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Prognostic Model for Survival and Recurrence in Patients with Early-Stage Cervical Cancer: A Korean Gynecologic Oncology Group Study (KGOG 1028)
E Sun Paik, Myong Cheol Lim, Moon-Hong Kim, Yun Hwan Kim, Eun Seop Song, Seok Ju Seong, Dong Hoon Suh, Jong-Min Lee, Chulmin Lee, Chel Hun Choi
Cancer Res Treat. 2020;52(1):320-333.   Published online August 5, 2019
DOI: https://doi.org/10.4143/crt.2019.124
AbstractAbstract PDFPubReaderePub
Purpose
We aimed to develop and validate individual prognostic models in a large cohort of cervical cancer patients that were primarily treated with radical hysterectomy.
Materials and Methods
We analyzed 1,441 patients with early-stage cervical cancer treated between 2000 and 2008 from the Korean Gynecologic Oncology Group multi-institutional cohort: a train cohort (n=788) and a test cohort (n=653). Models predicting the risk for overall survival (OS), disease- free survival (DFS), lymphatic recurrence and hematogenous recurrence were developed using Cox analysis and stepwise backward selection and best-model options. The prognostic performance of each model was assessed in an independent patient cohort. Model-classified risk groups were compared to groups based on traditional risk factors.
Results
Independent risk factors for OS, DFS, lymphatic recurrence, and hematogenous recurrence were identified for prediction model development. Different combinations of risk factors were shown for each outcome with best predictive value. In train cohort, area under the curve (AUC) at 2 and 5 years were 0.842/0.836 for recurrence, and 0.939/0.882 for OS. When applied to a test cohort, the model also showed accurate prediction result (AUC at 2 and 5 years were 0.799/0.723 for recurrence, and 0.844/0.806 for OS, respectively). The Kaplan-Meier plot by proposed model-classified risk groups showed more distinctive survival differences between each risk group.
Conclusion
We developed prognostic models for OS, DFS, lymphatic and hematogenous recurrence in patients with early-stage cervical cancer. Combining weighted clinicopathologic factors, the proposed model can give more individualized predictions in clinical practice.

Citations

Citations to this article as recorded by  
  • External validation of the annual recurrence risk model for tailored surveillance strategy in patients with cervical cancer
    Luigi A. De Vitis, Gabriella Schivardi, Aurora Gaeta, Giuseppe Caruso, Marina Rosanu, Lucia Ribero, Diletta Fumagalli, Jvan Casarin, Ilaria Betella, Giorgio Bogani, Carrie L. Langstraat, Giovanni D. Aletti, Nicoletta Colombo, Vanna Zanagnolo, Sara Gandini
    International Journal of Gynecological Cancer.2025; 35(6): 101756.     CrossRef
  • Stratification by Mutational Landscape Reveals Differential Immune Infiltration and Predicts the Recurrence and Clinical Outcome of Cervical Cancer
    Chun Gao, Qian Zhou, Liting Liu, Hong Liu, Yifan Yang, Shen Qu, Qing He, Yafei Huang, Ximiao He, Hui Wang
    Phenomics.2025;[Epub]     CrossRef
  • Which factors predict the effectiveness of adjuvant treatment in patients with non-high-risk early-stage cervical cancer? Ancillary analysis of KGOG-1028
    Junhwan Kim, Jieun Jang, Myong Cheol Lim, Moon-Hong Kim, Yun Hwan Kim, Eun Seop Song, Seok Ju Seong, Dong Hoon Suh, Jong-Min Lee, Chulmin Lee, Chel Hun Choi, Sokbom Kang
    Gynecologic Oncology.2025; 196: 10.     CrossRef
  • Oncologic outcomes of minimally invasive surgery vs. abdominal hysterectomy in patients with low-risk, early-stage cervical cancer: A retrospective analysis of KGOG 1028 data based on SHAPE trial eligibility criteria
    Jaekyung Bae, Uisuk Kim, E. Sun Paik, Myong Cheol Lim, Moon-Hong Kim, Yun Hwan Kim, Eun Seop Song, Seok Ju Seong, Dong Hoon Suh, Jong-Min Lee, Chulmin Lee, Chel Hun Choi, Sokbom Kang
    Gynecologic Oncology.2025; 197: 91.     CrossRef
  • Multiparametric MRI-based radiomics nomogram for identifying cervix-corpus junction cervical adenocarcinoma from endometrioid adenocarcinoma
    Yuhan Fang, Keying Wang, Meiling Xiao, Jiejun Cheng, Zijing Lin, Jinwei Qiang, Ying Li
    Abdominal Radiology.2024; 49(5): 1557.     CrossRef
  • Determination of ovarian transposition through prediction of postoperative adjuvant therapy in young patients with early stage cervical cancer undergoing surgery: a Korean multicenter retrospective study (KGOG 1042)
    Woo Yeon Hwang, Chel Hun Choi, Kidong Kim, Moon-Hong Kim, Myong Cheol Lim, Banghyun Lee, Myounghwan Kim, Yun Hwan Kim, Seok Ju Seong, Jong-Min Lee
    Obstetrics & Gynecology Science.2024; 67(3): 296.     CrossRef
  • Predictive models for personalized precision medical intervention in spontaneous regression stages of cervical precancerous lesions
    Simin He, Guiming Zhu, Ying Zhou, Boran Yang, Juping Wang, Zhaoxia Wang, Tong Wang
    Journal of Translational Medicine.2024;[Epub]     CrossRef
  • From the Beginning of the Korean Gynecologic Oncology Group to the Present and Next Steps
    Kyung-Jin Min, Nam Kyeong Kim, Jae-Yun Song, Min Chul Choi, Shin Wha Lee, Keun Ho Lee, Min Kyu Kim, Sokbom Kang, Chel Hun Choi, Jeong-Won Lee, Eun-Ju Lee, Keun-Yong Eom, Sang Wun Kim, Hanbyoul Cho, Sun Joo Lee, Myong Cheol Lim, Jaeman Bae, Chong Woo Yoo,
    Cancers.2024; 16(19): 3422.     CrossRef
  • Prognostic Factors for Cervical Cancer in Asian Populations: A Scoping Review of Research From 2013 to 2023
    Syed S Abrar, Seoparjoo Azmel Mohd Isa, Suhaily Mohd Hairon, Najib M Yaacob, Mohd Pazudin Ismail
    Cureus.2024;[Epub]     CrossRef
  • Radiomics based on MRI in predicting lymphovascular space invasion of cervical cancer: a meta-analysis
    Chongshuang Yang, Min Wu, Jiancheng Zhang, Hongwei Qian, Xiangyang Fu, Jing Yang, Yingbin Luo, Zhihong Qin, Tianliang Shi
    Frontiers in Oncology.2024;[Epub]     CrossRef
  • Systematic review and meta-analysis of prediction models used in cervical cancer
    Ashish Kumar Jha, Sneha Mithun, Umeshkumar B. Sherkhane, Vinay Jaiswar, Biche Osong, Nilendu Purandare, Sadhana Kannan, Kumar Prabhash, Sudeep Gupta, Ben Vanneste, Venkatesh Rangarajan, Andre Dekker, Leonard Wee
    Artificial Intelligence in Medicine.2023; 139: 102549.     CrossRef
  • Selective photodynamic effects on cervical adenocarcinoma cells provided by F127 Pluronic®-based micelles modulating hypericin delivery
    Kayane Harumi Mashiba, Lucimara Rofrigues Carobeli, Maria Vítoria Felipe de Souza, Lyvia Eloiza de Freitas Meirelles, Natália Lourenço Mari, Gabriel Batista César, Renato Sonchini Gonçalves, Wilker Caetano, Edilson Damke, Vânia Ramos Sela da Silva, Gabrie
    Brazilian Journal of Pharmaceutical Sciences.2023;[Epub]     CrossRef
  • Optimising follow-up strategy based on cytology and human papillomavirus after fertility-sparing surgery for early stage cervical cancer: a nationwide, population-based, retrospective cohort study
    Teska N Schuurman, Mirte Schaafsma, Kaylee H To, Viola M J Verhoef, Karolina Sikorska, Albert G Siebers, Hans H B Wenzel, Maaike C G Bleeker, Eva Maria Roes, Ronald P Zweemer, Peggy J de Vos van Steenwijk, Refika Yigit, Jogchum J Beltman, Petra L M Zuster
    The Lancet Oncology.2023; 24(12): 1349.     CrossRef
  • Surgical Treatment for Early Cervical Cancer in the HPV Era: State of the Art
    Mario Palumbo, Luigi Della Corte, Carlo Ronsini, Serena Guerra, Pierluigi Giampaolino, Giuseppe Bifulco
    Healthcare.2023; 11(22): 2942.     CrossRef
  • Comparison of treatment modalities for selected advanced laryngeal squamous cell carcinoma
    Aihemaiti Wushouer, Wenming Li, Minfa Zhang, Dapeng Lei, Xinliang Pan
    European Archives of Oto-Rhino-Laryngology.2022; 279(1): 361.     CrossRef
  • The positive threshold of the immunohistochemical parameter Ki67 for predicting the recurrence of cervical cancer
    Yuan Tu, Peng Jiang, Jingni Zhang, Shan Jiang, Qianlin Yi, Rui Yuan
    International Journal of Gynecology & Obstetrics.2022; 158(2): 330.     CrossRef
  • Management of Early-Stage Cervical Cancer: A Literature Review
    Yasmin Medeiros Guimarães, Luani Rezende Godoy, Adhemar Longatto-Filho, Ricardo dos Reis
    Cancers.2022; 14(3): 575.     CrossRef
  • The Value of Whole-Tumor Texture Analysis of ADC in Predicting the Early Recurrence of Locally Advanced Cervical Squamous Cell Cancer Treated With Concurrent Chemoradiotherapy
    Xiaomiao Zhang, Qi Zhang, Lizhi Xie, Jusheng An, Sicong Wang, Xiaoduo Yu, Xinming Zhao
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • The recurrences of cervical cancer: Possibilities of molecular prediction
    L. A. Ashrafyan, T. E. Belokrinitskaya, L. F. Sholokhov, E. V. Kayukova, V. A. Mudrov
    Acta Biomedica Scientifica.2022; 7(2): 34.     CrossRef
  • Modern diagnostics and treatment of distant metastasis of cervical cancer
    R. K. Minyazeva, G. Y. Battalova, I. V. Sakhautdinova, I. R. Gilyazova
    Creative surgery and oncology.2022; 12(2): 128.     CrossRef
  • Clinical Outcomes and Their Prognostic Factors among Cervical Cancer Patients with Bone Recurrence
    Thiti Atjimakul, Jitti Hanprasertpong, Enrique Hernandez
    Obstetrics and Gynecology International.2022; 2022: 1.     CrossRef
  • Adjuvant radiotherapy for cervical cancer in South Korea: a radiation oncology survey of the Korean Radiation Oncology Group (KROG 20-06)
    Nalee Kim, Won Park
    Japanese Journal of Clinical Oncology.2021; 51(7): 1107.     CrossRef
  • Prediction Models for Prognosis of Cervical Cancer: Systematic Review and Critical Appraisal
    Bingjie He, Weiye Chen, Lili Liu, Zheng Hou, Haiyan Zhu, Haozhe Cheng, Yixi Zhang, Siyan Zhan, Shengfeng Wang
    Frontiers in Public Health.2021;[Epub]     CrossRef
  • Significance of serum CA125 level in surgically resected cervical adenocarcinoma with adverse features
    Nalee Kim, Won Park, Won Kyung Cho, Duk-Soo Bae, Byoung-Gie Kim, Jeong-Won Lee, Chel Hun Choi, Tae-Joong Kim, Yoo-Young Lee
    Journal of Gynecologic Oncology.2021;[Epub]     CrossRef
  • The annual recurrence risk model for tailored surveillance strategy in patients with cervical cancer
    David Cibula, Lukáš Dostálek, Jiri Jarkovsky, Constantijne H. Mom, Aldo Lopez, Henrik Falconer, Anna Fagotti, Ali Ayhan, Sarah H. Kim, David Isla Ortiz, Jaroslav Klat, Andreas Obermair, Fabio Landoni, Juliana Rodriguez, Ranjit Manchanda, Jan Kosťun, Ricar
    European Journal of Cancer.2021; 158: 111.     CrossRef
  • Prognostic Assessment of Cervical Cancer Patients by Clinical Staging and Surgical-Pathological Factor: A Support Vector Machine-Based Approach
    Lin Xie, Ran Chu, Kai Wang, Xi Zhang, Jie Li, Zhe Zhao, Shu Yao, Zhiwen Wang, Taotao Dong, Xingsheng Yang, Xuantao Su, Xu Qiao, Kun Song, Beihua Kong
    Frontiers in Oncology.2020;[Epub]     CrossRef
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SUVmax Predicts Disease Progression after Stereotactic Ablative Radiotherapy in Stage I Non-small Cell Lung Cancer
Yoo-Kang Kwak, Hee Hyun Park, Kyu Hye Choi, Eun Young Park, Soo Yoon Sung, Sea-Won Lee, Ji Hyun Hong, Hyo Chun Lee, Ie Ryung Yoo, Yeon Sil Kim
Cancer Res Treat. 2020;52(1):85-97.   Published online May 17, 2019
DOI: https://doi.org/10.4143/crt.2019.007
AbstractAbstract PDFPubReaderePub
Purpose
Fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) is gaining evidence as a predictive factor in non-small cell lung cancer (NSCLC). Stereotactic ablative radiotherapy (SABR) is the standard treatment in early-stage NSCLC when a patient is unsuitable for surgery. We performed a study to assess the prognostic clinical significance of PET-CT after SABR in early-stage NSCLC.
Materials and Methods
Seventy-six patients with stage I NSCLC treated with SABR were investigated. Total radiation dose ranged from 36 to 63 Gy in three to eight fractions depending on tumor location and size. Respiratory motion control was implemented at simulation and during treatment. PET-CT prior to SABR was performed in 66 patients (86.8%).
Results
Median follow-up time was 32 months (range, 5 to 142 months). Local control rate at 1, 2, and 5 years were 95.9%, 92.8%, and 86.7%, respectively. Overall survival (OS) at 1, 2, and 5 years were 91.0%, 71.3%, and 52.1% respectively. Cause-specific survival at 1, 2, and 5 years were 98.6%, 93.1%, and 84.3% respectively. Tumor size and pre-SABR maximal standardized uptake value (SUVmax) demonstrated statistical significance in the Kaplan-Meier survival analyses with log-rank test. In multivariate analyses pre-SABR SUVmax remained statistically significant in correlation to OS (p=0.024; hazard ratio [HR], 3.2; 95% confidence interval [CI], 1.2 to 8.8) and with marginal significance in regards to regional progression-free survival (p=0.059; HR, 32.5; 95% CI, 2.6 to 402.5).
Conclusion
Pre-SABR SUVmax demonstrated a predictive power in statistical analyses. Tumors with SUVmax above 6 at diagnosis were associated with inferior outcomes.

