Joo Hyun Nam

• MD, PhD
• Professor (Full) at Asan Medical Center

Background/Objectives: Fertility-sparing surgery (FSS) is a standard practice for managing early stage cervical cancer, yet significant variation exists in clinical approaches worldwide. Our objective was to ascertain current practices and preferences for cerclage use among expert centers globally regarding FSS in patients with early stage cervical...

Olaparib treatment significantly improved objective response rate (primary end point) and progression-free survival versus nonplatinum chemotherapy in patients with BRCA-mutated platinum-sensitive relapsed ovarian cancer in the open-label phase III SOLO3 trial (ClinicalTrials.gov identifier: NCT02282020 ). We report final overall survival (OS; pres...

Simple Summary Established in 2002, the Korean Gynecologic Oncology Group (KGOG) has presented improved clinical outcomes based on multi-center clinical trials. To date, KGOG has approved 156 studies and published 68 KGOG-led studies. The organization aims to advance gynecologic cancer research through sustained efforts and international collaborat...

Introduction/Background To evaluate the role of FloSeal for preventing symptomatic lymphocele following pelvic and/or para-aortic lymphadenectomy in patients with gynecological cancers. Methodology Between Oct 2014 and Apr 2015, 40 patients with gynecological cancers planned for surgical management were randomly placed into FloSeal and non-FloSeal...

Introduction/Background The purpose of this study is to develope a scoring system for predicting recurrence in early-stage adenocarcinoma of cervix after radical hysterectomy. Methodology The medical records of 322 patients with stage IA2-IIB cervical cancer with adenocarcinoma who underwent radical hysterectomy were retrospectively reviewed. Res...

Highlighting over 50 hot topics where controversy exist in management of patients with gynecologic malignancy, this book presents expertly argued opinions for and against, incorporating current evidence and clinical trials outcomes. A diverse range of topics are included that pertain to several disciplines in gynecologic oncology, including surgica...

Objective To evaluate the feasibility and safety of laparoendoscopic single-site (LESS) vaginal hysterectomy compared to conventional three-port laparoscopic-assisted vaginal hysterectomy (LAVH) for benign and pre-invasive uterine disease. Design Randomised controlled trial. Setting South Korea. Population Patients who were scheduled to undergo lap...

Objective: To evaluate the feasibility and safety of laparo-endoscopic single-site surgery (LESS) compared with conventional laparoscopic surgery (CLS) for early-stage endometrial cancer. Methods: Patients with clinical stage IA, IB, grade 1-3 endometrial cancer were randomly assigned to undergo LESS or CLS. The primary endpoint was the non-infe...

Introduction Since sentinel lymph node mapping in endometrial cancer is becoming more widely used, the need of standardizing surgical technique is needed. The objective of this surgical video is to describe the procedure of two-step pelvic and para-aortic sentinel lymph node mapping using indocyanine green and fluorescent camera in endometrial canc...

Objectives In the open-label Phase III SOLO3 trial (NCT02282020), olaparib treatment improved objective response rate (primary endpoint) and progression-free survival, versus single-agent non-platinum chemotherapy treatment of physician’s choice (TPC), in patients with germline BRCA1 and/or BRCA2-mutated (gBRCAm) platinum-sensitive relapsed ovarian...

Objectives To evaluate the feasibility of laparo-endoscopic single-site staging surgery (LESS group) compared to conventional laparoscopic staging surgery (four-port group) for early-stage endometrial cancer. Methods Patients with clinical stage IA, IB, grade 1–3 endometrial cancer were randomly assigned to LESS group or four-port group. The prima...

Introduction/Background The purpose of this study was to evaluate the efficacy of docetaxel/cisplatin chemotherapy followed by pelvic radiation therapy after staging surgery in high-risk endometrial cancer patients. Methodology This was a prospective, phase 2, multicenter clinical trial (Clinical trial identifier: NCT01461746). Eligible patients i...

Objective: The primary objective of the study was to estimate the 12-month progression-free survival (PFS) for carboplatin/paclitaxel + temsirolimus in women with newly diagnosed clear cell ovarian cancer (CCOC), compared to historical controls in this patient population. Methods: Patients with Stage III or IV CCOC were treated with Paclitaxel 1...

