Cancer Research and Treatment

Original Articles

Novel Bronchoscopy Method for Molecular Profiling of Lung Cancer: Targeted Washing Technique: Mi-Hyun Kim, Hayoung Seong, Hyojin Jang, Saerom Kim, Wanho Yoo, Soo Han Kim, Jeongha Mok, Kwangha Lee, Ki Uk Kim, Min Ki Lee, Jung Seop Eom; Received November 25, 2024 Accepted February 25, 2025 Published online February 26, 2025; DOI: https://doi.org/10.4143/crt.2024.1128 [Accepted]

Abstract PDF: Purpose
There have been efforts to find alternative samples other than standard samples of tissue or plasma for mutational analyses for lung cancer patients. However, no other sample or technique has replaced the mutational analyses using standard samples. In this prospective study, we assessed a novel bronchoscopy method, named as targeted washing technique, for detecting the EGFR mutation.
Materials and Methods
A 3.0-mm ultrathin bronchoscope was precisely navigated to the target lung lesion with the assistance of virtual bronchoscopic navigation and fluoroscopy. Once the bronchoscope is placed in front of target lung lesion, 0.9% normal saline was instilled for targeted washing. EGFR testing using targeted washing fluid (TWF) was compared to standard methods using plasma or tumor tissue.
Results
In 41 TWF samples, the T790M mutation was detected in tissue, plasma, and TWF samples at rates of 22%, 10%, and 29%, respectively. The overall EGFR T790M detection rate using tissue, plasma, or TWF samples was 37%, with TWF samples increasing the T790M mutation detection rate by up to 10%. The accuracy of T790M mutation detection using TWF sample was 83% compared with standard samples. Four patients were found to have the EGFR T790M mutation solely through EGFR testing using TWF, which repeated rebiopsies using either plasma or tissue finally confirmed to have the T790M mutation.
Conclusion
We demonstrated the clinical potential of targeted washing technique for molecular testing, which can be a good option to overcome spatial heterogeneity, low sensitivity of plasma sample or technical limitations in collecting tumor tissues.

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Breast cancer

Molecular Classification of Breast Cancer Using Weakly Supervised Learning: Wooyoung Jang, Jonghyun Lee, Kyong Hwa Park, Aeree Kim, Sung Hak Lee, Sangjeong Ahn; Cancer Res Treat. 2025;57(1):116-125. Published online June 25, 2024; DOI: https://doi.org/10.4143/crt.2024.113

Abstract PDF Supplementary Material PubReader ePub: Purpose
The molecular classification of breast cancer is crucial for effective treatment. The emergence of digital pathology has ushered in a new era in which weakly supervised learning leveraging whole-slide images has gained prominence in developing deep learning models because this approach alleviates the need for extensive manual annotation. Weakly supervised learning was employed to classify the molecular subtypes of breast cancer.
Materials and Methods
Our approach capitalizes on two whole-slide image datasets: one consisting of breast cancer cases from the Korea University Guro Hospital (KG) and the other originating from The Cancer Genomic Atlas dataset (TCGA). Furthermore, we visualized the inferred results using an attention-based heat map and reviewed the histomorphological features of the most attentive patches.
Results
The KG+TCGA-trained model achieved an area under the receiver operating characteristics value of 0.749. An inherent challenge lies in the imbalance among subtypes. Additionally, discrepancies between the two datasets resulted in different molecular subtype proportions. To mitigate this imbalance, we merged the two datasets, and the resulting model exhibited improved performance. The attentive patches correlated well with widely recognized histomorphologic features. The triple-negative subtype has a high incidence of high-grade nuclei, tumor necrosis, and intratumoral tumor-infiltrating lymphocytes. The luminal A subtype showed a high incidence of collagen fibers.
Conclusion
The artificial intelligence (AI) model based on weakly supervised learning showed promising performance. A review of the most attentive patches provided insights into the predictions of the AI model. AI models can become invaluable screening tools that reduce costs and workloads in practice.

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General

Clinicopathological Characteristics of NRG1 Fusion–Positive Solid Tumors in Korean Patients: Yoon Jin Cha, Chung Lee, Bio Joo, Kyung A Kim, Choong-kun Lee, Hyo Sup Shim; Cancer Res Treat. 2023;55(4):1087-1095. Published online June 15, 2023; DOI: https://doi.org/10.4143/crt.2023.682

Abstract PDF PubReader ePub

Purpose
Neuregulin 1 (NRG1) gene fusion is a potentially actionable oncogenic driver. The oncoprotein binds to ERBB3-ERBB2 heterodimers and activates downstream signaling, supporting a therapeutic approach for inhibiting ERBB3/ERBB2. However, the frequency and clinicopathological features of solid tumors harboring NRG1 fusions in Korean patients remain largely unknown.
Materials and Methods
We reviewed archival data from next-generation sequencing panel tests conducted at a single institution, specifically selecting patients with in-frame fusions that preserved the functional domain. The clinicopathological characteristics of patients harboring NRG1 fusions were retrospectively reviewed.
Results
Out of 8,148 patients, NRG1 fusions were identified in 22 patients (0.27%). The average age of the patients was 59 years (range, 32 to 78 years), and the male-to-female ratio was 1:1.2. The lung was the most frequently observed primary site (n=13), followed by the pancreaticobiliary tract (n=3), gastrointestinal tract (n=2, stomach and rectum each), ovary (n=2), breast (n=1), and soft tissue (n=1). Histologically, all tumors demonstrated adenocarcinoma histology, with the exception of one case of sarcoma. CD74 (n=8) and SLC3A2 (n=4) were the most frequently identified fusion partners. Dominant features included the presence of fewer than three co-occurring genetic alterations, a low tumor mutation burden, and low programmed death-ligand 1 expression. Various clinical responses were observed in patients with NRG1 fusions.
Conclusion
Despite the rarity of NRG1 fusions in Korean patients with solid tumors, identification through next-generation sequencing enables the possibility of new targeted therapies.

Citations

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Continuous multimodal data supply chain and expandable clinical decision support for oncology
Jee Suk Chang, Hyunwook Kim, Eun Sil Baek, Jeong Eun Choi, Joon Seok Lim, Jin Sung Kim, Sang Joon Shin
npj Digital Medicine.2025;[Epub] CrossRef
Expert Consensus on the Diagnosis and Treatment of NRG1/2 Gene Fusion Solid Tumors
Chunwei Xu, Qian Wang, Dong Wang, Wenxian Wang, Wenfeng Fang, Ziming Li, Aijun Liu, Jinpu Yu, Wenzhao Zhong, Zhijie Wang, Yongchang Zhang, Jingjing Liu, Shirong Zhang, Xiuyu Cai, Anwen Liu, Wen Li, Ping Zhan, Hongbing Liu, Tangfeng Lv, Liyun Miao, Lingfen
Global Medical Genetics.2024; 11(01): 086. CrossRef
Analysis on the pathogenesis and treatment progress of NRG1 fusion-positive non-small cell lung cancer
Hongyan Li, Lina Xu, Hongshun Cao, Tianyi Wang, Siwen Yang, Yixin Tong, Linlin Wang, Qiang Liu
Frontiers in Oncology.2024;[Epub] CrossRef
Analysis of CD74 Occurrence in Oncogenic Fusion Proteins
Jasmine Vargas, Georgios Pantouris
International Journal of Molecular Sciences.2023; 24(21): 15981. CrossRef

