• Title/Summary/Keyword: Advanced thyroid cancer

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Role of adjuvant postoperative external beam radiotherapy for well differentiated thyroid cancer

  • Kwon, Jeanny;Wu, Hong-Gyun;Youn, Yeo-Kyu;Lee, Kyu Eun;Kim, Kwang Hyun;Park, Do Joon
    • Radiation Oncology Journal
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    • v.31 no.3
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    • pp.162-170
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    • 2013
  • Purpose: To analyze the outcome of adjuvant postoperative external beam radiotherapy (EBRT) in well-differentiated thyroid cancer (WDTC). Materials and Methods: We identified 84 patients treated with EBRT for WDTC from February 1981 to December 2010. Among them, we analyzed 39 patients who received EBRT after initial radical surgery. Twenty-four females and 15 males were included. The median age was 49 years (range, 16 to 72 years). There were 34 papillary thyroid carcinomas and 5 follicular thyroid carcinomas. Most patients showed pathologic T3/T4 stage (54%/26%). Ten patients (25.6%) had gross residual tumors. Five patients (12.8%) had tumor cells at the margin. The median EBRT dose and fraction size were 62.6 Gy and 1.8 to 2.0 Gy, respectively. Results: The median follow-up was 73 months (range, 21 to 372 months). The five-year overall survival (OS) and locoregional recurrence free survival (LRFS) were 97.4% and 86.9%, respectively. Locoregional failures occurred in 5 and all failure sites were the neck node area. In univariate analysis, OS was significantly influenced by invasion of the trachea (p = 0.016) or esophagus (p = 0.006). LRFS was significantly decreased by male (p = 0.020), gross residuum after resection (p = 0.002), close or positive tumor at surgical margin involvement (p = 0.044), and tracheal invasion (p = 0.040). No significant prognostic factor was identified in the multivariate analysis. No patient experienced the Radiation Therapy Oncology Group grade 3 or more toxicity. Conclusion: Our locoregional control rate of 87.2% is comparable to historical controls with surgery alone, even though our study had a large proportion of advanced stage. Adjuvant EBRT may an effective and safe treatment option in patients with WDTC.

Costs During the First Five Years Following Cancer Diagnosis in Korea

  • Shin, Ji-Yeon;Kim, So Young;Lee, Kun-Sei;Lee, Sang-Il;Ko, Young;Choi, Young-Soon;Seo, Hong Gwan;Lee, Joo-Hyuk;Park, Jong-Hyock
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3767-3772
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    • 2012
  • Objective: We estimated the total medical costs incurred during the 5 years following a cancer diagnosis and annual medical use status for the six most prevalent cancers in Korea. Methods: From January 1 to December 31, 2006, new patients registered with the six most prevalent cancers (stomach, liver, lung, breast, colon, and thyroid) were randomly selected from the Korea Central Cancer Registry, with 30% of patients being drawn from each cancer group. For the selected patients, cost data were generated using National Health Insurance claims data from the time of cancer diagnosis in 2006 to December 31, 2010. The total number of patients selected was 28,509. Five-year total medical costs by tumor site and Surveillance, Epidemiology, and End Results (SEER) stage at the time of diagnosis, and annual total medical costs from diagnosis, were estimated. All costs were calculated as per-patient net costs. Results: Mean 5-year net costs per patient varied widely, from $5,647 for thyroid cancer to $20,217 for lung cancer. Advanced stage at diagnosis was associated with a 1.8-2.5-fold higher total cost, and the total medical cost was highest during the first year following diagnosis and decreased by the third or fourth year. Conclusions: The costs of cancer care were substantial and varied by tumor site, annual phase, and stage at diagnosis. This indicates the need for increased prevention, earlier diagnosis, and new therapies that may assist in reducing medical costs.

