Cancer Research and Treatment

Original Articles

Conditional Relative Survival and Competing Mortality in Surgically Treated Patients with Localized and Regional Kidney Cancer in Korea: A Nationwide Cohort Study: Hyun Bin Shin, Dong Wook Shin, In Young Cho, Junhee Park, Jung Jin Hyung, Kyungdo Han, Jinsung Park; Received May 24, 2025 Accepted March 5, 2026 Published online March 9, 2026; DOI: https://doi.org/10.4143/crt.2025.557 [Accepted]

Abstract PDF: Purpose
To investigate the 5-year conditional relative survival and competing mortality in surgically treated patients with localized and regional kidney cancer.
Materials and Methods
Using a nationwide population-based database, the Korea Clinical Data Utilization Network for Research Excellence, conditional relative survival conditioned on 1 to 3 years of survival after diagnosis was measured. These rates were stratified by age, sex, socioeconomic status, comorbidities, and treatment received. Cause of death and estimated cause-specific mortality were also described and considered with competing risks.
Results
This study included a total of 19,749 newly diagnosed patients with kidney cancer who underwent surgical treatment from 2013 to 2019. The baseline conditional relative survival rates for the entire cohort, patients with localized disease, and patients with regional disease were 97.2%, 99.4%, and 82.6%, respectively. After one year, these rates increased to 99.4%, 100.0%, and 95.3%, respectively. Patients who underwent surgery only had the highest baseline conditional relative survival rates (99.3%) compared with those who received surgery with radiotherapy (74.0%), with chemotherapy (38.9%), and with chemotherapy and radiotherapy (16.2%). Specifically, patients who underwent robotic surgery or partial nephrectomy showed higher baseline conditional relative survival rates (>100%) than others. Furthermore, kidney cancer was the leading cause of death (49.6%), followed by other types of cancer and cardiovascular disease. Over time, kidney cancer-specific mortality decreased.
Conclusion
Conditional survival after surgery for localized or regional kidney cancer was high and improved over time. These findings indicate that long-term prognosis varies by stage and patient characteristics and should inform postoperative surveillance.

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Skin cancer

Association between Obesity and Melanoma Risk in an Asian Population: A Nationwide Cohort Study: Hye Yeon Koo, Kyungdo Han, Jihye Park, Jinhyung Jung, Seonghye Kim, Hyeonjin Cho, In Young Cho, Dong Wook Shin; Cancer Res Treat. 2026;58(2):677-685. Published online June 18, 2025; DOI: https://doi.org/10.4143/crt.2025.169

Abstract PDF Supplementary Material PubReader ePub

Purpose
Previous studies from mostly Western populations have suggested possible associations between obesity and melanoma risk. This study aimed to investigate associations between obesity status and melanoma using a nationwide cohort of Koreans.
Materials and Methods
A total of 4,441,403 adults who received a national health examination in 2012 were included from the Korean National Health Insurance Service database, and followed until December 31, 2022. Obesity status was defined based on the body mass index at the baseline health examination. Cox proportional hazards analyses were performed to evaluate associations between obesity status and incident melanoma, with adjustment for confounders. Stratified analyses were performed by sex and menopausal status (in women).
Results
Overall, melanoma risk increased according to obesity status (p for trend=0.024); adjusted hazard ratios (95% confidence intervals) for melanoma risk were 0.766 (0.438–1.340) in underweight; 1.292 (1.072–1.557) in overweight; 1.202 (1.002–1.442) in obesity; and 1.191 (0.798–1.778) in severe obesity compared to normal weight (reference). In stratified analyses, similar trends to those of the overall study population were observed among men and premenopausal women (p for trend=0.052 in men and 0.036 in premenopausal women). Among premenopausal women, the risk of melanoma increased linearly with obesity status. Meanwhile, among postmenopausal women, melanoma risk showed no significant difference or trend according to obesity status.
Conclusion
Overweight and obesity were associated with increased risk of melanoma in a population-based cohort of Koreans. Obese individuals, especially men and premenopausal women, may require more thorough prevention and screening strategies for melanoma.

