Sang Young Roh

Prognostic significance of CD44s expression in resected non-small cell lung cancer.

BackgroundCD44s is a cell adhesion molecule known to mediate cellular adhesion to the extracellular matrix, a prerequisite for tumor cell migration. CD44s plays an important role in invasion and metastasis of various cancers. In the present study, we sought to determine whether CD44s is involved in clinical outcomes of patients with resected non-small cell lung cancer (NSCLC).MethodsUsing immunohistochemical staining, we investigated CD44s protein expression using tissue array specimens from 159 patients with resected NSCLC (adenocarcinoma (AC; n = 82) and squamous cell carcinoma (SCC; n = 77). Additionally, the immunoreactivity of cyclooxygenase (COX)-2 was also studied. The clinicopathological implications of these molecules were analyzed statistically.ResultsHigh CD44s expression was detected more frequently in NSCLC patients with SCC (66/72; 91.7%) than in those with AC histology (P < 0.001). Additionally, high CD44s expression was significant correlated with more advanced regional lymph node metastasis (P = 0.021). In multivariate analysis of survival in NSCLC patients with AC histology, significant predictors were lymph node metastasis status (P < 0.001), high-grade tumor differentiation (P = 0.046), and high CD44s expression (P = 0.014). For NSCLC patients with SCC histology, the significant predictor was a more advanced tumor stage (P = 0.015). No significant association was found between CD44s and clinical outcome (P = 0.311).ConclusionsHigh CD44s expression was a negative prognostic marker with significance in patients with resected NSCLC, particularly those with AC histology, and was independent of tumor stage.

Clinical characteristics and prognostic factors for primary appendiceal carcinoma.

Aim:  Primary adenocarcinoma of the appendix is a rare malignancy. This study assessed prognostic factors affecting the clinical outcome in patients with appendiceal neoplasms.

Clinical Characteristics of Primary Peritoneal Carcinoma

PURPOSE The goal of this study was to determine the clinical and therapeutic characteristics of women with a primary peritoneal carcinoma (PPC). MATERIALS AND METHODS A retrospective clinical study was conducted to evaluate 22 women diagnosed with a PPC from 1993 to 2007 at the Hospitals of The Catholic University of Korea. Diagnoses were based on the Gynecologic Oncology Group criteria and clinical data. We collected patient clinicopathological data including age, presenting symptoms, pretreatment CA-125 values (U/ml), clinical stage (based on the FIGO stage), performance status (using the Eastern Cooperative Oncology Group scale), whether cytoreductive surgery was optimal or not, types of chemotherapy and response to treatment. We evaluated the clinical characteristics and response to treatment, time to treatment failure and overall survival. RESULTS The median overall survival of all patients was 23.1 months. The estimated 3-year survival rate was 29% (SE, 13%). The response rate to first-line platinum-based chemotherapy was 79% and the median time to treatment failure was 9.9 months (95% confidence interval, 1.38~18.4 months). By univariate and multivariate analysis, performance status was the only significant factor associated with overall survival (p<0.05). CONCLUSION We evaluated the clinical characteristics and treatment response of patients with a primary peritoneal carcinoma. Our results showed that it is possible to achieve long-term survival in patients with PPC. A further clinical study is to need to establish clinical characteristics and treatment outcomes.

Increased Prevalence of Colorectal Neoplasia in Korean Patients with Sporadic Duodenal Adenomas: A Case-Control Study

Background/Aims Recent data from Western populations have suggested that patients with sporadic duodenal adenomas are at a higher risk for the development of colorectal neoplasia. In this study, we compared the frequency of colorectal neoplasia in patients with sporadic duodenal adenomas to healthy control subjects. Methods This retrospective case-control study used the databases of 3 teaching hospitals in Gyeonggi-do Province, South Korea. The colonoscopy findings of patients with sporadic duodenal adenomas were compared with those of age- and gender-matched healthy individuals who had undergone gastroduodenoscopies and colonoscopies during general screening examinations. Results Between 2001 and 2008, 45 patients were diagnosed endoscopically with sporadic duodenal adenomas; 26 (58%) of these patients received colonoscopies. Colorectal neoplasia (42% vs 21%; odds ratio [OR], 2.8; 95% confidence interval [CI], 1.1 to 7.4) and advanced colorectal adenoma (19% vs 3%; OR, 9.0; 95% CI, 1.6 to 50.0) were significantly more common in patients with sporadic duodenal adenomas than in healthy control subjects. Conclusions Compared with healthy individuals, patients with sporadic duodenal adenomas were at a significantly higher risk for developing colorectal neoplasia. Such at-risk patients should undergo routine screening colonoscopies.

