• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3767-3772
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• 2012

Objective: We estimated the total medical costs incurred during the 5 years following a cancer diagnosis and annual medical use status for the six most prevalent cancers in Korea. Methods: From January 1 to December 31, 2006, new patients registered with the six most prevalent cancers (stomach, liver, lung, breast, colon, and thyroid) were randomly selected from the Korea Central Cancer Registry, with 30% of patients being drawn from each cancer group. For the selected patients, cost data were generated using National Health Insurance claims data from the time of cancer diagnosis in 2006 to December 31, 2010. The total number of patients selected was 28,509. Five-year total medical costs by tumor site and Surveillance, Epidemiology, and End Results (SEER) stage at the time of diagnosis, and annual total medical costs from diagnosis, were estimated. All costs were calculated as per-patient net costs. Results: Mean 5-year net costs per patient varied widely, from $5,647 for thyroid cancer to $20,217 for lung cancer. Advanced stage at diagnosis was associated with a 1.8-2.5-fold higher total cost, and the total medical cost was highest during the first year following diagnosis and decreased by the third or fourth year. Conclusions: The costs of cancer care were substantial and varied by tumor site, annual phase, and stage at diagnosis. This indicates the need for increased prevention, earlier diagnosis, and new therapies that may assist in reducing medical costs.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1495-1504
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• 2012

Objective: Improvements in diet can decrease the cancer rates. The aim of the present study was to determine the relationships between self-perception of diet quality and personality, impulsiveness, stress, coping strategy, sense of coherence, self-efficacy, and social support. Methods: This cross-sectional study was conducted using a multiple-stratified random sampling method based on the Korea Census of 2007. In October 2009, investigators conducted 15-minute face-to-face interviews with 1,530 South Korean volunteers who ranged from 30 to 69 years of age without a history of cancer. Results: Respondents were more likely to perceive that they consumed a healthy diet if they were older than 50 years, lived with a partner, had a monthly family income greater than $4,000 USD, had a low perceived risk of cancer, consumed less alcohol, exercised regularly, had a less agreeable or conscientious personality, had low stress levels, had a high sense of coherence or self-efficacy, and had ample social support. Conclusion: Psychosocial factors, such as personality, stress, sense of coherence, self-efficacy, and social support, are associated with the self-perception of diet quality. Analysis of the factors that contribute to a perceived healthy diet could assist with the design of educational campaigns.

• Radiation Oncology Journal
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• v.34 no.3
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• pp.193-201
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• 2016

Purpose: To assess the clinical outcomes of radiotherapy (RT) using two-dimensional (2D) and three-dimensional conformal RT (3D-CRT) for patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma to evaluate the effectiveness of involved field RT with moderate-dose and to evaluate the benefit of 3D-CRT comparing with 2D-RT. Materials and Methods: Between July 2003 and March 2015, 33 patients with stage IE and IIE gastric MALT lymphoma received RT were analyzed. Of 33 patients, 17 patients (51.5%) were Helicobacter pylori (HP) negative and 16 patients (48.5%) were HP positive but refractory to HP eradication (HPE). The 2D-RT (n = 14) and 3D-CRT (n = 19) were performed and total dose was 30.6 Gy/17 fractions. Of 11 patients who RT planning data were available, dose-volumetric parameters between 2D-RT and 3D-CRT plans was compared. Results: All patients reached complete remission (CR) eventually and median time to CR was 3 months (range, 1 to 15 months). No local relapse occurred and one patient died with second primary malignancy. Tumor response, survival, and toxicity were not significantly different between 2D-RT and 3D-CRT (p > 0.05, each). In analysis for dose-volumetric parameters, $D_{max}$ and CI for PTV were significantly lower in 3D-CRT plans than 2D-RT plans (p < 0.05, each) and $D_{mean}$ and V15 for right kidney and $D_{mean}$ for left kidney were significantly lower in 3D-CRT than 2D-RT (p < 0.05, each). Conclusion: Our data suggested that involved field RT with moderate-dose for gastric MALT lymphoma could be promising and 3D-CRT could be considered to improve the target coverage and reduce radiation dose to the both kidneys.

• Journal of Preventive Medicine and Public Health
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• v.37 no.3
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• pp.246-252
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• 2004

Objectives : Cancer is the leading cause of death in Korea. Therefore, a National Cancer Screening Program (NCSP) was launched in 1999. This study planned to evaluate the performance of the NCSP to identifying the influencing factors in relation to characteristic public health centers. Methods : To analyze the performance, the database of the NCSP records for 2002 was used. The performance index was measured by the goal achievement rate, which was defined by the real number of screenees against the expected number of screenees. Also, a survey was conducted by a self-administered questionnaire to identify the factors associated with the goal achievement rate. The questionnaire was divided into two sections. In the first section, the individual characteristics of the program coordinator in each public health center were measured, and second section was comprised of questions about the organizational characteristics associated with the NCSP. A total of 121 subjects from 241 public health centers completed the questionnaire. Results : Of the 121 public health centers (50.2% response rate), the average goal achievement rate was 72.8%. The results of the regression model showed that public health centers located in rural area (parameter estimates=38.2) and had great support from a head of center or province (parameter estimates=0.20) and tended to have higher goal achievement rates. However, the characteristics of the program coordinator, especially their knowledge of and attitude toward cancer screening, were not significantly related to the goal achievement rates. Conclusions : It appears that the most important associated factors to the goal achievement rate in the NSCP were the location of the public health center and the support for the NCSP from the head of the center or province.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.32.1-32.6
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• 2016

