• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.17
• /
• pp.7351-7355
• /
• 2014

Background: Laryngeal carcinogenesis is a multifactorial process that has not been fully elucidated. Despite extensive research, reliable markers with diagnostic and prognostic value are still lacking. It was recently reported that an elevated preoperative neutrophil-to-lymphocyte ratio (NLR) may correlate with an increased risk of recurrence, tumor aggressiveness and poorer prognosis in various malignancies. The aim of this study was to examine whether NLR could be used as an inflammatory marker to differentiate laryngeal squamous cell carcinoma (LSCC) patients from benign laryngeal lesion (BLL) and precancerous laryngeal lesion (PLL) patients. Materials and Methods: This retrospective study was performed on 209 patients admitted to a tertiary referral center with laryngeal lesions and undergoing biopsies to establish their histopathological diagnosis. We reviewed the patient files for their clinical, histopathological and laboratory data. The patients were divided into three groups according to their histopathological findings, as BLL, PLL and LSCC groups. The patients in the PLL group were also divided into three subgroups as mild, moderate and severe dysplasia/carcinoma in situ (CIS) subgroups. The groups were compared for NLR and the other laboratory data. Results: The mean NLRs of the BLL, PLL and the LSCC groups were $2.12{\pm}0.86$, $2.32{\pm}0.68$ and $3.46{\pm}1.51$, respectively, and the difference was statistically significant (p=0.001). The mean NLRs of the patients with PLL and LSCC were significantly higher than the patients with BLL (p=0.031 and p=0.001, respectively). The mean NLRs were similar among mild dysplasia, moderate dysplasia and severe dysplasia / CIS groups (p>0.05). Conclusions: To our knowledge, this is the first study investigating NLR in BLL, PLL and LSCC. NLR is an inexpensive, reproducible and widely available blood test, and could be a useful inflammatory marker to differentiate LSCC from BLL and PLL.

• Radiation Oncology Journal
• /
• v.29 no.4
• /
• pp.260-268
• /
• 2011

Purpose: To evaluate the treatment outcome and prognostic factor after postoperative radiotherapy in retroperitoneal sarcoma. Materials and Methods: Forty patients were treated with surgical resection and postoperative radiotherapy for retroperitoneal sarcoma from August 1990 to August 2008. Treatment volume was judged by the location of initial tumor and surgical field, and 45-50 Gy of radiation was basically delivered and additional dose was considered to the high-risk area. Results: The median follow-up period was 41.4 months (range, 3.9 to 140.6 months). The 5-year overall survival (OS) was 51.8% and disease free survival was 31.5%. The 5-year locoregional recurrence free survival was 61.9% and distant metastasis free survival was 50.6%. In univariate analysis, histologic type (p = 0.006) was the strongest prognostic factor for the OS and histologic grade (p = 0.044) or resection margin (p = 0.032) had also effect on the OS. Histologic type (p = 0.004) was unique significant prognostic factor for the actuarial local control. Conclusion: Retroperitoneal sarcoma still remains as a poor prognostic disease despite the combined modality treatment including surgery and postoperative radiotherapy. Selective dose-escalation of radiotherapy or combination of effective chemotherapeutic agent must be considered to improve the treatment result especially for the histopathologic type showing poor prognosls.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.7
• /
• pp.3057-3063
• /
• 2014

