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14 "Sun Young Kim"
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Original Articles
Clinical Characteristics of and Treatment Pattern for EGFR-Amplified Colorectal Cancer
Seong-Eun Kim, Hyehyun Jeong, Sun Young Kim, Jeong Eun Kim, Yong Sang Hong, Deokhoon Kim, Jihun Kim, Ji Sung Lee, Tae-Won Kim
Received June 17, 2024  Accepted January 7, 2025  Published online January 10, 2025  
DOI: https://doi.org/10.4143/crt.2024.569    [Accepted]
AbstractAbstract PDF
Purpose
To compare clinicopathologic features and clinical outcomes of metastatic colorectal cancer (mCRC) based on EGFR amplification status.
Materials and Methods
Patients with mCRC who underwent next-generation sequencing using a targeted 244-gene panel from 2016 to 2021 were identified and screened for EGFR copy numbers. Cases with at least 5 copies were reviewed for tumor purity adjustment, and those with an adjusted copy number of ≥6 were defined as EGFR-amplified (EGFR amp+). Their clinical characteristics were compared with those without EGFR amplification (EGFR amp-).
Results
Among 2,421 patients, 35 (1.4%) were EGFR amp+. Clinical characteristics did not significantly differ according to EGFR amplification status, but EGFR amp+ cases had fewer instances of peritoneal seeding (8.6% vs. 21.8%). Overall survival (OS) tended to be better in EGFR amp+ patients compared with EGFR amp- patients (median OS 76 vs. 37 months, p=0.15). Among 572 patients who received anti-EGFR antibody-based chemotherapy (anti-EGFR CTx) during disease course, mOS tended to be better in 16 EGFR amp+ patients (79 months) compared with 556 EGFR amp- patients (39 months, p=0.048). Seven out of 35 EGFR amp+ patients were treated with front-line anti-EGFR CTx, and their progression-free survival did not differ from that of EGFR amp- patients treated with front-line anti-EGFR CTx (20 vs. 14 months, p=0.344).
Conclusion
This study may suggest a favorable predictive impact of EGFR amplification in patients treated with anti-EGFR CTx. However, the benefit of front-line anti-EGFR antibody treatment in this group was not notable.
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Palliative medicine
Factors Affecting Life-Sustaining Treatment Decisions and Changes in Clinical Practice after Enforcement of the Life-Sustaining Treatment (LST) Decision Act: A Tertiary Hospital Experience in Korea
Yoon Jung Jang, Yun Jung Yang, Hoi Jung Koo, Hye Won Yoon, Seongbeom Uhm, Sun Young Kim, Jeong Eun Kim, Jin Won Huh, Tae Won Kim, Seyoung Seo
Cancer Res Treat. 2025;57(1):280-288.   Published online July 1, 2024
DOI: https://doi.org/10.4143/crt.2024.360
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
In Korea, the Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment (LST) was implemented on February 4, 2018. We aimed to investigate relevant factors and clinical changes associated with LST decisions after law enforcement.
Materials and Methods
This single-center retrospective study included patients who completed LST documents using legal forms at Asan Medical Center from February 5, 2018, to June 30, 2020.
Results
5,896 patients completed LST documents, of which 2,704 (45.8%) signed the documents in person, while family members of 3,192 (54%) wrote the documents on behalf of the patients. Comparing first year and following year of implementation of the act, the self-documentation rate increased (43.9% to 47.2%, p=0.014). Moreover, the number of LST decisions made during or after intensive care unit admission decreased (37.8% vs. 35.2%, p=0.045), and the completion rate of LST documents during chemotherapy increased (6.6% vs. 8.9%, p=0.001). In multivariate analysis, age < 65 (odds ratio [OR], 1.724; 95% confidence interval [CI], 1.538 to 1.933; p < 0.001), unmarried status (OR, 1.309; 95% CI, 1.097 to 1.561; p=0.003), palliative care consultation (OR, 1.538; 95% CI, 1.340 to 1.765; p < 0.001), malignancy (OR, 1.864; 95% CI, 1.628 to 2.133; p < 0.001), and changes in timing on the first year versus following year (OR, 1.124; 95% CI, 1.003 to 1.260; p=0.045) were related to a higher self-documentation rate.
Conclusion
Age < 65 years, unmarried status, malignancy, and referral to a palliative care team were associated with patients making LST decisions themselves. Furthermore, the subject and timing of LST decisions have changed with the LST act.
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General
Impact of Patient Sex on Adverse Events and Unscheduled Utilization of Medical Services in Cancer Patients Undergoing Adjuvant Chemotherapy: A Multicenter Retrospective Cohort Study
Songji Choi, Seyoung Seo, Ju Hyun Lee, Koung Jin Suh, Ji-Won Kim, Jin Won Kim, Se Hyun Kim, Yu Jung Kim, Keun-Wook Lee, Jwa Hoon Kim, Tae Won Kim, Yong Sang Hong, Sun Young Kim, Jeong Eun Kim, Sang-We Kim, Dae Ho Lee, Jae Cheol Lee, Chang-Min Choi, Shinkyo Yoon, Su-Jin Koh, Young Joo Min, Yongchel Ahn, Hwa Jung Kim, Jin Ho Baek, Sook Ryun Park, Jee Hyun Kim
Cancer Res Treat. 2024;56(2):404-413.   Published online November 7, 2023
DOI: https://doi.org/10.4143/crt.2023.784
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The female sex is reported to have a higher risk of adverse events (AEs) from cytotoxic chemotherapy. Few studies examined the sex differences in AEs and their impact on the use of medical services during adjuvant chemotherapy. This sub-study aimed to compare the incidence of any grade and grade ≥ 3 AEs, healthcare utilization, chemotherapy completion rate, and dose intensity according to sex.
Materials and Methods
This is a sub-study of a multicenter cohort conducted in Korea that evaluated the impact of healthcare reimbursement on AE evaluation in patients who received adjuvant chemotherapy between September 2013 and December 2016 at four hospitals in Korea.
Results
A total of 1,170 patients with colorectal, gastric, or non–small cell lung cancer were included in the study. Female patients were younger, had fewer comorbidities, and experienced less postoperative weight loss of > 10%. Females had significantly higher rates of any grade AEs including nausea, abdominal pain, stomatitis, vomiting, and neutropenia, and experienced more grade ≥ 3 neutropenia, nausea, and vomiting. The dose intensity of chemotherapy was significantly lower in females, and they also experienced more frequent dose reduction after the first cycle. Moreover, female patients receiving platinum-containing regimens had significantly higher rates of unscheduled outpatient visits.
Conclusion
Our study found that females experienced a higher incidence of multiple any-grade AEs and severe neutropenia, nausea, and vomiting, across various cancer types, leading to more frequent dose reductions. Physicians should be aware of sex differences in AEs for chemotherapy decisions.

