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Volume 50(3); July 2018
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Original Articles
Risk Factors for a False-Negative Result of Sentinel Node Biopsy in Patients with Clinically Node-Negative Breast Cancer
Seung Ah Lee, Hak Min Lee, Hak Woo Lee, Ban Seok Yang, Jong Tae Park, Sung Gwe Ahn, Joon Jeong, Seung Il Kim
Cancer Res Treat. 2018;50(3):625-633.   Published online July 31, 2017
DOI: https://doi.org/10.4143/crt.2017.089
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Although sentinel lymph node biopsy (SLNB) can accurately represent the axillary lymph node (ALN) status, the false-negative rate (FNR) of SLNB is the main concern in the patients who receive SLNB alone instead of ALN dissection (ALND).
Materials and Methods
We analyzed 1,886 patientswho underwent ALNDafter negative results of SLNB,retrospectively. A logistic regression analysis was used to identify risk factors associated with a falsenegative (FN) result. Cox regression model was used to estimate the hazard ratio of factors affecting disease-free survival (DFS).
Results
Tumor located in the upper outer portion of the breast, lymphovascular invasion, suspicious node in imaging assessment and less than three sentinel lymph nodes (SLNs) were significant independent risk factors for FN in SLNB conferring an adjusted odds ratio of 2.10 (95% confidence interval [CI], 1.30 to 3.39), 2.69 (95% CI, 1.47 to 4.91), 2.59 (95% CI, 1.62 to 4.14), and 2.39 (95% CI, 1.45 to 3.95), respectively. The prognostic factors affecting DFS were tumor size larger than 2 cm (hazard ratio [HR], 1.86; 95% CI, 1.17 to 2.96) and FN of SLNB (HR, 2.51; 95% CI, 1.42 to 4.42) in SLN-negative group (FN and true-negative), but in ALN-positive group (FN and true-positive), FN of SLNB (HR, 0.64; 95% CI, 0.33 to 1.25) did not affect DFS.
Conclusion
In patients with risk factors for a FN such as suspicious node in imaging assessment, upper outer breast cancer, less than three harvested nodes, we need attention to find another metastatic focus in non-SLNs during the operation. It may contribute to provide an exact prognosis and optimizing adjuvant treatments.

Citations

Citations to this article as recorded by  
  • Detection of presence or absence of metastasis in WSI patches of breast cancer using the dual-enhanced convolutional ensemble neural network
    Ruigang Ge, Guoyue Chen, Kazuki Saruta, Yuki Terata
    Machine Learning with Applications.2024; 17: 100579.     CrossRef
  • Ultrasound radiomics based on axillary lymph nodes images for predicting lymph node metastasis in breast cancer
    Yu-Long Tang, Bin Wang, Tao Ou-Yang, Wen-Zhi Lv, Shi-Chu Tang, An Wei, Xin-Wu Cui, Jiang-Sheng Huang
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • Future Directions in the Assessment of Axillary Lymph Nodes in Patients with Breast Cancer
    Filippo Pesapane, Luciano Mariano, Francesca Magnoni, Anna Rotili, Davide Pupo, Luca Nicosia, Anna Carla Bozzini, Silvia Penco, Antuono Latronico, Maria Pizzamiglio, Giovanni Corso, Enrico Cassano
    Medicina.2023; 59(9): 1544.     CrossRef
  • Axillary Lymph Node Dissection Can Be Omitted in Breast Cancer Patients With Mastectomy and False-Negative Frozen Section in Sentinel Lymph Node Biopsy
    Jing Si, Rong Guo, Huan Pan, Xiang Lu, Zhiqin Guo, Chao Han, Li Xue, Dan Xing, Wanxin Wu, Caiping Chen
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • False-negative frozen section of sentinel nodes in early breast cancer (cT1-2N0) patients
    Zhu-Jun Loh, Kuo-Ting Lee, Ya-Ping Chen, Yao-Lung Kuo, Wei-Pang Chung, Ya-Ting Hsu, Chien-Chang Huang, Hui-Ping Hsu
    World Journal of Surgical Oncology.2021;[Epub]     CrossRef
  • What Is High-risk Breast Cancer With Pathologically Negative Lymph Nodes for Regional Recurrence?
    Sang-Won Kim, Won Kyung Cho, Doo Ho Choi, Haeyoung Kim, Oyeon Cho, Won Park, Mison Chun
    International Journal of Radiation Oncology*Biology*Physics.2021; 111(4): 992.     CrossRef
  • Validating the ACOSOG Z0011 Trial Result: A Population-Based Study Using the SEER Database
    Jiwoong Jung, Byoung Hyuck Kim, Jongjin Kim, Sohee Oh, Su-jin Kim, Chang-Sup Lim, In Sil Choi, Ki-Tae Hwang
    Cancers.2020; 12(4): 950.     CrossRef
  • Retrospectively validating the results of the ACOSOG Z0011 trial in a large Asian Z0011-eligible cohort
    Jiwoong Jung, Wonshik Han, Eun Sook Lee, So-Youn Jung, Jai Hong Han, Dong-Young Noh, Yumi Kim, Hee Jun Choi, Jeong Eon Lee, Seok Jin Nam, Jong Won Lee, Hee Jeong Kim, Eunhae Um, Joo Heung Kim, Seho Park, Young Up Cho
    Breast Cancer Research and Treatment.2019; 175(1): 203.     CrossRef
  • Preliminary study of contrast-enhanced ultrasound in combination with blue dye vs. indocyanine green fluorescence, in combination with blue dye for sentinel lymph node biopsy in breast cancer
    Yidong Zhou, Yan Li, Feng Mao, Jing Zhang, Qingli Zhu, Songjie Shen, Yan Lin, Xiaohui Zhang, He Liu, Mengsu Xiao, Yuxin Jiang, Qiang Sun
    BMC Cancer.2019;[Epub]     CrossRef
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  • 10 Web of Science
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Are We Predicting Disease Progress of the Rectal Cancer Patients without Surgery after Neoadjuvant Chemoradiotherapy?
Bo Young Oh, Jung Wook Huh, Woo Yong Lee, Yoon Ah Park, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Ho-Kyung Chun
Cancer Res Treat. 2018;50(3):634-645.   Published online July 3, 2017
DOI: https://doi.org/10.4143/crt.2017.069
AbstractAbstract PDFPubReaderePub
Purpose
There are patients who do not undergo surgery, regardless of tumor response for neoadjuvant chemoradiotherapy (nCRT) in rectal cancer. However, there have been few reports focused on how oncologic outcomes are worse in these patients. We sought to investigate oncologic outcomes for these non-operated patients with rectal cancer after nCRT.
Materials and Methods
A total of 1,063 records of patients with rectal cancer who were treated with nCRT from January 2002 to December 2013 were retrospectively reviewed. We categorized patients into the non-operated group (n=77), transanal local excision (TLE) group (n=54), ortotal mesorectal excision (TME) group (n=932) and compared each group using propensity score matching.
Results
In the non-operated group, the most common reason for no surgery was patient refusal (n=64). Eleven patients were considered to have achieve clinical complete response (cCR), which was an independent prognostic factor of progression-free survival (p=0.045). In patients with disease progression in the non-operated group, the overall survival did not improved according to salvage treatments (p=0.451). The non-operated group showed worse survivals compared to the TLE or TME group before and after matching (p < 0.001). This finding was also noted in the analysis of survival only in patients with cCR.
Conclusion
In this study, non-operated patients did not secure oncologic safety regardless of cCR after nCRT. Our results suggest that a non-operative management must be carefully considered even if cCR is achieved.

