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Human papillomavirus (HPV) DNA is considered as a hallmark of cervical cancer. We investigated whether persistent HPV DNA at the cervix is associated with local recurrence after radiotherapy in patients with locally advanced cervical cancer. A total of 156 patients with HPV-positive cervical cancer (International Federation of Gynecology and Obstetrics stage IB–IVB) treated with radiotherapy between July 2003 and December 2006 were analyzed. HPV DNA was measured prior to radiotherapy and after completion of radiotherapy. The results of HPV DNA test at postradiotherapy 1, 3, 6 and 12 months were analyzed individually for association with local recurrence-free survival (LRFS). In addition, the result of any last follow-up HPV test within 24 months postradiotherapy was defined as the overall status of HPV at 24 months and was also analyzed for association with LRFS. HPV DNA was cleared in 127 patients (81.4%) and persistent in 29 patients (18.6%) by 24 months. In 18 patients with local recurrences, 14 patients (78%) showed positive HPV tests at 1–3 months. Among the various time points analyzed, a positive HPV test at 3 months was the most accurate predictor of local recurrence. Multivariate analysis indicated that overall status of HPV at 24 months, low HPV viral load and histologic grade as being significantly related to poor LRFS. In HPV-positive cervical carcinoma treated primarily with radiotherapy, persistent HPV DNA within 24 months after treatment indicates a high risk of local recurrence. Diagnostic accuracy of HPV test was highest at 3 months.

Aim: To compare the efficacy and toxicity between topotecan- and belotecan-based chemotherapies in recurrent epithelial ovarian cancer (EOC). Methods: The clinical data of 80 patients treated with topotecan- (n = 45) or belotecan- (n = 35) based chemotherapy as at least a second-line chemotherapy were reviewed retrospectively between July 2001 and December 2007. Response was evaluated using the Response Evaluation Criteria in Solid Tumours (RECIST) and serum CA-125 levels. Hematological toxicity was examined according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 2.0. Time to progressive disease (TTPD), chemotherapy-specific survival (CSS) and overall survival (OS) according to the 2 chemotherapies were evaluated by the Kaplan-Meier analysis with the log-rank test. Results: Overall response rate (ORR) was 24.4% in patients treated with topotecan-based chemotherapy, while it was 45.7% in those treated with belotecan-based chemotherapy (P = 0.046). Moreover, ORR was higher in platinum-sensitive patients treated with belotecan-based chemotherapy (58.8%) than those treated with topotecan-based chemotherapy (22.2%) (P = 0.041) although it was not significantly different in platinum-resistant patients (P = 0.471). Grade 3 or 4 anemia, neutropenia and thrombocytopenia developed in 14.8% vs 3.6%, 43.1% vs 55.6%, and 20.0% vs 12.8% of cycles in topotecan- and belotecan-based chemotherapies, respectively (P

The aim of this study was to determine the maximum tolerated dose (MTD) and therapeutic efficacy of a newly developed CKD-602 topoisomerase I inhibitor and cisplatin in patients with recurrent epithelial ovarian cancer. CKD-602 (0.30 mg/m(2) daily for 5 days) and cisplatin (60 mg/m(2) on day 5) were administered to patients every 3 weeks with dose adjustment of CKD-602 by 0.05 mg/m(2) daily until the MTD was reached. Dose-limiting toxicity was defined as grade >or= 3 neutropenia or thrombocytopenia for more than 4 days or accompanied by fever >or= 38.5 degrees C, infection, hemorrhage, or transfusion; grade >or= 3 nonhematological toxicity except for alopecia, nausea, and vomiting. We enrolled 26 patients with recurrent epithelial ovarian cancer who had measurable disease (MD) estimated by computed tomography scan (n= 12) and nonmeasurable disease (NMD) evaluated by serum CA-125 levels (n= 14). All patients received 188 cycles of CKD-602 and cisplatin with a median number of six cycles per patient (range, 2 to 12). MTD of CKD-602 was 0.30 mg/m(2) daily. The overall response rate was 69.2% (18/26) with 58.3% (7/12) and 78.6% (11/14) in MD and NMD, respectively. Among the responsive patients, 14 were platinum sensitive (14/18, 77.7%) and four were platinum resistant (4/8, 50.0%). The most common toxicity was grade >or= 3 neutropenia developing in 17 patients (65.4%) and 72 cycles (38.3%). Grade 3 nausea and anorexia were the most common gastrointestinal toxicities, developing in 15 cycles (8.0%) of four patients (15.4%) and 10 cycles (5.3%) of five patients (19.3%), respectively. The median disease-free interval was 6 months (range 0-26 months). CKD-602 at a concentration of 0.3 mg/m(2) daily for 5 days and cisplatin at 60 mg/m(2) on day 5 every 3 weeks showed high efficacy, with acceptable toxicity, against platinum-sensitive/resistant recurrent epithelial ovarian cancer.

To the editor: We read the article "Prognostic factors of secondary cytoreductive surgery for patients with recurrent epithelial ovarian cancer" by Bae et al.1 with interest. The authors reviewed the clinical profiles of 54 patients who received secondary cytoreductive surgery (SCS) at their institute and examined the factors which were associated with prolonged survival. We have some opinions regarding this important topic (SCS in recurrent ovarian cancer) and want to discuss it with other readers. When a patient with recurrent ovarian cancer (ROC) visits a clinic, a physician must decide whether he or she will perform SCS. If the patient has platinum-resistant or unresectable tumors, SCS is usually abandoned and palliative chemotherapy is administered. However, when the patient has platinum-sensitive and resectable tumors, it is unclear whether we should perform SCS. Numerous studies including the study by Bae et al. has been conducted to find who will benefit from the SCS, and found several factors (residual tumor size after SCS, progression-free survival (PFS) from primary treatment to recurrence, ascites, number of recurrent tumors, good performance status) were associated with prolonged survival after SCS.1 However, these studies did not directly address the issue - 'If the patient has platinum-sensitive and resectable tumors, should we perform SCS?' - because these studies did not compare the patients who had undergone SCS with those who had not. In the study by Bae et al., all patients with resectable tumors underwent SCS. Therefore, based on the study by Bae et al., we do not know whether SCS is beneficial or not. The GOG has recently initiated a randomized trial (GOG 213) addressing the role of SCS in patients with ROC. In GOG 213, the patients with ROC who had resectable tumors will be randomized into surgery vs. no surgery. The GOG 213 is anticipated to provide the answer for the role of SCS. Many studies on the outcome of patients who underwent SCS suggested that the greatest benefit of SCS is seen if all gross tumor is resected.2 Unless tumors are optimally debulked, the benefit of SCS is unclear. Therefore, attempts to preoperatively identify the patients whose tumor will be optimally debulked have been conducted. In AGO-DESKTOP 2 trial, the value of a criteria (AGO score) in preoperatively predicting complete resection at SCS was investigated. The results were a complete resection was achieved in 76% of patients with AGO score positive (good performance status, complete resection at initial surgery, and absence of ascites >500 ml).3 In the study by Bae et al., their own criteria were used to select surgical candidates. They performed SCS in patients with PFS ≥6 months, GOG performance status ≤2, and no radiographic findings of extra-abdominal metastasis or unresectable intra-abdominal tumors (e.g. peritoneal carcinomatosis, multiple liver metastasis, involvement of the porta hepatis, pancreatic head, abdominal wall, para-aortic lymph node above the renal vein). After SCS, a complete resection was possible in 32 patients (59%), and residual tumor

