Cancer Research and Treatment

Original Articles

Lung and Thoracic cancer

Development of the Korean Association for Lung Cancer Clinical Practice Guidelines: Recommendations on Radial Probe Endobronchial Ultrasound for Diagnosing Lung Cancer - An Updated Meta-Analysis: Soo Han Kim, Hyun Sung Chung, Jinmi Kim, Mi-Hyun Kim, Min Ki Lee, Insu Kim, Jung Seop Eom; Cancer Res Treat. 2024;56(2):464-483. Published online November 29, 2023; DOI: https://doi.org/10.4143/crt.2023.749

Abstract PDF Supplementary Material PubReader ePub: Purpose
Radial probe endobronchial ultrasound (RP-EBUS) accurately locates peripheral lung lesions (PLLs) during transbronchial biopsy (TBB). We performed an updated meta-analysis of the diagnostic yield of TBB for PLLs using RP-EBUS to generate recommendations for the development of the Korean Association of Lung Cancer guidelines.
Materials and Methods
We systematically searched MEDLINE and EMBASE (from January 2013 to December 2022), and performed a meta-analysis using R software. The diagnostic yield was evaluated by dividing the number of successful diagnoses by the total lesion number. Subgroup analysis was performed to identify related factors.
Results
Forty-one studies with a total of 13,133 PLLs were included. The pooled diagnostic yield of RP-EBUS was 0.72 (95% confidence interval [CI], 0.70 to 0.75). Significant heterogeneity was observed among studies (χ²=292.38, p < 0.01, I²=86.4%). In a subgroup analysis, there was a significant difference in diagnostic yield based on RP-EBUS findings (within, adjacent to, invisible), with a risk ratio of 1.45 (95% CI, 1.23 to 1.72) between within and adjacent to, 4.20 (95% CI, 1.89 to 9.32) between within and invisible, and 2.59 (95% CI, 1.32 to 5.01) between adjacent to and invisible. There was a significant difference in diagnostic yield based on lesion size, histologic diagnosis, computed tomography (CT) bronchus sign, lesion character, and location from the hilum. The overall complication rate of TBB with RP-EBUS was 6.8% (bleeding, 4.5%; pneumothorax, 1.4%).
Conclusion
Our study showed that TBB with RP-EBUS is an accurate diagnostic tool for PLLs with good safety profiles, especially for PLLs with within orientation on RP-EBUS or positive CT bronchus sign.

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Hematologic malignancy

Efficacy of Salvage Treatments in Relapsed or Refractory Diffuse Large B-Cell Lymphoma Including Chimeric Antigen Receptor T-Cell Therapy: A Systematic Review and Meta-Analysis: Jinchul Kim, Jinhyun Cho, Sang Eun Yoon, Won Seog Kim, Seok Jin Kim; Cancer Res Treat. 2023;55(3):1031-1047. Published online March 13, 2023; DOI: https://doi.org/10.4143/crt.2022.1658

Abstract PDF Supplementary Material PubReader ePub

Purpose
We intend to evaluate the efficacy of salvage treatments for relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL) through meta-analysis.
Materials and Methods
R/R DLBCL trials were divided into two groups based on eligibility for autologous stem-cell transplantation (ASCT), and meta-analysis of each group was performed. Random effects models were used to estimate the 1-year progression-free survival (PFS) rate, and chimeric antigen receptor (CAR) T-cell therapy was used as reference treatment.
Results
Twenty-six ASCT-eligible cohorts from 17 studies comprising 2,924 patients and 59 ASCT-ineligible cohorts from 53 studies comprising 3,617 patients were included in the pooled analysis. In the ASCT-eligible group, the pooled 1-year PFS rate was 0.40 (95% confidence interval [CI], 0.15 to 0.65) for the CAR T-cell group and 0.34 (95% CI, 0.30 to 0.37) for the group with chemotherapy followed by ASCT intention. The two treatments were not significantly different in meta-regression analysis. In the ASCT-ineligible group, the pooled 1-year PFS was 0.40 (95% CI, 0.35 to 0.46) for CAR T-cell, and the highest primary outcome was 0.47 (95% CI, 0.37 to 0.57) for the tafasitamab group. CAR T-cell therapy showed significantly better outcomes than chemotherapy and therapies based on ibrutinib, lenalidomide, and selinexor. However, loncastuximab, polatuzumab plus bendamustine and rituximab, and the tafasitamab group showed no different efficacy than CAR T-cell therapy after adjusting for median number of previous lines of treatment.
Conclusion
Although several regimens were crudely grouped for classification, CAR T-cell therapy did not outperform chemotherapy followed by ASCT in the second-line setting or several recently developed agents in the ASCT-ineligible setting.

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Polatuzumab vedotin combined with bendamustine and rituximab for relapsed/refractory diffuse large B-cell lymphoma: A systematic review protocol
Mohammadreza Eslami, Mahdi Mehrabi, Mehrdad Payandeh, Fakhredin Saba, Chen Li
PLOS ONE.2024; 19(8): e0308247. CrossRef
Real-world effectiveness of chemoimmunotherapy and novel therapies for patients with relapsed/refractory aggressive large B-cell lymphoma
Loretta J. Nastoupil, Clark R. Andersen, Amy Ayers, Yucai Wang, Thomas M. Habermann, Dai Chihara, Brad S. Kahl, Brian K. Link, Jean L. Koff, Jonathon B. Cohen, Peter Martin, Izidore S. Lossos, Michele Stanchina, Sara Haddadi, Carla Casulo, Sabarish Ayyapp
Clinical Lymphoma Myeloma and Leukemia.2024;[Epub] CrossRef
Clinical scoring systems, molecular subtypes and baseline [18F]FDG PET/CT image analysis for prognosis of diffuse large B-cell lymphoma
Zhuxu Sun, Tianshuo Yang, Chongyang Ding, Yuye Shi, Luyi Cheng, Qingshen Jia, Weijing Tao
Cancer Imaging.2024;[Epub] CrossRef
Targeting CD22 for B-cell hematologic malignancies
Jia Xu, Wenjing Luo, Chenggong Li, Heng Mei
Experimental Hematology & Oncology.2023;[Epub] CrossRef

