• 제목/요약/키워드: metastasis risk

검색결과 354건 처리시간 0.033초

MicroRNAs and Lymph Node Metastasis in Papillary Thyroid Cancers

  • Mutalib, Nurul-Syakima Ab;Yusof, Azliana Mohamad;Mokhtar, Norfilza Mohd;Harun, Roslan;Muhammad, Rohaizak;Jamal, Rahman
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제17권1호
    • /
    • pp.25-35
    • /
    • 2016
  • Lymph node metastasis (LNM) in papillary thyroid cancer (PTC) has been shown to be associated with increased risk of locoregional recurrence, poor prognosis and decreased survival, especially in older patients. Hence, there is a need for a reliable biomarker for the prediction of LNM in this cancer. MicroRNAs (miRNAs) are small noncoding RNAs that regulate gene translation or degradation and play key roles in numerous cellular functions including cell-cycle regulation, differentiation, apoptosis, invasion and migration. Various studies have demonstrated deregulation of miRNA levels in many diseases including cancers. While a large number of miRNAs have been identified from PTCs using various means, association of miRNAs with LNM in such cases is still controversial. Furthermore, studies linking most of the identified miRNAs to the mechanism of LNM have not been well documented. The aim of this review is to update readers on the current knowledge of miRNAs in relation to LNM in PTC.

Unexpected Seizure Attack in a Patient with Spinal Metastasis Diagnosed as Posterior Reversible Encephalopathy Syndrome

  • Kim, Chang-Hyoun;Kim, Chi-Heon;Chung, Chun-Kee;Jahng, Tae-Ahn
    • Journal of Korean Neurosurgical Society
    • /
    • 제50권1호
    • /
    • pp.60-63
    • /
    • 2011
  • Seizure is a foreseeable risk in patients with brain lesion. However, seizure during treating non-brain lesion is not a familiar situation to neurosurgeon. Posterior reversible encephalopathy syndrome (PRES) is a relatively common situation after systemic chemotherapy. The aim of this study is to make neurosurgeons aware of this potential medical problem. A 52-year-old woman with advanced gastric cancer, presented with low back pain due to spinal metastasis at the 4th lumbar vertebra. Ten cycles of chemotherapy with FOLFOX (5-Fluoruracil/Oxaliplatin) had been completed 23 days ago. Two days before the planned operation, a generalized tonic clonic seizure occurred. She did not have a history of hypertension or seizure. The seizure was stopped with lorazepam 4mg. The brain magnetic resonance (MR) imaging showed high signal changes in both parieto-occipital lobes on the T2-weighted images, and these were partially enhanced, suggesting PRES. The surgery was preceded by treatment with an antiepileptic drug. The MR images, taken 1.5 months after the seizure, showed that the lesion was no longer present. At 3 month follow-up, no additional seizure attack occurred without any seizure medication. The possibility of a seizure attack should be considered if the patient has a history of chemotherapy.

Assessment of prognostic factors in dogs with mammary gland tumors: 60 cases (2014-2020)

  • Moon, Chang-Hwan;Kim, Dae-Hyun;Yun, Sung-Ho;Lee, Hae-Beom;Jeong, Seong-Mok
    • 대한수의학회지
    • /
    • 제62권1호
    • /
    • pp.9.1-9.6
    • /
    • 2022
  • Canine mammary gland tumors are the most common neoplasms in intact female dogs. Approximately half of all mammary tumors are malignant, and there is a risk of metastasis, which is associated with a poor prognosis. This study was to evaluate the prognostic factors of canine mammary gland tumors and the risk factors associated with the development of malignant tumors. From 2014 to 2020, 60 dogs with mammary gland tumors that underwent surgical treatment were evaluated in this retrospective study. Tumor size, TNM stage, and histopathological results were prognostic factors for 2-year survival after surgery. Every 10 mm increase in tumor size, increased the risk of death within 2 years after surgery 1.213 times. Dogs with TNM stage IV or V had 8.667 fold risk of death within 2 years after surgery. The 2-year survival rate for dogs with benign tumors was 90.2% and for malignant tumors was 67.3%. Tumor size is the most important prognostic factor for canine mammary gland tumors. As tumor size increased by 10 mm, the risk for development of malignant tumors increased by 1.487 times. Tumors larger than 30 mm are highly likely to be malignant, and metastatic evaluation and wide resection should be considered.

