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Yang HJ, Lee H, Kim TJ, Jung DH, Choi KD, Ahn JY, Lee WS, Jeon SW, Kim JH, Kim GH, Park JM, Kim SG, Shin WG, Kim YI, Choi IJ. A Modified eCura System to Stratify the Risk of Lymph Node Metastasis in Undifferentiated-Type Early Gastric Cancer After Endoscopic Resection. J Gastric Cancer 2024; 24:172-184. [PMID: 38575510 PMCID: PMC10995829 DOI: 10.5230/jgc.2024.24.e13] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/03/2023] [Accepted: 12/07/2023] [Indexed: 04/06/2024] Open
Abstract
PURPOSE The original eCura system was designed to stratify the risk of lymph node metastasis (LNM) after endoscopic resection (ER) in patients with early gastric cancer (EGC). We assessed the effectiveness of a modified eCura system for reflecting the characteristics of undifferentiated-type (UD)-EGC. MATERIALS AND METHODS Six hundred thirty-four patients who underwent non-curative ER for UD-EGC and received either additional surgery (radical surgery group; n=270) or no further treatment (no additional treatment group; n=364) from 18 institutions between 2005 and 2015 were retrospectively included in this study. The eCuraU system assigned 1 point each for tumors >20 mm in size, ulceration, positive vertical margin, and submucosal invasion <500 µm; 2 points for submucosal invasion ≥500 µm; and 3 points for lymphovascular invasion. RESULTS LNM rates in the radical surgery group were 1.1%, 5.4%, and 13.3% for the low- (0-1 point), intermediate- (2-3 points), and high-risk (4-8 points), respectively (P-for-trend<0.001). The eCuraU system showed a significantly higher probability of identifying patients with LNM as high-risk than the eCura system (66.7% vs. 22.2%; McNemar P<0.001). In the no additional treatment group, overall survival (93.4%, 87.2%, and 67.6% at 5 years) and cancer-specific survival (99.6%, 98.9%, and 92.9% at 5 years) differed significantly among the low-, intermediate-, and high-risk categories, respectively (both P<0.001). In the high-risk category, surgery outperformed no treatment in terms of overall mortality (hazard ratio, 3.26; P=0.015). CONCLUSIONS The eCuraU system stratified the risk of LNM in patients with UD-EGC after ER. It is strongly recommended that high-risk patients undergo additional surgery.
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Affiliation(s)
- Hyo-Joon Yang
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyuk Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Jun Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Da Hyun Jung
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Kee Don Choi
- Division of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yong Ahn
- Division of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Wan Sik Lee
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Seong Woo Jeon
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jie-Hyun Kim
- Department of Internal Medicine, Institute of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Gwang Ha Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jae Myung Park
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Sang Gyun Kim
- Division of Gastroenterology, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Woon Geon Shin
- Department of Internal Medicine, Institute for Liver and Digestive Diseases, Hallym University College of Medicine, Chuncheon, Korea
| | - Young-Il Kim
- Center for Gastric Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Il Ju Choi
- Center for Gastric Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
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Pyun H, Gunathilake M, Lee J, Choi IJ, Kim YI, Sung J, Kim J. Functional Annotation and Gene Set Analysis of Gastric Cancer Risk Loci in a Korean Population. Cancer Res Treat 2024; 56:191-198. [PMID: 37340842 PMCID: PMC10789951 DOI: 10.4143/crt.2022.958] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 06/17/2023] [Indexed: 06/22/2023] Open
Abstract
PURPOSE We aimed to identify the associated single nucleotide polymorphisms (SNPs) with gastric cancer (GC) risk by genome-wide association study (GWAS) and to explore the pathway enrichment of implicated genes and gene-sets with expression patterns. MATERIALS AND METHODS The study population was comprised of 1,253 GC cases and 4,827 controls from National Cancer Center and an urban community of the Korean Genome Epidemiology Study and their genotyping was performed. SNPs were annotated, and mapped to genes to prioritize by three mapping approaches by functional mapping and annotation (FUMA). The gene-based analysis and gene-set analysis were conducted with full GWAS summary data using MAGMA. Gene-set pathway enrichment test with those prioritized genes were performed. RESULTS In GWAS, rs2303771, a nonsynonymous variant of KLHDC4 gene was top SNP associated significantly with GC (odds ratio, 2.59; p=1.32×10-83). In post-GWAS, 71 genes were prioritized. In gene-based GWAS, seven genes were under significant p < 3.80×10-6 (0.05/13,114); DEFB108B had the lowest p=5.94×10-15, followed by FAM86C1 (p=1.74×10-14), PSCA (p=1.81×10-14), and KLHDC4 (p=5.00×10-10). In gene prioritizing, KLDHC4 was the only gene mapped with all three gene-mapping approaches. In pathway enrichment test with prioritized genes, FOLR2, PSCA, LY6K, LYPD2, and LY6E showed strong enrichment related to cellular component of membrane; a post-translation modification by synthesis of glycosylphosphatidylinositol (GPI)-anchored proteins pathway. CONCLUSION While 37 SNPs were significantly associated with the risk of GC, genes involved in signaling pathways related to purine metabolism and GPI-anchored protein in cell membrane are pinpointed to be playing important role in GC.
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Affiliation(s)
- Hyojin Pyun
- Division of Genome and Health Big Data, Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul,
Korea
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, Goyang,
Korea
| | - Madhawa Gunathilake
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, Goyang,
Korea
| | - Jeonghee Lee
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, Goyang,
Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center Hospital, National Cancer Center, Goyang,
Korea
| | - Young-Il Kim
- Center for Gastric Cancer, National Cancer Center Hospital, National Cancer Center, Goyang,
Korea
| | - Joohon Sung
- Division of Genome and Health Big Data, Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul,
Korea
- Institute of Health and Environment, Seoul National University, Seoul,
Korea
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, Goyang,
Korea
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Lattery G, Kaulfers T, Cheng C, Hasan S, Choi IJ, Simone CB, Lin H, Kang M, Chang J. Proton Single-Energy Bragg-Peak FLASH Using Clinical Systems Can Achieve IMPT-Equivalent Plan Quality for Breast and Prostate Cancers. Int J Radiat Oncol Biol Phys 2023; 117:S141. [PMID: 37784361 DOI: 10.1016/j.ijrobp.2023.06.551] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Most current proton FLASH-RT studies focus on transmission proton techniques. In this study, we propose a novel method for achieving FLASH dose rate in hypofractionated proton radiotherapy using the Bragg peak of a single-energy proton beam. The dosimetric characteristics using this novel technique for proton pencil beam scanning (PBS) stereotactic body radiation therapy (SBRT) of prostate and breast cancers were first investigated based on the clinically available cyclotron beam parameters. MATERIALS/METHODS This novel approach uses the distal tracking technique that enables PBS Bragg-peak of the highest proton energy to adapt to the target distally. Positioning of the Bragg peak at different depths is achieved using a universal range shifter and range compensator. To investigate the feasibility of this approach, we developed an in-house treatment planning platform for intensity-modulated proton therapy (IMPT) delivery and performed dosimetric studies on prostate and breast SBRT cases previously treated with conventional proton PBS technique. FLASH plans were generated using a similar clinical beam arrangement to deliver 40 Gy (RBE) in 5 fractions. Dose metrics were compared between the clinical and FLASH plans. Dose-rate volume histograms (DRVH) were also calculated to investigate the 40 Gy/s coverage (V40 Gy/s) of organs-at-risk (OARs) for FLASH plans. RESULTS The distal tracking can precisely stop the Bragg peak at the target distal edge, and Bragg peak plans achieved tumor coverage and dose conformality equivalent to IMPT plans. The clinical IMPT plans yielded slightly superior target dose uniformity -CTV Dmax of FLASH plans was 10% higher for prostate and 2% higher for breast. There was no significant difference between the clinical and FLASH plans in dose metrics for major OARs, including rectum, large bowel, heart, and lung. Higher maximal doses to femoral heads (∼2 Gy) and urethra (∼6 Gy) were observed in prostate FLASH plans than in the clinical plans but were still within clinically accepted dose limits. The V40 Gy/s for OARs were >90% for prostate FLASH plans and >76.5% for breast FLASH plans. CONCLUSION The proposed single-energy Bragg-peak FLASH technique eliminates exit dose associated with transmission proton FLASH and can still yield comparable plan quality and OAR sparing while preserve sufficient FLASH dose rate coverage for prostate and breast proton SBRT. This study demonstrates the potential application of Bragg peaks for highly conformal FLASH-RT using clinical cyclotron systems to treat prostate and breast cancer patients, which moves towards clinical application.
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Affiliation(s)
- G Lattery
- Department of Physics and Astronomy, Hofstra University, HEMPSTEAD, NY
| | - T Kaulfers
- Department of Physics and Astronomy, Hofstra University, HEMPSTEAD, NY
| | - C Cheng
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - S Hasan
- Allegheny Health Network, Department of Radiation Oncology, Pittsburgh, PA
| | - I J Choi
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - H Lin
- New York Proton Center, New York, NY
| | - M Kang
- New York Proton Center, New York, NY
| | - J Chang
- Center for Advanced Medicine-Northwell Health, Lake Success, NY
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Lin H, Yu F, Gorovets D, Kabarriti R, Alektiar KM, Ohri N, Hasan S, Tsai P, Shim A, Kang M, Barker CA, Wolden SL, Hajj C, Mehta KJ, Lee NY, Chhabra AM, Shepherd AF, Choi IJ, Yamada Y, Simone CB. Pencil Beam Scanning Proton Stereotactic Body Radiation Therapy (SBRT): A Robust Single Institution Experience. Int J Radiat Oncol Biol Phys 2023; 117:e686-e687. [PMID: 37786018 DOI: 10.1016/j.ijrobp.2023.06.2155] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To describe the feasibility of treating a complex and diverse group of patients using pencil beam scanning (PBS) proton stereotactic body radiation therapy (SBRT: 5 or fewer fractions, with a fraction size of at least 5 Gy). MATERIALS/METHODS Our center treats on average 105-120 PBS proton treatments daily, of which 9.5% of treatment courses are proton SBRT. Statistics of disease sites, treatment planning parameters (target volume, prescriptions, number of fields, SFO vs. MFO), and treatment efficiencies (scheduled time slots, actual treatment time) are presented for 305 consecutive SBRT patients receiving 1507 fractions in the past three years. Thermoplastic masks or Vacuum-lock bags are used to immobilize SBRT patients and index the patients' treatment position. Imaging guidance of orthogonal kV images and volumetric cone-beam CT is routinely used for patient setup. RESULTS SBRT patients are grouped based on the target locations: pelvis (31%), liver (17%), thoracic (13%), spine (8%), abdominal (8%), brain (7%), non-spine bone (7%), ocular (6%), and head and neck (2%). Only 112 patients (37%) were receiving their 1st RT course, whereas 113 (37%) had one prior in-field RT course, and 80 (26%) had multiple prior in-field RT courses. The median [IQR] target volume was 65.4 [29.3, 168] cc (range: 0.3-2475 cc). 72% of cases were planned with SFO and 28% with MFO. On average, 3.76 fields (range: 2 to 12) were planned for each treatment. 44% of the treatments were planned with three or fewer fields, and 10% received more than five fields, most of which involved repainting for moving targets. Over 97% of treatments were delivered in 5 fractions, with ∼3% delivered in 3 fractions. The median [IQR] prescription per treatment was 8 [7, 10] Gy (range: 5-18 Gy per treatment). 85% (84%) of the SBRT treatments were scheduled (delivered) in a 45-minute or shorter slot, and 6% (7%) of treatments were scheduled (delivered) in over a one-hour slot, most commonly for multiple isocenter treatments. 93% of treatments were delivered within 15 minutes of the planned treatment time or shorter. Deep-inspiration breath-hold (DIBH) was applied to 45% of liver SBRT cases, with the remaining 55% planned on 4D CT with (14%) or without (86%) abdominal compression. DIBH was applied in 13% of lung SBRT cases. The application of other motion mitigation approaches, such as volumetric repainting, was determined by the target motion amplitude and whether the patient could tolerate DIBH. CONCLUSION In the most diverse and largest proton SBRT experience delivered in the world over the past 3 years, over 300 patients were treated, demonstrating the feasibility and efficiency of delivering proton SBRT in a very busy center. The planning and treatment parameter statistics reported serve as a helpful reference for the proton community.
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Affiliation(s)
- H Lin
- New York Proton Center, New York, NY; Memorial Sloan Kettering Cancer Center, New York, NY
| | - F Yu
- New York Proton Center, New York, NY
| | - D Gorovets
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - R Kabarriti
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - K M Alektiar
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - N Ohri
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - S Hasan
- New York Proton Center, New York, NY; Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - P Tsai
- New York Proton Center, New York, NY
| | - A Shim
- New York Proton Center, New York, NY
| | - M Kang
- New York Proton Center, New York, NY
| | - C A Barker
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - S L Wolden
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - C Hajj
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - K J Mehta
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - N Y Lee
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - A M Chhabra
- New York Proton Center, New York, NY; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - A F Shepherd
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - I J Choi
- New York Proton Center, New York, NY; Memorial Sloan Kettering Cancer Center, New York, NY
| | - Y Yamada
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - C B Simone
- New York Proton Center, New York, NY; Memorial Sloan Kettering Cancer Center, New York, NY
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Muallem JL, Hasan S, Marshall DC, Fox JL, Bakst RL, Chhabra AM, Simone Ii CB, Choi IJ. Practice Patterns and Disparities of Fractionation Schemes for Post-Mastectomy Comprehensive Nodal Irradiation. Int J Radiat Oncol Biol Phys 2023; 117:e194-e195. [PMID: 37784834 DOI: 10.1016/j.ijrobp.2023.06.1062] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Hypofractionated (HF) radiotherapy is the established standard of care for whole breast irradiation and is being investigated for comprehensive nodal irradiation, but appropriate patient selection for the latter is currently undefined. This study aims to report national practice patterns and patient selection for HF comprehensive nodal irradiation compared to conventional fractionation (CF). The hypothesis is that the rate of HF for comprehensive nodal irradiation in breast cancer has been increasing over time and is more likely to be offered to disparate demographic populations. MATERIALS/METHODS We queried the National Cancer Database and identified 128,693 patients who received comprehensive nodal irradiation between 2008-2016 in the United States. No patient who underwent lumpectomy received HF nodal irradiation; therefore, only post-mastectomy patients were included in this study. After the exclusion, 29,053 post-mastectomy patients with adjuvant comprehensive nodal irradiation remained. A multivariable binomial regression analysis between HF and CF patients was performed. RESULTS Of the patients identified, 1,910 received HF (6.57%), and 27,143 received CF (93.43%) radiotherapy. All patients had locally advanced breast cancer treated with mastectomy, lymph node dissection, adjuvant radiation, and +/- chemotherapy. The median dose in the HF group was 4,256 cGy in 16 fractions, and in the CF group was 6,040 cGy in 33 fractions. HF rate grew from 3.56% in 2004-2007, 5.29% in 2008-2011, 7.42% in 2012-2013, and 12.05% in 2014-2016. HF was favored in older patients (median age 66 vs. 51, OR = 1.16, 95% Cl 1.11-1.22) and those who lived in suburban or rural regions compared to urban or metropolitan regions (OR = 9.48, 95% CI 1.17-76.9). However, there was no correlation when distance from treatment site was evaluated as a continuous variable. A "boost" dose was used in only 10.58% of HF patients compared to 54.6% of CF patients (OR = 0.17, 95% Cl 0.14-0.21). Chemotherapy was delivered in 36.91% of HF patients compared to 78.14% of CF patients (OR = 0.77, 95% Cl 0.59-0.99). There were no statistically significant correlates of either fractionation scheme for breast laterality, stage, grade, or receptor status. Notably, other than population density and age, demographic factors including race, Hispanic origin, insurance type, median income, and education level demonstrated no correlation with radiation fractionation scheme. CONCLUSION HF for comprehensive nodal irradiation in breast cancer is still uncommon but growing in popularity. Currently, HF is more likely to be used in elderly patients and lower population density centers and less likely to be used in those determined to benefit from receipt of a boost or chemotherapy.
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Affiliation(s)
| | - S Hasan
- Allegheny Health Network, Department of Radiation Oncology, Pittsburgh, PA
| | - D C Marshall
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - J L Fox
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - R L Bakst
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - A M Chhabra
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - I J Choi
- Memorial Sloan Kettering Cancer Center, New York, NY
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Tian S, McCook A, Choi IJ, Simone CB, Vargas CE, Yu NY, Chang JHC, Mihalcik SA, Tsai H, Zeng J, Rosen LR, Rana ZH, Urbanic JJ, Stokes WA, Kesarwala AH, Bradley JD, Higgins KA. Treatment of Thymoma and Thymic Carcinoma with Proton Beam Therapy: Outcomes from the Proton Collaborative Group Prospective Registry. Int J Radiat Oncol Biol Phys 2023; 117:e66. [PMID: 37785956 DOI: 10.1016/j.ijrobp.2023.06.792] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Given the generally long natural history of thymic malignancies, proton beam therapy (PBT) is advocated to minimize the risk of long-term toxicities to mediastinal organs. Adverse events (AE) and long-term clinical outcomes for this population have not been well-characterized. MATERIALS/METHODS The Proton Collaborative Group registry (NCT01255748), a multi-institutional prospective database of academic and community proton centers in the US, was queried for patients with thymomas and thymic carcinomas treated with PBT. Patients with recurrent/metastatic disease, non-thymic histology, received either prior or palliative radiotherapy (dose < 40 Gy RBE) were excluded. Overall survival (OS) and local control (LC) were estimated using Kaplan-Meier methods. RESULTS A total of 97 patients were identified in the PCG registry. After applying relevant exclusion criteria, 70 patients from 12 proton centers treated from 2011-2021 were included for analysis. Median follow-up length was 16 months. Median age was 58.5 years (IQR 46-63), and 60% were female. 81.4% had a diagnosis of thymoma, and 18.6% thymic carcinoma. 59 patients underwent surgical resection. 11 were treated with definitive PBT, of which 5 received concurrent chemotherapy. Median dose was 54 Gy RBE (range 41.4 - 70 Gy RBE), median number of fractions was 30 (range 21 - 38). 73.4% received pencil beam scanning and 23% uniform scanning PBT. Treatment was overall well-tolerated: a single patient developed grade 4 pneumonitis. Grade 3 AEs were seen in 3 patients - dyspnea, anorexia, and heart failure. Highest grade toxicity experienced was grade 2 for 47.1% and grade 1 for 42.9% of patients. 3-year overall survival (OS) was 82.6% for the entire cohort. 3-year OS was 94% for resected/adjuvant cohort and 35.6% in the non-surgical/definitive cohort. 3-year local control (LC) was 91.7% for the entire cohort. By surgery/margin status, 3-year LC was 96.8% in patients with close or negative margins (a single failure in a patient with close margins), whereas 3-year LC was 55.1% for patients with positive margins/unresectable disease. CONCLUSION Thymic malignancies treated with PBT appear to have favorable outcomes, especially in the adjuvant setting, in this cohort representing the largest series of such patients.
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Affiliation(s)
- S Tian
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - A McCook
- Emory Winship Cancer Institute, Atlanta, GA
| | - I J Choi
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - C E Vargas
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ
| | - N Y Yu
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ
| | - J H C Chang
- The Oklahoma Proton Center, Oklahoma City, OK
| | - S A Mihalcik
- Northwestern Medicine Chicago Proton Center, Warrenville, IL
| | - H Tsai
- Procure Proton Therapy Center, Somerset, NJ
| | - J Zeng
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - L R Rosen
- Willis-Knighton Proton Therapy Center, Shreveport, LA
| | - Z H Rana
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD
| | | | - W A Stokes
- Winship Cancer Institute of Emory University, Department of Radiation Oncology, Atlanta, GA
| | - A H Kesarwala
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - J D Bradley
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - K A Higgins
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
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Abeloos CH, Gorovets D, Lewis A, Ji W, Lozano A, Tung CC, Yu F, Hanlon A, Lin H, Kha A, Yamada Y, Kabarriti R, Lazarev S, Hasan S, Chhabra AM, Simone CB, Choi IJ. Prospective Evaluation of Patient-Reported Outcomes of Invisible Ink Tattoos for the Delivery of External Beam Radiation Therapy: The PREFER Trial. Int J Radiat Oncol Biol Phys 2023; 117:e234. [PMID: 37784934 DOI: 10.1016/j.ijrobp.2023.06.1152] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Invisible ink tattoos allow for setup accuracy while avoiding the cosmetic permanence of visible ink tattoos. The goal of this trial was to evaluate patient-reported preference for the use of invisible ink tattoos in a radiation oncology clinic. MATERIALS/METHODS In an IRB-approved, prospective, feasibility trial, patients at a single institution receiving pencil beam scanning proton therapy to the thorax, abdomen, or pelvis underwent invisible ink tattoo-based treatment setup. Patient preference surveys comparing visible and invisible ink tattoos were completed prior to simulation (17 questions), immediately following simulation (5 questions), and at the end of treatment (18 questions), with preference scored on a 5-point Likert scale from strongly disagree to strongly agree, and cosmesis scored on a 4-point Likert scale of excellent-good-fair-poor. Differences in distributions were examined using Wilcoxon rank-sum tests, Fisher's exact tests, or chi-square tests, where statistical significance was considered at p<0.05. RESULTS Of 107 patients screened, 102 were enrolled and 94 completed all surveys. Mean age was 55.0 years, and 58.5% were female. Most patients were white (79.1%) and non-Hispanic (92.6%). Patients most commonly had breast (34.0%), prostate (16.0%), and lung (9.6%) cancer. An average of 5 (range 3-8) invisible ink tattoos were placed per patient. Overall, 75.5% of patients reported that they would prefer to receive invisible tattoos vs. visible tattoos, and 88.3% rated the overall cosmetic outcome of invisible ink tattoo marks as excellent or good. Compared to males, females were more willing to travel farther from their home in order to avoid receiving visible tattoos (45.4% vs. 23.1%, p = 0.035) and would pay additional money to avoid receiving visible tattoos (34.5% vs. 5.1%, p = 0.002). Patients who had previously received any tattoo (cosmetic or visible RT tattoos) were more satisfied with the appearance of their invisible ink tattoos compared to those who had never previously received tattoos (82.9% vs. 61.5%, p = 0.022). Patients receiving definitive intent RT were more satisfied with the appearance of the tattoos compared to those receiving palliative intent RT (67.1% vs. 38.9%, p = 0.011). Patients with at least a college education were less satisfied with the appearance of tattoos compared to those without a college education (67.0% vs. 95.0% p = 0.018). CONCLUSION These findings demonstrate stronger avoidance of visible tattoos and patient preference for invisible tattoos. The standard incorporation of invisible ink tattoos for patient setup should be strongly considered.