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General

Role of Local Treatment for Oligometastasis: A Comparability-Based Meta-Analysis: Chai Hong Rim, Won Kyung Cho, Jong Hoon Lee, Young Seok Kim, Yang-Gun Suh, Kyung Hwan Kim, Eui Kyu Chie, Yong Chan Ahn, The Oligometastasis Working Group, Korea Cancer Association; Cancer Res Treat. 2022;54(4):953-969. Published online August 16, 2022; DOI: https://doi.org/10.4143/crt.2022.329

Abstract PDF Supplementary Material PubReader ePub

Purpose
We intend to investigate the oncological efficacy and feasibility of local consolidative therapy (LCT) through a meta-analysis method.
Materials and Methods
Four databases including PubMed, MEDLINE, Embase, and Cochrane library were searched. Target studies are controlled trials comparing outcomes of LCT versus a control group. Primary endpoints are overall survival (OS) and progression-free survival (PFS).
Results
A total of 54 studies involving 7,242 patients were included. Pooled analyses showed that the LCT arm could achieve improved OS with pooled odds ratio of 2.896 (95% confidence interval [CI], 2.377 to 3.528; p < 0.001). Regarding PFS, pooled analyses showed pooled odds ratio of 3.045 (95% CI, 2.356 to 3.937; p < 0.001) in favor of the LCT arm. In the subgroup analyses including the studies with reliable comparability (e.g. randomized studies or intentionally matched studies without significant favorable prognosticator in LCT arms), pooled odds ratio was 2.548 (95% CI, 1.808 to 3.591; p < 0.001) favoring the LCT arm regarding OS. Regarding PFS, pooled OR was 2.656 (95% CI, 1.713 to 4.120; p < 0.001) which also favored the LCT arm. Subgroup analyses limited to the randomized controlled trials (RCT) were also performed and pooled odds ratios on OS and PFS were 1.535 (95% CI, 1.082 to 2.177; p=0.016) and 1.668 (95% CI, 1.187 to 2.344; p=0.003). The rates of grade ≥ 3 complications related to LCT was mostly low (< 10%) and not significantly higher compared to the control arm.
Conclusion
Pooled analyses results of all included studies, selected studies with reliable comparability, and RCT’s demonstrated the survival benefit of LCT. These consistent results suggest that LCT was beneficial to the patients with oligometastasis.

