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Original Articles
Psychometric Validation of Sheffield Profile for Assessment and Referral to Care (SPARC) in Korean Cancer Patients
Hong Jun Kim, Eun Hee Jung, Jung Hye Kwon, Yu Jung Kim, Su-Jin Koh, Myung Ah Lee, Jung Hun Kang, Sun Young Rha, Eun Mi Nam, Sun Kyung Baek, Ha Yeon Lee, Hun Ho Song, Young-Woong Won, Hanbyul Lee
Received July 26, 2024  Accepted December 4, 2024  Published online December 5, 2024  
DOI: https://doi.org/10.4143/crt.2024.706    [Accepted]
AbstractAbstract PDF
Purpose
Identifying the palliative care needs of patients with advanced cancer is important for maintaining quality of life and timely transition to palliative care. We aimed to validate the Korean Sheffield Profile for Assessment and Referral for Care (K-SPARC) in such patients and establish its psychometric properties, including reliability, validity, and responsiveness to change.
Materials and Methods
We used the forward-back translated version of SPARC, which was verified through a pilot study, to assess the palliative care needs of patients with advanced cancer. Reliability was evaluated by internal consistency using Cronbach's alpha coefficients and test-retest reliability. Criterion validity was analyzed against other questionnaires, including the Korean versions of the Functional Assessment of Cancer Therapy-General (FACT-G Korean) and Korean versions of the Edmonton Symptom Assessment System (K-ESAS). Factor analysis was used to assess construct validity.
Results
Two hundred fifty-nine patients were included from 2019 to 2022. Forty-nine percent of all patients were women, and the median age was 63 years. Cronbach’s alpha coefficient (range, 0.642–0.903) and test-retest reliability (range, 0.574–0.749) indicated acceptable reliability. The correlation coefficients between K-SPARC and FACT-G Korean suggested significant criterion validity. The correlation coefficients for the physical, social, emotional, and functional domains were 0.701, 0.249, 0.718, and 0.511, respectively (p-value <0.001, all). Factor analysis demonstrated satisfactory construct validity of the tool.
Conclusion
This study demonstrated the utility of K-SPARC as an evaluation tool for providing palliative care to patients with advanced cancer through psychometric validation; the tool had good internal consistency, reliability, and acceptable validity.
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General
The Survival and Financial Benefit of Investigator-Initiated Trials Conducted by Korean Cancer Study Group
Bum Jun Kim, Chi Hoon Maeng, Bhumsuk Keam, Young-Hyuck Im, Jungsil Ro, Kyung Hae Jung, Seock-Ah Im, Tae Won Kim, Jae Lyun Lee, Dae Seog Heo, Sang-We Kim, Keunchil Park, Myung-Ju Ahn, Byoung Chul Cho, Hoon-Kyo Kim, Yoon-Koo Kang, Jae Yong Cho, Hwan Jung Yun, Byung-Ho Nam, Dae Young Zang
Cancer Res Treat. 2025;57(1):39-46.   Published online July 10, 2024
DOI: https://doi.org/10.4143/crt.2024.421
AbstractAbstract PDFPubReaderePub
Purpose
The Korean Cancer Study Group (KCSG) is a nationwide cancer clinical trial group dedicated to advancing investigator-initiated trials (IITs) by conducting and supporting clinical trials. This study aims to review IITs conducted by KCSG and quantitatively evaluate the survival and financial benefits of IITs for patients.
Materials and Methods
We reviewed IITs conducted by KCSG from 1998 to 2023, analyzing progression-free survival (PFS) and overall survival (OS) gains for participants. PFS and OS benefits were calculated as the difference in median survival times between the intervention and control groups, multiplied by the number of patients in the intervention group. Financial benefits were assessed based on the cost of investigational products provided.
Results
From 1998 to 2023, KCSG conducted 310 IITs, with 133 completed and published. Of these, 21 were included in the survival analysis. The analysis revealed that 1,951 patients in the intervention groups gained a total of 2,558.4 months (213.2 years) of PFS and 2,501.6 months (208.5 years) of OS, with median gains of 1.31 months in PFS and 1.58 months in OS per patient. When analyzing only statistically significant results, PFS and OS gain per patients was 1.69 months and 3.02 months, respectively. Investigational drug cost analysis from six available IITs indicated that investigational products provided to 252 patients were valued at 10,400,077,294 won (approximately 8,046,481 US dollars), averaging about 41,270,148 won (approximately 31,930 US dollars) per patient.
Conclusion
Our findings, based on analysis of published research, suggest that IITs conducted by KCSG led to survival benefits for participants and, in some studies, may have provided financial benefits by providing investment drugs.
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Breast cancer
Eflapegrastim versus Pegfilgrastim for Chemotherapy-Induced Neutropenia in Korean and Asian Patients with Early Breast Cancer: Results from the Two Phase III ADVANCE and RECOVER Studies
Yong Wha Moon, Seung Ki Kim, Keun Seok Lee, Moon Hee Lee, Yeon Hee Park, Kyong Hwa Park, Gun Min Kim, Seungtaek Lim, Seung Ah Lee, Jae Duk Choi, Eunhye Baek, Hyesun Han, Seungjae Baek, Seock-Ah Im
Cancer Res Treat. 2023;55(3):766-777.   Published online January 19, 2023
DOI: https://doi.org/10.4143/crt.2022.987
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We investigated the consistent efficacy and safety of eflapegrastim, a novel long-acting granulocyte-colony stimulating factor (G-CSF), in Koreans and Asians compared with the pooled population of two global phase 3 trials.
Materials and Methods
Two phase 3 trials (ADVANCE and RECOVER) evaluated the efficacy and safety of fixed-dose eflapegrastim (13.2 mg/0.6 mL [3.6 mg G-CSF equivalent]) compared to pegfilgrastim (6 mg based on G-CSF) in breast cancer patients who received neoadjuvant or adjuvant docetaxel/cyclophosphamide. The primary objective was to demonstrate non-inferiority of eflapegrastim compared to pegfilgrastim in mean duration of severe neutropenia (DSN) in cycle 1, in Korean and Asian subpopulations.
Results
Among a total of 643 patients randomized to eflapegrastim (n=314) or pegfilgrastim (n=329), 54 Asians (29 to eflapegrastim and 25 to pegfilgrastim) including 28 Koreans (14 to both eflapegrastim and pegfilgrastim) were enrolled. The primary endpoint, DSN in cycle 1 in the eflapegrastim arm was non-inferior to the pegfilgrastim arm in Koreans and Asians. The DSN difference between the eflapegrastim and pegfilgrastim arms was consistent across populations: –0.120 days (95% confidence interval [CI], –0.227 to –0.016), –0.288 (95% CI, –0.714 to 0.143), and –0.267 (95% CI, –0.697 to 0.110) for pooled population, Koreans and Asians, respectively. There were few treatment-related adverse events that caused discontinuation of eflapegrastim (1.9%) or pegfilgrastim (1.5%) in total and no notable trends or differences across patient populations.
Conclusion
This study may suggest that eflapegrastim showed non-inferior efficacy and similar safety compared to pegfilgrastim in Koreans and Asians, consistently with those of pooled population.

