4th Biennial Meeting 2015

C O N T E N T S
004 Welcome Message Day 2

049 Plenary Session III
005 Meeting Information [Uterine Cervix]
006 ASGO 2015 Executive Committee 061 Plenary Session IV

[Ovary]
007 Local Organizing Committee of ASGO 2015
073 Presidential Lecture
008 Program at a Glance
079 Luncheon Symposium II
009 Floor Plan
083 Symposium I
010 Official Sponsors [Rare Tumor]
011 Exhibition 093 Symposium II

[Int'l Collaboration of Clinical Trials]
012 Scientific Program
107 Symposium III
[MIS for Gynecologic Cancers]
Abstracts 117 Free Communication I

Day 1
023 Plenary Session I 123 Free Communication II
[Current Issues in Gynecologic Cancers]
129 Free Communication III
035 Plenary Session II
[Surgery for Gynecologic Cancers] 135 Free Communication IV
141 Free Communication V
147 Free Communication VI

Day 3
155 Symposium IV
[Translational Research]
169 Symposium V
[Radiation Oncology]
183 Symposium VI
[Tips for Writing Better Manuscripts]
193 Symposium VII

[Uterine Corpus]
209 Symposium VIII

[Uterine Cervix]
223 Symposium IX
[Ovary]
237 Luncheon Symposium III
241 Young Doctors Session I
247 Young Doctors Session II
253 Young Doctors Session III
257 Poster Session
378 Author Index

Welcome Message
Dear Friends and Colleagues!
On behalf of the Organizing Committee of the 4th Biennial Meeting of the Asian Society of Gynecologic
Oncology (ASGO), we would like to warmly welcome you to the 4th ASGO Biennial Meeting on November
12-14, 2015 in Seoul, Korea.
Since ASGO was officially founded in 2008 by a group of committed gynecologic oncologists from Asia,
the ASGO has been rapidly growing through various scientific and educational activities of three ASGO
Biennial Meetings and Workshops, which have been successfully held in Korea and Japan. There were
great opportunities to exchange ideas and receive specialized educations, to welcome medical oncologists,
radiation oncologists and all others interested in the care of patients with gynecologic malignancy to this
society. We firmly believe that ASGO will play a leading role to establish systematic studies and educational
environment and to care Asian patients who are suffered from gynecologic tumors.
In the 4th ASGO Biennial Meeting, under the theme of “For The Most, For The Best Practice in Gynecologic
Oncology”, there will be a wide range of scientific programs which will discuss the cutting-edge of
Gynecologic Oncology as well as convey the knowledge on the Uterine Cervical Cancer, Uterine Corpus,
Rare tumor, International Collaboration of Clinical trials, MIS and Ovarian Cancer. Participants will have the
advantage of conversing and debating hot issues in Gynecologic Oncology.
The venue, Lotte Hotel Seoul, located in the heart of Seoul, has easy access to a variety of cultural
heritage and modern landmarks; Gyeongbokgung Palace, N Seoul Tower and Myeong-dong. Especially,
Myeong-dong, main street right next to the meeting place, offers a wide range of unique experience from
sightseeing to DIY activities, shopping, dining and night life. With so much to do, see and enjoy in Seoul,
we are sure you will meet the present of Seoul and make unforgettable memories during your stay.
We extend a warm invitation to you to join us in Seoul, Korea, and are very much looking forward to
greeting you and your colleagues at the 4th ASGO Biennial Meeting.
Sincerely yours,
Joo-Hyun Nam, M.D., Ph.D. Hee-Sug Ryu, M.D., Ph.D.

President Chairman
Asian Society of Gynecologic Local Organizing Committee
Oncology (ASGO) of ASGO 2015
004
Meeting Information
D A T E November 12 (Thu) – 14 (Sat), 2015
V E N U E Lotte Hotel Seoul
T H E M E For the Most, For the Best Practice in Gynecologic Oncology
HOSTED BY Asian Society of Gynecologic Oncology (ASGO)
SUPPORTED BY KSGO, KGOG, GCIG, IGCS, ESGO, SGO, AOFOG, AOGIN
LANGUAGE English
WEBSITE www.asgo2015.org
Registration & Information Desk
Place Lobby (2F), Lotte Hotel Seoul
November 12 (Thu) 07:00-18:00
Operation Hours November 13 (Fri) 07:00-18:00
November 14 (Sat) 07:00-12:00
Registration fee includes admission to all scientific session, final program & abstract, and meeting kit,
and access to exhibition, welcome reception, banquet, luncheon symposiums, and complimentary coffee
booth.
Certificate
Certificate of attendance will be issued to all participants, and you can find it on the last page of this
Final Program & Abstracts.
005
ASGO Council Members
President
Joo-Hyun Nam (Korea)
President-Elect
Ikuo Konishi (Japan)
Immediate Past-President
Toshiharu Kamura (Japan)
Honorary Advisor
Soon-Beom Kang (Korea) Shingo Fujii (Japan)

Noriyuki Inaba (Japan)
Council Members
Mohamad Farid Aziz (Indonesia) Duk-Soo Bae (Korea)

Zeyi Cao (China) Yin Nin Chia (Singapore)
Uma Devi (India) Efrén Domingo (Philippines)
Seung Cheol Kim (Korea) Suresh Kumarasamy (Malaysia)
Hextan Ngan (Hong Kong) Kazunori Ochiai (Japan)
Hee-Sug Ryu (Korea) Yasuhiro Udagawa (Japan)
Kung-Liahng Wang (Taiwan) Sarikapan Wilailak (Thailand)
Secretary General
Jong-Hyeok Kim (Korea)
Treasurer
Jae-Weon Kim (Korea)
Editor-in-Chief, Journal of Gynecologic Oncology
Jae-Weon Kim (Korea)
006
Local Organizing Committee of ASGO 2015
Chairman Advisor
Hee-Sug Ryu Soon-Beom Kang
Secretary General Assistant Secretary General
Suk-Joon Chang Eun Ji Nam Dong Hoon Suh
Scientific Committee
Duk-Soo BaeChair Young Tae KimVice Chair Jae-Weon KimVice Chair Sokbom Kang
Dae-Yeon Kim Keun Ho Lee Jeong-Won Lee Chulmin Lee
Eun Ji Nam Dong Hoon Suh Chi-Heum Cho
Finance Committee
Seung Cheol KimChair Seok-Mo KimVice Chair Jae-Hoon KimVice Chair Jae-Kwan Lee
Sung-Hoon Kim Woong Ju Jong-Min Lee Sun Joo Lee
Hyun Hoon Chung Jin Hwa Hong Young-Han Park
International Relations Committee
Young-Tak KimChair Byoung-Gie KimVice Chair Sang-Young RyuVice Chair Joong Sub Choi
Soo-Young Hur Teak Sang Lee Sang Wun Kim Tae-Joong Kim
Jae Yun Song Sang-Hoon Kwon Yong Il Kwon
Planning Committee
Sang-Yoon ParkChair Yong Sang SongVice Chair Yong-Man KimVice Chair Suk-Joon Chang
Yong-Joong Song Kwang Beom Lee Myong Cheol Lim Seok Ju Seong
Yong-Beom Kim Woo Dae Kang Kye-Hyun Nam
Advertising/Exhibition Committee
Byung Chan OhChair Sung Han KimVice Chair Ki-Sung RyuVice Chair Yong Il Ji
Yun Hwan Kim Ju-won Roh Won Duk Joo Jeong-Yeol Park
Jaeman Bae HanByeol Cho Hee Seung Kim
Publication Committee
Ki Tae KimChair Seon-Kyung LeeVice Chair Nak Woo LeeVice Chair Dae Hoon Jeong
Jae Yun Song Ki Hyung Kim Chel Hun Choi Dae Gy Hong
Eun-ju Lee Seob Jeon Eun-Seop Song
Abstract Reviewer Committee
Duk-Soo BaeChair Suk-Joon Chang Hyun Hoon Chung Sung Hoon Kim
Jae-Kwan Lee Keun Ho Lee Jeong-Won Lee Chulmin Lee
Dong Hoon Suh Jeong-Yeol Park Myong Cheol Lim Dae Hoon Jeong
Woo Dae Kang Yong Jung Song Jaeman Bae Kyung-Jin Min
So Jin Shin
007
Program at a Glance
Thursday, Nov. 12 Friday, Nov. 13 Saturday, Nov. 14
DAY 1 DAY 2 DAY 3
Crystal Ballroom (2F) Crystal Ballroom (2F) Crystal Ballroom (2F)
Registration
08:00
Symposium Symposium Symposium
08:30 IV V VI
Plenary Session III
(08:00-09:40) (08:00-09:40) (08:00-09:40)
Exhibition & Poster (2F Lobby & Emerald Room)

(08:00-09:40)
09:00 KGOG [Translational [Radiation [Tips for
[Uterine Cervix]
Meeting Research] Oncology] Writing Better
Domestic (08:00- Manuscripts]
09:30 Meeting 10:30)
(09:00-
10:00 10:20) Coffee Break (09:40-10:10) Coffee Break (09:40-10:10)
10:30 Coffee Break

(10:20-10:50) KGOG- Symposium Symposium Symposium
JGOG Plenary Session IV
11:00 VII VIII IX
Domestic Meeting (10:10-12:00)
(10:10-12:10) (10:10-12:10) (10:10-12:10)
Meeting (Closed) [Ovary]
[Uterine [Uterine [Ovary]
11:30 (10:50- (10:30- Corpus] Cervix]

12:00) 12:00)
12:00
Presidential Lecture
Luncheon Symposium (12:00-12:30)
12:30 Luncheon Symposium
(12:00-13:00)
(12:10-13:10)
13:00 Luncheon Symposium
KGOG- (12:30-13:40)
Young Young Young
13:30 Domestic SGOG
Doctors Doctors Doctors
Meeting Meeting
Session I Session II Session III
(13:00- (Closed) Symposium I Symposium Symposium
14:00 II III (13:10-14:10) (13:10-14:10) (13:10-14:00)
14:30) (13:00- (13:40-15:00) (13:40-14:55)
14:30) (13:40-15:00) Closing (14:10-14:20)
[Rare Tumor] [Int'l
14:30 Collaboration [MIS for
Coffee Break of Clinical Gynecologic
(14:30-15:00) Trials] Cancers]
15:00
Coffee Break (15:00-15:30)
Plenary Session I
15:30 (15:00-16:20)
Free Free Free
[Current Issues in
Communication Communication Communication
16:00 Gynecologic Cancers]
I II III
(15:30-16:30) (15:30-16:30) (15:30-16:30)
16:30
Plenary Session II Free Free Free
(16:20-17:40) Communication Communication Communication
17:00
[Surgery for Gynecologic IV V VI
Cancers] (16:30-17:30) (16:30-17:30) (16:30-17:30)
17:30
18:00
18:30
Opening Ceremony & Banquet &
19:00 Welcome Reception ASGO 2015 Awards Ceremony
(18:30-20:00) (18:30-20:00)
Video Recording Session
008
Floor Plan
<2nd Floor>
• Exhibition • Preview Room / Secretariat
• Lounge
• Poster Session
Jade Emerald Room

Room
Registration
• Domestic Meeting (KSGO, KGOG) Crystal Ballroom

• KSGO General Meeting
• Plenary Session (I-IV)
• Symposium (I-IX)
• Free Communication (I-VI)
• Young Doctors Session (I-III)
• Luncheon Symposium (I-III)
• Presidential Lecture
• Opening Ceremony & Welcome Reception
• Banquet & ASGO 2015 Awards Ceremony
• Closing
<3rd Floor>
• VIP Room (Nov. 11 - 13)

Athene
Garden • AGOG Meeting (Nov. 12)
• KSGO Board Meeting (Nov. 12)
• Council Meeting (Nov. 13)
009
Official Sponsors
010
Exhibition
The Organizing Committee of ASGO 2015 sincerely thanks all exhibitors for their contributions and support.
DATE & TIME November 12 (Thu) – 13 (Fri) 08:00-18:00
November 14 (Sat) 08:00-11:00
P L A C E Lobby (2F), Lotte Hotel Seoul, Korea
Exhibition Floor Plan
S9 S10 S11 S12 S13 S14 S15
S1 S2 S3 S4
S24 S16 S17 S18 S19 S20 S21

S5 S6 S7 S8 G1 G2 G3 G4 P2
Registration S22 S23 D1 D2 P1
Crystal Ballroom
No. Category Booth No. Exhibitor No. Category Booth No. Exhibitor
1 D2 Roche Korea 16 S14 Hospicare
Diamond
2 D1 Janssen Korea 17 S15 Covidien
3 P2 AstraZeneca 18 S4 Huons
Platinum
4 P1 MSD Korea 19 S6 Bom Medical
5 G2 Intuitive Surgical 20 S5 AM Tech
6 G1 Boryung Pharmaceutical 21 S13 CJ Health Care
Gold
7 G4 Olympus 22 S8 Samsung Medison
8 G3 Bayer Korea 23 Silver S12 UNIMED
9 S22 & S23 Samyang Biopharm 24 S9 Meditech Inframed
10 S18 Astellas Pharma Korea 25 S10 GSK
11 S19 Hanmi Pharmaceutical 26 S24 Stryker
12 Silver S20 Dalim Medical 27 S3 Johnson & Johnson Medical
13 S21 Chong Kun Dang 28 S11 Ildong Pharmaceutical
14 S17 HOIL BIOMED 29 S16 Pharmbio Korea
15 S7 NTL Medical Institute 30 S2 Shinpoong
011
Scientific Program
Day 1 – November 12 (Thu), 2015
Plenary Session I. Current Issues in Gynecologic Cancers
Time & Place: 15:00-16:20, Crystal Ballroom (2F)

Chairperson: Toshiharu Kamura (Japan), Soon-Beom Kang (Korea)
PS1-01 (15:00-15:20) The development of PARP inhibitors to treat ovarian cancer Jonathan Ledermann (UK)
Fertility preservation in patients with gynecologic cancer:

PS1-02 (15:20-15:40) Nao Suzuki (Japan)
new topics of ovarian tissue cryopreservation
Clearance of persistent HPV infection and cervical lesion by

PS1-03 (15:40-16:00) Tae Jin Kim (Korea)
therapeutic DNA vaccine in CIN3 patients
Robot assisted radical hysterectomy with complete resection of

PS1-04 (16:00-16:20) uterosacral ligament (Modified total mesometrial Resectiom,TMMR) Yoon Soon Lee (Korea)
for the cervical cancer
Plenary Session II. Surgery for Gynecologic Cancers

Chairperson: Shingo Fujii (Japan), Hextan Ngan (Hong Kong)
PS2-01 (16:20-16:40) Impact of aggressive surgery on survival in advanced ovarian cancer Dennis Chi (USA)
PS2-02 (16:40-17:00) Upper abdominal debulking procedures in advanced ovarian cancer Suk-Joon Chang (Korea)
Role of modified posterior pelvic exenteration in gynecologic

PS2-03 (17:00-17:20) Kazuyoshi Kato (Japan)
cancers
PS2-04 (17:20-17:40) Radical Trachelectomy: Nerve-Sparing Procedures Rongyu Zang (China)
Opening Ceremony & Welcome Reception
012
Day2 – November 13 (Fri), 2015
Plenary Session III. Uterine Cervix

Chairperson: Ikuo Konishi (Japan), Duk-Soo Bae (Korea)
Suresh Kumarasamy
PS3-01 (08:00-08:20) HPV infection-epidemiology and burden of disease
(Malaysia)
PS3-02 (08:20-08:40) Primary HPV screening for cervical cancer Warner Huh (USA)
PS3-03 (08:40-09:00) Clinical implications of functional imaging in uterine cervical cancer Hyun Hoon Chung (Korea)
PS3-04 (09:00-09:20) Sentinel node navigation surgery for uterine cervical cancer Hiroaki Kobayashi (Japan)
PS3-05 (09:20-09:40) The effect of neo-adjuvant chemotherapy in cervical cancer Lan Xie (China)
Plenary Session IV. Ovary

Chairperson: Kazunori Ochiai (Japan), Seung Cheol Kim (Korea)
PS4-01 (10:10-10:35) Report of the 5th OCCC Aikou Okamoto (Japan)
Prevalence Study of Germline BRCA 1/2 Mutation in Korean Patients

PS4-02 (10:35-11:00) Byoung-Gie Kim (Korea)
with Ovarian Cancer
PS4-03 (11:00-11:30) Novel therapeutics in ovarian cancer Robert Coleman (USA)
PS4-04 (11:30-12:00) Immunotherapy in ovarian cancer Eric Pujade-Lauraine (France)
Time & Place: 12:00-12:30,Crystal Ballroom (2F)

Chairperson: Hee-Sug Ryu (Korea)
PL-01 (12:00-12:30) Evolution of surgery in gynecologic oncology Joo-Hyun Nam (Korea)
Luncheon Symposium II
Time & Place: 12:30-13:40,Crystal Ballroom (2F)

Chairperson: Seon-Kyung Lee (Korea)
How bevacizumab has changed the landscape of ovarian cancer

LS-02 Eric Pujade-Lauraine (France)
resistant disease: the AURELIA trial
Symposium I. Rare Tumor
Time & Place: 13:40-15:00, Crystal Ballroom 2 (2F)

Chairperson: Yasuhiro Udagawa (Japan), Gatot Purwoto (Indonesia)
Suwanit Therasakvichya
S1-01 (13:40-14:00) Multiple primary cancer
(Thailand)
Endometriosis associated ovarian carcinoma:

S1-02 (14:00-14:20) Xipeng Wang (China)
what is molecular pathogenesis drive
Alternative chemotherapy to EMACO in the treatment of

S1-03 (14:20-14:40) Karen Chan (Hong Kong)
gestational trophoblastic neoplasia
S1-04 (14:40-15:00) Leiomyosarcoma after morcellation of leiomyoma Keun Ho Lee (Korea)
013
Symposium II. International Collaboration of Clinical Trials

Chairperson: Daisuke Aoki (Japan), Young Tae Kim (Korea)
The value of collaborative international clinical trials in women's

S2-01 (13:40-13:55) Gavin Stuart (Canada)
cancer
Update on recently completed and planned randomized clinical

S2-02 (13:55-14:10) Michael Bookman (USA)
trials from NRG-GOG
S2-03 (14:10-14:25) Important JGOG studies of ovary/corpus/cervix Toru Sugiyama (Japan)
S2-04 (14:25-14:40) Ongoing trials from KGOG Jae-Hoon Kim (Korea)
S2-05 (14:40-14:55) ENGOT clinical trials: future development in ovarian cancer therapy Christian Marth (Austria)
Symposium III. Minimally Invasive Surgery for Gynecologic Malignancies

Chairperson: Zeyi Cao (China), Kung-Liahng Wang (Taiwan)
S3-01 (13:40-14:00) Role of LESS in oncology Tae-Joong Kim (Korea)
S3-02 (14:00-14:20) Robotic pelvic exenteration for recurrent cervical cancer Peter Lim (USA)
S3-03 (14:20-14:40) Unexpected uterine malignancy: pitfall of laparoscopic surgery Pao-Ling Torng (Taiwan)
S3-04 (14:40-15:00) The variations on robotic radical hysterectomy Dae-Yeon Kim (Korea)
Free Communication I

Chairperson: Ting-Chang Chang (Taiwan), Jae-Kwan Lee (Korea)
Clinical impact of anti-PD-1 antibody (Nivolumab) for platinum-

FC1-01 (15:30-15:40) Junzo Hamanishi (Japan)
resistant ovarian cancer
Clinical significance of BRCA testing and genetic counseling in

FC1-02 (15:40-15:50) Min Kyu Kim (Korea)
advanced stage ovarian carcinoma
Ascites derived tumor associated macrophages alter chemosensitivity

FC1-03 (15:50-16:00) Seob Jeon (Korea)
in ovarian cancer cell line
IL-17a and IL-21 combined with surgical status predict the outcome
FC1-04 (16:00-16:10) Yu-Li Chen (Taiwan)
of ovarian cancer patients
Extensive upper abdominal surgery prolongs the long term survival

FC1-05 (16:10-16:20) Yulan Ren (China)
of patients with chemosensitive stage IIIC and IV ovarian cancer
Paradigm shift in surgical complexity since change in surgical

FC1-06 (16:20-16:30) Pesona Lucksom (India)
practice from optimal to complete cytoreduction in ovarian cancer
014
Free Communication II
Chairperson: Xiaohua Wu (China), Yong Man Kim (Korea)
Incidence and capability to treat cervical cancer in Dr.Soetomo
FC2-01 (15:30-15:40) Hari Nugroho (Indonesia)
General Hospital Surabaya Indonesia
Parametrial involvement in early stage cervical cancer patients
FC2-02 (15:40-15:50) Jinwei Miao (China)
treated with radical/modified radical hysterectomy in Beijing
The survival rate of abdominal radical trachelectomy versus abdominal
FC2-03 (15:50-16:00) radical hysterectomy for stage IB1 cervical cancer ≥2cm: Xiaoqi Li (China)
a case-control study with 248 patients
Cervical stenosis following abdominal radical trachelectomy:
FC2-04 (16:00-16:10) Jin Li (China)
a report of 10-years experience
Pelvic reirradiation as an effective alternative to pelvic exenteration
FC2-05 (16:10-16:20) Taehun Kim (Korea)
in recurrent cervical cancer
The possibility of omission of adjuvant radiotherapy for patients
FC2-06 (16:20-16:30) Tomoyasu Kato (Japan)
with vulvar cancer stage IIIA
Free Communication III
Chairperson: Chyong-Huey Lai (Taiwan), Joong Sub Choi (Korea)
Health behaviors and associated sociodemographic factors in cervical
FC3-01 (15:30-15:40) Boyoung Park (Korea)
cancer survivors: baseline data from Health Examinee Cohort
FC3-02 (15:40-15:50) The role of sentinel lymph node mapping for endometrial cancer Navamol Lekskul (Thailand)
Which type of hysterectomy and adjuvant treatment for stage II
FC3-03 (15:50-16:00) endometrioid endometrial cancer is suitable? Hung-Chun Fu (Taiwan)
(A Taiwanese Gynecologic Oncology Group study)
Prognostic impact of tumor grade and histology in metastatic
FC3-04 (16:00-16:10) Tien Le (Canada)
(stage II to IV) endometrial carcinoma
A retrospective review of clinical presentation, and prognosis of
the squamous cell carcinoma malignant transformation in mature
FC3-05 (16:10-16:20) An Jen Chiang (Taiwan)
teratoma of the ovary-Multiple Medical Center Cooperation Study
(TGOG)
The way of tumor removal with oncologic safety in uterine sarcoma:
FC3-06 (16:20-16:30) Jin Young Choi (Korea)
macro-versus micro-seeding
Free Communication IV
Chairperson: Pengpeng Qu (China), Jong Min Lee (Korea)
Cervical cancer screening in Indonesia:
FC4-01 (16:30-16:40) Laila Nuranna (Indonesia)
from VIA, to DoVIA, to tele-DoVIA
FC4-02 (16:40-16:50) Cervical cancer screening with VIA in eastern Nepal - 3 years analysis Pappu Rijal (Nepal)
Prediction of LVSI in endometrioid adenocarcinoma by transvaginal
FC4-03 (16:50-17:00) Yuan Yang (China)
ultrasound through intrauterine echo flow resistance index
The difference in the declining of β HCG levels between low risk
Gatot N A Winarno
FC4-04 (17:00-17:10) gestational trophoblastic tumor chemotherapy which is given
(Indonesia)
vitamin A and chemotherapy alone
Clinical characteristics and management protocol of Gestational
FC4-05 (17:10-17:20) Sabera Khatun (Bangladesh)
Trophoblastic Disease (GTD) in BSMMU
FC4-06 (17:20-17:30) Epidemiology of ovarian cancer in Zaria, Nigeria Marliyya Zayyan (Nigeria)
015
Free Communication V

Chairperson: Hidetaka Katabuchi (Japan), Wisit Supakarapongkul (Thailand)
Fas Ligand (FasL) in association with Tumor-Infiltrating Lymphocytes Tricia Dewi Anggraeni
FC5-01 (16:30-16:40)
(TILs) in early stage cervical cancer (Indonesia)
The impact of 10 most common HPV genotypes on the progression

FC5-02 (16:40-16:50) of cervical intraepithelial lesions in women with ASCUS or LSIL Mi-Kyung Kim (Korea)
at 6 months follow-up: the Korean HPV cohort study
Feasibility study of personalized peptide vaccine in recurrent of

FC5-03 (16:50-17:00) advanced cervical cancer previously treated with platinum based Kouichiro Kawano (Japan)
chemotherapy
The mutation spectrum revealed by paired genome sequences from

FC5-04 (17:00-17:10) Lijun Zhao (China)
a endometrial serous carcinoma patient
FC5-05 (17:10-17:20) Genetic features of endometrial stromal sarcoma of uterus Youn Jin Choi (Korea)
Sphingosine kinase 1 is a reliable prognostic factor and a novel

FC5-06 (17:20-17:30) Gun Yoon (Korea)
therapeutic target for uterine cervical cancer
Free Communication VI

Chairperson: Andri Andrijono (Indonesia), Kye-Hyun Nam (Korea)
Application of topical imiquimod for treatment cervical

FC6-01 (16:30-16:40) intraepithelial neoplasia in young women: Phill-Seung Jung (Korea)
a preliminary result of a pilot study
Single port transperitoneal laparoscopic infrarenal paraaortic

FC6-02 (16:40-16:50) lymphadenectomy as part of staging operation for early ovary Yoon Hee Lee (Korea)
cancer and high grade endometrial cancer
Ultrasound-guided intranodal lymphangiography with glue

FC6-03 (16:50-17:00) embolization: a novel technique to treat chylous or lymphatic ascites Tae-Wook Kong (Korea)
after retroperitoneal lymphadenectomy in gynecologic cancer
Controversies in the management of endometrial cancer:

FC6-04 (17:00-17:10) Jung-Yun Lee (Korea)
an international survey from East Asia
Cost effectiveness analysis on advanced stage cervical carcinoma

FC6-05 (17:10-17:20) Rizal Sanif (Indonesia)
patients at General Hospital of Dr. M. Hoesin Palembang
Primary cytoreductive and NACT-IDS in advanced epithelial ovarian

FC6-06 (17:20-17:30) Jayashree Natarajan (India)
cancer: Kmio experience
Banquet & ASGO 2015 Awards Ceremony
016
Day3- November 14 (Sat), 2015
Symposium IV. Translational Research

Chairperson: Yin Nin Chia (Singapore), Chi-Heum Cho (Korea)
S4-01 (08:00-08:20) Novel therapeutic modality of epithelial ovarian cancer Hidetaka Katabuchi (Japan)
Precision cancer therapeutics using conditionally reprogrammed cell
S4-02 (08:20-08:40) Eun Ji Nam (Korea)
and patient-derived xenograft model
Triple screening of gynecological cancers: the power and promise of
S4-03 (08:40-09:00) Hung-Cheng Lai (Taiwan)
DNA methylation biomarkers
S4-04 (09:00-09:20) Drug repositioning: a new therapeutic strategy for ovarian cancer Jeong-Won Lee (Korea)
Malignant transformation of endometriosis based on the role of
S4-05 (09:20-09:40) Hariyono Winarto (Indonesia)
oxidative stress
Symposium V. Radiation Oncology
Chairperson: Sarikapan Wilailak (Thailand), Won Park (Korea)
S5-01 (08:00-08:25) Current status of IMRT for cervical cancer Takafumi Toita (Japan)
S5-02 (08:25-08:50) The present and future of image-guided brachytherapy Yeon-Joo Kim (Korea)
S5-03 (08:50-09:15) The role of adjuvant radiotherapy in uterine carcinosarcoma Yong Bae Kim (Korea)
Prevention of radiation-induced acute intestinal symptoms in
S5-04 (09:15-09:40) Juan Wang (China)
gynecologic cancers
Symposium VI. Tips for Writing Better Manuscripts
Chairperson: Kimio Ushijima (Japan), Noh Hyun Park (Korea)
S6-01 (08:00-08:30) Ten tips of writing medical articles Sung-Tae Hong (Korea)
S6-02 (08:30-08:50) How to paraphrase English text effectively? Chulmin Lee (Korea)
S6-03 (08:50-09:20) Common mistakes by Asian medical writers Myong Cheol Lim (Korea)
S6-04 (09:20-09:40) How to respond to reviewer's comments? Seung-Hyuk Shim (Korea)
Symposium VII. Uterine Corpus
Chairperson: Suresh Kumarasamy (Malaysia), Young Tak Kim (Korea)
Progestins in the fertility-sparing treatment for patients with primary
S7-01 (10:10-10:30) Jeong-Yeol Park (Korea)
and recurrent endometrial cancer
The role of adjuvant therapy for endometrial cancer: Chomporn Sitathanee
S7-02 (10:30-10:50)
experience in Thailand (Thailand)
S7-03 (10:50-11:10) Controversies in surgical treatment of early endometrial cancer Taek Sang Lee (Korea)
S7-04 (11:10-11:30) Endocrine profile of endometrial hyperplasia and cancer Xiaojun Chen (China)
S7-05 (11:30-11:50) Identification and characterization of endometrial cancer stem-like cells Kiyoko Kato (Japan)
Expression of cyclin D1, D3, and retinoblastoma as risk factors of Yudi Mulyana Hidayat
S7-06 (11:50-12:10)
persistent mole (Indonesia)
017
Symposium VIII. Uterine Cervix
Chairperson: Noriaki Sakuragi (Japan), Yoon Soon Lee (Korea)
Surgical strategy for functional radical surgery in patients with
S8-01 (10:10-10:30) Hee Seung Kim (Korea)
cervical cancer
Radical trachelectomy for early stage cervical cancer during
S8-02 (10:30-10:50) Takayuki Enomoto (Japan)
pregnancy
S8-03 (10:50-11:10) HPV genotype and HSIL in menopause women Woo Dae Kang (Korea)
Wichai Termrungruanglert
S8-04 (11:10-11:30) Self-sampling HPV test
(Thailand)
Adenocarcinoma of the uterine cervix: should we treat it differently
S8-05 (11:30-11:50) Dae Hoon Jeong (Korea)
to squamous cell carcinoma?
Response to neoadjuvant chemotherapy in cervical cancer stage IB2 Maringan DL Tobing
S8-06 (11:50-12:10)
and IIA2 (Indonesia)
Symposium IX. Ovary
Chairperson: Jean Anne B. Toral (Philippines), Sang-Yoon Park (Korea)
Fully-sialylated alpha-chain of complement 4-binding protein:
S9-01 (10:10-10:30) Mikio Mikami (Japan)
Diagnostic utility for ovarian clear cell carcinoma
S9-02 (10:30-10:50) Epigenetic alterations in aggressive phenotype ovarian cancer Woong Ju (Korea)
John Whay Kuang Chia
S9-03 (10:50-11:10) Subtype specific trial design for ovarian cancers
(Singapore)
Overcome the limitation of neoadjuvant chemotherapy in epithelial
S9-04 (11:10-11:30) Sung Hoon Kim (Korea)
ovarian cancer
S9-05 (11:30-11:50) Precision management of ovarian cancer by molecular subtypes Ruby Huang (Singapore)
S9-06 (11:50-12:10) The emerging roles of sex hormone receptors in ovarian cancer Yao-Ching Hung (Taiwan)
Luncheon Symposium III
Chairperson: Byung Chan Oh (Korea)
Identification of BRCA mutation in women with epithelial ovarian
LS-03 Hyun Hoon Chung (Korea)
cancer
Young Doctors Session I
Chairperson: Uma Devi (India), Jianliu Wang (China)
YS1-01 (13:10-13:20) Vulva cancer in Neplaese women Jitendra Pariyar (Nepal)
YS1-02 (13:20-13:30) Search for novel genes responsible for ovarian cancer dissemination Koji Yamanoi (Japan)
Fascin as a survival prognostic factor in advanced stage epithelial
YS1-03 (13:30-13:40) Fara Vitranti (Indonesia)
ovarian carcinoma
Optimization of cytoreductive surgery in relation to CA-125 in
YS1-04 (13:40-13:50) Jayashree. N (India)
epithelial ovarian cancer
Targeted nanoparticle system conjugated with FSH peptides against
YS1-05 (13:50-14:00) Xiaoyan Zhang (China)
ovarian carcinoma
Laterally extended endopelvic resection: extended application for
YS1-06 (14:00-14:10) Maria Lee (Korea)
primary or recurrent cervical cancer
018
Young Doctors Session II
Chairperson: Junzo Kigawa (Japan), Soo Young Hur (Korea)
The journey to move Thailand towards minimally invasive surgery

YS2-01 (13:10-13:20) Navamol Lekskul (Thailand)
in gynecologic oncology
Role of UTZ as an alternative to CT scan in assessing para-aortic

YS2-02 (13:20-13:30) Ana Dy-Echo (Philippines)
lymph node metastasis
Possible surrogate marker for an effective dose-dense chemotherapy

YS2-03 (13:30-13:40) Chueh-Yi Huang (Taiwan)
in treating ovarian cancer
The role of subcutaneous suction drain following median

YS2-04 (13:40-13:50) Leena Rose Johnson (India)
laparotomy in gynecological oncosurgery
Whether the lower extremity deep thrombosis affect the prognosis

YS2-05 (13:50-14:00) Zhiqi Wang (China)
of endometrial carcinoma?
Malignant ovarian germ cell tumour: the role of lymphadenectomy

YS2-06 (14:00-14:10) Siew Fei Ngu (Hong Kong)
and VAC chemotherapy
Young Doctors Session III

Chairperson: Ji-Hong Liu (China), Jong-Hyeok Kim (Korea)
Krissada Paiwattananupant
YS3-01 (13:10-13:20) The quality of life is patient's life
(Thailand)
Recent reports on gestational trophoblastic diseases in the

YS3-02 (13:20-13:30) Jimmy Billod (Philippines)
Philippines
YS3-03 (13:30-13:40) The challenges of cervical cancer screening in Malaysia Jamil Omar (Malaysia)
Management and outcomes of stage 1C1 epithelial ovarian Chin Hui Xian Felicia
YS3-04 (13:40-13:50)
carcinoma (Singapore)
YS3-05 (13:50-14:00) Peri-operative period as a critical target for cancer treatment Yoo-Young Lee (Korea)
Closing
019
Day 1
November 12 (THU)
021
Plenary Session I
Current Issues in Gynecologic Cancers
CHAIRPERSON
Soon-Beom Kang (Korea) Toshiharu Kamura (Japan)
SPEAKERS
The development of PARP inhibitors to treat ovarian cancer
Jonathan Ledermann (UK)

Nao Suzuki (Japan)
Clearance of persistent HPV infection and cervical lesion by therapeutic DNA

vaccine in CIN3 patients
Tae Jin Kim (Korea)
Robot assisted radical hysterectomy with complete resection of uterosacral

ligament (Modified total mesometrial Resectiom,TMMR) for the cervical cancer
Yoon Soon Lee (Korea)
023
PS1-01 Speaker
Session I
Plenary
Jonathan Ledermann
Organization
UCL Cancer Institute, University College London, Great Britain
Education
Professor of Medical Oncology, UCL Cancer Institute, and Director Cancer

Research UK & UCL Cancer Trials Centre.
Consultant in Medical Oncology, UCL Hospitals Cancer Centre, London UK
Clinical Researcher in Gynaecological Cancer and Director of one of Cancer
Research UK's National Cancer Trials Centre in the UK
Professional Organizations / Memberships
Member of ASCO, ESMO, ESGO and IGCS. Council of ESGO and Chair of
Gynaecological Cancer Education section at ESMO. Council member of British
Gynaecological Cancer Society, Former Council member of IGCS and past Chair
of the NCRI UK Gynaecological Cancer Studies Group
Main Scientific Publication
More than 200 publications in the field of Clinical Cancer Research in Gynaecological
Cancers and medical oncology. Book chapters and reviews on Gynaecological
Cancers. Book Editor - Management of Ovarian Cancer and Controversies in
Gynecological Cancers. Contributing author for ESMO guidelines for the treatment
of ovarian cancer. Clinical research publications are mostly focussed on phase I to
phase III clinical trials and translational research in ovarian cancer
025
PS1-01
Session I
Plenary
The development of PARP inhibitors to treat ovarian cancer
Jonathan Ledermann
UCL Cancer Institute, University College London, London, UK
Research in the last 10 years has led to a significant change in the opportunities for treating ovarian
cancer, based on knowledge of the biology of the tumour. Central to this is has been the ability to exploit
defective DNA damage repair, present in approximately half of the high-grade tumours and a feature of
platinum sensitivity. Mutations of the BRCA genes play a major role in homologous recombination (HR)
repair of DNA and HR deficiency (HRD) is key to the therapeutic success of inhibitors of PARP (poly-ADP
ribose polymerase), an enzyme involved in the repair of single strand DNA breaks. PARP inhibitors lead to
the accumulation of double strand DNA breaks that cannot be repaired in the presence of HRD, resulting
in cell death by ‘synthetic lethality’. This is exemplified in ovarian cancers with BRCA1/2 mutations, as
the defective proteins results in HRD. Tumour responses, sometimes prolonged were seen in phase I trials
with the PARP inhibitor olaparib, principally in BRCA mutated but also in high-grade serous tumours
without a BRCA mutation. Randomised trials have explored the activity of olaparib as a single agent, in
combination with chemotherapy and as maintenance treatment following chemotherapy. Maintenance
olaparib in women with recurrent high-grade serous cancer responding to chemotherapy resulted in a
significant improvement in progression-free survival (PFS). Overall survival data are immature, but the
benefit of olaparib was seen beyond progression with a significant improvement in the PFS2, the time
to subsequent progression following relapse chemotherapy after progressing on olaparib. Olaparib is
now licensed as maintenance therapy in the EU. In the USA, olaparib is licensed for third or greater line
therapy in BRCA-mutated ovarian cancer as a single agent on the basis of response and PFS data. Other
PARP inhibitors such as niraparib and rucaparib are undergoing clinical trials in both BRCA-mutated and
BRCA-wild type ovarian cancers. There is evidence so suggest that a proportion of patients without germ
line BRCA mutations also have tumour HRD. PARP inhibitors are also being evaluated in combination
with chemotherapy and in combination with other molecularly targeted therapies, for example anti-
angiogenic agents, such as cediranib or bevacizumab. Ovarian cancer can no longer be considered a
single disease, with similar treatments being given to all patients. Mutations of the BRCA gene are the
first established predictive markers in ovarian cancer for response to PARP inhibitors, and refinement of
HRD testing will most likely increase the group of patients who will benefit from this molecularly targeted
therapy. Testing for germ line mutations in the BRCA gene are now becoming part of routine practice,
and about 17-20% women with high-grade disease have either germ line or somatic BRCA mutations.
Integration of testing into clinical practice requires co-operation between oncologists, geneticists and the
laboratory, but has for the first time provided patients with a new oral and well-tolerated treatment that
in some cases controls ovarian cancer for several years
026
PS1-02 Speaker
Session I
Plenary
Nao Suzuki
Organization
Obstetrics and Gynecology, St. Marianna University, Japan
Education
1984-1990 M.D., School of Medicine, Keio University, Tokyo, Japan

1993-1997 Ph.D. in Obstetrics and Gynecology, Graduate School of
Medicine, 1993-1998 Keio University, Tokyo, Japan Medical
license
Apr 1990 Passed national medical board examination and licensed to
practice medicine in Japan Post-graduate medical training
in obstetrics and gynecology
1990-1991 First Year Residency Training at Keio University Hospital,
Tokyo, Japan
1991-1992 Second Year Residency Training at Saiseikai Utsunomiya
Hospital, Tochigi, Japan
1992-1993
Third Year Residency Training at Tokyo Dental College General
Hospital, Chiba, Japan Post-graduate research training
Apr 1996-Sep 1999 Visiting Post-Doctoral Research Fellow, The Burnham
Institute: La Jolla, California, U.S.A. Supervisor: Michiko
N. Fukuda, PhD Research project: Analysis of cellular
and molecular mechanism of the embryo implantation
Experience in obstetrics and gynecology
2000-2005 Instructor at Keio University, School of Medicine, Tokyo, Japan
2005-2008 Assistant Professor at St. Marianna University School of
Medicine, Kanagawa, Japan
2009-2010 Associate Professor at St. Marianna University School of
Medicine, Kanagawa, Japan
2011-2012 Professor at St. Marianna University School of Medicine,
Kanagawa, Japan
2012-present Professor and Chairman at St. Marianna University School
of Medicine, Kanagawa, Japan
027
Session I
Plenary
Japan Society of Obstetrics and Gynecology (JSOG) The Japan Society of Gynecologic Oncology (JSGO)
Asian Society of Gynecologic Oncology (ASGO) The International Gynecologic Cancer Society (IGCS)
Japan Society for Fertility Preservation (JSFP) International Society for Fertility Preservation (ISFP) Asia
Pacific Initiative on Reproduction (ASPIRE)
028
PS1-02
Session I
Plenary
Nao Suzuki
Department of Obstetrics and Gynecology, St. Marianna University, Kawasaki, Japan
Several options are currently available to preserve fertility and give women a chance to have children at
later date for female cancer survivors, including the cryopreservation of embryos, oocytes, and ovarian
tissue. Selection of the most suitable strategy to preserve fertility depends on the type and timing of
chemotherapy, the cancer, the patient’s age, and the patient’s partner. Several studies have shown that
the ovarian tissue can be successfully frozen and grafted in human. Based on Dr. Donnez’s statement,
ovarian tissue cryopreservation should be offered to the patient with cancer before gonadotoxic
chemotherapy in all cases where there is a high risk of POI and where emergency IVF is not possible.
Until now, there are approximately 60 live births after transplantation of frozen-thawed ovarian tissue.
Slow freezing has been a standard method for ovarian tissue cryopreservation and transplantation,
while vitrification is commonly used for cryopreservation of embryos, oocytes, and sperm. We have
conducted preclinical studies using cynomolgus monkeys since 2006 (Hashimoto S, Suzuki N, et al.
Repro Bio Online 2010, Suzuki N, et al. Hum Reprod 2012) and clinical studies since 2010, and we
have reported two live births after ovarian tissue cryopreservation ahdn transplantation with vitrification
(Kawamura K, Cheng Y, Suzuki N, et al. Proc Natl Acad Sci 2013, Suzuki N, et al. Hum Reprod 2015 ).
Vitrification does not require a programmed freezer and it is simpler than the slow freezing method.
However, all cryopreservation protocols employ cryoprotectants that show cytotoxicity, so it is important
to determine the optimal conditions for vitrification by taking into consideration the safety and efficacy
of cryoprotectants. Although this technology does not become suitable indication in most patients with
gynecologic cancer, we hope that the addition of vitrification for OTCP will enable more cancer patients
to have children in the future.
029
PS1-03 Speaker
Session I
Plenary
Tae Jin Kim
Organization
Cheil General Hospital & Women’s Healthcare Center,

Dankook University Colleage of Medicine, Seoul, Korea
Education and Professional Experience
1983-1991 Hanyang University,M.D.

1991-1992 Internship in Samsung Cheil Hospital, Seoul, Korea
1992-1996 Residency in Department of Obstetrics and Gynecology,
Samsung Cheil Hospital, Seoul, Korea
1999-2002 Graduate School, Hanyang University Ph.D.
2004-2006 MD Anderson cancer center, Visiting professor
2015.4.1-present Professor in Dept. of Obstetrics and Gynecology, Director of
Medical Research Institute, Cheil General Hospital & Women’s
Healthcare Center, College of Medicine, Dankook University,
Seoul, Korea
Memberships
The Korean Medical Association

The Korean Cancer Association
The Korean Society of Obstetrics & Gynecology
The Korean Society of Menopause
The Korean Society of Gynecologic Endoscopy
The Korean Society of Gynecologic Oncology and Colposcopy
American Association for Cancer Research
European Society of Gynecological Oncology
030
PS1-03
Session I
Plenary
Clearance of persistent HPV infection and cervical lesion by
therapeutic DNA vaccine in CIN3 patients
Tae Jin Kim

Cheil General Hospital and Women’s Healthcare Center, College of Medicine, Dankook University
Here, we demonstrate that electroporation-enhanced immunization with a rationally designed HPV

DNA vaccine (GX-188E), preferentially targeting HPV antigens to dendritic cells, elicits a significant
E6/E7-specific IFN-g-producing T-cell response in all nine cervical intraepithelial neoplasia 3 (CIN3)
patients. Importantly, eight out of nine patients exhibit an enhanced polyfunctional HPV-specific CD8
T-cell response as shown by an increase in cytolytic activity, proliferative capacity and secretion of
effector molecules. Notably, seven out of nine patients display complete regression of their lesions and
viral clearance within 36 weeks of follow up. GX-188E administration does not elicit serious vaccine-
associated adverse events at all administered doses. These findings indicate that the magnitude of
systemic polyfunctional CD8 T-cell response is the main contributing factor for histological, cytological
and virological responses, providing valuable insights into the design of therapeutic vaccines for
effectively treating persistent infections and cancers in humans.
031
PS1-04 Speaker
Session I
Plenary
Yoon Soon Lee
Organization
Chief of Gynecologic Cancer Center, Kyungpook National University Medical

Center, School of Medicine, Daegu, Korea
Yoon S Lee has pioneered in laparoscopic oncologic surgery in the Korea.

He has experienced of in live surgery at foreign country about robot gynecologic
oncologic surgery and single port laparoscopic radical hysterectomy. He is
the first robotic surgeon who had experience of over 300 robotic surgeries in
Korea. He had experience of 430 cases of robotic surgeries. And he has many
lectures for laparoscopic radical hysterectomy and robot oncologic surgery for all
around world. And he taught the techniques of the robotic radical surgery at his
hospital for Asian Drs, from Japan and Twain, Turkey. He had published a book
about single port surgery for the first time in the world. “Mastering single port
gynecologic surgery using by OCTOport” in year of 2014.
Professional Experience
1993-1997 Assistant professor in Kyungpook national university, school

of medicine
1996-1998 Research fellow in Washington University, Department of
gynecologic oncology, St. Louis. USA
1997-2000 Associated professor in Kyungpook national university, school
of medicine
1999. July Visiting Professor at Dep. of Gynecologic oncology, Friedrich
Schiller University, Jena, Germany
2000 to present Professor in Kyungpook national university, school of medicine
Main scientific publications:
Presentation: SGO Montz Symposium, Invited lecture, SGO 2012 Annual Meeting
March 24-26, 2012, Texas, Austin
032
PS1-04
Session I
Plenary
Robot assisted radical hysterectomy with complete resection of
uterosacral ligament (Modified total mesometrial resectiom, TMMR)
for the cervical cancer
Yoon Soon Lee

Kyungpook National University Hospital Medical Center, Daegu, Korea
The ontogenetic compartment theory means that cancer growth is confined to compartment from a
common primordium in embryonic development. Tumor spread may be through ontogenic compartment
but inhibit at the compartment border.
Conception of TMMR procedure is not familiar to gynecologic oncologist, but Hȍckel introduce the
ontogenetic compartment theory, however most of gynecologic oncologist does not agree with his
theory.
TMMR means complete resection of uterosacral ligament which insert to coccygeous and sacrospinous
ligament complex or pyriformis, sciatic foramen, sacrum.
It is difficult to identify the insertion area of uterosacral ligament, so we inject the methylene blue dye to
cervix, and then identify the blue stained ligament more easily.
First separated mesoureter, IHP and Hypogastric nerve from uterosacral ligament, then cut at level of
insertion to coccygeous and sacrospinous ligament complex or pyriformis, sciatic foramen or sacrum.
After that cut the rectovaginal ligament with preservation of branches of rectal artery.
Whole procedures are performed by delicate movement of robotic system more easily.
We introduce our modified TMMR procedure with da Vinci robotic system.
033
Plenary Session II
Surgery for Gynecologic Cancers
CHAIRPERSON
Shingo Fujii (Japan) Hextan Ngan (Hong Kong)
SPEAKERS
Upper abdominal debulking procedures in advanced ovarian cancer
Dennis Chi (USA)
Upper abdominal procedures in advanced ovarian cancer

Suk-Joon Chang (Korea)
Role of modified posterior pelvic exenteration in gynecologic cancers

Kazuyoshi Kato (Japan)
Radical trachelectomy: nerve-sparing procedures

Rongyu Zang (China)
035
PS2-01 Speaker
Dennis S. Chi
Organization
Session II
Plenary
Memorial Sloan Kettering Cancer Center, USA
BA: Columbia College, Columbia University

MD: NYU School of Medicine Ob/Gyn
Residency: NYU School of Medicine Gyn Onc
Fellowship: Memorial Sloan Kettering Cancer Center
American Medical Association

American Cancer Society of Surgical Oncology
American Society of Clinical Oncology
American College of Obstetricians & Gynecologists
Society of Laparoendoscopic Surgeons
Society of Gynecologic Oncologists
Korean American Medical Association
International Gynecologic Cancer Society
American College of Surgeons
Korean American Medical Physicians Association Society of Pelvic Surgeons
1. Chi DS, Franklin CC, Levine DA, Akselrod F, Sabbaini P, Jarnagin WR, Dematteo
R, Poynor EA, Abu-Rustum N, Barakat RR. Improved optimal cytoreduction
rates for stage IIIC and IV epithelial ovarian, fallopian tube, and primary
peritoneal carcinoma: a change in surgical approach. Gynecol Oncol 2004;94:
650-654
2. Eisenhauer EL, Abu-Rustum NR, Sonoda Y, Levine DA, Poynor EA, Aghajanian
CA, Jarnagin WR, DeMatteo RP, D’Angelica MI, Barakat RR, Chi DS.
The addition of extensive upper abdominal surgery to achieve optimal
cytoreduction improves survival in patients with stage IIIC-IV epithelial ovarian
cancer. Gynecol Oncol 2006;103:1083- 1090
037
PS2-01
Impact of aggressive surgery on survival in advanced ovarian cancer
Dennis S. Chi
Session II
Plenary
Memorial Sloan Kettering Cancer Center, USA
PURPOSE: To determine the impact on progression-free survival (PFS) and overall survival (OS) of a
programmatic change in surgical approach to advanced epithelial ovarian cancer (EOC). Patients and
METHODS: Two groups of patients with stage IIIC and IV ovarian, tubal, and peritoneal carcinoma
were compared. Group 1, the control group, consisted of all 168 patients who underwent primary
cytoreduction from 1/96-12/99. Group 2, the study group, consisted of all 210 patients who underwent
primary surgery from 1/01-12/04, during which time a more comprehensive debulking of upper
abdominal disease was utilized.
RESULTS: There were no differences between the groups in age, primary site of disease, surgical stage,
tumor grade, American Society of Anesthesiologists class, preoperative serum CA-125 and platelet levels,
percentage with or amount of ascites, size or location of largest tumor mass, or type of postoperative
chemotherapy. Patients in Group 2 versus Group 1 more frequently had extensive upper abdominal
procedure (s) (38% vs 0%, respectively; P<0.001) and cytoreduction to residual disease < 1 cm (80% vs
46%, respectively; P<0.01). Five-year PFS and OS rates were significantly improved in Group 2. For Group
2 versus Group 1 patients, 5-year PFS rates were 31% vs 14%, respectively (hazard ratio [HR], 0.757;
95% CI, 0.601-0.953‘ P=0.01]; and 5-year OS rates were 47% vs 35%, respectively (HR, 0.764; 95% CI,
0.592-0.987; P=0.03].
CONCLUSION: The incorporation of extensive upper abdominal procedures resulted in increased optimal
cytoreduction rates and significantly improved PFS and OS. A paradigm shift toward more complete
primary cytoreduction can improve survival for patients with advanced ovarian, tubal and peritoneal
carcinomas.
038
PS2-02 Speaker
Suk-Joon Chang
Organization
Session II
Plenary
Director, Gynecologic Cancer Center
Professor, Department of Obstetrics & Gynecology
Ajou University School of Medicine, Suwon, Korea
Education
1995 MD at Ajou University School of Medicine, Suwon, Korea

2000 MS at Ajou University School of Medicine, Suwon, Korea
2010 PhD at University of Ulsan College of Medicine, Ulsan, Korea
Post Doctorate Training
Residency
1997-2001 Obstetrics and Gynecology, Ajou University Hospital, Suwon, Korea
Fellowship
2004-2005 Gynecologic Oncology, Ajou University Hospital, Suwon, Korea
2005-2006 Gynecologic Oncology, Asan Medical Center, Seoul, Korea Visiting
Scholar
2011-2012 Gynecologic Oncology, UC Irvine Medical Center, Orange, California
Academic Appointments
2006-2010 Assistant Professor, Department of Obstetrics & Gynecology

2010-2015 Associate Professor, Department of Obstetrics & Gynecology
2012-present Director, Gynecologic Cancer Center
2012-present Professor, Department of Obstetrics & Gynecology
Ajou University School of Medicine, Suwon, Korea
Professional Organizations
Korean Medical Association, Korean Society of Obstetrics & Gynecology, Korean

Cancer Association, Korean Society of Gynecologic Oncology, Korean Society of
Gynecologic endoscopy and minimally invasive surgery, Society of Gynecologic
Oncology, international member
039
Publications
1. Chang SJ, Bristow RE, Chi DS, Cliby WA. Role of aggressive surgical cytoreduction in advanced ovarian
cancer. J Gynecol Oncol. 2015 Oct;26 (4):1-7.
2. Chang SJ, Bristow RE. Surgical technique of en bloc pelvic resection for advanced ovarian cancer. J
Session II
Plenary
Gynecol Oncol. 2015 ;26 (3): 115.

3. Chang SJ, Hodeib M, Chang J, Bristow RE. Survival impact of complete cytoreduction to no gross residual
disease for advanced-stage ovarian cancer: A meta-analysis. Gynecol Oncol. 2013;130 (3):493-8.
4. Chang SJ, Bristow RE, Ryu HS. Analysis of para-aortic lymphadenectomy up to the level of the renal
vessels in apparent early-stage ovarian cancer. J Gynecol Oncol. 2013 Jan;24 (1):29-36.
5. Chang SJ, Bristow RE, Ryu HS. Impact of Complete Cytoreduction Leaving No Gross Residual Disease
Associated with Radical Cytoreductive Surgical Procedures on Survival in Advanced Ovarian Cancer.
Ann Surg Oncol. 2012;19 (13):4059-67.
6. Chang SJ, Bristow RE, Ryu HS. Prognostic significance of systematic lymphadenectomy as part of
primary debulking surgery in patients with advanced ovarian cancer. Gynecol Oncol. 2012 Sep;126
(3):381-6.
7. Chang SJ, Ryu HS, Nam JH. Uterine artery-preserving laparoscopic radical trachelectomy for early
cervical cancer: technical aspects. Gynecol Oncol. 2012 Aug;126 (2):277-8.
8. Chang SJ, Ryu HS. Laparoscopic para-aortic lymphadenectomy in endometrial cancer patient with left-
sided inferior vena cava. Gynecol Oncol. 2012 Jul;126 (1):147-8.
9. Chang SJ, Bristow RE, Ryu HS. A model for prediction of parametrial involvement and feasibility of less
radical resection of parametrium in patients with FIGO stage IB1 cervical cancer. Gynecol Oncol. 2012
Jul;126 (1):82-6.
10. Chang SJ, Bristow RE. Evolution of surgical treatment paradigms for advanced-stage ovarian cancer:
redefining 'optimal' residual disease. Gynecol Oncol. 2012 May;125 (2):483-92.
11. Chang SJ, Kong TW, Kim WY, Yoo SC, Yoon JH, Chang KH, Ryu HS. Lymph-vascular space invasion as
a significant risk factor for isolated para-aortic lymph node metastasis in endometrial cancer: a study
of 203 consecutive patients. Ann Surg Oncol. 2011 Jan;18 (1):58-64.
12. Yoon JH, Yoo SC, Kim WY, Chang SJ, Chang KH, Ryu HS. Para-aortic lymphadenectomy in the
management of preoperative grade 1 endometrial cancer confined to the uterine corpus. Ann Surg
Oncol. 2010 Dec;17 (12):3234-40.
13. Chang SJ, Lee EJ, Kim WY, Yoo SC, Yoon JH, Chang KH, Ryu HS. The Value of Sonohysterography in
Preoperative Assessment of Myometrial Invasion for Patients with Endometrial Cancer J Ultrasound
Med. 2010;29 (6):923-9.
14. Chang SJ, Ryu HS, Chang KH, Yoo SC, Yoon JH. Prognostic significance of the micropapillary pattern
in patients with serous borderline ovarian tumors. Acta Obstet Gynecol Scand. 2008;87 (4):476-81.
15. Chang SJ, Kim WY, Yoon JH, Yoo SC, Chang KH, Ryu HS. Para-aortic lymphadenectomy improves
survival in patients with intermediate to high-risk endometrial carcinoma. Acta Obstet Gynecol Scand.
2008;87 (12):1361-9.
040
PS2-02
Upper abdominal debulking procedures for advanced ovarian cancer
Suk-Joon Chang
Session II
Plenary
Gynecologic Cancer Center, Department of Obstetrics and GynecologyAjou University School of Medicine, Suwon, Korea
Ovarian cancer is one of the most lethal gynecologic cancers worldwide, with approximately 240,000
new cases and 150,000 deaths annually. The majority of these patients present with advanced stage
disease, which accounts for the high mortality rate. Primary cytoreductive surgery followed by taxane-
and platinum-based combination chemotherapy is the mainstay of treatment for advanced ovarian
cancer patients. Optimal cytoreduction is associated with a significant survival benefit in patients with
this disease and the contemporary definition of optimal cytoreduction is generally considered as no
gross residual disease (NGR) after primary cytoreductive surgery. Ovarian cancer commonly spreads
along the peritoneal surfaces to the abdomen breaking out of organ boundaries and often it involves
the upper abdomen by direct extension or by peritoneal implantation. It is largely accepted that upper-
abdominal spread of disease represents a major limit to achieve an optimal residual disease after primary
cytoreduction. Furthermore, the addition of extensive upper abdominal debulking surgery increases
the rate of optimal cytoreduction and it is associated with improved survival rates in advanced ovarian
cancer undergoing primary debulking surgery. Reports of optimal cytoreduction rates greater than 50%
generally include a substantial number of patients who underwent extensive upper abdominal procedures
to attain optimal residual disease. In this lecture, I would like to introduce upper abdominal cytoreductive
surgical procedures required to achieve optimal cytoreduction in patients with advanced ovarian cancer
and to analyze the impact of radical upper abdominal surgery - as part of maximal tumor debulking - on
the amount of residual tumor and survival rates.
041
PS2-03 Speaker
Kazuyoshi Kato
Organization
Session II
Plenary
Department of Gynecology, Cancer Institute Hospital Japan, Japan
Education
1987-1993 Chiba University School of Medicine, Chiba, Japan

1999-2003 Chiba University Graduate School of Medicine, Chiba, Japan
Training and professional background
1993-1996 Internship and Residentship, Department of General Surgery,

Chiba University Hospital, Chiba, Japan
1996-1999 Resident, National Cancer Center Hospital, Tokyo, Japan
Training fields; Colorectal Surgery, Gynecology, Urology
2004-2008 Medical Doctor, Department of Gynecology, Chiba Cancer
Center, Chiba, Japan
2008-2012 Research Associate, Department of Obstetrics and Gynecology,
Chiba University School of Medicine, Chiba, Japan
2012- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
Qualification: Specialist of general obstetrics and gynecology in Japan Society of

Obstetrics and Gynecology Specialist of general surgery in Japan Surgical Society
Specialist of gynecologic oncology in Japan Society of Gynecologic Oncology
1. Kato K, Usami T, Takeshima N. Secondary debulking surgery for isolated para-

aortic nodal recurrence in ovarian cancer involving the division of the left renal
vein. Gynecol Oncol 2015;137:188-9.
2. Kazuyoshi Kato, Akiko Yamamoto, Nobuhiro Takeshima. Cytoreduction of
para-aortic lymph nodes behind the inferior vena cava and the right renal
vessels in a patient with fallopian tube cancer. Gynecol Oncol 2014;134:164-5.
3. Kyoko Nishikimi, Shinichi Tate, Kazuyoshi Kato, Takako Kiyokawa, Makio
Shozu. Microscopic residual carcinoma at interval debulking surgery after
neoadjuvant chemotherapy in patients with IIIc/IV Müllerian carcinoma. J Clin
Oncol 32:5s, 2014 (suppl; abstr 5567).
042
PS2-03
Role of modified posterior pelvic exenteration in ovarian cancer
Kazuyoshi Kato
Session II
Plenary
Department of Gynecology, Cancer Institute Hospital Japan, Tokyo, Japan
The effectiveness of maximal cytoreductive surgery for the management of advanced ovarian cancer
has been accepted. As the anatomic proximity of the rectosigmoid colon to the female pelvic organs
and its frequent involvement in advanced ovarian cancer, rectosigmoid resection is the most frequently
performed bowel resection to achieve optimal cytoreduction. Modified posterior pelvic exenteration,
also known as radical oophorectomy or low anterior en bloc resection, during surgery for bulky pelvic
tumor obliterating the cul-de-sac and infiltrating into neighboring pelvic organs facilitates complete
cytoreduction with acceptable morbidity and mortality rates. In this session, I would like to discuss the
role of modified posterior pelvic exenteration as part of maximal cytoreduction in the management of
advanced ovarian cancer and present the tips and pitfalls of the procedures of this surgery.
043
PS2-04 Speaker
Rongyu Zang
Organization
Session II
Plenary
Department of Gynecologic Oncology, Fudan University, Shanghai, China
1. Principal investigator-The effect of secondary cytoreductive surgery on survival

of patients with advanced epithelial ovarian cancer (1996-1999).
2. Principal investigator-Ad.E1a mediated gene therapy for ovarian carcinoma
(1997-1999).
3. Principal investigator-A randomized prospective clinical study of secondary
cytoreduction for advance EOC has been supported by the fund of Shanghai
Health Bureau from 1999 to 2002 (principal investigator).
4. Research experience -osteopontin in early diagnosis of ovarian cancer-National
Oncogene & Related Genes Key Laboratory, Shanghai Cancer Institute (2002.9-
2003.7)
5. Postdoctoral research-Chemoprevention of ovarian cancer, bladder cancer,
and cervical cancer in vivo and in vitro. Modulation of biomarkers in women at
low-risk and high-risk for ovarian cancer using fenretinide (4HPR); translational
study on 4HPR, Poly (L-gutamic acid)-4HPR and agents in chemoprevention;
molecular mechanisms involved in regulation of growth, differentiation and
apoptosis by 4HPR. Arizona Cancer Center, University of Arizona (2003.8-
2004.7) Related methodological experience in cell biology, molecular biology
and IHC: Cell culture, primary cultures; development of recombinant adenoviral
vectors, propagation and purification of adenovirus; apoptosis analysis; DNA/
RNA/protein purification; PCR; RT-PCR; DNA methylation; western blot; tissue
slide preparation and immunohistochemistry; human tumor xenografted nude
mice models. 5 Principal investigator- Weekly intraperitoneal chemotherapy
for patients with advanced epithelial ovarian cancer, a Phase II randomised trial
(2009-2012)
6. Principal investigator- A phase III study to compare the efficacy of additional
cytoreductive surgery versus chemotherapy alone for recurrent platinum-
sensitive ovarian cancer (2011-2015)
044
Other Education Relative to Lecture
7 Principal investigator - A randomized multicenter study to compare the efficacy of additional tumor
debulking surgery versus chemotherapy alone for recurrent platinum-sensitive ovarian cancer (AGO
DESKTOP OVAR III) (2010-2013) 8 Principal investigator - A Phase III Study to Evaluate the Efficacy and
Session II
Plenary
Safety of Pazopanib Monotherapy Versus Placebo in Women Who Have not Progressed after First Line
Chemotherapy for Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer (AGO-OVAR16 /
VEG110655) (2010-2013) 9 Principal investigator - A Phase II Study to Evaluate the Efficacy and Safety
of Pazopanib Monotherapy Versus Placebo in Asian Women Who Have not Progressed after First Line
Chemotherapy for Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer (VEG114012) (2010-
2015) 10 Principal investigatorv-A Phase II,Randomized Study of an Addition Intraperitoneal Cisplatin and
Etoposide to Standard First-line Therapy in Stage IIIC and Stage IV Epithelial Ovarian, Fallopian Tube, and
Primary Peritoneal Cancer (EOC, FTC, PPC) (2009-) ( Recruiting) 11 Principal investigatorv- Evaluation of
Secondary Cytoreductive Surgery in Platinum-Sensitive Recurrent Ovarian Cancer: A Phase III, Multicenter,
Randomized Trial (2012-) ( Recruiting)
1.Vice chairman of the Shanghai Society of Gynecologic Oncology 2.The convener of SGOG (Shanghai
Gynecologic Oncology Group) 3. Member, Chinese Gynecologic Oncology Society
1. Shi TY, Jiang Z, Jiang R, Yin S, Wang MY, Yu KD, Shao ZM, Sun MH, Zang R*, Wei Q. Polymorphisms
in the kinesin-like factor 1 B gene and risk of epithelial ovarian cancer in Eastern Chinese women.
Tumor Biol., 2015; DOI 10.1007/s13277-015-3394-2
2. du Bois A, Floquet A, Kim JW, Rau J, del Campo JM, Friedlander M, Pignata S, Fujiwara K, Vergote
I, Colombo N, Mirza MR, Monk BJ, Kimmig R, Ray-Coquard I, Zang R, Diaz-Padilla I, Baumann KH,
Mouret-Reynier MA, Kim JH, Kurzeder C, Lesoin A, Vasey P, Marth C, Canzler U, Scambia G, Shimada M,
Calvert P, Pujade-Lauraine E, Kim BG, Herzog TJ, Mitrica I, Schade-Brittinger C, Wang Q, Crescenzo R,
Harter P. Incorporation of pazopanib in maintenance therapy of ovarian cancer. J Clin Oncol. 2014;32
(30):3374-82.
3. Chen K, Ma H, Li L, Zang R (Co-first author), Wang C, Song F, Shi T, et al. Genome-wide association
study identifies new susceptibility loci for epithelial ovarian cancer in Han Chinese women. Nature
Commun., 2014; 19 (5): 4682.
045
PS2-04
Radical trachelectomy: nerve-sparing procedures
Rongyu Zang
Session II
Plenary
Department of Gynecologic Oncology, Fudan University, Shanghai, China
Radical trachelectomy is now standard of care in patients with early-stage cervical cancer wishing to
preserve fertility. Operative, oncologic, and obstetrical outcomes are promise and well described by
literature. Either vaginal or abdominal; laparoscopic or robotic procedures are practical, and more, simple
vaginal trachelectomy has been used in early-stage low-risk cervical cancer. Nerve-sparing techniques
are valid in radical surgical procedures for those patients in preserving bladder function and improving
quality of life. However, till now no standard technique is generally recognized in nerve-sparing radical
hysterectomy or trachelectomy (NSRH/T). The oncologic safety of NSRH/T have been addressed by long-
term follow-up and meta-analysis, but the description of NSRH/T in detail fails to be translated into
universal practice because the pelvic plexus may be injured at any time during the surgery, even by
qualified professional surgeons. Herein, we introduce a new approach to preserve the pelvic plexus.
046
Day 2
November 13 (Fri)
047
Plenary Session III
Uterine Cervix
CHAIRPERSON
Ikuo Konishi (Japan) Duk-Soo Bae (Korea)
SPEAKERS
HPV infection-epidemiology and burden of disease
Suresh Kumarasamy (Malaysia)
Primary HPV screening for cervical cancer

Warner Huh (USA)
Clinical implications of functional imaging in uterine cervical cancer

Hyun Hoon Chung (Korea)
Sentinel node navigation surgery for uterine cervical cancer

Hiroaki Kobayashi (Japan)
The effect of neo-adjuvant chemotherapy in cervical cancer

Lan Xie (China)
049
PS3-01 Speaker
Suresh Kumarasamy
Organization
Gynaecological Oncology, Penang Medical College/ Gleneagles Penang, Malaysia
Session III
Plenary
Fellowship in Gynaecological Oncology (U.K.)
Fellowship of the Royal College of Obstetricians & Gynaecologists, London
Fellowship of the Royal College of Physicians of Ireland
Masters in Obstetrics & Gynaecology, University of Malaya
Memberships
Council Member, Asian Society of Gynaecological Oncology Chairman,

Gynaecologiccal Oncology Sub-committee, Obstetrical & Gynaecological Society
of Malaysia
Basic oncology including treatment in less resourced locations. A textbook of

Gynaecology for Less-Resourced Locations. Editors: Heleen van Beekhuizen
& Regine Unkels. Sapients Publishing, 2012 Screening for Gynaecological
Malignancies in Obstetrics and Gynaecology for Postgraduates. Editors: S.
Arulkumaran, Sarala Gopalan and Pratap Kumar. Universities Press (2009)
051
PS3-01
HPV infection - epidemiology & burden of disease
Suresh Kumarasamy
Department of Gynaecological Oncology, Penang Medical College/ Gleneagles Penang, Pulau Pinang, Malaysia
Human Papilloma Virus (HPV) is the number two carcinogen after tobacco. It causes 5% of human
Session III
Plenary
cancer, 10% of cancer in women and 15% of cancer in women in developing countries. Ninety five
percent of HPV related cancers in the developing world occur in women. In industrialised countries, the
incidence of HPV related non-cervical cancer is similar to cervical cancer due to the reduction of cervical
cancer by organized screening programs. In these countries, up to 30% of HPV associated cancers arise
in men. Globally HPV is responsible for almost 100% of cervical cancer, 88% of anal cancer, 70% of
vaginal cancer and 43% of vulval cancer. In addition 42% of penile cancer and 22% of oropharyngeal
cancer is caused by HPV infection. The worldwide estimate of HPV-related cancers in men and women is
more than 600,000 cases annually. This comprises of 500,000 cases of cervical cancer, 24,000 cases of
anal cancer 21,400 cases of oro-pharyngeal cancer, 21,000 cases if vulvar & vaginal cancer and 11,000
cases of penile cancer. In addition 30 million cases of genital warts and the rare recurrent respiratory
papillomatosis are linked to HPV serotypes 6 and 11. Treatment of HPV pre-cancerous lesions detected
by screening programs in developed countries, represent a significant chunk of the healthcare budget.
Globally, HPV sub-types 16 & 18 cause 71% of cervical cancer. The next five most common sub-types
31,33,45,52 and 58 account for another 19% of cases of cervical cancer. In Asia some variability in the
contribution of HPV16 and HPV18 to cervical cancer is seen, ranging from 54% in the Philippines to 90%
in Bangladesh. When the 5 additional high-risk HPV serotypes are added, the variability disappears and
the seven most common subtypes cause 90% of cervical cancer.
052
PS3-02 Speaker
Warner K. Huh
Rank / Title
Rank: Margaret Cameron Spain Endowed Chair in Obstetrics and Gynecology

Professor (Tenured)
Senior Scientist (Comprehensive Cancer Center)
Session III
Plenary
Department: Obstetrics and Gynecology
Hospital and other(non academic) Appointments
University of Alabama at Birmingham
Education
1987 High School Diploma (Graduated with Honors), Phillips Exeter

Academy, Exeter, NH
1991 Bachelor of Arts, Skidmore College, Saratoga Springs, NY
1995 Doctor of Medicine, Georgetown University, Washington, DC
Board Certification
2003 American Board of Obstetrics and Gynecology

2005 Subspecialty Certification: Gynecologic Oncology
2011-2014 Maintenance of Certification:
Postdoctoral Training
1995-1998 Resident, Obstetrics and Gynecology, Tufts University School of

Medicine
19981999 Administrative Chief Resident, Tufts University School of Medicine
January 1998 Felix Rutledge Fellowship, University of Texas, M.D. Anderson
Cancer Center
1999-2002 Fellow/Instructor, University of Alabama, Gynecologic Oncology at
Birmingham
2014 Division Director, University of Alabama, Gynecologic Oncology at

Birmingham
2013 Margaret Cameron Spain Endowed, University of Alabama, Chair
in Obstetrics and Gynecology at Birmingham
053
PS3-02
Primary HPV screening for cervical cancer
Warner Huh
Obstetrics and Gynecology, University of Alabama at Birmingham, USA
On April 24th 2014, the United States Food and Drug Administration (FDA) approved high risk HPV (hrHPV)
Session III
Plenary
testing for primary cervical cancer screening in the United States (US). This was following unanimous
support (13-0) from the FDA Medical Devices Advisory Committee Microbiology Panel Meeting, which
included numerous US experts in the area of cervical cancer screening and prevention, in March
2014. This approval was based and supported from data derived from the ATHENA (Addressing the Need
for Advanced HPV Diagnostics) trial. ATHENA, the largest cervical cancer screening study conducted in
the US, was a registration study sponsored by Roche Molecular Systems that utilized the cobas® 4800
system. The public announcement of an FDA application by Roche for a primary HPV screening claim
triggered the creation of an interim guidance panel to review recent evidence and address specific
questions and concerns regarding using a hrHPV test for primary screening, including ATHENA and data
relevant to the primary HPV screening labeling. This presentation will discuss the rationale of primary
HPV screening, the known limitations of cytology, and the performance of screening in a vaccinated
population.
054
PS3-03 Speaker
Hyun Hoon Chung
Organization
Dept. of Obstetrics & Gynecology, Seoul National University College of Medicine,

Seoul National University Hospital, Korea
Session III
Plenary
Education
1997.02 M.D. Seoul National University College of Medicine, Seoul

2005.08 M.S. Seoul National University College of Medicine, Seoul
(Obstetrics and Gynecology)
2010.08 Ph.D. Seoul National University College of Medicine, Seoul
2003.4-2005.4 Board-Certified Gynecologic Oncologist, Center for Uterine

Cancer, National Cancer Center, Korea
2005.5-2007.2 Clinical Fellow in Obstetrics & Gynecology, Seoul National,
University College of Medicine
2007.3- 2010.2 Commissioned Professor, Seoul National University Hospital
2010.3-2014.2 Clinical Assistant Professor, Seoul National University Hospital
2014.3- Associate Professor, Seoul National University College of
Medicine, Seoul National University Hospital
1. Sarker A, Im HJ, Cheon GJ, Chung HH, Kang KW, Chung JK, Kim EE, Lee DS.
Prognostic Implications of the SUVmax of Primary Tumors and Metastatic
Lymph Node Measured by 18F-FDG PET in Patients With Uterine Cervical
Cancer: A Meta-analysis. Clin Nucl Med. 2015 in press.
2. Chung HH, Cheon GJ, Kim HS, Kim JW, Park NH, Song YS. Pre-operative PET/
CT standardized FDG uptake values of pelvic lymph nodes as a significant
prognostic factor in patients with endometrial cancer. Eur J Nucl Med Mol
Imaging 2014;41 (9):1793-9
055
PS3-03
Clinical implications of functional imaging in uterine cervical cancer
Hyun Hoon Chung

Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University
Hospital, Seoul, Republic of Korea
Session III
Plenary
Cervical cancer is the second most common malignancy in women worldwide. Although the widespread
introduction of cervical cancer screening program and human papillomavirus vaccination have been
credited with dramatically reducing the incidence and mortality, cervical cancer remains a major threat to
women’s health globally.
PET/CT also has become an established imaging method for the evaluation of cervical cancer. The
functional information about regional glucose metabolism obtained with FDG PET/CT provides for
superior sensitivity and specificity in most cancer imaging applications in comparison with conventional
modalities such as CT and MRI.
The role of FDG PET/CT in the evaluation of patients with cervical cancer has expanded rapidly. Value of
PET/CT has been found in the detection of loco-regional and distant nodal metastases and subsequent
change in management. Use of FDG PET/CT facilitates radiation therapy planning. The FDG PET/CT–
derived parameters such as SUVmax, MTV, and TLG are emerging as useful predictive markers and
possible stratification tools.
056
PS3-04 Speaker
Hiroaki Kobayashi
Organization
Obstetrics and Gynecology, Kagoshima University, Japan
Session III
Plenary
1985 Degree of M.D., Graduate School of Medical Sciences, Kyushu
University, JAPAN
1991 Degree of Ph.D., Medical Institute of Bioregulation, Kyushu University,
JAPAN
1991- 1993 Postdoctoral Research fellow, Sunnybrook Health Science Centre,
Toronto, CANADA
1993-1997 Assistant Professor, Dept. of OBGY, Graduate School of Medical
Sciences, Kyushu University, JAPAN
1997-2009 Lecturer, Dept. of OBGY, Graduate School of Medical Sciences,
Kyushu University, JAPAN
2009-2014 Associate Professor, Dept. of OBGY, Graduate School of Medical
Sciences, Kyushu University, JAPAN
2014- Associate Professor, Dept. of OBGY, Faculty of Medicine, Kagoshima
University, JAPAN
Memberships
Japanese Society of Gynecologic Oncology (Councilor, Certified oncologist)

Japanese Society of Obstetrics and Gynecology (Councilor, Certified specialist)
Japanese Society of Clinical Oncology (Councilor, Editorial board member)
Japanese Society of Clinical Cytology (Councilor, Certified cytopathologist)
Japanese Breast Society for Gynecologists and Obstetricians (Director) Japanese
Association for Molecular Target Therapy of Cancer (Councilor) ASCO, IGCS,
Japan Cancer Association, etc.
057
PS3-04
Sentinel node navigation surgery for uterine cervical cancer
Hiroaki Kobayashi
Department of Obstetrics and Gynecology, Kagoshima University, Kagoshima, Japan
Uterine cervical cancer is one of cancers in which sentinel lymph node (SN) concept is almost established.
Session III
Plenary
By our feasibility study of 82 cervical cancer patients including 15 cases with lymph node metastasis, we
confirmed (1) radio-isotope (RI) method is suitable for SN identification rather than blue-dye method,
(2) SN is stably detected in stage IB cases excluding the cases with large tumor size (over 3cm in
diameter), deep stromal invasion and swollen lymph nodes, (3) SN showed 100% negative predictive
value for lymph node metastasis (Int J Clin Oncol, 2010). Since this study indicating the usefulness of
intraoperative SN biopsy, we started the IRB-approved clinical trial of SN navigation surgery (SNNS) only
for the patients excluding the above-mentioned cases. Although this study is still in progress, SNNS
seems to produce not only low risk of postsurgical leg lymphedema but also higher detection accuracy
for lymph node metastasis by serial histological sections of SNs. RI method can be used only in hospitals
available for nuclear medicine, and the fluorescence-dye method using ICG as a non-RI tracer recently
appeared and applied to detect SNs of breast cancer and skin melanoma. However, the reports applying
ICG to cervical cancer are rare. Therefore, we tried to compare three tracers of RI, ICG and blue dye in
the same cervical cancer patient in order to clarify the advantage and disadvantage of each. On the day
before surgery, 99mTc-labeled phytate was subepithelially injected into four cervical quadrants outside
the tumor. Intraoperatively, patent blue and ICG were similarly injected to the cervix. After opening pelvic
retroperitoneal space, "blue node" and "bright node" were searched by the naked eye and the near-
infrared light camera system, respectively. Then, radioactive "hot nodes" were identified by gamma probe
and biopsied as SNs finally. As for blue-dye method, the injected blue dye flew rapidly and easily drained
into downstream of SN. Therefore, it was difficult to identify the primary node of SN by this method. In
the case of bright-dye method, SNs were detected as bright nodes although the injected ICG similarly
flew rapidly. However, also the downstream nodes of SN were strongly stained, and it was difficult to
distinguish SN from the other downstream lymph nodes. As for RI method, 99m Tc-labeled phytate could
stagnate in SNs owing to its higher molecular weight. Therefore, a gamma probe could easily detect SNs
as radioactive hot nodes even located deep under the tissues. Finally, it was confirmed that the best way
to detect SN of cervical cancer seemed to be RI method rather than blue-dye and bright-dye methods,
both of which are probably useful if each tracer-injected site and SN site are existed on the same surgical
plain and surgeons can follow the route of lymphatic flow between them. In my presentation, I would
like to show the actual cases of (1) the above mentioned trial using three tracers in abdominal radical
hysterectomy, and (2) RI method performed in robotically-assisted laparoscopic radical hysterectomy.
058
PS3-05 Speaker
Lan Xie
Organization
Obstetrics and Gynecology, Sichuan Provincial People's Hospital, China
Session III
Memberships
Plenary
Committe member of Obstetrics and Gynecology in China International Exchange
and Promotive Association for Medical and Health Care, Committee member of
pregnancy-related disease and birth defects prevention and control in Chinese
Preventive Medicine Association (CPMA), Committee member of China Medical
Women’s Association (CMWA), Vice-chairmen of Sichuan Preventive Medicine
Association, Committee member of Sichuan Medical Association, Cice-chairmen
of Chengdu Perinatology
Relative to Lecture
”The characteristics of blood transfusion in Obstetrics" presented at Sichuan

blood transfusion training class
“Assisted reproduction pregnancy management” presented at National assisted
reproduction summit
"The side effects of chemotherapy" presented at National Gynecologic tumor
continued education training class
“The application of abdominal aortic balloon occlusion in Obstetrics surgeries"
presented at the first national severe obstetric crisis training class
Xie L., Yue J., Qiao X. Analysis of the termination of pregnancy and pregnancy
outcome in 304 patients with severe preeclampsia. Sichuan Medical Journal.
2012; 1147-1149. Mei L., Yue J., Lan X. Clinical analysis of 39 cases of cesarean
scar pregnancy by hysteroscopy combined with laparoscopy. Sichuan Medical
Journal. 2012; 33 (11): 1906-1908. Mei L., Yue J., Xie L. The clinical pathological
analysis of 54 cases with borderline ovarian tumor. Medical journal of west China.
2012; 24 (5):858-863. Zou B., Pu H., Xie L. Study of Influence factors on cervical
lesions of 210 cases infected with high-risk human papillomavirus. Journal of
practical Obstetrics and Gynecology. 2013, 29 (12): 938-940.
059
PS3-05
The effect of neo-adjuvant chemotherapy in cervical cancer
Lan Xie, Yan Wang

Department of Obstetrics and Gynecology, Sichuan Provincial People's Hospital, Sichuan, China
Our study aimed to explore the clinical role of neo-adjuvant chemotherapy in cervical carcinoma, when
Session III
Plenary
the synchronization of chemotherapy cannot be performed in the stage Ib2-IIIa in the areas where have
extremely scarce medical resources. From 2009 to 2014, 92 patients, who had high risk to be treated
by surgery, accepted neo-adjuvant chemotherapy in the stage of Ib2-IIIa in our department. These
patients included 88 cases of squamous cell carcinoma, 3 cases of adenocarcinoma, and 1 case of
adenosquamous carcinoma. Patients received 2 to 3 courses of the cisplatin + paclitaxel chemotherapy.
2 to 3 weeks after the chemotherapy, radical hysterectomy and pelvic lymph node dissection or para-
aortic lymphadenectomy were used. The chemotherapy was ineffective or not progressive for 10
patients, among whom 5 patients turned to radiotherapy, and the other 5 patients chose to end the
therapy. After 2 to 3 courses of chemotherapy, surgeries were performed to the remaining 82 patients,
who hoped to retain normal sexual functions, as well as to keep postoperative retroperitoneal lymph
node-negative, no vascular invasion, and surgical margin negative. After the surgery, 12 cases showed
no microscopic residual cancer, that is to say, 12 patients obtained complete clinical remission. In
the remaining 70 patients, lymph node metastasis was 25.61%, and the parametrical invasion was
6.1%. Because of theses high risk factors relating to the 70 patients, postoperative chemotherapy or
radiotherapy were performed. After the treatment, the evaluable 3-year survival rate was 88.66%. The
primary side effects were gastrointestinal reactions, leucopenia, hair loss, and fever. Our results suggest
that after the neoadjuvant chemotherapy, most patients were able to reduce the clinical stage and obtain
the opportunity to perform radical surgery. Neoadjuvant chemotherapy has impoved the prognosis of
the patients who were diagnosed with locally advanced cervical carcinoma. In addition, it is an effective
treatment option for the patients whose ages were under 45 to perser4ve fertility and sexual functions.
Therefore, i is a treatment that deserved to be popularized especially in the developing countries or
regions.
060
Plenary Session IV
Ovary
CHAIRPERSON
Kazunori Ochiai (Japan) Seung Cheol Kim (Korea)
SPEAKERS
Report of the 5th OCCC
Aikou Okamoto (Japan)
Prevalence Study of Germline BRCA1/2 mutation in Korean patients with

ovarian cancer
Byoung-Gie Kim (Korea)
Novel therapeutics in ovarian cancer

Robert Coleman (USA)
Immunotherapy in ovarian cancer

Eric Pujade-Lauraine (France)
061
PS4-01 Speaker
Aikou Okamoto
Organization
Department of Obstetrics and Gynecology, The Jikei University School of Medicine,

Tokyo, Japan
Education
1979 Graduated from High School associated with Tokyo Gakugei

University
Session IV
Plenary
1986 M.D. Graduated cum laude, the Tokyo Jikei University School of
Medicine
1991 Certified by Japanese Society of Obstetrics and Gynecology
1992 Ph.D. Medical Science, the Tokyo Jikei University School of
Medicine, Thesis: p53 alterations in ovarian cancer
Brief Chronology of Employment
1986-1988 Clinical fellow in Obstretrics and Gynecology, the Tokyo Jikei

University, School of Medicine
1988-1989 Assistant Professor, Department of Obstetrics and Gynecology,
the Tokyo Jikei University, School of Medicine
1989-1990 Research Resident, Section of Studies on Metastasis, National
Cancer Center Research Institute, Tokyo
1990-1991 Staff Researcher, Section of Studies on Metastasis, National
Cancer Center Research Institute, Tokyo
the Tokyo Jikei University, School of Medicine
1992-1995 Guest Researcher, Laboratory of Human Carcinogenesis,
National Cancer Institute, NIH, Bethesda
the Tokyo, Jikei
University, School of Medicine
1998-2013 Concurrent Assistant Professor, Department of Gene Therapy,
Institute of DNA Medicine, The Jikei University School of Medicine
2001-2009 Lecturer, Assistant Professor, Department of Obstetrics and
Gynecology, the Jikei University, School of Medicine
2009-2012 Associate Professor, Department of Obstetrics and Gynecology,
the Jikei University, School of Medicine
2012-present
C hief Professor, Chairman, Department of Obstetrics and
Gynecology, the Jikei University, School of Medicine
063
PS4-1
5th Ovarian Cancer Consensus Conference

(5th Ovarian Cancer Consensus Conference; 5th OCCC)
Aikou Okamoto
Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
The 5th ovarian cancer Consensus Conference (5th OCCC) will be held at The Jikei University School of
Medicine in Tokyo from November 7 to 9, in this year. The history of this OCCC is, starting with the first
Session IV
round in 1993 at Elsinore in Denmark, the second time in 1998 at Bergen aan Zee in Netherland, 3rd
Plenary
in 2004 at Baden-Baden in Germany, and fourth times at Vancouver in Canada in 2010. The OCCC is
closed meeting, and it has been held about every five years.
In 5th OCCC, there are four topics including individualized therapy and patient factors, first line
intervention, rare tumors, and recurrent disease. The first day, there is a keynote lecture on each topic,
and then divided into four groups for discussion, it is planned to create statements on clinical trials of
ovarian cancer seeing through the next five years in three days. On the third day of the afternoon of the
last day, there will be voting, and final statements will be fixed. I will present about this 5th OCCC.
064
PS4-02 Speaker
Byoung-Gie Kim
Organization
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan

University School of Medicine, Korea
Education and Professional experience
1984 M.D. Medical College of Seoul Nat. Univ., Seoul, Korea

1995 Master Medical College of Seoul Nat. Univ., Seoul, Korea
Session IV
Plenary
1998 Ph.D. Medical College of Seoul Nat. Univ., Seoul, Korea
POSTGRADUATE TRAINING:
1987-88 Internship, Seoul Nat. Univ. Hosp., Seoul, Korea
1988-92 Residency, Dept. of Ob/Gyn. Seoul Nat. Univ. Hosp.
1992-93 Postdoc Fellow, Division of Gynecologic Oncology, Department of
Ob/Gyn. Seoul Nat. Univ. Hosp.
1998-99 Guest Researcher, Lab. of Cell Regulation and Transformation
Section, Division of Basic Sciences, NCI, Bethesda, MA, USA
Current Position
Professor Department of Obstetrics and Gynecolgy, Samsung Medical Center,

Sungkyunkwan University School of Medicine
Director Gynecologic Cancer Center, Samsung Medical Center
President Korean Gynecologic Oncology Group (KGOG)
1. Herzog TJ, Scambia G, Kim BG, Lhommé C, Markowska J, Ray-Coquard I,

