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JYMS : Journal of Yeungnam Medical Science

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Sang Woon Kim 8 Articles
Treatment Options for Early Gastric Cancer
Sang Woon Kim
Yeungnam Univ J Med. 2007;24(2 Suppl):S152-158.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2S.S152
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Patients with early gastric cancer (EGC) have had a good prognosis with conventional gastrectomy and radical lymph node dissection. The conventional surgery revealed some kinds of early and late complications which may hurt patients seriously. Therefore, treatment options for EGC which preserve patients’ quality of life with maintaining a high level of curability have been developed. In surgeon’s field, these include limited gastrectomy with or without modified lymph node resection, gastrectomy with vagal nerve preservation, pylorus preserving gastrectomy, and laparoscopic gastrectomy. Laparoscopic gastrectomy has introduced a new concept of procedure in the treatment of EGC. Endoscopic mucosal resection (EMR) by endoscopist has also become a standard treatment option for EGC with limited indications. The development of endoscopic submucosal dissection (ESD) expanded the clinical relevance of EMR. Certain treatment options for EGC, such as laparoscopic surgery or EMR, are known to be good options for EGC treatment, but the long-term results should be confirmed by randomized prospective study before becoming standard treatments. At present. these less invasive treatment should be applied under the strict indications.
Efficacy of Unresectable or Recurred Gastric Cancer Treated with TS-1 Chemotherapy or TS-1/CDDP Combination Chemotherapy
Se Won Kim, Sang Woon Kim, Sun Kyo Song
Yeungnam Univ J Med. 2007;24(2 Suppl):S391-398.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2S.S391
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Purpose:Although several chemotherapy regimens used against advanced and recurred gastric cancer have been studied extensively in an attempt to further improve the prognosis of patients, no standard chemotherapeutic regimens have been established. The aim of this study was to determine the anti-tumor efficacy and safety of TS-1 or TS-1 plus cisplatin (CDDP). Materials and Methods:From December 2004 to June 2007, we treated 43 patients with unresectable or recurred gastric cancer either with 80 mg/m2 of TS-1 for 28 days, which was followed by a 2-week rest, or with 80 mg/m2 of TS-1 for 28 days and 60 mg/m2 of CDDP on day 3 every 6 weeks.
Results
:Tumor response rates in the primary chemotherapy group and in the recurrent group were 46.7% and 21.4%, respectively. The median survival rates in the primary and the recurrent group were 14 months and 8 months, and it was not significantly different. But the one-year survival rates according to the kinds of regimens (TS-1 or TS-1/CDDP group) were significantly different (P=0.0014). The incidences of grade 3 or 4 adverse effects were 18%, respectively.
Conclusion
:The anti-tumor efficacy and safety of TS-1 and TS-1 plus CDDP in unresectable or recurred gastric cancer patients seemed to be high with modest adverse effects, thus suggesting the possible use of this regimen for unresectable or recurred gastric cancer patients.
Efficacy and Side Effect of Docetaxel Based Chemotherapy as Second-Line Treatment in Recurrent Gastric Cancer
Se Won Kim, Sang Woon Kim, Sun Kyo Song
Yeungnam Univ J Med. 2007;24(2 Suppl):S399-406.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2S.S399
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Purpose:To investigate the efficacy and safety of docetaxel based chemotherapy as a secondline treatment in patients with metastatic or recurrent gastric cancer. Materials and Methods:Between January 2001 and March 2007, 28 patients with recurrent or metastatic gastric cancer were enrolled. The administered doses of decetaxel was 75 mg/m2 on day 1 and 5, cisplatin 60 mg/m2 on day 3, 5-FU 600 mg/m2 over 24 hrs on day 1 to day 5, every 4 weeks. The response was assessed every 2 cycles. The toxicities were evaluated for every course of chemotherapy according to National Cancer Institute-common toxicity criteria (NCI-CTC).
Results
:For response rates, 3 (10.7%) partial response, 13 (46.4%) stable disease, and 12 (42.9%) progressive disease, respectively. The overall disease control rate was 57.1%. The median time to progression was 3.0 months (2-8 months). Median overall survival was 8 months (5-11 months). NCI-CTC grade 3 leukocytopenia occurred in 1 cases, grade 3 anemia in 1case and grade 3 nausea/vomiting in 2 cases.
