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Song C, Jang TK, Kong S, Kang H, Kwon SH, Cho CH. Robotic Single-Site Radical Hysterectomy for Early Cervical Cancer: A Single Center Experience of 5 Years. J Pers Med 2023; 13:jpm13050733. [PMID: 37240903 DOI: 10.3390/jpm13050733] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/18/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The mainstay of treatment for early-stage cervical cancer is surgery; we present a 5-year experience of robotic single-site radical hysterectomy (RSRH) focused on surgical and oncologic outcomes. METHODS This retrospective study included 44 cases of RSRH performed in patients with early-stage cervical cancer. RESULTS The median follow-up period for the 44 patients was 34 months. The mean total operation time was 156.07 ± 31.77 min, while mean console time was 95.81 ± 24.95 min. Two cases had complications, which required surgical management, while four cases (9.1%) exhibited recurrence. The disease-free survival rate at 5 years was 90.9%. The sub-division analysis showed that Stage Ia2 and stage Ib1 patient sub-group showed better DFS than that of the stage Ib2 patient sub-group. The learning curve analysis showed that the CUSUM-T initially peaks at the sixth case then gradually decreases before rising and peaking at the 24th case. After 24th case, the CUSUM-T gradually decreases and reaches zero. CONCLUSION The surgical outcomes of RSRH for early-stage cervical cancer treatment were safe and acceptable. However, RSRH could be considered carefully only in well-selected patient groups. Large-scale prospective studies are necessary in the future to validate the results.
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Affiliation(s)
- Changho Song
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Tae-Kyu Jang
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Soomin Kong
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Heeju Kang
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Sang-Hoon Kwon
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Chi-Heum Cho
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
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Jang TK, Kim H, Eo W, Kim KH, Lee CM, Kim M. Clinical Significance of the Combination of Serum HE4 Levels, Hemoglobin-to-Red Cell Distribution Width Ratio, and CT Imaging for the Pretreatment Assessment of Adnexal Masses. J Cancer 2023; 14:600-610. [PMID: 37057288 PMCID: PMC10088533 DOI: 10.7150/jca.81174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/13/2023] [Indexed: 03/14/2023] Open
Abstract
Background: This study aimed to determine the optimal combination of biomarkers that can predict epithelial ovarian cancer (EOC) and compare the combination with the risk of ovarian malignancy algorithm (ROMA) or Copenhagen index (CPH-I). Methods: Data from 66 patients with EOC and 599 patients with benign ovarian masses who underwent definitive tissue diagnosis of adnexal masses between January 2017 and March 2021 were analyzed. The Mann-Whitney U test or Kruskal-Wallis test was used for between-group comparisons of medians. Logistic regression was used to establish an EOC predictor model. Area under the curve (AUC) comparisons between models were performed using the Delong nonparametric approach. Results: The median age of the patients was 43 years. Twenty-nine (43.9%) patients had early-stage disease (stages I-II) and 37 (56.1%) patients had advanced-stage disease (stages III-IV). The median age, body mass index, white blood cell count, hemoglobin-to-red cell distribution width ratio (HRR), platelet count, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, serum albumin level, cancer antigen 125, human epididymal secretory protein 4 (HE4), ROMA, and CPH-I were significantly different between the stage I-IV EOC and benign ovarian mass groups. Multivariate logistic regression analysis revealed that HE4, HRR, and computed tomography (CT) imaging were significant predictors of both stages I-IV and I-II EOC. Using these covariates, an interim model (IM) (consisting of HE4 and HRR) and a full model (FM) (consisting of HE4, HRR, and CT imaging) were constructed. When predicting stage I-IV EOC, the AUC of IM was comparable to that of ROMA or CPH-I, whereas the AUC of FM outperformed ROMA or CPH-I. In predicting stage I-II EOC, the AUC of IM was comparable to that of CPH-I but higher than that of ROMA, and the AUC of FM outperformed ROMA or CPH-I. Conclusion: FM outperformed ROMA or CPH-I in predicting stage I-IV EOC and stage I-II EOC. Therefore, FM could be a promising model for improving preoperative prediction of EOC at an early stage. However, further prospective studies are required to validate these results.
