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Recent prospective studies have shown poorer oncologic outcomes following minimally invasive surgery, which has led many surgeons to deeply inspect their practices. We reviewed our experience and evaluated the results of radical hysterectomy in patients with early stage cervical cancer. This retrospective study included patients with early stage cervical cancer (Ia1 - IIa1) who were treated with radical hysterectomy from May 2006 to Dec 2016. Patients were divided into three groups according to the surgical approach: radical abdominal hysterectomy (RAH), laparoscopic radical hysterectomy (LRH), and robot-assisted radical hysterectomy (RRH). Learning curves of each type of surgery were obtained using the cumulative sum method. Survival rates were compared using Kaplan–Meier curves. To analyze the learning curve of a single surgeon, 89 patients were selected from the whole population. Learning curves of each group showed two distinct phases. The minimum number of cases required to achieve surgical improvement were 16 in RAH, 13 in LRH, and 21 in RRH. Progression-free survival (PFS) and overall survival did not vary between RAH and minimally invasive surgery (MIS) (p =.828 and p =.757, respectively). However, when stratified by the phases of the learning curves, patients included in the early phase of MIS showed a poorer PFS (p =.014). Surgical proficiency could significantly affect the oncologic outcome in MIS. A prospective study regarding sufficient surgical competence is necessary for elaborate analysis of the feasibility of minimally invasive radical hysterectomy. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The purpose of this study was to evaluate the efficacy of cervical cancer screening (CCS) in Korean women over 65years of age and to determine the age at which CCS becomes inefficacious, so that providers and policy makers can be more informed about when to stop screening. Materials and Methods: The data of 999 women, who underwent CCS followed by colposcopy at the Korea University hospital from January 2007 to May 2012, were retrospectively evaluated. Age groups were classified as <21 (n=11), 21–29 (n=128), 30–65 (n=768), and >65 (n=92). To evaluate the value of CCS in women older than 65, age groups were simply divided into ≤65 or >65. Participants were also categorized into five strata of age groups (≤55 vs. >55, ≤60 vs. >60, ≤65 vs. >65, ≤70 vs. >70, and ≤75 vs. >75) that were compared to the sample to assess a cutoff-age at which to cease screening based on decreased efficacy. Results: The mean age was 45.5±13.7 (range14–80). There were no differences in the pathologic results for cervical intraepithelial neoplasia (CIN) values of 65 (13.0%) vs. ≤65 (6.6%), (p=0.037). To assess the cervical cancer incidence (CCI) from the larger number of cases by age, a prediction formula was calculated from a national dataset. CCI (per 100,000) continuously increased by age even for those in their 90s. Conclusion: CCS is still necessary in Korean women older than 65 since there is a substantial CCI rate occurring in these women. It is time to consider new guidelines that include the appropriate age and conditions for discontinuing screening. [Copyright &y& Elsevier]

MicroRNA (miRNA) is an abundant class of small noncoding RNAs that act as gene regulators. Recent studies have suggested that miRNA deregulation is associated with the initiation and progression of human cancer. However, information about cancer-related miRNA is mostly limited to tissue miRNA. The aim of this study was to find specific profiles of serum-derived miRNAs of ovarian cancer based on a comparative study using a miRNA microarray of serum, tissue, and ascites.From 2 ovarian cancer patients and a healthy control, total RNA was isolated from their serum, tissue, and ascites, respectively, and analyzed by a microarray. Under the comparative study of each miRNA microarray, we sorted out several miRNAs showing a consistent regulation tendency throughout all 3 specimens and the greatest range of alteration in serum as potential biomarkers. The availability of biomarkers was confirmed by qRT-PCR of 18 patients and 12 controls.Out of 2222 kinds of total miRNAs that were identified in the microarray analysis, 95 miRNAs were down-regulated and 88 miRNAs were up-regulated, in the serum, tissue, and ascites of cancer patients. Among the miRNAs that showed a consistent regulation tendency through all specimens and showed more than a 2-fold difference in serum, 5 miRNAs (miR-132, miR-26a, let-7b, miR-145, and miR-143) were determined as the 5 most markedly down-regulated miRNAs in the serum from ovarian cancer patients with respect to those of controls. Four miRNAs (miR-132, miR-26a, let-7b, and miR-145) out of 5 selected miRNAs were significantly underexpressed in the serum of ovarian cancer patients in qRT-PCR.Serum miR-132, miR-26a, let-7b, and miR-145 could be considered as potential candidates as novel biomarkers in serous ovarian cancer. Also, serum miRNAs is a promising and useful tool for discriminating between controls and patients with serous ovarian cancer. [ABSTRACT FROM AUTHOR]

Abstract: Transvaginal natural orifice transluminal endoscopic surgery (NOTES) with pneumoperitoneum has been used in cholecystectomies, appendectomies, and nephrectomies, but transvaginal NOTES using a single port in gynecologic procedures has not been described despite gynecologist familiarity with the vaginal approach. We performed transvaginal single-port NOTES in 10 women with benign uterine adnexal disease: oophorectomy in 3 patients, salpingostomy and salpingectomy in 2 each, and ovarian cystectomy, paratubal cystectomy, and ovarian wedge resection in 1 each. The patients were discharged at 1 or 2 days postoperatively, and were satisfied, with minimal pain, no abdominal scar, and no complications at 2-month follow-up. We conclude that transvaginal single-port NOTES to treat benign uterine adnexal disease is a feasible and attractive option. [Copyright &y& Elsevier]