OBJECTIVE: To assess whether there is an association between improvement of computed tomography imaging results prior to interval debulking with survival in patients treated by neoadjuvant chemotherapy. METHODS: The clinical and outcome data of all advanced ovarian, primary peritoneal and tubal carcinoma patients who after diagnosis had neoadjuvant chemotherapy and underwent interval debulking during the period 2000-2010, were abstracted. Results of computed tomography imaging at diagnosis and prior to interval debulking were compared. Two parameters were assessed: the change of the size and number of abnormal findings and the change in the amount of ascites. CA-125 level response was also calculated. An assessment of progression free survival and of survival by the Kaplan-Meier method was made according to the change in computed tomography imaging results and according to response of CA-125 levels. RESULTS: The median progression free survival and the median survival of the 37 study group patients were 7.9 and 49.2 months respectively. No significant difference in progression free survival and survival was observed between patients with marked improvement in the computed tomography results and those with less desirable results (7.93 vs. 7.23 months respectively, p=0.89; 45.8% vs. 52.5% months respectively, p=0.95). There were also no statistically significant difference according to CA-125 level response. CONCLUSION: It seems that neither improvement in imaging results nor CA-125 level response can predict the survival of ovarian carcinoma patients prior to interval debulking after neoadjuvant chemotherapy.
Ascites ; Disease-Free Survival ; Humans

PURPOSE: Hepatic resection and liver transplantation are considered a curative treatment for hepatocellular carcinoma (HCC) within the Milan criteria. In this study, we examine the outcome of hepatic resection for HCC within the Milan criteria, and determine the effectiveness of hepatic resection as the primary treatment for HCC within the Milan criteria in Child-Pugh class A. METHODS: 110 patients underwent curative surgical resection for HCC in Child-Pugh class A between August 1991 and June 2008. Fifty-six patients met Milan criteria (Group M) and the remaining 54 did not (Group N). RESULTS: Overall survival rates at 1, 3, and 5 years were 92.6%, 72.5% and 54.6% versus 70.4%, 43.1%, and 28.7% in Group M and Group N, respectively (P=0.0043). The corresponding disease-free survival rates were 81.5%, 69.7%, and 38.2% versus 46.0%, 32.9%, and 26.9% in Group M and Group N (P=0.0012). HCC recurred in 25 patients in Group M (44.6%) and 35 patients in Group N (64.8%)(P=0.034). Outcomes of hepatic resection in Group M were significantly better compared to Group N. CONCLUSION: Hepatic resection can achieve a comparable 5-year overall survival & disease-free survival to that reported for liver transplantation. Hepatic resection should be considered as the standard therapy for HCC within the Milan criteria in Child-Pugh class A patients.
Carcinoma, Hepatocellular ; Disease-Free Survival ; Humans ; Liver Transplantation ; Survival Rate

Authors analyzed the results of treatment in 49 cases of medulloblastoma who had been operated upon at the Seoul National University Hospital from January 1972 to June 1987. There were 2 cases(4%) of postoperative mortality(death within postoperative one month) and 13 cases of late moratlity. The 3-year overall survival rate was 49.3% and 3-year disease-free survival rate was 48.5%. The risk period of recurrence was about 2 years after surgery. The 3-year survival rate was significantly better in "grow total resection" group, "radiation dose more than 50 Gy" group, and group II(23 cases operated after July 1982) (p<0.05). The rate of posterior fossa recurrence was lower in "gross total resection" group for the patients who received posterior fossa irradiation of more than 50 Gy.
Disease-Free Survival ; Humans ; Medulloblastoma ; Prognosis* ; Recurrence ; Seoul ; Survival Rate

PURPOSE: We analyzed the clinical outcome of osteosarcoma developed in distal radius and the effect of delayed treatment on prognosis. MATERIALS AND METHODS: Twelve patients with distal radius osteosarcoma were analysed. We categorized patients into two groups of standard treatment or non-standard treatment. The patients of standard treatment group are all stage IIB and non-standard treatment group includes five stage IIB and one stage III. RESULTS: Five-year overall survival and disease-free survival rates of standard treatment group were 100% and 83%. Five-year overall survival rate of non-standard treatment group was 44%. Between two group, there are differences in age, tumor size, surgery type, symptom duration. CONCLUSION: Distal radius osteosarcoma have good prognosis than other extremity osteosarcoma. Survival rate of non-standard treatment group were lower than standard treatment group. Although the prognosis of non standard treatment group is poorer, the duration till death was longer than that of other sites with similar condition. Further multi-institutional study should be needed.
Disease-Free Survival ; Extremities ; Humans ; Osteosarcoma ; Prognosis ; Radius ; Survival Rate

