1.Assessment of Weight Change and All-Cause Mortality Based on Body Mass Index Intervals in South Korea: A 12-Year Follow-Up of the Korean Longitudinal Study of Aging
DaHye CHO ; Jae Hyuck LEE ; Seung Wan HONG ; Young Sung SUH ; Dae Hyun KIM
Korean Journal of Health Promotion 2024;24(4):143-149
Background:
Obesity and weight loss are associated with increased mortality. Understanding the association between weight change and mortality is critical and can help inform effective prevention and intervention strategies. Therefore, this study aimed to investigate the association between weight change and mortality based on body mass index (BMI) intervals using data from a 12-year follow-up survey in Korea.
Methods:
We used data from the Korean Longitudinal Study of Aging from 2006 to 2018. Individuals aged 45–69 years without a history of malignancy and chronic obstructive pulmonary disease at baseline were selected. Cox regression analysis was used to compare mortality based on body mass index and weight change.
Results:
Compared with individuals with a body mass index of 20.0–25.0 kg/m2 and an increase in body weight of <5 kg, mortality was 3.8 times higher in the group with a body mass index of <20.0 kg/m2 and a weight loss of <5 kg, two times higher in the group with a body mass index of 20.0–25.0 kg/m2 and weight loss of >10 kg, and 4.3 times higher in the group with a body mass index of ≥25.0 kg/m2 and weight gain of ≥10 kg.
Conclusions
Weight loss in underweight or normal-weight individuals and weight gain in individuals with obesity increased the mortality rate compared with individuals with normal weight and less weight change. This suggests that body weight and the changes in the weight of individuals are crucial, and weight loss in patients with underweight and weight gain in patients with obesity are closely related to increased mortality.
2.Single-Center Real-World Experience with Primary Central Nervous System Lymphoma in the 21st Century
Hyungwoo CHO ; Jung Yong HONG ; Dae Ho LEE ; Shin KIM ; Kyoungmin LEE ; Eun Hee KANG ; Sunjong LEE ; Jung Sun PARK ; Jeong Hoon KIM ; Jin Sook RYU ; Jooryung HUH ; Cheolwon SUH
Korean Journal of Medicine 2024;99(1):37-49
Background/Aims:
In Korea, the incidence of primary diffuse large B-cell lymphoma of the central nervous system (PCNSL) is increasing and autologous stem cell transplantation (ASCT) has improved the survival of younger patients. We explored our real-world experience with PCNSL at Asan Medical Center (AMC).
Methods:
We used the AMC lymphoma registry to collect patient data prospectively. We analyzed 279 patients diagnosed from 2002 until August 2019.
Results:
The PCNSL incidence at AMC increased progressively and comprised 7.4-8.9% of new non-Hodgkin lymphoma patients annually during the most recent 4 years. The median age was 60 years (range, 17-85) and males comprised 55%. Patients under 65 years of age (n = 183) had no significant differences in characteristics compared to those aged 65 years or over, with the exception of less occipital lobe involvement and lower beta-2 microglobulin levels. Rituximab, methotrexate, procarbazine, and vincristine (R-MPV) combination induction had the best overall response, of 95%. The median overall survival was 3.8 years with 5- and 10-year survival rates of 41.5% and 30.2%, respectively. Survival was better in younger patients and those treated with ASCT. Thiotepa, busulfan, and cytoxan (TBC) conditioning chemotherapy had better survival than other combinations. The International Extranodal Lymphoma Study Group and Memorial Sloan Kettering Cancer Center prognostic score systems were valid in this cohort. Age and performance status were independent prognostic factors. Exclusive extra-central nervous system failure occurred in six patients (5.6%) among 107 failures.
Conclusions
The incidence of PCNSL is rising. R-MPV induction therapy followed by ASCT with TBC has improved the survival of young, fit PCNSL patients.
