Factors Associated with Postoperative Recurrence in Stage I to IIIA Non-Small Cell Lung Cancer with Epidermal Growth Factor Receptor Mutation: Analysis of Korean National Population Data.

Purpose: Recent development in perioperative treatment of resectable non-small cell lung cancer (NSCLC) have changed the landscape of early lung cancer management. The ADAURA trial has demonstrated the efficacy of adjuvant osimertinib treatment in resectable NSCLC patients; however, studies are required to show which subgroup of patients are at a high risk of relapse and require adjuvant epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) treatment. This study evaluated risk factors for postoperative relapse among patients who underwent complete resection. Materials and Methods: Data were obtained from the Korean Association for Lung Cancer Registry (KALC-R), a database created using a retrospective sampling survey by the Korean Central Cancer Registry (KCCR) and the Lung Cancer Registration Committee. Results: A total of 3,176 patients who underwent curative resection was evaluated. The mean observation time was approximately 35.4 months. Among stage I to IIIA NSCLC patients, the EGFR-mutant subgroup included 867 patients, and 75.2%, 11.2%, and 11.8% were classified as stage I, stage II, and stage III, respectively. Within the EGFR-mutant subgroup, 44 (5.1%) and 121 (14.0%) patients showed early and late recurrence, respectively. Multivariate analysis on association with postoperative relapse among the EGFR-mutant subgroup showed that age, pathologic N and TNM stages, pleural invasion status, and surgery type were independent significant factors. Conclusion: Among the population that underwent complete resection for early NSCLC with EGFR mutation, patients with advanced stage, pleural invasion, or limited resection are more likely to show postoperative relapse.

Colon cancer: the 2023 Korean clinical practice guidelines for diagnosis and treatment.

Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients' values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.

Enhanced Cycling Performance of a Li-Excess Li2CuO2 Cathode Additive by Cosubstitution Nanoarchitectonics of Ni and Mn for Lithium-Ion Batteries.

The adoption of Li2CuO2 has drawn interest as a Li-excess cathode additive for compensating irreversible Li+ loss in anodes during cycling, which would move forward high-energy-density lithium-ion batteries (LIBs). Li2CuO2 provides a high irreversible capacity (>200 mAh g-1) in the first cycle and an operating voltage comparable with commercial cathode materials, but its practical use is still restricted by the structural instability and spontaneous oxygen (O2) evolution, resulting in poor overall cycling performance. It is thus crucial to reinforce the structure of Li2CuO2 to make it more reliable as a cathode additive for charge compensation. Pursuing the structural stability of Li2CuO2, herein, we demonstrate cosubstitution by heteroatoms, such as nickel (Ni) and manganese (Mn), for improving the structural stability and electrochemical performance of Li2CuO2. Such an approach effectively enhances the reversibility of Li2CuO2 by suppressing continuous structural degradation and O2 gas evolution during cycling. Our findings provide new conceptual pathways for developing advanced cathode additives for high-energy LIBs.

Characteristics of Cobalt Thin Films Deposited by Very High Frequency Plasma Enhanced Atomic Layer Deposition (60 and 100 MHz) Using Cobaltocene (Co(Cp)2)/NH3.

In this study, cobalt films were deposited by plasma enhanced atomic layer deposition (PEALD) with cobaltocene (Co(Cp)2) using two different very high frequency (VHF) NH3 plasmas (60 MHz, 100 MHz), and the effect of different frequencies of VHF on the characteristics of NH3 plasmas and the properties of cobalt films were investigated. It is found that the higher frequency showed the higher plasma density at the same input power and, the NH radicals, which are required to remove the ligands of the cobalt precursor during the plasma exposure step in the ALD cycle, were higher at 100 MHz than those at 60 MHz. The RMS surface roughness and carbon impurity percentage of the deposited cobalt films were lower at the higher frequency possibly indicating denser films due to more active surface reactions at the higher frequency. As a result, it is expected that the cobalt thin films deposited by the higher VHF PEALD will improve the characteristics of deposited thin films.

Potential prognostic value of heat-shock protein 90 in the presence of phosphatidylinositol-3-kinase overexpression or loss of PTEN, in invasive breast cancers.