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Park SE, Ryu JE, Jang TK. Laparoscopic excision and repair of a cesarean scar pregnancy in a woman with uterine didelphys: a case report. J Yeungnam Med Sci 2022; 40:202-206. [PMID: 35570649 PMCID: PMC10076921 DOI: 10.12701/jyms.2022.00115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/06/2022] [Indexed: 11/04/2022]
Abstract
Cesarean scar pregnancy (CSP) is a rare complication that occurs in less than 1% of ectopic pregnancies, and uterine didelphys is one of the rarest uterine forms. We report a successful laparoscopic excision and repair of CSP in a woman with uterine didelphys and a double vagina. A 34-year-old gravida one, para one woman with a history of low transverse cesarean section presented to our hospital with a suspected CSP. She was confirmed to have uterine didelphys with a double vagina during an infertility examination 7 years earlier. Magnetic resonance imaging showed a 2.5-cm gestational sac-like cystic lesion in the lower segment of the right uterus at the cesarean scar. We decided to perform a laparoscopic approach after informing the patient of the surgical procedure. The lower segment of the previous cesarean site was excised with monopolar diathermy to minimize bleeding. We identified the gestational sac in the lower segment of the right uterus, which was evacuated using spoon forceps. The myometrium and serosa of the uterus were sutured layer-by-layer using synthetic absorbable sutures. No remnant gestational tissue was visible on follow-up ultrasonography one month after the surgery. This laparoscopic approach to CSP in a woman with uterine didelphys is an effective and safe method of treatment. In women with uterine anomalies, it is important to confirm the exact location of the gestational sac by preoperative imaging for successful surgery.
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Affiliation(s)
- Seong-Eon Park
- Department of Obstetrics and Gynecology, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Ji-Eun Ryu
- Department of Obstetrics and Gynecology, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Tae-Kyu Jang
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, Korea
- Corresponding author: Tae-Kyu Jang, MD Department of Obstetrics and Gynecology, Keimyung University School of Medicine, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea Tel: +82-53-258-7809 • Fax: +82-53-250-7599 • E-mail:
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Gweon B, Jang TK, Thuy PX, Moon EY. Primary Cilium by Polyinosinic:Polycytidylic Acid Regulates the Regenerative Migration of Beas-2B Bronchial Epithelial Cells. Biomol Ther (Seoul) 2022; 30:170-178. [PMID: 35221299 PMCID: PMC8902458 DOI: 10.4062/biomolther.2022.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 01/29/2022] [Accepted: 01/30/2022] [Indexed: 11/17/2022] Open
Abstract
The airway epithelium is equipped with the ability to resist respiratory disease development and airway damage, including the migration of airway epithelial cells and the activation of TLR3, which recognizes double-stranded (ds) RNA. Primary cilia on airway epithelial cells are involved in the cell cycle and cell differentiation and repair. In this study, we used Beas-2B human bronchial epithelial cells to investigate the effects of the TLR3 agonist polyinosinic:polycytidylic acid [Poly(I:C)] on airway cell migration and primary cilia (PC) formation. PC formation increased in cells incubated under serum deprivation. Migration was faster in Beas-2B cells pretreated with Poly(I:C) than in control cells, as judged by a wound healing assay, single-cell path tracking, and a Transwell migration assay. No changes in cell migration were observed when the cells were incubated in conditioned medium from Poly(I:C)-treated cells. PC formation was enhanced by Poly(I:C) treatment, but was reduced when the cells were exposed to the ciliogenesis inhibitor ciliobrevin A (CilioA). The inhibition of Beas-2B cell migration by CilioA was also assessed and a slight decrease in ciliogenesis was detected in SARS-CoV-2 spike protein (SP)-treated Beas-2B cells overexpressing ACE2 compared to control cells. Cell migration was decreased by SP but restored by Poly(I:C) treatment. Taken together, our results demonstrate that impaired migration by SP-treated cells can be attenuated by Poly(I:C) treatment, thus increasing airway cell migration through the regulation of ciliogenesis.
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Affiliation(s)
- Bomi Gweon
- Department of Mechanical Engineering, Sejong University, Seoul 05006, Republic of Korea
| | - Tae-Kyu Jang
- Department of Integrated Bioscience and Biotechnology, Sejong University, Seoul 05006, Republic of Korea
| | - Pham Xuan Thuy
- Department of Integrated Bioscience and Biotechnology, Sejong University, Seoul 05006, Republic of Korea
| | - Eun-Yi Moon
- Department of Integrated Bioscience and Biotechnology, Sejong University, Seoul 05006, Republic of Korea
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Jang TK, Park JY, Kim DY, Suh DS, Kim JH, Kim YM, Kim YT, Nam JH. The Clinical Significance and Utility of HPV-DNA Testing in Korean Women with Atypical Glandular Cells in Cervical Pap Tests: An Analysis of 311 Cases at a Single Institution. Cancer Invest 2021; 39:885-892. [PMID: 34279158 DOI: 10.1080/07357907.2021.1952593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The aim of this study is to analyze the correlation between clinically significant histologic results and HPV in women with AGC in pap test. Of the 311 women confirmed as AGC, 111 women (35.7%) was identified as positive for HPV. In the AGC analysis, cervical lesions were significantly more common in HPV positive group compared to HPV negative group (61.2 vs. 10.5%, p < 0.001). In contrast, endometrial lesions were not associated with HPV infection (8.1 vs. 4.5%, p = 0.12). The HPV-DNA testing in women with AGC may be a useful tool for predicting clinically significant cervical lesions.
