) twice daily on days 1-14, every 3 weeks) followed by concurrent chemoradiotherapy (CCRT) (46 Gy, 2 Gy/d with oxaliplatin 130 mg/m(2) on days 1 and 21 and S1 30 mg/m(2) twice daily, 5 days per week during radiation therapy) and esophagectomy (arm A), or the same CCRT followed by esophagectomy without ICT (arm B). The primary endpoint was the pathologic complete response (pCR) rate. A total of 97 patients were randomized (arm A/B, 47/50), 70 of whom underwent esophagectomy (arm A/B, 34/36). The intention-to-treat pCR rate was 23.4% (95% confidence interval [CI] 11.2-35.6%) in arm A and 38% (95% CI 24.5% to 51.5%) in arm B. With a median follow-up duration of 30.3 months, the 2-year progression-free survival rate was 58.4% in arm A and 58.6% in arm B, whereas the 2-year overall survival rate was 60.7% and 63.7%, respectively. Grade 3 or 4 thrombocytopenia during CCRT was more common in arm A than in arm B (35.4% vs 4.1%). The relative dose intensity of S1 (89.5% ± 20.6% vs 98.3% ± 5.2%, P=.005) and oxaliplatin (91.4% ± 16.8% vs 99.0% ± 4.2%, P=.007) during CCRT was lower in arm A compared with arm B. Three patients in arm A, compared with none in arm B, died within 90 days after surgery. Combination chemotherapy of S1 and oxaliplatin is an effective chemoradiotherapy regimen to treat esophageal cancer. However, we failed to show that the addition of ICT to the regimen can improve the pCR rate. Copyright © 2015 Elsevier Inc. All rights reserved.
    International journal of radiation oncology, biology, physics 03/2015; 91(3). DOI:10.1016/j.ijrobp.2014.11.019 · 4.26 Impact Factor
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    ABSTRACT: Objective: We aimed to investigate the optimal cutoff value of circumferential resection margin (CRM) of esophageal squamous cell carcinoma (ESCC) in patients who underwent radical esophagectomy. Background: Tumor involvement of a CRM in ESCC has not been clearly defined. Methods: We reviewed 479 pT3 ESCC patients to find the optimal cutoff point of distance from CRM in addition to 0 [mu]m for discriminating survival time. Results: The partitions at and near the 500 [mu]m distance from CRM generated the largest log-rank statistics (P = 0.0086). Therefore, we added 500 [mu]m as an additional cutoff value for a positive CRM. Compared to patients with CRM greater than 500 [mu]m, patients with CRM 0 [mu]m showed worse overall survival (P < 0.001) and progression-free survival (P < 0.001), followed by patients with 0 to 500 [mu]m (P = 0.008 and 0.066, respectively). In multivariable analyses, overall survival differences remained significant [0 < CRM <= 500 [mu]m vs CRM > 500 [mu]m, hazards ratio (HR) = 1.875, 97.5% CI: 1.243-2.829, P = 0.002; CRM = 0 [mu]m vs CRM > 500 [mu]m, HR = 2.666, 97.5% CI: 1.745-4.076, P < 0.001]. In comparison of criteria from the College of American Pathologists, the Royal College of Pathologists, and this study, HRs of positive CRM (95% CI, P-value) were 1.969 (1.501-2.584, P < 0.001), 1.384 (1.039-1.844, P = 0.027), and 1.696 (1.342-2.143, P < 0.001), respectively. Conclusions: In patients with ESCC, we developed new, 3-tiered CRM criteria providing more detailed prognostic information than the 2-tiered criteria.
