Cancer Research and Treatment

Original Articles

Lung and Thoracic cancer

Enhancing Identification of High-Risk cN0 Lung Adenocarcinoma Patients Using MRI-Based Radiomic Features: Harim Kim, Jonghoon Kim, Soohyun Hwang, You Jin Oh, Joong Hyun Ahn, Min-Ji Kim, Tae Hee Hong, Sung Goo Park, Joon Young Choi, Hong Kwan Kim, Jhingook Kim, Sumin Shin, Ho Yun Lee; Cancer Res Treat. 2025;57(1):57-69. Published online June 26, 2024; DOI: https://doi.org/10.4143/crt.2024.251

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study aimed to develop a magnetic resonance imaging (MRI)–based radiomics model to predict high-risk pathologic features for lung adenocarcinoma: micropapillary and solid pattern (MPsol), spread through air space, and poorly differentiated patterns.
Materials and Methods
As a prospective study, we screened clinical N0 lung cancer patients who were surgical candidates and had undergone both ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography–computed tomography (PET/CT) and chest CT from August 2018 to January 2020. We recruited patients meeting our proposed imaging criteria indicating high-risk, that is, poorer prognosis of lung adenocarcinoma, using CT and FDG PET/CT. If possible, these patients underwent an MRI examination from which we extracted 77 radiomics features from T1-contrast-enhanced and T2-weighted images. Additionally, patient demographics, maximum standardized uptake value on FDG PET/CT, and the mean apparent diffusion coefficient value on diffusion-weighted image, were considered together to build prediction models for high-risk pathologic features.
Results
Among 616 patients, 72 patients met the imaging criteria for high-risk lung cancer and underwent lung MRI. The magnetic resonance (MR)–eligible group showed a higher prevalence of nodal upstaging (29.2% vs. 4.2%, p < 0.001), vascular invasion (6.5% vs. 2.1%, p=0.011), high-grade pathologic features (p < 0.001), worse 4-year disease-free survival (p < 0.001) compared with non-MR-eligible group. The prediction power for MR-based radiomics model predicting high-risk pathologic features was good, with mean area under the receiver operating curve (AUC) value measuring 0.751-0.886 in test sets. Adding clinical variables increased the predictive performance for MPsol and the poorly differentiated pattern using the 2021 grading system (AUC, 0.860 and 0.907, respectively).
Conclusion
Our imaging criteria can effectively screen high-risk lung cancer patients and predict high-risk pathologic features by our MR-based prediction model using radiomics.

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Gastrointestinal cancer

Neoadjuvant Nivolumab Therapy for Esophageal Squamous Cell Carcinoma: A Single-Arm, Phase II Study: Sehhoon Park, Yurimi Lee, Jiyun Lee, Yang Won Min, Hong Kwan Kim, Joon Young Choi, Hyun Ae Jung, Yong Soo Choi, Yoon-La Choi, Young Mog Shim, Jong-Mu Sun; Cancer Res Treat. 2024;56(2):567-579. Published online October 16, 2023; DOI: https://doi.org/10.4143/crt.2023.897

Abstract PDF Supplementary Material PubReader ePub: Purpose
Programmed death-1/programmed death-ligand 1 (PD-L1) inhibitors have shown efficacy in metastatic esophageal squamous cell carcinoma (ESCC) therapy. However, data is still limited regarding neoadjuvant immunotherapy for operable ESCC.
Materials and Methods
Patients with clinical stage T2 or T3 and N0 ESCC received three cycles of nivolumab therapy every two weeks before surgical resection. The primary endpoint is major pathologic responses (MPR) rate (≤ 10% of residual viable tumor [RVT]).
Results
Total 20 patients completed the planned nivolumab therapy. Among them, 17 patients underwent surgery as protocol, showing MPR in two patients (MPR rate, 11.8%), including one pathologic complete response, on conventional pathologic response evaluation. Pathologic response was re-evaluated using the immune-related pathologic response criteria based on immune-related RVT (irRVT). Three patients were classified as immunologic major pathologic response (iMPR; ≤ 10% irRVT, iMPR rate: 17.6%), five as pathologic partial response (> 10% and < 90% irRVT), and nine as pathologic nonresponse (≥ 90% irRVT). The combined positive score (CPS) for PD-L1 in the baseline samples was predictable for iMPR, with the probability as 37.5% in CPS ≥ 10 (3/8) and 0% in CPS < 10 (0/9).
Conclusion
Although the efficacy of neoadjuvant nivolumab therapy was modest in unselected ESCC patients, further researches on neoadjuvant immunotherapy are necessary in patients with PD-L1 expressed ESCC.

