• 대한두경부종양학회지
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• 제37권2호
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• pp.33-41
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• 2021

Background/Objectives: Extra-nodal extension (ENE) is one of the strongest prognosticators in oral cancers. Here we tried to evaluate clinicopathological factors associated with the presence of ENE. Materials & Methods: We retrospectively analyzed clinical information of 120 patients who diagnosed with oral cancer and received curative surgery at our hospital from Mar 2012 to Apr 2020. We comparatively analyzed clinicopathological factors associated with the presence of lymph node (LN) metastasis and ENE, respectively. Results: Variable factors of primary tumor characteristics such as lymphovascular invasion, perineural invasion, largest diameter of tumor, depth of invasion and maximum standardized uptake value were significantly associated with the presence of cervical LN metastasis. The largest diameter of tumor was statistically significant also in multivariate analysis for predicting the LN metastasis. Meanwhile, the association between primary tumor characteristics and the presence of ENE were not statistically significant except the primary tumor size. Importantly, factors associated with LN characteristics including the maximum diameter and number of metastatic LNs were significantly associated with ENE. Conclusion: In this study, several factors affecting cervical LN metastasis and ENE in oral cancer patients were identified. The ENE seems to be influenced by the status of the metastatic LNs, such as the number of metastatic LNs, rather than the characteristics of the primary tumor itself.

• 대한종양외과학회지
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• 제14권2호
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• pp.76-82
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• 2018

Purpose: Lgr5 is a well-known stem cell marker in colorectal cancer (CRC). This retrospective study evaluated the expressions of Lgr5 in CRC specimens, and examined whether these expressions were associated with survival outcomes. Methods: We used immunohistochemistry to retrospectively examine expressions of Lgr5 in paraffin-embedded specimens from 337 patients with CRC between January 2009 and December 2013. All clinicopathologic data were collected by retrospective review based on medical records. The correlation between its expression and clinicopathological data as well as clinical outcomes of patients was analyzed. Results: Low expression and high expression of Lgr5 in 337 patients were 175 (51.9%) and 162 (48.1%), respectively. There was no statistically significant difference in the association of Lgr5 expression with clinicopathologic factors (age, tumor location, lymphatic invasion, vascular invasion, perineural invasion, TNM stage, and differentiation). In the survival analysis, the high expression group of Lgr5 showed a better prognosis than the low expression group in disease-free survival (P=0.044). However, overall survival was not significantly different between the two groups (P=0.087). In multivariate analysis, we found that high expression of Lgr5 was independent prognostic factor for tumor relapse (hazard ratio, 0.601; 95% confidence interval, 0.388-0.929; P=0.022). Conclusion: In present study, high expression of Lgr5 is an independent predictor of favorable prognosis in patients with CRC. So, further well designed, prospective, large scale studies are needed to examine the value of Lgr5 as a prognostic biomarker for CRC.

• Journal of Gastric Cancer
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• 제9권3호
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• pp.143-151
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• 2009

목적: 위암은 한국에서 제일 흔한 암으로 저자들은 단일 술자에 의해 위절제술을 시행받은 환자들을 대상으로 임상병리학적 특성 및 5년 생존율과 이에 따른 예후인자를 알아보고자 한다. 대상 및 방법: 1998년 9월부터 2003년 8월까지 만 5년간 위암으로 진단되어 인제대학교 서울백병원 한국위암센터에서 위절제술을 시행한 위암환자 1,435예의 환자를 대상으로 성별 및 연령, 종양의 위치 및 크기, 육안적 분류 및 조직학적 분류, 위벽 침윤도, 림프절 전이, 혈관, 신경초, 림프관 침윤 및 수술 방법 등의 인자들을 후향적으로 조사하였다. 결과: 남녀 비는 2.29 : 1이었고 평균 연령은 56.7세였으며 UICC TNM Stage IA 35.4%, Stage IB 14.1%, Stage II 12.6%, Stage IIIA 12.3%, Stage IIIB 8.3%, Stage IV 17.3%였고 전체 5년 생존율은 69.6%였다. 단변량 분석 결과 연령, 종양의 위치, 종양의 크기, Borrmann type, 분화도, Lauren 분류, 위벽 침윤도, 림프절 전이, UICC TNM 변기, 신경초 침윤, 혈관 침윤, 림프관 침윤, 수술방법에 따라 생존율에 유의한 차이가 있었다. 다변량 분석결과 위벽 침윤도, 림프절 전이만0| 독립적인 예후인자였다. 결론: 다양한 임상병리학적 특성들이 위암환자의 예후에 영향을 주지만 이들 인자들 중 결국 위벽 침윤도와 림프절 전이, 즉 병기가 예후에 가장 중요함을 알 수 있었다. 따라서 위암환자 생존을 향상을 위해서 조기 검진을 통한 위암의 조기 발견과 예후 영향인자에 대한 다각적인 치료 방법이 연구, 개발되어야 하겠다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권2호
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• pp.83-90
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• 2019

