Cancer Research and Treatment

Original Articles

Breast cancer

Molecular Classification of Breast Cancer Using Weakly Supervised Learning: Wooyoung Jang, Jonghyun Lee, Kyong Hwa Park, Aeree Kim, Sung Hak Lee, Sangjeong Ahn; Cancer Res Treat. 2025;57(1):116-125. Published online June 25, 2024; DOI: https://doi.org/10.4143/crt.2024.113

Abstract PDF Supplementary Material PubReader ePub: Purpose
The molecular classification of breast cancer is crucial for effective treatment. The emergence of digital pathology has ushered in a new era in which weakly supervised learning leveraging whole-slide images has gained prominence in developing deep learning models because this approach alleviates the need for extensive manual annotation. Weakly supervised learning was employed to classify the molecular subtypes of breast cancer.
Materials and Methods
Our approach capitalizes on two whole-slide image datasets: one consisting of breast cancer cases from the Korea University Guro Hospital (KG) and the other originating from The Cancer Genomic Atlas dataset (TCGA). Furthermore, we visualized the inferred results using an attention-based heat map and reviewed the histomorphological features of the most attentive patches.
Results
The KG+TCGA-trained model achieved an area under the receiver operating characteristics value of 0.749. An inherent challenge lies in the imbalance among subtypes. Additionally, discrepancies between the two datasets resulted in different molecular subtype proportions. To mitigate this imbalance, we merged the two datasets, and the resulting model exhibited improved performance. The attentive patches correlated well with widely recognized histomorphologic features. The triple-negative subtype has a high incidence of high-grade nuclei, tumor necrosis, and intratumoral tumor-infiltrating lymphocytes. The luminal A subtype showed a high incidence of collagen fibers.
Conclusion
The artificial intelligence (AI) model based on weakly supervised learning showed promising performance. A review of the most attentive patches provided insights into the predictions of the AI model. AI models can become invaluable screening tools that reduce costs and workloads in practice.

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Genitourinary cancer

TNM-Based Head-to-Head Comparison of Urachal Carcinoma and Urothelial Bladder Cancer: Stage-Matched Analysis of a Large Multicenter National Cohort: Sang Hun Song, Jaewon Lee, Young Hwii Ko, Jong Wook Kim, Seung Il Jung, Seok Ho Kang, Jinsung Park, Ho Kyung Seo, Hyung Joon Kim, Byong Chang Jeong, Tae-Hwan Kim, Se Young Choi, Jong Kil Nam, Ja Yoon Ku, Kwan Joong Joo, Won Sik Jang, Young Eun Yoon, Seok Joong Yun, Sung-Hoo Hong, Jong Jin Oh; Cancer Res Treat. 2023;55(4):1337-1345. Published online April 17, 2023; DOI: https://doi.org/10.4143/crt.2023.417

Abstract PDF Supplementary Material PubReader ePub

Purpose
Outcome analysis of urachal cancer (UraC) is limited due to the scarcity of cases and different staging methods compared to urothelial bladder cancer (UroBC). We attempted to assess survival outcomes of UraC and compare to UroBC after stage-matched analyses.
Materials and Methods
Total 203 UraC patients from a multicenter database and 373 UroBC patients in single institution from 2000 to 2018 were enrolled (median follow-up, 32 months). Sheldon stage conversion to corresponding TNM staging for UraC was conducted for head-to-head comparison to UroBC. Perioperative clinical variables and pathological results were recorded. Stage-matched analyses for survival by stage were conducted.
Results
UraC patients were younger (mean age, 54 vs. 67 years; p < 0.001), with 163 patients (80.3%) receiving partial cystectomy and 23 patients (11.3%) radical cystectomy. UraC was more likely to harbor ≥ pT3a tumors (78.8% vs. 41.8%). While 5-year recurrence-free survival, cancer-specific survival (CSS) and overall survival were comparable between two groups (63.4%, 67%, and 62.1% in UraC and 61.5%, 75.9%, and 67.8% in UroBC, respectively), generally favorable prognosis for UraC in lower stages (pT1-2) but unfavorable outcomes in higher stages (pT4) compared to UroBC was observed, although only 5-year CSS in ≥ pT4 showed statistical significance (p=0.028). Body mass index (hazard ratio [HR], 0.929), diabetes mellitus (HR, 1.921), pathologic T category (HR, 3.846), and lymphovascular invasion (HR, 1.993) were predictors of CSS for all patients.
Conclusion
Despite differing histology, UraC has comparable prognosis to UroBC with relatively favorable outcome in low stages but worse prognosis in higher stages. The presented system may be useful for future grading and risk stratification of UraC.

