Cancer Research and Treatment

Original Articles

Adjuvant Chemotherapy in Breast Cancer After Neoadjuvant Therapy: Essential or Optional?: Di Zhang, Luo Yang, Yuan Zheng, Qi Zhou; Received December 31, 2024 Accepted April 20, 2025 Published online April 24, 2025; DOI: https://doi.org/10.4143/crt.2024.1254 [Accepted]

Abstract PDF: Purpose
This study aimed to evaluate the impact of postoperative adjuvant chemotherapy (AC) on survival outcomes in breast cancer (BC) patients who have already undergone neoadjuvant chemotherapy (NAC) followed by surgery.
Materials and Methods
Data from a population-based cohort (2010-2020) were analyzed for BC patients treated with NAC and surgery. Univariate and multivariate Cox regression identified prognostic factors for overall survival (OS), and a nomogram was developed and validated. Personalized scores from the nomogram were used for risk stratification to assess the effect of postoperative AC.
Results
A total of 15,921 BC patients were analyzed, with 11,144 in the training cohort and 4,777 in the validation cohort. The key prognostic indicators for OS included age, race, marital status, histological grade, breast cancer subtype, T stage, N stage, type of surgery, and response to NAC (all p<0.05). The nomogram effectively predicted individualized OS rates and stratified patients into various risk categories. Postoperative AC was found to significantly enhance OS in the high-risk subgroup (p=0.011 in the training cohort, p=0.012 in the overall population). However, for the low-risk subgroup, there was no significant survival benefit from postoperative AC (p=0.130 for the training cohort, p=0.588 for the overall population), suggesting that some patients might safely forgo unnecessary postoperative AC.
Conclusion
This study efficiently differentiates between varying levels of risk, enabling clinicians to identify patients unlikely to benefit from postoperative AC and thus reduce the likelihood of overtreatment.

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Gynecologic cancer

Application of Machine Learning Algorithms for Risk Stratification and Efficacy Evaluation in Cervical Cancer Screening among the ASCUS/LSIL Population: Evidence from the Korean HPV Cohort Study: Heekyoung Song, Hong Yeon Lee, Shin Ah Oh, Jaehyun Seong, Soo Young Hur, Youn Jin Choi; Cancer Res Treat. 2025;57(2):547-557. Published online September 6, 2024; DOI: https://doi.org/10.4143/crt.2024.465

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Purpose
We assessed human papillomavirus (HPV) genotype-based risk stratification and the efficacy of cytology testing for cervical cancer screening in patients with atypical squamous cells of undetermined significance (ASCUS)/low-grade squamous intraepithelial lesion (LSIL).
Materials and Methods
Between 2010 and 2021, we monitored 1,273 HPV-positive women with ASCUS/LSIL every 6 months for up to 60 months. HPV infections were categorized as persistent (HPV positivity consistently observed post-enrollment), negative (HPV negativity consistently observed post-enrollment), or non-persistent (neither consistently positive nor negative). HPV genotypes were grouped into high-risk (Hr) groups 1 (types 16, 18, 31, 33, 45, 52, and 58) and 2 (types 35, 39, 51, 56, 59, 66, and 68) and a low-risk group. Hr1 was subdivided into types (a) 16 and 18; (b) 31, 33, and 45; and (c) 52 and 58. Cox regression and machine learning (ML) algorithms were used to analyze progression rates.
Results
Among 1,273 participants, 17.6% with persistent HPV infections experienced disease progression versus no progression in the HPV-negative group (p < 0.001). Cox analysis revealed the highest hazard ratios (HRs) for Hr1-a (11.6, p < 0.001), followed by Hr1-b (9.26, p < 0.001) and Hr1-c (7.21, p < 0.001). HRs peaked at 12-24 months, with Hr1-a maintaining significance at 24-36 months (10.7, p=0.034). ML analysis identified the final cytology change pattern as the most significant factor, with 14-15 months the optimal time for detecting progression from the first examination.
Conclusion
In ASCUS/LSIL cases, follow-up strategies should be based on HPV risk types. Annual follow-up was the most effective monitoring for detecting progression/regression.