Citations

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  • Enhanced NSCLC subtyping and staging through attention-augmented multi-task deep learning: A novel diagnostic tool
    Runhuang Yang, Weiming Li, Siqi Yu, Zhiyuan Wu, Haiping Zhang, Xiangtong Liu, Lixin Tao, Xia Li, Jian Huang, Xiuhua Guo
    International Journal of Medical Informatics.2025; 193: 105694.     CrossRef
  • Invasive Nodal Staging via Endobronchial Ultrasound and Outcome in Patients Treated with Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer – Results from a Single Institution Study
    Benjamin George, Atallah Baydoun, Samar Bhat, Lauryn Bailey, Theodore Arsenault, Yilun Sun, Yuxia Zhang, Yiran Zheng, Prashant Vempati, Tarun Podder, Tithi Biswas
    Clinical Lung Cancer.2024; 25(4): e181.     CrossRef
  • Prognostic value of consolidation-to-tumor ratio on computed tomography in NSCLC: a meta-analysis
    Yongming Wu, Wenpeng Song, Denian Wang, Junke Chang, Yan Wang, Jie Tian, Sicheng Zhou, Yingxian Dong, Jing Zhou, Jue Li, Ziyi Zhao, Guowei Che
    World Journal of Surgical Oncology.2023;[Epub]     CrossRef
  • Tumor to liver maximum standardized uptake value ratio of FDG-PET/CT parameters predicts tumor treatment response and survival of stage III non-small cell lung cancer
    Pengfei Zhang, Wei Chen, Kewei Zhao, Xiaowen Qiu, Tao Li, Xingzhuang Zhu, Peng Sun, Chunsheng Wang, Yipeng Song
    BMC Medical Imaging.2023;[Epub]     CrossRef
  • Evaluation of response to stereotactic body radiation therapy for nonsmall cell lung cancer: PET response criteria in solid tumors versus response evaluation criteria in solid tumors
    Jixia Han, Qi Song, Feng Guo, Rui Du, Henghu Fang, Jingbo Kang, Zejun Lu
    Nuclear Medicine Communications.2022;[Epub]     CrossRef
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    Giulia Riva, Sara Imparato, Giovanni Savietto, Mattia Pecorilla, Alberto Iannalfi, Amelia Barcellini, Sara Ronchi, Maria Rosaria Fiore, Chiara Paganelli, Giulia Buizza, Mario Ciocca, Guido Baroni, Lorenzo Preda, Ester Orlandi
    The British Journal of Radiology.2021;[Epub]     CrossRef
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    Jin Meng, Emmanuel Deshayes, Li Zhang, Wei Shi, Xiaomeng Zhang, Xingxing Chen, Xin Mei, Jinli Ma, Yizhou Jiang, Jiong Wu, Zhimin Shao, Xiaoli Yu, Zhaozhi Yang, Xiaomao Guo
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  • Parámetros cuantitativos de la PET/TC con 18F-FDG como factores pronósticos en el cáncer de pulmón localizado e inoperable
    J.R. Infante, J. Cabrera, J.I. Rayo, C. Cruz, J. Serrano, M. Moreno, A. Martínez, P. Jiménez, A. Cobo
    Revista Española de Medicina Nuclear e Imagen Molecular.2020; 39(6): 353.     CrossRef
  • 18F-FDG PET/CT quantitative parameters as prognostic factors in localized and inoperable lung cancer
    J.R. Infante, J. Cabrera, J.I. Rayo, C. Cruz, J. Serrano, M Moreno, A. Martínez, P. Jiménez, A. Cobo
    Revista Española de Medicina Nuclear e Imagen Molecular (English Edition).2020; 39(6): 353.     CrossRef
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  • 134 Download
  • 9 Web of Science
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Characteristics, Prognostic Factors, and Survival of Patients with NK/T-Cell Lymphoma of Non-upper Aerodigestive Tract: A 17-Year Single-Center Experience
Ze-Long Liu, Xi-Wen Bi, Xue-Wen Zhang, De-Xin Lei, Pan-Pan Liu, Hang Yang, Yan Gao, Yuan-Xue Jiang, Wen-Qi Jiang, Yi Xia
Cancer Res Treat. 2019;51(4):1557-1567.   Published online April 1, 2019
DOI: https://doi.org/10.4143/crt.2018.681
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The extranodal natural killer (NK)/T-cell lymphoma (NKTCL) of non-upper aerodigestive tract (NUAT) was found to have clinical heterogeneity compared with NKTCL of the upper aerodigestive tract (UAT) in small scale studies. We conducted this study in a much larger cohort to analyze the clinical characteristics, prognostic factors, treatment modality, and clinical outcomes of patients with NUAT-NKTCL.
Materials and Methods
From January 2001 to December 2017, a total of 757 NKTCL patients were identified and included in this study, including 92 NUAT-NKTCL patients (12.2%) and 665 UAT-NKTCL patients (87.8%).
Results
NUAT-NKTCL patients had relatively poorer performance status, more unfavorable prognostic factors, and more advanced stage, compared with UAT-NKTCL patients. The 5-year overall survival (OS) was 34.7% for NUAT-NKTCL, which was significantly worse than UAT-NKTCL (64.2%, p<0.001). The median OS duration was 30.9 months for NUAT-NKTCL. Multivariate analysis showed that presence with B symptoms and elevated serum lactate dehydrogenase independently predicted worse OS. International prognostic index score and prognostic index of natural killer lymphoma score still had prognostic values in NUAT-NKTCL, while the Ann Arbor system could not accurately predict the OS.
Conclusion
NUAT-NKTCL is a distinctive subtype of NKTCL in many aspects. Patients with NUAT-NKTCL have relatively poorer performance status, more unfavorable prognostic factors, more advanced stage, and poorer prognosis.

