• Journal of Korean Traditional Oncology
• /
• v.28 no.1
• /
• pp.45-53
• /
• 2023

Objectives: To report the reduction of adverse effects of chemotherapy and improvement in the quality of life in recurrent liver metastasis by Korean medicine treatments. Methods: In 2018, a 75-year-old male patient underwent surgery for primary cancer in the ampulla of Vater. In 2021, he was diagnosed with recurrent liver metastasis. Following the failure of tumor treatment with gemcitabine/cisplatin and the development of severe side effects, he decided to discontinue chemotherapy. Subsequently, with a significantly enlarged liver tumor, he resumed capecitabine/oxaliplatin treatment, alongside moxibustion, acupuncture, and herbal prescriptions from August 2021 to August 2023. The changes of chief complaints, abdominal CT, and laboratory findings were investigated. Results: After combined treatment of Korean traditional medicine and chemotherapy, the mass was decreased. Laboratory findings, and chief complaints of hand-foot syndrome, fatigue, abdominal distension, nausea and anorexia were improved. Conclustions: This case study suggests that Korean traditional medicine is effective in enhancing anticancer effects, suppressing the side effects of chemotherapy, and improving general conditions.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.11
• /
• pp.6227-6231
• /
• 2013

In the past, hepatitis B virus (HBV) infection was endemic in the general Korean population. The association of HBV infection with the occurrence of liver cancer has been well demonstrated in several epidemiologic studies. While the mortality rates of liver cancer in Korea have decreased steadily over the last decade, the presence of hepatitis B surface antigen (HBsAg) in mothers remains high at 3-4%, and 25.5% of these HBsAg positive mothers are positive for hepatitis B e antigen (HBeAg). HBV infection caused almost a quarter of hepatocellular carcinoma (HCC) cases and one-third of deaths from HCC. These aspects of HBV infection prompted the Korean government to create a vaccination program against HBV in the early 1980s. In 1995, the Communicable Disease Prevention Act (CDPA) was reformed, and the government increased the number of HBV vaccines in the National Immunization Program (NIP), driving the vaccination rate up to 95%. In 2000, the National Health Insurance Act (NHIA) was enacted, which provided increased resources for the prevention of perinatal HBV infection. Then in 2002, the Korean government, in conjunction with the Korean Medical Association (KMA), launched an HBV perinatal transmission prevention program. The prevalence of HBsAg in children had been high (4-5%) in the early 1980s, but had dropped to below 1% in 1995, and finally reached 0.2% in 2006 after the NIP had been implemented. After the success of the NIP, Korea finally obtained its first certification of achievement from the Western Pacific Regional Office of the World Health Organization (WPRO-WHO) for reaching its goal for HBV control. An age-period-cohort analysis showed a significant reduction in the liver cancer mortality rate in children and adolescents after the NIP had been implemented. In addition to its vaccination efforts, Korea launched the National Cancer Screening Program (NCSP) for 5 leading sites of cancer, including the liver, in 1999. As a consequence of this program, the 5-year liver cancer survival rate increased from 13.2% (1996-2000) to 23.3% (2003-2008). The development of both the primary and secondary prevention for liver cancer including HBV immunization and cancer screening has been of critical importance.

• Journal of Preventive Medicine and Public Health
• /
• v.27 no.4 s.48
• /
• pp.735-745
• /
• 1994

The incidence data (1991. 7. 1$\sim$1992. 6. 30) from the Implementation Study of Seoul Cancer Registry (ISSCR) were evaluated in terms of its completeness and validity. Two indicators for the completeness, Mortality/Incidence ratio (M/I ratio) and Age-specific Incidence Curve, showed fairy good registration throughout the age-sex specific strata, except the strata aged over 75 years old. The strata had very high M/I ratio (over 100%) and decreasing pattern of incidence, which suggested incomplete registration of cancer in this group. The active surveillance by a ISSCR staff improved the registration rate especially among elderlies. From the site specific M/I ratio, we found that liver cancer had oddly high M/I ratio. Since this high M/I ratio of liver cancer appears consistently in other reliable cancer registries, it is more like to be due to the high fatality of it rather than incomplete registration. The validity of the incidence data was assessed by three indicators; Histological Verification (HV%), Primary Site Unknown (PSU%), and Age Unknown (Age UNK%). The average HV% were 77% for men and 85% for women, which were slightly lower than those of other reliable cancer registries. This low HV% might be due to the considerable size of relative frequency of liver cancer in Korea, regarding the fact that the diagnosis of liver cancer is made mostly by non-biopsical radiologic methods (CT, Ultrasono, Angiography, MRI etc.). The level of PSU% and Age UNK% were in acceptable range, but not low enough, especially in terms of Age UNK%. Although ISSCR data had acceptable quality in general, it is needed to have more hospitals participate in the registry surveillance, to make registery data merged with death certificate data regulary, and educate the registration stans to be more competent and dedicated.