INTRODUCTION: Evaluating the expression of signaling molecule proteins from the mitogen-activated protein kinase (MAPK) pathway and the phosphatidylinositol-3-kinase (PI3K) pathway in invasive breast cancers may identify prognostic marker(s) associated with early relapse. METHODS: Immunohistochemical analyses of phosphatase and tensin homologue deleted on chromosome 10 (PTEN), PI3K-p110alpha, phospho-AKT, phospho-p70S6 kinase, phospho-S6 ribosomal protein, phospho-RAF, phospho-p44/42 MAPK, and heat-shock protein 90 (HSP90) were performed on tumor samples from 212 patients with invasive breast cancer. Statistically significant relations between protein expression, clinicopathologic factors, and relapse-free survival (RFS) were analyzed. RESULTS: Expression of HSP90 was associated with 5-year RFS, as well as T stage, N stage, histologic grade, estrogen receptor (ER) expression, human epidermal growth factor receptor 2 (HER2) expression, and the Ki-67 proliferation index. On multivariate analysis, coexpression of HSP90 and PI3K-p110alpha or expression of HSP90 along with PTEN loss demonstrated significantly worse RFS. In subgroup analyses, both exhibited strong prognostic significance in HER2-positive cases, but not in HER2-negative cases. CONCLUSIONS: The coexpression of HSP90 with PI3K-p110alpha or expression of HSP90 along with PTEN loss has a potential as a molecular prognostic marker to predict early relapse in patients with invasive breast cancers.

Treatment outcomes for radiotherapy alone are comparable with neoadjuvant chemotherapy followed by radiotherapy in early-stage nasopharyngeal carcinoma.

OBJECTIVES: To analyze the impact of neoadjuvant chemotherapy (CT) on the treatment of early-stage nasopharyngeal carcinoma (NPC) as compared with radiotherapy (RT) alone. METHODS: We analyzed retrospectively the outcome of 60 previously untreated and histologically confirmed early-stage NPC patients treated with either RT alone or with neoadjuvant CT followed by RT (CT/RT) at the Seoul National University Hospital between 1986 and 2004. Neoadjuvant CT consisted of three cycles with 5-fluourouracil and cisplatin. RT was given to the nasopharynx and neck nodes. The median dose to the primary site, involved nodes, and elective nodes was 70.2 Gy, 63 Gy, and 45 Gy, respectively. According to the 1997 American Joint Committee on Cancer staging system, 9 patients had stage I or IIA disease, and 22 patients had stage IIB disease in the RT group. For the CT/RT group, 8 patients had stage I or IIA disease, and 21 patients had stage IIB disease. The median follow-up for all patients was 124.5 (range, 5-239) months. RESULTS: The 5-year locoregional failure-free (LRFF), distant metastasis-free (DMF), disease-free survival (DFS), and overall survival (OS) rate was 84%, 93%, 81%, and 84% for the RT group and 77%, 86%, 71%, and 79% for the CT/RT group, respectively. There were no significant differences in LRFF (P = .728), DMF (P = .433), DFS (P = .562), and OS (P = .625) rates between the RT and CT/RT groups. Multivariate analysis revealed that delaying RT for more than 81 days was significantly associated with an increased risk of locoregional failure in the subgroup of patients with stage IIB disease (P = .044). CONCLUSIONS: In our retrospective analysis, the use of neoadjuvant CT showed no additional benefit to treatment with RT alone. Neoadjuvant CT may cause deleterious effect on stage IIB disease by delaying RT.

Radiation Therapy for Anal Squamous Cell Carcinoma: A Retrospective Multicenter Study.

AIM: To analyze the treatment outcomes, patterns of failures and prognostic factors for patients with anal cancer treated with radiotherapy (RT). MATERIALS AND METHODS: Between January 2000 and December 2015, 83 patients with anal squamous cell carcinoma were treated with definitive RT. The median RT dose applied to the primary carcinoma site was 55 (range=45-64) Gy. Seventy-six patients (91.6%) received concurrent chemotherapy, and the most common regimen was 5-fluorouracil plus mitomycin C. RESULTS: The median age of patients was 64 (range=36-86) years, and there were 21 males and 62 females. The overall complete remission rate was 89.2%. The median duration of follow-up was 51 (range=3-173) months. The actuarial 5-year overall, progression-free survival (PFS), locoregional progression-free, and distant metastasis-free survival rates were 85.0%, 70.4%, 78.2%, and 82.6%, respectively. On multivariate analysis, eventual treatment response was the only prognostic factor for overall (p=0.023) and progression-free (p<0.001) survival. Age (p=0.013) and eventual treatment response (p<0.001) were significantly associated with locoregional progression-free survival. Initial treatment response, lymph node involvement and RT technique significantly affected distant metastasis-free survival (p=0.016, 0.048 and 0.002, respectively). CONCLUSION: RT, mainly with concurrent chemotherapy, showed acceptable treatment outcomes and safe toxicity profiles.

Cochlear tolerance of Nd:YAG laser myringotomy.

