1.More microinvasive foci in larger tumours of breast ductal carcinoma in situ.
Xiao-Yang CHEN ; Aye Aye THIKE ; Johnathan Xiande LIM ; Boon Huat BAY ; Puay Hoon TAN
Singapore medical journal 2023;64(8):493-496
INTRODUCTION:
Microinvasion (Mi) is often thought to be an interim stage between ductal carcinoma in situ (DCIS) and invasive ductal carcinoma. This study aimed to investigate the potential influence of Mi on survival and assess its correlations with clinicopathological parameters, prognosis and molecular markers.
METHODS:
The number of Mi foci in a cohort of 66 DCIS-Mi cases was assessed from haematoxylin and eosin-stained sections. Disease-free survival, clinicopathological parameters and biomarker expression were correlated with the number of Mi foci.
RESULTS:
Higher numbers of Mi foci were found in larger tumours (P = 0.031).
CONCLUSION
Greater extent of DCIS is associated with multifocal Mi.
Humans
;
Female
;
Carcinoma, Intraductal, Noninfiltrating
;
Prognosis
;
Disease-Free Survival
;
Progression-Free Survival
;
Breast Neoplasms
;
Carcinoma, Ductal, Breast/pathology*
;
Neoplasm Invasiveness
2.Prognostic and clinical value of circPRKCI expression in diverse human cancers.
Zhongyue LIU ; Xiaolei REN ; Zhimin YANG ; Lin MEI ; Wenyi LI ; Chao TU ; Zhihong LI
Chinese Medical Journal 2024;137(2):152-161
BACKGROUND:
Highly expressed in various human cancers, circular RNA Protein Kinase C Iota (circPRKCI) has been reported to play an important role in cancer development and progression. Herein, we sought to reveal the prognostic and clinical value of circPRKCI expression in diverse human cancers.
METHODS:
We searched the Pubmed, Web of Science, and the Cochrane Library databases from inception until May 16, 2021. The relationship between circPRKCI expression and cancer patients' survival, including overall survival (OS) and disease-free survival (DFS), was assessed by pooled hazard ratios (HR) with corresponding 95% confidence interval (CI). The correlation between circPRKCI expression and clinical outcomes was evaluated using odds ratios (OR) with corresponding 95% CI. The data were analyzed by STATA software (version 12.0) or Review Manager (RevMan 5.3).
RESULTS:
A total of 15 studies with 1109 patients were incorporated into our meta-analysis. The results demonstrated that high circPRKCI expression was significantly related to poor OS (HR = 1.96, 95% CI: 1.61, 2.39, P <0.001) when compared with low circPRKCI expression in diverse human cancers. However, elevated circPRKCI expression was not associated with DFS (HR = 1.34, 95% CI: 0.93, 1.95, P = 0.121). Furthermore, the patient with a higher circPRKCI expression was prone to have a larger tumor size, advanced clinical stage, and lymph node metastasis, but it was not significantly correlated with age, gender, and distant metastasis.
CONCLUSION
Elevated circPRKCI expression was correlated with worse OS and unfavorable clinical features, suggesting a novel prognostic and predictive role of circPRKCI in diverse human cancers.
Humans
;
Prognosis
;
RNA, Long Noncoding/genetics*
;
Neoplasms/metabolism*
;
Disease-Free Survival
;
Progression-Free Survival
;
Lymphatic Metastasis
;
Biomarkers, Tumor/metabolism*
3.Sequential Chemoradiotherapy for Stage I/II Nasal Natural Killer/T Cell Lymphoma.
