• Journal of Gastric Cancer
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• v.15 no.1
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• pp.19-28
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• 2015

Purpose: To compare the clinicopathological data and long-term survival of gastric cancer patients in China and Korea. Materials and Methods: Patients who had undergone gastrectomy for gastric cancer between 1998 and 2009 in 2 high-volume institutions in both China (n=1,637) and Korea (n=2,231) were retrospectively evaluated. Clinicopathological variables, overall survival (OS), progression-free survival (PFS), and surgery-related complications were assessed for all patients and compared between the 2 institutions. Results: Chinese patients included in the study were significantly older and had a significantly lower body mass index (BMI) than the Korean patients. Esophagogastric junction tumors were more frequent in Chinese patients. However, the number of patients with stage I gastric cancer, the number of harvested lymph nodes, and the number of total gastrectomies were significantly higher in the Korean population. Korean patients also presented with fewer undifferentiated tumors than Chinese patients. Furthermore, Korean patients had prolonged OS and PFS for stage III cancers only. BMI, tumor-node-metastasis (TNM) stage, tumor invasion, number of positive lymph nodes, and distant metastases were all independent factors affecting OS and PFS. Conclusions: Although China and Korea are neighboring Asian countries, the clinicopathological characteristics of Chinese patients are significantly different from those of Korean patients. Korean gastric cancer patients had longer OS and PFS than Chinese patients. Influencing factors included TNM stage, tumor invasion, and lymph node metastasis.

• Journal of Gastric Cancer
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• v.9 no.3
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• pp.143-151
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• 2009

Purpose: Gastric cancer is prevalent in Korea, therefore the purpose of this study was to determine the clinicopathologic characteristics, 5-year survival rate, and prognostic factors for gastric patients who underwent gastrectomy by a single surgeon. Materials and Methods: A total of 1,435 patients diagnosed with gastric cancer who underwent gastrectomy in the Department of Korean Gastric Cancer Center at Seoul Paik Hospital between September 1998 and August 2003, and the gender, age, location and size of the tumor, visual and histologic analysis, depth of invasion, lymph node metastasis, invasion (perineural, venous, and lymphatic), and surgical method were examined retrospectively. Results: The ratio between males and females was 2.29 : 1, and the average age was 56.7 years. Based on the UICC TNM classification, the patients were distributed as follows: IA 35.4%, IB 14.1%, II 12.6%, IIIA 12.3%, IIIB 8.3% and IV 17.3%. The 5-year survival rate was 69.6%. The results of univariate analysis showed that there were significant differences in the survival rate by age, location and size of tumor, Borrmann type, level of differentiation, Lauren's classification, depth of invasion, metastasis in lymph nodes, UICC TNM stage, invasion (perineural, venous, and lymphatic), and surgical method. Based on multivariate analysis, only the depth of invasion and lymph node metastasis were independent prognostic factors. Conclusion: Although various clinicopathologic characteristics affect the prognostic factors of the patients with gastric cancer, the results of this study showed that the stage of disease, such as depth of invasion and metastasis in lymph nodes, are the most critical factors. There is a need to establish the diagnosis of gastric cancer early and to study and develop various treatment methods based on the diagnostic factors in order to improve the survival of patients with gastric cancer.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.3
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• pp.710-714
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• 2009

Several studies showed that the survival rate of stage IIIB disease with malignant pleural effusion is worse than stage IIIB disease without malignant effusion. But, malignant pleural effusion was considered T4. To analyze changes the survival time for malignant pleural effusion, in the seventh revision of TNM classification for lung cancer. The records of all patients had to have either a histological or cytological diagnosis of non-small cell lung cancer (NSCLC), who were admitted to Wonkwang university hospital between January 2004 and December 2006 were reviewed retrospectively. We evaluated the survival time of 187 patients with advanced lung cancer with and without malignant pleural effusion. This included the pleural effusion or nodule M1 a (pleural dissemination, currently classified as T4), nodule(s) in the other lung M1 a (contralateral lung nodule, currently classified as M1), nodule(s) with the same lobe as the primary tumor T3 (currently classified as T4), other T4 factors T4 (T4 MO anyN), and extrathoracic sites of disease M1b (distant metastasis, currently classified M1). Among the 187 patients, T4anyNMO was 57 patients in the current TNM classification. In the next edition of the TNM classification, T4MOanyN-T4 (excluding same lobe nodules) was 12 patients, pleural dissemiantion-M1a was 45 patients, contralateral lung nodule(s)-M1a was 7 patients, and metastatic disease-M1b was 55 patients. We compared the survival time for these groups. Survival time was 11 months, 8 months, 11 months, and 4 months. The survival time of malignant pleural effusion was shorter than other T4 factors without pleural effusion. But, there was no remarkable difference in statistics due to small cases (p=0.23). We strongly suggest that malignant pleural effusion in advanced NSCLC will be categorized with metastatic disease.

