Journal of Yeungnam Medical Science

Original article

Diagnostic performance of F-18 FDG PET or PET/CT for detection of recurrent gastric cancer: a systematic review and meta-analysis: Chang In Choi, Jae Kyun Park, Tae Yong Jeon, Dae-Hwan Kim; J Yeungnam Med Sci. 2023;40(Suppl):S37-S46. Published online August 17, 2023; DOI: https://doi.org/10.12701/jyms.2023.00220

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Abstract PDF: Background
This systematic review and meta-analysis investigated the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) or PET/computed tomography (PET/CT) for the detection of disease recurrence after curative resection of gastric cancer.
Methods
The PubMed and Embase databases, from the earliest available date of indexing through November 30, 2019, were searched for studies evaluating the diagnostic performance of F-18 FDG PET or PET/CT to detect recurrent disease after gastric cancer surgery.
Results
Across 17 studies (1,732 patients), the pooled sensitivity for F-18 FDG PET or PET/CT was 0.82 (95% confidence interval [CI], 0.74–0.88) with heterogeneity of I2=76.5 (p<0.001), and the specificity was 0.86 (95% CI, 0.78–0.91) with heterogeneity of I2=94.2 (p<0.001). Likelihood ratio (LR) tests gave an overall positive LR of 6.0 (95% CI, 3.6–9.7) and negative LR of 0.2 (95% CI, 0.14–0.31). The pooled diagnostic odds ratio was 29 (95% CI, 13–63). The summary receiver operating characteristic curve indicates that the area under the curve was 0.91 (95% CI, 0.88–0.93).
Conclusion
The current meta-analysis showed good sensitivity and specificity of F-18 FDG PET or PET/CT for detecting recurrent disease after curative resection of gastric cancer despite heterogeneity in ethnicity, recurrence rate, histology, and interpretation method.

Case report

Intraabdominal abscess mimicking gastric cancer recurrence: a case report: Yong-Eun Park; J Yeungnam Med Sci. 2023;40(4):426-429. Published online February 1, 2023; DOI: https://doi.org/10.12701/jyms.2022.00864

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Abstract PDF: Surgical site infection is a common healthcare-associated infection that rarely occurs several months after surgery. Herein, a case is described in which an abdominal mass lesion was found at a 6-month follow-up visit after gastrectomy was performed for early gastric cancer. Positron emission tomography-computed tomography revealed a 2.5 cm-sized mass with a high maximal standard uptake value (8.32), located above a previous anastomosis site. Locoregional recurrence of gastric cancer was diagnosed by multidisciplinary team discussion, and explorative laparotomy was performed. However, surgical and pathologic findings revealed that the mass was an intraabdominal abscess. In conclusion, differential diagnosis of delayed abscess formation should be considered if the possibility of tumor recurrence is low, especially after early gastric cancer surgery.

Original Article

Prognostic role of preoperative carcinoembryonic antigen levels in colorectal cancer: propensity score matching: Cho Shin Kim, Sohyun Kim; Yeungnam Univ J Med. 2017;34(2):216-221. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.216

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Abstract PDF: BACKGROUND
This study was conducted to investigate preoperative carcinoembryonic antigen (CEA) as a prognostic factor in colorectal cancer. METHODS: Between January 2000 and July 2011, 1298 patients with primary adenocarcinoma colorectal cancer without metastasis, who underwent curative resection were retrospectively identified. The patients were divided into two groups according to serum CEA level at primary diagnosis: a high CEA (HCEA) group (serum CEA ≥6 ng/mL) and a normal CEA (NCEA) group (serum CEA <6 ng/mL). A 1:1 propensity score matching analysis was applied to reduce bias. Finally, 364 patients were enrolled in this study. Matched variables were age, gender, preoperative chemoradiotherapy, tumor site, cell differentiation and pathologic stage. RESULTS: The clinicopathological characteristics of the two groups did not differ significantly difference. The systemic metastasis rate was 16.5% (30/182) and 25.3% (46/182) in the NCEA and HCEA groups, respectively (p=0.039). There were no significant differences in local recurrence or metastatic sites between groups. The 5-year disease-free survival (DFS) rate of the HCEA group was worse than that of the NCEA group; however, there was no significant difference in overall survival between the two groups. CONCLUSION: Elevated preoperative CEA was related to frequent systemic recurrence and low DFS. Therefore, elevated preoperative CEA could be considered a prognostic factor for worse clinical outcomes in patients with colorectal cancer.

Case Report

Relapsed plasmacytoma in central nervous system after complete remission of extramedullary plasmacytoma.: Sun Mi Kang, Seong Gyu Kim, Ji Ho Seo, Ji Yoon Kim, Woo Jung Sung, Sung Hwa Bae, Hun Mo Ryoo; Yeungnam Univ J Med. 2014;31(1):43-47. Published online June 30, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.1.43

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Abstract PDF: Extramedullary plasmacytoma (EMP) is a rare disease that occurs in 3% to 5% of patients with plasma cell disorder. It occurs most commonly in the upper respiratory tract and the oral cavity. Very few EMP cases have been reported in the central nervous system (CNS). We report herein an unusual case of EMP in the nasal cavity that recurred in the CNS without systemic involvement. A 67-year-old man visited our hospital due to a month-long bout with exophthalmos. He was diagnosed with EMP in the nasal cavity, paranasal sinus, and orbital cavity. He received radiotherapy to which he had complete responses. After 2 years, he visited our hospital because of a month-long headache. He was diagnosed with EMP recurrence in the CNS via brain magnetic resonance imaging and cerebrospinal fluid analysis. He was treated with whole brain radiotherapy and intrathecal chemotherapy with methotrexate, but he expired due to pneumonia.

Original Article

A study of dose distribution in postoperative radiotherapy in uterine cervical cancer.: Sei One Shin, Sung Kyu Kim, Myung Se Kim; Yeungnam Univ J Med. 1991;8(1):166-177. Published online June 30, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.1.166

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Abstract PDF: Uterine cervical cancer is the most common malignancy in Korean women. In spite of recent development of early diagnostic and therapeutic modalities, about 40% of treated patient will develop relapse. So more aggressive local treatment such as more extensive surgery and higher radiation dose and administration of systemic chemotherapy will promote the curability but treatment related complications cannot be avoidable. We used 22 cases of early cervical cancer, treated with surgery and post-operative radiotherapy, clinical data of these patients were analyzed to determine relationship between clinical parameters and final outcome. Three out of 22 cases revealed relapse and one patient showed rectovaginal fistula and another patient showed small bowel obstruction and the other patient showed rectal obstruction. Two out of three recurrence were stage IIa and the other one case was stage Ib adenocarcinoma with lymphovascular involvement. Nineteen out of 22 cases were followed without remarkable side effect or treatment related complication or sequelae. We concluded that out treatment policy was safe and effective to eradicate high risk postoperative cervical cancer with acceptable side effects or complication.

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