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Comparison of the Data of a Next-Generation Sequencing Panel from K-MASTER Project with That of Orthogonal Methods for Detecting Targetable Genetic Alterations: Yoon Ji Choi, Jung Yoon Choi, Ju Won Kim, Ah Reum Lim, Youngwoo Lee, Won Jin Chang, Soohyeon Lee, Jae Sook Sung, Hee-Joon Chung, Jong Won Lee, Eun Joo Kang, Jung Sun Kim, Taekyu Lim, Hye Sook Kim, Yu Jung Kim, Mi Sun Ahn, Young Saing Kim, Ji Hyun Park, Seungtaek Lim, Sung Shim Cho, Jang Ho Cho, Sang Won Shin, Kyong Hwa Park, Yeul Hong Kim; Cancer Res Treat. 2022;54(1):30-39. Published online May 20, 2021; DOI: https://doi.org/10.4143/crt.2021.218

Abstract PDF PubReader ePub

Purpose
K-MASTER project is a Korean national precision medicine platform that screened actionable mutations by analyzing next-generation sequencing (NGS) of solid tumor patients. We compared gene analyses between NGS panel from the K-MASTER project and orthogonal methods.
Materials and Methods
Colorectal, breast, non–small cell lung, and gastric cancer patients were included. We compared NGS results from K-MASTER projects with those of non-NGS orthogonal methods (KRAS, NRAS, and BRAF mutations in colorectal cancer [CRC]; epidermal growth factor receptor [EGFR], anaplastic lymphoma kinase [ALK] fusion, and reactive oxygen species 1 [ROS1] fusion in non–small cell lung cancer [NSCLC], and Erb-B2 receptor tyrosine kinase 2 (ERBB2) positivity in breast and gastric cancers).
Results
In the CRC cohort (n=225), the sensitivity and specificity of NGS were 87.4% and 79.3% (KRAS); 88.9% and 98.9% (NRAS); and 77.8% and 100.0% (BRAF), respectively. In the NSCLC cohort (n=109), the sensitivity and specificity of NGS for EGFR were 86.2% and 97.5%, respectively. The concordance rate for ALK fusion was 100%, but ROS1 fusion was positive in only one of three cases that were positive in orthogonal tests. In the breast cancer cohort (n=260), ERBB2 amplification was detected in 45 by NGS. Compared with orthogonal methods that integrated immunohistochemistry and in situ hybridization, sensitivity and specificity were 53.7% and 99.4%, respectively. In the gastric cancer cohort (n=64), ERBB2 amplification was detected in six by NGS. Compared with orthogonal methods, sensitivity and specificity were 62.5% and 98.2%, respectively.
Conclusion
The results of the K-MASTER NGS panel and orthogonal methods showed a different degree of agreement for each genetic alteration, but generally showed a high agreement rate.

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Genomic Profiling of Driver Gene Alterations in Patients With Non–Small Cell Lung Cancer, Patterns of Treatment and Impact on Survival Outcomes: A Single Center Experience of More Than 1200 Patients
Minit Shah, Vanita Noronha, Vijay Patil, Ajay Kumar Singh, Nandini Menon, Supriya Goud, Srushti Shah, Sucheta More, Akhil Kapoor, Bal Krishna Mishra, Pratik Chandrani, Anuradha Chougule, Vinod Gupta, Priyanka Pange, Omshree Shetty, Trupti Pai, Rajiv Kaush
Clinical Lung Cancer.2025;[Epub] CrossRef
Integrated clinical and genomic models using machine-learning methods to predict the efficacy of paclitaxel-based chemotherapy in patients with advanced gastric cancer
Yonghwa Choi, Jangwoo Lee, Keewon Shin, Ji Won Lee, Ju Won Kim, Soohyeon Lee, Yoon Ji Choi, Kyong Hwa Park, Jwa Hoon Kim
BMC Cancer.2024;[Epub] CrossRef
Supporting Biomarker-Driven Therapies in Oncology: A Genomic Testing Cost Calculator
Albrecht Stenzinger, Brian Cuffel, Noman Paracha, Eric Vail, Jesus Garcia-Foncillas, Clifford Goodman, Ulrik Lassen, Gilles Vassal, Sean D Sullivan
The Oncologist.2023; 28(5): e242. CrossRef
Genomic analysis of plasma circulating tumor DNA in patients with heavily pretreated HER2 + metastatic breast cancer
Kyoungmin Lee, Jongwon Lee, Jungmin Choi, Sung Hoon Sim, Jeong Eun Kim, Min Hwan Kim, Yeon Hee Park, Jee Hyun Kim, Su-Jin Koh, Kyong Hwa Park, Myoung Joo Kang, Mi Sun Ahn, Kyoung Eun Lee, Hee-Jun Kim, Hee Kyung Ahn, Han Jo Kim, Keon Uk Park, In Hae Park
Scientific Reports.2023;[Epub] CrossRef
Recommendations for the Use of Next-Generation Sequencing and the Molecular Tumor Board for Patients with Advanced Cancer: A Report from KSMO and KCSG Precision Medicine Networking Group
Shinkyo Yoon, Miso Kim, Yong Sang Hong, Han Sang Kim, Seung Tae Kim, Jihun Kim, Hongseok Yun, Changhoon Yoo, Hee Kyung Ahn, Hyo Song Kim, In Hee Lee, In-Ho Kim, Inkeun Park, Jae Ho Jeong, Jaekyung Cheon, Jin Won Kim, Jina Yun, Sun Min Lim, Yongjun Cha, Se
Cancer Research and Treatment.2022; 54(1): 1. CrossRef

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Carcinoembryonic Antigen Improves the Performance of Magnetic Resonance Imaging in the Prediction of Pathologic Response after Neoadjuvant Chemoradiation for Patients with Rectal Cancer: Gyu Sang Yoo, Hee Chul Park, Jeong Il Yu, Doo Ho Choi, Won Kyung Cho, Young Suk Park, Joon Oh Park, Ho Yeong Lim, Won Ki Kang, Woo Yong Lee, Hee Cheol Kim, Seong Hyeon Yun, Yong Beom Cho, Yoon Ah Park, Kyoung Doo Song, Seok-Hyung Kim, Sang Yun Ha; Cancer Res Treat. 2020;52(2):446-454. Published online September 25, 2019; DOI: https://doi.org/10.4143/crt.2019.261

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to investigate the role of carcinoembryonic antigen (CEA) levels in improving the performance of magnetic resonance imaging (MRI) for the prediction of pathologic response after the neoadjuvant chemoradiation (NCRT) for patients with rectal cancer.
Materials and Methods
We retrospectively reviewed the medical records of 524 rectal cancer patients who underwent NCRT and total mesorectal excision between January 2009 and December 2014. The performances of MRI with or without CEA parameters (initial CEA and CEA dynamics) for prediction of pathologic tumor response grade (pTRG) were compared by receiver-operating characteristic analysis with DeLong’s method. Cox regression was used to identify the independent factors associated to pTRG and disease-free survival (DFS) after NCRT.
Results
The median follow-up was 64.0 months (range, 3.0 to 113.0 months). On multivariate analysis, poor tumor regression grade on MRI (mrTRG; p < 0.001), initial CEA (p < 0.001) and the mesorectal fascia involvement on MRI before NCRT (mrMFI; p=0.054) showed association with poor pTRG. The mrTRG plus CEA parameters showed significantly improved performances in the prediction of pTRG than mrTRG alone. All of mrTRG, mrMFI, and initial CEA were also identified as independent factors associated with DFS. The initial CEA further discriminated DFS in the subgroups with good mrTRG or that without mrMFI.
Conclusion
The CEA parameters significantly improved the performance of MRI in the prediction of pTRG after NCRT for patients with rectal cancer. The DFS was further discriminated by initial CEA level in the groups with favorable MRI parameters.

