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48. Pretreatment depression as a prognostic indicator of survival and nutritional status in patients with head and neck cancer.

Author

Kim SA, Roh JL, Lee SA, Lee SW, Kim SB, Choi SH, Nam SY, and Kim SY

Subjects
Adult, Aged, Carcinoma, Squamous Cell physiopathology, Female, Head and Neck Neoplasms physiopathology, Humans, Male, Middle Aged, Nutritional Status, Prognosis, Prospective Studies, Quality of Life, Squamous Cell Carcinoma of Head and Neck, Surveys and Questionnaires, Survival Analysis, Carcinoma, Squamous Cell psychology, Depression physiopathology, Head and Neck Neoplasms psychology
Abstract

Background: The emotional status of cancer patients is associated with disease course and treatment outcomes. In this study, the authors evaluated associations between the presence of pretreatment depression and pretreatment quality of life (QOL), nutritional status, and survival outcomes in patients with head and neck squamous cell carcinoma (HNSCC)., Methods: For this prospective study, 241 patients with previously untreated HNSCC who underwent curative treatments were enrolled. Patients completed the Beck Depression Inventory (BDI)-II, the European Organization for Research and Treatment of Cancer (EORTC) 30-item Core QOL Questionnaire (QLQ-C30), and the EORTC QLQ Head and Neck Cancer module (QLQ-H&N35). EORTC QLQ scores were compared between depressive and nondepressive patients, as determined according to pretreatment BDI-II scores ≥ 14 and <14, respectively. Univariate and multivariate analyses were performed to assess whether the presence of depression was associated with overall survival, disease-free survival (DFS), or posttreatment changes in nutritional status and laboratory data., Results: Pretreatment depression was present in 60 patients (24.9%). In depressive and nondepressive patients, the 3-year overall survival rates were 70.8% and 82.7%, respectively (P = .045), and the 3-year DFS rates were 63.5% and 79.1%, respectively (P = .015). After controlling for clinical factors, the presence of depression was predictive of 3-year DFS (P = .032). EORTC QLQ-C30 and QLQ-HN35 scores on all items except feeding tube, nutritional supplement, and problem with mouth opening differed between depressive and nondepressive patients (P < .05). Depressive patients had lower pretreatment serum albumin levels than nondepressive patients (P < .05)., Conclusions: There was a significant correlation between pretreatment depression and pretreatment QOL, nutritional status, and survival outcomes in patients with HNSCC., (© 2015 American Cancer Society.)

Published
2016
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49. Epithelial-mesenchymal transition: clinical implications for nodal metastasis and prognosis of tongue cancer.

Author

Han MW, Lee JC, Kim YM, Cha HJ, Roh JL, Choi SH, Nam SY, Cho KJ, Kim SW, and Kim SY

Subjects
Adult, Aged, Cohort Studies, Female, Humans, Lymphatic Metastasis, Male, Middle Aged, Neoplasms, Second Primary, Prognosis, Young Adult, Epithelial-Mesenchymal Transition, Tongue Neoplasms pathology
Abstract

Objective: The development of biomarkers for the prediction of lymph node metastasis and prognosis is critical for deciding the treatment modality of tongue cancer. The purpose of our study is to investigate the clinical implications of epithelial-mesenchymal transition (EMT) expression in tongue cancer., Study Design: Historical cohort study, Setting: Tertiary-care hospital., Subjects and Methods: The study included 95 subjects with tongue cancer who underwent wide excision and neck dissection. According to characteristics of immunohistochemical staining for E-cadherin and vimentin, we classified the tumors as complete EMT phenotype, incomplete EMT phenotype, or epithelial phenotype. The correlation between risk factors and nodal metastasis was assessed, and disease-free survival (DFS) was analyzed., Results: Positive lymph nodes were detected in 46 (48.4%) patients and was found to correlate significantly with depth of invasion ≥ 4 mm and EMT expression on multivariate analysis (P = .030, P = .022, respectively). The mean follow-up period of all patients was 96.3 months (range, 6-149 months). Overall 5-year DFS was 61.7%. On multivariate analysis, the only factors affecting DFS were nodal stage and EMT expression (P = .033, P = .021, respectively)., Conclusions: Our study reveals that EMT expression is a significant biomarker for predicting lymph node metastasis and tumor recurrence in tongue cancer. Evaluation of EMT expression in tongue cancer can allow therapy to be offered accordingly., (© American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.)

Published
2015
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50. Can response to induction chemotherapy be a predictive marker for ultimate outcome in hypopharyngeal cancer?

Author

Han MW, Ryu IS, Lee SW, Kim SB, Roh JL, Choi SH, Kim SY, and Nam SY

Subjects
Adult, Aged, Aged, 80 and over, Disease-Free Survival, Female, Follow-Up Studies, Humans, Hypopharyngeal Neoplasms mortality, Hypopharyngeal Neoplasms surgery, Male, Middle Aged, Republic of Korea epidemiology, Retrospective Studies, Survival Rate trends, Time Factors, Treatment Outcome, Antineoplastic Agents therapeutic use, Hypopharyngeal Neoplasms drug therapy, Induction Chemotherapy methods, Laryngectomy methods
Abstract

Objective: Induction chemotherapy (ICT) may reduce rates of distant metastases and enhance organ preservation and survival rates in patients with hypopharyngeal cancer. The authors compared survival data in patients who underwent chemoradiotherapy or surgery after ICT and investigated whether response to ICT is a predictive marker for outcome in patients with hypopharyngeal cancer., Study Design: Historical cohort study., Setting: Tertiary-care hospital., Subjects and Methods: The authors enrolled 97 patients (89 men, 8 women; mean age 61.2 years; range, 29-80 years) with previously untreated hypopharyngeal cancer who underwent ICT between January 1997 and December 2006 at Asan Medical Center. Disease-free survival (DFS), overall survival (OS), and laryngectomy-free survival (LFS) were analyzed., Results: At a mean follow-up of 38.0 months, the 3-year DFS and OS for all patients were 48.3% and 49.2%, respectively. The 3-year LFS rate of patients who underwent nonsurgical therapy (n = 85) after ICT was 48.0%. Only response to ICT was associated with DFS (P = .047), OS (P = .003), and LFS (P = .009) in multivariate analysis. When the authors compared survival data in patients who underwent surgical and nonsurgical treatments after ICT, they found that there was no statistical difference in terms of the 3-year DFS in partial response (42.9% vs 50.5%, P = .77) and nonresponse groups (50.0% vs 0%, P = .43) between the 2 treatment types., Conclusion: ICT permits assessment of tumor responsiveness and alters subsequent therapy accordingly. Response to ICT may be useful in the prediction of ultimate outcomes and organ conservation in patients with hypopharyngeal cancer.

Published
2012
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