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Volume 46(3); July 2014
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Review Article
Regulation and Role of EZH2 in Cancer
Hirohito Yamaguchi, Mien-Chie Hung
Cancer Res Treat. 2014;46(3):209-222.   Published online July 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.3.209
AbstractAbstract PDFPubReaderePub
Polycomb repressive complex 2 (PRC2) is the epigenetic regulator that induces histone H3 lysine 27 methylation (H3K27me3) and silences specific gene transcription. Enhancer of zeste homolog 2 (EZH2) is an enzymatic subunit of PRC2, and evidence shows that EZH2 plays an essential role in cancer initiation, development, progression, metastasis, and drug resistance. EZH2 expression is indeed regulated by various oncogenic transcription factors, tumor suppressor miRNAs, and cancer-associated non-coding RNA. EZH2 activity is also controlled by post-translational modifications, which are deregulated in cancer. The canonical role of EZH2 is gene silencing through H3K27me3, but accumulating evidence shows that EZH2 methlyates substrates other than histone and has methylase-independent functions. These non-canonical functions of EZH2 are shown to play a role in cancer progression. In this review, we summarize current information on the regulation and roles of EZH2 in cancer. We also discuss various therapeutic approaches to targeting EZH2.

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Original Articles
Cost-Effectiveness of Liver Cancer Screening in Adults at High Risk for Liver Cancer in the Republic of Korea
Young Hwa Lee, Kui Son Choi, Jae Kwan Jun, Mina Suh, Hoo-Yeon Lee, Youn Nam Kim, Chung Mo Nam, Eun-Cheol Park, Woo-Hyun Cho
Cancer Res Treat. 2014;46(3):223-233.   Published online July 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.3.223
AbstractAbstract PDFPubReaderePub
Purpose
This study was conducted in order to determine the most cost-effective strategy, in terms of interval and age range, forliver cancer screening in the high-risk population of Korea. Materials and Methods A stochastic modelwas used to simulate the cost-effectiveness ofliver cancer screening by combined ultrasonography and alpha-fetoprotein testing when varying both screening intervals and age ranges. The effectiveness of these screening strategies in the high-risk population was defined as the probability of detecting preclinical liver cancer, and costwas based on the direct cost ofthe screening and confirmative tests. Optimal cost-effectiveness was determined using the incremental cost-effectiveness ratio. Results Among the 36 alternative strategies, one-year or two-year interval screening for men aged between 50 and 80 years, six-month or one-year interval screening for men aged between 40 and 80 years, and six-month interval screening for men aged between 30 and 80 years were identified as non-dominated strategies. For women, identified non-dominated strategies were: one-year interval screening between age 50 and 65 years, one-year or six-month interval screening between age 50 and 80 years, six-month interval screening between age 40 and 80 years, and six-month interval screening between age 30 and 80 years. Conclusion In Korea, a one-year screening interval for men aged 50 to 80 years would be marginally cost-effective. Further studies should be conducted in order to evaluate effectiveness of liver cancer screening, and compare the cost effectiveness of different liver cancer screening programs with a final outcome indicator such as qualityadjusted life-years or disability-adjusted life-years.

