Myounghwan Kim

Risk of cancers in women with polycystic ovary syndrome: Cohort study based on health insurance database in South Korea

Abstract Objective To evaluate the risk of all cancer types associated with polycystic ovary syndrome (PCOS) in a Korean population‐based study. Methods This retrospective cohort study used national health checkups and insurance data between January 1, 2011, and December 31, 2020. Women aged 20–50 years who attended medical institutions for PCOS or underwent health checkups were included. In total, 774 811 participants were included. The PCOS and non‐PCOS groups comprised 127 980 and 563 850 patients, respectively. After 1:1 propensity score matching, each group consisted of 127 712 participants. Hazard ratios were evaluated for all types of cancers associated with PCOS across age groups. Results Demographic and clinical characteristics of women with and without PCOS were not significantly different. However, in the PCOS group, the total cancer risk increased (hazard ratio: 1.156, 95% confidence interval: 1.058–1.263, P  = 0.001), and the risk of uterine and ovarian cancers increased (hazard ratio: 4.963, 95% confidence interval: 3.282–7.504, P  < 0.001; hazard ratio: 1.774, 95% confidence interval: 1.142–2.755, P  = 0.011, respectively). The risk of thyroid cancer increased in the 20–29 years age group within the PCOS group (hazard ratio: 1.2, 95% confidence interval: 1.009–1.427, P  = 0.039). Conclusion PCOS is associated with an increased risk of uterine and ovarian cancers. An increased risk of thyroid cancer was associated with PCOS in the 20–29 years age group. However, no link was found between PCOS and breast cancer. This should be considered when treating patients with PCOS.

Developing standardized informed consent for hysterectomy and vulva cancer surgery

Informed consent is a fundamental aspect of surgical care, designed to reinforce patient autonomy, promote shared decision-making, and potentially mitigate legal conflicts by ensuring the provision of comprehensive and consistent information in clinical practice. The Korean Society of Gynecologic Oncology (KSGO) previously published detailed informed consent documents for cervical, endometrial, and ovarian cancer surgery. However, standardized consent forms remain relatively lacking for laparoscopic-robotic hysterectomy performed for non-malignant indications, as well as for vulvar cancer surgery. Hence, the KSGO subcommittee collected, reviewed, and discussed consent forms from domestic medical institutions and subsequently developed informed consent for laparoscopic-robotic hysterectomy and vulvar cancer surgery, aiming to build patient trust and understanding.

Long-term risk of uterine malignancies in women with uterine fibroids confirmed by myomectomy: a population-based study

Leiomyosarcomas may originate from pre-existing uterine fibroids. However, recent studies showed that leiomyosarcomas do not arise from malignant changes in fibroids. Epidemiological data on the long-term risk of uterine malignancy with uterine fibroids are lacking. We aimed to determine whether uterine fibroids are a risk factor for uterine cancer. Patient data (2007-2020) from the Korean Health Insurance program were obtained. Using the procedure and diagnostic codes, data from patients who underwent myomectomy and appendicitis (control group) were extracted Using 1:1 propensity-score matching, 84,507 women were each allocated to the uterine fibroids and control groups. Endometrial cancer occurred in 36 44 and 44 36 women in the uterine fibroids and control groups (

Incidence and risk of venous thromboembolism according to primary treatment in women with ovarian cancer: A retrospective cohort study

Objective This study aimed to investigate incidence and risk for venous thromboembolism (VTE) according to primary treatment in women with ovarian cancer. Methods We selected 26,863 women newly diagnosed with ovarian cancer between 2009 and 2018 from the Korean Health Insurance Review and Assessment Service databases. During the total follow-up period and the first six months after initiation of primary treatments, incidence and risk of VTE were evaluated according to primary treatment as no treatment, surgery, radiotherapy, or chemotherapy. Results The mean follow-up period was 1285.5±6 days. The VTE incidence was highest in women who underwent chemotherapy (306 per 10,000 women). Among women who underwent surgery, VTE was highest in surgery with neoadjuvant chemotherapy (536 per 10,000 women), followed by surgery with adjuvant chemotherapy (360 per 10,000 women) and surgery alone (132 per 10,000 women). During the first 12 months, monthly incidence of VTE decreased. Compared with women with no treatment, risk of VTE significantly increased in women undergoing chemotherapy (HR 1.297; 95% CI, 1.08–1.557; P = 0.005) during the total follow-up period and decreased in women undergoing surgery (HR 0.557; 95% CI, 0.401–0.775; P<0.001) and radiotherapy (HR 0.289; 95% CI, 0.119–0.701; P = 0.006) during the first six months. Among women who underwent surgery, VTE risk significantly increased in surgery with neoadjuvant chemotherapy (HR 4.848; 95% CI, 1.86–12.632; P = 0.001) followed by surgery with adjuvant chemotherapy (HR 2.807; 95% CI, 1.757–4.485; P<0.001) compared with surgery alone during the total follow-up period and in surgery with neoadjuvant chemotherapy (HR 4.223; 95% CI, 1.37–13.022; P = 0.012) during the first six months. Conclusions In this large Korean cohort study, incidence and risk of VTE were highest in women with ovarian cancer who underwent chemotherapy and surgery with neoadjuvant chemotherapy as a primary cancer treatment. Incidence of VTE decreased over time.