This review summarized the results of clinical trials in 2024 that were believed to have a significant impact on clinical practice in the field of gynecologic oncology. The SHAPE trial, INTERLACE and KEYNOTE-A18 trials, and BEATcc and COMPASSION-16 trials were included in early-stage, locally advanced, and recurrent/metastatic cervical cancer, respectively. For uterine corpus cancer, updated survival data of the four trials (NRG-GY018, RUBY, AtTEnd, DUO-E) for endometrial cancer and the first survival data of LMS-04 trial for leiomyosarcoma were described. For ovarian cancer, the final overall survival results of PRIMA study were followed by DUO-O, ATHENA-combo, and FIRST-ENGOT-OV44 trial in different disease conditions. Finally, the results of DESTINY-PanTumor02, a basket trial of trastuzumab deruxtecan, were briefly addressed.

We updated the Korean Society of Gynecologic Oncology (KSGO) practice guideline for the management of ovarian cancer as version 5.1. The ovarian cancer guideline team of the KSGO published announced the fifth version (version 5.0) of its clinical practice guidelines for the management of ovarian cancer in December 2023. In version 5.0, the selection of the key questions and the systematic reviews were based on the data available up to December 2022.Therefore, we updated the guidelines version 5.0 with newly accumulated clinical data and added 5 new key questions reflecting the latest insights in the field of ovarian cancer between 2023 and 2024. For each question, recommendation was provided together with corresponding level of evidence and grade of recommendation, all established through expert consensus.

Background: Recurrent gynecological clear cell carcinoma (rGCCC) has a low objective response rate (ORR) to chemotherapy. Previous preclinical and clinical data suggest a potential synergy between immune checkpoint inhibitors and bevacizumab in rGCCC.Dostarlimab, a humanized monoclonal antibody targeting programmed cell death protein 1 (PD-1), combined with the anti-angiogenic bevacizumab, presents a novel therapeutic approach. This study will investigate the efficacy of dostarlimab +/− bevacizumab in rGCCC. Methods DOVE is a global, multicenter, international, open-label, randomized phase 2 study of dostarlimab +/− bevacizumab with standard chemotherapy in rGCCC. We will enroll 198 patients with rGCCC and assign them to one of three groups in a 1:1:1 ratio: arm A (dostarlimab monotherapy), B (dostarlimab + bevacizumab), and C (investigator’s choice of chemotherapy [weekly paclitaxel, pegylated liposomal doxorubicin, doxorubicin, or gemcitabine]). Patients with disease progression in arm A or C will be allowed to cross over to arm B. Stratification factors include prior bevacizumab use, prior lines of therapy (1 vs. >1), and primary site (ovarian vs. non-ovarian). Key inclusion criteria are histologically proven recurrent or persistent clear cell carcinoma of the ovary, endometrium, cervix, vagina, or vulva; up to five prior lines of therapy; disease progression within 12 months after platinumbased chemotherapy; and measurable disease. Key exclusion criteria are prior treatment with an anti–PD-1, anti–programmed death-ligand 1, or anti–programmed death-ligand 2 agent.The primary endpoint is progression-free survival determined by investigators. Secondary endpoints are ORR, disease control rate, clinical benefit rate, progression-free survival 2, overall survival, and toxicity. Exploratory objectives include immune biomarkers.

Objective: We evaluated the occupational exposure levels of healthcare workers while conducting rotational pressurized intraperitoneal aerosol chemotherapy (RIPAC) using cisplatin in a large animal model. Methods: We performed RIPAC using cisplatin in 6 female pigs and collected surface and air samples during the procedure. Surface samples were obtained from RIPAC devices and personal protective equipment (PPE) by wiping, and air samples were collected around the operating table.All samples were analyzed by inductively coupled plasma–mass spectrometry to detect platinum. Results: Among all surface samples (n=44), platinum was detected in 41 samples (93.2%) but not in all air samples (n=16). Among samples collected from RIPAC devices (n=23), minimum and maximum cisplatin levels of 0.08 and 235.09 ng/cm2 were detected, mainly because of direct aerosol exposure in the abdominal cavity. Among samples collected from healthcare workers’ PPE (n=21), 18 samples (85.7%) showed contamination levels below the detection limit, with a maximum of 0.23 ng/cm2 . There was no significant contamination among samples collected from masks, shoes, or gloves. Conclusion During the RIPAC procedures, there is a potential risk of dermal exposure, as platinum, a surrogate material for cisplatin, was detected at low concentration levels in some surface samples. However, the respiratory exposure risk was not identified, as platinum was not detected in the airborne samples in this study.

Purpose: The career ladder system is a pivotal strategy for securing excellent nurses. The aim of this study is to understand hospital nurses’ experiences of participating in the career ladder system and to explore the essence of this system. Methods: In February 22 to March 3, 2022, nurses employed at a general hospital in South Korea were selected for this study using snowball and purposive sampling. Data were collected from interviews with three focus groups, the compositions of which are as follows: group 1, 6 participants; group 2, 5 participants; and group 3, 6 participants. All interviews were recorded, transcribed verbatim, and subsequently analyzed using qualitative research methods. Results: The following six categories were derived under the overall theme of “the arduous journey to discovering a nurse’s true name”: (1) rites of passage to becoming the ideal nurse; (2) unexpected challenges in the promotion preparation process; (3) biased criteria for evaluating nursing competencies; (4) unclear changes in roles and perceptions after promotion; (5) self-discovered pride and fulfillment as a nurse; and (6) the unspoken struggles of evaluators. Conclusion The findings suggest that the career ladder system fosters nurses’ professional growth and self-actualization. However, for effective implementation, nurses’ deep understanding and systematic management of the career ladder system are essential. This study offers valuable insights and benchmarks for healthcare institutions aiming to adopt the system.

