Cancer Research and Treatment

Woo Chul Noh

12 Articles

Sarcoma and Sarcomatous Metaplastic Carcinoma of the Breast: Sang Han Yu, Woo Chul Noh, Ho Yoon Bang, Dae Yong Hwang, Dong Wook Choi, Jong Inn Lee, Nam Sun Paik, Nan Mo Moon, Jin Haeng Jung; Cancer Res Treat. 2001;33(6):463-468. Published online December 31, 2001; DOI: https://doi.org/10.4143/crt.2001.33.6.463

PURPOSE
Primary sarcoma and SMC (sarcomatous metaplastic carcinoma) of the breast are very rare tumors, accounting for less than 1% of all breast malignancies. There are many controversies concerning the biological characteristics, prognosis and optimal treatment of these tumors owing to the rarity of incidence. The aims of this study were to elucidate the clinicopathologic characteristics of these tumors and to assist in elucidating the optimal treatment plan for the disease.
MATERIALS AND METHODS
13 cases of primary sarcoma and 10 cases of SMC that had been treated at KCCH between 1984 and 2001 were retrospectively reviewed. Phyllodes tumors were excluded from our study.
RESULTS
Among the 13 cases of primary sarcoma included, stromal sarcoma occurred in 5 cases, osteosarcoma in 3 cases, angiosarcoma in 3 cases and spindle cell sarcoma in 2 cases. The mean age of the patients with primary sarcoma and SMC was 39.7 years and 55.1 years respectively (p=0.002). When survival rates were compared according to histologic types, size of tumor, histologic grade, type of surgery and use of adjuvant therapy, both size of tumor (p=0.0256) and histologic grade (p=0.0197) were shown to be prognostic factors.
CONCLUSION
There were no significantly different features between primary sarcoma and SMC in terms of biologic characteristics or survival rates, with the exception that patients with SMC were older than those with primary sarcoma. Histologic grade and size of tumor were significant prognostic factors of these tumors.

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Primary breast osteosarcoma: A case report and review of the literature
Ramesh Omranipour, Fereshteh Ensani, Maryam Hassanesfahani
Clinical Case Reports.2021;[Epub] CrossRef

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Secretory Carcinoma of the Breast in Three Year-old Girl: A Case report: Woo Chul Noh, Nam Sun Paik, Kyung Ja Cho, Jin Haeng Chung, Seung Kon Nam, Doo Hwan Choe, Nan Mo Moon; J Korean Cancer Assoc. 2000;32(4):822-826.

Abstract PDF: Secretory carcinoma is one of the least common forms of breast cancer and demonstrates distinctive clinical and pathological characteristics. We herein report a case of secretory carcinoma of the breast in 3 year and 1 month-old girl. At presentation, the patient had a 2.5cm sized mass on her left breast which was firmly attached to the overlying nipple. The aspiration cytologic findings of the tumor were consistent with a secretory carcinoma. After confirming malignancy by frozen section diagnosis, a modified radical mastectomy was performed and secretory carcinoma was finally diagnosed. To our knowledge, secretory breast carcinoma in children has not been reported previously in Korea and this seems to be the youngest case of secretory carcinoma of the breast which had been reported in English literature.

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The Role of bcl-2 and p53 in Tamoxifen-Induced Apoptosis of Human Breast Cancer Cell Lines: Woo Chul Noh, Dong Young Noh, Yong Ho Ham, Chang Min Kim, Nam Sun Paik, Nan Mo Moon, Kuk Jin Choe; J Korean Cancer Assoc. 2000;32(3):531-538.

Abstract PDF: PURPOSE
Tamoxifen has been well known as an effective anti-tumor agent against breast cancer. The important role of bcl-2 and p53 proteins in tamoxifen-induced apoptosis of breast cancer cells has been suggested. However, the paradoxical fact that bcl-2 over-expression is assdegrees Ciated with better prognosis in clinic has not yet been clearly explained. To investigate this paradox, we analyzed the effect and dynamics of bcl-2 and p53 on the apoptosis after treatment of breast cancer cells with tamoxifen.
MATERIALS AND METHODS
The human breast cancer cell lines MCF-7 and MB MDA-468 were treated with 17-betaestradiol (E2) and tamoxifen.
RESULTS
Following tamoxifen treatment, MCF-7 cells underwent apoptosis accompanied by reduced bcl-2 expression. E2 pre-treatment led to the inhibition of tamoxifen-mediated apoptosis and bcl-2 down-regulation. When MB MDA-468 cells were treated with E2 or tamoxifen, bcl-2 and p53 protein expression did not change and apoptosis did not develop.
CONCLUSION
We observed that the down-regulation of bcl-2 by tamoxifen treatment can facilitate the apoptosis of breast cancer cells without p53 mutations. This finding was consistent with clinical experiences in which bcl-2 positive tumors were assdegrees Ciated with more indolent phenotypes in breast cancer.