    Annals of Surgery 01/2015; DOI:10.1097/SLA.0000000000001039 · 8.33 Impact Factor
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    ABSTRACT: Thoracoscopic wedge resection is generally accepted as a standard surgical procedure for primary spontaneous pneumothorax. Because of the relatively high recurrence rate after surgery, additional procedures such as mechanical pleurodesis or visceral pleural coverage are usually applied to minimize recurrence, although mechanical pleurodesis has some potential disadvantages. The aim of this study was to clarify whether an additional coverage procedure on the staple line after thoracoscopic bullectomy prevents postoperative recurrence compared with additional pleurodesis. A total of 1,414 patients in 11 hospitals with primary spontaneous pneumothorax undergoing thoracoscopic bullectomy were enrolled. After bullectomy with staplers, patients were randomly assigned to either the coverage group (n = 757) or the pleurodesis group (n = 657). In the coverage group, the staple line was covered with absorbable cellulose mesh and fibrin glue. The pleurodesis group underwent additional mechanical abrasion on the parietal pleura. The coverage group and the pleurodesis group showed comparable surgical outcomes. After a median follow-up of 19.5 months, the postoperative 1-year recurrence rate was 9.5% in the coverage group and 10.7% in the pleurodesis group. The 1-year recurrence rate requiring intervention was 5.8% in the coverage group and 7.8% in the pleurodesis group. The coverage group showed better recovery from pain. In terms of postoperative recurrence rate, visceral pleural coverage after thoracoscopic bullectomy was not inferior to mechanical pleurodesis. Visceral pleural coverage may potentially replace mechanical pleurodesis, which has potential disadvantages such as disturbed normal pleural physiology. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
    The Annals of Thoracic Surgery 12/2014; 98(6):2005-11. DOI:10.1016/j.athoracsur.2014.06.047 · 3.85 Impact Factor
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    ABSTRACT: Background: Some esophageal cancer patients may have residual nodal metastases following pathologic complete response (pCR) of the primary tumor after neoadjuvant chemoradiotherapy (CRT). This study examines the prognosis according to lymph node metastases in pathologic T0 patients who received neoadjuvant CRT followed by surgery for esophageal squamous cell carcinoma (SCC). Methods: Prospectively-collected data from patients who underwent protocol-based esophageal resection and reconstruction after neoadjuvant CRT for esophageal SCC from 2000 to 2010 at the Asan Medical Center, Seoul, Korea, were retrospectively studied. Overall survival (OS), recurrence-free survival (RFS), and risk factors for ypT0N1 were analyzed and compared with ypT0N0. Results: A total of 211 patients underwent prospective, protocol-based esophageal resection and reconstruction after neoadjuvant CRT for esophageal SCC. Of these, 123 patients had a pCR of the primary tumor and were enrolled in this study. Lymph node status was ypT0N0 in 103 patients and ypT0N1 in 20 patients. The two groups did not show significant differences in sex, initial clinical stage, tumor location, and histologic grade. Recurrence occurred in 13 patients (12.6 %) with ypT0N0 and six patients (30.0 %) with ypT0N1, respectively (p = 0.083). Five-year OS and RFS of ypT0N1 were 42.8 ± 13.9 and 41.7 ± 12.8 %, respectively. Survival was compared between the two groups using a log-rank test, and there were no significant differences for OS or RFS. Conclusions: Residual lymph node metastases did not significantly influence prognosis in pathologic T0 patients who received neoadjuvant CRT followed by surgery for esophageal SCC.
    Annals of Surgical Oncology 10/2014; 22(6). DOI:10.1245/s10434-014-4195-3 · 3.93 Impact Factor
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    ABSTRACT: Purpose: To better understand the complete genomic architecture of lung adenocarcinoma. Experimental design: We used array experiments to determine copy number variations and sequenced the complete exomes of the 247 lung adenocarcinoma tumor samples along with matched normal cells obtained from the same patients. Fully annotated clinical data were also available, providing an unprecedented opportunity to assess the impact of genomic alterations on clinical outcomes. Results: We discovered that genomic alternations in the RB pathway are associated with significantly shorter disease-free survival in early-stage lung adenocarcinoma patients. This association was also observed in our independent validation cohort. The current treatment guidelines for early-stage lung adenocarcinoma patients recommend follow-up without adjuvant therapy after complete resection, except for high-risk patients. However, our findings raise the interesting possibility that additional clinical interventions might provide medical benefits to early-stage lung adenocarcinoma patients with genomic alterations in the RB pathway. When examining the association between genomic mutation and histologic subtype, we uncovered the characteristic genomic signatures of various histologic subtypes. Notably, the solid and the micropapillary subtypes demonstrated great diversity in the mutated genes, while the mucinous subtype exhibited the most unique landscape. This suggests that a more tailored therapeutic approach should be used to treat patients with lung adenocarcinoma. Conclusions: Our analysis of the genomic and clinical data for 247 lung adenocarcinomas should help provide a more comprehensive genomic portrait of lung adenocarcinoma, define molecular signatures of lung adenocarcinoma subtypes, and lead to the discovery of useful prognostic markers that could be used in personalized treatments for early-stage lung adenocarcinoma patients.