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Clinical Presentation and Targeted Interventions in Urachal Adenocarcinoma: A Single-Institution Case Series and Review of Emerging Therapies
Akshay Mathavan, Akash Mathavan, Rodrigo Murillo-Alvarez, Kriti Gera, Urszula Krekora, Aaron J. Winer, Mohit Mathavan, Ellery Altshuler, Brian Hemendra Ramnaraign
Clinical Genitourinary Cancer.2024; 22(1): 67. CrossRef
Robotic‐assisted approaches to urachal carcinoma: A comprehensive systematic review of the safety and efficacy outcomes
Caio Vinícius Suartz, Lucas Motta Martinez, Pedro Henrique Brito, Carlos Victori Neto, Maurício Dener Cordeiro, Luiz Antonio Assan Botelho, Fábio Pescarmona Gallucci, José Maurício Mota, William Carlos Nahas, Leopoldo Alves Ribeiro‐Filho
BJUI Compass.2024; 5(3): 327. CrossRef

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Breast cancer

Diagnostic Assessment of Deep Learning Algorithms for Frozen Tissue Section Analysis in Women with Breast Cancer: Young-Gon Kim, In Hye Song, Seung Yeon Cho, Sungchul Kim, Milim Kim, Soomin Ahn, Hyunna Lee, Dong Hyun Yang, Namkug Kim, Sungwan Kim, Taewoo Kim, Daeyoung Kim, Jonghyeon Choi, Ki-Sun Lee, Minuk Ma, Minki Jo, So Yeon Park, Gyungyub Gong; Cancer Res Treat. 2023;55(2):513-522. Published online September 6, 2022; DOI: https://doi.org/10.4143/crt.2022.055

Abstract PDF Supplementary Material PubReader ePub

Purpose
Assessing the metastasis status of the sentinel lymph nodes (SLNs) for hematoxylin and eosin–stained frozen tissue sections by pathologists is an essential but tedious and time-consuming task that contributes to accurate breast cancer staging. This study aimed to review a challenge competition (HeLP 2019) for the development of automated solutions for classifying the metastasis status of breast cancer patients.
Materials and Methods
A total of 524 digital slides were obtained from frozen SLN sections: 297 (56.7%) from Asan Medical Center (AMC) and 227 (43.4%) from Seoul National University Bundang Hospital (SNUBH), South Korea. The slides were divided into training, development, and validation sets, where the development set comprised slides from both institutions and training and validation set included slides from only AMC and SNUBH, respectively. The algorithms were assessed for area under the receiver operating characteristic curve (AUC) and measurement of the longest metastatic tumor diameter. The final total scores were calculated as the mean of the two metrics, and the three teams with AUC values greater than 0.500 were selected for review and analysis in this study.
Results
The top three teams showed AUC values of 0.891, 0.809, and 0.736 and major axis prediction scores of 0.525, 0.459, and 0.387 for the validation set. The major factor that lowered the diagnostic accuracy was micro-metastasis.
Conclusion
In this challenge competition, accurate deep learning algorithms were developed that can be helpful for making a diagnosis on intraoperative SLN biopsy. The clinical utility of this approach was evaluated by including an external validation set from SNUBH.

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Detection of metastatic breast carcinoma in sentinel lymph node frozen sections using an artificial intelligence-assisted system
Chia-Ping Chang, Chih-Yi Hsu, Hsiang Sheng Wang, Peng-Chuna Feng, Wen-Yih Liang
Pathology - Research and Practice.2025; 267: 155836. CrossRef
Value of frozen section to tailor surgical staging in apparent early-stage epithelial ovarian cancer
Stefano Di Berardino, Nicolò Bizzarri, Marianna Ciancia, Francesca Moro, Belen Padial Urtueta, Claudia Marchetti, Gian Franco Zannoni, Giovanni Scambia, Anna Fagotti
International Journal of Gynecological Cancer.2025; : 101746. CrossRef
Comparing the diagnostic efficacy of optical coherence tomography and frozen section for margin assessment in breast-conserving surgery: a meta-analysis
Shishun Fan, Huirui Zhang, Zhenyu Meng, Ang Li, Yuqing Luo, Yueping Liu
Journal of Clinical Pathology.2024; 77(8): 517. CrossRef
Intraoperative Margin Assessment in Breast Conservation Surgery: A Necessity or a Luxury?
Srijan Shukla, Nisha Hariharan
Annals of Surgical Oncology.2023; 30(9): 5314. CrossRef

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General

Reclassification of Five BRCA1/2 Variants with Unknown Significance Using Complex Functional Study: Anikó Bozsik, János Papp, Vince Kornél Grolmusz, Attila Patócs, Edit Oláh, Henriett Butz; Cancer Res Treat. 2022;54(4):970-984. Published online February 8, 2022; DOI: https://doi.org/10.4143/crt.2021.1078

