Cancer Research and Treatment

Original Articles

Validation of 2023 FIGO Stage IA1–IIIC2 Endometrial Carcinoma: A Retrospective Analysis of Two Tertiary Centers in South Korea and Taiwan: Myeong-Seon Kim, Yen-Ling Lai, Yurimi Lee, Hyun-Soo Kim, Yu-Li Chen, Yoo-Young Lee; Received December 11, 2024 Accepted February 10, 2025 Published online February 17, 2025; DOI: https://doi.org/10.4143/crt.2024.1190 [Accepted]

Abstract PDF: Purpose
As understanding of the molecular pathogenesis of endometrial carcinoma (EC) advanced, the International Federation of Gynecology and Obstetrics (FIGO) staging system was revised in 2023. This study compared EC survival outcomes using the 2009 and 2023 FIGO staging systems.
Materials and Methods
We retrospectively analyzed 3,029 patients diagnosed with 2009 FIGO stage I–III EC between 1985 and 2022 in South Korea, and between 2020 and 2022 in Taiwan. All patients were reclassified using the 2023 FIGO staging, and survival and risk factors were examined under both systems.
Results
Transitioning from the 2009 to 2023 FIGO resulted in 549 (18.0%) patients being upstaged and their survival curves being diversified, indicating significant prognostic value of the 2023 FIGO. Re-classification using the 2023 FIGO upstaged the 2009 FIGO stage IA high-risk ECs, allowing more intensive treatment and potentially improving survival outcomes. The most significant changes occurred in the 2009 FIGO stages IA, IB, and IIIA ECs: upstaging in 16.5%, 49.0%, and 2.0% of IA, IB, and IIIA tumors, respectively, and downstaging 0.3% and 40.8% of IB and IIIA tumors, respectively. The risk factors for poor survival included old age (≥60), menopause, diabetes, substantial lymphovascular space invasion, aberrant p53 expression, and some aggressive histological types (carcinosarcoma, undifferentiated carcinoma, mesonephric-like adenocarcinoma, and neuroendocrine carcinoma).
Conclusion
The 2023 FIGO staging provides more refined stratification of early-stage EC than the 2009 version. Thus, the 2023 FIGO may more accurately guide prognosis and therapeutic decision-making.

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Lung and Thoracic cancer

Differences in the Prognostic Impact between Single-Zone and Multi-Zone N2 Node Metastasis in Patients with Station-Based Multiple N2 Non–Small Cell Lung Cancer: Shia Kim, Geun Dong Lee, SeHoon Choi, Hyeong Ryul Kim, Yong-Hee Kim, Dong Kwan Kim, Seung-Il Park, Jae Kwang Yun; Cancer Res Treat. 2025;57(1):95-104. Published online July 22, 2024; DOI: https://doi.org/10.4143/crt.2024.120

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Purpose
The International Association for the Study of Lung Cancer suggests further subdivision of pathologic N (pN) category in non–small-cell lung cancer (NSCLC) by incorporating the location and number of involved lymph node (LN) stations. We reclassified patients with the station-based N2b disease into single-zone and multi-zone N2b groups and compared survival outcomes between the groups.
Materials and Methods
This retrospective study included patients with pN2 NSCLC who underwent lobectomy from 2006 to 2019. The N2 disease was subdivided into four categories: single-station N2 without N1 (N2a1), single-station N2 with N1 (N2a2), multiple-station N2 with single zone involvement (single-zone N2b), and multiple-station N2 with multiple zone involvement (multi-zone N2b). LN zones included in the subdivision of N2 disease were upper mediastinal, lower mediastinal, aortopulmonary, and subcarinal.
Results
Among 996 eligible patients, 211 (21.2%), 394 (39.6%), and 391 (39.3%) were confirmed to have pN2a1, pN2a2, and pN2b disease, respectively. In multivariable analysis after adjustment for sex, age, pT category, and adjuvant chemotherapy, overall survival was significantly better with single-zone N2b disease (n=125, 12.6%) than with multi-zone N2b disease (n=266, 26.7%) (hazard ratio [HR], 0.67; 95% confidence interval [CI], 0.49 to 0.90; p=0.009) and was comparable to that of N2a2 disease (HR, 1.12; 95% CI, 0.83 to 1.49; p=0.46).
Conclusion
Prognosis of single-zone LN metastasis was better than that of multiple-zone LN metastasis in patients with N2b NSCLC. Along with the station-based N descriptors, zone-based descriptors might ensure optimal staging, enabling the most appropriate decision-making on adjuvant therapy for patients with pN2 NSCLC.

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Prediction of Lymph Node Metastasis in Non–Small Cell Lung Carcinoma Using Primary Tumor Somatic Mutation Data
Victor Lee, Nicholas S. Moore, Joshua Doyle, Daniel Hicks, Patrick Oh, Shari Bodofsky, Sajid Hossain, Abhijit A. Patel, Sanjay Aneja, Robert Homer, Henry S. Park
JCO Clinical Cancer Informatics.2025;[Epub] CrossRef

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Genitourinary cancer

TNM-Based Head-to-Head Comparison of Urachal Carcinoma and Urothelial Bladder Cancer: Stage-Matched Analysis of a Large Multicenter National Cohort: Sang Hun Song, Jaewon Lee, Young Hwii Ko, Jong Wook Kim, Seung Il Jung, Seok Ho Kang, Jinsung Park, Ho Kyung Seo, Hyung Joon Kim, Byong Chang Jeong, Tae-Hwan Kim, Se Young Choi, Jong Kil Nam, Ja Yoon Ku, Kwan Joong Joo, Won Sik Jang, Young Eun Yoon, Seok Joong Yun, Sung-Hoo Hong, Jong Jin Oh; Cancer Res Treat. 2023;55(4):1337-1345. Published online April 17, 2023; DOI: https://doi.org/10.4143/crt.2023.417

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Purpose
Outcome analysis of urachal cancer (UraC) is limited due to the scarcity of cases and different staging methods compared to urothelial bladder cancer (UroBC). We attempted to assess survival outcomes of UraC and compare to UroBC after stage-matched analyses.
Materials and Methods
Total 203 UraC patients from a multicenter database and 373 UroBC patients in single institution from 2000 to 2018 were enrolled (median follow-up, 32 months). Sheldon stage conversion to corresponding TNM staging for UraC was conducted for head-to-head comparison to UroBC. Perioperative clinical variables and pathological results were recorded. Stage-matched analyses for survival by stage were conducted.
Results
UraC patients were younger (mean age, 54 vs. 67 years; p < 0.001), with 163 patients (80.3%) receiving partial cystectomy and 23 patients (11.3%) radical cystectomy. UraC was more likely to harbor ≥ pT3a tumors (78.8% vs. 41.8%). While 5-year recurrence-free survival, cancer-specific survival (CSS) and overall survival were comparable between two groups (63.4%, 67%, and 62.1% in UraC and 61.5%, 75.9%, and 67.8% in UroBC, respectively), generally favorable prognosis for UraC in lower stages (pT1-2) but unfavorable outcomes in higher stages (pT4) compared to UroBC was observed, although only 5-year CSS in ≥ pT4 showed statistical significance (p=0.028). Body mass index (hazard ratio [HR], 0.929), diabetes mellitus (HR, 1.921), pathologic T category (HR, 3.846), and lymphovascular invasion (HR, 1.993) were predictors of CSS for all patients.
Conclusion
Despite differing histology, UraC has comparable prognosis to UroBC with relatively favorable outcome in low stages but worse prognosis in higher stages. The presented system may be useful for future grading and risk stratification of UraC.

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Urachal Carcinomas: A Comprehensive Systematic Review and Meta-analysis
Caio Vinícius Suartz, Lucas Motta Martinez, Marcelo Henrique Lima Silvestre, Richard Dobrucki de Lima, Pedro Henrique Souza Brito, Ketlyn Assunção Galhardo, Roberto Iglesias Lopes, Victor Hondo Silva de Moraes, Caio Mazzonetto Teofilo de Moraes, Luana Cov
International braz j urol.2025;[Epub] CrossRef
Clinical Presentation and Targeted Interventions in Urachal Adenocarcinoma: A Single-Institution Case Series and Review of Emerging Therapies
Akshay Mathavan, Akash Mathavan, Rodrigo Murillo-Alvarez, Kriti Gera, Urszula Krekora, Aaron J. Winer, Mohit Mathavan, Ellery Altshuler, Brian Hemendra Ramnaraign
Clinical Genitourinary Cancer.2024; 22(1): 67. CrossRef
Robotic‐assisted approaches to urachal carcinoma: A comprehensive systematic review of the safety and efficacy outcomes
Caio Vinícius Suartz, Lucas Motta Martinez, Pedro Henrique Brito, Carlos Victori Neto, Maurício Dener Cordeiro, Luiz Antonio Assan Botelho, Fábio Pescarmona Gallucci, José Maurício Mota, William Carlos Nahas, Leopoldo Alves Ribeiro‐Filho
BJUI Compass.2024; 5(3): 327. CrossRef

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Lung and Thoracic cancer

Diagnostic Performance of Endosonography to Detect Mediastinal Lymph Node Metastasis in Patients with Radiological N1 Non–Small Cell Lung Cancer: Bo-Guen Kim, Jong Ho Cho, Sun Hye Shin, Kyungjong Lee, Sang-Won Um, Hojoong Kim, Jhingook Kim, Young Mog Shim, Byeong-Ho Jeong; Cancer Res Treat. 2023;55(3):832-840. Published online March 2, 2023; DOI: https://doi.org/10.4143/crt.2022.1428

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Purpose
Guidelines recommend that non–small cell lung cancer (NSCLC) patients with suspected hilar lymph node (LN) metastases should undergo invasive mediastinal LN staging prior to surgical treatment via endosonography. We evaluated the diagnostic performance of endosonography for detecting occult mediastinal metastases (OMM) and determined the factors associated with OMM in NSCLC patients with radiological N1.
Materials and Methods
Patients with confirmed primary NSCLC with radiological N1 who underwent endosonography for nodal staging assessment from January 2013 to December 2019 were retrospectively analyzed.
Results
The prevalence of OMM was found to be 83/279 (29.7%) and only 38.6% (32/83) were diagnosed via endosonography. However, five of them were confirmed as N3 by endosonography. The overall diagnostic sensitivity, negative predictive value, accuracy, and area under the curve of endosonography were 38.6%, 79.4%, 81.7%, and 0.69, respectively. In multivariable analysis, central tumor (adjusted odds ratio [aOR], 2.05; 95% confidence interval [CI], 1.15 to 3.68; p=0.016), solid tumor (aOR, 10.24; 95% CI, 1.32 to 79.49; p=0.026), and adenocarcinoma (aOR, 3.01; 95% CI, 1.63 to 5.55; p < 0.001) were related to OMM in radiological N1 NSCLC patients.
Conclusion
Although the sensitivity of endosonography for detecting OMM was only 40%, the prevalence of OMM was not low (30%) and some cases even turned out to be N3 diseases. Clinicians should be aware that OMM may be more likely in patients with central, solid, and adenocarcinomatous tumor when performing nodal staging in radiological N1 NSCLC via endosonography.

