Publications by authors named "Ho-Kyoung Hwang"
Purpose: Improvements in surgical quality and patient safety are critical components of the healthcare system. Despite excellent cancer survival rates in Korea, there is a lack of standardized postoperative complication management systems. To address this gap, the Korean Surgical Society initiated the development of the Korean Quality Improvement Platform in Surgery (K-QIPS) program.
View Article and Find Full Text PDFBackground: Pancreatic neuroendocrine tumors (PNETs) are the leading cause of death related to multiple endocrine neoplasia type 1 (MEN1). Previous studies have linked certain mutations in the MEN1 gene and loss of interactions with MENIN's functional partners to the mortality or aggressiveness of PNETs. This study aimed to evaluate the genotype-phenotype correlations of MEN1-related PNETs in Korean patients and to summarize the treatment outcomes comprehensively.
View Article and Find Full Text PDFIntroduction: This study aimed to compare the long-term effects of neoadjuvant therapy and upfront surgery on overall survival (OS) and progression-free survival (PFS) in patients with resectable pancreatic ductal adenocarcinoma (PDAC).
Methods: We retrospectively analyzed 202 patients, including 167 who had upfront surgery and 35 who received neoadjuvant therapy followed by surgery. Surgical outcomes and survival rates were compared using propensity score matching to minimize selection bias.
Purpose: Several studies have evaluated the impact of sarcopenic obesity (SO) on postoperative complications, including postoperative pancreatic fistula (POPF), in patients undergoing pancreatoduodenectomy (PD). Previous studies have shown that SO increases POPF, but it remains unclear whether SO increases postoperative complications. In this study, we aimed to determine the relationship between SO and immediate postoperative complications.
View Article and Find Full Text PDFBackgrounds/aims: This study aimed to compare the minimally invasive pancreatoduodenectomy with venous vascular resection (MI-PDVR) and open pancreatoduodenectomy with venous vascular resection (O-PDVR) for periampullary cancer.
Methods: Data of 124 patients who underwent PDVR (45 MI-PDVR, 79 O-PDVR) between January 1, 2016, and December 31, 2023, was retrospectively reviewed.
Results: MI-PDVR is significantly better than O-PDVR in terms of perioperative outcomes (median operation time [452.
Article Synopsis
- Elderly patients after pancreatic surgeries like PPPD and DP often face issues with protein digestion and absorption, which can lead to malnutrition and sarcopenia.
- A study with 23 patients taking protein supplements showed that they had significantly higher protein intake and improved quality of life compared to a placebo group.
- Results indicated that increased protein intake was linked to better muscle mass, walking speed, and overall nutrition, suggesting that protein supplementation could benefit elderly patients post-surgery.
Article Synopsis
- The study examines how well natural language processing (NLP) can predict survival rates for pancreatic cancer patients using their CT radiology reports.
- Researchers trained and tested NLP models on a large dataset of patients and their CT reports from two different hospitals, calculating indexes to assess predictive accuracy.
- Results showed that the NLP model significantly improved survival predictions when trained on multiple CT reports, indicating its potential to assist clinical decisions based on radiology report data.
Background: Lymph node (LN) metastasis is an established prognostic factor for patients with surgically resected ampulla of Vater (AoV) cancer. The standard procedure for radical resection, including removal of regional LNs, is pancreaticoduodenectomy (PD); however, local excision has been considered as an alternative option for patients in the early stage cancer with significant comorbidities. In the present study, we elucidated the preoperative factors associated with LN metastasis to determine the appropriate surgical extent for T1 AoV cancer.
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- The study investigates the impact of angiotensin system inhibitors (ASIs) on patients with pancreatic ductal adenocarcinoma (PDAC) who underwent surgery, given the aggressive nature of the disease due to a fibrous microenvironment.
- A total of 410 patients were analyzed, categorized based on ASI usage and hypertension status, but there were no significant differences in clinical characteristics among the groups.
- Results showed that ASI users had higher 5-year overall survival rates compared to non-users, suggesting ASIs might be a beneficial addition to treatment for PDAC patients with hypertension.
We retrospectively evaluated the usefulness of an elevated glucose-to-lymphocyte ratio (GLR) as a sensitive prognostic biomarker of disease-specific survival in 338 patients who underwent surgical resection of pancreatic ductal adenocarcinoma (PDAC). The optimal GLR cutoff value was determined using the method of Contal and O'Quigley. Patient demographics, clinical information, and imaging data were analyzed to identify preoperative predictors of long-term survival outcomes.
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- * Researchers conducted single-cell RNA sequencing on cells from 17 pancreatic tumor tissues and paired this with spatial transcriptomic data from 7 samples, uncovering five subclusters of cancer cells and six of fibroblasts.
- * One notable finding was the identification of a new cancer cell subcluster, Ep_VGLL1, which displays characteristics that bridge basal-like and classical subtypes, hinting at its potential as a therapeutic target.
Background: Although many formulas for predicting postoperative pancreatic fistula (POPF) have been introduced, POPF is generally predicted during pancreatic surgery due to pancreatic texture. This study was designed to verify the correlation between Hounsfield units (HU) and pancreatic texture and to suggest a fistula risk score (FRS) that can be used before surgery.
Methods: Data from 545 patients who underwent pancreatoduodenectomy for malignant disease between January 2008 and December 2019 were retrospectively reviewed.
