Journal of Yeungnam Medical Science

Original articles

Oncology and Cancer Research
Extended therapeutic efficacy of dacarbazine following prior treatment with immune checkpoint inhibitors in metastatic melanoma: a single center retrospective study in Korea: Jihyun Na, Jun Young Kim, Seok-Jong Lee, In Hee Lee, Soo Jung Lee; J Yeungnam Med Sci. 2026;43:14. Published online January 16, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.14

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Abstract PDF: Background
Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of advanced malignant melanoma. This study examined the real-world efficacy of dacarbazine (dimethyl triazeno imidazole carboxamide, DTIC) in patients who had previously received pembrolizumab, based on the hypothesis that prior ICI treatment enhances the therapeutic response to subsequent chemotherapy.
Methods
This retrospective study included 71 patients with histologically confirmed malignant melanoma treated at Kyungpook National University Chilgok Hospital (Daegu, Korea) between 2011 and 2023. The patients received DTIC for unresectable stage IIIC, IIID, or IV melanoma (American Joint Committee on Cancer, 8th edition).
Results
Among the 71 patients, the median patient age was 64 years (range, 25–89 years). When categorized by melanoma subtype, 18 patients (25.4%) had acral melanoma, 40 (56.3%) had cutaneous melanoma, and 13 (18.3%) had mucosal melanoma. Sixteen of the DTIC-treated patients had not received pembrolizumab previously (DTIC-only group), while 55 had (pem-DTIC group). The median progression-free survival was 2.3 months in the DTIC-only group and 3.9 months in the pem-DTIC group (hazard ratio [HR], 0.246; 95% confidence interval [CI], 0.106–0.576; p=0.001). The median overall survival was 6.8 months in the DTIC-only group and 19.0 months in the pem-DTIC group (HR, 0.198; 95% CI, 0.068–0.574; p=0.003). The duration of response (DoR) was 4.64 months in the DTIC group and 8.11 months in the pem-DTIC group.
Conclusion
This study demonstrated that the DoR to DTIC was prolonged following ICI therapy (4.64 months vs. 8.11 months). This indicates that prior ICI treatment may enhance tumor sensitivity to chemotherapy, making DTIC a viable option for treating refractory, relapsed, or progressive melanoma.

Ophthalmology
Comparison of ganglion cell-inner plexiform layer thickness among patients with intermittent exotropia according to fixation preference: a retrospective observational study: Yeon Ju Lim, Soo Jung Lee; J Yeungnam Med Sci. 2025;42:6. Published online October 25, 2024; DOI: https://doi.org/10.12701/jyms.2024.00864

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Abstract PDF: Background
This study was performed to compare the thickness of the ganglion cell-inner plexiform layer (GCIPL) depending on the presence or absence of fixation preference in patients with intermittent exotropia (IXT) with refractive values close to emmetropia and with no amblyopia.
Methods
The study recruited pediatric patients diagnosed with IXT with a spherical equivalent within ±1.25 diopter and no amblyopia. The patients were categorized into two groups: a monocular exotropia group with fixation preference and an alternating exotropia group without fixation preference. GCIPL thickness was measured using spectral domain optical coherence tomography, and the macula was divided into nine sectors according to the Early Treatment Diabetic Retinopathy Study (ETDRS). GCIPL thickness in each sector was compared between the monocular and alternating exotropia groups.
Results
In the monocular exotropia group, GCIPL thickness was significantly thinner in the dominant eye than in the nondominant eye in the S1 sector (91.2±7.4 μm vs. 93.3±5.2 μm, p=0.019). However, in the alternating exotropia group, there were no significant differences between the eyes across all ETDRS sectors. When comparing the interocular differences in GCIPL thickness between the two groups, the monocular exotropia group (absolute value of the dominant eye minus the nondominant eye) exhibited significantly greater differences in several ETDRS sectors than the alternating exotropia group (absolute value of the right eye minus the left eye).
Conclusion
The significant interocular difference in GCIPL thickness in the monocular exotropia group suggests that fixation preference may influence the anatomical structure of the macula in patients with IXT.