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Clinical outcomes of neoadjuvant chemoradiotherapy followed by total mesorectal excision in locally advanced rectal cancer with mesorectal fascia involvement
Jeong Ha Lee, Nalee Kim, Jeong Il Yu, Gyu Sang Yoo, Hee Chul Park, Woo-Yong Lee, Seong Hyeon Yun, Hee Cheol Kim, Yong Beom Cho, Jung Wook Huh, Yoon Ah Park, Jung Kyong Shin, Joon Oh Park, Seung Tae Kim, Young Suk Park, Jeeyun Lee, Won Ki Kang
Radiation Oncology Journal.2024; 42(2): 130. CrossRef
Predicting the response to neoadjuvant chemoradiation for rectal cancer using nomograms based on MRI tumour regression grade
S. Qin, Y. Chen, K. Liu, Y. Li, Y. Zhou, W. Zhao, P. Xin, Q. Wang, S. Lu, H. Wang, N. Lang
Cancer/Radiothérapie.2024; 28(4): 341. CrossRef
Body composition parameters combined with blood biomarkers and magnetic resonance imaging predict responses to neoadjuvant chemoradiotherapy in locally advanced rectal cancer
Jianguo Yang, Qican Deng, Zhenzhou Chen, Yajun Chen, Zhongxue Fu
Frontiers in Oncology.2023;[Epub] CrossRef
Pretreatment blood biomarkers combined with magnetic resonance imaging predict responses to neoadjuvant chemoradiotherapy in locally advanced rectal cancer
Xinyu Shi, Min Zhao, Bo Shi, Guoliang Chen, Huihui Yao, Junjie Chen, Daiwei Wan, Wen Gu, Songbing He
Frontiers in Oncology.2022;[Epub] CrossRef
Clinical implication and management of rectal cancer with clinically suspicious lateral pelvic lymph node metastasis: A radiation oncologist’s perspective
Gyu Sang Yoo, Hee Chul Park, Jeong Il Yu
Frontiers in Oncology.2022;[Epub] CrossRef
High-Resolution T2-Weighted MRI to Evaluate Rectal Cancer: Why Variations Matter
Kirsten L Gormly
Korean Journal of Radiology.2021; 22(9): 1475. 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

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Selection Criteria for Active Surveillance of Patients with Prostate Cancer in Korea: A Multicenter Analysis of Pathology after Radical Prostatectomy: Chang Wook Jeong, Sung Kyu Hong, Seok Soo Byun, Seong Soo Jeon, Seong Il Seo, Hyun Moo Lee, Hanjong Ahn, Dong Deuk Kwon, Hong Koo Ha, Tae Gyun Kwon, Jae Seung Chung, Cheol Kwak, Hyung Jin Kim; Cancer Res Treat. 2018;50(1):265-274. Published online April 14, 2017; DOI: https://doi.org/10.4143/crt.2016.477

Abstract PDF Supplementary Material PubReader ePub

Purpose
Korean patients with prostate cancer (PC) typically present with a more aggressive disease than patients in Western populations. Consequently, it is unclear if the current criteria for active surveillance (AS) can safely be applied to Korean patients. Therefore, this study was conducted to define appropriate selection criteria for AS for patients with PC in Korea.
Materials and Methods
We conducted a multicenter retrospective study of 2,126 patients with low risk PC who actually underwent radical prostatectomy. The primary outcome was an unfavorable disease, which was defined by non-organ confined disease or an upgrading of the Gleason score to ≥ 7 (4+3). Predictive variables of an unfavorable outcome were identified by multivariate analysis using randomly selected training samples (n=1,623, 76.3%). We compared our selected criteria to various Western criteria for the primary outcome and validated our criteria using the remaining validation sample (n=503, 23.7%).
Results
A non-organ confined disease rate of 14.9% was identified, with an increase in Gleason score ≥ 7 (4+3) of 8.7% and a final unfavorable disease status of 20.8%. The following criteria were selected: Gleason score ≤ 6, clinical stage T1-T2a, prostate-specific antigen (PSA) ≤ 10 ng/mL, PSA density < 0.15 ng/mL/mL, number of positive cores ≤ 2, and maximum cancer involvement in any one core ≤ 20%. These criteria provided the lowest unfavorable disease rate (11.7%) when compared to Western criteria (13.3%-20.7%), and their validity was confirmed using the validation sample (5.9%).
Conclusion
We developed AS criteria which are appropriate for Korean patients with PC. Prospective studies using these criteria are now warranted.