Abstract PDF Supplementary Material PubReader ePub

Purpose
While BRCA1/2 genes are commonly investigated, variants of unknown significance (VUS) and variants with potential splice effect are still being detected and they represent a substantial challenge in genetic counseling and therapy.
Materials and Methods
Out of genetically tested 3,568 hereditary breast and ovarian cancer probands five, functionally not investigated variants with potential splice-modifying effect were subjected to functional characterization. Transcript-level analysis on peripheral blood-derived RNA of the carriers was performed to test aberrant splicing. The completeness of the aberrant splicing event was also studied, existence and extent of nonsense-mediated decay was even addressed. Clinical and phenotype data, pedigree and co-segregation analyses were also done. Locus-specific loss of heterozygosity (LOH) in tumor tissues was additionally tested.
Results
In case of the BRCA1:c.4484+4dupA and the BRCA1:c.5407-10G>A variants functional results allowed us to reclassify them from VUS into likely pathogenic category. BRCA1:c.4358-31A>C, by producing incomplete aberrant splicing, was highlighted as strong VUS, but in lack of other supporting evidence, re-categorization was not possible. The likely pathogenic assertion of previously not reported BRCA2:c.8487G>T was reinforced based on its spliceogenic property and tumor LOH, while BRCA2:c.793G>A failed to present aberrant splicing in spite of suggestive predictions, which altered its original VUS evaluation into likely benign class.
Conclusion
We presented molecular and clinical evidence for reclassification of four out of five BRCA1/2 variants. Both up- and down-classification harbour important clinical significance. Patients carrying re-classified pathogenic variants in the future will not be dropped out from medical surveillance, preventive measures, treatment and predictive family screening in relatives at risk.

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Korean patients with hereditary cancer: a prospective multicentre cohort study protocol exploring psychosocial and health outcomes
Jun-Kyu Kim, Mi-Ae Jang, Jong Eun Park, Dongju Won, Jung-Sook Ha, Kyoung-Bo Kim, Boyoung Park, Sun-Young Kong
BMJ Open.2025; 15(2): e093905. CrossRef
Genome sequencing-based discovery of a novel deep intronic APC pathogenic variant causing exonization
Anikó Bozsik, Henriett Butz, Vince Kornél Grolmusz, Csaba Polgár, Attila Patócs, János Papp
European Journal of Human Genetics.2023; 31(7): 841. CrossRef
Challenging interpretation of germline TP53 variants based on the experience of a national comprehensive cancer centre
Henriett Butz, Anikó Bozsik, Vince Grolmusz, Erika Szőcs, János Papp, Attila Patócs
Scientific Reports.2023;[Epub] CrossRef

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Head and Neck Cancer

Prognostic Value of Serum Epstein-Barr Virus Antibodies and Their Correlation with TNM Classification in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma: Wan-Ru Zhang, Yu-Yun Du, Chun-Yan Guo, Han-Xing Zhou, Jie-Yi Lin, Xiao-Han Meng, Hao-Yuan Mo, Dong-Hua Luo; Cancer Res Treat. 2021;53(4):991-1003. Published online January 13, 2021; DOI: https://doi.org/10.4143/crt.2020.1298

Abstract PDF PubReader ePub

Purpose
This study assessed the correlation between Epstein-Barr virus (EBV) biomarkers and the eighth American Joint Committee on Cancer staging system and the prognostic values of IgG antibodies against replication and transcription activator (Rta-IgG), IgA antibodies against Epstein-Barr nuclear antigen 1, and BamH1 Z transactivator (Zta-IgA) in locoregionally advanced nasopharyngeal carcinoma (NPC) patients.
Materials and Methods
Serum EBV antibody levels were measured by enzyme-linked immunosorbent assay in 435 newly diagnosed stage III-IVA NPC patients administered intensity-modulated radiation therapy±chemotherapy. The primary endpoint was progression-free survival (PFS).
Results
Rta-IgG and Zta-IgA levels were positively correlated with the N category and clinical stage. Patients with high Rta-IgG levels (> 29.07 U/mL) showed a significantly inferior prognosis as indicated by PFS (77% vs. 89.8%, p=0.004), distant metastasis–free survival (DMFS) (88.3% vs. 95.8%, p=0.021), and local recurrence-free survival (LRFS) (91.2% vs. 98.3%, p=0.009). High Rta-IgG levels were also significantly associated with inferior PFS and LRFS in multivariable analyses. In the low-level EBV DNA group (≤ 1,500 copies/mL), patients with high Rta-IgG levels had significantly inferior PFS and DMFS (both p < 0.05). However, in the high-level EBV DNA group, Rta-IgG levels were not significantly associated with PFS, DMFS, and LRFS. In the advanced T category (T3-4) subgroup, high Rta-IgG levels were also significantly associated with inferior PFS, DMFS, and LRFS (both p < 0.05).
Conclusion
Rta-IgG and Zta-IgA levels were strongly correlated with the TNM classification. Rta-IgG level was a negative prognostic factor in locoregionally advanced NPC patients, especially those with advanced T category or low EBV DNA level.

