Impact of parental leave system on the childbirth plan among working married women: a three-year follow-up study of the Korean longitudinal survey of women and families.

BACKGROUND: The Korean government seeks to balance work and family and alleviate low fertility by implementing a parental leave system. This study aimed to identify the impact of the parental leave system on childbirth among married working women in South Korea. METHODS: This study used three-year follow-up data from the Korean Longitudinal Survey of Women and Families (2016, 2018, and 2020). The number of participants was 324 at baseline. Logistic regressions using a generalized estimating equation model were performed to examine the impact of parental leave on childbirth. Sub-analyses of covariates, childbirth support, and parental leave systems were conducted. RESULTS: Of workers covered by the parental leave system, 31.7% considered childbirth. Women covered by parental leave were 3.63 times more likely to plan childbirth (95% confidence interval [CI], 1.32-9.99). The tendency to plan childbirth was pronounced among those in their early 30s (adjusted odds ratio [AOR], 7.20) and those who thought that having children was necessary (AOR, 4.30). Child planning was more influenced by leave support (AOR, 6.61) than subsidies. CONCLUSIONS: Parental leave systems can have a positive impact on working married women's childbirth plans. Although this system was effective in a group interested in childbirth, it did not create a fundamental child plan. Time support is more important than money concerning childbirth plans. The parental leave system had an impact on childbirth plan. Appropriate parenting policies can effectively increase the fertility rate.

Effects of disability-related limitations in daily living on unmet needs: a longitudinal-study1.

BACKGROUND: Unmet health needs are particularly important to people with disabilities; however, these unmet needs owing to limitations in daily life have been under-researched thus far. This study examined the effects of disability-related limitations in daily life on unmet needs. METHODS: This study included 5,074 adults with disabilities from the 2018-2020 Korea Disability and Life Dynamics Panel. We analyzed the effects of disability-related limitations in daily life on unmet needs using logistic regression with a generalized estimating equation model. RESULTS: Overall, 4.8% men and 4.6% women with disabilities had unmet needs. For men, unmet needs were 1.46 times (95% confidence interval [CI] 1.09-1.96) higher for those with moderate limitations in daily life. For women, unmet needs were 1.79 times (95% CI 1.22-2.39) higher when there were moderate limitations in daily life. The prominent factors causing this effect were physical or brain lesion disability for men and internal or facial disability and burden of medical expenses for women. CONCLUSIONS: Limitations in daily life due to disability increase the risk of having unmet needs, an effect that is significantly more pronounced in men. These unmet needs differ depending on an individual's sex, disability type, limited body parts, and other specific causes. Efforts are required to reduce the unmet needs of people with disabilities by considering the type of disability, impaired body parts, and causes of unmet needs in daily life.

New-onset dyslipidemia in adult cancer survivors from medically underserved areas: a 10-year retrospective cohort study.

BACKGROUND: Cancer survival rates are increasing; however, studies on dyslipidemia as a comorbidity of cancer are limited. For efficient management of the disease burden, this study aimed to understand new-onset dyslipidemia in medically underserved areas (MUA) among cancer survivors > 19 years. METHODS: This study used 11-year (2009-2019) data from the Korean National Health Insurance Service sample cohort. Cancer survivors for five years or more (diagnosed with ICD-10 codes 'C00-C97') > 19 years were matched for sex, age, cancer type, and survival years using a 1:1 ratio with propensity scores. New-onset dyslipidemia outpatients based on MUA were analyzed using the Cox proportional hazards model. RESULTS: Of the 5,736 cancer survivors included in the study, the number of new-onset dyslipidemia patients was 855 in MUA and 781 in non-MUA. Cancer survivors for five years or more from MUA had a 1.22-fold higher risk of onset of dyslipidemia (95% CI = 1.10-1.34) than patients from non-MUA. The prominent factors for the risk of dyslipidemia in MUA include women, age ≥ 80 years, high income, disability, complications, and fifth-year cancer survivors. CONCLUSIONS: Cancer survivors for five years or more from MUA had a higher risk of new-onset dyslipidemia than those from non-MUA. Thus, cancer survivors for five years or more living in MUA require healthcare to prevent and alleviate dyslipidemia.

Associations between the type of help after sexual harm and adolescents' suicidal ideation.

