• Journal of Gastric Cancer
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• v.20 no.4
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• pp.395-407
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• 2020

Purpose: A phase II study was conducted to evaluate the safety and efficacy of preoperative, intra-arterial perfusion of epirubicin, etoposide, and oxaliplatin combined with oral chemotherapy S-1 (SEEOX) for the treatment of type 4 gastric cancer. Materials and Methods: A single-center, single-arm phase II trial was conducted on 36 patients with histologically proven type 4 gastric cancer without distant peritoneal or organ metastasis. Patients received 3, 21-day courses of SEEOX preoperative chemotherapy. The primary endpoint was overall survival (OS) and the secondary outcomes assessed were chemotherapeutic response, radical resection rate, pathological regression, toxicities, postoperative morbidity, and mortality. Results: All patients were at an advanced stage of cancer (stage III or IV) and completed the entire course of treatment. Based on changes in tumor volume and peritoneal metastasis, the objective response rate was 55.6% (20/36; 95% confidence interval [CI], 38.5%-72.6%) and the disease control rate was 69.4% (25/36; 95% CI, 53.6%-85.3%). The radical resection rate was 75% (27/36; 95% CI, 60.1%-89.9%) and the proportion of R0 resections was 66.7% (21/36; 95% CI, 50.5%-82.8%). The pathological response rate was 33.3%, of which 13.9% showed complete pathological regression. The median survival was 27.1 months (95% CI, 22.24-31.97 months), and the 2-year OS was 48.5% (95% CI, 30.86%-66.1%). Conclusions: Preoperative SEEOX is a safe and effective treatment for type 4 gastric cancer. Based on these preliminary data, a phase III study will be conducted to confirm the superiority of this regimen over standard treatment.

• Journal of Korean Academy of Oral Health
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• v.41 no.1
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• pp.16-21
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• 2017

Objectives: Dental caries and periodontitis are major oral bacterial infections associated with dental plaque. Infection and inflammation play a role in carcinogenesis, and a significant link has been found between some highly prevalent oral and dental diseases and some types of cancer. Therefore, the aim of this study was to evaluate the relationship between cancer and oral health among Korean adults. Methods: Data from the 6th Korea National Health and Nutrition Examination Survey were used to analyze the incidence of cancer according to oral health. Demographic and socioeconomic statuses and oral behavior of the participants was analyzed using complex chi-square tests. Logistic regression was used to analyze the relationship between a high DMFT index and cancer by calculating the 95% confidence intervals. Results: In total, 6,450 case-control subjects were included. Significant difference was observed in the DMFT index, but not in periodontal diseases, between the cases and controls. The odds ratio for cancer was 1.80 (95% confidence interval: 1.18 to 2.73) in the high-risk group. However, no significant difference was observed after adjusting for age, education level, and income. Conclusions: The results provide potential evidence of a significant association between cancer and oral disease.

• Korean Journal of Head & Neck Oncology
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• v.37 no.2
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• pp.19-24
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• 2021

Background/Objectives: The aim of this national population-based retrospective study was to analyze the status and treatment outcome in patients with hypopharyngeal cancer. Materials & Methods: Participants were included in the KNHIS national sample cohort who received a KNHIS health check-up in 2008 and 2009, and we followed these individuals until 2017. Patients were defined as having hypopharynx cancer if they had admissions records for hypopharynx cancer in their national health insurance data from 2010 to 2017. Results: The study cohort included 3,922 patients. According to our nationwide data, 3,533(90.1%) were male with a median age of 65.03±11.04 years at the time of diagnosis. Among parametric models for hypopharyngeal cancer prognosis, old age (Hazard ratio [HR]:1.92; 95% confidence interval[CI]:1.76-2.09), female (HR:0.77; 95% CI:0.66-0.89), and low socioeconomic status (HR:1.216; 95% CI:1.114-1.327) were significantly associated with survival. Compared with concurrent chemoradiotherapy, patients who received no treatment (HR, 1.88; 95% CI, 1.31-2.70), neoadjuvant chemotherapy followed by surgery (HR, 1.21; 95% CI, 1.04-1.41), and chemotherapy alone (HR, 1.16; 95% CI, 1.03-1.27) showed poor prognosis in hypopharyngeal cancer. Conclusion: Our data indicated that age, sex, and income were significant predictors of lifetime survival in patients with hypopharyngeal cancer. Treatment modalities were also associated with prognosis. The data have implications for treatment investigations and prevention strategies.

