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Lyu AR, Kim TH, Shin SA, Kim EH, Yu Y, Gajbhiye A, Kwon HC, Je AR, Huh YH, Park MJ, Park YH. Hearing Impairment in a Mouse Model of Diabetes Is Associated with Mitochondrial Dysfunction, Synaptopathy, and Activation of the Intrinsic Apoptosis Pathway. Int J Mol Sci 2021; 22:ijms22168807. [PMID: 34445504 PMCID: PMC8395823 DOI: 10.3390/ijms22168807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 07/26/2021] [Accepted: 08/13/2021] [Indexed: 11/16/2022] Open
Abstract
Although previous studies continuously report an increased risk of hearing loss in diabetes patients, the impact of the disease on the inner ear remains unexplored. Herein, we examine the pathophysiology of diabetes-associated hearing impairment and cochlear synaptopathy in a mouse model of diabetes. Male B6.BKS(D)-Leprdb/J (db/db, diabetes) and heterozygote (db/+, control) mice were assigned into each experimental group (control vs. diabetes) based on the genotype and tested for hearing sensitivity every week from 6 weeks of age. Each cochlea was collected for histological and biological assays at 14 weeks of age. The diabetic mice exerted impaired hearing and a reduction in cochlear blood flow and C-terminal-binding protein 2 (CtBP2, a presynaptic ribbon marker) expression. Ultrastructural images revealed severely damaged mitochondria from diabetic cochlea accompanied by a reduction in Cytochrome c oxidase subunit 4 (COX4) and CR6-interacting factor 1 (CRIF1). The diabetic mice presented significantly decreased levels of platelet endothelial cell adhesion molecule (PECAM-1), B-cell lymphoma 2 (BCL-2), and procaspase-9, but not procaspase-8. Importantly, significant changes were not found in necroptotic programmed cell death markers (receptor-interacting serine/threonine-protein kinase 1, RIPK1; RIPK3; and mixed lineage kinase domain-like pseudokinase, MLKL) between the groups. Taken together, diabetic hearing loss is accompanied by synaptopathy, microangiopathy, damage to the mitochondrial structure/function, and activation of the intrinsic apoptosis pathway. Our results imply that mitochondrial dysfunction is deeply involved in diabetic hearing loss, and further suggests the potential benefits of therapeutic strategies targeting mitochondria.
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Affiliation(s)
- Ah-Ra Lyu
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon 35015, Korea; (A.-R.L.); (E.-H.K.); (Y.Y.)
- Department of Medical Science, College of Medicine, Chungnam National University, Daejeon 35015, Korea; (A.G.); (H.-C.K.)
| | - Tae-Hwan Kim
- Biomedical Convergence Research Center, Chungnam National University Hospital, Daejeon 35015, Korea;
| | - Sun-Ae Shin
- Brain Research Institute, College of Medicine, Chungnam National University, Daejeon 35015, Korea;
| | - Eung-Hyub Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon 35015, Korea; (A.-R.L.); (E.-H.K.); (Y.Y.)
| | - Yang Yu
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon 35015, Korea; (A.-R.L.); (E.-H.K.); (Y.Y.)
| | - Akanksha Gajbhiye
- Department of Medical Science, College of Medicine, Chungnam National University, Daejeon 35015, Korea; (A.G.); (H.-C.K.)
| | - Hyuk-Chan Kwon
- Department of Medical Science, College of Medicine, Chungnam National University, Daejeon 35015, Korea; (A.G.); (H.-C.K.)
| | - A Reum Je
- Electron Microscopy Research Center, Korea Basic Science Institute, Cheongju 28119, Korea; (A.R.J.); (Y.H.H.)
| | - Yang Hoon Huh
- Electron Microscopy Research Center, Korea Basic Science Institute, Cheongju 28119, Korea; (A.R.J.); (Y.H.H.)
| | - Min Jung Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon 35015, Korea; (A.-R.L.); (E.-H.K.); (Y.Y.)
- Brain Research Institute, College of Medicine, Chungnam National University, Daejeon 35015, Korea;
- Correspondence: (M.J.P.); (Y.-H.P.)
| | - Yong-Ho Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon 35015, Korea; (A.-R.L.); (E.-H.K.); (Y.Y.)
- Department of Medical Science, College of Medicine, Chungnam National University, Daejeon 35015, Korea; (A.G.); (H.-C.K.)
- Biomedical Convergence Research Center, Chungnam National University Hospital, Daejeon 35015, Korea;
- Brain Research Institute, College of Medicine, Chungnam National University, Daejeon 35015, Korea;
- Correspondence: (M.J.P.); (Y.-H.P.)
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Oh SY, Shin A, Kim SG, Hwang JA, Hong SH, Lee YS, Kwon HC. Relationship between insulin-like growth factor axis gene polymorphisms and clinical outcome in advanced gastric cancer patients treated with FOLFOX. Oncotarget 2017; 7:31204-14. [PMID: 27144430 PMCID: PMC5058750 DOI: 10.18632/oncotarget.9100] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 04/11/2016] [Indexed: 01/08/2023] Open
Abstract
The insulin-like growth factor (IGF) axis plays a crucial role in proliferation, differentiation, migration, angiogenesis, and apoptosis. The present study evaluated the associations between IGF axis single-nucleotide polymorphisms (SNPs) and clinical outcomes in advanced gastric cancer (AGC) patients treated with oxaliplatin, 5-fluorouracil, and leucovorin (FOLFOX). A total of 190 patients undergoing FOLFOX chemotherapy for AGC were considered eligible for this study. Forty-four SNPs of 10 IGF axis genes were genotyped. Levels of serum IGF1 were measured using enzyme-linked immunoassays. SNPs of the IGF1R (rs12423791), and IGF1 (rs2162679, rs5742612, rs35767) genes were significantly associated with tumor response to FOLFOX. SNPs of rs4619 and rs17847203 were significantly associated with PFS (hazard ratio [HR] 0.575, 95% CI 0.385–0.858, P = 0.007; and HR 2.530, 95% CI 1.289–4.966, P = 0.007; respectively). SNPs of rs2872060 were significantly associated with OS—OS was shorter in patients carrying the TT variant than in those with the GG/GT genotypes (HR, 1.708, 95% CI 1.024–2.850, P = 0.040). The GT genotype of rs12847203 was also identified as an independent prognostic factor (HR 2.087, 95% CI 1.070–4.069, P = 0.031). These results suggest that IGF axis-pathway SNPs could be used as prognostic biomarkers of the outcome of FOLFOX chemotherapy in AGC patients. This information may facilitate identification of population subgroups that could benefit from IGF1R-targeted agents.
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Affiliation(s)
- Sung Yong Oh
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University, Korea
| | - Seong-Geun Kim
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jung-Ah Hwang
- Cancer Genomics Branch, Research Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - Seung Hyun Hong
- Cancer Genomics Branch, Research Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - Yeon-Su Lee
- Cancer Genomics Branch, Research Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
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Kim WS, Ogura M, Kwon HC, Choi D. Looking to the future and learning lessons from the recent past: changing stakeholder perceptions of biosimilars in cancer. Future Oncol 2017; 13:17-29. [PMID: 28482701 DOI: 10.2217/fon-2017-0154] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
As the patents for many biologic anticancer drugs expire, significant growth in the use of biosimilars is predicted, offering an opportunity to help combat the rising costs of treatment and increase patient access to biologic therapy. Attainment of regulatory approval, involving numerous nonclinical and clinical comparative studies versus each reference product, is only one of several barriers to realize the potential gains offered by biosimilars. It is important to understand the current perceptions and informational needs of different stakeholders if biosimilars are to be accepted and widely used in the clinic. We discuss these considerations and refer to recent experiences with CT-P13, a biosimilar of the TNF inhibitor infliximab used to treat rheumatoid arthritis and other inflammatory disorders.
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Affiliation(s)
- Won Seog Kim
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Michinori Ogura
- Department of Hematology, Tokai Central Hospital, Gifu, Kakamigahara, Japan
| | - Hyuk-Chan Kwon
- CELLTRION Healthcare Co. Ltd, Incheon, Republic of Korea
| | - Dasom Choi
- CELLTRION Healthcare Co. Ltd, Incheon, Republic of Korea
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Buske C, Ogura M, Kwon HC, Yoon SW. An introduction to biosimilar cancer therapeutics: definitions, rationale for development and regulatory requirements. Future Oncol 2017; 13:5-16. [DOI: 10.2217/fon-2017-0153] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Monoclonal antibodies and other biologic drugs play important roles in the treatment of various hematological malignancies and solid tumors. However, such drugs are intrinsically more expensive to develop than small molecules and their clinical benefits are often accompanied by challenges relating to affordability and access. Patent expiry for ‘originator’ biologics is providing opportunities for a new generation of biosimilar drugs, potentially capable of relieving pressure on healthcare budgets. This article discusses key characteristics of biosimilars, distinguishes them from generics and noncomparable biologics and outlines the robust regulatory requirements that must be followed to establish biosimilarity with a reference product. The path to approval is discussed with reference to the rituximab biosimilar CT-P10, the first licensed monoclonal antibody biosimilar cancer therapeutic.
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Affiliation(s)
| | - Michinori Ogura
- Department of Hematology, Tokai Central Hospital, Gifu, Kakamigahara, Japan
| | - Hyuk-Chan Kwon
- CELLTRION Healthcare Co. Ltd, Incheon, Republic of Korea
| | - Sang Wook Yoon
- CELLTRION Healthcare Co. Ltd, Incheon, Republic of Korea
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Ogura M, Coiffier B, Kwon HC, Yoon SW. Scientific rationale for extrapolation of biosimilar data across cancer indications: case study of CT-P10. Future Oncol 2017; 13:45-53. [DOI: 10.2217/fon-2017-0156] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
For a biosimilar to gain regulatory approval, a comprehensive comparability exercise must demonstrate that it is highly similar to its originator biologic, or reference product. Once biosimilarity has been shown, it is possible to approve the biosimilar for additional indications held by the reference product, without clinical trials in these indications. Extrapolation of clinical data is permitted by regulatory agencies as long as it is scientifically justified. CT-P10, a biosimilar of rituximab, was recently approved in Europe for all indications held by its reference product, incorporating both autoimmune diseases and hematological cancers. Here, we review the scientific rationale for extrapolation in biosimilar development using the example of CT-P10 as a case study.
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Affiliation(s)
- Michinori Ogura
- Department of Hematology, Tokai Central Hospital, Gifu, Japan
| | | | - Hyuk-Chan Kwon
- CELLTRION Healthcare Co. Ltd, Incheon, Republic of Korea
| | - Sang Wook Yoon
- CELLTRION Healthcare Co. Ltd, Incheon, Republic of Korea
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Abstract
Biosimilars are highly similar versions of approved biologic drugs that may confer equivalent efficacy at a reduced cost. Patents for several biological cancer therapeutics are past or approaching expiry, presenting an opportunity to increase affordability and global accessibility of key drugs through the development of biosimilars. To receive approval, a biosimilar must show no clinically meaningful differences from the reference product in terms of efficacy or safety. The first monoclonal antibody biosimilar cancer therapeutic to gain approval was CT-P10, a biosimilar of rituximab. Here, we review the oncology clinical development program for CT-P10, providing insights into the rationale for, and design of, CT-P10 clinical trials in patients with cancer. Trials of biosimilar cancer therapeutics in development are also discussed.
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Affiliation(s)
- Won Seog Kim
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | | | - Hyuk-Chan Kwon
- CELLTRION Healthcare Co. Ltd, Incheon, Republic of Korea
| | - SuYeon Kim
- CELLTRION Healthcare Co. Ltd, Incheon, Republic of Korea
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Hwang IG, Choi JH, Park SH, Oh SY, Kwon HC, Lee SI, Lim DH, Lee GW, Kang JH. Chemotherapy in advanced gastric cancer patients associated with disseminated intravascular coagulation. Cancer Res Treat 2014; 46:27-32. [PMID: 24520220 PMCID: PMC3918524 DOI: 10.4143/crt.2014.46.1.27] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 05/08/2013] [Indexed: 01/27/2023] Open
Abstract
Purpose Little is known about the clinical features of advanced gastric cancer (AGC) combined with disseminated intravascular coagulation (DIC). The main objective of this study was to determine the clinical outcome of patients with AGC complicated by DIC. Materials and Methods We conducted a retrospective review of 68 AGC patients diagnosed with DIC at four tertiary medical centers between January 1995 and June 2010. Results Sixty eight patients were included. The median age was 55 years (range, 25 to 78 years). Nineteen patients received chemotherapy, whereas 49 patients received only best supportive care (BSC). The median overall survival (OS) of the 68 patients was 16 days (95% confidence interval [CI], 11 to 21 days). Significantly prolonged OS was observed in the chemotherapy group, with a median survival of 61 days compared to 9 days in the BSC group (p<0.001, log-rank test). Age and previous chemotherapy were another significant factors that were associated with OS in univariate analysis. In multivariate analysis, age (≥65 vs. <65; hazard ratio [HR], 0.38; 95% CI, 0.18 to 0.78; p<0.001), chemotherapy (BSC vs. chemotherapy; HR 0.31; 95% CI, 0.15 to 0.63; p<0.001), and previous chemotherapy (yes or no; HR, 0.49; 95% CI, 0.25 to 0.98; p<0.045) were consistently independent prognostic factors that impacted OS. Conclusion Our study showed that patients with AGC complicated by DIC had very poor OS, and suggested that chemotherapy might improve OS of these patients.
