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Original Articles
Association between Tumor Size at the Time of Disease Progression and Survival Outcomes
Chi Hoon Maeng, Bum Jun Kim, Myung-Ju Ahn, In Sil Choi, Dae Young Zang, Bo-Hyung Kim, Minji Kwon, Dae Seog Heo, Bhumsuk Keam
Received July 24, 2024  Accepted October 20, 2024  Published online October 22, 2024  
DOI: https://doi.org/10.4143/crt.2024.690    [Epub ahead of print]
AbstractAbstract PDFSupplementary Material
Purpose
This study evaluates the prognostic significance of tumor size at disease progression (PD) and depth of response (DOR) in cancer patients.
Materials and Methods
We performed post hoc analysis using data from six prospective clinical trials conducted by the Korean Cancer Study Group. Patients with tumor size at PD was categorized into ‘Mild PD’ and ‘Significant PD’ based on the cutoff values of relative change from baseline using maximally selected rank statistics. The overall survival (OS) and progression-free survival (PFS) were compared between PD and DOR categories.
Results
Among the 194 evaluable patients, 130 experienced PD. A 35.48% decrease from baseline in tumor size at PD was chosen for the cutoff between mild and significant PD for OS (mild PD: tumor size from the baseline ≤ −35.48%; significant PD > −35.48%). The mild PD had superior OS compared to the significant PD (25.8 vs. 12.8 months; Hazard ratio [HR] 0.47, 95% CI 0.266-0.843, p=0.009). When using an exploratory cutoff based on whether the tumor size was below vs. exceeded from the baseline (mild PD: tumor size from the baseline ≤ 0%; significant PD > 0%), OS remained significantly longer in the mild PD (17.1 vs. 11.8 months; HR 0.60, 95% CI 0.392-0.932, p=0.021). The greatest DOR was associated with the longest OS and PFS (p<0.001 for both).
Conclusion
Tumor size at PD and DOR were significant prognostic factors for progressive disease. Maintaining a sufficiently reduced tumor size even during PD was associated with better survival outcomes.
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Lung and Thoracic cancer
Upfront Stereotactic Radiosurgery or Fractionated Stereotactic Radiotherapy in Elderly Patients with Brain Metastases from Non–Small Cell Lung Cancer: A Retrospective Analysis of a 10-Year Bi-institutional Experience
Myungsoo Kim, Jihye Cha, Hun Jung Kim, Woo Chul Kim, Jeongshim Lee
Cancer Res Treat. 2025;57(1):47-56.   Published online July 3, 2024
DOI: https://doi.org/10.4143/crt.2024.223
AbstractAbstract PDFPubReaderePub
Purpose
Stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT) are increasingly used as initial therapies for brain metastases (BM). We aimed to assess the outcomes of SRS/FSRT in patients aged ≥ 65 years who had 1-10 BM from non–small cell lung cancer (NSCLC).
Materials and Methods
We retrospectively reviewed 91 elderly NSCLC patients with 222 BM who were treated with SRS/FSRT at two institutions between 2010 and 2020. The primary endpoint was overall survival (OS) after SRS/FSRT. In addition, in-field local control (IFLC) within the treated field was evaluated. Statistical analysis was performed to identify the prognostic factors affecting OS and IFLC.
Results
During a median follow-up of 18 months, the median OS was 32 months. The 1- and 2-year survival rates were 69.8% and 56.1%, respectively. In multivariate analysis, the NSCLC-specific graded prognostic assessment (GPA) score (p=0.007) and administration of systemic therapy (p=0.039) were defined as prognosticators affecting OS. The median IFLC period was 31 months, and the 1- and 2-year IFLC rates were 75.9% and 57.6%, respectively. The total BM volume (p=0.042) significantly affected IFLC. No severe adverse events were reported after SRS/FSRT.
Conclusion
SRS/FSRT is an effective upfront treatment option for BM arising from NSCLC in elderly patients, with a good OS without severe side effects. Higher GPA score and active systemic treatment were associated with improved OS, indicating that elderly patients are significant candidates for SRS/FSRT.
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Pediatric cancer
Absolute Neutrophil Count after the First Chemotherapy Cycle as a Surrogate Marker for Treatment Outcomes in Patients with Neuroblastoma
Ji Won Lee, Joon Seol Bae, Jin Ho Kim, Hee Won Cho, Hee Young Ju, Keon Hee Yoo, Hong Hoe Koo, Sook-young Woo, Seonwoo Kim, Ki Woong Sung
Cancer Res Treat. 2022;54(1):259-268.   Published online April 12, 2021
DOI: https://doi.org/10.4143/crt.2021.010
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
We performed this study to determine whether the degree of neutropenia after the first chemotherapy cycle can be used as a surrogate marker of individual susceptibility to chemotherapeutic agents affecting treatment outcome in patients with neuroblastoma.
Materials and Methods
The study included 313 patients who received the first cycle chemotherapy with a CEDC (cisplatin+etoposide+doxorubicin+cyclophosphamide) regimen and had absolute neutrophil count (ANC) data available. The cumulative incidences of progression and treatment-related mortality (TRM) were estimated. To identify genetic variations associated with the ANC, a genome-wide association study (GWAS) was performed.
Results
An ANC of 32.5/μL was determined as the cutoff point to categorize patients into the good and poor prognosis subgroups in terms of progression. Patients with a high nadir ANC had a higher cumulative incidence of progression than those with a low nadir ANC (p < 0.001). In multivariate analysis, high nadir ANC, age, bone marrow involvement, and unfavorable histology were poor prognostic factors. With regard to the TRM, patients with a low nadir ANC (ANC < 51.0/μL) had a higher cumulative incidence of TRM than those with a high nadir ANC (p=0.010). In GWAS, single-nucleotide polymorphisms of LPHN2 and CRHR1 were significantly associated with the nadir ANC.
Conclusion
In neuroblastoma patients, the degree of neutropenia after the first chemotherapy cycle can be used as a surrogate marker to predict an individual’s susceptibility to chemotherapeutic agents. Tailoring of treatment based on the degree of neutropenia needs to be considered.