3.Assessment of Weight Change and All-Cause Mortality Based on Body Mass Index Intervals in South Korea: A 12-Year Follow-Up of the Korean Longitudinal Study of Aging
DaHye CHO ; Jae Hyuck LEE ; Seung Wan HONG ; Young Sung SUH ; Dae Hyun KIM
Korean Journal of Health Promotion 2024;24(4):143-149
Background:
Obesity and weight loss are associated with increased mortality. Understanding the association between weight change and mortality is critical and can help inform effective prevention and intervention strategies. Therefore, this study aimed to investigate the association between weight change and mortality based on body mass index (BMI) intervals using data from a 12-year follow-up survey in Korea.
Methods:
We used data from the Korean Longitudinal Study of Aging from 2006 to 2018. Individuals aged 45–69 years without a history of malignancy and chronic obstructive pulmonary disease at baseline were selected. Cox regression analysis was used to compare mortality based on body mass index and weight change.
Results:
Compared with individuals with a body mass index of 20.0–25.0 kg/m2 and an increase in body weight of <5 kg, mortality was 3.8 times higher in the group with a body mass index of <20.0 kg/m2 and a weight loss of <5 kg, two times higher in the group with a body mass index of 20.0–25.0 kg/m2 and weight loss of >10 kg, and 4.3 times higher in the group with a body mass index of ≥25.0 kg/m2 and weight gain of ≥10 kg.
Conclusions
Weight loss in underweight or normal-weight individuals and weight gain in individuals with obesity increased the mortality rate compared with individuals with normal weight and less weight change. This suggests that body weight and the changes in the weight of individuals are crucial, and weight loss in patients with underweight and weight gain in patients with obesity are closely related to increased mortality.
4.Single-Center Real-World Experience with Primary Central Nervous System Lymphoma in the 21st Century
Hyungwoo CHO ; Jung Yong HONG ; Dae Ho LEE ; Shin KIM ; Kyoungmin LEE ; Eun Hee KANG ; Sunjong LEE ; Jung Sun PARK ; Jeong Hoon KIM ; Jin Sook RYU ; Jooryung HUH ; Cheolwon SUH
Korean Journal of Medicine 2024;99(1):37-49
Background/Aims:
In Korea, the incidence of primary diffuse large B-cell lymphoma of the central nervous system (PCNSL) is increasing and autologous stem cell transplantation (ASCT) has improved the survival of younger patients. We explored our real-world experience with PCNSL at Asan Medical Center (AMC).
Methods:
We used the AMC lymphoma registry to collect patient data prospectively. We analyzed 279 patients diagnosed from 2002 until August 2019.
Results:
The PCNSL incidence at AMC increased progressively and comprised 7.4-8.9% of new non-Hodgkin lymphoma patients annually during the most recent 4 years. The median age was 60 years (range, 17-85) and males comprised 55%. Patients under 65 years of age (n = 183) had no significant differences in characteristics compared to those aged 65 years or over, with the exception of less occipital lobe involvement and lower beta-2 microglobulin levels. Rituximab, methotrexate, procarbazine, and vincristine (R-MPV) combination induction had the best overall response, of 95%. The median overall survival was 3.8 years with 5- and 10-year survival rates of 41.5% and 30.2%, respectively. Survival was better in younger patients and those treated with ASCT. Thiotepa, busulfan, and cytoxan (TBC) conditioning chemotherapy had better survival than other combinations. The International Extranodal Lymphoma Study Group and Memorial Sloan Kettering Cancer Center prognostic score systems were valid in this cohort. Age and performance status were independent prognostic factors. Exclusive extra-central nervous system failure occurred in six patients (5.6%) among 107 failures.
Conclusions
The incidence of PCNSL is rising. R-MPV induction therapy followed by ASCT with TBC has improved the survival of young, fit PCNSL patients.
5.Assessment of Weight Change and All-Cause Mortality Based on Body Mass Index Intervals in South Korea: A 12-Year Follow-Up of the Korean Longitudinal Study of Aging
DaHye CHO ; Jae Hyuck LEE ; Seung Wan HONG ; Young Sung SUH ; Dae Hyun KIM
Korean Journal of Health Promotion 2024;24(4):143-149
Background:
Obesity and weight loss are associated with increased mortality. Understanding the association between weight change and mortality is critical and can help inform effective prevention and intervention strategies. Therefore, this study aimed to investigate the association between weight change and mortality based on body mass index (BMI) intervals using data from a 12-year follow-up survey in Korea.
