[Show abstract][Hide abstract] ABSTRACT: AIM: Although serum carcinoembryonic antigen (CEA) level is prognostic in colorectal cancer, the prognostic role of tumor CEA expression is unclear. The aim of this study is to identify the prognostic and surveillance roles of tissue CEA expression along with serum CEA concentration in patients curatively resected for colorectal cancer. METHOD: Between January and December 2003, two hundred ninety four patients who underwent curative resection for colorectal cancer were included in the study. Correlation of tissue CEA expression with overall survival (OS), disease-free survival (DFS) and elevated serum CEA concentration at tumor recurrence were analyzed. RESULTS: Tissue CEA expression was positive in 215 patients (73.1%). CEA expression was an independent prognostic factor for OS (hazard ratio [HR]=2.537, 95% confidence interval [CI]=1.065-6.042, p=0.035) and DFS (HR=3.090, 95% CI=1.405-6.795, p=0.005). Serum CEA elevation at tumor recurrence was significantly lower in patients without than with tissue CEA expression (14.3% vs. 57.6%, P=0.045). Moreover, when patients were grouped according to a combination of serum CEA elevation and tissue CEA expression, those with tissue CEA expression and elevated serum CEA (group 3) had significantly poorer OS and DFS (p<0.001 each) than those without CEA expression and elevated serum CEA (group 1) and those with either tissue CEA expression or elevated serum CEA (group 2). OS (p=0.006) and DFS (p=0.027) were both significantly greater in group 1 than in group 2. CONCLUSION: Tissue CEA expression is a prognostic factor in patients with colorectal cancer. Analysis of tissue CEA expression may be helpful in determining the clinical utility of serial measurements of serum CEA as surveillance in patients with curatively resected colorectal cancer. This article is protected by copyright. All rights reserved.
[Show abstract][Hide abstract] ABSTRACT: Background We conducted a population-based retrospective cohort study to investigate the influence of hospital volume, delay of surgery, and both together on the long-term survival of postoperative cancer patients. Methods Using information from the Korea Central Cancer Registry from 2001 through 2005 and the National Health Insurance claim database, we determined survival for 147 682 patients who underwent definitive surgery for any of six cancers. Results Regardless of cancer site, surgical patients in low- to medium-volume hospitals showed significantly worse survival [adjusted hazard ratio (aHR) = 1.36-1.86] than those in high-volume hospitals in multivariable analyses. Among the latter, treatment delays > 1 month were not associated with worse survival for stomach, colon, pancreatic, or lung cancer but were for rectal [aHR = 1.28; 95% confidence interval (CI), 1.17-1.40] and breast (aHR = 1.59; 95% CI, 1.37-1.84) cancer. For patients in low- to medium-volume hospitals, treatment delay was associated with worse survival for all types of cancer (aHR = 1.78-3.81). Conclusion Our findings suggest that the effect of hospital volume and surgical treatment delay on overall survival of cancer patients should be considered in formulating or revising national health policy.
Annals of Oncology 05/2012; 23(10):2731-7. · 7.38 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To evaluate the prognostic effect of lymph node ratio (LNR) in patients with locally advanced rectal cancer who were treated with curative resection after preoperative chemoradiotherapy (CRT).
Between October 2001 and December 2007, 519 patients who had undergone curative resection of primary rectal cancer after preoperative CRT were enrolled. Of these, 154 patients were positive for lymph node (LN) metastasis and were divided into three groups according to the LNR (≤ 0.15 [n=80], 0.16-0.3 [n=44], >0.3 [n=30]) to evaluate the prognostic effect on overall survival (OS) and disease-free survival (DFS).
LNR (≤ 0.15, 0.16-0.3, and >0.3) was significantly associated with 5-year OS (90.3%, 75.1%, and 45.1%; p<0.001) and DFS (66.7%, 55.8%, and 21.9%; p<0.001) rates. In a multivariate analysis, LNR (≤ 0.15, 0.16-0.3, and >0.3) was a significant independent prognostic factor for OS (hazard ratios [HRs], 1, 3.609, and 8.197; p<0.001) and DFS (HRs, 1, 1.699, and 3.960; p<0.001). LNR had a prognostic impact on OS and DFS in patients with <12 harvested LNs, as well as in those with ≥ 12 harvested LNs (p<0.05).
LNR was a significant independent prognostic predictor for OS and DFS in patients with locally advanced rectal cancer who were treated with curative resection after preoperative CRT.
European journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 03/2012; 38(6):478-83. · 2.56 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To investigate clinicopathologic findings of patients with small cell carcinoma of the uterine cervix (SCCUC), and evaluate their prognosis.
We retrospectively reviewed the medical records of 20 patients with histologically confirmed SCCUC treated between October 1996 and December 2004 at Asan Medical Center, Korea. The review included demographic data, pathologic findings, treatments, and outcomes.
Of 1,358 invasive cervical carcinoma, the incidence of SCCUC was 1.5%. Median age was 45.5 years. The clinical stages were Ib in 11, IIa in two, IIb in one, IIIa in one, IIIb in one, IVa in three and IVb in one. Fourteen patients underwent radical hysterectomy. Ten patients are alive and nine show no evidence of disease. Median overall survival was 77.0 months and 5-year overall survival rate was 50%. There was significant difference in overall survival with FIGO stage and tumor mass size.
Advanced FIGO stage and tumor mass size are poor prognostic factors for overall survival in patients with SCCUC. Even though SCCUC is a highly aggressive neoplasm, early diagnosis and combined therapeutic modalities may lead to longer survival in some patients.
European journal of gynaecological oncology 01/2009; 30(5):539-42. · 0.58 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To evaluate the outcomes of pregnancy in young women (<40 years old) with early endometrial cancer or atypical complex hyperplasia who were treated by conservative management followed by assisted reproductive technology (ART).
Medical charts of 11 patients treated from January 1997 to October 2007 at Asan Medical Center were retrospectively reviewed. These patients had all been treated with progestin and serial dilatation and curettage as primary fertility-preserving therapies.
After pathological remission of disease, 10 patients tried to become pregnant by ART, 4 by in vitro fertilization and embryo transfer, and 6 by controlled ovarian hyperstimulation, with or without intrauterine insemination. Eight women had intrauterine pregnancies, and 6 patients had live births. Patients have been followed up for 9 to 51 months (mean, 21 months) after delivery, with no evidence of tumor recurrence.
Fertility-preserving therapy followed by ART can be a good option in well-selected patients with early endometrial cancer who want to become pregnant.
International Journal of Gynecological Cancer 01/2009; 19(1):147-51. · 1.94 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The objective of this study was to evaluate the validity and clinical impact of positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) using 18-fluoro-2-deoxy-D-glucose in the posttherapy surveillance of patients with endometrial carcinoma. Eighty-eight patients previously treated for histopathologically diagnosed endometrial adenocarcinoma underwent 99 PET or PET/CT scans at follow-up visits at Asan Medical Center, Seoul, Korea, between 2001 and 2007. The standard of reference for tumor recurrence consisted of histopathologic confirmation or follow-up information at least 6 months after PET or PET/CT. Of the 88 patients, 24 underwent PET (n = 11) and/or PET/CT (n = 14) scans due to suspected disease recurrence. The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of PET and/or PET/CT in detecting recurrence in these patients were 100%, 83.3%, 96%, 95%, and 100%, respectively. Especially, PET/CT revealed true-positive findings in three patients with elevated tumor markers but negative CT findings. The remaining 64 patients underwent PET (n = 8) and/or PET/CT (n = 66) as part of routine posttherapy surveillance; these patients were asymptomatic, with no evidence of disease. The sensitivity, specificity, accuracy, PPV, and NPV of PET and/or PET/CT in detecting recurrence in these patients were all 100%. Clinical decisions on treatment were changed in 14 (21.9%) patients by introducing PET or PET/CT into their conventional posttherapy surveillance program. PET and/or PET/CT were highly effective in discriminating true recurrence in patients with suspected recurrence, highly sensitive in detecting recurrence in asymptomatic patients, and had impacts on clinical decisions in a considerable portion of patients.
International Journal of Gynecological Cancer 10/2008; 18(6):1332 - 1338. · 1.94 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To evaluate whether pre-operative chemo-radiotherapy (CRT) improves the sphincter preservation rate for distal rectal cancers within 3 cm of the anal verge.
Between January 2001 and December 2004, 49 patients underwent surgery with or without pre-operative CRT for primary rectal adenocarcinoma within 3 cm of the anal verge. Clinical data were retrospectively reviewed, including stage workups, surgical records and pathology records to determine sphincter preservation rate and the factors influencing sphincter preservation.
