• Title/Summary/Keyword: Tumor staging

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FDG-PET in Gynecologic Cancer (부인암에서 FDG-PET의 역할)

  • Ryu, Sang-Young
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.46-52
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    • 2002
  • Whole-body positron emission tomography (PET) imaging with 18-F deoxyglucose (FDG) is a molecular imaging modality that detects metabolic alteration in tumor cells. In various human cancers, FDG-PET shows a potential clinical benefit in screening, tumor characterization, staging, therapeutic follow-up and detecting recurrence. In gynecologic cancers, FDG-PET is also known to be effective in characterization of adnexal masses, detection of recurrence, and lymph node invasion. This review discusses the clinical feasibility and future clinical application of this imaging modality in patients with cervical cancer, ovarian cancer, and other gynecologic cancers.

MicroRNAs as Promising Biomarkers for Tumor-staging: Evaluation of MiR21 MiR155 MiR29a and MiR92a in Predicting Tumor Stage of Rectal Cancer

  • Yang, Yun;Peng, Wei;Tang, Tian;Xia, Lin;Wang, Xiao-Dong;Duan, Bao-Feng;Shu, Ye
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5175-5180
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    • 2014
  • Objective: In this study, tumor-stage predictive abilities of miR21, miR155, miR29a and miR92a were evaluated in rectal cancer (RC). Methods: Expression of miR21, miR155, miR29a and miR92a was detected and quantitated in tumor tissue and in adjacent normal tissue from 40 patients by TaqMan MicroRNA assay. Results: Significant overexpression of miR21, miR155, miR29a and miR92a was observed in RC tissues. While high expression of miR21, miR155 and miR29a in N1-2 and C-D stages presented a potential correlation with N and Duke stages, partial correlation analysis suggested that only miR155 rather than miR21 and miR29a played a greater influencing role. Receiver operating characteristics (ROC) curve analysis showed that miR155 could discriminate N0 from N1-2 with 85.0% sensitivity and 85.0% specificity, N2 from N0-1 with 90.0% sensitivity and 96.7% specificity, and C-D stage from A-B stage with 81.0% sensitivity and 84.2% specificity. Conclusions: Increase in expression of miR155 might represent a novel predictor for RC N and Dukes staging.

Clinical Application of $^{18}F-FDG$ PET in Cervix Cancer (자궁경부암에서 $^{18}F-FDG$ PET의 임상 이용)

  • Oh, So-Won;Kim, Seok-Ki
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.101-109
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    • 2008
  • Cervix cancer is one of common gynecological cancers in the world, and staged with FIGO or TNM system. However, these clinical staging systems lack information about lymph node or distant metastases, thus imaging modalities are considered to make an appropriate therapeutic plan and enhance overall survival rate. In this context, FDG PET is recommended to pre-treatment stating and prognosis prediction, for it could noninvasively evaluate the status of lymph nodes, especially abdominal paraaortic nodes which are closely related with prognosis. Moreover, the degree of FDG uptake is correlated with prognosis. Although there is no consistent method for surveillance of cervix cancer, FDG PET seems a very important tool in detecting tumor recurrence because it is much more advantageous than conventional imaging modalities such as MRI for discerning recurrent tumor from fibrosis caused by radiation or surgery. Furthermore, FDG PET could be used to evaluate treatment response. On the other hand, recently introduced PET/CT is expected to play an ancillary role to FIGO staging by adding anatomical information, and enhance diagnostic performance of PET by decreasing false positive findings.

Survival Rate and Prognostic Factors of Liposarcoma (지방 육종의 생존율과 예후 인자)

  • Kim, Jae-Do;Park, Keon;Son, Jeong-Hwan;Hong, Young-Gi;Park, Jeong-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.2 no.1
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    • pp.54-59
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    • 1996
  • Liposarcoma is second in frequency only to malignant fibous histocytoma among the soft tissue sarcoma. Many different factors which might affect the survival rate of liposarcoma have been reported by many authors. The purpose of this study was to evaluate survival rate of liposarcoma and define the prognostic factors that affected survival rate. The authors analysed retrospectively 17 patients of liposarcoma in extremities from May 1984 to Dec. 1995 who had been treated in department of orthopaedic surgery of Kosin University Medical Center. All cases were resected with marginal or wide margin. There were 9 men and 8 women. The mean age was 48 years. The follow-up period ranged from 15 to 96 months. We compared the prognosis of the patients with several factors; age, sex, surgical staging, size, site, histologic type and treatment modality. At last follow-up, the presence of local recurrence was in 3 cases and the presence of lung metastasis was in 8 cases. The survival rates by Kaplan-Meier product limit method at 2 years and 5 years were 87% and 57% respectively. The statististically significant difference was estimated in histologic type, but was not estimated in age, sex surgical staging, size, site and treatment modality. In conclusion, the histologic type is considered as the most important factor of the prognosis in liposarcoma. Although it was too few patients for the differences to be statistically significant, we consider that surgical staging, site, size, the radio-therapy and chemothrapy in liposarcoma will affect the prognosis.