Methods:
We used data from the Korean Longitudinal Study of Aging from 2006 to 2018. Individuals aged 45–69 years without a history of malignancy and chronic obstructive pulmonary disease at baseline were selected. Cox regression analysis was used to compare mortality based on body mass index and weight change.
Results:
Compared with individuals with a body mass index of 20.0–25.0 kg/m2 and an increase in body weight of <5 kg, mortality was 3.8 times higher in the group with a body mass index of <20.0 kg/m2 and a weight loss of <5 kg, two times higher in the group with a body mass index of 20.0–25.0 kg/m2 and weight loss of >10 kg, and 4.3 times higher in the group with a body mass index of ≥25.0 kg/m2 and weight gain of ≥10 kg.
Conclusions
Weight loss in underweight or normal-weight individuals and weight gain in individuals with obesity increased the mortality rate compared with individuals with normal weight and less weight change. This suggests that body weight and the changes in the weight of individuals are crucial, and weight loss in patients with underweight and weight gain in patients with obesity are closely related to increased mortality.
6.Single-Center Real-World Experience with Primary Central Nervous System Lymphoma in the 21st Century
Hyungwoo CHO ; Jung Yong HONG ; Dae Ho LEE ; Shin KIM ; Kyoungmin LEE ; Eun Hee KANG ; Sunjong LEE ; Jung Sun PARK ; Jeong Hoon KIM ; Jin Sook RYU ; Jooryung HUH ; Cheolwon SUH
Korean Journal of Medicine 2024;99(1):37-49
Background/Aims:
In Korea, the incidence of primary diffuse large B-cell lymphoma of the central nervous system (PCNSL) is increasing and autologous stem cell transplantation (ASCT) has improved the survival of younger patients. We explored our real-world experience with PCNSL at Asan Medical Center (AMC).
Methods:
We used the AMC lymphoma registry to collect patient data prospectively. We analyzed 279 patients diagnosed from 2002 until August 2019.
Results:
The PCNSL incidence at AMC increased progressively and comprised 7.4-8.9% of new non-Hodgkin lymphoma patients annually during the most recent 4 years. The median age was 60 years (range, 17-85) and males comprised 55%. Patients under 65 years of age (n = 183) had no significant differences in characteristics compared to those aged 65 years or over, with the exception of less occipital lobe involvement and lower beta-2 microglobulin levels. Rituximab, methotrexate, procarbazine, and vincristine (R-MPV) combination induction had the best overall response, of 95%. The median overall survival was 3.8 years with 5- and 10-year survival rates of 41.5% and 30.2%, respectively. Survival was better in younger patients and those treated with ASCT. Thiotepa, busulfan, and cytoxan (TBC) conditioning chemotherapy had better survival than other combinations. The International Extranodal Lymphoma Study Group and Memorial Sloan Kettering Cancer Center prognostic score systems were valid in this cohort. Age and performance status were independent prognostic factors. Exclusive extra-central nervous system failure occurred in six patients (5.6%) among 107 failures.
Conclusions
The incidence of PCNSL is rising. R-MPV induction therapy followed by ASCT with TBC has improved the survival of young, fit PCNSL patients.
7.Assessment of Weight Change and All-Cause Mortality Based on Body Mass Index Intervals in South Korea: A 12-Year Follow-Up of the Korean Longitudinal Study of Aging
DaHye CHO ; Jae Hyuck LEE ; Seung Wan HONG ; Young Sung SUH ; Dae Hyun KIM
Korean Journal of Health Promotion 2024;24(4):143-149
Background:
Obesity and weight loss are associated with increased mortality. Understanding the association between weight change and mortality is critical and can help inform effective prevention and intervention strategies. Therefore, this study aimed to investigate the association between weight change and mortality based on body mass index (BMI) intervals using data from a 12-year follow-up survey in Korea.
