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Review Article
The Current Evidence and Future Direction of Adjuvant Treatment for Gastric Cancer in the Era of Precision Medicine
Jong Hyuk Yun, Yoon Young Choi, Jae-Ho Cheong
Received December 18, 2024  Accepted January 22, 2025  Published online January 23, 2025  
DOI: https://doi.org/10.4143/crt.2024.1222    [Accepted]
AbstractAbstract PDF
Although gastric cancer remains a significant global health burden, its treatment strategies vary across different geographical regions, leading to distinct guidelines. In Asia, particularly in Korea, D2 gastrectomy followed by adjuvant chemotherapy has been established as the standard treatment for stage II/III gastric cancer based on landmark clinical trials. However, this "one-size-fits-all" approach requires refinement as emerging evidence suggests heterogeneous outcomes even within the same stage. This review discusses the evolving landscape of adjuvant treatment in gastric cancer, emphasizing the transition towards precision medicine. Recent molecular characterization of gastric cancer has revealed distinct subtypes with varying prognoses and chemotherapy responses, exemplified by the favorable outcomes of microsatellite instability-high tumors without adjuvant chemotherapy. Additionally, clinical factors including sub-stages within stage II/III, patient performance status, comorbidities, and personal preferences should be considered in treatment decisions. The integration of these molecular and clinical factors, along with shared decision-making between physicians and patients, represents a crucial step toward personalized treatment approaches. Looking ahead, the field is poised for further evolution with the emergence of immune checkpoint inhibitors, growing evidence for neoadjuvant chemotherapy in selected cases, and the potential of circulating tumor DNA as a biomarker for minimal residual disease. This comprehensive approach to treatment decision-making, considering both tumor biology and patient factors, will be essential for realizing precision medicine in gastric cancer care.
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Original Articles
Phase II Trial of Neoadjuvant Docetaxel/Cisplatin/5-Fluorouracil Combined with Pegteograstim for Unresectable, Locally Advanced Sinonasal Squamous Cell Carcinoma: KCSG HN18-07
Bhumsuk Keam, Ho Jung An, Seong Hoon Shin, Min Kyoung Kim, Jung Hae Cho, Seyoung Seo, Sung-Bae Kim
Received October 24, 2024  Accepted December 13, 2024  Published online December 16, 2024  
DOI: https://doi.org/10.4143/crt.2024.1025    [Accepted]
AbstractAbstract PDF
Purpose
The role of neoadjuvant chemotherapy in locally advanced sinonasal squamous cell carcinoma (SNSCC) has not been established prospectively. We conducted a phase II trial of neoadjuvant chemotherapy (NAC) with docetaxel/cisplatin/5-fluorouracil (TPF) in this population.
Materials and Methods
Eligible patients had unresectable, locally advanced SNSCC, defined as T3/4 stage or potential compromise of critical organ function on surgery. Three TPF (docetaxel 75 mg/m2 and cisplatin 75 mg/m2 on day 1, 5-fluorouracil 1,000 mg/m2 on days 1–4 every 3 weeks) cycles were administered with prophylactic pegteograstim. The primary outcome was the overall response rate (ORR); the secondary outcomes included 2-year progression-free survival (PFS), eyeball preservation rate, and safety.
Results
Among 28 patients screened, 25 were evaluable for efficacy (one screen-failure; two evaluable for safety only). The confirmed ORR was 72.0%. The definitive post-NAC treatment comprised chemoradiotherapy (n=15) and surgery (n=10). With a median follow-up of 25.5 months, median PFS was not reached and the 2-year PFS rate was 60.4%. Response to NAC was related to prolonged PFS (p=0.038). No patient underwent eyeball exenteration at the data cutoff point. Treatment-related adverse events of grade ≥3 were neutropenia (48.1%) including febrile neutropenia (14.8%), followed by acute kidney injury (22.2%), nausea/vomiting (11.1%), anemia (7.4%), thrombocytopenia (7.4%), and enterocolitis (3.7%).
Conclusion
TPF NAC showed a promising efficacy and might help preserve critical structures in this population, which needs to be validated in a large prospective trial (KCT0003377).
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Predictive Value of the nProfiler 1 Assay for the Efficacy of Adjuvant S-1-Based Doublet Chemotherapy in Stage III Gastric Cancer: A Post-Hoc Analysis of a Randomized Phase III Trial
Dong Ki Lee, Choong-kun Lee, Hyo Song Kim, Sun Jin Sym, Dae Young Zang, Ki Hyang Kim, Joo Han Lim, Hae Su Kim, Kyung Hee Lee, Heon Yung Gee, Sun Young Rha, Hyunki Kim, Minkyu Jung
Received July 25, 2024  Accepted November 9, 2024  Published online November 12, 2024  
DOI: https://doi.org/10.4143/crt.2024.705    [Accepted]
AbstractAbstract PDF
Purpose
The nProfiler 1 Stomach Cancer Assay (nProfiler1), designed to predict responses to fluorouracil-based adjuvant chemotherapy, measures the expression of four gastric cancer target genes (GZMB, WARS, SFRP4, and CDX1). The randomized phase III POST trial aimed to compare the efficacies of two adjuvant S-1-based doublet chemotherapies: S-1 plus cisplatin (SP) and S-1 plus docetaxel (DS). This study aimed to validate the nProfiler1 assay using a distinct cohort from the POST trial.
Materials and Methods
The nProfiler1 assay stratifies patients into three groups (low-risk, intermediate-risk, and high-risk) using the prognostic single-patient classifier and two groups (chemotherapy-benefit and no-benefit) using the predictive single-patient classifier. The nProfiler1 assay was applied to formalin-fixed paraffin-embedded slides obtained from the POST trial. Disease-free survival (DFS) and overall survival (OS), including 5-year survival rates, were calculated for the enrolled patients.
Results
Of the 153 patients in the POST trial, 118 were included in the post-hoc analysis. With a median follow-up of 57.9 months, no significant difference in DFS or OS was observed between the SP and DS groups. The prognostic single-patient classifier predicted the OS in the SP group (p=0.0425) but not in the DS group (p=0.5940). The chemotherapy-benefit group exhibited numerically longer DFS than the no-benefit group in the SP and DS groups.
Conclusion
The nProfiler1 assay offers valuable insights into the prognosis and efficacy of adjuvant chemotherapy based on fluorouracil plus platinum doublet regimens but not docetaxel-containing regimens. Further validation with larger patient cohorts and different regimens is warranted.
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Lung and Thoracic cancer
Adjuvant Pembrolizumab in Patients with Stage IIIA/N2 Non–Small Cell Lung Cancer Completely Resected after Neoadjuvant Concurrent Chemoradiation: A Prospective, Open-Label, Single-Arm, Phase 2 Trial
Junghoon Shin, Sehhoon Park, Kyung Hwan Kim, Eui-Cheol Shin, Hyun Ae Jung, Jong Ho Cho, Jong-Mu Sun, Se-Hoon Lee, Yong Soo Choi, Jin Seok Ahn, Jhingook Kim, Keunchil Park, Young Mog Shim, Hong Kwan Kim, Jae Myoung Noh, Yong Chan Ahn, Hongryull Pyo, Myung-Ju Ahn
Cancer Res Treat. 2024;56(4):1084-1095.   Published online April 30, 2024
DOI: https://doi.org/10.4143/crt.2024.084
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Optimal treatment for stage IIIA/N2 non–small cell lung cancer (NSCLC) is controversial. We aimed to assess the efficacy and safety of adjuvant pembrolizumab for stage IIIA/N2 NSCLC completely resected after neoadjuvant concurrent chemoradiation therapy (CCRT).
Materials and Methods
In this open-label, single-center, single-arm phase 2 trial, patients with stage IIIA/N2 NSCLC received adjuvant pembrolizumab for up to 2 years after complete resection following neoadjuvant CCRT. The primary endpoint was disease-free survival (DFS). Secondary endpoints included overall survival (OS) and safety. As an exploratory biomarker analysis, we evaluated the proliferative response of blood CD39+PD-1+CD8+ T cells using fold changes in the percentage of proliferating Ki-67+ cells from days 1 to 7 of cycle 1 (Ki-67D7/D1).
Results
Between October 2017 and October 2018, 37 patients were enrolled. Twelve (32%) and three (8%) patients harbored EGFR and ALK alterations, respectively. Of 34 patients with programmed cell death ligand 1 assessment, 21 (62%), nine (26%), and four (12%) had a tumor proportion score of < 1%, 1%-50%, and ≥ 50%, respectively. The median follow-up was 71 months. The median DFS was 22.4 months in the overall population, with a 5-year DFS rate of 29%. The OS rate was 86% at 2 years and 76% at 5 years. Patients with tumor recurrence within 6 months had a significantly lower Ki-67D7/D1 among CD39+PD-1+CD8+ T cells than those without (p=0.036). No new safety signals were identified.
Conclusion
Adjuvant pembrolizumab may offer durable disease control in a subset of stage IIIA/N2 NSCLC patients after neoadjuvant CCRT and surgery.
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Genitourinary cancer
Adjuvant Chemotherapy for Upper Tract Urothelial Carcinoma: A Real-World, Retrospective Study
Junho Lee, Sung Hee Lim, Jae Hoon Chung, Wan Song, Hyun Hwan Sung, Byong Chang Jeong, Se Hoon Park
Cancer Res Treat. 2024;56(3):871-876.   Published online January 16, 2024
DOI: https://doi.org/10.4143/crt.2023.1226
AbstractAbstract PDFPubReaderePub
Purpose
The aim of this retrospective study was to evaluate the efficacy of adjuvant cisplatin-based chemotherapy in patients with locally advanced upper tract urothelial carcinoma (UTUC), administered following radical nephroureterectomy.
Materials and Methods
Patients with UTUC, arising from renal pelvis or ureter, staged pT3/T4 or N+ were treated with adjuvant chemotherapy following surgery. The chemotherapy consisted of gemcitabine 1,000 mg/m2 on days 1 and 8, cisplatin 70 mg/m2 on day 1. Treatment was repeated every 3 weeks for up to 4 cycles. Endpoints included disease-free survival (DFS), metastasis-free survival (MFS), and safety.
Results
Among 89 eligible patients, 85 (95.5%) completed at least 3 cycles of adjuvant chemotherapy. Chemotherapy was well tolerated, the main toxicities being mild-to-moderate gastrointestinal toxic effects and pruritus. With a median follow-up of 37 months, median DFS was 30 months (95% confidence interval, 22 to 39), and the median MFS was not reached. The 3-year DFS and MFS were 44% and 56%, respectively. Multivariate analyses revealed that the main factor associated with DFS and MFS was the lymph node involvement, whereas age, T category, grade, or the primary site of UTUC were not significantly associated with DFS or MFS.
Conclusion
Adjuvant cisplatin-based chemotherapy after radical surgery of pT3/T4 or N+ UTUC was feasible and may demonstrate benefits in DFS and MFS. Whether novel agents added to the chemotherapy regimen, as a concurrent combination or maintenance, impacts on survival or reduces the development of metastases remains to be studied.