BACKGROUNDS/AIMS: Liver resection is a curative procedure performed worldwide for hepatocellular carcinoma (HCC). Deciding on the appropriate resection range for postoperative hepatic function preservation is an important surgical consideration. This study compares survival outcomes of HCC patients who underwent anatomical or non-anatomical resection, to determine which offers the best clinical survival benefit. METHODS: One hundred and thirty-one patients underwent liver resection with HCC, between January 2007 and February 2015, and were divided into two groups: those who underwent anatomical liver resection (n=88) and those who underwent non-anatomical liver resection (n=43). Kaplan-Meier survival analysis and Cox regressions were used to compare the disease-free survival (DFS) and overall survival (OS) rates between the groups. RESULTS: The mean follow-up periods were 27 and 40 months in the anatomical and non-anatomical groups, respectively (p=0.229). The 3- and 5-year DFS rates were 70% and 60% in the anatomical group and 62% and 48% in the non-anatomical group, respectively. The 3 and 5-year OS rates were 94% and 78% in the anatomical group, and 86% and 80% in the non-anatomical group, respectively. The anatomical group tended to show better outcomes, but the findings were not significant. However, a relative risk of OS between the anatomical and non-anatomical group was 0.234 (95% CI, 0.061-0.896; p=0.034), which is statistically significant. CONCLUSIONS: Although statistical significance was not detected in survival curves, anatomical resection showed better results. In this respect, anatomical resection is more likely to perform in HCC patients with preserve liver function than non-anatomical resection.
Carcinoma, Hepatocellular* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Liver

PURPOSE: The purpose of this study was to investigate the clinical features of epithelial ovarian cancer (EOC) patients according to BRCA1/2 mutation status (mutation, variant of uncertain significance [VUS], or wild type). MATERIALS AND METHODS: We analyzed 116 patients whose BRCA1/2 genetic test results were available for mutation type and clinical features, including progression-free survival (PFS), overall survival (OS), and response rate. These characteristics were compared according to BRCA1/2 mutation status. RESULTS: Thirty-seven (37/116, 31.9%) BRCA1/2mutations were identified (BRCA1, 30; BRCA2, 7). Mutation of c.3627_3628insA (p.Leu1209_Glu1210?fs) in BRCA1 was observed in five patients (5/37, 13.5%). Twenty-five patients had BRCA1/2 VUSs (25/116, 21.6%). Personal histories of breast cancer were observed in 48.6% of patients with BRCA1/2 mutation (18/37), 16.0% of patients with BRCA1/2 VUS (4/25), and 7.4% of patients with BRCA wild type (4/54) (p < 0.001). Patients with BRCA1/2 mutation showed longer OS than those with BRCA1/2 wild type (p=0.005). No significant differences were detected in PFS, OS, or response rates between patients with BRCA1/2 VUS and BRCA1/2 mutation (p=0.772, p=0.459, and p=0.898, respectively). CONCLUSION: Patientswith BRCA1/2 mutation had longer OS than thosewith BRCA1/2wild type. Patients with BRCA1/2 mutation and BRCA1/2 VUS displayed similar prognoses.
Breast Neoplasms ; Disease-Free Survival ; Humans ; Ovarian Neoplasms* ; Prognosis

PURPOSE: To evaluate the role of postoperative radiotherapy in the management of primary or recurrent intracranial meningiomas. METHODS AND MATERIALS: A retrospective review of 34 intracranial meningioma patients referred to the Yonsei Cancer Center for postoperative radiotherapy between 1981 and 1990 was undertaken. Of the 34 patients, 24 patients received elective postoperative radiotherapy after total or subtotal resection(Group 1), and 10 patients received postoperative radiotherapy as a salvage treatment for recurrent tumors(Group 2). Ten patients received postoperative radiotherapy after total resection, and twenty-four after subtotal resection. Ten patients who had total tumor resection were referred for radiotherapy either because of angioblastic or malignant histologic type (4 patients in Group 1) or because of recurrent disease after initial surgery(6 patients in Group 2). Radiation dose of 50-56Gy was delivered over a period of 5-5.5 weeks using 4MV LINAC or Co-60 teletherapy unit. RESULTS: Overall actuarial progression free survival (PFS) at 5 years was 80%. Survival was most likely affected by histologic subtypes. Five year PFS rate was 52% for benign angioblastic histology, as compared with 100% for classic benign histology. For malignant meningiomas, 5 year PFS rate was 44%. The recurrence rates of classic, angioblastic, and malignant type were 5%(1/21), 80%(4/5), and 50%(4/8), respectively. The duration between salvage post-operative radiotherapy and recurrence was longer than the duration between initial surgery and recurrence in the patients of group 2 with angioblastic or malignant histology. CONCLUSION: Postoperative radiotherapy of primary or recurrent intracranial meningiomas appears to be effective modality, especially in the patients with classic meningiomas. In angioblastic or malignant histologies, a more effective approach seems to be needed for decreasing recurrence rate.
Disease-Free Survival ; Humans ; Meningioma* ; Radiotherapy* ; Recurrence ; Retrospective Studies