To investigate morbidities and surgical outcomes of total colectomy conducted during primary cytoreductive surgery in advanced Müllerian cancer.The authors reviewed the medical records of 22 patients with stage IIIC or IV advanced Müllerian cancer that underwent total colectomy at the National Cancer Center Korea between January 2003 and December 2007.Total colectomy was performed in 22 patients, of whom 2 (9.1%) underwent prophylactic ileostomy and 1 (4.5%) permanent ileostomy. Optimal cytoreduction (residual tumor1 cm) was possible in 20 patients (90.9%). Median times at passage of flatus and initiation of tolerable diet were days 4 (2-10) and 6 (4-18) postoperatively, respectively. Nine postoperative morbidities, not directly related to ileo-rectal anatomosis, occurred in 7 patients (31.8%) and were successfully managed conservatively. No fistula developed during a mean follow-up of 16 months (range, 2-56). There was no surgery-related mortality. Diarrhea after total colectomy was well managed by medical treatment in most patients. Median time to recovery to previous bowel habits was 12 months (range, 6-20) in the 11 patients evaluable. Five-year progression free survival and overall survival rates were 38.6% and 74.4%, respectively.Total colectomy is a feasible and safe procedure in terms of minimizing residual tumor in most patients with advanced Müllerian cancer with acceptable morbidities.

A venous thromboembolism (VTE) is prevalent in patients with ovarian clear cell carcinoma (OCCC). Tumor burden and extensive cytoreductive surgery are well-known risk factor for a VTE. The purpose of this study was to define the incidence of VTE after extensive cytoreductive surgery and to clarify the relationship between VTE and extensive cytoreductive surgery in patients with OCCC. We reviewed the medical charts of 43 patients treated at the National Cancer Center between June 2000 and July 2007. Most surgical procedures were performed with peri-operative thrmoboprophylaxis. Eight (18.6%) patients had deep vein thromboses and three of eight patients had a pulmonary thromboembolism. A VTE was identified at initial presentation in four patients, at recurrence in one patient, and during 3rd line chemotherapy in three patients when the patients had a bulky tumor burden. The rate of optimal debulking surgery was 95.3% and no patient had a VTE during the postoperative recovery period and adjuvant chemotherapy. A VTE was associated with disease status only (P = 0.042). Minimizing residual tumor by extensive cytoreductive surgery with peri-operative thromboprophylaxis may decrease the incidence of a postoperative VTE in patients with OCCC. Larger, prospective studies are needed to confirm these preliminary findings.

We evaluated the additional diagnostic value of magnetic resonance/positron emission tomography (MR/PET) fusion in the detection of metastatic lymph nodes in cervical cancer patients. Seventy nine patients with FIGO stage IB-IVA cervical cancer who had undergone both magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) before lymphadenectomy were included in this study. Image analysis was first performed with PET/CT images only. A second analysis was then performed with MR/PET fused images that focused on the additional information obtained from the MR images. Lymphadenectomy involved removing all visible lymph nodes in the surgical field. To enable nodal group-specific comparisons, para-aortic and pelvic lymph nodes were divided into seven nodal groups: para-aortic, both common iliac, both external iliac and both internal iliac/obturator areas. Histopathological evaluation of lymph nodes has been the diagnostic standard. The value of the additional information from the MR images was evaluated by means of receiver operating characteristic (ROC) analysis. Fused MR/PET rendered readers to detect six more metastatic lymph node groups. The sensitivity and specificity of PET/CT and fused MR/PET were 44.1%, 93.9% and 54.2%, 92.7% respectively. The ROC analysis demonstrated a higher diagnostic performance of fused MR/PET compared to PET/CT alone for detecting lymph node metastases (p = 0.0259). The findings of this study demonstrate the additional diagnostic value of fused MR/PET images compared with PET/CT in the detection of metastatic lymph nodes in patients with uterine cervical cancer.

Background: This study was to investigate the prognostic significance of clinicopathologic characteristics in patients with clear-cell carcinoma (CCC) of the ovary. Materials and methods: Two hundred and one patients with CCC of the ovary were registered in the Korean Gynecologic Oncology Group. The Korean Gynecologic Pathology Study Group reviewed the pathological slides centrally, using a universal grading system. The prognostic significances of clinicopathologic factors were evaluated by multivariate analysis. Results: Most of the patients were diagnosed at an early stage (stage I, 61.3%), and the overall 5-year survival rate was 57%. Early-stage disease showed a favorable prognosis, but advanced diseases showed poor prognosis. Stage of disease was the only significant prognostic factor on multivariate analysis (P < 0.001). However, universal grade and residual tumor also showed prognostic significance on the forward stepwise likelihood ratio test. There was no survival difference observed between patients treated with paclitaxel-based and those treated with platinum-based combination chemotherapy. Conclusions: The stage, residual tumor, and universal grade were significant prognostic factors in patients with CCC of the ovary. The universal grading system is applicable in determining prognosis of CCC of the ovary. Further clinical trials for optimal chemotherapy are in need.