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    Thi Phuong Thao Tran, Minji Han, Ngoc Minh Luu, Jin‐Kyoung Oh
    Cancer Medicine.2023; 12(7): 8754.     CrossRef
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    Anh Le Tuan Nguyen, Hoa Thi Thu Nguyen, Kwang Chien Yee, Andrew J. Palmer, Christopher Leigh Blizzard, Barbara de Graaff
    Value in Health.2021; 24(5): 733.     CrossRef
  • Disparities in Liver Cancer Surveillance Among People With Disabilities
    Jae Youn Seo, Dong Wook Shin, Su Jong Yu, Jin Hyung Jung, Kyungdo Han, In Young Cho, So Young Kim, Kui Son Choi, Jong Heon Park, Jong Hyock Park, Ichiro Kawachi
    Journal of Clinical Gastroenterology.2021; 55(5): 439.     CrossRef
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    Jin Won Kwon, Ha Jin Tchoe, Jayoun Lee, Jae Kyung Suh, Jeong-Hoon Lee, Sangjin Shin
    Gut and Liver.2020; 14(1): 108.     CrossRef
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A Phase I Study of Oral Paclitaxel with a Novel P-Glycoprotein Inhibitor, HM30181A, in Patients with Advanced Solid Cancer
Hyun Jung Lee, Dae-Seog Heo, Joo-Youn Cho, Sae-Won Han, Hye-Jung Chang, Hyeon-Gyu Yi, Tae-Eun Kim, Se-Hoon Lee, Do-Youn Oh, Seock-Ah Im, In-Jin Jang, Yung-Jue Bang
Cancer Res Treat. 2014;46(3):234-242.   Published online July 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.3.234
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study is to determine the maximum tolerated dose (MTD), safety, pharmacokinetics, and recommended phase II dose of an oral drug composed of paclitaxel and HM30181A, which is an inhibitor of P-glycoprotein, in patients with advanced cancers. Materials and Methods Patients with advanced solid tumors received standard therapy were given the study drug at escalating doses, using a 3+3 design. The study drug was orally administered on days 1, 8, and 15, with a 28-day cycle of administration. The dose of paclitaxel was escalated from 60 to 420 mg/m2, and the dose of HM30181A was escalated from 30-210 mg/m2. Results A total of twenty-four patients were enrolled. Only one patient experienced a doselimiting toxicity—a grade 3 neutropenia that persisted for more than 2 weeks, at 240 mg/m2 of paclitaxel. MTD was not reached. The maximum plasma concentration was obtained at a dose level of 300 mg/m2 and the area under the curve of plasma concentration- time from 0 to the most recent plasma concentration measurement of paclitaxel was reached at a dose level of 420 mg/m2. The absorption of paclitaxel tends to be limited at doses that exceed 300 mg/m2. The effective plasma concentration of paclitaxel was achieved at a dose of 120 mg/m2. Responses of 23 patients were evaluated; 8 (34.8%) had stable disease and 15 (65.2%) had progressive disease. Conclusion The study drug appears to be well tolerated, and the effective plasma concentration of paclitaxel was achieved. The recommended phase II dose for oral paclitaxel is 300 mg/m2.

