• Title/Summary/Keyword: Regional metastasis

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Clinical outcomes in patients treated with radiotherapy after surgery for cervical cancer

  • Yang, Kyungmi;Park, Won;Huh, Seung Jae;Bae, Duk-Soo;Kim, Byoung-Gie;Lee, Jeong-Won
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.39-47
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    • 2017
  • Purpose: The purpose of this study was to analyze clinical outcomes from cervical cancer and stratify patients into risk groups for prognostic factors for early-stage disease. Materials and Methods: We retrospectively reviewed patients with stage IB or IIA cervical cancer treated with adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) following primary surgery at Samsung Medical Center from 2001 to 2011. Adjuvant RT was added for patients with intermediate-risk factors, and adjuvant CCRT was performed on high-risk patients after surgery. Results: We reviewed 247 patients-149 in the high-risk group and 98 in intermediate-risk group. The median follow-up was 62 months. Loco-regional failure (LRF) alone occurred in 7 patients (2.8%), distant metastasis alone in 37 patients (15.0%) and LRF with DM in 4 patients (1.6%). The 5-year disease-free survival (DFS) and overall survival (OS) rates for both groups were 79.7% and 87.6%, respectively. In the high-risk group, the 5-year DFS and OS probabilities were 72.5% and 81.9%, respectively. Histologic type, pathologic tumor size, and the number of pelvic lymph node (PLN) metastasis were significant prognostic factors for DFS and OS. We suggest a scoring system (0-3) using these prognostic factors to predict poor prognosis in high-risk patients. Using this system, patients with higher scores have higher recurrence and lower survival rates. Conclusion: In the high-risk cervical-cancer group who received primary surgery and adjuvant CCRT, non-squamous type, large tumor size and the number of PLN metastasis were significant prognostic factors, and the number of these factors was associated with survival rates.

A Case Report on Papillary Thyroid Cancer for the Recurrence of Regional Cervical Lymph Nodes improved by Korean medicine (갑상선 유두암으로 수술 후 좌우 림프절 전이 환자의 장기간 복합 한의약 치료 증례보고)

  • Hae-won, Lee;Soo-bin, Lee;Hye-won, Kim;Jin-Gu, No;Hye In, Jeong;Jun-Hyoung, Kim;Kyeong Han, Kim
    • Journal of Society of Preventive Korean Medicine
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    • v.26 no.3
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    • pp.29-40
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    • 2022
  • Objective : This study assessed the effect of a combination of Korean medicine on a thyroid papillary cancer patient who was diagnosed with local lymph node metastasis after thyroidectomy and lymph node dissection but did not want surgery. Methods : Gami-Palmultang administration and moxibustion(large Bmoxa cautery) were performed for six years. Treatment outcomes were evaluated with Brief Fatigue Inventory (BFI), Numerical Rating Scale (NRS), Insomnia Severity Index (ISI), Functional Assessment of Cancer Therapy-General (FACT-G), blood test/ CT imaging results, and patient's statements. Results : After the treatment, all symptoms have been alleviated, the quality of life has increased, and it has been maintained without further metastasis of tumors for six years. Conclusion : Korean medicine treatment along with active observation can be an alternative to patients who do not want surgical treatment after recurrence of local lymph nodes in thyroid papillary cancer, and can have positive results in improving the quality of life.

Role of Postoperative Radiotherapy for Patients with Pathological Stage III Non-Small-Cell Lung Cancer after Curative Resection (근치적 절제술 후 병기3의 비소세포성 폐암에서 수술 후 방사선 치료의 역할)