Oncology and Cancer Research
Treatment decision for cancer patients with fever during the coronavirus disease 2019 (COVID-19) pandemic: In Hee Lee, Sung Ae Koh, Soo Jung Lee, Sun Ah Lee, Yoon Young Cho, Ji Yeon Lee, Jin Young Kim; Yeungnam Univ J Med. 2021;38(4):344-349. Published online August 23, 2021; DOI: https://doi.org/10.12701/yujm.2021.01144

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Abstract PDF: Background
Cancer patients have been disproportionally affected by the coronavirus disease 2019 (COVID-19) pandemic, with high rates of severe outcomes and mortality. Fever is the most common symptom in COVID-19 patients. During the COVID-19 pandemic, physicians may have difficulty in determining the cause of fever (COVID-19, another infection, or cancer fever) in cancer patients. Furthermore, there are no specific guidelines for managing cancer patients with fever during the COVID-19 pandemic. Thus, this study evaluated the clinical characteristics and outcomes of cancer patients with fever during the COVID-19 pandemic.
Methods
This study retrospectively reviewed the medical records of 328 cancer patients with COVID-19 symptoms (fever) admitted to five hospitals in Daegu, Korea from January to October 2020. We obtained data on demographics, clinical manifestations, laboratory test results, chest computed tomography images, cancer history, cancer treatment, and outcomes of all enrolled patients from electronic medical records.
Results
The most common COVID-19-like symptoms were fever (n=256, 78%). Among 256 patients with fever, only three (1.2%) were diagnosed with COVID-19. Most patients (253, 98.8%) with fever were not diagnosed with COVID-19. The most common solid malignancies were lung cancer (65, 19.8%) and hepatobiliary cancer (61, 18.6%). Twenty patients with fever experienced a delay in receiving cancer treatment. Eighteen patients discontinued active cancer treatment because of fever. Major events during the treatment delay period included death (2.7%), cancer progression (1.5%), and major organ dysfunction (2.7%).
Conclusion
Considering that only 0.9% of patients tested for COVID-19 were positive, screening for COVID-19 in cancer patients with fever should be based on the physician’s clinical decision, and patients might not be routinely tested.

Surgery
The effectiveness of prophylactic ipsilateral central neck dissection in selected patients who underwent total thyroidectomy for clinically node-negative unilateral papillary thyroid carcinoma: Jin Gu Kang, Young Ah Kim, Jung Eun Choi, Soo Jung Lee, Su Hwan Kang; Yeungnam Univ J Med. 2020;37(3):202-209. Published online April 10, 2020; DOI: https://doi.org/10.12701/yujm.2020.00031

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Abstract PDF

Background
Prophylactic central neck dissection (CND) in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) remains controversial. The purpose of this study was to evaluate the benefits of prophylactic ipsilateral CND compared with bilateral CND in total thyroidectomy for cN0 unilateral PTC.
Methods
We retrospectively enrolled 174 patients who underwent total thyroidectomies with prophylactic CND for cN0 unilateral PTC between January 2009 and May 2010. The prophylactic CND patients were divided into group 1, the ipsilateral CND group (n=74), and group 2, the bilateral CND group (n=100). The incidence of central lymph node metastasis (CLNM) and postoperative complications, such as hypoparathyroidism, recurrent laryngeal nerve injury, and recurrence were assessed.
Results
CLNM was found in 22 (29.8%) in group 1 and 69 (69%) in group 2. The incidence of postoperative severe hypocalcemia less than 7.0 was also significantly different (six patients [8.1%] in group 1 and 23 [23%] in group 2; p=0.009). Permanent hypoparathyroidism was significantly more frequent in group 2 (4.1% vs. 19%; p=0.005). However, the incidence of transient hypoparathyroidism, recurrence, and recurrent laryngeal nerve injury was not significantly different.
Conclusion
Prophylactic ipsilateral CND has advantage not only to reduce incidence of some complications but also to have similar recurrence rate compared with bilateral CND. We suggest that prophylactic ipsilateral CND may be safe and effective for selected patients undergoing total thyroidectomy for cN0 unilateral PTC.