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Identifying Trends in Oncology Research through a Bibliographic Analysis of Cancer Research and Treatment
Choong-kun Lee, Jeong Min Choo, Yong Chan Ahn, Jin Kim, Sun Young Rha, Chai Hong Rim
Cancer Research and Treatment.2025; 57(1): 11. CrossRef
The Society of Thoracic Surgeons (STS) Clinical Practice Guideline on Surgical Management of Oligometastatic Non-small Cell Lung Cancer
Mara B. Antonoff, Kyle G. Mitchell, Samuel S. Kim, Hai V. Salfity, Svetlana Kotova, Robert Taylor Ripley, Alfonso L. Neri, Pallavi Sood, Saumil G. Gandhi, Yasir Y. Elamin, Jessica S. Donington, David R. Jones, Elizabeth A. David, Stephen G. Swisher, Isabe
The Annals of Thoracic Surgery.2025;[Epub] CrossRef
Aggressive Local Ablative Radiotherapy Mitigates Progression Risk in Oligometastatic Lung Adenocarcinoma
Gowoon Yang, Kyung Hwan Kim, Chang Geol Lee, Min Hee Hong, Hye Ryun Kim, Yeona Cho, Hong In Yoon
Cancer Research and Treatment.2024; 56(1): 115. CrossRef
MR-guided stereotactic radiotherapy of infra-diaphragmatic oligometastases: Evaluation of toxicity and dosimetric parameters
Mette van Overeem Felter, Pia Krause Møller, Mirjana Josipovic, Susanne Nørring Bekke, Uffe Bernchou, Eva Serup-Hansen, Kasper Madsen, Parag J. Parikh, Joshua Kim, Poul Geertsen, Claus P. Behrens, Ivan R. Vogelius, Mette Pøhl, Tine Schytte, Gitte Fredberg
Radiotherapy and Oncology.2024; 192: 110090. CrossRef
Clinical implication of neck dissection for metastatic lymph nodes originating from non-head and neck regions
Min Ji Kim, So Hee Kang, MinSu Kwon, Young Ho Jung, Seung-Ho Choi, Soon Yuhl Nam, Yoon Se Lee
Acta Oto-Laryngologica.2024; 144(2): 153. CrossRef
Surgery for Oligometastatic Pancreatic Cancer: Defining Biologic Resectability
Shruti Koti, Lyudmyla Demyan, Gary Deutsch, Matthew Weiss
Annals of Surgical Oncology.2024; 31(6): 4031. CrossRef
Radiation Oncologists’ Perspectives on Oligometastatic Disease: A Korean Survey Study
Chai Hong Rim, Won Kyung Cho, Jong Hoon Lee, Young Seok Kim, Yang-Gun Suh, Kyung Hwan Kim, Ah Ram Chang, Eui Kyu Chie, Yong Chan Ahn
Cancer Research and Treatment.2024; 56(2): 414. CrossRef
Radiation Oncologists’ Perspectives on Oligometastatic Prostate Cancer: A Survey from Korean Oligometastasis Working Group
Gyu Sang Yoo, Sunmin Park, Chai Hong Rim, Won Kyung Cho, Ah Ram Chang, Young Seok Kim, Yong Chan Ahn, Eui Kyu Chie
Current Oncology.2024; 31(6): 3239. CrossRef
Local Ablative Therapy Combined With Pembrolizumab in Patients With Synchronous Oligometastatic Non-Small Cell Lung Cancer: A Recursive Partitioning Analysis
Hye In Lee, Eun Kyung Choi, Su Ssan Kim, Young Seob Shin, Junhee Park, Chang-Min Choi, Shinkyo Yoon, Hyeong Ryul Kim, Young Hyun Cho, Si Yeol Song
International Journal of Radiation Oncology*Biology*Physics.2024; 120(3): 698. CrossRef
Retrospective Analysis of Efficacy and Toxicity of Stereotactic Body Radiotherapy and Surgical Resection of Adrenal Metastases from Solid Tumors
Jamie Lütscher, Hans Gelpke, Adrian Zehnder, Laetitia Mauti, Christian Padevit, Hubert John, Nidar Batifi, Daniel Rudolf Zwahlen, Robert Förster, Christina Schröder
Cancers.2024; 16(15): 2655. CrossRef
A new proposal of simplified classification of non-small cell lung cancer oligometastases for easy applicability through systematic literature analysis and meta-analysis validation
Hanseung Kang, Woohyeon Do, Yong Chan Ahn, Eui Kyu Chie, Chai Hong Rim
European Journal of Cancer.2024; 212: 115043. CrossRef
Oligometastasis: More Lessons to Be Learned
Kyung Hwan Kim, Yong Chan Ahn
Cancer Research and Treatment.2023; 55(1): 1. CrossRef
Top Ten Lessons Learned from Trials in Oligometastatic Cancers
Vivian S. Tan, David A. Palma
Cancer Research and Treatment.2023; 55(1): 5. CrossRef
Genomic Characteristics and the Potential Clinical Implications in Oligometastatic Non–Small Cell Lung Cancer
Rongxin Liao, Kehong Chen, Jinjin Li, Hengqiu He, Guangming Yi, Mingfeng Huang, Rongrong Chen, Lu Shen, Xiaoyue Zhang, Zaicheng Xu, Zhenzhou Yang, Yuan Peng
Cancer Research and Treatment.2023; 55(3): 814. CrossRef
Metastasis-Directed Local Therapy of Hepatic Oligometastasis from Colorectal Cancer and Future Perspective in Radiation Therapy
Gyu Sang Yoo, Chai Hong Rim, Won Kyung Cho, Jae-Uk Jeong, Eui Kyu Chie, Hyeon-Min Cho, Jun Won Um, Yong Chan Ahn, Jong Hoon Lee
Cancer Research and Treatment.2023; 55(3): 707. CrossRef
Barriers in Oligometastasis Care in Korea: Radiation Oncologists’ Perspectives
Eui Kyu Chie, Chai Hong Rim, Won Kyung Cho, Yong Chan Ahn
Cancer Research and Treatment.2023; 55(4): 1063. CrossRef
Impact of high dose radiotherapy for breast tumor in locoregionally uncontrolled stage IV breast cancer: a need for a risk-stratified approach
Nalee Kim, Haeyoung Kim, Won Park, Won Kyung Cho, Tae Gyu Kim, Young-Hyuck Im, Jin Seok Ahn, Yeon Hee Park, Ji-Yeon Kim
Radiation Oncology.2023;[Epub] CrossRef
Oligometastasis: Expansion of Curative Treatments in the Field of Oncology
Ah Reum Lim, Chai Hong Rim
Medicina.2023; 59(11): 1934. CrossRef
Treating Oligometastses, Prelude or Just Hassles of Systemic Treatment
Dae Ho Lee
Cancer Research and Treatment.2022; 54(4): 951. CrossRef

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Lung and Thoracic cancer

Clinical Efficacy of Immune Checkpoint Inhibitors in Non–Small Cell Lung Cancer Patients with Liver Metastases: A Network Meta-Analysis of Nine Randomized Controlled Trials: Qing Yin, Longguo Dai, Ruizhu Sun, Ping Ke, Liya Liu, Bo Jiang; Cancer Res Treat. 2022;54(3):803-816. Published online October 25, 2021; DOI: https://doi.org/10.4143/crt.2021.764

