Cancer Research and Treatment

Original Articles

Significant Dissatisfaction with the Anachronistic System: A Survey on The Experience of Application for Off-Label Use of Anti-Cancer Drugs by Korean Society of Medical Oncology: Jae Lyun Lee, Dong-Hoe Koo, Young-Woong Won, Young Saing Kim, Hee Kyung Ahn, Seungtaek Lim; Received August 7, 2024 Accepted February 10, 2025 Published online February 11, 2025; DOI: https://doi.org/10.4143/crt.2024.749 [Accepted]

Abstract PDF: Purpose
This study evaluates the experiences and satisfaction levels of Korean medical oncologists with the prior authorization system for the off-label use of anti-cancer drugs. Conducted by the Korean Society of Medical Oncology (KSMO), the survey aimed to identify challenges and areas for improvement in the current regulatory framework.
Materials and Methods
A cross-sectional web-based survey was carried out between May 4 and May 14, 2023, targeting 261 active KSMO medical oncologists. Invitations were sent via email, and the survey, comprising 19 questions, was hosted on Microsoft Forms. The questions covered personal characteristics, work environment, experiences with the pre-application process, and post-approval experiences.
Results
For the 261 invitations sent, 110 responses (42.1%) were received. Most respondents had over 10 years of experience and worked in tertiary hospitals. Although 93.6% were familiar with the pre-application system, 67.3% expressed moderate to high dissatisfaction. The key issues included complex applications, long approval period, stringent criteria, and inconsistent reviews. Additionally, 74.4% respondents spent over 3 hours on first-time applications, with 68.3% experiencing rejections. Emotional responses to rejections were largely negative, with many feeling disregarded. Post-approval, patients of 96.8% respondents faced financial burdens leading to treatment discontinuation. Most oncologists (86.0%) supported selective reimbursement if the disease was controlled for a certain period.
Conclusion
The survey highlights significant dissatisfaction with the current system, suggesting the need for streamlining the application process, easing approval criteria, and reconsidering the financial aspects of post-approval treatments to support patient care and oncologists’ decision-making autonomy.

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Psychometric Validation of Sheffield Profile for Assessment and Referral to Care (SPARC) in Korean Cancer Patients: Hong Jun Kim, Eun Hee Jung, Jung Hye Kwon, Yu Jung Kim, Su-Jin Koh, Myung Ah Lee, Jung Hun Kang, Sun Young Rha, Eun Mi Nam, Sun Kyung Baek, Ha Yeon Lee, Hun Ho Song, Young-Woong Won, Hanbyul Lee; Received July 26, 2024 Accepted December 4, 2024 Published online December 5, 2024; DOI: https://doi.org/10.4143/crt.2024.706 [Accepted]

Abstract PDF: Purpose
Identifying the palliative care needs of patients with advanced cancer is important for maintaining quality of life and timely transition to palliative care. We aimed to validate the Korean Sheffield Profile for Assessment and Referral for Care (K-SPARC) in such patients and establish its psychometric properties, including reliability, validity, and responsiveness to change.
Materials and Methods
We used the forward-back translated version of SPARC, which was verified through a pilot study, to assess the palliative care needs of patients with advanced cancer. Reliability was evaluated by internal consistency using Cronbach's alpha coefficients and test-retest reliability. Criterion validity was analyzed against other questionnaires, including the Korean versions of the Functional Assessment of Cancer Therapy-General (FACT-G Korean) and Korean versions of the Edmonton Symptom Assessment System (K-ESAS). Factor analysis was used to assess construct validity.
Results
Two hundred fifty-nine patients were included from 2019 to 2022. Forty-nine percent of all patients were women, and the median age was 63 years. Cronbach’s alpha coefficient (range, 0.642–0.903) and test-retest reliability (range, 0.574–0.749) indicated acceptable reliability. The correlation coefficients between K-SPARC and FACT-G Korean suggested significant criterion validity. The correlation coefficients for the physical, social, emotional, and functional domains were 0.701, 0.249, 0.718, and 0.511, respectively (p-value <0.001, all). Factor analysis demonstrated satisfactory construct validity of the tool.
Conclusion
This study demonstrated the utility of K-SPARC as an evaluation tool for providing palliative care to patients with advanced cancer through psychometric validation; the tool had good internal consistency, reliability, and acceptable validity.

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General

A Multicenter, Prospective, Observational Study to Evaluate Ethanol-Induced Symptoms in Patients Receiving Docetaxel Chemotherapy: Young-Woong Won, Jin-Hyoung Kang, Jung Hye Kwon, Dong-Hoe Koo, Jung Hun Kang, Chi Hoon Maeng, Hee Kyung Ahn, Sung Yong Oh, Dae-Won Lee, Joohyuk Sohn, So Yeon Oh, Kyung Hee Lee, Su-Jin Koh, Keun Seok Lee, Chan-Kyu Kim, Ji-Yeon Kim, Jun Ho Ji, Sung-Bae Kim, Joo Young Ha, Ho Young Kim; Cancer Res Treat. 2023;55(4):1096-1103. Published online April 7, 2023; DOI: https://doi.org/10.4143/crt.2022.1565

Abstract PDF Supplementary Material PubReader ePub

Purpose
Several previous studies and case reports have reported ethanol-induced symptoms in patients receiving anticancer drugs containing ethanol. Most docetaxel formulations contain ethanol as a solvent. However, there are insufficient data on ethanol-induced symptoms when docetaxel-containing ethanol is administered. The primary purpose of this study was to investigate the frequency and pattern of ethanol-induced symptoms during and after docetaxel administration. The secondary purpose was to explore the risk factors for ethanol-induced symptoms.
Materials and Methods
This was a prospective, multicenter, observational study. The participants filled out ethanol-induced symptom questionnaire on the day of chemotherapy and the following day.
Results
Data from 451 patients were analyzed. The overall occurrence rate of ethanol-induced symptoms was 44.3% (200/451 patients). The occurrence rate of facial flushing was highest at 19.7% (89/451 patients), followed by nausea in 18.2% (82/451 patients), and dizziness in 17.5% (79/451 patients). Although infrequent, unsteady walking and impaired balance occurred in 4.2% and 3.3% of patients, respectively. Female sex, presence of underlying disease, younger age, docetaxel dose, and docetaxel-containing ethanol amount were significantly associated with the occurrence of ethanol-induced symptoms.
Conclusion
The occurrence of ethanol-induced symptoms was not low in patients receiving docetaxel-containing ethanol. Physicians need to pay more attention to the occurrence of ethanol-induced symptoms and prescribe ethanol-free or low-ethanol-containing formulations to high-risk patients.