Citations

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  • Comparison of Prophylactic Efficacy of Eflapegrastim and Pegteograstim for Chemotherapy-induced Neutropenia in Pancreatic Cancer Patients Receiving FOLFIRINOX/mFOLFIRINOX
    Eui Seon Lee, Min Jung Geum, Jong Hee Ko, Jae Song Kim, Eun Sun Son, Yun Mi Yu
    Journal of Korean Society of Health-System Pharmacists.2024; 41(3): 253.     CrossRef
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  • 273 Download
  • 1 Crossref
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General
Pilot study for the Psychometric Validation of the Sheffield Profile for Assessment and Referral to Care (SPARC) in Korean Cancer Patients
Jung Hye Kwon, Sun Kyung Baek, Do Yeun Kim, Yu Jung Kim, Myung Ah Lee, Hye Jin Choi, Ja Min Byun, Jin Young Jeong, Sam H Ahmedzai, Geun-Doo Jang
Cancer Res Treat. 2021;53(1):25-31.   Published online August 31, 2020
DOI: https://doi.org/10.4143/crt.2020.235
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to validate the Sheffield Profile for Assessment and Referral to Care (SPARC) as an effective tool for screening palliative care needs among Korean cancer patients.
Materials and Methods
The English version of the SPARC was translated by four Korean oncologists and reconciled by a Korean language specialist and a medical oncologist fluent in English. After the first version of the Korean SPARC (K-SPARC) was developed, back-translation into English was performed by a professional translator and bilingual oncologist. The back-translated version was reviewed by the original author (S.H.A.), and modifications were made (ver. 2). The second version of the K-SPARC was tested against other questionnaires, including the Functional Assessment of Cancer Therapy-General (FACT-G) and the Edmonton Symptom Assessment System (ESAS).
Results
Thirty patients were enrolled in the pilot trial. Fifteen were male, and the median age was 64.5 years. Six patients had an Eastern Cooperative Oncology Group performance status of 2 or more. All patients except one were receiving chemotherapy. Regarding internal consistency, the Cronbach’s α scores for physical symptoms, psychological issues, religious and spiritual issues, independency and activity, family and social issues, and treatment issues were 0.812, 0.804, 0.589, 0.843, 0.754, and 0.822, respectively. The correlation coefficients between the SPARC and FACT-G were 0.479 (p=0.007) for the physical domain and –0.130 (p=0.493) for the social domain.
Conclusion
This pilot study indicates that the K-SPARC could be a reliable tool to screen for palliative care needs among Korean cancer patients. A further study to validate our findings is ongoing.

Citations

Citations to this article as recorded by  
  • Translation and linguistic validation of the Sheffield Profile for Assessment and Referral for Care (SPARC) to Colombian Spanish
    Socorro Moreno, Cindy V. Mendieta, Esther de Vries, Sam H. Ahmedzai, Karen Rivera, Camilo Cortes-Mora, Jose A. Calvache
    Palliative and Supportive Care.2024; 22(6): 1801.     CrossRef
  • Validation of traditional Chinese version of Sheffield Profile for Assessment and Referral for Care Questionnaire in Taiwanese patients
    Ming-Chieh Tsai, Yun-Yun Chou, El-Wui Loh, Ashleigh Peng Lin, Hsueh-Chi Wu, Li-Sin Hsiao, Chia-Li Chang, Shu-Fen Chen, Sam H. Ahmedzai, Ka-Wai Tam
    Journal of the Chinese Medical Association.2024; 87(1): 58.     CrossRef
  • Validation of the Spanish translation Sheffield Profile for Assessment and Referral for Care (SPARC-Sp) at the Hospital Universitario San Jose of Popayan, Colombia
    Cindy V. Mendieta, Jose A. Calvache, Martín A. Rondón, Carlos Javier Rincón-Rodríguez, Sam H. Ahmedzai, Esther de Vries
    Palliative and Supportive Care.2024; 22(5): 1282.     CrossRef
  • Co-Designing a Strategy for Implementing the SPARC Holistic Needs Assessment Tool in the Colombian Clinical Context
    Cindy V. Mendieta, Esther de Vries, Jose Andrés Calvache, Sam H. Ahmedzai, Gillian Prue, Tracey McConnell, Joanne Reid
    Healthcare.2023; 11(22): 2917.     CrossRef
  • Outpatient palliative care referral system (PCRS) for patients with advanced cancer: an impact evaluation protocol
    Cinzia Brunelli, Ernesto Zecca, Alessandra Pigni, Paola Bracchi, Mariangela Caputo, Silvia Lo Dico, Viviana Fusetti, Antonino Tallarita, Cristiana Bergamini, Marta Brambilla, Alessandra Raimondi, Monica Niger, Salvatore Provenzano, Pierangela Sepe, Sara A
    BMJ Open.2022; 12(10): e059410.     CrossRef
  • Unmet needs related to the quality of life of advanced cancer patients in Korea: a qualitative study
    Jeehee Pyo, Minsu Ock, Mina Lee, Juhee Kim, Jaekyung Cheon, Juhee Cho, Jung Hye Kwon, Hyeyeoung Kim, Hyeon-Su Im, Young Joo Min, Su-Jin Koh
    BMC Palliative Care.2021;[Epub]     CrossRef
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  • 164 Download
  • 7 Web of Science
  • 6 Crossref
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Pediatric malignancy
Genome-Wide Association Study for the Identification of Novel Genetic Variants Associated with the Risk of Neuroblastoma in Korean Children
Joon Seol Bae, Ji Won Lee, Jung Eun Yoo, Je-Gun Joung, Keon Hee Yoo, Hong Hoe Koo, Yun-Mi Song, Ki Woong Sung
Cancer Res Treat. 2020;52(4):1251-1261.   Published online June 30, 2020
DOI: https://doi.org/10.4143/crt.2020.140
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Neuroblastoma (NB) is the most common extracranial solid tumor found in children. To identify significant genetic factors for the risk of NB, several genetic studies was conducted mainly for Caucasians and Europeans. However, considering racial differences, there is a possibility that genetic predispositions that contribute to the development of NB are different, and GWAS study has not yet been conducted on Korean NB patients.
Materials and Methods
To identify the genetic variations associated with the risk of pediatric NB in Korean children, we performed a genome-wide association analysis with 296 NB patients and 1000 unaffected controls (total n = 1,296) after data cleaning and filtering as well as imputation of non-genotyped SNPs using IMPUTE v2.3.2.
Results
After adjusting for multiple comparisons, we found 21 statistically significant SNPs associated with the risk of NB (Pcorr < 0.05) within 12 genes (RPTN, MRPS18B, LRRC45, KANSL1L, ARHGEF40, IL15RA, L1TD1, ANO7, LAMA5, OR7G2, SALL4, and NEUROG2). Interestingly, out of these, 12 markers were nonsynonymous SNPs. The SNP rs76015112 was most significantly associated with the risk of NB (p = 8.1E-23, Pcorr = 2.3E-17) and was located in the RPTN gene. In addition, significant nonsynonymous SNPs in ADGRE1 were found in patients with MYCN amplification (rs7256147, p = 2.6E-05). In high-risk group, rs7256147 was observed as a significant SNP (p = 5.9E-06).
Conclusion
Our findings might facilitate improved understanding of the mechanism of pediatric NB pathogenesis. However, functional evaluation and replication of these results in other populations are still needed.

