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  • BMJ  (10)
  • Kim, Jong-Hyeok  (10)
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  • BMJ  (10)
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  • 1
    Online-Ressource
    Online-Ressource
    Preoperative Fluorine 18 Fluorodeoxyglucose Tumoral Uptake Ratio Between Upper and Lower Abdomen in Primary Advanced-Stage Ovarian Cancer
    BMJ ; 2013
    In:  International Journal of Gynecological Cancer Vol. 23, No. 8 ( 2013-10), p. 1383-1392
    Details
    In: International Journal of Gynecological Cancer, BMJ, Vol. 23, No. 8 ( 2013-10), p. 1383-1392
    Materialart: Online-Ressource
    ISSN: 1048-891X
    URL: Article
    DOI: 10.1097/IGC.0b013e3182a58992
    Sprache: Englisch
    Verlag: BMJ
    Publikationsdatum: 2013
    ZDB Id: 2009072-9
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    Online-Ressource
    Online-Ressource
    Laparoendoscopic Single-Site Versus Conventional Laparoscopic Surgical Staging for Early-Stage Endometrial Cancer
    BMJ ; 2014
    In:  International Journal of Gynecologic Cancer Vol. 24, No. 2 ( 2014-02), p. 358-363
    Details
    In: International Journal of Gynecologic Cancer, BMJ, Vol. 24, No. 2 ( 2014-02), p. 358-363
    Kurzfassung: This study aims to compare the feasibility, safety, and efficacy of laparoendoscopic single-site (LESS) surgical staging for early-stage endometrial cancer with conventional laparoscopic surgical staging. Materials and Methods The prospective study group consisted of 37 consecutive patients who underwent LESS surgical staging including hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection. The historical control group consisted of 74 consecutive patients who underwent 4-port laparoscopic surgical staging including hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection. Surgical outcomes were compared between the 2 groups. Results No patient in the LESS or conventional laparoscopic surgery group required an additional trocar or conversion to laparotomy. There were no intergroup differences in mean age, menopause status, body mass index, and previous history of abdominal surgery. Further, there were no inter-group differences in the number of total (LESS vs. conventional, 25.9 ± 10.6 vs. 24.6 ± 9.0, P = 0.497), pelvic (24.6 ± 0.497 vs. 23.3 ± 7.7, P = 0.459), and para-aortic (4.9 ± 2.5 vs. 6.9 ± 7.3, P = 0.494) lymph nodes retrieved; the operating time (183 ± 50 min vs. 173 ± 106, P = 0.388); estimated blood loss (194 ± 149 mL vs. 173 ± 106 mL, P = 0.394); number of patients requiring transfusion (5.4% vs. 8.1%, P = 0.717); postoperative hospital stay (5.0 ± 1.8 days vs. 5.1 ± 1.8 days, P = 0.911); intraoperative complications (2.7% vs. 0%, P = 0.333); and postoperative complications (0% vs. 1.4%, P 〉 0.999). The postoperative pain scores and analgesic requirements were significantly lower in the LESS surgical staging group. Conclusions Laparoendoscopic single-site surgical staging was a feasible, safe, and efficacious procedure for surgical management of early-stage endometrial cancer. It was associated with less postoperative pain and analgesic requirements and was comparable to conventional laparoscopic surgical staging in perioperative outcomes.
