• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.18
• /
• pp.7533-7537
• /
• 2014

Background: Breast cancer (BC) is the most frequent cancer type, and the leading cause of death from cancer among women in Israel. The Bedouin-Arab (BA) population in southern Israel is characterized by a high rate of consanguinity, common hereditary disorders, and transition from a semi-nomadic, traditional society to a more sedentary and urbanized society. In this hospital-based study, the demographic and the clinicopathological characteristics of BC in BA were compared with Jewish patients. Materials and Methods: 85 BA patients treated at the Soroka Medical Center, Beer Sheba, during the years 2004-2012, were studied and compared with 180 consecutive Jewish patients treated during the year 2007. Clinicopathological features compared included age, menopausal state, number of births, a history of BC in first-degree relatives, tumor size (T), extent of lymph-node involvement (N), distant metastases (M), stage, grade, estrogen and progesterone receptor (ER/PR), and Her2 status. Types of treatment, relapse rate and site, as well as outcome were also studied. Cox's regression models were applied for studying disease-free, and overall survival. Results: Compared with Jewish patients, BA patients were younger (average age $49{\pm}12$ yrs vs $59{\pm}13$, p<0.001), had a lower rate of BC in first-degree relatives (p<0.001), and a larger number of births ($6{\pm}4.2$ vs $2.5{\pm}1.9$, p<0.001). BA patients had larger tumors (p=0.02), more extensive lymph-node involvement (p=0.002), and more advanced stage (p=0.003). Grade, ER, PR, and Her2 status were similar in the two ethnic groups. Relapse type was most commonly systemic in BA patients (p=0.05), and loco-regional in Jewish patients (p=0.02). Median survival was 63, and 35 months for Jewish and BA patients, respectively (log-rank test, p=0.02). In Cox multivariate analysis, stage and PR status (HR-0.14, p<0.0001; HR-3.11, p=0.046), but not ethnicity, influenced overall survival. Conclusions: BC presents a decade earlier, and with more advanced disease in BA compared with Jewish patients. Biologic parameters including grade, ER, PR, and Her2 status were similar in both groups. Although prognosis was worse in BA than in Jewish patients, it was affected only by stage and PR status, but not by ethnicity.

• Radiation Oncology Journal
• /
• v.7 no.1
• /
• pp.29-36
• /
• 1989

One hundred and ten patients with carcinoma of the nasopharynx were treated by radiation therapy in Department of Therapeutic Radiology, Seoul National University Hospital between 1979 and 1985. Among these, one hundred and five patients were treated with curative intent and 5 patients with palliative aim. Excluding 16 patients who did not receive a full course of radiation therapy, the remaining 89 patients were reviewed for this analysis. Minimum follow-up period of survivors was 36 months. Forty-three percent of the patients had T4 primary lesions and $72\%$ had stage IV disease. The histology was squamous cell carcinoma in $46\%$ of the patients. undifferentiated carcinoma in $49\%$, and lymphoepithelioma in $5\%$. Total radiation dose to the primary site averaged 6,500cCY for T1, T2 lesions and 7500cCY for T3, T4 lesions. Neck node were given boost treatment to a maximum 7,500cCY depending on the extent of disease. Early primary lesion (T1, T2) and neck nodes were successfully controlled in most cases when dose of greater than 6,500cCY was delievered. Forty two patients $(47\%)$ had recurred, 16 of whom $(38\%)$ed at the primary site and $24(57\%)$ developed distant metastases. Of these. 9 patients received re-irradiation with or without chemotherapy and local control was obtained in 2 patients$(22\%)$. Actuarial overall survival and disease-free survival rate was $42\%\;and\;38\%$ at 5 years. T-stage and histologic subtype were not correlated with survival. However, N-stage was related to survival significantly (p=0.043).