Citations

Citations to this article as recorded by  
  • Expression of anoctamin 7 (ANO7) is associated with poor prognosis and mucin 2 (MUC2) in colon adenocarcinoma: a study based on TCGA data
    Chen Chen, Siripat Aluksanasuwan, Keerakarn Somsuan
    Genomics & Informatics.2023; 21(4): e46.     CrossRef
  • An Overview of Long Non-Coding (lnc)RNAs in Neuroblastoma
    Francesca Baldini, Matilde Calderoni, Laura Vergani, Paola Modesto, Tullio Florio, Aldo Pagano
    International Journal of Molecular Sciences.2021; 22(8): 4234.     CrossRef
  • 7,041 View
  • 155 Download
  • 6 Web of Science
  • 2 Crossref
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Public Attitudes towards Cancer Survivors among Korean Adults
Su Yeon Kye, Hyun Jeong Lee, Yeonseung Lee, Young Ae Kim
Cancer Res Treat. 2020;52(3):722-729.   Published online February 6, 2020
DOI: https://doi.org/10.4143/crt.2019.265
AbstractAbstract PDFPubReaderePub
Purpose
We evaluated public attitudes towards cancer survivors and identified the characteristics associated with these attitudes in Korea.
Materials and Methods
We performed this cross-sectional study using proportionate quota random sampling of the 2015 Korean Census. In May 2017, investigators conducted face-to-face interviews with 1,500 Korean volunteers aged between 20 and 79 years. The questionnaire recorded sociodemographic factors, smoking and drinking habits, cancer history in family and acquaintances, interest in cancer survivors, cancer-survivor blame, and attitudes towards cancer survivors.
Results
Many participants had negative attitudes towards cancer survivors. People with a monthly household income above US $7,000 were less likely to have a negative attitude than those with monthly incomes below US $1,499. People in their 70s, without a religion, living in rural areas, smokers, or those who blame cancer survivors for their own cancer were more likely to have a negative attitude than people outside these categories. People interested in cancer survivors were less likely to have a negative attitude than those who were not interested.
Conclusion
To improve attitudes towards cancer survivors, it will be necessary to increase interest in cancer survivors through education, publicity, and advocacy using strategic messaging that focuses on social and institutional aspects and emphasizes that responsibility for cancer should not be attributed to cancer patients. Inducing the public to be interested in cancer survivors will be important for positive attitudes toward cancer survivors.

Citations

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  • Role performance and factors affecting quality of life in bladder cancer survivors with ileal orthotopic neobladder
    So Hee Kim, Eunjung Ryu, Byong Chang Jeong
    Asia-Pacific Journal of Oncology Nursing.2024; 11(6): 100490.     CrossRef
  • Effects of stigma on quality of life of cancer survivors: Preliminary evidence from a survivorship programme in Kenya
    Koech J. Maureen, Judy Mwangi, Benda Kithaka, Serah Kimaru, Ndinda Kusu, Lucy Munyi, Sidney Chahonyo, Francis Makokha
    Heliyon.2024; 10(9): e30165.     CrossRef
  • Perception of Korean healthy adolescents on cancer and adolescent cancer survivors: a cross-sectional survey
    Min Kyung Hyun, Yeonseung Lee, Hyun Jeong Lee, Young Ae Kim
    BMC Public Health.2024;[Epub]     CrossRef
  • Experiences of Cancer Survivors Returning to Work in Korean Society: A Qualitative Study
    Kisook Kim, Hyohyoen Yoon, Booyoung Oh
    Asian Oncology Nursing.2024; 24(3): 114.     CrossRef
  • A Multilabel Text Classifier of Cancer Literature at the Publication Level: Methods Study of Medical Text Classification
    Ying Zhang, Xiaoying Li, Yi Liu, Aihua Li, Xuemei Yang, Xiaoli Tang
    JMIR Medical Informatics.2023; 11: e44892.     CrossRef
  • How should the healthcare system support cancer survivors? Survivors’ and health professionals’ expectations and perception on comprehensive cancer survivorship care in Korea: a qualitative study
    Su Jung Lee, Dal-Lae Jin, Young Ae Kim, Hyun-Ju Seo, Seok-Jun Yoon
    BMC Cancer.2023;[Epub]     CrossRef
  • 6,812 View
  • 134 Download
  • 7 Web of Science
  • 6 Crossref
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Characteristics and Treatment Patterns of Patients with Advanced Soft Tissue Sarcoma in Korea
Hyo Song Kim, Chung Mo Nam, Suk-Yong Jang, Sun Kyu Choi, Minkyung Han, Seonmin Kim, Maria Victoria Moneta, Sae Young Lee, Jae Min Cho, Diego Novick, Sun Young Rha
Cancer Res Treat. 2019;51(4):1380-1391.   Published online February 18, 2019
DOI: https://doi.org/10.4143/crt.2018.476
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
A soft tissue sarcoma (STS) is a rare type of cancer, accounting for 1% of adult solid cancers. The aim of the present study is to determine the incidence of localized and advanced STS in Korean patients, their treatment patterns, and the survival of patients by disease status.
Materials and Methods
The STS patient cohort was defined using National Health Insurance Service medical data from 2002 to 2015. Incidence, distribution, anatomical location of tumors, survival rates (Kaplan-Meyer survival function) and treatment patterns were analyzed by applying different algorithms to the STS cohort containing localized and advanced STS cases.
Results
A total of 7,813 patients were diagnosed with STS from 2007 to 2014, 4,307 were localized STS and 3,506 advanced STS cases. The total incidence of STS was 2.49 per 100,000 person- years: 1.37 per 100,000 person-years for localized STS and 1.12 per 100,000 person-years for advanced STS. The 5-year survival rate after diagnosis was 56.4% for all STS, 82.4% for localized, and 27.2% for advanced STS. Half of the advanced STS patients (49.98%) received anthracycline-containing chemotherapy as initial treatment after diagnosis.
Conclusion
This study provides insights into localized and advanced STS epidemiology, treatment patterns and outcomes in Korea, which could be used as fundamental data in improving clinical outcomes of STS patients in the future.

