• Radiation Oncology Journal
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• v.10 no.1
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• pp.59-67
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• 1992

From March 1979 through December 1986, 124 patients with early stage carcinoma of the uterine cervix received curative radiation therapy. According to FIGO classification, 35 patients were stage IB and 89 were stge II A. In stage IB, five year locoregional control, five year disease free survival, and five year overall survival was $79.0\%$, $76.4\%$ and $81.8\%$, respectively. In stage II A, five year locoregional control, five year disease free survival, and five year overall survival were $78.0\%$, $66.8\%$, and $72.1\%$, respectively. To identify prognostic factors, pretreatment parameters including age, ECOG performance status, number of pregnancies, history of diabetes mellitus and hypertension, histology, size and shape of primary tumor, CT findings and blood parameters were retrospectively analyzed in terms of locoregional control, disease free survival and overall survival using univariate analysis and multivariate analysis. In univariate analysis, tumor size on physicai examination and rectal invasion on CT significantly affected locoregional control, disease free survival and overall survival. Parametrial involvement on CT was a significant prognostic factor on locoregional control and disease free survival. Hemoglobin level affected disease free survival and overall survival. Histology and age were significant prognostic factors on locoregional control. In multivariate analysis excluding CT finding, tumor size on physical examination was a significant factor in terms of locoregioal control and overall survival. Hemoglobin level was significant in terms of disease free survival. In multivariate analysis including CT, histology was a prognostic factor on locoregional control and disease free survival. Hemoglobin level and rectal invasion on CT were significant factors on locoregional control.

• The Journal of the Korean bone and joint tumor society
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• v.16 no.2
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• pp.62-68
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• 2010

Purpose: We analyzed disease free survival and the prognostic factors of liposarcoma in the extremity. Materials and Methods: Between 1994 and 2005, of 44 patients who were diagnosed and treated for liposarcoma of the extremity, 40 patients were restrospectively analysed. 13 out of 40 patients got postoperative radiotherapy. We examined local recurrence, distant metastasis and disease free 5-year survival rate. We also analyzed clinical prognostic factors, such as age, gender, size of tumor, prior unplanned excision, histologic type, surgical excision margin and postoperative radiotherapy respectively. Results: There were 3 cases of local recurrence and 4 cases of distant metastasis. The disease free 5-year survival rate was 85.0%. 26 patients presented with myxoid, 8 well differentiated, 4 round cell, 1 pleomorphic and 1 dedifferentiated histology. The disease free 5-year survival rate of mixoid, well differentiated and round cell liposarcoma were 100.0%, 84.6% and 75.0% (p=0.419). The 5-year disease free survival rate was 90.6% in negative surgical margin (n=25) and 62.5% in positive surgical margin (n=15) (p=0.003). Conclusion: Our study suggests that surgical excision margin is significant prognostic factor for 5-year disease free survival rate.

• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1260-1265
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• 2003

Purpose : In 1970, the Berlin-Frankfurt-Munster(BFM) group introduced an intensification therapy after remission induction to reduce relapse of acute lymphoblastic leukemia(ALL) in childhood. Delayed intensification(DI) phase has been included for treatment of ALL in our hospital since the mid-1990s. The purpose of this study is to evaluate the outcome with vs. without DI phase and the outcome with two vs. one DI phase for intermediate risk patients. Methods : One hundred and thirty nine children with ALL who were treated at the Department of Pediatrics of Wonju Christian Hospital and Yonsei University Medical Center between March, 1990 and July, 2002 were analysed retrospectively. Results : Thirty-eight patients were treated with a DI phase, and 101 patients were treated without a DI phase. Among the DI patients, seven patients were treated with a double DI phase. Five-year overall survival(OS) in the low, intermediate, and high risk groups were 68%, 66% and 58%, respectively. 5-year OS in DDI, DI, and control were 95%, 86% and 40%, respectively. In the low risk group, 5-year event free survival(EFS) in DI, and control were 94% and 58%, respectively. Conclusion : Delayed intensification improved EFS on childhood ALL in all risk groups.

• Journal of Chest Surgery
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• v.34 no.8
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• pp.615-620
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• 2001

The new stage of metastatic lung cancer based upon resectability, disease-free interval, and the number of pulmonary metastases was proposed in 1998 by Ginsberg, et al. We evaluated the validity of the new staging proposal for pulmonary metastases through the analysis of experiences at Severance Hospital. Material and Method: The cases of 111 patients who underwent resection of metastatic lung cancer during the eleven-year period (1990-2000) were reviewed. Of these patients, 103(92.8%) underwent compete surgical resection. The primary tumor was carcinoma in 60 cases, sarcoma in 46, and others in 5. The disease-free interval(DFI) was 0 to 35 months in 79 cases adn more than 36 months in 32 cases. Single metastasis accounted for 53 cases and multiple lesions for 58 cases. Mean follow-up was 49 months. Result: The actuarial survival after complete metastasectomy was 48.2% at 3 years and 32.6% at 5 years; the corresponding values for incomplete resection were 21.9% at 3 years. The 3-year survival rate(3-YSR) for complete resction was 40.5% and 5-year survival rate(5-YSR) was 30.4% for patients with a DFI less than 36 months, the 3-YSR, 75.8% and 5-YSR, 39.0% for those with a DFI equal or more than 36 moths; 45.8% and 30.5% for single lesions, 50.0% and 34.4% for multiple lesions. The 3-YSR and 5-YSR were 58.5% and 43.8% for stage I patients, 54.0% and 37.4% for stage II, 38.2% and 27.9% for stage III and 21.9% for stage IV. Conclusion: The result of the analysis of new stage of pulmonary metastases showed that the survival rate was different according to stage and there was no statistical significance. We need more experiences and long-term follow up to determine the prognostic factor of metastatic lung cancer surgery.