Citations

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Geneticsbiologiesingle cell and expression analysis for erectile dysfunction and cervical cancer targets
Tengfei Zhao, Yangyang Li, Huixue Liu, Chongxin Tong
Discover Oncology.2024;[Epub] CrossRef

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Lung and Thoracic cancer

Predictive Value of Interstitial Lung Abnormalities for Postoperative Pulmonary Complications in Elderly Patients with Early-stage Lung Cancer: Won Gi Jeong, Yun-Hyeon Kim, Jong Eun Lee, In-Jae Oh, Sang Yun Song, Kum Ju Chae, Hye Mi Park; Cancer Res Treat. 2022;54(3):744-752. Published online September 28, 2021; DOI: https://doi.org/10.4143/crt.2021.772

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Purpose
Identifying pretreatment interstitial lung abnormalities (ILAs) is important because of their predictive value for complications after lung cancer treatment. This study aimed to assess the predictive value of ILAs for postoperative pulmonary complications (PPCs) in elderly patients undergoing curative resection for early-stage non-small cell lung cancer (NSCLC).
Materials and Methods
Elderly patients (age ≥ 70 years) who underwent curative resection for pathologic stage I or II NSCLC with normal preoperative spirometry results (pre-bronchodilator forced expiratory volume in 1 s to forced vital capacity [FVC] ratio > 0.70 and FVC ≥ 80% of the predicted value) between January 2012 and December 2019 were retrospectively identified. Univariable and multivariable regression analyses were performed to assess risk factors for PPCs. The Kaplan–Meier method and log-rank test were used to analyze the relationship between ILAs and postoperative mortality. One-way analysis of variance was performed to assess the correlation between ILAs and hospital stay duration.
Results
A total of 262 patients (median age, 73 [interquartile range, 71–76] years; 132 male) were evaluated. A multivariable logistic regression model revealed that, among several relevant risk factors, fibrotic ILAs independently predicted both overall PPCs (adjusted odds ratio [OR], 4.84; 95% confidence interval [CI], 1.35–17.38; p=0.016) and major PPCs (adjusted OR, 8.72; 95% CI, 1.71–44.38; p=0.009). Fibrotic ILAs were significantly associated with higher postoperative mortality and longer hospital stay (F=5.21, p=0.006).
Conclusion
Pretreatment fibrotic ILAs are associated with PPCs, higher postoperative mortality, and longer hospital stay.

Citations

Citations to this article as recorded by

Prevalence and prognostic significance of interstitial lung abnormalities in lung cancer: A meta-analysis
Ruiyuan Yang, Haoyu Wang, Dan Liu, Weimin Li
Lung Cancer.2025; : 108458. CrossRef
Pretreatment Interstitial Lung Abnormalities Detected on Abdominal Computed Tomography Scans in Prostate Cancer Patients
Hyun Jin Kim, Won Gi Jeong, Jeong Yeop Lee, Hyo-Jae Lee, Byung Chan Lee, Hyo Soon Lim, Yun-Hyeon Kim
Journal of Computer Assisted Tomography.2024; 48(3): 406. CrossRef
Interstitial Lung Abnormalities
Noriaki Wada, Gary M. Hunninghake, Hiroto Hatabu
Clinics in Chest Medicine.2024; 45(2): 433. CrossRef
Incidence and risk factors of pulmonary complications after lung cancer surgery: A systematic review and meta-analysis
Ting Deng, Jiamei Song, Jinmei Tuo, Yu Wang, Jin Li, Lorna Kwai Ping Suen, Yan Liang, Junliang Ma, Shaolin Chen
Heliyon.2024; 10(12): e32821. CrossRef
Survival impact of fibrotic interstitial lung abnormalities in resected stage IA non-small cell lung cancer
Won Gi Jeong, Yun-Hyeon Kim
The British Journal of Radiology.2023;[Epub] CrossRef
Radiologic Progression of Interstitial Lung Abnormalities following Surgical Resection in Patients with Lung Cancer
Yoon Joo Shin, Jeong Geun Yi, Mi Young Kim, Donghee Son, Su Yeon Ahn
Journal of Clinical Medicine.2023; 12(21): 6858. CrossRef
Mycophenolate mofetil versus cyclophosphamide plus in patients with connective tissue disease-associated interstitial lung disease: Efficacy and safety analysis
Pengfei Wang, Li Zhang, Qian Guo, Lifen Zhao, Yanyan Hao
Open Medicine.2023;[Epub] CrossRef
Clinical implication of interstitial lung abnormality in elderly patients with early‐stage non‐small cell lung cancer
Seong Woo Cho, Won Gi Jeong, Jong Eun Lee, In‐Jae Oh, Sang Yun Song, Hye Mi Park, Hyo‐Jae Lee, Yun‐Hyeon Kim
Thoracic Cancer.2022; 13(7): 977. CrossRef

