• Title/Summary/Keyword: Poor prognosis

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Case Report of Partial Endocardial Cushion Defect with Mild Pulmonary Hypertension in Old Age (경증의 폐동맥 고혈압을 동반한 고령에서의 심내막상 결손 환자 치험 1예)

  • Kim Woo-Shik;An Jae-Bum;Song Chang-Min;Kim Mi-Jung;Jung Sung-Chol;Shin Yong-Chul;Kim Byung-Yul;Kim In-Sub
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.633-636
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    • 2006
  • The partial endocardial cushion defect including ostium primum atrial septal defect and anterior mitral leaflet cleft, presents less significant clinical symptoms than complete endocardial cushion defect. But, as mitral insufficiency develops, cardiomegaly, congestive heart failure, pulmonary arterial hypypertension appear. So, partial endocardial cushion defect has poor prognosis and is rarely seen in elderly patients. A 67 years old woman admitted at our hospital for operative treatment with partial endocardial cushion defect. She had increased pulmonary pressure of 45/22 mmHg, mean 32 mmHg. She had repair of ostium primum defect with patch, and the mitral valve was treated with valve replacement. Because advanced atrioventricular block developed postoperatively, she received permanent pacemaker.

Clinical Features and the Risk Factors of Distant Metastasis in Locally Advanced Advanced Head and Neck Cancer Patients after Induction Chemotherapy Followed Locoregional Control Therapy (유도화학요법 및 국소 치료 후 원격전이를 보인 국소 진행성 두경부암 환자군의 임상 특징 및 위험인자에 관한 연구)

  • Lee, Hye-Won;Baek, Dong-Hoon;Lee, Kyung-Nam;Cho, Eun-Jung;Kim, Hyo-Jeong;Seol, Young-Mi;Song, Moo-Kon;Choi, Young-Jin;Shin, Ho-Jin;Chung, Joo-Seop;Cho, Goon-Jae
    • Korean Journal of Head & Neck Oncology
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    • v.27 no.2
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    • pp.177-182
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    • 2011
  • Backgrounds : Head and neck cancer is one of the most prevalent cancers in the world. It tends to remain localized at the primary site and regional lymph nodes, but if distant metastasis occurs, it has a poor prognosis. This study was performed to evaluate the prevalence of distant metastasis and to determine the risk factor in locally advanced head and neck cancer after induction chemotherapy followed locoregional control therapy. Methods : A retrospective review was performed in 420 patients with locally advanced head and neck cancer who treated with induction chemotherapy followed locoregional control therapy from January 2001 to December 2010. Among them, 31 patients who had distant metastasis as first relapse within 2 years after termination of therapy were analyzed for clinical features and the risk factors of distant metastasis. Results : The overall incidence of distant metastasis was 7.3%. The bone, lung, and liver were the most frequent metastatic organs. In univariate analysis, nodal stage, nasopharyngeal cancer, laryngeal cancer, G3/G4 neutropenia during induction chemotherapy, and concurrent chemoradiotherapy were the influencing factors for distant metastasis. In multivariate analysis, advanced N stage and nasopharynx were the risk factors of distant metastasis, and grade 3/4 neutropenia during induction chemotherapy was considered to decrease distant metastasis. Conclusion : This study suggests that the advanced N stage is the risk factor of distant metastasis and Grade 3/4 neutropenia during induction chemotherapy can be beneficial against distant metastasis in locally advanced head and neck cancer patients treated with induction chemotherapy followed locoregional control therapy.

