Search

This study compared the surgical outcomes of transoral endoscopic thyroidectomy vestibular approach (TOETVA) and transoral robotic thyroidectomy (TORT) in papillary thyroid cancer (PTC).The TOETVA and TORT groups comprised 119 and 121 patients between November 2016 and May 2022. Clinico-surgical outcomes and operation times were retrospectively reviewed.The TORT group showed a higher number of retrieved central compartment lymph nodes, shorter hospital stays, and lower pain score after 48 h than the TOETVA group. No significant difference was observed in the other postoperative complications, including permanent vocal cord palsy. Total operation, working space creation, and endoscopic or robotic surgery times of the TORT group were longer than those of the TOETVA group.TORT and TOETVA are feasible and safe. TORT may have some advantages, such as central compartment node dissection, shorter hospital stays, and pain score after 48 h in PTC, despite a longer operative time.

Background: Robot nipple sparing mastectomy (RNSM) has emerged for breast cancer treatment and for risk reducing mastectomy in women who have high risk of pathogenic variants. Even though several studies have reported that RNSM is a feasible procedure, some argue that RNSM are only performed by several specialized surgeons and there is only limited data reporting about the oncologic outcome and patient reported outcome (PRO). Recently, the United States Food and Drug Administration and several surgeons have warned that robot breast surgery should be performed only by specialized surgeons and the benefits, risks, and alternatives of all available treatment options should be discussed with patients to make the most informed treatment decision. The Korea Robot-Endoscopy Minimal Access Breast Surgery Study Group (KoREa-BSG) has been established to evaluate, standardize, and developing education program this cutting-edge procedure. We designed a multicenter prospective cohort study of Mastectomy with Reconstruction including Robot Endoscopic Surgery (MARRES) to report surgical outcome, PRO, and oncologic outcome. Methods: The MARRES study is a multi-institution cohort study that prospectively collects data from patients undergoing mastectomy and reconstruction. Patients' inclusion criteria are as below; adult women over the age of 19, with breast cancer or high risk of breast cancer (patients with a BRCA1/2 mutation, TP53 mutation, and PALB2 mutation), who scheduled therapeutic or prophylactic mastectomy, and who want immediate reconstruction. Surgical outcomes, oncologic outcomes, cost-effectiveness, and PRO were collected. The primary endpoints were postoperative complication rates in postoperative 30 days and Clavien-Dindo grade of postoperative complications in postoperative 180 days. The secondary endpoints were recurrence free survival in postoperative 5 years, cancer incidence rate in postoperative 5 years for those who underwent risk reducing mastectomy, patient's satisfaction within preoperative 4 weeks and results within postoperative 6 months to 12 months, surgeon's satisfaction about the postoperative results in postoperative 6 months, and cost-effectiveness of the definitive surgery. Patient recruitment will be finished in April 2025 and the goal number of enrolled patients is 2,000. Discussion: This study will provide evidence of the surgical outcome, PRO, and oncologic outcome of RNSM and endoscopic NSM compared to conventional NSM. Trial registration: ClinicalTrials.gov Identifier NCT04585074. Registered April 8, 2020. Citation Format: Jeea Lee, Jai Min Ryu, Jee Yeon Lee, Beom Seok Ko, Saebyeol Lee, Joo Heung Kim, Hee Jun Choi, Hyuk-Jae Shin, Young Woo Chang, Hye Yoon Lee, Hong-Kyu Kim, Hyung Seok Park. Mastectomy with reconstruction including robot endoscopic surgery (MARRES): A prospective cohort study of the Korea robot-endoscopy minimal access breast surgery study group (KoREa-BSG) [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr OT2-12-01.

The ranked discrepancy model (RDM) is a relatively novel needs assessment approach and is optimized for addressing ordinal and non-normally distributed data. This study aimed to explore the viability of the RDM by comparing the results obtained from it with those obtained using two other long-standing needs assessment models, and to prioritize the learning needs of secondary school career guidance teachers in South Korea using the RDM as an initial effort to improve the pre-service and in-service educational programs of teachers. Data were collected from 75 career guidance teachers by using a survey questionnaire. The results from the RDM, the weighted total index (WTI) approach, and the Borich model demonstrated a great deal of consistency in terms of the rankings of career guidance teachers’ learning needs. This implies that the RDM is a useful quantitative method for needs assessment in cases involving ordinal items, cross-sectional data, or non-normally distributed data. This study also revealed that “providing and utilizing occupational information” is the biggest shortfall among the job tasks required of secondary school career guidance teachers, compared to its importance. Uncertainty about the future might make it more difficult for career guidance teachers to provide students with the appropriate occupational guidance.

