Purpose: The results of the TAILORx trial have shown that premenopausal patients with intermediate Oncotype Dx (ODx) recurrence score of 16–25 may benefit from adjuvant chemotherapy. In addition, the clinicopathological features showed the information complementary to ODx results. However, the characteristics may vary depending on menopausal status even in the same score. This study aimed to analyze the differences in the clinical characteristics by menopausal status. Methods: This study conducted a retrospective analysis of 756 patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative, and node-negative breast cancer who underwent the ODx test from July 2013 to December 2020 at the Severance Hospital. Results: Of the 756 patients, 261 patients were postmenopausal, and 495 were premenopausal. The premenopausal patients with a midrange ODx had similar clinicopathological features as compared to those with a high ODx. Conversely, the postmenopausal patients with a midrange ODx did not show significantly different clinicopathological features from those with a low ODx, whereas a difference was seen as compared to those with a high ODx. Conclusion In this study, unlike the postmenopausal patients, some of the clinicopathological characteristics of the premenopausal patients with a midrange ODx were closer to those with a high ODx than those with a low ODx. In the premenopausal patients with a midrange ODx, considering the baseline characteristic itself, there was a significant difference between those with a low ODx when compared with postmenopausal patients. Therefore, more aggressive treatment decisions may be helpful in premenopausal patients with a midrange ODx.

Purpose: The results of the TAILORx trial have shown that premenopausal patients with intermediate Oncotype Dx (ODx) recurrence score of 16–25 may benefit from adjuvant chemotherapy. In addition, the clinicopathological features showed the information complementary to ODx results. However, the characteristics may vary depending on menopausal status even in the same score. This study aimed to analyze the differences in the clinical characteristics by menopausal status. Methods: This study conducted a retrospective analysis of 756 patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative, and node-negative breast cancer who underwent the ODx test from July 2013 to December 2020 at the Severance Hospital. Results: Of the 756 patients, 261 patients were postmenopausal, and 495 were premenopausal. The premenopausal patients with a midrange ODx had similar clinicopathological features as compared to those with a high ODx. Conversely, the postmenopausal patients with a midrange ODx did not show significantly different clinicopathological features from those with a low ODx, whereas a difference was seen as compared to those with a high ODx. Conclusion In this study, unlike the postmenopausal patients, some of the clinicopathological characteristics of the premenopausal patients with a midrange ODx were closer to those with a high ODx than those with a low ODx. In the premenopausal patients with a midrange ODx, considering the baseline characteristic itself, there was a significant difference between those with a low ODx when compared with postmenopausal patients. Therefore, more aggressive treatment decisions may be helpful in premenopausal patients with a midrange ODx.

Purpose: The results of the TAILORx trial have shown that premenopausal patients with intermediate Oncotype Dx (ODx) recurrence score of 16–25 may benefit from adjuvant chemotherapy. In addition, the clinicopathological features showed the information complementary to ODx results. However, the characteristics may vary depending on menopausal status even in the same score. This study aimed to analyze the differences in the clinical characteristics by menopausal status. Methods: This study conducted a retrospective analysis of 756 patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative, and node-negative breast cancer who underwent the ODx test from July 2013 to December 2020 at the Severance Hospital. Results: Of the 756 patients, 261 patients were postmenopausal, and 495 were premenopausal. The premenopausal patients with a midrange ODx had similar clinicopathological features as compared to those with a high ODx. Conversely, the postmenopausal patients with a midrange ODx did not show significantly different clinicopathological features from those with a low ODx, whereas a difference was seen as compared to those with a high ODx. Conclusion In this study, unlike the postmenopausal patients, some of the clinicopathological characteristics of the premenopausal patients with a midrange ODx were closer to those with a high ODx than those with a low ODx. In the premenopausal patients with a midrange ODx, considering the baseline characteristic itself, there was a significant difference between those with a low ODx when compared with postmenopausal patients. Therefore, more aggressive treatment decisions may be helpful in premenopausal patients with a midrange ODx.

