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Clinical Significance of Peripheral Blood CEA mRNA Expression in Gastric Cancer Patients Underwent Curative Resection.

Jae Hong SEO ; Sun Hee PARK ; Chang Won BAK ; Chul Won CHOI ; Byoung Soo KIM ; Sang Won SHIN ; Yeul Hong KIM ; Jun Suk KIM ; Young Jae MOK ; Jong Suk KIM ; Seon Ae HAN ; Jung In YOON

Cancer Research and Treatment.2001;33(6):483-488.

PURPOSE: Recent advances in molecular technology have made it possible to detect small numbers of circulating tumor cells in the peripheral blood or bone marrow. Carcinoembryonic antigen (CEA) is an oncofetal antigen that is expressed in epithelial tumor cells. CEA mRNA may be a reliable marker for the detection of tumor cells in the peripheral blood of patients with epithelial cancer. MATERIALS AND METHODS: We analyzed the peripheral blood of 46 patients with gastric cancer who had undergone curative resection. The presence of CEA mRNA was serially monitored using RT-PCR (Preop, Post op 15 day, 2 months (m), 4 m, 6 m, 8 m, 10 m, 12 m). The clinical characteristics, serum CEA level and immunohistochemical staining of tumor tissue were also evaluated. Patients were followed up for 6 to 12 months. RESULTS: There was no significant relationship seen between CEA mRNA RT-PCR positivity in the peripheral blood and sex, stage, serum CEA level or immunohistochemical staining for CEA antigen, During follow up,eight patients experienced recurrence; were positve for CEA mRNA RT-PCR recurrence was seen in 66.7% (6/9) of the patients who before clinical recurrence as compared to 5.4% (2/37) of patients who were negative (p=0.0002). Serial changes of CEA mRNA RT-PCR correlated with clinical recurrence; 100% in the positively converted group (3/3), 0% in the negatively converted group(0/18), 50% in all positive group (3/6) and 10.5% in all negative group (2/19) experienced recurrence, respectively. CONCLUSION: RT-PCR analysis of CEA mRNA in the peripheral blood seems to be a promising tool for the early detection of micrometastatic circulating tumor cells in gastric cancer patients and may be useful in determining patients at high risk for recurrence. However, definitive correlation with recurrence certainly requires a longer follow up duration in further studies.
Bone Marrow ; Carcinoembryonic Antigen ; Follow-Up Studies ; Humans ; Neoplastic Cells, Circulating ; Recurrence ; RNA, Messenger* ; Stomach Neoplasms*

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Reoperation of Recurrent Gastric Cancer.

Seung Man PARK ; Chul Hee LEE ; Cho Hyun PARK ; Wook KIM ; Chang Jun AHN ; Geun Woo LIM ; Woo Bae PARK ; Seung Nam KIM ; In Chul KIM

Cancer Research and Treatment.2001;33(6):478-482.

PURPOSE: The aim of this study was to evaluate the outcome of reoperation in recurrent gastric cancers. MATERIALS AND METHODS: We conducted a retrospective analysis of 86 patients who underwent reoperation for recurrent gastric cancer. We reviewed the time interval between first operation and reoperation, as well as the recurrence pattern, type of reoperation, and survival following reoperation. RESULTS: the average time to reoperation following curative resection was 27.8+/-25.9 months (median 18.4 months). Fifty-three cases (61.6%) of reoperation were performed within 2 years follwoing the first operation. The most common reason for reoperation was intestinal obstruction followed by gastric remnant recurrence and intra-abdominal mass. Complete resection was possible in 14 cases (16.3%) and a palliative procedure such as partial resection or bypass procedures was performed in 54 cases. In 18 cases (20.9%), simple lapalotomy was done without any aid. The most common site of recurrence was the peritoneum followed by the gastric remnant, distant lymph node and hematogenous liver metastasis. Operative mortality was 10.5%. Excluding the 9 cases of operative mortality, the mean survival time after reoperation was 15.4+/-2.5 months (mean 8.6 months). Survival following complete resection was much longer than palliative procedure and exploration only (37.9+/-8.7 vs 10.9+/-1.5 vs 4.7+/-0.8 months, p=0.000) Conclusion : The complete resection of recurrent gastric cancer can prolong survival. Early detection of localized recurrence is important in order to increase the chance of complete resection.
Gastric Stump ; Humans ; Intestinal Obstruction ; Liver ; Lymph Nodes ; Mortality ; Neoplasm Metastasis ; Peritoneum ; Recurrence ; Reoperation* ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

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Clinical Features of Neuroendocrine Lung Cancer.

