Cancer Research and Treatment

Original Articles

Preoperative Prediction Model for Early Recurrence of Intrahepatic Cholangiocarcinoma After Surgical Resection: Development and External Validation Study: Dong Hwan Kim, Sang Hyun Choi, Sehee Kim, Hyungjin Rhee, Eun-Suk Cho, Suk-Keu Yeom, Sumi Park, Seung Soo Lee, Mi-Suk Park; Received December 10, 2024 Accepted February 4, 2025 Published online February 5, 2025; DOI: https://doi.org/10.4143/crt.2024.1187 [Accepted]

Abstract PDF: Purpose
We aimed to develop a preoperative risk scoring system to predict early recurrence (ER) of intrahepatic cholangiocarcinoma (ICCA) after resection, utilizing clinical and computed tomography (CT) features.
Materials and Methods
This multicenter study included 365 patients who underwent curative-intent surgical resection for ICCA at six institutions between 2009 and 2016. Of these, 264 patients from one institution constituted the development cohort, while 101 patients from the other institutions constituted the external validation cohort. Logistic regression models were constructed to predict ER based on preoperative variables and were subsequently translated into a risk-scoring system. The discrimination performance of the risk-scoring system was validated using external data and compared to the American Joint Committee on Cancer (AJCC) TNM staging system.
Results
Among the 365 patients (mean age, 62±10 years), 153 had ER. A preoperative risk scoring system that incorporated both clinical and CT features demonstrated superior discriminatory performance compared to the postoperative AJCC TNM staging system in both the development (area under the curve [AUC], 0.78 vs. 0.68; p=0.002) and validation cohorts (AUC, 0.69 vs. 0.66; p=0.641). The preoperative risk scoring system effectively stratified patients based on their risk for ER: the 1-year recurrence-free survival rates for the low, intermediate, and high-risk groups were 85.5%, 56.6%, and 15.6%, respectively (p<0.001) in the development cohort, and 87.5%, 58.5%, and 25.0%, respectively (p<0.001) in the validation cohort.
Conclusion
A preoperative risk scoring system that incorporates clinical and CT imaging features was valuable in identifying high-risk patients with ICCA for ER following resection.

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Gastrointestinal cancer

Clinical and Radiologic Predictors of Response to Atezolizumab-Bevacizumab in Advanced Hepatocellular Carcinoma: Se Jin Choi, Sung Won Chung, Jonggi Choi, Kang Mo Kim, Hyung-Don Kim, Changhoon Yoo, Baek-Yeol Ryoo, Seung Soo Lee, Won-Mook Choi, Sang Hyun Choi; Cancer Res Treat. 2024;56(4):1219-1230. Published online May 7, 2024; DOI: https://doi.org/10.4143/crt.2024.283

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to identify clinical and radiologic characteristics that could predict response to atezolizumab-bevacizumab combination therapy in patients with advanced hepatocellular carcinoma (HCC).
Materials and Methods
This single-center retrospective study included 108 advanced HCC patients with intrahepatic lesions who were treated with atezolizumab-bevacizumab. Two radiologists independently analyzed imaging characteristics of the index tumor on pretreatment computed tomography. Predictive factors associated with progressive disease (PD) at the best response based on Response Evaluation Criteria in Solid Tumors, ver. 1.1 were evaluated using logistic regression analysis. Progression-free survival (PFS) was estimated by the Kaplan-Meier method and compared with the log-rank test.
Results
Of 108 patients with a median PFS of 15 weeks, 40 (37.0%) had PD during treatment. Factors associated with PD included the presence of extrahepatic metastases (adjusted odds ratio [aOR], 4.13; 95% confidence interval [CI], 1.19 to 14.35; p=0.03), the infiltrative appearance of the tumor (aOR, 3.07; 95% CI, 1.05 to 8.93; p=0.04), and the absence of arterial-phase hyperenhancement (APHE) (aOR, 6.34; 95% CI, 2.18 to 18.47; p < 0.001). Patients with two or more of these factors had a PD of 66.7% and a median PFS of 8 weeks, indicating a significantly worse outcome compared to the patients with one or no of these factors.
Conclusion
In patients with advanced HCC treated with atezolizumab-bevacizumab treatment, the absence of APHE, infiltrative appearance of the intrahepatic tumor, and presence of extrahepatic metastases were associated with poor response and survival. Evaluation of early response may be necessary in patients with these factors.

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Liver Transplantation for Hepatocarcinoma: Results over Two Decades of a Transplantation Programme and Analysis of Factors Associated with Recurrence
María Martínez Burgos, Rocío González Grande, Susana López Ortega, Inmaculada Santaella Leiva, Jesús de la Cruz Lombardo, Julio Santoyo Santoyo, Miguel Jiménez Pérez
Biomedicines.2024; 12(6): 1302. CrossRef

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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