• Journal of Gastric Cancer
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• v.6 no.3
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• pp.173-180
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• 2006

Purpose: The TNM staging system showed limitation in stratifying patients into different prognostic groups with gastric cancer Since the treatment for stage IV gastric cancer with distant metastasis (M1) is defined as non-curative one, we hypothesized that the survival rate of stage IV gastric cancer with M1 is different to that of stage IV gastric cancer with no distant metastasis (M0), which will provide a rationale to subdivide stage IV into IVa and IVb. Materials and Methods: From June 1992 to December 2005, of 1,630 gastric cancer patients who underwent surgery, 308 patients with stage IV gastric cancer were selected and analyzed. The clinicopathologic characteristics and survival of the patients, according to distant metastasis, were determined retrospectively. Median follow-up period was 13 months (range: $1{\sim}154$ month). Results: 5 year survival rate of M0 and M1 group was 35% and 16% respectively with statistic significance (P=0.0000). When the survival rate of M0 group was analyzed according to the difference of T and M factor, T1-3N3M0 and T4N1-2M0 group showed no significant statistical difference (P=0.1898). Conclusion: Given the result in this study, we suggest that the stage IV gastric cancer be subclassified into stage IVa and IVb according to M factor.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2429-2434
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• 2016

Transforming growth factor-B1 ($TGF-{\beta}1$ )and its coreceptor endoglin (ENG) have been shown to contribute to hepatocellular tumor development and malignant progression. Our aim was to evaluate the serum expression levels of $ENG/TGF-{\beta}1$ mRNAs and risk of hepatocellular carcinoma in cirrhotic Egyptian patients. Our study included 77 subjects. Real time polymerase chain reaction was used to evaluate the expression level of ENG and $TGF-{\beta}1$mRNAs. The relative expression ratio of ENG mRNA was 0.82 (0.1 -3.2), 0.66 (0.15-5.3), 0.38(0.007-2.8) and 0.12 (0.00-0.22) and the relative expression ratio of $TGF-{\beta}1$mRNA was 1.4 (0.19 -6.2), 1.2 (0.22-4.3), 1.0 (0.15-4.4) and 0.6 (0.00-2.2) for cirrhotic HCC cirrhotic, HCC only and healthy control groups respectively. Increased ENG and $TGF-{\beta}1$ mRNA gene expression was correlated with TNM clinical stage. The expression ratio in TNM stage III-IV 1.1 (0.07-3.2), 1.55 (0.15-6.2) was statistically significantly higher than that in stage I-II 0.47 (0.007-2.8), 1.0 (0.31-4.4) (P<0.05). Our data suggested that increased ENG and $TGF-{\beta}1$ gene expression may participate in hepatocarcinogenesis and increased risk of HCC in individuals with cirrhosis. Early screening for evidence of cirrhosis and consideration of ENG and $TGF-{\beta}1$ as targets for therapy and treatment strategies are warranted.

• Advances in pediatric surgery
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• v.14 no.2
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• pp.164-172
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• 2008

The survival rate for rhabdomyosarcoma (RMS) has significantly improved after the introduction of combined multimodality treatment. We report the 20-year treatment outcome of pediatric rhabdomyosarcoma in a single institution. The medical records of 16 patients treated for rhabdomyosarcoma between December 1986 and August 2007 at the Department of Pediatric Surgery, Seoul National University Children's Hospital, were retrospectively reviewed. Mean age at diagnosis was 7.1 years (range: 1.3 -14.2 years). Retroperitoneum was the most common primary site (n=7, 43.8 %), and embryonal type was predominant (n=11, 6 %). Before the treatment, most patients were in advanced TNM stage (stage III 50 %, IV; 25 %). The patient distribution according to the Intergroup Rhabdomyosarcoma Study Clinical Grouping System (IRS-CGS) was as follows; Group I 31.3 %, Group II 12.5 %, Group III 31.3 % and Group IV 25 %. Patients were classified into three groups according to the extent of resection of the primary tumor; complete resection (CR, n=5; 31.3 %), gross total resection (GTR, n=7; 43.8 %) and incomplete resection (IR, n=4; 25 %). Recurrence was observed in 9 patients (56.3 %) while there was no recurrence in CR patients. All patients with recurrence were identified as moderate or high-risk according to the IRS-V Risk Group. Pre-treatment TNM stage of RMS in our institution was advanced with aggressive clinical feature, however postsurgical conditions according to IRS-CGS were similar to the previous reports by IRS. This suggests that down-staging of IRS-CGS was achieved with multimodality treatment with CR or GTR. It also suggests that complete resection is the most important prognostic factor in the treatment of RMS in children. Patients classified as moderate or high-risk need close follow-up due to high recurrence rate. In case of localized recurrence, better outcome may be achieved with multimodality treatment including limited surgery.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.730-744
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• 1987

