• Health Policy and Management
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• v.31 no.1
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• pp.100-113
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• 2021

Background: This study aims to figure out the gaps in health status by estimating amenable mortality rate by region, reflecting the characteristics of Korea, and estimating the years of life lost (YLL) per capita by disease. Methods: People who died from amenable diseases between 2008 and 2018 were extracted from the cause of death statistics provided by Statistics Korea. The age-standardized amenable mortality rates were estimated to compare the health status of 229 regions. YLL per capita was calculated to compute the burden of diseases caused by treatable deaths by region. The YLL per capita by region was calculated to identify the burden of disease caused by amenable deaths. Results: First, while the annual amenable mortality rate in Korea is on a steady decline, but there is still a considerable gap between urban and rural areas when comparing the mortality rates of 229 areas. Second, YLL per capita due to the amenable deaths is approximately 14 person-years during the analysis period (2008-2018). Conclusion: Although the health status of Koreans has continuously improved, there is still a gap in health status region by region in terms of amenable mortality rates. Amenable death accounts for a loss of life equivalent to 14 person-years per year. Since the amenable mortality rate is an indicator that can measure the performance of the health care system, efforts at each local area are required to lower it.

• Journal of Chest Surgery
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• v.57 no.2
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• pp.136-144
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• 2024

Background: Early non-small cell lung cancer (NSCLC) that abuts adjacent structures requires careful evaluation due to its potential impact on postoperative outcomes and prognosis. We examined stage I NSCLC with invasion into adjacent structures, focusing on the prognostic implications after curative surgical resection. Methods: We retrospectively analyzed the records of 796 patients who underwent curative surgical resection for pathologic stage IA/IB NSCLC (i.e., visceral pleural invasion only) at a single center from 2008 to 2017. Patients were classified based on tumor abutment and then reclassified by the presence of visceral pleural invasion. Clinical characteristics, pathological features, and survival rates were compared. Results: The study included 181 patients with abutting NSCLC (22.7% of all participants) and 615 with non-abutting tumors (77.3%). Those with tumor abutment exhibited higher rates of non-adenocarcinoma (26.5% vs. 9.9%, p<0.01) and visceral/lymphatic/vascular invasion (30.4%/33.1%/12.7% vs. 8.5%/22.4%/5.7%, respectively; p<0.01) compared to those without abutment. Multivariable analysis identified lymphatic invasion and male sex as risk factors for overall survival (OS) and disease-free survival (DFS) in stage I NSCLC measuring 3 cm or smaller. Age, smoking history, vascular invasion, and recurrence emerged as risk factors for OS, whereas the presence of non-pure ground-glass opacity was a risk factor for DFS. Conclusion: NSCLC lesions 3 cm or smaller that abut adjacent structures present higher rates of various risk factors than non-abutting lesions, necessitating evaluation of tumor invasion into adjacent structures and lymph node metastasis. In isolation, however, the presence of tumor abutment without visceral pleural invasion does not constitute a risk factor.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.96-101
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• 2012

Purpose: Glomerular filtration rate is an important index for assessment of renal function, early discovery of renal disease, and progress observation of chronic renal disease patients. In the present study, the objective is to conduct a comparative analysis of differences between Gates and Modified Gates method in dynamic renal scintigraphy based on MDRD (Modification of Diet Renal Disease) formula using blood collection. Materials and Methods: Renal scintigraphy was performed for 45 patients who visited our hospital between November 2010 and August 2011. For 20 patients of those tested, glomerular filtration rates from Gates method and MDRD formula using AGUS equipment, were compared. For the other 20 patients, glomerular filtration rates from Modified Gates method and MDRD formula using INFINIA equipment. Finally, Gates and Modified Gates method were compared for 5 patients who indicated no change in glomerular filtration rates from MDRD formula during progress observation. Results: Glomerular filtration rates from both Gates and Modified Gates method showed a high correlation with those from MDRD formula ($p$<0.01, r=0.903, r=0.867), with a paired difference mean for Gates method of $2.05{\pm}2.54mL/min/1.73m$, and that for Modified Gates method of $25.2{\pm}3.71mL/min/1.73m$. Finally, the values for Gates method and those for Modified Gates method showed a high correlation for the five patients ($p$<0.05, r=0.949), with a paired difference mean of $20.4{\pm}8.84mL/min/1.73m$. Conclusion: Glomerular filtration rates from Gates method, Modified Gates method and MDRD formula showed mutually high correlations. If the tests are performed with recognition for the correlations between Gates and Modified Gates method used in a dynamic renal scintigraphy, then an accurate assessment of renal function is considered possible with an improved diagnostic ability.

