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1.
J Pers Med ; 14(6)2024 Jun 04.
Article de Anglais | MEDLINE | ID: mdl-38929822

RÉSUMÉ

The purpose of this study was to establish the noninferiority of robotic single-site (RSS) surgery compared with multiport laparoscopic (MPL) surgery in surgical outcomes and overall survival for early endometrial cancer. This study was conducted retrospectively in a single center and included 421 patients who underwent either RSS (n = 146) or MPL (n = 275) surgery between 2014 and 2022. In terms of perioperative outcomes, the RSS group had a longer operating time than the MPL surgery group (mean (standard deviation [SD]) RSS 97.55 [29.79] vs. MPL 85.56 [26.13], p < 0.001). However, no significant differences in estimated blood loss or perioperative complications were found between the groups (p = 0.196 and p = 0.080, respectively). The patients in the RSS group were discharged earlier than those in the MPL group (mean [SD]): 4.06 [3.24] vs. 9.39 [4.76], p < 0.001). Regarding oncologic outcomes, no significant differences in the type of therapy, disease stage, tumor grade, histopathological type, or lymphovascular invasion were found between the groups. No statistically significant differences were found in the disease-free (p = 0.27) and overall survival rates (p = 0.5) either. In conclusion, this study suggests that RSS and MPL surgery are both safe and effective options for staging operations in patients with early-stage endometrial cancer.

2.
Cancer Epidemiol Biomarkers Prev ; 33(5): 681-693, 2024 May 01.
Article de Anglais | MEDLINE | ID: mdl-38412029

RÉSUMÉ

BACKGROUND: Distinguishing ovarian cancer from other gynecological malignancies is crucial for patient survival yet hindered by non-specific symptoms and limited understanding of ovarian cancer pathogenesis. Accumulating evidence suggests a link between ovarian cancer and deregulated lipid metabolism. Most studies have small sample sizes, especially for early-stage cases, and lack racial/ethnic diversity, necessitating more inclusive research for improved ovarian cancer diagnosis and prevention. METHODS: Here, we profiled the serum lipidome of 208 ovarian cancer, including 93 early-stage patients with ovarian cancer and 117 nonovarian cancer (other gynecological malignancies) patients of Korean descent. Serum samples were analyzed with a high-coverage liquid chromatography high-resolution mass spectrometry platform, and lipidome alterations were investigated via statistical and machine learning (ML) approaches. RESULTS: We found that lipidome alterations unique to ovarian cancer were present in Korean women as early as when the cancer is localized, and those changes increase in magnitude as the diseases progresses. Analysis of relative lipid abundances revealed specific patterns for various lipid classes, with most classes showing decreased abundance in ovarian cancer in comparison with other gynecological diseases. ML methods selected a panel of 17 lipids that discriminated ovarian cancer from nonovarian cancer cases with an AUC value of 0.85 for an independent test set. CONCLUSIONS: This study provides a systemic analysis of lipidome alterations in human ovarian cancer, specifically in Korean women. IMPACT: Here, we show the potential of circulating lipids in distinguishing ovarian cancer from nonovarian cancer conditions.


Sujet(s)
Lipidomique , Tumeurs de l'ovaire , Humains , Femelle , Tumeurs de l'ovaire/sang , Lipidomique/méthodes , République de Corée/épidémiologie , Adulte d'âge moyen , Marqueurs biologiques tumoraux/sang , Adulte , Sujet âgé , Métabolisme lipidique , Lipides/sang
3.
J Gynecol Oncol ; 2024 Jan 22.
Article de Anglais | MEDLINE | ID: mdl-38330380

