Purpose: We evaluated the socio-personal and clinical factors that can affect preoperative quality of life to determine how to improve preoperative quality of life in patients with gastric cancer. Materials and Methods: The preoperative quality of life data of 200 patients (68 females and 132 males; mean age $58.9{\pm}12.6years$) with gastric cancer were analyzed according to socio-personal and clinical factors. The Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core (QLQ) 30 and the EORTC QLQ-STO22, a gastric cancer-specific module, were used to assess quality of life. Patients were asked to complete the questionnaire preoperatively by themselves. Results: Patients with a higher academic background and stage I disease tended to have higher global health status scores. Highly educated younger men had better physical functioning scores. Highly educated and well-nourished patients with stage I cancer had higher role functioning scores. Married patients had better emotional scores. The symptom scales were affected by sex, age, education level, nutrition, and cancer stage. Conclusions: Preoperative quality of life in patients with gastric cancer can be improved by nutritional support and treatment of symptoms caused by disease progression. Psychological support may be helpful for patients with a poor quality of life.
Objective: To assess the safety and effectiveness of thalidomide (produced by CHANGZHOU PHARMACEUTICAL FACTORY CO.LTD) combined with chemotherapy in treating patients with advanced colorectal cancer. Method: A consecutive cohort of pretreated patients with advanced colorectal cancer were treated with thalidomide combined with chemotherapy. And chemotherapy for patients with advanced colorectal cancer were administered according to the condition of patients. Thalidomide was orally administered at a dosage of 50mg/day to 150mg/day before sleeping for at least 14 days. After at least 14 days of treatment, safety and side effects were evaluated. Results: There were 12 female and 3 male patients with advanced cancer recruited into this study, including 9 patients with colon, 6 patients with rectal cancer. The median age of patients was 57(41-82) years. Partial response was observed in 2 patients (2/15), and stable disease in 3 patients(3/15). Incidences of Grade 1 to 2 myelosuppression was observed in 1/15 patients, and Grade 1 to 2 elevation of hepatic enzyme was recorded in 1/15 patients. Adverse effects on the gastrointestinal tract were documented in 1/15 patients, and were Grade 1. No Grade 3-4 toxicities were diagnosed. No treatment related death was found. Conclusions: Thalidomide combined with chemotherapy was safe and mildly effective in treating patients with advanced colorectal cancer. However, further study should be conducted to clarify the effectiveness of this combination.
Purpose: Rectal cancers with high microsatellite-instable have clinical and pathological features that differentiate them from microsatellite-stable or low-frequency carcinomas, which was studied rarely in stage II rectal cancer, promoting the present investigation of the usefulness of microsatellite-instability status as a predictor of the benefit of adjuvant chemotherapy with fluorouracil in stage II rectal cancer. Patients and Methods: Data of 460 patients who underwent primary anterior resection with a double stapling technique for rectal carcinoma at a single institution from 2008 to 2012 were retrospectively collected. All patients experienced a total mesorectal excision (TME) operation. Survival analysis were analyzed using the Cox regression method. Results: Five-year rate of disease-free survival (DFS) was noted in 390 (84.8%) of 460 patients with stage II rectal cancer. Of 460 tissue specimens, 97 (21.1%) exhibited high-frequency microsatellite instability. Median age of the patients was 65 (50-71) and 185 (40.2%) were male. After univariate and multivariate analysis, microsatellite instability (p= 0.001), female sex (p<0.05) and fluorouracil-based adjuvant chemotherapy (p<0.001), the 3 factors were attributed to a favorable survival status independently. Among 201 patients who did not receive adjuvant chemotherapy, those cancers displaying high-frequency microsatellite instability had a better 5-year rate of DFS than tumors exhibiting microsatellite stability or low-frequency instability (HR, 13.61 [95% CI, 1.88 to 99.28]; p= 0.010), while in 259 patients who received adjuvant chemotherapy, there was no DFS difference between the two groups (p= 0.145). Furthermore, patients exhibiting microsatellite stability or low-frequency instability who received adjuvant chemotherapy had a better 5-year rate of DFS than patients did not (HR, 5.16 [95% CI, 2.90 to 9.18]; p<0.001), while patients exhibiting high-frequency microsatellite instability were not connected with increased DFS (p= 0.696). It was implied that female patients had better survival than male. Conclusion: Survival status after anterior resection of rectal carcinoma is related to the microsatellite instability status, adjuvant chemotherapy and gender. Fluorouracil-based adjuvant chemotherapy benefits patients of stage II rectal cancer with microsatellite-stable or low microsatellite-instable, but not those with high microsatellite-instable. Additionally, free of adjuvant chemotherapy, carcinomas with high microsatellite-instable have a better 5-year rate of DFS than those with microsatellite-stable or low microsatellite-instable, and female patients have a better survival as well.
