• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.327-330
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• 2014

Background: Ewing sarcoma is a small round cell tumor arising from soft tissue and bone that predominantly affects children and adolescents. The most unfavorable prognostic factor is the presence of distant metastasis at the time of diagnosis. Materials and Methods: The records of 26 Ewing sarcoma patients (14 male, 12 female) were re-evaluated retrospectively. Results: The median age was 26.5 (19-42) years. Eight patients (31%) showed a primary tumor in their extremities, 8 (31%) in the thorax, 4 (15%) at the vertebra, 4 (15%) in the head and neck, and 2 (8%) in the abdomen. Five patients (19%) had distant metastasis at diagnosis. The median progression-free survival was 72 months and 10 months in localized and metastatic disease, respectively (p=0.005). The overall survival rate was 19 months in metastatic disease, and the 5-year overall survival rate was 64% in localized disease (p=0.006). Patients who had localized disease in the extremities and were under age 30 had a favorable prognosis. Conclusions: Although Ewing sarcoma is a tumor affecting children and adolescents, it may be seen in adults, where the prognosis is generally worse. Although it is a highly malignant tumor, it is possible to achieve improved survival with combined modality treatments.

• 대한병리학회지
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• 제52권6호
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• pp.369-377
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• 2018

Background: Chemokine receptor CXC chemokine receptor type 4 (CXCR4) and its ligand CXC motif chemokine 12 (CXCL12; stromal cell-derived factor-1) are implicated in tumor growth, metastasis, and tumor cell-microenvironment interaction. A number of studies have reported that increased CXCR4 expression is associated with worse prognosis in triple-negative breast cancer (TNBC), but its prognostic significance has not been studied in TNBC patients treated with adjuvant chemotherapy. Methods: Two hundred eighty-three TNBC patients who received adjuvant chemotherapy were retrospectively analyzed. Tissue microarray was constructed from formalin-fixed, paraffin-embedded tumor tissue and immunohistochemistry for CXCR4 and CXCL12 was performed. Expression of each marker was compared with clinicopathologic characteristics and outcome. Results: High cytoplasmic CXCR4 expression was associated with younger age (p=.008), higher histologic grade (p=.007) and lower pathologic stage (p=.045), while high CXCL12 expression was related to larger tumor size (p=.045), positive lymph node metastasis (p=.005), and higher pathologic stage (p=.017). The patients with high cytoplasmic CXCR4 experienced lower distant recurrence (p=.006) and better recurrence-free survival (RFS) (log-rank p=.020) after adjuvant chemotherapy. Cytoplasmic CXCR4 expression remained an independent factor of distant recurrence (p=.019) and RFS (p=.038) after multivariate analysis. Conclusions: High cytoplasmic CXCR4 expression was associated with lower distant recurrence and better RFS in TNBC patients treated with adjuvant chemotherapy. This is the first study to correlate high CXCR4 expression to better TNBC prognosis, and the underlying mechanism needs to be elucidated in further studies.

• Journal of Korean Neurosurgical Society
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• 제30권7호
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• pp.876-882
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• 2001

