Cancer Research and Treatment

Original Articles

Characteristics, Prognostic Factors, and Survival of Patients with NK/T-Cell Lymphoma of Non-upper Aerodigestive Tract: A 17-Year Single-Center Experience: Ze-Long Liu, Xi-Wen Bi, Xue-Wen Zhang, De-Xin Lei, Pan-Pan Liu, Hang Yang, Yan Gao, Yuan-Xue Jiang, Wen-Qi Jiang, Yi Xia; Cancer Res Treat. 2019;51(4):1557-1567. Published online April 1, 2019; DOI: https://doi.org/10.4143/crt.2018.681

Abstract PDF Supplementary Material PubReader ePub

Purpose
The extranodal natural killer (NK)/T-cell lymphoma (NKTCL) of non-upper aerodigestive tract (NUAT) was found to have clinical heterogeneity compared with NKTCL of the upper aerodigestive tract (UAT) in small scale studies. We conducted this study in a much larger cohort to analyze the clinical characteristics, prognostic factors, treatment modality, and clinical outcomes of patients with NUAT-NKTCL.
Materials and Methods
From January 2001 to December 2017, a total of 757 NKTCL patients were identified and included in this study, including 92 NUAT-NKTCL patients (12.2%) and 665 UAT-NKTCL patients (87.8%).
Results
NUAT-NKTCL patients had relatively poorer performance status, more unfavorable prognostic factors, and more advanced stage, compared with UAT-NKTCL patients. The 5-year overall survival (OS) was 34.7% for NUAT-NKTCL, which was significantly worse than UAT-NKTCL (64.2%, p<0.001). The median OS duration was 30.9 months for NUAT-NKTCL. Multivariate analysis showed that presence with B symptoms and elevated serum lactate dehydrogenase independently predicted worse OS. International prognostic index score and prognostic index of natural killer lymphoma score still had prognostic values in NUAT-NKTCL, while the Ann Arbor system could not accurately predict the OS.
Conclusion
NUAT-NKTCL is a distinctive subtype of NKTCL in many aspects. Patients with NUAT-NKTCL have relatively poorer performance status, more unfavorable prognostic factors, more advanced stage, and poorer prognosis.

