The cure rate for children with acute lymphoblastic leukemia in big treatment centers in Western countries is now about 80%. This accomplishment is owe to patients successful treatment based on combination of multiagent chemotherapy, risk-based intensification of therapy and central nerve system prophylaxis. Stratification of patients is according to prognostic factors that predict risk of relapse. It is necessary to consider the interrelationship of prognostic factors. In host-related factors, which are generally known as age, gender, race, and pharmacogenetics. Disease-related factors include white blood cell count, immunopheno typing, cytogenetic or molecular genetics features, etc. Treatment-related factors are what can be modified. Early response to treatment is often the strongest prognostic factor. Large, controlled and usually randomized clinical trials greatly improve the prognosis of childhood acute lymphoblastic leukemia.
Child ; Female ; Humans ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; ethnology ; mortality ; Prognosis ; Sex Factors

BACKGROUND: About 13,000 people immigrated to New York City from the Republic of Korea between 1986 and 1990, creating an important ethnic minority. METHODS: Using US-born Whites as a reference, age-adjusted proportional mortality ratios were computed for 314 men and 248 women of Korean ancestry born abroad who died in New York City in 1986-90. RESULTS: Males had a significant excess of viral hepatitis, cancer, stroke, and external causes: accidents, suicide, and homicide. They had significantly reduced proportional rates of AIDS and heart disease. Mortality patterns were similar for Korean women, who had significantly increased proportional rates of stroke and accidents, and reduced heart disease. Stomach and liver cancers were significantly elevated in both sexes, while female breast cancer was low. There were two male and one female tuberculosis deaths (4 to 7 fold increase), and one Korean woman died of childbirth complications (59-fold increase). CONCLUSIONS: Except for violent deaths, these observations resemble known mortality patterns in Korea.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; *Emigration and Immigration ; *Ethnic Groups ; Female ; Human ; Infant ; Korea/ethnology ; Male ; Middle Age ; *Mortality ; New York City/ethnology ; Support, U.S. Gov't, P.H.S.

INTRODUCTIONWe describe the natural history of Asian adult soft tissue sarcomas (STSs) in the extremities and predict prognosticative factors for local recurrence, metastasis and tumour-related death.

MATERIALS AND METHODSBetween January 1999 and May 2009, 67 adult patients with first presentation STSs of extremity sites underwent surgical treatment at a single institution. The associations between patient demographics and pathological features with local recurrence, metastasis and mortality were studied using univariate and multivariate analysis.

RESULTSThe mean age of our patients was 52.4 years with most presentations occurring in the thigh. Majority of Asian STSs were high grade (61.3%) and large tumours with 81.0% being >5 cm. Stages Ia, Ib, IIa, IIb, IIc, III and IV accounted for 6.6%, 6.6%, 26.2%, 11.5%, 3.3%, 42.6% and 3.3% of presentations, respectively. Patients were followed-up for a mean period of 45.9 months. On univariate analysis, high tumour grade and advanced stage (IIc to IV) were predictive of local recurrence and metastasis. Deep lesions were more likely to recur but not metastasise or cause death. Age, sex, size, and margin positivity were not predictive for all end-points. On multivariate testing, only pathological high grade was associated adversely with local recurrence [odds ratio (OR) = 10.0, 95% CI, 1.2 to 84.9, P = 0.035], metastasis (OR = 12.7, 95% CI, 2.46 to 65.2, P = 0.002) and mortality (OR = 16.2, 95% CI, 1.95 to 135.0, P = 0.010).

CONCLUSIONSAsian adult extremity soft tissue sarcomas present late and are most commonly found in the thigh. High pathological grade is a consistent independent predictor for local failure, distant spread and tumour-related death. Our results reaffirm the current thinking that tumour biology is of primary importance in determining patient outcomes.

Adult ; Aged ; Aged, 80 and over ; Asia ; epidemiology ; Extremities ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Sarcoma ; classification ; ethnology ; mortality ; pathology ; surgery ; Soft Tissue Neoplasms ; classification ; ethnology ; mortality ; pathology ; surgery

INTRODUCTIONThis paper examines the incidence, mortality and survival patterns among all Chinese residents with prostate cancer reported to the Singapore Cancer Registry in Singapore from 1968 to 2002 by metastatic staging.