Citations

Citations to this article as recorded by  
  • Impact of 10% Dose Reductions and Duration of Treatment Delays in the Management of Chemotherapy‐Induced Neutropenia in Dogs Treated With Common Chemotherapy Protocols: A Single‐Centre Experience
    Suzanne Busser, Laura Blackwood, Constanza Pereira, Margo Chase‐Topping, Spela Bavcar, Quentin Fournier
    Veterinary and Comparative Oncology.2024; 22(4): 542.     CrossRef
  • Targeting the myeloid microenvironment in neuroblastoma
    Marjolein C. Stip, Loes Teeuwen, Miranda P. Dierselhuis, Jeanette H. W. Leusen, Daniëlle Krijgsman
    Journal of Experimental & Clinical Cancer Research.2023;[Epub]     CrossRef
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Gastrointestinal cancer
Trends in Chemotherapy Patterns and Survival of Patients with Advanced Gastric Cancer over a 16-Year Period: Impact of Anti-HER2–Targeted Agent in the Real-World Setting
Dong-Hoe Koo, Min-Hee Ryu, Mi-Yeon Lee, Heejung Chae, Eo Jin Kim, Mee-Sun Moon, Yoon-Koo Kang
Cancer Res Treat. 2021;53(2):436-444.   Published online October 6, 2020
DOI: https://doi.org/10.4143/crt.2020.725
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to evaluate the survivals of patients with metastatic or recurrent gastric cancer (MRGC) over a period of 16 years and to investigate the recent changes in chemotherapy patterns.
Materials and Methods
A total of 5,384 patients who received chemotherapy for MRGC between 2000 and 2015 were analyzed. The analysis focused on a comparison of the first-line chemotherapy between four periods: 2000–2003 (period 1), 2004–2007 (period 2), 2008–2011 (period 3), and 2012–2015 (period 4).
Results
There were 880 patients (16%) in period 1, 1,573 (29%) in period 2, 1,435 (27%) in period 3, and 1,496 (28%) in period 4. Cytotoxic doublet-based therapy was the most commonly used (78%) first-line chemotherapy, and the combination of trastuzumab and doublet chemotherapy was provided to 288 patients. The OS rates at 12 and 24 months were steadily improved as follows: 39.2% and 14.6% in period 1, 43.5% and 17.6% in period 2, 50.3% and 20.6% in period 3, and 51.7% and 24.1% in period 4, respectively (p < 0.001). Among the patients who received the doublet-based chemotherapy, the median OS of those who received trastuzumab was 18.0 months (95% CI, 15.5–20.6), while that of those who received other doublet therapies was 11.2 months (95% CI, 10.8–11.6).
Conclusion
The OS was improved over time with advancements in chemotherapy, particularly the introduction of the anti-HER2–targeted agent, which contributed to the increase in the number of long-term survivors and established the superiority of OS for the treatment of MRGC.

