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Original Articles
Impact of Metabolic Syndrome on Risk of Lung Cancer among Korean Never-Smokers: A Nationwide Population-Based Cohort Study
Sung Woo Moon, Jiyeong Kim, Dong-Woo Han, Dong Won Park
Received January 31, 2026  Accepted July 29, 2026  Published online July 30, 2026  
DOI: https://doi.org/10.4143/crt.2026.0116    [Accepted]
AbstractAbstract PDF
Purpose
To determine the association between metabolic syndrome (MetS) and lung cancer risk in a large population-based cohort of never-smokers in Korea.
Materials and Methods
Using the Korean National Health Insurance Service database, we identified adults who underwent national health screening in 2009 and consistently reported their never-smoker status at baseline and subsequent examinations. Cox proportional hazards models were used to estimate hazard ratios (HRs) for lung cancer incidence, adjusting for age, sex, body mass index (BMI), physical activity, residential area, income, and alcohol consumption. Analyses were further stratified according to sex and BMI.
Results
Overall, 2,721,804 never-smokers were followed up for a mean of 14.0 years. The incidence of lung cancer was higher among participants with MetS than those without (adjusted HR: 1.04, 95% CI: 1.01–1.07). MetS was significantly associated with lung cancer risk in men (HR: 1.18, 95% CI 1.11–1.25) but not in women (HR: 1.03, 95% CI 0.99–1.07), with the risk evident in normal-weight and pre-obese men but, in women, mainly in those with obesity (HR: 1.10, 95% CI 1.03–1.16).
Conclusion
MetS was associated with a modest increase in the risk of lung cancer among Korean never-smokers, showing a significant association among men but not women. MetS risk was evident even among normal-weight men, whereas among women, it was more pronounced in those with obesity. These findings suggest that metabolic abnormalities, relatively underrecognized as cancer-related risk factors, could contribute to the risk of lung cancer, even in the absence of tobacco exposure.
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Treatment Outcome of Children with Acute Lymphoblastic Leukemia According to Risk-Group Stratification: A Single Institution Experience
Juyeon Lee, Young Bae Choi, Hyun Joo Jung, Jun Eun Park
Received April 20, 2026  Accepted July 11, 2026  Published online July 15, 2026  
DOI: https://doi.org/10.4143/crt.2026.0421    [Accepted]
AbstractAbstract PDF
Purpose
Outcomes of children and adolescents with acute lymphoblastic leukemia (ALL) treated using an institutional risk-adapted strategy were assessed, and survival was compared among risk groups.
Materials and Methods
This retrospective study included patients newly diagnosed with ALL during 2006–2020. Patients were stratified as standard-risk (SR), high-risk (HR), or very-high-risk (VHR). The SR group received a POG 9605-based protocol in 2006–2011 and a modified regimen with an additional delayed intensification phase in 2012–2020. The HR group received the ALL 0601 regimen, and the VHR group received institutional hematopoietic stem cell transplantation-oriented treatment.
Results
Ninety-two patients were included (SR, 34; HR, 45; and VHR, 13). The 10-year overall survival (OS) and event-free survival (EFS) were 85.2% and 70.9%, with cumulative incidences of relapse and treatment-related mortality of 22.6% and 3.3%, respectively. The 10-year OS was 92.8%, 88.7%, and 60.9% in the SR, HR, and VHR groups, and the corresponding 10-year EFS was 78.5%, 77.2%, and 34.2%, respectively. In SR, 10-year OS/EFS were 85.1%/71.4% in 2006–2011 and 100%/84.4% in 2012–2020. In the HR group, rapid early responders exhibited significantly better outcomes than did slow early responders, with 10-year OS of 97.0% vs. 63.6% (p = 0.001) and 10-year EFS of 87.9% vs. 43.6% (p < 0.001). Most relapses occurred during therapy or within 3 years of treatment completion.
Conclusion
VHR patients and HR patients with slow early response demonstrated the poorest outcomes. This supports refining risk-directed treatment strategies, including prospective evaluation of intensified and novel therapeutic approaches.
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Impact of Carboplatin-Free Interval on Hypersensitivity Risks in Solid Tumor Patients with Silent Sensitization
Junyeong Jang, Jeong-Min Lee, Su Jeong Song, Eunyoung Sa, Young-Chan Kim, Hye‑Ryun Kang
Received October 3, 2025  Accepted May 6, 2026  Published online May 8, 2026  
DOI: https://doi.org/10.4143/crt.2025.1087    [Accepted]
AbstractAbstract PDF
Purpose
Carboplatin hypersensitivity reactions (HSRs) often occur after silent sensitization in patients with solid tumors through repeated uneventful exposures. The carboplatin-free interval (CFI) has been implicated in HSR risk, but its independent impact on previously asymptomatic yet sensitized patients, as well as temporal risk patterns, remain unclear. We aimed to identify risk factors for HSRs following carboplatin re-administration in patients who had completed prior carboplatin treatment without HSRs, and to clarify the temporal association between CFI and HSR risk.
Materials and Methods
We retrospectively analyzed patients with solid tumors who received carboplatin after CFI ≥2 months at Seoul National University Hospital (2014–2016), excluding those with prior HSRs. Multivariable logistic regression identified factors associated HSRs. HSR incidence and severity were assessed across CFI strata (<12, 12–24, 24–36, ≥36 months).
Results
Among 258 patients with previous uneventful exposure, 52 (20.2%) developed HSRs, including 15 (5.8%) severe cases. Independent risk factors were female sex (odds ratio [OR] 6.105; p = 0.015), history of drug allergy (OR 2.991; p = 0.005), and CFI ≥12 months (OR 2.198; p = 0.030). Overall HSR incidence peaked at 33.3% with CFIs of 24–36 months, whereas severe HSRs were rare within 12 months but became progressively more frequent with longer CFIs, reaching the highest proportion beyond 36 months.
Conclusion
Longer CFI independently increases the risk of carboplatin-induced HSRs. These findings support using CFI as a predictor for individualized risk assessment, particularly for patients re-administered after CFIs of 24–36 months, who may warrant closer monitoring and preventive strategies.
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Is Adjuvant Chemotherapy Necessary for All Patients with pT3N0 Rectal Cancer after Upfront Surgery? A Multicenter Retrospective Study
Kyong-Min Kang, Ho Yung Lee, Hong-min Ahn, Heung-Kwon Oh, Duck-Woo Kim, Sung-Bum Kang, Dong Woon Lee, Sung Chan Park, Jae Hwan Oh, Min Jung Kim, Ji Won Park, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park
Received November 27, 2025  Accepted April 30, 2026  Published online May 4, 2026  
DOI: https://doi.org/10.4143/crt.2025.1308    [Accepted]
AbstractAbstract PDF
Purpose
The role of adjuvant chemotherapy (ACT) in pathologic T3N0 (pT3N0) rectal cancer, which has a favorable prognosis, remains controversial because high-risk groups for recurrence are not well defined. This study investigated prognostic factors for survival in this patient group and evaluated the benefit of ACT based on these factors.
Materials and Methods
This retrospective study analyzed 352 patients with pT3N0 rectal cancer who underwent upfront radical surgery at three referral hospitals between November 2003 and December 2020. A multivariable Cox regression model was used to identify the prognostic factors for 5-year recurrence-free survival (RFS). Patients were categorized as high or low risk based on these factors, and survival outcomes were compared between those who received ACT and those who did not, using the log-rank test.
Results
Median follow-up was 52.8 months. 193 (54.8%) patients received ACT. Multivariable analysis revealed that ACT, circumferential resection margin (CRM) ≤ 2mm, vascular invasion, and perineural invasion were independent predictors of 5-year RFS. In patients with ≥ 1 risk factor, ACT significantly improved RFS (92.5% vs. 72.8%, hazard ratio [HR] 0.247, 95% confidence interval [CI] 0.090–0.683, p < 0.01). In those without risk factors, no significant benefit was observed (98.0% vs. 91.6%, HR 0.272, 95% CI 0.057–1.313, p=0.082).
Conclusion
This study identified CRM ≤ 2mm, vascular invasion, and perineural invasion as high-risk features for recurrence in pT3N0 rectal cancer. ACT improved RFS only in patients with these features. While these findings support risk-based ACT administration in this patient population, further validation of our risk stratification system is needed.
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Postoperative Radiotherapy May Improve Survival in Certain Patients with pN2 Non-Small Cell Lung Cancer Who Do Not Have Extranodal Extension
Seung Hyuck Jeon, Changhoon Song, Jae Hyun Jeon, Jin-Haeng Chung, Sukki Cho, Kwhanmien Kim, Sanghoon Jheon, Se Hyun Kim, Yu Jung Kim, Jae-Sung Kim
Received June 20, 2025  Accepted February 1, 2026  Published online February 3, 2026  
DOI: https://doi.org/10.4143/crt.2025.644    [Epub ahead of print]
AbstractAbstract PDF
Purpose
The aim of this study was to identify subgroups of patients with pathologic N2 (pN2) non-small cell lung cancer (NSCLC) who may benefit from postoperative radiotherapy (PORT). Particular attention was given to evaluating whether extranodal extension (ENE) influences the therapeutic efficacy of PORT.
Materials and Methods
A total of 231 patients with pN2 NSCLC who underwent surgical resection followed by adjuvant chemotherapy at a single institution were analyzed retrospectively. Propensity score matching was performed to compare treatment outcomes according to the receipt of PORT.
Results
Propensity score matching yielded 99 matched pairs of patients with no significant differences in clinical parameters. There were no significant differences in the overall survival (OS; p=0.112) and disease-free survival (DFS; p=0.286) between the PORT and no PORT groups. However, PORT significantly improved the locoregional recurrence (LRR)–free rate (p=0.011), whereas the distant metastasis–free rate was comparable between groups (p=0.646). In subgroup analyses, PORT was associated with improved OS in patients with 1-3 positive N2 lymph nodes (p=0.013) and with significantly improved DFS among patients without ENE (p=0.046) or lymphatic invasion (p=0.032).
Conclusion
Although PORT did not improve OS or DFS in the matched overall cohort, it significantly reduced LRR. Subgroup analyses suggested potential benefits in patients with limited nodal burden and in those without ENE or lymphatic invasion. These findings, however, should be interpreted cautiously given small subgroup sizes and inherent limitations of retrospective design.
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Smoking, Alcohol, and Abdominal Obesity Increase Gastric Cancer Risk after Helicobacter pylori Eradication
Joo Hyun Lim, Cheol Min Shin, Kyungdo Han, Jin-Hyung Jung, Jinju Choi, Eun Hyo Jin, Seung Joo Kang, Dong Ho Lee
Received November 3, 2025  Accepted December 30, 2025  Published online January 2, 2026  
DOI: https://doi.org/10.4143/crt.2025.1200    [Epub ahead of print]
AbstractAbstract PDFPubReaderePub
Purpose
Helicobacter pylori is the single most important risk factor for gastric cancer (GC). However, H. pylori eradication (HPE) does not eliminate risk of GC. To clarify the association of lifestyle factors with GC risk after HPE.
Materials and Methods
Using the Korean National Health Insurance Services (NHIS) database, adult individuals who claimed HPE between 2010 and 2016 were analyzed. The adjusted hazard ratios (aHR) for GC were analyzed according to the lifestyle status including smoking (never; light [<10PY]; moderate [10-20PY]; heavy [≥20PY]), alcohol (none; mild [<30g/day]; heavy [30g/day]), and abdominal obesity by using Cox proportional hazard model.
Results
During a median follow-up period of 6.7 years, 9,754 individuals were newly diagnosed with GC among the total of 1,282,702 subjects. Compared with never smokers, moderate (aHR, 1.12 [95% confidence interval (CI), 1.04 to 1.20]) and heavy smokers (1.34 [95% CI, 1.27 to 1.42]) had greater risks of post-HPE GC with dose-response manner. Heavy drinkers had increased risk of GC (1.23 [95% CI, 1.15 to 1.32]) compared with non-drinkers, and those with abdominal obesity had slightly elevated GC risk compared with those without that (1.11 [95% CI, 1.06 to 1.15]). In subgroup analyses, those who had HPE at age ≥ 55 were shown to be more affected by the unhealthy lifestyles (smoking [p-for-interaction < 0.001], alcohol [0.019], and abdominal obesity [0.024]). Also, male showed greater risk increase by smoking habit (p-for-interaction=0.022) than female.
Conclusion
Unhealthy lifestyles like smoking, alcohol, and abdominal obesity were shown as risk factors for post-HPE GC. Those with late HPE were more likely to be affected by unhealthy lifestyles.

