• Title/Summary/Keyword: Tumor recurrence

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Prognostic Factors for Node-Negative Advanced Gastric Cancer after Curative Gastrectomy

  • Lee, Eun Woo;Lee, Woo Yong;Koo, Ho-Seok
    • Journal of Gastric Cancer
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    • v.16 no.3
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    • pp.161-166
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    • 2016
  • Purpose: Lymph node (LN) metastasis is the best prognostic indicator in non-distant metastatic advanced gastric cancer. This study aimed to assess the prognostic value of various clinicopathologic factors in node-negative advanced gastric cancer. Materials and Methods: We retrospectively analyzed the clinical records of 254 patients with primary node-negative stage T2~4 gastric cancer. These patients were selected from a pool of 1,890 patients who underwent radical resection at Memorial Jin-Pok Kim Korea Gastric Cancer Center, Inje University Seoul Paik Hospital between 1998 and 2008. Results: Of the 254 patients, 128 patients (50.4%), 88 patients (34.6%), 37 patients (14.6%), and 1 patient (0.4%) had T2, T3, T4a, and T4b tumors, respectively. In a univariate analysis, operation type, T-stage, venous invasion, tumor size, and less than 15 LNs significantly correlated with tumor recurrence and cumulative overall survival. In a multivariate logistic regression analysis, tumor size, venous invasion, and less than 15 LNs significantly and independently correlated with recurrence. In a multivariate Cox proportional hazards analysis, tumor size (hazard ratio [HR]: 2.926; 95% confidence interval [CI]: 1.173~7.300; P=0.021), venous invasion (HR: 3.985; 95% CI: 1.401~11.338; P=0.010), and less than 15 LNs (HR: 0.092; 95% CI: 0.029~0.290; P<0.001) significantly correlated with overall survival. Conclusions: Node-negative gastric cancers recurred in 8.3% of the patients in our study. Tumor size, venous invasion, and less than 15 LNs reliably predicted recurrence as well as survival. Aggressive postoperative treatments and timely follow-ups should be considered in cases with these characteristics.

Inhibitory Effect of D-chiro-inositol on Both Growth and Recurrence of Breast Tumor from MDA-MB-231 Cancer Cells

  • Kim, Yoon-seob;Park, Ji-sung;Kim, Minji;Hwang, Bang Yeon;Lee, Chong-kil;Song, Sukgil
    • Natural Product Sciences
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    • v.23 no.1
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    • pp.35-39
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    • 2017
  • D-chiro-inositol (DCI) is a secondary messenger in insulin signal transduction. It is produced in vivo from myo-inositol via action of epimerase. In this study, we evaluated antitumor activity of DCI against human breast cancer both in vitro and in vivo. In order to determine the inhibitory effects of DCI on growth of human breast cancer cells (MDA-MB-231), two different assessment methods were implemented: MTT assay and mouse xenograft assay. MTT assay demonstrated downturn in cell proliferation by DCI treatment (1, 5, 10, 20 and 40 mM) groups by 18.3% (p < 0.05), 17.2% (p < 0.05), 17.5% (p < 0.05), 18.4% (p < 0.05), and 24.9% (p < 0.01), respectively. Also, inhibition of tumor growth was investigated in mouse xenograft model. DCI was administered orally at the dose of 500 mg/kg and 1000 mg/kg body weight to treat nude mouse for 45 consecutive days. On the 45th day, tumor growth of DCI (500 mg/kg and 1000 mg/kg) groups was suppressed by 22.1% and 67.6% as mean tumor volumes were $9313.8{\pm}474.1mm^3$ and $3879.1{\pm}1044.1mm^3$, respectively. Furthermore, breast cancer stem cell (CSC) phenotype ($CD44^+/C24^-$) was measured using flow cytometry. On the 46th day, CSC ratios of DCI (500 mg/kg) and co-treatment with doxorubicin (4 mg/kg) and DCI (500 mg/kg) group decreased by 24.7% and 53.9% (p < 0.01), respectively. Finally, from tumor recurrence assay, delay of 5 days in the co-treatment group compared to doxorubicin (4 mg/kg) alone group was observed. Based on these findings, we propose that DCI holds potential as an anti-cancer drug for treatment of breast cancer.

