• Korean Journal of Head & Neck Oncology
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• v.37 no.2
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• pp.19-24
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• 2021

Background/Objectives: The aim of this national population-based retrospective study was to analyze the status and treatment outcome in patients with hypopharyngeal cancer. Materials & Methods: Participants were included in the KNHIS national sample cohort who received a KNHIS health check-up in 2008 and 2009, and we followed these individuals until 2017. Patients were defined as having hypopharynx cancer if they had admissions records for hypopharynx cancer in their national health insurance data from 2010 to 2017. Results: The study cohort included 3,922 patients. According to our nationwide data, 3,533(90.1%) were male with a median age of 65.03±11.04 years at the time of diagnosis. Among parametric models for hypopharyngeal cancer prognosis, old age (Hazard ratio [HR]:1.92; 95% confidence interval[CI]:1.76-2.09), female (HR:0.77; 95% CI:0.66-0.89), and low socioeconomic status (HR:1.216; 95% CI:1.114-1.327) were significantly associated with survival. Compared with concurrent chemoradiotherapy, patients who received no treatment (HR, 1.88; 95% CI, 1.31-2.70), neoadjuvant chemotherapy followed by surgery (HR, 1.21; 95% CI, 1.04-1.41), and chemotherapy alone (HR, 1.16; 95% CI, 1.03-1.27) showed poor prognosis in hypopharyngeal cancer. Conclusion: Our data indicated that age, sex, and income were significant predictors of lifetime survival in patients with hypopharyngeal cancer. Treatment modalities were also associated with prognosis. The data have implications for treatment investigations and prevention strategies.

• Journal of Trauma and Injury
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• v.20 no.2
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• pp.138-143
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• 2007

Purpose: $S100{\beta}$, a marker of traumatic brain injury (TBI), has been increasingly focused upon during recent years. $S100{\beta}$, is easily measured not only in cerebrospinal fluid (CSF) but also in serum. After TBI, serum S 10019, has been found to be increased at an early stage. The purpose of this study was to evaluate the clinical correlations between serum $S100{\beta}$, and neurologic outcome, and severity in traumatic brain injury. Methods: From August 2006 to October 2006, we made a protocol and studied prospectively 42 patients who visited the emergency room with TBI. Venous blood samples for $S100{\beta}$, protein were taken within six hours after TBI and vital signs, as well as the Glasgow Coma Scale (GCS), were recorded. The final diagnosis and the severity were evaluated using the Abbreviated Injury Score (AIS), and the prognosis of the patients was evaluated using the Glasgow Outcome Score (GOS). Results: Thirty-eight patients showed a favorable prognosis (discharge, recovery, transfer), and four showed an unfavorable prognosis. Serum $S100{\beta}$, was higher in patients with an unfavorable prognosis than in patients with a favorable prognosis, and a significant difference existed between the two groups ($0.74{\pm}1.50\;{\mu}g/L$ vs $7.62{\pm}6.53\;{\mu}g/L$ P=0.002). A negative correlation existed between serum $S100{\beta}$, and the Revised Traumatic Score (R2=-0.34, P=0.03), and a positive correlation existed between serum $S100{\beta}$, and the Injury Severity Score (R2=0.33, P=0.03). Furthermore, the correlation between serum $S100{\beta}$, and the initial GCS and the GCS 24 hours after admission to the ER were negative (R2=-0.62, P<0.001; R2=-0.47, P=0.005). Regarding the GOS, the mean serum concentration of $S100{\beta}$, was $7.62\;{\ss}{\partial}/L$ (SD=${\pm}6.53$) in the expired patients, $1.15\;{\mu}g/L$ in the mildly disable patient, and $0.727\;{\mu}g/L$ (SD=${\pm}0.73$) in the recovered patients. These differences are statistically significant (p<0.001). Conclusion: In traumatic brain injury, a higher level of serum concentration of $S100{\beta}$, has a poor prognosis for neurologic outcome.

• Journal of Chest Surgery
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• v.45 no.2
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• pp.101-109
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• 2012

Background: A better understanding of the histopathology and molecular biology of lung cancer might improve our capability to predict the outcome for any individual patient. The purpose of this study was to evaluate several histopathologic and molecular markers in order to assess their prognostic value in stage I non-small cell lung cancer. Materials and Methods: One hundred ten patients at the Kyungpook National University Hospital were enrolled in the study. Histopathologic factors and molecular markers were selected. Results: Univariate analysis showed that the T stage, differentiation, visceral pleural invasion, and survivin expression were significantly associated with recurrence. Multivariate analysis demonstrated that differentiation and survivin overexpression emerged as independent prognostic factors of recurrence. Conclusion: In resected stage I non-small cell lung cancer, poor differentiation and survivin overexpression have been identified as independent predictors of poor disease-free survival.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.6
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• pp.611-615
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• 2008