Citations

Citations to this article as recorded by  
  • Prognostic model for patients with hepatoid adenocarcinoma of the stomach
    Shan Tong, Boqi Xu, Xiang Ye, Jun Yin, Hao Hu
    BMC Gastroenterology.2026;[Epub]     CrossRef
  • 1,461 View
  • 59 Download
  • 1 Crossref
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Chemoradiotherapy Increases the Incidence Rate of Cachexia in Head and Neck Cancer: A Cohort Study
Nan-Chin Lin, Kuo-Ting Sun, Yu-Hsin Tseng, Tzong-Ming Shieh, Yin-Hwa Shih
Received May 6, 2025  Accepted October 15, 2025  Published online October 30, 2025  
DOI: https://doi.org/10.4143/crt.2025.482    [Epub ahead of print]
AbstractAbstract PDFPubReaderePub
Purpose
In Taiwan, head and neck cancer (HNC) ranks among the five most prevalent cancers in men. HNC tumours can impair the patient’s ability to ingest food following treatment, which may lead to cachexia. Currently, in Taiwan, no study has investigated the association between the risk of cachexia and patients’ clinical characteristics.
Materials and Methods
This retrospective cohort study analysed data from the cancer registry database of Show-Chwan Memorial Hospital between 2021-2022. We evaluated 115 patients who underwent initial treatment and assessed the presence of cachexia 6 months after treatment. Clinical data were collected and compared between patients with cachexia and those without cachexia to explore the associated risk factors in the HNC population.
Results
In the database, oral cancer constituted the primary diagnosis for 67.0% of cases. According to pathological assessments, most patients presented with locally advanced disease and moderate tumour differentiation. No correlation was observed between patient-reported complications, risk behaviours, and the incidence of cachexia. Notably, patients who underwent concurrent chemoradiotherapy exhibited a 3.8-fold higher risk of developing cachexia.
Conclusion
Concurrent chemotherapy is the leading risk factor of treatment-induced cachexia. The results of this study could help clinicians manage this issue adequately and devise solutions to limit its incidence.

Citations

Citations to this article as recorded by  
  • Targeting transcriptional and post-transcriptional pathways in head and neck cancer
    Prabhat Kumar, Archita Dey, Rishabh Lakhera, Jayant Maini, Bhudev C. Das, Shilpi Gupta
    Biochimica et Biophysica Acta (BBA) - Reviews on Cancer.2026; 1881(4): 189647.     CrossRef
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  • 53 Download
  • 1 Crossref
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Impact of Pre-admission Central Nervous System Medication Use on Delirium in Hospitalized Patients with Advanced Cancer: A Multicenter, Prospective, Observational Study in Korea
Min Jung Geum, Shin Hye Yoo, Si Won Lee, Moonki Hong, Eun Hee Jung, Yu Jung Kim, Beodeul Kang
Received April 29, 2025  Accepted August 26, 2025  Published online August 27, 2025  
DOI: https://doi.org/10.4143/crt.2025.460    [Epub ahead of print]
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study investigated the impact of pre-admission central nervous system (CNS) medication use on delirium incidence, duration, and survival in hospitalized patients with advanced cancer.
Materials and Methods
In this multicenter prospective study across four tertiary hospitals in South Korea, adults with advanced cancer were enrolled and categorized based on their use of CNS medications within 90 days preceding admission. Associations between pre-admission CNS medication use and outcomes (delirium incidence, delirium duration, and overall survival) were assessed using multivariable regression and Cox proportional hazards models.
Results
Of the 190 patients enrolled, 140 had used CNS medications prior to admission. Delirium occurred in 22.1% of the patients with CNS medication use versus 14.0% of those without (adjusted odds ratio [aOR], 2.53; 95% confidence interval [CI], 0.95 to 7.60; not significant). Opioid (aOR, 2.48; 95% CI, 1.01 to 6.61) and antidepressant (aOR, 5.58; 95% CI, 1.22 to 27.35) use were significantly associated with increased delirium risk. Use of three or more CNS medication classes was associated with a markedly high risk (aOR, 11.15; 95% CI, 2.13 to 64.17). Delirium duration did not differ significantly between groups. Patients with pre-admission CNS medication exposure exhibited shorter overall survival (adjusted hazard ratio [aHR], 1.45; 95% CI, 1.01 to 2.09). Prior opioid use was also associated with increased mortality (aHR, 1.45; 95% CI, 1.03 to 2.05).
Conclusion
Pre-admission exposure to CNS medication, particularly opioids and antidepressants, was associated with an increased risk of delirium in patients with advanced cancer. A thorough medication history review upon admission is crucial to identifying high-risk patients and implementing early preventive interventions.

Citations

Citations to this article as recorded by  
  • Prevalence of delirium among patients with advanced cancer: a systematic review and meta-analysis
    Linshan Jiang, Zhongyin Zhang, Xiaojun Liu, Yanxing Jiang, Qianqian Mou
    Frontiers in Neurology.2026;[Epub]     CrossRef
  • 1,608 View
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  • 1 Crossref
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Hematologic malignancy
A Novel CD58 Mutation–Related Signature Predicts Prognosis Risk in Diffuse Large B-Cell Lymphoma Patients
Hui-Li Wang, Chun-Yu Shang, Wei Hua, Hua Yin, Yue Li, Jun-Heng Liang, Rui Gao, Bi-Hui Pan, Xin-Yu Zhang, Jia-Zhu Wu, Hao-Rui Shen, Li Wang, Jian-Yong Li, Jin-Hua Liang, Wei Xu
Cancer Res Treat. 2026;58(3):979-1001.   Published online July 28, 2025
DOI: https://doi.org/10.4143/crt.2024.1143
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
CD58, a ligand of the CD2 receptor on T cells and natural killer cells, is abnormally expressed in diffuse large B-cell lymphoma (DLBCL). However, data on the value of CD58 mutation (CD58mut) in DLBCL are limited. Here, we aimed to evaluate the characteristics and prognostic value of CD58mut in DLBCL patients.
Materials and Methods
The available clinical information and corresponding mutation data of DLBCL were obtained from published articles. Ultimately, 3,025 DLBCL patients in published cohorts were enrolled in the final analysis. Among the 202 DLBCL patients in the Jiangsu Province Hospital (JSPH) cohort, all tumor tissue samples were collected to perform next-generation sequencing and gene expression was analyzed via RNA-seq.
Results
We found that 8.2% (250/3,025) of patients were CD58mut in integrated cohort, whereas 11.4% (23/202) in the JSPH cohort. CD58mut patients exhibit inferior progression-free survival (the integrated cohort: hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.77 to 1.20; p=0.663 the JSPH cohort: HR, 1.85; 95% CI, 0.85 to 4.04; p=0.052) and overall survival (the integrated cohort: HR, 1.43; 95% CI, 1.15 to 1.77; p < 0.001; the JSPH cohort: HR, 2.40; 95% CI, 0.83 to 6.93; p=0.026). A model based on six signature genes (MRO, OXTR, RASL11A, RLN1, SIGLEC1, and PROM2) was constructed via machine learning. To optimize risk stratification and survival prediction for CD58mut patients, biological mechanism of the poorer prognosis in high-risk group may be related to the greater abundance of immunosuppressive cells, especially M2 macrophages.
Conclusion
Our results indicated that CD58mut could serve as a novel prognostic factor for DLBCL patients, and further exploration of personalized treatment strategies for high-risk DLBCL patients based on the risk score model is needed.