• Radiation Oncology Journal
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• v.8 no.1
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• pp.35-43
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• 1990

Retrospective analysis of survival rates was undertaken in the patients of 58 cases treated with conventional radiation therapy for malignant salivary gland tumors between January 1975 and December 1984 in Korea Cancer Center Hospital (KCCH). They were patients whose long-term follow-up was possible and who had refused surgery or had had recurrences postoperatively. Out of 58 patients, 25 patients ($43.1\%$) had mucoepidermoid carcinomas and 24 patients ($41.3\%$) adenoid cystic carcinoma. Total actuarial survival rates at 5 years and 10 years were $68.2\%\;and\;31.8\%$ respectively, but disease-free survival rates, $43.2\%\;and\;13.0\%$, respectively. According to TNM stage, the survival rates at 5 years were $86.5\%$ in $T_1,\;40.0\%\;in\;T_2+T_3,\;and\;0\%\;in\;T_4$. In terms of histologic types, 5 years disease-free survival rate of adenoid cystic carcinomas ($40.1\%$) was lower than that of mucoepidermoid carcinomas ($49.8\%$) but overall survival rate ($77.3\%$) was much higher than that of mucoepidermoid carcinomas ($51.5\%$). There-fore, we concluded that the patients, who had had disease after failure of treatment, could survive during a certain period of time and their alive times were 2 years on the average. There was a difference in survival rates in the mucoepidermoid carcinomas in terms of histological grade of differentiation and it was a arbiter in prognosis: 5 YSR of low-grade was $78.8\%$ and higher 2 times than that of high-grade. There was no difference in survival rates according to location and sex. The number of patients having minor salivary gland tumors was 6 cases and their actuarial 5 YSR was $32.3\%$. Consequently, prognostic factors which influence the survival rates of patients with malignant salivary gland tumors are thought to be 1) histological subtypes 2) T and N staging (AJCC) 3) histological grade, especially in mucoepidermoids.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.9
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• pp.3945-3949
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• 2014

Background: A cancer registry program has been established in East Azerbaijan and this has emphasized the importance of cancers of gastrointestinal tract in this region. The aim of the present pathology-based cancer registry report is to renew epidemiologic aspects of gastrointestinal tract cancers and estimate recent trends. Materials and Methods: A survey team reviewed and collected all records of cancer cases from all referral and valid pathology laboratories of East Azerbaijan province during September 2007-2011. Crude rates, age-specific rates of cancer incidence and annual percent change were calculated. Results: The total newly diagnosed cancer cases (n=6,889)comprised 4,341 males (63.0%) and 2,540 females (36.9%). Gastric cancer was the most common GI tract cancer with an ASR (per $10^5$) of 23.1 for males and 7.69 for females. The ASRs for esophageal and colorectal cancers were 9.69 and 11.2 in males and 7.35 and 8.93 in females. Trend analysis showed a significant decline for esophageal cancer and increasing incidence for colorectal cancer in females. Conclusions: The prevalence of gastric cancer is high in East Azerbaijan province of Iran. This pathology based cancer registry showed an ascending trend for colorectal cancer and decreasing trend for esophageal cancer in females during 2007-2011.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2595-2598
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• 2013

Background: Prostate cancer is common in elderly men, especially in western countries, and incidences are rising in low-risk populations as well. In India, the age-standardized rates vary between registries. Under these circumstances we have estimated the survival of prostate cancer patients based on age, family history, diabetes, hypertension, tobacco habit, clinical extent of disease (risk group) and treatment received. Materials and Methods: The present retrospective study was carried out at the Tata Memorial Hospital (TMH), Mumbai, India. During years 1999-2002, some 850 prostate cancer cases, including 371 new cases, treated in TMH were considered as eligible entrants for the study. Five-year survival rates using actuarial and loss-adjusted (LAR) method were estimated. Results: The patient population was distributed uniformly over the three age groups. A larger proportion of the patients were diagnosed at 'metastatic stage' and hormone treatment was most common. 20% patients had history of diabetes and 40% with hypertension. The 5-year overall survival rate was 64%. Survival was 55%, 74% and 52% for '<59 years','60-69 years' and '>70 years' respectively. Non-diabetic (70%), hypertensive (74%), with family history (80%) of cancer, with localized-disease (91%) and treated with surgery, either alone or in combination, (91%) had better survival. Conclusions: The present study showed that prostate cancer patients with localized disease at diagnosis experience a better outcome. Local treatment with either surgery or radiation achieves a reasonable outcome in prostate cancer patients. A detailed study will help in understanding the prognostic indicators for survival especially with the newer treatment technologies available now.