Citations

Citations to this article as recorded by

Obesity and Cancer: Mechanisms, Epidemiological Evidence, and Potential Risk Reduction
Jung-sun Lim, Seonghye Kim, In Young Cho, Dong Wook Shin
Journal of Obesity & Metabolic Syndrome.2026; 35(1): 14. CrossRef
Obesity and melanoma: unraveling the paradoxical survival benefit in immunotherapy
Junjie Yang, Qingqing Hu, Chunyu Xue
Cancer and Metastasis Reviews.2026;[Epub] CrossRef

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Breast cancer

Secondary Cancer Risk in Breast Cancer with and without Radiotherapy: The Observational Health Data Sciences and Informatics (OHDSI) Cohort Study: Seok Kim, Dachung Boo, Sooyoung Yoo, Borham Kim, Kyubo Kim, Kwangsoo Kim, Eunhye Song, Junmo Kim, Hyun Gee Ryoo, Jin Chul Paeng, In Young Choi, SooJeong Ko, Ie Ryung Yoo, Rae Woong Park, Ho-Young Lee; Cancer Res Treat. 2026;58(2):481-491. Published online June 5, 2025; DOI: https://doi.org/10.4143/crt.2024.968

Abstract PDF Supplementary Material PubReader ePub: Purpose
Radiotherapy is used to reduce the risk of breast cancer recurrence after surgery, but it is a potential cause of secondary cancer. We validated the risk of secondary cancer in primary breast cancer who received radiotherapy compared with those who did not from a matched cohort using a large-scale observational study of the Observational Health Data Sciences and Informatics (OHDSI) data network.
Materials and Methods
A retrospective comparative cohort study using propensity score-matched cohorts was performed using two Observational Medical Outcome Partnership common data model databases, from tertiary general hospitals in South Korea. Among female patients who underwent surgery after the diagnosis of breast cancer, the risk of secondary primary malignant occurrence after 1:1 matching was analyzed.
Results
Among 27,078 patients with breast cancer, there was no significant difference in the risk of secondary cancer following radiotherapy in 4,426 patients after 1:1 propensity-score matching. Further, there were no significant differences in the sensitivity analysis according to age, latency period, and number of radiation treatments.
Conclusion
There was no difference in the risk of secondary cancer in the patients diagnosed with breast cancer depending on whether or not radiotherapy was performed after surgery. In the future, it is necessary to analyze including data generated during cancer treatment.

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General

Weight Change after Cancer Diagnosis and Risk of Diabetes Mellitus: A Population-Based Nationwide Study: Hye Yeon Koo, Kyungdo Han, Mi Hee Cho, Wonyoung Jung, Jinhyung Jung, In Young Cho, Dong Wook Shin; Cancer Res Treat. 2025;57(2):339-349. Published online August 29, 2024; DOI: https://doi.org/10.4143/crt.2024.586

Abstract PDF Supplementary Material PubReader ePub

Purpose
Cancer survivors are at increased risk of diabetes mellitus (DM). Additionally, the prevalence of obesity, which is also a risk factor for DM, is increasing in cancer survivors. We investigated the associations between weight change after cancer diagnosis and DM risk.
Materials and Methods
This retrospective cohort study used data from the Korean National Health Insurance Service. Participants who were newly diagnosed with cancer from 2010 to 2016 and received national health screening before and after diagnosis were included and followed until 2019. Weight change status after cancer diagnosis was categorized into four groups: sustained normal weight, obese to normal weight, normal weight to obese, or sustained obese. Cox proportional hazard analyses were performed to examine associations between weight change and DM.
Results
The study population comprised 264,250 cancer survivors. DM risk was highest in sustained obese (adjusted hazard ratios [aHR], 2.17; 95% confidence interval [CI], 2.08 to 2.26), followed by normal weight to obese (aHR, 1.66; 95% CI, 1.54 to 1.79), obese to normal weight (aHR, 1.29; 95% CI, 1.21 to 1.39), and then sustained normal weight group (reference). In subgroup analyses according to cancer type, most cancers showed the highest risks in sustained obese group.
Conclusion
Obesity at any time point was related to increased DM risk, presenting the highest risk in cancer survivors with sustained obesity. Survivors who changed from obese to normal weight had lower risk than survivors with sustained obesity. Survivors who changed from normal weight to obese showed increased risk compared to those who sustained normal weight. Our finding supports the significance of weight management among cancer survivors.