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    Wen Wee Ma, Jenny J. Li, Nilofer S. Azad, Elaine T. Lam, Jennifer R. Diamond, Grace K. Dy, Mateusz Opyrchal, Jay Zhi, Douglas Kramer, Wing-Kai Chan, David Cutler, Rudolf Kwan, Alex A. Adjei, Antonio Jimeno
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    Marit A C Vermunt, Andries M Bergman, Eric van der Putten, Jos H Beijnen
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    Mahdi Ghadi, Seyed Jalal Hosseinimehr, Fereshteh Talebpour Amiri, Alireza Mardanshahi, Zohreh Noaparast
    European Journal of Pharmacology.2021; : 173892.     CrossRef
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    Michael P. Smolinski, Sameer Urgaonkar, Laura Pitzonka, Murray Cutler, GwanSun Lee, Kwee Hyun Suh, Johnson Y. N. Lau
    Journal of Medicinal Chemistry.2021; 64(7): 3677.     CrossRef
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    Christopher G. C. A. Jackson, Tak Hung, Eva Segelov, Paula Barlow, Hans Prenen, Blair McLaren, Noelyn Anne Hung, Katriona Clarke, Tsu‐Yi Chao, Ming‐Shen Dai, Hsien‐Tang Yeh, David L. Cutler, Douglas Kramer, Jimmy He, Jay Zhi, Wing‐Kai Chan, Rudolf Kwan, S
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    Yuanfeng Wei, Shengyan Zhou, Tianyun Hao, Jianjun Zhang, Yuan Gao, Shuai Qian
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    Marco C. Cavaco, Carolina Pereira, Bruna Kreutzer, Luis F. Gouveia, Beatriz Silva-Lima, Alexandra M. Brito, Mafalda Videira
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Outcome of Local Excision Following Preoperative Chemoradiotherapy for Clinically T2 Distal Rectal Cancer: A Multicenter Retrospective Study (KROG 12-06)
Jae Myoung Noh, Won Park, Jae-Sung Kim, Woong Sub Koom, Jin Hee Kim, Doo Ho Choi, Hee Chul Park
Cancer Res Treat. 2014;46(3):243-249.   Published online July 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.3.243
AbstractAbstract PDFPubReaderePub
Purpose
The aim of this study was to examine the clinical implications of a pathologically complete response after neoadjuvant chemoradiotherapy (CRT) followed by local excision for patients with cT2 rectal cancer who refused radical surgery. Materials and Methods Seventeen patients with cT2 primary rectal cancer within 6 cm from the anal verge who received neoadjuvant CRT and local excision because of patient refusal of radical surgery or poor performance status were included. Two patients had clinical involvement of a regional lymph node. Preoperative radiotherapy was delivered to the whole pelvis at a dose of 44 to 50.4 Gy in 22 to 28 fractions. All patients underwent transanal excision and eight patients (47%) received postoperative chemotherapy. Results Ten patients (59%) achieved ypT0. At a median follow-up period of 75 months (range, 22 to 126 months), four (24%) patients developed recurrence (two locoregional and two distant). The 5-year disease-free survival of all patients was 82%, and was higher in patients with ypT0 (90%) than in patients with ypT1-2 (69%, p=0.1643). Decreased disease-free survival was also observed in patients receiving capecitabine compared with 5-fluorouracil (54% vs. 100%, p=0.0298). Conclusion Local excision could be a feasible alternative to radical surgery in patients with ypT0 after neoadjuvant CRT for cT2 distal rectal cancer without further radical surgery.

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    Laurence Bernier, Svetlana Balyasnikova, Diana Tait, Gina Brown
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    Bo Young Oh, Jung Wook Huh, Woo Yong Lee, Yoon Ah Park, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Ho-Kyung Chun
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    Fraser McLean Smith, Abdul Ahad, Rodrigo Oliva Perez, John Marks, Krzysztof Bujko, Richard J. Heald
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    Deborah S. Keller, Reena N. Tahilramani, Juan R. Flores-Gonzalez, Ali Mahmood, Eric M. Haas
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    T. Sprenger, H. Rothe, T. Beissbarth, L.-C. Conradi, A. Kauffels, K. Homayounfar, C. L. Behnes, C. Rödel, T. Liersch, M. Ghadimi
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    Sung Min Jung, Chang Sik Yu, In Ja Park, Tae Won Kim, Jong Hoon Kim, Yong Sik Yoon, Seok-Byung Lim, Jin Cheon Kim
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    Sam Atallah, Deborah Keller
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  • Influence of Preoperative Chemoradiotherapy on the Surgical Strategy According to the Clinical T Stage of Patients With Rectal Cancer
    In Ja Park, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Jong Seok Lee, Seong Ho Park, Jin Hong Park, Jong Hoon Kim, Chang Sik Yu, Jin Cheon Kim
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    Juefeng Wan, Kaitai Liu, Ji Zhu, Guichao Li, Zhen Zhang
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  • Prediction of pathologic staging with magnetic resonance imaging after preoperative chemoradiotherapy in rectal cancer: Pooled analysis of KROG 10-01 and 11-02
    Jong Hoon Lee, Hong Seok Jang, Jun-Gi Kim, Myung Ah Lee, Dae Yong Kim, Tae Hyun Kim, Jae Hwan Oh, Sung Chan Park, Sun Young Kim, Ji Yeon Baek, Hee Chul Park, Hee Cheol Kim, Taek-Keun Nam, Eui Kyu Chie, Ji-Han Jung, Seong Taek Oh
    Radiotherapy and Oncology.2014; 113(1): 18.     CrossRef
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A Case-Control Study to Identify Risk Factors for Totally Implantable Central Venous Port-Related Bloodstream Infection
Guk Jin Lee, Sook Hee Hong, Sang Young Roh, Sa Rah Park, Myung Ah Lee, Hoo Geun Chun, Young Seon Hong, Jin Hyoung Kang, Sang Il Kim, Youn Jeong Kim, Ho Jong Chun, Jung Suk Oh
Cancer Res Treat. 2014;46(3):250-260.   Published online July 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.3.250
AbstractAbstract PDFPubReaderePub
Purpose
To date, the risk factors for central venous port-related bloodstream infection (CVPBSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer.
Materials and Methods
A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time.
Results
CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047).
Conclusion
In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.