INTRODUCTION: This cross-sectional study aimed to determine the association between receiving external help after sexual harm and suicidal ideation among Korean adolescents. The help received was classified into professional and nonprofessional to test the strength of the association according to the type of help. METHODS: Using data from the 2017-2019 Korean children and youth rights study, we analyzed a total of 18,740 middle and high school students. The dependent variable was suicidal ideation; the primary and secondary independent variable was experience of sexual harm and receiving help after sexual harm, respectively. Data were analyzed using χ2  tests and multivariable logistic regression analyses. RESULTS: Experience of sexual harm was significantly associated with higher suicidal ideation, and receiving help after sexual harm was significantly associated with lower suicidal ideation compared with not receiving help, regardless of gender. Furthermore, lower suicidal ideation was more strongly associated with receiving professional help in female adolescents, and receiving nonprofessional help in male adolescents. CONCLUSIONS: Receiving help after sexual harm was negatively associated with suicidal ideation, and the strength of this association varied with gender and the type of help received. These results can aid the development of evidence-based crisis intervention for victims of sexual harm.

Healthcare vulnerability disparities in pancreatic cancer treatment and mortality using the Korean National Sample Cohort: a retrospective cohort study.

BACKGROUND: The gap in treatment and health outcomes after diagnosis of pancreatic cancer is a major public health concern. We aimed to investigate the differences in the health outcomes and treatment of pancreatic cancer patients in healthcare vulnerable and non-vulnerable areas. METHODS: This retrospective cohort study evaluated data from the Korea National Health Insurance Corporation-National Sample Cohort from 2002 to 2019. The position value for relative comparison index was used to define healthcare vulnerable areas. Cox proportional hazard regression was used to estimate the risk of mortality in pancreatic cancer patients according to healthcare vulnerable areas, and multiple logistic regression was used to estimate the difference in treatment. RESULTS: Among 1,975 patients, 279 (14.1%) and 1,696 (85.9%) lived in the healthcare vulnerable and non-vulnerable areas, respectively. Compared with the non-vulnerable area, pancreatic cancer patients in the vulnerable area had a higher risk of death at 3 months (hazard ratio [HR]: 1.33, 95% confidence interval [CI] = 1.06-1.67) and 6 months (HR: 1.23, 95% CI = 1.03-1.48). In addition, patients with pancreatic cancer in the vulnerable area were less likely to receive treatment than patients in the non-vulnerable area (odds ratio [OR]: 0.70, 95% CI = 0.52-0.94). This trend was further emphasized for chemotherapy (OR: 0.68, 95% CI = 0.48-0.95). CONCLUSION: Patients with pancreatic cancer belonging to medically disadvantaged areas receive less treatment and have a higher risk of death. This may be a result of the late diagnosis of pancreatic cancer among these patients.

Association between years with incidence of communicable diseases focused on COVID-19 and hand hygiene among adults in South Korea: a cross-sectional study.

BACKGROUND: Handwashing is important considering the impact of communicable diseases on the public. We aimed to identify the association between years with incidence of communicable diseases during the coronavirus disease 2019 (COVID-19) pandemic and hand hygiene in South Korea. METHODS: This cross-sectional study evaluated 5 years (2013, 2015, 2017, 2019, and 2020) of data from the Korea Community Health Survey and included 1,034,422 adults. Multinomial logistic regression analysis was performed to assess handwashing frequency by year. Receiver operating characteristic analysis was used to determine the cut-off point for handwashing frequency. RESULTS: The always/frequently handwashing rate was 44.7%. This tendency was stronger in adults with each ascending year, with reference to 2013 (2015, odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.08, 1.13; 2017, OR = 1.10, 95% CI = 1.08, 1.13; 2019, OR = 1.17, 95% CI = 1.14, 1.20; 2020, OR = 3.21, 95% CI = 3.14, 3.29). Among women, the OR of frequently/always handwashing was 3.55 times higher (95% CI = 3.45, 3.66) in 2020 than in 2013. This OR was 2.95 among men (95% CI = 2.86, 3.04). In influenza-vaccinated participants, the OR of frequent/always handwashing was 3.25 times higher in 2020 than in 2013 (95% CI = 3.15, 3.36), while in non-vaccinated participants it was 3.17 (95% CI = 3.08, 3.27). Among adults who practiced physical distancing during the COVID-19 pandemic, the OR was 1.36 times higher (95% CI = 1.29, 1.42) with frequent handwashing, 1.64 times higher (95% CI = 1.57, 1.70) than those who did not practice it. CONCLUSIONS: There was a strong tendency toward frequent handwashing over the years; the trend was even greater in 2020 during the COVID-19 pandemic. Given that communicable diseases and handwashing are closely related, it is necessary to promote hand hygiene for prevention.