Citations

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Incorporating Lymph Node Size at CT as an N1 Descriptor in Clinical N Staging for Lung Cancer
Yura Ahn, Sang Min Lee, Jooae Choe, Se Hoon Choi, Kyung-Hyun Do, Joon Beom Seo
Radiology.2025;[Epub] CrossRef
Prevalence and Risk Factors for Pathologic N2 Disease in Resected Lung Cancers Assessed as N0 or N1 Disease on Preoperative Imaging
Yura Ahn, Sang Min Lee, Jooae Choe, Sehoon Choi, Kyung-Hyun Do, Joon Beom Seo
American Journal of Roentgenology.2025;[Epub] CrossRef
EBUS‐TBNA for mediastinal staging of centrally located T1N0M0 non‐small cell lung cancer clinically staged with PET/CT
Pere Serra Mitjà, Bruno García‐Cabo, Ignasi Garcia‐Olivé, Joaquim Radua, Ramón Rami‐Porta, Lluís Esteban, Bienvenido Barreiro, Sergi Call, Carmen Centeno, Felipe Andreo, Carme Obiols, Juan Manuel Ochoa, Mireia Martínez‐Palau, Nina Reig, Mireia Serra, José
Respirology.2024; 29(2): 158. CrossRef
Clinical Effect of Endosonography on Overall Survival in Patients with Radiological N1 Non–Small Cell Lung Cancer
Bo-Guen Kim, Byeong-Ho Jeong, Goeun Park, Hong Kwan Kim, Young Mog Shim, Sun Hye Shin, Kyungjong Lee, Sang-Won Um, Hojoong Kim, Jong Ho Cho
Cancer Research and Treatment.2024; 56(2): 502. CrossRef
Clinical utility of artificial intelligence–augmented endobronchial ultrasound elastography in lymph node staging for lung cancer
Yogita S. Patel, Anthony A. Gatti, Forough Farrokhyar, Feng Xie, Waël C. Hanna
JTCVS Techniques.2024; 27: 158. CrossRef
Artificial Intelligence Algorithm Can Predict Lymph Node Malignancy from Endobronchial Ultrasound Transbronchial Needle Aspiration Images for Non-Small Cell Lung Cancer
Yogita S. Patel, Anthony A. Gatti, Forough Farrokhyar, Feng Xie, Waël C. Hanna
Respiration.2024; : 1. CrossRef

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Gastrointestinal Cancer

Effect of Preoperative Tumor Under-Staging on the Long-term Survival of Patients Undergoing Radical Gastrectomy for Gastric Cancer: Mi Lin, Qi-Yue Chen, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Chang-Ming Huang; Cancer Res Treat. 2021;53(4):1123-1133. Published online March 5, 2021; DOI: https://doi.org/10.4143/crt.2020.651

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Purpose
This study aimed to evaluate the effect of preoperative tumor staging deviation (PTSD) on the long-term survival of patients undergoing radical gastrectomy for gastric cancer (RGGC).
Materials and Methods
Clinicopathological data of 2,346 patients who underwent RGGC were retrospectively analyzed. The preoperative tumor-lymph node-metastasis (TNM) under-staging group (uTNM) comprised patients who had earlier preoperative TNM than postoperative TNM, and the no preoperative under-staging group (nTNM) comprised the remaining patients.
Results
There were 1,031 uTNM (44.0%) and 1,315 nTNM cases (56.0%). Cox prognostic analysis revealed that PTSD independently affected the overall survival (OS) after surgery. The 5-year OS was lower in the uTNM group (41.8%) than in the nTNM group (71.6%). The patients less than 65 years old, with lower American Society of Anaesthesiologists score, 2-5 cm tumor located at the lower stomach, and cT1 or cN0 preoperative staging would more likely undergo D1+ lymph node dissection (LND) in uTNM (p < 0.05). Logistic analyses revealed that tumor size > 2 cm and body mass index ≤ 22.72 kg/m2 were independent risk factors of preoperative TNM tumor under-staging in patients with cT1N0M0 staging (p < 0.05).
Conclusion
Underestimated tumor staging is not rare, which possibly results in inadequate LND and affects the long-term survival for patients undergoing RGGC. D2 LND should be carefully performed in patients who are predisposed to this underestimation.

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PREOPERATIVE PREDICTION OF WALL INVASION DEPTH OF PRIMARY TUMOR (PT) IN GASTRIC CANCER PATIENTS
M.YU. REUTOVICH, O.V. KRASKO, A.I. PATSEIKA, H.S. HUSSEIN
AVICENNA BULLETIN.2025; 27(2): 327. CrossRef
Preoperative prediction of gastric cancer T-staging based on ordinal regression models
O. V. Krasko, M. Yu. Reutovich, A. L. Patseika
Informatics.2024; 21(2): 36. CrossRef
rhG-CSF is associated with an increased risk of metastasis in NSCLC patients following postoperative chemotherapy
Yong Wang, Chen Fang, Renfang Chen, Shangkun Yuan, Lin Chen, Xiaotong Qiu, Xiaoying Qian, Xinwei Zhang, Zhehao Xiao, Qian Wang, Biqi Fu, Xiaoling Song, Yong Li
BMC Cancer.2022;[Epub] CrossRef
Factors of Organizing Surgical Treatment of Upper Gastrointestinal Cancers and Patient Survival: Real-World Data
D. A. Andreev, A. A. Zavyalov
Russian Journal of Gastroenterology, Hepatology, Coloproctology.2022; 32(6): 20. CrossRef

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Pretreatment Lymph Node Metastasis as a Prognostic Significance in Cervical Cancer: Comparison between Disease Status: Soo Young Jeong, Hyea Park, Myeong Seon Kim, Jun Hyeok Kang, E Sun Paik, Yoo-Young Lee, Tae Joong Kim, Jeong Won Lee, Byoung-Gie Kim, Duk Soo Bae, Chel Hun Choi; Cancer Res Treat. 2020;52(2):516-523. Published online October 29, 2019; DOI: https://doi.org/10.4143/crt.2019.328

Abstract PDF Supplementary Material PubReader ePub

Purpose
Lymph node metastasis (LNM) is the most significant prognostic factor in cervical cancer that was recently incorporated into the International Federation of Gynecology and Obstetrics (FIGO) staging system. This study was performed to evaluate whether the prognostic significance of LNM differs according to disease status.
Materials and Methods
Patients with FIGO stage IB or higher cervical cancer who had pretreatment computed tomography and/or magnetic resonance imaging studies as well as long-term follow-up were enrolled in this retrospective study. The hazard ratio (HR) of Cox regression was used to determine the prognostic significance of LNM. The HRs were compared between the different tumor groups (based on stage, histology, tumor size, primary treatment, age, parametrium involvement, and lymphovascular space invasion).
Results
A total of 970 patients treated between January 1999 and December 2007 were included. The pretreatment LNM had prognostic significance in patients with stage IB1/IIA (HR for progression-free survival 2.10, p=0.001; HR for overall survival 1.99, p=0.005). However, the significance gradually decreased or disappeared with advancing stages. Similarly, the prognostic significance of the pretreatment LNM decreased with advancing disease status, including old age, parametrial involvement or lymphovascular space involvement. In contrast, the tumor size was associated with the prognostic significance of LNM with advancing status. The significance of the clinical LNM did not reflect the significance of the clinical stage. In contrast, the tumor size, parametrial involvement, and significance of the pathologic LNM reflected the clinical stage.
Conclusion
In patients with cervical cancer, pretreatment LNM on imaging has different clinical significance depending on the tumor status.

