Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease primarily targeting the joints, leading to progressive inflammation, joint damage, and functional impairment. The pathogenesis of RA involves a complex interplay of genetic predisposition and environmental factors, such as smoking, which together drive the dysregulated activation of both the innate and adaptive immune systems. The introduction of disease-modifying antirheumatic drugs marked a pivotal advancement in RA management, transforming the disease from a debilitating chronic condition into a treatable disorder. Ongoing progress in basic and clinical research has identified novel therapeutic targets, paving the way for precision medicine tailored to individual patient needs, with the ultimate goal of achieving long-term remission. This review outlines current treatment options and summarizes key treatment guidelines established by major rheumatology societies. Additionally, it highlights emerging therapies, including selective glucocorticoid receptor modulators, and Bruton’s tyrosine kinase inhibitors, and epigenetic modulators. Finally, novel cell-based therapies, such as chimeric antigen receptor T cells and T cell engagers, which hold the potential to enable durable, drug-free remission.These current and emerging treatments will help further optimize RA management and improve patient outcomes.

Background: s/Aims: Hepatocellular carcinoma (HCC) is the sixth most common cancer and second leading cause of cancer-related deaths in South Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2016-2018. Methods: Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative database of patients newly diagnosed with HCC in South Korea, were analyzed. This study investigated 4,462 patients with HCC registered in the KPLCR in 2016-2018. Results: The median patient age was 63 years (interquartile range, 55-72). 79.7% of patients were male. Hepatitis B infection was the most common underlying liver disease (54.5%). The Barcelona Clinic Liver Cancer (BCLC) staging system classified patients as follows: stage 0 (14.9%), A (28.8%), B (7.5%), C (39.0%), and D (9.8%). The median overall survival was 3.72 years (95% confidence interval, 3.47-4.14), with 1-, 3-, and 5-year overall survival rates of 71.3%, 54.1%, and 44.3%, respectively. In 2016-2018, there was a significant shift toward BCLC stage 0-A and Child-Turcotte-Pugh liver function class A (P<0.05), although survival rates did not differ by diagnosis year. In the treatment group (n=4,389), the most common initial treatments were transarterial therapy (31.7%), surgical resection (24.9%), best supportive care (18.9%), and local ablation therapy (10.5%). Conclusions Between 2016 and 2018, HCC tended to be diagnosed at earlier stages, with better liver function in later years. However, since approximately half of the patients remained diagnosed at an advanced stage, more rigorous and optimized HCC screening strategies should be implemented.

Background: s/Aims: Hepatocellular carcinoma (HCC) is the sixth most common cancer and second leading cause of cancer-related deaths in South Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2016-2018. Methods: Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative database of patients newly diagnosed with HCC in South Korea, were analyzed. This study investigated 4,462 patients with HCC registered in the KPLCR in 2016-2018. Results: The median patient age was 63 years (interquartile range, 55-72). 79.7% of patients were male. Hepatitis B infection was the most common underlying liver disease (54.5%). The Barcelona Clinic Liver Cancer (BCLC) staging system classified patients as follows: stage 0 (14.9%), A (28.8%), B (7.5%), C (39.0%), and D (9.8%). The median overall survival was 3.72 years (95% confidence interval, 3.47-4.14), with 1-, 3-, and 5-year overall survival rates of 71.3%, 54.1%, and 44.3%, respectively. In 2016-2018, there was a significant shift toward BCLC stage 0-A and Child-Turcotte-Pugh liver function class A (P<0.05), although survival rates did not differ by diagnosis year. In the treatment group (n=4,389), the most common initial treatments were transarterial therapy (31.7%), surgical resection (24.9%), best supportive care (18.9%), and local ablation therapy (10.5%). Conclusions Between 2016 and 2018, HCC tended to be diagnosed at earlier stages, with better liver function in later years. However, since approximately half of the patients remained diagnosed at an advanced stage, more rigorous and optimized HCC screening strategies should be implemented.

Background: s/Aims: Hepatocellular carcinoma (HCC) is the sixth most common cancer and second leading cause of cancer-related deaths in South Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2016-2018. Methods: Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative database of patients newly diagnosed with HCC in South Korea, were analyzed. This study investigated 4,462 patients with HCC registered in the KPLCR in 2016-2018. Results: The median patient age was 63 years (interquartile range, 55-72). 79.7% of patients were male. Hepatitis B infection was the most common underlying liver disease (54.5%). The Barcelona Clinic Liver Cancer (BCLC) staging system classified patients as follows: stage 0 (14.9%), A (28.8%), B (7.5%), C (39.0%), and D (9.8%). The median overall survival was 3.72 years (95% confidence interval, 3.47-4.14), with 1-, 3-, and 5-year overall survival rates of 71.3%, 54.1%, and 44.3%, respectively. In 2016-2018, there was a significant shift toward BCLC stage 0-A and Child-Turcotte-Pugh liver function class A (P<0.05), although survival rates did not differ by diagnosis year. In the treatment group (n=4,389), the most common initial treatments were transarterial therapy (31.7%), surgical resection (24.9%), best supportive care (18.9%), and local ablation therapy (10.5%). Conclusions Between 2016 and 2018, HCC tended to be diagnosed at earlier stages, with better liver function in later years. However, since approximately half of the patients remained diagnosed at an advanced stage, more rigorous and optimized HCC screening strategies should be implemented.