Young Joo NOH ; Yong Chan AHN ; Won Seog KIM ; Young Hyeh KO
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2004;22(3):177-183
PURPOSE: Authors would report the results of sequential CHOP chemotherapy (cyclophosphamide, adriamycin, vincristine, and prednisone) and involved field radiotherapy (IFRT) for early stage nasal natural killer/T-cell lymphoma (NKTCL). MATERIALS AND METHODS: Fourteen among 17 patients, who were registered at the Samsung Medical Center tumor registry with stage I and II nasal NKTCL from March 1995 to December 1999 received this treatment protocol. Three to four cycles of CHOP chemotherapy were given at 3 weeks' interval, which was followed by local IFRT including the known tumor extent and the adjacent draining lymphatics. RESULTS: Favorable responses after chemotherapy (before IFRT) were achievable only in seven patients (5 CR's+2 PR's: 50%), while seven patients showed disease progression. There were six patients with local failures, two with distant relapses, and none with regional lymphatic failure. The actuarial overall survival and progression-free survival at 3 years were 50.0% and 42.9%. All the failures and deaths occurred within 13 months of the treatment start. The factors that correlated with the improved survival were the absence of 'B' symptoms, the favorable response to chemotherapy and overall treatment, and the low risk by international prognostic index on univariate analyses. CONCLUSION: Compared with the historic treatment results by IFRT either alone or followed by chemotherapy, the current trial failed to demonstrate advantages with respect to the failure pattern and survival. Development of new treatment strategy in combining IFRT and chemotherapy is required for improving outcomes.
Chemoradiotherapy*
;
Clinical Protocols
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Disease Progression
;
Disease-Free Survival
;
Doxorubicin
;
Drug Therapy
;
Humans
;
Lymphoma*
;
Radiotherapy
;
Recurrence
;
Vincristine
4.The combination of intravenous bevacizumab and metronomic oral cyclophosphamide is an effective regimen for platinum-resistant recurrent ovarian cancer.
Emma L BARBER ; Emese ZSIROS ; John R LURAIN ; Alfred RADEMAKER ; Julian C SCHINK ; Nikki L NEUBAUER
Journal of Gynecologic Oncology 2013;24(3):258-264
OBJECTIVE: To determine the efficacy, progression-free survival (PFS) and overall survival (OS) for the combination of intravenous bevacizumab and oral cyclophosphamide in heavily pretreated patients with recurrent ovarian carcinoma. METHODS: A retrospective review was performed for all patients with recurrent ovarian carcinoma treated with intravenous bevacizumab 10 mg/kg every 14 days and oral cyclophosphamide 50 mg daily between January 2006 and December 2010. Response to treatment was determined by Response Evaluation Criteria in Solid Tumors criteria and/or CA-125 levels. RESULTS: Sixty-six eligible patients were identified. Median age was 53 years. Fifty-five patients (83%) had undergone optimal cytoreduction. All patients were primarily or secondarily platinum resistant at the time of administration of bevacizumab and cyclophosphamide. The median number of prior chemotherapy treatments was 6.5 (range, 3 to 16). Eight patients (12.1%) had side effects which required discontinuation of bevacizumab and cyclophosphamide. There was one bowel perforation (1.5%). Overall response rate was 42.4%, including, complete response in 7 patients (10.6%), and partial response in 21 patients (31.8%), while 15 patients (22.7%) had stable disease and 23 patients (34.8%) had disease progression. Median PFS for responders was 5 months (range, 2 to 14 months). Median OS from initiation of bevacizumab and cyclophosphamide was 20 months (range, 2 to 56 months) for responders and 9 months (range, 2 to 51 months) for non-responders (p=0.004). CONCLUSION: Bevacizumab and cyclophosphamide is an effective, well-tolerated chemotherapy regimen in heavily pretreated patients with recurrent ovarian carcinoma. This combination significantly improved PFS and OS in responders. Response rates were similar and favorable to the rates reported for similar patients receiving other commonly used second-line chemotherapeutic agents.
Antibodies, Monoclonal, Humanized
;
Bevacizumab
;
Cyclophosphamide
;
Disease Progression
;
Disease-Free Survival
;
Humans
;
Ovarian Neoplasms
;
Platinum
;
Retrospective Studies
5.Liver Resection Versus Transplantation for Hepatocellular Carcinoma within Milan Criteria: An Intention-to-treat Analysis.