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Clinical Analysis of Operative treatment of Remnant Gastric Cancer: Kwang Ho Lee, Jong Inn Lee, Ho Yoon Bang, Woo Chul Noh, Dae Yong Hwang, Dong Wook Choi, Nam Sun Paik, Nan Mo Moon; J Korean Cancer Assoc. 1999;31(5):964-971.

Abstract PDF: PURPOSE
Authors analyzed the clinico-pathologic parameters of 34 remnant gastric cancers to know the general behavior and prognosis of remnant gastric cancer.
MATERIALS AND METHODS
Medical records of 34 patients were reviewed retrospectively, who were diagnosed as remnant gastric adenocarcinoma and underwent operation in Korea Cancer Center Hospital from February of 1988 to March of 1998.
RESULTS
The incidence of remnant gastric cancer was 0.7% (34/4,904 cases). Sex ratio, male to female, was 2.8: 1. Mean age was 55 years of age. Diagnoses of primary lesion were 10 cases of benign lesion, 24 cases of malignant lesion. The operation for the remnant gastric cancer is total gastrectomy or extended total gastrectomy. The most common extended-resected organ was spleen (21 cases). The morbidity following operation of remnant gastric cancer were quite rare and treated conservatively. The overall five year survival rate was 11.3%.
CONCLUSION
Authors concluded that aggressive operation of remnant gastric cancer is warranted, as it is proved relatively safe and is the only option to lengthen patients survival and to alleviate their QOL (quality of life).

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Free Cancer Cell Detection in Peritoneal Cavitr of Gastric Cancer Patients by RT-PCR for CEA: See Young Kim, Jong Inn Lee, Nan Mo Moon, Nam Sun Paik, Dong Wook Choi, Ho Yoon Bang, Woo Chul Noh; J Korean Cancer Assoc. 1999;31(1):24-30.

Abstract PDF: PURPOSE
This study is aimed to evaluate the efficacy of a novel method (RT-PCR for CEA) to diagnose free cancer cells in peritoneal cavity of gastric cancer patients, which can be used as a indication of prophylactic treatment to prevent peritoneal recurrence after curative resection of gastric cancer.
MATERIALS AND METHODS
114 gastric adenocarcinoma patients were included for this study. With pellet of peritoneal washing fluid, cytology and RT-PCR for CEA were performed with specific primers.
RESULTS
Positive rate of PCR as a whole was 55.3% (63 cases); however, that of cytology was 15.8% (18 cases). Positive rate of PCR increased with depth of invasion of the lesion (p=0.026); however, that of cytology didn't (p=0.233). In early gastric cancer and seeding cases, PCR was not more sensitive than cytologic examination in detection of free cancer cell, but in pm, ss and si cancers, PCR was much more sensitive than cytology (p<0.001).
CONCLUSION
PCR was more sensitive to diagnose free cancer cells in peritoneal cavity of gastric cancer patients especially in pm, ss and si cancers than conventional cytologic examination, and it can be a good candidate of indication of prophylactic treatment to prevent peritoneal recurrence after curative resection.

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Comparision between New Version of UICC-TNM Classification with Old Versions Including Japanese Classifications of Gastric Cancer Patientw: Sung Sik Bae, Jong Inn Lee, Nan Mo Moon, Nam Sun Paik, Dong Wook Choi, Dae Yong Hwang, Ho Yoon Bang, Woo Chul Noh; J Korean Cancer Assoc. 1999;31(1):43-53.