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Affiliation(s)
- In Gyu Hwang
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jin Hwa Choi
- Department of Radiation Oncology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Se Hoon Park
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Yong Oh
- Department of Internal Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea
| | - Hyuk-Chan Kwon
- Department of Internal Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea
| | - Soon Il Lee
- Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| | - Do Hyoung Lim
- Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| | - Gyeong-Won Lee
- Department of Internal Medicine, Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jung Hun Kang
- Department of Internal Medicine, Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea
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Kim KW, Kwon HC, Kim SH, Oh SY, Lee S, Lee JH, Roh MH, Kim MC, Kim KH, Kim YH, Roh YH, Jeong JS, Kim HJ. Prognostic significance of thymidylate synthase, thymidine phosphorylase and dihydropyrimidine dehydrogenase expression in biliary tract cancer patients receiving adjuvant 5-fluorouracil-based chemotherapy. Mol Clin Oncol 2013; 1:987-994. [PMID: 24649282 DOI: 10.3892/mco.2013.166] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 07/02/2013] [Indexed: 12/14/2022] Open
Abstract
Biliary tract cancer (BTC) is a relatively uncommon type of cancer, accounting for ∼4% of the malignant neoplasms of the gastrointestinal tract. The aim of this study was to determine whether the expression of thymidylate synthase (TS), thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD) predict clinical outcome in BTC patients treated with adjuvant 5-fluorouracil (5-FU)-based chemotherapy. TS and TP expression were found to be significantly correlated with cancer location (P=0.044 and 0.031, respectively). The multivariate analysis revealed that age [hazard ratio (HR)=2.157, P=0.008], stage (HR=2.234, P<0.001), resection margin status (HR=2.748, P=0.004) and TP expression (HR=2.014, P=0.039) were independently associated with overall survival (OS).
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Affiliation(s)
- Kwan Woo Kim
- Department of Surgery, Haeundae Paik Hospital, College of Medicine, Inje University
| | - Hyuk-Chan Kwon
- Departments of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Sung-Hyun Kim
- Departments of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Sung Yong Oh
- Departments of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Suee Lee
- Departments of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Ji Hyun Lee
- Departments of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Myung Hwan Roh
- Departments of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Min Chan Kim
- Surgery, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Ki Han Kim
- Surgery, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Young Hoon Kim
- Surgery, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Young Hoon Roh
- Surgery, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Jin Sook Jeong
- Pathology, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Hyo-Jin Kim
- Department of Surgery, Haeundae Paik Hospital, College of Medicine, Inje University
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Park KH, Sohn JH, Lee S, Park JH, Kang SY, Kim HY, Park IH, Park YH, Im YH, Lee HJ, Hong DS, Park S, Shin SH, Kwon HC, Seo JH. A randomized, multi-center, open-label, phase II study of once-per-cycle DA-3031, a biosimilar pegylated G-CSF, compared with daily filgrastim in patients receiving TAC chemotherapy for early-stage breast cancer. Invest New Drugs 2013; 31:1300-6. [PMID: 23677653 DOI: 10.1007/s10637-013-9973-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 05/07/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUNDS A pegylated form of recombinant granulocyte-colony stimulating factor (G-CSF) was developed for prophylactic use in breast cancer. The aim of this study was to evaluate the efficacy and safety of once-per-cycle DA-3031 in patients receiving chemotherapy for breast cancer. METHODS A total of 61 patients receiving docetaxel, doxorubicin, and cyclophosphamide (TAC) chemotherapy were randomized in cycle 1 to receive daily injections of filgrastim (100 μg/m(2)) or a single subcutaneous injection of pegylated filgrastim DA-3031 at a dose of either 3.6 mg or 6 mg. RESULTS The mean duration of grade 4 neutropenia in cycle 1 was comparable among the treatment groups (2.48, 2.20, and 2.05 days for filgrastim, DA-3031 3.6 mg and 6 mg, respectively; P=0.275). No statistically significant differences were observed in the incidence of febrile neutropenia between the treatment groups (9.5 %, 15.0 %, and 5.0 % for filgrastim, DA-3031 3.6 mg and 6 mg, respectively; P=0.681) in cycle 1. The incidences of adverse events attributable to G-CSF were similar among the treatment groups. CONCLUSIONS Fixed doses of 3.6 mg or 6 mg DA-3031 have an efficacy comparable to that of daily injections of filgrastim in ameliorating grade 4 neutropenia in patients receiving TAC chemotherapy.
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Affiliation(s)
- K H Park
- Division of Oncology/Hematology, Department of Internal medicine, Korea University College of Medicine, 97 Guro-dong Gil, Guro-gu, Seoul, Korea
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Oh SY, Kwon HC, Kim SH, Lee S, Lee JH, Hwang JA, Hong SH, Graves CA, Camphausen K, Kim HJ, Lee YS. The relationship of vascular endothelial growth factor gene polymorphisms and clinical outcome in advanced gastric cancer patients treated with FOLFOX: VEGF polymorphism in gastric cancer. BMC Cancer 2013; 13:43. [PMID: 23374220 PMCID: PMC3573956 DOI: 10.1186/1471-2407-13-43] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 01/30/2013] [Indexed: 12/14/2022] Open
Abstract
Background The aim of this study is to evaluate the associations between vascular endothelial growth factor (VEGF) Single-nucleotide polymorphisms (SNPs) and clinical outcome in advanced gastric cancer patients treated with oxaliplatin, 5-fluorouracil, and leucovorin (FOLFOX). Methods Genomic DNA was isolated from whole blood, and six VEGF (−2578C/A, -2489C/T, -1498 T/C, -634 G/C, +936C/T, and +1612 G/A) gene polymorphisms were analyzed by PCR. Levels of serum VEGF were measured using enzyme-linked immunoassays. Results Patients with G/G genotype for VEGF -634 G/C gene polymorphism showed a lower response rate (22.2%) than those with G/C or C/C genotype (32.3%, 51.1%; P = 0.034). Patients with the VEGF -634 G/C polymorphism G/C + C/C genotype had a longer progression free survival (PFS) of 4.9 months, compared with the PFS of 3.5 months for those with the G/G (P = 0.043, log-rank test). By multivariate analysis, this G/G genotype of VEGF -634 G/C polymorphism was identified as an independent prognostic factor (Hazard ratio 1.497, P = 0.017). Conclusion Our data suggest that G/G genotype of VEGF -634 G/C polymorphism is related to the higher serum levels of VEGF, and poor clinical outcome in advanced gastric cancer patients.
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Affiliation(s)
- Sung Yong Oh
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
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Park KW, Kwon HC, KIm SJ, Lee HS. Clinicopathologic significance of expression of nuclear factor kappa Β and vascular endothelial growth factor in gastric cancer patients. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.4_suppl.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
50 Background: Nuclear factor-κB (NF-κB) and vascular endothelial growth factor (VEGF) are involved in cell proliferation, invasion, angiogenesis and metastases. The principal objective of this study was to assess the prognostic significance of NF-κB and VEGF expression in gastric cancer Methods: The tumor tissues of 154 patients with gastric cancer, all of whom underwent potentially curative resection, were immunohistochemically evaluated using monoclonal antibodies against NF-κB and VEGF. Results: Positivity rates of NF-κB and VEGF were 44.2% and 39.6%, respectively. NF-κB expression in tumor tissues was correlated significantly with VEGF expression (p < 0.001). VEGF expression was related to Lauren’s classification (p = 0.002), differentiation (p = 0.043), depth of invasion (p = 0.005), carcinoembryonic antigen (p = 0.032), and stage (p = 0.026). However, NF-κB expression was not related to any of these parameters. Univariate analysis demonstrated that NF-κB expression was significantly related with both 5-year disease free survival (65.2% vs. 46.4%, p = 0.007), and 5-year overall survival (60.0% vs. 42.5%, p = 0.014). Multivariate analysis verified that NF-κB was independently associated with disease free survival (hazard ratio: 2.082, p = 0.005), and overall survival (hazard ratio: 1.841, p = 0.008). However, VEGF did not appear to be related to adverse clinical outcome. Conclusions: NF-κB expression in tumor tissue is associated with poor survival in gastric cancer patients.
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Affiliation(s)
| | - Hyuk-Chan Kwon
- Department of Internal Medicine, Dong-A University Medical Center, Busan, South Korea
| | - Su-Jin KIm
- Dong-A University Medical Center, Busan, South Korea
| | - Hyung-Sik Lee
- Department of Radiation Oncology, Dong-A University Medical Center, Busan, South Korea
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Oh SY, Kwon HC, Kim SH, Lee S, Lee JH, Graves CA, Camphausen K, Kim HJ. Prognostic significance of serum levels of vascular endothelial growth factor and insulin-like growth factor-1 in advanced gastric cancer patients treated with FOLFOX chemotherapy. Chemotherapy 2013; 58:426-34. [PMID: 23295255 DOI: 10.1159/000345918] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 11/18/2012] [Indexed: 12/14/2022]
Abstract
BACKGROUND Tumor vascular endothelial growth factor (VEGF) is a key angiogenic factor and may have an impact on tumor progression and response to chemotherapy. The insulin-like growth factor (IGF) system is related to cell proliferation and tumor growth. However, there is limited available data regarding the clinical and prognostic significance of VEGF or IGF-1 in advanced gastric cancer. The aim of this study was to evaluate the prognostic significance of serum VEGF and IGF-1 levels in advanced gastric cancer patients who were treated with oxaliplatin/5-fluorouracil (FOLFOX). METHODS The study population consisted of 100 advanced gastric cancer patients (median age 56 years). Patients were treated with oxaliplatin 85 mg/m(2) as a 2-hour infusion on day 1 plus leucovorin 20 mg/m(2) over 10 min, followed by a 5-fluorouracil (5-FU) bolus 400 mg/m(2) and 22 h of continuous infusion of 600 mg/m(2) on days 1-2. Treatment was repeated in 2-week intervals. The levels of serum VEGF and IGF-1 were measured using enzyme-linked immunoassays. RESULTS There was a significant correlation between the serum level of VEGF and Lauren's classification (p = 0.030) and previous operations (p = 0.010). IGF-1 was associated with the number of metastases (p = 0.012). The median level of serum VEGF was decreased after FOLFOX chemotherapy (p = 0.034). However, none of the measured serum markers were significantly correlated with response. In univariate analysis, overall survival (p < 0.001) was significantly shorter in patients with high serum levels of VEGF. Multivariate analysis revealed that VEGF was an independent factor for overall survival (HR 2.221; 95% CI 1.377-3.583, p = 0.001). Furthermore, IGF-1 had no significant influence on the clinical outcome. CONCLUSION A high level of serum VEGF is an independent prognostic factor in patients with advanced gastric cancer treated with chemotherapy. This may help to identify the patients who are more sensitive to the FOLFOX regimen.
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Affiliation(s)
- Sung Yong Oh
- Department of Internal Medicine, Dong-A University College of Medicine, Busan 602-715, Korea
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Lee JH, Kim EK, Oh JY, Kwon HC, Kim SH, Kim DC, Lee M, Cho SH, Nam KJ. US screening for detection of nonpalpable locoregional recurrence after mastectomy. Eur J Radiol 2012; 82:485-9. [PMID: 23131395 DOI: 10.1016/j.ejrad.2012.10.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 07/12/2012] [Accepted: 10/13/2012] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess the value of screening ultrasonography (US) in the detection of nonpalpable locoregional recurrence following mastectomy for breast cancer and to describe the US appearances of occult recurrent cancers. MATERIALS AND METHODS During a 36-month period, 1180 consecutive US screenings were performed for mastectomy sites and ipsilateral axillary fossae in 468 asymptomatic women who had undergone mastectomy for breast cancer. All US results were divided into three groups: negative findings, probably benign nodules, and suspicious for malignant nodules. The final diagnoses were based on pathology results and clinical or sonographic follow-up for more than 12 months. The diagnostic performance of US for detecting nonpalpable locoregional recurrence was assessed. The US appearances of occult recurrent cancers were retrospectively reviewed. RESULTS Of the 468 patients assessed, 19 (4.1%) showed "suspicious for malignant nodules"; of these lesions, 10 were malignant. One false-negative case was identified. The sensitivity and specificity were 90.9% and 98.0%, respectively. A biopsy positive predictive value of 52.6% was observed. Cancer detection rates were 2.1% with US screenings of mastectomy sites and ipsilateral axillary fossae. The common US features of occult recurrences at the mastectomy sites were irregular shaped, not-circumscribed marginated, and hypoechoic masses with intratumoral vascularities. The most common location was within the deep muscle layer. CONCLUSION Although locoregional recurrence infrequently occurs after mastectomy for breast cancer, screening US enables detection of nonpalpable cancer before it can be detected by clinical examination. Routine follow-up US can be advocated for early detection of nonpalpable locoregional recurrent cancer.
