Asian Society of Gynecologic Oncology International Workshop 2018 / 부인종양

The Asian Society of Gynecologic Oncology International Workshop 2018 on gynecologic oncology was held in the Ajou University Hospital, Suwon, Korea on the 24th to 25th August 2018. The workshop was an opportunity for Asian doctors to discuss the latest findings of gynecologic cancer, including cervical, ovarian, and endometrial cancers, as well as the future of fertility-sparing treatments, minimally invasive/radical/debulking surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy. Clinical guidelines and position statement of Asian countries were presented by experts. Asian clinical trials for gynecologic cancers were reviewed and experts emphasized the point that original Asian study is beneficial for Asian patients. In Junior session, young gynecologic oncologists presented their latest research on gynecologic cancers.

Distinguishing benign from malignant pelvic mass utilizing an algorithm with HE4, menopausal status, and ultrasound findings / 부인종양

OBJECTIVE: The purpose of this study was to develop a risk prediction score for distinguishing benign ovarian mass from malignant tumors using CA-125, human epididymis protein 4 (HE4), ultrasound findings, and menopausal status. The risk prediction score was compared to the risk of malignancy index and risk of ovarian malignancy algorithm (ROMA). METHODS: This was a prospective, multicenter (n=6) study with patients from six Asian countries. Patients had a pelvic mass upon imaging and were scheduled to undergo surgery. Serum CA-125 and HE4 were measured on preoperative samples, and ultrasound findings were recorded. Regression analysis was performed and a risk prediction model was developed based on the significant factors. A bootstrap technique was applied to assess the validity of the HE4 model. RESULTS: A total of 414 women with a pelvic mass were enrolled in the study, of which 328 had documented ultrasound findings. The risk prediction model that contained HE4, menopausal status, and ultrasound findings exhibited the best performance compared to models with CA-125 alone, or a combination of CA-125 and HE4. This model classified 77.2% of women with ovarian cancer as medium or high risk, and 86% of women with benign disease as very-low, low, or medium-low risk. This model exhibited better sensitivity than ROMA, but ROMA exhibited better specificity. Both models performed better than CA-125 alone. CONCLUSION: Combining ultrasound with HE4 can improve the sensitivity for detecting ovarian cancer compared to other algorithms.

Therapeutic Effect of "Keishi-bukuryo-gan" on Premenstrual Syndrome. Newly developed "PMS Scores(Jikei)" and their application / 日本東洋医学雑誌

Premenstrual syndrome (PMS) is defined as psychological or physical signs and symptoms which persist for three to ten days prior to menstruation and decrease or disappear when menstruation starts. Various hypotheses have been proposed as to the cause of PMS, such as a lack of balance between estrogen and progesterone, vitamin B₁ deficiency, hypoglycemia, and autoimmunity. However, what the real cause is remains a matter of debate, and various kinds of treatment have, therefore, been attempted. It is necessary to investigate therapeutic efficacy objectively.<br>We established PMS scores, in which clinical signs and symptoms were divided into individual conditions, such as psychology, nerves, breast, water retention, gastrointestinal tract, skin, etc., and scores of 0-20 were given to each of these conditions making a maximum score of 100. When the scores decreased after treatment by 30% or less compared to pretreatment scores, the results were defined as “excellent”. When the scores fell by 31-60%, the results were defined as “good”.<br>When four patients with “hyper-functioning condition” suffering from PMS were given Keishi-bukuryo-gan extract (TJ-25), “excellent” results were obtained in two and “good” in the other two. No adverse reactions were observed. This study suggests that TJ-25 is effective for PMS.