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Clinical features, prognostic stratification, and treatment of advanced-stage non-nasal type extranodal natural killer/T-cell lymphoma: a multi-institutional real-world study
Yu-Ce Wei, Wei-Xin Liu, Fei Qi, Chang-Gong Zhang, Bao-Min Zheng, Yan Xie, Bo Chen, Di Zhang, Wei-Ping Liu, Hui Fang, Yue Chai, Shu-Nan Qi, Ye-Xiong Li, Wei-Hu Wang, Yu-Qin Song, Jun Zhu, Mei Dong
Annals of Hematology.2024; 103(1): 163. CrossRef
Genomic features reveal potential benefit of adding anti-PD-1 immunotherapy to treat non-upper aerodigestive tract natural killer/T-cell lymphoma
Zegeng Chen, He Huang, Huageng Huang, Le Yu, Huawei Weng, Jian Xiao, Liqun Zou, Huilai Zhang, Chaoyong Liang, Hui Zhou, Hongqiang Guo, Zhao Wang, Zhiming Li, Tao Wu, Hongyu Zhang, Huijing Wu, Zhigang Peng, Linzhu Zhai, Xinggui Chen, Yang Liang, Huangming
Leukemia.2024; 38(4): 829. CrossRef
Research progress on EBV-associated NK/T cell lymphoma
Jun CAI, Yi CAO, LiYun QIU, Yan GAO, HuiQiang HUANG, QingQing CAI
SCIENTIA SINICA Vitae.2024; 54(12): 2363. CrossRef
Real‐World clinical features and survival outcomes associated with primary gastrointestinal natural killer/T‐cell lymphoma from 1999 to 2020
Yang Chunli, Jiang Ming, Ma Ziyan, Ji Jie, Lv Shuli, Huang Jie, Wu Yu, Xu Caigang, Zou Liqun
Cancer Medicine.2023; 12(3): 2614. CrossRef
Diagnostic and prognostic value of pretreatment PET/CT in extranodal natural killer/T-cell lymphoma: a retrospective multicenter study
Mingjie Yu, Zegeng Chen, Zhao Wang, Xiaojie Fang, Xi Li, Haimei Ye, Tongyu Lin, He Huang
Journal of Cancer Research and Clinical Oncology.2023; 149(11): 8863. CrossRef
Comparative analysis of upper aerodigestive tract and non-upper aerodigestive tract in NK/T-cell lymphoma
Xiaohong Liu, Dedong Cao, Hui Liu, XiaoKang Ke, Xin Liu, Ximing Xu
Clinical and Translational Oncology.2023; 26(1): 214. CrossRef
Intensive therapy can improve long‐term survival in newly diagnosed, advanced‐stage extranodal NK/T‐cell lymphoma: A multi‐institutional, real‐world study
Yu‐Ce Wei, Fei Qi, Bao‐Min Zheng, Chang‐Gong Zhang, Yan Xie, Bo Chen, Wei‐Xin Liu, Wei‐Ping Liu, Hui Fang, Shu‐Nan Qi, Di Zhang, Yue Chai, Ye‐Xiong Li, Wei‐Hu Wang, Yu‐Qin Song, Jun Zhu, Mei Dong
International Journal of Cancer.2023; 153(9): 1643. CrossRef
A retrospective study on the clinicopathological and molecular features of 22 cases of natural killer/T-cell lymphoma in children and adolescents
Guan‑Nan Wang, Wu‑Gan Zhao, Xu-Dong Zhang, Xiang-Yu Jian, Chong-Li Zhang, Ming-Zhi Zhang, Wen‑Cai Li
Scientific Reports.2022;[Epub] CrossRef
Comparison analysis of first-line asparaginase- versus non-asparaginase-based regimens for early-stage extranodal NK/T-cell lymphoma
Fei Qi, Yan Xie, Dedao Wang, Yue Chai, Bo Chen, Yan Sun, Weiping Liu, Shunan Qi, Yuce Wei, Hui Fang, Dan Zhao, Lin Gui, Yong Yang, Xiaoli Feng, Ning Ding, Lan Mi, Shaokun Shu, Yexiong Li, Yuqin Song, Mei Dong, Jun Zhu
Annals of Hematology.2022; 101(9): 2021. CrossRef

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Clinical Analysis of 1136 Early Gastric Cancers: Jin Pok Kim, Yoon Seok Hur, Kuk Jin Choe, Kuhn Uk Lee, Kyoo Wan Choi, Byung Ihn Choi, Yong Il Kim; J Korean Cancer Assoc. 1993;25(6):808-818. Published online August 1, 2014

Abstract PDF: Gastric cancer is the most frequent cancer and leading cause of death from cancer in Korea. From 1974 to l992, we had experienced 7606 cases of gastric cancer and performed 6928 gastric resections. 1136 cases were early gastric cancer(14.9% of all cases and 16.4% of resected cases). These lesians were in 757 men and in 379 women. The mean age was 54.8 years and peak incidence of age was 6th decade in male, and 5th decade in female. The diagnostic tools were upper gastrointestinal series and gastrofibroscope, and the accuracy was 89.8% and 93.8% respectively. Among them mucosal lesions were 548 cases(48.2%), submucosal lesions were 588 cases(51.8%) and 178 cases(15.7%) had lymph nade metastasis. According to the depth of invasion, the rate of lymph node metastasis was 6.4% in mucosal lesion and 24.3% in submucosal lesion. Macroscopically, Type IIc was the most frequently encountered lesion(52.2%, 593 cases). Histologically, signet ring cell type is the most frequent(25.6%). Overall five-year survival rate was 91.8%, and 94.2% in mucosal lesions, 91.3% in submucosal lesions, 94.5% in NO lesions, 88.3% in Nl lesions and 77.3% in N2 lesions. The most important factor for survival was the status of lymph nade metastasis. The factors associated with lymph node metastasis were depth of invasion, macroscopic type (protruding type) but the size of the lesion, histologic type, sex and age, site of lesion had no association statistically.