Citations

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  • Cancer care for transgender and gender‐diverse people: Practical, literature‐driven recommendations from the Multinational Association of Supportive Care in Cancer
    Elizabeth J. Cathcart‐Rake, Alexandre Chan, Alvaro Menendez, Denise Markstrom, Carla Schnitzlein, Yee Won Chong, Don S. Dizon
    CA: A Cancer Journal for Clinicians.2025; 75(1): 68.     CrossRef
  • Characterisation of the effects of the chemotherapeutic agent paclitaxel on neuropathic pain-related behaviour, anxiodepressive behaviour, cognition, and the endocannabinoid system in male and female rats
    Chiara Di Marino, Álvaro Llorente-Berzal, Alba M. Diego, Ariadni Bella, Laura Boullon, Esther Berrocoso, Michelle Roche, David P. Finn
    Frontiers in Pharmacology.2025;[Epub]     CrossRef
  • Toxicidad del esquema FOLFOX-6, asociado o no a bolo de 5-fluorouracilo, en cáncer colorrectal metastásico
    María Teresa Garrido Martínez, María Rodríguez Jorge, Ignacio García Giménez, María Isabel Guzmán Ramos, Salvador Grutzmancher Sáiz, Victoria Aviñó Tarazona
    Farmacia Hospitalaria.2024;[Epub]     CrossRef
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Gastrointestinal cancer
Histopathologic and Molecular Biomarkers of PD-1/PD-L1 Inhibitor Treatment Response among Patients with Microsatellite Instability‒High Colon Cancer
Jaewon Hyung, Eun Jeong Cho, Jihun Kim, Jwa Hoon Kim, Jeong Eun Kim, Yong Sang Hong, Tae Won Kim, Chang Ohk Sung, Sun Young Kim
Cancer Res Treat. 2022;54(4):1175-1190.   Published online January 12, 2022
DOI: https://doi.org/10.4143/crt.2021.1133
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Recent clinical trials have reported response rates < 50% among patients treated with programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors for microsatellite instability‒high (MSI-H) colorectal cancer (CRC), and factors predicting treatment response have not been fully identified. This study aimed to identify potential biomarkers of PD-1/PD-L1 inhibitor treatment response among patients with MSI-H CRC.
Materials and Methods
MSI-H CRC patients enrolled in three clinical trials of PD-1/PD-L1 blockade at Asan Medical Center (Seoul, Republic of Korea) were screened and classified into two groups according to treatment response. Their histopathologic features and expression of 730 immune-related genes from the NanoString platform were evaluated, and a machine learning–based classification model was built to predict treatment response among MSI-H CRCs patients.
Results
A total of 27 patients (15 responders, 12 non-responders) were included. A high degree of lymphocytic/neutrophilic infiltration and an expansile tumor border were associated with treatment response and prolonged progression-free survival (PFS), while mucinous/signet-ring cell carcinoma was associated with a lack of treatment response and short PFS. Gene expression profiles revealed that the interferon-γ response pathway was enriched in the responder group. Of the top eight differentially expressed immune-related genes, PRAME had the highest fold change in the responder group. Higher expression of PRAME was independently associated with better PFS along with histologic subtypes in the multivariate analysis. The classification model using these genes showed good performance for predicting treatment response.
Conclusion
We identified histologic and immune-related gene expression characteristics associated with treatment response in MSI-H CRC, which may contribute to optimal patient stratification.