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  • Port type is a possible risk factor for implantable venous access port-related bloodstream infections and no sign of local infection predicts the growth of gram-negative bacilli
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Low-Dose Whole Brain Radiotherapy with Tumor Bed Boost after Methotrexate-Based Chemotherapy for Primary Central Nervous System Lymphoma
Byoung Hyuck Kim, Il Han Kim, Sung-Hye Park, Chul Kee Park, Hee Won Jung, Tae Min Kim, Se-Hoon Lee, Dae Seog Heo
Cancer Res Treat. 2014;46(3):261-269.   Published online July 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.3.261
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study is to evaluate the outcome of low-dose whole brain radiotherapy (WBRT) with tumor bed boost after methotrexate-based chemotherapy in the management of primary central nervous system lymphoma (PCNSL). Materials and Methods We retrospectively analyzed 64 patients with pathologically proven PCNSL between 2000 and 2011. Methotrexate-based chemotherapy with a median of five cycles was followed by radiotherapy to the whole brain and to the initial tumor bed. The median dose to the whole brain and to the tumor bed was 27 Gy (range, 18 to 36 Gy) and 50.4 Gy (range, 45 to 54 Gy), respectively. Results With a median follow-up period of 27 months, 55 patients (85.9%) achieved complete response (CR). The 5-year overall survival (OS) and progression-free survival (PFS) rates were 52.6% and 39.3%, respectively. In univariate analysis, factors associated with OS were age, performance status, involvement of deep structure, and CR to sequential chemoradiotherapy (CRT). These variables remained as significant factors for OS in multivariate analysis. CR to sequential CRT was the only positive factor associated with PFS (p=0.009). Neurologic toxicity was more common in elderly patients older than 60 years (p=0.025). Conclusion Low-dose WBRT with tumor bed boost after methotrexate-based chemotherapy might be an effective method for management of PCNSL.

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Early Postoperative Intraperitoneal Chemotherapy for Macroscopically Serosa-Invading Gastric Cancer Patients
Oh Kyoung Kwon, Ho Young Chung, Wansik Yu
Cancer Res Treat. 2014;46(3):270-279.   Published online July 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.3.270
AbstractAbstract PDFPubReaderePub
Purpose
Peritoneal recurrence is one of the most common patterns of recurrence after gastric cancer surgery and it has a poor prognosis despite all efforts. The aim of this study is to evaluate the prognostic impact of early postoperative intraperitoneal chemotherapy (EPIC) after surgery with curative intent for macroscopically serosa-invading gastric cancer patients. Materials and Methods The records of 245 patients under the age of 70 were reviewed. These patients were suffering from macroscopically seroa-invading gastric cancer and they underwent curative surgery from 1995 to 2004 at the Kyungpook National University Hospital, Daegu, Korea. The overall survival, gastric cancer-specific survival, complications, and patterns of recurrence were compared between the patients who were treated with EPIC and those who were not. Results EPIC was administered to 65 patients, and the remaining 180 patients did not receive this treatment. The 5-year overall and gastric cancer-specific survival rates for the EPIC group were 47.4% and 53.1%, respectively, and those for the non-EPIC group were 26.7% and 29.7%, respectively (p=0.012 for overall survival and p=0.011 for gastric cancer-specific survival). The rates of peritoneal recurrence for the EPIC group and the non-EPIC group were 18.5% and 32.2%, respectively (p=0.038). There were no significant differences in the morbidity or mortality between the two groups. Based on a multivariate analysis of the factors with prognostic significance in univariate analyses, EPIC, pathological lymph node metastasis, differentiation, and the extent of gastric resection were independent prognostic factors. Conclusion The use of EPIC to treat gastric cancer patients with macroscopic serosal invasions resulted in better survival rate by reducing the risk of peritoneal recurrence.