Citations

Citations to this article as recorded by

New‐onset prediabetes/diabetes worsens overall survival in patients with cancer: A real‐world retrospective cohort study
Maci Winn, Svenja Pauleck, Stephanie Richardson, Richard Viskochil, Prasoona Karra, Howard Colman, Jennifer A. Doherty, Yizhe Xu, Siwen Hu‐Lieskovan, Michelle Litchman, Mary C. Playdon, Sheetal Hardikar
Diabetes, Obesity and Metabolism.2026; 28(2): 1247. CrossRef
Risk of Newly Incident Diabetes Mellitus and Treatment Risk Factors in Breast Cancer Survivors: Landmark Analyses of Nationwide Data
Hyeongjin Shim, Bong-seong Kim, Kyungdo Han, Hye Yeon Koo, Seonghye Kim, Dagyeong Lee, In Young Cho, Wonyoung Jung, Dong Wook Shin
Asia Pacific Journal of Public Health.2026; 38(4): 265. CrossRef
Effects of smoking behavior change on diabetes incidence after cancer development: A nationwide cohort study
MI Hee Cho, Jinhyung Jung, Hye Yeon Koo, Wonyoung Jung, Kyungdo Han, In Young Cho, Dong Wook Shin
Diabetes & Metabolism.2025; 51(1): 101604. CrossRef

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Re-stratification of Patients with High-Risk Prostate Cancer According to the NCCN Guidelines among Patients Who Underwent Radical Prostatectomy: An Analysis Based on the K-CaP Registry: Kwang Suk Lee, Kyo Chul Koo, In Young Choi, Ji Youl Lee, Jun Hyuk Hong, Choung-Soo Kim, Hyun Moo Lee, Sung Kyu Hong, Seok-Soo Byun, Koon Ho Rha, Byung Ha Chung; Cancer Res Treat. 2018;50(1):88-94. Published online March 7, 2017; DOI: https://doi.org/10.4143/crt.2016.494

Abstract PDF PubReader ePub

Purpose
The present study aimed to re-stratify patients with high-risk prostate cancer according to the National Comprehensive Cancer Network guidelines among patients who underwent radical prostatectomy (RP).
Materials and Methods
This study used the Korean Prostate Cancer Database registry and identified 1,060 patients with high-risk prostate cancer who underwent RP between May 2001 and April 2013. All patients were categorized into risk groups, and subgroups were identified according to the type and number of high-risk factors.
Results
Of the 1,060 high-risk patients, 599 (56.5%), 408 (38.5%), and 53 (5.0%) had 1, 2, and 3 risk factors, respectively. In multivariate analysis, the Gleason score, percentage of positive biopsy cores, and number of risk factors present were identified as independent predictors of biochemical recurrence. There were significant differences in the 5-year postoperative biochemical failure-free survival (BCFFS) rate among the different high-risk factor subgroups (log-rank p < 0.001). There were no significant differences in the BCFFS rate between the subgroup of high-risk patients with a prostate-specific antigen level > 20 ng/mL alone and the intermediate-risk group with all factors (log-rank p=0.919 and p=0.781, respectively). Additionally, no significant differencewas noted in the BCFFS rate between high-risk patients having all factors and those in the very-high-risk group (p=0.566).
Conclusion
We successfully re-stratified patients with high-risk prostate cancer and identified the combinations of high-risk criteria that will help in the selection of patients for RP.

