• Title/Summary/Keyword: metastasis risk

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Utility of FDG PET/CT Scans on Extracapsular Spread of Squamous Cell Carcinoma in the Larynx (후두 편평상피암종의 림프절 피막외 침범에 대한 FDG PET/CT 영상의 유용성)

  • Joo, Young-Hoon;Yoo, Ie-Ryung;Cho, Kwang-Jae;Song, Jee-Nam;Yoo, Dong-Joon;Lee, Ho-Suk;Kim, Min-Sik
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.2
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    • pp.118-121
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    • 2012
  • Backgrounds : To evaluated the use of FDG PET/CT for the identification of extracapsular spread(ECS) with histologic correlation in laryngeal cancer. Methods : We reviewed 79 medical records of patients who underwent of FDG PET/CT for laryngeal cancer before surgery. Results : ECS was present in 41.9%(18/43) dissected necks and in 34.5%(20/58) dissected cervical levels. There was a significant difference in the SUVmax between cervical lymph nodes with ECS and without ECS($6.39{\pm}4.53$ vs. $1.19{\pm}1.64$, p<0.001). The cut-off value for the SUVmax for differentiating with ECS from without ECS was 2.8 with the sensitivity of 85.7% and the specificity of 85.6%. Conclusion : The median SUVmax cut-off values of FDG PET/CT higher than 2.8 was associated with greater risk cervical lymph node metastasis with ECS in patients with laryngeal cancer.

Predictive Potential of Glutathione S-Transferase Polymorphisms for Prognosis of Osteosarcoma Patients on Chemotherapy

  • Zhang, Shai-Lin;Mao, Ning-Fang;Sun, Jun-Ying;Shi, Zhi-Cai;Wang, Bing;Sun, Yong-Jian
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2705-2709
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    • 2012
  • Objective: To evaluate the predictive value of glutathione S-transferase (GST) gene polymorphisms for the prognosis of osteosarcoma patients receiving chemotherapy. Methods: A total of 159 patients were included in our study between January 2005 and December 2007., with follow-up until January 2012. Genotyping was based upon the duplex polymerase-chain-reaction with the PCR-CTPP method. Results: At the time of diagnosis, 15.4% of the patients presented with metastasis, while 22.3% developed metastasis during follow-up. At the time of final analysis on January 2012, the median follow-up was 45.5 months. Patients with null GSTM1 and GSTT1 had a higher event free survival rate than non-null genotype, but no significant association was found between the two genotypes and prognosis of osteosarcoma. Individuals with GSTP1 Val/Val genotype tended to live shorter than with the IIe/IIe genotype, and we found a significantly higher risk of death from osteosarcoma (adjusted HR=2.35, 95% CI=1.13-4.85). Conclusion: The GSTP1 gene polymorphism may have an important role in the prognosis of osteosarcoma patients with chemotherapy. Further analyses with larger samples and more genes encoding metabolizing and DNA repair enzymes are warranted.

Factors Predicting Microinvasion in Ductal Carcinoma in situ

  • Ozkan-Gurdal, Sibel;Cabioglu, Neslihan;Ozcinar, Beyza;Muslumanoglu, Mahmut;Ozmen, Vahit;Kecer, Mustafa;Yavuz, Ekrem;Igci, Abdullah
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.55-60
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    • 2014
  • Background: Whether sentinel lymph node biopsy (SLNB) should be performed in patients with pure ductal carcinoma in situ (DCIS) of the breast has been a question of debate over the last decade. The aim of this study was to identify factors associated with microinvasive disease and determine the criteria for performing SLNB in patients with DCIS. Materials and Methods: 125 patients with DCIS who underwent surgery between January 2000 and December 2008 were reviewed to identify factors associated with DCIS and DCIS with microinvasion (DCISM). Results: 88 patients (70.4%) had pure DCIS and 37 (29.6%) had DCISM. Among 33 DCIS patients who underwent SLNB, one patient (3.3%) was found to have isolated tumor cells in her biopsy, whereas 1 of 14 (37.8%) patients with DCISM had micrometastasis (7.1%). Similarly, of 16 patients (18.2%) with pure DCIS and axillary lymph node dissection (ALND) without SLNB, none had lymph node metastasis. Furthermore, of 20 patients with DCISM and ALND, only one (5%) had metastasis. In multivariate analysis, the presence of comedo necrosis [relative risk (RR)=4.1, 95% confidence interval (CI)=1.6-10.6, P=0.004], and hormone receptor (ER or PR) negativity (RR=4.0, 95%CI=1.5-11, P=0.007), were found to be significantly associated with microinvasion. Conclusions: Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with comedo necrosis or hormone receptor negativity are more likely to have a microinvasive component in definitive pathology following surgery, and should be considered for SLNB procedure along with patients who will undergo mastectomy due to DCIS.