Sehouli J, Colombo N, Shan M, Petrenciuc O, Oza A. A randomized phase II
trial of maintenance therapy with Sorafenib in front-line ovarian carcinoma.
Gynecol Oncol. 2013 Jul;130 (1):25-30
2. Park YA, Lee JW, Kim HS, Lee YY, Kim TJ, Choi CH, Choi JJ, Jeon HK, Cho
YJ, Ryu JY, Kim BG, Bae DS. Tumor Suppressive Effects of Bromodomain-
Containing Protein 7 (BRD7) in Epithelial Ovarian Carcinoma. Clin Cancer Res.
2014 Feb 1;20 (3):565-75
3. Sung CO, Choi CH, Ko YH, Ju H, Choi YL, Kim N, Kang SY, Ha SY, Choi K,
Bae DS, Lee JW, Kim TJ, Song SY, Kim BG. Integrative analysis of copy number
alteration and gene expression profiling in ovarian clear cell adenocarcinoma.
Cancer Genet. 2013 May;206 (5):145-53
065
PS4-2
Prevalence study of germline BRCA1/2 mutation in Korean patients

with ovarian cancer
Byoung-Gie Kim
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
Epithelial ovarian cancer (EOC) has the highest mortality rate among gynecologic malignancies. The
incidence of EOC increased in recent 20 years in Korea. The association between germ-line mutations in
Session IV
Plenary
BRCA1/2 and EOC is well established. Although widely believed that germ-line BRCA mutations account
for between 5% and 10% of all EOCs, recent reports suggest this is probably an underestimate. Selection
for germline BRCA1/2 mutation testing is currently variable both within and across countries and offered
predominantly on family history grounds in the context of determining and managing cancer risks in
family members. Germ-line BRCA mutations are associated with longer survival rates after EOC diagnosis
and generally favorable response to platinum-based therapy. The significant activity of poly (ADP-ribose)
polymerase inhibitors in BRCA mutation carriers has also focused attention on BRCA1/2 testing early in
disease management. Despite this, the utility of incorporating a patient’s BRCA1/2 mutation status in
treatment planning remains unclear and is not routinely used in the ongoing management of the EOC
patient. And also with only one exception (Israel), all the major epidemiology data on BRCA mutation
frequency are from US or Western Europe or Australia. Therefore, we performed retrospective study
to evaluate the frequency of germline mutation in BRCA1/2 genes using next generation sequencing
method in more than 300 Korean patients with high-grade serous and/or endometrioid epithelial ovarian,
fallopian tube, or primary peritoneal cancer. The results including the association BRCA1/2 mutation and
clinical characteristics will be presented.
066
PS4-03 Speaker
Robert L. Coleman
Present Title and Affiliation
Primary Appointment
Professor, Department of Gynecologic Oncology and Reproductive Medicine,
University of Texas MD Anderson Cancer Center, Houston, TX
Vice Chair, Clinical Research, Department of Gynecologic Oncology and
Reproductive Medicine, The University of Texas MD Anderson Cancer Center,
Session IV
Plenary
Houston, TX
Deputy Chair, Department of Gynecologic Oncology and Reproductive Medicine,
The University of Texas MD Anderson Cancer Center, Houston, TX
Ann Rife Cox Chair in Gynecology, Department of Gynecologic Oncology and
Reproductive Medicine, The University of Texas MD Anderson Cancer Center,
Houston, TX
President Elect II, Society of Gynecologic Oncology (SGO), Chicago, IL
Education
Degree-Granting Education
Creighton University, Omaha, NE, BS, 1983, Mathematics
Creighton University School of Medicine, Omaha, NE, MD, 1987, Medicine
Postgraduate Training
Credentials
Board Certification
National Board of Medical Examiners, 1/1987
American Board of Obstetrics and Gynecology, 1/1994-12/2016
American Board of Obstetrics and Gynecology, Division of Gynecologic Oncology,
1/1996-12/2016
EXPERIENCE/SERVICE
Assistant Professor, Obstetrics and Gynecology, Creighton University School of
Medicine, Omaha, NE, 7/1993-8/1996
Assistant Professor, Obstetrics & Gynecology, University of Texas Southwestern
Medical Center, Dallas, TX, 9/1996-8/2000
Associate Professor, Department of Obstetrics and Gynecology, University of Texas
067
Southwestern Medical Center, Dallas, TX, 9/2000-7/2004
Associate Professor, Department of Gynecologic Oncology and Reproductive Medicine, University of Texas
M. D. Anderson Cancer Center, Houston, TX, 7/2004-8/2006
Professor, Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD
Anderson Cancer Center, Houston, TX, 9/2006-present
Administrative Appointments/Responsibilities
Director, Obstetrics & Gynecology, Gynecologic Oncology, Creighton University School of Medicine,
Omaha, NE, 7/1993-6/1996
Vice-chairman (Gynecologic Services), Obstetrics and Gynecology, UT Southwestern Medical Center,
Dallas, TX, 9/2001-7/2004
Session IV
Plenary
Interim Program Director, Graduate Education Training Program, Department of Gynecologic Oncology
and Reproductive Medicine, UT M.D. Anderson Cancer Center, Houston, TX, 7/2005-1/2006
Director of Clinical Research, Department of Gynecologic Oncology and Reproductive Medicine, The
University of Texas MD Anderson Cancer Center, Houston, TX, 12/2005-8/2010
Vice Chair, Clinical Research, Department of Gynecologic Oncology and Reproductive Medicine, The
University of Texas MD Anderson Cancer Center, Houston, TX, 9/2010-present
Deputy Chair, Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas
MD Anderson Cancer Center, Houston, TX, 9/2013-present
Endowed Positions
Patricia Duniven Fletcher Professor in Gynecologic Oncology, University of Texas Southwestern Medical
Center, Dallas, TX, 2/2001-7/2004
Ann Rife Cox Chair in Gynecology, The University of Texas MD Anderson Cancer Center, Houston, TX,
6/2010-present
HONORS AND AWARDS
Alpha Omega Alpha Medical Research Forum, Third Place, 1984

Alpha Omega Alpha Medical Research Forum, First Place, 1985
Medical Foundation Scholarship, Creighton University, 1986
Outstanding Resident Award, Chicago Maternity Center, 1991
Reis Resident Research Award, Northwestern University, 1991
Clinical Oncology Fellowship Award, American Cancer Society, 1992-1993
APGO Excellence in Teaching Award, APGO Medical Education Foundation, 1994
Junior Faculty Development Award, Berlex Foundation, 1994
Faculty Development Award, APGO/CREOG, 1999
2011 Margaret Greenfield/Carmel Cohen, MD, Excellence in Ovarian Cancer Research Prize, Gynecologic
Cancer Foundation, 2011
068
PS4-3
Novel therapeutics for ovarian cancer
Robert Coleman
Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center,
Houston, TX
Although significant success has been achieved in the treatment of advanced and recurrent ovarian
cancer, there is clearly room for improvement. The use of targeted agents in this patient population has
Session IV
Plenary
the promise to provide improved survival and quality of life. There are a myriad of relevant pathways
under exploration in all settings of ovarian cancer. Clinical trial data are accumulating for antiangiogenic
therapy, including vascular endothelial growth factor (VEGF)-specific inhibitors and multiple angiogenic
signaling target inhibitors, as well as poly-ADP-ribose polymerase (PARP) inhibitors. Other types of
tumorigenic pathway inhibitors, including those that target phosphatidylinositol-3-kinase (PI3K),
mammalian target of rapamycin (mTOR), protein kinase B (AKT), Src, folate receptor alpha, and insulin-
like growth factor-1 receptor (IGF-1R) pathways are in earlier phases of development for ovarian cancer.
Attempts to target the epidermal growth factor receptor (EGFR) of ovarian tumors have been met
with limited success; however, newer agents that inhibit this pathway show promise. P53 function is
altered in over 90% of high-grade serous ovarian cancers. Increased understanding of the impact of
this loss has ushered in a new generation of inhibitors attempting to restore or leverage this aberration
as functional target. For instance, the role of Wee-1 in p53-deficient tumors has opened the door for
an inhibitor of this tyrosine kinase (AZD1775), which is being evaluated in recurrent ovarian cancer.
Finally, a revolutionary new wave of immunotherapeutics is beginning to show promise in patients with
ovarian cancer. However, as with all new discoveries, a logistical challenge exists as to how to define
and determine the optimal patients, timing and proper combinations of these new approaches, as well
as, concomitant administration with conventional chemotherapeutics. In general, reported results have
beenv modest; however, our growing understanding of these pathways and their interaction in the tumor
microenvironment will be potentially reflected in a greater impact on response and survival.
069
PS4-04 Speaker
Eric Pujade-Lauraine
Organization
Hôpital Hôtel-Dieu, AP-HP, Université Paris Descartes, Paris, France
Eric Pujade-Lauraine MD PhD is founder of the French GINECO Group, which

is devoted to clinical research in gynecologic cancer. He is head of the Women
Cancer and Clinical Research Department at Hôpitaux Universitaires Paris Centre,
Session IV
Plenary
Site Hôtel-Dieu, AP-HP in Paris, France and co-chair of the French gynecologic
rare tumor network (TMRG)
While receiving his medical degree from the University of Paris VI, Professor
Pujade-Lauraine was an intern at Assistance Publique des Hôpitaux de Paris,
France. He later obtained his PhD from the University of Paris VI. He is now
Professor of Medical Oncology at University Paris Descartes. As well as serving on
several advisory boards, Professor Pujade-Lauraine is a member of the American
Society of Clinical Oncology (ASCO), the European Society for Medical Oncology
(ESMO) and the Executive Board of the European Network of Gynecological Trials
(ENGOT). He is past chair of the Gynecologic Cancer Academy (GCA), the ENGOT
Translational group and the international Gynecologic Cancer Intergroup (GCIG).
070
PS4-4
Immunotherapy in ovarian cancer
There is a large body of data suggesting that the immune system can recognize and respond to a
diversity of ovarian cancer targets and antigens. The evidence that the immune system plays a critical role
in ovarian cancer has been brought by the landmark paper from Zhang et al who showed that ovarian
cancer patients can be divided in 2 subsets with highly different prognosis according the presence or
Session IV
Plenary
not of intratumoral T Cells (TILs). This observation has been confirmed in several reports which led to a
metaanalysis by Hwang et al who found that the presence of TILs and overall survival were correlated
with a Hazard Ratio of 2.24 (95%CI 1.71, 2.92). But T-cells are not the only players of the immune
response to tumor antigen. T regulatory cells, plasmacytoid dendritic cells, macrophage expressing B7-H4
seem to play an important role in the downregulation of immune responses and have been associated
with a poor outcome in ovarian cancer. These data suggest that the modulation of the immune system
could have a therapeutic effect in ovarian cancer. Immunotherapy has indeed a long history in ovarian
cancer from cytokines mostly delivered through the intraperitoneal route, followed by monoclonal
antibody against mucin antigens including CA125, vaccines and educated autologous dendritic cells.
None of these approaches have yet yielded a definitive benefit in ovarian cancer patients. However a new
breath of optimism is coming from the new checkpoint inhibitors. CTLAA-4 and PD-1/L1 checkpoints
that maintain that maintain physiologic self-tolerance have been implicated in the down-regulation
of anti-tumor immunity. CTLA-4 is expressed on the surface of activated T-lymphocytes and exerts a
suppressive effect on the induction of immune responses after interaction between T-cell receptor (TCR)
and human lymphocyte antigen (HLA)/peptide molecules on the antigen-presenting cell (APC). Unlike
CTLA-4 antibodies, the PD-1/PD-L1 antibodies aim to potentiate the antitumor T-cell response at a tumor-
specific level, by impairing the interaction of the inhibitory receptor PD-1 on T cells with PD-L1 expressed
on tumor cells. PDL-1 is expressed in about half of the patients with ovarian cancer and PDL-1 positive
ovarian cancer patients have been shown to carry a worse prognosis compared to PDL-1 negative. Anti-
PD-1 antibody (nivolumab) has been found to have activity in highly pre-treated ovarian cancer patients
(n=18) with a 17% response rate, and prolonged control of disease over 1 year in 4/18 patients (22%).
The median OS was 20 months for the whole cohort of patients. The anti-PD1 pembrolizumab achieved
a 11.5% objective response rate in pretreated metastatic ovarian cancer patients. Anti-PDL-1 (avelumab)
was also found active in pre-treated relapsing ovarian cancer with a 14.7% shrinkage of tumor more
than 30% in patients treated with Avelumab.
Current trials in project are exploring anti-PD1/PDL-1 alone and in combination with chemotherapy,
bevacizumab or other immune modulators in the different settings of ovarian cancer disease evolution.
071
CHAIRPERSON
Hee-Sug Ryu (Korea)
SPEAKERS
Evolution of surgery in gynecologic oncology
Joo-Hyun Nam (Korea)
073
PL-01 Speaker
Joo-Hyun Nam
Professor, University of Ulsan, College of Medicine, Asan Medical Center, Korea
Education
3/1969-8/1971 Premedical Course, College of Liberal Arts and Sciences,

Seoul National University, Seoul, Korea
3/1971-2/1975 College of Medicine, Seoul National University, Seoul, Korea
(M.D. degree)
3/1978-2/1985 Graduate School, Seoul National University, Seoul, Korea (M.S.
Presidential
and PhD in Medicine)
Lecture
Postgraduate Professional Training
3/1975-2/1976 Internship, Seoul National University Hospital, Seoul, Korea

3/1976-2/1980 Residency in Department of Obstetrics & Gynecology, Seoul
National University Hospital, Seoul, Korea
1/1988-12/1989 Postdoctoral Fellow in Gynecologic Oncology, Yale University,
School of Medicine, New Haven, CT. U.S.A.
7/1997-8/1997 Visiting Professor, Brigham & Women's Hospital, Harvard
Medical School, Boston, MA. U.S.A.
Professional Appointments
2/1980-4/1983 Armed Services in the Republic of Korea Navy

5/1983-8/1985 Staff in Department of Obstetrics & Gynecology, Kangnam
Municipal Hospital, Seoul, Korea
8/1985-8/1987 Instructor, Department of Obstetrics & Gynecology, College
of Medicine, Hallym University, Seoul, Korea
9/1987-2/1992 Assistant Professor in Department of Obstetrics &
Gynecology, College of Medicine, Hallym University, Seoul,
Korea
3/1992-3/1997 Associate Professor in Department of Obstetrics &
Gynecology, University of Ulsan, College of Medicine, Asan
Medical Center, Seoul, Korea
075
3/1994-2/1996 Associate Dean of Student Affair in College of Medicine, University of Ulsan,
Seoul, Korea
4/1997-present Professor of Department of Obstetrics & Gynecology, University of Ulsan,
College of Medicine, Asan Medical Center, Seoul, Korea
9/1998-8/2004 Chairman of Department of Obstetrics & Gynecology, University of Ulsan,
College of Medicine, Asan Medical Center, Seoul, Korea
3/2000-2/2004 Associate Dean of Academic Affair in College of Medicine, University of Ulsan,
Seoul, Korea
3/2005-2/2007 Director of Asan Cancer Center, Asan Medical Center, Seoul, Korea
License
Presidential
3/1975 Licensed to Practice Medicine and Surgery in the Republic of Korea (# 15725)
Lecture
3/1980 Diploma, Korean Board of Obstetrics & Gynecology (# 1117)
Professional Societies
President, Korean Gynecologic Oncology Group (2010 – present)

President, Korean Society of Gynecologic Cancer Surgery (2009 – present)
President-elect, Korea Society of Gynecologic Oncology & Colposcopy (2010 - present)
Chairman of Executive board, Korean Society of Obstetrician & Gynecologist (2005-2007)
President, Korean Society of Gynecologic Endoscopy and Minimally Invasive Surgery (2006-2008)
President, Asia-Pacific Association of Gynecologic Endoscopy and Minimally Invasive Therapy (2008-2009)
Chairman, Endoscopy Committee, Asia-Oceania Federation of Obstetrics and Gynecology (2007-present)
Chairman, Oncology Committee, Asia-Oceania Federation of Obstetrics and Gynecology (2005-2007)
Member, American Society of Clinical Oncology (since 1994)
Member, International Gynecologic Cancer Society (since 1995)
Member, European Society of Gynecologic Oncology (since 2002)
Member, American Association of Gynecologic Laparoscopists (since 2002)
International Member, Society of Gynecologic Oncologists (since 2005)
Member, International Society of Gynecologic Endoscopy (since 2006)
Founding & Council member, Asian Society of Gynecologic Oncology (since 2008)
Honorary Fellow, Taiwan Association of Obstetrics and Gynecology (since 2010)
Honorary Fellow, Japanese Society of Obstetrics and Gynecology Endoscopy (since 2010)
076
PL-01
Evolution of surgery in gynecologic oncology
Joo-Hyun Nam
Department of Obstetrics and Gynecology, University of Ulsan College of Medicine,
Asan Medical Center, Seoul, Korea
Surgical management is the main stay of the treatment for gynecologic malignancies. For the last few
decades, gynecologic oncologic surgery evolved more rapidly than ever before. More precisional and
evidence-based surgical management is the current paradigm of gynecologic oncologic surgery. Surgery
became more aggressive and radical for advanced or recurrent cervical and ovarian cancer to maximize
the survival outcomes. The use of neoadjuvant chemotherapy may reduce the surgery related morbidity
Presidential
Lecture
in elderly or medically compromised patients with advanced ovarian cancer without decreasing the
survival outcomes. The radicality of surgery was tailored for early cervical and endometrial cancer to
avoid overtreatment and to minimize surgery related adverse events. Surgical techniques for early cervical
cancer became more sophisticated to preserve physiologic function of patients including autonomic nerve
function and reproductive function. Minimally invasive surgery including laparoscopic and robotic surgery
became the preferred surgical approach for early cervical and endometrial cancer. However, there remain
many unsolved issues in the gynecologic oncologic surgery. These issues can be solved through the
prospective randomized controlled trials of surgical management. Every surgeon should exert all possible
efforts on surgery trials for the evolution of gynecologic oncologic surgery.
077
Luncheon Symposium II
CHAIRPERSON
Seon-Kyung Lee (Korea)
SPEAKERS
Eric Pujade-Lauraine (France)
079
LS-02 Speaker
Organization
Eric Pujade-Lauraine MD PhD is founder of the French GINECO Group, which

is devoted to clinical research in gynecologic cancer. He is head of the Women
Cancer and Clinical Research Department at Hôpitaux Universitaires Paris Centre,
Site Hôtel-Dieu, AP-HP in Paris, France and co-chair of the French gynecologic
rare tumor network (TMRG)
While receiving his medical degree from the University of Paris VI, Professor
Pujade-Lauraine was an intern at Assistance Publique des Hôpitaux de Paris,
France. He later obtained his PhD from the University of Paris VI. He is now
Symposium II
Luncheon
Professor of Medical Oncology at University Paris Descartes. As well as serving on
several advisory boards, Professor Pujade-Lauraine is a member of the American
Society of Clinical Oncology (ASCO), the European Society for Medical Oncology
(ESMO) and the Executive Board of the European Network of Gynecological Trials
(ENGOT). He is past chair of the Gynecologic Cancer Academy (GCA), the ENGOT
Translational group and the international Gynecologic Cancer Intergroup (GCIG).
081
LS-02

Almost all the patients with recurrent ovarian cancer will see their disease becoming resistant to
chemotherapy, particularly to platinum. The strict GCIG definition of early relapse or resistant disease is
when the disease is relapsing within 6 months of the last dose of chemotherapy.
The accepted guidelines in this setting is to rechallenge the patient with non-platinum single agent.
The 4 drugs with equivalent activity, but different toxicity profile, which are often used are pegylated
liposomal doxorubicin (PLD), paclitaxel, gemcitabine and topotecan. However, only 5-15% of the patients
will achieve an objective response rate (ORR)with a median progression-free (PFS) and overall survival (OS)
which do not exceed 3-4 months and 12-13 months respectively.
Symposium II
In the AURELIA trial, 361 patients with resistant disease occurring after one or 2 lines of chemotherapy
Luncheon
were offered to be randomized either to chemotherapy and bevacizumab (BEV) (15 mg/kg every 3 weeks)
or to chemotherapy followed at progression by single agent BEV. Chemotherapy could be either PLD,
weekly paclitaxel or topotecan at the investigator choice and the cohorts were capped up to 120 patients
each and were stratified.
The results showed an impressive and significant benefit for the combination arm of chemotherapy plus
BEV in term of response rate (27.3% versus 11.8%) and median PFS (6.7 versus 3.4 months) with a non-
stratified hazard ratio (HR) of 0.48 (stratified HR = 0.38). Overall survival was increased from 13.3 up
to 16.6 months, but the difference did not reached statistical significance. The benefit of the BEV plus
chemotherapy combination appeared prominent when chemotherapy was weekly paclitaxel.
Hematological toxicity, bleeding and thromboembolism were not increased by the addition of BEV.
Neurotoxicity (with paclitaxel) and hand-foot syndrome (with PLD) were more frequent in the BEV arm, but
strictly correlated to the increased exposure due to the decreased incidence of relapse. Gastro-intestinal
perforation/fistula were observed in a minority of patients (4%), but the eligibility criteria excluded patients
with an history of occlusive or subocclusive disease or evidence of bowel infiltration on the CT-scan.
Importantly, patients significantly benefited from the addition of BEV to chemotherapy compared to
chemotherapy alone both in terms of gastro-intestinal (GI) symptom improvement (21.9% versus 9.3%)
and global quality of life (12.2% vs 3% according to FOSI). This improvement of GI symptoms was
particularly spectacular for patients with ascites (44% vs 4%) who needed repeated punctures to control
ascites in a minority of the cases.
All these data led bevacizumab to approved in 2014 both in EU and US in combination with paclitaxel,
pegylated liposomal doxorubicin or topotecan chemotherapy for the treatment of women with platinum-
resistant, recurrent, epithelial ovarian, fallopian tube, or primary peritoneal cancer, who have received no
more than two prior chemotherapy regimens.
082
Symposium I
Rare Tumor
CHAIRPERSON
Yasuhiro Udagawa (Japan) Gatot Purwoto (Indonesia)
SPEAKERS
Multiple primary cancer
Suwanit Therasakvichya (Thailand)
Endometriosis associated ovarian carcinoma: what is molecular

pathogenesis drive
Xipeng Wang (China)
Alternative chemotherapy to EMACO in the treatment of gestational

trophoblastic neoplasia
Karen Chan (Hong Kong)
Leiomyosarcoma after morcellation of leiomyoma

Keun Ho Lee (Korea)
083
S1-01 Speaker
Suwanit Therasakvichy
Organization
Obstetrics & Gynecology, Siriraj Hospital, Bangkok, Thailand
Other Education
Gynecologic Oncology Epidemiology (Health Development)
Memberships
Siriraj Cancer Center Thai Gynecologic Cancer Society (TGCS)
Multiple primary cancer
Symposium I
085
S1-01
Multiple primary cancer sites in Thai women, epidemiologic study in

Siriraj hospital
Suwanit Therasakvichy
Department of Obstetrics and Gynecology, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Multiple primary cancer sites in Thai women, epidemiologic study in Siriraj Hospital Suwanit
Therasakvichya MD, Siriraj Cancer Center and Department of Obstetrics and Gynecology Faculty of
Medicine, Siriraj Hospital, Mahidol University, Thailand Over 50,000 female cancer patients had revealed
from 20 year-hospital base- registry at Siriraj Hospital, between 1991-2010. Clinical apparent second
primary cancers in different organs or tissues were observed in 82 cases, at prevalence rate of 0.16. All
were proven by histological diagnosis which were in the criteria: I. A new primary in the opposite organ
or opposite quadrant in a bilaterally paired organ ; for breast, lung. II. A new primary in the remaining
tissue of single organ ; for example skin, urinary bladder, large intestine. III. An anatomical system or tract
containing subsites of common embryologic origin; for example female lower genital tract (cervix, vagina,
vulva) and anus. Vary rate from breast, endometrial, ovarian, skin (squamous cell carcinoma)and urothelial
Symposium I
cancer and thyroid cancer. Around 60% of breast cancers were diagnosed bilaterally at the same period;
some showed the same histology with either same or different study for receptor type (ER, PR,Her-2).
Some developed the second primary later, during chemoprevention. In this study, the prevalence rate of
multiple primary in breast cancer showed 2 times more frequently in the latter than the early 10 year-
period which because of awareness and more quality of breast imaging such as digital mammography
and high resolution of ultrasound. However, less data about genetic or familial history of associated
cancers. Meanwhile, for lower genital tract cancers there was no related HPV data in this registry. To date,
not only phenotypic patterns but also integration with genomic, proteomic and metabolomics studies of
each cancer may explain the complex issue of multiple primary cancers in the near future.
086
S1-02 Speaker
Xipeng Wang
Organization
Professor, Director of Gynecology, Shanghai First Maternity and Infant Hospital,

Tongji University, Shanghai, China
Education / Training
Norman Bethune University of Medical Sciences, Changchun, China

Shanghai Second Medical University, Shanghai, China
Shanghai Second Medical University, Shanghai, China
Dept. Gynecology Medical Oncology, MD Anderson Cancer Center
Professional Positions
08/1996 – 03/2001 Resident Doctor, Dept. of Obstetrics and Gynecology, Renji

Hospital, Shanghai Second Medical University, Shanghai,
P.R.China
Symposium I
04/2001 – 08/2003 Chief Resident Doctor, Dept. of Obstetrics and Gynecology,
Renji Hospital, Shanghai Second
Medical University, Shanghai, P.R.China
10/2003 – 10/2007 Attending Physician, Dept. of Obstetrics and Gynecology,
Renji Hospital, Shanghai Second
Medical University, Shanghai, P.R.China
12/2003 – 10/2005 Postdoc fellow, Dept. of Gynecologic Medical Oncology,
Texas of University MD Anderson Cancer Center
11/2005-10/2009 associated professor, Dept. of Obstetrics and Gynecology,
Renji Hospital
10/2009- present Professor, Dept. of Gynecology, Shanghai First Materntiy
and Infant Hospital, Tongji Universtiy
Awards
10/2013 Top 100 Young Doctor Elite –Shanghai, P.R. China

12/2011 The superior teacher award – Shanghai educational
committee, P.R.China
12/02 - 10/03 The Superior Doctor – Shanghai Second Medical University,
Shanghai, P.R. China
087
S1-02
Endometriosis associated ovarian carcinoma:

what is molecular pathogenesis drive
Xipeng Wang
Dept. Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University, Shanghai, China
Ovarian cancers are a heterogeneous group of diseases with different features, it has been proved that
ovarian clear-cell carcinomas (OCCC, low grade serous carcinomas (LGSC) and ovarian endometrioid
carcinomas (OEC) may arise from endometriosis. Gene mutations may contribute to the malignant
transformation of Endometriosis, which mainly refer to PIK3CA, ARID1A, PTEN, KRAS and PPP2R1A
gene. How does these gene mutations promote carcinogenesis of normal ovarian epithelial is not very
clear. Mutations in Exon 9 and 20 of PIK3CA were identified in ovarian cancers, which were revealed that
the mutation is mainly located in H1047R, and it commonly coexists with loss of ARID1A protein. ARID1A
mutation is also an early event in endometriosis associated ovarian cancers, with the mutation rate of
57% in OCCC. This gene mutation usually led to the loss of BAF250a, which is encoded by ARID1A.
It has been proposed that the IHC scores of ARIDIA and PTEN are lower compared with corresponding
Symposium I
normal tissues. In another research, OEC mice model was successfully build when ARID1A and PTEN
mutation be induced by AdCre. What’s more, combined K-rasG12D activation and conditional deletion
of PTEN can also led to OEC. These genes may provide new therapeutic targets for treatment of ovarian
cancers. Interestingly, loss of ARID1A expression sensitizes cancer cells to PIK3-and AKT inhibition and
EAH2 methyltransferase.
088
S1-03 Speaker
Karen Chan
Organization
O&G, University of Hong Kong, Hong Kong
Education
After graduating in medicine at Cambridge University, UK, Dr Chan trained in

Obstetrics and Gynaecology in both the UK and in Hong Kong. In 2002, She
joined the University of Hong Kong Department of Obstetrics and Gynaecology,
the tertiary referral centre for GTN in Hong Kong. She obtained the fellowship of
the Hong Kong College of Obstetricians and Gynaecologists (HKCOG) in 2005
and completed her subspecialty training in Gynaecological Oncology in 2008.
1. President of Hong Kong Society for Colposcopy and Cervical Pathology

2. Council Member of Hong Kong College of Obstetricians and Gyanecologists
3. Honorary Secretary for Asia- Oceanic Organisation in Genital infections and
Symposium I
Neoplasia ( AOGIN )
1. Chan K.K.L., Leung T.H.Y., Chan D.W., WEI N., Lau T.Y., Liu S., Siu K.Y. and
Ngan H.Y.S. Targeting estrogen receptor subtypes (ERalpha and ERbeta) with
selective ER modulators in ovarian cancer, Journal of Endocrinology, 221, 325-
336, ( / 2014)
2. Ngu S.F. and Chan K.K.L. Management of Chemoresistant and Quiescent Gestational
Trophoblastic Disease, Current Obstetrics and Gynecology Reports, ( / 2014)
3. C han K.K.L., Chen C.A., Nam J.H., Ochiai K., Wilailak S., Choon A.T.,
Sabaratnam S., Hebbar S., Sicken J., Schodin B.A. and Sumpaico W.W. The
use of HE4 in the prediction of ovarian cancer in Asian womenn with a pelvic
mass, Gynecolgic Oncology, 128 (2), 239-44, ( / 2013)
4. Cheung A.N.Y. and Chan K.K.L. Perplexing hCG profile after evacuation of
hydatidiform mole, Lancet, 379, 98-100, ( / 2012)
5. Chan K.K.L., Yao T.J., Jones B., Zhao J.F., Ma K.F., Leung C.Y., Lau S.K., Yip
M.W. and Ngan H.Y.S. The use of Chinese herbal medicine to improve quality
of life in women undergoing chemotherapy for ovarian cancer: a double-blind
placebo-controlled randomized trial with immunological monitoring, Ann
Oncol, 25 Feb 2011, ( / 2011)
089
S1-03
Alternative chemotherapy to EMA-CO in the treatment of gestational

trophoblastic neoplasia
Karen Chan
Department of Obstetrics and Gynecology, University of Hong Kong, Hong Kong
The management of GTN is guided by the FIGO risk score ( RS ) which reflects the likelihood of resistance
to single agent chemotherapy. While low risk diseases (RS < 7) are usually successfully treated by single
agent chemotherapy, combination chemotherapy should be given to those with RS 7 or above. In 1977,
Bagshawe reported a 83% sustained remission rate in high-risk GTN with the use of a seven-drug
chemotherapy regimen CHAMOMA (cyclophosphamide, hydroxyurea, actinomycin D, methotrexate,
vincristine, melphalan and doxorubin). After etoposide was shown to be highly effective in the
treatment of GTN in the early nineties, the EMA-CO regimen (etoposide, methotrexate, actinomycin
D, cyclophosphamide and vincristine) had been the most popular regime for high risk disease, with an
overall survival of around 85% with an acceptable toxicity profile . However, the use of etoposide was
subsequently found to be associated with an increased incidence of secondary malignancies, particularly
Symposium I
primary leukaemia. In view of the young age of many of our GTN patients, our centre took into
account of this risk and adopted the CHAMOC combination, which was modified from on the original
CHAMOMA regime, with the removal of melphalan and doxorubicin to reduce toxicity. Twenty-seven
year experience ( 1985-2012 ) from our unit suggested that CHAMOC could achieve a 85.3% remission
rate, which was comparable to the remission rates reported in literature for EMA-CO. The toxicity profile
was also similar. However, no leukaemia was reported in 79 patients treated with CHAMOC at our unit
with a median follow up of about 13 years. Our data suggested that CHAMOC could be an alternative
to EMA-CO in the primary treatment of high risk GTN. The use of CHAMOC for recurrent disease is also
promising but the salvage rate for CHAMOC in the setting of chemo-resistant GTN after single agent
chemotherapy appears to be inferior to EMA-CO. If the disease is refractory to EMA-CO/ CHAMOC,
salvage with other platinum based regimes such as EMA-EP (EMA alternating weekly with etoposide and
cisplatin ) or TE/TP ( paclitaxel and etoposide alternating twice weekly with paclitaxel and cisplatin, with
salvage rates over 75% can be considered.
090
S1-04 Speaker
Keun Ho Lee
Organization
Department of Obstetrics and Gynecology, Catholic University, Seoul, Korea
Education
1999.9 - 2005.8 Graduate School of Medicine, Catholic University, Ph.D.

1997.3 - 1999.2 Graduate School of Medicine, Catholic University, M.D.
1989.3 - 1995.2 College of Medicine, Catholic University
2009.3- Present Assistant Professor, Department of Obstetrics & Gynecology,

The Catholic University of Seoul, St. Mary’s Hospital
2007.8 - 2009.2 Training for Gynecologic Oncology, at UT MD Anderson
Cancer Center
2004.3 - 2009.2 Lecturer, Department of Obstetrics & Gynecology, The
Symposium I
Catholic University of Seoul, St. Maty’s Hospital Uijeongbu
Membership
Member, Korean Society of Obstetrics and Gynecology

Member & Scientific Committee, Korean Society of Gynecologic Oncology
Assistant administrator, Korean Gynecologic Oncology Group
Member, Korean Cancer Association
Member, Korean Society of Gynecologic Endoscopy and Minimally Invasive
Surgery
Member, American Association for Cancer Research
Publication
2014. Gynecology (5th edition)

2013. Neoadjuvant chemotherapy for cervical cancer; Rationale and evolving data
091
S1-04
Leimyosarcoma after morcellation of leiomyoma
Keun Ho Lee
Department of Obstetrics and Gynecology, The Catholic University, Seoul, Korea
Uterine sarcomas are rare uterine malignancies that are difficult to diagnose preoperatively. Because
of hidden malignancy after morcellated specimen, disseminated leiomyosarcoma is the fatal result in
laparoscopic hysterectomy or myomectomy. FDA warned the use of power morcellation and discouraged
the use it in case of all the presumed uterine leiomyoma. But minimal invasive surgery including
laparoscopic momectomy or hysterectomy is common procedure and incidence of sarcoma is not so high
in real situation. Here the risk of incidental uterine sarcoma is reviewed and the impact of morcellation
on prognosis of uterine sarcoma is estimated. And the prophylatic method for dissemination of incidental
sarcoma would be discussed.
Symposium I
092
Symposium II
International Collaboration of Clinical Trials
CHAIRPERSON
Daisuke Aoki (Japan) Young Tae Kim (Korea)
SPEAKERS
The value of collaborative international clinical trials in women's cancer
Gavin Stuart (Canada)
Update on recently completed and planned randomized clinical trials from

NRG-GOG
Michael Bookman (USA)
Important JGOG studies of ovary/corpus/cervix

Toru Sugiyama (Japan)
Ongoing trials from KGOG

Jae-Hoon Kim (Korea)
ENGOT clinical trials: future development in ovarian cancer therapy

Christian Marth (Austria)
093
S2-01 Speaker
Gavin Stuart
Organization
Faculty of Medicine at the University of British Columbia, Vancouver, Canada
Dr. Gavin Stuart has been Dean of the Faculty of Medicine at the University
of British Columbia from September 2003 through to September 2015. Since
September 2009, he was appointed as UBC’s Vice-Provost Health, which involves
representing the University in health-related interactions with other universities
and health authorities. He was appointed to a second term in this role as of
September 1st, 2015. He is the past-Chair of the Board of the Association of
Faculties of Medicine of Canada.
A native of Manitoba, he attended the University of Western Ontario for his
undergraduate medical and postgraduate training in obstetrics and gynecology.
He pursued a fellowship in Gynecologic Oncology at Wayne State University in
Detroit, where he stayed on as a faculty member. He then moved to the Tom
Baker Cancer Centre in Calgary, where he was the first Director of Gynecology.
After completing his term as Head of the Department of Obstetrics and
Gynecology at the University of Calgary, he was appointed as Professor and Head,
Symposium II
Department of Oncology and Director of the Tom Baker Cancer Centre in 1993.
In 1999, he was appointed as Vice-President of the Alberta Cancer Board. He
was then appointed as Dean of the Faculty of Medicine at UBC in 2003. He was
named an Honorary Alumnus of UBC Faculty of Medicine in 2009.
Currently, in addition to his role as Vice-Provost Health, Dr. Stuart continues to be
an active teacher, clinician and researcher. His clinical activity is as a member of
the outstanding gynecologic oncology team based at Vancouver General Hospital
and the BC Cancer Agency. His clinical research and publications have been in the
area of gynecologic cancer, including population-based screening programs and
the conduct of clinical trials as therapeutic interventions in gynecologic cancer. He
is the principal investigator of several large phase III clinical trials.
In the past, Dr. Stuart has held multiple leadership positions in the field: Chair of
the Gynecologic Cancer Intergroup,; Co-Chair of the Gynecology Site Committee
of the NCI Canada; and President of the Society of Gynecologic Oncology/La
Societe de Gyneco-Oncologie du Canada (GOC). In 2009, Dr. Stuart received the
Presidential Medal Award from the GOC. He is a fellow of the Canadian Academy
of Health Sciences.
095
S2-01
The value of collaborative international clinical trials in women’s

cancer
Gavin Stuart
Department of Gynecologic Oncology, University of British Columbia, Canada
The mission of the Gynecologic Cancer InterGroup (GCIG) has been to enhance global impact of
clinical trials in gynecologic cancer. The GCIG is comprised of 28 international member organizations.
The primary focus has been the conduct of high quality phase III clinical trials. The purpose of this
presentation is to document this impact and demonstrate how the GCIG has increased global capacity
for trials in this domain. The output of the GCIG is reviewed including clinical trials completed and open,
publications, consensus statements and networks. The journals in which these publications have been
made are reviewed with regard to impact factor and citation index. A social network map is developed
for these publications in order to identify how the GCIG has increased capacity for clinical trials globally.
Since being formed in 1997, the GCIG has grown to include 28 international member organizations and
11 Pharma/Biotech partners. Over the past 10 years, 74 manuscripts have been published. There are
currently 37 open GCIG trials. The citation index and impact factor of these publications in aggregate
reflect the high quality of well-conducted international cooperative clinical trials. The social network
map demonstrates how the GCIG has increased capacity at a global level for the timely conduct of well-
Symposium II
designed trials. Trial design has been informed by 4 quinquennial ovarian cancer consensus conferences.
In the 18 years since its inception, the GCIG has increased global capacity for high quality trials in the
population of women affected by gynecologic cancer.
096
S2-02 Speaker
Michael Bookman
Organization
Medical Gynecologic Oncology, US Oncology Research and Arizona Oncology, USA
Fellowship in Medical Oncology, National Cancer Institute, National Institutes of

Health Board Certified, Internal Medicine, Medical Oncology
Chair, Ovarian Committee, NRG Oncology and GOG Foundation Director, Office
of Educational Resources, International Gynecologic Cancer Society (IGCS)
Director, Gynecologic Oncology Research, US Oncology Research Member ASCO,
AACR, AAI, IGCS, ESGO
1. Bookman MA, McGuire WP III,, Kilpatrick D, Keenan E, Hogan WM, Johnson

SW, O’Dwyer P, Rowinsky E, Gallion HH, Ozols RF. Carboplatin and Paclitaxel in
Ovarian Carcinoma: A phase I study of the Gynecologic Oncology Group. J Clin
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Oncol 14:1895-902, 1996
2. B ookman MA, Darcy KM, Clarke-Pearson D, Boothby RA, Horowitz IR.
Evaluation of monoclonal humanized anti-HER2 antibody, trastuzumab, in
patients with recurrent or refractory ovarian or primary peritoneal carcinoma
with overexpression of HER2: A phase II trial of the Gynecologic Oncology
Group. J Clin Oncol 21:283-290, 2003.
3. Bookman MA, Brady MF, McGuire WP, Harper PG, Alberts DS, Friedlander M,
Colombo N, Fowler JM, Argenta PA, De Geest K, Mutch DG, Burger RA, Swart
AM, Trimble EL, Accario-Winslow C, Roth LM . Evaluation of New Platinum-
Based Treatment Regimens in Advanced-Stage Ovarian Cancer: a Phase III trial
of the Gynecologic Cancer InterGroup (GCIG). J Clin Oncol 2009;27:1419-25.
PMID: 19224846
4. B urger RA, Brady MF, Bookman MA,, Fleming GF, Monk BJ, Huang H,
Mannel RS, Homesley HD, Fowler J, Greer BE, Boente M, Birrer MJ, Liang SX.
Incorporation of bevacizumab in the primary treatment of ovarian cancer. N
Engl J Med. 2011;365:2473-83. PMID: 22204724.
097
S2-02
Recently completed and planned randomized clinical trials from

NRG-GOG
Michael Bookman
Medical Gynecologic Oncology, US Oncology Research and Arizona Oncology, USA
In 2014, the Gynecologic Oncology Group (GOG) merged with NSABP and RTOG to form NRG Oncology,
part of the National Clinical Trials Network (NCTN) which receives support from the National Cancer
Institute (NCI). All NCTN trials undergo intensive review through the Gynecologic Cancer Steering
Committee (GCSC) and must be approved in order to receive financial support from NCI. NRG Oncology
also supports a mechanism for retrospective analysis of data from published randomized trials. GCSC
priorities to guide the development of new studies in ovarian were updated in 2015 and include: -
Biomarker-driven neoadjuvant designs to study novel agents and new chemotherapy approaches with
access to pre- and post-therapy biospecimens - Identification of molecular and/or clinico-pathologic
cancer subsets with which to drive treatment recommendations for all stages of disease - Investigation
of immunotherapy treatment and predictive biomarkers at all phases of disease life cycle - Development
of combination strategies to enhance synthetic lethality - Therapeutic manipulation of the host-tumor
microenvironment In addition, the GOG Foundation was established to facilitate pharmaceutical industry
Symposium II
collaboration on trials external to NCI. The Ovarian Committee has joint responsibility for the review and
prioritization of studies through NRG Oncology as well as the GOG Foundation. Selected studies from
each pathway will be discussed, with an emphasis on emerging priorities for clinical research. GOG0262
(PI: J Chan) A randomized phase III trial of every-3-weeks paclitaxel versus dose dense weekly paclitaxel
in combination with carboplatin with or without concurrent and consolidation bevacizumab in the
treatment of primary stage III or IV epithelial ovarian, peritoneal or fallopian tube cancer GOG0252 (PI: JL
Walker) A phase III clinical trial of bevacizumab with IV versus IP chemotherapy in ovarian, fallopian tube
and primary peritoneal carcinoma Ancillary Data Analysis GOG0182 (PI: NS Horowitz) Does Aggressive
Surgery Improve Outcomes? Interaction Between Preoperative Disease Burden and Complex Surgery
in Patients With Advanced-Stage Ovarian Cancer GOG0213 (PI: R Coleman) A phase III randomized
controlled clinical trial of carboplatin and paclitaxel alone or in combination with bevacizumab followed
by bevacizumab and secondary cytoreductive surgery in platinum-sensitive, recurrent ovarian, peritoneal
primary and fallopian tube cancer GOG3005 (PI: K Bell-McGuinn) A phase 3 placebo-controlled study of
carboplatin/paclitaxel with or without concurrent and continuation maintenance veliparib (parp inhibitor)
in subjects with previously untreated stages III or IV high-grade serous epithelial ovarian, fallopian tube,
098
or primary peritoneal cancer NRG-GY004 (PI: JF Liu) Phase III study comparing single-agent olaparib or
the combination of cediranib and olaparib to standard platinum-based chemotherapy in women with
recurrent platinum-sensitive ovarian, fallopian tube, or primary peritoneal cancer NRG-GY005 (PI: J-M
Lee) A Randomized Phase II/III study of the combination of Cediranib and Olaparib compared to Cediranib
or Olaparib alone, or Standard of care chemotherapy in women with recurrent platinum-resistant or
-refractory ovarian, fallopian tube, or primary peritoneal cancer NRG-GY007 (PI: RA Burger) A phase I and
randomized phase II study of ruxolitinib with front-line neoadjuvant and post-surgical therapy in patients
with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer
Symposium II
099
S2-03 Speaker
Toru Sugiyama
Organization
Department of Obstetrics and Gynecology, Iwate Medical University, Iwate, Japan
Education
1978-1982 Kurume University School of Medicine, Graduate School

1983-2004 Kurume University Hospital
2004-2008 Iwate Medical University Hospital
Professor and Chairman of department of Obstetrics and Gynecology, Vice

president of Iwate Medical University
Japan Society of Obstetrics and Gynecology (Councilor, ~2015Director Specialist)
Japan Society of Clinical Oncology (~2013 Director/Councilor, 47th President)
Japan Society of Cancer Research (Councilor)
Japan Society of Medical Oncology (Councilor)
Japan Society of Gynecologic Oncology (Director, Specialist)
Japanese Gynecologic Oncology Group (JGOG: President)
The Japanese Society of Clinical Cytology (Specialist)
Symposium II
International Collage of Surgeons (Fellow)

American Society of Clinical Oncology, active member
International Gynecologic Cancer Society (IGCS)
1. An internally and externally validated nomogram for predicting the risk of
irinotecan-induced severe neutropenia in advanced colorectal cancer patients.
British J Cancer 2015 1-8, doi: 10.1038/bjc.2015.122.
2. Molecular analysis of isolated tumor glands from endometrial endometrioid
adenocarcinomas: Molecular analysis of uterine cancer. Pathol Int 2015;65 (5):
doi:10.1111/pin.12274.
3. Fibroblast growth factor receptor 2 is associated with poor overall survival in
clear cell carcinoma of the ovary and may be a novel therapeutic approach. Int
J Gynecol Cancer 2015.doi:10.1097
4. Investigation of the clinicopathological features of squamous cell carcinoma of
the vulva: a retrospective survey of the Tohoku Gynecologic Cancer Unit. Int J
Clin Oncol 2015. Doi:10.1007/s10147-015-0803-x.
100
S2-03
Important JGOG studies of ovary, corpus and cervix
Toru Sugiyama
Department of Obstetrics and Gynecology, Iwate Medical University, Iwate, Japan
Of ovarian cancer therapy, dose-dense paclitaxel/carboplatin (TC) regimen is the essential option of
standard therapy based on the results of JGOG3016 study. Subsequently, JGOG3017 study of clear
cell adenocarcinoma was conducted in cooperation with KGOG and the results were presented in the
ASCO 2014. Ongoing studies include JGOG3018 study for dose-finding of Doxil, JGOG3019 study to
evaluate the priority of intraperitoneal administration, and JGOG3020 study to evaluate postoperative
chemotherapy for early cancer, for which JGOG is promoting the accumulation of subjects. We expect
these studies will be conducted in cooperation with Asian countries as much as possible. Efficacy of
bevacizumab to Japanese patients with primary disease (JGOG3022 study) and platinum-resistant
disease (JGOG3023 study) is under evaluation. Adjuvant chemotherapy was confirmed to be effective
to endometrial cancer. JGOG2043 study (AP vs. TC vs. DP) is attracting attention around the world and
we will show the results in the ASCO next year. Based on the results of the survey about consultation of
uterine leiomyosarcoma (JGOG2049S), a study is planned to start in order to evaluate the usefulness of
dose-dense TC regimen. Several phase II studies and observation studies of cervical cancer are ongoing. A
study of concurrent chemoradiotherapy (CCRT) with cisplatin and paclitaxel is in progress in patients with
Symposium II
locally advanced cervical adenocarcinoma, however, the study has problems of subject accumulation.
Of NRG-Oncology study, GOG237 study of atypical glandular cells (AGC) is in progress faster in Japan.
In addition, we participate in GOG268, GOG213 and GOG275 studies. The future direction of JGOG
is the cooperation with Asian countries. We would like to develop cooperative relations with them to
conduct studies, which are planned in Asia and performed worldwide. As a member of GCIG, we would
like to participate in studies of not only the US but also European groups. The key word is international
cooperation.
101
S2-04 Speaker
Jae-Hoon Kim
Organization
Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei

University College of Medicine,Seoul, Korea
Education
1989 M.D., The Catholic University of Korea, College of Medicine, Seoul, Korea
1998 Ph.D., The Catholic University of Korea, Postgraduate School, Seoul, Korea
Mar. 1989 - Feb. 1990 Internship, The Hospitals of The Catholic University of
Korea, Seoul, Korea
Mar. 1990 - Feb. 1994 Residency, Department of Obstetrics and Gynecology,
The Hospitals of The Catholic University of Korea, Seoul,
Korea
Positions Held & Faculty Appointment
Jul. 2000 - Feb. 2002 Gynecologic Oncology Research Fellow,Department

of Obstetrics and Gynecology, Brigham and Women’s
Hospital, Harvard Medical School
Mar. 2004 - Associate Professor, Department of Obstetrics and
Symposium II
Gynecology, Yongdong Severance Hospital,Yonsei

Mar. 2010 - Professor and Chair,Department of Obstetrics and
Gynecology,Gangnam Severance Hospital
Mar.2012 - President, Korea Gynecologic CancerBank
Mar. 2013 - Vice-Director, Yonsei Biomedical Reserch Institute
Memberships
Korean Association of Obstetrics & Gynecology

Korean Society of Gynecology Oncology and Colposcopy
Secretary General of KSGOC (2002. 11.1 – 2004. 10.31)
Korean Society of Oncology
European Society of Gynecologic Oncology
American Association of Cancer Research
Gynecologic Oncology Group (GOG)
Korean Gynecologic Oncology Group (KGOG)
Asian Gynecologic Oncology Group (AGOG)
102
S2-04
Ongoing trials from Korean Gynecologic Oncology Group
Jae-Hoon Kim
Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
On January 2003, the Korean Gynecologic Oncology Group (KGOG) took the first step toward becoming
a gynecologic cancer clinical trial group. After several reform processes, KGOG is now composed of a
research committee and a steering subcommittee as the major organizations, and three major tumor-
specific subcommittees of cervical cancer, ovarian cancer and endometrial cancer, as well as pathology,
radiotherapy, medical oncology and translation research subcommittees as advisory organizations.
Although the KGOG is just 10-years old, the group has accumulated experience in conducting practice-
defining, multi-institutional phase 2 and 3 trials sponsored primarily by the government as well as by
industries.
After several retrospective multicenter studies, the KGOG made efforts not only to do domestic
multicenter trials but also to participate in GOG and GCIG protocols. Until now, the KGOG has
successfully performed almost 49 domestic clinical trials including prospective studies (cervix; 10, uterine;
16, ovary; 23) and 39 international protocols (cervix; 24, uterine; 4, ovary; 11). At present, KGOG are
conducting 24 trials (cervix; 11, uterine; 4, ovary; 9). Recently, the KGOG has collaborated with AGOG,
Symposium II
SGOG and other Asian countries. GOG 263, a GOG protocol by the KGOG, and the TACO trial, a
protocol also proposed by the KGOG will be considered stepping-stones for international collaboration.
103
S2-05 Speaker
Christian Marth
Current Position
Head and Professor of the Department of Obstetrics and Gynecology

Innsbruck Medical University, Innsbruck, Austria

1981-1985 Education at the Medical faculty of the University of Innsbruck, Austria

1981-1985 Scientific assistant at the Department of Obstetrics and Gynecology,
Innsbruck University Hospital
1982-1983
Scientific assistant of Prof. Dr. G. C. Buehring, University of California,
Berkeley (Cell culture and hormone dependency; one year)
1985 Medical Degree at the University of Innsbruck
1985-1991 Specialization in Obstetrics and Gynecology at the Department of
Obstetrics and Gynecology, Innsbruck University Hospital, trained by
Otto Dapunt, member of the Society of Pelvic Surgeons
1990-1996 Senior physician at the the Department of Obstetrics and Gynecology,
Innsbruck University Hospital (Head: Otto Dapunt)
1991 Specialist in Obstetrics and Gynecology.
1991 Habilitation (PhD) in Obstetrics and Gynecology
Symposium II
1996-1998 Senior physician at the Department of Gynecologic Oncology, The

Norwegian Radiumhospital, Oslo (Head: C. Tropé, member of the
Society of Pelvic Surgeons)
1997 Associated Professor at the University of Innsbruck
1998- Head of the Department of Obstetrics and Gynecology, Innsbruck
Medical University
2001-2003 President of the Austrian Association for Gynecologic Oncology
2002- President of the Austrian Study Center for Gynecologic Oncology
2006- Vice President of the Austrian Breast and Colorectal Study Group (ABCSG)
2007-12 Chair of the Ovarian Committee of Gynecological Cancer Intergroup
(GCIG)
2009-13 Council member of the European Society of Gynecologic Oncology
ESGO
2011-2013 President of the Austrian Society of Obstetrics and Gynecology
2013- President of the Austrian Association for Gynecologic Oncology
2014- Chair of the European Network of Gynaecological Oncological Trial
Groups
104
Awards
1985 Award of the Hoechst-Stiftung

1990 Award of the Austrian Society of Senology
1991 Hugo-Husslein-Award of the Austrian Society of Obstetrics and Gynecology
1992 Award of the Medical Association of Tirol and Voralberg
Award of the Austrian Society of Senology
Award of the Austrian Society for In-vitro Fertilization
Award of the Austrian Society of Senology
Smithkline-Beecham Award
Member of scientific organizations
Österreichische Gesellschaft für Gynäkologie und Geburtshilfe

Deutsche Gesellschaft für Gynäkologie und Geburtshilfe
Arbeitsgemeinschaft Gynäkologische Onkolgie of the Österreichischen Gesellschaft für Gynäkologie und
Geburtshilfe
International Society for Interferon and Cytokine Research
American Society of Clinical Oncology
Society of Gynecologic Oncology
Symposium II
European Association for Cancer Research
European Organization for Research and Treatment of Cancer - Preclinical Therapeutic Models Group
Society of Pelvic Surgeons
Reviewer of scientific journals
American Journal of Obstetrics and Gynecology

Cancer Research
Gynecologic Oncology
International Journal of Cancer
Journal of Cellular Biochemistry
Journal of the National Cancer Institute
Journal of Steroid Biochemistry and Molecular Biology
Publications
345 Papers in peer-reviewed journals
105
S2-05
ENGOT clinical trials:

future development in ovarian cancer therapy
Christian Marth
Head and Professor of the Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Austria
The European Network of Gynaecological Oncological Trial Groups (ENGOT) is a research network of
the European Society of Gynaecological Oncology, which was founded in 2007. Currently, 19 European
trial groups are members of ENGOT. As a network of European national or regional clinical trials groups,
ENGOT promotes clinical trials within Europe in women with gynecological cancer. This coordination
is particularly relevant not only for academic clinical trials, translational research, and research on rare
diseases, but also for clinical trials in cooperation with the industry desiring to perform multinational
studies with academic groups in Europe.
ENGOT is a platform that guarantees that the European spirit and culture is incorporated into the medical
progress in gynaecological oncology, and that all European patients and countries can participate in an
active way in clinical research and progress.
The ultimate goal is to bring the best treatment to gynaecological cancer patients through the best
science, and enabling every patient in every European country to access a clinical trial. The Open and
ongoing trials are listed: http://www.esgo.org/engot/Pages/ENGOTTrials.aspx
Symposium II
106
Symposium III
Minimally Invasive Surgery for Gynecologic Malignancies
CHAIRPERSON
Zeyi Cao (China) Kung-Liahng Wang (Taiwan)
SPEAKERS
Role of LESS in oncology
Tae-Joong Kim (Korea)
Robotic pelvic exenteration for recurrent cervical cancer

Peter Lim (USA)
Unexpected uterine malignancy: pitfall of laparoscopic surgery

Pao-Ling Torng (Taiwan)
The variations on robotic radical hysterectomy

Dae-Yeon Kim (Korea)
107
S3-01 Speaker
Tae-Joong Kim
Organization
Ob/Gyn. Samsung Medical Center, Korea
TJ Kim graduated from Seoul National University College of Medicine. He

completed his internship, residency and oncologic fellowship training at Samsung
Medical Center, Sungkyunkwan University School of Medicine. He is now an
assistant professor there. TJ Kim has been an invited lecturer at international
symposia and conferences as an honored guest speaker. He has also performed
live demonstration surgery in the field of single-port surgery. He has published
more than 140 peer-reviewed international journal articles (SCI (E)) in the field of
gynecologic oncology as well as minimally invasive surgery. TJ Kim has interests
in clinical trials concerning innovative minimally invasive surgery (Robot, NOTES,
LESS), ovarian cancer prevention and chemotherapy. He is the first surgeon who
started single-port laparoscopy, NOTES and single-site da Vinci surgery in Korea.
He serves as a secretary general of Korean society of gynecologic oncology.
Symposium III
109
S3-01
Role of LESS in oncology
Tae-Joong Kim
Department of Obstetrics and Gynecology, Samsung Medical Center, Seoul, Korea
LESS has emerged as a growing trend in minimally invasive surgery. Since LESS has intrinsic limitations of
triangulation loss and insufficient traction, it has been considered for easy procedures in the beginning
stage of oncologic field; Hysterectomy for cervical intraepithelial neoplasis and risk-reducing salpingo-
oophorectomy. Along with evolution of the instruments, its usage has been expanded to complex
procedures; staging operation including lymphadenectomy, triage surgery for ovarian cancer. Benefits
of LESS are in less postoperative pain and excellent cosmetic satisfaction for patients rather than multi-
port laparoscopic surgery. In additions to patients advantages, LESS gives us some technical benefits as
follows: 1) specimen removal from the abdominal cavity is easier, 2) a big umbilical opening functions
as an entry like minilaparotomy, 3) the wound retractor used in single-port platform can protect wound
and may lessen port-site metastasis, 4) the instruments can approach to whole abdomen as well as pelvis
efficiently from the umbilicus located in the center of the abdomen. With these benefits, we can adopt
LESS for various situations in oncologic field. I’d like to share what I learned from LESS application. I will
explain technical benefits of LESS and tips for its use in gynecologic oncology.
Symposium III
110
S3-02 Speaker
Peter C. Lim
Current Position
Medical Director Center of Hope & Robotic Institute at Renown Regional Medical
Center, USA
Graduated from Hahnemann University, completed internship and residency in

Obstetrics & Gynecology at Women's and Children's Hospital at L.A. County,
University of Southern California, and Fellowship in Gynecologic Oncology at
Mayo Clinic. He is currently the Medical Director of Gynecologic Oncology and
Robotic Surgery at Center of Hope and Robotics and Minimally Invasive Surgical
Institute at Renown Regional Medical Center. Dr. Lim has published in peer
reviewed journals and presented at International meetings on topics of Robotics
and Minimally Invasive surgery. He was the recipient of Robotics Technology
paper award at the AAGL 2009, 2011, and 2012. He has been named one of
the 5 Epicenter Surgeons in Gynecologic Oncology in the United States. He has
performed over 1500 robotic procedures.
Symposium III
111
S3-02
Robotic assisted pelvic exenteration, lessons learned
Peter C. Lim
Medical Director Center of Hope & Robotic Institute at Renown Regional Medical Center, USA
Central pelvic recurrent gynecologic malignancy such as cervix, vagina, uterine and vulvar cancer after
failed primary surgical therapy and/or radiotherapy require pelvic exenteration with either urinary, bowel
and pelvic floor reconstruction for curative intent. Pelvic exenteration is generally performed via open
approach and it is associated with increased intraoperative morbidity, postoperative complications with
prolonged hospitalization and recuperation. It has been suggested that advantage of minimal invasive
surgery such as laparoscopic or robotic may potentially be an alternative option to reduce intraoperative
blood loss, postoperative complications and shorter hospitalization. However, traditional laparoscopic
instrumentations may have limitation in performing this complex surgical procedure.
We present our experience and lessons learned in performing robotic assisted pelvic exenteration and
reconstructive urinary and bowel surgery. The indications, the procedural steps and intraoperative and
postoperative outcomes will be discussed and presented.
Symposium III
112
S3-03 Speaker
Pao-Ling Torng
Organization
Obstetric and Gynecology, National Taiwan University Hospital, Taiwan
Education
Associate professor of Medical College of National Taiwan University

Education and Degree: National Taiwan University, College of medicine, M.D.
National Taiwan University, Graduated Institute of Clinical Medicine, Ph.D.
Taiwan association of Obstetrics and Gynecology (TAOG), member Taiwan

Association for Minimally Invasive Gynecology (TAMIG), Councilor Taiwan
Association of Gynecologic Oncologist (TAGO), Councilor Taiwan Robotic Surgery
Association (TRSA), Councilor Advancing minimally invasive gynecology worldwide
(AAGL), member Gynecology and Minimally Invasive Therapy (GMIT), Executive
Editor Taiwan Journal of Obstetrics and Gynecology (TJOG), Editorial Board
1. Lin KH, Shih HJ, Chen CL, Torng PL*. The effect of tumor mrcellation during
surgery in patients with early uterine leiomyosarcoma. Gynecol Min Invasive
Symposium III
Ther 2015;4: 81-6.
2. Lin KH, Torng PL*, Tsai KH, et al. Clinical outcome affected by tumor morcellation
in unexpected early uterine leiomyosarcoma. Taiwan J Obstet Gynecol 2015;54:172-7.
3. Torng PL* (First author and corresponder). Adhesion prevention in laparoscopic
myomectomy. Gynecol Min Invasive Ther 2014;3:7-11.
4. Torng PL, Lin KH, Hwang JS, et al. Learning curve for laparoendoscopic single-
site surgery for an experienced laparoscopic surgeon. Gynecol Min Invasive
Ther 2013;2:126-131.
5. Torng PL, Lin CW, Chan MW, et al. Promoter methylation of IGFBP-3 and p53
expression in ovarian endometrioid carcinoma. Mol Cancer 2009;8:120.
6. Torng PL, Lee YCG, Huang CYF, et al. Insulin-like growth factor binding
protein-3 (IGFBP-3) acts as an invasion-metastasis suppressor in ovarian
endometrioid carcinoma. Oncogene 2008;27:2137-47.
113
S3-03
Unexpected uterine malignancy: pitfall of laparoscopic surgery
Pao-Ling Torng
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Zhongzheng, Taiwan
Uterine malignancies, such as leiomyosarcomas (LMS), are rare and aggressive but difficult to predict
before surgery. The prevalence for unsuspected uterine sarcoma was reported by FDA as 1 in 352 for any
sarcoma and 1 in 498 for leiomyosarcoma. Recently, a more precise prevalence estimates leiomyosarcoma
of 1 per 8300 surgeries using a more comprehensive review of published data. Minimally invasive
surgery using electric or knife morcellation might cause tumor spreading during manipulating of tumor
tissue. Quite a number of patients developed subsequent trocar sites and local pelvic recurrence after
tumor morcellation of unexpected leiomyosarcoma. However, a few cases were reported to be up-
staged after post-morcellation image studies or at re-operation for tumor staging. It could be possible
that presumed early stage leiomyosarcoma during initial operation were actually at advanced stage.
Perri et al reported that Leiomyosarcoma injured by sharp instrument during open surgery could as well
cause high tumor recurrent rate and poor survival outcome. A retrospective study reported by Park et
al who compared 25 patients with and 31 without tumor morcellation during operation on apparently
early stage leiomyosarcoma. Tumor morcellation showed increased abdomino-pelvic dissemination and
affected patient survivals. We reviewed 43 of our patients who were operated and diagnosed as early
stage leiomyosacoma during the past 21 years in our hospital. Interestingly, we found no increase of
local recurrent rates using morcellation and that patient outcome was related to tumor size. When size
Symposium III
was matched and adjusted, we could then see a partial poor effect of morcellation on patient survival.
This suggests the poor biological nature of leiomyosarcoma itself is a major cause of poor patient survival
outcome. A more complete and precise medical record with a longer period of follow-up before the
decision of operation might therefore reduce the pitfall of this unexpected leiomyosarcoma.
114
S3-04 Speaker
Dae-Yeon Kim
College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea
Education
3/1984-2/1987 Jemulpo High School, Inchon

3/1987-2/1989 Premedical Course, College of Liberal Arts and Science, Seoul
National Univ, Seoul, Korea
3/1989-2/1993 College of Medicine, Seoul National Univ, Seoul, Korea (M.D.
degree)
3/1996-2/1998 Graduate School, Seoul National Univ, Seoul, Korea (M.S. in
Medical Science)
3/2002-8/2005 Graduate School, Seoul National Univ, Seoul, Korea (Ph.D. in
Medical Science)
Professional Appointments
2/1998-4/2001 Armed Service in the Republic of Korea. (as a public doctor in

Pyeonchang, Korea)
5/2001-2/2003 Clinical Fellowship in Gynecologic Oncology, Asan Medical
Center, Seoul, Korea
3/2003- 2/2008 Assistant Professor, Asan Medical Center, Seoul, Korea
Symposium III
7/2009 - 2/2011 Research fellow, Massachusetts General Hospital, Harvard
Medical School
Professional Organization / Membership
Member, Korean Medical Association (1993)

Member, Korean Society of Ob & Gyn (1998)
Member, Korean Association of Gynecologic Oncology & Colposcopy (2001)
Member, AAGL (2007)
Member, KGOG (2007)
115
S3-04
Variations on robotic and laparoscopic radical hysterectomy
Dae-Yeon Kim
Deapartment of Obstetrics and Gynecology, Asan Medical Center, Seoul, Korea
1. Less radical approaches – nerve sparing and modified TMMR

2.Vaginal approach (colpotomy and tumor extraction) in robotic radical hysterectomy - should be a
prefered method in bulky cervical cancer:
OBJECTIVE : We evaluated the recurrence rate and pattern of patients with bulky cervical cancer who
had underwent robotic radical hysterectomy through vaginal colpotomy (RRH-VC) or robotic radical
trachelctomy through vaginal colpotomy (RRT-VC). And, other surgical and oncological outcomes were
also evaluated.
METHODS : From January 2012 to May 2015, 31 patients had underwent RRH-VC or RRT-VC by a single
gynecologic oncologist. Patients’ clinicopathologic findings, surgical results, and oncological outcomes
were retrospectively reviewed.
RESULTS : Twenty eight patients with stage IB1, IB2, IIB cervical cancer and three patients with stage
IB1 underwent RRH-VC and RRT-VC, respectively. Median total operative time was 277 minutes (range,
165-522 minutes). Median estimated blood loss was 200 ml (range, 50-700 ml). Median postoperative
hospital stay was 7 days (range, 5-11 days). None of the patient experienced intraoperative complications.
Fifteen patients (48.4%) experienced postoperative complications but the most common postoperative
Symposium III
complication was voiding difficulty and was transient. A median distance from tumor to vaginal cuff were
3cm (1.5-4.5cm). At a median 14 months of follow-up (range, 3-44 months), no recurrence or death
were found.
CONCLUSION : Robotic radical hysterectomy combined with vaginal approach in patients with bulky
cervical cancer is feasible and safe surgical procedure with low local recurrence rate compared with
historical control. Large multicenter prospective study with longer follow-up duration is warranted.
116
Free Communication I
CHAIRPERSON
Ting-Chang Chang (Taiwan) Jae-Kwan Lee (Korea)
SPEAKERS
Clinical impact of anti-PD-1 antibody (Nivolumab) for platinum-resistant
ovarian cancer
Junzo Hamanishi (Japan)
Clinical significance of BRCA testing and genetic counseling in advanced stage

ovarian carcinoma
Min Kyu Kim (Korea)
Ascites derived tumor associated macrophages alter chemosensitivity in

ovarian cancer cell line
Seob Jeon (Korea)
IL-17a and IL-21 combined with surgical status predict the outcome of ovarian
cancer patients
Yu-Li Chen (Taiwan)
Extensive upper abdominal surgery prolongs the long term survival of

patients with chemosensitive stage IIIC and IV ovarian cancer
Yulan Ren (China)
Paradigm shift in surgical complexity since change in surgical practice from

optimal to complete cytoreduction in ovarian cancer
Pesona Lucksom (India)
117
FC1-01 months) at study termination.
CONCLUSION: This study is the first to explore the effects
Clinical impact of anti-PD-1 antibody
of Nivolumab against ovarian cancer. The encouraging
(Nivolumab) for platinum-resistant ovarian
safety and clinical efficacy of Nivolumab in patients with
cancer
platinum-resistant ovarian cancer indicate the merit of
further large-scale investigations (UMIN Clinical Trials
Junzo Hananishi1, Masaki Mandai2, Noriomi Matsumura1,
1 1 1
Kaoru Abiko , Tsukasa Baba , Ikuo Konishi , Ken Yamaguchi 1 Registry: UMIN000005714).
1
Gynecology and Obstetrics, Kyoto University, Kyoto, Japan,
2
Obstetrics and Gynecology, Kinki University Faculty of Medicine,
FC1-02
Osaka, Japan
Clinical significance of BRCA testing and
OBJECTIVE: Programmed death-1 (PD-1) is a co-inhibitory genetic counseling in advanced stage ovarian
receptor expressed on activated T cells and relates to carcinoma
regulate anti-tumor immunity. Nivolumab is a fully human
IgG4 that blocks the binding of PD-1 and PD-1 ligand Min Kyu Kim1, Soo Hyun Kim2
(PD-L1). In this report we present anti-tumor activity and 1
Obstetrics and Gynecology, Sungkyunkwan University of
durable tumor remission cases with Nivolumab in ovarian Medicine, Samsung Changwon Hospital, Changwon, Korea 2
cancer patients. Obstetrics and Gynecology, Samsung Medical Center, Seoul, Korea
METHODS: The single-center, open-label, investigator
initiated phase II clinical trial was conducted in two cohorts OBJECTIVE: BRCA testing and genetic counseling is
of platinum-resistant ovarian cancer patients from 2011 recommended for women among ovarian cancer with
to 2014 in Kyoto University Hospital, Nivolumab was regard to survival benefit and prevention of cancer
administered every 2 weeks to patients, at the doses of including patient and mutation carrier among family
1 or 3 mg/kg during two cohort examination in each members. There are not much studies about adequate
10 patients. This trial defined 1st endpoint of response timing and barriers for accepting genetic counseling
rate, and 2nd endpoints of safety, disease control rate, according to disease severity. We undertook this study to
progression free survival and overall survival. Patients investigate whether advanced staging can be a barrier in
received Nivolumab up to one year or until disease BRCA testing and genetic counseling.
progression. Response rate was assessed by RECIST v1.1, METHODS: A case control study was done between early (I-
and adverse events were evaluated by CTCAE v4.0. II) and advanced (III-IV) ovary carcinoma patients regarding
RESULTS: Twenty patients were treated with Nivolumab (1 BRCA mutation and genetic counseling acceptance. Total
mg/kg: n=10, 3mg/kg: n=10), and evaluated. Grade 3 or 34 patients were evenly divided between them. After Communication
4 treatment-related adverse events occurred in seven (40 complete surgical staging and pathology result, single Free
I
%) of 20 patients. Two patients had severe adverse events. gynecologic oncologist offered genetic counseling about
One patient treated with 1 mg/kg cohort had events of risk assessment based on pathology, family history and
fever, disorientation and gait disturbance. Another one immunohistochemistry. BRCA1/2 gene sequencing was
with 3 mg/kg cohort had severe fever elevation. In the 20 done for approved patient. Among BRCA positive patients,
patients in whom responses could be evaluated, the best second genetic counseling for risk management options
overall response was 15%, including two patients with (family counseling, risk reducing surgery, surveillance for
a durable complete response (3mg/kg cohort) for over BRCA associated cancer and chemoprevention) was done.
one year, while this rate of 1mg/kg cohort was 10% (1 Clinical information was extracted from the medical records
patient with partial response). The disease control rate was including age, family history, stage at diagnosis, histology
in all 20 patients was 45%. The median progression-free type, disease free interval (DFI), type of genetic testing and
survival was 3.5 months (95%CI, 1.7 to 3.9 months), with type of gene mutation.
a median overall survival of 20.0 months (95%CI: 7.0– RESULTS: Advanced stage group was a little bit older than
119
early stage group, median age were 57.77 (45-75) vs on ovarian cancer cell line in the presence of Macrophage
52.53 (20-73) (p>0.05). In contrast to early stage group, cell line by transwell assay
advanced stage group had high proportion of serous METHODS: We generated macrophage cell line from ascites
carcinoma (15/17 (88.2%) vs 6/17 (35.3%)) (p<0.05) and of mouse ovarian cancer model through cell harvest,
short DFI (10.87 vs 22.27 months) (p<0.05). Among 34 sorting, and immortalizing process, and to determine
patients, only 2 patients refused BRCA testing and gene phenotype of generated macrophage we performed flow
counseling at each group. Patient with cancer related cytometry, quantitative real time polymerase chain reaction,
family history is 1 (5.9%) in early stage and 3 (17.6%) in immunofluorescence staining and LDL uptake assay. And
advanced stage. In early stage group, BRCA testing period we investigated carboplatin treatment response of ovarian
after the operation (126.38 (6-981 days) vs 50.69 (6-315 cancer cells cocultured with macrophages by transwell
days) (p>0.05)) was longer than advanced group. BRCA1 assay and cell viability assay.
was found by three patients in advanced stage group only RESULTS: TAMs from ascites of mouse ovarian cancer model
and BRCA2 was not detected in all groups. Eleven patients had mixed phenotype with M1 and M2. In vitro transwell
were found VUS (Variation of Unknown Significance) in assay, ovarian cancer cells which were cocultured with
early stage group and three patients were found VUS in TAMs had more chemoresistant than control group upon
advanced stage group. carboplatin treatment.
CONCLUSION: Genetic counseling even at advanced stage CONCLUSION: Our data suggest that soluble factors from
of ovary cancer by gynecologic oncologist is feasible. ascites derived TAMs may alter carboplatin chemotherapy
Comprehensive cancer care including treatment, prevention response in ovarian cancer cells. Blockade of these function
and early detection of BRCA mutation of ovary carcinoma of TAMs might increase the clinical effect of platinum-
is equally important. Therefore, advanced staging patient based chemotherapy.
may not be an obstacle for early counseling by surgeon
about BRCA mutation.
FC1-04
IL-17a and IL-21 combined with surgical status

FC1-03
predict the outcome of ovarian cancer patients
Ascites derived tumor associated macrophages
Yu-Li Chen
alter chemosensitivity in ovarian cancer cell
line Department of Obstetrics and Gynecology, National Taiwan
University Hsin-Chu Branch, Hsinchu City, Taiwan
Seob Jeon1, Oliver Dorigo2, Huanhuan He2, Kyehyun Nam3,
Jaegun Sunwoo3, Seungdo Choi3
Communication
OBJECTIVE: Aside from tumor cells, ovarian cancer-related

1
Obstetrics and Gynecology, Soonchunhyang Medical College, ascites contains the immune components. The aim of this
Free
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Cheonan, Korea, 2 Department of Obstetrics and Gynecology, study was to evaluate whether a combination of clinical
School of Medicine Stanford University, California, USA, 3
and immunological parameters can predict survival in
Department of Obstetrics and Gynecology, School of Medicine
patients with ovarian cancer.
Soonchunhyang University, Bucheon, Korea
METHODS: Ascites specimens and medical records from 144
ovarian cancer patients in our hospital were used as the
OBJECTIVE: Macrophages are the dominant myeloid cells derivation group to select target clinical and immunologic
found in tumor microenvironment. Tumor associated factors to generate a risk scoring system to predict patient
macrophage (TAM) has been proved to promote tumor survival. Eighty-two cases from another hospital were used
growth, metastasis and chemoresistance. In this study we as the validation group to evaluate this risk scoring system.
generated macrophage cell line from the ascites of ovarian RESULTS: The surgical status and expression levels of
cancer model of ID8 injected mouse, determined it's interleukin (IL)-17a and IL-21 in ascites were selected for
phenotype and investigated carboplatin chemosensitivity the risk scoring system in the derivation group. The areas
120
under receiver operating characteristic (AUROC) curves and 44.3% in stage IIIC and IV EOC, respectively. The
of the overall score for disease-free survival (DFS) of the median follow-up time was 25.4 months (range: 16–80
ovarian cancer patients were 0.84 in the derivation group, months). The estimated 5-year survival rate of women with
0.85 in the validation group and 0.84 for all the patients. chemosensitive disease was 73% after EUAS, compared
The AUROC curves of the overall score for overall survival with 42% for those who did not received EUAS. Among
(OS) of cases were 0.78 in the derivation group, 0.76 in patients with chemoresistant disease, survival rates at 1–3
the validation group, and 0.76 for all the studied patients. years were greater for those who received EUAS than those
Good correlations between overall risk score and survival who did not receive EAUS (median survival: 29 months vs.
of the ovarian cancer patients were demonstrated by sub- 20.1 months, respectively). Receiving EUAS, FIGO stage,
grouping all participants into four groups (p for trend clear cell histology, bowel mesenteric carcinomatosis and
<0.001 for DFS and OS). age were predictors of chemosensitivity (P=0.000, 0.009,
CONCLUSION: Therefore, a combination of clinical and 0.017, 0.022 and 0.007, respectively).
immunological parameters can provide a practical scoring CONCLUSION: EUAS prolonged the long term survival in
system to predict the survival of patients with ovarian chemosensitive stage IIIC and IV EOC. A well designed
carcinoma. IL-17a and IL-21 can potentially be used as randomized trial is on the way.
prognostic and therapeutic biomarkers.
FC1-06
FC1-05
Paradigm shift in surgical complexity since
Extensive upper abdominal surgery prolongs change in surgical practice from optimal to
the long term survival of patients with complete cytoreduction in ovarian cancer
chemosensitive stage IIIC and IV ovarian
cancer Pesona Lucksom, Dhanabir Thangjam, Basumita Chakraborti,
Anik Ghosh, Jaydip Bhaumik, Asima Mukhopadhyay
Yulan Ren1, Rong Jiang2, Wen-Fang Cheng3, Yuqin Zhang2,
Department of Gynecologic Oncology, Tata Medical Centre,
Chi-An Chen3, Sheng Yin2, Tingyan Shi2,
Kolkata, India
Pan Wang4, Xi Cheng4, Jie Tang4, Rongyu Zang2
1
Department of Gynecologic Oncology, Fudan University OBJECTIVE: To study the trend change in surgical modality
Zhongshan Hospital, Shanghai, China.2Department of Obstetrics as well as surgical complexity score (SCS) since adopting a
and Gynecology, Fudan University Zhongshan Hospital, Shanghai, strategy for complete cytoreduction in primary (PDS) and
China, 3Department of Obstetrics and Gynecology, National Taiwan interval debulking surgery (IDS).
University Hospital, Taipei, Taiwan, 4Department of Gynecologic
METHODS: Retrospective observational study. Data was Communication
Oncology, Fudan University Shanghai Cancer Center, Shanghai,
obtained from operation records in the hospital electronic
Free
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China
database. Patients with ovarian/fallopian tube/primary
peritoneal cancer undergoing PDS (including completion
OBJECTIVE: This study aimed to identify patients with bulky staging) and IDS were included. SCS was calculated for PDS
stage IIIC and IV epithelial ovarian cancer (EOC) whose and IDS at 6 monthly treatment periods P1- P7 (P1: Jan -
survival could benefit from extensive upper abdominal Jun 2012, P7: Jan-June 2015). We changed our practice in
surgery (EUAS). 2015; data was analysed separately (PDS=20, IDS=15)
METHODS: We reviewed 408 patients with bulky stage RESULTS: In total, 169 cases were evaluated; 56 PDS and
IIIC–IV EOC who were treated between January 2009 and 113 IDS. There was an increasing trend for performing
December 2012, and evaluated their progression-free PDS: P1- 20% to P7-60%. Major resection procedures
survival (PFS) and overall survival (OS). for PDS & IDS in 2015 were: Diaphragm (70% vs. 46%),
RESULTS: Of the 408 patients, 116 (28.4%) underwent Pelvic peritoneum (85% vs. 73%), Rectosigmoidectomy
EUAS, and 239 (59.0%) were chemosensitive, with 61.2% -anastomosis (40% vs. 26%), Splenectomy (35% vs.6.0%),
121
Small bowel (25% vs.6%), Total colectomy (15% vs. 0 ),
lesser sac tumour (40% vs. 0%), porta hepatis tumor (25%
vs. 0), Distal pancreatectomy (15% vs. 0 ), Cholecystectomy
(40 % vs. 20%). There was an increasing trend (P1 to P7)
for mean SCS both for PDS (4.0 to 9.9) and IDS (5.0 to
7.9). Optimal cytoreduction was 90% in both PDS and
IDS groups (P1-P7). R0 rates in IDS improved from 60% in
P1 to 80% in P7. Low SCS and 100 % RO resection rate
in PDS prior to 2015 may reflect selection bias with early
stage and lesser complex procedures.
CONCLUSION: • Primary debulking surgery rate has
increased from 20 % to 60% and from January 2015
has overtaken IDS. • There was markedly increase in
stage III/IV patients undergoing PDS. • More than 90%
optimal cytoreduction rate was achieved in both groups
throughout. Significant increase was noted in R0 rate in
IDS. • There was increase in surgical complexity and upper
abdominal procedures with R0 resection and PDS. This
has been possible with inclusion of a multi-disciplinary
team of colorectal, urology, hepato-biliary and critical care
expertise. • Significant increase in SCS in PDS (4 to 10)
has impacted on IDS as well with increase in SCS (5 to 8).
Marked increase in surgical complexity since 2015 in both
groups reflect a shift in paradigm – R0 from R1. • Detailed
prospective recording with regular audit of practice and
outcome should be mandatory. Morbidity and survival rate
data is undergoing analysis.
Communication
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122
Free Communication II
CHAIRPERSON
Xiaohua Wu (China) Yong Man Kim (Korea)
SPEAKERS
Incidence and capability to treat cervical cancer in Dr.Soetomo General
Hospital Surabaya Indonesia
Hari Nugroho (Indonesia)
Parametrial involvement in early stage cervical cancer patients treated with

radical/modified radical hysterectomy in Beijing
Jinwei Miao (China)
The survival rate of abdominal radical trachelectomy versus abdominal radical

hysterectomy for stage IB1 cervical cancer ≥2cm: a case-control study with 248 patients
Xiaoqi Li (China)
Cervical stenosis following abdominal radical trachelectomy: a report of

10-years experience
Jin Li (China)
Pelvic reirradiation as an effective alternative to pelvic exenteration in

recurrent cervical cancer
Taehun Kim (Korea)
The possibility of omission of adjuvant radiotherapy for patients with vulvar

cancer stage IIIA
Tomoyasu Kato (Japan)
123
FC2-01 1,975 new patients underwent radiation, 32.3% patients
with cervical cancer.
Incidence and capability to treat cervical
CONCLUSION: There are 3-4 new cervical cancer patients
cancer In Dr. Soetomo General Hospital
came to gynecologic oncology outpatient clinic every day.
Surabaya Indonesia
Of all, 67% in stadium IIIB and 23% in stadium IIB. Most
of the patients came with the late stage. Only 2 of 136
Hari Nugroho1, Brahmana Askandar1, Lulus Handayani2
patients (2.5%) with cervical cancer have radiotherapy
1
Department of Obstetrics and Gynecology, Airlangga University, service within 5 months which showed total new patients
Dr. Soetomo General Hospital, Surabaya. Indonesia, 2Department
are bigger compared to service offered by radiotherapy
of Radiology Faculty of Medicine, Airlangga University, Dr.
installation. The length of this queue caused the inadequate
Soetomo General Hospital, Surabaya. Indonesia
service of cervical cancer in Surabaya supported by data
showed at least 23.5% patients IIIA-IIIB passed away within
OBJECTIVE: To investigate the incidence and the capability
5 months after diagnosis without radiotherapy service.
to treat cervical cancer in Dr. Soetomo general hospital
Compliance of patients with cervical cancer in Surabaya is
Surabaya.
very bad. There are 16% patients that refused to continue
METHODS: A cohort prospective study was undertaken
treatment with varied reasons and 26% patients were
in new patients with cervical cancer in outpatient clinic lost of follow up. Only 32.1% patients are willing to have
of gynecologic oncology Dr. Soetomo general hospital chemotherapy while they were waiting for the queue of
Surabaya, second largest hospital in Indonesia, during radiotherapy. More cervical cancer screening are needed to
January-December 2014. Data included name, age, and increase early diagnostic of cervical cancer, and hopefully
stage were recorded. Follow-up was done every month for it can decrease the number of patient with cervical cancer.
5 months. More center of radiotherapy are also needed.
RESULTS: There were 842 new patients of cervical cancer
from January-December 2014. The most common stage
was IIIB (67,3%) and IIB (23,3%). Early stage that still
operable (IA-IIA) was only found in 30 patients (7,1%). FC2-02
Based on 5 months follow-up after patients diagnosed Parametrial involvement in early stage cervical
in stadium IIIA-IIIB, only 2.5% had radiotherapy, 23.5% cancer patients treated with radical/modified
died, 25.9% lost of follow up, 16% refused any further radical hysterectomy in Beijing
treatment and 32.1% had chemotherapy with Cisplatin
until the radiotherapy schedule. Surabaya as the second Jinwei Miao
largest city in Indonesia only has 2 radiotherapy services.
Department of Gynecologic Oncology, Beijing Obstetrics and
The biggest one in Surabaya is in Dr. Soetomo general Gynecology Hospital, Beijing, China
hospital with 4 devices of external radiation consist of
3 linear accelerators and 1 Cobalt (cannot be operated OBJECTIVE: Background: Radical hysterectomy is one of the
due to the lack energy sources). Brachytherapy service in treatment options for early stage cervical cancer, in which
Communication
Dr. Soetomo general hospital has 1 HDR: Microselectron parameter need to be resected as near as possible to the
Free
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Gammamed. Data in 2013 showed that Installation of pelvic wall, which could result in significant morbidity. In
Radiotherapy in Dr. Soetomo general hospital had 638 order to decrease the radicality of parametrial resection,
new patients of cervical cancer during a year, and done it is necessary to define a subset of patients at low risk
radiation for 8834 times in patients with cervical cancer. for parametrial metastases. Objectives: To determine the
The waiting time of patients with cervical cancer to get frequency and risk factors associated with parametrial
radiation treatment was 5-6 months since the diagnosis involvement (PI) in early cervical cancer patients who
made. Cervical cancer was the most common cancer that underwent radical/modified radical hysterectomy in the
underwent radiation. In 2013 there were 42,540 radiation University Hospital in Beijing, China.
treatment given, 33,7% were cervical cancer patients and METHODS: Materials and methods: Retrospective data on
125
1057 cases, in which 329 IA1 patients underwent modified FC2-03
radical hysterectomy and 728 IA2-IIA2 patients treated by
The survival rate of abdominal radical
radical hysterectomy between 1999 and 2015 at Beijing
trachelectomy versus abdominal radical
Obstetrics and Gynecology Hospital, was reviewed. PI
hysterectomy for stage IB1 cervical cancer
associated factors including age, clinical stage, tumor size,
≥2cm: a case-control study with 248 patients
histological grade, depth of infiltration (DI), and pelvic
lymph node involvement (LNI) were compared. Pearson’s
Xiaoqi Li, Xiaohua Wu
X2 test and Fisher's exact test were used to categorical
Department of Gynecologic Oncology, Fudan University Shanghai
variables and the risk criteria were analyzed using a logistic
Cancer Center, Shanghai, China
regression model.
RESULTS: RESULTS: 36 patients (3.41%) had PI. There
was no PI in IA1. The PI rate were 5.26% (3 patients) in OBJECTIVE: To compare the survival rates of abdominal
IA2, 3.34% (15 patients) in IB1, 6.33% (5 patients) in radical trachelectomy (ART) to abdominal radical
IB2, 6.70% (8 patients) in IIA1 and 18.52% (5 patients) hysterectomy (ARH) for stage IB1 cervical cancer. Our
in IIA2, respectively. Univariate analysis showed that DI, objective was to know whether it was safe to perform ART
LNI, the tumor size and lymphovascular space invasion for stage IB1 cervical cancer≥2cm.
were significant different between parametrial positive METHODS: Patients with stage IB1 cervical cancer who
and negative groups (p<0.05). In the further multivariate underwent ART and lymph node dissection between
analysis, the cervical stromal invasion> 1/2 (OR:2.908, 95% November 2006 and December 2014 had been compared
CI:1.108- 7.636, p=0.030) and LNI (OR 2.864, 95% CI to patients treated with ARH by the same surgeon at our
1.303-6.294, p=0.009)were independent pathologic risk institution in the same period. The control group consisted
factors for PI. The PI rate (1.55%, 6/387) was significant of patients with stage IB1 diseases who met the inclusion
lower in patients with cervical stromal invasion ≤ 1/2 depth criteria of a fertility-sparing surgery.
and no LNI (p<0.05). In 671 stage IB1-IIA2 cases, other RESULTS: Of the 107 and 141 patients who underwent
than DI (OR:3.095, 95% CI:1.324-7.235, p=0.009) and ART and ARH, respectively, 61 and 82 patients had a
LNM (OR:3.929, 95% CI:1.863-8.290, p=0.000), the tumor tumor ≥2cm (P=NS). With a median follow-up of 30 and
size (OR:2.446, 95% CI:1.167-5.129, p=0.018) was also a 49 months, 2 patients treated with ART and 3 patients
independent risk factor for PI. Among above cases, there treated with ARH recurred: the 5-year RFS rate was 97.8%
were 337 patients with tumor size≤2cm and no LNI, in and 97.0% respectively (P=NS). Only 3 patients died in
which the PI rate was 0.89% (3/337), which was significant the ARH group: The 5-year overall survival (OS) was 100%
lower than the tumor size>2cm and/or LNI patients for the ART group and 96.9% for the ARH group (P=NS).
(p<0.05). Considering tumors measuring 2 to 4 cm, the 5-year RFS
CONCLUSION: Conclusions. PI rate was lower in early stage and the 5-year OS were, respectively, 96.5% and 100% for
cervical cancer with the depth of invasion ≤1/2 and no LNI, the ART group, and 94.8% and 94.8% for the ARH group.
which suggested that the subgroup of patients at low risk The difference of 5-year RFS and 5-year OS between the
of PI could undertake less radical surgery. In this dataset, two groups did not reach statistical significance.
Communication
a model using tumor size and LNI as the PI risk factors CONCLUSION: ART appears to have equal or better survival
Free
could highly predict PI before radical surgery, which could

II
rates to ARH and can be performed safely in stage IB1

be of more feasibility in clinical practice for less radical cervical cancers ≥2 cm.
parametrial resection.
126
FC2-04 menstruation were the most common symptoms. Although
stenosis could be effectively prevented by installation of a
Cervical stenosis following abdominal radical
tailed T-IUD, late occurrence after withdraw of the device
trachelectomy: a report of 10-years experience
should still be aware of. Sometimes repeated dilation of
Jin Li, Xiaohua Wu

the neo-cervix must be performed to obtain optimal results
in patients with severe cervical stenosis.
Cancer Center, Shanghai, China
FC2-05
OBJECTIVE: Cervical stenosis is the major and unique
postoperative complication for abdominal radical Pelvic reirradiation as an effective alternative
trachelectomy (ART). The purpose of the study was to to pelvic exenteration in recurrent cervical
investigate the incidence of cervical stenosis in patients cancer
after ART, and to present our experience in preventing and
managing stenosis during the past 10 years. Taehun Kim1, Sang-Young Ryu1, Moon-Hong Kim1, Beob-Jong
METHODS: We conducted a retrospective review of a Kim1, Sang-Il Park2
prospectively maintained database of patients undergoing 1

