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.