MATERIALS AND METHODSThis is a retrospective population-based study including all prostate cancer cases aged over 20 reported to the Singapore Cancer Registry (SCR) from 1968 to 2002 who are Singapore Chinese residents. Follow-up was ascertained by matching with the National Death Register until 2002. Metastatic status was obtained from the SCR. Age-standardised incidence and mortality rates, as well as the 5-year relative survival ratios (RSRs), were obtained for each 5-year period and grouped by metastatic stage. A weighted linear regression was performed on the log-transformed age-standardised incidence and mortality rates over the study period.

RESULTSIn the most recent period of 1998 to 2002, the age-standardised incidence and mortality rates (per 100,000) for prostate cancer among the Chinese were 30.9 (95% CI, 29.1 to 32.8) and 9.6 (95% CI, 8.6 to 10.7), respectively. The percentage increase in the age-standardised incidence and age-standardised mortality rates per year were 5.6% and 6.0%, respectively, for all Chinese Singapore residents. There was an improvement in the 5-year RSRs for Chinese diagnosed with non-metastatic cases from 51.3% in 1973 to 1977, to 76.1% in 1998 to 2002. However, the RSR remains poor (range, 11.1% to 49.7%) for Chinese diagnosed with metastatic prostate cancer.

CONCLUSIONSBoth age-standardised incidence and mortality rates for prostate cancer among Chinese Singapore residents are still on the rise especially since the 1990s. Since the 1990s, the improvement in RSRs was substantial for the Chinese non-metastatic cases.

Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; ethnology ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; diagnosis ; Prostatic Neoplasms ; epidemiology ; ethnology ; mortality ; Registries ; Retrospective Studies ; Singapore ; epidemiology ; Survival Rate ; trends ; Young Adult

Objective: To understand the distribution of cancer deaths in China in 2015 and provide reference for the prevention and control of cancer. Methods: Based on the results of Global Burden of Disease 2015, the cancer death distributions in different age groups, sex groups, provinces or by different malignant tumor in Chinese were described. Results: The age-standardized mortality rate of cancer was 159.01/100 000 in China in 2015. The mortality rate was highest in age group ≥70 years (1 102.73/100 000), and lowest in age group 5-14 years (5.40/100 000). The mortality rate in males was 2.15 times higher than that in females. The first 5 provinces with high cancer mortality rate were Anhui, Qinghai, Sichuan, Guangxi and Henan. Lung cancer, liver cancer, stomach cancer, esophageal cancer and colorectal cancer ranked 1-5 in term of mortality rate. Conclusion: The cancer mortality differed with age, gender, area and different malignant tumors, suggesting the necessity to develop targeted prevention and control strategies.
Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Asian People/statistics & numerical data* ; Child ; Child, Preschool ; China/epidemiology* ; Colonic Neoplasms/mortality* ; Colorectal Neoplasms/mortality* ; Female ; Humans ; Liver Neoplasms/mortality* ; Lung Neoplasms/mortality* ; Male ; Middle Aged ; Mortality/ethnology* ; Neoplasms/mortality* ; Residence Characteristics ; Sex Distribution ; Stomach Neoplasms/mortality* ; Young Adult

Polyarteritis nodosa (PAN) is a systemic vasculitis characterized by multi-organ involvement with protean manifestations. We evaluated the clinical features of PAN in Korea. Twenty-seven patients were diagnosed as PAN at Seoul National University Hospital between January 1990 and July 2003. The male-to-female ratio was 1.7:1 and mean age at onset (+/-SD) was 47.4+/-20 yr. Their presenting features at diagnosis were similar to those reported previously, i.e., myalgia, muscle weakness or leg tenderness (70%), fever (52%), weight loss >4 kg (44%), skin rash (44%), peripheral edema (33%), abdominal pain (33%), and arthralgia/arthritis (30%). However, the prevalence of testicular pain or tenderness was higher (24%) than reported previously and only three (11.5%) had HBsAg positivity without liver enzyme elevation. Nine patients (33%) had a five-factor score (FFS) of 2. Fourteen patients (52%) responded to treatment, 2 patients relapsed and 4 died within 1 yr of diagnosis. During a median follow-up of 55.5 months, three of the four PAN-related deaths had an initial FFS of 2. The clinical features of PAN were not significantly different from those reported previously. However, testicular pain or tenderness was more frequent and patients with a high FFS tended to have a poorer prognosis.
Survival Rate ; Polyarteritis Nodosa/ethnology/mortality/*pathology ; Middle Aged ; Male ; Korea ; Humans ; Fever/pathology ; Female ; Exanthema/pathology ; *Asian Continental Ancestry Group ; Adult ; Adolescent

