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Purpose: To determine whether the prognostic impact of lymph node ratio (LNR), defined as the ratio between the number of positive lymph nodes and removed lymph nodes, differs between open and minimally invasive surgical approaches for radical hysterectomy (RH) in node-positive, early-stage cervical cancer. Materials and Methods: We retrospectively identified 2009 International Federation of Gynecology and Obstetrics stage IB1-IIA2 patients who underwent primary type C RH between 2010 and 2018. Among them, only those with pathologically proven lymph node metastases who received adjuvant radiation therapy were included. The prognostic significance of LNR was investigated according to open surgery and minimally invasive surgery (MIS). Results: In total, 55 patients were included. The median LNR (%) was 9.524 (range, 2.083--62.500). Based on receiver operating characteristic curve analysis, the cut-off value for LNR (%) was determined as 8.831. Overall, patients with high LNR (≥8.831%; n=29) showed worse disease-free survival (DFS) than those with low LNR (<8.831%, n=26) (p=0.027), whereas no difference in overall survival was observed. Multivariate analyses adjusting for clinicopathologic factors revealed that DFS was adversely affected by both MIS [adjusted hazard ratio (HR), 8.132; p=0.038] and high LNR (adjusted HR, 10.837; p=0.045). In a subgroup of open surgery cases, LNR was not associated with disease recurrence. However, in a subgroup of MIS cases, high LNR was identi- fied as an independent poor prognostic factor for DFS (adjusted HR, 14.578; p=0.034). Conclusion: In patients with node-positive, early-stage cervical cancer, high LNR was associated with a significantly higher disease recurrence rate. This relationship was further consolidated among patients who received MIS RH. [ABSTRACT FROM AUTHOR]

Objective Evidence on recurrence patterns after bevacizumab in epithelial ovarian cancer is still insufficient. The aim of this study was to evaluate recurrence patterns after treatment with bevacizumab as second-line treatment in patients with platinum-sensitive, recurrent epithelial ovarian cancer. Methods We retrospectively identified epithelial ovarian cancer patients who relapsed ≥6 months after primary treatment consisting of surgery and platinum-based chemotherapy between January 2008 and June 2019. Only those who received platinum-based doublet chemotherapy with bevacizumab or without bevacizumab as second-line treatment were included (n=192). To adjust confounders, we conducted 1:2 propensity score matching for platinum-free interval and secondary debulking surgery. Imaging studies were performed to locate newly developed or enlarged pre-existing tumors. Recurrence patterns were compared between bevacizumab users (study group) and non-users (control group). Results After matching, the study group (n=52) and control group (n=104) showed similar baseline clinicopathologic characteristics including platinumfree interval (median (range) 15.3 (6.2--87.3) vs 14.0 (6.2--143.5) months; p=0.29) and patient age at the time of first recurrence (median (range) 55.5 (33.7--72.4) vs 55.0 (35.7--84.2) years; p=0.56). Initially, FIGO stage III disease was the most common in both two groups (55.8% vs 66.3%; p=0.20). Bevacizumab users were less likely to develop disease recurrence in the retroperitoneal lymph nodes (13.5% vs 34.6%; p=0.005), pelvis (17.3% vs 35.6%; p=0.018), and abdomen (40.4% vs 61.5%; p=0.012). However, no difference in distant metastasis was observed between the groups (23.1% vs 24.0%; p>0.99). Multivariate analyses adjusting for stage, histologic type, grade, platinum-free interval, and secondary debulking surgery revealed that the use of bevacizumab significantly reduced risks of nodal (adjusted HR (aHR) 0.24; 95% CI 0.10 to 0.56; p=0.001), pelvic (aHR 0.32; 95% CI 0.15 to 0.68; p=0.003), and abdominal recurrences (aHR 0.43; 95% CI 0.26 to 0.71; p=0.001). Nevertheless, use of bevacizumab did not influence risk of distant metastasis (aHR 0.70; 95% CI 0.35 to 1.40; p=0.32). Conclusions In patients with platinum-sensitive, recurrent epithelial ovarian cancer, second-line chemotherapy with bevacizumab is associated with reduced risks of nodal, pelvic, and abdominal recurrences, but similar risks of distant metastases. [ABSTRACT FROM AUTHOR]

background The optimal treatment of recurrent ovarian clear cell carcinoma remains unknown. There is increasing rationale to support the role of immune checkpoint inhibitors targeting the programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) axis in ovarian clear cell carcinoma. Primary objective To evaluate the efficacy of durvalumab (MEDI-4736) compared with standard chemotherapy in patients with recurrent ovarian clear cell carcinoma. study hypothesis Patients with recurrent ovarian clear cell carcinoma treated with durvalumab will have improved progression-free survival compared with those treated with chemotherapy of physician's choice. trial design The MOCCA study is a multicenter, open-label, randomized phase II trial in patients with recurrent ovarian clear cell carcinoma, which recruited from eight sites across Gynecologic Cancer Group Singapore (GCGS), Korean Gynecologic-Oncology Group (KGOG), and Australia New Zealand Gynecological Oncology Group (ANZGOG). Enrolled patients were randomized in a 2:1 ratio to receive durvalumab or physician's choice of chemotherapy until disease progression, intolerable toxicity, or withdrawal of patient consent. Major inclusion/exclusion criteria Eligible patients required histologically documented diagnosis of recurrent ovarian clear cell carcinoma, as evidenced by WT1 negativity. All patients must have been of Eastern Cooperative Oncology Group (ECOG) performance status 2 or better, and have had previous treatment with, and progressed or recurred after prior platinum-based chemotherapy. No more than four prior lines of treatment were allowed and prior immune checkpoint inhibitor treatment was not permitted. Primary endpoints The primary endpoint was the median progression-free survival following treatment with durvalumab, compared with physician's choice of chemotherapy. Progression-free survival was defined as the time from the first day of treatment to the first observation of disease progression, or death due to any cause, or last follow-up. sample size The target sample size was 46 patients. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the effect of a nurse short message service by cellular phone and the Internet on glycosylated hemoglobin (HbA1c) levels and adherence to diabetes control recommendations. The patients with diabetes were asked to input their blood glucose levels every day by cellular phone or the Internet. Optimal recommendations were sent weekly to each patient by short message service. After 12 weeks, the patients had a mean decrease of 1.1% in HbA1c level and an increase in diabetic medication taking, 30 minutes of physical exercise, and foot care adherence. [ABSTRACT FROM AUTHOR]

This study applied a 12-week educational intervention that used both the cellular phone and the Internet to send short message service. Forty-two diabetic patients were asked to access a Web site by using a cellular phone or wire Internet and input their blood glucose levels every day. Patients were sent the optimal recommendations by both the cellular phone and the Internet. After 12 weeks, the patients had a mean decrease of 28.6 mg/dL in fasting plasma glucose and 78.4 mg/dL in 2-hour postprandial blood sugar levels and a mean increase in the care satisfaction score. [ABSTRACT FROM AUTHOR]

This study investigated the effects of a nurse-coordinated intervention on patients with type 2 diabetes in Korea. Fifteen patients were randomly assigned to an intervention group and 10 to a control group. The intervention was implemented for 12 weeks by telephone. Patients in the intervention group had a mean decrease of 1.2% in glycosylated hemoglobin (HbA1c) levels and those in the control group had a mean increase of 0.5%. Patients' satisfaction with care was higher in the intervention group than in the control group after the intervention. These findings indicated that the nurse-coordinated intervention could improve HbA1c levels and satisfaction with care in patients with type 2 diabetes in Korea. [ABSTRACT FROM AUTHOR]