Eun Kyoung KIM ; Geun Doo JANG ; Cheol Won SUH ; Sang We KIM ; Sang Do LEE ; Woo Seong KIM ; Jung Shin LEE ; Ho Jung LEE ; In Cheol LEE

Cancer Research and Treatment.2001;33(6):474-477.

PURPOSE: This study was performed to investigate the clinical features of neuroendocrine lung cancer. MATERIALS AND METHODS: We performed a retrospective review of the histopathology and clinical information of 21 patients diagnosed as having neuroendocrine lung cancer between 1995 and 1999. RESULTS: Nineteen cases were male and 2 were female. The median age was 64 years (range: 45~80). Pathologic classification were atypical carcinoid (AC) in 2 cases, large cell neuroendocrine carcinoma (LCNEC) in 7 cases, and intermediate cell neuroendocrine carcinoma (ICNC) in 12 cases. Nine patients received tumor resection as first line therapy; adjuvant chemotherapy was given to 3 patients. Concurrent chemoradiotherapy was given to 1 patient. Six patients received palliative chemotherapy. The chemotherapy regimen included etoposide cisplatin in 5 cases and vinorelbine+cisplatin in 1 case. The median survival times were 11, 16 and 59 weeks for AC, LCNEC and ICNC, respectively. The estimated 2-year survival rates were AC 0%, LCNEC 22% and ICNC 31%. CONCLUSION: Surgery may have a positive effect on survival in patients with early stage cansers. Further investigation is required to improve survival in cases of advanced stage cancer.
Carcinoid Tumor ; Carcinoma, Neuroendocrine ; Chemoradiotherapy ; Chemotherapy, Adjuvant ; Cisplatin ; Classification ; Drug Therapy ; Etoposide ; Female ; Humans ; Lung Neoplasms* ; Lung* ; Male ; Retrospective Studies ; Survival Rate

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Efficacy of Low-dose Paclitaxel and Cisplatin in Patients with Advanced Non-Small Cell Lung Cancer.

Byung Su KIM ; Do Youn OH ; Yo Han JOH ; Do Yeun KIM ; Jee Hyun KIM ; Se Hoon LEE ; Dae Ho LEE ; Tae You KIM ; Dae Seog HEO ; Yung Jue BANG ; Noe Kyeong KIM

Cancer Research and Treatment.2001;33(6):469-473.

PURPOSE: To evaluate the efficacy and toxicity of combination chemotherapy with low-dose paclitaxel and cisplatin in patients with advanced non-small cell lung cancer. MATERIALS AND METHODS: Chemotherapy-naive patients with unresectable, pathologically proven non-small cell lung cancer were eligible for inclusion in the study. Patients received paclitaxel (145 mg/m2 iv 3 hour D1) and cisplatin (60 mg/m2 iv D1) every 3 weeks. RESULTS: Forty-two patients were enrolled between February 2000 and February 2001. The median age was 53.5 years. Patients with adenocarcinoma numbered 29, squamous cell carcinoma 7, large cell carcinoma 3, and undifferentiated carcinoma 3. Seventeen patients had stage IIIB, 19 had stage IV disease and the remaining 6 displayed recurred disease after previous surgical resection. Four patients terminated treatment early because of hypersensitivity (1) and severe emesis (3). Of the 38 evaluable patients, 14 had PR and the response rate was 36.8%. Among partial responders, 6 patients received additional chest radiation. The median duration of response was 47.9 weeks and the median overall survival was 54.0 weeks. Of the total 176 courses, 14 were delayed, 22 required dose reduction, and grade 3~4 neutropenia occurred in 5.6% of courses. Only one episode of neutropenic fever developed and there were no treatment- related mortalities. Other toxicities were generally mild. CONCLUSION: The combination chemotherapy with low-dose paclitaxel and cisplatin was effective and tolerable in patients with advanced non-small cell lung cancer.
Adenocarcinoma ; Carcinoma ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Cisplatin* ; Drug Therapy ; Drug Therapy, Combination ; Fever ; Humans ; Hypersensitivity ; Mortality ; Neutropenia ; Paclitaxel* ; Thorax ; Vomiting

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Sarcoma and Sarcomatous Metaplastic Carcinoma of the Breast.

