• Journal of Chest Surgery
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• v.33 no.1
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• pp.68-72
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• 2000

Background: The resection of recurrent non-small cell lung cancer can be performed very rarely. There has been many arguments for longterm result and therapeutic role in surgical management of recurrent non-small cell lung cancer(NSCLC). We analyze our result of surgical re-resection of recurrent NSCLC for 10 years retrospectively. Material and Method: In the period from 1987 to 1997, 702 patients who had been confirmed for NSCLC had undergone complete resection in Seoul National University Hospital. As December 1997, 22 of these patients have been operated on the diagnosis of recurrent lung cancer. In these patients one has revealed for benign nodule at postoperative pathologic pathologic was unresectable. and two had revealed other cell type on postoperative pathologic examination. Analysis about postoperative survival rate and the factors that influence postoperative survival rate - sex, age, pathologic stage, cell type, operation adjuvant therapy after first and second operation location of recurrence disease free survival-was 59.1$\pm$10.9 year. There were 14 men and 3 women. Four patients was received radiation therpy after first opration and two patients was received postoperative chemotherapy. At first operation 2 patients was stage Ia, 8 was stage Ib, 1 was stage IIa 6 was stage IIb. Eleven patients had squamous. cell carcinoma at postoperatrive pathologic examination five had adenocarcinoma and one had bronchioalveolar carcinoma. In second operation 8 patients were received limited resection. 9 were received lobectomy or pneumonectomy. One-year survival rate was 82.4% and five-year survival rate was 58.2% Non-adjuvant therapy group after initial operation was more survived than adjuvant therapy group statistically. Conclusion: operation was more survived than adjuvant therapy group statistically. Conclusion : Operation was feasible treatment modality for re-resectable non-small cell lung cancer. But we cannot rule out possibility of double primary lung cancer for them. Postoperative prognostic factor was adjuvant therapy or nor after first oepration but further study of large scale is needed for stastically more valuable result.

• Radiation Oncology Journal
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• v.11 no.2
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• pp.347-354
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• 1993

This is a retrospective analysis of 67 patients with histologically proven invasive carcinoma of uterine cervix treated with surgery followed by adjuvant radiotherapy at Inje University Seoul Paik Hospital between october 1983 and september 1991, Postoperative radiotherapy was carried out in patients with high risks of locoregional recurrence such as positive pelvic lymph node (38 pts), large tumor size more than 3 cm (22 pts), cervical stromal invasion more than 2/3 (46 pts), parametrial involvement (9 pts), positive resection margin (14 pts), endo/myometrial extension (10 pts), and angiolymphatic invasion (13 pts). Stage I A, I B, and IIA were 2 $(3\%),$ 39 $(58.2\%),\;and\;26\;(38.8\%),$ respectively. Median follow-up period was 48 months with ranges from 13 to 115 months. All 67 patients were treated externally with standard pelvic field with radiation dose ranging from 4080 to 6120 cGy in 4~6 weeks period of time. Of these, 45 patients received intracavitary radiotherapy. The overall survival rate and disease free survival rate at 5-year were $88.0\%\;and\;82.1\%,$ respectively. The survival rates by stage were $87.1\%$ in IB and $88.4\%$ in IIA. Local control rate was $80.6\%(58\;pts).$ The treatment failure was noted in 12 of 67 patients $(17.9\%):$ locoregional failure in $7(10.4\%),$ distant metastasis in 3 $(4.5\%),$ and locoregional and distant metastasis in $2(3\%),$ The univariate analysis of prognostic factors disclosed endo/myometrial extension as a significant factor of survival and recurrence $(70.0\%\;vs\;91.1\%\;P<0.05\;&\;30.0\%\;vs\;15.8\%,\;respectively).$ The complication of postoperative radiothrapy was not significant and all patient were well tolerated. In conclusion, postoperative radiotherapy in patients with high risks of locoreginal recurrence is relatively well tolerated and it gives significantly improved survival rate especially in patients with positive lymph nodes, bulky tumor size $(\geqq3\;cm),$ parametrial involvement, cervical stromal invasion more than 2/3, positive resection margin and angiolymphatic invasion.