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    Antonio Macrì, Federico Morabito
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    Zhen Wang, Jun-qiang Chen, Jin-lu Liu, Lei Tian
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A New Isolated Mediastinal Lymph Node or Small Pulmonary Nodule Arising during Breast Cancer Surveillance Following Curative Surgery: Clinical Factors That Differentiate Malignant from Benign Lesions
Tae-Yong Kim, Kyung-Hun Lee, Sae-Won Han, Do-Youn Oh, Seock-Ah Im, Tae-You Kim, Wonshik Han, Kyubo Kim, Eui Kyu Chie, In-Ae Park, Young Tae Kim, Dong-Young Noh, Sung Whan Ha, Yung-Jue Bang
Cancer Res Treat. 2014;46(3):280-287.   Published online July 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.3.280
AbstractAbstract PDFPubReaderePub
Purpose
A newly isolated mediastinal lymph node (LN) or a small pulmonary nodule, which appears during breast cancer surveillance, may pose a diagnostic dilemma with regard to malignancy. We conducted this study to determine which clinical factors were useful for the differentiation of malignant lesions from benign lesions under these circumstances. Materials and Methods We enrolled breast cancer patients who were presented with a new isolated mediastinal LN or small pulmonary nodule that arose during surveillance, and whose lesions were pathologically confirmed. Tissue diagnosis was made by mediastinoscopy, video-assisted thoracic surgery or thoracotomy. Results A total of 43 patients were enrolled (mediastinal LN, 13 patients; pulmonary nodule, 30 patients). Eighteen patients (41.9%) were pathologically confirmed to have a benign lesion (benign group), and 25 patients (58.1%) were confirmed to have malignant lesion (malignant group). Between the two groups, the initial tumor size (p=0.096) and N stage (p=0.749) were similar. Hormone receptor negativity was more prevalent in the malignant group (59.1% vs. 40.9%, p=0.048). The mean lesion size was larger in the malignant group than in the benign group (20.8 mm vs. 14.4 mm, p=0.024). Metastatic lesions had a significantly higher value of maximal standardized uptake (mSUV) than that of benign lesions (6.4 vs. 3.4, p=0.021). Conclusion Hormone receptor status, lesion size, and mSUV on positron emission tomography are helpful in the differentiation of malignant lesions from benign lesions in breast cancer patients who were presented with a new isolated mediastinal LN or small pulmonary nodule during surveillance.

