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Breast Conservation Therapy Versus Mastectomy - Preliminary Results of Pattern of Failure and Survival Rate in Early Breast Cancer (조기유방암에서 유방보존치료와 유방전절제술의 치료결과 및 실패양상 비교)

  • Kim Yeon-Sil;Yoon Sei-Chul;Chung Su-Mi;Ryu Mi-Ryeong;Jung Sang-Sul;Choi Ihl-Bohng
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.115-123
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    • 2004
  • Purpose : This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy In early breast cancer. Materials and Methods : We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary's Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. in the BCT group, all patients received whole breast irradiation to a total dose of 45$\~$50 Gy/5$\~$6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1$\%$) patients in BCT and 40 (45.5$\%$) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19$\~$111 months). Log rank test was used to estimate the prognostic factors for treatment failure. Results : Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5$\%$)in the mastectomy group and 10 patients (11.8%$\%$ in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT Five patients fatted at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of S BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2$^{nd}$ primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade In the mastectomy group were risk factors for treatment fallure (p < 0.05). Concousion : Although further careful follow-up is necessary to confirm the trends evident In this serles, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.

Correlation between Self-Evaluation Factor, Satisfaction, Utilization Frequency and Academic Achievement in Cyber Anatomical Education according to Major (전공에 따른 해부학 가상강의의 자기평가요인, 가상강의실 활용도, 학업성취도 간의 상관관계 비교)

  • Kim, Kwang-Hwan;Kim, Jee-Hee;Lee, Young-Il;Park, Jeong-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.1
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    • pp.281-287
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    • 2011
  • In anatomical education, cyber class has been studied as a strong strategy coincided with academic characterestics. In the present study, we investigated the correlation between self-evaluation factors, use of cyber classroom and academic achievement of health allied undergraduate students according to application of cyber class in the anatomical education. The subjects of study were totally 231 students who were majored in nursing science (n=143) and sports science (n=88) in last 3 years (2007-2009). Based on frequency of log-in, survey and grade of score, we analyzed correlation of their factors and their scores using frequency analysis, T-test and analysis of variance. Regardless of their major, most of students gave high scores in all of self-evaluation factors, convinience of cyber classroom, suitability of assignment. The frequency of log-in correlated highly with academic achievement(r=0.246, p<0.01, nursing science; r=0.234, p<0.05 sports medicine). The academic achievement also had a high correlation of 0.218(p<0.01) with the level of difficulty in nursing science students, 0.499(p<0.05) with the levels of satisfaction difficulty and interest. in sports science students. This study suggested that cyber class was very useful and would be a promising strategy in anatomical education.

Prognostic Significance of Preoperative Serum Alpha-fetoprotein in Hepatocellular Carcinoma and Correlation with Clinicopathological Factors: a Single-center Experience from China

  • An, Song-Lin;Xiao, Ting;Wang, Li-Ming;Rong, Wei-Qi;Wu, Fan;Feng, Li;Liu, Fa-Qiang;Tian, Fei;Wu, Jian-Xiong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4421-4427
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    • 2015
  • Objectives: To investigate the prognosis significance of preoperative serum alpha-fetoprotein (AFP) and the correlation with clinicopathological factors of hepatocellular carcinoma (HCC) patients who underwent hepatectomy. Materials and Methods: Clinicopathological data of retrospective analysis were collected for 251 HCC patients undergoing hepatectomy in this study. According to preoperative AFP level, patients were categorized into AFP-negative (0-20ng/mL) and AFP-positive (>20 ng/mL) groups for Kaplan-Meier analysis and Cox proportional hazard regression modeling. Results: The results demonstrated that increased AFP was associated with longer prothrombin time (PTs), liver capsule invasion, low grade differentiation, and late Barcelona Clinic Liver Center (BCLC) stage. Moreover, the female patients had a greater prevalence of increased preoperative AFP than male patients [284.8 (3.975-3167.5) vs (3.653-140.65); Z-2.895, p=0.004]. The 1-, 3-, and 5-year recurrence-free survival (RFS) rates were 78.1, 57.5, and 40.6 % in the AFP-negative group and 61.8, 37.7, and 31.4 %, respectively, in the AFP-positive group (log-rank test 8.312, p=0.004). The 1-, 3-, and 5-year overall survival (OS) rates were 94.4, 83.8, and 62.3% in the AFP-negative group and 87.2, 60.0, and 36.7%, respectively, in the AFP-positive group. The difference was statistically significant (log-rank test, 16.884, p=0.000). Cox proportional-hazards model identified preoperative AFP to be an independent prognostic predictor of overall survival. Conclusions: Preoperative serum AFP is an independent predictor of prognosis among HCC patients following surgical resection. Female patients have a higher preoperative AFP than their male counterparts.