Response of Triple Negative Breast Cancer to Neoadjuvant Chemotherapy: Correlation between Ki-67 Expression and Pathological Response

  • Elnemr, Gamal M;El-Rashidy, Ahmed H;Osman, Ahmed H;Issa, Lotfi F;Abbas, Osama A;Al-Zahrani, Abdullah S;El-Seman, Sheriff M;Mohammed, Amrallah A;Hassan, Abdelghani A
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.807-813
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    • 2016
  • Triple-negative breast cancers constitute about 15% of all cases, but despite their higher response to neoadjuvant chemotherapy, the tumors are very aggressive and associated with a poor prognosis as well as a higher risk of early recurrence. This study was retrospectively performed on 101 patients with stage II and III invasive breast cancer who received 6-8 cycles of neo-adjuvant chemotherapy. Out of the total, 23 were in the triple negative breast cancer subgroup. Nuclear Ki-67 expression in both the large cohort group (n=101) and triple negative breast cancer subgroup (n=23) and its relation to the pathological response were evaluated. The purpose of the study was to identify the predictive value of nuclear protein Ki-67 expression among patients with invasive breast cancers, involving the triple negative breast cancer subgroup, treated with neoadjuvant chemotherapy in correlation to the rate of pathological complete response. The proliferation marker Ki-67 expression was highest in the triple negative breast cancer subgroup. No appreciable difference in the rate of Ki-67 expression in triple negative breast cancer subgroup using either a cutoff of 14% or 35%. Triple negative breast cancer subgroup showed lower rates of pathological complete response. Achievement of pathological complete response was significantly correlated with smaller tumor size and higher Ki-67 expression. The majority of triple negative breast cancer cases achieved pathological partial response. The study concluded that Ki-67 is a useful tool to predict chemosensitivity in the setting of neoadjuvant chemotherapy for invasive breast cancer but not for the triple negative breast cancer subgroup.

ST6Gal-I Predicts Postoperative Clinical Outcome for Patients with Localized Clear-cell Renal Cell Carcinoma

  • Liu, Hai-Ou;Wu, Qian;Liu, Wei-Si;Liu, Yi-Dong;Fu, Qiang;Zhang, Wei-Juan;Xu, Le;Xu, Jie-Jie
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10217-10223
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    • 2015
  • Hyperactivated ${\alpha}2$-6-sialylation on N-glycans due to overexpression of the Golgi enzyme ${\beta}$-galactoside: ${\alpha}2$-6-sialyltransferase (ST6Gal-I) often correlates with cancer progression, metastasis, and poor prognosis. This study was aimed to determine the association between ST6Gal-I expression and the risk of recurrence and survival of patients with localized clear-cell renal cell carcinoma (ccRCC) following surgery. We retrospectively enrolled 391 patients (265 in training cohort and 126 in validation cohort) with localized ccRCC underwent nephrectomy at a single center. Tissue microarrays were constructed for immunostaining of ST6Gal-I. Prognostic value and clinical outcomes were evaluated. High ST6Gal-I expression was associated with Fuhrman grade (p<0.001 and p=0.016, respectively) and the University of California Los-Angeles Integrated Staging System (UISS) score (p=0.004 and p=0.017, respectively) in both cohorts. Patients with high ST6Gal-I expression had significantly worse overall survival (OS) (p<0.001 and p<0.001, respectively) and recurrence free survival (RFS) (p<0.001 and p=0.002, respectively) than those with low expression in both cohorts. On multivariate analysis, ST6Gal-I expression remained associated with OS and RFS even after adjusting for the UISS score. Stratified analysis suggested that the association is more pronounced among patients with low and intermediate-risk disease defined by the UISS score. High ST6Gal-I expression is a potential independent adverse predictor of survival and recurrence in ccRCC patients, and the prognostic value is most prominent in those with low and intermediate-risk disease defined by the UISS score.