This study was designed to develop a preoperative predictor model using multidetector CT (MDCT) imaging findings for the prediction of surgical outcome in patients with advanced epithelial ovarian cancer (EOC). Seventy-seven patients with advanced EOC who had preoperative MDCT and who had undergone primary cytoreductive surgery between January 1999 and June 2008 were enrolled in the study. All MDCT examinations were analysed retrospectively, assessing nine imaging features without knowledge of the operative findings. The complete debulking rate and optimal debulking rate were 42.5% and 93.2%, respectively. Based on the use of univariate and multivariate analysis, one imaging feature that showed the presence of upper abdominal ascites was significantly associated with incomplete tumour resection (P = 0.019 on univariate analysis, P = 0.04 on multivariate analysis). The combination of the MDCT findings that showed the presence of upper abdominal ascites and diffuse subdiaphragmatic peritoneal nodularity was associated with an incomplete resection of a tumour (P = 0.04; specificity 80.0%; positive predictive value 76.9%). It is important that emphasis on the upper abdominal sites of the tumour is helpful when reporting preoperative MDCT results.

Embryonic natural orifice transumbilical endoscopic surgery (E-NOTES) has shown promise as a minimally invasive laparoscopic surgery technique. To investigate the feasibility and surgical outcome of E-NOTES for adnexal tumors. We performed E-NOTES in 12 patients with adnexal tumors through a 2-cm intraumblical incision. A single-port access system comprising a wound protractor and a surgical glove was used. A prospective data registry was used in this study. Since 1 July 2008, 12 patients have undergone E-NOTES for adnexal tumors. E-NOTES in all 12 cases was completed successfully without conversion to standard laparoscopic approach. Median operative time for creating an E-NOTES access system and the ensuing operative procedures was 6 min (range 5–15 min) and 73 min (range 25–110 min), respectively. Median blood loss was

Objective The objective of this study was to determine the clinical significance of hepatic parenchymal metastasis on survival in patients with advanced epithelial ovarian cancer. Methods We conducted a retrospective review of ovarian cancer patients with stages IIIc and IV hepatic parenchymal metastasis who were treated at the National Cancer Center in Korea between January 2001 and January 2008. Hepatic metastases were divided into unresectable, hematogenous parenchymal metastasis and resectable, parenchymal metastasis from peritoneal seeding. Results One hundred twenty patients were identified, 113 of whom were included in the study. The stage IIIc group included 97 patients, and the group with stage IV disease and hepatic parenchymal metastasis included 16 patients. Of the 16 patients with hepatic parenchymal metastasis, 2 patients had unresectable, hematogenous parenchymal metastasis with a poor prognosis compared to the patients with resectable, hepatic parenchymal metastasis from peritoneal seeding. Fourteen patients with hepatic parenchymal metastases from peritoneal seeding underwent complete resection without complications as follows: wedge resection ( n =7), segmentectomy ( n =5), and hemi-hepatectomy ( n =2). Age, tumor grade, histology, serum CA-125 level, and the rate of optimal debulking were similar in patients with stage IIIc disease and patients with stage IV disease who had resectable, hepatic parenchymal metastasis from peritoneal seeding. The 5-year progression free survival rate and the 5-year overall survival rate for patients with stage IIIc disease and patients with stage IV disease and hepatic parenchymal metastasis from peritoneal seeding were 25 and 23% ( p =0.8063), and 55 and 51% ( p =0.5671), respectively. Conclusion Our findings suggest that complete hepatic resection should be attempted for patients with hepatic parenchymal metastasis from peritoneal seeding.

Objectives: This study was conducted to evaluate the psychometric properties of the Korean version of the Quality of Life questionnaire cervical cancer module (QLQ-CX24), developed by the European Organization for Research and Treatment of Cancer (EORTC). Methods: The EORTC QLQ-CX24 and the core questionnaire (the EORTC QLQ-C30) were administered to 860 Korean disease-free survivors of cervical cancer and 494 female control subjects from the general Korean population. The construct reliability and validity of the EORTC QLQ-CX24 questionnaire were assessed via factor analysis, multitrait scaling analyses and known group comparisons. Results: Factor structure of the Korean version of the EORTC QLQ-CX24 questionnaire agreed with the originally hypothesized scale structure. Scale reliability was confirmed by Cronbach’s α coefficients for internal consistency, which ranged from 0.78 to 0.87. Convergent and discriminant validity was confirmed by multitrait scaling analysis, which revealed scaling errors of 0.9. The clinical validity of the Korean version of the EORTC QLQ-CX24 was demonstrated by the ability to discriminate among controls and patient subgroups of different stages, treatments and overall health status. Conclusions: The Korean version of the EORTC QLQ-CX24 was found to be a reliable and a valid measure of quality of life among survivors of cervical cancer when administered in a large survey setting.

Background We sought to identify the role of serum CA-125 levels in early-stage epithelial ovarian cancer (EOC) on preoperative CT and MRI. Methods Clinical data of 101 patients with early-stage EOC on preoperative CT and MRI were collected between January 2000 and December 2007. Clinical stage I ( n = 59) was defined as tumor limited to the ovaries with or without ascites, whereas clinical stage II ( n = 42) was defined as tumor within the pelvis with or without ascites. The primary endpoint was to investigate the efficacy of serum CA-125 levels for the prediction of advanced-stage disease, and secondary endpoints were to evaluate the accuracy of preoperative CT and MRI, and to examine the role of serum CA-125 levels as a prognostic factor for survival. Results The results of preoperative CT and MRI were concordant with no peritoneal implants outside the pelvis in 50/101 (50%) and no lymph node metastasis in 71/101 (70%) patients. The receiver operating characteristic curves showed that best cut-off values of serum CA-125 levels were 320 U/ml (71% sensitivity, 84% specificity) and 510 U/ml (67% sensitivity, 80% specificity) for the prediction of peritoneal implants outside the pelvis and lymph node metastasis. The serum CA-125 level (≥320 U/ml) was a significant factor for the prediction of advanced-stage disease (adjusted OR, 7.43; 95% CI, 2.39–23.04). However, it was not an independent prognostic factor for survival. Conclusions Serum CA-125 levels may be very useful for the prediction of advanced-stage disease in early-stage EOC on preoperative CT and MRI.