BACKGROUND/AIMS: To compare the clinical characteristics and outcomes of systemic lupus erythematosus between male and female Korean patients. METHODS: A retrospective analysis was performed at a single tertiary hospital from August 1994 to May 2010. Male patients were matched with two to three female patients based on age and disease duration. Organ damage was assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index (SLICC/ACR DI). RESULTS: Fifty-three male patients were compared with 150 female patients. Renal disorders were found more frequently in male patients at disease onset (p < 0.001); the adjusted odds ratio (OR) demonstrated a significant sex preponderance for renal manifestations (OR, 3.26; 95% confidence interval [CI], 1.62 to 6.57). Diffuse proliferative lupus nephritis and end-stage renal disease requiring dialysis during the disease course were more prevalent in male patients (p = 0.025 and p < 0.001, respectively). The risk for requiring long-term dialysis was significantly higher in male than in female patients (OR, 4.02; 95% CI, 1.07 to 15.06), as was the mean SLICC/ACR DI (1.55 +/- 1.35 vs. 1.02 +/- 1.57, respectively; p = 0.028). CONCLUSIONS: Our data demonstrate that Korean patients with lupus have characteristics similar to those of cohorts reported previously. Male patients had significantly higher incidences of renal manifestations and organ damage.
Adult ; *Asian Continental Ancestry Group ; Female ; Humans ; Immunosuppressive Agents/therapeutic use ; Incidence ; Kaplan-Meier Estimate ; Kidney Failure, Chronic/diagnosis/ethnology/therapy ; Lupus Erythematosus, Systemic/diagnosis/*ethnology/mortality/therapy ; Lupus Nephritis/diagnosis/ethnology/therapy ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Prevalence ; Prognosis ; Renal Dialysis ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Sex Distribution ; Sex Factors ; Tertiary Care Centers ; Time Factors ; Young Adult

BACKGROUND/AIMS: Hyponatremia is a well-known risk factor for poor outcomes in Western studies of heart failure (HF) patients. We evaluated the predictive value of hyponatremia in hospitalized Asian HF patients. METHODS: The Clinical Characteristics and Outcomes in the Relation with Serum Sodium Level in Asian Patients Hospitalized for Heart Failure (the COAST) study enrolled hospitalized patients with systolic HF (ejection fraction < 45%) at eight centers in South Korea, Taiwan, and China. The relationship between admission sodium level and clinical outcomes was analyzed in 1,470 patients. RESULTS: The mean admission sodium level was 138 +/- 4.7 mmol/L, and 247 patients (16.8%) had hyponatremia defined as Na+ < 135 mmol/L. The 12-month mortality was higher in hyponatremic patients (27.9% vs. 14.6%, p < 0.001), and hyponatremia was an independent predictor of 12-month mortality (hazard ratio, 1.72; 95% confidence interval, 1.12 to 2.65). During hospital admission, 57% of hyponatremic patients showed improvement without improvement in their clinical outcomes (p = 0.620). The proportion of patients with optimal medical treatment was only 26.5% and 44.2% at admission and discharge, respectively, defined as the combined use of angiotensin-converting-enzyme inhibitor/angiotensin receptor blocker and beta-blocker. Underuse of optimal medical treatment was more pronounced in hyponatremic patients. CONCLUSIONS: In hospitalized Asian HF patients, hyponatremia at admission is common and is an independent predictor of poor clinical outcome. Furthermore, hyponatremic patients receive less optimal medical treatment than their counterparts.
Aged ; Aged, 80 and over ; Asia/epidemiology ; *Asian Continental Ancestry Group ; Biomarkers/blood ; Cardiovascular Agents/therapeutic use ; Disease-Free Survival ; Female ; Guideline Adherence ; Healthcare Disparities ; Heart Failure/*diagnosis/drug therapy/ethnology/mortality/physiopathology ; *Hospitalization ; Humans ; Hyponatremia/blood/*diagnosis/drug therapy/ethnology/mortality ; Male ; Middle Aged ; Practice Guidelines as Topic ; Predictive Value of Tests ; Proportional Hazards Models ; Risk Factors ; Sodium/*blood ; Stroke Volume ; Time Factors ; Treatment Outcome