Citations

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Evaluation of self-assembling properties of paclitaxel-biotin conjugates
Dmitry V. Beigulenko, Anna Yu. Belyaeva, Ekaterina S. Kazakova, Maria M. Antonova, Aleksander S. Peregudov, Aleksey A. Nikitin, Tatyana S. Kovshova, Yulia V. Ermolenko, Konstantin A. Kochetkov
Nano-Structures & Nano-Objects.2024; 40: 101375. CrossRef

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Hematologic malignancy

Current Treatment Patterns and the Role of Upfront Autologous Stem Cell Transplantation in Patients with Peripheral T-Cell Lymphoma: A Korean Nationwide, Multicenter Prospective Registry Study (CISL 1404): Hyungwoo Cho, Dok Hyun Yoon, Dong-Yeop Shin, Youngil Koh, Sung-Soo Yoon, Seok Jin Kim, Young Rok Do, Gyeong-Won Lee, Jae-Yong Kwak, Yong Park, Min Kyoung Kim, Hye Jin Kang, Jun Ho Yi, Kwai Han Yoo, Won Sik Lee, Byeong Bae Park, Jae Cheol Jo, Hyeon-Seok Eom, Hyo Jung Kim, Seong Hyun Jeong, Young-Woong Won, Byeong Seok Sohn, Ji-Hyun Kwon, Cheolwon Suh, Won Seog Kim; Cancer Res Treat. 2023;55(2):684-692. Published online January 2, 2023; DOI: https://doi.org/10.4143/crt.2022.1434

Abstract PDF Supplementary Material PubReader ePub

Purpose
We conducted a nationwide, multicenter, prospective registry study for newly diagnosed patients with peripheral T-cell lymphoma (PTCL) to better define the clinical characteristics, treatment patterns, survival outcomes, and the role of upfront autologous stem cell transplantation (ASCT) in these patients.
Materials and Methods
Patients with PTCL receiving chemotherapy with curative intent were registered and prospectively monitored. All patients were pathologically diagnosed with PTCL.
Results
A total of 191 patients with PTCL were enrolled in this prospective registry study. PTCL, not otherwise specified (PTCL-NOS) was the most common pathologic subtype (n=80, 41.9%), followed by angioimmunoblastic T-cell lymphoma (AITL) (n=60, 31.4%). With a median follow-up duration of 3.9 years, the 3-year progression-free survival (PFS) and overall survival (OS) rates were 39.5% and 60.4%, respectively. The role of upfront ASCT was evaluated in patients who were considered transplant-eligible (n=59). ASCT was performed as an upfront consolidative treatment in 32 (54.2%) of these patients. There were no significant differences in PFS and OS between the ASCT and non-ASCT groups for all patients (n=59) and for patients with PTCL-NOS (n=26). However, in patients with AITL, the ASCT group was associated with significantly better PFS than the non-ASCT group, although there was no significant difference in OS.
Conclusion
The current study demonstrated that the survival outcomes with the current treatment options remain poor for patients with PTCL-NOS. Upfront ASCT may provide a survival benefit for patients with AITL, but not PTCL-NOS.

Citations

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Successful Treatment, with Chemotherapy and Intravenous Administration of Ascorbic Acid, of a Patient with Peripheral T-Cell Lymphoma, Not Otherwise Specified
Chiaki Tokoro, Atsushi Tashiro, Kenji Ina, Yoshiteru Tanaka, Hiroyuki Kobayakawa, Takashi Yoshida, Satoshi Kayukawa
Journal of Cancer Research Updates.2024; 13: 1. CrossRef
Role of upfront autologous transplant for peripheral T-cell lymphoma patients achieving a complete remission with first-line therapy: a systematic review and meta-analysis
L. Girard, Y. J. Koh, L. P. Koh, Y. L. Chee, H. L. Chan, J. Lee, S. de Mel, L. M. Poon, M. Samuel
Bone Marrow Transplantation.2024; 59(6): 838. CrossRef
Angioimmunoblastic T-cell lymphoma and correlated neoplasms with T-cell follicular helper phenotype: from molecular mechanisms to therapeutic advances
Luís Alberto de Pádua Covas Lage, Hebert Fabricio Culler, Cadiele Oliana Reichert, Sheila Aparecida Coelho da Siqueira, Juliana Pereira
Frontiers in Oncology.2023;[Epub] CrossRef
Advances in the pathogenesis and therapeutic strategies of angioimmunoblastic T-cell lymphoma
Qingyang Zhang, Le Yin, Qinqiao Lai, Yan Zhao, Hongling Peng
Clinical and Experimental Medicine.2023; 23(8): 4219. CrossRef

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Special Articles

Palliative Sedation in End-of-Life Patients in Eastern Asia: A Narrative Review: Seung Hun Lee, Jung Hye Kwon, Young-Woong Won, Jung Hun Kang; Cancer Res Treat. 2022;54(3):644-650. Published online April 19, 2022; DOI: https://doi.org/10.4143/crt.2022.187

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Although palliative sedation (PS) is a common practice in the palliative care of cancer patients in Western countries, there is little related research on the practice in Korea. PS can be classified into several categories according to sedation level and continuity. PS is clearly distinct from euthanasia. While euthanasia is illegal and regarded as unethical in Korea, there is little ethical and legal controversy about PS in terms of the doctrine of double effect. Most studies have asserted that PS does not shorten the survival of terminal cancer patients. Since preference for PS heavily depends on stakeholder value, it should be preceded by shared decision-making through full communication among the patient, family members, and medical team. This is a narrative review article analyzing previous studies, especially from the three Eastern Asian countries, Korea, Japan and Taiwan, which share similar cultures compared with Western countries. Practical issues concerning PS—for example, prevalence, type and dosage of medications, salvage medication, timing of its initiation, and assessment—are described in detail.

Citations

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Continuous Sedation in Palliative Care in Portugal: A Prospective Multicentric Study
José António Ferraz-Gonçalves, Alice Flores, Ana Abreu Silva, Ana Simões, Carmen Pais, Clarisse Melo, Diana Pirra, Dora Coelho, Lília Conde, Lorena Real, Madalena Feio, Manuel Barbosa, Maria de Lurdes Martins, Marlene Areias, Rafael Muñoz-Romero, Rita Cun
Journal of Palliative Care.2025; 40(1): 72. CrossRef
Ethical and moral principles for oncology healthcare workers: A brief report from a Bioethics consortium emphasizing on need for education
Manjeshwar S. Baliga, Vijaya Marakala, Lal P. Madathil, Thomas George, Russell F. D’souza, Princy L. Palatty
Journal of Education and Health Promotion.2024;[Epub] CrossRef
Survival Outcomes in Palliative Sedation Based on Referring Versus On-Call Physician Prescription
Cristina Lojo-Cruz, Juan Mora-Delgado, Víctor Rivas Jiménez, Fernando Carmona Espinazo, Juan-Bosco López-Sáez
Journal of Clinical Medicine.2023; 12(16): 5187. CrossRef
Current Status and Future Directions of Research on Palliative Sedation
In Cheol Hwang
The Korean Journal of Hospice and Palliative Care.2022; 25(4): 193. CrossRef
Legislation concerning Physician-assisted Suicide in Korea
Younsuck KOH
Korean Journal of Medical Ethics.2022; 25(4): 313. CrossRef

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The Situation of Life-Sustaining Treatment One Year after Enforcement of the Act on Decisions on Life-Sustaining Treatment for Patients at the End-of-Life in Korea: Data of National Agency for Management of Life-Sustaining Treatment: Ha Yeon Lee, Hwa Jung Kim, Jung Hye Kwon, Sun Kyung Baek, Young-Woong Won, Yu Jung Kim, Su Jin Baik, Hyewon Ryu; Cancer Res Treat. 2021;53(4):897-907. Published online June 2, 2021; DOI: https://doi.org/10.4143/crt.2021.327

