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Background: This study aimed to assess the feasibility and efficacy of neoadjuvant chemotherapy (NACT) in treating patients with high-grade neuroendocrine carcinoma of the uterine cervix (HGNEC). Methods: We performed a retrospective case-control study at Asan Medical Center, Seoul, Republic of Korea, from January 1993 to December 2017, involving 60 patients with surgically treated HGNEC. Thirteen patients (21.7%) received NACT before undergoing surgery. Regarding the comparison between the group that underwent NACT and the group that did not, we used a propensity score-matched analysis, matching 22 patients in the primary radical surgery group with 11 patients in the neoadjuvant chemotherapy followed by radical hysterectomy group. Results: In the entire cohort, primary open surgery was more common in the primary surgery group compared to the NACT group (p = 0.004). After propensity score matching (PSM), the median tumor size was 3.5 cm in the primary surgery group and 2.4 cm in the NACT group (p = 0.078). After matching, there was no significant difference in the recurrence rate between the two groups (63.6% in the primary surgery group vs. 63.6% in the neoadjuvant chemotherapy group, p = 0.782). After PSM, the primary surgery group exhibited a lower intraoperative transfusion rate (10%) than the NACT group (45.5%, p = 0.052). Conclusions: While NACT was feasible in patients with HGNEC, it did not significantly improve the survival rate over primary radical surgery.

ObjectivesFertility-sparing treatment (FST) might be considered an option for reproductive patients with low-risk endometrial cancer (EC). On the other hand, the matching rates between preoperative assessment and postoperative pathology in low-risk EC patients are not high enough. We aimed to predict the postoperative pathology depending on preoperative myometrial invasion (MI) and grade in low-risk EC patients to help extend the current criteria for FST.Methods/materialsThis ancillary study (KGOG 2015S) of Korean Gynecologic Oncology Group 2015, a prospective, multicenter study included patients with no MI or MI ResultsAmong 251 eligible patients, Groups 1-4 included 106, 41, 74, and 30 patients, respectively. The new prediction models showed superior prediction values to those from conventional analysis. In the new prediction models, the best NPV, sensitivity, and AUC of preoperative each group to predict postoperative each group were as follows: 87.2%, 71.6%, and 0.732 (Group 1); 97.6%, 78.6%, and 0.656 (Group 2); 71.3%, 78.6% and 0.588 (Group 3); 91.8%, 64.9%, and 0.676% (Group 4).ConclusionsIn low-risk EC patients, the prediction of postoperative pathology was ineffective, but the new prediction models provided a better prediction.

Portal biliopathy refers to the changes in the bile duct caused by portal vein thrombosis or obstruction. It is assumed to be caused by cavernous transformation due to the development of the venous system surrounding the bile duct, but the exact pathology is still unknown. Biliary morphologic abnormalities of portal biliopathy are discovered incidentally on radiographic images, but it is sometimes difficult to differentiate them from cholangiocarcinoma. Given the poor prognosis of cholangiocarcinoma, a surgical approach can be considered when the diagnosis is uncertain. Herein, we report a case of portal biliopathy with bile ductal wall thickening, which was diagnosed after surgical resection was performed due to the presumed diagnosis of cholangiocarcinoma.

Objective: Extramammary Paget's disease (EMPD) of the vulva is a rare disease which predominantly presents in postmenopausal Caucasian women. As yet, no studies on Asian female patients with EMPD have been performed. This study aimed to identify the clinical features of patients with vulvar EMPD in Korea, and to evaluate the risk factors of recurrence and postoperative complications in surgically treated EMPD. Methods: We retrospectively reviewed 47 patients with vulvar EMPD who underwent wide local excision or radical vulvectomy. The clinical data and surgical and oncological outcomes following surgery were extracted from medical records and analyzed. Univariate and multivariate analyses for predicting recurrence and postoperative complications were performed. Results: 21.3% of patients had complications after surgery, and wound dehiscence was the most common. 14.9% of patients experienced recurrence, and the median interval to recurrence from initial treatment was 69 (range 33-169) months. Vulvar lesions larger than 40 mm was the independent risk factor of postoperative complications (odds ratio [OR]=7.259; 95% confidence interval [CI]=1.545-34.100; p=0.012). Surgical margin status was not associated with recurrence in surgically treated vulvar EMPD patients (OR=0.83; 95% CI=0.16-4.19; p=1.000). Conclusion: Positive surgical margin is a frequent finding in the patients with vulvar EMPD, but disease recurrence is not related with surgical margin status. Since EMPD is a slow growing tumor, a surveillance period longer than 5 years is required. [ABSTRACT FROM AUTHOR]

Growth responses along the gradient of water temperature, salinity, and light intensity and cytotoxicity against Artemia nauplii were explored using Ostreopsis sp. and Coolia canariensis strains, representing the two potentially toxic epiphytic dinoflagellate (EPD) species from Jeju coastal waters of Korea. Variation in maximum growth rate (GRmax) and maximum biomass yield (Ymax) along the environmental gradients was quite contrasting between the two strains, which appears to be reflected in the in situ abundance distribution of the corresponding genera. The more eurythermal characteristics of Ostreopsis sp. strain were in good agreement with the relative distribution of Ostreopsis spp. and Coolia spp. in 520 macroalgal samples collected from 6 stations. The more stenohaline C. canariensis strain was well matched by a markedly narrower range of salinities in the in situ distribution of Coolia spp. than the salinity range for Ostreopsis species. The differences in light adaptation between the high light-preferring Ostreopsis sp. strain and the more euryphotic C. canariensis strain were remarkably consistent with the distinct vertical profiles of Ostreopsis spp. and Coolia spp. abundance in the red alga Amphiroa sp. off Moom-seom. Cytotoxicity against Artemia nauplii in the Ostreopsis sp. preparation with 1000 cells ml-1 was similar to that in C. canariensis preparation with 12000 cells ml-1, which is noteworthy. Thus, the new potential cytotoxicity risks from C. canariensis along with the well-known toxic genus Ostreopsis may be introduced to Jeju coasts, which necessitates further exploration into the contrasting ecological niches occupied by EPD species in relation to their cytotoxicity. [ABSTRACT FROM AUTHOR]