RÉSUMÉ

BACKGROUND: Bulky or multiple lymph node (LN) metastases are associated with poor prognosis in cervical cancer, and the size or number of LN metastases is not yet reflected in the staging system and therapeutic strategy. Although the therapeutic effects of surgical resection of bulky LNs before standard treatment have been reported in several retrospective studies, well-planned randomized clinical studies are lacking. Therefore, the aim of the Korean Gynecologic Oncology Group (KGOG) 1047/DEBULK trial is to investigate whether the debulking surgery of bulky or multiple LNs prior to concurrent chemoradiation therapy (CCRT) improves the survival rate of patients with cervical cancer IIICr diagnosed by imaging tests. METHODS: The KGOG 1047/DEBULK trial is a phase III, multicenter, randomized clinical trial involving patients with bulky or multiple LN metastases in cervical cancer IIICr. This study will include patients with a short-axis diameter of a pelvic or para-aortic LN ≥2 cm or ≥3 LNs with a short-axis diameter ≥1 cm and for whom CCRT is planned. The treatment arms will be randomly allocated in a 1:1 ratio to either receive CCRT (control arm) or undergo surgical debulking of bulky or multiple LNs before CCRT (experimental arm). CCRT consists of extended-field external beam radiotherapy/pelvic radiotherapy, brachytherapy and LN boost, and weekly chemotherapy with cisplatin (40 mg/m²), 4-6 times administered intravenously. The primary endpoint will be 3-year progression-free survival rate. The secondary endpoints will be 3-year overall survival rate, treatment-related complications, and accuracy of radiological diagnosis of bulky or multiple LNs. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05421650; Clinical Research Information Service Identifier: KCT0007137.

4.
J Gynecol Oncol ; 35(4): e52, 2024 Jul.
Article de Anglais | MEDLINE | ID: mdl-38330377

RÉSUMÉ

OBJECTIVE: This study aimed to determine the safety and efficacy of the RKP00156 vaginal tablet, a CDK9 inhibitor, in healthy women and patients with cervical intraepithelial neoplasia grade 2 (CIN2). METHODS: We conducted a phase 1/2a clinical trial of RKP00156. In step 1, RKP00156 at a dose of 10, 25, or 50 mg or a placebo tablet was administered transvaginally to 24 healthy women. In step 2, RKP00156 at a dose of 10, 25, or 50 mg or a placebo tablet was administered once daily for 4 weeks in 62 patients with CIN2. The primary endpoints of this trial were the safety of RKP00156 and the change in the human papillomavirus (HPV) viral load. RESULTS: A total of 86 patients were enrolled and randomized. RKP00156 administration did not cause serious drug-associated adverse events (AEs). Although no significant difference in the HPV viral load was found between the experimental and placebo groups, a reduction in the HPV viral load was observed in the 25 mg-dose group (-98.61%; 95% confidence interval=-99.83%, 4.52%; p=0.046) after treatment completion in patients with a high HPV viral load, despite a lack of statistical power. No differences in histologic regression and HPV clearance were observed. CONCLUSION: The safety of RKP00156 was proved with no serious AEs. Although the study did not show any significance in histologic regression and HPV clearance, our findings indicate that RKP00156 may have a possibility of short-term inhibitory effect on HPV replication in patients with higher viral loads. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02139267.


Sujet(s)
Infections à papillomavirus , Dysplasie du col utérin , Tumeurs du col de l'utérus , Charge virale , Humains , Femelle , Dysplasie du col utérin/virologie , Dysplasie du col utérin/traitement médicamenteux , Adulte , Adulte d'âge moyen , Tumeurs du col de l'utérus/virologie , Tumeurs du col de l'utérus/traitement médicamenteux , Tumeurs du col de l'utérus/anatomopathologie , Infections à papillomavirus/virologie , Infections à papillomavirus/complications , Jeune adulte , Relation dose-effet des médicaments , Administration par voie vaginale , Kinase-9 cycline-dépendante/antagonistes et inhibiteurs , Comprimés , Méthode en double aveugle , Papillomaviridae/isolement et purification , Résultat thérapeutique
5.
J Pers Med ; 13(5)2023 Apr 26.
Article de Anglais | MEDLINE | ID: mdl-37240903

RÉSUMÉ

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.

6.
Sci Rep ; 12(1): 5390, 2022 03 30.
Article de Anglais | MEDLINE | ID: mdl-35354828

RÉSUMÉ

Rapid outbreak of coronavirus disease 2019 (Covid-19) raised major concern regarding medical resource constraints. We constructed and validated a scoring system for early prediction of progression to severe pneumonia in patients with Covid-19. A total of 561 patients from a Covid-19 designated hospital in Daegu, South Korea were randomly divided into two cohorts: development cohort (N = 421) and validation cohort (N = 140). We used multivariate logistic regression to identify four independent risk predictors for progression to severe pneumonia and constructed a risk scoring system by giving each factor a number of scores corresponding to its regression coefficient. We calculated risk scores for each patient and defined two groups: low risk (0 to 8 points) and high risk (9 to 20 points). In the development cohort, the sensitivity and specificity were 83.8% and 78.9%. In the validation cohort, the sensitivity and specificity were 70.8% and 79.3%, respectively. The C-statistics was 0.884 (95% CI 0.833-0.934) in the development cohort and 0.828 (95% CI 0.733-0.923) in the validation cohort. This risk scoring system is useful to identify high-risk group for progression to severe pneumonia in Covid-19 patients and can prevent unnecessary overuse of medical care in limited-resource settings.


