• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.9-15
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• 2005

Objectives : To analyze medical expenses by cancer site and survival time among cancer patients in their last year of life. Method : The study subjects were 45,394 people that had died of cancers in 2002, were registered by the Korea Central Cancer Registry and received National Health Insurance benefit in the last year (360 days) of life. Personal identification data, general characteristics, dates of death and cancer incidence, and site of cancer were collected from the National Statistical Office and the Korea Central Cancer Registry, and merged with the data of the individual medical expenses of the Health Insurance Review Agency. Results : Average monthly cost curves were U-shaped with high costs near the time of diagnosis and death, and lower costs in between. Medical expenses in the last year of life were around 30.3, 16.7, 13.0, and 12.1 million won among leukemia, lymphoma, ovarian cancer, and breast cancer patients, respectively. Digestive organ cancers including stomach, esophagus, liver, pancreas, and colorectal cancers had relatively low medical expenses. Medical expenses in the last year of life were inverse U-shaped with high expenses near one year of survival. Average monthly cost in the 12 months before death among the patients who had survived $10{\sim}15$ years were more than two-fold greater than the cost before diagnosis among those who had survived for less than one year. Conclusions : Leukemia was the most expensive cancer. It is possible that once diagnosed as cancer, medical expenses do not return to the level before diagnosis. Further research will be needed to understand the magnitude and change of the medical expenses among cancer patients with long term follow up data.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.7161-7165
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• 2015

Background: Esophageal squamous cell carcinoma (ESCC) is a common cancer in the north east of India. The present study concerned the prevalence of human papilloma virus (HPV) in the ESCC in north eastern India and its impact on response to chemotherapy. Materials and Methods: p16 expression, a surrogate marker for HPV infection was assessed in 101 pre-treatment biopsies of locally advanced ESCC, reported from a comprehensive cancer centre in north east India, using immunohistochemistry. All patients received neo-adjuvant chemotherapy. Response was assessed clinically and histopathologically with attention to p16 expression. Results: p16 was expressed in 22% of ESCC (22 out of 101) and was more prevalent in patients who were more than 45 years of age (P=0.048). p16 positive tumors appeared more commonly in the upper 2/3 of the thoracic esophagus (18 in 22). Nine of the 22 (41%) p16 positive tumors achieved pathologic complete response following neo-adjuvant chemotherapy (P=0.008). There was a trend towards reduced mortality in this group (P=0.048). Some 9 of the 20 (45%) patients who achieved pathologic complete response were p16 positive. Conclusions: Expression of p16 in ESCC correlates with higher rate of pathologic complete remission in patients undergoing neo adjuvant chemotherapy and could be a predictive marker for response assessment.

• Radiation Oncology Journal
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• v.35 no.3
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• pp.241-248
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• 2017

Purpose: To evaluate the efficacy and safety of extended-field radiation therapy for patients with thoracic superficial esophageal cancer (SEC). Materials and Methods: From May 2007 to October 2016, a total of 24 patients with thoracic SEC (T1a and T1b) who underwent definitive radiotherapy and were analyzed retrospectively. The median total radiotherapy dose was 64 Gy (range, 54 to 66 Gy) in conventional fractionation. All 24 patients received radiotherapy to whole thoracic esophagus and 23 patients received elective nodal irradiation. The supraclavicular lymph nodes, the celiac lymph nodes, and both of those nodal areas were included in 11, 3, and 9 patients, respectively. Results: The median follow-up duration was 28.7 months (range 7.9 to 108.0 months). The 3-year overall survival, local control, and progression-free survival rates were 95.2%, 89.7%, and 78.7%, respectively. There were 5 patients (20.8%) with progression of disease, 2 local failures (8.3%) and 3 (12.5%) regional failures. Three patients also experienced distant metastasis and had died of disease progression. There were no treatment-related toxicities of grade 3 or higher. Conclusion: Definitive extended-field radiotherapy for thoracic SEC showed durable disease control rates in medically inoperable and endoscopically unfit patients. Even extended-field radiotherapy with elective nodal irradiation was safe without grade 3 or 4 toxicities.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.12
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• pp.5159-5164
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• 2016

