• Asian Oncology Nursing
• /
• v.12 no.2
• /
• pp.156-165
• /
• 2012

Purpose: This study was to identify predictors of sexual function in gynecologic cancer patients. Methods: The participants were 154 patients treated at a university medical center in A city, Korea. The data collection was performed through a structured questionnaire from July to December, 2010. The instruments used in this study were Female Sexual Function Index (FSFI) perceived health status scale, Eastern Cooperative Oncology Group (ECOG) performance status, body image, and depression. Data were analyzed using descriptive statistics, Mann-Whitney test, Kruskal-Wallis test and stepwise multiple regression with the SPSS 18.0. Results: The mean score of perceived health status was 8.42 and sexual function was 8.42. The lowest score among sexual function was lubrication. The scores of sexual function was significantly different by age, job, marital status, period after diagnosis of cancer and diagnosis. There were significant correlations between sexual function, perceived health status, ECOG performance, body image and depression. In multiple regression analysis, predictors were identified as ECOG performance, age, diagnosis and period after diagnosis of cancer (Adj.$R^2$=.28). The most powerful predictor of female sexual function was ECOG performance (19.0%). Conclusion: The above findings indicate that it is necessary to develop a more effective and personalized sexual function improvement program for gynecologic cancer patient.

• Journal of Pharmacopuncture
• /
• v.17 no.1
• /
• pp.20-26
• /
• 2014

Objectives: The study aimed to determine changes in laboratory data for cancer patients receiving Korean medicine (KM) care, with a focus on patients' functional status, cancer-coagulation factors and cancer immunity. Methods: We conducted an observational study of various cancer patients in all stages admitted to the East-West Cancer Center (EWCC), Dunsan Korean Hospital of Daejeon University, from Mar. 2011 to Aug. 2011. All patients were under the center's multi-modality Korean-medicine-based inpatient cancer care program. The hospitalization stay at EWCC ranged from 9 to 34 days. A total of 80 patients were followed in their routine hematologic laboratory screenings performed before and after hospitalization. Patients were divided into three groups depending on the status of their treatment: prevention of recurrence and metastasis group, KM treatment only group, and combination of conventional and KM treatment group. The lab reports included natural killer cell count (CD16 + CD56), fibrinogen, white blood cell (WBC), lymphocytes, monocytes, neutrophil, red blood cell (RBC), hemoglobin, platelet, Erythrocyte Sedimentation Rate (ESR), and Eastern Cooperative Oncology Group (ECOG) performance status. Results: With a Focus on patients' functional status, cancer-coagulation factors and cancer immunity, emphasis was placed on the NK cell count, fibrinogen count, and ECOG scores. Data generally revealed decreased fibrinogen count, fluctuating NK cell count and decreased ECOG, meaning improved performance status in all groups. The KM treatment only group showed the largest decrease in mean fibrinogen count and the largest increase in mean NK cell count. However, the group's ECOG score showed the smallest decrease, which may be due to the concentration of late-cancer-stage patients in that particular group. Conclusions: Multi-modality KM inpatient care may have positive effect on lowering the cancer coagulation factor fibrinogen, but its correlation with the change in the NK cell count is not clear.

• Journal of Gastric Cancer
• /
• v.23 no.3
• /
• pp.462-475
• /
• 2023

Purpose: This study aimed to analyze the incidence and risk factors of complications following gastric cancer surgery in Korea and to compare the correlation between hospital complications based on the annual number of gastrectomies performed. Materials and Methods: A retrospective analysis was conducted using data from 12,244 patients from 64 Korean institutions. Complications were classified using the Clavien-Dindo classification (CDC). Univariate and multivariate analyses were performed to identify the risk factors for severe complications. Results: Postoperative complications occurred in 14% of the patients, severe complications (CDC IIIa or higher) in 4.9%, and postoperative death in 0.2%. The study found that age, stage, American Society of Anesthesiologists (ASA) score, Eastern Cooperative Oncology Group (ECOG) score, hospital stay, approach methods, and extent of gastric resection showed statistically significant differences depending on hospital volumes (P<0.05). In the univariate analysis, patient age, comorbidity, ASA score, ECOG score, approach methods, extent of gastric resection, tumor-node-metastasis (TNM) stage, and hospital volume were significant risk factors for severe complications. However, only age, sex, ASA score, ECOG score, extent of gastric resection, and TNM stage were statistically significant in the multivariate analysis (P<0.05). Hospital volume was not a significant risk factor in the multivariate analysis (P=0.152). Conclusions: Hospital volume was not a significant risk factor for complications after gastric cancer surgery. The differences in the frequencies of complications based on hospital volumes may be attributed to larger hospitals treating patients with younger age, lower ASA scores, better general conditions, and earlier TNM stages.