Tumor Markers for Diagnosis, Monitoring of Recurrence and Prognosis in Patients with Upper Gastrointestinal Tract Cancer

  • Jing, Jie-Xian;Wang, Yan;Xu, Xiao-Qin;Sun, Ting;Tian, Bao-Guo;Du, Li-Li;Zhao, Xian-Wen;Han, Cun-Zhi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10267-10272
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    • 2015
  • To evaluate the value of combined detection of serum CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS for the clinical diagnosis of upper gastrointestinal tract (GIT) cancer and to analyze the efficacy of these tumor markers (TMs) in evaluating curative effects and prognosis. A total of 573 patients with upper GIT cancer between January 2004 and December 2007 were enrolled in this study. Serum levels of CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS were examined preoperatively and every 3 months postoperatively by ELISA. The sensitivity of CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS were 26.8%, 36.2%, 42.9%, 2.84%, 25.4%, 34.6%, 34.2% and 30.9%, respectively. The combined detection of CEA+CA199+CA242+CA724 had higher sensitivity and specificity in gastric cancer (GC) and cardiac cancer, while CEA+CA199+CA242+SCC was the best combination of diagnosis for esophageal cancer (EC). Elevation of preoperative CEA, CA19-9 and CA24-2, SCC and CA72-4 was significantly associated with pathological types (p<0.05) and TNM staging (p<0.05). Correlation analysis showed that CA24-2 was significantly correlated with CA19-9 (r=0.810, p<0.001). The levels of CEA, CA19-9, CA24-2, CA72-4 and SCC decreased obviously 3 months after operations. When metastasis and recurrence occurred, the levels of TMs significantly increased. On multivariate analysis, high preoperative CA72-4, CA24-2 and SCC served as prognostic factors for cardiac carcinoma, GC and EC, respectively. combined detection of CEA+CA199+CA242+SCC proved to be the most economic and practical strategy in diagnosis of EC; CEA+CA199+CA242+CA724 proved to be a better evaluation indicator for cardiac cancer and GC. CEA and CA19-9, CA24-2, CA72-4 and SCC, examined postoperatively during follow-up, were useful to find early tumor recurrence and metastasis, and evaluate prognosis. AFP, TPA and TPS have no significant value in diagnosis of patients with upper GIT cancer.

Tumor Recurrence in Hepatocellular Carcinoma Patients after Radiofrequency Ablation: Portal Hypertension as an Indicator of Recurrence of Hepatocellular Carcinoma (간세포암 환자의 고주파열치료 후 종양 재발: 예후인자로서 문맥고혈압)

  • Jang, Seong Won;Cho, Yun Ku;Kim, Ju Won;Gil, Je Ryung;Kim, Mi Young;Lee, Young
    • Journal of the Korean Society of Radiology
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    • v.79 no.5
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    • pp.264-270
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    • 2018
  • Purpose: To evaluate the effect of portal hypertension on the tumor recurrence in patients with hepatocellular carcinoma (HCC) and without hepatic decompression following radiofrequency ablation (RFA). Materials and Methods: Treatment-naïve HCC patients within the Milan criteria and with Child-Pugh class A were included in this study, who had performed RFA in our hospital between January 2010 and March 2017. Univariate and multivariate analyses using the Cox proportional hazard model were performed to find the predictors of local or distant tumor recurrence. Results: Overall, 178 patients were included in this study. Median follow-up period was 40.2 months. The difference in the local tumor progression rates depending on the absence or presence of portal hypertension was not statistically significant (p = 0.195). The 1-, 3-, and 5-year distant intrahepatic tumor spread rates were 6.6%, 29.5%, and 537% in patients without portal hypertension, and 23.4%, 51.9%, and 63.6% in patients with portal hypertension, respectively. The difference was statistically significant (p = 0.011). Univariate and multivariate analysis showed that portal hypertension was an independent predictor for distant intrahepatic tumor spread (p = 0.008). Conclusion: For HCC patients with Child-Pugh class A, portal hypertension adversely affected distant intrahepatic tumor progression.