    Materialart: Online-Ressource
    ISSN: 1048-891X , 1525-1438
    URL: Article
    DOI: 10.1097/IGC.0000000000000046
    Sprache: Englisch
    Verlag: BMJ
    Publikationsdatum: 2014
    ZDB Id: 2009072-9
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
    Online-Ressource
    Online-Ressource
    Outcomes of Surgery Alone and Surveillance Strategy in Young Women With Stage I Malignant Ovarian Germ Cell Tumors
    BMJ ; 2016
    In:  International Journal of Gynecologic Cancer Vol. 26, No. 5 ( 2016-06), p. 859-864
    Details
    In: International Journal of Gynecologic Cancer, BMJ, Vol. 26, No. 5 ( 2016-06), p. 859-864
    Kurzfassung: This study aimed to evaluate the safety of surgery alone followed by surveillance in young women with stage I malignant ovarian germ cell tumor (MOGCT). Methods A retrospective review was performed on 31 patients with stage I MOGCT who were treated by surgery alone with follow-up. Results The median patient age was 22 years (range, 6–45 years). The histological type was dysgerminoma in 17, immature teratoma in 11, yolk sac tumor in 1, and mixed MOGCT in 2 cases. Seventeen patients were stage IA, 1 was IB, and 13 were IC. All patients underwent fertility-sparing surgery, which involved either unilateral salpingo-oophorectomy or oophorectomy. Additionally, 12 (38.7%) patients underwent cystectomy of the contralateral ovary, but only 1 patient had MOGCT in the contralateral ovary. Twenty (65%) patients underwent a complete staging operation that included peritoneal exploration, biopsy, cytology, and/or omentectomy or omental biopsy; 7 (22.6%) patients who underwent pelvic and para-aortic lymphadenectomy. After a median follow-up time of 137 months (range, 24–268 months), 7 (22.6%) patients had recurrent disease, and underwent secondary surgery followed by chemotherapy with bleomycin, etoposide, and cisplatin (BEP). Six (86%) patients were successfully salvaged, but 1 died of disease progression. The 10-year disease-free survival rate was 77%, but the 10-year overall survival rate was 97%. Conclusions Fertility-sparing surgery alone with surveillance could be a safe treatment strategy. Most recurrence can be successfully salvaged by surgery and BEP chemotherapy and the overall survival is not compromised. Using this strategy, 77.4% of patients may avoid unnecessary BEP chemotherapy.
    Materialart: Online-Ressource
    ISSN: 1048-891X , 1525-1438
    URL: Article
    DOI: 10.1097/IGC.0000000000000702
    Sprache: Englisch
    Verlag: BMJ
    Publikationsdatum: 2016
    ZDB Id: 2009072-9
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
    Online-Ressource
    Online-Ressource
    Comparison of Laparoscopic and Open Surgery for Patients With Borderline Ovarian Tumors
    BMJ ; 2018
    In:  International Journal of Gynecologic Cancer Vol. 28, No. 9 ( 2018-11), p. 1657-1663
    Details
    In: International Journal of Gynecologic Cancer, BMJ, Vol. 28, No. 9 ( 2018-11), p. 1657-1663
    Kurzfassung: The aim of this study was to compare surgical and oncologic outcomes of open and laparoscopic surgery in patients with borderline ovarian tumors (BOTs). Materials and Methods This study included patients with BOTs who underwent open (n = 433) or laparoscopic (n = 210) surgery between 1990 and 2015. Surgical outcomes, perioperative morbidity, and disease-free survival and overall survival were compared. Results There was no significant difference in age, histologic type of tumor, and laterality of tumor. However, body mass index was slightly higher for the open surgery group ( P = 0.046). The open surgery group had a higher serum cancer antigen 125 level ( P 〈 0.001), larger tumor size ( P 〈 0.001), more frequent radical surgery ( P = 0.001), higher stage ( P = 0.034), and higher incidence of invasive implants ( P = 0.035). The operative time ( P 〈 0.001), time interval to return of bowel movement ( P 〈 0.001), and length of postoperative hospital stay ( P 〈 0.001) were significantly shorter and estimated blood loss was significantly less ( P 〈 0.001) in the laparoscopic group. Perioperative complications were documented in 5 (2.4%) patients in the laparoscopic surgery group and 17 (3.9%) in the open surgery group ( P = 0.064). Twenty-three (5.3%) patients in the open surgery group and 9 (4.3%) in the laparoscopic surgery group had recurrence ( P = 0.902) at a median follow-up of 57 months. The 10-year disease-free survival was 96% and 97% for the open and laparoscopic groups, respectively ( P = 0.851), with no significant difference between the groups after adjusting for independent factors (odds ratio, 1.0; 95% confidence interval, 0.4–2.4; P = 0.999). The 10-year overall survival was 99% for both groups, respectively ( P = 0.441). Conclusions Laparoscopic surgery and open surgery showed similar survival outcomes in BOTs. The surgical outcomes of laparoscopic surgery were more favorable.