Sujet(s)
COVID-19 , Pneumopathie infectieuse , Études de cohortes , Humains , Modèles logistiques , Pneumopathie infectieuse/épidémiologie , Facteurs de risque
7.
Int J Med Robot ; 17(4): e2255, 2021 Aug.
Article de Anglais | MEDLINE | ID: mdl-33817949

RÉSUMÉ

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.


Sujet(s)
Laparoscopie , Interventions chirurgicales robotisées , Robotique , Tumeurs du col de l'utérus , Femelle , Humains , Hystérectomie , Lymphadénectomie , Études rétrospectives , Résultat thérapeutique , Tumeurs du col de l'utérus/chirurgie
8.
J Clin Med ; 10(4)2021 Feb 10.
Article de Anglais | MEDLINE | ID: mdl-33578930

RÉSUMÉ

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.

9.
Br J Cancer ; 124(2): 375-382, 2021 01.
Article de Anglais | MEDLINE | ID: mdl-32994466

RÉSUMÉ

BACKGROUND: This Phase 2b study compared the efficacy and toxicity of belotecan and topotecan in recurrent ovarian cancer. METHODS: Patients with platinum-sensitive recurrent or platinum-resistant recurrent ovarian cancer (PRROC) were randomised 1:1 to receive belotecan 0.5 mg/m2 or topotecan 1.5 mg/m2 for five consecutive days every 3 weeks. The primary endpoint was overall response rate (ORR); secondary endpoints were progression-free survival (PFS), overall survival (OS), and toxicity. RESULTS: A total of 140 (belotecan, n = 71; topotecan, n = 69) and 130 patients (belotecan, n = 66; topotecan, n = 64) were included in the intention-to-treat (ITT) and per-protocol (PP) populations. ORR did not differ significantly between the belotecan and topotecan groups (ITT, 29.6% versus 26.1%; PP, 30.3% versus 25%). Although PFS did not differ between the groups, belotecan was associated with improved OS compared with topotecan in the PP population (39.7 versus 26.6 months; P = 0.034). In particular, belotecan showed longer OS in PRROC and non-high-grade serous carcinoma (non-HGSC; PP, adjusted hazard ratios, 0.499 and 0.187; 95% confidence intervals 0.255-0.977 and 0.039-0.895). Furthermore, there were no differences in toxicities between the two groups. CONCLUSIONS: Belotecan was not inferior to topotecan in terms of overall response for recurrent ovarian cancer. CLINICAL TRIAL REGISTRATION: NCT01630018.


Sujet(s)
Antinéoplasiques/usage thérapeutique , Camptothécine/analogues et dérivés , Carcinome épithélial de l'ovaire/traitement médicamenteux , Récidive tumorale locale/traitement médicamenteux , Topotécane/usage thérapeutique , Adulte , Sujet âgé , Camptothécine/usage thérapeutique , Carcinome épithélial de l'ovaire/mortalité , Femelle , Humains , Adulte d'âge moyen , Récidive tumorale locale/mortalité , Survie sans progression
10.
Proc Natl Acad Sci U S A ; 117(50): 31993-32004, 2020 12 15.
Article de Anglais | MEDLINE | ID: mdl-33262282

RÉSUMÉ

Effective cancer prevention requires the discovery and intervention of a factor critical to cancer development. Here we show that ovarian progesterone is a crucial endogenous factor inducing the development of primary tumors progressing to metastatic ovarian cancer in a mouse model of high-grade serous carcinoma (HGSC), the most common and deadliest ovarian cancer type. Blocking progesterone signaling by the pharmacologic inhibitor mifepristone or by genetic deletion of the progesterone receptor (PR) effectively suppressed HGSC development and its peritoneal metastases. Strikingly, mifepristone treatment profoundly improved mouse survival (∼18 human years). Hence, targeting progesterone/PR signaling could offer an effective chemopreventive strategy, particularly in high-risk populations of women carrying a deleterious mutation in the BRCA gene.