AIM: The objective of this study was to assess whether Nd:YAG laser myringotomy has a negative effect on the cochlea. MATERIALS AND METHODS: Ten adult guinea pigs with a normal Preyer's reflex were treated by myringotomy with an Nd:YAG laser (power output 8-10W) under surgical microscopic guidance. Preoperative and immediately postoperative hearing tests were performed using auditory brainstem response. The cochlear hair cells were investigated by scanning electron microscope (SEM). RESULTS: The mean postoperative hearing threshold of the auditory brainstem response showed an insignificant elevation. SEM findings revealed normal outer and inner hair cells after laser myringotomy. CONCLUSION: No negative effect of Nd:YAG laser myringotomy on the cochlea was found. From these results, it can be concluded that the Nd:YAG laser is safe and effective for myringotomy.

Obesity and Hypertension among School-going Adolescents in Peru.

BACKGROUND: Adolescent obesity and hypertension are global public health issues. The burden of adolescent obesity and hypertension in Peru is unclear. The aim of this study was to determine the prevalence of obesity and hypertension and their relationship among school-attending adolescents and to assess the need for health-promoting school programs in the study area. METHODS: A cross-sectional school-based survey was conducted in a randomly selected sample of 952 secondary school adolescents from 11 schools in Lima or Callao, Peru, in 2014. Weight, height, and blood pressure (BP) were measured and categorized. Obesity was defined as ≥ 95(th) percentile in body mass index (BMI) for age and sex. Hypertension was defined as average systolic blood pressure and/or diastolic blood pressure ≥95(th) percentile in BP for sex, age, and height. Chi-square test and univariate logistic regressions were used at a 5% significance level to determine the relationship between BMI and BP category. RESULTS: The mean age of subjects was 14.6 years; 46.4% were boys and 53.6% were girls. The prevalence of overweight and obesity was 20.2% and 9.5% overall, 17.4% and 11.1% for boys, and 22.5% and 8.0% for girls, respectively. The prevalence of hypertension was 26.7% overall, 34.8% for boys, and 19.6% for girls. In both sexes, BMI was strongly associated with BP (p < 0.01). CONCLUSION: The prevalence of obesity and hypertension observed in the study area is relatively high. Overweight and obesity are strongly associated with BP status among adolescents. Health-promoting school programs may reduce the burdens of obesity and hypertension among school-going adolescents.

Treatment-related pneumonitis and acute esophagitis in non-small-cell lung cancer patients treated with chemotherapy and helical tomotherapy.

PURPOSE: To assess clinical outcomes and complications in patients with non-small-cell lung cancer (NSCLC) treated with helical tomotherapy (HT) with or without chemotherapy. METHODS AND MATERIALS: Data from 37 NSCLC patients treated between January 2007 and August 2008 were analyzed retrospectively. Twenty-eight patients had Stage III disease. Concurrent and neoadjuvant chemotherapy was given to 24 and 14 patients, respectively. Radiotherapy was delivered to a total dose of 60-70.4 Gy at 2.0-2.4 Gy per fraction to the gross tumor volume and 50-64 Gy at 1.8-2.0 Gy per fraction to the planning target volume. RESULTS: With a median follow-up of 18 months (range, 6-27 months), 2-year local control and overall survival rates were 63% and 56% for all 37 patients, respectively, and were 78% and 75% for the patients with Stage III disease who received concurrent chemoradiotherapy alone. Acute esophagitis and treatment-related pneumonitis (TRP) ≥Grade 3 occurred in 5 and 7 patients, respectively. Four patients died of treatment-related death (TRD) after HT. In univariate analysis, poor performance status, total lung V(5), contralateral lung (CL) V(5), and V(10) were associated with TRD. Only CL V(5) remained significant in the multivariate analysis (p = 0.029). CONCLUSIONS: HT with chemotherapy has shown promising clinical outcomes, esophagitis, and TRPs. However, HT has produced a somewhat high rate of fatal pulmonary complications. Our data suggest that CL V(5) should be considered and kept as low as possible (<60%) in addition to the conventional dosimetric factors.

The effect of anchoring suture on the anastomotic blood flow in a rat model of human esophagojejunostomy.

PURPOSE: An impairment of anastomotic blood flow (ABF) and the resulting hypoxia readily lead to the complications such as leakage and stricture. We performed an animal study to evaluate the effect of anchoring suture for minimizing the impairment of ABF caused by tensile loading. MATERIALS AND METHODS: An end-to-side jejunojejunostomy was done in 20 rats, and this followed the modeling of a human end-to-side esophagojejunostomy. Laser Doppler flowmetry was checked in three different tensile conditions to evaluate the influence of anchoring suture on the ABF. RESULTS: Before anchoring suture, the mean ABF was 129.06 perfusion unit (PU), 96.99 PU, and 69.04 PU, in the order of tensile stress. After anchoring suture, the mean ABF was 121.68, 103.30, and 87.06 PU (P < 0.01). CONCLUSION: Anchoring suture is a novel method to reduce the impairment of the anastomotic blood flow that is caused by tension.