• Title/Summary/Keyword: TNM Stage

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A Case of Intermediate Grade Bronchial Mucoepidermoid Carcinoma and Review in Korean Cases (중간등급의 기관지 점액표피양 암종 1예와 국내 보고에 대한 고찰)

  • Cha, Sung Chul;Kim, Si Woo;Cho, Yoo Jin;Park, Sung Kyoon;Park, Hyun Keun;Kim, Jong Sang;Kwak, Jae Wook;Yoo, Moon Bin;Cho, Hye Jae;Lee, Jae Jin
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.1
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    • pp.41-48
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    • 2008
  • Bronchial mucoepidermoid carcinoma is uncommon, representing 0.2% of all lung tumors. The disease usually presents with symptoms of airway obstruction and recurrent pneumonia. It is commonly classified into two grades in Korea, low and high. We report a case of a bronchial mucoepidermoid carcinoma in a 40-year-old woman who complained of symptoms of an upper respiratory infection. The histological grade after a bronchoscopic biopsy was intermediate. A left upper lobectomy was performed as treatment. The TNM stage of this case was IA (T1N0M0). In addition, 25 cases of bronchial mucoepidermoid carcinoma from 1984 in Korea are also reviewed from the viewpoint of the relationship between the histological grade, TNM stage and clinical course of the tumor.

Evaluation of the 7th AJCC TNM Staging System in Point of Lymph Node Classification

  • Kim, Sung-Hoo;Ha, Tae-Kyung;Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.11 no.2
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    • pp.94-100
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    • 2011
  • Purpose: The 7th AJCC tumor node metastasis (TNM) staging system modified the classification of the lymph node metastasis widely compared to the 6th edition. To evaluate the prognostic predictability of the new TNM staging system, we analyzed the survival rate of the gastric cancer patients assessed by the 7th staging system. Materials and Methods: Among 2,083 patients who underwent resection for gastric cancer at the department of surgery, Hanyang Medical Center from July 1992 to December 2009, This study retrospectively reviewed 5-year survival rate (5YSR) of 624 patients (TanyN3M0: 464 patients, TanyNanyM1: 160 patients) focusing on the number of metastatic lymph node and distant metastasis. We evaluated the applicability of the new staging system. Results: There were no significant differences in 5YSR between stage IIIC with more than 29 metastatic lymph nodes and stage IV (P=0.053). No significant differences were observed between stage IIIB with more than 28 metastatic lymph nodes and stage IV (P=0.093). Distinct survival differences were present between patients who were categorized as TanyN3M0 with 7 to 32 metastatic lymph nodes and stage IV. But patients with more than 33 metastatic lymph nodes did not show any significant differences compared to stage IV (P=0.055). Among patients with TanyN3M0, statistical significances were seen between patients with 7 to 30 metastatic lymph nodes and those with more than 31 metastatic lymph nodes. Conclusions: In the new staging system, modifications of N classification is mandatory to improve prognostic prediction. Further study involving a greater number of cases is required to demonstrate the most appropriate cutoffs for N classification.

The Prognostic Significance of Tumor Angiogenesis and Expression of Vascular Endothelial Growth Factor in Papillary Carcinomas of the Thyroid Gland (갑상선 유두상 암종에서 종양혈관형성 및 혈관내피성장인자 발현의 예후인자적 의의)

  • Kang Hun-Dae;Kim Seong-Bae;Kim Tae-Hyun;Oh Sang-Hoon;Yoon Hye-Kyong;Kim Sang-Hyo
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.2
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    • pp.135-142
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    • 2004
  • Objectives: The purpose of this study was to evaluate for prognostic significance of VEGF expression and tumor angiogenesis in papillary carcinomas of the thyroid. Materials and Methods: The materials were 79 cases of papillary thyroid carcinomas, and age, sex, tumor size, multiplicity of tumor, capsular invasion, lymph node metastasis, recurrence, TNM stage, DeGroot stage and AMES scale were evaluated. An immunohistochemical stains for CD 34 to estimate microvessel density (MVD), and VEGF were done. MVD was defined as an average count of vessels per ${\times}400$ power field in the most vascularized area. VEGF expression was interpreted as 1+ and 2+ according to staining intensity and percentages of positive cells. Results: Mean score of MVD was $39.7{\pm}16.9.$ MVD were significantly higher in cases with capsular invasion (p=0.0001), lymph node metastasis (p=0.0001), TNM stage III (p=0.0022), DeGroot stage III (p=0.0163) and high risk group by AMES scale (p=0.0001). VEGF 2+ expression rate was significantly increased in cases with capsular invasion and lymph node metastasis (p=0.0006, p=0.0013), and in cases with TNM stage III, DeGroot stage III and high risk group by AMES scale (p=0.0236, p=0.0003, p=0.0293). In VEGF 2 + expression group, MVD was significantly higher than in VEGF 1 + group (p=0.0008), and MVD showed positive relation to VEGF 2 + expression (r=0.4616). Conclusion: VEGF expression and high MVD were significantly correlated to capsular invasion, lymph node metastasis, TNM stage III, DeGroot stage III and high risk group by AMES scale. The expression of VEGF and high MVD could be considered to be one of prognostic factor in papillary thyroid carcinomas.