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Affiliation(s)
- Tae-Kyu Jang
- Department of Obstetrics and Gynecology, Donsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Jeong-Yeol Park
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dae-Yeon Kim
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dae-Shik Suh
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong-Hyeok Kim
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yong-Man Kim
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Tak Kim
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joo-Hyun Nam
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Chung H, Jang TK, Kwon SY, Ha J, Shin SJ. A proximal type epithelioid sarcoma of the vulva with multiple distant metastases: A case report and review of the literature. Gynecol Oncol Rep 2021; 37:100835. [PMID: 34377757 PMCID: PMC8327478 DOI: 10.1016/j.gore.2021.100835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/12/2022] Open
Abstract
Epithelioid sarcomas (ESs) are rare and aggressive malignancy of a poor prognosis. Radiotherapy may be an alternative treatment to decrease the size of the lesion. Targeted therapy with pazopanib may be a treatment option for soft tissue sarcomas.
Epithelioid sarcomas (ESs) of the vulva are extremely rare soft tissue tumors characterized by an aggressive clinical course and a poor prognosis. The proximal type of ES occurs in the trunk and external genital area and has higher recurrence and distant metastasis rates than the distal type, which is found in the upper and lower extremities. We describe a case of a vulvar ES in a 24-year-old patient who was referred from the department of plastic surgery with protruding mushroom-like lesions in multiple areas, including the lower abdomen, whole vulva, anus, and both inguinal lesions. A biopsy of the lesions confirmed a proximal-type ES. Computed tomography and magnetic resonance imaging revealed multiple metastatic lesions in several regions, including the perineum, vagina, and inguinal regions; nodal metastases in the left external iliac and right inguinal region; and distant metastases in the lungs, pleura of the left lung, bones, and soft tissue. The patient underwent active palliative radiotherapy, followed by chemotherapy, and showed a partial response to treatment. Nineteen months after the initial diagnosis, the patient expired due to cancer progression and pneumothorax.
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Affiliation(s)
- Hyewon Chung
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, South Korea
| | - Tae-Kyu Jang
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, South Korea
| | - Sun Young Kwon
- Department of Pathology, Keimyung University School of Medicine, Daegu, South Korea
| | - Jinkyeong Ha
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, South Korea
| | - So-Jin Shin
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, South Korea
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Jang TK, Chung H, Kwon SH, Shin SJ, Cho CH. Robotic single-site versus multiport radical hysterectomy in early stage cervical cancer: An analysis of 62 cases from a single institution. Int J Med Robot 2021; 17:e2255. [PMID: 33817949 PMCID: PMC8365681 DOI: 10.1002/rcs.2255] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/01/2021] [Accepted: 03/24/2021] [Indexed: 12/09/2022]
Abstract
Background This study aimed to compare the surgical outcomes and cost of robotic single‐site radical hysterectomy (RSSRH) versus robotic multiport radical hysterectomy (RMPRH) with pelvic lymph node dissection in early stage cervical cancer. Methods Sixty‐two patients with early stage cervical cancer were recruited between November 2011 and July 2017 and underwent RSSRH (20 patients) and RMPRH (42 patients) for early stage cervical cancer using the da Vinci Si Surgical System (Intuitive Surgical). Results There were no significant difference between the two groups in most of parameters. However, postoperative hospital discharge and total hospital costs for RSSRH were significantly shorter than RMPRH (both p < 0.001). However, lymph node retrieval of RMPRH was significantly higher than RSSRH in (18.0 vs. 9.5, respectively; p < 0.001). Conclusions RSSRH has comparable surgical outcomes to the RMPRH method. RSSRH could be considered a surgical option in a well‐selected patient group.
