• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2413-2418
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• 2015

Background: Although adjuvant chemotherapy is a standard treatment in stage III colon cancer, its benefit is not as clear for stage II patients. In this retrospective analysis, we aimed to evaluate the survival of patients with low-risk stage II colon cancer, the efficacy of adjuvant chemotherapy in high-risk stage II colon cancer patients, and prognostic factors in stage II disease. Materials and Methods: One hundred and seventeen patients who were diagnosed with stage II colon cancer between January 2006 and December 2011 were included in the study. Patients were stratified into two groups as being low-risk and high-risk according to risk factors for stage II disease. Adjuvant 5-fluorouracil-based chemotherapy were administered to the patients with risk factors. Results: Ninety-four patients were treated with adjuvant chemotherapy due to high risk factors and 23 were monitored without treatment. Median follow-up time was 43 months. In terms of disease free survival and overall survival, adjuvant chemotherapy did not provide a statistically significant difference. Univariate analysis demonstrated that bowel obstruction was the major risk factor for shortened disease-free survival, while bowel perforation and perineural invasion were both negative prognostic factors for overall survival. Conclusions: The recommendation of adjuvant chemotherapy for stage II colon cancer is not clear. In our study, it was found that adjuvant chemotherapy did not contribute to survival in high-risk stage II patients. Due to the fact that prognosis of stage II patients is good, many more patients will be needed for statistically significant differences in survival. Adjuvant chemotherapy containing 5 fluorouracil is being used to high-risk stage II patients although it is not a standard treatment approach.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.2101-2105
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• 2013

Background: Long-term survival is a problem with locally advanced and metastatic renal cell carcinomas. Sunitinib malate is an oral multitargeted tyrosine kinase inhibitor, but data on sunitinib use as a second line treatment in metastatic renal cell carcinoma (mRCC) are limited. Prognostic and predictive value of peripheral blood markers has been shown for many cancers. Materials and Methods: Efficacy and safety profiles of sunitinib after interferon alpha (IFN-${\alpha}$) were evaluated based on retrospective data for 23 patients with mRCC. Hematological parameters (neutrophils, lymphocytes, platelets, mean platelet volume, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio) were recorded at the time of metastasis. It was evaluated whether hematological parameters were prognostic and predictive factors. Results: Median progression-free survival (PFS) time was 16.5 months (95%CI: 0-34.5). Median overall survival (OS) time was 25.7 months (95%CI: 10.8-40.0). Most common side effects were neutropenia (52.2%), stomatitis (26.1%) and hand-food syndrome (26.1%). PFS was found 3.13 vs 17.1 months in patients with neutrophil / lymphocyte ratio (NLR)>3 vs $NLR{\leq}3$ (p:0.012). Median OS was 6.96 vs 27.1 months in patients with NLR>3 vs $NLR{\leq}3$ (p:0.001).While 75% of patients who responded to sunitinib had $NLR{\leq}3$, in 72% of patients with no response to sunitinib NLR>3 was detected (p:0.036). The association between the Memorial Sloan-Kettering Cancer Center (MSKCC) criteria and NLR was statistically significant (p:0.022). Conclusions: Data on second line sunitinib treatment following cytokine in mRCC are limited. In our study, we observed second line sunitinib treatment following IFN-${\alpha}$ to be effective and tolerable. NLRappeared to have prognostic and predictive value.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.9
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• pp.4025-4028
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• 2014

Background: Relationships between smoking and bladder neoplasms, one of the common malignancies, are well-known. Different smoking-related malignancies may occur together. In this study, we evaluated the stage and grade of bladder neoplasms in patients also featuring lung or larynx cancer. Materials and Methods: From January 2006 to February 2012, patients who underwent surgery for bladder neoplasms in our clinic were screened retrospectively. In the evaluation, 5 patients had larynx cancer and 20 patients have lung cancer in addition, all having been smoking for a long time. The bladder tumor stage and grade were investigated in these 25 cases. Results: Mean age of patients was 66.8 (49-78). In the evaulation, all of 5 patients who had larnyx cancer also had high grade urothelial cancer. One had T2 urothelial, and 3 T1 urothelial cancer. In the same way, all of the 20 patients with lung cancer also have high grade urothelial cancer, three T2, and 13 T1. Bladder cancer stage and grade were determined to be significantly increased in patients with concomitant bladder and lung or larynx cancer. Conclusions: In the patients who have smoking releated second malignancy, bladder cancer prognosis appears more aggressive. We now need a larger series and multi-center studies for understanding relevant pathophysiology.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.9
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• pp.3993-3996
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• 2014

