• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.347-350
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• 2013

The aim of the present study was to determine whether allogeneic red blood cell transfusions showed a deleterious effect and what might be preoperative risk factors for blood transfusion in patients with TNM stage II colon cancer. Total 470 patients who fulfilled inclusion criteria were selected for a further 10-year follow-up study. We found that there were statistical significance between non-transfused and transfused group in mortality (P=0.018), local recurrence (P=0.000) and distant metastasis (P=0.040). Local recurrence and distant metastasis between 1 to 3 units and more than 3 units group did not show any significant differences. There was no difference in survival rate between non-transfused and 1 to 3 units group (log rank=0.031, P=0.860). The difference between different blood transfusion volume in transfused patients was found (78.77% vs 63.83%, P=0.006). Meanwhile, the significant difference of survival rate was existed between non-transfused group and more than 3 units group (84.83% vs 63.83%, P=0.002 ). Univariate analysis showed the following 3 variables to be associated with an increased risk of allogeneic blood transfusions: preoperative CEA level (P<0.05), location of tumor (P<0.01) and diameter of tumor (P<0.01). Multivariate analysis revealed that location of tumor and diameter of tumor are two independent factors for requirement of perioperative transfusions. Therefore, allogeneic transfusion increase the postoperative tumor mortality, local recurrence and distant metastasis in patients with stage II colon cancer. The postoperative tumor mortality, local recurrence and distant metastasis were not associated with the blood transfusion volume. The blood transfusion volume was associated with the survival rate. Location of tumor and diameter of tumor were the independent preoperative risk factors for blood transfusion.

• Korean Journal of Head & Neck Oncology
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• v.13 no.2
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• pp.187-199
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• 1997

Thyroid carcinoma ranks low in incidence and as a cause of death when compared to carcinomas arising in the other site. With adequate surgical treatment, the prognosis of operable thyroid carcinoma is good. However, the extent of surgical resection in treatment of thyroid cancer remains still controversy. The aim of this study was to assess the results of thyroid cancer patients treated surgically and to analyze the prognostic factors affecting survival and to improve the survival rate. We retrospectively analyzed the outcome of a total of 278 thyroid cancer patients treated surgically at Inje University Paik Hospital from 1980 to 1995 and followed for 1 to 16 years. There were man in 47 and woman in 231 patients with age range of 14 to 79 years(mean 42 years). Histopathologic findings were papillary carcinoma in 233, follicular carcinoma in 33, mixed carcinoma in 7, medullary carcinoma in 2, and undifferentiated carcinoma in 3 patients, respectively. Operative procedures were unilateral lobectomy in 111, subtotal thyroidectomy in 100, and total thyroidectomy in 67 patients. Central node dissection was performed in 92, modified neck disseciton in 62, radical neck dissection in 28, and no node dissection in 96 patients. Thyroid hormone was administered for the period of 3 to 5 years to suppress endogenous TSH production. Overall 5-year survival rate according to Kaplan-Meier method was 91.1%. Independently, significant factors affecting the prognosis were age at diagnosis, tumor size, pathologic type, tumor stage, lymph node metastasis, angioinvasion, extrathyroidal extension, and 'risk' group category. but, the prognosis were not influenced by sex and capsular invasion. Patients at low risk or with small size carcinomas had long survival over 5 years with only lobectomy. Lymph node dissection was carried out with a limited type in no jugular metastasis, radical neck dissection was performed only therapeutically in proved jugular node metastasis. Fifteen patients were dead of tumor recurrence after surviving for three months to two and half years, and the cause of death was local recurrence in nine, bone metastasis in four and lung metastasis in two patients. In conclusion, more extensive surgery including total thyroidecotmy and systematic compartment-oriented dissection of the lymph node metastases in patient at high-risk group will results in better survival and lower recurrence rate.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6219-6225
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• 2014