Abstract PDF Supplementary Material PubReader ePub

Purpose
The “Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End-of-Life” was enacted on February 3, 2016 and went into effect on February 4, 2018 in Korea. This study reviewed the first year of determination to life-sustaining treatment (LST) through data analysis of the National Agency for Management of Life-Sustaining Treatment.
Materials and Methods
The National Agency for Management of LST provided data between February 4, 2018 and January 31, 2019 anonymously from 33,549 patients. According to the forms patients were defined as either elf-determinants or family-determinants.
Results
The median age of the patient was 73 and the majority was male (59.9%). Cancer patients were 59% and self-determinants were 32.1%. Cancer patients had a higher rate of self-determinants than non-cancer (47.3% vs. 10.1%). Plan for hospice service was high in cancer patients among self-determinants (81.0% vs. 37.5%, p < 0.001). In comparison to family-determinants, self-determinants were younger (median age, 67 years vs. 75 years; p < 0.001) and had more cancer diagnosis (87.1% vs. 45.9%, p < 0.001). Decision of withholding or withdrawing of LSTs in cancer patients was higher than non-cancer patients in four items.
Conclusion
Cancer patients had a higher rate in self-determination and withholding or withdrawing of LSTs than non-cancer patients. Continued revision of the law and education of the public will be able to promote withdrawing or withholding the futile LSTs in patients at end-of-life. Further study following the revision of the law should be evaluated to change of end-of-life care.

Citations

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Factors Affecting Life-Sustaining Treatment Decisions and Changes in Clinical Practice after Enforcement of the Life-Sustaining Treatment (LST) Decision Act: A Tertiary Hospital Experience in Korea
Yoon Jung Jang, Yun Jung Yang, Hoi Jung Koo, Hye Won Yoon, Seongbeom Uhm, Sun Young Kim, Jeong Eun Kim, Jin Won Huh, Tae Won Kim, Seyoung Seo
Cancer Research and Treatment.2025; 57(1): 280. CrossRef
Issues and implications of the life-sustaining treatment decision act: comparing the data from the survey and clinical data of inpatients at the end-of-life process
Eunjeong Song, Dongsoon Shin, Jooseon Lee, Seonyoung Yun, Minjeong Eom, Suhee Oh, Heejung Lee, Jiwan Lee, Rhayun Song
BMC Medical Ethics.2024;[Epub] CrossRef
Recent Trends in the Withdrawal of Life-Sustaining Treatment in Patients with Acute Cerebrovascular Disease : 2017–2021
Seung Hwan Kim, Ji Hwan Jang, Young Zoon Kim, Kyu Hong Kim, Taek Min Nam
Journal of Korean Neurosurgical Society.2024; 67(1): 73. CrossRef
Healthcare Utilization and Supportive Care Timing in South Korean People Living With Amyotrophic Lateral Sclerosis: A Single-Center Retrospective Study
Min Seol Jang, Shin Hye Yoo, Min Sun Kim, Belong Cho, Kyae Hyung Kim, Jeongmi Shin, Inyoung Hwang, Seok-Jin Choi, Jung-Joon Sung, Sun Young Lee
Journal of Clinical Neurology.2024; 20(2): 166. CrossRef
Differences in end-of-life care patterns between types of hospice used for cancer patients: a retrospective cohort study
Il Yun, Eun-Cheol Park, Chung Mo Nam, Jaeyong Shin, Suk-Yong Jang, Sung-In Jang
BMC Palliative Care.2024;[Epub] CrossRef
Validation of the Korean Version of the Clinical Frailty Scale-Adjusted Korean Triage and Acuity Scale for Older Patients in the Emergency Department
Ho Sub Chung, Yunhyung Choi, Ji Yeon Lim, Keon Kim, Sung Jin Bae, Yoon Hee Choi, Dong Hoon Lee
Medicina.2024; 60(6): 955. CrossRef
Beyond Legal Boundaries: Public and Clinician Perspectives on Treatment Withdrawal in Infants With Poor Neurological Prognosis
In Gyu Song, Jung Lee, Min Sun Kim, Ji Weon Lee, So Yeon Jeon, Shin Hye Yoo, Hye Yoon Park
Journal of Korean Medical Science.2024;[Epub] CrossRef
Preferred versus Actual Place of Care and Factors Associated with Home Discharge among Korean Patients with Advanced Cancer: A Retrospective Cohort Study
In Young Hwang, Yohan Han, Min Sun Kim, Kyae Hyung Kim, Belong Cho, Wonho Choi, Yejin Kim, Shin Hye Yoo, Sun Young Lee
Healthcare.2023; 11(13): 1939. CrossRef
Comparison of the end-of-life decisions of patients with hospital-acquired pneumonia after the enforcement of the life-sustaining treatment decision act in Korea
Ae-Rin Baek, Sang-Bum Hong, Soohyun Bae, Hye Kyeong Park, Changhwan Kim, Hyun-Kyung Lee, Woo Hyun Cho, Jin Hyoung Kim, Youjin Chang, Heung Bum Lee, Hyun-Il Gil, Beomsu Shin, Kwang Ha Yoo, Jae Young Moon, Jee Youn Oh, Kyung Hoon Min, Kyeongman Jeon, Moon S
BMC Medical Ethics.2023;[Epub] CrossRef
Problems Related to the Act on Decisions on Life-Sustaining Treatment and Directions for Improvement
Dae Seog Heo, Shin Hye Yoo, Bhumsuk Keam, Sang Ho Yoo, Younsuck Koh
The Korean Journal of Hospice and Palliative Care.2022; 25(1): 1. CrossRef
Hospice-Palliative Medicine as a Model of Value-Based Healthcare
Dae Seog Heo, Shin Hye Yoo, Bhumsuk Keam, Keunjoo Yoo, Insun Choi, Min-Jeong Kim
Journal of Korean Medical Science.2022;[Epub] CrossRef
Will implementation of the Life-sustaining Treatment Decisions Act reduce the incidence of cardiopulmonary resuscitation?
In-Ae Song
Acute and Critical Care.2022; 37(2): 256. CrossRef
Aggressiveness of care in the last days of life in the emergency department of a tertiary hospital in Korea
Jung Sun Kim, Sun Young Lee, Min Sung Lee, Shin Hye Yoo, Jeongmi Shin, Wonho Choi, Yejin Kim, Hyung Sook Han, Jinui Hong, Bhumsuk Keam, Dae Seog Heo
BMC Palliative Care.2022;[Epub] CrossRef
Hospice Care Preferences and Its Associated Factors among Community-Dwelling Residents in China
Huijing Lin, Eunjeong Ko, Bei Wu, Ping Ni
International Journal of Environmental Research and Public Health.2022; 19(15): 9197. CrossRef
Impact of COVID-19 on the End-of-Life Care of Cancer Patients Who Died in a Korean Tertiary Hospital: A Retrospective Study
Jeongmi Shin, Yejin Kim, Shin Hye Yoo, Jin-Ah Sim, Bhumsuk Keam
The Korean Journal of Hospice and Palliative Care.2022; 25(4): 150. CrossRef
The Law Changes Behaviors: Is It Just Enough?
Dae Ho Lee
Cancer Research and Treatment.2021; 53(4): 895. CrossRef

