Cancer Research and Treatment

Original Articles

Sarcoma

Incidence Patterns and Outcomes of Ewing Sarcoma in South Korea (1999-2017): A Retrospective Analysis Using Korea Central Cancer Registry Data: Jun Ah Lee, Jiwon Lim, Dayeon Park, Hye Young Jin, Meerim Park, Hyeon Jin Park, Jong Woong Park, June Hyuk Kim, Hyun Guy Kang, Young-Joo Won; Cancer Res Treat. 2022;54(2):590-596. Published online July 20, 2021; DOI: https://doi.org/10.4143/crt.2021.311

Purpose
Due to low incidence, epidemiologic data of Ewing sarcoma in the Asian population are scarce. We aimed to examine the incidence pattern and outcome of patients with Ewing sarcoma in the Republic of Korea.
Materials and Methods
Data of patients with Ewing sarcoma diagnosed between 1999 and 2017 were obtained from the Korea Central Cancer Registry (KCCR). Incidence, clinical characteristics, and survival rates were analyzed and compared between different age groups.
Results
There were 788 cases (459 males, 329 females), with a median age at diagnosis of 20 years. The age-standardized rate of Ewing sarcoma was 1.01. The number of cases and incidence rates in each age group were as follows: children, 1.6; adolescents and young adults (AYA), 0.93; adults, 0.44; and elderly, 0.53. There were more male cases in children and the AYA group (p < 0.001). Extraskeletal tumors (p < 0.001), primary sites other than extremity (p=0.007), and presence of metastasis at diagnosis (p=0.031) were more frequent in the adults and elderly group. With a median survival time of 78 months, the 5-year overall survival (OS) rate of the entire cohort was 52%. Children fared best (5-year OS, 75%), and the 5-year OS of AYA patients (51%) approximated the OS of the entire cohort. A two-fold difference of 5-year OS was observed between adults and elderly patients (42% vs. 19%). On univariate and multivariate analyses, age ≥ 15 years and presence of metastasis were adverse prognostic factors.
Conclusion
This was the first epidemiologic study of Ewing sarcoma using the KCCR data. With a similar incidence to other Asian countries, the survival rate was slightly lower than that of Euro-American cases. Collaborative clinical studies are necessary to improve the outcome of Ewing sarcoma in low-incidence populations.

Citations

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Twenty‐year outcome of prevalence, incidence, mortality and survival rate in patients with malignant bone tumors
Yao Xu, Fanqi Shi, Yanting Zhang, Mengfan Yin, Xiuxin Han, Jinyan Feng, Guowen Wang
International Journal of Cancer.2024; 154(2): 226. CrossRef
A Machine Learning-Based Predictive Model for Predicting Lymph Node Metastasis in Patients With Ewing’s Sarcoma
Wenle Li, Qian Zhou, Wencai Liu, Chan Xu, Zhi-Ri Tang, Shengtao Dong, Haosheng Wang, Wanying Li, Kai Zhang, Rong Li, Wenshi Zhang, Zhaohui Hu, Su Shibin, Qiang Liu, Sirui Kuang, Chengliang Yin
Frontiers in Medicine.2022;[Epub] CrossRef
TrkC, a novel prognostic marker, induces and maintains cell survival and metastatic dissemination of Ewing sarcoma by inhibiting EWSR1-FLI1 degradation
Min Soo Kim, Won Sung Lee, Hanki Lee, Wook Jin
Cell Death & Disease.2022;[Epub] CrossRef

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Gastrointestinal cancer

First Course of treatment and Prognosis of Exocrine Pancreatic Cancer in Korea from 2006 to 2017: Mee Joo Kang, Jiwon Lim, Sung-Sik Han, Hyeong Min Park, Sang-Jae Park, Young-Joo Won, Sun-Whe Kim; Cancer Res Treat. 2022;54(1):208-217. Published online May 21, 2021; DOI: https://doi.org/10.4143/crt.2021.421