  • Kim, Mi-Young;Wu, Hong-Gyun;Kim, Hak-Jae;Heo, Dae-Seog;Kim, Young-Whan;Kim, Dong-Wan;Lee, Se-Hoon;Kim, Joo-Hyun;Kim, Young-Tae;Kang, Chang-Hyun
    • Radiation Oncology Journal
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    • v.29 no.1
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    • pp.44-52
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    • 2011
  • Purpose: To evaluate the outcomes and prognostic factors of postoperative radiotherapy (PORT) for patients with pathological stage III non-small-cell lung cancer (NSCLC) at a single institution. Materials and Methods: From 2000 to 2007, 88 patients diagnosed as having pathologic stage III NSCLC after curative resection were treated with PORT. There were 80 patients with pathologic stage IIIA and eight patients with pathologic stage IIIB in the AJCC 6th staging system. The majority of patients (n=83) had pathologic N2 disease, and 56 patients had single station mediastinal LN metastasis. PORT was administered using conventional technique (n=76) or three-dimensional conformal technique (n=12). The median radiation dose was 54 Gy (range, 30.6 to 63 Gy). Thirty-six patients received chemotherapy. Radiation pneumonitis was graded by the Radiation Therapy Oncology Group system, and other treatment-related toxicities were assessed by CTCAE v 3.0. Results: Median survival was 54 months (range, 26 to 77 months). The 5-year overall survival (OS) and disease free survival (DFS) rates were 45% and 38%, respectively. The number of metastatic lymph nodes was associated with overall survival (hazard ratio, 1.037; p-value=0.040). The 5-year locoregional recurrence free survival (LRFS) and distant metastasis free survival (DMFS) rates were 88% and 48%, respectively. Multiple stations of mediastinal lymph node metastasis was associated with decreased DFS and DMFS rates (p-value=0.0014 and 0.0044, respectively). Fifty-one relapses occurred at the following sites: 10 loco-regional, 41 distant metastasis. Grade 2 radiation pneumonitis was seen in three patients, and symptoms were well tolerated with anti-tussive medication. Grade 2 radiation esophagitis was seen in 11 patients. There were no grade 3 or more severe complications associated with PORT. Conclusion: Our retrospective data show that PORT for pathological stage III NSCLC is a safe and feasible treatment and could improve loco-regional control. The number of metastatic lymph nodes and stations of mediastinal lymph node metastasis were analyzed as prognostic factors. Furthermore, efforts are needed to reduce distant metastasis, which is a major failure pattern of advanced stage NSCLC.

Value of Postoperative Radiation Therapy for Regional Control after Dissection in Head and Neck Squamous Cell Carcinoma Cases

  • Li, Xiao-Ming;Di, Bin;Shang, Yao-Dong;Tao, Zhen-Feng;Cheng, Ji-Min;He, Zhan-Guo
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4273-4278
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    • 2013
  • Objective: We aimed to define clinicopathologic risk factors associated with regional recurrence (RR) and thus the effectiveness of postoperative radiotherapy (PORT) for neck control for head and neck squamous cell carcinomas (HNSCCs) with differing cervical lymph node status. Methods: A retrospective study was performed in 196 HNSCC patients with pathologically positive neck node (N+) to evaluate the high-risk factors for RR and to define the role of PORT in control after neck dissection and postoperative radiotherapy (PORT). Results: Overall, the RR rate after neck dissection and PORT was 29%. Extracapsular spread (ECS) was confirmed to be the only independent risk factor for RR. There were no significant risk factors associated with RR in the ECS- group. The 5-year disease-specific survival rate was 45%, which descended to 10% with the emergence of RR. Conclusions: ECS remains a determined risk factor for RR after neck dissection and PORT in patients with N+. PORT alone is not adequate for preventing RR in the neck with ECS after neck dissection. More intensive postoperative adjuvant therapies, especially combined chemotherapy and radiotherapy, are needed to prevent regional failure in HNSCC patients with ECS.

Neck dissection for oral squamous cell carcinoma: our experience and a review of the literature

  • Rani, Pooja;Bhardwaj, Yogesh;Dass, Praveen Kumar;Gupta, Manoj;Malhotra, Divye;Ghezta, Narottam Kumar
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.6
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    • pp.299-305
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    • 2015
  • Objectives: This article describes our experience with neck dissection in 10 patients with oral squamous cell carcinoma. Materials and Methods: Between January 2007 and October 2009, 10 patients underwent primary surgery for the treatment of squamous cell carcinoma of the oral cavity. For patients with $N_0$ disease on clinical exam, selective neck dissection (SND [I-III]) was performed. In patients with palpable cervical metastases (N+), modified radical neck dissections were performed, except in one patient in whom SND (I-III) was performed. The histopathologic reports were reviewed to assess the surgical margins, the presence of extra-capsular spread, perineural invasion, and lymphatic invasion. Results: On histopathologic examination, positive soft tissue margins were found in three patients, and regional lymph node metastases were present in five of the ten patients. Perineural invasion was noted in five patients, and extra nodal spread was found in four patients. Regional recurrence was seen in two patients and loco-regional recurrence plus distant metastasis to the tibia was observed in one patient. During the study period, three patients died. Seven patients remain free of disease to date. Conclusion: Histopathological evaluation provides important and reliable information for disease staging, treatment planning, and prognosis. The philosophy of neck dissection is evolving rapidly with regard to the selectivity with which at-risk lymph node groups are removed. The sample size in the present study is small, thus, caution should be employed when interpreting these results.