Citations

Citations to this article as recorded by  
  • Factors associated with the efficacy of first-line nivolumab plus chemotherapy in advanced gastric cancer patients with deficient mismatch repair
    Young-Gyu Park, Hyung-Don Kim, Jaewon Hyung, Young Soo Park, Min-Hee Ryu
    Gastric Cancer.2024; 27(4): 840.     CrossRef
  • Varlitinib and Paclitaxel for EGFR/HER2 Co-expressing Advanced Gastric Cancer: A Multicenter Phase Ib/II Study (K-MASTER-13)
    Dong-Hoe Koo, Minkyu Jung, Yeul Hong Kim, Hei-Cheul Jeung, Dae Young Zang, Woo Kyun Bae, Hyunki Kim, Hyo Song Kim, Choong-kun Lee, Woo Sun Kwon, Hyun Cheol Chung, Sun Young Rha
    Cancer Research and Treatment.2024; 56(4): 1136.     CrossRef
  • Breakthroughs in the Systemic Treatment of HER2-Positive Advanced/Metastatic Gastric Cancer: From Singlet Chemotherapy to Triple Combination
    Sun Young Rha, Hyun Cheol Chung
    Journal of Gastric Cancer.2023;[Epub]     CrossRef
  • Association between HER2 heterogeneity and clinical outcomes of HER2-positive gastric cancer patients treated with trastuzumab
    Kyunghye Bang, Jaekyung Cheon, Young Soo Park, Hyung-Don Kim, Min-Hee Ryu, Yangsoon Park, Meesun Moon, Hyungeun Lee, Yoon-Koo Kang
    Gastric Cancer.2022; 25(4): 794.     CrossRef
  • Clinicopathological features and CT findings of papillary gastric adenocarcinoma
    Mengying Xu, Song Liu, Xiangmei Qiao, Lin Li, Changfeng Ji, Zhengyang Zhou
    Abdominal Radiology.2022; 47(11): 3698.     CrossRef
  • New prognostic model for patients with advanced gastric cancer: Fluoropyrimidine/platinum doublet for first-line chemotherapy
    Dong-Hoe Koo, Min-Hee Ryu, Mi-Yeon Lee, Mee-Sun Moon, Yoon-Koo Kang
    World Journal of Gastroenterology.2021; 27(48): 8357.     CrossRef
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  • 6 Crossref
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Gynecologic cancer
Early Assessment of Response to Neoadjuvant Chemotherapy with 18F-FDG-PET/CT in Patients with Advanced-Stage Ovarian Cancer
Young Shin Chung, Hyun-Soo Kim, Jung-Yun Lee, Won Jun Kang, Eun Ji Nam, Sunghoon Kim, Sang Wun Kim, Young Tae Kim
Cancer Res Treat. 2020;52(4):1211-1218.   Published online April 28, 2020
DOI: https://doi.org/10.4143/crt.2019.506
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The aim of this study was to evaluate the ability of sequential 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) after one cycle of neoadjuvant chemotherapy (NAC) to predict chemotherapy response before interval debulking surgery (IDS) in advanced-stage ovarian cancer patients.
Materials and Methods
Forty consecutive patients underwent 18F-FDG-PET/CT at baseline and after one cycle of NAC. Metabolic responses were assessed by quantitative decrease in the maximum standardized uptake value (SUVmax) with PET/CT. Decreases in SUVmax were compared with cancer antigen 125 (CA-125) level before IDS, response rate by Response Evaluation Criteria in Solid Tumors criteria before IDS, residual tumor at IDS, and I chemotherapy response score (CRS) at IDS.
Results
A 40% cut-off for the decrease in SUVmax provided the best performance to predict CRS 3 (compete or near-complete pathologic response), with sensitivity, specificity, and accuracy of 81.8%, 72.4%, and 72.4%, respectively. According to this 40% cut-off, there were 17 (42.5%) metabolic responders (≥ 40%) and 23 (57.5%) metabolic non-responders (< 40%). Metabolic responders had higher rate of CRS 3 (52.9% vs. 8.7%, p=0.003), CA-125 normalization (< 35 U/mL) before IDS (76.5% vs. 39.1%, p=0.019), and no residual tumor at IDS (70.6% vs. 31.8%, p=0.025) compared with metabolic non-responders. There were significant associations with progression-free survival (p=0.021) between metabolic responders and non-responders, but not overall survival (p=0.335).
Conclusion
Early assessment with 18F-FDG-PET/CT after one cycle of NAC can be useful to predic response to chemotherapy before IDS in patients with advanced-stage ovarian cancer.

Citations

Citations to this article as recorded by  
  • The Evaluation Value of CT in the Efficacy of Neoadjuvant Chemotherapy in Ovarian Cancer Patients
    Daying Mou, Shengyan Xie, Pingyuan Li, Mohammad Farukh Hashmi
    Contrast Media & Molecular Imaging.2022;[Epub]     CrossRef
  • Radiomics Analysis of PET and CT Components of 18F-FDG PET/CT Imaging for Prediction of Progression-Free Survival in Advanced High-Grade Serous Ovarian Cancer
    Xihai Wang, Zaiming Lu
    Frontiers in Oncology.2021;[Epub]     CrossRef
  • 8,374 View
  • 135 Download
  • 7 Web of Science
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Prognostic Value of TP53 Mutation for Transcatheter Arterial Chemoembolization Failure/Refractoriness in HBV-Related Advanced Hepatocellular Carcinoma
Miao Xue, Yanqin Wu, Wenzhe Fan, Jian Guo, Jialiang Wei, Hongyu Wang, Jizhou Tan, Yu Wang, Wang Yao, Yue Zhao, Jiaping Li
Cancer Res Treat. 2020;52(3):925-937.   Published online March 30, 2020
DOI: https://doi.org/10.4143/crt.2019.533
AbstractAbstract PDFPubReaderePub
Purpose
This study aimed to investigate the clinicopathologic features and mutational landscape of patients with hepatitis B virus (HBV)–related advanced hepatocellular carcinomas (HCC) undergoing transcatheter arterial chemoembolization (TACE).
Materials and Methods
From January 2017 to December 2018, 38 patients newly diagnosed with HBV-related advanced HCC were enrolled in the final analysis. Their pathological tissues and corresponding blood samples before TACE treatment were collected for whole-exome sequencing. Response to TACE was evaluated at 1-3 months after two consecutive use of TACE. Predictive factors were analyzed by univariate and multivariate analyses in a bivariate Logistic regression model. Enrichment of related pathways of all driver genes were acquired using the gene set enrichment analysis (GSEA).
Results
Among 38 patients, 23 (60.5%) exhibited TACE failure/refractoriness. Patients with TACE failure/refractoriness showed higher frequency of TP53 mutation than their counterparts (p=0.020). Univariate and multivariate analyses showed that only vascular invasion and TP53 mutation were significantly correlated with TACE failure/refractoriness in HBV-related advanced HCC. Of the 16 patients without vascular invasion, eight (50.0%) had TP53 mutations, and TP53 mutation was associated with TACE failure/refractoriness (p=0.041). Moreover, GSEA showed that mitogen-activated protein kinase and apoptosis pathways induced by TP53 mutation were possibly associated with TACE failure/refractoriness.
Conclusion
Our study suggested that TP53 mutation was independently related with TACE efficacy, which may work via mitogen-activated protein kinase and apoptosis pathways. These findings may provide evidence to help distinguish patients who will particularly benefit from TACE from those who require more personalized therapeutic regimens and rigorous surveillance in HBV-related advanced HCC.