Purpose: The selection of primary tumor resection (PTR) vs. self-expanding metallic stents (SEMS) in obstructive unresectable stage IV colorectal cancer (CRC) is critical, profoundly impacting patient outcome. This study evaluates the influence of PTR and SEMS on overall survival (OS) in conjunction with chemotherapy. Methods: The analysis included 137 patients with obstructive, unresectable stage IV CRC who underwent PTR or attempted SEMS placement. The primary objective was to assess the OS of patients, specifically examining how PTR and SEMS interventions influence these survival outcomes. Results: In a cohort of 137 patients with obstructive, unresectable stage IV CRC, 30 initially opted for PTR, while stent placement was attempted in 107 cases. Following 14 stent failures, which resulted in 8 diversions and 6 additional PTR interventions, exclusions due to elective surgeries led to a final analysis of 36 PTR and 72 SEMS cases. Cox regression analysis identified no significant survival advantage between PTR and SEMS interventions (hazard ratio [HR], 0.848; 95% confidence interval [CI], 0.555–1.298; P = 0.449). Critical findings highlighted that the absence of chemotherapy markedly reduced survival prospects (HR, 1.963; 95% CI, 1.200–3.211; P = 0.007). These insights were substantiated through propensity score matching. Conclusions The comparative analysis reveals that neither PTR nor SEMS offers a definitive survival advantage in managing obstructive, unresectable stage IV CRC. However, the necessity for subsequent invasive interventions is notably lower in the PTR group.

Purpose: Esophagojejunostomy leakage (EJL) remains one of the most critical complications following total gastrectomy for gastric cancer. This study aimed to evaluate the evolving therapeutic approaches and clinical outcomes of EJL using data from a large-scale multicenter retrospective cohort. Methods: Among 6,577 patients who underwent total gastrectomy or proximal gastrectomy with double tract reconstruction at nine institutions from 2003 to 2024, 196 (3.0%) developed EJL. Of these, 162 patients with comprehensive clinical data were included in the final analysis. The study examined treatment modalities, changes in management over time, patient characteristics, surgical variables, and clinical outcomes. Four groups were defined according to treatment approach: conservative, endoscopic, reoperation, and multimodal (combined) therapy. Results: Endoscopic therapy was first introduced in 2011 and has progressively supplanted reoperation, now comprising 32.5% of cases. The average time to EJL diagnosis was 8.4 days after surgery. Overall in-hospital mortality was 6.1% (10/162). When conservative management was excluded, endoscopic treatment demonstrated the highest rate of therapeutic success (94.3%, p = 0.004). Both the duration until diet resumption and length of hospital stay were notably reduced in the endoscopic and conservative groups compared with reoperation and multimodal therapy (p < 0.001). Moreover, although the highest post-leakage hospitalization costs were observed with multimodal treatment (p < 0.001), overall hospitalization expenses were significantly lower for patients managed conservatively or with endoscopic intervention (p < 0.001). Conclusion Over the past two decades, management of EJL has shifted toward endoscopic approaches. Endoscopic therapies yield superior clinical outcomes and should be considered a primary option for appropriate candidates.

Background: Bulky or multiple lymph node (LN) metastases are associated with poor prognosis in cervical cancer, and the size or number of LN metastases is not yet reflected in the staging system and therapeutic strategy. Although the therapeutic effects of surgical resection of bulky LNs before standard treatment have been reported in several retrospective studies, wellplanned randomized clinical studies are lacking. Therefore, the aim of the Korean Gynecologic Oncology Group (KGOG) 1047/DEBULK trial is to investigate whether the debulking surgery of bulky or multiple LNs prior to concurrent chemoradiation therapy (CCRT) improves the survival rate of patients with cervical cancer IIICr diagnosed by imaging tests. Methods The KGOG 1047/DEBULK trial is a phase III, multicenter, randomized clinical trial involving patients with bulky or multiple LN metastases in cervical cancer IIICr. This study will include patients with a short-axis diameter of a pelvic or para-aortic LN ≥2 cm or ≥3 LNs with a short-axis diameter ≥1 cm and for whom CCRT is planned. The treatment arms will be randomly allocated in a 1:1 ratio to either receive CCRT (control arm) or undergo surgical debulking of bulky or multiple LNs before CCRT (experimental arm). CCRT consists of extended-field external beam radiotherapy/pelvic radiotherapy, brachytherapy and LN boost, and weekly chemotherapy with cisplatin (40 mg/m 2 ), 4–6 times administered intravenously.The primary endpoint will be 3-year progression-free survival rate. The secondary endpoints will be 3-year overall survival rate, treatment-related complications, and accuracy of radiological diagnosis of bulky or multiple LNs.