The Expression of MUC1 and CD44s in Non-small Cell Lung Cancer (비소세포폐암에서 MUC1과 CD44s의 발현)

  • Park, Hye-Kyung;Lee, Ji-Seok;Lee, Jun-Hee;Lee, Jung-Wook;Kim, Yun-Seong;Lee, Min-Ki;Kim, Young-Dae;Lee, Hyung-Ryu;Kim, Kun-Il;Lee, Chang-Hun;Park, Soon-Kew
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.2
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    • pp.117-127
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    • 2002
  • Backgroud : MUC1 mucin is a heavily glycosylated large glycoprotein and is expressed aberrantly in carcinoma. CD44 is polymorphic family of cell surface glycoproteins participating in cell-cell adhesion and modulation of the cell-matrix interaction. MUC1 mucin and CD44 expression have been implicated in a tumor invasion and metastasis in certain malignancies. In this study, the expression of MUC1 and the standard form of CD44 (CD44s) was examined in non-small cell lung cancer (NSCLC). Methods : Immunohistochemical staining using monoclonal antibodies including MUC1 glycoprotein and CD44s was performed on 80 NSCLC surgical specimens. The association between MUC1 and CD44s expression and the histological type and tumor stage was investigated. Results : Depolarized MUC1 expression in more than 10% of cancer cells was found in 12 (27.9%) out of 43 squamous cell carcinomas (SCCs) and 12 (32.4%) out of 37 adenocarcinomas (ACs). It was not associated with the tumor histological type and the TNM-stage in SCCs. Depolarized MUC1 expression correlated with the N-stage in ACs (p=0.036). CD44s was expressed in 36 (83.7%) out of 43 SCCs and 14 (37.8%) out of 37 ACs. Reduced CD44s expression correlated with the N-stage (p=0.031) and the TNM-stage (p=0.006) in SCCs. Conclusions : Depolarized MUC1 expression was related to the nodal stage in NSCLC adenocarcinoma. Reduced CD44s expression was related to nodal involvement and the TNM-stage in squamous cell carcinoma. This suggests that MUC1 and CD44s expression in NSCLC might play important roles in tumor progression and cap be used as prognostic variables.

Refining prognostic stratification of human papillomavirus-related oropharyngeal squamous cell carcinoma: different prognosis between T1 and T2

  • Lee, Sumin;Lee, Sang-wook;Park, Sunmin;Yoon, Sang Min;Park, Jin-hong;Song, Si Yeol;Ahn, Seung Do;Kim, Jong Hoon;Choi, Eun Kyung;Kim, Su Ssan;Jung, Jinhong;Kim, Young Seok
    • Radiation Oncology Journal
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    • v.35 no.3
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    • pp.233-240
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    • 2017
  • Purpose: To validate the 8th edition of the American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) TNM staging system for human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) and investigate whether a modified classification better reflects the prognosis. Materials and Methods: Medical records of patients diagnosed with non-metastatic HPV-related OPSCC between 2010 and 2016 at a single institution were retrospectively reviewed. HPV status was determined by immunohistochemical analysis of p16 and/or HPV DNA polymerase chain reaction (PCR). We reclassified TNM stage T0-1 and N0-1 as group A, T2-3 or N2 as B, and T4 or N3 as C. Survival analysis according to 8th AJCC/UICC TNM staging and the modified classification was performed. Results: Of 383 OPSCC patients, 211 were positive for HPV DNA PCR or p16. After exclusion, 184 patients were included in this analysis. Median age was 56 years (range, 31 to 81 years). Most primary tumors were in the palatine tonsil (148 tumors, 80%). The eighth AJCC/UICC TNM classification could not differentiate between stage I and II (p = 0.470) or II and III (p = 0.209). Applying modified grouping, the 3-year overall survival rate of group A was significantly higher than that of group B and C (98% vs. 91%, p = 0.039 and 98% vs. 78%, p < 0.001, respectively). Differentiation between group B and C was marginally significant (p = 0.053). Conclusion: The 8th AJCC/UICC TNM staging system did not clearly distinguish the prognosis of stage II from that of other stages. Including the T2N0-1 group in stage II may improve prognostic stratification.

Does the New UICC/AJCC TNM Staging System (7th Edition) Improve Assessing Prognosis in Gastric Cancer Compared to the Old System (6th Edition)? (UICC/AJCC 제7판 위암 병기 분류법은 제6판 분류법에 비하여 예후 예측을 증진시키는가?)

  • Ha, Tae-Kyung;Kim, Hyun-Ja;Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.159-166
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    • 2009
  • Purpose: We evaluated the efficacy and prognostic predictability of the $7^{th}$ UICC TNM classification compared to $6^{th}$ UICC TNM classification in patients with gastric cancer. Materials and Methods: Between June 1992 and December 2006, 1,633 patients with gastric cancer who had undergone gastric surgery and who had been analyzed by the $6^{th}$ UICC method were analyzed using the new $7^{th}$ UICC system. Results: Significant differences in 5-year survival rates were observed for $7^{th}$ UICC N0, N1, N2, N3a, and N3b compared to $6^{th}$ UICC. There were no significant differences in 5-year survival rates between T2 and T3. Distinct survival differences were present between stage III (IIIa, IIIb, and IIIc) and stage IV in $7^{th}$ UICC. Significant differences in 5-year survival rates were not expected for Ia versus Ib, Ib versus IIa, and IIb versus IIIa. The survival rates for the same stages were not homogeneously differentiated by $7^{th}$ UICC except for stage IV. Conclusion: The $7^{th}$ UICC classification system is not better able to predict patient survival compared to 6th UICC in patients with gastric cancer, but is better for accurate prognosis of patients with stage IV gastric cancer.

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Relationship between S-Phase Fraction and Survival Time in Patients with Primary Squamous Lung Cancer (편평상피성 폐암에 있어서 S-Phase Fraction과 생존기간과의 관계)

  • Jung, Byung-Hak;Kang, Jeong-Seong;Chang, Keun;Jeong, Eun-Taik;Chung, Hun-Taeg;Moon, Hyung-Bae
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.669-676
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    • 1993
  • Background: DNA content analysis of human solid tumor is now widely performed by flow cytometric study. One of the most interesting and potentially important observation in this field is that proliferative activity(S-Phase fraction of cell cycle) may profoundly affect prognosis. Method: S-Phase fraction(SPF) have been measured by flow cytometric method using tumor cells isolated from paraffin embedded tissue. To evaluate the prognostic significance, SPF of squamous lung cancer cell was assessed in 21 patients who died without any specific treatment. Results: 1) Mean survival time of squamous lung cancer patients was 225(${\pm}162$) days. Survival time were shortened, when TNM stage and PS scale were advanced. 2) Mean value of SPF of squamous lung cancer patients was 23.4(${\pm}11.3$)%. SPF had nothing to do with advance of TNM stage and PS scale. 3) Mean survival time of high SPF group(more than 20% of cell proliferation cycle) and low SPF group were 153(${\pm}99$) days and 342(${\pm}180$) days(p<0.01). In each identical TNM stage and PS scale, there were also statistic significant differences in mean survival time between high and low SPF group. Conclusion: On multivariate analysis including TNM stage and performance status, SPF was the significant and independent prognostic factor in the primary squamous lung cancer patients group.