Objectives: In the open-label Phase III SOLO3 trial (NCT02282020), olaparib monotherapy provided clinically relevant and statistically significant improvements in objective response rate (ORR; primary endpoint) and progression-free survival (PFS; secondary endpoint), compared with single-agent non-platinum chemotherapy, in patients (pts) with germl...

Purpose This study evaluated whether coping strategies (positive reframing, planning, and active coping) and depression mediate the relationship between sense of coherence (SOC) and quality of life (QoL) using a serial multiple mediator model in patients with gynecologic cancer who are undergoing chemotherapy. Methods A sample of 148 participants,...

To compare the oncologic outcomes between chemoradiotherapy (CRT) and radical hysterectomy followed by tailored adjuvant therapy in patients with early cervical cancer presenting with pelvic lymph node metastasis. We retrospectively analyzed the medical records of women with early cervical cancer presenting with positive pelvic nodes identified on...

The aim of this study is to analyze the correlation between clinically significant histologic results and HPV in women with AGC in pap test. Of the 311 women confirmed as AGC, 111 women (35.7%) was identified as positive for HPV. In the AGC analysis, cervical lesions were significantly more common in HPV positive group compared to HPV negative grou...

Background Olaparib, a poly (ADP-ribose) polymerase (PARP) inhibitor, has previously been shown to extend progression-free survival versus placebo when given to patients with relapsed high-grade serous or endometrioid ovarian cancer who were platinum sensitive and who had a BRCA1 or BRCA2 (BRCA1/2) mutation, as part of the SOLO2/ENGOT-Ov21 trial. T...

Objectives: Staging procedure in borderline ovarian tumors is a topic of controversy. Upstaging in non-serous borderline ovarian tumors that are confined to the ovary is rare. The aim of this study was to assess the impact of surgical staging on clinical outcomes in mucinous borderline ovarian tumors. Methods: This was a retrospective study cond...

The lymph node status is the most important prognostic factor for endometrial cancer. This study aimed to assess whether sentinel lymph node mapping (SLNM) is applicable in endometrial cancer. A retrospective review of patients with endometrial cancer who were diagnosed and treated in Asan Medical Centre from September 2015 to December 2017 was con...

Objective To compare the oncologic outcomes between chemoradiotherapy and radical hysterectomy followed by tailored adjuvant therapy in patients with early cervical cancer presenting with pelvic lymph node metastasis. Methods We retrospectively analyzed the medical records of women with early cervical cancer presenting with positive pelvic nodes id...

(Abstracted from N Engl J Med 2019;381:1929–1939) The National Comprehensive Cancer Network recommends secondary cytoreduction for ovarian cancer patients with recurrent disease who have received no treatment for a period of 6 months following a complete response from prior chemotherapy. Retrospective reviews and meta-analyses have shown the most b...

PURPOSE A phase II study (ClinicalTrials.gov identifier: NCT00628251 ) showed activity of olaparib capsules versus pegylated liposomal doxorubicin in patients with germline BRCA-mutated platinum-resistant or partially platinum-sensitive relapsed ovarian cancer. We conducted a phase III trial (SOLO3) of olaparib tablets versus nonplatinum chemothera...

Background: Secondary surgical cytoreduction in women with platinum-sensitive, recurrent epithelial ovarian, primary peritoneal, or fallopian-tube ("ovarian") cancer is widely practiced but has not been evaluated in phase 3 investigation. Methods: We randomly assigned patients with recurrent ovarian cancer who had received one previous therapy,...

Objective: To determine the accuracy of frozen section diagnosis and factors associated with final pathological diagnosis upgrade in patients with mucinous ovarian tumors. Methods: This study included 1,032 patients with mucinous ovarian tumors who underwent frozen section diagnosis during surgery. Sensitivity, specificity, and diagnostic accura...

Background This phase III randomized placebo (PL) controlled multinational trial evaluated whether progression-free survival (PFS) is increased when V is added to front-line carboplatin and paclitaxel (CP) and continued as maintenance in newly diagnosed HGSC pts considering BRCA mutations (m), homologous recombination deficiency (HRD), and neoadjuv...