Sang Han YU ; Woo Chul NOH ; Ho Yoon BANG ; Dae Yong HWANG ; Dong Wook CHOI ; Jong Inn LEE ; Nam Sun PAIK ; Nan Mo MOON ; Jin Haeng JUNG

Cancer Research and Treatment.2001;33(6):463-468.

PURPOSE: Primary sarcoma and SMC (sarcomatous metaplastic carcinoma) of the breast are very rare tumors, accounting for less than 1% of all breast malignancies. There are many controversies concerning the biological characteristics, prognosis and optimal treatment of these tumors owing to the rarity of incidence. The aims of this study were to elucidate the clinicopathologic characteristics of these tumors and to assist in elucidating the optimal treatment plan for the disease. MATERIALS AND METHODS: 13 cases of primary sarcoma and 10 cases of SMC that had been treated at KCCH between 1984 and 2001 were retrospectively reviewed. Phyllodes tumors were excluded from our study. RESULTS: Among the 13 cases of primary sarcoma included, stromal sarcoma occurred in 5 cases, osteosarcoma in 3 cases, angiosarcoma in 3 cases and spindle cell sarcoma in 2 cases. The mean age of the patients with primary sarcoma and SMC was 39.7 years and 55.1 years respectively (p=0.002). When survival rates were compared according to histologic types, size of tumor, histologic grade, type of surgery and use of adjuvant therapy, both size of tumor (p=0.0256) and histologic grade (p=0.0197) were shown to be prognostic factors. CONCLUSION: There were no significantly different features between primary sarcoma and SMC in terms of biologic characteristics or survival rates, with the exception that patients with SMC were older than those with primary sarcoma. Histologic grade and size of tumor were significant prognostic factors of these tumors.
Breast Neoplasms ; Breast* ; Hemangiosarcoma ; Humans ; Incidence ; Osteosarcoma ; Phyllodes Tumor ; Population Characteristics ; Prognosis ; Retrospective Studies ; Sarcoma* ; Survival Rate

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Clinical Analysis of Phyllodes Tumor of the Breast.

Sang Hoon HAN ; Woon Gi LEE ; Kyung Ho CHA ; Tae Hoon LEE ; Dong Bock SHIN ; Seung Yun HA ; Heung Gyu PARK

Cancer Research and Treatment.2001;33(6):458-462.

PURPOSE: Phyllodes tumors are fibroepithelial mammary lesions that tend to behave in a benign fashion but may undergo sarcomatous transformation. They account for 0.3 to 0.5 percent of all breast tumors. Their behavior is not well understood by many clinicians. MATERIALS AND METHODS: We retrospectively reviewed the clinical, radiologic, and pathologic finding and treatment modality of 31 patients of phyllodes tumor diagnosed at the Breast Clinic, Gachon Medical School Gil Medical Center between July 1992 and July 2000. RESULTS: Pathologically, 6 patients (19.3%) had malignant tumor and 25 patients (80.7%) had benign lesions. All were women with average age of 36 years. The patients with malignant tumors tended to be older and had larger tumors and shorter duration. For preoperative diagnosis, we used mammography, sonography, and MIBI Scintimammography, fine needle aspiration cytology and biopsy. All these diagnostic methods suggested the diagnosis of phyllodes tumors in only 8 cases (26%). All patients received surgical treatment: excision in 21 cases, wide excision in 3 cases, simple mastectomy in 5 cases, and simple mastectomy with axillary lymph node dissection 2 cases. One patient with malignant tumor, two patients with borderline tumor and three patients with benign tumor experienced recurrence (19.3%). CONCLUSION: None of the clinical or radiologic characteristics was useful in predicting for phyllodes tumor. Phyllodes tumors were difficult to make proper preoperative diagnoses and to differ malignant tumor from a benign one. This led to a simple excision and resulted in high local recurrence. We suggest that the initial or subsequent wide excision is an appropriate surgery to decrease the recurrence.
Biopsy ; Biopsy, Fine-Needle ; Breast Neoplasms ; Breast* ; Diagnosis ; Female ; Humans ; Lymph Node Excision ; Mammography ; Mastectomy, Simple ; Phyllodes Tumor* ; Recurrence ; Retrospective Studies ; Schools, Medical

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A Phase II Study of Genexol(R) (paclitaxel) in Metastatic Breast Cancer.