Citations

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  • Long-term efficacy of transanal local excision versus total mesorectal excision after neoadjuvant treatment for rectal cancer: A meta-analysis
    Yihui Lei, Li Lin, Qiming Shao, Weiping Chen, Guoyan Liu, Antonio Brillantino
    PLOS ONE.2023; 18(11): e0294510.     CrossRef
  • Non-operative Management (NOM) of Rectal Cancer: Literature Review and Translation of Evidence into Practice
    Christopher J. Anker, Dmitriy Akselrod, Steven Ades, Nancy A. Bianchi, Nataniel H. Lester-Coll, Peter A. Cataldo
    Current Colorectal Cancer Reports.2021; 17(2): 23.     CrossRef
  • Prognostic Factors and Treatment of Recurrence after Local Excision of Rectal Cancer
    Moon Suk Choi, Jung Wook Huh, Jung Kyong Shin, Yoon Ah Park, Yong Beom Cho, Hee Cheol Kim, Seong Hyeon Yun, Woo Yong Lee
    Yonsei Medical Journal.2021; 62(12): 1107.     CrossRef
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    Adam C. Fields, Pamela W. Lu, James Yoo, Jennifer Irani, Joel E. Goldberg, Ronald Bleday, Nelya Melnitchouk
    Journal of Surgical Oncology.2020; 121(6): 990.     CrossRef
  • MRI Assessment of Complete Response to Preoperative Chemoradiation Therapy for Rectal Cancer: 2020 Guide for Practice from the Korean Society of Abdominal Radiology
    Seong Ho Park, Seung Hyun Cho, Sang Hyun Choi, Jong Keon Jang, Min Ju Kim, Seung Ho Kim, Joon Seok Lim, Sung Kyoung Moon, Ji Hoon Park, Nieun Seo
    Korean Journal of Radiology.2020; 21(7): 812.     CrossRef
  • Survival Effects of Cytoreductive Surgery for Refractory Patients after Neoadjuvant Chemotherapy in Advanced Epithelial Ovarian Cancer
    Wonkyo Shin, Joseph J. Noh, Sang-Soo Seo, Sokbom Kang, Chel-Hun Choi, Sang-Yoon Park, Byoung-Gie Kim, Myong Cheol Lim
    Yonsei Medical Journal.2020; 61(11): 935.     CrossRef
  • Oncologic Risk of Rectal Preservation Against Medical Advice After Chemoradiotherapy for Rectal Cancer: A Multicenter Comparative Cross‐Sectional Study with Rectal Preservation as Supported by Surgeon
    Kwang‐Seop Song, Sung Chan Park, Dae Kyung Sohn, Jae Hwan Oh, Min Jung Kim, Ji Won Park, Seung‐Bum Ryoo, Seung‐Yong Jeong, Kyu Joo Park, Heung‐Kwon Oh, Duck‐Woo Kim, Sung‐Bum Kang
    World Journal of Surgery.2019; 43(12): 3216.     CrossRef
  • 10,305 View
  • 246 Download
  • 7 Web of Science
  • 7 Crossref
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Inter-alpha Inhibitor H4 as a Potential Biomarker Predicting the Treatment Outcomes in Patients with Hepatocellular Carcinoma
Eun-Jung Lee, Seung-Hyun Yang, Kyoung-Jin Kim, Hyejung Cha, Seo Jin Lee, Ji-Hye Kim, Junkyu Song, Kyung-Hee Chun, Jinsil Seong
Cancer Res Treat. 2018;50(3):646-657.   Published online July 17, 2017
DOI: https://doi.org/10.4143/crt.2016.550
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Early prediction of treatment outcomes represents an essential step towards increased treatment efficacy and survival in patients with hepatocellular carcinoma (HCC). In this study, we performed two-dimensional electrophoresis (2-DE) followed by protein profiling to identify biomarkers predictive of therapeutic outcomes in patients with HCC who received liver-directed therapy (LDTx) involving local radiotherapy (RT), and studied the underlying mechanisms of the identified proteins.
Materials and Methods
2-DE analysis was conducted by pooling sera from patients with a good or poor prognosis; serum proteomic profiles of the two groups were compared and analyzed using matrixassisted laser desorption/ionization time-of-flight mass spectrometry. Identified proteins were confirmed via enzyme-linked immunosorbent assay. An invasion assay was performed after overexpression and knockdown of target protein in Huh7 cells.
Results
Levels of inter-alpha inhibitor H4 (ITIH4), fibrinogen gamma chain, keratin 9/1 complex, carbonic anhydrase I, and carbonmonoxyhemoglobin S were changed by more than 4-fold in response to LDTx. In particular, pre-LDTx ITIH4 expression was more than 5-fold higher in patients with a good prognosis, compared to patients with a poor prognosis. The migration ability of Huh7 cells was significantly suppressed and enhanced by ITIH4 overexpression and knockdown, respectively. The tumors of patients with HCC and a good prognosis expressed high levels of ITIH4, compared to those of patients with a poor prognosis.
Conclusion
Taken together, ITIH4 may be a potential therapeutic target that could inhibit cancer metastasis, as well as a prognostic marker for patients with HCC who are receiving LDTx.

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    Clinica Chimica Acta.2021; 523: 365.     CrossRef
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BCL2 Regulation according to Molecular Subtype of Breast Cancer by Analysis of The Cancer Genome Atlas Database
Ki-Tae Hwang, Kwangsoo Kim, Ji Hyun Chang, Sohee Oh, Young A Kim, Jong Yoon Lee, Se Hee Jung, In Sil Choi
Cancer Res Treat. 2018;50(3):658-669.   Published online July 4, 2017
DOI: https://doi.org/10.4143/crt.2017.134
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We investigated B-cell lymphoma 2 (BCL2) regulation across DNA, RNA, protein, and methylation status according to molecular subtype of breast cancer using The Cancer Genome Atlas (TCGA) database.
Materials and Methods
We analyzed clinical and biological data on 1,096 breast cancers from the TCGA database. Biological data included reverse phase protein array (RPPA), mRNA sequencing (mRNA-seq), mRNA microarray, methylation, copy number alteration linear, copy number alteration nonlinear, and mutation data.
Results
The luminal A and luminal B subtypes showed upregulated expression of RPPA and mRNAseq and hypomethylation compared to the human epidermal growth factor receptor 2 (HER2) and triple-negative subtypes (all p < 0.001). No mutations were found in any subjects. High mRNA-seq and high RPPA were strongly associated with positive estrogen receptor, positive progesterone receptor (all p < 0.001), and negative HER2 (p < 0.001 and p=0.002, respectively). Correlation analysis revealed a strong positive correlation between protein and mRNA levels and a strong negative correlation between methylation and protein and mRNA levels (all p < 0.001). The high BCL2 group showed superior overall survival compared to the low BCL2 group (p=0.006).
Conclusion
The regulation of BCL2 was mainly associated with methylation across the molecular subtypes of breast cancer, and luminal A and luminal B subtypes showed upregulated expression of BCL2 protein, mRNA, and hypomethylation. Although copy number alteration may have played a minor role, mutation status was not related to BCL2 regulation. Upregulation of BCL2 was associated with superior prognosis than downregulation of BCL2.

Citations

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    Maiquidieli Dal Berto, Laura Martin Manfroi, Aniúsca Vieira dos Santos, Giovana Tavares dos Santos, Gabriela Krüger da Costa, Camila Macedo Boaro, Péttala Rigon, Rafael José Vargas Alves, Claudia Giuliano Bica
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Comparison of Native Escherichia coli L-Asparaginase versus Pegylated Asparaginase, in Combination with Ifosfamide, Methotrexate, Etoposide, and Prednisolone, in Extranodal NK/T-Cell Lymphoma, Nasal Type
Hyun Jee Kim, Chan-Young Ock, Tae Min Kim, Sung Hee Lee, Ju-Yeun Lee, Sun hoi Jung, Yoon Sook Cho, Miso Kim, Bhumsuk Keam, Dong-Wan Kim, Il Han Kim, Dae Seog Heo
Cancer Res Treat. 2018;50(3):670-680.   Published online July 3, 2017
DOI: https://doi.org/10.4143/crt.2017.051
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The aim of this study was to compare asparaginase-related toxicities in two asparaginase preparations, namely native Escherichia coli L-asparaginase (L-ASP) and pegylated asparaginase (PEG-ASP) in combination with ifosfamide, methotrexate, etoposide, and prednisolone (IMEP) in natural killer (NK)/T-cell lymphoma (NTCL).
Materials and Methods
A total of 41 NTCL patients who received IMEP plus native E. coli L-ASP or PEG-ASP at Seoul National University Hospital were included in this study between January 2013 and March 2016. IMEP/ASP treatment consisted of ifosfamide, methotrexate, etoposide, plus native E. coli L-ASP (6,000 IU/m2 on days 1, 3, 5, 7, 9, and 11) or PEG-ASP (2,500 IU/m2 on day 1) every 3 weeks. ASP-related toxicities, toxicity patterns, length of hospital stay, and clinical outcomes were compared between the different treatment groups.
Results
The frequency of ASP-related toxicities was similar between the IMEP plus native E. coli L-ASP group and the PEG-ASP group apart from hypofibrinogenemia (native E. coli L-ASP vs. PEG-ASP group, 86.4% vs. 36.8%; p=0.001). Although post-treatment transaminase and albumin levels were significantly high and low, respectively, hepatotoxicity gradients before and after treatment did not differ significantly between the groups. Since PEG-ASP was given at an outpatient clinic in some patients, length of hospital stay was significantly shorter in the IMEP plus PEG-ASP group (median, 4.0 vs. 6.0 days; p=0.002). A favorable tendency of clinical outcomes was observed in NTCL patients treated with IMEP plus PEG-ASP (complete remission rate, 73.7% vs. 45.5%; p=0.067).
Conclusion
IMEP plus PEG-ASP showed similar ASP-related toxicities, shorter length of hospital stay, and a trend towards improved clinical outcomes compared with IMEP plus native E. coli L-ASP in NTCL.

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  • PEG-L-CHOP treatment is safe and effective in adult extranodal NK/T-cell lymphoma with a low rate of clinical hypersensitivity
    Wen Zheng, Yuhuan Gao, Xiaoyan Ke, Weijing Zhang, Liping Su, Hanyun Ren, Ningjing Lin, Yan Xie, Meifeng Tu, Weiping Liu, Lingyan Ping, Zhitao Ying, Chen Zhang, Lijuan Deng, Xiaopei Wang, Yuqin Song, Jun Zhu
    BMC Cancer.2018;[Epub]     CrossRef
  • 11,758 View
  • 389 Download
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Patient’s Cognitive Function and Attitudes towards Family Involvement in Cancer Treatment Decision Making: A Patient-Family Caregiver Dyadic Analysis
Dong Wook Shin, Juhee Cho, Debra L. Roter, So Young Kim, Jong Hyock Park, Hyung Kook Yang, Hyun Woo Lee, Sun-Seog Kweon, Yune Sik Kang, Keeho Park
Cancer Res Treat. 2018;50(3):681-690.   Published online July 4, 2017
DOI: https://doi.org/10.4143/crt.2017.201
AbstractAbstract PDFPubReaderePub
Purpose
Older patient populations commonly have cognitive impairment, which might impact decisional capacity. We examined patients and family caregivers preferences for family involvement in treatment decision making assuming different level of cognitive impairment, and sought to explore the factors associated with the preferences and the degree to which patients and family members agree on preferences.
Materials and Methods
A total of 358 elderly cancer patient and caregiver dyads were recruited from the 11 cancer centers in Korea andwere asked to express their preferences forfamily involvement in treatment decision making using hypothetical scenarios with three different levels of cognitive status (intact, mild impairment, and severe impairment).
Results
Both patients and family caregivers preferred greater family dominance in treatment decision makingwith the increasing the level of cognitive impairment (39.7%, 60.9%, and 86.6% for patients and 45.0%, 66.2%, and 89.7% for caregivers in each scenarios). Patient and family caregiver concordance in decisional control preference was small for all three scenarios (weighted κ=0.32, κ=0.26, and κ=0.36, respectively). Higher patient education was associated with preference for patient dominance in treatment decision in conditions of both mild and severe cognitive impairment. The association of higher patient education and patient-caregiver preference concordance was positive with intact cognition, while it was negative with severe cognitive impairment.
Conclusion
Decision control preferences were affected by hypothesized cognitive status of the patients. Findings from our study would be helpful to develop effective strategy for optimizing family involvement in cancer treatment decision in the context of deteriorating cognitive function of the patients.

