Cancer Research and Treatment

The Prognostic Significance of the p53 Overexpession on Complete Response and Survival in Preoperative Chemoradiotherapy Treated Squamous Cell Esophageal Carcinoma: Sung Bae Kim, Sang Hee Kim, Hwoon Yong Jung, Hun Kyung Lee, Gyeong Hoon Kang, Jong Hoon Kim, Ho Young Song, Seung Il Park, Dong Kwan Kim, Hae Ryun Kim, Won Sun Hong, Je Hwan Lee, Sang We Kim, Cheol Won Sun, Kyoo Hyung Lee, Jung Shin Lee, Woo Kun Kim, Young Il Min; J Korean Cancer Assoc. 1998;30(2):278-287.

Abstract PDF: PURPOSE
To determine the frequency of p53 overexpression and to analyse the relationship between p53 overexpression and complete response rate, survival in locoregionl squamous cell esophageal cancers treated with preoperative chemoradiation multimodality approaches.
MATERIALS AND METHODS
Using a microwave oven heating method, we have detected p53 overexpression by immunohistochemically with a monoclonal antibody(DO-7) in formalin- fixed paraffin-embedded samples of 42 patients with locoregional squamous cell esophageal cancer, who treated with concurrent chemotherapy and radiatian followed by surgery.
RESULTS
In 27 of 42 tumors(64.2%), nuclear immunoreactivity for the p53 protein was detected. Complete response rate, evaluated in surgical specimen 3-4 weeks after chemoradiation seemed to be high in p53 positive group compared to p53 negative group, however, there was no statistically significant difference in acquiring better complete response rate, overall survival and progression free survival between p53 positive and p53 negative group(p=0.0546, p=0.0599, p= 0.6832). Complete response group(n=17) survived longer than non-complete response group(n=25)(p=0.0010).
CONCLUSION
The results indicate that p53 is not a statistically significant prognostic factor in obtaining better complete response rate, overall survival and progression free survival of the patients with esophageal carcinoma treated with preoperative chemoradiotherapy. Additional studies are warranted for further evaluation.

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Transhiatal Esophagectomy Using Laparoscope in Esophageal Cancer: Dong Heon Kim; J Korean Cancer Assoc. 1997;29(6):1094-1099.

Abstract PDF: PURPOSE
To remove the tumor and to restore continuity is very important in patients with esophageal cancer for cure of disease or palliation. To compare the outcome of Transhiatal Esophagectomy using Laparoscope (Lapa-THE), author`s modification of traditional tanshiatal esophagectomy, with that of transhiatal esophagectomy (THE). MATERIALS AND METHODS: The author performed THE in 10 cases with esophageal cancer and Lapa-THE in 5 cases with esophageal cancer from March 1992 to August 1996 in Department of Surgery, Pusan National University Hospital.
RESULTS
Of all 15 cases with esophageal cancer, 6 cases were occurred at 6th decade and 3 cases were occurred at 7th decade. The ratio of male to female was 4:1. The all 5 cases with Lapa-THE were mid-thoracic esophageal cancers. Of 10 cases with THE, the cancer occurred 2 cases in mid-thoracic esophagus, 4 cases in lower-thoracic esophagus and 4 cases in cardia portin. According to pathological type, the 12 cases were squamous cell carcinoma, 2 cases were adenocarcinoma, and 1 case was small cell carcinoma. Of all 10 cases with THE, the postoperative death was occurred in 1 case due to graft necrosis, other postoperative complications were occured in 5 cases, stenosis of anastomotic site in 3 cases, wound infection in 1 case and pleural effusion in 1case. In the cases with Lapa-THE, stenosis was occurred in 1 case, wound infection in 1 case and there was no postoperative death.
CONCLUSION
The Lapa-THE is comparable therapeutic technique with conventional THE for treatment of patient with esophsgeal cancer, especially it was useful in mid-thoracic esophageal cancer.

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A Case of Pyloric Obstruction Caused by Self-expandable Metallic Stent for Palliation of Malignant Dysphagia: Yeon Hee Park, Young Soo Do, Yoon Koo Kang, Nam Hyun Hur, Baek Yeol Ryoo, Tae You Kim, Young Hyuck Im, Jhin Oh Lee, Tae Woong Kang; J Korean Cancer Assoc. 1997;29(3):534-539.

Abstract PDF: Placement of the self-expandable metallic stents for palliative treatment of malignant esophagogastric strictures has been thought to be easy, fast and effective method than conventional methods (bypass procedures, radiation therapy, laser treatment, esophageal intubation, etc.). The expandable metallic stent tubes were found to overcome some of the limitations of nonexpandable conventional tubes. Their implantation is better tolerated and safer than that of nonexpandable tubes, because the risks of migration and perforation are lower.On our knowledge, there has been no report of pyloric obstruction after this metallic stent insertion.We hereby report a case of pyloric obstruction caused by a migrated self-expandable metallic stent for palliative treatment of malignant esophageal stricture.

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Effects of Concurrent Chemoradiotherapy Followed by Surgery in Locoreginal Cancer - preliminary report -: Yun Hae Chang, Sung Bae Kim, Sang Hee Kim, Jong SU Choi, Dae Young Chang, Je Whan Lee, Sang We Kim, Cheolwon Suh, Kyon Hung Lee, Jung Shin Lee, Woo Gyun Kim, Ho Young Song, Hye Sook Chang, Hong Hoon K; J Korean Cancer Assoc. 1996;28(4):690-698.

Abstract PDF: Prognosis of locoregional esophageal cancer treated with conventional surgery or radiotherapy alone has been very poor. In order to improve outcome and determine the efficacy of a combined modality therapy, this prospective study was performed. Between May 1993 and April l995, 44 patients with locoregional esophageal cancer were entered this study. They were treated with 2 courses of 5-FU(DI-5, D30-33) and cisplatin (Dl, D29) plus 48Gy radiation therapy over 4 weeks. 44 patients completed the preoperative reatment. A transhiatal esophagectomy was planned 3~4 weeks after chemoradiotherapy. Clinical response were reevaluable in 43 patients after treatment: 34 patients showed improvement, 5 patients showed stable, 4 patients showed progression. One patient was died of sepsis 1 week after completion of chemotherapy. l8 patients underwent operation after chemoradiation and 9 patients showed complete pathologic response. Grade 3,4 leukopenia and thrombocytopenia were observed in 21% and 7%, respectively. Esophagitis and vomiting were moderate to severe in 43% patients. Median follow-up duration was 7.5months(2-21M), the median survival was not reached. In conclusion, this intensive combined therapy is promising modality with regards to relatively high pathologic complete response rate. Further randomized Jarge scaled study was warrented

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