Virtual Library

 x 
My Library Virtual Library FAQ

Start Your Search

E.K. Cho



Author of

  • +

    P1.10 - Poster Session 1 - Chemotherapy (ID 204)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
    • +

      P1.10-027 - A Phase II Trial of Genexol-PM(a Cremophor-free, polymeric micelle formulation of paclitaxel) and Gemcitabine in Patients with Advanced Non-small Cell Lung Cancer. (ID 1486)

      09:30 - 09:30  |  Author(s): E.K. Cho

      • Abstract

      Background
      Genexol-PM is a Cremorphor EL(CrEL)-free polymeric micelle formulation of paclitaxel, which renders higher dose administration with less hypersensitivity. This study was designed to evaluate the efficacy and safety of Genexol-PM and gemcitabine combination in advanced non-small cell lung cancer patients as first line treatment

      Methods
      This is a prospective single arm, single center Phase II study. Patients with advanced NSCLC received Genexol-PM at 230mg/m2 on day 1 and gemcitabine 1000mg/m2 on day 1 and day 8 of a 3-week cycle as first-line chemotherapy. Six cycles of chemotherapy were administered unless there is a disease progression. The primary endpoint was response rate.

      Results
      Forty-three patients received the study drugs with median of 4 cycles per patient (range, 1-6). Among 35 patients who received more than one cycle, mean dose intensity of CrEL-free paclitaxel and gemcitabine was 209 mg/m[2]/3-week and 1853mg/m[2]/3-week respectively. Overall response rate was 46.5%. The median progression free survival was 4.0 months (95% CI 2.0-6.0 months) and median overall survival was 14.8 months (95% CI 9.1-20.5 months). 18 patients (51%) experienced grade 3/4 adverse events, including neutropenia or febrile neutropenia (n=7), pneumonia (n=3), asthenia (n=3), peripheral neuropathy (n=2), diarrhea (n=1), skin rash (n=1), myalgia (n=1), pulmonary thromboembolism (n=1), LV dysfunction (n=1), dyspnea with sudden death (n=1). Adverse events leading to drug discontinuation were occurred in 9 patients, among which 2 patients were died of adverse events (pneumonia, dyspnea with sudden death)

      Conclusion
      CrEL-free paclitaxel in combination with gemcitabine demonstrated comparable antitumor activity with less emetogenicities in non-small cell lung cancer patients. Safety issue should be evaluated cautiously.

  • +

    P3.12 - Poster Session 3 - NSCLC Early Stage (ID 206)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
    • +

      P3.12-006 - Clinical Significance of Ki67 Expression in Curatively Resected Non-small Cell Lung Cancer (ID 1521)

      09:30 - 09:30  |  Author(s): E.K. Cho

      • Abstract

      Background
      Ki67 and p53 were suggested to be associated poor survival in stage I-III patients. The aim of this study was to explore the association of Ki67 and p53 expression with prognosis in curatively resected non-small cell lung cancer (NSCLC) patients.

      Methods
      We retrospectively identified patients with stage I-III NSCLC who underwent curative surgery in Gachon University Gil Medical Center from January 2007 to December 2012. Ki67 and p53 expression levels were evaluated by immunohistochemistry. Clinicopathologic features and disease free survival (DFS) were retrospectively estimated.

      Results
      One hundred and eighteen consecutive patients with Ki67 or p53 results were identified. Median Ki-67 labeling index was 30%. P53 expression was positive in 88 (25%) patients. Higher Ki67 expression (>30%) was significantly frequent in male(53.0% vs 13.3% of female, p<0.001) and non-adenocarcinoma(64.3% vs. 20.3% of adenocarcinoma, p<0.001) patients. In univariate analysis, median DFS had a trend toward worse in patients with higher Ki67 (55.9 months vs. not reached in those with lower Ki67 expression, p=0.113) and with positive p53 (55.9 months vs. not reached in those with negative p53 expression, p=0.123). In Cox multivariate analysis, higher Ki-67 expression was an signitifant independent prognostic factor associated with poorer DFS (HR 3.083, 95% CI 1.342-7.084), along with histology and stage. Among 44 stage Ib patients, 14 patients received adjuvant chemotherapy. In stage IB patients with higher Ki67 expression, adjuvant chemotherapy administration had a trend toward higher 3-year DFS rate (100% vs. 72% in patients without adjuvant chemotherapy). In contrast, 3-year DFS rate with adjuvant chemotherapy was 69%, compared with 79% without adjuvant chemotherapy in stage IB patients with lower Ki67 expression. In patients with tumor size≥4cm, there was no differences in DFS according to adjuvant chemotherapy.

      Conclusion
      Higher Ki67 expression was independently associated with shorter DFS in resected NSCLC patients. In stage IB, higher Ki67 seemed to be associated benefit of adjuvant chemotherapy. The value of Ki67 as a predictive biomarker of advantage of adjuvant chemotherapy should be further studied in a prospective larger cohort.

  • +

    P3.13 - Poster Session 3 - SCLC (ID 202)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
    • +

      P3.13-008 - Long-term Survival of 187 Patients with Small Cell Lung Cancer Based on the AJCC 6th and 7th TNM Edition (ID 1603)

      09:30 - 09:30  |  Author(s): E.K. Cho

      • Abstract

      Background
      The AJCC 7[th] TNM staging system is recommended for both non-small cell and small cell lung cancer (SCLC), although SCLC has traditionally been classified using the limited and extensive definition. We evaluated long-term survival of patients with SCLC according to the AJCC 6[th] and 7[th] TNM edition.