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    Supportive Care in Cancer.2024;[Epub]     CrossRef
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    Hiroko Komatsu, Yasuhiro Komatsu
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    Semra Ozdemir, Sean Ng, Isha Chaudhry, Chetna Malhotra, Eric Andrew Finkelstein
    Cancer.2023; 129(9): 1443.     CrossRef
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    Journal of Geriatric Oncology.2023; 14(6): 101525.     CrossRef
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    Chia Jie Tan, Melinda Si Yun Tan, Chandramouli Nagarajan, Wee Joo Chng, Yen-Lin Chee, Melissa Ooi, Lawrence Cheng Kiat Ng, Yunxin Chen, Joanne Su Yin Yoong, Xin Yi Wong, Wei-Ying Jen
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Crizotinib versus Chemotherapy in Asian Patients with ALK-Positive Advanced Non-small Cell Lung Cancer
Makoto Nishio, Dong-Wan Kim, Yi-Long Wu, Kazuhiko Nakagawa, Benjamin J. Solomon, Alice T. Shaw, Satoshi Hashigaki, Emiko Ohki, Tiziana Usari, Jolanda Paolini, Anna Polli, Keith D. Wilner, Tony Mok
Cancer Res Treat. 2018;50(3):691-700.   Published online July 6, 2017
DOI: https://doi.org/10.4143/crt.2017.280
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Crizotinib has demonstrated superior progression-free survival (PFS) and objective response rates (ORRs) versus chemotherapy in previously treated and untreated patients with anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer (NSCLC). We report the safety and efficacy of crizotinib in Asian subpopulations of two global phase III trials.
Materials and Methods
This analysis evaluated previously treated and untreated patients in two randomized, openlabel phase III trials of crizotinib versus chemotherapy in ALK-positive advanced NSCLC in second-line (PROFILE 1007) and first-line settings (PROFILE 1014). Efficacy and safety were analyzed by race in the intention-to-treat and “as-treated” populations for efficacy and safety endpoints, respectively.
Results
In previously treated (n=157) and untreated (n=157) Asian patients, PFS was statistically significantly longer with crizotinib versus chemotherapy (hazard ratio for PFS, 0.526; 95% confidence interval, 0.363 to 0.762; p < 0.001 and hazard ratio, 0.442; 95% confidence interval, 0.302 to 0.648; p < 0.001, respectively). Similar antitumor activity was seen in the non-Asian and overall populations. ORRs were statistically significantly higher with crizotinib versus chemotherapy in both Asian and non-Asian previously treated and untreated patients (p < 0.05). The most common treatment-emergent adverse events (any grade)with crizotinib were vision disorder, diarrhea, and nausea, which were observed at a comparable incidence across Asian and non-Asian populations, irrespective of previous treatment status. Most adverse events were mild to moderate in severity.
Conclusion
These data, currently the only analysis showing Asian and non-Asian populations in the same study, support the efficacy and safety of crizotinib in Asian patients with previously treated or untreated ALK-positive advanced NSCLC.

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Pretreatment Serum Amyloid A and C-reactive Protein Comparing with Epstein-Barr Virus DNA as Prognostic Indicators in Patients with Nasopharyngeal Carcinoma: A Prospective Study
Qiu-Yan Chen, Qing-Nan Tang, Lin-Quan Tang, Wen-Hui Chen, Shan-Shan Guo, Li-Ting Liu, Chao-Feng Li, Yang Li, Yu-Jing Liang, Xue-Song Sun, Ling Guo, Hao-Yuan Mo, Rui Sun, Dong-Hua Luo, Yu-Ying Fan, Yan He, Ming-Yuan Chen, Ka-Jia Cao, Chao-Nan Qian, Xiang Guo, Hai-Qiang Mai
Cancer Res Treat. 2018;50(3):701-711.   Published online July 14, 2017
DOI: https://doi.org/10.4143/crt.2017.180
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The measuring Epstein-Barr virus (EBV) DNA is an important predictor of nasopharyngeal carcinoma (NPC). This study evaluated the predictive value of pretreatment serum amyloid A (SAA) and C-reactive protein (CRP) comparing with EBV DNA in patients with NPC.
Materials and Methods
In an observational study of 419 non-metastatic NPC patients, we prospectively evaluated the prognostic effects of pretreatment SAA, CRP, and EBV DNA on survival. The primary endpoint was progress-free survival (PFS).
Results
The median level of SAA and CRP was 4.28 mg/L and 1.88 mg/L, respectively. For the highSAA group (> 4.28 mg/L) versus the low-SAA (≤ 4.28 mg/L) group and the high-CRP group (> 1.88 mg/L) versus the low-CRP (≤ 1.88 mg/L) group, the 5-year PFS was 64.5% versus 73.1% (p=0.013) and 65.2% versus 73.3% (p=0.064), respectively. EBV DNA detection showed a superior predictive result, the 5-year PFS in the EBV DNA ≥ 1,500 copies/mL group was obviously different than the EBV DNA < 1,500 copies/mL group (62.2% versus 77.8%, p < 0.001). Multifactorial Cox regression analysis confirmed that in the PFS, the independent prognostic factors were including EBV DNA (hazard ratio [HR], 1.788; p=0.009), tumour stage (HR, 1.903; p=0.021), and node stage (HR, 1.498; p=0.049), but the SAA and CRP were not included in the independent prognostic factors.
Conclusion
The results of SAA and CRP had a certain relationship with the prognosis of NPC, and the prognosis of patients with high level of SAA and CRP were poor. However, the predictive ability of SAA and CRP was lower than that of EBV DNA.

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Which Patients with Isolated Para-aortic Lymph Node Metastasis Will Truly Benefit from Extended Lymph Node Dissection for Colon Cancer?
Sung Uk Bae, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Kang Young Lee, Nam Kyu Kim
Cancer Res Treat. 2018;50(3):712-719.   Published online July 14, 2017
DOI: https://doi.org/10.4143/crt.2017.100
AbstractAbstract PDFPubReaderePub
Purpose
The prognosis of patientswith colon cancer and para-aortic lymph node metastasis (PALNM) is poor. We analyzed the prognostic factors of extramesenteric lymphadenectomy for colon cancer patients with isolated PALNM.
Materials and Methods
We retrospectively reviewed 49 patients with PALNM who underwent curative resection between October 1988 and December 2009.
Results
In univariate analyses, the 5-year overall survival (OS) and disease-free survival (DFS) rates were higher in patients with ≤ 7 positive para-aortic lymph node (PALN) (36.5% and 27.5%) than in those with > 7 PALN (14.3% and 14.3%; p=0.010 and p=0.027, respectively), and preoperative carcinoembryonic antigen (CEA) level > 5 was also correlated with a lower 5-year OS and DFS rate of 21.5% and 11.7% compared with those with CEA ≤ 5 (46.3% and 41.4%; p=0.122 and 0.039, respectively). Multivariate analysis found that the number of positive PALN (hazard ratio [HR], 3.291; 95% confidence interval [CI], 1.309 to 8.275; p=0.011) was an independent prognostic factor for OS and the number of positive PALN (HR, 2.484; 95% CI, 0.993 to 6.211; p=0.052) and preoperative CEA level (HR, 1.953; 95% CI, 0.940 to 4.057; p=0.073) were marginally independent prognostic factors for DFS. According to our prognostic model, the 5-year OS and DFS rate increased to 59.3% and 53.3%, respectively, in patients with ≤ 7 positive PALN and CEA level ≤ 5.
Conclusion
PALN dissection might be beneficial in carefully selected patients with a low CEA level and less extensive PALNM.

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The Effect of Hospice Consultation on Aggressive Treatment of Lung Cancer
Shin Hye Yoo, Bhumsuk Keam, Miso Kim, Tae Min Kim, Dong-Wan Kim, Dae Seog Heo
Cancer Res Treat. 2018;50(3):720-728.   Published online July 14, 2017
DOI: https://doi.org/10.4143/crt.2017.169
AbstractAbstract PDFPubReaderePub
Purpose
The aims of this study were to investigate trends of aggressive treatment of non-small cell lung cancer (NSCLC) patients at the end-of-life (EOL) during the recent 5 years and examine the relationship between hospice consultation (HC) and aggressive care.
Materials and Methods
The medical records of 789 patients with stage IIIB-IV NSCLC at Seoul National University Hospital (SNUH) who received palliative chemotherapy and died from 2010 to 2014 were retrospectively reviewed. Indicators of aggressive treatment were evaluated, and the association of HC with these indicators was analyzed.
Results
During the last 5 years, the frequency of HC increased from 26.7% to 43.6%. The time interval from last chemotherapy to death increased, and the proportion of patients who received palliative chemotherapy, visited an emergency room, were admitted to intensive care unit, during the last month of life, and died in SNUH significantly decreased over time. Referral to HC was significantly associated with lower intensive care unit admission rates, lower out-of-hospital death rates, and less use of the chemotherapy within 1 month prior to death. Overall survival did not differ by HC.
Conclusion
The pattern of cancer care nearthe EOL has become less aggressivewhen HCwas provided. The positive association of HCwith better EOL care suggests that providing HC at the optimal time might help to avoid futile aggressive treatment.