Citations

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  • Factors predictive of second‐line chemotherapy in soft tissue sarcoma: An analysis of the National Genomic Profiling Database
    Takao Mochizuki, Masachika Ikegami, Toru Akiyama
    Cancer Science.2024; 115(2): 575.     CrossRef
  • Comparative Evaluation of Second-Line Chemotherapy Agents for Advanced Soft Tissue Sarcoma: Gemcitabine/Docetaxel, Pazopanib, and Alternatives
    Tae Hun Kim, Ki Hyuk Sung, So Hak Chung
    Journal of the Korean Orthopaedic Association.2024; 59(1): 22.     CrossRef
  • Secondary hematological malignancies in patients with sarcoma: A single‑center retrospective study
    Yoon Jang, Hong Jeong, Chang-Bae Kong, Won Song, Wan Cho, Dae Jeon, Heyjin Kim, Sung Yang, Im Na, Hyo-Rak Lee, Hye Kang
    Oncology Letters.2024;[Epub]     CrossRef
  • Necroptosis-related lncRNA-based novel signature to predict the prognosis and immune landscape in soft tissue sarcomas
    Qiuzhong Long, Zhengtian Li, Wenkang Yang, Ke Huang, Gang Du
    Journal of Cancer Research and Clinical Oncology.2024;[Epub]     CrossRef
  • First-Line Anlotinib Treatment for Soft-Tissue Sarcoma in Chemotherapy-Ineligible Patients: An Open-Label, Single-Arm, Phase 2 Clinical Trial
    Tao Li, Ying Dong, Yongzhong Wei, Shoufeng Wang, Yunxia Liu, Jia Chen, Wenhua Xiong, Nong Lin, Xin Huang, Meng Liu, Xiaobo Yan, Zhaoming Ye, Binghao Li
    Clinical Cancer Research.2024; 30(19): 4310.     CrossRef
  • Mortality patterns of soft-tissue sarcomas worldwide up to 2018, with predictions for 2025
    Margherita Pizzato, Giulia Collatuzzo, Claudia Santucci, Matteo Malvezzi, Paolo Boffetta, Alessandro Comandone, Fabio Levi, Carlo La Vecchia, Paola Bertuccio, Eva Negri
    European Journal of Cancer Prevention.2023; 32(1): 71.     CrossRef
  • Chemotherapeutic drugs for soft tissue sarcomas: a review
    Zhichao Tian, Weitao Yao
    Frontiers in Pharmacology.2023;[Epub]     CrossRef
  • Identification of m5C-related molecular subtypes and prediction models in the prognosis and tumor microenvironment infiltration of soft tissue sarcoma
    Xianfeng Wang, Yicheng Mao, Hanlu Xu, Jiyang Chen, Xiao chen
    Heliyon.2023; 9(9): e19680.     CrossRef
  • Incidence, Treatment and Outcome of Patients with Retroperitoneal Soft‐Tissue Sarcoma in Switzerland 2005–2015: A Population‐Based Analysis
    Johanna C. F. Willburger, Marco von Strauss, Caspar J. Peterson, Tracy R. Glass, Christoph Kettelhack
    World Journal of Surgery.2022; 46(2): 461.     CrossRef
  • A Necroptosis-Related lncRNA Signature Predicts Prognosis and Indicates the Immune Microenvironment in Soft Tissue Sarcomas
    Binfeng Liu, Zhongyue Liu, Chengyao Feng, Chao Tu
    Frontiers in Genetics.2022;[Epub]     CrossRef
  • A novel inflammatory signature for evaluating immune microenvironment status in soft tissue sarcoma
    Zhehong Li, Honghong Zheng, Lirui Liu, Zhen Fen, Haiying Cao, Jilong Yang, Junqiang Wei
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • Issues of diagnostic search of soft tissue sarcoma
    A. N. Sergeev, D. A. Maksimov, A. M. Morozov, M. A. Belyak, E. V. Penyaz', M. O. Popova
    Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH).2022;[Epub]     CrossRef
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    A. N. Sergeev, D. A. Maksimov, A. M. Morozov, M. A. Belyak, E. V. Penyaz', M. O. Popova
    Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH).2022; 12(6): 15.     CrossRef
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    Rui Shen, Bo Liu, Xuesen Li, Tengbo Yu, Kuishuai Xu, Jinfeng Ma
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    Wenjing Huang, Yuhe Duan, Xiuwei Yang, Cong Shang, Xin Chen, Huanyu Zhang, Fujiang Li
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    Charles A Gusho, Christopher W Seder, Nicolas Lopez-Hisijos, Alan T Blank, Marta Batus
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    Li Zhang, Xianzhe Tang, Jia Wan, Xianghong Zhang, Tao Zheng, Zhengjun Lin, Tang Liu