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Comparison of Total Body Irradiation (TBI) Conditioning with Non-TBI for Autologous Stem Cell Transplantation in Newly Diagnosed or Relapsed Mature T- and NK-Cell Non-Hodgkin Lymphoma: Chi Hoon Maeng, Young Hyeh Ko, Do Hoon Lim, Eun Suk Kang, Joon Young Choi, Won Seog Kim, Seok Jin Kim; Cancer Res Treat. 2017;49(1):92-103. Published online May 9, 2016; DOI: https://doi.org/10.4143/crt.2015.476

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Purpose
This retrospective study was conducted for comparison of survival outcomes and toxicities of autologous stem cell transplantation (ASCT) based on the use of total body irradiation (TBI) as a part of the conditioning regimen in patients with mature T- and natural killer (NK)-cell lymphomas.
Materials and Methods
Patients who underwent ASCT in the upfront or salvage setting between January 2000 and December 2013 were analyzed. Patients were dichotomized according to the TBI group (n=38) and non-TBI group (n=60) based on the type of conditioning regimen for ASCT.
Results
Patients with responsive disease underwent upfront ASCT (TBI, n=16; non-TBI, n=29) whereas patients with refractory disease (TBI, n=9; non-TBI, n=12) or relapsed disease (TBI, n=13; non-TBI, n=19) underwent ASCT after salvage treatment. Hematologic and non-hematologic toxicities were manageable, and the median cumulative toxicity score according to Seattle criteria was estimated as 2 (range, 0 to 7) in both groups. No significant difference in 100-day mortality was observed between the TBI (13%, 5/38) and non-TBI (12%, 12/60) groups, and most deaths were related to disease progression. There was no difference in overall and progression-free survival; however, the TBI group showed a trend of better survival in upfront and salvage ASCT than the non-TBI group. However, patients with refractory disease showed the worst outcome regardless of the use of TBI. Patients who showed complete response before ASCT showed better progression-free survival than thosewho showed partial response.
Conclusion
TBI could be used as an effective part of conditioning for ASCT in patients with mature T- and NK-cell lymphomas.

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Whole body irradiation with intensity-modulated helical tomotherapy prior to haematopoietic stem cell transplantation: analysis of organs at risk by dose and its effect on blood kinetics
Mümtaz Köksal, Jonathan Baumert, Danny Jazmati, Felix Schoroth, Stephan Garbe, David Koch, Davide Scafa, Gustavo R. Sarria, Christina Leitzen, Gregor Massoth, Achilles Delis, Annkristin Heine, Tobias Holderried, Peter Brossart, Thomas Müdder, Leonard C. S
Journal of Cancer Research and Clinical Oncology.2023; 149(10): 7007. CrossRef
The impacts of total body irradiation on umbilical cord blood hematopoietic stem cell transplantation
Hao Wang, Kristin N. Berger, Elizabeth L. Miller, Wei Fu, Larisa Broglie, Frederick D. Goldman, Heiko Konig, Su Jin Lim, Arthur S. Berg, Julie-An Talano, Melanie A. Comito, Sherif S. Farag, Jeffrey J. Pu
Therapeutic Advances in Hematology.2023;[Epub] CrossRef
Helical versus static approaches to delivering tomotherapy to the junctional target for patients taller than 135 cm undergoing total body irradiation
Mümtaz Köksal, Jonathan Baumert, Felix Schoroth, Thomas Müdder, Davide Scafa, David Koch, Christina Leitzen, Gustavo R. Sarria, Leonard C. Schmeel, Frank A. Giordano
European Journal of Medical Research.2022;[Epub] CrossRef
National survey of myeloablative total body irradiation prior to hematopoietic stem cell transplantation in Japan: survey of the Japanese Radiation Oncology Study Group (JROSG)
Naoya Ishibashi, Toshinori Soejima, Hiroki Kawaguchi, Takeshi Akiba, Masatoshi Hasegawa, Kouichi Isobe, Hitoshi Ito, Michiko Imai, Yasuo Ejima, Masaharu Hata, Keisuke Sasai, Emiko Shimoda, Toshiya Maebayashi, Masahiko Oguchi, Tetsuo Akimoto
Journal of Radiation Research.2018; 59(4): 477. CrossRef