Background: Diabetes is a chronic disease characterized by impaired fasting blood glucose that leads to disturbances in various organs. In this study, we evaluated relationships between tumor size and grade in a population of diabetic and non-diabetic patients with renal cell carcinoma. Materials and Methods: Between 2007-2013, in our clinic radical nephrectomy performed to 310 patients for renal tumors and pathology reported renal cell carcinoma cases were enrolled in the study. Patients with and without a history of diabetes regarding fasting glucose and HgA1c levels were evaluated during surgery for tumor size and Fuhrman grade. Results: Diabetes was found in 95 patients. The mean age of the patients with and without diabetes mellitus was 64.3 (40-79) and 58.4 (31-87) years, respectively. In the diabetes group 51% of patients had a tumor size over 7 cm and 54% a tumor grade over Fuhrman 3. The respective figures in the non-diabetes group were 35% and 30% (p<0.05 in both cases). Conclusions: Renal cancer appears more aggressive in patients with diabetes. In this study lifestyle and risk factors with diabetes regulation were observed to be important for renal cancer patients. Multicenter studies are needed in larger series for more accurate results.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7351-7354
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• 2013

Background: Metabolic syndrome (MetS) is a multifactorial disease characterized by impaired glucose tolerance/diabetes, obesity, high triglyceride levels, low HDL levels, and hypertension. In this study we evaluate the relationship between tumor size and grade, and presence of the metabolic syndrome in patients with renal cell carcinoma. Materials and Methods: Between 2007-2013, radical nephrectomy was performed for 310 patients with renal tumors in our clinic and those with pathology reported renal cell carcinoma were enrolled and divided into two groups, with and without metabolic syndrome diagnosed on the basis of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria. The relationship between tumor size and grade of the two groups (Fuhrman nuclear degree) was evaluated statistically. Results: The metabolic syndrome was found in 70 patients, with a mean age of 65.5 (40-87), as compared to 58.8 (31-84) years in the non-metabolic syndrome group. Tumor size over 7 cm was found in 54% and 33%, respectively, and tumor grade over Fuhrman 3 in 56% and 32% of patients. Patients with metabolic syndrome had significantly higher tumor size and grade (p<0.05). In the presence of hypertension, diabetes and high triglyceride levels, significant assocations were again observed (p<0.05). Tumor size and degree also increased with increasing body mass index but this was not statistically significant (p>0.05). Conclusions: Renal cancer is more aggressive in patients with metabolic syndrome. Lifestyle and risk factors were revealed to be significant influences in renal cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10631-10636
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• 2015

Background: We aimed to investigate anxiety, depression and sexual satisfaction levels and the effects of depression and anxiety upon the sexual satisfaction of Turkish breast cancer patients and their partners. Materials and Methods: Data were collected from one hundred breast cancer patients and their partners, using three forms: one covering information about socio-demographic characteristics of the patients, the Hospital Anxiety and Depression Scale (HADs) and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). Results: The frequencies, avoidance and touch subscores were statistically significantly high in the patients. Among those with high anxiety scores, the frequency, communication, satisfaction, touch, and anorgasmic subscale scores of GRISS were found to be significantly high. Among the partners whose anxiety scores were high, only the premature ejaculation subscale was statistically significant. It was determined that for partners with higher depression scores, the communication, satisfaction, avoidance, premature ejaculation and erectile dysfunction subscores of GRISS were statistically higher compared to partners with lower depression scores. Conclusions: Patients' quality of life may be increased by taking precautions to reduce their and their partners' psychosocial and psychosexual concerns.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1447-1451
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• 2014

Purpose: To compare histopathologic findings of patients who underwent transurethral resection of a bladder tumor (TUR-B) between groups with and without the metabolic syndrome. Materials and Methods: We retrospectively analyzed data of 535 patients who underwent TUR-B in our department between October 2005 and March 2011. All patients had primary urethelial cell carcinoma (UCB). Histologic stage, grade, the presence of hypertension, diabetes mellitus, body mass index (BMI), waist circumference, HDL and trigliseride levels were evaluated. The TNM classification was used, with Ta tumor accepted as lower stage and T1 and T2 tumors as higher stage bladder cancers. Also, the pathological grading adopted by the 2004 World Health Organization grading system were applied. Non-invasive papillary urothelial neoplasms of low malignant potential were regarded as low grade. Results: Among the total of 509 patients analyzed in our study, there were 439 males (86.2%) and 70 females (13.8%). Metabolic syndrome was significantly associated with high histologic grade, and high pathologic stage (p<0.001). Conclusions: The patients with metabolic syndrome were found to have statistically significant higher T stage and grade of bladder cancer. Further studies with more patients are needed to confirm our study.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2555-2558
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• 2014