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Purpose
Hospital-based clinical studies have limitations in holistic assessment of cancer treatment and prognosis, as they omit out-of-hospital patients including elderly individuals. This study aimed to investigate trends in initial treatment and corresponding prognosis of patients with exocrine pancreatic cancer (EPC) in Korea.
Materials and Methods
The Korea Central Cancer Registry data of patients with EPC from 2006 to 2017 were retrospectively reviewed. We defined the first course of treatment (FT) as the cancer-directed treatment administered within four months after cancer diagnosis according to Surveillance, Epidemiology, and End Results (SEER) program.
Results
Among 62,209 patients with EPC, localized and regional (LR) SEER stage; patients over 70 years old; and ductal adenocarcinoma excluding cystic or mucinous (DAC) accounted for 40.6%, 50.1%, and 95.9%, respectively. “No active treatment” (NT, 46.5%) was the most frequent, followed by non-surgical FT (28.7%) and surgical FT (22.0%). Among 25,198 patients with LR EPC, surgical FT increased (35.9% to 46.3%) and NT decreased (45.0% to 29.5%) from 2006 to 2017. The rate of surgical FT was inversely related to age (55.1% [< 70 years], 37.3% [70-79 years], 10.9% [≥ 80 years]). Five-year relative survival rates of LR DAC were higher after surgical FT than after NT in localized (46.1% vs. 12.9%) and regional stage (23.6% vs. 4.9%) from 2012 to 2017.
Conclusion
Less than half of overall patients with LR EPC underwent surgical FT, and this proportion decreased significantly in elderly individuals. Clinicians should focus attention on elderly patients with EPC to provide appropriate medical advice.

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Conditional Relative Survival of Exocrine Pancreatic Cancer: A Population-Based Study
Mee Joo Kang, Johyun Ha, Hyeong Min Park, Sang-Jae Park, Kyu-Won Jung, Sung-Sik Han
Annals of Surgical Oncology.2024; 31(2): 1178. CrossRef
Potential role of Fibrosis‐4 score in hepatocellular carcinoma screening: The Kangbuk Samsung Health Study
Sujeong Shin, Won Sohn, Yoosoo Chang, Yoosun Cho, Min‐Jung Kwon, Sarah H. Wild, Christopher D. Byrne, Seungho Ryu
Hepatology Research.2024; 54(6): 551. CrossRef
Three-year follow-up study reveals improved survival rate in NSCLC patients underwent guideline-concordant diagnosis and treatment
Huijuan Mu, Xing Yang, Yanxia Li, Bingzheng Zhou, Li Liu, Minmin Zhang, Qihao Wang, Qian Chen, Lingjun Yan, Wei Sun, Guowei Pan
Frontiers in Oncology.2024;[Epub] CrossRef
Epidemiological trends and factors associated with survival in patients with medulloblastoma: A 45-year population-based retrospective study
Dongjie He, Yahui Yang, Peiwen Wu, Siying Zhu, Hao Chang, Chao Zhang, Qiuju Shao, Zongyan Yu
Journal of Clinical Neuroscience.2024; 126: 154. CrossRef
Surgical management for elderly patients with pancreatic cancer
Sun-Whe Kim
Annals of Surgical Treatment and Research.2023; 105(2): 63. CrossRef
Exocrine pancreatic cancer as a second primary malignancy: A population-based study
Mee Joo Kang, Jiwon Lim, Sung-Sik Han, Hyeong Min Park, Sung Chun Cho, Sang-Jae Park, Sun-Whe Kim, Young-Joo Won
Annals of Hepato-Biliary-Pancreatic Surgery.2023; 27(4): 415. CrossRef
Distinct prognosis of biliary tract cancer according to tumor location, stage, and treatment: a population-based study
Mee Joo Kang, Jiwon Lim, Sung-Sik Han, Hyeong Min Park, Sun-Whe Kim, Woo Jin Lee, Sang Myung Woo, Tae Hyun Kim, Young-Joo Won, Sang-Jae Park
Scientific Reports.2022;[Epub] CrossRef
Trend Analysis and Prediction of Hepatobiliary Pancreatic Cancer Incidence and Mortality in Korea
Hyeong Min Park, Young-Joo Won, Mee Joo Kang, Sang-Jae Park, Sun-Whe Kim, Kyu-Won Jung, Sung-Sik Han
Journal of Korean Medical Science.2022;[Epub] CrossRef
Epidemiology of Gastric Cancer in Korea: Trends in Incidence and Survival Based on Korea Central Cancer Registry Data (1999–2019)
Sin Hye Park, Mee Joo Kang, E Hwa Yun, Kyu-Won Jung
Journal of Gastric Cancer.2022; 22(3): 160. CrossRef
Incidence, mortality and survival of gallbladder, extrahepatic bile duct, and pancreatic cancer using Korea central cancer registry database: 1999-2019
Mee Joo Kang, E Hwa Yun, Kyu-Won Jung, Sang-Jae Park
Annals of Hepato-Biliary-Pancreatic Surgery.2022; 26(3): 220. CrossRef
Incidence, mortality, and survival of liver cancer using Korea central cancer registry database: 1999-2019
Sung Yeon Hong, Mee Joo Kang, Taegyu Kim, Kyu-Won Jung, Bong-Wan Kim
Annals of Hepato-Biliary-Pancreatic Surgery.2022; 26(3): 211. CrossRef