Long Non-coding RNAs are Differentially Expressed in Hepatocellular Carcinoma Cell Lines with Differing Metastatic Potential

  • Fang, Ting-Ting;Sun, Xiao-Jing;Chen, Jie;Zhao, Yan;Sun, Rui-Xia;Ren, Ning;Liu, Bin-Bin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10513-10524
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    • 2015
  • Background: Metastasis is a major reason for poor prognosis in patients with cancer, including hepatocellular carcinoma (HCC). A salient feature is the ability of cancer cells to colonize different organs. Long non-coding RNAs (lncRNAs) play important roles in numerous cellular processes, including metastasis. Materials and Methods: In this study, the lncRNA expression profiles of two HCC cell lines, one with high potential for metastasis to the lung (HCCLM3) and the other to lymph nodes (HCCLYM-H2) were assessed using the Arraystar Human LncRNA Array v2.0, which contains 33,045 lncRNAs and 30,215 mRNAs. Coding-non-coding gene co-expression (CNC) networks were constructed and gene set enrichment analysis (GSEA) was performed to identify lncRNAs with potential functions in organ-specific metastasis. Levels of two representative lncRNAs and one representative mRNA, RP5-1014O16.1, lincRNA-TSPAN8 and TSPAN8, were further detected in HCC cell lines with differing metastasis potential by qRT-PCR. Results: Using microarray data, we identified 1,482 lncRNAs and 1,629 mRNAs that were differentially expressed (${\geq}1.5$ fold-change) between the two HCC cell lines. The most upregulated lncRNAs in H2 were RP11-672F9.1, RP5-1014O16.1, and RP11-501G6.1, while the most downregulated ones were lincRNA-TSPAN8, lincRNA-CALCA, C14orf132, NCRNA00173, and CR613944. The most upregulated mRNAs in H2 were C15orf48, PSG2, and PSG8, while the most downregulated ones were CALCB, CD81, CD24, TSPAN8, and SOST. Among them, lincRNA-TSPAN8 and TSPAN8 were found highly expressed in high lung metastatic potential HCC cells, while lowly expressed in no or low lung metastatic potential HCC cells. RP5-1014O16.1 was highly expressed in high lymphatic metastatic potential HCC cell lines, while lowly expressed in no lymphatic metastatic potential HCC cell lines. Conclusions: We provide the first detailed description of lncRNA expression profiles related to organ-specific metastasis in HCC. We demonstrated that a large number of lncRNAs may play important roles in driving HCC cells to metastasize to different sites; these lncRNAs may provide novel molecular biomarkers and offer a new basis for combating metastasis in HCC cases.

Association of CYP39A1, RUNX2 and Oxidized Alpha-1 Antitrypsin Expression in Relation to Cholangiocarcinoma Progression

  • Khenjanta, Chakkaphan;Thanan, Raynoo;Jusakul, Apinya;Techasen, Anchalee;Jamnongkan, Wassana;Namwat, Nisana;Loilome, Watcharin;Pairojkul, Chawalit;Yongvanit, Puangrat
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10187-10192
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    • 2015
  • Cytochrome P450 (CYP) enzymes are a large family of constitutive and inducible mono-oxygenase enzymes that play a central role in the oxidative metabolism of both xenobiotic and endogenous compounds. Several CYPs are involved in metabolism of oxysterols, which are cholesterol oxidation products whose expression may be dysregulated in inflammation-related diseases including cancer. This study focused on CYP39A1, which can metabolize 24-hydroxycholesterol (24-OH) that plays important roles in the inflammatory response and oxidative stress. We aimed to investigate the expression status of CYP39A1 and its transcription factor (RUNX2) in relation to clinical significance in cholangiocarcinoma (CCAs) and to determine whether 24-OH could induce oxidative stress in CCA cell lines. Immunohistochemistry showed that 70% and 30% of CCA patients had low and high expression of CYP39A1, respectively. Low expression of CYP39A1 demonstrated a significant correlation with metastasis. Our results also revealed that the expression of RUNX2 had a positive correlation with CYP39A1. Low expression of both CYP39A1 (70%) and RUNX2 (37%) was significantly related with poor prognosis of CCA patients. Interestingly, oxidized alpha-1 antitrypsin (ox-A1AT), an oxidative stress marker, was significantly increased in CCA tissues in which CYP39A1 and RUNX2 were down regulated. Additionally, immunocytochemistry showed that 24-OH could induce ox-A1AT in CCA cell lines. In conclusion, our study revealed putative roles of the CYP39A1 enzyme in prognostic determination of CCAs.