Pirpose: The aim of this study to analyze the association between history of diabetes mellitus (DM) with risk of prostate cancer (PCa) and cancer grade among men undergoing radical prostatectomy for PCa. Materials and Methods: 50 patients with DM and 50 patients without DM who undervent radical prostatectomy (RP) were included in the study. Age at biopsy, height, weight, digital rectal examination (DRE), pre-biopsy PSA levels, prostate volume, histopathologic diagnosis after surgery and gleason scores were collected data from all patients. Histologic material obtained at biopsy was given a Gleason score; tumours with a Gleason score ${\geq}7$ were considered high grade and <7 were considered low grade. Results: The mean age at the time of biopsy was 63.7 in patients with DM and 61.6 in patients without DM. Diabetic men had significantly lower PSA levels (p=0.01). Mean PSA level $7.04{\pm}2.85$ in patients with DM and $8.7{\pm}2.86$ in patients without DM, respectively. Also, diabetic men had higher RP tumor grade than men without DM (p=0.04). We found that HbA1c levels were higher in patients who have high grade prostate cancer (p<0.05). Conclusions: Diabetic men undergoing RP have lower PSA levels and have significantly higher grade PCa. We must be careful for screening PCa in patients with DM. Although the patients had lower PSA levels, they might have high grade disease.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7119-7123
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• 2014

Background: The role of second-line therapy in metastatic pancreatic cancer is not clear. In this study, we aimed to explore the second-line efficiency of capecitabine and oxaliplatin (XELOX) in patients with advanced pancreatic cancer who have received gemcitabine-based first-line therapy. Materials and Methods: We retrospectively evaluated 47 patients with locally advanced or metastatic pancreatic cancer previously treated with gemcitabine-based first-line regimens. Treatment consisted of oxaliplatin $130mg/m^2$ and capecitabine $1000mg/m^2$ twice daily with a 3 week interval, until unacceptable toxicity or disease progression. Results: Median number of cycles was 4 (range, 2-10). The overall disease control rate was 38.3%. The median overall survival and progression-free survival from the start of second-line therapy were 23 weeks (95%CI: 16.6-29.5 weeks) and 12 weeks (95%CI: 9.8-14.4 weeks), respectively. The most common grade 3-4 toxicities were nausea, vomiting and hematologic side effects. Conclusions: Our result suggests that the combination of capecitabine and oxaliplatin was tolerated with manageable toxicity and showed encouraging activity as second-line treatment of advanced or metastatic pancreatic cancer patients with ECOG performance status 0-2.

• Korea Journal of Hospital Management
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• v.12 no.4
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• pp.96-118
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• 2007

This study were tried to suggest basic materials for making education and training plan, and members of organization were researched about thinking of education and training effectiveness and perceptible level. The subjects of this study were 762 hospital employee selected from ten of university hospitals in Seoul, Incheon, and Kyung Gi which are doing an education and training, and conducted a self-completion questionnaire. As a result of study and plan for raising the effectiveness were indicated following statements. Firstly, according to the general specific, training effectiveness was appeared similar. So, it requires suitable alternatives to make educational programs. Secondly, according to analysis of education and training necessity, achieving a goal for education and training have difference. it needs to be scientific analysis about necessity of education and training. Thirdly, when contents of education and training program are satisfied to educatee and fit for them, thinking of education and training effectiveness is higher. Therefore, establishing the goal of education training is concrete, realistic, and measurable for increasing learning motivation. Next to, thinking of education and training effectiveness is higher, when education and training person in charge taught to educatee very well, and they were satisfied about teaching. Consequently, they who nourishment of education and training person in charge within company have to improve their ability. And then, when educatee fit for teaching technique and satisfied about it, thinking of education and training effectiveness is higher. So, education and training were tried to find many of technique for fitting the desire of educatee. Sixth, the more education and training environment is satisfactory, the more educatee have high thinking of education and training effectiveness. CEO in hospitals have to think about many-sided solution for employee. Seventh, the more education and training have correct achieving organizational goal, the more educatee have high thinking of education and training effectiveness. Accordingly, hospital management should make up for education and training system. Then, thinking of education and training effectiveness is higher, when education and training measure an effect, and reflect to personnel management and assessment of an employee's performance. It should be the feedback for using information which is planning education and training. In conclusion, when result of measurement of education and training reflect to make a education and training plan, thinking of education and training effectiveness is higher, and result of measurement of education and training should reflect to make a education and training plan.