Department of Obstetrics & Gynecology, Korea Cancer Center
ART at our institution from 2004 to 2014. Each patient Hospital, Seoul, Korea, 2 Dongnam Institute of Radiological &
was asked to fulfill a survey evaluating symptoms which Medical Sciences, Busan, Korea
may relate to cervical stenosis (e.g., abdominal pain,
irregular menstrual cycle, hematometra) at follow-ups. To OBJECTIVE: To evaluate the efficacy and toxicity of pelvic
prevent cervical stenosis, we have been placing a tailed reirradiation in recurrent cervical cancer patient with
T-IUD before the utero-vaginal reconstruction since 2007. previously irradiated pelvis.
We also sutured the endometrium to the fibromyometrial METHODS: were identified. All patients had received
wall of the uterus at 3, 6, 9 and 12 o'clock orientation to whole pelvic radiation as adjuvant or definite treatment.
prevent stenosis. Dilatation of the cervical ostium with or Patients having distant metastasis were excluded. Central
without ultrasonic guidance was utilized to treat patients recurrence was defined as existence of tumor in cervix,
with severe cervical stenosis. vagina, and uterus. If there was any tumor in other pelvic
RESULTS: A total of 220 patients underwent ART at area such as pelvic lymph nodes and pelvic wall, those were
our institution. According to the follow-up survey, classified as pelvic recurrence. Surgery and/or reirradiation
approximately 20% had mildly symptomatic stenosis not were conducted with curative intent only in patients
requiring neo-cervical dilation. Among them, 56% and who agreed for those treatments. Overall survival was
42% patients complained about abdominal pain and defined from day of 1st recurrence to death date or last
prolonged menstruation. Fourteen (6.4%) patients had follow up date. Reirradiation consisted of brachytherapy,
severe cervical stenosis and required neo-cervical dilation. intensity modulated radiotherapy (IMRT), stereostatic body
Among them, 3 patients required 8 times of repeated radiotherapy (SBRT).
Communication
dilation and all recovered eventually. Four patients had RESULTS: A total of 43 patients were identified. Central
Free
II
late occurrence of cervical stenosis after withdraw of the and pelvic recurrence was 24 (55.8%) and 19 (44.2%),
tailed T-IUDs. They were suggested to have regular neo- respectively. 15 patients refused further treatment. 4
cervical dilation every 2 weeks until they get pregnant. Four patients received only palliative chemotherapy. 14 patients
patients had difficulty to remove their T-IUDs since the tail received only pelvic reirradiation and 10 patients received
dropped, and ultrasonic guided neo-cervical dilation was surgery with or without pelvic reirradiation. Brachytherapy,
utilized to remove the device. SBRT, and IMRT were performed in 10, 3, and 7 patients,
CONCLUSION: Cervical stenosis was the major and unique respectively. Median overall survival was 13.6, 32.0, and
post-trachelectomy complication with a total incidence 65.0 months in no treatment of chemotherapy only group,
of 26.4% of all patients. Abdominal pain and prolonged reirradiation only group, and surgery group, respectively
127
(p=0.011). There was no treatment related death among IIIA (i) in 4 cases, IIIA (ii) in 1 case, and IIIB (i) in 2 cases,
patients who received reirradiation. Among 9 patients with respectively. Among those with stage III, all patients had
central recurrence who was treated with reirradiation only, superficial lymph node metastases. The range of number
5 patients survived more than 5 years with no evidence of of metastatic nodes is 1 to 4. Only 1 patient had metastatic
disease. node to the deep groin region (stage IIIA (i)). Although
CONCLUSION: For patients with local recurrence on she had deep groin lymph node metastasis, she did not
irradiated area, reirradiation using brachytherapy, SBRT, and received postoperative radiotherapy due to her age and
IMRT can be the alternatives to surgical resection, which a medical complication and survived without recurrence.
require high quality surgical skill and good performance The remaining 4 patients with stage IIIA were omitted
status. postoperative radiotherapy and all of them are alive with
no evidence of disease. Of 2 patients with stage IIIB,
one patient who had positive for surgical margin was
FC2-06 received postoperative chemotherapy and survived without
recurrence. But another patient who had four metastatic
The possibility of omission of adjuvant
nodes was not received any postoperative radiotherapy,
radiotherapy for patients with vulvar cancer
and died due to a distant metastasis with the overall
stage IIIA
survival period of 7 months.
CONCLUSION: All 5 patients with stage IIIA are alive without
Tomoyasu Kato, Kenta Takahashi, Mayumi Kobayashi, Yae
Takehara, Tomoko Sumikura, Mitsuya Ishikawa, Shunichi Ikeda postoperative radiotherapy, even though 2 of 5 those
with 2 or more positive nodes. It is suggested that patient
Department of Gynecology, National Cancer Center Hospital,
with vulva cancer stage IIIA may be omit the adjuvant
Tokyo, Japan
radiotherapy. Further study would be needed to validate
whether the location and number of groin lymph node
OBJECTIVE: The groin nodes are the most important
metastases is the parameter to determine the indication of
prognostic factors in squamous cell carcinoma of the vulva.
adjuvant radiotherapy.
Adjuvant radiotherapy is indicated for patients with node-
positive disease consisting of two or more microscopically
metastatic and one macroscopically or extra-capsular
invasion. For these patients, adjuvant radiotherapy should
include bilateral inguinal and pelvic regions. The most
common complication s of adjuvant radiotherapy is the
development of lower extremity lymphedema. Lymph
drainage from the vulva rarely bypass the superficial groin
nodes, and from these superficial groin nodes the disease
spread to the deep groin nodes. We regard the absence of
deep groin node metastasis as a low risk for pelvic lymph
node metastasis, so we have omitted adjuvant radiotherapy
Communication
for patients with node metastasis limited to the superficial

Free
II
groin region. The aim of this study is to define the factors

that allow the omission of postoperative radiotherapy for
stage III vulvar cancer.
METHODS: Among 21 women with vulvar squamous cell
carcinoma who were treated at our hospital from April
1993 to August 2014, 7 patients were included in stage III.
RESULTS: The median age of these 7 patients was 68
years (range: 58-79) and their median follow up period
was 61month (range: 6-179). Subgroup of stage III was
128
Free Communication III
CHAIRPERSON
Chyong-Huey Lai (Taiwan) Joong Sub Choi (Korea)
SPEAKERS
Health behaviors and associated sociodemographic factors in cervical cancer
survivors: baseline data from Health Examinee Cohort
Boyoung Park (Korea)
The role of sentinel lymph node mapping for endometrial cancer

Navamol Lekskul (Thailand)
Which type of hysterectomy and adjuvant treatment for stage II endometrioid

endometrial cancer is suitable? (A Taiwanese Gynecologic Oncology Group study)
Hung-Chun Fu (Taiwan)
Prognostic impact of tumor grade and histology in metastatic (stage 2 to 4)

endometrial carcinoma
Tien Le (Canada)
A retrospective review of clinical presentation, and prognosis of the squamous

cell carcinoma malignant transformation in mature teratoma of the ovary-
Multiple Medical Center Cooperation Study (TGOG)
An Jen Chiang (Taiwan)
The way of tumor removal with oncologic safety in uterine sarcoma: macro-
versus micro-seeding
Jin Young Choi (Korea)
129
FC3-01 FC3-02
Health behaviors and associated The role of sentinel lymph node mapping for
sociodemographic factors in cervical cancer endometrial cancer
survivors:
Baseline data from health examinee cohort Navamol Lekskul
Department of Obstetrics and Gynecology, Ramathibodi Hospital,

Boyoung Park1, Sang-Soo Seo3, Sokbom Kang3, Sang-Yoon Bangkok, Thailand
Park1, Myong Cheol Lim2
1
Department of Cancer Control and Policy, Graduate School of OBJECTIVE: To describe the techniques and updates of
Cancer Science and Policy, 2Department of Uterine Cancer, National sentinel lymph node mapping for endometrial cancer
Cancer Center, Goyang, Korea3 METHODS: Sentinel lymph node is the first node in the
lymphatic basin which receives the lymphatic flow and,
OBJECTIVE: This study investigated the prevalence of consequently, the first node where cancer metastasize. The
smoking, alcohol drinking, physical activity, and obesity sentinel lymph node concept is to resect only the sentinel
in cervical cancer survivors and the associations between node to represent the entire lymph node status, in order to
sociodemographic factors and each health behavior. avoid the comprehensive lymphadenectomy which could
METHODS: This study included 448 cervical cancer potentially result in a prolonged operation and potential
survivors who were ≥ 2 years from the initial diagnosis complications, such as lymphocele and lymphedema of the
and completed treatment and 4,480 age, education, and lower limbs, not to mention the higher risk of nerve and
household income-matched (1:10) cancer-free controls vascular injuries.
from the Health Examinee Cohort baseline study. Structured RESULTS: There are three major techniques currently used
questionnaire was used to obtain information of health- in sentinel lymph node mapping for endometrial cancer,
related behaviors and sociodemographic characteristics. lymphoscintigraphy with technetium-99, colored dye
RESULTS: The prevalences of current smoking, current
injection, and fluorescent sentinel lymph node mapping
alcohol drinking, physically inactive, and obesity in cervical with indocyanine green, which is emerging as a new
cancer survivors (2.7%, 23.9%, 62.0%, and 32.8%) were
promising method with increasing number of supporting
not significantly different from those in matched non-
studies. Three sites of injections were reported: 1) uterine
cancer controls (2.2%, 26.4%, 64.6%, and 29.8%). These
subserosal, 2) cervical, and 3) endometrial via hysteroscopy.
behaviors were not affected by years since diagnosis except
The cervical injection technique was proved to yield higher
obesity, which were lower in the 6-10 years after diagnosis
detection rate with the convenience to apply.
(P-value=0.004). Age (decrement), marital status (married),
CONCLUSION: Although the present benchmark of
and education (≥college) were associated with lower odds
surgical staging for endometrial cancer is complete pelvic
of current drinking, otherwise household income (<2000$),
lymphadenectomy, more and more studies were conducted
employment, and self-rated health status (less healthy)
to confirm the feasibility of sentinel lymph node mapping.
increased the risk of physical inactivity. For obesity, age and
The cornerstone of success is to improve a detection rate
years since diagnosis were the associated factors.
while maintaining a low false-negative rate. Surgeons’
CONCLUSION: Cervical cancer survivors’ health behaviors
increasing experiences and the use of ultrastaging might be
were not different from matched non-cancer controls.
the key factors that we require.
Health behaviors are modifiable, therefore identifying
Communication
cervical cancer survivors with higher probabilities of

Free
III
unhealthy lifestyles would allow individual- and population-

based intervention programs to more effectively use in
limited resources.
131
FC3-03 hysterectomy (SH) only, 122 cases with SH and radiotherapy
(RT), 51 with radical hysterectomy (RH) only, 51 cases
Which type of hysterectomy and adjuvant
with RH and RT. Median age was 52 years, and median
treatment for stage II endometrioid endometrial
duration of follow-up was 79.7 months. By multivariate
cancer is suitable? (A Taiwanese gynecologic
analysis, only age (p=0.024), para status (p=0.019) and
oncology group study.)
depth of invasion (p=0.036) were predictors of survival.
And, the histologic grade (p=0.023) and depth of invasion
Hunh-Chun Fu1, Ming-Shyen Yen2, Min-Yu Chen3, Jen-Ruei
p=0.044) were predictor of diseases free survival. There
Chen4, Hei-Yu Lau2, Keng-Fu Hsu5, Wen-Fang Cheng6, Yu-Min
were no significant difference of age, body mass index,
Ke7, An-Jen Chiang8, Yin-Yi Chang9
menopause status, histologic parameters, recurrence and
1
Department of Obstetrics and Gynecology, Kaohsiung Chang
survival between different surgical types. We found longer
Gung Memorial Hospital, Kaohsiung City, Taiwan, 2 Department
operation time, more blood loss, longer hospital stay and
of Obstetrics and Gynecology, National Yang-Ming University,
higher chronic complication rate in radical hysterectomy
Taipei Veterans General Hospital, Taipei, Taiwan, 3Department
group. We further investigated surgical types and adjuvant
of Obstetrics and Gynecology, Chang Gung Memorial Hospital
radiotherapy. There were no significant differences of
and Chang Gung University, Taoyuan, Taiwan, 4Department of
progression-free survival (PFS) and overall survival (OS)
Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei,
Taiwan, 5Department of Obstetrics and Gynecology, National
amount the 4 groups (SH, SH with RT, RH, RH with RT).
Cheng Kung University Hospital, College of Medicine, National Chronic complication rate was higher in RH and RH with RT
Cheng Kung University, Tainan, Taiwan, 6Department of Obstetrics groups.
and Gynecology, College of Medicine, National Taiwan University, CONCLUSION: Type of hysterectomy with/without
7
Taipei, Taiwan, Department of Obstetrics and Gynecology, radiotherapy was not identified as a prognostic factor in
Taichung Veterans General Hospital, Taichung, Taiwan, stage II EEC. Perioperative and chronic complication rate
8
Department of Obstetrics and Gynecology, Kaohsiung Veterans were higher in patients treated with RH, especially RH
General Hospital, Kaohsiung, Taiwan, 9Department of Obstetrics with RT. Adjuvant radiotherapy might improve the DFS of
and Gynecology, China Medical University Hospital, Taichung, patients with SH. Patients receiving RH does not appear to
Taiwan benefit from adjuvant radiotherapy.
OBJECTIVE: Endometrioid adenocarcinoma of the

endometrium (EEC) is the most common histologic
type of endometrial cancer. Radical hysterectomy and FC3-04
adjuvant radiotherapy are recommended for stage II Prognostic impact of tumor grade and histology
(International Federation of Gynecology and Obstetrics in metastatic (stage 2 to 4) endometrial
(FIGO) 2009 staging system) EEC. The aim of this study carcinoma
was to investigate the most suitable type of hysterectomy
and adjuvant treatments for the stage II ECC in relation to Tien Le, Kathryn Cossair
patient outcomes and complications. Department of Gynecologic Oncology, University of Ottawa,
METHODS: The clinicopathological data and the Ottawa, Canada
managements of all patients with stage II EEC who
presented between 2001 and 2010 at 14 member hospitals OBJECTIVE: Endometrial cancer (EC) is the 6th most
Communication
of the Taiwanese Gynecologic Oncology Group (TGOG) common cancer worldwide. Adjuvant therapies are often
were retrospectively reviewed. Primary endpoint was overall
Free
recommended for extra uterine disease. We studied the

III
survival, and secondary endpoints were progression-free prognostic significance of tumour grades and histology
survival and adverse effects. in patients with extra uterine metastasis to determine if
RESULTS: A total of 263 patients were enrolled. Multi- further stratification of prognosis can be made.
regression analysis revealed that primary surgery and METHODS: A retrospective review was performed on all
adjuvant radiotherapy were identified: 33 cases with simple endometrial cancer cases from 2010 to 2015 to identify all
132
stage 2 to 4 patients. Relevant patients’ demographics and FC3-05
treatment related variables together with survival outcomes
A retrospective review of clinical presentation,
were abstracted from hospital electronic database. Primary
and prognosis of the squamous cell carcinoma
outcomes are progression free and overall survivals.
malignant transformation in mature teratoma
Progression free and overall survival statistics are estimated
of the ovary- Multiple Medical Center
by Kaplan-Meier methods with comparison of survival
Cooperation Study (TGOG)
curves carried out with the log rank tests. Multivariate Cox
regression models are built to examine the impact of age
An-Jen Chiang1, Min-Yu Chen2, Chia-Sui Weng3, Hao Lin4,
(more vs. less than 60), stage (2 vs. 3/4) and final tumour
Chien-Hsing Lu5, Peng-Hui Wang6, Yu-Fang Huang7, Ying-
grade (1 /2 vs. 3) on patients’ progression free (PFS) and
Cheng Chiang8, Mu-Hsien Yu9, Chih-Long Chang3
overall survival (OS)
1
Department of Obstetrics and Gynecology, Kaohsiung Veterans
RESULTS: 309 patients were reviewed. The median age
General Hospital, Kaohsiung City, Taiwan, 2 Department of
was 64 with a median BMI of 29.4. Forty-five percent of
Obstetrics and Gynecology, Chang Gung Memorial Hospital,
patients had stage 3 disease; fifty percent had stage 2
Taoyuan, Taiwan, 3Department of Obstetrics and Gynecology,
with five percent diagnosed with stage 4 cancers. Serous
Mackay Memorial Hospital, Taipei Taiwan, 4Department of
/ Clear cell histology were seen in 10%. Grade 1 / 2,
Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial
and 3 tumours were seen in 71% and 29% of patients
Hospital and Chang Gung University College of Medicine,
respectively. With a median follow up time of 38.1 months, Kaohsiung, Taiwan, 5Department of Obstetrics and Gynecology,
disease progression was observed in 95/309 (30.7%) of Taichung Veterans General Hospital, Taichung, Taiwan,
patients. Median PFS was 16.2 months. Pelvic and distant 6
Department of Obstetrics and Gynecology, Taipei Veterans
recurrences were seen in 15% and 16% of patients General Hospital, Taipei, Taiwan, 7Department of Obstetrics and
respectively. There were a significantly higher proportion of Gynecology, National Cheng Kung University Hospital, College
upper abdominal recurrences in grade 3 tumours vs. grade of Medicine, National Cheng Kung University, Tainan, Taiwan,
8
1 /2 (20.8% vs. 8.9% p=0.003) and in stage 3/4 disease Department of Obstetrics and Gynecology, College of Medicine,
compared to stage 2 (19.5% vs. 6.5% p=0.001). There was National Taiwan University, Taipei, Taiwan, 9Department of
no significant difference in recurrence patterns between Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei
serous/clear cell cancers and other histology. At last follow Taiwan
up, 66/309 (21.4%) patients had died. In the Cox model

examining PFS, age >60 (HR 2.93, 95% CI:1.80-4.76, OBJECTIVE: Squamous cell carcinoma (SCC) malignant
p<0.005), grade 3 (HR 1.59, 95% CI:1.04-2.44, p<0.005) transformation of mature cystic teratoma (MCT) of ovary is
and stage 3/4 (HR 2.88, 95% CI:1.84-4.52, p<0.005) were very rare. Therefore, the clinicopathologic characteristics,
independent adverse prognostic factors. For OS, age >60 treatment and prognostic factors are not yet well
(HR 2.37, 95% CI:1.38-4.07, p=0.002), and stage 3/4 understood. The aim of this study was to review multiple
(HR 2.71, 95% CI:1.59-4.59, p<0.05) were independent medical centers experience in Taiwan with this malignancy
predictors. and previously published reports in the literature.
CONCLUSION: In patients with extra uterine metastatic METHODS: A review of pathological reports for patients
endometrial cancers, Tumour grade, age and stage are with SCC malignant transformation of ovarian MCT
independent prognostic factors for survival. Patterns of (24040) and 16001 patients with primary ovarian cancer
recurrence are also different between high and low-grade who were treated at the multiple centers in Taiwan, from
tumours that can be used to design individualized follow
Communication
1990 to 2011 identified 52 patients with SCC malignant

up monitoring plans. transformation from MCT.
Free
III
R E S U LT S : T h e i n c i d e n c e r a t e o f S C C m a l i g n a n t
transformation was 0.3% of all ovarian MCT. The median
age of the 52 patients was 52 years (range, 29-89
years). Mean tumor size was 10.5 cm (range, 1 - 40 cm).
According to the review of the patients in our study and
133
of the literature, early detection and complete surgical of the patients with carcinosarcoma did (p<0.001). All
resection are important for long-term survival. It seems power morcellation happened in stage I leiomyosarcoma.
that adjuvant chemotherapy or concurrent chemoradiation Progression-free survival (PFS) of micro-seeding group
therapy have roles in treating this malignancy. was not different from that of no seeding group (5-
CONCLUSION: Early detection is important for patient long- yr PFS 58.3% vs. 52.5%; p=0.378). However, macro-
term survival. Old age, large tumor size, and solid portion in seeding group had a significantly poor PFS than no seeding
mature cystic teratoma seem to predict the SCC malignant group (p=0.019). Without power morcellation, neither
transformation of mature cystic teratoma. myomectomy followed by hysterectomy vs. primary
hysterectomy nor vaginal tumor-cutting had association
with poor PFS.
FC3-06 CONCLUSION: Power morcellation possibly causing tumor
macro-seeding appears to be associated with early
The way of tumor removal with oncologic
recurrence of uterine carcinosarcoma or leiomyosarcoma.
safety in uterine sarcoma: macro-versus micro-
However, vaginal removal with or without tumor-cutting
seeding
from outside, which, if any, potentially causes tumor micro-
1 1 1 seeding, is not likely to worsen PFS.
Jin Young Choi , Meseon Kim , Dong Hoon Suh , Hee Seung
Kim2, Maria Lee2, Kidong Kim3, Jae Hong No3, Hyun Hoon
Chung2, Yong-Beom Kim3, Jae-Weon Kim2
1
Department of Gynecologic Oncology, 3Department of Obstetrics
and Gynecology Seoul National University Bundang Hospital,
Seongnam, Korea, 2 Department of Obstetrics and Gynecology,
Seoul National University Hospital, Seoul, Korea
OBJECTIVE: Most of the recent studies on risk of tumor

recurrence in uterine sarcoma have focused on power
morcellation which is likely to cause tumor macro-seeding
in abdominal cavity. The aim of this study is to evaluate the
potential effect of various ways of tumor removal on tumor
recurrence in patients with uterine sarcoma.
METHODS: A total of 91 patients who finally underwent
hysterectomy and had pathologic diagnosis of uterine
carcinosarcoma or leiomyosarcoma were retrospectively
reviewed on the way of tumor removal at the first surgery.
Prognostic impact was compared between three ways of
tumor removal in terms of the possibility of tumor seeding
was compared: (1) no seeding: open hysterectomy (n=63)
and laparoscopic hysterectomy with intact tumor (n=18);
(2) micro-seeding: open myomectomy (n=3), laparoscopic
myomectomy with vaginal removal of intact tumor (n=1)
Communication
and laparoscopic hysterectomy with vaginal tumor-cutting

(n=4); (3) macro-seeding: laparoscopic myomectomy with
Free
III
power morcellation (n=2).

RESULTS: Median follow up was 21 months (range 1-188
months). Seventy one (78%) had a stage I disease.
Only 45.9% of the patients with leiomyosarcoma had
a preoperative diagnosis of malignancy, whereas 90%
134
Free Communication IV
CHAIRPERSON
Pengpeng Qu (China) Jong Min Lee (Korea)
SPEAKERS
Cervical cancer screening in Indonesia: from VIA, to DoVIA, to tele-DoVIA
Laila Nuranna (Indonesia)
Cervical cancer screening with VIA in eastern Nepal - 3 years analysis

Pappu Rijal (Nepal)
Prediction of LVSI in endometrioid adenocarcinoma by transvaginal ultrasound

through intrauterine echo flow resistance index
Yuan Yang (China)
The difference in the declining of β HCG levels between low risk gestational
trophoblastic tumor chemotherapy whichis given vitamin A and chemotherapy
alone
Gatot N A Winarno (Indonesia)
Clinical characteristics and management protocol of Gestational Trophoblastic

Disease (GTD) in BSMMU
Sabera Khatun (Bangladesh)
Epidemiology of ovarian cancer in Zaria, Nigeria

Marliyya Zayyan (Nigeria)
135
FC4-01 sent to the communication portal (17.2% of consults).
Thus, we feel that there is a need to train health providers
Cervical cancer screening in Indonesia: From
on how to take good quality documentation of VIA,
VIA, to DoVIA, to Tele-DoVIA
especially for the aim of distant consultation. If this could
Laila Nuranna1, Ditha Adriana Loho2, Kartiwa Hadi Nuryanto2, be achieved, the network of Tele-DoVIA has the potential
2 2
Tricia Dewi Anggraeni , Tofan Widya Utami , Fitriyadi Kusuma , 2 to improve screening in Indonesia.
Gatot Purwoto2, Sigit Purbadi2, Andrijono Andrijono2 CONCLUSION: DoVIA and Tele-DoVIA is a promising concept
1 in advancing VIA as cervical cancer screening in Indonesia.
Department of Gynecologic Oncology, University of Indonesia,
2
Rumah Sakit Cipto Mangunkusumo, Jakarta, Indonesia, Faculty DoVIA can solve the problem of lack of documentation in
of Medicine, University of Indonesia, Indonesian Society of VIA. Tele-DoVIA can bridge the communication and provide
Gynecologic Oncology, Depok, Indonesia means of long-distance consultation in the practice of VIA
in the community.
OBJECTIVE: We aim to present the advancement of visual
inspection with acetic acid (VIA) as a method of cervical
cancer screening in Indonesia in the development of DoVIA
FC4-02
as documentation of VIA and Tele-DoVIA as a portal of
consultation and supervision. Cervical cancer screening with VIA in eastern
METHODS: To overcome the problem of documentation in Nepal - 3 years analysis
VIA, we have developed the concept of DoVIA, where the
result of VIA is documented using a smartphone equipped Pappu Rijal
with a camera. Furthermore, to overcome the problem of
B.P Koirala Institute of Health Sciences, Dharan, Nepal
achieving competence in VIA and supervision of health
providers, we developed a communication portal using
OBJECTIVE: was to analyse VIA as a screening tool for
instant messaging service as means of consultation and
cervical cancer screeing and efficacy of the treatment done
communication between health providers and gynecologic
fro VIA positive lesions after one year follow up .
oncologists where health providers can send pictures of
METHODS: from 2012 april till 2015 april all women of
VIA to seek expertise. We have started to socialize the
age 30-60 years are included in the study. mobile field
concept of DoVIA since 2014 in numerous cervical cancer
camps were conducted in remote areas of the region at the
prevention trainings for health providers in Jakarta, as well
lowest level health facility like PHC or VDC with the help
as in Sorong and Ende. Moreover, we have also socialized
of social organizations .As many people were requested to
the concept of Tele-DoVIA among health providers since
March 2015. participate . patients were counselled for cervical cancer
RESULTS: In areas where we have socialized the concept

screening in the first step and VIA testing in next step and
of DoVIA, the reception and uptake of DoVIA have been the possible results and treatment options, cryotherapy/
adequate among health providers. Although we have faced LEEP and its side effects if +ve VIA test result and the follow
resistance from clients when health providers documented up after treatment if needed .At the end of one year repeat
their VIA results, we discovered that when patients were VIA was tested and repeat treatment was done if found to
given information prior to the examination, they were be positive oe asked fpor follow up if found negative
willing and sometimes even had the initiative to request RESULTS: till date 12321 women have been already
for their picture from the health provider. With DoVIA, we screened and 721 VIA +ve have been found and in 601
can improve on the weakness of VIA with documentation cryotherapy and rest 120 -LEEP has been performed. Apart
through smartphone camera. Since the instigation of from this 22 invasive cancers of cervix were detected and
the Tele-DoVIA portal in March 2015, we have received refered for radiotherapy. After 1 year of cryotherapy during
Communication
29 consultations through Tele-DoVIA consultation. One follow up 130 have been found to be VIA negative and rest
Free
IV
problem commonly encountered in the process of Tele- is yet to complete the one year after treatment.
DoVIA consultation is the unsatisfactory quality of pictures CONCLUSION: VIA is a easily acceptable and feasible means
137
for cervical cancer screening in rural Nepal. We should not,especially for hypertension patients. Preoperative tests
increase public awareness by various means to increase of RI are useful to select clinical surgical modes.
participation in screening to detect disease in pre invasive
phase and prevent cancer related deaths.
FC4-04
The difference in the declining of β hcg levels

FC4-03 between low risk gestational trophoblastic
tumor chemotherapy which is given vitamin a
Prediction of LVSI in endometrioid
and chemotherapy alone
adenocarcinoma by transvaginal ultrasound
through intrauterine echo flow resistance Dobi Suardi, Gatot N A Winarno, Agus Heriyanto, Abdullah
index Firmansyah, Benny H Purwana, Sofie R Krisnadi,
Yuan Yang, Jing Geng, Jianliu Wang, Department of Obstetrics and Gynecology, Indonesian Society of
Gynecologic Oncology, West Java, Indonesia
Department of Gynecology and Obstetrics, Peking University
People's Hospital, Beijing, China
OBJECTIVE: To know the difference of the β HCG declining
level between a low risk TTG chemotherapy which is given
OBJECTIVE: Lymphovascular space invasion (LVSI) is the
vitamin A compared to chemotherapy alone.
independent factor affecting the survival of endometrioid
METHODS: This research used a single blind randomized
adenocarcinoma.However,preoperative lack effective
clinical trials on 36 low risk TTG at Dr.Hasan Sadikin
methods predict LVSI.Transvaginal ultrasound is a routine
hospital Bandung from August 2014 until they were cured.
examination of endometrioid adenocarcinoma, but the role
The subjects were given 100,000 UI dose of vitamin A
of the vaginal ultrasound in uterine blood flow resistance
while they were in the low risk TTG chemotherapy from
index (RI) and LVSI in patients with patients is still unclear.
start to finish. This statistic analysis used p < 0.05.
METHODS: Clinical datas of 178 patients with endometrial
RESULTS: The subjects in this research were 18 samples
adenocarcinoma from January 2008 to December 2010
from each group. There were three subjects from the
were collected from Peking University People’s Hospital.
controlled group who failed therapy and was given
The mean age of patients was (55.4± 9.8) years, BMI (25.6
±4.6), FIGO stage I 125cases, stage II 38cases,stage III combined chemotherapy, whereas there was one who
15 cases. FIGO grade G1 63 cases (35.3%), G2 81 cases failed therapy and one who was lost to follow up in the
(45.5%), and G3 34 cases (19.2%). Myometrial invasion treatment group. The initial dose of β hCG in the controlled
was less than 1/2 128 cases (71.8%) and more than 1/2 50 and treatment group was 70,935.71 vs 137,909.16. The
cases (28.2%), cervical involvement 30 cases (16.9%), LVSI amount of chemotherapy cycle in the controlled and
15 cases (8.4%). The mean of vaginal ultrasound uterine treatment group was 3.89 vs 3.56. The initial dose of
length (5.8 ± 2.0) cm, the mean endometrial thickness (0.7 the vitamin A in the controlled and treatment group was
± 0.6) cm, the mean maximum diameter of lesions (3.2 ± 188.22 vs 163.89, while the increasing percentage of the
2.1) cm and the mean of RI (0.5 ± 0.2). vitamin A from the controlled and treatment group was
RESULTS: In 178 patients, the RI of LVSI negative patients 11.27 vs 207.92. The difference of declining β HCG level
was (0.486 ± 0.15),and the RI of LVSI positive patients percentage, which was significant, between the controlled
was (0.581 ± 0.15), univariate analysis showed that RI was and treatment group took place in the chemotherapy I that
LVSI risk factors (P=0.027, P<0.05). Multivariate logistics was 71.79 vs 88.46 (p 0.001 / p < 0.05). The p value of the
regression analysis showed that RI was independent of BMI, comparison of the declining β HCG in the controlled and
endometrial thickness and uterine length. Hypertension may treatment group was 0.355 vs 0.030.
Communication
increase LVSI risk through RI chaging (P = 0.009, P <0.05). CONCLUSION: There was a difference in the declining of β
Free
IV
CONCLUSION: Increased RI in endometrioid adenocarcinoma HCG levels between a low risk TTG chemotherapy which is
maybe used to assess whether the patient occurred LVSI or given vitamin A compared to chemotherapy alone.
138
FC4-05 FC4-06
Clinical characteristics and management Epidemiology of ovarian cancer in Zaria,

protocol of Gestational Trophoblastic Disease Nigeria
(GTD) in BSMMU
Marliyya Zayyan, Adekule Oguntayo, Saad Ahmed,
Sabera Khatun Abimbola Kolawole, Tajudeen Olasinde
Department of Obstetrics and Gynecology, Bangabandhu Sheikh Department of Obstetrics and Gynecology, Ahmadu Bello
Mujib Medical University, Dhaka, Bangladesh University Zaria, Zaria, Nigeria
OBJECTIVE: To find out the clinical characteristics and OBJECTIVE: To study the epidemiology of ovarian cancers
effective management protocol of Gestational Trophoblastic over a ten year period. To identify group of women most
Disease (GTD) in BSMMU. affected by the disease.
METHODS: Bangabandhu Sheikh Mujib Medical University METHODS: All patients presenting with histologic diagnosis
(BSMMU) is the only medical university in Bangladesh of ovarian cancer between 1st January 2004 to 31st
which is a low income country. This retrospective analytic December 2013 were retrieved from the records using
study was done at the Gynaecologic Oncology Division the histopathology register, theater and ward records.
of BSMMU from the record of the "MOLOR CARD" from Information from the folders was extracted and analyzed
2007 to 2013. Number of cases were 275. Variables with Excel Statistical Package.
studied were age, para, gravida, income, blood group, RESULTS: Seventy- six patients were histologically diagnosed
residence, interval between diagnosis and treatment, pre with ovarian cancer in this period. Between 4-13 cases
and post evacuation β-hCG, management by surgery were seen in a year with a tendency to increasing
or chemotherapy etc. Values of these parameters were incidence. The patients were between the ages of 7-75
calculated and expressed in percentage. years. The mean age of patients was 36 years. Sixty patients
RESULTS: Prevalence of GTD in BSMMU was 2%. (78.9%) were premenopausal women. Postmenopausal
Prevalence was highest in the age group 21-25 years ( women accounted for only 21. 1% of the cases. There
33%), 39.32% patients had nill parity, primigravida was were 17 cases (22.3%) of aggressive cancers in patients
31.58%, income was <100$ per month in 53% cases, twenty years or less. Serous adenocarcinoma accounted
blood group was“0”+ve in 34.56% cases, duration of for 32 (41%) cases. Granulosa cell tumor was the second
amenorrhoea was > 8 weeks in 67.24% cases, residence commonest with 18 cases ( 23.1%). The mean age of
of 64.56% patients was outside Dhaka city. Pre-evacuation occurrence of serous adenocarcinoma was 31 years and
β-hCG was estimated in 75.73% cases. Diagnosis was for epithelial ovarian cancers in general it was 33.5 years.
performed by USG in 84.84%. Interval between diagnosis Factors like parity, age of first child birth, breast feeding did
and evacuation was <1 month in 87.59%. Histopathology not appear to be protective to the occurrence of malignant
of evacuated specimen was available in 57.25%. Serum ovarian tumour in this group.
β-hCG report, 48 hours after evacuation was available in CONCLUSION: Ovarian Cancers have remained an enigma
only 28.08%. Post-evacuation USG report was available in and research is yet to define the cause or precursor of the
37.70%. Chemotherapy required in 19% cases. Surgical disease. Epidemiological studies may provide information
treatment was given only in 8.72% cases. Mortality was nil that could break grounds in the search for the identity of
among the cases. this group of diseases.
CONCLUSION: An effective management protocol can save
the life of 100% of GTD patients.
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Free Communication V
CHAIRPERSON
Hidetaka Katabuchi (Japan) Wisit Supakarapongkul (Thailand)
SPEAKERS
Fas Ligand (FasL) in association with Tumor-Infiltrating Lymphocytes (TILs) in
early stage cervical cancer
Tricia Dewi Anggraeni (Indonesia)
The impact of 10 most common HPV genotypes on the progression of cervical

intraepithelial lesions in women with ASCUS or LSIL at 6 months follow-up:
the Korean HPV cohort study
Mi-Kyung Kim (Korea)
Feasibility study of personalized peptide vaccine in recurrent of advanced

cervical cancer previously treated with platinum based chemotherapy
Kouichiro Kawano (Japan)
The mutation spectrum revealed by paired genome sequences from a

endometrial serous carcinoma patient
Lijun Zhao (China)
Genetic features of endometrial stromal sarcoma of uterus

Youn Jin Choi (Korea)
Sphingosine kinase 1 is a reliable prognostic factor and a novel therapeutic

target for uterine cervical cancer
Gun Yoon (Korea)
141
FC5-01 Mee-Kyung Kee1, Chun Kang1, Chi-Heum Cho2, Ho Sun Choi3,
Communication
Sung Ran Hong1, Won-Chul Lee4, Ki Tae Kim5, Jong Sup Park4
Fas Ligand (FasL) in association with Tumor-
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1
Department of Obstetrics and Gynecology, Dankook University
Infiltrating Lymphocytes (TILs) in early stage
College of Medicine, Cheil General Hospital, Seoul, Korea, 2
cervical cancer
Department of Gynecologic Oncology, Keimyung University
Dongsan Medical Center, Daegu, Korea, 3Department of Obstetrics
Tricia Dewi Anggraeni1, M. Farid Aziz2
and Gynecology, Chonnam National University, Munhwa Woman
1
Department of Obstetrics and Gynecology, Indonesian Society Hospital, Gwangju, Korea, 4Catholic University, Seoul, Korea, 5
2
of Gynecologic Oncology, West Java, Indonesia, Department of Busan Paik Hospital, Busan, Korea
Obstetrics and Gynecology, RSUPN Cipto Mangunkusumo, Jakarta,
Indonesia
OBJECTIVE: The objective of this study was to evaluate
the impact of 10 most common HPV genotypes on the
OBJECTIVE: To investigate the association between Fas progression of cervical intraepithelial lesions in women with
Ligand (FasL) and tumor-infiltrating lymphocytes (TILs) in ASCUS or LSIL after 6 months follow-up.
early stage cervical cancer undergoing radical hysterectomy. METHODS: We analyzed the data from the Korean HPV
METHODS: This study was a cross-sectional study of cohort study. The women who satisfied with both HPV
early stage cervical cancer (stage ≤ IIA2) patients who positivity and abnormal cervical cytology showing ASCUS
underwent radical hysterectomy from January 2007 to May or LSIL were recruited from five institutions nationwide.
2011. Data were obtained retrospectively in the Division Enrolled patients undertook cervical cytology and HPV DNA
of Gynecology Oncology, Department of Obstetrics and test again after 6 months.
Gynecology and Department of Pathology RSUPN Dr. Cipto RESULTS: The 10 most common HPV types among Korean
Mangunkusumo. We obtained tumor tissue and conducted women with ASCUS or LSIL were HPV16 (12.4%), 58
immunohistochemical examination on 32 samples to assess (9.8%), 56, 53, 52, 39, 18, 51, 68, and 66 by prevalence.
TILs. One hundred thirty-eight women showed HPV 16 positivity
RESULTS: In a study conducted on 32 subjects, there is a at enrollment. Among 92 followed up at 6 month, cytology
strong negative correlation between FasL expression and showed progression in 26.1%, no-change in 23.9%,
TILs (r=0.658; p<0.001 ). There is a statistically association and regression in 50%. Sixty-six women were HPV 18
(p < 0.001) between FasL association (overexpression/≥140 positive at enrollment, and 35 women were followed up
and non overexpression/<140 ) and mean TILs. In at 6 months. Cytology showed progression in 8.5%, no-
bivariate analysis, there is inverse association between change in 37.1%, and regression in 54.2%. Five hundred
FasL classification and mean TILs (p=0.01), between FasL ninety-seven women were 8 high-risk HPV positive except
classification and TILs classification (p=0.01). HPV 16 and 18, and 389 women were followed up at
CONCLUSION: There is a strong inverse statistically 6 months, cytology showed progression in 17.2%, no-
significant association between increase FasL expression change in 23.6%, and regression in 59.1%. In HPV 58
and decrease TILs levels. infection group, the progression rate at 6 month follow-
up was 34.4%, which was the highest in high-risk HPV
infection groups, but not statistically significant (OR=1.65,
p=0.18) compared to entire high-risk HPV infection groups.
FC5-02
The progression rates of HPV 56, 53, 52, 39, 51, 68, 66
The impact of 10 most common HPV genotypes infection groups were 1.7%, 9.4%, 21.6%, 14.6%, 8.6%,
on the progression of cervical intraepithelial 25.8%, 15.6%, in sequence.
lesions in women with ASCUS or LSIL at 6 CONCLUSION: HPV 16 was the most common genotype
months follow-up: The Korean HPV cohort at enrollment, however, HPV 58 showed the highest
study progression rate of cervical cytology in Korean women with
ASCUS or LSIL at 6 months follow-up.
Mi-Kyung Kim1, Taejin Kim1, Ki-Heon Lee, Mi Seon Jeong1,
143
FC5-03 protocol treatment. No vaccine-related systemic severe
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adverse events were observed in any patients. Skin reaction

Feasibility study of personalized peptide
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at injection site was observed in 15 cases (Grade 1: 8 cases,

vaccine in recurrent of advanced cervical
Grade 2: 7 cases) Boosting of CTL or IgG responses specific
cancer previously treated with platinum based
for the peptides used for vaccination was observed in 7
chemotherapy
cases after the 1st cycle. All 12 cases which have evaluable
1 2 2
Hiroaki Itamochi , Nao Oumi , Teturo Oishi , Tadahiro Shouji , 1 lesion showed progress disease by RECIST criteria. The
3 3 4
Hiroyuki Fujiwara , Mitsuaki Suzuki , Junzo Kigawa , Tasuku median survival time was 8.3 months. Injection site skin
Harada2, Toru Sugiyama1 reaction was significantly prognostic of OS (Hazard ratio:
1 0.192, 95% Confidential Interval: 0.037- 0.811, p=0.003).
Department of Obstetrics and Gynecology, Iwate Medical
2
University, Iwate, Japan, Tottori University School of Medicine, CONCLUSION: Increase of immunological reaction and
Tottori, Japan, 3Jichi Medical University, Tochigi, Japan 4Matsue City safety of PPV for poor prognostic cervical cancer patients
Hospital, Shimane, Japan were verified. It is still unclear whether prolongation of OS
by PPV or second line systemic chemotherapy. Therefore,
OBJECTIVE: To evaluate increase of immunological reaction further clinical trials of PPV in advanced or recurrent
and safety of a personalized peptide vaccine (PPV) for cervical cancer patients who have received chemotherapy
cervical cancer patients who have received platinum based are recommended.
chemotherapy, feasibility study of PPV was performed.
METHODS: Patients who have recurrent or advanced
cervical cancer and who are HLA-A2, -A24, -A26, or -A3 FC5-04
superfamily positive were enrolled in this study. A maximum
The mutation spectrum revealed by paired
of 4 peptides were selected based on HLA-A types and IgG
genome sequences from a endometrial serous
responses to peptides in pre-vaccination plasma. Peptides
carcinoma patient
were administrated subcutaneously with incomplete
Freund’s adjuvant once a week for 6 consecutive weeks at
Lijun Zhao
first cycle. After the first cycle of 6 vaccinations, peptides
were administered every 2 weeks. Adverse events were Department of Gynecology and Obstetrics, Peking University
evaluated by NCI-CTC version4. Peptide specific IgG in People's Hospital, Beijing, China
plasma of the patients were measured by Luminex system.

Peptide specific cytotoxic T-lymphocyte (CTL) response was OBJECTIVE: To investigate the driver somatic mutations
evaluated by IFN-γ ELISPOT assay. The clinical responses of endometrial serous carcinoma by next-generation
were evaluated using the Response Evaluation Criteria in sequencing technique and find useful molecular markers to
Solid Tumors (RECIST) in the vaccinated patients, whose predict the prognosis of endometrial carcinoma
radiological findings by computed tomography scan or METHODS: 1. Genomic DNA was extracted respectively
magnetic resonance imaging were available before and from the peripheral blood and the cancer tissue of one
after vaccinations. Correlation of immunological response patient with IIIc2G3 endometrial serous carcinoma.The
and overall survival (OS) was analyzed by Cox hazard sequencing library of 500 bp insertion fragments was
model. OS was defined as the duration from the day of first established by Illumina library building kit. Sequencing
vaccination to death. The survival curves were examined was processed in Paired-End Model in HiSeq-2000. 2.
by the Kaplan-Meier method. Differences in the values of Sequencing data was compared with the public database
individual variables were compared by the log-rank test including the reference human genome sequence and
for the analysis of the survival curves. Predictive factors for filtered using BWA software. Specific mutations of the
OS were evaluated by the Cox proportional hazard model. sample (including SNPs, InDel, SV and CNV) were identified.
The protocol was approved by the institutional ethical Removed the common mutations both in peripheral blood
committee. and cancer tissue (germ-line background mutation), then
RESULTS: Nine of 16 patients failed to complete the we got the unique rare somatic mutations of the cancer
144
sample; Function of candidated mutations was analyzed. We found 15 putative cancer genes catalogued in cancer-
Communication
RESULTS: 1. 1295 SNV were detected within the whole related databases, including PPARG and IRF4 mutations.
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genome. TP53, PPP2R1A, PIK3CA and LCK as known CONCLUSION: Our data show that gene fusions and CNAs
oncogene, probably were the driver mutations, additional are the principal drivers for LG-ESS and USS, respectively,
RRAS2, LAMB4, OPRM1 and LINGO4 gene mutations were but both may require additional genomic alterations
forecasted for harmful mutations by SIFT and PolyPhen2 including point mutations. These differences may explain
software. 2. 1345 InDel and 423 somatic SV were detected. the different biologic behaviors between LG-ESS and UUS.
copy number changed in 433 gene.including known
oncogene YWHAE, ERBB2 and FHIT copy number increase,
CDX2 hybrid lost (ratio 0.59). It is important to note that
FC5-06
cancer gene ERBB2 exist eight copies.
CONCLUSION: 1. Compared with other endometrial cancer Sphingosine kinase 1 is a reliable prognostic
research, the tumor has a similar mutation spectrum factor and a novel therapeutic target for uterine
in this case, which proved that high grade endometrial cervical cancer
serous carcinoma and other types of endometrial cancer
may experience the same mutation process. 2. The ultra- Gun Yoon
high copy number change of ERBB2 is likely to be the Department of Obstetrics and Gynecology, Pusan National
cause of the high degree of malignant endometrial serous University, Busan, Korea
carcinoma.
OBJECTIVE: Sphingosine kinase 1 (SPHK1), an oncogenic
kinase, has previously been found to be upregulated in
FC5-05 various types of human malignancy and to play a crucial
role in tumor development and progression. Although
Genetic features of endometrial stromal SPHK1 has gained increasing prominence as an important
sarcoma of uterus enzyme in cancer biology, its potential as a predictive
biomarker and a therapeutic target in cervical cancer
Youn Jin Choi, Soo Young Hur, Sug Hyung Lee
remains unknown. SPHK1 expression was examined in 287
Department of Gynecology and Obstetrics, Peking University formalin-fixed, paraffin-embedded cervical cancer tissues
People's Hospital, Beijing, China using immunohistochemistry, and its clinical implications
and prognostic significance were analyzed. Cervical
OBJECTIVE: Characterize endometrial stromal sarcoma cancer cell lines including HeLa and SiHa were treated
genomes and extend the knowledge on genetic with the SPHK inhibitors SKI-II or FTY720, and effects on
mechanisms for endometrial stromal sarcoma development, cell survival, apoptosis, angiogenesis, and invasion were
the following questions were investigated in this study examined. Moreover, the effects of FTY720 on tumor
METHODS: We performed whole-exome sequencing, growth were evaluated using a patient-derived xenograft
transcriptome sequencing and copy number profiling for (PDX) model of cervical cancer. Immunohistochemical
five endometrial stromal sarcomas ( (three low-grade ESS analysis revealed that expression of SPHK1 was significantly
(LG-ESS) and two undifferentiated uterine sarcomas (UUSs)). increased in cervical cancer compared with normal tissues.
RESULTS: All three LG-ESSs exhibited either one of JAZF1- SPHK1 expression was significantly associated with tumor
SUZ12, JAZF1-PHF1 and MEAF6-PHF1 fusions, whereas size, invasion depth, FIGO stage, lymph node metastasis,
the two UUSs did not. All ESSs except one LG-ESS and lymphovascular invasion. Patients with high SPHK1
exhibited copy number alterations (CNAs), many of which expression had lower overall survival and recurrence-free
encompassed cancer-related genes. In UUSs, five CNAs survival rates than those with low expression. Treatment
encompassing cancer-related genes (EZR, CDH1, RB1, TP53 with SPHK inhibitors significantly reduced viability and
and PRKAR1A) accompanied their expressional changes, increased apoptosis in cervical cancer cells. Furthermore,
suggesting that they might stimulate UUS development. FTY720 significantly decreased in vivo tumor weight in
145
the PDX model of cervical cancer. We provide the first
Communication
convincing evidence that SPHK1 is involved in tumor

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development and progression of cervical cancer. Our data

suggest that SPHK1 might be a potential prognostic marker
and therapeutic target for the treatment of cervical cancer.
146
Free Communication VI
CHAIRPERSON
Andri Andrijono (Indonesia) Kye-Hyun Nam (Korea)
SPEAKERS
Application of topical imiquimod for treatment cervical intraepithelial
Neoplasia in young women: a preliminary result of a pilot study
Phill-Seung Jung (Korea)
Single port transperitoneal laparoscopic infrarenal paraaortic

lymphadenectomy as part of staging operation for early ovary cancer and
high grade endometrial cancer
Yoon Hee Lee (Korea)
Ultrasound-guided intranodal lymphangiography with glue embolization:

a novel technique to treat chylous or lymphatic ascites after retroperitoneal
lymphadenectomy in gynecologic cancer
Tae-Wook Kong (Korea)
Controversies in the management of endometrial cancer:

an international survey from East Asia
Jung-Yun Lee (Korea)
Cost effectiveness analysis on advanced stage cervical carcinoma patients at

General Hospital of Dr. M. Hoesin Palembang
Rizal Sanif (Indonesia)
Primary cytoreductive and NACT-IDS in advanced epithelial ovarian cancer:

Kmio experience
Jayashree Natarajan (India)
147
FC6-01 12 patients. On the last exam, 14 (70.0%) patients showed
negative intraepithelial lesion, 3 (15.0%) showed atypical
Application of topical imiquimod for treatment
squamous cells of undetermined significance, and 1 (5.0%)
cervical intraepithelial neoplasia in young
showed LSIL. There were 2 patients who showed persistent
women: a preliminary result of a pilot study
Communication
HSIL; one patient underwent LEEP, resulting in CIN3 with
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positive resection margin, the other patient underwent
VI
Phill-Seung Jung, Ju-Hyun Kim, Dae-Yeon Kim
punch biopsy, resulting in intermediate cells and restarted
Department of Gynecologic Oncology, Asan Medical Center, Seoul, imiquimod therapy. Only seven patients showed negative
Korea
for HR HPV.
CONCLUSION: As a result, despite somewhat low HPV
OBJECTIVE: In young, nulliparous women, it is not easy
clearance rate (21.2%), our study showed topical
to decide excisional therapy, such as loop electrosurgical imiquimod therapy was effective for treatment of high-
excision procedure (LEEP), to treat cervical intraepithelial grade CIN with 85.7% (14/20) of histologic regression rate.
neoplasia (CIN). We aimed to evaluate how effective topical Based on our result, topical imiquimod therapy might gain
imiquimod is in treatment high-grade CIN so that excisional successful therapeutic effect in young women with CIN 2-3
therapy can be omitted in young women. so that they can omit the excisional therapy. In addition,
METHODS: Patients with CIN, proven by punch biopsy, were it could be more reassuring treatment option than just
allocated to this pilot study. They did not want excisional follow-up after few months in CIN 1. To confirm its efficacy,
therapy and agreed with topical imiquimod therapy which a phase II study with larger cohort would be needed.
required once-a-week hospital visit for 8 weeks for applying
imiquimod to cervix by a gynecologic oncologist. In the
case of that the lesion gets worse or needs to be excised
during treatment, imiquimod therapy would be stopped FC6-02
and converted to excisional therapy. Four weeks after

Single port transperitoneal laparoscopic
8-week treatment with topical imiquimod, the cervix was infrarenal paraaortic lymphadenectomy as part
re-evaluated by high-risk (HR) HPV test and liquid-based of staging operation for early ovary cancer and
cytology (LBC) with/without punch biopsy of suspicious high grade endometrial cancer
lesion under colposcopy. The main outcome was histologic
regression rate, and the secondary outcome was HPV Yoon Hee Lee, Gun Oh Chong, Dae Gy Hong, Young Lae
clearance rate. Cho, Yoon Soon Lee
RESULTS: A total of 36 patients, with the median age of
Department of Gynecologic Oncology, Kyungpook National
29 (range: 22-41), were agreed with topical imiquimod University Hospital, Daegu, Korea
therapy. Among them, 32 (88.9%) patients were positive
for HR HPV, only one patient had low-risk type HPV, and OBJECTIVE: To describe the feasibility, clinical outcomes
3 were negative for HPV. Twenty-five (69.4%) patients of women with 7 cases of early ovary cancer and 2
showed low-grade squamous intraepithelial lesion cases of grade 3 endometrial cancer treated with single
(LSIL), and 11 (30.6%) showed high-grade squamous port transperitoneal laparoscopic infrarenal paraaortic
intraepithelial lesion (HSIL) on their initial LBC. In the case lymphadenectomy as part of staging procedures.
of suspicious lesion under colposcopy at the first visit, METHODS: Between Nov 2013 and Jan 2015, 9 patients
punch biopsy was done. Twenty-eight patients underwent (7 ovary cancer, 2 endometrial cancer) underwent single
punch biopsy, which proved CIN 1 in 7 (19.4%), CIN 2 in port transperitoneal laparoscopic infrarenal paraaortic
11 (30.6%), and CIN 3 in 10 (27.8%) patients. Until now, lymphadenectomy as part of staging procedures. We used
twenty patients has finished 8-week imiquimod therapy OCToport as single-port device, and OCToport was inserted
and underwent follow-up HPV test and LBC with/without through the 2.5-cm incision at the umbilicus. A rigid,
punch biopsy. Among them, 14 patients were proven to 10-mm, 30° extra-long laparoscope was introduced for
have CIN 2 or 3, and 6 were CIN 1. HR HPV was positive in monitoring, and conventional laparoscopic instruments was
149
used for handling. Lymph node dissections were included Department of Obstetrics and Gynecology, Ajou University School
hypogastric, inf. and sup. gluteal, presacral, common of Medicine, Suwon, Korea
and below infrarenal paraaortic nodes. And we always
identified ovarian vein, ureter and lumbar vessels. Only OBJECTIVE: The aim of this study was to show the feasibility
Communication
1 patient had divided IMA due to poor operation view. of ultrasound (US)-guided intranodal lymphangiography
(LAG) with embolization for managing lymphatic leakage
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To prevent chylous ascites, we use hemolock or Ligasure

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application to upper part of infrarenal node and aortocaval following retroperitoneal lymphadenectomy in gynecologic
nodes. cancer.
RESULTS: The mean age and body mass index were METHODS: We report 15 cases of chylous or lymphatic
46.3years and 22.6 kg/m², respectively. The mean total ascites following systematic pelvic and para-aortic
number of pelvic and paraaortic lymph nodes removed lymphadenectomy for gynecologic cancer. Conservative
was 66.3 (range 52-112). The mean total number of treatment failed, and the patients underwent LAG. Under
paraaortic lymph nodes removed was 34.1 (range 20-62). US guidance, inguinal lymph node was accessed with
The mean staging operative time was 260 minutes (range a spinal needle, and ethiodized oil was directly injected
227-280), and estimated blood loss was 94 mL (range 50- into the lymph nodes, demonstrating retroperitoneal
200). No major intraoperative complications occurred. The lymphatic duct leakage. Pelvic lymphatic duct leakage was
postoperative period was uneventful in all patients, but 2 treated successfully with US-guided percutaneous n-butyl
cases had chylous ascites. The mean hospital stay was 9.9 cyanoacrylate glue embolization by catheterizing the
days (range 7-12). Among them 1 patient (endometrial leaking lymphatic channel through the chylous or lymphatic
cancer) had positive pelvic node and infrarenal node collection.
metastasis and 1 patient (ovary cancer) had infrarenal node RESULTS: The mean volume of the lymphatic leakage
metastasis . before LAG ranged between 710 and 1,226 mL/day. The
CONCLUSION: Even though the technique of single lymphatic drainage fluid appeared clear and lymphatic
port surgery is still difficult operation, even in expert at drainage volume was <300 mL/day after LAG. In the first
laparoscopy, mean operation times takes 4.3 hours, the two patients, the time intervals between surgery and pelvic
quality of single port transperitoneal infrarenal paraaortic catheter drainage were 55 and 36 days, respectively. In
node dissection is excellent, especially mean number the remaining 13 patients with lymphatic leakage greater
of paraaortic nodes. In cases of staging procedures for than approximately 800-1,000 mL/day, early intervention
ovary and endometrial cancer, single port transperitoneal between 7 to 14 days postoperatively shortened the length
paraaortic lymphadenectomy is acceptable to oncologic of pelvic drainage (range; 9-21 days) and hospital stay
procedure. Larger studies are needed to confirm benefits of (range; 9-22 days). There was no evidence of recurrence
oncologic and surgical outcomes by use of single port cancer after this procedure.
operation in spite of technical difficulty and demonstrate its CONCLUSION: Simple US-guided puncture of a readily
rationale for routine gynecologic oncology practice. accessible lymph node in the groin and intranodal
LAG with glue embolization can be used to treat the
leaking lymphatic channels in patients with chylous or
lymphatic ascites after retroperitoneal lymphadnectomy in
FC6-03 gynecologic cancer. Intranodal LAG with glue embolization
is an easier and more practical way to demonstrate the
Ultrasound-guided intranodal
lymphatic leakage and might reduce the length of pelvic
lymphangiography with glue embolization:
drainage and hospital stay.
a novel technique to treat chylous or lymphatic
ascites after retroperitoneal lymphadenectomy
in gynecologic cancer
Tae-Wook Kong, Suk-Joon Chang, Jinoo Ki, Hyogyeong Park,

Hana Cho, Jiheum Paek, Je Hwan Won, Hee-Sug Ryu
150
FC6-04 FC6-05
Controversies in the management of Cost effectiveness analysis on advanced

endometrial cancer: an international survey stage cervical carcinoma patients at general
from East Asia hospital of Dr. M. Hoesin Palembang
Communication
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Jung-Yun Lee1, Taek Sang Lee2 Rizal Sanif, Wahyu Sulistiadi, Hariadi Manan
1
Department of Obstetrics and Gynecology, Yonsei University, Department of Obstetrics and Gynecology, Sriwijaya University, Dr.
2
Seoul, Korea. Department of Obstetrics and Gynecology, SMG- M. Hoesin Hospital, Palembang, Indonesia
SNU Boramae Medical Center, Seoul, Korea
OBJECTIVE: Study of cost effectiveness analysis of full dose
OBJECTIVE: To identify current practice patterns for chemotherapy every three weeks with chemoradiation
unresolved issues in the surgical and adjuvant management which dose of combined chemotherapy is divided weekly
of endometrial cancer in East Asia (Korea, Japan, China, and radiation on advanced stage cervical carcinoma so we
Taiwan). can determined the best modalities for these cases.
METHODS: We designed and conducted a survey of all METHODS: This research design is operational research
active members of the major gynecologic oncology group with economic evaluation on medical services for advanced
to try to identify how they would manage various case stage cervical cancer that treated with chemotherapy
scenarios for endometrial cancer. Data were collected using or chemoradiation at M Hoesin Palembang Hospital.
an Internet survey database. Furthermore, the cost calculation was done by using
RESULTS: A total of 288 members from Korea (n=108), “Activity Based Costing” (ABC) method to obstained the
Japan (n=140), China (n=22), Taiwan (n=18) responded to cost per activity. Alternatives selection are chosen with cost
the survey. Laparoscopy (59.6%) was the most commonly effective analysis ratio
used mode of surgery in early-stage endometrial cancer RESULTS: Between January- December 2014, there are
from East Asia. Of all the respondents, 17.7% stated 188 cervical cancer patient. Based on inclusion and
that lymphadenectomy could be omitted and 18.0% exclusion criteria, there are 105 patient selected, which
recommended selective lymphadenectomy based on divided to 66 patient underwent chemotherapy and 39
sentinel biopsy or frozen results for patients with presumed patients underwent chemoradiation. Chemotherapy was
Stage IA/Grade 1 disease. On the other hand, 71.4 % of given because of limited resource radiotherapy. Based on
respondents recommended para-aortic lymphadenectomy clinical examination, there were 64.76 % patient with
for patients with presumed Stage IB/Grade 1 disease and chemoradiation experienced complete response compare
86.4% recommended this treatment for presumed Stage with 57.57 % with chemotherapy. Component for
IB/Grade 3 disease. Whole pelvic radiotherapy and vaginal investment cost for chemoradiation are more expensive
brachytherapy were the most frequently used options 63,405 IDR than chemotherapy. The highest component of
for high-risk stage I disease in Korea, China, and Taiwan, investment cost are medical equipment which cost 62.48
whereas chemotherapy was the most frequently used % for chemotherapy and 67.28 % for chemoradiation.
options in Japan. Almost all respondents administered Component for functional cost of chemotherapy are lower
adjuvant therapy when node metastasis was found, and compare to chemoradiation, which costs IDR 1,502,448,446
concurrent chemoradiotherapy was the most preferred and 1,591,510,404 IDR. Component for maintenance
option for Stage IIIC1 disease in Korea, China, and Taiwan, cost is lower in chemotherapy than in chemoradiation
whereas chemotherapy alone was the most preferred in which cost 1,357,894,519 IDR. and 1,553,144,519 IDR.
Japan. Cost per treatment on advance stage cervical cancer
CONCLUSION: There is broad variation in both the surgical on year 2014 are 43,345,805 IDR for chemotherapy
and adjuvant treatment of endometrial cancer in East Asia compare to 80,644,767 IDR for chemoradiation. Cost
effectiveness ratio was gotten chemoradiation is lower
than chemotherapy whether it is on complete, partial, and
151
progressive clinical response complete CT, the median pfs was 30 months and 28
CONCLUSION: Based on the cost effectiveness analysis, the months for the patients who took incomplete CT. In the
use of chemoradiation modalities was more effective than suboptimal cytoreduced group, the median pfs in patients
chemotherapy who took complete ct was 18 months and 15 months
Communication
in patients who took incomplete CT. (P=ns). Multivariate

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forward stepwise cox regression by including age,

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FC6-06
tumor histology, tumor grade, residual disease, adjuvant
chemotherapy, complete chemotherapy has resulted in
Primary cytoreductive and NACT-IDS in prediction of pfs by complete chemotherapy only in PS
advanced epithelial ovarian cancer: kmio group (P=0. 001). In NACT-IDS group multivariate analysis
experience has shown prediction for pfs by NACT response (0. 001),
residual disease (P=0. 001) and by complete chemotherapy
Shobha K, Uma Devi K, Jayashree Natarajan, Uththamchand
(P=0. 03).
D Bafna
CONCLUSION: The PFS is similar in both the groups.
Department of Gynecologic Oncology, Kidwai Memorial Institute Optimal debulking and Completing the regimen of CT are
of Oncology, bangalore, Karnataka, India important factors in determining the PFS in NACT and PS
groups respectively. The guidelines for selection of cases for
OBJECTIVE: 1. To compare the clinical characteristics of NACT and time of intervention needs to be standardized in
patients who underwent PDS and ‘NACT –IDS’ and their larger randomised studies to determine overall survival.
outcome. 2. To analyse progression free survival in both
the arms. 3. To determine prognostic factors based on
univariate and multivariate analysis .
METHODS: This is a retrospective study which included
patients who underwent surgery for advanced EOC
(stage 3&4) between the year 2005-2009. Totally 276
(75. 8%) patients had advanced cancer. Out of them 144
patients (52%) had primary cytoreductive surgery and
132 patients (48%) had NACT and interval debulking
surgery. After primary surgery, patients received 6 cycles
of either single agent platinum or combined with taxol
adjuvant chemotherapy. After interval debulking surgery
patients received 3-4 cycles of adjuvant chemotherapy.
6 cycles was considered as complete chemotherapy. All
patients were followed up every 3 months by clinical
examination, ultrasonography and CA 125 levels for 2
years and subsequently once in 6 months. The interval
between complete treatment and occurrence of disease
(image, cytological and histological evidence) was taken as
progression free survival.
RESULTS: In optimal cytoreductive group, when patients
took complete chemotherapy, the median pfs was 21
months and in patients with incomplete chemotherapy it
was 10 months (P=0. 025). In suboptimal cytoreductive
group, when complete chemotherapy was taken, the
median pfs was 24 months when compared to 6 months
in those who took incomplete chemotherapy (p=0. 001)
In the optimal cytoreduced group, for patients who took
152
Day 3
November 14 (SAT)
153
Symposium IV
Translational Research
CHAIRPERSON
Yin Nin Chia (Singapore) Chi-Heum Cho (Korea)
SPEAKERS
Novel therapeutic modality of epithelial ovarian cancer
Hidetaka Katabuchi (Japan)
Precision cancer therapeutics using conditionally reprogrammed cell and

patient-derived xenograft model
Eun Ji Nam (Korea)
Triple screening of gynecological cancers: the power and promise of DNA

methylation biomarkers
Hung-Cheng Lai (Taiwan)
Drug repositioning: a new therapeutic strategy for ovarian cancer

Jeong-Won Lee (Korea)
Malignant transformation of endometriosis based on the role of oxidative stress

Hariyono Winarto (Indonesia)
Targeting macrophage in ovarian cancer as a novel therapeutic approach

Oliver Dorigo (USA)
155
S4-01 Speaker
Hidetaka Katabuchi
Organization
Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto

University, Japan
Symposium IV
Education
April 1976 – March 1982 Kumamoto University School of Medicine, Japan,

General medicine,Degree: M.D.
April 1984 – March 1988 Post-Graduate School of Kumamoto University School
of Medicine, Japan, Obstetrics and Gynecology, and
Pathology, Degree: Ph.D.
July 1993 – March 1995 Post-Doctoral Research Fellow, Department of
Pathology, The Johns Hopkins University School of
Medicine, U.S.A.
American Association for Cancer Research American Society of Clinical Oncology

Asia-Oceania Research Organisation in Genital Infection and Neoplasia Asian
Society of Gynecologic Oncology European Society of Gynaecological Oncology
International Federation of Placental Association International Gynecologic
Cancer Society International Society of Gynecological Pathologists International
Society for Immunology of Reproduction The Johns Hopkins Medical and Surgical
Association
Nakamura M, et al. Virchows Arch A 424:59-67, 1994 Katabuchi H, et al.

Cancer Res 55:5556-5560, 1995 Katabuchi H, et al. Int J Gynecol Pathol 17:54-
60, 1998 Ohtake H, et al. Gynecol Oncol 71:177-184, 1998 Connolly DC, et al.
Am J Pathol 156:339-346, 2000 Nitta M, et al. Gynecol Oncol 81:10-17, 2001
Ferguson AM, et al. Am J Pathol 159:51-55, 2001 Okamura H and Katabuchi H.
Ital J Anat Embryol 106 (Suppl 2): 263-276, 2001 Seidman JD, et al. Int J Gynecol
Pathol 21: 101-107, 2002 Tashiro H, et al. Cancer Sci 94:953-959, 2003 Shedden
157
KA, et al. Clin Cancer Res 11: 2123-2131, 2005 Okamura H and Katabuchi H. Int Rev Cytol 242: 1-54,
2005 Maeda T, et al. Br J Cancer 93: 116-123, 2005 Fukunaga M, et al. Am J Surg Pathol 29: 942-947,
2005 Begum M, et al. Lab Invest 86: 286-296, 2006 Zhu Y, et al. Proteomics 6:5846-5856, 2006 Wu R,
et al. Cancer Cell 11: 321-333, 2007 Sangha N, et al. Neoplasia 10: 1362-1372, 2008 Sasaki R, et al.
Carcinogenesis 30: 423-431, 2009 Kawamura K, et al. Pathol Int 59: 300-305, 2009 Nagase S, et al.
Int J Clin Oncol 15:117-124, 2010 Motohara T, et al. Cancer Sci 101: 1550-1556, 2010 Takaishi K, et
Symposium IV
al. Cancer Sci 101: 2128-2136, 2010 Suh D.H, et al. ASGO Workshop 2010. J Gynecol Oncol 21: 137-
150, 2010 Saito F, et al. Int J Gynecol Cancer 21: 1343-1349, 2011 Motohara T, et al. Carcinogenesis
32: 1597-1608, 2011 Fujiwara Y, et al. Oncol Lett 6: 1619-1623, 2013 Zaino R, et al. Tumours of the
uterine corpus. Epithelial tumours and precursors. WHO Classification of Tumours of Female Reproductive
Organs (eds., R.J. Kurman, M.L.Carcangiu, C.S.Herringtona, R.H.Young). IARC 125-135, 2014 Tashiro T
and Katabuchi H, Curr Obstet Gynecol Rep 3:9-17, 2014 Sakaguchi I, et al. J Gynecol Oncol 26: 193-200,
2015 Ebina Y, et al. Int J Clin Oncol 20: 240-248, 2015 Matsuo Y, et al. Med Mol Morphol 2015 (in press)
Yamaguchi M, et al. J Gynecol Cancer 2015 (in press) Tihay F, et al. Cancer Sci 2015 (in press)
158
S4-01
The cell of origin and carcinogenesis for epithelial ovarian cancer:

Is the pendulum swinging from ovarian surface epithelium to
fallopian tube?
Hidetaka Katabuchi
Symposium IV
Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Chuo-Ku, Japan
OBJECTIVE: Current clinical management of epithelial ovarian cancer exists against a background of
insufficient information regarding the precursor cells, risk factors, and molecular carcinogenesis. In this
lecture, I extract keywords from ovarian cancer research and discuss the outlook for the cells of origin,
molecular mechanisms of ovarian carcinogenesis, and novel therapeutic concepts for targeting ovarian
cancer stem cells (CSCs). In order to elucidate the ovarian carcinogenesis, we attempted to establish
an in vitro carcinogenesis model of ovarian cancer with defined genetic elements using immortalized
human ovarian surface epithelium (OSE) cells, and to generate the mouse model of ovarian CSCs by
the introduction of oncogenes. Furthermore, we evaluated clinically the effects of the extensive pelvic
peritoneal stripping surgical procedure on eliminating peritoneal disseminated tumors, including ovarian
CSCs. Although most ovarian cancers have been thought to arise from the OSE, the cells of origin
of ovarian cancer remained obscure. Recently, emerging evidence indicated that a subgroup of these
tumors arise from the serous tubal intraepithelial carcinoma (STIC) in the fallopian tube, resulting in
a paradigm shift that will likely have important implications for ovarian carcinogenesis, therapy, and
prevention. Another recent topic is the hypothesis that endometriosis is the matrix for the occurrence
of ovarian cancer, such as endometrioid and clear cell adenocarcinoma. In relation to the risk factors
for ovarian cancer, such as lifetime ovulation, hormones, and chemical substances, it has been shown
that ovarian carcinogenesis is caused by multiple genetic alterations, which distinguish different types
of ovarian cancer. In our recent studies involving the transformation of immortalized human OSE cells
with defined oncogenic alterations, we identified the novel insights into ovarian carcinogenesis. In more
recent years, the CSC theory has proposed that the bulk of tumor cells are generated by CSCs, which
contribute to tumor metastasis and resistance to therapy. In a related move, we have established the
mouse model of ovarian CSCs generated by transduction of defined oncogenes. Additionally, we newly
clarified that peritoneal disseminated ovarian tumors contain highly enriched CSCs, which correlate with
chemoresistance. In an effort of removal of CSCs in the pelvic peritoneum, we evaluated the effects
of the extensive pelvic peritoneal stripping procedure; consequently, the impact on survival of adding
the peritoneal stripping in advanced ovarian cancer was demonstrated. Although further elucidation
of ovarian cancer-specific pathogenesis is needed, the advancement in our current perspective would
find a way to unlock the black box of ovarian carcinogenesis. Regardless of the site of origin, including
OSE, STIC, or endometriosis, CSC-targeted therapy might offer a promising and novel approach for the
treatment of ovarian cancer.
159
S4-02 Speaker
Eun Ji Nam
Organization
Obstetrics and Gynecology, Yonsei University College of Medicine, Korea

Symposium IV
Education
1995 – 2001 M.D., Yonsei University College of Medicine, Seoul, Korea

2003 – 2006 M.S., Yonsei University College of Medicine, Seoul, Korea
2006 – 2011 Ph.D., Yonsei University College of Medicine, Seoul, Korea
2006 – present Member of Korean Society of Gynecologic Oncology and

Colposcopy
2002 – present Member of Korean Society of Obstetrics and Gynecology
2008 – present Member of Korean Cancer Association
2009 – present Member of International Gynecologic Cancer Society
2010 – present Member of Korean Society of Gynecologic Endoscopy and
Minimally Invasive Surgery
2011 – present Member of Society of Gynecologic Oncology
1. Kim HJ, Yim GW, Nam EJ, Kim YT. Synergistic Effect of COX-2 Inhibitor on
Paclitaxel-Induced Apoptosis in the Human Ovarian Cancer Cell Line OVCAR-3.
Cancer Res Treat. 2014 Jan;46 (1):81-92. doi: 10.4143/crt.2014.46.1.81. Epub
2014 Jan 15.
2. Nam EJ, Lee M, Yim GW, Kim JH, Kim S, Kim SW, Kim YT. MicroRNA profiling
of a CD133+ spheroid-forming subpopulation of the OVCAR3 human ovarian
cancer cell line. BMC Med Genomics. 2012 May 29;5:18.
3. Eun Ji Nam, Heejei Yoon, Sang Wun Kim, Hoguen Kim, Young Tae Kim, Jae
Hoon Kim, Jae Wook Kim, Sunghoon Kim. MicroRNA expression profiles in
serous ovarian carcinoma. Clin Cancer Res 2008 May 1;14 (9):2690-5.
160
S4-02
Development of personalized precision cancer therapeutics using

conditionally reprogrammed cells and patient-derived xenograft model
Eun Ji Nam
Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea
Symposium IV
Precision Medicine refers to the tailoring of medical treatment to the individual characteristics of each
patient. It does not literally mean the creation of drugs or medical devices that are unique to a patient,
but rather the ability to classify individuals into subpopulations that differ in their susceptibility to
a particular disease, in the biology and/or prognosis of those diseases they may develop, or in their
response to a specific treatment. Ovarian cancer cell lines used as pre-clinical models in drug discovery;
however which cannot account for tumor heterogeneity and become very different from tumors growing
in patients. The patient-derived xenograft (PDX) model, whereby tumors are collected from patients and
implanted into mice, has recently been characterized. Because they derive directly from patient tumor
samples with minimal manipulation, the xenografts retain the cellular structure and molecular markers of
the original tumors. Therefore, tumor xenografts recapitulate the biological characteristics of the disease
of origin and are suitable for evaluation of an individual patient's cancer chemosensitivity, providing
not only an investigational platform but a potential therapeutic decision-making tool. Human tumor
xenograft models have been developed for several types of cancers, such as lung, prostate, breast, liver,
and colon carcinomas as tools for evaluation of new therapeutic strategies or individualization of cancer
treatment. In ovarian cancer, development of PDX models have been demonstrated and consistently been
found to be similar to patient samples. However, there are drawbacks to the model. The rates for success
of PDX establishment are reported as 37% ~ 85.3% in ovarian cancer. And the time for detectable
PDX tumor growth is variable, estimate from 1 month to 6 months. It takes 4 months for carboplatin-
paclitaxel chemotherapy after initial cytoreductive surgery in ovarian cancer patients; most patients
do not have time to wait for a model of their tumor to undergo drug response testing. Hereby we
propose a pre-clinical model combining Conditional Reprogramming of Epithelial Cells (CRCs) and PDX
in personalizing treatment for ovarian cancer patients. CRC refers a method to indefinitely extend the
life span of primary human keratinocytes using both fibroblast feeder cells and a Rho-associated kinase
(ROCK) inhibitor, Y-27632. Compared with conventional primary culture of ovarian cancer cells from
patients, the average success rate of establishing CRCs is expected to be higher. And the ability to rapidly
generate many tumor cells from small biopsy specimens and frozen tissue provides opportunity for drug
response testing in the short term. In conclusion, pre-clinical model combining CRCs and PDX is able to
overcome drawbacks to the each model. CRCs can allow drug response testing for initial treatment in
ovarian cancer and PDX model can replicate properties of the original patient tumor, which provide clues
to investigate the clinical problems of recurrence.
161
S4-03 Speaker
Hung-Cheng Lai
Organization
Obstetrics and Gynecology, Taipei Medical University/Shuang Ho Hospital, Taiwan

Symposium IV
Education
2000.08-2003.02 PhD, Graduate Institute of Medical Sciences, National

Defense Medical Center, Taipei, Taiwan, R.O.C.
1986.08-1993.07 MD, National Defense Medical Center, Taipei, Taiwan, R.O.C.
1. International American Association of Cancer Research (AACR), Active Member

International Gynecologic Cancer Society (IGCS) Asia Society of Gynecologic
Oncology (ASGO)
2. D omestic Taiwanese Association of Obstetrics and Gynecology (TAOG)
Taiwanese Association of Gynecologic Oncology (TAGO),Council Member
Taiwan Genomic Medicine and Biomarker Society, Council Member Taiwan
Association for Minimally Invasive Gynecology (TAMIG), Council Member
1. Pun PB; …, Lai HC*. Triage of high-risk human papillomavirus-positive women

by methylated POU4F3. Clin Epigenetics. 2015 Aug ;7 (1)
2. Chang CC; …, Lai HC*. Triage of Atypical Glandular Cell by SOX1 and POU4F3
Methylation: A Taiwanese Gynecologic Oncology Group (TGOG) Study. PLoS
One. 2015 Jun ;10 (6)
3. Lai HC; …, Chao TK* DNA methylation as a biomarker for the detection of
hidden carcinoma in endometrial atypical hyperplasia. Gynecol Oncol. 2014
Dec;135 (3):552
4. Chang CC; …, Lai HC* High Methylation Rate of LMX1A, NKX6-1, PAX1,
PTPRR, SOX1, and ZNF582 Genes in Cervical Adenocarcinomas. IJGC. 2014
Feb;24 (2)
5. Liao YP; …, Lai HC*. Hypomethylation Signature of Tumor-initiating Cells
Predicts Poor Prognosis of Ovarian Cancer Patients. Hum Mol Genet. 2014 Apr
;23 (7)
162
S4-03
Triple screening of gynecological cancers:

the power and promise of DNA methylation
Hung-Cheng Lai
Department of Obstetrics and Gynecology, Taipei Medical University, Shuang Ho Hospital, Taipei, Taiwan
Symposium IV
Epigenetics is a driving force for cancer development. Our previous research on the epigenomics of
cervical cancer using genome-wide approaches identified candidate genes that were hypermethylated
in cervical cancer tissues. The testing of DNA methylation in cervical scrapings has been shown to be
promising in the future cervical cancer screening in conjunction with conventional cytology or HPV
testing. Recent researches demonstrated that gene mutations in cervical scrapings can reflect the status
of endometrial and ovarian cancer. We hypothesized that DNA methylation at cervical scrapings could
detect the presence of endometrial/ovarian cancers. We tested the methylation status of these 14 genes
discovered from cervical cancer project in endometrial and ovarian cancer tissues. Genes hypermethylated
in cancer tissues were selected for further testing using cervical scrapings from 19 endometrial or 27
ovarian cancer patients and 43/25 controls. The evaluation of the clinical performance characteristics of
DNA methylation, including sensitive, specificity, positive predictive value, and negative predictive value
were calculated. Four (PTGDR, HS3ST2, POU4F3, MAGI2) of the 14 genes showed hypermethylation
in endometrial and ovarian tissues. POU4F3 revealed the best clinical performance with sensitivity and
specificity of 88% and 85% for detecting endometrial cancers, 63% and 100% for detecting ovarian
cancers. To further discovery novel genes methylated in endometrial cancer and ovarian cancer, we
integrated in house and online genomic and methylomic database and deciphered the differential DNA
methylation between cancer and normal tissues. Candidate genes were subjected to verification in
tissues and in cervical scrapings. We discovered candidate gene methylation panels that can have almost
100% sensitivity and 100% specificity for endometrial cancer and 92% sensitivity and 72% specificity
for ovarian cancer detection from cervical cancer scrapings. Our pilot study shed a new light of triple
screening of gynecological cancers using DNA methylation biomarkers from cervical scrapings.
163
S4-04 Speaker
Jeong-Won Lee
Organization
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan

University School of Medicine, Seoul, Korea
Symposium IV
Education
1995 MD, Medicine, Gyeongsang National University, Korea

2005 MSc, Ob/Gyn, Sungkyunkwan University, Korea
2010 PhD, Ob/Gyn, Korea University, Korea
1995. 3. ~ 2000. 2. Internship & Resident

Samsung Medical Center, Seoul, Korea
2003. 5. ~ 2005. 2 Clinical Fellow in Gynecologic Oncology
Department of Obstetrics and Gynecology
Samsung Medical Center, Seoul, Korea
2007. 6. ~ 2008, 11 Visiting Assistant Professor
Department of Gynecologic Oncology
MD Anderson Cancer Center, Houston, Texas, USA
2005. 3. ~ 2009, 2 Clinical Assistant Professor
Samsung Medical Center
Sungkyunkwan University Schools of Medicine, Seoul, Korea
2009.3. ~ 2013. 3 Assistant Professor
2013. 3 ~ 2013. 12 Secretary-General, Organizing Committee of Asia-pacific
Association of Gynecologic Endoscopy 2013
2013. 3 ~ present Associate Professor
164
S4-04
Drug repositioning: a new therapeutic strategy for ovarian cancer
Jeong-Won Lee
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
Symposium IV
The goals of drug repositioning are to find a new pharmacological effect for a drug for which human
safety and pharmacokinetics are established and to expand the therapeutic range of the drug to another
disease. Little research has been done to address the huge opportunities that may exist to reposition
existing approved or generic drugs for alternate uses in cancer therapy. Despite an enormous increase
in R&D spending, the number of new drugs being brought to market has been falling. Drugs for which
indications have been expanded by drug repositioning include thalidomide, aspirin, metformin, and
digoxin. Thalidomide is a sedative hypnotic agent that has serious teratogenic effects in administration
to pregnant women. However, thalidomide is effective against multiple myeloma and leprosy and is now
used for these diseases. Aspirin, a nonsteroidal anti-inflammatory drug with antiplatelet effects, has also
been shown to be effective against colorectal cancer; metformin, a drug for type 2 diabetes, is effective
against many cancers; and digoxin, a cardiac glycoside, has efficacy against prostate cancer. Recently,
our group has studied several candidates for repositioning including proton pump inhibitor, anti-fungal
agents, anti-malarial agents and anti-hypertensive agents to treat ovarian cancer. I will talk the methods
and results of preclinical research for this topic using in vitro and in vivo experiment including patient-
derived xenograft model in ovarian cancer.
165
S4-05 Speaker
Hariyono Winarto
Organization
OBGYN, INASGO, Indonesia

Symposium IV
Education
Assistant Arzt Chirurgie in Herz-und-Diabeteszentrum, Bad Oeynhausen, NRW,

Germany. “G to G” cooperation. Research Fellowship in Biomedics, Asia Link
Programme. Pathology Dept. of Leids Universitair Medisch Centrum, Leiden, The
Netherlands Surgical Training in Gynecologic Oncology & Laparoscopy in UMC
Utrecht, The Netherlands, IGCS Doctoral Program, Biomedic Science, University of
Indonesia
Indonesian Society of Gynecologic Oncology (INASGO) Member of International

Gynecology Cancer Society (IGCS) Member of European Society of Gynecologic
Oncology (ESGO) Member of ASIAN Society of Gynecologic Oncology (Asian
SGO) Member of Indonesian Gynecologic Endoscopy Society (IGES) Member of
Asia Pacific Association of Gynecologic Endoscopy (APAGE) Member of American
Association Gynecologic Laparoscopy (AAGL) Faculty of ICTEC (Indonesian Clinical
Training and Education Centre)
1. Stephen Chee Liang Koh, Chan Yiong Huak, Delfi Lutan, Johny Marpuang,
Suwiyoga Ketut, Nyoma Gede Budiana, Agustria Zainu Saleh, Mohamad
Farid Aziz, Hariyono Winarto, Heru Pradjatmo, Nguyen Khac Han Hoan,
Pham Viet Thanh, Mahesh Choolani. Combined panel of serum human tissue
kallikreins and CA-125 for the detection of epithelial ovarian cancer. Journal of
Gynecologic Oncology. Journal of Gynecologic Oncology 07/2012; 23 (3):175-
81. DOI:10.3802/jgo.2012.23.3.175. PMID: 22808360
2. H ariyonoWinarto, EvaFebia, GatotPurwoto, LailaNuranna. The Need for
Laparoscopic Ovarian Transposition in Young Patients with Cervical Cancer
Undergoing Radiotherapy. International Journal of Reproductive Medicine.
10/2013; 2013. DOI:http://dx.doi.org/10.1155/2013/173568. (Hindawi)
166
S4-05
Malignant transformation of endometriosis based on the role of

oxidative stress
Hariyono Winarto
Department of Obstetrics and Gynecology, Indonesian Society of Gynecologic Oncology, Jakarta, Indonesia
Symposium IV
Endometriosis is a unique neoplasm, it is considered as a benign tumor but has malignant characteristics.
The incidence of endometriosis is about 10% among all ovarian tumor. It can transform itself into
cancer. One of the most important characteristics in endometriosis is its periodic exuviate of its
ectopic endometrium and the release of heme and iron. Ferrous Fe (2+) (oxyhemoglobin) state to the
methemoglobin lead to product excess reactive oxygen species. This oxidative stress is considered as
an important factor in endometriosis developmen and could trigger DNA damage that lead either
into apoptosis or development. One of the important supressor gene that considered mutated in
Endometriosis is ARID1A. Studies found that ARID1A was frequently mutated and inactivated in
endometriosis associated ovarian cancer. We conduct the study to analyze the role of oxidative stress on
ARID1A expresion in endometriosis and epithelial ovarian cancer. We found that oxidative stress has a
role in repressing the expression of ARID1A gene at the mRNA and protein levels on the endometriosis.
The enhance of oxidative stress and antioxidant seemed to function either promoting cell death or
malignant transformation and development.
167
Symposium V
Radiation Oncology
CHAIRPERSON
Sarikapan Wilailak (Thailand) Won Park (Korea)
SPEAKERS
Current status of IMRT for cervical cancer
Takafumi Toita (Japan)
The present and future of image-guided brachytherapy

Yeon-Joo Kim (Korea)
The role of adjuvant radiotherapy in uterine carcinosarcoma

Yong Bae Kim (Korea)
Prevention of radiation-induced acute intestinal symptoms in gynecologic

cancers
Juan Wang (China)
169
S5-01 Speaker
Takafumi Toita
Organization
Radiology, University of the Ryukyus, Nishihara, Japan
Education
1. Toita T, Tamaki N, Murayama S. Future plans for carbon ion radiotherapy in

Okinawa. HIMAC International Symposium 2015. January 19-20, Tokyo.
Symposium V
2. Toita T, Kasuya G, Ariga T, Heianna J, Kakinohana Y, Murayama S. Image-
guided 3D intracavitary brachytherapy (IGBT) using CT images: preliminary
experiences. Educational Lecture, Radiation Oncology
3. Toita T. Concurrent chemoradiotherapy (CCRT) for locally advanced cervical
cancer: what is next? Morning Lecture[1] “Treatment of Advanced Cervical
Cancer: Update”, The 3rd Biennial Meeting of ASGO, Kyoto, 13-15 December,
2013.
4. The 15th Asian Oceanian Congress of Radiology, September 24-28, 2014,
Kobe, S140.
Professional Organizations / Memberships Japan Society of Radiology (JRS)

Japanese Society for Therapeutic Radiology and Oncology (JASTRO), council
Japan Society of Gynecologic Oncology, council Japan Society of Clinical
Oncology American Society of Therapeutic Radiology and Oncology (ASTRO)
European Society of Therapeutic Radiology and Oncology (ESTRO) Japanese
Clinical Oncology Group (JCOG), Radiotherapy Committee Japanese Gynecologic
Oncology Group (JGOG), council, Radiation Committee chair
1. Pant A, Susumu N, Toita T, et al. What is the role of cytotoxic chemotherapy

in advanced cervical cancer? Controversies in the management of gynecologic
cancers. Eds: Ledermann JA, Creutzberg CL, Quinn MA. Springer 2014, pp 79-90.
2. Randall ME, Fracasso PM, Toita T, Tedjarati SS, and Michael H. Section III:
Disease site. Cervix. Principles and Practice of Gynecologic Oncology. 6th
Edition. Eds: Barakat RR, Berchuck A, Markman M, and Randall ME. Wolters
Kluwer/Lippincot Williams & Wilkins. 2013, 598-660.
171
3. Toita T, Kitagawa R, Hamano T, Umayahara K, Hirashima Y, Aoki Y, Oguchi M, Mikami M, Takizawa
K; Cervical Cancer Vulva Cancer Committee of the Japanese Gynecologic Oncology Group. Feasibility
and acute toxicity of Concurrent Chemoradiotherapy (CCRT) with high-dose rate intracavitary
brachytherapy (HDR-ICBT) and 40-mg/m2 weekly cisplatin for Japanese patients with cervical cancer:
results of a Multi-Institutional Phase 2 Study (JGOG1066). Int J Gynecol Cancer. 2012; 22: 1420-6.
4. Toita T, Kitagawa R, Hamano T, Umayahara K, Hirashima Y, Aoki Y, Oguchi M, Mikami M, Takizawa K;
Cervical Cancer (Vulva Cancer) Committee of Japanese Gynecologic Oncology Group (JGOG). Phase
II study of concurrent chemoradiotherapy with high-dose-rate intracavitary brachytherapy in patients
with locally advanced uterine cervical cancer: efficacy and toxicity of a low cumulative radiation dose
Symposium V
schedule. Gynecol Oncol. 2012; 126: 211-6.