Sujet(s)
Protéine BRCA1/génétique , Cystadénocarcinome séreux/prévention et contrôle , Mifépristone/pharmacologie , Tumeurs de l'ovaire/prévention et contrôle , Progestérone/antagonistes et inhibiteurs , Adulte , Animaux , Région mammaire/anatomopathologie , Tumeurs du sein/génétique , Tumeurs du sein/anatomopathologie , Tumeurs du sein/prévention et contrôle , Cystadénocarcinome séreux/composition chimique , Cystadénocarcinome séreux/génétique , Cystadénocarcinome séreux/anatomopathologie , Modèles animaux de maladie humaine , Oestradiol/administration et posologie , Femelle , Humains , Souris , Adulte d'âge moyen , Mifépristone/usage thérapeutique , Mutation , Tumeurs expérimentales/induit chimiquement , Tumeurs expérimentales/génétique , Tumeurs expérimentales/anatomopathologie , Tumeurs expérimentales/prévention et contrôle , Tumeurs de l'ovaire/induit chimiquement , Tumeurs de l'ovaire/génétique , Tumeurs de l'ovaire/anatomopathologie , Ovaire/anatomopathologie , Ovaire/chirurgie , Progestérone/administration et posologie , Progestérone/métabolisme , Récepteurs à la progestérone/génétique , Récepteurs à la progestérone/métabolisme , Salpingo-ovariectomie , Transduction du signal/effets des médicaments et des substances chimiques , Transduction du signal/génétique
11.
Bull World Health Organ ; 98(12): 842-848, 2020 Dec 01.
Article de Anglais | MEDLINE | ID: mdl-33293744

RÉSUMÉ

OBJECTIVE: To document the experiences of converting a general hospital to a coronavirus disease 2019 (COVID-19) designated hospital during an outbreak in Daegu, Republic of Korea. METHODS: The hospital management formed an emergency task force team, whose role was to organize the COVID-19 hospital. The task force used different collaborative channels to redistribute resources and expertise to the hospital. Leading doctors from the departments of infectious diseases, critical care and pulmonology developed standardized guidelines for treatment coherence. Nurses from the infection control team provided regular training on donning and doffing of personal protective equipment and basic safety measures. FINDINGS: Keimyung University Daegu Dongsan hospital became a red zone hospital for COVID-19 patients on 21 February 2020. As of 29 June 2020, 1048 COVID-19 patients had been admitted to the hospital, of which 22 patients died and five patients were still being treated in the recovery ward. A total of 906 health-care personnel worked in the designated hospital, of whom 402 were regular hospital staff and 504 were dispatched health-care workers. Of these health-care workers, only one dispatched nurse acquired COVID-19. On June 15, the hospital management and Daegu city government decided to reconvert the main building to a general hospital for non-COVID-19 patients, while keeping the additional negative pressure rooms available, in case of resurgence of the disease. CONCLUSION: Centralized coordination in frontline hospital operation, staff management, and patient treatment and placement allowed for successful pooling and utilization of medical resources and manpower during the COVID-19 outbreak.


Sujet(s)
COVID-19/épidémiologie , Hôpitaux spécialisés/organisation et administration , Prévention des infections/organisation et administration , Personnel de santé/enseignement et éducation , Capacité hospitalière , Humains , Formation en interne/organisation et administration , Équipement de protection individuelle/ressources et distribution , Guides de bonnes pratiques cliniques comme sujet , République de Corée/épidémiologie , SARS-CoV-2 , Centres de soins tertiaires/organisation et administration
13.
Gynecol Oncol Rep ; 34: 100663, 2020 Nov.
Article de Anglais | MEDLINE | ID: mdl-33204794

RÉSUMÉ

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.

14.
Int J Mol Sci ; 21(21)2020 Oct 28.
Article de Anglais | MEDLINE | ID: mdl-33126484

RÉSUMÉ

N-α-acetyltransferase 10 (NAA10) is an acetyltransferase that acetylates both N-terminal amino acid and internal lysine residues of proteins. NAA10 is a crucial player to regulate cell proliferation, migration, differentiation, apoptosis, and autophagy. Recently, mounting evidence presented the overexpression of NAA10 in various types of cancer, including liver, bone, lung, breast, colon, and prostate cancers, and demonstrated a correlation of overexpressed NAA10 with vascular invasion and metastasis, thereby affecting overall survival rates of cancer patients and recurrence of diseases. This evidence all points NAA10 toward a promising biomarker for cancer prognosis. Here we summarize the current knowledge regarding the biological functions of NAA10 in cancer progression and provide the potential usage of NAA10 as a prognostic marker for cancer progression.