Citations

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Predicting the risk of lymph node metastasis in colon cancer: development and validation of an online dynamic nomogram based on multiple preoperative data
Longlian Deng, Lemuge Che, Haibin Sun, Riletu En, Bowen Ha, Tao Liu, Tengqi Wang, Qiang Xu
BMC Gastroenterology.2025;[Epub] CrossRef
Complete remission of a high-risk, locally advanced cervical cancer with para-aortic lymph node metastases treated with first-line tislelizumab plus bevacizumab combined with chemotherapy followed by radiotherapy with maintenance therapy: a case report
Juan Lang, Qianqian Liu, Rong Ji, Miao Qiu, Siben Wang, Qingmeng Liu, Dapeng Li, Ping Chen, Zhongkui Xiong
Frontiers in Immunology.2025;[Epub] CrossRef
Application of CT in predicting lymph node metastasis in cervical cancer and construction of a preoperative nomogram
Xiao Meng, Siyu Song, Ke Li, Yajie Duan, Jiayuan Zhong, Jiawei Wang, Shichao Han
Scientific Reports.2025;[Epub] CrossRef
Development of cervical intraepithelial neoplasia and invasive cervical cancer due to oxidative stress
Amir Asotić, Memić Asotić, Muhamed Memić, Kerim Asotić, Amra Asotić
Sanamed.2024; 19(1): 39. CrossRef
Investigating and Analyzing Prognostic Factors and Their Impact on Recurrent Cervical Cancers
Ashish Uke, Shweta B Dahake, Anurag Luharia, Monika Luharia, Gaurav V Mishra, Chanrashekhar Mahakalkar
Cureus.2024;[Epub] CrossRef
Based on 3D-PDU and clinical characteristics nomogram for prediction of lymph node metastasis and lymph-vascular space invasion of early cervical cancer preoperatively
Shuang Dong, Yan-Qing Peng, Ya-Nan Feng, Xiao-Ying Li, Li-Ping Gong, Shuang Zhang, Xiao-Shan Du, Li-Tao Sun
BMC Women's Health.2024;[Epub] CrossRef
Recent Advances in Cervical Cancer Management: A Review on Novel Prognostic Factors in Primary and Recurrent Tumors
Angela Santoro, Frediano Inzani, Giuseppe Angelico, Damiano Arciuolo, Emma Bragantini, Antonio Travaglino, Michele Valente, Nicoletta D’Alessandris, Giulia Scaglione, Stefania Sfregola, Alessia Piermattei, Federica Cianfrini, Paola Roberti, Gian Franco Za
Cancers.2023; 15(4): 1137. CrossRef
Identification of lymph node metastasis in pre‐operation cervical cancer patients by weakly supervised deep learning from histopathological whole‐slide biopsy images
Qingqing Liu, Nan Jiang, Yiping Hao, Chunyan Hao, Wei Wang, Tingting Bian, Xiaohong Wang, Hua Li, Yan zhang, Yanjun Kang, Fengxiang Xie, Yawen Li, XuJi Jiang, Yuan Feng, Zhonghao Mao, Qi Wang, Qun Gao, Wenjing Zhang, Baoxia Cui, Taotao Dong
Cancer Medicine.2023; 12(17): 17952. CrossRef
Roles of DWI and T2-weighted MRI volumetry in the evaluation of lymph node metastasis and lymphovascular invasion of stage IB–IIA cervical cancer
Y. Wang, X. Chen, H. Pu, Y. Yuan, S. Li, G. Chen, Y. Liu, H. Li
Clinical Radiology.2022; 77(3): 224. CrossRef
Risk Factor Assessment of Lymph Node Metastasis in Patients With FIGO Stage IB1 Cervical Cancer
Mu Xu, Xiaoyan Xie, Liangzhi Cai, Yongjin Xie, Qiao Gao, Pengming Sun
Frontiers in Oncology.2022;[Epub] CrossRef
Intravoxel Incoherent Motion (IVIM) MR Quantification in Locally Advanced Cervical Cancer (LACC): Preliminary Study on Assessment of Tumor Aggressiveness and Response to Neoadjuvant Chemotherapy
Miriam Dolciami, Silvia Capuani, Veronica Celli, Alessandra Maiuro, Angelina Pernazza, Innocenza Palaia, Violante Di Donato, Giusi Santangelo, Stefania Maria Rita Rizzo, Paolo Ricci, Carlo Della Rocca, Carlo Catalano, Lucia Manganaro
Journal of Personalized Medicine.2022; 12(4): 638. CrossRef
The prognostic significance of pretreatment squamous cell carcinoma antigen levels in cervical cancer patients treated by concurrent chemoradiation therapy and a comparison of dosimetric outcomes and clinical toxicities between tomotherapy and volumetric
Yuan-Kai Cheng, Shih-Hsun Kuo, Heng-Hsuan Yen, Jing-Hu Wu, Yu-Chieh Chen, Ming-Yii Huang
Radiation Oncology.2022;[Epub] CrossRef
What MRI-based tumor size measurement is best for predicting long-term survival in uterine cervical cancer?
Njål Lura, Kari S. Wagner-Larsen, David Forsse, Jone Trovik, Mari K. Halle, Bjørn I. Bertelsen, Øyvind Salvesen, Kathrine Woie, Camilla Krakstad, Ingfrid S. Haldorsen
Insights into Imaging.2022;[Epub] CrossRef
Clinical value of MRI, serum SCCA, and CA125 levels in the diagnosis of lymph node metastasis and para-uterine infiltration in cervical cancer
Chao Ran, Jian Sun, Yunhui Qu, Na Long
World Journal of Surgical Oncology.2021;[Epub] CrossRef
A Novel Four-Gene Prognostic Signature as a Risk Biomarker in Cervical Cancer
Jun Wang, Hua Zheng, Yatian Han, Geng Wang, Yanbin Li, Cuida Meng
International Journal of Genomics.2020; 2020: 1. CrossRef

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Validation of the 8th AJCC Cancer Staging System for Pancreas Neuroendocrine Tumors Using Korean Nationwide Surgery Database: Yunghun You, Jin-Young Jang, Song Cheol Kim, Yoo-Seok Yoon, Joon Seong Park, Chol Kyoon Cho, Sang-Jae Park, Jae Do Yang, Woo Jung Lee, Tae Ho Hong, Keun Soo Ahn, Chi-Young Jeong, Hyeon Kook Lee, Seung Eun Lee, Young Hoon Roh, Hee Joon Kim, Hongbeom Kim, In Woong Han; Cancer Res Treat. 2019;51(4):1639-1652. Published online April 19, 2019; DOI: https://doi.org/10.4143/crt.2019.023

Abstract PDF PubReader ePub

Purpose
The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for pancreatic neuroendocrine tumor (PNET) included several significant changes. We aim to evaluate this staging system compared to the 7th edition AJCC staging system and European Neuroendocrine Tumors Society (ENETS) system.
Materials and Methods
We used Korean nationwide surgery database (2000-2014). Of 972 patients who had undergone surgery for PNET, excluding patients diagnosed with ENETS/World Health Organization 2010 grade 3 (G3), only 472 patients with accurate stage were included.
Results
Poor discrimination in overall survival rate (OSR) was noted between AJCC 8th stage III and IV (p=0.180). The disease-free survival (DFS) curves of 8th AJCC classification were well separated between all stages. Compared with stage I, the hazard ratio of II, III, and IV was 3.808, 13.928, and 30.618, respectively (p=0.007, p < 0.001, and p < 0.001). The curves of OSR and DFS of certain prognostic group in AJCC 7th and ENETS overlapped. In ENETS staging system, no significant difference in DFS between stage IIB versus IIIA (p=0.909) and IIIA versus IIIB (p=0.291). In multivariable analysis, lymphovascular invasion (p=0.002), perineural invasion (p=0.003), and grade (p < 0.001) were identified as independent prognostic factors for DFS.
Conclusion
This is the first large-scale validation of the AJCC 8th edition staging system for PNET. The revised 8th system provides better discrimination compared to that of the 7th edition and ENETS TNM system. This supports the clinical use of the system.

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Imaging Update of Pancreatic Neuroendocrine Neoplasms
Eric Rupe, Mahmoud Diab, LeeAnn Xoubi, Noha Kabeel, Ajaykumar Morani, Albert Klekers, Priya Bhosale
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Matteo Tacelli, Manuel Gentiluomo, Paolo Biamonte, Justo P. Castano, Maja Cigrovski Berković, Mauro Cives, Sanja Kapitanović, Ilaria Marinoni, Sonja Marinovic, Ilias Nikas, Lenka Nosáková, Sergio Pedraza-Arevalo, Eleonora Pellè, Aurel Perren, Jonathan Str
Seminars in Cancer Biology.2025; 112: 112. CrossRef
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Laura Degand, Clément Abi-Nader, Alexandre Bône, Rebeca Vetil, Davide Placido, Piotr Chmura, Marc-Michel Rohé, Federico De Masi, Søren Brunak
Investigative Radiology.2025;[Epub] CrossRef
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Subin Heo, Hyo Jung Park, Hyoung Jung Kim, Jung Hoon Kim, Seo Young Park, Kyung Won Kim, So Yeon Kim, Sang Hyun Choi, Jae Ho Byun, Song Cheol Kim, Hee Sang Hwang, Seung Mo Hong
Cancer Imaging.2024;[Epub] CrossRef
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Akash Kartik, Valerie L. Armstrong, Chee-Chee Stucky, Nabil Wasif, Zhi Ven Fong
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Estela Regina Ramos Figueira, André Luis Montagnini, Jessica Okubo, Ana Gabriela Vivarelli Fernandes, Marina Alessandra Pereira, Ulysses Ribeiro Junior, Paulo Herman, José Jukemura
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Aleksander Kosmala, Sebastian E. Serfling, Wiebke Schlötelburg, Thomas Lindner, Kerstin Michalski, Andreas Schirbel, Takahiro Higuchi, Philipp E. Hartrampf, Andreas K. Buck, Alexander Weich, Rudolf A. Werner
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Sean Lim, Lynn Chong, Saania Peeroo, Olukunle Onasanya, Evelyn He, Simon Banting, Daniel Croagh
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Validation of a supplementary condition of eighth AJCC staging system for stage II hepatocellular carcinoma
Min Li, Linquan Wu, Shuaiwu Luo, Yaran Liu, Chi Sun, Enliang Li, Jiakun Wang, Bowen Li, Zhihao Huang, Jin Ge, Jun Lei, Fan Zhou, Wenjun Liao
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Prognostic Value and Staging Classification of Lymph Nodal Necrosis in Nasopharyngeal Carcinoma after Intensity-Modulated Radiotherapy: Yanru Feng, Caineng Cao, Qiaoying Hu, Xiaozhong Chen; Cancer Res Treat. 2019;51(3):1222-1230. Published online December 27, 2018; DOI: https://doi.org/10.4143/crt.2018.595

Abstract PDF PubReader ePub

Purpose
The aim of the present study was to evaluate the prognostic value of magnetic resonance imaging (MRI)‒determined lymph nodal necrosis (LNN) in nasopharyngeal carcinoma (NPC) and explore the feasibility of an N-classification system based on the 8th edition of the American Joint Committee on Cancer (AJCC) system.
Materials and Methods
The MRI scans of 616 patients with newly diagnosed stage T1-4N1-3M0 NPC who were treated with definitive intensity-modulated radiotherapy (IMRT) were reviewed.
Results
Multivariate analysis showed that LNN was an independent negative prognostic predictor of distant metastasis free survival (hazard ratio, 1.634; 95% confidence interval, 1.023 to 2.609; p=0.040) and overall survival (hazard ratio, 2.154; 95% confidence interval, 1.282 to 3.620; p=0.004). Patients of classification N1 disease with LNN were reclassified as classification N2, and classification N2 disease with LNN as classification N3 in the proposed N-classification system. Correlation with death and distant failure was significant, and the total difference between N1 and N3 was wider with the proposed system.
Conclusion
MRI-determined LNN is an independent negative prognostic factor for NPC. The proposed N classification system is powerfully predictive.