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  • Cisplatin/gemcitabine

    Reactions Weekly.2024; 2027(1): 127.     CrossRef
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General
Impact of Patient Sex on Adverse Events and Unscheduled Utilization of Medical Services in Cancer Patients Undergoing Adjuvant Chemotherapy: A Multicenter Retrospective Cohort Study
Songji Choi, Seyoung Seo, Ju Hyun Lee, Koung Jin Suh, Ji-Won Kim, Jin Won Kim, Se Hyun Kim, Yu Jung Kim, Keun-Wook Lee, Jwa Hoon Kim, Tae Won Kim, Yong Sang Hong, Sun Young Kim, Jeong Eun Kim, Sang-We Kim, Dae Ho Lee, Jae Cheol Lee, Chang-Min Choi, Shinkyo Yoon, Su-Jin Koh, Young Joo Min, Yongchel Ahn, Hwa Jung Kim, Jin Ho Baek, Sook Ryun Park, Jee Hyun Kim
Cancer Res Treat. 2024;56(2):404-413.   Published online November 7, 2023
DOI: https://doi.org/10.4143/crt.2023.784
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The female sex is reported to have a higher risk of adverse events (AEs) from cytotoxic chemotherapy. Few studies examined the sex differences in AEs and their impact on the use of medical services during adjuvant chemotherapy. This sub-study aimed to compare the incidence of any grade and grade ≥ 3 AEs, healthcare utilization, chemotherapy completion rate, and dose intensity according to sex.
Materials and Methods
This is a sub-study of a multicenter cohort conducted in Korea that evaluated the impact of healthcare reimbursement on AE evaluation in patients who received adjuvant chemotherapy between September 2013 and December 2016 at four hospitals in Korea.
Results
A total of 1,170 patients with colorectal, gastric, or non–small cell lung cancer were included in the study. Female patients were younger, had fewer comorbidities, and experienced less postoperative weight loss of > 10%. Females had significantly higher rates of any grade AEs including nausea, abdominal pain, stomatitis, vomiting, and neutropenia, and experienced more grade ≥ 3 neutropenia, nausea, and vomiting. The dose intensity of chemotherapy was significantly lower in females, and they also experienced more frequent dose reduction after the first cycle. Moreover, female patients receiving platinum-containing regimens had significantly higher rates of unscheduled outpatient visits.
Conclusion
Our study found that females experienced a higher incidence of multiple any-grade AEs and severe neutropenia, nausea, and vomiting, across various cancer types, leading to more frequent dose reductions. Physicians should be aware of sex differences in AEs for chemotherapy decisions.

Citations

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  • Cancer care for transgender and gender‐diverse people: Practical, literature‐driven recommendations from the Multinational Association of Supportive Care in Cancer
    Elizabeth J. Cathcart‐Rake, Alexandre Chan, Alvaro Menendez, Denise Markstrom, Carla Schnitzlein, Yee Won Chong, Don S. Dizon
    CA: A Cancer Journal for Clinicians.2025; 75(1): 68.     CrossRef
  • Characterisation of the effects of the chemotherapeutic agent paclitaxel on neuropathic pain-related behaviour, anxiodepressive behaviour, cognition, and the endocannabinoid system in male and female rats
    Chiara Di Marino, Álvaro Llorente-Berzal, Alba M. Diego, Ariadni Bella, Laura Boullon, Esther Berrocoso, Michelle Roche, David P. Finn
    Frontiers in Pharmacology.2025;[Epub]     CrossRef
  • Toxicidad del esquema FOLFOX-6, asociado o no a bolo de 5-fluorouracilo, en cáncer colorrectal metastásico
    María Teresa Garrido Martínez, María Rodríguez Jorge, Ignacio García Giménez, María Isabel Guzmán Ramos, Salvador Grutzmancher Sáiz, Victoria Aviñó Tarazona
    Farmacia Hospitalaria.2024;[Epub]     CrossRef
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Gastrointestinal cancer
The Role of Adjuvant Chemotherapy after Neoadjuvant Chemoradiotherapy Followed by Surgery in Patients with Esophageal Squamous Cell Carcinoma
Seong Yong Park, Hong Kwan Kim, Yeong Jeong Jeon, Junghee Lee, Jong Ho Cho, Yong Soo Choi, Young Mog Shim, Jae Il Zo
Cancer Res Treat. 2023;55(4):1231-1239.   Published online April 24, 2023
DOI: https://doi.org/10.4143/crt.2022.1417
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to investigate the efficacy of adjuvant chemotherapy after neoadjuvant chemoradiotherapy (CCRTx) followed by surgery in patients with esophageal squamous cell carcinoma (ESCC).
Materials and Methods
We retrospectively analyzed the data from 382 patients who received neoadjuvant CCRTx and esophagectomy for ESCC between 2003 and 2018.
Results
This study included 357 (93.4%) men, and the years median patient age was 63 (range, 40 to 84 years). Overall, 69 patients (18.1%) received adjuvant chemotherapy, whereas 313 patients (81.9%) did not. The median follow-up period was 28.07 months (interquartile range, 15.50 to 62.59). The 5-year overall survival (OS) and disease-free survival were 47.1% and 42.6%, respectively. Adjuvant chemotherapy did not improve OS in all patients, but subgroup analysis revealed that adjuvant chemotherapy improved the 5-year OS in patients with ypT+N+ (24.8% vs. 29.9%, p=0.048), whereas the survival benefit of adjuvant chemotherapy was not observed in patients with ypT0N0, ypT+N0, or ypT0N+. Multivariable analysis revealed that ypStage and adjuvant chemotherapy (hazard ratio, 0.601; p=0.046) were associated with OS in patients with ypT+N+. Freedom from distant metastasis was marginally different according to the adjuvant chemotherapy (48.3% vs. 41.3%, p=0.141).
Conclusion
Adjuvant chemotherapy after neoadjuvant therapy followed by surgery reduces the distant metastasis in ypT+N+ ESCC patients, thereby improving the OS. The consideration could be given to administration of adjuvant chemotherapy to ypT+N+ ESCC patients with tolerable conditions.

Citations

Citations to this article as recorded by  
  • Adjuvant therapy provides no additional recurrence-free benefit for esophageal squamous cell carcinoma patients after neoadjuvant chemoimmunotherapy and surgery: a multi-center propensity score match study
    Shu-Han Xie, Li-Tao Yang, Hai Zhang, Zi-Lu Tang, Zhi-Wei Lin, Yi Chen, Zhi-Nuan Hong, Rong-Yu Xu, Wan-Li Lin, Ming-Qiang Kang
    Frontiers in Immunology.2024;[Epub]     CrossRef
  • Clinical implications of C-reactive protein–albumin–lymphocyte (CALLY) index in patients with esophageal cancer
    Ruiya Ma, Yoshinaga Okugawa, Tadanobu Shimura, Shinji Yamashita, Yuhki Sato, Chengzeng Yin, Ryo Uratani, Takahito Kitajima, Hiroki Imaoka, Mikio Kawamura, Yuhki Morimoto, Yoshiki Okita, Shigeyuki Yoshiyama, Masaki Ohi, Yuji Toiyama
    Surgical Oncology.2024; 53: 102044.     CrossRef
  • Adjuvant immunotherapy after neoadjuvant immunochemotherapy and esophagectomy for esophageal squamous cell carcinoma: a real-world study
    Jifeng Feng, Liang Wang, Xun Yang, Qixun Chen
    Frontiers in Immunology.2024;[Epub]     CrossRef
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Survival Benefit of Adjuvant Chemotherapy in Patients with Pancreatic Ductal Adenocarcinoma Who Underwent Surgery Following Neoadjuvant FOLFIRINOX
So Heun Lee, Dae Wook Hwang, Changhoon Yoo, Kyu-pyo Kim, Sora Kang, Jae Ho Jeong, Dongwook Oh, Tae Jun Song, Sang Soo Lee, Do Hyun Park, Dong Wan Seo, Jin-hong Park, Ki Byung Song, Jae Hoon Lee, Woohyung Lee, Yejong Park, Bong Jun Kwak, Heung-Moon Chang, Baek-Yeol Ryoo, Song Cheol Kim
Cancer Res Treat. 2023;55(3):956-968.   Published online February 27, 2023
DOI: https://doi.org/10.4143/crt.2022.409
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The benefit of adjuvant chemotherapy following curative-intent surgery in pancreatic ductal adenocarcinoma (PDAC) patients who had received neoadjuvant FOLFIRINOX is unclear. This study aimed to assess the survival benefit of adjuvant chemotherapy in this patient population.
Materials and Methods
This retrospective study included 218 patients with localized non-metastatic PDAC who received neoadjuvant FOLFIRINOX and underwent curative-intent surgery (R0 or R1) between January 2017 and December 2020. The association of adjuvant chemotherapy with disease-free survival (DFS) and overall survival (OS) was evaluated in overall patients and in the propensity score matched (PSM) cohort. Subgroup analysis was conducted according to the pathology-proven lymph node status.
Results
Adjuvant chemotherapy was administered to 149 patients (68.3%). In the overall cohort, the adjuvant chemotherapy group had significantly improved DFS and OS compared to the observation group (DFS: median, 13.8 months [95% confidence interval (CI), 11.0 to 19.1] vs. 8.2 months [95% CI, 6.5 to 12.0]; p < 0.001; and OS: median, 38.0 months [95% CI, 32.2 to not assessable] vs. 25.7 months [95% CI, 18.3 to not assessable]; p=0.005). In the PSM cohort of 57 matched pairs of patients, DFS and OS were better in the adjuvant chemotherapy group than in the observation group (p < 0.001 and p=0.038, respectively). In the multivariate analysis, adjuvant chemotherapy was a significant favorable prognostic factor (vs. observation; DFS: hazard ratio [HR], 0.51 [95% CI, 0.36 to 0.71; p < 0.001]; OS: HR, 0.45 [95% CI, 0.29 to 0.71; p < 0.001]).
Conclusion
Among PDAC patients who underwent surgery following neoadjuvant FOLFIRINOX, adjuvant chemotherapy may be associated with improved survival. Randomized studies should be conducted to validate this finding.