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Hematologic Malignancy

Prognostic Stratification of Patients with Burkitt Lymphoma Using Serum β2-microglobulin Levels: Hyung-Don Kim, Hyungwoo Cho, Shin Kim, Kyoungmin Lee, Eun Hee Kang, Jung Sun Park, Chan-Sik Park, Jooryung Huh, Jin Sook Ryu, Sang-Wook Lee, Dok-Hyun Yoon, Seok Jin Kim, Young Hyeh Ko, Won Seog Kim, Cheolwon Suh; Cancer Res Treat. 2021;53(3):847-856. Published online December 17, 2020; DOI: https://doi.org/10.4143/crt.2020.1060

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Purpose
We aimed to investigate the prognostic value of serum β2-microglobulin for patients with Burkitt lymphoma (BL) and to propose a risk-stratifying classification system.
Materials and Methods
A prospective registry-based cohort study of BL patients treated with dose-intensive or effective dose-adjusted chemotherapies (n=81) was conducted. Survival outcomes were compared based on previously reported risk groups and/or serum β2-microglobulin levels. A risk-stratifying classification system incorporating serum β2-microglobulin levels was proposed and validated in an independent validation cohort (n=60).
Results
The median age was 47 years, and 57 patients (70.4%) were male. Patients with high serum β2-microglobulin levels (> 2 mg/L) had significantly worse progression-free survival (PFS) and overall survival (OS) (p < 0.01 for both). Serum β2-microglobulin levels further stratified patients in the low-risk and high-risk groups in terms of PFS (p=0.010 and p=0.044, respectively) and OS (p=0.014 and p=0.026, respectively). Multivariate analyses revealed that a high serum β2-microglobulin level (> 2 mg/L) was independently associated with a shorter PFS (hazards ratio [HR], 3.56; p=0.047) and OS (HR, 4.66; p=0.043). The new classification system incorporating the serum β2-microglobulin level allowed the stratification of patients into three distinct risk subgroups with 5-year OS rates of 100%, 89.5%, and 62.5%. In an independent cohort of BL, the system was validated by stratifying patients with different survival outcomes.
Conclusion
Serum β2-microglobulin level is an independent prognostic factor for BL patients. The proposed β2-microglobulin–based classification system could stratify patients with distinct survival outcomes, which may help define appropriate treatment approaches for individual patients.