Objectives : Meningeal hemangiopericytoma is a rare tumor. Clinical and radiological features are similar to those of an ordinary meningioma. But its biological behavior is quite different from those of a meningioma as it brings profuse bleeding in the operation field, frequent recurrence and metastasis to other systemic organs even in the case of gross total resection. In order to find out the prognostic factors and to compare longterm outcome after various treatment modalities, the authors reviewed consecutive 20 operated cases of meningeal hemangiopericytoma to characterize their clinical features, surgical outcomes and effectiveness of the radiation therapy. Methods : Twenty patients with a hemangiopericytoma were treated between 1982 and 1999 in our department. They are composed of 13 patients of hemangiopericytoma and 7 patients who were initially diagnosed as angioblastic type meningioma and then confirmed as a hemangiopericytoma after review of their previous histopathology slides. The mean follow-up period was 99 months(1-256 months). The long-term outcomes after various treatment modalities were evaluated according to recurrence-free survival and image follow-up. Recurrence-free survival curves are compared between the patient groups according to the extent of removal and radiation therapy. Results : There were 10 cases of recurrence and 4 cases of distant metastases ; lung, liver and femur(2 cases) respectively. The 5-year recurrence rate was 37%, while the 10-year recurrence rose to 77%. There was also statistically significant difference of median recurrence-free survival between the completely-resected group(Simpson grade 1 or 2) and partially-resected group(Simpson grade 3 or 4 or 5) ; 137 months compared to 47 months, respectively(p=0.009). The median recurrence-free period after subtotal resection of tumor and postoperative radiotherapy was 47 months compared to 117 months of the patients who underwent gross total resection of tumor and did not receive radiotherapy. But radiation therapy alone did not show significant difference in recurrence-free survival. Marked tumor volume reduction and easy removal of tumors without bleeding were found in 2 recurred cases. Conclusion : The extent of tumor resection and presence of metastasis are the most important factors related to long-term outcome of the patients with hemangiopericytoma. Radiation therapy after the first operation did not have a role in extending the recurrence-free survival, but it affected favorably to decrease the size of residual mass and intraoperative bleeding during the second operation.

• Radiation Oncology Journal
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• 제15권4호
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• pp.305-313
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• 1997

목적 : 비인두강종양의 방사선치료의 결과를 후향적으로 분석하여 방사선치료의 효과와 예후인자를 분석하고자 하였다. 대상 및 방법 : 1989년부터 1996년까지 서울중앙병원에서 비인두강종양으로 진단받고 근치적 방사선치료를 시행한 56명을 대상으로 하였다 병기별로 보면 T1, T2, T3, T4가 각각 17, 10, 11,18명이었고 NO, Nl, N2, N3가 각각 11명, 27명, 4명, 14명이었다. 근치적 방사선치료만 시행한 환자는 28명, 유로항암요법을 병용한 환자는 7명, 매주 CDDP 항암요법을 병용한 환자는 21명이었다. 조사량은 6940-8620cGy였고 중앙값은 7440cGy였다. 외부방사선조사 60Gy이후 원발병소에 대한 부가적치료는 1명은 외부방사선조사, 46명은 강내조사, 9명은 삼차원 입체조형치료를 받았다. 추적관찰기간은 5-92개월이었고 중앙값은 34개월이었다. 결과 : 전치료후 47명은 완전관해, 8명은 부분관해, 1명은 무반응을 보여줬다. 5년 생존율은 $67.2\%$, 5년 무병생존율은 $53.6\%$이였다. 국소재발이 생긴 시기는 6-45개월(중앙값: 14개월)이었으며 전신적 전이가 생긴 시기는 3-49개월(중앙값: 16개월)이었다. 8명의 환자$(14.3\%)$에서 국소재발이 발생하였고 18명의 환자$(32.1\%)$에서 전신적 전이가 발생하였다. T3나 T4 환자 중 강내조사를 받은 20명중 4명$(20\%)$예서 원발병소에 재발이 있었고 삼차원 입체조형치료를 받은 9명중 1명$(11\%)$에서 원발병소에 재발이 발생하였다. 전신적 전이는 골전이가 가장 많았다. 생존율에 영향을 주는 예후인자로는 생존율에는 KPS(P=0.005), 방사선치료에 대한 반응(P=0.0001)이 통계학적으로 유의하였고 무병생존율에는 KPS(P=0.02), 방사선치료에 대한 반응(P=0.005)이 통계학적으로 유의하였다. 국소재발과 관련있는 예후인자는 없었으며 원격전이와 관련있는 예후인자는 Nstage(P=0.06), 병기(P=0.06)가 다소 의미있는 경향을 보였고, 방사선치료에 대한 반응(P=0.009)이 통계학적으로 유의하였다. 결론 : 비인두강종양에서 방사선치료로 5년생존율 $67.2\%$이었고 5년 무병생존율은 $53.6\%$이였다. 재발양상을 보면 국소재발보다는 전신적 전이율이 높음을 알 수 있었고 항암치료와의 병용은 관련이 없었다. T3 혹은 T4 병기에서 삼차원 입체조형치료를 받은 환자에 대해서는 앞으로 추적 관찰이 좀 더 필요할 것으로 생각된다. 앞으로 국소관해를 높이기 위한 방사선치료방법과 전신적 전이율의 감소를 위한 항암요법에 관한 연구가 필요할 것으로 생각된다.

