• Title/Summary/Keyword: metastasis risk

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Effect of CXCR4 and CD133 Co-expression on the Prognosis of Patients with Stage II~III Colon Cancer

  • Li, Xiao-Feng;Guo, Xiao-Guang;Yang, Yong-Yan;Liu, Ai-Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1073-1076
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    • 2015
  • Background: To explore the relationship between CXCR4, CD133 co-expression and clinicopathological features as well as prognosis of patients with phase II~III colon cancer. Materials and Methods: Forty-nine paraffin-embedded samples of tumor tissue and epithelial tissue adjacent to cancer were collected from patients with colon cancer undergoing radical surgery in Baotou Cancer Hospital from January, 2010 to June, 2011. CXCR4 and CD133 expression was detected using immunohistochemistry and its relationship with clinicopathological features and the 3-year survival rate was analyzed. Results: In the tumor tissue and colonic epithelial tissue adjacent to cancer, the positive expression rates of CXCR4 were respectively 61.2% (30/49) and 8.16% (4/49), while those of CD133 being 36.7% (18/49) and 6.12% (3/49). CXCR4 and CD133 expression in tumor tissue was not related to patient age, gender, primary focal sites, tumor size, TNM staging, histological type, tumor infiltration depth and presence or absence of lymphatic metastasis, but CXCR4 and CD133 co-expression was associated with TNM staging and lymphatic metastasis. The 3-year survival rate of patients with CXCR4 and CD133 co-expression was 27.3% (3/11), and that of the remainderwas 76.3% (29/38), the difference being significant ($X^2=7.0206$, p=0.0081). Conclusions: CXCR4 and CD133 co-expression may be a risk factor for poor prognosis of patients with stage II~III colon cancer.

Prognostic Value of Osteopontin in Patients Treated with Primary Radiotherapy for Head and Neck Cancer

  • Etiz, Durmus;Ataizi, Fulya Colak;Bayman, Evrim;Akcay, Melek;Acikalin, Mustafa Fuat;Colak, Ertugrul;Ciftci, Evrim
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5175-5178
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    • 2013
  • Background: The prognostic value of tumor osteopontin (OPN) in patients with squamous-cell head and neck cancer (SCHNC) was investigated. Materials and Methods: OPN expression was assessed by immunohistochemical methods in 50 patients, who were treated with primary radiotherapy (RT) for locally advanced SCHNC. The effects of OPN on clinical parameters, local-regional control after RT and metastasis-free survival, was assessed. Results: The rate of OPN expression in tumor tissue was 76%. OPN positive cases had lower Hb levels (p=0.088). Mean time to local recurrence was 53.8 months (SE 3.9) in OPN-negative cases and 39.1 months (SE 4.7) in OPN-positive cases (p=0.047). OPN increased the risk of local recurrence 5.9 times (p=0.085). It had no effect on metastasis-free (p=0.116) or overall survival (p=0.123). OPN was positive in 12 of 19 cases that developed grade 3-4 acute radiation dermatitis (p=0.096). Conclusions: OPN expression is associated with an increase in local recurrence in patients who were treated with primary RT for locally advanced SCHNC.

The value of prophylactic cranial irradiation in limited-stage small cell lung cancer: should it always be recommended?

  • Koh, Minji;Song, Si Yeol;Jo, Ji Hwan;Park, Geumju;Park, Jae Won;Kim, Su Ssan;Choi, Eun Kyung
    • Radiation Oncology Journal
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    • v.37 no.3
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    • pp.156-165
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    • 2019
  • Purpose: Prophylactic cranial irradiation (PCI) is a standard treatment for limited-stage small cell lung cancer (LS-SCLC) showing a response to initial treatment, but many patients do not receive PCI due to comorbidities or refusal. This study aims to define the patient group for whom PCI can be omitted with minimal risk. Materials and Methods: Patients with LS-SCLC who underwent radiotherapy with curative aim at our institution between January 2004 and December 2015 were retrospectively reviewed. Patients who did not receive PCI were evaluated for brain metastasis-free survival (BMFS), progression-free survival (PFS), overall survival (OS), and prognostic factors for survival, and treatment outcomes were compared with a patient cohort who received PCI. Results: A total of 350 patients achieved a response following thoracic radiotherapy, and 190 of these patients did not receive PCI. Stage I-II and a complete response (CR) to initial therapy were good prognostic factors for BMFS and OS on univariate analysis. Patients with both stage I-II and a CR who declined PCI showed comparable 2-year BMFS to those who received PCI (92% vs. 89%). In patients who achieved CR, PCI did not significantly improve OS or PFS. Conclusion: There should be less concern about omitting PCI in patients with comorbidities if they have stage I-II or a CR, with brain metastasis control being comparable to those patients who receive PCI.