• Journal of Gastric Cancer
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• v.6 no.3
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• pp.173-180
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• 2006

Purpose: The TNM staging system showed limitation in stratifying patients into different prognostic groups with gastric cancer Since the treatment for stage IV gastric cancer with distant metastasis (M1) is defined as non-curative one, we hypothesized that the survival rate of stage IV gastric cancer with M1 is different to that of stage IV gastric cancer with no distant metastasis (M0), which will provide a rationale to subdivide stage IV into IVa and IVb. Materials and Methods: From June 1992 to December 2005, of 1,630 gastric cancer patients who underwent surgery, 308 patients with stage IV gastric cancer were selected and analyzed. The clinicopathologic characteristics and survival of the patients, according to distant metastasis, were determined retrospectively. Median follow-up period was 13 months (range: $1{\sim}154$ month). Results: 5 year survival rate of M0 and M1 group was 35% and 16% respectively with statistic significance (P=0.0000). When the survival rate of M0 group was analyzed according to the difference of T and M factor, T1-3N3M0 and T4N1-2M0 group showed no significant statistical difference (P=0.1898). Conclusion: Given the result in this study, we suggest that the stage IV gastric cancer be subclassified into stage IVa and IVb according to M factor.

• Journal of Gastric Cancer
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• v.10 no.2
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• pp.55-62
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• 2010

Purpose: We evaluated the clinicopathological charicterics and prognostic impacts of lymphatic vessel invasion in gastric cancer without lymph node involvement. Materials and Methods: Among 1,795 patients who underwent gastric surgery with gastric cancer at the department of surgery, Hanyang university college of medicine from June 1992 to March 2009, we retrospectively evaluated 890 patients with lymph node negative gastric cancer. Results: The lymphatic vessel invasion correlated significantly with tumor stage, age, tumor size, perineural invasion and operation method. The survival rates were only significantly different between the patients with and without lymphatic vessel invasion in patients with stage Ia (P=0.036). Univariate and multivariate analysis demonstrated that blood vessel invasion and preoperative serum CEA level were significant factor influencing the survival rate in lymph node negative gastric cancer patients with lymphatic invasion. Conclusions: In patients with lymph node negative gastric cancer, the survival rate is significantly lower in those with lymphatic vessel invasion than in those without. Especially, in patients with stage Ia gastric cancer, the survival rates is significantly different between those with and those without lymphatic vessel invasion. Blood vessel invasion and preoperative serum CEA level is an adverse prognostic indicator in patients with stage Ia gastric cancer with lymphatic invasion. Thus we should consider further adjuvant therapies in case of need and need to show more concern to identify gastric cancer patients early at risk for recurrence.

• Journal of Aquaculture
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• v.9 no.3
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• pp.215-222
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• 1996

An experiment was conducted to assess the effects of dietary 3,5,3'-triiodo-L-thyronine ($T_3$) at 0, 10, 20, 50, 100 ppm on growth and survival rate in juvenile black seabream held at $27.9{\pm}1.1^{\circ}C$ for 50 days. Fish were fed the $T_{3}$ experimental diet for 4() days by hand to satiation in $2{\~}4$ times per day. After 50 days period, food intake rate (${\%}$), feed efficiency (${\%}$), survival rate (${\%}$), growth of weight and length (specific growth rates), and condition factor were measured. Food intake rate was inversely related to the dietary $T_{3}$ level. But feed efficiency was not changed by $T_{3}$ level. $T_{3}$ slightly improved survival rate of larvae. Survival rate of larvae from 100 ppm was significantly higher than that of fish from control. Dietary $T_{3}$ influenced growth in length and weight. Growth of black seabream fed a diet containing 10 ppm of $T_{3}$ was significantly higher than that of fish fed control. However 100 ppm of $T_{3}$ induced the inhibition for length and weight growth. The condition factor was inversely related to the dietary $T_{3}$ content.