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Affiliation(s)
| | - D Gorovets
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - A Lewis
- Rutgers Robert Wood Johnson, Newark, NJ
| | - W Ji
- Virginia Tech, Roanoke, VA
| | | | - C C Tung
- New York Proton Center, New York, NY
| | - F Yu
- New York Proton Center, New York, NY
| | | | - H Lin
- New York Proton Center, New York, NY
| | - A Kha
- New York Proton Center, New York, NY
| | - Y Yamada
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - R Kabarriti
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - S Lazarev
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - S Hasan
- New York Proton Center, New York, NY
| | | | - C B Simone
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Proton Center, New York, NY
| | - I J Choi
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Proton Center, New York, NY
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Marshall DC, Shim A, Chen CC, Lin H, Yu F, Argiriadi P, Choi IJ, Chhabra AM, Simone CB. A Dosimetric Assessment of Sexual Organ Sparing Proton Radiotherapy in Female Pelvic Cancer Patients. Int J Radiat Oncol Biol Phys 2023; 117:e695. [PMID: 37786040 DOI: 10.1016/j.ijrobp.2023.06.2174] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Optimizing treatment techniques for female patients undergoing curative treatment for pelvic cancers requires incorporating the goals of maximizing cure while maintaining quality of life. Optimizing treatment to maintain sexual quality of life has received little attention in female patients despite the presence of and toxicity risks to functional anatomic organs and their associated neurovasculature, including the bulboclitoris, vagina, and ovaries. Recent dosimetric data without employing sexual organ sparing suggest that mean VMAT dose to the bulboclitoris in low rectal cancer is around 3300 cGy, and in anal cancer, mean dose is around 2000 cGy to the external genitalia and 4500-5000 cGy to the bulboclitoris, all of which would be expected to result in clinically significant toxicity. Therefore, investigation of the avoidance of these important organs is needed and we hypothesize that proton techniques may achieve greater sparing than photon techniques. MATERIALS/METHODS In this study, we dosimetrically compare proton- vs. photon-based techniques in sparing functional sexual organs. The cohort consisted of four consecutive female pelvic cancer cases that had received 5000 cGy or greater. All cases were re-planned with VMAT and protons while optimizing dose to functional sexual organs and maintaining target coverage. Sexual organ structures assessed include the genitalia, vagina, ovaries, bulboclitoris and internal pudendal arteries. Given the small number of patients included in this demonstration study, statistical tests were not performed. RESULTS MRI was required to appropriately delineate soft tissue. In all cases, dosimetric sparing of sexual organs was improved with proton therapy without compromising target coverage. Mean doses were marginally decreased for structures within the PTV, while structures such as the bulboclitoris were spared substantially. Mean dose to the external genitalia was low with sparing using both VMAT (Median [IQR] (cGy): 852 [811, 1090]) and Proton techniques (Median [IQR] (cGy): 39.4 [11.9, 78.5]). Similarly, mean dose with sparing to the external genitalia was lower than would be expected without sparing, using both VMAT and Proton techniques (Median (IQR) Dmean (cGy) VMAT 3100 [2890, 3580] vs. Proton 1530 [1100, 2090]), with protons demonstrating greater sparing. In one case of a sacral chordoma, ovaries were substantially spared to below ablative thresholds (Dmean (cGy) VMAT 3598.8 and 3548.0 vs Proton 34.1 and 103.3). CONCLUSION Magnetic resonance imaging at simulation combined with proton radiotherapy for female sexual organ sparing may provide a technically feasible route to more equitable sexual outcomes for female patients. These results will guide future studies to optimize proton treatment techniques for female sexual organ sparing for future trials.
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Affiliation(s)
- D C Marshall
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - A Shim
- New York Proton Center, New York, NY
| | - C C Chen
- New York Proton Center, New York, NY
| | - H Lin
- New York Proton Center, New York, NY
| | - F Yu
- New York Proton Center, New York, NY
| | - P Argiriadi
- Icahn School of Medicine at Mount Sinai, Department of Radiology, New York, NY
| | - I J Choi
- New York Proton Center, New York, NY; Memorial Sloan Kettering Cancer Center, New York, NY
| | - A M Chhabra
- New York Proton Center, New York, NY; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - C B Simone
- New York Proton Center, New York, NY; Memorial Sloan Kettering Cancer Center, New York, NY
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Yang HJ, Kim YI, Ahn JY, Choi KD, Kim SG, Jeon SW, Kim JH, Shin SK, Lee H, Lee WS, Kim GH, Park JM, Shin WG, Choi IJ. Corrigendum to: External Validation of the eCura System for Undifferentiated-Type Early Gastric Cancer with Noncurative Endoscopic Resection. Gut Liver 2023; 17:825-827. [PMID: 37712191 PMCID: PMC10502488 DOI: 10.5009/gnl220333.e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/16/2023] Open
Affiliation(s)
- Hyo-Joon Yang
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young-Il Kim
- Center for Gastric Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Ji Yong Ahn
- Division of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kee Don Choi
- Division of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Gyun Kim
- Division of Gastroenterology, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Seong Woo Jeon
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jie-Hyun Kim
- Department of Internal Medicine, Institute of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Kwan Shin
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Hyuk Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wan Sik Lee
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Gwang Ha Kim
- Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea
| | - Jae Myung Park
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Woon Geon Shin
- Department of Internal Medicine, Institute for Liver and Digestive Diseases, Hallym University College of Medicine, Chuncheon, Korea
| | - Il Ju Choi
- Center for Gastric Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
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Yang HJ, Kim YI, Ahn JY, Choi KD, Kim SG, Jeon SW, Kim JH, Shin SK, Lee H, Lee WS, Kim GH, Park JM, Shin WG, Choi IJ. External Validation of the eCura System for Undifferentiated-Type Early Gastric Cancer with Noncurative Endoscopic Resection. Gut Liver 2023; 17:537-546. [PMID: 37161698 PMCID: PMC10352065 DOI: 10.5009/gnl220333] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/06/2022] [Accepted: 12/20/2022] [Indexed: 05/11/2023] Open
Abstract
Background/Aims The eCura system, a scoring model for stratifying the lymph node metastasis risk after noncurative endoscopic resection for early gastric cancer (EGC), has been internally validated, primarily for differentiated-type EGC. We aimed to externally validate this model for undifferentiated-type EGC. Methods This multicenter, retrospective cohort study included 634 patients who underwent additional surgery (radical surgery group, n=270) or were followed up without additional treatment (no additional treatment group, n=364) after noncurative endoscopic resection for undifferentiated-type EGC between 2005 and 2015. The lymph node metastasis and survival rates were compared according to the risk categories. Results For the radical surgery group, the lymph node metastasis rates were 2.6%, 10.9%, and 14.8% for the low-, intermediate-, and high-risk eCura categories, respectively (p for trend=0.003). For the low-, intermediate-, and high-risk categories in the no additional treatment group, the overall survival (92.7%, 68.9%, and 80.0% at 5 years, respectively, p<0.001) and cancer-specific survival rates (99.7%, 94.7%, and 80.0% at 5 years, respectively, p<0.001) differed significantly. In the multivariate analysis, the hazard ratios (95% confidence interval) in the no additional treatment group relative to the radical surgery group were 3.18 (1.41 to 7.17; p=0.005) for overall mortality and 2.60 (0.46 to 14.66; p=0.280) for cancer-specific mortality in the intermediate-to-high risk category. No such differences were noted in the low-risk category. Conclusions The eCura system can be applied to undifferentiated-type EGC. Close follow-up without additional treatment might be considered for low-risk patients, while additional surgery is recommended for intermediate- and high-risk patients.
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Affiliation(s)
- Hyo-Joon Yang
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young-Il Kim
- Center for Gastric Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Ji Yong Ahn
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kee Don Choi
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Gyun Kim
- Division of Gastroenterology, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Seong Woo Jeon
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jie-Hyun Kim
- Department of Internal Medicine, Institute of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Kwan Shin
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Hyuk Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wan Sik Lee
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Gwang Ha Kim
- Department of Internal Medicine, Pusan National University College of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jae Myung Park
- Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Woon Geon Shin
- Department of Internal Medicine, Institute for Liver and Digestive Diseases, Hallym University College of Medicine, Chuncheon, Korea
| | - Il Ju Choi
- Center for Gastric Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
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11
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Luu XQ, Lee K, Jun JK, Suh M, Jung KW, Choi IJ, Choi KS. Risk of upper gastrointestinal cancer and death in persons with negative screening results: results from the National Cancer Screening Program in South Korea. Gastric Cancer 2023; 26:580-589. [PMID: 37020074 DOI: 10.1007/s10120-023-01387-0] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/24/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND The Korea National Cancer Screening Program (KNCSP) offers upper endoscopy or upper gastrointestinal series (UGIS) biannually for people aged ≥ 40 years. This study aimed to assess the effect of negative screening results on the incidence of and mortality from upper gastrointestinal (GI) cancer. METHODS A population-based retrospective cohort of 15,850,288 men and women was constructed using data from 3 national databases. The participants were followed until the end of 2017 for data on cancer incidence and in 2019 for data on the vital status. Cox proportional hazard model with time-varying exposure was used to assess the association. RESULTS By the end of the follow-up period, 230,783 upper GI cancer cases and 99,348 upper GI cancer deaths were recorded. Negative gastric cancer screening was significantly associated with a lower risk of upper GI cancer in both UGIS (adjusted hazard ratio [aHR] = 0.81, 95% CI = 0.80-0.82) and upper endoscopy (aHR = 0.67, 95% CI = 0.67-0.68) groups. The HRs for upper GI mortality were 0.55 (95% CI = 0.54-0.56) and 0.21 (95% CI = 0.21-0.22) for the UGIS and upper endoscopy groups, respectively. The most significant reductions in the risk of upper GI cancer (UGIS: aHR = 0.76, 95% CI = 0.74-0.77; upper endoscopy: aHR = 0.60, 95% CI = 0.59-0.61) and death (UGIS: aHR = 0.54, 95% CI = 0.52-0.55; upper endoscopy: aHR = 0.19, 95% CI = 0.19-0.20) were observed among individual aged 60-69 years. CONCLUSION Negative screening cases, especially in upper endoscopy of the KNCSP, were associated with an overall reduction in the risk of and mortality from upper GI cancer.
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Affiliation(s)
- Xuan Quy Luu
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, 10408, South Korea
| | - Kyeongmin Lee
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, 10408, South Korea
| | - Jae Kwan Jun
- National Cancer Control Institute, National Cancer Center, Goyang, 10408, South Korea
| | - Mina Suh
- National Cancer Control Institute, National Cancer Center, Goyang, 10408, South Korea
| | - Kyu-Won Jung
- National Cancer Control Institute, National Cancer Center, Goyang, 10408, South Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center Hospital, National Cancer Center, Goyang, 10408, South Korea
| | - Kui Son Choi
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, 10408, South Korea.
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12
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Abdulameer NJ, Acharya U, Adare A, Aidala C, Ajitanand NN, Akiba Y, Akimoto R, Alfred M, Apadula N, Aramaki Y, Asano H, Atomssa ET, Awes TC, Azmoun B, Babintsev V, Bai M, Bandara NS, Bannier B, Barish KN, Bathe S, Bazilevsky A, Beaumier M, Beckman S, Belmont R, Berdnikov A, Berdnikov Y, Bichon L, Black D, Blankenship B, Bok JS, Borisov V, Boyle K, Brooks ML, Bryslawskyj J, Buesching H, Bumazhnov V, Campbell S, Canoa Roman V, Chen CH, Chiu M, Chi CY, Choi IJ, Choi JB, Chujo T, Citron Z, Connors M, Corliss R, Corrales Morales Y, Csanád M, Csörgő T, Datta A, Daugherity MS, David G, Dean CT, DeBlasio K, Dehmelt K, Denisov A, Deshpande A, Desmond EJ, Ding L, Dion A, Doomra V, Do JH, Drees A, Drees KA, Durham JM, Durum A, En'yo H, Enokizono A, Esha R, Fadem B, Fan W, Feege N, Fields DE, Finger M, Finger M, Firak D, Fitzgerald D, Fokin SL, Frantz JE, Franz A, Frawley AD, Gallus P, Gal C, Garg P, Ge H, Giles M, Giordano F, Glenn A, Goto Y, Grau N, Greene SV, Grosse Perdekamp M, Gunji T, Guragain H, Gu Y, Hachiya T, Haggerty JS, Hahn KI, Hamagaki H, Hanks J, Han SY, Harvey M, Hasegawa S, Hemmick TK, He X, Hill JC, Hodges A, Hollis RS, Homma K, Hong B, Hoshino T, Huang J, Ikeda Y, Imai K, Imazu Y, Inaba M, Iordanova A, Isenhower D, Ivanishchev D, Jacak BV, Jeon SJ, Jezghani M, Jiang X, Ji Z, Johnson BM, Joo E, Joo KS, Jouan D, Jumper DS, Kang JH, Kang JS, Kawall D, Kazantsev AV, Key JA, Khachatryan V, Khanzadeev A, Khatiwada A, Kihara K, Kim C, Kim DH, Kim DJ, Kim EJ, Kim HJ, Kim M, Kim T, Kim YK, Kincses D, Kingan A, Kistenev E, Klatsky J, Kleinjan D, Kline P, Koblesky T, Kofarago M, Koster J, Kotov D, Kovacs L, Kurgyis B, Kurita K, Kurosawa M, Kwon Y, Lajoie JG, Larionova D, Lebedev A, Lee KB, Lee SH, Leitch MJ, Leitgab M, Lewis NA, Lim SH, Liu MX, Li X, Loomis DA, Lynch D, Lökös S, Majoros T, Makdisi YI, Makek M, Manion A, Manko VI, Mannel E, McCumber M, McGaughey PL, McGlinchey D, McKinney C, Meles A, Mendoza M, Meredith B, Miake Y, Mignerey AC, Miller AJ, Milov A, Mishra DK, Mitchell JT, Mitrankova M, Mitrankov I, Miyasaka S, Mizuno S, Mondal MM, Montuenga P, Moon T, Morrison DP, Moukhanova TV, Muhammad A, Mulilo B, Murakami T, Murata J, Mwai A, Nagamiya S, Nagle JL, Nagy MI, Nakagawa I, Nakagomi H, Nakano K, Nattrass C, Nelson S, Netrakanti PK, Nihashi M, Niida T, Nouicer R, Novitzky N, Nukazuka G, Nyanin AS, O'Brien E, Ogilvie CA, Oh J, Orjuela Koop JD, Orosz M, Osborn JD, Oskarsson A, Ozawa K, Pak R, Pantuev V, Papavassiliou V, Park JS, Park S, Patel L, Patel M, Pate SF, Peng JC, Peng W, Perepelitsa DV, Perera GDN, Peressounko DY, PerezLara CE, Perry J, Petti R, Pinkenburg C, Pinson R, Pisani RP, Potekhin M, Pun A, Purschke ML, Radzevich PV, Rak J, Ramasubramanian N, Ravinovich I, Read KF, Reynolds D, Riabov V, Riabov Y, Richford D, Riveli N, Roach D, Rolnick SD, Rosati M, Rowan Z, Rubin JG, Runchey J, Saito N, Sakaguchi T, Sako H, Samsonov V, Sarsour M, Sato S, Sawada S, Schaefer B, Schmoll BK, Sedgwick K, Seele J, Seidl R, Sen A, Seto R, Sett P, Sexton A, Sharma D, Shein I, Shibata M, Shibata TA, Shigaki K, Shimomura M, Shi Z, Shukla P, Sickles A, Silva CL, Silvermyr D, Singh BK, Singh CP, Singh V, Slunečka M, Smith KL, Soltz RA, Sondheim WE, Sorensen SP, Sourikova IV, Stankus PW, Stepanov M, Stoll SP, Sugitate T, Sukhanov A, Sumita T, Sun J, Sun Z, Sziklai J, Takahama R, Takahara A, Taketani A, Tanida K, Tannenbaum MJ, Tarafdar S, Taranenko A, Timilsina A, Todoroki T, Tomášek M, Torii H, Towell M, Towell R, Towell RS, Tserruya I, Ueda Y, Ujvari B, van Hecke HW, Vargyas M, Velkovska J, Virius M, Vrba V, Vznuzdaev E, Wang XR, Wang Z, Watanabe D, Watanabe Y, Watanabe YS, Wei F, Whitaker S, Wolin S, Wong CP, Woody CL, Wysocki M, Xia B, Xue L, Yalcin S, Yamaguchi YL, Yanovich A, Yoon I, Younus I, Yushmanov IE, Zajc WA, Zelenski A, Zou L. Measurement of Direct-Photon Cross Section and Double-Helicity Asymmetry at sqrt[s]=510 GeV in p[over →]+p[over →] Collisions. Phys Rev Lett 2023; 130:251901. [PMID: 37418716 DOI: 10.1103/physrevlett.130.251901] [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] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 11/04/2022] [Accepted: 04/28/2023] [Indexed: 07/09/2023]
Abstract
We present measurements of the cross section and double-helicity asymmetry A_{LL} of direct-photon production in p[over →]+p[over →] collisions at sqrt[s]=510 GeV. The measurements have been performed at midrapidity (|η|<0.25) with the PHENIX detector at the Relativistic Heavy Ion Collider. At relativistic energies, direct photons are dominantly produced from the initial quark-gluon hard scattering and do not interact via the strong force at leading order. Therefore, at sqrt[s]=510 GeV, where leading-order-effects dominate, these measurements provide clean and direct access to the gluon helicity in the polarized proton in the gluon-momentum-fraction range 0.02<x<0.08, with direct sensitivity to the sign of the gluon contribution.