Inhibitory Effects of Paeonia suffruticosa Andrews Extracts on VEGF Binding to VEGF Receptor

  • Lee, Hak-Kyo;Lee, Sung-Jin
    • Natural Product Sciences
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    • v.13 no.2
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    • pp.128-131
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    • 2007
  • Tumor angiogenesis is a critical step f3r the growth and metastasis of solid tumors. Vascular endothelial growth factor (VEGF) is the most important angiogenic molecule associated with tumor-induced neovascularization. VEGF exerts its activity through binding to its receptor tyrosine kinase, KDR/Flk-1, expressed on the surface of endothelial cells. This study was carried out to investigate inhibitory effect of extracts from root cortex of Paeonia suffruticosa Andrews on VEGF binding to VEGF receptor. The MeOH extract from P. suffrutiocosa Andr. inhibited the binding of KDR/Flk-1-Fc to immobilized VEGF$_{165}$ more than 45% at the concentration of 100 ${\mu}$g/mL. The MeOH extract was further fractionated into n-hexane, ethyl acetate, n-BuOH, and aqueous fractions. Among the four fractions, the ethyl acetate fraction from the root cortex of P. suffruticosa Andr. exhibited highly effective inhibition (${\approx}$ 79% inhibition) and then n-BuOH fraction (${\approx}$ 45% inhibition) on the binding of KDR/Flk-1-Fc to immobilized VEGF$_{165}$ at the concentration of 100 ${\mu}$g/mL. The ethyl acetate fraction from the root cortex of P. suffruticosa Andr. more efficiently blocked VEGF-induced human umbilical vein endothelial cell proliferation, than the growth of HT1080 human fibrosarcoma. Our results suggest that P. suffruticosa Andr. may be used as a candidate fur developing anti-angiogenic agent.

A Case of Bronchopulmonary Atypical Carcinoid Tumor with Liver Metastasis (간전이를 동반한 폐기관지 비정형 카르시노이드 종양 1예)

  • Lee, Dong Soo;Lee, Tae Won;Kim, Gye Yean;Kim, Hwi Jung;Song, So Hyang;Kim, Seok Chan;Kim, Young Kyoon;Song, Jung Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.623-629
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    • 1996
  • Bronchial carcinoid tumors are uncommon, constituting approximately 5% of all primary lung cancers. Carcinoid tumors belong to the calss of neuroendocrine tumors that consist of cells that can store and secrete neuramines and neuropeptides. Neuroendocrine tumors of the lung include three pathologic types : a low-grade malignancy, the so-called 'typical carcinoid', a more aggressive tumor, the "atypical carcinoid", and the most aggressive malignant neoplasm, the small-cell carcinoma. Atypical carcinoid tumor have a higher malignant potential, is more commonly peripheral than is the typical carcinoid tumor. Histologic features would characterize a carcinoid as hitologically atypical : increased mitotic activity, pleomorphism and irregularity of neuclei with promonent nucleoli, hyperchromatin, and abnormal nuclear-cytoplasmic ratio, areas of increased cellularity with disorganization of architecture, and areas of tumor necrosis. Metastatic involvement of regional lymph nodes and distant organ is common. The prognosis is related to size of the tumor, typical of atypical appearance, endoluminal of extraluminal growth, vascular invasion, node metastasis, Pulmonary resection is the treatement of choice for bronchial carcinoid. We experienced one case of bronchopulmonary atypical carcinoid tumor. In the case, radiologic study showed solitary lung mass with liver metastasis and the level of 5-HIAA was elevated. There was no history of cutaneous flushing, diarrhea, valvular heart disease. The authors reported a case of bronchopulmonary atypical carcinoid tumor with review of literatures.