• Radiation Oncology Journal
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• 제3권2호
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• pp.113-121
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• 1985

1979년 2월부터 1982년 9월까지 서울대학교병원 치료방사선과에서 두경부에 국한된 Non-Hodgkin's Lymphoma환자중 근치적 방사선치료를 받은 54예를 대상으로 다음과 같은 결론을 얻었다. 1. 원발병소의 관해율은 완전관해가 $81\%$, 부분관해가 $19\%$이었다. 2. 2년 생존을 및 무병 생존율은 각각 $57\%,\;45\%$, 이었으며 병기별, 발생부위별, 임파절 종대의 앙측성 여부, 조직아형에 따라 생존율에 통제학적으로 유의한 차이가 있었다. 3. 재발율은 $54.5\%$(24예/44예)로 국소재발이 $29\%$, 원격전이가 $54\%$, 원격전이와 국소재발이 공존했던 경우가 $17\%$로 $92\%$가 2년이내에 재발하였다. 4. 원발병소의 크기가 6cm이상이지나 다발성인 경우, 원발병소가 임파절외 장기 또는 조직아형이 미만성이거나 대세포형인 경우 원격전이율이 높아 국소방사선치료후 전신적 항암요법의 추가치료가 고러되어야 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권10호
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• pp.4225-4231
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• 2014

Aim: To determine prognostic value of blood parameters on overall and progression-free survival in cases received adjuvant radiotherapy and chemotherapy with diagnosis of stage I-III breast cancer. Materials and Methods: We retrospectively reviewed files of 350 patients with non-metastatic breast cancer who were treated in the Radiation Oncology Department of Kayseri Teaching Hospital between 2005 and 2010. Pretreatment white blood cell (WBC), neutrophil, monocyte, basophil and eosinophil counts, and the neutrophil/lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) were recorded. The relationship between clinicopathological findings and blood parameters was assessed. Results: Overall, 344 women and 6 men were recruited. Median age was $55.3{\pm}0.3$ years (range: 22-86). Of the cases, 243 (61.4%) received radiotherapy while 329 (94.3%), received chemotherapy and 215 (61.4%) received hormone therapy. Mean overall survival (OS) and progression-free survival (PFS) was 84.4 and 78.8 months, respectively. During follow-up, 48 patients died due to either disease-related or non-related causes. Local recurrence was detected in 14 cases, while distant metastasis was noted in 45 cases. In univariate analysis, age, pathology, perinodal invasion were significantly associated with overall survival, whereas gender, stage and hormone therapy were significantly associated with progression-free survival. In multivariate analysis, histopathological diagnosis (OR: 0.3; 95%: 0.1-0.7; p=0.006) and perinodal invasion (OR: 0.1; 95% CI: 0.1-1.3; p=0.026) were significantly associated with overall survival, whereas tumor stage (OR: 2.1; 95% CI: 0.0-0.7; p=0.014) and hormone therapy (OR: 2.1; 95%: 1.2-3.8; p=0.010) were significantly associated with progression-free survival. Conclusions: It was found that serum inflammatory markers including WBC, neutrophil, lymphocyte and monocyte counts, and NLR and PLR had no effect on prognosis in patients with breast cancer who underwent surgery and received adjuvant radiotherapy and chemotherapy.