Conclusion
:Docetaxel based chemotherapy has a tolerable efficacy with acceptable toxicities in patients with recurrent gastric cancer as a second-line treatment.
The Clinical Relevance of Distinguishing pT2 Gastric Cancer According to the Depth of Invasion and a Difference of Prognosis
Se Won Kim, Sun Kyo Song, Sang Woon Kim
Yeungnam Univ J Med. 2007;24(2 Suppl):S416-423.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2S.S416
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AbstractAbstract PDF
Purpose:A difference of a pathologic characteristic in proportion to depth of invasion analyzed in T2 gastric cancer and a difference of depth of invasion examined an influence to lymph node metastasis and prognosis. Materials and Methods:The clinicopathologic outcomes of 432 patients who underwent curative resection for pT2 stage gastric cancers from 1995 to 1999 were reviewed retrospectively. We are compared on lymphatic metastasis, stage distribution, histologic classification, Bormann’s classification, Lauren classification, vessel invasion, lymphatic invasion, neural invasion and 5-year survival rate of pT2 groups(mp vs. ss).
Results
:pT2b(ss) group compare to pT2a(mp) in Lauren classification, ratio of diffused type was higher(p<0.05) and in Bormann classification, infiltration type was higher (p<0.01). Vessel and lymphatic invasion, neural invasion showed significant difference between pT2a(mp) and pT2b(ss) (p<0.01). Difference noted between pT2a(mp) and pT2b(ss) group in a lymph node metastatic rate, degree of a metastasis and stage distribution (p<0.01). On stratifying patients according to depth of invasion, 5-year suvival rate for those with pT2a(mp) group was significantly greater than those with pT2b(ss) group(82.4% vs. 47.4%, respectively: P<0.01). In this study, appeared with the significant prognostic factor in 5-year suvival rate which multivariate analysis, depth of invasion(P<0.05) and lymph node metastasis (P<0.01) that enforced the total gastric cancer patient who had T2 gastric cancer with the object noted, but for patients with accurately staged pN0 group, suvival characteristics were similar for pT2a (mp) and pT2b(ss) gastric cancer (P=0.97).
Conclusion
:The subclassification of pT2 gastric cancer into pT2a(mp) and pT2b(ss) is necessary to demonstrate their different prognosis.

Citations

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  • The Analysis of Clinical Characteristics of pT2a and pT2b Gastric Cancer
    Byoung Hyun Choi, Ji Hoon Kim, Jin Ho Kwak, Hyuck Jae Jang, Myung Sik Han
    Journal of the Korean Surgical Society.2009; 77(4): 257.     CrossRef
Apoptosis Induced by 4-HPR on Human Stomach Adenocarcinoma Cell Line SNU1
Hyou Youn Kim, Sang Woon Kim, Seong Yong Kim
Yeungnam Univ J Med. 2007;24(2 Suppl):S606-616.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2S.S606
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AbstractAbstract PDF
Purpose:Retinoids derived from vitamin A have diverse effects on development, morphogenesis, and homeostasis. They also have effects for prevention and treatment of cancers. In this study, the effect of N-(4-hydroxyphenyl) retinamide (4-HPR) on growth and/or proliferation of human gastric adenocarcinoma cell line SNU1 was investigated. Materials and Methods:The cytotoxic effect of 4-HPR was assessed by MTT assay. The apoptosis induced by 4-HPR was analyzed with cytoplasmic DNA Fragmentation, flow cytometry, and Western blot.
Results
:4-HPR induced cell death of SNU1. The cytoplasmic DNA fragmentation was increased time dependently after treatment of 4-HPR and the cells in the sub-G0/G1 fraction of flow cytometric analysis were also increased time dependently after treatment of 4-HPR. The cleavage of caspase 3 and PARP were detected after treatment of 4-HPR to SNU1. The phosphorylations of Raf, ERK and AKT were induced by 4-HPR but after pre-treatment of MAPK inhibitor (PD98059) or PI-3 kinase inhibitor (LY294002) the 4-HPR-induced cytoplasmic DNA fragmentation, the cells in the sub-G0/G1 fraction fraction of flow cytometric analysis, and cleavage of caspase 3 and PARP were diminished in SNU1 cells.