The impact of entering poverty on the unmet medical needs of Korean adults: a 5-year cohort study.

BACKGROUND: Studies on the effects of poverty on unmet medical needs are limited. Therefore, this study aimed to identify the impact of entering poverty on the unmet medical needs of South Korean adults. METHODS: This study used data from the Korea Health Panel Survey (2014-2018) and included 10,644 adults. Logistic regression was used to examine the impact of entering poverty on unmet medical needs (poverty status: no → no, yes → no, no → yes, yes → yes; unmet medical needs: no, yes). Poverty line was considered to be below 50% of the median income. RESULTS: When entering poverty, the proportion of unmet medical needs was 22.8% (adjusted odds ratio [AOR] 1.17, 95% confidence interval [CI] 1.01-1.36). Men (AOR 1.29, 95% CI 1.02-1.64), rural dwellers (AOR 1.24, 95% CI 1.01-1.50), and national health insurance (NHI) beneficiaries (AOR 1.21, 95% CI 1.04-1.42) were susceptible to unmet medical needs and entering poverty. Poverty line with below-median 40% had an AOR of 1.48 (95% CI 1.28-1.71). For the cause of unmet medical needs, the AORs were 1.50 for poverty (95% CI 1.16-1.94) and 1.08 for low accessibility to health care and information (95% CI 0.79-1.48). CONCLUSIONS: Entering poverty had the potential to adversely affect unmet medical needs. Men, rural dwellers, and NHI beneficiaries were vulnerable to unmet medical needs after entering poverty. Rigid definitions of poverty and inaccessibility to health care and information increase the likelihood of unmet medical needs and poverty. Society must alleviate unmet medical needs due to the increase in the population entering poverty.

The impact of work interference with family on depressive symptoms among married working women: A longitudinal panel study.

PURPOSE: This study aimed to investigate the effects of work interference with family (WIF) on depressive symptoms among married working women. METHODS: Data from 2014‒2018 of the Korean Longitudinal Survey of Women and Families were used. Only married women living with their husbands and wage workers were included, whereas those diagnosed with depression at the baseline year and those with missing values were excluded. A total of 1,504 individuals were included as the study population. The impact of WIF on depressive symptoms was analyzed using the generalized estimating equation model with a logit link. RESULTS: After adjusting for all the potential confounding variables, it was found that WIF had an effect on depressive symptoms. Women whose work interfered with their family were 1.58 times more likely to experience depressive symptoms than those who did not experience WIF (95% Confidence interval (CI): 1.30‒1.92). WIF due to irregular working hours had the highest odds ratio for depression (Adjusted odds ratio (OR): 2.01, 95% CI: 1.32‒3.08). Women with WIF were more likely to develop depressive symptoms when they had two or more children (With 2 children, Adjusted OR: 1.69, 95% CI: 1.31‒2.18; With 3 or more children, Adjusted OR: 1.63, 95% CI: 1.07-2.49). CONCLUSIONS: Thus, married working women who experienced WIF were found to be at a higher risk of developing depressive symptoms. Therefore, considering how prevailing stereotypes that roles of men and women are separated can harm women's mental health, policy measures should be implemented to ensure women's quality of life based on the work-family balance.

Association between family financial decline due to COVID-19 and generalized anxiety disorder among Korean adolescents.

BACKGROUND: COVID-19 has had a worldwide economic impact. A decline in family financial level can adversely affect adolescents' mental health. This study examined the association between perceived family financial decline due to COVID-19 and generalized anxiety disorder (GAD) among South Korean adolescents. METHODS: Data from 54,948 middle and high school students from the 2020 Korea Youth Risk Behavior Survey were collected in this cross-sectional study. The effect of the perceived family financial decline due to COVID-19 related to GAD was analyzed using binary and multinomial logistic regression. RESULTS: The relationship between perceived family financial decline due to COVID-19 and GAD was linear with increasing odds ratios and confidence intervals (the possibility of GAD, no financial decline: OR 1.00, mild: OR 1.11, CI 1.05-1.17, moderate: OR 1.30, CI 1.22-1.39, severe: OR 1.48, CI 1.34-1.63). Girls, low-income class, and living with family were vulnerable to GAD. GAD levels of mild, moderate, and severe were most likely to occur in each case of mild, moderate, and severe financial decline, respectively. LIMITATIONS: As this is a cross-sectional study, causality is unknown. Because this study data was self-reported by adolescents, they may have been overestimated or underestimated. CONCLUSION: GAD in adolescents is closely related to perceived decreased family finances due to COVID-19. The dose-response of GAD according to financial decline became gradually severe. Anxious adolescents were afraid of uncertain and adverse outcomes affecting them or their families. Therefore, there is a vital need to care for financially affected adolescents.

