Surgery is the only curative modality for the treatment of gastric cancer. There has been no drastic improvement in the treatment of gastric cancer with chemotherapy. Clinical trials have attempted to demonstrate the benefit of the preoperative chemotherapy for gastric cancer. The benefit of the use of preoperative chemotherapy or chemoradiotherapy has been demonstrated for other solid cancers such as breast cancer, esophageal cancer and rectal cancer. Despite the rationale of the use of preoperative chemotherapy for patients with gastric cancer, the evidence of positive results with the use of preoperative chemotherapy has not been clear. Recently the British Medical Research Council Adjuvant Gastric Cancer Infusional Chemotherapy (MAGIC) study demonstrated the survival benefit of preoperative and postoperative chemotherapy. However, this study had several problems with the use of a heterogeneous population of patients, the method of surgery and the use of perioperative chemotherapy. Further studies with new drugs are warranted to determine the role of pre-operative chemotherapy for patients with gastric cancer.
Breast Neoplasms ; Chemoradiotherapy ; Esophageal Neoplasms ; Humans ; Rectal Neoplasms ; Stomach ; Stomach Neoplasms

No abstract available.
Humans ; Nutritional Status* ; Prognosis*

Gastric cancer is the second cause of cancer that is related to death and the fourth most common cancer, worldwide. Complete resection of cancer is the only curative treatment for gastric cancer. However, even if complete resection is possible, recurrence is frequently observed in Gastric patients. Therefore, adjuvant treatment modality for resectable gastric cancer is needed to increase the survival of patients. This study wants to describe the role of adjuvant chemotherapy for resectable gastric cancer, with updated data of recent studies. Several meta-analysis studies demonstrated a benefit of adjuvant chemotherapy for resectable gastric cancer. Due to the heterogeneity of the population and regimens, there is no consensus regarding the adjuvant chemotherapy. Recently published, well designed phase III studies demonstrated the statistically significance of adjuvant chemotherapy for the resectable gastric cancer, with the extended lymph node dissection. Further phase III trials, to determine the best regimen and schedule of adjuvant chemotherapy, was suggested to use the fluoropyrimidine based regimen as control group.
Appointments and Schedules ; Chemotherapy, Adjuvant ; Consensus ; Humans ; Lymph Node Excision ; Population Characteristics ; Recurrence ; Stomach Neoplasms

No abstract available.
Biomarkers, Tumor

Brunners gland adenoma is a benign epithelial tumor of the duodenum originating from submucosal Brunners gland. This is an extremely rare entity that account for only 10.6% of benign duodenal tumor, which are themselves relatively rare, representing 0.008% of all surgical and autopsy specimens. The clinical manifestation are nonspecific gastrointestinal complaints, such as bloating or epigastric pain, and the tumor gives rise to melena or anemia, due to the ulceration or erosion of the tumor. The diagnosis is usually made by radiologic studies and gastroduodenal endoscopy which can also provide definitive treatment. The aim of treatment is complete removal of the lesion and exclude malignancy. We report on 4 cases of Brunners gland adenoma which was confirmed by operation or endoscopic polypectomy.
Adenoma* ; Anemia ; Autopsy ; Diagnosis ; Duodenum ; Endoscopy ; Melena ; Ulcer

Gastric cancer (GC) is the second leading cause of cancer mortality and the fourth most commonly diagnosed malignant diseases. While continued efforts have been focused on GC treatment, the introduction of trastuzumab marked the beginning of a new era of target-specific treatments. Considering the diversity of mutations in GC, satisfactory results obtained from various target-specific therapies were expected, yet most of them were unsuccessful in controlled clinical trials. There are several possible reasons underlying the failures, including the absence of patient selection depending on validated predictive biomarkers, the inappropriate combination of drugs, and tumor heterogeneity. In contrast to targeted agents, immuno-oncologic agents are designed to regulate and boost immunity, are not target-specific, and may overcome tumor heterogeneity. With the successful establishment of predictive biomarkers, including Epstein-Barr virus pattern, microsatellite instability status, and programmed death-ligand 1 (PD-L1) expression, as well as ideal combination regimens, a new frontier in the immuno-oncology of GC treatment is on the horizon. Since the field of immuno-oncology has witnessed innovative, practice-changing successes in other cancer types, several trials on GC are ongoing. Among immuno-oncologic therapies, immune checkpoint inhibitors are the mainstay of clinical trials performed on GC. In this article, we review target-specific agents currently used in clinics or are undergoing clinical trials, and highlight the future clinical application of immuno-oncologic agents in inoperable GC.
Biomarkers ; Herpesvirus 4, Human ; Immunotherapy ; Microsatellite Instability ; Mortality ; Patient Selection ; Population Characteristics ; Stomach Neoplasms* ; Trastuzumab