Medulloblastoma in the Molecular Era

  • Kuzan-Fischer, Claudia Miranda;Juraschka, Kyle;Taylor, Michael D.
    • Journal of Korean Neurosurgical Society
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    • v.61 no.3
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    • pp.292-301
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    • 2018
  • Medulloblastoma is the most common malignant brain tumor of childhood and remains a major cause of cancer related mortality in children. Significant scientific advancements have transformed the understanding of medulloblastoma, leading to the recognition of four distinct clinical and molecular subgroups, namely wingless (WNT), sonic hedgehog, group 3, and group 4. Subgroup classification combined with the recognition of subgroup specific molecular alterations has also led to major changes in risk stratification of medulloblastoma patients and these changes have begun to alter clinical trial design, in which the newly recognized subgroups are being incorporated as individualized treatment arms. Despite these recent advancements, identification of effective targeted therapies remains a challenge for several reasons. First, significant molecular heterogeneity exists within the four subgroups, meaning this classification system alone may not be sufficient to predict response to a particular therapy. Second, the majority of novel agents are currently tested at the time of recurrence, after which significant selective pressures have been exerted by radiation and chemotherapy. Recent studies demonstrate selection of tumor sub-clones that exhibit genetic divergence from the primary tumor, exist within metastatic and recurrent tumor populations. Therefore, tumor resampling at the time of recurrence may become necessary to accurately select patients for personalized therapy.

Study on Alternative Medicine in Cancer Therapy (건비익기법(健脾益氣法)의 종양치료활용(腫瘍治療活用)에 대(對)한 연구(硏究))

  • Kang, Yeon-yee;Kim, Sung-hoon;Kim, Dong-hee
    • Journal of Haehwa Medicine
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    • v.10 no.2
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    • pp.1-10
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    • 2002
  • In review of "invigorating spleen and supplementing qi" of clinical and experimental studies on malignant tumor, we obtained the conclusions as follows 1. Asthenic splenic qi is an important factor in mutation, occurrence and development of tumor. 2. The anti-tumor mechanism of "invigorating spleen and supplementing qi" is improvement of immune suveillance, controling cell proliferating period and enhancing body metabolism. 3. "Invigorating spleen and supplementing qi" is often used with "nourishing kidney" or "expelling pathogen" for treating cnacer. 4. In experimental studies, "invigorating spleen and supplementing qi" has effects on inhibiting occurrence and development of tumor, protecting mutation, inhibiting recurrence and metastasis, immune activity, enhancing metabolism, promoting bone marrow hemopoietic cell proliferation, increasing anti-tumor effect and protecting normal cells. 5. In clinical studies, "invigorating spleen and supplementing qi" has effects on prolonging the survival period of cancer patients, improving clinical symptoms and quality of life of cancer patients, degrading the side effects of western therapie(operation, chemotherapy and radiotherapy). 6. "Invigorating spleen and supplementing qi" is an extensive discipline of syndrome differentiation used to inhibit occurence, development, recurrence and metastasis.

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Metastatic Carotid Body Tumor with Bivalvular Insufficiency in a Dog

  • Kim, Dong-Yun;Choi, Jeong Uk;Kim, Keon;Park, Sang-Ik;Suh, Guk-Hyun;Cho, Young-Chang;Lee, Chang-Min
    • Journal of Veterinary Clinics
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    • v.38 no.6
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    • pp.310-314
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    • 2021
  • Compared to the other chemodectoma, aortic body tumors, the carotid body tumor is rarer and more often malignant. In the present case, a 12-year-old, intact female Shih-tzu dog presented to the hospital with a right ventral cervical mass. The mass was diagnosed by immunohistochemical staining with chromogranin A (CgA) as a carotid body tumor. The cervical mass and metastasized lymph node were removed by surgical resection. Because the dog had valvular heart disease, chemotherapy with carboplatin was initiated over 6 months to prevent metastasis and recurrence as an adjunctive treatment. After over two years of management, tumor metastasis and recurrence were not observed until recently. This report shows that proper management and chemotherapy as an adjunctive therapy can treat carotid body tumors in elderly dogs with concurrent heart disease.

Can Recurrence and Progression be Predicted by HYAL-1 Expression in Primary T1 Bladder Cancer?

