Purpose: In Korea, the Health Insurance Review and Assessment Service (HIRA) mandates patient participation in outpatient multidisciplinary team (MDT) meetings as part of national cancer quality assessment. However, the necessity of involving patients and families in MDT discussions remains debatable. This study explored international expert perspectives on patient participation in gastric cancer MDTs. Methods: A cross-national expert survey was conducted in September 2021 among 15 gastric cancer specialists from Korea, China, Japan, Singapore, and the United States. The survey assessed the frequency of patient and family member attendance, perceived pros and cons, and preferences regarding mandatory versus selective involvement. Additionally, MDT structures and policies were reviewed by countries. Results: Most respondents reported that patients and families rarely or never attend MDT meetings: nine stated that patients are never included, three reported “usually not,” and three indicated “sometimes.” None consistently included patients. The most cited benefits were sharing opinions with patients and families simultaneously, followed by improved explanation of treatment and legal protection. Major concerns included hindered discussion, inefficiency, and logistical challenges. Only four respondents supported routine participation, while 11 favored case-dependent involvement. Conclusion International experts do not widely support mandatory patient participation in MDT meetings. A flexible approach that allows MDTs to operate with or without patient involvement may better reflect actual clinical practice.

OBJECTIVE: This retrospective study is to evaluate the efficacy and toxicity of combination chemotherapy with etoposide and ifosfamide (ETI) in the management of pretreated recurrent or persistent epithelial ovarian cancer (EOC). METHODS: Patients with recurrent or persistent EOC who had measurable disease and at least one chemotherapy regimen were to receive etoposide at a dose of 100 mg/m²/day intravenous (IV) on days 1 to 3 in combination with ifosfamide 1 g/m²/day IV on days 1 to 5, every 21 days. RESULTS: From August 2008 to August 2016, 66 patients were treated with ETI regimen. Most patients were heavily pretreated prior to ETI: 53 (80.3%) patients had received 3 or more chemotherapy regimens. The response rate (RR) of ETI chemotherapy was 18.2% and median duration of response was 6.8 months (range, 0–30). Median survival of all patients was 5 months at a median follow up of 7.2 months. Platinum-free interval (PFI) more than 6 months prior to ETI has statistically significant correlation with overall survival (OS; 9.2 vs. 5.6 months; P=0.029) and RR (34.5% vs. 5.4%; P < 0.010). However, treatment free interval before ETI, number of prior chemotherapy regimen, and optimality of primary surgery did not show significant difference for RR or OS. Grade 3 or 4 hematologic toxicities were observed in 7 cases (3%) of the 232 cycles of ETI. CONCLUSION: The ETI combination regimen shows comparatively low toxicity and modest activity in heavily pretreated recurrent or persistent EOC patients with more than 6 months of PFI after last platinum treatment.
Drug Therapy ; Drug Therapy, Combination* ; Etoposide* ; Follow-Up Studies ; Humans ; Ifosfamide* ; Ovarian Neoplasms* ; Platinum ; Recurrence ; Retrospective Studies*

Cancer stem cells are a subpopulation of cancer cells characterized by self-renewal ability, tumorigenesis and drug resistance. The aim of this study was to investigate the role of HMGA1, a chromatin remodeling factor abundantly expressed in many different cancers, in the regulation of cancer stem cells in ovarian cancer. Spheroid-forming cancer stem cells were isolated from A2780, SKOV3 and PA1 ovarian cancer cells by three-dimensional spheroid culture. Elevated expression of HMGA1 was observed in spheroid cells along with increased expression of stemness-related genes, such as SOX2, KLF4, ALDH, ABCB1 and ABCG2. Furthermore, spheroid A2780 cells, compared with adherent cells, showed higher resistance to chemotherapeutic agents such as paclitaxel and doxorubicin. HMGA1 knockdown in spheroid cells reduced the proliferative advantage and spheroid-forming efficiency of the cells and the expression of stemness-related genes. HMGA1 overexpression in adherent A2780 cells increased cancer stem cell properties, including proliferation, spheroid-forming efficiency and the expression of stemness-related genes. In addition, HMGA1 regulated ABCG2 promoter activity through HMGA1-binding sites. Knockdown of HMGA1 in spheroid cells reduced resistance to chemotherapeutic agents, whereas the overexpression of HMGA1 in adherent ovarian cancer cells increased resistance to chemotherapeutic agents in vitro. Furthermore, HMGA1-overexpressing A2780 cells showed a significant survival advantage after chemotherapeutic agent treatment in a xenograft tumorigenicity assay. Together, our results provide novel insights regarding the critical role of HMGA1 in the regulation of the cancer stem cell characteristics of ovarian cancer cells, thus suggesting that HMGA1 may be an important target in the development of therapeutics for ovarian cancer patients.
Carcinogenesis ; Chromatin Assembly and Disassembly ; Doxorubicin ; Drug Resistance* ; Heterografts ; Humans ; In Vitro Techniques ; Neoplastic Stem Cells ; Ovarian Neoplasms* ; Paclitaxel ; Stem Cells*