Citations

Citations to this article as recorded by

Prospective Observational Study of the Role of Unilateral Prophylactic Central Compartmental Lymph Node Dissection in Early Papillary Thyroid Cancer
Surekha Talasila, M Ramya, T Sravanthi
Cureus.2026;[Epub] CrossRef
Comparison of prophylactic ipsilateral and bilateral central lymph node dissection in papillary thyroid carcinoma: a meta-analysis
Yujie Li, Lingling Lao
Brazilian Journal of Otorhinolaryngology.2023; 89(6): 101318. CrossRef
Fine-Needle Pricking Test of the Parathyroid Gland during Thyroid Surgery in Predicting Parathyroid Function
Ying-Jun Wu, Jian-Biao Wang, Fei-Bo Li, Lei Jin, Liang Zhou, Lei Xie, Claudio Casella
International Journal of Endocrinology.2022; 2022: 1. CrossRef

Case report

Oncology and Cancer Research
Impressive effect of cisplatin monotherapy on a patient with heavily pretreated triple-negative breast cancer with poor performance: Dong Won Baek, Ji-Young Park, Soo Jung Lee, Yee Soo Chae; Yeungnam Univ J Med. 2020;37(3):230-235. Published online January 22, 2020; DOI: https://doi.org/10.12701/yujm.2019.00423

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Abstract PDF

Systemic therapy for metastatic triple-negative breast cancer (TNBC) still remains challenging because there are no targeted agents or endocrine therapies currently available. The present case report documents the successful use of cisplatin monotherapy to manage a heavily pretreated TNBC patient showing poor response to therapy. The patient was a 51-year-old woman who had already undergone several lines of systemic chemotherapy for widespread TNBC. Although the mutation analysis performed on DNA isolated from blood cells and progressed lesion samples confirmed the tumor to be germline BRCA wild-type, cisplatin monotherapy was administered based on the increasing evidence of safety and efficacy of platinum for breast cancer. After three cycles of cisplatin treatment, the patient’s metastatic lesions dramatically improved without any major toxicity, and she completed 17 cycles with good response. This case study indicates that patients with heavily pretreated TNBC can potentially achieve a good response to cisplatin monotherapy.