Background: Increasing evidence from animal, epidemiological and clinical investigations suggest that dietary anthocyanins have potential to prevent chronic diseases, including cancers. It is also noteworthy that human epidermal growth factor receptor 2 (ErbB2) protein overexpression or ErbB2 gene amplification has been included as an indicator for metastasis and higher risk of recurrence for breast cancer. Materials and Methods: The present experiments investigated the anti-metastasis effects of black rice anthocyanins (BRACs) on ErbB2 positive breast cancer cells in vivo and in vitro. Results: Oral administration of BRACs (150 mg/kg/day) reduced transplanted tumor growth, inhibited pulmonary metastasis, and decreased lung tumor nodules in BALB/c nude mice bearing ErbB2 positive breast cancer cell MDA-MB-453 xenografts. The capacity for migration, adhesion, motility and invasion was also inhibited by BRACs in MDA-MB-453 cells in a concentration dependent manner, accompanied by decreased activity of a transfer promoting factor, urokinase-type plasminogen activator (u-PA). Conclusions: Together, our results indicated that BRACs possess anti-metastasis potential against ErbB2 positive human breast cancer cells in vivo and in vitro through inhibition of metastasis promoting molecules.

• Korean Journal of Radiology
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• v.23 no.11
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• pp.1102-1111
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• 2022

Objective: To evaluate the ultrasonography (US) features for diagnosing metastasis in cervical lymph nodes (LNs) in patients with thyroid cancer and compare the US classification of risk of LN metastasis between European and Korean guidelines. Materials and Methods: From January 2014 to December 2018, US-guided fine-needle aspiration was performed on 836 LNs from 714 patients for the preoperative nodal staging of thyroid cancer. The US features of LNs were retrospectively reviewed for the following features: size, presence of hilum, margin, orientation, cystic change, punctate echogenic foci (PEF), large echogenic foci, eccentric cortical thickening, abnormal vascularity, and cortical hyperechogenicity. A multiple logistic regression analysis was performed to identify the independent US features for the diagnosis of metastatic LNs. The diagnostic performance of independent US features was subsequently evaluated. LNs were categorized according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and European Thyroid Association (ETA) guidelines, and the correlation between the two sets of classifications was assessed. Results: Absence of the hilum, presence of cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features of metastatic LNs. Cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity showed high specificity (86.8%-99.6%). The absence of the hilum had the highest sensitivity yet low specificity (66.4%). When LNs were classified according to the ETA guidelines and K-TIRADS, they yielded similar categorizations of malignancy risks and were strongly correlated (Spearman coefficient, 0.9766 [95% confidence interval, 0.973-0.979]). According to the ETA guidelines, 9.8% (82/836) of LNs were classified as "not specified." Conclusion: Absence of hilum, cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features suggestive of metastatic LNs in thyroid cancer. Both K-TIRADS and the ETA guidelines provided similar risk stratification for metastatic LNs with a high correlation; however, the ETA guidelines failed to classify 9.8% of LNs into a specific risk stratum. These results may provide a basis for revising LN classification in future guidelines.

• Korean Journal of Head & Neck Oncology
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• v.26 no.1
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• pp.3-8
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• 2010

Background : Though papillary microcarcinoma(PMC) of thyroid gland is known to have very favorable long-term prognosis, the recurrence in the neck and distant metastasis have been often reported. The predictive factors of node metastasis and tumor recurrence in clinical course were investigated to define surgical decision or guidelines in surgery of papillary microcarcinoma. Methods : The authors conducted a retrospective analysis of 216 patients of PMC treated with surgery at Department of Surgery, Busan Paik Hospital for the period from 1997 to 2007. Of these patients, 58 cases showing cervical lymph node metastasis at initial surgery were studied. Results : In overall 216 patients, the sex ratio of male to female was 1 : 9.3(male 21, female 195 cases), the mean age at the time of diagnosis was 44.7 years and the median tumor size was 6.61mm. Neck lymph node metastasis was found in 58 patients(26.9%), thyroid capsular invasion was 56 cases(25.9%), multifocality and bilaterality were found in 32(14.8%) and 29 cases(13.4%), respectively. Through statistical analysis, sex, capsular invasion, ETE, and tumor size(>5mm) were considered to be predictive factors of cervical lymph nodes metastasis. Of them, capsular invasion was the most predictive indicator of cervical lymph node metastasis on multivariate analysis. Nodal recurrence was observed in 6 of 58 patients of node positive at initial surgery. Conclusion : The cervical lymph node metastasis is known to be a risk factor of prognosis in PMC of thyroid gland. The results of this study showed four statistically significant independent predictive factors of cervical lymph node metastasis in PMC : capsular invasion, tumor size(>5mm), ETE, and sex. On multivariate analysis, capsular invasion was a great influencing factor in prediction of lymph node metastasis. Basically, patients who has predictive factors of cervical lymph node metastasis should have a thorough investigation, and close surveillance for nodal status is required in follow-up.

