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Original Articles
Comparative Clinical and Economic Analysis of Robotic versus Video-Assisted Thoracoscopic Anatomical Resection for Lung Cancer
Ji Hyeon Park, Young Eun Hong, Hana Shim, Taeyoung Yun, Bubse Na, Kwon Joong Na, Hyun Joo Lee, In Kyu Park, Young Tae Kim, Chang Hyun Kang
Received February 27, 2025  Accepted March 16, 2026  Published online March 17, 2026  
DOI: https://doi.org/10.4143/crt.2025.230    [Epub ahead of print]
AbstractAbstract PDF
Purpose
This study aimed to compare the clinical outcomes and costs of robotic-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) in patients undergoing minimally invasive anatomical resection for primary lung cancer.
Materials and Methods
A retrospective analysis was conducted on 2,086 patients who underwent surgery at a single institution from January 2017 to July 2020, including 134 RATS and 1,952 VATS cases. Propensity score matching (PSM) was applied, resulting in 268 matched patients (134 RATS and 134 VATS). Cost data were obtained from hospital billing files, encompassing 20 categories, including total hospitalization fees, anesthesia fees, surgery fees, costs of surgical instruments and materials, and general examination fees.
Results
After PSM, RATS patients had a shorter median postoperative stay (5 days vs. 6 days, p=0.009) and lower thoracotomy conversion rate (1.5% vs. 14.9%, p < 0.001) than VATS. However, RATS incurred higher total costs by an average of $1,228 (p < 0.001), mainly due to increased surgical expenses ($1,163, p < 0.001). In multivariate analysis, RATS (12.41%, p < 0.001), neoadjuvant therapy (13.3%, p=0.005), complications (4.2%, p < 0.001), and length of stay (2.0%, p < 0.001) were found to be associated with higher costs.
Conclusion
Although RATS has been shown to reduce the thoracotomy conversion rate and length of hospital stay, it incurs higher costs than VATS, primarily due to increased surgical expenses. The justification for RATS should be further evaluated through sustainability and cost-effectiveness studies with long-term follow-up.
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Safety and Efficacy of Combining Metastasis-Directed Stereotactic Ablative Radiation Therapy with Tyrosine Kinase Inhibitors versus Immune Checkpoint Inhibitors in Metastatic Hepatocellular Carcinoma
Eunyeong Yang, Jeong Il Yu, Hee Chul Park, Myung Ji Goh, Byeong Geun Song, Wonseok Kang, Dong Hyun Sinn, Geum-Youn Gwak, Yong-Han Paik, Joon Hyeok Lee, Moon Seok Choi, Jung Yong Hong, Minsuk Kwon, Nalee Kim
Received September 5, 2025  Accepted February 1, 2026  Published online February 3, 2026  
DOI: https://doi.org/10.4143/crt.2025.966    [Epub ahead of print]
AbstractAbstract PDFSupplementary Material
Purpose
Immune checkpoint inhibitors (ICIs) have become a standard therapy for metastatic hepatocellular carcinoma (HCC), often as an alternative to tyrosine kinase inhibitors (TKIs). However, safety data combining ICIs with stereotactic ablative radiotherapy (SABR) remain limited. We compared the safety and efficacy of SABR combined with ICIs versus TKIs in patients with extrahepatic metastatic HCC.
Materials and Methods
This single-center retrospective study included patients with HCC who received SABR for extrahepatic metastases combined with either TKIs or ICIs within 30 days of SABR between January 2010 and June 2024. Adverse events (AEs; Common Terminology Criteria for Adverse Events ver. 5.0) and oncologic outcomes were evaluated using logistic regression and Cox models.
Results
Among 103 patients with 128 SABR-treated lesions, 72 patients (90 lesions) received SABR+TKI and 31 patients (38 lesions) received SABR+ICI. Acute AEs occurred only in the SABR+TKI group (8.9%), predominantly grade 1. Grade 3 late AEs were rare, occurring in one case in each group, while late AEs of lower grades were more frequent with SABR+ICI (any-grade: 57.9% vs. 25.6%, p < 0.001; grade ≥ 2: 23.7% vs. 8.9%, p=0.024). Multivariable analysis showed borderline increased risk of grade ≥ 2 late AEs with SABR+ICI (p=0.052). One-year local control, progression-free survival, and overall survival were 76.6%, 35.3%, and 72.3% respectively, with no significant differences between groups.
Conclusion
Metastasis-directed SABR combined with either TKIs or ICIs was generally well tolerated in patients with extrahepatic metastatic HCC, with rare grade 3 late AEs; grade ≥ 2 late AEs were more frequent with SABR plus ICIs, warranting prospective evaluation.
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Response to Neoadjuvant Systemic Therapy May Serve as an Indicator for Omitting Post–Breast-Conserving Surgery Radiation Therapy in Women with Early-Stage Breast Cancer
Chaofan Li, Yusheng Wang, Mengjie Liu, Shiyu Sun, Yiwei Jia, Jingkun Qu, Shuqun Zhang, Chong Du
Received June 1, 2025  Accepted September 7, 2025  Published online September 10, 2025  
DOI: https://doi.org/10.4143/crt.2025.584    [Epub ahead of print]
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
To avoid unnecessary toxicities and optimize the allocation of healthcare resources, it is crucial to adequately select patients with extremely low recurrence risk to downgrade or eliminate radiation therapy (RT).
Materials and Methods
From the Surveillance, Epidemiology, and End Results database, clinical data of 7,291 female patients with early-stage breast cancer who underwent neoadjuvant systemic therapy (NST) and breast-conserving surgery (BCS) were collected for this study. The patients were stratified by their response to NST, and the long-term survival, and risk of recurrence were assessed using Cox regression analysis and Fine-Gray competing risk models for those with and without post-BCS RT, respectively.
Results
Our results showed that female patients with early-stage breast cancer who achieved complete response (CR) to NST, omitting post-BCS RT achieved the same overall survival and disease-free survival as those who received the post-BCS RT, and the omission did not increase the risk of recurrence or breast cancer–specific death. For patients who did not achieve CR to NST, five clinical indicators (including age, N category, grade, response to NST, and molecular subtype) were employed to construct a nomogram for clinical prediction of overall survival, thereby identification of patients at relatively low recurrence risk. The validated results affirmed our model’s ability to accurately discriminate high- and low-risk patients and its promising clinical application value.
Conclusion
Post-BCS RT can be omitted for women with early-stage breast cancer who achieved CR to NST. For those who failed to achieve CR to NST, a nomogram was constructed for clinicians to decide whether to omit post-BCS RT or not based on individualized assessment.
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Lung and Thoracic cancer
Trends and Outcomes of Lung Cancer Surgery in South Korea
Joon Beom Park, Su-Jin Cho, Myung-Il Hahm, Danbee Kang, Seong Yong Park
Cancer Res Treat. 2026;58(2):443-453.   Published online May 27, 2025
DOI: https://doi.org/10.4143/crt.2025.295
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study analyzed nationwide trends in lung cancer surgery in South Korea over 14 years, focusing on surgical volume, patient demographics, surgical approaches, and outcomes.
Materials and Methods
We performed a retrospective cohort study using nationwide health insurance claims data (124,334 cases) and robotic surgery data (1,740 cases) provided by the manufacturer. Patients who underwent lung cancer surgery between 2010 and 2023 were included. Annual trends were assessed using the annual percentage change (APC), and logistic as well as linear regression models were used to identify predictors of mortality and prolonged hospital stay.
Results
The annual surgical volume increased from 4,557 in 2010 to 14,184 in 2023 (APC, 8.86%; p < 0.001). Video-assisted thoracoscopic surgery (VATS) became the predominant approach, rising from 52.9% to 94.8% (APC, 4.11%; p < 0.001). Sub-lobar resections increased, with wedge resections growing from 9.0% to 18.5% (APC, 5.72%; p < 0.001) and segmentectomies from 3.0% to 17.9% (APC, 14.63%; p < 0.001). The proportion of female patients increased from 32.0% to 44.7% (APC, 2.39%; p < 0.001), while patients aged 70-79 years increased from 26.3% to 32.3% (APC, 1.60%; p < 0.001) and those aged ≥ 80 years from 2.0% to 6.2% (APC, 9.63%; p < 0.001). The median hospital stay decreased from 13 to 7 days (APC, –4.34%; p < 0.001), and 30-day mortality declined from 2.45% to 0.76% (APC, –8.32%; p < 0.001).
Conclusion
Lung cancer surgery in Korea has increased substantially, with a notable shift toward minimally invasive and lung-sparing techniques that have improved outcomes. However, persistent disparities underscore the need for a national surgical registry.
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Gastrointestinal cancer
Combined Transarterial Chemoembolization and External Beam Radiotherapy for Identifying Surgical Candidates for Hepatocellular Carcinoma with Macroscopic Vascular Invasion: A Propensity Score–Weighted Analysis
Sumin Lee, Jinhong Jung, Jonggi Choi, So Yeon Kim, Jin Hyoung Kim, Danbi Lee, Ju Hyun Shim, Kang Mo Kim, Young-Suk Lim, Han Chu Lee, Gi-Won Song, Jin-hong Park, Sang Min Yoon
Cancer Res Treat. 2026;58(1):275-283.   Published online May 22, 2025
DOI: https://doi.org/10.4143/crt.2025.076
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to evaluate the role of hepatic resection in patients with objective responses after combined transarterial chemoembolization (TACE) and radiotherapy (RT) for hepatocellular carcinoma (HCC) with macroscopic vascular invasion (MVI).
Materials and Methods
We retrospectively reviewed the patients treated with combined TACE and RT for HCC with MVI between 2010 and 2015. Some of the patients with objective responses underwent hepatic resection or liver transplantation; to investigate the impact of surgery, patients with objective responses who did not undergo surgery were selected as the control group. Survival outcomes were compared using a propensity score–based stabilized inverse probability of treatment weighting method.
Results
Out of the 170 patients with objective responses after combined TACE and RT, 41 patients underwent surgery, including eight liver transplantations. The unweighted surgery group was younger and had a higher proportion of solitary tumors and unilateral vascular involvement. After adjustment, the 3-year overall survival (OS) rates were 61.0% and 28.6% in the surgery and non-surgery groups, respectively. The most important prognostic factor for OS was surgery (adjusted Cox hazard ratio [HR], 0.28; 95% confidence interval [CI], 0.17 to 0.46; p < 0.001). Complete response after TACE and RT (vs. partial response) was also a significant prognostic factor for OS (adjusted HR, 0.41; 95% CI, 0.27 to 0.61; p < 0.001). There was no surgical mortality. Four patients (9.8%) required additional surgery due to bleeding or graft failure.
Conclusion
Hepatic resection was significantly associated with improved OS in patients who showed objective responses after receiving combined TACE and RT for HCC with MVI.