Abstract B41: Different clinical outcomes of systemic chemotherapy in non-small cell lung cancer without EGFR and K-ras mutation according to smoking status.

Background: The current treatment strategy in non-small cell lung cancer (NSCLC) adenocarcinoma without epidermal growth factor receptor (EGFR) activating mutation or anaplastic large cell kinase gene (ALK) rearrangement does not differentiate between genotype or smoking status even though resent advances in molecular study in NSCLC. In terms of second line treatment, pemetrexed is considered as a standard treatment in non-squamous NSCLC without EGFR activating mutation or ALK rearrangement. We retrospectively analyzed clinical outcomes of systemic chemotherapy according to molecular characteristics. Methods: Between 2006 and 2012, 131 patients with stage 4 NSCLC adenocarcinoma patients who were enrolled in a Seoul St. Marys hospital lung cancer multidisciplinary center registry were available for molecular pathology regarding EGFR and v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation status. Mutations in EGFR (exons 18 to 21) and KRAS (codons 12 and 13) were determined by direct sequencing. Results: Among 131 patients, the frequency of EGFR mutations, KRAS mutations, and no mutations in both genes (double negative [DN]) was 28.2%, 5.3% and 66.4% respectively. Among the DN genotype, 47.1%were never smoker and 37.9% were female. The median progression free survival (PFS) with 1st line platinum based combination chemotherapy was 5.4 months (95% CI: 3.7-7.02) for DN genotype and 7.4 months (95% CI: 5.73-9.06) for EGFR mutation group (p=0.047). According to smoking status, the median PFS with 1st line platinum based combination chemotherapy for never smokers in EGFR mutation group was significantly longer than the DN group (DN-N) (8.4 vs 6.7 months: p=0.018). However among the smokers, no significant difference in median PFS with 1st line chemotherapy between EGFR mutation and DN group (DN-S) were found (6.7 vs 4.6 months: p=0.515). In terms of second line treatment except EGFR tyrosine kinase inhibitors (EGFR-TKI), 64% of DN group and 70.3% of EGFR mutation group received pemetrexed, 21% of DN group and 29.7% of EGFR mutation group received docetaxel. 15.1% of DN group received EGFR-TKIs. The median PFS with second line treatment in DN-N group was 7.7 months (95% CI: 2.1-18.9), 3.1 months (95% CI: 1.4-4.8) and 4.4 months (95% CI: 2.2-6.5) for pemetrexed, docetaxel and EGFR-TKI respectively (p=0.009). However, no significant differences in median PFS between second line treatments was found in DN-S group [3.0 vs 2.8 vs 1.7 months for pemetrexed, docetaxel and EGFR-TKI respectively (p=0.100)]. In EGFR mutation group, no significant difference between pemetrexed and docetaxel was found according to the smoking status. Conclusions: NSCLC without EGFR and K-ras mutation (DN group) had different clinical outcomes according to smoking history. Smoking history could be a useful clinical marker to choose a second-line treatment. However, further genomic study to find a druggable target in this group should be conducted. Citation Information: Mol Cancer Ther 2013;12(11 Suppl):B41. Citation Format: Sook Hee Hong, JinHyoung Kang, Eun kyung Jeon, Seung Joon Kim, Kyo-Young Lee, Sang young Roh. Different clinical outcomes of systemic chemotherapy in non-small cell lung cancer without EGFR and K-ras mutation according to smoking status. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr B41.

Resting palliative chemotherapy in patients with gastric cancer.

122 Background: In gastric cancer, platinum and fluorouracil combination chemotherapy (CTx) is commonly used. But the optimal duration of CTx in palliative setting is not known. Thus, we reviewed the pts who rested CTx despite of persistent disease control. Methods: From Mar 2007 to Feb 2012 at Seoul St. Mary’s hospital, we retrospectively reviewed pts as follows; (1) had metastatic or recurrent gastric cancer, (2) received 9 cycles of FOLFOX as 1st-line, (3) had no progressive disease (PD) and rested after completion of 9th cycle. Results: Total 25 pts were reviewed. Median age was 54 (36~77) and 15 pts (60%) were male. 13 pts (52%) had recurrent disease and 12 metastatic initially. All pts were treated with oxaliplatin 100 mg/m2, leucovorin 400 mg/m2 on day 1 and 5-FU 1200 mg/m2 on day 1-2 every 2 weeks. All pts had metastasis; carcinomatosis peritonei (CP, 56%), lymph node (36%), liver (20%) and bone (8%). Nine pts (48%) had non-measurable lesions and 3 no evidence of disease (NED) on CT after palliati...