Abstract PDF: PURPOSE
This study was designed to examine the reliability and easy applicability of new version of UICC-TNM classification (UICC, 1997) compared with old version of UICC-TNM classification (UICC, 1992) and JRSGC (Japanese Research Society for Gastric Cancer) classification of gastric cancer.
MATERIALS AND METHODS
For 1043 patients who underwent curative resection from Jan. 1992 to Dec. 1996 in Korea Cancer Center (KCCH), old version of UICC-TMN classification and JRSGC classification were compared with the new version of UICC-TNM classification.
RESULTS
Correlation coefficient between topographic classification (old UICC-TNM, JRSGC) of lymph node and numeric classification was 0.9 (p<0.05). 5-year survival rates according to old UICC, TRSGC, new UICC classification were 94.9% at stage Ia; 96.6, 96.5, 97.1% at stage Ib; 73.8, 73.8, 73.0% at stage II; 54.1, 55.8, 58.0% at stage IIIa; 35.5, 42.0, 36.0% at stage IIlb; 25.9, 22.3, 23.9% at stage IV. 5-year survival rates of each classification had significant difference among stages (p<0.0001), but there was no significant difference among each classification.
CONCLUSION
The new version of UICC-TNM classification based on the number of involved lymph nodes allows a staging system as reliable as the old version of UICC-TNM and JRSGC classification. In addition, the new version of UICC-TNM classification can be applied without methodologic problems and seems more convenient and reproducible.

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Clinical Analysis of the Favorable Type of Breast Cancer - Medullary , Mucinous , Papillary and Tubular Carcinoma: Chang Wan Jeon, Woo Chul Noh, Nan Mo Moon, Nam Sun Paik, Jong Inn Lee, Dong Wook Choi, Ho Yoon Bang; J Korean Cancer Assoc. 1999;31(1):82-89.

Abstract PDF: PURPOSE
The favorable types of the breast cancer - medullary, mucinous, papillary and tubular carcinoma are uncommon subtypes and their incidences in different series ranges between 2.0% and 8.0%, 1% and 2%, 0.3% and 3%, less than 2% of all breast cancers, respectively. In westem countries these subtypes have been reported to have good prognosis and slow growth rate. Clinically, these tumors have lower frequency of axillary nodal involvement and better 5-year or 10-year surviral rate than the other common types of breast cancer.
MATERIALS AND METHODS
To determine the clinical characteristics and to evaluate the correlation between the progrostic factors and survival rate of these tumors, the medical records of 83 women with medullary, mucinous, papillary and tubular carcinoma treated at Korea Cancer Center Hospital between Jan. 1987 and Dec. 1997 were reviewed retrospectively.
RESULTS
The incidences of medullary, mucinous, papillary and tubular carcinoma were 0.51%, 1.45%, 0.71% and 0.14% of all breast cancer, respectively. There were 1 case of local recurrence and 5 cases of systemic relapse during the follow-up (median follow-up peroid of 56 months). Overall 5-year survival and 10-year survival rate were 98.5% and 94.2%, respectively. No significant difference in overall survival rate was detected according to histologic types of these tumors but disease-free survival was significantly lower in papillary carcinoma than the other types of these tumors (p=0.042). Standard prognostic factors of breast cancer such as tumor size, lymph node status, age of the patient and ER status did not affect the prognosis of these tumors.
CONCLUSION
Medullary, mucinous, papillary and tubular carcinoma revealed very excellent prognosis in this study regardless of tumor size, lymph node status, age of the patients and ER status.

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Intraperitoneal and Retroperitoneal Sarcomas: Young Wook Jung, Woo Chul Noh, Nan Mo Moon, Nam Sun Paik, Jong Inn Lee, Dong Wook Choi, Ho Yoon Bang; J Korean Cancer Assoc. 1999;31(1):173-179.