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Case Reports

Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Tissue Type Involving the Dura: Joon Young Choi, Ji Hwan Chung, Young Jun Park, Geun Yong Jung, Tae Wook Yoon, Yoon Jung Kim, Tae kyu Lim, Bong Seog Kim, Seung-Hyun Nam; Cancer Res Treat. 2016;48(2):859-863. Published online July 17, 2015; DOI: https://doi.org/10.4143/crt.2014.334

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Primary central nervous system marginal zone B-cell lymphoma (MZBCL) is very rare, with only a few reported cases worldwide. It has an indolent disease course with high cure potential. We experienced a rare case of dural MZBCL of mucosa-associated lymphoid tissue (MALT) in a 69-year-old man who presented with headache. A magnetic resonance imaging scan of brain showed a 1.9×3.6-cm-sized extra-axial mass with a broad based dural attachment to the anterosuperior aspect of the falx cerebri, radiographically consistent with meningioma. Surgical resection yielded a MZBCL of the MALT type. Histopathology revealed a lymphoplasmacytic infiltration of the dura, and immunohistochemical study showed a B-cell phenotype with CD20, bcl-2, MUM- 1, Ki-67 positive. He was treated with chemotherapy after complete surgical resection and remained free of disease at 30 months after chemotherapy. MALT lymphoma must be considered in the differential diagnosis in patients presenting radiographically with meningioma.