    Frontiers in Molecular Biosciences.2021;[Epub]     CrossRef
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    Zhengjun Lin, Yiting Xu, Xianghong Zhang, Jia Wan, Tao Zheng, Hongxuan Chen, Shijie Chen, Tang Liu
    International Journal of General Medicine.2021; Volume 14: 8263.     CrossRef
  • Demographics, Changes in Treatment Patterns, and Outcomes of Bone and Soft Tissue Sarcomas in Korea—A Sarcoma-Specific, Institutional Registry-Based Analysis
    Hyehyun Jeong, Hyeon-Su Im, Wanlim Kim, Jong-Seok Lee, Si Yeol Song, Joon Seon Song, Kyung-Ja Cho, Hye Won Chung, Min Hee Lee, Jeong Eun Kim, Jin-Hee Ahn
    Cancer Management and Research.2021; Volume 13: 8795.     CrossRef
  • Characterization of Immune-Related Long Non-coding RNAs to Construct a Novel Signature and Predict the Prognosis and Immune Landscape of Soft Tissue Sarcoma
    Zhengjun Lin, Ke Pang, Hongli Li, Xianghong Zhang, Jia Wan, Tao Zheng, Tang Liu, Weijun Peng
    Frontiers in Cell and Developmental Biology.2021;[Epub]     CrossRef
  • Real-World Outcomes of Pazopanib Treatment in Korean Patients with Advanced Soft Tissue Sarcoma: A Multicenter Retrospective Cohort Study
    Chung Ryul Oh, Jung Yong Hong, Jee Hung Kim, Ji Sung Lee, Hyo Song Kim, Tae Won Kim, Jin-Hee Ahn, Jeong Eun Kim
    Targeted Oncology.2020; 15(4): 485.     CrossRef
  • Comprehensive profiling of immune-related genes in soft tissue sarcoma patients
    Chuan Hu, Bo Chen, Zhangheng Huang, Chuan Liu, Lin Ye, Cailin Wang, Yuexin Tong, Jiaxin Yang, Chengliang Zhao
    Journal of Translational Medicine.2020;[Epub]     CrossRef
  • 11,173 View
  • 242 Download
  • 20 Web of Science
  • 22 Crossref
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Clinical and Genetic Characteristics of BRCA1/2 Mutation in Korean Ovarian Cancer Patients: A Multicenter Study and Literature Review
Byung Su Kwon, Jung Mi Byun, Hyun Joo Lee, Dae Hoon Jeong, Tae Hwa Lee, Kyung-Hwa Shin, Dong Soo Suh, Ki Hyung Kim
Cancer Res Treat. 2019;51(3):941-950.   Published online October 8, 2018
DOI: https://doi.org/10.4143/crt.2018.312
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We investigated the clinical relevance and spectrum of BRCA1/2 mutations in Korean ovarian cancer (KoOC) patients.
Materials and Methods
Two hundred seventy-nine KoOC patients were enrolled from three university hospitals between 2012 and 2017. Their peripheral blood samples were obtained for BRCA1/2 mutation analysis by direct sequencing. Clinicopathological characteristics were retrospectively reviewed, and spectrum analyses of BRCA1/2 mutation were assessed by systematic literature review.
Results
Frequency of BRCA1/2 mutations was 16.5% in KoOC patients. BRCA1/2 mutations were significantly associated with family history of breast/ovarian cancer (p<0.001), serous histology (p=0.044), and advanced International Federation of Gynecology and Obstetrics (FIGO) stage (III/IV, p=0.018) but not with early age-of-onset (age < 50, p=0.729). Literature review of BRCA1/2 mutations in KoOC patients found 111 (55 distinct) mutations with high proportion of Korean-specific mutations (24/55, 43.6%). Comparing the spectrum of BRCA1/2 mutation between KoOC and Korean breast cancer (KoBC) patients, the ratio of BRCA1-to-BRCA2 mutations was different, with BRCA1 (78.4%) being predominant in KoOC and BRCA2 in KoBC (59.2%). The most common mutation also differed between the two (c.3627insA of BRCA1 in KoOC and c.7480C>T of BRCA2 in KoBC).
Conclusion
The clinical relevance of BRCA1/2 mutations in KoOC patients was confirmed but that of early age-of-onset was not. Possible inconsistency in the ratio of BRCA1-to-BRCA2 mutations and the most common mutation between KoOC and KoBC may probably suggest presence of mutation sequence-associated penetrance tendency in hereditary Korean breast and ovarian cancer. These data may provide insights for optimal genetic counseling and prophylactic treatment for at-risk relatives of KoOC patients.