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Nationwide Trends in the Incidence of Melanoma and Non-melanoma Skin Cancers from 1999 to 2014 in South Korea
Chang-Mo Oh, Hyunsoon Cho, Young-Joo Won, Hyun-Joo Kong, Yun Ho Roh, Ki-Heon Jeong, Kyu-Won Jung
Cancer Res Treat. 2018;50(3):729-737.   Published online July 14, 2017
DOI: https://doi.org/10.4143/crt.2017.166
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This descriptive study was aimed to examine trends in the incidence of melanoma and nonmelanoma in South Korea.
Materials and Methods
The nationwide incidence data for melanoma and non-melanoma skin cancer was obtained from the Korea Central Cancer Registry. Age-standardized rates were calculated and analyzed, using a Joinpoint regression model.
Results
The incidence of basal cell carcinoma has increased dramatically both in men (average annual percentage change [AAPC], 8.0 [95% confidence interval (CI), 6.0 to 10.1]) and women (AAPC, 9.0 [95% CI, 7.5 to 10.4]). Squamous cell carcinoma has also steadily increased both in men (AAPC, 3.3 [95% CI, 2.6 to 4.0]) and women (AAPC, 6.8 [95% CI, 5.3 to 8.4]). Cutaneous melanoma increased continuously from 1999 to 2014 inwomen (AAPC, 3.5 [95% CI, 2.4 to 4.6]), whilst rapidly increasing in men until 2005 (APC, 7.9 [95% CI, 2.4 to 13.7]) after which no increase has been observed (APC, ‒0.2 [95% CI, ‒2.3 to 2.0]).
Conclusion
The incidence rates of melanoma and non-melanoma skin cancer have increased over the past years, with the exception of melanoma in men. Further studies are required to investigate the reasons for the increased incidence of these skin cancers in South Korea.

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    Melanoma Research.2018; 28(6): 629.     CrossRef
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Risky Lifestyle Behaviors among Gastric Cancer Survivors Compared with Matched Non-cancer Controls: Results from Baseline Result of Community Based Cohort Study
Minkyung Kim, Kui Son Choi, Mina Suh, Jae Kwan Jun, Kumban Walter Chuck, Boyoung Park
Cancer Res Treat. 2018;50(3):738-747.   Published online July 24, 2017
DOI: https://doi.org/10.4143/crt.2017.129
AbstractAbstract PDFPubReaderePub
Purpose
This study investigated the prevalence of smoking, drinking, and physical inactivity and the associated factors of these behaviors in gastric cancer survivors.
Materials and Methods
The baseline data from the nationwide cohort study was used. Four hundred thirty-seven gastric cancer survivors who survived ≥ 2 years from diagnosis and reported completion of treatment were matched with 4,370 controls according to age, sex, education, and household income.
Results
The prevalence rates of current smoking and drinking among gastric cancer survivors were 8.7% and 38.3%, which were significantly lower than those among matched controls (p ≤ 0.001), but the prevalence rates of physical inactivity were not significantly different (55.8% vs. 59.9%, p=0.248). In gastric cancer survivors, ≥ 5 years since cancer diagnosis and current drinking contributed to more current smoking; otherwise, age increment and femalewere associatedwith lower current smoking. Thosewith household income ≥ $2,000 and current smokers were more likely to drink and female showed less drinking. Female, currently employed state, and self-rated health status were associated with more physical inactivity.
Conclusion
Although gastric cancer survivors showed better health behaviors than controls, suggesting that the diagnosis of cancer may motivate individuals towards healthy behaviors, their current prevalence rates of smoking and drinking were still high, and more than 50% of them were physically inactive. Tailored interventions to improve their health behaviors considering associated factors for the gastric cancer survivors are necessary.

Citations

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  • Gastric Cancer Survivorship: Multidisciplinary Management, Best Practices and Opportunities
    Era Cobani, Mohammed Najeeb Al Hallak, Anthony F. Shields, Jordan Maier, Thomas E. Kelly, Niren Naidoo, Miguel Tobon, Steve Kim, Eliza W. Beal
    Journal of Gastrointestinal Cancer.2024; 55(2): 519.     CrossRef
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    Jiyeong Kim, Theresa H. Keegan
    Journal of Cancer Survivorship.2023; 17(6): 1799.     CrossRef
  • Risk of Metabolic Syndrome and Fatty Liver Diseases in Gastric Cancer Survivors: A Propensity Score-Matched Analysis
    Sang Jo Han, Su Jung Baik, Young Hoon Yoon, Jie Hyun Kim, Hye Sun Lee, Soyoung Jeon, Hyojin Park
    The Korean Journal of Gastroenterology.2023; 81(4): 154.     CrossRef
  • Factors related to Cancer Preventive Behavior among Patients with Early Gastric Cancer who Underwent Endoscopic Submucosal Dissection
    Sunghye Choo, Sanghee Kim, Yong Chan Lee, Eunsung Kim
    Asian Oncology Nursing.2023; 23(2): 47.     CrossRef
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    Haithm Mousa, Menglang Yuan, Xinsheng Zhang, Xiaomeng Li, Abdullah Shopit, Marwan Almoiliqy, Mohammed Alshwmi, Aisha Al-Dherasi, Yue Xu, Yunfei Zuo
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  • Assessment of Diet Quality and Adherence to Dietary Guidelines in Gastrointestinal Cancer Survivors: A Cross-Sectional Study
    Sara Moazzen, Francisco O. Cortés-Ibañez, Barbara L. van Leeuwen, Behrooz Z. Alizadeh, Geertruida H. de Bock
    Nutrients.2020; 12(8): 2232.     CrossRef
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    Kyoungsik Jeong, Hoseok Kim, Siwoo Lee, Younghwa Baek
    Journal of Physiology & Pathology in Korean Medicine.2020; 34(1): 53.     CrossRef
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    Junghyun Yoon, Boyoung Park
    Journal of Cancer Prevention.2020; 25(3): 173.     CrossRef
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    Hong-dan Xu, Wen Luo, Yuanlong Lin, Jiawen Zhang, Lijuan Zhang, Wei Zhang, Shu-ming Huang
    RSC Advances.2019; 9(19): 10905.     CrossRef
  • Compliance with Multiple Health Behaviour Recommendations: A Cross-Sectional Comparison between Female Cancer Survivors and Those with no Cancer History
    Daniel N Tollosa, Meredith Tavener, Alexis Hure, Erica L James
    International Journal of Environmental Research and Public Health.2019; 16(8): 1345.     CrossRef
  • El consumo de alcohol en los supervivientes al cáncer: estado de la cuestión y propuestas para el desarrollo de intervenciones psicológicas
    Francisco García-Torres, Francisco J. Alós, Rosario Castillo-Mayén
    Psicooncología.1970; 15(1): 65.     CrossRef
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Lung Cancer Screening with Low-Dose CT in Female Never Smokers: Retrospective Cohort Study with Long-term National Data Follow-up
Hyae Young Kim, Kyu-Won Jung, Kun Young Lim, Soo-Hyun Lee, Jae Kwan Jun, Jeongseon Kim, Bin Hwangbo, Jin Soo Lee
Cancer Res Treat. 2018;50(3):748-756.   Published online July 17, 2017
DOI: https://doi.org/10.4143/crt.2017.312
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Because of growing concerns about lung cancer in female never smokers, chest low-dose computed tomography (LDCT) screening is often performed although it has never shown clinical benefits. We examinewhether or not female never smokers really need annual LDCT screening when the initial LDCT showed negative findings.
Materials and Methods
This retrospective cohort study included 4,365 female never smokers aged 40 to 79 years who performed initial LDCT from Aug 2002 to Dec 2007. Lung cancer diagnosis was identified from the Korea Central Cancer Registry Database registered until December 31, 2013. We calculated the incidence, cumulative probability, and standardized incidence ratio (SIR) of lung cancer by Lung Imaging Reporting and Data System (Lung-RADS) categories showed on initial LDCT.
Results
After median follow-up of 9.69 years, 22 (0.5%) had lung cancer. Lung cancer incidence for Lung-RADS category 4 was 1,848.4 (95% confidence interval [CI], 1,132.4 to 3,017.2) per 100,000 person-years and 16.4 (95% CI, 7.4 to 36.4) for categories 1, 2, and 3 combined. The cumulative probability of lung cancer for category 4 was 10.6% at 5 years and 14.8% at 10 years while they were 0.07% and 0.17% when categories 1, 2, and 3 were combined. The SIR for subjects with category 4 was 43.80 (95% CI, 25.03 to 71.14), which was much higher than 0.47 (95% CI, 0.17 to 1.02) for categories 1, 2, and 3 combined.
Conclusion
Considering the low risk of lung cancer development in female never smokers, it seems unnecessary to repeat annual LDCT screening for at least 5 years or even longer unless the initial LDCT showed Lung-RADS category 4 findings.