Citations

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  • Magnetic Resonance Imaging and [18F]‐Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography‐Guided Therapy Improves Survival in Upper Aerodigestive Tract NK/T‐Cell Lymphoma, Nasal Type: A Prospective Cohort Study
    Quanguang Ren, Yue Cui, He Huang, Xueying Li, Huangming Hong, Zhao Wang, Xiaojie Fang, Chengcheng Guo, Yuyi Yao, Zegeng Chen, Ying Huang, Zhiming Li, Qingqing Cai, Ying Tian, Hanyu Wang, Xiaoping Lin, Wei Fan, Lie Zheng, Suxia Lin, Ying Guo, Tongyu Lin
    Head & Neck.2025;[Epub]     CrossRef
  • Clinical features, prognostic stratification, and treatment of advanced-stage non-nasal type extranodal natural killer/T-cell lymphoma: a multi-institutional real-world study
    Yu-Ce Wei, Wei-Xin Liu, Fei Qi, Chang-Gong Zhang, Bao-Min Zheng, Yan Xie, Bo Chen, Di Zhang, Wei-Ping Liu, Hui Fang, Yue Chai, Shu-Nan Qi, Ye-Xiong Li, Wei-Hu Wang, Yu-Qin Song, Jun Zhu, Mei Dong
    Annals of Hematology.2024; 103(1): 163.     CrossRef
  • Genomic features reveal potential benefit of adding anti-PD-1 immunotherapy to treat non-upper aerodigestive tract natural killer/T-cell lymphoma
    Zegeng Chen, He Huang, Huageng Huang, Le Yu, Huawei Weng, Jian Xiao, Liqun Zou, Huilai Zhang, Chaoyong Liang, Hui Zhou, Hongqiang Guo, Zhao Wang, Zhiming Li, Tao Wu, Hongyu Zhang, Huijing Wu, Zhigang Peng, Linzhu Zhai, Xinggui Chen, Yang Liang, Huangming
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    Jun CAI, Yi CAO, LiYun QIU, Yan GAO, HuiQiang HUANG, QingQing CAI
    SCIENTIA SINICA Vitae.2024; 54(12): 2363.     CrossRef
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    Yang Chunli, Jiang Ming, Ma Ziyan, Ji Jie, Lv Shuli, Huang Jie, Wu Yu, Xu Caigang, Zou Liqun
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    Yu‐Ce Wei, Fei Qi, Bao‐Min Zheng, Chang‐Gong Zhang, Yan Xie, Bo Chen, Wei‐Xin Liu, Wei‐Ping Liu, Hui Fang, Shu‐Nan Qi, Di Zhang, Yue Chai, Ye‐Xiong Li, Wei‐Hu Wang, Yu‐Qin Song, Jun Zhu, Mei Dong
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Prognostic Significance of Retroperitoneal Lymphadenectomy, Preoperative Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio in Primary Fallopian Tube Carcinoma: A Multicenter Study
Kemal Gungorduk, Ibrahim E. Ertas, Aykut Ozdemir, Emrah Akkaya, Elcin Telli, Salih Taskin, Mehmet Gokcu, Ahmet Baris Guzel, Tufan Oge, Levent Akman, Tayfun Toptas, Ulas Solmaz, Askın Dogan, Mustafa Cosan Terek, Muzaffer Sanci, Aydin Ozsaran, Tayup Simsek, Mehmet Ali Vardar, Omer Tarik Yalcin, Sinan Ozalp, Yusuf Yildirim, Firat Ortac
Cancer Res Treat. 2015;47(3):480-488.   Published online November 17, 2014
DOI: https://doi.org/10.4143/crt.2014.058
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study is to evaluate the prognostic role of preoperative neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) and the need for para-aortic lymphadectomy in patients with primary fallopian tube carcinoma (PFTC). Materials and Methods Ninety-one patients with a diagnosis of PFTC were identified through the gynecologic oncology service database of six academic centers. Clinicopathological, surgical, and complete blood count data were collected. Results In univariate analysis, advanced stage, suboptimal surgery, and NLR > 2.7 were significant prognostic factors for progression-free survival, whereas in multivariate analysis, only advanced stage and suboptimal surgery were significant. In addition, in univariate analysis, cancer antigen 125 ≥ 35 m/IU, ascites, advanced stage, suboptimal surgery, NLR > 2.7, PLR > 233.3, platelet count ≥ 400,000 cells/mm3, staging type, and histological subtype were significant prognostic factors for overall survival (OS); however, in multivariate analysis, only advanced stage, suboptimal surgery, NLR > 2.7, and staging type were significant. Inclusion of pelvic and para-aortic lymphadenectomy in surgery showed significant association with longer OS, with a mean and median OS of 42.0 months and 35.5 months (range, 22 to 78 months), respectively, vs. 33.5 months and 27.5 months (range, 14 to 76 months), respectively, for patients who underwent surgery without para-aortic lymphadenectomy (hazard ratio, 3.1; 95% confidence interval, 1.4 to 5.7; p=0.002). Conclusion NLR (in both univariate and multivariate analysis) and PLR (only in univariate analysis) were prognostic factors in PFTC. NLR and PLR are inexpensive and easy tests to perform. In addition, patients with PFTC who underwent bilateral pelvic and para-aortic lymphadenectomy had longer OS.

Citations

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  • An evaluation of serum blood parameters and amyloid A levels in pregnant women with threatened miscarriage
    Bekir Sitki Isenlik, Mehmet Cihan Sarica, Bilgesu Cetinel Kaygun, Hasan Ali Inal
    American Journal of Reproductive Immunology.2024;[Epub]     CrossRef
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    Dmytro Sumtsov, Artem Skulbeda, Georgy Sumtsov, Iryna Nikitina
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    Durmus Onder, Meryem Busra Birsen, Derya Erturk, Ahmet Ilker Eryilmaz, Ozgur Ozdemir, Guzin Aykal, Zeynep Ozturk Inal
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    Tuan Vo, Duy Nguyen, Thang Ho, Hoang Tran, Dat Nguyen, Thuong Bui, Thinh Cao, Brian Vo
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    Dmitrii Sumtsov
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    C. Iavazzo, A. Fotiou, V. Psomiadou, N. Vrachnis, J. Spiliotis
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    Zi-Yu Xu, Xing-Chen Yao, Xiang-Jun Shi, Xin-Ru Du
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Clinical Analysis of 1136 Early Gastric Cancers
Jin Pok Kim, Yoon Seok Hur, Kuk Jin Choe, Kuhn Uk Lee, Kyoo Wan Choi, Byung Ihn Choi, Yong Il Kim
J Korean Cancer Assoc. 1993;25(6):808-818.   Published online August 1, 2014
AbstractAbstract PDF
Gastric cancer is the most frequent cancer and leading cause of death from cancer in Korea. From 1974 to l992, we had experienced 7606 cases of gastric cancer and performed 6928 gastric resections. 1136 cases were early gastric cancer(14.9% of all cases and 16.4% of resected cases). These lesians were in 757 men and in 379 women. The mean age was 54.8 years and peak incidence of age was 6th decade in male, and 5th decade in female. The diagnostic tools were upper gastrointestinal series and gastrofibroscope, and the accuracy was 89.8% and 93.8% respectively. Among them mucosal lesions were 548 cases(48.2%), submucosal lesions were 588 cases(51.8%) and 178 cases(15.7%) had lymph nade metastasis. According to the depth of invasion, the rate of lymph node metastasis was 6.4% in mucosal lesion and 24.3% in submucosal lesion. Macroscopically, Type IIc was the most frequently encountered lesion(52.2%, 593 cases). Histologically, signet ring cell type is the most frequent(25.6%). Overall five-year survival rate was 91.8%, and 94.2% in mucosal lesions, 91.3% in submucosal lesions, 94.5% in NO lesions, 88.3% in Nl lesions and 77.3% in N2 lesions. The most important factor for survival was the status of lymph nade metastasis. The factors associated with lymph node metastasis were depth of invasion, macroscopic type (protruding type) but the size of the lesion, histologic type, sex and age, site of lesion had no association statistically.
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Nomogram to Predict Treatment Outcome of Fluoropyrimidine/Platinum-Based Chemotherapy in Metastatic Esophageal Squamous Cell Carcinoma
Hyun Ae Jung, Antoine Adenis, Jeeyun Lee, Se Hoon Park, Chi Hoon Maeng, Silvia Park, Hee Kyung Ahn, Young Mog Shim, Nicolas Penel, Young-Hyuck Im
Cancer Res Treat. 2013;45(4):285-294.   Published online December 31, 2013
DOI: https://doi.org/10.4143/crt.2013.45.4.285
AbstractAbstract PDFPubReaderePub
PURPOSE
The degree of benefit from palliative chemotherapy differs widely among patients with metastatic esophageal squamous cell carcinoma (MESCC). The purpose of this study was to develop and validate a prognostic nomogram to predict survival and aid physicians and patients in the decision-making process regarding treatment options.
MATERIALS AND METHODS
Clinicopathologic variables and treatment outcomes of 239 patients who were diagnosed with MESCC and received either fluorouracil/cisplatin (FP) or capecitabine/cisplatin (XP) as first-line chemotherapy were reviewed. A nomogram was developed as a prognostic scoring system incorporating significant clinical and laboratory variables based on a multivariate Cox proportional hazards regression model. An independent series of 61 MESCC patients treated with FP served as an independent data set for nomogram validation.
RESULTS
No difference in response rate was observed between the FP group (44.8%) and the XP group (54.2%). Similarly, no significant differences in median progression-free survival and median overall survival were observed between regimen groups. Multivariate analysis showed that poor performance status (Eastern Cooperative Oncology Group [ECOG] status> or =2), weight loss (10% of the weight loss for 3 months), low albumin level (< or =3.5 g/dL), and absence of previous esophagectomy at the time of chemotherapy were significantly associated with low OS in both groups (p<0.05). Based on these findings, patients were classified into favorable (score, 0 to 90), intermediate (91-134), and poor (>135) prognostic groups. The median survival for those with a favorable ECOG was 13.8 months (95% confidence interval [CI], 10.8 to 18.6 months), for intermediate 11.2 months (95% CI, 8.7 to 11.9 months), and for poor, 7.0 months (95% CI, 3.6 to 10.0 months). External validation of the nomogram in a different patient cohort yielded significantly similar findings.
CONCLUSION
The nomogram described here predicts survival in MESCC patients and could serve as a guide for the use of FP/XP chemotherapy in MESCC patients.

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    Nuria Kotecki, Sandrine Hiret, Pierre-Luc Etienne, Nicolas Penel, Emmanuelle Tresch, Eric François, Marie Pierre Galais, Meher Ben Abdelghani, Pierre Michel, Laetitia Dahan, François Ghiringelli, Laurent Bedenne, Emmanuelle Samalin, Guillaume Piessen, Jaf
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    Cancer Research and Treatment.2013; 45(4): 285.     CrossRef
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Clinical Responses and Prognostic Indicators of Concurrent Chemoradiation for Non-small Cell Lung Cancer
Dong-Soo Lee, Yeon-Sil Kim, Jin-Hyoung Kang, Sang-Nam Lee, Young-Kyoun Kim, Myung-Im Ahn, Dae-Hee Han, Ie-Ryung Yoo, Young-Pil Wang, Jae-Gil Park, Sei-Chul Yoon, Hong-Seok Jang, Byung-Oak Choi
Cancer Res Treat. 2011;43(1):32-41.   Published online March 31, 2011
DOI: https://doi.org/10.4143/crt.2011.43.1.32
AbstractAbstract PDFPubReaderePub
PURPOSE
To evaluate treatment outcomes and prognostic factors in non-small cell lung cancer (NSCLC) patients treated with concurrent chemoradiation.
MATERIALS AND METHODS
From January 2005 to June 2009, 51 patients were treated with concurrent chemoradiation for 3 different aims: locally advanced stage III, locally recurrent disease, and postoperative gross residual NSCLC. Median age was 63 years. Distribution of stages by the 6th edition of American Joint Committee on Cancer (AJCC) was as follows: IIIA (37.3%), IIIB (56.9%). Chemotherapy was administered every week concurrently with radiation using one of the following regimens: paclitaxel (60 mg/m2), docetaxel+cisplatin (20 mg/m2+20 mg/m2), cisplatin (30 mg/m2). Total radiation dose was 16-66.4 Gy (median, 59.4 Gy).
RESULTS
Median follow-up duration was 40.8 months. The overall response rate was 84.3% with 23 complete responses. The median survival duration for the overall patient group was 17.6 months. The 3-year survival rate was 17.8%. A total of 21 patients had recurrent disease at the following sites: loco-regional sites (23.6%), distant organs (27.5%). In the multivariate analysis of the overall patient group, a clinical tumor response (p=0.002) was the only significant prognostic factor for overall survival (OS). In the multivariate analysis of the definitive chemoradiation arm, the use of consolidation chemotherapy (p=0.022), biologically equivalent dose (BED)10 (p=0.007), and a clinical tumor response (p=0.030) were the significant prognostic factors for OS.The median survival duration of the locally recurrent group and the postoperative gross residual group were 26.4 and 23.9 months, respectively.
CONCLUSION
Our study demonstrated that clinical tumor response was significantly associated with OS in the overall patient group. Further investigations regarding the optimal radiation dose in the definitive chemoradiation and the optimal treatment scheme in locally recurrent NSCLC would be required.