The prognosis of oral malignant melanoma is poor compared with cutaneous melanoma. It may be related to the difficulty of wide enough resection, the early hematogenous matastases, higher stage at initial diagnosis, and tendency to growth vertically. In the view of histological differences between oral mucosa and skin, it is impossible use Clark's and Breslow's classifications for prognosis. The great problem is that there is still no consensus on the treatment due to rarity. Because data collection from case reports is considered to be the best source of information and should be pooled to analyze key determinants of outcome, We analysed 6 cases of primary malignant melanoma of the oral cavity which were diagnosed and treated in Pusan National University Hospital on recent 7 years and reviewed the literatures. Immunohistochemical study on S 100 Protein, GP 100 (HMB-45) with biopsy was usable to confirm the melanoma. Three patients who were treated by surgery, chemotherapy are alive, but a patients who couldn't received benefit care surgically due to poor condition was died of distant metastasis, and two patients who refused to surgery are still alive. Neck dissection including wide excision is recommended if lymph node involvement is suspected. Additionally, adjuvant chemotherapy could be considered as supporting therapy for malignant melanoma.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4645-4649
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• 2012

Metaplastic breast carcinoma (MpBC) is a rare disease entity, accounting for less than 1% of all breast carcinomas. Furthermore, it is a heterogenous disease with different subgroups, including malignant epithelial (carcinoma) and stromal (sarcoma) features. Here we evaluated, retrospectively, 14 female MpBC patients admitted to Ankara Oncology Training and Research Hospital between 2005 and 2011. Median age was 45.5 (range:16.0-76.0) and tumor size 57.5 mm (range: 20.0-80.0 mm). Histopathological subtypes were as follows: 5 carcinosarcoma, 5 squamous and 4 adenosquamous carcinoma. All but one with upfront lung metastasis, had their primary breast tumor operated. Axillary lymph nodes were involved in 64.3%. The most common sites of metastasis were lungs and brain. Chemotherapy including antracycline, taxane and even platinium was planned for adjuvant, neoadjuvant and palliative purposes in 9, 3 and 1 patient, respectively. Median cycles of chemotherapy was 6 (range:4-8). Median follow-up of the patients was 52 months (95%CI 10.4-93.6 month). Median 3 year progression free survival (PFS) and overall survival (OS) in this patients cohort were 33% and 56%, respectively. In conclusion, MpBC is a rare and orphan disease without standardized treatment approaches and the prognosis is poor so that larger studies to investigate different treatment schedules are urgently needed.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8351-8359
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• 2014

Background: Recent epidemiological data have implicated human papilloma virus (HPV) infection in the pathogenesis of head and neck cancers, especially oropharyngeal cancers. Although, HPV has been detected in varied amounts in persons with oral dysplasia, leukoplakias and malignancies, its involvement in oral tongue carcinogenesis remains ambiguous. Materials and Methods: HPV DNA prevalence was assessed by PCR with formalin fixed paraffin embedded sections (n=167) of oral tongue squamous cell carcinoma patients and the physical status of the HPV16 DNA was assessed by qPCR. Immunohistochemistry was conducted for p16 evaluation. Results: We found the HPV prevalence in tongue cancers to be 51.2%, HPV 16 being present in 85.2% of the positive cases. A notable finding was a very poor concordance between HPV 16 DNA and p16 IHC findings (kappa<0.2). Further molecular classification of patients based on HPV16 DNA prevalence and p16 overexpression showed that patients with tumours showing p16 overexpression had increased hazard of death (HR=2.395; p=0.005) and disease recurrence (HR=2.581; p=0.002) irrespective of their HPV 16 DNA status. Conclusions: Our study has brought out several key facets which can potentially redefine our understanding of tongue cancer tumorigenesis. It has emphatically shown p16 overexpression to be a single important prognostic variable in defining a high risk group and depicting a poorer prognosis, thus highlighting the need for its routine assessment in tongue cancers. Another significant finding was a very poor concordance between p16 expression and HPV infection suggesting that p16 expression should possibly not be used as a surrogate marker for HPV infection in tongue cancers. Interestingly, the prognostic significance of p16 overexpression is different from that reported in oropharyngeal cancers. The mechanism of HPV independent p16 over expression in oral tongue cancers is possibly a distinct entity and needs to be further studied.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4735-4739
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• 2016