CD3+ CD4+ and CD3+ CD8+ Lymphocyte Subgroups and their Surface Receptors NKG2D and NKG2A in Patients with Non-small Cell Lung Cancer

  • Yu, Da-Ping;Han, Yi;Zhao, Qiu-Yue;Liu, Zhi-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2685-2688
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    • 2014
  • Background: To explore the prevalence of lymphocyte subgroups $CD3^+$ $CD4^+$ and $CD3^+$ $CD8^+$ and their surface receptors NKG2D and NKG2A in patients with non-small cell lung cancer (NSCLC). Materials and Methods: A total of 40 patients with NSCLC were divided into different groups according to different clinical factors (TNM staging, pathological patterns and genders) for assessment of relations with $CD3^+$ $CD4^+$ and $CD3^+$ $CD8^+$ and the surface receptors NKG2D and NKG2A of T lymphocytes in peripheral blood by flow cytometry. Results: Patients in the advanced group had evidently lower levels of $CD3^+$ $CD4^+$ but markedly higher levels of $CD3^+$ $CD8^+$ in peripheral blood than those with early lesions (p<0.05). In addition, NSCLC patients in the advanced group had obviously higher $CD3^+$ $CD4^+$ NKG2D and $CD3^+$ $CD8^+$ NKG2A expression rates but lower $CD3^+$ $CD4^+$ NKG2A and $CD3^+$ $CD8^+$ NKG2D expression rates (p<0.05). However, there were no significant differences between NSCLC patients with different genders and pathological patterns in expression levels of lymphocyte subgroups $CD3^+$ $CD4^+$ and $CD3^+$ $CD8^+$ and their surface receptors NKG2D and NKG2A. Conclusions: Unbalanced expression of surface receptors NKG2D and NKG2A in $CD3^+$ $CD4^+$ and $CD3^+$ $CD8^+$ lymphocytes may be associated with a poor prognosis, greater malignancy and immunological evasion by advanced cancers, related to progression of lung cancer.

Evaluation of Treatment Outcomes of Early-Stage Endometrial Cancer Radiotherapy: A Single Center Experience

  • Demiral, S.;Beyzadeoglu, M.;Sager, O.;Dincoglan, F.;Uysal, B.;Gamsiz, H.;Akin, M.;Turker, T.;Dirican, B.
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9599-9602
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    • 2014
  • Background: Postoperative adjuvant radiotherapy (RT) in the management of early stage endometrial cancer (EC) is still controversial. Here we report our institutional experience with patients who received postoperative RT for stage I-II EC over a period of 35 years and assess potential predictors of local recurrence (LR), distant metastasis (DM), and overall survival (OS). Materials and Methods: A total of 188 patients undergoing postoperative RT for stage IA-II EC between 1977 and 2012 were evaluated. Some 96 received median 46 Gy whole pelvic radiotherapy (WPRT) (range: 40-60 Gy), 37 were given WPRT with vaginal cuff therapy (VCT), and 55 received only VCT either with brachytherapy (BT) or stereotactic body radiotherapy (SBRT). Chemotherapy was given to 5 patients with uterine papillary serous carcinoma (UPSC). Logistic regression analysis was used to assess the effect of clinicopathological factors on LR, DM, and OS. Results: Median follow-up time was 11 years (range: 1-35 years). At the time of analysis, 34 patients were not alive. Of the 15 patients with LR, 7 (46.7%) recurred in the vaginal stump, 5 (33.3%) in the pelvic region, and 3 (20%) in the paraaortic nodal region, while 12 had distant metastasis. UPSC histology (p=0.027), sole VCT (p=0.041), high histologic grade (p=0.034), and age ${\geq}71$ (p=0.04) were poor prognostic factors on univariate analysis. Conclusions: In our patients receiving radiotherapy for early-stage EC, grade III disease and age ${\geq}71$ were associated with shorter OS whereas UPSC histology was an independent predictor for both LR and DM.

