Objective: This study aimed to investigate the impact of polycystic ovary syndrome (PCOS) on fertility-sparing treatment in young patients with atypical endometrial hyperplasia (AEH) or endometrioid endometrial cancer (EEC). Methods: A total of 285 patients with EEC (n=76, FIGO stage IA, without myometrium invasion) or AEH (n=209) who received progestin-based fertility-sparing treatment were evaluated retrospectively. Among the 285 patients, 103 (36.1%), including 70 AEH cases and 33 EEC cases, were diagnosed with PCOS. General characteristics, cumulative 16- and 32-week complete response (CR) rate, pregnancy outcome and recurrence were compared between patients with or without PCOS. Results: The cumulative 16-week CR rate was lower in the PCOS group than in the non-PCOS group (18.4% vs. 33.8%, p=0.006). Patients with PCOS took longer treatment duration to achieve CR (7.0 months vs. 5.4 months, p=0.006) and shorter time to relapse after CR (9.6 months vs. 17.6 months, p=0.040) compared with non-PCOS group. After adjusting for patient age, body mass index, PCOS, homeostasis model assessment-insulin resistance index, and serum testosterone levels, we found that body mass index ≥25 kg/m2 (HR=0.583; 95% CI=0.365–0.932; p=0.024) and PCOS (HR=0.545; 95% CI=0.324–0.917; p=0.022) were significantly correlated with lower 16-week CR rate. Conclusion PCOS was associated with lower 16-week CR rate, longer treatment duration and shorter recurrence interval in patients with AEH or EEC receiving fertility-preserving treatment.

Objective: This study aimed to investigate the impact of molecular classification and PTEN, KRAS and PIK3CA gene mutation on the outcome of fertility-preserving treatment in the patients with endometrioid endometrial cancer (EEC) and endometrial atypical hyperplasia (EAH). Methods: This is a single-center retrospective study. A total of 135 patients with EEC and EAH receiving fertility-preserving treatment and molecular classification were reviewed. The distribution of the four types of molecular classification was described. The impact of non-specific molecular profile (NSMP), mismatch repair-deficiency (MMRd), and PTEN, KRAS and PIK3CA gene mutation on the outcome of fertility-preserving treatment was analyzed. Results: Of the patients analyzed, 86.7% (117/136) were classified as having NSMP; 14 (10.4%), MMRd; 1 (0.7%), POLEmut EAH; and 3 (2.2%), p53abn EEC. The patients having NSMP and MMRd achieved similar 16-, 32-, and 48-week complete response rates. The patients harboring tier I and tier II PTEN mutations (PTENmut-Clin) achieved lower cumulative 32-week CR rates than those with PTEN-others (without PTENmut-Clin) (22/47, 46.8% vs. 50/74, 67.6%; p=0.023; odds ratio=0.422; 95% confidence interval [CI]=0.199–0.896). Insulin-resistance (hazard ratio [HR]=0.435; 95% CI=0.269–0.702; p=0.001) and PTENmut-Clin (HR=0.535; 95% CI=0.324–0.885; p=0.015) were independent negative predictors for lower 32-week CR rates. Conclusion PTENmut-Clin is an independent risk factor for unfavorable fertility-preserving treatment outcomes in the patients with EEC and EAH. The patients with MMRd receiving fertility-preserving treatment achieved outcomes similar to those of the patients with NSMP. The molecular profiles might guide fertility-preserving treatment in the prognosis and clinical decisions.

Objective: To evaluate the therapeutic effect and security of Buyang Huanwu decoction in treatment of the ischemic stroke recovery. Methods: We retrieved the relevant articles of random and semi- random control trials in treating ischemic stroke recovery using Buyang Huanwu decoction, published in China National Knowledge Infrastructure (CNKI), the Wanfang Data, the Weipu Information Resources System, the Chinese Biomedical Literature Database (CBM), Cochrane Library, PUBMED and MEDLINE from the date of establishment until to March 2018. The quality of studies was evaluated according to the Cochrane Reviewers?? handbook 5.1, and the study was carried out using Cochrane system assessment methods. Statistical analysis was performed with Rev Man 5.3. Results: Altogether 39 studies and 3539 cases of ischemic stroke recovery were enrolled. In terms of clinical efficacy, the difference between Buyang Huanwu Decoction and Western Medicine conventional therapy in the treatment of ischemic stroke was significantly different from that of conventional western medicine therapy [RR =1.26, 95％CI (1.20, 1.31), Z =10.05, P ＜ 0.00001], and the difference between Buyang Huanwu Decoction and other Chinese patent medicines was statistically significant [RR =1.12, 95％CI(1.06, 1.19), Z =3.82, P =0.0001]; neurological deficit NIHSS score [MD =-2.55, 95％CI (-3.10, -2.01), Z =9.20, P ＜ 0.00001]; clinical neurological deficit score (CSS) [MD =-3.85, 95％CI (-5.21, -2.50), Z =5.56, P ＜ 0.00001]; limb motor function score (FMA) [MD =6.10, 95％CI (1.19, 11.01), Z =2.43, P =0.01]; Barthel Index of Daily Living Activity Scale [MD =9.09, 95％CI (6.95, 11.23), Z =8.33, P ＜ 0.00001]; In terms of improving blood rheology index, serum peroxide lipid (LPO), serum superoxide dismutase (SOD) and other biochemical indicators, due to the small number of studies, it may have a certain effect. Most studies did not report adverse reactions. Conclusion: Based on the existing clinical evidence, combination of Buyang Huanwu decoction and western medicine has higher clinical efficacy than western medicine alone for the ischemic stroke recovery. Due to the limited methodological quality of the included studies, more high- quality RCTs with large scale are needed to increase the strength of the above evidence.

The Asian Society of Gynecologic Oncology International Workshop 2018 on gynecologic oncology was held in the Ajou University Hospital, Suwon, Korea on the 24th to 25th August 2018. The workshop was an opportunity for Asian doctors to discuss the latest findings of gynecologic cancer, including cervical, ovarian, and endometrial cancers, as well as the future of fertility-sparing treatments, minimally invasive/radical/debulking surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy. Clinical guidelines and position statement of Asian countries were presented by experts. Asian clinical trials for gynecologic cancers were reviewed and experts emphasized the point that original Asian study is beneficial for Asian patients. In Junior session, young gynecologic oncologists presented their latest research on gynecologic cancers.
Antineoplastic Agents ; Asian Continental Ancestry Group ; Drug Therapy ; Education ; Endometrial Neoplasms ; Female ; Gyeonggi-do ; Humans ; Immunotherapy ; Korea ; Ovarian Neoplasms ; Radiotherapy ; Uterine Cervical Neoplasms