Cancer Research and Treatment

Original Articles

General

Presentation of Benefits and Harms in Cancer Screening Guidelines for Koreans: A Systematic Review: Mi Ah Han, Hunju Lee, Kwangmin Kim, Seong Jung Kim, Eu Chang Hwang, Jae Hung Jung; Cancer Res Treat. 2025;57(4):923-931. Published online March 27, 2025; DOI: https://doi.org/10.4143/crt.2024.1151

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study systematically reviewed cancer screening guidelines for the Korean population to evaluate the benefits and harms of the recommended cancer screening practices.
Materials and Methods
We searched international electronic databases from inception to July 2023. Two reviewers independently conducted reference screening and data extraction. Data were extracted based on recommendations from each guideline and presentation of benefits and harms. General characteristics of the cancer screening guidelines, including cancer type, recommended screening methods, certainty of evidence, were collected. Moreover, we obtained key information on the benefits and harms of screening interventions, including the quantification of their relative and absolute effects.
Results
Fifteen recommendations were identified for the use of interventions for the early detection of stomach, liver, colorectal, breast, cervical, and lung cancers in nine guidelines published between 2011 and 2015. Seven guidelines collected evidence through de novo systematic reviews. Eight guidelines presented the certainty of evidence and strength of recommendations. Benefits are presented as relative risks, and harms are presented as absolute risks. Six recommendations presented the absolute effects of both benefits and harms (comparable); eight presented them unevenly, including quantifying benefits relatively but presenting harms as absolute measures (asymmetric); and one presented neither benefits nor harms (incomplete).
Conclusion
More than half of guidelines fail to present the benefits and harms of screening in a balanced manner. To enable users and beneficiaries make informed decisions based on evidence, the benefits and harms supporting recommendations should be given in a transparent and balanced manner.

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Gynecologic cancer

Adherence to Cancer Prevention Guidelines and Endometrial Cancer Risk: Evidence from a Systematic Review and Dose-Response Meta-analysis of Prospective Studies: Hui Sun, Qing Chang, Ya-Shu Liu, Yu-Ting Jiang, Ting-Ting Gong, Xiao-Xin Ma, Yu-Hong Zhao, Qi-Jun Wu; Cancer Res Treat. 2021;53(1):223-232. Published online September 14, 2020; DOI: https://doi.org/10.4143/crt.2020.546

Abstract PDF PubReader ePub

Purpose
The evidence of adherence to cancer prevention guidelines and endometrial cancer (EC) risk has been limited and controversial. This study summarizes and quantifies the relationship between adherence to cancer prevention guidelines and EC risk.
Materials and Methods
The online databases PubMed, Web of Science, and EMBASE were searched for relevant publications up to June 2, 2020. This study had been registered at PROSPERO. The registration number is CRD42020149966. Study quality evaluation was performed based on the Newcastle-Ottawa Scale. The I² statistic was used to estimate heterogeneity among studies. Egger’s and Begg’s tests assessed potential publication bias. Summary hazard ratios (HRs) and 95% confidence intervals (CIs) for the relationship between adherence to cancer prevention guidelines score was assigned to participants by summarizing individual scores for each lifestyle-related factor. The scores ranged from least healthy (0) to most healthy (20) and the EC risk was calculated using a randomeffects model.
Results
Five prospective studies (four cohort studies and one case‑cohort study) consisted of 4,470 EC cases, where 597,047 participants were included. Four studies had a low bias risk and one study had a high bias risk. Summary EC HR for the highest vs. lowest score of adherence to cancer prevention guidelines was 0.54 (95% CI, 0.40 to 0.73) and had a high heterogeneity (I²=86.1%). For the dose-response analysis, an increment of 1 significantly reduced the risk of EC by 6%. No signiﬁcant publication bias was detected.
Conclusion
This study suggested that adherence to cancer prevention guidelines was negatively related to EC risk.

Citations

Citations to this article as recorded by

Global trends in endometrial cancer and metabolic syndrome research: A bibliometric and visualization analysis
Xiaoqiang Pan, Jiajia Li, Panbo Liu, Jin Li, Mingyue Zhao, Yulun Wu, Shuyu Ji, Tong Ren, Qiuhua Jiang, Songling Zhang
Computers in Biology and Medicine.2025; 192: 110362. CrossRef
Obesity as a Catalyst for Endometrial Hyperplasia and Cancer Progression: A Narrative Review of Epidemiology, Molecular Pathways, and Prevention
Ionela-Mihaela Ordeanu, Cristina Jana Busuioc, Constantin-Cristian Văduva, Răzvan-Cosmin Pană, Ana-Maria Petrescu, Renata Maria Văruț, Mihaela Stanciu, Mihaela Popescu
Biomedicines.2025; 13(11): 2612. CrossRef
Expression of EMT-related genes in lymph node metastasis in endometrial cancer: a TCGA-based study
He Li, Junzhu Wang, Liwei Li, Luyang Zhao, Zhiqi Wang
World Journal of Surgical Oncology.2023;[Epub] CrossRef
Advances on Prevention and Screening of Gynecologic Tumors: Are We Stepping Forward?
Andrea Giannini, Giorgio Bogani, Enrico Vizza, Vito Chiantera, Antonio Simone Laganà, Ludovico Muzii, Maria Giovanna Salerno, Donatella Caserta, Ottavia D’Oria
Healthcare.2022; 10(9): 1605. CrossRef

