PURPOSE: To find out the role of postoperative adjuvant radiotherapy in the treatment of rectal cancer by comparing survival, pelvic control, complication rate, and any prognostic factor between surgery alone and postoperative radiotherapy group. MATERIALS AND METHODS: From Feb. 1982 to Dec. 1996 total 212 patients were treated by radical surgery with or without postoperative radiotherapy due to rectal carcinoma of modified Astler-Coller stage B2-C3. Of them, 18 patients had incomplete radiotherapy and so the remaining 194 patients were the database analyzed in this study. One hundred four patients received postoperative radiotherapy and the other 90 patients had surgery only. Radiotherapy was performed in the range of 39.6-55.8 Gy (mean: 49.9 Gy) to the whole pelvis and if necessary, tumor bed was boosted by 5.4-10 Gy. Both survival and pelvic control rates were calculated by Kaplan-Meier method and their statistical significance was tested by Log-rank test. Multivariate analysis was performed by Cox proportional hazards model. RESULTS: 5-year actuarial survival rate (5YSR) and 5-year disease-free survival rate (5YDFSR) of entire patients were 53% and 49%, respectively. 5YSRs of surgery alone group and adjuvant radiotherapy group were 63% vs 45%, respectively ( p=0.03). This difference is thought to reflect uneven distribution of stages between two treatment groups ( p<0.05 by x2-test) with more advanced disease patients in adjuvant radiotherapy group. 5YSRs of surgery alone vs adjuvant radiotherapy group in MAC B2+3, C1, C2+3 were 68% vs 55% ( p=0.09), 100% vs 100%, 40% vs 33% ( p=0.71), respectively. 5YDFSRs of surgery alone vs adjuvant radiotherapy group in above three stages were 65% vs 49% ( p=0.14), 100% vs 100%, 33% vs 31% ( p=0.46), respectively. 5-year pelvic control rate (5YPCR) of entire patients was 72.5%. 5YPCRs of surgery alone and adjuvant radiotherapy group were 71% vs 74%, respectively (p=0.41). 5YPCRs of surgery alone vs adjuvant radiotherapy group in B2+3, C1, C2+3 were 79% vs 75% ( p= 0.88), 100% vs 100%, 44% vs 68% ( p=0.01), respectively. Multivariate analysis showed that only stage was significant factor affecting overall and disease-free survival in entire patients and also in both treatment groups. In view of pelvic control, stage and operation type were significant in entire patients and only stage in surgery alone group but in adjuvant radiotherapy group, operation type instead of stage was the only significant factor in multivariate analysis as a negative prognostic factor in abdominoperineal resection cases. CONCLUSION: Our retrospective study showed that postoperative adjuvant radiotherapy could improve the pelvic control in MAC C2+3 group. To improve both pelvic control and survival in all patients with MAC B2 or more, other treatment modality such as concurrent continuous infusion of 5-FU, which is the most standard agent, along with radiotherapy should be considered.
Disease-Free Survival ; Fluorouracil ; Humans ; Multivariate Analysis ; Pelvis ; Proportional Hazards Models ; Radiotherapy ; Radiotherapy, Adjuvant* ; Rectal Neoplasms* ; Retrospective Studies ; Survival Rate

Telangiectasia is characterized by permanently dilated small vessels usually arising from the suprapapillary plexus of venule capillaries, or arterioles. It may be etvlogically divided into the primary and secondary types. Rosacea, varicose vein, prolonged sun xvsure, radiation, and physical trauma may be the causes of secondary telangiectasia. We report herein a case of secondary telangiectasia associated which operation for a femur fracture.
Arterioles ; Capillaries ; Femur ; Rosacea ; Solar System ; Telangiectasis* ; Varicose Veins ; Venules

Angiofibroma is a disfiguring facial deformity that constitutes pait of the multiple system involvement in tuberous sclerosis. We describe eight affected patients who have been treated with:arbon dioxide laserabration and subsequent copper vapor later treatment for residual angiomatous component, which resulted in conspicious cosmetic improvement without scarring or recurrence. This report documents that the treatment with carbon dioxide later and subsequent copper vapor laser is an efficient and safe remedy for treating multiple facial angioibromas.
Angiofibroma* ; Carbon Dioxide* ; Carbon* ; Cicatrix ; Congenital Abnormalities ; Copper* ; Humans ; Lasers, Gas* ; Recurrence ; Tuberous Sclerosis

No abstract available.