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Affiliation(s)
- Jin Hwa Lee
- Department of Radiology, Dong-A University College of Medicine, 1,3-ga, Dongdaesin-dong, Seo-gu, Busan 602-715, Republic of Korea.
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Kim KH, Kim MC, Jung GJ, Kim SJ, Jang JS, Kwon HC. Long term survival results for gastric GIST: is laparoscopic surgery for large gastric GIST feasible? World J Surg Oncol 2012; 10:230. [PMID: 23114111 PMCID: PMC3517899 DOI: 10.1186/1477-7819-10-230] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2012] [Accepted: 09/26/2012] [Indexed: 02/07/2023] Open
Abstract
Background Recently, laparoscopic resection for relatively small sized gastric gastrointestinal stromal tumors (GISTs) has been widely accepted as minimally invasive surgery. However, no report on the long-term safety and efficacy of this surgery for large sized gastric GISTs has been published to date. Methods Between July 1998 and January 2011, 104 consecutive patients who underwent resection for gastric GISTs were enrolled in this retrospective study. We assessed the clinicopathological characteristics, postoperative outcomes, patient survival, and tumor recurrence. Results Of the 104 patients with gastric GISTs who were included in the study, there were 47 males and 57 females whose mean age was 59.8 years. Sixty-four patients (61.5%) had symptoms associated with tumor. Ten patients included in the group 1, 49 in the group 2, 15 in the group 3a, 9 in the group 5, 14 in the group 6a, and 7 in the group 6b. There was one minor complication and no mortalities. Recurrence was noted in 5 patients, with a median follow-up period of 49.3 months (range, 8.4 to 164.4). The 5-year overall and disease free survival rates of 104 patients were 98.6% and 94.8%, respectively. When comparing large tumor (5–10 cm) between laparoscopic and open surgery, there were statistically differences in age, tumor size, tumor location, and length of hospitalization. There were no statistical differences in the 5-year survival rate between laparoscopic and open surgery for large tumor (5-10cm). Conclusion Laparoscopic surgery is feasible and effective as an oncologic treatment of gastric GISTs. Moreover, laparoscopic surgery can be an acceptable alternative to open methods for gastric GISTs of size bigger than 5 cm.
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Affiliation(s)
- Ki-Han Kim
- Department of Surgery, Dong-A University College of Medicine, 3-1 Dongdaeshin-Dong, Busan 602-715, Korea
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Lee S, Kwon HC, Kim SH, Oh SY, Lee JH, Lee YS, Seo D, Han JY, Kim HJ. Identification of genes underlying different methylation profiles in refractory anemia with excess blast and refractory cytopenia with multilineage dysplasia in myelodysplastic syndrome. Korean J Hematol 2012; 47:186-93. [PMID: 23071473 PMCID: PMC3464335 DOI: 10.5045/kjh.2012.47.3.186] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Revised: 06/20/2012] [Accepted: 08/03/2012] [Indexed: 11/17/2022]
Abstract
BACKGROUND Myelodysplastic syndrome (MDS) is a preleukemic condition that transforms into acute myeloid leukemia. However, the genetic events underlying this transformation remain poorly understood. Aberrant DNA methylation may play a causative role in the disease and its prognosis. Thus, we compared the DNA methylation profiles in refractory anemia with excess blast (RAEB) to those in refractory cytopenia with multilineage dysplasia (RCMD). METHODS Bone marrow samples were collected from 20 patients with primary MDS (9 with RAEB and 11 with RCMD), and peripheral blood samples were collected from 4 healthy controls. These samples were assessed using a commercial whole genome-wide methylation assay. Methylation-specific polymerase chain reaction (PCR) was used to detect the methylation of candidate gene promoters in RAEB and RCMD. RESULTS Microarray data revealed significant hypermethylation in 69 genes within RAEB but not RCMD. Candidate genes were mapped to 5 different networks, and network 1 had the highest score due to its involvement in gene expression, cancer, and cell cycle. Five genes (GSTM5, BIK, CENPH, RERG, and ANGPTL2) were associated with malignant disease progression. Among them, the methylated promoter pairs of GSTM5 (55.5% and 20%), BIK (20% and 0%), and ANGPTL2 (44.4% and 10%) were observed more frequently in RAEB. CONCLUSION DNA methylation of GSTM5, BIK, and ANGPTL2 may induce epigenetic silencing and contribute to the increasing blasts and resulting MDS progression; however, the functions of these genes were not determined. Further study focusing on epigenetic silencing using various detection modalities is required.
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Affiliation(s)
- Suee Lee
- Department of Internal Medicine, Dong-A University Medical Center, Busan, Korea
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Kwon HC, Kim SH, Oh SY, Lee S, Lee JH, Jang JS, Kim MC, Kim KH, Kim SJ, Kim SG, Kim HJ. Clinicopathologic significance of expression of nuclear factor-κB RelA and its target gene products in gastric cancer patients. World J Gastroenterol 2012; 18:4744-50. [PMID: 23002344 PMCID: PMC3442213 DOI: 10.3748/wjg.v18.i34.4744] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Revised: 06/04/2012] [Accepted: 06/15/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the prognostic significance of nuclear factor-κB (NF-κB) and its target genes in gastric cancer.
METHODS: The tumor tissues of 115 patients with gastric cancer were immunohistochemically evaluated using monoclonal antibodies against NF-κB RelA. Preoperative serum levels of vascular endothelial growth factor (VEGF), interleukin-6 (IL-6) were assessed via enzyme-linked immuno-sorbent assay. C-reactive protein (CRP) and serum amyloid A (SAA) were measured via immunotrubidimetry.
RESULTS: Positive rate of NF-κB RelA was 42.6%. NF-κB RelA expression in tumor tissues was also related to serum levels of IL-6 (P = 0.044) and CRP (P = 0.010). IL-6, SAA, CRP were related to depth of invasion, VEGF and SAA were correlated with lymph node metastasis. IL-6, VEGF, SAA and CRP were related to the stage. Univariate analysis demonstrated that immunostaining of NF-κB RelA, levels of IL-6, VEGF, SAA were significantly related with both disease free survival and overall survival (OS). Multivariate analysis verified that NF-κB RelA [hazard ratio (HR): 3.40, P = 0.024] and SAA (HR: 3.39, P = 0.045) were independently associated with OS.
CONCLUSION: Increased expression of NF-κB RelA and high levels of serum SAA were associated with poor OS in gastric cancer patients.
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Abstract
PURPOSE Natural orifice transluminal endoscopic surgery (NOTES) is a new method of accessing intracavitary organs in order to minimize pain by avoiding incisions in the body wall. The aim of this study is to determine patients' acceptance of NOTES in Korea and to compare their views about laparoscopic surgery and NOTES for benign and malignant diseases. MATERIALS AND METHODS The target number of total subjects was calculated to be 540. The subjects were classified into 18 sub-groups based on age groups, gender, and history of prior surgery. The questionnaire elicited information about demographic characteristics, medical check-ups, diseases, endoscopic and surgical histories, marital status and childbirth, the acceptance of NOTES, and the preferred routes for NOTES. In addition, the subjects chose laparoscopic surgery or NOTES for a hypothetical cholecystectomy and rectal cancer surgery, and responded to questions regarding the acceptable complication rate of NOTES, the appropriate cost of NOTES, and the reason(s) why they did not select NOTES. RESULTS 486 of 540 patients (90.0%) who agreed to participate in this study completed the questionnaire. NOTES was preferred by the following patients: elderly; a history of treatment due to a disease; having regular check-ups; and a history of an endoscopic procedure (p<0.05). The most preferred route for NOTES was the stomach (67.1%). Eighty-four percent of the patients choosing NOTES responded that the complication rate of the new surgical method should be the same or lower than laparoscopic surgery. Vague anxiety over a new surgical method was the most common reason why NOTES was not selected in benign and malignant diseases (64% and 73%), respectively. CONCLUSION Patients appear to be interested in the potential benefits of NOTES and would embrace it if their concerns about safety are met. We believe that qualified surgical endoscopists can meet these safety concerns, and that NOTES development has the potential to flourish.
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Affiliation(s)
- Min-Chan Kim
- Department of Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Ki-Han Kim
- Department of Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Jin-Seok Jang
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Hyuk-Chan Kwon
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Byoung-Gwon Kim
- Department of Preventive Medicine, Dong-A University College of Medicine, Busan, Korea
| | - David W. Rattner
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Kim KH, Kim MC, Jung GJ, Choi HJ, Jang JS, Kwon HC. Comparative analysis of five-year survival results of laparoscopy-assisted gastrectomy versus open gastrectomy for advanced gastric cancer: a case-control study using a propensity score method. Dig Surg 2012; 29:165-71. [PMID: 22614362 DOI: 10.1159/000338088] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Accepted: 03/15/2012] [Indexed: 12/31/2022]
Abstract
BACKGROUND The aim of this study was to investigate the surgical and oncologic outcomes of laparoscopy-assisted gastrectomy (LAG) and open gastrectomy (OG) for advanced gastric cancer (AGC) using the case-control method with a sufficient follow-up period. PATIENTS AND METHODS The authors retrospectively analyzed 89 patients who underwent LAG and 345 patients who underwent OG for AGC between August 1999 and June 2007. A total of 176 matched cases were included in the final analysis. RESULTS Except for tumor size and reconstruction, there were no statistically significant differences in the clinicopathological parameters between the two groups. Although operation time was significantly longer for LAG than OG (228.3 vs. 183.6 min, p < 0.0001), first flatus time and postoperative hospital stay without complications were significantly shorter in the LAG group (3.2 vs. 3.7 days, p < 0.0001; 7.0 vs. 10.4 days, p < 0.0001, respectively). Operation-related complications occurred in 7 cases (8.0%) in both groups. 13 patients (14.8%) in the LAG group and 15 patients (17.1%) in the OG group had recurrence. There was no statistically significant difference in the 5-year and disease-free survival rates between LAG and OG. CONCLUSIONS LAG for AGC might be considered to be a minimally invasive surgery in some selected cases, although a well-designed prospective study comparing LAG with OG for AGC is needed.
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Affiliation(s)
- Ki-Han Kim
- Department of Surgery, Dong-A University College of Medicine, Busan, Korea
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Lee S, Oh SY, Kwon HC, Kim SH, Lee JH, Kim MC, Kim KH, Kim HJ. The clinical significance of neutrophil-lymphocyte ratio versus platelet-lymphocyte ratio in patients with metastatic gastric cancer. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e14686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14686 Background: Several inflammatory response materials could be biomarkers for prediction of prognosis of cancer patients. The neutrophil/lymphocyte ratio (NLR), and the platelet/lymphocyte ratio (PLR) has been introduced for prognostic scoring system in several cancer. The objective of this study was to determine whether the neutrophil-lymphocyte ratio (NLR), or the platelet-lymphocyte ratio (PLR) are significant prognostic marker in metastatic gastric cancer. Methods: We analyzed 150 patients with metastatic gastric cancer who received mFOLFOX regimen as the first-line chemotherapy. The NLR and PLR were calculated from complete blood counts in baseline laboratory test before the first cycle chemotherapy. Results: The overall response rate was 34.7% and stable disease was 38.7%. The median progression-free survival (PFS) was 4.2 months (95% CI, 3.5-4.8 months) and the median overall survival (OS) was 13.1 months (95% CI, 10.6-15.5 months). Kaplan-Meier analysis and log-rank test revealed that higher NLR (≥3) was a good prognostic biomarker of OS (p=0.024), but not associated with PFS (p=0.838). The PLR was not associated with PFS and OS (p=0.373 and p=0.304, respectively). In Cox regression analysis for predicting OS, younger age, good performance status, response of chemotherapy, and lower NLR (<3) were independent prognostic markers (Hazard ratio 2.052, 95% CI 1.370-3.075, p<0.001, hazard ratio 8.467, 95% CI 1.937-37.017, p=0.005, hazard ratio 1.889, 95% CI 1.222-2.921, p=0.004, and hazard ratio 1.616, 95% CI 1.080-2.416, p=0.019, respectively). Conclusions: Although prognosis in metastatic gastric cancer was associated with age and performance status, the NLR might be simple and prognostic index for metastatic gastric cancer.