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Prognosis of pN3 Stage Gastric Cancer
Jung Ryun Ahn, Minkyu Jung, Chan Kim, Min Hee Hong, Hong Jae Chon, Hye Ryun Kim, Hei-Cheul Jeung, Woo Jin Hyung, Sung Sook Lee, Hyun Cheol Chung, Sung Hoon Noh, Sun Young Rha
Cancer Res Treat. 2009;41(2):73-79.   Published online June 30, 2009
DOI: https://doi.org/10.4143/crt.2009.41.2.73
AbstractAbstract PDFPubReaderePub
Purpose

The aim of this study was to determine the prognosis of pN3 stage gastric cancer patients after they have undergone curative resection, and we also wanted to identify the prognostic factors according to the clinico-pathologic features.

Materials and Methods

Between January 2000 and December 2004, we retrospectively reviewed the medical records of the patients with histologically confirmed pN3 stage gastric cancer. They underwent both gastrectomy and lymphadenectomy with a curative aim. We categorized the pN3 stage patients into 2 groups; one with pN3 only (pN3M0) and the other with pN3 combined with M1 stage (pN3M1) that included peritoneal seeding, hepatic metastasis or para-aortic LN metastasis.

Results

Out of 467 patients with stage IV gastric adenocarcinoma who received surgery, 260 patients underwent curative resection and they were pathologically staged as N3. Among these 260 patients, 78 patients were classified as the pN3/M1 stage. For all the patients, the median follow-up period was 19 months (range: 1~108 months) and the median overall survival time was 16.2 months (95% CI, 14.1~18.3%). The 5-year survival rate of the pN3/M0 group was significantly higher than that of the pN3/M1 group (12.6% vs. 2.6%, respectively, p<0.0001). The identified predictor for a worse prognosis was an advanced T4 stage (HR: 3.38, 95% CI, 1.4~8.3, p=0.008) for the pN3 patients.

Conclusion

The survival for the pN3 gastric cancer patients after curative gastrectomy was significantly longer in the pN3/M0 group as compared to that of the pN3/M1 group. An advanced T stage was a predictor for a poor prognosis for the pN3 patients. Therefore, diverse treatment strategies for these heterogeneous pN3 gastric cancer patients are needed for improving their survival.

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    Yan Li, Xiao-Yu Li, Li-Xiang Li, Ru-Chen Zhou, Yinhe Sikong, Xiang Gu, Bi-Ying Jin, Bing Li, Yan-Qing Li, Xiu-Li Zuo
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    Marta Molina Romero, Emilio José Laserna Mendieta, Gema María Varo Sánchez, María Concepción Alonso-Cerezo, María Orera Clemente
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Uterine Leiomyosarcoma : 14-year Two-center Experience of 31 Cases
Woo Young Kim, Suk-Joon Chang, Ki-Hong Chang, Jong-Hyuck Yoon, Jang Hee Kim, Byoung-Gie Kim, Duk-Soo Bae, Hee-Sug Ryu
Cancer Res Treat. 2009;41(1):24-28.   Published online March 31, 2009
DOI: https://doi.org/10.4143/crt.2009.41.1.24
AbstractAbstract PDFPubReaderePub
Purpose

The aim of this study was to evaluate the clinicopathological characteristics of uterine leiomyosarcoma (LMS) and possible prognostic factors.

Materials and Methods

This study included 31 patients with histologically proven LMS at Samsung Medical Center and Ajou University Hospital between 1994 and 2007. The medical records and available histological slides were reviewed retrospectively.

Results

The median age was 46 years (range, 32~63). The most common symptom was vaginal bleeding (11 patients, 35.5%). There were 23 patients with stage I, one patient with stage III, seven patients with stage IV disease. The median follow up time was 29 months (range, 1~94). The most common recurrence site was lung (5 case), followed by pelvis and upper abdomen (2 case). Nine patients died of disease with a 5-year overall survival rate of 63%. Early tumor stage and mitotic count were the prognostic factor in univariate analysis (p<0.0001 and p=0.0031, respectively), but early tumor stage only was associated with prognosis in multivariate analysis (p=0.010 vs p=0.143). Adjuvant treatment for early stage disease did not decrease the recurrence rate (p=0.1075), but high mitotic count (15>10HPF) had a trend for disease recurrence in early stage LMS (p=0.0859).

Conclusion

Mitotic count less than 15/HPF in early stage may be related with longer progression-free interval, but we could not reach the conclusion that adjuvant therapy in early stage LMS be effective.

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Prognostic Significance of Serum and Tissue Carcinoembryonic Antigen in Patients with Gastric Adenocarcinomas
Seong-Hoon Park, Ki-Beom Ku, Ho-Young Chung, Wansik Yu
Cancer Res Treat. 2008;40(1):16-21.   Published online March 31, 2008
DOI: https://doi.org/10.4143/crt.2008.40.1.16
AbstractAbstract PDFPubReaderePub
Purpose

Carcinoembryonic antigen (CEA) is known to be elevated in nearly all solid malignancies. The prognostic role of CEA in gastric cancers however, is still controversial. We evaluated preoperative serum CEA levels and CEA expression from the resected tumor tissues to determine whether they have prognostic significance in gastric cancer patients.

Materials and Methods

Medical records of 810 patients who underwent surgery for gastric adenocarcinoma from June, 1998 to February, 2002 in Kyungpook National University Hospital were reviewed. Serum CEA level was evaluated by radioimmunoassay preoperatively, and the cut-off level for positivity was 7.0 ng/ml. Labeled streptavidin-biotin peroxidase method was used to determine CEA expression from the gastric cancer tissues.

Results

Serum and tissue CEA were positive in 9.3% and 91.1% of the patients, respectively. They had no correlation with each other. The positivity rate of serum CEA had positive correlation with invasion depth (p<0.001), lymph node metastasis (p<0.001), distant metastasis (p=0.006), and final stage (p<0.001). Well differentiated tumors showed higher serum CEA positivity (p=0.002). Patients with positive serum CEA had higher recurrence rate (p<0.001). Multivariate analysis showed significantly lower survival rate in patients with preoperative CEA levels over 7 ng/ml than those with lower levels (48.0% vs. 80.7%; p<0.001). The positivity rates of tissue CEA were higher in advanced cancers (p=0.033) and in more advanced stages (p=0.029). Tissue CEA positivity showed no correlation with recurrence or survival.

Conclusions

Preoperative serum CEA level had correlation with disease progression and survival in gastric cancer patients, and proved to be an independent prognostic factor. Tissue CEA expression in gastric cancers had no prognostic information.

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Case Report
Palliative Radiotherapy in a Patient with Pulmonary Adenoid Cystic Carcinoma
BoKyong Kim
Cancer Res Treat. 2007;39(4):185-188.   Published online December 31, 2007
DOI: https://doi.org/10.4143/crt.2007.39.4.185
AbstractAbstract PDFPubReaderePub

Primary adenoid cystic carcinoma in the lung is very rare, so its clinicopathologic characteristics have usually been extrapolated from the salivary disease. However, the clinical courses of pulmonary adenoid cystic carcinomas may be different from those of salivary disease, and individual differences may also exist. I report here on a case of a patient who was initially diagnosed as pulmonary adenoid cystic carcinoma with liver metastases and the tumor showed extreme radiosensitivity, but it also underwent an aggressive clinical course. Adenoid cystic carcinoma is usually known to be a slowly growing tumor, but it may rapidly disseminate, like in this patient. Therefore, the factors predicting aggressive behavior should be determined and the treatment might be individualized according to the primary sites and on the patient's basis.

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Original Articles
Prognostic Factors for Advanced Gastric Cancer: Stage-stratified Analysis of Patients who Underwent Curative Resection
Joong-Min Park, Woo-Sang Ryu, Jong-Han Kim, Sung-Soo Park, Seung-Joo Kim, Chong-Suk Kim, Young-Jae Mok
Cancer Res Treat. 2006;38(1):13-18.   Published online February 28, 2006
DOI: https://doi.org/10.4143/crt.2006.38.1.13
AbstractAbstract PDFPubReaderePub
Purpose

Advanced gastric cancer patients have a poorer prognosis as compared to the patients with early gastric cancer. This study was conducted to define the prognostic factors for advanced gastric cancer.

Materials and Methods

606 patients with advanced gastric cancer who underwent curative gastric resection at our hospital were retrospectively examined. The patients were divided into two groups: group 1 was comprised of patients with a survival time <5 years, and group 2 patients had a survival time ≥5 years. We compared clinicopathological characteristics of the two groups by performing univariate and multivariate analysis. We also investigated the prognostic factors according to the stage.

Results

On univariate analysis, 7 factors (age, tumor size, Borrmann type, resection type, distal resection margin, depth of invasion and lymph node status) were found to be different, and multivariate analysis revealed that patient age, depth of invasion and lymph node metastasis were the only significantly differences between the two groups. On the other hand, age and the Borrmann type for stage I b patients, age and the number of retrieved lymph nodes for stage II patients, tumor size for stage III patients, and the type of resection for stage IV patients were found to be the independent prognostic factors.

Conclusion

The age of patients had prognostic value in the early stages of advanced gastric cancers such as stage I b or II. The number greater than 20 retrieved lymph nodes affected the survival, particularly for the patients with stage II disease, and the tumor size was a significant prognostic factor for patients with stage III disease. Therefore, physicians are advised to pay special attention to lymph node dissection for those patients with stage II or III disease.

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Clinical Prognostic Factors for Radical Cystectomy in Bladder Cancer
Seung Hyun Jeon, Sung-Hyun Jeon, Sung-Goo Chang
Cancer Res Treat. 2005;37(1):48-53.   Published online February 28, 2005
DOI: https://doi.org/10.4143/crt.2005.37.1.48
AbstractAbstract PDFPubReaderePub
Purpose

We investigated the effects of radical cystectomy and the prognostic factors that affect the survival of bladder cancer patients.

Materials and Methods

From 1979 to 2002, 59 patients with long-term follow up results of at least 2 years were enrolled in this study. Indications for surgery included muscle invasive bladder cancer and high-risk superficial bladder cancer. The cancer specific and recurrence free survival rates with respect to the possible prognostic factors were determined using Kaplan-Meier statistics.

Results

The mean patient age was 62.8 years (M: 48, F: 11), and the estimated 5- and 10-year survival rates were 62% and 39.4%, respectively. The median time to local or systemic recurrence was 16 months (range: 5~100), and the average survival durations after local and systemic recurrence were 14.4 months and 12.7 months, respectively. Pathologic stage, tumor grade, mean nuclear area, sex and lymphatic invasion were significant factors by univariate analysis (p<0.05). The disease related survival rate in patients having progression from an initial superficial tumor was lower than for those patients who displayed muscle invasive disease at the initial treatment. Multivariate analysis identified pathologic stage and lymphatic invasion as independent prognostic factors.