Citations

Citations to this article as recorded by  
  • Lipid Metabolism Reprogramming in Diffuse Large B-Cell Lymphoma (DLBCL): Mechanisms and Treatment Strategies
    Yue-E Ding, Yi-Ran Zhong, Lai-Shun Zhang, Lei Xu, Jia Li, Yi Wen
    Cancers.2026; 18(4): 701.     CrossRef
  • Regulation of immune checkpoint molecules in cancer immune evasion and therapy
    Cansu Eris, Cheng Zu, Yanling Xiao, Michael Platten, Chong Sun
    Nature Reviews Cancer.2026; 26(8): 560.     CrossRef
  • ESAE-SDA: ensemble sparse autoencoder framework for epigenomics-informed snoRNA-disease associations prediction
    Xinqing Jiang, Xiaojun Chen, Lifeng Xu, Feng Zhang, Jiawei Chen, Wenqian Zhang
    BMC Bioinformatics.2025;[Epub]     CrossRef
  • 3,586 View
  • 112 Download
  • 3 Web of Science
  • 3 Crossref
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Genitourinary cancer
Dose-Response Association between Alcohol Consumption and Kidney Cancer Risk Differs According to Glycemic Status: A Nationwide Cohort Study of 9.4 Million Individuals
Joo-Hyun Park, Jung Yong Hong, Kyungdo Han, Jay J. Shen, Se Hoon Park
Cancer Res Treat. 2025;57(4):1178-1186.   Published online January 31, 2025
DOI: https://doi.org/10.4143/crt.2024.996
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Previous studies suggested an association between alcohol consumption and reduced kidney cancer risk. Given a potential interaction between alcohol’s insulin-sensitizing effect and hyperglycemia-related insulin resistance, we aimed to assess whether the dose-response association between alcohol intake and kidney cancer risk varies based on glycemic status.
Materials and Methods
This nationwide cohort study analyzed data from 9,492,331 adults who underwent a national health screening program in 2009 and were followed until 2018. Multivariable-adjusted Cox regression models were applied to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).
Results
Over a median follow-up period of 8.3 years, 12,381 participants were diagnosed with kidney cancer. A U-shaped relationship between alcohol consumption and kidney cancer risk was observed among individuals with normoglycemia (light-to-moderate: HR, 0.94; 95% CI, 0.89 to 0.99 and heavy: HR, 1.00; 95% CI, 0.91 to 1.09, respectively). In prediabetic individuals, alcohol consumption was not significantly associated with kidney cancer risk. In individuals with diabetes, a dose-dependent increase in kidney cancer risk was noted with higher alcohol consumption (light-to-moderate consumption: HR, 1.12; 95% CI, 1.03 to 1.22; heavy consumption: HR, 1.24; 95% CI, 1.09 to 1.42; p for trend < 0.01).
Conclusion
A modest U-shaped dose-response association between alcohol consumption and kidney cancer risk was observed exclusively in individuals with normoglycemia. Individuals with diabetes demonstrated a dose-dependent increased risk of kidney cancer with higher alcohol consumption. Tailored patient education and personalized risk assessments regarding alcohol consumption and kidney cancer risk should be emphasized over a generalized ‘one-size-fits-all’ approach.

Citations

Citations to this article as recorded by  
  • Alcohol Consumption Trajectories from Early Adulthood to Adulthood and Cancer Risk in Adulthood: A Systematic Review and Meta-analysis
    Samira Behboudi-Gandevani, Ingunn Jystad Brustad, Tommy Haugan, Vegar Rangul, Ellen Christin Arntzen, Marianne Sivertsen, Sarah Cook, Razieh Bidhendi-Yarandi
    Cancer Epidemiology, Biomarkers & Prevention.2026; 35(6): 824.     CrossRef
  • 7,196 View
  • 138 Download
  • 1 Web of Science
  • 1 Crossref
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Pediatric cancer
Survival of Children with Acute Lymphoblastic Leukemia with Risk Group–Based Protocol Changes: A Single-Center Experience with 460 Patients over a 20-Year Period
Na Hee Lee, Hee Young Ju, Eun Sang Yi, Young Bae Choi, Keon Hee Yoo, Hong Hoe Koo
Cancer Res Treat. 2025;57(2):558-569.   Published online September 27, 2024
DOI: https://doi.org/10.4143/crt.2024.127
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Recent treatments for pediatric acute lymphoblastic leukemia (ALL) are founded on risk stratification. We examined the survival rates and prognostic factors of patients over a 20-year period at a single institution.
Materials and Methods
This study analyzed patients diagnosed with ALL and treated at the Pediatric Department of Samsung Medical Center (SMC). Patients were categorized into standard-risk (SR), high-risk (HR), and very high-risk (VHR) groups. The SMC protocol for the HR group underwent two changes during the study period: a modified Children’s Cancer Group (CCG)-1882 protocol was used from 2000 to 2005, the Korean multicenter HR ALL-0601 protocol from 2006 to 2014, and the Korean multicenter HR ALL-1501 protocol from 2015 to 2019.
Results
Of the 460 patients, complete remission was achieved in 436 patients (94.8%). The 10-year overall survival rate (OS) was 83.8±1.9% for all patients. OS according to the SMC risk group was as follows: 95.9%±1.4% in the SR group, 83.8%±3.6% in the HR group, and 66.2%±6.9% in the VHR group. The 5-year OS within the HR group varied according to the treatment protocol: 73.9%±7.5%, in the modified CCG-1882 protocol, 83.0%±3.9%, in the 0601 protocol, and 96.2%±2.6%, in the 1501 protocol. For those aged 15 years and older, the OS was only 56.5%±13.1%. Relapse occurred in 71 patients (15.4%), and the OS after relapse was 37.7%±6.0%.
Conclusion
The treatment outcomes of patients with ALL improved markedly. However, there is a need to further characterize adolescents and young adult patients, as well as those who have experienced relapses.

Citations

Citations to this article as recorded by  
  • Attention-deficit/hyperactivity disorder in pediatric cancer survivors: risk and medication use in a nationwide population-based study
    Jae Sik Kim, Jung Lee, Joo Ho Lee
    Child and Adolescent Psychiatry and Mental Health.2026;[Epub]     CrossRef
  • Molecular and Mechanistic Divergence of Seizures in Pediatric Acute Lymphoblastic Leukemia: CNS Infiltration Versus Chemotherapy-Induced Neurotoxicity
    Jin Joo, Woo Sub Yang, Hyun Jung Koh
    International Journal of Molecular Sciences.2026; 27(7): 3307.     CrossRef
  • Toxicity during induction of pulsed versus continuous prednisolone in children with acute lymphoblastic leukaemia: a multi-centre, open label, randomised, phase 3 trial from India (2016–2022)
    Parag Das, Nandana Das, Gaurav Narula, Amita Trehan, Sameer Bakhshi, Venkatraman Radhakrishnan, Rachna Seth, Prashant Tembhare, Man Updesh Singh Sachdeva, Anita Chopra, Shirley Sundersingh, Soumyadeep Das, Manash Pratim Gogoi, Mayur Parihar, Rahul Bhattac
    The Lancet Regional Health - Southeast Asia.2026; 50: 100788.     CrossRef
  • Conjugated Hyperbilirubinemia in Pediatric Acute Lymphoblastic Leukemia at Diagnosis: A Case Series
    Sarita Verma, Ambrish Kumar Mishra, Kannan Subramanian, Snehavardhan Pandey
    Indian Pediatrics.2026;[Epub]     CrossRef
  • Clinical characteristics and outcome of pediatric patients diagnosed with acute lymphoblastic leukemia over 6 years’ period, single institute experience (Children Welfare Teaching Hospital)
    Raghad Majid Al-Saeed, Hebatallah Ali Hussein
    Iraqi Journal of Hematology.2026;[Epub]     CrossRef
  • Global Challenges in Paediatric Acute Lymphoblastic Leukaemia
    Shekhar Krishnan, Vaskar Saha
    Acta Haematologica.2025; 149(1): 39.     CrossRef
  • 12,312 View
  • 227 Download
  • 5 Web of Science
  • 6 Crossref
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Gastrointestinal cancer
Association between Metabolically Healthy Status and Risk of Gastrointestinal Cancer
Haozhe Cui, Fei Tian, Yongliang Chen, Xiangming Ma
Cancer Res Treat. 2024;56(1):238-246.   Published online August 2, 2023
DOI: https://doi.org/10.4143/crt.2023.539
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Although obesity is associated with numerous diseases, the risks of disease may depend on metabolically healthy status. Nevertheless, it is unclear to whether metabolically healthy status affects risk of gastrointestinal (GI) cancer in general Chinese population.
Materials and Methods
A total of 114,995 participants who met the criteria were included from the Kailuan Study. The study participants were divided into four groups according to body mass index (BMI)/waist circumference (WC) and metabolic status. Incident of GI cancer (esophageal cancer, gastric cancer, liver cancer, biliary cancer, pancreatic cancer, and colorectal cancer) during 2006-2020 were confirmed by review of medical records. The Cox proportional hazard regression models were used to assess the association metabolically healthy status with the risk of GI cancer by calculating the hazard ratios (HR) and 95% confidence interval (CI).
Results
During a mean 13.76 years of follow-up, we documented 2,311 GI cancers. Multivariate Cox regression analysis showed that compared with the metabolically healthy normal-weight group, metabolically healthy obese (MHO) participants demonstrated an increased risk of developing GI cancer (HR, 1.54; 95% CI, 1.11 to 2.13) by BMI categories. However, such associations were not found for WC category. These associations were moderated by age, sex, and anatomical site of the tumor. Individuals with metabolic unhealthy normal-weight or metabolic unhealthy obesity phenotype also have an increased risk of GI cancer.
Conclusion
MHO phenotype was associated with increased risk of GI cancer. Moreover, individuals who complicated by metabolic unhealthy status have an increased risk of developing GI cancer. Hence, clinicians should consider the risk of incident GI cancer in people with abnormal metabolically healthy status and counsel them about metabolic fitness and weight control.

