• Journal of Gastric Cancer
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• v.10 no.3
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• pp.87-90
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• 2010

Early gastric cancer (EGC) is defined as tumor invasion confined to the mucosa or submucosa, regardless of the presence of regional lymph node metastasis. Lymph node metastasis is the most powerful and important prognostic factor for gastric cancer. Based on the risk of lymph node metastasis in EGC obtained from a large number of surgical cases in Japan, it was suggested that the criteria for endoscopic mucosal resection (EMR) and endoscopic submucosal resection (ESD) as local treatment for EGC might be extended. However, extending the indications for EMR and ESD remains controversial because the long-term outcomes of these procedures have not been fully documented, and there is a risk for lymph node metastasis. Furthermore, current diagnostic imaging techniques are unsatisfactory for accurately predicting metastasis to lymph nodes. Moreover, the long-term results of standard radical gastrectomy including minimally invasive procedures for stage IA have been increasing and have reached 99 to 100%. To determine the true efficacy of endoscopic resection of EGC, we need more evidence of long-term follow-up, standardization of techniques, and pathological interpretation.

• Journal of Digestive Cancer Research
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• v.4 no.1
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• pp.39-42
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• 2016

A 67-year-old male was admitted due to abdominal pain. Abdominal CT scan performed in a local clinic showed about 2 cm sized pancreatic tail mass with extensive liver and multiple regional lymph node metastasis. Histology of liver biopsy revealed poorly differentiated adenocarcinoma. He underwent chemotherapy with gemcitabine and erlotinib for 5 cycles followed by 8 cycles of second line chemotherapy with 5-fluorouracil and cisplatin. At 12 months after diagnosis, follow-up abdominal CT scan revealed marked reduction of tumor mass in the liver and pancreas with small residual tumor. After one month of last chemotherapy, he complained radiating pain along left leg. Blood chemistry revealed isolated elevation of alkaline phosphatase (ALP) and multiple bone metastasis were demonstrated in bone scan. Palliative radiation therapy to pelvic bone was performed for the relief of bone pain. The prognosis of advanced pancreatic cancer is extremely poor. We report late occurrence of multiple bone metastasis in a patient with well controlled advanced pancreatic cancer with chemotherapy.

• Journal of Gastric Cancer
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• v.4 no.3
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• pp.180-185
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• 2004

Recently, we experienced two advanced gastric cancer (AGC) patients younger than 17 years of age. The first case was a 15-year, 2-month-old male who had suffered from epigastric soreness for 5 weeks. His grandfather died of gastric cancer at 39 years of age. Under the diagnosis of AGC, he underwent a total gastrectomy with D2 lymph node dissection. There was no evidence of distant metastasis. Pathologic examination revealed a 4.5$\times$4 cm, signet ring cell adenocarcinoma with subserosal invasion and with metastasis in 9 of 42 regional lymph nodes (T2bN2M0). The second case was a 17-year, 11-month-old male who had suffered from epigastric pain for 2 years without familial clustering. Under the diagnosis of AGC, he underwent a distal subtotal gastrectomy with D2 lymph node dissection. There was no evidence of distant metastasis. Pathologic examination revealed a 3$\times$2 cm, signet ring cell adenocarcinoma with subserosal invasion and with metastasis in 9 of 45 regional lymph nodes (T2bN2M0). The two patients have been alive without recurrence for 27 months and 4 months, respectively. Even among teenagers, patients with abdominal complaints should be subjected to a thorough examination of the gastrointestinal tract.

• Korean Journal of Head & Neck Oncology
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• v.18 no.2
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• pp.157-162
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• 2002

Background and Objectives: Adenoid cystic carcinoma (ACC) is a unique tumor characterized by frequent and delayed distant metastasis (DM) with uncommon regional lymph node metastasis. We evaluated the factors affecting DM of ACC and survival after appearance of DM. Materials and Methods: Medical records, radiographs and pathologic slides were reviewed for 94 patients from 1979 through 2001. Results: DM of ACC occurred in 46 patients, and developed more frequently in patients with tumors of the solid histologic subtype than in patients with tubular or cribriform subtypes. DM occurred less frequently in the sinonasal tract, and development of DM was not affected by tumor stage. Disease-specific 5- and 10-year survival rates were 88% and 72% for patients without DM, respectively and 76% and 48% for those with DM(p=0.02). Regarding the site of DM and its impact on outcomes, 30 patients had lung metastasis alone, 5 patients bone metastasis alone and 6 patients developed both lung and bone metastasis. Median survivals after appearance of DM among patients with isolated lung metastases and those with bone metastases with or without lung involvement were 54 and 21 months, respectively (p=0.04). Conclusions: Development of DM in ACC is predicted by solid histologic subtype, and major salivary gland or oral/pharyngeal rather than sinonasal primary site. Those patients with bone involvement with our without lung metastases had worse outcomes than those with pulmonary metastasis only.

