278
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S-477￭
Primary burnt-out metastatic prostate cancer: a case report
성균관의대 강북삼성병원 1내과, 2비뇨기과, 3병리과
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구동회
1, 유수현
1, 오석중
1, 주관중
2, 채승완
3, 이승세
1Prostate carcinoma has a well-known pattern of metastatic disease, most frequently involving the axial skeleton and local lymph nodes. Since its metastasis usually encountered in the presence of advanced disease, distant metastasis with undetectable primary tumor is very rare. A 66-year-old man visited our hospital for both leg weaknesses, and checked MRI showed cord compression at T7 level. Since rapid progression of paraplegia and suspicious malignancy, total corpectomy (T7) and fusion/fixation was done. Bone biopsy revealed metastatic carcinoma with strong positive for PSA, and negative for CK7/CK20. Following prostate biopsy showed adenocarcinoma, with a Gleason score of 6 (3+3), affect- ing only 1% of the 12 tissue pieces. The initial prostate-specific antigen (PSA) value was 1.5 ng/mL. Because he was considered to have no residual disease with normal range of PSA, he was given post-operative radiotherapy and on active surveillance. During a 3-month follow-up, he still has been asymptomatic with a low level of PSA (1.8 ng/mL), and we consider this case as burnt-out metastatic prostate cancer.
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S-478￭
Prognostic factor analysis of chemotherapy in advanced biliary tract cancer
1Division of Hematology & Oncology, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul; 2Division of Hematology & Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Kyounggi-do;
3Division of Hematology & Oncology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Chungchungnam-do; 4Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Bucheon
Hospital, Kyounggi-do, Korea
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Min-Young Lee
1, Sang-Cheol Lee
1, Kyoung Ha Kim
1, Hyun Jung Kim
2, Jina Yoon
2, Se Hyoung Kim
2, Sang Byung Bae
3, Chan-Kyu Kim
2, Namsu Lee
1, Kyu Taeg Lee
3, Sung Kyu Park
2, Han Jo Kim
3,
Jong Ho Moon
4, Dae Sik Hong
2, Hee Sook Park
1, Jong-Ho Won
1Purpose: There is no evidence that second-line chemotherapy in advanced biliary tract cancer (BTC) will result in substantial prolongation of survival. The purpose of this study was to evaluate prognostic factors for the survival of patients with advanced biliary tract cancer who was refractory BTC for first-line chemotherapy. Material and Methods: We reviewed 89 patients with advanced biliary tract cancer who had enrolled in two clinical trials at three branches of Soonchunhyang university hospital. They received palliative chemotherapy with 2 regimens (biweekly GEMOX and modified FOLFOX-6). GEMOX is consist of gemcitabine 1,000 mg/m2 intravenously on day 1 and oxaliplatin 85 mg/m2 intra- venously on day 2 every 2 weeks and mFOLFOX-6 is that Oxaliplatin 85 mg/m2 and folinic acid 400 mg/m2 on day 1 followed by a 5-FU bolus 400 mg/m2 and 46-h infusion 2,400 mg/m2 every 2 weeks. To evaluate the clinico-pathologic factors that affected overall survival, uni- variate and multivariate analyses were performed on the baseline factors. Results: 89 patients were enrolled from Sep 2006 to Aug 2010. Median age was 62 years (range 35-81). Univariate analysis revealed 4 prognostic factors affecting overall survival after first-line chemotherapy.
Performance status of 0-1 versus >2 (p=0.014), salvage chemotherapy (p=0.021), loco-regional disease versus disseminated disease (p=0.046) and responder of first-line chemotherapy (p=0.025) was revealed. Multivariate analysis found 2 prognostic factors affecting overall survival. They were salvage chemotherapy and initial responder. Conclusions: These results suggest that 2nd-line chemotherapy is needed for patients with good per- formance and responder of initial chemotherapy.²