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Affiliation(s)
- Suee Lee
- Department of Internal Medicine, Dong-A University Medical Center, Busan, South Korea
| | - Sung Yong Oh
- Department of Internal Medicine, Dong-A University Medical Center, Busan, South Korea
| | - Hyuk-Chan Kwon
- Department of Internal Medicine, Dong-A University Medical Center, Busan, South Korea
| | - Sung-Hyun Kim
- Department of Internal Medicine, Dong-A University Medical Center, Busan, South Korea
| | - Ji Hyun Lee
- Department of Internal Medicine, Dong-A University Medical Center, Busan, South Korea
| | - Min Chan Kim
- Department of Surgery, Dong-A University Medical Center, Busan, South Korea
| | - Ki-Han Kim
- Department of Surgery, Dong-A University Medical Center, Busan, South Korea
| | - Hyo-Jin Kim
- Department of Internal Medicine, Dong-A University Medical Center, Busan, South Korea
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Kang JH, Lee SI, Lim DH, Park KW, Oh SY, Kwon HC, Hwang IG, Lee SC, Nam E, Shin DB, Lee J, Park JO, Park YS, Lim HY, Kang WK, Park SH. Salvage Chemotherapy for Pretreated Gastric Cancer: A Randomized Phase III Trial Comparing Chemotherapy Plus Best Supportive Care With Best Supportive Care Alone. J Clin Oncol 2012; 30:1513-1518. [DOI: 10.1200/jco.2011.39.4585] [Citation(s) in RCA: 466] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Purpose When designing this trial, there was no evidence that salvage chemotherapy (SLC) in advanced gastric cancer (AGC) resulted in substantial prolongation of survival when compared with best supportive care (BSC). However, SLC is often offered to pretreated patients with AGC for anecdotal reasons. Patients and Methods Patients with AGC with one or two prior chemotherapy regimens involving both fluoropyrimidines and platinum and with an Eastern Cooperative Oncology Group performance status (PS) 0 or 1 were randomly assigned in a ratio of 2:1 to SLC plus BSC or BSC alone. Choice of SLC—either docetaxel 60 mg/m2 every 3 weeks or irinotecan 150 mg/m2 every 2 weeks—was left to the discretion of investigators. Primary end point was overall survival (OS). Results Median OS was 5.3 months among 133 patients in the SLC arm and 3.8 months among 69 patients in the BSC arm (hazard ratio, 0.657; 95% CI, 0.485 to 0.891; one-sided P = .007). OS benefit for SLC was consistent in most of the prospectively defined subgroups, including age, PS, number of prior treatments, metastatic sites, hemoglobin levels, and response to prior chemotherapy. SLC was generally well tolerated, and adverse events were similar in the SLC and BSC arms. We found no median OS difference between docetaxel and irinotecan (5.2 v 6.5 months; P = .116). Conclusion To our knowledge, this is the largest phase III trial comparing SLC plus BSC with BSC alone in AGC. In pretreated patients, SLC is tolerated and significantly improves OS when added to BSC.
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Affiliation(s)
- Jung Hun Kang
- Jung Hun Kang, Gyeongsang National University Hospital, Jinju; Soon Il Lee, Do Hyoung Lim, and Keon-Woo Park, Dankook University Hospital, Cheonan; Sung Yong Oh and Hyuk-Chan Kwon, Dong-A University Hospital, Busan; In Gyu Hwang, Chung-Ang University College of Medicine; Sang-Cheol Lee, Soonchunhyang University Hospital; Eunmi Nam, Ewha Womans University School of Medicine; Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, and Se Hoon Park, Sungkyunkwan University Samsung Medical
| | - Soon Il Lee
- Jung Hun Kang, Gyeongsang National University Hospital, Jinju; Soon Il Lee, Do Hyoung Lim, and Keon-Woo Park, Dankook University Hospital, Cheonan; Sung Yong Oh and Hyuk-Chan Kwon, Dong-A University Hospital, Busan; In Gyu Hwang, Chung-Ang University College of Medicine; Sang-Cheol Lee, Soonchunhyang University Hospital; Eunmi Nam, Ewha Womans University School of Medicine; Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, and Se Hoon Park, Sungkyunkwan University Samsung Medical
| | - Do Hyoung Lim
- Jung Hun Kang, Gyeongsang National University Hospital, Jinju; Soon Il Lee, Do Hyoung Lim, and Keon-Woo Park, Dankook University Hospital, Cheonan; Sung Yong Oh and Hyuk-Chan Kwon, Dong-A University Hospital, Busan; In Gyu Hwang, Chung-Ang University College of Medicine; Sang-Cheol Lee, Soonchunhyang University Hospital; Eunmi Nam, Ewha Womans University School of Medicine; Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, and Se Hoon Park, Sungkyunkwan University Samsung Medical
| | - Keon-Woo Park
- Jung Hun Kang, Gyeongsang National University Hospital, Jinju; Soon Il Lee, Do Hyoung Lim, and Keon-Woo Park, Dankook University Hospital, Cheonan; Sung Yong Oh and Hyuk-Chan Kwon, Dong-A University Hospital, Busan; In Gyu Hwang, Chung-Ang University College of Medicine; Sang-Cheol Lee, Soonchunhyang University Hospital; Eunmi Nam, Ewha Womans University School of Medicine; Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, and Se Hoon Park, Sungkyunkwan University Samsung Medical
| | - Sung Yong Oh
- Jung Hun Kang, Gyeongsang National University Hospital, Jinju; Soon Il Lee, Do Hyoung Lim, and Keon-Woo Park, Dankook University Hospital, Cheonan; Sung Yong Oh and Hyuk-Chan Kwon, Dong-A University Hospital, Busan; In Gyu Hwang, Chung-Ang University College of Medicine; Sang-Cheol Lee, Soonchunhyang University Hospital; Eunmi Nam, Ewha Womans University School of Medicine; Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, and Se Hoon Park, Sungkyunkwan University Samsung Medical
| | - Hyuk-Chan Kwon
- Jung Hun Kang, Gyeongsang National University Hospital, Jinju; Soon Il Lee, Do Hyoung Lim, and Keon-Woo Park, Dankook University Hospital, Cheonan; Sung Yong Oh and Hyuk-Chan Kwon, Dong-A University Hospital, Busan; In Gyu Hwang, Chung-Ang University College of Medicine; Sang-Cheol Lee, Soonchunhyang University Hospital; Eunmi Nam, Ewha Womans University School of Medicine; Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, and Se Hoon Park, Sungkyunkwan University Samsung Medical
| | - In Gyu Hwang
- Jung Hun Kang, Gyeongsang National University Hospital, Jinju; Soon Il Lee, Do Hyoung Lim, and Keon-Woo Park, Dankook University Hospital, Cheonan; Sung Yong Oh and Hyuk-Chan Kwon, Dong-A University Hospital, Busan; In Gyu Hwang, Chung-Ang University College of Medicine; Sang-Cheol Lee, Soonchunhyang University Hospital; Eunmi Nam, Ewha Womans University School of Medicine; Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, and Se Hoon Park, Sungkyunkwan University Samsung Medical
| | - Sang-Cheol Lee
- Jung Hun Kang, Gyeongsang National University Hospital, Jinju; Soon Il Lee, Do Hyoung Lim, and Keon-Woo Park, Dankook University Hospital, Cheonan; Sung Yong Oh and Hyuk-Chan Kwon, Dong-A University Hospital, Busan; In Gyu Hwang, Chung-Ang University College of Medicine; Sang-Cheol Lee, Soonchunhyang University Hospital; Eunmi Nam, Ewha Womans University School of Medicine; Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, and Se Hoon Park, Sungkyunkwan University Samsung Medical
| | - Eunmi Nam
- Jung Hun Kang, Gyeongsang National University Hospital, Jinju; Soon Il Lee, Do Hyoung Lim, and Keon-Woo Park, Dankook University Hospital, Cheonan; Sung Yong Oh and Hyuk-Chan Kwon, Dong-A University Hospital, Busan; In Gyu Hwang, Chung-Ang University College of Medicine; Sang-Cheol Lee, Soonchunhyang University Hospital; Eunmi Nam, Ewha Womans University School of Medicine; Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, and Se Hoon Park, Sungkyunkwan University Samsung Medical
| | - Dong Bok Shin
- Jung Hun Kang, Gyeongsang National University Hospital, Jinju; Soon Il Lee, Do Hyoung Lim, and Keon-Woo Park, Dankook University Hospital, Cheonan; Sung Yong Oh and Hyuk-Chan Kwon, Dong-A University Hospital, Busan; In Gyu Hwang, Chung-Ang University College of Medicine; Sang-Cheol Lee, Soonchunhyang University Hospital; Eunmi Nam, Ewha Womans University School of Medicine; Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, and Se Hoon Park, Sungkyunkwan University Samsung Medical
| | - Jeeyun Lee
- Jung Hun Kang, Gyeongsang National University Hospital, Jinju; Soon Il Lee, Do Hyoung Lim, and Keon-Woo Park, Dankook University Hospital, Cheonan; Sung Yong Oh and Hyuk-Chan Kwon, Dong-A University Hospital, Busan; In Gyu Hwang, Chung-Ang University College of Medicine; Sang-Cheol Lee, Soonchunhyang University Hospital; Eunmi Nam, Ewha Womans University School of Medicine; Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, and Se Hoon Park, Sungkyunkwan University Samsung Medical
| | - Joon Oh Park
- Jung Hun Kang, Gyeongsang National University Hospital, Jinju; Soon Il Lee, Do Hyoung Lim, and Keon-Woo Park, Dankook University Hospital, Cheonan; Sung Yong Oh and Hyuk-Chan Kwon, Dong-A University Hospital, Busan; In Gyu Hwang, Chung-Ang University College of Medicine; Sang-Cheol Lee, Soonchunhyang University Hospital; Eunmi Nam, Ewha Womans University School of Medicine; Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, and Se Hoon Park, Sungkyunkwan University Samsung Medical
| | - Young Suk Park
- Jung Hun Kang, Gyeongsang National University Hospital, Jinju; Soon Il Lee, Do Hyoung Lim, and Keon-Woo Park, Dankook University Hospital, Cheonan; Sung Yong Oh and Hyuk-Chan Kwon, Dong-A University Hospital, Busan; In Gyu Hwang, Chung-Ang University College of Medicine; Sang-Cheol Lee, Soonchunhyang University Hospital; Eunmi Nam, Ewha Womans University School of Medicine; Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, and Se Hoon Park, Sungkyunkwan University Samsung Medical
| | - Ho Yeong Lim
- Jung Hun Kang, Gyeongsang National University Hospital, Jinju; Soon Il Lee, Do Hyoung Lim, and Keon-Woo Park, Dankook University Hospital, Cheonan; Sung Yong Oh and Hyuk-Chan Kwon, Dong-A University Hospital, Busan; In Gyu Hwang, Chung-Ang University College of Medicine; Sang-Cheol Lee, Soonchunhyang University Hospital; Eunmi Nam, Ewha Womans University School of Medicine; Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, and Se Hoon Park, Sungkyunkwan University Samsung Medical
| | - Won Ki Kang
- Jung Hun Kang, Gyeongsang National University Hospital, Jinju; Soon Il Lee, Do Hyoung Lim, and Keon-Woo Park, Dankook University Hospital, Cheonan; Sung Yong Oh and Hyuk-Chan Kwon, Dong-A University Hospital, Busan; In Gyu Hwang, Chung-Ang University College of Medicine; Sang-Cheol Lee, Soonchunhyang University Hospital; Eunmi Nam, Ewha Womans University School of Medicine; Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, and Se Hoon Park, Sungkyunkwan University Samsung Medical
| | - Se Hoon Park
- Jung Hun Kang, Gyeongsang National University Hospital, Jinju; Soon Il Lee, Do Hyoung Lim, and Keon-Woo Park, Dankook University Hospital, Cheonan; Sung Yong Oh and Hyuk-Chan Kwon, Dong-A University Hospital, Busan; In Gyu Hwang, Chung-Ang University College of Medicine; Sang-Cheol Lee, Soonchunhyang University Hospital; Eunmi Nam, Ewha Womans University School of Medicine; Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, and Se Hoon Park, Sungkyunkwan University Samsung Medical
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Kwon HC, Kim SH, Oh SY, Lee S, Lee JH, Graves CA, Hwang JA, Hong SH, Kim HJ, Camphausen K, Lee YS. Abstract 4539: Vascular endothelial growth factor gene polymorphisms and clinical outcome in advanced gastric cancer treated with FOLFOX. Cancer Res 2012. [DOI: 10.1158/1538-7445.am2012-4539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Single-nucleotide polymorphisms (SNPs) of the vascular endothelial growth factor (VEGF) gene may have an impact on tumor progression, and response to chemotherapy. The aim of this study is to evaluate the associations between VEGF SNPs and clinical outcome in advanced gastric cancer patients treated with oxaliplatin, 5-fluorouracil, and leucovorin (FOLFOX). Methods: One hundred ninety recurrent or metastatic gastric cancer patients were enrolled in this study and treated with FOLFOX regimen. Genomic DNA was isolated from whole blood, and six VEGF (-2578C/A, –2489C/T, –1498T/C, –634G/C, 936C/T, and 1612G/A) gene polymorphisms were analyzed by PCR. Results: Patients genotyped G/G for –634G/C gene polymorphism had lower response rate (22.2%) than those G/C or C/C (32.3%, 51.1%; p = 0.034). The median serum levels of VEGF was higher in G/G genotypes than G/C + C/C (724.1 pg/ml vs. 462.4 pg/ml, p = 0.041). Patients with the VEGF –634CG/C polymorphism G/C + C/C genotype had a longer time to progression (TTP) of 4.9 months, compared with the TTP of 3.5 months for those with the G/G (p = 0.012, log-rank test). By multivariate analysis, this G/G genotype of –634G/C polymorphism was identified as an independent prognostic factor (Hazard ratio 1.497, p = 0.017). No significant influence on overall survival (OS) was observed by the –634 G/C. However, other SNPs were not related to response rate, TTP, or OS. Conclusion: Our data suggest that G/G genotype of –634G/C polymorphism is related to the higher serum levels of VEGF, and poor clinical outcome in advanced gastric cancer patients. It may help to identify patients who are more sensitive to FOLFOX regimen.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4539. doi:1538-7445.AM2012-4539
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Affiliation(s)
| | - Sung-Hyun Kim
- 1Dong-A Univ. Medical Ctr., Busan, Republic of Korea
| | - Sung Yong Oh
- 1Dong-A Univ. Medical Ctr., Busan, Republic of Korea
| | - Suee Lee
- 1Dong-A Univ. Medical Ctr., Busan, Republic of Korea
| | - Ji Hyun Lee
- 1Dong-A Univ. Medical Ctr., Busan, Republic of Korea
| | | | | | | | - Hyo-Jin Kim
- 1Dong-A Univ. Medical Ctr., Busan, Republic of Korea
| | | | - Yeon-Su Lee
- 3National Cancer Center, Goyang, Republic of Korea
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Kim J, Park S, Kang HM, Ahn CW, Kwon HC, Song JH, Lee YJ, Lee KH, Yang H, Baek SY, Yoo SH, Kim SH, Kim H. Human insulin secreted from insulinogenic xenograft restores normoglycemia in type 1 diabetic mice without immunosuppression. Cell Transplant 2012; 21:2131-47. [PMID: 22490341 DOI: 10.3727/096368912x636803] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
In the present study, we examined the therapeutic potential of human amnion-derived insulin-secreting cells for type 1 diabetes. Human amniotic mesenchymal stem cells (hAMs) were isolated from amnion and cultivated to differentiate into insulin-secreting cells in vitro. After culture in vitro, the differentiated cells (hAM-ISCs) were intensively stained with dithizone and secreted insulin and c-peptide in a high-glucose-dependent manner. They expressed mRNAs of pancreatic cell-related genes, including INS, PDX1, Nkx6-1, NEUROG3, ISL1, NEUROD1, GLUT1, GLUT2, PC1/3, PC2, GCK, PPY, SST, and GC, and were positive for human insulin and c-peptide. Transplantation of hAM-ISCs into the kidneys of mice with streptozotocin-induced diabetes restored body weight and normalized the blood glucose levels, which lasted for 210 days. Only human insulin and c-peptide were detected in the blood of normalized mice after 2 months of transplantation, but little mouse insulin and c-peptide. Removal of graft-bearing kidneys from these mice resulted in causing hyperglycemia again. Human cell-specific gene, hAlu, and human pancreatic cell-specific genes, insulin, PDX1, GLUT1, GLP1R, Nkx6-1, NEUROD1, and NEUROG3, were detected in the graft-bearing kidneys. Colocalization of human insulin and human nuclei antigen was also observed. These results demonstrate that hAMs could differentiate into functional insulin-secreting cells in vitro, and human insulin secreted from hAM-ISCs following transplantation into type 1 diabetic mice could normalize hyperglycemia, overcoming immune rejection for a long period.