5. Toita T, Kato S, Niibe Y, Ohno T, Kazumoto T, Kodaira T, Kataoka M, Shikama N, Kenjo M, Tokumaru
S, Yamauchi C, Suzuki O, Sakurai H, Numasaki H, Teshima T, Oguchi M, Kagami Y, Nakano T, Hiraoka
M, Mitsuhashi N. Prospective multi-institutional study of definitive radiotherapy with high-dose-rate
intracavitary brachytherapy in patients with nonbulky (<4-cm) stage I and II uterine cervical cancer
(JAROG0401/JROSG04-2). Int J Radiat Oncol Biol Phys. 2012; 82: e49-56.
172
S5-01
Current status of IMRT for cervical cancer
Takafumi Toita1, Naoya Murakami2, Fumiaki Isohashi3, Hiroyuki Okamoto2, Yoko Hasumi4,
Takahiro Kasamatsu5
1
Department of Radiation Oncology, University of the Ryukyu, Okinawa, Japan
2
Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
3
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
4
Department of Obstetrics and Gynecology, Mitsui Memorial Hospital, Tokyo, Japan
5
Department of Obstetrics and Gynecology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
Symposium V
OBJECTIVE: Radiotherapy plays an important role in the treatment of uterine cervical cancer. Radiotherapy
can be applied as a part of definitive treatment, adjuvant treatment to surgery, or palliative treatment.
External beam radiotherapy (EBRT) is indicated in all of these situations. In both the definitive and
adjuvant postoperative treatments, whole pelvic EBRT (WP-EBRT) is generally employed. WP-EBRT has
been delivered with three-dimensional conformal radiotherapy (3DCRT) through antero-posterior/
postero-anterior (AP/PA) opposed portals or four (AP/PA and opposed lateral) portals. Although 3DCRT
achieves almost homogeneous dose distribution over the target volume, the surrounding normal
organs (e.g., small bowel, rectum, sigmoid colon, bladder, and bone) also receive almost the same dose.
Intensity modulated radiation therapy (IMRT) is one of the high-precision EBRT that can deliver the
appropriate dose to targets of complicated shapes while minimizing the dose delivered to surrounding
normal structures. Since the early 2000s, the results of dosimetric analyses and clinical experiences
with WP-EBRT and IMRT (WP-IMRT) have been reported in cervical cancer patients. Most investigators
have demonstrated that WP-IMRT decreases the dose/volume to surrounding organs and radiation-
related toxicities. A group in the India performed a randomized clinical trial and reported positive results
using WP-IMRT as a part of definitive concurrent chemoradiotherapy (CCRT). However, some issues
with WP-IMRT for patients with the intact uterus remain to be solved. The most important challenge
is to overcome intra/interfractional organ motion, which leads to missing the target volumes as well as
unexpected involvement of critical organs within the high-dose IMRT target volume. Recently, several
investigators reported promising clinical results in patients treated with IMRT boost as an alternative
to intracavitary brachytherapy (ICBT). However, in the US National Cancer Database (NCDB) analysis,
significantly inferior oncologic outcomes were reported in patients treated with IMRT boosts compared
with those treated with ICBT. Therefore, we consider it is too early to replace ICBT with IMRT as the
boost in definitive RT/CCRT for cervical cancer. The clinical value of IMRT is more significant with adjuvant
postoperative radiotherapy. In patients who undergo radical hysterectomy, a large volume of the small
173
bowel is in the pelvic cavity due to removal of the uterus and adipose tissue of the nodal regions. When
treated with postoperative WP-EBRT with 3DCRT (WP-3DCRT), a large volume of the small bowel receives
a high dose of radiation resulting in bowl toxicities. Adverse effects of small bowel from WP-3DCRT are
diarrhea, abdominal cramping, and ileus. Several reports have indicated that WP-IMRT decreases the
volume of small bowel that receives high radiation doses, and decreases small bowel complications. A
prospective phase 2 study (RTOG0418) investigating feasibility, toxicities, and oncologic outcomes was
performed in patients with cervical/endometrial cancer treated by surgery. A phase 3 study (RTOG1203)
is currently ongoing. Eligibility for the RTOG1203 trial includes both endometrial and cervical cancer
with various pathological risk factors, and primary endpoint is acute gastrointestinal toxicity rather than
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survival outcome. To determine whether WP-IMRT as part of postoperative CCRT achieves equivalent
oncologic outcomes (survival) to those of WP-3DCRT but with less small bowel toxicity, we are currently
preparing a prospective multi-institutional trial (JCOG1402) for high-risk cervical cancer patients with
positive pelvic node and /or parametrial involvement.
174
S5-02 Speaker
Yeon-Joo Kim
Organization
Radiation Oncology, Proton Therapy Center, National Cancer Center, Seoul, Korea
Mar 2013 – present Radiation oncologist faculty, National Cancer Center,

Goyang, Korea
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Mar 2011 – Feb 2013 Clinical Fellow, National Cancer Center, Goyang, Korea
Mar 2007 – Feb 2011 Radiation Oncology Residency, Seoul National University
Hospital, Seoul, Korea
Mar 2006 – Feb 2007 Transitional Year Internship, Seoul National University
Hospital, Seoul, Korea
Mar 2002 – Feb 2006 M.D., Seoul National University, College of Medicine
Seoul, Korea
Mar 2000 – Feb 2002 B.S. in Science, Seoul National University, Premedical
school Seoul, Korea
Mar 2007 – present KOSTRO (The Korean Society for Therapeutic Radiology &
Oncology)
Mar 2008 – present KCA (Korean Cancer Association)
Oct 2011 – present KSGO (Korean Society of Gynecologic Oncology)
Mar 2015 – present KBCS (Korean Breast Cancer Society)
1. Kim YJ, Cho KH, Pyo HR, Lee KH, Moon SH, Kim TH, Shin KH, Kim JY, Kim YK,
Lee SB. Radical prostatectomy versus external beam radiotherapy for localized
prostate cancer : Comparison of treatment outcomes. Strahlentherapie und
Onkologie. 2014 Oct 23 [Epub ahead of print]
2. Kim YJ, Kim JY, Kim TH, Lim YK, Yoon MG, Joo JN, Park SY. Dosimetric
Evaluation of Magnetic Resonance Imaging-based Intracavitary Brachytherapy
for Cervical Cancer. Technology in Cancer Research and Treatment. 2014
Jun;13 (3):243~251
3. Kim YJ, Cho KH, Lim YK, Park J, Kim JY, Shin KH, Kim TH, Moon SH, Lee
SH, Yoo H. The volumetric change and dose-response relationship following
hypofractionated proton therapy for chordomas. Acta Oncologica. 2014
April;53 (4):563-8
175
S5-02
The present and future of image-guided brachytherapy
Yeon-Joo Kim
Department of Radiation Oncology, Proton Therapy Center, National Cancer Center, Goyang, Korea
Brachytherapy with external beam radiation therapy is an integral component of standard treatment
for the patients with cervix cancer. Intensity-modulated radiation therapy or stereotactic body radiation
therapy were used in place of brachytherapy when brachytherapy was not available, but the treatment
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outcomes were much inferior to brachytherapy [1-2]. Brachytherapy provides an advantage of optimal
target coverage while sparing surrounding normal organs. Potter and Kirisits from the Medical University
of Vienna introduced magnetic resonance image (MRI)-guided brachytherapy for cervical cancer in 2002
[3] and the Gynecologic Groupe European de Curietherapie, European Society for Therapeu¬tic Radiology
and Oncology (GEC-ESTRO) have developed systematic recommendations for MRI-guided brachytherapy
[4-7]. However, many institutes still prefer to use conventional two-dimensional brachytherapy using
orthogonal radiographs because of the limited time, resource, and low reimbursement of brachytherapy.
In 2011, Potter et al. reported the excellent treatment outcome and low rate of complication of MRI-
guided brachytherapy [8]. Complete remission was achieved in 151/156 patients (97%). Overall local
control at 3 years was 95% and cancer specific survival at 3 years was overall 74%. Only 11 grade 3
or 4 late events were observed in 143 patients. Compared to the historical Vienna series, there was
relative reduction in pelvic recurrence by 65–70% and reduction in major morbidity. We use MRI-guided
brachytherapy at our institution since 2008 and the treatment outcome and toxicity rate were comparable
with those of Medical University of Vienna. We believe that MRI-guided brachytherapy should be
the standard brachytherapy technique for cervical cancer patients to improve treatment outcome
without increasing toxicity. 1. Gill, B.S., et al., National cancer data base analysis of radiation therapy
consolidation modality for cervical cancer: the impact of new technological advancements. Int J Radiat
Oncol Biol Phys, 2014. 90 (5): p. 1083-90. 2. Han, K., et al., Trends in the utilization of brachytherapy
in cervical cancer in the United States. Int J Radiat Oncol Biol Phys, 2013. 87 (1): p. 111-9. 3. Kirisits, C.,
et al., Dose and volume parameters for MRI-based treatment planning in intracavitary brachytherapy
for cervical cancer. Int J Radiat Oncol Biol Phys, 2005. 62 (3): p. 901-11. 4. Haie-Meder, C., et al.,
Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group (I): concepts and terms in 3D
image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment
of GTV and CTV. Radiother Oncol, 2005. 74 (3): p. 235-45. 5. Potter, R., et al., Recommendations from
gynaecological (GYN) GEC ESTRO working group (II): concepts and terms in 3D image-based treatment
planning in cervix cancer brachytherapy-3D dose volume parameters and aspects of 3D image-based
176
anatomy, radiation physics, radiobiology. Radiother Oncol, 2006. 78 (1): p. 67-77. 6. Hellebust, T.P., et al.,
Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group: considerations and pitfalls
in commissioning and applicator reconstruction in 3D image-based treatment planning of cervix cancer
brachytherapy. Radiother Oncol, 2010. 96 (2): p. 153-60. 7. Dimopoulos, J.C., et al., Recommendations
from Gynaecological (GYN) GEC-ESTRO Working Group (IV): Basic principles and parameters for MR
imaging within the frame of image based adaptive cervix cancer brachytherapy. Radiother Oncol, 2012.
103 (1): p. 113-22. 8. Potter, R., et al., Clinical outcome of protocol based image (MRI) guided adaptive
brachytherapy combined with 3D conformal radiotherapy with or without chemotherapy in patients with
locally advanced cervical cancer. Radiother Oncol, 2011. 100 (1): p. 116-123
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177
S5-03 Speaker
Yong Bae Kim
Organization
Radiation Oncology, Yonsei Cancer Center, Seoul, Korea
Education
Mar. 1992 - Feb. 1998 Bachelor Degree, Yonsei University College of

Medicine, Seoul, Korea
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Mar. 2001 - Feb. 2003 Master’s Degree of Medical Science, Yonsei University
College of Medicine, Seoul, Korea
Mar. 2006 – Aug. 2010 Ph.D. Degree of Medical Science, Yonsei University
College of Medicine, Seoul, Korea
Mar. 1999 - Feb. 2003 Residency, Severance Hospital, Department of Radiation

Oncology, Yonsei University College of Medicine, Seoul,
Korea
May, 2006 - Feb. 2008 Clinical and Research Fellowship, Severance Hospital,
Department of Radiation Oncology, Yonsei University
College of Medicine, Seoul. Korea
Mar. 2008 - Feb. 2012 Assistant Professor, Severance Hospital, Department
of Radiation Oncology, Yonsei University College of
Sep. 2010 - Aug. 2012 Visiting Scientist, Department of Experimental Radiation
Oncology, M.D.Anderson Cancer Center, Houston, Texas,
U.S.A
Mar. 2012 - Present Associate Professor, Severance Hospital, Department
of Radiation Oncology, Yonsei University College of
Korean Cancer Association, Korean Society for Radiation Oncology Korean

Association for Clinical Oncology, Korean Breast Cancer Society, Korean Society of
Gynecology Oncology
178
S5-03
The role of adjuvant radiotherapy in uterine carcinosarcoma
Yong Bae Kim

Department of Radiation Oncology, Yonsei Cancer Center, Seoul, Korea
Uterine carcinosarcoma (CS), also known as malignant mixed müllerian tumor, is a rare gynecologic
malignancy with an annual incidence of fewer than 2 per 100,000 women in the United States. It only
accounts for less than 5% of all uterine malignancies, but more than 15% of uterine cancer-associated
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deaths are associated with this aggressive tumor (1). Patients with uterine CS have a very poor prognosis
with 5-year survival rates that range from 35% to 39% (2, 3).
There has been no controversy that treatment of choice is surgery, and the current surgical practice
recommended is total abdominal hysterectomy (TAH) with salpingo-oophorectomy (BSO), pelvic
lymphadenectomy, and para-aortic lymph node sampling with peritoneal washings. However, high rates
of relapse and metastases postoperatively suggest a need for effective adjuvant therapies (4). The role of
adjuvant radiotherapy (RT) in management of uterine CS patients has been studied.
To prospectively evaluate the efficacy of adjuvant RT, EORTC performed the randomized controlled study
for uterine sarcoma including CS patients. RT reduced local replapses to one half in CS patients. Many
retrospective studies also supported the enhancement of local control by adjuvant RT. Korean Radiation
Oncology Group performed multi-institutional retrospective studies to evaluate locoregional control
according to adjuvant RT. Even though RT group had worse characteristics compared with non-RT group,
RT group seemed to reduce locoregional recurrences. Without extensive surgical staging, RT improved
local control significantly.
Due to rarity of CS, no confirmative randomized trial seems to be feasible in the future. In conclusion,
adjuvant RT might be considered to reduce locoregional recurrences after surgery in CS patients,
especially for less extensive surgery. Reference 1. El-Nashar SA, Mariani A. Uterine carcinosarcoma.
Clin Obstet Gynecol. 2011;54: 292-304. 2. Nielsen SN, Podratz KC, Scheithauer BW, O'Brien PC.
Clinicopathologic analysis of uterine malignant mixed mullerian tumors. Gynecol Oncol. 1989;34: 372-
378. 3. Dinh TV, Slavin RE, Bhagavan BS, Hannigan EV, Tiamson EM, Yandell RB. Mixed mullerian tumors
of the uterus: a clinicopathologic study. Obstet Gynecol. 1989;74: 388-392. 4. Callister M, Ramondetta
LM, Jhingran A, Burke TW, Eifel PJ. Malignant mixed Mullerian tumors of the uterus: analysis of patterns
of failure, prognostic factors, and treatment outcome. Int J Radiat Oncol Biol Phys. 2004;58: 786-796.
179
S5-04 Speaker
Juan Wang
Organization
Radiation Oncology, First Affiliated Hospital of Medical College of Xi’an Jiaotong

University, Shanghai, China
I’m a Doctor. My profession is Radiation Oncology. I graduated from the Xi’an jiao
tong University in Dec, 2010. Since 2011 I’m a resident physician on Department
Radiation Oncology of the First Affiliated Hospital of Xi'an Jiao tong University.
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I have do some research on metabolomics about tumor and radiation-induced

acute intestinal symptoms in gynecologic cancers. Meanwhile I have published
many articles on the international journals and won the first prize of science and
technology Shan’xi province.
1. Yanlan Chai, Juan Wang, Tao Wang, Yunyi Yang, Jin Su, Fan Shi, Jiquan Wang,
Xi Zhou, Bin He, Hailin Ma, Zi Liu, Application of 1H NMR spectroscopy-based
metabonomics to feces of cervical cancer patients with radiation-induced
acute intestinal symptoms, Radiother Oncol (2015), http://dx.doi.org/10.1016/
j.radonc.2015.07.037.
2. Wang J, Chai YL, Wang T, Liu JH, Dai PG, Liu Z.Genetic alterations of PIK3CA
and tumor response in patients with locally advanced cervical squamous cell
carcinoma treated with cisplatin-based concurrent chemoradiotherapy, Exp
Mol Pathol, 2015, 98 (3):407-410.
3. Juan Wang, Tao Wang, YunYi Yang, YanLan Chai, Fan Shi, Zi Liu, Patient
age, tumor appearance and tumor size are risk factors for early recurrence of
cervical cancer, Molecule Clinical Oncology, 2015, 3 (2):363-366.
4. Yanlan CHAI, Juan WANG, Ying GAO, Tao WANG, Fan SHI, Jin SU, Yunyi
YANG, Xi ZHOU, Liping SONG, Zi LIU, Identification of biomarkers for
radiation-induced acute intestinal symptoms (RIAISs) in cervical cancer patients
by serum protein profiling, Journa of radiation research, 2015, 56 (1):134-140.
5. Chai, Yanlan, Wang, Tao, Wang, Juan, Yang, Yunyi, Gao, Ying, Gao, Jiyong,
Gao, Shangfeng, Wang, Yueling, Zhou, Xi, Liu, Zi, Radical hysterectomy with
adjuvant radiotherapy versus radical (*) radiotherapy for FIGO stage IIB cervical
cancer, BMC Cancer, 2014, 14.
6. Wang, Juan, Zhang, Shu, Li, Zongfang, Yang, Jun, Huang, Chen, Liang,
Rongrui, Liu, Zhongwei, Zhou, Rui, H-1-NMR-based metabolomics of tumor
tissue for the metabolic characterization of rat hepatocellular carcinoma
formation and metastasis, Tumor Biology, 2011, 32 (1): 223-231.
180
S5-04
Identification of protein biomarkers and metabolic profile for

radiation-induced acute intestinal symptoms in cervical cancers
Juan Wang
Radiation Oncology, First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Shanghai, China
OBJECTIVE: Radiation-induced acute intestinal symptoms (RIAISs) are a common complication of
radiotherapy for cervical cancer. They cause great pain and limit the treatment efficacy. The aim of this
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study was 1) to identify serum biomarkers of RIAISs in cervical cancer patients by surface-enhanced
laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS) 2) to develop a metabolic
profile of patients with RIAISs by 1H nuclear magnetic resonance (1H NMR) combined with chemometric
analysis.
METHODS: Serum and fecal samples were collected from 66 cervical cancer patients prior to pelvic
radiotherapy. In our study, RIAISs occurred in 11 patients. An additional 11 patients without RIAISs
were selected as controls, whose age, stage, histological type and treatment methods were matched to
RIAISs patients. The 22 sera were subsequently analyzed by SELDI-TOF MS, and 22 fecal were analyzed
by 1H-NMR spectroscopy. The resulting protein profiles were evaluated to identify biomarkers using
appropriate bioinformatics tools. And multivariate pattern recognition analysis was used to generate
metabolic profile data, as well as to establish a RIAIS-specific metabolic phenotype.
RESULTS: Comparing the protein profiles of serum samples from the RIAIS group and the control group, it
was found that 22 protein peaks were significantly different (P < 0.05), and six of these peaks with mass-
to-charge (m/z) ratios of 7514.9, 4603.94, 6887.41, 2769.21, 3839.72 and 4215.7 were successfully
identified. A decision tree model of biomarkers was constructed based on three biomarkers (m/z
1270.88, 1503.23 and 7514.90), which separated RIAIS-affected patients from the control group with an
accuracy of 81%. Orthogonal partial least-squares discriminant analysis was used to distinguish samples
between RIAIS patients and controls. Fecal samples in RIAIS patients relative to controls, trimethylamine,
n-butyrate, fumarate and acetate were down-regulated and valine, TMAO, taurine, phenylalanine,
lactate, isoleucine and creatinine were up-regulated.
CONCLUSIONS: We obtained protein biomarkers and the metabolic profile of RIAIS patients respectively
from serum and fecal samples using SELDI-TOF MS based proteomics and NMR-based metabonomics.
This profile has the potential to be developed into a novel clinical tool for RIAIS diagnosis or therapeutic
monitoring, and could contribute to an improved understanding of the disease mechanism.
181
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Tips for Writing Better Manuscripts
CHAIRPERSON
Kimio Ushijima (Japan) Noh Hyun Park (Korea)
SPEAKERS
Ten tips of writing medical articles
Sung-Tae Hong (Korea)
How to paraphrase English text effectively?

Chulmin Lee (Korea)
Common mistakes by Asian medical writers

Myong Cheol Lim (Korea)
How to respond to reviewer's comments?

Seung-Hyuk Shim (Korea)
183
S6-01 Speaker
Sung-Tae Hong
Organization
Paristology & Tropical Medicine, Seoul National University, Seoul, Korea
Education
1979 Seoul National University College of Medicine
2009 - present Editor-in-Chief, Journal of Korean Medical Science
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2014 - present President, Korean Association of Medical Journal Ediotrs
1. Sung-Tae Hong, TEN TIPS IN WRITING IN MEDICAL ARTICLE, Seoul National

University Press, 2015
2. Hong ST, Editor's note: About this supplement, J Korean Med Sci 2014 Jun 29
(suppl 1): S1
3. Hong ST, Lesson of the Seventh International Congress on Peer Review and
Biomedical Publication, J Korean Med Sci 2013 Oct 28 (10): 1413-1414
4. Hong ST, Over the journal impact factor, J Korean Med Sci 2013 Jul 28 (7):
969.
185
S6-01
Ten tips for authors of scientific articles
Sung-Tae Hong
Department of Paristology and Tropical Medicine, Seoul National University, Seoul, Korea
Writing a good quality scientific article takes experience and skill. I propose ‘Ten Tips’ that may help to
improve the quality of manuscripts for scholarly journals. It is advisable to draft first version of manuscript
and revise it repeatedly for consistency and accuracy of the writing. During the drafting and revising
the following tips can be considered: 1) focus on design to have proper content, conclusion, points
compliant with scope of the target journal, appropriate authors and contributors list, and relevant
references from widely visible sources; 2) format the manuscript in accordance with instructions to
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authors of the target journal; 3) ensure consistency and logical flow of ideas and scientific facts; 4)
provide scientific confidence; 5) make your story interesting for your readers; 6) write up short, simple
and attractive sentences; 7) bear in mind that properly composed and reflective titles increase chances
of attracting more readers; 8) do not forget that well-structured and readable abstracts improve citability
of your publications; 9) when revising adhere to the rule of ‘First and Last’ - open your text with topic
paragraph and close it with resolution paragraph; - open a paragraph with topic sentence and close it
with resolution sentence; 10) use connecting words linking sentences within a paragraph by repeating
relevant keywords. The ‘Ten Tips’ may improve not only writing manuscripts but also reviewing or editing
articles.
186
S6-02 Speaker
Chulmin Lee
Organization
Ob/Gyn, Sanggye Paik Hospital, Seoul, Korea
1990 Graduated from College of Medicine, Seoul National University

1991 Internship in Seoul National University Hospital
1995 Finished resident in Dept of Ob/Gyn, Seoul National University
Hospital
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1998-1999 Fellowship of Gynecologic Oncology in Dept of Ob/Gyn, Seoul
National University Hospital
Currently Associate Professor in Dept of Ob/Gyn, Inje University, Sanggye

Paik Hospital
2010-2012 Secretary General, Korean Society of Gynecologic Oncology
M.S. degree (2000) Homozygous deletion of p16INK4 and p15INK4B genes in

human advanced ovarian carcinoma Ph.D. degree (2006) Screening of ovarian
cancer by proteomic analysis of serum using surface-enhanced laser desorption/
ionization mass spectrometry
187
S6-02
How to paraphrase english text effectively?
Chulmin Lee
Department of Obstetrics and Gynecology, Sanggye Paik Hospital, Seoul, Korea
Citation of papers, works, and a bit of ideas written by others or by yourself is an essential or sometimes
inevitable part of the publication. The process of citation forms a brain-storming for the author and
confers objectivity to the reader. You could cite by direct quoting, summarizing, and by paraphrasing.
Paraphrasing per se is defined as "expressing the meaning of using different words, especially to
achieve greater clarity" (Oxford English Dictionary), meaning that it is the restatement in other words. To
paraphrase, careful reading of the material and comprehensive understanding is the prerequisite. Only
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after digesting and ruminating what you have learned, you could then compile it in your own way and
jot down in your own words. Avoid looking at the original source which lures you to become complacent
in the idea which is not yours. And read your manuscript again carefully after writing. However, It is
easy for an author to plagiarize if not vigilant enough. Simple substitution of words or restructuring
may be construed as plagiarism. Using quotation mark is a good practice when a citation is needed.
Conventional designations and preferred bias-free language are those examples that quotation marks are
not mandatory.
188
S6-03 Speaker
Myong Cheol Lim
Organization
Gynecologic Oncology, National Cancer Center, Korea
Education
Mar.1993 - Feb.1999 M.D. Kyung Hee University, College of Medicine, Seoul,

Korea
Mar.2002 - Feb.2007 M.S. (Medicine), Kyung Hee University, Graduate School
of Medicine, Seoul, Korea
Mar.2007 - Feb.2009 Ph.D. (Medicine), Kyung Hee University, Graduate School
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of Medicine, Seoul, Korea
Memberships
2001 – Present Korean Society of Obstetrics and Gynecology

2005 – Present Korean Society of Gynecologic Oncology
2009 – Present Member, Community Genetic Network
2009 – Present Member, European Association of Transluminal Surgery (EATS)
2011 – Present Assistant Editor, Journal of Gynecologic Oncology
2012 – Present Member of board of directors, Korean Society of Lymphedema
2013 – Present Editorial board, Surgery, BioMed Research International
2014 - Present Member of board of directors, Korean Society of Peritoneal
Surface Malignancy
2014 - Present Editorial board, Journal of Tumor (ISSN: 1910-6187)
1. K im MK, Seong SJ, Lee TS, Ki KD, Lim MC, Kim YH, Kim K, Joo WD.
Comparison of diagnostic accuracy between endometrial curettage and
pipelle aspiration biopsy in patients treated with progestin for endometrial
hyperplasia: a Korean Gynecologic Oncology Group Study (KGOG 2019). Jpn
J Clin Oncol. 2015 Jul 22. pii: hyv106. [Epub ahead of print] PMID:26206899
[2014 SCIE, Impact Factor = 2.016] [Co-author]
2. Lim MC, Won YJ, Lim J, Kim YJ, Seo SS, Kang S, Lee ES, Oh JH, Kim JY, Park SY.
Second Primary Cancer after Diagnosis and Treatment of Cervical Cancer.
Cancer Res Treat. 2015 Jul 17. doi: 10.4143/crt.2014.326. [Epub ahead of
print] PMID:26194366 [2014 SCIE, Impact Factor = 3.318] [First author]
189
S6-03
Common mistake by Asian medical writers
Myong Cheol Lim

Gynecologic Oncology, National Cancer Center, Goyang, Korea
Paucity of the researches for the common mistake of Asian medical writer is available. From the previous
researches on this, common mistakes are found in poor logic development for the necessity and priority
of the study in the section of introduction, deficient description related to the reproducibility in materials
and methods, illogical and unsystematic description of the results, unfocused discussion, and inconsistent
or overestimated conclusion based on the authors’ study results. Additionally, English grammar is one of
the issues, but this might be improved after submission.
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190
S6-04 Speaker
Seung-Hyuk Shim
Position
Clinical assistant professor, School of Medicine, Konkuk University, Seoul, Korea
Education
1997~ 2003 M.D. University of Eulji College of Medicine, Daejeon, Korea

2006~2008 M.S. University of Ulsan Postgraduate school of Medicine, Seoul,
Korea
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Postdoctoral Training
2003~2004 Internship, University of Ulsan College of Medicine, Asan Medical

2004~2008 Medical Residency, Department of Obstetrics and Gynecology,
University of Ulsan College of Medicine, Asan Medical Center,
Seoul, Korea
2011~2013 Clinical Fellowship in Gynecologic Oncology, Asan Medical Center,
Seoul, Korea
Professional Organization / Membership
2003 Licensed to Practice Medicine and Surgery in the Republic of Korea

(# 78236)
2008 Diploma, Korean Board of Obstetrics & Gynecology (# 6156)
Member, Korean Medical Association
Member, Korean Society of Ob & Gyn
Member, Korean Association of Gynecologic Oncology & Coposcopy
Member, Korean Gynecologic Oncology Group (KGOG)
Member, Korean Society of Gynecologic Endoscopy and Minimally Invasive Surgery
Managing editor, Journal of Gynecologic Oncology
Editorial board, International Journal of Gynecologic Cancer
191
S6-04
How to respond to reviewer’s commets?
Seung-Hyuk Shim
Department of Obstetrics and Gynecology, School of Medicine, Konkuk University, Seoul, Korea
In general, a reviewer’s mission is to strengthen the science behind a study. Despite the advantages of the
peer review process in providing validation, quality control and added value in the form of constructive
feedback, the whole process can evoke much anguish amongst authors. There is a fear that it may be
impossible to be truly impartial, that the process causes a long delay, and that comments are often too
brief to be helpful.
This topic provides some practical steps to guide authors in this task and attain publication of their
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manuscript. A response should integrate the requested revisions without diffusing the focus of the study.
Being organized as you perform the requested revisions, and providing an organized response letter to
the editor and reviewers are important components of a successful resubmission. Comments from peer
reviewers offer an excellent opportunity to improve the quality of your manuscript. Addressing them
adequately may increase the chances of acceptance, if not in that journal, elsewhere at least.
Following the principles outlined in this topic will enable authors to successfully meet the challenges of
manuscript revision and hasten the route to publication.
192
Symposium VII
Uterine Corpus
CHAIRPERSON
Suresh Kumarasamy (Malaysia) Young Tak Kim (Korea)
SPEAKERS
Progestins in the fertility-sparing treatment for patients with primary and
recurrent endometrial cancer
Jeong-Yeol Park (Korea)
The role of adjuvant therapy for endometrial cancer: experience in Thailand

Chomporn Sitathanee (Thailand)
Controversies in surgical treatment of early endometrial cancer

Taek Sang Lee (Korea)
Endocrine profile of endometrial hyperplasia and cancer

Xiaojun Chen (China)
Identification and characterization of endometrial cancer stem-like cells

Kiyoko Kato (Japan)
Expression of cyclin D1, D3, and retinoblastoma as risk factors of persistent

mole
Yudi Mulyana Hidayat (Indonesia)
193
S7-01 Speaker
Jeong-Yeol Park
Organization
Department of Obstetrics and Gynecology, College of Medicine, University of

Ulsan,Asan Medical Center, Seoul, Korea,
Education
1989-1995 M.D. from Gyeongsang University Medical College

1997-2000 Master from Ulsan University Medical College
2002-2009 PhD from Ulsan University Medical College
Post Graduate Training
1999-2000 Internship at College of Medicine, University of Ulsan, Asan

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2000-2004 Residency at Department of Obstetrics and Gynecology, College of
Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea
2004-2007 Public Health Care Doctor at Division of Gynecologic Oncology,
Department of Obstetrics and Gynecology, Center for Uterine
Cancer, National Cancer Center, Research Institute and Hospital,
Korea
2007-2009 Clinical fellowship at Department of Obstetrics and Gynecology,
College of Medicine, University of Ulsan, Asan Medical Center,
Seoul, Korea
2009-Present Clinical associate professor at Department of Obstetrics and
Gynecology, College of Medicine, University of Ulsan, Asan
Membership
1995 Korean Medical Association

2000 Korean Society of Obstetrics and Gynecology
2004 Korean Cancer Association
2004 Korean Society of Gynecologic Oncology and Colposcopy
2004 Korean Society of Gynecologic Endoscopy and Minimally Invasive Surgery
2004 Korean Society of Cancer Prevention
2004 Korean Society for Public Health and Medicine
2007 American Association of Gynecologic Laparoscopist (AAGL)
2010 Korean Gynecologic Oncology Group
195
S7-01
Progestins in the fertility-sparing treatment for patients with primary

and recurrent endometrial cancer
Jeong-Yeol Park
Department of Obstetrics and Gynecology, University of Ulsan College of Medicine,
Asan Medical Center, Seoul, Korea
Endometrial cancer is the most common gynecologic malignancy in Western countries. In Eastern
countries, the incidence of endometrial cancer is rapidly increasing and it will be the most common
gynecologic malignancy in the near future. Approximately 3–14% of all endometrial cancers are
diagnosed in women younger than age 40 years who might want to preserve their fertility, and the
incidence of endometrial cancer in this age group is increasing. Because current standard treatment,
including hysterectomy and bilateral salpingo-oophorectomy, might not be acceptable for women who
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want to retain their fertility, many of these women are being managed conservatively with oral progestin.
The long-term oncologic outcomes and pregnancy outcomes after progestin treatment have been
reported to be promising in selected women with primary and recurrent endometrial cancer. The selection
of appropriate patients through comprehensive pretreatment evaluation is of paramount importance to
achieve the best outcomes without compromising survival. In this lecture, the most up-to-date findings
regarding fertility-sparing progestin therapy for young women with primary and recurrent endometrial
cancer is addressed in terms of diagnosis, treatment, follow-up, and oncologic and reproductive
outcomes.
196
S7-02 Speaker
Chomporn Sitathanee
Present position
Assistant Professor in Radiation Oncology

Chief Radiation Oncology Unit, Radiology Department
Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Consultant Radiation Oncologist, Bumrungrad International Hospital
Educational Committee, Thai Association of Radiation Oncology
Academic Qualifications
1990-1996 M.D., Faculty of Medicine Ramathibodi Hospital, Mahidol

University, Bangkok, Thailand.
1997-2000 Diploma of Thai Board of Radiation Oncology, Faculty of Medicine
Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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Post-Graduate Training
Mar.2002-Sep 2003 Visiting scholar at Arthur G. James Cancer Hospital and

Richard J. Solove Research Institute, the Ohio State University, Columbus, Ohio,
and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Specialty
Breast, gynaecologic, genitourinary, and lower GI malignancies
Publications
1. Puataweepong P, Dhanachai M, Hansasuta A, Dangprasert S, Sitathanee C,

Swangsilpa T, Vitoonpanich P, Yongvithisatid P. Outcomes for pituitary adenoma
patients treated with linac-based stereotactic radiosurgery and radiotherapy: a
long-term experience in Thailand. Asian Pac J Cancer Prev. 2015;16 (13):5279-84.
2. Larbcharoensub N, Kanoksil W, Cheewaruangroj W, Wiratkapun C, Sitathanee
C, Sirachainan E. Esthesioneuroblastoma metastasis to the breast: A case report
and review of the literature. Oncol Lett. 2014;8 (4):1505-8.
3. Puddhikarant P, Swangsilpa T, Dhanachai M, Narkwong L, Sitathanee C,
Puataweepong P, Jiarpinitnun C, Witoonpanich P, Ruangkanchanasetr R. Clinical
outcome of postoperative radiotherapy with or without chemotherapy in adult
glioblastoma multiforme in Ramathibodi Hospital: a retrospective study. J Med
Assoc Thai. 2014;97 (6):655-61.
197
S7-02
Adjuvant therapy for endometrial cancer: experience in Thailand
Chomporn Sitathanee, M.D.

Radiation Oncology Unit, Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University,
Bangkok, Thailand.
Endometrial cancer is the third most common gynecologic cancer in Thailand after the cervical and
ovarian cancer. In 2007-2009, the age-standardized incidence rate was 4.0/100,000 of Thai female
population. In Ramathibodi Hospital, the number of new endometrial cancer cases ranges from 70-
100 cases per year. Approximately 70% are stage I, 20% stage III, and the rest are stage II and IV. The
standard primary treatment is surgery which also provides staging and prognostic information. Surgical
staging procedure includes peritoneal washing cytology, extrafascial hysterectomy and bilateral salpingo-
oophorectomy, and omental biopsy. Extent of lymph node staging can be varied among institutions. Most
common practice nowadays is to perform pelvic with or without para-aortic lymph node dissection.
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Adjuvant treatment for endometrial cancer, including radiation and chemotherapy, usually adapted for
disease extent and various clinical and pathological risk factors. For early-stage/uterine-confined disease,
the use of vaginal brachytherapy alone is increasingly adopted. Pelvic radiation is reserved for those
who are in high risk group or have bad prognostic features. For advanced/extra-uterine disease, either
combined-modality approach with chemotherapy and tumor volume-directed radiation therapy (TDRT)
or chemotherapy alone are our treatment options. We have no standard recommendation regarding
the sequencing or how to combine chemotherapy and radiation. In Ramathibodi Hospital, we prefer to
use concurrent chemotherapy (cisplatin or carboplatin) and pelvic radiation followed by chemotherapy
(paclitaxel and carboplatin) for stage IIIB-IIIC1 and chemotherapy (paclitaxel and carboplatin) followed
by extended-field radiation for stage IIIC2 if feasible. Most of the patients with serous and clear cell
histology receive chemotherapy followed by TDRT. With modern radiotherapy technology, serious long-
term complication is quite uncommon in the adjuvant setting. Treatment outcome in terms of tumor
control and survival is very promising in low-intermediate risk disease. However, distant failure is still the
main problem in those with high risk or advanced disease. Adjuvant treatment strategy for this group of
patients is evolving. We are looking forward to the results of the major randomized controlled trials with
hope to improve treatment outcome for our patients.
198
S7-03 Speaker
Taek Sang Lee
Organization
Obstetrics and Gynecology, SMG-SNU Boramae Medical Center, Seoul, Korea
Education
1996 M.D. Seoul National University, College of Medicine, Seoul

2006 M.S. Seoul National University, Seoul (Obstetrics and Gynecology)
2011 Ph.D Seoul National University, Seoul (Obstetrics and Gynecology)
2004 -2006.4 Clinical Fellow in Obstetrics & Gynecology College of Medicine,

Seoul National University
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2006, 5- Clinical professor in Seoul Metropolitan Boramae Hospital
2014, 9- Chairperson of department of Obstetric and Gynecology in Seoul
Metropolitan Boramae Medical Center
Membership
2001- Member The Korean Association of Obstetricians and Gynecologists

2004- Member The Korean Society of Gynecologic Oncology and Colposcopy
2004- Committee Member The Korean Gynecologic Oncology Group
2007- A secretary of editing committee in Korean Gynecologic
Endoscopy and Minimally invasive surgery
2008- Administrative editor of Journal of Womens Medicine
2012.10- Associate editor of Obstetrics and Gynecology Science
1. Lee TS, Jung JY, Kim JW, Park NH, Song YS, Kang SB, Lee HP. Feasibility of
ovarian preservation in patients with early stage endometrial carcinoma.
Gynecol Oncol. 2007 Jan;104 (1):52-7
2. Lee TS, Kim JW, Kim SH, Seong SJ, Song ES, Kim JH, Kim JH, Park NH, Lee KH,
Lee NW, Ryu HS. Surgical Practice Patterns in Endometrial Cancer: Results of
the Korean Gynecologic Oncology Group Survey J Gynecol Oncol 2009 Jun; 20
(02): 107~112.
199
S7-03
Controversies in surgical treatment of early endometrial cancer
Taek Sang Lee

Department of Obstetrics and Gynecology, SMG-SNU Boramae Medical Center, Seoul, Korea
For early stage endometrial cancer patients, developing the best management plan involves a fine
balance between the risk of recurrence resulting from undertreatment and the risk of complications
from overtreatment. Despite the publication of numerous studies, including some multi-centered
randomized controlled trials, there continues to be vigorous debate regarding use of laparoscopic surgery
for surgical staging, the optimal surgical treatment of early stage endometrial cancer, including the
extent of lymphadenectomy, issue for the ovarian preservation during surgery. Resolving these questions
has become increasingly important in view of the increase of endometrial cancer, related to the aging
population and the relative increase of young aged patients. Advancement in minimally invasive surgical
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techniques has allowed extensive staging procedures to be performed with significantly reduced patient
morbidity. Using surgical staging it is possible to avoid unnecessary adjuvant treatment in low-risk
patients, while defining a group of higher risk early-stage patients who may benefit from more aggressive
adjuvant therapy, such as systemic chemotherapy. Hopefully the result of currently enrolling randomized
trials will further elucidate the most efficient therapy for these high-risk patients. In this session, I focused
on the advantages of minimally invasive surgery, the value of lymphadenectomy and ovarian savings and
some of the current controversies surrounding surgical treatment.
200
S7-04 Speaker
Xiaojun Chen
Organization
Gynecology, Ob&Gyn Hospital of Fudan University, Shanghai, China
Education
1992.9-1997.6 Shanghai Medical University (bachelor degree for clinical

medicine) Shanghai, China
1997.9-1999.9 Graduate School of Shanghai Medical University Ob&Gyn
Hospital (M.S.), Shanghai, China
1999.9-2002.6 Graduate School of Fudan University Ob&Gyn Hospital (M.D.&
Ph.D.), Shanghai, China
2003.3-2003.4 From research to practice: postgraduate training in
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reproductive health. Geneva Switzerland.
2005.4-2006.3 Visiting scholar at Shinshu University Japan. Research in
gynecological oncology. (Sasakawa fellowship)
Professor, Obstetrics & Gynecology Hospital of Fudan University

Member, Gynecological Oncology Association, Chinese Medical Association
Shanghai Branch Member, Gynecological Oncology Association, Chinese
Anticancer Association
Member, Shanghai Gynecological Oncology Group
1. Zhang X, Sun L, Chen X, Hua K: Uterus Preserving Reposition of Non-Puerperal

Uterine Inversion under Laparoscope: A Case Report and Literature Review.
Gynecol Obstet Invest 2015, epub ahead.
2. Shan W, Wang C, Zhang Z, Luo X, Ning C, Yu Y, Feng Y, Gu C, Chen X: ATM
may be a protective factor in endometrial carcinogenesis with the progesterone
pathway. Tumour Biol 2015, epub ahead
3. Shan Weiwei, Wang Chao, Zhang Zhenbo, Gu Chao, Ning Chengcheng, Luo
Xuezhen, Zhou Qiongjie, Chen Xiaojun.Conservative therapy with metformin
plus megestrol acetate for endometrial atypical hyperplasia. J Gynecol Oncol.
2014 Jul;25 (3):214-20 IF 1.7
201
S7-04
Sex hormonal and metabolic profiles in endometrial hyperplasia and

cancer patients
Xiaojun Chen, Bingyi Yang, Weiwei Shan, Xuezhen Luo

Department of Obstetrics and Gynecology, Hospital of Fudan University, Shanghai, China
OBJECTIVE: Objective. In this study, we explored the sex hormonal and metabolic profile in DPE (disordered
proliferative endometrium), EH (endometrial hyperplasia) and EC (endometrial cancer) and investigated

the possible relationship between serum endocrine change and development of endomtrial cancer.
Methods. We conducted a prospective cross-sectional study that lasted from September 2011 to May
2015 in the Obstetrics and Gynecology Hospital of Fudan University. 689 cases were enrolled, including
100 cases of DPE, 201 cases of SH (simple hyperplasia), 126 cases of CH (complex hyperplasia), 84 cases
of EAH (endometrial atypical hyperplasia), 79 cases of grade 1 & grade 2 type I EC (endometrial cancer)
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and 21 cases of grade 3 type I EC & type II EC. 78 healthy women were collected as a control group. All
of them signed informed consent forms. General information was collected; serum lipids, sex hormone
binding globulin (SHBG), sex hormones, fasting insulin, fasting blood glucose (FBG) and postprandial
glucose level were examined. Statistical analysis was performed using SPSS 20.0 (Chicago, USA), and 0.05
was chosen as the significance test level. Results. 1.General information The median (inter-quartile) age
of the 663 study subjects was 46 (14) years, with the ages ranging from 21 to 80 years. The median age
of healthy women (control), DPE, SH, CH, EAH, G1&G2 EC, G3 EC and type II EC was 35 (18), 42 (10),
46 (7), 41 (15), 38 (13), 54 (18), 54 (18), respectively. The body mass index (BMI, kg/m2) of the study
population ranged from 18.59 to 35.38. The G1&G2 endometrioid EC group had the highest BMI of
24.77 (5.22) (median (inter-quartile)). Control group showed a lower BMI than other group (P<0.001). No
statistically significant difference in BMI was found between EAH group and G1&G2 group. 2.Hormonal
profiles Serum sex hormonal level could be affected by age and menstruation. In order to eliminate
this bias, we stratified patients into three subgroups in each group: premenopausal women with age
≤ 40, premenopausal women with age > 40 and postmenopausal women. We did not find increased
serum estradiol (E2) level among all groups after stratifying the patients by age. Then we compared
serum estradiol level in G1 & G2 EC patients with normal women in an age-paired mode. Again, no
significant difference was found between the two groups. Circulating estradiol could be combined
with SHBG which affects its bioactivity. We then analyzed serum SHBG level in different groups. No
significant difference was found in serum SHBG level among all groups. We then calculated the ratio of
E2/SHBG among all groups. E2/SHBG showed a downward trend from healthy women to G1&G2 EC
202
and G3 & type II EC in postmenopausal women, but the difference was not statistically significant. In
premenopausal women, E2/SHBG had no statistical difference among all groups. Lacking of progestin
protection is also regarded as the key factor in estrogen driven EC theory. We then asked whether there
was difference in progesterone level among different groups. Again no significant difference was found.
No statistically significant difference in other sex hormones like FSH, LH and total testosterone (T) was
found among all groups. 3. Metabolic profiles Increased fasting insulin, FBG and postprandial glucose
level were all related to DPE, SH, CH, EAH, G1&G2 EC, G3 & type II EC, with OR > 1. The homeostasis
model assessment-insulin resistance (HOMA-IR) index was used to evaluate insulin resistance. HOMA-IR
was calculated as FBG (mmol/L) × FINS (μU/mL) / 22.5. Based on the distribution of non-diabetic patients'
HOMA-IR values in our study, we chose 3.04 (the lower limit of the top quartile of HOMA-IR distribution
in non-diabetic patients) to judge the status of insulin resistance. We also assessed the insulin sensitivity
using the Quantitative Insulin Sensitivity Check Index (QUICKI). QUICKI was calculated as 1 / [log (fasting
glucose (mmol/L)) + log (fasting insulin (μU/mL))]. After adjusted for age, menopause and BMI, we found
that higher HOMA-IR was associated with development of endometrial hyperplasia as well as endometrial
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cancer. The multivariate OR for DPE was 2.735 (95% CI (coefficient interval): 1.559–4.799, P < 0. 001),
that for SH was 2.139 (95% CI: 1.343–3.406, P = 0.001), CH was 2.374 (95% CI: 1.567–3.596, P <
0.001), EAH was 2.892 (95% CI: 1.790–4.670, P < 0.001), G1&G2 EC was 3.170 (95% CI: 1.827–5.499,
P < 0.001), and that for G3 & type II EC was 4.385 (95% CI: 1.752–10.974, P = 0.002). Opposite trends
were observed with respect to QUICKI in the five study groups. 4. Blood lipids Blood lipids level showed
no significant correlation with endometrial lesions. Conclusions. In our study, we did not find elevated
serum free estradiol level in endometrial hyperplasia and cancer patients. Insulin resistance happened
at DPE which is the earliest stage of endometrial hyperplasia. Insulin resistance is associated with
development of endometrial hyperplasia and cancer. Increased local estrogen sensitivity might be the key
mechanism involved in development of endometriod endometrial cancer.
203
S7-05 Speaker
Kiyoko Kato
Professor,
Department of Obstetrics and Gynecology, Graduate School of Medical Science,
Kyushu University
1986 graduate from Medical School of Graduate School of Medical

Science, Kyushu University
1986-1989 Medical Doctor of the department of Obstetrics and Gynecology,
Kyushu University
1989-1992 esearch fellow of La Jolla Cancer Research Foundation, USA
1992-2009 Medical Insitute of Bioregulation,Kyushu University
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1992-1998 Assistant Professor

1998-2009 Associate Professor (lectuler)
Faculty of Medicine, Juntendo University
2012-present Professor,Department of Obstetrics and Gynecology, Graduate
School of Medical Science, Kyushu University
Specialized field
Gynecologic Oncology, molecular target therapy,cell biology cancer stem cell

research
Memberships, Executive Board of Japan Society of Obstetrics and Gynecology (JSOG)
Editor-in Chief, Officer of Asia and Oceania Federation of Obstetrics and
Gynecology (AOFOG)
Editor-in-Chief JOGR, Executive Board of Japan Society of Gynecologic Oncology
(JSGO)
Chairperson of Scientific Program Committee
Main Publication
Kato K, Cox AD, Hisaka MM, Graham S, Buss JE, Der CJ:
Isoprenoid addition to ras protein is the critical modification for its membrane
204
association and transforming activity.
Proc Natl Acad Sci USA. 89 (14): 6403-6407, 1992
Kato K, Ueoka Y, Kato K, Hachiya T, Nishida J and Wake N :
Contribution of enhanced transcriptional activation by ER to [12Val] K-Ras mediated NIH3T3 cell
transformation.
Oncogene. 15 (25), 3037-3046, 1997
Kato K, Horiuchi S, Takahashi T, Ueoka Y, Arima T, Matsuda T, KatoH,NishidaJ,Nakabeppu Y, Wake N :
Contribution of estrogen receptor (ER ) to oncogenic K-Ras-mediated NIH3T3 cell transformation and its
implication for escape from senescence by modulating the p53 pathway.
J Biol Chem. 277 (13): 11217-11224, 2002
Kato K, Yoshimoto M, Kato K, Adachi S, Yamayoshi A, Arima T, Asanoma K, Kyo S,Nakahata T, Wake N :
Characterization of side population cells in human normal endometrium.
Hum Reprod. 22 (5): 1214-1223, 2007
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205
S7-05
Identification and characterization of endometrial cancer stem-like cells
Kiyoko Kato
Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Japan
Stem-like cell subpopulations, referred to as side-population (SP) cells, have been identified in several
tissue and tumor types based on their ability to remove intracellular Hoechst 33342, a fluorescent dye.
We have isolated and characterized SP cells from an endometrial cancer cell line. Endometrial cancer
SP cells (EC-SP cells) possess the following characteristics: i) reduced expression levels of differentiation
markers, ii) long-term repopulating properties, iii) self-renewal capacity, iv) enhanced migration and podia
formation, v) enhanced tumorigenicity, and vi) bi-potential development (tumor cells and stroma-like
cells), suggesting that these SP cells have cancer stem-like cell features. Microarray analysis showed that
epithelial-mesenchymal transition (EMT)-related genes and extracellular matrix (ECM)-related genes were
enhanced in SP cells compared with non-SP cells. We demonstrated that EMT processes were observed
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inEC-SP cells and the level of fibronectin was enhanced in Hec1-SP cells.
SPARC was one of the genes detected by microarray expression analysis during screens for up-regulated
genes. The level of SPARC expression was enhanced in EC-SP cells compared with that in non-SP cells.
SPARC enhanced fibronectin expression and promoted migration activity. SPARC expression suppressed
tumor growth but promoted formation of tumor stroma. SPARC was expressed in endometrial cancer
tissues, in particular, poorly differentiated endometrioid, clear and serous adenocarcinoma, but not in
normal endometrial tissue.
EC-SP cells also display higher resistance to conventional chemotherapeutic drugs. In contrast, treatment
with a histone deacetylases (HDAC) inhibitor, sodium butyrate (NaB), reduced self-renewal capacity and
completely suppressed colony formation of EC-SP cells in a soft agar. The levels of intracellular reactive
oxygen species (ROS) and the number of γH2AX foci were increased by NaB treatment of both EC-SP
cells and EC-NSP cells. The expression levels of γH2AX, p21, p27, and phospho-p38 mitogen-activated
protein kinase were enhanced in RK12V-SP cells compared with RK12V-NSP cells. These results imply that
treatment with NaB induced production of intracellular ROS and DNA damage in both EC-SP and EC-
NSP cells. Following NaB treatment, DNA damage response signals were enhanced more in EC-SP cells
than inEC-NSP cells. HDAC inhibitors may represent an attractive antitumor therapy based upon their
inhibitoryeffects on cancer stem–like cells.
Salinomycin is a selective inhibitor of cancer stem cells (CSCs). Salinomycin is anantibacterial and
coccidiostatic therapeutic drug. It has been shown to kill breast cancer stem cells in mice at least
100-times more effectively than the commonly used anti-cancer drug paclitaxel. Several studies
demonstrate that salinomycin has an inhibitory effect on proliferation of CSCs.
We demonstrated that salinomycin induced apoptosis and inhibited Wnt signaling. Salinomycin inhibited
the proliferation, migration, invasiveness and tumorigenicity of these SP cells. These results demonstrated
an inhibitory effect of salinomycin on the properties of endometrialCSCs.
206
S7-06 Speaker
Yudi Mulyana Hidayat
Organization
Department of Obstetric Gynecology, RS. Hasan Sadikin, Jawa Barat, Indonesia
Education BACKGROUND
Year 1988 Faculty of Medicine Universitas Padjadjaran – Bandung

Year 1998 Obstetrics and Gynecology Universitas Padjadjaran – Bandung
Year 2007 Consultant in Gynecology Oncology Universitas Indonesia – Jakarta
Year 2008 Program Diploma Minimal Access Surgery,
The Global Open University of New Delhi India.
Year 2015 Doctoral Program Universitas Padjadjaran
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CURRENT POST
1. Secretary of TKPPDS Faculty of medicine Universitas Padjadjaran, 2008 - 2010

2. S ecretary of human Resources Depelopment & QA Departement Obstetric
Gynelogyn, SMF OBGIN Faculty of medicine Universitas Padjadjaran, 2008 - 2014.
3. Coordinator JCI (Joint Commission International) Departement Obstetric
Gynecology, SMF OBGIN Faculty of medicine Universitas Padjadjaran, 2013.
4. Chairman of Indonesian Obstetric and Gynecology Departement Obstetric
Gynecology SMF OBGIN Faculty of medicine Universitas Padjadjaran, 2014 -
present
5. Speciality staff of Dean Universitas Padjadjaran in Cooperation Program,
Faculty of medicine Universitas Padjadjaran, 2014-present
EXPERIENCE IN JOURNAL MANAGE
1. Buku Panduan Peserta Asuhan Pasca Keguguran, Published by: Jaringan

Nasional Pelatihan Klinik Kesehatan Reproduksi (JNPK-KR)-POGI, in 2002.
2. Buku Pedoman Pengelolaan Penyakit Trofoblas Gestasional, Published by: Buku
Kedokteran EGC, in 2005.
3. H ubungan ekspresi Her-2/neu dan p53 terhadap respons terapi dan
kelangsungan hidup penderita kanker ovarium jenis epitel, Published by:
Majalah Obstetric Dan Ginekologi Indonesia, in 2008.
4. B uku acuan modul pelatihan keterampilan bedah dasar obstetric dan
ginekologi, Published by: Kolegium Obstetri dan Ginekologi, Jakarta, in 2008.
207
S7-06
Role of cell cycle signaling on complete mole as risk factors of

persistent mole
Yudi Mulyana Hidayat

Department of Obstetric Gynecology, RS. Hasan Sadikin, Jawa Barat, Indonesia
*All correspondence to: Yudi M. Hidayat, MD., PhD

Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran –Dr. Hasan
Sadikin General Hospital, Jl. Pasteur No. 38, Bandung 40161, Indonesia
ABSTRACT
Changes of the complete hydatidiform mole (CHM) to become persistent was difficult to handle because
the pathogenesis of malignancy that preceded by persistent mole is still unclear. The growth of abnormal
cells in the CHM allegedly caused by components’ abnormalities of the cell cycle. Among components
that play roles in this phase include cyclin D and retinoblastoma (Rb). Cyclin D1 protein is known to
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be responsible in the process of proliferation, cyclin D3 in the process of cell differentiation, and the
Rb protein which play a role as the tumor suppressor gene. Impaired expression/regulation of several
components of the cell cycle were proven to affect the malignancy or proliferation rate in several types
of cancer. Therefore, cyclin D1, cyclin D3 and Rb allegedly involved in the process of persistent mole. The
aim of this study was to determine the role of clinical risk factors and the expression of cyclin D1, cyclin
D3, and Rb in the occurrence of persistent mole.
This research was a retrospective cohort study involving 68 CHM cases at Hasan Sadikin Hospital from
2007-2011. Protein expression of cyclin D1, cyclin D3, and Rb were determined by immunohistochemistry.
The results were analyzed by comparing the two groups of CHM that becomes persistent and those
returned to normal, which was determined by Mochizuki regression curve assessment.
The results showed that the numbers of CHM that become persistent were 20 cases (29%) and those
returned to normal were 48 cases (71%). Significant clinical variables were age (p<0.05), histopathology
(p<0.00) and βhCG (p<0.05). Immunoexpression of cyclin D1 (1.42), cyclin D3 (1.41) and mutant Rb (1.77)
in the CHM that become persistent was higher than the CHM which returned normal. The statistical
calculation showed a significant differences in the immunoexpressions of cyclin D1 (p≤0.05) and Rb
(p≤0.05), whereas the cyclin D3 was not shown a significant difference (P>0.05).
Based on this result, we conclude that there is a strong relationship between clinical risk factors of age,
excessive proliferation histopathology, serum βhCG levels ≥100.000 mu/mL, immunoexpression of cyclin
D1 and Rb mutant with the incidence of persistent mole after evacuation of the CHM. In this study we
could also designed an application model to predict risks of persistent moles with a cut-off point of 2,384
which can be used as a reference for CHM patients.
KEYWORDS: Complete hydatidiform mole (CHM), Persistent mole (PM), Cyclin D1, Cyclin D3,
Retinoblastoma (Rb), Clinical risk factor
208
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Uterine Cervix
CHAIRPERSON
Noriaki Sakuragi (Japan) Yoon Soon Lee (Korea)
SPEAKERS
Surgical strategy for functional radical surgery in patients with cervical cancer
Hee Seung Kim (Korea)
Radical trachelectomy for early stage cervical cancer during pregnancy

Takayuki Enomoto (Japan)
HPV genotype and HSIL in menopause women

Woo Dae Kang (Korea)
Self-sampling HPV test

Wichai Termrungruanglert (Thailand)
Adenocarcinoma of the uterine cervix: should we treat it differently to

squamous cell carcinoma?
Dae Hoon Jeong (Korea)
Response to neoadjuvant chemotherapy in cervical cancer stage IB2 and IIA2

Maringan DL Tobing (Indonesia)
209
S8-01 Speaker
Hee Seung Kim
Organization
Department of Obstetrics and Gynecology, Seoul National University Hospital,

Seoul, Korea
Education
1996-1998 Premedical School, Seoul National University

1998-2002 Bachelor’s degree, Seoul National University College of Medicine
2009-2011 Master’s degree, Seoul National University
2011-2013 Doctor course completion, Seoul National University
Representative Careers
2002-2003 Intern, Seoul National University Hospital

2003-2007 Resident, Department of Obstetrics and Gynecology, Seoul National
University Hospital
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2007-2009 Fellow, Division of Gynecologic Oncology, Department of Obstetrics
and Gynecology, Seoul National University Hospital
2009-2014 Commissioned professor, Department of Obstetrics and Gynecology,
Seoul National University Hospital
2014.7 Short training course in Leipzig University, Charité Medical
University and Asklepios Klinik in Germany
2015- Clinical assistant professor, Department of Obstetrics and
Gynecology, Seoul National University Hospital
1. Kim HS, Kim MA, Lee M, Suh DH, Kim K, No JH, Chung HH, Kim YB, Song YS.
Effect of Endometriosis on the Prognosis of Ovarian Clear Cell Carcinoma: A
Two-Center Cohort Study and Meta-analysis. Ann Surg Oncol. 2015 Feb 14
2. Kim HS, Kim TH, Suh DH, Kim SY, Kim MA, Jeong CW, Hong KS, Song YS.
Success Factors of Laparoscopic Nerve-sparing Radical Hysterectomy for
Preserving Bladder Function in Patients with Cervical Cancer: A Protocol-Based
Prospective Cohort Study. Ann Surg Oncol. 2015;22:1987-95.
3. Kim HS, Kim TH, Chung HH, Song YS. Risk and prognosis of ovarian cancer in
women with endometriosis: a meta-analysis. Br J Cancer. 2014;110:1878-90.
211
S8-01
Surgical strategy for functional radical surgery in patients with

cervical cancer
Hee Seung Kim

Department of Obstetrics and Gynecology, Seoul National University Hospital, Republic of Korea
From the early 1900s when Wertheim surgery was developed, radical hysterectomy has been the
standard treatment for early-stage cervical cancer. Thereafter, the interest in functional preservation of
pelvic organs increased with the understanding of neurophysiology about pelvic autonomic nerves. So,
the efficacy and safety on nerve-sparing radical hysterectomy has been investigated in many studies,
which is going to hold a seat as the standard surgery instead of conventional radical hysterectomy.
For women with cervical cancer who want fertility preservation, conventional radical trachelectomy is
considered within the strict criteria for surgical feasibility. However, recent studies also show the feasibility
of nerve-sparing technique or preservation of the uterine artery for preserving pelvic autonomic nerve
functions and increasing the success rate of pregnancy. Moreover, ontogenetic surgery can be considered
to treat early-stage or locally advanced cervical cancer without radiotherapy by removing Müllerian
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compartments with tumor in spite of a lack of validation studies. So, I will review a recent trend of
functional radical surgery for cervical cancer, and show my experience during a short period.
212
S8-02 Speaker
Takayuki Enomoto
Organization
Obstetrics & Gynecology, Niigata University Graduate School of Medicine, Niigato,

Japan
1976 M.D., Osaka University Faculty of Medicine

1994 Ph.D., Osaka University Faculty of Medicine Professional Training
and Employment
1983 Resident in Department of Obstetrics and Gynecology, Osaka
University Hospital
1984-1986 Clinical Fellow in Department of Obstetrics and Gynecology, Osaka
Welfare Pension Hospital
1986-1991 Visiting Fellow and Guest Researcher in Laboratory of Comparative
Carcinogenesis, National Cancer Institute, Frederick Cancer
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Research and Development Center, Fort Detrick, Frederick, MD
21701, U.S.A
1991-1994 Clinical Fellow in Department of Obstetrics and Gynecology, Osaka
University Hospital
1994-1995 Resident in Department of Gynecology, Osaka Center for Adult
Diseases
1996-1999 Assistant Professor in Department of Obstetrics and Gynecology,
Osaka University Faculty of Medicine
1999-2001 Acting Chief in Department of Obstetrics and Gynecology, Osaka
Rosai Hospital
2001-2002 Assistant Professor in Department of Obstetrics and Gynecology,
Osaka University Faculty of Medicine
Osaka University Graduate School of Medicine
2008-2012 Professor, Department of Obstetrics and Gynecology, Osaka
University Hospital
2012-present Professor and Chairman, Department of Obstetrics and Gynecology,
Niigata University Graduate School of Medical and Dental Science
Guest Professor, Osaka University Graduate School of Medicine
213
S8-02
Abdominal radical tracheletomy for early stage cervical cancer

during pregnancy
Takayuki Enomoto
Department of Obstetrics and Gynecology, Niigata University Graduate School of Medicine, Niigata, Japan
INTRODUCTION Standard treatment of early stage cervical cancer diagnosed during pregnancy has been
radical hysterectomy accompanied by immediate termination of the pregnancy. However, management
in women who desire to retain their pregnancy remains a significant challenge, from both oncological
and obstetrical standpoints. One commonly used option is to delay the primary treatment of the cancer
until the fetus can survive ex utero without significant morbidity. Unfortunately, a delay of treatment
may cause undue maternal risk. The second option is to conduct neo-adjuvant chemotherapy during the
pregnancy so that the cancer can be treated without delay. There is a justified concern, however, that
exposure of the fetus to platinum-based chemotherapy in utero may increase its risk for future cancer.
Recently, radical trachelectomy (RT) has been described as a potential option in cervical cancer patients
who have a strong desire to continue their pregnancy and yet still treat the disease without delay.
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RESULTS Abdominal radical trachelectomy was successfully performed for five cases of cervical carcinoma
(4 cases of stage 1B1, 1 case of stage 2A1) at 15-17 weeks of gestation (under written informed
consent). Planned cesarean section was performed, at 37 weeks of gestation in 2 cases, and at 31 weeks
of gestation in one case. Emergent cesarean section, due to intrauterine infection, was performed in one
case. Continuation to full term pregnancy was planned in one case. General anesthesia with propofol
made manipulation of the gravid uterus easier than with the general anesthesia sevoflurane, which made
the gravid uterus too relaxed to lift up. Precise procedure will be shown by video. CONCLUSION Our
present study, together with previously published data, suggests that abdominal radical trachelectomy
for early stage cervical cancer at 15-17 weeks of gestation may have high utility options for women who
strongly desire to have the baby.
214
S8-03 Speaker
Woo Dae Kang
Organization
Division of Gynecologic Oncology, Chonnam National University Medical School,

Gwangju, Korea
1994-2000 MD, Chonnam National University Medical School, Gwangju, Korea

2002-2004 Master degree, Chonnam National University Medical School,
Gwangju, Korea
2005-2009 PhD, Chonnam National University Postgraduate School,
Gwangju, Korea
2012- Present Assistant Professor Division of Gynecologic Oncology,
Department of Obstetrics and Gynecology, Chonnam National
University Hospital, Gwangju, Korea
Memberships
Symposium VIII
Korean Society of Obstetricians and Gynecology - Member
Korean Society of Gynecologic Oncology - Member
Asian Society of Gynecologic Oncology - Member
International Gynecologic Cancer Society - Member
1. Kang WD, Kim SM. Human papillomavirus genotyping as a reliable prognostic

marker of recurrence after loop electrosurgical excision procedure for high-
grade cervical intraepithelial neoplasia (CIN2-3) especially in postmenopausal
women. Menopause. 2015 Jun 8. [Epub ahead of print]
2. Kang WD, Choi HS, Kim SM. Is vaccination with quadrivalent HPV vaccine after
Loop Electrosurgical Excision Procedure effective in preventing recurrence in
patients with High-grade Cervical Intraepithelial Neoplasia (CIN2-3)? Gynecol
Oncol 2013;130:264-8.
3. Kang WD, Choi HS, Kim SM. Prediction of persistent gestational trophobalstic
neoplasia: the role of hCG level and ratio in 2 weeks after evacuation of
complete mole. Gynecol Oncol. 2012;124 (2):250-3.
4. Kang WD, Kim CH, Cho MK, Kim JW, Cho HY, Kim YH, Choi HS, Kim SM.
HPV-18 is a poor prognostic factor, unlike the HPV viral load, in patients with
stage IB-IIA cervical cancer undergoing radical hysterectomy. Gynecol Oncol
2011;121 (3):546-50.
215
S8-03
HPV genotype and HSIL in menopausal women
Woo Dae Kang

Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju, Korea
The evaluation of the menopausal cervix is difficult, given the tendency for the transition zone to recede
into the cervical canal in the absence of estrogen stimulation. This makes adequate cytologic sampling
challenging and adequate colposcopy evaluation often difficult. This study was conducted to determine
whether the human papillomavirus (HPV) genotype by the HPV DNA chip test (HDC) is predictive of
recurrent CIN2-3 following a LEEP in menopausal women. Between January 2007 and February 2013,
206 menopausal women with CIN2-3 were treated by a LEEP and followed with cytology, the hybrid
capture II assay (HC2), and the HDC. Post-LEEP follow-up was performed at 3, 6, 9, 12, 18, and 24
months during the first 2 years and yearly thereafter. Of the 206 patients, the HC2 was positive in 199
patients (96.6%) and the HDC was positive in 201 patients (97.6%) before LEEP. The overall agreement
between the HDC and HC2 was 99.0%. Twenty-six (12.6%) patients developed a recurrence, and those
who developed a recurrence tested positive for the same HR-HPV genotype before and after the LEEP.
Symposium VIII
The same HR-HPV genotype by the HDC during the follow-up had a sensitivity and a negative predictive
value of 100% in detecting recurrent disease. HPV-18 was significantly associated with recurrent CIN2-
3 (P < 0.05). In postmenopausal women, persistent infection with the same HR-HPV genotype, especially
HPV-18, should be considered a risk factor for developing recurrent CIN2-3, and after LEEP such patients
warrant special attention with intense follow-up.
216
S8-04 Speaker
Present title and affiliation
Associate Professor, Director of Gynecologic Oncology Division, Department

of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University,
Bangkok, Thailand
Secretary General of Thai Gynecologic Cancer Society (TGCS)
Executive Board of Thai Society of Colposcopists and Cervical Pathology (TSCCP)
Education
1980-1986 M.D., Faculty of Medicine, Chulalongkorn University, Bangkok,

Thailand
1989-1991 Residency training in Obstetrics and Gynecology

Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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1995-1996 Clinical Fellow, Gynecologic Medical Oncology
Section of Gynecologic Medical Oncology
Department of Clinical investigation, The University of Texas
M.D. Anderson Cancer Center, Houston, Texas, USA.
Specialty Boards
Board of Obstetrics and Gynecology 1992

Sub-board of Gynecologic Oncology 1996
Honors and Awards
1986 Second – Class Honored Medical Degree

Faculty of Medicine, Chulalongkorn University
Bangkok, Thailand
217
S8-04
Self-sampling HPV test
Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Self-sampling HPV test is a promising new cervical cancer screening option for women who are reluctant
or unable to attend a health-care provider services. It has been proved that it has high concordance rate
between physician taken specimen and self-sampling in HPV detection rate. Moreover, it also has been
proved that it can increase coverage for cervical cancer screening in the national screening program in
some country. There are some studies showed that the response rate of self sampling HPV testing is
better than notification letters in women who did not attend annual screening program (non-attendee).
Acceptability of self-sampling HPV testing is also proved worldwide. Women from most countries,
even in resource-poor setting with substantial cultural diversity, accept that self sampling HPV test is
easy to use, convenience, less pain and less embarrassment. The acceptability of the test in our study
from Chulalongkorn University, Bangkok, Thailand revealed good (85 % easily to use, 82% feel less
pain and 82% will use it next time). Surprisingly, 20% of the participant in our study did not feel less
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embarrassment while using self-sampling device. Other factors like price of the test, confidence and
reliability of the test may be obstacles for using self-sampling device in Thailand. Recently, we did a study
to compare the detection rate of high risk HPV infection between self-collected HPV test and clinician-
collected HPV test in routine cervical cancer screening. A total number of 400 women were enrolled
in our study. The detection rate of high-risk HPV was 10.0% and 7.5% by self-collected and clinician-
collected HPV test, respectively (kappa = .72). HPV test positive rate in case of cytology ASC-US or more
was not significantly different between two groups (p = 1.0). Positive predictive value of self-collected
HPV test in ASC-US or more was 35.0 % and high sensitivity for HSIL detection (100%). HPV test positive
for detection CIN was not significantly different between self-collected and clinician-collected test (p= 1.0).
We concluded that self-sampling HPV test can be an alternative option for primary cervical screening
program. It's time to support the implementation to establish the optimal programme integrating self-
sampling HPV test to improve the coverage of cervical cancer screening particularly un-screened and
under-screened women.
218
S8-05 Speaker
Dae Hoon Jeong
Organization
Department of Obstetrics & Gynecology, Busan Paik Hospital, Inje University,

Busan, Korea
Education
1996. M.D. Inje University, College of Medicine, Busan, South Korea

2001. M.Sc. Inje University, Graduate School, Busan, South Korea
2005. Ph.D. Inje University, Gradulate School, Busan, South Korea
Academic and Hospital Appointments
2010 - present. Associate Professor, Department of Obstetrics & Gynecology,

Busan Paik Hospital, Inje University, Busan, South Korea
2004 - 2010. Assistant Professor, Department of Obstetrics & Gynecology,
2002 - 2004. Full-time Instructor, Department of Obstetrics & Gynecology,
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2012 – 2013. Visiting Professor, Department of Gynecologic Oncology,
University of Alabama at Birmingham, Alabama, USA
Korean Society of Obstetrics & Gynecology

Korean Society of Gynecologic Oncology
Korean Gynecologic Oncologic Group
Korean Society of Gynecologic Endoscopy and Minimally Invasive Surgery
Korean Society of Menopause
Korean Cancer Association
Awards
2007.04.20 A best oral presentation award at 22nd annual congress of Korean

Society of Gynecologic Oncology.
2011.09.30 A best poster presentation award at 97th annual congress of
Korean Society of Obstetrics & Gynecology
219
S8-05
Adenocarcinoma of the uterine cervix:

should we treat it differently to squamous cell carcinoma?
Dae Hoon Jeong

Department of Obstetrics and Gynecology, Inje University, Busan Paik Hospital, Busan, Korea
Cervical cancer is the fourth most common cancer in women worldwide and the leading cause of cancer
death in women from developing countries. The incidence of cervical cancer has been declining for
several decades in many countries after introduction of cervical screening. The overall incidence of cervical
cancer has declined mainly by increase of detection and effective treatment of precancerous lesions of
squamous cell carcinoma (SCC). However, the incidence of adenocarcinoma (AC) of the cervix has been
increasing, especially among younger women and recently AC is consist of more than 20 - 25% of
cervical cancer compared with 5% of cervical cancer in the 1960s. The prognostic significance according
to histological type for SCC and AC remains controversial. However, most studies suggest that prognosis
of AC is worse than SCC, with a 10% to 20% difference in 5-year overall survival rates. But, AC of the
uterine cervix are treated similar to SCC. There is no difference in the treatment guideline between SCC
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and AC in the National Comprehensive Cancer Network (NCCN) guidelines. AC of the uterine cervix is
different from SCC based on its molecular pathogenesis, histological appearance, patterns of spread
and recurrence. Therefore, it will be necessary to develop a different treatment strategy and to perform
clinical Trial by international collaboration for improving survival rate of AC patients.
220
S8-06 Speaker
Maringan Diapari Lumban Tobing
Organization
H ead of Department of Obstetrics and Gynecology, Faculty of Medicine,

Universitas Padjadjaran/ Dr. Hasan Sadikin Hospital
Education Background
1982 Faculty of Medicine Universitas Padjadjaran – Bandung

1990 Obstetrics and Gynecology Universitas Padjadjaran – Bandung
2003 Consultant in Gynecology Oncology Universitas Indonesia – Jakarta 2008
Master Program Graduate of Universitas Padjadjaran of Basic Medical
Science Program Field of Study main Obstetrics Gynecology Year : 2014
Doctoral Program Universitas Padjadjaran
Experience in Journal Manage
2014 Maringan Diapari Lumban Tobing, Edhyana Sahiratmadja, Mufti Dinda,

Bethy Suryawathy Hernowo, Herman Susanto on Asian Pacific Journal
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of Cancer Prevention “Human Papillomavirus genotypes profil in cervical
cancer patients at Dr. Hasan sadikin General Hospital, Bandung, Indonesia.
2014 Iin Kurnia, Budiningsih Siregar, Setiawan Soetopo, Irwan Ramli, Tjahya
kurjana, Andrijono, Maringan Diapari Lumban Tobing, Bethy Suryawathy
Hernowo, Teja Kisnanto on HAYATI Journal of Biosciences “Correlation
between AKT and p53 protein expression and chemoradiotherapy
response in cervical cancer patients.
2014 I. Kurnia, B. Siregar, S. Soetopo, I. Ramli, T. Kurjana, D. Tetriana, B.S.
Hernowo, A. Andrijono, and M.D.M. Tobing on Article in Press Atom
Indonesia “Correlation between expression of MVP, Index of p53 and
AgNOR value with chemoradiotherapy clinical response of cervical cancer.
2014 Maringan Diapari Lumban Tobing, Herman Susanto, Bethy Suryawathy
Hernowo, Siti Salima, Leri Septiani on Indonesian Journal of Cancer
“Hubungan antara ekspresi P63 dengan jenis histopatologis penderita
kanker serviks stadium IB2 dan IIA.
2014 Patiyus Agustiansyah, Maringan Diapari Lumban Tobing, Gatot
Nyarumenteng A. Winarno on Indonesian Journal of Cancer “VEGF-C
Serum level as predictor lymph node metastasis in advanced stage
cervical cancer.
221
S8-06
Response to neoadjuvant chemotherapy in cervical cancer stage IB2

and IIA2
Maringan Tobing
Department of Obstetrics and Gynecology, Indonesian Society of Gynecologic Oncology, West Java, Indonesia
Patients with bulky cervical cancer stage IB2 and stage IIA2 often had local recurrence, and poorer survival
rate than the lower volume cervical cancer. Neoadjuvant chemotherapy (NACT) before surgery should be
considered in order to decrease tumor volume. This study was to find out the role of P-170 glycoprotein,
DNA methylation of MDR1 gene and anti-CD34 antibody to NACT response in bulky cervical cancer stage
IB2 and IIA2.
This case control observational analytic study was held between December 2013 until April 2014.
The sample was used from Archived Biological Material obtained from Molecular Genetics Laboratory
Social Services and Research Unit, and Anatomical Pathology Laboratory of Medical Faculty Universitas
Padjadjaran Bandung. Expression levels of P-170 Gp and anti CD-34 antibody were analyzed by
immunohistochemistry on a total of 42 cervical tissue sample. The methylation status was analyzed by
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bisulphate modification and methylation-specific PCR (MSP).

We obtained 42 qualified subjects out of 52 enrolled. Test results showed 5 patients with complete
response, 25 patients had partial response, and the remaining 12 patients with no response. Double
logistic regression analytic analyzing the correlation between histoscore cut off point of P170-Gp (>3) and
methylation ratio cut off point (>48.96%), showed the risk of chemoresistance was 3.89 times compared
to histoscore of P-170Gp ≤3, and risk of chemoresistance was 4.17 times compared to methylation ratio
≤48.96%.
Methylation status, P-170 Glycoprotein expression showed significant correlation between the positive
and negative responses after NACT, and antibody anti-CD34 did not show significant correlation between
the positive and negative response after NACT.

KEY WORDS: Bulky tumor cervical cancer,methylation status MDR1 DNA gene, P-170 Gp, anti-CD34
antibody, multidrug resistance
222
Symposium IX
Ovary
CHAIRPERSON
Jean Anne B. Toral (Philippines) Sang-Yoon Park (Korea)
SPEAKERS
Fully-sialylated alpha-chain of complement 4-binding protein: Diagnostic
utility for ovarian clear cell carcinoma
Mikio Mikami (Japan)
Epigenetic alterations in aggressive phenotype ovarian cancer

Woong Ju (Korea)
Subtype specific trial design for ovarian cancers

John Chia Whay Kuang (Singapore)
Overcome the limitation of neoadjuvant chemotherapy in epithelial ovarian

cancer
Sung Hoon Kim (Korea)
Precision management of ovarian cancer by molecular subtypes

Ruby Huang (Singapore)
The emerging roles of sex hormone receptors in ovarian cancer

Yao-Ching Hung (Taiwan)
223
S9-01 Speaker
Mikio Mikami
Education
1984 M.D., Keio University, School of Medicine

1991 Ph.D., Keio University, School of Medicine
1984-1985 Department of Obstetrics and Gynecology, Keio University Hospital

1985-1986 Department of Obstetrics and Gynecology, Hamamatsu Red Cross
Hospital
1986-1987 Department of Obstetrics and Gynecology, Ohtawara Red Cross
Hospital
1987-1990 Department of Obstetrics and Gynecology, Keio University Hospital
1990-1991 Department of Obstetrics and Gynecology, National Saitama Hospital
Positions Held and Faculty Appointments
1991-1992 Reseach Fellow

La Jolla Cancer Research Foundation (USA)
(present Sanford-Burnham Medical Research Institute)
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1993-1995 Chief Doctor
Department of Obstetrics and Gynecology, Sho Hospital (Itabashi)
1995-1997 Fellow
Department of Obstetrics and Gynecology, Keio University Hospital
1997-1998 Technical Official, Ministry of Health, Labour and Welfare
Department of Obstetrics and Gynecology, National Saitama Hospital
1998-2005 Chief Physician
Department of Obstetrics and Gynecology, National Hospital Organization
Saitama National Hospital
1998-2002 Visiting Assistant Professor
Keio University School of Medicine
2003-2006 Visiting Associate Professor
Keio University School of Medicine
2006- Professor and Chairman
Department of Obstetrics and Gynecology, Tokai University School
of Medicine
225
S9-01
Fully-sialylated alpha-chain of complement 4-binding protein:

Diagnostic utility for ovarian clear cell carcinoma
Mikio Mikami
Keio University, School of Medicine, Kanagawa, Japan
Epithelial ovarian cancer (EOC) is the leading cause of death among gynecological cancers. To achieve
early detection of EOC, screening has been tried by measurement of serum CA125, commonly used
as a marker for EOC, and transvaginal ultrasonography, as well as combined measurement of CA125
and other markers, but the effectiveness of these methods has not been reported. CA125 has the
fundamental problem of not being cancer-specific and often shows elevation in benign gynecological
conditions like endometrioma, which was reported to increases the subsequent risk of developing ovarian
cancer, especially clear cell carcinoma (OCCC). Therefore patients with history of endometrioma should
be observed for a long time and the good new marker to distingish OCCC from endometrioma had been
waited for a long time. However, for more than 30 years, attempts including recent proteomic and nucleic
acid–based analyses, have been made to identify more effective biomarkers than CA125, but no marker
has been discovered. It was necessary to develop the novel technology to explore the new markers of
EOC. Recent improvements of mass spectrum technology have enabled detection of low concentrated and
complicated sugar chain alterations caused by cancer. Therefore we focused on the glycan structures of
serum glycoproteins to explore the new markers of EOC, supplementing the demerit of CA125.
Symposium XI
We explored more than 100,000 glycan structures of serum glycoproteins in mass spectrum approach
as follows. Enriched glycopeptides were obtained from serum proteins by protease digestion and lectin
chromatography, and then subjected to liquid chromatography mass spectrometry analysis. We screened
all serum glycoproteins detected in 134 women with EOC and 159 controls, who were not only healthy
women but also women with conditions that often cause false-positive results for CA125.
We identified A2160, fully-sialylated alpha-chain of complement 4-binding protein (C4BP), as a novel
biomarker for diagnosing EOC. The AUC of A2160 for discriminating between OCCC and endometrioma
was significantly higher than that of CA125. This A2160 was much more elevated even in the early stage
of OCCC than CA125. Comparison of AUCs between the EOC patients and the control group revealed
that alpha chain of C4BP with fully sialylated glycans showed much higher AUC values than alpha
chain of C4BP with partially sialylated glycans. Importantly, diagnostic accuracy of A2160 to distinguish
OCCC from endometrioma is paramount higher than that of CA-125 especially in early-stage disease. In
addition, fully-sialylated glycans had a larger accuracy for diagnosing EOC compared to partially-sialylated
glycans of alpha-chain of C4BP.
We discovered a novel marker for EOC, which distinguishes early stage OCCCs from benign
endometriomas with much higher specificity than CA125. Fully sialylated glycans are essential to this new
marker. This new biomarker can be applied for the monitoring of endometrioma, which could make the
early diagnosis of OCCC possible.
226
S9-02 Speaker
Woong Ju
Organization
Department of Obstetrics and Gynecology. Ewha Womans University School of

Education
1996. 2. 27 Graduated from Seoul National University, School of Medicine

2004. 8. 30 Graduated from Seoul National University, School of Medicine,
Master’s degree (MS) for Medicine
2007. 2. 26 Graduated from Seoul National University, School of Medicine, PhD
for Medicine
2012. 5. 30 Graduated from Harvard University, School of Public Health, Master
of Public Health (MPH)
Memberships
Korean Cancer Association

Korean Society of Obstetrics and Gynecology
Korean Society of Gynecologic Oncology
Korean Gynecologic Oncology Group
Gynecologic Oncology Group (USA)
Symposium XI
AAGL Advancing Minimally Invasive Gynecology Worldwide
Society of Gyecologic Oncologists (USA)
Awards
1. Best oral presentation Award, The Korean Society of Obstetrics and Gynecology,
Annual meeting, Seoul, Korea, 2013
2. Best professor in Research Award, Ewha Medical Center, Ewha Womans
University School of Medicine. 2010
3. B est oral presentation Award, The Korean Society of Obstetrics and
Gynecology, Annual meeting, Seoul, Korea, 2008
4. BMS Best Presentation Award, The Korean Society of Gynecologic Oncology
and Colposcopy, Jeju, Korea, 2005
5. Young Gynecologist Award, Asia and Oceanic Congress of Obstetrics and
Gynecology, Seoul, Korea, 2005
6. AACR-Avon Scholar-in-Training Award, AACR Frontiers in Cancer Prevention
Research Conference, Seattle, WA, 2004
7. President Award for Best Article, The Korean Society of Gynecologic Endoscopy,
2003
227
S9-02
Epigenetic alterations in aggressive phenotype ovarian cancer
Woong Ju, Yun-Hwan Kim, Seung Cheol Kim

Department of Obstetrics and Gynecology, School of Medicine, Ewha Womans University, Seoul, Korea
Despite progress in cancer therapy, a lack of reliable biomarkers for early detection and risk of metastatic
recurrences makes ovarian cancer the most lethal gynecological cancer.
To understand the molecular mechanisms involved in ovarian cancer metastasis in vivo, we analyzed
genome-wide interplay between promoter CpG DNA methylation and gene expression in a mouse model
of metastatic ovarian cancer to identify genes whose expression was regulates by abnormal changes
of DNA methylation during metastatic ovarian tumor formation. The GABRP, CA9, SLC6A12, and MAL
showed increased mRNA expression and hypomethylation of promoter CpG in metastasized tumor
tissues. The DNA methylation-dependent transcriptional regulation of those genes was confirmed by
treatment of demethylating agent. We also found that overexpression of those genes caused increased
migration and invasiveness in SK-OV-3 cells via activation of extracellular signal-regulated kinase (ERK).
Conversely, silencing of those genes decreased phosphorylation of ERK1/2 and selective inhibition of
ERK1/2 significantly decreased migration and invasiveness in SK-OV-3 cells.
Our result also revealed that hypomethylation of GABRP and other genes within promoter CpG is
Symposium XI
associated with advanced stage and metastasis to the lymph node in patients with ovarian cancer.
Receiver operating characteristics analysis showed good discrimination between patients at early and
advanced stage.
In this study, we provide novel evidence for epigenetic regulation of relevant genes in ovarian cancer. We
herein suggest that the DNA methylation status within GABRP, CA9, SLC6A12, and MAL promoter region
may be a potential biomarker that can indicate the aggressive behavior of ovarian cancer.
228
S9-03 Speaker
John Whay-Kuang Chia
MBBS (Singapore), MRCP (UK)

FAMS (Medical Oncology)
Dr John WK Chia is a Senior Consultant Medical Oncologist at the Department

of Medical Oncology, National Cancer Center Singapore, Visiting Consultant, KK
Womens and Childrens Hospital, and Adjunct Associate Professor at Duke-NUS.
He completed his undergraduate Medical training at NUS in 1999 and obtained
his membership at the Royal College of Physicians Edinburgh in 2002. Upon
finishing his medical oncology board examinations, he trained with Professor
Malcom Brenner and Professor Stephen Gottschalk at the Centre for Cell and
Gene Therapy, Baylor College of Medicine, Houston from 2009-2010 in the field
of cancer vaccines and adoptive T-cell immunotherapy for solid tumors. In 2011
and 2012, he trained as a post-doctoral fellow with Prof Stan Kaye at The Royal
Marsden Hospital London in Gynecology Oncology. His major passion has been
to improve cancer therapeutic through clinical trials – and he has developed
several phase 1, 2 and 3, clinical trial studies. He holds several scientific research
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grants and has published in the fields of inflammation, immunotherapy, and
gynecological and colon cancers. He is married with 2 active children and in his
spare time, enjoys collecting Chinese Contemporary Ink Paintings and Asian
Pottery.
229
S9-03
Sub-type specific trial design for ovarian cancers
John Whay-Kuang Chia

Department of Medical Oncology, National Cancer Center Singapore
Epithelial Ovarian Cancer (EOC) is no longer recognized as a single entity but at least 5 different cancers
involving the ovary. These subtypes - high grade serous (HGS), clear cell (CC), endometroid (E), mucinous
(M) and low grade serous (LSG) - are characterized by differing cells of origin, pathogenesis, molecular
aberrations, patterns of involvement and spread, response to chemotherapy, and prognosis – that qualify
them as bona fide separate tumors. The European Medicines Agency advises that for clinical trials “the
more heterogeneous the study population, the greater the importance of subgroup analyses to check
that the estimated overall effect is broadly applicable across the breadth of the proposed indication.”
Most chemotherapy trials for EOC have been underpowered for covariate-analyses in subgroups in
particular non-HGS subtypes, where they each constitute less than 15% of the overall trial populations.
The success EGFR, ALK, Her2, and BRAF inhibitors in lung cancer, breast cancer and melanoma – has
underpin the logic precision therapy in particular non-serous ovarian cancer. At least 50% of high grade
serous (HGS) ovarian cancers have some aberration of the Homologous recombinant (HR) pathway–
which may be epigenetic, somatic or germline. Germline and somatic mutation of HR proteins (including
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BRCA1, BRCA2, ATM, BARD1, BRIP1, CHEK1, CHEK2, FAM175A, MRE11A, NBN, PALB2, RAD51C,
and RAD51D) confer for hypersensitivity to platinum chemotherapy and PARP inhibitors. The advent of
Immune Checkpoint Inhibitors (ICIs) offers a new therapeutic paradigm for ovarian cancer. Predictive
markers of response to ICIs have not yet been well-defined, but may include PDL1 expression in tumor,
tumor mutational and antigen load (immunogenicity), microsatellite instability status, and the degree
of infiltration with tumor infiltrating lymphocytes (TILs). The challenges in designing histotype-specific
EOC drug trials - lie in the infeasibility of timely patient recruitment for rare tumors, high cost trial
related activities over geography and time, and problems of assay standardizations, positive and negative
thresholds, and inter- and intratumor heterogeneity. Apart from drug trials, development of evidence-
based care for EOC subtypes should also encompass unique strategies for cancer prevention, screening,
treatment of early stage disease, surgery and radiation therapy – acknowledging the differing biological
history and program of these subtypes.
230
S9-04 Speaker
Sunghoon Kim
Organization
Department of Obstetrics & Gynecology, Yonsei University College of Medicine,

Seoul, Korea
Education and Career
1990-1996 Yonsei University College of Medicine (MD)

2001-2003 The Graduate School, Yonsei University (MS)
2003-2009 The Graduate School, Yonsei University (PhD)
1998-2002 Resident in Department of Obstetrics & Gynecology, Severance
Hospital
2009-2011 Research Fellow in Department of Gynecologic Oncology,
Massachusettes General Hospital
Academic Appointments & Position
2004-2006 Instructor in Department of Obstetrics & Gynecology, Yonsei

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2006-2012 Assistant Professor in Department of Obstetrics & Gynecology,
Yonsei University College of Medicine
2012-Present Associate Professor in Department of Obstetrics & Gynecology,
Yonsei University College of Medicine
Memberships
Member of Korean Society of Gynecologic Oncology & Colposcopy.

Member of Korean Society of Obstetrics and Gynecology
Member of American Association of Gynecologic Laparoscopy
International Member of Society of Gynecologic Oncology
231
S9-04
Overcome the limitation of neoadjuvant chemotherapy in epithelial

ovarian cancer
Sunghoon Kim
Department of Obstetrics & Gynecology, Yonsei University College of Medicine, Seoul, Korea
Ovarian cancer is the leading cause of death from gynecological cancer in developed countries. More
than 75% of women have advanced stage (FIGO stage IIIC or IV) at diagnosis, of whom a substantial
proportion have a 5-year survival rate of less than 25%. Surgery remains the cornerstone of treatment
for advanced epithelial ovarian cancer (EOC) preceded or followed by chemotherapy. Complete resection
of all macroscopic disease at primary debulking surgery (PDS) has been shown to be the single most
important independent prognostic factor in advanced EOC. In the current study, the importance of this
prognostic factor was confirmed by the results of the multivariate analyses and the survival analyses
according to the extent of residual tumor after both PDS and interval debulking surgery (IDS).
Optimal PDS is not always technically feasible, but IDS after neoadjuvant chemotherapy (NACT) is an
accepted alternative approach. According to published two randomized controlled phase III trials (Vergote
et al. (2010), and Kehoe et al. (2015)), IDS after NACT is not inferior to PDS followed by chemotherapy
for patients with advanced stage EOC. No significant advantages of IDS or PDS were observed with
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respect to survival, adverse effects, quality of life, or postoperative morbidity or mortality.

