• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1171-1176
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• 2012

Objective: The current study aimedto screen for possible factors which affect prognosis of chondrosarcoma. Methods: Thirty seven cases were selected and analyzed statistically. The patients received surgical treatment at our hospital between December 2005 and March 2008. All of them had complete follow-up data. The survival rates were calculated by univariate analysis using the Kaplan-Meier method and tested by Log-rank. ${\chi}^2$ or Fisher exact tests were carried out for the numeration data. The significant indexes after univariate analysis were then analyzed by multivariate analysis using COX regression model. Based on the literature, factors of gender, age, disease course, tumor location, Enneking grades, surgical approaches, distant metastasis and local recurrence were examined. Results: Univariate analysis showed that there were significant differences in Enneking grades, surgical approaches and distant metastasis related to the patients' 3-year survival rate after surgery (P<0.001). No significant difference was not found in gender, age, disease course, tumor location or local recurrence (P>0.05). Multivariate analysis showed that Enneking grade (P=0.007) and surgical approaches (P=0.010) were independent factors affecting the prognosis of chondrosarcoma, but distant metastasis was not (P=0.942). Conclusion: Enneking grades, surgical approaches and distant metastasis are risk factors for prognosis of chondrosarcoma, among which the former two are independent factors.

• Radiation Oncology Journal
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• v.32 no.4
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• pp.238-246
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• 2014

Purpose: To evaluate the clinical outcome of high-dose-rate (HDR) interstitial brachytherapy (IBT) in patients with oral cavity cancer. Materials and Methods: Sixteen patients with oral cavity cancer treated with HDR remote-control afterloading brachytherapy using $^{192}Ir$ between 2001 and 2013 were analyzed retrospectively. Brachytherapy was administered in 11 patients as the primary treatment and in five patients as salvage treatment for recurrence after the initial surgery. In 12 patients, external beam radiotherapy (50-55 Gy/25 fractions) was combined with IBT of 21 Gy/7 fractions. In addition, IBT was administered as the sole treatment in three patients with a total dose of 50 Gy/10 fractions and as postoperative adjuvant treatment in one patient with a total of 35 Gy/7 fractions. Results: The 5-year overall survival of the entire group was 70%. The actuarial local control rate after 3 years was 84%. All five recurrent cases after initial surgery were successfully salvaged using IBT ${\pm}$ external beam radiotherapy. Two patients developed local recurrence at 3 and 5 months, respectively, after IBT. The acute complications were acceptable (${\leq}grade$ 2). Three patients developed major late complications, such as radio-osteonecrosis, in which one patient was treated by conservative therapy and two required surgical intervention. Conclusion: HDR IBT for oral cavity cancer was effective and acceptable in diverse clinical settings, such as in the cases of primary or salvage treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.189-195
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• 2016

Oral tongue squamous cell carcinoma (OTSCC) is the most common oral cancer subtype with a maximum propensity for regional spread. Our objective was to study if p53 expression might have any correlation with aggressive patterns of invasion within oral tongue cancers as well as with the histologically identified degree of oral tongue dysplasia. p53 immunoexpression was studied using immunohistochemistry in early staged OTSCCs (n=155), oral tongue dysplasias, (n=29) and oral tongue normal specimens (n=10) and evaluated for correlations with histological and clinicopathological parameters. Our study (n=194) showed a pattern of p53 expression increasing with different grades of tongue dysplasia to different grades of invasive OTSCC (p=0.000). Among the OTSCC tumours, positive p53 expression was seen in 43.2% (67/155) and a higher p53 labelling index was significantly associated with increased Bryne's grade of the tumour invasive front (p=0.039) and increased tumour depth (p=0.018). Among the OTSCC patients with tobacco habits, (n=91), a higher p53 labelling index was significantly associated with increased risk of local recurrence (p=0.025) and with lymphovascular space involvement (p=0.014). Evaluation of p53 through varying degrees of dysplasia to oral tongue cancer indicates that p53 expression is linked to aggressive features of oral tongue cancers and tongue precancers entailing a closer monitoring in positive cases. Among the OTSCCs, p53 expression is associated with tumour aggressiveness correlating with increased grading of invasive tumour front and tumour depth.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5755-5762
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• 2015