Background: Data are limited regarding the use of poly(adenosine diphosphate [ADP]-ribose) polymerase inhibitors, such as veliparib, in combination with chemotherapy followed by maintenance as initial treatment in patients with high-grade serous ovarian carcinoma. Methods: In an international, phase 3, placebo-controlled trial, we assessed the e...

Objectives: To perform a systematic review and meta-analysis of the prognostic value of post-treatment ¹⁸F-fluorodeoxyglucose positron emission tomography (¹⁸F-FDG PET) in uterine cervical cancer patients treated with radiotherapy (RT) with or without chemotherapy. Methods: PubMed and Embase databases were searched up to July 22, 2018, for studi...

Background Data from a randomized Phase II trial (NCT00628251) of olaparib (capsules, 200 or 400 mg bid, n=32 per arm) vs pegylated liposomal doxorubicin (PLD, n=33) in gBRCAm OC pts with recurrence ≤12 months after prior platinum therapy indicated efficacy for olaparib (Kaye et al. JCO 2012). However, the efficacy of PLD was higher than previously...

5506 Background: Data from a randomized Phase II trial (NCT00628251) of olaparib (capsules, 200 or 400 mg bid, n=32 per arm) vs pegylated liposomal doxorubicin (PLD, n=33) in gBRCAm OC pts with recurrence ≤12 months after prior platinum therapy indicated efficacy for olaparib (Kaye et al. JCO 2012). However, the efficacy of PLD was higher than prev...

Background Angiopoietin 1 and 2 regulate angiogenesis and vascular remodelling by interacting with the tyrosine kinase receptor Tie2, and inhibition of angiogenesis has shown promise in the treatment of ovarian cancer. We aimed to assess whether trebananib, a peptibody that inhibits binding of angiopoietin 1 and 2 to Tie2, improved progression-free...

Objective: To investigate the expression of different histone deacetylases and their association with disease characteristics and survival outcomes in uterine leiomyosarcoma patients. Methods: The immunohistochemical expression of different histone deacetylases and p53 by tissue microarray and histological subtypes were assessed in tumor tissue...

Objective: To evaluate the efficacy of combined oral medroxyprogesterone acetate (MPA)/levonorgestrel-intrauterine system (LNG-IUS) treatment and to compare the diagnostic accuracy of endometrial aspiration biopsy with dilatation & curettage (D&C) in young women with early-stage endometrial cancer (EC) who wished to preserve their fertility. Meth...

Objective To explore the factors influencing adoption of the sentinel lymph node (SLN) technique for endometrial cancer staging among gynecologic oncologists. Methods A self-administered, web-based survey was sent via email (April 20 through May 21, 2017) to all members of European Society of Gynecologic Oncologists, International Gynecologic Canc...

The aim of this study is to determine the rate of clinically significant histopathologic lesions in women identified with atypical glandular cells (AGC). Five-hundered and forty patients with AGC, from a cohort of 1013 with AGC, met inclusion criteria for this study by having a proper histologic evaluation. Clinically significant histologic results...

Objectives: The aim of this study was to compare surgical and oncologic outcomes of open and laparoscopic surgery in patients with borderline ovarian tumors (BOTs). Materials and methods: This study included patients with BOTs who underwent open (n = 433) or laparoscopic (n = 210) surgery between 1990 and 2015. Surgical outcomes, perioperative m...

Abstract Background Palliative chemotherapy should be used with caution when attempting to alleviate symptoms in patients with end-stage cancer. However, palliative chemotherapy continues to be utilized in cancer patients during their last stages of life. In this study, we analyzed the pattern of chemotherapy administered during the last 6 months o...

To evaluate the immunohistochemical (IHC) expression of hormone receptors and analyze the prognostic implication of these receptors in patients with endometrial stromal sarcoma (ESS). Fifty-one patients with ESS whose paraffin blocks and pathologic slides, which were obtained after hysterectomy, were available and included in this study. Clinicopat...