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Development and Validation of a Multi‐Omics Model Integrating MR Radiomics and Immune Scores for Prognostic Prediction in Locally Advanced Nasopharyngeal Carcinoma
Zhun Zhong, Feng Xiao, Dong Kuang, Qian Peng, Ling Zhu, Li Yang, Shengyu Kuang, Yunxiao Han, Kun Wu, Haibo Xu, Xiong Chen
Flavour and Fragrance Journal.2025;[Epub] CrossRef
Antibody Profiling of Pan-Cancer Viral Proteome Reveals Biomarkers for Nasopharyngeal Carcinoma Diagnosis and Prognosis
Te Liang, Hao Chen, Lei Liu, Yongqiang Zheng, Zhaoen Ma, Ling Min, Jiahui Zhang, Lianfu Wu, Jie Ma, Zexian Liu, Qingfeng Zhang, Kai Luo, Di Hu, Tianxing Ji, Xiaobo Yu
Molecular & Cellular Proteomics.2024; 23(3): 100729. CrossRef
A clinical–radiomics nomogram based on multisequence MRI for predicting the outcome of patients with advanced nasopharyngeal carcinoma receiving chemoradiotherapy
Liucheng Chen, Zhiyuan Wang, Ying Meng, Cancan Zhao, Xuelian Wang, Yan Zhang, Muye Zhou
Frontiers in Oncology.2024;[Epub] CrossRef

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Hepatic Resection Provides Survival Benefit for Selected Intermediate-Stage (BCLC-B) Hepatocellular Carcinoma Patients: Zhang Zhaohui, Shen Shunli, Chen Bin, Li Shaoqiang, Hua Yunpeng, Kuang Ming, Liang Lijian, Peng Bao Gang; Cancer Res Treat. 2019;51(1):65-72. Published online February 26, 2018; DOI: https://doi.org/10.4143/crt.2018.038

Abstract PDF PubReader ePub

Purpose
The intermediate stage of hepatocellular carcinoma (HCC) (Barcelona Clinic Liver Cancer [BCLC] B) comprises a highly heterogeneous population, and the treatment strategy is still controversial. Because of the heterogeneity, a subclassification of intermediate-stage HCCs was put forward by Bolondi according to the ‘beyond Milan and within up-to-7’ criteria and Child-Pugh score. In this study, we aim to analyze the prognosis of BCLC-B stage HCC patients who received hepatic resection according to the Bolondi’s subclassification.
Materials and Methods
One thousand and one hundred three patients diagnosedwith HCC and treatedwith hepatic resectionwere enrolled in our hospital between 2006 and 2012. According to Bolondi’s subclassification, the BCLC-B patients were divided into four groups. Recurrence-free survival (RFS) and overall survival (OS) were analyzed.
Results
According to Bolondi’s subclassification, the BCLC-B patients were divided into four groups: B1 (n=41, 18.7%), B2 (n=160, 73.1%), B3 (n=11, 5.0%), and B4 (n=7, 3.2%). Significant difference was observed between B1 and other groups (B1 vs. B2, p=0.022; B1 vs. B3, p < 0.001; B1 vs. B4, p < 0.001), but no difference for B2 vs. B4 (p=0.542) and B3 vs. B4 (p=0.542). In addition, no significant differences were observed between BCLC-A and BCLC-B1 group for both RFS (p=0.087) and OS (p=0.643). In multivariate analysis, BCLC-B subclassification was not a risk factor for both OS (p=0.263) and RFS (p=0.892).
Conclusion
In our study, HCC patients at B1 stagewere benefited from hepatic resection and had similar survival to BCLC-A stage patients. Our study provided rationality of hepatic resection for selected BCLC-B stage HCC patients instead of routine transarterial chemoembolization.