• Journal of Chest Surgery
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• 제33권4호
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• pp.301-305
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• 2000

Background: The surgical indications of stage IV non-small cell lung cancer(NSCLC) are extremely limited with its controversial results. We analyzed the surgical results and survival in selected patients with resectable stage IV NSCLC. Material and Method: We reviewed the medical records of 21 patients who underwent operation for stage IV NSCLC from Jan. 1992 to Sep. 1999. Result: The mean age of patients was 55.6 years(range: 35 to 78). Sixteen were men and 5 were women. Tissue types were squamous cell carcinoma in 10(45.5%), adenocarcinoma in 9(40.9%), large cell carcinoma in 1 and carcinosarcoma in 1. Distant metastatic lesions were ipsilateral other lobe of lung in 18, brain in 2 and adrenal gland in 1. Pneumonectomy was performed in 16 patients, bilobectomy in 3, and lobectomy in 2 who underwent previous operatin for brain metastasis. Mean follow-up duration was 21.2$\pm$17.7 months. During follow-up period, 13 patients died. Three-and 5-year survival of patients were 38.0% and 19.0%, the median survival time was 19.1$\pm$7.8 months. In the group with ipsilateral pulonary metastasis(PM, n=18), 3- and 5-year survival of patients with N0 and N1(n=9) disease were 64.8% and 32.4%, median survival time was 55.3$\pm$27.2 months. Three-year survival of patients with N2(n=9) disease was 11.1%, median survival time was 10.6$\pm$0.3 months. The survival of N0 and N1 disease group was significantly better than that of N2 disease group(p=0.042). Also the disease free survival of N0 and N1 was significantly better than that of N2 disease in overall group(53.3 months vs 12.1 months, p=0.036) and ipsilateral PM group(63.4 months vs 8.8 months, p=0.001). Conclusion: We suggest that surgical treatment is worthful modality in well selected patients with stage IV NHSCLC especially with ipsilateral PM and N0 or N1 disease,. Nevertheless our study indicate questions that will need to be experienced further in larger studies.

• Radiation Oncology Journal
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• 제35권1호
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• pp.39-47
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• 2017

Purpose: The purpose of this study was to analyze clinical outcomes from cervical cancer and stratify patients into risk groups for prognostic factors for early-stage disease. Materials and Methods: We retrospectively reviewed patients with stage IB or IIA cervical cancer treated with adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) following primary surgery at Samsung Medical Center from 2001 to 2011. Adjuvant RT was added for patients with intermediate-risk factors, and adjuvant CCRT was performed on high-risk patients after surgery. Results: We reviewed 247 patients-149 in the high-risk group and 98 in intermediate-risk group. The median follow-up was 62 months. Loco-regional failure (LRF) alone occurred in 7 patients (2.8%), distant metastasis alone in 37 patients (15.0%) and LRF with DM in 4 patients (1.6%). The 5-year disease-free survival (DFS) and overall survival (OS) rates for both groups were 79.7% and 87.6%, respectively. In the high-risk group, the 5-year DFS and OS probabilities were 72.5% and 81.9%, respectively. Histologic type, pathologic tumor size, and the number of pelvic lymph node (PLN) metastasis were significant prognostic factors for DFS and OS. We suggest a scoring system (0-3) using these prognostic factors to predict poor prognosis in high-risk patients. Using this system, patients with higher scores have higher recurrence and lower survival rates. Conclusion: In the high-risk cervical-cancer group who received primary surgery and adjuvant CCRT, non-squamous type, large tumor size and the number of PLN metastasis were significant prognostic factors, and the number of these factors was associated with survival rates.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.2101-2107
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• 2012