Background: Anaplastic lymphoma kinase (ALK) gene rearrangement in non-small cell lung cancer (NSCLC) has been intensively studied. The gold standard for ALK detection is FISH, but this is not routinely conducted in clinical practice, so that the IHC method has a role. The aim of this study was to identify the incidence of ALK rearrangement and risk or prognostic factors for ALK positivity using both of IHC and FISH methods. Materials and Methods: From January 2008 to December 2012, 267 completely resected NSCLC patients in Chiang Mai University Hospital were enrolled in this study. Clinical and pathological variables and outcomes of treatment were retrospectively reviewed. IHC and FISH were used to evaluate ALK rearrangement. Sensitivity and specificity of IHC were analyzed. Multivariable analysis was used to identify clinico-pathological correlations with positive results of IHC and clinical outcomes. Results: Twenty-two (8.2%) of 267 specimens were IHC-positive for ALK with intense cytoplasmic staining, whereas only 10 (3.8%) were FISH-positive. Sensitivity, specificity and the positive likelihood ratio with IHC were 80.0%, 94.9%, and 15.8 respectively. Age less than 55 years (RR 4.4, 95%CI 1.78-10.73, p value=0.001) and presence of visceral pleural invasion (VPI) (RR 2.9, 95%CI 1.21-6.78, p value =0.017) were identified as risk factors for ALK rearrangement with FISH. There were no statistically significant differences in other clinical and pathological variables. ALK rearrangement was not a prognostic factor for tumor recurrence or overall survival. Conclusions: The incidences of ALK positivity in completely resected NSCLCs in northern Thailand were 8.2% by IHC and 3.8% by FISH. IHC with mouse monoclonal, Ventana D5F3 antibody can be used as a screening tool before FISH method because of high specificity and high positive likelihood ratio. Age less than 55 years and VPI are risk factors for ALK positivity.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.7
• /
• pp.3595-3600
• /
• 2016

Background: To investigate the association between preoperative pathological Ki-67 labeling index and serum tumor marker cancer antigen 15-3 (CA 15-3) with clinic-pathological parameters and treatment outcomes in early breast cancer. Materials and Methods: A retrospective study at 4 cancer centers in Saudi Arabia and Egypt was performed. Data were collected for female patients diagnosed with unilateral early breast cancer between March 2010 and October 2013. Cases treated with neoadjuvant chemotherapy (NACT) followed by surgery and radiotherapy were included. NACT included 6-8 cycles of anthracycline and taxane based regimens. Trastuzumab and hormonal treatments were added according to HER2 and hormone receptor status. Baseline serum CA15.3 and pathological Ki67 levels were evaluated and correlated with disease free survival (DFS) and overall survival (OS). Results: A total of 280 pts was included. The median age was 49 years (38-66 y) and median overall survival was 35 (20-38) months (mo). Estrogen receptors (ER), progesterone receptors (PR) and HER 2 receptors were positive in 233 (83.2%), 198 (70%) and 65 cases (23.2%), respectively. High preoperative Ki67 and CA15.3 were noted in 177 (63.2%) and 131 (46.8%). A total of 45 (16%) patients had distal or local recurrence and 24 (8.6%) died of their disease. Most of the relapsed cases had high preoperative Ki-67 (n=41, 91%) and CA15.3 (n=28, 62%) values. All of the patients who died had a high Ki-67 but CA15.3 was high in 9 (37%) only. Mean DFS/OS in patients with high preoperative Ki-67 was 32 months /32 months as compared to 37 months/35 months in those with normal Ki-67 (p<0.001). Correlation of preoperative CA15.3 and survival was statistically not significant. Conclusions:Preoperative Ki-67 can be a predictive and prognostic marker. Higher levels are associated with poor DFS and OS in patients with early BC.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.9
• /
• pp.5165-5169
• /
• 2013