• Journal of Preventive Medicine and Public Health
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• v.55 no.3
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• pp.273-279
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• 2022

Objectives: The aim of this study was to present the baseline results of a pilot project conducted to evaluate the effectiveness of lung cancer screening using low-dose chest computed tomography (CT) in regions with excessive radon levels in the Republic of Kazakhstan. Methods: In total, 3671 participants were screened by low-dose chest CT. Current, former, and never-smokers who resided in regions with elevated levels of radon in drinking water sources and indoor air, aged between 40 and 75 with no history of any cancer, and weighing less than 140 kg were included in the study. All lung nodules were categorized according to the American College of Radiology Lung Imaging Reporting and Data System (Lung-RADS 1.0). Results: Overall, 614 (16.7%) participants had positive baseline CT findings (Lung-RADS categories 3 and 4). Seventy-four cancers were detected, yielding an overall cancer detection rate of 2.0%, with 10.8% (8/74) stage I and a predominance of stage III (59.4%; 44/74). Women never-smokers and men current smokers had the highest cancer detection rates, at 2.9% (12/412) and 6.1% (12/196), respectively. Compared to never-smokers, higher odds ratios (ORs) of lung cancer detection were found in smokers (OR,2.48; 95% confidence interval [CI], 1.52 to 4.05, p<0.001) and former smokers (OR, 2.32; 95% CI, 1.06 to 5.06, p=0.003). The most common histologic type of cancer was adenocarcinoma (58.1%). Conclusions: Implementation of low-dose CT screening for lung cancer in regions with elevated radon levels is an effective method for both smokers and never-smokers.

• Journal of Korean Neurosurgical Society
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• v.66 no.4
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• pp.465-475
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• 2023

Objective : Our objective is to analyze the occurrence, clinical course and risk factors for glioma patients with leptomeningeal metastasis (LM) according to different metastasis patterns and clinical variables. Methods : We retrospectively reviewed data from 376 World Health Organization (WHO) grade II-IV adult glioma patients who were treated in the National Cancer Center from 2001 to 2020. Patients who underwent surgery at other institutions, those without initial images or those with pathologically unconfirmed cases were excluded. LM was diagnosed based on magnetic resonance imaging (MRI) findings or cerebrospinal fluid (CSF) cytology. The metastasis pattern was categorized as nodular or linear according to the enhancement pattern. Tumor proximity to the CSF space was classified as involved or separated, whereas location of the tumor was dichotomized as midline, for tumors residing in the thalamus, basal ganglia and brainstem, or lateral, for tumors residing in the cerebral and cerebellar hemispheres. Results : A total of 138 patients were enrolled in the study. A total of 44 patients (38%) were diagnosed with LM during a median follow-up of 9 months (range, 0-60). Among the clinical variables, tumor proximity to CSF space, the location of the tumor and the WHO grade were significant factors for LM development in univariate analysis. In multivariate analysis, the midline location of the tumor and WHO grade IV gliomas were the most significant factor for LM development. The hazard ratio was 2.624 for midline located gliomas (95% confidence interval [CI], 1.384-4.974; p=0.003) and 3.008 for WHO grade IV gliomas (95% CI, 1.379-6.561; p=0.006). Conclusion : Midline location and histological grading are an important factor for LM in glioma patients. The proximity to the CSF circulation pathway is also an important factor for WHO grade IV glioma LM. Patients carrying high risks should be followed up more thoroughly.

• Korean Journal of Radiology
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• v.21 no.6
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• pp.684-694
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• 2020

Objective: The purpose was to review the diagnostic performance of the length of tumor capsular contact (LCC) on magnetic resonance imaging (MRI) for detecting prostate cancer extraprostatic extension (EPE). Materials and Methods: PubMed and EMBASE databases were searched up to March 24, 2019. We included diagnostic accuracy studies that evaluated LCC on MRI for EPE detection using radical prostatectomy specimen histopathology as the reference standard. Quality of studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity were pooled and graphically presented using hierarchical summary receiver operating characteristic (HSROC) plots. Meta-regression and subgroup analyses were conducted to explore heterogeneity. Results: Thirteen articles with 2136 patients were included. Study quality was generally good. Summary sensitivity and specificity were 0.79 (95% confidence interval [CI] 0.73-0.83) and 0.67 (95% CI 0.60-0.74), respectively. Area under the HSROC was 0.81 (95% CI 0.77-0.84). Substantial heterogeneity was present among the included studies according to Cochran's Q-test (p < 0.01) and Higgins I² (62% and 86% for sensitivity and specificity, respectively). In terms of heterogeneity, measurement method (curvilinear vs. linear), prevalence of Gleason score ≥ 7, MRI readers' experience, and endorectal coils were significant factors (p ≤ 0.01), whereas method to determine the LCC threshold, cutoff value, magnet strength, and publication year were not (p = 0.14-0.93). Diagnostic test accuracy estimates were comparable across all assessed MRI sequences. Conclusion: Greater LCC on MRI is associated with a higher probability of prostate cancer EPE. Due to heterogeneity among the studies, further investigation is needed to establish the optimal cutoff value for each clinical setting.