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Analysis of the Clinical and Histopathological Patterns of 100 Consecutive Cases of Primary Cutaneous Melanoma and Correlation with Staging

  • Nam, Kyung Wook;Bae, Yong Chan;Bae, Seong Hwan;Song, Kyung Ho;Kim, Hoon Soo;Choi, Young Jin
    • Archives of Plastic Surgery
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    • v.42 no.6
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    • pp.746-752
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    • 2015
  • Background This study analyzed 100 consecutive patients with primary cutaneous melanoma over the course of 13 years to determine whether epidemiological differences correspond to different stages of the disease. We also investigated whether epidemiological characteristics affected the survival rate. Our results were compared with those of selected descriptive studies of melanoma in other East Asian populations, in order to determine whether cutaneous melanoma patterns are similar in East Asian populations. Methods The patients' medical records were reviewed retrospectively, and we analyzed the relationship of epidemiological characteristics to staging and survival rate. Additionally, papers from Hong Kong and Japan describing these phenomena in East Asian populations were subjected to a statistical comparison. Results The ratio of males to females was 1:1.8, and the foot was the most frequent tumor site (49%). Acral lentiginous melanoma occurred most frequently (55%). Nodular melanoma was associated with a higher stage. Stage III-IV tumors with Clark levels of IV-V were significantly associated with a low survival rate. A statistical analysis of comparable papers reported in Hong Kong and Japan showed similar results with regard to age, tumor location, and histopathological subtypes. Conclusions This study provides the first full epidemiological description of 100 consecutive cases of primary cutaneous melanoma in Korea, with results similar to those observed in other East Asian populations. Corresponding to previous findings, nodular melanoma tended to occur at a higher stage than other types, and tumors with high Clark levels and high stages showed a lower survival rate.

Retrospective Evaluation of Discrepancies between Radiological and Pathological Size of Hepatocellular Carcinoma Masses

  • Tian, Fei;Wu, Jian-Xiong;Rong, Wei-Qi;Wang, Li-Ming;Wu, Fan;Yu, Wei-Bo;An, Song-Lin;Liu, Fa-Qiang;Feng, Li;Liu, Yun-He
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9487-9494
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    • 2014
  • Background: The size of a hepatic neoplasm is critical for staging, prognosis and selection of appropriate treatment. Our study aimed to compare the radiological size of solid hepatocellular carcinoma (HCC) masses on magnetic resonance imaging (MRI) with the pathological size in a Chinese population, and to elucidate discrepancies. Materials and Methods: A total of 178 consecutive patients diagnosed with HCC who underwent curative hepatic resection after enhanced MRI between July 2010 and October 2013 were retrospectively identified and analyzed. Pathological data of the whole removed tumors wereassessed and differences between radiological and pathological tumor size were identified. All patients were restaged using a modified Tumor-Node-Metastasis (TNM) staging system postoperatively according to the maximum diameter alteration. The lesions were classified as hypo-staged, iso-staged or hyper-staged for qualitative assessment. In the quantitative analysis, the relative pre and postoperative tumor size contrast ratio ($%{\Delta}size$) was also computed according to size intervals. In addition, the relationship between radiological and pathological tumor diameter variation and histologic grade was analyzed. Results: Pathological examination showed 85 (47.8%) patients were overestimated, 82 (46.1%) patients underestimated, while accurate measurement by MRI was found in 11 (6.2%) patients. Among the total subjects, 14 (7.9%) patients were hypo-staged and 15 (8.4%) were hyper-staged post-operatively. Accuracy of MRI for calculation and characterized staging was related to the lesion size, ranging from 83.1% to 87.4% (<2cm to ${\geq}5cm$, p=0.328) and from 62.5% to 89.1% (cT1 to cT4, p=0.006), respectively. Overall, MRI misjudged pathological size by 6.0 mm (p=0.588 ), and the greatest difference was observed in tumors <2cm (3.6 mm, $%{\Delta}size=16.9%$, p=0.028). No statistically significant difference was observed for moderately differentiated HCC (5.5mm, p=0.781). However, for well differentiated and poorly differentiated cases, radiographic tumor maximum diameter was significantly larger than the pathological maximum diameter by 3.15 mm and underestimated by 4.51 mm, respectively (p=0.034 and 0.020). Conclusions: A preoperative HCC tumor size measurement using MRI can provide relatively acceptable accuracy but may give rise to discrepancy in tumors in a certain size range or histologic grade. In pathological well differentiated subjects, the pathological tumor size was significantly overestimated, but underestimated in poorly differentiated HCC. The difference between radiological and pathological tumor size was greatest for tumors <2 cm. For some HCC patients, the size difference may have implications for the decision of resection, transplantation, ablation, or arterially directed therapy, and should be considered in staging or selecting the appropriate treatment tactics.