• Journal of Chest Surgery
• /
• v.54 no.6
• /
• pp.487-493
• /
• 2021

Background: Predicting postoperative lung function after pneumonectomy is essential. We retrospectively compared postoperative lung function to predicted postoperative lung function based on computed tomography (CT) volumetry and perfusion scintigraphy in patients who underwent pneumonectomy. Methods: Predicted postoperative lung function was calculated based on perfusion scintigraphy and CT volumetry. The predicted function was compared to the postoperative lung function in terms of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV₁), using 4 parameters: FVC, FVC%, FEV₁, and FEV₁%. Results: The correlations between postoperative function and predicted function based on CT volumetry were r=0.632 (p=0.003) for FVC% and r=0.728 (p<0.001) for FEV₁%. The correlations between postoperative function and predicted postoperative function based on perfusion scintigraphy were r=0.654 (p=0.002) for FVC% and r=0.758 (p<0.001) for FEV₁%. The preoperative Eastern Cooperative Oncology Group (ECOG) scores were significantly higher in the group in which the gap between postoperative FEV₁ and predicted postoperative FEV₁ analyzed by CT was smaller than the gap analyzed by perfusion scintigraphy (1.2±0.62 vs. 0.4±0.52, p=0.006). Conclusion: This study affirms that CT volumetry can replace perfusion scintigraphy for preoperative evaluation of patients needing pneumonectomy. In particular, it was found to be a better predictor of postoperative lung function for poor-performance patients (i.e., those with high ECOG scores).

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.3
• /
• pp.985-989
• /
• 2015

Background: Docetaxel, cisplatin, 5-fluorouracil (DCF) given every three weeks is an effective, but palliative regimen and significantly toxic especially in patients who have a low performance score. Here, we aimed to evaluate the efficacy and tolerability of a weekly formulation of DCF in locally advanced and metastatic gastric cancer patients. Materials and Methods: 64 gastric cancer patients (13 locally advanced and 51 metastatic) whose ECOG (Eastern Cooperative Oncology Group) performance status (PS) was 1-2 and who were treated with at least two cycles of weekly DCF protocol as first-line treatment were included retrospectively. The weekly DCF protocol included $25mg/m^2$ docetaxel, $25mg/m^2$ cisplatin, and 24 hours infusion of $750mg/m^2$ 5-fluorouracil, repeated every week. Disease and patient characteristics, prognostic factors, treatment response, grade 3-4 toxicity related to treatment, progression free survival (PFS) and overall survival (OS) were evaluated. Results: Of the patients, 41 were male and 23 were female; the median age was 63 (29-82) years. Forty-one patients were ECOG-1 and 23 were ECOG-2. Of the total, 81.2% received at least three cycles of chemotherapy. Partial response was observed in 28.1% and stabilization in 29.7%. Overall, the disease was controlled in 57.8% whereas progression was noted in 42.2%. The median time to progression was 4 months (95%CI, 2.8-5.2 months) and median overall survival was 12 months (95%CI, 9.2-14.8 months). The evaluation of patients for grade 3-4 toxicity revealed that 10.9% had anemia, 7.8% had thrombocytopenia and 10.9% had neutropenia. Non-hematologic toxicity included renal toxicity (7.8%) and thrombosis (1.6%). Conclusions: In patients with locally advanced or metastatic gastric cancer who were not candidates for DCF administered every-3-weeks, a weekly formulation of DCF demonstrated modest activity with minimal hematologic toxicity, suggesting that weekly DCF is a reasonable treatment option for such patients.