Association between perceived decline in family income due to COVID-19 and alcohol consumption among Korean adolescents.

BACKGROUND: This study examines the relationship between the perceived decline in family income due to COVID-19 and alcohol consumption among Korean adolescents. METHODS: Korea Youth Risk Behavior Web-Based Survey 2020 data were used. The study included 42,922 participants (20,672 males; 22,250 females). Multiple logistic regression estimated the relationship between the decline in family income due to COVID-19 and drinking (yes or no) and alcohol-induced blackout (yes or no) status among Korean adolescents. RESULTS: Adolescent males who perceived worsened family income due to COVID-19 had a higher OR for drinking status and alcohol-induced blackout within 30 days (drinking status: OR 1.27, CI 1.15-1.42, alcohol-induced blackout: OR 1.60, CI 1.19-2.15). Females had a higher OR for current drinking (OR 1.22, CI 1.09-1.38). 7th grade females and 10th grade males were more likely to drink alcohol when their household income decline, compared to high school students (10th grade male: OR 1.54 CI 1.18-2.00; 7th grade female: OR 1.57 CI 1.08-2.27). The male group perceiving family financial loss were likely to have an increased frequency of drinking within 30 days (1-9 days: OR 1.26 CI 1.11-1.42, 10-19 days; OR 1.70 CI 1.22-2.36 over 20 days; OR 1.74 CI 1.15-3.09). LIMITATIONS: Cross-sectional design and self-reported data are the main limitation of our study. And the cut-off points for drinking status and heavy drinking factors may be difficult to generalize our findings to different population. CONCLUSIONS: A significantly positive association of perceived decline in family income due to COVID-19 with increased risks of alcohol consumption was observed among Korean adolescents of both sexes. 7th grade females and 10th grade males were more likely to drink alcohol when their household income changed, compared to high school students. Further, adolescents who perceived family financial loss had an increased frequency of drinking.

Association of the "Weekend Warrior" and Other Physical Activity Patterns with Metabolic Syndrome in the South Korean Population.

These days, it is not common for people to have time to do physical activities regularly because of their own work. So, they perform physical activities all at once, which is often called the "weekend warrior". Therefore, this study aimed to examine the association of the "weekend warrior" and other physical activity patterns with metabolic syndrome. Data from the Korea National Health and Nutrition Examination Survey were used, and 27,788 participants were included. The participants were divided into inactive, weekend warriors, and regularly active based on physical activity patterns. The risk of metabolic syndrome in each group was analyzed using multiple logistic regression. The inactive and weekend warrior groups showed a higher likelihood of developing metabolic syndrome than the regularly active groups (weekend warrior: odds ratio (OR) 1.29, confidence interval (CI) 1.02-1.65; inactive: OR 1.38, CI 1.25-1.53). According to the physical activity patterns, the weekend warrior group showed a dose-response relationship compared to the regularly active group (only moderate: OR 1.85, CI 1.25-2.72; only vigorous: OR 1.41, CI 0.93-2.14; both: OR 0.84, CI 0.56-1.27). This study found increasing the amount of physical activity and performing vigorous-intensity physical activity helped manage metabolic syndrome in the weekend warrior group.

Association between Smartphone Addiction and Suicide.