Expansion of Indication for Endoscopic SD in Early Gastric Cancer

  • Kim, Do-Hoon;Jung, Hwoon-Yong
    • Journal of Gastric Cancer
    • /
    • 제10권2호
    • /
    • pp.49-54
    • /
    • 2010
  • Endoscopic resection is now accepted as curative treatment modalities for early gastric cancer without lymph node metastasis. However, based on large-scaled data about the risk of lymph node metastasis in early gastric cancer and as a result of the technical development of endoscopic devices, it was suggested that the criteria for endoscopic resection should be extended. According to the treatment guidelines for gastric cancer in Japan, the extended indications include the following: differentiated-type mucosal cancer without ulceration and greater than 2 cm in diameter, differentiated-type mucosal cancer with ulceration and up to 3 cm in diameter, undifferentiated-type mucosal cancer without ulceration and up to 2 cm in diameter, and, in the absence of lymphovascular invasion, a tumor not deeper than submucosal level 1 (less than $500\;{\mu}m$). In this review, we discuss the evidence of the application of expanded endoscopic indication based on analysis of biologic behavior and data of endoscopic resection.

직결장암 환자에서 Bevacizumab에 의한 단백뇨 발현과 치료효과와의 상관관계 분석 (Correlation of Bevacizumab-induced Proteinuria with Therapeutic Effects in Patients with Colorectal Cancer)

  • 사예지;김경덕;안혜림
    • 한국임상약학회지
    • /
    • 제30권4호
    • /
    • pp.234-242
    • /
    • 2020
  • Background: Bevacizumab-induced proteinuria is known to occur when vascular endothelial cell receptors are blocked, which leads to decreased protein filtration. Although several studies have analyzed the correlation between therapeutic effect of bevacizumab and proteinuria, no conclusion has been established. Methods: In this retrospective study, colorectal cancer patients who received bevacizumab and urinary protein check from January 2015 to December 2016, were included. The incidence of proteinuria and the grade according to Common Terminology Criteria for Adverse Events (CTCAE) 4.0 were evaluated after bevacizumab administration. The primary objective was to correlate proteinuria with overall response rate (ORR) and time to progression (TTP). Primary lesion, metastasized organs, surgery or radiation therapy, chemotherapy were investigated for analysis of risk factors for proteinuria development. Results: A total of 149 patients included in the analysis. Proteinuria occurred 19.5% (n=29) in the study patients; 20 in grade 1, 7 in grade 2, and 2 in grade 3. ORR was 55.2% in the proteinuria group and 51.7% in the non-proteinuria group. There was no difference between two groups (p=0.89). The TTP through the survival curve was similar in both groups (10 months, p=0.97). The risk of proteinuria was high in patients who had liver metastasis (p=0.02) and no surgery (p=0.01). Conclusions: These result indicates that bevacizumab-induced proteinuria expression was not correlated with the therapeutic effect on patients with colorectal cancer. Further analysis is required to find out the correlation between proteinuria and therapeutic effects. The risk of proteinuria was increased from patients who had liver metastasis, and no surgery.

후두전적출술후 기관공재발의 위험요소 분석 (An Analysis of Risk Factors in Stomal Recurrence after Total Layngectomy)

  • 박지훈;김형진;오병훈;최건;정광윤;최종욱
    • 대한기관식도과학회지
    • /
    • 제6권1호
    • /
    • pp.80-86
    • /
    • 2000
  • Background : Stomal recurrence that occasionally follows total laryngectomy is associated with very poor prognosis regardless of treatment modality, so it is very important to identify high risk patients to prevent stomal recurrence. Objectives : We attempted to select an optimal management method to prevent stomal recurrence by analyzing risk factors in each patient who was found to have stomal recurrence following total laryngectomy. Materials and Methods : Risk factors in each of eleven patients who had stomal recurrence out of 159 patients who underwent total laryngectomy in the last ten years were analyzed retrospectively. Data were gathered on risk factors such as the presence of subglottic extension, extralaryngeal extension, thyroid gland invasion, lymph node metastasis, timing of tracheotomy, tumor stage, postoperative radiotherapy, and inclusion of the stoma in the radiotherapy field. Results : There were eight cases of subglottic extension, six cases of extralaryngeal invasion, one case of pharyngocutaneous fistula that occurred as a postoperative complication, and one case who was taken completion laryngectomy following conservation surgery. With the exception of one case who was taken tracheotomy prior to total laryngectomy, all tracheotomies were performed intra-operatively after endotracheal intubation. There was no evidence of paratracheal lymph node or prelaryngeal lymph node metastasis on preoperative neck CT scan. There were six cases of T4 tumors, four cases of T3 tumors, and one case of T2 tumor. Salvage surgery was performed following radiotherapy in three cases, and aside from one case who was not taken post-operative radiotherapy, postoperative radiotherapy including the stoma was performed in the remaining seven cases within one month after surgery. Conclusion : Total laryngectomy with wide paratracheal lymph node dissection, thyroidectomy, and tracheotomy should be performed for patients who have high risk factors such as subglottic extension and advanced stage. We believe that tracheotomy should be precede endotracheal intubation. Efforts should be made to prevent stomal recurrence by utilizing postoperative radiotherapy and by minimizing postoperative complications such as infection and fistula.

