Seon-Mi Lee

Is omentectomy mandatory in patients with epithelial ovarian cancer having a macroscopically normal-appearing omentum?: A retrospective study

This study aims to determine the necessity of mandatory omentectomy during staging surgery in patients with epithelial ovarian cancer (EOC) with a normal-appearing omentum. This study analyzed patients with EOC who underwent staging surgery at Korea University Anam Hospital between January 2010 and December 2023, excluding those with incomplete data and those lost to follow-up. The patients were categorized into the omentectomy and non-omentectomy groups. We compared the characteristics, disease-free survival, overall survival, and recurrence risk factors, using statistical tests including the Student t test, chi-square test, Fisher’s exact test, Kaplan–Meier analysis, and Cox regression, conducted with SPSS. Among 222 patients, 166 underwent omentectomy and 56 did not. The median follow-up period for all patients was 43 months, and no significant difference in disease-free survival or overall survival was observed between the groups. Factors associated with increased EOC recurrence included advanced stages (stage III: adjusted hazard ratio [HR], 2.19; P  = .006 and stage IV: adjusted HR, 4.55; P  < .001), elevated cancer antigen 125 level (adjusted HR, 3.37; P  < .001), positive pelvic lymph nodes (adjusted HR, 2.34; P  = .001), more chemotherapy (adjusted HR, 1.05; P  < .001), and positive washing cytology (adjusted HR, 1.77; P  = .014). Omentectomy status in patients with EOC with unsuspected omental metastasis was not associated with survival benefit, suggesting that omentectomy is not mandatory for a normal-appearing omentum and may be considered optional during staging surgery. To reduce the risk of recurrence, close monitoring is crucial for patients with advanced-stage EOC, elevated cancer antigen 125 level, positive pelvic lymph nodes, more chemotherapy, and positive washing cytology.

The Value of the Naples Prognostic Score at Diagnosis as a Predictor of Cervical Cancer Progression

Background and Objectives: The Naples prognostic score (NPS), which incorporates inflammatory and nutritional indicators, is increasingly used as a prognostic score for various malignancies. Nonetheless, few studies have specifically evaluated the NPS as a prognostic factor for cervical cancer. This study aimed to assess the value of NPS at diagnosis as a predictor of cancer progression. Materials and Methods: This study included patients diagnosed with cervical cancer at Korea University Anam Hospital from January 2019 to December 2023. Patients with incomplete data or those who were lost to follow-up were excluded. The NPS was calculated based on laboratory results at the time of diagnosis, categorizing patients into the low-NPS group (NPS 0–1) and high-NPS group (NPS ≥ 2). Survival analysis was performed using the Kaplan–Meier method and log-rank test. Univariate and multivariate Cox proportional hazards models were used to identify independent prognostic factors. Results: Out of 178 patients, 98 and 80 were categorized into the low-NPS and high-NPS groups, respectively. Kaplan–Meier survival analysis showed that the high-NPS group had significantly lower disease-free survival (DFS) (p < 0.001) and overall survival (OS) (p = 0.02) rates than the low-NPS group. Multivariate Cox regression analysis identified the NPS as an independent prognostic factor for DFS (adjusted hazard ratio, 1.98; p = 0.017), but not for OS. Conclusions: This study demonstrated that the NPS measured at diagnosis may serve as a useful independent prognostic factor for cancer progression in patients with cervical cancer.

The necessity of continuing cervical cancer screening of elderly Korean women aged 65 years or older

AbstractBackgroundAlthough the incidence of cervical cancer has decreased since the 1980s in Korea, it remains high among the elderly women. This study evaluated the suitability of cervical cancer screening for elderly Korean women aged ≥65 years according to recommendations by the American Society of Cytopathology and American Society for Colposcopy and Cervical Pathology.MethodsWe retrospectively reviewed the records of patients who underwent cervical cancer screening, followed by liquid‐based Pap test, human papillomavirus (HPV) test, and colposcopic punch biopsy at two academic hospitals from May 2008 to May 2018. The participants were divided into two groups <65 and ≥65 years old. Logistic regression analysis was performed to evaluate the association between cytology tests, HPV tests and the occurrence of high‐risk lesions, ≥cervical intraepithelial neoplasia2 (CIN2).ResultsThe mean patient age was 49.02 ± 15.437 (range 15–91) years. No patients aged <25 years showed atypical squamous cell‐cannot exclude high grade (ASC‐H), squamous cell carcinoma (SCC), or adenocarcinoma (ADC). The incidence of high‐grade squamous intraepithelial lesion (HISL) (39.7%) and ≥CIN 3 (40.2%) was significantly higher in patients ≥65 years of age than in other age groups. However, patients ≥65 years showed increased HSIL and HPV negativity and ASC‐H, HSIL, and HPV positivity in those with ≥CIN 2 (both p = .043).ConclusionKorean women aged ≥65 years should undergo cervical cancer screening. The relevance of HPV or Cytology test alone or co‐test for screening should be evaluated in this population.