The aim of this study was to compare laparoscopic and laparotomic surgical staging in patients with stage I epithelial ovarian cancer in terms of feasibility and safety. A retrospective chart review was undertaken of all patients with apparent stage I epithelial ovarian cancer who underwent laparoscopic (laparoscopy group) or laparotomic (laparotomy group) surgical staging at the Center for Uterine Cancer, National Cancer Center, Korea, between January 2001 and August 2006. During the study period, 19 patients underwent laparotomic surgical staging and 17 patients underwent laparoscopic surgical staging. No cases were converted from laparoscopy to laparotomy. The two groups were similar in terms of age, body mass index, procedures performed, number of lymph nodes retrieved, and operating time. The laparoscopy group had less estimated blood loss (P= 0.001), faster return of bowel movement (P< 0.001), and a shorter postoperative hospital stay (P= 0.002) compared to the laparotomy group. Transfusions were required only in two laparotomy patients, and postoperative complications occurred only in four laparotomy patients. However, two patients with stage IA grade 1 and 2 disease in laparoscopy group had recurrence with one patient dying of disease. The accuracy and adequacy of laparoscopic surgical staging were comparable to laparotomic approach, and the surgical outcomes were more favorable than laparotomic approach. However, the oncologic safety of laparoscopic staging was not certain. This is the first report on the possible hazards of laparoscopic staging in early-stage ovarian cancer. In the absence of a large prospective trial, this technique should be performed cautiously.

In endometrial carcinomas (ECs), previous report suggested thatPIK3CAmutations do not coexist withKRASmutations, but the significant mutual exclusiveness has not been demonstrated. In this study, we examined the mutation frequency ofPIK3CAin EC and its mutual exclusiveness withKRASmutation. We performed mutational analysis ofPIK3CAthrough a polymerase chain reaction single-strand conformation polymorphism assay in 44 cases of endometrial cancer and analyzed the correlation with loss ofPTEN,KRASmutation, andRASSF1Ahypermethylation. Somatic mutations ofPIK3CAwere detected in 14 of 44 (31.8%) of endometrial cancers. In exon 9, sevenPIK3CAmutations were located, while seven mutations were located in exon 20. The most common mutation was E545A (35.7%), followed by H1047R (28.6%). Concomitant loss ofPTENexpression andPIK3CAmutation was found in four cases of endometrial cancer.KRASmutations were mutually exclusive withPIK3CAmutations, and those mutations were inversely correlated with statistical significance (P= 0.039). Also, we found that mutations inERBB2were mutually exclusive withPIK3CAmutations.RASSF1AandhMLH1methylation were not correlated with the presence ofPIK3CAmutations.PIK3CAwas frequently mutated in endometrial cancers.KRASandPIK3CAmutations are inversely correlated, suggesting that genetic alterations ofKRASandPIK3CAmay play equivalent roles in endometrial carcinogenesis.

BACKGROUND: Many studies have shown that a polymorphism (G870A) in cyclin D1 (CCND1) is associated with carcinogenesis in a variety of cancers. Our aim was to determine if an association exists between the CCND1 G870A polymorphism and uterine leiomyoma in Korean women. METHODS: Blood samples of 331 cases and 204 controls aged 47.4+ +7.6 and 46.8+ +10.4 years (mean + SD), respectively, were collected. CCND1 genotyping was determined by PCR and restriction fragment length polymorphism. RESULTS: Allelic frequencies of cases (A, 0.53; G, 0.47) were not significantly different from those of controls (A, 0.49; G, 0.51) (P 5 0.22). After adjustment for menarche age and BMI, multivariate logistic regression analysis showed that the AA genotype was not associated with increased risk for uterine leiomyoma [odds ratio (OR) 5 1.38, 95% confidence interval (CI); 0.85‐2.26, P 5 0.19]. However, in stratification analysis of cases and controls with BMI >25 kg/m 2 , allelic frequencies of cases (A, 0.56; G, 0.44) were significantly different from controls (A, 0.36; G, 0.64) (P 5 0.005), and the AA genotype was associated with increased risk for uterine leiomyoma (OR 5 3.61, 95% CI; 1.02‐12.73, P 5 0.046). Furthermore, the OR for AA compared with combined GG and AG genotypes was 3.16 (95% CI 1.01‐9.92, P 5 0.048). CONCLUSIONS: The A allele and AA genotype of CCND1 G870A polymorphism have a significant association with an increased risk of the uterine leiomyoma in obese Korean women.

Aim: The aim of the present study was to evaluate the DNA hypermethylation profiles of 14 genes known to be associated with tumor behavior and their clinical significance in cervical cancer. Method: The clinical features of 82 patients with stage IB cervical cancer were analyzed in terms of DNA hypermethylation of 14 genes (hMLH1, p16, COX-2, CDH1, APC, DAPK, MGMT, p14, RASSF1A, RUNX3, TIMP3, FHIT, THBS1, and HLTF). Results: Of 14 genes investigated, only hypermethylation of COX-2 showed significant association with poor disease-free survival (P = 0.001). To further investigate an alteration in COX-2 expression by DNA hypermethylation, immunohistochemistry for COX-2 protein was performed in the cervical cancer tissues. We found no significant association between hypermethylation and expression patterns of the COX-2 gene. Conclusions: The present results suggest that DNA hypermethylation of the COX-2 gene may be a potential prognostic marker in early stage cervical cancer, the underlying mechanism of which is independent of gene silencing.

Recently, we experienced a case of port-site and liver metastases after 75 cases of laparoscopic transperitoneal pelvic lymph node dissection (PLND) and para-aortic lymph node dissection (PALND) for surgical staging of locally advanced cervical cancer. A 45-year-old-woman with stage IIB cervical adenocarcinoma underwent laparoscopic PLND and PALND for surgical staging. There was no intraperitoneal disease and cervical tumor was not manipulated at the time of laparoscopic surgery. Pathologic examination revealed only one micrometastasis in left internal iliac lymph node (LN), measuring 1 mm, of the 60 pelvic and para-aortic LNs removed. She received concurrent chemoradiation therapy and pelvic mass disappeared completely. One month after the completion of therapy, both lateral and umbilical port-site and liver metastases were detected. We conclude that although cases of port-site metastasis have mostly occurred after extensive disease, the possibility of such complication should be kept in mind at laparoscopy of early cancer and laparoscopy which does not manipulate primary tumor.