OBJECTIVE: This study aimed to explore the associations between smartphone overdependence (smartphone addiction) and suicidal ideation and attempts among Korean adolescents to acknowledge the risk of smartphone overuse. METHODS: Data were obtained from the results of the 2020 Korea Youth Risk Behavior Web-based Survey. Smartphone addiction was categorized into three groups: adolescents who scored less than 23 were categorized as the general user group and formed the reference, those with scores of 23-30 were categorized as the potential-risk user group, and those with scores higher than 31 were categorized under the high-risk user group. Suicidal ideation and suicide attempt were identified as dependent variables in the present study. Multiple logistic regression was used to analyze the relationship between SA and suicidal ideation and suicide attempt status among Korean adolescents. RESULTS: This study included 41,173 general users of smartphones, 12,142 potential-risk users, and 1633 high-risk users from among 54,948 adolescents who were middle- and high-school students. Adolescents with potentially risky smartphone use showed a higher likelihood of suicidal ideation (OR: 1.50, CI: 1.42-1.60). Similarly, adolescents with high-risk smartphone use showed a significant risk of suicidal ideation (OR: 2.49, CI: 2.21-2.81) and suicide attempt (OR: 1.87, CI: 1.48-2.37) compared to the adolescents who were general users. CONCLUSION: Our study results encourage parents and social workers to acknowledge that adolescents' smartphone addiction leads to a higher risk to their mental health, wherein they may engage in suicidal ideation and even resort to a suicide attempt.

Impact of the Acceptance of Disability on Self-Esteem among Adults with Disabilities: A Four-Year Follow-Up Study.

This study identified the acceptance of disability's impact on self-esteem among adults with disabilities in South Korea. This is a four-year follow-up study that obtained data from the Panel Survey of Employment for Persons with Disabilities from 2017 to 2020. In total, 3329 individuals participated. Logistic regression examined the acceptance of disability's effect on self-esteem. These variables were categorized based on the acceptance of disability (high→high, low→high, high→low, and low→low) and self-esteem (low and not low). Compared to the participants with a consistently high acceptance of disability, those with constantly low acceptance were 2.35 times (95% CI 1.81-3.04) more likely to have low self-esteem. When the acceptance of disability was low→high and high→low, the low self-esteem probability was 1.23 and 1.66 times, respectively. Low self-esteem was prominent for the following: men, 50-64-year olds, married, urban, economic activists, the mid-low household income category, and those with sensory disability. Acceptance of disability can adversely affect self-esteem when it is consistently low or changes from high to low. Among socio-economic factors, there were several risk factors that could make individuals more vulnerable to low self-esteem. Therefore, it is necessary to help people accept their disabilities to maintain healthy self-esteem levels.

Association between the Perceived Household Financial Decline Due to COVID-19 and Smartphone Dependency among Korean Adolescents.

This cross-sectional study identified the association between COVID-19-related perceived household financial decline and smartphone dependency among adolescents in South Korea. Data from the 2020 Youth Risk Behavior Survey of Korea was used and 54,809 middle and high school students were included. COVID-19-related perceived household financial decline was categorized as no financial decline, mild, moderate, and severe. Smartphone dependency was calculated by 10 questions and was largely categorized as yes and no, and as normal, low, and high (prevalence rate: 25.0%). Binary and multinomial regression analyses were performed to analyze the association. The more severe the financial decline, the more pronounced the risk of high-risk smartphone dependency (mild financial decline: odds ratio (OR) 1.11, 95% CI 0.96-1.28; moderate: OR 1.22, 95% CI 1.04-1.43; severe: OR 2.56, 95% CI 2.06-3.17). Poor family relationships (OR 1.06, 95% CI 1.03-1.10) and severe social conflict (OR 2.99, 95% CI 2.50-3.58) were also related to smartphone dependency. The ORs were 2.63 with more than three bathrooms and 1.63 with their own bedroom. Smartphone dependency among adolescents is closely related to COVID-19-related perceived household financial decline. As smartphone dependency relates to complicated psychological issues, further evaluation is necessary, especially for vulnerable adolescents.

Surtuin 1 as a potential prognostic biomarker in very elderly patients with colorectal cancer.

BACKGROUND/AIMS: Colorectal cancer (CRC) rate increases with aging. Aging-related proteins, such as sirtuins (SIRTs) may be a potential therapeutic target in the elderly patients with CRC. The clinical implications of SIRT1 and SIRT2 have not been reported for elderly patients with cancer. The aim of this study was to evaluate the impact of expression of SIRT1 and SIRT2 on clinical outcome in two extreme age groups of patients with CRC. METHODS: The expression of SIRT1 and SIRT2 were evaluated in CRC tissues of 101 patients aged ≥ 80 years and 29 patients aged ≤ 40 years by immunohistochemistry. We defined the patients aged ≥ 80 years as the very elderly and patients aged ≤ 40 years as the young patients. Correlations between the expression of these proteins and clinicopathological features were analyzed. RESULTS: The prognosis for the very elderly patients with high expressions of SIRT1 was significantly worse than that for patients showing low expression (median survival, 24.9 months vs. 38.6 months, p = 0.027) whereas high expression of SIRT2 better prognosis (median survival, 37.9 months vs. 17.3 months, p = 0.006). However, the young patients did not show any difference in prognosis according to expression of SIRT1 and SIRT2. In multivariate analysis, high SIRT1 expression retained statistical significance as a poor prognostic factor in the very elderly patients with CRC. CONCLUSION: The results suggest that high SIRT1 expression could be predictive of a poor outcome for very elderly patients with CRC.