Citations

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Has Active Surveillance for Prostate Cancer Become Safer? Lessons Learned from a Global Clinical Registry
Chris Bangma, Paul Doan, Lin Zhu, Sebastiaan Remmers, Daan Nieboer, Jozien Helleman, Monique J. Roobol, Mikio Sugimoto, Byung Ha Chung, Lui Shiong Lee, Mark Frydenberg, Laurence Klotz, Michael Peacock, Antoinette Perry, Anders Bjartell, Antti Rannikko, Mi
European Urology Oncology.2025; 8(2): 324. CrossRef
Outcomes of active surveillance for Japanese patients with prostate cancer (PRIAS‐JAPAN)
Takuma Kato, Ryuji Matsumoto, Akira Yokomizo, Yoichiro Tohi, Hiroshi Fukuhara, Yoichi Fujii, Keiichiro Mori, Takuma Sato, Junichi Inokuchi, Katsuyoshi Hashine, Shinichi Sakamoto, Hidefumi Kinoshita, Koji Inoue, Toshiki Tanikawa, Takanobu Utsumi, Takayuki
BJU International.2024; 134(4): 652. CrossRef
Establishment of Prospective Registry of Active Surveillance for Prostate Cancer: The Korean Urological Oncology Society Database
Gyoohwan Jung, Jung Kwon Kim, Seong Soo Jeon, Jae Hoon Chung, Cheol Kwak, Chang Wook Jeong, Hanjong Ahn, Jae Young Joung, Tae Gyun Kwon, Sung Woo Park, Seok-Soo Byun
The World Journal of Men's Health.2023; 41(1): 110. CrossRef
The Role of Magnetic Resonance Imaging (MRI) and MRI-Targeted Biopsy for Active Surveillance
Chang Wook Jeong
Journal of Urologic Oncology.2023; 21(2): 97. CrossRef
Incidence and mortality projections for major cancers among Korean men until 2034, with a focus on prostate cancer
Sahyun Pak, Kyu-Won Jung, Eun-Hye Park, Young Hwii Ko, Young-Joo Won, Jae Young Joung
Investigative and Clinical Urology.2022; 63(2): 175. CrossRef
Role of single nucleotide polymorphisms of the HSD3B1 gene (rs6203 and rs33937873) in the prediction of prostate cancer risk
Yasmine Amrousy, Hesham Haffez, Doaa Abdou, Hanaa Atya
Molecular Medicine Reports.2022;[Epub] CrossRef
A single-center long-term experience of active surveillance for prostate cancer: 15 years of follow-up
Sang Hun Song, Jung Kwon Kim, Hakmin Lee, Sangchul Lee, Sung Kyu Hong, Seok-Soo Byun
Investigative and Clinical Urology.2021; 62(1): 32. CrossRef
The clinical impact of strict criteria for active surveillance of prostate cancer in Korean population: Results from a prospective cohort
Jungyo Suh, Hyeong Dong Yuk, Minyong Kang, Bum Sik Tae, Ja Hyeon Ku, Hyeon Hoe Kim, Cheol Kwak, Chang Wook Jeong
Investigative and Clinical Urology.2021; 62(4): 430. CrossRef
Comparison of Characteristics, Follow-up and Outcomes of Active Surveillance for Prostate Cancer According to Ethnicity in the GAP3 Global Consortium Database
Kerri Beckmann, Aida Santaolalla, Jozien Helleman, Peter Carroll, Byung Ha Chung, Lui Shiong Lee, Antoinette Perry, Jose Rubio-Briones, Mikio Sugimoto, Bruce Trock, Riccardo Valdagni, Prokar Dasgupta, Mieke Van Hemelrijck, Oussama Elhage, Bruce Trock, Beh
European Urology Open Science.2021; 34: 47. CrossRef
Patients with Biopsy Gleason Score 3 + 4 Are Not Appropriate Candidates for Active Surveillance
Juhyun Park, Sangjun Yoo, Min Chul Cho, Chang Wook Jeong, Ja Hyeon Ku, Cheol Kwak, Hyeon Hoe Kim, Hyeon Jeong
Urologia Internationalis.2020; 104(3-4): 199. CrossRef
Current status and progress of focal therapy in Asia
Takumi Shiraishi, Osamu Ukimura
Current Opinion in Urology.2018; 28(6): 529. CrossRef
The MMP2 rs243865 polymorphism increases the risk of prostate cancer: A meta-analysis
Kun Liu, Shuo Gu, Xuzhong Liu, Qing Sun, Yunyan Wang, Junsong Meng, Zongyuan Xu
Oncotarget.2017; 8(42): 72933. CrossRef

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Gastroenteropancreatic Neuroendocrine Tumors with Liver Metastases in Korea: A Clinicopathological Analysis of 72 Cases in a Single Institute: Yooju Shin, Sang Yun Ha, Jiyeon Hyeon, Boram Lee, Jeeyun Lee, Kee-Taek Jang, Kyoung-Mee Kim, Young Suk Park, Cheol-Keun Park; Cancer Res Treat. 2015;47(4):738-746. Published online February 16, 2015; DOI: https://doi.org/10.4143/crt.2014.224

Abstract PDF PubReader ePub

Purpose
Management of gastroenteropancreatic (GEP) neuroendocrine tumors with liver metastases (NETLM) presents many clinical challenges. Assessment of the extent of disease and primary tumor site is crucial for management. In this study, we investigated the primary tumor sites and prognostic factors in GEP NETLM among Korean patients. Materials and Methods We reviewed the medical records of 72 Korean patients diagnosed with GEP NETLM between January 1999 and May 2013, focusing on their clinical and pathologic characteristics.
Results
The most frequently encountered primary tumor sites were the pancreas (n=25, 35%), stomach (n=8, 11%), gall bladder (n=4, 6%) and rectum (n=3, 4%). Twenty-five patients (35%) had occult primary tumor. Twelve patients (17%) had histological grade G1 tumors, 30 patients (42%) had G2 tumors, and 30 patients (42%) had G3 tumors. The mean follow-up period after histological confirmation of hepatic metastases was 11.30±2.44 months for G3 tumors, 19.67±4.09 months for G2 tumors, and 30.67±6.51 months for G1 tumors. Multivariate analyses revealed that an unknown primary tumor site (p=0.001) and higher histological grade (p < 0.001) were independent prognostic indicators for shorter overall survival (OS). Most long-term survivors (OS > 24 months) had received antitumor treatment. Conclusion The primary tumor site most frequently associated with GEP NETLM was the pancreas. Unknown primary tumor and higher histological grade were independent prognostic indicators for shorter OS. Patients identified as being at a risk of shorter OS should be followed up closely.

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The Value of Ultrasound and Contrast‐Enhanced Ultrasound in a Young Asymptomatic Patient With Duodenal Neuroendocrine Neoplasms: A Case Report
Huiyu Yang, Lin Zhao, Xiang Jing, Yanmin Kan
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Clinicopathological Characteristics of Nonfunctional Pancreatic Neuroendocrine Neoplasms and the Effect of Surgical Treatment on the Prognosis of Patients with Liver Metastases: A Study Based on the SEER Database
Abuduhaibaier Sadula, Gang Li, Dianrong Xiu, Chen Ye, Siqian Ren, Xin Guo, Chunhui Yuan, Min Tang
Computational and Mathematical Methods in Medicine.2022; 2022: 1. CrossRef
Effects of tumor origins and therapeutic options on the prognosis of hepatic neuroendocrine tumors
Xiaoxiao Jiao, Wenqing Luan, Xiaoqian Peng, Lu Liu, Lianfeng Zhang, Lin Zhou
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Analysis of B-ultrasound and contrast-enhanced ultrasound characteristics of different hepatic neuroendocrine neoplasm
Xiao-Ning Kang, Xiao-Yu Zhang, Jie Bai, Zun-Yi Wang, Wen-Jie Yin, Li Li
World Journal of Gastrointestinal Oncology.2019; 11(5): 436. CrossRef
Prognostic and predictive factors on overall survival and surgical outcomes in pancreatic neuroendocrine tumors: recent advances and controversies
Lingaku Lee, Tetsuhide Ito, Robert T Jensen
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Quang Duy Pham, Ichiro Mori, Robert Y. Osamura
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Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Yuichi Waragai, Mika Takasumi, Satoshi Kawana, Yuko Hashimoto, Takuto Hikichi, Hiromasa Ohira
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Gastroenteropancreatic—origin neuroendocrine carcinomas
Yong Gyun Won, Kyung-Jin Seo, Jiyeon Hyeon, Ok Ran Shin, Eundeok Chang, Der Sheng Sun, Hae Sung Won, Yoon Ho Ko, Sae Jung Na, Su Lim Lee, Young Mi Ku, Dong Soo Lee
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A retrospective cohort study of pancreatic neuroendocrine tumors at single institution over 15 years: New proposal for low- and high-grade groups, validation of a nomogram for prognosis, and novel follow-up strategy for liver metastases
Liangtao Ye, Huilin Ye, Quanbo Zhou, Zhihua Li, Qing Lin, Langping Tan, Wenchao Gao, Zhiqiang Fu, Shangyou Zheng, Rufu Chen
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Bita Geramizadeh, Ali Kashkooe, Seyed Ali Malekhosseini
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Neuroendocrine neoplasms of liver - A 5-year retrospective clinico-pathological study applying World Health Organization 2010 classification
Deepak Kalyansingh Burad, Thomas Alex Kodiatte, Sayd Mohamed Rajeeb, Ashish Goel, Chundamannil Eapen Eapen, Banumathi Ramakrishna
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The Journal of Medical Investigation.2015; 62(3.4): 251. CrossRef

