• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.853-857
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• 2015

Background: Gastric cancer is the most common cancer in the Iranian population. The aim of this study was to determine the effect of clinicopathological factors on prognosis by meta-analysis. Materials and Methods: A literature search was conducted using MEDLINE, EMBASE and Cochrane library and extensive literature search using the Persian databases until February 2011. Prospective follow up studies with multivariate analysis of overall survival of the patients with gastric cancer were included in this review. The data were analyzed by CMA.2. Publication bias are checked by funnel plot and data are shown as Forest plots. Results: From a total of 63 articles, 14 retrospective studies which examined 5 prognostic factors and involving 10,500 patients were included. Tumor size (>35mm) was the main significant factor predicting an unfavorable prognosis for the patients with gastric cancer (RR=1.829, p<0.001) followed by presence of distant metastases (RR=1.607, p<0.001), poor differentiation (RR=1.408, p<0.001) and male sex (RR=1.194, p<0.001). Lymph node metastases (RR=1.058, p=0.698) and moderate differentiation (RR=0.836, p=0.043) were not statistically significant as prognostic factors. Conclusions: This meta-analysis suggests that tumor size>35mm, poor differentiation, presence of distant metastasis and male gender are strongly associated with a poor prognosis in Iranian patients with gastric cancer.

• Korean Journal of Radiology
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• v.19 no.6
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• pp.1066-1076
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• 2018

Objective: The reliability of size measurements of liver metastases from neuroendocrine tumors (NETs) on contrast-enhanced computed tomography (CT) phases made by different readers may be hampered due to transient, variable rim enhancement in arterial phase (AP) or portal venous phase (PVP) images. We aimed to assess the reliability of tumor size measurements in pre- and post-contrast scans. Materials and Methods: The study coordinator selected target lesions according to Response Evaluation Criteria in Solid Tumors 1.1 guidelines in 44 consecutive patients with pathologically confirmed NET liver metastases. Two blinded readers measured the longest diameters of target lesions on pre-contrast, AP, and PVP images twice with a 4-week interval. Inter- and intra-observer agreements were evaluated using Bland-Altman plots and 95% limit of agreement (LOA) calculations. Results: Of the 79 target lesions (approximate mean size of 3 cm), 45 showed rim enhancement. Inter-observer agreement assessed based on LOA was highest in pre-contrast CT images (-6.1-5.7 mm), followed by PVP (-7.9-7.1 mm) and AP (-8.5-7.4 mm) images. Intra-observer agreement showed the same trend: -2.8-2.9 mm and -2.9-2.9 mm for readers 1 and 2, respectively, on pre-contrast CT, -2.8-2.9 mm and -3.0-3.2 mm, respectively, on PVP, and -3.2-4.2 mm and -3.4-3.2 mm, respectively, on AP images. Mean tumor diameters differed significantly among the phases in the following increasing order: pre-contrast CT, PVP, and AP images. Conclusion: There was better inter- and intra-observer agreement in size measurements of NET liver metastases on pre-contrast scans than on AP and PVP scans. Pre-contrast CT may be the optimal for measuring NET liver metastases if its accuracy is proven.

• Journal of Gastric Cancer
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• v.15 no.2
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• pp.143-146
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• 2015

Sarcomatoid carcinoma of the small intestine is rare, and only 30 cases have been reported to date. This disease generally exhibits a very poor prognosis. Here we report the case of a 67-year-old man with a sarcomatoid carcinoma in the jejunum, who was hospitalized for diarrhea, fever, nausea, and vomiting. The tumor was located at the jejunum and had a large round shape with geographic necrosis. It involved the entire wall of the small intestine and had directly invaded the neighboring sigmoid colon. Both lobes of the liver had multiple metastases. The patient underwent surgical resection of the jejunum. On immunohistochemical analysis, the tumor was positive for epithelial and mesenchymal markers. The patient died from rapid progression of the liver metastases 6 weeks after the surgery.