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Affiliation(s)
- J Kim
- bcellbio, Inc., Seoul, South Korea
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Kang HJ, Ryu MH, Kim KM, Park YS, Choi J, Ryoo BY, Kim WH, Im SA, Bang YJ, Park SH, Lee JH, Chung IJ, Bae HI, Kim JG, Lee KH, Song HS, Kwon HC, Baek JH, Shin DB, Lee KE, Kang YK. Imatinib efficacy by tumor genotype in Korean patients with advanced gastrointestinal stromal tumors (GIST): The Korean GIST Study Group (KGSG) study. Acta Oncol 2012; 51:528-36. [PMID: 22150077 DOI: 10.3109/0284186x.2011.636753] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE To assess the efficacy of imatinib for different tumor genotypes in Korean patients with advanced gastrointestinal stromal tumors (GIST). MATERIAL AND METHODS Clinical data were collected from 370 consecutive patients with locally advanced unresectable, metastatic, or recurrent GIST treated with imatinib 400 mg/day between August 2001 and December 2007 at 20 Korean institutions. Tumor genotypes were determined for 290 patients by direct DNA sequencing of KIT exons 9, 11, 13, and 17, and PDGFRA exons 12, 14, and 18. RESULTS Of 290 patients assessed for genotype, 261 (90.0%) had mutations in KIT: 222 (76.6%) in exon 11, 35 (12.1%) in exon 9 and two each (0.7%) for exons 13 and 17. Four patients (1.4%) had mutations in the PDGFRA gene: one in exon 12, and three in exon 18. Twenty-five patients (8.6%) had no detectable mutations. The best responses of the 235 patients with measurable lesions were: 15 complete response (6.4%), 126 partial response (53.5%), 86 stable disease (36.6%), and eight progressive disease (3.4%). Patients with KIT exon 9 mutations, compared with patients with KIT exon 11 mutations, had a lower objective response rate (36.7% vs. 63.6%, p = 0.007) and a shorter progression-free survival (median 28.7 months vs. 49.4 months, p = 0.001). No statistical difference in overall survival was observed between these genotypes. CONCLUSION This study confirms that imatinib efficacy is dependent on genotype in Korean GIST patients, consistent with results demonstrated by Western patients with GIST.
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Affiliation(s)
- Hye Jin Kang
- Division of Hematology/Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
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Kwon HC, Kim SH, Oh SY, Lee S, Lee JH, Choi HJ, Park KJ, Roh MS, Kim SG, Kim HJ, Lee JH. Clinical significance of preoperative neutrophil-lymphocyte versus platelet-lymphocyte ratio in patients with operable colorectal cancer. Biomarkers 2012; 17:216-22. [PMID: 22424597 DOI: 10.3109/1354750x.2012.656705] [Citation(s) in RCA: 284] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The objective of this study was to clarify whether the neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) are significant prognostic markers in patients with resectable colorectal cancer (CRC). A total of 200 patients who underwent curative resection for CRC were enrolled. The NLR and PLR were positively correlated (p < 0.001). Both the NLR and PLR were shown to be good prognostic biomarkers of overall survival (OS) (p=0.002 and p=0.001, respectively). The PLR was an independent prognostic factor of OS based on multivariate analysis (hazard ratio, 1.971; 95% confidence interval, 1.102-3.335; p=0.021).
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Affiliation(s)
- Hyuk-Chan Kwon
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea
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Lee S, Kwon HC, Kim SH, Oh SY, Lee JH, Yoon HH, Choi HJ, Kim HJ. Capecitabine monotherapy and the clinical significance of neutrophil-lymphocyte ratio versus platelet-lymphocyte ratio in patients with metastatic colorectal cancer. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.4_suppl.660] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
660 Background: Oxaliplatin- and irinotecan-based combination chemotherapy with infusional 5-FU and leucovorin are currently the standard therapies for metastatic colorectal cancer. The objectives of this study were to evaluate the efficacy of capecitabine monotherapy as third line therapy for metastatic colorectal cancer after failure of chemotherapy containing oxaliplatin and irinotecan, and to determine whether the neutrophil-lymphocyte ratio (NLR), or the platelet-lymphocyte ratio (PLR) are significant prognostic marker in metastatic colorectal cancer. Methods: We analyzed 60 patients with metastatic colorectal cancer who received capecitabine monotherapy after the failure of FOLFOX and FOLFIRI. Capecitabine was administered at 1250mg/m2 twice daily for 2 weeks, every 3 weeks. The NLR and PLR were calculated from complete blood counts in baseline laboratory test before the first cycle chemotherapy. Results: The overall response rate was 6.7% and stable disease was 41.7%. The disease control rate was 48.3%. The median progression-free survival (PFS) was 2.8 months (95% CI, 1.5-4.1 months) and the median overall survival (OS) was 9.7 months (95% CI, 7.6-11.7 months). The most frequent adverse event was hand-foot syndrome (all-grade 26.6%; grade3 5%). The response of capecitabine, NLR, and PLR were observed as good prognostic markers of OS in univariate analysis (p<0.001, 0.004, and 0.002, respectively). The response of capecitabine and PLR were independent prognostic marker in multivariate analysis (Hazard ratio 2.757, 95% CI 1.357-5.599, p=0.005 and hazard ratio 2.091, 95% CI 1.231-3.552, p=0.006, respectively). Conclusions: The capecitabine monotherapy showed a moderate disease control and a tolerable toxicity profile as third line treatment for metastatic colorectal cancer. The response of capecitabine and PLR may be simple and useful prognostic index for metastatic colorectal cancer.
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Affiliation(s)
- Suee Lee
- Department of Internal Medicine, Dong-A University Medical Center, Busan, South Korea; Department of Surgery, Dong-A University Medical Center, Busan, South Korea
| | - Hyuk-Chan Kwon
- Department of Internal Medicine, Dong-A University Medical Center, Busan, South Korea; Department of Surgery, Dong-A University Medical Center, Busan, South Korea
| | - Sung-Hyun Kim
- Department of Internal Medicine, Dong-A University Medical Center, Busan, South Korea; Department of Surgery, Dong-A University Medical Center, Busan, South Korea
| | - Sung Yong Oh
- Department of Internal Medicine, Dong-A University Medical Center, Busan, South Korea; Department of Surgery, Dong-A University Medical Center, Busan, South Korea
| | - Ji Hyun Lee
- Department of Internal Medicine, Dong-A University Medical Center, Busan, South Korea; Department of Surgery, Dong-A University Medical Center, Busan, South Korea
| | - Hyun-Hwa Yoon
- Department of Internal Medicine, Dong-A University Medical Center, Busan, South Korea; Department of Surgery, Dong-A University Medical Center, Busan, South Korea
| | - Hong Jo Choi
- Department of Internal Medicine, Dong-A University Medical Center, Busan, South Korea; Department of Surgery, Dong-A University Medical Center, Busan, South Korea
| | - Hyo-Jin Kim
- Department of Internal Medicine, Dong-A University Medical Center, Busan, South Korea; Department of Surgery, Dong-A University Medical Center, Busan, South Korea
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Park SH, Ryu MH, Ryoo BY, Im SA, Kwon HC, Lee SS, Park SR, Kang BY, Kang YK. Sorafenib in patients with metastatic gastrointestinal stromal tumors who failed two or more prior tyrosine kinase inhibitors: a phase II study of Korean gastrointestinal stromal tumors study group. Invest New Drugs 2012; 30:2377-83. [PMID: 22270258 DOI: 10.1007/s10637-012-9795-9] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 01/17/2012] [Indexed: 02/08/2023]
Abstract
PURPOSE To evaluated the efficacy and safety of sorafenib in patients with advanced gastrointestinal stromal tumors (GIST) who failed to previous standard treatments. EXPERIMENTAL DESIGN Thirty-one patients with measurable metastatic GIST who failed both imatinib and sunitinib were accrued. Sorafenib was administered orally at 400 mg twice daily until disease progression or development of intolerance. The primary endpoint was disease control rate (response + stable disease, DCR) at 24 weeks. RESULTS Sorafenib was well tolerated, with hand-foot skin reaction, fatigue, hypertension, and abdominal pain being the most frequent adverse events. The relative dose intensity of sorafenib during the first 6 months was >80%. Four patients achieved partial response (response rate 13%, 95% CI 1-25%), and 16 (52%) had stable disease. DCR at 24 weeks was measured as 36% (95% CI 19-52%). Median progression-free and overall survivals were 4.9 and 9.7 months, respectively. Progression-free survival of patients with prior use of nilotinib (P = .0085) and with primary genotypes other than KIT exon 11 mutation (P = .0341) was significantly shorter than that of patients without. CONCLUSIONS Sorafenib showed antitumor activity in this population of imatinib and sunitinib pretreated GIST. With sorafenib, about one third of patients can maintain disease control for more than 24 weeks.