Sujet(s)
Marqueurs biologiques tumoraux/métabolisme , N-terminal acetyltransferase A/métabolisme , N-terminal acetyltransferase E/métabolisme , Tumeurs/anatomopathologie , Évolution de la maladie , Humains , Tumeurs/métabolisme
15.
Int J Infect Dis ; 98: 462-466, 2020 Sep.
Article de Anglais | MEDLINE | ID: mdl-32702415

RÉSUMÉ

OBJECTIVES: Two Coronavirus Disease 2019 (COVID-19) outbreaks simultaneously occurred at a church and a long-term care facility in Daegu, South Korea. This study aimed to investigate the epidemiological characteristics of COVID-19 and factors related to severe outcomes. METHODS: We enrolled all inpatients diagnosed with COVID-19 between February 21 and April 2, 2020, in Daegu Dongsan Hospital. We analyzed their clinical and demographic data, laboratory parameters, radiological findings, symptoms, and treatment outcomes. RESULTS: Of 694 patients, severe cases accounted for 19.7% (137 patients). No severe case was observed among patients aged ≤19 years. Hypertension was the most common comorbidity (27%), and cough was the most common symptom (59%). Asymptomatic patients accounted for 14.4% of cases. Lymphopenia, lactate dehydrogenase, C-reactive protein, and albumin were associated with severe outcomes. The first outbreak was mostly associated with younger age groups, and asymptomatic patients mostly showed mild progression. In the second outbreak involving a long-term care facility, both the number of severe patients and the mortality rate were higher. CONCLUSIONS: The overall mortality in Daegu was low, which might have resulted from large scale mass screening to detect patients and starting appropriate treatment, including hospitalization for severe cases, and quarantine for asymptomatic patients.


Sujet(s)
Betacoronavirus/physiologie , Infections à coronavirus/diagnostic , Infections à coronavirus/épidémiologie , Pneumopathie virale/diagnostic , Pneumopathie virale/épidémiologie , Adolescent , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Betacoronavirus/génétique , Protéine C-réactive/métabolisme , COVID-19 , Enfant , Enfant d'âge préscolaire , Infections à coronavirus/métabolisme , Infections à coronavirus/virologie , Toux , Épidémies de maladies , Femelle , Hôpitaux , Humains , Mâle , Dépistage de masse , Adulte d'âge moyen , Pandémies , Pneumopathie virale/métabolisme , Pneumopathie virale/virologie , République de Corée/épidémiologie , SARS-CoV-2 , Résultat thérapeutique , Jeune adulte
16.
PLoS Genet ; 16(6): e1008808, 2020 06.
Article de Anglais | MEDLINE | ID: mdl-32497036

RÉSUMÉ

Metastasis is responsible for 90% of human cancer mortality, yet it remains a challenge to model human cancer metastasis in vivo. Here we describe mouse models of high-grade serous ovarian cancer, also known as high-grade serous carcinoma (HGSC), the most common and deadliest human ovarian cancer type. Mice genetically engineered to harbor Dicer1 and Pten inactivation and mutant p53 robustly replicate the peritoneal metastases of human HGSC with complete penetrance. Arising from the fallopian tube, tumors spread to the ovary and metastasize throughout the pelvic and peritoneal cavities, invariably inducing hemorrhagic ascites. Widespread and abundant peritoneal metastases ultimately cause mouse deaths (100%). Besides the phenotypic and histopathological similarities, mouse HGSCs also display marked chromosomal instability, impaired DNA repair, and chemosensitivity. Faithfully recapitulating the clinical metastases as well as molecular and genomic features of human HGSC, this murine model will be valuable for elucidating the mechanisms underlying the development and progression of metastatic ovarian cancer and also for evaluating potential therapies.


