Publications by authors named "Suk Joon Chang"

Aim: Staging surgery in early stage endometrial cancer has been shown to be feasible and safe with minimally invasive surgery (MIS) in many previous studies. However, there is limited literature on MIS's safety in advanced stages. This study aims to identify factors associated with survival in stage III endometrial cancer and investigate survival differences based on surgical approach.

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  • - The study aimed to determine if intraoperative rupture during surgeries for early-stage epithelial ovarian cancer affects patient outcomes, specifically focusing on progression-free survival (PFS).
  • - Researchers analyzed data from 338 patients (197 unruptured and 141 ruptured) and found no significant difference in 5-year PFS before matching but a concerning trend after adjusting for other factors, particularly in patients with aggressive tumor types.
  • - The conclusions suggest that while the effect of rupture on PFS wasn’t statistically significant, it could still have negative implications for treatment and outcomes, emphasizing the importance of preventing rupture during surgery.
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Background: Although two recent phase III randomized controlled trials showed survival benefits of undergoing secondary cytoreductive surgery for an initial relapse of ovarian cancer, patients who received a poly-ADP ribose polymerase inhibitor (PARPi) as the first-line maintenance treatment, which is currently the standard treatment for advanced ovarian cancer, were not included in those trials. Therefore, determining an optimal treatment strategy, including secondary cytoreductive surgery, in patients whose cancer progresses even with PARPi treatment, is needed.

Primary Objective: To determine whether secondary cytoreductive surgery is beneficial in patients who have progressed on PARPi maintenance treatment.

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  • The report examines the outcomes of advanced ovarian cancer patients who underwent bowel surgery as part of maximal cytoreductive surgery, comparing results between surgeries performed by gynecologic oncologists (GOs) and general surgeons (GSs).
  • It involved 761 patients, revealing that both groups had similar characteristics and complication rates, but GOs had shorter operation times.
  • The study concludes that GOs can safely and feasibly perform bowel surgeries without impacting patient survival, suggesting a need for enhanced training for GOs in this area.
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Objective: To evaluate whether treatment with erythropoiesis-stimulating agents (ESAs) for chemotherapy-induced anemia affects progression-free survival (PFS) in patients receiving front-line chemotherapy following surgery for ovarian cancer (OC).

Methods: We retrospectively reviewed all consecutive patients who received front-line chemotherapy after surgery between 2013 and 2019 at six institutions. The patients were divided according to the use of ESAs during front-line chemotherapy.

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We aimed to determine whether pretreatment squamous cell carcinoma antigen (SCC-Ag) levels and the average logarithmic change in SCC-Ag levels ( ) after concurrent chemoradiotherapy (CCRT) could predict treatment outcomes in patients with stage IIIC1 cervical squamous cell carcinoma (SCC). We analyzed 168 patients with stage IIIC1 cervical SCC who underwent primary CCRT and collected data on age, local extension, treatment details, hematological parameters, and tumor markers such as SCC-Ag and carcinoembryonic antigen 21-1 (Cyfra). Predictive performances of pretreatment SCC-Ag levels and were assessed using receiver operating characteristic curves.

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  • This study investigated the effectiveness of lymphadenectomy (removal of lymph nodes) in patients with early-stage epithelial ovarian cancer (EOC) to see if it improves survival rates compared to those who did not undergo the procedure.
  • The research included 586 patients and found no significant difference in survival rates between the lymphadenectomy group and the non-lymphadenectomy group, although those with serous histology did experience better disease-free survival with lymphadenectomy.
  • Despite some potential benefits, the lymphadenectomy group had longer surgery times and higher rates of complications, suggesting it should be considered carefully based on individual patient factors.
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Complex surgery is an essential component in the management of advanced ovarian cancer. Furthermore, achieving complete gross resection in cytoreductive surgery appears to be associated with significant survival benefits in patients with advanced ovarian cancer. The goal of this review is to demonstrate the advancement of surgical techniques in gynecologic oncology surgery, including resection of disease within the intrathoracic and inguinal regions.