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Affiliation(s)
- S H Park
- Division of Hematology-Oncology, Department of Medicine, Sungkyunkwan University Samsung Medical Center, Seoul, South Korea
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Lee DH, Oh SY, Lee YR, Huh SJ, Yoon HH, Kim SH, Lee S, Lee JH, Kim Y, Kim HJ, Kwon HC. A Phase II Study of Modified FOLFOX4 for Colorectal Cancer Patients with Peritoneal Carcinomatosis. Cancer Res Treat 2011; 43:225-30. [PMID: 22247707 PMCID: PMC3253864 DOI: 10.4143/crt.2011.43.4.225] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Accepted: 08/12/2011] [Indexed: 12/21/2022] Open
Abstract
Purpose Peritoneal carcinomatosis (PC) of colorectal cancer (CRC) is common and is the second most common cause of death. Clinical studies regarding chemotherapy for CRC with PC have been classically rather limited in scope. We evaluated the efficacy of modified oxaliplatin, leucovorin, and fluorouracil (m-FOLFOX4) regimen for PC of CRC origin. Materials and Methods CRC patients with PC were treated with cycles of oxaliplatin at 85 mg/m2 on day 1, leucovorin 20 mg/m2 followed by 5-fluorouracil (5-FU) via a 400 mg/m2 bolus and a 22 hours continuous infusion of 600 mg/m2 5-FU on days 1-2 at 2-week intervals. Results Forty patients participated in this study. Median age was 55 years. Thirty-two patients (80.0%) received previous operation, and 60.0% of PC occurred synchronously. Thirty-five patients (87.5%) were assessable and exhibited measurable lesions. Two patients (5.7%) demonstrated complete response and five patients (14.3%) showed partial response. The median time to progression was 4.4 months (95% confidence interval, 2.5 to 6.3 months), the median overall survival time was 21.5 months (95% confidence interval, 17.2 to 25.7 months). There was no treatment related death. Presence of liver metastasis (p=0.022), performance status (p=0.039), and carcinoembryonic antigen level (p=0.016) were related to the time to progression. Patients with low carcinoembryonic antigen level (37.2 months vs. 15.6 months, p=0.001) or good performance status (22.5 months vs. 6.8 months, p=0.040) showed better overall survival. Conclusion The m-FOLFOX4 regimen was determined to be effective for CRC patients with PC.
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Affiliation(s)
- Dong Hyun Lee
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
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Lee SM, Shin JS, Choi HJ, Park KJ, Roh YH, Kwon HC, Roh MS, Lee HS, Kim C. Prognostic implication of metastatic lymph node ratio in node-positive rectal cancer. J Korean Surg Soc 2011; 80:260-6. [PMID: 22066045 PMCID: PMC3204678 DOI: 10.4174/jkss.2011.80.4.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Accepted: 08/31/2010] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of this study was to evaluate the prognostic significance of the ratio between metastatic and examined lymph nodes (LNs) in patients with stage III rectal cancer. METHODS A review was made of 175 (male, 98) patients with stage III rectal cancer of R0 resection. LN disease was stratified both by the American Joint Committee on Cancer/International Union Against Cancer nodal classification (pN) and by quartiles of the lymph node ratio (LNR). Disease-free survivals (DFS) were made using Kaplan-Meier curves and assessed by the log rank test and multivariate analysis was performed using the Cox proportional hazards model. RESULTS Patients ranged in age from 29 to 83 (median, 60) years with median follow-up of 47 months (range, 13 to 181 months). months. There was a significant correlation between the number of metastatic LNs and the LNR (r = 0.8681, P < 0.0001). Cut-off points of LNR quartiles best to separate patients with regard to 5-year DFS were between quartile 2 and 3, and between 3 and 4 (LNR1, 2, and 3); the 5-year DFS according to such stratification was 89.6%, 55.8%, and 18.2% in LNR1, 2, and 3, respectively (P < 0.0001). Cox model identified the LNR as the most significant independent prognostic covariate; LNR2 showed 3.6 times (95% confidence interval [CI], 1.682 to 7.584; P = 0.0009) and LNR3, 18.7 times (95% CI, 6.872 to 50.664; P < 0.0001) more risky than LNR1. CONCLUSION This study suggests that ratio-based LN staging, which reflects the number of LNs examined and the quality of LN dissection, is a simple and reliable system for prognostic LN stratification in patients with stage III rectal cancer.
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Affiliation(s)
- Sang-Min Lee
- Department of Surgery, Dong-A University Medical Center, Busan, Korea
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Lee JH, Kim MC, Oh SY, Kwon HC, Kim SH, Kwon KA, Lee S, Jeong JS, Choi SR, Kim HJ. Predictive value of in vitro adenosine triphosphate-based chemotherapy response assay in advanced gastric cancer patients who received oral 5-Fluorouracil after curative resection. Cancer Res Treat 2011; 43:117-23. [PMID: 21811428 PMCID: PMC3138915 DOI: 10.4143/crt.2011.43.2.117] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Accepted: 11/22/2010] [Indexed: 01/08/2023] Open
Abstract
Purpose To assess the usefulness of adenosine triphosphate-based chemotherapy response assay (ATP-CRA) results in advanced gastric cancer patients receiving adjuvant chemotherapy. Materials and Methods Sixty-two patients underwent curative surgical resection between January, 2006 and December, 2008. Their highly purified surgical specimens were evaluated by ATP-CRAs. Of the 62, 49 had successful assay results and they received either oral 5-fluorouracil or other chemotherapies. We retrospectively analyzed data for 24 patients who were treated with oral 5-fluorouracil and whose assays were successful. Results The median observation time was 24.6 months (range, 10.1 to 40.9 months). The median treatment time was 11.2 months (range, 1.2 to 17.7 months). The median age was 66 years (range, 30 to 81 years). Patients were grouped into sensitive- and resistant-groups according to adenosine triphosphate-based chemotherapy response results for fluorouracil. The sensitive-group showed a significantly longer time to relapse (not reached in the sensitive-group vs. 24.8 months in the resistant-group, p=0.043) and longer overall survival compared to the resistant-group (not reached in the sensitive-group vs. 35.7 months in the resistant-group, p=0.16, statistically insignificant). Conclusion Patients who receive curative surgical resection significantly benefit from sensitive adjuvant chemotherapy according to ATP-CRA results for time to relapse.
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Affiliation(s)
- Ji Hyun Lee
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
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Lee YR, Huh SJ, Lee DH, Yoon HH, Seol YM, Choi YJ, Kwon KA, Lee S, Oh SY, Kim SH, Kim HJ, Kwon HC. Phase II Study of Vinorelbine Plus Trastuzumab in HER2 Overexpressing Metastatic Breast Cancer Pretreated with Anthracyclines and Taxanes. J Breast Cancer 2011; 14:140-6. [PMID: 21847410 PMCID: PMC3148545 DOI: 10.4048/jbc.2011.14.2.140] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Accepted: 05/02/2011] [Indexed: 01/16/2023] Open
Abstract
Purpose The role of first-line trastuzumab-based therapy has been firmly established in patients with human epidermal growth factor receptor-2 (HER2) positive metastatic breast cancer. In this trial, we evaluated the efficacy and safety of a vinorelbine and trastuzumab combination chemotherapy in patients who were pretreated with anthracyclines and taxanes. Methods Thirty-three patients with HER2 overexpressing metastatic breast cancer, all of whom had previously been treated with anthracyclines and taxanes, were included in this study. The patients were treated with 25 mg/m2 of vinorelbine (over a 15-minute infusion) on days 1 and 8 every 3 weeks. Additionally, trastuzumab was administered at an initial dose of 4 mg/kg over 90 minutes, and was subsequently administered at weekly doses of 2 mg/kg (over 30 minutes). Results The median age of the patients was 53 years (range, 39-72 years). The overall response rate was 30.3% (10 patients; 95% confidence interval [CI], 23-57%). The median time to progression was 6.8 months (95% CI, 5.3-8.2 months). The median overall survival was 12.4 months (95% CI, 10.3-14.6 months). In the 194 cycles of treatment, the incidence rates of grade ≥3 neutropenia and anemia were 7.2% and 1.0%, respectively. Neutropenic fever was detected in three cycles (1.5%). The non-hematological toxicities were not severe: grade 1 or 2 nausea or vomiting was detected in 15.2%, and grade 2 neuropathy was noted in 6.1% of patients. None of the patients experienced any serious cardiac toxicity, and no treatment-related deaths occurred. Conclusion These results show that a combination chemotherapy consisting of vinorelbine and trastuzumab is useful in patients with HER2-overexpressing metastatic breast cancer who were pretreated with anthracyclines and taxanes, with a favorable toxicity profile.
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Affiliation(s)
- Yu Rim Lee
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
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Lee JH, Kwon KA, Lee S, Oh SY, Kim SH, Kwon HC, Han JY, Song MK, Chung JS, Lee HS, Kim YS, Lee SM, Joo YD, Kim HJ. Incidence and clinical characteristics of clonal cytogenetic abnormalities of acquired aplastic anemia in adults. Korean J Hematol 2010; 45:242-6. [PMID: 21253425 PMCID: PMC3023049 DOI: 10.5045/kjh.2010.45.4.242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 10/30/2010] [Accepted: 11/18/2010] [Indexed: 12/02/2022]
Abstract
Background Cytogenetic abnormalities (CAs) have been reported frequently in patients with otherwise typical aplastic anemia (AA), but their implications in the prognosis and in the evolution to hematologic malignancies are controversial. Methods We retrospectively analyzed 127 adult AA patients who had successful cytogenetic analysis at initial diagnosis. Results The patients were classified into 3 groups according to the initial and follow-up results of cytogenetic profiles. Group 1 included patients who had persistent AA with normal cytogenetic profiles (N=117); Group 2, those who had a normal cytogenetic profile at initial diagnosis but later acquired CA (N=4, 3.1%); and Group 3, those who had CA at the initial diagnosis, regardless of follow-up cytogenetic status (N=6,4.7%). In Group 2, 2 patients later developed CA without progression to acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS); the other 2 patients later progressed to AML. None of the patients in Group 3 progressed to AML or MDS. There was no significant difference in overall survival between Groups 1 and 3. Conclusion AA patients with CA at initial diagnosis or follow-up may not be at greater risk for evolution to AML or MDS, or show shorter survival periods. Prospective studies and a larger patient samples are needed to establish the clinical relevance of CA.
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Affiliation(s)
- Ji Hyun Lee
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
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Kim KH, Kwon HC, Oh SY, Kim SH, Lee S, Kwon KA, Jang JS, Kim MC, Kim SJ, Kim HJ. Clinicopathologic significance of ERCC1, thymidylate synthase and glutathione S-transferase P1 expression for advanced gastric cancer patients receiving adjuvant 5-FU and cisplatin chemotherapy. Biomarkers 2010; 16:74-82. [PMID: 21133646 DOI: 10.3109/1354750x.2010.533284] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The objective of this study was to determine whether the expressions of the excision cross-complementing (ERCC1), thymidylate synthase (TS) and glutathione S-transferase P1 (GSTP1) are predictive of clinical outcomes in advanced gastric cancer (AGC) patients receiving treatment with adjuvant 5-fluorouracil (5-FU) and cisplatin (FP) chemotherapy. One hundred forty nine patients were included in this study. ERCC1 and GSTP1 expression was correlated significantly with tumor size (p = 0.040, p = 0.018, respectively). Stage and positive lymph node ratio were associated independently with disease free survival (DFS) and overall survival (OS). Both ERCC1 and GSTP1 expression had a significant impact on OS (hazard ratio = 0.069, p = 0.021). TS expression was not related to DFS and OS.
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Affiliation(s)
- Ki Han Kim
- Department of Surgery, Dong-A University College of Medicine, Busan, Korea
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Abstract
AIM To investigate the effect of nonthermal atmospheric pressure plasma on intracoronal tooth bleaching in blood stained human teeth. METHODOLOGY Forty extracted single-root and blood stained human teeth were used. The teeth were randomly divided into two groups (n=20): group 1 received 30% HP activated by nonthermal atmospheric pressure plasma in the pulp chamber for 30 min, whilst group 2 received 30% HP alone in the pulp chamber for 30 min. The overall colour changes (ΔE) were assessed using the Commission Internationale de L'Eclairage (CIE) Lab Colour System. The data were analysed using Student's t-test to determine the significant differences. RESULTS The temperature of all teeth was maintained at approximately 37 °C during plasma bleaching. The plasma treatment with 30% HP resulted in significantly higher bleaching efficacy compared to 30% HP alone in discoloured teeth (P<0.05). The average ΔE values of group 1 and group 2 were 9.24 (0.37) and 4.47 (1.62), respectively, at 30 min. CONCLUSIONS The application of nonthermal atmospheric pressure plasma to intracoronal bleaching could be a novel and efficient therapy in the bleaching of haemorrhagically stained teeth.
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Affiliation(s)
- J K Park
- Department of Conservative Dentistry, School of Dentistry, Pusan National University, Yangsan, Korea
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Kwon HC, Kim SH, Oh SY, Lee S, Kwon KA, Choi HJ, Park KJ, Kim HJ, Roh MS. Clinicopathological significance of p53, hypoxia-inducible factor 1alpha, and vascular endothelial growth factor expression in colorectal cancer. Anticancer Res 2010; 30:4163-4168. [PMID: 21036736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND The principal objective of this study was to evaluate the prognostic significances of p53, hypoxia inducible factor-1 alpha (HIF-1α), and vascular endothelial growth factor (VEGF) expression in colorectal cancer. MATERIALS AND METHODS The tumor tissues of 311 patients with colorectal carcinoma that had undergone potentially curative resections were immunohistochemically assessed using monoclonal antibodies against p53, HIF-1α, and VEGF. RESULTS Positivity rates of p53, HIF-1α, and VEGF were 42.4%, 63.0%, and 56.6%, respectively. HIF-1α expression in tumor tissues was determined to be correlated significantly with the expression of VEGF (p=0.040), and depth of invasion (p=0.019). Multivariate analysis demonstrated that HIF-1α was independently associated with poor overall survival (p=0.002). CONCLUSION HIF-1α expression is associated with VEGF expression and angiogenesis in colorectal carcinoma. Additionally, the expression of HIF-1α in tumor tissue is associated with angiogenesis and poor overall survival in patients with colorectal cancer.