Sujet(s)
Antinéoplasiques/pharmacologie , Cystadénocarcinome séreux/génétique , Tumeurs de l'ovaire/anatomopathologie , Tumeurs du péritoine/génétique , Animaux , Antinéoplasiques/usage thérapeutique , Lignée cellulaire tumorale , Instabilité des chromosomes , Cystadénocarcinome séreux/traitement médicamenteux , Cystadénocarcinome séreux/secondaire , DEAD-box RNA helicases/génétique , Réparation de l'ADN , Modèles animaux de maladie humaine , Résistance aux médicaments antinéoplasiques/génétique , Tests de criblage d'agents antitumoraux/méthodes , Études de faisabilité , Femelle , Humains , Souris , Souris knockout , Mutation , Grading des tumeurs , Métastase tumorale/génétique , Tumeurs de l'ovaire/traitement médicamenteux , Tumeurs de l'ovaire/génétique , Phosphohydrolase PTEN/génétique , Tumeurs du péritoine/traitement médicamenteux , Tumeurs du péritoine/secondaire , Culture de cellules primaires , Ribonuclease III/génétique , Protéine p53 suppresseur de tumeur/génétique
17.
Reprod Sci ; 27(3): 905-915, 2020 03.
Article de Anglais | MEDLINE | ID: mdl-32052358

RÉSUMÉ

Dienogest (DNG) is a progestin with highly selective progesterone activity and known to be effective in the treatment of endometriosis. This prospective cohort study in patients who had been treated with DNG 2 mg (Visanne®) for endometriosis was conducted to assess the safety and effectiveness of DNG in a large Korean cohort. This study included 3356 patients with endometriosis from 73 centers in Korea. All patients were treated with DNG 2 mg daily and were followed up for at least 6 months after initial visit. Any adverse events were recorded including severity, onset/closing date, outcomes, treatments, and the causality with DNG. Effectiveness of DNG was measured by changes in visual analogue scale (VAS) from baseline at the end of follow-up. The mean age of the subjects was 34.96 years, and the mean duration of treatment was 285.44 days. Incidence of adverse drug reaction (ADR) was 13.27% (413/3113). The most frequently reported ADR were "abnormal uterine bleeding" 4.14% (129/3113), "increased weight" 2.57% (80/3113), and "headache" 1.22% (38/3113). The number of patients (%) with favorable bleeding patterns was observed to increase as the duration of treatment increases. Amenorrhea was observed in 29.63%, 41.25%, 46.26%, and 53.20% of patients at 3 months, 6 months, 12 months, and more than 12 months follow-up period, respectively. The mean (±SD) VAS change from baseline at the last follow-up visit was -28.19 ± 28.39 mm (P value < 0.0001). This large cohort study confirms, in routine clinical practice, that DNG is safe and effective for treatment of endometriosis.


Sujet(s)
Endométriose/traitement médicamenteux , Antihormones/usage thérapeutique , Nandrolone/analogues et dérivés , Adulte , Endométriose/complications , Femelle , Humains , Adulte d'âge moyen , Nandrolone/usage thérapeutique , Douleur/complications , Douleur/prévention et contrôle , Études prospectives , Résultat thérapeutique
18.
Clin Cancer Res ; 26(7): 1616-1623, 2020 04 01.
Article de Anglais | MEDLINE | ID: mdl-31727676

RÉSUMÉ

PURPOSE: To determine the efficacy of the therapeutic DNA vaccine GX-188E for inducing regression of cervical intraepithelial neoplasia (CIN) 3. PATIENTS AND METHODS: We conducted a prospective, randomized, multicenter, open-label, phase II clinical trial of GX-188E in CIN3 patients positive for human papillomavirus (HPV) type 16/18. The primary endpoint was to determine the histopathologic regression to ≤CIN1 at visit seven (V7; 20 weeks after the first GX-188E injection), and an extension study was pursued until visit 8 (V8; 36 weeks after the first GX-188E injection). HPV-sequencing analysis and an ex vivo IFNγ ELISpot assay were performed using the collected cervical biopsy and blood samples from patients. RESULTS: In total, 72 patients were enrolled and underwent randomization. Of them, 64 patients were included in per-protocol analysis (V7) and 52 in extension analysis (V8). Our data showed 52% (33/64) of patients at V7 and 67% (35/52) of patients at V8 presented histopathologic regression after receiving the GX-188E injection. We found that 73% (V7) and 77% (V8) of the patients with histologic regression showed HPV clearance. HPV clearance and histopathologic regression were significantly associated at V7 and at V8. Compared with the measurements at V1 (baseline), the patients at V8 with HPV clearance showed significantly higher fold changes in their IFNγ ELISpot responses compared with those without HPV clearance. The HPV sequence analysis revealed that the HPV type 16 E6/E7 variants D25E, V83L, and N29S were inversely associated with histopathologic regression at V8. CONCLUSIONS: GX-188E is an effective therapeutic vaccine against a cohort containing only CIN3 patients.