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Affiliation(s)
- N J Abdulameer
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - U Acharya
- Georgia State University, Atlanta, Georgia 30303, USA
| | - A Adare
- University of Colorado, Boulder, Colorado 80309, USA
| | - C Aidala
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - N N Ajitanand
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - Y Akiba
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - R Akimoto
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - M Alfred
- Department of Physics and Astronomy, Howard University, Washington, D.C. 20059, USA
| | - N Apadula
- Iowa State University, Ames, Iowa 50011, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - Y Aramaki
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - H Asano
- Kyoto University, Kyoto 606-8502, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - E T Atomssa
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - T C Awes
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - B Azmoun
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - V Babintsev
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - M Bai
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - N S Bandara
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003-9337, USA
| | - B Bannier
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - K N Barish
- University of California-Riverside, Riverside, California 92521, USA
| | - S Bathe
- Baruch College, City University of New York, New York, New York 10010, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Bazilevsky
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Beaumier
- University of California-Riverside, Riverside, California 92521, USA
| | - S Beckman
- University of Colorado, Boulder, Colorado 80309, USA
| | - R Belmont
- University of Colorado, Boulder, Colorado 80309, USA
- Physics and Astronomy Department, University of North Carolina at Greensboro, Greensboro, North Carolina 27412, USA
| | - A Berdnikov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - Y Berdnikov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - L Bichon
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - D Black
- University of California-Riverside, Riverside, California 92521, USA
| | - B Blankenship
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - J S Bok
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - V Borisov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - K Boyle
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M L Brooks
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Bryslawskyj
- Baruch College, City University of New York, New York, New York 10010, USA
- University of California-Riverside, Riverside, California 92521, USA
| | - H Buesching
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - V Bumazhnov
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - S Campbell
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
- Iowa State University, Ames, Iowa 50011, USA
| | - V Canoa Roman
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - C-H Chen
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Chiu
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - C Y Chi
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - I J Choi
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - J B Choi
- Jeonbuk National University, Jeonju, 54896, Korea
| | - T Chujo
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - Z Citron
- Weizmann Institute, Rehovot 76100, Israel
| | - M Connors
- Georgia State University, Atlanta, Georgia 30303, USA
| | - R Corliss
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | | | - M Csanád
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - T Csörgő
- MATE, Laboratory of Femtoscopy, Károly Róbert Campus, H-3200 Gyöngyös, Mátraiút 36, Hungary
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - A Datta
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | | | - G David
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - C T Dean
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - K DeBlasio
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - K Dehmelt
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - A Denisov
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - A Deshpande
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - E J Desmond
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - L Ding
- Iowa State University, Ames, Iowa 50011, USA
| | - A Dion
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - V Doomra
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - J H Do
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - A Drees
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - K A Drees
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J M Durham
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A Durum
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - H En'yo
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - A Enokizono
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - R Esha
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - B Fadem
- Muhlenberg College, Allentown, Pennsylvania 18104-5586, USA
| | - W Fan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - N Feege
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - D E Fields
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - M Finger
- Charles University, Faculty of Mathematics and Physics, 180 00 Troja, Prague, Czech Republic
| | - M Finger
- Charles University, Faculty of Mathematics and Physics, 180 00 Troja, Prague, Czech Republic
| | - D Firak
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - D Fitzgerald
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - S L Fokin
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - J E Frantz
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - A Franz
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A D Frawley
- Florida State University, Tallahassee, Florida 32306, USA
| | - P Gallus
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - C Gal
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - P Garg
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - H Ge
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M Giles
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - F Giordano
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - A Glenn
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - Y Goto
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - N Grau
- Department of Physics, Augustana University, Sioux Falls, South Dakota 57197, USA
| | - S V Greene
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | | | - T Gunji
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - H Guragain
- Georgia State University, Atlanta, Georgia 30303, USA
| | - Y Gu
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - T Hachiya
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J S Haggerty
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - K I Hahn
- Ewha Womans University, Seoul 120-750, Korea
| | - H Hamagaki
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - J Hanks
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - S Y Han
- Ewha Womans University, Seoul 120-750, Korea
- Korea University, Seoul 02841, Korea
| | - M Harvey
- Texas Southern University, Houston, Texas 77004, USA
| | - S Hasegawa
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - T K Hemmick
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - X He
- Georgia State University, Atlanta, Georgia 30303, USA
| | - J C Hill
- Iowa State University, Ames, Iowa 50011, USA
| | - A Hodges
- Georgia State University, Atlanta, Georgia 30303, USA
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - R S Hollis
- University of California-Riverside, Riverside, California 92521, USA
| | - K Homma
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - B Hong
- Korea University, Seoul 02841, Korea
| | - T Hoshino
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - J Huang
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Y Ikeda
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - K Imai
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - Y Imazu
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - M Inaba
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - A Iordanova
- University of California-Riverside, Riverside, California 92521, USA
| | - D Isenhower
- Abilene Christian University, Abilene, Texas 79699, USA
| | - D Ivanishchev
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - B V Jacak
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - S J Jeon
- Myongji University, Yongin, Kyonggido 449-728, Korea
| | - M Jezghani
- Georgia State University, Atlanta, Georgia 30303, USA
| | - X Jiang
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Z Ji
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - B M Johnson
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Georgia State University, Atlanta, Georgia 30303, USA
| | - E Joo
- Korea University, Seoul 02841, Korea
| | - K S Joo
- Myongji University, Yongin, Kyonggido 449-728, Korea
| | - D Jouan
- IPN-Orsay, Univ. Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, BP1, F-91406 Orsay, France
| | - D S Jumper
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - J H Kang
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - J S Kang
- Hanyang University, Seoul 133-792, Korea
| | - D Kawall
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003-9337, USA
| | - A V Kazantsev
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - J A Key
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - V Khachatryan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - A Khanzadeev
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - A Khatiwada
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - K Kihara
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - C Kim
- Korea University, Seoul 02841, Korea
| | - D H Kim
- Ewha Womans University, Seoul 120-750, Korea
| | - D J Kim
- Helsinki Institute of Physics and University of Jyväskylä, P.O.Box 35, FI-40014 Jyväskylä, Finland
| | - E-J Kim
- Jeonbuk National University, Jeonju, 54896, Korea
| | - H-J Kim
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - M Kim
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - T Kim
- Ewha Womans University, Seoul 120-750, Korea
| | - Y K Kim
- Hanyang University, Seoul 133-792, Korea
| | - D Kincses
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - A Kingan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - E Kistenev
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J Klatsky
- Florida State University, Tallahassee, Florida 32306, USA
| | - D Kleinjan
- University of California-Riverside, Riverside, California 92521, USA
| | - P Kline
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - T Koblesky
- University of Colorado, Boulder, Colorado 80309, USA
| | - M Kofarago
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - J Koster
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - D Kotov
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - L Kovacs
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - B Kurgyis
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - K Kurita
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - M Kurosawa
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - Y Kwon
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - J G Lajoie
- Iowa State University, Ames, Iowa 50011, USA
| | - D Larionova
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - A Lebedev
- Iowa State University, Ames, Iowa 50011, USA
| | - K B Lee
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S H Lee
- Iowa State University, Ames, Iowa 50011, USA
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M J Leitch
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M Leitgab
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - N A Lewis
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - S H Lim
- Pusan National University, Pusan 46241, Korea
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - M X Liu
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - X Li
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D A Loomis
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - D Lynch
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - S Lökös
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - T Majoros
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - Y I Makdisi
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Makek
- Weizmann Institute, Rehovot 76100, Israel
- Department of Physics, Faculty of Science, University of Zagreb, Bijenička c. 32 HR-10002 Zagreb, Croatia
| | - A Manion
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - V I Manko
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - E Mannel
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M McCumber
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - P L McGaughey
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D McGlinchey
- University of Colorado, Boulder, Colorado 80309, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C McKinney
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - A Meles
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - M Mendoza
- University of California-Riverside, Riverside, California 92521, USA
| | - B Meredith
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - Y Miake
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - A C Mignerey
- University of Maryland, College Park, Maryland 20742, USA
| | - A J Miller
- Abilene Christian University, Abilene, Texas 79699, USA
| | - A Milov
- Weizmann Institute, Rehovot 76100, Israel
| | - D K Mishra
- Bhabha Atomic Research Centre, Bombay 400 085, India
| | - J T Mitchell
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Mitrankova
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - Iu Mitrankov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - S Miyasaka
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - S Mizuno
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - M M Mondal
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - P Montuenga
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - T Moon
- Korea University, Seoul 02841, Korea
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - D P Morrison
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T V Moukhanova
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - A Muhammad
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - B Mulilo
- Korea University, Seoul 02841, Korea
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, School of Natural Sciences, University of Zambia, Great East Road Campus, Box 32379 Lusaka, Zambia
| | - T Murakami
- Kyoto University, Kyoto 606-8502, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J Murata
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - A Mwai
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - S Nagamiya
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J L Nagle
- University of Colorado, Boulder, Colorado 80309, USA
| | - M I Nagy
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - I Nakagawa
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - H Nakagomi
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - K Nakano
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - C Nattrass
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - S Nelson
- Florida A&M University, Tallahassee, Florida 32307, USA
| | | | - M Nihashi
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - T Niida
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - R Nouicer
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - N Novitzky
- Helsinki Institute of Physics and University of Jyväskylä, P.O.Box 35, FI-40014 Jyväskylä, Finland
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - G Nukazuka
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A S Nyanin
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - E O'Brien
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - C A Ogilvie
- Iowa State University, Ames, Iowa 50011, USA
| | - J Oh
- Pusan National University, Pusan 46241, Korea
| | | | - M Orosz
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - J D Osborn
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - A Oskarsson
- Department of Physics, Lund University, Box 118, SE-221 00 Lund, Sweden
| | - K Ozawa
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - R Pak
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - V Pantuev
- Institute for Nuclear Research of the Russian Academy of Sciences, prospekt 60-letiya Oktyabrya 7a, Moscow 117312, Russia
| | - V Papavassiliou
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - J S Park
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - S Park
- Mississippi State University, Mississippi State, Mississippi 39762, USA
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - L Patel
- Georgia State University, Atlanta, Georgia 30303, USA
| | - M Patel
- Iowa State University, Ames, Iowa 50011, USA
| | - S F Pate
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - J-C Peng
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - W Peng
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - D V Perepelitsa
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- University of Colorado, Boulder, Colorado 80309, USA
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - G D N Perera
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - D Yu Peressounko
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - C E PerezLara
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - J Perry
- Iowa State University, Ames, Iowa 50011, USA
| | - R Petti
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - C Pinkenburg
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - R Pinson
- Abilene Christian University, Abilene, Texas 79699, USA
| | - R P Pisani
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Potekhin
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Pun
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - M L Purschke
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - P V Radzevich
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - J Rak
- Helsinki Institute of Physics and University of Jyväskylä, P.O.Box 35, FI-40014 Jyväskylä, Finland
| | - N Ramasubramanian
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | | | - K F Read
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - D Reynolds
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - V Riabov
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - Y Riabov
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - D Richford
- Baruch College, City University of New York, New York, New York 10010, USA
| | - N Riveli
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - D Roach
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - S D Rolnick
- University of California-Riverside, Riverside, California 92521, USA
| | - M Rosati
- Iowa State University, Ames, Iowa 50011, USA
| | - Z Rowan
- Baruch College, City University of New York, New York, New York 10010, USA
| | - J G Rubin
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - J Runchey
- Iowa State University, Ames, Iowa 50011, USA
| | - N Saito
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
| | - T Sakaguchi
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - H Sako
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - V Samsonov
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - M Sarsour
- Georgia State University, Atlanta, Georgia 30303, USA
| | - S Sato
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - S Sawada
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
| | - B Schaefer
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - B K Schmoll
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - K Sedgwick
- University of California-Riverside, Riverside, California 92521, USA
| | - J Seele
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - R Seidl
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Sen
- Iowa State University, Ames, Iowa 50011, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - R Seto
- University of California-Riverside, Riverside, California 92521, USA
| | - P Sett
- Bhabha Atomic Research Centre, Bombay 400 085, India
| | - A Sexton
- University of Maryland, College Park, Maryland 20742, USA
| | - D Sharma
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - I Shein
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - M Shibata
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
| | - T-A Shibata
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - K Shigaki
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - M Shimomura
- Iowa State University, Ames, Iowa 50011, USA
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
| | - Z Shi
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - P Shukla
- Bhabha Atomic Research Centre, Bombay 400 085, India
| | - A Sickles
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - C L Silva
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D Silvermyr
- Department of Physics, Lund University, Box 118, SE-221 00 Lund, Sweden
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - B K Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - C P Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - V Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - M Slunečka
- Charles University, Faculty of Mathematics and Physics, 180 00 Troja, Prague, Czech Republic
| | - K L Smith
- Florida State University, Tallahassee, Florida 32306, USA
| | - R A Soltz
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - W E Sondheim
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S P Sorensen
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - I V Sourikova
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - P W Stankus
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - M Stepanov
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003-9337, USA
| | - S P Stoll
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T Sugitate
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - A Sukhanov
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T Sumita
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J Sun
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - Z Sun
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - J Sziklai
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - R Takahama
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
| | - A Takahara
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - A Taketani
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - K Tanida
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - M J Tannenbaum
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - S Tarafdar
- Vanderbilt University, Nashville, Tennessee 37235, USA
- Weizmann Institute, Rehovot 76100, Israel
| | - A Taranenko
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - A Timilsina
- Iowa State University, Ames, Iowa 50011, USA
| | - T Todoroki
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - M Tomášek
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - H Torii
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - M Towell
- Abilene Christian University, Abilene, Texas 79699, USA
| | - R Towell
- Abilene Christian University, Abilene, Texas 79699, USA
| | - R S Towell
- Abilene Christian University, Abilene, Texas 79699, USA
| | - I Tserruya
- Weizmann Institute, Rehovot 76100, Israel
| | - Y Ueda
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - B Ujvari
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - H W van Hecke
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M Vargyas
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - J Velkovska
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - M Virius
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - V Vrba
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
- Institute of Physics, Academy of Sciences of the Czech Republic, Na Slovance 2, 182 21 Prague 8, Czech Republic
| | - E Vznuzdaev
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - X R Wang
- New Mexico State University, Las Cruces, New Mexico 88003, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - Z Wang
- Baruch College, City University of New York, New York, New York 10010, USA
| | - D Watanabe
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - Y Watanabe
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - Y S Watanabe
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
| | - F Wei
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - S Whitaker
- Iowa State University, Ames, Iowa 50011, USA
| | - S Wolin
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - C P Wong
- Georgia State University, Atlanta, Georgia 30303, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C L Woody
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Wysocki
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - B Xia
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - L Xue
- Georgia State University, Atlanta, Georgia 30303, USA
| | - S Yalcin
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - Y L Yamaguchi
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - A Yanovich
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - I Yoon
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - I Younus
- Physics Department, Lahore University of Management Sciences, Lahore 54792, Pakistan
| | - I E Yushmanov
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - W A Zajc
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - A Zelenski
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - L Zou
- University of California-Riverside, Riverside, California 92521, USA
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13
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Nouri Z, Choi SW, Choi IJ, Ryu KW, Woo SM, Park SJ, Lee WJ, Choi W, Jung YS, Myung SK, Lee JH, Park JY, Praveen Z, Woo YJ, Park JH, Kim MK. Exploring Connections between Oral Microbiota, Short-Chain Fatty Acids, and Specific Cancer Types: A Study of Oral Cancer, Head and Neck Cancer, Pancreatic Cancer, and Gastric Cancer. Cancers (Basel) 2023; 15:cancers15112898. [PMID: 37296861 DOI: 10.3390/cancers15112898] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/25/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
The association between oral microbiota and cancer development has been a topic of intense research in recent years, with compelling evidence suggesting that the oral microbiome may play a significant role in cancer initiation and progression. However, the causal connections between the two remain a subject of debate, and the underlying mechanisms are not fully understood. In this case-control study, we aimed to identify common oral microbiota associated with several cancer types and investigate the potential mechanisms that may trigger immune responses and initiate cancer upon cytokine secretion. Saliva and blood samples were collected from 309 adult cancer patients and 745 healthy controls to analyze the oral microbiome and the mechanisms involved in cancer initiation. Machine learning techniques revealed that six bacterial genera were associated with cancer. The abundance of Leuconostoc, Streptococcus, Abiotrophia, and Prevotella was reduced in the cancer group, while abundance of Haemophilus and Neisseria enhanced. G protein-coupled receptor kinase, H+-transporting ATPase, and futalosine hydrolase were found significantly enriched in the cancer group. Total short-chain fatty acid (SCFAs) concentrations and free fatty acid receptor 2 (FFAR2) expression levels were greater in the control group when compared with the cancer group, while serum tumor necrosis factor alpha induced protein 8 (TNFAIP8), interleukin-6 (IL6), and signal transducer and activator of transcription 3 (STAT3) levels were higher in the cancer group when compared with the control group. These results suggested that the alterations in the composition of oral microbiota can contribute to a reduction in SCFAs and FFAR2 expression that may initiate an inflammatory response through the upregulation of TNFAIP8 and the IL-6/STAT3 pathway, which could ultimately increase the risk of cancer onset.
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Affiliation(s)
- Zahra Nouri
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, 323 Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea
| | - Sung Weon Choi
- Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, 323 Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, 323 Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea
| | - Keun Won Ryu
- Center for Gastric Cancer, National Cancer Center, 323 Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea
| | - Sang Myung Woo
- Center for Liver and Pancreatobiliary Cancer, National Cancer Center, 323 Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea
| | - Sang-Jae Park
- Center for Liver and Pancreatobiliary Cancer, National Cancer Center, 323 Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea
| | - Woo Jin Lee
- Center for Liver and Pancreatobiliary Cancer, National Cancer Center, 323 Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea
| | - Wonyoung Choi
- Center for Rare Cancers, National Cancer Center, 323 Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea
| | - Yuh-Seog Jung
- Department of Otorhinolaryngology, National Cancer Center, 323 Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea
| | - Seung-Kwon Myung
- Department of Cancer AI & Digital Health, National Cancer Center Graduate School of Cancer Science and Policy, 323 Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea
| | - Jong-Ho Lee
- Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, 323 Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea
| | - Joo-Yong Park
- Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, 323 Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea
| | - Zeba Praveen
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, 323 Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea
| | - Yun Jung Woo
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, 323 Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea
| | - Jin Hee Park
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, 323 Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea
| | - Mi Kyung Kim
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, 323 Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea
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14
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Lee JH, Oh JY, Kim YI, Lee JY, Kim CG, Choi IJ, Ryu KW, Kim YW, Cho SJ. Endoscopic submucosal dissection for papillary early gastric carcinoma: Insights from a large-scale analysis of post-gastrectomy pathology specimens. Medicine (Baltimore) 2022; 101:e32085. [PMID: 36550814 PMCID: PMC9771273 DOI: 10.1097/md.0000000000032085] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Gastric papillary adenocarcinoma is considered a differentiated adenocarcinoma in the current endoscopic submucosal dissection indication guidelines. However, the safety of endoscopic submucosal dissection remains controversial. Currently, data regarding which papillary early gastric cancer should be considered for endoscopic submucosal dissection are unavailable. Thus, the aim of this study was to investigate lymph node metastasis and the safety of endoscopic submucosal dissection in patients with papillary early gastric cancer. This observational study recruited 4264 consecutive patients with early gastric cancer who underwent curative gastrectomy between October 2000 and December 2017 at the National Cancer Center, Korea. Of these, 45 had pathologically confirmed papillary early gastric cancer, 2106 had differentiated non-papillary early gastric cancer, and 2113 had undifferentiated early gastric cancer. Logistic regression analysis was performed to identify risk factors for lymph node metastasis. Mucosal tumors were less common in papillary early gastric cancer (37.9%) than in differentiated non-papillary early gastric cancer (48.8%) and undifferentiated early gastric cancer (60.4%) (both P < .001). Lymph node metastasis was more common in papillary early gastric cancer (20.0%) than in differentiated non-papillary early gastric cancer (9.2%) and undifferentiated early gastric cancer (11.7%; both P < .001). In multivariate analysis, non-mixed-type papillary early gastric cancer showed marginally increased odds of lymph node metastasis than differentiated early gastric cancer (odds ratio [OR]: 2.5, 95% confidence interval [CI]: 1.0-6.3). Rates of lymph node metastasis (1/10, 10%) and angiolymphatic invasion (2/10, 20%) for papillary early gastric cancer meeting expanded criteria were higher than those for other histology types meeting endoscopic submucosal dissection absolute or expanded criteria (P = .03 and P < .001, respectively). Endoscopic submucosal dissection should be considered carefully for papillary early gastric cancer, especially if it meets expanded endoscopic submucosal dissection indications since it is associated with high rates of submucosal invasion and lymph node metastasis.
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Affiliation(s)
- Jung Hwan Lee
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
- Department of Hospital Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Ju Yeon Oh
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Young-Il Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Jong Yeul Lee
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Chan Gyoo Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Keun Won Ryu
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Young-Woo Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Soo-Jeong Cho
- Division of Gastroenterology, Department of Internal Medicine and Liver Research Institute, Seoul National University, Seoul, Korea
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15
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Kong MG, Suh J, Moon IK, Lee KY, Jang HJ, Kim JS, Choi IJ. Heart failure with improved ejection fraction (HFimpEF) in patients treated with sacubitril/valsartan (SV). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.967] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Several studies demonstrated that patients with improvement of left ventricular ejection fraction (LVEF) and symptoms had good prognosis in heart failure with reduced ejection fraction (HFrEF). Based on these results, new classification of HF according to LVEF was currently proposed. Sacubitril/valsartan (SV) is recommended as one of the first-line therapy of HFrEF patients. SV reduced hospitalization for HF and cardiovascular mortality compared to enalapril in PARADIGM-HF trial. However, it is unclear that patients with improvement of LVEF also have better prognosis compared to patients without LVEF improvement among patients treated with SV.
Purpose
We aimed to evaluate the clinical characteristics and outcomes of heart failure with improved ejection fraction (HFimpEF) in heart failure with reduced ejection fraction (HFrEF) patients treated with SV.
Methods
We analyzed 230 patients with HFrEF taking SV in a multicenter retrospective cohort (RECORD-SV registry) from 2017 to 2019. Enrolled 230 patients were performed baseline and 1-year follow-up echocardiography. Based on 2 echocardiographic results, we defined “HFimpEF” as HF with a baseline LVEF ≤40%, ≥10% increase from baseline LVEF and a follow-up measurement of LVEF >40%. Others were defined as “Persistent HFrEF”. We analyzed and compared clinical characteristics and outcomes between two groups. Primary endpoint was a composite outcome of all-cause death and hospitalization for HF (HHF).
Results
From 230 patients, 65 patients with HFimpEF and 165 patients with Persistent HFrEF were analyzed. The median follow-up duration was 557 days (interquartile range 364 to 727 days). Patients with HFimpEF had a higher prevalence of female gender (50.8% vs. 30.3%) and de novo HF (44.6% vs. 21.2%). There were no significant differences for age, etiology (ischemic vs. non-ischemic), diabetes, atrial fibrillation, hypertension, and HF medications including SV dose between two groups. Patients with HFimpEF showed lower rate of all-cause death or HHF as a primary endpoint compared to patients with persistent HFrEF (6.2% vs. 22.4%; IPTW adjusted HR 0.24; 95% CI 0.13–0.46; p<0.001) (Table 1). It was also shown that HFimpEF patients had a reduced risk of primary endpoint in the Kaplan-Meier curves compared with persistent HFrEF (Log-rank p=0.045) (Figure 1). We demonstrated that Non-prior MI (adjusted OR 7.29; 95% CI 1.50–35.36; p=0.014) and de novo HF (adjusted OR 4.33; 95% CI 1.70–11.04; p=0.002) were independent prognostic factors of HFimpEF in HFrEF patients treated with SV.
