A meta‑analysis of erlotinib versus docetaxel for advanced nonsmall‑cell lung cancer with poor prognosis.

BACKGROUND: The extent of the benefit of erlotinib in the treatment of advanced nonsmall‑cell lung cancer (NSCLC) is still controversial when compared with docetaxel. This meta‑analysis was performed to compare the efficacy of erlotinib with docetaxel for different patients with advanced NSCLC. MATERIALS AND METHODS: We searched Cochrane Library, PubMed, CNKI, and identified 23 randomized controlled clinical trials from 2008 to 2015. According to our further full‑text screening, 6 clinical trials were included in the final meta‑analysis. RESULTS: Six papers were included in this study. The progression‑free survival (PFS), overall survival (OS), objective response rate (ORR), and toxicity were included in our outcomes. The pooled hazard ratio (HR) of PFS was 1.57 (95% confidential index [CI] = 1.47–1.69). The pooled HR of OS was 1.66 (95% CI = 1.43–1.92). The pooled risk ratio of ORR was 0.56 (95% CI = 0.35–0.91). The toxicity analysis showed odds ratio = 1.79 (95% CI = 1.20–2.69). CONCLUSIONS: In terms of PFS, OS, and toxicity the effect of erlotinib in the treatment of advanced NSCLC patients is superior to docetaxel.

Prognostic Factors of Stage II Rectal Cancer / 대한소화기학회지

BACKGROUND/AIMS: We aimed to verify the prognostic factors of stage II rectal cancer and the effect of radiation therapy on the survival and local recurrence rate. METHODS: This study was undertaken in 202 patients who underwent curative resection of rectal cancer and confirmed to be stage II between July 1989 and December 1996. Univariate and multivariate (Cox's model) analyses of survival were employed to identify prognostic factors. Statistical significance was assigned by p value of <0.05. RESULTS: Overall recurrence occurred in 32 patients. Four patterns of recurrence were observed: hematogenous recurrence in 17 patients, local recurrence in 11, peritoneal seeding in two and simultaneous hematogenous and local recurrence in two cases. Overall 5-year survival rate was 85.6% and 5 year disease free survival rate was 82.8%. There was no significant difference in local recurrence rate and survival according to radiation therapy or location of cancer. In multivariate analysis, the number of harvested lymph node was only a prognostic factor. CONCLUSIONS: The number of harvested lymph nodes has prognostic value in stage II rectal cancer. Postoperative radiation therapy should be considered for stage II rectal cancer with poor prognostic factors although radiation did not decrease local recurrence rate in present study.

Clinical Features and Prognostic Factors in Primary Adenocarcinoma of the Appendix / 대한소화기학회지

BACKGROUND/AIMS: Primary appendiceal adenocarcinoma is a rare neoplasm that constitutes less than 0.5% of all gastrointestinal neoplasm. The aim of this study was to figure out its clinicopathologic characteristics that are not well understood. METHODS: We reviewed the medical records of nineteen patients (9 males and 10 females) with histologically proven appendiceal adenocarcinoma. They had been treated at Asan Medical Center between June 1989 and December 2002. Their median follow-up duration was 72.5 months. RESULTS: Their median age was 56.5 (range, 33~80) years. Thirteen patients had mucinous variants and the other five had adenocarcinoma. Seven patients (36.8%) were diagnosed as acute appendicitis. In fact, none of the patients was diagnosed correctly before surgery. The operative procedure, included right hemicolectomy in 9 patients, appendectomy alone in 2 patients, and debulking of their tumors or a biopsy in 8 patients. The 5-year survival rate was 20.5%. The patients with mucinous type had better prognosis than those with the non-mucinous type (p<0.01). In the patients with mucinous type, the survival rate after debulking operation was similar to that after right hemicolectomy. CONCLUSIONS: The most important prognostic factor of primary appendiceal adenocarcinoma was histology. The outcome of debulking operation is being watched compared with that of right hemicolectomy in mucinous variant.

Clinicopathological Correlation of hMLH1 and hMSH2 Protein Expressions in Stage III Colon Cancer

PURPOSE: Functional loss of mismatch repair has been reported to be the reason for resistance to several chemotherapeutic drugs. The expressions of hMLH1 and hMSH2 were examined to assess whether they correlated with the biological behavior and the chemotherapeutic responsiveness in paflents with sporadic colon cancers. METHODS: Ninety-one patients with stage III primary colon cancer were included from the tumor registry of the Asan Medical Center, Seoul, Korea. All patients underwent a curative operation and postoperative chemotherapy with 5- fluorouracil and leucovorin for 6 cycles between 1993 and 1997. Immunohistochemical staining for hMLH1 and hMSH2 was performed using archival paraffin blocks. A positive expression was determined when unequivocal nuclear staining was identified in more than 10% of the cancer cells. The survival and the clinicopathologic variables regarding hMLH1 and hMSH2 expressions were assessed using the log-rank test and the Cox proportional regression method. RESULTS: Either hMLH1 or hMSH2 expression was lost in nine cases (9.9%). hMLH1 and hMSH2 expressions were significantly correlated with tumor invasion (P=0.012) and tumor differentiation (P=0.017). The disease-free survival did not differ with respect to hMLH1 and hMSH2 expressions. The number of metastatic lymph nodes and the preoperative serum CEA level were independent predictors of disease-free survival on a multivariate analysis. CONCLUSIONS: The loss of hMLH1 or hMSH2 expresscon appears to be involved in the differentiation of and the invasion by colon cancer. However, nether hMLH1 nor hMSH2 expression was correlated withthe 5-fluorouracil responsiveness.