Clinical Characteristics of Clear Cell Ovarian Cancer: A Retrospective Multicenter Experience of 308 Patients in South Korea.

PURPOSE: The purpose of this study was to evaluate clinical characteristics and treatment pattern of ovarian clear cell carcinoma (OCCC) in Korea and the role of adjuvant chemotherapy in early stage. MATERIALS AND METHODS: Medical records of 308 cases of from 21 institutions were reviewed and data including age, performance status, endometriosis, thromboembolism, stage, cancer antigen 125, treatment, recurrence, and death were collected. RESULTS: Regarding stage of OCCC, it was stage I in 194 (63.6%), stage II in 34 (11.1%), stage III in 66 (21.6%), and stage IV in 11 (3.6%) patients. All patients underwent surgery. Optimal surgery (residual disease ≤ 1 cm) was achieved in 89.3%. Majority of patients (80.5%) received postoperative chemotherapy. The most common regimen was taxane-platinum combination (96%). Median relapse-free survival (RFS) was 138.5 months for stage I, 33.4 for stage II, 19.3 for stage III, and 9.7 for stage IV. Median overall survival (OS) were not reached, 112.4, 48.7, and 18.3 months for stage I, II, III, and IV, respectively. Early-stage (stage I), endometriosis, and optimal debulking were identified as favorable prognostic factors for RFS. Early-stage and optimal debulking were also favorable prognostic factors for OS. Majority of patients with early-stage received adjuvant chemotherapy. However, additional survival benefit was not found in terms of recurrence. CONCLUSION: Majority of patients had early-stage and received postoperative chemotherapy regardless of stage. Early-stage and optimal debulking were identified as favorable prognostic factors. In stage IA or IB, adding adjuvant chemotherapy did not show difference in survival. Further study focusing on OCCC is required.

A Case Report of Recurrent Metastatic Sebaceous Carcinoma Which Showed Favorable Response Tt Non-Fluorouracil Based Chemotherapy.

BACKGROUND Sebaceous carcinoma is a rare malignant tumor of the skin adnexa. While surgical resection is a treatment of choice in localized disease, frequent recurrence and distant metastasis make treatment difficult. Moreover, due to its rarity, optimal systemic treatment has not been determined. CASE REPORT A 59-year-old female presented with disseminated subcutaneous nodules. Past history indicated she received repeated surgery, radiation therapy, and fluorouracil-based systemic chemotherapy for recurrent sebaceous carcinoma. Following a subcutaneous nodule biopsy, histopathologic examination confirmed recurrent metastasis of sebaceous carcinoma. Because there was no established regimen as salvage chemotherapy, we decided to administer paclitaxel plus Adriamycin as a combination regimen after a thorough search of previous reports on PubMed. After the patient received 6 cycles of chemotherapy, all masses dramatically regressed. Unfortunately, several new lesions appeared 3 months after cessation of chemotherapy. Therefore, she was treated with anti-HGF antibody through a clinical trial. After that, she received nivolumab. But treatment with all the new agents did not show any response. Furthermore, her disease progressed rapidly. We re-challenged with the paclitaxel and Adriamycin regimen, 2 cycles of chemotherapy, and the follow-up positron emission tomography - computed tomography revealed marked decrement of multiple metastatic nodules. CONCLUSIONS Although several clinical reports have shown the effectiveness of fluorouracil, especially 5-fluorouracil-based chemotherapy, there has been a paucity of reports on other chemotherapeutic agents. We report a case of metastatic sebaceous carcinoma which showed favorable response to non-fluorouracil-based chemotherapy.

Clinical characteristics and treatment propensity in elderly patients aged over 80 years with colorectal cancer.