Objective: The aim of this study was to investigate postoperative imaging findings of patients who underwent breastconserving surgery for cancer and reconstruction with MegaDerm® (sheet-type and pellet-type), analyzing false positives and recurrences, using multi-modality images. Materials and Methods: This study included 201 women (age range: 28–81 years, mean age ± standard deviation: 53.2 ± 8.6 years) who underwent breast-conserving surgery and immediate reconstruction with MegaDerm®. Post-surgery, each patient underwent at least one mammography (MG), ultrasonography (US), and MRI, totaling 713 MG, 1063 US, and 607 MRI examinations. Postoperative images were reviewed separately for the two types of MegaDerm®, and suspicious imaging findings (false positives and recurrences) were analyzed, with a particular focus on the findings in direct contact with MegaDerm®. Results: MegaDerm® appeared as a circumscribed mass with homogeneous iso- or high density on MG, posterior shadowing on US, and no enhancement on MRI. Calcification was more common and increased in size in sheet-type MegaDerm®, while pellet-type often exhibited irregular margins. Nine out of 17 false positives had suspicious findings in direct contact with MegaDerm®, and six out of nine recurrences showed similar findings. Common suspicious findings included calcifications, asymmetries, and MegaDerm® irregularities on MG; masses and MegaDerm® irregularities on US; and enhancing masses and MegaDerm® irregularities with enhancement on MRI. Notably, MegaDerm® irregularity with calcification was observed on MG and US in only one recurrence case. In 44.4% (4/9) of false-positives in direct contact with MegaDerm®, suspicious findings showed no change or resolution on follow-up. Conclusion Suspicious imaging findings in direct contact with MegaDerm® may be associated with false positives or recurrences. Therefore, it is essential to recognize these characteristic findings and review the patient’s history of MegaDerm® insertion when in doubt.

Objectives: . This study evaluates the enduring efficacy and patient satisfaction of dupilumab with interdose interval adjustments based on the Sino-Nasal Outcome Test (SNOT-22) in chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: . A retrospective analysis was conducted on 44 patients who had been treated with dupilumab for over 6 months. This study targeted individuals diagnosed with CRSwNP according to the 2020 edition of the European Position Paper on Rhinosinusitis and Nasal Polyps Criteria. The treatment involved an add-on dupilumab regimen, where the interdose interval was adjusted based on the SNOT-22 scores. Dosage adjustments were made such that patients with initial SNOT-22 scores greater than 40 were tapered to a target level of 20 or less. Similarly, for patients with initial scores of 40 or less, the treatment aimed for an improvement of 50% or more. At each visit, the effectiveness of the treatment was evaluated using SNOT-22, nasal polyp scores (NPS), and a subjective satisfaction questionnaire adapted from the Treatment Satisfaction Questionnaire for Medication (TSQM v.1.4). Results: . The adjustment of the interdose interval for dupilumab based on SNOT-22 scores demonstrated sustained improvements in patients’ subjective symptoms, satisfaction, and NPS. The mean (standard deviation) SNOT-22 scores significantly decreased from 46.04 (22.30) to 14.72 (13.66) over 6 months (P<0.001). Similarly, NPS scores improved from 3.20 (2.24) to 1.72 (1.46) within the same period (P<0.001). Satisfaction scores, ranging from 0 to 5, consistently remained above 3.5 for up to 6 months (P=0.166). Additionally, there was a significant correlation between the improvement in the nasal symptom domain of the SNOT-22 scores and higher satisfaction scores. Conclusion . Adjusting dupilumab dosing intervals based on SNOT-22 scores from the outset resulted in sustained efficacy and patient satisfaction in Korean patients with CRSwNP. This approach will meaningfully assist clinicians in determining the optimal dupilumab dosing interval.