Analysis of Clinical Characteristics for 899 Cancer Patients Treated at an Oriental Hospital (한방병원에서 치료받은 암환자 899명에 대한 임상적 특성 분석)

  • Jeong, Tae-Young;Lee, Yeon-Weol;Cho, Chong-Kwan;Yoo, Hwa-Seung
    • The Journal of Internal Korean Medicine
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    • v.31 no.1
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    • pp.102-112
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    • 2010
  • Objective : This study was aimed to obtain epidemiological information of cancer patients treated with Oriental medicine. Methods :The medical records of 899 cancer patients treated at the East-West Cancer Center of Dunsan Oriental Hospital from January to December 2008 were analyzed. Careful investigations were done by categorizing these patients by their sex, origin, stage, treatment duration, conventional treatment type, etc. Results : 61.7% of the patients had stage IV tumor. 53.1% of patients visited Oriental hospital for combination treatment with conventional medicine. In the tumor origin, lung cancer showed the largest proportion (21.6%). Of the two genders, lung cancer was the most frequent cause (31%) in male patients, and breast cancer in females (21.2%). In inpatients, thyroid cancer resulted in the highest percentage (24.0%). Lung, colon, stomach cancer patients were mostly in stage III or IV. Thyroid cancer patients were mostly in stage I. Conclusions : This study presented the characteristics of cancer patients treated by Oriental medicine. Based on this study, further advanced study of Oriental medical cancer treatments is needed.

A Case of Advanced Thyroid Insular Carcinoma with Invasion of the Sternum (흉골침습을 동반한 진행성 갑상선 섬암종(Insular Carcinoma) 1예)

  • Koh Yoon-Woo;Lee Seung-Won;Lee Jong-Dae;Kim Hyo-Jin;Kim Hee-Kyung
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.2
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    • pp.178-182
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    • 2005
  • Insular carcinoma(poorly differentiated thyroid cancer) is defined as a aggressive, follicular-derived thyroid carcinoma with behavior intermediate between follicular/papillary and anaplastic carcinomas. It was described by Carcangiu in 1984, but its prognosis, classification and the origin is not yet clear. And preoperative fine needle aspiration cytology of insular carcinoma has not been satisfactory. We experienced a case of advanced thyroid insular carcinoma with invasion of the sternum. So we intend to present the case with a review of the related literatures.

Environmental Impact Assessment of Nuclear Power Plant Accident using Spatial Information Modeling: A Case Study of Chernobyl (공간정보 모델링을 이용한 원전 사고의 환경 영향 평가: 체르노빌 사례연구)

  • Lee, Sang-Won;Song, Ah-Ram;Park, No-Wook
    • Korean Journal of Remote Sensing
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    • v.28 no.1
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    • pp.129-143
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    • 2012
  • This paper demonstrates the effectiveness of advanced spatial modeling techniques for environmental monitoring and impact assessment through a case study of Chernobyl nuclear accident occurred in 1986. Land-cover types changed after the accident are analysed by a post classification comparison method using bi-temporal Landsat TM data acquired in 1986 and 1992 near the accident site. Spatial modeling including various kriging algorithms are also applied to analyze the relationships between Cesium concentrations in soil and thyroid cancer incidence rates in Belarus, which was greatly damaged by the accident. The change detection results clearly showed the decrease of croplands and the increase of abandoned lands, and concrete structures were newly built around the nuclear plant to prevent the spread of radioactive contamination. In Belarus, high Cesium concentrations were observed in southern areas with high thyroid cancer risk estimated by Poisson kriging. Geographically weighted regression, which could account for geographic variations of independent variables including Cesium concentrations and distances from the Chernobyl nuclear power plant, was applied to extract the relationships between the independent variables and the thyroid cancer risk. The estimated risk values showed a correlation coefficient value of 0.98 with respect to the thyroid cancer risk values, which implied that the thyroid cancer risk in Belarus was affected by the accident. In conclusion, it is expected that advanced spatial modeling techniques applied in this study would be useful for environmental impact assessment and public health research.

