7.Health-Related Quality of Life Assessment in Prostate Cancer Patient Undergoing Androgen Deprivation Therapy: Real-World Experience in the READT Study
Jasmine LIM ; Chi-Fai NG ; Yong WEI ; Teng Aik ONG ; Peggy Sau-Kwan CHU ; Wayne Kwun Wai CHAN ; Chao Yuan HUANG ; Kuo-Kang FENG ; Jeremy Yuen-Chun TEOH ; Ning XU ; Jer Wei LOW ; Wei Sien YEOH ; Peter Ka-Fung CHIU ; Chi-Hang YEE ; Steven Chi Ho LEUNG
The World Journal of Men's Health 2024;42(2):449-459
Purpose:
To investigate the effect of androgen deprivation therapy (ADT) on health-related quality of life (HRQOL) in Asian men with all stages of prostate cancer.
Materials and Methods:
READT (real-life evaluation of the effect of ADT in prostate cancer patients in Asia) was a multi-center, prospective observational study involving six sites across four Asian populations. We enrolled eligible prostate cancer patients, who opted for ADT alone or in combination without prior neoadjuvant or adjuvant ADT within 12 months. The EuroQoL-5 dimensions, 5 level scale (EQ-5D-5L) utility index scores and visual analog scale (VAS) were evaluated at baseline, month 6 and month 12.
Results:
A total of 504 patients were recruited into READT between September 2016 and May 2020 with 52.9% diagnosed with metastatic prostate cancer. The EQ-5D-5L was evaluable in 442/504 (87.7%) of patients. Overall baseline EQ-5D-5L utility index score was 0.924 (interquartile range [IQR] 0.876–1.000). We observed a statistically significant difference in baseline EQ-5D-5L utility index score among different populations with a median EQ-5D-5L utility index score of 1 for Taiwan & Hong Kong, 0.897 for China and 0.838 for Malaysia. Similar trend was observed throughout multiple treatment time-points. Stage IV prostate cancer were significantly associated with a lower baseline EQ-5D-5L utility index score compared to stage I–III prostate cancer, producing a median disutility value of -0.080. Participants had a high median VAS (80, IQR 70–90), indicating good overall health on average during ADT initiation.
Conclusions
The study highlights the differences in health state utility index scores among various Asian prostate cancer patients receiving ADT at real-world setting. Our findings will be informative and useful in cost-effectiveness evaluation and policy decision making.
8.Clinical Outcome of Endoscopic Submucosal Dissection for Papillary Type Early Gastric Cancer: A Multicenter Study
Hyun-Deok SHIN ; Ki Bae BANG ; Sun Hyung KANG ; Hee Seok MOON ; Jae Kyu SUNG ; Hyun Yong JEONG ; Dong Kyu LEE ; Ki Bae KIM ; Sun Moon KIM ; Seung Woo LEE ; Dong Soo LEE ; Young Sin CHO ; Il-Kwun CHUNG ; Ju Seok KIM
Gut and Liver 2024;18(3):426-433
Background/Aims:
Papillary adenocarcinoma is classified to differentiated-type gastric cancer and is indicated for endoscopic submucosal dissection. However, due to its rare nature, there are limited studies on it. The purpose of this study was to determine the outcome of endoscopic submucosal dissection in patients with papillary-type early gastric cancer and to find the risk factors of lymph node metastasis.
Methods:
Patients diagnosed with papillary-type early gastric cancer at eight medical centers, who underwent endoscopic submucosal dissection or surgical treatment, were retrospectively reviewed. The clinical results and long-term outcomes of post-endoscopic submucosal dissection were evaluated, and the risk factors of lymph node metastasis in the surgery group were analyzed.
Results:
One-hundred and seventy-six patients with papillary-type early gastric cancer were enrolled: 44.9% (n=79) in the surgery group and 55.1% (n=97) in the endoscopic submucosal dissection group. As a result of endoscopic submucosal dissection, the en bloc resection and curative resection rates were 91.8% and 86.6%, respectively. The procedure-related complication rate was 4.1%, and local recurrence occurred in 3.1% of patients. Submucosal invasion (odds ratio, 3.735; 95% confidence interval, 1.026 to 12.177; p=0.047) and lymphovascular invasion (odds ratio, 7.636; 95% confidence interval, 1.730 to 22.857; p=0.004) were the risk factors of lymph node metastasis in papillary-type early gastric cancer patients.