  • PDF

골육종에서 수술 전 항암 약물치료가 생존에 미치는 영향 (Effect of Preoperative Chemotherapy on Survival in High-grade Localized Osteosarcoma of the Extremity)

  • 최은석;한일규;조환성;김한수
    • 대한골관절종양학회지
    • /
    • 제18권2호
    • /
    • pp.59-65
    • /
    • 2012
  • 목적: 본 연구는 수술 전 항암 약물 치료가 전이가 없는 골육종 환자의 생존율과 전이에 미치는 영향에 대해 알아보고자 하였다. 대상 및 방법: 1984년부터 2010년까지 사지에 발생한, 전이가 없는 원발성 골육종으로 수술적 절제술과 수술 후 항암 약물 치료를 시행한 30세 미만의 환자 225명을 후향적으로 분석하였다. 평균 연령은 14.4세, 평균 추시기간은 9.1년이었다. 수술 후에만 항암 약물 치료를 시행한 군과 수술 전, 후 약물 치료를 시행했던 두군의 임상적 특성과 생존율을 비교하였다. 결과: 전체 225예 중 수술 후 약물 치료 군은 32예, 수술 전후 약물 치료 군은 193예였다. 수술 후 약물 치료 군은 절단 수술과(p<0.001), 전이의 빈도가 유의하게(p=0.004) 높았으며, 전이 발생시기도 빨랐다. 수술 후 약물 치료 군에서는 5년 생존율 51%로 수술 전후 약물 치료 군의 84%보다 낮았다(p=0.001). 국소재발은 유의한 차이가 없었다. 결론: 사지에 발생한 골육종 환자에서 수술 전 항암 약물 치료는 전이의 억제와 생존율 향상에 도움이 된다.

Predictors of Positive Bone Metastasis in Newly Diagnosed Prostate Cancer Patients

  • Chien, Tsu-Ming;Lu, Yen-Man;Geng, Jiun-Hung;Huang, Tsung-Yi;Ke, Hung-Lung;Huang, Chun-Nung;Li, Ching-Chia;Chou, Yii-Her;Wu, Wen-Jeng;Huang, Shu-Pin
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제17권3호
    • /
    • pp.1187-1191
    • /
    • 2016
  • Background: The prevalence of prostate cancer (PCa) has been increasing in recent years. Treatment strategies are largely based on the results of bone scan screening. Therefore, our aim was to investigate predictors of positive bone metastasis in newly diagnosed PCa patients. Materials and Methods: After extensive review, 336 consecutive patients newly diagnosed with PCa between April 2010 and November 2013 at our institution were enlisted in the study. Patients were divided into two groups according to bone scan results. Univariate analyses (Chi-square test for discrete variables and independent t-test for continuous variables) were applied to determine the potentially significant risk factors associated with distant bone metastasis. Binary logistic regression analyses were used to further investigate the influence of these factors on bone metastasis. Results: The patient mean age was $71.9{\pm}8.6years$ (range: 48 to 94 years). The mean prostate specific antigen (PSA) level and biopsy Gleason score were $260.2{\pm}1107.8ng/mL$ and $7.4{\pm}1.5$, respectively. The body mass index (BMI) for the series was $24.5{\pm}3.4kg/m^2$. Sixty-four patients (19.0%) had a positive bone scan result. Patients with positive bone scan results had a significantly lower BMI ($23.3{\pm}3.5$ vs. $24.8{\pm}3.3$; p=0.003), a higher Gleason score ($8.5{\pm}1.1$ vs. $7.1{\pm}1.5$; p < 0.001), and a higher PSA level ($1071.3{\pm}2337.1$ vs. $69.4{\pm}235.5$; p < 0.001) than those without bone metastasis. Multivariate logistic regression analysis employing the above independent predictors demonstrated that a Gleason score of ${\geq}7$, clinical stage ${\geq}T3$, $BMI{\leq}22kg/m^2$, and an initial PSA level of ${\geq}20ng/mL$ were all independent predictors of bone metastasis. Conclusions: A bone scan might be necessary in newly diagnosed PCa patients with any of the following criteria: clinical stage T3 or higher, a Gleason score of 7 or higher, BMI equal to or less than 22, and a PSA level of 20 or higher.