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Hao Xu, Ai Wang, Chi Zhang, Jing Ren, Peng Zhou, Jieke Liu
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Wenmiao Cao, Xiaoxin Li, Jianqi Yang, Enming Xing, Wenjuan Wu, Yizhi Ge, Buhai Wang
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Yongfeng Piao, Caineng Cao, Yuanfan Xu, Shuang Huang, Feng Jiang, Ting Jin, Qifeng Jin, Yonghong Hua, Qiaoying Hu, Xiaozhong Chen
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Comparison of the 7th and the 8th AJCC Staging System for Non-metastatic D2-Resected Lymph Node–Positive Gastric Cancer Treated with Different Adjuvant Protocols: Jeong Il Yu, Do Hoon Lim, Jeeyun Lee, Won Ki Kang, Se Hoon Park, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Seung Tae Kim, Su Jin Lee, Sung Kim, Tae Sung Sohn, Jun Ho Lee, Ji Yeong An, Min Gew Choi, Jae Moon Bae, Heejin Yoo, Kyunga Kim; Cancer Res Treat. 2019;51(3):876-885. Published online October 1, 2018; DOI: https://doi.org/10.4143/crt.2018.401

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to compare prognostic differentiation performances of the 7th and the 8th edition of American Joint Commission on Cancer (AJCC) staging system for gastric cancer (GC) patients.
Materials and Methods
A total of 1,633 GC patients who underwent curative D2 resection followed by adjuvant chemotherapy alone (CA) or concurrent chemo-radiotherapy (CCRT) from 2004 to 2013 were included. Concordance index (c-index) was applied to compare the discriminatory ability.
Results
In the 8th edition, migration of stage was detected in 248 patients (15.2%). Among them, 121 patients were up-staged while 127 patients were down-staged. Overall, there was no statistically significant difference in the discriminatory ability between the 7th and 8th editions. The new edition of staging system, however, showed a trend of better prognostic performance not only in recurrence-free survival (c-index=0.734; 95% confidence interval [CI], 0.706 to 0.762 in the 7th edition vs. c-index=0.740; 95% CI, 0.712 to 0.768 in the 8th edition; p=0.14), but also in overall survival (c-index=0.717; 95% CI, 0.688 to 0.745 in the 7th edition vs. c-index=0.722; 95% CI, 0.694 to 0.751 in the 8th edition; p=0.19), especially in stage III. This finding was repeated in the subgroup analysis regardless of adjuvant CA or CCRT.
Conclusion
Generally, the 8th edition of AJCC staging system had failed to show a superior discriminatory ability for curatively D2 resected GC patients than the 7th edition, although there was a trend of better prognostic performance of the new edition, regardless of adjuvant treatment method.

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Ri-Sheng Zhao, Yi-Nan Liu, Wei-Gang Dai, Si-Le Chen, Jin-Ning Ye, Er-Tao Zhai, Shi-Rong Cai, Jian-Hui Chen
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Cancers.2020; 12(4): 943. CrossRef

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Validation of the Eighth American Joint Committee on Cancer Staging System for Distal Bile Duct Carcinoma: Sun-Young Jun, You-Na Sung, Jae Hoon Lee, Kwang-Min Park, Young-Joo Lee, Seung-Mo Hong; Cancer Res Treat. 2019;51(1):98-111. Published online March 2, 2018; DOI: https://doi.org/10.4143/crt.2017.595

Abstract PDF PubReader ePub

Purpose
T category of the eighth edition of the American Joint Committee on Cancer (AJCC) staging system for distal bile duct carcinoma (DBDC) was changed to include tumor invasion depth measurement, while the N category adopted a 3-tier classification system based on the number of metastatic nodes.
Materials and Methods
To validate cancer staging, a total of 200 surgically resected DBDCs were staged and compared according to the seventh and eighth editions.
Results
T categories included T1 (n=37, 18.5%), T2 (n=114, 57.0%), and T3 (n=49, 24.5%). N categories included N0 (n=133, 66.5%), N1 (n=50, 25.0%), and N2 (n=17, 8.5%). Stage groupings included I (n=33, 16.5%), II (n=150, 75.0%), and III (n=17, 8.5%). The overall 5-year survival rates (5-YSRs) of T1, T2, and T3 were 59.3%, 42.4%, and 12.2%, respectively. T category could discriminate patient survival by both pairwise (T1 and T2, p=0.011; T2 and T3, p < 0.001) and overall (p < 0.001) comparisons. The overall 5-YSRs of N0, N1, and N2 were 47.3%, 17.0%, and 14.7%, respectively. N category could partly discriminate patient survival by both pairwise (N0 and N1, p < 0.001; N1 and N2, p=0.579) and overall (p < 0.001) comparisons. The overall 5-YSRs of stages I, II, and III were 59.0%, 35.4%, and 14.7%, respectively. Stages could distinguish patient survival by both pairwise (I and II, p=0.002; II and III, p=0.015) and overall (p < 0.001) comparisons. On multivariate analyses, T and N categories (p=0.014 and p=0.029) and pancreatic invasion (p=0.006) remained significant prognostic factors.
Conclusion
The T andNcategories of the eighth edition AJCC staging system for DBDC accurately predict patient prognosis.

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Paranasal Sinus Invasion in Nasopharyngeal Carcinoma after Intensity-Modulated Radiotherapy: Caineng Cao, Feng Jiang, Qifeng Jin, Ting Jin, Shuang Huang, Qiaoying Hu, Yuanyuan Chen, Yongfeng Piao, Yonghong Hua, Xinglai Feng, Xiaozhong Chen; Cancer Res Treat. 2019;51(1):73-79. Published online February 26, 2018; DOI: https://doi.org/10.4143/crt.2017.607

Abstract PDF PubReader ePub

Purpose
The aim of this study is to evaluate the prognostic significance of paranasal sinus invasion for nasopharyngeal carcinoma (NPC) and its suitable position in the T classification.
Materials and Methods
The magnetic resonance imaging (MRI) scans of 695 patients with previously untreated, biopsy-proven, non-metastatic NPC that was treated with intensity-modulated radiotherapy (IMRT) were reviewed retrospectively.
Results
The incidence of paranasal sinus invasion was 39.4% (274 of 695 patients). Multivariate analysis showed that paranasal sinus invasion was an independent negative prognostic factor for local failure-free survival (LFFS) (p < 0.05). According to the eighth American Joint Committee on Cancer (AJCC) staging system, 275 patients were classified as T3 classification. Of these, 78 patients (28.4%) developed paranasal sinus invasion (T3b) and 197 (71.6%) didn’t (T3a). The estimated 5-year LFFS and overall survival (OS) rates for the patients with T3b and T3a classification were 88.6% versus 95.0% (p=0.047), and 84.5% versus 93.3% (p=0.183), respectively. The estimated 5-year LFFS and OS rates for the patientswith T4 classificationwere 89.5% and 83.2%,whichwere similarwith the outcomes of patients with T3b classification.
Conclusion
MRI-determined paranasal sinus invasion is an independent prognostic factor of NPC treated by IMRT. Paranasal sinus invasion is recommended to classify as T4 classification in the 8th AJCC staging system for NPC.

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Clinical Study of Early-Nasal Intervention Among Individuals With Nasopharyngeal Cancer to Prevent Radiation-Induced Sinusitis
Tianbin Ouyang, Hou Shi, Yaowen Wang, Jianliang Zhou
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Use of 18F‐FDG PET/MRI as an Initial Staging Procedure for Nasopharyngeal Carcinoma
Caineng Cao, Yuting Fang, Bocheng Yu, Yuanfan Xu, Mengyun Qiang, Changjuan Tao, Shuang Huang, Xiaozhong Chen
Journal of Magnetic Resonance Imaging.2024; 59(3): 922. CrossRef
Extent of paranasal sinus involvement and its prognostic value in nasopharyngeal carcinoma: Proposed modification in the current UICC/AJCC staging system
Xiao-Yi Wang, Si-Yu Zhu, Wei-Jie WU, Hao-Jiang Li, Jiao Li, Xiao-Feng Lin, Li Li, Li-Zhi Liu
Radiotherapy and Oncology.2021; 160: 221. CrossRef
Prognostic Factors for Overall Survival in Nasopharyngeal Cancer and Implication for TNM Staging by UICC: A Systematic Review of the Literature
Chi Leung Chiang, Qiaojuan Guo, Wai Tong Ng, Shaojun Lin, Tiffany Sze Wai Ma, Zhiyuan Xu, Youping Xiao, Jishi Li, Tianzhu Lu, Horace Cheuk Wai Choi, Wenqi Chen, Eric Sze Chun Chau, Peter Ho Yin Luk, Shao Hui Huang, Brian O’Sullivan, Jianji Pan, Anne Wing
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Locoregional Extension Patterns of Nasopharyngeal Carcinoma Detected by FDG PET/MR
Caineng Cao, Yuanfan Xu, Shuang Huang, Feng Jiang, Ting Jin, Qifeng Jin, Yonghong Hua, Qiaoying Hu, Xiaozhong Chen
Frontiers in Oncology.2021;[Epub] CrossRef
Impact of Paranasal Sinus Invasion on Oncologic and Dosimetric Outcomes in Nasopharyngeal Carcinoma Following Intensity-Modulated Radiation Therapy—Implications for Risk Stratification and Planning Optimization
Xin Zhou, Xiayun He, Fen Xue, Xiaomin Ou, Chaosu Hu
Frontiers in Oncology.2020;[Epub] CrossRef
Prognostic Value and Staging Classification of Lymph Nodal Necrosis in Nasopharyngeal Carcinoma after Intensity-Modulated Radiotherapy
Yanru Feng, Caineng Cao, Qiaoying Hu, Xiaozhong Chen
Cancer Research and Treatment.2019; 51(3): 1222. CrossRef
Paranasal sinus invasion suggested T4 classification of patients of nasopharyngeal carcinoma: A two‐center retrospective investigation
Liqing Wu, Shuiqing Zhuo, Weike Zeng, Shaobo Liang, Shunxin Wang, Chunyan Cui, Jian Zhou, Guangyin Ruan, Shuoyu Xu, Lifei Wang, Ling Huang, Lizhi Liu, Haojiang Li
Head & Neck.2019; 41(12): 4088. CrossRef

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Magnetic Resonance Imaging–Detected Intracranial Extension in the T4 Classification Nasopharyngeal Carcinoma with Intensity-Modulated Radiotherapy: Caineng Cao, Jingwei Luo, Li Gao, Junlin Yi, Xiaodong Huang, Suyan Li, Jianping Xiao, Zhong Zhang, Guozhen Xu; Cancer Res Treat. 2017;49(2):518-525. Published online August 24, 2016; DOI: https://doi.org/10.4143/crt.2016.299

Abstract PDF PubReader ePub

Purpose
This study was conducted is to identify the prognostic value and staging categories of magnetic resonance imaging (MRI)–detected intracranial extension in nasopharyngeal carcinoma (NPC) with intensity-modulated radiotherapy (IMRT) to determine whether it is necessary to subclassify the T4 classification NPC.
Materials and Methods
A total of 335 nonmetastatic T4 classificationNPC patientswith MRI treated between March 2004 and June 2011 by radical IMRTwere included. The T4 classification patientswere subclassified into two grades (T4a, without intracranial extension vs. T4b, with intracranial extension) according to the site of invasion.
Results
The frequency of intracranial extensionwas 40.9% (137 of 335 patients). Multivariate analysis identified subclassification (T4a vs. T4b) as an independent prognostic factor for local failure-free survival (p=0.049; hazard ratio [HR], 0.498) and overall survival (p=0.004; HR, 0.572); however, it had no effect on regional failure-free survival or distant failure-free survival (p > 0.050).
Conclusion
For patients with T4 classification NPC, those with MRI-detected intracranial extension are more likely to experience local failure and death afterIMRT than patientswithout intracranial extension. According to the site of invasion, subclassification of T4 patients as T4a or T4b has prognostic value in NPC.