The objective of this study was to determine the prognostic significance of the pre- and posttreatment serum levels of the squamous cell carcinoma antigen (SCC-Ag) and carcinoembryonic antigen (CEA). From 2001 to 2005, 211 patients were treated with concurrent chemoradiotherapy (CCRT). The SCC-Ag and CEA levels were measured before treatment, 1 month after treatment, and during the follow-up. The association between the pretreatment tumor marker levels and the clinical prognostic factors was evaluated. The frequency of complete remission (CR) and the normalization of the posttreatment tumor marker were also analyzed. The pretreatment serum levels of CEA and SCC-Ag were elevated in 68 (32.2%) and 148 (70.1%) patients, respectively. The number of patients with an elevated pretreatment SCC-Ag level was associated with the FIGO stage, tumor volume, and pelvic lymph node status. The pretreatment CEA was only significantly related to the tumor volume and pelvic lymph node involvement. One month after completing CCRT, the CEA and SCC-Ag levels were normalized in almost all patients with an incidence of 88.2% (60/68) and 93.2% (138/148), respectively. Among the patients who gained CR with a previously elevated pretreatment CEA and SCC-Ag, the values were normalized in 92.1% (58/63) and 96.4% (134/139) at 1 month, respectively. Combination assays of the pre- and posttreatment serum CEA and SCC-Ag levels appear to be useful for both predicting the prognosis and estimating the clinical response in cervical cancer. However, the routine combined measurement with SCC-Ag of CEA in all patients had limited additional effect in predicting the prognostic significance.

5568 Background: Although there are many studies that compared the outcome of neoadjuvant chemotherapy (NAC) and primary surgery in advanced ovarian cancer, most of them showed some limitations such as selection bias and the quality control of surgical procedure. Methods: Data of 1124 patients with advanced epithelial ovarian cancer (stage III-IV) were reviewed retrospectively. To mitigate the possible biases from the retrospective nature of the study, we performed a propensity score analysis. Progression-free survival was assessed using a multivariate Cox-proportional hazards regression model with inverse probability weights to adjust for propensity score. Results: Among the 1124 patients, 198 patients (17.6%) underwent NAC. The factors associated with the use of NAC were old age, non-serous histology, poor histologic grade, stage IV and higher serum CA 125 levels (P-value 0.211, 0.050, < 0.001, < 0.001 and < 0.001, respectively). After a propensity score adjustment using those factors, the progression-f...

Objective To identify current practice patterns for unresolved issues in the surgical and adjuvant management of endometrial cancer in Korea. Methods We designed and conducted a survey of all 218 active members of the Korean Gynecologic Oncology Group to try to identify how they would manage various case scenarios for endometrial cancer. Data were collected using an Internet survey database. Results A total of 108 members (49.5%) responded to the survey. Laparoscopy (81.6%) was the most commonly used mode of surgery in early-stage endometrial cancer. Of all the respondents, 19.8% stated that lymphadenectomy could be omitted and 21.7% recommended selective lymphadenectomy based on sentinel biopsy or frozen results for patients with presumed stage IA/grade 1 disease. On the other hand, 71.9% of respondents recommended para-aortic lymphadenectomy for patients with presumed stage IB/grade 1 disease and 86.4% recommended this treatment for presumed stage IB/grade 3 disease. The majority of respondents performed adjuvant therapy for stage IB/grade 2 (91.7%), IB/grade 3 (99.0%), and stage II (89.6%). Whole pelvic radiotherapy and vaginal brachytherapy were the most frequently used options among these patients. All respondents administered adjuvant therapy when node metastasis was found, and concurrent chemoradiotherapy (53.2%) was the most preferred option for stage IIIC1 disease. Conclusion There is broad variation in both the surgical and adjuvant treatment of endometrial cancer among Korean gynecologic oncologists.

In 2014, 9 topics were selected as major advances in clinical research for gynecologic oncology: 2 each in cervical and corpus cancer, 4 in ovarian cancer, and 1 in breast cancer. For cervical cancer, several therapeutic agents showed viable antitumor clinical response in recurrent and metastatic disease: bevacizumab, cediranib, and immunotherapies including human papillomavirus (HPV)-tumor infiltrating lymphocytes and Z-100. The HPV test received FDA approval as the primary screening tool of cervical cancer in women aged 25 and older, based on the results of the ATHENA trial, which suggested that the HPV test was a more sensitive and efficient strategy for cervical cancer screening than methods based solely on cytology. For corpus cancers, results of a phase III Gynecologic Oncology Group (GOG) 249 study of early-stage endometrial cancer with high-intermediate risk factors are followed by the controversial topic of uterine power morcellation in minimally invasive gynecologic surgery. Promising results of phase II studies regarding the effectiveness of olaparib in various ovarian cancer settings are summarized. After a brief review of results from a phase III study on pazopanib maintenance therapy in advanced ovarian cancer, 2 outstanding 2014 ASCO presentations cover the topic of using molecular subtypes in predicting response to bevacizumab. A review of the use of opportunistic bilateral salpingectomy as an ovarian cancer preventive strategy in the general population is presented. Two remarkable studies that discussed the effectiveness of adjuvant ovarian suppression in premenopausal early breast cancer have been selected as the last topics covered in this review.

Both hypermethylation of the tumor suppressor gene RASSF1A and activating mutations of the KRAS and/or BRAF gene have been reported in a variety of human cancers. To investigate these epigenetic and genetic alterations in endometrial carcinoma (EC), we examined their frequency in 4 uterine EC cell lines and in 75 sporadic primary ECs. Using methylation specific PCR, we found RASSF1A methylation in 25 of 75 (33.3%) ECs. RASSF1A methylation was significantly associated with microsatellite instability (MSI, p < 0.001) and also with hMLH1 methylation (p < 0.001). KRAS mutations were detected in 14 of 75 (18.7%) ECs. BRAF mutations were identified in only 3 of 75 (4.0%) ECs and were not found in ECs with KRAS mutations or RASSF1A methylation. RASSF1A methylation was more frequent in KRAS mutation-negative ECs than in KRAS mutation-positive ECs (37.7% vs 14.3%), but this inverse correlation is not statistically significant (p = 0.122). However, we observed that RASSF1A methylation was inversely correlated with KRAS and/or BRAF mutations (p = 0.028) in MSI-negative ECs, while this inverse correlation disappeared in MSI-positive ECs. Furthermore, in MSI-positive ECs, 2 cases of concomitant RASSF1A methylation and KRAS mutation were found. Taken together, these results provide strong evidence that, in EC tumorigenesis, RASSF1A promoter hypermethylation is as important as KRAS mutations in activating the RAS pathway. © 2006 Wiley-Liss, Inc.