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155 Download
3 Web of Science
4 Crossref

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

Abstract PDF PubReader ePub

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

Citations

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Oxidative Stress and Redox Signaling in Gastric Cancer: From Mechanisms to Therapeutic Implications
Zehua Chen, Jiawu Fan, Xiaolong Chen, Kun Yang, Kui Wang
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Differences in the Effect of Physical Activity on the Prevention of Gastric Cancer According to Sex
Hyeong Ho Jo, Nayoung Kim, Jieun Jang, Yonghoon Choi, Jung Won Lee
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Short-term outcomes of minimally invasive gastrectomy in population with obesity versus population without obesity: the obesity paradox
Marco Milone, Anna D’Amore, Gian Luca Baiocchi, Fabio Cianchi, Giovanni De Manzoni, Stefano De Pascale, Maurizio Degiuli, Giorgio Ercolani, Giovanni Ferrari, Laura Fortuna, Romario Uberto Fumagalli, Monica Gualtierotti, Federico Marchesi, Andrea Peri, Fra
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Meta-Analysis

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

Abstract PDF PubReader ePub

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

Citations

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Survival of pancreatic cancer patients is negatively correlated with age at diagnosis: a population-based retrospective study
Hongcheng Wang, Jiazhe Liu, Guanggai Xia, Shizhou Lei, Xiuyan Huang, Xinyu Huang
Scientific Reports.2020;[Epub] CrossRef
Circumferential resection margin (CRM) in pancreatic cancer
Lena Häberle, Irene Esposito
Surgery in Practice and Science.2020; 1: 100006. CrossRef
Clinical impacts of resection margin status and clinicopathologic parameters on pancreatic ductal adenocarcinoma
Tsengelmaa Jamiyan, Takayuki Shiraki, Yoshihiro Kurata, Masanori Ichinose, Keiichi Kubota, Yasuo Imai
World Journal of Surgical Oncology.2020;[Epub] CrossRef
Prognostic Implications of 18-FDG Positron Emission Tomography/Computed Tomography in Resectable Pancreatic Cancer
Cosimo Sperti, Alberto Friziero, Simone Serafini, Sergio Bissoli, Alberto Ponzoni, Andrea Grego, Emanuele Grego, Lucia Moletta
Journal of Clinical Medicine.2020; 9(7): 2169. CrossRef
Multidisciplinary standards of care and recent progress in pancreatic ductal adenocarcinoma
Aaron J. Grossberg, Linda C. Chu, Christopher R. Deig, Eliot K. Fishman, William L. Hwang, Anirban Maitra, Daniel L. Marks, Arnav Mehta, Nima Nabavizadeh, Diane M. Simeone, Colin D. Weekes, Charles R. Thomas
CA: A Cancer Journal for Clinicians.2020; 70(5): 375. CrossRef
Survival benefit of adjuvant chemoradiotherapy for positive or close resection margin after curative resection of pancreatic adenocarcinoma
Byoung Hyuck Kim, Kyubo Kim, Jin-Young Jang, Wooil Kwon, Hongbeom Kim, Kyung-Hun Lee, Do-Youn Oh, Haeryoung Kim, Kyung Bun Lee, Eui Kyu Chie
European Journal of Surgical Oncology.2020; 46(11): 2122. CrossRef
Pre‐operative diabetes mellitus does not worsen survival and post‐operative outcomes in Chinese patients undergoing resection for pancreatic adenocarcinoma
Adrian H. K. Yu, Albert C. Y. Chan
Surgical Practice.2020; 24(4): 132. CrossRef
Multiagent neoadjuvant chemotherapy and tumor response are associated with improved survival in pancreatic cancer
Nathan M. Bolton, Adam H. Maerz, Russell E. Brown, Mona Bansal, John S. Bolton, William C. Conway
HPB.2019; 21(4): 413. CrossRef
The learning curve for a surgeon in robot-assisted laparoscopic pancreaticoduodenectomy: a retrospective study in a high-volume pancreatic center
Tao Zhang, Zhi-Ming Zhao, Yuan-Xing Gao, Wan Yee Lau, Rong Liu
Surgical Endoscopy.2019; 33(9): 2927. CrossRef
Selecting chemotherapy for pancreatic cancer: Far away or so close?
Si Shi, Xianjun Yu
Seminars in Oncology.2019; 46(1): 39. CrossRef
Adjuvant chemotherapy followed by concurrent chemoradiation is associated with improved survival for resected stage I‐II pancreatic cancer