Estimation of the Cure Rate in Iranian Breast Cancer Patients

  • Rahimzadeh, Mitra;Baghestani, Ahmad Reza;Gohari, Mahmood Reza;Pourhoseingholi, Mohamad Amin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.12
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    • pp.4839-4842
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    • 2014
  • Background: Although the Cox's proportional hazard model is the popular approach for survival analysis to investigate significant risk factors of cancer patient survival, it is not appropriate in the case of log-term disease free survival. Recently, cure rate models have been introduced to distinguish between clinical determinants of cure and variables associated with the time to event of interest. The aim of this study was to use a cure rate model to determine the clinical associated factors for cure rates of patients with breast cancer (BC). Materials and Methods: This prospective cohort study covered 305 patients with BC, admitted at Shahid Faiazbakhsh Hospital, Tehran, during 2006 to 2008 and followed until April 2012. Cases of patient death were confirmed by telephone contact. For data analysis, a non-mixed cure rate model with Poisson distribution and negative binomial distribution were employed. All analyses were carried out using a developed Macro in WinBugs. Deviance information criteria (DIC) were employed to find the best model. Results: The overall 1-year, 3-year and 5-year relative survival rates were 97%, 89% and 74%. Metastasis and stage of BC were the significant factors, but age was significant only in negative binomial model. The DIC also showed that the negative binomial model had a better fit. Conclusions: This study indicated that, metastasis and stage of BC were identified as the clinical criteria for cure rates. There are limited studies on BC survival which employed these cure rate models to identify the clinical factors associated with cure. These models are better than Cox, in the case of long-term survival.

The Effectiveness of Osteoplasty System (Vertebroplasty using Large Cannula-low Pressure Delivery System) in Compression Fracture and other Spinal Pathology

  • Kang, Jeong-Han;Kuh, Sung-Uk;Shin, Zun-Zae;Cho, Yong-Eun;Yoon, Young-Sul;Chin, Dong-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.38 no.4
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    • pp.259-264
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    • 2005
  • Objective : The vertebroplasty is an excellent procedure in spine compression fracture, but there are some problems such as cement leakage and difficulties in bone biopsy. Recently, the osteoplasty system is developed to solve these problems, so we will report the usefulness of the osteoplasty system. Methods : From January 2003 to November 2003, there are 9patients with simple osteoporotic spine compression fracture, 2 compression fracture patients combined with suspicious spinal metastasis, 1patient with suspicious primary bone tumor, and 2patient with infection on spine. All patients were treated using the osteoplasty system. Results : All 11 compression fracture patients were relived the back pain after the osteoplasty and there is no complication. The bone biopsies in 3 suspicious cancer patients were also effectively performed using the osteoplasty system; negative result in 2patients and positive result in 1patient. The culture result of spontaneous discitis was no growth for 48hours. The spine tuberculosis was confirm using the osteoplasty system. Conclusion : The osteoplasty system has distinguished advantages in comparison with the vertebroplasty. That is, the risk of cement leakage is lower than vertebroplasty because of low pressure delivery system. And we can obtain the specimen effectively in bone biopsy because of large cannula. In conclusion, we emphasize that the osteoplasty system is a more useful procedure in spine compression fracture especially in the patient needed bone biopsy for diagnosis.