Recent clinical outcomes of multi-regimen chemotherapy in patients with cholangiocarcinoma (CCC) have shown benefits in terms of overall survival. However, repeated endoscopic biliary drainage (EBD) and serious adverse events negatively affect prolongation of the survival period.The aim of this study was to investigate the prevalence of massive hemobilia and the outcomes of its management with fully covered self-expandable metal stents (FC-SEMSs) in patients with hilum-involving CCC receiving multi-regimen chemotherapy. The methods and effects of FCSEMS placement were retrospectively investigated following the occurrence of massive hemobilia during EBD. A total of 356 patients with CCC received multi-regimen chemotherapy. Among them, 181 patients had hilar invasion, and seven patients (3.9%) developed massive hemobilia during repeated EBD using removable stents. In all cases, the tumor encased the right hepatic artery. In six patients (85.7%), hemostasis was immediately and completely achieved by inserting one or two FC-SEMSs proximal to the hilar invasion area. Therefore, if the tumor encases the right hepatic artery, massive hemobilia is likely to occur during multi-regimen chemotherapy.Thus, prompt placement of a FC-SEMS would be an effective treatment option for massive hemobilia in patients with hilum-involving CCC.

Objective: The aim of this study was to investigate postoperative imaging findings of patients who underwent breastconserving surgery for cancer and reconstruction with MegaDerm® (sheet-type and pellet-type), analyzing false positives and recurrences, using multi-modality images. Materials and Methods: This study included 201 women (age range: 28–81 years, mean age ± standard deviation: 53.2 ± 8.6 years) who underwent breast-conserving surgery and immediate reconstruction with MegaDerm®. Post-surgery, each patient underwent at least one mammography (MG), ultrasonography (US), and MRI, totaling 713 MG, 1063 US, and 607 MRI examinations. Postoperative images were reviewed separately for the two types of MegaDerm®, and suspicious imaging findings (false positives and recurrences) were analyzed, with a particular focus on the findings in direct contact with MegaDerm®. Results: MegaDerm® appeared as a circumscribed mass with homogeneous iso- or high density on MG, posterior shadowing on US, and no enhancement on MRI. Calcification was more common and increased in size in sheet-type MegaDerm®, while pellet-type often exhibited irregular margins. Nine out of 17 false positives had suspicious findings in direct contact with MegaDerm®, and six out of nine recurrences showed similar findings. Common suspicious findings included calcifications, asymmetries, and MegaDerm® irregularities on MG; masses and MegaDerm® irregularities on US; and enhancing masses and MegaDerm® irregularities with enhancement on MRI. Notably, MegaDerm® irregularity with calcification was observed on MG and US in only one recurrence case. In 44.4% (4/9) of false-positives in direct contact with MegaDerm®, suspicious findings showed no change or resolution on follow-up. Conclusion Suspicious imaging findings in direct contact with MegaDerm® may be associated with false positives or recurrences. Therefore, it is essential to recognize these characteristic findings and review the patient’s history of MegaDerm® insertion when in doubt.

Recent clinical outcomes of multi-regimen chemotherapy in patients with cholangiocarcinoma (CCC) have shown benefits in terms of overall survival. However, repeated endoscopic biliary drainage (EBD) and serious adverse events negatively affect prolongation of the survival period.The aim of this study was to investigate the prevalence of massive hemobilia and the outcomes of its management with fully covered self-expandable metal stents (FC-SEMSs) in patients with hilum-involving CCC receiving multi-regimen chemotherapy. The methods and effects of FCSEMS placement were retrospectively investigated following the occurrence of massive hemobilia during EBD. A total of 356 patients with CCC received multi-regimen chemotherapy. Among them, 181 patients had hilar invasion, and seven patients (3.9%) developed massive hemobilia during repeated EBD using removable stents. In all cases, the tumor encased the right hepatic artery. In six patients (85.7%), hemostasis was immediately and completely achieved by inserting one or two FC-SEMSs proximal to the hilar invasion area. Therefore, if the tumor encases the right hepatic artery, massive hemobilia is likely to occur during multi-regimen chemotherapy.Thus, prompt placement of a FC-SEMS would be an effective treatment option for massive hemobilia in patients with hilum-involving CCC.