Sung Jun Ma, Gregory M. Hermann, Kavitha M. Prezzano, Lucas M. Serra, Austin J. Iovoli, Anurag K. Singh
Cancer Medicine.2019; 8(3): 939. CrossRef
Duktales Adenokarzinom des Pankreas
E. Gallmeier, T. M. Gress
Der Gastroenterologe.2019; 14(2): 131. CrossRef
Management of pancreatic head adenocarcinoma: From where to where?
Kemal Dolay, Fatma Umit Malya, Sami Akbulut
World Journal of Gastrointestinal Surgery.2019; 11(3): 143. CrossRef
Defining and Predicting Early Recurrence in 957 Patients With Resected Pancreatic Ductal Adenocarcinoma
Vincent P. Groot, Georgios Gemenetzis, Alex B. Blair, Roberto J. Rivero-Soto, Jun Yu, Ammar A. Javed, Richard A. Burkhart, Inne H. M. Borel Rinkes, I. Quintus Molenaar, John L. Cameron, Matthew J. Weiss, Christopher L. Wolfgang, Jin He
Annals of Surgery.2019; 269(6): 1154. CrossRef
A Prospective Clinical Trial to Determine the Effect of Intraoperative Ultrasound on Surgical Strategy and Resection Outcome in Patients with Pancreatic Cancer
Babs G. Sibinga Mulder, Shirin Feshtali, Arantza Fariña Sarasqueta, Alexander L. Vahrmeijer, Rutger-Jan Swijnenburg, Bert A. Bonsing, J. Sven D. Mieog
Ultrasound in Medicine & Biology.2019; 45(8): 2019. CrossRef
Microvascular invasion is a major prognostic factor after pancreatico‐duodenectomy for adenocarcinoma
Fabrizio Panaro, Tarek Kellil, Julie Vendrell, Valentina Sega, Regis Souche, Tullio Piardi, Piera Leon, Christophe Cassinotto, Eric Assenat, Edoardo Rosso, Francis Navarro
Journal of Surgical Oncology.2019; 120(3): 483. CrossRef
Role of surgical resection in the era of FOLFIRINOX for advanced pancreatic cancer
Yoonhyeong Byun, Youngmin Han, Jae Seung Kang, Yoo Jin Choi, Hongbeom Kim, Wooil Kwon, Sun‐Whe Kim, Do‐Youn Oh, Sang Hyub Lee, Ji Kon Ryu, Yong‐Tae Kim, Jin‐Young Jang
Journal of Hepato-Biliary-Pancreatic Sciences.2019; 26(9): 416. CrossRef
Keratin 17 identifies the most lethal molecular subtype of pancreatic cancer
Lucia Roa-Peña, Cindy V. Leiton, Sruthi Babu, Chun-Hao Pan, Elizabeth A. Vanner, Ali Akalin, Jela Bandovic, Richard A. Moffitt, Kenneth R. Shroyer, Luisa F. Escobar-Hoyos
Scientific Reports.2019;[Epub] CrossRef
Comment on “The Impact of Positive Resection Margins on Survival and Recurrence Following Resection and Adjuvant Chemotherapy for Pancreatic Ductal Adenocarcinoma”
Niccolo Petrucciani, Laura Antolino, Giovanni Moschetta, Giovanni Ramacciato
Annals of Surgery.2019; 270(6): e129. CrossRef
Determining Optimal Routes to Surgery for Borderline Resectable Venous Pancreatic Cancer—Where Is the Least Harm and Most Benefit?
Rupaly Pandé, Keith J. Roberts
Frontiers in Oncology.2019;[Epub] CrossRef
Duktales Adenokarzinom des Pankreas
E. Gallmeier, T. M. Gress
Der Internist.2018; 59(8): 805. CrossRef
Adjuvant Chemotherapy Versus Chemoradiation for Patients with Resected Pancreatic Adenocarcinoma: A Single-Center Retrospective Study
Do Young Kim, Young Jin Choi, Young Mi Seol, Hyojeong Kim
The Korean Journal of Pancreas and Biliary Tract.2018; 23(3): 108. CrossRef
Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes
Andrew McGuigan, Paul Kelly, Richard C Turkington, Claire Jones, Helen G Coleman, R Stephen McCain
World Journal of Gastroenterology.2018; 24(43): 4846. CrossRef
Combined hepatic arterial resection in pancreatic resections for locally advanced pancreatic cancer
Masaru Miyazaki, Hideyuki Yoshitomi, Shigetsugu Takano, Hiroaki Shimizu, Atsushi Kato, Hiroyuki Yoshidome, Katunori Furukawa, Tsukasa Takayashiki, Satoshi Kuboki, Daisuke Suzuki, Nozomu Sakai, Masayuki Ohtuka
Langenbeck's Archives of Surgery.2017; 402(3): 447. CrossRef
The TRIANGLE operation – radical surgery after neoadjuvant treatment for advanced pancreatic cancer: a single arm observational study
Thilo Hackert, Oliver Strobel, Christoph W. Michalski, André L. Mihaljevic, Arianeb Mehrabi, Beat Müller-Stich, Christoph Berchtold, Alexis Ulrich, Markus W. Büchler
HPB.2017; 19(11): 1001. CrossRef

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