Citations

Citations to this article as recorded by  
  • Exploring the effect of BRCA1/2 status on chemotherapy-induced hematologic toxicity in patients with ovarian cancer
    In Hee Lee, Soo Jung Lee, Juhyung Kim, Yoon Hee Lee, Gun Oh Chong, Jong Mi Kim, Juhun Lee, Nan Young Lee, Seo Young Park, Dea Gy Hong, Yee Soo Chae
    Cancer Chemotherapy and Pharmacology.2024; 94(1): 103.     CrossRef
  • Utility of Next-Generation Sequencing Panel Including Hereditary Breast and Ovarian Cancer-Related Genes for Pathogenic Variant Detection
    Jae Hee Lee, Do-Hoon Kim
    Keimyung Medical Journal.2024; 43(1): 44.     CrossRef
  • Basic knowledge for counseling patients undergoing risk-reducing salpingo-oophorectomy
    Jihye Kim, Chel Hun Choi
    Obstetrics & Gynecology Science.2024; 67(4): 343.     CrossRef
  • Prevalence of BRCA1 and BRCA2 mutations in ovarian cancer patients from Yunnan Province in southwest China
    Yongmei Peng, Jiaqian Liao, Xian He, Yongchun Zhou, Lei Zhang, Yue Jia, Hongying Yang
    European Journal of Cancer Prevention.2024;[Epub]     CrossRef
  • Validation of multi-gene panel next-generation sequencing for the detection of BRCA mutation in formalin-fixed, paraffin-embedded epithelial ovarian cancer tissues
    Eun Taeg Kim, Ha Eun Jeong, Hyung Joon Yoon, Ki Hyung Kim, Dong Soo Suh
    Taiwanese Journal of Obstetrics and Gynecology.2023; 62(1): 66.     CrossRef
  • Using species richness calculations to model the global profile of unsampled pathogenic variants: Examples from BRCA1 and BRCA2
    Nandana D. Rao, Brian H. Shirts, Alvaro Galli
    PLOS ONE.2023; 18(2): e0278010.     CrossRef
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    Stefania Stella, Silvia Rita Vitale, Federica Martorana, Michele Massimino, Giuliana Pavone, Katia Lanzafame, Sebastiano Bianca, Chiara Barone, Cristina Gorgone, Marco Fichera, Livia Manzella
    Cancer Management and Research.2022; Volume 14: 1341.     CrossRef
  • How to start niraparib in real-world Asian ovarian cancer patients?
    Sook-Hee Hong
    Journal of Gynecologic Oncology.2021;[Epub]     CrossRef
  • Identification of BRCA1:c.5470_5477del as a Founder Mutation in Chinese Ovarian Cancer Patients
    Jun Li, Sile Han, Cuiyun Zhang, Yanlin Luo, Li Wang, Ping Wang, Yi Wang, Qingxin Xia, Xiaoyan Wang, Bing Wei, Jie Ma, Hongle Li, Yongjun Guo
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    E Sun Paik, Eun Jin Heo, Chel Hun Choi, Jae‐Hoon Kim, Jae‐Weon Kim, Yong‐Man Kim, Sang‐Yoon Park, Jeong‐Won Lee, Jong‐Won Kim, Byoung‐Gie Kim
    Cancer Science.2021; 112(12): 5055.     CrossRef
  • Impact of proactive high-throughput functional assay data on BRCA1 variant interpretation in 3684 patients with breast or ovarian cancer
    Hyun-Ki Kim, Eun Jin Lee, Young-Jae Lee, Jisun Kim, Yongsub Kim, Kyunggon Kim, Shin-Wha Lee, Suhwan Chang, Young Joo Lee, Jong Won Lee, Woochang Lee, Sail Chun, Byung Ho Son, Kyung Hae Jung, Yong-Man Kim, Won-Ki Min, Sei-Hyun Ahn
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Application of the International Metastatic Renal Cell Carcinoma Database Consortium and Memorial Sloan Kettering Cancer Center Risk Models in Patients with Metastatic Non-Clear Cell Renal Cell Carcinoma: A Multi-Institutional Retrospective Study Using the Korean Metastatic Renal Cell Carcinoma Registry
Jung Kwon Kim, Sung Han Kim, Mi Kyung Song, Jungnam Joo, Seong Il Seo, Cheol Kwak, Chang Wook Jeong, Cheryn Song, Eu Chang Hwang, Ill Young Seo, Hakmin Lee, Sung-Hoo Hong, Jae Young Park, Jinsoo Chung, Korean Renal Cell Carcinoma Study Group
Cancer Res Treat. 2019;51(2):758-768.   Published online September 7, 2018
DOI: https://doi.org/10.4143/crt.2018.421
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) and the Memorial Sloan Kettering Cancer Center (MSKCC) risk models were developed predominantly with clear cell renal cell carcinoma (RCC). Accordingly, whether these two models could be applied to metastatic non-clear cell RCC (mNCCRCC) as well has not been well-known and was investigated herein.
Materials and Methods
From the Korean metastatic RCC registry, a total of 156 patients (8.1%) with mNCCRCC among the entire cohort of 1,922 patients were analyzed. Both models were applied to predict first-line progression-free survival (PFS), total PFS, and cancer-specific survival (CSS).
Results
The median first-line PFS, total PFS, and CSS were 5, 6, and 24 months, respectively. The IMDC risk model reliably discriminated three risk groups to predict survival: the median firstline PFS, total PFS, and CSS for the favorable, intermediate, and poor risk groups were 9, 5, and, 2 months (p=0.001); 14, 7, and 2 months (p < 0.001); and 41, 21, and 8 months (p < 0.001), all respectively. The MSKCC risk model also reliably differentiated three risk groups: 9, 5, and, 2 months (p=0.005); 10, 7, and 3 months (p=0.002); and 50, 21, and 8 months (p < 0.001), also all respectively. The concordance indices were 0.632 with the IMDC model and 0.643 with the MSKCC model for first-line PFS: 0.748 and 0.655 for CSS.
Conclusion
The current IMDC and MSKCC risk models reliably predict first-line PFS, total PFS, and CSS in mNCCRCC.