Joo Young JUNG ; Hyun Chul JEONG ; Sung Soo YOON ; Jae Hoon LEE ; Jun Seok KIM ; Hyo Jin KIM ; Ki Hyun KIM ; Jun O PARK ; Won Seop LEE ; Dae Seog HEO ; Yung Jue BANG ; Noe Kyeong KIM

Cancer Research and Treatment.2001;33(6):451-457.

PURPOSE: Paclitaxel is a very effective agent in the treatment of breast cancer. Samyang Corporation has developed its own process to produce paclitaxel in a large volume using plant cell culture technology. To evaluate the efficacy and safety of Genexol(R) in patients with metastatic breast cancer who have failed to respond to standard therapy, we performed a prospective, multi- center phase II clinical trial. MATERIALS AND METHODS: Patients with metastatic breast cancer were included in this study. Enrollees were required to have histologically confirmed breast cancer with bidimensionally measurable metastatic disease. Genexol(R) was administered at 175 mg/m2 as a 3-hour intravenous infusion every 3 weeks. All patients were premedicated with hydrocortisone, pheniramine maleate, and H2 blocker 30 minutes prior to paclitaxel. We planned to administer at least 4 courses of paclitaxel unless there was disease progression or unacceptable toxicity and to continue treatment up to a total of 6 courses in cases of objective response following 4 courses. RESULTS: The median duration of follow-up was 8.9 (2.07~13.7) months. Forty-five patients were registered and 43 were eligible. The performance status of patients was ECOG 0~1 in 39 patients (90.7%) and 2 in 4 (9.3%). The location of metastases at the start of the study were the lung (15 patients), liver (8 patients), lymph nodes (22 patients), and other (7 patients). Among the 40 evaluable patients, 15 patients obtained partial responses (PRs) (37.5%, 95% CI: 22.5~52.5%). The median duration of response was 11.67 (4.1~11.7) months and the median time to progression was 7.73 (2.8~11.7) months. The median survival time was not reached at 13.7 months, and the overall survival rate at 13.7 months was 70.1%. The hematologic toxicity was primarily neutropenia with grade 3 or 4 in 10 patients (23.3%). The grade 3 or 4 non-hematologic toxicities included alopecia (17, 39.5%), myalgia (2, 4.7%), neuropathy (2, 4.7%), and pruritus (1, 2.3%). Mild hypersensitivity reaction was observed in 2 patients, although it did not cause withdrawal of the test drug. CONCLUSION: The results suggest that the Genexol injection is an effective anticancer formulation for the treatment of metastatic breast cancer and toxicity is acceptable.
Alopecia ; Breast Neoplasms* ; Breast* ; Disease Progression ; Drug Therapy ; Follow-Up Studies ; Humans ; Hydrocortisone ; Hypersensitivity ; Infusions, Intravenous ; Liver ; Lung ; Lymph Nodes ; Myalgia ; Neoplasm Metastasis ; Neutropenia ; Paclitaxel ; Pheniramine ; Plant Cells ; Prospective Studies ; Pruritus ; Survival Rate

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A Case of Erdheim-Chester Disease with Asymptomatic Renal Involvement.

Hyun Jung LEE ; Kyoung Yul LEE ; Dong Yeop SHIN ; Yun Gyoo LEE ; Se Youn CHOI ; Kyung Chul MOON ; Il Kyu HAN ; Tae Min KIM

Cancer Research and Treatment.2012;44(2):146-150.