Citations

Citations to this article as recorded by  
  • Multimodal deep learning model for predicting prognosis following radiotherapy-based combination therapy in unresectable hepatocellular carcinoma
    Haoming Xia, Qizhen Huang, Ziyue Huang, Ziqi Zhou, Yongyi Zeng, Jingguang Ma, Xiangyu Fan, Yechong Huang, Yuexi Dong, Haitao Zhao, Gong Li, Jitao Wang, Shizhong Yang, Jiahong Dong
    Cancer Letters.2026; 636: 218122.     CrossRef
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Rare cancer
Outcomes of Stereotactic Body Radiation Therapy for Large Uveal Melanoma: A Retrospective Analysis of Asian Population
Jong Won Park, Seowoong Jun, Ki Chang Keum, Christopher Seungkyu Lee, Kyung Hwan Kim
Cancer Res Treat. 2025;57(4):1218-1230.   Published online December 31, 2024
DOI: https://doi.org/10.4143/crt.2024.580
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to investigate the clinical outcomes of stereotactic body radiation therapy (SBRT) in patients with large uveal melanoma (UM).
Materials and Methods
We conducted a retrospective review of 64 consecutive patients with UM treated with CyberKnife at Yonsei Cancer Center from September 2015 to October 2021. The median radiation dose was 60 Gy (range, 48 to 64 Gy) administered in four fractions every alternate day. The local failure-free rate (LFFR), distant metastasis-free rate (DMFR), progression-free survival (PFS), and overall survival (OS) were assessed using the Kaplan-Meier method and log-rank test. Cox regression analysis was performed to analyze the predictive factors affecting survival outcomes and the factors associated with vision loss.
Results
The median tumor diameter and height were 11.5 mm and 8.4 mm, respectively. After a median follow-up of 32.1 months (range, 4.9 to 89.9 months), the 3-year LFFR, DMFR, PFS, and OS were 89.5%, 70.5%, 65.5%, and 89.4%, respectively. Enucleation was performed in 13 (20.3%) patients, with three cases attributed to disease progression. A larger tumor diameter was associated with significantly worse DMFR (hazard ratio [HR], 1.35; p=0.015) and OS (HR, 1.49; p=0.026) in the multivariate analysis. Regarding visual prognosis, 41 patients (64.1%) had baseline visual acuity ≥ 20/200, but only four patients (6.3%) maintained visual acuity ≥ 20/200 by the final follow-up. Initial visual acuity ≥ 20/40 (HR, 0.45; p=0.030) was the single favorable significant factor predicting visual retention ≥ 20/200 in multivariate analysis.
Conclusion
SBRT using CyberKnife demonstrated a comparable local control rate to that observed in historical studies for patients with large UM. Distant metastasis and treatment-related ocular toxicity remain the limitations of this treatment.

Citations

Citations to this article as recorded by  
  • Carbon Ion Versus Photon-based Stereotactic Ablative Radiation Therapy for Patients with Choroidal Melanoma
    Jina Kim, Masaru Wakatsuki, Shuri Aoki, Jong Won Park, Nao Kobayashi, Ki Chang Keum, Hirokazu Makishima, Christopher Seungkyu Lee, Hitoshi Ishikawa, Kyung Hwan Kim
    Advances in Radiation Oncology.2025; 10(12): 101915.     CrossRef
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Lung and Thoracic cancer
Upfront Stereotactic Radiosurgery or Fractionated Stereotactic Radiotherapy in Elderly Patients with Brain Metastases from Non–Small Cell Lung Cancer: A Retrospective Analysis of a 10-Year Bi-institutional Experience
Myungsoo Kim, Jihye Cha, Hun Jung Kim, Woo Chul Kim, Jeongshim Lee
Cancer Res Treat. 2025;57(1):47-56.   Published online July 3, 2024
DOI: https://doi.org/10.4143/crt.2024.223
AbstractAbstract PDFPubReaderePub
Purpose
Stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT) are increasingly used as initial therapies for brain metastases (BM). We aimed to assess the outcomes of SRS/FSRT in patients aged ≥ 65 years who had 1-10 BM from non–small cell lung cancer (NSCLC).
Materials and Methods
We retrospectively reviewed 91 elderly NSCLC patients with 222 BM who were treated with SRS/FSRT at two institutions between 2010 and 2020. The primary endpoint was overall survival (OS) after SRS/FSRT. In addition, in-field local control (IFLC) within the treated field was evaluated. Statistical analysis was performed to identify the prognostic factors affecting OS and IFLC.
Results
During a median follow-up of 18 months, the median OS was 32 months. The 1- and 2-year survival rates were 69.8% and 56.1%, respectively. In multivariate analysis, the NSCLC-specific graded prognostic assessment (GPA) score (p=0.007) and administration of systemic therapy (p=0.039) were defined as prognosticators affecting OS. The median IFLC period was 31 months, and the 1- and 2-year IFLC rates were 75.9% and 57.6%, respectively. The total BM volume (p=0.042) significantly affected IFLC. No severe adverse events were reported after SRS/FSRT.
Conclusion
SRS/FSRT is an effective upfront treatment option for BM arising from NSCLC in elderly patients, with a good OS without severe side effects. Higher GPA score and active systemic treatment were associated with improved OS, indicating that elderly patients are significant candidates for SRS/FSRT.

