1.Risk Factors for Emergency Room Visits Among Patients With Head and Neck Cancer: A Longitudinal Cohort Study Within the Korean Healthcare System
Heejun YI ; Hyojun KIM ; Younghac KIM ; Ye-Jin SUH ; Joo Hyun PARK ; Nayeon CHOI ; Han-Sin JEONG
Clinical and Experimental Otorhinolaryngology 2025;18(1):64-72
Objectives:
. A substantial proportion of patients with head and neck cancer (HNC) require emergency room (ER) visits or unplanned hospitalizations during or after treatment with various modalities. We investigated HNC cases that necessitated ER visitation after cancer treatment, aiming to identify potential risk factors in the context of the Korean healthcare system.
Methods:
. This single-center cohort study examined patients with HNC who received cancer treatments at Samsung Medical Center in 2019 (n=566). Treatment modalities included surgery alone (n=184), surgery and adjuvant therapy (n=138), curative non-surgical treatment such as radiation or chemoradiation (n=209), and palliative treatments (n=35). We followed these cases for up to 3 years, focusing on those who visited the ER during or after cancer treatment, and analyzed the primary reasons and risk factors associated with these visits.
Results:
. The ER visitation rate was 8.0% (n=45) among patients with HNC, with a total of 70 ER visits (12.4%; mean, 1.56; range, 1–4). The rate of treatment-related ER visitation was 4.6%. Common reasons for ER visits included surgical site or wound complications (31.1% of patients visiting the ER, 22.9% of ER visits) and issues with oral intake or feeding (22.2% of patients, 31.4% of visits). Significant risk factors for ER visits included tumor subsite (with hypopharyngeal cancer associated with a 17.9% rate of treatment-related ER visits), tumor stage (T2–4, 8.6%–12.2%; N+ status, 6.7%), and treatment modality (surgery with adjuvant chemoradiation, 19.4%). Patient age and comorbidities did not represent significant factors.
Conclusion
. The most frequent reasons for ER visits among patients with HNC included complications with wounds and feeding. Additionally, tumor characteristics and treatment modality were independent risk factors for ER visits. Adequate planning and management to address these issues could potentially decrease the number of ER visits, lower costs, and improve patient care.
2.Prognostic Evaluation and Survival Prediction for Combined Hepatocellular-Cholangiocarcinoma Following Hepatectomy
Seok-Joo CHUN ; Yu Jung JUNG ; YoungRok CHOI ; Nam-Joon YI ; Kwang-Woong LEE ; Kyung-Suk SUH ; Kyoung Bun LEE ; Hyun-Cheol KANG ; Eui Kyu CHIE ; Kyung Su KIM
Cancer Research and Treatment 2025;57(1):229-239
Purpose:
This study aimed to assess prognostic factors associated with combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and to predict 5-year survival based on these factors.
Materials and Methods:
Patients who underwent definitive hepatectomy from 2006 to 2022 at a single institution was retrospectively analyzed. Inclusion criteria involved a pathologically confirmed diagnosis of cHCC-CCA.
Results:
A total of 80 patients with diagnosed cHCC-CCA were included in the analysis. The median progression-free survival was 15.6 months, while distant metastasis-free survival (DMFS), hepatic progression-free survival, and overall survival (OS) were 50.8, 21.5, and 85.1 months, respectively. In 52 cases of recurrence, intrahepatic recurrence was the most common initial recurrence (34/52), with distant metastasis in 17 cases. Factors associated with poor DMFS included tumor necrosis, lymphovascular invasion (LVI), perineural invasion, and histologic compact type. Postoperative carbohydrate antigen 19-9, tumor necrosis, LVI, and close/positive margin were associated with poor OS. LVI emerged as a key factor affecting both DMFS and OS, with a 5-year OS of 93.3% for patients without LVI compared to 35.8% with LVI. Based on these factors, a nomogram predicting 3-year and 5-year DMFS and OS was developed, demonstrating high concordance with actual survival in the cohort (Harrell C-index 0.809 for OS, 0.801 for DMFS, respectively).