Citations

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  • Lung cancer screening for never smokers: current evidence and future directions
    Kay Choong See
    Singapore Medical Journal.2024;[Epub]     CrossRef
  • Cooking oil fume exposure and Lung-RADS distribution among school cafeteria workers of South Korea
    Minjun Kim, Yangho Kim, A Ram Kim, Woon Jung Kwon, Soyeoun Lim, Woojin Kim, Cheolin Yoo
    Annals of Occupational and Environmental Medicine.2024;[Epub]     CrossRef
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    Jiali Cai, Marleen Vonder, Gert Jan Pelgrim, Mieneke Rook, Gerdien Kramer, Harry J.M. Groen, Geertruida H. de Bock, Rozemarijn Vliegenthart, Albert de Roos
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    Fu-Zong Wu, Yeun-Chung Chang
    Journal of the American College of Radiology.2023; 20(2): 156.     CrossRef
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    Kim L. Sandler, Travis S. Henry, Arya Amini, Saeed Elojeimy, Aine Marie Kelly, Christopher T. Kuzniewski, Elizabeth Lee, Maria D. Martin, Michael F. Morris, Neeraja B. Peterson, Constantine A. Raptis, Gerard A. Silvestri, Arlene Sirajuddin, Betty C. Tong,
    Journal of the American College of Radiology.2023; 20(5): S94.     CrossRef
  • Performance of Lung-RADS in different target populations: a systematic review and meta-analysis
    Yifei Mao, Jiali Cai, Marjolein A. Heuvelmans, Rozemarijn Vliegenthart, Harry J. M. Groen, Matthijs Oudkerk, Marleen Vonder, Monique D. Dorrius, Geertruida H. de Bock
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    Yeon Wook Kim, Hye-Rin Kang, Byoung Soo Kwon, Sung Yoon Lim, Yeon Joo Lee, Jong Sun Park, Young-Jae Cho, Ho Il Yoon, Kyung Won Lee, Jae Ho Lee, Choon-Taek Lee
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    Li-Hsin Chien, Chung-Hsing Chen, Tzu-Yu Chen, Gee-Chen Chang, Ying-Huang Tsai, Chin-Fu Hsiao, Kuan-Yu Chen, Wu-Chou Su, Wen-Chang Wang, Ming-Shyan Huang, Yuh-Min Chen, Chih-Yi Chen, Sheng-Kai Liang, Chung-Yu Chen, Chih-Liang Wang, Mei-Hsuan Lee, Ren-Hua C
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    Hye-Rin Kang, Jun Yeun Cho, Sang Hoon Lee, Yeon Joo Lee, Jong Sun Park, Young-Jae Cho, Ho Il Yoon, Kyung Won Lee, Jae Ho Lee, Choon-Taek Lee
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Trend Analysis for the Choice and Cost of Lung Cancer Treatment in South Korea, 2003-2013
Dohun Kim, So Young Kim, Beomseok Suh, Jong Hyock Park
Cancer Res Treat. 2018;50(3):757-767.   Published online September 4, 2017
DOI: https://doi.org/10.4143/crt.2017.050
AbstractAbstract PDFPubReaderePub
Purpose
Our study aimed to report the annual changes in lung cancer statistics and analyze trends in sociodemographic, medical, and financial factors from 2003 to 2013 in the national database from the Korean National Health Insurance (KNHI).
Materials and Methods
Among 7,489 patients with code C34 in KNHI database, only lung cancer patients newly diagnosed after 2003 were included in the study population, for a total of 4,582 patients. Descriptive statistics were used to characterize treatment patterns and medical costs according to sociodemographic factors.
Results
Approximately 70% of subjects were male, and the mean age was 67 years. Around 46% of patients were over 70 years old, and 12% were over 80 years old. The medical costs were highest for patients younger than 60 and lowest for those over 80 years old. Surgery was more common in younger patients, while “no treatment” increased greatly with age. In trend analysis, the proportions of aging (p for trend < 0.001), female (p for trend=0.003), metropolitan/urban (p for trend=0.041), and lowest or highest-income patients (p for trend=0.004) increased over time, along with the prevalence of surgery as the primary treatment (p for trend < 0.001). There was also a trend with regard to change in medical costs (p for trend < 0.001), in that those of surgery and radiotherapy increased.
Conclusion
Surgery as a curative treatment has increased over the past decade. However, the elderly, suburban/rural residents, and low-income patients were more likely to be untreated. Therefore, active measures are required for these increasingly vulnerable groups.

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    Wenzhi Zhu, Jiaonan Yang, Xiaoyi Wang, Xinqiang Ji, Hongyu Tan
    International Journal of General Medicine.2024; Volume 17: 5453.     CrossRef
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    Dohun Kim, Jung-Won Lee
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    Kyu-Tae Han, Woorim Kim, Areum Song, Yeong Jun Ju, Dong-Woo Choi, Seungju Kim
    Health Policy.2021; 125(8): 1047.     CrossRef
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    Juhwan Noh, Heeseon Jang, Jaelim Cho, Dae Ryong Kang, Tae Hyun Kim, Dong Chun Shin, Changsoo Kim
    Science of The Total Environment.2020; 749: 141573.     CrossRef
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  • 209 Download
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Survival Nomograms after Curative Neoadjuvant Chemotherapy and Radical Surgery for Stage IB2-IIIB Cervical Cancer
Claudia Marchetti, Francesca De Felice, Anna Di Pinto, Alessia Romito, Angela Musella, Innocenza Palaia, Marco Monti, Vincenzo Tombolin, Ludovico Muzii, PierLuigi Benedetti Panici
Cancer Res Treat. 2018;50(3):768-776.   Published online July 19, 2017
DOI: https://doi.org/10.4143/crt.2017.141
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to develop nomograms for predicting the probability of overall survival (OS) and progression-free survival (PFS) in locally advanced cervical cancer treated with neoadjuvant chemotherapy and radical surgery.
Materials and Methods
Nomograms to predict the 5-year OS rates and the 2-year PFS rates were constructed. Calibration plots were constructed, and concordance indices were calculated. Evaluated variableswere body mass index, age, tumor size, tumor histology, grading, lymphovascular space invasion, positive parametria, and positive lymph nodes.
Results
In total 245 patients with locally advanced cervical cancer who underwent neoadjuvant chemotherapy and radical surgery were included for the construction of the nomogram. The 5-year OS and PFS were 72.6% and 66%, respectively. Tumor size, grading, and parametria status affected the rate of OS, whereas tumor size and positive parametria were the main independent PFS prognostic factors.
Conclusion
We constructed a nomogram based on clinicopathological features in order to predict 2-year PFS and 5-year OS in locally advanced cervical cancer primarily treated with neoadjuvant chemotherapy followed by radical surgery. This tool might be particularly helpful for assisting in the follow-up of cervical cancer patients who have not undergone concurrent chemoradiotherapy.

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    Yue Feng, Zijian Sun, Huan Zhang, Zhao Wang, Lichao Wang, Hui Ye, Xiaojing Zhang, Zhuomin Yin, Juan Ni, Jingkui Tian, Hanmei Lou, Xiaojuan Lv, Wei Zhu
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Neutropenia during the First Cycle of Induction Chemotherapy Is Prognostic for Poor Survival in Locoregionally Advanced Nasopharyngeal Carcinoma: A Real-World Study in an Endemic Area
Cheng Xu, Shi-Ping Yang, Yuan Zhang, Ling-Long Tang, Guan-Qun Zhou, Xu Liu, Yan-Ping Mao, Rui Guo, Wen-Fei Li, Lei Chen, Ai-Hua Lin, Ying Sun, Jun Ma
Cancer Res Treat. 2018;50(3):777-790.   Published online July 24, 2017
DOI: https://doi.org/10.4143/crt.2017.255
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study was to investigate the effect of neutropenia during the first cycle of induction chemotherapy (IC-1) on survival in locoregionally advanced nasopharyngeal carcinoma (LANPC).
Materials and Methods
Eligible patients (n=545) with LANPC receiving IC+concurrent chemoradiotherapy were included. Based on nadir neutrophil afterIC-1, all patientswere categorized into three groups: no/grade 1-2/grade 3-4 neutropenia. Five-year overall survival (OS) and disease-free survival (DFS) were compared between groups and subgroups stratified by IC regimen. We also explored the occurrence of IC-1–induced myelosuppression events and the minimal value of post-treatment neutrophil-to-lymphocyte ratio (post-NLRmin). Univariate/multivariate analyses were performed to investigate the effect of IC-1–induced neutropenia, timing of neutropenia, number of myelosuppression events, and high post-NLRmin on OS/DFS.
Results
Grade 1-2/grade 3-4 neutropeniawere associatedwith poorer OS/DFS than no neutropenia (all p < 0.05); OS/DFS were not significantly different between patients experiencing grade 1-2 vs. 3-4 neutropenia. Neutropenia had no significant effect on OS/DFS in patients receiving docetaxel–cisplatin–5-fluorouracil (TPF). Grade 1-2 (grade 3-4) neutropenia negatively influenced OS/DFS in patients receiving cisplatin–5-fluorouracil (PF) (PF and docetaxel–cisplatin [TP]; all p < 0.05). Neutropenia, two/three myelosuppression events, and high post-NLRmin (≥ 1.33) was most frequent on days 5-10, second and third week of IC-1, respectively. After adjustment for covariates, IC-1–induced neutropenia, two/three myelosuppression events, and post-NLRmin ≥ 1.33were validated as negative predictors of OS/DFS (all p < 0.05); timing of neutropenia had no significant effect.
Conclusion
Occurrence of neutropenia, number of myelosuppression events, and high post-NLRmin during PF/TP IC-1 have prognostic value for poor survival in LANPC.

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    Tingting Yu, Yiwei Zhang, Jiawen Li, Zhuo Li, Rui Tong
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    Jun Wang, Baosheng Li
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    Jun Wang, Baosheng Li
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Chemotherapy versus Best Supportive Care in Advanced Biliary Tract Carcinoma: A Multi-institutional Propensity Score Matching Analysis
Jun Ho Ji, Young Saing Kim, Inkeun Park, Soon Il Lee, Rock Bum Kim, Joon Oh Park, Sung Yong Oh, In Gyu Hwang, Joung-Soon Jang, Haa-Na Song, Jung-Hun Kang
Cancer Res Treat. 2018;50(3):791-800.   Published online August 23, 2017
DOI: https://doi.org/10.4143/crt.2017.044
AbstractAbstract PDFPubReaderePub
Purpose
Although chemotherapy is recommended by various guidelines for advanced biliary tract cancer (BTC), the evidence supporting its use over best supportive care (BSC) is limited. The aim of this study was to investigate the survival benefit of chemotherapy over that of BSC in advanced BTC patients.
Materials and Methods
Advanced BTC patientswith a good performance status (Eastern CooperativeOncologyGroup [ECOG] 0-2) were eligible for the study. Data were retrospectively collected from four tertiary cancer centers and analyzed using propensity score matching (PSM). Of the 604 patients enrolled, 206 received BSC and 398 received chemotherapy. PSM analysis was performed using the following variables: age, ECOG status, carcinoembryonic antigen (CEA) level, white blood cell level, albumin level, total bilirubin level, and aspartate aminotransferase level. The sample size of each group was 164 patients after PSM. Median survival was compared between the two groups by using the Kaplan-Meier method, and prognostic factors were investigated using Cox proportional regression analysis.
Results
In post-PSM analysis, the respective median survival for the chemotherapy and BSC groups was dependent on the following prognostic factors: total population, 12.0 months vs. 7.5 months (p=0.001); locally advanced disease, 16.7 months vs. 13.4 months (p=0.490); cancer antigen 19-9 ≤ 100 IU/mL, 12.7 months vs. 10.6 months (p=0.330); and CEA ≤ 3.4 ng/mL, 17.1 months vs. 10.6 months (p=0.052).
Conclusion
Chemotherapy improved overall survival of patients with advanced BTC who had a good performance status. However, this survival benefit was not observed in BTC patients with locally advanced disease or with lower tumor marker. Individualized approach is needed for initiation of palliative chemotherapy in advanced BTC.