PURPOSE: To evaluate the correlation between serum methotrexate (MTX) peak levels and clinical outcome of osteosarcoma, as well as to determine the correlation of these levels with the histologic response and event-free survival (EFS). METHODS: To maintain the homogeneity of the study population, we selected 52 patients with localized extremity osteosarcoma who had received two cycles of neoadjuvant chemotherapy consisting of high-dose (HD) MTX (12 g/m2), cisplatin (100 mg/m2), and doxorubicin (60 mg/m2). RESULTS: Totally, 204 courses of HD MTX were administered. The serial MTX levels (mean+/-SE) at 4 h (peak), 24 h, 48 h, and 72 h were 1292.14+/-12.83 micrometer, 9.29+/-3.89 micrometer, 1.73+/-1.37 micrometer, and 0.58+/-0.44 micrometer, respectively. The peak MTX serum level was 1292.14+/-12.83 micrometer. Neither the continuous average MTX peak level nor the dichotomized MTX peak level was related to the histologic response. However, the patients with a high 24-h MTX level (3.4 micrometer) had a poor histologic response (P=0.044). An inverse relationship was observed between MTX levels and survival: the EFS was better in the patients with a mean MTX peak level of less than 1,400 micrometer (P=0.002) and mean 24-h MTX level of less than 3.4 micrometer (P=0.011). CONCLUSION: The inverse correlation between the MTX level and the outcome is an unexpected finding. Further study on the pharmacokinetics of MTX is required to substantiate our findings and elucidate the mechanism involved.
Cisplatin ; Disease-Free Survival ; Doxorubicin ; Extremities ; Humans ; Methotrexate ; Osteosarcoma

PURPOSE: To evaluate the correlation between serum methotrexate (MTX) peak levels and clinical outcome of osteosarcoma, as well as to determine the correlation of these levels with the histologic response and event-free survival (EFS). METHODS: To maintain the homogeneity of the study population, we selected 52 patients with localized extremity osteosarcoma who had received two cycles of neoadjuvant chemotherapy consisting of high-dose (HD) MTX (12 g/m2), cisplatin (100 mg/m2), and doxorubicin (60 mg/m2). RESULTS: Totally, 204 courses of HD MTX were administered. The serial MTX levels (mean+/-SE) at 4 h (peak), 24 h, 48 h, and 72 h were 1292.14+/-12.83 micrometer, 9.29+/-3.89 micrometer, 1.73+/-1.37 micrometer, and 0.58+/-0.44 micrometer, respectively. The peak MTX serum level was 1292.14+/-12.83 micrometer. Neither the continuous average MTX peak level nor the dichotomized MTX peak level was related to the histologic response. However, the patients with a high 24-h MTX level (3.4 micrometer) had a poor histologic response (P=0.044). An inverse relationship was observed between MTX levels and survival: the EFS was better in the patients with a mean MTX peak level of less than 1,400 micrometer (P=0.002) and mean 24-h MTX level of less than 3.4 micrometer (P=0.011). CONCLUSION: The inverse correlation between the MTX level and the outcome is an unexpected finding. Further study on the pharmacokinetics of MTX is required to substantiate our findings and elucidate the mechanism involved.
Cisplatin ; Disease-Free Survival ; Doxorubicin ; Extremities ; Humans ; Methotrexate ; Osteosarcoma

BACKGROUND: Chromophobe renal cell carcinoma is a category of renal cell carcinoma composed of histologically characteristic tumor cells. E-cadherin is an intercellular adhesion protein that has been correlated with tumor aggressiveness in many carcinomas, including clear cell renal cell carcinoma. However, the significance of an E-cadherin expression in chromophobe renal cell carcinoma is not known. METHODS: We evaluated the E-cadherin expression status of 65 chromophobe renal cell carcinomas by performing immunohistochemical staining with the tissue microarray method. The percentage of positively stained tumor cells was evaluated and this was then classified into two categories: a low expression where 0 to 25% of the cells are positive, and a high expression where more than 25% of the cells are positive. RESULTS: Among 65 cases, 11 cases (17%) showed a low expression, and 54 cases (83.0%) showed a high expression. The tumors with low expression were more likely to have a higher stage but this was not significant (p=0.056). On the survival analysis, a low E-cadherin expression was significantly associated with poor cancer-specific survival (p=0.005) and progression-free survival (p=0.003). CONCLUSIONS: The E-cadherin expression is a good prognostic marker for survival in patients with chromophobe renal cell carcinoma.
Cadherins ; Carcinoma, Renal Cell ; Disease-Free Survival ; Humans ; Immunohistochemistry