Citations

Citations to this article as recorded by  
  • Prognostic factors, patterns of failure and re-irradiation in hypofractionated stereotactic radiotherapy-treated brain metastases from non-small cell lung cancer
    Dayu Xu, Yechun Pang, Jinghan Qu, Jiuang Mao, Tiantian Guo, Shanshan Jiang, Yue Zhou, Li Chu, Xi Yang, Xiao Chu, Shengping Wang, Tong Tong, Zhengfei Zhu, Jianjiao Ni
    Clinical and Translational Radiation Oncology.2025; 55: 101038.     CrossRef
  • Prognostic Analysis of Lung Cancer With Brain Metastases in Elderly Patients: A Multicenter Retrospective Study
    Anqi Li, Daqin Feng, Chang Liu, Chaojue Huang, Tang Li, Donggui Wei, Fangyi Wei, Muling Shen, Congzhi Qin, Shufang Deng, Hui Liang, Panlin Mo, Minhai Dong, Yongjia Yu, Lun Liang
    AGING MEDICINE.2025; 8(6): 585.     CrossRef
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Clinical Effect of Endosonography on Overall Survival in Patients with Radiological N1 Non–Small Cell Lung Cancer
Bo-Guen Kim, Byeong-Ho Jeong, Goeun Park, Hong Kwan Kim, Young Mog Shim, Sun Hye Shin, Kyungjong Lee, Sang-Won Um, Hojoong Kim, Jong Ho Cho
Cancer Res Treat. 2024;56(2):502-512.   Published online December 4, 2023
DOI: https://doi.org/10.4143/crt.2023.840
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
It is unclear whether performing endosonography first in non–small cell lung cancer (NSCLC) patients with radiological N1 (rN1) has any advantages over surgery without nodal staging. We aimed to compare surgery without endosonography to performing endosonography first in rN1 on the overall survival (OS) of patients with NSCLC.
Materials and Methods
This is a retrospective analysis of patients with rN1 NSCLC between 2013 and 2019. Patients were divided into ‘no endosonography’ and ‘endosonography first’ groups. We investigated the effect of nodal staging through endosonography on OS using propensity score matching (PSM) and multivariable Cox proportional hazard regression analysis.
Results
In the no endosonography group, pathologic N2 occurred in 23.0% of patients. In the endosonography first group, endosonographic N2 and N3 occurred in 8.6% and 1.6% of patients, respectively. Additionally, 51 patients were pathologic N2 among 249 patients who underwent surgery and mediastinal lymph node dissection (MLND) in endosonography first group. After PSM, the 5-year OSs were 68.1% and 70.6% in the no endosonography and endosonography first groups, respectively. However, the 5-year OS was 80.2% in the subgroup who underwent surgery and MLND of the endosonography first group. Moreover, in patients receiving surgical resection with MLND, the endosonography first group tended to have a better OS than the no endosonography group in adjusted analysis using various models.
Conclusion
In rN1 NSCLC, preoperative endosonography shows better OS than surgery without endosonography. For patients with rN1 NSCLC who are candidates for surgery, preoperative endosonography may help improve survival through patient selection.
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Aggressive Local Ablative Radiotherapy Mitigates Progression Risk in Oligometastatic Lung Adenocarcinoma
Gowoon Yang, Kyung Hwan Kim, Chang Geol Lee, Min Hee Hong, Hye Ryun Kim, Yeona Cho, Hong In Yoon
Cancer Res Treat. 2024;56(1):115-124.   Published online August 29, 2023
DOI: https://doi.org/10.4143/crt.2023.600
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to determine the role of local ablative radiotherapy (LART) in oligometastatic/oligoprogressive lung adenocarcinoma.
Materials and Methods
Patients (n=176) with oligometastatic lung adenocarcinoma treated with LART were identified, and those treated with LART at the initial diagnosis of synchronous oligometastatic disease (OMD group) or treated with LART when they presented with repeat oligoprogression (OPD group) were included.
Results
In the OMD group (n=54), the 1- and 3-year progression-free survival (PFS) were 50.9% and 22.5%, respectively, whereas the 1- and 3-year overall survival in the OPD group were 75.9% and 58.1%, respectively. Forty-one patients (75.9%) received LART at all gross disease sites. Tyrosine kinase inhibitor (TKI) use and all-metastatic site LART were significant predictors of higher PFS (p=0.018 and p=0.046, respectively). In patients treated with TKIs at the time of LART (n=23) and those treated with all-metastatic site LART, the 1-year PFS was 86.7%, while that of patients not treated with all-metastatic site LART was 37.5% (p=0.006). In the OPD group (n=122), 67.2% of the patients (n=82) maintained a systemic therapy regimen after LART. The cumulative incidence of changing systemic therapy was 39.6%, 62.9%, and 78.5% at 6 months, 1 year, and 2 years after LART, respectively.
Conclusion
Aggressive LART can be an option to improve survival in patients with oligometastatic disease. Patients with synchronous oligometastatic disease receiving TKI and all-metastatic site LART may have improved PFS. In patients with repeat oligoprogression, LART might potentially extend survival by delaying the need to change the systemic treatment regimen.
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Sublobar Resection versus Stereotactic Body Radiation Therapy for Clinical Stage I Non–Small Cell Lung Cancer: A Study Using Data from the Korean Nationwide Lung Cancer Registry
Jeonghee Yun, Jong Ho Cho, Tae Hee Hong, Kyungmi Yang, Yong Chan Ahn, Hong Kwan Kim, Korean Association for Lung Cancer, Korea Central Cancer Registry
Cancer Res Treat. 2023;55(4):1171-1180.   Published online April 17, 2023
DOI: https://doi.org/10.4143/crt.2022.1581
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Stereotactic body radiotherapy (SBRT) had been increasingly recognized as a favorable alternative to surgical resection in patients with high risk for surgery. This study compared survival outcomes between sublobar resection (SLR) and SBRT for clinical stage I non–small cell lung cancer (NSCLC).
Materials and Methods
Data were obtained from the Korean Association of Lung Cancer Registry, a sampled nationwide database. This study retrospectively reviewed 382 patients with clinical stage I NSCLC who underwent curative SLR or SBRT from 2014 to 2016.
Results
Of the patients, 43 and 339 underwent SBRT and SLR, respectively. Patients in the SBRT group were older and had worse pulmonary function. The 3-year overall survival (OS) rate was significantly better in the SLR group compared with the SBRT group (86.6% vs. 57%, log-rank p < 0.001). However, after adjusting for age, sex, tumor size, pulmonary function, histology, smoking history, and adjuvant therapy, treatment modality was not an independent prognostic factor for survival (hazard ratio, 0.99; 95% confidence interval, 0.43 to 2.77; p=0.974). We performed subgroup analysis in the following high-risk populations: patients who were older than 75 years; patients who were older than 70 years and had diffusing capacity of lung for carbon monoxide ≤ 80%. In each subgroup, there were no differences in OS and recurrence-free survival between patients who underwent SLR and those who received SBRT.
Conclusion
In our study, there were no significant differences in terms of survival or recurrence between SBRT and SLR in medically compromised stage I NSCLC patients. Our findings suggest that SBRT could be considered as a potential treatment option for selected patients.

Citations

Citations to this article as recorded by  
  • Real-world Decision-making Process for Stereotactic Body Radiotherapy Versus Minimally Invasive Surgery in Early-stage Lung Cancer Patients
    Stijn Vanstraelen, Kay See Tan, Prasad S. Adusumilli, Manjit S. Bains, Matthew J. Bott, Robert J. Downey, Daniel R. Gomez, Katherine D. Gray, James Huang, James M. Isbell, Daniela Molena, Bernard J. Park, Andreas Rimner, Valerie W. Rusch, Narek Shaverdian
    Annals of Surgery.2026; 283(5): 807.     CrossRef
  • Sublobar resection, stereotactic body radiotherapy, and thermal ablation for early-stage non-small cell lung cancer: a systematic review and meta-analysis
    Shahar Adar, Alexandra Ádám, Tamara Balogh, Mátyás Rédei, Karen Krisztina Fazekas, Mátyás Paczkó, Nina Galdzytska, Marie Anne Engh, András Bibok, Gábor Zoltán Duray, Péter Hegyi, Dénes Balázs Horváthy
    Lung Cancer.2026; 217: 109467.     CrossRef
  • The limits of pooled evidence in early-stage NSCLC: are we comparing treatments or patients?
    Peter S.N. van Rossum, Famke L. Schneiders, Suresh Senan
    Lung Cancer.2026; : 109555.     CrossRef
  • Surgery Versus Stereotactic Body Radiotherapy for Early-Stage Non-small Cell Lung Cancer (NSCLC): A Comprehensive Review of Survival and Local Control Outcomes
    Abdulrahman Bin Sumaida, Nandan M Shanbhag, Nadeem Pervez, Khalifa AlKaabi, Khalid Balaraj
    Cureus.2025;[Epub]     CrossRef
  • Surgery for all patients with T1N0 non-small cell lung cancer?
    Claudia Pouypoudat, Sébastien Thureau, Nicolas Giraud, Yaniss Belaroussi, Étienne Martin
    Cancer/Radiothérapie.2025; 29(5-6): 104683.     CrossRef
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Clinical Outcome of Stereotactic Body Radiotherapy in Patients with Early-Stage Lung Cancer with Ground-Glass Opacity Predominant Lesions: A Single Institution Experience
Jeong Yun Jang, Su Ssan Kim, Si Yeol Song, Young Seob Shin, Sei Won Lee, Wonjun Ji, Chang-Min Choi, Eun Kyung Choi
Cancer Res Treat. 2023;55(4):1181-1189.   Published online March 21, 2023
DOI: https://doi.org/10.4143/crt.2022.1656
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The detection rate of early-stage lung cancer with ground-glass opacity (GGO) has increased, and stereotactic body radiotherapy (SBRT) has been suggested as an alternative to surgery in inoperable patients. However, reports on treatment results are limited. Therefore, we performed a retrospective study to investigate the clinical outcome after SBRT in patients with early-stage lung cancer with GGO-predominant tumor lesions at a single institution.
Materials and Methods
This study included 89 patients with 99 lesions who were treated with SBRT for lung cancer with GGO-predominant lesions that had a consolidation-to-tumor ratio of ≤0.5 at Asan Medical Center between July 2016 and July 2021. A median total dose of 56.0 Gy (range, 48.0–60.0) was delivered using 10.0–15.0 Gy per fraction.
Results
The overall follow-up period for the study was median 33.0 months (range, 9.9 to 65.9 months). There was 100% local control with no recurrences in any of the 99 treated lesions. Three patients had regional recurrences outside of the radiation field, and three had distant metastasis. The 1-year, 3-year, and 5-year overall survival rates were 100.0%, 91.6%, and 82.8%, respectively. Univariate analysis revealed that advanced age and a low level of diffusing capacity of the lungs for carbon monoxide were significantly associated with overall survival. There were no patients with grade ≥3 toxicity.
Conclusion
SBRT is a safe and effective treatment for patients with GGO-predominant lung cancer lesions and is likely to be considered as an alternative to surgery.