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Prognostic Analysis of Schistosomal Rectal Cancer

  • Wang, Meng;Zhang, Yuan-Chuan;Yang, Xu-Yang;Wang, Zi-Qiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9271-9275
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    • 2014
  • Background: Schistosomiasis is an infectious disease that affects more than 230 million people worldwide, according to conservative estimates. Some studies published from China and Japan reported that schistosomiasis is a risk factor for colorectal cancer in Asia where the infective species is S. japonicum. Hoqwever, there have been only few reports of prognosis of patients with schistosomal rectal cancer SRC. Objectives: This study aimed to analyze differences in prognosis between SRC and non-schistosomal rectal cancer(NSRC) with current treatments. Materials and Methods: A retrospective review of 30 patients with schistosomal rectal cancer who underwent laparoscopic total mesorectal excision operation (TME) was performed. For each patient with schistosomal rectal cancer, a control group who underwent laparoscopic TME with non-schistosomal rectal cancer was matched for age, gender and tumor stage, resulting in 60 cases and controls. Results: Univariate analysis showed pathologic N stage (P=0.006) and pathologic TNM stage (P=0.047) statistically significantly correlated with disease-free survival (DFS). Pathologic N stage (P=0.014), pathologic TNM stage (P=0.002), and with/without schistosomiasis (P=0.026) were statistically significantly correlated with overall survival (OS). Schistosomiasis was the only independent prognostic factor for DFS and OS in multivariate analysis. Conclusions: The prognosis of patients with schistosomal rectal cancer is poorer than with non-schistosomal rectal cancer.

Screening of MicroRNA in Patients with Esophageal Cancer at Same Tumor Node Metastasis Stage with Different Prognoses

  • Zhao, Bao-Sheng;Liu, Shang-Guo;Wang, Tian-Yun;Ji, Ying-Hua;Qi, Bo;Tao, Yi-Peng;Li, Han-Chen;Wu, Xiang-Nan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.139-143
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    • 2013
  • Patients at the same pathological stage of esophageal cancer (EC) that received the same surgical therapy by the same surgeon may have distinct prognoses. The current study aimed to explore the possibility of differentially-expressed microRNAs (miRNAs) underlying this phenomenon. Samples were collected from EC patients at the same tumor node metastasis (TNM) stage but with different prognoses. Paracancerous normal tissues were taken as controls. The specimens were histopathologically analyzed. Differentially-expressed miRNAs were analyzed using real-time quantitative reverse transcription polymerase chain reaction. Compared with patients with poor prognosis, those with good prognosis exhibited 88 two-fold or more than two-fold increased miRNA fragments and 4 half-decreased miRNAs. The most noticeably up-regulated miRNAs included hsa-miR-31, hsa-miR-196b, hsa-miR-652, hsa-miR-125a-5p, hsa-miR-146b, hsa-miR-200c, hsa-miR-23b, hsa-miR-29a, hsa-miR-186, hsa-miR-205, hsa-miR-376a, hsa-miR-410, hsa-miR-532-3p, and hsa-miR-598, whereas the most significantly-downregulated miRNAs were hsa-let-7e, hsa-miR-130b, and hsa-miR-103. EC patients at same TNM stage but with different prognoses show differentially-expressed miRNAs.

Clinical Characteristics of Patients with Bronchioloalveolar Carcinoma: A Retrospective Study of 44 Cases

  • Dirican, Nigar;Baysak, Aysegul;Cok, Gursel;Goksel, Tuncay;Aysan, Tulin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4365-4368
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    • 2013
  • Background: Bronchioloalveolar carcinoma (BAC) is considered a subtype of adenocarcinoma of the lung. Recently BAC has been variously termed adenocarcinoma in situ, minimally invasive adenocarcinoma, lepidic predominant invasive adenocarcinoma, and invasive mucinous adenocarcinoma. The aim of the study was to analyze and detect prognostic factors of patients with BAC over a 7-year period. Materials and Methods: This retrospective single-center study included 44 patients with BAC. The impact on survival of fifteen variables (gender, age, smoking status, cough, dyspnea, hemoptysis, fever, chest pain, sputum, metastasis number, Karnofsky performance status, pT, pN, TNM stage, cytotoxic chemoterapy) were assessed. Results: Median age was 55 years (38-83). Most patients were male (63.6%) and stage IV (59.1%). Twenty-one patients (47.7%) received cytotoxic chemotherapy (platinum-based regimens) for metastatic disease. Objective response rate was 33.3% (4 partial, 3 complete responses). Stable disease was observed in nine in patients (42.8%). Disease progression was noted in 5 (23.8%). The median OS for all patients was 12 months (95%CI, 2.08-22.9 months). Independent predictors for overall survival were: Karnofsky performance status (HR:3.30, p 0.009), pN (HR:3.81, p 0.018), TNM stage (HR:6.49, p 0.012) and hemoptysis (HR:2.31, p 0.046). Conclusions: Karnofsky performance status, pN, TNM stage and hemoptysis appear to have significant impact on predicting patient survival in cases of BAC.