Novel Promoter Polymorphism in RUNX2 Is Associated with Serum Triglyceride Level

  • Shin, Hyoung Doo;Jeon, Jae-Pil;Park, Byung Lae;Bae, Joon Seol;Nam, Hye-Young;Shim, Sung-Mi;Park, Kyong Soo;Han, Bok-Ghee
    • Molecules and Cells
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    • v.26 no.5
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    • pp.459-461
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    • 2008
  • Much research evidence supports the hypothesis that chronic, low-grade inflammation related to innate immunity may play an important role in the pathophysiology of type 2 diabetes mellitus (T2DM). Runt-related transcription factor 2 (RUNX2; MIM# 600211) acts as a scaffold that controls the integration, organization, and assembly of nucleic acids. To examine whether the novel promoter variant in RUNX2 is associated with the risk of T2DM and related phenotypes, RUNX2-742G > T was genotyped in 378 T2DM patients and 382 normal controls recruited in the Korean T2DM Study. Statistical analysis revealed that RUNX2-742G > T was associated with serum triglyceride level (TG) in nondiabetic controls, although it was not associated with the risk of T2DM. Individuals who carry T/T, T/G, and G/G genotypes had the highest ($2.061{\pm}0.20$), intermediate ($2.01{\pm}0.19$), and the lowest ($1.97{\pm}0.18$) levels of log [TG (mmol/l)] (P = 0.007), respectively. Our data on this important variant of RUNX2 suggest that lipid metabolism might be affected by genetic polymorphisms in the promoter region.

A Study on the Development of Children's Health Assessment Tools in Child Care Centers (보육시설 영유아의 건강사정을 위한 기록지 개발)

  • Han, Kyung-Ja;Bang, Kyung-Sook;Kwon, Mi-Kyung;Kim, Ji-Soo;Choi, Mi-Young;Huh, Bo-Yun
    • Korean Parent-Child Health Journal
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    • v.12 no.1
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    • pp.61-76
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    • 2009
  • Purpose: The purpose of this study was to develop child's health assessment tools for children in child care centers. Methods: Based on the literature review and several types of workshops participated with the child health nursing professors, doctoral students, nurses in pediatric units and pediatric psychiatric units from July to December 2006, the standards of child health assessment tools were developed. Graduate students and 4th grade students in nursing were trained for health assessment and used these assessment tools to validate the content and reliability of said tools. Results: Some record forms were newly developed, including demographic characteristics, past history, present health status, behavioral problems, and appropriate developmental screening tests in child care centers were selected. For systematic health care management in child care centers, daily care report, illness log, and referral sheet were also developed. Conclusion: In the face of growing utilization of daycare and their association with increased risk of various diseases, assessment and control measures are indispensable to the promotion of child health. Children's physical and mental health and developmental problems can be assessed using this assessment tools. They can be used for establishing the direction for developing a health care service system for young children.