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.200-208
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• 2005

Purpose: Palliative procedures or surgical interventions not only manage various symptoms of malignant gastrointestinal obstruction, but also improve the quality of life. We investigated the clinical characteristics and prognostic factors of terminal cancer patients with palliative procedures for malignant gastrointestinal obstruction. Methods: We retrospectively reviewed the medical records of 48 terminal cancer patients with palliative procedures for malignant gastrointestinal obstruction at Sam Anyang hospital from May in 2002 to May in 2005. We excluded patients with palliative tumor resection. We analyzed prognostic factors in symtom-free survival and overall survival using Kaplan-Meier method, univariate and multivariate analysis. Results: There were 25 males (52%) and 23 females (48%), and median age of 48 patients was 65 years. The most common cause of malignant gastrointestinal obstruction was colorectal (26 patients, 55%), followed by stomach (10, 21%). Twenty patients (42%) received previous treatment (chemotherapy, surgery, and radiotherapy) and 28 (58%) never received any. Eighteen of 20 had received chemotherapy. The most common symptom was pain (15 patients, 31%). Twenty three patients (48%) had Eastern Cooperative Oncology Group(ECOG) performance status of 1 or 2 score and 25 patients (52%) 3 or 4 score. The most common palliative procedure was colostomy and there was no mortality concerning the palliative procedures. By univariate and multivariate analysis, performance status was the only independent prognostic factor in overall survival and symptom-free survival. Overall survival was 150 days and symptom-free survival was 90 days. Conclusion:. We confirmed that perftatdormance status is significant independent prognostic factor in terminal cancer patients with palliative procedures for malignant gastrointestinal obstruction.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.299-304
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• 2014

Cholangiocarcinoma (CCA), a malignancy of biliary duct with a very poor prognosis, is the leading cause of cancer death in countries of the Mekong subregion. Liver fluke infection is the main etiological factor, but genetic variation has been recognized as also important in conferring susceptibility to CCA risk. Nuclear factor (erythroid derived 2)-like 2 (NRF2) is a key transcription factor in detoxification and antioxidant defense. Emerging evidence has demonstrated that genetic polymorphisms in the NRF2 gene may be associated with cancer development. The objectives of this study were to investigate the association of NRF2 genetic polymorphism with CCA risk and to evaluate the influence of the NRF2 genotype on survival time of affected patients. Single nucleotide polymorphisms (SNPs) of the NRF2 gene, including rs6726395: A/G, rs2886161: C/T, rs1806649: C/T, and rs10183914: C/T, were analyzed using TaqMan$^{(R)}$ SNP genotyping assays. Among 158 healthy northeastern Thai subjects, the allele frequencies were 41, 62, 94, and 92%, respectively. The correlation of NRF2 SNPs and CCA risk was analyzed in the 158 healthy subjects and 198 CCA patients, using unconditional logistic regression. The results showed that whereas the NRF2 SNPs were not associated with CCA risk (p>0.05), Kaplan-Meier analysis of 88 intrahepatic CCA patients showed median survival time with rs6726395 genotypes of GG and AA/AG to be $344{\pm}138$ (95%CI: 73-615) days and $172{\pm}37$ (95%CI: 100-244) days, respectively, (p<0.006). On multivariate Cox proportional hazard analysis, the GG genotype of rs6726395 was found to be associated with longer survival with a hazard ratio of 0.54 (95%CI: 0.31-0.94). In addition, non-papillary adenocarcinoma was associated with poor survival with a hazard ratio of 2.09 (95%CI: 1.16-3.75). The results suggest that the NRF2 rs6726395 polymorphism can be a potential prognostic biomarker for CCA patients.