      Methods
      239 patients had been pathologically diagnosed with SCLC from January 2000 through December 2009 in our hospital. We included 187 patients who had initial CT scan of the thorax. We analyzed all available data for TNM staging using the AJCC 6[th] and 7[th] edition as well as the long-term survival rates.

      Results
      According to stages defined by the 6th TNM edition system, 5-year stage-specific survivals (5-YSR) were 43% for stage I and II, 36% for stage IIIA, 10% for stage IIIB, and 7% for stage IV. Applying the 7th edition system, 5-YSR were 46% for stage I and II, 24% for stage IIIA, 7% for stage IIIB, and 9% for stage IV. Using the 7[th] edition, 5-YSR of the stage IV was higher than that of stage IIIB. The number of changed stage from IIIB in the 6[th] edition to IV in the 7[th] edition was 22 and all were related to malignant pleural effusion.

      Conclusion
      Application of the TNM staging to SCLC stratifies survival more distinctly than limited and extensive definition by providing more substages. Slightly better survival of stage IV SCLC than that of stage IIIB in the 7[th] edition is related to malignant pleural effusion.

  • +

    P3.19 - Poster Session 3 - Imaging (ID 181)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Imaging, Staging & Screening
    • Presentations: 2
    • +

      P3.19-006 - Pseudopathologic Vertebral Body Enhancement in the Presence of Superior Vena Cava Obstruction on Computed Tomography (ID 1519)

      09:30 - 09:30  |  Author(s): E.K. Cho

      • Abstract

      Background
      Superior vena cava (SVC) obstruction can cause development of collateral vessels. During contrast-enhanced thoracic CT, contrast material may reflux into the collaterals such as paravertebral venous plexus. However, unusual pseudopathologic vertebral body enhancement on CT in the presence of SVC obstruction has not been studied previously. So, the aim of this study was to demonstrate clinical presentation and imaging findings of pseudopathologic vertebral body enhancement in patients with SVC obstruction.

      Methods
      From March 2009 to September 2012, a retrospective radiologic database review was performed to identify patients with obstruction of SVC causing contrast reflux into collateral vessels and presented with unusual vertebral body enhancement on thoracic CT. Thirteen patients (eleven men, mean age 51.4 years) with vertebral body enhancement were enrolled. The underlying diseases that caused SVC obstruction were adenocarcinoma of the lung in four, non-small cell lung cancer in two, large cell neuroendocrine carcinoma, small cell lung cancer, thymic carcinoma, sarcomatoid carcinoma, diffuse large B-cell lymphoma, Hodgkin’s lymphoma and metastatic lymphadenopathy from pancreatic cancer in one patient each. Enhancement patterns, locations and the presence of a connection between vertebral body enhancement and the paravertebral venous plexus were evaluated. Enhancement patterns of vertebral bodies were classified as nodular enhancement with round shape that occupying < 1/3 of vertebral body or polygonal enhancement that occupying ≥ 1/3 of vertebral body on axial image. The locations of enhanced areas within vertebral bodies were described using right lateral/central/left lateral, anterior/posterior, and upper/middle/lower in the x-, y-, or z-axis directions, respectively.

      Results
      A total of 39 vertebral body enhancements were found in the 13 patients, involving cervical (n = 12), thoracic (n = 25), or lumbar (n = 2) vertebrae. Vertebral body enhancements showed a nodular (n = 19) or a polygonal (n = 20) pattern. The central portions of vertebral bodies were more frequently involved. The connection to the paravertebral venous plexus was observed in 34 lesions (87.2%).

      Conclusion
      Patients with SVC obstruction with extensive collateral vessels might exhibit a pseudopathologic vertebral enhancement. They tended to involve the central portion of the vertebral body and most of them showed connection to the paravertebral venous plexus.

    • +

      P3.19-013 - The relationship between iodine-related attenuation of dual-energy CT and standardized uptake value of <sup>18</sup>FDG PET-CT in patients with non-small cell lung cancer (ID 2065)

      09:30 - 09:30  |  Author(s): E.K. Cho

      • Abstract

      Background
      A recent study revealed that maximum iodine-related attenuation (IRA~max~) of dual-energy CT (DECT) of primary tumor strongly correlates with maximum standardized uptake value (SUV~max~) of [18]FDG PET-CT in non-small cell lung cancer (NSCLC) (n = 27; r = 0.785; p = 0.001). It suggested that DECT could serve as a valuable functional imaging test in NSCLC. The aim of our study is to validate the previous results in our NSCLC cohort.

      Methods
      Twenty-seven patients with NSCLC who underwent both DECT and [18]FDG PET-CT were analyzed. The maximum and mean IRA as well as virtual non-contrast (VNC) images were calculated from DECT. Pearson correlation test was used to analyze the relationship between all measurements of DECT and the SUV~max~ of [18]FDG PET-CT in primary tumors and lymph nodes.

      Results
      Twenty-seven primary tumors and 51 thoracic lymph nodes with an SUV~max~ of >2.5 were included in analyses. In primary tumors, there was a moderate correlation between IRA~max~ and SUV~max~ (r = 0.565; p = 0.002) whereas no correlation was found between other DECT measurements and SUV~max.~ In lymph nodes, we observed no correlation between IRA~max~ and SUV~max~ (r = 0.197; p = 0.165) as well as between other DECT measurements and SUV~max.~

      Conclusion
      In patients with NSCLC, correlation between IRA~max~ and SUV~max ~was observed in primary tumors but not in lymph nodes. Because of relatively small population in our study and previous study, further large prospective studies are needed for validation.