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Current Trends of the Incidence and Pathological Diagnosis of Gastroenteropancreatic Neuroendocrine Tumors (GEP-NETs) in Korea 2000-2009: Multicenter Study: Mee-Yon Cho, Joon Mee Kim, Jin Hee Sohn, Mi-Jung Kim, Kyoung-Mee Kim, Woo Ho Kim, Hyunki Kim, Myeong-Cherl Kook, Do Youn Park, Jae Hyuk Lee, HeeKyung Chang, Eun Sun Jung, Hee Kyung Kim, So-Young Jin, Joon Hyuk Choi, Mi Jin Gu, Sujin Kim, Mi Seon Kang, Chang Ho Cho, Moon-Il Park, Yun Kyung Kang, Youn Wha Kim, Sun Och Yoon, Han Ik Bae, Mee Joo, Woo Sung Moon, Dae Young Kang, Sei Jin Chang; Cancer Res Treat. 2012;44(3):157-165. Published online September 30, 2012; DOI: https://doi.org/10.4143/crt.2012.44.3.157

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PURPOSE
As a result of various independently proposed nomenclatures and classifications, there is confusion in the diagnosis and prediction of biological behavior of gastroenteropancreatic neuroendocrine tumors (GEP-NETs). A comprehensive nationwide study is needed in order to understand the biological characteristics of GEP-NETs in Korea.
MATERIALS AND METHODS
We collected 4,951 pathology reports from 29 hospitals in Korea between 2000 and 2009. Kaplan-Meier survival analysis was used to determine the prognostic significance of clinicopathological parameters.
RESULTS
Although the GEP-NET is a relatively rare tumor in Korea, its incidence has increased during the last decade, with the most significant increase found in the rectum. The 10-year survival rate for well-differentiated endocrine tumor was 92.89%, in contrast to 85.74% in well differentiated neuroendocrine carcinoma and 34.59% in poorly differentiated neuroendocrine carcinoma. Disease related death was most common in the biliary tract (62.2%) and very rare in the rectum (5.2%). In Kaplan-Meier survival analysis, tumor location, histological classification, extent, size, mitosis, Ki-67 labeling index, synaptophysin expression, lymphovascular invasion, perineural invasion, and lymph node metastasis showed prognostic significance (p<0.05), however, chromogranin expression did not (p=0.148). The 2000 and 2010 World Health Organization (WHO) classification proposals were useful for prediction of the prognosis of GEP-NET.
CONCLUSION
The incidence of GEP-NET in Korea has shown a remarkable increase during the last decade, however, the distribution of tumors in the digestive system differs from that of western reports. Assessment of pathological parameters, including immunostaining, is crucial in understanding biological behavior of the tumor as well as predicting prognosis of patients with GEP-NET.

