1.Association between Tumor Size at the Time of Disease Progression and Survival Outcomes
Chi Hoon MAENG ; Bum Jun KIM ; Myung-Ju AHN ; In Sil CHOI ; Dae Young ZANG ; Bo-Hyung KIM ; Minji KWON ; Dae Seog HEO ; Bhumsuk KEAM
Cancer Research and Treatment 2025;57(2):362-368
Purpose:
This study evaluates the prognostic significance of tumor size at disease progression (PD) and depth of response (DOR) in cancer patients.
Materials and Methods:
We performed post hoc analysis using data from six prospective clinical trials conducted by the Korean Cancer Study Group. Patients with tumor size at PD was categorized into ‘Mild PD’ and ‘Significant PD’ based on the cutoff values of relative change from baseline using maximally selected rank statistics. The overall survival (OS) and progression-free survival (PFS) were compared between PD and DOR categories.
Results:
Among the 194 evaluable patients, 130 experienced PD. A 35.48% decrease from baseline in tumor size at PD was chosen for the cutoff between mild and significant PD for OS (mild PD: tumor size from the baseline ≤ −35.48%; significant PD > −35.48%). The mild PD had superior OS compared to the significant PD (25.8 vs. 12.8 months; Hazard ratio [HR] 0.47, 95% CI 0.266-0.843, p=0.009). When using an exploratory cutoff based on whether the tumor size was below vs. exceeded from the baseline (mild PD: tumor size from the baseline ≤ 0%; significant PD > 0%), OS remained significantly longer in the mild PD (17.1 vs. 11.8 months; HR 0.60, 95% CI 0.392-0.932, p=0.021). The greatest DOR was associated with the longest OS and PFS (p<0.001 for both).
Conclusion
Tumor size at PD and DOR were significant prognostic factors for progressive disease. Maintaining a sufficiently reduced tumor size even during PD was associated with better survival outcomes.
2.Association between Tumor Size at the Time of Disease Progression and Survival Outcomes
Chi Hoon MAENG ; Bum Jun KIM ; Myung-Ju AHN ; In Sil CHOI ; Dae Young ZANG ; Bo-Hyung KIM ; Minji KWON ; Dae Seog HEO ; Bhumsuk KEAM
Cancer Research and Treatment 2025;57(2):362-368
Purpose:
This study evaluates the prognostic significance of tumor size at disease progression (PD) and depth of response (DOR) in cancer patients.
Materials and Methods:
We performed post hoc analysis using data from six prospective clinical trials conducted by the Korean Cancer Study Group. Patients with tumor size at PD was categorized into ‘Mild PD’ and ‘Significant PD’ based on the cutoff values of relative change from baseline using maximally selected rank statistics. The overall survival (OS) and progression-free survival (PFS) were compared between PD and DOR categories.
Results:
Among the 194 evaluable patients, 130 experienced PD. A 35.48% decrease from baseline in tumor size at PD was chosen for the cutoff between mild and significant PD for OS (mild PD: tumor size from the baseline ≤ −35.48%; significant PD > −35.48%). The mild PD had superior OS compared to the significant PD (25.8 vs. 12.8 months; Hazard ratio [HR] 0.47, 95% CI 0.266-0.843, p=0.009). When using an exploratory cutoff based on whether the tumor size was below vs. exceeded from the baseline (mild PD: tumor size from the baseline ≤ 0%; significant PD > 0%), OS remained significantly longer in the mild PD (17.1 vs. 11.8 months; HR 0.60, 95% CI 0.392-0.932, p=0.021). The greatest DOR was associated with the longest OS and PFS (p<0.001 for both).
Conclusion
Tumor size at PD and DOR were significant prognostic factors for progressive disease. Maintaining a sufficiently reduced tumor size even during PD was associated with better survival outcomes.
3.Association between Tumor Size at the Time of Disease Progression and Survival Outcomes
Chi Hoon MAENG ; Bum Jun KIM ; Myung-Ju AHN ; In Sil CHOI ; Dae Young ZANG ; Bo-Hyung KIM ; Minji KWON ; Dae Seog HEO ; Bhumsuk KEAM
Cancer Research and Treatment 2025;57(2):362-368
Purpose:
This study evaluates the prognostic significance of tumor size at disease progression (PD) and depth of response (DOR) in cancer patients.
Materials and Methods:
We performed post hoc analysis using data from six prospective clinical trials conducted by the Korean Cancer Study Group. Patients with tumor size at PD was categorized into ‘Mild PD’ and ‘Significant PD’ based on the cutoff values of relative change from baseline using maximally selected rank statistics. The overall survival (OS) and progression-free survival (PFS) were compared between PD and DOR categories.