Conclusions

Radical cystectomy for organ-confined cancer showed favorable 5- and 10-year survival rates. The survival rate for patients with progression from an initial superficial tumor was worse than for those patients with invasive tumor at the initial presentation. The most significant independent prognostic factors were the pathologic stage and the presence of lymphatic invasion, which were highly correlated with all the investigated disease endpoints.

Citations

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  • Development of robust artificial neural networks for prediction of 5-year survival in bladder cancer
    Hriday P. Bhambhvani, Alvaro Zamora, Eugene Shkolyar, Kris Prado, Daniel R. Greenberg, Alex M. Kasman, Joseph Liao, Sumit Shah, Sandy Srinivas, Eila C. Skinner, Jay B. Shah
    Urologic Oncology: Seminars and Original Investigations.2021; 39(3): 193.e7.     CrossRef
  • Alterations of Global Histone H3K9 and H3K27 Methylation Levels in Bladder Cancer
    Jörg Ellinger, Anne Bachmann, Friederike Göke, Turang E. Behbahani, Claudia Baumann, Lukas C. Heukamp, Sebastian Rogenhofer, Stefan C. Müller
    Urologia Internationalis.2014; 93(1): 113.     CrossRef
  • Global histone H4K20 trimethylation predicts cancer-specific survival in patients with muscle-invasive bladder cancer
    Ann-Christin Schneider, Lukas C. Heukamp, Sebastian Rogenhofer, Guido Fechner, Patrick J. Bastian, Alexander von Ruecker, Stefan C. Müller, Jörg Ellinger
    BJU International.2011; 108(8b): E290.     CrossRef
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Expression of Cyclooxygenase (COX)-2 as a Prognostic Factor in Nasopharyngeal Cancer
Kyubo Kim, Hong-Gyun Wu, Suk Won Park, Chong Jai Kim, Charn Il Park
Cancer Res Treat. 2004;36(3):187-191.   Published online June 30, 2004
DOI: https://doi.org/10.4143/crt.2004.36.3.187
AbstractAbstract PDFPubReaderePub
Purpose

To evaluate the relationship between treatment failure and COX-2 expression in nasopharyngeal cancer patients treated with chemotherapy and radiotherapy.

Materials and Methods

The subjects of this study were 22 nasopharyngeal cancer patients. The patients were treated with neoadjuvant chemotherapy, followed by radiotherapy, or with radiotherapy alone. The formalin-fixed, paraffin-embedded tissues of 11 patients who developed a locoregional recurrence (n=7) or distant metastasis (n=4) were compared with those of 11 disease free patients. Prognostic factors, including histological type, stage, radiation dose and chemotherapy, were well balanced between the two groups. The COX-2 expression was determined immunohistochemically.

Results

COX-2 expression was stronger in the patients with a locoregional recurrence or distant metastasis than in those free of disease. The COX-2 distribution scores of the control group were as follows: 0 in 7, 1 in 2 and 2 in 2 patients. In the recurrence group, the scores were as follows; 0 in 3, 1 in 1, 2 in 2 and 3 in 5 patients. COX-2 expression was shown to have a statistically significant influence on the treatment failure by the Mann-Whitney U test (p=0.024) and Mantel-Haenszel Chi-Square test (p=0.018). It also significantly influenced the treatment failure when an analysis was performed within patients with a undifferentiated histology (p=0.039 by the Mann-Whitney U test, p=0.037 by the Mantel-Haenszel Chi-Square test).

Conclusion

COX-2 expression is believed to be one of the important factors associated with a locoregional recurrence or distant metastasis.

Citations

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  • Clinicopathological and prognostic significance of cyclooxygenase-2 expression in head and neck cancer: A meta-analysis
    Bin Yang, Lin Jia, Qiaojuan Guo, Hui Ren, Yanping Hu, Tao Xie
    Oncotarget.2016; 7(30): 47265.     CrossRef
  • Prognostic significance of expression of cyclooxygenase‐2, vascular endothelial growth factor, and epidermal growth factor receptor in nasopharyngeal carcinoma
    Jianji Pan, Tianlan Tang, Luying Xu, Jiade J. Lu, Senan Lin, Sufang Qiu, Gang Chen, Ivan W. K. Tham
    Head & Neck.2013; 35(9): 1238.     CrossRef
  • Immunohistochemical study identifying prognostic biomolecular markers in nasopharyngeal carcinoma treated by radiotherapy
    Yeon‐Joo Kim, Heounjeong Go, Hong‐Gyun Wu, Yoon Kyung Jeon, Suk Won Park, Seung Hee Lee
    Head & Neck.2011; 33(10): 1458.     CrossRef
  • Immunohistochemical Study to Evaluate the Prognostic Significance of Four Biomolecular Markers in Radiotherapy of Nasopharyngeal Carcinoma
    Yeon-Joo Kim, Seung Hee Lee, Hong-Gyun Wu, Heounjeong Go, Yoon Kyung Jeon
    The Journal of the Korean Society for Therapeutic Radiology and Oncology.2010; 28(2): 57.     CrossRef
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The Prognostic Significance of the Overexpression of HER-2/ neu in Korean Gastric Carcinomas and the In Vitro Effects of Anti-HER-2/neu Antibody on Cell Growth in the Gastric Carcinoma Cell Lines
Seock Ah Im, Kyung Eun Lee, Eunmi Nam, Seung Hyun Nam, Do Yeun Kim, Chu Myong Seong, Hae Young Park, Woon Sup Han, Ju Young Seoh, Soon Nam Lee
Cancer Res Treat. 2003;35(2):109-116.   Published online April 30, 2003
DOI: https://doi.org/10.4143/crt.2003.35.2.109
AbstractAbstract PDF
PURPOSE
The HER2 gene encodes a 185-kd transmembrane glycoprotein receptor (p185(HER2)) that has partial homology with the epidermal growth factor receptor (EGFR) and shares intrinsic tyrosine kinase activity. The HER2 gene has been found to be amplified in various human cancers and to be associated with poor prognosis. The authors investigated the correlation between clinicopathologic factors and the overexpression of the p185(HER2) in Korean gastric adenocarcinoma patients, and determined whether the antiproliferative effects of anti- p185(HER2) antibody can also be observed on gastric cancer cell lines that overexpress this growth factor receptor. MATERIALS AND METHODS: We evaluated the relationship between p185(HER2) overexpression and clinicopathological features in 94 (M: F=52: 42) gastric adenocarcinoma patients (median age 59 years). Protein expression was analysed by immunohistochemical staining in paraffin embedded tissues with monoclonal antibody for p185(HER2). To explore the role of humanized anti-p185(HER2) monoclonal antibody trastuzumab (Herceptin ) in vitro, the growth curve of Korean gastric cancer cells that overexpress the p185(HER2) protein was studied and a cell cycle analysis was performed. RESULTS: p185(HER2) overexpression correlates positively with lymph node metastasis (p=0.002), distant metastasis (p=0.01), AJCC classification (p=0.01), higher relapse rate p=0.001), and a tendential association with the pT stage (p=0.054). p185(HER2) overexpression was found to be more frequent in advanced gastric cancer than early gastric cancer (54.1% vs 24.2%, p=0.008). Patients with overexpression of p185(HER2) were found to have significantly lower relapse-free (p=0.003) and overall survival (p= 0.0004) than patients without overexpression. Among several Korean gastric cancer cell lines, SNU-1, SNU-5, and SNU-620 overexpress p185(HER2). Trastuzumab inhibited the proliferation of p185(HER2) overexpressed Korean gastric cancer cell line by 21% with down-regulation of p185(HER2) protein expression. DNA fluorescence flow cytometry of propidium iodide-stained nuclei showed a reduction in the fraction of the S phase following treatment with trastuzumab. CONCLUSIONS: Taken together, our observations suggest the potential prognostic significance of p185(HER2) overexpression in Korean gastric adenocarcinoma patients and point to the need for further research on this mechanism. This suggests the possible use of p185(HER2) as a therapeutic target in gastric cancer.

Citations

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  • A case of pathological complete regression in combined modality treatment of resectable Her2/neu-positive gastric cancer
    A. V. Avgustinovich, S. G. Afanasyev, L. V. Spirina, E. V. Kaygorodova, R. V. Ermolenko, E. N. Samtsov, I. G. Frolova, O. V. Cheremisina
    Siberian journal of oncology.2024; 23(1): 170.     CrossRef
  • The Chinese Society of Clinical Oncology (CSCO): clinical guidelines for the diagnosis and treatment of gastric cancer
    Feng‐Hua Wang, Lin Shen, Jin Li, Zhi‐Wei Zhou, Han Liang, Xiao‐Tian Zhang, Lei Tang, Yan Xin, Jing Jin, Yu‐Jing Zhang, Xiang‐Lin Yuan, Tian‐Shu Liu, Guo‐Xin Li, Qi Wu, Hui‐Mian Xu, Jia‐Fu Ji, Yuan‐Fang Li, Xin Wang, Shan Yu, Hao Liu, Wen‐Long Guan, Rui‐Hu
    Cancer Communications.2019; 39(1): 1.     CrossRef
  • The neutrophil-to-lymphocyte ratio prechemotherapy and postchemotherapy as a prognostic marker in metastatic gastric cancer
    Hyunho Kim, Sang Mi Ro, Ji Hyun Yang, Joon Won Jeong, Ji Eun Lee, Sang Young Roh, In-Ho Kim
    The Korean Journal of Internal Medicine.2018; 33(5): 990.     CrossRef
  • Potential Prognostic Significance of p185HER2 Overexpression with Loss of PTEN Expression in Gastric Carcinomas
    Seock-Ah lm, Kyung Eun Lee, Eunmi Nam, Do Yeun Kim, Joo-Ho Lee, Ho-Seong Han, Ju-Young Seoh, Hae-Young Park, Min-Sun Cho, Woon Sup Han, Soon Nam Lee
    Tumori Journal.2005; 91(6): 513.     CrossRef
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A Clinical Analysis of PTEN Expressions in Breast Cancers
Hang Ju Cho, Jeong Soo Kim, Kee Hwan Kim, Chang Hyeok Ahn, Woo Chan Park, Se Jeong Oh, Sang Seol Jung, Keun Woo Lim, Seock Ah Im
Cancer Res Treat. 2003;35(2):102-108.   Published online April 30, 2003
DOI: https://doi.org/10.4143/crt.2003.35.2.102
AbstractAbstract PDF
PURPOSE
The PTEN gene, a novel tumor suppressor, is localized to chromosome 10q23.3 and shares extensive homology with the cytoskeletal protein, tensin. A high frequency of mutations at the PTEN locus has been described in a variety of neoplasms including breast cancer and Cowden Disease. However, the role of PTEN alterations and its association with clinicopathological factors have not been well established. We investigated the relationship between the PTEN expression and clinicopathological factors.
MATERIALS AND METHODS
Formalin-fixed, paraffin-embedded tissues from 105 women with breast cancer were evaluated for the PTEN expression and were scored semi-quantitatively based on staining intensity and distribution. Results were statistically compared with clinicopathological factors.
RESULTS
Forty-seven (45%) of the 105 breast cancers had a loss of the PTEN expression. In the recurrent group, 19 of 32 (59%) patients showed a loss of the PTEN expression, whereas in the non-recurrent group, only 28 of 73 (38%) patients showed a loss of the PTEN expression. The loss of PTEN expression correlated with estrogen receptors (ER) (p=0.027), recurrence (p=0.046), HER-2/neu overexpression (p=0.016), disease-free survival (p=0.0163), and overall survival (p=0.0357). In particular, when HER-2/ neu was overexpressed, the overall survival rate correlated with the loss of PTEN expression statistically (p=0.0454), whereas when HER-2/neu was negative, there was no correlation (p=0.9808). Progesterone receptor (PR) and disease stage had no relationship with the PTEN expression. CONCLUSION: Our results support that PTEN plays a role as a tumor suppressor in breast cancer and is a prognostic factor in predicting recurrence.

