• Journal of Chest Surgery
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• v.40 no.2 s.271
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• pp.109-113
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• 2007

Background: In non-small cell lung cancer (NSCLC), malignant pleural effusion is a frequently observed com-plication, and is an important negative prognostic factor. Although many studies concerned to diagnosis and treatment of malignant pleural effusion have been performed, prognostic factors of malignant pleural effusion have rarely been investigated. This study was performed to determine the prognostic factors of malignant pleural effusion n non-small cell lung cancer. Material and Method: We evaluated 33 NSCLC patients with malignant effusion treated between January 2002 and December 2003. We analyzed possible factors: gender, age, TNM Stage, fluid analysis (pH, CEA, LDH, glucose, albumin) and treatment modality. Median survival time of each factor was calculated by Kaplan-Meier method and difference of median survival time between groups of factor compared by log-rank test. The Cox proportional hazards regression model was used to confirm the significance of prognostic factor. Results: Of the 33 patients, 23 (69.7%) patients were adenocarcinoma. The median interval of the diagnosis of lung cancer and malignant effusion was 7.3 months ($25^{th}{\sim}75^{th}:\;3.9{\sim}11.8$), and the median survival time was 3.6 months (95% Confidence Interval: $1.14{\sim}5.99$). In the univariate analysis, using the log-rank test, those with an adenocarcinoma showed a relatively longer median survival time than those of a non-adenocarcinoma (4.067 vs. 1.867 months, p=0.067) without statistical significance. In the multivariate analysis, using the Cox regression, those with a non-adenocarcinoma showed a trend of high risk of cancer death than those with an adenocarcinoma without statistical significance (Relative risk; 2.754, 95% Cl: $0.988{\sim}7.672$, p=0.053). Conclusion: We could not find an independent prognostic factor of malignant pleural effusion in NSCLC. As there was a trend of high risk of cancer death according to histology, further study will be needed.

• Radiation Oncology Journal
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• v.9 no.2
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• pp.197-204
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• 1991

A retrospective study of 53 patients suffering from non-small cell carcinoma of lung with brain metastases is presented. They were treated in the Department of Therapeutic Radiology of Kyung Hee University Hospital from 1983 to 1990. There were 37 male and 10 female patients. The age range was 39 to 85 years (median=59). The most common histologic cell type of tumor was adenocarcinoma ($50.9\%$), followed by squamous cell carcinoma and large cell carcinoma. All patients were treated with whole-brain photon irradiation (WBI) using lateral opposing fields. The overall median survival time was 5 months. Age, sex, histologic type, and initial performance status were not prognostically important. The most important prognostic factors were the response to radiotherapy and the presence of brain metastases alone. increasing the dose of radiotherapy to the main bulk of tumor may improve the symptom-free survival or overall survival in patients who present with brain metastases as the sole site of extrathoracic disease.

• Radiation Oncology Journal
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• v.24 no.2
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• pp.110-115
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• 2006

Purpose: This study was performed to determine the prognostic factors influencing relapse pattern, overall and disease-free survival in patients treated with postoperative radiotherapy for endometrial carcinoma. Materials and Methods: The records of 54 patients with endometrial adenocarcinoma treated postoperative radiotherapy at Pusan National University Hospital between April 1992 and May 2003 were reviewed retrospectively. Median age of the patients was 55 (range $35{\sim}76$). The distribution by surgical FIGO stages were 63.0% for 0Stage I, 14.8% for Stage II, 22.2% for Stage III. All patients received postoperative external radiotherapy up to $41.4{\sim}54Gy$ (median: 50.4 Gy). Additional Intravaginal brachytherapy was app led to 20 patients (37.0% of all). Median follow-up time was 35 months ($5{\sim}115$ months). Significant factors of this study: histologic grade, Iymphovascular space invasion and myometrial invasion depth were scored (GLM score) and analyzed. Survival analysis was peformed using Kaplan-Meier method. The log-rank test was used for univariate analysis and the Cox regression model for multivariate analysis. Results: 5-year overall and disease-free survival rates were 87.7% and 871%, respectively. Prognostic factors related with overall and disease-free survival were histologic grade, Iymphovascular space invasion and myometrial invasion according to the univariate analysis. According to the multivariate analysis, Iymphovascular space invasion was associated with decreased disease-free survival. GLM score was a meaningful factor affecting overall and disease-free survival (p=0.0090, p=0.0073, respectively) and distant recurrence (p=0.0132), which was the sum of points of histologic grade, Iymphovascular space Invasion and myometrial invasion. Total failure rate was 11% with 6 patients. Relapse sites were 2 para-aortic Iymph nodes, 2 lungs, a supraclavicular Iymph node and a vagina. Conclusion: The prognosos in patients with endometrial carcinoma treated by postoperative radiotherapy was closely related with surgical histopathology. If further explorations confirm the system of prognostic factors in endometrial carcinoma, it will help us to predict the progression pattern and to manage.