Conclusions
HFimpEF patients had better clinical outcomes compared to those with persistent HFrEF in HFrEF patients treated with SV. Non-prior MI and de novo HF were independent predictors of HFimpEF in patients treated with SV.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M G Kong
- Soonchunhyang University Hospital , Bucheon , Korea (Republic of)
| | - J Suh
- Soonchunhyang University Hospital , Bucheon , Korea (Republic of)
| | - I K Moon
- Soonchunhyang University Hospital , Bucheon , Korea (Republic of)
| | - K Y Lee
- The Catholic University of Korea Seoul St. Mary's Hospital, Cardiovascular center and cardiology , Seoul , Korea (Republic of)
| | - H J Jang
- Sejong general hospital, Cardiology , Seoul , Korea (Republic of)
| | - J S Kim
- Dongguk University hospital, Cardiology , Ilsan , Korea (Republic of)
| | - I J Choi
- St.Marys Hospital, Cardiology , Incheon , Korea (Republic of)
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16
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Huang RJ, Epplein M, Hamashima C, Choi IJ, Lee E, Deapen D, Woo Y, Tran T, Shah SC, Inadomi JM, Greenwald DA, Hwang JH. An Approach to the Primary and Secondary Prevention of Gastric Cancer in the United States. Clin Gastroenterol Hepatol 2022; 20:2218-2228.e2. [PMID: 34624563 PMCID: PMC8983795 DOI: 10.1016/j.cgh.2021.09.039] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/02/2021] [Accepted: 09/10/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND & AIMS Gastric cancer (GC) remains a leading cause of mortality among certain racial, ethnic, and immigrant groups in the United States (US). The majority of GCs are diagnosed at advanced stages, and overall survival remains poor. There exist no structured national strategies for GC prevention in the US. METHODS On March 5-6, 2020 a summit of researchers, policy makers, public funders, and advocacy leaders was convened at Stanford University to address this critical healthcare disparity. After this summit, a writing group was formed to critically evaluate the effectiveness, potential benefits, and potential harms of methods of primary and secondary prevention through structured literature review. This article represents a consensus statement prepared by the writing group. RESULTS The burden of GC is highly inequitably distributed in the US and disproportionately falls on Asian, African American, Hispanic, and American Indian/Alaskan Native populations. In randomized controlled trials, strategies of Helicobacter pylori testing and treatment have been demonstrated to reduce GC-specific mortality. In well-conducted observational and ecologic studies, strategies of endoscopic screening have been associated with reduced GC-specific mortality. Notably however, all randomized controlled trial data (for primary prevention) and the majority of observational data (for secondary prevention) are derived from non-US sources. CONCLUSIONS There exist substantial, high-quality data supporting GC prevention derived from international studies. There is an urgent need for cancer prevention trials focused on high-risk immigrant and minority populations in the US. The authors offer recommendations on how strategies of primary and secondary prevention can be applied to the heterogeneous US population.
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Affiliation(s)
- Robert J Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Stanford, California
| | - Meira Epplein
- Department of Population Health Sciences, Duke University, and Cancer Risk, Detection, and Interception Program, Duke Cancer Institute, Durham, North Carolina
| | | | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, South Korea
| | - Eunjung Lee
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Dennis Deapen
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Yanghee Woo
- Division of Surgical Oncology, Department of Surgery, City of Hope National Comprehensive Cancer Center, Duarte, California
| | - Thuy Tran
- Division of Surgical Oncology, Department of Surgery, City of Hope National Comprehensive Cancer Center, Duarte, California
| | - Shailja C Shah
- Gastroenterology Section, Veterans Affairs San Diego Healthcare System, La Jolla, California; Division of Gastroenterology and Moores Cancer Center, University of California, San Diego, La Jolla, California
| | - John M Inadomi
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - David A Greenwald
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joo Ha Hwang
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Stanford, California.
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17
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Kim YI, Choi IJ. Current status of the gastric cancer screening program in Korea. J Korean Med Assoc 2022. [DOI: 10.5124/jkma.2022.65.5.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: In 2019, gastric cancer was one of the most common cancers in Korea. As a secondary prevention strategy for gastric cancer, the cancer screening has been provided since 1999 by the National Cancer Screening Program every 2 years for adults aged ≥40 years.Current Concepts: The participation rates for gastric cancer screening program have increased from 7.4% in 2002 to 62.9% in 2019. Until 2017, either upper gastrointestinal series or endoscopy were recommended for screening method. Since 2018, endoscopy has become the preferred screening method and 89.1% of the participants underwent endoscopy in 2019. After the introduction of the screening program, the 5-year relative survival rates have markedly improved (43.9% between 1993 and 1995 vs. 77.5% between 2015 and 2019), and the proportion of early gastric cancer detection has increased (28.6% in 1995 vs. 63.6% in 2019). The risk of death from gastric cancer decreased by 47% in participants who had undergone endoscopy screening. Additionally, the gastric cancer screening program is cost-effective, and endoscopy-associated adverse events rarely occur.Discussion and Conclusion: With the implementation of the screening program, mortality due to gastric cancer has decreased owing to early detection. After the completion of ongoing clinical trials in the general population, the primary prevention strategy of Helicobacter pylori eradication should be considered to effectively reduce the incidence of gastric cancer. Further studies are also required to provide optimal screening interval according to the presence of risk factors including H. pylori infection and presence of gastric mucosal atrophy.
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18
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Kim J, Lee J, Choi IJ, Kim YI, Kim J. Gastric cancer risk is reduced by a predominance of antioxidant factors in the oxidative balance: a hospital-based case-control study in Korea. Epidemiol Health 2022; 44:e2022089. [PMID: 36265518 DOI: 10.4178/epih.e2022089] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Gastric carcinogenesis is linked to oxidative stress from both exogenous and endogenous exposures. This study aimed to determine the association between the risk of gastric cancer and the oxidative balance score (OBS), which comprises antioxidant and pro-oxidant factors, including diet and lifestyle. METHODS For this hospital-based case-control study, 808 controls and 404 patients with gastric cancer who had clinical records indicating Helicobacter pylori infection and the histological subtype of cancer were recruited. The OBS was determined based on diet and lifestyle factors obtained from a 106-item semiquantitative food frequency questionnaire and a constructed questionnaire. Logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS A higher OBS was associated with a reduced gastric cancer risk (OR, 0.49; 95% CI <sub.T3 vs. T1, 0.33 to 0.71; p for trend <0.001). In a subgroup analysis, antioxidant factors showed inverse associations with gastric cancer risk (OR, 0.53; 95% CI T3 vs. T1, 0.35 to 0.79; p for trend=0.003). A stronger association with antioxidant factors was observed in patients with intestinal gastric cancer (OR, 0.34; 95% CI T3 vs. T1, 0.19 to 0.62; p for trend<0.001) and those with H. pylori infection (OR, 0.57; 95% CI T3 vs. T1, 0.37 to 0.88; p for trend=0.014). CONCLUSIONS A predominance of antioxidant factors compared to pro-oxidant factors from diet and lifestyle reduced the risk of gastric cancer. The combined effect of oxidative stress, which involves an altered balance between antioxidants and pro-oxidants, is important for modulating the risk of gastric cancer.
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Affiliation(s)
- Jimi Kim
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Jeonghee Lee
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center Hospital, National Cancer Center, Goyang, Korea
| | - Young-Il Kim
- Center for Gastric Cancer, National Cancer Center Hospital, National Cancer Center, Goyang, Korea
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
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Eom SS, Choi W, Eom BW, Park SH, Kim SJ, Kim YI, Man Yoon H, Lee JY, Kim CG, Kim HK, Kook MC, Choi IJ, Kim YW, Park YI, Ryu KW. A Comprehensive and Comparative Review of Global Gastric Cancer Treatment Guidelines. J Gastric Cancer 2022; 22:3-23. [PMID: 35425651 PMCID: PMC8980601 DOI: 10.5230/jgc.2022.22.e10] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/18/2022] [Accepted: 03/19/2022] [Indexed: 12/24/2022] Open
Abstract
Countries differ in their treatment expertise and research results regarding gastric cancer; hence, treatment guidelines are diverse based on evidence and medical situations. A comprehensive and comparative review of each country’s guidelines is imperative to understand the similarities and differences among countries. We reviewed and compared five gastric cancer treatment guidelines in terms of endoscopic, surgical, perioperative, and palliative systemic treatment based on evidence levels and recommendation grades, as well as the postoperative follow-up strategies for each guideline. The Korean, Chinese, and European guidelines provided evidence and grading of the recommendations. The United States guidelines suggested categories for evidence and consensus. The Japanese guidelines suggested evidence and recommendations only for systemic treatment. The Korean and Japanese guidelines described endoscopic treatment, surgery, and lymphadenectomy in detail. The Chinese, United States, and European guidelines more intensively considered perioperative chemotherapy. In particular, the indications for chemotherapy and the regimens recommended by each guideline differed slightly. Considering their medical situations, each guideline had some diversity in terms of adopting evidence, which resulted in heterogeneous recommendations. This review will help medical personnel to comprehensively understand the diversity in gastric cancer treatment guidelines for each country in terms of evidence and recommendations.
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Affiliation(s)
- Sang Soo Eom
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Wonyoung Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Bang Wool Eom
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Sin Hye Park
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Soo Jin Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Young Il Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Hong Man Yoon
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Jong Yeul Lee
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Chan Gyoo Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Hark Kyun Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | | | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Young-Woo Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Young Iee Park
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Keun Won Ryu
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
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20
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Yang HJ, Kim JH, Kim NW, Choi IJ. Comparison of long-term outcomes of endoscopic submucosal dissection and surgery for undifferentiated-type early gastric cancer meeting the expanded criteria: a systematic review and meta-analysis. Surg Endosc 2022; 36:3686-3697. [PMID: 35194664 PMCID: PMC9085673 DOI: 10.1007/s00464-022-09126-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 02/07/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND There have been concerns over the long-term outcomes of endoscopic submucosal dissection (ESD) for undifferentiated-type early gastric cancer (UD EGC). We aimed to compare the long-term outcomes of ESD and surgery for patients with UD EGC. METHODS We searched PubMed, Embase, and Cochrane Library databases through March 2021 to identify studies that compared the long-term outcomes of ESD and surgery for UD EGC meeting expanded criteria for curative resection. The risk of bias was assessed with the Cochrane tool for non-randomized studies. The risk ratio (RR) was estimated using a fixed-effect model. RESULTS Overall, 1863 patients from five retrospective cohort studies, including 908 patients with propensity score matching (PSM), were eligible for meta-analysis. ESD was associated with inferior overall survival (OS) compared to surgery in the overall cohort (RR 2.11; 95% CI 1.26-3.55) but not in the PSM cohort (RR 1.18; 95% CI 0.60-2.32). In the PSM cohort, ESD had a lower disease-free survival (DFS) (RR 2.49; 95% CI 1.42-4.35) and higher recurrence (RR 12.61; 95% CI 3.43-46.37), gastric recurrence (RR 11.25; 95% CI 3.06-41.40), and extragastric recurrence (RR 4.23; 95% CI 0.47-37.93). Recurrence outcomes were similar between the overall and PSM cohorts. Disease-specific survival was not significantly different between the two groups in both the overall and PSM cohorts. CONCLUSION Although OS after curative ESD for UD EGC was not different from that after surgery in the PSM cohort, DFS and recurrence were inferior after ESD. Limitations included a lack of randomized trials. Further prospective studies comparing the long-term outcomes of ESD and surgery for UD EGC are needed (PROSPERO CRD 42021237097).
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Affiliation(s)
- Hyo-Joon Yang
- grid.264381.a0000 0001 2181 989XDivision of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jie-Hyun Kim
- grid.15444.300000 0004 0470 5454Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Na Won Kim
- grid.15444.300000 0004 0470 5454Yonsei University Medical Library, Yonsei University, Seoul, Korea
| | - Il Ju Choi
- grid.410914.90000 0004 0628 9810Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi 10408 Republic of Korea
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21
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Kim YI, Choi IJ. Current Evidence for a Paradigm Shift in Gastric Cancer Prevention From Endoscopic Screening to Helicobacter pylori Eradication in Korea. J Gastric Cancer 2022; 22:169-183. [PMID: 35938364 PMCID: PMC9359887 DOI: 10.5230/jgc.2022.22.e22] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 11/29/2022] Open
Abstract
Gastric cancer is prevalent in Korea and ranked as the third most common cancer in 2019, followed by lung and thyroid cancers. The National Cancer Screening Program (NCSP) for gastric cancer has been implemented in adults aged ≥40 since 1999 and involves endoscopic screening every 2 years. The beneficial effects of the current NCSP on early cancer detection, cost-effectiveness, and mortality reduction are evident. However, the screening program results in a large socioeconomic burden and the consumption of medical resources, as it focuses solely on secondary prevention (early detection) rather than primary prevention of cancer. Helicobacter pylori is defined as a group I carcinogen by the International Agency for Research on Cancer. Hence, its eradication has been suggested as an important primary gastric cancer prevention strategy. Well-designed randomized controlled trials involving high-risk groups (post-endoscopic resection of early gastric cancer and family history of gastric cancer) and long-term follow-up studies in the general population have provided high-quality evidence regarding the effects of H. pylori eradication on gastric cancer prevention. In this review, we discussed the evidences for a possible modification of the current gastric cancer secondary prevention strategy by introducing primary prevention through H. pylori eradication. Areas for future research to optimize primary prevention strategies were also suggested.
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Affiliation(s)
- Young-Il Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
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22
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Acharya UA, Aidala C, Akiba Y, Alfred M, Andrieux V, Apadula N, Asano H, Azmoun B, Babintsev V, Bandara NS, Barish KN, Bathe S, Bazilevsky A, Beaumier M, Belmont R, Berdnikov A, Berdnikov Y, Bichon L, Blankenship B, Blau DS, Bok JS, Brooks ML, Bryslawskyj J, Bumazhnov V, Campbell S, Canoa Roman V, Cervantes R, Chi CY, Chiu M, Choi IJ, Choi JB, Citron Z, Connors M, Corliss R, Corrales Morales Y, Cronin N, Csanád M, Csörgő T, Danley TW, Daugherity MS, David G, DeBlasio K, Dehmelt K, Denisov A, Deshpande A, Desmond EJ, Dion A, Dixit D, Do JH, Drees A, Drees KA, Durham JM, Durum A, Enokizono A, En'yo H, Esha R, Esumi S, Fadem B, Fan W, Feege N, Fields DE, Finger M, Finger M, Fitzgerald D, Fokin SL, Frantz JE, Franz A, Frawley AD, Fukuda Y, Gal C, Gallus P, Garg P, Ge H, Giles M, Giordano F, Goto Y, Grau N, Greene SV, Grosse Perdekamp M, Gunji T, Guragain H, Hachiya T, Haggerty JS, Hahn KI, Hamagaki H, Hamilton HF, Han SY, Hanks J, Harvey M, Hasegawa S, Haseler TOS, He X, Hemmick TK, Hill JC, Hill K, Hodges A, Hollis RS, Homma K, Hong B, Hoshino T, Hotvedt N, Huang J, Huang S, Imai K, Inaba M, Iordanova A, Isenhower D, Ivanishchev D, Jacak BV, Jezghani M, Ji Z, Jiang X, Johnson BM, Jouan D, Jumper DS, Kang JH, Kapukchyan D, Karthas S, Kawall D, Kazantsev AV, Khachatryan V, Khanzadeev A, Khatiwada A, Kim C, Kim EJ, Kim M, Kincses D, Kingan A, Kistenev E, Klatsky J, Kline P, Koblesky T, Kotov D, Kudo S, Kurgyis B, Kurita K, Kwon Y, Lajoie JG, Larionova D, Lebedev A, Lee S, Lee SH, Leitch MJ, Leung YH, Lewis NA, Li X, Lim SH, Liu MX, Loggins VR, Lökös S, Loomis DA, Lovasz K, Lynch D, Majoros T, Makdisi YI, Makek M, Manko VI, Mannel E, McCumber M, McGaughey PL, McGlinchey D, McKinney C, Mendoza M, Mignerey AC, Milov A, Mishra DK, Mitchell JT, Mitrankov I, Mitrankova M, Mitsuka G, Miyasaka S, Mizuno S, Mondal MM, Montuenga P, Moon T, Morrison DP, Mulilo B, Murakami T, Murata J, Nagai K, Nagashima K, Nagashima T, Nagle JL, Nagy MI, Nakagawa I, Nakano K, Nattrass C, Nelson S, Niida T, Nouicer R, Novák T, Novitzky N, Nukazuka G, Nyanin AS, O'Brien E, Ogilvie CA, Orjuela Koop JD, Osborn JD, Oskarsson A, Ottino GJ, Ozawa K, Pantuev V, Papavassiliou V, Park JS, Park S, Pate SF, Patel M, Peng W, Perepelitsa DV, Perera GDN, Peressounko DY, PerezLara CE, Perry J, Petti R, Phipps M, Pinkenburg C, Pisani RP, Potekhin M, Pun A, Purschke ML, Radzevich PV, Ramasubramanian N, Read KF, Reynolds D, Riabov V, Riabov Y, Richford D, Rinn T, Rolnick SD, Rosati M, Rowan Z, Runchey J, Safonov AS, Sakaguchi T, Sako H, Samsonov V, Sarsour M, Sato S, Schaefer B, Schmoll BK, Sedgwick K, Seidl R, Sen A, Seto R, Sexton A, Sharma D, Sharma D, Shein I, Shibata TA, Shigaki K, Shimomura M, Shioya T, Shukla P, Sickles A, Silva CL, Silvermyr D, Singh BK, Singh CP, Singh V, Slunečka M, Smith KL, Snowball M, Soltz RA, Sondheim WE, Sorensen SP, Sourikova IV, Stankus PW, Stoll SP, Sugitate T, Sukhanov A, Sumita T, Sun J, Sun Z, Sziklai J, Tanida K, Tannenbaum MJ, Tarafdar S, Taranenko A, Tarnai G, Tieulent R, Timilsina A, Todoroki T, Tomášek M, Towell CL, Towell RS, Tserruya I, Ueda Y, Ujvari B, van Hecke HW, Velkovska J, Virius M, Vrba V, Vukman N, Wang XR, Watanabe YS, Wong CP, Woody CL, Xu C, Xu Q, Xue L, Yalcin S, Yamaguchi YL, Yamamoto H, Yanovich A, Yoo JH, Yoon I, Yu H, Yushmanov IE, Zajc WA, Zelenski A, Zharko S, Zou L. Probing Gluon Spin-Momentum Correlations in Transversely Polarized Protons through Midrapidity Isolated Direct Photons in p^{↑}+p Collisions at sqrt[s]=200 GeV. Phys Rev Lett 2021; 127:162001. [PMID: 34723614 DOI: 10.1103/physrevlett.127.162001] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/26/2021] [Accepted: 08/10/2021] [Indexed: 06/13/2023]
Abstract
Studying spin-momentum correlations in hadronic collisions offers a glimpse into a three-dimensional picture of proton structure. The transverse single-spin asymmetry for midrapidity isolated direct photons in p^{↑}+p collisions at sqrt[s]=200 GeV is measured with the PHENIX detector at the Relativistic Heavy Ion Collider (RHIC). Because direct photons in particular are produced from the hard scattering and do not interact via the strong force, this measurement is a clean probe of initial-state spin-momentum correlations inside the proton and is in particular sensitive to gluon interference effects within the proton. This is the first time direct photons have been used as a probe of spin-momentum correlations at RHIC. The uncertainties on the results are a 50-fold improvement with respect to those of the one prior measurement for the same observable, from the Fermilab E704 experiment. These results constrain gluon spin-momentum correlations in transversely polarized protons.