Results:
Among the 194 evaluable patients, 130 experienced PD. A 35.48% decrease from baseline in tumor size at PD was chosen for the cutoff between mild and significant PD for OS (mild PD: tumor size from the baseline ≤ −35.48%; significant PD > −35.48%). The mild PD had superior OS compared to the significant PD (25.8 vs. 12.8 months; Hazard ratio [HR] 0.47, 95% CI 0.266-0.843, p=0.009). When using an exploratory cutoff based on whether the tumor size was below vs. exceeded from the baseline (mild PD: tumor size from the baseline ≤ 0%; significant PD > 0%), OS remained significantly longer in the mild PD (17.1 vs. 11.8 months; HR 0.60, 95% CI 0.392-0.932, p=0.021). The greatest DOR was associated with the longest OS and PFS (p<0.001 for both).
Conclusion
Tumor size at PD and DOR were significant prognostic factors for progressive disease. Maintaining a sufficiently reduced tumor size even during PD was associated with better survival outcomes.
4.Voice of Customer Analysis of Nursing Care in a Tertiary Hospital:Text Network Analysis and Topic Modeling
Hyunjung KO ; Nara HAN ; Seulki JEONG ; Jeong A JEONG ; Hye Ryoung YUN ; Eun Sil KIM ; Young Jun JANG ; Eun Ju CHOI ; Chun Hoe LIM ; Min Hee JUNG ; Jung Hee KIM ; Dong Hyu CHO ; Seok Hee JEONG
Journal of Korean Academy of Nursing Administration 2024;30(5):529-542
Purpose:
This study aimed to explore customer perspectives of nursing services in tertiary hospitals.
Methods:
The data comprised mobile Voice Of Customer (VOC) data related to “nursing” or “nurses” generated from June 25, 2019, to December 31, 2022, in a tertiary hospital. A total of 44,727 VOC data points were collected, of which 4,040 were selected for the final analysis. Text network analysis and topic modeling were conducted using NetMiner 4.5.1.
Results:
Topic modeling identified five topics for positive aspects and four topics for areas requiring improvement.The positive aspects were: 1) sincere nursing care; 2) rapid response from professional medical staff; 3) teamwork for delivering customer-centric services; 4) provision and coordination of system-based healthcare services; and 5) customer-focused responsiveness. The areas requiring improvement were: 1) demand for skilled nursing care tailored to customer expectations; 2) demand for enhanced communication and reduced mechanical responses; 3) demand for appropriate handling of diverse situations; and 4) demand for overall improvements to the healthcare system, including reservation systems.
Conclusion
These results may be used to enhance customer and patient experiences in tertiary hospitals and are necessary for utilization from a hospital management perspective.
5.Voice of Customer Analysis of Nursing Care in a Tertiary Hospital:Text Network Analysis and Topic Modeling
Hyunjung KO ; Nara HAN ; Seulki JEONG ; Jeong A JEONG ; Hye Ryoung YUN ; Eun Sil KIM ; Young Jun JANG ; Eun Ju CHOI ; Chun Hoe LIM ; Min Hee JUNG ; Jung Hee KIM ; Dong Hyu CHO ; Seok Hee JEONG
Journal of Korean Academy of Nursing Administration 2024;30(5):529-542
Purpose:
This study aimed to explore customer perspectives of nursing services in tertiary hospitals.
Methods:
The data comprised mobile Voice Of Customer (VOC) data related to “nursing” or “nurses” generated from June 25, 2019, to December 31, 2022, in a tertiary hospital. A total of 44,727 VOC data points were collected, of which 4,040 were selected for the final analysis. Text network analysis and topic modeling were conducted using NetMiner 4.5.1.
Results:
Topic modeling identified five topics for positive aspects and four topics for areas requiring improvement.The positive aspects were: 1) sincere nursing care; 2) rapid response from professional medical staff; 3) teamwork for delivering customer-centric services; 4) provision and coordination of system-based healthcare services; and 5) customer-focused responsiveness. The areas requiring improvement were: 1) demand for skilled nursing care tailored to customer expectations; 2) demand for enhanced communication and reduced mechanical responses; 3) demand for appropriate handling of diverse situations; and 4) demand for overall improvements to the healthcare system, including reservation systems.
Conclusion
These results may be used to enhance customer and patient experiences in tertiary hospitals and are necessary for utilization from a hospital management perspective.