Citations

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  • The survival effect of neoadjuvant therapy and neoadjuvant plus adjuvant therapy on pancreatic ductal adenocarcinoma patients with different TNM stages: a propensity score matching analysis based on the SEER database
    Hao Hu, Yang Xu, Qiang Zhang, Yuan Gao, Zhenyu Wu
    Expert Review of Anticancer Therapy.2024; 24(6): 467.     CrossRef
  • Neoadjuvant treatment of pancreatic ductal adenocarcinoma: Whom, when and how
    Nebojsa Manojlovic, Goran Savic, Stevan Manojlovic
    World Journal of Gastrointestinal Surgery.2024; 16(5): 1223.     CrossRef
  • Case Study on Analysing the Early Disease Detection of Pancreatic Ductal Adenocarcinoma in Korean Association for Clinical Oncology
    Sijithra Ponnarassery Chandran, N. Santhi
    American Journal of Clinical Oncology.2024; 47(10): 475.     CrossRef
  • Evaluating the benefits of adjuvant chemotherapy in patients with pancreatic cancer undergoing radical pancreatectomy after neoadjuvant therapy—a systematic review and meta-analysis
    Jiahao Wu, Yike Zhang, Haodong Wang, Wenyi Guo, Chengqing Li, Yichen Yu, Han Liu, Feng Li, Lei Wang, Jianwei Xu
    Frontiers in Oncology.2024;[Epub]     CrossRef
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Lung and Thoracic cancer
The Role of Adjuvant Therapy Following Surgical Resection of Small Cell Lung Cancer: A Multi-Center Study
Seong Yong Park, Samina Park, Geun Dong Lee, Hong Kwan Kim, Sehoon Choi, Hyeong Ryul Kim, Yong-Hee Kim, Dong Kwan Kim, Seung-Il Park, Tae Hee Hong, Yong Soo Choi, Jhingook Kim, Jong Ho Cho, Young Mog Shim, Jae Ill Zo, Kwon Joong Na, In Kyu Park, Chang Hyun Kang, Young-Tae Kim, Byung Jo Park, Chang Young Lee, Jin Gu Lee, Dae Joon Kim, Hyo Chae Paik
Cancer Res Treat. 2023;55(1):94-102.   Published online June 9, 2022
DOI: https://doi.org/10.4143/crt.2022.290
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This multi-center, retrospective study was conducted to evaluate the long-term survival in patients who underwent surgical resection for small cell lung cancer (SCLC) and to identify the benefit of adjuvant therapy following surgery.
Materials and Methods
The data of 213 patients who underwent surgical resection for SCLC at four institutions were retrospectively reviewed. Patients who received neoadjuvant therapy or an incomplete resection were excluded.
Results
The mean patient age was 65.29±8.93 years, and 184 patients (86.4%) were male. Lobectomies and pneumonectomies were performed in 173 patients (81.2%), and 198 (93%) underwent systematic mediastinal lymph node dissections. Overall, 170 patients (79.8%) underwent adjuvant chemotherapy, 42 (19.7%) underwent radiotherapy to the mediastinum, and 23 (10.8%) underwent prophylactic cranial irradiation. The median follow-up period was 31.08 months (interquartile range, 13.79 to 64.52 months). The 5-year overall survival (OS) and disease-free survival were 53.4% and 46.9%, respectively. The 5-year OS significantly improved after adjuvant chemotherapy in all patients (57.4% vs. 40.3%, p=0.007), and the survival benefit of adjuvant chemotherapy was significant in patients with negative node pathology (70.8% vs. 39.7%, p=0.004). Adjuvant radiotherapy did not affect the 5-year OS (54.6% vs. 48.5%, p=0.458). Age (hazard ratio [HR], 1.032; p=0.017), node metastasis (HR, 2.190; p < 0.001), and adjuvant chemotherapy (HR, 0.558; p=0.019) were associated with OS.
Conclusion
Adjuvant chemotherapy after surgical resection in patients with SCLC improved the OS, though adjuvant radiotherapy to the mediastinum did not improve the survival or decrease the locoregional recurrence rate.

Citations

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  • Application of postoperative adjuvant radiotherapy in limited-stage small cell lung cancer: A systematic review and meta-analysis
    Chuanhao Zhang, Genghao Zhao, Huajian Wu, Jianing Jiang, Wenyue Duan, Zhijun Fan, Zhe Wang, Ruoyu Wang
    Radiotherapy and Oncology.2024; 193: 110123.     CrossRef
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    Sevcan Atay
    Cancers.2023; 15(21): 5219.     CrossRef
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Gastrointestinal cancer
Adjuvant Imatinib Treatment for 5 Years versus 3 Years in Patients with Ruptured Localized Gastrointestinal Stromal Tumor: A Retrospective Analysis
Sora Kang, Min-Hee Ryu, Yeong Hak Bang, Hyung-Don Kim, Hyung Eun Lee, Yoon-Koo Kang
Cancer Res Treat. 2022;54(4):1167-1174.   Published online December 6, 2021
DOI: https://doi.org/10.4143/crt.2021.1040
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Three years of adjuvant imatinib is the standard treatment for resected gastrointestinal stromal tumors (GISTs) with rupture, but the recurrence rate is prominently high. We aimed to investigate the efficacy and safety of 5-year adjuvant imatinib compared with 3-year treatment in patients with a ruptured GIST following surgical resection.
Materials and Methods
A total of 51 patients were included in the analysis. The assessment of GIST rupture was based on Nishida’s classification. Twenty patients who were diagnosed before November 2013 were treated with 5 years of imatinib, and 31 patients who were diagnosed after November 2013 were treated with 3 years of imatinib. We retrospectively compared the clinical outcomes of the two groups.
Results
Baseline characteristics and the incidence of the adverse events were generally comparable between the two groups. During a median follow-up duration of 43.8 months and 104.2 months in the 3- and 5-year group, 8 and 9 patients had a disease recurrence, respectively. The 5-year group showed better recurrence-free survival (RFS) than the 3-year group. In multivariate analysis, low mitotic index was a significant independent favorable prognostic factor for RFS, while 5-year imatinib treatment was marginally associated with a favorable RFS.
Conclusion
Five years of adjuvant imatinib treatment in patients with ruptured GIST was associated with favorable survival outcomes with manageable toxicity profiles. Our findings warrant validation and confirmation in future studies.

Citations

Citations to this article as recorded by  
  • Clinical importance of tumor rupture in gastrointestinal stromal tumor
    Toshirou Nishida, Naoto Gotouda, Tsuyoshi Takahashi, Hui Cao
    Journal of Digestive Diseases.2024; 25(9-10): 542.     CrossRef
  • Survival of patients with ruptured gastrointestinal stromal tumour treated with adjuvant imatinib in a randomised trial
    Heikki Joensuu, Annette Reichardt, Mikael Eriksson, Peter Hohenberger, Kjetil Boye, Silke Cameron, Lars H. Lindner, Philipp J. Jost, Sebastian Bauer, Jochen Schütte, Stefan Lindskog, Raija Kallio, Panu M. Jaakkola, Dorota Goplen, Eva Wardelmann, Peter Rei
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    Maria M Pereira, Elisabete Couto, Ali Shamseddine, Teresa Macedo
    Cureus.2024;[Epub]     CrossRef
  • Imatinib

    Reactions Weekly.2023; 1960(1): 224.     CrossRef
  • Evaluation of Systemic Treatment Options for Gastrointestinal Stromal Tumours
    Marin Golčić, Robin L. Jones, Paul Huang, Andrea Napolitano
    Cancers.2023; 15(16): 4081.     CrossRef
  • Impact of tumour rupture risk on the oncological rationale for the surgical treatment choice of gastrointestinal stromal tumours
    Nadia Peparini
    World Journal of Gastrointestinal Surgery.2023; 15(8): 1559.     CrossRef
  • Clinical outcomes and prognostic factors for patients with high‐risk gastrointestinal stromal tumors treated with 3‐year adjuvant imatinib
    Yeong Hak Bang, Min‐Hee Ryu, Hyung‐Don Kim, Hyung Eun Lee, Yoon‐Koo Kang
    International Journal of Cancer.2022; 151(10): 1770.     CrossRef
  • Prediction of recurrence-free survival and adjuvant therapy benefit in patients with gastrointestinal stromal tumors based on radiomics features
    Fu-Hai Wang, Hua-Long Zheng, Jin-Tao Li, Ping Li, Chao-Hui Zheng, Qi-Yue Chen, Chang-Ming Huang, Jian-Wei Xie
    La radiologia medica.2022; 127(10): 1085.     CrossRef
  • Development and validation of a prognostic model to predict the prognosis of patients with colorectal gastrointestinal stromal tumor: A large international population-based cohort study
    Yiding Li, Yujie Zhang, Yang Fu, Wanli Yang, Xiaoqian Wang, Lili Duan, Liaoran Niu, Junfeng Chen, Wei Zhou, Jinqiang Liu, Jing Wang, Daiming Fan, Liu Hong
    Frontiers in Oncology.2022;[Epub]     CrossRef
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Lung and Thoracic cancer
The Role of Neutrophil-to-Lymphocyte Ratio in Predicting Pathological Response for Resectable Non–Small Cell Lung Cancer Treated with Neoadjuvant Chemotherapy Combined with PD-1 Checkpoint Inhibitors
Xiaoyan Sun, Yingnan Feng, Bin Zhang, Wuhao Huang, Xiaoliang Zhao, Hua Zhang, Dongsheng Yue, Changli Wang
Cancer Res Treat. 2022;54(4):1017-1029.   Published online November 23, 2021
DOI: https://doi.org/10.4143/crt.2021.1007
AbstractAbstract PDFPubReaderePub
Purpose
The aim of our study was to investigate the value of baseline and preoperative neutrophil-to-lymphocyte ratio (NLR) in predicting the pathological response and disease-free survival (DFS) of neoadjuvant chemotherapy alone or combined with programmed cell death-1 (PD-1) checkpoint inhibitors in patients with resectable non‒small cell lung cancer (NSCLC).
Materials and Methods
Resectable NSCLC patients who underwent neoadjuvant chemotherapy alone or combined with PD-1 checkpoint inhibitors between January 2018 and January 2020 were included. Peripheral venous blood samples of the patients were collected within 3 days prior to the first neoadjuvant treatment and within 3 days prior to surgery.
Results
A total of 79 patients in neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors group and 89 patients in neoadjuvant chemotherapy alone group were included. Thirty-five point four percent of the patients achieved pathological complete response (pCR) in neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors group, whereas only 9.0% reached pCR in the group of neoadjuvant chemotherapy. High NLR level were correlated with poor pathological response and DFS in neoadjuvant chemotherapy or combined with PD-1 checkpoint inhibitors group. Multivariate analysis revealed that baseline NLR could independently predict pathological response and DFS in the neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors group.
Conclusion
High NLR level were correlated with poor pathological response and shorter DFS in patients with NSCLC undergoing neoadjuvant chemotherapy or combined with PD-1 checkpoint inhibitors. Meanwhile, baseline NLR could independently predict response to pathological response and DFS, revealing its potential as a screening tool in NSCLC patients who received neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors.