Internal Radiotherapy of Metastatic Hepatic Malignancy Using Colloidal P-32 in Various Gabtrointebtinal Tumors - The First Report: Prevention of Liver Metastasis Using Colloidal p-32 in Colo-Rectal Cancer- (각종(各種) 소화기암(消化器癌)에서 교질성(膠質性) 방사성(放射性) 인(燐)을 이용(利用)한 전이성(轉移性) 간암(肝癌의) 방사선(放射線) 내부치료(內部治療) -제1보(第1報) : 대장(大腸)-직장암(直腸癌)에서 교질성(膠質性) 인(燐)을 이용(利用)한 간전이(肝轉移)의 예방(豫防)-)

  • Kim, Ji-Yeul;Bom, Hee-Seung;Choi, Won;Kim, Young-Jin
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.2
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    • pp.274-278
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    • 1990
  • Metastases to the liver presents a common clinical problem in the management of patients with cole-rectal cancer, and are responsible for a high degree of morbidity and mortality associated with this malignancy. Unfortunately, attempts at preventing the development of liver metastases in "high risk" patients has so far been unsuccessful. Ongoing studies of adjuvant chemotherapy have not yet illustrated a significant increase in survival in patients receiving such therapy. The purpose of the study is to investigate the value of adjuvant radiotherapy given in the form of colloidal chromic phosphate P-32 suspension administered via portal vein after radical resection of the primary cancer, in preventing the growth of occult metastases in the liver. Twenty one patients (10 patients of treated group with 11 controls) were followed 18 months after operation. There was no significant change in the CBC and liver functions after administration of P-32 labeled colloidal chromic phosphate. The number of patients who showed local metastases at 18 months were 2 in the treated group and 3 in the control group. While liver metastases occurred in one patient at 6 months and in three at 12 months in the control group, there was no development of liver metastases by 12 months in the treated group. At 18 month follow-up CT scan one patient in the treated group showed a single nodule in the liver. In conclusion liver metastasis rate was lower in the patients who received colloidal P-32 chromic phosphate via portal vein after radical resection of the primary cole-rectal cancer.

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Is Surgical Treatment Necessary after Non-curative Endoscopic Resection for Early Gastric Cancer?

  • Lee, Ji-Ho;Kim, Jae-Hun;Kim, Dae-Hwan;Jeon, Tae-Yong;Kim, Dong-Heon;Kim, Gwang-Ha;Park, Do-Yoon
    • Journal of Gastric Cancer
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    • v.10 no.4
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    • pp.182-187
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    • 2010
  • Purpose: Additional surgery is commonly recommended in gastric cancer patients who have a high risk of lymph node metastasis or a positive resection margin after endoscopic resection. We conducted this study to determine factors related to residual cancer and to determine the appropriate treatment strategy. Materials and Methods: A total of 28 patients who underwent curative gastrectomy due to non-curative endoscopic resection for early gastric cancer between January 2006 and June 2009 were enrolled in this study. Their clinicopathological findings were reviewed retrospectively and analyzed for residual cancer. Results: Of the 28 patients, surgical specimens showed residual cancers in eight cases (28.6%) and lymph node metastasis in one case (3.8%). Based on results of the endoscopic resection method, the rate of residual cancer was significantly different between the en-bloc resection group (17.4%) and the piecemeal resection group (80.0%). The rate of residual cancer was significantly different between the diffuse type group (100%) and the intestinal type group (20%). The rate of residual cancer in the positive lateral margin group (25.0%) was significantly lower than that in the positive vertical margin group (33.3%) or in the positive lateral and vertical margin group (66.7%). Conclusions: We recommended that patients who were lateral and vertical margin positive, had a diffuse type, or underwent piecemeal endoscopic resection, should be treated by surgery. Minimal invasive procedures can be considered for patients who were lateral margin positive and intestinal type through histopathological examination after en-bloc endoscopic resection.