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Gynecologic cancer

Second Primary Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancers after Breast Cancer Diagnosis: Korea Central Cancer Registry: Hyeong In Ha, Eun-Gyeong Lee, Jiwon Lim, So-Youn Jung, Yoon Jung Chang, Young-Joo Won, Myong Cheol Lim; Cancer Res Treat. 2021;53(2):541-548. Published online November 18, 2020; DOI: https://doi.org/10.4143/crt.2020.1001

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Purpose
A prior history of breast cancer is a risk factor for the subsequent development of primary peritoneal, epithelial ovarian, and fallopian tubal (POFT) cancers. This study aimed to estimate the incidence of secondary POFT malignancy in breast cancer patients and the clinical outcomes of primary and secondary POFT cancer.
Materials and Methods
We searched the Korea Central Cancer Registry to find patients with primary and secondary POFT cancer who had breast cancer in 1999-2017. The incidence rate and standardized incidence ratio were calculated. Additionally, we compared the overall survival of patients with primary and secondary POFT cancer.
Results
Based on the age-standardized rate, the incidence of second primary POFT cancer after breast cancer was 0.0763 per 100,000 women, which increased in Korea between 1999 and 2017. Among the 30,366 POFT cancer patients, 25,721 were primary POFT cancer only, and 493 had secondary POFT cancer after a breast cancer diagnosis. Second primary POFT cancer patients were older at the time of diagnosis (55 vs. 53, p < 0.001) and had a larger proportion of serous histology (68.4% vs. 51.2%, p < 0.001) than patients with primary POFT. There were no differences between the two groups in tumor stage at diagnosis. The 5-year overall survival rates were 60.2% and 56.3% for primary and secondary POFT cancer, respectively (p=0.216).
Conclusion
The incidence of second primary POFT cancer after breast cancer increased in Korea between 1999 and 2017. Besides, second primary POFT cancer patients were diagnosed at older ages and had more serous histology.

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Eberhard Paul, Sebastian M. Jud
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High-grade pelvic-type serous carcinoma presenting as a breast rash
Mark Weingarten, Michael Weingarten, Tamara Kalir, Angela Lamb
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General

Cancer Incidence and Survival among Adolescents and Young Adults in Korea: An Update for 2016: Meerim Park, Jiwon Lim, Jun Ah Lee, Byung Kiu Park, Kyu-Won Jung, Young-Joo Won, Hyeon Jin Park; Cancer Res Treat. 2021;53(1):32-44. Published online October 5, 2020; DOI: https://doi.org/10.4143/crt.2020.644

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study investigated the incidence and relative survival rates (RSRs) for cancers among adolescents and young adults (AYAs) aged 15-39 years between 1993 and 2016 in Korea
Materials and Methods
Data from the Korea Central Cancer Registry were used to calculate percent distributions, age-specific incidence rates, age-standardized incidence rates (ASRs) per million, annual percent changes (APCs), average APCs, and RSRs for cancers diagnosed in AYAs.
Results
ASR of all cancers among AYAs was 654.5 per million. The largest diagnosed group of cancers was carcinomas (almost 80%). Crude incidence increased with age, from 170.4 per million for those aged 15-19 years to 1,639.8 per million for those aged 35-39 years. ASR increased from 414.8 per million to 820.4 per million, with an APC of 9.0%. The incidence of thyroid carcinoma showed the most rapid increment (APC, 14.0%), followed by non-Hodgkin lymphoma (APC, 13.4%). The 5-year RSR among AYAs significantly improved from 62.1% to 90.8%. Survival improvement in AYAs was higher than that in children but lower than that in older adults (APC, 2.1% vs. 1.9% vs. 3.1%). The most marked survival improvement was found for leukemia and lymphoma. Astrocytoma, rhabdomyosarcoma, and carcinoma of the trachea, bronchus, and lung had a 5-year RSR of < 50%.
Conclusion
There was an improvement in cancer survivals in AYAs, comparable to that achieved in children. However, survivals in several cancer types do not appear to be improving. Further research focusing on the epidemiology and therapeutic strategies for cancers in AYAs is needed.