Treatment responses of $N_0$ stage nasopharyngeal carcinoma were firstly analyzed comprehensively to evaluate long term outcomes of patients and identify prognostic factors. A total of 610 patients with $N_0$ NPC, undergoing definitive radiotherapy to their primary lesion and prophylactic radiation to upper neck, were reviewed retrospectively. Concomitant chemotherapy was administrated to 65 out of the 610. Survival rates of the patients were calculated using the Kaplan-Meier method and compared by log-rank test. Prognostic factors were identified by the Cox regression model. The study revealed the 5-year and 10-year overall, disease-free, disease-specific, local failure-free, regional failure-free, locoregional failure-free and distant metastasis-free survival rates to be 78.7% and 66.8%, 68.8% and 55.8%, 79.9% and 70.4%, 81.2% and 72.5%, 95.8% and 91.8%, 78.3% and 68.5%, 88.5% and 85.5%, respectively. There were 192 patients experiencing failure (31.5%) after radiotherapy or chemoradiotherapy. Of these, local recurrence, regional relapse and distant metastases as the first event of failure occurred in 100 (100/610, 16.4%), 15(15/610, 2.5%) and 52 (52/610, 8.5%), respectively. Multivariate analysis showed that T stage was the only independent prognostic factor for patients with $N_0$ NPC (P=0.000). Late T stage (P=0.000), male (P=0.039) and anemia (P=0.007) were independently unfavorable factors predicting disease-free survival. After treatment, satisfactory outcome wasgenerally achieved in patients with $N_0$ NPC. Local recurrence represented the predominant mode of treatment failure, while T stage was the only independent prognostic factor for overall survival. Late T stage, male gender, and anemia independently predicted lower possibility of the disease-free survival.

• Radiation Oncology Journal
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• 제21권2호
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• pp.112-117
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• 2003

목적: 진행된 두경부암을 대상으로 다분할 방사선치료를 시행한 후 실패양상 및 생존율을 분석하고 다분할 방사선치료의 효과를 알아보고자 한다. 대상 및 방법: 1990년 9월부터 1995년 10월 사이에 계명대학교 동산의료원 방사선종양학과에서 진행된 두경부암으로 다분할 방사선치료를 시행한 환자 24명을 대상으로 하였다. 환자의 연령분포는 38세에서 71세로 중앙값 55세이었다. 병기별로 3기 11명, 4기 13명이었으며 남자가 21명이었고 비인두암 6명, 하인두암 6명, 후두암 5명, 구강인두암 3명, 부비동암 3명, 구강암 1명이었다. 방사선치료는 6 MV x-선으로 1일 2회, 최소 6시간 간격으로 분할조사량 1.2 Gy 시행하여 총치료선량은 64.4 Gy에서 76.8 Gy로 평균총방사선량은 72 Gy이었다. 추적관찰기간은 3개월에서 136개월이었고 중간 추적관찰기간은 52개월이었다. 결과: 전체환자의 3년 생존율과 5년 생존율은 각각 66.7$\%$, 52.4$\%$이었고 전체 환자의 3년 무병생존율은 66.7$\%$, 5년 무병생존율은 47.6$\%$이었다. 병기별로 3년, 5년 무병생존율은 3기는 81.8$\%$, 63.6$\%$, 4기는 53.8$\%$, 32.3$\%$이었다. 국소재발이나 원격전이의 소견 없이 생존해 있는 환자가 10명이며 원격전이는 25$\%$, 국소재발은 12.5$\%$로 원격전이가 주된 실패원인이었다. 원격전이인지 국소 재발인지 분명하지 않은 경우가 2명, 다른 원인으로 사망한 경우가 3명이었다. 원격전이 장소는 폐 3명, 뼈 1명, 간 2명이었으며 1명에서 식도에 2차암이 발생하여 사망하였다. 추적관찰 기간 중 1명에서 방사선치료 후 58개월에 하악골괴사로 수술한 경우를 제외하고 중등도 이상의 심각한 만성부작용이 발생한 환자는 없었다. 결론: 대상 환자의 수는 적으나 진행된 병기의 두경부암에서 다분할 방사선치료법이 급성 부작용은 다소 증가하나 만기부작용의 증가 없이 국소 재발의 감소와 무병생존율을 증가시킬 수 있을 것이라고 생각한다.