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  • The prognostic value and potential drug target of phosphatase and tensin homolog in breast cancer patients
    Feng Xu, Chao Zhang, Jianxiu Cui, Jun Liu, Jie Li, Hongchuan Jiang
    Medicine.2017; 96(36): e8000.     CrossRef
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Ependymoma: a Retrospective Analysis of 25 Cases
Young Seok Kim, Seung Do Ahn, Eun Kyung Choi, Jong Hoon Kim, Sang Wook Lee, Young Ju Noh, Chang Jin Kim, Jeong Hoon Kim, Byung Duk Kwun
Cancer Res Treat. 2002;34(6):450-456.   Published online December 31, 2002
DOI: https://doi.org/10.4143/crt.2002.34.6.450
AbstractAbstract PDF
PURPOSE
We evaluated the patterns of failure, survival rate, prognostic factors and treatment related complication in postoperative radiation treatment of patients with ependymoma.
MATERIALS AND METHODS
We retrospectively analyzed 25 patients with histologically confirmed ependymoma treated between Jun. 1990 and Jun. 2001 with postoperative radiotherapy at Asan Medical Center. The study group comprised of 16 men and 9 women, with a median age of 23 years; including 6 supratentorial, 15 infratentorial and 4 spinal cord lesions. The extents of resection were ranked as either: gross total, near total, subtotal, partial resection or biopsy, with these types of surgical resection being performed in 13, 3, 6, 1 and 2 patients, respectively. Twelve of the patients had low grade ependymoma, and the other 13 a high grade tumor. The postoperative irradiation was administered using 4 MV or 6 MV photons, up to median dose of 55.0 Gy (range, 45.0~59.4 Gy), with the radiation field encompassing the preoperative tumor volume plus a 2 cm margin. Only 8 of the patients received either pre- or postoperative chemotherapy. The median follow-up period of survivors was 43 months.
RESULTS
Ten of the 25 patients (40%) developed a recurrence, and 5 died. Of the 10 recurred patients, 6 showed an in-field recurrence, and one developed both an in-field and an out of field recurrence. The remaining 3 patients showed an out of field recurrence, including one case with a leptomeningeal recurrence. The 5-year overall survival, and progression-free, survival rates were 74.0 and 56.1%, respectively. The histological grades were statistically significant prognostic factors of the overall and progression-free survival rates. There were no significant treatment related complications, with the exception of one case of panhypopituitarism, which occurred 30 months after completion of the radiotherapy.
CONCLUSION
The main pattern of recurrence was due to local failure. In order to improve the local control, and to reduce complications, advanced radiation treatment techniques, such as 3 dimensional radiotherapy, may be needed.

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  • Clinical outcomes of radiotherapy for spinal cord ependymoma with adverse prognostic features: a single-center study
    Hwa Kyung Byun, Seong Yi, Hong In Yoon, Se Hoon Kim, Jaeho Cho, Chang-Ok Suh
    Journal of Neuro-Oncology.2018; 140(3): 649.     CrossRef
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Results of Curative Radiotherapy Alone in Patients with Uterine Cervical Carcinomas
Taek Keun Nam, Byung Sik Nah, Sung Ja Ahn, Woong Ki Chung, Ho Seon Choi, Yoon Kyeong Oh
Cancer Res Treat. 2002;34(5):365-371.   Published online October 31, 2002
DOI: https://doi.org/10.4143/crt.2002.34.5.365
AbstractAbstract PDF
PURPOSE
To evaluate the role of curative radiotherapy alone in the treatment of uterine cervical carcinomas, by a retrospective analysis with respects to survival and pelvic control, and to find any risk factors of failure MATERIALS AND METHODS: Between Jan. 1990 and Dec. 1995, a total of 187 patients, diagnosed with uterine cervical carcinomas in FIGO stages greater than IA, were treated by curative radiotherapy alone with no chemotherapy. The ages of the patients ranged from 26 to 80 years, with a median of 60 years. The number of patients diagnosed with squamous cell carcinomas were 183 (97.9%). The number of patients with FIGO stage IB1, IB2, IIA, IIB, IIIA, IIIB and IVA were 61 (32.6%), 7 (3.7%), 43 (23.0%), 62 (33.3%), 3 (1.6%), 7 (3.7%) and 4 (2.1%), respectively. External radiotherapy was performed with 6 MV or 10 MV X-rays, with a dose range of 19.8 Gy~ 50.4 Gy (median; 30.6), to whole pelvis. Intracavitary radiation (ICR) was then performed using a high-dose rate remote controlled afterloader with radioisotopes of Co-60 and Cs-137. The fraction size of the ICR was 5 Gy twice a week, and was delivered up to total doses of 10 Gy~ 55 Gy (median; 40). After the ICR, additional pelvic external radiotherapy with midline shielding width of 4 cm was performed with the dose range of 0~30.6 Gy (median; 19.8), and the resultant total doses of A points ranged between 49.8 Gy and 86.0 Gy (median; 70.6).
RESULTS
The five-year overall survival rates of FIGO IB1, IB2, IIA, IIB, III and IVA were 88.3%, 83.3%, 86.1%, 65.2%, 60.0% and 50.0%, respectively (p=0.005). The pelvic control rates of each stage were 90.1%, 85.7%, 86.1%, 69.4%, 68.6% and 50.0%, respectively (p=0.03). From the multivariate analysis, the radiation response and tumor diameter were found to be significant factors affecting the overall survival. The significant factors influencing pelvic control were the radiation response and pre-treatment hemoglobin level.
CONCLUSION
The radiation response and tumor diameter were significant factors affecting survival, so patients with tumor diameters greater than 4 cm should be considered for a combined modality, such as concurrent chemoradiotherapy.
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Treatment Outcome of Brain Metastasis after the Cranial Radiotherapy Followed by Fractionated Stereotactic Radiotherapy and Its Prognostic Factors
Hak Jae Kim, Semie Hong, Suzy Kim, Jin Ho Kim, Il Han Kim, Charn Il Park, Sung Whan Ha, Hong Gyun Wu, Wee Saing Kang
Cancer Res Treat. 2002;34(4):284-288.   Published online August 31, 2002
DOI: https://doi.org/10.4143/crt.2002.34.4.284
AbstractAbstract PDF
To evaluate the effectiveness of whole brain radiotherapy followed by stereotactic radiotherapy for newly diagnosed brain metastasis.
MATERIALS AND METHODS
Thirty-three metastatic brain tumors received radiotherapy to the whole brain and stereotactic radiotherapy in 25 patients. Lung carcinomas were the most common (17/25) primary tumor. The radiation dose was 30 to 40 Gy for the whole brain, with a 12 to 40 Gy boost to the metastatic foci. Survival and local control rates were determined, and the prognostic factors for survival were evaluated.
RESULTS
The overall median survival was 15 months and the actuarial survivals at 1- and 2-year were 67% and 31%, respectively. The local tumor control rate was 79%, with a median follow-up period of 9 months (2~36 months). The prognostic factors associated with survival were age, tumor size and the existence of active extracranial metastasis, with the performance status showing marginal significance. No acute or chronic complications were observed in the patients.
CONCLUSION
From our data, cranial radiotherapy followed by stereotactic radiotherapy was useful in the local control of metastatic tumors, and in the survival of patients with tumor factors, such as small size or the absence of extracranial tumor activity, and host factors, such as young age or good performance status.

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  • Prognostic Factors and Survival Outcome of Whole Brain Radiotherapy in Metastatic Brain Cancer- A Single Regional Cancer Centre Experience in North India
    Purnima Thakur, Aman Sharma, Manish Gupta, Anupama Dhiman, Jyoti Sharma
    Journal of Evolution of Medical and Dental Sciences.2019; 8(43): 3206.     CrossRef
  • Clinical outcome of central nervous system metastases from breast cancer: differences in survival depending on systemic treatment
    Hee-Jun Kim, Seock-Ah Im, Bhumsuk Keam, Yu-Jung Kim, Sae-Won Han, Tae Min Kim, Do-Youn Oh, Jee Hyun Kim, Se-Hoon Lee, Eui Kyu Chie, Wonshik Han, Dong-Wan Kim, Tae-You Kim, Dong-Young Noh, Dae Seog Heo, In Ae Park, Yung-Jue Bang, Sung Whan Ha
    Journal of Neuro-Oncology.2012; 106(2): 303.     CrossRef
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Clinical Prognostic Factors and Treatment Outcome of Aggressive Non-Hodgkin's Lymphoma in Elderly Patients
Jung Hye Choi, Myung Ju Ahn, Mo Ran Ki, Ho Suk Oh, Young Yuel Lee, Il Young Choi, In Soon Kim
Cancer Res Treat. 2001;33(4):324-328.   Published online August 31, 2001
DOI: https://doi.org/10.4143/crt.2001.33.4.324
AbstractAbstract PDF
PURPOSE
The aim of this study was to determine the prognostic factors and treatment outcome of for elderly patients (age>or=60 at time of diagnosis) with aggressive non-Hodgkin's lymphoma (NHL).
MATERIALS AND METHODS
We analyzed 52 patients diagnosed with aggressive NHL between January 1990 and May 2000.
RESULTS
The patient's median age was 69 years (range: 60~92). Thirty-two (61.5%) patients were male. Patients included those with diffuse large B cell (53.8%), peripheral T cell (23.1%), AILD-like T-cell (3.8%), angiocentric (3.8%), mantle cell (3.8%), Burkitt's lymphoma (3.8%), and others (7.9%). International prognostic index (IPI) parameters were as follows: elevated LDH (60.8%), ECOG performance status>or=2 (32.7%), advanced stage (III/IV, 62.7%), and extranodal site>or=2 (11.5%). Twenty-six (50.0%) patients demonstrated a high and high-intermediate IPI. The median follow-up for surviving patients was 26.6 months. The overall median survival was 22.7 months and the 2-year survival rate was 46.9%. Among the 49 patientstreated with chemotherapy, 28 (57.1%) patients achieved complete remission (CR). Univariate analysis identified 8 prognostic factors for overall survival: age<70 (P=0.04), low/low-intermediate IPI (P=0.02), good performance (P= 0.04), normal WBC (P=0.008), normal Hb (P=0.02), normal LDH (P=0.04), CR on first line therapy (P<0.001), and absence of B symptom (P=0.001). In the multivariate analysis, the independent prognostic factors for improved overall survival were age <70 (P=0.03), low/low-intermediate IPI (P=0.03), normal WBC (P=0.006), and CR on first line therapy (P<0.001).
CONCLUSION
In our experience, even elderly patients (>or=60 years) with aggressive NHL can be successfully treated with conventional chemotherapy and the important prognostic factors for survival are age, IPI, initial WBC, and CR on first line treatment.