Citations

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  • The Relationship of PRAME Expression with Clinicopathologic Parameters and Immunologic Markers in Melanomas: In Silico Analysis
    Yasemin Cakir, Banu Lebe
    Applied Immunohistochemistry & Molecular Morphology.2025;[Epub]     CrossRef
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    Hang Yu, Qingquan Liu, Keting Wu, Shuang Tang
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    Loredana Farcaș, Diana Voskuil-Galoș
    Journal of Medical and Radiation Oncology.2024; 4(7): 1.     CrossRef
  • High serum IL-6 correlates with reduced clinical benefit of atezolizumab and bevacizumab in unresectable hepatocellular carcinoma
    Hannah Yang, Beodeul Kang, Yeonjung Ha, Sung Hwan Lee, Ilhwan Kim, Hyeyeong Kim, Won Suk Lee, Gwangil Kim, Sanghoon Jung, Sun Young Rha, Vincent E. Gaillard, Jaekyung Cheon, Chan Kim, Hong Jae Chon
    JHEP Reports.2023; 5(4): 100672.     CrossRef
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    Zhe Yang, Feiran Chen, Feng Wang, Xiubing Chen, Biaolin Zheng, Xiaomin Liao, Zhejun Deng, Xianxian Ruan, Jing Ning, Qing Li, Haixing Jiang, Shanyu Qin
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  • Systemic Delivery of a STING Agonist‐Loaded Positively Charged Liposome Selectively Targets Tumor Immune Microenvironment and Suppresses Tumor Angiogenesis
    Eun‐Jin Go, Hannah Yang, Wooram Park, Seung Joon Lee, Jun‐Hyeok Han, So Jung Kong, Won Suk Lee, Dong Keun Han, Hong Jae Chon, Chan Kim
    Small.2023;[Epub]     CrossRef
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    Norah A. Alturki
    Journal of Clinical Medicine.2023; 12(13): 4301.     CrossRef
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    Seminars in Cancer Biology.2022; 87: 137.     CrossRef
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Radiofrequency Ablation versus Stereotactic Body Radiation Therapy in the Treatment of Colorectal Cancer Liver Metastases
Jesang Yu, Dong Hwan Kim, Jungbok Lee, Yong Moon Shin, Jong Hoon Kim, Sang Min Yoon, Jinhong Jung, Jin Cheon Kim, Chang Sik Yu, Seok-Byung Lim, In Ja Park, Tae Won Kim, Yong Sang Hong, Sun Young Kim, Jeong Eun Kim, Jin-hong Park, So Yeon Kim
Cancer Res Treat. 2022;54(3):850-859.   Published online October 13, 2021
DOI: https://doi.org/10.4143/crt.2021.674
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to compare the treatment outcomes of radiofrequency ablation (RFA) and stereotactic body radiation therapy (SBRT) for colorectal cancer liver metastases (CRLM) and to determine the favorable treatment modality according to tumor characteristics.
Materials and Methods
We retrospectively analyzed the records of 222 colorectal cancer patients with 330 CRLM who underwent RFA (268 tumors in 178 patients) or SBRT (62 tumors in 44 patients) between 2007 and 2014. Kaplan–Meier method and Cox models were used by adjusting with inverse probability of treatment weighting (IPTW).
Results
The median follow-up duration was 30.5 months. The median tumor size was significantly smaller in the RFA group than in the SBRT group (1.5 cm vs 2.3 cm, p<0.001). In IPTW-adjusted analysis, difference in treatment modality was not associated with significant differences in 1-year and 3-year recurrence-free survival (35% vs 43%, 22% vs 23%; p=0.198), overall survival (96% vs 91%, 58% vs 56%; p=0.508), and freedom from local progression (FFLP; 90% vs 72%, 78% vs 60%; p=0.106). Significant interaction effect between the treatment modality and tumor size was observed for FFLP (p=0.001). In IPTW-adjusted subgroup analysis of patients with tumor size >2 cm, the SBRT group had a higher FFLP compared with the RFA group (HR, 0.153; p<0.001).
Conclusion
SBRT and RFA showed similar local control in the treatment of patients with CRLM. Tumor size was an independent prognostic factor for local control and SBRT may be preferred for larger tumors.

