Yeon Jee Lee

The pathologic and clinical outcomes of risk-reducing salpingo-oophorectomy in asymptomatic carriers of homologous recombination repair gene mutation

To investigate the prevalence of pathological findings and clinical outcomes of risk-reducing salpingo-oophorectomy (RRSO) in asymptomatic carriers with germline homologous recombination repair (HRR) gene pathogenic/likely pathogenic variants (PV/LPV). This retrospective study enrolled asymptomatic carriers with germline HR gene PV/LPV who underwent RRSO between 2006 and 2022 at the National Cancer Center in Korea. Clinical characteristics, including history of breast cancer, family history of ovarian/breast cancer, parity, and oral contraceptive use, were analyzed. Of the 255 women who underwent RRSO, 129 (50.6%) had PV/LPV in Women with HRR gene mutations PV/LPV who undergo RRSO are at a risk of detecting occult neoplasms, with a of 3.5%. Even in the absence of precursor lesions during RRSO, there was a cumulative risk of peritoneal carcinomatosis development, emphasizing the need for continued surveillance.

Trends in the incidence and survival outcomes of endometrial cancer in Korea: a nationwide population-based cohort study

To evaluate trends in the incidence and survival outcomes of endometrial cancer (EC) based on the year of diagnosis, stage, age, and histologic types. Women with primary EC diagnosed between 1999 and 2018, and who were followed up with until 2019, were identified from the Korea Central Cancer Registry using the International Classification of Diseases, 10th revision. The age-standardized rates (ASRs) of incidence, annual percent changes (APCs), and survival were estimated according to age, stage, histology, and year of diagnosis. The ASR for EC increased from 2.38 per 100,000 in 1999 to 7.29 per 100,000 in 2018 across all histologic types (APCs of 9.82, 15.97, and 7.73 for endometrioid, serous, and clear cell, respectively, p<0.001). There were significant differences in the 5-year survival rates based on histology (90.9%, 55.0%, and 68.5% for endometrioid, serous, and clear cell, respectively, p<0.001), stage (93.4%, 77.0%, and 31.0% for localized, regional, and distant, respectively, p<0.001), and age (93.0% for <50 years and 80.6% for ≥50 years, p<0.001). The 5-year survival was significantly better in the group diagnosed between 2000 and 2018 (85.9%) than that in the 1999-2008 group (83.3%) (p<0.001). This trend was only observed for endometrioid cancer (p<0.001). The incidence of EC increased across the all 3 subtypes. Survival of patients with endometrioid histology improved over the past two decades, but remained static for serous or clear cell histology. Healthcare strategies to prevent EC incidence in at-risk populations and apply effective treatments for high-risk histology are needed.

Impact of Changes in Obesity and Abdominal Obesity on Endometrial Cancer Risk in Young Korean Women: A Nationwide Cohort Study

Abstract Background: The increasing incidence of endometrial cancer in young women parallels the increasing prevalence of obesity, a well-established risk factor. However, the impact of longitudinal changes in obesity and abdominal obesity on early-onset endometrial cancer remains insufficiently understood. Methods: This nationwide cohort study utilized data from the Korean National Health Insurance Service. Women, ages 20 to 39 years, who underwent two health examinations at a 3-year interval between 2009 and 2015, with no history of cancer, were included. Participants were categorized based on changes in obesity (body mass index ≥25 kg/m2) or abdominal obesity (waist circumference ≥85 cm) into four groups: stable non-obese, non-obese to obese, obese to non-obese, and stable obese. The risk of endometrial cancer was assessed using Cox proportional hazards models. Results: Among 935,600 women, 798 developed endometrial cancer. Compared with the stable non-obese group, adjusted HRs for endometrial cancer were 1.940 (1.468–2.563), 2.083 (1.447–3.001), and 2.083 (1.447–3.001) in the non-obese to obese, obese to non-obese, and stable obese groups, respectively. With regard to abdominal obesity, the adjusted HRs were 2.048 (1.581–2.651), 2.302 (1.684–3.146), and 4.394 (3.557–5.427), respectively. The risk of cancer was higher in the obese to non-obese group than in the non-obese to obese group. Conclusions: Changes in obesity and abdominal obesity statuses were associated with early-onset endometrial cancer, with persistent abdominal obesity showing the highest risk. Impact: These findings support the need for early, sustained obesity interventions to reduce endometrial cancer risk in young women.

Preoperative laboratory parameters associated with deep vein thrombosis in patients with ovarian cancer: retrospective analysis of 3,147 patients in a single institute

Patients with ovarian cancer have a high risk of developing thrombosis. We aimed to investigate laboratory parameters associated with deep vein thrombosis (DVT) in patients treated for ovarian cancer. We retrospectively analyzed pre-operation laboratory data of patients with ovarian cancer for DVT at the National Cancer Center, Korea, between January 2000 and February 2021. The test items were white blood cell count, absolute neutrophil count (ANC), hemoglobin, platelets, monocytes, serum glucose, CA125, D-dimer, fibrinogen, prothrombin time (PT), activated partial thromboplastin time (aPTT), and body mass index (BMI). Differences between patients with and without DVT were compared with Wilcoxon rank-sum test. We analyzed the variables using logistic regression. Items with significant odds ratios were included in multivariate logistic regression. Significant variables were selected using backward elimination. Items were further categorized based on reference ranges. Univariate and multivariate analyses were performed to identify items with abnormal values associated with DVT. From 3,147 patient samples analyzed, 286 (9.1%) patients with DVT were selected. Differences between patients with vs without DVT were statistically significant for hemoglobin, monocyte, serum glucose, CA125, PT, aPTT, fibrinogen, D-dimer, and BMI. After univariate and multivariate analysis, monocyte, glucose, and PT remained significant. Among the categorical variables, low hemoglobin, high monocyte, high CA125, prolonged PT, and high BMI remained significant after univariate and multivariate analysis. Pre-operation laboratory data of low hemoglobin, high monocyte percentage, high serum glucose, high CA125, prolonged PT, and high BMI were associated with DVT.