• Radiation Oncology Journal
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• v.24 no.3
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• pp.164-170
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• 2006

[ $\underline{Purpose}$ ]: This study identified the result of postoperative radiation therapy and the prognostic factors to affect survival rates in cancer patients. $\underline{Materials\;and\;Methods}$: One hundred and thirty three patients with cervical cancer who were treated with postoperative radiation therapy following surgery at our institution between June 1985 and November 2002 were retrospectively analyzed. One hundred and thirteen patients had stage IB disease, and 20 patients had stage IIA disease. Histological examination revealed 118 squamous cell carcinoma patients and 15 adenocarcinoma patients. Sixty seven patients were noted to have stromal invasion greater than 10 mm, and 45 patients were noted to have stromal Invasion 10 mm or less. Positive lymphovascular invasion was found in 24 patients, and positive pelvic lymph nodes were noted in 39 patients. Positive vaginal resection margin was documented in 8 patients. All of the patients were treated with external beam radiation therapy to encompass whole pelvis and primary surgical tumor bed. Intracavitary radiation therapy was added to 19 patients who had positive or close surgical margins. $\underline{Results}$: Actuarial overall and disease-free survival rates for entire group of the patients were 88% and 84% at 5 years, respectively. Five-year disease-free survival rates for patients with stromal invasion greater than 10 mm and 10 mm or less were 76% and 97%, respectively (p<0.05). Also there was a significantly lower survival in patients with positive pelvic lymph nodes compared with patients with negative pelvic lymph nodes (p<0.05). However, lymphovascular invasion, positive vaginal resection margins were not statistically significant prognostic factors. Addition of neoadjuvant chemotherapy or type of surgery did not affect disease-free survival. $\underline{Conclusion}$: Postoperative radiation therapy appears to achieve satisfactory local control with limited morbidity in cervical cancer patients with high pathologic risk factors. Distant metastasis was a dominant failure pattern to affect survival in cervical cancer patients after radical surgery and radiation and more effective systemic treatment should be investigated in these high-risk patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.3
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• pp.105-114
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• 2017

The purpose of this study was to examine the effects of obesity at diagnosis on the prognosis of Korean breast cancer patients after classifying them according to their reproductive history and age by comparing the overall survival rate (OS) and disease-free survival rate (DFS). This study is a retrospective cohort study using 4181 breast cancer cases at one of the medical centers in Korea during the 3 year period from 2006 to 2008. We confirmed the levels of death and recurrence through a follow-up study completed in May 30. 2015. In conclusion, the parous patients had a lower OS than the non-parous patients (p=.000), and the younger patients below 40 years old had a lower OS and DFS than those who were 40 years old or older (p=.003, p=.000), while obesity did not affect the OS and DFS significantly. However, several subgroups in which obesity affected the OS and DFS were found after classifying the patients according to their reproductive history and age. For the subgroups classified by reproductive history, the obese patients had a lower OS and DFS than the non-obese patients in the subgroup in which the patients have a reproductive history (p=.001, p=.005). For the subgroups classified according to age, the obese patients had a lower OS and DFS than the non-obese patients in the subgroup in which the patients were 40 years old or older (p=.005, p=.014). Obesity affected the OS and DFS in the subgroup in which the patients were 40 years old or older and had a reproductive history (p=.000, p=.003). The results of this study show that obesity has an effect on the prognosis of breast cancer patients in the subgroups classified by reproductive history and age, whereas it has no effect on the OS and DFS of the patients when they are examined in their entirety. It also suggests that appropriate nursing intervention is needed for the subgroups in which obesity has effects on prognosis.

• Radiation Oncology Journal
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• v.21 no.3
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• pp.199-206
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• 2003

Purpose: This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Materials and Methods: Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study. The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, lymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer fellowing simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was $40\~50$ Gy. Vagina cuff Irradiation was peformed, after completion of the external beam irradiation, at a low-dose rate of Cs-137, with the total dose of $4488\~4932$ chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months ($15\~108$ months). Results: The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were $98\%,\;95\%\;and\;94\%$, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients ($9\%$) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Conclusion: Our results indicate that postoperative radiation therapy can achieve good local control and survival rates for patients with stages IB-IIB cervical cancer, treated with a simple hysterectomy, as well as for those treated with a radical hysterectomy, and with unfavorable pathological findings. The prognostic factor for disease-free survival was invasion of the parametrium. The prognosic factor identified in this study for treatment failure can be used as a selection criterion for the combined treatment of radiation and che motherapy.