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  • Circulating biomarkers as predictors of response to immune checkpoint inhibitors in NSCLC: Are we on the right path?
    Calogera Claudia Spagnolo, Francesco Pepe, Giuliana Ciappina, Francesco Nucera, Paolo Ruggeri, Andrea Squeri, Desirèe Speranza, Nicola Silvestris, Umberto Malapelle, Mariacarmela Santarpia
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    Mingming Hu, Xiaomi Li, Haifeng Lin, Baohua Lu, Qunhui Wang, Li Tong, Hongxia Li, Nanying Che, Shaojun Hung, Yi Han, Kang Shi, Chenghai Li, Hongmei Zhang, Zhidong Liu, Tongmei Zhang
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  • Dynamics of peripheral blood inflammatory index predict tumor pathological response and survival among patients with locally advanced non-small cell lung cancer who underwent neoadjuvant immunochemotherapy: a multi-cohort retrospective study
    Wenyu Zhai, Chao Zhang, Fangfang Duan, Jingdun Xie, Shuqin Dai, Yaobin Lin, Qihang Yan, Bingyu Rao, Liang Li, Yuheng Zhou, Zerui Zhao, Hao Long, Junye Wang
    Frontiers in Immunology.2024;[Epub]     CrossRef
  • Predicting Pathologic Complete Response in Locally Advanced Rectal Cancer with [68Ga]Ga-FAPI-04 PET, [18F]FDG PET, and Contrast-Enhanced MRI: Lesion-to-Lesion Comparison with Pathology
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    Journal of Nuclear Medicine.2024; 65(10): 1548.     CrossRef
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    Frontiers in Oncology.2024;[Epub]     CrossRef
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    Zhao Shuang, Xiong Xingyu, Cheng Yue, Yu Mingjing
    The Clinical Respiratory Journal.2024;[Epub]     CrossRef
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    Huan Zhang, Fan Lin, Zhuocai Wang
    BMC Cancer.2023;[Epub]     CrossRef
  • Development and validation of a radiomics-based nomogram for predicting a major pathological response to neoadjuvant immunochemotherapy for patients with potentially resectable non-small cell lung cancer
    Chaoyuan Liu, Wei Zhao, Junpeng Xie, Huashan Lin, Xingsheng Hu, Chang Li, Youlan Shang, Yapeng Wang, Yingjia Jiang, Mengge Ding, Muyun Peng, Tian Xu, Ao’ran Hu, Yuda Huang, Yuan Gao, Xianling Liu, Jun Liu, Fang Ma
    Frontiers in Immunology.2023;[Epub]     CrossRef
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    Zilong Xiao, Xinxin Wang, Xiaoxiao Chen, Jiawei Zhou, Haitao Zhu, Jiangnan Zhang, Wensheng Deng
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • Pan-Immune-Inflammatory Value in Patients with Non-Small-Cell Lung Cancer Undergoing Neoadjuvant Immunochemotherapy
    Wen-Yu Zhai, Fang-Fang Duan, Yao-Bin Lin, Yong-Bin Lin, Ze-Rui Zhao, Jun-Ye Wang, Bing-Yu Rao, Lie Zheng, Hao Long
    Journal of Inflammation Research.2023; Volume 16: 3329.     CrossRef
  • The predictive value of 18F-FDG PET/CT combined with inflammatory index for major pathological reactions in resectable NSCLC receiving neoadjuvant immunochemotherapy
    Xiaoqin Yin, Jian Li, Bei Chen, Kehuang Liu, Shuo Hu
    Lung Cancer.2023; 186: 107389.     CrossRef
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    Yue Zheng, Baijie Feng, Jingyao Chen, Liting You
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    Ana Oitabén, Pablo Fonseca, María J. Villanueva, Carme García-Benito, Aida López-López, Alberto Garrido-Fernández, Clara González-Ojea, Laura Juaneda-Magdalena, Martín E. Lázaro, Mónica Martínez-Fernández
    Cancers.2022; 14(11): 2626.     CrossRef
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Gastrointestinal cancer
Adjuvant Chemotherapy for Resected Ampulla of Vater Carcinoma: Retrospective Analysis of 646 Patients
Jwa Hoon Kim, Jae Ho Jeong, Baek-Yeol Ryoo, Kyu-pyo Kim, Heung-Moon Chang, Dongwook Oh, Tae Jun Song, Sang Soo Lee, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim, Yejong Park, Jae Woo Kwon, Dae Wook Hwang, Jae Hoon Lee, Woohyung Lee, Song Cheol Kim, Changhoon Yoo, Ki Byung Song
Cancer Res Treat. 2021;53(2):424-435.   Published online November 9, 2020
DOI: https://doi.org/10.4143/crt.2020.953
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study evaluated the efficacy of adjuvant chemotherapy (AC) in patients with resected ampulla of Vater (AoV) carcinoma.
Materials and Methods
Data from 646 patients who underwent surgical resection at Asan Medical Center between 2000 and 2017 were retrospectively reviewed.
Results
The median age of the patients was 62 years, and 54.2% were male. Patients were classified into AC group (n=165, 25.5%) and no AC group (n=481, 74.5%). With a median follow-up duration of 88 months, in patients with stage I, II, III, median recurrence-free survival (RFS) was not reached, 44 months, and 15 months, respectively, and the median overall survival (OS) were not reached, 88 months and 35 months, respectively. Despite no statistical significance, RFS and OS were better in stage II patients with AC than in those without AC (median RFS, 151 months vs. 38 months; p=0.156 and median OS, 153 months vs. 74 months; p=0.299). In multivariate analysis for RFS and OS, TNM stage, R1 resection status, presence of lymphovascular invasion, and perineural invasion remained significant factors, whereas AC (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.54 to 1.00; p=0.052) was marginally related with RFS. After propensity score matching in only stage II/III patients, RFS and OS with AC were numerically longer than those without AC (HR, 0.80; 95% CI, 0.60 to 1.06; p=0.116 and HR, 0.77; 95% CI, 0.56 to 1.06; p=0.111).
Conclusion
AC with fluoropyrimidine did not improve survival of patients with resected AoV carcinoma. However, multivariate analysis with prognostic factors showed a marginally significant survival benefit with AC.

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  • Survival benefit of concurrent chemoradiotherapy for advanced ampulla of Vater cancer
    Chae Hwa Kwon, Hyung Il Seo, Dong Uk Kim, Sung Yong Han, Suk Kim, Nam Kyung Lee, Seung Baek Hong, Ji Hyun Ahn, Young Mok Park, Byeong Gwan Noh
    World Journal of Clinical Cases.2024; 12(2): 267.     CrossRef
  • Prognostic efficacy of lymph node parameters in resected ampullary adenocarcinoma based on long-term follow-up data after adjuvant treatment
    Namyoung Park, In Rae Cho, Sang Hyub Lee, Joo Seong Kim, Jin Ho Choi, Min Woo Lee, Woo Hyun Paik, Kwang Ro Joo, Ji Kon Ryu, Yong-Tae Kim
    World Journal of Surgical Oncology.2024;[Epub]     CrossRef
  • Adjuvant Chemotherapy and Effect on Long-Term Survival in Ampullary Adenocarcinoma: A Multicenter Cohort Study
    Dong Woo Shin, Jae Min Lee, Jong-chan Lee, Hee Seung Lee, Seung Bae Yoon, Dong Kee Jang, Joo Kyung Park, Min Kyu Jung, Yoon Suk Lee, Jin-Hyeok Hwang
    Journal of the American College of Surgeons.2023; 237(3): 501.     CrossRef
  • Role of adjuvant chemotherapy on recurrence and survival in patients with resected ampulla of Vater carcinoma
    Se Jun Park, Kabsoo Shin, In-Ho Kim, Tae Ho Hong, Younghoon Kim, Myung-ah Lee
    World Journal of Gastrointestinal Oncology.2023; 15(4): 677.     CrossRef
  • Remission from the 5-Fu-Based Chemotherapy to Gemcitabine-Based Chemotherapy-Based on the Pathological Classification of Periampullary Carcinoma: A Case Report and Literature Review
    Wei Hu, Zhiqing Duan, Yinuo Zhang, Jing Liu, Jing Bao, Ruqing Gao, Yajie Tang, Tiande Liu, Hu Xiong, Wen Li, Xiaowei Fu, Shousheng Liao, Lu Fang, Bo Liang
    OncoTargets and Therapy.2022; Volume 15: 891.     CrossRef
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Gynecologic cancer
A Preoperative Nomogram for Predicting Chemoresistance to Neoadjuvant Chemotherapy in Patients with Locally Advanced Cervical Squamous Carcinoma Treated with Radical Hysterectomy
Zhengjie Ou, Dan Zhao, Bin Li, Yating Wang, Shuanghuan Liu, Yanan Zhang
Cancer Res Treat. 2021;53(1):233-242.   Published online September 14, 2020
DOI: https://doi.org/10.4143/crt.2020.159
AbstractAbstract PDFPubReaderePub
Purpose
This study aimed to investigate the factors associated with chemoresistance to neoadjuvant chemotherapy (NACT) followed by radical hysterectomy (RH) and construct a nomogram to predict the chemoresistance in patients with locally advanced cervical squamous carcinoma (LACSC).
Materials and Methods
This retrospective study included 516 patients with International Federation of Gynecology and Obstetrics (2003) stage IB2 and IIA2 cervical cancer treated with NACT and RH between 2007 and 2017. Clinicopathologic data were collected, and patients were assigned to training (n=381) and validation (n=135) sets. Univariate and multivariate analyses were performed to analyze factors associated with chemoresistance to NACT. A nomogram was built using the multivariate logistic regression analysis results. We evaluated the discriminative ability and accuracy of the model using a concordance index and a calibration curve. The predictive probability of chemoresistance to NACT was defined as > 34%.
Results
Multivariate analysis confirmed menopausal status, clinical tumor diameter, serum squamous cell carcinoma antigen level, and parametrial invasion on magnetic resonance imaging before treatment as independent prognostic factors associated with chemoresistance to NACT. The concordance indices of the nomogram for training and validation sets were 0.861 (95% confidence interval [CI], 0.822 to 0.900) and 0.807 (95% CI, 0.807 to 0.888), respectively. Calibration plots revealed a good fit between the modelpredicted probabilities and actual probabilities (Hosmer-Lemeshow test, p=0.597). Furthermore, grouping based on the nomogram was associated with progression-free survival.
Conclusion
We developed a nomogram for predicting chemoresistance in LACSC patients treated with RH. This nomogram can help physicians make clinical decisions regarding primary management and postoperative follow-up of the patients.

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  • Neoadjuvant chemotherapy with carboplatin and paclitaxel in pregnant women with advanced stage cervical cancer: Maternal and perinatal outcomes
    Bruna Elias Parreira Lopes Ferraz, Roney César Signorini Filho, Lucas Ribeiro Borges Carvalho, Michelle Samora Almeida, Tatiana Carvalho de Souza Bonetti, Edward Araujo Júnior, Antonio Braga, Sue Yazaki Sun
    Journal of Gynecology Obstetrics and Human Reproduction.2025; 54(2): 102890.     CrossRef
  • Are biomarkers expression and clinical-pathological factors predictive markers of the efficacy of neoadjuvant chemotherapy for locally advanced cervical cancer?
    Antonino Ditto, Mariangela Longo, Giulia Chiarello, Luigi Mariani, Biagio Paolini, Umberto Leone Roberti Maggiore, Fabio Martinelli, Giorgio Bogani, Francesco Raspagliesi
    European Journal of Surgical Oncology.2024; 50(6): 108311.     CrossRef
  • A Deep Learning Radiomics Nomogram to Predict Response to Neoadjuvant Chemotherapy for Locally Advanced Cervical Cancer: A Two-Center Study
    Yajiao Zhang, Chao Wu, Zhibo Xiao, Furong Lv, Yanbing Liu
    Diagnostics.2023; 13(6): 1073.     CrossRef
  • Machine Learning-Assisted Ensemble Analysis for the Prediction of Response to Neoadjuvant Chemotherapy in Locally Advanced Cervical Cancer
    Yibao Huang, Qingqing Zhu, Liru Xue, Xiaoran Zhu, Yingying Chen, Mingfu Wu
    Frontiers in Oncology.2022;[Epub]     CrossRef
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Gastrointestinal cancer
Evaluation and Comparison of Predictive Value of Tumor Regression Grades according to Mandard and Becker in Locally Advanced Gastric Adenocarcinoma
Yilin Tong, Yanmei Zhu, Yan Zhao, Zexing Shan, Dong Liu, Jianjun Zhang
Cancer Res Treat. 2021;53(1):112-122.   Published online August 10, 2020
DOI: https://doi.org/10.4143/crt.2020.516
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Tumor regression grade (TRG) has been widely used in gastrointestinal carcinoma to assess pathological responses to neoadjuvant chemotherapy (NCT). There are various standards without a consensus, and it is still unclear which kind of system has better predictive value. This study aims to investigate and compare the predictive ability of the Mandard and Becker TRGs in patients with locally advanced gastric cancer.
Materials and Methods
A total of 290 patients with locally advanced gastric adenocarcinoma who underwent NCT and curative surgery were studied. Survival analysis for overall survival (OS) and disease-free survival (DFS) were based on the Kaplan-Meier method and Cox proportional hazards method. Predictive values of TRGs and models were assessed by time-dependent receiver operating characteristic (ROC) curve, the area under the ROC curve (AUC), nomogram, and calibration curve.
Results
In multivariable analysis, the Mandard TRG was associated with OS (hazard ratio [HR], 1.806; p=0.026) and DFS (HR, 1.792; p=0.017). The Becker TRG was also related to OS (HR, 1.880; p=0.014) and DFS (HR, 1.919; p=0.006). The Mandard and Becker TRG AUCs for 5-year survival were 0.72 and 0.71, respectively. The whole models showed an increased predictive value, with AUCs of 0.85 and 0.86, respectively. There was no significant difference between the two TRGs and two models.
Conclusion
TRG was an independent predictor for survival, and there was no significant difference between these two systems.