Yang Won NAH ; Chang Woo NAM ; Neung Hwa PARK ; Jung Woo SHIN
Korean Journal of Hepato-Biliary-Pancreatic Surgery 2010;14(1):30-36
PURPOSE: Postoperative as well as intention-to-treat outcomes of deceased donor liver transplantation (DDLT) for patients with hepatocellular carcinoma (HCC) within the Milan criteria were compared to outcomes for patients who underwent liver resection. The goal was to select the optimal therapeutic option for these patients. METHODS: Among 1363 patients diagnosed with HCC between Jan 2001 and Sep 2008, 57 underwent liver resection for HCC within the Milan criteria (LRX group) and 47 registered for DDLT (WAIT group). Thirteen patients underwent DDLT (LTX group), including 2 salvage DDLT for recurrent HCC after resection. The outcomes for the LRX group were compared with those for the LTX and WAIT groups. RESULTS: Child class B or C patients accounted for 5% in the LRX group and 81% in the WAIT group (p=0.000). Among 47 registrants in the WAIT group, 11 underwent DDLT after a mean waiting time of 282 days (LTX group). Tweleve patients were dropped from the waitlist due to death or disease progression after a mean time of 317 days after registration. There was 1 operative death in the LTX group 14 days after DDLT due to primary graft nonfunction. The 3-year overall and disease-free survival rates were comparable between the LRX and LTX groups. On the other hand, the LRX group showed a significantly better intention-to-treat outcome than the WAIT group. The 3-year survival rates were 80.4% for the LRX group and 52.0% for the WAIT group (p=0.002). CONCLUSION: For HCC patients within the Milan criteria, liver resection should be considered as their primary option of treatment in Korea, where the DDLT rate is below 6%.
Carcinoma, Hepatocellular
;
Child
;
Disease Progression
;
Disease-Free Survival
;
Hand
;
Humans
;
Korea
;
Liver
;
Liver Transplantation
;
Survival Rate
;
Tissue Donors
;
Transplants
6.Clinical Characteristics and Treatment Results of Pediatric Osteosarcoma: The Role of High Dose Chemotherapy with Autologous Stem Cell Transplantation.
Ji Won LEE ; Hyery KIM ; Hyoung Jin KANG ; Han Soo KIM ; Sung Hye PARK ; In One KIM ; Hyo Seop AHN ; Hee Young SHIN
Cancer Research and Treatment 2008;40(4):172-177
PURPOSE: In this study, we investigated the clinical characteristics and treatment results of osteosarcoma during the past 7 years, and evaluated the role of high dose chemotherapy (HDCT) with autologous stem cell transplantation (ASCT). MATERIALS AND METHODS: We retrospectively analyzed the clinical data of patients who were diagnosed as osteosarcoma at our center from January, 2000 to December, 2007. RESULTS: The 5-year overall survival and event-free survival of the patients were 72.6% and 55.9%, respectively. Seventeen (41.5%) patients showed disease progression during treatment or relapse after the end of treatment. The patients who had metastasis at diagnosis or who had a lower grade of necrosis after neoadjuvant chemotherapy showed decreased overall and event-free survival. Four patients received ASCT after HDCT, and 3 of them are alive without disease. CONCLUSIONS: The patients who relapsed or had refractory osteosarcoma or who had metastasis at diagnosis or a lower grade of necrosis after neoadjuvant chemotherapy showed poor prognosis. HDCT with ASCT could be an alternative treatment option for these patients.
Disease Progression
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Disease-Free Survival
;
Humans
;
Necrosis
;
Neoplasm Metastasis
;
Osteosarcoma
;
Pediatrics
;
Prognosis
;
Recurrence
;
Retrospective Studies
;
Stem Cell Transplantation
;
Stem Cells
7.Prognostic factors in breast cancer with extracranial oligometastases and the appropriate role of radiation therapy.
