• Title/Summary/Keyword: Peritoneal metastasis

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Clinical Significance of Measuring Levels of CEA, CA19-9 in Peritoneal Washing Fluid in Patients with Gastric Cancer (위암 환자에서 복강 세척액의 CEA, CA19-9 측정의 임상적 의의)

  • Shim, Gyu-Beom;Park, Ji-Hun;Koo, Tea-Young;Min, Hyun-Sik
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.125-131
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    • 2006
  • Purpose: Free cancer cells exfoliated from cancer-invaded serosa contribute to peritoneal dissemination, the most frequent pattern of recurrence in patients with gastric cancer. To detect free cancer cells, CEA and CA19-9 were introduced as the markers of gastric cancer, and many methods, such as cytology, immunoassay, and reverse transcription polymerase chain reaction (RT-PCR), exist for detecting them. The aim of this study is to define the clinical significance of using immunoassay to measure the levels of CEA and CA19-9 in the peritoneal washings in patients with gastric cancer. Materials and Methods: The peritoneal washing fluids were obtained from 130 patients with gastric cancer who received a curative gastrectomy, palliative gastrectomy or open and closure. The pCEA and pCA19-9 levels were measured by using immunoassay and cytology. The results were compared with the clinicopathological data. Results: The pCEA and pCA19-9 levels were correlated with tumor invasion, lymph-node metastasis, and stage (P<0.05). Conclusion: A correlation was found between elevated pCEA and pCA19-9 levels measured by immunoassay and the TNM stage. Therefore, a combined pCEA and pCA19-9 assay could be a sensitive detector of peritoneal dissemination, as well as a predictor of postoperative prognosis. pCEA and pCA19-9 may also determine the adjuvant management strategy.

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Advantages of ypTNM Staging in Post-surgical Prognosis for Initially Unresectable or Stage IV Gastric Cancers

  • Jeong, Gyu-Seong;Lee, In-Seob;Park, Young-Soo;Kim, Beom-Su;Yoo, Moon-Won;Yook, Jeong-Hwan;Kim, Byung-Sik
    • Journal of Gastric Cancer
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    • v.20 no.3
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    • pp.233-244
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    • 2020
  • Purpose: For unresectable or initially metastatic gastric cancer, conversion surgery (CVS), after systemic chemotherapy, has received attention as a treatment strategy. This study evaluated the prognostic value of ypTNM stage and the oncologic outcomes in patients receiving CVS. Materials and Methods: A retrospective review of clinicopathologic findings and oncologic outcomes of 116 patients who underwent CVS with curative intent, after combination chemotherapy, between January 2000 and December 2015, has been reported here. Results: Twenty-six patients (22.4%) underwent combined resection of another organ and 12 patients received para-aortic lymphadenectomy (10.3%). Pathologic complete remission (CR) was confirmed in 11 cases (9.5%). The median overall survival (OS) and disease-free survival (DFS) times were 35.0 and 21.3 months, respectively. In multivariate analysis, ypTNM stage was the sole independent prognostic factor for DFS (P=0.042). Tumors invading an adjacent organ or involving distant lymph nodes showed better survival than those with peritoneal seeding or solid organ metastasis (P=0.084). Kaplan-Meier curves showed that the 3-year OS rate of patients with pathologic CR and those with CR of the primary tumor but residual node metastasis was 81.8% and 80.0%, respectively. OS was 65.8% for stage 1 patients, 49.8% for those at stage 2, and 36.3% for those at stage 3. Conclusions: The ypTNM staging is a significant prognostic factor in patients who underwent CVS for localized unresectable or stage IV gastric cancers. Patients with locally advanced but unresectable lesions or with tumors with distant nodal metastasis may be good candidates for CVS.

Experimental Studies on Antimetastatic and Immunomodulating Effects of Ulmus davidiana (유근피(楡根皮)의 선천 면역 활성화에 의한 암 전이 억제 효과)

