• Title/Summary/Keyword: Regional metastasis

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Long Term Outcomes of Patients with Endometrial Carcinoma Treated with Radiation - Siriraj Hospital Experience

  • Setakornnukul, Jiraporn;Petsuksiri, Janjira;Wanglikitkoon, Sirentra;Warnnissorn, Malee;Thephamongkhol, Kullathorn;Chansilp, Yaowalak;Veerasarn, Vutisiri
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2279-2285
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    • 2014
  • Background: To evaluate treatment outcomes of patients with stage I-III endometrial cancer treated with postoperative radiation. Materials and Methods: A retrospective review of 166 endometrial cancer patients, undergoing surgery and postoperative radiotherapy at Siriraj Hospital from 2005-2008 was performed. Pathology was reviewed. Results of treatment were reported with 5-year loco-regional recurrence free survival (LRRFS), 5-year overall survival (OS), patterns of failure and toxicity, and according to stage and risk groups. Results: Median follow up time was 62.8 months. Pathological changes were found in 36.3% of the patients after central reviews, leading to 19% changes in risk groups. Most of the patients (83.7%) received pelvic radiation (PRT) and vaginal brachytherapy (VBT). Five-year LRRFS and OS of all patients were 94.9% and 85.5%, respectively. There was no recurrence or death in low and low-intermediate risk groups. For the high-intermediate risk group, 5-year LRRFS and OS were 96.2% and 90.8%, respectively, and for the high risk group 90.5% and 71%. Late grade 3 and 5 gastrointestinal toxicity was found in 3% and 1.2% of patients, respectively. All of them received PRT 5,000 cGy in 25 fractions. Conclusions: Low and intermediate risk patients had good results with surgery and adjuvant radiation therapy. For high risk patients, postoperative radiation therapy alone appeared to be inadequate as the most common pattern of failure was distant metastasis.

Lack of any Prognostic Role of Insulin-Like Growth Factor-1 Receptor in Non-Small Cell Lung Cancer

  • Dilli, Utku Donem;Yildırim, Mustafa;Suren, Dinc;Alikanoglu, Arsenal;Kaya, Vildan;Goktas, Sevil;Yildiz, Mustafa;Sezer, Cem;Gunduz, Seyda
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5753-5757
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    • 2014
  • Background: The purpose of this study is to determine whether the IGF1R expression has a prognostic role in non-small cell lung cancer. Materials and Methods: Forty-seven patients histopathologically diagnosed with small cell lung cancer upon bronchoscopic biopsy or resection materials were included in the study. IGF1R expression was examined via immunohistochemical methods. In samples, >10% staining were assessed as positive and ${\leq}10%$ as negative. Information about demographic datas and treatments was obtained by retrospective searches of patient files. Results: IGF1R expression was determined as positive in 38 (80.9%) and as negative in 9 (19.1%) patients. There was no significant relation between IGF1R expression and histological sub-type, local invasion, lymph node and metastasis status (p=0.842, p=0.437, 0.064, 0.447, respectively). There was also no correlation with IGF1R expression and survival (p=0.141). Conclusions: There are conflicting results between IGF1R and its prognostic effects in the various studies. It has been claimed in some studies it is not related to prognosis as in our study, and in some studies it has been claimed that it is a good prognostic factor whereas in some studies it has been claimed as being a factor for worse prognosis. We think that IGF1R expression in non-small cell lung carcinoma patients deserves further analysis, because of its potential prognostic and predictive roles.

Radiotherapy of Squamous Cell Carcinoma of Maxillary Antrum (원발성 상악동 편평상피암의 방사선치료)

  • Yun, Hyong-Geun;Park, Charn-Il;Kim, Kwang-Hyun
    • Radiation Oncology Journal
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    • v.8 no.1
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    • pp.45-50
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    • 1990
  • One hundred-ten patients with squamous cell carcinoma of the maxillary antrum treated at the Department of Therapeutic Radiology, Seoul National Unviersity Hospital between February 1979 and September 1986 were retrospectively analyzed. Of these, only 73 patients were eligible for analysis. Forty-one patients were treated with combination of surgery and radiation therapy and 32 patients were treated with radiation therapy alone. The majority of patients had advanced stage (including $47\%\;T_4$ tumor). Overall 5 year survival rate was $40.0\%$. In the radiotherapy alone group,5 year survival rate was $22.1\%$, and in the combined surgery and radiotherapy group,5 year survival rate was $65.3\%$. Of 31 patients who had failures,22 patients ($71.0\%$) had local failures, 6 patients ($19.3\%$) had regional failures and 3 patients ($9.7\%$) had distant metastasis. Planned combined treatment with surgery followed by radiation therapy is an effective modality for carcinoma of the maxillary antrum.