Citations

Citations to this article as recorded by

Primary central nervous system marginal zone lymphoma
Elena Flospergher, Fabrizio Marino, Teresa Calimeri, Maria Giulia Cangi, Andrés José María Ferreri, Maurilio Ponzoni, Lucia Bongiovanni
British Journal of Haematology.2024; 204(1): 31. CrossRef
Primary cerebral immunoglobulin light chain amyloidoma in a patient with multiple sclerosis
Marissa J M Traets, Krisna Chuwonpad, Roos J Leguit, Stephan T F M Frequin, Monique C Minnema
BMJ Case Reports.2024; 17(1): e256537. CrossRef
Intracranial dural based marginal zone MALT-type B-cell lymphoma: a case – Based update and literature review
G. La Rocca, A. M. Auricchio, E. Mazzucchi, T. Ius, G. M. Della Pepa, R. Altieri, F. Pignotti, M. Gessi, V. De Santis, C. Zoia, G. Sabatino
British Journal of Neurosurgery.2023; 37(6): 1480. CrossRef
Mucosa-Associated Lymphoid Tissue Lymphoma With Lymphomeningothelial Lesion of the Dura
Pınar Celepli, Tuncer Taşcioğlu, Yağmur Ciman, Yavuz Erdem, Haydar Çelik, Ömer Günhan
International Journal of Surgical Pathology.2023; 31(5): 879. CrossRef
Case report: Primary intracranial mucosa-associated lymphoid tissue lymphoma presenting as two primary tumors involving the cavernous sinus and extra-axial dura, respectively
Shiyun Tian, Tao Pan, Bingbing Gao, Wanyao Li, Jiashen Liu, Kun Zou, Yanwei Miao
Frontiers in Oncology.2023;[Epub] CrossRef
Primary pituitary stalk mucosa-associated lymphoid tissue lymphoma: a case report and literature review
Shihao Cai, Juexian Xiao, Peng Chen, Haitao Luo, Zujue Cheng
Frontiers in Neurology.2023;[Epub] CrossRef
Low-grade B-cell lymphomas in the spinal epidural space: A case series and review of the literature
Sandra Leskinen, Hamza Khilji, Faina Ablyazova, Avraham Zlochower, Manju Harshan, A. Gabriella Wernicke, Morana Vojnic, Randy S. D'Amico
Current Problems in Cancer: Case Reports.2023; 12: 100269. CrossRef
Primary mucosa-associated lymphoid tissue lymphoma in the midbrain: A case report
Yong-Rui Zhao, Rong-Hua Hu, Rui Wu, Jian-Kun Xu
World Journal of Clinical Cases.2021; 9(22): 6566. CrossRef
Hide and seek
Marta Saint-Gerons, Silvia Muñoz, Jurij R. Bilyk
Survey of Ophthalmology.2020; 65(1): 109. CrossRef
An international multicenter retrospective analysis of patients with extranodal marginal zone lymphoma and histologically confirmed central nervous system and dural involvement
Andrew J. Sunderland, Raphael E. Steiner, Musa Al Zahrani, Chelsea C. Pinnix, Bouthaina Shbib Dabaja, Jillian R. Gunther, Loretta J. Nastoupil, Mats Jerkeman, David Joske, Gavin Cull, Tarec El‐Galaly, Diego Villa, Chan Yoon Cheah
Cancer Medicine.2020; 9(2): 663. CrossRef
Extranodal Marginal Zone Lymphoma of the Central Nervous System
Adanma Ayanambakkam, Sami Ibrahimi, Khalid Bilal, Mohamad A. Cherry
Clinical Lymphoma Myeloma and Leukemia.2018; 18(1): 34. CrossRef
A Rare Case of Composite Dural Extranodal Marginal Zone Lymphoma and Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
Mark Bustoros, Benjamin Liechty, David Zagzag, Cynthia Liu, Timothy Shepherd, Deborah Gruber, Bruce Raphael, Dimitris G. Placantonakis
Frontiers in Neurology.2018;[Epub] CrossRef
Intracranial Marginal Zone B-Cell Lymphoma Mimicking Meningioma
Diana G. Douleh, Peter J. Morone, Jonathan A. Forbes, Reid C. Thompson
World Neurosurgery.2016; 91: 676.e9. CrossRef

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Unusual Manifestation of Intravascular Large B-Cell Lymphoma: Severe Hypercalcemia with Parathyroid Hormone-Related Protein: Jung Min Ha, Eun Kim, Woo Joo Lee, Ji-Won Hwang, Sehyo Yune, Young Hyeh Ko, Joon Young Choi, Seok Jin Kim, Won Seog Kim; Cancer Res Treat. 2014;46(3):307-311. Published online July 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.3.307

Abstract PDF PubReader ePub

Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of non-Hodgkin lymphoma. It usually presents with nonspecific symptoms, such as fever, rather than with overt lymphadenopathy. Reports of hypercalcemia, as the initial presentation of IVLBCL, are limited in the literature, despite it being a well-known complication of various solid cancers. We present a 68-year-old male with severe hypercalcemia and increased levels of serum parathyroid hormone-related protein. He was diagnosed with IVLBCL, involving the bone marrow and spleen, and was successfully treated with rituximab-containing chemotherapy. A few previous case reports have shown hypercalcemia in patients with IVLBCL. Much like our case, previous cases with hypercalcemia had advanced diseases, including bone marrow invasion. Although it was an extremely rare manifestation of IVLBCL, we suggest that IVLBCL should be a part of the differential diagnosis in patients with unexplained hypercalcemia. Therefore, an active work-up might be recommended, including positron emission tomography/ computed tomography scan and bone marrow examination, which may be useful for early diagnosis.