Conclusion
The prognosis of cHCC-CCA is notably poor when combined with LVI. Given the significant impact of adverse features, accurate outcome prediction is crucial. Moreover, consideration of adjuvant therapy may be warranted for patients exhibiting poor survival and increased risk of local recurrence or distant metastasis.
3.Risk Factors for Emergency Room Visits Among Patients With Head and Neck Cancer: A Longitudinal Cohort Study Within the Korean Healthcare System
Heejun YI ; Hyojun KIM ; Younghac KIM ; Ye-Jin SUH ; Joo Hyun PARK ; Nayeon CHOI ; Han-Sin JEONG
Clinical and Experimental Otorhinolaryngology 2025;18(1):64-72
Objectives:
. A substantial proportion of patients with head and neck cancer (HNC) require emergency room (ER) visits or unplanned hospitalizations during or after treatment with various modalities. We investigated HNC cases that necessitated ER visitation after cancer treatment, aiming to identify potential risk factors in the context of the Korean healthcare system.
Methods:
. This single-center cohort study examined patients with HNC who received cancer treatments at Samsung Medical Center in 2019 (n=566). Treatment modalities included surgery alone (n=184), surgery and adjuvant therapy (n=138), curative non-surgical treatment such as radiation or chemoradiation (n=209), and palliative treatments (n=35). We followed these cases for up to 3 years, focusing on those who visited the ER during or after cancer treatment, and analyzed the primary reasons and risk factors associated with these visits.
Results:
. The ER visitation rate was 8.0% (n=45) among patients with HNC, with a total of 70 ER visits (12.4%; mean, 1.56; range, 1–4). The rate of treatment-related ER visitation was 4.6%. Common reasons for ER visits included surgical site or wound complications (31.1% of patients visiting the ER, 22.9% of ER visits) and issues with oral intake or feeding (22.2% of patients, 31.4% of visits). Significant risk factors for ER visits included tumor subsite (with hypopharyngeal cancer associated with a 17.9% rate of treatment-related ER visits), tumor stage (T2–4, 8.6%–12.2%; N+ status, 6.7%), and treatment modality (surgery with adjuvant chemoradiation, 19.4%). Patient age and comorbidities did not represent significant factors.
Conclusion
. The most frequent reasons for ER visits among patients with HNC included complications with wounds and feeding. Additionally, tumor characteristics and treatment modality were independent risk factors for ER visits. Adequate planning and management to address these issues could potentially decrease the number of ER visits, lower costs, and improve patient care.
4.Prognostic Evaluation and Survival Prediction for Combined Hepatocellular-Cholangiocarcinoma Following Hepatectomy
Seok-Joo CHUN ; Yu Jung JUNG ; YoungRok CHOI ; Nam-Joon YI ; Kwang-Woong LEE ; Kyung-Suk SUH ; Kyoung Bun LEE ; Hyun-Cheol KANG ; Eui Kyu CHIE ; Kyung Su KIM
Cancer Research and Treatment 2025;57(1):229-239
Purpose:
This study aimed to assess prognostic factors associated with combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and to predict 5-year survival based on these factors.
Materials and Methods:
Patients who underwent definitive hepatectomy from 2006 to 2022 at a single institution was retrospectively analyzed. Inclusion criteria involved a pathologically confirmed diagnosis of cHCC-CCA.