Abstract PDF Supplementary Material PubReader ePub

Purpose
This network meta-analysis (NMA) was conducted to compare the efficacy of immune checkpoint inhibitors in advanced non–small cell lung cancer (NSCLC) patients with liver metastases.
Materials and Methods
English literature was retrieved from the PubMed, American Society of Clinical Oncology, and European Society for Medical Oncology databases from January 2015 to January 2021. We pooled the overall survival (OS) and progression-free survival (PFS) hazard ratios (HRs) using an NMA and ranked treatments by the surface under the cumulative ranking curve. Publication bias was evaluated by Begg’s and Egger’s tests. STATA 15.0 was used for the sensitivity analysis, and the remaining statistical analyses were performed using R 4.0.2.
Results
Nine eligible phase III randomized controlled trials were included, including 1,141 patients with liver metastases. Pembrolizumab+chemotherapy ranked highest, followed by atezolizumab+bevacizumab+chemotherapy and nivolumab. However, no significant difference in OS rates was observed across these three treatments (HR, 0.98; 95% confidence interval [CI], 0.43 to 2.22 for pembrolizumab+chemotherapy vs. atezolizumab+bevacizumab+chemotherapy; HR, 0.91; 95% CI, 0.52 to 1.57 for pembrolizumab+chemotherapy vs. nivolumab). Regarding the PFS rate, atezolizumab+bevacizumab+chemotherapy and pembro-lizumab+chemotherapy ranked highest and no significant difference was observed between them (HR, 0.79; 95% CI, 0.36 to 1.70 for atezolizumab+bevacizumab+chemotherapy vs. pembrolizumab+chemotherapy).
Conclusion
Pembrolizumab+chemotherapy, atezolizumab+bevacizumab+chemotherapy, and nivolumab were superior to other treatments in NSCLC patients with liver metastases. These new findings may help clinicians better select therapeutic strategies for NSCLC patients with liver metastases.

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Progress of immune checkpoint inhibitors therapy for non-small cell lung cancer with liver metastases
Fan-jie Qu, Yi Zhou, Shuang Wu
British Journal of Cancer.2024; 130(2): 165. CrossRef
Effectiveness and Safety of Immune Checkpoint Inhibitors Alone or in Combination With Chemotherapy in Pulmonary Sarcomatoid Carcinoma
Daisuke Hazama, Kenji Nakahama, Hiroaki Kodama, Akito Miyazaki, Koichi Azuma, Yosuke Kawashima, Yuki Sato, Kentaro Ito, Yoshimasa Shiraishi, Keita Miura, Takayuki Takahama, Satoshi Oizumi, Yoshinobu Namba, Satoshi Ikeda, Hiroshige Yoshioka, Asuka Tsuya, Y
JTO Clinical and Research Reports.2024; 5(1): 100613. CrossRef
Evolving landscape of treatments targeting the microenvironment of liver metastases in non-small cell lung cancer
Lingling Zhu, Xianzhe Yu, Xiaojun Tang, Chenggong Hu, Lei Wu, Yanyang Liu, Qinghua Zhou
Chinese Medical Journal.2024; 137(9): 1019. CrossRef
Treatment Options for Patients with Non-Small Cell Lung Cancer and Liver Metastases
Vesna Ćeriman Krstić, Natalija Samardžić, Milija Gajić, Milan Savić, Biljana Šeha, Marina Roksandić Milenković, Dragana Jovanović
Current Issues in Molecular Biology.2024; 46(12): 13443. CrossRef
Assessing the Relationship Between Liver Metastases and the Survival of Patients With Non-Small Cell Lung Cancer After Immune Checkpoint Inhibitors Treatment: A Systematic Review and Meta-Analysis
Huilin Xu, Pingpo Ming, Zhenyu Zhao, Nan Zhao, Dingjie Zhou, Xixian Tang, Dedong Cao
Integrative Cancer Therapies.2023;[Epub] CrossRef
Liver metastases and the efficacy of immune checkpoint inhibitors in advanced lung cancer: A systematic review and meta-analysis
Handai Xia, Wengang Zhang, Yuqing Zhang, Xiaoling Shang, Yanguo Liu, Xiuwen Wang
Frontiers in Oncology.2022;[Epub] CrossRef

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Gastrointestinal Cancer

Neurocognitive Effects of Chemotherapy for Colorectal Cancer: A Systematic Review and a Meta-Analysis of 11 Studies: Soo Young Hwang, Kwanghyun Kim, Byeonggwan Ha, Dongkyu Lee, Seonung Kim, Seongjun Ryu, Jisu Yang, Sun Jae Jung; Cancer Res Treat. 2021;53(4):1134-1147. Published online March 17, 2021; DOI: https://doi.org/10.4143/crt.2020.1191

Abstract PDF Supplementary Material PubReader ePub

Purpose
Chemotherapy-related cognitive impairment (CRCI) is a controversial concept not much explored on colorectal cancer patients.
Materials and Methods
We identified 11 prospective studies: eight studies on 696 colorectal cancer patients who received chemotherapy and three studies on 346 rectal cancer patients who received neoadjuvant chemoradiotherapy. Standardized mean differences (SMDs) of neuropsychological test results and the cognitive quality-of-life scale were calculated using random effect models. A meta-regression was conducted to investigate the association between mean study population age and effect sizes.
Results
The association between chemotherapy and cognitive impairment was not clear in colorectal cancer patients (SMD, 0.003; 95% confidence interval, ‒0.080 to 0.086). However, a meta-regression showed that older patients are more vulnerable to CRCI than younger patients (β=‒0.016, p < 0.001).
Conclusion
Chemotherapy has an overall positive negligible effect size on the cognitive function of colorectal patients. Age is a significant moderator of CRCI.

