Cancer Research and Treatment

Original Articles

Breast cancer

Quality Assessment and Trend for Breast Cancer Treatment Practice across South Korea Based on Nationwide Analysis of Korean Health Insurance Data during 2013-2017: Kyu Hye Choi, Soo-Yoon Sung, Sea-Won Lee, Ye Won Jeon, Sung Hwan Kim, Jong Hoon Lee; Cancer Res Treat. 2023;55(2):570-579. Published online December 5, 2022; DOI: https://doi.org/10.4143/crt.2022.882

Purpose
Quality assessment of breast cancer treatment in South Korea showed the upward standardization of the grade since 2013, but treatment disparities still have existed. This study analyzed the five year trend between 2013 and 2017 in the assessment of breast cancer treatment practice using the Korean health insurance data.
Materials and Methods
All the medical records including surgery, chemotherapy, and radiotherapy for 7,354 patients a year on average were evaluated. Twenty indices were consisted of one structural, 17 process-related, and 2 result-related factors. We calculated the coefficient of variation (CV) annually to determine the variation in adherence rate of evaluation indices according to the type of institution (advanced vs. general hospital vs. clinic).
Results
Based on the initial assessment in 2013, 10 out of 20 indicators showed significant variation among the types of institutions with a CV of less than 0.1%. Six of them had a CV decline of less than 0.1%. The CV was still 0.1% or higher in the four indicators, including the composition of professional staff, the implementation of target therapy, the average length of hospital stay, and the hospitalization cost. Regarding the first-grade of assessment, there was a statistically significant relationship between the institution type (p=0.029) and region (metropolitan vs. province, p<0.001).
Conclusion
There were disparities in the structural and systemic treatment factors depending on the institutional type. The quality improvement of the regional institutions and multidisciplinary experts for breast cancer is necessary.

Citations

Citations to this article as recorded by

Exploring the experiences of cancer patients: What drives them to seek treatment outside their residential area and what are the experiences resulting from that decision? A qualitative study
Jeehee Pyo, Mina Lee, Haneul Lee, Minsu Ock, Ali Haider Mohammed
PLOS ONE.2025; 20(3): e0319650. CrossRef
Contrasting income-based inequalities in incidence and mortality of breast cancer in Korea, 2006-2015
Jinwook Bahk, Hee-Yeon Kang, Young-Ho Khang, Kyunghee Jung-Choi
Epidemiology and Health.2024; 46: e2024074. CrossRef

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Head and Neck Cancer

Recent Treatment Patterns of Oropharyngeal Cancer in Korea Based on the Expert Questionnaire Survey of the Korean Society for Head and Neck Oncology (KSHNO): Kyu Hye Choi, Jin Ho Song, Yeon-Sil Kim, Ji-hoon Kim, Woo-Jin Jeong, Inn-Chul Nam, Jin Ho Kim, Hee Kyung Ahn, Sang Hoon Chun, Hyun Jun Hong, Young-Hoon Joo, Young-Gyu Eun, Sung Ho Moon, Jeongshim Lee; Cancer Res Treat. 2021;53(4):1004-1014. Published online January 29, 2021; DOI: https://doi.org/10.4143/crt.2020.973

Abstract PDF Supplementary Material PubReader ePub

Purpose
The incidence of human papillomavirus (HPV)-related oropharyngeal cancer (OPC) has increased, and staging and optimal therapeutic approaches are challenging. A questionnaire survey was conducted to investigate the controversial treatment policy of stage T2 OPC according to the N category and determine the opinions of multidisciplinary experts in Korea.
Materials and Methods
Five OPC scenarios were developed by the Subcommittee on Oropharyngeal Treatment Guidelines of the Korean Society for Head and Neck Oncology and distributed to experts of multidisciplinary treatment hospitals.
Results
Sixty-five experts from 45 institutions responded. For the HPV-positive T2N0M0 scenario, 67.7% of respondents selected surgery followed by definitive concurrent chemoradiotherapy (CCRT) or radiotherapy alone. For the T2N1M0 HPV-positive scenario, there was a notable difference in the selection of primary treatment by expert specialty; 53.9% of respondents selected surgery and 39.8% selected definitive CCRT as the primary treatment. For the T2N3M0 advanced HPV-positive scenario, 50.0% of respondents selected CCRT and 33.3% considered induction chemotherapy (IC) as the primary treatment. CCRT and IC were significantly more frequently selected for the HPV-related OPC cases (p=0.010). The interdepartmental variability showed that the head and neck surgeons and medical oncologists favored surgery, whereas the radiation oncologists preferably selected definitive CCRT (p < 0.001).
Conclusion
In this study, surgery was preferred for lymph node-negative OPC, and as lymph node metastasis progressed, CCRT tended to be preferred, and IC was administered. Clinical practice patterns by stage and HPV status showed differences according to expert specialty. Multidisciplinary consensus guidelines will be essential in the future.