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  • CT-Derived Quantitative Image Features Predict Neoadjuvant Treatment Response in Adenocarcinoma of the Gastroesophageal Junction with High Accuracy
    Markus Graf, Sebastian Ziegelmayer, Stefan Reischl, Yannick Teumer, Florian T. Gassert, Alexander W. Marka, Philipp Raffler, Jeannine Bachmann, Marcus Makowski, Daniel Reim, Fabian Lohöfer, Egon Burian, Rickmer Braren
    Cancers.2025; 17(2): 216.     CrossRef
  • Microsatellite instability in gastric cancer: An institutional case series analysis in patients treated with neoadjuvant therapy
    Laura Lorenzon, Alberto Biondi, Gloria Santoro, Annamaria Agnes, Antonio Laurino, Antonia Strippoli, Riccardo Ricci, Roberto Persiani, Domenico D'Ugo
    Clinical Surgical Oncology.2024; 3(1): 100031.     CrossRef
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    Colum Dennehy, Alisha F. Khan, Ali H. Zaidi, Vincent K. Lam
    Cancers.2024; 16(2): 286.     CrossRef
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    Markus Graf, Joshua Gawlitza, Marcus Makowski, Felix Meurer, Thomas Huber, Sebastian Ziegelmayer
    Investigative Radiology.2024; 59(8): 583.     CrossRef
  • Deep learning nomogram for predicting neoadjuvant chemotherapy response in locally advanced gastric cancer patients
    Jingjing Zhang, Qiang Zhang, Bo Zhao, Gaofeng Shi
    Abdominal Radiology.2024; 49(11): 3780.     CrossRef
  • Intratumoral heterogeneity affects tumor regression and Ki67 proliferation index in perioperatively treated gastric carcinoma
    Magnus Kock am Brink, Laura Sophie Dunst, Hans-Michael Behrens, Sandra Krüger, Thomas Becker, Christoph Röcken
    British Journal of Cancer.2023; 128(2): 375.     CrossRef
  • Time to Surgery does not Affect Oncologic Outcomes in Locally Advanced Gastric Cancer after Neoadjuvant Chemotherapy: A Meta-Analysis
    Zining Liu, Zhening Zhang, Hua Liu, Junbing Chen
    Future Oncology.2023; 19(5): 397.     CrossRef
  • Response Evaluation after Neoadjuvant Chemotherapy for Resectable Gastric Cancer
    Alina Desiree Sandø, Reidun Fougner, Elin Synnøve Røyset, Hong Yan Dai, Jon Erik Grønbech, Erling Audun Bringeland
    Cancers.2023; 15(8): 2318.     CrossRef
  • Profiling complete regression after pre-operative therapy in gastric cancer patients using clinical and pathological data
    Alberto Biondi, Laura Lorenzon, Gloria Santoro, Annamaria Agnes, Antonio Laurino, Roberto Persiani, Domenico D'Ugo
    European Journal of Surgical Oncology.2023; 49(11): 106969.     CrossRef
  • Concurrent clinical and pathological response predicts favorable prognosis of patients with gastric cancer after neoadjuvant therapy: a real-world study
    Chongyuan Sun, Penghui Niu, Xiaojie Zhang, Lulu Zhao, Wanqing Wang, Xiaoyi Luan, Xue Han, Yingtai Chen, Dongbing Zhao
    BMC Cancer.2023;[Epub]     CrossRef
  • Sintilimab Plus Fluorouracil, Leucovorin, Oxaliplatin and Docetaxel Regimen as Neoadjuvant Therapy for Resectable Gastric Cancer and Biomarker Exploration
    Jiangpeng Wei, Xin Guo, Xisheng Yang, Jinqiang Liu, Qianqian Duan, Yuan Tan, Qin Zhang, Tingting Sun, Chuang Qi, Xiaohua Li, Gang Ji
    Future Oncology.2023; 19(36): 2395.     CrossRef
  • Evaluation of dual-energy CT derived radiomics signatures in predicting outcomes in patients with advanced gastric cancer after neoadjuvant chemotherapy
    Yong Chen, Fei Yuan, Lingyun Wang, Elsie Li, Zhihan Xu, Michael Wels, Weiwu Yao, Huan Zhang
    European Journal of Surgical Oncology.2022; 48(2): 339.     CrossRef
  • MORBIDITY AND SURVIVAL AFTER PERIOPERATIVE CHEMOTHERAPY IN GASTRIC CANCER: A STUDY USING THE BECKER’S CLASSIFICATION AND REGRESSION
    Maria Cecília de Aguiar MACHADO, José Pedro Coimbra de Vargas Lobarinhas BARBOSA, Filipa Ferreira de OLIVEIRA, José Adelino Lobarinhas BARBOSA
    ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo).2022;[Epub]     CrossRef
  • Validating a nodal regression system for gastric cancer: An ancillary cohort study of the GASTRODOC trial
    Luca Saragoni, Leonardo Solaini, Daniele Marrelli, Maria Raffaella Ambrosio, Maria Bencivenga, Anna Tomezzoli, Carlo Milandri, Valentina Terrinazzi, Gian Luca Baiocchi, Carla Baronchelli, Flavia Foca, Giorgio Ercolani, Paolo Morgagni
    International Journal of Surgery.2021; 94: 106112.     CrossRef
  • Comparison of tumor regression grading systems for locally advanced gastric adenocarcinoma after neoadjuvant chemotherapy
    Zi-Ning Liu, Yin-Kui Wang, Li Zhang, Yong-Ning Jia, Shan Fei, Xiang-Ji Ying, Yan Zhang, Shuang-Xi Li, Yu Sun, Zi-Yu Li, Jia-Fu Ji
    World Journal of Gastrointestinal Oncology.2021; 13(12): 2161.     CrossRef
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Adjuvant Chemotherapy in Microsatellite Instability–High Gastric Cancer
Jin Won Kim, Sung-Yup Cho, Jeesoo Chae, Ji-Won Kim, Tae-Yong Kim, Keun-Wook Lee, Do-Youn Oh, Yung-Jue Bang, Seock-Ah Im
Cancer Res Treat. 2020;52(4):1178-1187.   Published online June 11, 2020
DOI: https://doi.org/10.4143/crt.2020.313
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Microsatellite instability (MSI) status may affect the efficacy of adjuvant chemotherapy in gastric cancer. In this study, the clinical characteristics of MSI-high (MSI-H) gastric cancer and the predictive value of MSI-H for adjuvant chemotherapy in large cohorts of gastric cancer patients were evaluated. Material and Methods This study consisted of two cohorts. Cohort 1 included gastric cancer patients who received curative resection with pathologic stage IB-IIIC. Cohort 2 included patients with MSI-H gastric cancer who received curative resection with pathologic stage II/III. MSI was examined using two mononucleotide markers and three dinucleotide markers.
Results
Of 359 patients (cohort 1), 41 patients (11.4%) had MSI-H. MSI-H tumors were more frequently identified in older patients (p < 0.001), other histology than poorly cohesive, signet ring cell type (p=0.005), intestinal type (p=0.028), lower third tumor location (p=0.005), and absent perineural invasion (p=0.027). MSI-H status has a tendency of better disease-free survival (DFS) and overall survival (OS) in multivariable analyses (hazard ratio [HR], 0.4; p=0.059 and HR, 0.4; p=0.063, respectively). In the analysis of 162 MSI-H patients (cohort 2), adjuvant chemotherapy showed a significant benefit with respect to longer DFS and OS (p=0.047 and p=0.043, respectively). In multivariable analysis, adjuvant chemotherapy improved DFS (HR, 0.4; p=0.040).
Conclusion
MSI-H gastric cancer had distinct clinicopathologic findings. Even in MSI-H gastric cancer of retrospective cohort, adjuvant chemotherapy could show a survival benefit, which was in contrast to previous prospective studies and should be investigated in a further prospective trial.

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    Katherine I. Zhou, Brent A. Hanks, John H. Strickler
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    Journal of Inflammation Research.2023; Volume 16: 4373.     CrossRef
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    Satya Das, Taymeyah Al-Toubah, Jonathan Strosberg
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  • 20 Web of Science
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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
AbstractAbstract PDFPubReaderePub
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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  • Ovarian clear cell carcinoma: open questions on the management and treatment algorithm
    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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    Daichi Kodama, Motoki Takenaka, Chiemi Saigo, Masako Azuma, Yuki Hanamatsu, Masanori Isobe, Tamotsu Takeuchi
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    Mengqi Huang, Li Ling, Yanbo Liu, Yujuan Li
    Clinical and Experimental Obstetrics & Gynecology.2024;[Epub]     CrossRef
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    Li Shuqing, Zhu Zhiling
    Cancer Medicine.2023; 12(6): 6668.     CrossRef
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    Hamidreza Didar, Farah Farzaneh, Hanieh Najafiarab, Kosar Namakin, Kimiya Gohari, Ali Sheidaei, Sepehr Ramezani
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    Yuan Zhuang, Hua Yang
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    Satoe Fujiwara
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    Caner ÇAKIR, Fatih KILIÇ, Çiğdem KILIÇ, Dilek YÜKSEL, Vakkas KORKMAZ, Günsu KİMYON CÖMERT, Osman TÜRKMEN, Taner TURAN
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S-1 Based Doublet as an Adjuvant Chemotherapy for Curatively Resected Stage III Gastric Cancer: Results from the Randomized Phase III POST Trial
Choong-kun Lee, Minkyu Jung, Hyo Song Kim, Inkyung Jung, Dong Bok Shin, Seok Yun Kang, Dae Young Zang, Ki Hyang Kim, Moon Hee Lee, Bong-Seog Kim, Kyung Hee Lee, Jae-Ho Cheong, Woo Jin Hyung, Sung Hoon Noh, Hyun Cheol Chung, Sun Young Rha
Cancer Res Treat. 2019;51(1):1-11.   Published online February 5, 2018
DOI: https://doi.org/10.4143/crt.2018.028
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We conducted a randomized, multicenter, phase III trial to compare S-1 plus docetaxel (DS) with S-1 plus cisplatin (SP) as adjuvant chemotherapy for stage III gastric cancer patients.
Materials and Methods
Stage III gastric cancer patients who had received curative gastrectomy with D2 lymphadenectomy were randomized into equal groups to receive adjuvant chemotherapy of eight cycles of DS (S-1 70 mg/m2 /day on days 1-14 plus docetaxel 35 mg/m2 on days 1 and 8) every 3 weeks or SP (S-1 70 mg/m2 /day on days 1-14 plus cisplatin 60 mg/m2 on day 1) every 3 weeks. The primary endpoint was 3-year disease-free survival (DFS) rate.
Results
Between November 2010 and July 2013, 153 patients (75 patients to DS and 78 patients to SP) were enrolled from 8 institutions in Korea. After the capecitabine plus oxaliplatin was approved based on the CLASSIC study, itwas decided to close the study early. With a median follow-up duration of 56.9 months, the 3-year DFS rate between two groups was not significantly different (49.14% in DS group vs. 52.5% in SP group). The most common grade 3-4 adverse event was neutropenia (42.7% in DS and 38.5% in SP, p=0.351). SP group had more grade 3-4 anemia (1.3% vs. 11.5%, p=0.037), whereas grade 3-4 hand-foot syndrome (4.1% vs. 0%, p=0.025) and mucositis (10.7% vs. 2.6%, p=0.001) were more common in DS group. Fifty-one patients (68%) in DS group and 52 (66.7%) in SP group finished planned treatment.
Conclusion
Our findings suggest that SP or DS is an effective and tolerable option for patients with curatively resected stage III gastric cancer.