Citations

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  • Therapeutic efficacy and prognostic indicators in re-resection for recurrent hepatocellular carcinoma: Insights from a retrospective study
    Qi Fan, Pengcheng Wei, Delin Ma, Qian Cheng, Jie Gao, Jiye Zhu, Zhao Li
    Surgery Open Science.2025; 23: 16.     CrossRef
  • TP53 Mutation Predicts Worse Survival and Earlier Local Progression in Patients with Hepatocellular Carcinoma Treated with Transarterial Embolization
    Ken Zhao, Anita Karimi, Luke Kelly, Elena Petre, Brett Marinelli, Erica S. Alexander, Vlasios S. Sotirchos, Joseph P. Erinjeri, Anne Covey, Constantinos T. Sofocleous, James J. Harding, William Jarnagin, Carlie Sigel, Efsevia Vakiani, Etay Ziv, Hooman Yar
    Current Oncology.2025; 32(1): 51.     CrossRef
  • Clinical Therapy: HAIC Combined with Tyrosine Kinase Inhibitors and Programmed Cell Death Protein-1 Inhibitors versus HAIC Alone for Unresectable Hepatocellular Carcinoma
    Baokun Liu, Lujun Shen, Wen Liu, Zhiyong Zhang, Jieqiong Lei, Zhengguo Li, Qinquan Tan, Hengfei Huang, Xingdong Wang, Weijun Fan
    Journal of Hepatocellular Carcinoma.2024; Volume 11: 1557.     CrossRef
  • Enhanced interactions within microenvironment accelerates dismal prognosis in HBV-related HCC after TACE
    Libo Wang, Jiahui Cao, Zaoqu Liu, Shitao Wu, Yin Liu, Ruopeng Liang, Rongtao Zhu, Weijie Wang, Jian Li, Yuling Sun
    Hepatology Communications.2024;[Epub]     CrossRef
  • Development and validation of survival prediction models for patients with hepatocellular carcinoma treated with transcatheter arterial chemoembolization plus tyrosine kinase inhibitors
    Kun Huang, Haikuan Liu, Yanqin Wu, Wenzhe Fan, Yue Zhao, Miao Xue, Yiyang Tang, Shi-Ting Feng, Jiaping Li
    La radiologia medica.2024; 129(11): 1597.     CrossRef
  • Identification of BRD7 by whole-exome sequencing as a predictor for intermediate-stage hepatocellular carcinoma in patients undergoing TACE
    Kun Huang, Yanqin Wu, Wenzhe Fan, Yue Zhao, Miao Xue, Haikuan Liu, Yiyang Tang, Jiaping Li
    Journal of Cancer Research and Clinical Oncology.2023; 149(13): 11247.     CrossRef
  • Prediction model of no-response before the first transarterial chemoembolization for hepatocellular carcinoma: TACF score
    Jia-Wei Zhong, Dan-Dan Nie, Ji-Lan Huang, Rong-Guang Luo, Qing-He Cheng, Qiao-Ting Du, Gui-Hai Guo, Liang-Liang Bai, Xue-Yun Guo, Yan Chen, Si-Hai Chen
    Discover Oncology.2023;[Epub]     CrossRef
  • Mechanisms of Pharmacoresistance in Hepatocellular Carcinoma: New Drugs but Old Problems
    Jose J.G. Marin, Marta R. Romero, Elisa Herraez, Maitane Asensio, Sara Ortiz-Rivero, Anabel Sanchez-Martin, Luca Fabris, Oscar Briz
    Seminars in Liver Disease.2022; 42(01): 087.     CrossRef
  • Non-Apoptotic Programmed Cell Death-Related Gene Signature Correlates With Stemness and Immune Status and Predicts the Responsiveness of Transarterial Chemoembolization in Hepatocellular Carcinoma
    Guixiong Zhang, Wenzhe Fan, Hongyu Wang, Jie Wen, Jizhou Tan, Miao Xue, Jiaping Li
    Frontiers in Cell and Developmental Biology.2022;[Epub]     CrossRef
  • Plasma arginase-1 as a predictive marker for early transarterial chemoembolization refractoriness in unresectable hepatocellular carcinoma
    Wei-Li Xia, Shi-Jun Xu, Yuan Guo, Xiao-Hui Zhao, Hong-Tao Hu, Yan Zhao, Quan-Jun Yao, Lin Zheng, Dong-Yang Zhang, Chen-Yang Guo, Wei-Jun Fan, Hai-Liang Li
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • Useful genes for predicting the efficacy of transarterial chemoembolization in hepatocellular carcinoma
    Yuan Guo, Hongtao Hu, Shijun Xu, Weili Xia, Hailiang Li
    Journal of Cancer Research and Therapeutics.2022; 18(7): 1860.     CrossRef
  • Development and Validation of a Predictive Model for Early Refractoriness of Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma
    Tian-Cheng Wang, Tian-Zhi An, Jun-Xiang Li, Zi-Shu Zhang, Yu-Dong Xiao
    Frontiers in Molecular Biosciences.2021;[Epub]     CrossRef
  • Transcatheter arterial chemoembolization followed by surgical resection for hepatocellular carcinoma: a focus on its controversies and screening of patients most likely to benefit
    Zhan-Qi Wei, Yue-Wei Zhang
    Chinese Medical Journal.2021; 134(19): 2275.     CrossRef
  • Recent Updates of Transarterial Chemoembolilzation in Hepatocellular Carcinoma
    Young Chang, Soung Won Jeong, Jae Young Jang, Yong Jae Kim
    International Journal of Molecular Sciences.2020; 21(21): 8165.     CrossRef
  • 8,558 View
  • 149 Download
  • 15 Web of Science
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Clinical Characteristics and Treatment Outcomes of Pediatric Patients with Non-Hodgkin Lymphoma in East Asia
Jin Kyung Suh, Yi-Jin Gao, Jing-Yan Tang, Shiann-Tarng Jou, Dong-Tsamn Lin, Yoshiyuki Takahashi, Seiji Kojima, Ling Jin, Yonghong Zhang, Jong Jin Seo
Cancer Res Treat. 2020;52(2):359-368.   Published online July 29, 2019
DOI: https://doi.org/10.4143/crt.2019.219
AbstractAbstract PDFPubReaderePub
Purpose
The presentations and geographic incidence of pediatric non-Hodgkin lymphoma (NHL) differ from those of adults. This study delineated the characteristics and outcomes of pediatric NHL in East Asia.
Materials and Methods
Medical records of 749 pediatric patients with NHL treated at participating institutions in mainland China, Japan, Korea, and Taiwan from January 2008 to December 2013 were reviewed. Demographic and clinical features, survival outcomes, and putative prognostic factors were analyzed.
Results
Five hundred thirty patients (71%) were male. The most common pathologic subtypes were Burkitt lymphoma (BL) (36%). Six hundred seven patients (81%) had advanced diseases at diagnosis. The 5-year overall survival and event-free survival (EFS) rates were 89% and 84%. The 5-year EFS rates of BL, lymphoblastic lymphoma, and diffuse large B-cell lymphoma were 88%, 88%, and 89%, and those of anaplastic large cell lymphoma (ALCL) and peripheral T-cell lymphoma (PTCL) were 71% and 56% (p < 0.001). Central nervous system involvement, high lactate dehydrogenase level (> 250 IU/mL), and advanced disease at diagnosis (≥ stage III) were associated with poor outcomes (p < 0.05). ALCL and PTCL relapsed more frequently than other pathologic subtypes (p < 0.001).
Conclusion
In East Asia, PTCL was more frequent than in Western countries, and bone marrow involvement did not affect treatment outcome. This international study should motivate future collaborative study on NHL in East Asia.