• Journal of Hospice and Palliative Care
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• v.1 no.1
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• pp.30-38
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• 1998

Background : Hepatocellular carcinomoma is the 3rd most common malignancy and the 2nd most common cause of death in Korea. The prediction of life-expectancy in terminal cancer patients is a major problem for patients, families, and physicians. We would like to investigate the prognostic factors of hepatocellular carcinoma, and therefore contribute to the prediction of the survival time of patients with hepatocellular carcinoma. Methods : A total of 91 patients(male 73, female 18) with hepatocellular carcinoma who were admitted to the hospital between January and lune 1995 were entered into the study, and data were collected prospectively on 28 clinical parameters through medical obligation record. We surveyed an obligation and local district office records, and confirmed the surivival of patients till July, 1996. Using Cox-proportional hazard model, give the significant variables related to survival. These determined prognostic factors. Life regressional analysis was used, there were calculated predicted survival day based on combinations of the significant prognostic factors. Results : 1) Out of 91 patients, 73 were male, and 18 were female. The mean age was $56.7{\pm}10.6$ ears. During the study, except for 16 patients who could not follow up, out of 75 patients, the number of deaths was 57(76%) and the number of survivals was 18(24%). 2) Out of the 28 clinical parameters, the prognostic factors related to reduced survival rate were prothrombin time<40%(relative risk:10.8), weight loss(RR:4.4), past history of hypertension (RR:3.2), ascites(RR:2.8), hypocalcemia(RR:2.5)(P<0.001). 3) Out of five factors, the survival day is 1.7 in all of five, $4.2{\sim}10.0$ in four, $10.4{\sim}41.9$ in three, $29.5{\sim}118.1$ in two, $124.0{\sim}296.6$ in one, 724.0 in none. Conclusion : In hepatocellular carcinoma we found that the prognostic factors related to reduce survival rate were prolonged prothrombin time(<40%), weight loss, past history of hypertension, ascites, and hypocalcemia(<8.7mg/dl). The five prognostic factors enabled the prediction of life-expectancy in patients with hepatocellular carcinoma and may assist in managing patients with hepatocellular carcinomal.

• 대한두경부종양학회:학술대회논문집
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• 2004.11a
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• pp.264-264
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• 2004

• Radiation Oncology Journal
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• v.12 no.3
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• pp.349-359
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• 1994

Purpose: The primary gastrointestinal non-Hodgkin's lymphoma(GI-NHL) is the most common extranodal NHL. Surgery with postoperative radiotherapy or chemotherapy was tried with some success, but proper management guidelines have not been estabilished in localized GI-NHL due to its rarity and the lack of randomized trials. So we designed this study to evaluate treatment results and the lack of randomized trials. So we designed this study to evaluate treatment results and prognostic factors in localized GI-NHL, and to assess proper treatment mdality after surgical resection accordig to risk factors by survival analysis. Method: Seventy three patients who received surgical resection due to localized GI-NHL from Jan. 1916 to Apr. 1991 were reviewed in this study. Prognostic factors were analyzed by multivariate analysis program including postoperative treatment methods, and treatment results were compared according to prognostic factors and treatment modalities. Results: Overall 5-year survival rate was 62.3%, for all patients. The 5-year survival rate was 80.0% for patients with stage I GI-NHL and 45.7% for those with stage II. Chemotherapy or not, stage and residuum or not after surgical resection were significant independent prognositic factors. Postoperative adjuvant treatments showed significant survival benefit. In patients with high risk factors such as stage II or residuum after surgical resection, postoperative combined chemotherapy and radiotherapy showed better survival than those treated with single modality. Conclusions: Chemothrapy or not, stage, and residuum or not were important prognostic factors of patients with localized GI-NHL after surgical resection. Either chemotherapy or radiation therapy alone after surgical resection is recommanded for patients without high risk factors(stage II or residuum after surgical resection) but the postoperative combined chemotherapy and radiotherapy seems to be beneficial for patients with high risk factors.

• Radiation Oncology Journal
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• v.14 no.3
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• pp.181-189
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• 1996

Purpose : To find the more effective treatment methods that improving the survival of patients with glioblastoma multiforme(GBM), we analyze the prognostic factors and the outcome of therapy in patients with GBM. Materials and Methods : One hundred twently-one patients with a diagnosis of GBM treated at Severance Hospital between 1973 and 1993 were analyzed for survival with respect to patients characteristics, that is, duration of symptom, age, and Karnofsky performance status, as well as treatment related variables such as extent of surgery and radiotherapy. Results : The median survival time(MST) and 2-year overall survival rate (OSR) of the patients with GBM were 13 months and $20.8\%$, respectively. Duration of symptom, age, Karnofsky performance status(KPS), radiotherapy, and extent of surgical resection were associated with improved survial in a univariate analysis. Patients whose duration of symptom was longer than 3 months, had the 2-year OSR of $47.2\%$(p=0.0082), who were younger than age 50, $32.9\%$(p=0.0003) In patients with a KPS of 80 or higher, the 2-rear OSR was $36.9\%$(p=0.0422). Patients undergoing radiotherapy had the 2-year OSR of $22.9\%$(p=0.0030), and surgical resection of $23.3\%$ (p<0.000). A Cox regression model confirmed a significant correlation of duration of symptom, age, radiotherapy, and extent of surgical resection with survival, excluding KPS(P=0.8823). The 2-year OSR were $22.3\%$ and $19.4\%$, combined with chemotherapy or without, respectively(p=0.6028). The duration of symptom of 3 months or shorter, 50 years of age or older, and undergoing stereotactic biopsy only were considered as risk factors, then patients without any risk factors had the MST of 29 months and 2-year OSR of $53.9\%$ compared to 4 months and $0\%$ for Patients who had all 3 risk factors. Most of all treatment failures occurred in the primary tumor site($80.4\%$). Conclusion : The duration of symptom, age, radiotherapy, and extent of surgical resection were a prognostically significant indeuendent variables. To get a better survival, it seems to be reasonable that the study design which improves the local control rates is warranted.