Citations

Citations to this article as recorded by  
  • Metabolic Outcomes in Bariatric/Metabolic Surgery Individuals: Impact of Metabolic Health Definition, Type of Surgery, and Follow-Up Duration—An Observational, Retrospective Study
    Anna Pluemacher, Cláudia Camila Dias, Bárbara Peleteiro, Denise Pinheiro, Paula Freitas, Eduardo Lima, Alexandra Leitão, Elisabete Martins, Maria João Martins
    Metabolites.2026; 16(1): 47.     CrossRef
  • Metabolic Syndrome Components and Cancer Risk in Normal-Weight Subjects: Systematic Review and Meta-Analysis in over 18 Million Individuals
    Yasmin Ezzatvar, Jorge Olivares-Arancibia, Jacqueline Páez-Herrera, Rodrigo Yáñez-Sepúlveda, Óscar Caballero
    Journal of Clinical Medicine.2026; 15(2): 538.     CrossRef
  • Metabolic Phenotypes and the Risk of Cancer Occurrence: A Prospective Cohort Study with 18-Year Follow-up
    Mahdieh Golzarand, Nazanin Moslehi, Farhad Hosseinpanah, Parvin Mirmiran, Fereidoun Azizi
    Journal of Obesity & Metabolic Syndrome.2026; 35(2): 188.     CrossRef
  • Metabolic Phenotype and Risk of Obesity-Related Cancers in the Women’s Health Initiative
    Prasoona Karra, Sheetal Hardikar, Maci Winn, Garnet L. Anderson, Benjamin Haaland, Aladdin H. Shadyab, Marian L. Neuhouser, Rebecca A. Seguin-Fowler, Cynthia A. Thomson, Mace Coday, Jean Wactawski-Wende, Marcia L. Stefanick, Xiaochen Zhang, Ting-Yuan Davi
    Cancer Prevention Research.2025; 18(2): 63.     CrossRef
  • Associations of Social Vulnerability and Race‐Ethnicity With Gastrointestinal Cancers in the United States
    David J. Fei‐Zhang, David J. Bentrem, Jeffrey D. Wayne, Lifang Hou, Peiwen Fei, Timothy M. Pawlik
    Cancer Medicine.2025;[Epub]     CrossRef
  • Association between metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction subtypes and risk of colorectal cancer: A prospective cohort study
    Yuan Li, Xiang-ming Ma, Jian-guo Jia, Li-ying Cao
    Clinics and Research in Hepatology and Gastroenterology.2025; 49(5): 102573.     CrossRef
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    Fernanda Duarte Mendes, Hully Cantão dos Santos, José Geraldo Mill, Maria Del Carmen Bisi Molina, Maria de Fátima H. Sander Diniz, Carla Romagnolli Quintino, Márcio Sommer Bittencourt, Carolina Perim de Faria, Julia Robinson
    PLOS Global Public Health.2025; 5(4): e0004325.     CrossRef
  • Association between transitions in metabolic health and colorectal cancer across categories of body size phenotype: a prospective cohort study
    Qian Liu, Fei Si, Yuntao Wu, Jing Yu
    Obesity.2024; 32(10): 1948.     CrossRef
  • Gastric Cancer - Epidemiology, Modifiable and Non-modifiable Risk Factors, Challenges and Opportunities: An Updated Review
    Tajul Islam Mamun, Sabrina Younus, Md. Hashibur Rahman
    Cancer Treatment and Research Communications.2024; : 100845.     CrossRef
  • Research Progress of Scutellaria baicalensis in the Treatment of Gastrointestinal Cancer
    Lankang Wang, Baoyi Ni, Jia Wang, Jilai Zhou, Junyi Wang, Jiakang Jiang, Yutong Sui, Yaoyao Tian, Feng Gao, Yufeng Lyu
    Integrative Cancer Therapies.2024;[Epub]     CrossRef
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Risk Factors for Distant Metastasis in Extrahepatic Bile Duct Cancer after Curative Resection (KROG 1814)
Younghee Park, Tae Hyun Kim, Kyubo Kim, Jeong Il Yu, Wonguen Jung, Jinsil Seong, Woo Chul Kim, Jin Hwa Choi, Ah Ram Chang, Bae Kwon Jeong, Byoung Hyuck Kim, Tae Gyu Kim, Jin Hee Kim, Hae Jin Park, Hyun Soo Shin, Jung Ho Im, Eui Kyu Chie
Cancer Res Treat. 2024;56(1):272-279.   Published online July 31, 2023
DOI: https://doi.org/10.4143/crt.2023.616
AbstractAbstract PDFPubReaderePub
Purpose
Risk factors predicting distant metastasis (DM) in extrahepatic bile duct cancer (EHBDC) patients treated with curative resection were investigated.
Materials and Methods
Medical records of 1,418 EHBDC patients undergoing curative resection between Jan 2000 and Dec 2015 from 14 institutions were reviewed. After resection, 924 patients (67.6%) were surveilled without adjuvant therapy, 297 (21.7%) were treated with concurrent chemoradiotherapy (CCRT) and 148 (10.8%) with CCRT followed by chemotherapy. To exclude the treatment effect from innate confounders, patients not treated with adjuvant therapy were evaluated.
Results
After a median follow-up of 36.7 months (range, 2.7 to 213.2 months), the 5-year distant metastasis-free survival (DMFS) rate was 57.7%. On multivariate analysis, perihilar or diffuse tumor (hazard ratio [HR], 1.391; p=0.004), poorly differentiated histology (HR, 2.014; p < 0.001), presence of perineural invasion (HR, 1.768; p < 0.001), positive nodal metastasis (HR, 2.670; p < 0.001) and preoperative carbohydrate antigen (CA) 19-9 ≥ 37 U/mL (HR, 1.353; p < 0.001) were significantly associated with inferior DMFS. The DMFS rates significantly differed according to the number of these risk factors. For validation, patients who underwent adjuvant therapy were evaluated. In patients with ≥ 3 factors, additional chemotherapy after CCRT resulted in a superior DMFS compared with CCRT alone (5-year rate, 47.6% vs. 27.7%; p=0.001), but the benefit of additional chemotherapy was not observed in patients with 0-2 risk factors.
Conclusion
Tumor location, histologic differentiation, perineural invasion, lymph node metastasis, and preoperative CA 19-9 level predicted DM risk in resected EHBDC. These risk factors might help identifying a subset of patients who could benefit from additional chemotherapy after resection.
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Prevalence and Risk Factors of Germline Pathogenic Variants in Pancreatic Ductal Adenocarcinoma
Kum Hei Ryu, Sunhwa Park, Jung Won Chun, Eunhae Cho, Jongmun Choi, Dong-Eun Lee, Hyoeun Shim, Yun-Hee Kim, Sung-Sik Han, Sang-Jae Park, Sang Myung Woo, Sun-Young Kong
Cancer Res Treat. 2023;55(4):1303-1312.   Published online April 3, 2023
DOI: https://doi.org/10.4143/crt.2023.291
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The genetic attribution for pancreatic ductal adenocarcinoma (PDAC) has been reported as 5%-10%. However, the incidence of germline pathogenic variants (PVs) in Korean PDAC patients has not been thoroughly investigated. Therefore, we studied to identify the risk factors and prevalence of PV for future treatment strategies in PDAC.
Materials and Methods
Total of 300 (155 male) patients with a median age of 65 years (range, 33 to 90 years) were enrolled in National Cancer Center in Korea. Cancer predisposition genes, clinicopathologic characteristics, and family history of cancer were analyzed.
Results
PVs were detected in 20 patients (6.7%, median age 65) in ATM (n=7, 31.8%), BRCA1 (n=3, 13.6%), BRCA2 (n=3), and RAD51D (n=3). Each one patient showed TP53, PALB2, PMS2, RAD50, MSH3, and SPINK1 PV. Among them, two likely PVs were in ATM and RAD51D, respectively. Family history of various types of cancer including pancreatic cancer (n=4) were found in 12 patients. Three patients with ATM PVs and a patient with three germline PVs (BRCA2, MSH3, and RAD51D) had first-degree relatives with pancreatic cancer. Familial pancreatic cancer history and PVs detection had a significant association (4/20, 20% vs. 16/264, 5.7%; p=0.035).
Conclusion
Our study demonstrated that germline PVs in ATM, BRCA1, BRCA2, and RAD51D are most frequent in Korean PDAC patients and it is comparable to those of different ethnic groups. Although this study did not show guidelines for germline predisposition gene testing in patients with PDAC in Korea, it would be emphasized the need for germline testing for all PDAC patients.

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  • DNA damage response inhibitors in pancreatic cancer: progress and challenges
    Yeyao Wu, Wei Li, Mengyun Wu
    Frontiers in Oncology.2026;[Epub]     CrossRef
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    Xu Ding, Jinjun Shi, Zhengqing Lei, Guoqing Wang, Chenchun Fu, Xiangyu Su, Guangyu Zhu
    Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease.2025; 1871(3): 167673.     CrossRef
  • Mutant KRAS and GATA6 Stratify Survival in Patients Treated with Chemotherapy for Pancreatic Adenocarcinoma: A Prospective Cohort Study
    Jung Won Chun, Dong-eun Lee, Nayoung Han, SooBeen Heo, Hyeji Kim, Mi Rim Lee, Hyeong Min Park, Sung-Sik Han, Sang-Jae Park, Tae Hyun Kim, Woo Jin Lee, Yun-Hee Kim, Sun-Young Kong, Sang Myung Woo
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    Sayeeda Sultana, Rehana Parveen
    International Journal Of Community Medicine And Public Health.2025; 12(6): 2921.     CrossRef
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    Wen-Jing Liu, Jun Lu, Wei-Xun Zhou, Jian-Zhou Liu, Li Zhou
    Laboratory Investigation.2024; 104(9): 102107.     CrossRef
  • Clinical Significance of PALB2 Pathogenic Germline Variant
    Min-Chae Kang, R.N., Jong Eun Park, Mi-Ae Jang, Dongju Won, Boyoung Park, Seeyoun Lee, Dong Ock Lee, Kum Hei Ryu, Yoon-Jung Chang, Sun-Young Kong
    Laboratory Medicine Online.2024; 14(4): 311.     CrossRef
  • Prevalence Estimation of the PALB2 Germline Variant in East Asians and Koreans through Population Database Analysis
    Jong Eun Park, Min-Chae Kang, Taeheon Lee, Eun Hye Cho, Mi-Ae Jang, Dongju Won, Boyoung Park, Chang-Seok Ki, Sun-Young Kong
    Cancers.2024; 16(19): 3318.     CrossRef
  • Understanding the Genetic Landscape of Pancreatic Ductal Adenocarcinoma to Support Personalized Medicine: A Systematic Review
    Antonino Pantaleo, Giovanna Forte, Candida Fasano, Martina Lepore Signorile, Paola Sanese, Katia De Marco, Elisabetta Di Nicola, Marialaura Latrofa, Valentina Grossi, Vittoria Disciglio, Cristiano Simone
    Cancers.2023; 16(1): 56.     CrossRef
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Breast cancer
Epidemiology of Second Non-breast Primary Cancers among Survivors of Breast Cancer: A Korean Population–Based Study by the SMARTSHIP Group
Haeyoung Kim, Su SSan Kim, Ji Sung Lee, Jae Sun Yoon, Hyun Jo Youn, Hyukjai Shin, Jeong Eon Lee, Se Kyung Lee, Il Yong Chung, So-Youn Jung, Young Jin Choi, Jihyoung Cho, Sang Uk Woo, Korean Breast Cancer Society
Cancer Res Treat. 2023;55(2):580-591.   Published online December 27, 2022
DOI: https://doi.org/10.4143/crt.2022.410
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to evaluate the incidence and prognosis of second non-breast primary cancer (SNBPC) among Korean survivors of breast cancer.
Materials and Methods
Data from the Korean National Health Insurance Service were searched to identify women who received curative surgery for initial breast cancer (IBC) between 2003 and 2008 (n=64,340). Among them, patients with the following characteristics were excluded: other cancer diagnosis before IBC (n=10,866), radiotherapy before IBC (n=349), absence of data on sex or age (n=371), or male (n=248). Accordingly, data of 52,506 women until December 2017 were analyzed. SNBPC was defined as a newly diagnosed SNBPC that occurred 5 years or more after IBC diagnosis.
Results
The median follow-up time of all patients was 12.13 years. SNBPC was developed in 3,084 (5.87%) women after a median of 7.61 years following IBC diagnosis. The 10-year incidence of SNBPC was 5.78% (95% confidence interval [CI], 5.56 to 6.00). Higher SNBPC incidence was found in survivors with the following factors: old age at IBC diagnosis, low household income, and receiving combined chemotherapy with endocrine therapy, whereas receiving radiotherapy was related to a lower incidence of SNBPC (hazard ratio, 0.89; p < 0.01). Among the patients with SNBPC, the 5-year survival rate was 62.28% (95% CI, 65.53 to 69.02).
Conclusion
Approximately 5% of breast cancer survivors developed SNBPC within 10 years after IBC diagnosis. The risk of SNBPC was associated with patient’s age at IBC diagnosis, income level, and a receipt of systemic treatments.