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.14
• /
• pp.5923-5931
• /
• 2015

Background: Registry data from four major public hospitals indicate trends over three decades from 1980 to 2010 in treatment and survival from colorectal cancer with distant metastases at diagnosis (TNM stage IV). Materials and Methods: Kaplan-Meier product-limit estimates and Cox proportional hazards models for investigating disease-specific survival and multiple logistic regression analyses for indicating first-round treatment trends. Results: Two-year survivals increased from 10% for 1980-84 to 35% for 2005-10 diagnoses. Corresponding increases in five-year survivals were from 3% to 16%. Time-to-event risk of colorectal cancer death approximately halved (hazards ratio: 0.48 (0.40, 0.59) after adjusting for demographic factors, tumour differentiation, and primary sub-site. Survivals were not found to differ by place of residence, suggesting reasonable equity in service provision. About 74% of cases were treated surgically and this proportion increased over time. Proportions having systemic therapy and/or radiotherapy increased from 12% in 1980-84 to 61% for 2005-10. Radiotherapy was more common for rectal than colonic cases (39% vs 7% in 2005-10). Of the cases diagnosed in 2005-10 when less than 70 years of age, the percentage having radiotherapy and/or systemic therapy was 79% for colorectal, 74% for colon and 86% for rectum (&RS)) cancers. Corresponding proportions having: systemic therapies were 75%, 71% and 81% respectively; radiotherapy were 24%, 10% and 46% respectively; and surgery were 75%, 78% and 71% respectively. Based on survey data on uptake of offered therapies, it is likely that of these younger cases, 85% would have been offered systemic treatment and among rectum (&RS) cases, about 63% would have been offered radiotherapy. Conclusions: Pronounced increases in survivals from metastatic colorectal cancer have occurred, in keeping with improved systemic therapies and surgical interventions. Use of radiotherapy and/or systemic therapy has increased markedly and patterns of change accord with clinical guideline recommendations.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.8
• /
• pp.4769-4774
• /
• 2013

This paper is the first to present the incidence and overall survival of patients with squamous cell carcinoma of the head and neck (SCCHN) from the extreme northern part of the Philippines. We retrospectively retrieved the records of patients with histologically-confirmed squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx and larynx at the Mariano Marcos Memorial Hospital and Medical Center, Ilocos Norte, Philippines, from 2003 to 2012 and analysed prognostic factors associated with survival. Of the 150 cases, only 80 (53.3%) were still living when the study was terminated. Median age at initial diagnosis was 61.5 years and the male to female ratio was 7:3. The majority of the cases had tumours in the oral cavity (50.7%), followed by the larynx (36.7%). Sex (log rank=1.94, p value/${\alpha}$=0.16), tumor site (log rank=0.02, p value/${\alpha}$=0.90), tumor grade (log rank=1.74, p value/${\alpha}$=0.42), and node stage (log rank=0.07, p value/${\alpha}$=0.80) were not shown to be associated with the survival of our cases. Only 45 (30.0%) had no regional lymph node involvement (N0) at presentation and 12 (8.0%) had already developed distant metastases. Among the 150 patients, 71 (47.3%) were not able to receive treatment of any kind. Oddly, treatment (log rank=1.65, p value/${\alpha}$=0.20) was also shown to be not associated with survival. The survival rate of those who underwent surgery, radiotherapy, or both was not statistically different from those who did not receive any treatment. Only the tumor stage (log rank=4.51, p value/${\alpha}$=0.03) was associated with patient survival. The overall mean survival was 49.3 months, with survival rate diminishing from 88.3% during the 1st year to 1.80% by end of the study. This relatively low survival rate of our cases only reflects their poor access to quality diagnostic and treatment facilities.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.12
• /
• pp.5101-5106
• /
• 2016