Continuous identification of common polymorphisms in various genes helps us to understand the possible association between endometrial cancer risk and the germline polymorphism. Estrogen receptor genes and the group of genes associated with the metabolism of estrogen have been investigated well. Second, the polymorphism in the p53 gene and the genes involved in its downstream pathway were correlated to a risk of developing endometrial cancer. Finally, the polymorphism in the genes involved in cellular proliferation and differentiation, regulating cell cycles, and DNA-damage repair were studied. In this way, recent research has begun to identify common genetic polymorphisms that augment the effects of risk-factor exposure, such as genes that affect the metabolism of hormones or are involved in cellular anti-tumor activities. The accumulation of data through these approaches would make genetic testing for the risk of development of endometrial cancer possible in the near future.

Excision repair cross-complementing group 1 (ERCC1) is a major DNA repair protein. Recent studies have addressed the association between ERCC1 polymorphism and carcinogenesis.We investigated a polymorphism of ERCC1 at nucleotide 19007 (C--T, Asn118Asn) in 94 epithelial ovarian cancer patients, 102 endometrial cancer patients, and in 329 control subjects.We observed no evidence of associations between the C19007T ERCC1 polymorphism and risk of epithelial ovarian or endometrial cancer, which had the same adjusted odds ratios of 0.91 (p = 0.711, 0.691 respectively).Our findings suggest that the C19007T ERCC1 polymorphism is unlikely to play an important role in epithelial ovarian or endometrial cancer in Korean women.

In a previous study, we demonstrated that elevation of COX-2 is significantly associated with lymph node metastasis in squamous cell carcinoma (SCC) of cervix. The main objective of this study is to characterize the relationship between elevation of COX-2 and its possible clinical role in adenocarcinoma (AC) of cervix. Using immunohistochemistry, we examined COX-2 expression levels in 84 patients with AC of uterine cervix [71 ACs, 13 adenosquamous carcinomas (ASCs)]. Elevation of COX-2 was correlated with clinicopathological variables and p53 expression, as detected by immunohistochemistry. Elevation of COX-2 was detected in 13.0% (11 of 84) of the tumors. Elevation of COX-2 was significantly correlated with histologic type (AC 8.5% vs. ASC 38.5%, P=0.011). Both tumor stage and lymph node metastasis were correlated with elevation of COX-2 with a borderline significance (P=0.062 and 0.068, respectively). Elevation of p53 was not associated with elevation of COX-2. The association between lymph node metastasis and elevation of COX-2 was stronger in cases of AC than in cases of ASC (28.4 vs. 4.3%, P=0.023). According to the results of univariate analysis, elevation of COX-2 was significantly associated with decreased overall survival (P=0.003, log-rank test). However, multivariate analyses revealed that only tumor stage was independently associated with overall survival, suggesting that elevation of COX-2 itself may not be an independent prognostic factor. The present study shows that elevation of COX-2 may contribute to lymph node metastasis in AC of uterine cervix. This suggests that the potential therapeutic role of COX-2 inhibitors should be validated, not only in SCC, but also in AC of uterine cervix.

When patients exhibited involvement of the margin after LLETZ some authors insisted that an involved margin after conization usually indicates the presence of residual disease and warrants further management such as immediate second LLETZ or even hysterectomy. However there were some opinions that expectant management is reasonable for patients with CIN III and positive margins after cold-knife conization is reasonable with careful follow-up. The purpose of this study was to analyze retrospectively the methods of management utilized in cases of margin involvement after LLETZ in patients with CIN III and microinvasive squamous cell carcinoma of the uterine cervix (MSC). A retrospective analysis was performed on all clinicopathologic records for the 2341 patients who underwent outpatient LLETZ for the cervical lesions diagnosed as CIN I—III or MSC by punch biopsy. (excerpt)

Cyclooxygenase-2 (COX-2) has been known to be related with various types of carcinoma, but we have insufficient knowledge about the association between COX-2 and endometrial cancer. Many have reported a close relationship between p53 expression and a poor prognosis in endometrial cancer, but it is unclear whether p53 is an independent prognostic factor. To clarify these uncertainties, we examined the expressions of COX-2 and p53 in endometrial cancer tissues. The study was carried on 152 endometrial cancer patients who had operation at Seoul National University Hospital. Paraffin-embedded tissue blocks were sectioned and immunostained using monoclonal anti-COX-2 and anti-p53 antibodies. Twenty-seven (17.8%) specimens stained as COX-2 positive. COX-2 positivity was more frequently observed in postmenopausal patients than in premenopausal patients (8.8% versus 25.0%; P = 0.009). However, COX-2 positivity did not show a statistically significant association with any other clinicopathologic characteristic (parity, body mass index, histotype, International Federation of Gynecology and Obstetrics stage, grade, lymph node metastasis, deep myometrial invasion, or p53 overexpression). Thirty-one (20.4%) specimens showed p53 overexpression and this was significantly correlated with an advanced stage (P = 0.001), poor differentiation (P < 0.001), lymph node metastasis (P = 0.012), and deep myometrial invasion (P < 0.001). Multivariate Cox regression analysis showed that advanced stage was an independent prognostic factor of survival, but p53 overexpression was not. COX-2 may be associated with endometrial cancer carcinogenesis during the postmenopausal period but not with tumor aggressiveness and p53 overexpression. The p53 overexpression was found to be strongly associated with endometrial cancer aggressiveness.

Objectives: The purpose of this study was to compare the myometrial invasion assessed by preoperative MRI and intraoperative examination in endometrial cancer. Methods: Eighty-seven consecutive endometrial cancer patients from a single institution, evaluated between September 2011 and May 2013, were included. MRI was part of the preoperative routine evaluation. All underwent total hysterectomy and bilateral salpingo-oophorectomy, with the intraoperative assessment of depth of myometrium invasion performed by an experienced pathologist. The final pathology report was used as definitive diagnosis. To calculate the positive predictive value (PPV) and negative predictive value (NPV), the reports were divided in 2 categories: ≤50% and N50% myometrial invasion. Results: All patients underwent perioperative examination, and the MRI report was available in 78 patients. MRI failed to predict the depth of myometrial invasion in the final pathology report in 50% of the cases; the perioperative assessment erred in 23%. The PPV and NPP for the MRI were 64.3% and 68%, respectively. The PPV and NPP for the intraoperative evaluation were 80% and 89.5%, respectively. Final results are shown in Table 1.