Citations

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  • Development of a risk prediction model for second primary thyroid cancer in female breast cancer patients based on machine learning algorithms
    Qianqian Yang, Zhihong Li, Yunfei Zhang, Roza Doktorzhan, Xiuhua Zhang, Wenjia Guo
    Scientific Reports.2026;[Epub]     CrossRef
  • Risk of second primary cancer in young breast cancer survivors: an important yet overlooked issue
    Xinyi Liang, Yiwei Qin, Pengwei Li, You Mo, Dawei Chen
    Therapeutic Advances in Medical Oncology.2025;[Epub]     CrossRef
  • Molecule subtypes play important roles for second primary malignancies development based on 324,661 breast cancer survivors
    Jin Shi, Jian Liu, Guo Tian, Daojuan Li, Di Liang, Yutong He
    Scientific Reports.2025;[Epub]     CrossRef
  • Comorbidity burden and risk of second primary non-breast cancer in breast cancer survivors
    Amrita Mukherjee, Zheng Gu, Lie Hong Chen, Rowan T. Chlebowski, Arnold L. Potosky, Reina Haque
    Cancer Epidemiology.2025; 97: 102867.     CrossRef
  • Association of radiotherapy for stage I–III breast cancer survivors and second primary malignant cancers: a population-based study
    Jin Shi, Jian Liu, Guo Tian, Daojuan Li, Di Liang, Jun Wang, Yutong He
    European Journal of Cancer Prevention.2024; 33(2): 115.     CrossRef
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Lung and Thoracic cancer
The Value of the Illness-Death Model for Predicting Outcomes in Patients with Non–Small Cell Lung Cancer
Kum Ju Chae, Hyemi Choi, Won Gi Jeong, Jinheum Kim
Cancer Res Treat. 2022;54(4):996-1004.   Published online November 19, 2021
DOI: https://doi.org/10.4143/crt.2021.902
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The illness-death model (IDM) is a comprehensive approach to evaluate the relationship between relapse and death. This study aimed to illustrate the value of the IDM for identifying risk factors and evaluating predictive probabilities for relapse and death in patients with non–small cell lung cancer (NSCLC) in comparison with the disease-free survival (DFS) model.
Materials and Methods
We retrospectively analyzed 612 NSCLC patients who underwent a curative operation. Using the IDM, the risk factors and predictive probabilities for relapse, death without relapse, and death after relapse were simultaneously evaluated and compared to those obtained from a DFS model.
Results
The IDM provided more detailed risk factors according to the patient’s disease course, including relapse, death without relapse, and death after relapse, in patients with resected lung cancer. In the IDM, history of malignancy (other than lung cancer) was related to relapse and smoking history was associated with death without relapse; both were indistinguishable in the DFS model. In addition, the IDM was able to evaluate the predictive probability and risk factors for death after relapse; this information could not be obtained from the DFS model.
Conclusion
Compared to the DFS model, we found that the IDM provides more comprehensive information on transitions between states and disease stages and provides deeper insights with respect to understanding the disease process among lung cancer patients.

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  • Variable Selection for Illness‐Death Processes Under Dual Observation Schemes
    Xianwei Li, Liqun Diao, Richard J. Cook
    Statistics in Medicine.2026;[Epub]     CrossRef
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    Andres Arguedas, David Schneck, Erjia Cui, Annette Xenopoulos-Oddsson, Ximena Arcila-Londono, Christian Lunetta, James Wymer, Nicholas Olney, Kelly Gwathmey, Senda Ajroud-Driss, Ghazala Hayat, Terry Heiman-Patterson, Federica Cerri, Christina Fournier, Jo
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    J Wang, S Vordenbäumen, M Schneider, R Brinks
    Scandinavian Journal of Rheumatology.2024; 53(3): 161.     CrossRef
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    Jiancong Wang, Sabrina Tulka, Stephanie Knippschild, Matthias Schneider, Jörg H. W. Distler, Xenofon Baraliakos, Ralph Brinks, Philipp Sewerin
    Rheumatology International.2023; 43(11): 2037.     CrossRef
  • Difference of serum tumor markers in different clinical stages of elderly patients with non-small cell lung cancer and evaluation of diagnostic value
    Wen Qin, Ping Wang, CuiMin Ding, Fei Peng
    Journal of Medical Biochemistry.2023; 42(4): 607.     CrossRef
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    Lijalem Melie Tesfaw, Zelalem G. Dessie, Haile Mekonnen Fenta
    Frontiers in Oncology.2023;[Epub]     CrossRef
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  • 164 Download
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Hematologic malignancy
Association between Kidney Function, Proteinuria and the Risk of Multiple Myeloma: A Population-Based Retrospective Cohort Study in South Korea
Taewoong Choi, Wooin Ahn, Dong Wook Shin, Kyungdo Han, Dahye Kim, Sohyun Chun
Cancer Res Treat. 2022;54(3):926-936.   Published online September 27, 2021
DOI: https://doi.org/10.4143/crt.2021.951
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
While renal impairment is one of the first clinical manifestations of multiple myeloma (MM), declined renal function may conversely be a risk factor for cancers including MM. In this study, we investigated the relationship between chronic kidney disease and MM at a population level.
Materials and Methods
A total of 9,809,376 adults who participated in a nationwide health screening program and had no MM, cancer or end-stage renal disease at baseline were investigated for incidence of MM. The impact of estimated glomerular filtration rate (eGFR) and random urine dipstick proteinuria, and interactive associations of the two factors on the MM incidence were evaluated.
Results
The general incidence of MM was 4.8 per 100,000 person-years (mean follow-up of 8.3 years). Participants with eGFR < 60 mL/min/1.73 m2 (5.8% of participants) had higher MM incidence than those with eGFR ≥ 60 mL/min/1.73 m2 (adjusted hazard ratio, 1.29; 95% confidence interval, 1.17 to 1.43). When eGFR was graded into five levels, there was a significant inverse dose-response relationship between eGFR level and MM incidence at the lower eGFR levels (reference: eGFR 60-89 mL/min/1.73 m2). A dose-response relationship was also found with degree of dipstick proteinuria and incidence of MM.
Conclusion
Adults with decreased renal function indicated either by decreased eGFR or presence of proteinuria are at a higher risk of developing MM compared to those without, and there is a dose-response relationship between the severity of renal impairment and MM incidence.

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  • Silymarin induces multiple myeloma cell apoptosis by inhibiting the JAK2/STAT3 signaling pathway
    Haiyun Liu, Tingting Liu, Junquan Zeng, Quangang Fang
    Oncology Letters.2025; 30(3): 1.     CrossRef
  • End-stage renal diseases associated with SGLT2 inhibitors versus GLP-1 receptor agonists in metabolic dysfunction-associated steatotic liver disease
    Hwa Yeon Ko, Bin Hong, Sungho Bea, Jae Hyun Bae, Young Min Cho, Yoosoo Chang, Seungho Ryu, Christopher D Byrne, Ju-Young Shin
    Diabetes Research and Clinical Practice.2025; 229: 112921.     CrossRef
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    Suein Choi, Eunjin Kim, Jinhee Jung, Sung-Soo Park, Chang-Ki Min, Seunghoon Han
    Scientific Reports.2024;[Epub]     CrossRef
  • 12,004 View
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Gastrointestinal cancer
Population Attributable Fraction of Established Modifiable Risk Factors on Colorectal Cancer in Korea
Sooyoung Cho, Aesun Shin
Cancer Res Treat. 2021;53(2):480-486.   Published online October 6, 2020
DOI: https://doi.org/10.4143/crt.2019.742
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We estimated the population attributable fraction (PAF) of established risk factors for colorectal cancer, to provide evidence for prioritizing cancer prevention policy.
Materials and Methods
The exposure prevalence was calculated by using data from the 2005 Korean National Health Examination Survey for tobacco smoking, alcohol consumption, obesity, physical inactivity, and meat intake. Risk estimates (relative risks) were selected from the published meta-analyses. Cancer incidence data from the Korea Central Cancer Registry were used to estimate the preventable number of colorectal cancer cases in 2015.
Results
The PAFs of the tobacco smoking, alcohol consumption, obesity, physical inactivity, and consumption of red and processed meat were as follows: 9.2%, 11.1%, 9.1%, 18.9%, and 10.1% for colon cancer and 21.8%, 12.3%, 3.5%, 5.3%, and 9.2% for rectal cancer among men; 1.0%, 1.3%, 2.7%, 12.3% and 9.2% for colon cancer and 1.7%, 2.3%, 0.8%, 7.2%, and 8.3% for rectal cancer among women. The PAFs of selected risk factors were 46.2% for colon and 42.4% for rectum among men, while 24.3% for colon and 18.9% for rectum among women. The attributable numbers of colon and rectal cancer to selected risk factors were 4,028 and 3,049 cases among men, respectively, while 1,644 and 778 cases among women in the year of 2015.
Conclusion
Changes in modifiable risk factors could prevent half of the colorectal cancer in the Korean population.