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Affiliation(s)
- Hyuk-Chan Kwon
- Department of Internal Medicine, Dong-A University College of Medicine, Seo-gu, Busan, Republic of Korea
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Oh SY, Kwon HC, Jeong SH, Joo YT, Lee YJ, Cho SH, Kang MH, Go SI, Lee GW, Kim HG, Kang JH. A phase II study of S-1 and oxaliplatin (SOx) combination chemotherapy as a first-line therapy for patients with advanced gastric cancer. Invest New Drugs 2010; 30:350-6. [PMID: 20706861 DOI: 10.1007/s10637-010-9507-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2010] [Accepted: 07/23/2010] [Indexed: 12/28/2022]
Abstract
BACKGROUND Palliative chemotherapy has been shown to have a survival benefit for patients with recurrent or metastatic gastric cancer. 5-fluorouracil (5-FU) and cisplatin have been widely used in a variety of combinations. We conducted a phase II study of combination chemotherapy with new agents, S-1 and oxaliplatin (SOx), in advanced gastric cancer patients in an effort to evaluate the efficacy and toxicity of this regimen. METHOD Histologically confirmed recurrent or metastatic gastric cancer were treated by the oral administration of S-1 80 mg/m(2)/day on days 1-28, and oxaliplatin 85 mg/m(2) administered as a 90-min intravenous infusion on days 1, 15, and 29. Treatment courses were repeated every 6 weeks. Patients received a maximum of four cycles. RESULTS From Feb 2006 to May 2008, 41 patients were enrolled in this study. The ratio of males to females was 28 to 13. The median patient age was 61 years (range, 36-74 years), and 85.4% (35/41) of the patients had a performance status (ECOG) of 1. The median number of chemotherapy cycles administered was 3 (range, 1-4). According to the results of our Intent-to-Treat analysis, 22 patients (53.7%) achieved a partial response (95% CI, 38-70%). 15 patients (36.6%) evidenced a stable disease, and 1 patient (2.4%) progressed during the course of the treatment. 3 patients were lost to follow-up prior to evaluation. The median time to progression and overall survival time were 4.6 months (95% CI, 3.4-5.8 months) and 7.8 months (95% CI, 6.9-8.7 months) from the start of the chemotherapy, respectively. A total of 114 cycles were assessed for toxicity. The major hematologic toxicities included grade 2 anemia (41.2%), grade 1-2 neutropenia (28.1%), and grade 1 thrombocytopenia (23.7%). Only 1 cycle of neutropenic fever occurred. The non-hematological toxicities observed were grade 3 vomiting (12.2%) and grade 3 diarrhea (4.9%). No treatment-related deaths occurred in our patient population during the study period. CONCLUSION The SOx regimen evidenced a relatively high response rate and was well tolerated as a first-line therapy for advanced gastric cancer.
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Affiliation(s)
- Sung Yong Oh
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
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Kim SH, Lee JH, Choi J, Kwon KA, Lee S, Oh SY, Kwon HC, Han JY, Kim HJ. Improvement of the WHO classification-based prognostic scoring system (WPSS) by including age for Korean patients with the myelodysplastic syndrome. Leuk Res 2010; 34:1589-95. [PMID: 20633929 DOI: 10.1016/j.leukres.2010.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2010] [Revised: 02/28/2010] [Accepted: 03/01/2010] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of this study was to improve the predictive power of the WHO classification-based prognostic scoring system (WPSS) by including age in patients with the myelodysplastic syndrome (MDS). PATIENTS AND METHODS 136 Korean patients with de novo MDS between 1995 and 2008 were evaluated retrospectively. All patients were reclassified according to WHO criteria. 114 patients were included in the final analysis. An individualized age-adapted scoring system was developed to improve the accuracy of prognosis of the WPSS. RESULTS The WPSS was significantly associated with the prediction of survival and the leukemia-free survival. While the risk of a patient with the WPSS was best represented by the values 0 (very low), +1 (low), +2 (intermediate), +3 (high), and +4 (very high), these values were found to vary between -1.0 and 4.2 in the same patients when age was included as a factor. The WPSS may vary according to age, <55 or ≥55 years. The estimated difference in median survival was more prominent in the lower risk groups of the WPSS than in the higher-risk groups. CONCLUSION In addition to the WPSS, age was found to significantly influence the prognosis of patients with MDS and provided a more individualized prognosis for the patients with MDS.
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Affiliation(s)
- Sung-Hyun Kim
- Department of Internal Medicine, Dong-A University College of Medicine, Seo-gu, Busan, South Korea
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Kwon KA, Kwon HC, Kim MC, Kim SH, Oh SY, Lee S, Kim HJ. A case of 5-fluorouracil induced encephalopathy. Cancer Res Treat 2010; 42:118-20. [PMID: 20622967 DOI: 10.4143/crt.2010.42.2.118] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2009] [Accepted: 10/05/2009] [Indexed: 11/21/2022] Open
Abstract
Patients with reduced dihydropyrimidine dehydrogenase (DPD) activity are at risk for experiencing serious adverse effects following 5-fluorouracil (5-FU) based chemotherapy. Neurotoxicity is considered an extremely rare side effect of 5-FU. We report here on an unusual case of 5-FU induced encephalopathy. A 38-year-old woman with advanced gastric carcinoma was treated with adjuvant chemotherapy that consisted of infused 5-FU (1,000 mg/m²) for 5 days and cisplatin (60 mg/m²) on day 1 following total gastrectomy. Nineteen days after starting chemotherapy, the patient displayed a sudden onset of slurred speech, confusion, cognitive disturbances and paranoia. A magnetic resonance image (MRI) of the brain showed no structural abnormalities, and the other laboratory tests provided no explanations for her symptoms, other than a slightly elevated ammonia level. The patient was treated with a lactulose retention enema and thiamine infusion, the 5-FU was halted and her symptoms then recovered after 7 days.
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Affiliation(s)
- Kyung A Kwon
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
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Lee JH, Choi J, Kwon KA, Lee S, Oh SY, Kwon HC, Kim HJ, Han JY, Kim SH. Fludarabine-based myeloablative regimen as pretransplant conditioning therapy in adult acute leukemia/myelodysplastic syndrome: comparison with oral or intravenous busulfan with cyclophosphamide. Korean J Hematol 2010; 45:102-8. [PMID: 21120188 PMCID: PMC2983027 DOI: 10.5045/kjh.2010.45.2.102] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2010] [Revised: 05/27/2010] [Accepted: 05/31/2010] [Indexed: 11/28/2022]
Abstract
Background A combination of busulfan (Bu) and cyclophosphamide (Cy) has been used as a standard myeloablative regimen for allogeneic hematopoietic stem cell transplantation (HSCT). Recent studies postulate that fludarabine (Flu) is a less toxic substitute for Cy. Methods Forty-two patients who were diagnosed with acute leukemia or myelodysplastic syndrome and received BuFlu (n=17) or BuCy (n=25) from August, 1999 to July, 2009 at Dong-A University Medical Center were retrospectively analyzed. Results The median follow-up duration was 39.75 months. The BuFlu group showed a lower incidence of mucositis (P=0.005), but there was no significant intergroup difference in the time of engraftment, nausea/vomiting, acute/chronic graft-versus-host disease, hepatic veno-occlusive disease, or hemorrhagic cystitis. Moreover, the 2 groups showed no significant difference in the cumulative risk of relapse, event-free survival, or overall survival. Conclusion BuFlu administration can be employed as a preparative regimen for allogeneic HSCT and shows efficacy and transplant-adverse effects comparable to those of BuCy. However, randomized prospective studies in more patients are warranted.
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Affiliation(s)
- Ji Hyun Lee
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
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Kwon KA, Kim SH, Oh SY, Lee S, Han JY, Kim KH, Goh RY, Choi HJ, Park KJ, Roh MS, Kim HJ, Kwon HC, Lee JH. Clinical significance of preoperative serum vascular endothelial growth factor, interleukin-6, and C-reactive protein level in colorectal cancer. BMC Cancer 2010; 10:203. [PMID: 20465852 PMCID: PMC2886042 DOI: 10.1186/1471-2407-10-203] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 05/14/2010] [Indexed: 12/30/2022] Open
Abstract
Background Angiogenesis is a multistep process in which many growth factors and cytokines have an essential role. Vascular endothelial growth factor (VEGF) is a potent angiogenic agent that acts as a specific mitogen for vascular endothelial cells through specific cell surface receptors. The interleukin-6 (IL-6) pathway is another mechanism linking angiogenesis to malignancy. C-reactive protein (CRP), a representative marker for inflammation, is known for its association with disease progression in many cancer types. The aim of this study was to determine preoperative serum levels of VEGF, IL-6, and CRP in colorectal carcinoma, and to correlate them with disease status and prognosis. Methods A 132 of 143 patients who underwent curative resection for colorectal cancer were enrolled in this study. 11 patients with resection margin positive were excluded. Factors considered in analysis of the relationship between VEGF, IL-6, and CRP and histological findings. Patient prognosis was investigated. Serum levels of VEGF and IL-6 were assessed using Enzyme-Linked Immuno-Sorbent Assay (ELISA), and CRP was measured using immunoturbidimetry. Results Median follow-up duration was 18.53 months (range 0.73-43.17 months) and median age of the patients was 62 years (range, 26-83 years). Mean and median levels of VEGF and CRP in colorectal cancer were significantly higher than in the normal control group; 608 vs. 334 pg/mL and 528 (range 122-3242) vs. 312 (range 16-1121) (p < 0.001); 1.05 mg/dL vs. 0.43 mg/dL and 0.22 (range 0.00-18.40) vs. 0.07 (range 0.02-6.94) (p = 0.002), respectively. However mean and median level of IL-6 in patients were not significantly higher than in control; 14.33 pg/mL vs. 5.65 pg/mL and 6.00 (range 1.02-139.17) vs. 5.30 (4.50-13.78) (p = 0.327). Although IL-6 and CRP levels were not correlated with other pathological findings, VEGF level was significantly correlated with tumor size (p = 0.012) and CEA (p = 0.038). When we established the cutoff value for VEGF (825 pg/mL), IL-6 (8.09 pg/mL), and CRP (0.51 mg/dL) by Receiver Operating Characteristic (ROC) curve, we noted that high VEGF levels tended to reduce overall survival (p = 0.053), but not significantly. However, IL-6 and CRP demonstrated no significance with regard to disease free survival (p = 0.531, p = 0.701, respectively) and overall survival (p = 0.563, p = 0.572, respectively). Multivariate analysis showed that VEGF (p = 0.032), CEA (p = 0.012), lymph node metastasis (p = 0.002), and TNM stage (p = 0.025) were independently associated with overall survival. Conclusions Preoperative serum VEGF and CRP level increased in colorectal cancer patients. High VEGF level has been proposed as a poor prognostic factor for overall survival in patients with colorectal cancer.
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Affiliation(s)
- Kyung A Kwon
- Department of Internal Medicine, Dong-A university College of Medicine, Busan, Korea
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OH SUNGYONG, Kim KH, Kim SH, Lee S, Kwon KA, Jang JS, Kim MC, Kim SJ, Kim HJ, Kwon HC. Abstract 3739: Clinicopathologic significance of ERCC1, Thymidylate Synthase and Glutathione S-Transferase P1 expression for advanced gastric cancer patients receiving adjuvant 5-FU and cisplatin chemotherapy. Cancer Res 2010. [DOI: 10.1158/1538-7445.am10-3739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The aim of this study was to determine whether expressions of the excision cross-complementing (ERCC1), thymidylate synthase (TS) and glutathione S-transferase P1 (GSTP1) predict clinical outcome in patients with advanced gastric cancer treated with adjuvant 5-fluorouracil (5-FU) and cisplatin (FP) chemotherapy.
Patients and methods: The study population consisted of 149 advanced gastric cancer patients. After curative resection, if the patients had stage II or higher disease, we administered adjuvant FP combination chemotherapy. The FP regimen was as follows. Cisplatin 60 mg/m2 was administered intravenously on day 1, and 5-FU 1,000 mg/m2 was administered intravenously on days 1 to 5. This regimen was repeated every three weeks. The expressions of ERCC1, TS and GSTP1 of primary tumors were examined by immunohistochemistry. Clinicopathologic information, including tumor size, histological grade, Lauren's classification, Borrmann type, vascular invasion, ratio of involved lymph nodes to dissected nodes, stage, carcinoembryonic antigen (CEA), and disease-free survival (DFS) and overall survival (OS) were evaluated with respect to the expressions of ERCC1, TS and GSTP1.