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Feasibility of Charcoal Tattooing of Cytology-Proven Metastatic Axillary Lymph Node at Diagnosis and Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy in Breast Cancer Patients
Seho Park, Ja Seung Koo, Gun Min Kim, Joohyuk Sohn, Seung Il Kim, Young Up Cho, Byeong-Woo Park, Vivian Youngjean Park, Jung Hyun Yoon, Hee Jung Moon, Min Jung Kim, Eun-Kyung Kim
Cancer Res Treat. 2018;50(3):801-812.   Published online August 17, 2017
DOI: https://doi.org/10.4143/crt.2017.210
AbstractAbstract PDFPubReaderePub
Purpose
Sentinel lymph node biopsy (SLNB) can be performed when node-positive disease is converted to node-negative status after neoadjuvant chemotherapy (NCT). Tattooing nodes might improve accuracy but supportive data are limited. This study aimed to investigate the feasibility of charcoal tattooing metastatic axillary lymph node (ALN) at presentation followed by SLNB after NCT in breast cancers.
Materials and Methods
Twenty patientswith cytology-proven node metastases prospectively underwent charcoal tattooing at diagnosis. SLNB using dual tracers and axillary surgery after NCT were then performed. The detection rate of tattooed node and diagnostic performance of SLNB were analyzed.
Results
All patients underwent charcoal tattooingwithout significant morbidity. Sentinel and tattooed nodes could be detected during surgery after NCT. Nodal pathologic complete response was achieved in 10 patients. Overall sensitivity, false-negative rate (FNR), negative predictive value, and accuracy of hot/blue SLNB were 80.0%, 20.0%, 83.3%, and 90.0%, respectively. Retrieving more nodes and favorable nodal response were associated with improved performance. The best accuracy was observed when excised tattooed node was calculated together (FNR, 0.0%). Cold/non-blue tattooed nodes of five patients were removed during non-sentinel axillary surgery but clinicopathological parameters did not differ compared to patients with hot/blue tattooed node detected during SLNB, suggesting the importance of the tattooing procedure itself to improve performance.
Conclusion
Charcoal tattooing of cytology-confirmed metastatic ALN at presentation is technically feasible and does not limit SLNB after NCT. The tattooing procedure without additional preoperative localization is advantageous for improving the diagnostic performance of SLNB in this setting.

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Human Papillomavirus Genotype-Specific Persistence and Potential Risk Factors among Korean Women: Results from a 2-Year Follow-up Study
Cecile Ingabire, Min Kyung Lim, Young-Joo Won, Jin-Kyoung Oh
Cancer Res Treat. 2018;50(3):813-822.   Published online August 17, 2017
DOI: https://doi.org/10.4143/crt.2017.340
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
High-risk human papillomavirus (HPV) infection progression should be considered a critical factor for preventing cervical cancer, although most infections are transient and rarely persist. This study aimed to examine the specific types of HPV infections, their change patterns, and the potential risk factors among Korean women.
Materials and Methods
We included 4,588 women who visited hospitals in Busan and Suwon for cervical cancer screening, and 1,224 of thesewomen attended a 2-yearfollow-up. Infection statuswas evaluated using HPV DNA testing (Hybrid Capture 2) and genotyping testing (Linear Array). Data regarding the potential risk factors for HPV infection were collected by trained nurses using structured questionnaires.
Results
Among the 1,224 women (mean age, 47 years), 105 women (8.6%) were HPV-positive at baseline. HPV infections had been cleared among 92 women (87.6%) within 2 years. Only 13 infections (12.4%) were remained, and the 10 cases of them are high-risk HPV types including genotype 33, 45, 16, 35, and 52. Among women who were negative at baseline, the HPV incidence was 4.8%. The HPV incidence was marginally associated with having multiple sexual partners (odds ratio, 2.0; 95% confidence interval, 1.0 to 3.9), although it was not significantly associated with HPV persistence.
Conclusion
Most HPV infections (88%) among Korean women were cleared within 2 years, with only a small number of persistent infections. The persistent HPV genotypes were different in our study, compared to those from previous studies. Having multiple sexual partners was associated with acquiring a HPV infection, but not with persistence.

Citations

Citations to this article as recorded by  
  • Investigation of Human Papillomavirus (HPV) Frequency and Genotype Analysis in Cervical Samples
    Yeliz Çetinkol, Selahattin Ünlü, Melahat Gürbüz, Cengiz Demir
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    秋培 谭
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    Miriam Dellino, Eliano Cascardi, Antonio Simone Laganà, Giovanni Di Vagno, Antonio Malvasi, Rosanna Zaccaro, Katia Maggipinto, Gerardo Cazzato, Salvatore Scacco, Raffaele Tinelli, Alessandro De Luca, Marina Vinciguerra, Vera Loizzi, Antonella Daniele, Ett
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    Yawo Tufa Nyasenu, Fifonsi A Gbeasor-Komlanvi, Sabi Abdul-Raouf Issa, Amivi Ehlan, Martin Kouame Tchankoni, Brice M Yambiyo, Mireille Prince-David, Mounerou Salou, Didier K Ekouevi, Anoumou Dagnra
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APEX1 Polymorphism and Mercaptopurine-Related Early Onset Neutropenia in Pediatric Acute Lymphoblastic Leukemia
Hyery Kim, Heewon Seo, Yoomi Park, Byung-Joo Min, Myung-Eui Seo, Kyung Duk Park, Hee Young Shin, Ju Han Kim, Hyoung Jin Kang
Cancer Res Treat. 2018;50(3):823-834.   Published online September 4, 2017
DOI: https://doi.org/10.4143/crt.2017.351
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Mercaptopurine (MP) is one of the main chemotherapeutics for acute lymphoblastic leukemia (ALL). To improve treatment outcomes, constant MP dose titration is essential to maintain steady drug exposure, while minimizing myelosuppression. We performed two-stage analyses to identify genetic determinants of MP-related neutropenia in Korean pediatric ALL patients.
Materials and Methods
Targeted sequencing of 40 patients who exhibited definite MP intolerance was conducted using a novel panel of 211 pharmacogenetic-related genes, and subsequent analysis was performed with 185 patients.
Results
Using bioinformatics tools and genetic data, four functionally interesting variants were selected (ABCC4, APEX1, CYP1A1, and CYP4F2). Including four variants, 23 variants in 12 genes potentially linked to MP adverse reactions were selected as final candidates for subsequent analysis in 185 patients. Ultimately, a variant allele in APEX1 rs2307486was found to be strongly associated with MP-induced neutropenia that occurred within 28 days of initiating MP (odds ratio, 3.44; p=0.02). Moreover, the cumulative incidence of MP-related neutropenia was significantly higher in patients with APEX1 rs2307486 variants, as GG genotypes were associated with the highest cumulative incidence (p < 0.01). NUDT15 rs116855232 variants were strongly associated with a higher cumulative incidence of neutropenia (p < 0.01), and a lower median dose of tolerated MP throughout maintenance treatment (p < 0.01).
Conclusion
We have identified that APEX1 rs2307486 variants conferred an increased risk of MP-related early onset neutropenia. APEX1 and NUDT15 both contribute to cell protection from DNA damage or misincorporation, so alleles that impair the function of either gene may affect MP sensitivities, thereby inducing MP-related neutropenia.

Citations

Citations to this article as recorded by  
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Phase 1 Studies of Poziotinib, an Irreversible Pan-HER Tyrosine Kinase Inhibitor in Patients with Advanced Solid Tumors
Tae Min Kim, Keun-Wook Lee, Do-Youn Oh, Jong-Seok Lee, Seock-Ah Im, Dong-Wan Kim, Sae-Won Han, Yu Jung Kim, Tae-You Kim, Jee Hyun Kim, Hyesun Han, Woo Ho Kim, Yung-Jue Bang
Cancer Res Treat. 2018;50(3):835-842.   Published online August 29, 2017
DOI: https://doi.org/10.4143/crt.2017.303
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Poziotinib, a pan-human epidermal growth factor receptor 2 (HER) tyrosine kinase inhibitor, has shown potent activity againstwild type of epidermal growth factorreceptor(EGFR) family kinases including EGFR, HER2, and HER4 and EGFR-mutant cells in vitro. Two phase I studies were conducted to determine the maximum tolerated dose (MTD), pharmacokinetics, safety, and antitumor activity against advanced solid tumors.
Materials and Methods
Standard 3+3 dose escalation scheme using two different dosing schedules were studied: once daily, 14-day on, and 7-day off (intermittent schedule); and once daily continuous dosing with food effect. Additional patients were enrolled in an expansion cohort.
Results
A total of 75 patients were enrolled in the two studies. The most common drug-related treatment-emergent adverse eventswere diarrhea,rash, stomatitis, pruritus, and anorexia. Doselimiting toxicities were grade 3 diarrhea in the intermittent schedule and grade 3 anorexia and diarrhea in the continuous dosing schedule. The MTDs were determined as 24 mg/day in the intermittent dosing schedule and 18 mg/day in the continuous dosing schedule. Eight (16%) and 24 (47%) of 51 evaluable patients in the intermittent schedule achieved partial response (PR) and stable disease (SD), respectively. Four (21%) and six (32%) of 19 evaluable patients in continuous dosing schedule achieved PR and SD, respectively. Patients with PR (n=7) or SD ≥ 12 weeks (n=7) had HER2 amplification (n=7; breast cancer, 5; and stomach cancer, 2) and EGFR amplification (n=1, squamous cell lung cancer).
Conclusion
Poziotinib was safe and well tolerated in patients with advanced solid tumors. It showed an encouraging activity against EGFR-mutant and HER2-amplified cancers.