Citations

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  • Effects of maximum dose on local control after stereotactic body radiotherapy for oligometastatic tumors of colorectal cancer
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    Japanese Journal of Radiology.2022; 40(10): 1035.     CrossRef
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A Phase II Study of Avelumab Monotherapy in Patients with Mismatch Repair–Deficient/Microsatellite Instability–High or POLE-Mutated Metastatic or Unresectable Colorectal Cancer
Jwa Hoon Kim, Sun Young Kim, Ji Yeon Baek, Yong Jun Cha, Joong Bae Ahn, Han Sang Kim, Keun-Wook Lee, Ji-Won Kim, Tae-You Kim, Won Jin Chang, Joon Oh Park, Jihun Kim, Jeong Eun Kim, Yong Sang Hong, Yeul Hong Kim, Tae Won Kim
Cancer Res Treat. 2020;52(4):1135-1144.   Published online April 24, 2020
DOI: https://doi.org/10.4143/crt.2020.218
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We evaluated the efficacy and safety of avelumab, an anti-PD-L1 antibody, in patients with metastatic or unresectable colorectal cancer (mCRC) with mismatch repair deficiency (dMMR)/microsatellite instability-high (MSI-H) or POLE mutations.
Materials and Methods
In this prospective, open-label, multicenter phase II study, 33 patients with mCRC harboring dMMR/MSI-H or POLE mutations after failure of ≥1st-line chemotherapy received avelumab 10 mg/kg every 2 weeks. dMMR/MSI-H was confirmed with immunohistochemical staining (IHC) by loss of expression of MMR proteins or polymerase chain reaction (PCR) for microsatellite sequences. POLE mutation was confirmed by next-generation sequencing (NGS). The primary endpoint was the objective response rate (ORR) by Response Evaluation Criteria in Solid Tumors ver. 1.1.
Results
The median age was 60 years, and 78.8% were male. Thirty patients were dMMR/MSI-H and three had POLE mutations. The ORR was 24.2%, and all of the responders were dMMR/MSI-H. For 21 patients with MSI-H by PCR or NGS, the ORR was 28.6%. At a median follow-up duration of 16.3 months, median progression-free survival and overall survival were 3.9 and 13.2 months in all patients, and 8.1 months and not reached, respectively, in patients with MSI-H by PCR or NGS. Dose interruption and discontinuation due to treatment-related adverse events occurred in 4 and 2 patients, respectively, with no treatment-related deaths.
Conclusion
Avelumab displayed antitumor activity with manageable toxicity in patients with previously treated mCRC harboring dMMR/MSI-H. Diagnosis of dMMR/MSI-H with PCR or NGS could be complementary to IHC to select patients who would benefit from immunotherapy.