Abstract PDF: PURPOSE
Sarcomas arising in intraperitaneal cavity and retroperitoneal space are relatively uncommon. Thus, studies characterizing the results of long-term follow-up are limited. The purpose of this study was to identify the clinicopathologic features and prognostic factors of intraperitoneal and retroperitoneal sarcomas. Materials and Method: Thirtyeight patients with intraperitaneal or retroperitoneal sarcoma who had been treated at Department of Surgery, Korea Cancer Center Hospital during the period from January 1987 to December 1997 were reviewed retrospectively.
RESULTS
The ratio between male to female was 0.9: 1. The mean age of the patients was 48.3 (32-75) years. The most common symptom was abdominal pain or discomfort (61%), followed by palpable mass (55%), GI bleeding (34%), weight loss (26%), and change of bowel habits (21%). The most comman histologic type was leiomyosarcoma (73.7%), followed by liposarcoma (23.7%), and malignant fibrous histiocytoma (2.6%). The mean tumor size was 15.5 x12.1 x 8.7 cm. Among 38 cases, 25 cases developed in intraperitoneal cavity and 13 cases arose in retroperitoneal space. Overall, 44 operations were performed in 31 patients. Among them, complete surgical resection constituted 73%. In 20 cases, combined resection of adjacent organ was performed to accomplish complete surgical resection of tumors. During the median follow up period of 23 months (3~116 months), the overall 5-year survival rate was 34.7%. The patients who had been treated by complete surgical resection showed better survival than those in whom palliative resection or biopsy only was performed (38.6% vs 0% of 5 YSR, P=0.015). Liposarcoma showed better prognosis than leiomyosarcoma (41.7% vs 34.2% of 5 YSR, P=0.0000). The size of tumor (10 cm>vs 10 cm< or =) was not a statistically significant prognostic factor.
CONCLUSION
In this series, The histologic type and complete surgical resection were important factors that can affect the survival of the patients. Aggressive surgical resections are therefore wananted to obtain better outcome of the patients with intraperitoneal and retroperitoneal sarcomas.

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Clinical Analysis of 329 Cases of Total Gastrectomy: Woo Sung Lee, Nam Sun Paik, Seon Mi Moon, Woo Chul Noh, Ho Yoon Bang, Dong Wook Choi, Jong Inn Lee, Nan Mo Moon; J Korean Cancer Assoc. 1998;30(1):63-71.

Abstract PDF: PURPOSE
This study was designed to evaluate the safety including the morbidity and mortality of total gastrectomy and combined organ resection, to examine the survival rate and the prognostic factors of gastric cancer following the total gastrectomy and to assess the prognostic predictability of new UICC staging system after surgery in gastric cancer patients. MATERIAL AND METHOD: To evaluate demographic features, clinical presentations, preoperative diagnostic accuracy, postoperative complications and prognostic factors, we analyzed 329 patients who underwent the total gastrectomy or the total gastrectomy with combined resection for gastric malignancy at KCCH from Jan. 1990 to Dec. 1993 retrospectively.
RESULTS
The early postoperative complication rates of overall patients and combined resection group were 9.1% and 8.9%. Mortality of these were 0.9% and 1.1%(p>0.05). The overall 5YSR was 52.8% and there was no significant differrence in the survival rate between the total gastrectomy only group and the combined resection group. The accuracy of preoperative UGIS and abdominal CT for determiantion of resectability were over 80%. The depth of invasion and lymph node metastasis were independent prognostic factors.
CONCLUSION
The total gastrectomy with combined resection should be considered when indicated, because the postoperative morbidity and mortality is low and long term survival is expected. The new UICC staging system seems to be good to predict prognosis in gastric cancer patients.

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Clinical Analysis of Typical Medullary Carcinoma of the Breast: Kyu Hwan Choi, Woo Chul Noh, Nam Sun Paik, Nan Mo Moon, Ho Yoon Bang, Dong Wook Choi, Jong Inn Lee, Seon Mi Moon; J Korean Cancer Assoc. 1998;30(1):113-118.

Abstract PDF: PURPOSE
Medullary carcinoma of the breast is an uncommon subtype of infiltrating ductal carcinoma and its incidence in different series ranges between 2% and 8% of all breast canoers. The histopathologic criteria for medullary carcinoma of the breast used by most pathologists today were delineated by Ridolfi et al. in 1977. The criteria of typical medullary carcinoma include all of followings: 75% or more of syncytial growth pattern, microscopically completely circumscribed, no intraductal component, moderate to marked diffuse mononuclear stromal invasion, nuclear grade 1 or 2. Medullary carcinoma has a more favorable prognosis than usual invasive breast cancer. MATERIALS & METHODS: To determine clinical characteristics of this tumor, the medical records of 15 women with typical medullary carcinoma treated at KCCH between 1985 and 1996 were reviewed retrospectively.
RESULTS
The incidence of typical medullary carcinoma in KCCH was 0.51%(15/2946) of all breast cancers. Age ranged from 27 to 56 years and mean age was 40.1 years. The peak age group was 4th decade(46.6%), followed by 5 th decade(40%). Most of the patients were premenopausal status(14/15). The major clinical manifestation of all patients was a palpable mass. Twelve patients were investigated for ER status, but all were negative. Preoperative fine needle aspiration cytology was checked in 6 patients, all cases showed positive findings for malignancy. The mean size of tumor was 3.01 cm in diameter and the rate of lymph node positivity was 40%(6/15). There was one case of systemic recurrence at 38 months after operation and the patient expired at 3 months after detection of recurrence. The others were alive without evidence of disease for mean follow-up period of 64.7 months.
CONCLUSIONS
The mean age of the patients of medullary carcinoma was relatively younger than that of the patients with other usual invasive breast cancer. The incidence of medullary carcinoma in this study was slightly lower than western series. Medullary carcinoma showed good prognosis, even if estrogen receptors were negative, but to determine clinical characteristics of Korean medullary carcinoma of the breast, multicenter data should be collected.