Objective To investigate the completeness of pedigree and of number of pedigree analysis to know the acceptable familial history in Korean women with ovarian cancer. Methods Interview was conducted in 50 ovarian cancer patients for obtaining familial history three times over the 6 weeks. The completeness of pedigree is estimated in terms of familial history of disease (cancer), health status (health living, disease and death), and onset age of disease and death. Results The completion of pedigree was 79.3, 85.1, and 85.6% at the 1st, 2nd, and 3rd time of interview and the time for pedigree analysis was 34.3, 10.8, and 3.1 minutes, respectively. The factors limiting pedigree analysis were as follows: out of contact with their relatives (38%), no living ancestors who know the family history (34%), dispersed family member because of the Korean War (16%), unknown cause of death (12%), reluctance to ask medical history of relatives (10%), and concealing their ovarian cancer (10%). The percentage of cancers revealed in 1st (2%) and 2nd degree (8%) relatives were increasing through surveys, especially colorectal cancer related with Lynch syndrome (4%). Conclusion Analysis of pedigree at least two times is acceptable in Korean woman with ovarian cancer from the first study. The completion of pedigree is increasing, while time to take family history is decreasing during three time survey.

The consensus guideline development committee of Korean Society of Gynecologic Oncology was reconvened in March 2012. The committee consisted of 36 experts representing 12 university hospitals and professional organizations. The objective of this committee was to develop standardized guidelines for cervical cancer screening tests for Korean women and to distribute these guidelines to every clinician, eventually improving the quality of medical care. Since the establishment of the consensus guideline development committee, evidence-based guidelines have either been developed de novo considering specific Korean situations or by adaptation of preexisting consensus guidelines from other countries. Recommendations for cervical cancer screening tests, management of atypical squamous and glandular cells, and management of low-grade and high-grade squamous intraepithelial lesions were developed. Additionally, recommendations for human papillomavirus DNA testing and recommendations for adolescent and pregnant women with abnormal cervical screening test results were also included.

Objective To evaluate the effectiveness of ovarian transposition procedures in preserving ovarian function in relation to the location of the transposed ovaries in patients who underwent surgery with or without pelvic radiotherapy. Design Retrospective. Setting Uterine cancer center. Patient(s) A total of 53 patients with cervical cancer who underwent ovarian transposition between November 2002 and November 2010. Intervention(s) Ovarian transposition to the paracolic gutters with or without radical hysterectomy and lymph node dissection. Main Outcome Measure(s) Preservation of ovarian function, which was assessed by patient's symptoms and serum FSH level. Result(s) Lateral ovarian transposition was performed in 53 patients. Based on receiver operator characteristic curve analysis, optimum cutoff value of location more than 1.5 cm above the iliac crest was significantly associated with preservation of ovarian function after treatment (area under receiver operator characteristic curve: 0.757, 95% confidence interval [CI]: 0.572–0.943). In univariate analysis, higher location of transposed ovary more than 1.5 cm from the iliac crest was the only independent factor for intact ovarian function (odds ratio 9.91, 95% CI: 1.75–56.3). Multivariate analysis confirmed that the location of transposed ovary (odds ratio 11.72, 95% CI 1.64–83.39) was the most important factor for intact ovarian function. Conclusion(s) Location of transposed ovary higher than 1.5 cm above the iliac crest is recommended to avoid ovarian failure after lateral ovarian transposition after primary or adjuvant pelvic radiotherapy in cervical cancer.

Objective The aim of this study was to identify a standard for the evaluation of future models for prediction of lymph node metastasis in endometrial cancer through estimation of performance of well-known surgicopathological models. Methods Using the medical records of 947 patients with endometrial cancer who underwent surgical management with lymphadenectomy, we retrospectively assessed the predictive performances of nodal metastasis of currently available models. Results We evaluated three models included: 1) a model modified from the Gynecologic Oncology Group (GOG) pilot study; 2) one from the GOG-33 data; and 3) one from Mayo Clinic data. The three models showed similar negative predictive values ranging from 97.1% to 97.4%. Using Bayes' theorem, this can be translated into 2% of negative post-test probability when 10% of prevalence of lymph node metastasis was assumed. In addition, although the negative predictive value was similar among these models, the proportion that was classified as low-risk was significantly different between the studies (56.4%, 44.8%, and 30.5%, respectively; p

Objective To evaluate survival and morbidity after pelvic exenteration (PE) for the curative management of recurrent cervical cancer. Methods We retrospectively evaluated patients with recurrent cervical cancer who underwent PE from January 2001 to April 2011. Patients were identified from the registry of our institution. The clinical status and demographic information was obtained by reviewing the medical records. Results Sixty-one recurrent cervical cancer patients underwent PE. Patients who received radiotherapy, operation, chemotherapy before PE were 98%, 41%, and 23%, respectively. The total morbidity rate was 44%; 10 (16%) patients had early complications (30 days or less after PE), whereas 22 (36%) patients had late complications. Wound problems were common early complications (7/18), and bowel fistulas were common late complications (9/30). The five-year overall survival and five-year disease-free survival were 56% and 49%, respectively. Median follow-up was 22 months (range, 1.8 to 60 months). Affecting factors for overall survival were resection margin status, pelvic wall and rectal involvement. Conclusion Our overall 5-year survival is encouraging. Although the morbidity rate is still high, PE is a potentially curative opportunity in gynecological malignancies with no other treatment options. The most important factors for overall survival after PE are the resection margin status, pelvic wall involvement and rectal involvement.

Although maximal cytoreduction is the cornerstone of current treatment for patients with advanced ovarian cancer, optimal cytoreduction is not always achievable in the clinic. Therefore, using clinical characteristics, diagnostic imaging, serum biomarkers or laparoscopic findings, many studies have attemptesd to find models for predicting surgical resectability. However, most of these prediction models showed limited effectiveness and have not been properly validated. To establish a reliable prediction model, several requirements should be met. First, the goal of surgical cytoreduction should be adequately defined. Second, the desired accuracy for making the model clinically useful should be defined. Third, the model should test all relevant predictors, including clinical, radiological and biochemical predictors, and be developed using a large dataset that provides a sufficient number of events. Fourth, any prediction model should be validated with a relevant external dataset. Lastly, the prediction model should be able to aid decision making and, thereby, improve the outcome of patients. Therefore, randomized clinical trials with decision making based on prediction models are urgently required.

