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Renal cell carcinoma ´ëÀå°æ

1. Robin staging

stage I : kidney³» ±¹ÇÑ

stage II : renal capsule±îÁö extend, but Gerota's fascia¿¡ µÑ·¯½Î¿© ÀÖÀ½

stage IIIA : renal vein or IVC involve

stage IIIB : hilar LN involve

stage IV : ÁÖÀ§Àå±â ħ¹ü(adrenal gland´Â Á¦¿Ü) or distant metastasis

2. Ä¡·á : stage I, II: radical nephrectomy(en bloc resection)

stage III : en bloc resection

advanced disease¿¡¼­´Â INF-¥á, IL-2(response´Â 20% ¹Ì¸¸)

3. classic triad: hematuria, abdominal pain, mass

¸ðµÎ µ¿¹ÝµÇ´Â °æ¿ì´Â 10-20%¿¡ ºÒ°úÇÏ´Ù.

4. clear cell type(75%), 3p deletion

erythrocytosis(3%), anemia°¡ ÈçÈ÷ µ¿¹Ý

Prostate cancer

1. Áø´ÜÀ» À§ÇØ Ã³À½ °Ë»çÇØ¾ß ÇÒ °Í: PSA, DRE

2. PSA: 65%¿¡¼­ »ó½ÂÇØ ÀÖÀ¸¸ç Á¶±âÁø´Ü¿¡ °¡Àå ¹Î°¨. Ä¡·áÈ¿°ú ÆÇÁ¤¿¡ À¯¿ë

3. diffuse bone metastasis·Î ÀÎÇÑ bone painÀÌ ½ÉÇÒ ¶§ pain controlÇÏ´Â ¹æ»ç¼º ¾àǰ

89Sr or diposponates unlabeled or labelded wit samarium(153Sm)

4. BPHÄ¡·áÁ¦·Î prostatic cancerÄ¡·á¿¡ ¿¬±¸µÇ°í ÀÖÀ¸¸ç testosterone -> DHTÀ¸·Î ÀüȯµÉ

¶§ ÇÊ¿äÇÑ 5¥á-reductase¸¦ ¾ïÁ¦ÇÏ´Â ¾à? Finasteride(5¥á-reductase inhibitor)

Finasteride = Proscar(1T = 5mg)

5. advanced prostate cancer

GnRH analogue(leuprolide, Goserelin=Zoladex)

androgen blocker(flutamide = Eulexin)

diethylstilesterol

Testicular cancer

1. AFP, hCG ÃøÁ¤

AFP : nonseminomatous germ cell tumor¿¡¼­¸¸ »ó½Â

2. residual disease Ä¡·á

* retroperitoneum: nonseminomatous -> bilateral retroperitoneal LN dissection

seminoma -> 3cm ¹Ì¸¸ÀÎ °æ¿ì observation

3. germ cell tumor¿¡¼­ Áø´Ü ¹× ¿¹ÈÄ¿Í °ü·ÃÀÌÀÖ´Â ¿°»öü ÀÌ»ó: i(12p)

isochromosome of short arm of chr 12

4. BEP¸¦ ±âº»À¸·Î ÇÏ´Â chemoterapy¸¦ ½ÃÇà

seminoma: ÀÜÁ¸Á¾¾çÀÇ Å©±â°¡ 3cm ¹Ì¸¸À̸é F/U

non-seminoma: ÀÜÁ¸Á¾¾çÀº ²À Á¦°ÅÇØ¾ß ÇÑ´Ù.

ÀýÁ¦ÇÑ Á¶Á÷¿¡¼­ viable tumor°¡ ÀÖÀ¸¸é CTx¸¦ 2cycle´õ ½ÃÇàÇÑ´Ù.