Citations

Citations to this article as recorded by

Prostate‑specific antigen density and preoperative MRI findings as predictors of biochemical recurrence in high‑risk and very high‑risk prostate cancer
Cheng-Kuang Yang, Chi-Rei Yang, Yen-Chuan Ou, Chen-Li Cheng, Hao-Chung Ho, Kun-Yuan Chiu, Shian-Shiang Wang, Jian-Ri Li, Chuan-Shu Chen, Chi-Feng Hung, Cheng-Che Chen, Shu-Chi Wang, Chia-Yen Lin, Sheng-Chun Hung
Oncology Letters.2023;[Epub] CrossRef
Comparison of the clinicopathologic features of prostate cancer in US and Chinese populations
Lei Zhang, Xiaoyan Liu, Rong Xia, Fei Chen, Xin Wang, Jia Bao, Yongzhao Shao, Xian Lu, Yan Wang, Jili Wang, May Thu Tun, Jonathan Melamed, Hebert Lepor, Fang-Ming Deng, Dongwen Wang, Guoping Ren
Pathology - Research and Practice.2022; 234: 153933. CrossRef
Ten-Year Results From a Phase II Study on Image Guided, Intensity Modulated Radiation Therapy With Simultaneous Integrated Boost in High-Risk Prostate Cancer
Christian Ekanger, Svein Inge Helle, Daniel Heinrich, Dag Clement Johannessen, Ása Karlsdóttir, Yngve Nygård, Ole Johan Halvorsen, Lars Reisæter, Rune Kvåle, Liv Bolstad Hysing, Olav Dahl
Advances in Radiation Oncology.2020; 5(3): 396. CrossRef

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3 Crossref

Do Korean Doctors Think a Palliative Consultation Team Would Be Helpful to Their Terminal Cancer Patients?: Hye-Young Shim, Yoon Jung Chang, Kiu-Sang Kawk, Tran Thi Xuan Mai, Jin Young Choi, Eun Mi Ahn, Hyun Jung Jho, So-Jung Park; Cancer Res Treat. 2017;49(2):437-445. Published online August 10, 2016; DOI: https://doi.org/10.4143/crt.2015.495

Abstract PDF PubReader ePub

Purpose
Hospice and palliative care services (HPC) are not commonly utilized in Korea; however, palliative care teams (PCTs) have been found to be effective at addressing the shortcomings in HPC. In this study, we attempted to outline unmet palliative care needs of terminal cancer patients and the potential benefits of PCTs as perceived by doctors in Korea.
Materials and Methods
We surveyed 474 doctors at 10 cancer-related academic conferences from June to November 2014 with a self-report questionnaire to assess their perceptions of end-of-life care needs and the expected effects of PCTs on caring for terminal cancer patients. Among those surveyed, 440 respondents who completed the entire questionnaire were analyzed.
Results
In all domains, fewer participants reported satisfaction with palliative care services than those reporting needs (p < 0.001). The surveyed participants also reported difficulties with a shortage of time for treatment, psychological burden, lack of knowledge regarding hospice care, lengths of stay, and palliative ward availability. Multivariate logistic regression analysis revealed that female doctors (odds ratio [OR], 2.672; 95% confidence interval [CI], 1.035 to 6.892), doctors who agreed that referring my patients to a HPC means I must give up on my patient (OR, 3.075; 95% CI, 1.324 to 7.127), and doctors who had no experience with HPC education (OR, 3.337; 95% CI, 1.600 to 7.125) were associated with higher expected effectiveness of PCT activities.
Conclusion
The PCT activities were expected to fill the doctor’s perceived unmet HPC needs of terminal cancer patients and difficulties in communications.