Citations

Citations to this article as recorded by  
  • Prognostic analysis of helical tomotherapy stereotactic body radiotherapy in multiple primary or second primary lung cancers
    Jintao Ma, Xiaohong Xu, Wenhan Huang, Yong Hu, Gang Chen, Jian He
    BMC Cancer.2025;[Epub]     CrossRef
  • Place de la radiothérapie en conditions stéréotaxiques dans les cancers bronchiques non à petites cellules localisés
    Catherine Durdux, Aurélia Alati
    Bulletin du Cancer.2025; 112(3): 3S31.     CrossRef
  • Prognostic Impact of Tumor Solid Components in Stereotactic Body Radiotherapy for Clinical Stage Tis–1N0M0 Lung Cancer
    Junki Fukuda, Hiroshi Doi, Atsushi Kono, Takaya Inagaki, Naoko Ishida Hamazawa, Saori Tatsuno Imamura, Takuya Uehara, Masahiro Inada, Kiyoshi Nakamatsu, Makoto Hosono, Kazunari Ishii, Yukinori Matsuo
    Thoracic Cancer.2025;[Epub]     CrossRef
  • Management of possible idiopathic inferior vena cava compression during stereotactic body radiation therapy for lung cancer
    Shinya Neri, Yuma Ichikawa
    BMJ Case Reports.2025; 18(8): e263832.     CrossRef
  • European Respiratory Society and European Society of Thoracic Surgeons clinical practice guideline on fitness for curative intent treatment of lung cancer
    Alessandro Brunelli, Georgia Hardavella, Rudolf M. Huber, Thierry Berghmans, Armin Frille, Maria Rodriguez, Ilona Tietzova, Lieven Depypere, Riccardo Asteggiano, Tim Batchelor, Adrien Costantini, Dirk De Ruysscher, Valerie Durieux, Corinne Faivre-Finn, Ma
    European Respiratory Journal.2025; 66(5): 2500156.     CrossRef
  • European Respiratory Society and European Society of Thoracic Surgeons clinical practice guideline on fitness for curative intent treatment of lung cancer
    Alessandro Brunelli, Georgia Hardavella, Rudolf M Huber, Thierry Berghmans, Armin Frille, Maria Rodriguez, Ilona Tietzova, Lieven Depypere, Riccardo Asteggiano, Tim Batchelor, Adrien Costantini, Dirk De Ruysscher, Valerie Durieux, Corinne Faivre-Finn, Mar
    European Journal of Cardio-Thoracic Surgery.2025;[Epub]     CrossRef
  • Recent Advancements in Minimally Invasive Surgery for Early Stage Non-Small Cell Lung Cancer: A Narrative Review
    Jibran Ahmad Khan, Ibrahem Albalkhi, Sarah Garatli, Marcello Migliore
    Journal of Clinical Medicine.2024; 13(11): 3354.     CrossRef
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General
Role of Local Treatment for Oligometastasis: A Comparability-Based Meta-Analysis
Chai Hong Rim, Won Kyung Cho, Jong Hoon Lee, Young Seok Kim, Yang-Gun Suh, Kyung Hwan Kim, Eui Kyu Chie, Yong Chan Ahn, The Oligometastasis Working Group, Korea Cancer Association
Cancer Res Treat. 2022;54(4):953-969.   Published online August 16, 2022
DOI: https://doi.org/10.4143/crt.2022.329
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We intend to investigate the oncological efficacy and feasibility of local consolidative therapy (LCT) through a meta-analysis method.
Materials and Methods
Four databases including PubMed, MEDLINE, Embase, and Cochrane library were searched. Target studies are controlled trials comparing outcomes of LCT versus a control group. Primary endpoints are overall survival (OS) and progression-free survival (PFS).
Results
A total of 54 studies involving 7,242 patients were included. Pooled analyses showed that the LCT arm could achieve improved OS with pooled odds ratio of 2.896 (95% confidence interval [CI], 2.377 to 3.528; p < 0.001). Regarding PFS, pooled analyses showed pooled odds ratio of 3.045 (95% CI, 2.356 to 3.937; p < 0.001) in favor of the LCT arm. In the subgroup analyses including the studies with reliable comparability (e.g. randomized studies or intentionally matched studies without significant favorable prognosticator in LCT arms), pooled odds ratio was 2.548 (95% CI, 1.808 to 3.591; p < 0.001) favoring the LCT arm regarding OS. Regarding PFS, pooled OR was 2.656 (95% CI, 1.713 to 4.120; p < 0.001) which also favored the LCT arm. Subgroup analyses limited to the randomized controlled trials (RCT) were also performed and pooled odds ratios on OS and PFS were 1.535 (95% CI, 1.082 to 2.177; p=0.016) and 1.668 (95% CI, 1.187 to 2.344; p=0.003). The rates of grade ≥ 3 complications related to LCT was mostly low (< 10%) and not significantly higher compared to the control arm.
Conclusion
Pooled analyses results of all included studies, selected studies with reliable comparability, and RCT’s demonstrated the survival benefit of LCT. These consistent results suggest that LCT was beneficial to the patients with oligometastasis.

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Gynecologic cancer
Effect of BRCA1/2 Mutational Status on Survival Outcomes According to Secondary Cytoreductive Surgery and Maintenance Therapy in Platinum-Sensitive Relapsed Ovarian Cancer: A Real-World Evidence Study
Se Ik Kim, Hyunji Lim, Hee Seung Kim, Hyun Hoon Chung, Jae-Weon Kim, Noh Hyun Park, Yong-Sang Song, Maria Lee
Cancer Res Treat. 2023;55(1):245-257.   Published online July 19, 2022
DOI: https://doi.org/10.4143/crt.2022.232
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to investigate the impact of BRCA1/2 mutational status on survival outcomes in patients with platinum-sensitive relapsed (PSR) epithelial ovarian cancer (EOC).
Materials and Methods
We retrospectively identified patients who received secondary treatment for PSR EOC at our institution between January 2007 and June 2021 and who underwent BRCA1/2 gene testing by either germline or somatic methods. The association between BRCA1/2 mutational status and survival outcomes was evaluated. Both secondary cytoreductive surgery (CRS) and maintenance therapy were stratified considering real-world clinical practice.
Results
Of 262 patients, 91 (34.7%) and 171 (65.3%) were assigned to BRCA1/2 mutation and wild-type groups, respectively. The two groups had similar proportions of patients undergoing secondary CRS (26.4% vs. 32.7%, p=0.286) and maintenance therapy (54.9% vs. 46.2%, p=0.178). Overall, no differences in progression-free survival (PFS; median, 19.7 vs. 15.1 months, p=0.120) and overall survival (OS; p=0.400) were observed between the two groups. In multivariate analyses, BRCA1/2 mutational status was not associated with PFS (adjusted hazard ratio, 0.816; 95% confidence interval, 0.596 to 1.119; p=0.207). BRCA1/2 mutational status did not affect PFS among patients who underwent secondary CRS (n=80) and among those who did not (n=182) (p=0.074 and p=0.222, respectively). PFS did not differ in the BRCA1/2 mutational status among the patients who received bevacizumab maintenance (n=90, p=0.992).
Conclusion
In this real-world evidence study, BRCA1/2 mutational status itself was not associated with PFS and OS in PSR EOC, which was consistent with whether secondary CRS or not and with bevacizumab maintenance.
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Breast cancer
Effect of Postoperative Radiotherapy after Primary Tumor Resection in De Novo Stage IV Breast Cancer: A Multicenter Retrospective Study (KROG 19-02)
Yeon Joo Kim, Yeon-Joo Kim, Yong Bae Kim, Ik Jae Lee, Jeanny Kwon, Kyubo Kim, Jihye Cha, Myungsoo Kim, In Young Jo, Jung Hoon Kim, Jaehyeon Park, Jin Hee Kim, Juree Kim, Kyung Hwan Shin, Su Ssan Kim
Cancer Res Treat. 2022;54(2):478-487.   Published online July 12, 2021
DOI: https://doi.org/10.4143/crt.2021.632
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to investigate the impact of postoperative radiotherapy (PORT) in de novo metastatic breast cancer (dnMBC) patients undergoing planned primary tumor resection (PTR) and to identify the subgroup of patients who would most benefit from PORT.
Materials and Methods
This study enrolled 426 patients with dnMBC administered PTR alone or with PORT. The primary and secondary outcomes were overall and progression-free survival (OS and PFS), respectively.
Results
The median follow-up time was 53.7 months (range, 3.1 to 194.4). The 5-year OS and PFS rates were 73.2% and 32.0%, respectively. For OS, clinical T3/4 category, triple-negative breast cancer (TNBC), postoperative chemotherapy alone were significantly poor prognostic factors, and administration of PORT failed to show its significance. Regarding PFS, PORT was a favorable prognostic factor (hazard ratio, 0.64; 95% confidence interval, 0.50 to 0.82; p < 0.001), in addition to T1/2 category, ≤ 5 metastases, and non-TNBC. According to the multivariate analyses of OS in the PORT group, we divided the patients into three groups (group 1, T1/2 and non-TNBC [n=193]; group 2, T3/4 and non-TNBC [n=171]; and group 3, TNBC [n=49]), and evaluated the effect of PORT. Although PORT had no significance for OS in all subgroups, it was a significant factor for good prognosis regarding PFS in groups 1 and 2, not in group 3.
Conclusion
PORT was associated with a significantly better PFS in patients with dnMBC who underwent PTR. Patients with clinical T1/2 category and non-TNBC benefited most from PORT, while those with TNBC showed little benefit.

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    Anna Maria Merlotti, Stefania Martini, Anna Maria Vandone, Riccardo Bonomi, Salvatore Dario Solla, Francesco Olivero, Lavinia Spinelli, Paola Critelli, Luca Gianello, Riccardo Vigna Taglianti, Grazia Sciancalepore, Alessio Garetto, Gianmauro Numico, Richa
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    E. V. Timoshkina, S. I. Tkachev, O. P. Trofimova, M. V. Chernykh, Yu. I. Pryamikova
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    Tian Yang, Xiaorong Zhong, Jun Wang, Zhongzheng Xiang, Yuanyuan Zeng, Siting Yu, Zelei Dai, Ningyue Xu, Ting Luo, Lei Liu
    Cancer Medicine.2023; 12(7): 8112.     CrossRef
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    Nalee Kim, Haeyoung Kim, Won Park, Won Kyung Cho, Tae Gyu Kim, Young-Hyuck Im, Jin Seok Ahn, Yeon Hee Park, Ji-Yeon Kim
    Radiation Oncology.2023;[Epub]     CrossRef
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    SSRN Electronic Journal .2022;[Epub]     CrossRef
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Head and Neck cancer
Radiotherapy versus Surgery in Early-Stage HPV-Positive Oropharyngeal Cancer
Dong-Yun Kim, Hong-Gyun Wu, Jin Ho Kim, Joo Ho Lee, Soon-Hyun Ahn, Eun-Jae Chung, Keun-Yong Eom, Young Ho Jung, Woo-Jin Jeong, Tack-Kyun Kwon, Suzy Kim, Chan Woo Wee
Cancer Res Treat. 2022;54(2):406-416.   Published online June 23, 2021
DOI: https://doi.org/10.4143/crt.2021.441
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to compare the outcomes of primary radiotherapy (RT) versus surgery in early-stage human papilloma virus–positive oropharyngeal squamous cell carcinoma (hpv+OPC), and investigate the preoperative clinical factors that can predict the requirement for postoperative adjuvant treatment.
Materials and Methods
This multicenter study included 166 patients with American Joint Committee on Cancer 8th edition-Stages I-II hpv+OPC. Sixty (36.1%) and 106 (63.9%) patients underwent primary (concurrent chemo)radiotherapy [(CC)RT] and surgery, respectively. Seventy-eight patients (73.6%) in the surgery group received postoperative (CC)RT.
Results
With a median follow-up of 45.6 months for survivors, the 2-year overall survival (OS), progression-free survival (PFS), and locoregional control (LC) for RT/surgery were 97.8%/96.4%, 91.1%/92.0%, and 92.9%/93.3%, respectively. In multivariate analyses, patients with synchronous radiologic extranodal extension and conglomeration (ENEcong) of metastatic lymph nodes (LNs) showed significantly poorer OS (p=0.047), PFS (p=0.001), and LC (p=0.003). In patients undergoing primary surgery, two or more clinically positive LN metastases (odds ratio [OR], 5.15; p=0.004) and LN metastases with ENEcong (OR, 3.75; p=0.009) were predictors of postoperative chemoradiotherapy. No patient in the primary RT group demonstrated late severe toxicity whereas three (2.8%), one (0.9%), and one (0.9%) patient in the surgery group showed grade 3 dysphagia, grade 3 xerostomia, and fatal oral cavity bleeding.
Conclusion
We found no differences in OS, PFS, and LC between upfront RT and surgery in stage I-II hpv+OPC which warrants comparison through a prospective trial in the treatment de-escalation era. However, most early-stage hpv+OPC patients undergoing surgery received adjuvant (CC)RT. Pretreatment LN findings were prognostic and predictive for adjuvant treatment.