Background: Short-course preoperative radiation (SCRT) with delayed surgery was found to increase pathologic complete response (pCR) rates in several trials. However, there was no clear answer on whether SCRT or long-course chemo-radiotherapy (LCRT) is more effective. Therefore we conducted this meta-analysis to evaluate the safety and efficacy of SCRT versus LCRT, both with delayed surgery, for treatment of rectal cancer. Materials and Methods: The literature was searched from PubMed, EMBASE, Web of Science, Cochrane Library and clinicaltrials.gov up to November, 2014. Quality of the randomized controlled trials (RCTs) was evaluated according to the Cochrane's risk of bias tool of RCT. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to rate the level of evidence. Review Manager 5.3 was employed for statistical analysis. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. Results: Three RCTs, with a total of 357 rectal cancer patients, were included in this systematic review. Metaanalysis results demonstrated there were no significantly differences in sphincter preservation rate, local recurrence rate, grade 3~4 acute toxicity, R0 resection rate and downstaging rate. Compared with SCRT, LCRT was associated with significant increase in the pCR rate [RR=0.49, 95%CI (0.31, 0.78), P=0.003]. Conclusions: In terms of sphincter preservation rate, local recurrence rate, grade 3~4 acute toxicity, R0 resection rate and downstaging rate, SCRT with delayed surgery is as effective as LCRT with delayed surgery for management of rectal cancer. LCRT significantly increased pCR rate compared with SCRT. Due to risk of bias and imprecision, further multi-center large sample RCTs were needed to confirm this conclusion.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.911-915
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• 2014

Aim: This study was to evaluate the effect of whole brain radiation (WBRT) combined with stereotactic radiotherapy (SRS) versus stereotactic radiotherapy alone for patients with brain metastases using a meta-analysis. Materials and Methods: We searched PubMed, EMBASE, Cochrane Library from their inception up to October 2013. Randomized controlled trials involving whole brain radiation combined with stereotactic radiotherapy versus stereotactic radiotherapy alone for brain metastases were included. Statistical analyses were performed using RevMan5.2 software. Results: Four randomized controlled trials including 903 patients were included. The meta-analysis showed statistically significant lowering of the local recurrence rate (OR=0.29, 95%CI: 0.17~0.49), new brain metastasis rate (OR=0.45, 95%CI: 0.28~0.71) and symptomatic late neurologic radiation toxicity rate (OR=3.92, 95%CI: 1.37~11.20) in the combined group. No statistically significant difference existed in the 1-year survival rate (OR=0.78, 95%CI: 0.60~1.03). Conclusions: The results indicate that whole brain radiotherapy combined with stereotactic radiotherapy has advantages in local recurrence and new brain metastasis rates, but stereotactic radiotherapy alone is associated with better neurological function. However, as the samples included were not large, more high-quality, large-sample size studies are necessary for confirmation.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.278-282
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• 2007

Purpose: Diffuse pigmented villonodular synovitis (PVNS) is an uncommon aggressive synovial proliferative disorder of unknown etiology affecting the joint linings. Though a histologically benign inflammatory process, because of its aggressive growth with bone destruction or recurrence, it is frequently suggested to occur as a low malignant neoplasm. Optimal treatment is surgery, but the local recurrence rate after radical synovectomy for diffuse PVNS is relatively high due to the infiltrative growth pattern. External beam radiotherapy with moderate doses or intra-articular instillation of radioactive isotopes may improve the likelihood of local control and long-term function in patients with incompletely resected or recurrent diffuse PVNS. I report one case of diffuse PVNS of the right knee joint treated with arthroscopic synovectomy and external beam radiotherapy is presented.