Erdheim-Chester disease is a rare non-Langerhans-cell histiocytosis involving bones and multiple organs. Its clinical course can vary, from an asymptomatic state to a fatal disease, with renal involvement being a common cause of death. A 41-year-old man presented with a 10-month history of bilateral lower limb pain. Left perirenal soft-tissue infiltration had been found incidentally two years earlier. No progression of the lesion or deterioration of renal function was observed for a period of two years. At admission, plain radiography and magnetic resonance imaging of the patient's lower limbs showed patchy osteosclerosis. Biopsy of the tibia revealed histiocytic infiltration, which was found to be positive for CD68 and negative for CD1a. This report describes an unusual case of Erdheim-Chester disease involving a stationary course of disease with no specific treatment for a long period of time.
Adult ; Asymptomatic Diseases ; Biopsy ; Cause of Death ; Erdheim-Chester Disease ; Histiocytosis, Non-Langerhans-Cell ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Osteosclerosis ; Retroperitoneal Fibrosis ; Tibia

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Metastatic Skin Lesions on Lower Extremities in a Patient with Recurrent Serous Papillary Ovarian Carcinoma: A Case Report and Literature Review.

Moon Kyung KIM ; Seo Hee KIM ; Yoo Young LEE ; Chel Hun CHOI ; Tae Joong KIM ; Jeoung Won LEE ; Je Ho LEE ; Duk Soo BAE ; Byoung Gie KIM

Cancer Research and Treatment.2012;44(2):142-145.

Clinical observation of skin metastasis in ovarian cancer cases is relatively uncommon. And distant metastatic skin lesions including the extremities are much rarer still as most metastatic skin lesions are located in the skin in the abdominal wall adjacent to where the primary ovarian tumors exist. We report the case of a 60-year-old woman who presented skin lesions on both lower extremities as a consequence of the metastasis of serous papillary adenocarcinoma of the ovary. She presented with erythematous and painful cutaneous nodules on both upper legs and in the inguinal area 42 months after initial diagnosis of ovarian cancer. Skin biopsy revealed metastasis of adenocarcinoma in the dermis. She was treated with surgical excision and systemic chemotherapy. Literature review has suggested that a combined modality approach including surgical excision and chemotherapy may be useful in the management of skin metastases due to ovarian cancer.
Abdominal Wall ; Adenocarcinoma ; Adenocarcinoma, Papillary ; Biopsy ; Dermis ; Extremities ; Female ; Humans ; Leg ; Lower Extremity ; Middle Aged ; Neoplasm Metastasis ; Ovarian Neoplasms ; Ovary ; Palliative Care ; Skin ; Skin Neoplasms

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Irradiation of Donor Mononuclear Cells for Treatment of Chemorefractory Metastatic Solid Cancers: A Community-Based Immune Transplant Pilot Study.

John T REYNOLDS ; John M WATKINS ; Tarek A DUFAN ; Shrikant S KUBSAD

Cancer Research and Treatment.2012;44(2):133-141.

PURPOSE: Chemotherapy has demonstrated ability to generate tumor antigens secondary to induction of apoptosis, against which human leukocyte antigen-compatible, irradiated, related donor mononuclear cells may be administered with immune stimulation to activate antigen presenting and cytotoxic T cells, while minimizing risk of graft-versus-host disease (GVHD). The present study endeavours to describe feasibility and efficacy of this treatment, specifically in the community setting. MATERIALS AND METHODS: Eligible patients had rapidly progressive, chemorefractory metastatic solid tumors. Treatment consisted of intravenous etoposide and cyclosporine for three days followed by granulocyte-macrophage colony-stimulating factor for 5 days. The following week, 5x10(7) haploidentical or more closely matched irradiated donor mononuclear cells were given weekly for 10 weeks along with interleukin-2. RESULTS: Three patients were enrolled, and the regimen was well-tolerated, with no GVHD observed. All patients had clinical response, despite advanced and heavily pretreated disease. CONCLUSION: The above-outlined protocol demonstrates favorable tolerability and efficacy, and appears to be feasible in the community setting. While the optimal chemotherapy, immunostimulation, and irradiation regimens may be further optimized, future investigation appears warranted, and may include community oncology programs.
Antigens, Neoplasm ; Apoptosis ; Cyclosporine ; Etoposide ; Graft vs Host Disease ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Immunization ; Immunomodulation ; Leukocytes ; Leukocytes, Mononuclear ; Neoplasm, Residual ; Pilot Projects ; T-Lymphocytes ; Tissue Donors ; Transplants

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