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Clinical Prognostic Factors and Treatment Outcome of Aggressive Non-Hodgkin's Lymphoma in Elderly Patients: Jung Hye Choi, Myung Ju Ahn, Mo Ran Ki, Ho Suk Oh, Young Yuel Lee, Il Young Choi, In Soon Kim; Cancer Res Treat. 2001;33(4):324-328. Published online August 31, 2001; DOI: https://doi.org/10.4143/crt.2001.33.4.324

Abstract PDF

PURPOSE
The aim of this study was to determine the prognostic factors and treatment outcome of for elderly patients (age>or=60 at time of diagnosis) with aggressive non-Hodgkin's lymphoma (NHL).
MATERIALS AND METHODS
We analyzed 52 patients diagnosed with aggressive NHL between January 1990 and May 2000.
RESULTS
The patient's median age was 69 years (range: 60~92). Thirty-two (61.5%) patients were male. Patients included those with diffuse large B cell (53.8%), peripheral T cell (23.1%), AILD-like T-cell (3.8%), angiocentric (3.8%), mantle cell (3.8%), Burkitt's lymphoma (3.8%), and others (7.9%). International prognostic index (IPI) parameters were as follows: elevated LDH (60.8%), ECOG performance status>or=2 (32.7%), advanced stage (III/IV, 62.7%), and extranodal site>or=2 (11.5%). Twenty-six (50.0%) patients demonstrated a high and high-intermediate IPI. The median follow-up for surviving patients was 26.6 months. The overall median survival was 22.7 months and the 2-year survival rate was 46.9%. Among the 49 patientstreated with chemotherapy, 28 (57.1%) patients achieved complete remission (CR). Univariate analysis identified 8 prognostic factors for overall survival: age<70 (P=0.04), low/low-intermediate IPI (P=0.02), good performance (P= 0.04), normal WBC (P=0.008), normal Hb (P=0.02), normal LDH (P=0.04), CR on first line therapy (P<0.001), and absence of B symptom (P=0.001). In the multivariate analysis, the independent prognostic factors for improved overall survival were age <70 (P=0.03), low/low-intermediate IPI (P=0.03), normal WBC (P=0.006), and CR on first line therapy (P<0.001).
CONCLUSION
In our experience, even elderly patients (>or=60 years) with aggressive NHL can be successfully treated with conventional chemotherapy and the important prognostic factors for survival are age, IPI, initial WBC, and CR on first line treatment.

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Primary Palatine Tonsil Non-Hodgkin Lymphoma in Western Romania: A Comparison of Lower-Stage and Advanced-Stage Disease
Raluca Morar, Norberth-Istvan Varga, Delia Ioana Horhat, Ion Cristian Mot, Nicolae Constantin Balica, Alina-Andree Tischer, Monica Susan, Razvan Susan, Diana Luisa Lighezan, Rodica Anamaria Negrean
Hematology Reports.2025; 17(2): 17. CrossRef
Reduced Dose Intensity FOLFOX-4 as First Line Palliative Chemotherapy in Elderly Patients with Advanced Colorectal Cancer
Jee Hyun Kim, Do-Youn Oh, Yu Jung Kim, Sae Won Han, In-Sil Choi, Dong-Wan Kim, Seock-Ah Im, Tae-You Kim, Jong-Seok Lee, Dae-Seog Heo, Yung-Jue Bang, Noe Kyeong Kim
Journal of Korean Medical Science.2005; 20(5): 806. CrossRef
Doxorubicin‐based chemotherapy for diffuse large B‐cell lymphoma in elderly patients
Keun‐Wook Lee, Dae‐Young Kim, Tak Yun, Dong‐Wan Kim, Tae‐You Kim, Sung‐Soo Yoon, Dae Seog Heo, Yung‐Jue Bang, Seonyang Park, Byoung Kook Kim, Noe Kyeong Kim
Cancer.2003; 98(12): 2651. CrossRef

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Clinical Features and Prognosis of Lung Cancer with Brain Metastasis: Kyung Eun Lee, Eun Mi Nam, He Jin Lee, Seung Hyun Nam, Do Yeun Kim, Seock Ah Im, Chu Myung Seong, Soon Nam Lee, Kyung Ja Lee; Cancer Res Treat. 2001;33(3):250-255. Published online June 30, 2001; DOI: https://doi.org/10.4143/crt.2001.33.3.250