Methods:
We used data from the Korean Longitudinal Study of Aging from 2006 to 2018. Individuals aged 45–69 years without a history of malignancy and chronic obstructive pulmonary disease at baseline were selected. Cox regression analysis was used to compare mortality based on body mass index and weight change.
Results:
Compared with individuals with a body mass index of 20.0–25.0 kg/m2 and an increase in body weight of <5 kg, mortality was 3.8 times higher in the group with a body mass index of <20.0 kg/m2 and a weight loss of <5 kg, two times higher in the group with a body mass index of 20.0–25.0 kg/m2 and weight loss of >10 kg, and 4.3 times higher in the group with a body mass index of ≥25.0 kg/m2 and weight gain of ≥10 kg.
Conclusions
Weight loss in underweight or normal-weight individuals and weight gain in individuals with obesity increased the mortality rate compared with individuals with normal weight and less weight change. This suggests that body weight and the changes in the weight of individuals are crucial, and weight loss in patients with underweight and weight gain in patients with obesity are closely related to increased mortality.
8.Single-Center Real-World Experience with Primary Central Nervous System Lymphoma in the 21st Century
Hyungwoo CHO ; Jung Yong HONG ; Dae Ho LEE ; Shin KIM ; Kyoungmin LEE ; Eun Hee KANG ; Sunjong LEE ; Jung Sun PARK ; Jeong Hoon KIM ; Jin Sook RYU ; Jooryung HUH ; Cheolwon SUH
Korean Journal of Medicine 2024;99(1):37-49
Background/Aims:
In Korea, the incidence of primary diffuse large B-cell lymphoma of the central nervous system (PCNSL) is increasing and autologous stem cell transplantation (ASCT) has improved the survival of younger patients. We explored our real-world experience with PCNSL at Asan Medical Center (AMC).
Methods:
We used the AMC lymphoma registry to collect patient data prospectively. We analyzed 279 patients diagnosed from 2002 until August 2019.
Results:
The PCNSL incidence at AMC increased progressively and comprised 7.4-8.9% of new non-Hodgkin lymphoma patients annually during the most recent 4 years. The median age was 60 years (range, 17-85) and males comprised 55%. Patients under 65 years of age (n = 183) had no significant differences in characteristics compared to those aged 65 years or over, with the exception of less occipital lobe involvement and lower beta-2 microglobulin levels. Rituximab, methotrexate, procarbazine, and vincristine (R-MPV) combination induction had the best overall response, of 95%. The median overall survival was 3.8 years with 5- and 10-year survival rates of 41.5% and 30.2%, respectively. Survival was better in younger patients and those treated with ASCT. Thiotepa, busulfan, and cytoxan (TBC) conditioning chemotherapy had better survival than other combinations. The International Extranodal Lymphoma Study Group and Memorial Sloan Kettering Cancer Center prognostic score systems were valid in this cohort. Age and performance status were independent prognostic factors. Exclusive extra-central nervous system failure occurred in six patients (5.6%) among 107 failures.
Conclusions
The incidence of PCNSL is rising. R-MPV induction therapy followed by ASCT with TBC has improved the survival of young, fit PCNSL patients.
9.Impact of Patient Sex on Adverse Events and Unscheduled Utilization of Medical Services in Cancer Patients Undergoing Adjuvant Chemotherapy: A Multicenter Retrospective Cohort Study
Songji CHOI ; Seyoung SEO ; Ju Hyun LEE ; Koung Jin SUH ; Ji-Won KIM ; Jin Won KIM ; Se Hyun KIM ; Yu Jung KIM ; Keun-Wook LEE ; Jwa Hoon KIM ; Tae Won KIM ; Yong Sang HONG ; Sun Young KIM ; Jeong Eun KIM ; Sang-We KIM ; Dae Ho LEE ; Jae Cheol LEE ; Chang-Min CHOI ; Shinkyo YOON ; Su-Jin KOH ; Young Joo MIN ; Yongchel AHN ; Hwa Jung KIM ; Jin Ho BAEK ; Sook Ryun PARK ; Jee Hyun KIM
Cancer Research and Treatment 2024;56(2):404-413
Purpose:
The female sex is reported to have a higher risk of adverse events (AEs) from cytotoxic chemotherapy. Few studies examined the sex differences in AEs and their impact on the use of medical services during adjuvant chemotherapy. This sub-study aimed to compare the incidence of any grade and grade ≥ 3 AEs, healthcare utilization, chemotherapy completion rate, and dose intensity according to sex.