Clinical Outcomes of Gastrectomy after Incomplete EMR/ESD

  • Lee, Hye-Jeong;Jang, You-Jin;Kim, Jong-Han;Park, Sung-Soo;Park, Seung-Heum;Park, Jong-Jae;Kim, Seung-Joo;Kim, Chong-Suk;Mok, Young-Jae
    • Journal of Gastric Cancer
    • /
    • 제11권3호
    • /
    • pp.162-166
    • /
    • 2011
  • Purpose: Endoscopic resection is widely accepted as standard treatment for early gastric cancer (EGC) without lymph node metastasis. The procedure is minimally invasive, safe, and convenient. However, surgery is sometimes needed after endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) due to perforation, bleeding, or incomplete resection. We evaluated the role of surgery after incomplete resection. Materials and Methods: We retrospectively studied 29 patients with gastric cancer who underwent a gastrectomy after incomplete EMR/ESD from 2006 to 2010 at Korea University Hospital. Results: There were 13 incomplete resection cases, seven bleeding cases, three metachronous lesion cases, three recurrence cases, two perforation cases, and one lymphatic invasion case. Among the incomplete resection cases, a positive vertical margin was found in 10, a positive lateral margin in two, and a positive vertical and lateral margin in one case. Most cases (9/13) were diagnosed as mucosal tumors by endoscopic ultrasonography, but only three cases were confirmed as mucosal tumors on final pathology. The positive residual tumor rate was two of 13. The lymph node metastasis rate was three of 13. All lymph node metastasis cases were submucosal tumors with positive lymphatic invasion and no residual tumor in the gastrectomy specimen. No cases of recurrence were observed after curative resection. Conclusions: A gastrectomy is required for patients with incomplete resection following EMR/ESD due to the risk of residual tumor and lymph node metastasis.

Predictive Factors of Survival Time of Breast Cancer in Kurdistan Province of Iran between 2006-2014: A Cox Regression Approach

  • Karimi, Asrin;Delpisheh, Ali;Sayehmiri, Kourosh;Saboori, Hojjatollah;Rahimi, Ezzatollah
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권19호
    • /
    • pp.8483-8488
    • /
    • 2014
  • Background: Breast cancer is the most common cancer and the second most common cause of cancer-induced mortalities in Iranian women, following gastric carcinoma. The survival of these patients depends on several factors, which are very important to identify in order to understand the natural history of the disease. Materials and Methods: In this retrospective study, 313 consecutive women with pathologically-proven diagnosis of breast cancer who had been treated during a seven-year period (January 2006 until March 2014) at Towhid hospital, Sanandaj city, Kurdistan province of Iran, were recruited. The Kaplan-Meier method was used for data analysis, and finally those factors that showed significant association on univariate analysis were entered in a Cox regression model. Results: the mean age of patients was $46.10{\pm}10.81$ years. Based on Kaplan-Meier method median of survival time was 81 months and 5 year survival rate was $75%{\pm}0.43$. Tumor metastasis (HR=9.06, p=0.0001), relapse (HR=3.20, p=0.001), clinical stage of cancer (HR=2.30, p=0.03) and place of metastasis (p=0.0001) had significant associations with the survival rate variation. Patients with tumor metastasis had the lowest five-year survival rate (37%)and among them patients who had brain metastasis were in the worst condition (5 year survival rate= $11%{\pm}0.10$). Conclusions: Our findings support the observation that those women with higher stages of breast malignancies (especially with metastatic cancer) have less chance of surviving the disease. Furthermore, screening programs and early detection of breast cancer may help to increase the survival of those women who are at risk of breast cancer.