Citations

Citations to this article as recorded by

Exploring Oncologists’ Perspectives on the Early Integration of Specialty Palliative Care in Korea: Challenges, Needs, and Clinical Implications
Shin Hye Yoo, Yu Jung Kim, Ye Sul Jeung, Jung Sun Kim, Kwonoh Park, Eun Mi Nam, Si Won Lee, Jun Ho Ji, Jwa Hoon Kim, Joon Young Hur, Song Ee Park, Jung Lim Lee, Su-Jin Koh
Cancer Research and Treatment.2026; 58(1): 339. CrossRef
Improving Quality of End-of-Life Care Through the K-HOPE Consultative Palliative Care Model: A Prospective Study in a Tertiary Hospital
Yoo Jeong Lee, In Cheol Hwang, Eun Jeong Lee, Soon-Young Hwang, Youn Seon Choi
Current Oncology.2026; 33(4): 213. CrossRef
Effects of tertiary palliative care on the pattern of end‐of‐life care in patients with hematologic malignancies in Korea
Dong Hyun Kim, Jeonghwan Youk, Ja Min Byun, Youngil Koh, Junshik Hong, Tae Min Kim, Inho Kim, Sung‐Soo Yoon, Shin Hye Yoo, Dong‐Yeop Shin
European Journal of Haematology.2024; 112(5): 743. CrossRef
Development and validation of impact of early integration of palliative care and oncology(IEI PCO) questionnaire: a survey for medical oncologists and nurses
Abdulrahman Abdulaziz Abdullah, Wafaa Mostafa Abd-El-Gawad, Sobhi Mostafa AboSerea, Fatma AbdelShakor Ali, Saima Ali
BMC Palliative Care.2024;[Epub] CrossRef
Patients’ Dying Process From the Point of View of Family and Hospice Team: A Qualitative Exploration of Family Member and Hospice Team Experiences With Hospice in Korea
Sooyoun K. Han, Yugyeong Eo
OMEGA - Journal of Death and Dying.2022; 86(2): 533. CrossRef
Status of palliative care education in Mainland China: A systematic review
Antonia M. Willemsen, Stephen Mason, Silja Zhang, Frank Elsner
Palliative and Supportive Care.2021; 19(2): 235. CrossRef
Effectiveness of home hospice care: a nationwide prospective observational study
Eunmi Ahn, In Gyu Song, Jin Young Choi, Hyun Jung Jho, Ilyeon Park, Suah Sung, Seohyun Shin, So Jung Park, Eun Jung Nam, Sung Hoon Jeong, Yoon Jung Chang
Supportive Care in Cancer.2020; 28(6): 2713. CrossRef
Sedation for terminally ill cancer patients
Young Saing Kim, Haa-Na Song, Jin Seok Ahn, Su-Jin Koh, Jun Ho Ji, In Gyu Hwang, Jina Yun, Jung Hye Kwon, Jung Hun Kang
Medicine.2019; 98(5): e14278. CrossRef

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The Study for the Postoperative Changes of Peripheral Lymphocytes and their Subsets as Immune Function in Advanced Gastric Cancer: Yoon Sun Joh, Yon Geul Joh, Min Young Cho, Sung Ock Suh; J Korean Cancer Assoc. 1999;31(5):946-954.

Abstract PDF: PURPOSE
This study evaluated the immunologic function of the postoperative lymphacytes and their subsets during 2 years after the curative resection of advanced gastric cancer.
MATERIALS AND METHODS
The peripheral lymphocytes and their subset in 64 advanced gastric cancer patients were preoperatively and postoperatively measured by using fluorescent conjugated monoclonal antibodies with flow cytometry. The monoclonal antibodies to T lymphocyte (CD3), B lymphocyte (CD19), helper-inducer cell (CD4), suppressor- cytotoxic cell (CD8), natural killer cell (CD16), and activated T cell (HLA-DR) antigens were used individually corresponding to T lymphocytes, B lymphocytes, helper-inducer T cells, suppressor-cytotoxic T cells, natural killer cells and activated T cells in post- operative periods (1, 3, 6, 12, 18, K 24 months). Their postoperative data were compared to the preoperative data in advanced gastric cancer.
RESULTS
On sequential measurements, peripheral lymphocytes were significantly decreased in postoperative 1 month than preoperative 1 day but they were gradually increased in postoperative 3, 6, 12, 18 and 24 months with significance. The B lymphocytes were significantly decreased in postoperative 3 and 6 months. NK cells were significantly increased in postoperative 3 months.
CONCLUSION
The two years postoperative changing patterns of peripheral lymphocytes and their subsets may not be improved in advanced gastric cancer patients which were undertaken curative surgery except lymphocyte.