• The Korean Journal of Nuclear Medicine
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• v.17 no.2
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• pp.41-47
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• 1983

To evaluate the significance of assay of serum thyroglobulin(Tg) in monitoring the course of the thyroid cancer or its response to treatment, serum thyroglobulin levels were measured in 41 patients with thyroid cancer who visited Seoul National University Hospital from August, 1981 to August, 1982. The results were as follows: 1) Serum Tg levels $1\sim3$ months after thyroidectomy was $31{\pm}23$ ng/ml$(mean{\pm}S.D.)$ in 14 patients without metastasis, $66{\pm}41$ ng/ml in 21 patients with regional metastasis and $176{\pm}59$ ng/ml in 6 patients with distant metastasis and there were significant differences among three groups(p<0.01). 2) Serum Tg levels in 13 patients with metastasis before and after $^{131}I$ treatment were $134{\pm}62ng/ml$ and $67{\pm}52ng/ml$ respectively. 3) In the follow-up measurement of serum Tg levels every 3 months for about 1 year, almost all serum Tg levels were below 60 ng/ml in 12 patients without distant metastasis and serum Tg levels were elevated above 60 ng/ml in 5 of 6 patients with distant metastasis. 4) In 6 patients with distant metastasis, serum Tg levels were elevated in 5 patients and $^{131}I$ whole body scan showed definite metastatic evidence in 3 patients and suspicious evidence in 1 patient. From above results, we concluded that serum Tg level is very useful as an indicator of recurrence or metastasis in patients with thyroid cancer after operation.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10729-10733
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• 2015

Background: Adjuvant androgen deprivation therapy (ADT) is a treatment option for prostate cancer (PC) patients after radical prostatectomy (RP). Although it can achieve a good progression-free survival rate, some patients still develop clinical metastasis. We here investigated risk factors of clinical metastasis in post-prostatectomy patients who received immediate adjuvant ADT. Materials and Methods: We identified 197 patients with non-metastatic PC who underwent RP at our institution between 2000 and 2012, followed by adjuvant ADT. The associations of various clinicopathologic factors with clinical metastasis (primary endpoint) and cancer-specific survival (secondary endpoint) were assessed. Multivariate analysis was conducted using a Cox proportional hazards model. Median follow-up was 87 months after RP. Results: Nine (4.6%) patients developed clinical metastasis and six (3.0%) died from PC. Eight of nine metastatic patients had a pathologic Gleason score (GS) 9 and developed bone metastasis, while the remaining one had pathologic GS 7 and developed metastasis only to para-aortic lymph nodes. On multivariate analyses, pathologic GS ${\geq}9$ and regional lymph node metastasis (pN1) were independent predictors of clinical metastasis and pathologic GS ${\geq}9$ was an independent predictor of cancer-specific death. Conclusions: Pathologic GS ${\geq}9$ and pN1 were independent predictors of clinical metastasis in post-prostatectomy patients who received immediate adjuvant ADT. Furthermore, pathologic GS ${\geq}9$ was an indispensable condition for bone metastasis, which may imply that patients with GS ${\leq}8$ on adjuvant ADT are unlikely to develop bone metastasis.

• Korean Journal of Head & Neck Oncology
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• v.31 no.2
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• pp.86-90
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• 2015

Cystic lymph node metastasis of head and neck squamous cell carcinoma(HNSCC) which presumed to be mainly originated from oropharynx including Waldeyer's ring may present as a benign cystic mass on lateral neck such as branchial cleft cyst. Branchial cleft cyst is one of the most common lateral neck cystic mass which may result in regional infection or lymph adenopathy. Many of previously reported literatures showed the incidence of cystic lymph node metastasis from oropharynx including Waldeyer's ring. Preoperative imaging studies and fine needle aspiration cytology cannot provide the accurate results until excision of cystic mass for the diagnostic or therapeutic purpose. Recently, we experienced the rare case of cystic lymph node metastasis from ipsilateral tonsil, which mimicked infected 2nd branchial cleft cyst. Thus, we reported our experience with presentation of case and review of literatures.

• Toxicological Research
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• v.22 no.4
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• pp.349-356
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• 2006

Diallyl disulfide (DADS), an oil-soluble organosulfur compound in garlic has been reported to suppress tumor growth and to induce apoptosis in cancer. In the present study, we investigated the effects of DADS on pulmonary metastasis of B16-F10 murine melanoma cells. DADS (i.p. 40 mg/kg) significantly (p<0.05) reduced the number of pulmonary metastatic nodules (48%) in experimental pulmonary metastasis assay. We also found that DADS inhibited adhesion, invasion and migration of B16-F10 melanoma cells in a dose-dependent manner. To study the antimetastatic potential of DADS, we performed the effects of DADS on matrix metalloproteinase activity. DADS significantly inhibited the expression of matrix metalloproteinase-2 activity in B16-F10 cells by gelatin zymography. These results suggest that DADS prevent metastasis in part through suppression of migration of B16-F10 melanoma cells by Inhibiting matrix metalloproteirase-2 responsible for degradation of extracellar matrix.

• 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.

• Radiation Oncology Journal
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• v.11 no.2
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• pp.285-294
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• 1993

A total of forty patients with resected N2 stage non-small cell lung cancer treated with postoperative adjuvant radiation therapy between Jan. 1975 and Dec. 1990 at the Department of Radiation Oncology, Yonsei University College of Medicine, Yonsei Cancer Center were retrospectively analysed to evaluate whether postoperative radiation therapy improves survival. Patterns of failure and prognostic factors affecting survival were also analysed. The 5 year overall and disease free survival rate were $26.3\%,\;27.3\%$ and median survival 23.5 months. The 5 year survival rates by T-stage were $T1\;66.7\%,\;T2\;25.6\%\;and\;T3\;12.5\%.$ Loco-regional failure rate was $14.3\%$ and distant metastasis rate was $42.9\%$ and both $2.9\%.$ Statistically significant factor affecting distant failure rate was number of postitive lymph nodes(>=4). This retrospective study suggests that postoperative radiation therapy in resected N2 stage non-small cell lung cancer can reduce loco-regional recurrence and may improve survival rate as compared with other studies which were treated by surgery alone. Further study of systemic control is also needed due to high rate of distant metastasis.