Citations

Citations to this article as recorded by  
  • Hemoglobinopathies, merozoite surface protein-2 gene polymorphisms, and acquisition of Epstein Barr virus among infants in Western Kenya
    Perez K. Olewe, Shehu Shagari Awandu, Elly O. Munde, Samuel B. Anyona, Evans Raballah, Asito S. Amolo, Sidney Ogola, Erick Ndenga, Clinton O. Onyango, Rosemary Rochford, Douglas J. Perkins, Collins Ouma
    BMC Cancer.2023;[Epub]     CrossRef
  • iTRAQ-Based Proteomic Analysis Reveals Potential Serum Biomarkers for Pediatric Non-Hodgkin’s Lymphoma
    Runhong Yu, Linna Cheng, Shiwei Yang, Yufeng Liu, Zunmin Zhu
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • 8,996 View
  • 395 Download
  • 3 Web of Science
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The Effect of Hospital Case Volume on Clinical Outcomes in Patients with Nasopharyngeal Carcinoma: A Multi-institutional Retrospective Analysis (KROG-1106)
Boram Ha, Kwan Ho Cho, Sung Ho Moon, Chang-Geol Lee, Ki Chang Keum, Yeon-Sil Kim, Hong-Gyun Wu, Jin Ho Kim, Yong Chan Ahn, Dongryul Oh, Jae Myoung Noh, Jong Hoon Lee, Sung Hwan Kim, Won Taek Kim, Young-Taek Oh, Min Kyu Kang, Jin Hee Kim, Ji-Yoon Kim, Moon-June Cho, Chul Seoung Kay, Jin Hwa Choi
Cancer Res Treat. 2019;51(1):12-23.   Published online February 5, 2018
DOI: https://doi.org/10.4143/crt.2017.273
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study was to investigate the effect of hospital case volume on clinical outcomes in patients with nasopharyngeal carcinoma (NPC).
Materials and Methods
Data on 1,073 patients with cT1-4N0-3M0 NPC were collected from a multi-institutional retrospective database (KROG 11-06). All patients received definitive radiotherapy (RT) either with three-dimensional-conformal RT (3D-CRT) (n=576) or intensity-modulated RT (IMRT) (n=497). The patients were divided into two groups treated at high volume institution (HVI) (n=750) and low volume institution (LVI) (n=323), defined as patient volume ≥ 10 (median, 13; range, 10 to 18) and < 10 patients per year (median, 3; range, 2 to 6), respectively. Endpoints were overall survival (OS) and loco-regional progression-free survival (LRPFS).
Results
At a median follow-up of 56.7 months, the outcomes were significantly better in those treated at HVI than at LVI. For the 614 patients of propensity score-matched cohort, 5-year OS and LRPFS were consistently higher in the HVI group than in the LVI group (OS: 78.4% vs. 62.7%, p < 0.001; LRPFS: 86.2% vs. 65.8%, p < 0.001, respectively). According to RT modality, significant difference in 5-year OS was observed in patients receiving 3D-CRT (78.7% for HVI vs. 58.9% for LVI, p < 0.001) and not in those receiving IMRT (77.3% for HVI vs. 75.5% for LVI, p=0.170).
Conclusion
A significant relationship was observed between HVI and LVI for the clinical outcomes of patients with NPC. However, the difference in outcome becomes insignificant in the IMRT era, probably due to the standardization of practice by education.