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  • Unusual metastases of breast cancer: a single-center retrospective study
    Pınar ÖZDEMİR AKDUR, Nazan ÇİLEDAĞ
    The European Research Journal.2023; 9(6): 1444.     CrossRef
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    Lei Zhu, Haiman Bian, Lieming Yang, Jianjing Liu, Wei Chen, Xiaofeng Li, Jian Wang, Xiuyu Song, Dong Dai, Zhaoxiang Ye, Wengui Xu, Xiaozhou Yu
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Impact of Hyperglycemia on Survival and Infection-Related Adverse Events in Patients with Metastatic Colorectal Cancer Who Were Receiving Palliative Chemotherapy
Yong Joo Hong, Hye-Suk Han, Yusook Jeong, Jiwon Jeong, Sung-Nam Lim, Hyung Jin Choi, Hyun-Jung Jeon, Tae-Keun Oh, Sang-Jeon Lee, Ki Hyeong Lee
Cancer Res Treat. 2014;46(3):288-296.   Published online July 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.3.288
AbstractAbstract PDFPubReaderePub
Purpose
Non-metastatic colorectal cancer patients with diabetes have poor overall survival than those without diabetes. However, the effect of hyperglycemia on survival after diagnosis of metastatic colorectal cancer (CRC) has not been assessed. Therefore, we assessed the impact of hyperglycemia on the survival and infection-related adverse events (AEs) in patients with metastatic CRC. Materials and Methods We reviewed the records of 206 patients with newly diagnosed metastatic CRC who were treated with palliative chemotherapy from March 2000 to December 2012 at Chungbuk National University Hospital. The mean glucose level of each patient was calculated using all available glucose results. Results The mean glucose levels ranged between 76.8 and 303.5 mg/dL, and patients were categorized into quartiles in accordance to their mean glucose level: group 1 (< 106.7 mg/dL), group 2 (106.7-117.2 mg/dL), group 3 (117.3-142.6 mg/dL), and group 4 (> 142.6 mg/dL). The median overall survival for patients in groups 1, 2, 3, and 4 were 22.6, 20.1, 18.9, and 17.9 months, respectively; however, this difference was not statistically significant (p=0.643). Compared with patients in group 1, those in groups 2, 3, and 4 were at a higher risk of infection-related AEs, according to a multivariate analysis (p=0.002). Conclusion Hyperglycemia was not associated with shorter survival; however, it was associated with infection-related AEs in patients with newly diagnosed metastatic CRC receiving palliative chemotherapy.

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Interleukin-17 Indirectly Promotes M2 Macrophage Differentiation through Stimulation of COX-2/PGE2 Pathway in the Cancer Cells
Qingli Li, Lunxu Liu, Qiuyang Zhang, Sen Liu, Dongxia Ge, Zongbing You
Cancer Res Treat. 2014;46(3):297-306.   Published online July 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.3.297
AbstractAbstract PDFPubReaderePub
Purpose
Interleukin-17 (IL-17) is a proinflammatory cytokine that plays important roles in inflammation, autoimmunity, and cancer. The purpose of this study was to determine if IL-17 indirectly regulates macrophage differentiation through up-regulation of cyclooxygenase-2 (COX-2) expression in the cancer cell lines. Materials and Methods Human cervical cancer HeLa, human lung cancer A549, and mouse prostate cancer Myc-CaP/CR cell lines were treated with recombinant IL-17; Western blot analysis, enzyme-linked immunosorbent assay, and quantitative real-time polymerase chain reaction analysis were utilized to examine the cellular responses. Results IL-17 up-regulated expression of COX-2 mRNA and protein in HeLa, A549, and Myc- CaP/CR cell lines. IL-17’s effects were mediated through nuclear factor-κB and ERK1/2 signaling pathways as the inhibitors of these pathways could inhibit IL-17- induced COX-2 expression. The conditional medium obtained from the cancer cells contained prostaglandin E2, the levels of which were increased by IL-17 treatment. When treated with the conditional medium, particularly with the IL-17-induced conditional medium, mouse RAW264.7 macrophages and human THP-1 monocytes expressed higher levels of IL-10 (a marker of M2 macrophages) than inducible nitric oxide synthase or tumor necrosis factor α (markers of M1 macrophages). In contrast, when RAW264.7 and THP-1 cells were treated directly with IL-17, expression of these marker genes was not markedly changed. Conclusion The results of this study suggest that IL-17 indirectly promotes M2 macrophage differentiation through stimulation of the COX-2/PGE2 pathway in the cancer cells, thus IL-17 plays an indirect role in regulating the tumor immune microenvironment.