Citations

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Overexpression of tousled-like kinase 2 predicts poor prognosis in HBV-related hepatocellular carcinoma patients after radical resection
Bang Liu, Ling-Ling Lu, Li Yu, Xuan Mei, Jia Liu, Jiao-Long Zheng, Xiao-Ling Zhou, Hai-Yan Lin, Xiu-Ling Zhu, Dong-Liang Li
Frontiers in Genetics.2024;[Epub] CrossRef
Prognostic significance of early and multiple recurrences after curative resection for hepatocellular carcinoma
Akihiro Tanemura, Daisuke Noguchi, Toru Shinkai, Takahiro Ito, Aoi Hayasaki, Kazuyuki Gyoten, Takehiro Fujii, Yusuke Iizawa, Yasuhiro Murata, Naohisa Kuriyama, Masashi Kishiwada, Shugo Mizuno
BMC Surgery.2024;[Epub] CrossRef
TAC score better predicts survival than the BCLC following resection of hepatocellular carcinoma
Henrique A. Lima, Yutaka Endo, Zorays Moazzam, Laura Alaimo, Chanza Shaikh, Muhammad M. Munir, Vivian Resende, Alfredo Guglielmi, Hugo P. Marques, François Cauchy, Vincent Lam, George A. Poultsides, Irinel Popescu, Sorin Alexandrescu, Guillaume Martel, It
Journal of Surgical Oncology.2023; 127(3): 374. CrossRef
Multiplication of tumor maximum diameter and number as a new surgical indicator for Barcelona Clinic Liver Cancer intermediate‐stage hepatocellular carcinoma
Yuji Morine, Yu Saito, Shinichiro Yamada, Hiroki Teraoku, Yuhei Waki, Takayuki Noma, Tetsuya Ikemoto, Mitsuo Shimada
Hepatology Research.2023; 53(6): 531. CrossRef
Clinical consensus statement: Establishing the roles of locoregional and systemic therapies for the treatment of intermediate-stage hepatocellular carcinoma in Canada
Jason K. Wong, Howard J. Lim, Vincent C. Tam, Kelly W. Burak, Laura A. Dawson, Prosanto Chaudhury, Robert J. Abraham, Brandon M. Meyers, Gonzalo Sapisochin, David Valenti, Setareh Samimi, Ravi Ramjeesingh, Amol Mujoomdar, Ilidio Martins, Elijah Dixon, Maj
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Advances in post-operative prognostic models for hepatocellular carcinoma
Ziqin He, Xiaomin She, Ziyu Liu, Xing Gao, Lu Lu, Julu Huang, Cheng Lu, Yan Lin, Rong Liang, Jiazhou Ye
Journal of Zhejiang University-SCIENCE B.2023; 24(3): 191. CrossRef
Preoperative alpha fetoprotein, total bilirubin, fibrinogen, albumin, and lymphocytes predict postoperative survival in hepatocellular carcinoma
Jia Xu, Shu An, Ying Lu, Laisheng Li, Zhi‐Qi Wu, Hua‐Guo Xu
Cancer Medicine.2023; 12(12): 13319. CrossRef
Liver resection versus transarterial chemoembolisation for the treatment of intermediate hepatocellular carcinoma: a systematic review and meta-analysis
Aleksandar Bogdanovic, Jelena Djokic Kovac, Predrag Zdujic, Uros Djindjic, Vladimir Dugalic
International Journal of Surgery.2023; 109(5): 1439. CrossRef
Surgical resection versus transarterial chemoembolization for patients with hepatocellular carcinoma beyond Milan criteria: prognostic role of tumor burden score
Shu-Yein Ho, Po-Hong Liu, Chia-Yang Hsu, Yi-Hsiang Huang, Hao-Jan Lei, Jia-I Liao, Chien-Wei Su, Ming-Chih Hou, Teh-Ia Huo
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Clinical outcome of surgical resection for multifocal T2-T3 hepatocellular carcinoma up to 3 nodules: a comparative analysis with a single nodule
Sehyeon Yu, Hye-Sung Jo, Young-Dong Yu, Yoo jin Choi, Dong-Sik Kim
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Pretreatment Non-Invasive Biomarkers as Predictors to Estimate Portal Vein Tumor Thrombosis (PVTT) Risk and Long-Term Survival in HBV-Related Hepatocellular Carcinoma Patients Without PVTT
Bang Liu, Jia Liu, Xuan Mei, Zhi-Qiang Zhang, Jian Fang, Li-Li Zhou, Jiao-Long Zheng, Hai-Yan Lin, Xiu-Ling Zhu, Dong-Liang Li
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Tumor Burden Score and Serum Alpha-fetoprotein Subclassify Intermediate-Stage Hepatocellular Carcinoma
Henrique A. Lima, Yutaka Endo, Laura Alaimo, Zorays Moazzam, Muhammad Musaab Munir, Chanza Shaikh, Vivian Resende, Alfredo Guglielmi, Hugo P. Marques, François Cauchy, Vincent Lam, George A. Poultsides, Irinel Popescu, Sorin Alexandrescu, Guillaume Martel
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Hepatic Resection Versus Transarterial Chemoembolization for Intermediate-Stage Hepatocellular Carcinoma: A Cohort Study
Linbin Lu, Peichan Zheng, Zhixian Wu, Xiong Chen
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Vincent L. Chen, Amit G. Singal, Elliot B. Tapper, Neehar D. Parikh
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Complex treatment of hepatocellular carcinoma at early (BCLC-A) and intermediate (BCLC-B) stages
B. N. Kotiv, I. I. Dzidzava, S. A. Alent’yev, A. V. Smorodsky, K. I. Makhmudov, A. A. Apollonov, S. A. Soldatov, P. N. Zubarev
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Magnetic Resonance Imaging–Detected Intracranial Extension in the T4 Classification Nasopharyngeal Carcinoma with Intensity-Modulated Radiotherapy: Caineng Cao, Jingwei Luo, Li Gao, Junlin Yi, Xiaodong Huang, Suyan Li, Jianping Xiao, Zhong Zhang, Guozhen Xu; Cancer Res Treat. 2017;49(2):518-525. Published online August 24, 2016; DOI: https://doi.org/10.4143/crt.2016.299