Purpose: This study aimed to compare the factors influencing suicidal ideation among middle and high school students in South Korea. Methods: Data from the 18th Korea Youth Risk Behavior Web-based Survey conducted in 2022 (n=51,850) were analyzed using a logistic regression to calculate the odds ratios for suicidal ideation risk factors. Results: Among middle school students, smoking, drinking, and other delinquent behaviors had higher odds ratios compared to those of high school students. For high school students, depression, loneliness, anxiety, and other mental health issues showed greater odds ratios than in middle school students. The findings highlight developmental differences in suicidal ideation risk profiles between middle and high school students. Targeted prevention and intervention strategies tailored to each age group are recommended. Conclusion Despite the narrow age range, this study revealed distinct patterns of suicidal ideation risk factors among adolescents in their early and late teens. Schools and policymakers should consider these differences when designing suicide prevention programs.

Purpose: This study evaluated the impact of integrating virtual reality (VR) and high-fidelity simulation (HFS) in childbirth nursing education on nursing students’ knowledge, problem-solving ability, nursing performance, and learning satisfaction. Methods: A non-equivalent control group pretest-posttest quasi-experimental design was used. The participants included 41 third-year nursing students, with 21 in the experimental group and 20 in the control group. The experimental group received VR and HFS education, while the control group received HFS alone. The interventions were conducted over 3 weeks, and data collection occurred between May and August 2022. Results: The experimental group showed significant improvements in knowledge, problem-solving ability, and nursing performance compared to the control group. Learning satisfaction was also significantly higher in the experimental group. Conclusion Integrating virtual reality into nursing education can improve learning outcomes and increase satisfaction. Expanding VR-based practical training programs is vital to addressing clinical site shortages and improving educational outcomes.

Purpose: Compassion is integral to nursing, yet the concept of compassionate care is not thoroughly understood. This study aimed to clarify the nature of compassionate care among Korean clinical nurses using a hybrid model. Methods: This study utilized a mixed methods approach involving hybrid concept analysis to explore the nature and attributes of compassionate care, encompassing both theoretical and empirical stages. In the theoretical stage, the domains, attributes, and a preliminary definition of compassionate care were formulated. In the fieldwork stage, in-depth interviews with 18 nurses were conducted to gather insights, which were integrated in the final stage. Results: Compassionate care was categorized into three domains: cognitive, relational, and behavioral, with 11 defining attributes. It was defined as the capacity to recognize individual patient needs, engage empathetically with their suffering, establish trust through emotional connection, and deliver therapeutic partnership, specialized, personalized, ethical, and holistic care. Conclusion This study advances the understanding of compassionate care in nursing by providing a multidimensional framework. It lays the groundwork for future research and practical applications, emphasizing the need for measurement tools and strategies to promote compassionate care among clinical nurses.

Purpose: The purpose of this study was to gain insights into the challenges encountered by families of children with congenital heart defects. Methods: This exploratory study utilized text mining and semantic network analysis methods. Data were collected from domestic portal sites and social networking services between 2020 and 2023 using the TEXTOM program. Keywords were related to the concepts of heart defects, children, and concerns or worries. Text mining was performed using TEXTOM, and semantic network analysis was conducted using UCINET 6.0. Results: In total, 2,083 keywords were extracted from 1,072 texts. Among these, "surgery," "hospital," and "echocardiogram" showed high frequency and centrality. Semantic network analysis indicated that families encountered challenges related to the needs for diverse information for caregiving, choosing healthcare institutions for the best outcome, challenges in disease management and uncertainty in recovery, and unmanageable treatment costs and financial assistance. Conclusion Based on the findings of this study, it is recommended to initiate support programs for families at the point of diagnosis within the community. These programs should be tailored to the specific needs of each family, with the involvement of specialized personnel, and should continue throughout childhood. Furthermore, systemic improvements are necessary to ensure that families have access to reliable official resources to aid in the selection of appropriate healthcare institutions.

Lipoprotein(a) (Lp(a)), is not a new entity; however, it has become an increasingly discussed and studied risk factor for atherosclerotic cardiovascular disease (CVD) and aortic valve stenosis. Recent guidelines recommend measuring Lp(a) levels throughout the lifetime in patients at high risk for CVD, as Lp(a) can serve as a signature marker for identifying individuals at elevated risk for CVD. Numerous genetic and epidemiological studies have underscored the significant causal role of Lp(a) in the incidence of CVD. Individuals with high Lp(a) levels face an increased risk for CVD, even with optimal low-density lipoprotein cholesterol lowering. Furthermore, Lp(a) levels are primarily determined by genetics and are not significantly reduced by lifestyle changes or certain medications. This review will discuss the characteristics, genetic factors, and epidemiological properties of Lp(a) in relation to CVD.