Citations

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Research Progress: Exploring the Long-term Survival Status of Colorectal Cancer Survivors
Zhaobei Cai, Qianqian Chen, Enqiang Linghu
Clinical Cancer Investigation Journal.2024; 13(2): 34. CrossRef
Neurocognitive function and quality-of-life in patients with colorectal cancer
Ann M. Berger, Jean Grem, Matthew Garlinghouse, Elizabeth Lyden, Kendra Schmid
European Journal of Oncology Nursing.2023; 64: 102304. CrossRef
The impact of chemotherapy on cognitive performance post‐surgery in patients with colorectal cancer: A prospective cohort study
Marie‐Rose Dwek, Stanton P. Newman, Stefano Brini, Pru Holder, Michael Machesney, David Propper, Lorna R. Rixon, Shashivadan P. Hirani, Catherine S. Hurt
Psycho-Oncology.2023; 32(7): 1057. CrossRef
Virtual Reality-Based Exercise Rehabilitation in Cancer-Related Dysfunctions: Scoping Review (Preprint)
Zhenzhen Su, Liyan Zhang, Xuemin Lian, Miaomiao Guan
Journal of Medical Internet Research.2023;[Epub] CrossRef
Long-term neurocognitive function after whole-brain radiotherapy in patients with melanoma brain metastases in the era of immunotherapy
Martin Salzmann, Klaus Hess, Kristin Lang, Alexander H. Enk, Berit Jordan, Jessica C. Hassel
Strahlentherapie und Onkologie.2022; 198(10): 884. CrossRef
Chemotherapy-induced functional brain abnormality in colorectal cancer patients: a resting‐state functional magnetic resonance imaging study
Siwen Liu, Yesong Guo, Jie Ni, Na Yin, Chenchen Li, Xuan Pan, Rong Ma, Jianzhong Wu, Shengwei Li, Xiaoyou Li
Frontiers in Oncology.2022;[Epub] CrossRef
Neurological Complications of Conventional and Novel Anticancer Treatments
Paola Alberti, Alessandro Salvalaggio, Andreas A. Argyriou, Jordi Bruna, Andrea Visentin, Guido Cavaletti, Chiara Briani
Cancers.2022; 14(24): 6088. CrossRef
Effect of chemotherapy and radiotherapy on cognitive impairment in colorectal cancer: evidence from Korean National Health Insurance Database Cohort
Kwanghyun Kim, Chang Woo Kim, Aesun Shin, Hyunseok Kang, Sun Jae Jung
Epidemiology and Health.2021; 43: e2021093. CrossRef

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Population Attributable Fraction of Helicobacter pylori Infection–Related Gastric Cancer in Korea: A Meta-Analysis: Yoon Park, Moran Ki; Cancer Res Treat. 2021;53(3):744-753. Published online December 15, 2020; DOI: https://doi.org/10.4143/crt.2020.610

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to determine the proportion of gastric cancer attributable to Helicobactor pylori in the Korean population. Infection with H. pylori has been recognized as the most significant risk factor for gastric cancer. In Korea, gastric cancer is the most common cancer that accounted for 13.3% of all cancers in 2016. In particular, men are most commonly diagnosed with gastric cancer; the age-standardized incidence rate in men is 49.6 per 100,000, which is more than twice the incidence in women.
Materials and Methods
The population attributable fraction (PAF) was calculated as a function of the relative risk (RR) of gastric cancer associated with H. pylori infections. To estimate PAF of gastric cancer due to H. pylori, the prevalence of H. pylori infections was extrapolated for the year of 1990 and a pooled RR was obtained by conducting a meta-analysis of studies recently published in Korea.
Results
The estimated prevalence of H. pylori was 76.4% in men and 71.9% in women. The RRs (95% confidence interval) pooled from case-control studies using a random effects model was 1.69 (1.29-2.22) for overall gastric cancer and 2.17 (1.04-4.55) for non-cardia gastric cancer. Using the RR for overall gastric cancer, the estimated PAFs due to H. pylori were 34.5% in men and 33.2% in women.
Conclusion
The occurrence of gastric cancer in Koreans may be affected by other risk factors in addition to H. pylori infection, which may contribute to increasing baseline risk for gastric cancer.

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Eun Lee, Joo-Hee Kim, Hyo Choi, Ho Kang, Hyun Lim, Ji Kim, Seong-Jin Cho, Eun Nam, Ha Park, Nan Kim, Mi Kwon
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Technology in Cancer Research & Treatment.2022;[Epub] CrossRef
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Xuan Quy Luu, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, Kyu-Won Jung, Kui Son Choi
Journal of Gastroenterology.2022; 57(7): 464. CrossRef
Comparison of Concordance of Peptic Ulcer Disease, Non-Adenomatous Intestinal Polyp, and Gallstone Disease in Korean Monozygotic and Dizygotic Twins: A Cross-Sectional Study
Hyo Geun Choi, So Young Kim, Hyun Lim, Joo-Hee Kim, Ji Hee Kim, Seong-Jin Cho, Eun Sook Nam, Kyueng-Whan Min, Ha Young Park, Nan Young Kim, Sangkyoon Hong, Younghee Choi, Ho Suk Kang, Mi Jung Kwon
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Cancer Research.2021; 81(21): 5377. CrossRef

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Optimal Maintenance Strategy for First-Line Oxaliplatin-Containing Therapy with or without Bevacizumab in Patients with Metastatic Colorectal Cancer: A Meta-Analysis: Toshikazu Moriwaki, Masahiko Gosho, Akinori Sugaya, Takeshi Yamada, Yoshiyuki Yamamoto, Ichinosuke Hyodo; Cancer Res Treat. 2021;53(3):703-713. Published online December 1, 2020; DOI: https://doi.org/10.4143/crt.2020.805