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Preparation and Practice of the Necessary Documents in Hospital for the “Act on Decision of Life-Sustaining Treatment for Patients at the End-of-Life”: Sun Kyung Baek, Hwa Jung Kim, Jung Hye Kwon, Ha Yeon Lee, Young-Woong Won, Yu Jung Kim, Sujin Baik, Hyewon Ryu; Cancer Res Treat. 2021;53(4):926-934. Published online June 2, 2021; DOI: https://doi.org/10.4143/crt.2021.326

Abstract PDF Supplementary Material PubReader ePub

Purpose
Six forms relating to decisions on life-sustaining treatment (LST) for patients at the end-of-life (EOL) in hospital are required by the “Act on Decision of LST for Patients at the EOL.” We investigated the preparation and creation status of these documents from the database of the National Agency for Management of LST.
Materials and Methods
We analyzed the contents and details of each document necessary for decisions on LST, and the creation status of forms. We defined patients completing form 1 as “self-determined” of LST, and those whose family members had completed form 11/12 as “family decision” of LST. According to the determination subject, we compared the four items of LST on form 13 (the paper of implementation of LST) and the documentation time interval between forms.
Results
The six forms require information about the patient, doctor, specialized doctor, family members, institution, decision for LST, and intention to use hospice services. Of 44,381 who had completed at least one document, 36,693 patients had form 13. Among them, 11,531, 10,976, and 12,551 people completed forms 1, 11, and 12, respectively. The documentation time interval from forms 1, 11, or 12 to form 13 was 8.6±13.6 days, 1.0±9.5 days, and 1.5±9.7 days, respectively.
Conclusion
The self-determination rate of LST was 31% and the mean time interval from self-determination to implementation of LST was 8.6 days. The creation of these forms still takes place when the patients are close to death.

Citations

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Advance Care Planning in South Korea
Yu Jung Kim, Sun-Hyun Kim
Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen.2023; 180: 68. CrossRef
Use of antimicrobial agents in actively dying inpatients after suspension of life-sustaining treatments: Suggestion for antimicrobial stewardship
Dayeong Kim, Subin Kim, Kyoung Hwa Lee, Sang Hoon Han
Journal of Microbiology, Immunology and Infection.2022; 55(4): 651. CrossRef
The Law Changes Behaviors: Is It Just Enough?
Dae Ho Lee
Cancer Research and Treatment.2021; 53(4): 895. CrossRef

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Life-Sustaining Treatment States in Korean Cancer Patients after Enforcement of Act on Decisions on Life-Sustaining Treatment for Patients at the End of Life: Young-Woong Won, Hwa Jung Kim, Jung Hye Kwon, Ha Yeon Lee, Sun Kyung Baek, Yu Jung Kim, Do Yeun Kim, Hyewon Ryu; Cancer Res Treat. 2021;53(4):908-916. Published online June 2, 2021; DOI: https://doi.org/10.4143/crt.2021.325

Abstract PDF PubReader ePub

Purpose
In Korea, the “Act on Hospice and Palliative Care and Decisions on Life-sustaining Treatment for Patients at the End of Life” was enacted on February 4, 2018. This study was conducted to analyze the current state of life-sustaining treatment decisions based on National Health Insurance Service (NHIS) data after the law came into force.
Materials and Methods
The data of 173,028 cancer deaths were extracted from NHIS qualification data between November 2015 and January 2019.
Results
The number of cancer deaths complied with the law process was 14,438 of 54,635 cases (26.4%). The rate of patient self-determination was 49.0%. The patients complying with the law process have used a hospice center more frequently (28% vs. 14%). However, the rate of intensive care unit (ICU) admission was similar between the patients who complied with and without the law process (ICU admission, 23% vs. 21%). There was no difference in the proportion of patients who had undergone mechanical ventilation and hemodialysis in the comparative analysis before and after the enforcement of the law and the analysis according to the compliance with the law. The patients who complied with the law process received cardiopulmonary resuscitation at a lower rate.
Conclusion
The law has positive effects on the rate of life-sustaining treatment decision by patient’s determination. However, there was no sufficient effect on the withholding or withdrawing of life-sustaining treatment, which could protect the patient from unnecessary or harmful interventions.

Citations

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Factors Affecting Life-Sustaining Treatment Decisions and Changes in Clinical Practice after Enforcement of the Life-Sustaining Treatment (LST) Decision Act: A Tertiary Hospital Experience in Korea
Yoon Jung Jang, Yun Jung Yang, Hoi Jung Koo, Hye Won Yoon, Seongbeom Uhm, Sun Young Kim, Jeong Eun Kim, Jin Won Huh, Tae Won Kim, Seyoung Seo
Cancer Research and Treatment.2025; 57(1): 280. CrossRef
Characteristics and outcomes of patients with do-not-resuscitate and physician orders for life-sustaining treatment in a medical intensive care unit: a retrospective cohort study
Song-I Lee, Ye-Rin Ju, Da Hyun Kang, Jeong Eun Lee
BMC Palliative Care.2024;[Epub] CrossRef
Characteristics of Life-Sustaining Treatment Decisions: National Data Analysis in South Korea
Jiyeon Choi, Heejung Jeon, Ilhak Lee
Asian Bioethics Review.2024; 16(1): 33. CrossRef
Recent Trends in the Withdrawal of Life-Sustaining Treatment in Patients with Acute Cerebrovascular Disease : 2017–2021
Seung Hwan Kim, Ji Hwan Jang, Young Zoon Kim, Kyu Hong Kim, Taek Min Nam
Journal of Korean Neurosurgical Society.2024; 67(1): 73. CrossRef
The Impact of Withdrawing or Withholding of Life-Sustaining Treatment: A Nationwide Case-Control Study Based on Medical Cost Analysis
Claire Junga Kim, Do-Kyong Kim, Sookyeong Mun, Minkook Son
Journal of Korean Medical Science.2024;[Epub] CrossRef
For the Universal Right to Access Quality End-of-Life Care in Korea: Broadening Our Perspective After the 2018 Life-Sustaining Treatment Decisions Act
Hye Yoon Park, Min Sun Kim, Shin Hye Yoo, Jung Lee, In Gyu Song, So Yeon Jeon, Eun Kyung Choi
Journal of Korean Medical Science.2024;[Epub] CrossRef
Differences in end-of-life care patterns between types of hospice used for cancer patients: a retrospective cohort study
Il Yun, Eun-Cheol Park, Chung Mo Nam, Jaeyong Shin, Suk-Yong Jang, Sung-In Jang
BMC Palliative Care.2024;[Epub] CrossRef
Epidemiology of patients who died in the emergency departments and need of end-of-life care in Korea from 2016 to 2019
Sun Young Lee, Young Sun Ro, Sang Do Shin, Eunsil Ko, Seong Jung Kim
Scientific Reports.2023;[Epub] CrossRef
Use of high‐flow nasal cannula oxygen therapy for patients with terminal cancer at the end of life
Jung Sun Kim, Jeongmi Shin, Nam Hee Kim, Sun Young Lee, Shin Hye Yoo, Bhumsuk Keam, Dae Seog Heo
Cancer Medicine.2023; 12(13): 14612. CrossRef
Preferred versus Actual Place of Care and Factors Associated with Home Discharge among Korean Patients with Advanced Cancer: A Retrospective Cohort Study
In Young Hwang, Yohan Han, Min Sun Kim, Kyae Hyung Kim, Belong Cho, Wonho Choi, Yejin Kim, Shin Hye Yoo, Sun Young Lee
Healthcare.2023; 11(13): 1939. CrossRef
Healthcare resource utilization and medical costs in patients with terminal cancer during best supportive care
Dong-Won Kang, Yoon-Bo Shim, Eui-Kyung Lee, Mi-Hai Park, Wen-Chi Chou
PLOS ONE.2022; 17(6): e0269565. CrossRef
Aggressiveness of care in the last days of life in the emergency department of a tertiary hospital in Korea
Jung Sun Kim, Sun Young Lee, Min Sung Lee, Shin Hye Yoo, Jeongmi Shin, Wonho Choi, Yejin Kim, Hyung Sook Han, Jinui Hong, Bhumsuk Keam, Dae Seog Heo
BMC Palliative Care.2022;[Epub] CrossRef
Effect of life-sustaining treatment decision law on pediatric in-hospital cardiopulmonary resuscitation rate: A Korean population-based study
Jaeyoung Choi, Ah Young Choi, Esther Park, Meong Hi Son, Joongbum Cho
Resuscitation.2022; 180: 38. CrossRef
Association of perceived life satisfaction with attitudes toward life-sustaining treatment among the elderly in South Korea: a cross-sectional study
Il Yun, Hyunkyu Kim, Eun-Cheol Park, Suk-Yong Jang
BMC Palliative Care.2022;[Epub] CrossRef
Willingness of patients with cancer pain to participate in end-of-life decisions: a multi-center cross-sectional study from three coastal provinces in southern China
Xi Ke, Hongyu Zhu, Yu Zhang, Ling Yang, Simei Shi, Fang Zhu, Huiyu Luo
BMC Palliative Care.2022;[Epub] CrossRef
The Law Changes Behaviors: Is It Just Enough?
Dae Ho Lee
Cancer Research and Treatment.2021; 53(4): 895. CrossRef