Citations

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Controversies in Lung Cancer: Heterogeneity in Treatment Recommendations for Stage III NSCLC According to Disease Burden and Oncogenic Driver Alterations
Jeremy P Harris, Dylann K Fujimoto, Misako Nagasaka, Eric Ku, Garrett Harada, Hari Keshava, Ali Mahtabifard, Javier Longoria, Niral Patel, Steven Seyedin, Aaron Simon, Allen Chen
Clinical Lung Cancer.2022; 23(4): 333. CrossRef
Survey of radiation field and dose in human papillomavirus-positive oropharyngeal cancer: is de-escalation actually applied in clinical practice?
Kyu Hye Choi, Jin Ho Song, Yeon-Sil Kim, Sung Ho Moon, Jeongshim Lee, Young-Taek Oh, Dongryul Oh, Jin Ho Kim, Jun Won Kim
Radiation Oncology Journal.2021; 39(3): 174. CrossRef

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Gastrointestinal cancer

Current Trends in the Quality Assessment of Colorectal Cancer Practice and Treatment in South Korea during 2012-2017: Kyu Hye Choi, Jin Ho Song, Hong Seok Jang, Sung Hwan Kim, Jong Hoon Lee; Cancer Res Treat. 2021;53(2):487-496. Published online October 6, 2020; DOI: https://doi.org/10.4143/crt.2020.623

Abstract PDF PubReader ePub

Purpose
Colorectal cancer (CRC) is increasing in South Korea due to westernized eating habits and regular health check-ups. The Korean Health Insurance Review and Assessment Service (HIRA) has conducted a national quality assessment of the treatment of CRC. This study examined the quality assessment report of the Korean HIRA and analyzed the status of practice pattern and the epidemiology of CRC in South Korea.
Materials and Methods
The number of subjects was determined based on the number of surgical procedures in each institution during 2012-2017. The institution types were classified according to the number of beds and the composition of oncologic specialists. Twenty-one indicators for diagnosis, chemotherapy, radiotherapy, surgery, pathology, and mortality were analyzed and the interinstitutional variation for each indicator was calculated.
Results
Among 21 evaluation indices, indicators related to medical records, receipt of chemotherapy with a high coefficient of variation of ≥ 0.1% were improved over 6 years until the survey in 2017. In the analysis of indices affecting surgical mortality, the regional lymph node resection and examination rate (p=0.022) showed a negative correlation with surgical mortality. Hospitalization stay (p < 0.001) and hospitalization cost (p=0.002) were positively correlated with surgical mortality.
Conclusion
This study showed that the treatment quality and examination status for CRC in South Korea were appropriate for improving relevant medical records, receipt of chemotherapy, maintaining the quality of treatment, and mortality. These analyses could be the basis for developing an improved quality assessment program worldwide.

Citations

Citations to this article as recorded by

Exploring the experiences of cancer patients: What drives them to seek treatment outside their residential area and what are the experiences resulting from that decision? A qualitative study
Jeehee Pyo, Mina Lee, Haneul Lee, Minsu Ock, Ali Haider Mohammed
PLOS ONE.2025; 20(3): e0319650. CrossRef
Relationship between patient outcomes and patterns of fragmented cancer care in older adults with gastric cancer: A nationwide cohort study in South Korea
Dong-Woo Choi, Seungju Kim, Sun Jung Kim, Dong Wook Kim, Kwang Sun Ryu, Jae Ho Kim, Yoon-Jung Chang, Kyu-Tae Han
Journal of Geriatric Oncology.2024; 15(2): 101685. CrossRef
Effects of intensive care unit quality assessment on changes in medical staff in medical institutions and in-hospital mortality
Seungju Kim, Gui Ok Kim, Syalrom Lee, Yong Uk Kwon
Human Resources for Health.2024;[Epub] CrossRef
Quality control efforts of medical institutions: the impacts of a value-based payment system on medical staff and healthcare-associated infections
K-T. Han, S. Kim, G.O. Kim, S. Lee, Y.U. Kwon
Journal of Hospital Infection.2024; 153: 3. CrossRef
Quality Assessment and Trend for Breast Cancer Treatment Practice across South Korea Based on Nationwide Analysis of Korean Health Insurance Data during 2013-2017
Kyu Hye Choi, Soo-Yoon Sung, Sea-Won Lee, Ye Won Jeon, Sung Hwan Kim, Jong Hoon Lee
Cancer Research and Treatment.2023; 55(2): 570. CrossRef
Multidisciplinary treatment strategy for early rectal cancer
Gyung Mo Son, In Young Lee, Sung Hwan Cho, Byung-Soo Park, Hyun Sung Kim, Su Bum Park, Hyung Wook Kim, Sang Bo Oh, Tae Un Kim, Dong Hoon Shin
Precision and Future Medicine.2022; 6(1): 32. CrossRef
Colorectal cancer mortality trends in the era of cancer survivorship in Korea: 2000–2020
Min Hyun Kim, Sanghee Park, Nari Yi, Bobae Kang, In Ja Park
Annals of Coloproctology.2022; 38(5): 343. CrossRef
Pulmonary Metastasectomy in Colorectal Cancer: A Population-Based Retrospective Cohort Study Using the Korean National Health Insurance Database
Woo Sik Yu, Mi Kyung Bae, Jung Kyu Choi, Young Ki Hong, In Kyu Park
Cancer Research and Treatment.2021; 53(4): 1104. 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