Abstract PDF

PURPOSE
Brain metastasis is estimated to occur in 20~40% of solid tumor patients and the most common primary tumor is lung cancer. Even though the prognosis of brain metastasis is grave and the 1-year survival rate is only 15%, symptom palliations are made with whole brain radiation therapy. We retrospectively evaluated the clinical features and prognostic factors of lung cancer with brain metastasis.
MATERIALS AND METHODS
From January 1987 to October 1999, 50 lung cancer patients with brain metastasis underwent whole brain radiation therapy. We reviewed the improvement in neurologic symptoms and survival according to the following parameters; performance status, histological type, presence of brain metastasis at the initial diagnosis of lung cancer, presence of extracranial metastasis, multiplicity of brain lesion, presence of primary lung symptom and treatment modalities.
RESULTS
The most frequent symptom with brain metastasis was a headache (50%). Palliation of the headache and other symptoms was achieved in 81% of the patients. Median overall survival after brain metastasis was 21 weeks and the 1 year survival rate was 15%. Patients without extracranial metastasis had a longer median survival than those with, 38 weeks versus 15 weeks, respectively (p=0.01).
CONCLUSION
In lung cancer with brain metastasis, neurologic symptoms can be palliated with whole brain radiation therapy, and in this study among such patients, absence of extracranial metastasis can be a good prognostic factor.

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Combination of EGFR-Directed Tyrosine Kinase Inhibitors (EGFR-TKI) with Radiotherapy in Brain Metastases from Non-Small Cell Lung Cancer: A 2010–2019 Retrospective Cohort Study
Vineeth Tatineni, Patrick J. O’Shea, Shreya Saxena, Atulya A. Khosla, Ahmad Ozair, Rupesh R. Kotecha, Xuefei Jia, Yasmeen Rauf, Erin S. Murphy, Samuel T. Chao, John H. Suh, David M. Peereboom, Manmeet S. Ahluwalia
Cancers.2023; 15(11): 3015. CrossRef

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Prognostic Factors and Survival Analysis for Patients with Colorectal Carcinomas: S H Kim, Byung Kwon Ahn, S U Baek; J Korean Cancer Assoc. 2000;32(2):331-338.

Abstract PDF: PURPOSE
Colorectal carcinomas are one of the most common malignant tumors in western countries. In Korea, it is the fourth common malignancy and the incidence has been rising over the past 10 years. We studied respectively to analyse prognostic factors in patients with colorectal cancer.
MATERIALS AND METHODS
893 patients with primary colorectal carcinomas who were operated at our hospital between 1989 and 1997 were reviewed. We examined possible prognostic factors such as, age and sex of patients, size and location of tumors, preoperative serum CEA and CA19-9 level, modified Dukes stage, operative methods, and lymph node metastases.
RESULTS
Overall 5-year survival rate was 61.8%. The 5-year survival rates in modified Dukes stage A, Bl, B2, Cl, C2 and D were 100%, 89.4%, 72.5%, 63.3%, 55.1% and 21.5%, respectively. Univariate analysis showed that age, modified Dukes stage, preoperative serum CEA and CA19-9 level, and lymphatic metastases were significant factors. The size of tumor was a significant factor in rectal carcinomas but not in colon carcinomas. In extraperitoneal rectal carcinomas, there were no survival differences between low anterior resection and abdominoperineal resection groups. Preoperative serum CEA level and modified Dukes' stage were significant in multivariate analysis, CONCLUSION: Modified Dukes stage, preoperative serum CEA were independent prognostic factors for patients with colorectal cancer.

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Clinical Characteristics and Prognostic Factors of Metastatic Tumor of Unknown Primary: Eun Kyung Cho, Keun Seok Lee, Chul Won Jung, Won Seog Kim, Ki Hyeong Lee, Dae Seog Heo, Yung Jue Bang, Noe Kyeong Kim; J Korean Cancer Assoc. 1999;31(3):607-616.