At a time of global economic crisis, professional programs in universities are demanded to make continuous improvements based on new information on performance gaps of novice incumbents, in order to make their graduates more competitive, which ultimately leads to their job security and decent work. Accordingly, this study aimed to assess discrepancies in the importance and performance levels of professional capabilities required of novice Human Resource Development (HRD) practitioners and priorities in instructional needs, as perceived by immediate superiors as an initial effort to improve the curricula of undergraduate HRD courses. Data were collected from 193 HRD supervisors in organizations in South Korea and were analyzed using paired t-test and the ranked discrepancy model. These findings indicated that instructional needs in terms of professional capabilities were high in the following order: instructional design, learning science, career and leadership development, coaching, training delivery and facilitation, knowledge management, and technology application. The results implied that most undergraduate courses developed for the education of prospective HRD practitioners need to be updated and improved. This study also proposed an idiosyncratic and periodic formative evaluation process for the ongoing improvement of professional programs in universities as a part of efforts to sustain the global economic growth.

Introduction: The aim of this study was to evaluate the prognostic value of the number of lymph nodes removed in breast cancer patients who undergo axillary lymph node dissection (ALND) after neoadjuvant chemotherapy (NAC). Methods: We included patients who were diagnosed with invasive breast cancer and cytology with proven involved axillary node metastasis at diagnosis and treated with NAC followed by curative surgery at Samsung Medical Center between January 2007 and December 2015. The primary outcomes were disease-free survival (DFS) and overall survival (OS). Results: Among 772 patients with NAC and ALND, there were 285 ypN0, 258 ypN1, 135 ypN2, and 94 ypN3 cases. The median follow-up duration was 69.0 months. The group with less than 10 lymph nodes number (

We evaluated the relationship between breast pathologic complete response (BpCR) and axillary pathologic complete response (ApCR) after neoadjuvant chemotherapy (NACT) according to nodal burden at presentation. As the indications for NACT have expanded, clinicians have started clinical trials for the omission of surgery from the treatment plan in patients with excellent responses to NACT. However, the appropriate indications for axillary surgery omission after excellent NACT response remain unclear.Data were collected from patients in the Korean Breast Cancer Society Registry who underwent NACT followed by surgery between 2010 and 2020. We analyzed pathologic axillary nodal positivity after NACT according to BpCR stratified by tumor subtype in patients with cT1-3/N0-2 disease at diagnosis.A total of 6,597 patients were identified. Regarding cT stage, 528 (9.5%), 3,778 (67.8%), and 1,268 (22.7%) patients had cT1, cT2, and cT3 disease, respectively. Regarding cN stage, 1,539 (27.7%), 2,976 (53.6%), and 1,036 (18.7%) patients had cN0, cN1, and cN2 disease, respectively. BpCR occurred in 21.6% (n = 1,427) of patients, while ApCR and pathologic complete response (ypCR) occurred in 59.7% (n = 3,929) and ypCR 19.4% (n = 1,285) of patients, respectively. The distribution of biologic subtypes included 2,329 (39.3%) patients with hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative disease, 1,122 (18.9%) with HR-positive/HER2-positive disease, 405 (6.8%) with HR-negative/HER2-positive disease, and 2,072 (35.0%) with triple-negative breast cancer . Among the patients with BpCR, 89.6% (1,122/1,252) had ApCR. Of those with cN0 disease, most (99.0%, 301/304) showed ApCR. Among patients with cN1-2 disease, 86.6% (821/948) had ApCR.BpCR was highly correlated with ApCR after NACT. In patients with cN0 and BpCR, the risk of missing axillary nodal metastasis was low after NACT. Further research on axillary surgery omission in patients with cN0 disease is needed.