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ETS and DoR to predict survival benefit over third line chemotherapy in metastatic colorectal cancer
( Ka-rham Kim ),( Sang-hee Cho ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
Background: Taken into consideration of weak benefit of third line chemotherapy in metastatic colorectal cancer (mCRC), there has been no effective clinical markers to make a decision whether to go ahead or stop palliative chemotherapy after progression over second line chemotherapy. Recently early tumor shrinkage (ETS) and depth of response (DoR) have been adopted as prognostic markers to predict survival. Therefore we evaluate the role of ETS and DoR after 1st line chemotherapy in mCRC as clinical decision tools to select patients who would be benefit from further treatment after 2nd line chemotherapy. Methods: We retrospectively examined tumor response such as RECIST, ETS (≥ 20%) and DoR after 1st line palliative chemotherapy from 242 mCRC patients. The association between response measurements (ETS and DoR) and survival outcomes including of progression-free survival (PFS), post-progression survival (PPS) and overall survival (OS) were evaluated. Factors affecting survival benefit after receiving over third line chemotherapy were also evaluated. Results: After 1st line chemotherapy, overall response rate (ORR), ETS and median DoR were shown in 41.3%, 42.6% and 38.5% in patients, respectively and all these measurements were significantly associated with PFS, PPS and OS. The efficacy of third line chemotherapy, mostly using fluoropyrimidine based regimen (75%), had an ORR of 15.3%, disease control rate (DCR) of 42.4% with a duration of response about 15 weeks. In univariate analysis, the factors associated with survival benefit in patients receiving over third line chemotherapy were rectal cancer and DoR over 60% and only DoR over 60% was associated with survival in multivariate analysis. Conclusions: ETS and DoR are useful tool to predict survival in conventional chemotherapy in mCRC. In addition, patients who showed good response such as DoR over 60% after 1st line chemotherapy could be rechallenged using previously used fluoropyrimidine to prolong survival.
( Minah Kim ),( Ka Rham Kim ),( Bo Ram Lee ),( Seong Hoon Yoon ),( Hee Jung Ban ),( Yong Soo Kwon ),( In Jae Oh ),( Kyu Sik Kim ),( Yu Il Kim ),( Sung Chul Lim ),( Young Chul Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Expanding of public-private mix(PPM) projects, this study aimed to evaluate the effectiveness of PPM projects. Methods: Expanding of public-private mix(PPM) projects, this study aimed to evaluate the effectiveness of PPM projects. Results: The success rate of treatment of tuberculosis in the pre-PPM group was 39.1% whereas that of the post-PPM group was 66%, showing a significant difference( p<0.001). Conclusions: PPM project improved success rate of treatment of TB by increasing the implementation of drug sensitivity test and decreasing the rate of lost to follow-up. Thus, the need for PPM project should be recognized and the expansion and supplementation of PPM project will be needed.
( Chung Hwan Jun ),( Ka Rham Kim ),( Jae Hyun Yoon ),( Han Ra Koh ),( Won Suk Choi ),( Kyu Man Cho ),( Sung Uk Lim ),( Chang Hwan Park ),( Young Eun Joo ),( Hyun Soo Kim ),( Sung Kyu Choi ),( Jong Sun 대한내과학회 2014 The Korean Journal of Internal Medicine Vol.29 No.4
Background/Aims: To evaluate the long-term efficacy and safety of endoscopic injection of N-butyl-2-cyanoacrylate (NBC; Histoacryl) for treatment of bleeding gastric varices. Methods: We retrospectively analyzed the records of 455 patients with gastric variceal hemorrhage (GVH) who were consecutively treated with NBC from January 2004 to July 2013, with a mean follow-up period of 582 days. The patients` endoscopic findings, initial hemostasis, complications, rebleeding rates, and bleeding- related death rates were reviewed. Results: Hemostasis was achieved initially in 96.9% (441/455) of patients; rebleeding occurred in 35.2% (160/455), and the bleeding-related death rate was 6.8% (31/455) during follow-up. Complications included fever (6.8%), abdominal pain (3.7%), diarrhea (1.3%), spontaneous bacterial peritonitis (0.7%), bacteremia (0.4%), and embolism (0.2%). A red-color sign on concomitant esophageal varices (EVs) (p = 0.002) and previous history of variceal bleeding (p < 0.001) were significant risk factors for rebleeding within 1 year. The Child-Pugh score (p < 0.001), presence of hepatocellular carcinoma (p = 0.001), and failure of initial hemostasis (p < 0.001) were the risk factors most closely associated with bleeding-related death. Conclusions: This study provides a comprehensive overview of the outcomes and prognostic factors of patients with GVH. The results may help in the selection of effective treatment strategies for patients with GVH.