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Introduction: We evaluated the effect of high-dose polymeric nanoparticle micellar paclitaxel (PM-Pac) on survival in patients with stage III-IV high-grade serous ovarian cancer (HGSC) who underwent upfront surgery.

Methods: We prospectively recruited the patients who received PM-Pac (280 mg/m) and carboplatin at an area under the curve (AUC) of 5 (cohort 1) in two tertiary centers between October 2015 and June 2019. As historical controls, we retrospectively collected data on those who received paclitaxel (175 mg/m) and carboplatin (AUC 5; cohort 2) or paclitaxel (175 mg/m), carboplatin (AUC 5) and bevacizumab (15 mg/kg; cohort 3).

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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.

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Objective: The aim of this study was to identify high- and low-risk subgroups of patients with lymph node (LN) metastasis in presumed early-stage endometrioid endometrial cancer (EC) patients.

Methods: Clinicopathologic data of presumed early-stage endometrioid EC patients (n=361) treated with lymphadenectomy between March 2000 and July 2022 were analyzed. None of the patient had definite evidence of LN metastasis in a preoperative magnetic resonance imaging (MRI).

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Since the latest practice guidelines for ovarian cancer were developed by the Korean Society of Gynecologic Oncology (KSGO) in 2021, many studies have examined the efficacy and safety of various treatments for epithelial ovarian cancer (EOC). Therefore, the need to develop recommendations for EOC treatments has been raised. This study searched the literature using 4 key items and the Population, Intervention, Comparison, and Outcome: the efficacy and safety of poly-ADP ribose polymerase inhibitors in newly diagnosed advanced EOC; the efficacy and safety of intraperitoneal plus intravenous chemotherapy in optimally debulked advanced EOC; the efficacy and safety of secondary cytoreductive surgery in platinum-sensitive recurrent ovarian cancer; and the efficacy and safety of the addition of bevacizumab to platinum-based chemotherapy in first platinum-sensitive recurrent EOC patients who received prior bevacizumab.

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To review evidence around the value and challenges of surgery for recurrent epithelial ovarian cancer (ROC). Both cytoreductive and palliative aspects will be addressed RECENT FINDINGS: Prospective and retrospective evidence demonstrates a significantly longer remission derived from the combination of surgical and systemic modalities as opposed to systemic treatment alone in carefully selected ROC-patients who have relapsed more than 6 months from the end of their 1st line platinum-based chemotherapy. Nevertheless, this benefit appears to be limited when total macroscopic tumor clearance is not achieved.

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Objectives: This meta-analysis was undertaken to systematically evaluate the effects of poly (ADP-ribose) polymerase inhibitor (PARPi) maintenance therapy on the survival of newly diagnosed advanced epithelial ovarian cancer (EOC) patients.

Methods/materials: A systematic literature search revealed 3,227 studies. A subsequent selection process identified seven suitable randomized studies that assessed the survival outcomes in newly diagnosed advanced EOC patients administered PARPi (n = 1921; the PARPi group) or placebo (n = 1150; the placebo group).

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Objective: To identify the risk factors for failure of first-line poly (ADP-ribose) polymerase inhibitor (PARPi) maintenance therapy in patients with advanced ovarian cancer.

Method: Patients with stage III-IV epithelial ovarian cancer who received first-line PARPi maintenance therapy were retrospectively reviewed. Clinicopathologic factors were compared between two groups-recur/progression of disease (PD) and non-recur/PD.

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Importance: Hyperthermic intraperitoneal chemotherapy (HIPEC) followed by interval cytoreductive surgery (ICS) has shown survival benefits for patients with advanced-stage ovarian cancer. However, there is still a lack of consensus regarding the integration of HIPEC into clinical practice.

Objective: To evaluate the safety and effectiveness of ICS with HIPEC compared with ICS alone in clinical practice for patients with advanced-stage ovarian cancer.