Gyu Sang YOO ; Jeong Il YU ; Won PARK ; Seung Jae HUH ; Doo Ho CHOI
Radiation Oncology Journal 2015;33(4):301-309
PURPOSE: To identify prognostic factors for disease progression and survival of patients with extracranial oligometastatic breast cancer (EOMBC), and to investigate the role of radiation therapy (RT) for metastatic lesions. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 50 patients who had been diagnosed with EOMBC following standard treatment for primary breast cancer initially, and received RT for metastatic lesions, with or without other systemic therapy between January 2004 and December 2008. EOMBC was defined as breast cancer with five or less metastases involving any organs except the brain. All patients had bone metastasis (BM) and seven patients had pulmonary, hepatic, or lymph node metastasis. Median RT dose applied to metastatic lesions was 30 Gy (range, 20 to 60 Gy). RESULTS: The 5-year tumor local control (LC) and 3-year distant progression-free survival (DPFS) rate were 66.1% and 36.8%, respectively. High RT dose (> or =50 Gy10) was significantly associated with improved LC. The 5-year overall survival (OS) rate was 49%. Positive hormone receptor status, pathologic nodal stage of primary cancer, solitary BM, and whole-lesion RT (WLRT), defined as RT whose field encompassed entire extent of disease, were associated with better survival. On analysis for subgroup of solitary BM, high RT dose was significantly associated with improved LC and DPFS, shorter metastasis-to-RT interval (< or =1 month) with improved DPFS, and WLRT with improved DPFS and OS, respectively. CONCLUSION: High-dose RT in solitary BM status and WLRT have the potential to improve the progression-free survival and OS of patients with EOMBC.
Brain
;
Breast Neoplasms*
;
Breast*
;
Disease Progression
;
Disease-Free Survival
;
Humans
;
Lymph Nodes
;
Medical Records
;
Neoplasm Metastasis
;
Radiotherapy
;
Retrospective Studies
8.The low dose paclitaxel as first-line chemotherapy for metastatic or recurrent gastric cancer.
Jane SHIN ; Inho KIM ; Hwi Ra PARK ; Jung Sik MOON ; Hwung Soo WI ; Moon Hee LEE ; Yoon Seok HUR ; Seok Hwan SHIN ; Chul Soo KIM
Korean Journal of Medicine 2005;68(3):308-315
BACKGROUND: To assess the effect and toxicity of low-dose paclitaxel in patients with metastatic or recurrent gastric cancer with measurable lesions as first-line chemotherapy. METHODS: Patients with measurable metastatic or recurrent gastric cancer were eligible in this study. Paclitaxel and cisplatin were intravenously infused for 3h, at a dose of each 135 mg/m2 and 60 mg/m2, every 3 weeks and then this regimen was repeated until intolerable toxicity or disease progression. Objective tumor responses, duration of response, time to disease progression, and toxicity profile were evaluated in this study. RESULTS: Total 31 patients were enrolled in this study between May 2001 and January 2004. Sixteen patients had ECOG performance status (PS) 1, eleven had PS 2 and four had PS 3. A total of 122 cycles (median 3, range 1~12) were administered. Eleven (35%, 11/31) objective partial responses (PR) were observed and the remaining 19 patients showed stable (9 patients, 30%) and progressive disease (11 patients, 35%). The response rate was 35% (95% confidence interval, 18~51%). The estimated median survival was 8.1 months, median response duration was 5.3 months and median progression-free survival was 3.3 months. Severe toxicities were uncommon. There were 14 episodes (11.5%) of grade 3-4 neutropenia. Grade 3 nausea and vomiting occurred in 4%. Grade 3 peripheral neuropathy occurred in 3.3%. CONCLUSION: This low dose paclitaxel regimen (135 mg/m2) showed comparable results with previously published high-dose paclitaxel regimen (175~250 mg/m2) used in metastatic or recurrent gastric cancer and the toxicity was minimal.
Cisplatin
;
Disease Progression
;
Disease-Free Survival
;
Drug Therapy*
;
Humans
;
Nausea
;
Neutropenia
;
Paclitaxel*
;
Peripheral Nervous System Diseases
;
Stomach Neoplasms*
;
Vomiting
9.Results of a Phase II Study to Evaluate the Efficacy of Docetaxel and Carboplatin in Metastatic Malignant Melanoma Patients Who Failed First-Line Therapy Containing Dacarbazine.
