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송완(Wan Song),전황균(Hwang Gyun Jeon) 대한비뇨기종양학회 2014 대한비뇨기종양학회지 Vol.12 No.3
Image-guided thermal ablation is accepted as one of non-invasive modalities in the treatment of small renal tumor. Current EAU and AUA guidelines suggest cryoablation and radiofrequency ablation in patients with small renal tumor with/without significant comorbidities. Cryoablation and radiofrequency ablation have been most commonly used in the treatment of small renal tumor. A new ablation modality, microwave ablation, has been of increasing interest in the treatment of small renal tumor. Clinical studies show that ablation therapy is an effective treatment with good clinical outcomes and low risk of complications in selected patients over short- and medium-term periods of time. This article reviews the current published clinical long-term results and updates the results in the procedure, such as cryoablation, radiofrequency ablation and microwave ablation.
임상적으로 유의미한 전립선암의 예측 향상을 위한 Prostate Health Index와 PI-RADS Version 2 조합의 유용성
송완(Wan Song),이충언(Chung Un Lee),정재훈(Jae Hoon Chung),강민용(Minyong Kang),성현환(Hyun Hwan Sung),전황균(Hwang Gyun Jeon),정병창(Byong Chang Jeong),서성일(Seong Il Seo),전성수(Seong Soo Jeon),이현무(Hyun Moo Lee) 대한비뇨기종양학회 2022 대한비뇨기종양학회지 Vol.20 No.2
Purpose: To evaluate the performance of combining prostate health index (PHI) and Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) for detection of clinically significant prostate cancer (csPCa). Materials and Methods: We retrospectively reviewed patients who underwent prostate biopsy for elevated prostate-specific antigen (PSA) ≥2.5 ng/mL and/or abnormal digital rectal examination. Serum markers for PSA, free PSA (fPSA), and [-2] proPSA (p2PSA) were measured, and PHI was calculated as ([p2PSA/fPSA]×[PSA]<SUP>1/2</SUP>). Multiparametric magnetic resonance imaging was performed using a 3.0T scanner and scored using PI-RADSv2. csPCa was defined as either grade group (GG) ≥2 disease or GG1 cancer detected in >2 cores or >50% of positive on biopsy. Univariable and multivariable logistic regression modelling, along with receiver-operating characteristic (ROC) curve analysis was used to predict the probability of csPCa. Results: Of the total 358 patients, 159 (44.4%) were diagnosed with csPCa. On univariable analysis, age, PSA density (PSAD), PHI and PI-RADSv2 were associated with csPCa. The area under the ROC curve (AUC) of baseline model incorporating age and PSAD was 0.663. The AUC of combining PHI and PI-RADSv2 to baseline model was higher than that of PHI alone to baseline model (0.884 vs. 0.807, p<0.0001) and PI-RADSv2 alone to baseline model (0.884 vs. 0.846, p=0.0002), respectively. If biopsy was restricted to patients with PI-RADS 5 as well as PI-RADS 3 or 4 and PHI ≥27, 36.0% of unnecessary biopsy could be avoided at the cost of missing 4.7% of csPCa. Conclusions: The combination of PHI and PI-RADSv2 to baseline model incorporating age and PSAD had higher accuracy for detection of csPCa compared with PHI or PI-RADSv2 alone.
정현우(Hyunwoo Chung),송완(Wan Song),유재호(Jae Ho Yoo),강민용(Min Yong Kang),전황균(Hwang Gyun Jeon),정병창(Byong Chang Jeong),서성일(Seong Il Seo),전성수(Seong Soo Jeon),최한용(Han Yong Choi),김찬교(Chan Kyo Kim),박병관(Byung Kwan 대한비뇨기종양학회 2017 대한비뇨기종양학회지 Vol.15 No.2
Purpose: We compared biopsy results and surgical outcomes of magnetic resonance imaging (MRI)-guided biopsy with transrectal ultrasonography (TRUS)-guided biopsy to demonstrate efficacy of MRI-guided biopsy on previous biopsy negative patients. Materials and Methods: We retrospectively reviewed data of 120 patients who were categorized into MRI-guided biopsy groups (n=20) and TRUS-guided biopsy groups (n=100). All patients were diagnosed with prostate cancer (PCa) and had undergone radical prostatectomy (RP) after MRI-guided or TRUS-guided repeat biopsy between January 2010 and March 2016. Detection rate of significant cancer and Gleason score upgrading and downgrading were examined, in addition to biopsy results and subsequent RP outcomes. Results: Median values for prostate-specific antigen level of the TRUS-guided biopsy group and the MRI-guided biopsy group were 6.67 and 5.86 ng/mL (p=0.303), respectively. Median prostate volume of each group (34.1 mL vs. 23.5 mL, p=0.007), number of positive cores (2.0 vs. 3.0, p=0.001) and maximum cancer/core rate (30.0% vs. 60.0%, p<0.001) were statistically different. Positive core rates of each group were 21.9% and 87.1%, respectively. Pathologic T stage was the only variable that showed difference in surgical outcomes (p=0.002). Most of PCa was confirmed as clinically significant PCa after RP in MRI-guided biopsy group (95%). Conclusions: MRI-guided biopsy showed higher positive core rate and detection rate of clinically significant PCa than TRUS-guided biopsy in repeat biopsy setting. Prospective multicenter large-scale study and accumulation of data is expected to further define superiority of the MRI-guided biopsy.