    Materialart: Online-Ressource
    ISSN: 1048-891X , 1525-1438
    URL: Article
    DOI: 10.1097/IGC.0000000000001358
    Sprache: Englisch
    Verlag: BMJ
    Publikationsdatum: 2018
    ZDB Id: 2009072-9
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
  • 5
    Online-Ressource
    Online-Ressource
    Laparoscopic Management of Early-Stage Malignant Nonepithelial Ovarian Tumors : Surgical and Survival Outcomes
    BMJ ; 2013
    In:  International Journal of Gynecological Cancer Vol. 23, No. 2 ( 2013-02), p. 249-255
    Details
    In: International Journal of Gynecological Cancer, BMJ, Vol. 23, No. 2 ( 2013-02), p. 249-255
    Materialart: Online-Ressource
    ISSN: 1048-891X
    URL: Article
    DOI: 10.1097/IGC.0b013e318272e754
    Sprache: Englisch
    Verlag: BMJ
    Publikationsdatum: 2013
    ZDB Id: 2009072-9
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
  • 6
    Online-Ressource
    Online-Ressource
    Significance of Ovarian Endometriosis on the Prognosis of Ovarian Clear Cell Carcinoma
    BMJ ; 2018
    In:  International Journal of Gynecologic Cancer Vol. 28, No. 1 ( 2018-01), p. 11-18
    Details
    In: International Journal of Gynecologic Cancer, BMJ, Vol. 28, No. 1 ( 2018-01), p. 11-18
    Kurzfassung: The aim of this study was to evaluate the significance of ovarian endometriosis on the prognosis of ovarian clear cell carcinoma (OCCC). Methods Patients with OCCC were divided into 2 groups according to the presence of ovarian endometriosis: group 1, no coexisting ovarian endometriosis; group 2, clear cell carcinoma arising from ovarian endometriosis or the presence of ovarian endometriosis elsewhere in the ovary. Clinicopathologic characteristics, disease-free survival (DFS), and overall survival (OS) were compared between the 2 groups. Results Of 155 patients with OCCC, 77 were categorized into group 1 and 78 into group 2. Group 2 patients were younger than group 1 (median age, 48 vs 51 years; P = 0.005) and had higher incidence of early-stage disease (stage I, 77% vs 58%; P = 0.001) and lower incidence of lymph node metastasis (4% vs 17%; P = 0.008). Group 2 patients were observed to have a significantly higher 5-year DFS ( P 〈 0.001) and OS ( P = 0.001) compared with group 1. In stage I disease, group 2 had a significantly higher 5-year DFS ( P = 0.004) and OS ( P = 0.016) than did group 1. In the multivariate analysis, coexisting endometriosis and advanced International Federation of Obstetrics and Gynecology stage were significant factors for both DFS and OS rates. Conclusions Ovarian clear cell carcinoma with endometriosis was found more frequently in younger women and had a higher incidence of early-stage disease and a lower incidence of lymph node metastasis compared with OCCC without endometriosis. Ovarian endometriosis was associated with improved prognostic factors and a better DFS and OS even in stage I disease. Ovarian endometriosis was an independent prognostic factor for OCCC.
    Materialart: Online-Ressource
    ISSN: 1048-891X , 1525-1438
    URL: Article
    DOI: 10.1097/IGC.0000000000001136
    Sprache: Englisch
    Verlag: BMJ
    Publikationsdatum: 2018
    ZDB Id: 2009072-9
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 7
    Online-Ressource
    Online-Ressource
    Pathological findings and long-term prognosis in Korean BRCA1/2 mutation carriers undergoing risk-reducing salpingo-oophorectomy
    BMJ ; 2023
    In:  International Journal of Gynecologic Cancer
    Details
    In: International Journal of Gynecologic Cancer, BMJ
    Kurzfassung: Our study aimed to evaluate the incidence of pathological findings in asymptomatic Korean patients with BRCA1/2 pathogenic variants who underwent risk-reducing salpingo-oophorectomy and to assess their long-term prognosis. Methods We retrospectively analyzed the medical records of patients with a germinal BRCA1/2 pathologic variant who had undergone risk-reducing salpingo-oophorectomy at Asan Medical Center (Seoul, Korea) between January 2013 and December 2020. All pathologic reports were made based on the sectioning and extensively examining the fimbriated end of the fallopian tube (SEE/FIM) protocol. Results Out of 243 patients who underwent risk-reducing salpingo-oophorectomy, 121 (49.8%) had a BRCA1 mutation, 119 (48.9%) had a BRCA2 mutation, and three (1.2%) had both mutations. During the procedure, four (3.3%) patients with a BRCA1 mutation were diagnosed with serous tubal intraepithelial carcinoma (STIC) or serous tubal intraepithelial lesion (STIL), and another four patients (3.3%) were diagnosed with occult cancer despite no evidence of malignancy on preoperative ultrasound. In the BRCA2 mutation group, we found one (0.8%) case of STIC, but no cases of STIL or occult cancer. During the median follow-up period of 98 months (range, 44–104) for STIC and 54 months (range, 52–56) for STIL, none of the patients diagnosed with these precursor lesions developed primary peritoneal carcinomatosis. Conclusions Risk-reducing salpingo-oophorectomy, in asymptomatic Korean patients with BRCA1/2 pathogenic variants, detected ovarian cancer and precursor lesions, including STIC or STIL. Furthermore, our follow-up period did not reveal any instances of primary peritoneal carcinomatosis, suggesting a limited body of evidence supporting the imperative need for adjuvant treatment in patients diagnosed with these precursor lesions during risk-reducing salpingo-oophorectomy.
    Materialart: Online-Ressource
    ISSN: 1048-891X , 1525-1438
    URL: Article
    DOI: 10.1136/ijgc-2023-004618
    Sprache: Englisch
    Verlag: BMJ
    Publikationsdatum: 2023
    ZDB Id: 2009072-9
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 8
    Online-Ressource
    Online-Ressource
    Low value of staging in detecting extraovarian occult metastasis in mucinous borderline ovarian tumors
    BMJ ; 2020
    In:  International Journal of Gynecologic Cancer Vol. 30, No. 11 ( 2020-11), p. 1780-1783
    Details
    In: International Journal of Gynecologic Cancer, BMJ, Vol. 30, No. 11 ( 2020-11), p. 1780-1783
    Kurzfassung: Staging procedure in borderline ovarian tumors is a topic of controversy. Upstaging in non-serous borderline ovarian tumors that are confined to the ovary is rare. The aim of this study was to assess the impact of surgical staging on clinical outcomes in mucinous borderline ovarian tumors. Methods This was a retrospective study conducted at the Asan Medical Center, Seoul, Korea between January 1990 and December 2015, that included 432 patients with mucinous borderline ovarian tumors and at least 6 months follow-up. These patients were divided into a ‘staging group’ and ‘unstaged group’. The staging group referred to patients who, in addition to hysterectomy and/or adnexal surgery, underwent at least one of the following: cytology, omental biopsy/omentectomy, peritoneal biopsy, lymph node biopsy/lymphadenectomy, or appendectomy. The unstaged group referred to patients who did not undergo any staging procedure but underwent adnexal surgery (cystectomy or oophorectomy). Results Median patient age was 40 (range 9–87) years. A total of 367 patients (85%) underwent a staging procedure (staging group) and 65 (15.0%) patients did not (unstaged group). Among the staging group, 258, 4, 100, and 5 patients were FIGO stage IA, IB, IC, or II-III, respectively. Overall recurrence was confirmed in 15 patients and median time to recurrence was 13.4 (range 0.4–127.3) months. One patient was in the unstaged group and had borderline recurrence. Fourteen were in the staging group, and 11 of them had borderline and three had invasive recurrence. Extraovarian disease was found at recurrence only in two patients. There was no significant difference in recurrence-free survival (p=0.39) and in overall survival between the staging group and the unstaged group (p=0.40). In total, 16 (4.4%) of 367 patients who underwent a staging procedure were upstaged. Conclusion Staging in mucinous borderline ovarian tumors may be omitted if there is no obvious evidence of gross extraovarian disease.
    Materialart: Online-Ressource
    ISSN: 1048-891X , 1525-1438
    URL: Article
    URL: Article
    DOI: 10.1136/ijgc-2020-001355
    DOI: 10.1136/ijgc-2020-001355.supp1
    Sprache: Englisch
    Verlag: BMJ
    Publikationsdatum: 2020
    ZDB Id: 2009072-9
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 9
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    Online-Ressource
    Identification of a Preoperative Predictive Factor for Lymph Node Metastasis in Uterine Papillary Serous Carcinoma: Long-term Results From a Single Institution
    BMJ ; 2015
    In:  International Journal of Gynecologic Cancer Vol. 25, No. 1 ( 2015-01), p. 69-74
    Details
    In: International Journal of Gynecologic Cancer, BMJ, Vol. 25, No. 1 ( 2015-01), p. 69-74
    Kurzfassung: The purpose of this study was to identify preoperative clinicopathological predictive factors for lymph node (LN) metastasis in women diagnosed with uterine papillary serous carcinoma (UPSC). Methods Women diagnosed with UPSC in our institution from 1997 to 2012 were identified. All patients underwent hysterectomy and bilateral salpingo-oophorectomy plus pelvic and/or para-aortic lymphadenectomy. The predictive values of the risk factors for LN metastasis were analyzed using χ 2 and multivariate logistic regression analyses. Results A total of 94 patients met our study criteria. A CA-125 cutoff of 47.5 IU/mL on the receiver operating characteristic curve provided the best sensitivity and specificity (56.5% vs 90.1%, respectively) for LN metastasis prediction. The sensitivities and specificities of old age (≥60 years), body mass index of 25 kg/m 2 or greater, deep myometrial invasion, tumor size greater than 2 cm, tumor size greater than 4 cm, preoperative CA-125 greater than 47.5 IU/mL, LN metastasis on imaging, and extrauterine spread on imaging for the presence of a positive LN were 39.1%, 34.8%, 30.4%, 34.8%, 21.7%, 56.5%, 43.5%, and 52.2%, and 52.1%, 45.1%, 78.9%, 57.7%, 83.1%, 90.1%, 93.0%, and 90.1%, respectively. Preoperative CA-125 ( P 〈 0.001), LN metastasis on preoperative imaging ( P 〈 0.001), and extrauterine spread on preoperative imaging ( P = 0.009) were risk factors for LN metastasis on univariate analysis. Multivariate analysis revealed that preoperative CA-125 ( P = 0.001) was the only independent risk factor for LN metastasis. Conclusions Preoperative CA-125 is a preoperative predictive factor for LN metastasis in UPSC.
    Materialart: Online-Ressource
    ISSN: 1048-891X , 1525-1438
    URL: Article
    DOI: 10.1097/IGC.0000000000000318
    Sprache: Englisch
    Verlag: BMJ
    Publikationsdatum: 2015
    ZDB Id: 2009072-9
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 10
    Online-Ressource
    Online-Ressource
    Preoperative Predictive Factors for Complete Cytoreduction and Survival Outcome in Epithelial Ovarian, Tubal, and Peritoneal Cancer After Neoadjuvant Chemotherapy
    BMJ ; 2017
    In:  International Journal of Gynecological Cancer Vol. 27, No. 3 ( 2017-03), p. 420-429
    Details
    In: International Journal of Gynecological Cancer, BMJ, Vol. 27, No. 3 ( 2017-03), p. 420-429
    Materialart: Online-Ressource
    ISSN: 1048-891X
    URL: Article
    DOI: 10.1097/IGC.0000000000000924
    Sprache: Englisch
    Verlag: BMJ
    Publikationsdatum: 2017
    ZDB Id: 2009072-9
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
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