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Min Jeong Kim, Mi Jung Kwon, Ho Suk Kang, Kyung Chan Choi, Eun Sook Nam, Seong Jin Cho, Hye-Rim Park, Soo Kee Min, Jinwon Seo, Ji-Young Choe, Hyoung-Chul Park
BioMed Research International.2018; 2018: 1. CrossRef
A meta-analysis of Prognostic factor of Pancreatic neuroendocrine neoplasms
Yong Gao, Hao Gao, Guangfu Wang, Lingdi Yin, Wenbin Xu, Yunpeng Peng, Junli Wu, Kuirong Jiang, Yi Miao
Scientific Reports.2018;[Epub] CrossRef
Everolimus in the treatment of neuroendocrine tumors: efficacy, side-effects, resistance, and factors affecting its place in the treatment sequence
Lingaku Lee, Tetsuhide Ito, Robert T. Jensen
Expert Opinion on Pharmacotherapy.2018; 19(8): 909. CrossRef
Pancreatic Neuroendocrine Neoplasms: A Role of Laparoscopy in Surgical Treatment: Review
Jacek Szeliga, Marek Jackowski
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2018; 28(3): 147. CrossRef
Clinicopathological features and outcome for neuroendocrine neoplasms of gastroesophageal junction: A population‐based study
Panpan Zhang, Wei Wang, Ming Lu, Changqing Zeng, Jie Chen, Enxiao Li, Huangying Tan, Wei Wang, Xianjun Yu, Qiyun Tang, Jiemin Zhao, Lin Shen, Jie Li
Cancer Medicine.2018; 7(9): 4361. CrossRef
Neuroendocrine tumors with hepatic metastases: A review of evolving treatment options
Steven D. Colquhoun
Liver Research.2018; 2(2): 92. CrossRef
Endoscopic Treatment Outcome of Rectal Neuroendocrine Tumors Removed by Ligation-assisted Endoscopic Submucosal Resection
Min Geun Gu, Si Hyung Lee
The Korean Journal of Gastroenterology.2018; 72(3): 128. CrossRef
Clinicopathological features and prognosis of patients with gastric neuroendocrine tumors: A population‐based study
Fang‐Xi Tian, Yu‐Qing Cai, Lv‐Ping Zhuang, Ming‐Fang Chen, Zhong‐Biao Xiu, Yi Zhang, Hong Liu, Zhi‐Hong Liu, Guo‐Ping Liu, Chen Zeng, Fei‐Ling Lin, Jing Liu, Si‐Ting Huang, Liang‐Zhi Zhang, Hua‐Yang Lin
Cancer Medicine.2018; 7(11): 5359. CrossRef
Global burden of neuroendocrine tumors and changing incidence in Kentucky
Aman Chauhan, Qian Yu, Neha Ray, Zainab Farooqui, Bin Huang, Eric B. Durbin, Thomas Tucker, Mark Evers, Susanne Arnold, Lowell B. Anthony
Oncotarget.2018; 9(27): 19245. CrossRef
Gastroenteropancreatic neuroendocrine tumor registry study in China
Lin Cong, Wenming Wu, Wenhui Lou, Jinwan Wang, Feng Gu, Jiaming Qian, Jianming Xu, Feng Bi, Sanjun Cai, Chengwei Tang, Yulong He, Jie Zhong, Yupei Zhao
Journal of Pancreatology.2018; 1(1): 35. CrossRef
Incidence and clinical characteristics of gastroenteropancreatic neuroendocrine tumor in Korea: a single-center experience
Chul-Hyun Lim, In Seok Lee, Byoung Yeon Jun, Jin Su Kim, Yu Kyung Cho, Jae Myung Park, Sang Young Roh, Myung Ah Lee, Sang Woo Kim, Myung-Gyu Choi
The Korean Journal of Internal Medicine.2017; 32(3): 452. CrossRef
Uncommon Anal Neoplasms
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Surveillance and comparison of surgical prognosis for asymptomatic and symptomatic non-functioning pancreatic neuroendocrine tumors
Wenhao Ge, Dongkai Zhou, Shaoyan Xu, Weilin Wang, Shusen Zheng
International Journal of Surgery.2017; 39: 127. CrossRef
Recent updates on grading and classification of neuroendocrine tumors
Joo Young Kim, Seung-Mo Hong, Jae Y. Ro
Annals of Diagnostic Pathology.2017; 29: 11. CrossRef
Mixed adenoneuroendocrine carcinoma derived from the cystic duct: A case report
Yu-ki Takemoto, Tomoyuki Abe, Hironobu Amano, Keiji Hanada, Akihito Okazaki, Tomoyuki Minami, Tsuyoshi Kobayashi, Masahiro Nakahara, Shuji Yonehara, Hideki Ohdan, Toshio Noriyuki
International Journal of Surgery Case Reports.2017; 39: 29. CrossRef
Loss of Progesterone Receptor Expression Is an Early Tumorigenesis Event Associated with Tumor Progression and Shorter Survival in Pancreatic Neuroendocrine Tumor Patients
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Journal of Pathology and Translational Medicine.2017; 51(4): 388. CrossRef
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Kyong Joo Lee, Jae Hee Cho, Sang Hyub Lee, Si Young Song, Kwang Hyuk Lee, Seok Jeong, Ji Kon Ryu, Sang Myung Woo, Seungmin Bang, Jong Kyun Lee, Tae Hoon Lee, Woo Hyun Paik, Yong Tae Kim, Woo Jin Lee
Cancer Chemotherapy and Pharmacology.2017; 80(4): 799. CrossRef
Clinicopathological, treatment, and prognosis study of 43 gastric neuroendocrine carcinomas
De-Jun Liu, Xue-Liang Fu, Wei Liu, Lu-Ying Zheng, Jun-Feng Zhang, Yan-Miao Huo, Jiao Li, Rong Hua, Qiang Liu, Yong-Wei Sun
World Journal of Gastroenterology.2017; 23(3): 516. CrossRef
Is endoscopic ultrasonography essential for endoscopic resection of small rectal neuroendocrine tumors?
Su Bum Park, Dong Jun Kim, Hyung Wook Kim, Cheol Woong Choi, Dae Hwan Kang, Su Jin Kim, Hyeong Seok Nam
World Journal of Gastroenterology.2017; 23(11): 2037. CrossRef
Predictive Factors for Lymph Node Metastasis and Prognostic Factors for Survival in Rectal Neuroendocrine Tumors
Beonghoon Sohn, Yoomin Kwon, Seung-Bum Ryoo, Inho Song, Yoon-Hye Kwon, Dong Woon Lee, Sang Hui Moon, Ji Won Park, Seung-Yong Jeong, Kyu Joo Park
Journal of Gastrointestinal Surgery.2017; 21(12): 2066. CrossRef
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Hoonsub So, Su Hyun Yoo, Seungbong Han, Gwang-un Kim, Myeongsook Seo, Sung Wook Hwang, Dong-Hoon Yang, Jeong-Sik Byeon
Clinical Endoscopy.2017; 50(6): 585. CrossRef
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Medicine.2017; 96(49): e9009. CrossRef
Sex comb on midleg like-2 is a novel specific marker for the diagnosis of gastroenteropancreatic neuroendocrine tumors
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Experimental and Therapeutic Medicine.2017; 14(2): 1749. CrossRef
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Jin-Hu Fan, Yu-Qing Zhang, Su-Sheng Shi, Yuan-Jia Chen, Xing-Hua Yuan, Li-Ming Jiang, Shao-Ming Wang, Li Ma, Yu-Tong He, Chang-Yan Feng, Xi-Bin Sun, Qing Liu, Katrina Deloso, Yihebali Chi, You-Lin Qiao
Oncotarget.2017; 8(42): 71699. CrossRef
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Jie Li, Ming Lu, Zhihao Lu, Zhongwu Li, Yiqiang Liu, Li Yang, Jian Li, Xiaotian Zhang, Jun Zhou, Xicheng Wang, Jifang Gong, Jing Gao, Yan Li, Lin Shen
Oncotarget.2017; 8(15): 25669. CrossRef
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Dong-Hoon Yang, Yangsoon Park, Sang Hyoung Park, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang
Gastrointestinal Endoscopy.2016; 83(5): 1015. CrossRef
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Sven-Petter Haugvik, Eva Tiensuu Janson, Pia Österlund, Seppo W. Langer, Ragnhild Sørum Falk, Knut Jørgen Labori, Lene Weber Vestermark, Henning Grønbæk, Ivar Prydz Gladhaug, Halfdan Sorbye
Annals of Surgical Oncology.2016; 23(5): 1721. CrossRef
Evaluation of the risk factors associated with rectal neuroendocrine tumors: a big data analytic study from a health screening center
Jeung Hui Pyo, Sung Noh Hong, Byung-Hoon Min, Jun Haeng Lee, Dong Kyung Chang, Poong-Lyul Rhee, Jae Jun Kim, Sun Kyu Choi, Sin-Ho Jung, Hee Jung Son, Young-Ho Kim
Journal of Gastroenterology.2016; 51(12): 1112. CrossRef
Recent Updates on Neuroendocrine Tumors From the Gastrointestinal and Pancreatobiliary Tracts
Joo Young Kim, Seung-Mo Hong
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Metronomic temozolomide as second line treatment for metastatic poorly differentiated pancreatic neuroendocrine carcinoma
C. De Divitiis, C. von Arx, A. M. Grimaldi, D. Cicala, F. Tatangelo, A. Arcella, G. M. Romano, E. Simeone, R. V. Iaffaioli, P. A. Ascierto, S. Tafuto
Journal of Translational Medicine.2016;[Epub] CrossRef
Epidemiological features of gastroenteropancreatic neuroendocrine tumors in Chengdu city with a population of 14 million based on data from a single institution
Lin-Jie Guo, Chun-Hui Wang, Cheng-Wei Tang
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The Clinicopathologic Features and Treatment of 607 Hindgut Neuroendocrine Tumor (NET) Patients at a Single Institution
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Medicine.2016; 95(19): e3534. CrossRef
Clinicopathological Profile of Pure Neuroendocrine Neoplasms of the Esophagus: A South Indian Center Experience
Govind Babu Kanakasetty, Loknatha Dasappa, Kuntegowdanahalli Chinnagiriyappa Lakshmaiah, Mangesh Kamath, Linu Abraham Jacob, Suresh Babu Mallekavu, Lakkavalli Krishnappa Rajeev, Rudresha Antapura Haleshappa, Lokesh Kadabur Nagendrappa, Smitha Carol Saldan
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Endoscopic treatments for rectal neuroendocrine tumors smaller than 16 mm: a meta-analysis
Hai-Ping Zhang, Wei Wu, Sheng Yang, Jun Lin
Scandinavian Journal of Gastroenterology.2016; 51(11): 1345. CrossRef
Lymph node size is not a reliable criterion for predicting nodal metastasis in rectal neuroendocrine tumours
B. C. Kim, Y. E. Kim, H. J. Chang, S. H. Lee, E. G. Youk, D.‐S. Lee, J. B. Lee, E.‐J. Lee, M. J. Kim, D. K. Sohn, J. H. Oh
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Prognostic Validity of the American Joint Committee on Cancer and the European Neuroendocrine Tumors Staging Classifications for Pancreatic Neuroendocrine Tumors
Jae Hee Cho, Ji Kon Ryu, Si Young Song, Jin-Hyeok Hwang, Dong Ki Lee, Sang Myung Woo, Young-Eun Joo, Seok Jeong, Seung-Ok Lee, Byung Kyu Park, Young Koog Cheon, Jimin Han, Tae Nyeun Kim, Jun Kyu Lee, Sung-Hoon Moon, Hyunjin Kim, Eun Taek Park, Jae Chul Hw
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Endoscopic Resection for Small Rectal Neuroendocrine Tumors: Comparison of Endoscopic Submucosal Resection with Band Ligation and Endoscopic Submucosal Dissection
Byoung Wook Bang, Jin Seok Park, Hyung Kil Kim, Yong Woon Shin, Kye Sook Kwon, Joon Mee Kim
Gastroenterology Research and Practice.2016; 2016: 1. CrossRef
Surgical treatment and prognosis of gastric neuroendocrine neoplasms: a single-center experience
Chaoyong Shen, Huijiao Chen, Haining Chen, Yuan Yin, Luyin Han, Jiaju Chen, Sumin Tang, Xiaonan Yin, Zongguang Zhou, Bo Zhang, Zhixin Chen
BMC Gastroenterology.2016;[Epub] CrossRef
The clinicopathological significance of angiogenesis in hindgut neuroendocrine tumors obtained via an endoscopic procedure
Yoichiro Okubo, Osamu Motohashi, Norisuke Nakayama, Ken Nishimura, Rika Kasajima, Yohei Miyagi, Manabu Shiozawa, Emi Yoshioka, Masaki Suzuki, Kota Washimi, Kae Kawachi, Madoka Nito, Yoichi Kameda, Tomoyuki Yokose
Diagnostic Pathology.2016;[Epub] CrossRef
A Case of Endoscopically Complete Remission of Esophageal Neuroendocrine Tumors by Concurrent Chemoradiation Therapy
Myung Hee Kim, Hyun Yong Jeong, Jae Kyu Seong, Hee Seok Moon, Sun Hyung Kang, Duk Ki Kim
The Korean Journal of Gastroenterology.2016; 68(5): 265. CrossRef
Outcomes after local excision for rectal neuroendocrine tumor
Yoomin Kwon, Seung-Bum Ryoo, Inho Song, Yoon-Hye Kwon, Dong Woon Lee, Sang Hui Moon, Ji Won Park, Seung-Yong Jeong, Kyu Joo Park
Korean Journal of Clinical Oncology.2016; 12(2): 104. CrossRef
Multivariate analysis of metastasis-related risk factors for patients with gastroenteropancreatic neuroendocrine tumors based on clinicopathological and endoscopic features
Caiyun Tang, Lingqi Gong, Wenli Zou, Jie Zhang, Yuqian Zhou, Xiaoping Wu, Fanggen Lu, Chunhui Ouyang, Xiaowei Liu
Oncology Reports.2016; 36(6): 3343. CrossRef
Management of gastric and duodenal neuroendocrine tumors
Yuichi Sato, Satoru Hashimoto, Ken-ichi Mizuno, Manabu Takeuchi, Shuji Terai
World Journal of Gastroenterology.2016; 22(30): 6817. CrossRef
Surgical management for non-functional pancreatic neuroendocrine neoplasms with synchronous liver metastasis: A consensus from the Chinese Study Group for Neuroendocrine Tumors (CSNET)
Kaizhou Jin, Jin Xu, Jie Chen, Minhu Chen, Rufu Chen, Ye Chen, Zhiyu Chen, Bin Cheng, Yihebali Chi, Shi-Ting Feng, Deliang Fu, Baohua Hou, Dan Huang, Heguang Huang, Qiang Huang, Jie Li, Ying Li, Houjie Liang, Rong Lin, An'an Liu, Jixi Liu, Xubao Liu, Ming
International Journal of Oncology.2016; 49(5): 1991. CrossRef
ENETS Consensus Guidelines Update for the Management of Patients with Functional Pancreatic Neuroendocrine Tumors and Non-Functional Pancreatic Neuroendocrine Tumors
M. Falconi, B. Eriksson, G. Kaltsas, D.K. Bartsch, J. Capdevila, M. Caplin, B. Kos-Kudla, D. Kwekkeboom, G. Rindi, G. Klöppel, N. Reed, R. Kianmanesh, R.T. Jensen
Neuroendocrinology.2016; 103(2): 153. CrossRef
Epidemiological trends of pancreatic and gastrointestinal neuroendocrine tumors in Japan: a nationwide survey analysis
Tetsuhide Ito, Hisato Igarashi, Kazuhiko Nakamura, Hironobu Sasano, Takuji Okusaka, Koji Takano, Izumi Komoto, Masao Tanaka, Masayuki Imamura, Robert T. Jensen, Ryoichi Takayanagi, Akira Shimatsu
Journal of Gastroenterology.2015; 50(1): 58. CrossRef
Neuroendocrine neoplasms of the extrahepatic bile duct: radiologic and clinical characteristics
Nurhee Hong, Hyoung Jung Kim, Jae Ho Byun, So Yeon Kim, Kyoung Won Kim, Jin Hee Kim, Seung-Mo Hong
Abdominal Imaging.2015; 40(1): 181. CrossRef
Circumferential submucosal incision prior to endoscopic mucosal resection provides comparable clinical outcomes to submucosal dissection for well-differentiated neuroendocrine tumors of the rectum
Dae Young Cheung, Soo Kyoung Choi, Hyung-Keun Kim, Sung Soo Kim, Hiun-Suk Chae, Kyung Jin Seo, Young-Seok Cho
Surgical Endoscopy.2015; 29(6): 1500. CrossRef
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American Journal of Surgical Pathology.2015; 39(5): 632. CrossRef
Aggressive Locoregional Treatment Improves the Outcome of Liver Metastases from Grade 3 Gastroenteropancreatic Neuroendocrine Tumors
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Cancer Research and Treatment.2015; 47(4): 738. CrossRef
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Neuroendocrine Carcinomas of the Gastroenteropancreatic System: A Comprehensive Review
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Akira Watanabe, Mitsuyoshi Ota, Yusuke Suwa, Shinsuke Suzuki, Atsushi Ishibe, Jun Watanabe, Kazuteru Watanabe, Yasushi Ichikawa, Kingo Hirasawa, Mikiko Tanabe, Itaru Endo
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The Relation between Histopathologic Findings on Surgical Specimen and Outcomes in Patients with N2 Positive Stage IIIA Non-Small Cell Lung Cancer Receiving Preoperative Concurrent Radiochemotherapy and Surgery: Bo Kyong Kim, Kyoung Ju Kim, Yong Chan Ahn, Do Hoon Lim, Won Park, Joungho Han, Keunchil Park, Kwan Min Kim, Jhingook Kim, Young Mog Shim; Cancer Res Treat. 2003;35(6):497-501. Published online December 31, 2003; DOI: https://doi.org/10.4143/crt.2003.35.6.497