Association Between Alterations in the Serum 25-Hydroxyvitamin D Status During Follow-Up and Breast Cancer Patient Prognosis

  • Lim, Seung Taek;Jeon, Ye Won;Suh, Young Jin
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2507-2513
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    • 2015
  • Background: Serum vitamin D status can affect the prognosis of breast cancer patients. Our aim was to determine the association between alterations in the 25-hydroxyvitamin D [25(OH)D] status during follow-up and the prognosis of breast cancer patients. Additionally, we evaluated the association between the 25(OH)D status at the time of diagnosis and the prognosis using a detailed age and stage categorization. Materials and Methods: Four hundred and sixty-nine Korean breast cancer patients were included. We collected patient clinicopathological data, including their serum 25(OH)D concentration at diagnosis and at the annual follow-up until 4 years after diagnosis. The patients were divided according to their 25(OH)D status at diagnosis into a deficient (<20 ng/ml) and a non-deficient (${\geq}20ng/ml$) group. At follow-up, patients were categorized into the four following groups according to 25(OH)D status alterations: persistently deficient, improved, deteriorated and persistently non-deficient. Results: At diagnosis, 118 patients were classified into the deficient group and 351 into the non-deficient group. After a median follow-up period of $85.8{\pm}31.0$ months, the patients with advanced-stage disease or an older age in the non-deficient group showed a significantly better survival compared with the deficient group. Furthermore, at the 1-year follow-up of 25(OH)D status, the persistently non-deficient group and the improved group had better survival compared with the other two groups. Conclusions: Our results suggest that maintaining an optimal 25(OH)D status at diagnosis and during the 1-year follow-up period is important for improving breast cancer patient survival.

A Case of Advanced Gastric Cancer Patient Treated with Sojeukjungwon-san and Allergen Removed Rhus Verniciflua Stokes(aRVS) (소적정원산(消積正元散) 및 옻나무 추출물 투여로 체중증가 및 일반활동도의 개선을 보인 진행성 위암환자 1례)

  • An, Ji-Hye;Jerng, Ui-Min;Jeong, Jong-Soo;Park, Jae-Woo;Yoon, Seong-Woo
    • Journal of Korean Traditional Oncology
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    • v.14 no.1
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    • pp.21-27
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    • 2009
  • Advanced gastric cancer is the most common type of all cancers in Korea, which account for approximately 18.1% of all incident cancers, and mortality from advanced gastric cancer is estimated at nearly 15.6% of death that caused by all cancer. In the conventional medicine, treatments of advanced gastric cancer include chemotherapy such like FOLFOX. In this case report, we introduce a case of advanced gastric cancer with greater omentum, thyroid, supraclavicular lymph node metastasis who had received chemotherapy. Chemotherapy was stopped because of weight loss and neurologic symptom such like cognitive disorder. The patient visited $M{\cdot\mu}$ Integrative cancer center in 2008, and was treated by Sojeukjungwon-san and allergen removed Rhus verniciflua stokes(aRVS). There was no evidence of brain metastasis. The patient showed improvement of cognitive disorder and gained weight. Further case study will be needed in order to determine the effects of Sojeukjungwon-san and allergen removed Rhus verniciflua stokes(aRVS) for the quality of life of advanced gastric cancer patients after chemotherapy.

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Histopathological Patterns of Thyroid Disease in Al-Madinah Region of Saudi Arabia

  • Albasri, Abdulkader;Sawaf, Zeinab;Hussainy, Akbar Shah;Alhujaily, Ahmed
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5565-5570
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    • 2014
  • Objectives: This study aimed to characterize the histopathological pattern of thyroid lesions among Saudi patients and to highlight the age and gender variations of these lesions as base line data. Materials and Methods: We retrospectively analyzed the data from thyroid specimens received at the Department of Pathology, King Fahad Hospital, Madinah, Saudi Arabia from January 2006 to December 2013. Results: The 292 thyroidectomy specimens received during the study period came from 230 (78.8%) females and 62 (21.2%) males giving a female: male ratio of 3.7:1. Age of the patients ranged from 14 to 95 years with a mean age 39.7 years. Two hundred and eleven (72.3%) cases were found to be non-neoplastic and 81 (27.7%) cases were neoplastic. The non-neoplastic group included: colloid goiter, including both diffuse and nodular goiter (170 cases; 58.2%), nodular hyperplasia (28 cases; 9.6%), Hashimoto/chronic lymphocytic thyroiditis (12 cases; 4.1%), and Grave's disease (1 case; 0.3%). In neoplastic lesions, there were 7 benign tumors and 74 malignant tumors. Among the benign tumors, 5 were follicular adenomas and 2 were Hurthle cell adenomas. Papillary carcinoma was the commonest malignant tumor accounting for 87.8% of all thyroid malignancies, followed by lymphoma, follicular carcinoma and medullary carcinoma. The size of papillary carcinoma was more than 2 cm in 40 cases (76.9%). Conclusions: Non-neoplastic thyroid lesions were more common than neoplastic ones. Colloid goiter was the most common lesion. Follicular adenoma was the commonest benign tumor and papillary carcinoma was the commonest malignant lesion. There appears to be a slightly increased trend of papillary carcinoma diagnosis, most being diagnosed at an advanced stage.