Abstract PDF PubReader ePub

Purpose
This study was conducted is to identify the prognostic value and staging categories of magnetic resonance imaging (MRI)–detected intracranial extension in nasopharyngeal carcinoma (NPC) with intensity-modulated radiotherapy (IMRT) to determine whether it is necessary to subclassify the T4 classification NPC.
Materials and Methods
A total of 335 nonmetastatic T4 classificationNPC patientswith MRI treated between March 2004 and June 2011 by radical IMRTwere included. The T4 classification patientswere subclassified into two grades (T4a, without intracranial extension vs. T4b, with intracranial extension) according to the site of invasion.
Results
The frequency of intracranial extensionwas 40.9% (137 of 335 patients). Multivariate analysis identified subclassification (T4a vs. T4b) as an independent prognostic factor for local failure-free survival (p=0.049; hazard ratio [HR], 0.498) and overall survival (p=0.004; HR, 0.572); however, it had no effect on regional failure-free survival or distant failure-free survival (p > 0.050).
Conclusion
For patients with T4 classification NPC, those with MRI-detected intracranial extension are more likely to experience local failure and death afterIMRT than patientswithout intracranial extension. According to the site of invasion, subclassification of T4 patients as T4a or T4b has prognostic value in NPC.

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Wenjie Huang, Shuqi Li, Chao Luo, Zhiying Liang, Shumin Zhou, Haojiang Li, Yi Cai, Shaobo Liang, Guangying Ruan, Peiqiang Cai, Lizhi Liu
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BMC Cancer.2022;[Epub] CrossRef
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Prognostic Significance of Defining L-Cell Type on the Biologic Behavior of Rectal Neuroendocrine Tumors in Relation with Pathological Parameters: The Gastrointestinal Pathology Study Group of Korean Society of Pathologists, Jin Hee Sohn, Mee-Yon Cho, Yangsoon Park, Hyunki Kim, Woo Ho Kim, Joon Mee Kim, Eun Sun Jung, Kyoung-Mee Kim, Jae Hyuk Lee, Hee Kyung Chan, Do Youn Park, Mee Joo, Sujin Kim, Woo Sung Moon, Mi Seon Kang, So-Young Jin, Yun Kyung Kang, Sun Och Yoon, HyeSeung Han, EunHee Choi; Cancer Res Treat. 2015;47(4):813-822. Published online February 26, 2015; DOI: https://doi.org/10.4143/crt.2014.238

Abstract PDF PubReader ePub

Purpose
In 2010, the World Health Organization categorized L-cell type neuroendocrine tumors (NETs) as tumors of uncertain malignancy, while all others were classified as malignant. However, the diagnostic necessity of L-cell immunophenotyping is unclear, as are tumor stage and grade that may guide diagnosis and management. To clarify the predictive markers of rectal neuroendocrine neoplasms (NENs), 5- and 10-year overall survival (OS) was analyzed by pathological parameters including L-cell phenotype. Materials and Methods A total of 2,385 rectal NENs were analyzed from our previous multicenter study and a subset of 170 rectal NENs was immunophenotyped.
Results
In univariate survival analysis, tumor grade (p < 0.0001), extent (p < 0.0001), size (p < 0.0001), lymph node metastasis (p=0.0063), and L-cell phenotype (p < 0.0001) showed significant correlation with the prognosis of rectal NENs; however, none of these markers achieved independent significance in multivariate analysis. The 10-year OS of tumors of NET grade 1, < 10 mm, the mucosa/submucosa was 97.58%, 99.47%, and 99.03%, respectively. L-Cell marker, glucagon II (GLP-1&2), with a cut off score of > 10, is useful in defining L-Cell type. In this study, an L-cell immunophenotype was found in 83.5% of all rectal NENs and most, but not all L-cell type tumors were NET G1, small (< 10 mm) and confined to the mucosa/submucosa. Conclusion From these results, the biological behavior of rectal NENs does not appear to be determined by L-cell type alone but instead by a combination of pathological parameters.