Citations

Citations to this article as recorded by

Mitochondrial Redox Vulnerabilities in Triple-Negative Breast Cancer: Integrative Perspectives and Emerging Therapeutic Strategies
Alfredo Cruz-Gregorio
Metabolites.2026; 16(1): 60. CrossRef
Nanohydrogel Composites for Local Monotherapy and Dual Chemotherapy in the Management of Breast Cancer
Pooja Rani, Bhupinder Kapoor, Monica Gulati
Advanced Therapeutics.2026;[Epub] CrossRef
Synthesis, Structure, and Stability of Copper(II) Complexes Containing Imidazoline-Phthalazine Ligands with Potential Anticancer Activity
Łukasz Balewski, Iwona Inkielewicz-Stępniak, Maria Gdaniec, Katarzyna Turecka, Anna Hering, Anna Ordyszewska, Anita Kornicka
Pharmaceuticals.2025; 18(3): 375. CrossRef
Structure–activity insights and molecular modeling approaches of anti-TNBC agents: a comprehensive systematic review
Risqi Ayu Febriana, Dhania Novitasari, Nur Kusaira Khairul Ikram, Muchtaridi Muchtaridi
Future Science OA.2025;[Epub] CrossRef
Zeolitic Imidazole Framework/Silica Nanocomposite for Targeted Cancer Therapeutics: Comparative Study of Chemo-Drug Cisplatin (CPt) and Green Platinum (GPt) Efficacy
Hend Ghnaim Alotaibi, Eman Al-Abbad, Dana Almohazey, Vijaya Ravinayagam, Sultan Akhtar, Hatim Dafalla, B. Rabindran Jermy
International Journal of Molecular Sciences.2024; 25(6): 3157. CrossRef
Cisplatin Monotherapy as a Treatment Option for Patients with HER-2 Negative Breast Cancer Experiencing Hepatic Visceral Crisis or Impending Visceral Crisis
Mirosława Püsküllüoğlu, Małgorzata Pieniążek, Agnieszka Rudzińska, Agnieszka Pietruszka, Renata Pacholczak-Madej, Aleksandra Grela-Wojewoda, Marek Ziobro
Oncology and Therapy.2024; 12(3): 419. CrossRef
Hypoxia: syndicating triple negative breast cancer against various therapeutic regimens
Nityanand Srivastava, Salman Sadullah Usmani, Rajasekaran Subbarayan, Rashmi Saini, Pranav Kumar Pandey
Frontiers in Oncology.2023;[Epub] CrossRef
Inhibiting L1CAM Reverses Cisplatin Resistance of Triple Negative Breast Cancer Cells by Blocking AKT Signaling Pathway
Lu-Yao Zhang, Zhi-Xin Shen, Lu Guo
Cancer Investigation.2022; 40(4): 313. CrossRef
Curcumin as an Enhancer of Therapeutic Efficiency of Chemotherapy Drugs in Breast Cancer
Reyhaneh Farghadani, Rakesh Naidu
International Journal of Molecular Sciences.2022; 23(4): 2144. CrossRef
Atorvastatin improves cisplatin sensitivity through modulation of cholesteryl ester homeostasis in breast cancer cells
Diandra Zipinotti dos Santos, Isabella dos Santos Guimaraes, Mariam F. Hakeem-Sanni, Blake J. Cochran, Kerry-Anne Rye, Thomas Grewal, Andrew J. Hoy, Leticia B. A. Rangel
Discover Oncology.2022;[Epub] CrossRef
Targeting Hypoxia Sensitizes TNBC to Cisplatin and Promotes Inhibition of Both Bulk and Cancer Stem Cells
Andrew Sulaiman, Sarah McGarry, Jason Chambers, Emil Al-Kadi, Alexandra Phan, Li Li, Karan Mediratta, Jim Dimitroulakos, Christina Addison, Xuguang Li, Lisheng Wang
International Journal of Molecular Sciences.2020; 21(16): 5788. CrossRef
Antioxidant Supplementation in the Treatment of Neurotoxicity Induced by Platinum-Based Chemotherapeutics—A Review
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International Journal of Molecular Sciences.2020; 21(20): 7753. CrossRef

Original Article

Surgery
The Relationship Between the Expression of Estrogen Receptor beta and Recurrence in Breast Cancer.: Su Hwan Kang, Jung Eun Choi, Soo Jung Lee; Yeungnam Univ J Med. 2011;28(2):153-164. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.153