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Effect of Adjuvant Chemotherapy on Stage II Colon Cancer: Analysis of Korean National Data
Min Ki Kim, Daeyoun David Won, Sun Min Park, Taejung Kim, Sung Ryong Kim, Seong Taek Oh, Seung Kook Sohn, Mi Yeon Kang, In Kyu Lee
Cancer Res Treat. 2018;50(4):1149-1163.   Published online December 7, 2017
DOI: https://doi.org/10.4143/crt.2017.194
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Debates exist regarding the effectiveness of adjuvant chemotherapy for stage II colon cancer. This study aimed to investigate the current status of adjuvant chemotherapy and its impact on survival for Korean stage II colon cancer patients by analyzing the National Quality Assessment data.
Materials and Methods
A total of 7,880 patientswho underwent curative resection for stage II colon adenocarcinoma between January 2011 andDecember 2014 in Koreawere selected randomly as evaluation subjects for the quality assessment. The factors that influenced overall survival were identified. The high-risk group was defined as having at least one of the following: perforation/ obstruction, lymph node harvest less than 12, lymphovascular/perineural invasion, positive resection margin, poor differentiation, or pathologic T4 stage.
Results
The median follow-up period was 38 months (range, 1 to 63 months). Chemotherapy was a favorable prognostic factor for either the high- (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.38 to 0.59; p < 0.001) or low-risk group (HR, 0.74; 95% CI, 0.61 to 0.89; p=0.002) in multivariate analysis. This was also the case in patients over 70 years of age. The hazard ratio was significantly increased as the number of involved risk factors was increased in patients who didn’t receive chemotherapy. Adding oxaliplatin showed no difference in survival (HR, 1.36; 95% CI, 0.91 to 2.03; p=0.132).
Conclusion
Adjuvant chemotherapy can be recommended for stage II colon cancer patients, but the addition of oxaliplatin to the regimen must be selective.

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Survival Nomograms after Curative Neoadjuvant Chemotherapy and Radical Surgery for Stage IB2-IIIB Cervical Cancer
Claudia Marchetti, Francesca De Felice, Anna Di Pinto, Alessia Romito, Angela Musella, Innocenza Palaia, Marco Monti, Vincenzo Tombolin, Ludovico Muzii, PierLuigi Benedetti Panici
Cancer Res Treat. 2018;50(3):768-776.   Published online July 19, 2017
DOI: https://doi.org/10.4143/crt.2017.141
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to develop nomograms for predicting the probability of overall survival (OS) and progression-free survival (PFS) in locally advanced cervical cancer treated with neoadjuvant chemotherapy and radical surgery.
Materials and Methods
Nomograms to predict the 5-year OS rates and the 2-year PFS rates were constructed. Calibration plots were constructed, and concordance indices were calculated. Evaluated variableswere body mass index, age, tumor size, tumor histology, grading, lymphovascular space invasion, positive parametria, and positive lymph nodes.
Results
In total 245 patients with locally advanced cervical cancer who underwent neoadjuvant chemotherapy and radical surgery were included for the construction of the nomogram. The 5-year OS and PFS were 72.6% and 66%, respectively. Tumor size, grading, and parametria status affected the rate of OS, whereas tumor size and positive parametria were the main independent PFS prognostic factors.
Conclusion
We constructed a nomogram based on clinicopathological features in order to predict 2-year PFS and 5-year OS in locally advanced cervical cancer primarily treated with neoadjuvant chemotherapy followed by radical surgery. This tool might be particularly helpful for assisting in the follow-up of cervical cancer patients who have not undergone concurrent chemoradiotherapy.

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Effect of Adjuvant Chemotherapy after Complete Resection for Pathologic Stage IB Lung Adenocarcinoma in High-Risk Patients as Defined by a New Recurrence Risk Scoring Model
Hyo Joon Jang, Sukki Cho, Kwhanmien Kim, Sanghoon Jheon, Hee Chul Yang, Dong Kwan Kim
Cancer Res Treat. 2017;49(4):898-905.   Published online January 18, 2017
DOI: https://doi.org/10.4143/crt.2016.312
AbstractAbstract PDFPubReaderePub
Purpose
We conducted a retrospective analysis to determine if adjuvant chemotherapy prolongs overall survival in patients with pathologic stage IB lung adenocarcinoma who had undergone complete resection and were defined as high-risk by a newly developed recurrence risk scoring model.
Materials and Methods
Patientswho underwent curative resection for stage IB lung adenocarcinomawere analyzed with a newly developed recurrence risk scoring model and divided into a low-risk group and a high-risk group. The patients in the high-risk group were retrospectively divided into two groups based on whether they underwent adjuvant chemotherapy or observation. Recurrence-free survival and overall survival were compared between these two groups.
Results
A total of 328 patients who underwent curative resection between 2000 and 2009 were included in this study, of whom 110 (34%) received adjuvant chemotherapy and 218 (67%) underwent observation without additional treatment. According to our risk model, 167 patients (51%) were high-risk and 161 (49%) were low-risk. The 5-year recurrence-free survival rates and overall survival were 84.4% and 91.5% in low-risk patients and 53.9% and 74.7% in high-risk patients (p < 0.001). In high-risk patients, the 5-year overall survival rates were 77% among patients who underwent observation and 87% among those who underwent adjuvant chemotherapy (p=0.019).
Conclusion
Adjuvant chemotherapy prolonged overall survival among high-risk patients who had undergone complete resection for stage IB lung adenocarcinoma.

Citations

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  • Influence of adjuvant chemotherapy on survival for patients with completely resected high-risk stage IB NSCLC
    Zi-Qing Shen, Kun-Peng Feng, Zi-Yao Fang, Tian Xia, Shu Pan, Cheng Ding, Chun Xu, Sheng Ju, Jun Chen, Chang Li, Jun Zhao
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Role of Adjuvant Thoracic Radiation Therapy and Full Dose Chemotherapy in pN2 Non-small Cell Lung Cancer: Elucidation Based on Single Institute Experience
Hyojung Park, Dongryul Oh, Yong Chan Ahn, Hongryull Pyo, Jae Myung Noh, Jong-Mu Sun, Jin Seok Ahn, Myung-Ju Ahn, Keunchil Park, Hong Kwan Kim, Yong Soo Choi, Jhingook Kim, Jae Ill Zo, Young Mog Shim
Cancer Res Treat. 2017;49(4):880-889.   Published online December 12, 2016
DOI: https://doi.org/10.4143/crt.2016.442
AbstractAbstract PDFPubReaderePub
Purpose
The optimal adjuvant therapy modality for treating pN2 non-small cell lung cancer patients has not yet been established. In this study, the authors investigated clinical outcomes following three different adjuvant therapy modalities.
Materials and Methods
From January 2006 to December 2012, 240 patients with cN0/1 disease were found to have pN2 disease following curative resection and received one of three adjuvant therapy modalities:thoracic radiation therapy (TRT) and concurrent chemotherapy (CTx) (CCRT) (group I), CCRT plus consolidation CTx (group II), and CTx alone (group III). TRT was delivered to 155 patients (groups I/II), and full dose CTxwas delivered to 172 patients either as a consolidative or a sole modality (group II/III).
Results
During 30 months of median follow-up, 44 patients died and 141 developed recurrence. The 5-year overall survival (OS), locoregional control (LRC), distant metastasis-free survival (DMFS), and disease-free survival (DFS) rates of all patients were 76.2%, 80.7%, 36.4%, and 29.6%, respectively. There was no difference in OS among groups. TRT (groups I/II) significantly improved LRC, full dose CTx (groups II/III) did DMFS, and CCRT plus consolidation CTx (group II) did DFS, respectively.
Conclusion
The current study could support that TRT could improve LRC and full dose CTx could improve DMFS and that CCRT plus consolidation CTx could improve DFS.

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    Dailong Li, Wanqiang Li, Yaqi Pang, Lu Xu, Xinhua Xu
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    Zexu Wang, Baixia Yang, Ping Zhan, Li Wang, Bing Wan
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FGFR4 Arg388 Is Correlated with Poor Survival in Resected Colon Cancer Promoting Epithelial to Mesenchymal Transition
Sang Hee Cho, Chang Soo Hong, Hee Nam Kim, Min Ho Shin, Ka Rham Kim, Hyun Jeong Shim, Jun Eul Hwang, Woo Kyun Bae, Ik Joo Chung
Cancer Res Treat. 2017;49(3):766-777.   Published online November 9, 2016
DOI: https://doi.org/10.4143/crt.2016.457
AbstractAbstract PDFPubReaderePub
Purpose
Fibroblast growth factor receptor 4 (FGFR4) plays an important role in cancer progression during tumor proliferation, invasion, and metastasis. This study evaluated the prognostic role of FGFR4 polymorphism in patientswith resected colon cancer, including the underlying mechanism.
Materials and Methods
FGFR4 polymorphism was characterized in patientswho received curative resection for stage III colon cancer. FGFR4-dependent signal pathways involving cell proliferation, invasion, and migration according to genotypes were also evaluated in transfected colon cancer cell lines.
Results
Among a total of 273 patients, the GG of FGFR4 showed significantly better overall survival than the AG or AA, regardless of adjuvant treatment. In the group of AG or AA, combination of folinic acid, fluorouracil, and oxaliplatin (FOLFOX) resulted in better survival than fluorouracil/leucovorin or no adjuvant chemotherapy. However, in GG, there was no difference among treatment regimens. Using multivariate analyses, the Arg388 carriers, together with age, N stage, poor differentiation, absence of a lymphocyte response, and no adjuvant chemotherapy, had a significantly worse OS than patients with the Gly388 allele. In transfected colon cancer cells, overexpression of Arg388 significantly increased cell proliferation and changes in epithelial to mesenchymal transition markers compared with cells overexpressing the Gly388 allele.
Conclusion
The Arg388 allele of FGFR4 may be a biomarker and a candidate target for adjuvant treatment of patients with resected colon cancer.