Single nucleotide polymorphisms (SNPs) are the most abundant forms of human genetic variations and resources for mapping complex genetic traits and disease association studies. We have constructed a linkage disequilibrium(LD) map of chromosome 22 in Korean samples and compared it with those of other populations, including Yorubans in Ibadan, Nigeria (YRI), Centred'Etude du Polymorphisme Humain (CEPH) reference families (CEU), Japanese in Tokyo (JPT) and Han Chinese in Beijing (CHB) in the HapMap database. We genotyped 4681 of 111,448 publicly available SNPs in 90 unrelated Koreans. Among genotyped SNPs, 4167 were polymorphic. Three hundred and five LD blocks were constructed to make up 18.6% (6.4 of 34.5 Mb) of chromosome 22 with 757 tagSNPs and 815 haplotypes(frequency > or = 5.0%). Of 3430 common SNPs genotyped in all five populations, 514 were monomorphic in Koreans. The CHB + JPT samples have more than a 72% overlap with the monomorphic SNPs in Koreans, while the CEU + YRI samples have less than a 38% overlap. The patterns of hot spots and LD blocks were dispersed throughout chromosome 22, with some common blocks among populations, highly concordant between the three Asian samples. Analysis of the distribution of chimpanzee-derived allele frequency (DAF), a measure of genetic differentiation, Fst levels, and allele frequency difference (AFD) among Koreans and the HapMap samples showed a strong correlation between the Asians, while the CEU and YRI samples showed a very weak correlation with Korean samples. Relative distance as a quantitative measurement based upon DAF, Fst, and AFD indicated that all three Asian samples are very proximate, while CEU and YRI are significantly remote from the Asian samples. Comparative genome-wide LD studies provide useful information on the association studies of complex diseases.
Asian Continental Ancestry Group ; Chromosomes, Human, Pair 22 ; Gene Frequency ; Genetic Variation ; Haplotypes ; HapMap Project ; Humans ; Nigeria ; Polymorphism, Single Nucleotide ; Tokyo

Single nucleotide polymorphisms (SNPs) are the most abundant forms of human genetic variations and resources for mapping complex genetic traits and disease association studies. We have constructed a linkage disequilibrium(LD) map of chromosome 22 in Korean samples and compared it with those of other populations, including Yorubans in Ibadan, Nigeria (YRI), Centred'Etude du Polymorphisme Humain (CEPH) reference families (CEU), Japanese in Tokyo (JPT) and Han Chinese in Beijing (CHB) in the HapMap database. We genotyped 4681 of 111,448 publicly available SNPs in 90 unrelated Koreans. Among genotyped SNPs, 4167 were polymorphic. Three hundred and five LD blocks were constructed to make up 18.6% (6.4 of 34.5 Mb) of chromosome 22 with 757 tagSNPs and 815 haplotypes(frequency > or = 5.0%). Of 3430 common SNPs genotyped in all five populations, 514 were monomorphic in Koreans. The CHB + JPT samples have more than a 72% overlap with the monomorphic SNPs in Koreans, while the CEU + YRI samples have less than a 38% overlap. The patterns of hot spots and LD blocks were dispersed throughout chromosome 22, with some common blocks among populations, highly concordant between the three Asian samples. Analysis of the distribution of chimpanzee-derived allele frequency (DAF), a measure of genetic differentiation, Fst levels, and allele frequency difference (AFD) among Koreans and the HapMap samples showed a strong correlation between the Asians, while the CEU and YRI samples showed a very weak correlation with Korean samples. Relative distance as a quantitative measurement based upon DAF, Fst, and AFD indicated that all three Asian samples are very proximate, while CEU and YRI are significantly remote from the Asian samples. Comparative genome-wide LD studies provide useful information on the association studies of complex diseases.
Asian Continental Ancestry Group ; Chromosomes, Human, Pair 22 ; Gene Frequency ; Genetic Variation ; Haplotypes ; HapMap Project ; Humans ; Nigeria ; Polymorphism, Single Nucleotide ; Tokyo

