Cancer Research and Treatment

Original Articles

Breast cancer

Short-term Impact of Hormone Replacement Therapy on Risk of Breast Cancer in BRCA Mutation Carriers: A Nationwide Study in South Korea: Hye Yeon Kim, Jisoo Park, Seok Joo Moon, Sohyeon Jeong, Jin Hwa Hong, Jae Kwan Lee, Geum Joon Cho, Hyun-Woong Cho; Cancer Res Treat. 2024;56(1):143-148. Published online August 16, 2023; DOI: https://doi.org/10.4143/crt.2023.653

Purpose
BRCA1/2 mutations are well-known risk factors for breast and ovarian cancers in women. Risk-reducing salpingo-oophorectomy (RRSO) is the standard treatment for preventing ovarian cancer with BRCA mutations. Postmenopausal syndrome (symptoms after RRSO can be alleviated by hormone replacement therapy (HRT); however, the use of HRT in carriers of BRCA mutations has been controversial because of the concern that HRT increases the risk of breast cancer. This study aimed to evaluate the effects of HRT in BRCA mutation carriers who underwent RRSO.
Materials and Methods
A total of 151 carriers, who underwent RRSO between 2013 and 2020 after the diagnosis of BRCA1 or BRCA2 mutations were selected and followed up for a median of 3.03 years. Patients were divided into two groups: those who received HRT after RRSO (n=33) and those who did not (n=118). We compared the incidence of breast cancer over time between these two groups.
Results
There was no significant difference in the incidence of breast cancer between women who received HRT and those who did not (p=0.229). Multivariate logistic regression analysis, adjusted for age and parity revealed no significant difference in the risk of breast cancer between these two groups (hazard ratio, 0.312; 95% confidence interval, 0.039 to 2.480; p=0.278).
Conclusion
In this study, we found no relationship between post-RRSO HRT and breast cancer in the population with BRCA mutations. Therefore, healthcare providers may consider the alleviation of symptoms of postmenopausal syndrome through HRT in patients who underwent RRSO.

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A contemporary review of breast cancer risk factors and the role of artificial intelligence
Orietta Nicolis, Denisse De Los Angeles, Carla Taramasco
Frontiers in Oncology.2024;[Epub] CrossRef

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Gynecologic cancer

Germline and Somatic BRCA1/2 Gene Mutational Status and Clinical Outcomes in Epithelial Peritoneal, Ovarian, and Fallopian Tube Cancer: Over a Decade of Experience in a Single Institution in Korea: Se Ik Kim, Maria Lee, Hee Seung Kim, Hyun Hoon Chung, Jae-Weon Kim, Noh Hyun Park, Yong-Sang Song; Cancer Res Treat. 2020;52(4):1229-1241. Published online July 27, 2020; DOI: https://doi.org/10.4143/crt.2020.557

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to present a single institutional experience with BRCA1/2 gene tests and the effects of pathogenic mutations in epithelial peritoneal, ovarian, and fallopian tube cancer (POFTC) on survival outcomes.
Materials and Methods
We identified patients with epithelial POFTCs who underwent BRCA1/2 gene testing by either germline or somatic methods between March 2007 and March 2020. Based on the BRCA1/2 test results, patients were divided into BRCA mutation and wild-type groups, followed by comparisons of clinicopathologic characteristics and survival outcomes after primary treatment.
Results
The annual number of POFTC patients who received BRCA1/2 gene tests increased gradually. In total, 511 patients were included and BRCA1/2 mutations were observed in 143 (28.0%). Among 57 patients who received both germline and somatic tests, three (5.3%) showed discordant results from the two tests. Overall, no differences in progression-free survival (PFS; p=0.467) and overall survival (p=0.641) were observed between the BRCA mutation and wild-type groups; however, multivariate analyses identified BRCA1/2 mutation as an independent favorable prognostic factor for PFS (adjusted hazard ratio [aHR], 0.765; 95% confidence interval [CI], 0.593 to 0.987; p=0.040). In 389 patients with International Federation of Gynecology and Obstetrics stage III-IV, different results were shown depending on primary treatment strategy: while BRCA1/2 mutation significantly improved PFS in the subgroup of neoadjuvant chemotherapy (aHR, 0.619; 95% CI, 0.385 to 0.995; p=0.048), it did not affect patient PFS in the subgroup of primary debulking surgery (aHR, 0.759; 95% CI, 0.530 to 1.089; p=0.135).
Conclusion
BRCA1/2 mutations are frequently observed in patients with epithelial POFTCs, and such patients showed better PFS than did those harboring wild-type BRCA1/2.