Yoon, Kyong-Ah;Woo, Sang Myung;Kim, Yun-Hee;Kong, Sun-Young;Han, Sung-Sik;Park, Sang-Jae;Lee, Woo Jin
Genomics & Informatics
/
제16권4호
/
pp.35.1-35.3
/
2018
Biliary tract cancer (BTC) is a rare cancer and is associated with a poor prognosis. To understand the genetic characteristics of BTC, we analyzed whole-exome sequencing data and identified somatic mutations in patients with BTC. Tumors and matched blood or normal samples were obtained from seven patients with cholangiocarcinoma who underwent surgical resection. We discovered inactivating mutations of tumor suppressor genes, including APC, TP53, and ARID1A, in three patients. Activating mutations of KRAS and NRAS were also identified. Our analyses identified somatic mutations in Korean patients with BTC.
Objective: To access the safety of chemotherapy for elderly cancer patients complicated with hypertension. Methods: Elderly cancer patients who were complicated with hypertension and treated by chemotherapy were recruited. All patients were treated by chemotherapy after an intervention on hypertension by psychotherapy, exercise guidance, salt regulation and nutrition support, therapy on hypertension, as well as prevention on hypertension associated complications. Results: In 68 eligible patients, two suspended chemotherapy because of adverse reactions and 4 because of disease progression. The remaining 62 patients completed chemotherapy smoothly based on good hypertension control. Conclusion: With effective control of blood pressure, chemotherapy for elderly cancer patients complicated with hypertension is generally safe.
Eom, Bang Wool;Jung, Kyu-Won;Won, Young-Joo;Kim, Young-Woo
Journal of Gastric Cancer
/
제19권1호
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pp.92-101
/
2019
Purpose: The aim of this study was to evaluate the trend of non-compliance with treatment (NCT) among gastric cancer patients in the Korean population. Materials and Methods: Using data from the Korea Central Cancer Registry from 1999 to 2015, patients who did not receive any treatment for gastric cancer within 4 months after diagnosis were defined as the NCT group. The annual incidence rate, distributions according to age group and stage, and 5-year relative survival of the patients exhibiting NCT were analyzed. Results: The number of NCT patients was 5,871 (30.6%) in 1999 and continuously decreased to 4,434 (15.3%) in 2015. Between 2006 and 2015, the proportions of NCT patients decreased from 72.9% to 55.0% among those 80 years old or older and from 9.2% to 5.4% among patients younger than 40 years. In patients with distant metastases, this proportion decreased from 35.5% to 32.7%, and this proportion also decreased from 17.6% to 8.2% among those with localized disease. The 5-year relative survival rates of NCT patients between 2011 and 2015 were significantly lower than those of the treated patients in each stage (60.2% vs. 99.7%, 13.8% vs. 67.1%, and 2.0% vs. 8.3% among those with localized, regional, and distant disease, respectively). Conclusions: The proportion of NCT gastric cancer patients has decreased during the last 16 years. However, considerable numbers of elderly patients are still NCT. There must be a strategy to decrease NCT and improve the nationwide survival rate of patients with gastric cancer.