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Case Reports
Unusual Manifestation of Intravascular Large B-Cell Lymphoma: Severe Hypercalcemia with Parathyroid Hormone-Related Protein
Jung Min Ha, Eun Kim, Woo Joo Lee, Ji-Won Hwang, Sehyo Yune, Young Hyeh Ko, Joon Young Choi, Seok Jin Kim, Won Seog Kim
Cancer Res Treat. 2014;46(3):307-311.   Published online July 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.3.307
AbstractAbstract PDFPubReaderePub
Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of non-Hodgkin lymphoma. It usually presents with nonspecific symptoms, such as fever, rather than with overt lymphadenopathy. Reports of hypercalcemia, as the initial presentation of IVLBCL, are limited in the literature, despite it being a well-known complication of various solid cancers. We present a 68-year-old male with severe hypercalcemia and increased levels of serum parathyroid hormone-related protein. He was diagnosed with IVLBCL, involving the bone marrow and spleen, and was successfully treated with rituximab-containing chemotherapy. A few previous case reports have shown hypercalcemia in patients with IVLBCL. Much like our case, previous cases with hypercalcemia had advanced diseases, including bone marrow invasion. Although it was an extremely rare manifestation of IVLBCL, we suggest that IVLBCL should be a part of the differential diagnosis in patients with unexplained hypercalcemia. Therefore, an active work-up might be recommended, including positron emission tomography/ computed tomography scan and bone marrow examination, which may be useful for early diagnosis.

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Cyclosporine A as a Primary Treatment for Panniculitis-like T Cell Lymphoma: A Case with a Long-Term Remission
Won Sup Lee, Ji-Hyen Hwang, Moon Jin Kim, Se-Il Go, Anna Lee, Haa-Na Song, Min Jeong Lee, Myung Hee Kang, Hoon-Gu Kim, Jeong-Hee Lee
Cancer Res Treat. 2014;46(3):312-316.   Published online July 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.3.312
AbstractAbstract PDFPubReaderePub
Subcutaneous panniculitis-like T cell lymphoma (SPTL) is a distinctive cutaneous lymphoma characterized by an infiltration of subcutaneous tissue by neoplastic T cells, similar to panniculitis. It is well-established that patients who are diagnosed with SPTL usually respond poorly to chemotherapy, showing fatal outcome. As a first line treatment for SPTL, anthracycline-based chemotherapy was most frequently used. For the treatment of SPTL, the efficacy of cyclosporine A has been recently reported in relapsed SPTL after anthracycline-based chemotherapy. However, it is still not clear whether cyclosporine A can be used as a first-line treatment against SPTL. Here, we report a case of SPTL, which achieved complete remission for nine years after first-line cyclosporine A therapy. This study suggests that cyclosporine A can induce a complete long-term remission as a first-line treatment.

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Case Report of Pulmonary Sarcoidosis Suspected to be Pulmonary Metastasis in a Patient with Breast Cancer
Hye Sook Kim, Suk-young Lee, Sang Cheul Oh, Chul Won Choi, Jun Suk Kim, Jae Hong Seo
Cancer Res Treat. 2014;46(3):317-321.   Published online July 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.3.317
AbstractAbstract PDFPubReaderePub
Standard endocrine therapy and chemotherapy can induce long-term remission in breast cancer patients; however, breast cancer can recur at any site. Pulmonary nodules with lymphadenopathy in advanced cancer patients are likely to be assumed as metastases. A 44-year-old woman with a history of breast cancer was presented to our institution with abnormal findings on 18-fluorodeoxyglucose positron emission tomography imaging, which suggested lung metastasis. She had previously been diagnosed with breast cancer (T1N2M0, Stage IIIa, intraductal carcinoma, triple negative cancer). Histological analysis of the mediastinal lymph node biopsy demonstrated sarcoidosis, showing a chronic, non-caseating, granulomatous inflammation. Our case highlights the need for non-malignant diagnoses in those with prior malignancies, and the need for histological evaluations in the event of first recurrence following potentially curative therapy.

Citations

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