Objectives: This study evaluated the predictive factors for survival of patients with oral squamous cell carcinoma (OSCC) and investigated the overall and disease-specific survival (DSS) outcomes. Materials and Methods: A total of 67 consecutive patients who underwent surgery for OSCC from January 2006 to November 2014 were included in this study. Patients were classified according to age, sex, pTNM stages, primary sites, smoking and alcohol drinking habits, depth of invasion, perineural and lymphovascular invasion, cell differentiation and postoperative radiotherapy. Kaplan-Meier methods were used to estimate the survival categorized by patient groups. Cox regression methods were used to investigate the main independent predictors of survival. Results: Nineteen patients died of OSCC during follow-up periods. Another five patients died of other diseases including lung adenocarcinoma (n=1), cerebral infarction (n=1), general weakness (n=2), and pneumonia (n=1). The tongue (n=16) was the most common site for primary origin, followed by buccal mucosa (n=15), mandibular gingiva (n=15), maxillary gingiva (n=9), floor of mouth (n=9), retromolar trigone (n=2), and palate (n=1). Eleven patients had pTNM stage I disease, followed by stage II (n=22) and stage IV (n=34). No patients had pTNM stage III disease in this study. The overall survival of all patients was 64.2% and the DSS was 71.6%. DSS of patients with stage I and II disease was 100%. Stepwise Cox regression showed the two predictors for DSS were pTNM stage (P<0.0001, odds ratio=19.633) and presence of metastatic lymph nodes (P=0.0004, odds ratio=0.1039). Conclusion: OSCC has been associated with poor prognosis; however, there were improved survival outcomes compared with past studies. Advanced-stage disease and presence of metastatic lymph nodes were associated with poorer survival compared with early-stage OSCC and absence of neck node metastasis. Stage I and II OSCC were associated with excellent survival results in this study.

• Journal of Gastric Cancer
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• 제10권4호
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• pp.168-174
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• 2010

Purpose: Infection with Helicobacter pylori is an important risk factor for gastric cancer in humans. We compared the clinicopathologic features of gastric cancer patients based on H. pylori infection. Materials and Methods: We prospectively studied 155 patients who had gastric cancer and underwent gastrectomies in 1 hospital in Korea. We examined H. pylori infections using the rapid urease test (RUT) with gastrectomy specimens and collected clinical and pathologic data. Results: The number of H. pylori infections based on the RUT was 137 (88%). The H. pylori-negative group was significantly associated with AGC and tumor histology. H. pylori infection was significantly correlated with type I/IIa in EGC and type III/IV/V in AGC. AGC was significantly correlated with larger tumor size, lymphatic invasion, perineural invasion, and H. pylori infection based on univariate and multivariate analyses. Conclusions: We report the prevalence of H. pylori based on the RUT in gastric cancer patients. H. pylori infection influences the tumor histology, progression, and growth type of gastric cancer.

• Journal of Gastric Cancer
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• 제8권1호
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• pp.9-19
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• 2008

목적: 15년 동안 단일 병원에서 위절제술을 시행한 위암 환자를 대상으로 임상병리학적 특성, 생존율과 예후인자를 분석하여 보고하고자 하였다. 대상 및 방법: 1991년 1월부터 2005년 12월까지 15년 동안 원자력병원 외과에서 위암으로 위절제술을 시행받은 6,918명의 환자를 대상으로 의무기록을 후향적으로 조사하였다. 결과: 전체 위암 환자 6,918 예를 대상으로 환자들의 성별, 연령, 종양의 위치, 종양의 육안적 분류, 종양의 병리조직 학적 분류 (WHO 분류), Lauren 분류, 위벽 침윤도, 림프절 전이, 원격 전이, 수술 방법, UICC TNM 병기, 술 후 합병증, 술 후 보조적 항암화학요법, 림프관 침윤, 혈관 침윤, 신경초 침윤 등을 비교하였다. 전체 5년 생존율은 66.8%였다. 단변량 분석 결과 연령, 종양의 위치, 종양의 육안적 분류, WHO 분류에 따른 종양의 병리조직학적 분류, Lauren 분류, 위벽 침윤도, 림프절 전이, 원격 전이, 수술 방법, UICC TNM 병기, 술 후 합병증, 술 후 보조적 항암화학요법, 림프관 침윤, 혈관 침윤 및 신경초 침윤에서 생존율에 유의한 차이가 있었다. 다변량 분석 결과 연령, Borrmann type 4, WHO 분류에 따른 종양의 병리조직학적 분류, 위벽 침윤도, 림프절 전이, 원격 전이, 수술 방법, UlCC TNM 병기, 술 후 합병증, 술 후 보조적 항암화학요법 및 림프관 침윤 이 독립적인 예후인자였다. 결론: 위암 환자의 예후는 수술 당시의 병기에 의해 결정되므로 위암의 조기 진단이 중요하다. 적극적인 수술과 보조적 항암화학요법을 포함한 보다 효과적인 다병합요법이 개발되어야 전체 위암 환자의 생존율을 향상시킬 수 있을 것이다.

• Journal of Gastric Cancer
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• 제16권1호
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• pp.21-27
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• 2016

Purpose: Transducer-like enhancer of split 1 (TLE1) is a member of the Groucho/TLE family of transcriptional co-repressors that regulate the transcriptional activity of numerous genes. TLE1 is involved in the tumorigenesis of various tumors. We investigated the prognostic significance of TLE1 expression and its association with clinicopathological parameters in gastric cancer (GC) patients. Materials and Methods: Immunohistochemical analysis of six tissue microarrays was performed to examine TLE1 expression using 291 surgically resected GC specimens from the Soonchunhyang University Cheonan Hospital between July 2006 and December 2009. Results: In the non-neoplastic gastric mucosa, TLE1 expression was negative. In GC, 121 patients (41.6%) were positive for TLE1. The expression of TLE1 was significantly associated with male gender (P=0.021), less frequent lymphatic (P=0.017) or perineural invasion (P=0.029), intestinal type according to the Lauren classification (P=0.024), good histologic grade (P<0.001), early pathologic T-stage (P=0.012), and early American Joint Committee on Cancer stage (P=0.022). In the Kaplan-Meier analysis, the TLE1 expression was significantly associated with longer disease-free (P=0.022) and overall (P=0.001) survival rates. Conclusions: We suggested that TLE1 expression is a good prognostic indicator in GCs.