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    Yang Fu, Yue Zheng, Pei-Pei Wang, Yue-Yun Chen, Zhen-Yu Ding
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • CDK4/6 blockade provides an alternative approach for treatment of mismatch-repair deficient tumors
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    Wanting Hou, Cheng Yi, Hong Zhu
    Frontiers in Immunology.2022;[Epub]     CrossRef
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    龙坤 郑
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    Kyusang Hwang, Jin Hwan Yoon, Ji Hyun Lee, Sukmook Lee
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    Jianxin Chen, Haizhou Lou
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Changes of End of Life Practices for Cancer Patients and Their Association with Hospice Palliative Care Referral over 2009-2014: A Single Institution Study
Hyun Jung Jho, Eun Jung Nam, Il Won Shin, Sun Young Kim
Cancer Res Treat. 2020;52(2):419-425.   Published online September 3, 2019
DOI: https://doi.org/10.4143/crt.2018.648
AbstractAbstract PDFPubReaderePub
Purpose
In Korea, hospice palliative care (HPC) provision for cancer patients has increased recently. However, whether end of life (EoL) care practices have improved along with the development of HPC is unclear. We intended to investigate the changes in EoL care practices and their association with HPC referral. Materials and Methods Retrospective medical record review of adult cancer patients who died at National Cancer Center Korea from 1 January 2009 to 31 December 2014 was performed. Changes of EoL practices including chemotherapy within 2 weeks from death, death in intensive care unit (ICU), documentation of “do not resuscitate (DNR)” within 7 days from death and referral to HPC from 2009 to 2014 were analyzed as well as the association between referral to HPC and other practices.
Results
A total of 2,377 cases were included in the analysis. Between 2009 and 2014, referral to HPC increased and DNR documentation within 7 days from death decreased significantly. Cases for chemotherapy within 2 weeks from death and death in ICU didn’t change over the study period. Patients referred to HPC were less likely to receive chemotherapy within 2 weeks from death, die in ICU and document DNR within 7 days from death. Conclusion During the study period, EoL practices among cancer patients partly changed toward less aggressive in our institution. HPC referral was associated with less aggressive cancer care at the EoL. Policies to promote EoL discussion are necessary to improve the EoL practices of cancer patients.

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  • Decreased aggressive care at the end of life among advanced cancer patients in the Republic of Korea: a nationwide study from 2012 to 2018
    Sara Kwon, Kyuwoong Kim, Bohyun Park, So-Jung Park, Hyun Jung Jho, Jin Young Choi
    BMC Palliative Care.2024;[Epub]     CrossRef
  • Symptom burden, palliative care knowledge, and palliative care needs in advanced gynecological cancer patients in Korea
    Eungil Ko, Yaelim Lee
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  • End-of-Life Decision Making in Patients with Advanced Dementia: The Perspectives of the Korean General Population and Clinicians
    So Yeon Jeon, Shin Hye Yoo, Jung Lee, In Gyu Song, Min Sun Kim, Hye Yoon Park
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    Yu Jung Kim, Sun-Hyun Kim
    Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen.2023; 180: 68.     CrossRef
  • Public awareness of advance care planning and hospice palliative care: a nationwide cross-sectional study in Korea
    Boram Kim, Junyong Lee, Youn Seon Choi
    BMC Palliative Care.2023;[Epub]     CrossRef
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    Tangxing Jiang, Yanyan Ma, Jiaqi Zheng, Chunyi Wang, Kai Cheng, Chuanbao Li, Feng Xu, Yuguo Chen
    Heart & Lung.2022; 51: 9.     CrossRef
  • Discussing POLST-facilitated hospice care enrollment in patients with terminal cancer
    Ho Jung An, Hyun Jeong Jeon, Sang Hoon Chun, Hyun Ae Jung, Hee Kyung Ahn, Kyung Hee Lee, Min-ho Kim, Ju Hee Kim, Jaekyung Cheon, Su-Jin Koh
    Supportive Care in Cancer.2022; 30(9): 7431.     CrossRef
  • A National Study of Life-Sustaining Treatments in South Korea: What Factors Affect Decision-Making?
    So-Youn Park, Bomyee Lee, Jeong Yeon Seon, In-Hwan Oh
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    Hyeyeong Kim, Hyeon-Su Im, Kyong Og Lee, Young Joo Min, Jae-Cheol Jo, Yunsuk Choi, Yoo Jin Lee, Daseul Kang, Changyoung Kim, Su-Jin Koh, Jaekyung Cheon
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    Jung Sun Kim, Shin Hye Yoo, Wonho Choi, Yejin Kim, Jinui Hong, Min Sun Kim, Hye Yoon Park, Bhumsuk Keam, Dae Seog Heo
    Cancer Research and Treatment.2020; 52(3): 917.     CrossRef
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Redefining the Positive Circumferential Resection Margin by Incorporating Preoperative Chemoradiotherapy Treatment Response in Locally Advanced Rectal Cancer: A Multicenter Validation Study
Joo Ho Lee, Eui Kyu Chie, Seung-Yong Jeong, Tae-You Kim, Dae Yong Kim, Tae Hyun Kim, Sun Young Kim, Ji Yeon Baek, Hee Jin Chang, Min Ju Kim, Sung Chan Park, Jae Hwan Oh, Sung Hwan Kim, Jong Hoon Lee, Doo Ho Choi, Hee Chul Park, Sung-Bum Kang, Jae-Sung Kim
Cancer Res Treat. 2018;50(2):506-517.   Published online May 24, 2017
DOI: https://doi.org/10.4143/crt.2016.607
AbstractAbstract PDFPubReaderePub
Purpose
This study was conducted to validate the prognostic influence of treatment response among patients with positive circumferential resection margin for locally advanced rectal cancer.
Materials and Methods
Clinical data of 197 patientswith positive circumferentialresection margin defined as ≤ 2 mm after preoperative chemoradiotherapy followed by total mesorectal excision between 2004 and 2009were collected forthis multicenter validation study. All patients underwent median 50.4Gy radiationwith concurrentfluoropyrimidine based chemotherapy. Treatmentresponse was dichotomized to good response, including treatmentresponse of grade 2 or 3, and poor response, including grade 0 or 1.
Results
After 52 months median follow-up, 5-year overall survival (OS) for good responders and poor responders was 79.1% and 48.4%, respectively (p < 0.001). In multivariate analysis, circumferential resection margin involvement and treatment response were a prognosticator for OS and locoregional recurrence-free survival. In subgroup analysis, good responders with close margin showed significantly better survival outcomes for survival. Good responders with involved margin and poor responders with close margin shared similar results, whereas poorresponderswith involved margin hadworst survival (5-year OS, 81.2%, 57.0%, 50.0%, and 32.4%, respectively; p < 0.001).
Conclusion
Among patients with positive circumferential resection margin after preoperative chemoradiotherapy, survival of the good responders was significantly better than poor responders. Subgroup analysis revealed that definition of positive circumferential resection margin may be individualized as involvement for good responders, whereas ≤ 2 mm for poor responders.