Abstract PDF Supplementary Material PubReader ePub: Purpose
Maintenance therapy after oxaliplatin withdrawal is useful in patients with metastatic colorectal cancer (mCRC). This study aimed to investigate the timing of discontinuation or reintroduction of oxaliplatin and the optimal maintenance therapy regimen for survival.
Materials and Methods
PubMed and conference abstracts were searched to select phase II and III trials of first-line oxaliplatin-containing therapy with or without bevacizumab using maintenance therapy for mCRC. Correlations of median overall survival (OS) with induction therapy regimens, induction therapy duration, maintenance therapy regimens (fluoropyrimidine plus bevacizumab [FP+Bev], FP/Bev alone, and no treatment), and oxaliplatin reintroduction were investigated using correlation and weighted multivariate regression analyses.
Results
Twenty-two treatment arms were analyzed, including 2,581 patients. The maintenance therapy regimen FP+Bev showed the strongest correlation with a prolonged OS (Spearman’s partial correlation coefficient=0.42), and the other three variables correlated weakly with the OS. The maintenance therapy regimen significantly interacted with the induction chemotherapy duration (p=0.019). The predicted OS for FP+Bev crossed the lines of FP/Bev alone at 18 weeks of induction therapy, and of no treatment at 23 weeks. The corresponding OS at 12 and 27 weeks of induction therapies were 28.6 and 24.2 months for FP+Bev, 25.9 and 28.8 months for FP/Bev alone, and 20.5 and 27.5 months for no treatment.
Conclusion
The optimal maintenance therapy regimen for the OS is a continuous induction therapy as long as possible followed by FP/Bev alone and switching to FP+Bev within approximately 4 months if induction therapy is discontinued.

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Gastrointestinal cancer

Tumor Control and Overall Survival after Stereotactic Body Radiotherapy for Pulmonary Oligometastases from Colorectal Cancer: A Meta-Analysis: Hoon Sik Choi, Bae Kwon Jeong, Ki Mun Kang, Hojin Jeong, Jin Ho Song, In Bong Ha, Oh-Young Kwon; Cancer Res Treat. 2020;52(4):1188-1198. Published online July 21, 2020; DOI: https://doi.org/10.4143/crt.2020.402

Abstract PDF Supplementary Material PubReader ePub

Purpose
In pulmonary oligometastases from colorectal cancer (POM-CRC), the primarily recommended local therapy is metastasectomy. Stereotactic body radiotherapy (SBRT) is another local therapy modality that is considered as an alternative option in patients who cannot undergo surgery. The purpose of this meta-analysis is to demonstrate the effects of SBRT on POM-CRC by integrating the relevant studies.
Materials and Methods
The authors explored MEDLINE, EMBASE, Cochrane Library, Web of Science, and SCOPUS, and selected studies including patients treated with SBRT for POM-CRC and availability of local control (LC) or overall survival (OS) rate. In this meta-analysis, the effect of SBRT was presented in the form of the LC and OS rates for 1, 2, 3, and 5 years after SBRT as pooled estimates, and the frequency of pulmonary toxicity of grade 3 or higher after SBRT (PTG3-SBRT).
Results
Fourteen full texts among the searched 4,984 studies were the objects of this meta-analysis. The overall number of POM-CRC patients was 495 as per the integration of 14 studies. The pooled estimate LC rate at 1, 2, 3, and 5 years after SBRT was 81.0%, 71.5%, 56.0%, and 61.8%, and the OS rate was 86.9%, 70.1%, 57.9%, and 43.0%, respectively. The LC and OS rates gradually declined until 3 years after SBRT in a similar pattern. Among the 14 studies, only two studies reported PTG3-SBRT as 2.2% and 10.8%, respectively.
Conclusion
For POM-CRC, SBRT is an ablative therapy with a benefit on LC and OS rates and less adverse effects on the lung.

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Treatment of Colorectal Lung Metastases: Two Centers Retrospective Study
Myrtle F. Krul, Jan M. van Rees, Amihan M. de Boer, Karlijn K. Neve, Cornelis Verhoef, Koert F.D. Kuhlmann, Tarik R. Baetens, Tineke E. Buffart, Joost L. Knegjens, Houke M. Klomp, Theo J.M. Ruers, Marianne de Vries, Joost Rothbarth, Esther van Meerten, Jo
Digestive Diseases.2024; 42(6): 538. CrossRef
Clinical outcomes and lung toxicities after lung SABR using dynamic conformal arc therapy: a single-institution cohort study
Emmanuel Mesny, Myriam Ayadi, Pauline Dupuis, Guillaume Beldjoudi, Ronan Tanguy, Isabelle Martel-Lafay
Radiation Oncology.2023;[Epub] CrossRef
Knowing When to Use Stereotactic Ablative Radiation Therapy in Oligometastatic Cancer
Davide Franceschini, Maria Ausilia Teriaca, Luca Dominici, Ciro Franzese, Marta Scorsetti
Cancer Management and Research.2021; Volume 13: 7009. CrossRef

8,261 View
158 Download
11 Web of Science
3 Crossref

Body Mass Index and Risk of Gastric Cancer in Asian Adults: A Meta-Epidemiological Meta-Analysis of Population-Based Cohort Studies: Jong-Myon Bae; Cancer Res Treat. 2020;52(2):369-373. Published online August 12, 2019; DOI: https://doi.org/10.4143/crt.2019.241

