Jaekyung Bae

Treatment patterns and survival outcomes according to histologic subtype in malignant ovarian germ cell tumors: a nationwide real-world cohort study

Surgical outcomes of rectosigmoid colon resection versus rectosigmoid wall stripping for superficial rectal wall tumors at cytoreductions for advanced ovarian cancer

This study aimed to evaluate surgical outcomes of rectosigmoid resection versus rectosigmoid wall stripping for superficial tumor involvement during cytoreductive surgery for advanced ovarian cancer. This retrospective study included patients with the International Federation of Gynecology and Obstetrics stage III to IV ovarian cancer who underwent rectosigmoid resection or rectosigmoid wall stripping during primary or interval cytoreductive surgery between January 2021 and January 2024. Inverse probability of treatment weighting was used to balance baseline characteristics. Perioperative and oncologic outcomes were compared using appropriate statistical tests, including χ A total of 322 patients (rectosigmoid resection, n = 182; rectosigmoid wall stripping, n = 140) were included. A transition from rectosigmoid resection to rectosigmoid wall stripping began in mid-2022, resulting in an 83% reduction in rectosigmoid resection and a 900% increase in rectosigmoid wall stripping by late 2023. Rectosigmoid wall stripping was associated with shorter operation time (310 vs 400.8 minutes, p < .0001), lower blood loss (median, 489.4 vs 700 mL, p < .0001), fewer transfusions (31.3% vs 54.4%, p = .0002), shorter hospital stays (median, 11 vs 12 days, p = .0001), fewer thromboembolic events (6% vs 13.0%, p = .0356), and faster chemotherapy initiation (20 vs 22 days, p = .0002). Complete cytoreduction rates (72.6% vs 79.0%, p = .5152) and 6-month mortality (2.3% vs 1.7%, p = .6795) were similar. The rectosigmoid resection group showed a trend toward higher rates of bowel perforation (3.0% vs 0.8%) and fistula formation (2.0% vs 1.0%), although these differences were not statistically significant. For superficial and limited rectal serosal involvement, rectosigmoid wall stripping achieved macroscopic tumor clearance while reducing perioperative complications compared with rectosigmoid resection, which should be reserved for deeper or more extensive disease. Six-month follow-up showed comparable mortality rates between the 2 groups. Long-term and large-scale data are needed to ensure comparable oncologic safety.

Impact of Clostridium difficile Infection on Chemotherapy in Patients With Primary Ovarian Cancer

To investigate the impact of This retrospective study included patients with primary ovarian cancer diagnosed with CDI at the National Cancer Center, Korea, between January 2014 and December 2023. Patients with gastrointestinal symptoms and positive A total of 111 CDI episodes were identified in 90 patients, with 17 patients experiencing recurrent CDI. Among initial CDI episodes, 51.1% occurred during the first or second cycle of adjuvant chemotherapy after cytoreductive surgery. Adjuvant chemotherapy cycles were delayed in 81.1% of cases, with a median delay of 13 days. Additionally, 7.8% of patients discontinued chemotherapy, and CDI-related mortality was 2.2%. Severe or fulminant CDI was associated with higher rates of intensive care unit admission, bowel surgery, or death (38.9% vs. 4.2%; CDI can cause chemotherapy delays and severe adverse outcomes, such as septic shock or death. Early identification of CDI and a multidisciplinary approach are essential to minimize CDI-related complications in patients with ovarian cancer. Further research is needed to develop preventive strategies and evaluate the long-term impact of CDI on cancer prognosis.

Efficacy and toxicity of PARP inhibitor in elderly patients with homologous recombination-deficient newly diagnosed advanced ovarian cancer: the role of dose modification

To investigate the impact of age on the progression-free survival (PFS) and dose modification, discontinuation and adverse events of poly (adenosine diphosphate-ribose) polymerase inhibitor (PARPi) maintenance therapy in homologous recombination-deficient (HRD) ovarian cancer patients. We analyzed 324 patients with advanced stage III-IV epithelial ovarian cancer who had either BRCA mutation or HRD between July 2019 and November 2022. The primary objective was to evaluate the efficacy of PARPis by comparing PFS between patients who received PARPis and those who did not, specifically within 2 age groups: patients aged <60 years and those aged ≥60 years. The secondary objective included evaluating the rates of dose modification, discontinuation, and occurrence of treatment-emergent adverse events in patients who used PARPis. Of the 324 patients, 139 patients (42.9%) were diagnosed at ≥60 years. The use of PARPis resulted in a significant improvement in PFS in both age groups (hazard ratio [HR]=0.37; p<0.01) for patients aged <60 years (HR=0.41; p<0.01) for those aged ≥60 years. The multivariable Cox proportional hazards analysis revealed no significant difference in the PFS benefit between the 2 age groups (HR=0.95; 95% confidence interval [CI]=0.65-1.37; p=0.76). Dose modifications were more frequent in the elderly cohort (63.9% vs. 46.5%; p=0.04). PARPis significantly improved PFS in elderly ovarian cancer patients with BRCA mutations and HRD, with a toxicity profile similar to that of younger patients. Elderly patients benefited from frequent dose modifications without any negative impact on PFS outcomes.