Background: Intrahepatic cholangiocarcinoma (IHCCA) is an aggressive tumor for which surgical resection is a mainstay of treatment. However, recurrence after resection is common associated with a poor prognosis. Studies regarding recurrence of mass-forming IHCCA are rare; therefore, we investigated the pattern with our dataset. Methods: We retrospectively reviewed the medical and pathological records of 50 mass-forming IHCCA patients who underwent hepatic resection between January 2004 and December 2009 in order to determine the patterns of recurrence and prognosis. All demographic and operative parameters were analyzed for their effects on recurrence-free survival. Results: The median recurrence-free survival time was 188 days (95%CI: 149-299). The respective 1-, 2-, and 3-year recurrence-free survival rates were 16.2% (95%CI: 6.6-29.4), 5.4% (95%CI: 1.0-15.8) and 2.7% (95%CI: 0.2-12.0). There was an equal distribution of recurrence at solitary and multiple sites. Univariate analysis revealed no factors related to recurrence-free survival.Conclusion: The overall survival and recurrence-free survival after surgery for mass-forming IHCCA were found to be very poor. Almost all recurrences were detected within 2 years after surgery. Adjuvant chemotherapy after surgery may add benefit in the affected patients.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.2
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• pp.213-218
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• 2020

The loosely structured periodontal ligament and low mineralized bone surrounding erupting teeth provide minimal resistance to an extrusive force. The maxillary central incisors are the most frequently avulsed due to trauma. The prognosis of replanted teeth is affected by extra-alveolar period and conditions. Implant-supported restorations are contraindicated in adolescent patients with poor prognosis traumatized teeth. Autotransplantation of premolar to the anterior region provides a viable treatment alternative. This case report describes the autotransplantation of premolars and esthetic rehabilitation in a teenage patient with traumatized incisors, poor oral hygiene, and severe crowding. Comprehensive and long-term treatments were performed to improve complex and challenging oral problems.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.583-588
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• 2010

Purpose: Angiosarcoma is a tumor of mesenchymal origin with an extremely high rate of metastasis and invasiveness. This tumor is notorious for its very poor prognosis, although surgical excision followed by radiation therapy is considered to be effective by many. The authors experienced three angiosarcoma patients with their tumors removed and wounds covered with split-thickness skin grafts and/or latissimus dorsi free flaps. Methods: Three patients were admitted to our hospital showed plaques of different morphology. Based on their medical records, these patients were classified by sex, age, type of reconstruction, recurrence, and further treatment after surgical removal. Results: All patients were male, with a mean age of 72 years (range, 66 to 77 years). Split-thickness skin grafts with latissimus dorsi free flaps were performed on two cases, and of these two cases, cervical lymph node biopsy was done in one case, and radical neck dissection was done in the other. In all cases, radiation therapy was done within two weeks of tumor removal. Distant metastasis occurred without local recurrence in two of the cases. Lung was the first organ affected by metastasis. In the remaining case, the tumor recurred locally 6 times, and additional excision was necessary. All patients died due to local recurrence and lung metastasis. Conclusion: Irregular margins and high recurrence and metastasis rates cause a poor prognosis in large angiosarcoma of the scalp. Radiotherapy and chemotherapy should be strongly considered in large angiosarcomas.

• Journal of Trauma and Injury
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• v.31 no.1
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• pp.6-11
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• 2018

Purpose: The diagnosis of pelvic fractures pattern has become to be essential in the decision making of treatment modality and reducing morbidity and mortality in multiple trauma patients. Sacroiliac joint (SIJ) disruption can cause life-threatening massive arterial bleeding. This study aimed to determine a method of predicting the prognosis and treatment direction with pelvis X-ray alone in the emergency room. We investigated whether SIJ disruption can be used alone as a poor prognostic factor. Methods: We analyzed the medical records and radiologic examination results of 167 patients with pelvic fractures from January 1, 2015 to December 31, 2016 retrospectively. Patients with pathologic fractures, thoraco-abdominal bleeding, and acetabulum fractures and pediatric patients (n=63) were excluded. Factors related to the clinical manifestations and treatments, such as transfusion and surgery, were statistically compared. Results: The cross-sectional analysis showed that there was no correlation between SIJ injury and sex; there were statistically significant relationships between occurrences of shock, conjoined fractures, transfusion, and surgeries. The hospitalization period and partial thromboplastin time and prothrombin time values increased. The logistic regression analysis showed that when an SIJ injury occurred, blood transfusion and hypotension possibilities increased. Conclusions: When pelvic fractures occur near the SIJ, blood transfusion and shock possibilities increase. Physicians must be aware of the high severity and poor prognosis of such fractures when these are diagnosed in the emergency room. And furthermore, the physician has to predict and prepare the intensive care and multidisciplinary approaches.