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Clinical Analysis of Invasive Papillary Carcinoma of the Breast: Seon Mi Moon, Nam Sun Paik, Nan Mo Moon, Jong Inn Lee, Dong Wook Choi, Woo Chul Noh, Shin Kwang Khang; J Korean Cancer Assoc. 1996;28(6):981-988.

Abstract PDF: Invasive papillary carcinoma of the breast is an uncommon cancer and its incidence in different series ranges between 0.3% and 3% of all breast cancers. It has been reported that in western countries papillary carcinoma generally presents in the seventh decade and is more frequently found in postmenopausal, non-white women. Generally the gross appearance of papillary carcinoma is well circumscribed or may appear to be encapsulated. The size of invasive papillary carcinoma is usually small but varies. Clinically, this tumor has lower freguency rate of axillary nodal involvement and better 5-year or 10-year survival rate than the other common types of breast cancer. To determine clinical and histopathologic characteristics of this tumor, the medical records of 14 women with invasive papillary carcinoma treated at KCCH between 1983 and 1995 were reviewed retrospectively. The results were as follows: ¨c The incidence of invasive papillary carcinama was 0.48% (14/2935) of all breast cancers. ¨e The mean age at the diagnosis was 45.8 years. ¨e The most common clinical manifestatian was a palpable mass. ¨e The mean size of tumor was 4.2 cm in diameter. ¨e The rate of ER positivity was 50%(4/8). ¨i The rate of axillary nodal involvement was 30.8%(4/13). ¨i There was one case of systemic recurrence at 16 months after modified radical mastectomy and the patient expired at 29 months after operation. There was one case of ipsilateral cervical lymph node metsstasis at 21 months after modified radical mastectomy and the patient is still alive. In conclusion, the incidence and prognosis of invasive papillary carcinoma in this study was similar to western series, but the peak age group with invasive papillary carcinoma was younger than in western countries. To determine the clinical, histopathologic chracteristics of Korean papillary carcinoma of the breast, multicenter data should be collected.

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A Clinical Study of 14 Cases of Male Breast Cancer: Kuy Hee Her, Dong Young Noh, Ik Jin Yun, Woo Chul Noh, Han Kwang Yang, Kuk Jin Choe; J Korean Cancer Assoc. 1995;27(6):940-948.

Abstract PDF: Male breast cancer is uncommon disease accounting for approximately 1% of all breast cancers. Its rarity may prevent many physicians from seeing its natural history, cause, pathologic features, and pragnosis. Compared with female breast cancer, breast cancer in men accurs in older age groups, manifests in a more advanced state, and produces higher incidence of central location and ulceration. A clinical study was performed to the 14 cases of male breast cancer patients at the department of surgery, Seoul National university in a 14-year span, from Jan. 1981 to Dec. 1994. The results were as fallowings; 1) Prevalent age group was 8th decade(35.7%) 2) Their most common symptom was palpable mass(85.7%) 3) Five patients(35.7%) visited hospital over 1 year had passed 4) There were nine tumors(64.3%) situated in the left breast and eleven tumors(78.6%) were circumareola located 5) According to the TNM staging system, 6 cases(42.9%) were advanced(over stage III) stage breast cancer 6) Curative resections were performed in ten patients(71.4%) the procedures were 2 cases of Radical Mastectomy, 4 cases of Modified Radical Mastectomy, 4 cases of Simple Mastectomy and Axillary node dissection 7) Postoperative adjuvant therapies including multimodality approach were performed in 7 cases of the patients 8) Nine patients were expired, 6 were died of recurrences or metastases of the breast cancer and 3 were the other causes, the median survival period was 44 months. We observed that male breast cancer were detected older and far advanced. So early detection and treatment are important to promote the survival of the male breast cancer patients

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