Abstract PDF: PURPOSE
To evaluate the prognostic implication of histopathologic findings on the surgical specimens of N2 positive stage IIIA non-small cell lung cancer (NSCLC) patients who were treated with preoperative concurrent radiochemotherapy (CRCT) and surgery. MATERIALS AND METHODS: From May 1997 to April 2000, 48 patients with N2 positive stage IIIA NSCLC were treated with preoperative CRCT and surgery. Retrospective analyses were performed on 33 patients who underwent surgical resection. The thoracic radiation therapy (TRT) dose was 45 Gy over 5 weeks with a 1.8 Gy daily fraction using 10 MV X-rays. Chemotherapy consisted of two cycles of intravenous cisplatin (100 mg/m2, on days 1 and 29) and oral etoposide (50 mg/m2/day, on days 1~14 and 29~42), concurrently delivered with TRT. Surgery was performed around 4 weeks of the completion of CRCT. The median follow up was 18 months. The histopathologic findings, including the proportions of viable tumor cells, fibrosis, and necrosis, as well as the tumor and nodal statuses on the surgical specimens following the preoperative CRCT, were analyzed. RESULTS: The 3-year overall survival, disease-free survival, and local control rates were 46.1%, 49.5%, and 85.5%, respectively. Post-surgical stages decreased in 18 patients (54.5%), including 3 pathologic complete responses, were unchanged in 13 (39.4%), and increased in two (6.1%). On univariate analyses, the low proportion of the viable tumor cells was the only factor favorably affecting the overall survival rate (p=0.0386), and the histologic type of squamous cell carcinoma was a favorable factor affecting disease free survival rate (p=0.0452). On multivariate analyses, however, no factor affected the overall survival, disease free survival, or local control rates. CONCLUSION: The histopathologic findings of the proportion of viable tumor cells, fibrosis, and necrosis on the surgical specimens following preoperative CRCT had few prognostic implications on uni-and multi-variate analyses. Furthermore, the primary tumor and nodal responses to preoperative CRCT did not influence the outcomes. Longer-term follow-up with a larger number of patients, however, is awaited.