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  • Risk Factors for Early-Onset Colorectal Cancer: A Nested Case‒Control Study within the Korean National Health Insurance Service‒Health Screening Cohort
    Ji Yoon Baek, Seung-Yong Jeong, Aesun Shin
    Cancer Epidemiology, Biomarkers & Prevention.2026; 35(4): 647.     CrossRef
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    Federica Turati, Gianfranco Alicandro, Giulia Collatuzzo, Claudio Pelucchi, Matteo Malvezzi, Fabio Parazzini, Eva Negri, Paolo Boffetta, Carlo La Vecchia, Matteo Di Maso
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    Journal of Gastroenterology and Hepatology.2025; 40(2): 433.     CrossRef
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    Marko Mandic, Fatemeh Safizadeh, Michael Hoffmeister, Hermann Brenner
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    Ji Hyun Kim, Minhee Cho, Jung Eun Lee, Jeongseon Kim
    Journal of the Korean Medical Association.2025; 68(2): 108.     CrossRef
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    Seung-Ah Choe
    Journal of the Korean Society for Research on Nicotine and Tobacco.2025; 16(4): 108.     CrossRef
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    Mi Ah Han, Seo‐Hee Kim, Eu Chang Hwang, Jae Hung Jung, Sun Mi Park
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    Rosa María Márquez-González, Anilú Margarita Saucedo-Sariñana, César de Jesús Tovar-Jacome, Patricio Barros-Núñez, Martha Patricia Gallegos-Arreola, Mario Humberto Orozco-Gutiérrez, Ignacio Mariscal-Ramírez, Tomas Daniel Pineda-Razo, Aldo Antonio Alcaraz-
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    Seokyung An, Madhawa Gunathilake, Jeonghee Lee, Minji Kim, Jae Hwan Oh, Hee Jin Chang, Dae Kyung Sohn, Aesun Shin, Jeongseon Kim
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
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    Rachel Dankner, Angela Chetrit, Sivan Ben Avraham, Nirit Agay, Ofra Kalter‐Leibovici, Uri Goldbourt, Walid Saliba, Lital Keinan‐Boker, Danit Shahar, Laurence S. Freedman
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  • Body Mass Index and Risk of Colorectal Cancer Incidence and Mortality in Asia
    Pedram Paragomi, Zhongjie Zhang, Sarah Krull Abe, Md. Rashedul Islam, Md. Shafiur Rahman, Eiko Saito, Xiao-Ou Shu, Bashir Dabo, Yen Thi-Hai Pham, Yu Chen, Yu-Tang Gao, Woon-Puay Koh, Norie Sawada, Reza Malekzadeh, Ritsu Sakata, Atsushi Hozawa, Jeongseon K
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  • Risk and survival in colorectal cancer with increasing body mass index: A nationwide population‐based cohort study
    Usman Saeed, Tor Å. Myklebust, Trude E. Robsahm, Marlene F. Kielland, Bjørn Møller, Bjørn S. Skålhegg, Tom Mala, Sheraz Yaqub
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    Hong Hu, Xiaoyuan Gong, Kai Xu, Shenzheng Luo, Wei Gao, Baiwen Li, Dadao Jing
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    Jaesung Choi, JooYong Park, Ji-Eun Kim, Miyoung Lee, Daehee Kang, Aesun Shin, Ji-Yeob Choi
    Cancer Prevention Research.2023; 16(7): 405.     CrossRef
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    Fatemeh Safizadeh, Marko Mandic, Dianne Pulte, Tobias Niedermaier, Michael Hoffmeister, Hermann Brenner
    British Journal of Cancer.2023; 129(5): 829.     CrossRef
  • Modifiable lifestyle factors have a larger contribution to colorectal neoplasms than family history
    Shuyuan Wang, Zhen Yuan, Yuqi Wang, Xuanzhu Zhao, Weifeng Gao, Hongzhou Li, Yuanshun Zhao, Zili Zhang, Shuiqing Liang, Zhaoce Liu, Qinghuai Zhang, Hong Ma, Xipeng Zhang, Wei Cui, Chunze Zhang
    BMC Cancer.2022;[Epub]     CrossRef
  • 11,204 View
  • 230 Download
  • 16 Crossref
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Head/neck cancer
Nomogram for Predicting Central Lymph Node Metastasis in Papillary Thyroid Cancer: A Retrospective Cohort Study of Two Clinical Centers
Zheyu Yang, Yu Heng, Jianwei Lin, Chenghao Lu, Dingye Yu, Lei Tao, Wei Cai
Cancer Res Treat. 2020;52(4):1010-1018.   Published online June 9, 2020
DOI: https://doi.org/10.4143/crt.2020.254
AbstractAbstract PDFPubReaderePub
Purpose
Central lymph node metastasis (CNM) are highly prevalent but hard to detect preoperatively in papillary thyroid carcinoma (PTC) patients, while the significance of prophylactic compartment central lymph node dissection (CLND) remains controversial as a treatment option. We aim to establish a nomogram assessing risks of CNM in PTC patients, and explore whether prophylactic CLND should be recommended.
Materials and Methods
One thousand four hundred thirty-eight patients from two clinical centers that underwent thyroidectomy with CLND for PTC within the period 2016–2019 were retrospectively analyzed. Univariate and multivariate analysis were performed to examine risk factors associated with CNM. A nomogram for predicting CNM was established, thereafter internally and externally validated.
Results
Seven variables were found to be significantly associated with CNM and were used to construct the model. These were as follows: thyroid capsular invasion, multifocality, creatinine > 70 μmol/L, age < 40, tumor size > 1 cm, body mass index < 22, and carcinoembryonic antigen > 1 ng/mL. The nomogram had good discrimination with a concordance index of 0.854 (95% confidence interval [CI], 0.843 to 0.867), supported by an external validation point estimate of 0.825 (95% CI, 0.793 to 0.857). A decision curve analysis was made to evaluate nomogram and ultrasonography for predicting CNM.
Conclusion
A validated nomogram utilizing readily available preoperative variables was developed to predict the probability of central lymph node metastases in patients presenting with PTC. This nomogram may help surgeons make appropriate surgical decisions in the management of PTC, especially in terms of whether prophylactic CLND is warranted.

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    Ning Li, Ju-hua He, Chao Song, Li-chun Yang, Hong-jiang Zhang, Zhi-hai Li
    Cancer Management and Research.2020; Volume 12: 10789.     CrossRef
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Risk Factors for Cognitive Impairment in High-Grade Glioma Patients Treated with Postoperative Radiochemotherapy
Qiang Wang, Fengxia Xiao, Fei Qi, Xiaopeng Song, Yonghua Yu
Cancer Res Treat. 2020;52(2):586-593.   Published online December 12, 2019
DOI: https://doi.org/10.4143/crt.2019.242
AbstractAbstract PDFPubReaderePub
Purpose
Fractionated radiotherapy as well as concomitant and adjuvant chemotherapy such as temozolomide for postoperative high-grade glioma (HGG) patients improves progression-free survival and overall survival. Multiple factors such as chemotherapy, radiotherapy, tumor grade, residual tumor volume, and genetic modifications might play a role in the formation of cognitive impairment. The risk factors of cognitive impairment in postoperative patients with HGG receiving radiotherapy and chemotherapy remains a concern in this population. The purpose of this study was to identify risk factors for cognitive impairment in patients of postoperative HGG.
Materials and Methods
A total of 229 patients with HGG who underwent surgery were analyzed. Cognitive impairment was defined as a decrease of Cognitive Assessment Montreal (MoCA)’s score in at least two cognitive domains or any MoCA’s score of less than 26 points at the time of study compared with baseline level. Multiple potential risk factors including methylated status of the O6-methylguanine-DNA methyltransferase (MGMT) promoter, glioma World Health Organization (WHO) grade, residual tumor volume, education, and sex were analyzed. Cox univariate and multivariate regression analysis was used to detect the significant risk factors for cognitive impairment.
Results
At the end of follow-up among the 229 patients, 147 patients (67%) developed cognitive impairment. 82 patients (36%) remained in normal cognitive condition. In multivariate analysis, unmethylated MGMT promoter (hazard ratio [HR], 1.679; 95% confidence interval [CI], 1.212 to 2.326; p=0.002), glioblastoma (HR, 1.550; 95% CI, 1.117 to 2.149; p=0.009), and residual tumor volume > 5.58 cm3 (HR, 1.454; 95% CI, 1.047 to 2.020; p=0.026) were independent risk factors for cognitive impairment.
Conclusion
Methylated status of the MGMT promoter, glioma WHO grade, and residual tumor volume might be risk factors for the cognitive impairment in postoperative patients with HGG.