Abstract PDF PubReader ePub

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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Nutritional Experiences of Patients Undergoing Total Gastrectomy Surgery
Derya Şayır, Kevser Karacabay
Gastroenterology Nursing.2024; 47(3): 203. CrossRef
Exploring the Association between Health-Related Physical Fitness and Quality of Life in Patients with Cancer: A Cross-Sectional Study
Anita Borsati, Diana Giannarelli, Lorenzo Belluomini, Christian Ciurnelli, Alessio Colonna, Irene D’Amico, Arianna Daniele, Nicole Del Bianco, Linda Toniolo, Ilaria Trestini, Daniela Tregnago, Jessica Insolda, Marco Sposito, Massimo Lanza, Michele Milella
Healthcare.2024; 12(16): 1643. CrossRef
Research Progress on the Relationship between Nutritional Support and Postoperative Quality of Life in Patients with Gastric Cancer
思孟张
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U-shaped association between body mass index and health-related quality of life impairment in Korean cancer survivors: a nationwide representative cross-sectional survey
Jong Eun Park, Kyoung Eun Yeob, So Young Kim, Chul-Woung Kim, Hye Sook Han, Jong Hyock Park
Journal of Cancer Survivorship.2023; 17(5): 1522. CrossRef
The Predictive Value of a New Inflammatory-Nutritional Score for Quality of Life after Laparoscopic Distal Gastrectomy for Gastric Cancer
Simeng Zhang, Ruiqing Liu, Maoshen Zhang, JiLin Hu, Shuai Xiang, Zinian Jiang, Dongsheng Wang
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Grigorios Christodoulidis, Marina-Nektaria Kouliou, Konstantinos-Eleftherios Koumarelas, Dimitris Giakoustidis, Thanos Athanasiou
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Long-term health-related quality of life in patients with gastric cancer after total or distal gastrectomy: A propensity score-matched cohort study
Jianhong Yu, Zaozao Wang, Hong Yang, Chenghai Zhang, Jiadi Xing, Ming Cui, Hui Liu, Yu Wu, Xiangqian Su
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Hui-Ying Yang, Yun-Hsiang Lee, Jin-Ming Wu, I-Rue Lai, Shiow-Ching Shun
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Health-related quality of life in curatively-treated patients with esophageal or gastric cancer: A systematic review and meta-analysis
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Chronological Changes of Quality of Life in Long-Term Survivors after Gastrectomy for Gastric Cancer: Wansik Yu, Ki Bum Park, Ho Young Chung, Oh Kyoung Kwon, Seung Soo Lee; Cancer Res Treat. 2016;48(3):1030-1036. Published online January 6, 2016; DOI: https://doi.org/10.4143/crt.2015.398

Abstract PDF PubReader ePub

Purpose
A few studies have prospectively evaluated changes in quality of life (QoL) after surgery in short-term survivors; however, no prospective study has evaluated the longitudinal changes in QoL in long-terms survivors. We prospectively evaluated the chronological changes in QoL after a gastrectomy over a 5-year postoperative period in a large group of patients. Materials and Methods QoL data from the European Organization for Research and Treatment of Cancer QLQ-C30 and the QLQ-STO22 questionnaires were obtained from 254 patients who completed the entire series of QoL assessments preoperatively and at 1, 2, 3, 4, and 5 years after surgery.
Results
There was no statistically significant change in global health status/QoL during the 5-year postoperative period. Decreases in QoL from upper gastrointestinal symptoms including diarrhea (p < 0.001), dysphagia (p < 0.001), reflux symptoms (p=0.029), and eating restrictions (p < 0.001) were observed among the long-term survivors. Decreased physical functioning (p < 0.001), role functioning (p < 0.001), and cognitive functioning (p < 0.001), along with fatigue (p=0.045) and a poor body image (p=0.003), negatively impacted the patients’ QoL for a long time. Conclusion Management of gastrointestinal symptoms should be specifically targeted as a part of longterm patient care after a gastrectomy. Proper nutritional care will improve food intake resulting in weight gain and improved physical functioning, role functioning, and body image. In addition, patients should be encouraged to preserve self-esteem and maintain social activity.

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Quality of Life of Long-Term Survivors after a Distal Subtotal Gastrectomy: Seung Soo Lee, Ho Young Chung, Wansik Yu; Cancer Res Treat. 2010;42(3):130-134. Published online September 30, 2010; DOI: https://doi.org/10.4143/crt.2010.42.3.130

Abstract PDF PubReader ePub

Purpose

The aim of this study was to investigate the impact of a distal subtotal gastrectomy on the quality of life (QoL).

Materials and Methods

The QoL data of 126 patients were obtained on their 5th annual follow-up visit after a curative distal subtotal gastrectomy for gastric cancer (Group A). The QoL data of 130 age- and gender-adjusted healthy population were obtained from the individuals who visited the health screening center for a medical check-up (Group B). There were 42 women and 84 men in the study group and their mean age was 56.0±11.1 years. QoL was assessed using the Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire Core 30 (QLQ-C30) and QLQ-STO22.

Results

The EORTC QLQ-C30 global health status and QoL scores of Group A and Group B were 63.9±22.7 and 61.3±22.1, respectively (p=0.361). Group A revealed a better score for emotional functioning (84.1±16.1 and 75.2±21.4, respectively; p<0.001), cognitive functioning (82.0±16.4 and 75.0±21.4, respectively; p=0.004) and fatigue (27.7±20.8 and 33.8±23.2, respectively; p=0.028). However, Group A revealed a worse score for nausea and vomiting (14.8±20.0 and 10.2±16.0, respectively; p=0.042), financial difficulties (14.8±22.9 and 7.1±16.1, respectively; p=0.002), reflux (16.7±17.7 and 10.1±17.0, respectively; p=0.003), eating restrictions (13.6±15.2 and 6.6±10.2, respectively; p<0.001) and body image (23.3±25.4 and 16.2±24.6, respectively; p=0.023).

Conclusion

The QoL of long-term survivors after a distal subtotal gastrectomy is still influenced by the surgery itself even though they are considered to be free of disease.

Citations

Citations to this article as recorded by

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