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  • Does Smoking Influence Outcomes in Human Papillomavirus—Associated Oropharyngeal Cancer Treated with Transoral Robotic Surgery?
    Jane Y. Tong, Vera Bzhilyanskaya, Jason K. Molitoris, Matthew J. Ferris, Ranee Mehra, Kelly Moyer, Jeffrey Wolf, Rodney Taylor, Kyle M. Hatten
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Oncological and Functional Outcomes of Larynx-preserving Surgery for Hypopharyngeal Cancer: A Comparison with Definitive Radiation-based Treatment
Donghyeok Kim, Nalee Kim, Sungmin Koh, Man Ki Chung, Young-Ik Son, Dongryul Oh, Han-Sin Jeong, Yong Chan Ahn
Cancer Res Treat. 2022;54(1):84-95.   Published online March 26, 2021
DOI: https://doi.org/10.4143/crt.2020.1197
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Larynx-preserving surgery (LPS) have recently gained popularity and achieved comparable oncologic outcomes to conventional radical surgery for localized hypopharyngeal cancer (HPC). In the current study, the role of LPS has been assessed thoroughly in comparison with upfront radiation therapy (RT).
Materials and Methods
We retrospectively reviewed 185 candidates for LPS with cT1-2 disease; 59 patients underwent upfront LPS while 126 patients received upfront RT, respectively. Oncological and functional outcomes were investigated and compared.
Results
Following LPS, safe margin (≥ 5 mm) was achieved in 37.3% of patients. Overall, better clinical outcomes at 5 years were achieved following upfront LPS than those following upfront RT: overall survival (OS) (72.7% vs. 59.0%, p=0.045), disease-free survival (DFS) (59.8% vs. 45.0%, p=0.039), and functional laryngeal preservation (100% vs. 89.7%, p=0.010). Although similar outcomes were observed in patients with cT1 disease, better 5-year DFS was achieved following upfront LPS in patients with cT2 disease (57.0% vs. 36.4%, p=0.023) by virtue of better local control. Despite frequent cN2-3 disease in upfront LPS group, comparable outcomes were observed between upfront RT and LPS group. However, multivariable analyses revealed that performance status and double primary cancer diagnosed within 6 months of HPC diagnosis affected OS significantly, while treatment modality per se did not.
Conclusion
Although upfront LPS could provide better local control than upfront RT in patients with cT2 disease, overall outcomes were comparable following either modality. Treatment selection of larynx-preserving approach for HPC should be individualized based on tumor and patient factors.

Citations

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    Ari Nishimura, Naoki Fukuda, Daisuke Kawakita, Megumi Kitayama, Ken-ichi Nibu, Seiichi Yoshimoto, Hirokazu Uemura, Tadashi Kitahara
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    Mihaela Iuliana Ciortan (Sirbu), Maria Alina Marin, Doina Chioran, Iasmina-Alexandra Predescu, Nicolae Constantin Balica, Sergio Liga, Mircea Rivis, Ştefania Dinu, Şerban Talpoş
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    Kangpyo Kim, Yong Chan Ahn
    International Journal of Radiation Oncology*Biology*Physics.2024; 118(1): 308.     CrossRef
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    Brazilian Journal of Otorhinolaryngology.2023; 89(3): 401.     CrossRef
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    Ear, Nose & Throat Journal.2022; 101(8): 532.     CrossRef
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Lung Cancer
Prognostic Factor and Clinical Outcome in Stage III Non-Small Cell Lung Cancer: A Study Based on Real-World Clinical Data in the Korean Population
Ho Cheol Kim, Wonjun Ji, Jae Cheol Lee, Hyeong Ryul Kim, Si Yeol Song, Chang-Min Choi, Korean Association for Lung Cancer, Korea Central Cancer Registry
Cancer Res Treat. 2021;53(4):1033-1041.   Published online February 16, 2021
DOI: https://doi.org/10.4143/crt.2020.1350
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The optimal treatment for patients with stage III non-small cell lung cancer (NSCLC) remains controversial. This study aimed to investigate prognostic factors and clinical outcome in stage III NSCLC using real-world clinical data in the Korean population.
Materials and Methods
Among 8,110 patients with lung cancer selected from 52 hospitals in Korea during 2014-2016, only patients with stage III NSCLC were recruited and analyzed. A standardized protocol was used to collect clinical information and cox proportional hazards models were used to identify risk factors for mortality.
Results
A total of 1,383 patients (46.5% had squamous cell carcinoma and 40.9% had adenocarcinoma) with stage III NSCLC were enrolled, and their median age was 70 years. Regarding clinical stage, 548 patients (39.6%) had stage IIIA, 517 (37.4%) had stage IIIB, and 318 (23.0%) had stage IIIC. Pertaining to the initial treatment method, the surgery group (median survival period: 36 months) showed better survival outcomes than the non-surgical treatment group (median survival period: 18 months, p=0.001) in patients with stage IIIA. Moreover, among patients with stage IIIB and stage IIIC, those who received concurrent chemotherapy and radiation therapy (CCRT, median survival period: 24 months) showed better survival outcomes than those who received chemotherapy (median survival period: 11 months), or radiation therapy (median survival period: 10 months, p<0.001).
Conclusion
While surgery might be feasible as the initial treatment option in patients with stage IIIA NSCLC, CCRT showed a beneficial role in patients with stage IIIB and IIIC NSCLC.

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    Kun-Han Lue, Yu-Hung Chen, Sung-Chao Chu, Chih-Bin Lin, Bee-Song Chang, Pau-Yuan Chang, Shu-Hsin Liu
    Nuclear Medicine Communications.2026; 47(4): 479.     CrossRef
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    Tianjian Lu, Nan Chen, Zhe Wang, Weiping Lu
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    Yuxia Du, Weihong Qiu, Fei He, Zhibin Zhou, Weimin Ye
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    Liqiang Wang, Chulan Zhan, Qiying Huang, Haonan Gao, Tong Lin, Jianhui Wu, Jili Zhuang, Xinqing Lin, Maolin Zhou, Shuxi Zhuo, Qingchuang Lin, Lingliang Huang, Ni Sun, Ying Chen, Xiaohong Xie, Chengzhi Zhou
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    Hayoung Kim, Jin‐Hee Kwon, Heyjin Kim, Jin Kyung Lee, Young Jun Hong, Hye‐Ryoun Kim
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    Materials Today Communications.2025; 47: 113050.     CrossRef
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    Jiyun Lee, Hee Kyung Ahn, Sang‐We Kim, Ji‐Youn Han, Sung Sook Lee, Hyung Soon Park, Hyun Woo Lee, Joo‐Hang Kim, Eunhan Cho, Reto Huggenberger, Byoung Chul Cho
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    Jeong Yun Jang, Si Yeol Song, Young Seob Shin, Ha Un Kim, Eun Kyung Choi, Sang-We Kim, Jae Cheol Lee, Dae Ho Lee, Chang-Min Choi, Shinkyo Yoon, Su Ssan Kim
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    Mayra Viviana Zambrano Escobar, Julia Teresa Espinel García
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    Yu-Hung Chen, Yen-Chang Chen, Kun-Han Lue, Sung-Chao Chu, Bee-Song Chang, Ling-Yi Wang, Ming-Hsun Li, Chih-Bin Lin
    Annals of Nuclear Medicine.2023; 37(2): 139.     CrossRef
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    Yu-Hung Chen, Kun-Han Lue, Sung-Chao Chu, Bee-Song Chang, Chih-Bin Lin
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    Scientific Reports.2023;[Epub]     CrossRef
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    Cheol-Kyu Park, Nakyung Jeon, Hwa-Kyung Park, Hyung-Joo Oh, Young-Chul Kim, Ha-Lim Jeon, Yong-Hyub Kim, Sung-Ja Ahn, In-Jae Oh
    Cancers.2023; 15(5): 1606.     CrossRef
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    Jeong Uk Lim, Hye Seon Kang, Ah Young Shin, Chang Dong Yeo, Chan Kwon Park, Sang Haak Lee, Seung Joon Kim
    Thoracic Cancer.2022; 13(9): 1349.     CrossRef
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    Guohua Jia, Shuimei Zhou, Tangpeng Xu, Yabing Huang, Xiangpan Li
    Frontiers in Oncology.2022;[Epub]     CrossRef
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    Diagnostics.2021; 11(6): 1065.     CrossRef
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Gynecologic cancer
Nationwide Comparison of Surgical and Oncologic Outcomes in Endometrial Cancer Patients Undergoing Robotic, Laparoscopic, and Open Surgery: A Population-Based Cohort Study
Kyung-Jin Eoh, Eun-Ji Nam, Sang-Wun Kim, Minkyung Shin, Stella J-H Kim, Jung-Ae Kim, Yong-Tae Kim
Cancer Res Treat. 2021;53(2):549-557.   Published online October 22, 2020
DOI: https://doi.org/10.4143/crt.2020.802
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Population-based comparisons between minimally invasive surgery (MIS) (robotic surgery [RS] and laparoscopic surgery [LS]) and open surgery (OS) for managing endometrial cancer are lacking. This study aimed to compare surgical and oncologic outcomes between endometrial cancer patients who underwent surgical staging via MIS or OS.
Materials and Methods
A population-based retrospective cohort study was performed using claims data from the Korean National Health Insurance database from January 2012 to December 2016. All patients who underwent hysterectomy under diagnosis of endometrial cancer were identified. Patients were classified into RS, LS, and OS groups. Operative and oncologic outcomes were compared among the three groups after adjustments for age group, risk group (adjuvant therapy status), modified Charlson comorbidity index, income level, insurance type, and index year using propensity scores obtained via the inverse probability of treatment weighted method.
Results
After adjustment, 5,065 patients (RS, n=315; LS, n=3,248; OS, n=1,503) were analyzed. Patient demographics were comparable. Hospital stay, postoperative complications, and cost were more favorable in the RS and LS groups than in the OS group (all p < 0.001). Five-year overall survival was significantly longer in the RS and LS groups than in the OS group (94.8%, 91.9%, and 86.9%, respectively; p < 0.001). Moreover, the survival benefit of RS was shown in the subgroup analysis of low-risk endometrial cancer patients.
Conclusion
Our study provides further evidence for the RS being a safe surgical alternative to the LS and OS, especially in low-risk endometrial cancer patients, offering surgical and oncologic outcomes equivalent to other surgical approaches.