Abstract PDF PubReader ePub

Purpose
A previous meta-analysis (MA) published in 2009 reported that excess body weight was associated with an increased risk of gastric cancer in non-Asians, but not in Asians. The aim was to conduct a meta-epidemiological MA (MEMA) to evaluate association between excess body weight and the risk of gastric cancer in Asian adults with using the proposed classification of weight by body mass index (BMI) in Asian adults.
Materials and Methods
The selection criteria were population-based prospective cohort studies that measured BMI of cohort participants and evaluated a risk of gastric cancer. Overweight group (OW) and obesity group (OB) were defined as 23.0-24.9 and ≥ 25.0, respectively. A group only showing results for BMI over 23.0 was defined as overweight and obesity group (OWB). Random effect model was applied if I² value was over 50%.
Results
After four new studies were added through citation discovery tools, seven cohort studies with 21 datasets were selected finally for MEMA. The I² value of OW, OB, and OWB were 76.1%, 83.5%, and 97.1%, respectively. Only OWB in men had a I² value below 50% (22.5%) and showed a statistical significance with inverse association (summary relative risk, 0.79; 95% confidence interval, 0.77 to 0.81).
Conclusion
This MEMA supported the hypothesis that OW might be a protective factor in gastric cancer risk in Asian adults. It will be necessary to conduct additional cohort studies with lengthening follow-up periods and re-analyzing the effect of overweight and obesity classified by the Asian criteria.

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Siyi He, Zhiyi Zhang, Guohui Song, Zhenhai Wang, Chunyun Dai, Shipeng Yan, Kun Jiang, Bingbing Song, He Li, Maomao Cao, Dianqin Sun, Fan Yang, Xinxin Yan, Shaoli Zhang, Yi Teng, Qianru Li, Changfa Xia, Wanqing Chen
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Aaron P. Thrift, Theresa Nguyen Wenker, Hashem B. El-Serag
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Light Alcohol Drinking and Risk of Cancer: A Meta-Analysis of Cohort Studies: Yoon-Jung Choi, Seung-Kwon Myung, Ji-Ho Lee; Cancer Res Treat. 2018;50(2):474-487. Published online May 22, 2017; DOI: https://doi.org/10.4143/crt.2017.094

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to determine whether light alcohol drinking increases the risk of cancer by using a meta-analysis of cohort studies because the newly revised 2015 European Code against Cancer fourth edition on alcohol and cancer was based on critical flaws in the interpretation and citation of the previous meta-analyses.
Materials and Methods
PubMed and EMBASE were searched in April, 2016. Two authors independently reviewed and selected cohort studies on the association between very light (≤ 0.5 drink/day), light (≤ 1 drink/day), or moderate drinking (1-2 drinks/day) and the risk of cancer incidence and mortality. A pooled relative riskwith its 95% confidence intervalwas calculated by a randomeffects meta-analysis. Main outcome measures were cancer incidence and mortality.
Results
A total of 60 cohort studies from 135 articles were included in the final analysis. Very light drinking or light drinking was not associated with the incidence of most cancers except for female breast cancer in women and male colorectal cancer. Conversely, light drinking was associated with a decreased incidence of both female and male lung cancer significantly and both female and male thyroid cancer marginally significantly. Moderate drinking significantly increased the incidence of male colorectal cancer and female breast cancer,whereas it decreased the incidence of both female and male hematologic malignancy.
Conclusion
We found that very light or light alcohol drinking was not associated with the risk of most of the common cancers except for the mild increase in the incidence of breast cancer in women and colorectal cancer in men.

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Meta-Analysises

Impact of Resection Margin Distance on Survival of Pancreatic Cancer: A Systematic Review and Meta-Analysis: Kyung Su Kim, Jeanny Kwon, Kyubo Kim, Eui Kyu Chie; Cancer Res Treat. 2017;49(3):824-833. Published online August 26, 2016; DOI: https://doi.org/10.4143/crt.2016.336

Abstract PDF PubReader ePub

Purpose
While curative resection is the only chance of cure in pancreatic cancer, controversies exist about the impact of surgical margin status on survival. Non-standardized pathologic report and different criteria on the R1 status made it difficult to implicate adjuvant therapy after resection based on the margin status. We evaluated the influence of resection margins on survival by meta-analysis.
Materials and Methods
We thoroughly searched electronic databases of PubMed, EMBASE, and Cochrane Library. We included studies reporting survival outcomeswith different margin status: involved margin (R0 mm), margin clearance with ≤ 1 mm (R0-1 mm), and margin with > 1 mm (R>1 mm). Hazard ratio (HR) for overall survival was extracted, and a random-effects model was used for pooled analysis.
Results
A total of eight retrospective studies involving 1,932 patients were included. Pooled HR for overall survival showed that patients with R>1 mm had reduced risk of death than those with R0-1 mm (HR, 0.74; 95% confidence interval [CI], 0.61 to 0.88; p=0.001). In addition, patients with R0-1 mm had reduced risk of death than those with R0 mm (HR, 0.81; 95% CI, 0.72 to 0.91; p < 0.001). There was no heterogeneity between the included studies (I 2 index, 42% and 0%; p=0.10 and p=0.82, respectively).
Conclusion
Our results suggest that stratification of the patients based on margin status is warranted in the clinical trials assessing the role of adjuvant treatment for pancreatic cancer.