  • Kim, Heung-Soo;Cho, Jung-Honn;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub
    • The Journal of Korean Obstetrics and Gynecology
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    • v.23 no.1
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    • pp.1-11
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    • 2010
  • Purpose: This study was designed to investigate the antimetastatic and immunomodulating effects of extracts of Ulmus davidiana extracts(U. D. Ex.). Methods: Antimetastatic experiments were conducted in vitro and in vivo by using colon 26-M3.1 carcinoma, L5178Y-R lymphoma cell and Hela cell. To observe the immunomodulating effects of U. D. Ex., we measured IL-6, IL-10, IL-12 and TNF-$\alpha$ from peritoneal macrophages. And we evaluated the activation of NK cell by using anti-asialo-GM1 serum. Results: We found that the administration of U. D. Ex. significantly inhibited tumor metastasis in vivo. In vitro cytotoxicity analysis, cell growth are closer to 100% in case of Colon 26-M3.1 carcinoma, L5178Y-R lymphoma cell and Hela cell at low concentration. In case of macrophage, cell proliferation is closer to 100% less than $250{\mu}g/ml$ of U. D. Ex.. The level of cytokine such as IL-6, IL-10, IL-12 which stimulates U. D. Ex. was increased in dose-dependent manner compared to the control group. In case of TNF-$\alpha$, the level was increased at concentration of $1,000{\mu}g/ml$. The depletion of NK cells by anti-asialo GM1 serum partly abolished the inhibitory effect of U. D. Ex. on tumor metastasis. Conclusion: Ulmus davidiana appears to have considerable activity on the anti-metastasis by activation the immune system.

The Enhanced Effect of Oplopanax elatus Nakai on the Immune System and Antitumor Activity (땃두릅(Oplopanax elatus Nakai) 추출물의 면역자극 활성 및 항암 증진 효과)

  • Hur, Jin Woo;Cho, Eun Hee;Lee, Bo Kyung;Lee, Uiyoung;Yoon, Taek Joon
    • The Korean Journal of Food And Nutrition
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    • v.26 no.3
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    • pp.375-382
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    • 2013
  • The present study is designed to explore an anti-tumor activity on crude extracts of Oplopanax elatus. Water extractions of Oplopanax elatus were performed at $100^{\circ}C$(OeE-100). OeE-100 doses up to $62.5{\mu}g/m{\ell}$ had no cytotoxicity on the tumor cell lines in vitro. In experimental lung metastasis of colon26-M3.1 carcinoma or B16-BL6 melanoma, the prophylactic intravenous ($4{\sim}100{\mu}g/mouse$) or oral (2 mg/mouse) administration of OeE-100 significantly inhibited tumor metastasis as compared with tumor controls. Peritoneal macrophages stimulated with OeE-100 produced various cytokines such as TNF-${\alpha}$, IL-6 and IL-12. In an analysis of NK-cell activities, i.v. administration of OeE-100 ($10{\sim}100{\mu}g/mouse$) significantly augmented the cytotoxicity to YAC-1 tumor cells. Vaccination of mice with boiling-treated tumor cells (BT-vaccine) in combination with OeE-100 ($100{\mu}g/mouse$) showed higher inhibitions in tumor metastasis when compared with the mice of BT-vaccine treatment. In addition, the splenocytes from OeE-100 admixed BT-vaccine immunized mice secreted a higher concentration of Th1 type cytokine such as IFN-${\gamma}$. These results suggested that the OeE-100 stimulated immune system and was a good candidate adjuvant of anti-tumor immune responses.

Risk Factors of Lymph Node Metastases with Endometrial Carcinoma

  • Cetinkaya, Kadir;Atalay, Funda;Bacinoglu, Ahmet
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6353-6356
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    • 2014
  • Background: The purpose of this study was to investigate and evaluate risk factors for lymph node metastases (LNM) in cases of endometrial cancer (EC). Materials and Methods: A retrospective single institution analysis of patients surgically staged for EC at Ankara Oncology Education and Research Hospital from 1996 to 2010 was performed. Roles of prognostic factors, such as age, histological type, grade, depth of myometrial invasion, cervical involvement, peritoneal cytology, and tumor size, in the prediction of LNM were evaluated. Fisher's exact test and logistic regression analysis were used to assess the effects of various factors on LNM. Results: LNM was observed in 22 out of 247 patients (8.9%) and was significantly more common in the presence of tumors of higher grade, deep myometrial invasion (DMI), cervical involvement, size >2cm, and with positive peritoneal cytology. Logistic regression analysis revealed that DMI remained the only independent risk factor for LNM. NPV, PPV, sensitivity, and specificity for satisfying LNM risk were 98.0, 19.5, 86.3, and 65.3%, respectively for DMI. Conclusions: The incidence of LNM is influenced independently by DMI. If data support a conclusion of DMI, LND should be seriously considered.