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Intramasseteric Metastasis of Renal Cell Carcinoma: Case Report (교근 내로 전이된 신세포암의 치험례)

  • Park, Gun-Chan;Yoon, Kyu-Ho;Park, Kwan-Soo;Cheong, Jeong-Kwon;Bae, Jung-Ho;Park, Jae-An;Min, Sung-Chang;Sin, Jae-Myung;Baik, Jee-Sun;Kim, Hyun-Jung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.1
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    • pp.71-75
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    • 2012
  • Renal cell carcinoma (RCC) is the most frequent urological malignant tumor in adults and it occurs mostly between the fifth and the sixth decades of life. The male-female ratio is 3:1 and it is more common in smokers. It accounts for approximately 3% of adult malignancies; 90~95% of neoplasms of the kidney. The classic triad of presenting symptoms of RCC is hematuria, back pain and a mass in the flank. More than 50% of RCCs show metastasis to breast, lung and regional lymph nodes, and 15% present in the orofacialmaxillary region. This case is about a 66 year-old man who was treated for painless swelling in the left masseteric area. The mass was surgically excised and sent for biopsy. It was diagnosed as RCC and two weeks later nephronectomy of the left kidney was performed. Metastasis to other organs was detected and the patient received radiation therapy. In this case we were able to find the primary lesion by the metastatic lesion.

Clinical Features and Factors Affecting Prognosis of Papillary Thyroid Carcinoma in Male Patients (남성 갑상선 유두암 환자의 임상 특징과 예후에 미치는 인자에 관한 연구)

  • Kim, Nam Young;Kim, Kyoung Hun;Park, Sung Ho;Lee, Guk Haeng;Lee, Byeong Cheol;Lee, Myung-Chul;Choi, Ik Joon
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.2
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    • pp.1-4
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    • 2016
  • Background and Objectives: National cancer center institute reports that male patients of papillary thyroid carcinoma (PTC) are annually increasing. This study aimed to analyze the features of the male patients with PTC. Materials and Method: We retrospectively reviewed and analyzed clinical records of 170 patients who were treated for PTC in male patients between 2000 and 2010. Clinical features, size, pathologic type, extrathyroidal extension, recurrence, multiplicity, extent of surgery, and lymph node metastasis were retrospectively evaluated.Univariate and multivariate analyses of various clinical factors were performed. Results: Total 4145 patients received surgery for papillary thyroid carcinoma. The number of male patients was 170 (4.1%) among them. Of170 male patients, only 16(9.4%) patients underwent the recurrence of PTC. The size of tumor, central neck node metastasis, lateral neck node metastasis, extrathyroidal extension and RAI ablation therapy were associated with recurrence(p< 0.05) in univariate analysis. However, only the extrathyroidal extension [p=0.03, Odds ratio=3.58(95% CI. 1.09~14.24)] was related to the recurrence in multivariate analysis. Conclusion: Re-estimation of clinical features in male PTC patients should be concerned. The recurrence of PTC in male patients was 16(9.4%) and nearly same as the other studies. The extrathyroidal extension was revealed as an associated factor for the recurrence. Evaluation of regional or distant metastasis should be considered in patients with the extrathyroidal extension in male PTC patients during long-term follow-up.

Effect of Deep Sea Water on Cytochrome P450 1A1, Aromatase and MMP-9. (해양심층수의 cytochrome P450 1A1, aromatase 및 MMP-9 활성 억제 효과)

  • Shon, Yun-Hee;Kim, Mee-Kyung;Nam, Kyung-Soo
    • Journal of Life Science
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    • v.18 no.4
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    • pp.503-508
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    • 2008
  • Deep sea water from the East sea was tested for breast cancer chemoprevention and metastasis by measuring the activities of cytochrome P450 1A1 and aromatase, invasiveness, and activity and expression of matrix metalloproteinase (MMP)-9 in breast MDA-MB-231 cancer cell. The in vitro incubation of rat liver microsome with deep sea water (a hardness range of $100{\sim}1,000$) showed a hardness-dependent inhibition of 7,12-dimethylbenz[a]anthracene (DMBA)-induced cytochrome P450 1A1 activity. Deep sea water showed 27.1, 45.4 and 51.9% inhibition of microsomal aromatase activity at the hardness of 600, 800 and 1,000, respectively. In addition deep sea water inhibited not only the invasiveness of 12-O-tetradecanoylphorbol-13-acetate (TPA)-treated MDA-MB-231 cells through matrigel-coated membrane in a hardness-dependent manner but also the activity and expression of MMP-9 in MDA-MB-231 cell.