Citations

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Alcohol Intake and Risk of Thyroid Cancer: A Meta-Analysis of Observational Studies: Seung-Hee Hong, Seung-Kwon Myung, Hyeon Suk Kim, The Korean Meta-Analysis (KORMA) Study Group; Cancer Res Treat. 2017;49(2):534-547. Published online July 7, 2016; DOI: https://doi.org/10.4143/crt.2016.161

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to assess whether alcohol intake is associated with the risk of thyroid cancer by a meta-analysis of observational studies.
Materials and Methods
We searched PubMed and EMBASE in June of 2015 to locate eligible studies. We included observational studies such as cross-sectional studies, case-control studies, and cohort studies reporting odd ratios (ORs) or relative risk (RRs) with 95% confidence intervals (CIs).
Results
We included 33 observational studies with two cross-sectional studies, 20 case-controls studies, and 11 cohort studies, which involved a total of 7,725 thyroid cancer patients and 3,113,679 participants without thyroid cancer in the final analysis. In the fixed-effect model meta-analysis of all 33 studies, we found that alcohol intake was consistently associated with a decreased risk of thyroid cancer (OR or RR, 0.74; 95% CI, 0.67 to 0.83; I2=38.6%). In the subgroup meta-analysis by type of study, alcohol intake also decreased the risk of thyroid cancer in both case-control studies (OR, 0.77; 95% CI, 0.65 to 0.92; I2=29.5%; n=20) and cohort studies (RR, 0.70; 95% CI, 0.60 to 0.82; I2=0%; n=11). Moreover, subgroup meta-analyses by type of thyroid cancer, gender, amount of alcohol consumed, and methodological quality of study showed that alcohol intake was significantly associated with a decreased risk of thyroid cancer.
Conclusion
The current meta-analysis of observational studies found that, unlike most of other types of cancer, alcohol intake decreased the risk of thyroid cancer.

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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

Abstract PDF PubReader ePub

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 (p_interaction=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 (p_interaction=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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Wing-Lok Chan, Xiaodong Liu, Carlos King-Ho Wong, Michael Siu-Nam Wong, Ian Yu-Hong Wong, Ka-On Lam, Bryan Ho-Kwan Yun, Emina Edith Cheung, Rosa Pui-Ying Tse, Fion Chan, Simon Law, Dora Kwong
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Michael E. Johnston, Jeffrey J. Sussman, Sameer H. Patel
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Xuefei Wang, Junjie Zhao, Mark Fairweather, Tingsong Yang, Yihong Sun, Jiping Wang
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Irinotecan Monotherapy Versus Irinotecan-Based Combination as Second-Line Chemotherapy in Advanced Gastric Cancer: A Meta-Analysis: Yo-Han Cho, So Young Yoon, Soo-Nyung Kim; Cancer Res Treat. 2017;49(1):255-262. Published online May 18, 2016; DOI: https://doi.org/10.4143/crt.2015.452

Abstract PDF PubReader ePub

Purpose
A meta-analysis was conducted to examine the question of whether combination regimens are more effective than monotherapy as a second-line chemotherapy in advanced gastric cancer.
Materials and Methods
The MEDLINE and the EMBASE databases and the Cochrane Central Register for Controlled Trials were searched using appropriate keywords. Only randomized controlled trials were eligible.
Results
Taxane-based study is rare; thus, four irinotecan-based studies were finally included in the meta-analysis. Out of 661 patients, 331 patients were assigned to combination therapy and 330 to monotherapy. Cisplatin or fluoropyrimidine (S-1 or 5-fluorouracil) was used as a combination partner to irinotecan. The pooled hazard ratio (HR) for overall survival (OS) and for progression-free survival (PFS) was 0.938 (95% confidence interval [CI], 0.796 to 1.104; p=0.442) and 0.815 (95% CI, 0.693 to 0.958; p=0.013). In subgroup analysis according to previous exposure to a partner agent, the PFS benefit of combination was observed only in the partially exposed group (HR, 0.784; 95% CI, 0.628 to 0.980; p=0.032).
Conclusion
Second-line irinotecan-based combination was not associated with increased OS, but with PFS benefit, which seemed particularly significant for patients receiving combination with a new agent.

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Original Article

Apolipoprotein E (APOE) Polymorphisms and Susceptibility to Breast Cancer: A Meta-Analysis: Mostafa Saadat; Cancer Res Treat. 2012;44(2):121-126. Published online June 30, 2012; DOI: https://doi.org/10.4143/crt.2012.44.2.121

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PURPOSE
Apolipoprotein E (APOE, MIM: 107741) has three functionally distinct isoforms of the protein (E2, E3, and E4), encoded by corresponding alleles epsilon2, epsilon3, and epsilon4, which have been well described. Findings from previous studies investigating association between APOE polymorphisms and breast cancer risk have been inconsistent. The present meta-analysis was conducted in order to investigate association of APOE polymorphisms with risk of breast cancer.
MATERIALS AND METHODS
Several electronic databases were used for identification of studies containing information on APOE polymorphisms and breast cancer risk published up to January 2012. We identified 10 eligible studies, including 3,835 subjects (2008 patients, and 1,827 healthy controls), that reported on polymorphisms of APOE and risk of breast cancer. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using a fixed and random-effects models.
RESULTS
Among studies reported from Asia, an association of the epsilon4 allele with increased risk of breast cancer, in comparison with the epsilon3 allele, was observed (OR, 1.56; 95% CI, 1.19 to 2.04; p=0.001). It should be noted that allele epsilon2 showed no association with breast cancer risk. Among Caucasians, neither the epsilon4 (OR, 0.99; 95% CI, 0.83 to 1.17; p=0.917) nor the epsilon2 (OR, 0.92; 95% CI, 0.72 to 1.17; p=0.514) allele showed an association with susceptibility to breast cancer, when compared with the epsilon3 allele. Carriers of the epsilon4 allele (E4E4, E4E3, and E4E2 genotypes), in comparison with the E3E3 genotype, showed an association with elevated risk of breast cancer only among Asians (OR, 1.75; 95% CI, 1.23 to 2.47; p=0.002). No publication bias was detected.
CONCLUSION
This meta-analysis suggest that the APOEepsilon4 allele is a low-penetrant risk factor for development of breast cancer.

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