Objective: We investigate a real-world feasibility of whether clinical trial participation impacts overall survival in women with advanced recurrent cervical cancer. Methods: This study was a retrospective study conducted at a single institution, and was conducted on patients with advanced or recurrent cervical cancer from August 2018 to November 2023. A total of 75 patients were included in three types of phase 2 trials and five phase 3 clinical trials. Survival analysis was conducted in three types of phase 3 trials that allowed comparative analysis. Results: Among the 75 patients enrolled in the clinical trial and available for analysis, 51 patients were enrolled in the phase 3 trial. Survival analysis was conducted on 37 patients in three phase 3 clinical trials in which comparative analysis was possible. In the three phase 3 trial data available for comparative analysis, there were no significant differences between the study group and the control group in age, (mean 55 vs. 48 years, p=0.125), histological classification (p=0.564), stage (p=0.286), and previous treatments (surgery: p=0.286, radiation: p=0.478, chemotherapy: p=0.513, respectively). On univariate analysis, the study group was associated with significantly improved OS from the control group (median survival 27.1 vs. 8.7 months, hazard ratio=0.347; 95% confidence interval=0.138-0.877; p=0.007). Conclusion: This study shows that patients with advanced or recurrent cervical cancer improve their survival rate when they participate in clinical trials, which is considered to be good evidence for patients to actively participate in clinical. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prognostic impact of L1 celladhesion molecule (L1CAM), β-catenin, estrogen receptor (ER), and progesterone receptor (PR) in early-stage endometrial cancer (EC) patients undergoing fertility-sparing management, aiming to refine risk assessment beyond the Proactive Molecular Risk Classifier for Endometrial Cancer (ProMisE). Methods: This retrospective study analyzed EC patients treated at a single center (January 2011-December 2020). In this study, patient categorization was achieved using immunohistochemical (IHC) staining to detect mismatch repair (MMR) proteins and p53. Simultaneously, DNA polymerase epsilon (POLE) mutations were identified through hotspot sequencing with droplet digital polymerase chain reaction. The study also measured L1CAM, β-catenin, ER, and PR expression levels through IHC staining and assessed the complete response (CR) rate and progression-free survival (PFS) in each subgroup. Results: Out of 104 patients, one exhibited a POLE mutation, another showed mismatch repair deficiency (MMRd), and a third had a P53 abnormality, leaving 101 with no specific molecular profile (NSMP). A correlation was observed between β-catenin positivity and a higher rate of CR (p=0.022). Further analysis of PFS in the 64 patients who achieved CR revealed that L1CAM is a negative prognostic factor for PFS (p=0.039). Positivity for β-catenin, ER, and PR did not show a link to recurrence. Conclusion: β-catenin emerges as a positive marker for CR, and L1CAM as a negative prognostic factor for PFS in early-stage EC patients choosing fertility-sparing options. These results support incorporating these IHC markers into molecular classifiers like ProMisE for enhanced risk stratification and personalized treatment in EC. [ABSTRACT FROM AUTHOR]

Context: The upregulation of TRIB3 (Tribbles homolog 3), a stress-inducible gene encoding a pseudokinase, has been implicated in the development of insulin resistance in the skeletal muscle and liver of patients with obesity and type 2 diabetes. However, there is little information regarding TRIB3 expression in human adipose tissue. Objective: To investigate whether TRIB3 expression is dysregulated in human adipose tissue in the context of obesity and type 2 diabetes and whether TRIB3 expression in adipose tissues is associated with insulin resistance. Methods: We measured metabolic parameters and TRIB3 expression in abdominal subcutaneous and visceral adipose tissue in obese (with or without type 2 diabetes) and normal-weight women. Regulation of TRIB3 expression was studied in human adipocytes. Results: TRIB3 expression in both fat depots was higher in patients with obesity and/or type 2 diabetes; in addition, the expression level was significantly associated with insulin resistance. Incubating adipocytes under conditions mimicking the microenvironment of obese adipose tissue, including increased endoplasmic reticulum (ER) stress, induced TRIB3 expression. In human adipocytes, the overexpression of TRIB3 impaired insulin-stimulated protein kinase B (AKT) phosphorylation and caused dysregulation of the transcription of genes encoding bioactive molecules released from adipocytes, such as proinflammatory cytokines, adiponectin, and leptin. Pioglitazone, an insulin-sensitizing agent, reduced both these effects of TRIB3 and the ER stressor-induced expression of TRB3. Conclusion: Our data indicate that TRIB3 expression in adipose tissue is enhanced in patients with obesity and suggest that increased TRIB3 dysregulates adipocyte function, which may contribute to the development of insulin resistance. [ABSTRACT FROM AUTHOR]