Intrapulmonary Solitary Fibrous Tumor Masquerade Sigmoid Adenocarcinoma Metastasis

  • Sakellaridis, Timothy;Koukis, Ioannis;Marouflidou, Theodora;Panagiotou, Ioannis;Piyis, Anastasios;Tsolakis, Konstantinos
    • Journal of Chest Surgery
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    • v.46 no.4
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    • pp.295-298
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    • 2013
  • Solitary fibrous tumor is a rare spindle cell mesenchymal tumor entity, with either benign or malignant behavior that cannot be accurately predicted by histological findings. An intrapulmonary site of origin is even rarer. We report a case of a 51-year-old woman in whom an abnormal nodule in the lower right lung was detected during staging for sigmoid adenocarcinoma. The nodule was excised and pathological examination revealed an intrapulmonary solitary fibrous tumor.

A Comparison of T Classification of the AJCC and Ho Staging Systems for Nasopharyngeal Carcinoma (비인강암에서 AJCC와 Ho 병기 결정법에 따른 T병기의 비교)

  • Lee Sang-Wook;Seo In-Seok;Kang Mee-Jeong;Cho Seok-Hyun;Kim Kyung-Rae;Lee Hyung-Seok
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.2
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    • pp.179-183
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    • 2002
  • Objective: A comparison of American Joint Committee on Cancer (AJCC) 1988 and 1997 nasopharyngeal carcinoma (NPC) classifications was made in terms of patient distribution and efficacy in predicting prognosis. Materials and Methods: Between Jan. 1981 and Dec. 1998, 60 cases of node negative nasopharyngeal carcinoma were retrospectively reviewed. The extent of disease each patients restaged according to the 4th and 5th AJCC system and Ho system, respectively. Results: The overall and disease free 5-year survival rates were 61.1% and 62.6%, respectively. Among T classifications of 4th AJCC, 5th AJCC and Ho staging system were not observed significantly different in disease-free survival rates, respectively. Conclusion: We observed a better patient distribution with AJCC 1997 comparing to AJCC 1988. The new classification also attained better statistical significances among stages in the overall survival and disease free survival rates was needed.

Gallbladder Carcinoma: Analysis of Prognostic Factors in 132 Cases

  • Wang, Rui-Tao;Xu, Xin-Sen;Liu, Jun;Liu, Chang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2511-2514
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    • 2012
  • Objective: To evaluate the prognostic factors of gallbladder carcinoma. Methods: Presentation, operative data, complications, and survival outcome were examined for 132 gallbladder carcinoma patients who underwent gallbladder surgery in our unit during 2002-2007, and follow-up results were obtained from every patient for univariate and multivariate survival analysis. Results: The univariate analysis showed that gallbladder lesion history, tumor cell differentiation, Nevin staging, preoperative lymph node metastasis and the surgical approach significantly correlated with the prognosis of the patients (p<0.05). The results of the multivariate analysis (Cox regression) showed that gallbladder lesion history, Nevin staging and the surgical approach were independent predicators with relative risks of 6.9, 4.4, 2.8, respectively (p=0.002, 0.003, 0.008). Conclusion: Gallbladder lesion history, Nevin staging and the surgical approach are independent prognostic factors for gallbladder carcinoma, a rapidly fatal disease. Therefore, early diagnosis, anti-infective therapy and radical surgery are greatly needed to improve the prognosis of gallbladder carcinoma.

Clinical Application of $^{18}F-FDG$ PET in Ovarian Cancer (난소암에서 $^{18}F-FDG$ PET의 임상 이용)

  • Oh, So-Won;Kim, Seok-Ki
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.91-100
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    • 2008
  • Ovarian cancer is often fatal since it is difficult to diagnose early and recurrence is quite frequent despite successful implementation of cytoreductive surgery and chemotherapy, thus exact diagnosis and early detection of recurrence are crucial to patient management. For pre-treatment staging, FDG PET could be helpful in a limited patient group possessing high risks of ovarian cancer. Besides, FDG PET could be recommended to patients with a high suspicion of recurrence i.e. rise of CA-125, especially in cases of conventional diagnostic imaging modalities presenting no evidence of disease because FDG PET provides critical information for treatment planning such as recurrence site or pattern. In order to expand the use of FDG PET to general population at staging or routine surveillance of ovarian cancer, more investigation is needed. The usefulness of FDG PET in evaluating treatment response and prognosis of ovarian cancer has not yet been determined, but it has been reported that FDG PET could evaluate treatment response early and show a close relationship with overall survival. PET/CT has been actively adopted in management of ovarian cancer. Not only in detecting tumor recurrence and evaluating treatment response but also in pre-treatment staging, FDG PET/CT is expected to playa role due to available anatomical information.