Purpose: This retrospective study compared the maxillary sinus floor augmentation techniques (lateral and transcrestal approaches) to assess the impact of bone grafting, graft materials, and initial residual bone height (RBH). Materials and Methods: Fifty patients who underwent maxillary sinus floor augmentation for posterior maxillary implant placement were included. Panoramic radiographs were obtained before surgery (T0), immediately after surgery (T1), and 6-10 months post-surgery (T2). Length measurements on panoramic radiographs were performed using a digital caliper at T1 and T2. Statistical validation included one-way ANOVA, t-tests, Mann-Whitney U tests, and correlation analyses. Multivariate linear regression was used to assess associations after adjusting for confounding factors. Results: Of the 50 patients, 35 underwent a transcrestal approach and 15 underwent a lateral approach. The results showed significant endosinus bone gain (ESBG) differences between allogeneic and xenogeneic grafts and no grafts (p < .001). Osteotomy sinus floor elevation without grafting yielded 3.24 ± 1.42 of ESBG. When divided into three groups based on initial RBH, RBH 1 had 27 patients, RBH 2 had 12 patients, and RBH 3 had 11 patients. Within the RBH group 1 (RBH under 4), the lateral approach had significantly greater ESBG than the transcrestal approach (p < .001). Multivariate linear regression analysis confirmed statistically significant associations between the studied variables after adjusting for confounding factors. Conclusion When the RBH is < 4 mm, lateral-approach sinus augmentation and bone grafting should be performed to attain significant ESBG. The RBH, bone graft materials, and sinus elevation techniques vary considerably in ESBG.

Purpose: This study investigated the impact of the guide hole height on the accuracy of implant placement using CAD/ CAM-fabricated surgical guides in resin models. The hypothesis is that decreasing the height of the guide hole reduces placement accuracy. Materials and Methods: Ten identical partially edentulous maxillary models were each fitted with surgical guides featuring guide hole heights of 1 mm, 3 mm, and/or 5 mm. Using a surgical guide and drill kit, implants were placed in six predetermined sites per model. Placement accuracy was evaluated by comparing the actual implant positions with the planned positions using digital scanning and computer software analysis. Statistical analyses were performed using ANOVA and Kruskal-Wallis tests to determine the significance of deviations at both the coronal and apical positions. Results: The average deviations were 0.75±0.33 mm at the coronal position and 1.10±0.51 mm at the apical position. Placement accuracy didnot differ with different guide hole heights. Additionally, errors were consistent regardless of the guide hole height and were not influenced by the type of support or the implant placement site. Conclusion In this rotro study, varying the height of the guide hole did not significantly affect the accuracy of implant placement. The results suggest that guide hole height within the tested range does not have a substantial impact on placement errors. Our findings indicate that factors other than the guide holeheight may play a more critical role in implant placement accuracy.

Purpose: This study investigated the impact of the guide hole height on the accuracy of implant placement using CAD/ CAM-fabricated surgical guides in resin models. The hypothesis is that decreasing the height of the guide hole reduces placement accuracy. Materials and Methods: Ten identical partially edentulous maxillary models were each fitted with surgical guides featuring guide hole heights of 1 mm, 3 mm, and/or 5 mm. Using a surgical guide and drill kit, implants were placed in six predetermined sites per model. Placement accuracy was evaluated by comparing the actual implant positions with the planned positions using digital scanning and computer software analysis. Statistical analyses were performed using ANOVA and Kruskal-Wallis tests to determine the significance of deviations at both the coronal and apical positions. Results: The average deviations were 0.75±0.33 mm at the coronal position and 1.10±0.51 mm at the apical position. Placement accuracy didnot differ with different guide hole heights. Additionally, errors were consistent regardless of the guide hole height and were not influenced by the type of support or the implant placement site. Conclusion In this rotro study, varying the height of the guide hole did not significantly affect the accuracy of implant placement. The results suggest that guide hole height within the tested range does not have a substantial impact on placement errors. Our findings indicate that factors other than the guide holeheight may play a more critical role in implant placement accuracy.