Citations

Citations to this article as recorded by

Prognostic Factors for Survival in Adults With Burkitt Lymphoma: A Systematic Review
Aythami de Armas‐Castellano, Diego Infante‐Ventura, Tasmania del Pino‐Sedeño, Yadira González Hernández, Raul Quiros, Beatriz León‐Salas, Vincent Ribrag, María M. Trujillo‐Martín
Cancer Medicine.2025;[Epub] CrossRef
The clinical significance and prognostic value of serum beta-2 microglobulin in adult lymphoma-associated hemophagocytic lymphohistiocytosis: a multicenter analysis of 326 patients
Ze Jin, Yi Miao, Jie Zhang, Jing Zhang, Chunling Wang, Xuzhang Lu, Yuqing Miao, Miao Sun, Yunping Zhang, Yun Zhuang, Haiwen Ni, Jingyan Xu, Wanchuan Zhuang, Min Zhao, Jianfeng Zhu, Min Xu, Guoqiang Lin, Haiying Hua, Xiaoyan Xie, Maozhong Xu, Tao Jia, Liji
Annals of Hematology.2024; 103(7): 2257. CrossRef
Prognostic Value of18F-FDG PET/CT Radiomics in Extranodal Nasal-Type NK/T Cell Lymphoma
Yu Luo, Zhun Huang, Zihan Gao, Bingbing Wang, Yanwei Zhang, Yan Bai, Qingxia Wu, Meiyun Wang
Korean Journal of Radiology.2024; 25(2): 189. CrossRef
The Role of Beta2-Microglobulin in Central Nervous System Disease
Zhen-Yuan Liu, Feng Tang, Jin-Zhou Yang, Xi Chen, Ze-Fen Wang, Zhi-Qiang Li
Cellular and Molecular Neurobiology.2024;[Epub] CrossRef
Serum beta2-microglobulin acts as a biomarker for severity and prognosis in glioma patients: a preliminary clinical study
Zhen-Yuan Liu, Feng Tang, Jing Wang, Jin-Zhou Yang, Xi Chen, Ze-Fen Wang, Zhi-Qiang Li
BMC Cancer.2024;[Epub] CrossRef
Serum beta2-microglobulin and peripheral blood eosinophils for the assessment of severity and prognosis with omicron variant COVID-19 infection
Jie Tan, Hanxi Fang, Xiao Hu, Ming Yue, Junling Yang
Frontiers in Molecular Biosciences.2024;[Epub] CrossRef
A novel inflammation-related prognostic model for predicting the overall survival of primary central nervous system lymphoma: A real-world data analysis
Zhentian Wu, Chenyi Wang, Yao Lyu, Zheshen Lin, Ming Lu, Shixiong Wang, Bingxuan Wang, Na Yang, Yeye Li, Jianhong Wang, Xiaohui Duan, Na Zhang, Jing Gao, Yuan Zhang, Miaowang Hao, Zhe Wang, Guangxun Gao, Rong Liang
Frontiers in Oncology.2023;[Epub] CrossRef
Beta2-microglobulin is a valuable marker and identifies a poor-prognosis subgroup among intermediate-risk patients with diffuse large B cell lymphoma
Ning-Chun Chen, Hung Chang, Hsiao-Wen Kao, Che-Wei Ou, Ming-Chung Kuo, Po-Nan Wang, Tung-Liang Lin, Jin-Hou Wu, Yu-Shin Hung, Yi-Jiun Su, Yuen-Chin Ong, Hsuan-Jen Shih
Clinical and Experimental Medicine.2023; 23(7): 3759. CrossRef
Tuberculosis combined with Burkitt lymphoma in a kidney transplant recipient: A case report and literature review
Jian-Nan Hu, Mu-Qing Yu, Li-Juan Hua, Chen Bao, Qian Liu, Chao Liu, Zi-Ling Li, Xi Wang, Shu-Yun Xu
Medicine.2023; 102(18): e33671. CrossRef
Elevated serum beta-2 microglobulin level predicts short-term poor prognosis of patients with de novo acute omicron variant COVID-19 infection
Shengping Gong, Ruishuang Ma, Ting Zhu, Xiaoqin Ge, Rongrong Xie, Qingsong Tao, Cong Shi
Frontiers in Cellular and Infection Microbiology.2023;[Epub] CrossRef
An Externally Validated Nomogram for Predicting the Overall Survival of Patients With Diffuse Large B-Cell Lymphoma Based on Clinical Characteristics and Systemic Inflammatory Markers
Yajiao Liu, Li Sheng, Haiying Hua, Jingfen Zhou, Ying Zhao, Bei Wang
Technology in Cancer Research & Treatment.2023;[Epub] CrossRef
Prognostic significance of serum β2-microglobulin levels in patients with peripheral T-cell lymphoma not otherwise specified
Hyung-Don Kim, Hyungwoo Cho, Byeong Seok Sohn, Chan-Sik Park, Jooryung Huh, Jin Sook Ryu, Sang-Wook Lee, Sang Eun Yoon, Seok Jin Kim, Young Hyeh Ko, Won Seog Kim, Cheolwon Suh
Leukemia & Lymphoma.2022; 63(1): 124. CrossRef

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