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157 Download
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Current Status and Cardinal Features of Patient Autonomy after Enactment of the Life-Sustaining Treatment Decisions Act in Korea: Hwa Jung Kim, Yu Jung Kim, Jung Hye Kwon, Young-Woong Won, Ha Yeon Lee, Sun Kyung Baek, Hyewon Ryu, Do Yeun Kim; Cancer Res Treat. 2021;53(4):917-925. Published online June 2, 2021; DOI: https://doi.org/10.4143/crt.2021.324

Abstract PDF PubReader ePub

Purpose
The main purpose of the Life-Sustaining Treatment Decisions Act recently enacted in Korea is to respect the patient’s self-determination. We aimed to investigate the current status and features of patient self-determination after implementation of the law.
Materials and Methods
Between February 2018 and January 2019, 54,635 cancer deaths were identified from the National Health Insurance Service (NHIS) database. We analyzed the characteristics of decedents who complied with the law process by self-determination compared with decedents with family determination and with decedents who did not comply with the law process.
Results
In multivariable analysis, patients with self-determination were younger, were less likely to live in rural areas, were less likely to belong to the highest income quintile, were less likely to be treated in general hospitals, and were more likely to show a longer time from cancer diagnosis compared with patients with family determination. Compared with patients who did not comply with the law process, patients with self-determination were younger, lived in Seoul or capital area, were less likely to belong to the highest income quintile, were treated in general hospitals, were less likely to have genitourinary or hematologic malignancies, scored higher on the Charlson comorbidity index, and showed a longer time from cancer diagnosis. Patients with self-determination were more likely to use hospice and less likely to use intensive care units (ICUs) at the end-of-life (EOL).
Conclusion
Decedents with self-determination were more likely to be younger, reside in the Seoul or capital area, show a longer time from cancer diagnosis, and were less likely to belong to the highest income quintile. They utilized hospice more frequently, and received less ICU care at the EOL.

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Original Articles

Clinical Characteristics of Clear Cell Ovarian Cancer: A Retrospective Multicenter Experience of 308 Patients in South Korea: Hee Yeon Lee, Ji Hyung Hong, Jae Ho Byun, Hee-Jun Kim, Sun Kyung Baek, Jin Young Kim, Ki Hyang Kim, Jina Yun, Jung A Kim, Kwonoh Park, Hyo Jin Lee, Jung Lim Lee, Young-Woong Won, Il Hwan Kim, Woo Kyun Bae, Kyong Hwa Park, Der-Sheng Sun, Suee Lee, Min-Young Lee, Guk Jin Lee, Sook Hee Hong, Yun Hwa Jung, Ho Jung An; Cancer Res Treat. 2020;52(1):277-283. Published online July 12, 2019; DOI: https://doi.org/10.4143/crt.2019.292

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to evaluate clinical characteristics and treatment pattern of ovarian clear cell carcinoma (OCCC) in Korea and the role of adjuvant chemotherapy in early stage.
Materials and Methods
Medical records of 308 cases of from 21 institutions were reviewed and data including age, performance status, endometriosis, thromboembolism, stage, cancer antigen 125, treatment, recurrence, and death were collected.
Results
Regarding stage of OCCC, it was stage I in 194 (63.6%), stage II in 34 (11.1%), stage III in 66 (21.6%), and stage IV in 11 (3.6%) patients. All patients underwent surgery. Optimal surgery (residual disease ≤ 1 cm) was achieved in 89.3%. Majority of patients (80.5%) received postoperative chemotherapy. The most common regimen was taxane-platinum combination (96%). Median relapse-free survival (RFS) was 138.5 months for stage I, 33.4 for stage II, 19.3 for stage III, and 9.7 for stage IV. Median overall survival (OS) were not reached, 112.4, 48.7, and 18.3 months for stage I, II, III, and IV, respectively. Early-stage (stage I), endometriosis, and optimal debulking were identified as favorable prognostic factors for RFS. Early-stage and optimal debulking were also favorable prognostic factors for OS. Majority of patients with early-stage received adjuvant chemotherapy. However, additional survival benefit was not found in terms of recurrence.
Conclusion
Majority of patients had early-stage and received postoperative chemotherapy regardless of stage. Early-stage and optimal debulking were identified as favorable prognostic factors. In stage IA or IB, adding adjuvant chemotherapy did not show difference in survival. Further study focusing on OCCC is required.