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  • Primary Palatine Tonsil Non-Hodgkin Lymphoma in Western Romania: A Comparison of Lower-Stage and Advanced-Stage Disease
    Raluca Morar, Norberth-Istvan Varga, Delia Ioana Horhat, Ion Cristian Mot, Nicolae Constantin Balica, Alina-Andree Tischer, Monica Susan, Razvan Susan, Diana Luisa Lighezan, Rodica Anamaria Negrean
    Hematology Reports.2025; 17(2): 17.     CrossRef
  • Reduced Dose Intensity FOLFOX-4 as First Line Palliative Chemotherapy in Elderly Patients with Advanced Colorectal Cancer
    Jee Hyun Kim, Do-Youn Oh, Yu Jung Kim, Sae Won Han, In-Sil Choi, Dong-Wan Kim, Seock-Ah Im, Tae-You Kim, Jong-Seok Lee, Dae-Seog Heo, Yung-Jue Bang, Noe Kyeong Kim
    Journal of Korean Medical Science.2005; 20(5): 806.     CrossRef
  • Doxorubicin‐based chemotherapy for diffuse large B‐cell lymphoma in elderly patients
    Keun‐Wook Lee, Dae‐Young Kim, Tak Yun, Dong‐Wan Kim, Tae‐You Kim, Sung‐Soo Yoon, Dae Seog Heo, Yung‐Jue Bang, Seonyang Park, Byoung Kook Kim, Noe Kyeong Kim
    Cancer.2003; 98(12): 2651.     CrossRef
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Clinical Features and Prognosis of Lung Cancer with Brain Metastasis
Kyung Eun Lee, Eun Mi Nam, He Jin Lee, Seung Hyun Nam, Do Yeun Kim, Seock Ah Im, Chu Myung Seong, Soon Nam Lee, Kyung Ja Lee
Cancer Res Treat. 2001;33(3):250-255.   Published online June 30, 2001
DOI: https://doi.org/10.4143/crt.2001.33.3.250
AbstractAbstract PDF
PURPOSE
Brain metastasis is estimated to occur in 20~40% of solid tumor patients and the most common primary tumor is lung cancer. Even though the prognosis of brain metastasis is grave and the 1-year survival rate is only 15%, symptom palliations are made with whole brain radiation therapy. We retrospectively evaluated the clinical features and prognostic factors of lung cancer with brain metastasis.
MATERIALS AND METHODS
From January 1987 to October 1999, 50 lung cancer patients with brain metastasis underwent whole brain radiation therapy. We reviewed the improvement in neurologic symptoms and survival according to the following parameters; performance status, histological type, presence of brain metastasis at the initial diagnosis of lung cancer, presence of extracranial metastasis, multiplicity of brain lesion, presence of primary lung symptom and treatment modalities.
RESULTS
The most frequent symptom with brain metastasis was a headache (50%). Palliation of the headache and other symptoms was achieved in 81% of the patients. Median overall survival after brain metastasis was 21 weeks and the 1 year survival rate was 15%. Patients without extracranial metastasis had a longer median survival than those with, 38 weeks versus 15 weeks, respectively (p=0.01).
CONCLUSION
In lung cancer with brain metastasis, neurologic symptoms can be palliated with whole brain radiation therapy, and in this study among such patients, absence of extracranial metastasis can be a good prognostic factor.

