• Radiation Oncology Journal
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• v.36 no.4
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• pp.295-303
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• 2018

Purpose: We evaluated prognostic value of the 8th edition of the American Joint Committee on Cancer/International Union for Cancer Control (AJCC/UICC) staging system for nasopharyngeal cancer and investigated whether tumor volume/metabolic information refined prognostication of anatomy based staging system. Materials and Methods: One hundred thirty-three patients with nasopharyngeal cancer who were staged with magnetic resonance imaging (MRI) and treated with intensity-modulated radiotherapy (IMRT) between 2004 and 2013 were reviewed. Multivariate analyses were performed to evaluate prognostic value of the 8th edition of the AJCC/UICC staging system and other factors including gross tumor volume and maximum standardized uptake value of primary tumor (GTV-T and SUV-T). Results: Median follow-up period was 63 months. In multivariate analysis for overall survival (OS), stage group (stage I-II vs. III-IVA) was the only significant prognostic factor. However, 5-year OS rates were not significantly different between stage I and II (100% vs. 96.2%), and between stage III and IVA (80.1% vs. 71.7%). Although SUV-T and GTV-T were not significant prognostic factors in multivariate analysis, those improved prognostication of stage group. The 5-year OS rates were significantly different between stage I-II, III-IV (SUV-T ≤ 16), and III-IV (SUV-T > 16) (97.2% vs. 78% vs. 53.8%), and between stage I, II-IV (GTV-T ≤ 33 mL), and II-IV (GTV-T > 33 mL) (100% vs. 87.3% vs. 66.7%). Conclusion: Current anatomy based staging system has limitations on prognostication for nasopharyngeal cancer despite the most accurate assessment of tumor extent by MRI. Tumor volume/metabolic information seem to improve prognostication of current anatomy based staging system, and further studies are needed to confirm its clinical significance.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.3
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• pp.182-187
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• 2002

Matrix metalloproteinase(MMP) is the proteolytic enzyme of the extracellular matrix. MMPs play a role in the invasion and metastasis of malignant tumor, but it is not known whether the expression of MMPs in squamous cell carcinoma of the tongue is related to the prognostic factors of this tumor. In this study, 32 paraffin-embedded tumor specimens were examined immunohistochemically using monoclonal antibodies of MMP-2, MMP-3, MMP-10 and MMP-13. The possible relationships between the expressions of the MMPs and TNM staging, the differentiation of tumor cells, size of tumor mass and lymph node metastasis were anlaysed statistically. The results were as follows. 1. The expression of MMP-2 increased according to TNM staging (P<0.05) and lymph node metastasis (P<0.05) and the expression of MMP-2 was not affected by the differentiation of tumor cells or tumor size. 2. The expression of MMP-3 increased with increasing tumor size (P<0.05). However it was not related to TNM staging, the differentiation of tumor cells or lymph node metastasis. 3. The expression of MMP-10 was unrelated to TNM staging, differentiation of tumor cells, lymph node metastasis or tumor size. 4. The expression of MMP-13 increased as tumor size increased (P<0.05). However it was not related to TNM staging, the differentiation of tumor cells or lymph node metastasis. We concluded that the expression patterns of MMP-2, MMP-3, and MMP-13 may play a role in the diagnosis, treatment plan and prognostic evaluation of malignant tumors of the tongue.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.sup1
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• pp.137-139
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• 2008

Wilms Tumor is a great therapeutic success story within pediatric oncology. Therefore, accurate initial staging is needed to assess tumor spread and to assign patients appropriately to the different risk branches. However, it is recognized that FDG-PET can provide useful information about tumor and has better accuracy than CT and MRI for staging, but its role in Wilms tumor is unclear. According to clinical research data, FDG PET may be useful for the management of selected patients with Wilms tumors.

