• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4177-4180
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• 2013

Background: The aim of this research was to perform an epidemiologic survey of esophageal cancer in Ardabil province. Materials and Methods: In this cross-sectional descriptive study, 661 patients diagnosed with EC were studied from March 2002 to May 2011 e. The necessary data were collected with a checklist from the documents in Ardabil Cancer Registry (ACR) and analyzed by statistical methods with SPSS.18 software. Results: Of the total new cases of EC registered in ARC during study period, 430 (65.1%) of patients were male with the male to female standard ratio was 1.18, with a statistically significant gender bias. The most common morphology of EC was squamous cell carcinoma (SCC, 68.8%) followed by adenocarcinoma (28.5%). It was observed that in most of patients, EC lesions were in the middle third of esophagus. In addition, most patients were rural and about 40% had smoking habits. The age-standardized incidence rate of cancers was 48.4 per 100,000 among females and males. The annual incidence rates in males and females was 7.1 and 6.7 per 100,000; respectively. Conclusions: Results showed that the prevalence and annual incidence rate of cancer in Ardabil province is lower than other areas of the country with a male predominance and a relatively high proprortion of adenocarcinomas.

• Journal of Chest Surgery
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• v.25 no.4
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• pp.398-405
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• 1992

Twenty nine adult patients underwent surgical esohpagectomy and one, bypass procedure for documented carcinoma of esophagus and cadiac portion of stomach at Chonnam National University Hospital from Jan 1986 to April 1991. There were several kinds of esophagectomies including through transhiatal, left thoracotomy only, laparotomy and thoracotomy, and laparotomy and right thoracotomy and cervical incision. Twenty five and squamous cell carcinoma and 5, adenocarcinoma. The tumor locations were the upper third in 3, middle third in 12, lower third in 10 and cardiac portion of stomach in 5. After operation, 8[27%] patients were classified in Stage IIa, 6[20%] patients in Stage IIb, 15 patients[50%] in Stage III and one patient in Stage IV. Major postoperative complications included anastomotic narrowing in 3, limited suture line leak in 2, wound infection in 2, hoarseness in 2, pseudomembraneous enterocolitis in 1 and herpes zoster in 1. There was no death within 30 days of operation. Ten months survival was 100% for patients with Stage lIa, 67% for patients with Stage IIb, 50% for patients with Stage III. Furthermore, 20 months survival was 75% in IIIa, 33% in IIb, and 40% in III. But there were no significant differences in survivals among the stage. The actuarial survival is 58% at one year and 41% at two years, The periods of average survival is 589 days after operation.

• Tuberculosis and Respiratory Diseases
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• v.54 no.5
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• pp.563-569
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• 2003

Background : Pleural effusions with high amylase levels are reported frequently in patients with pancreatic diseases, a rupture of the esophagus and a malignancy. However, there is no data available on the clinical features of an amylase-rich pleural effusion in Korea. This report describes the causes of the high amylase levels in a pleural effusion and analyzes its association with malignancy. Methods : The records of patients with an amylase-rich pleural effusion who were assessed at the Gyeongsang National University Hospital from January 1998 to August 2002 were examined retrospectively, and the distribution of amylase levels in those patients, the causative diseases, and the histological type in the case of a malignancy were analyzed. Among the 532 patients whose pleural effusion was evident on a chest X-ray, there were 36 cases with an amylase-rich pleural effusion. The amylase levels were determined by an enzyme method (Hitach 747 autoanalyzer). Results : Of the 36 patients with an amylase-rich pleural effusion, there were 18 patients(50%) associated with a malignancy, 8 patients(22%) with a parapneumonic effusion, 7 patients(19%) with pancreatic disease, and 3 patients with other causes. The amylase level in a pleural effusion due to pancreatic disease was much higher than that due to other causes(p<0.01). Among the malignant pleural effusions with high amylase levels, the origin of the malignancy was a primary lung cancer in 13 cases and metastatic lung cancer in 5 cases. The histological types of malignant causes were adenocarcinoma in 10 cases(56%), squamous cell carcinoma in 2 cases(11%) and unknown type of carcinoma in 6 cases. The amylase level in the adenocarcinoma cases was much higher than that in the other cell type carcinomas(p<0.01). There was no significant association between the amylase level and the glucose level among the malignant cases with amylase-rich pleural effusion(p=0.21). Conclusion : The most frequent cause of an amylase-rich pleural effusion was a malignancy. Primary lung cancer and adenocarcinoma were the most common malignancies and histological types associated with a malignant pleural effusion with high amylase levels. The amylase level in a pleural effusion secondary to pancreatic disease was much higher than from any other causes.