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Overview of Molecular Diagnostics in Irish Clinical Oncology
Tyler Medina, Seán O. Hynes, Maeve Lowery, Paddy Gillespie, Walter Kolch, Cathal Seoighe
HRB Open Research.2024; 7: 16. CrossRef
Trends in the Incidence and Survival Rates of Primary Ovarian Clear Cell Carcinoma Compared to Ovarian Serous Carcinoma in Korea
Se Ik Kim, Hyeong In Ha, Kyung Jin Eoh, Jiwon Lim, Young-Joo Won, Myong Cheol Lim
Frontiers in Oncology.2022;[Epub] CrossRef
Characteristics of homologous recombination repair pathway genes mutation in ovarian cancers
Zongbi Yi, Min Chen, Shaoxing Sun, Chunxu Yang, Zijie Mei, Hui Yang, Qingming Xiang, Hui Qiu
Cancer Innovation.2022; 1(3): 220. CrossRef

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Oncologic, Perioperative Outcomes of Female Radical Cystectomy: Results from a Multicenter Study in Korea: Ji Sung Shim, Ho Kyung Seo, Ja Hyeon Ku, Byong Chang Jeong, Bumsik Hong, Seok Ho Kang, UCART (Urothelial Cancer-Advanced Research and Treatment Group in Korea) Group; Cancer Res Treat. 2019;51(3):1064-1072. Published online October 30, 2018; DOI: https://doi.org/10.4143/crt.2018.515

Abstract PDF PubReader ePub

Purpose
The lower incidence of bladder cancer among women has led to a lack of information on female radical cystectomy (RC). This study aimed to analyze the characteristics related with female RC in a cohort from multiple academic institutions.
Materials and Methods
This was a retrospective review of 384 female patients who underwent RC for bladder cancer. Epidemiologic, perioperative variables including urologic referral periodwith consequent pathologic stage distributions were assessed. The changes in surgical techniques over time were illustrated. Also, we evaluated recurrence-free survival (RFS) at 2 and 5 years and overall survival (OS) at 5 years with stage-specific analyses using the Kaplan-Meier method.
Results
The mean follow-up time was 35 months (interquartile rage [IQR], 9 to 55). The average time to urologic referral with initial symptoms was 5.5 (IQR, 1 to 6) months and over 20% of patients visited clinics after 6 months. In subsequent stage distributions according to referral period, T2 or higher stage distributions were abruptly increased after 1 year. Overall 2-year/5-year RFS rates were 0.72/0.57 and 5-year OS was 0.61. Notable surgical descriptions were as follows: 91% of patients underwent open RC; 80% of patients underwent an ileal conduit; and 83% of patients received anterior exenteration. However, the proportions of robotic surgery, orthotopic neobladder and organ sparing cystectomy have increased recen-tly.
Conclusion
We identified the general characteristics and changes in pattern of female RC. Our results also suggest that women are susceptible to delays in referral to an urologist and are at greater risk for worse prognosis.

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Perioperative, oncological, and survival outcomes of robotic radical cystectomy with urinary diversion in females
Varun V. Agarwal, B. Yuvaraja Thyavihally, Santosh Subhash Waigankar, Preetham Dev, Abhinav P. Pednekar, Diptiman Roy, Nevitha Athikari, Meenal Hastak, Naresh Badlani, D. Harshwardhan Pokharkar, Nagaraja Sekhar Ayyalasomayajula, Archan Khandekar, Ashish A
Indian Journal of Urology.2023; 39(1): 27. CrossRef
Safety and Efficacy of Reproductive Organ-Sparing Radical Cystectomy in Women With Variant Histology and Advanced Stage
Sunil H. Patel, Shirley Wang, Meredith R. Metcalf, Natasha Gupta, Andrew Gabrielson, Esther Lee, Mary Rostom, Phil Pierorazio, Armine Smith, Noah Hahn, Mark Schoenberg, Max Kates, Jean Hoffman-Censits, Trinity J. Bivalacqua
Clinical Genitourinary Cancer.2022; 20(1): 60. CrossRef
The learning curve for robot-assisted radical cystectomy with total intracorporeal urinary diversion based on radical cystectomy pentafecta
Tae Il Noh, Ji Sung Shim, Sung Gu Kang, Jun Cheon, Jong Hyun Pyun, Seok Ho Kang
Frontiers in Oncology.2022;[Epub] 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