• Journal of The Korean Radiological Technologist Association
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• v.28 no.1
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• pp.145-152
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• 2002

Purpose : Radiofrequency(RF) ablation has known effective treatment in patient with hepatocellular carcinoma(HCC) or hepatic metastases tumor(HMT). The purpose of this study was to evaluate the usefulness of performed patient liver RF ablation guide by CT

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2439-2443
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• 2016

Purpose: To determine the risk factors, clinical symptoms and patterns of spread in laryngeal cancer. Materials and Methods: A cross sectional study was carried out in the Regional Cancer Centre, Imphal, Manipur, India. One hundred and sixteen patients with laryngeal cancer were retrospectively reviewed for epidemiological data and descriptive statistics were reported for various variables. Results: Median age at presentation was 65 years and 32.8% were undernourished at presentation. The male to female ratio was 5.4:1. Heavy smoking and tobacco chewing was associated in 91.4% and 33.6% of patients respectively. Tracheostomy was required in 21.5% leading to diagnosis of laryngeal cancer. Almost all were squamous cell carcinoma with neuroendocrine and verrucous carcinoma accounting for less than 2%. Supraglottic, glottic and trans-glottic tumors were 56.9%, 36.3% and 6.9% respectively. Nodal metastases were seen in 81.8% of supraglottic cancers and 31.6% of glottic cancers with supraglottic involvement. Level II neck nodes were the commonest site followed by level III. Distant metastases (only liver) were apparent in 1.7% at presentation. Including these liver metastases, unresectable cases were limited to 6% of the patients. Conclusions: Tobacco use is implicated in almost all of the cases and the sex ratio has also decreased due to increased female smokers. The supraglottis remains the commonest site and incidence of nodal metastases is higher than in other countries. There is also a higher requirement for tracheostomy at presentation in this region.

• Journal of Gastric Cancer
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• v.16 no.2
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• pp.115-119
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• 2016

We report the case of a patient with gastric adenocarcinoma with multiple liver metastases. This patient showed complete remission for more than 68 months after S-1/cisplatin combination chemotherapy and radical total gastrectomy. The patient, a 63-year-old man, presented with dyspepsia and difficulty in swallowing. Endoscopic findings showed a huge ulcero-infiltrative mass at the lesser curvature of the mid-body, extending to the distal esophagus. Biopsy revealed a poorly differentiated tubular adenocarcinoma. An abdominal computed tomography scan demonstrated multiple hepatic metastases. S-1/cisplatin combination chemotherapy was initiated, and following completion of six cycles of chemotherapy, the gastric masses and hepatic metastatic lesions had disappeared on abdominal computed tomography. Radical total gastrectomy and D2 lymphadenectomy combined with splenectomy were performed. The patient underwent three cycles of S-1/cisplatin combination chemotherapy followed by tegafur-uracil therapy for 1 year. He remained in complete remission for more than 68 months after surgery.

• Radiation Oncology Journal
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• v.34 no.1
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• pp.34-44
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• 2016

Purpose: A prospective phase II trial was conducted to evaluate the effectiveness and toxicity of regional hyperthermia and whole liver irradiation (WLI) for numerous chemorefractory liver metastases from colorectal cancer. Materials and Methods: Enrolled patients had numerous chemorefractory hepatic metastases from colorectal cancer. Five sessions of hyperthermia and seven fractions of 3-gray WLI were planned. Health-related quality of life (HRQoL) was determined using the Korean version of the European Organization for Research and Treatment of Cancer quality of life questionnaire C-30 and the Functional Assessment of Cancer Therapy-Hepatobiliary version 4.0. Objective and pain response was evaluated. Results: A total of 12 patients consented to the study and the 10 who received WLI and hyperthermia were analyzed. WLI was completed as planned in nine patients and hyperthermia in eight. Pain response was partial in four patients and stable in four. Partial objective response was achieved in three patients (30.0%) and stable disease was seen in four patients at the 1-month follow-up. One patient died 1 month after treatment because of respiratory failure related to pleural metastasis progression. Other grade III or higher toxicities were detected in three patients; however, all severe toxicities were related to disease progression rather than treatment. No significant difference in HRQoL was noted at the time of assessment for patients who were available for questionnaires. Conclusion: Combined WLI and hyperthermia were well tolerated without severe treatment-related toxicity with a promising response from numerous chemorefractory hepatic metastases from colorectal cancer.