• Journal of Gastric Cancer
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• v.21 no.4
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• pp.426-438
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• 2021

Purpose: While the incidence of Barrett's neoplasia has been increasing in Western countries, the disease remains rare in Asian countries. Therefore, very few studies have investigated the endoscopic treatment for Barrett's neoplasia in Korea. Endoscopic submucosal dissection (ESD) enables en bloc and complete resection of gastrointestinal neoplastic lesions. This study aimed to evaluate the therapeutic outcomes of ESD for Barrett's neoplasia in a single center in Korea and to examine the predictive factors for incomplete resection. Materials and Methods: We conducted a retrospective observational study of 18 patients who underwent ESD for superficial Barrett's neoplasia (dysplasia and early cancer) between January 2010 and December 2019 at Pusan National University Hospital. The therapeutic outcomes of ESD and procedure-related complications were analyzed. Results: En bloc resection, complete resection, and curative resection were performed in 94%, 72%, and 61% of patients, respectively. Histopathology (submucosal or deeper invasion of the tumor) was a significant predictive factor for incomplete resection (P=0.047). Procedure-related bleeding and stenosis were not observed, whereas perforation occurred in one case. During the median follow-up period of 12 months (range, 6-74 months), local recurrence occurred in 2 patients with incomplete resection, one patient underwent repeat ESD, and the other patient received concurrent chemoradiotherapy. The 3-year overall and disease-specific survival rates were 73% and 93%, respectively. Conclusions: ESD seems to be an effective and safe treatment for superficial Barrett's neoplasia in Korea. Nevertheless, the suitability of ESD for Barrett's cancer cases should be determined considering the high risk of deep submucosal invasion.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.5107-5110
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• 2015

The State of Punjab has been in focus because of aperceived increasing rate of cancer. Both print and electronic media have created an impression that Punjab, especially the cotton belt of Malwa Region, has become a high incidence cancer region. Actually the increased number of cancer patients might be at least partly because of increasing population and heightened health awareness and reporting. The purpose of this study is to find out the pattern of cancer amongst patients registered in Mukh Mantri Punjab Cancer Rahat Kosh Scheme (MMPCRKS), under cancer registry at Rajindra Hospital Patiala from the various districts of Punjab. The study covers 500 cancer patients registered under MMPCRKS at Rajindra Hospital Patiala, for free cancer treatment. Information regarding age, gender, religion, method of diagnosis and affected sites was obtained. Results were analyzed statistically. Of the 500 patients, 65% were females and 35% were males. The most affected female age groups were 50-54 and 60-64; while males in the age groups of 65-69 and 60-64 had the highest risk. The leading cancers in females were breast followed by cervix and ovary where as in males they were were colon followed by esophagus and tongue. The commonest histological type was adenocarcinoma followed by squamous cell carcinoma. The increasing trend of cancer in Punjab is alarming. Since this study is a preliminary investigation, it could provide a leading role in prevention, treatment and future planning regarding cancer in Punjab.

• Journal of Chest Surgery
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• v.25 no.5
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• pp.504-510
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• 1992