Objective: The dynamics of morbidity, disability and death rates due to malignant neoplasms in the population in Uralsk city of the Republic of Kazakhstan were studied for 2011-2015, with a focus on age and sex, as well as tumor location. Methods: Statistics for total morbidity, primary disability and mortality from cancer in the adult population of the city of Uralsk for 2011-2015 were calculated per 100 thousand. Estimation of morbidity was based on data from form - $N{\underline{o}}12$ ${\ll}$Report on the number of diseases registered in patients living in the area of health care organizations and patient population under medical observation". Evaluation of primary disability was based on form $N{\underline{o}}7$ ${\ll}$The distribution of newly recognized disabled by disease class, age, sex and disability groups" for 2011-2015 in Ural city and analysis of cancer was carried out using annual form 7 "Report on the sick, and diseases of malignant neoplasms". Result: The most common localizations of cancer were the trachea, bronchi, lungs, stomach and mammary glands. High death rates were noted for patients with cancer of the trachea, bronchi, lung, as compared to stomach and esophagus. Conclusion: The results of our investigation and data in the literature indicate that regional characteristics influence the impact of risk factors associated with cancer. An unfavorable environmental background contributes to ill health of urban populations, contributing to development of cancer. Moreover behavioral risk factors are very important, such as smoking, alcohol drinking, and an unhealthy diet. All these factors require urgent adoption of a package of measures for prevention, early detection and timely treatment. Detailed study of cancer is necessary to develop national programs and activities for prevention and control.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.819-828
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• 1984

Between September 1973 and December 1983, 61 patients with carcinoma of the esophagus were treated surgically at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. Among 61 patients, male patients were 51 cases, female 10 cases and the age ranged from 21 years old to 72 years old with the average of 54.6 years old. Min symptoms of esophageal cancer were dysphagia (91.5%), weight loss (40.4%), pain(27.6%), and the average symptom duration was 3.85 months. The anatomical locations of esophageal cancer in preoperative esophagogram revealed 41.7% in middle 1/3, 8.3% in esophagograstic junction or cardia. Among 61 cases, 9 cases were managed by feeding gastrostomy due to inoperability, 8 cases by exploratory thoracotomy or lapatotomy only without curative or palliative resection, and 44 cases by curative or palliative resection with reconstruction. Among 52 cases of exploration, 44 cases were managed with curative or palliative resection of cancer and the resectability revealed 84.6% in operated cases. Among palliative or curative resected group, the esophagogastrostomy was performed in 40 cases (90.9%), esophagojejunostomy in 3 cases(6.8%), esophagectomy only in 1 case(2.3%). Postoperative complications were noticed in 12 cases, such as anastomotic leakage in 7 cases(15.6%), empyema in 2 cases (4.4%), respiratory failure in 2 cases (4.4%), anastomotic stricture in 1 case (2.2%). among 7 postoperative anastomotic leakage, 2 patients died as a result of that complication and the operative mortality revealed 4.3%. During follow-up work, the mean survival period was 19.3 months in patients who discharged hospital alive, and the 2 year survival rate was 34.6%.

• Journal of Chest Surgery
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• v.45 no.1
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• pp.53-55
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• 2012

We report a very rare case of surgery on gastric conduit cancer. A 67-year-old male patient underwent esophagectomy and intrathoracic esophagogastrostomy for squamous cell carcinoma of the lower thoracic esophagus 27 months ago. Upon follow-up, a gastric carcinoma at the intra-abdominal part of the gastric conduit was found on an esophagogastroduodenoscopy. We performed total gastrectomy and esophagocolonojejunostomy in the manner of Roux-en-Y anastomosis. The postoperative course was not eventful and an esophagogram on the 10th postoperative day showed no leakage or stenosis of the passage. The patient was discharged on the 17th day with no complications.

• Journal of Pharmacopuncture
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• v.21 no.1
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• pp.26-34
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• 2018

Objective: The purpose of this study was to investigate the efficacy and safety of spinal-Z, derived from Peganum harmala seeds and Dracocephalum Kotschyi Boiss leaves, in patients with esophageal and stomach adenocarcinoma, and squamous cell carcinoma of the esophagus. Methods: Sixty-one patients with malignancies of the upper gastrointestinal tract were randomly assigned to one of two groups (treatment or control) in a double-blind fashion. Six capsules of Spinal-Z were prescribed to the patients with the regimen of 600 mg/m2/day, and placebo to the control group, for six months. Results: There were no significant differences between the two groups with regard to age, sex, duration of cancer, type of cancer and family history of cancer. There were significant differences in abdominal pain, heartburn, constipation and vomiting between the two groups, following spinal-Z therapy. Evaluation of drug side effects showed no difference in cough or other respiratory symptoms, itching, headache or dizziness between the two groups, both before and after treatment. Conclusion: This study indicates that Spinal-Z is safe and efficacious in the management of patients with upper gastrointestinal tract cancers.