• Korean Journal of Head & Neck Oncology
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• v.3 no.1
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• pp.5-13
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• 1987

Cancer of the head and neck is an uncommon disease accounting for 5 % of all cancers. In an anatomic area so readily visible and palpable for examination without special and expensive diagnositic tools, it is unfortunate that many patients still present with advanced diseases. Since the prognosis is so intimately related to stage of disease, it is very important to detect the earliest stage of cancer with a complete head and neck examination. In the evaluation of cancer at any anatomic site, the description of the extent of the lesion is important. Not only does proper staging of the tumor lead to make decision of the most appropriate treatment, it also serves as a guide for the results of treatment. Proper staging demands a careful clinical assesment of the extent of the cancer. The current staging system for head and neck cancer uses the TNM system devised by American Joint Committee for Cancer Staging and End Result Reporting. T represent the primary tumor, N, regional nodal metastases, and M, distant metastases. The detection, diagnosis, and appropriate treatment of eary cancer will result in improved survival.

• Investigative Magnetic Resonance Imaging
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• v.21 no.3
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• pp.139-147
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• 2017

Purpose: To evaluate differences in staging accuracy of prostate cancer according to the extent of hemorrhage on multiparametric MRI performed after biopsy. Materials and Methods: We enrolled 71 consecutive patients with biopsy-proven prostate cancer. Patients underwent MRI followed by a prostatectomy at our institution in 2014. Two radiologists reviewed the MRI to determine the tumor stage. Correlation between biopsy-MRI interval and extent of hemorrhage was evaluated. Regression analyses were used to determine factors associated with accuracy of tumor staging. Results: The mean interval between biopsy and MRI was $17.4{\pm}10.2days$ (range, 0-73 days). The interval between prostate biopsy and MRI and the extent of hemorrhage were not significantly correlated (P = 0.880). There was no significant difference in the accuracy rate of staging between the small and large hemorrhage groups. Conclusion: Biopsy-induced hemorrhage in the prostate gland is not sufficiently absorbed over time. The extent of hemorrhage and the short interval between biopsy and MRI may not impair tumor detection or staging on multiparametric MRI.

• Journal of the Korean Society of Radiology
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• v.82 no.5
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• pp.1083-1102
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• 2021

Uterine cervical cancer is a common gynecological cancer prevalent in Korea. Early detection, precise diagnosis, and appropriate treatment can affect its prognosis. Imaging approaches play an important role in staging, treatment planning, and follow-up. MRI specifically provides the advantage of assessing tumor size and disease severity with high soft tissue contrast. The revised version of the International Federation of Gynecology and Obstetrics (FIGO) staging system has been introduced in 2018, which incorporates subdivided primary tumor size and lymph node metastasis. In this review, the staging of uterine cervical cancer based on previous studies, the recently revised FIGO staging, and various post-treatment images are primarily described using MRI.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.3
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• pp.141-147
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• 2006

PET detects only less than 50% of early gastric cancer and 62-98% of advanced gastric cancer. Therefore, mass screening programs are recommended for all adults over the age of 40 for early detection and early treatment of gastric cancer through endoscopy or various radiological tests. The most important step after being diagnosed with gastric cancer is accurate staging, which mainly evaluates tumor resectability to avoid unnecessary surgery. Important factors that affect tumor resectability are whether the tumor can be separated from adjacent organs or important blood vessels, the extent of lymph node metastasis, presence of peritoneal metastasis, or distant organ metastasis. To evaluate the extent of local tumor invasion, anatomical imaging that has superior spatial resolution is essential. There are a few studies on prognostic significance of FDG uptake with inconsistent results between them. In spite of lower sensitivities for lymph node staging, the specificities of CT and PET are very high, and the specificity for PET tends to be higher than that for CT. Limited data published so far show that PET seems less useful in the detection of lung and bone metastasis. In the evaluation of pleural or peritoneal metastasis, PET seems very specific but insensitive as well. When FDG uptake of the primary tumor is low, the distant metastasis is also known to show low FDG uptake reducing its detection. There are only a few data available in the evaluation of recurrence detection and treatment response using FDG PET.