Background: To evaluate the pathological characteristics of invasive margins in early-stage cervical squamous cell carcinomas and their association with other clinicopathological features including clinical outcomes. Materials and Methods: Patients with FIGO stage IB-IIA cervical squamous cell carcinomas who received surgical treatment and had available follow-up information were identified. Their histological slides were reviewed for prognostic variables including tumor size, grade, extent of invasion, lymphovascular invasion, involvement of vaginal margin or parametrium, and lymph node metastasis. The characteristics of invasive margins including invasive pattern (closed, finger-like, or spray-like type), degree of stromal desmoplasia, and degree of peritumoral inflammatory reaction were evaluated along the entire invasive fronts of tumours. Associations between the characteristics of invasive margins and other clinicopathological variables and disease-free survival were assessed. Results: A total of 190 patients were included in the study with a median follow-up duration of 73 months. Tumour recurrence was observed in 18 patients (9%). Spray-like invasive pattern was significantly more associated as compared with closed or finger-like invasive pattern (p=0.005), whereas the degree of stromal desmoplasia or peritumoral inflammatory reaction was not. Low degree of peritumoral inflammatory reaction appeared linked with lymph node metastasis (p=0.021). In multivariate analysis, a spray-like invasive pattern was independently associated with marked stromal desmoplasia (p=0.013), whilst marked desmoplasia was also independently associated with low inflammatory reactions (p=0.009). Furthermore, low inflammatory reactions were independently associated with positive margins (p=0.022) and lymphovascular invasion (p=0.034). The patients with spray-like invasive pattern had a significantly lower disease-free survival compared with those with closed or finger-like pattern (p=0.004). Conclusions: There is a complex interaction between cancer tissue at the invasive margin and changes in surrounding stroma. A spray-like invasive pattern has a prognostic value in patients with early-stage cervical squamous cell carcinoma.

• Korean Journal of Head & Neck Oncology
• /
• v.24 no.2
• /
• pp.162-168
• /
• 2008

Purpose：To know the results after induction chemotherapy followed by curative radiation therapy for locally advanced hypopharyngeal cancer Methods and Materials：From August 1990 to December 2003, forty patients who were treated with induction chemotherapy and curative radiation therapy were analyzed retrospectively. Median age of patients was 60 years(range：40-78 years) and clinical stage was wholly stage 3 or 4. Induction chemotherapy used cisplatin with 5-FU or docetaxel, and its interval was 3 weeks. Irradiated radiation dose was 70 to 78Gy (median：70.8Gy). Results：Median follow-up time was 39.4 months(range：8-115 months). Treatment failures were observed in 52.5% patients, and main failure pattern was local recurrence in 16 patients. 3 and 5 year disease free survival were 52.6%, 48.2% respectively and values of overall survival were 60.0, 43.9% and median survival time was 44.7 months. Treatment response was only a prognostic factor for survival. Laryngeal preservation was observed in twenty-four(60.0%) patients. Conclusion：Initial primary tumor stage was a significant prognostic factor for laryngeal preservation, and response after radiation therapy was a prognostic factor for long-term survival after induction chemotherapy followed by curative radiation therapy for locally advanced hypopharyngeal cancer.

• Radiation Oncology Journal
• /
• v.24 no.3
• /
• pp.201-206
• /
• 2006

Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving synovial membranes. Natural history and etiology of PVNS are not well known. PVNS presents as localized or diffuse tumor like nodular lesion of the synovial lining of the joint and the synovial spaces adjacent to the joints. Though histologically benign, it is a very aggressive lesion, capable of bone destruction and widespread infiltration of surrounding tissues. Standard therapy is surgical resection, but due to the infiltrative growth, the recurrence rate is significantly high. After several relapses surgical treatment of diffuse PVNS becomes difficult and may require amputation of the involved limb. Radiotherapy can provide an effective treatment option for patients with large lesions or lesions which are not suitable for surgery, after incomplete resection to prevent relapses or to avoid amputation. We report 2 cases of diffuse PVNS in the knee joint treated with arthroscopic gross total synovectomy and radiotherapy.