Results:
A total of 80 patients with diagnosed cHCC-CCA were included in the analysis. The median progression-free survival was 15.6 months, while distant metastasis-free survival (DMFS), hepatic progression-free survival, and overall survival (OS) were 50.8, 21.5, and 85.1 months, respectively. In 52 cases of recurrence, intrahepatic recurrence was the most common initial recurrence (34/52), with distant metastasis in 17 cases. Factors associated with poor DMFS included tumor necrosis, lymphovascular invasion (LVI), perineural invasion, and histologic compact type. Postoperative carbohydrate antigen 19-9, tumor necrosis, LVI, and close/positive margin were associated with poor OS. LVI emerged as a key factor affecting both DMFS and OS, with a 5-year OS of 93.3% for patients without LVI compared to 35.8% with LVI. Based on these factors, a nomogram predicting 3-year and 5-year DMFS and OS was developed, demonstrating high concordance with actual survival in the cohort (Harrell C-index 0.809 for OS, 0.801 for DMFS, respectively).
Conclusion
The prognosis of cHCC-CCA is notably poor when combined with LVI. Given the significant impact of adverse features, accurate outcome prediction is crucial. Moreover, consideration of adjuvant therapy may be warranted for patients exhibiting poor survival and increased risk of local recurrence or distant metastasis.
5.Prognostic Evaluation and Survival Prediction for Combined Hepatocellular-Cholangiocarcinoma Following Hepatectomy
Seok-Joo CHUN ; Yu Jung JUNG ; YoungRok CHOI ; Nam-Joon YI ; Kwang-Woong LEE ; Kyung-Suk SUH ; Kyoung Bun LEE ; Hyun-Cheol KANG ; Eui Kyu CHIE ; Kyung Su KIM
Cancer Research and Treatment 2025;57(1):229-239
Purpose:
This study aimed to assess prognostic factors associated with combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and to predict 5-year survival based on these factors.
Materials and Methods:
Patients who underwent definitive hepatectomy from 2006 to 2022 at a single institution was retrospectively analyzed. Inclusion criteria involved a pathologically confirmed diagnosis of cHCC-CCA.
Results:
A total of 80 patients with diagnosed cHCC-CCA were included in the analysis. The median progression-free survival was 15.6 months, while distant metastasis-free survival (DMFS), hepatic progression-free survival, and overall survival (OS) were 50.8, 21.5, and 85.1 months, respectively. In 52 cases of recurrence, intrahepatic recurrence was the most common initial recurrence (34/52), with distant metastasis in 17 cases. Factors associated with poor DMFS included tumor necrosis, lymphovascular invasion (LVI), perineural invasion, and histologic compact type. Postoperative carbohydrate antigen 19-9, tumor necrosis, LVI, and close/positive margin were associated with poor OS. LVI emerged as a key factor affecting both DMFS and OS, with a 5-year OS of 93.3% for patients without LVI compared to 35.8% with LVI. Based on these factors, a nomogram predicting 3-year and 5-year DMFS and OS was developed, demonstrating high concordance with actual survival in the cohort (Harrell C-index 0.809 for OS, 0.801 for DMFS, respectively).
Conclusion
The prognosis of cHCC-CCA is notably poor when combined with LVI. Given the significant impact of adverse features, accurate outcome prediction is crucial. Moreover, consideration of adjuvant therapy may be warranted for patients exhibiting poor survival and increased risk of local recurrence or distant metastasis.
6.Risk Factors for Emergency Room Visits Among Patients With Head and Neck Cancer: A Longitudinal Cohort Study Within the Korean Healthcare System
Heejun YI ; Hyojun KIM ; Younghac KIM ; Ye-Jin SUH ; Joo Hyun PARK ; Nayeon CHOI ; Han-Sin JEONG
Clinical and Experimental Otorhinolaryngology 2025;18(1):64-72
Objectives:
. A substantial proportion of patients with head and neck cancer (HNC) require emergency room (ER) visits or unplanned hospitalizations during or after treatment with various modalities. We investigated HNC cases that necessitated ER visitation after cancer treatment, aiming to identify potential risk factors in the context of the Korean healthcare system.