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  • 246 Download
  • 33 Web of Science
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Gastrointestinal cancer
Tumor Control and Overall Survival after Stereotactic Body Radiotherapy for Pulmonary Oligometastases from Colorectal Cancer: A Meta-Analysis
Hoon Sik Choi, Bae Kwon Jeong, Ki Mun Kang, Hojin Jeong, Jin Ho Song, In Bong Ha, Oh-Young Kwon
Cancer Res Treat. 2020;52(4):1188-1198.   Published online July 21, 2020
DOI: https://doi.org/10.4143/crt.2020.402
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
In pulmonary oligometastases from colorectal cancer (POM-CRC), the primarily recommended local therapy is metastasectomy. Stereotactic body radiotherapy (SBRT) is another local therapy modality that is considered as an alternative option in patients who cannot undergo surgery. The purpose of this meta-analysis is to demonstrate the effects of SBRT on POM-CRC by integrating the relevant studies.
Materials and Methods
The authors explored MEDLINE, EMBASE, Cochrane Library, Web of Science, and SCOPUS, and selected studies including patients treated with SBRT for POM-CRC and availability of local control (LC) or overall survival (OS) rate. In this meta-analysis, the effect of SBRT was presented in the form of the LC and OS rates for 1, 2, 3, and 5 years after SBRT as pooled estimates, and the frequency of pulmonary toxicity of grade 3 or higher after SBRT (PTG3-SBRT).
Results
Fourteen full texts among the searched 4,984 studies were the objects of this meta-analysis. The overall number of POM-CRC patients was 495 as per the integration of 14 studies. The pooled estimate LC rate at 1, 2, 3, and 5 years after SBRT was 81.0%, 71.5%, 56.0%, and 61.8%, and the OS rate was 86.9%, 70.1%, 57.9%, and 43.0%, respectively. The LC and OS rates gradually declined until 3 years after SBRT in a similar pattern. Among the 14 studies, only two studies reported PTG3-SBRT as 2.2% and 10.8%, respectively.
Conclusion
For POM-CRC, SBRT is an ablative therapy with a benefit on LC and OS rates and less adverse effects on the lung.

Citations

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    Davide Franceschini, Maria Ausilia Teriaca, Luca Dominici, Ciro Franzese, Marta Scorsetti
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Close layer
Laparoscopic Surgery for Colorectal Cancer in Korea: Nationwide Data from 2013 to 2018
Sun Jin Park, Kil Yeon Lee, Suk-Hwan Lee
Cancer Res Treat. 2020;52(3):938-944.   Published online April 6, 2020
DOI: https://doi.org/10.4143/crt.2020.043
AbstractAbstract PDFPubReaderePub
Purpose
We report nationwide data on the current status of laparoscopic surgery for colorectal cancer (CRC) in Korea.
Materials and Methods
Nationwide data of patients who underwent surgery for CRC from 2013 to 2018 were obtained from the Health Insurance Review & Assessment Service database. Data and trends of laparoscopy use for colorectal resection over six years were examined.
Results
In Korea, a total of 117,320 patients underwent surgical resection for CRC from 2013 to 2018. The proportion of laparoscopic resection increased from 64.9% in 2013 to 78.5% in 2018. The rate of laparoscopic resection for colon cancer increased from 64.7% in 2013 to 77.4% in 2018. For rectal cancer, the rate of laparoscopic resection increased from 65.4% to 81.6%. Males accounted for 59.8% of all patients, but females surpassed males at over 80 years of age. The age of peak incidence was in the 60s for males and in the 70s for females. A steady increase in the number of patients undergoing surgery for CRC was observed over 80 years of age.
Conclusion
The laparoscopic penetration rate for CRC in Korea continued to increase annually and reached 78.5% in 2018.

Citations

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  • Short-Term Outcomes of Laparoscopic Colorectal Cancer Surgery at a Tertiary Care Hospital: A Single-Surgeon Experience
    Hamza Çınar, Yasir Keçelioğlu
    Middle Black Sea Journal of Health Science.2026; 12(1): 105.     CrossRef
  • Comparison of minimally invasive versus open pancreaticoduodenectomy in patients with obesity, a NSQIP analysis
    Natalie Gugala, Sukhdeep Jatana, Kevin Verhoeff, A. M. James Shapiro, David L. Bigam, Blaire Anderson, Khaled Dajani
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Displacement of Surgical Clips in Patients with Human Acellular Dermal Matrix in the Excision Cavity during Whole Breast Irradiation Following Breast-Conserving Surgery
Wonguen Jung, Kyubo Kim, Nam Sun Paik
Cancer Res Treat. 2020;52(2):388-395.   Published online August 13, 2019
DOI: https://doi.org/10.4143/crt.2019.213
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to investigate the displacement of surgical clips in the excision cavity during whole breast irradiation following breast-conserving surgery (BCS) with or without acellular dermal matrix (ADM) insertion, and to analyze clinicopathologic factors associated with the displacement of surgical clips.
Materials and Methods
From 2016 to 2017, 100 consecutive breast cancer patients who underwent BCS with the placement of surgical clips (superior, inferior, medial, lateral, and deep sides) in the tumor bed were included in this study. All patients took first planning computed tomography (CT) scan (CT 1) before whole breast irradiation and second CT scan (CT 2) before boost irradiation. Between two sets of planning CT, the displacement of surgical clips was calculated from the ΔX (lateral–medial), ΔY (anterior–posterior), ΔZ (superior–inferior), and three-dimensional (3D) directions. Patients were divided into two groups according to the breast volume replacement with ADM: group A with ADM and group B without ADM.
Results
The means and 1 standard deviations of 3D displacement for superior, inferior, medial, lateral and deep clips were 5.2±2.9, 5.2±3.2, 5.6±4.5, 5.6±4.3, and 4.9±4.9 mm in entire cohort (n=100); 5.6±2.6, 6.0±3.5, 6.7±5.8, 6.7±5.7, and 6.1±7.4 mm in group A (n=38); 4.9±3.1, 4.8±3.0, 5.0±3.5, 5.0±2.9, and 4.3±2.8 mm in group B (n=62), respectively. The 3D displacements of group A were longer than those of group B, but only significant difference was observed in lateral clip (p=0.047).
Conclusion
This study demonstrated displacement of surgical clips during whole breast irradiation in patients with ADM insertion. For patients who had breast volume replacement using ADM, adaptive boost planning should be considered.

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  • Automatic segmentation of target volume of breast radiotherapy on CT using MSR-UNet: A multicenter study
    Desheng Zheng, Jianshu Wang, Jiping Liu, Hangyu Yuan, Jingshuo Xue, Hai Zeng, Weijia Zhang, Xiaoyu Li, Jun Cai, Xuwei Tian
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    Shuning Jiao, Yiqing Wang, Jiabin Ma, Jing Shen, Xi-Qian Zhang, Bing Zhou, Xiansong Sun, Haoran Xu, Xia Liu, Ke Hu, Fuquan Zhang, Xiaorong Hou, Jie Qiu
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    Yeong Yi An, Hyejung Hwang, Young Jin Suh
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    Mi Young Kim, Young Jin Suh, Yeong Yi An
    World Journal of Surgical Oncology.2021;[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.