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A Randomized Phase II Study of Leucovorin/5-Fluorouracil with or without Oxaliplatin (LV5FU2 vs. FOLFOX) for Curatively-Resected, Node-Positive Esophageal Squamous Cell Carcinoma
Sung Hee Lim, Young Mog Shim, Se Hoon Park, Hong Kwan Kim, Young Soo Choi, Myung-Ju Ahn, Keunchil Park, Jae Ill Zo, Jong-Mu Sun
Cancer Res Treat. 2017;49(3):816-823.   Published online November 9, 2016
DOI: https://doi.org/10.4143/crt.2016.417
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The optimal perioperative treatment for resectable esophageal squamous cell carcinoma (ESCC) remains controversial. We evaluated the efficacy and safety of leucovorin and 5-fluorouracil (LV5FU2) and LV5FU2 plus oxaliplatin (FOLFOX) combination chemotherapies administered adjuvantly for curatively-resected, node-positive ESCC.
Materials and Methods
Patients with pathologically node-positive esophageal cancer after curative R0 resection were enrolled and randomly assigned to receive LV5FU2 or FOLFOX biweekly for up to eight cycles. The primary endpoint was disease-free survival (DFS).
Results
Between 2011 and 2015, 62 patients were randomized into the two treatment groups (32 in the LV5FU2 arm and 30 in the FOLFOX arm). The median age was 60 years and both groups had similar pathologic characteristics in tumor, nodal status, and location. Treatment completion rates were similarly high in both groups. The DFS rate at 12 months was 67% in the LV5FU2 group and 63% in the FOLFOX group with a hazard ratio of 1.3 (95% confidence interval [CI], 0.66 to 2.62). After a median follow-up period of 27 months, the median DFS was 29.6 months (95% CI, 4.9 to 54.2) in the LV5FU2 arm and 16.8 months (95% CI, 7.5 to 26.1) in the FOLFOX arm (p=0.428), respectively, while the median overall survival was not reached in either arm. Grade 3 or 4 neutropenia was more frequent in patients in the FOLFOX arm than the LV5FU2 arm (20.0% vs. 3.1%).
Conclusion
The addition of oxaliplatin (FOLFOX) did not lead to better efficacy compared to LV5FU2 chemotherapy in an adjuvant setting in node-positive ESCC patients.

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Meta-Analysis
Adjuvant Chemotherapy for Advanced Gastric Cancer in Elderly and Non-elderly Patients: Meta-Analysis of Randomized Controlled Trials
Seong-Hwan Chang, Soo-Nyung Kim, Hye Jung Choi, Misuk Park, Rock Bum Kim, Se-Il Go, Won Sup Lee
Cancer Res Treat. 2017;49(1):263-273.   Published online July 5, 2016
DOI: https://doi.org/10.4143/crt.2016.054
AbstractAbstract PDFPubReaderePub
Purpose
This study evaluated the benefits of adjuvant chemotherapy on elderly patients with advanced gastric cancer (AGC) using meta-analysis of well-designed randomized controlled clinical studies.
Materials and Methods
PubMed, Embase, and Cochrane were searched to retrieve clinical studies evaluating the benefits of adjuvant chemotherapy in the elderly with AGC. Hazards ratios (HRs) with 95% confidence intervals (CIs) were pooled across studies using a fixed-effects model.
Results
Two studies were included in this meta-analysis to estimate HR for the overall survival (OS), and relapse-free survival (RFS) between adjuvant chemotherapy and surgery in elderly and non-elderly patients. HR for OS in the elderly and non-elderly was 0.745 (95% CI, 0.552 to 1.006, p=0.055) and 0.636 (95% CI, 0.522 to 0.776; p < 0.001), respectively, which showed no heterogeneity regarding HR between the two groups (pinteraction=0.389). HR for RFS in the elderly and non-elderly was 0.613 (95% CI, 0.466 to 0.806; p < 0.001) and 0.633 (95% CI, 0.533 to 0.753; p < 0.001), respectively (pinteraction=0.846).
Conclusion
Meta-analysis suggests that the benefit of adjuvant chemotherapy to the elderly is not big enough to reach statistical significance while the HR for OS is less than 1 (0.745) and no heterogeneity are observed regarding the HR between the elderly and non-elderly patients.

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Original Articles
Locoregional Recurrence by Tumor Biology in Breast Cancer Patients after Preoperative Chemotherapy and Breast Conservation Treatment
Eunjin Jwa, Kyung Hwan Shin, Ja Young Kim, Young Hee Park, So-Youn Jung, Eun Sook Lee, In Hae Park, Keun Seok Lee, Jungsil Ro, Yeon-Joo Kim, Tae Hyun Kim
Cancer Res Treat. 2016;48(4):1363-1372.   Published online February 18, 2016
DOI: https://doi.org/10.4143/crt.2015.456
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study is to determine whether breast cancer subtype can affect locoregional recurrence (LRR) and ipsilateral breast tumor recurrence (IBTR) after neoadjuvant chemotherapy (NAC) and breast-conserving therapy (BCT). Materials and Methods We evaluated 335 consecutive patients with clinical stage II-III breast cancer who received NAC plus BCT from 2002 to 2009. Patients were classified according to six molecular subtypes: luminal A (hormone receptor [HR]+/HER2–/Ki-67 < 15%, n=113), luminal B1 (HR+/HER2–/Ki-67 ≥ 15%, n=33), luminal B2 (HR+/HER2+, n=83), HER2 with trastuzumab (HER2[T+]) (HR–/HER2+/use of trastuzumab, n=14), HER2 without trastuzumab (HER2[T–]) (HR–/HER2+, n=31), and triple negative (TN) (HR–/HER2–, n=61).
Results
After a median follow-up period of 7.2 years, 26 IBTRs and 37 LRRs occurred. The 5-year LRR-free survival rates were luminal A, 96.4%; B1, 93.9%; B2, 90.3%; HER2(T+), 92.9%; HER2(T–), 78.3%; and TN, 79.6%. The 5-year IBTR-free survival rates were luminal A, 97.2%; B1, 93.9%; B2, 92.8%; HER2(T+), 92.9%; HER2(T–), 89.1%; and TN, 84.6%. In multivariate analysis, HER2(T–) (IBTR: hazard ratio, 4.2; p=0.04 and LRR: hazard ratio, 7.6; p < 0.01) and TN subtypes (IBTR: hazard ratio, 6.9; p=0.01 and LRR: hazard ratio, 8.1; p < 0.01) were associated with higher IBTR and LRR rates. A pathologic complete response (pCR) was found to show correlation with better LRR and a tendency toward improved IBTR controls in TN patients (IBTR, p=0.07; LRR, p=0.03). Conclusion The TN and HER2(T–) subtypes predict higher rates of IBTR and LRR after NAC and BCT. A pCR is predictive of improved IBTR or LRR in TN subtype.

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Is There a Role for Adjuvant Therapy in R0 Resected Gallbladder Cancer?: A Propensity Score-Matched Analysis
Se-Il Go, Young Saing Kim, In Gyu Hwang, Eun Young Kim, Sung Yong Oh, Jun Ho Ji, Haa-Na Song, Se Hoon Park, Joon Oh Park, Jung Hun Kang
Cancer Res Treat. 2016;48(4):1274-1285.   Published online February 12, 2016
DOI: https://doi.org/10.4143/crt.2015.502
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study is to assess the role of adjuvant therapy in stage I-III gallbladder cancer (GBC) patients who have undergone R0 resection.
Materials and Methods
Clinical data were collected on 441 consecutive patients who underwent R0 resection for stage I-III GBC. Eligible patients were classified into adjuvant therapy and surveillance only groups. Propensity score matching (PSM) between the two groups was performed, adjusting clinical factors.
Results
In total, 84 and 279 patients treated with adjuvant therapy and followed up with surveillance only, respectively, were included in the analysis. Before PSM, the 5-year relapse-free survival (RFS) rate was lower in the adjuvant therapy group than in the surveillance only group (50.8% vs. 74.8%, p < 0.001), although there was no statistically significant difference in the 5-year overall survival (OS) rate (66.2% vs. 79.5%, p=0.089). After the PSM, baseline characteristics became comparable and there were no differences in the 5-year RFS (50.8% vs. 64.8%, p=0.319) and OS (66.2% vs. 70.4%, p=0.703) rates between the two groups.
Conclusion
The results suggest that fluoropyrimidine-based adjuvant therapy is not indicated in stage I-III GBC patients who have undergone R0 resection.

Citations

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  • Prospective Randomized Controlled Trial Comparing Adjuvant Chemotherapy vs. No Chemotherapy for Patients with Carcinoma of Gallbladder Undergoing Curative Resection
    Sundeep Singh Saluja, Phani Kumar Nekarakanti, Pramod Kumar Mishra, Anurita Srivastava, Kishore Singh
    Journal of Gastrointestinal Surgery.2022; 26(2): 398.     CrossRef
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    Xiuqiong Chen, Fanqiao Meng, Hua Xiong, Yanmei Zou
    Frontiers in Oncology.2021;[Epub]     CrossRef
  • Current standards and future perspectives in adjuvant treatment for biliary tract cancers
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    Jung Ho Im, Woo Jung Lee, Chang Moo Kang, Ho Kyoung Hwang, Jinsil Seong
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  • Prognostic Factors for Operated Gallbladder Cancer
    Bala Basak Oven Ustaalioglu, Ahmet Bilici, Mesut Seker, Umut Kefeli, Dincer Aydin, Serkan Celik, Tarik Demir, Burcak Erkol
    Journal of Gastrointestinal Cancer.2019; 50(3): 451.     CrossRef
  • Role of Adjuvant Chemotherapy in Resected T2N0 Gall Bladder Cancer
    Abhay K. Kattepur, Shraddha Patkar, Mahesh Goel, Anant Ramaswamy, Vikas Ostwal
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The Frequency of and Risk Factors for the Use of Bisphosphonates in the Adjuvant Setting of Primary Breast Cancer in Germany
Eva-Maria Fick, Alexander Katalinic, Annika Waldmann
Cancer Res Treat. 2015;47(4):747-756.   Published online January 5, 2015
DOI: https://doi.org/10.4143/crt.2014.099
AbstractAbstract PDFPubReaderePub
Purpose
The aim of this cross-sectional health care study (use of bisphosphonates in primary tumors of the mammae, EBisMa) is to determine how often bisphosphonate medication is used in patients with non-metastatic primary breast cancer treatment, but who do not suffer from osteoporosis. Furthermore, we describe patients’ characteristics and the most frequently used type of bisphosphonate in adjuvant therapy.
Materials and Methods
The study population included primary breast cancer patients of four breast centers in northern Germany. Data on bisphosphonate therapy were collected by use of patient questionnaires; clinical data were extracted from the registers. Patients with and without prescribed bisphosphonate adjuvant treatment were tested for statistically significant differences regarding their characteristics.
Results
Four hundred seventy-four of 663 contacted patients participated in the study. Thirty-nine out of 474 patients (9.6%) were on adjuvant bisphosphonate therapy. Zoledronic acid was the most frequently reported bisphosphonate used for prevention of bone metastases. Compared to patients who did not report bisphosphonate medication, women who did report bisphosphonate therapy had a significantly higher advanced tumor stage (p < 0.001). Both the T2-T4 stage and N+ stage remained significant predictors in multivariate-adjusted regression models.
Conclusion
Bisphosphonates are rarely used in the adjuvant treatment of primary breast cancer. Patients with advanced tumor stage were more likely to use bisphosphonates in the adjuvant treatment of primary breast cancer. Further research is needed to identify patients who may benefit most from adjuvant bisphosphonate treatment.