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Affiliation(s)
- Tae-Kyu Jang
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, South Korea
| | - Hyewon Chung
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, South Korea
| | - Sang-Hoon Kwon
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, South Korea
| | - So-Jin Shin
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, South Korea
| | - Chi-Heum Cho
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, South Korea
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Chung H, Lee S, Song C, Jang TK, Bae JG, Kwon SH, Shin SJ, Cho CH. Modified Laparoscopic Transabdominal Cervicoisthmic Cerclage for the Surgical Management of Recurrent Pregnancy Loss due to Cervical Factors. J Clin Med 2021; 10:jcm10040693. [PMID: 33578930 PMCID: PMC7916712 DOI: 10.3390/jcm10040693] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 01/28/2021] [Accepted: 02/09/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed evaluate the feasibility of modified laparoscopic transabdominal cervicoisthmic cerclage (LTCC) and its impact on recurrent pregnancy loss (RPL) and is a retrospective observational cohort study of patients who underwent modified LTCC from 2003 to 2018 (n = 299). The surgery was performed at a mean gestational age of 12.5 weeks (range 10.5-17.5 weeks). Of the 299 patients, 190 were reported as having undergone abortion (one abortion: 91 (47.9%), two: 59 (31.1%), three or more: 40 (21.1%)) before the present pregnancy and prior to the surgery. The mean operation time was 47.4 min (range 15-100 min). We followed up with 205 of 299 patients and recorded their obstetric outcomes. There were 176 successful deliveries via cesarean section, and the fetal survival rate was 85.9% (176/205). The results of this study suggest that modified LTCC is a safe and feasible surgical option during pregnancy for patients with a history of RPL due to cervical factors.
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Affiliation(s)
- Hyewon Chung
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Korea; (H.C.); (S.L.); (C.S.); (T.-K.J.); (J.-G.B.); (S.-H.K.)
| | - Seungmee Lee
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Korea; (H.C.); (S.L.); (C.S.); (T.-K.J.); (J.-G.B.); (S.-H.K.)
| | - Changho Song
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Korea; (H.C.); (S.L.); (C.S.); (T.-K.J.); (J.-G.B.); (S.-H.K.)
| | - Tae-Kyu Jang
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Korea; (H.C.); (S.L.); (C.S.); (T.-K.J.); (J.-G.B.); (S.-H.K.)
| | - Jin-Gon Bae
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Korea; (H.C.); (S.L.); (C.S.); (T.-K.J.); (J.-G.B.); (S.-H.K.)
- Comprehensive Care Center for High Risk Pregnancy and Newborn, Keimyung University Dongsan Hospital, Daegu 42601, Korea
| | - Sang-Hoon Kwon
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Korea; (H.C.); (S.L.); (C.S.); (T.-K.J.); (J.-G.B.); (S.-H.K.)
| | - So-Jin Shin
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Korea; (H.C.); (S.L.); (C.S.); (T.-K.J.); (J.-G.B.); (S.-H.K.)
- Correspondence: (S.-J.S.); (C.-H.C.)
| | - Chi-Heum Cho
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Korea; (H.C.); (S.L.); (C.S.); (T.-K.J.); (J.-G.B.); (S.-H.K.)
- Correspondence: (S.-J.S.); (C.-H.C.)
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Jang TK, Kwon SH, Cho CH, Lee HW, Shin SJ. Giant uterine mass with uterine smooth muscle tumor of uncertain malignant potential: A case report. Gynecol Oncol Rep 2020; 34:100663. [PMID: 33204794 PMCID: PMC7649616 DOI: 10.1016/j.gore.2020.100663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/23/2020] [Accepted: 10/25/2020] [Indexed: 11/30/2022] Open
Abstract
STUMP is a rare disease histologically, and giant STUMP is extremely rare. To our knowledge, present case represents the largest STUMP reported. After successful surgery, the patient is alive without evidence of recurrence.
Background Uterine smooth muscle tumor of uncertain malignant potential (STUMP) is a rare tumor belonging to a group of smooth muscle tumors that possess both benign and malignant features, complicating the diagnosis. Case report. We present the case of a 41-year-old primiparous woman who complained of heavy menstrual bleeding and severe pressure symptoms in the lower abdomen for 3 months. Magnetic resonance imaging revealed a large intramural myoma measuring 35 × 25 cm in the lower uterine corpus. A laparotomy including total hysterectomy was performed. Grossly, the uterine mass measured 38.5 × 35.4 × 20.4 cm in the largest diameter and weighed 18.3 kg. Pathological analysis revealed a uterine mass diagnosed as a smooth muscle tumor of uncertain malignant potential. The patient was normally discharged 7 days after surgery and decided to follow up without further treatment. At the time of this report, the patient had been followed up as an outpatient for 18 months without recurrence. Conclusion Giant uterine STUMP is extremely rare and difficult to diagnose on physical examination and imaging findings alone. It is important to consider the possibility of an underlying malignancy when performing a preoperative examination and to perform frozen biopsy if malignancy is suspected. During follow-up, patients should undergo consultation with a gynecologic oncologist and should be surveilled closely because of the possibility of recurrence or metastasis.