BACKGROUND/AIMS: Although the incidence of T-cell non-Hodgkin's lymphoma (NHL) is higher in Far East Asia than in Western countries, its incidence and clinical course in Korea are not well-defined. Therefore, we assessed the relative frequency and clinical features of T-cell NHL in Korea. METHODS: We performed a retrospetcive analysis of 586 patients with NHL. RESULTS: 101 (17.2%) had T-cell NHL. The most frequent subtypes of T-cell NHL were extranodal NK/T-cell lymphoma, nasal type (NASAL), peripheral T-cell lymphoma, unspecified type (PTCL-U), and anaplastic large cell lymphoma, T/null cell, primary systemic type (ALCL). The seven pathological subtypes could be classified into three prognostic subgroups. When patients with the three most frequent subtypes were grouped together, their survival was reflected in the International Prognostic Index (IPI) scores. Univariate analysis of IPI elements and other clinical features showed that clinical stage and extranodal sites were significant predictors of survival. Cox multivariate analysis showed that the number of extranodal sites was the only independent prognostic indicator. CONCLUSIONS: The relative frequency of T-cell NHL seems to be decreasing in Korea, although NASAL remains frequent. Korean patients with ALCL appear to have an unfavorable prognosis. Large-scale studies are warranted for Korean patients with T-cell NHL.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Female ; Humans ; Incidence ; Kaplan-Meiers Estimate ; Korea/epidemiology ; Lymphoma, Non-Hodgkin/ethnology/*mortality/*pathology ; Lymphoma, T-Cell/ethnology/*mortality/*pathology ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Assessment ; Time Factors ; Young Adult

Accumulating studies explored the clinicopathologic and prognostic value of programmed death ligand-1 (PD-L1) in non-small cell lung cancer (NSCLC), but the results were controversial. We therefore conducted a meta-analysis to evaluate the predictive role of PD-L1 in NSCLC patients. We systematically collected relevant studies from PubMed, Embase, Web of Science and China National Knowledge Infrastructure. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) for overall survival (OS), and odd ratios (ORs) with 95% CIs for clinicopathologic factors were calculated. A total of 15 studies involving 3605 patients were included in this meta-analysis. The results showed no prognostic role of PD-L1 in the whole patients (HR=1.60, 95% CI: 0.88-2.89, P=0.123). Subgroup analysis showed that PD-L1 was associated with decreased OS in Asian patients (HR=2.00, 95% CI: 1.55-2.57, P<0.001). Among all the clinicopathologic factors, PD-L1 overexpression was significantly in relevance with poor tumor cell differentiation (HR=1.84, 95% CI: 1.49-2.28, P<0.001), late stage (HR=1.21, 95% CI: 1.02-1.43, P=0.026) and anaplastic lymphoma kinase (ALK) translocation (HR=2.63, 95% CI: 1.08-6.40, P=0.034), but not with other factors. In conclusion, our meta-analysis demonstrated that PD-L1 has a prognostic role in Asian patients with NSCLC.
Asian Continental Ancestry Group ; B7-H1 Antigen ; genetics ; metabolism ; Biomarkers, Tumor ; genetics ; metabolism ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; ethnology ; genetics ; mortality ; European Continental Ancestry Group ; Humans ; Lung Neoplasms ; diagnosis ; ethnology ; genetics ; mortality ; Neoplasm Grading ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Protein Transport ; Receptor Protein-Tyrosine Kinases ; genetics ; metabolism