Although NACT is now used in many countries, international consensus guidelines on optimal patient
selection have not been developed to date. In patients receiving NACT, optimal cytoreduction is still
significant, but it is less powerful than surgical resection status in patients who have not received NACT.
The aim of this session is to overcome the limitation and suggest the method for improving clinical
outcome of NACT in advanced EOC. Through the ideal patients’ inclusion criteria, appropriate
chemotherapeutic agent selection and optimal surgical technique, we can anticipate the improvement of
prognosis after NACT followed by IDS in advanced EOC. On the basis of data obtained in our institution
and literature review, we would like to introduce the optimal method for IDS after NACT in advanced
EOC.
232
S9-05 Speaker
Ruby Huang
Organization
Cancer Science Institute of Singapore, National University of Singapore, Singapore
2015 ~ Adjunct Assistant Professor: Department of Anatomy, NUS

2015 ~ Adjunct Assistant Professor: Cancer Science Institute of Singapore,
NUS
2013 ~ Principal Associate: Cancer Science Institute of Singapore, NUS
2009 ~ Resident Physician/Clinician Scientist: Department of Obstetrics &
Gynaecology, NUHS
2009 ~ 2015 Senior Research Fellow: Cancer Science Institute of Singapore,
NUS
2007 ~ 2009 Research Fellow: Institute of Molecular and Cell Biology, A*STAR
2006 ~ 2007 Visiting Scientist: Department of Obstetrics & Gynecology,
University of British Columbia
2003 ~ 2006 Clinical Fellow: Department of Oncology, National Taiwan
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University Hospital
1999 ~ 2003 Resident: Department of Obstetrics & Gynecology, National
Taiwan University Hospital
Member, Taipei Medical Association Member, Taiwanese Association of Obstetrics

and Gynecology (TAOG)
Member, Chinese Oncology Society Member, American Association of Cancer
Research (AACR)
Member, The EMT International Association (TEMTIA)
Tan TZ, Yang H, Ye J, Low J, Choolani M, Tan D, Thiery JP, Huang RY. CSIOVDB:
a microarray gene expression database of epithelial ovarian cancer subtype.
Oncotarget 2015 (In revision)
233
S9-05
Precision management of ovarian cancer by molecular subtypes
Ruby Huang
Cancer Science Institute of Singapore, National University of Singapore, Singapore
Epithelial ovarian cancer (EOC) is the most lethal gynecological malignancy in the world. From three
longitudinal registries of EOC patients during 1980 to 2004, the overall survival rate of EOC patients in
US, Australia, and Canada has not improved and remained unchanged. This stagnation of the overall
survival outcomes of EOC patients can be attributed to the lack of better strategies in overcoming
chemoresistance, and the slow innovation in targeted and personalized therapeutics for high risk EOC
patients. Therefore, there is an urgent need to develop better therapeutic strategies to improve the
disease outcome. EOC, in particular high grade serous carcinoma (HGSC), has been shown to exhibit
diverse molecular heterogeneity based on gene expression profiling by the Australian and the TCGA
cohorts. This molecular heterogeneity has been demonstrated to be very robust and reproducible by a
large-scale meta-analysis study consisting of 1,538 samples from our group. At least 5 distinct gene-
expression based molecular subtypes (GEMS) of EOC have been identified. The C1 and C5 subtype from
the Tothill dataset corresponds to the Mesenchymal and Proliferative subtype from the TCGA dataset
and the Mes and Stem-A subtype from the 1,538 meta-analysis dataset, respectively. These GEMS have
Symposium XI
been correlated with patient survival. The C1/Mesenchymal/Mes and C5/Proliferative/Stem-A GEMS
are associated with poorer survival outcomes. However, there has been limited preclinical/ clinical data
available regarding the appropriate optimal therapeutic strategies for each of these GEMS. Recently,
pre-clinical studies as well as the translational studies from the ICON7 trial have shed light to how these
GEMS might be relevant to therapeutic stratification. Therefore, establishing a translational program
aiming at molecular subtype specific management would provide a valuable opportunity for the
gynecologic oncology field to change our current practice in treating EOC patients.
234
S9-06 Speaker
Yao-Ching Hung
Organization
GYN Oncology, OBS & GYN, China Medical University Hospital, Taiwan
Education
M.D. (Oct. 1976 ~ Jun 1983)

School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Post doc. Research Fellow -- (May 1991 ~ May 1992),
Section of Gynecological Oncology, Department of Obstetrics and Gynecology,
Hershey Medical Center, Pennsylvania State University Hospital, Hershey,
Pennsylvania, U.S.A.
Ph.D. (April 2001 ~ March 2004)
Section of Gynecological Oncology, Department of Obstetrics and Gynecology,
Graduate Institute of Medicine, Osaka Medical College, Osaka, Japan.
1. Prof., Graduate Institution of Clinical Medical Science and Chairman, Dept. of

OBS & GYN, China Medical University
Symposium XI
2. Prof. & Director, Division of GYN Oncology, Dept. of OBS & GYN, China
Medical University Hospital
3. President, Society of Gynecologic Oncology, Republic of China
4. President, Taichung Cancer Society
5. Membership: ASGO, AGOG, IGCS, ESGO, AACR, ASCCP;
1. Chung WM, Chang WC, Chen LM, Lin TY, Chen LC, Hung YC*, Ma WL*,
Ligand-independent Androgen Receptors Promote Ovarian Teratocarcinoma
Cell Growth by Stimulating Self-Renewal of Cancer Stem/Progenitor Cells,
Stem Cell Research, 2014, 13: 24-35. (* corresponding author)
2. Hung YC, Chang WC, Chen LM, Chang YY, Wu LY, Chung WM, Lin TY, Chen
LC, Ma WL*, Non-genomic Estrogen/Estrogen Receptor Promotes Malignant
Immature Ovarian Teratoma in vitro, Journal of Cellular Physiology 2014, Jun,
229 (6):752-761; 2014, Oct 19. doi: 10.1002 / jcp.24495.
235
S9-06
The emerging roles of sex hormone receptors in ovarian cancer
Yao-Ching Hung1, Wei-Chung Chang1, Lumin Chen1, Wie-Min Chung2, Wen-Lung Ma2
1
Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan
2
Sex Hormone Research Center, China Medical University Hospital, Taichung, Taiwan
OBJECTIVE: Title: The emerging roles of sex hormone receptors in ovarian cancer Authors: Yao-Ching
Hung, MD Ph.D.1,2,3, Wei-Chung Chang, MD Ph.D.1, Lumin Chen, MD1,2, Wei-Min Chung, MS.2,3,
Wen-Lung Ma, PhD.2,3 Institutions: 1. Department of OBS/GYN; 2. Sex Hormone Research Center,
China Medical University Hospital; 3. Graduate Institution of Clinical Medical Science, China Medical
University Grant support: MOST103-2314-B-039-034; MOST 103-2321-B-039 -004Abstract There
are four histological subtypes with various malignancy of Ovarian adenocarcinoma (OVCA) namely:
serous, clear cell, endometroid, and mucinous. Sex hormone receptors e.g., androgen receptor (AR) and
Estrogen receptor (ER ) were reported to participate in the OVCA development, yet, controversial without
dissection in sub-types. Using web-based cDNA microarray data mining, we found AR expression was
associated with unfavorable prognosis in serous, but not endometrioid subtype. We further examined
AR/ER expressions in OVCA subtypes in a single hospital cohort, and found discrepancies that AR tends
to express in serous, while ER on serous and clear cells OVCA subtypes. The information suggests
preferential expressions of AR/ER in subtypes might be involved in OVCA development. Moreover,
Symposium XI
we’ve published works demonstrating that both receptors could promote ovary tumor through various
mechanism; e.g., 1). Both AR and ER enriched Cancer Stem/Progenitor Cells (CSPC; defined by CD133+)
population in ovarian teratocarcinoma (OVTC). 2). AR and ER increased CSPCs marker genes expression.
3). ER could promote cell migration/invasion of OVTC through ROCK-related signaling. 4). AR and ER co-
expressed with CD133 in patient OVTC lesions. 5). Both AR and ER exerted biological functions without
conventional transactivation, but through non-canonical pathways either p53 and ERK/miR21-related,
respectively. In conclusion, the molecular/cellular mechanisms validated in our research would shed lights
on in-depth understanding of hormonal biology in this devastating malignancy and implementing bases
for future medicine.
236
Luncheon Symposium III
CHAIRPERSON
Byung Chan Oh (Korea)
SPEAKERS
Identification of BRCA mutation in women with epithelial ovarian cancer
Hyun Hoon Chung (Korea)
237
LS-03 Speaker
Hyun Hoon Chung
Organization
Dept. of Obstetrics & Gynecology, Seoul National University College of Medicine,

Seoul National University Hospital, Korea
Education
1997.02 M.D. Seoul National University College of Medicine, Seoul

2005.08 M.S. Seoul National University College of Medicine, Seoul
2010.08 Ph.D. Seoul National University College of Medicine, Seoul
2003.4-2005.4 Board-Certified Gynecologic Oncologist, Center for Uterine

Cancer, National Cancer Center, Korea
2005.5-2007.2 Clinical Fellow in Obstetrics & Gynecology, Seoul National,
2007.3- 2010.2 Commissioned Professor, Seoul National University Hospital
2010.3-2014.2 Clinical Assistant Professor, Seoul National University Hospital
2014.3- Associate Professor, Seoul National University College of
Symposium III
Luncheon
Medicine, Seoul National University Hospital
1. Sarker A, Im HJ, Cheon GJ, Chung HH, Kang KW, Chung JK, Kim EE, Lee DS.
Prognostic Implications of the SUVmax of Primary Tumors and Metastatic
Lymph Node Measured by 18F-FDG PET in Patients With Uterine Cervical
Cancer: A Meta-analysis. Clin Nucl Med. 2015 in press.
2. Chung HH, Cheon GJ, Kim HS, Kim JW, Park NH, Song YS. Pre-operative PET/
CT standardized FDG uptake values of pelvic lymph nodes as a significant
prognostic factor in patients with endometrial cancer. Eur J Nucl Med Mol
Imaging 2014;41 (9):1793-9
239
LS-03
Identification of BRCA mutation in women with epithelial ovarian

cancer
Hyun Hoon Chung

Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University
Hospital, Seoul, Republic of Korea
Epithelial ovarian cancer is burdened by the highest mortality rate among gynecological cancers.
Alterations in the homologous repair pathway are thought to occur in 30%-50% of epithelial ovarian
cancers. Despite several adjustments occurred in cytotoxic drug in last decades, most patients continue
to relapse, and no significant enhancement has been reached in the overall survival. The development of
drug resistance and the recurrence of disease have prompted the investigations of other targets that can
be used in the treatment of ovarian cancer. Among such targets, poly (ADP-ribose) polymerase (PARP)
represents a novel way to target specific pathways involved in tumor growth. PARP inhibitors have shown
activity in cancers with BRCA mutations, with other deficient DNA repair genes or signaling pathways
that modulate DNA repair, or in association with DNA damaging agents not involved in DNA repair
dysfunction. According to the information on BRCA mutational status, the treatment strategy in ovarian
cancer may undergo revision in a near future.
Symposium III
Luncheon
240
Young Doctors Session I
CHAIRPERSON
Uma Devi (India) Jianliu Wang (China)
SPEAKERS
Vulva cancer in Neplaese women
Jitendra Pariyar (Nepal)
Search for novel genes responsible for ovarian cancer dissemination

Koji Yamanoi (Japan)
Fascin as a survival prognostic factor in advanced stage epithelial ovarian

carcinoma
Fara Vitranti (Indonesia)
Optimization of cytoreductive surgery in relation to CA-125 in epithelial

ovarian cancer
Jayashree. N (India)
Targeted nanoparticle system conjugated with FSH peptides against ovarian

carcinoma
Xiaoyan Zhang (China)
Laterally extended endopelvic resection: extended application for primary or

recurrent cervical cancer
Maria Lee (Korea)
241
YS1-01 YS1-02
Vulva cancer in Nepalese women Identification through functional genomics

screening of factors whose down-regulation
Jintendra Pariyar1, Binuma Shrestha2 enhances the side population in ovarian
1
Department of Gynecology, Civil Hospital, Kathmand, Nepal, 2B. P. cancer
Koirala Memorial Cancer Hospital, Nepal
Koji Yamanoi, Noriomi Matsumura, Kaoru Abiko, Ken
OBJECTIVE: To analyze the clinical presentation and Yamaguchi, Junzo Hamanishi, Tsukasa Baba, Masafumi
Koshiyama, Ikuo Konishi
management outcomes of vulva cancer managed in B. P.
Koirala Memorial Cancer Hospital. Department of Gynecology and Obstetrics, Graduate School of
METHODS: A descriptive study was conducted of all Medicine, Kyoto University, Kyoto, Japan
carcinoma of vulva cases managed at the B. P. Koirala
Memorial Cancer Hospital from1999 to 2009. The case OBJECTIVE: High grade serous ovarian cancer (HGSOC)
record of all women diagnosed to have carcinoma of vulva is the most frequent subtype with a very poor prognosis.
were retrieved and socio-demographic characteristics, Cancer stem cells (CSC) play a role in chemoresistance
clinical presentations, histological type, treatment and cancer relapse. Recently, it has been reported that
modalities and outcome were obtained and analyzed. HGSOC also contained a CSC-like fraction, which related
RESULTS: There were 5152 gynecological malignancies to poor prognosis of HGSOC. CSCs are enriched for a side
and vulva cancer accounted for 87, giving a prevalence of population (SP) of cells as detected by efflux of hoechst
1.7%. The ages ranged from 17 to 86 years (mean of 48.6 dye. In this research, we performed a functional genomics
years). Parity was 0-10. The usual presenting symptoms screen to identify genes whose downregulation generates
were lump or wound in vulva; itching and discomfort in a SP of serous ovarian cancer cells. We transfected a library
vulva and discharge or abnormal bleeding per vaginum. of 81,000 shRNA lentiviral plasmids (Cellecta) targeting
The commonest histological type of vulva cancer noted 15,000 genes into two serous ovarian cancer cell lines,
was squamous cell carcinoma, seen in 81 (93%) of the CH1 and SKOV3, which harbor minimal SP fractions (less
patients. There were three (3.5%) cases of Bartholin’s gland than 0.1%). Following transfection, we sorted cells to
adenocarcinoma and two (2.3%) cases of sarcoma and one obtain the SP fraction, expanded these from independently
case (1.2%) of malignant melanoma of vulva. Seven cases plated single SP cells and extracted DNA. We amplified
(8%) had Stage I, 24 (28%) had Stage II, 45 (52%) had the transduced shRNAs by PCR and reconstructed shRNA-
Stage III and 11 (12%) had Stage IV disease at the time lentiviral plasmids, followed by transfection into CH1 or
of presentation. 32% were treated primarily with surgery, SKOV3 to determine reproducibility. Furthermore, we
34% primarily with concurrent chemo-radiation and 28% transfected different sequences of shRNAs targeting the
Young Doctors
Session I
with combined modality. Clinical follow-up of one to five identified genes and confirmed the consequent increase
years showed that 30% (26) cases had local recurrence and in the SP fraction. As a result, suppression of GeneA,
25% (22) died of disease. GeneB and GeneC markedly increased the SP in CH1 cells
CONCLUSION: Vulva cancer is a rare gynecological (control; 0.08% vs GeneA; 1.1%, GeneB; 1.0%, GeneC;
malignancy in Nepal. Though known to be a disease of 2.0%). Suppression of GeneD, GeneE and GeneF markedly
elderly women, an increased incidence was observed increased the SP of SKOV3 cells (control; 0.07% vs GeneD;
among younger women. Surgery and radiotherapy remain 1.4%, GeneE; 1.1%, GeneF; 1.0%). Moreover, we
to be the mainstay of treatment. In Nepal’s context, delayed overexpressed five genes (GeneA, GeneC, GeneD, GeneE
presentation result into greater morbidity and mortality and GeneF) in two serous ovarian cancer cell lines, A2780
rates. Thus, focus should be made in early diagnosis by and IGROV1, which contain more abundant SP fractions
creating awareness among women to seek early medical and found a marked decrease of the SP fraction (IGROV1:
care and among health care providers to perform clinical control, 6.8% vs 0.65%, 2.1%, 4.2%, 0.34%, 0.35%,
examination. p<0.001, respectively, A2780: control, 3.48% vs 0.01%,
243
0.15%, 0.22%, 0.08%, 0.21%, p<0.001, respectively). to a marked increase in the SP of serous ovarian cancer,
We next analyzed phenotypic characteristics of CH1 cells through functional genomics screen. The generated SP cells
in which GeneA, GeneB or GeneC is suppressed. The had CSC-like phenotypes, such as high ability of sphere
CH1 SP had higher sphere formation ability than the MP formation, clonogenesity, chemoresistance and in vivo
following anchorage-independent sphere culture for 14 tumorgenesity. The results of this study would be useful to
days (control shRNA; 14.7, sh-GeneA-SP vs. MP: 31.2 vs. elucidate the molecular mechanisms of tumor recurrence.
26.2, sh-GeneB-SP vs. MP: 30.3 vs. 20.5, sh-GeneC-SP vs.
MP: 38.0 vs. 13.8, p<0.05, respectively). In clonogenicity
assays of single cells, we found that the SP had higher
clonogenicity than the main population (MP) and control YS1-03
cells (control shRNA; 1%, sh-GeneA-SP vs. MP; 10.7% vs.

Survival prognostic factor of fascin expression
5.5%, sh-GeneB-SP vs MP; 8.5% vs. 2.2%, sh-GeneC-
in advanced stage epithelial ovarian
SP 3.0% vs. 1.0%, p<0.05, respectively). The CH1 SP had
carcinoma
higher tumorigenicity than the MP following subcutaneous
injection of 1,000 cells into NOD/SCID mice (control shRNA, Fara Vitantri1, Sigit Purbadi2, Bundiningsih Siregar2, Bambang
1/4; sh-GeneA-SP vs. MP, 2/4 vs. 1/4; sh-GeneB-SP vs MP, Sutrisna2
4/4 vs. 1/4; sh-GeneC-SP vs MP, 4/4 vs. 0/4, respectively). 1
RSUP Fatmawati Hospital, Jakarta, Indonesia, 2Cipto
Suppression of these genes significantly elevated cisplatin
Mangunkusumo Hospital, Jakarta, Indonesia
IC50 values of CH1 cells as compared to the control
(control, 40.9nM; sh-GeneA, 110nM; sh-GeneB, 102.3nM;
OBJECTIVE: Purpose to evaluate fascin expression as a
sh-GeneC, 120.3nM; p<0.05, respectively) . In addition,
prognostic factor and its correlation with survival and
suppression of GeneB contributed to paclitaxel resistance
clinicopathology factors ( grade and stage).
while suppression of GeneC enhanced resistance to
METHODS: This study is prognostic study with cohort
gemcitabine and paclitaxel (p<0.05). Also we investigated
historical design. Fascin were analysed in paraffin blocks
characteristics of SKOV3 cells in which GeneD, GeneE or
tissue sections of 33 advance stage ovarian carcinoma
GeneF was suppressed. The SKOV3 SP had higher sphere
patients by immunohistochemistry. Fascin expression was
formation ability than the MP following anchorage-
tested for correlation with overall survival and correlation
independent sphere culture for 14 days (control shRNA;
with grade and stage
22.8, sh-GeneD-SP vs. MP: 40.6 vs. 24.2, sh-GeneE-SP vs.
RESULTS: In this study fascin expression has no correlation
MP: 83.7 vs. 57.2, sh-GeneF-SP vs. MP: 116.5 vs. 51.0,
with survival. In the periode 17-22 months, sample with
p<0.05, respectively). In clonogenicity assays of single
high expression had hazard with HR (CI 95%) 1,59 (0,38-
cells, we found that SP cells had higher clonogenicity than
6,67); p=0,449, but in periode 17-23 months both of
Young Doctors
MP and control cells (control shRNA, 4.0%; sh-GeneD-

Session I
SP vs. MP, 12.3% vs. 2.0%; sh-GeneE-SP vs. MP, 18.3% group had same hazard. In the periode of more than 23
vs. 9.0%; sh-GeneF-SP vs. MP, 37.7% vs. 21.5%; p<0.05, months, fascin with high expression had a better hazard
respectively). The SP had a tendency toward higher ratio with HR (CI 95%) 0,40 (0,04-4,38); p=0,449 No
tumorigenicity than the MP following injection of 100 cells significant correlation between fascin expression with grade
into NOD/SCID mice (control shRNA, 1/4; sh-GeneD-SP vs. p=0.442 OR (CI 95%)=2,08 (0,44-9,84) and stage p=0.360
MP, 2/4 vs. 0/4; sh-GeneE vs MP, 0/4 vs. 0/4; sh-GeneF- OR (CI 95%)=2,70 (0,39-18,96).
SP vs MP, 2/4 vs. 1/4, respectively). In addition, the SP CONCLUSION: In this study there were no correlation
cells were significantly resistant to liposomal doxorubicin, between fascin expression and survival, also no correlation
gemcitabine and paclitaxel compared to MP cells (p<0.05, between fascin, grade and stage. Further study with
respectively). Moreover, suppression of GeneD significantly more homogen sample, with confounding factors which
increased cisplatin and paclitaxel IC50 values compared are analysed and the bigger number of the sample are
to control cells (p<0.05, respectively). In conclusion, we required.
identified six genes, whose down-regulation contributed
244
YS1-04 2000, 2000 to 3000, 3000 to 4000, 4000 to 5000,5000
to10000, 10000 to 15000, 15000 to 20000, 20000 to
Optimization of cytoreductive surgery in
25000,… the number of cases in these ranges of serum Ca
relation to CA-125 in epithelial ovarian cancer
125 values and the number of cases with residual disease
studied. Majority of patients ( 125 Patients) studied had
Jayashree Natarajan, Uma Devi, Uththamchand Dyanchand
ca 125 values less than 1000. The value of Ca125 ranged
Bafna
between 20- 29324. The study showed 37 out of 194
Department of Gynecological Oncology, Kidwai Memorial Institute
(19.07%) patients studied had macroscopically visible
of Oncology, Bangalore, Karnataka, India
residual disease. The significance of values of serum ca
125 in patients in relation to the operability with optimal
OBJECTIVE: OPTIMISZATION OF CYTO REDUCTIVE
cytoreduction studied by linear regression analysis. This
SURGERY IN RELATION TO CA125 IN EPITHELIAL OVARIAN
study showed optimal cytoreduction in Carcinoma ovary is
CANCER Dr Jayashree N, Dr .Uma K Devi, Dr UD Bafna
not significantly related to the preoperative serum Ca 125
Department of Gynaecological Oncology, Kidwai Memorial
values.The correlation coefficient of serum Ca125 values
Institute of Oncology, Bangalore, Karnataka, India. PIN- and number of cases with optimal cytoreduction shows
560029 ABSTRACT INTRODUCTION: Estimation of serum no significance. Discussion: The value of Serum Ca 125
levels of Ca 125 plays an important role in evaluation of values though significantly raised in carcinoma ovary cases
ovarian masses.Ca 125 is a non specific marker for ovarian the absolute value of preoperative serum Ca 125 has no
malignancy. Even in patients with ovarian malignancy correlation with the operability and optimal cytoreduction.
the level of Ca 125 varies significantly over a wide range.
The role Of Ca125 as a diagnostic and prognostic tool in
malignant ovarian tumors,and in the follow up patients
operated has been studied in various studies. The absolute YS1-05
value of Ca 125 varies widely,with even values less than

Targeted gene silencing using follicle-
hundred to several thousands. The outcome of surgery
stimulating hormone peptide and MUC16
in patients with epithelial ovarian cancer depends on the
promoter-modified nanoparticles improves its
optimal cyto reduction . When patients are optimally cyto
efficacy in ovarian cancer
reduced with no macroscopic residual disease, patients are
found to have good survival. In this study the significance Xiaoyan Zhang, Shanshan Hong, Mingxing Zhang, Mo Che,
of absolute values of Ca 125 is compared with possibility of Liangqing Yao, Congjian Xu
achieving optimal cytoreduction in patients with epithelial
Department of Obstetrics and Gynecology, Hospital of Fudan
ovarian cancer. STUDY DESIGN : In the present study a University, Shanghai, China
retrospective cohort of 194 cases of epithelial ovarian Young Doctors
Session I
cancer with stage III disease operated between Jan 2014 OBJECTIVE: Most patients with ovarian cancer are
to March 2015 were studied for the correlation of ca125 diagnosed at advanced stages and have only a 30%
values and optimization in cytoreduction. Inclusion criteria 5-year survival rate. The treatment for these patients is a
– a)cases of Carcinoma ovary who had undergone primary combination of cytoreductive surgery and chemotherapy.
cytoreduction b)histologically confirmed Stage III epitheial However, conventional chemotherapy has inevitable
ovarian cancer were included in the study. Exclusion criteria drawbacks because of the side effects from nonspecific
–a)Cases of ovarian carcinoma with stage I,II, IV disease bio-distribution of chemotherapeutic drugs. Thus, we
; b) cases of ovarian cancer who has undergone interval developed follicle-stimulating hormone receptor (FSHR)-
cytoreduction after Neoadjuvant chemotherapy. RESULTS: targeted short interference RNA (siRNA) plasmid delivery
The average age of the patients were 51.7 ( with standard system, which could deliver sufficient therapeutic genes
deviation 10.14).The average of Ca 125 for the patients into target cancer cells and therefore bring fewer side
studied was 1730.85.The patients were charted as per their effects and increase efficacy. The shRNA targeted to growth
Ca125 values. i.e., Ca 125 values less than 1000, 1000 to regulated oncogene (gro- ) was synthesized and the shRNA
245
plasmid promoted by MUC16 promoter. Then polyethylene chemotherapy, who showed disease progression to stage
glycol-polyethylenimine nanoparticles were connected with IIIB. Thus, we did LEER including left pelvic wall resection,
the shRNA plasmid and nano compound were modified partial cystectomy and nerve-sparing surgery in right
with FSH β 33-53 peptide. The particle size and Zeta side for pelvic organ preservation. Although she received
potential of nano compound were measured using particle adjuvant chemotherapy, PFS was one month due to
size /Zeta potential instrument. In vitro studies showed right pelvic wall recurrence, so she received concurrent
that the modification of FSH β 33-53 peptide and MUC16 chemoradiation (CCR). However, we performed LEER with
promoter enhanced cytotoxic effects of gro- shRNA. In TPE due to disease progression during CCR. Thereafter,
vivo studies showed that the targeted nano compound she receives palliative chemotherapy with PFS of 3 months.
we prepared possessed higher antitumor efficacy against The third patient had incidentally detected mucinous
FSH receptor-expressing tumors compared with the nano adenocarcinoma of the cervix after hysterectomy (stage
compound without FSH peptide and MUC16 promoter. IB1), and received CCR. After 6 months, she showed left
This study indicated that FSH binding peptide and MUC16 pelvic recurrence. Thus, we did total peritonectomy with
promoter-mediated drug delivery system exhibited high lymphadenectomy in addition to LEER with TPE because
potential in the treatment of ovarian cancer. of undetected peritoneal seeding on preoperative imaging
studies. The forth patient had stage IIB disease (SCC), who
wants fertility preservation. Thus, she received three cycles
YS1-06 of neoadjuvant chemotherapy, then underwent LEER in left
pelvic wall, type C1 nerve sparing parametrectomy in right
Laterally extended endopelvic resection:
side, right uterine-artery preserving trachelectomy with
Extended application for primary or recurrent
McDonald operation, and ovarian tissue cryopreservation.
cervical cancer
Finally, we obtained R0 resection margin in all patients.
Maria Lee
In spite of short learning curve of five cases for LEER,
operation time was decreased gradually from 760 to 360
Department of Obstetrics and Gynecology, Seoul National
minutes, and a number of transfusion was also reduced
University Hospital, Seoul, Korea
from 47 to one. There were no life-threatening events in
the four patients, who show improved quality of life except
OBJECTIVE: Laterally Extended Endopelvic Resection (LEER)
controlled pelvic pain in the two patients with progressive
has been considered for surgical resection of pelvic side
disease.
wall recurrence in patients with cervical cancer. I introduce
CONCLUSION: LEER can be applied from recurrent disease
my experience in LEER for patients with primary or
in pelvic side wall to primary tumor showing resistance to
recurrent cervical cancer.
platinum or radiotherapy or fertility preservation requiring
METHODS: From March 2014 to September 2015, four
trachelectomy without radiotherapy. We will expand the
Young Doctors
patients received LEER, and one underwent it twice among

Session I
indication of LEER through more experience based on the

them. For LEER, internal iliac vessel system was removed,
concept of ontogenetic surgery.
and adjacent pelvic wall muscles such as obturator internus,
pubococcygeus, iliococcygeus and coccygeus were resected
depending on tumor location. After surgery, R0 resection
margin was evaluated on pathologic report.
RESULTS: The first patient had recurrent cervical cancer
(stage IB1, squamous cell carcinoma [SCC]), which
developed 4 months after primary treatment. Tumor size
was 5 cm, and invaded right pelvic wall including bladder
and sigmoid colon. She received LEER with total pelvic
exenteration (TPE) followed by adjuvant chemotherapy, and
Progression-free survival (PFS) was 7 months. The second
patient (stage IIB, SCC) received 3 cycles of neoajduvant
246
Young Doctors Session II
CHAIRPERSON
Junzo Kigawa (Japan) Soo Young Hur (Korea)
SPEAKERS
The journey to move Thailand towards minimally invasive surgery
in gynecologic oncology
Navamol Lekskul (Thailand)
Role of UTZ as an alternative to CT scan in assessing para-aortic lymph node

metastasis
Ana Dy-Echo (Philippines)
Possible surrogate marker for an effective dose-dense chemotherapy in

treating ovarian cancer
Chueh-Yi Huang (Taiwan)
The role of subcutaneous suction drain following median laparotomy in

gynecological oncosurgery
Leena Rose Johnson (India)
Whether the lower extremity deep thrombosis affect the prognosis of

endometrial carcinoma?
Zhiqi Wang (China)
Malignant ovarian germ cell tumour: the role of lymphadenectomy and VAC
chemotherapy
Siew Fei Ngu (Hong Kong)
247
YS2-01 conducted to determine the role of ultrasound in the
detection of para-aortic lymph node metastasis among
The journey to move thailand towards
patients diagnosed with endometrial cancer.
minimally invasive surgery in gynecologic
METHODS: Patients diagnosed with endometrial cancer
oncology
underwent preoperative sonographic evaluation of the
para-aortic area. Identified lymph nodes were described
Navamol Lekskul
in terms of number, size and morphology. The patients
subsequently underwent abdominal hysterectomy with
Bangkok, Thailand
bilateral salpingo-oophorectomy, pelvic lymph node
dissection and para-aortic lymph node evaluation and/
OBJECTIVE: Since the adoption of minimally invasive surgery
or sampling. Intraoperatively identified lymph nodes were
in gynecologic oncology, there have been established
described in terms of number, size and morphology. If
advantages in terms of postoperative pain, blood loss, possible, sampling of the para-aortic lymph nodes was
length of hospital stay, and postoperative complications. done, and specimens were submitted for histopathologic
With the increasing number of studies on oncologic evaluation. RESULTS: Forty-eight patients were included
outcome, the absence of significant adverse effects was in the study. On sonographic evaluation, 8 had positive
confirmed. However, despite the technical feasibility, findings. Positive nodes were either single of multiple, with
minimally invasive surgery requires surgeons’ particular sizes ranging from 1.2 to 5.1 cm. These were either ovoid,
expertise, as well as a dedicated team of operating theatre elongated, lobulated, reniform or globular, hypoechoic,
staff. Consequently, the proper trainings of the surgeons with or without central echogenicity. With intraoperative
and the team are exceptionally crucial. The other concern evaluation as standard, ultrasound had a sensitivity of
is inevitably the cost. In the developed countries with the 85.71%, specificity 95.12%, positive predictive value of
high cost of hospital stay, minimally invasive surgery is 75%, negative predictive value of 97.5%, and accuracy
proved to be cost-efficient based on decreasing length of of 93.75%. Among the 32 patients with histopathologic
hospitalization and recovery time. In contrast, the expenses evaluation of the para-aortic lymph nodes, ultrasound was
for novel instruments and prolonged operative time shown to have a sensitivity of 50%, specificity of 93.33%,
might outweigh the mentioned benefits, especially in the positive predictive value of 66.67%, negative predictive
developing countries. The application of the inexpensive value of 96.55%, and accuracy of 90.62%. CONCLUSION:
instruments, invention and adaptation of the affordable Ultrasound is a low cost diagnostic tool with acceptable
devices and proficient resource management will help sensitivity, specificity and accuracy in the detection of
justify the pertinent conduction of minimally invasive para-aortic lymph node metastasis among patients with
surgery. endometrial cancer.
YS2-02 YS2-03
Young Doctors
The utility of sonography as a low-cost Possible surrogate marker for an effective

Session II
diagnostic tool for para-aortic lymph node dose-dense chemotherapy in treating ovarian
metastasis in gynecologic malignancies cancer
Ana Victoria Dy Echo, Maria Divina Gracia Macalinao, Chueh-Yi Huang

Angelito Magno, Jericho Thaddeus Luna
Division of Gynecologic Oncology, Department of Obstetrics and
Department of Obstetrics and Gynecology, Philippine General Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
Hospital, Antipolo, Philippines
For ovarian cancer, chemotherapy refinement and
OBJECTIVE: This prospective descriptive study was optimization might be the other focus to overcome the
249
development of drug resistance and improve the survival or confirmed gynecological cancer from 30/4/2014 to
of the patients. Nowadays studies are still seeking another 22/4/2015 at Regional Cancer Centre,Thiruvananthapuram.
possible mode, schedule or regimen in order to overcome The study was registered with Clinical Trials Registry-India
the drug resistance issue in ovarian cancer treatment. (CTRI/2014/04/004558).Patients with subcutaneous fat
Among them, evidences have suggested a therapeutic thickness, >2cm (as measured intra-operatively), were
role of "dose-dense" (DD) schedule of chemotherapy, no included in the trial.Patients with clean wounds;those who
matter as the first-line or salvaged setting. Notably, DD underwent mesh repair of abdominal wall, or immediate
chemotherapy also exhibits therapeutic efficacy in drug- re-laparotomy were excluded from the trial. Subjects were
resistant disease. We speculated that there should be randomized into either the Drain arm or the No Drain arm.
mechanism (other than cytotoxicity) responsible for the In the Drain arm a suction drain (no.14 ) was applied along
tumor killing, which has been jeopardized in traditional the subcutaneous plane after closing the rectus sheath.
The drain was removed on the third postoperative day.The
maximum tolerated dose (MTD) chemotherapy. Previously
primary outcome measured was the incidence of superficial
we have documented a correlation between the induction
surgical site infection as defined by Centers for Disease
of serum interferon-gamma (IFN-γ) and interleukin-2 (IL-
Control and Prevention.Patients were followed up for 30
2) and the efficacy of chemotherapy by weekly low-dose
postoperative days. The baseline characteristics of subjects
carboplatin and paclitaxel in the patients having platinum-
in both arms were compared using descriptive statistics. In
resistant ovarian cancer, indicating a role of anti-tumor
addition, bivariate and multivariate analysis were performed
immunity in the DD chemotherapy.
using R (ver.3.1.3). A p value of < 0.05 was considered to
This project is to dissect the possible molecule responsible
be statistically significant
or as a surrogate marker for the immunogenic event.
RESULTS: 218 patients were included in the study (Drain:107
We have noted that DD chemotherapy acts through an
(49%); No Drain: 111 (51%)). Superficial surgical site
inflammasome-related pathway where NK and also γδ T
infection (s-SSI) occurred in 6/107 (5.6%) and 13/111
cells were triggered. We further evaluated the alteration (11.7%)in the Drain and No Drain arms respectively (p:
of IL-1β, IL-18, caspase-1 and NLRP3. These early events 0.14,OR (95%CI):0.44 (0.13-1.32). Logistic regression
could be a surrogate biomarker suggesting a successful DD analysis with the occurrence of s-SSI as dependent
chemotherapy in ovarian cancer. variable and subcutaneous fat thickness; arm of the study;
and duration of surgery as independent variables was
performed. A statistically significant relationship was found
YS2-04 between subcutaneous fat thickness > 5 cm and incidence
of s-SSI (OR (95% CI): 4.37 (1.49-12.80) [p: 0.007]. There
The role of subcutaneous suction drain was no significant difference in mean subcutaneous fat
following median laparotomy in gynecological thickness between both the arms.Among subjects in the
oncosurgery Drain arm, there was a statistically significant difference
in daily drain yield between those with sub-cutaneous fat
Leena Rose Johnson, Suchetha Sambasivan, Rema thickness ≤5 cm (12ml/day) and those with sub-cutaneous
Prabhakaran Nair, Iqbal Ahamed, Liaquat Roopesh Johnson
fat thickness >5 cm (35ml/day).In the 25 patients with
Young Doctors
Session II
Division of surgical oncology, Regional Cancer Centre, subcutaneous fat thickness>5cm,1/13 patients in the Drain
Thiruvananthapuram, India arm and 5/12 patients in the No Drain arm developed s-SSI
(p value-0.073,OR (95%CI):0.12 (0.002-1.469).
OBJECTIVE: To investigate whether subcutaneous suction CONCLUSION: The placement of a sub-cutaneous suction
drain would decrease the superficial surgical site infection drain was not found to be beneficial in prevention of s-SSI.
rate (s-SSI) following median laparotomy in gynecological However, both the daily drain output and occurrence
oncosurgery. of s-SSI were significantly higher in patients with sub-
METHODS: This article presents the interim analysis report cutaneous fat thickness >5 cm.Although not statistically
of a prospective randomized controlled trial on patients significant,avoidance of subcutaneous drains in this
who underwent elective median laparotomy for suspected subgroup may be associated with increase in s-SSI.
250
YS2-05 41.7 months and 66.5 months, there was no difference (t
= 1.588, P = 1.588). Thrombus group 3 patients recurred
Endometrial cancer patients with lower limbs
(3/10), control group 52 cases (12.3%) recurred. There was
deep vein thrombosis
no differences between the two groups (X2 = 1.387, P =
1.387). CONCLUSION: Patients with endometrial carcinoma
Zhiqi Wang, Sichen Liang, Wei Xia, Jianliu Wang
postoperative lower limb deep vein thrombosis is associated
Department of Obstetrics and Gynecology, Peking University
with old age and late stage, but had no obvious effect on
People's Hospital, Beijing, China
treatment and prognosis.
OBJECTIVE: OBJECTIVE: To study the relationship of

postoperative lower limb deep vein thrombosis with the
clinical pathological features of endometrial carcinoma YS2-06
patients. METHODS: 432 endometrial carcinoma cases
Malignant ovarian germ cell tumour: The role
admitted in Peking University people's hospital from
of lymphadenectomy and VAC chemotherapy
January 2000 to December 2009 were followed-up and
studied retrospectively. RESULTS: 10 cases (2.3%) with
Siew Fei Ngu1, Mandy Man Yee Chu2, Ka Yu Tse2, Karen Kar
lower limb swelling in examination showed lower extremity Loen Chan1, Philip Pun Ching Ip1, Annie Nga Yin Cheung1,
deep vein thrombosis among the 432 endometrial Hextan Yuen Sheung Ngan1
carcinoma patients were divided into thrombus group. 1
Department of Obstetrics and Gynaecology, The University
The other 422 cases as control group. The average age
of Hong Kong, Hong Kong, 2Department of Obstetrics and
of the two groups were 63.4 +/- 9.3 and 56.4 +/- 10.4 Gynaecology, Queen Mary Hospital, Hong Kong
years old for thrombus group and the control, respectively
(t = 2.103, P = 2.103). The hysterectomy scope was OBJECTIVE: Background. Malignant ovarian germ cell
extrafascial hysterectomy for thrombosis patients (10/10), tumours (MOGCT) are rare and comprise less than 5% of
in the control, 73.0% accepted extrafascial hysterectomy ovarian malignancies. It usually occurs in girls, adolescents
and 27.0% accepted wider hysterectomy. There was and young women. MOGCT are commonly diagnosed at
no statistically significant difference in the two groups early-stage of disease and are very chemosensitive with
(X2 = 3.670, P = 3.670). Pathological types of thrombus high cure rates even in advanced disease. Aims. The aim of
group were all endometrial adenocarcinoma (10/10). in this study was to review all MOGCT managed at our center,
the control group, there were 378 cases of endometrial focusing on the role of lymphadenectomy, and Vincristine,
adenocarcinoma (89.6%) and 44 cases of clear cell Actinomycin-D, Cyclophosphamide (VAC) chemotherapy.
carcinoma, serous carcinoma and squamous cell carcinomas Methods. We performed a retrospective chart review of
(10.4%). There was no statistically significant difference patients managed for MOGCT between January 1986
in the two groups (X2 = 1.161, P = 1.161). The late stage and December 2012. Results. 77 patients were managed
(stage III or IV, FIGO 2010) rate of the thrombus group was for MOGCT at our center. Median age at the time of
higher than the control (4 cases (4/10) and 59 cases (14.0%) diagnosis was 26 years (range, 10-50 years). The histologic
Young Doctors
respectively, X2 = 5.309, P = 5.309). The grade 1, 2 and 3 subtypes included 47 (61%) immature teratoma, 16
Session II
were 2 cases (2/10), 7 cases (7/10), and 1 case (1/10) in the (21%) yolk sac tumours, 9 (12%) dysgerminoma and
thrombus group and were 164 cases (38.9%), 179 cases 5 (6%) mixed germ cell tumours. There were 60 (78%)
(42.5%) and 65 cases (15.4%) respectively. There was no FIGO stage I tumours, 5 (6%) stage II, 11 (14%) stage III
statistically significant difference (P = 0.491). There were 5 and 1 (1%) stage IV disease. Staging operation was done
cases (5/10) and 120 cases (28.4%) received radiotherapy in 53 (69%) patients. Of the 65 patients with clinically
for the two groups. 5 cases (5/10) and 159 cases (37.7%) early stage tumours, 17 (26%) had lymphadenectomy
received chemotherapy.There was no statistically difference and 48 (74%) had no lymphadenectomy performed.
(P = 0.257, P = 0.257). Thrombus group and the control All 17 patients who had lymphadenectomy performed
group were followed up for 45.5 + / - 20.6 months + / - had no lymph node metastasis found on histology. The
251
overall survival was 100% for both lymphadenectomy
and no lymphadenectomy groups. Postoperative adjuvant
chemotherapy was administered to 51 (66%) patients, 38
(75%) of whom received VAC. Complete response and
overall cure rate of VAC regimen was 100% and 89%
respectively when used as first-line postoperative adjuvant
treatment. The median follow-up period was 138 months
(range, 25-349 months) and the overall survival was 97%.
Conclusions. Lymphadenectomy did not provide survival
benefits in patients with clinically early stage MOGCT.
The VAC chemotherapy regimen can be considered as an
option for primary postoperative treatment, especially in
patients with early-stage disease.
Young Doctors
Session II
252
Young Doctors Session III
CHAIRPERSON
Ji-Hong Liu (China) Jong-Hyeok Kim (Korea)
SPEAKERS
The quality of life is patient's life
Krissada Paiwattananupant (Thailand)
Recent reports on gestational trophoblastic diseases in the Philippines

Jimmy Billod (Philippines)
The challenges of cervical cancer screening in Malaysia

Jamil Omar (Malaysia)
Management and outcomes of stage 1C1 epithelial ovarian carcinoma

Chin Hui Xian Felicia (Singapore)
Peri-operative period as a critical target for cancer treatment

Yoo Young Lee (Korea)
253
YS3-01 mole. It was a double-blind randomized controlled trial
involving a total of 99 patients with high-risk complete
The quality of life is patient’s life
hydatidiform mole who underwent suction curettage
were randomly allocated to either the treatment or control
Krissada Paiwattananupant
group. The treatment group received methotrexate while
the control group received a vitamin B complex. Results
Mahidol University, Bangkok, Thailand
showed that there was no significant difference between
the two groups in terms of age, gravidity, baseline βhCG,
The aim of gynecologic malignancy treatment is to
age of gestation, and corpus size. The overall incidence of
improve not only the overall survival rate but also the
PMGTN was 27.9%. For the per protocol analysis, a total
quality of a patient’s life. Quality of life covers the physical,
of 30 patients received chemoprophylaxis while 31 patients
psychological, social and spiritual aspects of a patient’s life.
received placebo treatment. The total incidence of PMGTN
Patients with gynecologic malignancy either in the early
was 16.67% for the treatment group and 38.71% for the
or the advanced stage have some distressful experiences
control group. The computed risk ratio was 0.43 (95% C.I.:
during treatment. The patient’s quality of life is impacted
0.17-1.07, p value = 0.07).
by the nature of disease and required treatment regiment
Another study compared the percentage of patients who
consisting of surgery, radiation and chemotherapy. Adding
developed PMGTN during the 6-month follow up period
palliative care during treatment and end of life treatment
following normalization of βhCG titers compared to the
can not only improve the quality of a patient’s life but also
12-month follow up period. Among the 258 registered
that of their families.
hydatidiform mole patients, 205 patients (79.5%) attained
normal βhCG titers titer levels after evacuation of molar
products. There was no occurrence of PMGTN among
the patients who achieved normalization of βhCG titers
YS3-02
after treatment. βhCG levels did not attain normalization
Recent reports on gestational trophoblastic following evacuation in 53 patients (20.5%). Out of the
diseases in the Philippines 53 patients, 50 patients (94.3%) were detected to have
GTN within the first six months post-treatment while only
Jimmy Awisan Billod 3 patients (5.7%) were determined to have the disease
Section of Gynecologic Oncology, University of the Philippines progression after six months during the one-year follow-up
Manila, Philippine General Hospital, Philippines period. The median time to obtaining normal βhCG levels
is 88 days for those who received chemoprophylaxis and
Gestational Trophoblastic Disease (GTD) is a general term 85 days for those with lower initial βhCG values (less than
used to include tumors derived from abnormal growth 100, 000 mIU/ml).
of trophoblasts. The lesions ranged from the benign to Results on the methotrexate chemoprophylaxis failed to
the malignant form of disease. Broad variations in the reach statistical significance, but the findings may still have
distribution of molar pregnancy exist worldwide with clinical impact particularly in settings where the incidence
higher prevalence in Southeast Asia compared to Europe of hydatidiform mole is high and settings where high
and the United States. In the Philippines, the prevalence probability that patients will fail to follow the stringent
of hydatidiform mole is 2.4 per 1000 pregnancies. The βhCG monitoring schedule after molar evacuation. The
prevalence of choriocarcinoma ad other gestational use of methotrexate may run the risk of incurring toxicities,
Young Doctors
Session III
trophoblastic neoplasia is 0.56/1000 pregnancies. although most reported adverse effects were mild in nature
Two studies were recently completed involving patients with and did not require hospitalization or further treatment.
hydatidiform mole in our institution. The first study aimed Furthermore, the βhCG monitoring after a molar pregnancy
to determine the efficacy of methotrexate in preventing may be reduced for those patients whose serum βhCG
postmolar gestational trophoblastic neoplasia (PMGTN) levels decline earlier to normal levels after evacuation.
among patients with high-risk complete hydatidiform
255
YS3-03 YS3-05
The challenges of cervical cancer screening in Impact of time-of-day on survival outcomes

Malaysia after cytoreductive surgery for advanced
epithelial ovarian, tubal, peritoneal cancer
Jamil Omar, Yong Chee Meng
Department of Obstetrics & Gynecologic, Ampang Hopital,

Yoo-Young Lee, Aera Yoon, Tae-Joong Lim, Chel Hun Choi,
Jeong-Won Lee, Byoung-Gie Kim, Duk-Soo Bae
Malaysia
Department of Obstetrics and Gynecology, Samsung Medical
OBJECTIVE: ABSTRACT Cervical cancer has been a
challenging disease in Asia and especially so in Malaysia.
To evaluate the association between operative start time
In Malaysia, cervical cancer is third in the rank of the
and outcomes following cytoreductive surgery in advanced
commonest cancer in women with Age Standardised
epithelial ovarian, tubal, and primary peritoneal cancer.
Rate of 8.4 per 100,000. Issues related to screening
Methods: We retrospectively enrolled the advanced
have always been unresolved matter, thus in 2010 the
epithelial ovarian, tubal, peritoneal cancer patients (FIGO
Ministry of Health Malaysia, has taken a bold step towards stage III-IV) who underwent cytoreductive surgery at
prevention on cervical cancer in Malaysia by introducing Samsung Medical Center between January 2002 and
Human Papilloma Virus (HPV) vaccination in the school December 2011. Patients were stratified by operative start
vaccination programme. This does not resolve the issues of time into the 3 groups: group I was defined as 7 AM to
screening still, instead we need to reinforce the secondary 11:59 AM, group II as 12 PM to 4:59 PM, and group III as
prevention method of cervical cancer screening. Therefore after 5 PM. Cox prportional hzards regression with variable
we embarked on a pilot study using HPV DNA testing as a selection method was used to evaluate the prognostic
primary screening for cervical cancer and the preliminary significance of operative start time. Results: A total of
data will be discussed. 500 patients with stage III-IV epithelial ovarian (92.6%,
463/500), tubal (4.8%, 24/500), and primary peritoneal
(2.6%, 13/500) cancer were included. Of 500 patients,
YS3-04 285 (57.0%) patients were in group I, 184 (36.8%) in
group II and 31 (6.2%) in group III. Waiting time and year
Management and outcomes of stage IC1 of operation showed difference between groups. The year
epithelial ovarian cancer of operation, optimality of surgery and platinum sensitivity
had a prognostic significance for progression-free survival
Hui Xian, Yong Kuei Lim, Sheow Lei Lim
(PFS), and preoperative albumin and optimality of surgery
Department of Obstetrics and Gynaecology, KK Women's and revealed a prognostic factors for overall survival (OS) in the
Children's Hospital, Singapore multivariable model. Operations starting after 5 PM had
adversely prognostic for PFS comparing with those starting
Iatrogenic rupture at time of surgery - should adjuvant between 7 AM to 11:59 AM (HR 1.92, 95% CI 1.24-2.98,
chemotherapy be given? A 5-year retrospective review p = 0.032). In addition, operations starting between 12
of Stage IC1 epithelial ovarian cancer at KK Women's PM to 4:59 PM (HR 1.55, 95% CI 1.14-2.09, p = 0.004)
and Children's Hospital in Singapore aims to answer this and after 5 PM (HR 1.87, 95% CI 1.07-3.24, p = 0.025)
question, by studying the management and outcomes of showed significantly shorter OS than those starting 7 AM
Young Doctors
these cases. to 11:59 AM. Conclusion: The results of study suggest that
Session III
operative start time could be impact the patients outcomes

who need to extensive surgical procedures. These may
be explain by the association with preoperative fasting
time and prognosis of cancer patients. Further studies are
needed to clarify the effect of operative start time and
patient’s outcomes in ovarian cancer.
256
POSTER SESSION
257
List of Poster Presentation
Session : Ovary
Feasibility and outcomes of laparoscopic cytoreduction in patients with localized
PO-1001 E Sun Paik (Korea)
recurrent epithelial ovarian cancer
PO-1002 Dietary protein restriction inhibits the development of ovarian cancer Ahmed Taha (Japan)
Correlation of hypoxia inducible factor-1α (HIF-1α) and vascular endothelial
PO-1003 Riza Rivany (Indonesia)
growth factor (VEGF) with surgical outcome in epithelial ovarian cancer
Influence of residual tumor on timing of debulking surgery in stage IIIc and IV
PO-1004 Banghyun Lee (Korea)
epithelial ovarian cancer: a systematic review and meta-analysis
Laparoscopic cytoreductive surgery in women with epithelial ovarian cancer:
PO-1005 Jaeman Bae (Korea)
a matched pair study
PO-1006 The growing teratoma syndrome; regional cancer institute experience Praveen Rathod (India)
PO-1007 Role of PET/CT in recurrent ovarian cancer Kanika Batra (India)
AXL gene expression as a marker for the stemness and chemoresistance of
PO-1008 Chi-Heum Cho (Korea)
cancer stem-like cells in ovarian cancers
Clinical value of HE4 in response assessment after neoadjuvant chemotherapy in
PO-1009 Shiv Rajan (India)
advance stage ovarian carcinoma
Adjuvant concurrent chemoradiation followed by chemotherapy for high-risk
PO-1010 Yulan Ren (China)
endometrial cancer
Aggressive behavior in a subset of intraepithelial carcinoma of ovarian mucinous
PO-1011 Phill-Seung Jung (Korea)
tumors
Risk factors of para-aortic lymph node metastasis in endometrial cancer: Tricia Dewi Anggraeni
PO-1012
A retrospective study (Indonesia)
Margin status of conization specimen obtained by see-and-treat strategy and
PO-1013 Doo Haeng Lee (Korea)
three-step strategy
Incorporation of 3 dimensional printer in management of early stage cervical
PO-1014 Min-Hyun Baek (Korea)
cancer: a case report
Investigation of new therapeutic targets in undifferentiated endometrial
sarcoma
Prognostic value of preoperative total lesion glycolysis in patients with uterine
PO-1016 Hyun Hoon Chung (Korea)
carcinosarcoma
Incidence of epithelial ovarian cancer according to histologic subtypes in Korea,
PO-1017 Se Ik Kim (Korea)
1999-2012
The CA-125 level after neoadjuvant chemotherapy for relapse free survival
PO-1018 Youjung Lee (Korea)
prediction in patients with advanced ovarian cancer
PO-1019 Case series of struma obarii and strumal carcinoid-KMIO experience Jayashree Natarajan (India)
PO-1020 Rare case of primary leiomyosarcoma of ovary Jayashree Natarajan (India)
Expression of Factor-inhibiting hypoxia inducible factor predicts survival of high-
PO-1021 Yemi Bahk (Korea)
Poster Session
grade serous carcinoma of the ovary

Maspin as an angiogenetic factor affecting platinum resistance in high-grade
PO-1022 Seungmee Lee (Korea)
serous adenocarcinoma of the ovary
259
Session : Ovary
Diaphragmatic procedures in ovarian cancer - evolution, complications and
PO-1023 Sonia Mathai (India)
management: experience at TATA Medical Center, KOLKATA, INDIA11
IGFBP5-derived peptide as a novel angiogenesis inhibitor for treatment of

PO-1024 Eun Jin Heo (Korea)
ovarian cancer
Proton pump inhibitors enhance the effects of cytotoxic agents in

PO-1025 Eun Jin Heo (Korea)
chemoresistant epithelial ovarian carcinoma
Three case reports of stage I borderline ovarian tumors accompanied massive

PO-1026 Ai Miyoshi (Japan)
ascites
Four pathological subtypes of high-grade serous adenocarcinoma of ovary,

PO-1027 Takuma Ohsuga (Japan)
Fallopian tube and peritoneum demonstrate distinct clinical features
PO-1028 Retrospective analysis of epithelial Borderline ovarian tumors Sho Sato (Japan)
Long-term clinical outcome of patients with ovarian clear-cell adenocarcinoma

PO-1029 Kenichi Nakamura (Japan)
at reproductive age
Feasibility study of pegylated liposomal doxorubicin and gemcitabine for

PO-1030 Hidekatsu Nakai (Japan)
platinum resistant ovarian cancer
Loss of ARID1A expression is associated with poor prognosis in patients with

PO-1031 Hiroaki Itamochi (Japan)
stage I/II clear cell carcinoma of the ovary
Investigation of ovarian cancer biomarker patterns in blood plasma by

PO-1032 Jinghui Jin (Korea)
differential scanning calorimetry and mass spectrometry
Analysis of Her2/neu expression in advance stage ovarian carcinoma undergoing

PO-1033 Shiv Rajan (India)
neoadjuvant chemotherapy- A tertiary care center experience from India
Transvaginal ultrasound-guided biopsy of adnexal masses as a useful diagnostic

PO-1034 alternative replacing cytology or laparoscopy in advanced ovarian cancer Tae-Wook Kong (Korea)
patients
Radiotherapy for persistent malignant transformation from mature cystic

PO-1035 Kosuke Yoshida (Japan)
teratoma of the ovary
PO-1036 Twist promotes angiogenesis via CXCL11 in ovarian cancer cell Jin Hwa Hong (Korea)
Is there any association between retroperitoneal lymphadenectomy and survival

PO-1037 Masako Shida (Japan)
benefit in advanced epithelial ovarian carcinoma patients?
PO-1038 Intraperitoneal chemotherapy with paclitaxel and carboplatin, a feasibility study Young-Han Park (Korea)
Standard or goal directed intra-operative fluid therapy in ovarian cancer

PO-1039 Basumita Chakraborti (India)
cytoreductive surgery
PO-1040 Infections after ovarian cancer cytoreductive surgery: a retrospective audit Basumita Chakraborti (India)
PO-1041 HDAC7 inhibitor might inhibit HIF-1 activity In ovarian clear cell adenocarcinoma Takeshi Hirasawa (Japan)
Validation of revised FIGO staging system in stage IC mucinous epithelial ovarian

PO-1042 Phill-Seung Jung (Korea)
cancer
Accuracy of a combined use of pre-operative magnetic resonance imaging and

PO-1043 Uchul Ju (Korea)
intra-operative frozen section analysis for borderline ovarian tumors
Clinical impact of systematic lymphadenectomy for early stage epithelial ovarian

PO-1044 Masae Ikeda (Japan)
cancer
Poster Session
Impact of surgical staging on prognosis in patients with borderline ovarian

PO-1045 Seung-Hyuk Shim (Korea)
tumors: a meta-analysis
260
Session : Ovary
Prognostic significance of the Recurrence pattern and Risk factors for survival in
PO-1046 ovarian cancer patients with No gross residual disease after Primary Debulking E Sun Paik (Korea)
Surgery
Differences in survival outcome of recurrent Epithelial Ovarian Cancer patients

PO-1047 with Secondary Cytoreductive Surgery diagnosed recurrence by different initial E Sun Paik (Korea)
diagnostic method
Lipocalin2 enhances the tolerance against oxidative stress in clear cell carcinoma
PO-1048 Yasuhi Yamada (Japan)
cells through the upregulation of CD44 variant
A new microchip system for isolating circulating tumor cells (CTC) in epithelial
PO-1049 Maria Lee (Korea)
ovarian cancer patients
PO-1050 Profiling of epithelial ovarian cancer with BRCAness status Akira Hirasawa (Japan)
Pathologic Findings at Risk-Reducing Salpingo-Oophorectomy in patients with

PO-1051 breast cancer: significance of RRSO completion at proper age in germline BRCA Young-Jae Lee (Korea)
mutation carriers
Isolated suprafacial intramuscular tumor metastatic from primary ovarian serous

PO-1052 Yihung Sun (Taiwan)
cystadenoacarcinoma - A case report
Prevalence of subsequent ovarian cancer and oophorectomy after hysterectomy: Charuwan Saeteng
PO-1053
a 10-year experience at Chiang Mai University Hospital (Thailand)
Preoperative predictive factors for early recurrence in epithelial ovarian

PO-1054 and peritoneal cancer with incomplete cytoreduction after neo-adjuvant Min-Hyun Baek (Korea)
chemotherapy
Evaluation of prognostic factors for better survival outcome in secondary cyto

PO-1055 Jayashree Natarajan (India)
reduction in epithelial ovarian cancer
Impact of Interval from Definitive Surgery to Initiation of Adjuvant

PO-1056 Eun jin Heo (Korea)
Chemotherapy (ISC) on Survival for Advanced Epithelial Ovarian Cancer
Outcomes of laparoscopic fertility-sparing surgery in presumed early-stage

epithelial ovarian cancer
Nintita Sripaiboonkij
PO-1058 Survival rate for ovarian cancer in Thailand: Hospital base cancer registry
(Thailand)
Aberrant epigenetic regulation of gamma-aminobutyrate type A receptor pi

PO-1059 Woong Ju (Korea)
subunit (GABRP) associated with aggressive phenotype of ovarian cancer.
Preoperative prediction of cardiophrenic lymph node metastasis in advanced

PO-1060 Sang-Yoon Park (Korea)
ovarian cancer using computed tomography
Improved postoperative pain control for cytoreductive surgery in women with

PO-1061 Sang-Yoon Park (Korea)
ovarian cancer using patient-controlled epidural analgesia
TWIST expression as a predictor of unfavorable prognosis for epithelial ovarian

PO-1062 Ki Hyung Kim (Korea)
cancers
Expression of interactive genes associated with apoptosis and their prognostic

Poster Session

value for ovarian carcinoma
PO-1064 Obesity and ovarian cancer based on SRA-1 gene overexpression Inok Lee (Korea)
261
Session : Uterine Cervix
PO-2001 SIRT1 is a novel candidate of therapeutic target for ovarian carcinoma David Mvunta (Japan)
PO-2002 CIN outcome in postpartum patients Rie Urabe (Japan)
Correlation of CTR1, ERCC-1, and HSP70 expressions with cisplatin response in Brahmana Askandar
PO-2003
cervical cancer stage IIB (Indonesia)
Chemotherapeutical efficacy and toxicity of carboplatin as alternative Gatot N A Winarno
PO-2004
radiosensitizer compared to cisplatin in advanced stage of cervical cancer (Indonesia)
Chemotherapy and small cell neuroendocrine carcinoma of the uterine cervix:
PO-2005 Tze-Chien Chen (Taiwan)
a retrospective Taiwanese gynecologic oncology group (TGOG) study
High-dose oral tegaful-uracil maintenance therapy in patients with uterine
PO-2006 Isao Sakaguchi (Japan)
cervical cancer
Comparison of semiquantitative models: Fas Ligand (FasL) in association with Tricia Dewi Anggraeni
PO-2007
Tumor-Infiltrating Lymphocytes (TILs) in early stage cervical cancer (Indonesia)
Henny Meitri Andrie
PO-2008 Cervical cancer screening awareness in Jakarta
Rachmasari Putri (Indonesia)
Less radical surgery than radical hysterectomy in patients with stage 1 cervical Tomas Pichlik
PO-2009
cancer (Czech Republic)
Pretreatment factors associated with recurrence for patients with cervical cancer
PO-2010 Shih-Chieh Liu (Taiwan)
FIGO stage IB1 disease
Video demonstration of development of vaginal cuff in cancer cervix robotic
PO-2011 Kanika Batra (India)
hysterectomy cases
A novel highly sensitive and specific flow cytometry system for cervical cancer
PO-2012 Masakatsu Morita (Japan)
screening
Are our patients different? A 5-year review of cervical cancer cases managed in Alik Riasadesa Zakaria
PO-2013
tertiary cynaecological cancer unit in Malaysia (Malaysia)
Expression of P16, P53, IMP3, Bcl-2 and C-FLIPL and their clinical significance in
PO-2014 Xiaofeng Wang (China)
pre-malignant and malignant lesions of uterine cervix
Squamous carcinoma versus adenocarcinoma of the cervix: a 5-year single Alik Riasadesa Zakaria
PO-2015
institution review (Malaysia)
Surgical resection margin including parametrium and vagina significantly
PO-2016 correlates with survival of FIGO stage IB cervical cancer patients treated with Tae-Wook Kong (Korea)
radical hysterectomy: multivariate analysis of 360 patients
Adverse impact of bulky (≥2 cm) pelvic lymph node involvement determined by
PO-2017 magnetic resonance imaging in FIGO stage IIB cervical cancer patients treated Tae-Wook Kong (Korea)
with primary concurrent chemoradiation therapy
PO-2018 Regulation of radiation by autophagic modulator Yoon Kyung Lee (Korea)
Prognostic factors of oncological and reproductive outcomes in fertility-sparing
PO-2019 treatment of complex atypical hyperplasia and low grade endometrial cancer Rong Zhou (China)
using oral progestin in Chinese patients
PO-2020 A scoring system to predict the risk of uterine sarcoma in patients with a uterine mass Jung-Yun Lee (Korea)
Modified cervicography and visual inspection with acetic acid, an alternative
PO-2021 Gatot Purwoto (Indonesia)
screening for cervical cancer
Poster Session
Preoperative predictive factors for complete cytoreduction and survival outcome

in epithelial ovarian and peritoneal cancer after neo-adjuvant chemotherapy
262
Session : Uterine Cervix
PO-2023 Two rare variants of carcinoma cervix and review of literature Seema Singhal (India)
Robotic radical hysterectomy with extended lymphadenectomy and resection of
PO-2024 rectouterine ligament after neoadjuvant chemotherapy for stage IIB-IIIA locally Yoon Hee Lee (Korea)
advanced cervical cancer: a pilot study
PO-2025 Factors associated with participation in cervical cancer screening in Korea Ha Kyun Chang (Korea)
Circulating Retinol Binding Protein-4 (RBP4) concentration and CD4+:CD8+ T
cells ratio in normal cervix, with or without High Risk Human Papilloma Virus Tofan Widya Utami
PO-2026
(HPV) infection and cervical cancer: a Preliminary study in immunity towards (Indonesia)
cancer
Abdominal Radical Trachelectomy:
PO-2027 Jin Li (China)
What Can We Learn from the Recurrent Cases
Radical abdominal trachelectomy for cervical malignancies: Surgical, oncological
PO-2028 Jin Li (China)
and fertility outcomes from 10-years experience
Comparison of treatment response and survival of chemoradiation between
PO-2029 cisplatin-ifosfamide three-weekly and cisplatin-weekly on locally advanced Oni Khonsa (Indonesia)
cervical cancer (IIB - IIIB)
Paradoxical expressions of hypoxia-inducible factor-1α and apelin affecting
PO-2030 So Yeon Kim (Korea)
cervical carcinogenesis and prognosis
PO-2031 HER2 as a novel therapeutic target for cervical cancer Eun Jin Heo (Korea)
Examination of the indication of the adjuvant therapy after radical hysterectomy
PO-2032 Toshinori Kawagoe (Japan)
for the uterine cervix cancer
The prognostic value of squamous cell carcinoma antigen for predicting tumor
PO-2033 Seok Mo Kim (Korea)
recurrence in cervical squamous cell carcinoma patients
Squamous cell carcinoma predicts favorable post-recurrence survival in uterine
PO-2034 Shino Tanaka (Japan)
cervical cancer.
Correlation of lymph vessels invasion with pelvic lymph node metastasis in
PO-2035 Manuel Hutapea (Indonesia)
cervical cancer stage I B and II A
Serum level of Vascular endothelial growth factor (VEGF) and Squamous cell
PO-2036 carcinoma (SCC) antigen as markers of response of radiation therapy in cervical Ferry Armanza (Indonesia)
cancer
Metastatic adenocarcinoma of lung from primary cervical adenosquamous
PO-2037 Yihung Sun (Taiwan)
carcinoma – one case report
The minimum absolute lymphocyte count during concurrent chemoradiotherapy
PO-2038 Oyeon Cho (Korea)
in cervical cancer : a strong survival predictor
Comparison between robotic-assisted radical hysterectomy and abdominal
PO-2039 Yasushi Kotani (Japan)
radical hysterectomy
Relationship between removal of circumflex iliac nodes to the distal external iliac
PO-2040 Sho Takeshita (Japan)
nodes and postoperative lower-extremity lymphedema in uterine cervical cancer
Wertheim’s hysterectomy: a comprehensive 5-year review of surgical profiles Alik Riasadesa Zakaria
PO-2041
and complications in a tertiary gynaecological oncology unit in Malaysia (Malaysia)
Analysis of the correlation of MRI findings and pathological diagnosis in cervical
PO-2042 Ayako Suzuki (Japan)
Poster Session
cystic lesion
Pretreatment risk factors for parametrial involvement in FIGO stage IB1 cervical
PO-2043 Hiroyuki Yamazaki (Japan)
cancer
263
Complications of laser conization versus loop electrosurgical excision procedure
PO-2044 Kiyoshi Hasegawa (Japan)
in pre- and postmenopausal patients
PO-2045 Re-irradiation using helical tomotherapy for recurrent cervical cancer Myungsoo Kim (Korea)
Usefulness of a management protocol for preoperative diagnosis and the
PO-2046 treatment of patients with multi-cystic lesions of the uterine cervix: Koichi Ida (Japan)
a retrospective analysis of 94 cases
The risk factors and rate for progression of cervical intraepithelial lesions in HPV
PO-2047 16 or 18 infected women with ASCUS or LSIL within one year: The Korean HPV Taejin Kim (Korea)
cohort study
A lectin-based diagnostic system using circulating antibodies to detect cervical
PO-2048 Jinghui Jin (Korea)
intraepithelial neoplasia and cervical cancer
Comparison of quality of life and sexual function between cervical cancer
survivors and healthy women
Comparison of quality of life and sexual function between cervical cancer
PO-2050 Myong Cheol LIM (Korea)
survivors and healthy women
PO-2051 Surgical anatomy imaging associated with radical hysterectomy Masaru Nakamura (Japan)
Robotic radical hysterectomy or trachelectomy through vaginal colpotomy for
PO-2052 Hyun Ju Lee (Korea)
early cervical cancer: a study of 31 cases
PO-2053 Conservative treatment in women with Adenocarcinoma In Situ of the cervix Ho Sun Choi (Korea)
Characteristic and survival rate of patient with advanced stage cervical cancer Fitriyadi Kusuma Djajasasmita
PO-2054
that given adjuvant therapy in cipto mangunkusumo hospital, Jakarta (Indonesia)
Concurrent chemoradiation is better than systemic chemotherapy as a
PO-2055 Young-Han Park (Korea)
postoperative adjuvant therapy in advanced cervical cancer
Neoadjuvant chemotherapy followed by postpartum chemoradiotherapy for Lukkana Promwattanaphan
PO-2056
stage IB2 glassy cell cervical carcinoma during pregnancy (Thailand)
Presentation of HIV-infected among women with female cancer: Nintita Sripaiboonkij
PO-2057
hospital base cancer registry (Thailand)
Incidence rate of cervical intraepithelial neoplasia and cancer (CIN3+) among
PO-2058 women with abnormal Pap smear who underwent colposcopy test: 20 years
(Thailand)
cohort study
Laparoscopic cervicoisthmic cerclage to prevent preterm birth in second
PO-2059 Ya-Min Cheng (Taiwna)
trimester
Effect of Body Mass Index (BMI) on treatment outcome of patients with cervical
cancer (IB1 to IVA)
Prognostic factors affecting survival in cervical cancer patients who had
PO-2061 E Sun Paik (Korea)
recurrent parenchymal lung lesion
Factors effecting with of cervical intraepithelial neoplasia and cancer (CIN3+)
PO-2062 among women with abnormal PAP smear who underwent colposcopy test: 20
(Thailand)
years cohort study
PO-2063 Survival rate for cervical cancer in Thailand: Hospital base cancer registry
(Thailand)
Novel effects of narrow-band low-energy, middle-infrared radiation (MIR) in
PO-2064 Bor-Ching Sheu (Taiwan)
enhancing the anti-tumor activity of paclitaxel
Phospoinositide 3-Kinase (PI3K) inhibitior-induced FOXO3a nuclear translocation
PO-2065 determines synergistic anti-tumor effect of combined treatment of PI3K and Woong Ju (Korea)
Poster Session
autophagy inhibitors
Changes in bone density after cancer treatment in patients with cervical and
endometrial cancer
264
Session : Uterine Corpus
Infection profile among patients with endometrial carcinoma in an oncology
PO-3001 Basumita Chakraborti (India)
centre in Eastern India
Clinicopathological profile of endometrial hyperplasia, endometrial

PO-3002 Sabuhi Qureshi (India)
intraepithelial neoplasia and endometrial carcinoma
The influence of chemotherapy on vaginal microecology and its mechanism in

PO-3003 Liang Xudong (China)
gynecological malignancy
The outcome of uterine sarcoma found incidentally after uterus-preserving

PO-3004 Jung-Yun Lee (Korea)
surgery for presumed benign disease
PO-3005 Role of diagnostic laparoscopy in advanced epithelial ovarian cancer Jungwon Yoon (Korea)
Comparison of CA125, HE4, and ROMA (Risk of ovarian malignancy algorithm) Indira Ongkowidjaja
PO-3006
to predict ovarian cancer, epithelial type in cipto mangunkusumo hospital (Indonesia)
PO-3007 Lodng-term outcome of MRI-invisible endometrial cancer Hyun-Jin Choi (Korea)
Prevalence of HPV infection in the semen of Korean men and its effect on sperm
PO-3008 Taejin Kim (Korea)
parameters
PO-3009 Study of PTEN immunohistochemical expression in endometrial hyperplasia Sabuhi Qureshi (India)
Research on the resistance mechanism of endometrial cancer stem cells to

PO-3010 Naotake Tsuda (Japan)
Salinomycin+Paltitaxel
Low grade endometrial stromal sarcoma after adenomyosis resection :

PO-3011 Affi Ratnasari (Indonesia)
a case report
Preoperative diagnostic accuracy of myometrial invasion and histological

PO-3012 Yuri Yano (Japan)
subtypes in patients with endometrial cancer
Unenhanced areas in the tumor on MR imaging is the prognostic factors of

PO-3013 Ayami Inoue (Japan)
uterine carcinosarcoma
Case report: an advanced stage endometrial cancer with peritoneal spreading

PO-3014 Amirah Novaliani (Indonesia)
that could not be distinguished with cervical cancer
Is vaginal cytology and CA-125 measurement useful to detect recurrent

endometrial cancer in postoperative patients ?
Feasibility of uterine preservation in the management of early stage uterine

PO-3016 Young-Jae Lee (Korea)
adenosarcomas: a single institute experience
Relationship between removal of circumflex iliac nodes to distal external

PO-3017 iliac nodes and postoperative lower-extremity lymphedema in uterine corpus Yukiharu Todo (Japan)
malignant tumors
Mesonephric Carcinoma of the Uterine Corpus: a Report of Two Cases and

PO-3018 Jianguo Zhao (China)
Review of the Literature
EZH2 stimulates Twist expression by epigenetic silencing of its suppressor miR-

PO-3019 Kei Ihira (Japan)
361 through an YY1-dependent mechanism
Management of high grade endometrial carcinoma: 10 year experience from

PO-3020 Weng Yan Ho (Singapore)
the KK Women’s and Children’s Hospital Gynaecological Oncology group
Comparison of MRI and 18F-FDG PET/CT in the Preoperative Evaluation of

Poster Session
Uterine Carcinosarcoma
Prognostic values of metabolic parameters measured by 18F-FDG PET/CT in

patients with uterine carcinosarcoma
265
Session : Uterine Corpus
Differences in clinical outcomes among the three common types of uterine Chalong Cheewakriangkrai
PO-3023
sarcoma (Thailand)
Histone deacetylase as a promising therapeutic target in endometrial stromal

sarcoma
PO-3025 Survival rate for endometrial cancer in Thailand: Hospital base cancer registry
(Thailand)
Cost-effectiveness analysis of AS04-adjuvanted human papillomavirus 16/18

PO-3026 vaccine compared with screening alone in adolescent girls in Korea, with the Byoung-Gie Kim (Korea)
new 2-dose schedule
Survival impact of quality of lymphadenectomy in intermediate- or high-risk

PO-3027 group of endometrioid type endometrial cancer: a multi-center retrospective Dae-Yeon Kim (Korea)
cohort analysis
Mixed endometrial stromal and smooth muscle tumor of the uterus in a

postmenopausal woman
Large cell neuroendocrine carcinoma of the endometrium with cancer-

associated retinopathy in a postmenopausal woman
Session : Others
Regression curves of serum β-human chorionic gonadotropin in low risk
Sarah Dina Khaidirman
PO-4001 gestational trophoblastic neoplasia patients that initially treated with single
(Indonesia)
methotrexate chemotherapy at rsup. H. Adam malik medan
Bone mineral density in women treated for various types of gynecological

PO-4002 Dong Choon Park (Korea)
cancer
Clinical investigation on the impact of censored cases to the survival probability

PO-4003 Takashi Miyatake (Japan)
of gynecological cancer
A study on the epidemiology of vesicular mole and effect of chemotherapy for

PO-4004 Mini Chenicheri (India)
Persistent Trophoblastic Disease
Vulvar cancer : patterns of recurrence and clinicopathological prognostic factors

PO-4005 Kanika Batra (India)
involved in recurrent cases
Comparison of the prognostic value of F-18 PET metabolic parameters of

PO-4006 primary tumor and regional lymph node in locally advanced cervical cancer Gun Oh Chong (Korea)
patients treated with concurrent chemoradiotherapy
Current status of resources and work performance of the Korea Gynecologic

PO-4007 Doo Byung Chay (Korea)
Cancer bank
Henny Meitri Andrie

PO-4008 Versican and chondroitin sulfate alterations in ovarian cancer: the role of P53
Rachmasari Putri (Indonesia)
PO-4009 Menstrual pattern after abdominal radical trachelectomy Xiaohua Wu (China)
Outcomes and prognostic factors of cervical cancer after concurrent

PO-4010 Tae-Eung Kim (Korea)
chemoradiation
Robotic single-site versus laparoendoscopic single-site hysterectomy:

PO-4011 Jiheum Paek (Korea)
a propensity score matching study
PO-4012 TOM40 plays a major role in ovarian cancer growth and invasion Doo Byung Chay (Korea)
Poster Session
Ratio of intra-peritoneal metastatic tumour to lymph node SUV on preoperative

PO-4013 Hyun Hoon Chung (Korea)
PET/CT predicts prognosis in epithelial ovarian cancer
266
Session : Others
PO-4014 Effect of ischemic time on gene expression in ovarian cancer tissue Doo Byung Chay (Korea)
Identifying risk factors for CT-based diagnosed post-lymphadenectomy lower
PO-4015 Miseon Kim (Korea)
extremity lymphedema in patients with gynecologic cancers
Clinical determination of the appropriate time for removal of surgical drain in
PO-4016 Byung Su Kwon (Korea)
patients undergoing lymphadenectomy for the treatment of gynecologic cancer
PO-4017 Pregnancy after Radical Vulvectomy and Vaginoplasty Jayashree Natarajan (India)
Clinical value of the gynecologic consultation for basal endometrial evaluation
PO-4018 Miseon Kim (Korea)
before adjuvant tamoxifen treatment in women with breast cancer
Two case of Interventional radiology (IVR) on the palliative care in gynecologic
PO-4019 Masumi Takeda (Japan)
malignancies
PO-4020 Granulosa cell tumor of ovary: retrospective study of 11 cases Sachiko Kitamura (Japan)
The effectiveness of oral progestin as fertility preserving treatment of complex
atypical hyperplasia and early endometrial cancer in young women
The quality of life in gynecologic cancer survivors under community health
PO-4022 Jinwei Miao (China)
services model in Beijing
PO-4023 A case of primary clear cell adenocarcinoma of the broad ligament Naoko Komura (Japan)
Malignant mesothelioma of the omentum with seeding on intestine after
PO-4024 therapy for cervial adenosquamous carcinoma, presenting progressed systemic Yihung Sun (Taiwan)
thrombosis – an unusual but fulminate clinical course, one case report
PO-4025 A case of exaggerated placental site diagnosed by hysteroscopic biopsy Chiharu Tomonaga (Japan)
The curious case of a deviant mole: a case of an invasive mole metastatic to the Julienne Katrina Beltran
PO-4026
ovary (Philippines)
The role of immediate colposcopy in Atypical Squamous Cells of Undetermined
PO-4027 Kim-Seng Law (Taiwan)
significance (ASCUS)- a revisit
PO-4028 Adenoid Cystic Carcinoma of vulva-A case series Leena Rose Johnson (India)
Granulocyte macrophage colony-stimulating factor induces local accumulation
PO-4029 of dendritic cells and antigen-specific CD8+ T cells and enhances the efficacy of Sungjong Lee (Korea)
therapeutic vaccine in cervicovaginal tumor
PO-4030 Two cases of complete hydatidiform mole, occurred in perimenopausal women Serika Kanao (Japan)
PO-4031 Mothers’ awareness of the cervical cancer prevention for adolescent girls in Korea Hae Won Kim (Korea)
Uptake of risk-reducing salpingo-oophorectomy among female BRCA mutation
carriers: Experience at the National Cancer Center of Korea
The safety of gynecologic surgery combined with panniculectomy for highly
PO-4033 Kazuto Tasaki (Japan)
obese women
A real-time EMR-based surrogate marker for survival outcomes in gynecologic
PO-4034 Byung Su Kwon (Korea)
cancer patients: 3-year follow-up rate
Symptom severity in gynecological oncology patients receiving paclitaxel and Rachadapan Chaitosa
PO-4035
carboplatin (Thailand)
Breast cancer detection rate, the prevalence and incidence of breast cancer Nintita Sripaiboonkij
PO-4036
among Thai women by opportunistic mammography screening (Thailand)
Poster Session
symptom clusters in Thai gynecological oncology patients receiving first cycle of Rachadapan Chaitosa
PO-4037
carboplatin and paclitaxel (Thailand)
267
Poster Session : Ovary
PO-1001 PO-1002
Feasibility and outcomes of laparoscopic Dietary protein restriction inhibits the

cytoreduction in patients with localized development of ovarian cancer
recurrent epithelial ovarian cancer
Ahmed Taha1,2, Koshiyama Masafumi1, Matsumura Noriomi1,
E Sun Paik, Eun-jin Heo, Hyun Jin Choi, Aera Yoon, Yoo- Abiko Kaoru1, Yamaguchi Ken1, Hamanishi Jyunzo1, Baba
Young Lee, Tae-Joong Kim, Chel Hun Choi, Jeong-Won Lee, Tsukasa1, Kharma Budiman1, Ali Salah2, Konishi Ikuo1
Byoung-Gie Kim, Duk-Soo Bae 1
Department of Obstetrics and Gynecology, Kyoto Graduate School
Department of Obstetrics and Gynecology, Samsung Medical of Medicine, 2Sohag faculty of medicine, Egypt
OBJECTIVE: To investigate the effect of dietary protein
OBJECTIVE: To assess feasibility and outcomes of quality on ovarian cancer growth and its synergism with an
laparoscopic cytoreduction in patients with localized anticancer drug, using murine ovarian cancer models.
recurrent epithelial ovarian cancer (EOC). METHODS: We first established four groups of mice,
METHODS: We performed retrospective analysis of 125 EOC which were fed 20% or 10% animal protein or plant
patients who had localized recurrent sites, as demonstrated protein, respectively. We injected an ovarian cancer cell
by CT scan, MRI, or PET/CT scan; no ascites; had been line (HM-1) subcutaneously and intraperitoneally into
disease-free for 12 or more months; and who had immunocompetent B6C3F1 mice and examined the
undergone secondary or tertiary cytoreduction (laparoscopy tumor size and body weight of the mice over time. We
in 38, laparotomy in 87) at Samsung Medical Center also injected cisplatin into the mice intraperitoneally
between 2002 and 2013. By reviewing electric medical and observed tumor size, body weight and survival.
records, we investigated patient baseline characteristics, Different rates of tumor growth were confirmed by
surgical characteristics, and surgical outcomes. immunohistochemistry in the mice using Ki-67 index.
RESULTS: There were no statistically significant differences RESULTS: The inhibition of tumor growth of the
between two groups of patients in terms of age, BMI, subcutaneously implanted cancers were observed in
tumor type, initial stage, grade, recurrence site, types order in the mice fed with 20% plant, 10% plant, 10%
of adjuvant chemotherapy, or disease-free interval from animal and 20% animal protein diet (p<0.0001). The
previous treatment. With regard to surgical outcome, proliferation index (Ki67 index) was higher in the mice
laparoscopic approach provided beneficial outcomes that were fed animal protein diet. After the injection of
compared to laparotomy. Reduced operating time (58.45 cisplatin, the tumor size in the mice fed with 20% plant
min vs. 26.58 min, p<0.001), less EBL (165.96 ml vs. protein diet showed a significant decrease in comparison
415.86 ml, p=0.076), and shorter hospital stay (7.71 days to the mice fed with 20% animal protein diet (p<0.0001).
vs. 13.11 days, p<0.001) were achieved in laparoscopic In a peritoneal dissemination model with intraperitoneal
group. injection of HM-1, the survival of mice fed 20% animal
CONCLUSION: The laparoscopic approach is feasible without protein diet was worse than mice fed 20% plant protein
compromising morbidity in selected groups of patients with diet (log-rank test, p=0.0007). Furthermore, without tumor
recurrent EOC. The laparoscopic approach can be possible inoculation, the body weight in the mice that were fed
treatment option for recurrent EOC. 20% animal protein diet was significantly decreased by
cisplatin treatment in comparison to those that were fed
Poster Session
20% plant protein diet (p<0.0001).