Choong Kun LEE ; Minkyu JUNG ; Hye Jin CHOI ; Hye Ryun KIM ; Hyo Song KIM ; Mi Ryung ROH ; Joong Bae AHN ; Hyun Cheol CHUNG ; Su Jin HEO ; Sun Young RHA ; Sang Joon SHIN
Cancer Research and Treatment 2015;47(4):781-789
PURPOSE: There is no standard second-line regimen for malignant melanoma patients with disease progression after first-line chemotherapy, and platinum-alkylating agents combined with paclitaxel have shown modest efficacy. MATERIALS AND METHODS: We conducted a phase II, open-label, single-arm study to test the efficacy of docetaxel combined with carboplatin for malignant melanoma patients who failed previous treatment with dacarbazine. Intravenous docetaxel (35 mg/m2 on days 1 and 8 of each cycle) and carboplatin (area under the curve 3 on days 1 and 8 of each cycle) was administered every 21 days. Primary end point was objective response rate (ORR). RESULTS: Thirty patients were enrolled in the study, and the median follow-up duration was 19.8 months. Among 25 per-protocol patients, there were three responders (1 with complete response and 2 with partial response) and 17 stable disease patients (ORR, 12.0%). Among the per-protocol population, the median progression-free survival (PFS) was 4.3 months and the median overall survival (OS) was 9.6 months. Uveal melanoma patients (n=9) showed the best prognosis compared to other subtypes (median PFS, 7.6 months; OS, 9.9 months). The most common grade 3 or 4 adverse event was neutropenia (n=15, 50.0%). CONCLUSION: Docetaxel combined with carboplatin showed association with an acceptable safety profile and overall efficacy for patients with malignant melanoma who had progressed on chemotherapy containing dacarbazine.
Carboplatin*
;
Dacarbazine*
;
Disease Progression
;
Disease-Free Survival
;
Drug Therapy
;
Follow-Up Studies
;
Humans
;
Melanoma*
;
Neutropenia
;
Paclitaxel
;
Prognosis
10.Prostate-Specific Antigen Nadir and Time to Prostate-Specific Antigen Nadir Following Maximal Androgen Blockade Independently Predict Prognosis in Patients with Metastatic Prostate Cancer.
Seok Young HONG ; Dae Sung CHO ; Sun Il KIM ; Hyun Soo AHN ; Se Joong KIM
Korean Journal of Urology 2012;53(9):607-613
PURPOSE: To evaluate the influence of prostate-specific antigen (PSA) kinetics following maximal androgen blockade (MAB) on disease progression and cancer-specific survival in patients with metastatic, hormone-sensitive prostate cancer. MATERIALS AND METHODS: One hundred thirty-one patients with metastatic, hormone-sensitive prostate cancer treated with MAB at our institution were included in this study. Patients' characteristics, PSA at MAB initiation, PSA nadir, time to PSA nadir (TTN), and PSA decline were analyzed by using univariate and multivariate analysis. RESULTS: At a median follow-up of 30 months, 97 patients (74.0%) showed disease progression and 65 patients (49.6%) died. Fifty-nine patients (45.0%) died from prostate cancer. In the univariate analysis, PSA at MAB initiation, PSA nadir, TTN, and PSA decline were significant predictors of progression-free survival. Also, PSA nadir, TTN, and PSA decline were significant predictors of cancer-specific survival. In the multivariate analysis, higher PSA nadir (> or =0.2 ng/ml) and shorter TTN (<8 months) were independent predictors of shorter progression-free and cancer-specific survival. In the combined analysis of PSA nadir and TTN, patients with higher PSA nadir and shorter TTN had the worst progression-free survival (hazard ratio [HR], 14.098; p<0.001) and cancer-specific survival (HR, 14.050; p<0.001) compared with those with lower PSA nadir and longer TTN. CONCLUSIONS: Our results suggest that higher PSA nadir level and shorter TTN following MAB are associated with higher risk of disease progression and poorer survival in patients with metastatic, hormone-sensitive prostate cancer. Furthermore, these two variables have a synergistic effect on the outcome.
Disease Progression
;
Disease-Free Survival
;
Follow-Up Studies
;
Humans
;
Kinetics
;
Multivariate Analysis
;
Prognosis
;
Prostate
;
Prostate-Specific Antigen
;
Prostatic Neoplasms