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Identification of Significant Prognostic Tissue Markers Associated with Survival in Upper Urinary Tract Urothelial Carcinoma Patients Treated with Radical Nephroureterectomy: A Retrospective Immunohistochemical Analysis Using Tissue Microarray
Sung Han Kim, Weon Seo Park, Boram Park, Jinsoo Chung, Jae Young Joung, Kang Hyun Lee, Ho Kyung Seo
Cancer Res Treat. 2020;52(1):128-138.   Published online June 19, 2019
DOI: https://doi.org/10.4143/crt.2019.119
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study was to identify prognostic tissue markers for several survival outcomes after radical nephroureterectomy among patients with upper urinary tract urothelial carcinoma using tissue microarray and immunohistochemistry.
Materials and Methods
Retrospectively, data of 162 non-metastatic patients with upper urinary tract urothelial carcinoma after radical nephroureterectomy between 2004 and 2016 were reviewed to determine intravesical recurrence-free survival (IVRFS), disease-free survival (DFS), and overall survival (OS). The expression of 27 tissue markers on a tissue microarray of radical nephroureterectomy samples and prognostic values of clinicopathological parameters were evaluated using immunohistochemistry and Cox proportional hazard models after adjusting for significant prognostic clinicopathological variables. The expression of all tissue markers was categorized into a binary group with continuous H-scores (0-300).
Results
Median follow-up was 53.4 months (range, 3.6 to 176.5 months); and, 58 (35.8%), 48 (29.6%), and 19 (11.7%) bladder recurrence, disease progression, and all cause death, respectively, were identified. After adjusting for significant clinicopathological factors including intravesical instillation for bladder recurrence-free survival, pathologic T category and intravesical instillation for disease progression-free survival , and pathologic T category for OS (p < 0.05), IVRFS was associated with epithelial cadherin (hazard ratio [HR], 0.49), epidermal growth factor receptor/erythroblastosis oncogene B (c-erb) (HR, 2.59), and retinoblastoma protein loss (HR, 1.85); DFS was associated with cyclin D1 (HR, 2.16) and high-molecular-weight cytokeratin (HR, 0.42); OS was associated with E-cadherin (HR, 0.34) and programmed cell death 1 ligand (HR, 13.42) (p < 0.05).
Conclusion
Several significant tissue markers were associated with survival outcomes in upper urinary tract urothelial carcinoma patients treated with radical nephroureterectomy.

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Risk Assessment of Secondary Primary Malignancies in Nasopharyngeal Carcinoma: A Big-Data Intelligence Platform-Based Analysis of 6,377 Long-term Survivors from an Endemic Area Treated with Intensity-Modulated Radiation Therapy during 2003-2013
Lu-Lu Zhang, Guo-Hong Li, Yi-Yang Li, Zhen-Yu Qi, Ai-Hua Lin, Ying Sun
Cancer Res Treat. 2019;51(3):982-991.   Published online October 11, 2018
DOI: https://doi.org/10.4143/crt.2018.298
AbstractAbstract PDFPubReaderePub
Purpose
The incidence, risk factors and survival impact of secondary primary malignancies (SPMs) among survivors of nasopharyngeal carcinoma (NPC) treated with definitive intensity-modulated radiation therapy (IMRT) with or without chemotherapy are poorly characterized.
Methods
and Materials Consecutive patients (n=6,377) from the big-data intelligence platform at Sun Yat-sen University Cancer Center, China (in a high-incidence area) with newly diagnosed non-metastatic pathologically proven non-keratinizing undifferentiated NPC treated with IMRT±chemotherapy between January 2003 and June 2013 were retrospectively analyzed. Cumulative incidence of SPMs was calculated using the Kaplan-Meier method. Cox proportional hazards model was used to identify potential risk factors for SPMs and assess whether SPMs affect overall survival.
Results
Of the 6,377 patients, 189 (3.0%) suffered SPMs (median follow-up, 62 months). One-, 2-, 3-, 4-, and 5-cumulative risks of SPMs were 0.4%, 0.9%, 1.6%, 2.2%, and 2.6%, respectively. Latency from start of IMRT to SPMs diagnosis was 37 months (range, 6 to 102 months). In patients with SPMs, 14.3% suffered SPMs within 1 year post-IMRT: 1-3 years, 38.1%; 3-5 years, 33.9%; and >5 years, 13.7%. Lung cancer was the most common SPM (50/6,377, 0.78%). Multivariate analysis demonstrated sex (male, 64% increase), age (≥50 years, 68% increase), and smoking history (41% increase) were significant risk factors for SPMs, and SPMs were associated with poorer overall survival.
Conclusion
This large cohort study confirms SPMs a dreadful complication for long-term survivors of NPC treated with IMRT. SPMs negatively impact overall survival in NPC. Close follow-up is recommended for older male survivors with a smoking history.

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Risk Factor Analysis for Secondary Malignancy in Dexrazoxane-Treated Pediatric Cancer Patients
Hyery Kim, Hyoung Jin Kang, Kyung Duk Park, Kyung-Nam Koh, Ho Joon Im, Jong Jin Seo, Jae Wook Lee, Nack-Gyun Chung, Bin Cho, Hack Ki Kim, Jae Min Lee, Jeong Ok Hah, Jun Ah Lee, Young Ho Lee, Sang Kyu Park, Hee Jo Baek, Hoon Kook, Ji Yoon Kim, Heung Sik Kim, Hwang Min Kim, Hee Won Chueh, Meerim Park, Hoi Soo Yoon, Mee Jeong Lee, Hyoung Soo Choi, Hyo Seop Ahn, Yoshifumi Kawano, Ji Won Park, Seokyung Hahn, Hee Young Shin
Cancer Res Treat. 2019;51(1):357-367.   Published online May 14, 2018
DOI: https://doi.org/10.4143/crt.2017.457
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Dexrazoxane has been used as an effective cardioprotector against anthracycline cardiotoxicity. This study intended to analyze cardioprotective efficacy and secondary malignancy development, and elucidate risk factors for secondary malignancies in dexrazoxane-treated pediatric patients.
Materials and Methods
Data was collected from 15 hospitals in Korea. Patients who received any anthracyclines, and completed treatment without stem cell transplantation were included. For efficacy evaluation, the incidence of cardiac events and cardiac event-free survival rates were compared. Data about risk factors of secondary malignancies were collected.
Results
Data of total 1,453 cases were analyzed; dexrazoxane with every anthracyclines group (D group, 1,035 patients) and no dexrazoxane group (non-D group, 418 patients). Incidence of the reported cardiac events was not statistically different between two groups; however, the cardiac event-free survival rate of patients with more than 400 mg/m2 of anthracyclines was significantly higher in D group (91.2% vs. 80.1%, p=0.04). The 6-year cumulative incidence of secondary malignancy was not different between both groups after considering follow-up duration difference (non-D, 0.52%±0.37%; D, 0.60%±0.28%; p=0.55). The most influential risk factor for secondary malignancy was the duration of anthracycline administration according to multivariate analysis.
Conclusion
Dexrazoxane had an efficacy in lowering cardiac event-free survival rates in patients with higher cumulative anthracyclines. As a result of multivariate analysis for assessing risk factors of secondary malignancy, the occurrence of secondary malignancy was not related to dexrazoxane administration.

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Projection of Breast Cancer Burden due to Reproductive/Lifestyle Changes in Korean Women (2013-2030) Using an Age-Period-Cohort Model
Joo Eun Lee, Sang Ah Lee, Tae Hyun Kim, Sohee Park, Yoon Soo Choy, Yeong Jun Ju, Eun-Cheol Park
Cancer Res Treat. 2018;50(4):1388-1395.   Published online January 22, 2018
DOI: https://doi.org/10.4143/crt.2017.162
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The aim of this study was to estimate the burden of breast cancer that can be attributed to rapid lifestyle changes in South Korea in 2013-2030.
Materials and Methods
An age-period-cohort model was used to estimate the incidence and mortality. The Global Burden of Disease Study Group methodwas used to calculate the years of life lost and years lived with disability in breast cancer patients using a nationwide cancer registry. The population attributable riskswere calculated using meta-analyzed relative risk ratios and by assessing the prevalence of risk factors.
Results
Women’s reproductive/lifestyle changes, including advanced maternal age at first childbirth (from 37 to 85 disability-adjusted life years [DALYs] per 100,000 person-years), total period of breastfeeding (from 22 to 46 DALYs per 100,000 person-years), obesity (from 37 to 61 DALYs per 100,000 person-years), alcohol consumption (from 19 to 39 DALYs per 100,000 person-years), oral contraceptive use (from 18 to 27 DALYs per 100,000 person-years), and hormone replacement therapy use (from 2 to 3 DALYs per 100,000 person-years) were identified as factors likely to increase the burden of breast cancer from 2013 to 2030. Approximately, 34.2% to 44.3% of the burden of breast cancer could be avoidable in 2030 with reduction in reproductive/lifestyle risk factors.
Conclusion
The rapid changes of age structure and lifestyle in South Korea during the last decade are expected to strongly increase the breast cancer burden over time unless the risk factors can be effectively modified.

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Risk Factors of Female Breast Cancer in Vietnam: A Case-Control Study
Phuong Dung (Yun) Trieu, Claudia Mello-Thoms, Jennifer K. Peat, Thuan Doan Do, Patrick C. Brennan
Cancer Res Treat. 2017;49(4):990-1000.   Published online February 20, 2017
DOI: https://doi.org/10.4143/crt.2016.488
AbstractAbstract PDFPubReaderePub
Purpose
Rates of women with breast cancer have increased rapidly in recent years in Vietnam, with over 10,000 new patients contracting the disease every year. This study was conducted to identify demographic, reproductive and lifestyle risk factors for breast cancer in Vietnam.
Materials and Methods
Breast density, demographic, reproductive and lifestyle data of 269 women with breast cancer and 519 age-matched controls were collected in the two largest oncology hospitals in Vietnam (one in the north and one in the south). Baseline differences between cases and controls in all women, premenopausal and postmenopausal women were assessed using chi-squared tests and independent t tests. Conditional logistic regressionwas used to derive odds ratios (OR) for factors that had statistically significant associations with breast cancer.
Results
Vietnamesewomenwith breast cancerwere significantly more likely to have a breast density > 75% (OR, 1.7), be younger than 14 years at first menstrual period (OR, 2.2), be postmenopausal (OR, 2.0), have less than three pregnancies (OR, 2.1), and have less than two babies (OR, 1.7). High breast density (OR, 1.6), early age at first menstrual period (OR, 2.6), low number of pregnancies (OR, 2.3), hormone use (OR, 1.8), and no physical activities (OR, 2.2) were significantly associated with breast cancer among premenopausal women, while breast density (OR, 2.0), age at first menstrual period (OR, 1.8), number of pregnancies (OR, 2.3), and number of live births (OR, 2.4) were the risk factors for postmenopausal women.
Conclusion
Breast density, age at first menarche, menopause status, number of pregnancies, number of babies born, hormone use and physical activitieswere significantly associatedwith breast cancer in Vietnamese women.