To determine whether the pelvic lymph node ratio (LNR) has significant prognostic value for survival and disease recurrence in node-positive, early stage cervical cancer patients. The medical records of 872 consecutive women who received postoperative adjuvant chemoradiotherapy were reviewed. Of these, 397 women with pathologically proven lymph nod...

Objective: To evaluate survival impact of low anterior resection (LAR) in patients with epithelial ovarian cancer (EOC) grossly confined to the pelvis. Methods: We retrospectively reviewed 397 patients who underwent primary staging surgery for treatment of 2014 International Federation of Gynecology and Obstetrics (FIGO) stage II-IIIA EOC: 116 (...

Objective: To determine the role of preoperative serum cancer antigen 125 (CA 125) in malignant ovarian germ cell tumors (MOGCTs). Materials and methods: Using information from medical databases of Asan Medical Center (Seoul, Korea), we investigated 161 patients with histologically diagnosed MOGCTs and whose preoperative serum CA 125 had been ch...

The histoculture drug response assay (HDRA) has been correlated clinically to a number of cancer types (please see Chaps. 7– 11 of the present volume). The present chapter reviews the clinical trials of the HDRA for ovarian cancer. A prospective clinical trial of the HDRA for advanced epithelial ovarian cancer (AEOC) was performed at Asan Medical C...

Background: Lymph node metastasis is a significant predictive factor for disease recurrence and survival in cervical cancer patients. Given the importance of lymph node metastasis, it is imperative that patients harboring metastasis are identified and can undergo appropriate treatment. Sentinel lymph node (SLN) mapping has drawn attention as a lym...

Objective: To investigate the expression of androgen receptor (AR) and its correlation with disease status and survival outcome in uterine leiomyosarcoma with other hormone receptors. Methods: The medical records and paraffin blocks of 42 patients were reviewed. The immunohistochemical expression of AR, estrogen receptor (ER), progesterone recep...

Objective: The aim of this study was to evaluate the diagnostic value of integrated ¹⁸F-fluoro-2-deoxyglucose-positron emission tomography/computed tomography (¹⁸F-FDG-PET/CT) for suspected recurrence of epithelial ovarian cancer (EOC) with non-disseminated lesions. Methods: We retrospectively reviewed the medical records of recurrent EOC patien...

Currently, the indications for progestin therapy are limited to endometrioid adenocarcinoma that are International Federation of Gynecology and Obstetrics (FIGO) grade 1, FIGO stage IA, and confined to the endometrium. However, there have been attempts to broaden the indications of progestin therapy to patients with higher FIGO grades and/or with s...

Purpose: To investigate disease-free survival (DFS) and prognostic factors following the administration of postoperative (chemo)radiotherapy in patients with early-stage cervical cancers. Methods: The medical records of 1,069 patients from 10 participating institutions were reviewed. Statistically and clinically established factors were consider...

Kaplan-Meier survival plots of PFS (A, B) and OS (C, D) according to MTV3.0 and TLG3.0. MTV, metabolic tumor volume; OS, overall survival; PFS, progression-free survival; SUVmax, maximum standardized uptake value; TLG, total lesion glycolysis.

Time-dependent ROC curve analyses for determination of the cutoff values of SUVmax, MTV3.0, and TLG3.0 for predicting 3-year progression (A) and death (B). ROC, receiver operating characteristic; MTV, metabolic tumor volume; SUVmax, maximum standardized uptake value; TLG, total lesion glycolysis.

Young docters who gained travel award to participate the 3rd ASGO workshop.

Counsil members of ASGO, speakers, and chairpersons of the 3rd ASGO workshop.

Program of the 3rd ASGO International Workshop on Gynecolgic Oncology

Leiomyosarcoma, a malignant tumor that arises from mesenchymal tissues, is the most common soft-tissue sarcoma. Although rarely found in the female genital tract, leiomyosarcoma is the most malignant tumor that can occur in the female genital tract. Although leiomyosarcomacan occur anywhere through the female genital tract (including the uterine bo...

To compare feasibility, accuracy, and safety of laparoscopy and laparotomy in surgical staging of early-stage ovarian and fallopian tubal cancer. Outcomes of patients with stage I ovarian and fallopian tubal cancer who underwent complete surgical staging at Asan Medical Center, Korea between 2004 and 2007 were retrospectively evaluated. Nineteen pa...