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  • Tailored Strategy for Locally Advanced Rectal Carcinoma (GRECCAR 4): Long-term Results From a Multicenter, Randomized, Open-Label, Phase II Trial
    Philippe Rouanet, Eric Rullier, Bernard Lelong, Philippe Maingon, Jean-Jacques Tuech, Denis Pezet, Florence Castan, Stephanie Nougaret
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    Iresha Ratnayake, Jason Park, Natalie Biswanger, Allison Feely, Grace Musto, Kathleen Decker
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What Is the Ideal Tumor Regression Grading System in Rectal Cancer Patients after Preoperative Chemoradiotherapy?
Soo Hee Kim, Hee Jin Chang, Dae Yong Kim, Ji Won Park, Ji Yeon Baek, Sun Young Kim, Sung Chan Park, Jae Hwan Oh, Ami Yu, Byung-Ho Nam
Cancer Res Treat. 2016;48(3):998-1009.   Published online October 22, 2015
DOI: https://doi.org/10.4143/crt.2015.254
AbstractAbstract PDFPubReaderePub
Purpose
Tumor regression grade (TRG) is predictive of therapeutic response in rectal cancer patients after chemoradiotherapy (CRT) followed by curative resection. However, various TRG systems have been suggested, with subjective categorization, resulting in interobserver variability. This study compared the prognostic validity of four different TRG systems in order to identify the most ideal TRG system. Materials and Methods This study included 933 patients who underwent preoperative CRT and curative resection. Primary tumors alone were graded according to the American Joint Committee on Cancer (AJCC), Dworak, and Ryan TRG systems, and both primary tumors and regional lymph nodes were graded according to a modified Dworak TRG system. The ability of each TRG system to predict recurrence-free survival (RFS) and overall survival (OS) was analyzed using chisquare and C statistics.
Results
All four TRG systems were significantly predictive of both RFS and OS (p < 0.001 each), however none was a better predictor of prognosis than ypStage. Among the four TRGs, the mDworak TRG system was a better predictor of RFS and OS than the AJCC, Dworak, and Ryan TRG systems, and both the chi-square and C statistics were higher for the former, although the differences were not statistically significant. The combination of ypStage and the modified Dworak TRG better predicted RFS and OS than ypStage alone. Conclusion The modified Dworak TRG system for evaluation of entire tumors including regional lymph nodes is a better predictor of survival than current TRG systems for evaluation of the primary tumor alone.