Post Pelvic Radiotherapy Bony Changes (골반 방사선 치료후의 골 변화와 손상)

  • Huh, Seung-Jae
    • Radiation Oncology Journal
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    • v.27 no.1
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    • pp.1-9
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    • 2009
  • There has been recent interest in radiation-induced bone injury in clinical conditions, especially for pelvic insufficiency fracture (PIF). A PIF is caused by the effect of normal or physiological stress on bone with demineralization and decreased elastic resistance. Pelvic radiotherapy (RT) can also contribute to the development of a PIF. A PIF has been regarded as a rare complication with the use of megavoltage equipment. However, recent studies have reported the incidence of PIFs as $8.2{\sim}20%$ after pelvic RT in gynecological patients, an incidence that was higher than previously believed. The importance of understanding a PIF lies in the potential for misdiagnosis as a bony metastasis. If patients complain of pelvic pain after whole-pelvis radiation therapy, the presence of a PIF must be considered in the differential diagnosis. The use of multibeam arrangements and conformal RT to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture. In addition to a PIF, osteonecrosis and avascular necrosis of the femoral head can develop after radiation therapy. Osteoradionecrosis of the pelvic bone is a clinical diagnostic challenge that must be differentiated from an osseous metastasis. A post-radiation bone sarcoma can result as a long-term sequela of pelvic irradiation for uterine cervical cancer.

Postoperative radiotherapy in salivary ductal carcinoma: a single institution experience

  • Kim, Tae Hyung;Kim, Mi Sun;Choi, Seo Hee;Suh, Yang Gun;Koh, Yoon Woo;Kim, Se Hun;Choi, Eun Chang;Keum, Ki Chang
    • Radiation Oncology Journal
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    • v.32 no.3
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    • pp.125-131
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    • 2014
  • Purpose: We reviewed treatment outcomes and prognostic factors for patients with salivary ductal carcinoma (SDC) treated with surgery and postoperative radiotherapy from 2005 to 2012. Materials and Methods: A total of 16 patients were identified and 15 eligible patients were included in analysis. Median age was 61 years (range, 40 to 71 years) and 12 patients (80%) were men. Twelve patients (80%) had a tumor in the parotid gland, 9 (60%) had T3 or T4 disease, and 9 (60%) had positive nodal disease. All patients underwent surgery and postoperative radiotherapy. Postoperative radiotherapy was delivered using 3-dimensional conformal radiotherapy or intensity-modulated radiotherapy. Locoregional failure-free survival (LRFFS), distant failure-free survival (DFFS), progression-free survival (PFS), and overall survival (OS) were calculated using the Kaplan-Meier method. Differences in survival based on risk factors were tested using a log-rank test. Results: Median total radiotherapy dose was 60 Gy (range, 52.5 to 63.6 Gy). Four patients received concurrent weekly chemotherapy with cisplatin. Among 10 patients who underwent surgery with neck dissection, 7 received modified radical neck dissection. With a median follow-up time of 38 months (range, 24 to 105 months), 4-year rates were 86% for LRFFS, 51% for DFFS, 46% for PFS, and 93% for OS. Local failure was observed in 2 patients (13%), and distant failure was observed in 7 (47%). The lung was the most common involved site of distant metastasis. Conclusion: Surgery and postoperative radiotherapy in SDC patients resulted in good local control, but high distant metastasis remained a major challenge.

A case of Werner Syndrome Complicated by Bone Metastasis of Rhabdomyosarcoma (횡문근육종의 골전이가 동반된 워너증후군 1례)