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Prognostic value of MR-detected mandibular nerve involvement: potential indication for future individual induction chemotherapy in T4 nasopharyngeal carcinoma
Wenjie Huang, Shuqi Li, Chao Luo, Zhiying Liang, Shumin Zhou, Haojiang Li, Yi Cai, Shaobo Liang, Guangying Ruan, Peiqiang Cai, Lizhi Liu
Journal of Cancer Research and Clinical Oncology.2023; 149(9): 5951. CrossRef
The application of 3-dimensional magnetic resonance imaging in nasopharyngeal carcinoma with pterygopalatine fossa invasion
Bi Zhou, Zhuoyue Tang, Liang Lv, Jiayi Yu, Xiaojiao Li, Chao Yang, Shifeng Xiang, Zuhua Song, Dan Zhang
Magnetic Resonance Imaging.2023; 96: 38. CrossRef
MRI-based random survival Forest model improves prediction of progression-free survival to induction chemotherapy plus concurrent Chemoradiotherapy in Locoregionally Advanced nasopharyngeal carcinoma
Wei Pei, Chen Wang, Hai Liao, Xiaobo Chen, Yunyun Wei, Xia Huang, Xueli Liang, Huayan Bao, Danke Su, Guanqiao Jin
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Significance of boost dose for T4 nasopharyngeal carcinoma with residual primary lesion after intensity-modulated radiotherapy
Zhaodong Fei, Ting Xu, Xiufang Qiu, Mengying Li, Taojun Chen, Li Li, Chaoxiong Huang, Chuanben Chen
Journal of Cancer Research and Clinical Oncology.2021; 147(7): 2047. CrossRef
Can Arterial Spin Labeling Perfusion Imaging be Used to Differentiate Nasopharyngeal Carcinoma From Nasopharyngeal Lymphoma?
Zongqiong Sun, Shudong Hu, Yuxi Ge, Linfang Jin, Jianfeng Huang, Weiqiang Dou
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Detailed analysis of recovery process of cranial nerve palsy after IMRT-based comprehensive treatment in nasopharyngeal carcinoma
Jian Zang, Yan Li, Shanquan Luo, Jianhua Wang, Bingxin Hou, Min Yao, Lina Zhao, Mei Shi
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Chi Leung Chiang, Qiaojuan Guo, Wai Tong Ng, Shaojun Lin, Tiffany Sze Wai Ma, Zhiyuan Xu, Youping Xiao, Jishi Li, Tianzhu Lu, Horace Cheuk Wai Choi, Wenqi Chen, Eric Sze Chun Chau, Peter Ho Yin Luk, Shao Hui Huang, Brian O’Sullivan, Jianji Pan, Anne Wing
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Locoregional Extension Patterns of Nasopharyngeal Carcinoma Detected by FDG PET/MR
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Prognostic efficacy of extensive invasion of primary tumor volume for T3-4 nasopharyngeal carcinoma receiving intensity-modulated radiotherapy
Fen Xue, Dan Ou, Xiaomin Ou, Xin Zhou, Chaosu Hu, Xiayun He
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Sarbani Ghosh‐Laskar, Avinash Pilar, Carlton Johnny, Kumar Prabhash, Amit Joshi, Jai Prakash Agarwal, Tejpal Gupta, Ashwini Budrukkar, Vedang Murthy, Monali Swain, Vanita Noronha, Vijay Maruthi Patil, Prathamesh Pai, Deepa Nair, Devendra Arvind Chaukar, S
World Journal of Otorhinolaryngology - Head and Neck Surgery.2020; 6(1): 25. CrossRef
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Xin Zhou, Xiayun He, Fen Xue, Xiaomin Ou, Chaosu Hu
Frontiers in Oncology.2020;[Epub] CrossRef
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Caineng Cao, Feng Jiang, Qifeng Jin, Ting Jin, Shuang Huang, Qiaoying Hu, Yuanyuan Chen, Yongfeng Piao, Yonghong Hua, Xinglai Feng, Xiaozhong Chen
Cancer Research and Treatment.2019; 51(1): 73. CrossRef
Grading of MRI–detected skull-base invasion in nasopharyngeal carcinoma with skull-base invasion after intensity-modulated radiotherapy
Yanru Feng, Caineng Cao, Qiaoying Hu, Xiaozhong Chen
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Locoregional extension and patterns of failure for nasopharyngeal carcinoma with intracranial extension
Caineng Cao, Feng Jiang, Qifeng Jin, Ting Jin, Shuang Huang, Qiaoying Hu, Yuanyuan Chen, Yongfeng Piao, Yonghong Hua, Xinglai Feng, Xiaozhong Chen
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Preliminary Suggestion about Staging of Anorectal Malignant Melanoma May Be Used to Predict Prognosis: Won Young Chae, Jong Lyul Lee, Dong-Hyung Cho, Chang Sik Yu, Jin Roh, Jin Cheon Kim; Cancer Res Treat. 2016;48(1):240-249. Published online March 6, 2015; DOI: https://doi.org/10.4143/crt.2014.305

Abstract PDF PubReader ePub

Purpose
Anorectal malignant melanomas (AMM) are rare and have poor survival. The study aims to evaluate the clinicopathologic characteristics and outcomes of patients with AMM, and to devise a staging system predictive of survival outcome.
Materials and Methods
This was a retrospective study of 28 patients diagnosed with, and treated for AMM. Patients classified by clinical staging of mucosal melanoma (MM) were reclassified via rectal and anal TNM staging. Survival outcomes were compared among patients grouped by the three different staging systems.
Results
The three staging systems were equated with similar figures for 5-year overall survival (OS) and 5-year disease-free survival (DFS) of patients diagnosed with stage I disease. Patients (n=19) diagnosed with MM stage II disease were reclassified by rectal TNM staging into three subgroups: IIIA, IIIB, and IIIC. For these patients, both 5-year OS and 5-year DFS differed significantly between the subgroups IIIA and IIIC (OS: IIIA vs. IIIC, 66.7% vs. 0%, p=0.002; DFS: IIIA vs. IIIC, 51.4% vs. 0%, p < 0.001).
Conclusion
The accuracy of prognosis in patients diagnosed with AMM and lymph node metastasis has improved by using rectal TNM staging, which includes information regarding the number of lymph node metastases.

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Survival and Prognosis for Patients with Rectal Melanomas in the United States: A SEER-Based Study
Fan Zhang, Boqi Xu, Yao Peng, Runda Wu, Shan Tong, Zhongqi Mao
Journal of Investigative Surgery.2024;[Epub] CrossRef
Incidence and survival of patients with primary gastrointestinal melanoma: a population-based study
Yu Du, Xiaona Chang, Xiangxiang Li, Shugang Xing
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Melanoma anorrectal primario: reporte de un caso y revisión de una neoplasia infrecuente
Hernando Marulanda Fernández, Felipe Vera-Polanía, Juan Antonio Trejos Naranjo, Julian Ernesto Parga Bermudez, William Otero Regino
Revista colombiana de Gastroenterología.2023; 38(4): 504. CrossRef
A New Anorectal Melanoma Cell Line Derived from a Primary Human Rectal Tumor
Seiichi Shinji, Yuuki Shichi, Takeshi Yamada, Goro Takahashi, Ryo Ohta, Hiromichi Sonoda, Akihisa Matsuda, Kazuhide Yonaga, Takuma Iwai, Kohki Takeda, Koji Ueda, Sho Kuriyama, Toshimitsu Miyasaka, Yoshibumi Ueda, Norihiko Sasaki, Kimimasa Takahashi, Ryuji
Journal of Nippon Medical School.2022; 89(4): 368. CrossRef
Difficulties in diagnosing anorectal melanoma: A case report and review of the literature
Raluca Cristina Apostu, Elena Stefanescu, Radu Razvan Scurtu, Gabriel Kacso, Radu Drasovean
World Journal of Clinical Cases.2021; 9(36): 11369. CrossRef
Outcomes of Surgical Treatment for Patients with Anorectal Malignant Melanoma; Results of Nine Cases in a Single Institution
Tomoyuki Nagaoka, Toshiya Nagasaki, Takashi Akiyoshi, Toshiki Mukai, Tomohiro Yamaguchi, Eiji Shinozaki, Yosuke Fukunaga
Journal of the Anus, Rectum and Colon.2021; 5(2): 192. CrossRef
Management and outcomes of primary anorectal melanoma in the United States
Hari Menon, Roshal R Patel, Taylor R Cushman, Arya Amini, Steven N Seyedin, Anngela C Adams, Chi Lin, Vivek Verma
Future Oncology.2020; 16(8): 329. CrossRef
Melanoma anal, una patología radicalmente distinta al melanoma cutáneo, con un pronóstico infausto
Mireia Merichal Resina, Carlos Cerdan Santacruz, Enrique Sierra Grañón, Jordi Antoni Tarragona Foradada, Jorge Juan Olsina Kissler
Cirugía Española.2020; 98(8): 491. CrossRef
Anal Melanoma, a Radically Different Pathology to the Cutaneous Melanoma, With an Infaustic Forecast
Mireia Merichal Resina, Carlos Cerdan Santacruz, Enrique Sierra Grañón, Jordi Antoni Tarragona Foradada, Jorge Juan Olsina Kissler
Cirugía Española (English Edition).2020; 98(8): 491. CrossRef
Beyond adenocarcinoma: MRI of uncommon rectal neoplasms and mimickers
David D. B. Bates, Maria Clara Fernandes de Paula, Natally Horvat, Shannon Sheedy, Chandana Lall, Zahra Kassam, Perry Pickhardt, Neeraj Lalwani, Dhakshinamoorthy Ganeshan, Iva Petkovska
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Prognostic factors in primary anorectal melanoma: a clinicopathological study of 60 cases in China
Min Ren, Yawen Lu, Jiaojie Lv, Xuxia Shen, Jincheng Kong, Bo Dai, Yunyi Kong
Human Pathology.2018; 79: 77. CrossRef