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Affiliation(s)
- U A Acharya
- Georgia State University, Atlanta, Georgia 30303, USA
| | - C Aidala
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - Y Akiba
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Alfred
- Department of Physics and Astronomy, Howard University, Washington, D.C. 20059, USA
| | - V Andrieux
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - N Apadula
- Iowa State University, Ames, Iowa 50011, USA
| | - H Asano
- Kyoto University, Kyoto 606-8502, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - B Azmoun
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - V Babintsev
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - N S Bandara
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003-9337, USA
| | - K N Barish
- University of California-Riverside, Riverside, California 92521, USA
| | - S Bathe
- Baruch College, City University of New York, New York, New York 10010, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Bazilevsky
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Beaumier
- University of California-Riverside, Riverside, California 92521, USA
| | - R Belmont
- University of Colorado, Boulder, Colorado 80309, USA
- Physics and Astronomy Department, University of North Carolina at Greensboro, Greensboro, North Carolina 27412, USA
| | - A Berdnikov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - Y Berdnikov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - L Bichon
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - B Blankenship
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - D S Blau
- National Research Center "Kurchatov Institute," Moscow, 123098 Russia
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
| | - J S Bok
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - M L Brooks
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Bryslawskyj
- Baruch College, City University of New York, New York, New York 10010, USA
- University of California-Riverside, Riverside, California 92521, USA
| | - V Bumazhnov
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - S Campbell
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - V Canoa Roman
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - R Cervantes
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - C Y Chi
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - M Chiu
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - I J Choi
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - J B Choi
- Jeonbuk National University, Jeonju 54896, Korea
| | - Z Citron
- Weizmann Institute, Rehovot 76100, Israel
| | - M Connors
- Georgia State University, Atlanta, Georgia 30303, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - R Corliss
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | | | - N Cronin
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M Csanád
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - T Csörgő
- Eszterházy Károly University, Károly Róbert Campus, H-3200 Gyöngyös, Mátrai út 36, Hungary
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - T W Danley
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | | | - G David
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - K DeBlasio
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - K Dehmelt
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - A Denisov
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - A Deshpande
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - E J Desmond
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Dion
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - D Dixit
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - J H Do
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - A Drees
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - K A Drees
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J M Durham
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A Durum
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - A Enokizono
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - H En'yo
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - R Esha
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - S Esumi
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - B Fadem
- Muhlenberg College, Allentown, Pennsylvania 18104-5586, USA
| | - W Fan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - N Feege
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - D E Fields
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - M Finger
- Charles University, Ovocný trh 5, Praha 1, 116 36 Prague, Czech Republic
| | - M Finger
- Charles University, Ovocný trh 5, Praha 1, 116 36 Prague, Czech Republic
| | - D Fitzgerald
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - S L Fokin
- National Research Center "Kurchatov Institute," Moscow, 123098 Russia
| | - J E Frantz
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - A Franz
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A D Frawley
- Florida State University, Tallahassee, Florida 32306, USA
| | - Y Fukuda
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - C Gal
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - P Gallus
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - P Garg
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - H Ge
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M Giles
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - F Giordano
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - Y Goto
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - N Grau
- Department of Physics, Augustana University, Sioux Falls, South Dakota 57197, USA
| | - S V Greene
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | | | - T Gunji
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - H Guragain
- Georgia State University, Atlanta, Georgia 30303, USA
| | - T Hachiya
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J S Haggerty
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - K I Hahn
- Ewha Womans University, Seoul 120-750, Korea
| | - H Hamagaki
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - H F Hamilton
- Abilene Christian University, Abilene, Texas 79699, USA
| | - S Y Han
- Ewha Womans University, Seoul 120-750, Korea
- Korea University, Seoul 02841, Korea
| | - J Hanks
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M Harvey
- Texas Southern University, Houston, Texas 77004, USA
| | - S Hasegawa
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - T O S Haseler
- Georgia State University, Atlanta, Georgia 30303, USA
| | - X He
- Georgia State University, Atlanta, Georgia 30303, USA
| | - T K Hemmick
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - J C Hill
- Iowa State University, Ames, Iowa 50011, USA
| | - K Hill
- University of Colorado, Boulder, Colorado 80309, USA
| | - A Hodges
- Georgia State University, Atlanta, Georgia 30303, USA
| | - R S Hollis
- University of California-Riverside, Riverside, California 92521, USA
| | - K Homma
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - B Hong
- Korea University, Seoul 02841, Korea
| | - T Hoshino
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - N Hotvedt
- Iowa State University, Ames, Iowa 50011, USA
| | - J Huang
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - S Huang
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - K Imai
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - M Inaba
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - A Iordanova
- University of California-Riverside, Riverside, California 92521, USA
| | - D Isenhower
- Abilene Christian University, Abilene, Texas 79699, USA
| | - D Ivanishchev
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - B V Jacak
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M Jezghani
- Georgia State University, Atlanta, Georgia 30303, USA
| | - Z Ji
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - X Jiang
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - B M Johnson
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Georgia State University, Atlanta, Georgia 30303, USA
| | - D Jouan
- IPN-Orsay, Univ. Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, BP1, F-91406 Orsay, France
| | - D S Jumper
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - J H Kang
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - D Kapukchyan
- University of California-Riverside, Riverside, California 92521, USA
| | - S Karthas
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - D Kawall
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003-9337, USA
| | - A V Kazantsev
- National Research Center "Kurchatov Institute," Moscow, 123098 Russia
| | - V Khachatryan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - A Khanzadeev
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - A Khatiwada
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C Kim
- University of California-Riverside, Riverside, California 92521, USA
- Korea University, Seoul 02841, Korea
| | - E-J Kim
- Jeonbuk National University, Jeonju 54896, Korea
| | - M Kim
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - D Kincses
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - A Kingan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - E Kistenev
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J Klatsky
- Florida State University, Tallahassee, Florida 32306, USA
| | - P Kline
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - T Koblesky
- University of Colorado, Boulder, Colorado 80309, USA
| | - D Kotov
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - S Kudo
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - B Kurgyis
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - K Kurita
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - Y Kwon
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - J G Lajoie
- Iowa State University, Ames, Iowa 50011, USA
| | - D Larionova
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - A Lebedev
- Iowa State University, Ames, Iowa 50011, USA
| | - S Lee
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - S H Lee
- Iowa State University, Ames, Iowa 50011, USA
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M J Leitch
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Y H Leung
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - N A Lewis
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - X Li
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S H Lim
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
- Pusan National University, Pusan 46241, Korea
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - M X Liu
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - V-R Loggins
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - S Lökös
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - D A Loomis
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - K Lovasz
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - D Lynch
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T Majoros
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - Y I Makdisi
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Makek
- Department of Physics, Faculty of Science, University of Zagreb, Bijenička c. 32 HR-10002 Zagreb, Croatia
| | - V I Manko
- National Research Center "Kurchatov Institute," Moscow, 123098 Russia
| | - E Mannel
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M McCumber
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - P L McGaughey
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D McGlinchey
- University of Colorado, Boulder, Colorado 80309, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C McKinney
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - M Mendoza
- University of California-Riverside, Riverside, California 92521, USA
| | - A C Mignerey
- University of Maryland, College Park, Maryland 20742, USA
| | - A Milov
- Weizmann Institute, Rehovot 76100, Israel
| | - D K Mishra
- Bhabha Atomic Research Centre, Bombay 400 085, India
| | - J T Mitchell
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - Iu Mitrankov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - M Mitrankova
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - G Mitsuka
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - S Miyasaka
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - S Mizuno
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - M M Mondal
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - P Montuenga
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - T Moon
- Korea University, Seoul 02841, Korea
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - D P Morrison
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - B Mulilo
- Korea University, Seoul 02841, Korea
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - T Murakami
- Kyoto University, Kyoto 606-8502, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J Murata
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - K Nagai
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - K Nagashima
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - T Nagashima
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - J L Nagle
- University of Colorado, Boulder, Colorado 80309, USA
| | - M I Nagy
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - I Nakagawa
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - K Nakano
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - C Nattrass
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - S Nelson
- Florida A&M University, Tallahassee, Florida 32307, USA
| | - T Niida
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - R Nouicer
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T Novák
- Eszterházy Károly University, Károly Róbert Campus, H-3200 Gyöngyös, Mátrai út 36, Hungary
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - N Novitzky
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - G Nukazuka
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A S Nyanin
- National Research Center "Kurchatov Institute," Moscow, 123098 Russia
| | - E O'Brien
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - C A Ogilvie
- Iowa State University, Ames, Iowa 50011, USA
| | | | - J D Osborn
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - A Oskarsson
- Department of Physics, Lund University, Box 118, SE-221 00 Lund, Sweden
| | - G J Ottino
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - K Ozawa
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - V Pantuev
- Institute for Nuclear Research of the Russian Academy of Sciences, prospekt 60-letiya Oktyabrya 7a, Moscow 117312, Russia
| | - V Papavassiliou
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - J S Park
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - S Park
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - S F Pate
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - M Patel
- Iowa State University, Ames, Iowa 50011, USA
| | - W Peng
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - D V Perepelitsa
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- University of Colorado, Boulder, Colorado 80309, USA
| | - G D N Perera
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - D Yu Peressounko
- National Research Center "Kurchatov Institute," Moscow, 123098 Russia
| | - C E PerezLara
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - J Perry
- Iowa State University, Ames, Iowa 50011, USA
| | - R Petti
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Phipps
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - C Pinkenburg
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - R P Pisani
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Potekhin
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Pun
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - M L Purschke
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - P V Radzevich
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - N Ramasubramanian
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - K F Read
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - D Reynolds
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - V Riabov
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - Y Riabov
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - D Richford
- Baruch College, City University of New York, New York, New York 10010, USA
| | - T Rinn
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
- Iowa State University, Ames, Iowa 50011, USA
| | - S D Rolnick
- University of California-Riverside, Riverside, California 92521, USA
| | - M Rosati
- Iowa State University, Ames, Iowa 50011, USA
| | - Z Rowan
- Baruch College, City University of New York, New York, New York 10010, USA
| | - J Runchey
- Iowa State University, Ames, Iowa 50011, USA
| | - A S Safonov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - T Sakaguchi
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - H Sako
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - V Samsonov
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - M Sarsour
- Georgia State University, Atlanta, Georgia 30303, USA
| | - S Sato
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - B Schaefer
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - B K Schmoll
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - K Sedgwick
- University of California-Riverside, Riverside, California 92521, USA
| | - R Seidl
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Sen
- Iowa State University, Ames, Iowa 50011, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - R Seto
- University of California-Riverside, Riverside, California 92521, USA
| | - A Sexton
- University of Maryland, College Park, Maryland 20742, USA
| | - D Sharma
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - D Sharma
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - I Shein
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - T-A Shibata
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - K Shigaki
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - M Shimomura
- Iowa State University, Ames, Iowa 50011, USA
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
| | - T Shioya
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - P Shukla
- Bhabha Atomic Research Centre, Bombay 400 085, India
| | - A Sickles
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - C L Silva
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D Silvermyr
- Department of Physics, Lund University, Box 118, SE-221 00 Lund, Sweden
| | - B K Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - C P Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - V Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - M Slunečka
- Charles University, Ovocný trh 5, Praha 1, 116 36 Prague, Czech Republic
| | - K L Smith
- Florida State University, Tallahassee, Florida 32306, USA
| | - M Snowball
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - R A Soltz
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - W E Sondheim
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S P Sorensen
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - I V Sourikova
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - P W Stankus
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - S P Stoll
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T Sugitate
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - A Sukhanov
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T Sumita
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J Sun
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - Z Sun
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - J Sziklai
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - K Tanida
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - M J Tannenbaum
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - S Tarafdar
- Vanderbilt University, Nashville, Tennessee 37235, USA
- Weizmann Institute, Rehovot 76100, Israel
| | - A Taranenko
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
| | - G Tarnai
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - R Tieulent
- Georgia State University, Atlanta, Georgia 30303, USA
- IPNL, CNRS/IN2P3, Univ Lyon, Universit Lyon 1, F-69622 Villeurbanne, France
| | - A Timilsina
- Iowa State University, Ames, Iowa 50011, USA
| | - T Todoroki
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - M Tomášek
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - C L Towell
- Abilene Christian University, Abilene, Texas 79699, USA
| | - R S Towell
- Abilene Christian University, Abilene, Texas 79699, USA
| | - I Tserruya
- Weizmann Institute, Rehovot 76100, Israel
| | - Y Ueda
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - B Ujvari
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - H W van Hecke
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Velkovska
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - M Virius
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - V Vrba
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
- Institute of Physics, Academy of Sciences of the Czech Republic, Na Slovance 2, 182 21 Prague 8, Czech Republic
| | - N Vukman
- Department of Physics, Faculty of Science, University of Zagreb, Bijenička c. 32 HR-10002 Zagreb, Croatia
| | - X R Wang
- New Mexico State University, Las Cruces, New Mexico 88003, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - Y S Watanabe
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - C P Wong
- Georgia State University, Atlanta, Georgia 30303, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C L Woody
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - C Xu
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - Q Xu
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - L Xue
- Georgia State University, Atlanta, Georgia 30303, USA
| | - S Yalcin
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - Y L Yamaguchi
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - H Yamamoto
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - A Yanovich
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - J H Yoo
- Korea University, Seoul 02841, Korea
| | - I Yoon
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - H Yu
- New Mexico State University, Las Cruces, New Mexico 88003, USA
- Peking University, Beijing 100871, People's Republic of China
| | - I E Yushmanov
- National Research Center "Kurchatov Institute," Moscow, 123098 Russia
| | - W A Zajc
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - A Zelenski
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - S Zharko
- Saint Petersburg State Polytechnic University, St. Petersburg 195251, Russia
| | - L Zou
- University of California-Riverside, Riverside, California 92521, USA
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Gunathilake M, Lee J, Choi IJ, Kim YI, Kim J. Association between bacteria other than Helicobacter pylori and the risk of gastric cancer. Helicobacter 2021; 26:e12836. [PMID: 34268831 DOI: 10.1111/hel.12836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND The gastric microbiota, including Helicobacter pylori (HP), has a remarkable role in gastric cancer (GC) occurrence. Evidence for the role of non-HP bacteria in GC risk is limited. We aimed to observe the association between bacteria other than HP and risk of GC in a Korean population. METHODS In this study, 268 GC cases and 288 healthy controls were included. Demographic data and total energy intake data were collected using a general questionnaire and a semiquantitative food frequency questionnaire, respectively. 16S rRNA gene sequencing was performed using DNA extracted from gastric biopsy samples. RESULTS Actinobacteria, Bacteroidetes, Firmicutes, Fusobacteria, and non-HP Proteobacteria were the five main phyla in the gastric environment. The five phyla were negatively related to the relative abundance of Helicobacter species (all p < 0.001). The Shannon index, richness, and Pilou-evenness were negatively correlated with Helicobacter species (all p < 0.001), while the microbial dysbiosis index was positively correlated with Helicobacter species (p < 0.001). Participants with a higher relative abundance of Actinobacteria species showed a significantly increased risk of GC (OR: 3.16, 95% CI = 1.92-5.19, p-trend<0.001). The non-HP microbiota composition among the four groups (HP+cases, HP- cases, HP+controls, and HP- controls) was significantly different (ANOSIM R = 0.10, p = 0.001). CONCLUSION Other than HP, several bacterial species might be associated with GC risk. HP status and GC status could determine the differences in microbial compositions. Further large prospective studies are warranted to confirm our findings.
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Affiliation(s)
- Madhawa Gunathilake
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, Goyang-si, South Korea
| | - Jeonghee Lee
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, Goyang-si, South Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center Hospital, National Cancer Center, Goyang-si, South Korea
| | - Young-Il Kim
- Center for Gastric Cancer, National Cancer Center Hospital, National Cancer Center, Goyang-si, South Korea
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, Goyang-si, South Korea
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Lee YK, Lee EK, Lee YJ, Eom BW, Yoon HM, Kim YI, Cho SJ, Lee JY, Kim CG, Kong SY, Yoo MK, Hwangbo Y, Kim YW, Choi IJ, Kim HJ, Kwak MH, Ryu KW. Metabolic Effects of Gastrectomy and Duodenal Bypass in Early Gastric Cancer Patients with T2DM: A Prospective Single-Center Cohort Study. J Clin Med 2021; 10:jcm10174008. [PMID: 34501456 PMCID: PMC8432535 DOI: 10.3390/jcm10174008] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/20/2021] [Accepted: 08/30/2021] [Indexed: 12/24/2022] Open
Abstract
We evaluated the metabolic effects of gastrectomies and endoscopic submucosal dissections (ESDs) in early gastric cancer (EGC) patients with type 2 diabetes mellitus (T2DM). Forty-one EGC patients with T2DM undergoing gastrectomy or ESD were prospectively evaluated. Metabolic parameters in the patients who underwent gastrectomy with and without a duodenal bypass (groups 1 and 2, n = 24 and n = 5, respectively) were compared with those in patients who underwent ESD (control, n = 12). After 1 year, the proportions of improved/equivocal/worsened glycemic control were 62.5%/29.2%/8.3% in group 1, 40.0%/60.0%/0.0% in group 2, and 16.7%/50.0%/33.3% in the controls, respectively (p = 0.046). The multivariable ordered logistic regression analysis results showed that both groups had better 1-year glycemic control. Groups 1 and 2 showed a significant reduction in postprandial glucose (−97.9 and −67.8 mg/dL), body mass index (−2.1 and −2.3 kg/m2), and glycosylated hemoglobin (group 1 only, −0.5% point) (all p < 0.05). Furthermore, improvements in group 1 were more prominent when preoperative leptin levels were high (p for interaction < 0.05). Metabolic improvements in both groups were also observed for insulin resistance, leptin, plasminogen activator inhibitor-1, and resistin. Gastrectomy improved glycemic control and various metabolic parameters in EGC patients with T2DM. Patients with high leptin levels may experience greater metabolic benefits from gastrectomy with duodenal bypass.
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Affiliation(s)
- Young Ki Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea; (Y.K.L.); (E.K.L.); (Y.H.)
| | - Eun Kyung Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea; (Y.K.L.); (E.K.L.); (Y.H.)
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea; (H.M.Y.); (Y.-I.K.); (S.-Y.K.)
| | - You Jin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea; (Y.K.L.); (E.K.L.); (Y.H.)
- Correspondence: (Y.J.L.); (K.W.R.); Tel.: +82-31-920-1644 (Y.J.L.); +82-31-920-1628 (K.W.R.)
| | - Bang Wool Eom
- Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea; (B.W.E.); (S.J.C.); (J.Y.L.); (C.G.K.); (Y.-W.K.); (I.J.C.)
| | - Hong Man Yoon
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea; (H.M.Y.); (Y.-I.K.); (S.-Y.K.)
- Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea; (B.W.E.); (S.J.C.); (J.Y.L.); (C.G.K.); (Y.-W.K.); (I.J.C.)
| | - Young-Il Kim
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea; (H.M.Y.); (Y.-I.K.); (S.-Y.K.)
- Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea; (B.W.E.); (S.J.C.); (J.Y.L.); (C.G.K.); (Y.-W.K.); (I.J.C.)
| | - Soo Jeong Cho
- Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea; (B.W.E.); (S.J.C.); (J.Y.L.); (C.G.K.); (Y.-W.K.); (I.J.C.)
| | - Jong Yeul Lee
- Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea; (B.W.E.); (S.J.C.); (J.Y.L.); (C.G.K.); (Y.-W.K.); (I.J.C.)
| | - Chan Gyoo Kim
- Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea; (B.W.E.); (S.J.C.); (J.Y.L.); (C.G.K.); (Y.-W.K.); (I.J.C.)
| | - Sun-Young Kong
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea; (H.M.Y.); (Y.-I.K.); (S.-Y.K.)
- Department of Laboratory Medicine, National Cancer Center, Goyang 10408, Korea
| | - Min Kyong Yoo
- Department of Clinical Nutrition, National Cancer Center, Goyang 10408, Korea;
| | - Yul Hwangbo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea; (Y.K.L.); (E.K.L.); (Y.H.)
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea
| | - Young-Woo Kim
- Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea; (B.W.E.); (S.J.C.); (J.Y.L.); (C.G.K.); (Y.-W.K.); (I.J.C.)
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea; (B.W.E.); (S.J.C.); (J.Y.L.); (C.G.K.); (Y.-W.K.); (I.J.C.)
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea
| | - Hak Jin Kim
- Division of Cardiology, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea; (H.J.K.); (M.H.K.)
| | - Mi Hyang Kwak
- Division of Cardiology, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea; (H.J.K.); (M.H.K.)
| | - Keun Won Ryu
- Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea; (B.W.E.); (S.J.C.); (J.Y.L.); (C.G.K.); (Y.-W.K.); (I.J.C.)
- Correspondence: (Y.J.L.); (K.W.R.); Tel.: +82-31-920-1644 (Y.J.L.); +82-31-920-1628 (K.W.R.)
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25
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Kim YI, Lee JY, Khalayleh H, Kim CG, Yoon HM, Kim SJ, Yang H, Ryu KW, Choi IJ, Kim YW. Efficacy of endoscopic management for anastomotic leakage after gastrectomy in patients with gastric cancer. Surg Endosc 2021; 36:2896-2905. [PMID: 34254185 PMCID: PMC9001531 DOI: 10.1007/s00464-021-08582-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 02/02/2021] [Accepted: 06/02/2021] [Indexed: 12/24/2022]
Abstract
Background Anastomotic leakage (AL) after gastrectomy in gastric cancer patients is associated with high mortality rates. Various endoscopic procedures are available to manage this postoperative complication. The aim of study was to evaluate the outcome of two endoscopic modalities, clippings and stents, for the treatment of AL. Patients and methods There were 4916 gastric cancer patients who underwent gastrectomy between December 2007 and January 2016 at the National Cancer Center, Korea. A total of 115 patients (2.3%) developed AL. Of these, 85 patients (1.7%) received endoscopic therapy for AL and were included in this retrospective study. The endpoints were the complete leakage closure rates and risk factors associated with failure of endoscopic therapy. Results Of the 85 patients, 62 received endoscopic clippings (with or without detachable snares), and 23 received a stent insertion. Overall, the complete leakage closure rate was 80%, and no significant difference was found between the clipping and stent groups (79.0% vs. 82.6%, respectively; P = 0.89). The complete leakage closure rate was significantly lower in the duodenal and jejunal stump sites (60%) than esophageal sites (86.1%) and gastric sites (94.1%; P = 0.026). The multivariate analysis showed that stump leakage sites (adjusted odds ratio [aOR], 4.51; P = 0.031) and the presence of intra-abdominal abscess (aOR, 4.92; P = -0.025) were associated with unsuccessful leakage closures. Conclusions Endoscopic therapy using clippings or stents is an effective method for the postoperative management of AL in gastric cancer patients. This therapy can be considered a primary treatment option due to its demonstrated efficacy, safety, and minimally invasive nature.
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Affiliation(s)
- Young-Il Kim
- Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, Republic of Korea
| | - Jong Yeul Lee
- Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, Republic of Korea.
| | - Harbi Khalayleh
- Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, Republic of Korea.,The Department of Surgery, Faculty of Medicine, Kaplan Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Chan Gyoo Kim
- Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, Republic of Korea
| | - Hong Man Yoon
- Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, Republic of Korea
| | - Soo Jin Kim
- Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, Republic of Korea
| | - Hannah Yang
- Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, Republic of Korea.,Division of Biology and Biological Engineering, California Institute of Technology Pasadena, Pasadena, CA, 91125, USA
| | - Keun Won Ryu
- Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, Republic of Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, Republic of Korea
| | - Young-Woo Kim
- Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, Republic of Korea. .,Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, Republic of Korea.
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26
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Jung HK, Kang SJ, Lee YC, Yang HJ, Park SY, Shin CM, Kim SE, Lim HC, Kim JH, Nam SY, Shin WG, Park JM, Choi IJ, Kim JG, Choi M. Evidence based guidelines for the treatment of Helicobacter pylori infection in Korea 2020. Korean J Intern Med 2021; 36:807-838. [PMID: 34092054 PMCID: PMC8273819 DOI: 10.3904/kjim.2020.701] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/31/2020] [Accepted: 05/06/2021] [Indexed: 01/10/2023] Open
Abstract
Helicobacter pylori infection is one of the most common infectious diseases worldwide. H. pylori is responsible for substantial gastrointestinal morbidity with a high disease burden. Since the revision of the H. pylori Clinical Practice Guidelines in 2013 in Korea, the eradication rate of H. pylori has gradually decreased with the use of a clarithromycin based triple therapy. According to a nationwide randomized controlled study by the Korean College of Helicobacter and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was mostly due to increased antimicrobial resistance to clarithromycin. The clinical practice guidelines for treatment of H. pylori were updated based on evidence-based medicine from a meta-analysis conducted on a target group receiving the latest level of eradication therapy. The draft recommendations developed based on the meta-analysis were finalized after expert consensus on three recommendations regarding the indication for treatment and eight recommendations on the treatment itself. These guidelines were designed to provide clinical evidence for the treatment of H. pylori to patients, nurses, medical school students, policymakers, and clinicians. These may differ from current medical insurance standards, and will be revised if more evidence emerges in the future.