Citations

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  • Accumulated Dose Deviation of Rotational and Residual Setup Errors on Nasopharyngeal Carcinoma Using MIM Treated by Helical Tomotherapy
    Wenyan Yao, Jiang Hu, Peixun Xu, Mengxue He, Yongwen Fang, Mingzhi Liu, Zongtai Li, Huilang He, Hui Liu, Wenzhao Sun, Senkui Xu
    Technology in Cancer Research & Treatment.2023;[Epub]     CrossRef
  • Systematic Review and Meta-analysis of the Association Between Radiation Therapy Treatment Volume and Patient Outcomes
    Jerry Ye Aung Kyaw, Alice Rendall, Erin F. Gillespie, Tom Roques, Laurence Court, Yolande Lievens, Alison C. Tree, Chris Frampton, Ajay Aggarwal
    International Journal of Radiation Oncology*Biology*Physics.2023; 117(5): 1063.     CrossRef
  • The Influence of Hospital Volume on the Outcomes of Nasopharyngeal, Sinonasal, and Skull-Base Tumors: A Systematic Review of the Literature
    Stephanie Flukes, Rahul K. Sharma, Shivangi Lohia, Marc A. Cohen
    Journal of Neurological Surgery Part B: Skull Base.2022; 83(03): 270.     CrossRef
  • A Comprehensive Analysis of Treatment Management and Survival Outcomes in Nasopharyngeal Carcinoma
    Khodayar Goshtasbi, Brandon M. Lehrich, Jack L. Birkenbeuel, Arash Abiri, Jeremy P. Harris, Edward C. Kuan
    Otolaryngology–Head and Neck Surgery.2021; 165(1): 93.     CrossRef
  • Hospital volume and physician volume in association with survival in patients with nasopharyngeal cancer after radiation therapy
    Tzu-Yu Lai, Chiu-Mei Yeh, Yu-Wen Hu, Chia-Jen Liu
    Radiotherapy and Oncology.2020; 151: 190.     CrossRef
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  • 5 Web of Science
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Survival and Functional Outcome after Treatment for Primary Base of Tongue Cancer: A Comparison of Definitive Chemoradiotherapy versus Surgery Followed by Adjuvant Radiotherapy
Sangjoon Park, Yeona Cho, Jeongshim Lee, Yoon Woo Koh, Se-Heon Kim, Eun Chang Choi, Hye Ryun Kim, Ki Chang Keum, Kyung Ran Park, Chang Geol Lee
Cancer Res Treat. 2018;50(4):1214-1225.   Published online December 26, 2017
DOI: https://doi.org/10.4143/crt.2017.498
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to compare the clinical and functional outcomes in patients with primary base of tongue (BOT) cancer who received definitive radiotherapy (RT) or surgery followed by radiotherapy (SRT).
Materials and Methods
Between January 2002 andDecember 2016, 102 patientswith stage I-IVB primary BOT cancer underwent either definitive RT (n=46) or SRT (n=56), and treatment outcomeswere compared between two groups. The expression of p16 was also analyzed.
Results
The RT group had more patients with advanced T stage (T3-4) disease (58.7% vs. 35.7%, p=0.021) and who received chemotherapy (91.3% vs. 37.5%, p < 0.001) than the SRT group. At a median followup of 36.9 months (range, 3.3 to 181.5 months), the 5-year overall survival (OS) and disease-free survival (DFS) were 75.5% and 68.7%, respectively. With respect to treatment group, the 5-year OS and DFS in the RT and SRT groups did not differ significantly (OS, 68.7% vs. 80.5%, p=0.601; DFS, 63.1% vs. 73.1%, p=0.653). In multivariate analysis, OS differed significantly according to p16 expression (p16-negative vs. p16- positive; hazard ratio [HR], 0.145; 95% confidence interval [CI], 0.025 to 0.853; p=0.033). Regarding DFS, p16 expression (p16-negative vs. p16-positive; HR, 0.164; 95% CI, 0.045 to 0.598; p=0.006) showed a significant effect in multivariate analysis. Functional defects (late grade ≥ 3 dysphagia or voice alteration) were more frequently reported in the SRT than in the RT group (16.1% vs. 2.2%, p=0.021).
Conclusion
Despite advanced disease, patients in the RT group showed comparable survival outcomes and better functional preservation than those in the SRT group.