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A Distribution Weighted Prognostic Scoring Model for Node Status in Advanced Rectal Cancer: Kwang-Hee Yeo, Ho Hyun Kim, Dong-Yi Kim, Young-Jin Kim, Jae-Kyun Ju; Cancer Res Treat. 2014;46(1):41-47. Published online January 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.1.41

Abstract PDF PubReader ePub

PURPOSE
There are various lymph node-based staging systems. Nevertheless, there is debate over the use of parameters such as the number of involved lymph nodes and the lymph node ratio. As a possible option, the distribution of metastatic lymph nodes may have a prognostic significance in rectal cancer. This study is designed to evaluate the impact of distribution-weighted nodal staging on oncologic outcome in rectal cancer.
MATERIALS AND METHODS
From a prospectively maintained colorectal cancer database of our institution, a total of 435 patients who underwent a curative low anterior resection for mid and upper rectal cancer between 1995 and 2004 were enrolled. Patients were divided into 3 groups according to the location of apical metastatic nodes. A location-weighted prognostic score was calculated by a scoring model using a logistic regression test for location based-statistical weight to number of lymph nodes. All cases were categorized in quartiles from lymph node I to lymph node IV using this protocol.
RESULTS
The location of lymph node metastasis was an independent factor that was associated with a poor prognostic outcome (p<0.001). Based on this result, the location-weighted-nodal prognostic scoring model did not show lesser significant results (p<0.0001) in both overall survival and cancer-free survival analyses.
CONCLUSION
The location of apical nodes among the metastatic nodes does not have a lesser significant impact on oncologic result in patients with advanced rectal cancer. A location-weighted prognostic scoring model, which considered the numbers of involved lymph nodes as the rate of significance according to the location, may more precisely predict the survival outcome in patients with lymph node metastasis.

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Prognostic factors for T1-2 colorectal cancer after radical resection: Lymph node distribution is a valuable predictor of its survival
Xing Huang, Hao Liu, Xiangqi Liao, Zhigang Xiao, Zhongcheng Huang, Guoxin Li
Asian Journal of Surgery.2021; 44(1): 241. CrossRef
Chemical shift effect predicting lymph node status in rectal cancer using high-resolution MR imaging with node-for-node matched histopathological validation
Hongmei Zhang, Chongda Zhang, Zhaoxu Zheng, Feng Ye, Yuan Liu, Shuangmei Zou, Chunwu Zhou
European Radiology.2017; 27(9): 3845. CrossRef
Prognostic impact of lymph node skip metastasis in Stage III colorectal cancer
F. Bao, L.‐y. Zhao, A. I. Balde, H. Liu, J. Yan, T.‐t. Li, H. Chen, G.‐x. Li
Colorectal Disease.2016;[Epub] CrossRef
Prognostic Impact of Distribution of Lymph Node Metastases in Stage III Colon Cancer
Toshiya Nagasaki, Takashi Akiyoshi, Yoshiya Fujimoto, Tsuyoshi Konishi, Satoshi Nagayama, Yosuke Fukunaga, Masami Arai, Masashi Ueno
World Journal of Surgery.2015; 39(12): 3008. CrossRef
Five-year outcomes of preoperative chemoradiation for rectal carcinoma in Saudi population: single-institutional experience
Eyad Fawzi AlSaeed, Mutahir Tunio, Ahmad Zubaidi, Omar Al-Obaid, Abdullah Kamal Ahmed, Omar Abdulmohsen Al-Omar, Emad Ahmed Abid, Mohammed Jaber Alsiwat
Annals of Saudi Medicine.2015; 35(1): 23. CrossRef

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Clinical Value of New Staging Systems for Multiple Myeloma: Jung-Hye Choi, Jae-Hoon Yoon, Seong-Kyu Yang; Cancer Res Treat. 2007;39(4):171-174. Published online December 31, 2007; DOI: https://doi.org/10.4143/crt.2007.39.4.171

Abstract PDF PubReader ePub

Purpose

We wanted to investigate the validity of the recently introduced Southwest Oncology Group (SWOG) staging system and the International Staging System (ISS) by comparing both systems with the widely accepted Durie/Salmon (DS) system for multiple myeloma patients.

Materials and Methods

Between 1992 and 2005, 85 multiple myeloma patients (men: women 41:44, median age: 63 years (range: 36~87)) with available baseline values of albumin and β₂-microglobulin were enrolled. The clinical and laboratory data were retrospectively obtained.

Results

According to the ISS, 11 patients were stage I (12.9%), 30 patients stage II (35.3%) and 44 patients stage III (51.8%). The median survivals of the ISS stages I, II and III were 78.6 months, 31.8 months and 15.1 months, respectively (p=0.015). The DS staging system was not able to predict the survival. For the SWOG staging system, 14 patients were stage I (16.4%), 27 patients stage II (31.8%), 27 patients stage III (31.8%) and 17 patients were stage IV (20.0%). The median survivals of the SWOG staging system stage I, II, III and IV were 78.6 months, 31.8 months, 11.6 months and 24.8 months, respectively (p=0.0075).

Conclusion

The ISS staging system showed better reliability, simplicity and predictability for survival than the DS and SWOG staging systems for multiple myeloma patients.

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Risk stratification of cardiac metastases using late gadolinium enhancement cardiovascular magnetic resonance: prognostic impact of hypo-enhancement evidenced tumor avascularity
Angel T. Chan, William Dinsfriend, Jiwon Kim, Brian Yum, Razia Sultana, Christopher A. Klebanoff, Andrew Plodkowski, Rocio Perez Johnston, Michelle S. Ginsberg, Jennifer Liu, Raymond J. Kim, Richard Steingart, Jonathan W. Weinsaft
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Hyun Ae Jung, Mi-Ae Jang, Kihyun Kim, Sun-Hee Kim
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The Role of18F-FDG PET/CT in Multiple Myeloma Staging according to IMPeTUs: Comparison of the Durie–Salmon Plus and Other Staging Systems
Shengming Deng, Bin Zhang, Yeye Zhou, Xin Xu, Jihui Li, Shibiao Sang, Wei Zhang
Contrast Media & Molecular Imaging.2018; 2018: 1. CrossRef
Biochemical and electrophoretic evaluation of Clinically suspected multiple myeloma
R SREEVANI NAMANI, DR LAXMI NARAYANA SRIPURAM
International Journal of Pharma and Bio Sciences.2017;[Epub] CrossRef
Reconstruction of multiple myeloma lesions around the pelvis and acetabulum
Vasileios I. Sakellariou, Andreas F. Mavrogenis, Olga Savvidou, Franklin H. Sim, Panayiotis J. Papagelopoulos
European Journal of Orthopaedic Surgery & Traumatology.2015; 25(4): 643. CrossRef
Retrospective analysis of 264 multiple myeloma patients
CHUANYING GENG, NIAN LIU, GUANGZHONG YANG, AIJUN LIU, YUN LENG, HUIJUAN WANG, LIHONG LI, YIN WU, YANCHEN LI, WENMING CHEN
Oncology Letters.2013; 5(2): 707. CrossRef

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Differences in Overall Survival When Colorectal Cancer Patients are Stratified into New TNM Staging Strategy: Ho-Suk Oh, Hyoung-Jung Chung, Hearn-Kook Kim, Jong-Soo Choi; Cancer Res Treat. 2007;39(2):61-64. Published online June 30, 2007; DOI: https://doi.org/10.4143/crt.2007.39.2.61

Abstract PDF PubReader ePub

Purpose

The purpose of this study is to determine whether the prognosis can be more precisely gauged by the revised 6th AJCC staging system and if this is suitable for Korean colorectal cancer patients, and especially for those patients in the Youngdong district.

Materials and Methods

Between September 1996 and December 2003, 365 patients with histologically confirmed colorectal cancer were analyzed. Kaplan-Meier analyses were used to compare the overall and stage-specific 5-year survival. All the statistical tests were two-sided.

Results

The overall 5-year survival for the entire cohort was 62%. According to the stages defined by the AJCC fifth edition system, the 5-year stage-specific survival was 91% for stage I, 82% for stage II, 51% for stage III and 4% for stage IV. According to the stages defined by the AJCC sixth edition system, the 5-year stage-specific survival was 91% for stage I, 81% for stage IIa, 83% for stage IIb, 100% for stage IIIa, 64% for stage IIIb, 37% for stage IIIc and 4% for stage IV. The 5-year survival was significantly better for the patients with stage IIIb (64%) than those patients with stage IIIc (37%) (p<.001).

Conclusion

It is widely known that the AJCC sixth edition system for colorectal cancer stratifies survival more distinctly than does the fifth edition system by providing more substages. Our study showed that stage IIIb disease had better survival than stage IIIc disease, but we couldn't confirm that this new staging system is relevant in our Korean clinical practice due to the small study population. Therefore, further study is required in a larger population.