  • Song, Joon-Hwan;Sun, Dong-Shin;Kim, Ho;Lee, Yoon-Hee;Hong, Yong-Hee;Lee, Dong-Hwan
    • Journal of Genetic Medicine
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    • v.6 no.1
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    • pp.91-94
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    • 2009
  • Werner syndrome (WRN), or adult progeria, is a very rare, autosomal recessive disorder characterized by the appearance of accelerated aging, including cataracts, gray hair, skin atrophy, and atherosclerosis. This syndrome is caused by mutations in the WRN gene and had a high risk of a spectrum of rare neoplasms including: i) non-epithelial malignant or pre-malignant tumors/conditions, osteosarcomas and soft tissue sarcomas, malignant melanomas, myeloid leukemia and myelodysplastic syndrome; ii) an epithelial neoplasm, thyroid carcinoma, and iii) meningiomas. Recently, authors experienced a case of Werner syndrome complicated by bone metastasis of rhabdomyosarcoma in a 20-year old Korean man. The patient revealed a painful mass on his right knee and progeroid features, short stature, scalp alopecia, abnormal dentition, craniofacial disproportion, hypothyroidsm, cataracts and osteoporosis. The onset of symptoms of Werner syndrome generally precedes any later symptoms of associated conditions, such as malignant tumor. Therefore, early recognition of Werner syndrome is important to assist identification of malignant tumors at an early stage in this patient group.

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Characteristics of Oral Tongue and Base of the Tongue Cancer: A Hospital Cancer Registry Based Analysis

  • Krishnatreya, Manigreeva;Nandy, Pintu;Rahman, Tashnin;Sharma, Jagannath Dev;Das, Anupam;Kataki, Amal Chandra;Das, Ashok Kumar;Das, Rajjjyoti
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1371-1374
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    • 2015
  • Background: Tongue cancer is one of the leading sites of cancer in our population. Aim: To evaluate the socio-demographic profiles and stages at diagnosis of oral tongue (OT) and base of tongue (BT) cancers, and identify any possible variations in characteristics. Materials and Methods: A retrospective analysis was conducted on tongue cancer cases, divided into OT and BT, registered at the hospital cancer registry of North-East India during January 2010 to May 2013. Cases were analyzed for age, gender, residential status and different levels of education for patients, the stage at diagnosis and presence of distant metastasis. Results: A total of 1,113 cases of tongue cancers were registered, 846(76.1%) of BT and 267(23.9%) of OT. While 33.9% of BT cancer patients were above 65 years of age, the figure for OT cancers was 18.4%, stages III and IV accounting for 90.8% and 77%, respectively. The relative risk for distant metastasis in OT cancers was 3.3 (95% CI 1.08-10.1, p=0.03). Conclusions: In the subsites of tongue cancers in our population, the majority arose from the base of tongue, these tending to occur in older individuals and presenting at late stage.

Effect of CXCR4 and CD133 Co-expression on the Prognosis of Patients with Stage II~III Colon Cancer

  • Li, Xiao-Feng;Guo, Xiao-Guang;Yang, Yong-Yan;Liu, Ai-Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1073-1076
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    • 2015
  • Background: To explore the relationship between CXCR4, CD133 co-expression and clinicopathological features as well as prognosis of patients with phase II~III colon cancer. Materials and Methods: Forty-nine paraffin-embedded samples of tumor tissue and epithelial tissue adjacent to cancer were collected from patients with colon cancer undergoing radical surgery in Baotou Cancer Hospital from January, 2010 to June, 2011. CXCR4 and CD133 expression was detected using immunohistochemistry and its relationship with clinicopathological features and the 3-year survival rate was analyzed. Results: In the tumor tissue and colonic epithelial tissue adjacent to cancer, the positive expression rates of CXCR4 were respectively 61.2% (30/49) and 8.16% (4/49), while those of CD133 being 36.7% (18/49) and 6.12% (3/49). CXCR4 and CD133 expression in tumor tissue was not related to patient age, gender, primary focal sites, tumor size, TNM staging, histological type, tumor infiltration depth and presence or absence of lymphatic metastasis, but CXCR4 and CD133 co-expression was associated with TNM staging and lymphatic metastasis. The 3-year survival rate of patients with CXCR4 and CD133 co-expression was 27.3% (3/11), and that of the remainderwas 76.3% (29/38), the difference being significant ($X^2=7.0206$, p=0.0081). Conclusions: CXCR4 and CD133 co-expression may be a risk factor for poor prognosis of patients with stage II~III colon cancer.