Predictive Factors for Acute Urinary Retention After Transperineal Template-Guided Mapping Biopsy
Si Hyun Sung(성시현),Chung Un Lee(이충언),Jae Hoon Chung(정재훈),Wan Song(송완),Minyong Kang(강민용),Hyun Hwan Sung(성현환),Byong Chang Jeong(정병창),Seong Il Seo(서성일),Seong Soo Jeon(전성수),Hyun Moo Lee(이현무),Hwang Gyun Jeo 대한비뇨기종양학회 2021 대한비뇨기종양학회지 Vol.19 No.3
Purpose: We investigated the predictive factors for acute urinary retention (AUR) after transperineal template-guided mapping biopsy (TTMB). Materials and Methods: We retrospectively reviewed the records of 459 patients who had undergone TTMB between May 2017 and July 2020. Overall complications after TTMB were analyzed and categorized according to the Clavien-Dindo classification. Factors that were likely to affect AUR were analyzed using a logistic regression model. Results: Overall complications after TTMB were observed in 95 of the 459 patients (20.7%), of which AUR was the most commonly reported (17.4%, n=80), followed by hematuria (3.1%, n=14). Hematuria in one patient was categorized as Clavien-Dindo grade IIIa. All remaining complications were Clavien-Dindo grade I. In the multivariate regression model, age ≥65 (odds ratio, 2.44; 95% confidence interval [CI], 1.42–4.17; p=0.001), prostate volume ≥30 mL (odds ratio, 3.72; 95% CI, 1.19–11.62; p<0.02), and number of biopsy cores ≥30 (odds ratio, 2.89; 95% CI, 1.29–6.43; p=0.01) were identified as the predictors for AUR after TTMB. Conclusions: AUR is the most common complication after TTMB. Age ≥65 years, prostate volume ≥30 mL, and number of biopsy cores ≥30 were significant predictors of AUR following TTMB.
근치적 회음부 전립선 절제술의 종양학적 성적 및 합병증
박준형(Joon Hyung Park),이상은(Sang Eun Lee),최영효(Young Hyo Choi),송완(Wan Song),최한용(Han Yong Choi) 대한비뇨기종양학회 2016 대한비뇨기종양학회지 Vol.14 No.3
Purpose: To evaluate oncologic, functional outcomes and complications in patients with prostate cancer (PCa) who underwent radical perineal prostatectomy (RPP). Materials and Methods: A retrospective review of patients who underwent RPP by a single surgeon between 1995 and 2014 was performed. We analyze clinicopathologic characteristics and postoperative complications including urinary continence and erectile function. Kaplan-Meier survival analysis was used to access biochemical recurrence (BCR)-free survival (BFS) and cancer-specific survival (CSS) and log-rank test was applied. Complications were stratified by the Clavien-Dindo classification system. Results: A total of 816 patients were included in this study. The mean prostate-specific antigen and prostate volume was 8.89 ng/mL and 30.8 mL. Positive surgical margin was identified in 174 patients (21.3%) after RPP. During a mean follow-up of 58.7 months, 173 patients (21.2%) experienced BCR. Overall, 44 patients (5.4%) died, of which 15 (1.8%) died from PCa. The 5-year BFS in patients with T2, T3a, and T3b were 84.8%, 69.7%, and 46.7% (p<0.001), respectively. The 10-year CSS in patients with same groups were 98.9%, 98.2%, and 79.5% (p<0.001), respectively. At 12 months after RPP, recovery of urinary continence and erectile function was identified in 88.3% and 63.7% of patients. Wound dehiscence (8.9%) was the most common complication. However, approximately 78% of complications were grade I or II. Conclusions: Our study indicates that RPP shows acceptable outcomes in terms of oncologic results and complications in patients with PCa. Careful attention is required to prevent wound dehiscence.