Publications by authors named "Hankwang Yang"

Objective: The laparoscopic approach for locally advanced gastric cancer has recently been adopted based on the results of several randomized controlled trials (RCTs). However, findings from RCTs have not been examined at the national level. This study aimed to investigate the external validity of the Korean Laparoscopic Gastrointestinal Surgery Study-02 (KLASS-02) trial involving 13 tertiary hospitals, using data from the Korean Gastric Cancer Association (KGCA)-led nationwide survey involving 68 tertiary or general hospitals.

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  • This study explores the role of T cell subsets in microsatellite instability-high (MSI-H) gastric cancer, focusing on tumor-infiltrating lymphocyte (TIL) density and its implications for patient survival.
  • Researchers used various immunohistochemistry techniques to analyze 382 gastric cancer samples and found that while single immune cell densities did not correlate with overall survival, the ratio of CD8+/TCF1+ to CD8+ cells was linked to better outcomes.
  • The study concludes that the CD8+/TCF1+ to CD8+ ratio serves as an independent prognostic factor, suggesting that specific T cell subsets may influence the aggressiveness of MSI-H gastric cancer.
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Purpose: Laparoscopic distal gastrectomy is now widely used in East Asia and worldwide with different preferences and outcomes. This study aimed to compare the short- and long-term outcomes and preferences between two high-volume gastric cancer centers in Korea and China.

Methods: Patients who underwent laparoscopic-assisted distal gastrectomy (LADG) and totally laparoscopic distal gastrectomy (TLDG) for gastric cancer from Seoul National University Hospital (SNUH) and the First Affiliated Hospital of Nanjing Medical University (NMUH) from 2017 to 2020 were enrolled in this study.

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Backgruound: Medullary thyroid carcinoma (MTC) has a poorer prognosis than differentiated thyroid cancers; however, comprehensive data on the long-term outcomes of MTC remain scarce. This study investigated the extended clinical outcomes of MTC and aimed to identify prognostic factors.

Methods: Patients diagnosed with MTC between 1980 and 2020 were retrospectively reviewed.

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  • A study tested a mobile app designed to help patients eat the right amount of calories and protein after they had surgery for stomach cancer.
  • 39 patients used the app to track what they ate and learned how easy and helpful it was.
  • Results showed that patients who were underweight did a great job using the app and reaching their nutrition goals, suggesting that digital tools can really help people recover after such surgeries.
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  • The study aimed to compare the long-term outcomes of laparoscopic pylorus preserving gastrectomy (LPPG) and laparoscopic distal gastrectomy (LDG) for treating early gastric cancer (EGC) in a multicenter randomized controlled trial with 256 patients.
  • Results showed no significant difference in the incidence of dumping syndrome after one year (13.2% for LPPG vs. 15.8% for LDG), but LPPG had lower rates of gallstone formation and better preservation of hemoglobin and serum protein levels.
  • While LPPG had more instances of reflux esophagitis and delayed gastric emptying, overall survival and quality of life after three years were similar between the two
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  • * Results show that 75.3% of PD patients had AS accumulation compared to only 8.5% of control patients, indicating the diagnostic potential of AS presence in identifying PD.
  • * The research found that longer disease duration and the specific rostrocaudal distribution of AS accumulation in the GI tract serve as predictors for the presence of AS in PD patients, suggesting a distinct progression pattern in the disease.
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  • Various anastomotic and reconstruction techniques were assessed in patients undergoing minimally invasive total (miTG) and distal gastrectomy (miDG) to understand their impact on postoperative complications.
  • A study involving over 4,200 patients found that miTG had significantly higher rates of complications like anastomotic leakage and overall morbidity compared to miDG.
  • The findings suggest that miDG is preferable for patients needing surgery, while linear stapled techniques should be favored in miTG to minimize risks.*
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This study aimed to conduct an in-depth examination of gene expression and microenvironmental profiles of gastric neuroendocrine carcinoma (NEC) and mixed adeno-NEC (MANEC). Tissue microarrays from 55 patients with gastric MANEC (N = 32) or NEC (N = 23) were analyzed using digital spatial profiling (GeoMx DSP, NanoString Technologies). Representative regions of interest were selected from the adenocarcinoma (ADC) portion (ADC-MANEC) and the NEC portion (NEC-MANEC) of the MANEC cores, and pure NEC (pNEC) cores.

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Background: The technical challenges and safety concerns of single-incision laparoscopic gastrectomy for overweight and obese gastric cancer patients remain unclear. This study aimed to evaluate the safety and feasibility of single-incision laparoscopic distal gastrectomy (SIDG) compared to multiport laparoscopic distal gastrectomy (MLDG) in overweight and obese gastric cancer patients.