Sujet(s)
Infections à papillomavirus/complications , Vaccins contre les papillomavirus/usage thérapeutique , Dysplasie du col utérin/traitement médicamenteux , Tumeurs du col de l'utérus/traitement médicamenteux , Vaccins à ADN/usage thérapeutique , Adulte , Femelle , Papillomavirus humain de type 16/génétique , Papillomavirus humain de type 16/isolement et purification , Papillomavirus humain de type 18/génétique , Papillomavirus humain de type 18/isolement et purification , Humains , Infections à papillomavirus/virologie , Sécurité des patients , Études prospectives , Résultat thérapeutique , Tumeurs du col de l'utérus/immunologie , Tumeurs du col de l'utérus/anatomopathologie , Tumeurs du col de l'utérus/virologie , Dysplasie du col utérin/immunologie , Dysplasie du col utérin/anatomopathologie , Dysplasie du col utérin/virologie
19.
Obstet Gynecol Sci ; 62(3): 149-156, 2019 May.
Article de Anglais | MEDLINE | ID: mdl-31139590

RÉSUMÉ

OBJECTIVE: The aims of this study were to introduce surgical guidelines, and to evaluate the feasibility and safety of a robotic single-site staging (RSSS) operation for early-stage endometrial cancer. METHODS: Patients with a preoperative diagnosis of endometrial cancer (International Federation of Gynecology and Obstetrics stages IA to IB) from endometrial curettage and preoperative imaging studies were selected at Dongsan Medical Center from March 2014 to November 2015. All surgical procedures, including hysterectomy, salpingo-oophorectomy, bilateral pelvic node dissection, and cytology aspiration, were performed by robotic single-site instruments (da Vinci Si® surgical system; Intuitive Surgical, Sunnyvale, CA, USA). RESULTS: A total of 15 women with early-stage endometrial cancer underwent the RSSS operation. The median patient age and body mass index were 53 years (range, 37-70 years) and 25.4 kg/m2 (range, 18.3-46.4 kg/m2). The median docking time, console time, and total operative time were 8 minutes (range, 4-15 minutes), 75 minutes (range, 55-115 minutes), and 155 minutes (range, 125-190 minutes), respectively. The median retrieval of both pelvic lymph nodes was 9 (range, 6-15). There were no conversions to laparoscopy or laparotomy. CONCLUSION: The RSSS operation is feasible and safe in patients with early-stage endometrial cancer. In this study, operative times were reasonable, and the surgical procedure was well-tolerated by the patients. Further evaluation of patients with early-stage endometrial cancer should be performed in large-scale comparative studies using the laparoendoscopic, single-site staging operation to confirm the safety and benefits of the RSSS operation for early-stage endometrial cancer.

20.
SAGE Open Med Case Rep ; 7: 2050313X18823901, 2019.
Article de Anglais | MEDLINE | ID: mdl-30719317

RÉSUMÉ

A 73-year-old woman was referred to the pulmonology department for abnormal findings on chest computed tomography. She had undergone a laparoscopic staging operation including a hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic node and para-aortic node dissection, and concurrent chemo-radiation therapy for endometrial serous carcinoma stage IIIc cancer 15 months earlier. A follow-up chest computed tomography after the chemotherapy showed that the right lower lobe bronchus was obstructed, and it was necessary to differentiate a primary lung malignancy from a metastasis and secretion. A positron emission tomography revealed an intense hypermetabolic nodule in the right lower lobe bronchus and diffuse hypometabolism of the right lower lobe lung. Bronchoscopy revealed a tumor mass obstructing the right lower lobe bronchus, and an endobronchial biopsy confirmed a metastatic serous carcinoma from the endometrium. We described an endobronchial metastasis from an endometrial carcinoma with various diagnostic images and histology. To the best of our knowledge, this is the first report of an endobronchial metastasis from an endometrial carcinoma in Korea.

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