Abstract PDF Supplementary Material PubReader ePub

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

Citations to this article as recorded by

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
Distribution of Solid Lung Nodules Presence and Size by Age and Sex in a Northern European Nonsmoking Population
Jiali Cai, Marleen Vonder, Gert Jan Pelgrim, Mieneke Rook, Gerdien Kramer, Harry J.M. Groen, Geertruida H. de Bock, Rozemarijn Vliegenthart, Albert de Roos
Radiology.2024;[Epub] CrossRef
Toward More Effective Lung Cancer Risk Stratification to Empower Screening Programs for the Asian Nonsmoking Population
Fu-Zong Wu, Yeun-Chung Chang
Journal of the American College of Radiology.2023; 20(2): 156. CrossRef
ACR Appropriateness Criteria® Lung Cancer Screening: 2022 Update
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
European Radiology.2023; 34(3): 1877. CrossRef
Preoperative computed tomography-guided patent blue localization for pulmonary nodules
Po-Chih Chang, Shah-Hwa Chou, Che-Yu Chuang, I-Hsiao Yang, Yu-Wei Liu, Ming-Cheng Shi, Reu-Sheng Sheu, Ting-Wei Chang
Formosan Journal of Surgery.2022; 55(3): 102. CrossRef
Lung cancer screening in never-smokers: facts and remaining issues
Maurizio V. Infante, Giuseppe Cardillo
European Respiratory Journal.2020; 56(5): 2002949. CrossRef
Low-dose chest computed tomographic screening and invasive diagnosis of pulmonary nodules for lung cancer in never-smokers
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
European Respiratory Journal.2020; 56(5): 2000177. CrossRef
Predicting Lung Cancer Occurrence in Never-Smoking Females in Asia: TNSF-SQ, a Prediction Model
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
Cancer Epidemiology, Biomarkers & Prevention.2020; 29(2): 452. CrossRef
Role of Low-Dose Computerized Tomography in Lung Cancer Screening among Never-Smokers
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
Journal of Thoracic Oncology.2019; 14(3): 436. CrossRef
Prevention and Early Detection for NSCLC: Advances in Thoracic Oncology 2018
Haval Balata, Kwun M. Fong, Lizza E. Hendriks, Stephen Lam, Jamie S. Ostroff, Nir Peled, Ning Wu, Charu Aggarwal
Journal of Thoracic Oncology.2019; 14(9): 1513. CrossRef

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Clinicopathological Analysis of Female Gastric Cancer - Comparative study according to the sex fo the patients: Jin Pok Kim, Hang Jong Yu, Young Chul Kim, Soo Jin Kim, Joo Ho Lee, Han Kwang Yang; J Korean Cancer Assoc. 1998;30(5):879-885.

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the differences of the clinicopathological features and survival rates in gastric cancer according to the sex of the patients.
MATERIALS AND METHODS
We reviewed 5,784 cases of gastric cancer patients who underwent laparotomy at the Department of Surgery, Seoul National University Hospital fmm Jan. 1986 to Dec. 1995. We have analyzed clinicopathologic features including tumor location, Bonmann type, depth of invasicm, lymph node metastasis, distant metastasis, TNM stage, histologic differentiation and survival rates according to the sex of the patients.
RESULTS
The mean age of female patients was 52.4 years, which is lower than that of male, 54.8 years. There were no differences in tumor location, Borrmann type, depth of invasion, lymph node metastasis, distant metastasis, TNM stage of tumor between male and female. But there were some differences in histologic differentiation; well- and moderately differentiated cancers were more common in male and signet-ring cell cancers were more common in female. Female shows slightly better prognosis than male. But the prognosis of young female was poorer than that of young male.
CONCLUSION
In gastric cancer patients, differences in histologic differentiation and more aggressive nature of the signet-ring cell cancer in female may affect the survival differences according to the sex.

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