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Abstract PDF: BACKGROUND
It has been reported that estrogen receptor beta (ERbeta) mRNA expression was down-regulated during carcinogenesis and was inversely related to estrogen receptor alpha (ERalpha) expression in breast cancer. The association of ERbeta mRNA expression to tamoxifen resistance has also been reported. In this study, the expression of ERalpha and ERbeta via immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) was prompted, and an attempt was made to find out the relationship between ERbeta expression and recurrence in the hormonal therapy group, and between ERbeta expression and known prognostic factors. METHODS: Tumor specimens were obtained at surgery from 67 female breast cancer patients during the period of September 1995 to December 2000. All the specimens were frozen in liquid nitrogen and kept at -70degrees C until they were used. The medical records were analyzed retrospectively. The expressions of ER were analyzed using IHC and RT-PCR methods. RESULTS: The median follow-up was at 93.0 months (range: 14-157 months). The percentage of ERalpha+/ERbeta+, ERalpha+/ERbeta-, ERalpha-/ERbeta+, and ERalpha-/ERbeta group were 35.9% 9.4%, 47.2%, and 7.5%, respectively, in 53 patients with hormonal therapy. ERbeta was positive in 42 (82.3%) of 51 ER-positive patients. In the hormonal therapy group, the recurrence rates of each group was 15.8%, 0%, 40.0%, and 0%, respectively. In this group, the ERbeta expression tended to recur, but there was no clinical significance (p=0.084). CONCLUSION: The ERbeta expression may be a predictive marker of a poor response to endocrine therapy in breast cancer patients, although this needs to be confirmed in additional studies.

Case Report

Surgery
Adenoid Cystic Carcinoma of the Breast －A Case Report－: Jun Mo Kim, Mi Soo Hwang, Su Hwan Kang, Soo Jung Lee, Young Kyung Bae; Yeungnam Univ J Med. 2007;24(2 Suppl):S749-754. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S749

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Abstract PDF: Adenoid cystic carcinoma (ACC) is a rare malignant neoplasm of the breast accounting for approximately 0.1% of all breast carcinomas with a total 200 cases reported in the literature. In contrast to the aggressive nature of ACC in other organs, ACC of the breast is known to have an excellent prognosis. Recently we experienced the first case of ACC of the breast at Yeungnam University hospital. The case was diagnosed by preoperative fine needle aspiration cytology. We report a case of ACC of the breast managed with breast conserving surgery and review the literature.

Original Article

Radiation Oncology
Conservative surgery and definitive radiotherapy in early breast cancer: Sei One Shin, Jung Sook Hong, Myung Se Kim, Young Do Lee, Sung Kyu Kim, Soo Jung Lee; Yeungnam Univ J Med. 1993;10(2):380-387. Published online December 31, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.2.380

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Abstract PDF: Local excision and axillary dissection followed by radiation therapy to the breast has been shown to achieve equivalent local control and survival as mastectomy in an prospective randomized trials. We analyzed 28 cases of early breast cancer in order to evaluate the therapeutic effects of conservative f surgery and definitive radiotherapy in the management of early breast cancer as possible alternative of simple mastectomy, retrospectively. Obtained results were as follows 1. Treatment related acute side reactions are more prominant in the case of chemoradiotherapy group than radiotherapy alone group. 2. There were no cases of primary, regional or systemic failures on the last follow up examination. 3. Cosmetic results after treatment were satisfactory in 26 cases out of 28 cases on the last follow up examination. 4. There were no demonstrable differences of tumor control and cosmetic results between the treatment groups. Although, these results suggested that definitive radiotherapy after local excision would be a possible and desirable alternative instead of total mastectomy in the management of early breast cancers, analyzed cases were too small and follow up period was too short to evaluate the therapeutic effect of primary radiotherapy after local excision, exactly.

Case Report

Surgery
Intestinal lipoma near the ileocecal calve Report of 3 cases and review of the literature.: Min Chul Shim, Soo Jung Lee, Hyun Sik Min, Koing Bo Kwun; Yeungnam Univ J Med. 1986;3(1):333-337. Published online December 31, 1986; DOI: https://doi.org/10.12701/yujm.1986.3.1.333

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Abstract PDF: Three cases of intestinal lipoma near the ileocecal valve are described. In patients of cecal and ileocecal valve lipoma, they had right lower quadrant abdominal pain secondary to partial intestinal obstruction. In rarely developed segmental lipomatosis of the ileum, the patient had right abdominal mass and pain to fecal impaction of the diverticula. Diagnosis may be made by an abnormal roentgenographic pattern and confirmed by colonoscopy. Surgical removal of the affected segment results in cure in symptomatic patients.

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