Axillary Lymph Node Dissection Does Not Improve Post-mastectomy Overall or Disease-Free Survival among Breast Cancer Patients with 1-3 Positive Nodes / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Axillary lymph node dissection (ALND) may be avoidable for breast cancer patients with 1-2 positive lymph nodes (LN) after breast-conserving therapy. However, the effects of ALND after mastectomy remain unclear because radiation is not routinely used. Herein, we compared the benefits of post-mastectomy ALND versus sentinel node biopsy (SNB) alone for breast cancer patients with 1-3 metastatic LNs. MATERIALS AND METHODS: A total of 1,697 patients with pN1 disease who underwent mastectomy during 2000-2015 were identified from an institutional database. Outcomes were compared using the inverse probability of treatment weighted method. RESULTS: Patients who underwent SNB tended to have smaller tumors, a lower histology grade, a lower number of positive LNs, and better immunohistochemical findings. After correcting all confounding factors regarding patient, tumor, and adjuvant treatment, the SNB and ALND groups did not differ in terms of overall survival (OS) and disease-free survival (DFS), distant metastasis and locoregional recurrence. The 10-year DFS and OS rates were 83% and 84%, respectively, during a median follow-up period of 93 months. CONCLUSION: ALND did not improve post-mastectomy survival outcomes among patients with N1 breast cancer, even after adjusting for all histopathologic and treatment-related factors.

Clinical Efficacy of Combination Chemotherapy with Ifosfamide Cisplatin, and Etoposide(ICE) in Advanced Non-Small Cell Lung Cancer / 결핵

BACKGROUND: To evaluate the efficacy and toxicity of combination chemotherapy using ifosfamide, cisplatin, and etoposide in patients with advanced non-small cell lung cancer(NSCLC). MATERIALS AND METHODS: Thirty-three patients with inoperable NSCLC(stage III b+IV) who had measurable diseases, and had not been treated with chemotherapeutic drugs, were enrolled in this study(from March 1995 to December 1996). The patients received ifosfamide(1500mg/m2/day, a full drop with Mesna on days 1-5), Cisplatin (80mg/m2/day infusion with a hydration on day 2), and Etoposide (100mg/m2/day infusion for 2 hours on days 1-3). The treatment was repeated every 4 weeks. RESULTS: Ten patients showed a partial responses (30.3%). The overall survival time of the responders was longer than that of the non-responders (median 55 vs 22 weeks, p=0.01). The toxicities of this treatment were tolerable. Grade 3 or 4 leukopenia was observed in 21%. There was 1 death related to febrile neutropenia. The non-hematologic toxicity was mild. The relative dose intensity given to the patients was 0.86 ifosfamide, 0.87 cisplatin, and 0.89 etoposide, showing an average dose intensity of 0.87. CONCLUSIONS: A combination regimen of ifosfamide, cisplatin, and etoposide is effective and tolerable for treating advanced non-small cell lung cancer.

Resting Energy Expenditure in Patients with Lung Cancer / 결핵

BACKGROUND: Elevation of resting energy expenditure(REE) in patients with lung cancer has been described in earlier studies and may contribute to cancer cachexia, but limited information is available regarding the prevalence and determinants of the increased REE. The aim of this study was to assess the prevalence and contributing factors of a hypermetabolic state in newly detected patients with lung cancer and to assess the energy balance in order to improve our knowledge about weight loss in patients with lung cancer. METHODS: Thirty one consecutive, newly detected patients with lung cancer and 20 control patients with benign lung diseases were included in this study. Resting energy expenditure(REE) was measured by indirect calorimetry using ventilated hood system and predicted REE was calculated by the Harris-Benedict formular. RESULTS: The energy balance in newly detected lung cancer patients was disturbed in a high proportion of patients, and hypermetabolic state occurred in 61% of the patients. Tumor volume, cancer type, location, stage, the presence of atelectasis or infiltration, pulmonary fuction, or smoking behavior were not associated with increase in REE. But patients with distant metastasis had significantly higher REE comparing with patients without metastasis. Thirty nine percents of the patients with lung cancer had substantial loss of more than 10% of their pre-illness weight. Weight losing patients with lung cancer were not accompanied by an increase in REE. CONCLUSION: We concluded that the REE was elevated in a higher proportion of patients with lung cancer and distant metastasis was found to be contributing factor to the elevated REF.

Two Cases of Adenoid Cystic Carcinoma of the Left Main Bronchus and Trachea / 영남의대학술지

Adenoid cystic carcinoma is an uncommon histologic variant of adenocarcinoma which usuallyy arises from the salivary, lacrimal, or other exocrine glands. Characteristics of adenoid cystic carcinoma are its potential fo extending long distance submucosally and for perineural invasion. It grows slowly and may have a prolongec course before diagnosis and after treatment. Recently, we have experienced 2 cases of adenoid cystic carcinoma arising from main bronchus and trachea. One case was 58 years old female patient. Her symptoms were productive cough with dyspnea. She ha been history of shortness of breath, wheezing and cough during 4 years, which was initially diagnosed a bronchial asthma. The tumor was located on the left main stem bronchus which was obstructed the lumei nearly complete, by CT demonstration.

Reverse Doming of Anterior Mitral Leaflet with Aortic Regurgitation

The reverse doming of the anterior mitral leaflet by two-dimensional echocardiography was shown in 39 patients(83%) among 47 patients with aortic regurgitation. The reverse doming was noted in 21(80%) of 26 patients with mild AR and in 15(83%) of 18 patients with moderate AR and in all(100%) of 3 patients with severe AR. Thus observing the reverse doming of the anterior mitral leaflet by two-dimensional echocardiography may be an important auxiliary diagnostic aid in conjunction with well known other echocardiographic findings.