Purpose: We aimed to establish an inflammatory prognostic index (IPI) in early and advanced non-small cell lung cancer (NSCLC) patients based on hematologic and biochemical parameters and to analyze its predictive value for NSCLC survival. Materials and Methods: A retrospective review of 685 patients with early and advanced NSCLC diagnosed between 2009 and 2014 was conducted with collection of clinical, and laboratory data. The IPI was calculated as C-reactive protein ${\times}$ NLR (neutrophil/ lymphocyte ratio)/serum albumin. Univariate and multivariate analyses were performed to assess the prognostic value of relevant factors. Results: The optimal cut-off value of IPI for overall survival (OS) stratification was determined to be 15. Totals of 334 (48.8%) and 351 (51.2%) patients were assigned to high and low IPI groups, respectively. Compared with low IPI, high IPI was associated with older age, greater tumor size, high lymph node involvement, distant metastases, advanced stage and poor performance status. Median OS was worse in the high IPI group (low vs high, 8.0 vs 34.0 months; HR, 3.5; p<0.001). Progression free survival values of the patients who had high vs low IPI were determined 6 months (95% CI:5.3-6.6) and 14 months (95% CI:12.1-15.8), respectively (HR; 2.4, P<0.001). On multivariate analysis, stage, performance status, lactate dehydrogenase and IPI were independent prognostic factors for OS. Subgroup analysis showed IPI was generally a significant prognostic factor in all clinical variables. Conclusion: The described IPI may be an inexpensive, easily accessible and independent prognostic index for NSCLC patients, useful for clinical practice.

• Radiation Oncology Journal
• /
• v.13 no.4
• /
• pp.303-309
• /
• 1995

Purpose : The effect of dose escalation of up to 6500 cGy on local control and survial was investigated in locally advanced non-small cell lung cancer. Materials and Methods: Ninety eight patients with biopsy-proven unresec-table non-small cell lung cancer without distant metastases or medically inoperable patients with lower-stage were treated with definitive radio-therapy alone. Group A was treated by thoracic irradiation, 6000 cGy or less in total tumor dose with daily fractions of 180 to 200 cGy; and group B was treated with 6500 cGy of same daily fractions. Results : The actuarial overall survival rate for the entire group was 54% at 1 year, 26.6% at 2 years and 16.4% at 3 years with a median survival time of 13 months. Statistically significant prognostic factors that affect survival rate were stage and N-stage. However, no improvement in local control and survival has been seen with higher dose radiotherapy(group B). Conclusion : Dose escalation of up to 6500 cGy was no effect on local control and survival rate. To increase the survival rate of non-small cell lung cancer hyperfractionated radiotherapy or concurrent chemoradiotherapy should be considered.

• Journal of Veterinary Clinics
• /
• v.33 no.1
• /
• pp.74-79
• /
• 2016

A 7-year-old female Pointer dog with multiple masses in the axilla, mammary gland, and bladder was submitted to the Pathology Department of the College of Veterinary Medicine in the Jeju National University. Grossly, mass between right axilla and 1st mammary gland, $15{\times}10cm$ in size, was well delineated and firm, slightly soft center, oval shape. And masses in right 1st, 3rd and 5th mammary gland were well delineated and sulphur yellow in color on the cut-surface. Numerous round to oval shaped masses, 0.3 to 2 cm in diameter were existed in the lung. Urinary bladder mucosa had rough and thick and round to oval papillary masses, 0.1 to 2 cm in diameter, on surface. Microscopically, masses in right axilla, 1st mammary gland, lung and axillary lymph node were composed of poorly differentiated tubules originated from apocrine gland. Lining neoplastic epithelium showed high mitotic figures, typical apical secretory blebs, and PAS-positive diastase-resistant cytoplasmic granules. Masses in 3rd and 5th mammary gland were confirmed as mammary complex adenoma and simple adenoma respectively. The masses in the urinary bladder were covered with stratified transitional epithelium with marked cellular atypia and high mitotic figures. Some neoplastic cells showed focal invasion into substantia propria of bladder. Immunohistochemaically, neoplastic transitional epithelium demonstrated positive reactions for cytokeratin 7, AE1/AE3, and MNF116. Based on the gross, histopathologic and immunohistochemical characteristics, this dog was diagnosed as apocrine carcinoma, mammary gland tumor including simple adenoma and complex adenoma and bladder transitional cell carcinoma. And distant metastases of apocrine carcinoma in right axilla were observed in axillary lymph node and lungs. This is the first report for concurrent occurrence of apocrine carcinoma, mammary gland tumor, and transitional cell carcinoma in a same dog.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.6
• /
• pp.1008-1018
• /
• 1996