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Clinical Trial

Effects of Combined Splenectomy with Total Gastrectomy on the Prognosis in Gastric Cancer: Young Jae Mok, Seung Joo Kim, Gil Soo Son, Min Young Cho, Young Chul Kim, Sae Min Kim; J Korean Cancer Assoc. 1997;29(4):632-639.

Abstract PDF: PURPOSE
This study was carried out to evaluate the impact of combined splenectomy with total gastrectomy on survival and postoperative morbidity in advanced gastric cancer. PATIENTS AND METHODS: We performed a retrospective analysis of 193 patients who underwent curative resection among 289 patients with total gastrectomy during the period of Sep. 1983 through Dec. 1995 at the Department of Surgery, Korea University Hospital.
RESULTS
Out of 11 clinicopathologic factors, 5 were associated with splenectomy through univariate analysis. The incidence of splenectomy increased when the patients with advanced gastric cancer had Borrmann type III, Gross T3 & T4 stage, greater than 4 cm of tumor size, Serosal invasion, or UICC stage IIIb, IV (p<0.05). Postoperative complication occurred more commonly in splenectomy group than in non-splenectomy group (20.2% vs 16.9%). The 5-year survival rate of Stage II was lower in splenectomy group than in non-splenectomy group (63.5% vs 83.5%) but that of Stage III was higher in splenectomy group than in non-splenectomy group (22.8% vs 17.3%), there was no significant difference between the survival rates across different stages.
CONCLUSION
We could not find any beneficial effect of splenectomy in gastric cancer patients who underwent curative total gastrectomy in this retrospective analysis. There was no clinical evidence to support splenectomy as a general policy in patients with total gastrectomy. We conclude that the randomized prospective clinical trials using more precise criteria for the indication of splenectomy are needed in order to assess the beneficial effect of splenectomy.

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Original Article

Microcalcification Classifications on Mammography and Breast Cancer Incidences: Jeoung Won Bae, Jin Kim, Min Young Cho, Jae Bok Lee, Bum Hwan Koo; J Korean Cancer Assoc. 1999;31(2):275-281.

Abstract PDF: PURPOSE
Since needle localization biopsy was introduced, it is widely performed for nonpalpable microcalcified breast lesions, but there are many controversies in determining the disease characteristics and guidelines of the biopsy for microcalcifications detected mammographically in the absence of any palpable mass. This study was designed to detennine the breast cancers according to microcalcification types.
MATERIALS AND METHODS
We reviewed 91 patients, who underwent breast biopsies between January 1995 and June 1998 for only microcalcified lesions detected by mammography at the Department of Surgery, Korea University Hospitals. Microcalcifications were defined as calcifications less than 1.0 mm. The needle localization biopsy was performed only on patients who were found to have five or more microcalcifications. We classified the mictocalcifications into three types; casting type, crushed-stone-like type, and amorphous type.
RESULTS
The mean age was 49 years (25 82 years). Sixteen patients (17.6%) among the 91 patients were diagnosed with the breast cancer; four (22.2%) of 18 patients with casting type, eight (21.6%) of 37 patients with crushed-stone-like type, and four (11.1%) of 36 patients with amorphous type microcalcifications. Breast cancers were more prevalent in casting and crushed-stone-like types than in amorphous types. There was no difference in the size of microcalcifiations between benign and malignant lesions 13.11+-10.89 rnm vs 13.13+-9.51 mm.
CONCLUSIONS
The patients who have more than 5 microcalcifications clustered within 1 cm circle detected at mammographic evaluation, especially in case of casting or crushed-stone-like type, should be advised to have localization biopsy to detect early breast cancer.

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