Abstract PDF: PURPOSE
For malignant diseases, predictions about tumor behavior and determination of appropriate therapy are based on the primary tumor sites, but 2-9% of cancer patients are diagnosed without identifiable primary tumor sites. Metastatic tumors of unknown primary origin (MUO) are a heterogeneous group of tumors with variable natural histories. The majority of these patients fall outside of treatable subjects and seldom respond to therapy. To define further the natural history of MUO and identify prognostic factors, we undertook a clinical analysis of 141 consecutive patients with a presumed diagnosis of MUO.
MATERIALS AND METHODS
One hundred forty-one patients were diagnosed with unknown primary tumor from Jan. 1, 1992 through Aug. 31, 1995. The primary end point for the study was survival, which was calculated from the first day of patient registration diagnosed histologically. The survival curves were estimated using the Kaplan-Meier method and compared using the log-rank test. To identify important prognostic factors, univariate and multivariate analyses were conducted.
RESULTS
Most of the 141 patients had histologic or cytologic evidence of adenocarcinoma and had more than one site metastatically involved. The predominant sites of tumor involvement were lymph node, peritoneum, bone, liver, lung, and pleura. Univariate and multivariate analyses identified numerous important prognostic factors with a significant influence on survival, including performance status (P 0.0001), specific organ sites involved (lung P 0.0076 or liver P 0.0310), and chemotherapy group (P- 0.0480).
CONCLUSION
This study validated clinical courses and important prognostic factors that had an impact on survival in MUO.

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Clinical Trial

The Effect of Cytosine Arabinoside and Daunorubicin(AD) Combination Chemotherapy in Acute Myelogeous Leukemia: Chang Hoon Moon, Sung Hyun Kim, Hyung Ryoul Park, Jung Hwan Cho, Hyok Chan Kwon, Jae Seok Kim, Hyo Jin Kim; J Korean Cancer Assoc. 1998;30(4):842-852.

Abstract PDF: PURPOSE
Important advances in the treatment of acute myelogenous leukemia have been made with the introduction of cytosine arabinoside(ara-C) and anthracycline(daunorubicin) over the past 20 years. Currently, 50 to 85% of patients with acute myelogenous leukemia achieve complete remission with induction chemotherapy consisting of ara-C and daunorubicin. About 25% of complete responders will have extended long-term survival and may be cured. Therefore we treated patients having acute myelogenous leukemia with AD(7+3) regimen and analyzed factors complete remission rate, remission duration, and survival duration.
MATERIALS AND METHODS
Induction therapy; Thirty seven patients with previously untreated acute myelogenous leukemia treated with AD(7+ 3) regimen(ara-C, 200 mg/m2/d by continuous infusion for seven days, and daunorubicin, 45 mg/m2/d for 3 days). The second course of therapy was AD(5+2), if the patients failed to enter remission. Consolidation therapy; three cycles of consolidation chemotherapy were administrated with at least 4 week interval following remission. Course 1; ara-C at 100 mg/m2 by continuous infusion every 12 hour for five days, 6-thioguanine at 100 mg/m2/day orally for 5 days. Course 2; ara-C is same as course 1, vincristine at 1.2 mg/m2(maximum 2 mg) by bolus injection for 1 day, prednisolone at 40 mg/m'(maximum 60 mg) orally for 5 days. Course 3; ara-C is same as course 1, daunorubicin at 45 mg/m2 by 1 hour infusion for 2 days.
RESULT
62.2 percent of the 37 patients entered complete remission. The remission duration for all patients in complete remission ranged from 2 months to 63+ months, with the median of 15.1 months. The median duration of survival in complete responder group was 23.3 months. Among various prognostic factors, females and groups with normal chromosome and t(8;21) or t(15;17) had significantly higher complete remission rate than males and groups with other chromosomal abnormalities, respectively. Factors influencing on survival duration were female, normal chromosome, t(8;21) or t(15;17), Auer rod-positive, and peripheral blast % less than 50% at diagonosis. Groups with Auer rod-positive, normal chromosome, and t(8;21) or t(15;17) also had significantly longer remission duration.
CONCLUSION
Combination chemotherapy with cytosine arabinoside and daunorubicin is a effective regimen for acute myelogenous leukemia as much as other regimen for acute myelogenous leukemia. Further clinical trials for effective treatment regimen are necessary to increase the complete remissioin rate.

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Original Articles

Primary Intestinal Lymphoma Treatment Results and prognostic Factors in 52 Cases: In Chul Hong, Chang Hak Yoo, Sung Hoon Noh, Chang Hwan Cho, Kyung Shik Lee; J Korean Cancer Assoc. 1998;30(1):158-168.