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Affiliation(s)
- Hye-Kyung Jung
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul,
Korea
| | - Seung Joo Kang
- Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul,
Korea
| | - Yong Chan Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul,
Korea
| | - Hyo-Joon Yang
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Seon-Young Park
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju,
Korea
| | - Cheol Min Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam,
Korea
| | - Sung Eun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan,
Korea
| | - Hyun Chul Lim
- Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin,
Korea
| | - Jie-Hyun Kim
- Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul,
Korea
| | - Su Youn Nam
- Center for Gastric Cancer, Kyungpook National University Chilgok Hospital, Daegu,
Korea
| | - Woon Geon Shin
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon,
Korea
| | - Jae Myung Park
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang,
Korea
| | - Jae Gyu Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Miyoung Choi
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul,
Korea
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Kim YI, Kim YA, Kim HJ, Kim SH, Hwangbo Y, Kim JG, Kim JJ, Choi IJ. Effect of Helicobacter pylori treatment on the long-term mortality in patients with type 2 diabetes. Korean J Intern Med 2021; 36:584-595. [PMID: 33232592 PMCID: PMC8137405 DOI: 10.3904/kjim.2019.428] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 02/19/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND/AIMS Meta-analyses of randomized trials reported a non-significant increase in overall mortality risk after Helicobacter pylori eradication. In this study, we investigated whether H. pylori treatment is associated with increased risk of overall mortality in patients with type 2 diabetes. METHODS In this retrospective population-based cohort study, we identified 66,706 patients treated for type 2 diabetes between 2002 and 2010 from the Korean National Health Insurance Service-National Sample Cohort. Patients who received H. pylori treatment (Hp-treatment cohort, 1,727 patients) were matched to those who did not (non-treatment cohort, 3,454 patients) at a 1:2 ratio. The primary outcome was overall mortality. The secondary outcomes were mortalities due to cardiovascular disease, cerebrovascular disease, or cancers. To estimate hazard ratio (HR) with confidential interval (CI), we used the Cox proportional-hazard model. RESULTS During a median follow-up of 4.7 years, the overall mortality was 5.9% (101/1,727 patients) among patients in the Hp-treatment cohort and 7.6% (364/3,454 patients) among patients in the non-treatment cohort. Adjusted HR (aHR) for overall mortality in the Hp-treatment cohort was 0.74 (95% CI, 0.59 to 0.93; p = 0.011). The mortality risks due to cardiovascular disease (aHR, 1.34; 95% CI, 0.54 to 3.30; p = 0.529), cerebrovascular disease (aHR, 0.97; 95% CI, 0.37 to 2.55; p = 0.947), and cancer (aHR, 1.08; 95% CI, 0.68 to 1.72; p = 0.742) were not significantly different between the groups. CONCLUSION In type 2 diabetes patients, overall mortality did not increase after H. pylori treatment.
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Affiliation(s)
- Young-Il Kim
- Center for Gastric Cancer, National Cancer Center, Goyang,
Korea
| | - Young Ae Kim
- National Cancer Control Institute, National Cancer Center, Goyang,
Korea
| | - Hak Jin Kim
- Branch of Cardiology, Department of Internal Medicine, National Cancer Center, Goyang,
Korea
| | - Su-Hyun Kim
- Department of Neurology, Research Institute and Hospital, National Cancer Center, Goyang,
Korea
| | - Yul Hwangbo
- Division of Endocrinology, Department of Internal Medicine, National Cancer Center, Goyang,
Korea
| | - Jae Gyu Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Jae J. Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang,
Korea
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Oh YJ, Kim DH, Han WH, Eom BW, Kim YI, Yoon HM, Lee JY, Kim CG, Kook MC, Choi IJ, Kim YW, Ryu KW. Risk factors for lymph node metastasis in early gastric cancer without lymphatic invasion after endoscopic submucosal dissection. Eur J Surg Oncol 2021; 47:3059-3063. [PMID: 33934939 DOI: 10.1016/j.ejso.2021.04.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/03/2021] [Revised: 02/24/2021] [Accepted: 04/20/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Lymphatic invasion (LI) is a potent risk factor for lymph node metastasis (LNM) in early gastric cancer (EGC) after endoscopic submucosal dissection (ESD). However, there are also other risk factors for LNM. Hence, to identify the need for additional surgery in some case of EGC without LI, the present study aimed to identify the risk factors for LNM in patients with EGC without LI. METHODS Data from 2284 patients diagnosed with EGC who underwent curative surgery at National Cancer Center in Korea from January 2012 to May 2019 were collected. The clinicopathological characteristics of patients with EGC without LI were compared on the basis of LNM status. RESULTS There were 339 (17.1%) and 1648 (82.9%) patients with and without LI respectively. Among these patients with and without LI, 118 (34.8%) and 91 (5.5%) patients presented with LNM, respectively. In patients with EGC without LI, tumor size larger than 3 cm (OR = 2.12, 95% CI = 1.22-3.68; p = 0.007), submucosal invasion (OR = 4.14, 95% CI = 2.57-6.65; p < 0.001), and undifferentiated histologic type (OR = 2.33, 95% CI = 1.45-3.76; p < 0.001) were significant risk factors for LNM. Rates of LNM in patients meeting absolute, expanded, and beyond expanded criteria without LI were 0%, 1.5% (OR = 3.27, 95% CI = 0.18-59.41; p = 0.423), and 7.3% respectively. When the expanded criteria were divided into four subtypes patients with EGC, without LI within each subtype did not show significant risk of incidence of LNM compared to the absolute criteria. CONCLUSIONS The current expanded criteria for endoscopic resection (ER) are tolerable in cases without LI, even though minimal risk LNM exists. Therefore, additional surgery may not be needed for patients meeting expanded criteria for ER.
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Affiliation(s)
- Yoon Jung Oh
- Center for Gastric Cancer, National Cancer Center, Goyang, 410-769, South Korea
| | - Deok Hee Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, 410-769, South Korea
| | - Won Ho Han
- Center for Gastric Cancer, National Cancer Center, Goyang, 410-769, South Korea
| | - Bang Wool Eom
- Center for Gastric Cancer, National Cancer Center, Goyang, 410-769, South Korea
| | - Young Il Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, 410-769, South Korea
| | - Hong Man Yoon
- Center for Gastric Cancer, National Cancer Center, Goyang, 410-769, South Korea
| | - Jong Yeul Lee
- Center for Gastric Cancer, National Cancer Center, Goyang, 410-769, South Korea
| | - Chan Gyoo Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, 410-769, South Korea
| | - Myeong-Cherl Kook
- Center for Gastric Cancer, National Cancer Center, Goyang, 410-769, South Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, 410-769, South Korea
| | - Young-Woo Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, 410-769, South Korea
| | - Keun Won Ryu
- Center for Gastric Cancer, National Cancer Center, Goyang, 410-769, South Korea.
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Bang CS, Ahn JY, Kim JH, Kim YI, Choi IJ, Shin WG. Establishing Machine Learning Models to Predict Curative Resection in Early Gastric Cancer with Undifferentiated Histology: Development and Usability Study. J Med Internet Res 2021; 23:e25053. [PMID: 33856358 PMCID: PMC8085749 DOI: 10.2196/25053] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/15/2020] [Accepted: 03/21/2021] [Indexed: 12/17/2022] Open
Abstract
Background Undifferentiated type of early gastric cancer (U-EGC) is included among the expanded indications of endoscopic submucosal dissection (ESD); however, the rate of curative resection remains unsatisfactory. Endoscopists predict the probability of curative resection by considering the size and shape of the lesion and whether ulcers are present or not. The location of the lesion, indicating the likely technical difficulty, is also considered. Objective The aim of this study was to establish machine learning (ML) models to better predict the possibility of curative resection in U-EGC prior to ESD. Methods A nationwide cohort of 2703 U-EGCs treated by ESD or surgery were adopted for the training and internal validation cohorts. Separately, an independent data set of the Korean ESD registry (n=275) and an Asan medical center data set (n=127) treated by ESD were chosen for external validation. Eighteen ML classifiers were selected to establish prediction models of curative resection with the following variables: age; sex; location, size, and shape of the lesion; and whether ulcers were present or not. Results Among the 18 models, the extreme gradient boosting classifier showed the best performance (internal validation accuracy 93.4%, 95% CI 90.4%-96.4%; precision 92.6%, 95% CI 89.5%-95.7%; recall 99.0%, 95% CI 97.8%-99.9%; and F1 score 95.7%, 95% CI 93.3%-98.1%). Attempts at external validation showed substantial accuracy (first external validation 81.5%, 95% CI 76.9%-86.1% and second external validation 89.8%, 95% CI 84.5%-95.1%). Lesion size was the most important feature in each explainable artificial intelligence analysis. Conclusions We established an ML model capable of accurately predicting the curative resection of U-EGC before ESD by considering the morphological and ecological characteristics of the lesions.
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Affiliation(s)
- Chang Seok Bang
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea.,Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, Republic of Korea.,Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of Korea.,Division of Big Data and Artificial Intelligence, Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea
| | - Ji Yong Ahn
- Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jie-Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Il Kim
- Center for Gastric Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Il Ju Choi
- Center for Gastric Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Woon Geon Shin
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea.,Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, Republic of Korea
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Yang HJ, Lee WS, Lee BE, Ahn JY, Jang JY, Lim JH, Nam SY, Kim JH, Min BH, Joo MK, Park JM, Shin WG, Lee HL, Gweon TG, Park MI, Choi J, Tae CH, Kim YI, Choi IJ. Long-term Outcomes of Undifferentiated-Type Early Gastric Cancer with Positive Horizontal Margins after Endoscopic Resection. Gut Liver 2021; 15:723-731. [PMID: 33790056 PMCID: PMC8444099 DOI: 10.5009/gnl20291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/18/2020] [Accepted: 12/01/2020] [Indexed: 12/02/2022] Open
Abstract
Background/Aims This study examined the long-term outcomes of undifferentiated-type early gastric cancer (UD EGC) with positive horizontal margins (HMs) after endoscopic resection (ER) and compared them between additional surgery and nonsurgical management. Methods From 2005 to 2015, a total of 1,124 patients with UD EGC underwent ER at 18 tertiary hospitals in Korea. Of them, 92 patients with positive HMs as the only noncurative factor (n=25) or with both positive HMs and tumor size >2 cm (n=67) were included. These patients underwent additional surgery (n=40), underwent additional endoscopic treatment (n=6), or were followed up without further treatment (n=46). Results No lymph node (LN) metastasis was found in patients who underwent additional surgery. During a median follow-up of 57.7 months (interquartile range, 27.6 to 68.8 months), no LN or distant metastases or gastric cancer-related deaths occurred in the overall cohort. At baseline, the residual cancer rate was 57.8% (26/45) after additional surgery or ER. The 5-year local recurrence rate was 33.6% among patients who were followed up without additional treatment. The 5-year overall survival rates were 95.0% and 87.8% after additional surgery and nonsurgical management (endoscopic treatment or close follow-up), respectively (log-rank p=0.224). In the multivariate Cox regression analysis, nonsurgical management was not associated with an increased risk of mortality. Conclusions UD EGC with positive HMs after ER may have favorable long-term outcomes and a very low risk of LN metastasis. Nonsurgical management may be suggested as an alternative, particularly for patients with old age or chronic illness. (Gut Liver 2021;15-731)
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Affiliation(s)
- Hyo-Joon Yang
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wan-Sik Lee
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Bong Eun Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Ji Yong Ahn
- Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Young Jang
- Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Joo Hyun Lim
- Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Su Youn Nam
- Division of Gastroenterology, Kyungpook National University Hospital and School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jie-Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Byung-Hoon Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Moon Kyung Joo
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jae Myung Park
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Woon Geon Shin
- Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Hang Lak Lee
- Division of Gastroenterology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Tae-Geun Gweon
- Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Jeongmin Choi
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Chung Hyun Tae
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Young-Il Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
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Jung HK, Kang SJ, Lee YC, Yang HJ, Park SY, Shin CM, Kim SE, Lim HC, Kim JH, Nam SY, Shin WG, Park JM, Choi IJ, Kim JG, Choi M. Evidence-Based Guidelines for the Treatment of Helicobacter pylori Infection in Korea 2020. Gut Liver 2021; 15:168-195. [PMID: 33468712 PMCID: PMC7960974 DOI: 10.5009/gnl20288] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/14/2020] [Accepted: 10/20/2020] [Indexed: 01/10/2023] Open
Abstract
Helicobacter pylori infection is one of the most common infectious diseases worldwide. Although the prevalence of H. pylori is gradually decreasing, approximately half of the world's population still becomes infected with this disease. H. pylori is responsible for substantial gastrointestinal morbidity worldwide, with a high disease burden. It is the most common cause of gastric and duodenal ulcers and gastric cancer. Since the revision of the H. pylori clinical practice guidelines in 2013 in Korea, the eradication rate of H. pylori has gradually decreased with the use of a clarithromycin-based triple therapy for 7 days. According to a nationwide randomized controlled study conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was mostly due to increased antimicrobial resistance, especially from clarithromycin. The clinical practice guidelines for the treatment of H. pylori were updated according to evidence-based medicine from a meta-analysis conducted on a target group receiving the latest level of eradication therapy. The draft recommendations developed based on the meta-analysis were finalized after an expert consensus on three recommendations regarding the indication for treatment and eight recommendations for the treatment itself. These guidelines were designed to provide clinical evidence for the treatment (including primary care treatment) of H. pylori infection to patients, nurses, medical school students, policymakers, and clinicians. These may differ from current medical insurance standards and will be revised if more evidence emerges in the future.
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Affiliation(s)
- Hye-Kyung Jung
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Seung Joo Kang
- Department of Internal Medicine, Seoul National University Hospital Gangnam Center, Seoul, Korea
| | - Yong Chan Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyo-Joon Yang
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seon-Young Park
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Cheol Min Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung Eun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Hyun Chul Lim
- Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Jie-Hyun Kim
- Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Su Youn Nam
- Center for Gastric Cancer, Kyungpook National University Hospital Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Woon Geon Shin
- Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Jae Myung Park
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Jae Gyu Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Miyoung Choi
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
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Kang SJ, Jung HK, Lee YC, Yang HJ, Park SY, Shin CM, Kim SE, Lim HC, Kim JH, Nam SY, Shin WG, Park JM, Choi IJ, Kim JG, Choi M. Eradication Rates of Clarithromycin Triple Therapy in Korea: A Systematic Review and Meta-analysis. Korean J Helicobacter Up Gastrointest Res 2021. [DOI: 10.7704/kjhugr.2020.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background/Aims: Standard triple therapy, including a proton pump inhibitor, clarithromycin, and amoxicillin, has been recommended as the first-line for <i>Helicobacter pylori</i> infection. However, the eradication rate of standard triple therapy has declined over the past years because of the increasing resistance to clarithromycin in Korea. We analyzed the eradication rates and the 10-year change in the eradication rates in Korea.Methods: PubMed, EMBASE, the Cochrane Library, and KoreaMed were searched for studies published between January 2007 and June 2018. The pooled eradication rates and their 95% CIs were estimated using a random-effect logistic regression model.Results: Twenty-six randomized controlled studies on standard triple therapy conducted in Korea were selected. The intention-to-treat (ITT) and per protocol analyses showed pooled eradication rates of standard triple therapy of 71.6% (95% CI, 69.9~73.3%) and 79.6% (95% CI, 76.6~82.2%), respectively. The eradication rate decreased with time. The ITT analysis showed that the 14-day therapy (78.1% [95% CI, 75.2~80.7%]) had significantly higher eradication rates than the 7-day therapy (70.0% [95% CI, 68.5~71.4%]) (<i>P</i><0.01).Conclusions: These results suggest that the eradication rate of standard triple therapy, as the first-line therapy, has shown an unacceptable decrease. The eradication rate increased when the duration of therapy was increased to 14 days, but it was not satisfactory. Therefore, other treatment regimens or therapies based on susceptibility tests should be considered for the first-line therapy.
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Yang HJ, Jung HK, Kang SJ, Lee YC, Park SY, Shin CM, Kim SE, Lim HC, Kim JH, Nam SY, Shin WG, Park JM, Choi IJ, Kim JG, Choi M. Salvage Regimens after Failure of Previous Helicobacter pylori Eradication Therapy: A Systematic Review and Meta-analysis. Korean J Helicobacter Up Gastrointest Res 2021. [DOI: 10.7704/kjhugr.2020.0053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background/Aims: As antibiotic resistance increases and new first-line therapies emerge, salvage therapies for <i>Helicobacter pylori</i> (<i>H. pylori</i>) eradication failures are becoming more common and complicated. This study aimed to systematically review overall salvage regimens after previous failure of <i>H. pylori</i> eradication.Materials and Methods: A systematic review of randomized clinical trials evaluating salvage therapies after previous <i>H. pylori</i> eradication failure was performed. A meta-analysis was conducted when an adequate number of studies suitable for grouping was found.Results: Overall, 36 studies with 77 treatment arms were identified, and they were highly heterogeneous regarding previously failed regimens and salvage regimens under comparison. Bismuth quadruple therapy after failure of standard triple therapy showed a pooled intention-to-treat (ITT) eradication rate of 75.5% (95% CI, 71.6~79.1%), and the rates were significantly higher with 14-day therapy than 7-day therapy by 9% (95% CI, 2~15%). Levofloxacin triple therapy after failure of standard triple therapy demonstrated a pooled ITT eradication rate of 73.3% (95% CI, 68.4~77.3%). In direct comparison, the two regimens were not significantly different in eradication rates. No study evaluated salvage regimens after the failure of bismuth or non-bismuth quadruple therapy.Conclusions: The current studies regarding salvage regimens are highly heterogeneous. Bismuth quadruple therapy and levofloxacin triple therapy may be a reliable option after failure of standard triple therapy, but the regional profile of antibiotic resistance should be considered. Further studies are needed for salvage regimens after failure of non-bismuth or bismuth quadruple therapy.
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Kim YI, Lee JY, Kim CG, Park B, Park JY, Choi IJ. Ten-day bismuth-containing quadruple therapy versus 7-day proton pump inhibitor-clarithromycin containing triple therapy as first-line empirical therapy for the Helicobacter pylori infection in Korea: a randomized open-label trial. BMC Gastroenterol 2021; 21:95. [PMID: 33653284 PMCID: PMC7923489 DOI: 10.1186/s12876-021-01680-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 02/18/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND This randomized, open-label trial aimed to compare the efficacy of 10-day bismuth-containing quadruple therapy (BQT) with 7-day proton-pump inhibitor-clarithromycin containing standard triple therapy (STT) as an empirical first-line Helicobacter pylori therapy. METHODS Participants with H. pylori infection were randomly assigned to either 10-day BQT (daily doses of bismuth 300 mg, four times; lansoprazole 30 mg, twice; metronidazole 500 mg, three times; and tetracycline 500 mg, four times) or 7-day STT (lansoprazole 30 mg; amoxicillin 1,000 mg; and clarithromycin 500 mg; each given twice daily). Participants who failed initial therapy were crossed over to the alternative treatment regimen. Primary outcome was the eradication rates of first-line treatment by intention-to-treat analysis. RESULTS Study participants (n = 352) were randomized to receive either 10-day BQT (n = 175) or 7-day STT (n = 177). The BQT-group achieved a significantly higher eradication rate than the STT-group in the intention-to-treat analysis (74.3% vs 57.1%, respectively; P = 0.001), modified intention-to-analysis (87.2% [130/149] vs 68.7% [101/147], respectively; P < 0.001) and per-protocol analysis (92.9% [105/113] vs 70.1% [94/134], respectively; P < 0.001). Although there was no serious adverse event, the compliance was lower with BQT than STT as a higher proportion of participants in the BQT-group discontinued therapy because of adverse events than those in the STT-group (23.1% vs 9.1%, respectively; P = 0.001) CONCLUSIONS: Ten-day BQT had higher eradication rates compared to that of the 7-day STT as an empirical first-line treatment for H. pylori eradication in Korea. TRIAL REGISTRATION ClinicalTrials.gov, NCT02557932. Registered 23 September 2015, https://clinicaltrials.gov/ct2/show/NCT02557932?term=NCT02557932&draw=2&rank=1 .
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Affiliation(s)
- Young-Il Kim
- Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi, 10408, South Korea
| | - Jong Yeul Lee
- Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi, 10408, South Korea
| | - Chan Gyoo Kim
- Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi, 10408, South Korea
| | - Boram Park
- Biostatistics Collaboration Team, Research Core Center, Research Institute, National Cancer Center, Goyang, 10408, Korea
| | - Jin Young Park
- Prevention and Implementation Group, International Agency for Research on Cancer, 69372, Lyon, France
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi, 10408, South Korea.
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Park B, Yang S, Lee J, Choi IJ, Kim YI, Kim J. Gastric Cancer Risk Prediction Using an Epidemiological Risk Assessment Model and Polygenic Risk Score. Cancers (Basel) 2021; 13:cancers13040876. [PMID: 33669642 PMCID: PMC7923020 DOI: 10.3390/cancers13040876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/08/2021] [Revised: 02/01/2021] [Accepted: 02/09/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary Risk prediction models incorporate various established risk factors to estimate individual risk specifically in cancer. These models additionally include biological or genetic risk factors to assess cancer risk more accurately. The polygenic risk score (PRS) combines the effects of multiple single-nucleotide polymorphisms (SNPs) that are associated with disease; its discrimination ability was assessed both alone and when used in combination with conventional risk prediction models. As few studies have evaluated the combination of genetic variants to identify high risk population of gastric cancer (GC), and we examined the performance of a GC risk assessment model in combination with SNPs as a PRS in consideration of Helicobacter pylori (H. pylori) infection status. Such a combination improves the identification of a GC-susceptible population among people with H. pylori infection. Abstract We investigated the performance of a gastric cancer (GC) risk assessment model in combination with single-nucleotide polymorphisms (SNPs) as a polygenic risk score (PRS) in consideration of Helicobacter pylori (H. pylori) infection status. Six SNPs identified from genome-wide association studies and a marginal association with GC in the study population were included in the PRS. Discrimination of the GC risk assessment model, PRS, and the combination of the two (PRS-GCS) were examined regarding incremental risk and the area under the receiver operating characteristic curve (AUC), with grouping according to H. pylori infection status. The GC risk assessment model score showed an association with GC, irrespective of H. pylori infection. Conversely, the PRS exhibited an association only for those with H. pylori infection. The PRS did not discriminate GC in those without H. pylori infection, whereas the GC risk assessment model showed a modest discrimination. Among individuals with H. pylori infection, discrimination by the GC risk assessment model and the PRS were comparable, with the PRS-GCS combination resulting in an increase in the AUC of 3%. In addition, the PRS-GCS classified more patients and fewer controls at the highest score quintile in those with H. pylori infection. Overall, the PRS-GCS improved the identification of a GC-susceptible population of people with H. pylori infection. In those without H. pylori infection, the GC risk assessment model was better at identifying the high-risk group.