• Journal of Chest Surgery
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• v.23 no.2
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• pp.285-298
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• 1990

The records of 67 patients who had been operated as an esophageal cancer during the period from 1973 to 1989 at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital were reviewed retrospectively. The results were summarized as follows ; The age ranged from 28 years old to 80 years old. The highest incidence was 5th decades, then 6th decades, and the incidence of male was 10 times as the incidence of female[M:F= 10.16: 1]. The locations were lower esophagus 44%, middle esophagus 38.8%, upper esophagus 11.9% and cervical esophagus 4.4% The frequent symptoms were dysphagia [88%], epigastric or substernal pain and discomfort [29.8%], weight loss [20.8%], and laryngeal dryness [1.4%]. The most common interval between the onset of dysphagia and admission was 2-3 months; 82% of patients was within 6 months, The cancer consisted of stage I [3%], stage II [11.9%], stage III[47.6%], and stage IV [33.7%] The resectability of cancer was 67%. The organs of substitute were stomach in 21 cases, right colon 6 cases, and jejunum in 8 CRSCS. The relation between invasion of tumor and lymph node metastasis was analyzed: mucosal involvement: 1 case/2case, muscle invasion; 0/2 full thickness; 4/6, adjacent structure 7/12. Postoperative complications were pneumonia, pleural effusion, hoarseness, mediastinitis, anastomosis site leakage, reoperation due to stenosis, chylothorax, empyema, mechanical ileus, wound infection, meat impaction at anastomosis site, and repair of gastrostomy site leakage. Adjuvant therapies were irradiation [15cases], chemotherapy [14cases], and Bougie dilatation [4 cases],

• Journal of Korean Academy of Nursing
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• v.34 no.3
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• pp.400-411
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• 2004

Purpose: This study was aimed to develop a computerized reminder system and evaluate it's effect in terms of percent age change of screening, and satisfaction. Method: It was conducted through 6 phases: Analyzing the job and defining the basic input data, developing the information system, collecting and inputting data, testing the system, working with the system, and evaluating it's effect. Participants were 787 people (female 30-69 years, and males 40-49 years) in 2 dong of Suyoung gu, Busan, who haven't had cancer screening for the stomach, breast, or cervix since Dec. 2000. There were three experimental groups: a letter; calling and calling after the letter reminder, and a non-equivalent control group. To determine whether services were obtained, a telephone survey was done after two months of follow-up. Result: A cancer screening information system with five DB modules was developed. Overall compliance with screening was not statistically significantly changedbefore and after applying computerized reminders for all three screening sites. Only 16% were satisfied with the reminder. Conclusion: This data didn't show that a reminder effort was effective of screening. However, because the evaluation interval was too short to find a difference in screening rate, we recommend additional longer prospective follow up studies.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.769-773
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• 2013

Background: A literature review on 1,104,269 cancer patients concluded that the prevalence of multiple primary malignancies (MPM) is between 0.73% and 11.7%. MPMs seem to have higher incidence than that influenced by hazard only. The purpose of this study was to investigate clinically useful information for effective screening for synchronous and metachronous second primary cancers and to identify a potential surveillance protocol. Materials and Methods: Using statistical and epidemiological indicators we evaluated the patients with MPMs (double locations) admitted to Dr. Abdurrahman Yurtarslan Ankara Oncology Education and Research Hospital between 1981 and 2010. Results: Out of the 130 cases, 24 (18.4%) were synchronous while 106 cases (81.6%) were metachronous tumours. Mean interval time from first to second primary cancers was 4.65 years (0-27 years). The most frequent malignant associations were breast-breast, breast-endometrium and breast-ovary. Both primary and secondary tumors tended to be in an advanced stage explained by the low compliance of the patients to follow-up. Conclusions: The possibility that MPMs exist must always be considered during pretreatment evaluation. Screening procedures are especially useful for the early detection of associated tumors, whereas careful monitoring of patients treated for primary cancer and a good communication between patients and medical care teams should ensure early detection of secondary tumors, and subsequent appropriate management.

• Journal of Korean Society for Atmospheric Environment
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• v.18 no.6
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• pp.465-474
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• 2002

In order to reflect variability due to exposure factors as well as to assess uncertainty associated with cancer risk posed by airborne trace metals, a Monte Calro analysis has been made in this study. Input parameters for Monte Carlo analysis were developed or adjusted using body weight, lifetime, and exposure frequency of Koreans. Ambient distributions of toxic metals were founded to be lognormal distributions for most of them using goodness-of-fit tests. Thus, the 95% UCL and 95% LCL of carcinogenic metals were estimated by H-statistic method for lognormal distribution, respectively. The results of Monte Carlo analysis of 95% UCL showed that the 95th percentile risks for men and women were 1.2 and 1.1 times higher than an acceptable risk of 10$^{-5}$ , respectively. The probabilities which those risks exceed the acceptable risk were estimated to be 8% and 6%, respectively, while to be 95% and 94%, respectively on the basis of the minimum acceptable risk of 10$^{-6}$ , respectively. Approximately 90% of total cancer risk came from human carcinogens such as arsenic and hexavalent chromium. Therefore, it is necessary to properly manage both arsenic and hexavalent chromium emissions in the study area.