Recently, a number of evidences that human papillomavirus (HPV) testing was efficient in cervical cancer screening were introduced. Moreover, successful trial outcome of preventive cancer vaccine opened new era of cervical cancer prevention. However, undoubtedly, applying new cancer screening and prevention strategy would bring on economical concern about increased medical expense. Therefore, appropriate cost-benefit analysis is very important before establishing new strategy as standard policy. In this article, we presented a few recent results about cost-benefit effectiveness by other group. And we also suggested what would be needed to perform successful.
Cost-Benefit Analysis ; Early Detection of Cancer ; Humans* ; Mass Screening ; Uterine Cervical Neoplasms

No abstract available.
Humans ; Ovarian Neoplasms ; Tumor Burden

No abstract available.
Endometrial Neoplasms* ; Female ; Lymph Nodes* ; Neoplasm Metastasis*

No abstract available.
Adenocarcinoma ; Conization

No abstract available.
Ovarian Neoplasms*

No abstract available.
Risk Factors

We performed a retrospective study to evaluate the feasibility and safety of extensive upper abdominal surgery (EUAS) in elderly (> or =65 yr) patients with advanced ovarian cancer. Records of patients with advanced epithelial ovarian cancer who received surgery at our institution between January 2001 and June 2005 were reviewed. A total of 137 patients including 32 (20.9%) elderly patients were identified. Co-morbidities were present in 37.5% of the elderly patients. Optimal cytoreduction was feasible in 87.5% of the elderly while 95.2% of young patients were optimally debulked (P=0.237). Among 77 patients who received one or more EUAS procedures, 16 (20.8%) were elderly. Within the cohort, the complication profile was not significantly different between the young and the elderly, except for pleural effusion and pneumothorax (P=0.028). Elderly patients who received 2 or more EUAS procedures, when compared to those 1 or less EUAS procedure, had significantly longer operation times (P=0.009), greater blood loss (P=0.002) and more intraoperative transfusions (P=0.030). EUAS procedures are feasible in elderly patients with good general condition. However, cautious peri-operative care should be given to this group because of their vulnerability to pulmonary complications and multiple EUAS procedures.
Abdomen/*surgery ; Adult ; Age Factors ; Aged ; Disease-Free Survival ; Female ; *Gynecologic Surgical Procedures/adverse effects ; Humans ; Kaplan-Meiers Estimate ; Middle Aged ; Ovarian Neoplasms/mortality/*pathology/*surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: The aim of the current study is to test whether immortalized B-lymphocyte cell line via Ebstein-Barr virus (EBV) transformation is feasible and can be an unlimited source of genome wide study. METHODS: We obtained peripheral whole blood from 5 ovarian cancer patients and immortalized the B-cell lines using EBV transformation. The success rate was analyzed and the bio-identity of the genome was performed using human leukocyte antigen (HLA) identity test. RESULTS: EBV transformation was successful in all 5 cases (95% confidence interval, 46.3% to 100%). After cryopreservation of EBV-transformed B-cell lines and subsequent thawing, we observed that all cell lines were viable and proliferative. To check bio-identity, HLA-A, B, and DR were tested between the genome of the original samples and the transformed samples. The HLA typing revealed that all observed HLA-A, B, and DR type was identical in 5 cases before and after EBV-transformation. CONCLUSION: The current results suggest that EBV-transformation of peripheral blood is an efficient tool in genome banking. The EBV-transformed B-cell lines may be a valuable resource of genome in multi-center translational research by the Korean Gynecologic Oncology Group.
B-Lymphocytes ; Cell Line ; Cryopreservation ; Genome ; Genomics ; Herpesvirus 4, Human ; Histocompatibility Testing ; HLA-A Antigens ; Humans ; Leukocytes ; Ovarian Neoplasms ; Viruses

OBJECTIVES: Unequal access to cancer clinical trials is an important issue, given the potential benefits of participation for cancer patients. We evaluated regional disparities in access to cancer clinical trials in Korea. METHODS: From the Ministry of Food and Drug Safety database, we extracted 2,465 records of all cancer clinical trials approved between January 2012 and April 2023. To measure disparities in cancer clinical trial access, we calculated the ratio of clinical trials open to non-capital areas relative to those open to capital areas. We then analyzed temporal trends in this ratio, which we termed the trial geographical equity index (TGEI). RESULTS: Disparities in access to cancer clinical trials, as indicated by the TGEI, did not significantly improve during the study period (regression coefficient, 0.002; p=0.59). However, for phase II/III trials sponsored by global pharmaceutical companies, the TGEI improved significantly (regression coefficient, 0.021; p<0.01). In contrast, the TGEI deteriorated for trials initiated by investigators or those testing domestically developed therapeutics (regression coefficient, -0.015; p=0.05). Furthermore, the increasing trend of TGEI for phase II/III trials sponsored by global companies began to reverse after 2019, coinciding with the outbreak of coronavirus disease 2019 (COVID-19). CONCLUSIONS Over the past decade, access to cancer clinical trials has improved in Korea, particularly for phase II/III trials evaluating therapeutics from global companies. However, this increase in accessibility has not extended to trials initiated by investigators or those assessing domestically developed therapeutics. Additionally, the impact of COVID-19 on disparities in clinical trial access should be closely monitored.

OBJECTIVE: The aim of this study was to identify a standard for the evaluation of future models for prediction of lymph node metastasis in endometrial cancer through estimation of performance of well-known surgicopathological models. METHODS: Using the medical records of 947 patients with endometrial cancer who underwent surgical management with lymphadenectomy, we retrospectively assessed the predictive performances of nodal metastasis of currently available models. RESULTS: We evaluated three models included: 1) a model modified from the Gynecologic Oncology Group (GOG) pilot study; 2) one from the GOG-33 data; and 3) one from Mayo Clinic data. The three models showed similar negative predictive values ranging from 97.1% to 97.4%. Using Bayes' theorem, this can be translated into 2% of negative post-test probability when 10% of prevalence of lymph node metastasis was assumed. In addition, although the negative predictive value was similar among these models, the proportion that was classified as low-risk was significantly different between the studies (56.4%, 44.8%, and 30.5%, respectively; p<0.001). CONCLUSION: The current study suggests that a false negativity of 2% or less should be a goal for determining clinical usefulness of preoperative or intraoperative prediction models for low-risk of nodal metastasis.
Endometrial Neoplasms ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Prevalence ; Retrospective Studies ; Sensitivity and Specificity