Folliculosebaceous cystic hamartoma is a rare, benign condition. The histological criteria of folliculosebaceous cystic hamartoma have been well established by Kimura et al. We report two cases of folliculosebaceous cystic hamartoma which showed typical histological findings. As far as we know, it has not yet been reported in Korean dermatological literature. The first case is a 23-year-old man who had a pedunculated nodule on the scalp. The second one is a 46-year-old man who had a bean sized pedunculated nodule on the left cheek.
Cheek ; Hamartoma ; Humans ; Middle Aged ; Scalp ; Young Adult

A case of multiple trichilemmal cysts (TC) is presented. TC is known to be a kind of keratinous cyst with lining cells showing trichilemmal keratiniration. A 63-year-old female patient presented with a 30 year duration of increasing in size and number of twenty five nodular lesions on the scalp. All twenty five TC on the scalp were totally excised and examined microscopically. However, the evidence of proliferation or malignant change like the previous case reports was not found in our case.
Female ; Humans ; Middle Aged ; Scalp

Skin tags are very common skin tumors in middle age. In spite of their frequent occurrence, there was no reported cases of verruca vulgaris developing on the soft fibroma. We report a case of verruca vulgaris developing on the bag-like skin tag. We think that the incidence of HPV infection on the large skin tags may be higher than on normal skin due to their protrusion and repetitive irritation.
Fibroma ; Humans ; Incidence ; Middle Aged ; Skin* ; Warts*

PURPOSE: We performed the retrospective analysis to find the outcome of external beam radiotherapy alone in advanced esophageal cancer patients. METHODS AND MATERIALS: One hundred and six patients treated with external beam radiotherapy alone between July 1990 and December 1996 were analyzed retrospectively. We limited the site of the lesions to the thoracic esophagus and cell type to the squamous cell carcinoma. Follow-up was completed in 100 patients (9 4%) and ranged from 1 month to 92 months (median; 6 months). RESULTS: The median age was 62 years old and male to female ratio was 104:2. Fifty-three percent was the middle thorax lesion and curative radiotherapy was performed in 83%. Mean tumor dose delivered with curative aim was 58.6 Gy (55-70.8 Gy) and median duration o f the radiation therapy was 53 days. The median survival of all patients was 6 months and 1-year and 2-year overall survival rte was 27% and 12%, respectively. Improvement of dysphagia was obtained in most patients except fo 7 patients who underwent feeding gastrostomy. The complete response rate immediately after radiation therapy was 32% (34/106). The median survival and 2-year survival rate of the complete responder was 14 months and 30% respectively, while those of the nonresponder was 4 months and 0% respectively (p=0.000). The median survival and 2-year survival rate of the patients who could tolerate regular diet was 9 rnonths and 16% while those of the patients who could not tolerate regular diet was 3 months and 0%, respectively (p=0.004). The survival difference between the patients with 5 cm or less turnor length and those with more than 5 cm tumor length was rnarginally statistically significant (p=0.06). However, the survival difference according to the periesophageal invasion or mediastinal lymphadenopathy in the chest CT imaging study was not statistically significant in this study. In a multivariate analysis, the statistically significant covariates to the survival were complete response to radiotherapy, tumor length, and initial degree of dysphagia in a decreasing order. The complication was observed in 10 patients (9%). CONCLUSION: The survival outcome for advanced esophageal cancer patients treated by external be am radiotherapy alone was very poor, In the treatment of these patients, the brachytherapy and chemotherapy should be added to improve the treatment outcome.
Brachytherapy ; Carcinoma, Squamous Cell ; Deglutition Disorders ; Diet ; Drug Therapy ; Esophageal Neoplasms* ; Esophagus ; Female ; Follow-Up Studies ; Gastrostomy ; Humans ; Lymphatic Diseases ; Male ; Middle Aged ; Multivariate Analysis ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Thorax ; Tomography, X-Ray Computed ; Treatment Outcome

No abstract available.
Carbon Dioxide* ; Carbon* ; Lasers, Gas* ; Vulva*