Background: This study aimed to analyze and describe the morbidity and mortality associated with tracheostomy in patients with oral cancer and to identify the risk factors associated with tracheostomy complications. Methods: We performed a retrospective chart review of patients who underwent tracheostomy during a major oral cancer resection between March 2001 and January 2016 at the National Cancer Center, Korea. Overall, we included 51 patients who underwent tracheostomy after oral cancer surgery. We assessed the morbidity and mortality of tracheostomy and determined the risks associated with tracheostomy complications. Results: Twenty-two tracheostomy-related complications occurred in 51 patients. The morbidity and mortality rates were 35.2 % (n = 18) and 0 % (n = 0), respectively. Tracheostomy-related complications were tracheitis (n = 4), obstructed tracheostomy (n = 9), displaced tracheostomy (n = 5), air leakage (n = 1), stomal dehiscence (n = 1), and decannulation failure (n = 2). Most complications (19/22) occurred during the early postoperative period. Considering the risk factors for tracheostomy complications, the type of tube used was associated with the occurrence of tracheitis (p < 0.05). Additionally, body mass index and smoking status were associated with tube displacement (p < 0.05). However, no risk factors were significantly associated with obstructed tracheostomy. Conclusions: Patients with risk factors for tracheostomy complications should be carefully observed during the early postoperative period by well-trained medical staff.

• Journal of Gastric Cancer
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• v.23 no.1
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• pp.146-158
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• 2023

Endoscopic resection (ER) is widely performed for early gastric cancer (EGC) with a negligible risk of lymph node metastasis (LNM) in Eastern Asian countries. In particular, endoscopic submucosal dissection (ESD) leads to a high en bloc resection rate, enabling accurate pathological evaluation. As undifferentiated EGC (UD-EGC) is known to result in a higher incidence of LNM and infiltrative growth than differentiated EGC (D-EGC), the indications for ER are limited compared with those for D-EGC. Previously, clinical staging as intramucosal UD-EGC ≤2 cm, without ulceration, was presented as 'weakly recommended' or 'expanded indications' for ER in the guidelines of the United States, Europe, Korea, and Japan. Based on promising long-term outcomes from a prospective multicenter study by the Japan Clinical Oncology Group (JCOG) 1009/1010, the status of this indication has expanded and is now considered 'absolute indications' in the latest Japanese guidelines published in 2021. In this study, which comprised 275 patients with UD-EGC (cT1a, ≤2 cm, without ulceration) treated with ESD, the 5-year overall survival (OS) was 99.3% (95% confidence interval, 97.1%-99.8%), which was higher than the threshold 5-year OS (89.9%). Currently, the levels of evidence grades and recommendations for ER of UD-EGC differ among Japan, Korea, and Western countries. Therefore, a further discussion is warranted to generalize the indications for ER of UD-EGC in countries besides Japan.

• Journal of Gastric Cancer
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• v.15 no.4
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• pp.262-269
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• 2015

Purpose: Intraabdominal abscess is one of the most common reasons for re-hospitalization after gastrectomy. This study aimed to develop a model for estimating the probability of intraabdominal abscesses that can be used during the postoperative period. Materials and Methods: We retrospectively reviewed the clinicopathological data of 1,564 patients who underwent gastrectomy for gastric cancer between 2010 and 2012. Twenty-six related markers were analyzed, and multivariate logistic regression analysis was used to develop the probability estimation model for intraabdominal abscess. Internal validation using a bootstrap approach was employed to correct for bias, and the model was then validated using an independent dataset comprising of patients who underwent gastrectomy between January 2008 and March 2010. Discrimination and calibration abilities were checked in both datasets. Results: The incidence of intraabdominal abscess in the development set was 7.80% (122/1,564). The surgical approach, operating time, pathologic N classification, body temperature, white blood cell count, C-reactive protein level, glucose level, and change in the hemoglobin level were significant predictors of intraabdominal abscess in the multivariate analysis. The probability estimation model that was developed on the basis of these results showed good discrimination and calibration abilities (concordance index=0.828, Hosmer-Lemeshow chi-statistic P=0.274). Finally, we combined both datasets to produce a nomogram that estimates the probability of intraabdominal abscess. Conclusions: This nomogram can be useful for identifying patients at a high risk of intraabdominal abscess. Patients at a high risk may benefit from further evaluation or treatment before discharge.

• 대한위암학회:학술대회논문집
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• 2003.04a
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• pp.20-20
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• 2003

• 대한예방의학회:학술대회논문집
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• 2005.10a
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• pp.484-484
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• 2005

• Journal of Gastric Cancer
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• v.18 no.1
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• pp.30-36
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• 2018

Purpose: We investigated complications after laparoscopic sentinel basin dissection (SBD) for patients with gastric cancer who were enrolled in a quality control study, prior to the phase III trial of sentinel lymph node navigation surgery (SNNS). Materials and Methods: We analyzed prospective data from a Korean multicenter prerequisite quality control trial of laparoscopic SBD for gastric cancer and assessed procedure-related and surgical complications. All complications were classified according to the Clavien-Dindo Classification (CDC) system and were compared with the results of the previously published SNNS trial. Results: Among the 108 eligible patients who were enrolled in the quality control trial, 8 (7.4%) experienced complications during the early postoperative period. One patient with gastric resection-related duodenal stump leakage recovered after percutaneous drainage (grade IIIa in CDC). The other postoperative complications were mild and patients recovered with supportive care. No complications were directly related to the laparoscopic SBD procedure or tracer usage, and there were no mortalities. The laparoscopic SBD complication rates and patterns that were observed in this study were comparable to those of a previously reported trial. Conclusions: The results of our prospective, multicenter quality control trial demonstrate that laparoscopic SBD is a safe procedure during SNNS for gastric cancer.