• Tuberculosis and Respiratory Diseases
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• v.76 no.1
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• pp.8-14
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• 2014

Non-small cell lung cancer harboring epidermal growth factor receptor (EGFR) sensitizing mutations has a distinct disease entity. Patients with this cancer have better prognosis, and frequently achieve long-term survival. EGFR-tyrosine kinase inhibitor (TKI) is the drug of choice for this cancer; but the disease inevitably progresses, after durable response. The tumor is a mixture of EGFR-TKI sensitive clones and resistant clones, regardless of their molecular mechanisms. EGFR-TKI sensitive clones are very susceptible to this drug, but rarely eradicated; so, withdrawal of the drug permits rapid regrowth of drug sensitive clones, possibly causing "disease flare." Re-administration or continuation of EGFR-TKI can effectively suppress the expansion of drug sensitive clones, even when the total tumor volume continuously increases. Chemotherapy can definitely prolong the survival of patients experiencing EGFR-TKI failure. Prospective clinical trials are warranted to compare efficacies of chemotherapeutic agents. A few retrospective studies suggested that a taxanebased regimen may be superior to others. Here, we reviewed therapeutic options and clinical evidence about this unique disease entity.

• BMB Reports
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• v.35 no.1
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• pp.28-40
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• 2002

Apoptosis is a mode of cell death that plays an important role in both pathological and physiological processes. Research during the last decade has delineated the entire machinery needed for cell death, and its constituents were found to pre-exist in cells. The apoptotic cascade is triggered when cells are exposed to an apoptotic stimulus. It has been known for several years that inhibitors of protein synthesis can potentiate apoptosis that is induced by cytokines and other inducers. Until 1996, it was not understood why protein synthesis inhibitors potentiate apoptosis. Then three reports appeared that suggested the role of the transcription factor NF-${\kappa}B$ activation in protecting the cells from TNF-induced apoptosis. Since then several proteins have been identified that are regulated by NF-${\kappa}B$ and are involved in cell survival, proliferation, and protection from apoptosis. It now seems that when a cell is attacked by an apoptotic stimulus, the cell responds first by activating anti-apoptotic mechanisms, which mayor may not be followed by apoptosis. Whether or not a cell undergoes proliferation, the survival, or apoptosis, appears to involve a balance between the two mechanisms. Inhibitors of protein synthesis seem to suppress the appearance of protein that are involved in anti-apoptosis. The present review discusses how NF-${\kappa}B$ controls apoptosis.

• Journal of Yeungnam Medical Science
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• v.34 no.2
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• pp.216-221
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• 2017

Background: This study was conducted to investigate preoperative carcinoembryonic antigen (CEA) as a prognostic factor in colorectal cancer. Methods: Between January 2000 and July 2011, 1298 patients with primary adenocarcinoma colorectal cancer without metastasis, who underwent curative resection were retrospectively identified. The patients were divided into two groups according to serum CEA level at primary diagnosis: a high CEA (HCEA) group (serum CEA ${\geq}6ng/mL$) and a normal CEA (NCEA) group (serum CEA <6 ng/mL). A 1:1 propensity score matching analysis was applied to reduce bias. Finally, 364 patients were enrolled in this study. Matched variables were age, gender, preoperative chemoradiotherapy, tumor site, cell differentiation and pathologic stage. Results: The clinicopathological characteristics of the two groups did not differ significantly difference. The systemic metastasis rate was 16.5% (30/182) and 25.3% (46/182) in the NCEA and HCEA groups, respectively (p=0.039). There were no significant differences in local recurrence or metastatic sites between groups. The 5-year disease-free survival (DFS) rate of the HCEA group was worse than that of the NCEA group; however, there was no significant difference in overall survival between the two groups. Conclusion: Elevated preoperative CEA was related to frequent systemic recurrence and low DFS. Therefore, elevated preoperative CEA could be considered a prognostic factor for worse clinical outcomes in patients with colorectal cancer.