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Effect of Adjuvant Chemotherapy on Stage II Colon Cancer: Analysis of Korean National Data
Min Ki Kim, Daeyoun David Won, Sun Min Park, Taejung Kim, Sung Ryong Kim, Seong Taek Oh, Seung Kook Sohn, Mi Yeon Kang, In Kyu Lee
Cancer Res Treat. 2018;50(4):1149-1163.   Published online December 7, 2017
DOI: https://doi.org/10.4143/crt.2017.194
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Debates exist regarding the effectiveness of adjuvant chemotherapy for stage II colon cancer. This study aimed to investigate the current status of adjuvant chemotherapy and its impact on survival for Korean stage II colon cancer patients by analyzing the National Quality Assessment data.
Materials and Methods
A total of 7,880 patientswho underwent curative resection for stage II colon adenocarcinoma between January 2011 andDecember 2014 in Koreawere selected randomly as evaluation subjects for the quality assessment. The factors that influenced overall survival were identified. The high-risk group was defined as having at least one of the following: perforation/ obstruction, lymph node harvest less than 12, lymphovascular/perineural invasion, positive resection margin, poor differentiation, or pathologic T4 stage.
Results
The median follow-up period was 38 months (range, 1 to 63 months). Chemotherapy was a favorable prognostic factor for either the high- (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.38 to 0.59; p < 0.001) or low-risk group (HR, 0.74; 95% CI, 0.61 to 0.89; p=0.002) in multivariate analysis. This was also the case in patients over 70 years of age. The hazard ratio was significantly increased as the number of involved risk factors was increased in patients who didn’t receive chemotherapy. Adding oxaliplatin showed no difference in survival (HR, 1.36; 95% CI, 0.91 to 2.03; p=0.132).
Conclusion
Adjuvant chemotherapy can be recommended for stage II colon cancer patients, but the addition of oxaliplatin to the regimen must be selective.

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Clinical Outcomes of Proton Beam Therapy for Choroidal Melanoma at a Single Institute in Korea
Tae Wan Kim, Euncheol Choi, Jeonghoon Park, Dong-ho Shin, Su Kyung Jung, Susie Seok, Kwan Ho Cho, Joo-Young Kim, Dae Yong Kim, Tae Hyun Kim, Yang Kwon Suh, Yeon Joo Kim, Sung Ho Moon
Cancer Res Treat. 2018;50(2):335-344.   Published online April 19, 2017
DOI: https://doi.org/10.4143/crt.2017.070
AbstractAbstract PDFPubReaderePub
Purpose
This study retrospectively evaluated the clinical outcomes and complications of proton beam therapy (PBT) in a single institution in Korea and quantitatively analyzed the change in tumor volume after PBT using magnetic resonance imaging (MRI).
Materials and Methods
Twenty-four treatment-naïve patients who underwent PBT for choroidal melanoma between 2009 and 2015 were reviewed. Dose fractionation was 60-70 cobalt gray equivalents over 5 fractions. Orbital MRIs were taken at baseline and 3, 6, and 12 months after PBT and annually thereafter. The tumor volume was reconstructed and evaluated by stacking the tumor boundary in each thin-sliced axial T1-weighted image using MIM software.
Results
The median follow-up duration was 36.5 months (range, 9 to 82 months). One patient had suspicious local progression and two patients had distant metastasis. The 3-year local progression-free survival, distant metastasis-free survival, and overall survival rates were 95.8%, 95.8%, and 100%,respectively. Five Common Terminology Criteria for Adverse Event ver. 4.03 grade 3-4 toxicities were observed in four patients (16.7%), including one with neovascular glaucoma. The mean tumor volume at the baseline MRI was 0.565±0.084 mL (range, 0.074 to 1.610 mL), and the ratios of the mean volume at 3, 6, and 12 months to that at baseline were 81.8%, 67.3%, and 60.4%, respectively.
Conclusion
The local controlrate and complication profile after PBT in patientswith choroidal melanoma in Korea were comparable with those reported in a previous PBT series. The change in tumor volume after PBT exhibited a gradual regression pattern on MRI.

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    Ocular Oncology and Pathology.2021; 7(5): 368.     CrossRef
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    Pradeep Manchegowda, Arun D. Singh, Carol Shields, Swathi Kaliki, Parag Shah, Lingam Gopal, Pukhraj Rishi
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    Myeongsoo Kim, Sang Soo Kim, Haksoo Kim, Sung Ho Moon, Young Kyung Lim, Ui-Jung Hwang, Sang Hyoun Choi
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    PLOS ONE.2020; 15(12): e0242966.     CrossRef
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Cancer-Specific Mortality Among Korean Men with Localized or Locally Advanced Prostate Cancer Treated with Radical Prostatectomy Versus Radiotherapy: A Multi-Center Study Using Propensity Scoring and Competing Risk Regression Analyses
Kyo Chul Koo, Jin Seon Cho, Woo Jin Bang, Seung Hwan Lee, Sung Yong Cho, Sun Il Kim, Se Joong Kim, Koon Ho Rha, Sung Joon Hong, Byung Ha Chung
Cancer Res Treat. 2018;50(1):129-137.   Published online March 8, 2017
DOI: https://doi.org/10.4143/crt.2017.004
AbstractAbstract PDFPubReaderePub
Purpose
Studies comparing radical prostatectomy (RP) outcomes with those of radiotherapy with or without androgen deprivation therapy (RT±ADT) for prostate cancer (PCa) have yielded conflicting results. Therefore, we used propensity score-matched analysis and competing risk regression analysis to compare cancer-specific mortality (CSM) and other-cause mortality (OCM) between these two treatments.
Materials and Methods
The multi-center, Severance Urological Oncology Group registry was utilized to identify 3,028 patients with clinically localized or locally advanced PCa treated by RP (n=2,521) or RT±ADT (n=507) between 2000 and 2016. RT±ADT cases (n=339) were matched with an equal number of RP cases by propensity scoring based on age, preoperative prostate-specific antigen, clinical tumor stage, biopsy Gleason score, and Charlson Comorbidity Index (CCI). CSM and OCM were co-primary endpoints.
Results
Median follow-up was 65.0 months. Five-year overall survival rates for patients treated with RP and RT±ADT were 94.7% and 92.0%, respectively (p=0.105). Cumulative incidence estimates revealed comparable CSM rates following both treatments within all National Comprehensive Cancer Network risk groups. Gleason score ≥ 8 was associated with higher risk of CSM (p=0.009). OCM rates were comparable between both groups in the low- and intermediate-risk categories (p=0.354 and p=0.643, respectively). For high-risk patients, RT±ADT resulted in higher OCM rates than RP (p=0.011). Predictors of OCM were age ≥ 75 years (p=0.002) and CCI ≥ 2 (p < 0.001).
Conclusion
RP and RT±ADT provide comparable CSM outcomes in patients with localized or locally advanced PCa. The risk of OCM may be higher for older high-risk patients with significant comorbidities.