Citations

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    Nathaniel R. Wilson, Yusuf Acikgoz, Elshad Hasanov
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    Jung Kwon Kim, Sangchul Lee, Sung Kyu Hong, Cheol Kwak, Chang Wook Jeong, Seok Ho Kang, Sung-Hoo Hong, Yong-June Kim, Jinsoo Chung, Eu Chang Hwang, Tae Gyun Kwon, Seok-Soo Byun, Yu Jin Jung, Junghyun Lim, Jiyeon Kim, Hyeju Oh
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    Ilya Tsimafeyeu, Oxana Shatkovskaya, Sergei Krasny, Nurzhan Nurgaliev, Ilya Varlamov, Vladislav Petkau, Sufia Safina, Ruslan Zukov, Mikhail Mazhbich, Galina Statsenko, Sergey Varlamov, Olga Novikova, Igor Zaitsev, Pavel Moiseyev, Alexander Rolevich, Alesy
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    Ismail Selvi, Umut Demirci, Nazan Bozdogan, Halil Basar
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  • Life expectancy in patients with metastatic renal cell carcinoma in the Russian Federation: results of the RENSUR3 multicenter registry study
    I. V. Tsimafeyeu, I. S. Varlamov, V. V. Petkau, S. Z. Safina, R. A. Zukov, M. S. Mazhbich, G. B. Statsenko, S. A. Varlamov, I. V. Zaitsev, O. Yu. Novikova, S. А. Krasny, N. S. Nurgaliyev, I. L. Popova, L. Yu. Vladimirova
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Randomized Phase III Trial of Irinotecan Plus Cisplatin versus Etoposide Plus Cisplatin in Chemotherapy-Naïve Korean Patients with Extensive-Disease Small Cell Lung Cancer
Dong-Wan Kim, Hoon-Gu Kim, Joo-Hang Kim, Keunchil Park, Hoon-Kyo Kim, Joung Soon Jang, Bong-Seog Kim, Jin-Hyoung Kang, Kyung Hee Lee, Sang-We Kim, Hun Mo Ryoo, Jin-Soo Kim, Ki Hyeong Lee, Jung Hye Kwon, Jin-Hyuk Choi, Sang Won Shin, Seokyung Hahn, Dae Seog Heo
Cancer Res Treat. 2019;51(1):119-127.   Published online March 12, 2018
DOI: https://doi.org/10.4143/crt.2018.019
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This randomized phase III study was designed to compare the efficacy and safety of irinote-can plus cisplatin (IP) over etoposide plus cisplatin (EP) in Korean patients with extensive-disease small-cell lung cancer (SCLC).
Materials and Methods
Patients were randomly assigned to receive IP, composed of irinotecan 65 mg/m2 intravenously on days 1 and 8+cisplatin 70 mg/m2 intravenously on day 1 every 3 weeks, or EP, composed of etoposide 100 mg/m2 intravenously on days 1, 2, 3+cisplatin 70 mg/m2 intravenously on day 1, every 3 weeks for a maximum of six cycles, until disease progression, or until unacceptable toxicity occurred. The primary endpoint was overall survival.
Results
A total of 362 patients were randomized to IP (n=173) and EP (n=189) arms. There were no significant differences between IP and EP arms for the median overall survival (10.9 months vs. 10.3 months, p=0.120) and the median progression-free survival (6.5 months vs. 5.8 months, p=0.115). However, there was a significant difference in response rate (62.4% vs. 48.2%, p=0.006). The pre-planned subgroup analyses showed that IP was associated with longer overall survival in male (11.3 months vs. 10.1 months, p=0.036), < 65 years old (12.7 months vs. 11.3 months, p=0.024), and Eastern Cooperative Oncology Group performance status 0/1 (12.4 months vs. 10.9 months, p=0.040) patient groups. The severity of treatment-related adverse events such as grade 3/4 anemia, nausea and diarrhea was more frequent in patients treated with IP.
Conclusion
The IP chemotherapy did not significantly improve the survival compared with EP chemotherapy in Korean patients with extensive-disease SCLC.

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Identification of a Novel BRCA1 Pathogenic Mutation in Korean Patients Following Reclassification of BRCA1 and BRCA2 Variants According to the ACMG Standards and Guidelines Using Relevant Ethnic Controls
Ji Soo Park, Eun Ji Nam, Hyung Seok Park, Jung Woo Han, Jung-Yun Lee, Jieun Kim, Tae Il Kim, Seung-Tae Lee
Cancer Res Treat. 2017;49(4):1012-1021.   Published online January 17, 2017
DOI: https://doi.org/10.4143/crt.2016.433
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Comparison of variant frequencies in the general population has become an essential part of the American College of Medical Genetics and Genomics (ACMG) standards and guidelines for interpreting sequence variants. We determined the optimal number of relevant ethnic controls that should be used to accurately calculate the odds ratio (OR) of genetic variants.
Materials and Methods
Using the ACMG guidelines, we reclassified BRCA1 and BRCA2 mutations and variants of unknown significance in 745 Korean patients susceptible to hereditary breast and ovarian cancer compared with 1,314 Korean population controls.
Results
We observed that the ORs were falsely inflated when we analyzed several variants using non-Korean population data. Our simulation indicated that the number of controls needed for the lower limit of a 95% confidence interval to exceed 1.0 varied according to the frequency of the variant in each patient group, with more than 820 controls needed for a variant existing in 1% of cases. Using a sufficient number of relevant population data, we could efficiently classify variants and identified the BRCA1 p.Leu1780Pro mutation as a possible pathogenic founder mutation in Korean patients.
Conclusion
Our study suggests that BRCA1 p.Leu1780Pro is a novel pathogenic mutation found in Korean patients. We also determined the optimal number of relevant ethnic controls needed for accurate variant classification according to the ACMG guidelines.

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Feasibility and Efficacy of Eribulin Mesilate in Korean Patients with Metastatic Breast Cancer: Korean Multi-center Phase IV Clinical Study Results
Yeon Hee Park, Tae Yong Kim, Young-Hyuck Im, Keun-Seok Lee, In Hae Park, Joohyuk Sohn, Soo-Hyeon Lee, Seock-Ah Im, Jee Hyun Kim, Se Hyun Kim, Soo Jung Lee, Su-Jin Koh, Ki Hyeong Lee, Yoon Ji Choi, Eun Kyung Cho, Suee Lee, Seok Yun Kang, Jae Hong Seo, Sung-Bae Kim, Kyung Hae Jung
Cancer Res Treat. 2017;49(2):423-429.   Published online August 3, 2016
DOI: https://doi.org/10.4143/crt.2016.191
AbstractAbstract PDFPubReaderePub
Purpose
Eribulin mesilate was approved for the treatment of patients with locally advanced or metastatic breast cancer (MBC),who had received at least two chemotherapeutic regimens, including anthracycline and taxane. On the other hand, the efficacy and safety information of eribulin in Korean patients is limited by the lack of clinical trials.
Materials and Methods
In this multicenter, open-label, single-arm, phase IV study, locally advanced or MBC patients were enrolled between June 2013 and April 2014 from 14 centers in Korea. One point four mg/m2 dose of eribulin was administered on days 1 and 8 of every 21 days. The primary endpoint was the frequency and intensity of the treatment emergent adverse event. The secondary endpoint was the disease control rate, which included the rate of complete responses, partial responses, and stable disease.
Results
A total of 101 patients received at least one dose of eribulin and were included in the safety set. The patients received a total of 543 treatment cycles, with a median of three cycles (range, 1 to 31 cycles). The most common adverse event was neutropenia (91.1% of patients, 48.3% of cycles). The frequent non-hematological adverse events included alopecia, decrease in appetite, fatigue/asthenia, and myalgia/arthralgia. The peripheral neuropathy of any grade occurred in 27 patients (26.7%), including grade 3 in two patients. Disease control rate was 52.7% and 51.3% of patients in the full analysis set and per-protocol set, respectively.
Conclusion
This study demonstrated the feasible safety profile and activity of eribulin in Korean patients with MBC.