• Radiation Oncology Journal
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• v.35 no.3
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• pp.241-248
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• 2017

Purpose: To evaluate the efficacy and safety of extended-field radiation therapy for patients with thoracic superficial esophageal cancer (SEC). Materials and Methods: From May 2007 to October 2016, a total of 24 patients with thoracic SEC (T1a and T1b) who underwent definitive radiotherapy and were analyzed retrospectively. The median total radiotherapy dose was 64 Gy (range, 54 to 66 Gy) in conventional fractionation. All 24 patients received radiotherapy to whole thoracic esophagus and 23 patients received elective nodal irradiation. The supraclavicular lymph nodes, the celiac lymph nodes, and both of those nodal areas were included in 11, 3, and 9 patients, respectively. Results: The median follow-up duration was 28.7 months (range 7.9 to 108.0 months). The 3-year overall survival, local control, and progression-free survival rates were 95.2%, 89.7%, and 78.7%, respectively. There were 5 patients (20.8%) with progression of disease, 2 local failures (8.3%) and 3 (12.5%) regional failures. Three patients also experienced distant metastasis and had died of disease progression. There were no treatment-related toxicities of grade 3 or higher. Conclusion: Definitive extended-field radiotherapy for thoracic SEC showed durable disease control rates in medically inoperable and endoscopically unfit patients. Even extended-field radiotherapy with elective nodal irradiation was safe without grade 3 or 4 toxicities.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2851-2856
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• 2014

The aim of this study is to evaluate clinicopathologic characteristics and the multi-disciplinary treatment results of metaplastic breast cancer (MBC) patients treated in a single institute. Seventeen female patients with MBC treated in our department between June 2000 and January 2012 were identified and retrospectively evaluated. The median age at diagnosis was 46 years (range, 26-66 years). The median tumor size at diagnosis was 3.5 cm (range 1.5-12 cm). Six (35%) patients underwent breast conservation surgery and 11 (65%) mastectomy. Axillary lymph node metastasis was found in 6 (35%) patients. Twelve (71%) had triple negative tumors. Postoperative RT and systemic adjuvant treatment was given to all patients accordingly to stage and biological characteristics. Median follow-up time was 27 months (range, 12-151 months). At the time of this analysis, 14 (82%) patients were alive with no evidence of disease, and 1 (6%) was alive with disease. The 3-year OS was 91% and 5-year 80%, and DFS rates were 76% and 76%, respectively. Despite the young age of our patients with mostly high grade tumors, larger tumor size and higher rates of lymph node metastasis, the survival outcomes in our study are favorable in comparison with previously reported series.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8321-8325
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• 2016

Background: The incidence of hydatidiform mole (HM) differs among regions but has declined significantly over time. In Thailand, the initiation of universal health coverage in 2002 has resulted in a change of medical services countrywide. However, impacts of these policies on gestational trophoblastic disease (GTD) cases in Thailand have not been reported. This study aimed to find the incidence of hydatidiform mole (HM) in King Chulalongkorn Memorial Hospital (KCMH) from 1994-2013, comparing before and after the implementation of the universal coverage health policy. Materials and Methods: All cases of GTD in KCMH from 1994-2013 were reviewed from medical records. The incidence of HM, patient characteristics, treatment and remission rates were compared over two study decades between 1994-2003 and 2004-2013. Results: Hydatidiform mole cases decreased from 204 cases in the first decade to 111 cases in the seond decade. Overall incidence of HM was 1.70 per 1,000 deliveries. The incidence of HM in the first and second decades were 1.70 and 1.71 per 1,000 deliveries, respectively (p=0.65, 95%CI 1.54-1.88). Referred cases of nonmolar gestational trophoblastic neoplasia (GTN) increased from 12 (4.4%) to 23 (14.4%, p<0.01). Vaginal bleeding was the most common presenting symptom which decreased from 89.4% to 79.6% (p=0.02). Asymptomatic HM patients increased from 4.8% to 10.2% (p=0.07). Rate of postmolar GTN was 26%. Conclusions: The number of HM cases in this study decreased over 2 decades but incidence was unchanged. Referral rates of malignant cases were more common after universal health coverage policy initiation. Classic clinical presentation was decreased significantly in the last decade.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.11-13
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• 2013

Background: Esophagus cancer, the third most common gastrointestinal cancer overall, demonstrates high incidence in parts of Iran. The counties of Iran vary in size, shape and population size. The aim of this study was to account for spatial support with Area-to-Area (ATA) Poisson Kriging to increase precision of parameter estimates and yield correct variance and create maps of disease rates. Materials and Methods: This study involved application/ecology methodology, illustrated using esophagus cancer data recorded by the Ministry of Health and Medical Education (in the Non-infectious Diseases Management Center) of Iran. The analysis focused on the 336 counties over the years 2003-2007. ATA was used for estimating the parameters of the map with SpaceStat and ArcGIS9.3 software for analysing the data and drawing maps. Results: Northern counties of Iran have high risk estimation. The ATA Poisson Kriging approach yielded variance increase in large sparsely populated counties. So, central counties had the most prediction variance. Conclusions: The ATAPoisson kriging approach is recommended for estimating parameters of disease mapping since this method accounts for spatial support and patterns in irregular spatial areas. The results demonstrate that the counties in provinces Ardebil, Mazandaran and Kordestan have higher risk than other counties.