Abstract PDF PubReader ePub

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.

Citations

Citations to this article as recorded by

Enhanced NSCLC subtyping and staging through attention-augmented multi-task deep learning: A novel diagnostic tool
Runhuang Yang, Weiming Li, Siqi Yu, Zhiyuan Wu, Haiping Zhang, Xiangtong Liu, Lixin Tao, Xia Li, Jian Huang, Xiuhua Guo
International Journal of Medical Informatics.2025; 193: 105694. CrossRef
The utility of [18F]FDG PET in discriminating between local recurrence and inflammatory changes following SABR in primary lung cancer patients
Maria Fala, Eleni Josephides, Sweni Shah, Hemal Ariyaratne, Anant Patel, Gary J. R. Cook, Sugama Chicklore, Thomas Wagner
European Journal of Nuclear Medicine and Molecular Imaging.2025;[Epub] CrossRef
Invasive Nodal Staging via Endobronchial Ultrasound and Outcome in Patients Treated with Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer – Results from a Single Institution Study
Benjamin George, Atallah Baydoun, Samar Bhat, Lauryn Bailey, Theodore Arsenault, Yilun Sun, Yuxia Zhang, Yiran Zheng, Prashant Vempati, Tarun Podder, Tithi Biswas
Clinical Lung Cancer.2024; 25(4): e181. CrossRef
Prognostic value of consolidation-to-tumor ratio on computed tomography in NSCLC: a meta-analysis
Yongming Wu, Wenpeng Song, Denian Wang, Junke Chang, Yan Wang, Jie Tian, Sicheng Zhou, Yingxian Dong, Jing Zhou, Jue Li, Ziyi Zhao, Guowei Che
World Journal of Surgical Oncology.2023;[Epub] CrossRef
Tumor to liver maximum standardized uptake value ratio of FDG-PET/CT parameters predicts tumor treatment response and survival of stage III non-small cell lung cancer
Pengfei Zhang, Wei Chen, Kewei Zhao, Xiaowen Qiu, Tao Li, Xingzhuang Zhu, Peng Sun, Chunsheng Wang, Yipeng Song
BMC Medical Imaging.2023;[Epub] CrossRef
Evaluation of response to stereotactic body radiation therapy for nonsmall cell lung cancer: PET response criteria in solid tumors versus response evaluation criteria in solid tumors
Jixia Han, Qi Song, Feng Guo, Rui Du, Henghu Fang, Jingbo Kang, Zejun Lu
Nuclear Medicine Communications.2022;[Epub] CrossRef
Assessing tumor angiogenesis using dynamic contrast-enhanced integrated magnetic resonance-positron emission tomography in patients with non-small-cell lung cancer
Yu-Sen Huang, Jenny Ling-Yu Chen, Hsin-Ming Chen, Li-Hao Yeh, Jin-Yuan Shih, Ruoh-Fang Yen, Yeun-Chung Chang
BMC Cancer.2021;[Epub] CrossRef
Potential role of functional imaging in predicting outcome for patients treated with carbon ion therapy: a review
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
The British Journal of Radiology.2021;[Epub] CrossRef
Prognostic value of metabolic signature on 18F-FDG uptake in breast cancer patients after radiotherapy
Jin Meng, Emmanuel Deshayes, Li Zhang, Wei Shi, Xiaomeng Zhang, Xingxing Chen, Xin Mei, Jinli Ma, Yizhou Jiang, Jiong Wu, Zhimin Shao, Xiaoli Yu, Zhaozhi Yang, Xiaomao Guo
Molecular Therapy - Oncolytics.2021; 23: 412. CrossRef
Parámetros cuantitativos de la PET/TC con 18F-FDG como factores pronósticos en el cáncer de pulmón localizado e inoperable
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.2020; 39(6): 353. CrossRef
18F-FDG PET/CT quantitative parameters as prognostic factors in localized and inoperable lung cancer
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

7,800 View
134 Download
10 Web of Science
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