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Expression of microRNA-218 and its Clinicopathological and Prognostic Significance in Human Glioma Cases

  • Cheng, Mao-Wei;Wang, Ling-Ling;Hu, Gu-Yu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1839-1843
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    • 2015
  • Background: MicroRNAs are a class of noncoding RNAs which regulate multiple cellular processes during tumor development. The purpose of this report is to investigate the clinicopathological and prognostic significance of miR-218 in human gliomas. Materials and Methods: Quantitative RT-PCR (qRT-PCR) was conducted to detect the expression of miR-218 in primary normal human astrocytes, three glioma cell lines and 98 paired glioma and adjacent normal brain tissues.Associations of miR-218 with clinicopathological variables of glioma patients were statistically analyzed. Finally, a survival analysis was performed using the Kaplan-Meier method and Cox's proportional hazards model. Results: The expression level of miR-218 in primary normal human astrocytes was significantly higher than that in glioma cell lines (p<0.01). Also, the expression level of miR-218 in glioma tissues was significantly downregulated in comparison with that in the adjacent normal brain tissues (p<0.001). Statistical analyses demonstrated that low miR-218 expression was closely associated with advanced WHO grade (p=0.002) and low Karnofsky performance score (p=0.010) of glioma patients. Kaplan-Meier analysis with the log-rank test showed that patients with low-miR-218 expression had poorer disease-free survival and overall survival (p=0.0045 and 0.0124, respectively). Multivariate analysis revealed that miR-218 expression was independently associated with the disease-free survival (p=0.009) and overall survival (p=0.004) of glioma patients. Conclusions: Our results indicate that miR-218 is downregulated in gliomas and that its status might be a potential valuable biomarker for glioma patients.

Galectin-9 Acts as a Prognostic Factor with Antimetastatic Potential in Hepatocellular Carcinoma

  • Zhang, Zhao-Yang;Dong, Jia-Hong;Chen, Yong-Wei;Wang, Xian-Qiang;Li, Chong-Hui;Wang, Jian;Wang, Guo-Qiang;Li, Hai-Lin;Wang, Xue-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2503-2509
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    • 2012
  • Considerable research has been conducted concerning galectin-9 and carcinomas, but little information is available about any relation with the hepatocellular carcinoma. In this study, we employed a small interfering RNA (siRNA) targeting galectin-9 to down-regulate the expression in HepG2 cells. As a result, after galectin-9 expression was reduced, cell aggregation was suppressed, while other behaviour such as the proliferation, adhesion and invasion to ECM, cell-endothelial adhesion and transendothelial invasion of the cells were markedly enhanced. When tumors of 200 patients with hepatocellular carcinoma were tested for galectin-9 expression by immunohistochemistry, binding levels demonstrated intimate correlations with the histopathologic grade, lymph node metastasis, vascular invasion and intrahepatic metastasis (P<0.05). Moreover, survival analysis indicated that patients with galectin-9 expression had much longer survival time than those with negative lesions, and the Log-rank test indicated that this difference was statistical significant (P<0.0001). The Cox proportional hazards model suggested that negative galectin-9 expression in hepatocellular carcinoma represented a significant risk factor for patient survival. We propose that galectin-9 might be a new prognostic factor with antimetastatic potential in patients with hepatocellular carcinoma.

Lack of any Impact of Histopathology Type on Prognosis in Patients with Early-Stage Adenocarcinoma and Squamous Cell Carcinoma of the Uterine Cervix

  • Teke, Fatma;Yoney, Adnan;Teke, Memik;Inal, Ali;Urakci, Zuhat;Eren, Bekir;Zincircioglu, Seyit Burhanedtin;Buyukpolat, Muhammed Yakup;Ozer, Ali;Isikdogan, Abdurrahman;Unsal, Mustafa
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2815-2819
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    • 2014
  • Background: The aim of this study was to evaluate the prognosis of patients with stage IA-IIB cervical carcinoma and to investigate a possible correlation of histology with prognosis. Materials and Methods: Two hundred fifty one patients with adenocarcinoma and squamous cell carcinoma (SCC) histology for FIGO (International Federation of Gynecology and Obstetrics) stage IA-IIB uterine cervical carcinomas at the Radiation Oncology Clinic of GH Okmeydan Training and Research Hospital between January 1996 and December 2006 were selected, analyzed retrospectively and evaluated in terms of general characteristics and survival. Disease-free survival (DFS) and overall survival (OS) was calculated using the Kaplan-Meier method and differences were compared with the log-rank test. Multivariate analysis using a Cox-proportional hazards model was used to adjust for prognostic factors and to estimate hazard ratio (HR) with 95% confidence interval (CI). Results: There was no differences between the two tumour types in age, stage, pelvic nodal metastasis, parametrial invasion, surgical margin status, DSI, LVSI, maximal tumor diameter, grade, and treatment modalities. 5-year OS and DFS were 73% and 77%, versus 64% and 69%, for SCC and adenocarcinoma, respectively (p> 0.05). Multivariate analysis revealed independent prognostic factors including pelvic nodal metastasis and resection margin status for OS (p=0.008, p=0.002, respectively). Conclusions: Prognosis of FIGO stage IA-IIB cervical cancer patients was found to be the same for those with adenocarcinoma and SCC.