Results: Median follow-up duration was 65.2 months, and median patient age was 51 ± 11 years (range 24-75). The positive rates of ERCC1, TS, and GSTP1 were 63.1%, 76.5%, and 40.3%, respectively. ERCC1 and GSTP1 expression was significantly correlated with size (p = 0.040, p = 0.018, respectively). Positive relationships were found between the expression of TS and Borrmann type (p = 0.030) and stage (p = 0.041). Univariate analysis showed that Lauren classification, stage, positive lymph node ratio, and type of operation were associated with both DFS and OS. ERCC1 and GTP1 were significant variables affecting OS (p = 0.005, p = 0.024, respectively). Patients who were both ERCC1 and GSTP1 positive had longer survival (p = 0.003). Multivariate analysis revealed that stage and positive lymph node ratio were independently associated with DFS and OS. Expression of both ERCC1 and GSTP1significantly impacted on OS (hazard ratio = 0.069, p = 0.021).
Conclusion: Immunohistochemical studies for ERCC1 and GSTP1 were useful in prediction of the clinical outcome in advanced gastric cancer patients treated with adjuvant FP.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3739.
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Affiliation(s)
- SUNG YONG OH
- 1Dong-A University College of Medicine, Busan, Korea, Republic of
| | - Ki Han Kim
- 1Dong-A University College of Medicine, Busan, Korea, Republic of
| | - Sung Hyun Kim
- 1Dong-A University College of Medicine, Busan, Korea, Republic of
| | - Suee Lee
- 1Dong-A University College of Medicine, Busan, Korea, Republic of
| | - Kyung-A Kwon
- 1Dong-A University College of Medicine, Busan, Korea, Republic of
| | - Jin Seok Jang
- 1Dong-A University College of Medicine, Busan, Korea, Republic of
| | - Min Chan Kim
- 1Dong-A University College of Medicine, Busan, Korea, Republic of
| | - Su-Jin Kim
- 1Dong-A University College of Medicine, Busan, Korea, Republic of
| | - Hyo-Jin Kim
- 1Dong-A University College of Medicine, Busan, Korea, Republic of
| | - Hyuk-Chan Kwon
- 1Dong-A University College of Medicine, Busan, Korea, Republic of
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Oh SY, Jeong CY, Hong SC, Kim TH, Ha CY, Kim HJ, Lee GW, Hwang IG, Jang JS, Kwon HC, Kang JH. Phase II study of second line gemcitabine single chemotherapy for biliary tract cancer patients with 5-fluorouracil refractoriness. Invest New Drugs 2010; 29:1066-72. [DOI: 10.1007/s10637-010-9417-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Accepted: 03/02/2010] [Indexed: 01/10/2023]
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Oh SY, Ju YT, Choi SK, Ha CY, Lee WS, Kim HG, Lee GW, Kwon HC, Kang JH. Phase II study of irinotecan/S-1 combination chemotherapy for patients with oxaliplatin-refractory colorectal cancer. Invest New Drugs 2010; 29:1050-6. [DOI: 10.1007/s10637-010-9409-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Accepted: 02/17/2010] [Indexed: 01/22/2023]
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Kwon HC, Kim SH, Oh SY, Lee S, Kwon KA, Lee JH, Choi HJ, Park KJ, Lee HS, Roh MS, Kim HJ. Clinicopathological significance of nuclear factor-kappa B, HIF-1 alpha, and vascular endothelial growth factor expression in stage III colorectal cancer. Cancer Sci 2010; 101:1557-61. [PMID: 20398057 DOI: 10.1111/j.1349-7006.2010.01553.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Nuclear factor-kappaB (NF-kappaB), hypoxia-inducible factor 1alpha (HIF-1alpha), and vascular endothelial growth factor (VEGF) are involved in cell proliferation, invasion, angiogenesis, and metastases. The principal objective of this study was to assess the prognostic significance of NF-kappaB, HIF-1alpha, and VEGF expression in stage III colorectal cancer. Tumor tissues from 148 patients with stage III colorectal carcinoma, all of whom underwent potentially curative resection, were immunohistochemically evaluated using monoclonal antibodies against NF-kappaB, HIF-1alpha, and VEGF. Positivity rates of NF-kappaB, HIF-1alpha, and VEGF were 47.3%, 42.6%, and 61.5%, respectively. NF-kappaB expression in tumor tissues was correlated significantly with HIF-1alpha expression (P < 0.001), VEGF expression (P = 0.044), and the presence of vascular invasion (P = 0.013). Univariate analysis demonstrated that NF-kappaB expression was associated with poor 5-year overall survival (55.8 months vs 76.9 months, P = 0.012). Multivariate analysis verified that NF-kappaB was independently associated with adverse outcomes (relative risk: 1.92, P = 0.049). However, HIF-1alpha and VEGF did not appear to be related to clinical outcomes. NF-kappaB expression in tumor tissue is associated with angiogenesis and poor 5-year overall survival in stage III colorectal cancer patients.
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Affiliation(s)
- Hyuk-Chan Kwon
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
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Sohn YJ, Jang JS, Choi SR, Kwon HC, Jung GJ, Kim MC, Jeong JS. Early detection of recurrence after endoscopic treatment for early gastric cancer. Scand J Gastroenterol 2010; 44:1109-14. [PMID: 19593687 DOI: 10.1080/00365520903121701] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Although there have been many reports regarding clinical outcomes of endoscopic treatment for early gastric cancer (EGC), little is known about detection of recurrence after endoscopic submucosal dissection (ESD). This study aims to clarify the clinical value of serological marker or imaging tools, including conventional CT and PET-CT scans, in detecting recurrent gastric cancer after ESD in Korea. MATERIAL AND METHODS From July 2004 to March 2008, 212 patients who had received ESD for EGC were enrolled in the study. For preoperative staging, conventional CT and PET-CT scans were performed in 141 patients, and for detection of recurrence of cancer, conventional CT, PET-CT scans and tumour marker; CEA, CA19-9, AFP were checked in 165 patients. RESULTS The local recurrence rate was 4.7% (10/212) during the study period. At 9 months after endoscopic treatment, 3 cases recurred. Four showed recurrence at 12 months, 2 at 18 months and 1 at 24 months. The positive rate was 7.1% (10/141) in conventional CT and 0% (0/24) in PET-CT scans for preoperative staging. Conventional CT and PET-CT scans could not detect local recurrence of cancer during the follow-up period. Tumour markers did not show any significant correlation with recurrence of cancer. CONCLUSIONS The study suggests that conventional CT, PET-CT scans and tumour marker have no role in the primary surveillance of early gastric cancer and/or in detecting recurrence after endoscopic treatment. For early diagnosis of recurrence after endoscopic treatment, a biopsy specimen from the endoscopic examination has to be obtained at regular intervals.
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Affiliation(s)
- You Jung Sohn
- Department of Internal Medicine, Dong-A Medical Center, University of College of Medicine, Busan, Korea
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Jang JS, Choi SR, Graham DY, Kwon HC, Kim MC, Jeong JS, Won JJ, Han SY, Noh MH, Lee JH, Lee SW, Baek YH, Kim MJ, Jeong DS, Kim SK. Risk factors for immediate and delayed bleeding associated with endoscopic submucosal dissection of gastric neoplastic lesions. Scand J Gastroenterol 2010; 44:1370-6. [PMID: 19891589 DOI: 10.3109/00365520903194609] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE. Endoscopic submucosal dissection (ESD) of gastric neoplasia has been reported to have a higher bleeding rate than conventional endoscopic mucosal resection (EMR). The aim of this study was to identify the risk factors for bleeding associated with ESD. MATERIAL AND METHODS. The records of consecutive patients who underwent ESD for gastric adenoma/early gastric cancer were reviewed. Potential risk factors included patient age, lesion size, gross findings, location, and histology of the tumor. The primary end-point was the incidence of immediate or delayed bleeding related to ESD. RESULTS. A total of 144 patients were studied; bleeding occurred in 32 cases (22.2%) with immediate bleeding in 29 cases. Delayed bleeding (3 cases) occurred at day 2 (2 patients) and at day 7 in 1 patient. In all cases of immediate bleeding, immediate hemostatic therapy was successful. The histology of tumor was the only factor that was statistically significantly associated with bleeding (adjusted hazard ratio 6.770, 95% confidence interval 1.830-25.048, p=0.004). CONCLUSIONS. The only factor that correlated with an increased risk of bleeding with ESD was the presence of gastric malignancy. We found no factor that would, prospectively, be amenable to prevention of bleeding.
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Affiliation(s)
- Jin Seok Jang
- Department of Internal Medicine, Dong-A Medical Center, University College of Medicine, Busan, Korea
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Kwon HC, Oh SY, Kim SH, Lee S, Kwon KA, Choi YJ, Cho GJ, Kim YS, Lee M, Lee JH, Kim DC, Lee HS, Cho SH, Kim HJ. Clinical Outcomes and Breast Cancer Subtypes in Patients with Brain Metastases. ACTA ACUST UNITED AC 2010; 33:146-52. [DOI: 10.1159/000286281] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Kim SH, Lee MR, Lee KC, Lee JH, Kwon HC, Kim DC, Lee KW, Cho SH. Use of Antidepressants in Patients with Breast Cancer Taking Tamoxifen. J Breast Cancer 2010. [DOI: 10.4048/jbc.2010.13.4.325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Seong Hwan Kim
- Department of Psychiatry, Dong-A University College of Medicine, Busan, Korea
| | - Mi-Ri Lee
- Department of Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Keun-Cheol Lee
- Department of Plastic and Reconstructive Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Jin-Hwa Lee
- Department of Radiology, Dong-A University College of Medicine, Busan, Korea
| | - Hyuk-Chan Kwon
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Dae-Cheol Kim
- Department of Pathology, Dong-A University College of Medicine, Busan, Korea
| | - Kyeong Woo Lee
- Department of Rehabilitation Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Se-Heon Cho
- Department of Surgery, Dong-A University College of Medicine, Busan, Korea
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Kwon HC, Oh SY, Kim SH, Lee S, Kwon KA, Lee JH, Lee MR, Cho SH, Choi YJ, Kim HJ. Clinical Outcomes in Patients with Triple-negative Breast Cancer and Brain Metastases. J Breast Cancer 2010. [DOI: 10.4048/jbc.2010.13.2.160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Hyuk-Chan Kwon
- Medical Research Center for Cancer Molecular Therapy, Dong-A University College of Medicine, Busan, Korea
| | - Sung Yong Oh
- Medical Research Center for Cancer Molecular Therapy, Dong-A University College of Medicine, Busan, Korea
| | - Sung-Hyun Kim
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Suee Lee
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Kyung A Kwon
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Ji Hyun Lee
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Mi Ri Lee
- Department of Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Se Heon Cho
- Department of Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Young-Jin Choi
- Department of Internal Medicine, Pusan National University Hospital Medical Research Institute, Pusan National University School of Medicine, Busan, Korea
| | - Hyo-Jin Kim
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
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Han JS, Oh SY, Kim SH, Kwon HC, Hong SH, Han JY, Park KJ, Kim HJ. A case of pathologic splenic rupture as the initial manifestation of acute myeloid leukemia M2. Yonsei Med J 2010; 51:138-40. [PMID: 20046528 PMCID: PMC2799964 DOI: 10.3349/ymj.2010.51.1.138] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Revised: 06/06/2008] [Accepted: 06/06/2008] [Indexed: 11/27/2022] Open
Abstract
A pathologic splenic rupture refers to a rupture without trauma. A splenic rupture as the initial manifestation of acute myeloid leukemia is extremely rare. In this study, we described a rare case of acute myeloid leukemia presenting principally as an acute abdomen due to a pathologic splenic rupture in a 35-year old male patient. We can assert that a pathologic splenic rupture in hematologic diseases is a potentially life-threatening complication, which necessitates immediate operative intervention. Any such patient complaining about left upper abdominal tenderness should be closely observed, and further diagnostic investigations (ultrasonograph of the abdomen, abdominal CT scan) should be initiated in order to rule out a splenic rupture. The oncologist should be aware of this rare initial presentation of acute myeloid leukemia (AML) M2, as the condition generally necessitates a prompt splenectomy.
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Affiliation(s)
- Ji-Sun Han
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Sung Yong Oh
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Sung-Hyun Kim
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Hyuk-Chan Kwon
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Sook Hee Hong
- Department of Pathology, Dong-A University College of Medicine, Busan, Korea
| | - Jin Yeong Han
- Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Ki-Jae Park
- Department of Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Hyo-Jin Kim
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
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Oh SY, Kim WS, Kim JS, Kim SJ, Kwon HC, Lee DH, Won JH, Hwang IG, Kim MK, Lee SI, Chae YS, Yang DH, Lee GW, Choi CW, Park J, Suh C, Kim HJ. Pulmonary marginal zone B-cell lymphoma of MALT type—What is a prognostic factor and which is the optimal treatment, operation, or chemotherapy?: Consortium for Improving Survival of Lymphoma (CISL) Study. Ann Hematol 2009; 89:563-8. [DOI: 10.1007/s00277-009-0875-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2009] [Accepted: 11/25/2009] [Indexed: 11/29/2022]
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