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Sarcopenia Predicts Prognosis in Patients with Newly Diagnosed Hepatocellular Carcinoma, Independent of Tumor Stage and Liver Function
Yeonjung Ha, Daejung Kim, Seungbong Han, Young Eun Chon, Yun Bin Lee, Mi Na Kim, Joo Ho Lee, Hana Park, Kyu Sung Rim, Seong Gyu Hwang
Cancer Res Treat. 2018;50(3):843-851.   Published online September 4, 2017
DOI: https://doi.org/10.4143/crt.2017.232
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study was to demonstrate the prognostic significance of changes in body composition in patients with newly diagnosed hepatocellular carcinoma (HCC).
Materials and Methods
Patients (n=178) newly diagnosed with HCC participated in the study between 2007 and 2012. Areas of skeletal muscle and abdominal fat were directly measured using a three-dimensional workstation. Cox proportional-hazards modes were used to estimate the effect of baseline variables on overall survival. The inverse probability of treatmentweighting (IPTW) method was used to minimize confounding bias.
Results
Cutoff values for sarcopenia, obtained from receiver-operating characteristic curves, were defined as skeletal muscle index at the third lumbar vertebra of ≤ 45.8 cm/m2 for males and ≤ 43.0 cm/m2 for females. Sarcopenia patients were older, more likely to be female, and had lower body mass index. Univariable analysis showed that the presence of sarcopenia and visceral to subcutaneous fat area ratio (VSR) were significantly associatedwith prognosis. The multivariable analyses revealed that VSR was predictive of overall survival. However, in the multivariable Cox model adjusted by IPTW, sarcopenia, not VSR, were associated with overall survival.
Conclusion
The presence of sarcopenia at HCC diagnosis is independently associated with survival.

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Impact of Body Mass Index on the Quality of Life after Total Gastrectomy for Gastric Cancer
Ki Bum Park, Ji Yeon Park, Seung Soo Lee, Oh Kyoung Kwon, Ho Young Chung, Wansik Yu
Cancer Res Treat. 2018;50(3):852-860.   Published online September 13, 2017
DOI: https://doi.org/10.4143/crt.2017.080
AbstractAbstract PDFPubReaderePub
Purpose
We evaluated the impact of postoperative body mass index (BMI) shifts on the quality of life (QoL) following total gastrectomy in patients with gastric cancer.
Materials and Methods
QoL data collected from the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 and QLQ-STO22 questionnaires were obtained from 417 patients preoperatively and 1 year after surgery. Patients were divided into two groups based on changes in BMI: group 1 comprised patientswhose BMIrange category dropped, and group 2 included patients who maintained or rose to a higher category compared to their preoperative BMI category.
Results
There were 276 patients in group 1 and 141 in group 2. QoLs with respect to the global health status and functional scales were not significantly different between the groups 1 year after surgery. However, there were significantly greater decreases in QoL in group 1 due to gastrointestinal symptoms, such as nausea and vomiting (p=0.008), appetite loss (p=0.001), and constipation (p=0.038). Of the QLQ-STO22 parameters, dysphagia (p=0.013), pain (p=0.012), reflux symptoms (p=0.017), eating restrictions (p=0.007), taste (p=0.009), and body image (p=0.009) were associated with significantly worse QoL in group 1 than in group 2 1 year after surgery.
Conclusion
Patients have significantly different QoLs depending on the BMI shift after total gastrectomy. Efforts to reduce the gap in QoL should include intensive nutritional support and restoration of dietary behaviors. Appropriate clinical and institutional approaches, plus active medical interventions, are required for maintaining patients’ BMIs after surgery.

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Combination of Tumor Volume and Epstein-Barr Virus DNA Improved Prognostic Stratification of Stage II Nasopharyngeal Carcinoma in the Intensity Modulated Radiotherapy Era: A Large-Scale Cohort Study
Qiu-Yan Chen, Shao-Yan Guo, Lin-Quan Tang, Tong-Yu Lu, Bo-Lin Chen, Qi-Yu Zhong, Meng-Sha Zou, Qing-Nan Tang, Wen-Hui Chen, Shan-Shan Guo, Li-Ting Liu, Yang Li, Ling Guo, Hao-Yuan Mo, Rui Sun, Dong-Hua Luo, Chong Zhao, Ka-Jia Cao, Chao-Nan Qian, Xiang Guo, Mu-Sheng Zeng, Hai-Qiang Mai
Cancer Res Treat. 2018;50(3):861-871.   Published online September 13, 2017
DOI: https://doi.org/10.4143/crt.2017.237
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Little is known about combination of the circulating Epstein-Barr viral (EBV) DNA and tumor volume in prognosis of stage II nasopharyngeal carcinoma (NPC) patients in the intensity modulated radiotherapy (IMRT) era. We conducted this cohort study to evaluate the prognostic values of combining these two factors.
Materials and Methods
By Kaplan-Meier, we compare the differences of survival curves between 385 patients with different EBV DNA or tumor volume levels, or with the combination of two biomarkers mentioned above.
Results
Gross tumor volume of cervical lymph nodes (GTVnd, p < 0.001) and total tumor volume (GTVtotal, p < 0.001) were both closely related to pretreatment EBV DNA, while gross tumor volume of nasopharynx (GTVnx, p=0.047) was weakly related to EBV DNA. EBV DNA was significantly correlated with progress-free survival (PFS, p=0.005), locoregional-free survival (LRFS, p=0.039), and distant metastasis-free survival (DMFS, p=0.017), while GTVtotal, regardless of GTVnx and GTVnd, had a significant correlation with PFS and LRFS. The p-values of GTVtotal for PFS and LRFS were 0.008 and 0.001, respectively. According to GTVtotal and pretreatment EBV DNA level, patients were divided into a low-risk group (EBV DNA 0 copy/mL, GTVtotal < 30 cm3; EBV DNA 0 copy/mL, GTVtotal ≥ 30 cm3; or EBV DNA > 0 copy/mL, GTVtotal < 30 cm3) and a high-risk group (EBV DNA > 0 copy/mL, GTVtotal ≥ 30 cm3). When patients in the low-risk group were compared with those in the high-risk group, 3-year PFS (p=0.003), LRFS (p=0.010), and DMFS (p=0.031) rates were statistically significant.
Conclusion
Pretreatment plasma EBV DNA and tumor volume were both closely correlated with prognosis of stage II NPC patients in the IMRT era. Combination of EBV DNA and tumor volume can refine prognosis and indicate for clinical therapy.

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NUDT15 Variants Cause Hematopoietic Toxicity with Low 6-TGN Levels in Children with Acute Lymphoblastic Leukemia
Eun Sang Yi, Young Bae Choi, Rihwa Choi, Na Hee Lee, Ji Won Lee, Keon Hee Yoo, Ki Woong Sung, Soo-Youn Lee, Hong Hoe Koo
Cancer Res Treat. 2018;50(3):872-882.   Published online September 13, 2017
DOI: https://doi.org/10.4143/crt.2017.283
AbstractAbstract PDFPubReaderePub
Purpose
We aimed to identify the impact of NUDT15 variants on thiopurine intolerance and 6-thioguanine nucleotide (6-TGN) levels in Korean children with acute lymphoblastic leukemia (ALL).
Materials and Methods
Genotyping of NUDT15 was tested in 258 patients with ALL registered at Samsung Medical Center. Patients were classified into normal-activity (wild-type), intermediate-activity (heterozygous variant), and low-activity groups (homozygous or compound heterozygous variant). Clinical and laboratory features during the first year of maintenance therapy were investigated.
Results
A total of 182 patients were included in the final analysis. There were five (2.7%), 46 (25.3%), and 131 (72.0%) patients in low-, intermediate-, and normal-activity groups, respectively. The lowest 6-mercaptopurine (6-MP) dose (mg/m2/day) was administered to the low-activity group (low-activity group 7.5 vs. intermediate-activity group 24.4 vs. normalactivity group 31.1, p < 0.01) from three months to a year after beginning maintenance therapy. The low-activity group experienced the longest duration of therapy interruption during the first year (low-activity group 169 days vs. intermediate-activity group 30 days vs. normal-activity group 16 days, p < 0.01). They also showed the lowest blood cell counts and had a longer duration of leukopenia (low-activity group 131 days vs. intermediate-activity group 92 days vs. normal-activity group 59 days, p < 0.01). 6-TGN level and its ratio to 6-MP dose were lowest in the low-activity group.
Conclusion
NUDT15 variants cause hematopoietic toxicity with low 6-TGN levels. NUDT15 genotyping should be conducted before administering thiopurine, and dose adjustments require caution regardless of 6-TGN levels.