Overall 25,095 cases of general thoracic surgery were analysed, which were performed by 48 institutes in Korea during recent 6 years[242 hospital-years]. The proportions of tumorous disease and infectious disease to be operated were 6,864 cases[27.4%] and 6,775 cases [27.0%], The most common organ involved for operation was lung-bronchus 16,542 cases [69.5%], and remainders were pleura 2,500 [10.0%], esophagus 2,433[9.7%], mediastinum 1,902[7.6%], chest wall 1,297 [5.2%], and diaphragm 421 [1.7%] in order. Among 6,864 cases of tumorous diseases, the most common causes for operation were lung-bronchus tumor 3132 cases [45.6%] and most of them were lung cancer 2,731 cases [88.7%]. In the 2,019 cases of primary lung cancer with known cell type, squamous cell carcinoma 1,296 cases [64.2%] and adenocarcinoma 460 cases [22.8%] were the most. The common types in the 1,207 cases of mediastinal tumor with known cell type were neurogenic tumor 348 cases [28.8%], thymoma 311 [25.8%], and teratoma 252[20.9%]. The annual cases of operation for tumorous disease including malignant tumor were increased steadily. Operation for infectious lung diseases [including bronchiectasis and tuberculosis] were about twice common than infectious pleural disease [i.e. empyema], and operations for tuberculous disease occupied about half cases of infectious lung disease. In 11,456 cases of other disease entities, excluding tumorous and infectious disease, there were bullous lung disease 9,074 cases[79.2%], benign esophageal disease 484[4.2%], myasthenia gravis 356[3.1%], chest wall deformity 483[4.2%], and diaphragmatic lesion 421[3. 7%] in order. We propose that above results for inquiry can be used as the basic data of general thoracic surgery in Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1407-1412
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• 2012

Background & Objectives: Gastric cancer is a leading cause of cancer-related deaths in both sexes in Iran. This study was designed to assess upper GI endoscopic findings among people > 50 years targeted in a mass screening program in a hot-point region. Methods: Based on the pilot results in Guilan Cancer Registry study (GCRS), one of the high point regions for GC-Lashtenesha- was selected. The target population was called mainly using two methods: in rural regions, by house-house direct referral and in urban areas using public media. Upper GI endoscopy was performed by trained endoscopists. All participants underwent biopsies for rapid urea test (RUT) from the antrum and also further biopsies from five defined points of stomach for detection of precancerous lesions. In cases of visible gross lesions, more diagnostic biopsies were taken and submitted for histopathologic evaluation. Results: Of 1,394 initial participants, finally 1,382 persons (702 women, 680 men) with a mean age of $61.7{\pm}9.0$ years (range: 50-87 years) underwent upper GI endoscopy. H. pylori infection based on the RUT was positive in 66.6%. Gastric adenocarcinoma and squamous cell carcinoma of esophagus were detected in seven (0.5%) and one (0.07%) persons, respectively. A remarkable proportion of studied participants were found to have esophageal hiatal hernia (38.4%). Asymptomatic gastric masses found in 1.1% (15) of cases which were mostly located in antrum (33.3%), cardia (20.0%) and prepyloric area (20.0%). Gastric and duodenal ulcers were found in 5.9% (82) and 6.9% (96) of the screened population. Conclusion: Upper endoscopy screening is an effective technique for early detection of GC especially in high risk populations. Further studies are required to evaluate cost effectiveness, cost benefit and mortality and morbidity of this method among high and moderate risk population before recommending this method for the GC surveillance program at the national level.

• Journal of Chest Surgery
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• v.25 no.3
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• pp.247-257
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• 1992

Bronchial adenoma, firstly described by Muller[1882] had been reported on the subject stressed their benign nature prior to 1940`s, but these tumors including carcinoid tumor, mucoepidermoid carcinoma, adenoid cystic carcinoma, pleomorphic adenoma are now known to possess the various degree of malignant natures from benign course, low grade malignant potential to distant lymphatic or hematogenous metastasis or combination. Although histologically diffeerent, four varieties except carcinoid tumor which is a spectrum of neu-roendocrine tumor originating Kulchitsky cell of the bronchial epithelium and form the part of the APUD tumor spectrum, are morphologically and in many respects clinically similar to the corresponding tumor of the salivary gland is a specific varient of adenocarcinoma that occurs most commonly in the major and minor salivary gland and less frequently tra-cheobronchial tree, esophagus etc. To better understand the clinical characteristics and assess more precisely the malignat nature of bronchial adenoma, we studied 17 cases of bronchial adenoma, which had been experienced at the Department of Thoracic and Cardiovascular surgery of Catholic University Medical College from April 1977 to september 1991. Seventeen cases of bronchial adenoma consist of 2 carcinoid tumors, 6 adenoid cystic carcinomas, 8 mucoepidermoid carcinomas and one pleomorphic adenoma. There is a slight predominace of male patients[10/17] and the age of pt studied varied with a higher incidence occurring between the ages of 40 years and 60 years[mean age, 46.5 years]; the youngest being 15 years and oldest 69 years. Their leading complaints were hemoptysis[4], exertional dyspnea[8], fever & chilness [4], and symptoms mimicking the bronchial asthma[4]. Diagnosis was aided by the radiologic studies such as chest X-ray, polytomography, CT scan, brochography and bronchoscopy. The preferred locations of fumor were in the trachea[4], main stem bronchus[3], bronchus intermedius[3], bronchus of RUL[2], LUL[1], RLL[1], LLL[3] with no peripheral location. Modalities of treatments were single or combination of surgical resection, radiation therapy, chemotherapy. Complete resections were permitted in 12 cases with late recurrences of 4 cases ranging from 6 months to 10 years: pneumonectomy[4], lobectomy[4], bil-obectomy[2], sleeve resection[2]. Gross findings of resected specimens in 14 cases showed that 4 cases were polyp-like pedunculated mass[entirely intraluminal mass] with intact mucosa, 8 cases were broad-bas-ed sessile mass[predominatly intraluminal] and the main portions were located below the mucosa similar to tip of iceburg[predominantly extraluminal] in 2 cases. Follow-up information was availble in all 17 cases ; eight were alive without evidence of disese ranging from 1 month to 13 years. But seven cases died of the causes related to tumor[6 cases within 12 months, one case 10 years after pneumonectomy]. We concluded that 8 cases[47%] of 17 cases were metastasizing bronchial adenoma and precise survival rate cannot be answered by the scanty materials available for study.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6277-6283
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• 2012