Citations

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Case Report: Intravascular Large B-Cell Lymphoma: A Clinicopathologic Study of Four Cases With Review of Additional 331 Cases in the Literature
Yingying Han, Qingjiao Li, Dan Wang, Lushan Peng, Tao Huang, Chunlin Ou, Keda Yang, Junpu Wang
Frontiers in Oncology.2022;[Epub] CrossRef
Imaging Features and Prognostic Value of FDG PET/CT in Patients with Intravascular Large B-Cell Lymphoma
Chae Hong Lim, Sang Eun Yoon, Won Seog Kim, Kyung-Han Lee, Seok Jin Kim
Cancer Management and Research.2021; Volume 13: 7289. CrossRef
Missed diagnosis of lymphoma presenting with humoral hypercalcemia of malignancy due to cessation of oncological workup after negative computed tomography scans
Ellery Altshuler, Mahmoud Aryan, William King, Rolando Otero
BMJ Case Reports.2021; 14(12): e246669. CrossRef
The spectrum of lymphoproliferative disorders in endocrine organs: from histology to molecular genetics
Silvia Uccella, Francesca Magnoli, Cristina Amaglio, Fausto Sessa, Stefano La Rosa
Diagnostic Histopathology.2019; 25(5): 166. CrossRef
Diagnosis of intravascular large B cell lymphoma: novel insights into clinicopathological features from 42 patients at a single institution over 20 years
Kosei Matsue, Yoshiaki Abe, Kentaro Narita, Hiroki Kobayashi, Akihiro Kitadate, Masami Takeuchi, Daisuke Miura, Kengo Takeuchi
British Journal of Haematology.2019; 187(3): 328. CrossRef
Klinische und pathologische Charakteristika intravaskulärer Lymphome
L. Abraham, H. Kreipe, P. Raab, K. Hussein
Der Pathologe.2018; 39(3): 242. CrossRef
Primary Bone Marrow B-Cell Lymphoma Undetected by Multiple Imaging Modalities That Initially Presented with Hypercalcemia
Jin Sae Yoo, Juwon Kim, Hyeong Ju Kwon, Jung Soo Lim
Case Reports in Endocrinology.2018; 2018: 1. CrossRef
Klinische und pathologische Charakteristika intravaskulärer Lymphome
Lara Abraham, Hans H. Kreipe, Peter Raab, Kais Hussein
Wiener klinisches Magazin.2018; 21(5): 206. CrossRef

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Original Article

Response Evaluation after Neoadjuvant Chemoradiation by Positron Emission Tomography-Computed Tomography for Esophageal Squamous Cell Carcinoma: Joon Suk Park, Joon Young Choi, Seung Hwan Moon, Yong Chan Ahn, Jeeyun Lee, Dohun Kim, Kwhanmien Kim, Young Mog Shim; Cancer Res Treat. 2013;45(1):22-30. Published online March 31, 2013; DOI: https://doi.org/10.4143/crt.2013.45.1.22

Abstract PDF PubReader ePub

PURPOSE
Parameters of positron emission tomography-computed tomography (PET-CT) were compared with the results of histopathologic examination in order to determine which can provide an objective indication of response after neoadjuvant chemoradiation for treatment of thoracic esophageal squamous cell carcinoma (SCC).
MATERIALS AND METHODS
Between August 2003 and January 2010, data on 25 patients who underwent neoadjuvant chemoradiation and subsequent resection for treatment of esophageal SCC were retrospectively reviewed. Changes in maximum standardized uptake value (DeltaSUVmax), metabolic tumor volume (DeltaMTV), and total lesion glycolysis (DeltaTLG) were analyzed by comparison with the histopathologic findings.
RESULTS
Pathologic complete remission (CR) for the main tumor was achieved in 11 patients. Postradiation esophagitis was observed in 10 patients. DeltaSUVmax of the main tumor was significantly greater in the CR group than in the partial response (PR) group (p=0.039), while DeltaMTV and DeltaTLG of the main tumor were not (p=0.141 and p=0.349, respectively). The cut-off DeltaSUVmax value for CR was estimated as 72.1%, indicating significantly better accuracy than visual interpretation (p=0.045). Of the 48 involved lymph nodes, DeltaSUVmax and DeltaMTV of lymph nodes were significantly greater in the CR group than in the PR group (p=0.045 and p=0.014, respectively), while DeltaTLG was not (p=0.063). The cut-off value of DeltaSUVmax for prediction of CR in lymph nodes was calculated as 50.67%.
CONCLUSION
PET-CT could be used for prediction of response to neoadjuvant treatment in thoracic esophageal SCC. DeltaSUVmax may be a more significant predictor for CR after neoadjuvant chemoradiation than DeltaTLG and DeltaMTV.