Papillary Thyroid Carcinoma in Renal Allograft Recipients (신장이식후 발생한 유두상 갑상선암)

  • Lee, Jan-Dee;Hong, Hyeop;Jeong, Jong-Ju;Nam, Kee-Hyun;Chung, Woong-Youn;Soh, Euy-Young;Park, Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.1
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    • pp.64-68
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    • 2008
  • Purpose:The chronic use of immunosuppressive therapy in transplant recipients can increase the long-term risk of carcinoma. The aim of this study was to determine the incidence, biological behaviors, and treatment outcomes in PTC(papillary thyroid carcinoma) in renal allograft recipients. Material and Methods:The present study examined the incidence and biological behavior of PTCs in RA recipients. A total of 1,739 RA patients treated between January 1986 and December 1999 were followed-up for a median 137(84-238) months. During the follow-up period, 129(7.4%) recipients were identified as having posttransplant malignancies. Of those, 12(0.7%) had PTCs, and these comprised six male and six female patients with a median age of 41(23-57) years. Results:Nine cases(incidentalomas) were diagnosed based on ultrasonography(US) screening. Eight of those nine were TNM stage I, and two of the three clinical carcinomas were TNM stage IVa. During a median follow-up of 94(18-159) months, two(16.7%) PTC patients developed loco-regional recurrence, but no patients showed distant metastasis. Posttransplant PTC showed no gender bias, and was often associated with aggressive lymphatic metastasis. However, most incidentalomas showed a favorable treatment outcome. Conclusion:In conclusion, routine surveillance of the thyroid gland using US screening is recommended to ensure early detection, treatment and favorable prognosis in RA patients with PTC.

Tissue factor expression is associated with recurrence in patients with non-metastatic colorectal cancer

  • Jung, Hee Jae;Kim, Hye Jin;Kaneko, Kensuke;Kazama, Yoshihiro;Kawai, Kazushige;Ishihara, Soichiro;Choi, Gyu-Seog
    • Korean Journal of Clinical Oncology
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    • v.14 no.2
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    • pp.128-134
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    • 2018
  • Purpose: Previous studies have addressed the role of the hypercoagulable state in the pathogenesis of cancer progression and metastasis. In this study, we investigated the association between coagulation factors, including tissue factor (TF) expression, platelet count, and fibrinogen level, and disease recurrence in patients with non-metastatic colorectal cancer. Methods: Patients who underwent curative resection for stage II or III colorectal cancer between 2000 and 2007 were included in this study. Data from a prospectively maintained database were retrospectively reviewed. TF expression was determined by immunohistochemistry using an anti-TF monoclonal antibody. The Kaplan-Meier method was used to estimate 5-year disease-free survival. Results: TF was highly expressed in 257 of 297 patients (86.5%). TF expression was not significantly associated with the platelet counts (P=0.180) or fibrinogen level (P=0.281). The 5-year disease-free survival rate was lower in patients with high TF expression than in patients with low TF expression (72.3% vs. 83.9%, P=0.074). In Cox hazard analysis, high TF expression was an independent risk factor for tumor recurrence (hazard ratio [HR] 2.446; 95% confidence interval [CI], 1.054-5.674; P=0.037). Undifferentiated histologic type (HR, 2.911; 95% CI, 1.308-6.481; P=0.009), venous invasion (HR, 2.784; 95% CI, 1.431-5.417; P=0.003), and lymph node metastasis (HR, 2.497; 95% CI, 1.499-4.158; P<0.001), were also significantly associated with disease recurrence. Conclusion: TF expression is associated with a recurrence in patients with non-metastatic colorectal cancer. However, further studies are required to clarify the underlying mechanisms relating TF expression with oncologic outcomes and its potential role as a therapeutic target.

Associations between Hashimoto Thyroiditis and Clinical Outcomes of Papillary Thyroid Cancer: A Meta-Analysis of Observational Studies

  • Moon, Shinje;Chung, Hye Soo;Yu, Jae Myung;Yoo, Hyung Joon;Park, Jung Hwan;Kim, Dong Sun;Park, Young Joo
    • Endocrinology and Metabolism
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    • v.33 no.4
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    • pp.473-484
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    • 2018
  • Background: Epidemiological studies have suggested an association between Hashimoto thyroiditis (HT) and papillary thyroid cancer (PTC) development. Other studies, however, have reported a protective role of HT against PTC progression. Through this updated meta-analysis, we aimed to clarify the effects of HT on the progression of PTC. Methods: We searched citation databases, including PubMed and Embase, for relevant studies from inception to September 2017. From these studies, we calculated the pooled odds ratios (ORs) of clinicopathologic features and the relative risk (RR) of PTC recurrence with 95% confidence intervals (CIs) using the Mantel-Haenszel method. Additionally, the Higgins $I^2$ statistic was used to test for heterogeneity. Results: The meta-analysis included 71 published studies with 44,034 participants, among whom 11,132 had HT. We observed negative associations between PTC with comorbid HT and extrathyroidal extension (OR, 0.74; 95% CI, 0.68 to 0.81), lymph node metastasis (OR, 0.82; 95% CI, 0.72 to 0.94), distant metastasis (OR, 0.49; 95% CI, 0.32 to 0.76), and recurrence (RR, 0.50; 95% CI, 0.41 to 0.61). Conclusion: In this meta-analysis, PTC patients with HT appeared to exhibit more favorable clinicopathologic characteristics and a better prognosis than those without HT.