• Journal of Gastric Cancer
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• v.5 no.3 s.19
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• pp.174-179
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• 2005

Purpose: The 5-year survival rate is the most useful parameter for evaluating the effect of management on most malignant tumors. Recurrence after a curative resection for gastric cancer occurs mostly within 3 years of the operation, which caused us to evaluate whether a 3-year disease-free survival (3DFS) can be substituted for a 5-year overall survival (5OS). Materials and Methods: We reviewed the medical records of 656 consecutive patients who had undergone a curative resection for gastric cancer To assess whether 3DFS represents 5OS, we used a simple linear regression with survival probability calculated by using the survival function. Results: Recurrence was found in 175 cases during the follow-up periods. The accumulative frequencies of recurrence at postoperative 1 year, 3 years, and 5 years were 46% (81 cases), 89% (156 cases), and 97% (170 cases), respectively. The correlation coefficient (r) and the coefficient of determination $(r^2)$ between 3DFS and 5OS were 0.87 and 0.76, respectively, and the regression equation was $5OS=0.18+(0.80{\times}3DFS)$. The r and $R^2$ according to the type of recurrence were 0.89 and 0.80 in peritoneal seeding, 0.88 and 0.78 in hematogeneous metastasis, and 0.86 and 0.73 in local recurrence, respectively. The r (0.77) and $r^2$ (0.60) were relatively lower in low stages (stage I and II) compared to r (0.88) and $r^2(0.77)$ in high stages (stage III and IV). Conclusion: The 3DFS is an excellent predictor of 5OS. Therefore, if we use the former as the treatment evaluating method, 2-year time reduction in assessing and reporting treatment results is expected.

• Radiation Oncology Journal
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• v.24 no.4
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• pp.217-222
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• 2006

$\underline{Purpose}$: This study evaluated the results of definitive radiation therapy and the prognostic factors that affect survival rates for T2N0 glottic cancer patients. $\underline{Materials\;and\;Methods}$: Thirty patients with T2N0 glottic cancer who were treated with definitive radiation therapy at our institution between September 1986 and June 2004 were retrospectively reviewed. All patients were pathologically confirmed as having squamous cell carcinoma and were staged as AJCC T2N0. The age of the patients ranged from 39 to 79 (median 62) years and all were male. A total dose of $66{\sim}70\;Gy$ (median 66 Gy) was delivered with a 6-MV linear accelerator in $6.5{\sim}7$ weeks. The median follow-up period was 63 months. $\underline{Results}$: The actuarial disease-free survival rate for the entire group of the patients was 79% at 5 years. The five-year disease-free survival rates for patients without and with subglottic extension were 90% and 56%, respectively (p=0.03). However, anterior commissure involvement, supraglottic extension, and impaired cord mobility were not statistically significant prognostic factors. The five-year disease-free survival rates for patients with and without concurrent chemotherapy were 86% and 69%, respectively (p=0.47). $\underline{Conclusion}$: Subglottic extension can be considered a poor prognostic factor for T2N0 glottic cancer.

• Radiation Oncology Journal
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• v.14 no.2
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• pp.137-147
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• 1996

Purpose : This report is the result f retrospective analysis for children who received prophylactic cranial irradiation combined with intrathecal chemotherapy. Materials and Methods : Ninety children with ALL who had got bone marrow remission after induction chemotherapy received PCI. All but 3 children were treated with a dose of 1800 cGy as a standard regimen. While the PCI was given, all patients received intrathecal chemotherapy. Results : Nine of 90 patients experienced CNS relapse during the duration of follow-up ranged from 36 to 96 months (median 60 months). Three children experienced BM relapse prior to CNS relapse. Therefore, CNS relapse rate as the first adverse event was $6.7\%$. Median time interval of CNS relapse was 16 months from the first day of hematologic complete remission. Eighty-nine percent of patients who had CNS relapse were associated with hematologic relapse. and $78\%$ of CNS relpase occurred during maintenance chemotherapy (on-therapy relapse). The CNS RFS at 2 and 5 years are $68\%$ and $42\%$, respectively with median of 43 months. The Prognostic factors affecting CNS RFS are initial WBC count (cut-off point of 50,000/ul), FAB subtype and CALGB risk criteria. The DFS at 2 and 5 years are 61 and $39\%$, respectively with median of 34 months. The prognostic factors affecting DFS are initial WBC count (cut-off point of 50,000/ul), FAB subtype, POG and CALGB risk criteria. Conclusions : In our study, $6.7\%$ of CNS relapse rate as a first adverse event was comparable with other studies. Various risk criteria was based on age at diagnosis and initial WBC count such as POG and CALGB criteria, had prognostic significance for CNS RFS and DFS. Prospective randomized trial according to prognostic subgroup based on risk criteria and systematic study about neuropsychologic function for long term survivors, are essential to determine the most effective and least toxic form of CNS prophylaxis.