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Affiliation(s)
- Boyoung Park
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si 10408, Korea;
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea
| | - Sarah Yang
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si 10408, Korea; (S.Y.); (J.L.)
| | - Jeonghee Lee
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si 10408, Korea; (S.Y.); (J.L.)
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center Hospital, National Cancer Center, Goyang-si 10408, Korea; (I.J.C.); (Y.-I.K.)
| | - Young-Il Kim
- Center for Gastric Cancer, National Cancer Center Hospital, National Cancer Center, Goyang-si 10408, Korea; (I.J.C.); (Y.-I.K.)
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si 10408, Korea; (S.Y.); (J.L.)
- Correspondence: ; Tel.: +82-31-920-2570; Fax: +82-31-920-2579
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Kim J, Kim H, Lee J, Choi IJ, Kim YI, Kim J. Antioxidant-Rich Diet, GSTP1 rs1871042 Polymorphism, and Gastric Cancer Risk in a Hospital-Based Case-Control Study. Front Oncol 2021; 10:596355. [PMID: 33634021 PMCID: PMC7902036 DOI: 10.3389/fonc.2020.596355] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 08/19/2020] [Accepted: 12/14/2020] [Indexed: 12/20/2022] Open
Abstract
Background Chronic gastritis along with Helicobacter pylori (H. pylori) infection has been implicated in inflammatory response-related genes linked to the causation of gastric cancer. Glutathione S-transferase Pi (GSTP1) plays a role in regulating oxidative stress and detoxification against carcinogenesis. In this study, we aimed to determine whether an antioxidant-rich diet is associated with gastric cancer risk and identify how this association could be altered by GSTP1 genetic variants. Methods This study included 1,245 participants (415 cases and 830 controls) matched for age and sex. The dietary antioxidant capacity was estimated based on the oxygen radical absorbance capacity (ORAC) incorporated with a semiquantitative food frequency questionnaire. Five single nucleotide polymorphisms (SNPs) of GSTP1 (rs1695, rs749174, rs1871042, rs4891, and rs947895) were selected among the exome array genotype data. Results High dietary ORAC was inversely associated with gastric cancer (hydrophilic ORAC OR T3vs. T1, 95% CI = 0.57, 0.39–0.82, P = 0.004; lipophilic ORAC = 0.66, 0.45–0.95, P = 0.021; total phenolics = 0.57, 0.39–0.83, P = 0.005). The polymorphism rs1871042 increased the risk of gastric cancer (OR, 95% CI = 1.55, 1.10–2.16, P = 0.01, CT+TT vs. CC). A remarkably reduced risk of gastric cancer was observed among those who had a high dietary ORAC according to rs1871042 polymorphism (hydrophilic ORAC OR T3vs. T1, 95% CI = 0.36, 0.17–0.78, P for trend = 0.013; lipophilic ORAC = 0.58, 0.37–0.93, P for trend = 0.021; total phenolics = 0.38, 0.17–0.83, P for trend = 0.019). Conclusions Our findings indicate that dietary ORAC intake may be inversely associated with the risk of gastric cancer altered by genetic variants of GSTP1, providing new intervention strategies for gastric cancer patients.
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Affiliation(s)
- Jimi Kim
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, South Korea
| | - Hyejin Kim
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, South Korea
| | - Jeonghee Lee
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, South Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center Hospital, National Cancer Center, Goyang-si, South Korea
| | - Young-Il Kim
- Center for Gastric Cancer, National Cancer Center Hospital, National Cancer Center, Goyang-si, South Korea
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, South Korea
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Shin SY, Kim JH, Kook MC, Park DY, Ryu KW, Choi IJ, Noh SH, Kim H, Lee YC. Clinicopathologic Features of Submucosal Papillary Gastric Cancer Differ from Those of Other Differentiated-Type Histologies. Gut Liver 2021; 15:44-52. [PMID: 32295332 PMCID: PMC7817937 DOI: 10.5009/gnl19328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/19/2020] [Accepted: 01/21/2020] [Indexed: 12/20/2022] Open
Abstract
Background/Aims Papillary gastric cancer (GC) is classified as differentiated adenocarcinoma, together with well-differentiated (WD) and moderately differentiated (MD) adenocarcinoma. This study evaluated the risk of lymph node metastasis (LNM) in submucosal (SM) invasive papillary GC compared with other differentiated early GC types. Methods This retrospective study involved three tertiary hospitals and enrolled 1,798 lesions with differentiated SM invasive GC treated with curative gastrectomy between March 2001 and December 2012. All pathology slides were reviewed, and clinicopathologic findings associated with LNM, including tumor size, location, gross type, ulceration, depth and width of SM invasion, and lymphovascular invasion (LVI), were analyzed. Results The proportion of SM papillary GC was 2.8% (n=51). SM papillary GC was associated with larger tumor size and deeper and wider SM invasion than other differentiated GC types. LNM was significantly higher in the papillary type than in the MD and WD types. LNM was found in 27.5% of SM papillary GC patients (WD 9.0%, MD 21.2%). LVI was the only significant risk factor for LNM in SM papillary GC. The depth or width of SM invasion was not associated with LNM in papillary GC. Lower third location or elevated gross appearance was significantly associated with LVI. Conclusions SM papillary GC had the highest LNM rate, with features different from those of other differentiated SM invasive GCs. The treatment strategy for SM papillary GC should be carefully approached, especially for lesions located in the lower third or of the elevated gross type.
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Affiliation(s)
- Seung Yong Shin
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jie-Hyun Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Myeong-Cherl Kook
- Department of Pathology, Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Do Youn Park
- Department of Pathology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.,St. Maria Pathology Laboratory, Busan, Korea
| | - Keun Won Ryu
- Department of Surgery, Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Il Ju Choi
- Department of Internal Medicine, Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Sung Hoon Noh
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyunki Kim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Chan Lee
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Yang HJ, Jang JY, Kim SG, Ahn JY, Nam SY, Kim JH, Min BH, Lee WS, Lee BE, Joo MK, Park JM, Shin WG, Lee HL, Gweon TG, Park MI, Choi J, Tae CH, Kim YI, Choi IJ. Risk factors of lymph node metastasis after non-curative endoscopic resection of undifferentiated-type early gastric cancer. Gastric Cancer 2021; 24:168-178. [PMID: 32623585 DOI: 10.1007/s10120-020-01103-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/25/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study aimed to investigate risk factors for lymph node (LN) or distant metastasis after non-curative endoscopic resection (ER) of undifferentiated-type early gastric cancer (EGC). METHODS Of 1124 patients who underwent ER for undifferentiated-type gastric cancer at 18 tertiary hospitals across six geographic areas in Korea between 2005 and 2014, 634 with non-curative ER beyond the expanded criteria were retrospectively enrolled. According to the treatment after ER, patients were divided into additional surgery (n = 270) and follow-up (n = 364) groups. The median follow-up duration was 59 months for recurrence and 84 months for mortality. RESULTS LN metastasis was found in 6.7% (18/270) of patients at surgery. Ulcer [odds ratio (OR) 3.83; 95% confidence interval (CI) 1.21-12.13; p = 0.022] and submucosal invasion (OR 10.35; 95% CI 1.35-79.48; p = 0.025) were independent risk factors. In the follow-up group, seven patients (1.9%) developed LN or distant recurrence. Ulcer [hazard ratio (HR) 7.60; 95% CI 1.39-35.74; p = 0.018], LVI (HR 6.80; 95% CI 1.07-42.99; p = 0.042), and positive vertical margin (HR 6.71; 95% CI 1.28-35.19; p = 0.024) were independent risk factors. In the overall cohort, LN metastasis rates were 9.6% in patients with two or more risk factors and 1.2% in those with no or one risk factor. CONCLUSIONS LVI, ulcer, submucosal invasion, and positive vertical margin are independently associated with LN or distant metastasis after non-curative ER of undifferentiated-type EGC. Surgical resection is strongly recommended for patients with two or more risk factors.
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Affiliation(s)
- Hyo-Joon Yang
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Young Jang
- Department of Internal Medicine, College of Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemoon-gu, Seoul, 02447, Korea.
| | - Sang Gyun Kim
- Division of Gastroenterology, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.
| | - Ji Yong Ahn
- Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Su Youn Nam
- Gastroenterology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jie-Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Byung-Hoon Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wan-Sik Lee
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Bong Eun Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Moon Kyung Joo
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jae Myung Park
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Woon Geon Shin
- Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Hang Lak Lee
- Division of Gastroenterology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Tae-Geun Gweon
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Jeongmin Choi
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Chung Hyun Tae
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Young-Il Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
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Jung HK, Kang SJ, Lee YC, Yang HJ, Park SY, Shin CM, Kim SE, Lim HC, Kim JH, Nam SY, Shin WG, Park JM, Choi IJ, Kim JG, Choi M. Evidence-based Guidelines for the Treatment of Helicobacter pylori Infection in Korea: 2020 Revised Edition. Korean J Helicobacter Up Gastrointest Res 2020. [DOI: 10.7704/kjhugr.2020.0045] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Helicobacter pylori (H. pylori) infection is one of the most common infectious diseases worldwide. Although its incidence is gradually decreasing, about half of the world's population still get infected. H. pylori infection is responsible for substantial gastrointestinal morbidity worldwide. It is the most common cause of gastric and duodenal ulcers as well as gastric cancer. Since the revision of the H. pylori Clinical Practice Guidelines in 2013, the eradication rate of H. pylori has gradually decreased with the use of classical triple therapy, wherein amoxicillin, clarithromycin, and proton pump inhibitors are administered, for 7 days. According to a nationwide randomized controlled study conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was due to increased antimicrobial resistance induced by the use of antibiotics, especially clarithromycin. The update of clinical practice guideline for treatment of H. pylori was developed based on evidence-based medicine by conducting a meta-analysis. The draft recommendations were finalized after expert consensus on three recommendations regarding the indication for treatment and eight recommendations on the treatment itself. These guidelines are designed to provide patients, nurses, medical school students, policymakers, and clinicians with clinical evidence to guide primary care and treatment of H. pylori infection. These may differ from current medical insurance standards and will be revised further, if necessary, based on research-based evidence.
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Kim YI, Kim YA, Lee JW, Kim HJ, Kim SH, Kim SG, Kim JI, Kim JJ, Choi IJ. Effect of <i>Helicobacter pylori</i> Treatment on Long-term Mortality in Patients with Hypertension. Gut Liver 2020; 14:47-56. [PMID: 30974928 PMCID: PMC6974335 DOI: 10.5009/gnl18510] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 01/17/2019] [Accepted: 01/26/2019] [Indexed: 12/21/2022] Open
Abstract
Background/Aims A meta-analysis of randomized trials performed in healthy asymptomatic individuals suggested that overall mortality may increase after Helicobacter pylori eradication despite a significant decrease in the gastric cancer incidence and mortality rates. This retrospective population-based cohort study investigated if H. pylori treatment is associated with an increase in overall mortality in patients with hypertension. Methods From the database of the Korean National Health Insurance Sample Cohort, we selected 198,487 patients treated for hypertension between 2002 and 2010. Those who received H. pylori treatment (H. pylori treatment cohort, 5,541 patients) were matched to those who did not (nontreatment cohort, 11,082 patients) at the ratio of 1 to 2. The primary outcome was the risk of overall mortality. The secondary outcomes were the risks of mortality due to cardiovascular disease, cerebrovascular disease, and cancer. The outcomes were evaluated from 6 months after H. pylori treatment to December 2013. A Cox proportional hazard model was used to estimate the hazard ratios (HRs). Results During a median follow-up period of 4.8 years, death from any cause was reported in 4.1% of the patients in the H. pylori treatment cohort and 5.5% of the patients in the nontreatment cohort. The adjusted HR (aHR) for overall mortality in the H. pylori treatment cohort was 0.70 (95% confidence interval [CI], 0.60 to 0.82; p<0.001). With regard to cause-specific mortality, compared with the nontreatment cohort, the H. pylori treatment cohort had a lower risk of mortality due to cerebrovascular disease (aHR, 0.46; 95% CI, 0.26 to 0.81; p=0.007). The risks of mortality due to cancer and cardiovascular disease were not different between the cohorts. Conclusions H. pylori treatment is not associated with an increase in overall mortality in patients treated for hypertension.
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Affiliation(s)
- Young-Il Kim
- Center for Gastric Cancer, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Young Ae Kim
- Cancer Survivorship Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jang Won Lee
- College of Korean Medicine, Dongguk University, Gyeongju, Korea
| | - Hak Jin Kim
- Department of Cardiology, Center for Clinical Specialty, National Cancer Center, Goyang, Korea
| | - Su-Hyun Kim
- Department of Neurology, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Sang Gyun Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Il Kim
- Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae J Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Control Institute, National Cancer Center, Goyang, Korea
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Lee JH, Kim HT, Choi IJ, Heo YR, Jung YW. An unusual anatomical variant of the left phrenic nerve encircling the transverse cervical artery. Folia Morphol (Warsz) 2020; 80:1027-1031. [PMID: 33124034 DOI: 10.5603/fm.a2020.0131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/24/2020] [Revised: 09/25/2020] [Accepted: 10/18/2020] [Indexed: 11/25/2022]
Abstract
During educational dissection of cadavers, we encountered anatomical variability of the left phrenic nerve (PN). In this cadaver, nerve fibres from C3 and C4 descended and crossed behind the transverse cervical artery (TCA), a branch of the thyrocervical trunk, at the level of the anterior scalene muscle. On the other hand, nerve fibres from C5 descended obliquely above the TCA and then joined the fibres from C3-C4 on the medial side of the anterior scalene muscle to form the PN. To our knowledge, the encircling of the TCA by the left PN in the neck has not yet been reported and may pose a potential risk for nerve compression during movement of the neck. We discuss several types of anatomical variants of the PN and the associated risk during thorax and neck dissection procedures.
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Affiliation(s)
- J H Lee
- Department of Anatomy, School of Medicine, Keimyung University, Daegu, Korea, Republic Of
| | - H T Kim
- Department of Anatomy, School of Medicine, Catholic University of Daegu, Korea, Republic Of
| | - I J Choi
- Department of Anatomy, School of Medicine, Keimyung University, Daegu, Korea, Republic Of
| | - Y R Heo
- Department of Anatomy, School of Medicine, Keimyung University, Daegu, Korea, Republic Of
| | - Y W Jung
- Department of Anatomy, College of Medicine, Dongguk University, Gyeongju, Korea, Republic Of.
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Huang RJ, Koh H, Hwang JH, Abnet CC, Alarid-Escudero F, Amieva MR, Bruce MG, Camargo MC, Chan AT, Choi IJ, Corvalan A, Davis JL, Deapen D, Epplein M, Greenwald DA, Hamashima C, Hur C, Inadomi JM, Ji HP, Jung HY, Lee E, Lin B, Palaniappan LP, Parsonnet J, Peek RM, Piazuelo MB, Rabkin CS, Shah SC, Smith A, So S, Stoffel EM, Umar A, Wilson KT, Woo Y, Yeoh KG. A Summary of the 2020 Gastric Cancer Summit at Stanford University. Gastroenterology 2020; 159:1221-1226. [PMID: 32707045 PMCID: PMC7577947 DOI: 10.1053/j.gastro.2020.05.100] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 05/04/2020] [Accepted: 05/04/2020] [Indexed: 02/06/2023]
Abstract
There exists no coherent national strategy for the early detection or prevention of gastric cancer in the United States (US), even among identified high-risk groups such as Asian Americans, African Americans, Hispanic Americans, and Alaska Native/American Indian peoples. As a result, patients with gastric cancer in the US are diagnosed at later stages and demonstrate worse overall survival compared to nations of East Asia with established screening programs (Table 1). The under-recognition of gastric cancer risk within minority communities is a significant unaddressed healthcare disparity.
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Affiliation(s)
- Robert J. Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Stanford, CA
| | - Howard Koh
- Harvard TH Chan School of Public Health, Boston, MA
| | - Joo Ha Hwang
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Stanford, California.
| | | | - Christian C. Abnet
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD
| | - Fernando Alarid-Escudero
- Division of Public Administration, Center for Research and Teaching in Economics, Aguascalientes, Mexico
| | - Manuel R. Amieva
- Division of Infectious Diseases, Department of Pediatrics, Stanford University
| | - Michael G. Bruce
- Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, AK
| | - M. Constanza Camargo
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD
| | - Andrew T. Chan
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, South Korea
| | - Alejandro Corvalan
- Advanced Center for Chronic Diseases (ACCDiS), Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Jeremy L. Davis
- Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Dennis Deapen
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Meira Epplein
- Department of Population Health Sciences, Duke University, and Cancer Control and Population Sciences Program, Duke Cancer Institute, Durham, NC
| | - David A. Greenwald
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Chin Hur
- Division of Digestive & Liver Diseases, Columbia University, New York, NY
| | - John M. Inadomi
- Division of Gastroenterology, University of Washington, Seattle, WA
| | - Hanlee P. Ji
- Division of Hematology and Oncology, Department of Medicine, Stanford University
| | - Hwoon-Yong Jung
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Eunjung Lee
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Bryant Lin
- Division of Primary Care and Population Health, Department of Medicine, Stanford University
| | - Latha P. Palaniappan
- Division of Primary Care and Population Health, Department of Medicine, Stanford University
| | - Julie Parsonnet
- Division of Infectious Diseases, Department of Medicine, Stanford University
| | - Richard M. Peek
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN
| | - M. Blanca Piazuelo
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN
| | - Charles S. Rabkin
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD
| | - Shailja C. Shah
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN,Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN
| | - Aki Smith
- Hope for Stomach Cancer, Marina Del Rey, CA
| | - Samuel So
- The Asian Liver Center, Stanford University
| | - Elena M. Stoffel
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI
| | - Asad Umar
- Division of Cancer Prevention, National Cancer Institute, Rockville, MD
| | - Keith T. Wilson
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN,Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN
| | - Yanghee Woo
- Division of Surgical Oncology, Department of Surgery, City of Hope National Comprehensive Cancer Center, Duarte, CA
| | - Khay Guan Yeoh
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Adare A, Afanasiev S, Aidala C, Ajitanand NN, Akiba Y, Akimoto R, Al-Ta'ani H, Alexander J, Angerami A, Aoki K, Apadula N, Aramaki Y, Asano H, Aschenauer EC, Atomssa ET, Awes TC, Azmoun B, Babintsev V, Bai M, Bannier B, Barish KN, Bassalleck B, Bathe S, Baublis V, Baumgart S, Bazilevsky A, Belmont R, Berdnikov A, Berdnikov Y, Bing X, Blau DS, Boyle K, Brooks ML, Buesching H, Bumazhnov V, Butsyk S, Campbell S, Castera P, Chen CH, Chi CY, Chiu M, Choi IJ, Choi JB, Choi S, Choudhury RK, Christiansen P, Chujo T, Chvala O, Cianciolo V, Citron Z, Cole BA, Connors M, Csanád M, Csörgő T, Dairaku S, Datta A, Daugherity MS, David G, Denisov A, Deshpande A, Desmond EJ, Dharmawardane KV, Dietzsch O, Ding L, Dion A, Donadelli M, Drapier O, Drees A, Drees KA, Durham JM, Durum A, D'Orazio L, Edwards S, Efremenko YV, Engelmore T, Enokizono A, Esumi S, Eyser KO, Fadem B, Fields DE, Finger M, Finger M, Fleuret F, Fokin SL, Frantz JE, Franz A, Frawley AD, Fukao Y, Fusayasu T, Gainey K, Gal C, Garishvili A, Garishvili I, Glenn A, Gong X, Gonin M, Goto Y, Granier de Cassagnac R, Grau N, Greene SV, Grosse Perdekamp M, Gunji T, Guo L, Gustafsson HÅ, Hachiya T, Haggerty JS, Hahn KI, Hamagaki H, Hanks J, Hashimoto K, Haslum E, Hayano R, He X, Hemmick TK, Hester T, Hill JC, Hollis RS, Homma K, Hong B, Horaguchi T, Hori Y, Huang S, Ichihara T, Iinuma H, Ikeda Y, Imrek J, Inaba M, Iordanova A, Isenhower D, Issah M, Isupov A, Ivanischev D, Jacak BV, Javani M, Jia J, Jiang X, Johnson BM, Joo KS, Jouan D, Kamin J, Kaneti S, Kang BH, Kang JH, Kang JS, Kapustinsky J, Karatsu K, Kasai M, Kawall D, Kazantsev AV, Kempel T, Khanzadeev A, Kijima KM, Kim BI, Kim C, Kim DJ, Kim EJ, Kim HJ, Kim KB, Kim YJ, Kim YK, Kinney E, Kiss Á, Kistenev E, Klatsky J, Kleinjan D, Kline P, Komatsu Y, Komkov B, Koster J, Kotchetkov D, Kotov D, Král A, Krizek F, Kunde GJ, Kurita K, Kurosawa M, Kwon Y, Kyle GS, Lacey R, Lai YS, Lajoie JG, Lebedev A, Lee B, Lee DM, Lee J, Lee KB, Lee KS, Lee SH, Lee SR, Leitch MJ, Leite MAL, Leitgab M, Lewis B, Lim SH, Linden Levy LA, Litvinenko A, Liu MX, Love B, Maguire CF, Makdisi YI, Makek M, Malakhov A, Manion A, Manko VI, Mannel E, Masumoto S, McCumber M, McGaughey PL, McGlinchey D, McKinney C, Mendoza M, Meredith B, Miake Y, Mibe T, Mignerey AC, Milov A, Mishra DK, Mitchell JT, Miyachi Y, Miyasaka S, Mohanty AK, Moon HJ, Morrison DP, Motschwiller S, Moukhanova TV, Murakami T, Murata J, Nagae T, Nagamiya S, Nagle JL, Nagy MI, Nakagawa I, Nakamiya Y, Nakamura KR, Nakamura T, Nakano K, Nattrass C, Nederlof A, Nihashi M, Nouicer R, Novitzky N, Nyanin AS, O'Brien E, Ogilvie CA, Okada K, Oskarsson A, Ouchida M, Ozawa K, Pak R, Pantuev V, Papavassiliou V, Park BH, Park IH, Park SK, Pate SF, Patel L, Pei H, Peng JC, Pereira H, Peresedov V, Peressounko DY, Petti R, Pinkenburg C, Pisani RP, Proissl M, Purschke ML, Qu H, Rak J, Ravinovich I, Read KF, Reynolds R, Riabov V, Riabov Y, Richardson E, Roach D, Roche G, Rolnick SD, Rosati M, Rukoyatkin P, Sahlmueller B, Saito N, Sakaguchi T, Samsonov V, Sano M, Sarsour M, Sawada S, Sedgwick K, Seidl R, Sen A, Seto R, Sharma D, Shein I, Shibata TA, Shigaki K, Shimomura M, Shoji K, Shukla P, Sickles A, Silva CL, Silvermyr D, Sim KS, Singh BK, Singh CP, Singh V, Slunečka M, Soltz RA, Sondheim WE, Sorensen SP, Soumya M, Sourikova IV, Stankus PW, Stenlund E, Stepanov M, Ster A, Stoll SP, Sugitate T, Sukhanov A, Sun J, Sziklai J, Takagui EM, Takahara A, Taketani A, Tanaka Y, Taneja S, Tanida K, Tannenbaum MJ, Tarafdar S, Taranenko A, Tennant E, Themann H, Todoroki T, Tomášek L, Tomášek M, Torii H, Towell RS, Tserruya I, Tsuchimoto Y, Tsuji T, Vale C, van Hecke HW, Vargyas M, Vazquez-Zambrano E, Veicht A, Velkovska J, Vértesi R, Virius M, Vossen A, Vrba V, Vznuzdaev E, Wang XR, Watanabe D, Watanabe K, Watanabe Y, Watanabe YS, Wei F, Wei R, White SN, Winter D, Wolin S, Woody CL, Wysocki M, Yamaguchi YL, Yang R, Yanovich A, Ying J, Yokkaichi S, You Z, Younus I, Yushmanov IE, Zajc WA, Zelenski A, Zolin L. Erratum: Evolution of π^{0} Suppression in Au+Au Collisions from sqrt[s_{NN}]=39 to 200 GeV [Phys. Rev. Lett. 109, 152301 (2012)]. Phys Rev Lett 2020; 125:049901. [PMID: 32794791 DOI: 10.1103/physrevlett.125.049901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Indexed: 06/11/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.109.152301.
