PURPOSE: The clinical significance of a mucinous-type colorectal adenocarcinoma is still controversial. Mucinous colorectal adenocarcinomas have been suggested to have distinct clinicopathologic features, i.e., early-onset, right-side dominancy, and poor prognosis. We aimed to verify the biological behaviors of and survivals for mucinous adenocarcinomas compared with non-mucinous adenocarcinomas. METHODS: Using a database of colorectal cancers at Asan Medical Center between 1989 and 2000, we enrolled 121 mucinous adenocarcinoma and 2,289 non-mucinous adenocarcinoma patients in this study. Clinical, pathological characteristics of and prognoses for mucinous adenocarcinomas were analyzed and compared with those for non-mucinous adenocarcinomas, retrospectively. The median follow-up period was 24 (0~113) months for mucinous adenocarcinomas and 32 (0~130) months for non-mucinous adenocarcinoma. RESULTS: Compared to non-mucinous adenocarcinomas, mucinous adenocarcinomas showed distinctive clinicopathologic features of early-onset (P<0.001), frequent family history (P<0.001), right-side dominancy (P=0.010), advanced stage at diagnosis (P<0.001), and common peritoneal seeding at diagnosis (P<0.001). The recurrence rate in the mucinous adenocarcinoma group was 45.2% during the follow-up period: 21.6% distant metastasis, 14.3% peritoneal dissemination, 5.7% local recurrence, and 3.6% simultaneous local recurrence and distant metastasis. The five-year survival rates in stages II and III were 70% and 48.7%, respectively, for mucinous adenocarcinomas and 92% and 50.2%, respectively, for non-mucinous adenocarcinomas. This difference was statistically significant. CONCLUSIONS: Mucinous adenocarcinomas seem to have distinct biologic behaviors with different clinicopathologic features and poor prognosis. A surgical approach with a follow-up schedule considering the characteristics of mucinous adenocarcinomas is needed.
Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Appointments and Schedules ; Chungcheongnam-do ; Colon* ; Colorectal Neoplasms ; Diagnosis ; Follow-Up Studies ; Humans ; Mucins* ; Neoplasm Metastasis ; Prognosis* ; Rectum* ; Recurrence ; Retrospective Studies ; Survival Rate

Many advances, including the development of antibiotics, the advent of diagnostic techniques and the use of nonsurgical drainage have decreased the mortality rate of pyogenic liver abscess. But, early prompt diagnosis and proper treatment is mandatory in gas-forming pyogenic liver abscess because it may run a fulminating course to death. Gas-forming pyogenic liver abscess mostly occurred to old diabetics. Symptoms of duration are shorter and the prognosis is poorer in the gas-forming than in the non-gas-forming liver abscess. We report three cases of gas-forming pyogenic liver abscess which occurred in old diabetic patients. They were successfully managed by parenteral antibiotics and early percutaneous drainage under sonographic guidance. Early and adequate drainage of pus by pigtail catheter may play a crucial role on the treatment of gas-forming liver abscess.
Anti-Bacterial Agents ; Catheters* ; Diabetes Mellitus ; Diagnosis ; Drainage* ; Humans ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver* ; Mortality ; Prognosis ; Suppuration ; Ultrasonography

PURPOSE : Since the combination of cisplatin plus gemcitabine (CG) had a significant survival advantage for the treatment of patients with chemotherapynaive advanced or metastatic non-small cell lung cancer (NSCLC), CG combination have been evaluated with different schedules. However, the best schedule is still unclear. We designed to compare the efficacy and toxicity of CG combination chemotherapy in two different doses of gemcitabine (1,000 or 1,250 mg/m2 3-weekly). MATERIALS AND METHODS : We randomized patients with stage III or IV NSCLC into either gemcitabine 1,250 mg/m2 or gemcitabine 1,000 mg/m2. Patients received cisplatin 60 mg/m2 intravenously on day1 of each 3-week cycle. Gemcitabine was administered intravenously on days 1 and 8 of each 3-week cycle. RESULTS : From April 2002 until July 2004, 125 patients were enrolled from four university hospitals (55 patients in the gemcitabine 1,000 mg/m2 arm and 70 patients in the gemcitabine 1,250 mg/m2 arm). Response rates were not significantly different in both arms (56.4% vs. 55.7%). However, grade 3 neutropenia was significantly lower in gemcitabine 1,000 mg/m2 arm compared to gemcitabine 1,250 mg/m2 arm (11.0% vs. 15.8%). No differences in non-haematologic toxicities in both arms except anorexia were observed. The median survival was 13.4 months for gemcitabine 1,000 mg group compared with 15.8 months for gemcitabine 1,250 mg group. There were no statistically significant differences in survival between the groups. CONCLUSION : For stage III or IV non-small cell lung cancer, combination chemotherapy with gemcitabine 1,000 mg/m2 showed equivalent response rate with lesser neutropenia and anorexia compared to treatment with gemcitabine 1,250 mg/m2
Anorexia ; Appointments and Schedules ; Arm ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin ; Drug Therapy, Combination ; Hospitals, University ; Humans ; Neutropenia

PURPOSE: With the emergence of next-generation sequencing (NGS) technology, profiling a wide range of genomic alterations has become a possibility resulting in improved implementation of targeted cancer therapy. In Asian populations, the prevalence and spectrum of clinically actionable genetic alterations has not yet been determined because of a lack of studies examining high-throughput cancer genomic data. MATERIALS AND METHODS: To address this issue, 1,071 tumor samples were collected from five major cancer institutes in Korea and analyzed using targeted NGS at a centralized laboratory. Samples were either fresh frozen or formalin-fixed, paraffin embedded (FFPE) and the quality and yield of extracted genomic DNA was assessed. In order to estimate the effect of sample condition on the quality of sequencing results, tissue preparation method, specimen type (resected or biopsied) and tissue storage time were compared. RESULTS: We detected 7,360 non-synonymous point mutations, 1,164 small insertions and deletions, 3,173 copy number alterations, and 462 structural variants. Fifty-four percent of tumors had one or more clinically relevant genetic mutation. The distribution of actionable variants was variable among different genes. Fresh frozen tissues, surgically resected specimens, and recently obtained specimens generated superior sequencing results over FFPE tissues, biopsied specimens, and tissues with long storage duration. CONCLUSION: In order to overcome, challenges involved in bringing NGS testing into routine clinical use, a centralized laboratory model was designed that could improve the NGS workflows, provide appropriate turnaround times and control costs with goal of enabling precision medicine.
Academies and Institutes ; Asian Continental Ancestry Group ; DNA ; Humans ; Korea ; Methods ; Paraffin ; Point Mutation ; Precision Medicine ; Prevalence