OBJECTIVE: To evaluate the prevalence and features of non-endometrial cancers in Thai endometrial cancer (EC) patients. METHODS: EC patients treated in our institution were identified and the following data were collected: age, EC stage, histopathology, adjuvant therapy, other cancers, living status, and cause of death. RESULTS: The mean age of the 344 patients was 56.8+/-10.8 years. Fifty (14.5%) had other synchronous and metachronous cancers. Mean ages of the patients with or without other cancers were not significantly different, 55.7+/-10.04 years versus 57.1+/-11.0 years, respectively (p=0.358). History of any cancer in the family and tumor in the lower uterine segment were more frequent among the patients with other cancers (6.0% vs. 1.7%, p=0.095; 12.0% vs. 1.0%, p<0.001; respectively). Six patients had > or =2 other cancers. Ovarian, breast, and colon were the three most common other cancers. After a median follow-up of 57.1 months, 18.3% of patients had died: 30.0% of patients with other cancers and 16.3% of those without other cancers. The corresponding EC deaths were 14.0% and 11.2%. The 5-year overall survival was significantly lower in patients who had other cancers: 79.3% (95% confidence interval [CI], 68.3 to 90.3) vs. 86.0% (95% CI, 81.7 to 90.3) than in those without (p=0.023). However, the corresponding disease-specific survival was not significantly different: 85.1% (95% CI, 75.5 to 94.7) compared with 89.0% (95% CI, 85.1 to 92.9), respectively (p=0.514). CONCLUSION: Thai EC patients had a high incidence of other cancers. Overall survival of EC patients who had other cancers was worse than those without, while disease-specific survival was not significantly different.
Breast Neoplasms/mortality/pathology/therapy ; Chemotherapy, Adjuvant/methods ; Colonic Neoplasms/mortality/pathology/therapy ; Disease-Free Survival ; Endometrial Neoplasms/mortality/*pathology/therapy ; Female ; Humans ; Kaplan-Meier Estimate ; Middle Aged ; Neoplasm Recurrence, Local/mortality ; Neoplasms, Multiple Primary/mortality/*pathology/therapy ; Neoplasms, Second Primary/mortality/*pathology/therapy ; Radiotherapy, Adjuvant/methods ; Tertiary Care Centers/statistics & numerical data ; Thailand/epidemiology

BACKGROUND/AIMS: Percutaneous ethanol injection therapy (PEIT) is widely used for the treatment of hepatocellular carcinoma (HCC). However, its long-term therapeutic efficacy is not verified in Korea, one of hepatitis B virus (HBV) endemic areas. Thus, this study was to assess its efficacy and prognostic factors affecting tumor-free survival following PEIT in Korean HCC patients. METHODS: From 1997 to 1999, 100 consecutive patients who had 1 to 3 HCC nodules of maximum diameter less than 3 cm and underwent PEIT were enrolled. Therapeutic efficacy, overall and tumor-free survival rates were assessed during follow-up periods. RESULTS: In 83 patients, HCC nodules were completely ablated by PEIT. The cumulative 1, 2, and 3 year overall survival rates were 98%, 96%, and 88%, respectively. The cumulative 1, 2, and 3 year tumor-free survival rates were 73%, 50%, and 37%, respectively. Larger tumors (> or = were associated with a higher local recurrence rate. CONCLUSIONS: These results demonstrate that PEIT is therapeutically useful in patients with HCC less than 4 in number and less than 3 cm in diameter. However, since multiple or large tumors are associated with low tumor-free survival or high local recurrence rates, PEIT for these tumors and the subsequent post-treatment follow-up should be performed carefully.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/mortality/*therapy ; Ethanol/*administration & dosage ; Humans ; Injections, Intralesional ; Korea ; Liver Neoplasms/mortality/*therapy ; Male ; Middle Aged ; Neoplasms, Multiple Primary/mortality/therapy ; Survival Rate

BACKGROUND/AIMS: We investigated the clinical outcomes according to the method of treatment in synchronous esophageal and gastric cancer. METHODS: Synchronous esophageal squamous cell carcinoma and gastric adenocarcinoma were diagnosed in 79 patients between 1996 and 2010. We divided the patients into four groups according to treatment; Group 1 received surgical resection for both cancers or surgery for gastric cancer with chemoradiotherapy for esophageal cancer (n=27); Group 2 was treated by endoscopic resection with or without additional treatment (n=14); Group 3 received chemoradiotherapy only (n=18); and Group 4 received supportive care only (n=20). RESULTS: The median survival times in groups 1 and 2 were 86 and 60 months, respectively. The recurrence rate and mortality were 23% and 48%, respectively, in group 1 and 21% and 4%, respectively, in group 2. The median survival time was 12 months in group 3 and 9 months in group 4. Multivariate analysis showed that age (p<0.001) and treatment group (p=0.019) were significantly associated with death. Compared with group 1, treatment in the intensive care unit (p=0.003), loss of body weight (p=0.042), and decrease in hemoglobin (p=0.033) were worse in group 1. CONCLUSIONS: Endoscopic resection for synchronous esophageal and gastric cancer could be considered as a possible alternative to surgery for early-stage cancer.
Adenocarcinoma/mortality/*surgery/therapy ; Aged ; Carcinoma, Squamous Cell/mortality/*surgery/therapy ; Combined Modality Therapy ; Endoscopy, Gastrointestinal/*methods ; Esophageal Neoplasms/mortality/*surgery/therapy ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Multiple Primary/mortality/*surgery/therapy ; Nutritional Status ; Risk Factors ; Stomach Neoplasms/mortality/*surgery/therapy ; Survival Analysis

BACKGROUND/AIMS: Unexpected diagnosis of synchronous second primary cancers (SPC) complicates physicians' decision-making because clinical details of squamous esophageal cancer (EC) patients with SPC have been limited. We evaluated clinical features and treatment outcomes of patients with synchronous SPC detected during the initial staging of squamous EC. METHODS: We identified a total of 317 consecutive patients diagnosed with squamous EC. Relevant clinical and cancer-specific information were reviewed retrospectively. RESULTS: EC patients with synchronous SPC were identified in 21 patients (6.6%). There were significant differences in median age (70 years vs. 63 years, p = 0.01), serum albumin level (3.3 g/dL vs. 3.9 g/dL, p < 0.01) and body mass index (20.4 kg/m2 vs. 22.8 kg/m2, p = 0.01) between EC patients with and without SPC. Head and neck, lung and gastric cancers accounted for 18.2%, 22.7%, and 18.2% of SPC, respectively. Positron emission tomography-computed tomography (PET-CT) detected four cases (18.2%) of SPC that were missed on CT. Management plans were altered in 13 of 21 patients (61.9%) with detected SPC. Curative esophagectomy was attempted in 28.6% of EC patients with SPC (vs. 59.1% of patients without SPC; p = 0.006). EC patients with SPC had significantly lower 5-year survival than patients without SPC (10.6% vs. 36.7%, p = 0.008). CONCLUSIONS: Synchronous SPC were found in 6.6% of squamous EC patients, and PET-CT contributed substantially to the detection of synchronous SPC. EC patients with SPC had poor survival due to challenges of providing stage-appropriate treatment.
Aged ; Carcinoma, Squamous Cell/diagnostic imaging/mortality/*pathology/therapy ; Esophageal Neoplasms/diagnostic imaging/mortality/*pathology/therapy ; Esophagectomy ; Esophagoscopy ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Staging ; Neoplasms, Multiple Primary/diagnostic imaging/mortality/*pathology/therapy ; Positron Emission Tomography Computed Tomography ; Predictive Value of Tests ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome