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수록정보
37권0호(2022) |수록논문 수 : 136
간행물 제목
37권0호(2022년 04월) 수록논문
최근 권호 논문
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저자 : Ginger J. Gardner

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 2-18 (17 pages)

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저자 : Aikou Okamoto

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 20-33 (14 pages)

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저자 : Andreas Du Bois

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 36-46 (11 pages)

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저자 : Estrid Hoegdall

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 48-58 (11 pages)

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저자 : Eun Jung Yang , Seung Hyuk Shim , Woo Yeon Hwang , Suk-joon Chang , Hee Seung Kim , Nam Kyeong Kim , Tae Hun Kim , Yeorae Kim , Tae Wook Kong , Eun Ji Lee , Soo Jin Park , Joo-hyuk Son , Dong Hoon Suh

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 62-70 (9 pages)

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Objective: The aim of this study was to evaluate the role of lymphadenectomy by comparing survival outcomes for patients with clinically early-stage epithelial ovarian cancer (eEOC) who underwent lymphadenectomy versus those who underwent without lymphadenectomy.
Methods: We conducted a multi-center retrospective study of patients diagnosed with eEOC by imaging studies (abdominopelvic computed tomography or magnetic resonance imaging) from September 2007 to April 2021. All patients underwent staging operation. Clinicopathological characteristics and oncologic outcomes were compared between the lymphadenectomy group and the no lymphadenectomy group. Primary end point was progression free survival (PFS). Secondary endpoints were overall survival (OS) and perioperative outcomes.
Results: During the study period, 586 patients were identified as eEOC on imaging examination, 453 patients (77.3%) had lymphadenectomy and 133 patients (22.7%) did not undergo lymphadenectomy. After surgical staging, the upstaging was 4/133 (3.0%) in the no lymphadenectomy group 28/453 (6.6%) in the lymphadenectomy group; the upstaging by lymph node metastasis was 21/453 (4.6%). Compared to the no lymphadenectomy group , the lymphadenectomy group had a longer median operating time (P = 0.000), a higher estimated blood loss (P = 0.000), and a higher rate of postoperative adverse events (P = 0.004). There was no significant difference in 5-year PFS (88.9% vs 83.4%) and 5-year OS (97.7% vs 97.2%) in the lymphadenectomy group the no lymphadenectomy group, respectively. Among histological subtypes of eEOC, serous ovarian carcinoma showed more improved PFS in the lymphadenectomy group compared to no lymphadenectomy group (86.5% vs 74.4% , P = 0.048). In particular, in the case of high-grade serous ovarian carcinoma, there was a significant difference in lymphadenectomy group and no lymphadenectomy group (84.3% and 63.2%, P = 0.008). There was no difference in PFS in mucinous (P = 0.67), endometrioid (P = 0.41), and clear cell (P = 0.89) ovarian carcinomas between the two groups.
Conclusions: This study showed that in patients with clinical eEOC, histological subtype is associated with a survival benefit for lymphadenectomy. In serous ovarian carcinoma, lymphadenectomy showed improvement in PFS, but other histological subtypes did not differ significantly. Considering the higher risk of perioperative adverse events in lymphadenectomy, lymphadenectomy in patients with clinically eEOC can be considered and selected according to histological subtype.

저자 : Joo-hyuk Son , Tae Wook Kong , Soo Jin Park , Eun Ji Lee , Hee Seung Kim , Nam Kyeong Kim , Yeorae Kim , Woo Yeon Hwang , Dong Hoon Suh , Tae Hun Kim , Eun Jung Yang , Seung Hyuk Shim , Suk-joon Chang

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 71-72 (2 pages)

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Objectives: Optimum selection criteria for secondary cytoreductive surgery (SCS) in recurrent ovarian cancer is often dependent on the multiple confounding factors. This study aimed to evaluate the survival outcomes of recurrent ovarian cancer and investigated the factors identifying patients who most likely benefit from the SCS.
Methods: We retrospectively reviewed medical records of recurrent ovarian cancer patients from 5 referral hospitals in Korea from 2010 to 2020. Recurrent characteristics, following treatment methods and potential factors for survivals were evaluated between the chemotherapy and surgery groups.
Results: A total of 670 patients with recurrent ovarian cancer were identified. The patient's median age was 55(24-83) and 88.1% of patients had initial stage III/IV disease. Of all patients, 215 (32.1%) patients received SCS for the disease recurrence and others received 2nd line chemotherapy. The median survival was 85 months (95% CI, 65.0 - 105.0) in chemotherapy group and the median survival time was not reached in SCS group (p<0.001).
Among the patients received SCS, only patients received complete resection showed improved survival. Patients with any gross residual disease after SCS had no survival benefit compared to patients received chemotherapy (p=0.942). Patients received the SCS were more likely to be young and had no residual disease at primary surgery, platinum sensitive recurrence, limited regional recurrence (LRR, ≤3 lesions or regional carcinomatosis) with low rate of ascites (P<0.001, 0.001, 0.001, 0.001, 0.006 respectively). In multivariate cox analysis, residual disease at primary surgery, PFI, recurrent sites, ascites and SCS was significant prognostic factors for the survival. Meanwhile, predicting factor for complete resection after SCS was only recurrent sites (LRR, P<0.001).
Conclusions: SCS resulted in significantly favorable survival outcomes in well-selected patients. Platinum-sensitive recurrence with limited regional diseases (< 3 regions or limited carcinomatosis without ascites) can be considered as optimum criteria for SCS in recurrent ovarian cancer.

저자 : Soo Jin Park , Maria Lee , Hee Seung Kim , Eun-ju Lee , Yoo-young Lee , Hyun Hoon Chung , Yong Jung Song , Jae-weon Kim , Noh Hyun Park , Yong Sang Song

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 73-74 (2 pages)

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Background: Even though neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS) is considered as the standard treatment for advanced ovarian cancer, there are no studies on whether IDS is essential when the response to NAC is too good. Considering this situation, we investigated the selection criteria for omitting IDS after NAC due to a higher response to it for advanced ovarian cancer.
Methods: We searched the database of ovarian, fallopian, or primary peritoneal cancer registered between January 2000 and May 2021. We included only patients with clinical stage III to IV high-grade serous carcinoma of the ovary (HGSC) who received NAC using paclitaxel and carboplatin after serial measurement of serum levels of CA-125 regardless of IDS. For predicting chemosensitivity and prognosis, we calculated the CA-125 ELIMination of Rate Constant K (KELIM) value during two cycles of NAC. Then, we calculated KELIM values for predicting platinum resistance and then evaluated the effect of IDS on progression-free survival (PFS) and overall survival (OS) based on the values.
Results: A total of 254 patients met the inclusion criteria among 3,356 patients identified in the database, who consisted of 194 (76%) treated with NAC/IDS and 61 (24%) treated with chemotherapy alone. The cut-off value of KELIM for predicting platinum-sensitivity (12 months of PFS) in those treated with chemotherapy alone was 0.8000 (68.8% of sensitivity, 71.1% of specificity; AUC=0.723; p=0.009). Although NAC/IDS showed better PFS and OS than chemotherapy alone in patients with lower KELIM (<0.8000), PFS and OS were not different between the two treatments in those with higher KELIM (≥0.800; Figure 1). When we divided all patients into the four following groups: higher KELIM + R0 or R1; higher KELIM + R2 or no IDS; lower KELIM + R0 or R1; lower KELIM + R2 or no IDS, patients with lower KELIM + R2 or no IDS showed worse PFS and OS than the other groups (Figure 2). Moreover, lower KELIM + R2 or no IDS was an unfavorable factor for PFS and OS (adjusted HRs, 2.452 and 2.363; 95% CIs, 1.594 to 3.770 and 1.450 to 3.852) despite no difference in survival impact among the other groups.
Conclusion: IDS, especially R0 or R1 resection, may be necessary for improving survival in advanced HGSC patients with lower KELIM, whereas chemotherapy alone without IDS can be considered with a comparable prognosis in those with higher KELIM.

저자 : Ji Hyun Kim , Won Ho Han , Dong-eun Lee , Ki-ho You , Sung Sil Park , Dong Woon Lee , Sang-soo Seo , Sokbom Kang , Jee-hee Kim , Sang-yoon Park , Myong Cheol Lim

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 80-82 (3 pages)

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Background: The resection of the rectosigmoid colon is one of the crucial cytoreductive surgical procedures to minimize residual tumors in ovarian cancer. Anastomotic leakage (AL) after resection of the rectosigmoid colon is a critical postoperative complication. AL is related to septic shock and delayed initiation of postoperative adjuvant chemotherapy, resulting in poor treatment outcomes in the management of primary ovarian cancer. The study aimed to evaluate the risk factors of AL and develop a nomogram to predict the risk of AL in primary ovarian cancer from the largest study cohort.
Patients and Methods: We retrospectively reviewed 782 patients with primary ovarian cancer who underwent surgical resection of the rectosigmoid colon as part of cytoreductive surgery from January 2000 to December 2020. AL was defined based on radiologic studies or sigmoidoscopy with the relevant clinical finding. Logistic regression analyses were performed to identify the risk factor of AL, and a nomogram was developed based on the multivariable analysis. The boot strapped-concordance index was used for internal validation of the nomogram and calibration plots were constructed.
Result: The incidence of AL after resection of the rectosigmoid colon was 4.1% (32/782) in primary ovarian cancer. Four variables, including diabetes (OR, 3.38; 95% CI, 1.23-9.24; p=0.018), lower serum level of albumin (OR, 2.23; 95% CI, 1.23-4.02; p=0.008), co-operation with distal pancreatectomy (OR, 5.43; 95% CI, 2.25-18.3; p=0.001), and macroscopic residual tumor (OR, 3.168; 95% CI, 1.505-6.669; p=0.002) were identified as significant prognostic factors for AL. The nomogram with four risk factors drew a bootstrap-corrected concordance index of 0.73 (95% CI, 0.63-0.82). For easier clinical use, the online nomogram is developed ant the link is as follows: https://cienoutsourcing.github.io/.
Conclusion: Four risk factors for AL after resection of the rectosigmoid colon are identified from the largest ovarian cancer study cohort. The nomogram from this information provides a numerical risk probability of AL, which could be used in preoperative counseling with patients and intraoperative decision for accompanying surgical procedures for distal pancreatectomy and prophylactic use of ileostomy or colostomy to minimize the risk of postoperative leakage.

저자 : 김세익 , 김지현 , 노준호 , 김승호 , 김태은 , 김기동 , 박정열 , 이정원 , 임명철 , 김재원

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 83-83 (1 pages)

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Objective: Ovarian clear cell carcinoma (OCCC) is associated with a higher recurrence rate and tends to develop chemoresistance. Currently, optimal management of recurrent OCCC has not yet been established. Thus, we aimed to investigate survival outcomes according to the treatment methods in platinum-sensitive relapsed OCCC.
Methods: From five institutions, we identified OCCC patients who experienced platinum-sensitive recurrence between 2007 and 2020, and received second-line chemotherapy. Patients' clinicopathologic characteristics and survival outcomes were compared according to the use of cytoreductive surgery (CRS) and bevacizumab (BEV).
Results: In total, 139 patients were included: 43 (30.9%) and 36 (25.9%) received secondary CRS and BEV-containing chemotherapy regimens, respectively. In the CRS group, 69.8% of patients achieved complete resection. In terms of baseline characteristics, the CRS group had significantly lower serum CA-125 levels (P<0.001), a smaller number of recurred lesions (P<0.001), and better ECOG performance status (P=0.020), than the non-CRS group. However, no differences in the platinum-free interval, the proportion of patients with ascites, and BEV users were observed between the two groups. Meanwhile, between the BEV and non-BEV groups, no differences in serum CA-125 level (P=0.227), ECOG performance status (P=0.085), platinum-free interval (P=0.265), and proportion of patients with ascites (P=0.248) were observed. In contrast, the BEV group had a significantly smaller number of recurred lesions (P=0.027). During the median observation period of 17.5 months, the CRS group showed significantly better progression-free survival (PFS; median, 22.4 vs. 7.2 months; P<0.001) and overall survival (OS; 3-year survival rate, 77.6% vs. 33.7%; P<0.001), compared to the non-CRS group. Similarly, the BEV group also showed significantly better PFS (median, 15.4 vs. 7.5 months; P=0.042) and OS (3-year survival rate, 81.8% vs. 43.8%; P=0.032), compared to the non-BEV group. In multivariate analyses adjusting for confounders, including the number of recurred lesions, CRS and BEV were identified as independent favorable prognostic factors for PFS and OS.o
Conclusion: Our study results demonstrate that secondary CRS purporting complete resection and the use of BEV-containing chemotherapy regimens might be considered in the management of platinum-sensitive relapsed OCCC.

저자 : Seung-hyuk Shim , Eun-jung Yang , Seungjun Lee , Hee Seung Kim , Shin-wha Lee , Chi-son Chang , Chel Hun Choi , Heekyoung Song , Sung Jong Lee , Suk-joon Chang , Myong Cheol Lim

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 84-86 (3 pages)

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Background: Studies have suggested that erythropoietin-stimulating agents (ESAs) for chemotherapy-induced anemia may negatively affect oncologic outcomes in a variety of cancer types. Considering the debates of prognostic role of ESA in ovarian cancer, this study aimed to evaluate whether ESA treatment during front-line chemotherapy affected progression-free survival (PFS).
Methods: We retrospectively reviewed all consecutive patients who received front-line chemotherapy after surgery during 2013-2019 from seven institutions. Patients were divided according to the use of ESA during front-line chemotherapy (ESA vs No-ESA). Primary endpoints where PFS. The secondary endpoint included occurrence of thromboembolism.
Results: Overall, 1,830 patients (275 for ESA and 1,555 for No-ESA) were identified with median follow-up of 41.3 months. The median age was 53.5 (range15-82). ESA group showed significantly higher proportion of stage III/IV disease (78.9% vs 62.9%; P<0.001) and gross residual after surgery (34.2% vs 23.9%; P<0.001) compared to No-ESA group. In multivariable Cox regression adjusted by age, performance status, comorbidity, stage, and postoperative residual disease, use of ESA did not affect PFS (adjusted hazard ratio, 0.898; 95% confidence interval [CI], 0.742-1.087; P=0.269). The incidence of thromboembolism was 6.9% in the ESA group and 4.9% in the No-ESA group (unadjusted odds ratio [OR], 1.444; 95% CI, 0.859-2.429; P=0.166). After adjustment for differences in age, performance status, comorbidity, prior thromboembolic disease, tobacco use, and stage, OR for thromboembolism with use of ESA was 1.459 (95% CI, 0.365-5.836).
Conclusions: The current results indicated that use of ESA during front-line chemotherapy does not negatively affect PFS in patients with ovarian cancer after surgery and was not associated with increased risk of thromboembolism. Further randomized controlled trials are need.

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저자 : Ginger J. Gardner

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 2-18 (17 pages)

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저자 : Aikou Okamoto

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 20-33 (14 pages)

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저자 : Andreas Du Bois

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 36-46 (11 pages)

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저자 : Estrid Hoegdall

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 48-58 (11 pages)

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저자 : Eun Jung Yang , Seung Hyuk Shim , Woo Yeon Hwang , Suk-joon Chang , Hee Seung Kim , Nam Kyeong Kim , Tae Hun Kim , Yeorae Kim , Tae Wook Kong , Eun Ji Lee , Soo Jin Park , Joo-hyuk Son , Dong Hoon Suh

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 62-70 (9 pages)

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Objective: The aim of this study was to evaluate the role of lymphadenectomy by comparing survival outcomes for patients with clinically early-stage epithelial ovarian cancer (eEOC) who underwent lymphadenectomy versus those who underwent without lymphadenectomy.
Methods: We conducted a multi-center retrospective study of patients diagnosed with eEOC by imaging studies (abdominopelvic computed tomography or magnetic resonance imaging) from September 2007 to April 2021. All patients underwent staging operation. Clinicopathological characteristics and oncologic outcomes were compared between the lymphadenectomy group and the no lymphadenectomy group. Primary end point was progression free survival (PFS). Secondary endpoints were overall survival (OS) and perioperative outcomes.
Results: During the study period, 586 patients were identified as eEOC on imaging examination, 453 patients (77.3%) had lymphadenectomy and 133 patients (22.7%) did not undergo lymphadenectomy. After surgical staging, the upstaging was 4/133 (3.0%) in the no lymphadenectomy group 28/453 (6.6%) in the lymphadenectomy group; the upstaging by lymph node metastasis was 21/453 (4.6%). Compared to the no lymphadenectomy group , the lymphadenectomy group had a longer median operating time (P = 0.000), a higher estimated blood loss (P = 0.000), and a higher rate of postoperative adverse events (P = 0.004). There was no significant difference in 5-year PFS (88.9% vs 83.4%) and 5-year OS (97.7% vs 97.2%) in the lymphadenectomy group the no lymphadenectomy group, respectively. Among histological subtypes of eEOC, serous ovarian carcinoma showed more improved PFS in the lymphadenectomy group compared to no lymphadenectomy group (86.5% vs 74.4% , P = 0.048). In particular, in the case of high-grade serous ovarian carcinoma, there was a significant difference in lymphadenectomy group and no lymphadenectomy group (84.3% and 63.2%, P = 0.008). There was no difference in PFS in mucinous (P = 0.67), endometrioid (P = 0.41), and clear cell (P = 0.89) ovarian carcinomas between the two groups.
Conclusions: This study showed that in patients with clinical eEOC, histological subtype is associated with a survival benefit for lymphadenectomy. In serous ovarian carcinoma, lymphadenectomy showed improvement in PFS, but other histological subtypes did not differ significantly. Considering the higher risk of perioperative adverse events in lymphadenectomy, lymphadenectomy in patients with clinically eEOC can be considered and selected according to histological subtype.

저자 : Joo-hyuk Son , Tae Wook Kong , Soo Jin Park , Eun Ji Lee , Hee Seung Kim , Nam Kyeong Kim , Yeorae Kim , Woo Yeon Hwang , Dong Hoon Suh , Tae Hun Kim , Eun Jung Yang , Seung Hyuk Shim , Suk-joon Chang

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 71-72 (2 pages)

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Objectives: Optimum selection criteria for secondary cytoreductive surgery (SCS) in recurrent ovarian cancer is often dependent on the multiple confounding factors. This study aimed to evaluate the survival outcomes of recurrent ovarian cancer and investigated the factors identifying patients who most likely benefit from the SCS.
Methods: We retrospectively reviewed medical records of recurrent ovarian cancer patients from 5 referral hospitals in Korea from 2010 to 2020. Recurrent characteristics, following treatment methods and potential factors for survivals were evaluated between the chemotherapy and surgery groups.
Results: A total of 670 patients with recurrent ovarian cancer were identified. The patient's median age was 55(24-83) and 88.1% of patients had initial stage III/IV disease. Of all patients, 215 (32.1%) patients received SCS for the disease recurrence and others received 2nd line chemotherapy. The median survival was 85 months (95% CI, 65.0 - 105.0) in chemotherapy group and the median survival time was not reached in SCS group (p<0.001).
Among the patients received SCS, only patients received complete resection showed improved survival. Patients with any gross residual disease after SCS had no survival benefit compared to patients received chemotherapy (p=0.942). Patients received the SCS were more likely to be young and had no residual disease at primary surgery, platinum sensitive recurrence, limited regional recurrence (LRR, ≤3 lesions or regional carcinomatosis) with low rate of ascites (P<0.001, 0.001, 0.001, 0.001, 0.006 respectively). In multivariate cox analysis, residual disease at primary surgery, PFI, recurrent sites, ascites and SCS was significant prognostic factors for the survival. Meanwhile, predicting factor for complete resection after SCS was only recurrent sites (LRR, P<0.001).
Conclusions: SCS resulted in significantly favorable survival outcomes in well-selected patients. Platinum-sensitive recurrence with limited regional diseases (< 3 regions or limited carcinomatosis without ascites) can be considered as optimum criteria for SCS in recurrent ovarian cancer.

저자 : Soo Jin Park , Maria Lee , Hee Seung Kim , Eun-ju Lee , Yoo-young Lee , Hyun Hoon Chung , Yong Jung Song , Jae-weon Kim , Noh Hyun Park , Yong Sang Song

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 73-74 (2 pages)

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Background: Even though neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS) is considered as the standard treatment for advanced ovarian cancer, there are no studies on whether IDS is essential when the response to NAC is too good. Considering this situation, we investigated the selection criteria for omitting IDS after NAC due to a higher response to it for advanced ovarian cancer.
Methods: We searched the database of ovarian, fallopian, or primary peritoneal cancer registered between January 2000 and May 2021. We included only patients with clinical stage III to IV high-grade serous carcinoma of the ovary (HGSC) who received NAC using paclitaxel and carboplatin after serial measurement of serum levels of CA-125 regardless of IDS. For predicting chemosensitivity and prognosis, we calculated the CA-125 ELIMination of Rate Constant K (KELIM) value during two cycles of NAC. Then, we calculated KELIM values for predicting platinum resistance and then evaluated the effect of IDS on progression-free survival (PFS) and overall survival (OS) based on the values.
Results: A total of 254 patients met the inclusion criteria among 3,356 patients identified in the database, who consisted of 194 (76%) treated with NAC/IDS and 61 (24%) treated with chemotherapy alone. The cut-off value of KELIM for predicting platinum-sensitivity (12 months of PFS) in those treated with chemotherapy alone was 0.8000 (68.8% of sensitivity, 71.1% of specificity; AUC=0.723; p=0.009). Although NAC/IDS showed better PFS and OS than chemotherapy alone in patients with lower KELIM (<0.8000), PFS and OS were not different between the two treatments in those with higher KELIM (≥0.800; Figure 1). When we divided all patients into the four following groups: higher KELIM + R0 or R1; higher KELIM + R2 or no IDS; lower KELIM + R0 or R1; lower KELIM + R2 or no IDS, patients with lower KELIM + R2 or no IDS showed worse PFS and OS than the other groups (Figure 2). Moreover, lower KELIM + R2 or no IDS was an unfavorable factor for PFS and OS (adjusted HRs, 2.452 and 2.363; 95% CIs, 1.594 to 3.770 and 1.450 to 3.852) despite no difference in survival impact among the other groups.
Conclusion: IDS, especially R0 or R1 resection, may be necessary for improving survival in advanced HGSC patients with lower KELIM, whereas chemotherapy alone without IDS can be considered with a comparable prognosis in those with higher KELIM.

저자 : Ji Hyun Kim , Won Ho Han , Dong-eun Lee , Ki-ho You , Sung Sil Park , Dong Woon Lee , Sang-soo Seo , Sokbom Kang , Jee-hee Kim , Sang-yoon Park , Myong Cheol Lim

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 80-82 (3 pages)

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Background: The resection of the rectosigmoid colon is one of the crucial cytoreductive surgical procedures to minimize residual tumors in ovarian cancer. Anastomotic leakage (AL) after resection of the rectosigmoid colon is a critical postoperative complication. AL is related to septic shock and delayed initiation of postoperative adjuvant chemotherapy, resulting in poor treatment outcomes in the management of primary ovarian cancer. The study aimed to evaluate the risk factors of AL and develop a nomogram to predict the risk of AL in primary ovarian cancer from the largest study cohort.
Patients and Methods: We retrospectively reviewed 782 patients with primary ovarian cancer who underwent surgical resection of the rectosigmoid colon as part of cytoreductive surgery from January 2000 to December 2020. AL was defined based on radiologic studies or sigmoidoscopy with the relevant clinical finding. Logistic regression analyses were performed to identify the risk factor of AL, and a nomogram was developed based on the multivariable analysis. The boot strapped-concordance index was used for internal validation of the nomogram and calibration plots were constructed.
Result: The incidence of AL after resection of the rectosigmoid colon was 4.1% (32/782) in primary ovarian cancer. Four variables, including diabetes (OR, 3.38; 95% CI, 1.23-9.24; p=0.018), lower serum level of albumin (OR, 2.23; 95% CI, 1.23-4.02; p=0.008), co-operation with distal pancreatectomy (OR, 5.43; 95% CI, 2.25-18.3; p=0.001), and macroscopic residual tumor (OR, 3.168; 95% CI, 1.505-6.669; p=0.002) were identified as significant prognostic factors for AL. The nomogram with four risk factors drew a bootstrap-corrected concordance index of 0.73 (95% CI, 0.63-0.82). For easier clinical use, the online nomogram is developed ant the link is as follows: https://cienoutsourcing.github.io/.
Conclusion: Four risk factors for AL after resection of the rectosigmoid colon are identified from the largest ovarian cancer study cohort. The nomogram from this information provides a numerical risk probability of AL, which could be used in preoperative counseling with patients and intraoperative decision for accompanying surgical procedures for distal pancreatectomy and prophylactic use of ileostomy or colostomy to minimize the risk of postoperative leakage.

저자 : 김세익 , 김지현 , 노준호 , 김승호 , 김태은 , 김기동 , 박정열 , 이정원 , 임명철 , 김재원

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 83-83 (1 pages)

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Objective: Ovarian clear cell carcinoma (OCCC) is associated with a higher recurrence rate and tends to develop chemoresistance. Currently, optimal management of recurrent OCCC has not yet been established. Thus, we aimed to investigate survival outcomes according to the treatment methods in platinum-sensitive relapsed OCCC.
Methods: From five institutions, we identified OCCC patients who experienced platinum-sensitive recurrence between 2007 and 2020, and received second-line chemotherapy. Patients' clinicopathologic characteristics and survival outcomes were compared according to the use of cytoreductive surgery (CRS) and bevacizumab (BEV).
Results: In total, 139 patients were included: 43 (30.9%) and 36 (25.9%) received secondary CRS and BEV-containing chemotherapy regimens, respectively. In the CRS group, 69.8% of patients achieved complete resection. In terms of baseline characteristics, the CRS group had significantly lower serum CA-125 levels (P<0.001), a smaller number of recurred lesions (P<0.001), and better ECOG performance status (P=0.020), than the non-CRS group. However, no differences in the platinum-free interval, the proportion of patients with ascites, and BEV users were observed between the two groups. Meanwhile, between the BEV and non-BEV groups, no differences in serum CA-125 level (P=0.227), ECOG performance status (P=0.085), platinum-free interval (P=0.265), and proportion of patients with ascites (P=0.248) were observed. In contrast, the BEV group had a significantly smaller number of recurred lesions (P=0.027). During the median observation period of 17.5 months, the CRS group showed significantly better progression-free survival (PFS; median, 22.4 vs. 7.2 months; P<0.001) and overall survival (OS; 3-year survival rate, 77.6% vs. 33.7%; P<0.001), compared to the non-CRS group. Similarly, the BEV group also showed significantly better PFS (median, 15.4 vs. 7.5 months; P=0.042) and OS (3-year survival rate, 81.8% vs. 43.8%; P=0.032), compared to the non-BEV group. In multivariate analyses adjusting for confounders, including the number of recurred lesions, CRS and BEV were identified as independent favorable prognostic factors for PFS and OS.o
Conclusion: Our study results demonstrate that secondary CRS purporting complete resection and the use of BEV-containing chemotherapy regimens might be considered in the management of platinum-sensitive relapsed OCCC.

저자 : Seung-hyuk Shim , Eun-jung Yang , Seungjun Lee , Hee Seung Kim , Shin-wha Lee , Chi-son Chang , Chel Hun Choi , Heekyoung Song , Sung Jong Lee , Suk-joon Chang , Myong Cheol Lim

발행기관 : 대한부인종양학회 간행물 : 대한부인종양학회 학술대회지 37권 0호 발행 연도 : 2022 페이지 : pp. 84-86 (3 pages)

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Background: Studies have suggested that erythropoietin-stimulating agents (ESAs) for chemotherapy-induced anemia may negatively affect oncologic outcomes in a variety of cancer types. Considering the debates of prognostic role of ESA in ovarian cancer, this study aimed to evaluate whether ESA treatment during front-line chemotherapy affected progression-free survival (PFS).
Methods: We retrospectively reviewed all consecutive patients who received front-line chemotherapy after surgery during 2013-2019 from seven institutions. Patients were divided according to the use of ESA during front-line chemotherapy (ESA vs No-ESA). Primary endpoints where PFS. The secondary endpoint included occurrence of thromboembolism.
Results: Overall, 1,830 patients (275 for ESA and 1,555 for No-ESA) were identified with median follow-up of 41.3 months. The median age was 53.5 (range15-82). ESA group showed significantly higher proportion of stage III/IV disease (78.9% vs 62.9%; P<0.001) and gross residual after surgery (34.2% vs 23.9%; P<0.001) compared to No-ESA group. In multivariable Cox regression adjusted by age, performance status, comorbidity, stage, and postoperative residual disease, use of ESA did not affect PFS (adjusted hazard ratio, 0.898; 95% confidence interval [CI], 0.742-1.087; P=0.269). The incidence of thromboembolism was 6.9% in the ESA group and 4.9% in the No-ESA group (unadjusted odds ratio [OR], 1.444; 95% CI, 0.859-2.429; P=0.166). After adjustment for differences in age, performance status, comorbidity, prior thromboembolic disease, tobacco use, and stage, OR for thromboembolism with use of ESA was 1.459 (95% CI, 0.365-5.836).
Conclusions: The current results indicated that use of ESA during front-line chemotherapy does not negatively affect PFS in patients with ovarian cancer after surgery and was not associated with increased risk of thromboembolism. Further randomized controlled trials are need.

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