Background: Northern Iran counts as one of the highest prevalence regions for esophageal cancer (EC) worldwide. This study was designed to assess the epidemiologic aspects of EC in north central and northwest Iran over a 10 year period. Materials and Methods: The Guilan cancer registry study (GCRS) is a population-based cancer registry study featuring retrospective (1996-2003) and prospective (2004-2005) phases. A detailed questionnaire based on WHO standards for cancer registratration was applied to gather the required information. Two trained physicians coded information using ICD-O-3 in close coordination with an expert pathologist. Results: A total of 19,936 cases of malignancy (mean age $55.4{\pm}18.0$ years, range: 1-98 years) were registered, including 1,147 cases (670 males, 447 female; mean age: $64.0{\pm}11.5$ years) of EC. In 1996 the male/female ratio among patients with EC was 1.25 which increased to 1.53 in 2005. The lower third of the esophagus still remained the most common site of tumors. The average age-standardized rate (ASR) was 6.9 and 4.1 per $10^5$ men and women, respectively. In 1996, the ASRs were 7.2 and 5.2 per $10^5$ men and women which decreased to 6.9 and 4.1 per $10^5$ in 2004-2005. Squamous cell carcinoma (SCC) was the most prevalent histological subtype of EC accounting over 80% of cases. Conclusions: However the prevalence of adenocarcinoma (ADC) showed an increase to 18.4%. Guilan province may be considered a relatively low incidence region for EC.

• Journal of Gastric Cancer
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• v.8 no.4
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• pp.210-216
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• 2008

Purpose: Siewert's classification of adenocarcinoma of the esophagogastric junction (AEG) has been widely adopted, but there is a wide discrepancy of the clinicopathological features of AEG of the Asian patients as compared to that of the Western patients. The aim of this study was to investigate the clinicopathological characteristics of AEG according to the Siewert classification. Materials and Methods: Among the patients who underwent surgery for gastric carcinoma in our institution between May 2004 and February 2008, the AEG patients were selected based on their operation records and the photographs according to Siewert's classification. Results: There were 70 AEG patients (3.9%) among the total of 1,778 patients. There were 3 patients (4.3%) with type I, 30 patients (42.8%) with type II and 37 patients (52.8%) with type III. Curative resection (R0) was achieved in 68 cases (97.1%). No significant differences in gender, stage, Barrett's esophagus and the proximal margin were found between the patients with type II and type III AEG. The patients with type III were younger than the patients with type II (59 vs 64 years, respectively, P=0.049). Well differentiated histology (P=0.045) and the intestinal type (P=0.055) were significantly more frequent in the patients with type II as compared with that in the patients with type III. Conclusion: There was a striking difference of the Asian patients from the Western patients for the incidence of AEG (and especially type I). Some of the differences between type II and type III patients were similar to those of the previous Western studies. A large study is needed to investigate whether these features are typical in the Korean population.