6.Voice of Customer Analysis of Nursing Care in a Tertiary Hospital:Text Network Analysis and Topic Modeling
Hyunjung KO ; Nara HAN ; Seulki JEONG ; Jeong A JEONG ; Hye Ryoung YUN ; Eun Sil KIM ; Young Jun JANG ; Eun Ju CHOI ; Chun Hoe LIM ; Min Hee JUNG ; Jung Hee KIM ; Dong Hyu CHO ; Seok Hee JEONG
Journal of Korean Academy of Nursing Administration 2024;30(5):529-542
Purpose:
This study aimed to explore customer perspectives of nursing services in tertiary hospitals.
Methods:
The data comprised mobile Voice Of Customer (VOC) data related to “nursing” or “nurses” generated from June 25, 2019, to December 31, 2022, in a tertiary hospital. A total of 44,727 VOC data points were collected, of which 4,040 were selected for the final analysis. Text network analysis and topic modeling were conducted using NetMiner 4.5.1.
Results:
Topic modeling identified five topics for positive aspects and four topics for areas requiring improvement.The positive aspects were: 1) sincere nursing care; 2) rapid response from professional medical staff; 3) teamwork for delivering customer-centric services; 4) provision and coordination of system-based healthcare services; and 5) customer-focused responsiveness. The areas requiring improvement were: 1) demand for skilled nursing care tailored to customer expectations; 2) demand for enhanced communication and reduced mechanical responses; 3) demand for appropriate handling of diverse situations; and 4) demand for overall improvements to the healthcare system, including reservation systems.
Conclusion
These results may be used to enhance customer and patient experiences in tertiary hospitals and are necessary for utilization from a hospital management perspective.
7.Voice of Customer Analysis of Nursing Care in a Tertiary Hospital:Text Network Analysis and Topic Modeling
Hyunjung KO ; Nara HAN ; Seulki JEONG ; Jeong A JEONG ; Hye Ryoung YUN ; Eun Sil KIM ; Young Jun JANG ; Eun Ju CHOI ; Chun Hoe LIM ; Min Hee JUNG ; Jung Hee KIM ; Dong Hyu CHO ; Seok Hee JEONG
Journal of Korean Academy of Nursing Administration 2024;30(5):529-542
Purpose:
This study aimed to explore customer perspectives of nursing services in tertiary hospitals.
Methods:
The data comprised mobile Voice Of Customer (VOC) data related to “nursing” or “nurses” generated from June 25, 2019, to December 31, 2022, in a tertiary hospital. A total of 44,727 VOC data points were collected, of which 4,040 were selected for the final analysis. Text network analysis and topic modeling were conducted using NetMiner 4.5.1.
Results:
Topic modeling identified five topics for positive aspects and four topics for areas requiring improvement.The positive aspects were: 1) sincere nursing care; 2) rapid response from professional medical staff; 3) teamwork for delivering customer-centric services; 4) provision and coordination of system-based healthcare services; and 5) customer-focused responsiveness. The areas requiring improvement were: 1) demand for skilled nursing care tailored to customer expectations; 2) demand for enhanced communication and reduced mechanical responses; 3) demand for appropriate handling of diverse situations; and 4) demand for overall improvements to the healthcare system, including reservation systems.
Conclusion
These results may be used to enhance customer and patient experiences in tertiary hospitals and are necessary for utilization from a hospital management perspective.
8.Development of Parent Guidelines for Parent-Performed Developmental Screening Tests
Sung Sil RAH ; Soon-Beom HONG ; Ju Young YOON
Journal of the Korean Academy of Child and Adolescent Psychiatry 2023;34(2):141-149
Objectives:
Most developmental screening tests have been built as parent-performed questionnaires. However, they often do not guide parents on how to answer the questionnaire. This study aimed to develop easily applicable parent guidelines.
Methods:
We implemented the Delphi procedure with 20 panelists. The development of the initial questionnaire was based on the results of two surveys of parents and experts provided by a policy research report that investigated the item adequacy of the Korean Developmental Screening Test. Round one included 33 items comprising all possible measurements in six categories that were identified as difficult to understand or confusing. Round two merged and modified some items and included 32 items. We defined consensus as a median agreement value of one or less and convergence and stability values of 0.5 or less. The subjective usefulness of the parent guidelines was examined based on their previous test experiences.
Results:
Consensus was reached after the second round, reflecting the items with the highest level of accuracy in each category. Of the 167 parents who participated in the survey, 113 (67.7%) affirmed the usefulness of the guidelines, while 10 (6.0%) answered that they were not useful. Items that recommended a different scoring strategy in answering the questionnaire from their previous measurements were found to be more useful by the parents.
Conclusion
The parent guidelines, composed of five bullet points, drew on the consensus of the experts. Further studies are required to assess whether these guidelines improve the accuracy of screening tests in clinical settings.