Methods:
. This single-center cohort study examined patients with HNC who received cancer treatments at Samsung Medical Center in 2019 (n=566). Treatment modalities included surgery alone (n=184), surgery and adjuvant therapy (n=138), curative non-surgical treatment such as radiation or chemoradiation (n=209), and palliative treatments (n=35). We followed these cases for up to 3 years, focusing on those who visited the ER during or after cancer treatment, and analyzed the primary reasons and risk factors associated with these visits.
Results:
. The ER visitation rate was 8.0% (n=45) among patients with HNC, with a total of 70 ER visits (12.4%; mean, 1.56; range, 1–4). The rate of treatment-related ER visitation was 4.6%. Common reasons for ER visits included surgical site or wound complications (31.1% of patients visiting the ER, 22.9% of ER visits) and issues with oral intake or feeding (22.2% of patients, 31.4% of visits). Significant risk factors for ER visits included tumor subsite (with hypopharyngeal cancer associated with a 17.9% rate of treatment-related ER visits), tumor stage (T2–4, 8.6%–12.2%; N+ status, 6.7%), and treatment modality (surgery with adjuvant chemoradiation, 19.4%). Patient age and comorbidities did not represent significant factors.
Conclusion
. The most frequent reasons for ER visits among patients with HNC included complications with wounds and feeding. Additionally, tumor characteristics and treatment modality were independent risk factors for ER visits. Adequate planning and management to address these issues could potentially decrease the number of ER visits, lower costs, and improve patient care.
7.The Awareness of Sports Physicians about Relative Energy Deficiency in Sport
Soo Hyun PARK ; Eon Sook LEE ; Jieun KWON ; Lina KIM ; Yeonsoo KIM ; Tae Kyung KIM ; Nayoung AHN ; Young Kill YUN ; Sun Joo LEE ; Young Sun LEE ; Hyo Jeong LEE ; Suk Ha JEON ; Tae Im YI
The Korean Journal of Sports Medicine 2024;42(4):247-2533
Purpose:
Relative energy deficiency in sport (REDs) is a syndrome of physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic low energy availability. For the prevention and intervention of REDs, awareness of REDs among sports physicians is important, but it is largely unknown. This study aimed to survey the awareness and clinical treatment experience of REDs in sports physicians.
Methods:
We conducted an online survey to assess awareness of the triad and REDs among sports physicians and members of The Korean Society of Sports Medicine.
Results:
A total of 69 members (62.2% male, including sports physicians) to this survey. Most participants (84.1%) were aware of the triad compared to fewer with awareness regarding REDs (23.2%). People who knew about the difference between REDs and triad was 33.3%, which was lower than those who did not (66.6%). Only 10.1% of the study subjects had experience treating REDs patients, and the biggest difficulty in treating patients was a lack of information and education (50.7%). It appeared that the most information about REDs was obtained from academic conferences (59.4%).
Conclusion
This survey found relatively low awareness of REDs among physicians treating athletes and sports professionals. Considering the various negative effects of REDs on athlete health and performance, education and promotion are needed to increase awareness among sports physicians and sports professionals.
8.The Awareness of Sports Physicians about Relative Energy Deficiency in Sport
Soo Hyun PARK ; Eon Sook LEE ; Jieun KWON ; Lina KIM ; Yeonsoo KIM ; Tae Kyung KIM ; Nayoung AHN ; Young Kill YUN ; Sun Joo LEE ; Young Sun LEE ; Hyo Jeong LEE ; Suk Ha JEON ; Tae Im YI
The Korean Journal of Sports Medicine 2024;42(4):247-2533
Purpose:
Relative energy deficiency in sport (REDs) is a syndrome of physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic low energy availability. For the prevention and intervention of REDs, awareness of REDs among sports physicians is important, but it is largely unknown. This study aimed to survey the awareness and clinical treatment experience of REDs in sports physicians.
Methods:
We conducted an online survey to assess awareness of the triad and REDs among sports physicians and members of The Korean Society of Sports Medicine.