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    Yupeng Di, Haifeng Pang, Xuan Wang, Lingling Meng
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    Maria Fala, Eleni Josephides, Sweni Shah, Hemal Ariyaratne, Anant Patel, Gary J. R. Cook, Sugama Chicklore, Thomas Wagner
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    Benjamin George, Atallah Baydoun, Samar Bhat, Lauryn Bailey, Theodore Arsenault, Yilun Sun, Yuxia Zhang, Yiran Zheng, Prashant Vempati, Tarun Podder, Tithi Biswas
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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
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    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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Impact of 21-Gene Recurrence Score on Chemotherapy Decision in Invasive Ductal Carcinoma of Breast with Nodal Micrometastases
Wei-Rong Chen, Jia-Peng Deng, Jun Wang, Jia-Yuan Sun, Zhen-Yu He, San-Gang Wu
Cancer Res Treat. 2019;51(4):1437-1448.   Published online March 4, 2019
DOI: https://doi.org/10.4143/crt.2018.611
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to investigate the effect of 21-gene recurrence score (RS) on predicting prognosis and chemotherapy decision in node micrometastases (N1mi) breast invasive ductal carcinoma (IDC).
Methods
Patients with stage T1-2N1mi and estrogen receptor-positive IDC diagnosed between 2004 and 2015 were included. The associations of 21-gene RS with breast cancer-specific survival (BCSS), chemotherapy decision, and benefit of chemotherapy were analyzed.
Results
We identified 4,758 patients including 1,403 patients (29.5%) treated with adjuvant chemotherapy. In the traditional RS cutoffs, 2,831 (59.5%), 1,634 (34.3%), and 293 (6.2%) patients were in the low-, intermediate-, and high-risk RS groups, respectively. In 3,853 patients with human epidermal growth factor receptor-2 (HER2) status available, most patients were HER2-negative disease (98.3%). A higher RS was independently related to chemotherapy receipt, and 14.0%, 47.7%, and 77.8% of patients in the low-, intermediate-, and high-risk RS groups received chemotherapy, respectively. The multivariate analysis indicated that a higher RS was related to worse BCSS (p < 0.001). The 5-year BCSS rates were 99.3%, 97.4%, and 91.9% in patients with low-, intermediate-, and high-risk RS groups, respectively (p < 0.001). However, chemotherapy receipt did not correlate with better BCSS in low-, intermediate-, or high-risk RS groups. There were similar trends using Trial Assigning Individualized Options for Treatment RS cutoffs.
Conclusion
The 21-gene RS does predict outcome and impact on chemotherapy decision of N1mi breast IDC. Large cohort and long-term outcomes studies are needed to identify the effects of chemotherapy in N1mi patients by different 21-gene RS groups.

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  • 21-gene recurrence score predictive of the benefit of postoperative radiotherapy after breast-conserving surgery for elderly patients with T1N0 and luminal breast cancer
    Run-Jie Wang, Hai-Ying Liu, Lin-Feng Guo, De Yu, San-Gang Wu
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    HongMei Wang, Yi Peng, Jianbin Wu, ZhuangWei Chen, HuaLe Zhang
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    Yahiya Y. Syed
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Changes of Tumor Infiltrating Lymphocytes after Core Needle Biopsy and the Prognostic Implications in Early Stage Breast Cancer: A Retrospective Study
Jiahui Huang, Xiaosong Chen, Xiaochun Fei, Ou Huang, Jiayi Wu, Li Zhu, Jianrong He, Weiguo Chen, Yafen Li, Kunwei Shen
Cancer Res Treat. 2019;51(4):1336-1346.   Published online February 12, 2019
DOI: https://doi.org/10.4143/crt.2018.504
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to investigate the changes of tumor infiltrating lymphocytes (TILs) between core needle biopsy (CNB) and surgery removed sample (SRS) in early stage breast cancer patients and to identify the correlating factors and prognostic significance of TILs changes.
Materials and Methods
A retrospective study was carried out on 255 patients who received CNB and underwent surgical resection for invasive breast cancer. Stromal TILs levels of CNB and SRS were evaluated respectively. Tumors with ≥50% stromal TILs were defined as lymphocyte-predominant breast cancer (LPBC). Clinicopathological variables were analyzed to determine whether there were factors associated with TILs changes. Log-rank tests and Cox proportional hazards models were used to analyze the influences of TILs and TILs changes on survival.
Results
SRS-TILs (median, 10.0%) were significant higher than CNB-TILs (median, 5.0%; p<0.001). Younger age (<60 years, p=0.016) and long surgery time interval (STI, ≥4 days; p=0.003) were independent factors correlating with higher TILs changes. CNB-LPBC patients showed better breast cancer-free interval (BCFI, p=0.021) than CNB-non-LPBC (CNB-nLPBC) patients. Patients were categorized into four groups according to the LPBC change pattern from CNB to SRS: LPBC→LPBC, LPBC→nLPBC, nLPBC→LPBC, and nLPBC→nLPBC, with estimated 5-year BCFI 100%, 100%, 69.7%, and 86.0% (p=0.016). nLPBC→LPBC pattern was an independent prognostic factor of worse BCFI (hazard ratio, 2.19; 95% confidence interval, 1.06 to 4.53; p=0.035) compared with other patterns.
Conclusion
TILs were significantly higher in SRS than in CNB. Higher TILs changes were associated with younger age and long STI. Changing from nLPBC to LPBC after CNB indicated a worse BCFI, which needs further validation.

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The Feasibility of Spinal Stereotactic Radiosurgery for Spinal Metastasis with Epidural Cord Compression
Yi-Jun Kim, Jin Ho Kim, Kyubo Kim, Hak Jae Kim, Eui Kyu Chie, Kyung Hwan Shin, Hong-Gyun Wu, Il Han Kim
Cancer Res Treat. 2019;51(4):1324-1335.   Published online January 29, 2019
DOI: https://doi.org/10.4143/crt.2018.653
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to investigate the effectiveness and safety of spinal stereotactic radiosurgery (SRS) in treating spinal metastasis with epidural spinal cord compression (ESCC).
Materials and Methods
During 2013-2016, 149 regions of spinal metastasis in 105 patients treated with singlefraction (12-24 Gy) spinal SRS were reviewed. Cord compression of Bilsky grade 2 (with visible cerebrospinal fluid [CSF]) or 3 (no visible CSF) was defined as ESCC. Local progression (LP) and vertebral compression fracture (VCF) rates after SRS were evaluated using multivariate competing-risk regression analysis.
Results
The 1-year cumulative incidences of LP for Bilsky grades 0 (n=80), 1 (n=39), 2 (n=21), and 3 (n=9) were 3.0%, 8.4%, 0%, and 24.9%, respectively. Bilsky grade 2 ESCC did not significantly increase the LP rate (no LP for grade 2). The 1-year cumulative incidences of VCF for Bilsky grades 0, 1, 2, and 3 were 6.6%, 5.2%, 17.1%, and 12.1%, respectively. ESCC may increase VCF risk (subhazard ratio [SHR] for grade 2, 5.368; p=0.035; SHR for grade 3, 2.215; p=0.460). Complete or partial pain response rates after SRS were 79%, 78%, 53%, and 63% for Bilsky grades 0, 1, 2, and 3, respectively (p=0.008). No neurotoxicity of grade ≥ 3 was observed.
Conclusion
Spinal SRS for spinal metastasis with Bilsky grade 2 ESCC did not increase the LP rate, was not associated with severe neurotoxicity, and showed moderate VCF and pain response rates. Bilsky grade 3 had a high LP rate.

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High-Dose Thoracic Re-irradiation of Lung Cancer Using Highly Conformal Radiotherapy Is Effective with Acceptable Toxicity
Ji Hyun Hong, Yeon-Sil Kim, Sea-Won Lee, So Jung Lee, Jin Hyung Kang, Suk Hee Hong, Ju-Young Hong, GeumSeong Cheon
Cancer Res Treat. 2019;51(3):1156-1166.   Published online November 29, 2018
DOI: https://doi.org/10.4143/crt.2018.472
AbstractAbstract PDFPubReaderePub
Purpose
Thoracic re-irradiation (re-RT) of lung cancer has been challenged by the tolerance doses of normal tissues. We retrospectively analyzed local control, overall survival (OS) and toxicity after thoracic re-RT using highly conformal radiotherapy, such as intensity modulated radiotherapy and stereotactic body radiotherapy.
Materials and Methods
Thirty-one patients who received high-dose thoracic re-RT were analyzed. Doses were recalculated to determine biologically equivalent doses. The median interval to re-RT was 15.1 months (range, 4.4 to 56.3 months), the median initial dose was 79.2 Gy10 (range, 51.75 to 150 Gy10), and the median re-RT dose was 68.8 Gy10 (range, 43.2 to 132 Gy10).
Results
Eighteen (58.1%) and eleven (35.5%) patients showed loco-regional recurrence and distant metastasis, respectively, after 17.4 months of median follow-up. The 1-year and 2-year local control rates were 60.2% and 43.7%, respectively. The median loco-regional recurrence-free-survival (LRFS) was 15.4 months, and the median OS was 20.4 months. The cumulative and re-RT biologically equivalent dose for α/β=10 (BED10) doses were the most significant prognostic factors. Cumulative BED10 ≥145 Gy10 and re-RT BED10≥68.7 Gy10 were significantly associated with longer OS (p=0.029 and p=0.012, respectively) and LRFS (p=0.003 and p=0.000, respectively). The most frequent acute toxicity was grade 1-2 pulmonary toxicity (41.9%). No acute grade 3 or higher toxicities occurred.
Conclusion
Our results show that high-dose thoracic re-RT of lung cancer can be safely delivered using highly conformal radiotherapy with favorable survival and acceptable toxicity. An optimal strategy to select patients who would benefit from re-RT is crucial in extending the indications and improving the efficacy with a sufficiently high dose.