• Journal of Gastric Cancer
• /
• v.1 no.3
• /
• pp.136-143
• /
• 2001

Purpose: The prognosis for gastric cancer with peritoneal seeding is very poor, and the role of surgical intervention is limited. We evaluated the effect of radical removal of primary and metastatic lesions on survival in gastric cancer with peritoneal seeding. Materials and Methods: From May 1989 to March 1999 at Kosin University Gospel Hospital, 115 patients revealed gastric cancer with peritoneal seeding but without liver or lung metastasis and without follow-up loss. The study group included 86 patients who underwent surgery for radical removal of primary gastric and metastatic peritoneal lesions. The control group included 29 patients who experienced incomplete removal of primary or metastatic lesions. Both groups received intraoperative intraperitoneal chemotherapy using mytomycin or cisplatin, and 25 patients underwent postoperative intravenous chemotherapy. Results: The median survival times in the study and the control groups were 13 months and 4 months, respectively (p<0.0001). The 1-year, 2-year, and 5-year survival rates were, respectively, $50.6\%,\;18.1\%$, and $11.3\%$ in the study group and $14.8\%,\;3.7\%$ and $0\%$ in the control group (p<0.0001). In the study group, neither postoperative intravenous chemotherapy nor microscopic invasion of the resection margin had any effect on survival, but intraoperative intraperitoneal chemotherapy and degree of peri-toneal seeding, especially the amount of peritoneal seeding, had an effect on survival. In the control group, neither intraperitoneal nor intravenous chemotherapy had any effect on survival, but resection of the primary gastric lesion improved survival. Conclusion: Radical removal of primary gastric and metastatic peritoneal lesions improved the survival rate for gastric cancer with peritoneal seeding. However, a randomized prospective study is needed to correctly evaluate the effect of intraperitoneal or intravenous chemotherapy.

• The Korean Journal of Cytopathology
• /
• v.3 no.2
• /
• pp.100-103
• /
• 1992

We experienced a case of primary hepatic actinomycosis which was initially diagnosed by means of fine needle aspiration. The patient was a 31-year-old emaciated man with a 2-month history of 10 kg weight loss, right upper quadrant pain and flank pain. The liver was palpable and tender on physical examination. Computerized tomography scan of the liver showed two ill-defined hypodense masses in gallbladder fossa and inferior pole of right lobe. Hepatocellular carcinoma was clinically suspected. A CT-guided fine needle aspiration was peformed. Microscopically, smears showed numerous radiating clusters of filamentous bacteria with many neutrophils and monocytes in necrotic background. The symptoms were improved by incision and drainage and massive administration of penicillin.

• Journal of Digestive Cancer Research
• /
• v.1 no.1
• /
• pp.43-47
• /
• 2013

There have been very few reports related to pancreatic cancer developing in the remnant pancreas after a resection for pancreatic cancer. We report two cases of repeated pancreatectomy for second primary pancreatic cancer. A 58-year-old man with a 2.3 cm sized low attenuated pancreatic tail mass on abdomen CT scan, received a distal pancreatectomy (adenosquamous carcinoma, stage IIB) and adjuvant chemoradiotherapy. A follow-up abdomen CT scan revealed a 2.0 cm sized pancreatic head mass in the remnant pancreas at 35 months after the distal pancreatectomy. He received a pancreaticoduodenectomy and diagnosed as ductal adenocarcinoma (stage IIA). Another 62-year-old female was declared pancreatic head mass on a regular health examination. An abdomen CT scan revealed a 3.6 cm sized mixed solid and cystic mass. She received a pylorus-preserving pancreaticoduodenectomy (ductal adenocarcinoma, stage IB) and adjuvant chemoradiation therapy. At 20 months after the resection, a 1.8 cm sized ill-defined low attenuated mass developing in the tail of remnant pancreas was detected on a follow-up abdomen CT scan. The patient received a distal pancreatectomy and diagnosed as ductal adenocarcinoma (stage IIA).

• The Korean Journal of Physiology and Pharmacology
• /
• v.17 no.5
• /
• pp.375-383
• /
• 2013

Hepatocellular carcinoma (HCC) related to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections is thought to account for more than 80% of primary liver cancers. Both HBV and HCV can establish chronic liver inflammatory infections, altering hepatocyte and liver physiology with potential liver disease progression and HCC development. Cyclophilin A (CypA) has been identified as an essential host factor for the HCV replication by physically interacting with the HCV non structural protein NS5A that in turn interacts with RNA-dependent RNA polymerase NS5B. CypA, a cytosolic binding protein of the immunosuppressive drug cyclosporine A, is overexpressed in many cancer types and often associated with malignant transformation. Therefore, CypA can be a good target for molecular cancer therapy. Because of antiviral activity, the CypA inhibitors have been tested for the treatment of chronic hepatitis C. Nonimmunosuppressive Cyp inhibitors such as NIM811, SCY-635, and Alisporivir have attracted more interests for appropriating CypA for antiviral chemotherapeutic target on HCV infection. This review describes CypA inhibitors as a potential HCC treatment tool that is contrived by their obstructing chronic HCV infection and summarizes roles of CypA in cancer development.

