Su-Jung Kim

Biological characteristics and treatment outcomes of metastatic or recurrent neuroendocrine tumors: tumor grade and metastatic site are important for treatment strategy

BackgroundStudies about the biology, treatment pattern, and treatment outcome of metastatic/recurrent neuroendocrine tumor (NET) have been few.MethodsWe enrolled patients with metastatic/recurrent NET diagnosed between January 1996 and July 2007 and retrospectively analyzed.ResultsA total of 103 patients were evaluated. Twenty-six patients (25.2%) had pancreatic NET, 27 (26.2%) had gastrointestinal NET, 2 (1.9%) had lung NET, 28 (27.2%) had NET from other sites, and 20 (19.4%) had NET from unknown origin. The liver was the most common metastatic site (68.9%). Thirty-four patients had grade 1 disease, 1 (1.0%) had grade 2 disease, 15 (14.6%) had grade 3 disease, 9 (8.7%) had large cell disease, and 7 (6.8%) had small cell disease.Sixty-six patients received systemic treatment (interferon, somatostatin analogues or chemotherapy), 64 patients received local treatment (TACE, radiofrequency ablation, metastasectomy, etc.). Thirty-six patients received both systemic and local treatments.Median overall survival (OS) was 29.0 months (95% confidence interval, 25.0-33.0) in the103 patients. OS was significantly influenced by grade (p = .001). OS was 43.0, 23.0, and 29.0 months in patients who received local treatment only, systemic treatment only, and both treatments, respectively (p = .245). The median time-to-progression (TTP) was 6.0 months. Overall response rate was 34.0% and disease-control rate was 64.2%. TTP was influenced by the presence of liver metastasis (p = .011).ConclusionsOS of metastatic/recurrent NET was different according to tumor grade. TTP was different according to metastasis site. Therefore, development of optimal treatment strategy based on the characteristics of NET is warranted.

Association of oral mucositis with quality of life and symptom clusters in patients with solid tumors receiving chemotherapy

PurposeThe study aims to determine whether or not oral mucositis (OM) during active chemotherapy in patients with solid tumors is representative of the patient’s quality of life (QOL) and the suffering from adverse effects.MethodsFrom October 2007 to September 2008, we prospectively enrolled 344 consecutive patients with solid tumors who initiated a new chemotherapy regimen. OM, other adverse effects, and the QOL were surveyed by face-to-face interviews and patient diaries.ResultsOM developed during 175 of 633 cycles (27.7%). Forty-five percent of the patients experienced OM during two cycles of chemotherapy. The QOL in patients with OM was significantly lower than patients without OM, as evaluated by the Functional Assessment of Cancer Therapy—General (70.26 ± 15.36 and 75.09 ± 13.12, respectively; p < 0.001). Specifically, the physical and emotional well-being was lower in patients with OM compared with patients without OM. Moreover, other adverse effects were more frequent in chemotherapy cycles with OM compared with chemotherapy cycles without OM (amount of food intake, activity, nausea, vomiting, fever, myalgias, and sensory neuropathy; p < 0.001, p = 0.008, p < 0.001, p = 0.001, p = 0.002, p < 0.001, and p < 0.001, respectively).ConclusionsOM represents poor QOL and is a basic symptom of symptom clusters in patients with solid tumors receiving active chemotherapy.

Clinical course of neuroendocrine tumors with different origins (the pancreas, gastrointestinal tract, and lung).

ObjectivesNeuroendocrine tumor originates from several sites. This study was conducted to reveal the differences in clinical course of neuroendocrine tumors by the origin. MethodsWe reviewed data of patients diagnosed with neuroendocrine tumor between January 1996 and July 2007. ResultsA total of 371 patients were enrolled [pancreas 60, gastrointestinal (GI) tract 210, lung 35, other sites 46, unknown primary sites 20]. The primary tumor site correlated with the stage (P=0.000) and grade (P=0.000). At diagnosis, metastasis was observed in 28.3%, 6.7%, and 2.9% of the cases in pancreatic, GI, and pulmonary neuroendocrine tumors, respectively. Grade 3 neuroendocrine tumor was observed in 7.7%, 0.5%, and 0.0% in pancreatic, GI, and pulmonary neuroendocrine tumors. Overall survival was 116.0 months (95% confidence interval, 86.9-145.1). Overall survival was 116.0 months in pancreatic neuroendocrine tumor, not reached in GI neuroendocrine tumor and 120.0 months in pulmonary neuroendocrine tumor (P=0.024). The recurrence rate was 18.0%. It was 20.9%, 11.9%, and 2.9% in pancreatic, GI, and pulmonary neuroendocrine tumors (P=0.062). In multivariate analysis, stage, grade, and age were prognostic for overall survival (OS). Stage, grade, and sex were prognostic for disease-free survival. ConclusionsNeuroendocrine tumors from the pancreas, GI tract, and lung showed different clinical characteristics.

A case of desmoplastic small round cell tumor diagnosed in a young female patient.

Desmoplastic small round cell tumor is a very rare malignancy. We report the case of a 26-year-old woman who suffered from dyspepsia and abdominal pain for 2 months. We performed an endoscopic biopsy of the duodenal mass and diagnosed her disease as desmoplastic small round cell tumor using immunohistochemical staining, fluorescence in situ hybridization, and reverse transcriptase polymerase chain reaction. Because the mass invaded the pancreas and superior mesenteric vein as well as duodenum and the disease was disseminated to liver and peritoneum, she received palliative chemotherapy using vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide. The maximal response to chemotherapy was stable disease. The patient expired 9 months after diagnosis.

End-to-end learning of image based lane-change decision

We propose an image based end-to-end learning framework that helps lane-change decisions for human drivers and autonomous vehicles. The proposed system, Safe Lane-Change Aid Network (SLCAN), trains a deep convolutional neural network to classify the status of adjacent lanes from rear view images acquired by cameras mounted on both sides of the vehicle. Rather than depending on any explicit object detection or tracking scheme, SLCAN reads the whole input image and directly decides whether initiation of the lane-change at the moment is safe or not. We collected and annotated 77,273 rear side view images to train and test SLCAN. Experimental results show that the proposed framework achieves 96.98% classification accuracy although the test images are from unseen roadways. We also visualize the saliency map to understand which part of image SLCAN looks at for correct decisions.