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Correlation of Ultrasonographic Findings and Pathologic Prognostic Predictions in Breast Cancer: Hyung Il Seo, Hi Sook Kwak, Hong Jae Jo, Tae Yong Jeon, Young Tae Bae, Mun Sup Sim; Cancer Res Treat. 2001;33(4):296-301. Published online August 31, 2001; DOI: https://doi.org/10.4143/crt.2001.33.4.296

Abstract PDF: PURPOSE
Increased technologic capabilities have allowed for the expanded use of ultrasound beyond simple differentiation of a lesion as solid versus cystic nature, allowing us to classify lesions into various categories based on a number of descriptive features. The purpose of this study was to investigate whether to predict the preoperative prognosis of breast cancer through the correlation between ultrasonographic images and the grade of malignancy.
MATERIALS AND METHODS
The patient population for this study consisted of 107 patients with infiltrative ductal carcinoma who were evaluated using ultrasound technology. Ultrasonographic findings were divided as follows: Type I, round or oval shape and regular border; Type II, partially round or oval shape and partially irregular border; and Type III, irregular shape and irregular border.
RESULTS
1. The frequency of grade 1 (G1) was significantly higher in the Type I group than the othergroups. 2. In the 2.0 cm sized mass, the lymph node metastasis rate was significantly lower in the Type I group than the other groups. 3. In all the groups, Estrogen receptor (ER) positivity was insignificant regardless of tumor size and type. 4. In the 2.0 cm sized mass, c-erbB-2 positivity was significantly lower in the Type I than the other groups. There was no clear difference among the three groups in tumors greater than 2.0 cm in size.
CONCLUSION
These results show that our classification of ultrasonographic images reflect the grade of malignancy in terms of clinicopathological features in breast cancers less than 2.0 cm in size. Therefore, ultrasonographic findings may help predict the preoperative prognosis in T1 size breast cancer, although further study is required.

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Clinicopathologic Characteristics and p53, c-erbB2, nm23 Protein Expression in Gastric Remnant Cancer: Joo Ho Lee, Yoe Kyu Youn, Woo Ho Kim, Hang Jong Yu, Byoung Jo Suh, Han Kwang Yang, Kuk Jin Choe, Jin Pok Kim; J Korean Cancer Assoc. 2000;32(1):26-37.

Abstract PDF: PURPOSE
The goal of this study was to evaluate the clinicopathologic characteristics and to investigate the expression of p53, c-erbB2, and nm23 protein in gastric remnant cancer.
MATERIALS AND METHODS
We evaluated the clinicopathologic characteristics and expression of p53, c-erbB2, and nm23 protein in 37 cases gastric remnant cancer (GRC) that detected at least 5 years after initial surgery, and compare them with adenocarcinoma from intact stomach. Twenty-seven patients among the 37 patients of GRC and 271 patients of primary gastric cancer (PGC) were chosen for immunohistochemical staining against p53, c-erbB2, and nm23.
RESULTS
The median age was 59 years, male was predominant and median time interval between operations were 15 years. GRC initially operated for benign disease were detected later after initial gastrectomy and had a tendency toward lymph node metastasis than those initially operated for malignant disease. Resection was performed in 31 patients (81.0%) in whom 28 patient (71.0%) with curative intent. The overall 5-year survival rate was 44.8%. Multivariate analysis had revealed that depth of invasion was the most significant prognostic factor. p53, c-erbB2, and nm23 protein expression rates of GRC were 44.4%, 14.8%, and 66.7%, respectively and those of PGC were 45.4%, 16.2%, and 85.1%, respectively. p53 protein was more frequently expressed in well differentiated, Laurens intestinal carcinoma in both GRC and PGC. p53 protein expression and depth of invasion had an inverse relationship only in GRC. c-erbB2 protein was more frequently expressed in well differentiated, Laurens intestinal carcinoma in PGC. nm23 protein expression was more frequently expressed in the group of positive lymph node metastasis in GRC.
CONCLUSION
Early detection by periodic endoscopic follow-up and radical resection is a reasonable treatment policy for GRC. The results of p53, c-erbB2, and nm23 expression suggest that they might have somewhat different roles in the pathogenesis and progression in GRC and PGC, so further study may be of benefit hereafter.

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