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Pathological Characteristics, Prognostic Determinants and the Outcome of Patients Diagnosed with Colorectal Adenocarcinoma at the University Teaching Hospital of Kigali
Delphine Uwamariya, Déogratias Ruhangaza, Belson Rugwizangoga, Antonio Giovanni Solimando
Canadian Journal of Gastroenterology and Hepatology.2022; 2022: 1. CrossRef
Estimating short-term and long-term survival in rectal cancer patients using cure model
Behrouz Beiranvand, Shaghayegh Kamian, Robabeh Ghodssi-Ghassemabadi
Journal of Family Medicine and Primary Care.2022; 11(9): 5615. CrossRef
Assessment of prognostic factors in long-term survival of male and female patients with colorectal cancer using non-mixture cure model based on the Weibull distribution
Mehdi Azizmohammad Looha, Elaheh Zarean, Fatemeh Masaebi, Mohamad Amin Pourhoseingholi, Mohamad Reza Zali
Surgical Oncology.2021; 38: 101562. CrossRef
The role of socioeconomic disparity in colorectal cancer stage at presentation
Aesha Patel, Owen Gantz, Pavel Zagadailov, Aziz M. Merchant
Updates in Surgery.2019; 71(3): 523. CrossRef
The effects of time valuation in cancer optimal therapies: a study of chronic myeloid leukemia
Pedro José Gutiérrez-Diez, Miguel Ángel López-Marcos, Julia Martínez-Rodríguez, Jose Russo
Theoretical Biology and Medical Modelling.2019;[Epub] CrossRef
Permanent colostomy wound: Aeromedical disposal
U Bhattacharya, A Kumar, AVK Raju
Indian Journal of Aerospace Medicine.2019; 63: 39. CrossRef
Analyzing the Long-Term Survival of Patients with Colorectal Cancer: A Study Using Parametric Non-Mixture Cure Rate Models
Mehdi Azizmohammad Looha, Elaheh Zarean , Mohamad Amin Pourhoseingholi, Seyyed Vahid Hosseini, Tara Azimi, Soheila Khodakarim
International Journal of Cancer Management.2018;[Epub] CrossRef
Colorectal Cancer in Jordan: Survival Rate and Its Related Factors
Ghazi Faisal Sharkas, Kamal H. Arqoub, Yousef S. Khader, Mohammad R. Tarawneh, Omar F. Nimri, Marwan J. Al-zaghal, Hadil S. Subih
Journal of Oncology.2017; 2017: 1. CrossRef
ROR1 expression as a biomarker for predicting prognosis in patients with colorectal cancer
Jian-Kang Zhou, Yu-Zhu Zheng, Xue-Sha Liu, Qiheng Gou, Rui Ma, Cheng-Lin Guo, Carlo M. Croce, Lunxu Liu, Yong Peng
Oncotarget.2017; 8(20): 32864. CrossRef
High expression levels of unc-51-like kinase 1 as a predictor of poor prognosis in colorectal cancer
YIFENG ZOU, ZEXIAN CHEN, XIAOWEN HE, XIAOSHENG HE, XIANRUI WU, YUFENG CHEN, XIAOJIAN WU, JIANPING WANG, PING LAN
Oncology Letters.2015; 10(3): 1583. CrossRef
Follow-up After Curative Resection of Colorectal Cancer
Bridget N. Fahy
Annals of Surgical Oncology.2014; 21(3): 738. CrossRef
An overview of colorectal cancer survival rates and prognosis in Asia
Bijan Moghimi-Dehkordi
World Journal of Gastrointestinal Oncology.2012; 4(4): 71. CrossRef

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Usefulness of Additional Delayed Regional F-18 Fluorodeoxy-glucose Positron Emission Tomography in the Lymph Node Staging of Non-Small Cell Lung Cancer Patients: Young So, June-Key Chung, Jae Min Jeong, Dong Soo Lee, Myung Chul Lee; Cancer Res Treat. 2005;37(2):114-121. Published online April 30, 2005; DOI: https://doi.org/10.4143/crt.2005.37.2.114

Abstract PDF PubReader ePub

Purpose

In this study, we examined whether additional, delayed regional FDG PET scans could increase the accuracy of the lymph node staging of NSCLC patients.

Materials and Methods

Among 87 patients who underwent open thoracotomy or mediastinoscopic biopsy under the suspicion of NSCLC, 35 (32 NSCLC and 3 infectious diseases) who had visible lymph nodes on both preoperative whole body scan and regional FDG PET scan were included. The following 3 calculations were made for each biopsy-proven, visible lymph node: maximum SUV of whole body scan (WB SUV), maximum SUV of delayed chest regional scan (Reg SUV), and the percent change of SUV between WB and regional scans (% SUV Change). ROC curve analyses were performed for WB SUVs, Reg SUVs and % SUV Changes.

Results

Seventy lymph nodes (29 benign, 41 malignant) were visible on both preoperative whole bodyscan and regional scan. The means of WB SUVs, Reg SUVs and % SUV Changes of the 41 malignant nodes, 3.71±1.08, 5.18±1.60, and 42.59±33.41%, respectively, were all significantly higher than those of the 29 benign nodes, 2.45±0.73, 3.00±0.89, and 22.71±20.17%, respectively. ROC curve analysis gave sensitivity and specificity values of 80.5% and 82.8% at a cutoff of 2.89 (AUC 0.839) for WB SUVs, 87.8% and 82.8% at a cutoff of 3.61 (AUC 0.891) for Reg SUVs, and 87.8% and 41.4% at a cutoff of 12.3% (AUC 0.671) for % SUV Changes.

Conclusion

Additional, delayed regional FDG PET scans may improve the accuracy of lymph node staging of whole body FDG PET scan by providing additional criteria of Reg SUV and % SUV Change.

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KSNM60 in Clinical Nuclear Oncology
Seung Hwan Moon, Young Seok Cho, Joon Young Choi
Nuclear Medicine and Molecular Imaging.2021; 55(5): 210. CrossRef
18F-FDG PET/CT oncologic imaging at extended injection-to-scan acquisition time intervals derived from a single-institution 18F-FDG-directed surgery experience: feasibility and quantification of 18F-FDG accumulation within 18F-FDG-avid lesions and backgro
Stephen P Povoski, Douglas A Murrey, Sabrina M Smith, Edward W Martin, Nathan C Hall
BMC Cancer.2014;[Epub] CrossRef
Fluorodeoxyglucose positron-emission tomography ratio in non-small cell lung cancer patients treated with definitive radiotherapy
Hyun-Cheol Kang, Hong-Gyun Wu, Tosol Yu, Hak Jae Kim, Jin Chul Paeng
Radiation Oncology Journal.2013; 31(3): 111. CrossRef
Defining the role of modern imaging techniques in assessing lymph nodes for metastasis in cancer: evolving contribution of PET in this setting
Thomas C. Kwee, Sandip Basu, Drew A. Torigian, Babak Saboury, Abass Alavi
European Journal of Nuclear Medicine and Molecular Imaging.2011; 38(7): 1353. CrossRef
Imaging Atherosclerosis in the Carotid Arteries with F-18-Fluoro-2-deoxy-D-glucose Positron Emission Tomography: Effect of Imaging Time after Injection on Quantitative Measurement
Minyoung Oh, Ji Young Kim, Kwang-Ho Shin, Seol Hoon Park, Jin-Sook Ryu, Jae Seung Kim, Hye-Jin Kim, Dong-Wha Kang, Dae Hyuk Moon
Nuclear Medicine and Molecular Imaging.2010; 44(4): 261. CrossRef

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FDG-PET in Mediastinal Nodal Staging of Non-small Cell Lung Cancer: Correlation of False Results with Histopathologic Finding: Hee Jong Baek, Jin Haeng Chung, Jong Ho Park, Jae Ill Zo, Gi Jeong Cheon, Chang Woon Choi, Sang Moo Lim, Soo Yong Choi, Jong Myeon Hong, Jang Soo Hong; Cancer Res Treat. 2003;35(3):232-238. Published online June 30, 2003; DOI: https://doi.org/10.4143/crt.2003.35.3.232

Abstract PDF

PURPOSE
Mediastinal staging of non-small cell lung cancer can be markedly improved by FDG-PET scan, but the problem of false staging of mediastinal nodes by PET scan in non-small cell lung cancer has not yet been overcome. The aim of this study was to identify the mechanism underlying the false staging of mediastinal nodes by FDG-PET in the case of non-small cell lung cancer. MATERIALS AND METHODS: To evaluate the factors determining the FDG uptake in mediastinal nodes, FDG-PET was performed preoperatively, and mediastinal dissection with pulmonary resection was performed in 62 patients with NSCLC. GLUT-1 expression was studied by immunohistochemistry of the mediastinal nodes (n=111, true positive 31, true negative 41, false positive 27, false negative 12) using the anti-GLUT-1 antibody. The size, percentage of tumor (tumor ratio), labeling index (rate of stained tumor), staining intensity of the tumor, level of follicular hyperplasia, and staining intensity of the follicle center in the mediastinal node were also studied. RESULTS: There was no significant difference in size among the 4 nodal groups (TP, TN, FP, FN), nor in the tumor ratio of the metastatic nodes between the TP and FN groups. The labeling index and staining intensity of the TP group were higher than those of the FN group (Mann-Whitney test, p=.001, p=.007) in the case of the metastatic nodes. The level of follicular hyperplasia of the FP group was higher than that of the TN group in the case of the non-metastatic nodes (p=.000). CONCLUSION: These results suggest that in mediastinal staging of non-small cell lung cancer by FDG-PET, the FN node is associated with low uptake of FDG due to low expression of GLUT-1, and that the FP node is associated with a high level of follicular hyperplasia as a result of there being a reactive change to an inflammatory and/or immune reaction. This is the first report on the mechanism underlying the false results that are sometimes obtained, and which constitute a major problem in the clinical application of FDG-PET to the mediastinal staging of non-small cell lung cancer.

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Value of glucose transport protein 1 expression in detecting lymph node metastasis in patients with colorectal cancer
Hongsik Kim, Song-Yi Choi, Tae-Young Heo, Kyeong-Rok Kim, Jisun Lee, Min Young Yoo, Taek-Gu Lee, Joung-Ho Han
World Journal of Clinical Cases.2024; 12(5): 931. CrossRef
Associations between GLUT expression and SUV values derived from FDG-PET in different tumors—A systematic review and meta analysis
Hans-Jonas Meyer, Andreas Wienke, Alexey Surov, Pankaj K Singh
PLOS ONE.2019; 14(6): e0217781. CrossRef

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The Inefficiency of Routine Performance of a Batch of Tests in the Clinical Staging Work-up of Cervical Carcinoma: Soon Sup Shim, Jae Weon Kim, Yong Beom Kim, Ju Won Rho, Chul Min Lee, Noh Hyun Park, Yong Sang Song, Soon Beom Kang, Hyo Pyo Lee; J Korean Cancer Assoc. 2000;32(4):705-713.