The XPD Lys751Gln Polymorphism has Predictive Value in Colorectal Cancer Patients Receiving Oxaliplatin-Based Chemotherapy: a Systemic Review and Meta-analysis

  • Qian, Ying-Ying;Liu, Xin-You;Pei, Dong;Xu, Jia-Li;Shen, Hua;Chen, Xiao-Feng;Liu, Yi-Qian;Shen, Li-Zong;Shu, Yong-Qian
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9699-9706
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    • 2014
  • Background: The predictive value of the xeroderma pigmentosum group D (XPD) Lys751Gln polymorphism regarding clinical outcomes of patients with colorectal cancer (CRC) receiving oxaliplatin-based chemotherapy has been evaluated in numerous published studies, but the results remain inconclusive. Therefore, we performed a meta-analysis to determine the precise role of the XPD Lys751Gln polymorphism in this clinical situation and optimize individual chemotherapy. Materials and Methods: A multiple search strategy was used to identify eligible studies. Pooled odds ratios (ORs), generalized odds ratio (ORG) and their 95% confidence intervals (CIs) were used to estimate the objective response, while hazard ratios (HRs) with 95%CIs were used for progression-free survival (PFS) and overall survival (OS). Results: A total of 17 studies including 2,286 patients met the inclusion criteria. Overall, the XPD 751Gln allele was associated with a non-significant reduced objective response to oxaliplatin-based chemotherapy in all patients or in the Asian and Caucasian subgroups. However, poor PFS and OS of CRC patients treated with oxaliplatin-based regimens were significantly related to the XPD 751Gln allele in the dominant model (PFS: HR=2.10, 95%CI: 1.65-2.67; OS: HR=3.18, 95%CI: 1.57-6.47). On stratified analysis by ethnicity, these relationships were more pronounced in Asians (PFS: HR=2.49, 95%CI: 1.79-3.47; OS: HR=5.25, 95%CI: 3.46-7.94) than in Caucasians (PFS: HR=1.73, 95%CI: 1.22-2.46; OS: HR=1.78, 95%CI: 1.06-2.99). Conclusions: The XPD Lys751Gln polymorphism may have prognostic value in patients with CRC undergoing oxaliplatin-based chemotherapy.

Clinical & Radiologic Result of Arthroscopic Bankart Repair Using Knotless Suture Anchor (비매듭 금속 봉합 나사못을 이용한 관절경적 방카트 복원술: 임상적 및 방사선학적 결과의 비교)

  • Oh, Jung-Hwan;Lee, Sang-Hoon;Park, Hong-Keun;Jeon, Suk-Ha;Park, Joon-Suk;Kim, Cheol-Ki;Park, Jin-Young
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.135-141
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    • 2008
  • Purpose: To study the clinical and radiologic results with arthroscopic Bankart repair using knotless metal suture anchor. Materials and Methods: From February 2001 to January 2005, 68 patients, who underwent arthroscopic Bankart repair using knotless suture anchor and were followed up more than 12 months, were evaluated. A mean follow-up period was 34 months. All shoulders were evaluated by Rowe scoring system, range of motion of the shoulder, pain degree of VAS, and This was compared by radiologic findings after surgery. Results: The Rowe scoring system was 43.30 preoperatively, which improved to 95.55 postoperatively. At last follow-up, there was no significance difference between operated shoulder and non-operated shoulder in range of motion. The degree of VAS was measured from 3.3 preoperatively to 0.5 postoperatively. The radiolucent line was shown around suture anchor in 15 shoulders. 2 shoulders of 15 shoulders were reoperated due to redislocation and anchor arthropathy. In Odds ratio, this group (15 patients) had more 2.6 times the subjective instability than other group (53 patients). Conclusion: Arthroscopic Bankart repair using knotless anchor suture is very effective operative technique. But we have to be careful because the radiolucent line around anchor showed up during a follow -up period may indicate poor prognosis.

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