• Archives of Plastic Surgery
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• v.38 no.2
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• pp.189-193
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• 2011

Purpose: Mucinous eccrine carcinoma of the skin is rare skin adnexal malignant tumor, which most commonly occurs in the head and neck regions. This tumor, although rarely metastatic, has a high incidence of local recurrence. We report a case of mucinous eccrine carcinoma developed on the Lt. cheek which was treated by Mohs surgery. Methods: The patient was a 53-year-old man who showed a palpable skin-colored $1.5{\times}1.5cm$ sized mass on Lt. cheek. We treated it by wide excision, but it recurred several times on the same region. So we finally did the Mohs surgery and full thickness skin graft. Results: The histologic characteristics are large mucinous pools with fibrous septae and clusters of tumor cells. Special stains showed that the mucin was positive reactivity on Periodic acid Schiff. Also the immunocytochemical studies showed a positive reactivity to carcinoembryonic antigen, S-100 protein, cytokeratin-7. Therefore pathologist reported it as a mucinous eccrine carcinoma. Conclusion: Authors experienced a rare case of primary mucinous eccrine carcinoma on Lt. cheek which had recurred several times. Because of the high local recurrence rate, we did the Mohs surgery and got an good result. Therefore the early Mohs surgery would be a good choice to primary mucinous eccrine carcinoma.

• The Journal of the Korean bone and joint tumor society
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• v.8 no.2
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• pp.58-62
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• 2002

The incidence of giant cell tumors represents only 5% to 10% of all bone tumors. Occurrence on the small bones of the hand and foot are very rare. They typically present with pain and sometimes a pathologic fracture or even soft tissue extension. The radiographic appearance is highly characteristic. An eccentric osteolytic lesion is seen, producing cortical thinning and expansion, and possessing a delicate trabecular pattern. In tarsal bones, poorly or well-defined osteolytic lesions of variable size are encountered. Surgical treatment remains the preferred therapy. Marginal or wide en bloc resection has had far better results in term of local recurrence. Several authors have suggested extended curettage and cement as an alternative to en bloc resection. Follow-up is necessary to monitor for both local recurrence and the infrequent pulmonary metastases.

• The Journal of the Korean bone and joint tumor society
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• v.4 no.1
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• pp.30-36
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• 1998

Squamous cell carcinoma is a neglected disease entity in orthopedic oncology. The purpose of this study was to analyze overall survival and the role of surgery on survival and to evaluate the significance of possible prognostic factors. From Oct, 1986 to Aug, 1996, 57 patients were enlisted and 42 patients ere eligible. Inclusion criteria included more than one year follow-up and no distant metastasis at the first visit. Staging and survival followed AJC classification and Kaplan-Meier plot. Stage II included 17 cases and stage III, 25 cases. Thirty-eight patients underwent operations, chemotherapy, and/or radiotherapy, and the remaining four had operations only. The chemotherapeutic regimen was adriamycin-cisplatin. The average follow-up period was 45 months. The ten-year actuarial survival rate of whole patients was 65.4%. Location of primary lesion, stage, pathologic grading, and intensity of chemotherapy in the same stage showed a significant difference in survival. Nine out of 42 patients had local recurrence. Seven patients had inadequate wide margins and two had intralesional margins. Average period of recurrence from operation was 13(4-35)months. The operation itself had no impact on survival but a surgical margin of no less than 3cm from the lesion was important for local control. Pathological grade and staging were significant variables for long term survival. Acral lesion had a significantly higher chance of regional and distant metastasis but actual survival showed no difference. In stage II, aggressive chemotherapy could delay or reduce the chance of regional or distant metastasis.

• Korean Journal of Head & Neck Oncology
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• v.19 no.1
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• pp.16-20
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• 2003

Objectives: Radiotherapy is an effective treatment in the initial management of T1 glottic carcinoma, but local recurrent or residual tumor growth is found in approximately 10% of the patients. Even in recurrence or residual tumor, in highly selected cases, conservation surgery with preservation of a portion of the larynx is feasible. So we investigated the efficacy of salvage vertical partial laryngectomy for recurrent glottic carcinoma after irradiation. Material and Methods: Retrospectively we reviewed a consecutive series of 10 patients treated by conservative vertical partial laryngectomy of the larynx for radiation-failure, recurrent T1 glottic squamous cell carcinoma treated at Severance Hospital from 1994 to 2002. Results: Local recurrence developed in 4 patients (40%). Two patient was salvaged by further totallaryngectomy. Successful salvage was achieved finally in 8 (80%) of the 10 patients. There was no operative mortality. Postoperative perichondritis was developed in two patients. One was resolved by conservative treatment, but the other has underwent the total laryngectomy. Conclusion: A vertical partial laryngectomy in case of recurrent glottic carcinoma after a course of irridation should be the therapy of choice when stringent criteria are observed.