• Journal of Hospice and Palliative Care
• /
• v.2 no.2
• /
• pp.125-137
• /
• 1999

Purpose : Surveying the rates, severity, and variables influencing depression and their correlation between pain and depression in Korean cancer patients, we attempted to provide a basic database for the effective depression management program. Methods : The results of survey were colleted from 10 patients who were hospitalized at Seoul National University Hospital for cancer treatment from February to June of 1999. Factors of depression and the level of pain were examined by self-reported survey employing Korean version of Beck Depression Inventory(BDI) and an abridged version of Brief pain Inventory respectively. The purpose of this study and guidelines for the questionnaires were clearly explained to participating patients by Resgitered Nurses before answering the survey. Demographic and clinical characteristics of patients were compiled by reviewing their medical records in corporation with a family physician. The difference in the level of depression among patient groups was analyzed with the t-test and ANOVA, and the correlation between variables with Pearson correlation coefficient. Results : 1) 142 subjects comprised 79 male and 63 female, and their mean age was 51.86. 2) The mean scores of the worst pain for last 24-hours was 6.08(SD 2.23), the average pain for last 24-hours 4.44(SD 1.85), and the mean scores of pain at the time of survey 3.48(SD 2.25), while the mean scores of the least pain for last 24-hours 2.25(SD 1.83). 3) The mean BDI scores were 23.73(SD 0.99), and 55.6% of patients were evaluated to be in depression(cutting point 21). Scores of depression for cancer patients were higher than normal population. 4) The correlation between worst pain for last 24-hours and depression(r=0.252, P=0.002), average pain for last 24-hours and depression(r=0.225, P=0.007), present pain and depression(r=0.291, P=0.000) were significant. 5) Significant differences were found among groups of cancer patients with pain with respect to gender(t=3.59, p=0.000), level of education(F=4.063, P=0.009), ECOG(F=3.352, P=0.021). There was significant positive correlation between depression and pain(r=0.171, P=0.042). Conclusions : More than 50% of cancer patients with pain are suffering from depression. We have shown that the variables like the degree of pain, gender, level of education, ECOG, and age are significantly related to the depression in cancer patients. The findings of this study may be used for assessing high-risk patients in need of intervention and for planning effective therapeutic strategies for them after the routine assessment. Further study is necessary to investigate the cultural differences and the variables influencing on depression in Korean cancer patients.

• Journal of Korean Neurosurgical Society
• /
• v.57 no.2
• /
• pp.100-107
• /
• 2015

Objective : To report a minimally invasive treatment option using percutaneous pedicle screw fixation with adjuvant treatment for metastatic thoraco-lumbar and lumbar spinal tumors. Methods : This is a retrospective study of charts of patients with spinal metastases. All were older than 18 years of age and were considered to have more than 3 months of life expectancy. The patients had single or two level lesions, and compression fracture or impending fracture. Exclusion criterion was metastasis showing severe epidural compression with definite neurological symptoms. Usually spinal segments from one level above to below pathology were stabilized. Visual analog scale (VAS) score for pain assessment and Frankel scale for neurological deficit were used, while pre- and post-operative performance status was evaluated using the Eastern Cooperative Oncology Group (ECOG). Results : Twelve patients (nine men, three women; median age 54.29 years) underwent surgery. All patients presented with back pain with/without radicular pain. There were no early complications and perioperative mortalities. Following surgery, a significant difference between average pre- and post-operative VAS scores was found (p=0.003). Overall, 91.8% of patients (11/12) experienced improvement in their ECOG score post-operatively. The mean ambulation time was 196.9 days [95% confidence interval (CI), 86.2-307.6 days; median, 97 days]. During follow-up, nine patients died and the mean overall survival time in enrolled twelve patients was 249.9 days (95% CI, 145.3-354.4 days; median, 176 days). Conclusion : Minimally invasive treatment using percutaneous pedicle screw fixation with adjuvant treatment is a good alternative treatment option for potential instability of the thoraco-lumbar and lumbar spinal metastasis.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.12
• /
• pp.7669-7674
• /
• 2013