Methods: This study retrospectively analyzed overweight and obese patients (body mass index ≥ 25 kg/m) and pathologic stage T1 primary gastric adenocarcinoma treated with either SIDG or MLDG.

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Background: Accurate prediction of pathologic results for early gastric cancer (EGC) based on endoscopic findings is essential in deciding between endoscopic and surgical resection. This study aimed to develop an artificial intelligence (AI) model to assess comprehensive pathologic characteristics of EGC using white-light endoscopic images and videos.

Methods: To train the model, we retrospectively collected 4,336 images and prospectively included 153 videos from patients with EGC who underwent endoscopic or surgical resection.

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Purpose: Gastric cancer exhibits molecular heterogeneity, with the microsatellite instability-high (MSI-H) subtype drawing attention for its distinct features. Despite a higher survival rate, MSI-H gastric cancer lack significant benefits from conventional chemotherapy. The immune checkpoint inhibitors, presents a potential avenue, but a deeper understanding of the tumor immune microenvironment of MSI-H gastric cancer is essential.

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Background: Many gastric cancer patients in Western countries are diagnosed as metastatic with a median overall survival of less than twelve months using standard chemotherapy. Innovative treatments, like targeted therapy or immunotherapy, have recently proved to ameliorate prognosis, but a general agreement on managing oligometastatic disease has yet to be achieved. An international multi-disciplinary workshop was held in Bertinoro, Italy, in November 2022 to verify whether achieving a consensus on at least some topics was possible.

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Purpose: Hereditary diffuse gastric cancer (HDGC) presents a significant genetic predisposition, notably linked to mutations in the CDH1 and CTNNA1. However, the genetic basis for over half of HDGC cases remains unidentified. The aim of this study is to identify novel pathogenic variants in HDGC and evaluate their protein expression.

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  • The study aimed to create a reliable prognostic signature for gastric cancer by comparing early cancers with and without lymph node metastasis, addressing issues like tumor heterogeneity and selection bias.* -
  • Researchers used machine learning to analyze RNA expression data from 1003 cases, ultimately identifying a six-gene classifier (four overexpressed and two downregulated genes) that predicts poor prognosis.* -
  • Validation in cell lines and mouse models demonstrated that a high-risk score correlates with increased cancer invasion and metastasis, while it also proved to be an independent prognostic factor in three external patient cohorts.*
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Background: Obesity is known to increase overall disease burden but does obesity management actually help reduce disease burden?

Objectives: To investigate the effects of weight loss on disease burden in people with obesity using the National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) in Korea.

Setting: Pure longitudinal observational study using Nationwide cohort database.

Methods: Out of 514,866 NHIS-HEALS cohort, participants with class II obesity in Asia-Pacific region (30 ≤ body mass index [BMI] < 35) who underwent health check-up provided by NHIS during 2003-2004 (index date) were included.

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Background: This study aimed to investigate the oncologic long-term safety of proximal gastrectomy for upper-third advanced gastric cancer (AGC) and Siewert type II esophagogastric junction (EGJ) cancer.

Methods: The study enrolled patients who underwent proximal gastrectomy (PG) or total gastrectomy (TG) with standard lymph node (LN) dissection for pathologically proven upper-third AGC and EGJ cancers between January 2007 and December 2018. Propensity score-matching with a 1:1 ratio was performed to reduce the influence of confounding variables such as age, sex, tumor size, T stage, N stage, and tumor-node-metastasis (TNM) stage.

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Robot-assisted surgery platforms are utilized globally thanks to their stereoscopic vision systems and enhanced functional assistance. However, the necessity of ergonomic improvement for their use by surgeons has been increased. In surgical robots, issues with chronic fatigue exist owing to the fixed posture of the conventional stereo viewer (SV) vision system.

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Purpose: Bariatric surgery is an increasingly common treatment for obesity and related comorbidities. This meta-analysis aimed to compare the outcomes of bariatric surgery and medical treatment (MT).

Materials And Methods: A systematic search of articles published from January 2013 to May 2023 identified 20 studies.

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Objective: The present study aimed to compare intraoperative and postoperative outcomes of laparoscopic-assisted distal gastrectomy versus totally laparoscopic distal gastrectomy (TLDG) Billroth I (BI) for gastric cancer and to assess the impact of the initial introduction phase of TLDG BI anastomosis.

Patients And Methods: The study analyzed the prospectively collected data of patients who underwent laparoscopic distal gastrectomy BI from 2014 to 2021 at Seoul National University Hospital.

Results: Among 1116 patients, laparoscopic-assisted distal gastrectomy BI was performed in 566 patients and TLDG BI was performed in 550 patients.

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