• The Korean Journal of Nuclear Medicine
• /
• v.36 no.6
• /
• pp.368-380
• /
• 2002

Purpose: Liver transplantation (LT), one of the therapeutic options of primary liver cancer has been suffering from recurrence caused by metastasis in 8-54% of patients. This study was performed to investigate whether FDG-PET is useful for detecting hidden metastasis in LT candidates. Materials and Methods: Twenty-six patients (male:female=23:3, mean age 55.7 years) underwent FDG-PET. Their previous conventional diagnostic studies (CDS) like abdomen US and CT, chest x-ray and CT, and bone scan were negative (n=22) or equivocal (n=4) for metastasis. Positive FDG-PET findings were confirmed by biopsy or clinical follow-up. Results: Among 4 patients with equivocal metastatic lesions on CDS, 3 had 6 hypermetabolic lesions on FDG-PET, which were confirmed as metastasis and subsequently LTs were cancelled. Of these, 5 lesions were initially negative on CDS. Remained 1 patient underwent LT with a negative FDG-PET result. Among 22 patients without metastasis on CDS, 5 had 7 hypermetabolic lesions on FDG-PET. One of these patients proved to have 2 metastatic lesions, and LT was cancelled. The other 4 patients had S hypermetabolic lesions on FDG-PET, which were confirmed as benign lesions, and 3 patients of them underwent LT. In summary, FDG-PET was useful in avoiding 4 unwarranted LT by detecting unsuspected metastatic lesions on CDS. A total of 17 patients underwent LT. In comparison with pathology, the sensitivity and specificity of FDG-PET for detecting viable primary liver cancer were 55.6% (5/9) and 87.5% (7/8), respectively. Conclusion: FDG-PET can detect additional hidden metastasis and contribute to reducing unwarranted LT in the patients with primary liver cancer.

• Radiation Oncology Journal
• /
• v.11 no.1
• /
• pp.103-108
• /
• 1993

Among the patients with rectal cancer who entered Yonsei University Hospital for management from Jan. 1980 to Dec. 1990, we selected 23 subjects who were received surgical resection of tumor in rectum, and who proved to have liver metastasis during the diagnostic work-up, at the time of the operation, or within 3 months after starting definitive treatment. With those subjects, we investigated the role of radiation therapy by comparison of the treatment results of the patients without radiation therapy (S group) with those of the patients with radiation therapy to the primary site (S+R group). The local control rates of S group and S+R group were $64{\%}$ and $89{\%}$, and 2-year survival rates were $50{\%}$ and $78{\%}$, respectively. Although there was not statistically meaningful difference, local control rate and 2-year survival rate were higher in the group with radiation therapy to primary site than that without radiation therapy. The 2-year survival rates of the case with resection of the liver and the case without it were $63.6{\%}$ and $58.3{\%}$ respectively, which was not statistically significant. Also, the 2-year survival rate of the case with sustained local control was higher than that of the case with local failure, which was statistically significant ($76.5{\%}$ and $16.7{\%}$, p<0.005). From the above results, it is thought that radiation therapy to the primary site might improve the local control rate even in the patients with liver metastasis, which seems to be correlated to the higher survival rate.

• The Korean Journal of Cytopathology
• /
• v.2 no.2
• /
• pp.90-97
• /
• 1991

Liver is generally known as an organ which is most commonly involved by the metastic tumors. According to the tendency of using fine needle aspiration in the diagnosis of hepatic tumors, the differentital diagnosis between hepatocellular carcinoma and metastatic carcinoma frequently has been a main issue in the poorly differentitated cases, especially to the pathologists of Korea, an endemic area of hepatocellular carcinoma. Until now the problem has been usually solved by the comparison of cytologic characteristics of their tumor cells but not by background cytologic features which rarely have been studied. We observed the background cytologic features helpful for the differential diagnosis through the analysis of 20 cases who had confirmed primary cancer and were diagnosed as metastatic carcinomas in the liver by fine needle aspiration cytology. Twenty cases included 9 adenocarcinomas, 7 spuamous cell carcinomas, 1 small cell carcinoma, 1 carcinoid, 1 adenoid cystic carcinoma, and 1 renal cell cacinoma. Analysis of background cytologic features revealed that 77% of adenocacinoma cases showed benign mesenchymal components and hepatocytes and spuamous cell carcinoma cases disclosed benign mesenchymal tissue (71%) and necrosis (57%), Remaining cases showed variable combinations of benign mesenchymal component, necrosis, hepatocytes, and bile duct epithelial cells. No case revealed atypical hepatocytic naked nuclei, a useful cytologic finding of hepatocellular carcinoma. In summary, the background cytologic features more commonly observed in metastatic carcinomas than in the hepatocellular carcinoma were benign mesenchymal components, hepatocytes, necrosis, and bile duct epithelium. The endothelial cells and hepatocytic naked nuclei, two relatively specific findings of hepatocellular carcinoma were not observed except for renal ceil carcinoma. Above background cytologic features are thought to be helpful for the differential diagnosis between the hepatocellular carcinoma and various metastatic carcinomas in the poorly differentiated cases.