• Tuberculosis and Respiratory Diseases
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• v.43 no.6
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• pp.894-902
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• 1996

Background : Tumor angiogenesis is the growth of new vessels toward and within tumor. It has been demonstrated that the growth of tumor beyond a certain size requires angiogenesis and it is closely involved in tumor progression and metastasis. The finding that intensity of neovascularization correlates independently with metastasis may lead to identification of patients in whom radical surgery should be supplemented by systemic treatment. Method : We have collected paraffin blocks of bronchoscopic biopsy of patients with non-small cell lung cancer. We highlighted the vessel by staining endothelial cell with JC70 monoclonal antibody(to CD31) immunohistochemically and counted microvessels under 200 X field using light microscopy. Results : 1) The mean microvessel count was $32.7{\pm}20.8$ (9-96) in total 29 cases. 2) There were no correlations between microvessel counts and pathologic cell type, T staging, node melastasis(N) and hematogenous metastasis(M) (p>0.05). 3) The median follow-up duration was 15 months(2-46) and there was no correlation between the microvessel counts and survival rate of lung cancer patients (p>0.05). Conclusion : Tumor angiogenesis seems to be an important prognostic factor suggesting the probability of metastasis. But the microvessel count in the bronchoscopic biopsy specimen was inadequate and very limited. There has been no data about angiogenesis of lung cancer in korea yet So the study of tumor angiogenesis using resected lung tumor specimen would be demanded.

• Journal of Gastric Cancer
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• v.12 no.3
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• pp.179-186
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• 2012

Purpose: The use of 18F-2-deoxy-2-fluoro-D-glucose positron emission tomography-computed tomography as a routine preoperative modality is increasing for gastric cancer despite controversy with its usefulness in preoperative staging. In this study we aimed to determine the usefulness of preoperative positron emission tomography-computed tomography scans for staging of gastric cancer. Materials and Methods: We retrospectively analyzed 396 patients' positron emission tomography-computed tomography scans acquired for preoperative staging from January to December 2009. Results: The sensitivity of positron emission tomography-computed tomography for detecting early gastric cancer was 20.7% and it was 74.2% for advanced gastric cancer. The size of the primary tumor was correlated with sensitivity, and there was a positive correlation between T stage and sensitivity. For regional lymph node metastasis, the sensitivity and specificity of the positron emission tomography-computed tomography were 30.7% and 94.7%, respectively. There was no correlation between T stage and maximum standardized uptake value or between tumor markers and maximum standardized uptake value. Fluorodeoxyglucose uptake was detected by positron emission tomography-computed tomography in 24 lesions other than the primary tumors. Among them, nine cases were found to be malignant, including double primary cancers and metastatic cancers. Only two cases were detected purely by positron emission tomography-computed tomography. Conclusions: Positron emission tomography-computed tomography could be useful in detecting metastasis or another primary cancer for preoperative staging in gastric cancer patients, but not for T or N staging. More prospective studies are needed to determine whether positron emission tomography-computed tomography scans should be considered a routine preoperative imaging modality.

• Journal of Digestive Cancer Reports
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• v.7 no.1
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• pp.13-17
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• 2019

Stomach cancer is the fifth most common malignancy in the world. The incidence of stomach cancer is declining worldwide, however, gastric cancer still remains the third most common cause of cancer death. The tumor, node, and metastasis (TNM) staging system has been frequently used as a method for cancer staging system and the most important reference in cancer treatment. In 2016, the classification of gastric cancer TNM staging was revised in the 8^th American Joint Committee on Cancer (AJCC) edition. There are several modifications in stomach cancer staging in this edition compared to the 7^th edition. First, the anatomical boundary between esophagus and stomach has been revised, therefore the definition of stomach cancer and esophageal cancer has refined. Second, N3 is separated into N3a and N3b in pathological classification. Patients with N3a and N3b revealed distinct prognosis in stomach cancer, and these results brought changes in pathological staging. Several large retrospective studies were conducted to compare staging between the 7^th and 8^th AJCC editions including prognostic value, stage grouping homogeneity, discriminatory ability, and monotonicity of gradients globally. The main objective of this review is to evaluate the clinical and pathological implications of AJCC 8^th staging classification in the stomach cancer.