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Roberta Rosso, Margherita Turinetto, Fulvio Borella, Nicolas Chopin, Pierre Meeus, Alexandra Lainè, Isabelle Ray-Coquard, Olivia Le Saux, Domenico Ferraioli
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Zesi Liu, Chunli Jing, Fandou Kong
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SOX17 expression in ovarian clear cell carcinoma
Daichi Kodama, Motoki Takenaka, Chiemi Saigo, Masako Azuma, Yuki Hanamatsu, Masanori Isobe, Tamotsu Takeuchi
Journal of Ovarian Research.2024;[Epub] CrossRef
Construction of a Prediction Model of Cancer-Specific Survival after Ovarian Clear Cell Carcinoma Surgery
Mengqi Huang, Li Ling, Yanbo Liu, Yujuan Li
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Patients with stage IA ovarian clear cell carcinoma do not require chemotherapy following surgery
Li Shuqing, Zhu Zhiling
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Clear cell carcinoma of the ovary and venous thromboembolism: a systematic review and meta-analysis
Hamidreza Didar, Farah Farzaneh, Hanieh Najafiarab, Kosar Namakin, Kimiya Gohari, Ali Sheidaei, Sepehr Ramezani
Current Medical Research and Opinion.2023; 39(6): 901. CrossRef
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Satoe Fujiwara
Japanese Journal of Clinical Oncology.2023; 53(8): 664. CrossRef
Application of precision medicine based on next-generation sequencing and immunohistochemistry in ovarian cancer: a real-world experience
Yoo-Na Kim, Yun Soo Chung, Ji Hyun Lee, Eunhyang Park, Seung-Tae Lee, Sunghoon Kim, Jung-Yun Lee
Journal of Gynecologic Oncology.2023;[Epub] CrossRef
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Aglaja De Pauw, Eline Naert, Koen Van de Vijver, Tummers Philippe, Katrien Vandecasteele, Hannelore Denys
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Friend or foe? The prognostic role of endometriosis in women with clear cell ovarian carcinoma. A UK population-based cohort study
Anastasios Tranoulis, Felicia Helena Buruiana, Bindiya Gupta, Audrey Kwong, Aarti Lakhiani, Jason Yap, Janos Balega, Kavita Singh
Archives of Gynecology and Obstetrics.2022; 305(5): 1279. CrossRef
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Peng Chen, Chi-Yuan Zhang
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Yasushi Iida, Aikou Okamoto, Robert L Hollis, Charlie Gourley, C Simon Herrington
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Chenchen Zhu, Jing Zhu, Lili Qian, Hanyuan Liu, Zhen Shen, Dabao Wu, Weidong Zhao, Weihua Xiao, Ying Zhou
BMC Cancer.2021;[Epub] CrossRef
The oncological outcome of the patients with ovarian clear cell cancer: Platinum-based adjuvant chemotherapy is not suitable
Caner ÇAKIR, Fatih KILIÇ, Çiğdem KILIÇ, Dilek YÜKSEL, Vakkas KORKMAZ, Günsu KİMYON CÖMERT, Osman TÜRKMEN, Taner TURAN
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Qian Chen, Shu Wang, Jing-He Lang
Journal of Ovarian Research.2020;[Epub] CrossRef

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Validity and Reliability of Korean Version of Simplified Nutritional Appetite Questionnaire in Patients with Advanced Cancer: A Multicenter, Longitudinal Study: So Yeon Oh, Su-Jin Koh, Ji Yeon Baek, Kyung A Kwon, Hei-Cheul Jeung, Kyung Hee Lee, Young-Woong Won, Hyun Jung Lee; Cancer Res Treat. 2019;51(4):1612-1619. Published online April 12, 2019; DOI: https://doi.org/10.4143/crt.2018.505

Abstract PDF PubReader ePub

Purpose
Malnutrition and a loss of muscle mass are frequent in cancer patients and have a negative effect on clinical outcome. Nutrition risk screening aims to increase awareness and allow early recognition and treatment of cancer cachexia. Therefore, screenings should be brief, inexpensive, highly sensitive, and have good specificity. Simplified Nutritional Appetite Questionnaire (SNAQ) is a simple screening tool including four questions, and validated to predict weight loss within 6 months in community-dwelling adults and nursing home residents. Our study aimed to translate the SNAQ into Korean, and to assess the validity and reliability of the translated screening tool in advanced cancer patients.
Materials and Methods
The SNAQ was translated into Korean according to linguistic validation. The internal consistency of the SNAQ was evaluated by Cronbach’s alpha coefficient. Test-retest reliability was evaluated using the intraclass correlation coefficient. Concurrent validity was evaluated by measuring the Pearson’s correlation coefficient between the SNAQ and Mini-Nutritional Assessment (MNA) and Patient-Generated Subjective Global Assessment (PG-SGA).
Results
In the 194 patients included in full analysis set, cancer stage was predominantly metastatic (98.5%), the mean age was 60 years (range, 23 to 81 years), and the mean body mass index was 24 kg/m2 (range, 15.6 to 39.6 kg/m2). According to MNA score ≤ 11, 57 patients (29.4%) were malnourished. The mean score (±standard deviation) of the Korean version of the SNAQ was 13.8±2.5 with a range of 6-19. Cronbach’s alpha coefficient was 0.737, and intraclass correlation coefficient was 0.869. The SNAQ was moderately correlated with MNA (r=0.404, p < 0.001) and PG-SGA (r=–0.530, p < 0.001). A significant weight loss of > 5% of the original bodyweightwithin 6 months occurred in 46 of the 186 patients (24.7%). SNAQ score ≤ 14 predicted > 5% weight loss with a sensitivity of 56.5% and a specificity of 44.3%.
Conclusion
The Korean version of the SNAQ had high validity and reliability. SNAQ is useful for the screening tool for advanced cancer patients. The SNAQ had a limitation to predict impending weight loss in advanced cancer patients.

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Elaine B. Trujillo, Kunal C. Kadakia, Cynthia Thomson, Fang Fang Zhang, Alicia Livinski, Kim Pollard, Todd Mattox, Anne Tucker, Valaree Williams, Declan Walsh, Steven Clinton, Aaron Grossberg, Gordon Jensen, Rhone Levin, Jeannine Mills, Anurag Singh, Mere
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Konstantina Vamvakari, Iliana Evangelou, Ioanna Panagiota Kalafati, Michail Kipouros, Rena I. Kosti, Arezina N. Kasti, Odysseas Androutsos
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Binh Duong Thai, Jürgen M. Bauer, Annette Eidam, Jane Durga, Stefan Grund, Thomas Mross, Petra Benzinger
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Xu Chao, Zhang Lei, Liu Hongqin, Wang Ziwei, Li Dechuan, Du Weidong, Xu Lu, Chen Haitao, Zhang Bo, Ju Haixing, Yao Qinghua
Clinical Nutrition.2022; 41(3): 632. CrossRef
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Annamária Pakai, Emese Havasi‐Sántha, Erzsébet Mák, Orsolya Máté, Dorina Pusztai, Noémi Fullér, Miklós Zrínyi, András Oláh
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Sabrina Lau, Kalene Pek, Justin Chew, Jun Pei Lim, Noor Hafizah Ismail, Yew Yoong Ding, Matteo Cesari, Wee Shiong Lim
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A Retrospective Analysis for Patients with HER2-Positive Gastric Cancer Who Were Treated with Trastuzumab-Based Chemotherapy: In the Perspectives of Ethnicity and Histology: Jun Ho Yi, Jung Hun Kang, In Gyu Hwang, Hee Kyung Ahn, Hyun Jin Baek, Soon Il Lee, Do Hyoung Lim, Young-Woong Won, Jun Ho Ji, Hyo Song Kim, Sun Young Rha, Sung Yong Oh, Kyung Eun Lee, Taekyu Lim, Chi Hoon Maeng, Moon Jin Kim, Seung Tae Kim, Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, Se Hoon Park; Cancer Res Treat. 2016;48(2):553-560. Published online August 10, 2015; DOI: https://doi.org/10.4143/crt.2015.155