• Journal of Digestive Cancer Research
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• v.2 no.1
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• pp.28-31
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• 2014

Pancreatic cancer is a highly aggressive cancer with poor prognosis. Although, gemcitabine is the current standard regimen as first-line chemotherapy for advanced pancreatic cancer, effective regimens of second-line chemotherapy after gemcitabine failure have not been established yet. We report a case of gemcitabine refractory pancreatic cancer treated with second-line chemotherapy with FOLFIRINOX regimen. A 57-year-old-woman visited our hospital for pancreatic body mass detected by computed tomography (CT). The patient underwent distal pancreatectomy and splenectomy and the pathologic results after surgery demonstrated adenocarcinoma. Follow-up was performed after surgery and CT and positron emission tomography (PET) 4 months after surgery revealed multiple hepatic metastases. The patient underwent first-line chemotherapy with gemcitabine and erlotinib for recurred pancreatic cancer. However, CT after 7 cycles of the chemotherapy showed the progression of multiple hepatic metastases and switch to second-line chemotherapy with FOLFIRINOX was initiated. CT after 16 cycles of the FOLFIRINOX showed the complete remission of multiple hepatic metastases. The patient was admitted for infective endocarditis with septic pneumonia 17 months after the initiation of FOLFIRINOX. However, the patients died from the progression of septic embolism and acute respiratory distress syndrome.

• Radiation Oncology Journal
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• v.9 no.1
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• pp.65-72
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• 1991

One hundred and thirty five patients with carcinoma of the nasopharyx were treated by radiation therapy in the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University between August 1977 and July 1987. Of the 30 patients omitted: 8 had distant metastases at initial diagnosis or during radiotherapy; 18 Patients refused or did not receive a full course of radiation therapy, and four had not been confirmed histologically. The remaining 105 patients were analysed to determine the incidence and pattern of distant metastases. Diagnosis of distant metastases was made based on clinical signs and radiography, even though histologic confirmation was not made. Twenty-six patients developed distant metastases after definite irradiation of nasopharyx and neck, an incidence rate of $24.8\%$ . The common sites of distant metastases were, in descending order, bone, lung, liver, and brain. There was a strong correlation between Ho's N stage and distant metastases rate. But sex, age, histologic subtype (squamous cell and undifferentiated cell), AJC T and N stage, treatment modalities (radiotherapy alone and radiotherapy combined with chemotherapy) were not significant. Of those patients who developed distant metastases, $80.8\%$ were discovered within 2 years of their radical radiotherapy. The prognosis for nasopharyngeal carcinoma patients developing distant metastases was poor: median survival was nine months and $80\%$ of those patients died within two years of the initial diagnosis of distant metastasis.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.sup1
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• pp.60-65
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• 2008

Hepatocellular carcinoma is the most common primary tumor in the liver. FDG PET has been applied for staging and treatment planning of hepatocellular carcinoma. It could reflect tumor prognosis because glucose metabolism assessed by FDG PET is known to have correlations with the differentiation and aggressiveness of the tumor. Although the ability of FDG PET to detect well-differentiated or low grade tumors and intra-hepatic lesions is not good, it is expected to playa major role in pre-surgical assessments for liver transplantation because it is useful in detecting extra-hepatic lesions and unexpected distant metastases with a better diagnostic performance than other conventional imaging modalities. Additionally, FDG PET has an advantage to screen other cancers through whole body scanning. As a new tracer for PET, Acetate demonstrates higher sensitivity and specificity to FDG in evaluating hepatocellular carcinoma. It thus seems that simultaneous use of Acetate PET with FDG PET could be helpful in diagnosis, especially detecting extra-hepatic metastases.