(CKD 602), a topoisomerase I inhibitor, in persistent or recurrent carcinoma of the cervix. Methods: Belotecan was administrated at 0.5 mg/m 2 /day for 5 consecutive days every 3-week cycle in patients with recurrent or progressive cervical carcinoma who were unsuitable candidates for curative treatment with surgery or radiotherapy. Results: At the first stage of trial, a total of 16 patients were entered in the study. A median of three cycles were administrated per patient with a range of one to seven cycles. Fourteen of 16 patients (87.5%) had received radiotherapy or chemotherapy prior to the study. The most frequently severe adverse events were anemia and neutropenia. More than Grade 3 anemia and neutropenia were seen in 10 cycles (23.8%) and 6 cycles (14.3%) of 42 cycles, respectively. The incidence of non-hematologic toxicity was minimal. One patient died of treatment-related toxicities. There was no complete or partial response to belotecan. The median overall survival was 12.38 months (95% confidence interval, 9.71‐15.04). Conclusions: Belotecan was not active in the treatment of recurrent or progressive cervical cancer as a single agent.ClinicalTrials.gov identifier: NCT00430144

Objective We aimed to determine the ideal cut-off of nadir serum CA-125 level for prediction of progression free survival. Methods Among 267 patients who achieved complete remission after chemotherapy, the correlation between nadir CA-125 and progression free survival were compared among the subgroups classified according to the distribution of CA-125. The diagnostic odds ratio and area under the receiver operator characteristics curve were compared at various cut-off points. Results The nadir CA-125 levels did not have prognostic value under 12 U/mL (to 75 percentile). In contrast, they were significantly correlated with progression free survival only when the CA-125 level was greater than 12, which was 75 percentile (p=0.034). In predicting progression free survival 18 U/mL showed a hazard ratio of 2.85 (95% confidence interval, 1.70 to 4.76; p

Frequently, clinicians confront situations that a pile of cumulated data about a disease does not help them to make clear decision. Cervical adenocarcinoma in situ (AIS) is one of them. It has been commonly believed that the disease has multifocal location and this raised the concern for the safety of conservative management in treatment of cervical AIS. Thus, even with negative conization margins, many recommend further surgery in fear of a risk of residual or recurrent disease. However, due to its relatively lower incidence than its counterpart, many studies regarding of outcome of AIS are small-sized and retrospective, which limited their usefulness as an evidence for decision-making evidence. In this issue of Journal of Gynecologic Oncology, Kim et al. [1] reported the retrospective observational data of 99 women with AIS in single institution. Despite its retrospective nature, the study provides helpful insight of the disease and is one of the large-scale observational sets currently available. The most intriguing data in the study were the incidence of residual margin and recurrence data of AIS with negative margin. The authors found the residual disease only in 4.4% of patients who underwent further surgery. On the other hand, they also found the 3.6% of recurrence rate in the AIS patients who received conservative management, which was corresponds well to the pathologic outcome of surgically managed cases. The good correspondence between incidence rate of residual lesion and the recurrence rate is very interesting, especially in light of recent systemic review by Salani et al. [2]. In the report, the authors estimated the recurrence rate as 2.6% in the conservatively-managed patients, which is well corresponds to the study by Kim et al. However, the estimated incidence of residual disease in the hysterectomy specimen was as much as 20.3%, which is evidently higher than that of data presented by Kim et al. This discrepancy is not surprising. First, in the systemic review, the authors included many case reports. Many case reports reported the disastrous outcome of conservative expectation after conization when the margin was negative. Therefore, it can be serious source of bias exaggerating the incidence of failure in margin-negative patients. Indeed, simple application of random-effect model in the previous systemic review, we can easily found that the incidence decreased to 15%. On the other hand, in the Kim's data, selection bias might have influenced and decreased the incidence of conization failure in margin-negative patients because clinicians would advise hysterectomy more frequently in the patient with higher risk. Despite the discrepancy of rate of residual disease, the good correspondence of recurrence rate of margin-negative patients between two studies (2.6% and 3.6%, respectively) gave us important insight for selecting treatment strategy because the known recurrence rate of cervical carcinoma in situ is about 2% [3,4]. For the patients with margin-negative AIS, what treatment strategy can be drawn from these data? First, it is evident that margin-negative young patients who want to preserve their fertility can be treated with conservative expectation. Second, the collective evidences suggests that margin-negative patients should be given with the choice to select between decisive hysterectomy and conservative expectation with careful follow-up, even they do not wish to retain fertility. Adequate information including warning for the chance of residual disease and low incidence of recurrence rate should be provided through patient counseling. However, considering subsequent rate of residual disease and limited accuracy in surveillance technique, definite hysterectomy still should be regarded as the gold standard in margin-negative patients.

We performed a retrospective study to evaluate the feasibility and safety of extensive upper abdominal surgery (EUAS) in elderly (>/=65 yr) patients with advanced ovarian cancer. Records of patients with advanced epithelial ovarian cancer who received surgery at our institution between January 2001 and June 2005 were reviewed. A total of 137 patients including 32 (20.9%) elderly patients were identified. Co-morbidities were present in 37.5% of the elderly patients. Optimal cytoreduction was feasible in 87.5% of the elderly while 95.2% of young patients were optimally debulked (P=0.237). Among 77 patients who received one or more EUAS procedures, 16 (20.8%) were elderly. Within the cohort, the complication profile was not significantly different between the young and the elderly, except for pleural effusion and pneumothorax (P=0.028). Elderly patients who received 2 or more EUAS procedures, when compared to those 1 or less EUAS procedure, had significantly longer operation times (P=0.009), greater blood loss (P=0.002) and more intraoperative transfusions (P=0.030). EUAS procedures are feasible in elderly patients with good general condition. However, cautious peri-operative care should be given to this group because of their vulnerability to pulmonary complications and multiple EUAS procedures.

The aim of the current study is to test whether immortalized B-lymphocyte cell line via Ebstein-Barr virus (EBV) transformation is feasible and can be an unlimited source of genome wide study.We obtained peripheral whole blood from 5 ovarian cancer patients and immortalized the B-cell lines using EBV transformation. The success rate was analyzed and the bio-identity of the genome was performed using human leukocyte antigen (HLA) identity test.EBV transformation was successful in all 5 cases (95% confidence interval, 46.3% to 100%). After cryopreservation of EBV-transformed B-cell lines and subsequent thawing, we observed that all cell lines were viable and proliferative. To check bio-identity, HLA-A, B, and DR were tested between the genome of the original samples and the transformed samples. The HLA typing revealed that all observed HLA-A, B, and DR type was identical in 5 cases before and after EBV-transformation.The current results suggest that EBV-transformation of peripheral blood is an efficient tool in genome banking. The EBV-transformed B-cell lines may be a valuable resource of genome in multi-center translational research by the Korean Gynecologic Oncology Group.