Abstract PDF PubReader ePub

Purpose
While the Trastuzumab for Gastric Cancer (ToGA) trial demonstrated the efficacy and safety of trastuzumab-based chemotherapy in HER2-positive metastatic gastric cancer, the overall survival (OS) benefit was not found in Asian and diffuse-type cancer patients. The aim of the study is to investigate predictive markers for trastuzumab-based chemotherapy.
Materials and Methods
Data of patients with HER2-positive gastric cancer treated with trastuzumab-based chemotherapy were analyzed retrospectively.
Results
A total of 168 Asian patients were included. The median age was 60 years (range, 27 to 85 years) and the male:female ratio was 118 (70.2%):50 (29.8%). Fourteen (8.3%), 63 (37.5%), 75 (44.6%), and 11 (6.5%) patients had well, moderately, poorly-differentiated tubular adenocarcinoma and signet ring cell carcinoma, respectively. With 14 complete responses and 73 partial responses, the response rate was 50.6%. The median progression-free survival (PFS) was 10.2 months (95% confidence interval [CI], 8.7 to 11.7), and the median OS was 18.5 months (95% CI, 16.4 to 50.6). Next, we investigated the effect of poorly-differentiated histology (PDH, poorly-differentiated tubular adenocarcinoma+signet ring cell carcinoma) on clinical outcomes. The median PFS (8.9 months vs. 11.5 months, p=0.16) was slightly inferior in PDH patients, and the median OS was significantly shorter in PDH patients (14.6 months vs. 19.0 months, p=0.025).
Conclusion
While subset analysis of the ToGA trial demonstrated that trastuzumab-based chemotherapy may not be beneficial for Asians and patients with PDH, our data may suggest that even in Asian patients and patients with PDH, trastuzumab-based chemotherapy could be associated with improved clinical outcomes in patients with HER2-positive gastric cancer.

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Timing to Surgery and Lymph Node Upstaging in Gastric Cancer: An NCDB Analysis
Maria Cristina Riascos, Jacques A. Greenberg, Federico Palacardo, Rodrigo Edelmuth, V. Colby Lewis, Anjile An, Haythem Najah, Hala Al Asadi, Parima Safe, Brendan M. Finnerty, Paul J. Christos, Thomas J. Fahey, Rasa Zarnegar
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Deviating HER2 test results in gastric cancer: analysis from the prospective multicenter VARIANZ study
Katharina Kolbe, Ivonne Haffner, Katrin Schierle, Dieter Maier, Birgitta Geier, Birgit Luber, Hendrik Bläker, Christian Wittekind, Florian Lordick
Journal of Cancer Research and Clinical Oncology.2023; 149(3): 1319. CrossRef
Trastuzumab Combined With Ramucirumab and Paclitaxel in Patients With Previously Treated Human Epidermal Growth Factor Receptor 2–Positive Advanced Gastric or Gastroesophageal Junction Cancer
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Juin Park, Sun Kyoung Kang, Woo Sun Kwon, Inhye Jeong, Tae Soo Kim, Seo Young Yu, Sang Woo Cho, Hyun Cheol Chung, Sun Young Rha
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Wan-Ying Lin, Shih-Syuan Wang, Yi-No Kang, Andrea S. Porpiglia, Yu Chang, Chin-Hsuan Huang, Ronak Bhimani, Eahab Abdul-Lattif, Muneeba Azmat, Tsu-Hsien Wang, Yu-Shiuan Lin, Yu-Cheng Chang, Kuan-Yu Chi
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S.J. Merchant, W. Kong, B. Gyawali, T. Hanna, W. Chung, S. Nanji, S.V. Patel, C.M. Booth
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Ivonne Haffner, Katrin Schierle, Elba Raimúndez, Birgitta Geier, Dieter Maier, Jan Hasenauer, Birgit Luber, Axel Walch, Katharina Kolbe, Jorge Riera Knorrenschild, Albrecht Kretzschmar, Beate Rau, Ludwig Fischer von Weikersthal, Miriam Ahlborn, Gabriele S
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C.R. Akshatha, Smitha Bhat, R. Sindhu, Dharini Shashank, Sarana Rose Sommano, Wanaporn Tapingkae, Ratchadawan Cheewangkoon, Shashanka K. Prasad
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Atakan Topcu, Muhammed Mustafa Atci, Saban Secmeler, Mehmet Besiroglu, Murat Ayhan, Metin Ozkan, Oktay Bozkurt, Zuhat Urakci, Seval Ay, Caglayan Geredeli, Ayse Irem Yasin, Haci Mehmet Turk
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Lisa M Hess, Michael Grabner, Liya Wang, Astra M Liepa, Xiaohong Ivy Li, Zhanglin Lin Cui, Lee Bowman, William R Schelman
Pragmatic and Observational Research.2020; Volume 11: 27. CrossRef
Targeting HER2-positive gastric cancer with a novel 18F-labeled ZHER2:342 probe
Yunyun Pan, Zhengyang Yang, Yuping Xu, Zhicheng Bai, Donghui Pan, Runlin Yang, Lizhen Wang, Wenxian Guan, Min Yang
RSC Advances.2019; 9(19): 10990. CrossRef
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Sumi Yun, Jiwon Koh, Soo Kyung Nam, Jung Ok Park, Sung Mi Lee, Kyoungyul Lee, Kyu Sang Lee, Sang-Hoon Ahn, Do Joong Park, Hyung-Ho Kim, Gheeyoung Choe, Woo Ho Kim, Hye Seung Lee
Gastric Cancer.2018; 21(2): 225. CrossRef
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A. Ilhan-Mutlu, H. Taghizadeh, A. Beer, W. Dolak, A. Ba-Ssalamah, S. F. Schoppmann, M. Hejna, P. Birner, M. Preusser
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Giandomenico Roviello, Roberto Petrioli, Valerio Nardone, Pietro Rosellini, Andrea Giovanni Multari, Raffaele Conca, Michele Aieta
Medicine.2018; 97(20): e10745. CrossRef

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Predictive Value of the ERCC1 Expression for Treatment Response and Survival in Advanced Gastric Cancer Patients Receiving Cisplatin-based First-line Chemotherapy: Jina Yun, Kyoung-Mee Kim, Seung Tae Kim, Jung-Hoon Kim, Jung A Kim, Jee Hyun Kong, Soo Hyeon Lee, Young-Woong Won, Jong-Mu Sun, Jeeyun Lee, Se Hoon Park, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang; Cancer Res Treat. 2010;42(2):101-106. Published online June 30, 2010; DOI: https://doi.org/10.4143/crt.2010.42.2.101

Abstract PDF PubReader ePub

Purpose

The aim of this study was to determine whether the ERCC1 expression is effective to predict the clinical outcomes of patients with advanced gastric cancer (AGC) and who were treated with cisplatin-based first-line chemotherapy.

Materials and Methods

A total of 89 measurable AGC patients received cisplatin and capecitabine, with or without epirubicin, as a part of a randomized phase II study. Patients were included for the current molecular analysis if they had received two or more cycles of chemotherapy, their objective tumor responses were measured and if their paraffin-embedded tumor samples were available. The ERCC1 expression was examined by performing immunohistochemical (IHC) staining, and the patients were divided into two groups (positive or negative) according to the presence of IHC staining of the tumor cell nuclei.

