Cancer Research and Treatment

Original Articles

Long-term Prognostic Value and Analytical Parameters of the Next-Generation Sequencing–Based Multigene Assay in Hormone Receptor–Positive, HER2-Negative Breast Cancer: Hyunji Kim, Jiwon Koh, Hyunwoo Lee, Gyungyub Gong, Sujin Oh, Jiyoung Lee, Ho Eun Chang, Yunhee Choi, Eunhye Kang, Jai Min Ryu, Dong Seung Shin, Sae Byul Lee, Hee Jin Lee, Hong-Kyu Kim, Hee-Chul Shin, Wonshik Han, Han-Byoel Lee, Kyoung Un Park; Received July 7, 2025 Accepted August 29, 2025 Published online September 1, 2025; DOI: https://doi.org/10.4143/crt.2025.701 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Purpose
In hormone receptor (HR)–positive, human epidermal growth factor receptor 2 (HER2)–negative early breast cancer, gene expression testing facilitates treatment decisions. A next-generation sequencing (NGS)–based assay was developed to address test decentralization and underrepresentation of younger/premenopausal patients. We aimed to validate the long-term prognostic value of the NGS-based assay and analyze its quality control (QC) parameters.
Materials and Methods
We analyzed samples from 265 patients with breast cancer with at least 10 years of follow-up. We evaluated the long-term prognostic ability of the NGS-based assay according to the risk groups for distant recurrence, as determined by the Decision Index, and the performance of the QC parameters used for the experimental process.
Results
Among 265 participants, 60.4% were ≤ 50 years old, and 39 (14.7%) experienced distant recurrence within 10 years. In the Decision Index–stratified low- and high-risk groups (n=186, 70.2% and n=79, 29.8%), 10-year distant metastasis–free survival rates were 96.1% (95% confidence interval [CI], 92.1 to 98.1) and 79.3% (95% CI, 68.4 to 86.8), respectively. In patients aged ≤ 50 years, the high-risk group had a hazard ratio of 5.89 (95% CI, 2.84 to 12.20). Analyses including 106 samples that failed the stringent QC criteria showed inferior prognostic value, wherein DV200 and cDNA concentrations were the most crucial parameters.
Conclusion
We validated the prognostic ability of an NGS-based assay to stratify HR-positive/HER2-negative breast cancers and predict the risk of distant recurrence, and confirmed the requirement for stringent QC criteria to ensure its prognostic ability.

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Age-Period-Cohort Analysis of Female Breast Cancer Mortality in Korea: Yunhee Choi, Yeonju Kim, Sue K. Park, Hai-Rim Shin, Keun-Young Yoo; Cancer Res Treat. 2016;48(1):11-19. Published online May 14, 2015; DOI: https://doi.org/10.4143/crt.2015.021

Purpose
Despite the low mortality rate of breast cancer among women in Korea, the breast cancer mortality rate has increased. The aim of this study was to examine trends in breast cancer mortality from 1983 to 2012 in Korea, assessing the importance of age, period, and birth cohort as risk factors.
Materials and Methods
Data on the annual number of deaths due to female breast cancer and on female population statistics from 1983 to 2012 were obtained from Statistics Korea. A log-linear Poisson ageperiod- cohort model was used to estimate age, period, and cohort effects.
Results
The increasing breast cancer mortality can be explained predominantly by a birth cohort effect: the risk of breast cancer death showed a steady increase until the 1968 birth cohort, and decreased thereafter. There was a sharp increase in the magnitude of the age effect up to 60 years old, then a moderate increase in the effect during the sixties, followed by another sharp increase from 70 years old. The period effect on breast cancer mortality seems negligible based on its adjusted relative risk, even though it was statistically significant after adjusting for age and cohort effects.
Conclusion
In this study, the mortality pattern of breast cancer in Korea can be explained predominantly by a birth cohort effect. Hence, the overall mortality rate of breast cancer may increase for a while, and show a gradual decrease in the future, which will start from the younger age group.

Citations

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Increased breast cancer mortality only in the lower education group: age-period-cohort effect in breast cancer mortality by educational level in South Korea, 1983-2012
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Erratum

Correction: Long Term Trends and the Future Gastric Cancer Mortality in Korea: 1983~2013: Yunhee Choi, Jin Gwack, Yeonju Kim, Jisuk Bae, Jae-Kwan Jun, Kwang-Pil Ko, Keun-Young Yoo; Cancer Res Treat. 2007;39(1):44-46. Published online March 31, 2007; DOI: https://doi.org/10.4143/crt.2007.39.1.44; Corrects: Cancer Res Treat 2006;38(1):7

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Original Article

Long Term Trends and the Future Gastric Cancer Mortality in Korea: 1983~2013: Yunhee Choi, Jin Gwack, Yeonju Kim, Jisuk Bae, Jae-Kwan Jun, Kwang-Pil Ko, Keun-Young Yoo; Cancer Res Treat. 2006;38(1):7-12. Published online February 28, 2006; DOI: https://doi.org/10.4143/crt.2006.38.1.7; Correction in: Cancer Res Treat 2007;39(1):44

Abstract PDF PubReader ePub

Purpose

In spite of gastric cancer's decreasing incidence and mortality rates, it is still the most common cancer in Korea. In the present study, we examined the temporal trends of gastric cancer mortality during the past 20 years in Korea by using an age-period-cohort model, and we predicted the mortality rates for the next 10 years.

Materials and Methods

Data on the annual number of deaths due to gastric cancer and data on population statistics from 1984 to 2003 were obtained from the Korean National Statistical Office. A log-linear Poisson age-period-cohort model was used to estimate age, period and birth cohort effects. To project two periods (10 years) into the future, the new cohort values were estimated by performing linear regression that was applied to a chosen number of the most recent cohort values.

Results

The trends of gastric cancer mortality were predominantly explained by the cohort effect; the risk of gastric cancer death decreased since the 1919 birth cohort for both genders. The predicted, expected age-adjusted mortality rates per 100,000 for males and females are 45.72 and 23.75, respectively, during 2004~2008, and 34.62 and 17.93 respectively, during 2009~2013. During 2004~2008 and 2009~2013, the predicted numbers of deaths due to gastric cancer in males are 36,922 and 27,959, respectively, whereas those in females are 19,698 and 14,869, respectively.

Conclusions

Not only the mortality, but also the incidence of gastric cancer in Korea is expected to further decrease in both men and women if the trends of the past 20 years continue.

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