BACKGROUND/AIMS: Elderly patients (≥ 80 years) with colorectal cancer (CRC) tend to avoid active treatment at the time of diagnosis despite of recent advances in treatment. The aim of this study was to determine treatment propensity of elderly patients aged ≥ 80 years with CRC in clinical practice and the impact of anticancer treatment on overall survival (OS). METHODS: Medical charts of 152 elderly patients (aged ≥ 80 years) diagnosed with CRC between 1998 and 2012 were retrospectively reviewed. Patients' clinical characteristics, treatment modalities received, and clinical outcome were analyzed. RESULTS: Their median age was 82 years (range, 80 to 98). Of 152 patients, 148 were assessable for the extent of the disease. Eighty-two of 98 patients with localized disease and 28 of 50 patients with metastatic disease had received surgery or chemotherapy or both. Surgery was performed in 79 of 98 patients with localized disease and 15 of 50 patients with metastatic disease. Chemotherapy was administered in only 24 of 50 patients with metastatic disease. Patients who received anticancer treatment according to disease extent showed significantly longer OS compared to untreated patients (localized disease, 76.2 months vs. 15.4 months, p = 0.000; metastatic disease, 9.9 months vs. 2.6 months, p = 0.001). Along with anticancer treatment, favorable performance status (PS) was associated with longer OS in multivariate analysis of clinical outcome. CONCLUSION: Elderly patients aged ≥ 80 years with CRC tended to receive less treatment for metastatic disease. Nevertheless, anticancer treatment in patients with favorable PS was effective in prolonging OS regardless of disease extent.

Multicenter Retrospective Analysis of Clinical Characteristics, Treatment Patterns, and Outcomes in Very Elderly Patients with Diffuse Large B-Cell Lymphoma: The Korean Cancer Study Group LY16-01.

PURPOSE: The treatment strategy for elderly patients older than 80 years with diffuse large B-cell lymphoma (DLBCL) has not been established because of poor treatment tolerability and lack of data. MATERIALS AND METHODS: This multicenter retrospective study was conducted to investigate clinical characteristics, treatment patterns and outcomes of patients older than 80 years who were diagnosed with DLBCL at 19 institutions in Korea between 2005 and 2016. RESULTS: A total of 194 patients were identified (median age, 83.3 years). Of these, 114 patients had an age-adjusted International Prognostic Index (aaIPI) score of 2-3 and 48 had a Charlson index score of 4 or more. R-CHOP was given in 124 cases, R-CVP in 13 cases, other chemotherapy in 17 cases, radiation alone in nine cases, and surgery alone in two cases. Twenty-nine patients did not undergo any treatment. The median number of chemotherapy cycles was three. Only 37 patients completed the planned treatment cycles. The overall response rate from 105 evaluable patientswas 90.5% (complete response, 41.9%). Twentynine patients died due to treatment-related toxicities (TRT). Thirteen patients died due to TRT after the first cycle. Median overall survival was 14.0 months. The main causes of death were disease progression (30.8%) and TRT (27.1%). In multivariate analysis, overall survival was affected by aaIPI, hypoalbuminemia, elevated creatinine, and treatment. CONCLUSION: Age itself should not be a contraindication to treatment. However, since elderly patients show higher rates of TRT due to infection, careful monitoring and dose modification of chemotherapeutic agents is needed.

Metronomic chemotherapy in metastatic colorectal cancer.

Overall survival and quality of life of patients with metastatic colorectal cancer (mCRC) have improved due to the development of standard systemic treatment. However, many patients are still suffering from the eventual progression of cancer, treatment-related toxicities, and the economic burden of new drugs. Salvage or maintenance therapy, which consistently controls or stabilizes tumor progression without debilitating quality of life, is required. Recently, metronomic capecitabine maintenance therapy after disease control using conventional chemotherapy with maximal tolerated doses has demonstrated beneficial results in a phase III trial. Metronomic chemotherapy has been known to control tumors through antiangiogenesis and immunomodulation as well as a direct effect on tumor-initiating cells. It has the characteristics of being minimally toxic, inexpensive, and durable for maintaining disease stabilization. Therefore, patients with mCRC, who tend to be elderly and frail and have been previously treated, might be suitable for metronomic therapeutic strategies. Furthermore, antiangiogenic therapy has been an important component in treating mCRC, but the schedules and doses of metronomic chemotherapy have not yet been established. Here we review translational and clinical research on metronomic chemotherapy in colorectal cancer (CRC).