Abstract PDF: PURPOSE
This study was to evaluate the efficiency of routine performance of a batch of tests in the clinical staging work-up of cervical carcinoma.
MATERIALS AND METHODS
The medical records were reviewed for 1,393 consecutive cervical carcinoma patients who underwent pretreatment staging work-up in Seoul National University Hospital from January 1988 to December 1997. The impression stage -which is designated ten tatively by the findings of pelvic examination and biopsy-, the results of staging work-up, and the finally allotted FIGO clinical stage were reviewed. The annual trend of stage distribution and the positive yields of tests were evaluated.
RESULTS
Annual trend shows that Ia is increasing. The positive yield of chest x-ray was 0.22% (3/1, 379; Ib: 1, IIa: 1, IIb: 1), intravenous pyelography (IVP) 2.50% (31/1, 242; Ib: 2, IIa: 4, IIb: 17, IIIb: 8), cystoscopy 0.55% (6/1, 093; IIb: 4, IIIb: 2), and proctosigmoidoscopy 0.086% (1/1, 157; Ib: 1). After completing the staging work-up, 29 patients (2.08%) were upstaged. The routine performance of IVP in impression stage Ia and cystoscopy in impression stage IIa or less was considered inefficient. The routine performance of proctosigmoidoscopy was considered inefficient because of its very low yield.
CONCLUSION
The selective performance of tests according to the impression stage during staging work-up is recommended to minimize the unnecessary treatment delay, cost, and patients' discomfort.

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Role of PET Scan in Staging Work - up and Reevaluation after Therapy in Lymphoma: Young Jin Yuh, Chul Won Jung, Seock Ah Im, Dae Seog Heo, Yung Jue Bang, Seonyang Park, June Key Chung, Myung Chul Lee, Byoung Kook Kim, Noe Kyeong Kim; J Korean Cancer Assoc. 1999;31(5):1011-1017.

Abstract PDF: PURPOSE
The authors evaluated the usefulness of the positron emission tomography (PET) with fluorine-18-tluorodeoxyglucose (8F-FDG) in initial staging, reevaluation after radical therapy and diagnosis of recurrence for non-Hodgkin's lymphoma, compaired to conventional imaging studies.
MATERIALS AND METHODS
FDG-PET (ECAT Exact 47, Siemens) and conventional chest X-ray and computerized tomography (CT) were studied in patients with non-Hodgkins lymphoma.
RESULTS
There were 17 patients (13 male, 4 female). Age was ranged from 18 to 62 years (median 49). By histological subgroup, diffuse large cell were 8 cases, peripheral T cell were 2 cases, diffuse mixed was 1 case, follicular mixed was 1 case, Burkitt's lymphoma was 1 case, Hodgkin's disease were 3 cases. The aims for PET were the initial staging work-up in 7 cases, the reevaluation of residual disease after radical therapy in 7 cases, the diagnosis of recurrence after complete remission in 3 cases. Between PET image and the conventional image, there were 3 cases with discrepancy, 1 case for initial staging work-up and 2 cases for the reevaluation of residual disease after radical therapy. Among the 3 cases with discrepancy, the 2 cases for the reevaluation of residual disease after radical therapy revealed that PET image reflects the involvement of lymphoma more accurately than the conventional image.
CONCLUSION
The visual analysis of FDG-PET would be helpful in determining the residual disease of lymphoma after radical therapy.

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Evaluation of the New UICC Staging System for Gastric Carcinoma: Hyeong Myeong Back, Sung Joon Kwon, Oh Jung Kwon, Pah Jong Jung, Kwang Su Lee, Jin Young Kwak, Kyu Young Jun, Chi Kyu Won; J Korean Cancer Assoc. 1999;31(1):54-61.

Abstract PDF: PURPOSE
There are several kinds of classificatian dealing with the staging of the gastric adenocarcinoma. However, such different staging systems pose difficulty in the inter- institutional or intemational comparison of the disease status and the treatment results. The purpose of this study is to evaluate each staging system and to assess the usefulness of the new UICC-TNM staging system (1997) for gastric adenocarcinoma. MATERIAL AND METHODS: We retrospectively analysed 473 cases of gastric adenocarcinoma who were operated at the Department of General Surgery, Hanyang University Hospital during the period from 1992 to 1996. Using these cases, we analyzed their cumulative 5-year survival rate according to three kinds of staging systems; old UICC-TNM staging system (1987), new UICC-TNM staging system (1997), and the Japanese staging system for gastric carcinoma (1993).
RESULTS
The follow up rate was 94.3% and the median follow up period was 30.3 months. All of these three systems showed a statistically significant survival difference according to their different classifications. When the distribution of stage between old and new UICC-TNM staging system was compared, 95 cases (20.1%) were subjected to stage shifting, which involves 12.1% of up-staging and 8.4% of down-staging. Stage shifting was most prominent in stage IIIb (68.8%). The cumulative 5-year survival rate according to the new UICC-TNM staging system was 99.1% in stage Ia, 81.4% in stage Ib, 75.2% in stage II, 45.9% in stage IIIa, 21.0% in stage IIIb, and 19.4% in stage IV.
CONCLUSION
We conclude that the new UICC-TNM staging system is simple, practically convenient, and highly reproducible, and it showed a statistically significant survival difference according to their staging classification.

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Evaluation of Staging with MR Imaging in the Uterine Cervical Cancer: Woo Cheol Kim, Hae Jeong Jeon, Soon Gu Cho, Young Kap Cho, John K Loh; J Korean Cancer Assoc. 1997;29(5):842-850.

Abstract PDF: PURPOSE
Uterine cervical carcinoma is the most common cancer in Korean women. We evaluated the accuracy of magnetic resonance (MR) imaging in determining the stage and extent of disease in cervical carcinoma.
MATERIALS AND METHODS
From January 1994 through December 1996, in all 35 patients, MR imaging was performed before any operative procedure. With a 1.5T superconducting magnet, TR (repetition time)/TE (echo time) of 483/9msec for T1-weighted images and 3750/98msec for T2-weighted images were used. All patients underwent radical hysterectomy or total abdominal hysterectomy and had detailed histologic evaluation. MR image were reviewed and compared with pathologic findings on the presence of tumor size, depth of stromal invasion and vagina extension.
RESULTS
The accuracy of MRI in determination of stage was 74%. Its accuracy was 60% for the assessment of tumor size. Tumor size was underestimated in 6 patients (17%) and overestimated in 8 patients (23%). Tumor infiltration into the stroma was classified as no, partial, complete. The accuracy of MRI in cervical stromal invasion was 66%.
CONCLUSION
MR is a relatively promising method for staging and evaluating extent of disease in carcinoma of the uterine cervix.

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Quantitative Analysis of Metastatic Lymph Nodes after Curative Surgery in Gastric Cancer: Wansik Yu, Yeon Sik Ji, Gyu Seok Choi, Ilwoo Whang, In Soo Suh; J Korean Cancer Assoc. 1997;29(1):62-68.

Abstract PDF: PURPOSE
A consecutive series of 710 patients who underwent curative gastrectomy for carcinoma was studied with a special reference to the number or frequency of lymph node metastasis and the patient's prognosis. MATERIAL AND METHODS: Survival rates were calculated by the Kaplan-Meier method, and the difference between each group was evaluated statistically by the log-rank method. Follow-up was obtained for 709 patients (99.9%).
RESULTS
According to the number of lymph nodal metastases, the five year survival rate for group 1 (1~3 positive nodes) was 50.9%; for group 2 (4~6 positive nodes), 56.7%; and for group 3 (more than 6 positive nodes), 12.0% (p<0.0001). According to the frequency of lymph node metastases, the five year survival rate for those with up to 25 per cent frequency of metastases was 47.5%; for those with up to 50 per cent frequency of metastases, 15.6%; and for those with greater than 50 per cent metastases, 6.3% (p<0.0001). According to the frequency of the regional lymph nodes (which include perigastric nodes along the lesser and greater curvatures, nodes located along the left gastric, common hepatic, splenic, and celiac arteries) metastasis, we categorized them as group 0 (N0: no metastasis), 1 (N1: metastasis in up to 25%), and 2 (N2: metastasis in greater than 25%).
CONCLUSION
This subdivision could be successfully applied to the clinical evaluation of gastric carcinoma (five year survival rate for N0, 86.9%; for N1, 49.0%; and for N2, 10.7% (p<0.0001)) without difficulty in dividing certain lymph nodes into the correct location.

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Accuracy of Properative Pathologic Diagnosis and Clinical Staging for Clinically Staged 3A Non - Small Cell Lung Cancer: Mi Sook Kim, Kyoung Hwan Koh, Seong Yul Yoo, Chul Koo Cho, Jae Ill Zo, Young Soo Do, Kyung Ja Cho; J Korean Cancer Assoc. 1995;27(5):816-822.

Abstract PDF: The clinical staging of lung cancer, especially stage IIIA, provides important information for clinical analysis and treatment method to surgeon ar radiation oncologist. The aim of this analysis is to evaluate of difference between clinical staging and pathologic staging and determine to accuracy of preoperative pathologic diagnosis and clinical staging for clinically staged IIIA NSCLC. Analysis was performed on 138 patients who has been staged IIIA NSCLC. Pathologic diagnosis was performed using sputum cytology, bronchoscopy or percutaneous needle aspiration. All patients were evaluated by CT and staged according to American Joint Commit- tee on Cancer staging classification. All patients received the thoracotomy. The pathologic diagnosis was changed after surgery in 9 patients(6.5%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT in dis- tinguishing T3 from Tl-T2 were 62.5%, 89.7%, 47.6%, 87.5%, and 75.3%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT in distinguishing N2 from NO-Nl were 91.8%, 24.3%, 42.7%, 78.3%, and 54.8% respec- tively. According to pathologic staging, there were 27(19.6%) patients in stage I, 24(17.4%) in stage II, 64(46.4%) in stage IIIA, 21(15.2%) in stage IIIB, and 2(1.5%) in stage IV. Comparing clincal staging with pathologic staging, concordant results were found in 46.4%, 37.0% were clinically overestimated and 16.7% underestimated. Preoperative pathologic diagnosis was well correlate postoperative pathologic finding. But CT accuracy was low in both primary tumor and mediastinal lymph node. Especially to diagnose malignant involvement of mediastinal nodes, CT is not a valid means. Patients would not be denied the opportunity for curative surgery on the basis of CT signs.

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