Purpose: The prognosis of young colorectal cancer (CRC) patients has not fully been addressed. The prognostic significance of systemic inflammatory markers was examined in those patients. Methods: A total of 965 patients with resectable CRC were divided into young (≤ 50 years, n = 101) and old groups (>51 years, n = 864). Neutrophil-to-lymphocyte ratio (NLR) > 5, derived NLR (dNLR) > 3, lymphocyte-to-monocyte ratio (LMR) < 2, platelet-to-lymphocyte ratio (PLR) > 150, and prognostic nutritional index (PNI) < 45 were analyzed for prognosis.Overall survival (OS) and progression-free survival (PFS) were compared using the log-rank test. A multivariate analysis was performed using a Cox proportional hazards regression model. Results: In the young group, NLR > 5, LMR < 2, and PNI < 45 were significantly associated with OS with univariate analyses. dNLR > 3 and those markers showed significance for PFS. LMR < 2 was a significant marker for poor PFS (hazard ratio [HR], 5.81; P = 0.020) in the multivariate analysis. In the old group, all inflammatory markers were significantly associated with OS and PFS with univariate analyses. LMR < 2 (HR, 2.66; P = 0.016) and PNI < 45 (HR, 2.14; P = 0.016) were independently associated with OS in multivariate analyses. PLR > 150 (HR, 1.45; P = 0.036) and PNI < 45 (HR, 1.73; P = 0.002) were significant markers for PFS. Conclusion Systemic inflammation might be one of biologic factors that influence on prognosis of young CRC.

PURPOSE: Because data as a basis for the determination of proper age and modality for screening of colorectal neoplasms is lacking, we evaluated detection rates and anatomical distribution of colorectal neoplasms according to age in healthy individuals who underwent total colonoscopy for health checkup. METHODS: A total of 16,100 cases that had received the colonoscopic examination from January to December in 2014 were analyzed. The total number of individuals who received total colonoscopy were divided by the number of individuals harboring colorectal adenoma to calculate the detection rate of colorectal adenoma. Individuals ≤50 years old were classified as young-age group and aged >50 were old-age group. Differences in anatomical locations of colorectal neoplasms were analyzed in the 2 age groups by chi-square test. Risk factors for colorectal adenoma in each age group were analyzed using univariate and multivariate logistic regression analyses. RESULTS: Detection rates of colorectal adenoma were 13.7% in all cases and 12.8% for those in their 40′s. The main anatomical location of colorectal adenoma was proximal colon in both age groups (P < 0.001). Hyperplastic polyp was mainly distributed to the distal colon in both age groups (P < 0.001). Distal colon was the major site for colorectal cancer in the old-age group (P = 0.001). Proximal location of neoplasms was a risk factor for colorectal adenoma in both age groups with multivariate analysis. CONCLUSION: These data could be the bases for earlier initiation of screening for colorectal neoplasms with total colonoscopy to detect clinically significant colorectal polyps.
Adenoma ; Colon ; Colonoscopy ; Colorectal Neoplasms ; Humans ; Logistic Models ; Mass Screening ; Multivariate Analysis ; Polyps ; Risk Factors

PURPOSE: The cisplatin and etoposide had been reported to be an effective anti-tumor drug for small cell lung cancer, ovarian cancer, breast cancer and so on. The aim of this study was to evaluate the stability of cisplatin and etoposide in aqueous solution. MATERIALS AND METHODS: Cisplatin 200 microgram/ml was prepared in 0.9% sodium chloride and stored in either glass bottle or polyvinyl chloride (pvc) bag and protected from light or exposed to fluorescent light. Etoposide solution was prepared in 0.9% sodium chloride, and contained in glass bottle. Precipitating concentration was achieved using 200 microgram/ml, 400microgram/ml, 600 microgram/ml, and 1000 microgram/ml of etoposide solution. Samples were stored at room temperature and visually inspected and assayed for etoposide and cisplatin content by high-performance liquid chromatography after 15 minutes, 2, 4, 8, 12, 16 and 24 hours of storage. RESULT: 1) Cisplatin concentration decreased less than 10% from initial concentration for 24 hours of storage, both in glass bottle and pvc bag. Stability of cisplatin 200 microgram/ml in both container were not different. and Condition of light exposure did not have significant effect on stability of cisplatin 200 microgram/ml in glass bottle. 2) The etoposide 200 microgram/ml was not precipitated and stable for 24 hours, but we could find the precipitates of etoposide with the concentration of 400 microgram/ml or higher for 24 hours. CONCLUSION: Cisplatin 200 microgram/ml and etoposide 200 microgram/ml in 0.9% sodium chloride were stable at room temperature under room fluorescent light for 24 hours.
Breast Neoplasms ; Chromatography, Liquid ; Cisplatin* ; Etoposide* ; Glass ; Ovarian Neoplasms ; Polyvinyl Chloride ; Small Cell Lung Carcinoma ; Sodium Chloride

Systemic lupus erythematosus (SLE) is one of the connective diseases characterized by altered immunity and has a high incidence of cancers, such as malignant lymphoma, leukemia, breast cancer and cervical cancer. Lymphadenopathy is one of the clinical findings of SLE. But it is also seen in cancer metastasis. Therefore, if the SLE patient has lymphadenopathies from cancer metastasis it is very difficult to make a differential diagnosis between the manifestation of SLE and that of cancer metastasis. In Korea, there is no report on SLE associated with lymphadenopathies from cancer metastasis. This is the first report of a case of SLE with a cervical lympadenopathy that comes from the metastasis of head and neck squamous cell carcinoma.
Breast Neoplasms ; Carcinoma, Squamous Cell ; Diagnosis, Differential ; Head and Neck Neoplasms* ; Head* ; Humans ; Incidence ; Korea ; Leukemia ; Lupus Erythematosus, Systemic* ; Lymphatic Diseases ; Lymphoma ; Neck ; Neoplasm Metastasis ; Uterine Cervical Neoplasms