Results

Of the 32 eligible patients, 21 patients (66%) had tumor with a positive expression of ERCC1 and the remaining 11 patients had tumor with a negative ERCC1-expression. The ERCC1-negative patients achieved a higher response rate than that of the ERCC1-positive patients (44% vs. 28%, respectively), although the difference was not statistically significant (p=0.42). The median survival time for the all patients was 14.6 months (95% CI: 13.6 to 15.6 months). The one-year survival rate was similar for the ERCC1-negative patients (61%) and the ERCC1-positive patients (70%).

Conclusion

In the current study, the tumor ERCC1 expression by IHC staining could not predict the clinical response or survival of AGC patients who were treated with cisplatin-based first-line chemotherapy. The ERCC1 protein expression does not appear to be a useful tool for the selection of tailored chemotherapy for these patients.

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Histopathological regression of gastric adenocarcinoma after neoadjuvant therapy: a critical review
Eduardo Henrique Cunha Neves Filho, Rosane Oliveira de Sant'Ana, Luiz Vianney Saldanha Cidrão Nunes, Adriana Pinheiro Bezerra Pires, Maria do Perpétuo Socorro Saldanha da Cunha
APMIS.2017; 125(2): 79. CrossRef
Predictive biomarkers for targeted and cytotoxic agents in gastric cancer for personalized medicine
Shalong Wang, Lianwen Yuan
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Influence of ERCC1 and ERCC4 polymorphisms on response to prognosis in gastric cancer treated with FOLFOX-based chemotherapy
Zheng-mao Lu, Tian-hang Luo, Ming-ming Nie, Guo-en Fang, Li-ye Ma, Xu-chao Xue, Guo Wei, Chong-we Ke, Jian-wei Bi
Tumor Biology.2014; 35(4): 2941. CrossRef
The prognostic value of ERCC1 expression in gastric cancer patients treated with platinum-based chemotherapy: a meta-analysis
Kong-Kong Wei, Lei Jiang, Yao-Yao Wei, Yu-Feng Wang, Xuan-Kun Qian, Qiang Dai, Quan-Lin Guan
Tumor Biology.2014; 35(9): 8721. CrossRef
Predictive value of excision repair cross-complementation group 1 expression for platinum-based chemotherapy and survival in gastric cancer: a meta-analysis
Anqi Yao, You Wang, Xiaohong Peng, Rong Ye, Qiaoli Wang, Yuexiao Qi, Fuxiang Zhou
Journal of Cancer Research and Clinical Oncology.2014; 140(12): 2107. CrossRef
Correlation between expressions of ERCC1/TS mRNA and effects of gastric cancer to chemotherapy in the short term
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Phase II Study of Irinotecan, 5-Fluorouracil, and Leucovorin in Relapsed or Metastatic Colorectal Cancer as First-line Therapy: Young-Woong Won, Young-Hyo Lim, Ho-Yong Park, Ho-Suk Oh, Jung-Hye Choi, Young-Yeul Lee, In-Soon Kim, Il-Young Choi, Myung-Ju Ahn; Cancer Res Treat. 2004;36(4):235-239. Published online August 31, 2004; DOI: https://doi.org/10.4143/crt.2004.36.4.235

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Background

The purpose of this study was to assess the efficacy and toxicity of biweekly irinotecan plus 5-fluorouracil (FU) and leucovorin (LV) in patients with relapsed or metastatic colorectal cancer.

Materials and Methods

Between March 2002 and May 2004, 24 patients with histologically confirmed relapsed or metastatic colorectal cancer were enrolled in this study. One chemotherapy cycle consisted of irinotecan 180 mg/m² on days 1 and 15; 5-FU 400 mg/m² bolus IV with 600 mg/m² by a 22 hour intravenous infusion on days 1, 2, 15 and 16; and leucovorin 20 mg/m² on days 1, 2, 15 and 16, every 4 weeks.

Results

The median age of the 24 was 57.5 years (range, 38~69). Their metastatic sites included: the liver (62.5%), lung (20.8%), peritoneum (16.7%), lymph node (12.5%), ovary (8.3%) and pelvis/vagina (8.3%). Twenty-two patients were evaluable for a response. Six and 7 patients achieved partial responses and stable diseases, respectively. The overall response rate was 27.3% (95% Confidence interval; 10.3~44.5%). The median follow-up duration for surviving patients was 14.7 months (range, 1.7~26.5). Median overall survival (OS) and 1-year OS rates were 19 months and 86.3%, respectively. Median response duration and median progression free survival were 7.47 and 5.57 months, respectively. A total of 83 cycles (median 4 cycles) were administered. The main non-hematologic toxicities were nausea/vomiting (44.5%/18.1%) and diarrhea (8.4%). The most common hematologic toxicity was NCI grade I/II anemia (31.3%) and grade I/II neutropenia was 10.8%. There was no life-threatening toxicity.

Conclusion

The results suggested that irinotecan, 5-FU and leucovorin combination chemotherapy in a biweekly schedule is a practical and tolerable treatment option in patients with advanced colorectal cancer.

Citations

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A Phase I Study of UGT1A1 *28/*6 Genotype-Directed Dosing of Irinotecan (CPT-11) in Korean Patients with Metastatic Colorectal Cancer Receiving FOLFIRI
Kyu-Pyo Kim, Yong Sang Hong, Jae-Lyun Lee, Kyun Seop Bae, Ho-Sook Kim, Jae-Gook Shin, Jung Shin Lee, Tae Won Kim
Oncology.2015; 88(3): 164. CrossRef
Effect of an Irinotencan, 5-Fluorouracil, and Leucovorin Combination Chemotherapy (FOLFIRI) in Metastatic Colorectal Cancer
Seung Hyun Lee, Byung Kwon Ahn, Sung Uhn Baek
Journal of the Korean Society of Coloproctology.2007; 23(5): 333. CrossRef
A Phase II Study of Irinotecan, 5-Fluorouracil and Leucovorin for Treatment in Patients with Previously Untreated Advanced Colorectal Cancer
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Cancer Research and Treatment.2006; 38(2): 72. CrossRef
Irinotecan, Continuous 5-Fluorouracil, and Low dose of Leucovorin (modified FOLFIRI) as First Line of Therapy in Recurrent or Metastatic Colorectal Cancer
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The Korean Journal of Internal Medicine.2005; 20(3): 205. CrossRef
Responsiveness of CPT-11 in Respect to hMLH1 and hMSH2 Protein Expression in the Primary Colorectal Cancer
In Ja Park, Hee Cheol Kim, Chang Sik Yu, Heung Moon Chang, Jea Hwan Lee, Jong Hoon Kim, Tae Won Kim, Jung Sun Kim, Jin Cheon Kim
Cancer Research and Treatment.2004; 36(6): 360. CrossRef

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Correspondence

Hepatitis B Virus Reactivation in a Chronic Lymphocytic Leukemia Patient Treated with Ibrutinib: Jung Hye Choi, Joon Young Hur, Young-Woong Won; Cancer Res Treat. 2023;55(2):704-705.; DOI: https://doi.org/10.4143/crt.2022.1524

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Ahmed Azzam, Heba Khaled, Basem Osama Ashry, Sarah Mohamed Hussein, Manar Osama, Ameer Ahmed, Omar Yousef, Anees Hjazeen, Ahmed A. Allam, Gellan Alaa Mohamed Kamel
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