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Chinese Medical Journal.2022; 135(1): 42. CrossRef
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Mayuko Yamamoto, Takeshi Motohara, Yutaka Iwagoi, Shingo Tayama, Hironori Tashiro, Eiji Kondoh, Hidetaka Katabuchi
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Osteosarcoma in Adolescents and Young Adults
Jun Ah Lee, Jiwon Lim, Hye Young Jin, Meerim Park, Hyeon Jin Park, Jong Woong Park, June Hyuk Kim, Hyun Guy Kang, Young-Joo Won
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Comparing the Characteristics and Outcomes of Male and Female Breast Cancer Patients in Korea: Korea Central Cancer Registry: Eun-Gyeong Lee, So-Youn Jung, Myong Cheol Lim, Jiwon Lim, Han-Sung Kang, Seeyoun Lee, Jai Hong Han, Heein Jo, Young-Joo Won, Eun Sook Lee; Cancer Res Treat. 2020;52(3):739-746. Published online February 13, 2020; DOI: https://doi.org/10.4143/crt.2019.639

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to determine the incidence of male breast cancer (MBC) and its survival outcomes in Korea, and to compare these results to those for female breast cancer (FBC).
Materials and Methods
We searched the Korea Central Cancer Registry and identified 227,122 breast cancer cases that were diagnosed between 1999 and 2016. Demographic and clinical characteristics and overall survival (OS) rates were estimated according to sex, age, histological type, and cancer stage.
Results
The 227,122 patients included 1,094 MBC cases and 226,028 FBC cases. Based on the age-standardized rate, the male: female ratio was 0.0055:1. The most common ages at diagnosis were 60-69 years for MBC and 40-49 years for FBC (p < 0.001). Male patients were less likely than female patients to receive adjuvant radiotherapy (7.5% vs. 21.8%, p < 0.001) or adjuvant chemotherapy (40.1% vs. 55.4%, p < 0.001). The 5-year OS rates after diagnosis were 88.8% for all patients, although it was significantly lower for MBC than for FBC (76.2% vs. 88.9%, p < 0.001). In both groups, older age (≥ 60 years) was associated with shorter survival. The 5-year OS rates for the invasive histological types were 75.8% for men and 89.0% for women. The 5-year OS rates in both groups decreased with increasing cancer stage.
Conclusion
MBC was diagnosed at older ages than FBC, and male patients were less likely to receive radiotherapy and chemotherapy. The survival outcomes were worse for MBC than for FBC, with even poorer outcomes related to older age, the inflammatory histological types, and advanced stage. It is important that clinicians recognize the differences between FBC and MBC when treating these patients.

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Second Primary Cancer Risk among Kidney Cancer Patients in Korea: A Population-Based Cohort Study: Jae Young Joung, Whi-An Kwon, Jiwon Lim, Chang-Mo Oh, Kyu-Won Jung, Sung Han Kim, Ho Kyung Seo, Weon Seo Park, Jinsoo Chung, Kang Hyun Lee, Young-Joo Won; Cancer Res Treat. 2018;50(1):293-301. Published online April 19, 2017; DOI: https://doi.org/10.4143/crt.2016.543

Abstract PDF Supplementary Material PubReader ePub

Purpose
Secondary primary cancers (SPCs) commonly arise in patients with renal cell carcinoma (RCC). We designed the present study to estimate the SPC incidence in Korean patients with RCC.
Materials and Methods
The study cohort was population-based and consisted of 40,347 individuals from the Korean Central Cancer Registry who were diagnosed with primary renal cancer between 1993 and 2013. Standardized incidence ratios (SIRs) for SPCs were estimated for different ages at diagnosis, latencies, diagnostic periods, and treatments.
Results
For patients with primary RCC, the risk of developing a SPC was higher than the risk of developing cancer in the general population (SIR, 1.13; 95% confidence interval, 1.08 to 1.18). Most cancer types showed higher incidences in patients with RCC than in the general population. However, the relative incidence of gastric cancer as an SPC varied by age. Gastric cancer incidence was elevated in young patients (< 30 years) with RCC, but reduced in older (≥ 30) patients with RCC. Patients with advanced RCC died prematurely, regardless of SPC development. In contrast, those with early-stage RCC survived for longer periods, although SPC development affected their post-RCC survival. After SPC development, women had better survival than men.
Conclusion
In Korean patients with primary RCC, the incidence of SPC was 13% higher than the incidence of cancer in the general population. These findings may play important roles in the conduct of follow-up evaluations and education for patients with RCC.