• Journal of Gastric Cancer
• /
• v.1 no.2
• /
• pp.77-82
• /
• 2001

Purpose: The most important prognostic factors in gastric cancer are depth of invasion and lymph node metastasis. Therefore, the prognosis for serosa and lymph node negative gastric cancer is favorable. However, there is no general agreement on the prognostic factors in this subset of patients. This study was undertaken to evaluate the prognostic significances of venous invasion (VI), lymphatic invasion (LI), and perineural invasion (NI) in T1 and T2 gastric cancer without lymph node involvement. Materials and Methods: We retrospectively evaluated 206 patients with T1 and T2, lymph node negative gastric cancer who underwent a curative resection from 1989 to 1993 at Kangnam St. Mary's Hospital, Seoul, Korea. The Chi-square test was used to determine the statistical significance of differences, and the Kaplan-Meier method was used to calculate survival rates. Significant differences in the survival rates were assessed using the log-rank test, and the Cox regression method was used to evaluate independent prognostic significance. Results: The rate of VI, LI and NI correlated well with the depth of tumor invasion. The rates of VI (+) for T1 vs T2 was $0\%\;vs\;5.1\%$, of LI (+) was $5.6\%\;vs\;26.8\%$, and of NI (+) was $1.6\%\;vs\;26.8\%$ in NI (+). There were 13 recurrent cases, 10 cases out of the 13 were T2 gastric cancers, and the recurrence rate was higher in LI (+) and NI (+) cases than in LI (-) and NI (-) cases. The 5-year survival rates were $93.4\%$ in LI (-) cases, $77.4\%$ in LI (+) cases, $92.5\%$ in NI (-) cases, $74\%$ in NI(+) cases, $95.9\%$ in LI (-) NI (-) cases, and $73.9\%$ in LI (+) NI (+) cases. Multivariate analysis demonstrated that simultaneous LI and NI was the only significant factor influencing the prognosis. Conclusion: These results suggest that simultaneous lymphatic and perineural invasion may be an independent prognostic factor in patients with T1 and T2 gastric cancer without lymph node metastasis.

• Archives of Craniofacial Surgery
• /
• v.17 no.2
• /
• pp.56-62
• /
• 2016

Background: The two most common skin cancers are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The purpose of this study was to describe the detailed clinical behavior of BCC and SCC in the head and neck region over 19 years at a single institution. Methods: A retrospective analysis was performed for all patients with non-melanoma skin cancer who had undergone surgical resection over an 18-year period. Patient charts were reviewed for demographic information, tumor size, onset-to-diagnosis, anatomic location, clinical subtype, histologic differentiation, method of surgical treatment, and recurrence. Results: The review identified 265 cases of either BCC or SCC in 226 patients. Of the 226 patients, 80 (35.4%) were men and 146 (64.6%) were women. BCC (n=138, 55.9%) was more frequent than SCC (109, 44.1%). The most frequent age group was 70-to-79 year olds (45 patients, 35.2%) for BCC and 80-to-89 year olds (41 patients, 41.8%) for SCC. By aesthetic units of the face, the most common location was the nasal unit (44 cases, 31.9%) for BCC and the buccal unit (23 cases, 21.1%) for SCC. The most common clinical subtype of BCC was the nodular type (80 cases, 58.0%). Local flaps were most commonly used to cover surgical defects (136 cases, 55.1%). Recurrent rates were 2.2% for BCC and 5.5% for SCC. Conclusion: In our study, many characteristics of BCC and SCC were compared to previously published reports were generally similar, except the ratio of BCC to SCC. Further study can help to establish the characteristics of BCC and SCC.

• Tuberculosis and Respiratory Diseases
• /
• v.64 no.5
• /
• pp.374-378
• /
• 2008

Angiosarcoma is a rare but highly malignant tumorthat usually arises in the scalp or face of elderly males. Distant metastases favor the lung, liver, lymph nodes and skin. Metastatic pulmonary angiosarcoma commonly takes the form of a nodule but can sometimes appear as a thin-walled cyst. We report a case of 65 years-old male with a spontaneous pneumothorax, who underwent excision and radiotherapy for an angiosarcoma of the scalp 2 years ago. A chest CT scan revealed multiple cysts in the lung. The video-assisted thoracoscopic lung biopsy demonstrated subpleural cysts without tumor cells. A skin biopsy of the scalp showed an angiosarcoma. This case was diagnosed as a recurrence of an angiosarcoma with a supposed lung metastasis. This case suggests that a spontaneous pneumothorax in elderly people may be secondary to a pulmonary metastasis from an angiosarcoma of the scalp.