Schwannomas are rare tumors derived from the cells of Schwann which form the neural sheath. Some patients with gastrointestinal schwannoma have been previously reported in the literature. However, schwannomas of the colon are extremely rare. We herein describe a case of schwannoma of the colon. A 49-year-old woman was admitted with complaint of abdominal pain and investigations revealed the presence of a 4 cm sized mass in the ascending colon. Following right hemicolectomy, histopathology and immunohistochemistry confirmed the colonic lesion to be a benign schwannoma. There was no evidence of specific complication or recurrence until now.
Colon, Ascending/*pathology ; Colonic Neoplasms/*diagnosis/pathology/ultrasonography ; Female ; Humans ; Middle Aged ; Neurilemmoma/*diagnosis/pathology/ultrasonography ; S100 Proteins/analysis/immunology ; Tomography, X-Ray Computed

BACKGROUND: Ductal carcinoma in situ (DCIS) of the breast has been considered a relative rare form of breast cancer because its diagnosis was difficult but the widespread use of screening mammography has made it easy to detect breast disease and there has been a marked increase in the incidence of DCIS. But the exact diagnosis and treatment are controversial. METHOD: We reviewed the clinical record of 55 patients with DCIS treated at the Department of Surgery, Samsung Medical Center, between September 1994 and December 1997. If there was microinvasion noted, it was excluded from this study. RESULTS: The incidence of DCIS was 11.5% of all breast cancer (55 out of 477) with increasing tendency from 1995 to 1997. DCIS was most prevalent in woman who were in their fifth decades and the mean age was 47 years old. Chief complaints were palpable breast masses in 22 (40%), mammorgaphic abnormalities in 21 (38%), abnormal nipple discharge in 7 (13%), and others in 5 cases (9%). The most common mammographic finding was microcalcifications in 41(84%), but the mass density and architectural distortion were also noted in small percentage. Diagnostic methods for preperative pathology were fine needle aspiration (FNA) cytoloty in 15 (27%), localization and excisional biopsy in 16 (29.1%), excisional biopsy in 11 (20%), incisional biopsy in 5 (9%), stereotactic core biopsy in 3 (5.5%), US guided biopsy in 2 (3.6%) and ABBI (advanced breast biopsy instrumentation) biopsy in 3 (5.5%). If the chief complant was palpable masses, FNA was a diagnostic choice. On the other hand, if the problem was mammographic abnormalities, localization and excisional biopsy was preferred. The surgical procedures were modified radical mastectomy in 17 (31%), total mastectomy in 21 (38%) lumpectomy with axillary lymph node dissection in 7 (13%) and lumpectomy only in 10 (18%). If preoperative histology revealed the tumor of comedo type, mastectomy was preferred but in case of non-comedo type, conservative surgery was preferred. Conservative surgery was followed by radiation therapy. Cancers were subclassified according to their histologic subtypes in 51 cases and comedo was the most common type (42%). Prevalent size of the masses were less than 2 cm and the biggest one was 9 cm. There were one case (2%) of lymph node metastasis. It was comedo type and the size of cancer was 9 cm. CONCLUSION: The widespread use of screening mammography and variable diagnostic method will increase the chance to detect the incidence of DCIS and conservative surgery will be performed more frequently in selected group of patients.
Biopsy ; Biopsy, Fine-Needle ; Breast Diseases ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Diagnosis* ; Female ; Hand ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Mammography ; Mass Screening ; Mastectomy ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Middle Aged ; Neoplasm Metastasis ; Nipples ; Pathology

In capacitive heating device, which considered efficient for deep heating, parallel arrangement of the electrodes is a serious limiting factor in heating for eccentrically located lesions because it causes overheating of the exposed ipsilateral skin surface, the heating pattern is also frequently inappropriate, arid the arrangement tends to be unstable due to the patient's gravity. Therefore we attempted an angular arrangement of the electordes to achieve more homogenous and efficient heating for such lesions. In phantom study, both the thermal profile and thermogram established the heating pattern in this unusual angular arrangement of the electrodes at 60degree, 90degree and 120degree angles, respectively. An angular arrangement was also clinically applied to 3 patients. The patients' tolerance was good without significant complication and the thermal distribution was satisfactory. In conclusion, this unusual arrangement of electrodes appears to be promising in the clinical application to the eccentrically located lesions.
Electrodes* ; Gravitation ; Heating* ; Hot Temperature* ; Humans ; Skin