9.Status and Needs for the Return to School of Childhood and Adolescent Cancer Survivors
Eun Sil PARK ; Eun Young JU ; Jae Young LIM ; Hyun Sik KANG ; Jin Kyung SUH ; Meerim PARK ; Jun Ah LEE ; Bo-Yoon JEONG ; Young Ae KIM ; Hyeon Jin PARK
Clinical Pediatric Hematology-Oncology 2023;30(2):60-69
Background:
As the treatment effects for childhood and adolescent cancer continue to improve, the survivor group is gradually growing and their age is increasing. This study aimed to determine the perceptions toward childhood and adolescent cancer survivors and assess the current situation regarding their return to school, to undertake policy development to help them grow into healthy members of society.
Methods:
From December 2019, for about 4 months, a structured questionnaire was used to conduct one-on-one interviews with childhood and adolescent cancer survivors and their parents, as well as with parents of healthy children and adolescents.
Results:
The participants included 79 survivors of childhood and adolescent cancer, 186 parents of cancer survivors, and 661 general parents; their mean age was 21.8, 13.9, and 12.5 years, respectively. After completing their cancer treatment, 77.2% of the cancer survivors returned to school, with the majority returning to regular schools in the same grade as their peers. Reasons for not returning to school (20.3%) included concerns about health management (43.8%), concerns about psychological and emotional adjustment (12.5%), and poor school attendance (12.5%). Among the parents of cancer survivors, 48.9% stated that they were “satisfied” with their children’s school life; a better health status in children was associated with a higher level of satisfaction (P=0.0071). In addition, they stated that national-level support was needed in the following areas for a successful return to school: a continuous health management system (36.1%) and understanding homeroom teachers who enable flexible participation in classes and school events (29.5%).
Conclusion
For survivors of childhood and adolescent cancer to successfully return to school and society, nationwide awareness-raising activities should be expanded, in addition to services that are tailored to the survivors’ needs and characteristics such as management of physical and mental health and educating homeroom teachers and peers.
10.Clinical Characteristics and Treatment Outcomes of Childhood Acute Promyelocytic Leukemia in Korea: A Nationwide Multicenter Retrospective Study by Korean Pediatric Oncology Study Group
Kyung Mi PARK ; Keon Hee YOO ; Seong Koo KIM ; Jae Wook LEE ; Nack-Gyun CHUNG ; Hee Young JU ; Hong Hoe KOO ; Chuhl Joo LYU ; Seung Min HAN ; Jung Woo HAN ; Jung Yoon CHOI ; Kyung Taek HONG ; Hyoung Jin KANG ; Hee Young SHIN ; Ho Joon IM ; Kyung-Nam KOH ; Hyery KIM ; Hoon KOOK ; Hee Jo BAEK ; Bo Ram KIM ; Eu Jeen YANG ; Jae Young LIM ; Eun Sil PARK ; Eun Jin CHOI ; Sang Kyu PARK ; Jae Min LEE ; Ye Jee SHIM ; Ji Yoon KIM ; Ji Kyoung PARK ; Seom Gim KONG ; Young Bae CHOI ; Bin CHO ; Young Tak LIM
Cancer Research and Treatment 2022;54(1):269-276
Purpose:
Acute promyelocytic leukemia (APL) is a rare disease in children and there are some different characteristics between children and adult. We aimed to evaluate incidence, clinical characteristics and treatment outcomes of pediatric APL in Korea.
Materials and Methods:
Seventy-nine pediatric APL patients diagnosed from January 2009 to December 2016 in 16 tertiary medical centers in Korea were reviewed retrospectively.
Results:
Of 801 acute myeloid leukemia children, 79 (9.9%) were diagnosed with APL. The median age at diagnosis was 10.6 years (range, 1.3 to 18.0). Male and female ratio was 1:0.93. Thirty patients (38.0%) had white blood cell (WBC) count greater than 10×109/L at diagnosis. All patients received induction therapy consisting of all-trans retinoic acid and chemotherapy. Five patients (6.6%) died during induction chemotherapy and 66 patients (86.8%) achieved complete remission (CR) after induction chemotherapy. The causes of death were three intracranial hemorrhage, one cerebral infarction, and one sepsis. Five patients (7.1%) suffered a relapse during or after maintenance chemotherapy. The estimated 4-year event-free survival and overall survival (OS) rates were 82.1%±4.4%, 89.7%±5.1%, respectively. The 4-year OS was significantly higher in patients with initial WBC < 10×109/L than in those with initial WBC ≥ 10×109/L (p=0.020).
Conclusion
This study showed that the CR rates and survival outcomes in Korean pediatric APL patients were relatively good. The initial WBC count was the most important prognostic factor and most causes of death were related to serious bleeding in the early stage of treatment.

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