• Radiation Oncology Journal
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• v.24 no.4
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• pp.255-262
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• 2006

$\underline{Purpose}$: To evaluate the pathological prognostic factors related to local recurrence after radical surgery and adjuvant radiation therapy in advanced rectal cancer. $\underline{Materials\;and\;Methods}$: Fifty-four patients with advanced rectal cancer who were treated with radical surgery followed by adjuvant radiotherapy and chemotherapy between February 1993 and December 2001 were enrolled in this study. Among these patients, 14 patients experienced local recurrence. Tissue specimens of the patients were obtained to determine pathologic parameters such as histological grade, depth of invasion, venous invasion, lymphatic invasion, neural invasion and immunohistopathological analysis for expression of p53, Ki-67, c-erb, ezrin, c-met, phosphorylated S6 kinase, S100A4, and HIF-1 alpha. The correlation of these parameters with the tumor response to radiotherapy was statistically analyzed using the chi-square test, multivariate analysis, and the hierarchical clustering method. $\underline{Results}$: In univariate analysis, the histological tumor grade, venous invasion, invasion depth of the tumor and the over expression of c-met and HIF-1 alpha were accompanied with radioresistance that was found to be statistically significant. In multivariate analysis, venous invasion, invasion depth of tumor and over expression of c-met were also accompanied with radioresistance that was found to be statistically significant. By analysis with hierarchical clustering, the invasion depth of the tumor, and the over expression of c-met and HIF-1 alpha were factors found to be related to local recurrence. Whereas 71.4% of patients with local recurrence had 2 or more these factors, only 27.5% of patients without local recurrence had 2 or more of these factors. $\underline{Conclusion}$: In advanced rectal cancer patients treated by radical surgery and adjuvant chemo-radiation therapy, the poor prognostic factors found to be related to local recurrence were HIF-1 alpha positive, c-met positive, and an invasion depth more than 5.5 mm. A prospective study is necessary to confirm whether these factors would be useful clinical parameters to measure and predict a radio-resistance group of patients.

• Journal of Gastric Cancer
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• v.9 no.4
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• pp.238-245
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• 2009

Purpose: Treatment strategies for early gastric carcinoma (EGC) should be based on achieving a complete cure, but clear indications for limited surgery have not been established. We investigated surgical outcomes for early gastric cancer to determine the optimal? treatment strategy for EGC. Materials and Methods: Subjects included 881 patients who underwent curative surgery for EGC between 1986 and 2003. Retrospective uni & multi-variate analysis for prognostic factors, factors affecting lymph node metastasis, and risk factors for cancer recurrence were analyzed. Results: In multivariate survival analyses, age, operation method, macroscopic appearance and lymph node stage proved to be independent prognostic factors. Lymph node metastasis, depth of tumor invasion, tumor size, lymphatic and venous invasion were also significant risk factors in multivariate analyses. In multivariate analyses for cancer recurrence, depth of tumor invasion and lymph node metastasis proved to be significant risk factors. Conclusion: Appropriate surgical treatment with lymph node dissection is necessary for EGC patients with risk factors for lymph node metastasis.

• Journal of Chest Surgery
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• v.37 no.5
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• pp.423-431
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• 2004

Background : Tumor size in lung cancer is not as good a prognostic factor for adenocarcinoma as it is for other types of lung cancer; therefore it is difficult to estimate the prognosis preoperative. However, there have recently been some reports on the radiologic findings correlating to the clinicopathologic prognostic factors in peripheral small adenocarcinoma of lung. We tried to evaluate the prognostic importance of High-Resolution CT (HRCT) findings of such adenoearcinoma, Material and Method: One houndred and seventy-six surgically resected small peripheral adenocarcinoma measuring 3 cm or less in greatest dimension were reviewed radiologically and clinicopathologically. Result: The patients with greater extent of ground-glass attenuation (GGA) had better clinico-pathological factors. The tumors with gross appearance of GGA or bubble-like shape showed better clinicopathological prognostic factors than scar-like or solid shape. Conclusion: HRCT findings of small peripheral adenocarcinomas of the lung correlated well with the histologic and clinical prognostic factors. We can predict the post-operative prognosis with the radiologic findings.