Conclusion
:The results show that 4-HPR induces apoptosis of SNU1 and this 4-HPRinduced apoptosis may be mediated through ERK1/2 and PI3 kinase signaling pathways in SNU1.
The Comparison of Survival Rates of Postoperative Adjuvant Chemotherapies in The Stage III Gastric Cancer Patients.
Eun Mi Kim, Se Won Kim, Sang Woon Kim, Sun Kyo Song
Yeungnam Univ J Med. 2006;23(2):193-204.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.193
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PURPOSE: Various postoperative adjuvant chemotherapy regimens have been proposed for the patients with advanced gastric cancer. The majority of clinical trials have shown no significant difference in the survival benefit. The aim of this study was to compare the survival rates of postoperative adjuvant chemotherapies used in stage III gastric cancer patients who received curative gastrectomy. MATERIALS AND METHODS: Between 1990 and 1999, a survival analysis was performed in 260 patients who received curative gastric resection and postoperative adjuvant chemotherapy. The patients were divided into four groups according to the chemotherapeutic regimens received. The groups were: the F group: furtulon alone, FM group: furtulon and mitomycin, FAM group: 5-FU, adriamycin and mitomycin, FLEP group: 5-FU, leucovorin, etoposide and cisplatin. The survival rates were analyzed using the Kaplan-Meier method and the Cox proportional hazards model. RESULTS: There were no differences among the groups of patients with regard to tumor characteristics except for lymph node metastasis and the ratio of metastasis to lymph nodes. In the FLEP group, the ratio of metastasis to lymph nodes was higher than in the other groups. The five and ten year survival rates of F, FM, FAM and FLEP were 51.9%, 28.9%, 59.5%, 49.8%, 66.1%, 57.4% and 30.0%, 27.5%, respectively. The univariate analysis showed that age, Borrmann type, lymph node metastasis, ratio of metastasis to lymph nodes, postoperative adjuvant chemotherapy and recurrence were significant factors for survival. For the multivariate analysis, recurrence, age, Borrmann type, ratio of lymph node metastasis and lymph node dissection were independent prognostic factors; however, the postoperative adjuvant chemotherapy was not an independent prognostic factor. CONCLUSION: The FAM regimen was the most beneficial postoperative adjuvant chemotherapy for improved survival rates; the FM regimen was the second and the FLEP regimen was the last. In order to determine the effectiveness of postoperative adjuvant chemotherapy in stage III gastric cancer, well designed prospective studies including a surgery only group will be needed.
Surgical Treatment of Gastric Cancer.
Sang Woon Kim
Yeungnam Univ J Med. 2003;20(2):105-116.   Published online December 31, 2003
DOI: https://doi.org/10.12701/yujm.2003.20.2.105
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AbstractAbstract PDF
No abstract available.
The clinical relevance of nm23 protein expression in resected gastric cancer patient.
Sun Kyo Song, Hong Jin Kim, Sang Woon Kim
Yeungnam Univ J Med. 1999;16(1):43-51.   Published online June 30, 1999
DOI: https://doi.org/10.12701/yujm.1999.16.1.43
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The aim of present study was to elucidate whether the expression of nm23 protein might be of clinical value as prognostic factor in gastric cancer. The expression of nm23 protein was analyzed using immunohistochemical method in formalin-fixed and paraffin-embedded tissue samples of 76 gastric carcinoma patients. The cytoplasmic immunoreactivity of nm23 protein were detected in 53.9%(41/76). When the immunoreactivity of nm23 protein with TNM status and other histopathologic findings were compared by using Chi-Square test, nm23 was found to have correlations with the lymph node metastasis(p=0.04), the number of metastatic lymph node, and the invasion of lymphatic vessels(p=0.007). But, it has no correlation with TNM status. The conventional prognostic factors such as the depth of invasion, lymph node metastasis, distant metastasis, Borrmann type, size of tumor, and the curability of operation was found to have strong correlation with the survival time(p<0.003). But, the expression of nm23 protein was not significantly correlated with that in survival analysis. These results showed that the expression of nm23 protein is not a useful prognostic indicator in gastric cancer.

JYMS : Journal of Yeungnam Medical Science