Multivariate Analysis of the Prognosis of 37 Chondrosarcoma Patients

  • Yang, Zheng-Ming;Tao, Hui-Min;Ye, Zhao-Ming;Li, Wei-Xu;Lin, Nong;Yang, Di-Sheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1171-1176
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    • 2012
  • Objective: The current study aimedto screen for possible factors which affect prognosis of chondrosarcoma. Methods: Thirty seven cases were selected and analyzed statistically. The patients received surgical treatment at our hospital between December 2005 and March 2008. All of them had complete follow-up data. The survival rates were calculated by univariate analysis using the Kaplan-Meier method and tested by Log-rank. ${\chi}^2$ or Fisher exact tests were carried out for the numeration data. The significant indexes after univariate analysis were then analyzed by multivariate analysis using COX regression model. Based on the literature, factors of gender, age, disease course, tumor location, Enneking grades, surgical approaches, distant metastasis and local recurrence were examined. Results: Univariate analysis showed that there were significant differences in Enneking grades, surgical approaches and distant metastasis related to the patients' 3-year survival rate after surgery (P<0.001). No significant difference was not found in gender, age, disease course, tumor location or local recurrence (P>0.05). Multivariate analysis showed that Enneking grade (P=0.007) and surgical approaches (P=0.010) were independent factors affecting the prognosis of chondrosarcoma, but distant metastasis was not (P=0.942). Conclusion: Enneking grades, surgical approaches and distant metastasis are risk factors for prognosis of chondrosarcoma, among which the former two are independent factors.

Expression of EMSY, a Novel BRCA2-link Protein, is Associated with Lymph Node Metastasis and Increased Tumor Size in Breast Carcinomas

  • Madjd, Zahra;Akbari, Mohammad Esmaeil;Zarnani, Amir Hassan;Khayamzadeh, Maryam;Kalantari, Elham;Mojtabavi, Nazanin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1783-1789
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    • 2014
  • Background: The EMSY gene encodes a BRCA2-binding partner protein that represses the DNA repair function of BRCA2 in non-hereditary breast cancer. Although amplification of EMSY gene has been proposed to have prognostic value in breast cancer, no data have been available concerning EMSY tissue expression patterns and its associations with clinicopathological features. Materials and Methods: In the current study, we examined the expression and localization pattern of EMSY protein by immunohistochemistry and assessed its prognostic value in a well-characterized series of 116 unselected breast carcinomas with a mean follow up of 47 months using tissue microarray technique. Results: Immunohistochemical expression of EMSY protein was detected in 76% of primary breast tumors, localized in nuclear (18%), cytoplasmic (35%) or both cytoplasmic and nuclear sites (23%). Univariate analysis revealed a significant positive association between EMSY expression and lymph node metastasis (p value=0.045) and larger tumor size (p value=0.027), as well as a non-significant relation with increased risk of recurrence (p value=0.088), whereas no association with patients' survival (log rank test, p value=0.482), tumor grade or type was observed. Conclusions: Herein, we demonstrated for the first time the immunostaining pattern of EMSY protein in breast tumors. Our data imply that EMSY protein may have impact on clinicipathological parameters and could be considered as a potential target for breast cancer treatment.