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Incorporating Risk Factors to Identify the Indication of Post-mastectomy Radiotherapy in N1 Breast Cancer Treated with Optimal Systemic Therapy: A Multicenter Analysis in Korea (KROG 14-23)
Hae Jin Park, Kyung Hwan Shin, Jin Ho Kim, Seung Do Ahn, Ja Young Kim, Won Park, Yong Bae Kim, Yeon-joo Kim, Jin Hee Kim, Kyubo Kim, Kyung Ran Park, Hyun Soo Shin, Bae Kwon Jeong, Sun Young Lee, Suzy Kim
Cancer Res Treat. 2017;49(3):739-747.   Published online October 19, 2016
DOI: https://doi.org/10.4143/crt.2016.405
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
In a recent meta-analysis, post-mastectomy radiotherapy (PMRT) reduced any first recurrence (AFR) and improved survival in N1 and N2 patients. We investigated risk factors for AFR in N1 after optimal systemic therapy without PMRT, to define a subgroup of patients who may benefit from PMRT.
Materials and Methods
One thousand three hundred eighty-two pT1-2N1M0 breast cancer patients treated with mastectomy without PMRT between 2005 and 2010 were retrospectively analyzed. Only 0.6% had no systemic therapy.
Results
After a median follow-up of 5.9 years, there were 173 AFR (53 loco-regional recurrence [LRR] without distant metastases [DM], 38 LRR with DM, and 82 DM without LRR). The 5-year LRR and AFR rates were 6.1% and 12.0%, respectively. Multivariate analysis revealed that close resection margin (p=0.001) was the only independent risk factor for LRR. Multivariate analysis for AFR revealed that age < 35 years (p=0.025), T2 stage (p=0.004), high tumor grade (p=0.032), close resection margin (p=0.035), and triple-negative biological subtype (p=0.031) were independent risk factors. Two or three positive lymph nodes (p=0.078) were considered a marginally significant factor. When stratified by these six factors, the 5-year LRR rates were 3.6% with 0-1 (n=606), 7.5% with 2-3 (n=655), and 12.7% with 4-6 (n=93) risk factors. The 5-year AFR rates were 7.1% with 0-1, 15.0% with 2-3, and 24.5% with 4-6 risk factors.
Conclusion
Patients with pT1-2N1M0 breast cancer who underwent mastectomy and optimal systemic therapy showed excellent loco-regional control and disease control. The patients with four or more risk factors may benefit from PMRT, and those with two or three risk factors merit consideration of PMRT.

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Risk Factors for Thyroid Cancer: A Hospital-Based Case-Control Study in Korean Adults
Seung-Kwon Myung, Chan Wha Lee, Jeonghee Lee, Jeongseon Kim, Hyeon Suk Kim
Cancer Res Treat. 2017;49(1):70-78.   Published online June 23, 2016
DOI: https://doi.org/10.4143/crt.2015.310
AbstractAbstract PDFPubReaderePub
Purpose
Although the incidence of thyroid cancer in Korea has rapidly increased over the past decade, few studies have investigated its risk factors. This study examined the risk factors for thyroid cancer in Korean adults.
Materials and Methods
The study design was a hospital-based case-control study. Between August 2002 and December 2011, a total of 802 thyroid cancer cases out of 34,211 patients screened from the Cancer Screenee. Cohort of the National Cancer Center in South Korea were included in the analysis. A total of 802 control cases were selected from the same cohort, and matched individually (1:1) by age (±2 years) and area of residence for control group 1 and additionally by sex for control group 2.
Results
Multivariate conditional logistic regression analysis using the control group 1 showed that females and those with a family history of thyroid cancer had an increased risk of thyroid cancer, whereas ever-smokers and those with a higher monthly household income had a decreased risk of thyroid cancer. On the other hand, the analysis using control group 2 showed that a family history of cancer and alcohol consumption were associated with a decreased risk of thyroid cancer, whereas higher body mass index (BMI) and family history of thyroid cancer were associated with an increased risk of thyroid cancer.
Conclusion
These findings suggest that females, those with a family history of thyroid cancer, those with a higher BMI, non-smokers, non-drinkers, and those with a lower monthly household income have an increased risk of developing thyroid cancer.

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Identification of Prognostic Risk Factors for Transient and Persistent Lymphedema after Multimodal Treatment for Breast Cancer
Myungsoo Kim, Kyung Hwan Shin, So-Youn Jung, Seeyoun Lee, Han-Sung Kang, Eun Sook Lee, Seung Hyun Chung, Yeon-Joo Kim, Tae Hyun Kim, Kwan Ho Cho
Cancer Res Treat. 2016;48(4):1330-1337.   Published online February 3, 2016
DOI: https://doi.org/10.4143/crt.2015.463
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study is to identify risk factors for transient lymphedema (TLE) and persistent lymphedema (PLE) following treatment for breast cancer. Materials and Methods A total of 1,073 patients who underwent curative breast surgery were analyzed. TLE was defined as one episode of arm swelling that had resolved spontaneously by the next followup; arm swelling that persisted over two consecutive examinations was considered PLE.
Results
At a median follow-up period of 5.1 years, 370 cases of lymphedema were reported, including 120 TLE (11.2%) and 250 PLE (23.3%). Initial grade 1 swelling was observed in 351 patients, of which 120 were limited to TLE (34%), while the other 231 progressed to PLE (66%). All initial swelling observed in TLE patients was classified as grade 1. In multivariate analysis, chemotherapy with taxane and supraclavicular radiation therapy (SCRT) were associated with development of TLE, whereas SCRT, stage III cancer and chemotherapy with taxane were identified as risk factors for PLE (p < 0.05). The estimated incidence of TLE among initial grade 1 patients was calculated using up to three treatment-related risk factors (number of dissected axillary lymph nodes, SCRT, and taxane chemotherapy). The approximate ratios of TLE and PLE based on the number of risk factors were 7:1 (no factor), 1:1 (one factor), 1:2 (two factors), and 1:3 (three factors). Conclusion One-third of initial swelling events were transient, whereas the other two-thirds of patients experienced PLE. Estimation of TLE and PLE based on known treatment factors could facilitate prediction of this life-long complication.

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Cross-sectional Study of Patients with Diffuse Large B-Cell Lymphoma: Assessing the Effect of Host Status, Tumor Burden, and Inflammatory Activity on Venous Thromboembolism
Sung Hee Lim, Sook-young Woo, Seonwoo Kim, Young Hyeh Ko, Won Seog Kim, Seok Jin Kim
Cancer Res Treat. 2016;48(1):312-321.   Published online March 2, 2015
DOI: https://doi.org/10.4143/crt.2014.266
AbstractAbstract PDFPubReaderePub
Purpose
The risk factors for venous thromboembolism (VTE) in diffuse large B-cell lymphoma (DLBCL) are not clear although thrombosis can be associated with host status, tumor burden, and inflammatory activity. We assessed the effect of those factors on VTE in a cross-sectional study of patients enrolled in a prospective cohort study. Materials and Methods We analyzed the occurrence of VTE in 322 patients with newly diagnosed DLBCL who received rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) between 2008 and 2011. Serum levels of inflammatory cytokines were measured from serum samples archived at diagnosis.
Results
With a median follow-up duration of 41.9 months, VTE was documented in 34 patients (10.6%). A comparison of baseline characteristics indicated the group with VTE had higher percentage of old age, stage III/IV and extranodal involvements than the group without VTE (p < 0.05). Thus, the International Prognostic Index was significantly associated with VTE, but the Khorana score was not. A univariate competing risk factor analysis for VTE revealed that increased levels of inflammatory cytokines such as interleukin (IL)-6 and IL-10 were also associated with VTE (p < 0.05) in addition to host and tumor burden. However, a multivariate analysis showed that two host factors including age (≥ 60 years) and poor performance were independent risk factors for VTE. Conclusion Among potential risk factors for VTE including tumor burden and inflammatory activity, age and performance status had a strong impact on the occurrence of VTE in patients with DLBCL who received R-CHOP.

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Long-Term Outcome of Definitive Radiotherapy for Early Glottic Cancer: Prognostic Factors and Patterns of Local Failure
Yu Jin Lim, Hong-Gyun Wu, Tack-Kyun Kwon, J. Hun Hah, Myung-Whun Sung, Kwang Hyun Kim, Charn Il Park
Cancer Res Treat. 2015;47(4):862-870.   Published online February 13, 2015
DOI: https://doi.org/10.4143/crt.2014.203
AbstractAbstract PDFPubReaderePub
Purpose
This study evaluates the long-term results of definitive radiotherapy (RT) for early glottic cancer. Clinical and treatment factors related to local control and patterns of failure are analyzed. Materials and Methods We retrospectively reviewed 222 patients with T1-2N0 squamous cell carcinoma of the glottic larynx treated with definitive RT from 1981 to 2010. None of the patients received elective nodal RT or combined chemotherapy. The median total RT dose was 66 Gy. The daily fraction size was < 2.5 Gy in 69% and 2.5 Gy in 31% of patients. The RT field extended from the hyoid bone to the cricoid cartilage.
Results
The median age was 60 years, and 155 patients (70%) had T1 disease. The 5-year rates of local recurrence-free survival (LRFS) and ultimate LRFS with voice preservation were 87.8% and 90.3%, respectively. T2 (hazard ratio [HR], 2.30; 95% confidence interval [CI], 1.08 to 4.94) and anterior commissural involvement (HR, 3.37; 95% CI, 1.62 to 7.02) were significant prognostic factors for LRFS. In 34 patients with local recurrence, tumors recurred in the ipsilateral vocal cord in 28 patients. There were no contralateral vocal cord recurrences. Most acute complications included grade 1-2 dysphagia and/or hoarseness. There was no grade 3 or greater chronic toxicity.
Conclusion
Definitive RT achieved a high cure rate, voice preservation, and tolerable toxicity in early glottic cancer. T2 stage and anterior commissural involvement were prognostic factors for local control. Further optimization of the RT method is needed to reduce the risk of ipsilateral tumor recurrence.

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