Background: The hypothesis that patients who primarily progress on two consecutive chemotherapy regimens without evidence of clinical benefit may opt for supportive care was investigated. The purpose was to determine the quality of life in recurrent ovarian cancer patients choosing to receive salvage chemotherapy in addition to supportive care or palliative care alone. A secondary objective was to evaluate factors that affect quality of life in ovarian cancer patients. Materials and Methods: A descriptive study was conducted in patients who had histological confirmed epithelial ovarian cancer and failed to respond to at least one regimen of chemotherapy, coming for treatment at the King Chulalongkorn Memorial Hospital in Bangkok, Thailand over a six-month period from August 2012-March 2013. Each patient was asked to complete the FACT-G and a general personal questionnaire. The median quality of life score was analyzed. The Mann Whitney U Test was used to compare the difference between salvage chemotherapy and palliative care groups, and the Kruskal Wallis was used to evaluate other variables. Results: Thirty-eight ovarian cancer patients were identified who failed to respond to chemotherapy. Of the 38, 30 chose salvage chemotherapy and eight palliative care for further treatment. By histology the carcimnomas were predominantly endometrioid subtype and poorly differentiated. The majority of patients in this study had FIGO stage III, and ECOG status 0-1. The median quality of life score was 76.3 (35.8-94.0), with no significant differences between the groups. Factors associated with the quality of life were the ECOG score and number of chemotherapeutic courses. Conclusions: In the setting of refractory or recurrent epithelial ovarian cancer, patients who receive salvage chemotherapy have comparable quality of life scores with patients treated with palliative care alone, providing a contrast with previous studies.

• Journal of Korean Neurosurgical Society
• /
• v.57 no.1
• /
• pp.42-49
• /
• 2015

Objective : The cervicothoracic junction (CTJ) is a biomechanically and anatomically complex region that has traditionally posed problems for surgical access. In this retrospective study, we describe our clinical experiences of the treatment of metastatic spinal tumors at the CTJ and the results. Methods : From June 2006 to December 2011, 23 patients who underwent surgery for spinal tumors involving the CTJ were enrolled in our study. All of the patients were operated on through the posterior approach, and extent of resection was classified as radical, debulking, and simple neural decompression. Adjuvant radiation therapy (RT) was also considered. Visual analog scale score for pain assessment and Medical Research Council (MRC) grade for motor weakness were used, while pre- and post-operative performance status was evaluated using the Eastern Cooperative Oncology Group (ECOG). Results : Almost all of the patients were operated using palliative surgical methods (91.3%, 21/23). Ten complications following surgery occurred and revision was performed in four patients. Of the 23 patients of this study, 22 showed significant pain relief according to their visual analogue scale scores. Concerning the aspect of neurological and functional recovery, mean MRC grade and ECOG score was significantly improved after surgery (p<0.05). In terms of survival, radiation therapy had a significant role. Median overall survival was 124 days after surgery, and the adjuvant-RT group (median 214 days) had longer survival times than prior-RT (63 days) group. Conclusion : Although surgical procedure in CTJ may be difficult, we expect good clinical results by adopting a palliative posterior surgical method with appropriate preoperative preparation and postoperative treatment.

• The Journal of Internal Korean Medicine
• /
• v.37 no.2
• /
• pp.412-419
• /
• 2016

Objective: Because the number of geriatric cancer patients is on the rise but information on treatments for this population is limited, this study aimed to analyze clinical characteristics and the factors that influence treatment decisions among elderly cancer patients.Method: Data on elderly cancer patients (≥65 years of age) who were admitted to a traditional Korean medicine hospital from March 2014 to February 2016 were collected. We compared the clinical characteristics and overall survival rates of the chemotherapy group and the non-chemotherapy group.Results: Nineteen patients were included in this study. Nine people received chemotherapy, and ten people did not receive chemotherapy due to concerns about quality of life. Age, activities of daily living (ADL) score, and Eastern Cooperative Oncology Group (ECOG) performance status all showed differences between the two groups, although median survival times did not differ significantly between the two. Compared with chemotherapy alone, traditional Korean medicine combined with chemotherapy prolonged median survival times.Conclusion: Old age and low ECOG performance status and ADL scores appear to be influential factors for the decision to undergo chemotherapy. Further studies are needed to confirm that these factors influence decisions about cancer treatment methods among geriatric cancer patients.