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  • Combination of EGFR-Directed Tyrosine Kinase Inhibitors (EGFR-TKI) with Radiotherapy in Brain Metastases from Non-Small Cell Lung Cancer: A 2010–2019 Retrospective Cohort Study
    Vineeth Tatineni, Patrick J. O’Shea, Shreya Saxena, Atulya A. Khosla, Ahmad Ozair, Rupesh R. Kotecha, Xuefei Jia, Yasmeen Rauf, Erin S. Murphy, Samuel T. Chao, John H. Suh, David M. Peereboom, Manmeet S. Ahluwalia
    Cancers.2023; 15(11): 3015.     CrossRef
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Results of Radio-thermotherapy in Stage IIIb Uterine Cervical Cancer Local response, survival rate and analysis of prognostic factor
Chang Woo Moon
J Korean Cancer Assoc. 2000;32(4):714-723.
AbstractAbstract PDF
PURPOSE
This retrospective study was conducted to obtain local response and survival rates, and to analyze prognostic factors affecting survival of patients treated with radio-thermotherapy for stage IIIb uterine cervical cancer.
MATERIALS AND METHODS
From May 1992 to Dec. 1996, 24 patients treated with radio-thermo therapy for stage IIIb uterine cervical cancer at department of Radiation Oncology in Kosin Medical College, Kosin University were enrolled. Radiotherapy used 6~10 MV linear accelerator was performed in whole pelvis with 4 portals box technique by conventional (180~200 cGy/ fraction, 5 fraction/week) method in 5 patients (20.8%) or hyperfractionated (120~135 cGy/fr., 2 fr./day, 10 fr./wk) in 19 patients (79.2%). Total dose of A-point was 67~112 Gy (median: 77.27 Gy). Hyperthermia used 8 MHz radiofrequency capacitive heating device was applied in pelvic area with 2~3 sessions per wk. Each course started within 15 to 20 minutes after radio therapy and took 40 to 60 minutes. Local progression free (LPFS), disease free (DFS) and overall (OS) rates were calculated in survival analysis. Statistics was calculated by Kaplan-Meier Method in survival and Log-rank test in statistical significance. Multivariate analysis for prognostic factor was applied to Cox Regression model. Follow-up duration was 6~82 months (median: 25 months).
RESULTS
Overall local response rate was 95.8% (45.8% in CR/50.0% in PR). Five year LPFS, DFS, OS were 48.6%, 31.7%, 67.1%, respectively. In univariate analysis, an age was the signi ficant prognostic factor in terms of OS (p=0.03), but was insignificant in LPFS and DFS. In multivariate analysis, none of evaluated factors are important in LPFS, DFS or OS.
CONCLUSION
Radio-thermotherapy for stage IIIb uterine cervical cancer did not increase 5 year LPFS, DFS and OS in spite of higher local response rate. Age was the only significant factor for OS in univariate analysis.
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Prognostic Factors and Survival Analysis for Patients with Colorectal Carcinomas
S H Kim, Byung Kwon Ahn, S U Baek
J Korean Cancer Assoc. 2000;32(2):331-338.
AbstractAbstract PDF
PURPOSE
Colorectal carcinomas are one of the most common malignant tumors in western countries. In Korea, it is the fourth common malignancy and the incidence has been rising over the past 10 years. We studied respectively to analyse prognostic factors in patients with colorectal cancer.
MATERIALS AND METHODS
893 patients with primary colorectal carcinomas who were operated at our hospital between 1989 and 1997 were reviewed. We examined possible prognostic factors such as, age and sex of patients, size and location of tumors, preoperative serum CEA and CA19-9 level, modified Dukes stage, operative methods, and lymph node metastases.
RESULTS
Overall 5-year survival rate was 61.8%. The 5-year survival rates in modified Dukes stage A, Bl, B2, Cl, C2 and D were 100%, 89.4%, 72.5%, 63.3%, 55.1% and 21.5%, respectively. Univariate analysis showed that age, modified Dukes stage, preoperative serum CEA and CA19-9 level, and lymphatic metastases were significant factors. The size of tumor was a significant factor in rectal carcinomas but not in colon carcinomas. In extraperitoneal rectal carcinomas, there were no survival differences between low anterior resection and abdominoperineal resection groups. Preoperative serum CEA level and modified Dukes' stage were significant in multivariate analysis, CONCLUSION: Modified Dukes stage, preoperative serum CEA were independent prognostic factors for patients with colorectal cancer.
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Effect of Adjuvant Chemotherapy of Operable Breast Cancer : Survival and Prognostic Factor Analysis
Jeong Gyun Kim, Tae Won Kim, Je Hwan Lee, Sung Bae Kim, Cheolwon Suh, Kyoo Hyung Lee, Jung Shin Lee, Sei Hyun Ahn, Hyesook Chang, Sang Hee Kim, Woo Kun Kim
J Korean Cancer Assoc. 1999;31(5):1018-1026.
AbstractAbstract PDF
PURPOSE
Though the therapy using regimens similar to western countries has been done by medical oncologists in several different centers in Korea, there is no large scale study about the results of those adjuvant chemotherapy as in western country and it is not clear whether the results are same in Korean population as in western countries not only in overall outcome but also depending on various prognostic categories. It is important to review whether Korean patients would have equivalent results as in western countries or not when they were treated with the same standardized regimens. We examined the effect of adjuvant systemic chemotherapy on survival and analyzed prognostic factors.
MATERIALS AND METHODS
A retrospective analysis of survival and prognostic factors was done in 341 consecutive breast cancer patients who received curative operation followed by systemic conventional adjuvant chemotherapy between 1989 and 1996. The survival rate was compared using Kaplan-Meier method and Log-rank method. To evaluate an independent prognostic factors, Cox proportional hazard model was used.
RESULTS
After median follow up of 56 months (range 28 118 months), the mean disease-free survival (DFS) and overall survival (OS) was 81.0+/-2.7 and 91.5+/-2.6 months respectively. The 5-year DFS and OS rate was 61% and 77%, respectively. On univariate analysis, prognostic factors significant for DFS were tumor size (<2 cm vs. > 2 cm), hormonal receptor status, and histologic grade. Prognostic factors affecting both DFS and OS are as follows: age ((pound)40 vs 41-50 vs. (3)51), number of axillary node involvement, .and stage. Multivariate analysis showed that the number of axillary node involvement was the strongest adverse predictor.
CONCLUSION
The effect of adjuvant chemotherapy in Korean patients is not different from western countries and this report emphasizes the prognostic importance of number of axillary node involvement in breast cancer patients and necessity of intensive management of those with four or more positive nodes.
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The Clinical Value of CD44 in Gastric Cancer
Kyung Ho Ryu, Hyung Chul Kim, Moo Jun Baek, Ok Pyung Song, Chang Jin Kim
J Korean Cancer Assoc. 1999;31(5):921-930.
AbstractAbstract PDF
PURPOSE
This research was performed to investigate the relationship between CD44 and cancer cell invasion depth, histologic differentiation, tumor size and lymph node metastasis in the gastric carcinoma.
MATERIALS AND METHODS
In 20 cases of early gastric cancer and 40 cases of advanced gastric cancer, the immunohistochemical staining for CD44v3 and CD44v5 was performed.
RESULTS
1. In all 60 cases, the positive rates for CD44v3 and CD44v5 were 18.3% and 71.7% respectively. 2. CD44v5 was expressed in 45% of early gastric cancer and 85% of advanced gastric cancer. 3. Larger tumor exhibited higher positive rates for CD44v5. 4. There were 28 cases of lymph node metastases out of 43 cases of CD44v5-positive primary gastric carcinoma (65.1%), and were 4 cases of lymph node metastases out of 17 CD44v5-negative cases (23.5%). 5. The 5 year survival rate was low in CD44v5- positive cases (p-value=0.039).
CONCLUSION
The tumors that exhibit deep invasion and have large size and lymph node metastases tend to have more frequent expression of CD44v3 and CD44v5. In especially CD44v5. We found a good correlation between he expression of CD44v5 and the established prognostic factors. Actually we can use the CD44v5 rather than CD44v3 as a prognostic factor in advanced gastric cancer.
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Clinical Characteristics and Prognostic Factors of Metastatic Tumor of Unknown Primary
Eun Kyung Cho, Keun Seok Lee, Chul Won Jung, Won Seog Kim, Ki Hyeong Lee, Dae Seog Heo, Yung Jue Bang, Noe Kyeong Kim
J Korean Cancer Assoc. 1999;31(3):607-616.
AbstractAbstract PDF
PURPOSE
For malignant diseases, predictions about tumor behavior and determination of appropriate therapy are based on the primary tumor sites, but 2-9% of cancer patients are diagnosed without identifiable primary tumor sites. Metastatic tumors of unknown primary origin (MUO) are a heterogeneous group of tumors with variable natural histories. The majority of these patients fall outside of treatable subjects and seldom respond to therapy. To define further the natural history of MUO and identify prognostic factors, we undertook a clinical analysis of 141 consecutive patients with a presumed diagnosis of MUO.
MATERIALS AND METHODS
One hundred forty-one patients were diagnosed with unknown primary tumor from Jan. 1, 1992 through Aug. 31, 1995. The primary end point for the study was survival, which was calculated from the first day of patient registration diagnosed histologically. The survival curves were estimated using the Kaplan-Meier method and compared using the log-rank test. To identify important prognostic factors, univariate and multivariate analyses were conducted.
RESULTS
Most of the 141 patients had histologic or cytologic evidence of adenocarcinoma and had more than one site metastatically involved. The predominant sites of tumor involvement were lymph node, peritoneum, bone, liver, lung, and pleura. Univariate and multivariate analyses identified numerous important prognostic factors with a significant influence on survival, including performance status (P 0.0001), specific organ sites involved (lung P 0.0076 or liver P 0.0310), and chemotherapy group (P- 0.0480).
CONCLUSION
This study validated clinical courses and important prognostic factors that had an impact on survival in MUO.
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Results of Surgical Treatment and Analysis of Prognostic Factors in Primary Gastric Adenocarcinoma
Cheol Hun Chung, Young Jae Mok, Gil Soo Son, Seung Joo Kim, Sae Min Kim
J Korean Cancer Assoc. 1999;31(3):458-465.
AbstractAbstract PDF
PURPOSE
Despite gsstric cancer is one of the most common ma1ignancies, its prognosis has not been improved significantly. Therefore, it is important to know what clinical and pathological factors relate to survival in gastric carcinoma in order to improve survival rate. The aim of this retrospective study was to evaluate treatment results and to analyze the factors that affect the survival of patients with gastric carcinoma.
MATERIALS AND METHODS
A total of 1,580 patients with primary gastric adenocarcinoma who had been treated surgically during the period 1983-1996 at the Department of Surgery, Korea University College of Medicine was studied to evaluate the treatment outcome. Prognostic factors were investigated by univariate and multivariate analyses in 1,407 resected patients.
RESULTS
The 5-year survival rate was 57.1% in all case, 62.4% in resected cases, and there was no survivor at 2.5 year in unresectable cases. In univariate analysis, gross type, maximum tumor diameter, depth of invasion, lymph node involvement, distant metastasis, histologic type and type of operation were found to correlate significantly with survival. Multivariate analysis indicated that lymph node involvement, depth of invasion and type of cancer were independently conelated with survival. The stage-related survival rates (UICC, 1987) were 95.8% (stage Ia), 87.6% (stage Ib), 76.7% (stage II), 51.3% (stage 1IIa), 25.5% (stage IIlb), 9.4% (stage IV) and the stage-related survival rates (UICC, 1997) 95.8% (stage Ia), 87.6% (stage Ib), 76.4% (stage II), 55.2% (stage IIla), 24.0% (stage IIIb), 13.4% (stage IV). There was no difference between two staging systems.
CONCLUSIONS
These results suggest that lymph node involvement, depth of invasion, and gross type were the most important prognostic factors, indicating that they may be helpful as predictors of long-term survival and in planning the treatment.
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Infra-red Thermography as a Predictor of Prognosis in Breast Cancer
Man Kyu Chae, Yong Seok Jang, Kyung Kyw Park, Kyung Yul Hur, Hye Kyung Lee, Wook Park, Min Hyuk Lee
J Korean Cancer Assoc. 1999;31(2):282-288.
AbstractAbstract PDF
PURPOSE
The purpose of this study is to analyze the usefulness of breast thermography in assessing the prognosis in breast cancer and to obtain correlative evidence between thermographic prognosis and prognostic factors for breast cancer.
MATERIALS AND METHODS
Thermographic examinations were performed in a room maintained at 20C. The patient was undressed to the waist, with both arms elevated for 10 minutes prior to the examination in order to cool and equilibrate the breast skin at room temperature. Digital infrared thermographic system was used (NEC, San-ei, Therm Tracer 6T67). The thermographic prognosis was classified according to Dr. Hobbins (Sl good, S2=fair and S-poor) suggested by Dr. Hobbins. The results were analyzed by Chi-Squire. One hundred three patients of breast cancer were examined by digital infrared thermographic system between Jan 1992 and December 1996.
RESULTS
The mean age was 48, with a range from 20 to 85. According to the TNM classification 25 (24%) were in stage I, 47 (46%) stage II, 29 (28%) stage III, and 2 (2%) stage IV. The tumor size ranged from 0.5 to 20 cm (mean 4 cm), On histologic examination, 43 (43.%) patients had metastasis in the axillary nodes, 40 (55%) patients was estrogen-receptor positive. The nuclear grade I was 46 (35%) patients, II 24 (28%) and III 16 (19%). The classification of thermographic prognosis were Sl in 47 cases (46%), 82 in 32 (31%) and 83 in 24 (23%). The classification of the thermographic prognosis was found to be statistically correlated with tumor size (p<0.0001), axillary node status (p<0.0001) and TNM tumor stage (p<0.0001). But nuclear grade and estrogen receptor were not statistically correlated with the thermographic prognosis. The correlation between thermographic prognosis and actual survival rate was not available.
CONCLUSION
These results suggest that breast thermography would be useful as a predictor in breast cancer before surgery.
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Prognostic Factor Analysis of Aggressive Non - Hodgkin's Lymphoma Based on International Prognostic Index Model
Min Hee Ryu, Young Iee Park, Hark Kyun Kim, Dae Ho Lee, Joo Young Jeong, Dong Wan Kim, Im Il Na, Ji Hyun Kim, Se Hoon Lee, Dae Seog Heo, Yung Jue Bang, Seon Yang Park, Byoung Kook Kim, Noe Kyeong Kim
J Korean Cancer Assoc. 1998;30(6):1269-1278.
AbstractAbstract PDF
PURPOSE
International Prognostic Index Model (IPIM) in aggressive non-Hodgkin's lymphoma was published and accepted generally as a better predictive model for prognosis. This study was undertaken to identify prognostic factors of aggressive non- Hodgkin's lymphoma and usefulness of IPIM in Korea.
MATERIALS AND METHODS
Previously untreated, pathologically proven 226 aggressive non-Hodgkin's lymphoma patients who were treated with CHOP or COP-BLAM V between 1986 and 1995 in Seoul National University Hospital were evaluated for clinical features predictive of overall survival.
RESULTS
Complete response (CR) was reached in 76% of all patients. With a median follow-up of 62 months, 5-year disease free survival of complete reponders was 67% and 5-year overall survival of all patients was 54%. In a univriate analysis, age, ECOG performance status, Ann Arbor stage, histologic subtype, bone marrow involvement, bulkiness, serum LDH level and number of extranodal involvement were significant prognostic factors for CR and survival (p<0.05). Of these, by multivariate analysis, age(RR 0.4, 95% CI 0.2~0.9) alone was a independent prognostic factor for CR. For disease free survival, no independent prognostic factor was found. For overall survival, Ann Arbor stage (RR 1.7, 95% CI 1.1~2.8), age (RR 1.7, 95% CI 1.1~2.6), Histologic subtype (RR 1.7, 95% CI 1.1~2.8), serum LDH level (RR 1.7, 95% CI 1.1~2.6) and bone marrow involvement (RR 1.8, 95% CI 1.0~3.1) were independent prognostic factors. According to risk group of IPIM, 5-year overall survival rate was 72% in low risk group, 46% in low intermediate risk group, 32% in high intermediate risk group, respectively, and median survival of high risk group was 12 months (RR 1, 2.3, 4.3, 6.4 respectively).
CONCLUSION
IPIM is a useful model for identifying poor prognostic groups in aggressive non-Hodgkin's lymphoma.
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Clinical Trial
Prognostic Significance of Peritumoral Lymphatic Vassel Invasion in Breast Cancer
Geun Tong Park, Min Gyun Im, Lee Su Kim, Song Kim, Chang Sig Choi, Bong Hwa Lee
J Korean Cancer Assoc. 1998;30(5):943-950.
AbstractAbstract PDF
PURPOSE
The well-known prognostic factors for breast cancer, such as axillary lymph node status, do not always account for the exact outcome. The developinent of other accurate prognostic factors would help in assessing high risk for the disease recurrence and death. Recently, there are reports that peritumoral lymphatic vessel invasion is a good prognostic factor to solid tumors in animal studies and clinical trials. This study was performed to estimate the significance of peritumoral lymphatic vessel invasion (PLVI) as a prognostic factor in breast cancer. Also, PLVI was compared with established clinicopathological prognostic factors and hormone receptors.
MATERIALS AND METHODS
A group of patient was selected from the Department of Surgery, College of Medicine, Hallym University, which consists of 43 out of 96 patients who received curative operation from 1985 to 1993. Peritumoral lymphatic vessel invasion by tumor cells on H&E stain was considered PLVI positive. We classified 43 breast-cancer patients into 32 with negative PLVI and ll with positive PLVL. We estimated the correlation between the PLVI and other established prognostic factors. We also calculated survivals based on PLVI.
RESULTS
The 4-year disease-free survival rate was 61.8+/-8.7%, and the 4-year overall survival rate was 73.0+/-8.0%. The receptor status of estrogen and of progesterone had significant impacts on survival (ER: p=0.0001, PR: p=0.0001). Also, metastasis status of lymph node had significant impacts on overall survival (p=0.0148). We found a significant correlation between PLVI and tumor size (p=0.004), estrogen receptor (p=0.002), progesterone receptor (p=0.006), but could not find any significant corelation between PLVI and menopausal status, histologic grade, nuclear grade, lymph node metastasis. PLVI status was corelated with disease free survival rate (p=0.01) and overall survival rate (p=0.01).
CONCLUSION
The determination of PLVI in breast cancer tissue may be useful as a prognostic factor, but it is necessary to investigate the PLVI in a large number of patients before this conclusion can be stated with certainty.
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