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Next-generation sequencing identifies the mutational signature of double primary and metastatic malignancies: A case report
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Maria B. Bengtsen, Dóra K. Farkas, Henrik T. Sørensen, Mette Nørgaard
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BMC Cancer.2018;[Epub] CrossRef

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Current Trends in the Incidence and Survival Rate of Urological Cancers in Korea: Jae Young Joung, Jiwon Lim, Chang-Mo Oh, Kyu-Won Jung, Hyunsoon Cho, Sung Han Kim, Ho Kyung Seo, Weon Seo Park, Jinsoo Chung, Kang Hyun Lee, Young-Joo Won; Cancer Res Treat. 2017;49(3):607-615. Published online September 23, 2016; DOI: https://doi.org/10.4143/crt.2016.139

Abstract PDF Supplementary Material PubReader ePub

Purpose
This descriptive study assessed the current trends in the incidence of urological cancers and patient survival in Korea.
Materials and Methods
In this nationwide retrospective observational study based on the data from the Korea National Cancer Incidence Database (KNCIDB), this study analyzed the age-standardized incidence rates (ASRs) and annual percentage changes (APCs) of kidney, bladder, prostate, testicular, and penile cancers as well as cancer of the renal pelvis and ureter between 1999 and 2012. The relative survival rates (RSRs) were calculated for urological cancer patients diagnosed between 1993 and 2012 from the KNCIDB data.
Results
Prostate cancer was diagnosed in 66,812 individuals followed by bladder (41,549) and kidney (36,836) cancers. The overall ASR (18.26 per 100,000) increased with age because of the higher ASRs of bladder and prostate cancers in the elderly. The ASR for kidney cancer was highest in the 40-59-year-old group, whereas testicular cancer occurred most frequently before the age of 40. The incidence of most urological cancers increased (overall APC, 6.39%; p < 0.001), except for penile (APC, –2.01%; p=0.05) and bladder (APC, –0.40%; p=0.25) cancers. The overall survival increased steadily (5-year RSR, 66.4% in 1993-1995 vs. 84.2% in 2008-2012; p < 0.001), particularly for prostate (by 34.10%) and kidney (by 16.30%) cancers, but not for renal pelvis and ureter cancers (–7.20%).
Conclusion
The most common urological cancer in Korea was prostate cancer followed by bladder and kidney cancers. The incidence of most urological cancers, except for penile and bladder cancers, increased. Survival also increased, particularly for prostate and kidney cancers.

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Second Primary Cancer after Diagnosis and Treatment of Cervical Cancer: Myong Cheol Lim, Young-Joo Won, Jiwon Lim, Yeon-Joo Kim, Sang Soo Seo, Sokbom Kang, Eun Sook Lee, Jae Hwan Oh, Joo-Young Kim, Sang-Yoon Park; Cancer Res Treat. 2016;48(2):641-649. Published online July 17, 2015; DOI: https://doi.org/10.4143/crt.2014.326

Abstract PDF PubReader ePub

Purpose
This study was conducted to investigate the incidence and survival outcomes of second primary cancers after the diagnosis of cervical cancer.
Materials and Methods
Data from the Korea Central Cancer Registry between 1993 and 2010 were reviewed and analyzed. Standardized incidence ratios (SIRs) of second primary cancers among women with cervical cancer were analyzed. Kaplan-Meier survival curves were constructed for cervical cancer patients with or without a second primary cancer.
Results
Among 72,805 women with cervical cancer, 2,678 (3.68%) developed a second primary cancer within a mean follow-up period of 7.34 years. The overall SIR for a second cancer was 1.08 (95% confidence interval, 1.04 to 1.12). The most frequent sites of second primary cancers were the vagina, bone and joints, vulva, anus, bladder, lung and bronchus, corpus uteri, and esophagus. However, the incidence rates of four second primary cancers (breast, rectum, liver, and brain) were decreased. The 5-year and 10-year overall survival rates were 78.3% and 72.7% in all women with cervical cancer, and for women with a second primary cancer, these rates were 83.2% and 65.5% from the onset of cervical cancer and 54.9% and 46.7% from the onset of the second primary cancer, respectively.
Conclusion
The incidence rates of second primary cancers were increased in women with cervical cancer compared to the general population, with the exception of four decreasing cancers. The 10-year overall survival rates were decreased in cervical cancer patients with a second primary cancer.

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