Citations

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    Min Ho Park, Soo Jung Lee, Woo Chul Noh, Chang Wan Jeon, Seok Won Lee, Gil Soo Son, Byung-In Moon, Jin Sun Lee, Sung Soo Kang, Young Jin Suh, Geumhee Gwak, Tae Hyun Kim, Young Bum Yoo, Hyun-Ah Kim, Min Young Kim, Ju Yeon Kim, Joon Jeong
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Analysis of Clinical Trials in the Journal of Korean Cancer Association for the Last Ten Years
Y S Park
J Korean Cancer Assoc. 2000;32(2):431-438.
AbstractAbstract PDF
PURPOSE
In Korea, many clinical trials have been published in medical journals. However, there has yet to be a study focusing on the scientific competence of the planning, execution and result interpretation of these reports. Therefore, this paper analyzed the clinical trials in the Journal of Korean Cancer Association for the last 10 years.
MATERIALS AND METHODS
All the clinical trials were analyzed according to the characteristics of clinical trial, disease, types and goals of treatment, The prospective studies were analyzed according to the competence of objectives, methods, results, and conclusion section. Clinical trials of surgical treatment were excluded from this study.
RESULTS
A total 223 (20.6%) out of 1,0S2 papers were reports of clinical trials. Of all the elinical trials, phase II, prospective, and single center studies were most common. Among 157 studies (70.4%) that were prospective, 29 studies (18.5%) did not clearly define eligibility criteria. The most common defect in the results was the lack of patients for the analysis (68 trials, 43.3%), and the median size of the trial was 30 patients. Statistical errors were found in 38 trials (24.3%).
CONCLUSION
A lot of clinical trials reported in the Journal of Korean Cancer Association need to be improved in tenns of quality. Also, the editors should review the submitted reports more thoroughly.
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A Feasibility Study for the Implementation of Kwangju Cancer Registry (KCR)
Jin Su Choi, Seok Joon Shn, Baeg Ju Na, Byeong Hwan Sun, Kyeong Soo Park, Sun Seog Kweon, Jeong Soo Im, Young Jin Kim, Tai Ju Jwang
J Korean Cancer Assoc. 1999;31(4):749-757.
AbstractAbstract PDF
PURPOSE
This study was carrid out to assess the feasibility of cancer registry program (KCR) in Kwangju metropolitan city, Korea.
MATERIALS AND METHODS
The incidence cases and mortality data were mainly collected from the Korean national cancer registry system (NCR) and other resources such as medical insurance records, hospital records, pathology reports, radiation records and death certificates of 1996 in Kwangju metropolitan city.
RESULTS
This study identified 1,422 cases of cancer in 1996, which was about 1379o more than NCR. Cancer cases reported from the hospitals outside Kwangju metropolitan city reached almost 40% of total cases. Death certificate notification percent (DCN%) in 1996 was estimated about 31.1%. The proposed KCR would cover more than 95% of cancer cases in Kwangju metropolitan city.
CONCLUSION
The proposed KCR seems feasible in collecting cancer date with reasonable accuracy.
  • 2,564 View
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Effects of Lipid Soluble Components of Korean Red Ginseng on Proliferation and Cell Cycle Regulation Factors in Human Melanoma Cell Lines
Hye Jeong Kim, Joo Young Roh, Jong Ouck Choi, Sul Hee Park, In Sun Kim, Jeongwon Sohn, Chong Kun Ryu
J Korean Cancer Assoc. 1997;29(6):965-976.
AbstractAbstract PDF
PURPOSE
Growth inhibitory effects of lipid soluble components of the Korean red ginseng and the antineoplastic mechanism against human melanoma cell lines were investigated. To examine molecular mechanism of growth inhibitory effects of GX-PE, we analyzed the effect of GX-PE on cell cycle progression and expression of cell cycle regulatory factors such as retinoblastoma gene product (Rb), p27 (Kip1), p21 (WAF1), cdk2, cdk4 and cyclin D1 which are known to regulate cell cycle progression.
MATERIALS AND METHODS
Petroleum ether extract of the Korean red ginseng (GX-PE) was added to cultures of three human melanoma cell lines, SK-MEL-1, SK-MEL-2, and SK-MEL-5. Proliferation was measured by 3H-thymidine incorporation assay. Cell cycle and expression of cell cycle regulatory factors were analyzed by flow cytometry and Western blotting, respectively.
RESULTS
Growth of melanoma cells was inhibited by GX-PE in proportion to the concentration. GX-PE significantly inhibited cell cycle progression at G1 phase. GX-PE increased expression of negative cell cycle regulators, i.e., p27 (Kip1) in SK-MEL-2 and p21 (WAF1) and Rb in SK-MEL-1.
CONCLUSION
These results suggest that GX-PE inhibits proliferation of melanoma cells at a G1-S transition point of the cell cycle. The effect of GX-PE is most likely due to induction of negative cell cycle regulatory factors.
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Stomach Carcinoma in the Young Adults - Analysis of 111 Cases , and Review from Literatures -
Dong Soo Suk
J Korean Cancer Assoc. 1990;22(1):202-208.
AbstractAbstract PDF
There are lll cases under 40 years old out of 584 stomach carcinoma from Seoul and Pusan Paik hospitals, Korea. It is 19. 0% of the total stomach carcinoma, and male-female ratio is 1 2: l. Under 35 years, it is 10.0%(62 cases), and male-female ratio is 0.9: l. Undifferentiated carcinoma is the predominant type, 76.7%, and differentiated type 23.3%. Proximal parts of stomach (body, fundus, cardia) are affected more, 46.8%, and antrum 38.5%, and body with antrum 14.7%. The present data (10.6%) of the incidence under 35 years old is notably higher than that of Japan (1.7-2.8%) and America (0.49~2.2%). These data of the incidence appear proportionally high with the degree of risk factors of these three countries. There are more undifferentiated or diffusely infiltrating type in the young adults, and the incidence of this type is stable without affected much by the environmental factor. Only differentiated or intestinal type of stomach cancer is variable with the enviromentai risk factor. These facts suggest that enviromental factor is mostly responsible for the development of intestinal type, and hereditary factor for the diffuse type. Based upon these presumptions, it is easily understandable ta find an each different male-female ratio in older and younger age groups (2: 1, 1: 1, respectively). These principal findings can be expected to exist in other human cancers which are developed by known or suspected carcinogenic agents. Leukemia and nasopharyngeal carcinoma are good examples. For, it is speculated that in young age group, hereditary factor is the cause, and in older age group, environmental factor is the cause in the above cancers.
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