    Clinical Cancer Research 10/2014; 21(11). DOI:10.1158/1078-0432.CCR-14-0519 · 8.72 Impact Factor
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    ABSTRACT: Purpose: The role of non-surgical treatments (NS), such as chemoradiotherapy or radiotherapy, for clinical T1N0M0 esophageal cancer (cT1N0M0 EC) has not been well delineated. The aim of this study was to evaluate and compare the feasibility and efficacy of NS and Surgical treatment (S) in cT1N0M0 EC patients. Methods: The medical records of patients who received treatment for cT1N0M0 EC at Asan Medical Center between 2003 and 2012 were retrospectively reviewed. The baseline characteristics, treatment outcomes and complications, and survival were compared. Results: There were 264 S and 20 NS patients with respective median ages of 69.5 and 63.0. The main histologic finding was squamous cell carcinoma in both groups (97 and 100 %, respectively). The Eastern Cooperative Oncology Group performance status and Charlson comorbidity index score were poorer in the NS group. With a median follow-up of 49.0 months, 37 S patients (14 %) and 3 NS patients (15 %) exhibited recurrence. The first sites of recurrence for S and NS patients were locoregional (21 vs. 3 patients), distant (6 vs. 0), and both locoregional and distant (9 vs. 0), respectively. The median time-to-recurrence could not be calculated in either group (log-rank test P = 0.831). The estimated median overall survival was 64.4 months (95 % CI 37.2-91.6 months) in the NS group and could not be calculated in the S group (P = 0.056). Conclusions: Non-surgical treatments can be an effective alternative to S for patients with cT1N0M0 EC unfit for radical surgery. The role of NS for early stage EC needs to be further verified with prospective randomized trials.
    Cancer Chemotherapy and Pharmacology 09/2014; 74(5). DOI:10.1007/s00280-014-2573-y · 2.77 Impact Factor
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    ABSTRACT: OBJECTIVES Although there is no consensus on the management of bronchogenic cyst, most surgeons advocate early removal, even in asymptomatic patients. To evaluate the feasibility and safety of video-assisted thoracic surgery (VATS) in the management of bronchogenic cysts and long-term follow-up, a retrospective analysis was performed.
    Interactive Cardiovascular and Thoracic Surgery 07/2014; 19(5). DOI:10.1093/icvts/ivu228 · 1.16 Impact Factor
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    ABSTRACT: Background: We aimed to investigate the value of routine flexible bronchoscopy (FB) for the preoperative assessment of early-stage non-small cell lung cancer (NSCLC) diagnosed using percutaneous core needle biopsy (PCNB). Methods: We enrolled 688 NSCLC patients who were treated at our hospital between January 2003 and December 2012 and who met the following criteria: (1) early-stage lung cancer (stage I or II); (2) lung cancer had been diagnosed using PCNB; and (3) no evidence of endobronchial disease in the airways other than the primary cancer site on both chest computed tomography (CT) and positron emission tomography-CT (PET-CT). All NSCLC patients were from the same tertiary referral center, where FB is routinely performed preoperatively for this disease, and their medical records were reviewed retrospectively. Results: Of the 688 patients included in the study, 451 (65.6%) were male and the median age was 65 years. Pathology analysis revealed that adenocarcinoma was the most frequently observed cell type (516/688, 75.0%). The distribution of preoperative clinical staging for the 688 patients was (1) IA (54.5%, 375/688); (2) IB (22.1%, 152/688); (3) IIA (18.2%, 125/688); and (4) IIB (5.2%, 36/688). The majority of these patients (95.2%, 655/688) underwent surgical resection. Unsuspected malignant endobronchial lesion on FB was found in only two cases (0.3%), and the surgical strategy had to be modified for both of these patients. Conclusion: Preoperative FB is not beneficial for screening the airways of almost any patient with early-stage NSCLC, provided that neither PET-CT nor CT reveal any evidence of endobronchial malignant involvement other than at the primary cancer site.
    The Thoracic and Cardiovascular Surgeon 07/2014; 62(7). DOI:10.1055/s-0034-1377062 · 0.98 Impact Factor
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    ABSTRACT: This study was performed to assess the incidence, survival, and risk factors associated with unsuspected pathologic N2 disease in patients with resectable clinical N0-1 non-small cell lung cancer. Between January 2002 and December 2010, 1,821 patients with clinical N0-1 non-small cell lung cancer underwent pulmonary resection and mediastinal lymph node dissection. Clinical outcomes and risk factors for pathologic N2 disease were retrospectively analyzed for this cohort. Unsuspected pathologic N2 disease was identified in 196 patients (10.8%). The most common type of resection was lobectomy (81.6%). Adjuvant therapy was administered in 177 patients (90.3%). The median follow-up time was 28 months (range, 1 to 101 months). N2 involvement was single-station in 121 (66.8%) and multiple-station in 65 (33.2%). The 5-year overall and disease-free survival rates were 56.1% and 35.0%, respectively. The 5-year survival rates of single-station and multiple-station N2 were 66.6% and 36.4%, respectively (p < 0.001). Adenocarcinoma, clinical N1, tumor size (>3 cm), and a right middle lobe tumor were identified as independent risk factors for unsuspected multiple-station N2 disease by multivariate analysis. Incidence of unsuspected multiple-station N2 disease in low-risk classes (aggregate score, 0 to ≤2) was only 5.5%. The incidence of unsuspected N2 disease in our cohort was similar to that of previous reports. Survival outcomes were favorable for unsuspected single-station N2 disease but were poor for unsuspected multiple-station N2 disease. Clinical N0-1 non-small cell lung cancer patients with risk class of low score for unsuspected multiple-station N2 disease can be exempted from aggressive mediastinal staging.