Of 49 patients with rectal tumours within 3 cm of the anal verge, 31 underwent pre-operative CRT followed by surgery (CRT group), and 18 underwent surgery alone (non-CRT group). Sphincter preservation was possible in 11 of 31 CRT patients, and only one of 18 non-CRT patients (p=0.036). The factors most influencing sphincter preservation were reduction in tumour size (p=0.005) and downstaging (p=0.001) following pre-operative CRT.
We could observe that sphincter preservation was improved in CRT group with statistical significance when compared to non-CRT group in our study patients with rectal cancer within 3 cm of the anal verge.
European Journal of Surgical Oncology 04/2006; 32(2):162-7. · 2.61 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Nam JH, Kim YM, Jung MH, Kim KR, Yoo HJ, Kim DY, Kim JH, Kim YT, Mok JE. Primary peritoneal carcinoma: experience with cytoreductive surgery and combination chemotherapy. Int J Gynecol Cancer 2006;16:23–28.The objective of this study was to review the clinical outcome and prognosis of patients with primary peritoneal carcinoma (PPC) treated with cytoreductive surgery and combination chemotherapy. We retrospectively reviewed the charts of 27 patients with histologically confirmed PPC, treated between March 1990 and February 2004 at Asan Medical Center, South Korea. The review included demographic data, pathologic findings, treatments, and outcomes. The mean age of the 27 patients was 57.5 ± 7.2 years, and the rate of optimal cytoreduction was 70.4%. Seven patients had stage IIIB, 17 had stage IIIC, and 3 had stage IV; all patients received adjuvant chemotherapy. There were 4 patients with progressive disease, 5 partial responders, and 15 complete responders; the remaining 3 patients were nonevaluable. At the time of the review, 10 patients were alive without evidence of disease, 3 were alive with disease, and 14 had died from disease. The median overall survival time was 41 months, and the overall 5-year survival rate was 18.1%. Patients who had optimal cytoreduction had a longer median survival (42 months) than those who had suboptimal cytoreduction (10 months; P < 0.05). Combination chemotherapy after optimal cytoreductive surgery may be effective in the treatment of patients with PPC.
International Journal of Gynecological Cancer 01/2006; 16(1):23 - 28. · 1.94 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We report results of a systematic study on the specific heat and
electrical resistivity of the heavy-fermion compounds
CeNiGe2Six(0⩽x⩽ 1). The compounds of
x<1 show the antiferromagnetic order and the ordering temperature
shifts to lower temperature with increasing x. Then, the magnetic order
is smeared out at x=1. The anomaly observed in the specific heat is well
interpreted by the Kondo model for a degenerate impurity spin J=12 in
the Coqblin Schrieffer limit. In addition, there is significant
deviation from the Fermi-liquid behavior at the critical concentration
Physica B Condensed Matter 04/2005; · 1.28 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The transport, magnetic, and thermal properties are studied on an antiferromagnetic compound Ce5Ni2Si3 with TN=7.3 K. We find signatures of spin fluctuation in this geometrically frustrated magnet. The Curie-Weiss fit gives a large value of the paramagnetic Curie temperature, yielding a frustration parameter f=8.4. The electronic specific heat coefficient γ=300 mJ∕Ce mol K2 is strongly enhanced, leading to residual entropy at low temperatures. The spin fluctuation is suppressed as the magnetic field exceeds the metamagnetic transition field Hm=1 T, where the magnetoresistance decreases steeply. The steady increase of magnetic susceptibility below TN is likely to be associated with the presence of paramagnetic Ce ions. For La5Ni2Si3, a superconducting transition is observed at Tc=1.8 K.
Physical Review B 12/2004; 70(22). · 3.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Granular cell tumor (GCT) is uncommon in the colon and rectum. Here we report a case of GCT in the transverse colon. A 48-year-old male patient underwent a screening colonoscopy. A yellowish sessile lesion, about 4 mm in diameter, was found in the transverse colon. An endoscopic snare resection was performed without complication. Histological examination revealed the tumor consisted of plump neoplastic cells with abundant granular eosinophilic cytoplasm containing acidophilic periodic acid Schiff-positive, diastase-resistant granules. Immunohistochemical analysis showed the tumor cells expressed S-100 protein and neuron-specific enolase. Thus, the resected tumor was diagnosed as a GCT. Since GCTs are usually benign, endoscopic resection constitutes an easy and safe treatment. Colonoscopists should consider the possibility of GCT in the differential diagnosis of submucosal tumors of the colon.