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Affiliation(s)
- Tae-Kyu Jang
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, South Korea
| | - Sang-Hoon Kwon
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, South Korea
| | - Chi-Heum Cho
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, South Korea
| | - Hye-Won Lee
- Department of Pathology, Keimyung University School of Medicine, Daegu, South Korea
| | - So-Jin Shin
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, South Korea
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Jang TK, Park JY, Kim DY, Suh DS, Kim JH, Kim YM, Kim YT, Nam JH. Histologic Correlation and Clinical Significance of Atypical Glandular Cells on Cervical Pap Tests: Analysis of 540 Cases at a Single Institution. Cancer Invest 2019; 37:8-15. [DOI: 10.1080/07357907.2018.1547738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Tae-Kyu Jang
- Department of Obstetrics and Gynecology, Donsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Jeong-Yeol Park
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dae-Yeon Kim
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dae-Shik Suh
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong-Hyeok Kim
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yong-Man Kim
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Tak Kim
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joo-Hyun Nam
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Jang TK, Kim DY, Lee SW, Park JY, Suh DS, Kim JH, Kim YM, Kim YT, Nam JH. Trends in treatment during the last stages of life in end-stage gynecologic cancer patients who received active palliative chemotherapy: a comparative analysis of 10-year data in a single institution. BMC Palliat Care 2018; 17:99. [PMID: 30086748 PMCID: PMC6081917 DOI: 10.1186/s12904-018-0348-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 07/09/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Palliative chemotherapy should be used with caution when attempting to alleviate symptoms in patients with end-stage cancer. However, palliative chemotherapy continues to be utilized in cancer patients during their last stages of life. In this study, we analyzed the pattern of chemotherapy administered during the last 6 months of life in patients with end-stage gynecologic cancer who were treated with active palliative chemotherapy for the past 10 years. METHOD We retrospectively analyzed the data for patients with gynecologic cancer who died after undergoing active palliative chemotherapy without receiving hospice management at Asan Medical Center from 2006 to 2015. Patients were divided into two groups: those who died between 2006 and 2010, and those who died between 2011 and 2015. Based on the electronic medical records, the demographic and baseline characteristics of the patients, hospital admission during the last 6 months, invasive procedures, palliative chemotherapy patterns, and the time of the last chemotherapy session were confirmed. RESULTS A total of 193 patients with gynecologic cancer were eligible for this study. 92 patients died during 2006 to 2010, and 101 patients died during 2011 to 2015. The mean frequency of admission during the last 6 months was 5.12 for those who died in 2006-2010 and 6.06 for those who died during 2011-2015 (p = 0.003); similarly, the mean frequency of palliative chemotherapy during the last 6 months was 3.84 (2006-2010) vs. 4.93 times (2011-2015; p < 0.001). The proportion of patients undergoing invasive procedures during the last 3 months was 41.3% (2005-2010) vs. 56.4% (2011-2015; p = 0.044). CONCLUSIONS The frequency of palliative chemotherapy and the rate of invasive procedures have increased in patients with end-stage gynecologic cancer who were treated aggressively without hospice management over 2011-2015 when compared to 2006-2010, along with an increase in the mean frequency of admission during the last 6 months at our institution. Gynecologic oncologists need to evaluate whether active palliative chemotherapy is beneficial to patients at the end-of-life stage, and if not helpful, should communicate with the patients and caregivers about when the palliative chemotherapy should be discontinued.
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Affiliation(s)
- Tae-Kyu Jang
- Department of Obstetrics and Gynecology, Asan Medical center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Dae-Yeon Kim
- Department of Obstetrics and Gynecology, Asan Medical center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
| | - Shin-Wha Lee
- Department of Obstetrics and Gynecology, Asan Medical center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Jeong-Yeol Park
- Department of Obstetrics and Gynecology, Asan Medical center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Dae-Shik Suh
- Department of Obstetrics and Gynecology, Asan Medical center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Jong-Hyeok Kim
- Department of Obstetrics and Gynecology, Asan Medical center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Yong-Man Kim
- Department of Obstetrics and Gynecology, Asan Medical center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Young-Tak Kim
- Department of Obstetrics and Gynecology, Asan Medical center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Joo-Hyun Nam
- Department of Obstetrics and Gynecology, Asan Medical center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
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