Conclusions
The clinical results of endoscopic submucosal dissection in papillary-type early gastric cancer were relatively favorable, and endoscopic submucosal dissection is considered safe if appropriate indications are confirmed by considering the risk of lymph node metastasis.
9.Risk of Cerebral Aneurysm Rupture After Liver Transplantation:Development and Validation of a Hemorrhagic Stroke Scoring Model
Minwoo KIM ; Jae Hyun KIM ; Wonhyoung PARK ; Jung Cheol PARK ; Jae Sung AHN ; Byung Duk KWUN ; Sung-Gyu LEE ; Shin HWANG ; Moinay KIM ; Seungjoo LEE
Journal of Korean Medical Science 2024;39(9):e88-
Background:
Liver transplantation (LT) patients appear to be more prone to neurological events compared to individuals undergoing other types of solid-organ transplantation.The aims of the present study were to analyze the prevalence of unruptured intracranial aneurysms (UIAs) in patients undergoing liver transplantation (LT) and to examine the perioperative occurrence of subarachnoid hemorrhage (SAH). Also, it intended to systematically identify the risk factors of SAH and hemorrhagic stroke (HS) within a year after LT and to develop a scoring system which involves distinct clinical features of LT patients.
Methods:
Patients who underwent LT from January 2012 to March 2022 were analyzed.All included patients underwent neurovascular imaging within 6 months before LT. We conducted an analysis of prevalence and radiological features of UIA and SAH. The clinical factors that may have an impact on HS within one year of LT were also reviewed.
Results:
Total of 3,487 patients were enrolled in our study after applying inclusion and exclusion criteria. The prevalence of UIA was 5.4%. The incidence of SAH and HS within one year following LT was 0.5% and 1.6%, respectively. We developed a scoring system based on multivariable analysis to predict the HS within 1-year after LT. The variables were a poor admission mental status, the diagnosis of UIA, serum ammonia levels, and Model for End-stage Liver Disease (MELD) scores. Our model showed good discrimination among the development (C index, 0.727; 95% confidence interval [CI], 0.635–0.820) and validation (C index, 0.719; 95% CI, 0.598–0.801) cohorts.
Conclusion
The incidence of UIA and SAH was very low in LT patients. A poor admission mental status, diagnosis of UIA, serum ammonia levels, and MELD scores were significantly associated with the risk of HS within one year after LT. Our scoring system showed a good discrimination to predict the HS in LT patients.
10.Zinc dietary reference intakes and factorial analysis
Young-Eun CHO ; Mi-Kyung LEE ; Jae-Hee KWON ; In-Sook KWUN
Journal of Nutrition and Health 2024;57(4):365-375
Purpose:
Zinc is involved in regulating homeostasis and metabolism in the body, and understanding these processes is important for estimating intake requirements. This review aimed to assist in setting the standards for Dietary Reference Intakes for Koreans (KDRIs, 2025) for zinc by examining specific factors associated with role of zinc in the body and using the factorial analysis method.
Methods:
We reviewed the zinc-specific factors that should be considered when setting the required zinc intake to maintain zinc homeostasis in the body and used the factorial analysis method for estimating zinc requirements for different population groups.
Results
Factorial analysis involves estimating the required intake based on various factors that affect zinc metabolism and requirements. The key components and steps involved in determining the zinc dietary reference intake (DRI), particularly the estimated average requirement (EAR), include: 1) Estimating basal requirements, which involves calculating the amount of zinc needed to replace natural losses through the intestinal (feces) and nonintestinal (urine, skin and other body secretions) routes, 2) Accounting for the various biomarkers related to metabolic functions of zinc, 3) Considering physiological requirements for zinc, such as those for growth, development, pregnancy, and lactation since zinc is essential for DNA and protein synthesis, and 4) Estimating the dietary absorption rate of zinc. Conclusion: The factorial analysis for zinc requirement is based on scientific evidence and is tailored to meet the requirements of different population groups, ensuring optimal health and preventing deficiency. It includes considerations of physiological needs, dietary absorption, and population-specific characteristics.

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