Abstract PDF: PURPOSE
In spite of many published reports about the primary gastrointcstinal lymphoma in Korea, the majority of them unfortunately involved a small number of patients with diverse results conceming treatment, patient survival, and prognostic factors. There also were few reports mainly focusing on primary intestinal lymphoma alone. Therefore we studied the patient-survival and prognostic factors in 52 cases of intestinal lymphomas.
MATERIALS AND METHODS
We reviewed fifty two patients who received treatment due to primary intestinal lymphoma at Severance hospital, from January 1980 to June 1995.
RESULTS
The intestinal lymphomas were located in descending order of frequency at the terminal ileum, i1eocecal region, right colon, and the jejunum. The most common histologic type was diffuse large cell type and the majority showed an intermediate grade of differentiation. The average survival time was 40.7 months with a 5 year survival rate of 41.4%. The overall and complete remission rate of the intestinal lymphoma were 76.2%, 64.3%, respectively. Additional chemotherapy or radiotherapy to surgery improved remission rate. The overall 5 year survival rates were 50.4%, 47.3%, 33.3%, and 25.0% in stage I, II1, II2 and III~IV, respectively. The 5 year survival rate after curative resection was 57.0% and 16.6% after incomplete resection. The significant prognostic factors were residual tumor, site of the lesion, multiplicity, and adjacent organ invasion. However, the site of the lesion alone (worst in the jejunum) was the sole independent variable on multivariate analysis.
CONCLUSION
We concluded that early diagnosis and curative resection were important to improve survival rates in the primary intestinal lymphoma. More number of such cases are needed for further comparison of various treatment methods and results.

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Prognostic Factor Analysis of Small Cell Lung Cancer: Appropriateness of Two Staging System: Jae Jin Chang, Tae You Kim, Choon Taek Lee, Seung Mo Nam, Jae Hag Kim, Eun Jeong Song, Seong Hwan Kim, Bong Seog Kim, Baek Yeol Ryoo, Young Hyuck Im, Jhin Oh Lee, Tae Woong Kang, Yoon Koo Kang; J Korean Cancer Assoc. 1997;29(6):1000-1010.

Abstract PDF: PURPOSE
The two staging system, which divides the tumors into limited disease (LD) and extensive disease (ED) has been widely accepted as a major prognostic determinant in small cell lung cancer (SCLC). However this system has provoked several controversial issues in defining stage categories, for instance, ipsilateral pleural effusion as LD or ED. Furthermore, identification of favorable subgroups in the same stage has been recognized as an important factor to determine appropriate treatment strategies. In this study, we performed a retrospective analysis in an attempt to resolve the controversial issues about staging and identify the patient group with favorable prognosis based on this two staging system.
MATERIALS AND METHODS
The clinical data of 233 patients with SCLC treated from 1990 to 1996 at Korea Cancer Center Hospital were retrospectively analyzed for this study. All patients were treated with chemotherapy containing cisplatin and/or radiotherapy. The independent prognostic factors for survival were identified by multivariate analysis using Cox's proportional hazards model.
RESULTS
Performance status (relative risk of death [RR]:2.89), number of metastasis (RR:2.2), response to treatment (RR:2.2) as well as stage (RR:1.77) were identified as independent prognostic factors for survival in patient with SCLC. The median survival of patients with ipsilateral pleural effusion (13 months) which was categorized as ED was similar to that of patients with contralateral mediastinal or supraclavicular lymph nodes (13.8 months) or other LD patients (13.7 months). This result suggests that ipsilateral pleural effusion should be categorized as LD. In LD, response to treatment was the only independent prognostic factor (RR:2.34) and thoracic radiotherapy moderately improved survival as compared with combination chemotherapy alone (17.7 months vs. 10.4 months, p=0.06). In ED, the patient group with a good performance status (ECOG 0-1), normal range of serum alkaline phophatase, and metastasis less than 2 sites showed significantly prolonged survival, comparing with other ED patients (11.2 months vs. 7.2 months, p=0.0001).
CONCLUSION
As a result of survival analysis, we confirmed independent prognostic factors such as stage and performance status in SCLC. We could recommend that LD category include patients with ipsilateral pleural effusion as well as those with contralateral lymphadenopathy. In ED, the survival in patients with favorable prognostic factors was comparable to LD, suggesting this patient group may be a candidate for aggressive therapy.

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A Multivariate Analysis of Prognostic Factors of 3176 Gastric Cancers: Uck Sang Zung, Chung Han Lee, Sung Uhn Baek, Kyung Hyun Choi, Seung Do Lee; J Korean Cancer Assoc. 1994;26(2):179-188.