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Clinicopathologic Charcteristics of Korean Non - Hodgkin's Lymphomas Based on REAL Classification: Yoon Koo Kang, Bong Seog Kim, Tae Won Kim, Mon Hee Ryu, Seung Sook Lee, Baek Yeol Ryoo, Tae You Kim, Young Hyuck Im, Kyoo Hyung Lee, Jooryung Huh, Dae Seog Heo, Yung Jue Bang, Chulwoo Kim, Jung Shin Lee, Byoung Kook Kim, Woo Kun Kim, Sang Hee Kim, Noe Kveong Kim; J Korean Cancer Assoc. 1999;31(4):641-652.

Abstract PDF: PURPOSE
Non-Hodgkins lymphoma (NHL) is recognized as not a single disease but a group of diseases heterogeneous in biology and clinical characteristics. Recently, a new pathologic classification system, the REAL classification, has been introduced into the clinic. Although REAL classification has tried to define the subtypes biologically more correctly, its clinical usefulness has not been established yet. A retrospective study was performed to define the clinical characteristics of Korean NHLs according to the REAL classification and to determine its clinical usefulness.
MATERIALS AND METHODS
Pathologies of NHLs managed at 3 major hospitals in Korea between 1989 and 1995 were reviewed with immunophenotyping to determine the pathologic subtypes according to REAL classification. Clinical characteristics at the presentation and treatment outcomes of the eligible patients were analyzed. To determine the differences from the NHLs in the western countries, data of Non-Hodgkins Lymphoma Classification Project (NHLCP) were also compared.
RESULTS
Total 802 cases were eligible for this study. Although it was similar to NHLCP study that B-cell subtypes were the majority and diffuse large B-cell lymphoma was the most common subtype, the proportion of T-cell subtypes were much higher in our patient population than in the western population. It was because peripheral T-cell lymphomas, angiocentric lymphoma in particular, were more common and follicular lymphomas were less common in our patients. Eleven common pathologic subtypes could be classified into 3 prognostic groups. Marginal zone B-cell lymphoma and lymphoplasmacytoid lymphoma of which 5-year overall survival rate (5-yOSR) were > 80% were classified in the good prognostic group. Precursor T-lymphoblastic lymphoma was classified in the poor prognostic group because its 5-yOSR was less than 30%. The other 9 subtypes were classified in the intermediate prognostic group with S-yOSR of 30-79%.
CONCLUSION
The clinical. character' tics and prognoses of Korean NHLs could be defined according to REAL classification. These information would be helpful for the clinicians in formulating treatment strategies of Korean NHLs according to REAL classification.

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Clinical Analysis and Prognosis According to the Histopathologic Type of Advanced Gastric Cancer: Sung Ha Moon, Hyun Uk Shin, Jung Weon Shim, Hae Kyung Ahn, Kyung Suk Chung; J Korean Cancer Assoc. 1994;26(5):711-722.

Abstract PDF: The prognostic significance of histologic ciassifications in patients with advanced gastric cancer has been controversiaL The purpose of this study was to clarify clinical characteristics according to the Lauren's and Ming's classifications and to assess the implication of both classifications as a prognostic factor in advanced gastric cancer. The clinical characteristics accordin& to the histologic classifications were evaluated in 238 patients with advanced gastric cancer who underwent gastrectomy between 1984 and 1993. The authors also investigated whether the Lauren's and Ming's classifications represent a prognostic parameter by log-rank test and Cox proportional hazards models. Two hundred thirty eight patients were classified as intestinal (ll4/238, 48%), diffuse (111/ 238, 47%), and mixed(13/238, 5%), according to Lauren; and as expanding(112/238, 47%) and infiltrative (126/238, 53%), according to Ming. Carcinomas of intestinal type (n= 114) were mostly expanding type (n=101), and carcinomas of diffuse type (n= 111) were mostly infiltrative type (n=105). The percentages of diffuse or in- filtrative type with young age, Borrmann type III or IV, poorly differentiation, and T3-T4 inva- sion were significantly greater than those of intestinal or expanding type, respectively, but no significant differences in types of Laurens or Mings classifications were found with regard to the tumor size, regional 1ymph node metastasis and distant metastasis. The 5-year survival rate of patients with intestinal type (51.4%) was higher than those of patients with mixed type (45.8%) or diffuse type (30.5%). The 5-year survival rate of patient with expanding type (53.9%) was higher than that of patients with infiltrative type(29.6%). Multivariate analysis by Cox proportional hazards models revealed that primary tumor(T), Borrmann type, Lauren's classification, and regional lymph node(N) were significant prognostic factors. These results suggest that there are similarities between Lauren's and Ming's classification in regard of age or sex distribution, Borrmann type, tumor invasion, histologic differentiation, and 5-year survival rate. The combination of WHO histologic type with Lauren's and Mings classifications may provide a fairly complete picture of gastric cancer for prognostic purpose.