Objective: To investigate the effect of coenzyme complex on decreasing cardiotoxicity in elderly patients with gastrointestinal cancer who were treated by chemotherapy. Methods: From September 2011 to February 2015, we recruited 54 elderly (with more than 70 years of age) patients with gastrointestinal cancer, with advanced disease. Then treated with chemotherapy combined with or without coenzyme complex. After two cycles of treatment, the effect of coenzyme complex on decreasing cardiotoxicity were evaluated. Results: Chemotherapy was combined with coenzyme complex in 32 patients (22man, 10 woman; median age: 74 years, range: 70-87 years) without coenzyme complex in 22 patients (15man, 7 woman; median age: 73 years, range: 70-80 years) with gastrointestinal cancer. Cardiac event was significantly lower in patients treated with chemotherapy combined with coenzyme complex (p<0.01). Conclusions: Coenzyme Complex decreased cardiotoxicity when combined with chemotherapy in treating elderly patients with gastrointestinal cancer.
Background: Pancreatic cancer risk is increased in patients with type 2 diabetes, while being reduced by metformin treatment. However, it is unclear whether metformin could be associated with clinical outcomes of patients with pancreatic cancer and concurrent type 2 diabetes. Materials and Methods: A pooled analysis of 4 publications including 1,429 patients was performed to investigate the association of metformin and overall survival(OS) in patients with pancreatic cancer and concurrent type 2 diabetes. Results: A borderline significant relative survival benefit was found in metformin treated patients compared with non-metformin treated patients (hazard ratio 0.80; 95% CI: 0.62-1.03). Conclusions: These results suggest that further investigation is warranted of whether metformin may benefit the survival of patients with pancreatic cancer and concurrent type 2 diabetes.
Objective: To investigate the efficacy and side effects of Bifidobacterium tetragenous viable bacteria tablets in treating cancer patients with functional constipation during chemotherapy. Methods: A consecutive cohort of 100 cancer patients with functional constipation were divided into two equal groups: patients in the experimental group were given Bifidobacterium tetragenous viable bacteria tablets combined with chemotherapy, while patients in the control group received chemotherapy alone. After 4 weeks, the efficacy and side effects in treating functional constipation were evaluated. Results: Constipation in 48 patients in experimental group was controlled (9 returned to normal), with a total response rate of 96%, and 1 patient reported diarrhea (2%). In contrast only 16 patients in the control group demonstrated improvement and 34 were still constipated after chemotherapy, with a response rate of 32%. The difference in response rate was statistically significant (P<0.05). Conclusion: This study suggested that Bifidobacterium tetragenous viable bacteria tablets are effective and safe in treating cancer patients with functional constipation during chemotherapy.
Objective: This observational study was to identify risk factors for vulvar cancer recurrence. Materials and Methods: In the study 107 patients with primary vulvar cancer were analyzed. Surgical treatment consisted of radical excision of the primary tumor in combination with unilateral or bilateral superficial and deep inguinofemoral lymphadenectomy through separate incisions. Patients with deeper tumor invasion >1 mm or wider than 2 cm and/or groin lymphnode metastases were referred for adjuvant radiotherapy. Those with large privary vulvar tumors received neoadjuvant radiotherapy of 30Gy followed by surgical treatment and adjuvant radiotherapy. Results: Most of patients had only primary radiotherapy to the vulva and inguinal lymph nodes and only 34.5% of patients were eligible for surgical treatment. In 5 year follow-up period 25.2% (27) patients were alive without the disease, 15.0% (16) were alive with the disease and 59.8% (64) were dead. 60.7% (65) patients experienced local recurrence and 2.8% (3) patients had distant metastases. Median survival for patients without recurrent disease was $38.9{\pm}3.2$ months and $36.0{\pm}2.6$ months with no statistically significant difference. Patients with early stage vulvar cancer had longer mean survival rates-for stage I $53.1{\pm}3.4$ months, $38.4{\pm}4.4$ months for stage II and $33.4{\pm}2.6$ and $15.6{\pm}5.2$ months for patients with stage III and stage IV vulvar cancer, respectively. The only signifficant prognostic factor predicting vulvar cancer recurrence was involvement of the midline. Conclusions: Patients having midline involvement of vulvar cancer has lower recurrence risk, probably because of receiving more aggressive treatment. There is a tendency for lower vulvar cancer recurrence risk for patients over 70 years of age and patients who are receiving radiotherapy as an only treatment without surgery, but tendency for higher risk of recurrence in patients with multifocal vulvar cancer.
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