Abstract PDF: Between l980 and 1992, 3176 consecutive patients with adenocarcinoma of stomach under-went surgical treatment at Department of Surgery, Kosin Medical College. Follow up rate was 96.5%. The overall operative mortality rate was 1.26%. The overall cumulative survival rate was 74.5% at 1 year, 62.1/ at 2 years, 56.0% at 3 years, 52.0% at 4 years, 48.8% at 5 years, and median survival time was 53 months. The cumulative survival rate of radical resection group was 90.2% at 1 year, 78.2% at 2 years, 72.8% at 3 years, 68.3% at 4 years, 63.9% at 5 years, and median survival time was 141 months. To determine the progrostic factors, 9 variables were chosen; age, sex, location of tumor, size of tumor, Borrmann type, tumor invasion, lymph node metastasis, distant metastasis end stage. Survival rate was examined using Kaplan-Meier method. The prognostic factors were examined for their relationship to survival rate using Cox's Proportional Hazard Model The most important prognostic factor is distant metastasis(2.88 of hazard ratio). Other factors such as lymph node metastasis, tumor invasion, size of tumor were also important factors in gastric cancer patients. Improvement of the prognosis of stomach cancer will require early detection of gastric cancer, and more curative resection.

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The Significance of c-erbB-2 Oncoprotein as a Prognostic Factor in Human Breast Cancer: Sung Jun Park, Hwa Bong Doh; J Korean Cancer Assoc. 1994;26(5):746-756.

Abstract PDF: Prognostic factors help the clinician by providing information on the likely site of initial recurrence, predicting survival time after dignosis, the clinical course after relapse has occured, and the expected response to medical therapy. In order to investigate the prognostic significance of c-erbB-2 overexpression, sections of for- malin-fixed, paraffin-embeded tissue from 60 primary breast cancers were stained immunohistochemically against the c-erbB-2 oncoprotein.Positive reaction indicative of c- erbB-2 overexpression was observed on tumor cells in 25 (41.1%) samples. The overexpression of c-erbB-2 oncoprotein was not correlated with tumor size, lymph node involvement, estrogen and progesteron receptor status, epidermal growth factor receptor (EGFR) status, histologic type, menopausal status, but significantly correlated with nuclear grade. Overexpression of c-erbB-2 protein was more common among tumors of poor nuclear grade(grade 1)-16%-than those of good nuclear grade (grade 3)-25%-according to Blacks nuclear grading system. Postoperative clinical survey demonstrated a high tendency of recurrence rate and shorter survival time of patients with positive staining tumors as compared with those with negative staining tumors to overexpression of c-erbB-2 oncoprotein. In conclusion, these data suggest that the overexpressian of c-erbB-2 oncoprotein may be valuable for the prediction of biologically high malignant potential and the detection of c- erbB-2 oncoprotein in tumor section may have prognostic value in human breast cancer.

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The Expression of c-erbB-2 Oncoprotein and Epidermal Growth Factor Receptor ( EGFR ) in Breast Cancer Patients in Korea: Won Park, Nam Sun Paik, Yong Kyu Kim, Nan Mo Moon, Jong Inn Lee, Dong Wook Choi, Dae Yong Hwang, Ja June Jang; J Korean Cancer Assoc. 1994;26(6):901-912.

Abstract PDF: Samples of breast carcinoma were collected from 1l7 patients who underwent mastectomy in Korea Cancer Center Hospital from Jan. 1982 to Dec. 1984. We studied expression of the c-erbB- 2 oncoprotein and EGFR with the immunohistochemical technique. We also analyzed to clarify the relationship between expression of the c-erbB-2 oncoprotein and/or EGFR and tumor size, node metastasis, stage, histo1ogic grade, TIL, and EIC, and to evaluate the prognostic significance of c-erbB-2 oncoprotein and EGFR in breast cancer. EGFR expression rate was 37.6%(44/ ll7) and EGFR status had positive correlation with histologic grade(p<0.05), But, we did not find any other relationship with other clinicopathological prognostic factors. c-erbB-2 expression rate was 64.1%(71/1 l7). There was no relevance between c-erdB-2 expression and other prognostic factors. Higher histologic grade was poorer survival rate. EGFR positive patients had poorer prognosis than negative patients in stage I and II breast cancer(p<0.05).