    The Annals of thoracic surgery 04/2014; 97(6). DOI:10.1016/j.athoracsur.2014.03.004 · 3.85 Impact Factor
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    ABSTRACT: To determine the role of surgery in complete responders on FDG-PET after CRT and the prognostic significance of metabolic response in locally advanced esophageal squamous cell carcinoma. We retrospectively reviewed 154 patients with locally advanced esophageal cancer with increased uptake on FDG-PET. Eighty-one patients received definitive CRT and 73 received trimodality therapy. We defined metabolic complete remission (PET-CR) when FDG uptake of the primary tumor and lymph nodes were decreased and was indistinguishable from surrounding normal tissue. Oncologic outcomes were compared between trimodality group, definitive CRT group, and PET-CR subgroup of definitive CRT. Thirty-one (38.3%) of the definitive CRT patients and 39 (53.4%) of the trimodality therapy patients achieved PET-CR after CRT. The 2-year OS of the trimodality group was higher than that of the definitive CRT group, but equivalent to that of the PET-CR subgroup of definitive CRT. The 2-year LRFS and DFS of the trimodality group were higher than that of the PET-CR subgroup or the entire of definitive CRT group. The addition of surgery showed higher DFS and LRFS rates than those of the PET-CR subgroup of definitive CRT. Despite achieving PET-CR, surgery still seems to improve local tumor control. J. Surg. Oncol. © 2013 Wiley Periodicals, Inc.
    Journal of Surgical Oncology 04/2014; 109(5). DOI:10.1002/jso.23514 · 3.24 Impact Factor
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    Won-Young Lee · Choi Se Hoon · Hyeong Ryul Kim
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    ABSTRACT: Pulmonary and/or bronchial aneurysm with systemic thrombophlebitis can be seen in the case of both Behcet's disease and Hughes-Stovin syndrome. These two diseases may be indistinguishable since the clinical, radiological, and histopathological findings are similar in both cases. In particular, from the perspective of pulmonary involvement, hemoptysis is the leading cause of death in both conditions and is followed by aneurysmal rupture. Here, we report a case in which surgical resection was performed for a patient presenting recurrent hemoptysis as an atypical presentation of Behcet's disease.
    Korean Journal of Thoracic and Cardiovascular Surgery 04/2014; 47(2):178-180. DOI:10.5090/kjtcs.2014.47.2.178
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    Ho Jin Kim · Soyeon An · Hyeong Ryul Kim
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    ABSTRACT: We report a rare case of granular cell tumor arising in the left lower lobe (LLL) bronchus with secondary obstructive change in a 60-year-old male. The patient was found to have a nodule in the LLL on a computed tomography scan, three months prior to his presentation to the Asan Medical Center. Bronchoscopic biopsies revealed a granular cell tumor. After undergoing LLL lobectomy with bronchoplasty, the patient has not experienced any tumor recurrence. © The Korean Society for Thoracic and Cardiovascular Surgery. 2014.
    Korean Journal of Thoracic and Cardiovascular Surgery 04/2014; 47(2):193-196. DOI:10.5090/kjtcs.2014.47.2.193

Publication Stats

431 Citations
159.80 Total Impact Points


  • 2010–2015
    • University of Ulsan
      • College of Medicine
      Ulsan, Ulsan, South Korea
  • 2014
    • Asan Medical Center
      Sŏul, Seoul, South Korea
  • 2011–2014
    • Ulsan University Hospital
      Urusan, Ulsan, South Korea
  • 2007–2014
    • Seoul National University
      • Department of Biological Sciences
      Sŏul, Seoul, South Korea
    • Catholic University of Daegu
      Kayō, Gyeongsangbuk-do, South Korea
  • 2009
    • Seoul National University Bundang Hospital
      • Department of Thoracic and Cardiovascular Surgery
      Sŏul, Seoul, South Korea