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Clinicopathologic Features and Long-Term Outcomes of Elderly Breast Cancer Patients: Experiences at a Single Institution in Korea
Hee Kyung Kim, Jun Soo Ham, Seonggyu Byeon, Kwai Han Yoo, Ki Sun Jung, Haa-Na Song, Jinhyun Cho, Ji Yun Lee, Sung Hee Lim, Hae Su Kim, Ji-Yeon Kim, Jeong Eon Lee, Seok Won Kim, Seok Jin Nam, Se Kyung Lee, Soo Youn Bae, Jin Seok Ahn, Young-Hyuck Im, Yeon Hee Park
Cancer Res Treat. 2016;48(4):1382-1388.   Published online March 11, 2016
DOI: https://doi.org/10.4143/crt.2015.423
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study was to assess the tumor characteristics and long-term clinical outcomes of adjuvant treatments after surgery with a curative aim for patients with breast cancer who are 65 years and older. Materials and Methods Patients with breast cancer who underwent curative surgery from 2000 to 2009 were analyzed (n=4,388). Tumor characteristics and survival outcome were compared by dividing the patients into two age groups (< 65 and ≥ 65 years old). The Kaplan-Meier method was used for comparison of survival rates by log-rank test, and a Cox regression model was used to examine the effect of variables.
Results
Among 4,388 patients with invasive breast cancer, 317 patients (7.2%) were 65 years or older and the median age of all patients was 47 years (range, 18 to 91 years). Tumor characteristics were similar between the two age groups, but the older patients were treated less often with adjuvant treatments. During a median follow-up period of 122 months, recurrence-free survival (RFS) was equivalent for patients 65 years and older compared to younger patients, but significantly worse in overall survival (OS) and breast cancer–specific survival (BCSS) (5-year OS, 94.3% vs. 90.5%; p < 0.001 and 5-year BCSS, 94.7% vs. 91.8%; p=0.031). In the multivariate model, age ≥ 65 years old was identified as an independent risk factor for OS and RFS. Conclusion Elderly breast cancer appeared to have worse outcomes with very low prevalence in Korea, despite similar tumor characteristics. More active adjuvant therapies would have a role for aggressive subtypes for fit, elderly patients.

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Endometrial Stromal Sarcomas: A Retrospective Analysis of 28 Patients, Single Center Experience for 20 Years
Eun Ji Nam, Jae Wook Kim, Dae Woo Lee, Si Young Jang, Jong Wook Hong, Young Tae Kim, Jae Hoon Kim, Sunghoon Kim, Sang Wun Kim
Cancer Res Treat. 2008;40(1):6-10.   Published online March 31, 2008
DOI: https://doi.org/10.4143/crt.2008.40.1.6
AbstractAbstract PDFPubReaderePub
Purpose

The aim of this study was to evaluate the behavior of endometrial stromal sarcomas (ESSs) in relation to their clinical and pathogenic features, and to determine the optimal treatment strategy.

Materials and Methods

A retrospective analysis was performed involving 28 patients with histologic-proven ESSs treated at our institution between 1987 and 2006.

Results

The median follow-up was 54.7±63.1 months and the 5-year survival rate was 82.0%. Twenty-two (81.5%) and 5 patients (18.5%) had low- and high-grade disease, respectively. Univariate analysis revealed that the histologic grades, based on mitotic count, were associated with longer survival (p=0.004). However, among those patients with low-grade tumors, 5/20 patients (25%) had a recurrence and 2/21 patients (9.5%) had distant metastasis during the follow-up period. With the exception of 2 patients, 26 patients with ESSs underwent hysterectomy as primary treatment. Adjuvant treatment after surgery was administered to 14/26 patients (53.8%). Hormone therapy with progesterone, chemotherapy, and/or radiotherapy did not influence overall survival. However, the postoperative adjuvant therapy group, regardless of the treatment modality, was associated with relatively increased overall survival when compared to the surgery only group (p=0.054).

Conclusions

The preoperative differential diagnosis of ESSs from other benign gynecologic diseases is often difficult. We recommend adjuvant therapy be administered after hysterectomy in patients with ESS to prevent recurrence or distant metastasis.

Citations

Citations to this article as recorded by  
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