To evaluate the toxicity and efficacy of a newly developed topoisomerase I inhibitor, CKD-602 in second-line therapy of ovarian cancer. We enrolled 24 patients with recurrent ovarian cancer, of median age 54 years (range, 39-64). Eleven patients had measurable lesions on CT scan, and the other 13 had increased serum CA-125 levels. Eighteen patients...

Younger patients with invasive epithelial ovarian cancer (EOC) frequently want to preserve their fertility, but the role of fertility-sparing surgery in EOC has not been well defined. We therefore assessed tumor recurrence, patient survival and pregnancy outcomes in patients with invasive EOC who underwent fertility-sparing surgery. Records of 62 p...

Uterine sarcoma is a rare malignancy with the worst prognosis of all uterine cancers. This study evaluated the prognostic factors and treatment outcomes of patients with this disease. A retrospective analysis was performed on 127 patients with histologically verified uterine sarcoma who were treated and followed at the Asan Medical Center (Seoul, K...

To evaluate the clinical accuracy and clinical impact of positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) in detecting and treating tumor recurrence in patients with treated uterine sarcoma. Results of 36 patients who underwent PET or PET/CT in post-therapy surveillance of uterine sarcoma were retrospe...

To compare positron emission tomography/computed tomography (PET/CT) with magnetic resonance imaging (MRI) in the preoperative detection of primary lesions and lymph node (LN) and distant metastases in patients with uterine corpus cancer. The patient cohort consisted of 53 women with uterine corpus cancer who underwent preoperative workup, includin...

To compare monthly fluorouracil (FU) plus cisplatin and weekly cisplatin concurrent with radiotherapy for locally advanced cervical cancer. A total of 158 patients (stages IIB through IVA) without para-aortic lymph nodes were randomized to receive 3 monthly cycles of FU (1000 mg/m2/day i.v.) plus cisplatin (20 mg/m2/day i.v.) for 5 days (group I, n...

The purpose of this study was to identify problems related to long-term quality of life (QOL) and sexual function in cervical cancer survivors. The authors enrolled 860 women (median time since diagnosis, 5.86 years) with a history of cervical cancer (stage I to IVa) who had been treated at any of 6 hospitals from 1983 through 2004 and 494 control...

To assess the feasibility of laparoscopic surgery in the treatment of patients with early uterine cancer and to compare their outcomes with those of patients treated with laparotomy. The records of 388 patients with clinical stage I or II uterine cancer treated by laparoscopic-assisted vaginal hysterectomy (LAVH) or total abdominal hysterectomy (TA...

The loop electrosurgical excision procedure (LEEP) is widely used for cervical conization. It is unclear if margin status is the single most important factor for predicting residual or recurrent disease. We therefore sought to determine supplementary histologic factors that can be used to predict residual disease in subsequent hysterectomy specimen...

Objectives The human papillomavirus (HPV) is a well-known cause of cervical cancer. HPV tests are used as an adjunct test to decrease the false-negative rate of cytological screening. However, attempts are being made to replace the cytological screening with HPV tests. Therefore, this study was performed to examine the possibility of using HPV test...

The human papillomavirus (HPV) is a well-known cause of cervical cancer. HPV tests are used as an adjunct test to decrease the false-negative rate of cytological screening. However, attempts are being made to replace the cytological screening with HPV tests. Therefore, this study was performed to examine the possibility of using HPV tests as screen...

Objectives The aim of this study was to evaluate the effects of paclitaxel/cisplatin neoadjuvant chemotherapy in terms of the tumor volume change calculated by MRI in patients with stage IB-IIA locally advanced cervical cancer. Tumor volume is one of the prognostic factors and the tumor volume change might be correlated with chemo responsiveness. M...

Objective The aim of this study was to determine the response and toxicity in combination chemotherapy of gemcitabine, platinum, and paclitaxel in patients with advanced or refractory ovarian carcinoma. Methods From February 2002 to September 2002, we conducted this study trial in 18 patients with advanced or refractory ovarian carcinoma. The sched...