Results:
A total of 69 members (62.2% male, including sports physicians) to this survey. Most participants (84.1%) were aware of the triad compared to fewer with awareness regarding REDs (23.2%). People who knew about the difference between REDs and triad was 33.3%, which was lower than those who did not (66.6%). Only 10.1% of the study subjects had experience treating REDs patients, and the biggest difficulty in treating patients was a lack of information and education (50.7%). It appeared that the most information about REDs was obtained from academic conferences (59.4%).
Conclusion
This survey found relatively low awareness of REDs among physicians treating athletes and sports professionals. Considering the various negative effects of REDs on athlete health and performance, education and promotion are needed to increase awareness among sports physicians and sports professionals.
9.The Awareness of Sports Physicians about Relative Energy Deficiency in Sport
Soo Hyun PARK ; Eon Sook LEE ; Jieun KWON ; Lina KIM ; Yeonsoo KIM ; Tae Kyung KIM ; Nayoung AHN ; Young Kill YUN ; Sun Joo LEE ; Young Sun LEE ; Hyo Jeong LEE ; Suk Ha JEON ; Tae Im YI
The Korean Journal of Sports Medicine 2024;42(4):247-2533
Purpose:
Relative energy deficiency in sport (REDs) is a syndrome of physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic low energy availability. For the prevention and intervention of REDs, awareness of REDs among sports physicians is important, but it is largely unknown. This study aimed to survey the awareness and clinical treatment experience of REDs in sports physicians.
Methods:
We conducted an online survey to assess awareness of the triad and REDs among sports physicians and members of The Korean Society of Sports Medicine.
Results:
A total of 69 members (62.2% male, including sports physicians) to this survey. Most participants (84.1%) were aware of the triad compared to fewer with awareness regarding REDs (23.2%). People who knew about the difference between REDs and triad was 33.3%, which was lower than those who did not (66.6%). Only 10.1% of the study subjects had experience treating REDs patients, and the biggest difficulty in treating patients was a lack of information and education (50.7%). It appeared that the most information about REDs was obtained from academic conferences (59.4%).
Conclusion
This survey found relatively low awareness of REDs among physicians treating athletes and sports professionals. Considering the various negative effects of REDs on athlete health and performance, education and promotion are needed to increase awareness among sports physicians and sports professionals.
10.The Awareness of Sports Physicians about Relative Energy Deficiency in Sport
Soo Hyun PARK ; Eon Sook LEE ; Jieun KWON ; Lina KIM ; Yeonsoo KIM ; Tae Kyung KIM ; Nayoung AHN ; Young Kill YUN ; Sun Joo LEE ; Young Sun LEE ; Hyo Jeong LEE ; Suk Ha JEON ; Tae Im YI
The Korean Journal of Sports Medicine 2024;42(4):247-2533
Purpose:
Relative energy deficiency in sport (REDs) is a syndrome of physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic low energy availability. For the prevention and intervention of REDs, awareness of REDs among sports physicians is important, but it is largely unknown. This study aimed to survey the awareness and clinical treatment experience of REDs in sports physicians.
Methods:
We conducted an online survey to assess awareness of the triad and REDs among sports physicians and members of The Korean Society of Sports Medicine.
Results:
A total of 69 members (62.2% male, including sports physicians) to this survey. Most participants (84.1%) were aware of the triad compared to fewer with awareness regarding REDs (23.2%). People who knew about the difference between REDs and triad was 33.3%, which was lower than those who did not (66.6%). Only 10.1% of the study subjects had experience treating REDs patients, and the biggest difficulty in treating patients was a lack of information and education (50.7%). It appeared that the most information about REDs was obtained from academic conferences (59.4%).
Conclusion
This survey found relatively low awareness of REDs among physicians treating athletes and sports professionals. Considering the various negative effects of REDs on athlete health and performance, education and promotion are needed to increase awareness among sports physicians and sports professionals.

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