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Clinical Analysis and Prognosis According to the Hispopathologic Type in Stage 3 Gastric Cancer: Ki Young Yoon, Sang Ho Lee, Seung Do Lee, Man Ha Huh; J Korean Cancer Assoc. 1995;27(3):374-383.

Abstract PDF: Between 1980 and l992, 3l76 patients with adenocarcinoma of stomach underwent surgical treatment at the department of Surgery, Kosin Medical Collage. The purpose of this study was to evaluate clinical characteristics according to the WHO and Laurens classification and the implication of both classifications as a prognostic factor in stage III gastric cancer. The clinical characteristic according to the histopathologic factor in stage III gastric cancer. The clinical characteristic according to the histopathologic classification were evaluated in 788 patients with stage III gastric cancer who underwent gastrectomy. The relation of pathologic features according to WHO and Laurens classification and prognoss was studied. The 788 patients were classified as papillary type(11/788 1.40%), tubular well differenciated(l36/788 17.26%), tubular moderate differenciated(202/788 25.6%), poor differenciated(320/788 40.6%) mucinous(62/788 7.8 %), signet ring cell(50/788 6.35%), and others(7/788 0.8%) according to WHO, and as intestinal (399/788 50.6%), diffuse(293/788 37.1%), mixed(96/788 12.8%) according to Lauren. Carcinoma of tubular well differenciated and moderate differenciated were mostly intestinal type and carcinoma of poorly differenciated type were mostly diffuse type. The poorly differenciated and diffuse type were distributed considerably young age group and Borrmann type III and IV were significantly frequentr in tubular poor and diffuse type. But there no significant differ- ences were in tumor locations. The 5-years survival rate of stage IIIa patients were 63.3% in tubular well differenciated, 52.2% in tubular moderate differenciated, 39.8% in poorly differenciated, 44.l% in mucinous, 67.6% in signet ring cell, and 56.5% in intestinal, 40.7% in dif- fuse, 43.96% in mixed. The 5-years survival rate of stage IIIb patients were 40.7% in tubular well differenciate, 36.5% in tubular moderate differencite, 21.9% in poor differenciate, 34.3% in mixed. The combination of WHO histologic type and Lauren claesification may provide a good prognostic prediction in stage III gastric cancer.

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Clinical Parameters and prognosis Correlated to the Histopathologic Type in Gastric Cancer - Retrospective evaluation of 2099 cases -: Sang Ho Lee, Seung Do Lee, Kyung Hyun Choi, In Sun Jun, Man Ha Huh; J Korean Cancer Assoc. 1996;28(5):842-852.

Abstract PDF: Between 1980 and 1992, 3176 patients with adenocarcinoma of stomach underwent surgical treatment at the detartment of Surgery, Kosin University. The prognostic significance of histologic classification in patients with gastric cancer has been controversial. The purpose of this study was to evaluate clinical parameters according to the WHO and Lauren's classification and the implication of both classifications as a prognostic factor in gastric cancer. The clinical characteristic according to the histopathologic classification were evaluated in 2099 patients with gastric cancer who underwent gastrectomy. The authors also investigated whether the WHO and Lauren's classification represent a prognostic parameter by log-rank test and survival rate was examined with Kaplan-Meier method. The 2099 patients were classified as papillary type(23/2099 1.10%), tubular well differentiated(491/ 2099 l9.5%), tubular moderately differentiated(506/2099 24.2%), poorly differentiated(800/2099 38.2%), mucinous(l00/2099 4.8%), signet ring cell(230/2099 11%), and others(31/2099 0.3%), according to WHO, and as intestinal(1040/2099 49.6%), diffuse(835/2099 39.8%), and mixed(224/ 2099 10.6%) according to Lauren. The 5-years survival rate of gastric cancer patients in each stages were 100%, 100%, 50%, 7.6% in papillay adeno carcinoma, 89%, 80%, 49%, 4,8% in tubular well differentiated, 89%, 65%, 45%, 4.7% in tubular moderately differentiated, 86%, 62%, 36%, 4.2% in signet ring cell, 100%, 85%, 64%, 10% in mucinous carcinoma by the WHO's classification and 89%, 17%, 47%, 6% in intestinal type, 89%, 64%, 33%, 6% in diffuse type by the Lauren's classification. Based on the data presented in this study, we conclude the combination of WHO and Laurens classification may provide a good prognostic prediction in gastric cancer.

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