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Endoscopic Criteria for Evaluating Tumor Stage after Preoperative Chemoradiation Therapy in Locally Advanced Rectal Cancer
Kyung Su Han, Dae Kyung Sohn, Dae Yong Kim, Byung Chang Kim, Chang Won Hong, Hee Jin Chang, Sun Young Kim, Ji Yeon Baek, Sung Chan Park, Min Ju Kim, Jae Hwan Oh
Cancer Res Treat. 2016;48(2):567-573.   Published online September 22, 2015
DOI: https://doi.org/10.4143/crt.2015.195
AbstractAbstract PDFPubReaderePub
Purpose
Local excision may be an another option for selected patients with markedly down-staged rectal cancer after preoperative chemoradiation therapy (CRT), and proper evaluation of post-CRT tumor stage (ypT) is essential prior to local excision of these tumors. This study was designed to determine the correlations between endoscopic findings and ypT of rectal cancer.
Materials and Methods
In this study, 481 patients with locally advanced rectal cancer who underwent preoperative CRT followed by surgical resection between 2004 and 2013 at a single institution were evaluated retrospectively. Pathological good response (p-GR) was defined as ypT ≤ 1, and pathological minimal or no response (p-MR) as ypT ≥ 2. The patients were randomly classified according to two groups, a testing (n=193) and a validation (n=288) group. Endoscopic criteria were determined from endoscopic findings and ypT in the testing group and used in classifying patients in the validation group as achieving or not achieving p-GR.
Results
Based on findings in the testing group, the endoscopic criteria for p-GR included scarring, telangiectasia, and erythema, whereas criteria for p-MR included nodules, ulcers, strictures, and remnant tumors. In the validation group, the kappa statistic was 0.965 (p < 0.001), and the sensitivity, specificity, positive predictive value, and negative predictive value were 0.362, 0.963, 0.654, and 0.885, respectively.
Conclusion
The endoscopic criteria presented are easily applicable for evaluation of ypT after preoperative CRT for rectal cancer. These criteria may be used for selection of patients for local excision of down-staged rectal tumors, because patients with p-MR could be easily ruled out.

Citations

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Clinical Outcomes of Local Excision Following Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer
Nam Kwon Lee, Dae Yong Kim, Sun Young Kim, Jae Hwan Oh, Won Park, Doo Ho Choi, Taek-Keun Nam, Kyung-Ja Lee
Cancer Res Treat. 2014;46(2):158-164.   Published online April 15, 2014
DOI: https://doi.org/10.4143/crt.2014.46.2.158
AbstractAbstract PDFPubReaderePub
Purpose

To evaluate the treatment outcomes of local excision following preoperative chemoradiotherapy in patients with locally advanced rectal cancer who have not undergone radical surgery for any reason.

Materials and Methods

The data of 27 patients with locally advanced rectal cancer who underwent preoperative chemoradiotherapy followed by local excision were analyzed retrospectively. The primary endpoint was the 5-year relapse-free survival rate, and the secondary endpoint was the pattern of recurrence.

Results

The median follow-up time was 81.8 months (range, 28.6 to 138.5 months). The 5-year local relapse-free survival (LRFS), distant metastasis-free survival (DMFS), relapse-free survival (RFS), and overall survival (OS) were 88.9%, 81.1%, 77.8%, and 85.0%, respectively. Six (22%) patients developed treatment failure; one (4%) patient had local recurrence only, three (11%) patients had distant recurrence only, and two (7%) patients had both. The 5-year LRFS, DMFS, RFS, and OS for patients with ypT0-1 compared with ypT2-3 were 94.1% vs. 77.8% (p=0.244), 94.1% vs. 55.6% (p=0.016), 88.2% vs. 55.6% (p=0.051), and 94.1% vs. 66.7% (p=0.073), respectively.

Conclusion

Local excision following preoperative chemoradiotherapy may be an alternative treatment for highly selected patients with locally advanced rectal cancer who have achieved ypT0-1 after preoperative chemoradiotherapy.