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Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) has emerged as a treatment option at the time of cytoreductive surgery after neoadjuvant chemotherapy. The effect of active warming of HIPEC on postoperative pain needs to be investigated. This study aimed to investigate whether HIPEC reduces postoperative pain.

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  • The study aimed to find factors linked to disease recurrence in patients with early-stage cervical cancer (2018 FIGO stage IA to IB1) who were treated using minimally invasive surgery (MIS) between 2010 and 2021.
  • Out of 722 patients, 49 (6.8%) had disease recurrence, with notable five-year disease-free survival (90.7%) and overall survival (98.1%) rates; factors associated with higher recurrence risk included residual disease, specific surgical techniques, and positive resection margins.
  • Findings suggest that patients with cervical tumors ≤2 cm might be at risk for peritoneal recurrences and that those diagnosed through conization typically exhibit low-risk
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Objectives: To evaluate oncologic and pregnancy outcomes of fertility-sparing treatment (FST) using progestin in patients with stage I grade 2 endometrioid endometrial cancer (EC) without myometrial invasion (MI) or grade 1-2 with superficial MI.

Methods: Multicenter data of patients with stage I grade 2 EC without MI or grade 1-2 EC with superficial MI, who received FST between 2005 and 2021, were analyzed. Cox regression analysis identified independent factors for progressive disease (PD) during the FST.

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Background: To identify those most likely to benefit from secondary cytoreductive surgery (SCS), we evaluated the survival outcomes and factors predictive of prognosis in patients with recurrent ovarian cancer.

Methods: We retrospectively reviewed the medical records of patients with recurrent ovarian cancer treated at five high-volume Korean hospitals between 2010 and 2021. Recurrence characteristics, treatment methods, and potential predictors of survival were compared between the chemotherapy and surgery groups.

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Background: There have been no studies concerning the complications or benefits of cholecystectomy in ovarian cancer. In this study, we aimed to evaluate the outcomes of cholecystectomy performed during various time periods of the disease course and suggest a management strategy for cholecystectomy in ovarian cancer.

Methods: We retrospectively reviewed the medical records of patients with advanced ovarian cancer who underwent cholecystectomy during the cytoreductive surgery from 2009 to 2020.

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Objective: To analyze peritoneal spillage and displacement of indocyanine green (ICG)-stained tissues from uterine cervix to pelvis during intracorporeal/vaginal colpotomy in laparoscopic-assisted hysterectomy.

Materials And Methods: Eleven patients undergoing laparoscopic-assisted hysterectomy were included. One patient with an incidental diagnosis of endometrial cancer was excluded.

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Background: To evaluate the cost-effectiveness of the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) following interval cytoreductive surgery (ICS) for stage III-IV ovarian cancer from a randomized controlled phase III trial.

Methods: A comparative cost-effective analysis was performed using a Markov health-state transition model derived from the current trial cohort (ClinicalTrials.gov Identifier: NCT01091636).

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  • Research on RIPAC shows that patient posture greatly influences the distribution of chemotherapy agents, with the Trendelenburg position yielding better results for aerosol spread in the abdomen.* -
  • The study involved testing on nine pigs using a specific aerosol delivery method (DreamPen) and highlighted that depth and nozzle positioning affect penetration depth and distribution.* -
  • Results indicate that optimal distribution and penetration for anti-cancer agents can be achieved at a medium depth (around 4 cm) with the Trendelenburg position, suggesting important considerations for treatment effectiveness.*
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Purpose: To assess outcome and predictors of outcome after lymphatic embolization (LE) for early postoperative lymphatic leak after pelvic surgery.

Material And Methods: Lymphangiography (LG) procedures performed between May 2015 and February 2020 for postoperative intraperitoneal lymphatic leaks after pelvic surgery were reviewed. Treatment indication was lymphatic drainage of >500 mL/d persisting for >1 week.

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