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Adverse effect of excess body weight on survival in cervical cancer patients after surgery and radiotherapy

  • Choi, Yunseon;Ahn, Ki Jung;Park, Sung Kwang;Cho, Heunglae;Lee, Ji Young
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.48-54
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    • 2017
  • Purpose: This study aimed to assess the effects of body mass index (BMI) on survival in cervical cancer patients who had undergone surgery and radiotherapy (RT). Materials and Methods: We retrospectively reviewed the medical records of 70 cervical cancer patients who underwent surgery and RT from 2007 to 2012. Among them, 40 patients (57.1%) had pelvic lymph node metastases at the time of diagnosis. Sixty-seven patients (95.7%) had received chemotherapy. All patients had undergone surgery and postoperative RT. Median BMI of patients was $22.8kg/m^2$ (range, 17.7 to $35.9kg/m^2$). Results: The median duration of follow-up was 52.3 months (range, 16 to 107 months). Twenty-four patients (34.3%) showed recurrence. Local failure, regional lymph nodal failure, and distant failure occurred in 4 (5.7%), 6 (8.6%), and 17 (24.3%) patients, respectively. The 5-year actuarial pelvic control rate was 83.4%. The 5-year cancer-specific survival (CSS) and disease-free survival (DFS) rates were 85.1% and 65.0%, respectively. The presence of pelvic lymph node metastases (n = 30) and being overweight or obese (n = 34, $BMI{\geq}23kg/m^2$) were poor prognostic factors for CSS (p = 0.003 and p = 0.045, respectively). Of these, pelvic lymph node metastasis was an independent prognostic factor (p = 0.030) for CSS. Conclusion: Overweight or obese cervical cancer patients showed poorer survival outcomes than normal weight or underweight patients. Weight control seems to be important in cervical cancer patients to improve clinical outcomes.

Cold Lesions in $^{99m}Tc$-MDP Bone Scans of Patients with Skeletal Metastases ($^{99m}Tc$-MDP 골스캔에서 냉소로 나타난 전이 암의 분석)

  • Choi, C.W.;Yang, H.I.;Bae, S.K.;Lee, D.S.;Sohn, I.;Chung, J.K.;Lee, M.C.;Koh, C.S.
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.98-103
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    • 1993
  • The present study was purposed to evaluate the incidence and the characteristics of metastatic "cold" lesions in $^{99m}Tc$-MDP bone scans of adult patients with solid malignancies. There were 29 cold lesions in 24 patients. The incidence of cold lesions was about 1% of total cases of bone scans for the patients with malignancy, or 2.5% of cases with bone metastases. Th primary sites of malignancies were lung (four cases), uterine cervix (three cases), kidney, nasopharynx, thyroid, urinary bladder, prostate, lymphoma (two cases each other), liver, breast and others (one case each other). But the relative incidence of cold lesion in lung cancer and breast cancer was low. The most frequent site of cold lesion was spine, and pelvis, skull and rib were followed. The incidence of cold lesion was related to the regional incidence of bone metastases. The size of the cold lesions was greater than that of the hot. There were six cases of single cold lesion without any other abnormalities and two cases of cold lesion which were initially hot. So it should be considered that bone metastases might be presented as cold lesions in bone scan.

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A Clinical Analysis of Peripheral Nerve Sheath Tumors in the Head and Neck Region (두경부 말초신경초종의 임상적 고찰)

  • Kang, Seok-Young;Shin, Myung-Chul;Yoo, Han-Seok;Lee, Yong-Seop;Park, Chul-Won;Tae, Kyung
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.2
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    • pp.174-178
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    • 2008
  • Background and Objectives:Peripheral nerve sheath tumors(PNSTs) are uncommon neoplasm in the head and neck region. The treatment of PNSTs is surgical removal, but excision cause neurologic complications. This study was performed to evaluate the proper diagnosis and treatment of PNSTs with our experiences. Subjects and Method:During the period from October 1994 to July 2007, 58 patients were diagonised with PNSTs in head and neck region. We reviewed medical records and imaging study retrospectively. Result:95%(55/58) of the PNSTs in head and neck were benign;5%(3/58) were malignant peripheralnerve sheath tumors(MPNSTs). 63%(37/58) were neurilemoma, 20%(17/20) were neurofibroma, 2%(1/58) was perineuroma. 55 patients underwent surgery. 80%(45/55) of cases were treated with excision. Enucleation was performed in 7(14%) patients. All cases of benign neurogenic tumors showed no recurrence. Among 3 of MPNSTs 2 patients were Von Recklinghausen’s disease and expired with regional recurrence and lung metastasis. Conclusion:The benign PNSTs can be treated with enucleation if possible and observation can be another choice to minimize neurologic sequele.

A CASE REPORT OF SYNOVIAL SARCOMA (활액성 육종의 증례 보고)

  • Lee, Baek-Soo;Choi, Keun-Lak;Oh, Jung-Hwan;Lee, Sang-Chull;Kim, Yeo-Gab;Ryu, Dong-Mok;Kwon, Yong-Dae;Kim, Si-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.3
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    • pp.223-227
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    • 2004
  • A malignant sarcoma of soft tissue that arises near but not in a joint, most often in an adolescent or young adult, is typically slowgrowing, and may escapes notice until it causes pain. The diagnosis of this tumor can be suspected by X-ray or imaging, made by biopsy, and confirmed by chromosome studies. Cytogenic studies reveal a translocation between the X chromosome and chromosome 18 in the tumor cells. The most common treatment for the tumor is surgery to remove the entire tumor, nearby muscle, and lymph nodes. Synovial sarcoma tends to recur locally and to involve regional lymph nodes. Distant metastasis occurs in half cases. The well-documented and adequately followed cases are currently lacking and this report described an instance of Synovial sarcoma good result after treatment and review of literature.