Postoperative Adjuvant MVP Chemotherapy and Radiotherapy for Non-Small Cell Lung Cancer (비소세포성폐암의 수술후 MVP복합화학요법과 방사선병용치료 결과)

  • Kim, Jong-Hoon;Choi, Eun-Kyung;Chang, Hyesook;Kim, Sang-Wee;Suh, Chul-won;Lee, Kyoo-Hyung;Lee, Jung, Shin;Kim, Sang-Hee;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Park, Seung-Il;Sohn, Kwang-Hyun
    • Radiation Oncology Journal
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    • v.13 no.2
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    • pp.149-156
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    • 1995
  • Purpose : Since February 1991 a Prospective study for non-small cell lung cancer patients who underwent radical resection and had a risk factor of positive resection margin or regional lymph node metastasis has been conducted to evaluate the effect of MVP chemotherapy and radiotherapy on the pattern of failure, disease free and overall survival. and tolerance of combined treatment. Materials and Methods: Twenty nine patients were registered to this study until Sep. 1993; of these 26 received planned therapy Within 3 weeks after radical resection, two cycles of MVP(Mitomycin C $6mg/m^2,$ Vinblastin $6mg/m^2,$ Cisplatin $60mg/m^2$) chemotherapy was given with 4 weeks intervals. Radiotherapy (5040cGy tumor bed dose and 900cGy boost to high risk area) was started 3 to 4 weeks after chemotherapy. Results: One and two year overall survival rates were $76.5\%\;and\;58.6\%$ respectively. Locoregional failure developed in 6 patients$(23.1\%)$ and distant failure in 9 patients$(34.6\%)$ Number of involved lymph nodes, resection margin positivity showed some correlation with failure pattern but T-stage and N-stage showed no statistical significance. The group of patients who received chemotherapy within 2 weeks postoperatively and radiotherapy within 70 days showed lower incidence of distant metastasis. Postoperative combined therapy were well tolerated without definite increase of complication rate, and compliance rate in this study was $90\%$. Conclusion: 1) MVP chemotherapy showed no effect on locoregional recurrence, but appeared to decrease the distant metastasis rate and 2) combined treatments were well tolerated in all patients. 3) The group of patients who received chemotherapy within 2 weeks postoperatively and radiotherapy within 70days showed lower incidence of distant metastasis. 4) Addition of chemotherapy to radiotherapy failed to increase the overall or disease free survival.

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The Surgical Diagnosis for Detecting Early Gastric Cancer and Lymph Node Metastasis: Its Role for Making the Decision of the Limited Surgery (조기위암 및 림프절 전이에 대한 수술 중 외과적 병기판정의 정확도 및 유용성)

  • Park, Eun-Kyu;Jeong, Oh;Ryu, Seong-Yeop;Ju, Jae-Kyun;Kim, Dong-Yi;Jeong, Mi-Ran;Kim, Ho-Goon;Kim, Hoe-Won;Park, Young-Kyu
    • Journal of Gastric Cancer
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    • v.9 no.3
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    • pp.104-109
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    • 2009
  • Purpose: The aim of this study is to evaluate the accuracy of surgically diagnosing early gastric cancer (EGC) and lymph node metastasis, and to determine its role for performing limited surgery for EGC. Materials and Methods: We reviewed 369 patients who underwent gastrectomy for primary gastric carcinoma. The surgical diagnosis was evaluated by determining its sensitivity, specificity and accuracy, and this was compared with the preoperative examinations. Results: The sensitivity, specificity, and accuracy of the intraoperative diagnosis for EGC were 74.5%, 95.7% and 83.7%, respectively. The predictive value for EGC according to the intraoperative diagnosis was 95.7%. The surgical diagnosis of EGC showed higher specificity and a higher predictive value than preoperative examinations, which significantly reduced the risk of underestimating advanced gastric cancer (AGC) to EGC. The sensitivity, specificity, and accuracy for lymph node metastasis according to the surgical diagnosis were 73.2%, 78.1% and 76.4%, respectively. For 70 patients with a discrepancy in the diagnosis of EGC between the pre- and intra-operative diagnosis, the surgical diagnosis was correct in 63 (90%) patients, but the preoperative examinations were correct in only 7 (10%) patients. Conclusion: The surgical diagnosis showed better accuracy than the preoperative examinations for detecting EGC and lymph node metastasis. Our results suggest that the decision for conducting limited surgery based on the surgical diagnosis might reduce the risk of under-treatment of AGC to EGC better than the preoperative examinations.

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