Lymphovascular Invasion and HER2/neu Amplification as Predictive Factors for Axillary Lymph Node Metastasis in Early Breast Cancer Patients / 한국유방암학회지

PURPOSE: Axillary lymph node metastasis (ALNM) can occur even in breast cancer smaller than 2 cm in size. This study was performed to investigate the clinicopathologic factors that affect node metastasis in T1 breast cancer. METHODS: We reviewed the medical record of 206 T1 breast cancer patients and we divided them into two groups according to the presence or absence of lymph node metastasis. We analyzed the association between ALNM and various clinicopathological predictive factors such as age, tumor size (T1a, T1b, T1c), multiplicity, the histologic grade, the nuclear grade, the presence of lymphovascular invasion (LVI), the estrogen and progesterone receptor status, an HER2/neu expression, the Ki-67 labeling index and the bcl-2 expression. RESULTS: One hundred and thirty-nine were the node negative group (T1N0) and the remaining 67 cases were allotted to the node positive group (T1N1-3). On the univariate analysis, age (p=0.011), LVI (p<0.001), histologic grade (p=0.019), HER2/neu (p<0.005), Ki-67 (p=0.012) and bcl-2 (p=0.026) were the statistically significant predictive factors related to node metastasis. But on the multivariate analysis, LVI (p<0.001) and HER2/neu (p=0.009) were the statistically significant factors related to node metastasis. CONCLUSION: LVI and HER2/neu overexpression were related to the increased incidence of ALNM in T1 breast cancer patients. LVI was the most predictive factor of ALNM.

Survival Rate and Prognostic Factors in Perforated Colorectal Cancer Patients: A Case-Control Study

PURPOSE: Perforations are rare but serious complications in colorectal cancer. Controversy exists over whether to perform a radical operation because colorectal cancer perforation is considered as an advanced stage disease, and septic complications of peritonitis have been identified as being responsible for a poor prognosis. The aim of this study was to assess the correlation between the survival rate and the clinicopathological parameters that might be used as predictive factors of the prognosis for perforated colorectal cancer. METHODS: The analysis was based on 24 cases of perforated colorectal cancer (the case group), 48 cases of matching uncomplicated colorectal cancer (the control group), and 72 cases of the case and the control groups combined together (the combined group), all of which were identified during a 10-yr period in a single institution. RESULTS: The five-year survival rates of the perforated colorectal cancer patients and their matching controls were similar (P=0.484). No significant differences in the locations of the cancer, the pre-operative carcinoembryonic antigen (CEA) levels, the tumor sizes, the resection margins, or the numbers of the lymph nodes harvested were found between the two groups. A univariate analysis of the prognostic factors that influenced the case group revealed that adjuvant chemotherapy (P=0.004) was significantly correlated to a better five-year survival rate. A univariate analysis of the prognostic factors that influenced the five-year survival rate of the combined group revealed that the stage (P<0.001), the pre-op CEA level (P=0.018), the angio invasion (P=0.019), the perineural invasion (P=0.019), the number of harvested lymph nodes (P=0.004), and adjuvant chemotherapy (P=0.001) were significantly correlated to the five-year survival rate. The identified independent prognostic factors in the combined group were the stage (hazard ratio, 5.20), angio-invasion (hazard ratio, 2.81), and adjuvant chemotherapy (hazard ratio, 0.17). CONCLUSION: The clinical pathway of perforated colorectal cancer is similar to that of uncomplicated colorectal cancer. Therefore, perforated colorectal cancer patients should be recommended for treatment with the appropriate radical operation and adjuvant chemotherapy based on oncologic principles.

Analysis of Factors Affecting Local Recurrences after Thyroid Surgery in Low Risk Papillary Thyroid Carcinomas / 대한내분비외과학회지

PURPOSE: This study analyzed factors affecting local recurrences in AGES low risk papillary thyroid carcinomas (PTCs). METHODS: The clinical records of 89 patients who underwent thyroidectomy because of PTC were reviewed. Seventy patients had belonged to low risk PTC according to the AGES classification scheme. The clinical data of these patients concerning disease recurrence was analyzed considering age, gender, operative methods, tumor size, lymph node (LN) metastasis, postoperative radioactive iodine scan (RI scan ¹³¹I), and Synthyroid® intake. RESULTS: Of the 70 patients, 56 were female (80%). Thirtyseven patients underwent total thyroidectomy with central neck LN dissection and 33 patients underwent partial thyroidectomy with ipsilateral central neck LN dissection. Mean tumor size was 2 cm (0.4~6 cm) and 31 patients had LN metastasis. Levels were 2 cm (P=0.030) and partial thyroidectomy (P=0.045). There was no significant association between local recurrence and age, gender, extrathyroidal extension, LN metastasis, RI scan ¹³¹I, or Synthyroid® intake. CONCLUSION: Partial thyroidectomy and tumor size >2 cm are significantly associated with local recurrence in AGES low risk papillary thyroid carcinomas.