World Journal of Gastroenterology 01/2004; · 2.55 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We report on the magnetic susceptibility, specific heat and electrical resistivity of the heavy fermion compounds CeNiGe 2−x Si x (0 x 1). Compounds with x < 1 show antiferromagnetic order, which with increasing x shifts toward lower temperature owing to increased exchange coupling between the localized 4f magnetic moments and conduction electrons. Eventually, the magnetic order almost becomes absent, for x = 1. An anomaly observed in the specific heat is well interpreted by the Kondo model for a degenerate impurity spin J = 1/2 in the Coqblin–Schrieffer limit. A coherence peak indicative of the formation of a Kondo lattice is found in the electrical resistivity, whose features are consistent with the results for the specific heat. Interestingly, there is a significant deviation from Fermi-liquid behaviour at the critical concentration x = 1. This deviation is attributed to a quantum phase transition in a model with two-dimensional antiferromagnetic fluctuations.
[Show abstract][Hide abstract] ABSTRACT: Oxaliplatin shows preclinical activity in many cancer cell lines that are resistant to cisplatin, and also has synergism with 5-fluorouracil (5-FU). We undertook this study to evaluate the efficacy and toxicities of a combined oxaliplatin, 5-FU and leucovorin (LV) continuous infusion regimen in patients with advanced gastric cancer who progressed during or after treatment with 5-FU and platinum compounds.
Twenty-six patients with advanced gastric cancer, whose disease progressed while receiving, or after discontinuing, chemotherapy with a 5-FU and platinum regimen, were enrolled in this study. Treatment comprised oxaliplatin (85 mg/m2 on day 1) as a 2-h infusion followed by bolus 5-FU (400 mg/m2 on day 1), and 48-h infusion of 5-FU 2.4-3.0 g/m2 concurrently with LV 150 mg/m2. Cycles were repeated at 2-week intervals.
Of the 23 evaluable patients, there were six partial responses (response rate 26%). All responding patients were among those who entered into this trial immediately after failure of previous chemotherapy with 5-FU and cisplatin. The median time to progression was 4.3 months and the median overall survival was 7.3 months. The most common hematologic toxicity was grade 1-2 anemia in 39 cycles (39%). No grade 4 leukopenia or thrombocytopenia were observed. The most common non-hematologic toxicity was nausea/vomiting (33%). Peripheral neuropathy of grade 1 or 2 was noted (27%), but there was no grade 3 or 4 neurotoxicity.
This phase II study of oxaliplatin, 5-FU and LV continuous infusion showed activity in previously platinum-treated patients with advanced gastric cancer, with acceptable toxicities.
Annals of Oncology 04/2003; 14(3):383-7. · 7.38 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A simple in-situ gas monitoring system can be developed with micro discharge plasma sources based on optical emission spectroscopy. Helium concentrations are estimated from the visible line emission of atmospheric plasmas generated with various micro plasma discharges. With this technique, volumetric helium concentrations are accurately measured even down to a percent. Since selected emission lines are not affected by moisture, this measuring system can be operated even without sampling and drying processes, which is a crucial element of in-situ monitoring system. The compact in-situ gas monitoring system will be presented, and the system is expected to be applicable to measuring other elements than helium.
Plasma Science, 2002. ICOPS 2002. IEEE Conference Record - Abstracts. The 29th IEEE International Conference on; 02/2002
[Show abstract][Hide abstract] ABSTRACT: Previously collected data have indicated that the laryngeal chemoreflex (LCR) response is exaggerated during a critical period of postnatal development in several experimental animals. These animals had fewer anatomic and physiological similarities to humans than do puppies. This investigation of the LCR in 14 anesthetized puppies was undertaken to determine age-related differences in the response to stimulation of the supraglottic laryngeal mucosa by saline solution, distilled water, cow's milk, and acid at pH 1.0. The dogs were divided into 3 age groups: group 1 consisted of 4 dogs that were 2 weeks old, and in groups 2 and 3 there were 5 puppies each, of 4 and 6 weeks of age, respectively. The LCR response (laryngospasm, apnea, respiratory depression, and bradycardia) was found in the puppies only after stimulation of the laryngeal mucosa with acid at pH 1.0, and it was more easily achieved in the 4- and 6-week age groups than in the 2-week group. These findings suggest that the LCR is an age-dependent response that appears in dogs only after 2 weeks of age. The important implication of this finding is that postnatal neural maturation may influence the laryngeal reflex in humans to some extent.
The Annals of otology, rhinology, and laryngology 11/2001; 110(10):956-63. · 1.21 Impact Factor