Trends in the Incidence of 15 Common Cancers in Hong Kong, 1983-2008

  • Xie, Wen-Chuan;Chan, Man-Him;Mak, Kei-Choi;Chan, Wai-Tin;He, Miao
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3911-3916
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    • 2012
  • Background: The objective of this study WAS to describe cancer incidence rates and trends among THE Hong Kong population for the period 1983-2008. Methods: Incident cases and population data from 1983 to 2008 were obtained from the Hong Kong Cancer Registry and the Census and Statistics Department, respectively. Agestandardized incidence rates (ASIR) were estimated and joinpoint regression was applied to detect significant changes in cancer morbidity. Results: For all cancers combined, the ASIR showed declining trends (1.37% in men, 0.94% in women), this also being the case for cancers of lung, liver, nasopharynx, stomach, bladder, oesophagus for both genders and cervix cancer for women. With cancer of thyroid, prostate, male colorectal, corpus uteri, ovary and female breast cancer an increase was evident throughout the period. The incidence for leukemia showed a stable trend since early 1990s, following an earlier decrease. Conclusion: Although overall cancer incidence rates and certain cancers showed declining trends, incidence trends for colorectal, thyroid and sex-related cancers continue to rise. These trends in cancer morbidity can be used as an important resource to plan and develop effective programs aimed at the control and prevention of the spread of cancer amongst the Hong Kong population. It is particularly useful in allowing projection of future burdens on the society with the increase in certain cancer incidences.

Efficacy and Safety of Selumetinib Compared with Current Therapies for Advanced Cancer: a Meta-analysis

  • Shen, Chen-Tian;Qiu, Zhong-Ling;Luo, Quan-Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2369-2374
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    • 2014
  • Background and Aim: Selumetinib is a promising and interesting targeted therapy agent as it may reverse radioiodine uptake in patients with radioiodine-refractory differentiated thyroid cancer. We conduct this metaanalysis to compare the efficacy and safety of selumetinib with current therapies in patients with advanced cancer. Methods: An electronic search was conducted using PubMed/ Medicine, EMBASE and Cochrane library databases. Statistical analyses were carried out using either random-effects or fixed-effects models according to the heterogeneity of eligible studies. Results: Six eligible trials involved 601 patients were identified. Compared with current therapies, treatment schedules with selumetinib did not improve progression free survival (hazard ratio, 0.91; 95%CI 0.70-1.17, P= 0.448), but did identify better clinical benefits (odds ratio, 1.24; 95%CI 0.69-2.24, P = 0.472) and less disease progression (hazard ratio, 0.72; 95%CI 0.51-1.00, P = 0.052) though its impact was not statistically significant. Sub-group analysis resulted in significantly improved progression free survival (hazard ratio, 0.61; 95%CI 0.49-0.57, P = 0.00), clinical benefits (odds ratio, 3.04; 95%CI 1.60-5.77, P = 0.001) and reduced disease progression (hazard ratio, 0.35; 95%CI 0.18-0.67, P = 0.001) in patients administrated selumetinib. Dermatitis acneiform (risk ratio, 9.775; 95%CI 3.143-30.395, P = 0.00) and peripheral edema (risk ratio, 2.371; 95%CI 1.690-3.327, P = 0.00) are the most frequently observed adverse effects associated with selumetinib. Conclusions: Compared with current chemotherapy, selumetinib has modest clinical activity as monotherapy in patients with advanced cancer, but combinations of selumetinib with cytotoxic agents in patients with BRAF or KRAS mutations hold great promise for cancer treatment. Dermatitis acneiform and peripheral edema are the most frequently observed adverse effects in patients with selumetinib.