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    Eugenio Cammareri, Marloes Duijm, Patrick V. Granton, Wilco Schillemans, Steven Petit, Jose Belderbos, Erik van Werkhoven, Robin Cornelissen, Joost L. Knegjens, Joost J. Nuyttens
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Comparison of Breast Conserving Surgery Followed by Radiation Therapy with Mastectomy Alone for Pathologic N1 Breast Cancer Patients in the Era of Anthracycline Plus Taxane-Based Chemotherapy: A Multicenter Retrospective Study (KROG 1418)
Gyu Sang Yoo, Won Park, Jeong Il Yu, Doo Ho Choi, Yeon-Joo Kim, Kyung Hwan Shin, Chan Woo Wee, Kyubo Kim, Kyung Ran Park, Yong Bae Kim, Sung Ja Ahn, Jong Hoon Lee, Jin Hee Kim, Mison Chun, Hyung-Sik Lee, Jung Soo Kim, Jihye Cha
Cancer Res Treat. 2019;51(3):1041-1051.   Published online November 1, 2018
DOI: https://doi.org/10.4143/crt.2018.424
AbstractAbstract PDFPubReaderePub
Purpose
We compared the oncologic outcomes of breast-conserving surgery plus radiation therapy (BCS+RT) and modified radical mastectomy (MRM) under anthracycline plus taxane-based (AT) regimens and investigated the role of adjuvant radiation therapy (RT) in patients with pathologic N1 (pN1) breast cancer treated by mastectomy.
Materials and Methods
We retrospectively reviewed the medical records of 2,011 patients with pN1 breast cancer who underwent BCS+RT or MRM alone at 12 institutions between January 2006 and December 2010. Two-to-one propensity score matching was performed for balances in variables between the groups.
Results
The median follow-up duration for the total cohort was 69 months (range, 1 to 114 months). After propensity score matching, 1,074 patients (676 in the BCS+RT group and 398 in the MRM-alone group) were analyzed finally. The overall survival, disease-free survival, locoregional failure-free survival, and regional failure-free survival (RFFS) curves of the BCS+RT group vs. MRM-alone group were not significantly different. The subgroup analysis revealed that in the group with both lymphovascular invasion (LVI) and histologic grade (HG) III, the BCS+RT showed significantly superior RFFS (p=0.008). Lymphedema (p=0.007) and radiation pneumonitis (p=0.031) occurred more frequently in the BCS+RT group than in the MRM-alone group, significantly.
Conclusion
There are no differences in oncologic outcomes between BCS+RT and MRM-alone groups under the AT chemotherapy regimens for pN1 breast cancer. However, BCS+RT group showed superior RFFS to MRM-alone group in the patients with LVI and HG III. Adjuvant RT might be considerable for pN1 breast cancer patients with LVI and HG III.

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    Guang-Yi Sun, Ge Wen, Yu-Jing Zhang, Yu Tang, Hao Jing, Hui Fang, Jian-Yang Wang, Jiang-Hu Zhang, Xu-Ran Zhao, Si-Ye Chen, Yong-Wen Song, Jing Jin, Yue-Ping Liu, Yuan Tang, Shu-Nan Qi, Ning Li, Bo Chen, Ning-Ning Lu, Ye-Xiong Li, Shu-Lian Wang
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Comparative Effectiveness of Abdominal versus Laparoscopic Radical Hysterectomy for Cervical Cancer in the Postdissemination Era
Jin Hee Kim, Kyungjoo Kim, Seo Jin Park, Jung-Yun Lee, Kidong Kim, Myong Cheol Lim, Jae Weon Kim
Cancer Res Treat. 2019;51(2):788-796.   Published online September 11, 2018
DOI: https://doi.org/10.4143/crt.2018.120
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Despite the benefits of minimally invasive surgery for cervical cancer, there are a lack of randomized trials comparing laparoscopic radical hysterectomy and abdominal radical hysterectomy. We compared morbidity, cost of care, and survival between abdominal radical hysterectomy and laparoscopic radical hysterectomy for cervical cancer.
Materials and Methods
We used the Korean nationwide database to identify women with cervical cancer who underwent radical hysterectomy from January 1, 2011 to December 31, 2014. Patients who underwent abdominal radical hysterectomy were compared to those who underwent laparoscopic radical hysterectomy. Perioperative morbidity, the use of adjuvant therapy, and survival were evaluated after propensity score balancing.
Results
We identified 6,335 patients, including 3,235 who underwent abdominal radical hysterectomy and 3,100 who underwent laparoscopic radical hysterectomy. The use of laparoscopic radical hysterectomy increased from 46.1% in 2011 to 51.8% in 2014. Patients who were younger, had a more recent year of diagnosis, and were treated in the metropolitan area were more likely to undergo a laparoscopic procedure (p < 0.001). Compared to abdominal radical hysterectomy, laparoscopic radical hysterectomy was associated with lower rates of complication, fewertransfusions, a shorter hospital stay, less adjuvant therapy, and reduced total medical costs (p < 0.001). Laparoscopic surgery was associated with a better overall survival than abdominal operation (hazard ratio, 0.74; 95% confidence interval, 0.64 to 0.85).
Conclusion
In the postdissemination era, laparoscopic radical hysterectomy was associated with more favorable morbidity profiles, a lower cost of care, and comparable survival than abdominal radical hysterectomy.

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Long-term Outcomes of One Stage Surgery Using Transanal Colorectal Tube for Acute Colorectal Obstruction of Stage II/III Distal Colon Cancer
Yusuke Okuda, Tomonori Yamada, Yoshikazu Hirata, Takaya Shimura, Ryuzo Yamaguchi, Eiji Sakamoto, Satoshi Sobue, Takahiro Nakazawa, Hiromi Kataoka, Takashi Joh
Cancer Res Treat. 2019;51(2):474-482.   Published online June 6, 2018
DOI: https://doi.org/10.4143/crt.2018.059
AbstractAbstract PDFPubReaderePub
Purpose
Since oncological outcomes of transanal colorectal tube (TCT) placement, an endoscopic treatment for colorectal cancer (CRC) with acute colorectal obstruction (ACO), remain unknown, this study analyzed long-term outcomes of TCT placement for stage II/III CRC with ACO.
Materials and Methods
Data were retrospectively reviewed from consecutive patients with distal stage II/III CRC who underwent surgery between January 2007 and December 2011 at two Japanese hospitals. One hospital conducted emergency surgery and the other performed TCT placement as the standard treatment for all CRCs with ACO. Propensity score (PS) matching was used to adjust baseline characteristics between two groups.
Results
Among 754 patients with distal stage II/III CRC, 680 did not have ACO (non-ACO group) and 74 had ACO (ACO group). The PS matching between both hospitals identified 234 pairs in the non-ACO group and 23 pairs in the ACO group. In the non-ACO group, the surgical quality was equivalent between the two institutions, with no significant differences in overall survival (OS) and disease-free survival (DFS). In the ACO group, the rate of primary resection/anastomosis was higher in the TCT group than in the surgery group (87.0% vs. 26.1%, p < 0.001). No significant differences were noted between the surgery and the TCT groups in OS (5-year OS, 61.9% vs. 51.5%; p=0.490) and DFS (5-year DFS, 45.9% vs. 38.3%; p=0.658).
Conclusion
TCT placement can achieve similar long-term outcomes to emergency surgery, with a high rate of primary resection/anastomosis for distal stage II/III colon cancer with ACO.

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    Yaokai Ma, Huan Wang, Shoufang Liu, Zhixian Xu, Yinlong Cao, Guimao Wang, Xuan Liu, Kaiyue Zhang, Guangxin Guo
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    Yusuke Okuda, Takaya Shimura, Hiroyuki Kato, Tomonori Yamada, Yoshikazu Hirata, Makoto Natsume, Hiroyasu Iwasaki, Ryuzo Yamaguchi, Eiji Sakamoto, Satoru Takahashi, Hiromi Kataoka
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Long-term Survival in Patients Treated with a Robotic Radiosurgical Device for Liver Metastases
Sebastian Stintzing, Jobst von Einem, Christoph Fueweger, Alfred Haidenberger, Michael Fedorov, Alexander Muavcevic
Cancer Res Treat. 2019;51(1):187-193.   Published online April 16, 2018
DOI: https://doi.org/10.4143/crt.2017.594
AbstractAbstract PDFPubReaderePub
Purpose
The treatment of liver metastases with local procedures is a fast progressing field. For the most, long-term survival data is missing raising questions with regard to the efficacy of such modalities when compared to surgical resection. Radiosurgery using the CyberKnife device enables the treatment of liver lesions with a single-session approach. Here we present long-term survival data to explore the curative potential of this strategy.
Materials and Methods
Patients with oligo-metastatic disease limited to the liver have been treated with single-session or hypo-fractioned radiosurgery in curative intent and prospectively followed until death. Follow-up (FU) was performed using magnetic resonance imaging (MRI) 2 months after radiation and at 3-month intervals for the first 2 years. After that annual computed tomography or MRI scans were performed until 5 years post-treatment. Local recurrence in the radiated volume and recurrence outside the treated volume were used to define local and distant progression. Survival times were censored at the time of the last FU.
Results
One hundred twenty-six patients treated between 2005 and 2015 with 194 lesions were included into this study. Median FU was 30.0 months. According to Response Evaluation Criteria in Solid Tumors, 55.2% had a complete remission and 11.3% a partial remission. Seventy-two point two percent recurred outside the radiated lesion and median overall survival was 35.2 months with a 3-year survival rate of 47.7%.
Conclusion
This is currently the largest cohort of stereotactic body radiation therapy treated liver lesions with a median long-term follow of 30 months. Robotic radiosurgery using a single session approach has a high efficacy to control the radiated lesion with the potential to cure patients.

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    Colleen M. Garvey, Roy Lau, Alyssa Sanchez, Ren X. Sun, Emma J. Fong, Michael E. Doche, Oscar Chen, Anthony Jusuf, Heinz-Josef Lenz, Brent Larson, Shannon M. Mumenthaler
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