• Journal of Yeungnam Medical Science
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• v.17 no.1
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• pp.66-74
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• 2000

Background: During the follow up period after transarterial embolization(TAE), cases of pulmonary metastasis were more prevalent in TAE-treated patients than in TAE-untreated patients. Therefore, a study was conducted to evaluate whether TAE increases the incidence of pulmonary metastasis of hepatocellular carcinoma and to clarify the risk factors for pulmonary metastasis. Methods: From March 1991 to March 1995, 156 patients who had been diagnosed with hepatocellular carcinoma by serology, and radiographic and histologic methods at Yeungnam University hospital were involved in this study. We excluded 12 patients with lung metastasis on initial diagnosis and the others. The remaining 144 patients had been followed up for at least 5 months and, divided into four groups according to lung metastasis and trans-arterial embolization treatment, and evaluated for age, sex, child-pugh score, liver cirrhosis, and level of AFP. Results: Pulmonary metastasis was found in 18.0% (26/144), of which 92.3%(24/26) and 7.7%(2/26) of the patients with and without transarterial chemoembolization, respectively. Of the patients, 23.5% (24/102) with TAE had lung metastais during follow-up periods and 4.7% (2/42) without TAE had lung metastasis. There was more likelihood for lung metastasis after TAE. but there was no difference between two groups in age, sex, child-pugh class, the presence of liver cirrhosis, and AFP. Conclusions: The incidence of pulmonary metastasis of hepatocellular carcinoma after TAE was higher. Child-pugh class was the only related clinical preciptating factors for pulmonary metastasis in TAE in our study. Our results suggest that regular chest X-ray check-ups may be more frequently needed by patients who had TAE treatment for hepatocellular carcinoma.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.251-254
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• 2012

Purpose: To explore the relationship between auxiliary lymph node metastasis and clinical features, and to identify the factors that affect metastasis occurrence. Methods: A total of 164 cases of primary breast cancer were selected to investigate features such as age, concomitant chronic disease and pathologic diagnosis. Immunohistochemistry was used to detect the expression of the estrogen receptor (ER) and CerbB-2. Logistic regression was employed to analyze the factors that affect the incidence of lymph node metastases. Results: The incidence of lymph node metastases was 46.3% among elderly patients with breast cancer. Based on logistic regression, chronic disease, scale of tumor, age, and ER expression affected the occurrence of lymph node metastases; the ORs were 3.05, 2.18, 0.34, and 3.83, respectively. Between different pathologic diagnoses and the risk factors, the OR scores were 12.7 and 8.02, respectively, for aggressive ductal carcinoma and aggressive lobular carcinoma auxiliary lymph node metastases. Conclusion: The incidence of lymph node metastases is affected by chronic disease, scale of tumor, age, ER expression and pathologic diagnosis.