Background: Distal extrahepatic bile duct (EHBD) cancer is highly recurrent. More than 50% of patients suffer from disease relapse after curative resection. Some patients present with oligo-recurrence which could be a single loco-regional mass or lesions limited to a single solid organ.
View Article and Find Full Text PDFBackground/purpose: Little is known about the features of T1 pancreatic ductal adenocarcinoma (PDAC) and its definition in the eighth edition of the American Joint Committee on Cancer (AJCC) staging system needs validation. The aims were to analyze the clinicopathologic features of T1 PDAC and investigate the validity of its definition.
Method: Data from 1506 patients with confirmed T1 PDAC between 2000 and 2019 were collected and analyzed.
Pancreatoduodenectomy following neoadjuvant chemotherapy in duodenal adenocarcinoma.
Ann Hepatobiliary Pancreat Surg
February 2023
A 51-year-old male patient had four times of massive hematochezia episode three days before arrival. Carbohydrate antigen (CA) 19-9 level was extremely elevated. Computed tomography, magnetic resonance imaging, and positron emission tomography-computed tomography identified 5.
View Article and Find Full Text PDFThe objective of this study was to evaluate the role of regional lymph node (LN) metastasis detected on preoperative CT and/or F-fluoro-2-deoxyglucose-positron emission tomography (FDG-PET) scans in the prediction of early tumor recurrence after curative surgical resection of pancreatic ductal adenocarcinoma (PDAC). This retrospective study included 137 patients who underwent upfront surgery with R0 resection of PDAC between 2013 and 2016. Regional LN metastasis was identified using two criteria: positive findings for regional LN metastasis on either preoperative CT or FDG-PET scans (LN), or on both preoperative CT and FDG-PET scans (LN).
View Article and Find Full Text PDFBackground: This study aims to evaluate sinistral portal hypertension (SPH) development and its clinical impact on the long-term outcomes of patients with pancreatic cancer who underwent surgical resection with splenic vein (SV) ligation. Methods: Data from 94 consecutive patients who underwent pancreatoduodenectomy (PD) with vascular resection for pancreatic cancer from 2008 to 2019 were retrospectively collected. The patients were divided into two groups according to whether the SV was preserved or ligated during the surgery.
View Article and Find Full Text PDFBackground: This study aimed to validate and compare the performance of the original fistula risk scores (o-FRS), alternative (a-FRS), and updated alternative FRS (ua-FRS) after open pancreatoduodenectomy (OPD) and laparoscopic pancreatoduodenectomy (LPD) in an Asian patient cohort.
Methods: Data of 597 consecutive patients who underwent PD (305 OPD, 274 LPD) were collected from two tertiary centers. Model performance was assessed using the area under the receiver operating curve (AUC).
Background: Central pancreatectomy(CP) is more complex surgery and higher complication rate than distal pancreatectomy(DP). However, with the development of minimally invasive surgery, CP has become a safer surgery technique. In this study, we compare minimally invasive CP(MI-CP) and Minimally invasive spleen-preserving subtotal DP(MI-SpSTDP) to figure out the short-term and long-term outcomes of MI-CP.
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- The study investigates the Systemic Inflammation Response Index (SIRI) as a predictor of prognosis in pancreatic cancer patients who underwent neoadjuvant chemotherapy and surgery.
- It analyzes pre-neoadjuvant, post-neoadjuvant SIRI values, and their quotients to see how they affect patient survival rates.
- Results show significant SIRI thresholds that correlate with disease-free and overall survival, suggesting SIRI's potential as a prognostic tool for these patients.
Article Synopsis
- The study developed a nomogram to predict overall survival (OS) and recurrence-free survival (RFS) for patients with ampulla of Vater (AOV) cancer after surgery, based on data from a multicenter international study.
- A total of 2007 patients' data were analyzed, resulting in four nomograms that account for whether patients received adjuvant therapy or not, with varying levels of predictive accuracy measured by the C-index.
- The findings could assist clinicians in making informed treatment decisions and in better predicting patient outcomes for those with AOV cancer.
Article Synopsis
- After radical subtotal gastrectomy (RSTG) for stomach cancer, the remaining stomach relies on short gastric vessels for blood supply, raising concerns about ischemic damage during subsequent surgeries.
- This study explores the safety and feasibility of performing radical distal pancreatosplenectomy (DPS) in patients who have previously undergone RSTG and now have left-sided pancreatic cancer.
- Limited research exists on this issue, but the aim is to provide insights into the perioperative and long-term survival outcomes of DPS in this patient population, especially as more individuals survive resected gastric cancer.
Article Synopsis
- * The patient underwent neoadjuvant chemotherapy before surgery and successfully had the tumor removed while preserving important blood vessels and the pylorus.
- * The surgical team reconstructed major blood vessels to maintain blood supply to the stomach, despite the tumor's proximity to them, demonstrating the procedure's feasibility even in complex cases.
Article Synopsis
- Laparoscopic distal pancreatectomy (LDP) is commonly used for pancreatic ductal adenocarcinoma (PDAC) despite limited high-level evidence, leading to a study on its long-term outcomes using a national database.
- The study included 1202 patients from 16 hospitals and compared 5-year overall survival rates (5YOSR) and disease-free survival rates (5YDFSR) between LDP (356 patients) and open distal pancreatectomy (ODP, 846 patients).
- Results showed similar long-term survival outcomes for LDP and ODP; the LDP group had slightly better survival rates but without significant statistical differences, indicating that LDP can be performed effectively in selected PDAC