Citations

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Expressions of Blood Group Antigen A in Lung Cancer
Pyo Seong Han, Suk Chul Hong, Jong Jin Lee, Hai Jung Cho, Ae Kyung Kim, Ju Ock Kim, Sun Young Kim
J Korean Cancer Assoc. 1994;26(5):770-778.
AbstractAbstract PDF
Background
Blood group anti#gens A, B, and H, identical with those present in erythrocytes, are also found in some normal tissues. The expression of blood group antigens allows the identification of residual pneumocytes inside the tumor and the proper classification of some neoplasms. Variability of blood group antigen expression among tumor cells is a potentially useful indicator of functional tumor cell heterogeneity or progression. We evaluated the prognostic value of expression of blood group antigen A as a prognostic factors. Method: This study analyzed the expressions and losses of blood group antigen A in lung cancer patients with blood type A or AB. The presence of blood-group antigens was assessed immunohistochemically in paraffin-embedded tumor samples from 30 patients who underwent curative surgery, bronchoscopic biopy, percutaneous needle biopsy, lymph node biopsy for diagnosis of lung cancer from 1991 through 1994. Results; 1) The expression of blood group isoantigen A was observed in 15 cases (50%) 2) The expression of blaod group isoantigen A was observed in 64% of stage II, 47% of stage III, 25% of stage IV. 3) The expression of blood group isoantigen A was observed in 0% of large cell carcinoma, 17 % of small cell carcinoma, 63% of squamous cell carcinoma, 50% of adenocarcinoma, 100% of bronchioloalveolar cell carcinoma. 4) The losses of blood group isoantigen A were observed in 67% of patient who survived below 1 year, 44% of patients who survived 1 to 2 years, but no loss of expression were observed in patients who survived more than 2 years. 5) The median survival times of expressed group and lossed group of isoantigen A were 16.0, 9.8 months, respetively. 6) The loss of blood group antigen A was higher in patients who had metastatic lymph nade than in patients who had not. Conclusion: the expression of blood group antigen A in cancer cells is important favorable prognostic factor in patients with lung cancer.
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Neoadjuvant Chemotherapy in Locally Advanced Non - Small Cell Lung Cancer
Hai Jung Cho, Kyoung Sang Shin, Sang Ki Park, Ae Kyung Kim, Jong Jin Lee, Nam Jae Kim, Jee Won Seo, Ju Ock Kim, Seung Pyung Lim, Sun Young Kim
J Korean Cancer Assoc. 1995;27(4):608-620.
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Interphase Cytogenetic Analysis of Gastric Carcinogenesis using Chromosome in Situ Hybridization
Sun Young Kim, Ji Yun Bae, Jee Won Seo, Sang Suk Lee
J Korean Cancer Assoc. 1996;28(3):418-427.
AbstractAbstract PDF
Gastric cancer development has been proposed to present a multistep process characterized by dysregulation of proliferation and differentiation and driven by an accumulation of genetic alterations in anatomic field repeatedly exposed to carcinogens. As a first part,of research for gastric carcinogenesis and prevention, we probed 30 early gastric cancers and their adjacent normal tissue including premalignant lesions for numerical chromosome aberrations by nonisotopic, in situ hybridization using chromosome specific centromeric DNA probe for chromosome 17, to visualize the accumulation of genetic alterations during gastric carcinogenesis and to determine the extent of the genetically altered field. The mean chromosome index(CI) increased as the tissue passed from normal adjacent gland(NG) to intestinal metaplasia(IM) to cancer(EGC) (l.06, 1.12, 1.26). Moreover, the frequency of cells with chromosome polysomy (cells with 3 or more chromosome copies) increased as same pattern (4.2%, 9.4%, 20.2%). All cases with EGC, 28/30 cases with IM, 15/30 cases with NG showed significant polysomies(i.e., polysomy frequency > 3% of total populations). As a second part of investigation, 30 cases of gastric adenoma tissue were probe with same centromeric chromosome probes for 5 and 17, to visualize the genetic alteration of isolated benign or premalignant gastric lesion. The mean CI were 1.16 and 1.17, respectively and the frequency of polysomy were 7.6% and 4.0%, respectively. These findings of progressive genetic changes as the the tumor develops support the concept of multistep carcinogenesis and field cancerization. Such genetic parameters could serve as biomarkers of intermediate end points for risk assessment of progression to malignancy or chemoprevention trials.
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Cancer Res Treat : Cancer Research and Treatment
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