CONCLUSION: Our findings suggest that replacement
of dietary animal protein with plant protein could be
268
effective in inhibiting tumor growth and might reinforce CONCLUSION: There was a significant correlation between
an anticancer drug’s effect synergistically while inhibiting HIF-1α and VEGF expression but no significant correlation
adverse events, and could result in a better prognosis in between HIF-1α and VEGF expression with surgical
ovarian cancer. outcomes.
PO-1003 PO-1004
Correlation of Hypoxia Inducible Factor-1α Influence of residual tumor on timing of

(HIF-1α) and vascular endothelial growth factor debulking surgery in stage IIIc and IV epithelial
(VEGF) with surgical outcome in epithelial ovarian cancer: a systematic review and meta-
ovarian cancer analysis
Riza Rivany1, Herman Susanto2, Ali Budi Harsono2 Banghyun Lee, Yong-Beom Kim, Jae Hong No, Kidong Kim,
1 Dong Hoon Suh
Faculty of Medicine University of Sumatera Utara, Indonesia,
2
Department of Obstetrics and Gynecology, University of Department of Obstetrics and Gynecology, Seoul National
Padjadjaran, Bandung, Indonesia University Bundang Hospital, Seongnam, Korea
OBJECTIVE: Hypoxia inducible factor-1α (HIF-1α) regulates OBJECTIVE: Neoadjuvant chemotherapy-interval debulking
genes involved in response to hypoxia and promotes surgery (NACT-IDS) increase rate of optimal cytoreduction
angiogenesis. HIF-1α is a transcriptional factor to induce in optimally unresectable advanced epithelial ovarian cancer
vascular endothelial growth factor (VEGF). The objective (EOC) compared with primary debulking surgery (PDS).
of this study was to examine the correlation of HIF-1α and However, Survival of NACT-IDS is not different with that of
VEGF expression with surgical outcome in epithelial ovarian PDS in advanced EOC. Therefore, it is presumed that other
cancer. factors might have influence on this association. This study
METHODS: Thirty patients with epithelial ovarian cancer aimed to investigate whether a severity of residual tumor
who underwent primary surgery were included in this was an influencing factor about association between timing
study. Tumor tissues were obtained from surgery and of debulking surgery and survival of patients with advanced
examined with q reverse transcriptase polymerase chain EOC through a systemic review and meta-analysis.
reaction (qRT-PCR) for HIF-1α and VEGF expression analysis. METHODS: A PubMed search (October 2005 – May 2015)
Evaluation of surgical outcome was based on volume of and review articles (1988 – 2005) identified 556 articles.
residual tumor. Correlation between HIF-1α and VEGF A combination of the following key words was used in
was analyzed by using Spearman correlation test while the search: (advanced ovarian cancer/primary surgery/
the correlation between HIF-1α and VEGF and surgical neoadjuvant chemotherapy) or (advanced ovarian cancer/
outcome was analyzed by ANOVA. primary surgery/primary chemotherapy). When filtered for
RESULTS: The mean age of the study subjects was studies providing overall 5-year survival and comparing PDS
47.53±10.41 years. Eleven patients (36.7%) were with NACT-IDS for stage IIIc and IV EOC 5 retrospective
diagnosed with stage I ovarian cancer, 9 patients (30%) case-control studies including 975 patients (634 PDS,
with stage II, 8 patients (26.7%) stage III and 2 patients 341 NACT-IDS) met the selection criteria. Platinum based
(6.7%) with stage IV. Out of 30 patients, 22 patients adjuvant chemotherapy in all inclusion studies and
(73.3%) successfully underwent optimal debulking and 8 platinum based neoadjuvant chemotherapy in NACT-IDS
patients (26.7%) with suboptimal debulking. There was a were performed. Meta-analyses (fixed effect analyses) were
correlation between HIF-1α and VEGF expression (r=0.582) performed using Review Manager 5.2.
Poster Session
but no correlation between HIF-1α and VEGF expression RESULTS: When a total of 3 retrospective studies including
with surgical outcome in patients with epithelial ovarian 688 patients (478 PDS, 210 NACT-IDS) were analyzed,
cancer. overall 5-year survival was not dependent on timing
269
of debulking surgery [hazard ratio (HR), 1.01, 95% PO-1006
confidential interval (CI), 0.82 to 1.24, P = 0.94]. 2
The Growing Teratoma Syndrome; Regional
retrospective studies including 287 patients (156 PDS, 131
Cancer Institute experience
NACT-IDS) when analyzed according a severity of residual
tumors did not show differences in overall 5-year survival
Praveen Rathod, Uttam Bafna, Rajshekar kundargi, Pallavi V R,
between groups as follows: residual tumor zero (HR, 0.92, Uma Devi K
95% CI, 0.72 to 1.18, P = 0.53); Residual tumor ≤ 1cm (HR,
Department of Gynaecologic Oncology, Kidwai Memorial Institute
0.83, 95% CI, 0.55 to 1.27, P = 0.40); Residual tumor >
of Oncology, Bangalore, Karnataka, India
1cm (HR, 0.93, 95% CI, 0.62 to 1.38, P = 0.72).
CONCLUSION: This study demonstrates that a severity of
OBJECTIVE: Growing teratoma syndrome (GTS) is a rare
residual tumor does not have influence on survival rates
condition presents as enlarging retroperitoneal or other
according to timing of debulking surgery in patients with
metastatic masses containing mature teratoma during
stage IIIc and IV EOC.
chemotherapy or after the chemotherapy for germ cell
tumours and normalised tumour markers. The objective
of our study is to evaluate the clinical, surgical, histo-
PO-1005
pathological and survival outcome of the Growing
Laparoscopic cytoreductive surgery in women Teratoma Syndrome patients presenting in a Regional
with epithelial ovarian cancer: Cancer Institute.
a matched pair study METHODS: A retrospective study of three cases of GTS
diagnosed and treated in the Department of Gynaecologic
Jaeman Bae, Joong Sub Choi, Won Moo Lee, A Ra Koh Oncology at Kidwai Memorial Institute of Oncology
Department of Obstetrics and Gynecology, Hanyang University from August 2013 to June 2015. The clinical data,
College of Medicine, Seoul, Korea histopathological records, and surgical treatment details of
these patients were obtained from hospital patients files
OBJECTIVE: This study aimed to compare the overall and analysed.
survival and disease free survival between laparoscopic RESULTS: The GTS metastatic masses being in the
cytoreductive surgery and open surgery for primary retro peritoneum in one case, one case had both retro
epithelial ovarian cancer. peritoneum and intra-abdominal and other patient with
METHODS: We reviewed clinical charts of women with intra-abdominal masses. All three patients had normal
epithelial ovarian cancer in 2 tertiary Korean medical
tumor markers with increasing metastatic lesions. One
centers. We conducted the study using case-matched
patient presented after 20 years, one after 11 years
analysis to obtain equal cohorts of patients with respect to
and another after 2 ½ years of primary surgery and
age, FIGO stage, histopathologic type, and tumor grade to
chemotherapy. Surgical excision was carried out in all
assess surgical and survival outcomes.
three patients. One of the case revealed additional
RESULTS: Fifty-two patients (26 matched pairs) with
neuroendocrine elements in the metastatic deposits, which
epithelial ovarian cancer were selected to the study. Both
happens to be 3rd reported case in the world literature.
study groups were homogeneous in patient characteristics
The disease free survivals in these patients ranging from 6
and pathologic results. At a median follow-up of 48months
(range, 5-121 months), disease-free survival (P: 0.72) and to 18 months after surgery.
overall survival (P: 0.53) were similar in both groups. CONCLUSION: GTS is a rare clinical phenomenon. GTS
CONCLUSION: Laparoscopic cytoreductive surgery did not should be suspected in patients with increasing size of
show the differences in overall survival and Disease free metastatic lesions on serial imaging during or after systemic
survival compared to conventional open cytoreductive chemotherapy for the treatment of germ cell tumor ovary
Poster Session
surgery. Laparoscopic cytoreductive surgery can be offered with normalized serum tumor markers or a physiological
a treatment modality for selected women with epithelial explanation for the presence of abnormal tumor markers.
ovarian cancer. Good treatment outcomes are dependent on the following
270
five steps: (1) awareness of this condition, (2) vigilant sensitivity of PET-CT is 88.6%, specificity 56.2%, Positive
imaging of patients on chemotherapy for germ cell tumor predictive value being 72.1%, negative predictive value of
ovary, (3) early recognition of the paradoxical response of 69.2%. Accuracy of detecting lesions greater than 1cm is
disease to chemotherapy (enlarging tumors and normal 78.6% (44 of 56 lesions).
serum tumor markers), (4) early diagnosis and, finally, (5) a C O N C L U S I O N : C o r re l a t i o n b e t w e e n P E T / C T a n d
prompt and complete surgical resection of tumors. histopathological disease: k (cohen value)= 0.81 which
suggests excellent correlation. For selected patients
with ovarian cancer recurrence may benefit from a
PO-1007 comprehensive radiographic imaging survey (PET-CT) at
the time of even no or minimal CA-125 elevation in early
Role of PET/CT in recurrent ovarian cancer
detection and successful cytoreductive surgical resection
Kanika batra, Rupinder Sekhon, Shweta Giri, Sudhir Rawal

and an increase in overall survival.
Department of Gynaecologic Oncology, Rajiv Gandhi Cancer

Institute and Research Centre, Delhi, India
PO-1008
OBJECTIVE: The objectives of the study were to find AXL gene expression as a marker for the
the correlation between PET/CT findings and final stemness and chemoresistance of cancer
histopathological diagnosis after a secondary cytoreductive stem-like cells in ovarian cancers
surgery in suspected ovarian cancer recurrences.
METHODS: PET/CT was done in cases with rising or Kalyani Sushama1, Hyun-Gyo Lee2, So-Jin Shin1, Sang-Hoon
above normal CA-125 and with no radiological findings Kwon1, Soon-Do Cha1, Hyewon Chung1, Chi-Heum Cho1
(Ultrasound or CECT) .These patients who had an Department of Obstetrics and Gynecology1, Institute for Cancer
abnormal PET/CT findings were taken up for a secondary Research2 Keimyung University School of Medicine, Daegu, Korea
cytoreductive surgery and histopathological proven were
taken as the standard against which PET/CT positive OBJECTIVE: The reduced potency of chemo therapeutic
findings was compared. drugs and relapse are two major difficulties faced against
RESULTS: The mean age in our group of patients with the treatment of ovarian cancers. Cancer stem-like cells
suspected recurrence was 53 years ( Range 39-74 years). (CSCs), a small population of cancer cells with regenerative
Of the 52 patients with suspected recurrence, 40 patients potential, lead to the initiation and progression of
with a PET-CT scan with findings suggestive of an avid secondary tumors. Long term chemo treatment may result
uptake underwent surgery.22 patients had serous histology, in the generation of drug resistant side population of
12 mucinous and 8 had clear cell carcinoma. Stage-wise cancer cells known as cancer stem cells. Rising evidence
distribution at the time of primary surgery is as follows suggest the contribution of cancer stem-like cells in causing
stage I-3, stage II-7, stage III-26, stage IV-4. Of the 40 relapse. Cancer stem cells produce high levels of multiple
patients who underwent a second look surgery 32 had cytokines, chemokines and angiogenic factors and their
histopathologically confirmed recurrence. PET-CT detected receptors. AXL protein is a type I receptor tyrosine kinase
a total of 86 lesions in the 40 patients who underwent family member, namely the TAM family. This protein has
surgery. Of these, 38 were in the lymph nodes 28 in para- established its influence in tumour cells by increasing their
aortic and 10 in pelvic, 32 were peritoneal lesions and 14 proliferative, invasive and metastatic potential. This receptor
were pelvic, 2 were metastatic in the parenchyma of liver. family has a common ligand, Growth arrest specific gene-
Detection of the lesion on PET-CT was size dependant, of 6 (GAS-6). GAS6 has the highest affinity for AXL. When
the 9 lesions were missed on PET-CT, 7 were less than 0.5 the ligand, GAS6 binds to AXL, it dimerises and a series of
Poster Session
cm. The mean diameter of the lesions detected was 2.2cm downstream signalling cascades are activated.
(range 0.3-6.2 cm). PET-CT accurately identified 62 of 70 METHODS: In this study using western blot with anti-human
histopathologically proven lesions. The overall lesion-based AXL antibody, we have found that AXL protein is over
271
expressed in ovarian cancer stem-like cells (OCSCs). Also after neoadjuvant chemotherapy was 1125.02+/-384.72
by using anti-pAXL antibody, the phosphorylated (active) (p=0.0001). Both the sensitivity and negative predictive
form of the AXL protein was found to be expressed only in value was 100%. The specificity and positive predictive
stem cells but not in ovarian cancer cell lines. MTT based value of HE4 was 94.11% and 96.42% respectively. Overall
viability assays showed that OCSC are chemoresistant accuracy of HE4 to tell the response was 97.72%. Among
to concentration dependent Paclitaxel and Cisplatin patients in whom HE4 levels normalized after neoadjuvant
treatment. The influence of AXL protein expression in chemotherapy, no non-responders were identified in this
controlling chemoresistance has been studied by using an subgroup.
AXL inhibitor, named R428. CONCLUSION: Our results shows that HE4 is a useful
RESULTS: Treatment of the inhibitor has exponentially marker, with very high accuracy, to assess response after
increased the sensitivity of OCSCs to chemotherapeutic neoadjuvant chemotherapy in advanced stage ovarian
drugs. cancer patients who are not an ideal candidate for surgery
CONCLUSION: The study establishes the role of AXL, a upfront. Its role should be studied further and should
receptor tyrosine kinase as one of the key proteins influencing be considered in incorporating in ovarian carcinoma
the chemoresistance in the ovarian cancer stem cells. management guidelines.
PO-1009 PO-1010
Clinical value of HE4 in response assessment Adjuvant concurrent chemoradiation followed

after Neoadjuvant chemotherapy in advance by chemotherapy for high-risk endometrial
stage ovarian carcinoma cancer
Shiv Rajan, Vijay Kumar, Sameer Gupta, Naseem Akhtar, Yulan Ren1, Xiaowei Huang1, Boer Shan1, Xiaohua Wu1, Xiao
Sanjeev Misra, Ravi Kant, Prashant Dontula, Jeevan Vishnoi Huang1, Daren Shi2, Huaying Wang1
Department of Surgical Oncology, King George’s Medical Department of Gynecologic Oncology1, Department of Pathology2,
University, Lucknow, India Fudan University Shanghai Cancer Center, Shanghai, China
OBJECTIVE: Neoadjuvant chemotherapy is a reasonable OBJECTIVE: The adjuvant treatment of high-risk

approach among patients who present with extensive intra- endometrial cancer (HREC) remains controversial. This
abdominal disease rendering them not an ideal candidate prospective phase-II clinical trial was conducted to evaluate
for primary cytoreduction. CA 125 and imaging studies the adjuvant concurrent chemoradiotherapy followed by
are currently utilized to assess response after neoadjuvant chemotherapy in patients with HREC.
chemotherapy. This study was undertaken to study the role METHODS: A total of 122 patients were enrolled between
of serum HE4 (Human Epididymis protein 4) in predicting January 2007 and January 2013, in which 112 were
response in these subgroup of patients. analyzable. The inclusion criteria included endometrioid
METHODS: This prospective study includes 44 patients endometrial cancer of histological grade 3 and with greater
including 28 (63.6%) stage IIIC and 16 (36.4%) stage IV than 50% myometrial invasion, cervical stromal invasion,
patients. Standard neoadjuvant chemotherapy (three to pelvic and/or para-aortic lymph node metastases; non-
four cycles of Paclitexal and Carboplatin) was given after endometrioid endometrial cancer; no residual disease
confirming the diagnosis with FNAC or biopsy. Serum CA and distant metastases. Pelvic radiation was administered
125 and HE4 levels along with imaging was done before with cisplatin on days 1 and 28. Vaginal after loading
starting neoadjuvant chemotherapy and before surgery. brachytherapy was administered to the patients with
Poster Session
Response to chemotherapy was assessed and correlated cervical stromal invasion after external radiation. Para-
with change in HE4 levels. aortic intensity-modulated radiation was administered
RESULTS: Mean change in values of HE4 before and to the patients with confirmed para-aortic lymph node
272
metastases. Four courses of paclitaxel and carboplatin (PC) them, 15 (28.8%) patients underwent complete staging
or cisplatin, cyclophosphamide and epirubicin (CAP) were surgery, and 29 (55.8%) patients preserved their fertility.
administered at three-week interval after radiation. Fifty-one (98.1%) patients was stage I (Ia: 35, Ic: 16), and
RESULTS: Ninety-six patients (85.7%) completed the the other one had malignant pleural effusion. Sixteen
planned treatment. Treatment discontinuation was the (30.1%) patients underwent adjuvant chemotherapy, and
result of toxicity (5/112, 4.5%), disease progression (8/112, others were followed-up without adjuvant treatment.
7.1%), and patients refusal (3/112, 2.7%). There was As a result, 8 (15.4%) patients recurred, during 41.6
no life-threatening toxicity. Twenty-two (19.6%) patients (range: 7.1-157.8) months of median follow-up duration.
recurred, in which 4 cases recurred in the field of radiation, Among those with recurrence, 1 (1.9%) patient died of
and 10 (8.9%) patients died of endometrial cancer during disease and 3 (5.8%) transferred to hospice care center.
follow-up. The estimated five-year progression-free survival Due to the small number of cohort, we failed to identify
and overall survival were 74% and 86%, respectively. the statistically significant prognostic factor of IEC. Also,
Adverse effects were less common in patients who received there was no significant difference in progression-free
PC than CAP (p=0.001). survival rate between patients who underwent adjuvant
CONCLUSION: This regimen demonstrated acceptable chemotherapy and who did not (p=0.70).
toxicity and good survival outcomes despite a C O N C L U S I O N : B a s e d o n o u r re s u l t , I E C s h o w e d
preponderance (62.5%) of late stage disease. A well unexpectedly high recurrence rate (15.4%), despite an early
designed randomized trial is on the way. stage. There is a discrepant interpretation of IEC between
medical centers, pathologists, or gynecologic oncologists.
A centralized histological review and multicenter study is
PO-1011 needed to evaluate the robust prognosis and to identify the
prognostic factors of IEC.
Aggressive behavior in a subset of
intraepithelial carcinoma of ovarian mucinous
tumors
PO-1012
Phill-Seung Jung, Shin-Wha Lee, Jeong-Yeol Park, Dae-Shik Risk factors of para-aortic lymph node
Suh, Dae-Yeon Kim, Jong-Hyeok Kim, Yong-Man Kim, Young-
metastasis in endometrial cancer:
Tak Kim, Joo-Hyun Nam
a retrospective study
Department of Obstetrics and Gynecology, Asan Medical Center,
University of Ulsan, Seoul, Korea Yosep Sutandar, Jessica Octaviani, Tricia Dewi Anggraeni,
Tofan Widya Utami, Kartiwa Hadi Nuryanto, Hariyono Winarto,
OBJECTIVE: It is controversial that intraepithelial carcinoma Gatot Purwoto, Sigit Purbadi, Laila Nuranna, Andrijono
(IEC) of ovarian mucinous tumor should be classified as Andrijono
borderline or malignant tumor. Due to the rarity of IEC, not Department of obstetrics and gynecology, Dr.Cipto Mangunkusumo
much has been reported about the clinical behavior of IEC. Hospital, University of Indonesia, Jakarta, Indonesia
We aimed to evaluate the prognosis and tried to identify
the prognostic factors of IEC. OBJECTIVE: To outline the risk factors associated with para-
METHODS: Using the Asan Medical Center database, aortic lymph node metastasis in endometrial cancer.
we identified 52 patients with IEC of ovarian mucinous Methods: The subjects of this retrospective study were 269
tumor who had surgery at our institution between 2000 patients who were diagnosed with endometrial cancer
and 2012. After retrospective review and pathologic based in INASGO (Indonesian Society of Gynecologic
consultation, we evaluated their clinical outcome. Oncology) cancer registration from 2009 to 2014. The
Poster Session
RESULTS: The median age of 52 patients were 33 (range: study was conducted at Division of Gynecological Oncology,
13-78) years old at the time of surgery, and the median size Department of Obstetrics and Gynecology, Dr. Cipto
of the tumor was 16 (range: 2.9-33) centimeter. Among Mangunkusumo Hospital, Jakarta, Indonesia. All cases were
273
analyzed the association between PAN metastasis and the PO-1013
clinicopathologic factors such as histologic type, degree of
Margin status of conization specimen obtained
differentiation, the depth of myometrial invasion, cervical
by See-and-Treat strategy and Three-Step
invasion, and pelvic lymph node (PLN) metastasis. The
strategy
association of each factors was analyzed using univariate
analysis. And the independent association of each factor
Doo Haeng Lee, Se Hyun Nam, Donghee Lee
to the occurrence of PAN metastasis were analyzed using
Department of Obstetrics and Gynecology, Kangbuk Samsung
multivariate analysis. The data were analyzed on SPSS-21.
Hospital, Sungkyunkwan University, Seoul, Korea
Results: In this study the median age of our subject was
57 years old. According to FIGO surgical staging, there
OBJECTIVE: To evaluate the margin status of conization
were 117 cases (43.5%) in stage 1; 63 cases (23.4%)
specimens according to treatment strategy.
in stage 2; 67 cases (24.9%) in stage 3; dan 22 cases
METHODS: A retrospective review was performed for
(8.1%) in stage 4. Thus, stage 1 was the most common
patients who underwent conization at a single institution
stage found in our hospital. The most common histologic
from January 2003 to August 2012. The patients were
type or clinicopathologic subtype of endometrial cancer
was Type 1 estrogen related (n=235; 87.3%), while divided into two groups depending on whether the patient
mucinous adenocarcinoma (n=13; 4.8%) was the had undergone a punch biopsy before conization or not (the
least clinicopathologic subtype that we found in Type 'see-and-treat' group or the 'three-step' group). The final
2 nonestrogen related (n=34, 12.7%). Grade 1 well histologic results of the two groups were compared.
differentiated (n=123; 45.7%) was the most common RESULTS: Of the 862 patients, 694 women were ‘see-and-
degree of differentiation that we found in this study. treat’ group (cervical intraepithelial neoplasia (CIN) grade
Myometrial invasion more than 50% was found in 48% 1; 159 (22.9%), CIN 2; 87 (12.5%), CIN 3; 207 (29.8%),
(n=129) cases. We only found 23% (n=62) cases of Invasive carcinoma; 76 (10.9%)) and 168 women were
endometrial cancer with cervical invasion. Para-aortic ‘three-step’ group (CIN 1; 14 (8.3%), CIN 2; 31 (18.4%),
lymph node metastasis was found in 58 cases (21.6%). CIN 3; 68 (40.4%), Invasive carcinoma; 3 3 (19.6)) . There
Chi-square and fisher’s analysis was used to analyze if the was no significant statistical difference in the rate of cone
risk factors were associated with para-aortic lymph node margin involvement between 'see-and-treat' group and
metastasis. Degree of differentiation (p<0.01), myometrial 'three-step' group. However, cone margin involvement rate
invasion (p<0.01), cervical invasion (p<0.01), and pelvic of patients with CIN 3 was higher in the 'see-and-treat'
lymph node metastasis (p<0.01) were significantly related group (26.5% in the 'see-and-treat' group vs. 11.7% in the
to para-aortic lymph node metastasis. The result of 'three-step' group; p = 0.012).
multivariate analysis with logistic regression showed that CONCLUSION: Without inspection of cervical precancerous
degree of differentiation (p<0.01), myometrial invasion lesion, the patients with CIN 3 treated by ‘see-and-treat’
(p<0.01), cervical invasion (p<0.01), dan pelvic lymph strategy are more likely to show positive cone margin
node metastasis (p<0.01) were significant independent risk involvement. Therefore, the physicians had better follow
factor para-aortic lymph node metastasis. The highest odds 'three-step' strategy when treating the patient with high-
ratio for para-aortic lymph node metastasis was myometrial grade squamous intraepithelial lesion (HSIL).
invasion (OR=12.129).
CONCLUSION: It is very important to determine the nodal
status, especially PAN metastasis regarding the prognosis
of endometrial cancer. From our study, myometrial
invasion equal or more than 50%, cervical invasion, poor
differentiation, and pelvic lymph node metastasis are
Poster Session
significantly related to para-aortic lymph node metastasis.
274
PO-1014 OBJECTIVE: To investigate the expression of new therapeutic
targets in undifferentiated endometrial sarcoma (UES).
Incorporation of 3 dimensional printer in
METHODS: Ten patients with UES were eligible in this study.
management of early stage cervical cancer:
The immunohistochemical expression of each biomarker
a case report
was assessed using tissue microarrays.
RESULTS: Strong positive immune-reaction was observed
Min-Hyun Baek1,2, Dae-Yeon Kim1, Chae-Chun Rhim2, Young-
2 1 1
Han Park , Dae-Shik Suh , Jong-Hyeok Kim , Yong-Man Kim , 1 in 8 (80.0%) in vascular endothelial growth factor (VEGF),
Young-Tak Kim1, Joo-Hyun Nam1 protein kinase B (AKT1), human deacetylase (HDAC 2/7), 9
1
(90%) in phosphohistone (PPH-3), aromatase inhibitor, and
HDAC 6, and 10 (100%) in HDAC 1/4/8. Also, there was
University of Ulsan, Seoul, Korea, 2Department of Obstetrics and
Gynecology, Hallym university sacred heart hospital, Anyang, Korea
frequent weak to moderate expression in c-abl, platelet
derived growth factor receptor (PDGFR α/β), mammalian
OBJECTIVE: There is a vast difference in tumor size, target of rapamycin (mTOR), gonadotropin releasing
location, and anatomy in early stage cervical cancer, and it hormone (GnRH), and HDAC 3/5. Adjuvant therapy and
is questionable applying same indication for fertility sparing radicality of surgery had no statistical relevance with
surgery in every case. 3D (dimensional) printer creates disease-free and overall survival outcomes.
replica model which is same as anatomy of real lesion, and CONCLUSION: VEGF, AKT1, aromatase inhibitor, PPH-3, and
its application to various field of medicine is increasing HDAC 1/4/8 series which especially showed high frequency
recently. We performed a surgery simulation and patient of strong immunoreactivity and c-abl, PDGFR α/β, mTOR,
consultation using 3D model which is made by 3D printer. GnRH, and HDAC 3/5 with frequent weak to moderate
METHODS: We made a 3D replica model using 3D printer expression in UES can be considered as a promising
with stereotactic data from CT image of uterus. therapeutic target to improve prognosis.
RESULTS: In our study, the patient decided to undergo
radical hysterectomy after consultation with seeing her
3D model. 3D model was used to plan and simulate the PO-1016
surgery pre- and intra-operatively. Prognostic value of preoperative total

CONCLUSION: 3D printer is helpful in consulting patients
lesion glycolysis in patients with uterine
with early cervical cancer determining the treatment carcinosarcoma
method. Also, it can be a useful tool for deciding the
optimal extent of resection in fertility sparing surgery Jeong-Won Lee1, Eun Jin Heo1, Seung Hwan Moon1, Hyun
for various different cases. 3D printer will lead to better Jong Lee2, Gi Jeong Cheon2, Hyun Hoon Chung2
obstetric and oncologic outcome in cervical cancer. 1
Center, Sungkyunkwan University School of Medicine, Seoul,
Korea, 2Department of Obstetrics and Gynecology, Seoul National
PO-1015 University College of Medicine, Seoul, Korea
Investigation of new therapeutic targets in

undifferentiated endometrial sarcoma OBJECTIVE: Metabolic tumor volume (MTV) and total lesion
glycolysis (TLG) is measure of metabolic activity of tumors
Min-Hyun Baek1,2, Shin-Wha Lee1, Jeong-Yeol Park1, Dae- determined by fluorine-18 fluorodeoxyglucose ([18F]
1 2 1
Yeon Kim , Chae-Chun Rhim , Dae-Shik Suh , Jong-Hyeok FDG) uptake on positron emission tomography/computed
1 1 1 1
Kim , Yong-Man Kim , Young-Tak Kim , Joo-Hyun Nam tomography (PET/CT) images. The purpose of this study
1
Department of Obstetrics and Gynecology, Asan Medical Center, was to investigate the relationship between functional
Poster Session
2
University of Ulsan, Seoul, Korea, Department of Obstetrics and tumor parameter and clinical outcomes in patients with
Gynecology, Hallym university sacred heart hospital, Anyang, uterine carcinosarcoma.
Korea METHODS: We retrospectively reviewed patients with
275
pathologically proven uterine carcinosarcoma who standardized incidence rates (ASRs) and annual percentage
underwent preoperative 18F-FDG PET/CT scans to evaluate changes (APCs) in incidence rates were calculated. Patient
the prognostic significance of PET/CT parameters and data were divided into three groups based on age (<40
other clinicopathological variables. For each patient, we years, 40−59 years, and >59 years), and age-specific
determined highest (SUVmax and SUVavg), cumulative incidence rates were compared.
TLG, sum of all MTV, and compared their predictive value RESULTS: Overall, the incidence of EOC has increased.
on recurrence, and the effects of pretreatment functional Annual EOC cases increased from 922 in 1999 to 1,775
tumor activity on patient progression-free survival (PFS). in 2012. In 1999, the ASR was 3.52 per 100,000 and
RESULTS: Clinical data, treatment modalities, and results increased to 4.79 per 100,000 in 2012 (APC, 2.53%;
were reviewed for 30 eligible patients. The median duration P <0.001). The ASRs in 2012 and APCs between 1999
of PFS was 13 months (range, 3 to 80 months), and twelve and 2012 for the four major histologic subtypes were as
(40%) patients experienced recurrence. High value for follows (in order of incidence): serous carcinoma (ASR,
the TLG (P = 0.014, hazard ratio (HR) 132.764, 95% CI 2.32 per 100,000; APC, 4.34%; P <0.001), mucinous
2.697-6536.478), uterine serosal invasion (P = 0.020, HR carcinoma (ASR, 0.73 per 100,000; APC, -1.05%; P =
18.451, 95% CI 1.574-216.308), and age (P = 0.026, 0.131), endometrioid carcinoma (ASR, 0.51 per 100,000;
HR 1.095, 95% CI 1.011–1.186) were independent risk APC, 1.48%; P = 0.032), and clear cell carcinoma (ASR, 0.50
factors for recurrence in multivariate analysis. The Kaplan- per 100,000; APC, 8.13%; P <0.001). In the sub-analyses
Meier survival graphs showed that PFS significantly differed based on age, clear cell carcinoma was confirmed as the
in groups categorized based on TLG (P = 0.004, log-rank histologic subtype whose incidence had increased the most
test). since 1999.
CONCLUSION: Preoperative TLG showed statistically CONCLUSION: The incidence of EOC is increasing in Korea.
significant association with recurrence in patients with Among the histologic subtypes, the incidence of clear cell
uterine carcinosarcoma. Metabolic functional parameter can carcinoma has increased markedly across all age groups
be useful quantitative criteria for disease prognostication in since 1999.
patients with uterine carcinosarcoma before treatment.
PO-1018
PO-1017
The CA-125 level after neoadjuvant
Incidence of epithelial ovarian cancer chemotherapy for relapse free survival
according to histologic subtypes in Korea, prediction in patients with advanced ovarian
1999-2012 cancer
Se Ik Kim1, Myong Cheol Lim2, Young-Joo Won3, Sang-Soo Youjung Lee, Yong-Man Kim
2 2 2
Seo , Sokbom Kang , Sang-Yoon Park Department of Obstetrics and Gynecology, Asan Medical Center,
1
Department of Obstetrics and Gynecology, Seoul National University of Ulsan, Seoul, Korea
University College of Medicine, Seoul, Korea Center for Uterine
Cancer2 Cancer Registration and Statistics Branch3, National Cancer OBJECTIVE: Treatment for advanced ovarian cancer may
Center, Goyang, Korea include Primary debulking surgery (PDS) or neoadjuvant
chemotherapy (NACT) followed by interval debulking
OBJECTIVE: To investigate trends in the incidence of surgery. Several studies showed correlation between
epithelial ovarian cancer (EOC), according to histologic CA125 level and complete resectability after NACT. This
subtypes, in Korean women between 1999 and 2012. study was intended to predict the relapse free survival by
Poster Session
METHODS: Data from the Korea Central Cancer Registry serum CA-125 level after NACT.
recorded between 1999 and 2012 were evaluated. The METHODS: This was a retrospective review in single
incidences of EOC histologic subtypes were counted. Age- institute. The patients were included with advanced ovarian
276
cancer treated NACT followed by interval debulking bilateral salphingo oophorectomy. Histopathology of
surgery between 2010-2012. Dermographic data, CA- the tuor showed cystic teratoma with papillary thyroid
125 levels, relapse, chemotherapy and surgical pathologic carcinoma in area of struma ovarii. Case 2:38years old lady
information were obtained. A CA-125 response was with regular menstrualcycle presented with complaints of
defined as at least a 50% reduction in CA-125 levels. The pain abdomen of one week duration.Clinically 10x8 cm
patients were divided to a post treatment serum CA -125 pelvic mass felt. Preopertive tumor markers and thyroid
level normalized group and not normalized group. Relapse function test were normal. Patient underwent unilateral
– free survival (RFS) were estimated by the Kaplan meier salphingo oophorectomy (frozen section suggestive of
method and compared using the log rank test struma ovarii.Histopathology confirmed struma ovarii with
RESULTS: 49 patients met the study criteria. Those patients focal area of papillary carcinoma. Patient is on follow up
were given 3 cycle of paclitaxel/carboplatin before the for last 2years with no recurrence. Case 3: 45 years old
surgery and were treated 3 or 6 cycle after the surgery. lady with regular menstrual cycle presented with mass per
After the 3 cycle of NACT, 25 patients showed normal abdomen noticed 2 months before. Clinically 20x15x15cm
range of CA-125 level with response and 24 patients abdominopelvic mass found.preoperative Ca125 levels
showed responded CA-125 level but not normalized. RFS wer 116U/ml,other tumor markers and thyroid function
were different between two subgroups (30 months vs 17 test normal. Patient underwent hysterectomy with bilateral
months, P=0.075). These differences were not statistically oophorectomy.Histopahology of tumor suggestive of
significant. benign struma Ovarii. Case 4:72years old postmenopausal
CONCLUSION: Our data suggests that serum CA-125 level lady presented with complaints of pain abdomen.Clinically
after NACT could predict RFS. However this study doesn’t vgue mass with ascites was found. Preoperative Ca 125-
show statistically significance between two subgroups. 1593U/ml.peritoneal cytology negative for malignancy.
There are limitations for interpretation of serum CA-125 Chest Xray revealed Minimal basal pleural effusion (Pseudo
level after NACT as RFS predictive marker. Meig Syndrome) Intraoperatively solid cystic mass from
right ovary found.patient underwent staging laparotomy.
Histopathology of tumor suggested Struma Ovarii. Case
PO-1019 5: 52 years old postmenopausal lady with complaints of
pain abdomen of 6weeks duration, Clinically patient had
Case series of Struma Obarii and Strumal gross ascites with pelvic mass of 8x10cm. Preoperative
carcinoid-KMIO experience throid function test and tumor markers were normal.
CT scan revealed a solid cystic mass of 8x8 cm. Patient
Jayashree Natarajan, Uma Devi, Pallavi Reddy, Uththamchand
underwent hysterectomy with bilateral oophorectomy.
Bafna
Histopathologyof tumour suggestive of Strumal Carcinoid.
Department of Gynaecological Oncology, Kidwai Memorial RESULTS: Stuma ovarii is diagnosed when more than
Institute of Oncology, Bangalore, Karnataka, India 50% of tissues shows thyroid like features. The varied
presentations of struma ovarii in age, menopausal status,
OBJECTIVE: Struma ovarii is a rare ovarian tumor defined symptoms were found in our cases. The tumor may
by the presence of thyroid tissue comprising more than also produce thyroid hormones and can cause thyroid
50% of the overall mass. We present two cases of benign dysfunction. None of the patients presented with thyroid
struma ovarii, two cases of malignant struma ovarii and a dysfunction. Pseudomeig syndrome has been reported in
case of stumal carcinoid very few cases in literature. One of the cases with benign
METHODS: Case Summary: Case 1:61years old stuma ovarii presented with pseudomeig syndrome.
postmenopausal lady presented with pain abdomen of 6 CONCLUSION: Struma ovarii is a rare ovarian tumor with
months duration,clinically patient had a abdomino pelvic varied presentation and diagnostic dilemma. Frozen
Poster Session
mass measuring 26x24cm with restricted mobility and section when in dilemma will help to guide the surgeon in
ascites. Preoperative Thyroid function test were normal. management to decide the extent of surgery.
Ca125-21.5U/ml; patient underwent hysterectomy with
277
PO-1020 nonteratomatous origin also called true leiomyosarcoma
are infrequent. The ratio of incidence of ovarian sarcoma
Rare case of primary leiomyosarcoma of ovary
to carcinoma is generally reported at 1:40. Primary
ovarian sarcoma represents a heterogeneous group of
Jayashree Natarajan, Shruthi Shivdas, Uma Devi,
Uththamchand Bafna ovarian tumours. Though encountered in all age groups,
it primarily affects the post-menopausal patients. the
incidence of leiomyosarcoma is still rare, less than 0.1%.
Institute of Oncology, Bangalore, Karnataka, India
The tumour may be asymptomatic or may manifest with
lower abdominal pain like in our case. The definitive
OBJECTIVE: Ovarian leiomyosarcomas (OLS) is a rare disease
diagnosis of these lesions is difficult prior to surgical
with incidence of <0.1% of ovarian tumors.Ovarian
removal. Because there is no pathognomonic symptoms
Leiomyosarcoma has poor prognosis due to their late
or characteristic imaging findings. The correct diagnosis
presentation and aggressive nature of tumors. Around 20
of an ovarian leiomyosarcoma need histopathological
cases has been reported in literature.
and IHC confirmation. Surgery remains the main mode of
METHODS: 51 years old postmenopausal lady presented
treatment.
with complaints of pain abdomen and feeling of heaviness
CONCLUSION: Ovarian leiomyosarcoma though rare should
on abdomen. History of hysterectomy one year before
be considered as one of the differential diagnosis in ovarian
for her persisting complaints of menorrhagia with fibroid
tumors. The survival depends on the intactness of capsule,
uterus. Histopathology of the hysterectomy specimen
stage and residual disease. Surgery stays the mainstay of
showed intramural leiomyoma and chronic cervicitis.
treatment.
On examination patient had ascites with vague supra
pubic mass. Rectovaginal examination showed a high
up mass with restricted mobility. On evaluation CT Scan
PO-1021
of abdomen revealed isointense irregular opacity in the
pelvis extending in to abdomen, with solid ccomponents Expression of Factor-inhibiting hypoxia
with in. Mass showed irregular margin with thick content inducible factor predicts survival of high-grade
with in.free fluid seen in peritoneal cavity. There was no serous carcinoma of the ovary
evidence of retro peritoneal/ pelvic lymphadenopathy.
Her Ca 125 values were 78.34U/ml; CEA and Ca19.9 Yemi Bahk, Maria Lee, Hee Seung Kim, Hyun Hoon Chung,
were with in normal limits.Intra operatively cystic mass Jae Weon Kim, Noh Hyun Park, Yong Sang Song
measuring 20x18x18 cm with haemorrhagic content with Department of Obstetrics and Gynecology, Seoul National
in and engulfed in mesentry of small bowel was found. University College of Medicine, Seoul, Korea
Patient underwent tumour debulking with removal of the
remnant ovary, pelvic and para aortic node dissection with OBJECTIVE: The hypoxia inducible factor (HIF) pathway plays
total omentectomy. Histopathological examination was an important role by stimulating processes of angiogenesis,
suggestive of poorly differentiated malignant neoplasm of cell proliferation, cell survival and metastasis in various
ovary. Immuno histochemistry confirmed the diagnosis of types of malignancy. In particular, factor-inhibiting HIF
epitheloid leiomyosarcoma of the Ovary. Patient received 6 (FIH), an upstream protein regulating the HIF pathway,
cycles of Docetaxel with gemcitabine .She is asymptomatic is known as a prognostic marker by regulating hypoxia
and on regular follow up for last 12months. inducible factors-1α (HIF-1α) and -1β (HIF-1β) in renal clear
RESULTS: Primary soft tissue sarcomas of the ovary are rare cell carcinoma (RCCC). Thus, we evaluated the significance
tumours comprise less than 3% of all ovarian neoplasm. of FIH, HIF-1α and HIF-1β in clear cell carcinoma (OCCC),
They are often confused with undifferentiated carcinomas, compared with high-grade serous carcinoma of the ovary
Poster Session
mixed mullerian tumors, sarcomatoid form of sex cord (HGSC).

stromal tumours, Krukenberg tumors associated with METHODS: mRNA levels of FIH, HIF-1α and HIF-1β were
stromal reaction, and cellular fibroma. leiomyosarcoma of evaluated using RT/qRT-PCR in each 5 tissues of normal,
278
OCCC and HGSC. Then, we evaluated mRNA levels of the role of the three angiogenetic factors. mRNA levels of
three factors according to hypoxic condition (normal, 5% VEGF, apelin and maspin were evaluated using RT/qRT-PCR
O2, and 3% O2) and treatment of paclitaxel or cisplatin in in each 5 tissues of normal, OCCC and HGSC. Moreover,
ES-2 (OCCC) and OV90 cells (HGSC). Finally, we performed we performed immunohistochemistry (IHC) in OCCC (n=61)
immunohistochemistry in OCCC (n=61) and HGSC (n=142) and HGSC (n=142) for finding prognostic factor affecting
for finding prognostic factor affecting survival among the survival among the three factors.
three factors. RESULTS: mRNA levels of VEGF and apelin increased
RESULTS: mRNA levels of HIF-1α and HIF-1β decreased in gradually from normal ovary to HGSC. However, mRNA
OCCC and HGSC, compared with normal ovary. However, level of maspin decreased in OCCC, and increased in HGSC
mRNA levels of FIH increased in HGSC while it decreased when compared with normal ovary. IHC showed high
in OCCC, compared with normal ovary. In ES-2 and OV90 expression of VEGF in all tissues of OCCC and HGSC, and
cells, mRNA levels of the three factors tended to decrease high expression of apelin was not associated with age,
in hypoxic condition, but increase by treating paclitaxel or FIGO stage, optimal debulking and platinum-resistance.
cisplatin. However, only low expression of FIH in HGSC was However, high expression of maspin was associated with
associated with poor progression-free survival (median, Optimal debulking in OCCC (97.3% vs. 57.4%, p<0.01)
16.6 vs. 33.4 months, p=0.01), suggesting an independent and platinum-resistance in HGSC (32.4% vs. 14.7%,
prognostic factor (HR, 1.64; 95% CI, 1.05 to 2.58). p=0.02). However, high expression of maspin was only an
CONCLUSION: Although FIH, HIF-1α and HIF-1β were independent predictor for platinum-resistance in HGSC
not significant in OCCC, low expression of FIH was a (adjusted OR, 2.79; 95% CI, 1.14 to 6.83).
prognostic factor for a poor survival in HGSC. It means that CONCLUSION: High expression of maspin may be associated
FIH may be more significant in poorly differentiated tumor, with platinum-resistance in HGSC. It means that maspin
especially HGSC, in comparison with HIF-1α and HIF-1β. may be a useful biomarker for predicting platinum-
resistance when compared with VEGF showing high
expression in most of poorly differentiated tumor.
PO-1022
Maspin as an angiogenetic factor affecting

PO-1023
platinum resistance in high-grade serous
adenocarcinoma of the ovary Diaphragmatic procedures in ovarian cancer -
complications and management: Experience at
Seungmee Lee, Maria Lee, Hee Seung Kim, Hyun Hoon Tata Medical Center, Kolkata, India
Chung, Jae Weon Kim, Noh Hyun Park, Yong Sang Song
Department of Obstetrics and Gynecology, Seoul National Sonia Mathai, dhanabir Thangjam, Pesona Lucksom,
University College of Medicine, Seoul, Korea Anik Ghosh, Basumita Chakraborti, Jaydip Bhaumik, Asima
Mukhopadhyay
OBJECTIVE: Angiogenesis is a basic mechanism of disease Department of Gynaecological Oncology, Tata Medical Center,
progression and metastasis in most of cancers. Although Kolkata, India
vascular endothelial growth factor (VEGF) is a well-known OBJECTIVE: The aim of this study was to assess postoperative
angiogenetic factor, other factors including apelin and complications of Diaphragmatic Resection (DR) and
maspin have are little known about the relation with Diaphragmatic Stripping (DS) in stage III/IV Ovarian Cancer, its
clinical outcomes in ovarian cancer. Thus, we investigated complications and developing a protocol for management.
expressions of VEGF, apelin and maspin affecting outcomes METHODS: Retrospective chart review of all patients with
in ovarian cancer. Ovarian Cancer who underwent Diaphragmatic Resection
Poster Session
METHODS: We included only poorly differentiated tumor (DR) / Diaphragmatic Stripping (DS) from January 2014
such as ovarian clear cell carcinoma (OCCC) and high- through August 2015.
grade serous adenocarcinoma (HGSC) for evaluating the R E S U LT S : 4 7 / 1 0 1 ( 3 9 P D S / 6 2 I D S ) w o m e n h a d
279
diaphragmatic disease; 43 (91.48%) women underwent PO-1024
diaphragmatic surgery- 11.62% ablation, 93.02% stripping,
IGFBP5-derived peptide as a novel
18.60% muscle resection and 23.25% combination of
angiogenesis inhibitor for treatment of ovarian
procedures.23.25 % cases had prior pleural effusion
cancer
and 9.30% cases required pre-op thoracic intervention
(Drainage/VATS). 8 cases were performed before 2015 (7 Eun jin Heo1, Jae Ryoung Hwang2, Yoo-Young Lee1, Jeong-
with IDS and 1with PDS) and 35 cases from 2015 (15 with Won Lee1, Young-Jae Cho1, Yoonna Lee2, Youngmee Park2, Je-
IDS and 20 with PDS) when we changed our approach Ho Lee3, Byoung-Gie Kim1, Duk-Soo Bae1,
to complete cytoreduction rather than adopting optimal
Department of Obstetrics and Gynecology1 Samsung Biomedical
cytoreduction. DR/DS was performed during debulking for
Research Institute2, Samsung Medical Center, Sungkyunkwan
22/25 cases of IDS and 21/22 cases of PDS. The median University School of Medicine, Seoul, Korea, 3CHA Bundang
SCS for patients undergoing diaphragmatic surgery was Medical Center, CHA University, Seongnam, Korea.
10.13 for IDS and 11.04 for PDS. Most patients underwent
associated radical debulking procedures including OBJECTIVE: Insulin-like growth factor-binding protein
bowel resections (48.83%), hepatic resection (5.12%), 5 (IGFBP5) plays a role in cell growth, differentiation,
Splenectomy (37.20%) total peritonectomy (69.76%), and and apoptosis. We found that IGFBP5 was markedly
cholecystectomy (37.20%). Diaphragmatic lesions were downregulated in ovarian cancer tissue, and that its
confirmed by histology in 77.55% specimens, 95.23% in overexpression in cancer cells induced cell death. In this
PDS and 81.81 % in IDS. Residual disease was classified as study, we undertook to evaluate the functional significance
CCO/CC1 in 80% of cases and CC2/CC3 cm in 10%. Right of each region of IGFBP5 as a tumor suppressor of ovarian
diaphragm was involved in 100% and left in 69.76%, both cancer.
diaphragms in 69.76 % cases. Intra-op, 39.53% cases had METHODS: We found that the C-terminal region of
pleural effraction requiring repair. Postoperative pulmonary IGFBP5 inhibited tumor growth in a 2774 cell xenograft
complications occurred in 69.76% cases and included- mouse model, and that expression of VEGF, IL-6, and TNF-
effusion 62.79%, effusion requiring drainage 20.93 % alfa were inhibited in 2774 cells stably expressing the
and ICD 11.62%, diaphragm paralysis 2.3%, Pneumonia C-terminus of IGFBP5. In order to evaluate its effects on
6.97%, Atelectasis 30.23 %, Pneumothorax 2.3%, and tumor suppression, a peptide derived from the C-terminus
Pulmonary embolism 2.3%. Prolonged ventilation (> 1day) of IGFBP5 (BP5-C) was synthesized. As a control, a peptide
was required in 23.25%,16.27 % required non-invasive mutated in the IGF-binding site of BP5-C (BP5-Cmut), as
ventilation > 2 days,11.62 % required re-intubation, well as peptides derived from the IGFBP2 C-terminus and
and one patient required re-admission for respiratory heparin-binding site were also synthesized.
complications > 60 days after surgery. There was 2 deaths RESULTS: Of these peptides, BP5-C and BP5-Cmut inhibited
in PDS group. From 2015 onwards for patients who VEGF expression and NF-kB activity. Furthermore, BP5-C
underwent cytoreductive surgery (IDS and PDS), but no inhibited angiogenesis in an in vitro and an ex vivo system,
diaphragmatic surgery pulmonary complications were nil. consisting of HUVEC tube formation and rat aortic ring
Median hospital stay for these patients was 8 days for IDS blood vessel sprouting, respectively. The in vivo effect of
and 11 days for PDS. BP5-C on tumor growth was studied using i.p. injection
CONCLUSION: DR/ DS as part of cytoreductive surgery for of ovarian cancer 2774 cells into mice, as well as with a
ovarian cancer carries comparable risks to other radical patient-derived xenograft mouse model. BP5-C peptide
debulking procedures. (1) The majority of complications are significantly inhibited tumor growth, angiogenesis, and
expected outcomes after entrance into the pleural cavity VEGF expression in both xenograft models.
and generally manageable with conservative management CONCLUSION: These results suggest that the C-terminus
and intervention with pleural drainage or chest tube of IGFBP5 exerts an anti-cancer activity by inhibiting
Poster Session
insertion. (2) A protocol should be devised for optimal post- angiogenesis via downregulation of VEGF in an IGF-
operative management to reduce pulmonary complications. independent manner, and may be considered as a novel
angiogenesis inhibitor for the treatment of ovarian cancer.
280
PO-1025 PO-1026
Proton pump inhibitors enhance the effects of Three case reports of stageI borderline ovarian
cytotoxic agents in chemoresistant epithelial tumors accompanied massive ascites
ovarian carcinoma
Ai Miyoshi, Takashi Miyatake, Takeya Hara, Shinnosuke
Ha-Na Yoo, Eun jin Heo, E Sun Paik, Hyun Jin Choi, Yoo- Komiya, Naoko Komura, Asuka Tanaka, Serika Kanao, Masumi
Young Lee, Chel Hun Choi, Tae-Joong Kim, Jeong-Won Lee, Takeda, Mayuko Mimjra, Masaaki Nagamatsu, Takeshi Yokoi
Byoung-Gie Kim, Duk-Soo Bae Department of Obstetrics and Gynecology, Kaizuka City Hospital,
Department of Obstetrics and Gynecology, Samsung Medical Fukuoka, Japan
Korea OBJECTIVE: Borderline ovarian tumors represent 10-15%
of all ovarian tumors. This benign malignancy is defined
OBJECTIVE: This study was designed to investigate whether as an ovarian epithelial tumor with a stratification of the
proton pump inhibitors (PPI, V-ATPase blocker) could epithelial lining lacking of frank stromal invasion; it has
increase the effect of cytotoxic agents in chemoresistant a less aggressive behavior than more invasive epithelial
epithelial ovarian cancer (EOC). ovarian tumors, and the prognosis for those patients with
METHODS: Expression of V-ATPase protein was evaluated the disease limited to the ovary is excellent. However, the
in patients with EOC using immunohistochemistry, and size of borderline ovarian tumors is relatively large, so
patient survival was compared based on expression of they are often suspected of being ovarian cancers, having
V-ATPase mRNA from a TCGA data set. In vitro, EOC cell a much direr prognosis. We report three cases of stage I
lines were treated with chemotherapeutic agents with or borderline ovarian tumors with massive ascites that, before
without V-ATPase siRNA or PPI (omeprazole) pretreatment. their operation, were suspected of being advanced ovarian
Cell survival and apoptosis was assessed using MTT assay cancers. Their ascites disappeared rapidly after resection of
and ELISA, respectively. In vivo experiments were performed the mass and, strikingly, they lacked pleural effusion.
to confirm the synergistic effect with omeprazole and METHODS: We report three cases from medical record
paclitaxel on tumor growth in orthotopic and patient- retrospectively, and review of the literature concerning
derived xenograft (PDX) mouse models. conjectures as to why pleural effusions do or do not occur
RESULTS: Expression of V-ATPase protein in ovarian cancer in cases of pelvic tumors.
tissues was observed in 44 patients (44/59, 74.6%). Higher RESULTS: The ages of our patients were 35, 47 and 73
expression of V-ATPase mRNA was associated with poorer years old, respectively. All felt a fullness (distension) of
overall survival in TCGA data. Inhibition of V-ATPase by their abdomen before consulting a gynecologist. They
siRNA or omeprazole significantly increased cytotoxicity were diagnosed with a pelvic tumor by CT scan and were
or apoptosis to paclitaxel in chemoresistant (HeyA8-MDR, sent to our hospital for medical treatment. The maximum
SKOV3-TR) and clear cell carcinoma cells (ES-2, RMG-1), but diameter of their pelvic tumors was 11, 20, and 11 cm,
not in chemosensitive cells (HeyA8, SKOV3ip1). Moreover, respectively, and each was accompanied by massive ascites.
the combination of omeprazole and paclitaxel significantly Post-operatively, a pathological examination determined
decreased the total tumor weight compared with paclitaxel that all three cases were stage I borderline ovarian tumors.
alone in a chemoresistant EOC animal model and a PDX Two were mucinous tumors and one was serous. The
model of clear cell carcinoma. However, this finding was amount of the ascites present was 6,300, 2,600 and 3,600
not observed in chemosensitive EOC animal models. ml, respectively, and was serous in all three cases. The
CONCLUSION: These results show that omeprazole cytodiagnosis of the ascites was that one was positive for
pretreatment can increase the effect of chemotherapeutic floating tumor cells and two were negative. After resection
Poster Session
agents in chemoresistant EOC and clear cell carcinoma via of the mass, and without adjuvant chemotherapy, the
reduction of the acidic tumor microenvironment. ascites disappeared rapidly in all three cases. No recurrence
has been found to date; the disease-free survival intervals
281
were 1,264, 1,785 and 1,750 days, respectively, at last seven WD cases, which were treated from 2005 to 2014
checkup. at our institution were assessed retrospectively. Magnetic
CONCLUSION: We have encountered three cases of resonance findings of a main tumor, tumor markers
borderline ovarian tumor accompanied with massive (CA125, CA19-9 and CEA), presence of ascites, peritoneal
ascites. They were atypical in that they were not advanced dissemination and omental cakes, lymph nodes (LNs)
ovarian cancers, nor did they fit within the criteria of Meigs metastasis, and distant metastasis status were analyzed.
or pseudo-Meigs’ syndrome, because they lacked pleural RESULTS: There was no significant difference on age, LNs
effusion. This is not unusual, in that various types of benign metastasis and tumor markers between four subtypes. IR
to highly malignant ovarian tumors may present as massive cases showed significantly earlier stages, whereas MT cases
ascites of unknown origin. Physicians should be aware of indicated significantly advanced stages compared to the
the differential diagnostics needed to determine what type other subtypes (p=0.0009 and p=0.0007, respectively).
of mass they are dealing with. Pathological confirmation of The origin of all IR cases was ovary or Fallopian tube,
the tumor and its surgical removal are primary goals in such whereas fifty one cases with the other subtypes comprised
cases, in order to avoid unnecessary neo-adjuvant therapy twelve peritoneal cancers (p=0.0279). Especially eight of
and radiation/chemotherapy. twenty-seven MT cases were peritoneal origin (p=0.0495).
Magnetic resonance images demonstrated that a larger
proportion of SP cases (eleven out of sixteen) show solid
PO-1027 appearance compared with the other subtypes (twenty-
nine out of fifty-two, p=0.3562). Significant less peritoneal
Four pathological subtypes of high-grade dissemination was observed in IR cases compared with the
serous adenocarcinoma of ovary, Fallopian other subtypes (ten out of eighteen versus four out of fifty-
tube and peritoneum demonstrate distinct one, respectively; p<0.0001), whereas all MT cases showed
clinical features peritoneal dissemination (p=0.0008). SP cases tended to
include larger amount of ascites compared to the other
Takuma Ohsuga, Ken Yamaguchi, Ryusuke Murakami,
subtypes (p=0.0592). IR cases indicated significantly
Noriomi Matsumura, Kaoru Abiko, Yumiko Yoshioka, Junzo
less omental cake (p=0.0033). In terms of metastasis to
Hamanishi, Masafumi Koshiyama, Eiji Kondoh, Tsukasa Baba,
distant organs, ten out of twenty-seven MT cases showed
Ikuo Konishi
significantly more distant metastases (p=0.0008), whereas
Department of Gynecology and Obstetrics, Kyoto University all IR indicated no distant metastasis in eighteen cases
Graduate School of Medicine, Kyoto, Japan (p<0.0001).
CONCLUSION: The pathological subtypes of HGSAC show
OBJECTIVE: High-grade serous adenocarcinoma (HGSAC) distinct clinical behaviors as well as the different prognosis.
of ovary, Fallopian tube and peritoneum is classified IR subtype possibly drives from ovary or Fallopian tube
to four subtypes based on gene expression profiles: and exhibits early stages without peritoneal dissemination
Immunoreactive, Mesenchymal, Proliferative and nor omental cake. The origin of some MT subtype is
Differentiated. We identified pathological classification peritoneum. MT subtype spreads to peritoneum and distant
according to these subtypes, Immuno-reactive (IR), metastasis. SP subtype exhibits solid growth in primary
Mesenchymal Transition (MT), Solid and Proliferative (SP) tumor accompanied with large amount of ascites and
and Well Differentiated (WD). Although IR subtype is omental cake. These findings seem to reflect their different
known to show the most favorable prognosis in HGSAC, prognosis and lead to development of novel diagnostic
the other clinical features among these subtypes have not tools and therapeutic strategies based on precision
been explored yet. The object of this study is identification medicine.
of distinct clinical findings among four pathological
Poster Session
subtypes of HGSAC.
METHODS: Sixty-nine HGSAC cases including eighteen IR
cases, twenty-seven MT cases, seventeen SP cases and
282
PO-1028 observed in 3 cases (7.9%): 2 cases of serous borderline
tumor, 1 case of endometrioid borderline tumor. For both
Retrospective analysis of epithelial borderline
cases, tumor resection was performed only on the affected
ovarian tumors
side to preserve fertility. Treatment at time of reccurence
was successful and the patients have had an uneventful
Sho Sato, Yuichi Imai, Yuri Yano, Aki Miyasaka, Aiko
Ogasawara, Akira Yabuno, Akira Kurosaki, Hiroyuki Yoshida course without any repetitive recurrence. Of the women
Kosei Hasegawa, Keiichi Fujiwara during fertile age cases, 29 cases (76.3%) underwent
fertility-sparing surgery and subsequently 9 cases (31.0%)
Department of Gynecologic Oncology, Saitama Medical University
were confirmed with the establishment of pregnancy.
International Medical Center, Saitama, Japan
CONCLUSION: At our department, epithelial BOT cases
were observed with recurrence of serous borderline tumor
OBJECTIVE: The number of epithelial borderline ovarian
and endometrioid borderline tumor. However, mucinous
tumor (BOT) is considered to be increasing in recent
borderline tumor was not. There was no death case as far
years, but its prognosis is preferable overall. Taking into
as women during fertile age cases were concerned, so it
consideration that there are many women during fertile
was suggested that case-specific fertility-sparing surgery
age onset patients compared with ovarian epithelial
might be allowed at the initial treatment because disease
carcinoma, its treatment strategy of BOT is often discussed
control is possible by appropriate treatment at the time of
focusing on the pros and cons of fertility-sparing surgery. In
recurrence.
this study, therefore, we sought to investigate the cases of
our department with the aim to advocate the appropriate
treatment and follow-up of epithelial BOT.
PO-1029
METHODS: We retrospectively analyzed 110 cases of
epithelial BOT that were treated at our department from Long-term clinical outcome of patients
April 2007 to March 2015. Similarly, a retrospective with ovarian clear-cell adenocarcinoma at
examination was performed for women during fertile age reproductive age
onset patients under 40 years of age.
RESULTS: The age ranged from 16 to 87 years old (median: Kenichi Nakamura, Hiroaki Kajiyama, Fumi Utsumi, Kaoru
48.5 years). The clinical stage (FIGO1988) was observed Niimi, Kiyosumi Shibata, Fumitaka Kikkawa
as follows: 107 cases in stage I (97.2%) and 3 cases in Department of Obstetrics and Gynecology, Nagoya University
stage III (2.8%). Histological types were divided into as Graduate School of Medicine, Nagoya, Japan
follows: 66 cases of mucinous borderline tumor (60.0%),
33 cases of serous borderline tumor (30.0%), 5 cases of OBJECTIVE: We retrospectively analyzed the
endometrioid borderline tumor (4.5%), and 6 other cases clinicopathologic features and evaluated the prognostic
(5.5%). Recurrence was observed in 5 cases (4.5%): 4 indicators of long-term survival in patients with ovarian
cases of serous borderline tumor, 1 case of endometrioid clear-cell carcinoma (CCC) at reproductive age.
borderline tumor, and none for mucinous borderline tumor. METHODS: Between 1988 and 2012, as a multicentric
Two cases (1.9%) did not respond to treatment at the time retrospective study, clinicopathologic data on 130 young
of reccurence and died, both of whom were involved in patients with CCC collected under the central pathological
women during fertile age serous borderline tumor. There review system were subjected to uni- and multivariable
were 38 women during fertile age cases (34.5%). The analyses to evaluate overall survival (OS).
clinical stage was observed as follows: 37 cases in stage RESULTS: The median age was 40 (27-45) years. The median
I (97.4%) and 1 cases in stage III (2.6%). Histological follow-up period for surviving patients was 57.5 months.
types were divided into as follows: 20 cases of mucinous During the observation period, there were 16 recurrences/
Poster Session
borderline tumor (52.6%), 15 cases of serous borderline progression in 82 patients with stage I tumors (19.5%), 10
tumor (39.5%), 2 cases of endometrioid borderline tumor in 18 with stage II (55.6%), and 19 in 30 with III-IV (63.3%).
(5.3%), and one other case (2.6%). Recurrence was Consequently, 37 patients died of the disease. Those with
283
stage I or II did not reach the median OS. The median OS (range4-10), Overall response rate was 50%, and median
of stage III-IV was 24.9 months. Confining analysis to stage time to progression was 8 months. 3. The treatment was
I patients, there was no significant difference in the OS and discontinued for the reason that progressive disease 33%,
RFS of CCC patients between IA and IC1 (intraoperative thrombocytopenia 33.3%, PPE and mucositis 16.7%,
capsule rupture). In contrast, CCC patients with IC2/IC3 respectively.
showed a poorer OS than those with IA/ IC1 (P <0.0001). CONCLUSION: PLD plus Gemcitabine therapy appears to
In multivariable analysis confined to stage I patients, the be a tolerable regimen for Japanese woman with platinum
substage group were only an independent prognostic resistant ovarian cancer, and Gemcitabine 1000mg/m2 and
factor for OS {IA/IC1 vs. IC2/IC3} (hazard ratio [HR] =11.8; PLD 30mg/m2 were recommended.
95% CI, 1.026–150.650; P =0.048).
CONCLUSION: We should keep in mind the greater risk
of recurrence in patients higher than staged IC, except PO-1031
intraoperative rupture. Loss of ARID1A expression is associated with

poor prognosis in patients with stage I/II clear
cell carcinoma of the ovary
PO-1030
Hiroaki Itamochi1, Nao Oumi2, Teturo Oishi2, Tadahiro Shouji1,

Feasibility study of pegylated liposomal
Hiroyuki Fujiwara3, Mitsuaki Suzuki3, Junzo Kigawa4, Tasuku
doxorubicin and gemcitabine for platinum
Harada2, Toru Sugiyama1
resistant ovarian cancer
1
Department of Obstetrics and Gynecology, Iwate Medical
Hidekatsu Nakai, Takako Tobiume, Ayako Suzuki, Yasushi University, Japan, 2 Department of Obstetrics and Gynecology,
Kotani, Masaki Mandai Tottori University School of Medicine, Tottori, Japan, 3 Department
of Obstetrics and Gynecology, Jichi Medical University, Tochigi,
Department of Obstetrics and Gynecology, Kinki University Faculty
Japan, 4 Department of Obstetrics and Gynecology, Matsue City
of Medicine, Osaka, Japan
Hospital, Shimane, Japan
OBJECTIVE: Single agent chemotherapy is recommended in OBJECTIVE: Clear cell carcinoma of the ovary (CCC) has a
platinum-resistant ovarian cancer, but the median survival poor prognosis because of its resistance to conventional
time is extremely short. Pegylated liposomal doxorubicin platinum- or taxane-based chemotherapy. Consequently,
(PLD) and gemcitabine combination therapy has been there is a need to discover biomarkers for predicting
reported as useful regimen for platinum-resistant ovarian the outcome of patients with CCC and develop novel
cancer, but the feasibility of this combination therapy for treatment strategies (e.g., molecular-targeted agents)
Japanese woman has not been evaluated. To evaluate for this disease. Recent studies have shown that somatic
safety and efficacy of this regimen, fixed dose feasibility mutations in the AT-rich interactive domain 1A (SWI-
study was conducted. like) gene (ARID1A), also known as BAF250, are the most
METHODS: All patients have received platinum-taxane common genetic changes in CCC. This gene is located in
combination therapy, and disease has been recurrence chromosome 1p36 and encodes a member of the switch/
within 6 month. 9 patients treated at Kinki University sucrose-nonfermentable (SWI/SNF) family protein BAF250a
Hospital were included in this study. Gemcitabine 1000mg/ (ARID1A), which is involved in the regulation of many
m2 was infused intravenously on day 1, 8, and PLD 30mg/ cellular processes including development, differentiation,
m2 was infused intravenously on day 1. Treatment cycle proliferation, DNA repair, and tumor suppression. Here,
were repeated every 21days. we investigated whether ARID1A could be a prognostic
RESULTS: 1. The mean number of previous treatment biomarker for this disease..
Poster Session
regimen was 1.3 ±0.4 (range 1-2), and average of METHODS: Paraffin-embedded specimens were collected
platinum free interval was 3.2±1.5 month (range 1-5) 2. from 220 Japanese patients with epithelial ovarian
Mean number of treatment courses were 7 ±2 courses cancer, including 112 CCC and 108 high-grade serous
284
adenocarcinoma of the ovary (HG-SAC). We analyzed present study evaluates the use of DSC in differentiating
the protein expression of ARID1A in these samples the increasing severity of ovarian cancer among healthy
by immunohistochemical staining, and evaluated the women.
association of these molecular parameters with clinical METHODS: 47 diseased women were subdivided into 4
outcome. stages with respect to clinical relevance and severity. Stages
RESULTS: The loss of ARID1A expression was found in 39 I and II were regarded as early stages, whereas stages III and
% (44/112) of CCC, and strong expression of the protein IV were regarded as advanced stages. DSC thermograms
was not observed. ARID1A protein was present mainly were hypothesized to exhibit a differential expression of
in the cell nuclei of the tumors; however, in tumors with ovarian cancer biomarkers that subsequently bind to and
HG-SAC, only 8 (7 %) tumors showed loss of ARID1A affect the thermal behavior of the most abundant plasma
expression. The rate of absent expression of ARID1A in proteins.
CCC tumors was significantly higher than in HG-SAC RESULTS: Significant changes in two major thermal
tumors (P < 0.0001). We found no significant association transition peaks were detected as the cancer proceeded.
between ARID1A expression and patient age, FIGO stage, The two average transition temperatures (Tm) increased
and status of residual tumor in CCC. The 5-year survival with disease severity from 64.84°C and 70.32°C (healthy)
rate for FIGO stage I or II CCC patients with negative tumor to 68.46°C and 75.24°C (Stage IV), respectively. In
expression of ARID1A was lower than those with positive addition, the change in heat capacity of each peak was
tumor expression of ARID1A (74 % vs 91 %), but this dependent on the disease severity. To further support and
difference was not observed in FIGO stage III or IV patients. investigate the nature of the proposed interactions, MALDI-
Multivariable analysis revealed that FIGO stage and residual TOF MS analysis was also employed. The results suggest
tumor were independent prognostic factors, but ARID1A differences in peptide expression between early stage and
expression was not. However, ARID1A expression was an advanced stage ovarian cancer. In addition, the PCA-DA
independent prognostic factor in FIGO stage I or II CCC of the plasma samples identified the strongest principal
patients. Multivariable analysis revealed that ARID1A component sufficient to sort MS data into groups. Total
expression was an independent prognostic factor in FIGO ions were differentially abundant at p values < 0.05.
stage I or II CCC patients. CONCLUSION: The combined DSC and MS approach in this
CONCLUSION: The ARID1A protein may be a promising study was successful in identifying a unique signature of
prognostic marker for FIGO stage I and II CCC. Further ovarian cancer stages, and demonstrates the potential of
study is needed to confirm our findings and to elucidate DSC plasma profiles as a complementary diagnostic tool in
how ARID1A affects the clinical features of CCC. the evaluation of early stage ovarian cancer.
PO-1032 PO-1033
Investigation of ovarian cancer biomarker Analysis of Her2/neu expression in advance

patterns in blood plasma by differential stage ovarian carcinoma undergoing
scanning calorimetry and mass spectrometry neoadjuvant chemotherapy- A tertiary care
center experience from India
Jinghui Jin, Nam Ah Kim, Yun Hwan Kim, Woong Ju, Seong
Hoon Jeong, Seung Cheol Kim Shiv Rajan, Vijay Kumar, Sameer Gupta, Nasem Akhtar
Department of Obstetrics and Gynecology, Ewha Womans Department of Surgical Oncology, King George’s Medical
University MokDong Hospital, Seoul, Korea University, Lucknow, India
Poster Session
OBJECTIVE: Differential scanning calorimetry (DSC) has OBJECTIVE: Ovarian cancer is the leading cause of death
recently been shown to detect specific changes in the among gynaecological malignancies. Despite the recent
thermal behavior of plasma proteins in several diseases. The advances in the management, the 5-year survival is poor.
285
Considerable efforts are being made to identify novel of her2/neu and postmenopausal patients tend to have
markers which can help in better understanding the biology positive expression of her2/neu significantly. Response to
of the disease and developing newer drugs targeting these neoadjuvant chemotherapy and level of cytoreduction
markers. This study was undertaken to study the expression are not related to her2/neu expression. In other term,
of her2/neu in ovarian cancer cells in patients receiving her2/neu status neither predicts response to neoajuvant
neoadjuvant chemotherapy for stage IIIC and IV disease. chemotherapy nor predict level of cytoreduction.
METHODS: Total 82 patients with stage IIIC and IV ovarian
carcinoma were included in this prospective study cohort.
Standard 3 to 4 cycles of platinum based neoadjuvant PO-1034
chemotherapy was given after confirming diagnosis by
Transvaginal ultrasound-guided biopsy
tissue biopsy or fine needle aspiration cytology (FNAC).
of adnexal masses as a useful diagnostic
Response assessment was done by imaging using
RECIST 1.1 guidelines before and after chemotherapy.
alternative replacing cytology or laparoscopy
After surgery her2/neu expression was carried out by
in advanced ovarian cancer patients
immunohistochemistry utilizing DAKOPATIS antibodies.
Tae-Wook Kong, Suk-Joon Chang, Seong Woo Kang,
Total 62 patients were finally included in analysis including
Kyoungjin Chang, Jiheum Paek, Eun Ju Lee, Hee-Sug Ryu
50 her2/neu negative (no or weak IHC staining, incomplete
membrane staining in any proportion of tumour cells) Department of Obstetrics and Gynecology, Ajou University School
of Medicine, Suwon, Korea
and 12 patients with her2/neu positive results (uniform,
intense membrane staining of >30% of invasive tumour
OBJECTIVE: The aim of this study was to evaluate
cells) excluding 20 patients with equivocal her2/neu status
by IHC (complete membrane staining which is either non- transvaginal songraophy (TVS)-guided core biopsy of the
uniform or weak in intensity in at least 10% of cells). adnexal masses for neoadjuvant chemotherapy (NACT) in
Receptor status was then studied in relation with age, patients with advanced ovarian malignancies.
histology, menopausal status, response to neoadjuvant METHODS: We retrospectively reviewed the medical records
chemotherapy, and level of cytoreduction. of 62 patients who had undergone TVS-guided core
RESULTS: Total 50 patients were found her2/negative and biopsies in our gynecologic cancer center between March
12 were positive (19.3% prevalence). The mean age of 2009 and November 2014. TVS-guided core biopsies were
her2/neu positive and negative subjects were 49.00+/- 9.30 performed on patients with advanced ovarian malignancies
and 47.00 +/- 9.60 years respectively (p= 0.73). All patients who were considered as candidates for neoadjuvant
were having serous histology except two her2/neu negative chemotherapy (NACT) and patients with adnexal masses
patients with mucinous histology (p=0.61). All 12 (100%) who required a differential diagnosis of non-gynecologic
her2/neu positive patients were postmenopausal compared tumors.
to 40 (80%) pre- and 10 (20%) postmenopausal patients RESULTS: Forty-one patients (66.1%) were scheduled to
were her2/neu negative (p=0.0001). Among 12 her2/ undergo NACT due to the presence of coexisting illness,
neu positive patients 10 were responder and 2 were non- age, tumor burden, and location of metastatic sites.
responder compared to 44 responder and 6 non-responder Twenty-one patients (33.9%) underwent TVS-guided core
to neoadjuvant chemotherapy in her2/neu negative biopsies to determine if they had primary or secondary
group (p=0.75). Total 38 (61.3%) patients had achieved ovarian tumors. Histopathologic examinations revealed
optimalcytoreduction (4 her2/neu positive and 34 her2/neu primary ovarian tumors in 46 patients (74.2%). Non-
negative). Among patients with suboptimal cytoreduction gynecologic tumors including metastatic lymphoma,
8 patients had her2/neu positive and 16 patients had her2/ gastrointestinal stromal tumor, malignant mesothelioma,
neu negative expression (p=0.11). and metastatic tumor from gastric, colorectal and
Poster Session
CONCLUSION: Her2/neu expression in advance stage ovarian gallbladder cancer were found to be the second most
carcinoma in our subset of patients is relatively high. common disease (n = 7 [11.3%]). In five patients (8.1%),
Premenopausal patients tends to have negative expression histopathologic evaluations revealed tubo-ovarian
286
abscesses. Findings in the samples were non-diagnostic material showed relapsed lesion in the pelvis. So she was
in four patients (6.5%). With respect to the histological received 50Gy radiotherapy to the lesser pelvis. Since then,
concordance rate between TVS-guided core biopsy and no remarkable progress has been seen. Eventually she has
surgical specimen, diagnostic accuracy was 88.6%. There been well for 36 months from the initial diagnosis. Case
were no biopsy-related complications. 2 is a 37-year-old woman with stage IIB of this tumor. She
CONCLUSION: TVS-guided core biopsy may be a feasible was seen in a clinic for right lower abdominal pain and
procedure to diagnose adnexal masses, particularly in right ovarian tumor was diagnosed. Considering about CT
patients with advanced ovarian malignancies who are more scan and laboratory tests findings, malignant ovarian tumor
likely to benefit from NACT. was suspected. Although primary debulking surgery was
performed, it was impossible to remove the tumor around
the right ureter. As consequence, we performed abdominal
PO-1035 total hysterectomy, bilateral salpingo-oophorectomy
and omentectomy. Then she was received concurrent
Radiotherapy for persistent malignant
chemoradiotherapy (cisplatin-5-FU combination regimen
transformation from mature cystic teratoma of
and 54Gy to the whole pelvis) for residual tumor and has
the ovary
been well for 27 months from the surgery.
CONCLUSION: In general, SCC is common histologic
Kosuke Yoshida, Hiroaki Kajiyama, Fumi Utsumi, Ryuichiro
Sekiya, Shiro Suzuki, Hiroko Mitsui, Kaoru Niimi, Kiyosumi subtype and thought to be radiosensitive. Although there
Shibata, Fumitaka Kikkawa is no established therapy, radiotherapy or concurrent
chemoradiotherapy might have beneficial effect for this
Department of Obstetrics and Gynecology, Nagoya University
tumor like SCC from other tissue.
Graduate School of Medicine, Nagoya, Japan
OBJECTIVE: Although mature cystic teratomas (MCT)

PO-1036
are very common germ cell tumor of the ovary in the
childbearing age, malignant transformations of them Twist promotes angiogenesis via CXCL11 in
occur in the postmenopausal age and most of them are ovarian cancer cell
squamous cell carcinomas (SCC). Because of the extreme
rarity of this tumor, strategic treatment for advanced cases Jin Hwa Hong1, Yu Jin Koo2, Kyung-Jin Min1, Jae-Kwan Lee1
and postoperative therapy are not established. Therefore 1
Department of Obstetrics and Gynecology, Guro Hospital College
the prognosis is quite poor. of Medicine Korea University, Seoul, Korea, 2 Department of
METHODS: In this presentation, we report two cases that Obstetrics and Gynecology, Youngnam University Medical Center,
radiotherapy was thought to be effective for SCC arising Daegu, Korea
from MCT.
RESULTS: Case 1 is a 64-year-old woman with stage IIA OBJECTIVE: Twist, one of the epithelial-mesenchymal
of this tumor. She was initially admitted to the surgical transition markers, also plays a role in tumor angiogenesis.
department of a hospital for umbilical hernia and However, the underlying mechanisms are not as well
performed preoperative tests. Abdominal computed understood. We investigated how Twist promotes tumor
tomography (CT) scan showed MCT in the left ovary. angiogenesis by modifying tumor microenvironment.
Although left salpingo-oophorectomy was performed at METHODS: First, we performed real-time PCR to check
the same time of surgery for umbilical hernia, complete the baseline expression level of Twist in various ovarian
surgery was impossible because of the dense adhesion. cancer cell lines (A2780, SKOV3, CAOV3, OVCAR3, and
Pathological finding revealed SCC arising from MCT. As ES-2). To confirm Twist-induced angiogenesis, the extent
Poster Session
postoperative therapy for residual tumor, interval debulking of tube formation was compared between ovarian cancer
surgery after paclitaxel-carboplatin combination regimen cell lines knocked down by either Twist siRNA or control
was performed. Three months later, CT scan with contrast siRNA. Next, cytokine array was performed in conditioned
287
media to find the specific cytokine in accordance with < 1cm), retrospectively.
Twist expression. To confirm the role of Twist-cytokine METHODS: During 1991-2014, clinical records of 178 AEOC
signaling for angiogenesis in ovarian cancer cell line, ELISA, patients with optimal cytoreductive surgery were collected
western blot, and tube formation assay was performed. in Tokai University. All patients were divided into two
Migrating activity of tumor-associated macrophage was group. SLA group (n=78): patients underwent SLA, and
evaluated using THP1 cells in conditioned media following another non-SLA group (n=100): patients did not undergo
silencing the expression of cytokine and Twist to confirm SLA. Survival curves were calculated using the Kaplan-
the relationship between Twist-induced angiogenesis and Meier method. Differences in survival rates were analyzed
tumor microenvironment. using the log-rank test. Cox proportional hazards regression
RESULTS: Among various cancer cell lines, A2780 showed analysis was performed to analyze the prognostic factors.
the highest level of Twist expression. Tube formations of RESULTS: 1) The median age was 58 years (range: 25-
HUVECs cultured in Twist-knockdown conditioned media 79). Among the total of 178 patients, 111 (62.4%)
was decreased compared to those cultured in control siRNA patients showed serous, 29 (16.3%) clear-cell, 20 (11.2%)
knockdown conditioned media. Cytokine array revealed endometrioid, and 6 (3.4%) mucinous histology. 2) Median
that CXCL11 expression was suppressed in media from follow-up time was 46 months (7-213), the 5-year overall
A2780 cells with Twist siRNA rather than those with control survival (OS) rate in SLA group (61.6%) was significantly
siRNA, which was further confirmed by western blot. After better than in non-SLA group (48.9%) ( p=0.04). In
silencing CXCL11 in A2780 cells, inhibition of angiogenesis addition, the 5-year progression-free survival (PFS) in SLA
was also confirmed by HUVEC tube formation assay. Given group (42.1%) was also significantly better than in non-
that the chemotactic activity of CXCL11 for macrophage, SLA group (32.5%) (p=0.017). 3) Confining analysis to
we performed the migration assay and confirmed that histology (serous or non-serous), OS in SLA group was
the migrating activity of macrophage was decreased after significantly better than in non-SLA group in patients with
silencing CXCL11 in A2780 cells. non-serous adenocarcinoma ( p=0.041). 4) In multivariate
CONCLUSION: Our findings showed that Twist recruits analysis, SLA was a significant prognostic factor for AEOC
tumor-associated macrophage through inducing CXCL11 in patients with optimal cytoreductive surgery (HR 0.621,
to promote angiogenesis in ovarian cancer. 95%CI 0.392-0.983, p=0.042).
CONCLUSION: Our data suggest that AEOC patients
with optimal cytoreduction who underwent SLA show a
PO-1037 significant improvement in survival.
Is there any association between

retroperitoneal lymphadenectomy and PO-1038
survival benefit in advanced epithelial ovarian
carcinoma patients? Intraperitoneal chemotherapy with paclitaxel
and carboplatin, a feasibility study
Masako Shida, Rie Nakajima, Chisa Narayama, Yusuke
Sagara, Toshiki Tajima, Satoshi Asai, Masae Ikeda, Takeshi Young-Han Park, Jungyeob Seoung, Minhyun Baek
Hirasawa, Mikio Mikami
Department of Obstetrics and Gynecology, Hallym University
Department of Obstetrics and Gynecology, Tokai University, Sacred Heart Hospital, Anyang, Korea
Kanagawa, Japan
OBJECTIVE: The purpose of this preliminary study is to see
OBJECTIVE: The effect of systematic lymphadenectomy (SLA) the feasibility of intraperitoneal paclitaxel and platinum
remains controversial in patients with advanced epithelial combination chemotherapy.
Poster Session
ovarian cancer (AEOC) who optimally debulked. The aim METHODS: A retrospective medical record review was
of this study was to verify the impact of SLA on survival in mad of all patients who underwent IP chemotherapy for
AEOC patients with optimal cytoreduction (residual tumor epithelial ovarian cancer at Hallym University Medical
288
Center. Toxicities were graded according to the US PO-1039
National Cancer Institute Common Terminology Criteria for
Standard or goal directed intra-operative
Adversse Events (CTCAE) version 4.0. Response evaluation
fluid therapy in ovarian cancer cytoreductive
was performed according to definitions for response and
surgery
progression in ovarian cancer clinical trials incorporating
RECIST 1.1 and CA125 Agreed by GCIG. IP paclitaxel and
Basumita Chakraborti, Asima Mukhopadhyay, Kishore
platinum combination chemotherapy was performed as
Kumar Roy, Angshuman Rudra Pal, Jyotsna Goswami
followed. After 1L hydration on day 1, pre-chemotherapy
Department of Gyneacology Oncology, Tata Medical Center,
hydration of normal saline 500cc IV was performed on
Kotkata, India
day 2. Taxol 135mg/m2 was introduced into the peritoneal
cavity on day 2. Postchemo hydration 1L was injected
OBJECTIVE: Background: Massive fluid shifts occur during
intravenously. On day 3, after pre-chemotherapy hydration
ovarian cancer (OC) cytoreductive surgery (CRS) which is
with normal saline 500cc IV, carboplatin injected into
associated with increased morbidity. Goal directed therapy
peritoneal cavity. Postchemotherapy IP hydration 500mL
(GDT) for intra-operative fluid (IOF) has not been widely
was injected.
studied in OC; Only 2 studies showed reduction in median
RESULTS: In 19 patients, 144 cycles of IP chemotherapy
length of stay (LOS) and postoperative morbidity. Aim:
were performed. Mean age was 55.1 (42~70) years. Three
To analyse the current IOF management in OC CRS and
patients were early stage (1A, 1C, 2B) and sixteen patients
develop a study protocol for GDT.
were advanced stage (stage IIIc: 12, stage IVa: 2, IVb:2). IP
METHODS: Retrospective observational study using data
chemotherapy was performed as adjuvant therapy after
primary debulking surgery in 7 patients. And in 10 patients, from electronic medical records and prospectively recorded
chemotherapy was performed after second look surgery. databases between December 2014 and May 2015.
IP chemotherapy was performed to recurrent diseases in 8 RESULTS: 41 patients underwent primary debulking
patients. Major toxicity was myelosupression (Grade 3, 4 surgery (PDS, n=15) or interval debulking (IDS, n=26).
neutropenia in 138 cycles, febrile neutropenia in 32cycles, Median total IOF administration using standard approach
thrombocytopenia in 35 cycles). Abdominal pain during was 5000 mls (crystalloids 2000 mls, colloid 2000 mls).
chemotherapy was rare (Grade 3 in 1 cycle). Catheter Intra-operative acidosis occurred in 25 % patients, 29 %
related complication was found in 6 cycles. In 11 cycles, patients required intraoperative albumin infusion, 56 %
treatment was delayed over one week (mainly due to required vasopressors on POD1. There was no difference
thrombocytopenia). In stage III disease, complete remission in mean IOF administration between PDS (longer duration
was archived in 7 patients (58.3%) and median progression of surgery or DOS) (5304 mls, DOS=627 mins) vs. IDS
free survival was 22months. Overall survival was 28 month (5215 mls, DOS=504 mins). Cumulative fluid balance on
in stage III disease and 21.5 months in stage IV disease. POD1 was 2435 mls. The median LOS for PDS was 11 days
CONCLUSION: Intraperitoneal paclitaxel and platinum vs. 8 days in IDS. In a later cohort of 4 patients (PDS=3,
combination chemotherapy is effective and tolerable with IDS=1) where GDT was initiated using SVV (stroke-volume
acceptable adverse effects as intravenous chemotherapy. variability), median IOF requirement was 8000 mls and no
Optimal cytoreductive surgery is necessary before intra-operative acidosis occurred.
intraperitoneal chemotherapy. More study in large group CONCLUSION: GDT might give better guidance to replace
and long term follow up of patients is necessary. IOF loss and maintain tissue perfusion in OC CRS. We aim
to develop a prospective study (RIGoROCS) comparing
GDT versus standard fluid management and measure
impact on hospital stay, post-operative morbidity and cost-
effectiveness.
Poster Session
289
PO-1040 goal directed fluid therapy to minimise tissue hypoxia,
intense chest physiotherapy, early mobilisation and
Infections after ovarian cancer cytoreductive
removal of lines/catheters, prospective recording of POMS
surgery: a retrospective audit
(post-operative morbidity scoring) and daily input from
microbiology have been adopted as strategies to reduce
Basumita Chakraborti, Asima Mukhopadhyay, Radhakanta
Pal, Jaydip Bhaumik, Anik Ghosh post-operative infection. A further audit will be carried out
after 6 months.
Department of Gyneacology Oncology, Tata Medical Center,
Kotkata, India
PO-1041
OBJECTIVE: Background: Ovarian cancer (OC) cytoreductive
surgery (CRS) is associated with major SIRS (systemic HDAC7 inhibitor might inhibit HIF-1 activity In
inflammatory response) and risk factors for developing ovarian clear cell adenocarcinoma
post-operative infectious morbidity. We have adopted
a policy of monitoring pre-operative stool cultures to Takeshi Hirasawa, Masaki Miyazawa, Masae Ikeda, Masako
determine possible antibiotic resistance prior to deciding Shida, Toshinari Muramatsu, Mikio Mikami
on antibiotic prophylaxis and presumptive therapy prior to Department of Obstetrics and Gynecology, Toakai University School
obtaining culture reports in an event of clinically suspected of Medicine, Kanagawa, Japan
infection. Aim: To analyse the current trend of post-
operative infections in OC CRS and develop a protocol for OBJECTIVE: We have previously reported that hypoxia
prophylaxis inducible factor -1 (HIF-1) has a high transcriptional activity
METHODS: Retrospective observational study using data in ovarian clear cell adenocarcinoma, and its activation is
from electronic medical records and prospectively recorded possibly associated with histone deacetylase 7 (HDAC7).
morbidity data between January 2015 and August 2015. Although there are some reports indicating that activation
RESULTS: 52 patients underwent cytoreductive surgery: and stabilization of HIF-1 is associated with various HDAC
primary debulking (PDS 44%), primary staging (PSS 15%), families, the details have yet to be clarified. This time, we
interval debulking (IDS 32%) or secondary debulking examined the relationship between the HDAC family and
(SDS, n=4). 90% patients had pre-operative stool culture HIF-1 activation in ovarian clear cell adenocarcinoma.
sensitivity reports available, 2% had MDRO (multi-drug METHODS: In 68 patients with epithelial ovarian tumors
resistant organisms), 4% had MRSA. All patients received who gave informed consent and underwent curative
peri-operative antibiotic prophylaxis between 24-72 hrs resection at the Department of Obstetrics and Gynecology
cover. Commonest regime used was co-amoxiclav and of Tokai University Hospital, immunostaining of tumors
amikacin. 46% patients developed clinical infection < 30 specimens was done with an HDAC7 antibody and the
days post-operative period for which antibiotic was re- positive rate was evaluated. The relationship between the
started. Intra-operative risks factors were : Duration of presence / absence of HDAC7 positivity and overall survival
surgery > 8 hrs- 65 %, bowel surgery 32 %, diaphragmatic (OS) was also analyzed. Using seven ovarian carcinoma cell
surgery 48 %, peritonectomy 65 %, ureteric stenting 10%, lines (serous: C13 and 2008; clear cell: RMG-1, HUOCA-
splenectomy % .Following infections were documented: II, HAC-2, and OVISE; granulosa cell tumor: KGN), culture
respiratory tract 21%, wound 33%, intra-abdominal sepsis was performed with various concentrations (1μM or 5μM)
19%, urinary 29%, central line related 8%, fungal 2% and of the HDAC inhibitor vorinostat. Cells were harvested
bacteraemia 15%. after 24 hours and RNA was extracted. Then cDNA was
CONCLUSION: We have modified our policy on duration prepared and real-time RT-PCR was performed to analyze
of prophylaxis according to duration of surgery- < 8 hrs changes in the expression of mRNAs for various HDACs
Poster Session
(3 doses), 8-12 hrs (6 doses) and > 12 hours (9 doses). and HIF-related factors (HIFs).
Pre-operative gut sterilisation may be adopted for cases RESULTS: In patients with epithelial ovarian cancer, HDAC7
predicted higher risk for bowel surgery. Early extubation, was highly expressed and patients with positive tumors
290
appeared to have a poor prognosis. Compared with other IC1, and 1 was IC2. Five-year progression-free survival (PFS)
cell lines, clear cell adenocarcinoma cells showed higher rates of IA, IC1, IC2, and IC3 patients were 89.2%, 82.8%,
expression of HDACs and HIFs. Expression was highest in 80.0% and 75.5%, respectively (p=0.32). The overall
HAC-2 cells and OVISE cells. Expression of HDAC6, 7, HIF- survival (OS) rates of IA, IC1, IC2, and IC3 patients were
1α, and VEGF was related to 4 factors in any cell line tested. 91.8%, 93.0%, 75.0% and 100%, respectively (p=0.40).
Inhibition of the expression of HDAC7 and HIFs by vorinostat CONCLUSION: With regard to mEOCs, revised FIGO staging
varied among cell lines and sensitivity was also different. The system might not reflect the oncologic outcome. A
same results were not obtained in all cell lines. prospective studies with larger cohort would be needed to
CONCLUSION: For inhibition of HDACs including HDAC7, it verify its clinical application in mEOCs.
is considered that a novel HIF-1 inhibitor (vorinostat) may
be effective by blocking the expression of HIF-1α. However,
further investigation is needed to allow the selection of an PO-1043
appropriate HDAC inhibitor.
Accuracy of a combined use of pre-operative
magnetic resonance imaging and intra-
operative frozen section analysis for borderline
PO-1042
ovarian tumors
Validation of revised FIGO staging system in
stage IC mucinous epithelial ovarian cancer Uchul Ju, Woo Dae Kang, Seok Mo Kim