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Correlation of Tumor Grade and other prognostic factors in Invasive Breast Carcinoma: Young Bae Kim, Tae Sook Hwang, Joon Mee Kim, Young Chae Chu, Kyung Ja Cho, Ja June Jang; J Korean Cancer Assoc. 1994;26(6):926-936.

Abstract PDF: The prognostic factors in breast cancer are tumor stage, type, grade, hormonal receptor, tumor proliferative fraction, oncogene, altered growth factor receptor and angiogenesis. Since the first systematic study on grading system of breast cancer was published by Greenhough in 1925, a number of grading systems including Bloom-Richardson's histologic method and Blacks nuclear method have been reported and used. These grading systems have been considered as a classic and important prognostic factor for long time. In spite of this fact, there is a growing tendency that pathologists and clinicians disagree with grading system due to different results for prognosis and lack of reproducibility. Although these earlier analyses indicated that Bloom-Richardsons grade is prognostically more significant than Blacks grade, subsequent analysis indicate the converse. To investigate and evaluate usefulness of Bloom-Richardson grade and Black's grade, we examined the correlation of two grading systems and other estabiished prognostic factors, (i.e, tumor size, status of estrogen receptor, c-erbB-2 oncoprotein, Ki-67 labelling index, axillary nodal metastasis and microvessel count), in 62 cases of infiltrative ductal carcinoma of the breast. 1) Bloom-Richardson's histologic grade had significant correlation in nuclear grade, status of estrogen receptor, and Ki 67 labelling index. Tumor size and c-erbB-2 oncoprotein were also correlated with histologic grade, but it was statistically insignificant. 2) Blacks nuclear grade had also significant correlation in histologic grade, status of estro- gen receptor, c-erbB-2 oncoprotein and Ki 67 labelling index. Tumor size and axillary node metastasis were correlated, but they were statistically insignificant. 3) Metastasis and angiogenesis were not correlated with tumor grade. We could not compare histologic grade with nuclear grade fundamentally, because we failed to pursue patient's survival rate. However tumor grade in breast carcinoma served as a mandatory factor to get insights for status of other established prognostic factors or further prediction of patient's prognosis.

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Prognostic Factors in Node - Negative Breast Cancer: Kyung Hee Lee, Hyun Cheol Chung, Jae Yong Cho, Sun Young Rha, Joong Bae Ahn, Chong In Lee, Nae Choon Yoo, Joo Hang Kim, Jae Kyung Roh, Byung Soo Kim, Kyung Sik Lee, Kyl Beom Lee, Ho Yeong Lim, Jin Hy; J Korean Cancer Assoc. 1995;27(2):265-275.

Abstract PDF: Breast cancer is the third most common malignant neoplasm in Korean women. The effect of postoperative adjuvant systemic therapy in the treatment of primary breast cancer with pathologic involvement of the axillary lymph nodes has been well established. But, 20 30% of node-negative breast cancer patients will develop recurrent disease and risk death within 10 years after initial local therapy without adjuvant treatment. Therfore, it is reasonable to identify those node-negative breast cancer patients at significant risk for recurrence and who could be treated with adjuvant therapies. A clinical study was perofrmed in 184 cases of primary node-negative breast cancers from January 198l to December 1991 to study the natural course of the diaease and to find-out the prognostic factors. The following results were obtained; l) During 73 monthe(9-143) of follow-up duration, 5-year and 10-year relapse free survival rates were 88%, 77% respectively, and overall survival rates were 89%, 88%, respectively. 10 year recurrence rate was 19%. 2) Median disease-free and survival durations were 80 month, 17 months, respectively, in tumor size<2 cm group and 68.5 months, 62 months respectively in tumor size 2-5 cm group. 3) Median disease-free and overall survival durations were 73 months, 61 months, respectively, in premenopause patients and 74 months, 73 months in postmenopause patients. 4) No differences were found in disease-free and survival duration based on types of operation. 5) With adjuvant treatment, there was a decreasing tendency of systemic relapse. In conclusion, continuous relapse was found in node-negative breast cancer even after 5 years of operation. Even if decreasing tendency of systemic relapse was induced with adjuvant treatment, no clinically useful prognostic factors were found from surgical and pathologic factors until now. Further study of biological factors in node-negative breast cancer is warrented.

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