Clinicopathologic Significance of Gastric Adenocarcinoma with Neuroendocrine Features

  • Kim, Jang-Jin;Kim, June-Young;Hur, Hoon;Cho, Yong-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.11 no.4
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    • pp.195-199
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    • 2011
  • Purpose: Composite neuroendocrine-exocrine carcinomas are malignancies that have two distinct components residing within the same tumor: an adenocarcinomatous portion and a neuroendocrine portion. This is rare in gastric cancers; however, poorly differentiated adenocarcinomas can sometimes reveal evidence of neuroendocrine features (NEF) or be 'mixed endocrine and exocrine carcinomas'. This study aimed to review NEF in gastric adenocarcinoma and to evaluate its prognostic significance. Materials and Methods: We selected 29 patients who were diagnosed with gastric adenocarcinoma with NEF and received gastrectomies at the Department of Surgery, Ajou University Hospital between January 2001 and December 2009. We analyzed the clinicopathologic features of gastric cancer with NEF and the prognosis associated with such tumors. Results: The pathologic result with respect to TNM staging of the gastric cancers with NEF were as follows: 5 cases of T1, 5 cases of T2, 10 cases of T3, and 9 cases of T4. There were 7 cases of N0, 7 cases of N1, 8 cases of N2 and 7 cases of N3. The staging of patients with NEF was higher than that of patients without NEF. Especially tumor lymphovascular invasion rate was 82.8%. The overall survival of patients with gastric cancer characterized by NEF was 73.8 months. Conclusions: Positive NEF status might be correlated with clinicopathologic parameters such as a high stage and high frequency of regional lymph node metastasis.

THE APPLICATION OF NECK DISSECTION IN THE TREATMENT OF ORAL CANCER (구강암 치료에 있어 경부곽청술의 응용)

  • Kim, Chin-Soo;Kim, Sung-Kook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.1_2
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    • pp.97-104
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    • 1992
  • This is a report of three cancer patients treated with the different methods of neck dissection considering the state of the each patient. 1. A 76-year old femals patient who showed $T2_N0_M0$ squamous cell carcinoma received the regional neck dissection with resection of primary lesion. The postoperative result was uneventful without recurrence for 3.6 years. 2. A 52-year old male patient who was diagosed $_T3_N1_M0$ squamous cell carcinoma was treated with the bilateral neck dissection and radical resection of primary lesion. Metastasis was noticed on the right scapular area 8 months postoperatively. We treated him with radiation and chemotherapy, but he died 13 months postoperatively. 3. A 55-year old male patient who showed $_T2_N1_M0$ squamous cell cvarcinoma was treated with the classical neck dissection and the radical resection of primary lesion. The postoperative result was good with no recurrence for 4 years.

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Comparision of I-131 Diagnostic Scan and Therapeutic Scan in Thyroid Carcinoma (갑상선암 환자에서 I-131의 진단적 전신스캔과 치료후 전신스캔의 비교)

  • Lee, Bum-Woo;Lee, Dong-Soo;Moon, Dae-Hyuk;Chung, June-Key;Lee, Myung-Chul;Cho, Bo-Youn;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.1
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    • pp.80-86
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    • 1990
  • Fifty seven patients with differentiated thyroid carcinoma were performed radioactive iodine-131 whole body scans after administration of diagnostic dose $(2\sim10\;mCi)$ and therapeutic dose $(30\sim150\;mCi)$ within three months. We evaluated the state of radioactive iodine-131 uptakes in whole body scan to detect correct metastasis of thyroid carcinoma. The results are as follows: 1) In 20 of the 57 patients (35%), the therapeutic scan showed the additional uptakes that were not seen in the diagnostic scan. 2) In 9 (64.2%) of the 14 patients who had been received the thyroid ablation theraphy with I-131 previously, new additional lesions were found in the therapeutic scan but only 11 (25%) of the 32 patients who had not been received the thyroid ablation theraphy disclosed new uptake lesions (p < 0.01). 3) The additional uptake lesions of therapeutic scan were significantly more common in the bony metastatic foci (55.7%) than other areas (p < 0.01). In 11 (55%) of 20 patients, additional uptake regions were anterior neck areas (thyroid bed or regional lymph node). We conclude that diagnostic scan with $2\sim5$ mCi I-131 is inadequate in evaluating residual iodine avid tissues of patients with thyroid carcinoma. Also post-theraphy I-131 whole body scan would be important to evaluate the correct staging and prognosis of thyroid carcinoma, and to follow-up patients.

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