Citations

Citations to this article as recorded by

PET-Uptake Reduction into Lymph Nodes After Neoadjuvant Therapy is Highly Predictive of Prognosis for Patients Who have Thoracic Esophageal Squamous Cell Carcinoma Treated with Chemoradiotherapy Plus Esophagectomy
Yushi Nagaki, Satoru Motoyama, Yusuke Sato, Akiyuki Wakita, Hiromu Fujita, Kohei Kemuriyama, Yoshihiro Sasaki, Kazuhiro Imai, Eri Maeda, Yoshihiro Minamiya
Annals of Surgical Oncology.2022; 29(2): 1336. CrossRef
Prognostic factors associated with 18FDG-PET/CT in esophageal squamous cell carcinoma after trimodality treatment
Wei-Hsiang Feng, Ying-Yi Chen, Yen‐Shou Kuo, Kuan-Hsun Lin, Yuan-Ming Tsai, Ti-Hui Wu, Hsu-Kai Huang, Tsai-Wang Huang
BMC Cancer.2022;[Epub] CrossRef
SUVmax reduction predicts long-term survival in patients of non-pCR both in the tumor and lymph nodes after neoadjuvant chemoradiotherapy in esophageal squamous cell carcinoma
Yushi Nagaki, Satoru Motoyama, Yusuke Sato, Akiyuki Wakita, Hiromu Fujita, Yoshihiro Sasaki, Kazuhiro Imai, Yoshihiro Minamiya
World Journal of Surgical Oncology.2021;[Epub] CrossRef
18F-FDG PET/CT Parameters for Predicting Prognosis in Esophageal Cancer Patients Treated With Concurrent Chemoradiotherapy
Seokmo Lee, Yunseon Choi, Geumju Park, Sunmi Jo, Sun Seong Lee, Jisun Park, Hye-Kyung Shim
Technology in Cancer Research & Treatment.2021;[Epub] CrossRef
Accuracy of Detecting Residual Disease After Neoadjuvant Chemoradiotherapy for Esophageal Cancer
Ben M. Eyck, Barbera D. Onstenk, Bo J. Noordman, Daan Nieboer, Manon C. W. Spaander, Roelf Valkema, Sjoerd M. Lagarde, Bas P. L. Wijnhoven, J. Jan B. van Lanschot
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Supraclavicular and/or celiac lymph node metastases from thoracic esophageal squamous cell carcinoma did not compromise survival following neoadjuvant chemoradiotherapy and surgery
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Prognostic and Predictive Value of FDG-PET as an Aid in Oesophageal Cancer Management
Mian Xi, Steven H. Lin
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Ability of Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography to Predict Outcomes of Neoadjuvant Chemoradiotherapy Followed by Surgical Treatment for Esophageal Squamous Cell Carcinoma
Yoichi Hamai, Jun Hihara, Manabu Emi, Takaoki Furukawa, Ichiko Yamakita, Tomoaki Kurokawa, Morihito Okada
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PET/CT in the evaluation of treatment response to neoadjuvant chemoradiotherapy and prognostication in patients with locally advanced esophageal squamous cell carcinoma
Hui Yuan, Daniel K.H. Tong, Varut Vardhanabhuti, Simon Y.K. Law, Keith W.H. Chiu, Pek-Lan Khong
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Prognostic significance of PET assessment of metabolic response to therapy in oesophageal squamous cell carcinoma
Arpit Chhabra, Leonard T Ong, Deborah Kuk, Geoffrey Ku, David Ilson, Yelena Y Janjigian, Abraham Wu, Heiko Schöder, Karyn A Goodman
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