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    Apichaya Puangpetch, Rawiporn Tiyasirichokchai, Samart Pakakasama, Supaporn Wiwattanakul, Usanarat Anurathapan, Suradej Hongeng, Chonlaphat Sukasem
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Profiling of Serum Metabolites Using MALDI-TOF and Triple-TOF Mass Spectrometry to Develop a Screen for Ovarian Cancer
Jun Hwa Lee, Yun Hwan Kim, Kyung-Hee Kim, Jae Youl Cho, Sang Myung Woo, Byong Chul Yoo, Seung Cheol Kim
Cancer Res Treat. 2018;50(3):883-893.   Published online September 18, 2017
DOI: https://doi.org/10.4143/crt.2017.275
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We sought to develop a matrix assisted laser desorption ionization-time of flight (MALDI-TOF)-based, ovarian cancer (OVC), low-mass-ion discriminant equation (LOME) and to evaluate a possible supportive role for triple-TOF mass analysis in identifying metabolic biomarkers.
Materials and Methods
A total of 114 serum samples from patients with OVC and benign ovarian tumors were subjected to MALDI-TOF analysis and a total of 137 serum samples from healthy female individuals and patients with OVC, colorectal cancer, hepatobiliary cancer, and pancreatic cancer were subjected to triple-TOF analysis. An OVC LOME was constructed by reference to the peak intensity ratios of discriminatory low-mass ion (LMI) pairs. Triple-TOF analysiswas used to select and identify metabolic biomarkers for OVC screening.
Results
Three OVC LOMEs were finally constructed using discriminatory LMI pairs (137.1690 and 84.4119 m/z; 496.5022 and 709.7642 m/z; and 524.5614 and 709.7642 m/z); all afforded accuracies of > 90%. The LMIs at 496.5022 m/z and 524.5614 m/z were those of lysophosphatidylcholine (LPC) 16:0 and LPC 18:0. Triple-TOF analysis selected seven discriminative LMIs; each LMI had a specificity > 90%. Of the seven LMIs, fourwith a 137.0455 m/z ion atretention times of 2.04-3.14 minuteswere upregulated in sera from OVC patients; the ion was identified as that derived from hypoxanthine.
Conclusion
MALDI-TOF–based OVC LOMEs combined with triple-TOF–based OVC metabolic biomarkers allow reliable OVC screening; the techniques are mutually complementary both quantitatively and qualitatively.

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Participation of CCL1 in Snail-Positive Fibroblasts in Colorectal Cancer Contribute to 5-Fluorouracil/Paclitaxel Chemoresistance
Ziqian Li, Kaying Chan, Yifei Qi, Linlin Lu, Fen Ning, Mengling Wu, Haifang Wang, Yuan Wang, Shaohui Cai, Jun Du
Cancer Res Treat. 2018;50(3):894-907.   Published online September 18, 2017
DOI: https://doi.org/10.4143/crt.2017.356
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Cancer-associated fibroblasts (CAFs) activated by cancer cells has a central role in development and malignant biological behavior in colorectal cancer (CRC). Adult fibroblasts do not express Snail, but Snail-positive fibroblasts are discovered in the stroma of malignant CRC and reported to be the key role to chemoresistance. However, the reciprocal effect of CAFs expressed Snail to chemoresistance on CRC cells and the underlying molecular mechanisms are not fully characterized.
Materials and Methods
Snail-overexpressed 3T3 stable cell lines were generated by lipidosome and CT26 mixed with 3T3-Snail subcutaneous transplanted CRC models were established by subcutaneous injection. Cell Counting Kit-8, flow cytometry and western blotting assays were performed, and immunohistochemistry staining was studied. The cytokines participated in chemoresistance was validated with reverse transcriptase-polymerase chain reaction and heatmap.
Results
Snail-expression fibroblasts are discovered in human and mouse spontaneous CRCs. Overexpression of Snail induces 3T3 fibroblasts transdifferentiation to CAFs. CT26 co-cultured with 3T3-Snail resisted the impairment from 5-fluorouracil and paclitaxel in vitro. The subcutaneous transplanted tumor models included 3T3-Snail cells develop without restrictions even after treating with 5-fluorouracil or paclitaxel. Moreover, these chemoresistant processes may be mediated by CCL1 secreted by Snail-expression fibroblasts via transforming growth factor β/nuclear factor-κB signaling pathways.
Conclusion
Taken together, Snail-expressing 3T3 fibroblasts display CAFs properties that support 5-fluorouracil and paclitaxel chemoresistance in CRC via participation of CCL1 and suggest that inhibition of the Snail-expression fibroblasts in tumor may be a useful strategy to limit chemoresistance.

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EGFR Mutation Status in Lung Adenocarcinoma-Associated Malignant Pleural Effusion and Efficacy of EGFR Tyrosine Kinase Inhibitors
Jiyoul Yang, Ok-Jun Lee, Seung-Myoung Son, Chang Gok Woo, Yusook Jeong, Yaewon Yang, Jihyun Kwon, Ki Hyeong Lee, Hye Sook Han
Cancer Res Treat. 2018;50(3):908-916.   Published online September 19, 2017
DOI: https://doi.org/10.4143/crt.2017.378
AbstractAbstract PDFPubReaderePub
Purpose
Malignant pleural effusions (MPEs) are often observed in lung cancer, particularly adenocarcinoma. The aim of this study was to investigate epidermal growth factor receptor (EGFR) mutation status in lung adenocarcinoma-associated MPEs (LA-MPEs) and its correlation with efficacy of EGFR tyrosine kinase inhibitor (TKI) therapy.
Materials and Methods
Samples comprised 40 cell blocks of pathologically-confirmed LA-MPEs collected before the start of EGFR TKI therapy. EGFR mutation status was re-evaluated by peptide nucleic acid clamping and the clinical outcomes of EGFR TKI‒treated patients were analyzed retrospectively.
Results
EGFR mutations were detected in 72.5% of LA-MPE cell blocks (29/40). The median progression-free survival for patients with EGFR mutations in LA-MPEs was better than that for patients with wild-type EGFR (7.33 months vs. 2.07 months; hazard ratio, 0.486; 95% confidence interval, 0.206 to 1.144; p=0.032). The objective response rate (ORR) of 26 patients with EGFR mutations in LA-MPEs among the 36 patients with measurable lesions was 80.8%, while the ORR of the 10 patients with wild-type EGFR in LA-MPEs was 10% (p < 0.001). Among the 26 patients with EGFR mutations in LA-MPEs, the ORR of target lesions and LA-MPEs were 88.5% and 61.5%, respectively (p=0.026).
Conclusion
EGFR mutation status in cell blocks of LA-MPEs confirmed by pathologic diagnosis is highly predictive of EGFR TKI efficacy. For patients with EGFR mutations in LA-MPEs, the response to EGFR TKIs seems to be worse for pleural effusions than for solid tumors.

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Detection of Germline Mutations in Patients with Epithelial Ovarian Cancer Using Multi-gene Panels: Beyond BRCA1/2
Kyung Jin Eoh, Ji Eun Kim, Hyung Seok Park, Seung-Tae Lee, Ji Soo Park, Jung Woo Han, Jung-Yun Lee, Sunghoon Kim, Sang Wun Kim, Jae Hoon Kim, Young Tae Kim, Eun Ji Nam
Cancer Res Treat. 2018;50(3):917-925.   Published online September 27, 2017
DOI: https://doi.org/10.4143/crt.2017.220
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Next-generation sequencing (NGS) allows simultaneous sequencing of multiple cancer susceptibility genes and may represent a more efficient and less expensive approach than sequential testing. We assessed the frequency of germline mutations in individuals with epithelial ovarian cancer (EOC), using multi-gene panels and NGS.
Materials and Methods
Patients with EOC (n=117) with/without a family history of breast or ovarian cancer were recruited consecutively, from March 2016 toDecember 2016.GermlineDNAwas sequenced using 35-gene NGS panel, in order to identify mutations. Upon the detection of a genetic alteration using the panel, results were cross-validated using direct sequencing.
Results
Thirty-eight patients (32.5%) had 39 pathogenic or likely pathogenic mutations in eight genes, including BRCA1 (n=21), BRCA2 (n=10), BRIP1 (n=1), CHEK2 (n=2), MSH2 (n=1), POLE (n=1), RAD51C (n=2), and RAD51D (n=2). Among 64 patients with a family history of cancer, 27 (42.2%) had 27 pathogenic or likely pathogenic mutations, and six (9.3%) had mutations in genes other than BRCA1/2, such as CHECK2, MSH2, POLE, and RAD51C. Fifty-five patients (47.0%) were identified to carry only variants of uncertain significance.
Conclusion
Using the multi-gene panel test, we found that, of all patients included in our study, 32.5% had germline cancer-predisposing mutations. NGS was confirmed to substantially improve the detection rates of a wide spectrum of mutations in EOC patients compared with those obtained with the BRCA1/2 testing alone.

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Clinical Risk Factors Influencing Dental Developmental Disturbances in Childhood Cancer Survivors
Chung-Min Kang, Seung Min Hahn, Hyo Sun Kim, Chuhl Joo Lyu, Jae-Ho Lee, Jinae Lee, Jung Woo Han
Cancer Res Treat. 2018;50(3):926-935.   Published online October 10, 2017
DOI: https://doi.org/10.4143/crt.2017.296
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Although studies regarding dental developmental disturbances after childhood cancer treatment have increased, they have many limitations. Studies analyzing the significance of independent clinical risk factors with regard to the dental health status are also rare. We aimed to investigate the risk factors for dental developmental disturbances, particularly severe disturbances, in childhood cancer survivors (CCS).
Materials and Methods
Oral examinations and retrospective reviews of medical and panoramic radiographs were performed for 196 CCS (mean age, 15.6 years). Cancer type, age at diagnosis, treatment modality, type and accumulated dose of administered drugs, and dose and site of radiation were recorded. Dental developmental disturbances were diagnosed using panoramic radiographs and graded for severity according to the Modified Dental Defect Index (MDDI). Descriptive statistics and multivariate analyseswere performed to determine the association between dental abnormalities and clinical factors.
Results
In total, 109 CCS (55.6%) exhibited at least one dental anomaly, and the median value of MDDI was 2.5. Microdontia (30.6%) was the most prevalent anomaly, followed by tooth agenesis (20.4%), V-shaped roots (14.8%), and taurodontism (10.2%). Multivariate analysis revealed that a young age at diagnosis (≤ 3 years), a history of hematopoietic stem cell transplantation, the use of multiple classes of chemotherapeutic agents (≥ 4 classes), and the use of heavy metal agents were significant risk factors for severe dental disturbances.
Conclusion
CCS with any of the above risk factors for severe developmental disturbances should be comprehensively followed up to minimize adverse consequences to their dental development and preserve their future dental health.

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