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Eom BW, Kim CG, Kook MC, Yoon HM, Ryu KW, Kim YW, Rho JY, Kim YI, Lee JY, Choi IJ. Non-exposure Simple Suturing Endoscopic Full-thickness Resection with Sentinel Basin Dissection in Patients with Early Gastric Cancer: the SENORITA 3 Pilot Study. J Gastric Cancer 2020; 20:245-255. [PMID: 33024581 PMCID: PMC7521979 DOI: 10.5230/jgc.2020.20.e22] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/23/2020] [Accepted: 05/29/2020] [Indexed: 12/18/2022] Open
Abstract
Purpose Recently, non-exposure simple suturing endoscopic full-thickness resection (NESS-EFTR) was developed to prevent tumor exposure to the peritoneal cavity. This study aimed to evaluate the feasibility of NESS-EFTR with sentinel basin dissection for early gastric cancer (EGC). Materials and Methods This was the prospective SENORITA 3 pilot. From July 2017 to January 2018, 20 patients with EGC smaller than 3 cm without an absolute indication for endoscopic submucosal dissection were enrolled. The sentinel basin was detected using Tc99m-phytate and indocyanine green, and the NESS-EFTR procedure was performed when all sentinel basin nodes were tumor-free on frozen pathologic examination. We evaluated the complete resection and intraoperative perforation rates as well as the incidence of postoperative complications. Results Among the 20 enrolled patients, one dropped out due to large tumor size, while another underwent conventional laparoscopic gastrectomy due to metastatic sentinel lymph nodes. All NESS-EFTR procedures were performed in 17 of the 18 other patients (94.4%) without conversion, and the complete resection rate was 83.3% (15/18). The intraoperative perforation rate was 27.8% (5/18), and endoscopic clipping or laparoscopic suturing or stapling was performed at the perforation site. There was one case of postoperative complications treated with endoscopic clipping; the others were discharged without any event. Conclusions NESS-EFTR with sentinel basin dissection is a technically challenging procedure that obtains safe margins, prevents intraoperative perforation, and may be a treatment option for EGC after additional experience. Trial Registration ClinicalTrials.gov Identifier: NCT03216174
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Affiliation(s)
- Bang Wool Eom
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Chan Gyoo Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | | | - Hong Man Yoon
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Keun Won Ryu
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Young-Woo Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Ji Yoon Rho
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Young-Il Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Jong Yeul Lee
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
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Kim YI, Kook MC, Choi JE, Lee JY, Kim CG, Eom BW, Yoon HM, Ryu KW, Kim YW, Choi IJ. Evaluation of Submucosal or Lymphovascular Invasion Detection Rates in Early Gastric Cancer Based on Pathology Section Interval. J Gastric Cancer 2020; 20:165-175. [PMID: 32596000 PMCID: PMC7311219 DOI: 10.5230/jgc.2020.20.e14] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/14/2020] [Accepted: 03/19/2020] [Indexed: 12/15/2022] Open
Abstract
PURPOSE The guidelines for pathological evaluation of early gastric cancer (EGC) recommend wider section intervals for surgical specimens (5-7 mm) than those for endoscopically resected specimens (2-3 mm). Studies in surgically resected EGC specimens showed not negligible lymph node metastasis risks in EGCs meeting the expanded criteria for endoscopic submucosal dissection (ESD). MATERIALS AND METHODS This retrospective study included 401 EGC lesions with an endoscopic size of ≤ 30 mm detected in 386 patients. Pathological specimens obtained by ESD or surgery were cut into 2-mm section intervals for reference. Submucosal or lymphovascular invasion (LVI) was evaluated arbitrarily in 4- or 6-mm section intervals. McNemar's tests compared the differences between submucosal and LVI. RESULTS Submucosal invasion was detected in 29.2% (117/401) and LVI in 9.5% (38/401) at 2-mm interval. The submucosal invasion detection rates in 4-mm intervals decreased to 88.0% or 90.6% (both P<0.001), while the LVI detection rates decreased to 86.8% or 57.9% (P=0.025 and P<0.001, respectively). In 6-mm intervals, the submucosal and LVI detection rates decreased further to 72.7-80.3% (P<0.001 for all three sets) and 55.3-63.2% (P<0.001 for all three sets), respectively. Among 150 out-of-indication cases at 2-mm interval, 4-10 (2.7%-6.7%) at 4-mm intervals, and 10-17 (6.7%-11.3%) at 6-mm intervals were misclassified as lesions meeting the curative resection criteria due to the underestimation of submucosal or LVI. CONCLUSIONS After ESD, the 2-mm wide section interval was suitable for the pathological evaluation of focal submucosal or LVI. Thus, if an EGC lesion meets the expanded criteria for the ESD specimen pathological evaluation, it could be safely followed up.
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Affiliation(s)
- Young-Il Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | | | - Jee Eun Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Jong Yeul Lee
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Chan Gyoo Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Bang Wool Eom
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Hong Man Yoon
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Keun Won Ryu
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Young-Woo Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
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Kim YI, Choi IJ, Lee JY, Kim CG, Kim HK, Park YL. Comparison of the performance of risk scoring systems for tumor bleeding in patients with inoperable gastric cancer. Endoscopy 2020; 52:359-367. [PMID: 32097976 DOI: 10.1055/a-1114-6000] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The Glasgow - Blatchford bleeding score (GBS) and admission and full Rockall scores are widely used risk scoring systems to stratify risk and determine the need for intervention in patients with upper gastrointestinal bleeding. We evaluated the performance of these risk scoring systems in patients with gastric cancer and tumor bleeding. METHODS This retrospective study included patients with inoperable gastric cancer who presented with tumor bleeding at the National Cancer Center, Korea, between 2001 and 2015. The GBS, and admission and full Rockall scores were calculated. Primary outcome was the performance of the risk scoring systems in predicting the need for urgent interventions (endoscopic therapy, transarterial embolization, and surgery). The risk factors associated with urgent intervention were analyzed. RESULTS Of 357 patients with tumor bleeding, 118 (33.1 %; 116 endoscopic therapy, 2 trans-arterial embolization) required urgent intervention. The full Rockall score was better at predicting the need for urgent intervention (area under the receiver operating characteristic curve = 0.78; P < 0.001) than the GBS (0.56) and admission Rockall score (0.56). Hemostatic intervention was not performed in patients with a full Rockall score ≤ 6 (103 patients, 28.9 %). On multivariate analysis, endoscopic stigmata of recent hemorrhage of Forrest classes Ia - IIb were significant factors associated with urgent intervention. CONCLUSIONS The full Rockall score was superior to the GBS and admission Rockall score in predicting the need for urgent intervention for tumor bleeding. Thus, endoscopic evaluation is required to determine the need for urgent intervention in patients with gastric cancer and tumor bleeding.
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Affiliation(s)
- Young-Il Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Jong Yeul Lee
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Chan Gyoo Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Hark Kyun Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Young Lee Park
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
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Gunathilake M, Lee J, Choi IJ, Kim YI, Kim J. Identification of Dietary Pattern Networks Associated with Gastric Cancer Using Gaussian Graphical Models: A Case-Control Study. Cancers (Basel) 2020; 12:E1044. [PMID: 32340406 PMCID: PMC7226381 DOI: 10.3390/cancers12041044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/18/2020] [Accepted: 04/21/2020] [Indexed: 12/24/2022] Open
Abstract
Gaussian graphical models (GGMs) are novel approaches to deriving dietary patterns that assess how foods are consumed in relation to one another. We aimed to apply GGMs to identify dietary patterns and to investigate the associations between dietary patterns and gastric cancer (GC) risk in a Korean population. In this case-control study of 415 GC cases and 830 controls, food intake was assessed using a 106-item semiquantitative food frequency questionnaire that captured 33 food groups. The dietary pattern networks corresponding to the total population contained a main network and four subnetworks. For the vegetable and seafood network, those who were in the highest tertile of the network-specific score showed a significantly reduced risk of GC both in the total population (OR = 0.66, 95% CI = 0.47-0.93, p for trend = 0.018) and in males (OR = 0.55, 95% CI = 0.34-0.89, p for trend = 0.012). Most importantly, the fruit pattern network was inversely associated with the risk of GC for the highest tertile (OR = 0.56, 95% CI = 0.38-0.81, p for trend = 0.002). The identified vegetable and seafood network and the fruit network showed a protective effect against GC development in Koreans.
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Affiliation(s)
- Madhawa Gunathilake
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, Goyang-si 10408, Gyeonggi-do, Korea;
| | - Jeonghee Lee
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, Goyang-si 10408, Gyeonggi-do, Korea;
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center Hospital, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea; (I.J.C.); (Y.-I.K.)
| | - Young-Il Kim
- Center for Gastric Cancer, National Cancer Center Hospital, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea; (I.J.C.); (Y.-I.K.)
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, Goyang-si 10408, Gyeonggi-do, Korea;
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Kim BJ, Lee H, Lee YC, Jeon SW, Kim GH, Kim HS, Sung JK, Lee DH, Kim HU, Park MI, Choi IJ, Yoon SM, Kim SW, Baik GH, Lee JY, Kim JI, Kim SG, Kim J, Lee J, Kim JG, Kim JJ. Ten-Day Concomitant, 10-Day Sequential, and 7-Day Triple Therapy as First-Line Treatment for Helicobacter pylori Infection: A Nationwide Randomized Trial in Korea. Gut Liver 2020; 13:531-540. [PMID: 31505907 PMCID: PMC6743805 DOI: 10.5009/gnl19136] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/10/2019] [Accepted: 07/19/2019] [Indexed: 12/11/2022] Open
Abstract
Background/Aims This nationwide, multicenter prospective randomized controlled trial aimed to compare the efficacy and safety of 10-day concomitant therapy (CT) and 10-day sequential therapy (ST) with 7-day clarithromycin-containing triple therapy (TT) as first-line treatment for Helicobacter pylori infection in the Korean population. Methods Patients with H. pylori infection were assigned randomly to 7d-TT (lansoprazole 30 mg, amoxicillin 1 g, and clarithromycin 500 mg twice daily for 7 days), 10d-ST (lansoprazole 30 mg and amoxicillin 1 g twice daily for the first 5 days, followed by lansoprazole 30 mg, clarithromycin 500 mg, and metronidazole 500 mg twice daily for the remaining 5 days), or 10d-CT (lansoprazole 30 mg, amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg twice daily for 10 days). The primary endpoint was eradication rate by intention-to-treat (ITT) and per-protocol (PP) analyses. Results A total of 1,141 patients were included. The 10d-CT protocol achieved a markedly higher eradication rate than the 7d-TT protocol in both the ITT (81.2% vs 63.9%) and PP analyses (90.6% vs 71.4%). The eradication rate of the 10d-ST protocol was superior to that of the 7d-TT protocol (76.3% vs 63.9%, ITT analysis; 85.0% vs 71.4%, PP analysis). No significant differences in adherence or serious side effects were found among the three treatment arms. Conclusions The 10d-CT and 10d-ST regimens were superior to the 7d-TT regimen as standard first-line treatment in Korea.
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Affiliation(s)
- Beom Jin Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hyuk Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong Chan Lee
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seong Woo Jeon
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Gwang Ha Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Hyun-Soo Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jae Kyu Sung
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Heung Up Kim
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, Korea
| | - Soon Man Yoon
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Sang Wook Kim
- Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
| | - Gwang Ho Baik
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Ju Yup Lee
- Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Jin Il Kim
- Department of Internal Medicine, Yeouido St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang Gyun Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jayoun Kim
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Joongyup Lee
- Department of Prevention and Management, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Jae Gyu Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jae J Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Abstract
BACKGROUND Helicobacter pylori infection and a family history of gastric cancer are the main risk factors for gastric cancer. Whether treatment to eradicate H. pylori can reduce the risk of gastric cancer in persons with a family history of gastric cancer in first-degree relatives is unknown. METHODS In this single-center, double-blind, placebo-controlled trial, we screened 3100 first-degree relatives of patients with gastric cancer. We randomly assigned 1838 participants with H. pylori infection to receive either eradication therapy (lansoprazole [30 mg], amoxicillin [1000 mg], and clarithromycin [500 mg], each taken twice daily for 7 days) or placebo. The primary outcome was development of gastric cancer. A prespecified secondary outcome was development of gastric cancer according to H. pylori eradication status, assessed during the follow-up period. RESULTS A total of 1676 participants were included in the modified intention-to-treat population for the analysis of the primary outcome (832 in the treatment group and 844 in the placebo group). During a median follow-up of 9.2 years, gastric cancer developed in 10 participants (1.2%) in the treatment group and in 23 (2.7%) in the placebo group (hazard ratio, 0.45; 95% confidence interval [CI], 0.21 to 0.94; P = 0.03 by log-rank test). Among the 10 participants in the treatment group in whom gastric cancer developed, 5 (50.0%) had persistent H. pylori infection. Gastric cancer developed in 0.8% of participants (5 of 608) in whom H. pylori infection was eradicated and in 2.9% of participants (28 of 979) who had persistent infection (hazard ratio, 0.27; 95% CI, 0.10 to 0.70). Adverse events were mild and were more common in the treatment group than in the placebo group (53.0% vs. 19.1%; P<0.001). CONCLUSIONS Among persons with H. pylori infection who had a family history of gastric cancer in first-degree relatives, H. pylori eradication treatment reduced the risk of gastric cancer. (Funded by the National Cancer Center, South Korea; ClinicalTrials.gov number, NCT01678027.).
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Affiliation(s)
- Il Ju Choi
- From the Center for Gastric Cancer (I.J.C., C.G.K., J.Y.L., Y.-I.K., M.-C.K.), the Division of Cancer Epidemiology and Management, Research Institute (I.J.C., Y.-I.K., B.P., J.J.), and the Biostatistics Collaboration Team, Research Core Center, Research Institute (B.P.) - all at the National Cancer Center, Goyang, South Korea
| | - Chan Gyoo Kim
- From the Center for Gastric Cancer (I.J.C., C.G.K., J.Y.L., Y.-I.K., M.-C.K.), the Division of Cancer Epidemiology and Management, Research Institute (I.J.C., Y.-I.K., B.P., J.J.), and the Biostatistics Collaboration Team, Research Core Center, Research Institute (B.P.) - all at the National Cancer Center, Goyang, South Korea
| | - Jong Yeul Lee
- From the Center for Gastric Cancer (I.J.C., C.G.K., J.Y.L., Y.-I.K., M.-C.K.), the Division of Cancer Epidemiology and Management, Research Institute (I.J.C., Y.-I.K., B.P., J.J.), and the Biostatistics Collaboration Team, Research Core Center, Research Institute (B.P.) - all at the National Cancer Center, Goyang, South Korea
| | - Young-Il Kim
- From the Center for Gastric Cancer (I.J.C., C.G.K., J.Y.L., Y.-I.K., M.-C.K.), the Division of Cancer Epidemiology and Management, Research Institute (I.J.C., Y.-I.K., B.P., J.J.), and the Biostatistics Collaboration Team, Research Core Center, Research Institute (B.P.) - all at the National Cancer Center, Goyang, South Korea
| | - Myeong-Cherl Kook
- From the Center for Gastric Cancer (I.J.C., C.G.K., J.Y.L., Y.-I.K., M.-C.K.), the Division of Cancer Epidemiology and Management, Research Institute (I.J.C., Y.-I.K., B.P., J.J.), and the Biostatistics Collaboration Team, Research Core Center, Research Institute (B.P.) - all at the National Cancer Center, Goyang, South Korea
| | - Boram Park
- From the Center for Gastric Cancer (I.J.C., C.G.K., J.Y.L., Y.-I.K., M.-C.K.), the Division of Cancer Epidemiology and Management, Research Institute (I.J.C., Y.-I.K., B.P., J.J.), and the Biostatistics Collaboration Team, Research Core Center, Research Institute (B.P.) - all at the National Cancer Center, Goyang, South Korea
| | - Jungnam Joo
- From the Center for Gastric Cancer (I.J.C., C.G.K., J.Y.L., Y.-I.K., M.-C.K.), the Division of Cancer Epidemiology and Management, Research Institute (I.J.C., Y.-I.K., B.P., J.J.), and the Biostatistics Collaboration Team, Research Core Center, Research Institute (B.P.) - all at the National Cancer Center, Goyang, South Korea
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Ma DW, Lee SJ, Kook MC, Park DY, Ahn S, Ryu KW, Choi IJ, Noh SH, Kim H, Lee YC, Kim JH. The Suggestion of Revised Criteria for Endoscopic Resection of Differentiated-Type Submucosal Gastric Cancer. Ann Surg Oncol 2019; 27:795-801. [PMID: 31828690 DOI: 10.1245/s10434-019-08102-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND Early gastric cancer that meets the expanded criteria for endoscopic resection (ER) is expected to be associated with a negligible risk for lymph node metastasis (LNM); however, recent studies have reported LNM in submucosal gastric cancer patients who met the existing criteria. In this study, we develop the revised criteria for ER of submucosal gastric cancer with the aim of minimizing LNM. METHODS We analyzed the clinicopathological data of 2461 patients diagnosed with differentiated, submucosal gastric cancer who underwent surgery at three tertiary hospitals between March 2001 and December 2012, and re-analyzed the pathological slides of all patients. The depth of submucosal invasion was measured histopathologically in two different ways (the classic and alternative methods) to obtain accurate data. RESULTS Of the enrolled subjects, 306 (17.0%) had LNM. The width of submucosal invasion correlated well with the LNM. We defined the depth and width of submucosal infiltration associated with the lowest incidence of LNM. None of the 254 subjects developed LNM when the following criteria were met: tumor diameter ≤ 3 cm, submucosal invasion depth < 1000 μm (as measured using the alternative method), submucosal invasion width < 4 mm, no lymphovascular invasion, and no perineural invasion; however, LNM was observed in 2.7% of subjects (6/218) who met the existing criteria. CONCLUSIONS We revised the criteria for ER by adopting the alternative method to measure the depth of submucosal invasion and adding the width of such invasion. Our criteria better predicted LNM than the current criteria used to select ER to treat submucosal gastric cancer.
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Affiliation(s)
- Dae Won Ma
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Joo Lee
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Myeong-Cherl Kook
- Department of Pathology, Center for Gastric Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
| | - Do Youn Park
- Department of Pathology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.,St. Maria Pathology Laboratory, Busan, Korea
| | - Sangjeong Ahn
- Department of Pathology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.,Department of Pathology, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Inchon, Korea
| | - Keun Won Ryu
- Department of Surgery, Center for Gastric Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
| | - Il Ju Choi
- Department of Internal Medicine, Center for Gastric Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
| | - Sung Hoon Noh
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyunki Kim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
| | - Yong Chan Lee
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jie-Hyun Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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