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  • Osteonecrosis of the jaw and survival of patients with cancer: a nationwide cohort study in Denmark
    Priscila Corraini, Uffe Heide‐Jørgensen, Morten Schiødt, Sven Erik Nørholt, John Acquavella, Henrik Toft Sørensen, Vera Ehrenstein
    Cancer Medicine.2017; 6(10): 2271.     CrossRef
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Breast Cancer–Related Lymphedema after Neoadjuvant Chemotherapy
Myungsoo Kim, In Hae Park, Keun Seok Lee, Jungsil Ro, So-Youn Jung, Seeyoun Lee, Han-Sung Kang, Eun Sook Lee, Tae Hyun Kim, Kwan Ho Cho, Kyung Hwan Shin
Cancer Res Treat. 2015;47(3):416-423.   Published online November 17, 2014
DOI: https://doi.org/10.4143/crt.2014.079
AbstractAbstract PDFPubReaderePub
Purpose
The risk for lymphedema (LE) after neoadjuvant chemotherapy (NCT) in breast cancer patients has not been fully understood thus far. This study is conducted to investigate the incidence and time course of LE after NCT. Materials and Methods A total of 313 patients with clinically node-positive breast cancer who underwent NCT followed by surgery with axillary lymph node (ALN) dissection from 2004 to 2009 were retrospectively analyzed. All patients received breast and supraclavicular radiation therapy (SCRT). The determination of LE was based on both objective and subjective methods, as part of a prospective database. Results At a median follow-up of 5.6 years, 132 patients had developed LE: 88 (28%) were grade 1; 42 (13%) were grade 2; and two (1%) were grade 3. The overall 5-year cumulative incidence of LE was 42%. LE first occurred within 6 months after surgery in 62%; 1 year in 77%; 2 years in 91%; and 3 years in 96%. In a multivariate analysis, age (hazard ratio [HR], 1.66; p < 0.01) and the number of dissected ALNs (HR, 1.68; p < 0.01) were independent risk factors for LE. Patients with both of these risk factors showed a significantly higher 5-year cumulative incidence of LE compared with patients with no or one risk factor (61% and 37%, respectively; p < 0.001). The addition of adjuvant chemotherapy did not significantly correlate with LE. Conclusion LE after NCT, surgery, and SCRT developed early after treatment, and with a high incidence rate. More frequent surveillance of arm swelling may be necessary in patients after NCT, especially during the first few years of follow-up.

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The Clinical Impact of 21-Gene Recurrence Score on Treatment Decisions for Patients with Hormone Receptor-Positive Early Breast Cancer in Korea
Moo Hyun Lee, Wonshik Han, Jeong Eon Lee, Ku Sang Kim, Heeseung Park, Jongjin Kim, Soo Youn Bae, Hyun Joo Shin, Jong Won Lee, Eun Sook Lee
Cancer Res Treat. 2015;47(2):208-214.   Published online September 11, 2014
DOI: https://doi.org/10.4143/crt.2013.223
AbstractAbstract PDFPubReaderePub
Purpose
The 21-gene (Oncotype DX) recurrence score (RS) assay is useful in predicting the benefits of adjuvant chemotherapy for early breast cancer patients and is widely used in Western countries. However, to date, it has not gained much popularity in East Asia. We analyzed the results from five institutions’ experience from using the 21-gene assay and examined the impact of assay results on decision making of chemotherapy in Korean breast cancer patients and the associations between RS and clinicopathologic characteristics.
Materials and Methods
The 21-gene assay was performed on 212 patients with estrogen receptor-positive early breast cancer in five institutions. Each center made systemic treatment decisions both before and after the knowledge of assay results.
Results
Among the 212 patients, 132 (62.3%) had a low RS of < 18, 60 (28.3%) had an intermediate RS of 18-30, and 20 (9.4%) had a high RS of ≥ 31. Histologic grade, presence of micrometastases, Ki-67, and presence of lymphatic invasion were statistically associated with the RS results. Treatment decisions were changed in 115 of 212 patients (54.2%) in 109 of 212 (51.4%) from chemotherapy plus hormone therapy to hormone therapy, and in six of 212 (2.8%) from hormone therapy to chemotherapy plus hormone therapy.
Conclusion
The 21-gene breast cancer assay proved to have a significant impact on treatment decision- making. The test reduces chemotherapy use in more than 50% of Korean estrogen receptor-positive, early breast cancer patients.

Citations

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  • The Rochester Modified Magee Algorithm (RoMMa): An Outcomes Based Strategy for Clinical Risk-Assessment and Risk-Stratification in ER Positive, HER2 Negative Breast Cancer Patients Being Considered for Oncotype DX® Testing
    Bradley M. Turner, Brian S. Finkelman, David G. Hicks, Numbere Numbereye, Ioana Moisini, Ajay Dhakal, Kristin Skinner, Mary Ann G. Sanders, Xi Wang, Michelle Shayne, Linda Schiffhauer, Hani Katerji, Huina Zhang
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    Yufei Zeng, Weiqi Gao, Xiaosong Chen, Kunwei Shen
    British Journal of Cancer.2021; 124(5): 975.     CrossRef
  • Identifying Clinicopathological Factors Associated with Oncotype DX® 21-Gene Recurrence Score: A Real-World Retrospective Cohort Study of Breast Cancer Patients in Quebec City, Canada
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    Bradley M. Turner, Hani Katerji, Huina Zhang, David G. Hicks
    Human Pathology Reports.2021; 26: 300574.     CrossRef
  • Development of a Nomogram to Predict the Recurrence Score of 21-Gene Prediction Assay in Hormone Receptor–Positive Early Breast Cancer
    Shin Hye Yoo, Tae-Yong Kim, Miso Kim, Kyung-Hun Lee, Eunshin Lee, Han-Byoel Lee, Hyeong-Gon Moon, Wonshik Han, Dong-Young Noh, Sae-Won Han, Tae-You Kim, Seock-Ah Im
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    Yufei Zeng, Weiqi Gao, Lin Lin, Xiaosong Chen, Kunwei Shen
    Journal of Geriatric Oncology.2020; 11(5): 843.     CrossRef
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    Jeongmin Lee, Sung Hun Kim, Bong Joo Kang
    Scientific Reports.2020;[Epub]     CrossRef
  • The impact of the 21-gene recurrence score (Oncotype DX) on concordance of adjuvant therapy decision making as measured by the Liverpool Systemic Therapy Adjuvant Decision Tool
    Anna Olsson-Brown, Pavlos Piskilidis, Julie O'Hagan, Nicky Thorp, Peter Robson, Helen Innes, Helen Wong, Silvia Cicconi, Richard Jackson, Tamara Kiernan, Christopher Holcombe, Susan O'Reilly, Carlo Palmieri
    The Breast.2019; 44: 94.     CrossRef
  • Clinical significance of 21-gene recurrence score assay for hormone receptor–positive, lymph node-negative breast cancer in early stage
    Yang Yu-qing, Wang Lei, Huang Mei-ling, Xiao Jing-jing, Wei Mei-chen, Wu Jiang, Hao Jun-sheng, Ling Rui, Li Nan-lin
    Experimental and Molecular Pathology.2019; 108: 150.     CrossRef
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    Sue Harnan, Paul Tappenden, Katy Cooper, John Stevens, Alice Bessey, Rachid Rafia, Sue Ward, Ruth Wong, Robert C Stein, Janet Brown
    Health Technology Assessment.2019; 23(30): 1.     CrossRef
  • Uptake of the 21-Gene Assay Among Women With Node-Positive, Hormone Receptor−Positive Breast Cancer
    Megan C. Roberts, Allison W. Kurian, Valentina I. Petkov
    Journal of the National Comprehensive Cancer Network.2019; 17(6): 662.     CrossRef
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    Seho Park, Yunan Han, Ying Liu, Adetunji T. Toriola, Lindsay L. Peterson, Graham A. Colditz, Seung Il Kim, Young Up Cho, Byeong-Woo Park, Yikyung Park
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    Lizhe Zhu, Nan Ma, Bin Wang, Can Zhou, Yu Yan, Ke Wang, Jianjun He, Yu Ren
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    Jae-Myung Kim, Jai Min Ryu, Isaac Kim, Hee Jun Choi, Seok Jin Nam, Seok Won Kim, Jonghan Yu, Se Kyung Lee, Jeong Eon Lee
    Journal of Breast Cancer.2018; 21(2): 222.     CrossRef
  • Use of adjuvant chemotherapy in hormone receptor-positive breast cancer patients with or without the 21-gene expression assay
    Soo Jin Park, Moo Hyun Lee, Sun-Young Kong, Mi Kyung Song, Jungnam Joo, Youngmee Kwon, Eun-Gyeong Lee, Jai Hong Han, Sung Hoon Sim, So-Youn Jung, Seeyoun Lee, Keun Seok Lee, In Hae Park, Eun Sook Lee
    Breast Cancer Research and Treatment.2018; 170(1): 69.     CrossRef
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    Jonathan Chen, Xian Wu, Paul J. Christos, Silvia Formenti, Himanshu Nagar
    Breast Cancer Research.2018;[Epub]     CrossRef
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    Jai Min Ryu, Hee Jun Choi, Isaac Kim, Se Kyung Lee, Jonghan Yu, Jee-Eun Kim, Byeong-il Kang, Jeong Eon Lee, Seok Jin Nam, Seok Won Kim
    Breast Cancer Research and Treatment.2018; 172(3): 627.     CrossRef
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    Gynécologie Obstétrique & Fertilité.2015; 43(12): 780.     CrossRef
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Adjuvant Treatment Modalities, Prognostic Predictors and Outcomes of Uterine Carcinosarcomas
Kemal Gungorduk, Aykut Ozdemir, Ibrahim E. Ertas, Mehmet Gokcu, Elcin Telli, Tufan Oge, Ahmet Sahbaz, Sevil Sayhan, Muzaffer Sanci, Mehmet Harma, Sinan Ozalp
Cancer Res Treat. 2015;47(2):282-289.   Published online September 4, 2014
DOI: https://doi.org/10.4143/crt.2014.009
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study is to evaluate the clinicopathological characteristics, treatment, and prognosis of uterine carcinosarcoma (UC). Materials and Methods A retrospective review of three cancer registry databases in Turkey was conducted for identification of patients diagnosed with UC between January 1, 1996, and December 31, 2012. We collected clinicopathological data in order to evaluate factors important in disease- free survival (DFS) and overall survival (OS). Results A total of 66 patients with UC with a median age of 65.0 years were included in the analysis. The median survival time of all patients was 37.5 months and the 5-year OS rate was 59.1%. In early stage patients (I-II) who received adjuvant chemotherapy (CT) with radiation therapy (RT), the median DFS and OS was 44 months and 55 months, respectively, compared to 34.5 months and 36 months, respectively, in patients who received adjuvant RT or CT alone (hazard ratio [HR], 1.4; 95% confidence interval [CI], 0.7 to 3.1 for DFS; p=0.23 and HR, 2.2; 95% CI, 0.9 to 5.3 for OS; p=0.03). In advanced stage patients (III-IV), the median DFS and OS of patients receiving adjuvant RT with CT was 25 months and 38 months, respectively, compared to 23.5 months and 24.5 months, respectively, in patients receiving adjuvant RT or CT alone (HR, 3.1; 95% CI, 0.6 to 16.0 for DFS; p=0.03); (HR, 3.3; 95% CI, 0.7 to 15.0 for OS; p=0.01). In multivariate analysis, advanced International Federation of Gynecology and Obstetrics (FIGO) stage and suboptimal surgery showed significant association with poor OS. Conclusion In patients with early or advanced stage UC, adjuvant CT with RT is associated with improved DFS and OS, as compared to CT or RT alone.

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