Primary mediastinal nonseminomatous germ cell tumor is extremely rare. Apart from rarity and large size, mediastinal germ cell tumors show striking similarity to testicular tumors in age, incidence, and tumor type. The symptoms associated with these tumors are related mainly to size, invasion of neighboring structures, and distant metastases. Tissue diagnosis is obtained by biopsy of the primary lesion or by biopsy of metastatic sites. Tumors often present with advanced bulky disease, which are unresectable. So these tumors require an aggressive multidisciplinary approach to management. Optimal management includes aggressive surgical debulking and early use of cisplatin-bleomycin-based combination chemotherapy. Serial biomarker measurements permit early recognition of recwrence and improved timing of surgical intervention. The prognosis for mediastinal germ cell tumors is poor, not only because they are far advanced at the time of diagnosis but also because some of the tumors-such as embryonal carcinomas, choriocarcinomas, and endodermal sinus tumors-are very aggressive. In these cases, we present three young male patients with large mass on anterior mediastinum. Tissue diagnosis was obtained by primary lesion biopsy. All patients received surgical debulking and combination chemotherapy and experienced a brief response and eventually had relapses. We report these cases with a review of literatures.

• Tuberculosis and Respiratory Diseases
• /
• v.64 no.5
• /
• pp.374-378
• /
• 2008

Angiosarcoma is a rare but highly malignant tumorthat usually arises in the scalp or face of elderly males. Distant metastases favor the lung, liver, lymph nodes and skin. Metastatic pulmonary angiosarcoma commonly takes the form of a nodule but can sometimes appear as a thin-walled cyst. We report a case of 65 years-old male with a spontaneous pneumothorax, who underwent excision and radiotherapy for an angiosarcoma of the scalp 2 years ago. A chest CT scan revealed multiple cysts in the lung. The video-assisted thoracoscopic lung biopsy demonstrated subpleural cysts without tumor cells. A skin biopsy of the scalp showed an angiosarcoma. This case was diagnosed as a recurrence of an angiosarcoma with a supposed lung metastasis. This case suggests that a spontaneous pneumothorax in elderly people may be secondary to a pulmonary metastasis from an angiosarcoma of the scalp.

• Radiation Oncology Journal
• /
• v.9 no.2
• /
• pp.233-239
• /
• 1991

This is a retrospective study of 62 patients with unresected squamous cell carcinoma of the esophagus treated by radiotherapy alone (25 patients) or combined chemotherapy and radiotherapy (37 patients). Of these, 14 of 25 patients treated by radiation therapy alone and 25 of 37 patients treated by combined chemotherapy and radiotherapy completed radiotherapy consisting of 55 to 60 Gy in 5 to 6 weeks and were analyzed for local control rate and survival rate. Follow up ranged from 6 days to 58 months. Three ($8\%$) of 39 patients had a complete response, twenty-eight ($72\%$) a partial response and eight ($20\%$) minimal or no response. Overall median survival was 11 months for all stages. The 1 year and 2 year actuarial survival rates were $48.6\%$ and $13\%$ respectively. Age and stage had prognostic significances (p <0.05, p<0.05 respectively). The 1 year survival rate was $70.1\%$ for stage I, $47.6\%$ for stage II, and $28.4\%$ for stage III. The median survival was 19 months for stage I, 11 months for stage II, 6 months for stage III, and 5.5 months for stage III with distant metastases. The 1 year survival rate of patients 55 years and above was $69.6\%$, 54 years and below was $0\%$. There was no significant difference in survival rate between treatment modalities, locations of tumor, and responses of tumor.