-
[show abstract]
[hide abstract]
ABSTRACT: It is rare for low-grade gliomas to disseminate to the leptomeninges. However, low-grade gliomas with dissemination to the leptomeninges have been occasionally reported in children, and have generally been associated with local recurrence. A 16-year-old boy sought evaluation for diplopia and gait disturbance. A brain magnetic resonance imaging (MRI) revealed pontine mass, which was proved to be fibrillary astrocytoma on biopsy, later. Radiation therapy (5400 cGy) was given and the patient's symptoms were improved. He was followed-up radiologically for brain lesion. Seven months after diagnosis he complained of back pain and gait disturbance. A brain MRI showed a newly-developed lesion at the left cerebellopontine angle without an interval change in the primary lesion. A spinal MRI demonstrated leptomeningeal dissemination of the entire spine. Radiation therapy (3750 cGy) to the spine, and adjuvant chemotherapy with a carboplatin plus vincristine regimen were administered. However, he had a progressive course with tumoral hemorrhage and expired 13 months after diagnosis. We report an unusual case of a low-grade brainstem glioma with spinal dissemination, but without local recurrence, and a progressive course associated with hemorrhage.
Journal of Korean Neurosurgical Society 02/2012; 51(2):109-12. · 0.60 Impact Factor
-
Changhee Yoo,
Cheol Young Oh,
Jin Seon Cho,
Cheryn Song,
Seong Il Seo,
Hanjong Ahn,
Tae-Kon Hwang,
Jun Cheon,
Kang Hyun Lee,
Tae Gyun Kwon, [......],
Moon Kee Chung,
Sang Eun Lee,
Hyun Moo Lee,
Eun Sik Lee,
Young Deuk Choi,
Byung Ha Chung,
Hyung Jin Kim,
Wun-Jae Kim,
Seok-Soo Byun,
Han Yong Choi
[show abstract]
[hide abstract]
ABSTRACT: We investigated the clinical significance of large difference (≥ 2 points) between biopsy-derived (bGS) and post-prostatectomy Gleason scores (pGS). At 14 medical centers in Korea, 1,582 men who underwent radical prostatectomy for prostate cancer were included. According to the difference between bGS and pGS, the patients were divided into three groups: A (decreased in pGS ≥ 2, n = 30), B (changed in pGS ≤ 1, n = 1,361; control group), and C (increased in pGS ≥ 2, n = 55). We evaluated various clinicopathological factors of prostate cancer and hazards for biochemical failure. Group A showed significantly higher mean maximal percentage of cancer in the positive cores (max%) and pathological T stage than control. In group C, the number of biopsy core was significantly smaller, however, tumor volume and max% were significantly higher and more positive biopsy cores were presented than control. Worse pathological stage and more margin-positive were observed in group A and C than in control. Hazard ratio for biochemical failure was also higher in group A and C (P = 0.001). However, the groups were not independent factors in multivariate analysis. In conclusion, large difference between bGS and pGS shows poor prognosis even in the decreased group. However it is not an independent prognostic factor for biochemical failure.
Journal of Korean medical science 04/2011; 26(4):507-12. · 0.84 Impact Factor
-
Jae Seung Chung,
Han Yong Choi,
Hae-Ryoung Song,
Seok-Soo Byun,
Seong Il Seo,
Cheryn Song,
Jin Seon Cho,
Sang Eun Lee,
Hanjong Ahn,
Eun Sik Lee,
Tae-Kon Hwang,
Wun-Jae Kim,
Moon Kee Chung, Tae Young Jung,
Ho Song Yu,
Young Deuk Choi
[show abstract]
[hide abstract]
ABSTRACT: Due to the availability of serum prostate specific antigen (PSA) testing, the detection rate of insignificant prostate cancer (IPC) is increasing. To ensure better treatment decisions, we developed a nomogram to predict the probability of IPC.
The study population consisted of 1,471 patients who were treated at multiple institutions by radical prostatectomy without neoadjuvant therapy from 1995 to 2008. We obtained nonrandom samples of n = 1,031 for nomogram development, leaving n = 440 for nomogram validation. IPC was defined as pathologic organ-confined disease and a tumor volume of 0.5 cc or less without Gleason grade 4 or 5. Multivariate logistic regression model (MLRM) coefficients were used to construct a nomogram to predict IPC from five variables, including serum prostate specific antigen, clinical stage, biopsy Gleason score, positive cores ratio and maximum % of tumor in any core. The performance characteristics were internally validated from 200 bootstrap resamples to reduce overfit bias. External validation was also performed in another cohort.
Overall, 67 (6.5%) patients had a so-called "insignificant" tumor in nomogram development cohort. PSA, clinical stage, biopsy Gleason score, positive core ratio and maximum % of biopsy tumor represented significant predictors of the presence of IPC. The resulting nomogram had excellent discrimination accuracy, with a bootstrapped concordance index of 0.827.
Our current nomogram provides sufficiently accurate information in clinical practice that may be useful to patients and clinicians when various treatment options for screen-detected prostate cancer are considered.
Yonsei medical journal 01/2011; 52(1):74-80. · 0.77 Impact Factor
-
Jae Seung Chung,
Han Yong Choi,
Hae-Ryoung Song,
Seok-Soo Byun,
Seong il Seo,
Cheryn Song,
Jin Seon Cho,
Sang Eun Lee,
Hanjong Ahn,
Eun Sik Lee,
Won-Jae Kim,
Moon Kee Chung, Tae Young Jung,
Ho Song Yu,
Young Deuk Choi
[show abstract]
[hide abstract]
ABSTRACT: We developed a nomogram to predict the probability of extracapsular extension (ECE) in localized prostate cancer and to determine when the neurovascular bundle (NVB) may be spared. Total 1,471 Korean men who underwent radical prostatectomy for prostate cancer between 1995 and 2008 were included. We drew nonrandom samples of 1,031 for nomogram development, leaving 440 samples for nomogram validation. With multivariate logistic regression analyses, we made a nomogram to predicts the ECE probability at radical prostatectomy. Receiver operating characteristic (ROC) analyses were also performed to assess the predictive value of each variable alone and in combination. The internal validation was performed from 200 bootstrap re-samples and the external validation was also performed from the another cohort. Overall, 314 patients (30.5%) had ECE. Age, Prostate specific antigen (PSA), biopsy Gleason score, positive core ratio, and maximum percentage of biopsy tumor were independent predictors of the presence of ECE (all P values <0.05). The nomogram predicted ECE with good discrimination (an area under the ROC curve of 0.777). Our nomogram allows for the preoperative identification of patients with an ECE and may prove useful in selecting patients to receive nerve sparing radical prostatectomy.
Journal of Korean medical science 10/2010; 25(10):1443-8. · 0.84 Impact Factor