• Korean Journal of Bronchoesophagology
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• v.17 no.1
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• pp.14-18
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• 2011

The diagnosis and treatment of early gastrointestinal cancers is the gastroenterologists' mission because of national cancer screening program in South Korea. The detection of early cancers is emphasized, because these were previously treated with surgical treatment can be currently cured with endoscopic treatment. Gastroenterologists who achieved at least on some level can make an exact diagnosis regardless of what type of endoscopy, but generally, there are some required conditions for an optimal diagnosis. First, clinically important lesions have to be detected easily. Second, the border and morphology of lesions have to be characterized easily. Third, lesions have to be diagnosed exactly. Precancers and early cancers are often subtle and can pose a challenge to gastroenterologists to visualize using standard white light endoscopy. The use of dye solutions aids the diagnosis of early gastrointestinal cancers, however, it is a quite cumbersome to use dye solutions all the time and the solution often bothers the exact observation by pooling into the depression or ulceration of the lesion. To overcome this weakness, newer endoscopes are now developed so called "image enhanced endoscopy" using optical and/or electronic methods such as narrow band imaging (NBI), autofluorescence imaging (AFI), i-scan, flexible spectral imaging color enhancement (FICE) and confocal endomicroscopy (CLE).

• The Journal of Dong Guk Oriental Medicine
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• v.7 no.2
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• pp.155-162
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• 1999

Euonymus alatus(Thunb.) Sieb has been used for cancer theraphy such as Liver cancer, esophagus cancer, stomach cancer, and uterine cancer in folk. Eupolyphaga simemsis(ES) extracted from Euonymus alatus(Thunb.) Sieb increases HDL-C/TC ratio and LCAT activity. TGF-${\beta}$ and Insulin has been Knoen as factors to induce the supression of proliferation of Hep3B, Human hepatoblastoma cell. Plasma HDL3-C involved in carbohydrate methabolism in the liver was maintained in low level by Euonymus alatus(Thunb.) Sieb. The low level of plasma HDL3-C suppresses the transition from normal liver to Fat liver. Finally, this resuly in suppression of cancer in liver. In this study, Euonymus alatus(Thunb.) Sieb showed higher cell toxicity in hepatoblastoma cell(Hep3B) compared to the uterine cancer cell(HeLa). This means Euonymus alatus(Thunb.) Sieb seems not to affect in the all kinds of cancer. In future, we will study whether Euonymus alatus(Thunb.) Sleb have an effect on the liver cancer induced by virus and hepatocellular carcinoma. Also, the mechanims of suppression of cell proliferation in HCC need to investigated.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10981-10984
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• 2015

Background: Esophagogastroduodenoscopy (EGD) is the standard technique for diagnosis of patients presenting with upper gastrointestinal symptoms. Some reports have shown high prevalence of esophageal cancer in the northern part of Afghanistan. The aim of this study was to investigate epidemiological profile of esophageal cancer among patients in this region. Materials and Methods: We identified 364 consecutive patients that received EGD examinations to examine upper gastrointestinal tract at the endoscopy unit of Balkh regional Hospital from March 2012 to March 2013. The case subjects included both in-patients and out-patients aged 16 years or more. We evaluated the results retrospectively. Results: The cases consisted of 184 (51%) males and 180 (49%) females. The mean age was $47.3{\pm}17.8$ and the age range 17-88 years. Ninety two cases had esophageal cancer, out of which 58 (63.0%) were male. The mean age at time of diagnosis was $57.8{\pm}13.2years$. Uzbek-Turkmen peoples were more common among patients with esophageal cancer (52.2%). Dysphagia was the most frequent symptom among patients with esophageal cancer at the time of presentation, seen in 77 (84.8%) of cases. Conclusions: Our results showed high incidence of esophageal cancer in the northern part of Afghanistan, especially in the Uzbek-Turkmen ethnic group.