  • Mammadov, Elnur;Aslan, Guven;Tuna, Burcin;Bozkurt, Ozan;Yorukoglu, Kutsal
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10401-10405
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    • 2015
  • Background: Molecular prognostic markers have been under investigation for the last decade and no validated marker to date has been proven to be used in daily clinical practice for urinary bladder cancers. The aim of the present study is to evaluate the significance of HYAL-1 expression in prediction of recurrence and progression in pT1 urothelial carcinomas. Materials and Methods: Eighty-nine urothelial carcinoma cases staged as T1 according to 2004 WHO classification were studied. Representative sections from every case were stained immunohistochemically for HYAL-1 and scored between 0 and +3, according to staining density, and graded as low and high for the scores 0-1 and 2-3, respectively. Results: Of the 89 pT1 bladder cancer patients, HYAL-1 expression was high in 92.1% (82 patients; 72 patients +3 and 10 patients +2) and low in 7.9% (only 7 patients; 6 patients +1 and 1 patient 0) of the cases. Of the 89 patients, 38 (42.7%) had recurrence and 22 (24.7%) showed progression. HYAL-1 staining did not show significant characteristics for tumor grade, accompanying CIS, multiplicity, tumor size, age and sex. HYAL-1 expression did not have any prognostic value in estimating recurrence or progression. Conclusions: HYAL-1 expression was found to be high, but did not have any prognostic importance in T1 bladder urothelial carcinomas.

Case Report of Recurrent Osteoma at the Grafted Bone (이식된 뼈에서 재발한 뼈종의 치험례)

  • Joo, Chun Seung;Lee, Yoon Ho
    • Archives of Plastic Surgery
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    • v.33 no.3
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    • pp.367-370
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    • 2006
  • Surgical curettage or en bloc excision are the usual choice of treatment for osteoma. Local recurrence of osteoma after surgical treatment is not very common. We report a case of osteoma recurred at the grafted bone. A $5{\times}8cm$ sized osteoma of frontal bone was excised and then the defect was covered with calvarian bone and rib bone. Six years after reconstruction, recurrence from grafted area was noted. We completely removed the osteoma with enough normal tissue around it, after checking that the grafted bone has changed into an osteoma through a bicoronal incision. Then we covered the defect with a rib bone. The tissue was confirmed histologically as an osteoma. The recurrence of the tumor at the bone grafted site after osteoma excision is probably due to the fact that we covered grafted bone with periosteum left over osteoma. Therefore, we can learn that when we excise osteoma, galea should be carefully separated from the periphery of the tumor and that the periosteum should be completely removed, to prevent the osteoma from recurrence.

The location of locoregional recurrence in pathologic T3N0, non-irradiated lower rectal cancer

  • Kim, Mi Sun;Keum, Ki Chang;Rhee, Woo Joong;Kim, Hyunju;Kim, Minji;Choi, Seohee;Nam, Ki Chang;Koom, Woong Sub
    • Radiation Oncology Journal
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    • v.31 no.2
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    • pp.97-103
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    • 2013
  • Purpose: To investigate the patterns of locoregional recurrence of pathologic T3N0 (pT3N0) lower rectal cancer omitting postoperative radiotherapy (RT) and explore the potential of modification of a RT field. Materials and Methods: From Jan 2003 to Nov 2011, 35 patients omitting preoperative or postoperative RT for pT3N0 lower rectal cancer were included. We defined the lower rectal cancer as the tumor with the inferior margin located below the virtual line-a convergent level between rectal wall and levator ani muscle. All patients had radiologic examinations for recurrence evaluation during the follow-up duration. Results: The median follow-up duration was 66.4 months (range, 1.4 to 126.1 months). Eight (22.9%) of the 35 patients had recurrence. Three (8.6%) was local recurrence (LR) only, 3 (8.6%) was distant metastasis (DM) only, and 2 (5.7%) was LR with DM. All LR were located at primary tumor sites. The overall survival rate, LR-free survival rate, and DM-free survival rate at 5 years was 79.8%, 83%, and 87%, respectively. All LR developed from tumors over 5 cm. However, there was no statistical significance (p = 0.065). There was no other risk factor for LR. Conclusion: Even though the patients included in this study had pathologically favorable pT3N0 rectal cancer, LR developed in 14.3% of patients. Most of the LR was located at primary tumor sites prior to surgery. Based on these findings, it might seem reasonable to consider postoperative RT with a smaller radiation field to the primary tumor site rather than the conventional whole pelvic irradiation.