Colon Cancer with Appendiceal Perforation in a 13-year-old Boy (충수염으로 오인된 소아의 대장암)

  • Choi, Myung-Min;Lee, Un-Gi;Jeon, In-Sang;Kim, Hyun-Young
    • Advances in pediatric surgery
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    • v.14 no.2
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    • pp.189-195
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    • 2008
  • Colorectal cancer is extremely rare in children. Unlike adult colorectal cancer, the overall prognosis of colorectal cancer in children is poor. Delayed diagnosis, advanced stages of the disease at presentation, and mucinous type of histology are the major determinants of poor outcome in childhood. A 13-year-old boy with abdominal pain visited our hospital. Physical examination andabdominal ultrasonography identified acute appendicitis with perforation. He underwent appendectomy and then the pathologic findings revealed mucinous adenocarcinoma. The cancer was located at the transverse colon and had metastases on peritoneal wall at $2^{nd}$ laparotomy. Extended right hemicolectomy was performed. He underwent palliative chemotherapy. After 4 months later, hepatic metastasis and aggravated peritoneal seedings developed. He died of renal failure and pneumonia 13 months after operation. We need to have a high index of suspicion for the possibility of a malignant colorectal tumor in any childhood case with nonspecific signs and symptoms.

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[ $^{99m}Tc-DISIDA$ ] Scintigraphic Diagnosis Of Extrahepatic Hepatocellular Carcinoma Metastasis : Comparison with Primary Hepatocellular Carcinoma ($^{99m}Tc-DISIDA$ 신티그래피를 이용한 간세포암 간외 전이의 진단 : 원발 간세포암과의 비교)

  • Chung, Soo-Kyo;Kim, Sung-Hoon;Baik, Joon-Hyun;Kim, Young-Joo;Chun, Kyung-Ah;Park, Seog-Hee;Bahk, Yong-Whee;Shin, Kyung-Sub
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.4
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    • pp.484-491
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    • 1995
  • It is well known that hepatobiliary agent are taken up by metastatic hepatocellular carcinoma(HCC) as well as primary HCC. But the reported cases of the extrahepatic metastasis of HCC diagnosed by hepatobiliary scintigraphy are for the most part hematogenous ones. The relation of the uptake pattern of hepatobiliary agent in the primary and metastatic HCC is also still remains unknown. So we undertook this study to evaluate the relation of the hepatobiliary scintigraphic patterns of primary and metastatic HCC with different metastatic routes. Nine patients with primary HCC and twelve cases of metastatic HCC including four lung metastases, one bone metastasis, one right atrial metastasis, one peritoneal wall metastasis, and five lymph node metastases were studied with $^{99m}Tc-DISIDA$ scintigraphy. The images were taken on 10, 30 minutes, 1, 2, 4-6 hours. The overall detection rates of hematogenous metastases(lung and bone) is 60%(3 of 5), direct metastasis(right atrium and peritoneal wall), 100%(2 of 2) and lymphatic metastases, 0%(0 of 5). In four of five metastatic cases demonstrated with hepatobiliary scintigraphy, biliary agent is also taken up by primary HCC lesions. And the appearing time of the radioactivity in the direct metastatic HCC lesioin is same as that of primary HCC and in the cases of hematogenous metastasis, earlier than that of primary HCC. Hepatobiliary scintigraphy is more useful in the diagnosis of the metastatic HCC than primary HCC, in the cases of hematogenous and direct metastasis.

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Long Term Survivors with Metastatic Pancreatic Cancer Treated with Gemcitabine Alone or Plus Cisplatin: a Retrospective Analysis of an Anatolian Society of Medical Oncology Multicenter Study