From Nov. 1980 to Jun. 1987, 270 primary lung cancer patients were operated on at the department of Thoracic & Cardiovascular Surgery, Seoul National University Hospital. There Were 223 males & 47 females with 55.5 years of mean age. There were 151 [55.9%] squamous cell ca., 43 [18.8%] adenoca., 8 [3.5%] undiff. large cell, 9 [3.9%] undiff. small cell ca. & 18 [7.9%] mixed type, and also composed of 65 [28.3%] stage I, 31 [13.5%] stage II and 133 [58.1%] of stage III cases. They received 78 [34.1%] lobectomies, 62 [27.1%] pneumonectomies and 60 [26.2%] exploratory thoracotomies with 70% resectability rate. The five year actuarial survival rate of all patients was 37%. According to TNM stage, five year survival rate of the patients in stage I was 71%, those of stage II was 29% and of stage III 21%. According to histological cell type, five year actuarial survival rate of the squamous cell ca. was 35%, of adenoca. 49%, of undiff. large cell. 22%, 2 year survival rate of undiff. small cell was 31% and 3 year survival rate of mixed type was 47%. Hospital death was 2 case with a 1.3% early postop. mortality rate.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5643-5645
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• 2015

Background: The aim was to see compliance to minimum data set information in carcinoma cervix histopathology reports from a team of 13 pathologists; and also to analyse the distribution of parameters like tumor size, grade, depth of cervical stromal invasion, lymph node yield and pTNM stage. Materials and Methods: All pathology reports of radical hysterectomy for carcinoma cervix operated in house within a three year duration (2010-2012), (n=204) were retrieved from medical records and analyzed for the above parameters. Results: In 2010- 59 cases, in 2011- 67 cases and in 2012- 78 cases of carcinoma cervix underwent operations in our hospital. The median age was 50.5 years and the maximum T diameter was 2.8 cms in the reports of three years. Squamous carcinoma was the commonest subtype amongst all the tumors. It was noted that 60.8% of cases had cervical stromal involvement more than half the thickness of the cervical stroma. Parametrial involvement was seen in 4.82% of cases. pTNM Staging was not mentioned in 65.06% of the cases. The mean bilateral pelvic lymph node yield count in our study was 16.6 inclusive of all the three years. Conclusions: Compliance with provision of a minimum dataset in our team of 13 pathologists was generally good. Lymph node yield in our hands is reasonable, but constant striving for greater numbers should be made. pTNM staging should be more meticulously documented. Use of proformas /checklists is recommended.

• Radiation Oncology Journal
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• v.29 no.1
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• pp.36-43
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• 2011

Purpose: To evaluate the effectiveness of radiation therapy (RT) for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) and to analyze the prognostic factors. Materials and Methods: From December 2004 to April 2009, 70 patients who had HCC with PVTT were treated with RT at Keimyung University Dongsan Medical Center. Nineteen patients whose total dose was below 30 Gy and one patient who underwent liver transplantation were excluded. The remaining 50 patients (45 males, 5 females; median age 55 years) were analyzed. According to the LCSGJ TNM stage, there were 27 patients (54.0%) with stage III and 23 (46.0%) with stage IV. Total dose of 30~54 Gy was administered (median 45). Thirty patients (60.0%) were treated with concurrent chemoradiation therapy (CCRT). The median follow-up duration was from 13.5 months (range, 3 to 70 months). Results: The median survival time from the start of RT was 9 months. One-year and 2-year overall survival rates were 24.9% and 11.2%, respectively. At the follow-up time, three patients (6.0%) displayed no evidence of disease. Seven patients (14.0%) were alive with disease, and 40 (80.0%) patients had expired due to disease progression. CCRT was associated with worse survival than RT alone (p=0.034), Response to RT (p=0.037), CLIP stage (p=0.017), and TNM stage (p=0.041) were statistically significant prognostic factors. There was no radiation-induced liver disease. Conclusion: RT is an effective and safe modality for HCC with PVTT. Further studies such as prospective randomized trials are needed to confirm the role of RT for HCC with PVTT.

• Tuberculosis and Respiratory Diseases
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• v.68 no.1
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• pp.10-15
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• 2010

Background: Lung cancer is the most common cause of cancer mortality in Korea. The TNM stage at presentation in patients with non-small cell lung cancer (NSCLC) has the greatest impact on prognosis. Patients who undergo a complete resection for NSCLC are likely to develop recurrent and/or metastatic disease. There are several factors influencing the development of recurrence. We explored risk factors of recurrence in patients with stages I and II NSCLC, who had undergone curative resection. Methods: We reviewed patients who had complete surgical resection as definitive treatment for stage I or II. Patients followed up for more than 36 months. We evaluated several factors which might have relationship with recurrence, such as patient's demographic factors, TNM staging, pathologic finding, tumor markers and surgical technique. Results: A total of 75 patients were enrolled for analysis, of whom 58 were men and 17 were women with mean age of 61 (range, 37 to 76) years. The average size of tumors was 3.9 cm (0.7 to 10 cm). There were 64 patients with stage I NSCLC and 11 with stage II NSCLC. Among 64 patients with stage I NSCLC, 35 patients showed recurrences whereas 8 patients have recurred in stage II NSCLC. Grade of differentiation of tumor was closely related to the recurrence. Seventy-five percent of patients who had poor tumor differentiation experienced a recurrence. In contrast, 3 patients of twelve had recurrences, who revealed differentiation in their tissue (p<0.05). Conclusion: Tumor differentiation could be a predictive factor for tumor recurrence in patients who have undergone curative resection for stage I or II NSCLC.