Phill-Seung Jung, Shin-Wha Lee, Jeong-Yeol Park, Dae-Shik University Hwasun Hospital, Hwasun, Korea
Suh, Dae-Yeon Kim, Jong-Hyeok Kim, Yong-Man Kim, Young-
OBJECTIVE: To estimate the accuracy of intra-operative
Department of Obstetrics and Gynecology, Asan Medical Center, frozen section analysis (FSA) in suspected borderline ovarian
Ulsan University School of Medicine, Seoul, Korea tumors (BOT) by magnetic resonance imaging (MRI) and to
identify the factors associated with ovarian malignancy on
OBJECTIVE: We applied revised FIGO staging system to final histologic diagnosis.
identify its clinical impact of on stage IC mucinous epithelial METHODS: A retrospective review of patients diagnosed
ovarian cancer (mEOC). with BOT on MRI was performed, at Chonnam National
METHODS: After retrospective review of mEOC patients University Hospital from January 2005 to April 2015. FSA
who were treated between May, 1990 and March, 2013 and final histology reports were compared. Univariate and
at Asan medical center, a total of 142 patients with stage I multivariate regression analysis were used to assess the
were enrolled in the current study. Patients with FIGO stage influence of clinicopathological factors on the likelihood of
IC were reclassified as IC1, IC2 and IC3 according to revised a diagnostic discrepancy.
FIGO staging system. Oncologic outcomes between stage RESULTS: A total of 121 cases were suspected to BOT by
IA, IC1, IC2, and IC3 were compared using Kaplan-Meier MRI, but, only 60 (49.6%) were confirmed for BOT on final
methods. histology. The accuracy of FSA in BOT that was suspected
RESULTS: In our study cohort, 84 (59.2%) were stage IA, by MRI was yielded as a sensitivity of 83.3%, a specificity
58 (40.8%) were IC, and there were no stage IB. After of 90.2%, a positive predictive value of 89.3%, and a
reclassification of stage IC, 30 (21.1%) patients were negative predictive value of 84.6%, respectively. Among
IC1 (intraoperatively ruptured tumor), 8 (5.6%) were IC2 121 cases, 22 (18.2%) were reclassified as malignancy
(ovarian surface involvement) and 20 (14.1%) were IC3 on final diagnosis. Of these 22 cases, 5 had diagnosed
(positive cytology). During 72.1 (0.8-243.5) months of as borderline or benign ovarian tumor on FSA. In a
Poster Session
the median follow-up duration, 17 (12.0%) patients were univariate regression analysis, the ovarian malignancy was
recurred; 8 were IA, 3 were IC1, 1 were IC2, and 5 were associated with tumor size of greater than 10 cm (odds
IC3, and 8 (5.6%) patients died of mEOC; 6 were IA, 1 was ratio (OR), 5.000; P<0.05), presence of solid lesions (OR,
291
5.345; P<0.01), papillary portions (OR, 3.048; P<0.05) (OCCC), 55 (22.2%) with endometrioid adenocarcinoma,
and bilateral tumors (OR, 4.118; P<0.05). In a multivariate 51 (20.6%) with mucinous adenocarcinoma, 26 (10.5%)
analysis, tumor size ≥10 cm (OR, 6.183; P<0.05), presence with serous adenocarcinoma. Lymph node metastases were
of papillary portions (OR, 3.974; P<0.05) and bilateral detected in 18 cases (7.3%), and the half of them were
tumors (OR, 7.354; P<0.05) were independent predictors. OCCC. In this study, there were no significant differences
CONCLUSION: MRI seems to be a useful pre-operative test between the group A+C and the group B for OS (p=0.635)
for predicting the diagnosis of ovarian tumor and intra- or PFS (p=0.738).
operative FSA assists gynecological oncologists to perform CONCLUSION: This study revealed that systematic
the appropriate surgery. But, in BOTs, a single use of MRI or retroperitoneal lymphadenectomy could not improve the
FSA has low accuracy and causes over-and under-diagnosis. 5-year OS or PFS in early stage EOC. However, since the half
A combined use of two methods can increase the of lymph node metastasis was OCCC, pelvic and para-aortic
diagnostic accuracy and help proper decisions in surgery. lymphadenectomy may be effective for early stage OCCC.
Nonetheless, because suspected BOTs ≥10 cm in diameter,
as well as those with bilateral tumors and papillary portions
may be related to the ovarian malignancy, proper treatment PO-1045
is needed.
Impact of surgical staging on prognosis in
patients with borderline ovarian tumors:
a meta-analysis
PO-1044
Clinical impact of systematic Seung-Hyuk Shim, Soo-Nyung Kim, Sun Joo Lee
lymphadenectomy for early stage epithelial Department of Obstetrics and Gynecology, Konkuk University
ovarian cancer School of Medicine, Seoul, Korea
Masae Ikeda, Misaki Momose, Rie Nakajima, Chisa Agui, OBJECTIVE: To quantify the effect of complete surgical
Yusuke Sagara, Satoshi Asai, Toshiki Tajima, Masako Shida, staging (CSS) on prognosis in borderline ovarian tumor
Takeshi Hirasawa, Mikio Mikami (BOT) patients through a meta-analysis.
Department of Obstetrics and Gynecology, Tokai University School METHODS: We systematically reviewed published studies
of Medicine, Kanagawa, Japan comparing CSS with incomplete surgical staging (ISS)
in BOT patients through April 2015. Endpoints were
OBJECTIVE: To evaluate the clinical impact of pelvic and recurrence and mortality rates. Study design features that
para-aortic lymphadenectomy for early stage epithelial possibly affected participant selection, recurrence/death
ovarian cancer (EOC). detection, and manuscript publication were assessed. For
METHODS: In accordance with Helsinki Declaration, medical pooled estimates of the effect of CSS on recurrence/death,
records were reviewed retrospectively for 248 patients random- or fixed-effects meta-analytical models were used
treated surgically for early stage EOC (pT1+pT2) between after assessing cross-study heterogeneity.
July 1991 and February 2014 at Tokai University Hospital. RESULTS: Eighteen observational studies (CSS, 1297
Patients were categorized according to group A (pN0l, patients; ISS, 1473 patients) met our search criteria. Fixed-
n=203) or group B (pN1, n=18) or group C (pNX, n=65). effects model-based meta-analysis indicated a reduced
The primary endpoints were OS and PFS. All statistical recurrence risk among CSS patients (odds ratio [OR]=0.64;
analyses were carried out using the SPSS software program. 95% confidence interval [CI]: 0.47–0.87, P<0.05, I2=25.6).
RESULTS: The median age was 53.5 years (range: 20- However, no significant between-group difference in
88) and the median follow-up was 70.7 months (range: mortality was observed (OR=0.98; 95% CI: 0.42–2.29,
Poster Session
7-234). Of the 248 patients, 203 with pT1 (pT1a:61, P=0.97, I2=0). In subgroup analysis by histology, CSS was
pT1b:4, pT1c:138), 45 with pT2 (pT2a:4, pT2b:8, pT2c:33). associated with a reduced recurrence risk in 16 studies of
Histology were 100 (40.3%) with clear cell adenocarcinoma all histologic types (OR=0.66, 95% CI: 0.48–0.91, P<0.05,
292
I2=31.9) but not in two studies of only mucinous disease higher in mucinous + clear cell group than endometrioid +
(OR=0.41, 95% CI: 0.13–1.30, P=0.13, I2=0). In subgroup serous group (39.1% vs. 4.6%, p<0.001). In multivariate
analyses with four studies with recurrence data according analysis for overall survival, independently significant
to fertility-sparing surgery, no significant association was indicators related to recurrence were location (locoregional
found (OR=0.51, 95% CI: 0.18–1.43, P=0.20, I2=0). There vs. distant, p=0.002), recurrence type (discrete vs. diffuse,
was no evidence of publication bias. p=0.005) and spread pattern (transcoelomic vs. mixed,
CONCLUSION: In this meta-analysis based on observational p=0.016). Also, histology type (serous + endometroid vs.
studies, CSS appeared to significantly reduce recurrence mucinous + clear cell, p = 0.044) and platinum sensitivity
among BOT patients. No survival impact was observed. (sensitive vs. resistant, p<0.001) were significantly
Longer-term randomized controlled trials could verify this associated with overall survival.
relationship but appear infeasible for this rare tumor. CONCLUSION: In recurrent ovarian cancer patients with
no gross residual disease after primary debulking surgery,
patients with distant, diffuse recurrence, mixed spread
PO-1046 pattern, mucinous and clear cell histology are likely to have
higher risk in overall survival.
Prognostic significance of the recurrence
pattern and risk factors for survival in ovarian
cancer patients with no gross residual disease
PO-1047
after primary debulking surgery
Differences in survival outcome of recurrent
E Sun Paik epithelial ovarian cancer patients with
Department of Obstetrics and Gynecology, Samsung Medical secondary cytoreductive surgery diagnosed
Center, Sungkyunkwan University, Seoul, Korea recurrence by different initial diagnostic
method
OBJECTIVE: The aim of this study was to analyze the
patterns of recurrence and their association with clinical E Sun Paik, Aera Yoon, Eun Jin Heo, Hyun Jin Choi, Yoo-
outcomes in recurrent ovarian cancer patients with no Young Lee, Tae-Joong Kim, Chel Hun Choi, Jeong-Won Lee,
gross residual disease after primary debulking surgery. Byoung-Gie Kim, Duk-Soo Bae
METHODS: This study was conducted on 303 ovarian Department of Obstetrics and Gynecology, Samsung Medical
cancer patients with no residual disease after primary Center, Sungkyunkwan University, Seoul, Korea
cytoreduction in Samsung Medical Center since January
2002 to December 2012. For each relapse, information OBJECTIVE: The aim of this study was to compare two
on date of clinical/pathological recurrence, and pattern of groups of recurrent epithelial ovarian cancer (EOC) patients
disease presentation were retrieved. Survival probabilities who had secondary cytoreductive surgery (SCS) with
were compared by the log rank test. Cox's regression initially diagnosed recurrence by CA-125 elevation or
model with stepwise variable selection was used for imagining study.
multivariate prognostic analysis for overall survival. METHODS: This study was conducted on 99 recurrent EOC
RESULTS: Within a median follow-up of 53 months (range patients who had SCS in Samsung Medical Center since
3~156), 88 recurrences (29.0%) and 28 cancer-associated January 2002 to December 2013. Patients with optimal
deaths (9.2%) were recorded. By analyzing the pattern debulking in primary cytoreduction, more than 6 months
of relapse, most of the recurrences were distant (n=65, of platinum-free interval (PFI), without ascites and extensive
73.9%), discrete (n=57, 64.8%) and transcoelomic (n=41, dissemination at recurrence diagnosis for SCS were
46.6%). Of 88 recurrences, 79 cases (89.8%) recurred included in this study. By reviewing electric medical records,
Poster Session
within 36 months. Percentage of distant recurrence of we investigated patient baseline characteristics, surgical
stage III, IV was comparably higher than stage I, II (83.3% characteristics, recurrence pattern and survival outcomes.
vs. 53.6%, p=0.005). Percentage of platinum resistant was Survival probabilities were compared by the log rank test.
293
RESULTS: Within a median follow-up of 67 months (range using CCC cell lines.
21~189), 19 cancer-associated deaths (%) were recorded. METHODS: We examined the roles of LCN2 in the
Most of the patients were stage III (n=71, 71.7%) and regulation of intracellular iron concentrations, oxidative
serous type (n=70, 70.7%). First recurrence was initially stress, DNA damage, apoptosis, and anti-oxidative
noticed by either CA-125 elevation (n=40, 40.4%) or functions using LCN2-overexpressing (ES2), and LCN2-
imaging study (n=59, 59.6%). High percentage of extra- silenced (RMG-1) CCC cell lines and recombinant LCN2.
pelvic recurrence (50.0% vs 17.2%, p=0.003), multiple RESULTS: The results of calcein staining indicated that the
recurrence (46.4% vs.20.5%, p<0.001) and no residual elevated expression of LCN2 correlated with increased
after SCS (66.7% vs. 15.7%) were shown in group intracellular iron concentrations. However, the DCFH-DA
diagnosed recurrence by CA-125 elevation compared to assay and 8OHdG staining revealed that LCN2 reduced
group diagnosed by imaging study. Differences in median intracellular levels of reactive oxygen species (ROS) and DNA
PFI were also shown (19.5 (6~83) vs. 26 (7~151), p=0.008). damage. Furthermore, the expression of LCN2 suppressed
In survival analysis, group diagnosed with imaging study hydrogen peroxide-induced apoptosis and prolonged cell
showed better result for overall survival (OS). survival, suggesting an anti-oxidative role of LCN2. The
CONCLUSION: In recurrent EOC patients who had SCS, expression of mRNA and protein for various oxidative
patients diagnosed for recurrence by CA-125 elevation are stress-catalyzing enzymes, such as heme oxygenase (HO),
associated with multiple, extra-pelvic recurrence and they super oxide dismutase (SOD), and glutathione peroxidase,
are expected to have poor survival than patients diagnosed and peroxiredoxin, was not affected by LCN2, whereas
recurrence by imaging study without CA-125 elevation. intracellular concentration of a potent antioxidant,
glutathione (GSH), was increased by LCN2. Furthermore,
the expression of xCT, a cystin transporter protein, and
PO-1048 CD44 variant 8-10 (CD44v), a stem cell marker, was up-
Lipocalin2 enhances the tolerance against regulated by LCN2.
oxidative stress in clear cell carcinoma cells CONCLUSION: The present study demonstrated that LCN2
through the upregulation of CD44 variant worked as an antioxidant and the effect was caused by
CD44 variant-mediated increased expression of GSH.
Yasushi Yamada, Tutomu Miyamoto, Hiroyasu Kashima, Subsequently, LCN2 inhibits apoptosis and prolongs cell
Hisanori Kobara, Ryoichi Asaka, Hirohumi Ando, Shotaro survival under various stress conditions, including oxidative
Higuchi, Koichi Ida, Tanri Shiozawa stress and chemotherapy, thereby providing advantageous
characteristics to cancer cells to survive in stress-rich
Department of Obstetrics and Gynecology, Shinshu University
School of Medicine, Nagano, Japan endometriotic cysts.
OBJECTIVE: Ovarian clear cell carcinoma (CCC) arises

PO-1049
from ovarian endometriosis. Intra-cystic fluid contains
abundant amounts of free iron, which causes persistent A new microchip system for isolating
oxidative stress, a factor that has been suggested to induce circulating tumor cells (CTC) in epithelial
malignant transformation. However, the mechanisms ovarian cancer patients
linking oxidative stress and carcinogenesis in CCC currently
remain unclear. Lipocalin 2 (LCN2), a multi-functional Maria Lee, Hee Seung Kim, Hyun Hoon Chung, Jae-Weon
secretory protein, functions as an iron transporter as well Kim, Noh Hyun Park, Yong-Sang Song
as an antioxidant. We previously showed that LCN2 was Department of Obstetrics and Gynecology, Seoul National
strongly expressed in ovarian endometriosis and its related University Hospital, Seoul, Korea
Poster Session
carcinomas, and the up-regulation of LCN2 expression

was associated with poor outcome of ovarian carcinoma OBJECTIVE: Detection of circulating tumor cells (CTC) has
patients. Therefore, we herein examined the roles of LCN2 been proposed previously, but a sensitive detection system
294
has not been developed for clinical practice thereafter. cells with what is called BRCAness,that some sporadic
We evaluated the feasibility of a CTC chip with electrically cancers share with those occurring in either BRCA1/2
conductive, nano-roughened microfluidic platform for mutation carriers. Before PARP inhibitors can be approved
identifying CTCs in epithelial ovarian cancer (EOC) patients. in East Asia, molecular profiling of ovarian cancer (OC)
METHODS: A prospective study of 27 patients with EOC with BRCAness status is necessary to establish precision
recruited between August 2014 and May 2015 were medicine.
enrolled. Peripheral blood CTCs were detected before the METHODS: To determine the prevalence of BRCA1/2
primary tumor resection and before the start of adjuvant large genomic rearrangements, MLPA (multiplex ligation-
chemotherapy. dependent probe amplification) method was applied
RESULTS: Twelve patients with primary disease and 15 to find BRCAness status, retrospectively. Genomic DNA
patients with recurrence were included in the study. CTCs was extracted from 248 tumor samples (76 serous, 31
were detected in 96.3% (26/27) of patients. In the primary mucinous, 53 endometrioid, and 88 clear cell) from
disease group, the median number of single CTCs and epithelial OC stored at the Keio Women’s Health Biobank
CTC clusters were 4 (0-13) and 1 (0-14), respectively. In (KWB: Keio University School of Medicine, Tokyo, Japan).
recurrent disease, the median number of single CTCs and Classification (BRCA1-like or non-BRCA1-like) was carried
CTC clusters were 3 (1-9) and 1 (0-24), respectively. The out on the normalized data according to previous report.
results were not statistically significant according to tumor RESULTS: Seventy of 248 (28.2%) of OC cases were
stage, serum CA125 level and the number of CTCs and identified as BRCA1-like tumors. BRCA1-like tumors were
CTC clusters. However, the presence of CTC clusters was significantly found in serous adenocarcinoma than non-
related with platinum-resistance. The Isolation of CTCs and serous OC (p<0.001).
ex-vivo culture was succeeded in 2 patients. Isolated CTCs CONCLUSION: Our result predicted PARP inhibitors, which
showed a higher sensitivity anticancer drugs and more respond to tumor cells with deficient in homologous
rapid proliferation than established cell lines. recombination mediated DNA double-strand-break-repair,
CONCLUSION: This study showed promising results and could be effective in certain cases of OCs, especially in
feasibility of an electrically conductive, nano-roughened serous OCs.
microfluidic platform based chip for identification of CTCs
in EOC patients. Larger sample size and a longer follow-up
are needed for individualized testing and for application for PO-1051
clinical use.
Pathologic findings at risk-reducing Salpingo-
Oophorectomy in patients with breast cancer:
significance of RRSO completion at proper age
PO-1050
in germline BRCA mutation carriers
Profiling of epithelial ovarian cancer with
BRCAness status Young-Jae Lee, Yong-Man Kim, Joo-Hyun Nam, Young-Tak
Kim, Jong-Hyeok Kim, Dae-Yeon Kim, Dae-Shik Suh, Jeong-
Akira Hirasawa, Kenta Masuda, Tomoko Akahane, Tomomi Yeol Park, Shin-Wha Lee
Ninomiya, Wataru Yamagami, Hiroyuki Nomura, Fumio Department of Obstetrics and Gyneoclogy, Asan Medical Center,
Kataoka, Kouji Banno, Nobuyuki Susumu, Daisuke Aoki University of Ulsan, Seoul, Korea
Department of Obstetrics and Gynecology, Keio University School
of Medicine, Tokyo, Japan OBJECTIVE: The patients with high-grade serous ovarian
cancer (HGSOC) have a BRCA 1 or 2 genes germline
OBJECTIVE: Poly-ADP ribose polymerase (PARP) inhibitors mutation up to 20%. Since the discovery of tubal epithelial
Poster Session
kill tumor cells harbouring DNA repair defects, specifically dysplasia as the pre-malignant lesion of HGSOC in
BRCA1 and BRCA2 (BRCA1/2) mutations with a synthetic women with BRCA mutation, several retrospective studies
lethal mechanism. PARP inhibitors lead to apoptosis in performed from risk-reducing salpingo-oophorectomy
295
(RRSO). NCCN (National comprehensive cancer network) PO-1052
guideline recommend RRSO to be completed by age 40 in
Isolated suprafacial intramuscular tumor
women with BRCA 1/2 mutation. However, the majority
metastatic from primary ovarian serous
of women do not have RRSO by this age. We aimed to
cystadenoacarcinoma - A case report
analyze the prevalence and localization of serous tubal
intraepithelial carcinoma (STIC) and occult invasive cancer
Yihung Sun1, Chieh Yi Kang1, Sheng-Tsung Chang2
in RRSO specimens in BRCA-mutation carriers who have
Department of Obstetrics and Gynecology1, Department of
the history of breast cancer.
Pathology and Laboratory Medicine, Chimei Medical Center,
METHODS: We performed a retrospective review of patients
Tainan, Taiwan
with breast cancer who was identified as a BRCA-mutation
carrier (including VUS (variant of unknown significance))
OBJECTIVE: Distant metastasis from primary epithelial
and performed RRSO at a single institute, Asan Medical
ovarian carcinoma is commonly found as nodal and
Center, Seoul, Korea from 2010 through 2014. From
intraperitoneal spreading, via haematogenous or
2013, both fallopian tubes of all cases were examined
transcoelomic routes. Subcutaneous metastatic tumor from
according to the "SEE/FIM" protocol and executed
primary ovarian cancer is usually occurred through previous
immunohistochemistry (IHC) staining.
surgical route including drainage site.
RESULTS: Total 63 patients were performed RRSO, 24
METHODS: We described a case of advanced stage ovarian
patients in 2010~2012 and 39 patients in 2013~2014,
carcinoma presenting an isolated subcutaneous metastatic
respectively. BRCA 1 mutation carrier was 31, BRCA 2
mutation carrier was 23, VUS was 9 and mean age at tumor away from previous operation site.
RESULTS: A 42 years old female, had previous Cesarean
RRSO was 46.3. Occult invasive cancer was detected in
5 patients with tubal origin was 3, ovarian origin was 1, section due to fetal malpresentation, diagnosed bilateral
and metastatic breast origin was 1, respectively. All occult ovarian serous cystadenocarcinoma grade 2, FIGO stage
invasive cancer cases without metastasis detected in IIIc and AJCC T3cNxM0, was completed optimal debulking
patients above 40 years old. Pathologic type of identified surgery and adjuvant chemotherapy with taxol and
cancer was papillary serous carcinoma in 4 patients and carboplatin. Tumor recurrence was noted 42 months after
metastatic carcinoma of breast origin in 1 patient. In 39 adjuvant treatment. One recurrent tumor is between
patients of 2013~2014, 7 of p53 overexpression (OE), 3 of stomach and transverse colon, located deep into the meso-
Ki-67 OE, 3 of STIC was identified by SEE-FIM protocol and colon of transverse colon, the other one is in right pelvic
primary site location of all cases was distal tube. Detection cavity attach on the meso-rectum. She completed 2nd
rate of premalignant lesion (STIC) or cancer was 15.4% course of chemotherapy with taxol and carboplatin after
(6/39). The patients who have completed RRSO before 40 optimal debulking surgery. Tumor recurrence was noted
years old were 11/63 (17.5%). again 11 months later. Abdominal CT disclosed a tumor
CONCLUSION: BRCA mutation carrier will be more detected mass over left upper quadrant with suspected invasion to
by continuous increase of a BRCA test and consequently adjacent intestine and another solid subcutaneous mass
number of RRSO will be increasing. But many patients over right lower quadrant, comparable to one palpable
still hold tendency of delayed RRSO after 40 years old. noted at right lower abdomen near inguinal area, suspect
All premalignant lesion and occult invasive cancer cases tumor invasion from abdominal cavity. During third
detected in patients above 40 years old. Our findings debulking surgery, there is a tumor mass about 5cm invade
support the significance of RRSO to be completed by to jejunum and attach to ascending colon, with an enlarged
age 40 in germline BRCA mutation carriers and larger, lymphnode at mesentary near it. However, there is no mass
prospective study was required. lesion noted in the left lower quadrant of abdominal cavity
and the peritoneum is intact. On palpation, the tumor was
Poster Session
suspect above the fascia. We dissect the layer above fascia

from midline incision wound, along the direction to the
mass, to tip up the subcutaneous tissue. One intramuscular
296
tumor was identified on the rectus abdominis near the median age was 42 years with a range of 30 – 55 years. No
right pubic ramus. Optimal debulking including segmental case of subsequent ovarian cancer was found. Nevertheless
resection of small intestine with invaded tumor, resection 8 women (0.58%) had subsequent oophorectomy for
of the enlarged lymphnode and intramuscular tumor were benign ovarian cysts. The mean time interval between the
performed. She was under third course of chemotherapy first operation and the re-operation was 4.17 years.
with Lipodox- Carboplatin regimen and target therapy with CONCLUSION: In our population, development of
Bevacuzumab, with stable condition currently. ovarian cancer in women with prior hysterectomy for
CONCLUSION: Trace her surgical history, the peritoneum benign gynecologic conditions rarely occurs. The risk of
of inguinal area was not opened at those time and the subsequent oophorectomy is relatively low and, in general
drainage tube was placed at opposite site, which could are histologically benign.
not explain the tumor spreading. One possible route is
that the patient had previous Cesarean section and the
precancerous cell seeding there during dissection, and PO-1054
transformation after decades. Another possible route is
Preoperative predictive factors for early
from primary debulking surgery, along the round ligament
recurrence in epithelial ovarian and peritoneal
from the retracted cutting end. For recurrent ovarian
cancer with incomplete cytoreduction after
tumor, careful evaluation before and during operation
neo-adjuvant chemotherapy
was important for optimal tumor resection and patient
treatment.
Min-Hyun Baek1,2, Dae-Yeon Kim1, Chae-Chun Rhim2, Young-
Han Park2, Dae-Shik Suh1, Jong-Hyeok Kim1, Yong-Man Kim1,
Young-Tak Kim1, Joo-Hyun Nam1
PO-1053
1
Prevalence of subsequent ovarian cancer and University of Ulsan, Seoul, Korea, 2Department of Obstetrics and
oophorectomy after hysterectomy: a 10-year Gynecology, Hallym university sacred heart hospital, Anyang, Korea
experience at Chiang Mai University Hospital
OBJECTIVE: To identify preoperative predictors of early
Charuwan Saeteng, Aurapin Jitkunnatumkul, Kittipat recurrence in epithelial ovarian cancer and peritoneal
Charoenkwan, Jatupol Srisomboon cancer after neo-adjuvant chemotherapy (NACT) with
Department of Obstetrics and Gynecology, Chiang Mai University, residual tumor at interval debulking surgery (IDS).
Chiang Mai, Thailand METHODS: We performed a retrospective analysis of 44
patients with epithelial ovarian cancer and peritoneal
OBJECTIVE: To determine the prevalence of ovarian cancer cancer who had residual tumor at IDS.
in women with prior hysterectomy for benign conditions RESULTS: There were 34 (77.3%) ovarian and 10 (22.7%)
and the risk of subsequent oophorectomy due to ovarian peritoneal cancer patients. Twenty seven (61.4%) were
pathology after hysterectomy. FIGO stage III and 17 (38.6%) were stage IV. During the
METHODS: Women undergoing hysterectomy for benign follow up period, 37 (84.1%) have recurred and 33 (75.0%)
gynecologic diseases and pre-cancer conditions between died of disease. Age, performance status, CA-125 at
January 2004 and December 2013 at Chiang Mai diagnosis & before IDS, change of CA-125 at diagnosis to
University Hospital were retrospectively reviewed, using pre-IDS, response to NACT on follow up image, regimen of
medical records, operative notes and pathology reports. NACT, and cycles of NACT were analyzed as a preoperative
The prevalence of subsequent ovarian cancer development predictive factors for early recurrence. In univariate and
and subsequent oophorectomy after hysterectomy were multivariate analysis, progressive disease on follow up
Poster Session
analyzed. image during NACT and a change of CA-125 ≤80% after

RESULTS: During the study period, 1,035 women underwent NACT were preoperative predictive factors for early (6
hysterectomy for benign gynecologic conditions. The month) recurrence (P = 0.037 and 0.024).
297
CONCLUSION: A small change in CA-125 after NACT and significant when taken at 10 %. For patients with single
progressive disease on follow up image during NACT is an recurrence,median survival was 40.5 months and for
independent preoperative predictor for early recurrence. patients with multiple recurrences,median survival was 37
months,p value=0.791 which is not statistically significant.
Median survival of patients who had optimal cytoreduction
PO-1055 was 44.5 months and for those with suboptimal surgery
it was 37 months,which was statistically significant,p
Evaluation of prognostic factors for better
value=0.4738. Median disease free interval after SCRSfor
survival outcome in secondary cyto reduction
tumour size <5 cm was 19 months and for those with
in epithelial ovarian cancer
tumour tumour size >10 cm was 3.5 cm,p value =0.011
Shobha K, Uma Devi K, Uththamchand D bafna, Jayashree

which was statistically significant. As the tumour size
Natarajan increased,DFI decreased.
CONCLUSION: In the present study, the selection criteria for
SCRS i.e., patients with good performance status, longer
Institute of Oncongloy, Bangalore, Karnataka, India
DFI after primary therapy (>12 mon), localized isolated
tumor with small volume and with no ascites has proven to
OBJECTIVE: Primary objective: The objective of this study
be useful for optimal cytoreduction in majority of the cases
was, 1.to identify the prognostic factors for survival in
(80%).
patients undergoing secondary cytoreduction Secondary
objective: 1.to formulate selection criteria for cases who
are undergoing secondary cytoreduction.
PO-1056
METHODS: THIS STUDY IS A RETROSPECTIVE OBSERVARIONAL
STUDY OF Patients who had recurrent ovarian cancer and Impact of interval from definitive surgery to
who underwent SCRS between the year 2004-2009,27 were initiation of adjuvant chemotherapy (ISC) on
subjected to SCRS.27 patients had undergone SCRS based survival for advanced epithelial ovarian cancer
on the following criteria:- 1. DFI: the interval between the
completion of primary therapy and occurrence of recurrent Eun jin Heo, Yoo-Young Lee, E Sun Paik, Hyun Jin Choi,
disease of atleast 12 months 2. Isolated metastasis either Insuk Sohn, Chel Hun Choi, Tae-Joong Kim, Jeong-Won Lee8,
pelvis or abdomen diagnosed radiologically[CT scan] and Byoung-Gie Kim, Duk-Soo Bae
amenable to complete resection 3.Performance status Department of Obstetrics and Gynecology, Samsung Medical
of ECOG 0 4. Absence of ascites and multiple peritoneal Center, Sungkyunkwan University School of Medicine, Seoul, Korea
metastasis Kaplan Meier curve and Spearman’s co-relation
were used for statistical analysis. Comparison of survival OBJECTIVE: We investigate the prognostic impact of the
curves was done by log rank test. interval from surgery to initiation of adjuvant chemotherapy
RESULTS: Two patients were declared inoperable, only (ISC) in advanced epithelial ovarian cancer.
25 patients were analyzed. Among 25 patients, optimal METHODS: We enrolled patients with advanced epithelial
cytoreduction [residual disease<1cm] was achieved in 20 ovarian cancer (FIGO stage III and IV) who were treated
patients [80%]and 05 [20%] patients had suboptimal at the Samsung Medical Center from January 1, 2001 to
surgery [residual disease >1cm]. Mean follow up of December 31, 2010. We excluded patients who received
patients was 37 months. Mean age of patients at SCRS neoadjuvant chemotherapy.
was 50.7 years. Median survival was 37 months. Univariant RESULTS: 507 patients (stage III; 448, stage IV; 59) were
analysis was done. Age of the patient did not had impact enrolled, and the median ISC was 9 days with a range of
on optimality of SCRS[P value=0.247], as patients were 4 to 84 days. We divided the patients into three groups as
Poster Session
selected on basis of good performance status[ECOG 0-1]. no gross residual group (n = 109, 21.5%), optimal group (n
Grade 2 tumors had a median survival of 42 months and = 206, 40.6%), and suboptimal group (n = 192, 37.9%),
grade 3 patients had 37 months,p value=0.06 which is and delayed ISC is associated with increased HRs of overall
298
survival only in optimal group. Subsequent analyses were (16.7%) patients with mucinous, endometrioid, clear cell,
performed in optimal group, and we found that ISC as a and serous tumor types, respectively. Complete surgical
continuous variable (HR, 1.016; 95% CI, 1.005-1.031; P = staging to preserve the uterus and one ovary with adnexa
.007), history of consultation to the department of General was performed in 4 (22.2%) patients. During the median
Surgery (HR, 2.744; 95% CI, 1.345-5.599; P = .006), and follow up of 47.3 (11.5 – 195.3) months, there were no
platinum resistance (HR, 7.175; 95% CI, 4.112-12.52; perioperative or long term surgical complications. Four
P = .007) were significantly associated with poor overall (22.2%) women conceived after their respective ovarian
survival. On the multivariate analysis, ISC remained to be cancer treatments. Three (16.7%) of them completed full
a significant poor prognostic factor (HR, 1.018; 95% CI, term delivery and one is expecting a baby. One patient had
1.003-1.033; P = .022). disease recurrence. No patient died of the disease.
CONCLUSION: Based on the collected data, delayed CONCLUSION: Laparoscopic FSS in patients with presumed
adjuvant chemotherapy subsequent to surgery most early-stage EOC can be a feasible option for selected
likely would result in negative impact on overall survival patients who desire fertility preservation.
in advanced epithelial ovarian cancer patients who had
optimal cytoreduction.
PO-1058
Survival rate for ovarian cancer in Thailand:

PO-1057
Hospital base cancer registry
Outcomes of laparoscopic fertility-sparing
surgery in presumed early-stage epithelial Nintita Sripaiboonkij1, Tanapon Thonkamdee1, Pornsuda
ovarian cancer Jitkasikorn1, Sopit Promchana1, Sarikapan Wilailak2
Cancer Registry Unit1 Department of Obstetrics and Gynaecology,

Eun jin Heo, E Sun Paik, Hyun Jin Choi, Yoo-Young Lee, Chel Faculty of Medicine Ramathibodi Hospital, Mahidol University,
Hun Cho, Tae-Joong Kim, Jeong-Won Lee, Byoung-Gie Kim, Bangkok, Thailand
Duk-Soo Bae
Department of Obstetrics and Gynecology, Samsung Medical OBJECTIVE: In Thailand, ovarian cancer is the second
Center, Sungkyunkwan University School of Medicine, Seoul, common cancer found in women. The incidence rate for
Korea ovarian cancer between 2004-2006 and 2007-2009 were
5.6 and 6.2 per 100,000 women, respectively. Limited
OBJECTIVE: Fertility-sparing surgery (FSS) is becoming an survival data are available on ovarian cancer.The purpose
important technique in the surgical management of young of the study was to estimate survival probability by stage of
women with early-stage epithelial ovarian cancer (EOC). ovarian cancer at diagnosis.
We retrospectively evaluated the outcome of laparoscopic METHODS: Three hundred and ninety women with ovarian
FSS in presumed early-stage EOC. cancer from 2001 to 2008 were registered in Ramathibodi
METHODS: We retrospectively searched databases of hospital. The censoring dated on December 31, 2014.
patients who received laparoscopic FSS for EOC between Kaplan-Meier method was used to calculate the survival.
January 1999 and December 2012 at Samsung Medical The results will be analysis by STATA version 11.
Center. Women aged ≤ 40 years were included. The RESULTS: Of the 163 women were died at the end of the
perioperative, oncological, and obstetric outcomes of these study (41.79%). A total follow-up time for all women
patients were evaluated. is 787 person-years. Incidence density is 20.44 per 100
RESULTS: A total of 18 patients was evaluated. The median person-years (95%CI: 17.51 to 23.85). Overall survival at
age of the patients was 33.5 years (range: 14-40) years. 5 years is 30.91 %. Median survival time was 3.4 years
Poster Session
The number of patients with FIGO stage IA, IC, or IIIA1 .Survival probability rate was low in women stage IV. The
was 5 (27.8%), 11 (61.1%), and 2 (11.1%), respectively. 5 years overall survival are 45.36 %, 29.39 % and 7.19 %
There were 7 (38.9%), 5 (27.8%), 3 (16.7%), and 3 in women stage I-II, stage III and stage IV, respectively. By
299
Kaplan-Meier method estimates the OS is lower than 50% discrimination between patients at early and advanced
at the end of the study. stage.
CONCLUSION: The survival is lower than that of developed CONCLUSION: In this study, we provide novel evidence
countries. A confirmed poor prognostic factor is women in for epigenetic regulation of GABRP in ovarian cancer. We
high stage. Further study might needs a large of number of herein suggest that the DNA methylation status within the
ovarian cancer women to estimate the survival probability. GABRP promoter region may be a potential biomarker that
can indicate the aggressive behavior of ovarian cancer.
PO-1059
PO-1060
Aberrant epigenetic regulation of gamma-
aminobutyrate type A receptor pi subunit Preoperative prediction of cardiophrenic
(GABRP) associated with aggressive lymph node metastasis in advanced ovarian
phenotype of ovarian cancer cancer using computed tomography
Hye Youn Sung, Woong Ju, Jung-Hyuck Ahn, Yun Hwan Kim, Tae-Hyung Kim1, Myong Cheol Lim1, Se Ik Kim2, Sang-Soo
Seoung Cheol Kim Seo1, Sun Ho Kim1, Chong Woo Yoo1, Sang-Yoon Park1
1
Department of Obstetrics and Gynecology, Ewha Womans Center for Uterine Cancer and gynecologic Cancer Branch,
University, Seoul, Korea National Cancer Center, Goyang, Korea, 2Department of Obstetrics
and Gynecology, Seoul National University Hospital, Seoul, Korea
OBJECTIVE: The aim of this study was to understand
the molecular mechanisms involved in ovarian cancer OBJECTIVE: To determine whether the preoperative
metastasis in vivo, we analyzed genome-wide interplay diameter of cardiophrenic lymph nodes (CPLNs) along the
between promoter CpG DNA methylation and gene short and long axes, determined via computed tomography
expression in a mouse model of metastatic ovarian cancer. (CT), predicts CPLN metastasis in patients with advanced
METHODS: We performed genome-wide expression profile epithelial ovarian cancer.
analysis together with promoter CpG DNA methylation METHODS: The medical records of 31 consecutive patients
analysis to identify genes whose expression was regulates with primary advanced ovarian cancer who underwent
by abnormal changes of DNA methylation during CPLN dissection were retrospectively reviewed. A receiver
metastatic ovarian tumor formation. operating characteristic curve (ROC) was used to select the
RESULTS: The gamma-aminobutyrate type A receptor pi CPLN dimensions that best predicted CPLN metastasis.
subunit (GABRP) showed increased mRNA expression RESULTS: The median preoperative lengths of the short and
and hypomethylation of promoter CpG in metastasized long axes were 7 mm (range, 3–14 mm) and 12 mm (range
tumor tissues. The DNA methylation-dependent 6–23 mm), respectively. The median number of harvested
transcriptional regulation of GABRP was confirmed by CPLNs per patient was two (range, 0–12). Pathological
treatment of demethylating agent. We also found that evaluation revealed metastasis-positive CPLNs in 19
GABRP overexpression caused increased migration and patients. The preoperative serum CA-125 level significantly
invasiveness in SK-OV-3 cells via activation of extracellular correlated with the length of the short axis (Spearman
signal-regulated kinase (ERK). Conversely, silencing correlation coefficient, 0.407; P < 0.05) but not the long
of GABRP decreased phosphorylation of ERK1/2 and axis. The probability of CPLN metastasis increased as the
selective inhibition of ERK1/2 significantly decreased length of the short axis increased. ROC curve analysis
migration and invasiveness in SK-OV-3 cells. Our result also showed that the largest area under the curve (AUC) was
revealed that hypomethylation of GABRP within promoter acquired with a cutoff value of 8 mm for the short axis
Poster Session
CpG is associated with advanced stage and metastasis (Spearman correlation coefficient, 0.804; P < 0.04). Using
to the lymph node in patients with ovarian cancer. this cutoff, sensitivity was 79%, specificity was 65%,
Receiver operating characteristics analysis showed good the positive predictive value was 79%, and the negative
300
predictive value was 33%. be lower in the PCEA group at POD 2, 4, and 5. PCEA
CONCLUSION: The probability of CPLN metastasis in provided significantly better pain relief as analyzed by
patients with advanced ovarian cancer was approximately a mixed effect model. Complications, including bowel
80% when the short axis of the CPLN was >8 mm in function, were not significantly different between the PCEA
preoperative CT scans. Patients with CPLNs of this size and PCA group. There was no significant difference in pain
may be candidates for CPLN dissection to confirm the relief between both groups at POD 4 and POD 5.
pathological diagnosis. CONCLUSION: PCEA was more effective for postoperative
pain management compared with PCA from POD 0 to POD
3 in ovarian cancer patients who underwent cytoreductive
PO-1061 surgery, without increasing the morbidity.
Improved postoperative pain control for

cytoreductive surgery in women with ovarian
PO-1062
cancer using patient-controlled epidural
analgesia TWIST expression as a predictor of
unfavorable prognosis for epithelial ovarian
Tak Kyu Oh2, Jung Yeon Yun2, Yumi Lee3, Myong Cheol Lim1, cancers
Sang-Yoon Park1
Kyung Un Choi, Dong Soo Suh, Man Soo Yoon, Ki Hyung Kim
Center for Uterine Cancer and Gynecologic Cancer Branch1
Department of Anesthesiology and Pain Medicine Research Department of Obstetrics and Gynecology, Pusan National
Institute and Hospital2, National Cancer Center, Goyang, Korea, University Hospital, Pusan, Korea
3
Department of Nursing, Sorabol College, Gyeongju, Korea
OBJECTIVE: Many studies have compared different OBJECTIVE: Epithelial-mesenchymal transition (EMT) is
methods of postoperative pain management in patients associated with tumor hypoxia. EMT is regulated, in part, by
who underwent abdominal laparotomy; however, the action of TWIST, which inhibits of E-cadherin expression
the conclusions of the studies are inconsistent and and may interfere with the p53 tumor-suppressor pathway
controversial. Effective postoperative analgesia can reduce METHODS: We examined the expression of TWIST,
mortality and morbidity after surgery, and as such, an E-cadherin, hypoxia-inducible factor 1α (HIF1α), and p53
effective and safe method of pain management that does by immunohistochemistry in 123 cases of ovarian epithelial
not increase adverse reactions is essential. The aim of this cancers (OEC) to evaluate the role of TWIST in OEC. We
study was to compare the pain scores and complications of assessed the association between protein expression and
patients who underwent cytoreductive surgery for ovarian clinicopathologic parameters.
cancer and used either patient-controlled epidural analgesia RESULTS: The expression of TWIST, E-cadherin, HIF1α,
(PCEA) or patient-controlled intravenous analgesia (PCA) and p53 proteins was found in 28.5%, 51.2%, 35.0%,
for postoperative pain management. and 29.3% of cases, respectively. TWIST expression was
METHODS: The medical records of women who underwent associated with higher histologic grade and unfavorable
ovarian cancer surgery in 2014 were reviewed retrospectively. survival. TWIST expression was correlated with HIF1α
Pain scores for postoperative days (PODs) 0–5 days and the expression and reduced E-cadherin expression. The altered
incidence of complications were examined and compared in HIF1α/TWIST/E-cadherin pathway was associated with
patients who received PCEA and PCA. lower overall survival (OS), while the co-expression of
RESULTS: Of the 105 patients in the study, 38 patients TWIST and p53 was correlated with lower progression-free
received PCEA and 67 patients received PCA. Pain scores survival. In the multivariate analyses, TWIST expression was
were significantly lower in the PCEA group compared an independent prognostic factor for OS.
Poster Session
with the PCA group at POD 0 (2.47±1.75 vs. 4.39±1.17; CONCLUSION: Our data imply that TWIST expression could
p<0.001), 1 (2.65±1.02 vs. 3.32±1.09; p<0.001), and be a useful predictor of unfavorable prognosis for OEC.
3 (2.17±1.13 vs. 2.79±1.08; p=0.011), and tended to TWIST may affect the p53 tumor-suppressor pathway.
301
Moreover, hypoxia-mediated EMT, which involves the PO-1064
HIF1α/TWIST/E-cadherin pathway may play an important
Obesity and ovarian cancer based on SRA-1
role in the progression of OEC.
gene overexpression
Inok Lee, Sun Ae Park, Hee Jung Kim, Jung Won Yoon, Jung
PO-1063
Wyn Lee, Eun Ji Nam, Sunghoon Kim, Sang Wun Kim, Young
Expression of interactive genes associated Tae Kim
with apoptosis and their prognostic value for Department of Obstetrics and Gynecology, Yonsei University Health
ovarian carcinoma System1, Yonsei University College of Medicine2, Seoul, Korea
Ki Hyung Kim, Dong Soo Suh, Man Soo Yoon OBJECTIVE: The aim of this study was to determine
Department of Obstetrics and Gynecology, Pusan National association between obesity and ovarian cancer by obesity
University Hospital, Pusan, Korea related gene expressions.
METHODS: With patient informed consents, ovarian
OBJECTIVE: The tumor suppressor, p53, plays an important tissues had collected while oophorectomies regardless
role in regulating cell cycles and apoptosis. It is well-known of presumable pathologic results, from February 2008 to
that alterations in or mutation of p53 occur commonly in March 2013, in Severance Hospital of Yonsei University.
ovarian cancers. p53 is regulated by several molecules, and Total RNA was extracted from cancerous or non-cancerous
it interacts with other apoptotic proteins. In this study, we specimens and quantitative real-time polymerase chain
evaluated DNA-PKcs, Akt3, GSK-3β, and p53 expression as reaction (qRT-PCR) was performed. The PCR primer
prognostic indicators for serous papillary ovarian carcinoma. sequences were gene sequences of Steroid Receptor RNA
METHODS: DNA-PKcs, Akt3, GSK-3β, and p53 expression Activator-1 (SRA-1), Leptin, fat mass and obesity-associated
levels were scored using immunohistochemistry staining protein (FTO). SRA-1 gene has been proposed as promoting
of tissue samples from 132 women with ovarian serous adipocyte differentiation and probably insulin resistance.
adenocarcinoma. Expression was confirmed by real-time RT- Relative gene expression was analyzed and the results
PCR. Analyses were stratified by age, tumor grades, cancer were expressed as extent of change with respect to control
stages, serum CA 125 levels, and follow-up periods of up values. Obesity was defined by body mass index (BMI) over
to 5 years. 25.0 kg/m².
RESULTS: Significant differences in DNA-PKcs, Akt3, and RESULTS: Total 175 ovarian cancer and 63 benign ovarian
p53 expression were observed between participants tumor tissues had been collected. Only 158 patients who
with different stages and grades of ovarian serous were diagnosed as epithelial ovarian cancer were included
adenocarcinoma. DNA-PK, Akt, and p53 expression in this analysis. In the epithelial ovarian cancer group, 37
increased along with increasing cancer stage and grade, patients were obese, while 26 patients were obese in the
and with a decrease in survival rate; however, GSK-3β benign ovarian tumor. In the benign ovarian tumor group,
showed the opposite pattern, but without significance. SRA-1, Leptin, and FTO genes significantly over-expressed
CONCLUSION: This study shows that elevated expression of among obese patients compared to normal weights (p= <
DNA-PK, Akt, and p53 in ovarian serous adenocarcinoma 0.0001, for all three genes). However, in the ovarian cancer
tissues are an indication of more advanced disease and group, SRA-1, Leptin and FTO expressions had no statistical
worse prognosis. significance (p=0.694, 0.191, 0.957, respectively) between
the obese and the normal weights. Among normal weight
patients, SRA-1, Leptin, and FTO gene over-expressions
were noticed in the ovarian cancer group (p=0.007, 0.033,
Poster Session
0.077, respectively). Similar results were also noticed in

obese patients; SRA-1, Leptin, and FTO gene were over-
expressed in the ovarian cancer group. (p=0.009, 0.0002,
302
0.086, respectively).
CONCLUSION: Our findings were consisted with the concept
that pathophysiology of obesity is related to ovarian
cancer tumorigenesis. Further investigations in connection
between obesity and ovarian cancer will warrant new
therapeutic target in ovarian cancer patients.
Poster Session
303
Poster Session : Uterine Cervix
PO-2001 clear cell and mucinous carcinoma but not in serous

carcinoma (P=0.038). In addition, elevated SIRT1 expression
SIRT1 is a novel candidate of therapeutic
was a significant predictor of shorter survival both in
target for ovarian carcinoma
univariate (P=0.038) and multivariate (P=0.037) survival
3 analyses regardless of tumor stage. Knock-down of SIRT1
David Mvunta, Tsutomu Miyamoto, Ryoichi Asaka Yasushi
Yamada4 Hirofumi Ando5 Shotaro Higuchi, Koichi Ida, Hiroyasu decreased cell proliferation (TOV21G and RMG1, P<0.05),
Kashima, Tanri Shiozawa and cisplatin-resistance (ES2, P<0.05). Overexpression of
SIRT1 in ES2 cells facilitated the chemo-resistance against
Department of Obstetrics & Gynecology, Shinshu University
cisplatin (P<0.05) and paclitaxel (P<0.05), invasion (P<0.05),
Graduate School of Medicine, Nagoya, Japan
and reduced apoptosis (P<0.05). These effects of SIRT1
in ES2 cells were canceled out by the addition of EX527.
OBJECTIVE: Sirtuin 1 (SIRT1), originally identified as a
Moreover, the xenograft tumors of ES2-SIRT1 cells grew
longevity gene, regulates DNA repair and metabolism via
more rapidly than that of ES2-cont cells in nude mice
the deacetylation of target proteins such as p53. SIRT1
(P<0.05).
plays a key role in the pathophysiology of metabolic
CONCLUSION: These results suggest that overexpression of
diseases, neuro-degenerative disorders, and is considered
SIRT1 may be involved in the acquisition of aggressiveness
to protect against age-related diseases including cancer.
and chemo-resistance in OvCa. SIRT1 may be a novel
In contrast, previous studies have shown SIRT1 was over
therapeutic target for OvCa.
expressed in some cancers suggesting oncogenic roles.
However, the expression of SIRT1 in ovarian carcinoma
(OvCa) remains unclear. The aim of the present study was
PO-2002
to clarify the expression and role of SIRT1 in OvCa and its
cell lines. CIN outcome in postpartum patients
METHODS: The expression of SIRT1 was
immunohistochemically evaluated in 16 cases of normal Rie Urabe, Taeko Ueda, Tomoko Kurita, Seiji Kagami, Toshinori
ovaries, 35 cases of endometriosis with/ without Kawagoe, Yusuke Matsuura, Toru Hachisuga
carcinoma, and 68 cases of OvCa (endometrioid: 16, Department of Obstetrics and Gynecology, University of
clear cell: 20, mucinous: 16, serous: 16). Staining results occupational and environmental health, Fukuoka, Japan
were semiquantitatively evaluated by the Immunoreactive
Scoring System (IRS), and the relationships with the OBJECTIVE: We show outcomes about patients who
clinicopathological features and outcomes of patients were diagnosed of CIN during pregnancy and explore the effect
analyzed. The OvCa cell lines (ES2, TOV21G, RMG1) were of pregnancy on CIN.
used to analyze the functions of SIRT1 on cell proliferation METHODS: 41 pregnant women who were diagnosed
(WST-1 assay), chemo-sensitivity (WST-1 assay), apoptosis as having abnormal cervical cytology from Jan. 2005 to
(annexin V staining) and invasion (Matrigel invasion assay). Dec. 2010 were enrolled. Cervical lesions were rechecked
For these analyses, SIRT1 was knocked-down by siRNA/ with cytology, colposcopy and cervical biopsy at 2-3
shRNA method, up-regulated by cDNA, and inhibited months postpartum. All patients except in the case of post
using selective SIRT1 inhibitor (EX527). SIRT1 up-regulated treatment were observed for 2 years or more.
ES2 cells (ES2-SIRT1) and its control cells (ES2-cont) were RESULTS: The median age was 29 years (18-41). Punch
xenografted into nude mice to examine the effect for biopsies were performed and 11, 15 and 16 cases were
tumor growth. diagnosed as having CIN1, CIN2 and CIN3. One patient
Poster Session
RESULTS: Immunohistochemistry revealed that the underwent a cone excision during pregnancy.
expression of SIRT1 was higher in carcinoma than in CONCLUSION: Postpartum follow-up was crucial due to
ovarian epithelium (P=0.001), and higher in endometrioid, lesion persistence.
304
PO-2003 PO-2004
Correlation of CTR1, ERCC-1, AND HSP70 Chemotherapeutical efficacy and toxicity of

expressions with cisplatin response in carboplatin as alternative radiosensitizer
cervical cancer stage IIB compared to cisplatin in advanced stage of
cervical cancer
Brahmana Askandar, Suhatno Suhatno, Juliati Hood
Department of Obstetrics and gynecology, Airlangga University

Gatot N A Winarno, Devi R Vistani, Lina Lasminingrum, Tita
School of Medicine, Indonesia

H Madjid, Sofie R Krisnadi, Herman Susanto
Indonesian Soceity of Gynecologic Oncology (INASGO)

OBJECTIVE: To determine the correlation of CTR1, ERCC1
and HSP70 expression with the response to cisplatin in OBJECTIVE: OBJECTIVE: To compare the efficacy and the
cervical cancer stage IIB. toxicity of carboplatin as a radiosensitizer with cisplatin in
METHODS: An analytic observational study was done on 41 advanced stages of cervical cancer
cervical cancer patients stage IIB. Biopsy specimens were METHODS: Method: Randomized clinical trial with a double
taken before chemotherapy to evaluate the expression of blinding system. All subjects underwent serial examinations
CTR1, ERCC1 and HSP70 by immunohistochemistry study. of mass size and lactate dehydrogenase as parameters of
The tumor volume before chemotherapy were evaluated effectiveness. Serial examination of blood hemoglobin,
with MRI. Four cycles of cisplatin 50mg/m2 weekly was absolute neutrophil count, platelet count as parameters
given as a neoadjuvant chemotherapy. After completion of of myelotoxicity, examination of blood urea, creatinine,
chemotherapy, MRI was used to evaluate the tumor volume creatinine clearance and electrolyte as parameters of
after chemotherapy and response was categorized based nephrotoxicity, as well as audiometric examination and
on RECIST criterias. DPOAE (Distortion Product Oto-Acoustic Emission) as
RESULTS: Among 41 cervical cancer patients stage IIB, the parameters of ototoxicity were also carried out
mean of age of the patients was 45,56 years old + 7,69 RESULTS: Result: A total of 56 subjects who met the
years old and majority of the patients had squamous cell inclusion criteria that were divided randomly into 2
cancer (58,5%) followed by adenocarcinoma (31,7%) and groups,including a group of 28 subjects taking carboplatin
adenosquamous (9,8%). The expression of HSP70, ERCC1 and another group of 28 subjects taking cisplatin. The
and CTR1 were not different among these 3 types of clinical response comparison showed p value = 0.669,
histopathology with the p values of 0.444, 0.893 and 1.000 whereas lactate dehydrogenase decrease showed p value
respectively. The mean of tumor volume was 64,99 cm3 = 0.583. The comparison of nephrotoxicity blood urea (p
before chemotherapy and 38,88cm3 after chemotherapy. = 0.002*), creatinine (p = 0.0001*), creatinine clearance
The expression of HSP70, ERCC1 and CTR1 were not (p = 0.0001*), sodium (p = 0.0001*), potassium (p =
associated with the initial tumor volume (p=0,940, p=0,180 0.027* ) and magnesium (p = 0.023*) were all on value
and p=0,521 respectively). There was significant negative <0.05. Myelotoxicity comparison showed parameters of
correlation between HSP70 and tumor reponse, the higher hemoglobin (p = 0.0001*), platelet count (p = 0.187)
the expression of HSP70 the worse is the tumor response, and absolute neutrophil count (p = 0.225). Ototoxicity
with the p value of 0.003. Expression of CTR1 and ERCC1 comparative results on two parameters, namely audiometry
had no significant correlation with the tumor response (p = (p = 0.0001*) and DPOAE (Distortion Product Oto-Acoustic
0,618 and 0245 respectively). Emission) (p = 0.0001*) especially after treatment showed
CONCLUSION: Expression of HSP70 had significant negative both p <0.05
correlation with cisplatin response in cervical cancer stage CONCLUSION: Result: A total of 56 subjects who met
IIB the inclusion criteria that were divided randomly into 2
Poster Session
groups,including a group of 28 subjects taking carboplatin

and another group of 28 subjects taking cisplatin. The
clinical response comparison showed p value = 0.669,
305
whereas lactate dehydrogenase decrease showed p value regimen (n = 133) or not (n = 6) were part of primary
= 0.583. The comparison of nephrotoxicity blood urea (p treatment in 139 of the 166 patients. Among assessable
= 0.002*), creatinine (p = 0.0001*), creatinine clearance patients, the 64 (including 21 stage IIB-IV) receiving at least
(p = 0.0001*), sodium (p = 0.0001*), potassium (p = 5 cycles of platinum-based chemotherapy (P5+) had better
0.027* ) and magnesium (p = 0.023*) were all on value 5-year overall survival (OS) than the 53 (including 18 stage
<0.05. Myelotoxicity comparison showed parameters of IIB-IV) receiving 0-4 cycles (54% vs. 33%, P = 0.030), while
hemoglobin (p = 0.0001*), platelet count (p = 0.187) patients receiving platinum-based chemotherapy with (n =
and absolute neutrophil count (p = 0.225). Ototoxicity 85, including 25 stage IIB-IV) or without (n = 27, including
comparative results on two parameters, namely audiometry 8 stage IIB-IV) etoposide had similar 5-year OS (48% vs.
(p = 0.0001*) and DPOAE (Distortion Product Oto-Acoustic 52%, P = 0.755). Even for complete responders in stage
Emission) (p = 0.0001*) especially after treatment showed IIB-IV, the 13 patients with P5+ had better 5-year OS than
both p <0.05 the other 7 (77% vs. 21%, P = 0.023). Combining P5+
with primary radiotherapy (n = 19, including 12 stage IIB-
IV) resulted in a better 5-year OS than the others (n = 147,
PO-2005 including 40 stage IIB-IV) (72% vs. 39%; P = 0.015).
CONCLUSION: For SCNECC, cycle numbers of platinum-
Chemotherapy and small cell neuroendocrine
based chemotherapy might have significant impact on
carcinoma of the uterine cervix:
OS, and P5+ with primary radiotherapy was associated
a retrospective Taiwanese gynecologic
with acceptable survival outcome. However, the role of
oncology group (TGOG) study
etoposide remains to be determined.
1 2 3
Tze-Chien Chen , Huei-Jean Huang , Chi-Hau Chen , Ya-Min
Cheng4, Wen-Hsiung Liou5, Shih-Tien Hsu6, Kuo-Chang Wen7,
Yu-Che Ou8, Yao-Ching Hung9, Chih-Ming Ho10, Ting-Chang PO-2006
11
Chang
High-dose oral tegaful-uracil maintenance
Department of Obstetrics and Gynecology,1 Mackay Memorial therapy in patients with uterine cervical
Hospital, 2Chang Gung Memorial Hospital, Taoyuan 3National
cancer
Taiwan University Hospital, Taipei 4National Cheng Kung
University, Tainan 5Kaohsiung Veterans General Hospital,
Isao Sakaguchi, Takeshi Motohara, Fumitaka Saito, Kiyomi
Kaohsiung 6Taichung Veterans General Hospital, Taichung7Taipei
Takaishi, Hironori Tashiro, Hidetaka Katabuchi
Veterans General Hospital, Taipei8Kaohsiung Chang Gung
Memorial Hospital, Kaohsiung 9China Medical University Hospital, Department of Obstetrics and Gynecology, Faculty of Life Sciences,
10
Taichung Gynecologic cancer center, Cathay General Hospital, Kumamoto University, Japan
11
Taipei Chang Gung Memorial Hospital, Taoyuan, Taiwan
OBJECTIVE: The aim of this study study was to determine
OBJECTIVE: Chemotherapy for small cell neuroendocrine the efficacy and toxicity of oral administration of tegafur–
carcinoma of the uterine cervix (SCNECC) usually contains uracil (UFT) at a high dose, 600 mg/day, based on the
cisplatin and etoposide, and the toxicity is substantial. tegafur dose, against uterine cervical cancer.
However, the rarity of SCNECC makes prospective trials METHODS: This study consisted of a retrospective analysis.
extremely difficult. We retrospectively compared survival From April 1986 to March 1997, 309 patients with uterine
outcome by various chemotherapy. cervical cancer were registered. Oral UFT was administered
METHODS: A multicenter retrospective study was conducted to 162 patients for maintenance therapy after an initial
to review the data of patients with FIGO stage I-IV SCNECC treatment (the UFT group). The other 147 patients were
treated during 1987-2009 in 11 main hospitals in Taiwan, not treated with UFT (the control group). The survival rate
Poster Session
which included 166 patients with at least 2 years of follow- was calculated for both groups and statistically analyzed
up or documented disease progression or death. using the log-rank test. Adverse events were compared
RESULTS: Chemotherapy containing platinum-based between the UFT and control groups.
306
RESULTS: In the UFT group, 103 patients (63.6%) received with p value 0.01. Through Immunoreactive Scoring (IRS)
UFT for ≥90 days. The drug dose was 600 mg/day for 137 models, there is still an inverse association between FasL
patients (84.6%) and 300–400 mg/day for the remainder. classification (negative, mild, moderate, strong) and TILs
The overall survival rate was significantly higher in the UFT classification (negative, mild, moderate, strong) with p
group than in the control group (p < 0.05). The prognosis value 0.030. In comparison H-Score to IRS semiquantitative
was particularly favorable in stage III cases, in cases of scoring system, there is no significant difference with p
squamous cell carcinoma, and in cases that were treated by value 0.133 (FasL) and 0.692 (TILs). In FasL analysis, H-Score
radiotherapy. The most frequent side effects were nausea/ in comparison to IRS has sensitivity 100%, specificity 67%,
vomiting (12.2%), appetite loss (10.1%), and leukopenia/ PPV 16.7%, NPV 100% with AUC 83.3% (95% CI; 67.9-
neutropenia (5.8%). 98.8%) and p value 0.119. In TILs analysis, H-Score in
CONCLUSION: High-dose oral UFT maintenance treatment comparison to IRS has sensitivity 56.7%, specificity 50%,
prolonged the disease-free survival and overall survival of PPV 94.4%, NPV 7.2% with AUC 46.7% (95% CI; 4.6-
patients with uterine cervical cancer, particularly of those 88.7%) and p value 0.876.
with advanced disease. CONCLUSION: There is a strong inverse statistically
significant association between increasing FasL expression
and decreasing TILs levels. H-Score, compared to IRS, can
PO-2007 be widely used in FasL and TILs scoring system. However,
the study need to be reconducted with larger sample to
Comparison of semiquantitative models :
compare the semiquantitative models more accurate.
Fas Ligand (FasL) in association with Tumor-
Infiltrating Lymphocytes (TILs) in early stage
cervical cancer
PO-2008
Tricia Dewi Anggraeni1, M. Farid Azis1, Primaria Dewi2 Cervical cancer screening awareness in Jakarta
1 2
Department of Obstetry and Gynaecology, Department of Clinical
Pathology, Faculty of Medicine University of Indonesia, Indonesia Henny Meitri Andrie Rachmasari Putri
Department of Obstetrics and Gynecology, Indonesia Army

OBJECTIVE: To compare H-scores and Immunoreactive Hospital, Indonesia
score (IRS) as semiquantitative models in investigating the
association between FasL and TILs in early stage cervical OBJECTIVE: To describe the knowledge and awareness of
cancer underwent radical hysterectomy. cervical cancer among Indonesian women in Jakarta
METHODS: This study was a cross-sectional study of early METHODS: A questionnaire was translated and adapted
stage cervical cancer (stage ≤ IIA2) patients who underwent with permission from the survey instrument (the Cervical
radical hysterectomy from January 2007 to May 2011 in CAM) developed by the UCL Health Behaviour Research
Dr. Cipto Mangunkusumo Hospital. We obtained tumor Centre, in collaboration with the Department of Health
tissue and conducted immunohistochemical examination Cancer Team and The Eve Appeal. Ten PKK cadres
on 32 samples to assess FasL and TILs. We performed the (voluntary) were trained to spread and accompany subjects
semiquantitative assay through Noer Weidner and Bialas to fill put the questionnaire.
cell quantification procedure and compared the result RESULTS: A thousand and twelve women were randomly
through H-scores and Immunoreactive Scoring (IRS) system. included in the research. As many as 92% respondents
RESULTS: In a study conducted on 32 subjects, there have heard about cervical cancer and recognized some
is a strong negative correlation between FasL and of the symptoms (37 - 45%). Vaginal bleeding, excessive
TILs (r=0.658; p<0.001). In bivariate analysis through menstrual bleeding and contact bleeding were the top
Poster Session
H-Score semiquantitative models, there is an inverse answers. Infection of STD, compromised immunity, and
association between FasL classification (overexpression/ HPV infection have been the most popular answers. Age
no-overexpression) and TILs classification (≤160/>160) of 30-49 was the top answer for the age group most at
307
risk of cervical cancer. As in the act the cervical cancer SLN with laparoscopic pelvic lymphadenectomy and
prevention, only 24% went for Pap’s smear and 11% for laparoscopic assisted vaginal hysterectomy type A can
visual inspection of cervix with acetic acid. Among 1012 be a feasible and safe method in small tumor volume in
respondents, only 39% heard on Human papillomavirus early cervical cancer with preservation of excelent quality
vaccine and 15 respondents reported to have vaccinated. of life. This work was supported by Grant MH-CR 15-
CONCLUSION: There were discrepancies between the 25884A/5308
knowledge and action of cervical cancer among women in
Jakarta. The knowledge of cervical cancer has considered
to be good although the awareness to act based on the PO-2010
knowledge of prevention was still low.
Pretreatment factors associated with
recurrence for patients with cervical cancer
FIGO stage IB1 disease
PO-2009
Less radical surgery than radical hysterectomy Shih-Chieh Liu
in patients with stage I cervical cancer Department of Obstetrics and Gynecology, Kaohsiung Chang
Gung Memorial Hospital, Taiwan
Tomas Pichlik, Lukas Rob, Helena Robova, Marek Pluta, Petr
Skapa OBJECTIVE: Pretreatment prognostic information is lacking
1
Department of Obstetrics and Gynecology Department of for patients with cervical cancer FIGO stage IB1 disease.
Pathology, 2nd Medical Faculty Charles University Prague and Thus, we attempted to identify a high-risk subgroup
University Hospital Motol, Czech Republic among them prior to treatment.
METHODS: Cervical cancer FIGO stage IB1 patients who
OBJECTIVE: The purpose of the pilot study was to determine had received curative treatment with various modalities
feasibility and safety of less radical surgery - laparoscopic in our institute between January 2004 and December
lymphadenectomy with sentinel lymph node identification 2010 were enrolled. Pretreatment clinical parameters
(SLNI) with Tc + blue day, followed by laparoscopic assisted including age, squamous cell carcinoma antigen (SCC-
vaginal hysterectomy type A. Ag), carcinoembryonic antigen, hemoglobin level, platelet
METHODS: From December 2000 to September 2012, 126 count, histological type, and treatment modality were
women with squamous cell carcinoma or adenocarcinoma analyzed for treatment outcomes.
with tumor size less than 20 mm in largest diameter RESULTS: 197 patients were included with a median follow-
and infiltration of less than half of the cervical stroma up of 66 months (range 6-119 months). In Cox regression
underwent laparoscopic SLNI, frozen section (FS) with analysis, only SCC histology (HR: 0.457, 95% CI: 0.241-
laparoscopic lymphadenectomy or only SLN. FS sentinel 0.967, p=0.017) was an independent factor predicting
node negative patients underwent laparoscopic assisted better disease-free survival. Among SCC histology, patients
vaginal hysterectomy. FS sentinel node positive patients with a hemoglobin level less than 12 g/dL and a SCC-Ag
underwent radical hysterectomy type C2. level more than 3 ng/mL had worse treatment outcomes.
RESULTS: 8 women had positive lymph nodes (6.4%). FS of SLN The 5-year disease-free survival rates were 89.2%, 69.3%,
was positive in 6 cases (5 metastases, one micrometastases), and 44.4% for the patients at low-risk (SCC, hemoglobin
where radical hysterectomy type C2 was performed, 2 >12 g/dL, SCC-Ag≤3 ng/mL), intermediate-risk (non-SCC),
cases had false negative FS, all had micrometastases in final and high-risk (SCC, hemoglobin ≤12 g/dL, SCC-Ag>3 ng/
histopathology. All node positive patiens are in complete mL), respectively (p<0.001).
remission. One local vaginal recurrence was observed in SLN CONCLUSION: Non-SCC and SCC histology with both
Poster Session
negative group (1/118 - 0.85%), after chemoradiotherapy is in anemia and high pretreatment SCC-Ag level were
complete remission 20 month. associated with recurrence. Further validation studies are
CONCLUSION: Less radical surgery after negative FS of warranted for clarification.
308
PO-2011 OBJECTIVE: This study assessed the performance of a novel
flow cytometry (FCM) cervical cancer screening system
Video demonstration of development of vaginal
compared with human papillomavirus (HPV) Hybrid Capture
cuff in cancer cervix robotic hysterectomy
2 (HC2).
cases
METHODS: Chinese women aged 20 years or older were
Kanika Batra, Rupinder Sekhon, Sudhir Rawal enrolled in this study at Fudan University Shanghai Cancer
Center. All participants underwent cytology/pathology
Department of Gynaecologic Oncology1 Surgical Oncology2, Rajiv
testing (gold standard), HPV HC2 testing and FCM testing
Gandhi Cancer Institute, India
involving analysis of cell proliferation index (CPIx).
RESULTS: Among 437 women enrolled in this study, 185
OBJECTIVE: In a case of carcinoma cervix, it is imperative
women (42.3%) were diagnosed as “gold standard
to take adequate parametrium and vaginal margin. This
positive” by pathology with diseases including cervical
video demonstrates development of a vaginal cuff, an
intraepithelial neoplasia (CIN) grade 2 (n=11), CIN3 (n=41),
indegenous approach developed at our institute, for the
squamous cell carcinoma (SCC; n=115), adenocarcinoma
purpose of taking adequate vaginal margin in cases of
in situ (n=2) and adenocarcinoma (n=16). The remaining
robotic hysterectomy.
252 cases were deemed “gold standard negative”. The
METHODS: Video demonstration in a case a ca cervix stage
sensitivity was 87.6% (95% CI, 82.8–92.3) for FCM testing
IB undergoing robotic hysterectomy. Prior to docking of the
and 89.7% (95% CI, 85.4–94.1; p=0.5121) for HPV HC2
robot, development of vaginal cuff is done by dissecting
testing. The specificity of FCM testing was 90.5% (95% CI,
the cervix vaginally and using a gauze piece and attaching
86.2–94.7), which was superior to the specificity of HPV
it to the cervix and the vaginal wall anteriorly, posteriorly
HC2 testing (84.5%, 95% CI, 79.3–89.7; p=0.04). In the
and to the lateral walls. After this, robotic surgery is carried
20–29 years old group, the sensitivity and the specificity
out in the usual manner.
of FCM testing were 90.0% (95% CI, 71.4–100.0) and
RESULTS: This method aids in resection of adequate
92.9% (95% CI, 76.9–100.0), respectively. The FCM testing
parametrium and development of a vaginal cuff while
CPIx statistically increased with the transition from normal
doing robotic hysterectomy. Strategic placement of the
cervical specimens to SCC specimens.
gauze piece aids in easy development of planes for doing
CONCLUSION: Our results showed that the FCM screening
vaginectomy via the abdominal route.
system had high sensitivity and specificity for women
CONCLUSION: Routine use of this method for the
of various ages. The FCM CPIx was able to evaluate the
development of an adequate vaginal cuff helps the surgeon
severity of disease quantitatively.
save time and achieve precision in otherwise tedious step
of robotic radical hysterectomy.
PO-2013
PO-2012 Are our patients different? A 5-year review

A novel highly sensitive and specific flow of cervical cancer cases managed in tertiary
cytometry system for cervical cancer gynaecological cancer unit in Malaysia
screening
Norhuda Mat Ali, Alik Riasadesa Zakaria, Mokhtar Awang
1 2 3 2
Masakatsu Morita , Bo Ping , Xiaotian Han , Ryuichiro Ebi , Department of Obstetrics and Gynaecology, Hospital Tengku
2 2 4 4
Junya Inoue , Yosuke Tanaka , Ying Chen , Xiaochun Wan , Ampuan Afzan, Kuantan, Malaysia
Wentao Yang9, Bin Chang4, Xiaohua Wu3
1
Department of Research & Development 2 Product Development, OBJECTIVE: The purpose of this review is examine the
Poster Session
UB Product Engineering, HU Business Unit, Sysmex, Japan, clinicopathological characteristics of cervical cancer treated
3 4
Department of Gynecologic Oncology Department of Pathology, in this institution from 2010 to 2014.
Fudan University Shanghai Cancer Center, China METHODS: This is an observational retrospective study.
309
All cases of cervical cancer treated in this institution than other studies. Only one third of our patients had early
from January 2010 until December 2014 were reviewed. disease at presentation, which is likely due to poor cervical
Clinicopathological characteristics were recorded and smear uptake. Our adjuvant radiotherapy rate was higher
analysed using SPSS version 20. compared to others as most of our patients preferred
RESULTS: There were 31 cases of cervical carcinoma surgery (even if they needed adjuvant radiotherapy)
identified during that 5-year period. The mean age at compared to concurrent radiotherapy alone.
diagnosis was 51.0±12.7 years (range, 29-78 years). The
majority of them (87%) were diagnosed before the age
70. None of the patients participated in a cervical cancer PO-2014
screening programme and as a result less than 10%
Expression of P16, P53, IMP3, Bcl-2 and C-FLIPL
of women were diagnosed following an abnormal Pap
and their clinical significance in pre-malignant
smear test. More than 90% were symptomatic, out of
and malignant lesions of uterine cervix
which 82% were abnormal per vaginal bleeding and the
remaining 11% and 7% were postcoital bleeding and
Xiaofeng Wang, Pengpeng Qu
compressive symptoms respectively. Risk factors for cervical
cancer were identified in less than a third of the patients. Department of Gynecology Oncology, Tianjin Central Hospital of
Gynecology and Obstetrics, China
Premorbid medical conditions were identified in only 50%
of patients and 94% were hypertension and/or diabetes
mellitus. Similarly, the majority (94%) were categorised as OBJECTIVE: To assess the diagnostic values of P16, P53,
having either ECOG functional class 0 and 1 i.e. 81% and IMP3, Bcl-2 and C-FLIPL in cervical carcinogenesis by their
13% respectively. There was an equal breakdown between immunohistochemical expression and their correlation with
squamous cell carcinoma (SCC) and adenocarcinoma clinicopathological parameters and to assess their possible
(ACC), which was 48.4% each and the remaining 3.2% involvement in the pathogenesis of cervical cancer.
were others. For SCC, nearly all (94%) were large cell non- METHODS: Tissue samples with similar inclusion criteria
keratinising SCC with only 6% were large cell keratinising were collected from pathology department archives at
SCC subtype. As for ACC, the majority were mucinous Tianjin Central Hospital of Gynaecology and Obstetrics,
endocervical subtype (47%), 40% were unclassified and P.R.China. The study groups included cases of cervical
the remaining 13% were others. Almost all (96.8%) cancer, CIN II-III and CIN I. Samples obtained from
patients had an examination under anaesthesia (EUA) benign leiomyomata cases were used as controls.
and diagnostic imaging in the form of computer axial Immunohistochemical study was done to investigate
tomography (CT) scan to rule out locoregional and distant the expression of the markers mentioned above in these
metastasis. Just above half (55%) of the patient presented tissues. The expressions of these markers were evaluated
with stage 1 disease in which all were stage 1b i.e. 29% using microscopy and were analyzed together with other
1b1 and another 26% 1b2. Stage 2 contributed to about clinical information collected from patients’ previous
23% of which 13% were 2a and 10% were 2b. Stage history.
3 and stage 4 disease accounted for the remaining 9% RESULTS: The expression levels of p16, p53, IMP3 or
and 13 % respectively. About two-third of patients went C-FLIPL each among all the study groups were found to be
on to have treatment with us and the remaining one- statistically significant (P <0.05). No statistically significant
third sought an alternative form of treatment. Out of this, difference was observed in the expression of Bcl-2 between
47% had Wertheim’s hysterectomy, 6% had neoadjuvant CIN I and control cases (P>0.05), whereas a significantly
chemotherapy followed by Wertheim’s hysterectomy, 20% higher expression was observed in CIN II-III cases in
had concurrent chemoradiation and the remaining 13% comparison with CIN I cases (P<0.05).The expression of Bcl-
had palliative treatment. From the 16 patients who had 2 in cancer cases was significantly lower when compared
Poster Session
Wertheim’s hysterectomy, 8 of them (50%) required further with that in CIN II-III (P<0.05). The sensitivity and specificity
adjuvant treatment in the form of radiotherapy. of the co-expression of IMP3 and p16 to identify the
CONCLUSION: The incidence of adenocarcinoma is higher cervical precancerous and cancerous lesion was 87% and
310
87.5%, respectively. Likewise, the PPV was 93.7%, NPV with stage 1b and stage 2 in ACC group compared to
was 75.7%, positive likelihood ratio was 6.69 and negative SCC i.e. 52.4% versus 47.6%. Although, there was a
likelihood ratio was 0.15. The area under the ROC curve trend towards earlier stage at presentation for women
was 0.969. with ACC when compared to women with SCC but it did
CONCLUSION: IMP3 and C-FLIPL could be proposed as not reach statistical significance (p=0.06). In women with
markers of enhanced tumor aggressiveness, respectively. SCC, 80% had surgery and 20% had radiotherapy as
The diagnostic accuracy of detecting cervical precancerous compared to 60% had surgery and 40% had radiotherapy
and cancerous lesions is improved with co-expression of in women with ACC. However, these differences did
IMP3 and p16. The extrinsic pathway of apoptosis seems to not reach statistical significance, p=0.33. About 50%
be more exploited than intrinsic pathway in the progression of women in each group whom had surgery went on to
of the cervical cancer. received adjuvant radiotherapy. At the time this study was
conducted, 58% of patients were alive, 26% were lost to
follow-up and the remaining 16% had died. The mean
PO-2015 duration of follow-up was 23 months (ranging from 1 to
62 months). The mean overall survival (OS) for SCC was
Squamous carcinoma versus adenocarcinoma
17.3 ± 16.2 months, which was comparable to the mean
of the cervix:
OS for ACC i.e. 23.6 ± 24 months. There was no significant
A 5-year single institution review
difference in the mean overall survival between SCC and
Alik Riasadesa Zakaria1, Norhuda Mat Ali1, Mokhtar Awang2 ACC (p= 0.56).
1
CONCLUSION: From this study we can conclude that SCC
Department of Obstetrics and Gynaecology, Hospital Tengku
and ACC of the cervix have similar clinicopathological
Ampuan Afzan, Kuantan, Malaysia, 2 International Islamic
characteristics. We also found that, there was no difference
University Malaysia, Malaysia
in terms of prognosis between these two groups of cervical
carcinoma.
OBJECTIVE: The purpose of this study is to compare the
clinicopathological characteristics and outcomes between
squamous (SCC) and adenocarcinoma (ACC) of the cervix.
PO-2016
METHODS: This is an observational retrospectives study
conducted from January 2010 until December 2014. Case Surgical resection margin including
notes were retrieved and reviewed. Data were recorded parametrium and vagina significantly
and analysed using SPSS version 20. correlates with survival of FIGO stage IB
RESULTS: During the study period there were thirty cases of cervical cancer patients treated with radical
cervical cancer with an equal number of SCC and ACC i.e. hysterectomy: multivariate analysis of 360
fifteen cases in each group. There was no difference in the patients
mean age between women with SCC and ACC i.e. 49.2
± 9.0 years versus 52.7 ± 16.0 years, p= 0.76. There were Tae-Wook Kong, Suk-Joon Chang, Joo-Hyuk Son, Seong-Hye
also no differences found in terms of ethnic distribution Gweon, Jiheum Paek, Hee-Sug Ryu
(p=0.64), presenting symptoms (p=0.52), ECOG functional Department of Obstetrics and Gynecology, Ajou University School
class (p=0.41), risk factors (p=0.95) and type of growth of Medicine, Suwon, Korea
i.e. endophytic versus exophytic (p=0.22). With regards
to the size of tumour, there was also no statistically OBJECTIVE: The aim of this study was to identify the
significant difference observed in the mean tumour size independent clinicopathlogic prognostic factors for patients
between SCC and ACC, i.e. 41.1 ± 13.6mm versus 41.9 ± with FIGO stage IB cervical cancer treated with radical
Poster Session
12.8mm respectively (p=0.41). In this study, in both SCC hysterectomy (RH) with retroperitoneal lymphadenectomy.
and ACC groups none of patients had stage 1a disease at METHODS: We retrospectively reviewed clinicopathologic
presentation but there was a higher percentage of women data of 360 patients with FIGO stage IB cervical cancer
311
treated with RH with retroperitonal lymphadenectomy 139 patients with FIGO stage IIB cancer of the uterine
between March 2000 and March 2015. Positive parametrial cervix were analyzed retrospectively. Weekly concurrent
resection margin and vaginal cuff resection margin were cisplatin chemotherapy with a dose of 40 mg/m2 was
analyzed separately. The disease-free survival (DFS) and used in all patients. Irradiation consisted of external
overall survival (OS) were estimated using the Kaplan-Meier beam pelvic radiation with parametrial boost and high-
method. Univariate and multivariate Cox proportional dose rate brachytherapy. We investigated survival and
hazard models were applied to analyze prognostic factors. recurrence rates, and evaluated prognostic factors affecting
RESULTS: The median follow-up time was 56 months disease recurrence and survival after primary concurrent
(range, 3 to 184 months). The 5-year DFS and OS in FIGO chemoradiation.
stage IB cervical cancer were 91.4% and 97.9% (92.3% RESULTS: The median follow-up time was 43 months (range,
in DFS, 98.8% in OS, IB1 vs. 74.3% in DFS, 83.2% in OS, 7 to 168 months). The 5-year disease-free survival (DFS) and
IB2). In multivariate analysis, positive parametrial resection overall survival (OS) were 84.1% and 81.4%. In univariate
margin, tumor grade ≥2, positive vaginal cuff margin, and analysis, pelvic lymph node (LN) ≥2 cm in maximum short
FIGO stage IB2 were significantly related to DFS. Positive axis diameter (MSAD) on magnetic resonance imaging (MRI)
parametrial resection margin (OR, 15.041; [95% CI, 4.539- and pretreatment SCC-Ag/Cyfra 21-1 levels were associated
49.846]; P < 0.001), FIGO stage IB2 (OR, 3.533; [95% with DFS and OS. In multivariate analysis, pelvic LN ≥2 cm
CI, 1.283-9.728]; P = 0.015), and tumor grade ≥2 (OR, in MSAD on MRI (OR, 4.398; [95% CI, 1.187-16.288]; P
5.466; [95% CI, 1.150-25.983]; P = 0.033) were remained = 0.027) was remained an independent prognostic factor
independent prognostic factors for OS. for distant recurrence, DFS, and OS. There were significant
CONCLUSION: Surgical resection margin including differences in both 2-year DFS and OS between non-
parametrium and vagina correlates with poor prognosis. bulky (<2 cm) and bulky (≥2 cm) nodal groups (93.9% vs
The quality of radical parametrectomy and vaginectomy for 47.2% in DFS, 95.0% vs 42.1% in OS). Hematological
cervical cancer influence local tumor control and survival. toxicities were the most frequent acute toxicities (grade ≥3
Therefore, it is important to optimize and ensure the quality neutropenia, 10.8%; grade ≥3 anemia, 8.6%; grade ≥3
of surgical management for cervical cancer patients. thrombocytopenia, 2.9%). Sites of recurrence were within
the irradiation field in 8 cases, outside the field in 14 cases,
and in both fields in 4 cases.
PO-2017 CONCLUSION: Bulky pelvic LN ≥2 cm in FIGO stage
IIB cervical cancer has an adverse impact on survival.
Adverse impact of bulky (≥2 cm) pelvic Pretreatment pelvic LN status assessed by MRI might
lymph node involvement determined by be helpful to predict treatment outcome. Alternative
magnetic resonance imaging in FIGO stage IIB approaches are needed to improve outcome for such
cervical cancer patients treated with primary patients.
concurrent chemoradiation therapy
Tae-Wook Kong, Suk-Joon Chang, Jisun Lee, Su Hyun Kim,

Joohyung Lee, Jiheum Paek, Hee-Sug Ryu
Department of Obstetrics and Gynecology, Ajou University School

of Medicine, Suwon, Korea
OBJECTIVE: The aim of this study was to investigate

survival and recurrence rates and to evaluate risk factors
associated with recurrent disease in patients with FIGO
Poster Session
stage IIB cervical cancer treated by primary concurrent

chemoradiation.
METHODS: Between April 2001 and January 2013,
312
PO-2018 link between autophagy and radiation treatment.Inhibition
of autophagy seems to promote more cells to undergo
Regulation of radiation by autophagic
apoptosis, however, the relationship between autophagy
modulator
and apoptosis with IR treatment in cervical cancer cells
Yoon Kyung Lee, Keun Ho Lee

remain to be enlightened.Induction of autophagy may
interfere with the mechanism of homeostasis that is
Department of Obstetrics and Gynecology, Seoul St. Mary's
originally preserved by autophagy itself, and leads to cell
Hospital, The Catholic University of Korea, Seoul, Korea
death possibly altogether with apoptosis. The pathway via
which this process conducts also waits to be distinguished.
OBJECTIVE: On account of limited therapeutic options for
advanced and recurrent cervical cancer, novel therapeutic
modalities are being investigated based on translational
PO-2019
research. Among the promising topics is autophagy.
Autophagy can be refered to as a double edged sword Prognostic factors of oncological and
in a way that it is known to function in both tumor cell reproductive outcomes in fertility-sparing
suppression and survival. This study was carried out to treatment of complex atypical hyperplasia
determine the role of autophagy in treatment of cervical and low grade endometrial cancer using oral
cancer cells with radiation and effect of autophagy on progestin in Chinese patients
apoptosis when treated with autophagy inducer or
inhibitor. Rong Zhou, Yuan Yang Qun Lu, Jianliu Wang, Yali Miao,
METHODS: Human cervical cancer cells, Hela and Caski Shijun Wang, Zhiqi Wang, Chao Zhao, lihui Wei
were used. Western blot was implemented to detect Department of Gynecology and Obstetrics, Peking University
protein expression. Fluorescence microscopy and inverted People’s Hospital, Beijing, China
microscopy guided inspection confimed autophagy. Hela
and Caski cells were irradiated with r-rays (2 Gy / min) and OBJECTIVE: To evaluate progestin treatment efficacy and
again each time after treatment with autophagy inducer fertility outcomes for complex atypical hyperplasia (CAH)/
(Rapamycin) and inhibitor (3-MA). Expression of LC3 and grade I endometrial cancer (G1EC) in Chinese patients (≤40 y).
cell deaths in two cell preparations were examined. In METHODS: Women ≤40 y treated with progestin for CAH
addition, expression of Caspase3 and PARP were examined or G1EC from 9 provinces of China were identified. The
to identify apoptosis. time to achieve a complete response (CR) and the time
RESULTS: Notable increment of LC3 expression were from CR to recurrence or pregnancy was censored for
detected after radiation in both cell lines by western blot patients without events and was analyzed for associations
and microscope analyses. Radiation of pre-Rapamycin between patient and treatment characteristics.
treated cells showed further increased LC3 expression and RESULTS: Thirty-two patients were included. They were 13
pre-3-MA treated cells, less increased LC3 expression than CAH and 19 G1EC. Nine patients exhibited serum HbA1C
radiation alone compared to non-treated, not radiated elevation before treatment. After a mean follow-up of
cells. Cell viability decreased to 75 % in Hela cells and 32.5 months, CR rate was 84.4%. While patients who
79 % in Caski cells after radiation. When treated with exhibited HbA1C-elevation were more likely to experience
Rapamycin, cell viabilities were 59 % and 65 %, and with a CR and polycystic ovarian syndrome (PCOS) was on the
3-MA, 65 % and 70 % in each cell lines. opposite (p= 0.01, 0.03). Nine of 21 patients experienced
CONCLUSION: Radiation induces autophagy in cervical successful pregnancies. Eight patients underwent assisted
cancer cell lines. Autophagy induced by radiation could reproductive technology (ART). Five patients had newborn
be modified when treated with Rapamycin/ 3-MA which infants. Patients undergoing ART were more likely to
Poster Session
leads to more cell deaths.Further investigations are become pregnant (p= 0.04).
needed to identify the specific pathways mediating post- CONCLUSION: Oral progestin is an effective fertility-sparing
IR induced autophagy in order to confirm the functional treatment for women with CAH/G1EC in China. Patients
313
with HbA1C-elevations taking both metformin and identify low risk group patients who can undergo
progestin were more likely to achieve a CR, but PCOS was morcellation safely. The score might be helpful in the
not. ART is a good choice for a successful pregnancy after selection of risk-adapted surgical approach to avoid the
treatment incidental morcellation of uterine sarcoma.
PO-2020 PO-2021
A scoring system to predict the risk of uterine Modified cervicography and visual inspection
sarcoma in patients with a uterine mass with acetic acid, an alternative screening for
cervical cancer
Jung-Yun Lee, Young Tae Kim
Department of Obstetrics and Gynecology, Yonsei University, Seoul,

Gatot Purwoto1, Hasra Depiesa Dianika2, Laila Nuranna1
Korea Department of Gyneacologic Oncology, Dr. Cipto Mangunkusumo

Hospital1 Faculty of Medicine Universitas Indonesia2, Indonesia
OBJECTIVE: Although incidental morcellation of uterine
sarcoma was associated with poor outcome, there is no OBJECTIVE: This study aims to evaluate the sensitivity and
reliable method to diagnose uterine sarcoma preoperatively. specificity of these methods to detect precancerous lesion
The aim of this study was to develop a risk scoring model among Indonesian women.
for the prediction of uterine sarcoma among patients with METHODS: This is a cross-sectional study performed at
uterine mass. the gynecologic oncology clinic in Cipto Mangunkusumo
METHODS: We analyzed the demographics, blood tests, Hospital, a tertiary center in Jakarta, from February 2015
imaging study of 392 suspected uterine sarcoma cases – April 2015. The subject of this study is married women.
that underwent surgery from 2006 to 2015. Univariate, The exclusion criteria of this study is woman who refused
multivariate, and ROC curve analysis was performed. to participate in this study, pregnant, and with difficulty
Then, a risk-scoring model, including the best predictors of to obtain cervical view. All women were underwent both
uterine sarcoma, was tested. modified cervicography and VIA test and continued with
RESULTS: Univariate analysis indicated age, parity, maximal colposcopy examination as a reference test.
diameter of uterine mass, and number of uterine mass RESULTS: 185 women were eligibile for this study. Most
as significant predictors of uterine sarcoma. In contrast, of women were 31-50 years old (77.3%) and have no
multivariate analysis showed only parity and maximal cervicitis (88.1%). Most of examination could visualize
diameter of uterine mass as significant predictors. squamnocolumnar junction clearly (86.5%). 5.4% (10/185)
Accordingly, the latter were placed as 2 points, and the subjects were had positive colposcopy result. Sensitivity (se),
remaining age and number of uterine mass as 1 point. specificity (sp), positive predictive value (PPV), and negative
These variables were used to create a risk scoring model predictive value (PPV) of VIA to detect precancerous lesion
for the prediction of uterine sarcoma, with an area under were respectively 96.0%, 90.9%, 99.4%, and 58.8%.
the curve of 0.887 (95% confidence interval [CI], 0.836- Se, sp, PPV, and NPV of modified cervicography to detect
0.938). Based on these factors, we developed the following precancerous lesion were respectively 97.7%, 90.9%,
predictive score: low risk (score 0, 1, or 2), intermediate risk 99.4%, 71.4%.
(score 3 or 4), high risk (score 5 or 6). The frequencies of CONCLUSION: Modified cervicography and VIA are reliabe
uterine sarcoma were 0%, 4.34%, and 14.5% for the low- tools for cervical cancer screening. Modified cervicography
, intermediate-, high-risk categories, respectively (P<0.001). could be use as an alternative and innovative tool to
No case of uterine sarcoma was observed in patients with improve the documentation of VIA.
Poster Session
low risk group (negative predictive value, 100%: 95% CI,