Materials and Methods:
This is a sub-study of a multicenter cohort conducted in Korea that evaluated the impact of healthcare reimbursement on AE evaluation in patients who received adjuvant chemotherapy between September 2013 and December 2016 at four hospitals in Korea.
Results:
A total of 1,170 patients with colorectal, gastric, or non–small cell lung cancer were included in the study. Female patients were younger, had fewer comorbidities, and experienced less postoperative weight loss of > 10%. Females had significantly higher rates of any grade AEs including nausea, abdominal pain, stomatitis, vomiting, and neutropenia, and experienced more grade ≥ 3 neutropenia, nausea, and vomiting. The dose intensity of chemotherapy was significantly lower in females, and they also experienced more frequent dose reduction after the first cycle. Moreover, female patients receiving platinum-containing regimens had significantly higher rates of unscheduled outpatient visits.
Conclusion
Our study found that females experienced a higher incidence of multiple any-grade AEs and severe neutropenia, nausea, and vomiting, across various cancer types, leading to more frequent dose reductions. Physicians should be aware of sex differences in AEs for chemotherapy decisions.
10.Outcomes in Refractory Diffuse Large B-Cell Lymphoma: Results from Two Prospective Korean Cohorts
Jun Ho YI ; Seong Hyun JEONG ; Seok Jin KIM ; Dok Hyun YOON ; Hye Jin KANG ; Youngil KOH ; Jin Seok KIM ; Won-Sik LEE ; Deok-Hwan YANG ; Young Rok DO ; Min Kyoung KIM ; Kwai Han YOO ; Yoon Seok CHOI ; Whan Jung YUN ; Yong PARK ; Jae-Cheol JO ; Hyeon-Seok EOM ; Jae-Yong KWAK ; Ho-Jin SHIN ; Byeong Bae PARK ; Seong Yoon YI ; Ji-Hyun KWON ; Sung Yong OH ; Hyo Jung KIM ; Byeong Seok SOHN ; Jong Ho WON ; Dae-Sik HONG ; Ho-Sup LEE ; Gyeong-Won LEE ; Cheolwon SUH ; Won Seog KIM
Cancer Research and Treatment 2023;55(1):325-333
Purpose:
Diffuse large B-cell lymphoma (DLBCL) is the most common hematologic malignancy worldwide. Although substantial improvement has been achieved by the frontline rituximab-based chemoimmunotherapy, up to 40%-50% of patients will eventually have relapsed or refractory disease, whose prognosis is extremely dismal.
Materials and Methods:
We have carried out two prospective cohort studies that include over 1,500 DLBCL patients treated with rituximab plus CHOP (#NCT01202448 and #NCT02474550). In the current report, we describe the outcomes of refractory DLBCL patients. Patients were defined to have refractory DLBCL if they met one of the followings, not achieving at least partial response after 4 or more cycles of R-CHOP; not achieving at least partial response after 2 or more cycles of salvage therapy; progressive disease within 12 months after autologous stem cell transplantation.
Results:
Among 1,581 patients, a total of 260 patients met the criteria for the refractory disease after a median time to progression of 9.1 months. The objective response rate of salvage treatment was 26.4%, and the complete response rate was 9.6%. The median overall survival (OS) was 7.5 months (95% confidence interval, 6.4 to 8.6), and the 2-year survival rate was 22.1%±2.8%. The median OS for each refractory category was not significantly different (p=0.529).
Conclusion
In line with the previous studies, the outcomes of refractory DLBCL patients were extremely poor, which necessitates novel approaches for this population.

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