  • Inal, Ali;Ciltas, Aydin;Yildiz, Ramazan;Berk, Veli;Kos, F. Tugba;Dane, Faysal;Unek, Ilkay Tugba;Colak, Dilsen;Ozdemir, Nuriye Yildirim;Buyukberber, Suleyman;Gumus, Mahmut;Ozkan, Metin;Isikdogan, Abdurrahman
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1841-1844
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    • 2012
  • Background: The majority of patients with pancreatic cancer present with advanced disease. Systemic chemotherapy has limited impact on overall survival (OS) so that eligible patients should be selected carefully. The aim of this study was to analyze prognostic factors for survival in Turkish advanced pancreatic cancer patients who survived more than one year from the diagnosis of recurrent and/or metastatic disease and receiving gemcitabine (Gem) alone or gemcitabine plus cisplatin (GemCis). Methods: This retrospective evaluation was performed for patients who survived more than one year from the diagnosis of recurrent and/or metastatic disease and who received gemcitabine between December 2005 and August 2011. Twenty-seven potential prognostic variables were chosen for univariate and multivariate analyses to identify prognostic factors associated with survival. Results: Among the 27 variables in univariate analysis, three were identified to have prognostic significance: sex (p = 0.04), peritoneal dissemination (p =0.02) and serum creatinine level (p=0.05). Multivariate analysis by Cox proportional hazard model showed only peritoneal dissemination to be an independent prognostic factor for survival. Conclusion: In conclusion, peritoneal metastasis was identified as an important prognostic factor in metastatic pancreatic cancer patients who survived more than one year from the diagnosis of recurrent and/or metastatic disease and receiving Gem or GemCis. The findings should facilitate pretreatment prediction of survival and can be used for selecting patients for treatment.

Clinical Experience of Small-cell Carcinomas of the Stomach (위에 발생한 소세포암의 임상 경험)

  • Kim, Hyoung-Ju;Park, Moon-Hyang;Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.5 no.4 s.20
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    • pp.252-259
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    • 2005
  • To clarify the clinicopathologic features of small-cell carcinomas (SCC) of the stomach, we reviewed three cases of surgically treated SCC. The first case was a pure SCC, with severe pancreatic invasion and peritoneal seeding. A gastro-jejunostomy was performed. Postoperative chemotherapy was performed with CDDP and VP-16 (8 cycles) but showed disease progression (PD); a consecutive chemotherapy with CDDP and irinotencan (2 cycles) also showed PD. A third line with CDDP, VP16, ifosfamide, and mesna was followed by a 4th line (CDDP and Taxol). The male patient died with liver metastasis and peritoneal seeding 14 months after the operation. The second case was a SCC mixed with a poorly differentiated adenocarcinoma. Profound lymphadenopathy and liver metastasis were found. Two cycles of preoperative chemotherapy with TS-1 and CDDP were performed, which showed nearly complete remission for lymphadenopathy and partial response for the primary tumor site and liver metastatic lesion. A total gastrectomy and extended lymphadenectomy was performed. There were no viable cancer cells in 35 retrieved lymph nodes. Postoperative chemotherapy using the same regimen was performed for 4 cycles. Enlarged liver metastasis was found at the follow-up CT scan, so a posterior segmentectomy of liver was performed. After liver surgery, the chemotherapy regimen was changed to irinotecan and cisplatin. This male patient has been in good health for the f4 months since gastric surgery. The third case was a pure SCC, and a subtotal gastrectomy was performed curatively. That male patient received 5 cycles of TS-1 and is still in good health 14 months after operation.

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Immunomodulatory and anti-metastatic activities of a crude polysaccharide isolated from Korean apple vinegar (한국산 사과식초에서 분리한 다당의 면역 및 항전이 활성)

  • Kim, Han Wool;Shin, Kwang-Soon
    • Korean Journal of Food Science and Technology
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    • v.51 no.2
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    • pp.152-159
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    • 2019
  • To characterize new physiologically active components in Korean apple vinegar, a crude polysaccharide (KAV-0) was prepared by precipitation with 80% (v/v) ethanol. KAV-0 mainly comprises 38.2% mannose, 19.1% galactose and 14.3% glucose. In an in vitro cytotoxicity analysis, KAV-0 promoted the proliferation of peritoneal macrophages and RAW 264.7 cells in a dose-dependent manner, and showed no cytotoxicity in B16-BL6 melanoma cells. Murine peritoneal macrophages and RAW 264.7 cells stimulated by KAV-0 produced various cytokines such as interleukin (IL)-6, IL-12, and tumor necrosis factor $(TNF)-{\alpha}$, and nitric oxide (NO). Intravenous (i.v.) administration of KAV-0 significantly augmented NK cell cytotoxicity against Yac-1 tumor cells. In experimental lung metastasis caused by B16-BL6 melanomas, prophylactic i.v. administration of KAV-0 at a dosage of $1,000{\mu}g/mouse$ inhibited lung metastasis by 53.0%. These results suggest that the crude polysaccharide (KAV-0) isolated from Korean apple vinegar has a considerably high anti-metastatic activity and immunomodulatory activities beneficial to human health.