• Korean Journal of Head & Neck Oncology
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• v.13 no.1
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• pp.81-85
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• 1997

Basal cell adenocarcinoma is a rare, recently described neoplasm of the salivary gland. We have experienced three cases of basal cell adenocarcinoma of the parotid gland. The tumors from patient 1 and patient 2 showed intraparotid growth in superficial lobe without cervical lymphnode metastasis. So, patient 1 and patient 2 underwent only a superficial parotidectomy and subdigastric lymphnode dissection without any adjuvant therapy. They are alive without recurrence or distant metastasis. But that of patient 3 showed widely invasive growth with multiple cervical lymph node metastases. The CT scan showed a $8{\times}7cm$ sized huge mass replacing the parotid gland with irregular margin and multiple lymphnode enlargements along the internal jugular vein. Total parotidectomy with sacrifying the facial nerve and standard radical neck dissection were caried out. Microscopically, the tumor consisted of solid nest and sheet of uniform basaloid cells separated by a fibrous connective tissue stroma with the evidence of lymphovascular invasion. As a result of the lymphnode metastasis and invasiveness of the tumor, radiation therapy was given postoperatively. We thought that close follow-up would be mandatory in this patient because of high risk of possible local recurrence and distant metastasis.

• Archives of Craniofacial Surgery
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• v.23 no.5
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• pp.237-240
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• 2022

A 67-year-old man visited our plastic surgery clinic complaining of a palpable protruding mass (2.0×2.5 cm) in the right occipital region. To establish an appropriate treatment plan for the cystic mass, brain magnetic resonance imaging was performed. A 2.2 cm nodular lesion with peripheral enhancement in the right occipital region of the scalp was confirmed. In addition, two rim-enhancing nodular lesions up to 9 mm with marked perilesional edema in the right frontal lobe were confirmed. The findings suggested metastasis from cancer. After further evaluations, a mass in the right lower lung field was identified as adenocarcinoma of the lung. Histological examination characterized the excised lesion as a cutaneous metastasis from lung adenocarcinoma. This case report shows that a cystic mass, which commonly occurs in the scalp, may indicate lung cancer. In particular, if a cystic mass of the scalp is identified in a person at high risk for lung cancer, appropriate evaluation and urgent treatment should be performed.

• Korean Journal of Head & Neck Oncology
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• v.12 no.2
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• pp.153-160
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• 1996

Regardless of the prognostic factors in papillary thyroid cancer, such as sex, age, size of tumor, extent of disease, and distant metastasis, the prognosis of papillary thyroid cancer is sometimes difficult to predict from clinical and microscopic analysis alone and additional prognostic indicators are needed. Recent studies of thyroid cancer have indicated that DNA aneuploidy may be correlated to the biological behavior of malignancy and inversely correlated to the prognosis, but it still remains contraversal. We performed this study to assess DNA ploidy patterns in relation with the previously known prognostic factors in AMES scoring system and lateral neck node metastasis in papillary thyroid cancer. A series of 132 patients with papillary thyroid cancer and 80 patients with benign thyroid tumor(27 follicular adenomas and 53 adenomatous goiters) as a control group from October 1993 to Feburary 1995 were analyzed and their nuclear DNA content was measured with flow cytometry using fresh tissue specimens. DNA aneuploidy was found in 8(6.1%) in papillary cancer and 8(10%) in benign tumor. S-phase traction(SFP) and proliferative index(PI) were higher in thyroid cancers, being 2.18$\pm$4.24%, 6.34$\pm$4.94% in the papillary thyroid cancers and 1.97$\pm$2.93%, 4.44$\pm$3.80% in the benign tumors, respectively. However there was no significant difference of values between two groups(p>0.05). Among variable prognostic factors studied(age, sex, size of tun or, extent of disease, distant metastasis in AMES scoring system and lateral neck node metastasis), DNA aneuploidy was found to be common in distant metastasis(p<0.001) and in lateral neck node metastasis(p>0.035), but there was no significant difference between the high risk and low risk group according to the AMES scoring system(p<0.08). In our study, DNA aneuploidy was not valuable in determining the presence of malignancy and did not correlate to the AMES scoring system. However, follow-up study of more cases will be needed for accurate information about the DNA ploidy as a independent prognostic factor.