Objectives: . This study evaluates the enduring efficacy and patient satisfaction of dupilumab with interdose interval adjustments based on the Sino-Nasal Outcome Test (SNOT-22) in chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: . A retrospective analysis was conducted on 44 patients who had been treated with dupilumab for over 6 months. This study targeted individuals diagnosed with CRSwNP according to the 2020 edition of the European Position Paper on Rhinosinusitis and Nasal Polyps Criteria. The treatment involved an add-on dupilumab regimen, where the interdose interval was adjusted based on the SNOT-22 scores. Dosage adjustments were made such that patients with initial SNOT-22 scores greater than 40 were tapered to a target level of 20 or less. Similarly, for patients with initial scores of 40 or less, the treatment aimed for an improvement of 50% or more. At each visit, the effectiveness of the treatment was evaluated using SNOT-22, nasal polyp scores (NPS), and a subjective satisfaction questionnaire adapted from the Treatment Satisfaction Questionnaire for Medication (TSQM v.1.4). Results: . The adjustment of the interdose interval for dupilumab based on SNOT-22 scores demonstrated sustained improvements in patients’ subjective symptoms, satisfaction, and NPS. The mean (standard deviation) SNOT-22 scores significantly decreased from 46.04 (22.30) to 14.72 (13.66) over 6 months (P<0.001). Similarly, NPS scores improved from 3.20 (2.24) to 1.72 (1.46) within the same period (P<0.001). Satisfaction scores, ranging from 0 to 5, consistently remained above 3.5 for up to 6 months (P=0.166). Additionally, there was a significant correlation between the improvement in the nasal symptom domain of the SNOT-22 scores and higher satisfaction scores. Conclusion . Adjusting dupilumab dosing intervals based on SNOT-22 scores from the outset resulted in sustained efficacy and patient satisfaction in Korean patients with CRSwNP. This approach will meaningfully assist clinicians in determining the optimal dupilumab dosing interval.

Objective: The aim of this study was to investigate postoperative imaging findings of patients who underwent breastconserving surgery for cancer and reconstruction with MegaDerm® (sheet-type and pellet-type), analyzing false positives and recurrences, using multi-modality images. Materials and Methods: This study included 201 women (age range: 28–81 years, mean age ± standard deviation: 53.2 ± 8.6 years) who underwent breast-conserving surgery and immediate reconstruction with MegaDerm®. Post-surgery, each patient underwent at least one mammography (MG), ultrasonography (US), and MRI, totaling 713 MG, 1063 US, and 607 MRI examinations. Postoperative images were reviewed separately for the two types of MegaDerm®, and suspicious imaging findings (false positives and recurrences) were analyzed, with a particular focus on the findings in direct contact with MegaDerm®. Results: MegaDerm® appeared as a circumscribed mass with homogeneous iso- or high density on MG, posterior shadowing on US, and no enhancement on MRI. Calcification was more common and increased in size in sheet-type MegaDerm®, while pellet-type often exhibited irregular margins. Nine out of 17 false positives had suspicious findings in direct contact with MegaDerm®, and six out of nine recurrences showed similar findings. Common suspicious findings included calcifications, asymmetries, and MegaDerm® irregularities on MG; masses and MegaDerm® irregularities on US; and enhancing masses and MegaDerm® irregularities with enhancement on MRI. Notably, MegaDerm® irregularity with calcification was observed on MG and US in only one recurrence case. In 44.4% (4/9) of false-positives in direct contact with MegaDerm®, suspicious findings showed no change or resolution on follow-up. Conclusion Suspicious imaging findings in direct contact with MegaDerm® may be associated with false positives or recurrences. Therefore, it is essential to recognize these characteristic findings and review the patient’s history of MegaDerm® insertion when in doubt.