95.1%-100%).
CONCLUSION: This preoperative prediction model could
314
PO-2022 PO-2023
Preoperative predictive factors for complete Two rare variants of carcinoma cervix and
cytoreduction and survival outcome in review of literature
epithelial ovarian and peritoneal cancer after
neo-adjuvant chemotherapy Sunesh Kumar, Seema Singhal, Sandeep Mathur, Lalit Kumar,
DN Sharma
1,2 1 2
Min-Hyun Baek , Dae-Yeon Kim , Chae-Chun Rhim , Young-
Department of Obstetrics and Gynaecology, All India Institute of
Han Park2, Dae-Shik Suh1, Jong-Hyeok Kim1, Yong-Man Kim1,
Medical Sciences, India
Young-Tak Kim1, Joo-Hyun Nam1
1
Department of Obstetrics and Gynecology, Asan Medical Center, OBJECTIVE: The incidence of squamous cell carcinoma of
University of Ulsan, Seoul, Korea, 2Department of Obstetrics and cervix has decreased in past decade owing to cytologic
Gynecology, Hallym university sacred heart hospital, Anyang,
screening. Numerous studies have reported increasing rates
Korea
of cervical adenocarcinomas and other rare variants. Small
cell undifferentiated (neuroendocrine) carcinoma, and
adenosquamous carcinoma of the cervix are rare. Most of
OBJECTIVE: To identify preoperative predictive factors for
the centres have little experience with these tumour and
complete cytoreduction and survival outcome in epithelial
only small series have been published. They are known to
ovarian cancer and peritoneal cancer after neo-adjuvant
be more aggressive. Present therapy has not significantly
chemotherapy (NACT).
improved outcomes in these cases. We report two cases of
METHODS: We performed a retrospective analysis of 90
rare variants of cervical malignancy, share our experience
patients with epithelial ovarian cancer and peritoneal cancer.
and review the literature.
Patients were divided into two groups according to residual
METHODS: Case 1 A 38 years old P3L4 presented with
tumor at interval debulking surgery and clinicopathologic,
post coital bleeding for 6 months. On Per speculum
surgical, and follow up data were compared.
examination cervix was bulky, ectocervix appeared normal.
RESULTS: CA-125 levels before the interval debulking
On per vaginal examination uterus was anteverted normal
surgery after completion of NACT were higher in the
size and bilateral parametria were free. Her Pap smear
residual tumor group (45.3 vs 153.5 U/mL, P = 0.012).
showed atypical glandular cells. Small cell carcinoma
The change in CA-125 after NACT was higher in the
no residual tumor group (96.4% vs 91.6%, P = 0.009). of cervix was diagnosed on colposcopy and directed
Patients with residual tumor showed lower disease-free and biopsy. She underwent Type 3 radical hysterectomy with
overall survival outcomes than patients with no residual bilateral salpingo oophorectoy. Histopathology revealed
tumor. In univariate analysis, CA-125 ≤100 U/mL and a adenocarcinoma with extensive areas of neuro endocrine
change after NACT >80% were preoperative predictive differentiation. Surgical margins were negative and lymph
factors for complete cytoreduction. In multivariate analysis, nodes were also free from disease Post surgery patient was
a CA-125 change after NACT >80% was an independent given chemo radiation. After 1 year of follow up patient
preoperative predictive factor for complete cytoreduction is disease free. Case 2: 32 years old P2L2 presented with
(P = 0.047). In univariate and multivariate analysis, a CA- discharge per vaginum and post coital bleeding. She was
125 change after NACT ≤80% and progressive disease diagnosed to have stage 1B1 non keratinizing squamous
on follow up image during NACT was an independent cell carcinoma cervix. She underwent Type 3 radical
preoperative predictive factors for 1-year disease-free and hysterectomy with salpingectomy and ovarian transposition.
overall survival (P = 0.035 and < 0.001). HPE showed adnosquamous carcinoma with clear cell
CONCLUSION: A large change in CA-125 after NACT is an change. Post operatively patient received chemoradiation
independent preoperative predictive factor for complete and is under follow up.
Poster Session
cytoreduction. Also, it is an independent preoperative RESULTS: Small cell carcinoma cervix with neuro endocrine
predictive factor for early recurrence and death with component and cervical adenosquamous carcinoma are
progressive disease on follow up image after NACT. special histological type with high risk of poor prognosis.
315
Both our patients presented at a very young age. preoperative SCC level were 49 years (range 22-63 years),
Neuroendocrine tumors of the cervix account for fewer 21.6 kg/m2 (range 19.3-23.9 kg/m2) and 9.3 ng/ml (range
than 2% of all cervical malignancies. Small-cell carcinoma 1.3-22.3 ng/ml). The median operative time, blood loss,
of the cervix behaves in a similar manner to small-cell lung and acquired number of lymph nodes were 320 minutes
carcinoma, with vascular invasion common, and death (range 310-365 minutes), 80 ml (range 50-100 ml), and
most likely due to hematogenous spread and distant 52 (range 22-63). Three patients had parametrial invasion,
metastases. Three-year overall survival ranges from 29% to and one patient had node metastasis. And 7 patients had
60% in series with multimodality therapy with the highest received adjuvant chemotherpy instead of radiotherapy
survival in those treated with combined therapy (surgery, for low risk (4 patients) and high risk factor (3 patients).
chemoradiation). Adenosquamous carcinoma accounts for There was no intraoperative complication. However,
5-10% of cervical cancer. Lymph node metastasis, adjunct there was one case of prolonged ileus and one case of
post-operative therapy, tumour size more than 4 cm are ureter stricture. After median follow-up of 13 months, no
independent prognostic factors. The impact of ovarian recurrence occurred.
preservation on prognosis is unclear. CONCLUSION: Nerve-sparing RRH with extended
CONCLUSION: Recognition of rare variants carcinoma lymphadenectomy was feasible and safe treatment
cervix is important for appropriate therapy & management modality which may be an alternative treatment options
since these patients have worse clinical outcomes when for locally advanced cervical cancer and reduce radiation
compared with conventional squamous /adeno carcinoma induced complications. However, large number of study
of cervix. and long-term follow-up were needed to compare with
concurrent chemotherapy and radiotherapy.
PO-2024
PO-2025
Robotic radical hysterectomy with
extended lymphadenectomy and resection Factors associated with participation in
of rectouterine ligament after neoadjuvant cervical cancer screening in Korea
chemotherapy for stage IIB-IIIA locally
advanced cervical cancer: a pilot study Ha Kyun Chang, Keun Ho Lee, Soo Young Hur, Jong Sup
Park, Tae Chul Park
1 2 3
Yoon Hee Lee , Gun Oh Chong , Dae Gy Hong , Young Lae Department of Obstetrics and Gynecology, The Catholic University
Cho4, Yoon Soon Lee5 of Korea, medical college, Seoul, Korea
Department of Obstetrics and Gynecology, Kyungpook National
University Hospital, Daegu, Korea OBJECTIVE: Despite the Government’s National Cancer
Screening Program for cervical cancer screening, the
OBJECTIVE: To evaluate the feasibility, safety and oncological number of individuals participating in screening in Korea
outcomes of nerve-sparing robotic radical hysterectomy is low. Therefore, the aim of this study was to identify
(RRH) with extended lymphadenectomy and resection of associations between relevant risk factors and the uptake
rectouterine ligament after neoadjuvant chemotherapy for of screening in Korea.
stage IIB-IIIA locally advanced cervical cancer. METHODS: The Health Interview Survey sub-dataset
METHODS: Between July 2012 and September 2013, a derived from the Fifth Korean National Health and
total of 7 patients (6 squamous cell carcinoma stage IIB Nutrition Examination Surver (KNHANES V) was used to
and 1 adenocarcinoma stage IIIA) underwent nerve-sparing evaluate participation in cervical cancer screening and
RRH with extended lymphadenectomy and resection of factors associated with attendance in individuals aged
Poster Session
rectouterine ligament. All patients received platinum-based from 15 to 39. Those that completed the questionnaire
neoadjuvant chemotherapy. and not previously diagnosed with cervical cancer were
RESULTS: The median age, body mass index, and enrolled (3,734 subjects). Multi-dimensional covariates
316
were considered as potential predictors for cervical cancer and group with cervical cancer
screening in multivariated analyses. METHODS: This study was a cross-sectional study of healthy
RESULTS: Cervical cancer participation rate is high for patients with or without HPV infection, and cervical
overall test participation rate, but, the participation rate cancer patients. Patients with HPV infection and negative
is exceptionally low at aged 40 or less group. Because Liquid Base Cytology (LBC) were followed for 12-24
National Cancer Screeing Program for cervical cancer is for months before re-evaluation into persistence or clearance
over 30 years old subject, we divided into two groups (15- of HPV infection. Data were obtained consecutively
29, 30-39) and compare respectively. The following were from outpatients of Division of Gynecology Oncology,
associated with participation: age, education level, total pathology results from Pathology Department, National
household income, smoking, job status. In the present Referral Hospital Dr. Cipto Mangunkusumo. We perfomed
study, age was associated with cervical cancer screening peripheral vein blood twice before and after retinol
participation.Total household income is statistically administration and cervical mucus examination to examine
significant. Aged 30-39 group, especially in the more RBP4 concentration and CD4+:CD8+ Ratio
statistically significant increase in household incomes tend RESULTS: This study was conducted on 20 subjects divided
to increase participation in cervical cancer. Job status was into 4 groups : Group A of HPV (-)/LBC (-) (n=9); Group
also associated with the level of participation in cervical B of HPV (+)/LBC (-) clearance (n=4); Group C of HPV (+)/
cancer screening program in both aged 15-29 and 30-39 LBC (-) persistent (n=3); and Group D of cervical cancer
group. (n=4). Out of those subjects, there are subjects whose
CONCLUSION: To improve participation in cervical cancer RBP4 increased >20% after retinol administration, thus
screening, appropriate strategies must be directed considered having low retinol deposits, i.e: 3 among 9
toward vulnerable populations, such as those with low subjects in group A, 1 among 4 in group B, 1 among 3
socioeconomic status. in group C, and 1 among 4 in group D. Mean circulating

RBP4 concentrations in group A, B, C, and D are 100.81
mg/mL, 102.84 mg/mL, 114.23 mg/mL, 130.81 mg/mL,
PO-2026
respectively. Mean CD4:CD8 ratios are 1.36, 1.08, 1.11,
0.94, for group A, B, C, and D, respectively. There is no
Circulating Retinol Binding Protein-4 (RBP4) significant mean difference of CD4+:CD8+ ratio among all
concentration and CD4+:CD8+ T cells ratio groups (p=0.534). There is no significant mean difference
in normal cervix, with or without High Risk of RBP4 concentration before (p=0.803, ANOVA) and after
Human Papilloma Virus (HPV) infection (p=0.651, Kruskal-Wallis) RA administration in each group.
and cervical cancer: a Preliminary study in There is no correlation between CD4+:CD8+ ratio and
immunity towards cancer RBP4 concentration (p=0.942: r=0.017) among all subjects
CONCLUSION: No significant difference was found
Tofan widya utami1, Andrijono Andrijono1, Fera Ibrahim4, between mean RBP4 concentration before and after RA
Sofy Meilany4, Dewi Wulandari2, Ceza Kautsar Lasera3, administration in all the assessed groups. There is no
Mohamad Farid Aziz1
significant difference of mean CD4+:CD8+ ratio between
1 2
Department of Obstetrics and Gynecology Clinical Pathology groups. We conclude that there is no correlation between
Oncology Gynaecology3 Institute of Human Virology and Cancer CD4+:CD8+ ratio and RBP4 level among all groups
Biology4, University of Indonesia
OBJECTIVE: The first aim of study is to investigate circulating

RBP4 concentration and retinol deposit and local immunity
status represented by CD4+:CD8+ Tcells ratio in the cervix.
Poster Session
The second aim is to analyze the correlation between RBP4

concentration and CD4+:CD8+ ratio, retinol deposit, and
CD4+:CD8+ ratio in groups with or without HPV infection,
317
PO-2027 PO-2028
Abdominal radical trachelectomy: Radical abdominal trachelectomy for cervical

What can we learn from the recurrent cases malignancies: Surgical, oncological and fertility
outcomes from 10-year experience
Jin Li, Xiaohua Wu
Jin Li, Xiaohua Wu
Cancer Center, Shanghai, China Department of Gynecologic Oncology, Fudan University Shanghai
OBJECTIVE: The surgical radicality and oncological safety Cancer Center, Shanghai, China
of abdominal radical trachelectomy (ART) has been widely
acknowledged. Here we presented recurrent cases after OBJECTIVE: To report our experience of radical abdominal
ART from our experience to discuss possible risk factors trachelectomy for patients with cervical malignancies.
for treatment failure in patients with cervical cancer after METHODS: We conducted a retrospective review of a
fertility-sparing ART. prospectively maintained database of patients undergoing

METHODS: Two hundred and twenty-three patients with fertility-sparing radical abdominal trachelectomy for cervical
cervical malignances underwent ART between April 2004 malignancies at our institution from 04/2004 to 08/2014.
and August 2014. We classified the histological type, RESULTS: Two hundred and twenty-three patients with
presence of lymphvascular space invasion, depth of tumor cervical malignancies underwent laparotomy for planned
infiltration and tumor size as risk factors. In our study, radical abdominal trachelectomy. Twenty patients needed
immediate completion of radical hysterectomy due to
we evaluated the recurrence rates and examined the risk
unfavorable intraoperative findings. Median age was 28.9
factors for treatment failure. The mean follow-up time was
years (range, 11–41). Histology included 25 (11.2%) with
45.3 months.
adenocarcinoma, 179 (80.3%) with squamous carcinoma,
RESULTS: Five of the 223 patients had cancer recurrence.
9 (4%) with adenosquamous carcinoma and 10 (4.5%)
Recurrence appeared at a mean time of 23.6 months (9-
with botryoid sarcoma. Median number of nodes evaluated
39 months) after ART. One patient died 12 months after
was 25 (range, 12–53); Ninety-seven of 144 (45.5%) IB1
her diagnosis of recurrence. None of these 5 patients
cases had tumor size no less than 2 cm. Five recurrences
had distant metastasis at the time of recurrence. All five
were observed at a median follow-up of 44.8 months.
patients were treated with salvage surgery and adjuvant
Fourteen patients developed severe postoperative cervical
chemotherapy/chemoradiation. The mean follow-up
stenosis and required neo-cervical dilation. One hundred
after the recurrence of these 5 patients was 10.6 months
and twenty patients completed the survey which aimed
(6-15months). Four of the 5 patients with recurrences in
to understand what factors influenced these patients'
our series had adenosquamous carcinoma (2 patients) or
reproductive outcomes. For various reasons, only 55
adenocarcinoma (2 patients) while only one patient had
patients attempted to conceive and 9 of them succeeded.
squamous carcinoma. Three of all five recurrent patients Six of them delivered by cesarean section at 27- 39 weeks,
had tumor ≥2 cm. One patient had a positive pelvic lymph two miscarriaged at 10 and 13 weeks and the other is
node by the final pathology while her frozen section currently pregnant.
revealed no risk factors. She refused to undergo adjuvant CONCLUSION: Radical abdominal trachelectomy seems to
radiation and underwent chemotherapy instead. be a reasonable option for selected patients whose tumors
CONCLUSION: Although adenosquamous carcinoma and are no larger than 4 cm when conducted by experienced
adenocarcinoma are no contraindication for ART, patients gynecologic oncologists. The main perioperative
with these two histological types may carry higher risk complication is postoperative cervical stenosis, which could
for recurrence after ART when compared with those had be effectively prevented by installation of a tailed T-IUD
squamous carcinoma. It is strictly mandatory for patients to during the surgery. Social, familial and physical factors can
Poster Session
follow the standard treatment when there was discrepancy largely influence the patients' reproductive outcomes. The
between frozen section evaluation and final pathology. issues of reproductive concerns and quality of life require
further investigation.
318
PO-2029 Mean age of study subjects were 49.1 yo. On both study
groups, there were 68.8% stage IIIB then 27.9% stage IIB.
Comparison of treatment response and
Assesment of treatment respons between two groups was
survival of chemoradiation between cisplatin-
performed on 3 months after completed radiation therapy
ifosfamide three-weekly and cisplatin-weekly
by gynecological examination and US examination. On
on locally advanced cervical cancer (IIB - IIIB)
the comparison, most subjects have achieved complete
Oni Khonsa, Sigit Purbadi, Nana Supriana, Bambang Sutrisna

response with survival Hazard Ratio 1.4 (p 0.713). From
the DFS rate there is intersection curve that not fulfilled
Department of Oncology gynecology, Ciptomangunkusumo
HR assumption (p= 0.78). Evaluation of toxicity showed
Hospital, Jakarta, Indonesia
there were gastrointestinal toxicity, genitourinaria toxicity,
and hematology toxicity whom are the most commonest
OBJECTIVE: Data in RSCM from 2006-2010, there were
toxicity occured and mentioned in references.
2.297 cases of cervical cancer, with locally advanced disease
CONCLUSION: Chemoradiation with cisplatin-ifosfamide
(IIB to IVB) as much as 76.7%. According to the National
three-weekly and cisplatin weekly have the same efficacy
Cancer Institute (NCI), the five-year survival rate of cervical
in patients with locally advanced cervical cancer. However,
cancer in stage IIB-IIIB from 1996 to 2000 was 55%, while
the treatment of locally advanced stage cervical cancer in
stage IV was 14.6%. Systematic review from Green et al
terms of control of local recurrence, regional and distant
gets improvement of overall survival rate and progression
recurrence remains an issue, that allowed another potential
free survival was 10% and 13% of chemoradiation with
combination of therapy.
cisplatin. Due to study results, facing the effects of full-
dose chemotherapy on locally advanced cervical cancer,
and willingness to improve therapeutic response and
PO-2030
survival rate in locally advanced cervical cancer, Cipto
Mangunkusumo Hospital has been using the standard of Paradoxical expressions of hypoxia-inducible
treatment for cervical cancer locally advanced stage using factor-1α and apelin affecting cervical
chemoradiation with two chemotherapy regimens. This carcinogenesis and prognosis
study will evaluate the existing treatment regimens in terms
of assessing better treatment response and survival rate So Yeon Kim, Maria Lee, Hee Seung Kim, Hyun Hoon Chung,
and toxicity arising as a part of the protocol evaluation. Noh Hyun Park, Yong Sang Song, Jae-Weon Kim
METHODS: This is a historical cohort study held in Department of Obstetrics and Gynecology, Seoul National
Gynecology Oncology outpatient clinic, radiotherapy University Hospital, Seoul, Korea
department, and Gynecology Oncology division ward,
Dr. Cipto Mangunkusumo Hospital, from December OBJECTIVE: Hypoxia-inducible factor-1α (HIF-1α) is a well-
2013 until October 2014. The study subjects are locally known biomarker affecting tumor angiogenesis under
advanced stage cervical cancer patients (stage IIB-IIIB) who decreased oxygen tension by chronic hypoxia. Moreover,
were treated by chemoradiation therapy using cisplatin- apelin is also an factor stimulating angiogenesis in cardiac
ifosfamide and cisplatin weekly in RSCM Jakarta from disease and some types of malignancies. However, there
August 26th 2010 until June 28th 2014. Chemoradiation is no evidence of the role of apelin, especially compared
response was evaluated by degrees of tumor regression, with HIF-1α, in cervical cancer. Thus, we investigated their
defined by comparison between the tumor size prior to and expressions affecting cervical carcinogenesis and prognosis.
3 months after therapy. The patients were then evaluated METHODS: : We collected paraffin-embedded blocks
every month during therapy to see the toxicity effect, until including cervical tissues of 178 patients who received
3 months after the therapy was completed. loop electrosurgical excision procedure or hysterectomy
Poster Session
RESULTS: There were 61 cases fulfilled the selection criteria, between 2006 and 2010. All tissues consisted of three
with 32 cases using cisplatin-ifosfamide chemo-radiation groups: group 1 (normal, n=24; cervical intraepithelial
and 29 cases undergoing cisplatin-weekly chemoradiation. neoplasia [CIN] 1, n=16; CIN 2, n=32); group 2 (CIN 3,
319
n=36); group 3 (invasive squamous cell carcinoma, n=70). patient and PDX tumor tissue using H&E staining, array-
We made tissue microarray using them, and performed comparative genomic hybridization (aCGH) and targeted
immunohistochemistry using mouse monoclonal antibody next-generation sequencing (NGS) analysis.
for HIF-1 α (1:30) and rabbit polyclonal antibody (1:100) RESULTS: Of the 21 patient samples collected, 16 were
for apelin. successfully engrafted into mice and resulted in PDX
RESULTS: : Higher expression of HIF-1α was observed more models (engraftment rate = 76.2%). Serially passaged PDX
commonly in groups 2 (75%) and 3 (65.7%) than group 1 tumors retained both histopathologic and genetic features
(37.5%), whereas higher expression of apelin was shown of the original tumors. Among nine molecularly profiled
more frequently in groups 1 (20.8%) and 2 (22.2%) than cervical cancer patient samples, one HER2-amplified tumor
group 3 (15.7%) (p<0.05). Moreover, patients with higher was detected by aCGH and targeted NGS. We confirmed
expression of HIF-1α showed poor progression-free survival HER2 overexpression in the tumor and serially passaged
than those with lower expression of HIF-1α (mean, 84.2 PDX tissues. Moreover, co-administration of trastuzumab
and 94.3 months; p<0.05). However, higher expression of and lapatinib in the HER2-overexpressing PDX significantly
apelin was related with improved PFS (mean, 92.3 and 79.4 inhibited tumor growth compared to the control (P < 0.05).
months, p<0.05). CONCLUSION: We established histopathologically and
CONCLUSION: Although both HIF-1α and apelin were genomically homologous PDX models with human cervical
related with tumor angiogenesis, we found that they cancer tissue using subrenal implantation. We propose
showed paradoxical expressions affecting cervical using HER2 inhibitor-based therapy for HER2-amplified
carcinogenesis and progression-free survival in patients cervical cancer refractory to conventional therapy.
with invasive squamous cell carcinoma.
PO-2032
PO-2031
Examination of the indication of the adjuvant
HER2 as a novel therapeutic target for cervical therapy after radical hysterectomy for the
cancer uterine cervix cancer
Su-Jin Han, Eun jin Heo, E Sun Paik3, Hyun Jin Choi4, Yoo- Toshinori Kawagoe, Toru hachisuga, Rie Urabe, Taeko Ueda,
Young Lee5, Chel Hun Choi6, Tae-Joong Kim7, Jeong-Won Lee8, Tomoko Kurita, Seiji Kagami
9 10
Byoung-Gie Kim , Duk-Soo Bae Department of Obstetrics and Gynecology, University occupational
Department of Obstetrics and Gynecology, Samsung Medical and environmental health, Fukuoka, Japan
Korea OBJECTIVE: The purpose was to investigate the validity
of the indication of the adjuvant therapy after radical
OBJECTIVE: Although surgery and radiation represent the hysterectomy (RAH) for the uterine cervix cancer (CxCa)
current standards for the treatment of cervical cancer, there Stage 1b and Stage 2.
is no effective therapy for metastatic or recurrent cases. METHODS: 78 patients underwent primary RAH for the
In this study, we sought to establish a patient-derived CxCa Stage 1b and Stage 2 between January 2007 and
xenograft (PDX) model using human cervical cancer tissues December 2013. The cases of GOG score>120 of stage1b,
and apply it as part of a therapeutic strategy. pT2b, and lymph nodes metastasis were done adjuvant
METHODS: Small pieces of human cervical cancer were therapy after RAH. We compared and investigated
meticulously grafted under subrenal capsules of BALB/ prognostic factors (clinical tumor size, parametrial
C-nude mice within two hours after surgery. Grossly involvement, vaginal invasion, vessel permeation, lymph
Poster Session
visible and fresh tumor tissues in developed PDX tumors nodes metastasis, clinical stage) and GOG score during a
were serially transplanted for subsequent generations. presence of recurrence and a presence of adjuvant therapy.
Phenotypic and genetic features were compared between RESULTS: The frequency of the recurrence of the CxCa
320
was 9.0% (7/78 ). The cases of GOG120 parametrial value of pre-treatment and post-treatment SCC-Ag for
involvement and lymph nodes metastasis were recurred predicting recurrence was 1.86 ng/mL (area under the
much significantly by a relation between the prognostic curve [AUC] =0.663; p=0.000), and 0.9 ng/mL (AUC=0.581;
factors and a presence of recurrence. According to the p=0.002), respectively. In the multivariate Cox regression
treatment, the cases of GOG≦120 and no lymph node model, pre-treatment SCC-Ag >1.86 ng/mL (odds
metastasis in the cases of RAH only were not recurred ratio=2.11; 95% confidence interval, 1.38-3.22; p=0.001)
(0.0%). But 7 cases in the cases of adjuvant therapy were and post-treatment SCC-Ag >0.9 ng/mL (odds ratio=1.64;
recurred (18.4%). 95% confidence interval, 1.18-2.28; p=0.003) were
CONCLUSION: The cases of GOG≦120, no lymph node significantly associated with poor DFS.
metastasis and no parametrial involvement in the CxCa CONCLUSION: Patients with pre-treatment SCC-Ag >1.86
pT1b and pT2a was observed by RAH only and all cases ng/mL or post-treatment SCC-Ag >0.9 ng/mL should be
were not recurred. I thought that the our indication of considered at high risk for cancer recurrence after complete
adjuvant therapy after RAH was proper. remission, and therefore, closer surveillance is needed.
PO-2029 PO-2034
The prognostic value of squamous cell Squamous cell carcinoma predicts favorable
carcinoma antigen for predicting tumor post-recurrence survival in uterine cervical
recurrence in cervical squamous cell cancer
carcinoma patients
Shino Tanaka, Atsumi Kojima, Tomoyuki Fukagawa, Yasuko
Hyun Kyung Ryu, U Chul Ju, Woo Dae Kang, Seok Mo Kim Suga, Eriko Takatori, Takayuki Nagasawa, Tadahiro Shoji,
Fumiharu Miura. Satoshi Takeuchi, Toru Sugiyama
University Medical School, Gwangju, Korea Department of Obstetrics and Gynecology, Iwate Medical
University, Morioka, Japan
OBJECTIVE: The aim of this study was to evaluate the
prognostic value of squamous cell carcinoma antigen (SCC- OBJECTIVE: To clarify the difference of clinical courses
Ag) and the optimal cut-off value for predicting recurrence after recurrence between in patients with squamous cell
in cervical squamous cell carcinoma (SCC) patients with carcinoma (SCC) and in patients with non-SCC of uterine
complete remission after primary treatment. cervix.
METHODS: We reviewed the records of 783 cervical METHODS: 54 cases of stage IB-IIB cervical cancer initially
squamous cell cancer patients who underwent primary treated by radical hysterectomy at Iwate Medical University
therapy and showed complete remission at our institution Hospital from 2004-2008, were retrieved from the tumor
between January 2000 and April 2014. A receiver registry. In these patients, 20 patients (10 SCCs and 10
operating characteristic (ROC) curve was used to determine non-SCCs) had recurred in their courses and we analyzed
the optimal SCC-Ag threshold to predict recurrence. Cox the post-recurrence survival of SCC patients compared to
regression model for disease free survival (DFS) was used to non-SCC patients using the Kaplan-Meier method.
assess differences in outcome. RESULTS: Median age (range) in SCC patients and non-
RESULTS: The median follow-up period was 41.2 months, SCC patients was 40 (28-53) years and 52 (34-74) years,
and 154 patients (19.7%) had recurrent disease. The respectively (P=0.17), and median disease-free survival
median pre-treatment and post-treatment SCC-Ag level of these two group were 12 months and 7.5 months,
was 2.6 ng/mL (range, 0.1-532.0 ng/mL) and 0.7 ng/mL respectively. There was no significant difference in the
Poster Session
(range, 0.0-46.8 ng/mL), respectively. Both pre-treatment site of recurrences between SCC patients and non-SCC
and post-treatment SCC-Ag levels were higher in the patients. Median post-recurrence survival (PRS) of SCC
recurrence group (p=0.017 and 0.039). Optimal cut-off patients and the non-SCC patients are 25.5 months and
321
7 months, respectively, and 1 year-/ 2 years-/ 5years- PRS (LVI) was detected in 7 (17,07 %) D2-40 Podoplanin slides,
rates of SCCs and non-SCCs were 70%/ 50%/ 40% and and 9 (21,95%) HE slides. Pelvic lymph node metastasis
40%/ 20%/ 0%, respectively (P=0.03). 4 SCC patients, of was found in 6 (14,63%) samples. Positive LVI detected
whom 2 had local recurrence and 2 had distant metastases, by D2-40 Podoplanin was significantly correlated with
were alive more than 5 years after recurrence, and in these lymph node metastasis (p=0,02), but positive LVI detected
cases, one patient was removed her recurrent tumor by by Hematoxyllin-eosin was not significantly correlated
surgery and two patients were responsive to radiotherapy. (p=0,072)
On the other hand, one non-SCC patients treated by CONCLUSION: In this study we found significant
surgery was alive for twenty months after the operation, correlation between lymph vessel invasion detected by
while a patient treated by radiotherapy was died of her immunostainning D2-40 Podoplanin with pelvic lymph
disease within a half year. node metastasis in stage I B and II A cervical cancer.
CONCLUSION: Recurrent SCC patients tended to be younger
than non-SCC patients and showed better response to
the radiotherapy even at the recurrence. But for non-SCC PO-2036
patients, the course after recurrence was quite severe and
Serum level of Vascular endothelial growth
may need other strategy than SCC.
factor (VEGF) and Squamous cell carcinoma
(SCC) antigen as markers of response of
radiation therapy in cervical cancer
PO-2035
Correlation of lymph vessels invasion with Ferry Armanza, A Andrijono

pelvic lymph node metastasis in cervical Indonesian Society of Gynecologic Oncology (INASGO)
cancer stage I B and II A
OBJECTIVE: To explore whether serum levels of VEGF
Manuel Hutapea, Brahmana Askandar and SCC can be used as a tumor marker of response to
Department of Obstetrics and Gynecology, Dr.Soedarso General radiation therapy, and whether serum levels of VEGF is
Hospital, Pontianak, West Kalimantan, Indonesia more sensitive and specific than SCC in assessing response
to radiation therapy for advanced stage cervical cancer.
OBJECTIVE: To analize correlation between lymph vessel METHODS: The study was conducted by the method of
invasion detected by Hematoxyllin-eosin stainning, and analytic observational cohort study in 24 patients with
immunostainning D2-40 Podoplanin with pelvic lymph cervical cancer stage II-B and III-B in RSCM that met
node metastasis in stage I B and II A cervical cancer. inclusion criteria. Examination of VEGF and SCC in serum
METHODS: Design of research was cross-sectional study. samples was performed in the Prodia Laboratory Jakarta.
Clinicopathological data of 41 stage I B and II A cervical The examination was conducted twice before and after
cancer patients who underwent Radical hysterectomy radiation therapy. The subjects treated by radiation therapy
and pelvic lymphadenectomy at Dr. Soetomo Hospital, / chemoradiation according to standard procedures. After
Surabaya Indonesia from January 2008 - june 2013 were the completion of radiation having declared, response of
retrospectively reviewed. Age,histology type, clinical radiation therapy was conducted by clinical assessment.
stage, tumor size, number of removed pelvic lymph node, RESULTS: Of the 24 subjects obtained a mean level of tumor
parametrial invasion and LVI were analyzed to define markers SCC pre-radiation 23.43 ± 5.84 ng/mL and post-
their correlation with pelvic lymph node metastasis. IHC radiation 2.19 ± 0.68 ng/mL. The mean VEGF pre-radiation
stainning using MAb D2-40 Podoplanin was used to detect 790.41 ± 111.06 pg/mL and post-radiation 497.47 ± 79.26
lymph vessel invasion on the corresponding HE slides. pg/mL. ROC curves of each tumor marker obtained SCC
Poster Session
The correlation among variables was analized using Phi pre-radiation AUC 40%, p 0.53 (CI 0.18-0.68) and SCC
correlation test. post-radiation AUC 48.1%, p 0.91 (CI 0.21-0,75) can not
RESULTS: Among of total 41 patients, lymphvessels invasion be used as a diagnostic and prognostic factors of response
322
to radiation therapy. VEGF pre-radiation AUC 17.5%, p glandular involvement at least, with endocervical curettage
0.04 (CI 0.00-0.36) can not be used as a prognostic factor showed squamous cell carcinoma. With limited evidence of
for response to radiation therapy. VEGF after radiation AUC invasive disease, laparoscopy assisted vaginal hysterectomy
92.5%, p 0.01 (CI 0.81-1.00) can be a diagnostic factor with bilateral salpingo-oophorectomy were done. The
for response to radiation therapy. VEGF post-radiation post-operative pathology reported moderate differentiated
with cut-off point 614.75 pg/mL had a sensitivity 80%, adenosquamous cell carcinoma of cervix, about 2cm
specificity 75%, positive predictive value 94.12%, negative x 2 cm in size, with free margin but endometrium
predictive value 42.86%; positive likelihood ratio 3.2 ; and myometrium invasion. Post-operative adjuant
negative likelihood ratio 0.26 and accuracy 79.16%. There therapy including concurrent chemo-radiotherapy then
is a significant correlation between serum VEGF levels chemotherapy with cisplatin, bleomycin and vincristine (POB
decrease post-radiation and a positive response of radiation regimen) were completed. The patient was kept regular f/
therapy (p 0.01, CI 1.00-3.23). u at OPD up to 5 years without evidence of recurrence.
CONCLUSION: Examination of VEGF levels can be used to However, the patient suffered frequent cough and dyspnea
assess the response of radiation therapy with a sensitivity in the 6th year after treatment. There is one solitary lung
of 80% and specificity of 75%. nodularity was noted by chest –x ray and pathology from
CT guided biopsy disclosed adenocarcinoma. Upon her
history, immunostain for cervical specificity was performed
PO-2037 and proved metastatic adenocarcinoma from primary
cervical adenosquamous carcinoma.
Metastatic adenocarcinoma of lung from
CONCLUSION: Taken together with case reports in other
primary cervical adenosquamous carcinoma –
literatures, the variant histological presentation of distal
one case report
metastasis from primary adenosquamous carcinoma of
cervix may suggest different potential of recurrence or
Yihung Sun, Yue-Shan Lin, Ching-Cherng Tzeng
distal metastasis. Metastatic tumor in patient with previous
Department of Obstetrics and Gynecology, Chimei Medical Center,
malignancy should still be kept in mind even with unusual
Taiwan
clinical presentation.
OBJECTIVE: Approximately 10% of cervical carcinoma

is comprised of adenocarcinomas, which exhibit both
PO-2038
squamous and glandular differentiation and may be
associated with a poorer prognosis than squamous cell The minimum absolute lymphocyte count
carcinoma or adenocarcinomas, though still actively during concurrent chemoradiotherapy in
debated with conflicting results. Most recurrence of cervical cervical cancer: a strong survival predictor
cancer occurred in first 2 years and rarely after 5 years.
Solitary metastasis lung lesion was also rare. Oyeon Cho, Mison Chun, Young-Taek Oh, O Kyu Noh, Suk-
METHODS: Herein, we present a case presented solitary

Joon Chang
lung tumor diagnosed metastatic adenocarcinoma from Ajou University School of Medicine, Suwon, Korea
primary cervical adenosquamous carcinoma.
RESULTS: A 50 years old female was first presented to our OBJECTIVE: This study investigated whether the minimum
outpatient department due to abnormal Pap smear screen absolute lymphocyte count during chemoradiotherapy
result as severe dysplasia. Cervical biopsy under satisfactory (min ALC) could predict clinical outcomes in patients with
cervical condition only showed mild dysplasia. Repeated cervical cancer.
Pap smear 3 months later disclosed atypical glandular METHODS: We analyzed 190 patients with stage IB-IVB
Poster Session
cell favored neoplasm. Transvaginal sonography revealed cervical cancer who were treated with weekly cisplatin-
one endocervical tumor about 1.78 cm x 1.51 cm in size. based concurrent chemoradiotherapy (CCRT), including
Conization of cervix disclosed carcinoma in situ with 187 patients with min ALC data by using the Kaplan-Meier
323
method and the Cox proportional hazards model. The hospital stay, transfusion rate, complication rate).
variables such as age, pathologic subtype, stage, treatment RESULTS: No significant difference was found in the average
duration, total point A dose, high-dose-rate intracavitary age of patients (52.4 years for robotic hysterectomy and
brachytherapy ratio, hemoglobin, squamous cell carcinoma 52.2 years for abdominal hysterectomy) or BMI (21.9
antigen, pretreatment absolute lymphocyte count, and and 23.0 respectively). Significant increase was found
neutrophil to lymphocyte ratio were included for survival in operative time (515 min and 355 min respectively),
analysis. and significant decrease in blood loss (34 mL and 908
RESULTS: Min ALC was a statistically significant predictor of mL respectively), number of lymph nodes (21 and 34
overall survival and progression-free survival in multivariate respectively), and post-operative hospital stay (14 days and
analysis (hazard ratio [95% confidence interval]: 3.17 25 days respectively). Transfusion rate and complication
[1.69–5.97], p<0.001 and 2.82 [1.56–5.08], p=0.001, rate were 0% and 26%, 14% and 0% respectively, and
respectively). The 5-year overall survival and 5-year the differences were not significant.
progression free survival of patients with min ALC ≤ 210 CONCLUSION: Compared with the abdominal counterpart,
cells/µL were significantly lower than those of patients with robotic-assisted radical hysterectomy resulted in decreased
min ALC > 210 cells/µL (48.3% vs. 81.5%, p< 0.001 and blood loss and post-operative hospital stay, suggesting high
29.4% vs. 79.3%, p< 0.001, respectively). effectiveness. However, further study enrolling more cases
CONCLUSION: Min ALC could predict poor survival in is required due to challenges such as longer operative time
patients with cervical cancer who received CCRT. Its and smaller number of enucleated lymph nodes.
prognostic role should be evaluated in further prospective
studies.
PO-2040
Relationship between removal of circumflex

PO-2039
iliac nodes to the distal external iliac
Comparison between robotic-assisted nodes and postoperative lower-extremity
radical hysterectomy and abdominal radical lymphedema in uterine cervical cancer
hysterectomy
Sho Takeshita, Yukiharu Todo2, Hidenori Kato3
Yasushi Kotani, Ayako Suzuki, Isao Tsuji, Hidekatsu Nakai, Department of Gynecologic Oncology, Hokkaidou Cancer Center,
Takako Tobiume, Masao Shimaoka, Masayo Ukita, Hisamitsu Japan
Takaya, Kosuke Murakami, Masato Aoki, Masaki Mandai
Department of Obstetrics and Gynecology, Kinki University Faculty OBJECTIVE: This study aimed to determine if there is a
of Medicine, Osaka, Japan causal relationship between removal of the circumflex
iliac nodes to the distal external iliac nodes (CINDEIN) and
OBJECTIVE: Our department introduced robotic-assisted postoperative lower-extremity lymphedema (POLEL) after
surgery system in December 2013. Robotic- assisted surgery systematic lymphadenectomy in patients with cervical
seems to support safe and secure surgical operation. To cancer.
date, our department performed 7 cases of robotic-assisted METHODS: A retrospective chart review was performed
radical hysterectomy. This study reports our comparative for all living cervical cancer patients who underwent
evaluation of robotic-assisted radical hysterectomy and lymphadenectomy and were managed at Hokkaido
abdominal radical hysterectomy. Cancer Center between 1993 and 2013. The type of
METHODS: Seven cases of robotic-assisted radical lymphadenectomy gradually shifted from lymphadenectomy
hysterectomy and 19 cases of abdominal radical with removal of CINDEIN to without CINDEIN dissection
Poster Session
hysterectomy performed in 2013 and 2014 were compared during this period. The study period was divided into two
in surgery performance (mean age, operative time, blood phases; from 1993–2007 (first phase) and from 2008–2013
loss, number of enucleated lymph nodes, post-operative (second phase). We identified patients with POLEL. Logistic
324
regression analysis was used to select the risk factors for WH were significantly younger compared to patients who
POLEL. received CCRT with a mean age 44.9 ± 8.3 years versus
RESULTS: Implementation of CINDEIN-dissection 58.5 ± 12.1 years respectively, p= 0.01. They also had a
lymphadenectomy (94.0% vs. 20.6%, p<0.0001) and significantly lower BMI with a mean BMI of 24.4 ± 4.8
adjuvant radiotherapy (26.1% vs. 4.5%, p<0.0001) were versus 36.4 ± 16.9 years, p=0.01. The majority of women
significantly lower in the second phase than in the first who had WH did not have any significant premorbidity in
phase. Of 398 patients evaluated, POLEL was noted in comparison to women who had CCRT i.e. 71.4% versus
medical records of 80 patients (20.1%) with a median 28.6% compared to 16.7% versus 83.3%, p= 0.02. Out
follow-up period of 78.0 months. The occurrence rate of of the 14 women who had Wertheim’s hysterectomy, the
POLEL were significantly lower in the second phase than majority (71%) also had bilateral salpingo-oophorectomy
in the first phase (32.2% vs. 8.0%, p<0.0001) despite no with only 29% opting for ovarian preservation. The mean
change in the number of dissected lymph nodes between duration of surgery was 5.4± 0.3 hours with a mean blood
the two phases. Multivariate analysis showed that adjuvant loss of 1371 ± 184 mls of blood loss. As a result, 77% had
radiation therapy (odds ratio=2.6, 95% confidence intra-operative blood transfusion with and 23% did not.
interval=1.4-4.8) and removal of CINDEIN (odds ratio=4.6, Although, the blood transfusion rate was high, only a small
95% confidence interval=2.4-9.0) were independent risk proportion of these women (14%) had massive blood loss
factors for POLEL. warranting commencement of disseminated intravascular
CONCLUSION: Elimination of CINDEIN dissection is helpful coagulation (DIVC) transfusion regimen. All our women
for reducing the incidence of POLEL. received antibiotic prophylaxis at induction, which was
continued into the post-operative period. This lead to the
mean duration of postoperative fever being only 1.1 ± 0.4
PO-2041 days. The mean duration of urinary catheterization in our
women was 5.5 ± 1.0 days. The mean duration of hospital
Wertheim’s hysterectomy: a comprehensive stays in this study was 6.2 ± 0.8 days.
5-year review of surgical profiles and CONCLUSION: Women who had WH were significantly
complications in a tertiary gynaecological younger, had a lower BMI and lower rate of premobidity
oncology unit in Malaysia when compared to women who had CCRT. For those
who had WH the average blood loss was 1300mls with
Alik Riasadesa Zakaria, Mokhtar Awang, Norhuda Mat Ali,
a blood transfusion rate of 77%. The shorter duration of
Anna Liza Roslani
postoperative febrile illness was likely due to the routine
Department of Obstetrics and Gynaecology, Hospital Tengku usage of antibiotic prophylaxis. Most of our women
Ampuan Afzan, Kuantan, Malaysia required urinary catheterization for 5 to 6 days and they
stayed for 6 to 7 days in the hospital following WH.
OBJECTIVE: The purpose of the review is to look at
the surgical profiles and complications of all cases of
Wertheim’s hysterectomy performed for cervical carcinoma.
METHODS: All cases of cervical carcinoma treated in our
hospital from January 2010 until December 2014 were
retrieved and reviewed. Relevant data pertaining to
surgical profiles and complications in all patients who had
a Wertheim’s hysterectomy were recorded and analysed
using SPSS version 20.
RESULTS: In this study, there were a total of 20 patients.
Poster Session
Out of these, 14 (70%) of them had Wertheim’s

hysterectomy (WH) and the remaining 6 (30%) had
concurrent chemoradiation (CCRT). Patients who had
325
PO-2042 other disease. 2 of these invasive cancer and AIS cases
didn’t show abnormal cytology. Moreover, the AIS with
Analysis of the correlation of MRI findings
LEGH case didn’t appear as a characteristic multicystic
and pathological diagnosis in cervical cystic
lesion, so called “cosmos pattern”, and didn’t show high
lesion
intensity on DWI and low ADC.
CONCLUSION: We suggested that the important things on
Ayako Suzuki, Chiho Miyagawa, Kosuke Murakami,
Hisamitsu Takaya, Masayo Ukita, Yasushi Kotani, Takako diagnosis and management for the patients with cervical
Tobiume, Hidekatsu Nakai, Isao Tsuji, Masaki Mandai cystic lesions on MRI was not only the shape of lesions, but
also the presence or absence of solid component and the
Department of Obstetrics and Gynecology, Kinki University School
findings of DWI and ADC. And also it was considered that
of Medicine, Osaka, Japan
it should perform the histological diagnosis when it finds
an abnormal cytology and solid compornent in cervical
OBJECTIVE: Cystic lesions of uterine cervix are commonly
cystic lesions.
pointed out in daily practice. Most of these lesions are
benign disease such as nabothian cyst. However, in recent
years, we recoginize that lobular endocervical glandular
PO-2043
hyperplasia (LEGH) and minimal deviation adenocarcinoma
(MDA) are also has multicystic lesions in uterine cervix. Pretreatment risk factors for parametrial
Therefore, the management of the patients with cervical involvement in FIGO stage IB1 cervical cancer
cystic lesions has become more difficult. In this study, we
reviewed 13 cases that cervical cystic lesions is confirmed Hiroyuki Yamazaki
by transvaginal ultrasound examination or pelvic MRI, in Department of Gynecologic Oncology, Hokkaido cancer center,
order to search the important findings for management for Japan
the patients with cervical cystic lesions.
METHODS: We were examined preoperative cervical OBJECTIVE: All patients with stage IB1 cervical cancer do
cytology, MRI findings, postoperative pathological diagnosis not need to undergo parametrectomy. Some low-risk
and clinical course in 13 cases. criteria for parametrial involvement (PI) have been proposed
RESULTS: Of 13 cases, final pathological diagnosis based on pathological findings. The aim of this study was
included 1 case of nabothian cyst and 3 cases of glandular to determine pretreatment risk factors for PI in stage IB1
hypereplasia, 1 case of endocervicsis, 1 case each of LEGH, cervical cancer.
adenocarcinoma in situ (AIS), AIS with LEGH, endocervical METHODS: We retrospectively reviewed 115 patients
adenocarcinoma, endocervical adenocarcinoma with LEGH, with stage IB1 cervical cancer who underwent radical
MDA, 2 cases of gastric type adenocarcinoma with LEGH. hysterectomy or radical trachelectomy. Magnetic resonance
On MRI, cervical multicystic lesions was confirmed in all imaging (MRI) was performed and serum concentrations
cases. In five cases of nabothian cyst, glandular hyperplasia, of squamous cell carcinoma (SCC) antigen and cancer
and endocervicosis showed cystic lesions without solid antigen (CA) 125 were determined in all patients before
component between cystic lesions. 2 of these five cases initial treatment. The following pretreatment factors
showed glandular cell abnormalities in cytology. In 3cases were investigated: histological variant, maximum tumor
of AIS and LEGH appeared as a multicystic lesion with an diameter, tumor volume (volume index), pelvic lymph node
inner solid component, but this component didn’t show enlargement, and serum tumor markers. Logistic regression
high intensity on diffusion-weighted images (DWI) and low analysis was used to select the independent risk factors for
apparent diffusion coefficient (ADC) map. On the other PI.
hand, 5 cases of adenocarcinoma and the MDA showed RESULTS: Eighteen (15.7%) of the 115 patients were
Poster Session
multicystic lesions involving a solid component with high pathologically diagnosed with PI. Multivariate analysis
intensity on DWI and low ADC. This point was considered confirmed the following independent risk factors for PI:
a useful findings to distinguish from invasive cancer and MRI-based tumor diameter >25 mm (odds ratio [OR]: 9.9,
326
95% confidence interval [CI]: 2.1–48.1), MRI-based volume postmenopausal, 11.4 ± 2.7 mm; P = 0.12), the rate of
index >5000 mm3 (OR: 13.3, 95% CI: 1.4–125.0), and positive endocervical margins (24.0% vs. 17.6%), or the
positive serum tumor markers SCC >1.5 ng/mL or CA 125 rate of residual disease (13.2% vs. 17.6%). The rate of
>35 U/mL (OR: 5.7, 95% CI: 1.3–25.1). Of 53 patients with cervical stenosis was significantly higher in postmenopausal
no risk factors for PI, none had PI. patients (23.5% vs. 4.1%; P = 0.002); however this rate
CONCLUSION: Less radical surgery may become one of the was significantly lower than that seen in the laser group.
treatment options for stage IB1 cervical cancer patients with CONCLUSION: In postmenopausal patients, the rates of
MRI-based tumor diameter <25 mm, MRI-based volume positive endocervical cone margins and of residual disease
index <5000 mm3, and negativity for SCC antigen/CA 125. were higher in the LEEP group; however, the rate of cervical
stenosis was higher in the laser group. Physicians should be
aware of the characteristics of the devices used for cervical
PO-2044 conization in postmenopausal women with CIN.
Complications of laser conization versus loop

electrosurgical excision procedure in pre- and
PO-2045
postmenopausal patients
Re-irradiation using helical tomotherapy for
Kiyoshi Hasegawa, Kiyoshi Hasegawa, Kaori Kiuchi, Emi recurrent cervical cancer
Motegi, Nobuyuki Kosaka, Yasuhiro Udagawa, Ichio Fukasawa
Department of Obstetrics and Gynecology, Dokkyo Medical Myungsoo Kim1, Chul Seung Kay1, In-Young Jo1, Hye-Jin
University, Saitama, Japan Kang1, Duck-Young Ro2, Tae-Eung Kim2, Yong-Wook Kim2
Department of Radiation Oncology1 Department of Obstetrics and

OBJECTIVE: The aim of this retrospective study was to Gynecology2 Incheon St Mary's Hospital, College of Medicine, The
compare the results and complications of laser conization Catholic University of Korea, Seoul, Korea
and loop electrosurgical excision procedure (LEEP),
performed for cervical intraepithelial neoplasia (CIN) or OBJECTIVE: To investigate the clinical outcome of re-
microinvasive carcinoma, between postmenopausal and irradiation using helical tomotherapy (HT) for locoregionally
premenopausal patients. recurrent cervical cancer after pelvic irradiation.
METHODS: This study recruited a total of 551 patients. METHODS: Records of thirteen patients with recurrent
In the laser group (n = 405), there were 361 (89.1%) cervical cancer treated with re-irradiation using HT were
premenopausal and 44 (10.9%) postmenopausal women. reviewed. The median interval between prior radiotherapy
In the LEEP group (n = 146), there were 129 (88.4%) and re-irradiation was 11 months. The recurrent sites were
premenopausal and 17 (11.6%) postmenopausal women. the uterine cervix (n = 3), vaginal stump + pelvic lymph
The factors investigated in both groups were the length node (n = 3), vaginal stump (n = 1), pelvic lymph node (n
of the tissue cone removed and the presence of positive = 4), and pelvic wall (n = 2). At the time of re-irradiation,
endocervical cone margins, residual disease, and cervical median tumor size was 3.0 cm (range 2.0-8.0 cm). The
stenosis. median dose of 50 Gy in 25 fractions was delivered with
RESULTS: In the laser group, the length of the tissue cone HT over five weeks. The elective nodal irradiation was given
was significantly longer in postmenopausal patients when regional lymph node metastasis was detected (n =
(17.9 ± 3.9 mm vs. 15.7 ± 3.6mm; P = 0.002). The rate 7). The median cumulative dose was 115 Gy (range, 80 to
of positive endocervical margins was significantly higher 155.4 Gy).
in premenopausal patients (9.1% vs. 0%; P = 0.037). RESULTS: The median follow-up time was 14.2 months,
The rate of cervical stenosis was significantly higher in while the response rate was 58.3%. The median overall
Poster Session
postmenopausal patients (59.1% vs. 8.3%; P < 0.0001). survival was 18 months, and the 1- and 2-year overall
In the LEEP group, there were no differences in the length survival rates were 75.5% and 37.8%, respectively. The
of the tissue cone (premenopausal, 11.7 ± 1.9 mm vs. median duration time of local disease control was 20
327
months, and the 1- and 2-year local control rates were LEGH, 5 LEGH with atypia, and 2 MDA cases.
65.6% and 43.7%, respectively. The 1- and 2-year RESULTS: Of the 94 patients, 10 were clinically diagnosed
progression-free survival rates were 44.9% and 33.7%, with "suspicious of MDA or carcinoma (S/O MDA-Ca)", 59
respectively. Treatment-related toxicities were limited in were "suspicious of LEGH (S/O LEGH)", and 25 were "NC".
grade I or II toxicities, except for one patient who had All S/O MDA cases and 10 S/O LEGH cases underwent
grade III vesico-vaginal fistula. No treatment related death hysterectomy, and the correct ratio for diagnosis was 95%
was observed. (19/20). Forty-two LEGH and 18 NC patients were followed
CONCLUSION: Re-irradiation with HT appears to be a safe up for 12 months or more. Of the 42 S/O LEGH cases,
and feasible treatment option in recurrent cervical cancer 39 showed no change in lesion size on MRI, whereas 3
with prior radiotherapy. However, large scale clinical trials showed an increased tumor diameter. Of the 39 lesion-
with long-term follow-up are needed to confirm our results. stable patients, 3 underwent a hysterectomy due to
other diseases (CIN3: 2 cases, ovarian cyst: one case). The
three patients with an increased lesion size underwent a
PO-2046 hysterectomy. Histologically, one patient had NC, whereas
the remaining 2 had LEGH with atypia, which is presumed
Usefulness of a management protocol for as a precursor of MDA. The GNAS mutations leading to the
preoperative diagnosis and the treatment of amino acid changes p.R201H or p.R201C were observed
patients with multi-cystic lesions of the uterine in 2 cases of LEGH with atypia. In one case, no mutation
cervix: a retrospective analysis of 94 cases was detected in co-existing LEGH without atypia. The other
showed an increase in lesion size during the follow-up.
Koichi Ida, Hirofumi Ando, Tsutomu Miyamoto, Akiko Takatsu,
CONCLUSION: The management protocol for cervical multi-
Yasushi Yamada, David Hamisi, Shotaro Higuchi, Hiroyasu
cystic lesion was useful for the pre-operative diagnosis and
Kashima, Hisanori Kobara, Tanri Shiozawa
the following treatment. Interestingly, an increase in LEGH
Department of Obstetrics and Gynecology, Shinshu University lesion size may be an important indicator of the possible
School of Medicine, Japan malignant change of LEGH. Further studies are mandatory
to understand the natural history of LEGH and the impact
OBJECTIVE: The proper pre-operative diagnosis of cervical of GNAS mutations on the tumorigenesis of potential
proliferative disorders presenting with multi-cystic lesions malignant LEGH.
of the cervix, such as minimal deviation adenocarcinoma
(MDA) / adenocarcinoma, lobular endocervical glandular
hyperplasia (LEGH), and Nabothian cyst (NC) is important to PO-2047
select appropriate management. We previously proposed a
The risk factors and rate for progression of
protocol comprising a diagnostic approach using cytology,
cervical intraepithelial lesions in HPV 16 or
MRI, and gastric-type mucin and subsequent treatment
18 infected women with ASCUS or LSIL within
based on the results of a multicenter study. In the present
one year: The Korean HPV cohort study
study, we evaluated the usefulness of this protocol by
retrospectively analyzing the clinical courses of 94 cases Taejin Kim1, Chang Sun Hwang1, Soo Young Hur2, Jong Sup
with cervical multi-cystic lesions. We also sought to Park2, Jee Eun Rhee3, Chun Kang3, Sang Hoon Kwon4, Seok
evaluate the implications of GNAS mutations in LEGH. Mo Kim5, Sung Ran Hong1, Won-Chul Lee2, Dae Hoon Jeong6
METHODS: The clinical courses of 94 patients with cervical
Department of Obstetrics and Gynecology, 1Cheil General hospital,
multi-cystic lesions who visited our hospital between June Dankook University 2 The Catholic University,3 Korea Centers for
1995 and September 2014 were retrospectively analyzed. Disease Control and Prevention 4 Keimyung University Dongsan
MRI, cervical cytology and detection of gastric mucin using Medical Center 5Chonnam National University Medical School 6
Poster Session
HIK1083 kit were performed in all the patients for the Busan Paik Hospital, Korea
clinical diagnosis and the following treatment according
to our protocol. GNAS mutations were investigated in 10 OBJECTIVE: The purpose of this study is to evaluate the risk
328
factors and rate for progression of cervical intraepithelial PO-0541
lesions in HPV 16/18 infected Korean women with ASCUS
A lectin-based diagnostic system using
or LSIL within one year.
circulating antibodies to detect cervical
METHODS: We analyzed the data showing HPV 16/18
intraepithelial neoplasia and cervical cancer
infection from the Korean HPV cohort study.
RESULTS: Among enrolled 1114 women, 740 and 521
Jinghui Jin, Seung Cheol Kim, Woong Ju, Yun Hwan Kim,
women were followed up at 6 and 12 months, respectively.
Hong-Jin Kim
One hundred thirty-eight women showed HPV 16 positivity
Department of Obestetrics and Gynecology, Ewha Womans
(82 of single infection and 56 of multiple infection) at
University MokDong Hospital, Seoul, Korea
enrollment. Among 92 patients at 6 months follow-
up, cervical cytology showed progression in 26.1%, no-
OBJECTIVE: In the present study, we developed serological
change in 23.9%, and regression in 50.0%. Among 62
strategies using immunoglobulin fractions obtained by
patients at 12 months follow-up, cervical cytology showed
protein A chromatography to screen for cervical cancer and
progression in 21.0%, no-change in 56.4%, and regression
cervical intraepithelial neoplasia I (CIN I).
in 22.6%. Sixty-six women were HPV 18 positive (38 of
METHODS: The reactivities of the immunoglobulins
single infection and 27 of multiple infection) at enrollment.
purified from sera of women with normal cytology, CIN
At 6 and 12 months follow-up, cervical cytology revealed
I and cervical cancer were compared in enzyme-linked
progression in 8.5% and 11.1%, no-change in 37.1% and
immunosorbent assays (ELISA) and enzyme-linked lectin
29.6%, and regression in 54.2% and 59.2% among 35
and 27 women, respectively. The overall rate of cytologic assays (ELLAs). To capture the immunoglobulins, ELISAs
progression, no-change, and regression in this HPV cohort and ELLAs were performed in protein A immobilized
study was 17%, 18.9%, and 64.1%, when analyzing 853 microplates.
women who had followed up at least one time during RESULTS: The reactivity of immunoglobulin in ELISA was
4 years. The rate of progression on cervical cytology at 6 in the increasing order normal cytology, CIN I and cervical
months follow-up in HPV 16 positive group was higher cancer, while that in ELLAs for detecting fucosylation
than in entire group, but not statistically significant was in the decreasing order normal cytology, CIN I and
(OR=1.54, p=0.09). HPV 18 positive group showed lower cervical cancer. It was confirmed that women with CIN I
progression rate than entire group at 6 month follow-up, were distinguishable from women with normal cytology
but not statistically significant (OR=0.41, p=0.14). Both HPV or women with cervical cancer in the ELISA or the ELLA
16 and HPV 18 positive groups, the rate of progression at for detecting fucosylation with considerable sensitivity
12 month follow-up showed similar trend as entire group and specificity. Women with cervical cancer were also
although the sample sizes were small. In the comparison distinguishable from women with normal cytology with
of progression rates in HPV 16 single infection group high sensitivity (ELISA: 97%, ELLA: 87%) and specificity
and multiple infection group, multiple infection group (ELISA: 69%, ELLA: 72%). Moreover, the logistic regression
showed higher progression rate (OR=1.254), but it was not model of the ELISA and the ELLA discriminated cervical
statistically significant. Logistic regression analysis failed to cancer from normal cytology with 93% sensitivity and 93%
find significant epidemiologic factor but cigarette smoking, specificity.
oral contraceptive use, obesity, alcohol use, monthly CONCLUSION: These results indicate that the ELISAs and
number of oral intercourse showed the relationship with the ELLAs have great potential as strategies for primary
cytology progression. screening of cervical cancer and CIN. It is expected that the
CONCLUSION: HPV 16 positive group showed higher ELISA and the ELLA can provide new insights to understand
cervical cytology progression rate and HPV 16 multiple systemic changes of serum immunoglobulins during
infection didn’t show higher progression rate than single cervical cancer progression.
Poster Session
infection. Because our study failed to identify a significant

epidemiologic risk factor, it is necessary to make the study
with long term follow-up and large study populations.
329
PO-2049 OBJECTIVE: In 2014, cervical cancer was predicted to
account for 2.4% (3,205) of all new cancers and 2.8% (784)
Comparison of quality of life and sexual
of all cancer deaths among women in Korea. Treatment
function between cervical cancer survivors
for cervical cancer includes radiotherapy, chemotherapy,
and healthy women
or wide vaginal resection as a part of radical hysterectomy,
which may impact on the sexuality of cervical cancer
Yumi Lee2, Myong Cheol Lim2, Se Ik Kim1, Jungnam Joo2,
Dong Ock Lee2, Sang-Yoon Park2 survivors. As the survival rate for those with cervical cancer
1
has been much improved recently, quality of life (QoL),
Center Department of Obstetrics and Gynecology, Seoul National
including sexuality, has become one of the important issues
University College of Medicine, Seoul, Korea, 2 Uterine Cancer,
in the treatment for cervical cancer. Previous studies have
National Cancer Center, Goyang, Korea
described that the treatment for cervical cancer worsened
patients’ sexual functioning and QoL]. Some previous
OBJECTIVE: To compare quality of life (QoL) and sexual
studies evaluated the severity of deterioration in sexual
functioning between healthy women and cervical cancer
functioning and QoL according to the type of treatment.
survivors who had no evidence of disease and sexually active.
However, the QoL and sexuality of cervical cancer survivors
METHODS: A total of 104 cervical cancer survivors and 104
has not been properly compared to those of control
women in control group were compared after propensity
groups. Therefore, the aim of the current study was to
score matching. QoL and sexual functioning were assessed
compare QoL and sexual functioning between cervical
using three questionnaires; the European Organization
cancer survivors and healthy women.
for Research and Treatment of Cancer Core 30 (EORTC
METHODS: A total of 104 cervical cancer survivors and 104
QLQ-C30), the EORTC Cervical Cancer module, and the
women in control group were compared after propensity
Female Sexual Function Index.
score matching. QoL and sexual functioning were assessed
RESULTS: Scores for lymphedema were significantly higher
using three questionnaires; the European Organization
(mean, 20.2 vs. 12.2; p < 0.05) in cervical cancer survivors
for Research and Treatment of Cancer Core 30 (EORTC
compared to control group. In the assessment of sexual
QLQ-C30), the EORTC Cervical Cancer module, and the
functioning, cervical cancer survivors reported shorter
Female Sexual Function Index.
vaginal length than control group, however, statistical
RESULTS: Scores for lymphedema were significantly higher
significance was not observed (mean, 80.6 vs. 85.4; p =
(mean, 20.2 vs. 12.2; p < 0.05) in cervical cancer survivors
0.077). Sexual activity, sexual enjoyment, sexual worry,
compared to control group. In the assessment of sexual
desire, arousal, lubrication, orgasm, satisfaction, and pain
functioning, cervical cancer survivors reported shorter
were not statistically different between the two groups.
vaginal length than control group, however, statistical
CONCLUSION: Aggravated quality of life in term of
significance was not observed (mean, 80.6 vs. 85.4; p =
lymphedema and shorter vaginal length are frequently
0.077). Sexual activity, sexual enjoyment, sexual worry,
observed in cervical cancer survivors.
desire, arousal, lubrication, orgasm, satisfaction, and pain
were not statistically different between the two groups.
CONCLUSION: The findings from the current study
PO_0563 (PO-2050)
demonstrated that cervical cancer survivors who engaged
Comparison of quality of life and sexual in sexual activity had similar levels of sexual functioning as
function between cervical cancer survivors healthy subjects. However, in terms of QoL, lymphedema was
and healthy women more problematic in cervical cancer survivors compared to
control group. The two groups did not demonstrate significant
Yumi Lee1, Myong Cheol Lim1, Se Ik Kim2, Jungnam Joo1, Ki differences in any measured aspect of sexual functioning.
Byung Park1, Dong Ock Lee1, Sang-Yoon Park1 Prospective cohort studies are required in order to determine
Poster Session
1 2
Uterine Cancer, National Cancer Center, Goyang, Korea, Center strategies to improve cervical cancer survivors’ QoL.
University College of Medicine, Seoul, Korea
330
PO-2051 anatomy in the female pelvis. The radiological information
has practical usefulness for radiotherapeutic planning and
Surgical anatomy imaging associated with
surgical simulation.
radical hysterectomy
Masaru Nakamura1, Takuma Fujii1, Tomoko Kurihara1, Azumi

Miyauchi1, Tohru Morisada1, Takashi Iwata1, Kyoko Tanaka1, PO-2052
2 2 3
Nobuaki Imanishi , Sadakazu Aiso , Masahiro Jinzaki , Daisuke
Robotic radical hysterectomy or trachelectomy
Aoki1
through vaginal colpotomy for early cervical
Department of Obstetrics and Gynecology1 Department of cancer: a study of 31 cases
Anatomy2 Department of Radiology3 Keio University School of
Medicine, Tokyo, Japan Hyun Ju Lee, Dae-Yeon Kim, Jeong-Yeol Park, Shin-Wha Lee,
Dae-Shik Suh, Jong-Hyeok Kim, Yong-Man Kim, Young-Tak
OBJECTIVE: Radical hysterectomy is a standard surgical Kim, Joo-Hyun Nam
procedure for cervical cancer. A precise understanding
of surgical anatomy and sectional anatomy is important
University of Ulsan, Seoul, Korea
in order to accurately perform radical hysterectomy. The
objectives of this study were to visualize the surgical
OBJECTIVE: We evaluated the recurrence rate of patients
anatomical structures in the female pelvis by computed
with early stage cervical cancer who had underwent
tomography and to investigate the components of the
robotic radical hysterectomy through vaginal colpotomy
parametrium for anatomical education, radiological
(RRH-V) or trachelctomy through vaginal colpotomy (RRT-V).
diagnosis, and surgical simulation.
And, other surgical and oncological outcomes were also
METHODS: We surgically dissected fresh female cadavers
evaluated.
maintained in precise surgical anatomical positions, and
METHODS: From January 2012 to May 2015, 31 patients
examined the anatomical structures using experimental
had underwent RRH-V or RRT-V by a single gynecologic
fine cell detector multislice computed tomography (FDCT)
oncologist. Patients’ clinicopathologic findings, surgical
with a slice thickness of 0.3125 mm. In addition, we
results, and oncological outcomes were retrospectively
established a three-dimensional (3D) reconstruction model
reviewed.
for precise observation of the surgical anatomy using
RESULTS: Twenty eight patients with stage IB1, IB2,
Materialise’s Interactive Medical Image Control System
(Mimics). We evaluated two-dimensional (2D) images of IIB cervical cancer and three patients with stage IB1
the surgical anatomical structures in combination with the underwent RRH-V and RRT-V, respectively. Median total
3D reconstruction model. operative time was 277 minutes (range, 165-522 minutes).
RESULTS: The 3D model was reconstructed from 430 serial Median estimated blood loss was 200 ml (range, 50-700
axial pelvic CT images of a cadaver. The cardinal ligament, ml). Median postoperative hospital stay was 7 days (range,
uterosacral ligament, paravesical space, and pararectal 5-11 days). None of the patient experienced intraoperative
space were visualized on the CT images obtained from the complication. Fifteen patients (48.4%) experienced
surgically dissected part. The parametrium components postoperative complications and the most common
were clearly distinguished on the surgically dissected side. postoperative complication was voiding difficulty. At a
Based on the information from the dissected side, these median 11 months of follow-up (range, 3-44 months), no
components on the undissected side could be distinguished recurrence or death were found.
as well. We recognized the parametrium components in CONCLUSION: Robotic radical surgery through vaginal
the area extirpated during radical hysterectomy. colpotomy in patients with early cervical cancer is also
CONCLUSION: The approach using cadavers, experimental feasible and safe surgical procedure with low recurrence
Poster Session
FDCT, and 3D software provided excellent visualization of rate. Large multicenter prospective study with longer
pelvic structures. High-quality images of surgical anatomical follow-up duration is warranted for demonstrating our
structures provide new insight regarding precise surgical findings.
331
1
PO-2053 HOGI, Indonesia, 2 Department of Obstetrics and Gyneolcogy,
Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Conservative treatment in women with
adenocarcinoma in situ of the cervix OBJECTIVE: To overview the characteristics and survival rate
of patient with advanced stage cervical cancer that given
U Chul Ju2, Woo dai Kang2, Seok Mo Kim2, Ho Sun Choi1
adjuvant therapy in Cipto Mangunkusumo Hospital Jakarta.
Department of Obstetrics and Gyneoclogy, 1Munhwa Woman METHODS: Data was collected from hospital-based cancer
Hospital 2Chonnam University Hwasun Hospital, Korea registry in Indonesia National General Hospital Cipto
Mangunkusumo 2010-2014. Medical record of patients
OBJECTIVE: To study diagnostic and outcomes and follow- who meet the criteria of this research is collected. Survival
up in women with adenocarcinoma in situ (AIS) of the analysis is using Kaplan-meier survival analysis
uterine cervix and human papillomavirus (HPV) genotyping RESULTS: 361 patient was collected from cancer registry,
among women with negative cytology would have helped but only 105 patients who meet criteria for this research
with AIS recurrences. was collected. Mean age is 50 (30-74); Most of them has
METHODS: Records of AIS cases diagnosed between 1995 low education level, multiparity, and only have 1 partner.
and 2014 were reviewed. Clinical and histopathological Most common histopathology findings are squamous
data were analyzed. cell carcinoma. 71% is given complete radiation therapy.
RESULTS: Mean age at diagnosis was 44 years. Diagnosis Survival analysis showing that 1 year survival rate was 14%,
was established using cytology and biopsy. Primary 2 year survival rate was 6% and 5 years survival rate was 0%.
treatment for 87 patients was loop electrosurgical excision CONCLUSION: Advanced stage cervical cancer was still a
procedure (LEEP). The follow-up time was 18-60months. threat and need an improvement in early diagnosis and
Three recurrences were found after conservative treatment treatment.
in 56 patients. AIS with coexisting carcinoma in situ and AIS
alone were detected in 33 patients (59%) and 23 patients
(41%). 2 (8.7%) recurrences in AIS alone group and 1 PO-2055
(3.0%) recurrence in coexisting carcinoma in situ group
Concurrent chemoradiation is better than
occurred. 3 recurred women have same HPV genotype for
systemic chemotherapy as a postoperative
long time. High-risk HPV positivity was detected in 77 (89%)
adjuvant therapy in advanced cervical cancer
of 87 patients, with HPV-16 and HPV-18 being the most
commonly occuring subtype (84%).
Young-Han Park, JungYeob Seoung, Minhyun Baek, Min Sun
CONCLUSION: There is a small risk of recurrences after Kyung, Hong Bae Kim, Sung Taek Park, Sung Ho Park, Hye-yon
conservative therapy with LEEP when resection margins are Cho, Chae Chun Rhim, Bo Wook Kim, Sung Joo Kim
negative in women with AIS. Patiens should be given the
Department of Gynecologic oncology, Hallym University Medical
options of hysterectomy or conservative therapy with strict
Center, Anyang, Korea
long term follow-up. HPV genotyping was important value
to find recurrences.
OBJECTIVE: To evaluate the prognosis in patients with
advanced cervical cancer who underwent radical
hysterectomy and adjuvant therapy with chemotherapy or
PO-2054
concurrent chemoradiation (CCRT).
Characteristic and survival rate of patient with METHODS: We reviewed the medical records of patients
advanced stage cervical cancer that given with advanced cervical cancer who had been treated at
adjuvant therapy in cipto mangunkusumo the Hallym University Medical Center from 2006 to 2010.
hospital, Jakarta Kaplan-Meier analysis was used to calculate the disease-
Poster Session
specific survival. Differences in survival rates between the

1 2
Fitriyadi Kusuma Djajasasmita , Rivaldi Jovian , Ranti Pratiwi groups were compared using the log-rank test.
Permatasari2, Gatot Purwoto2 RESULTS: in total, 157 patients diagnosed with stage IIA-IVB
332
cervical cancer. Of the 157 patients, 76 were treated with male 2490 g without complication or maldevelopment.
CCRT, 26 with surgery and chemotherapy, 23 with surgery After the delivery, pelvic chemo-radiotherapy (cisplatin
and CCRT and the remaining 32 patients were treated 75 mg/m2 plus whole pelvic radiotherapy 45 Grays and
using alternative methods. There were no difference in brachytherapy 21 Grays) was given. At 6 weeks from the
clinic-pathologic characteristics including stage, serum SCC start of radiation, the tumor expanded and involved left
Ag. Concentration, tumor size, parametrial involvement, parametrium. Adjuvant carboplatin (AUC 5) and paclitaxel
resection margin involvement, presence of hydronephrosis, (175 mg/m2) were given in 21-day intervals. The patient
bladder invasion, lymph nodes status and cell type had disease progression and developed pyometra from
between chemotherapy alone and CCRT group. In patients tumor obstruction.
underwent surgery, patient group with adjuvant CCRT CONCLUSION: There are limited experiences with glassy cell
showed better survival than group whom treated with cervical carcinoma in pregnancy, nowadays. Neoadjuvant
adjuvant chemotherapy alone. Mean survival duration of chemotherapy with platinum based agents was reported
patients with surgery and adjuvant CCRT was 54.3 months with satisfying outcomes for the patients who desire to
while patients with surgery and adjuvant chemotherapy continue pregnancies.
was 45.7 months (Log rank test, p=0.026).
CONCLUSION: In advanced cervical cancer patients, CCRT
is better than systemic chemotherapy as a postoperative PO-2057
adjuvant therapy in advanced cervical cancer. As this study
Presentation of HIV-infected among women
was retrospective and includes small size samples, large
with female cancer: Hospital base cancer
prospective study is required.
registry
PO-2056
Faculty of Medicine Ramathibodi Hospital, Mahidol University,
Neoadjuvant chemotherapy followed by Bangkok, Thailand
postpartum chemoradiotherapy for stage
IB2 glassy cell cervical carcinoma during OBJECTIVE: Patient with human immunodeficiency virus
pregnancy (HIV) is associated with female cancer and lead for major
cause of mortality and low quality of life. Limited data are
Lukkana Promwattanaphan available on those with female cancer. The purposed of
The Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand study were to find out prevalence rate of HIV-infected in
women with female cancer who diagnosed in Ramathibodi
OBJECTIVE: To report the outcome after neoadjuvant Hospital.
chemotherapy followed by postpartum chemoradiotherapy METHODS: Women diagnosis with female cancer in
for stage IB2 glassy cell cervical carcinoma during Ramathibodi hospital from 2004 to 2014. Medical records,
pregnancy operative notes and pathological report of women
METHODS: one case report with female cancer and HIV-infected were reviewed.
RESULTS: A 36-year-old woman was diagnosed of cervical Demographic, behaviors were collected in the first time
glassy cell carcinoma, which was in FIGO stage IB2, at before diagnosed with female cancer (C51-C58). The
14 4/7 weeks gestation. Because of the patient’s strong results of prevalence, descriptive and other analysis will be
desire for full-term pregnancy, 6 cycles of neoadjuvant analysis by STATA version 11.
chemotherapy was administered after magnetic resonance RESULTS: 3,989 female cancer patients (10.9%) were
imaging evaluation of the tumor. During her pregnancy, diagnosed and registered during 2004 to 2014. Cervical
Poster Session
the tumor size was stabilized. The patient underwent cancer is the most common cancer found in women.
classical cesarean delivery at 35 6/7 weeks gestation due 1,997 women (50.1%), 902 women (22.1%) and 838
to premature rupture of membrane. The neonate was women (22.1%) were diagnoses for cervical cancer, uteri
333
cancerand ovary cancer, respectively. According to HIV- categories were management into a binary outcome
infected women, we have 31 women who had HIV- variable: negative or CIN1 or CIN 2 and CIN3 or cancer.
infected (0.78%), 15 women (48.4%) in age between 35- Cumulative survival percentages were estimated using
44 years, 7 women (22.6%) in age between 45-54 years the Kaplan-Meier method. Statistical significance of the
and 5 women (16.1%) in age between 25-34 years. In the differences in cumulative survival was tested using the log-
study, we found 23 HIV-infected women (74.19 %) with rank statistic for homogeneity.
cervical cancer and 5 HIV-infected women ( 16.1 %) with RESULTS: During the studied interval (1992-2011).There are
uteri cancer. Mean age were 53.7 (sd=13) years and 43 1,240 (29.2%) patients were diagnosis CIN3 and cancer. A
(sd=9.1) years in patient with non HIV-infected and patients total of follow-up time for all patients is 104,383 person-
with HIV-infected, respectively. years. Median follow-up period 45 years (43.2-46.8 years).
CONCLUSION: Data with HIV-infected patient in Thailand Incidence density of patient is 1.14 per 100 person-years
was limited. Only report form hospital base cancer registry (95%CI: 1.08 to 1.21). The overall survival of cancer 28.5%
may lead to under estimated. The further study still needs (95%CI: 23.3% to 34.1%). By Kaplan-Meier method
a large of number and cohort study with multicenter study estimates the overall survival probability is lower than 50%
will be the best methodology for the next study. at the end of the study. The overall incidence rate was 1.14
per 100 person-years (95%CI: 1.08 to 1.21). The incidence
rate was high in women who have HIV/AIDS infection: 1.67
PO-2058 (95%CI: 1.12 to 2.50) and 1.14 (95%CI: 1.07 to 1.20) per
100 person-years, respectively.
Incidence rate of cervical intraepithelial
CONCLUSION: The Incidence rate of CIN3+ is high in HIV-
neoplasia and cancer (CIN3+) among women
infected Thai women in comparison with other studies.
with abnormal Pap smear who underwent
Cancer screening and early detection of a cervical cancer
colposcopy test: 20 years cohort study
would be suggested especially for those who have known
risks for cervical cancer.
Nintita Sripaiboonkij1, Sarikapan Wilailak1, Bandit
Thinkamrop2
1
Department of Obstetrics and Gynaecology, Faculty of Medicine, PO-2059
Ramathibodi Hospital, Mahidol University, Thailand, 2Department
of Biostatistic, Faculty of Public Heath, Khon Kean University, Laparoscopic cervicoisthmic cerclage to
Thailand prevent preterm birth in second trimester
OBJECTIVE: Cervical cancer is the most common cancer Ya-Min Cheng

found in women. In Thailand, the incidence rate and death Department of Obstetrics and Gynecology, National Cheng Kung
rate of cervical cancer was 18.1 and 5.7 per 100,000 University Hospital, Taiwan
women. Patient with human immunodeficiency virus (HIV)
is associated with high-grade intraepithelial neoplasia and OBJECTIVE: We present an interesting case of laparoscopic
lead for major cause of mortality and low quality of life. To cervicoisthmic cerclages during second trimester of
date, there has been no information of incidence rate of pregnancy characterizing by cervical cancer stage Ia1 status
cervical cancer in women who underwent colposcopy. the post conization and elder primipara
purposed of study were to estimate incidence rate with METHODS: A 36-year-old female, gravida 1, para 0 with
cervical intraepithelial neoplasia grade3 or cancer in patient a history of cervical cancer stage Ia1 status post knife
that enrolled in cohort. conization 3 years ago, came to our hospital for prenatal
METHODS: In cohort study, 4,253 women were enrolling care at 10th weeks of gestation on March 6, 2013. At
Poster Session
the colposcopy clinic at Ramathibody Hospital between her prenatal follow-up visit, short cervical length (1.5cm)
1992 to 2008. Demographic, behaviors were collected in measured via transvaginal ultrasound at the 13th weeks
the first time before colposcopy test. The two diagnosis gestational. Conventional McDonald’s cervical cerclage
334
failed due to extremely short cervix. She was a candidate OBJECTIVE: To investigate the effect of body mass index
for a trans-abdominal cervicoisthmic cerclage due to her (BMI) on treatment outcomes of patients with cervical
short cervix. Then she received a successful laparoscopic carcinoma
cervicoisthmic cerclage surgery at the 18th week of METHODS: This retrospective cohort study included all
gestational age. patients with cervical carcinoma (IB1 to VIA) who were
RESULTS: Surgical procedure was described as follows: treated at Samsung Medical Center between April 1996
Under general endotracheal anesthesia, she was placed in and December 2007.
the dorsal lithotomy position with Foley catheter insertion RESULTS: A total of 1003 patients with cervical cancer
and no uterine manipulator used. One ring forceps covered were enrolled in this study. The median follow up time
with the gauze was put into the anterior cervical fornix and was 52 months (range, 1 to 181 months). The 5-year
lower segment of uterus was compressed with retractor to overall survival rate was 86.3%. There were 174 (17.3%)
reveal bladder reflection (Figure 1A). Then the vesicouterine recurrences or progressions and 124 (12.4%) deaths during
fold was incised and the bladder was dissected downward the study period. The median age and BMI of patients were
(Figure 1B). The 5-mm Mersilene tape without needles 50 years (21 to 85 years) and 23.6 kg/m2 (15.4 to 38.5),
was pulled through the windows and surrounded the respectively. In univariate analysis, compared to normal
cervix. The tape was then tied tightly anteriorly with weight (BMI 18.5-24.9 kg/m2) and overweight (BMI > 25
five knots using an intracorporeal knot tying (Figure 1D) kg/m2), a BMI <18.5 kg/m2 was associated with decreased
and the vesicouterine peritoneum was left without re- progression and overall survival. However, such association
approximation. After the surgery, fetal cardiac activity was not statistically significant. In multivariate analysis,
was confirmed and the cervix length with 2.6cm trans- higher BMI was significantly associated with better overall
abdominal ultrasound examination. Post-operation follow survival (HR; 0.941, 95% CI; 0.892-0.933). Complication
up course was smooth. rates were not different based on the BMI.
CONCLUSION: We present a pregnant case with a history CONCLUSION: Cervical cancer patients with lower BMI at
of microinvasive cervical cancer who received knife pre-treatment had diminished overall survival.
conization complicated with an extremely short cervix and
failed transvaginal cervical cerclage. She had a successful
pregnancy after laparoscopic cervicoisthmic cerclage. PO-2061
This procedure is a minimally invasive, extremely safe
Prognostic factors affecting survival in
and effective procedure in properly selected patients.
cervical cancer patients who had recurrent
The benefit of laparoscopic cervicoisthmic cerclages were
parenchymal lung lesion
confirmed from literature review. We believed that this
is the first case who received laparoscopic cervicoisthmic
Yoo-Young Lee, A Young Do, Young Soo Choi, Hong Kwan
cerclage during second trimester in Taiwan. Kim, Jhin Gook Kim, E Sun Paik, Eun Jin Heo, Hyun-Jin Choi,
Chel Hun Choi, Tae-Joong Kim, Jeong-Won Lee, Byoung-Gie
Kim, Duk-Soo Bae
PO-2060
Effect of Body Mass Index (BMI) on treatment Center, Sungkyunkwan University School of Medicine
outcome of patients with cervical cancer (IB1
to IVA) OBJECTIVE: Recurrent cervical cancer shows dismal
prognosis. Most of the recurrence occurs in locoregional
Eun jin Heo, Jung Min Park, E Sun Paik, Hyun Jin Choi, Yoo- area. In the other hand, distant recurrence shows multi-
Young Lee, Chel Hun Choi, Tae-Joong Kim, Jeong-Won Lee, organ involvements. Pulmonary recurrence of cervical
Poster Session
Byoung-Gie Kim, Duk-Soo Bae cancer without other organ involvement is rarely seen
Department of Obstetrics and Gynecology, Samsung Medical but sometimes it shows better survival than other distant
Center, Sungkyunkwan University School of Medicine recurrence cases. This study assessed the prognostic factors
335
affecting survival outcomes in cervical cancer patients who METHODS: Four thousand and two hundred fifty-three
have recurrent disease only in lungs. women who were cervical abnormalities via Pap smear
METHODS: We performed a retrospective study of 39 cervical and were referred to colposcopy test at colposcope clinic,
patients who had recurrence only in lungs and evaluated the Ramathibodi Hospital between 1992 to 2008 included in
clinical parameters, treatment and clinical outcomes. this study. Pap smear screening and colposcopy diagnosis
RESULTS: Median age was 44 years (27-69) and median were required to come back every sixth months. Overall
interval from initial treatment and pulmonary metastasis survival of women was started on the first of sexual
was 25 months (7-67). Median follow up period from initial intercourse until cancer occurred; the censored date on
diagnosis of pulmonary metastasis was 23 months (1-70) December 2011. As well as the association between other
and 5 year overall survival rate was 37%. 48.7% (19/39) factor and CIN3+, was estimate as the crude hazard ratios
patients had surgical resection and 87.2% (34/39) had (HR) and the 95% confidence interval (95% CI) form partial
chemotherapy. 59% had recurrent pulmonary lesions equal likelihood ratio test.. Statistical analysis was performed
or less than 3 and squamous cell carcinoma accounted using STATA 11
for 56.4% (22/39). Among various clinical parameters, RESULTS: As a result of univariate analysis, we found that
recurrent sites equal or more than 4 showed significant three factors reach the peak of hazard ratio (HR) when
poor overall survival on multivariate analysis (HR, 8.972; each group is compared, women who have one and more
95% CI, 1.174-68.58), however, age, initial FIGO stage, parity, married and HIV/AIDS infection. Concerning number
surgical resection, time interval from initial treatment of parity, women who have only one parity and women
and diagnosis of recurrence, and cell type did not show who have 2 and over parity are 1.77 and 1.10 times likely
prognostic role for overall survival. to have CIN3+ than those women who have null parity.
CONCLUSION: Recurrent cervical cancer with only Women who have married 1.67 times risky than those
pulmonary metastases can expect to achieve better overall who have single, separate and divorced. Prognosis of HIV/
survival when there are three or fewer metastatic lesions. AIDs infection was extremely poor, women with HIV/
AIDS infection are 2.31 time more likely to CIN3+ than
those women with HIV/AIDS uninfected (95%CI: 1.54 to
PO-2062 3.47, p-value<0.001). Median survival time are 29 years
(95%CI: 20.3 to 37.7) and 45 years (95%CI: 43.2 to 46.8)
Factors effecting with of cervical intraepithelial
in women with HIV/AIDS infected and HIV/AIDS uninfected
neoplasia and cancer (CIN3+) among women
women, respectively.
with abnormal PAP smear who underwent
CONCLUSION: The prognostic factors may be different from
colposcopy test: 20 years cohort study
other study. For the Behavior history, the women may have
not got their personal information as fact. The possible
Nintita Sripaiboonkij1, Sarikapan Wilailak1, Bandit
Thinkamrop2
poor prognostic factors are married and patients with HIV/
AIDs. Screening and early detection of a cervical cancer are
1
Cancer registry Unit, Faculty of Medicine, Ramathibodi Hospital,
needed for cervical cancer’s health promotion.
Mahidol University, Thailand, 2Department of Biostatistics, Faculty
of Public Health, Khon Kean University,Thailand
PO-2063
OBJECTIVE: Cervical cancer is the second most common
cancer in Thai women. The human immunodeficiency Survival rate for cervical cancer in thailand:
virus (HIV) infection is associated high grade cervical Hospital base cancer registry
intraepithelial neoplasia (CIN) and may lead to major
cause of mortality and low quality of life. The purpose of Nintita Sripaiboonkij, Sopit Promchana, Pornsuda Jitkasikorn,
Poster Session
the study was to examined factors effecting with cervical Sarikapan Wilailak
intraepithelial neoplasia grade3 or cancer (CIN3+) in patient Cancer registry unit, Faculty of Medicine, Ramathibodi Hospital,
that enrolled in cohort. Mahidol University
336
OBJECTIVE: Cervical cancer is the most common cancer energy, middle-infrared radiation (MIR) has been shown
found in women. In Thailand, the incidence rate was 16.7 to prevent tissue damage, and recent studies have begun
per 100,000 women. Limited survival data are available on combining MIR with paclitaxel. However, the cytotoxic
cervical cancer. The purpose of the study was to estimate effects of this treatment combination remain unclear.This
survival outcome among women with cervical cancer study investigated the effectiveness of treating HeLa human
stratify by stage at first diagnosed. cervical cancer cells with a combination of paclitaxel in
METHODS: Ramathibodi hospital registered 1,071 women conjunction with narrow-band MIR.
with cervical cancer from 2001 to 2008. Medical records, METHODS: A high-power, narrow-band triple layer Ag/
operative notes and pathological report of women with SiO2/Ag waveguide thermal emitter (WTE) was utilized to
cervical cancer were reviewed. Demographic, behaviors demonstrate that surface plasmon modes are replaced by
were collected in the first time before diagnosed with waveguide modes when the dielectric layer is thicker than
cervical cancer. The time censoring was dated December 1 mm. This study used WTEs to generate narrow-band
31, 2014. Overall survivals were method of Kaplan-Meier MIR at 4.1 and 5.0 mm with full width at a half maximum
method. The Cox proportional hazard model was used to (FWHM) of 0.5 mm. We used a wideband blackbody
identify independent prognostic factors. The results will be source combined with a 3.0–3.8 -mm bandpass filter to
analysis by STATA version 11. achieve a narrow-band IR at 3.6 mm. A Fourier transform
RESULTS: Of the 370 patients were died at the end of IR spectrometer (Perkin Elmer, Waltham, MA) was used to
the study. A total follow-up time for all women is 2,002 measure the emission spectra. The effectiveness of treating
person-years. Incidence density is 18.3 per 100 person- HeLa human cervical cancer cells with a combination
years (95%CI: 16.5 to 20.24). Overall survival is 15.27 %. of paclitaxel for 48 h in conjunction with narrow-band
Median survival time was 4.81 years .Survival probability MIR from 3.0 to 5.0 mm were masured. Annexin V-FITC/
rate was low in women stage IV. The 5 years overall survival PI apoptosis detection and cell mitochondrial membrane
are 75.20%, 54.83%, 28.61% and 11.20 % in women potential analyses were performed.
stage I, stage II, stage III and stage IV, respectively. By RESULTS: The combined treatment significantly inhibited
Kaplan-Meier method estimates the OS is lower than 50% the growth of HeLa cells. Specifically, results from Annexin
at the end of the study. V-FITC/PI apoptosis detection and cell mitochondrial
CONCLUSION: The survival is lower than that of developed membrane potential analyses revealed an increase in
countries. A confirmed poor prognostic factor is women apoptotic cell death and a collapse of mitochondrial
in high stage. Screening and early detection of a cervical membrane potential.

CONCLUSION: These Novel findings shad new lights on
cancer are needed for cervical cancer’s health promotion.
the combination of narrow-band MIR with paclitaxel
as an alternative approach in the treatment of human
PO-2064 malignancies.
Novel effects of narrow-band low-energy,

middle-infrared radiation (MIR) in enhancing
the anti-tumor activity of paclitaxel
Bor-Ching Sheu, Wen-Chun Chang, Si-Chen Lee
Department of Obstetrics and Gynecology, College of Medicine,

National Taiwan University, Taipei, Taiwan
OBJECTIVE: Paclitaxel is used as an essential chemotherapy

Poster Session
agent in treating a variety of human malignancies. Formally,

radiation therapy with high-energy radiation often
damages the healthy cells surrounding cancer cells. Low-
337
PO-2065 occurs, providing FOXO3a cellular localization as a
biomarker for predicting response to combination of PI3K
Phospoinositide 3-Kinase (PI3K) inhibitior-
and autophagy inhibitors.
induced FOXO3a nuclear translocation
determines synergistic anti-tumor effect of
combined treatment of PI3K and autophagy
PO-2066
inhibitors
Changes in bone density after cancer treatment
Hyun-Jung Kim, Chanyoung Kim, Woong Ju, Yun Hwan Kim, in patients with cervical and endometrial
Seung Cheol Kim cancer
Department of Obstetrics and Gynecology, Ewha Womans
University Mokdong Hospital, Seoul, Korea Dong Soo Suh, Man Soo Yoon, Ki Hyung Kim
Department of Obstetrics and Gynecology, Pusan National

OBJECTIVE: Autophagy is a lysosome-mediated degradation University School of Medicine, Pusan, Korea
and recycling process that can function as an adaptive
survival response during anti-cancer therapies and OBJECTIVE: This study aimed to evaluate the impact of
contribute to resistance to the therapies. Activation of the cancer treatment on bone mineraldensity (BMD) in the
PI3K pathway occurs frequently in solid tumors including lumbar spine (LS) and femur in the postmenopausal
cervical cancer. However, clinical results of single-agent PI3K women with cervical or endometrial cancer without bone
inhibitors show modest anti-cancer effect. Our goal was to metastasis compared to normal control postmenopausal
determine whether autophagy inhibition improves efficacy women.
of PI3K inhibitor in PIK3CA mutant cervical cancer cells. METHODS: We retrospectively evaluated the BMD data in
METHODS: We first examined whether Hydroxychloroquine the LS, femur neck (FN) and trochanter (FT) by dual-energy
(HCQ), autophagy inhibitor, enhances treatment efficacy X-ray absorptiometry and laboratory data of bone turnover
of BKM120, pan-PI3K inhibitor, in two PIK3CA mutant markers at baseline and after one year in 130 patients with
(Caski and C33A) and one wild type (Hela) cervical cancer cervical cancer, 68 patients with endometrial cancer, and
cell lines. Next, we assessed the effect of BKM120 on 225 healthy controls.
autophagy in these cells. RESULTS: There were no significant differences in the
RESULTS: Interestingly, autophagy inhibition enhanced the T-scores of basal BMD in LS and femur between patients
efficacy of BKM120 only in Caski cells, but not in C33A and with endometrial cancer and controls, and only T-score
Hela cells. BKM120 strongly induced autophagy in Caski of basal BMD at the fourth lumbar vertebra (L4) was
cells and weakly in C33A, but didn’t induce autophagy significantly lower in patients with cervical cancer
in Hela cells. FOXO family, an important transcription compared to controls. One year later, T-scores of BMD at all
factor regulated by PI3K-AKT, is also known to play a role LS sites and FN in patients with cervical cancer and T-scores
in autophagy induction. Here, we found that FOXO3a of BMD at L3, L4, FN, and FT in those with endometrial
localization was different in two PIK3CA mutant Caski cancer after cancer treatment were significantly lower
and C33A cells when BKM120 was treated. In Caski cells, compared to controls. Lower proportions of normal BMD
FOXO3a accumulation was shown in nucleus when treating at all skeletal sites except L2 in patients with endometrial
BKM120. However, majority of FOXO3a was retained in cancer and those at L1, L4, and FN in patients with cervical
cytosol in C33A cells by BKM120 treatment, indicating that cancer were observed compared to controls after cancer
BKM120-induced nuclear translocation of FOXO3a might treatment.
represent the synergistic effect of BKM120 with HCQ in CONCLUSION: Our results suggest that cancer treatment
PIK3CA mutant cervical cancer. increase bone loss in postmenopausal women with cervical
CONCLUSION: Taken together, our study shows that and endometrial cancer.
Poster Session
autophagy inhibition can enhance anti-cancer efficacy of

BKM120 in PIK3CA mutant cervical cancer cells in which
nuclear translocation of FOXO3a by BKM120 treatment
338
Poster Session : Uterine Corpus
PO-3001 and 2 had negative cultures. Fifteen out of 89 patients had

microbiologically documented urinary tract infection (UTI)
Infection profile among patients with
(17%), 80% of which were because of multidrug resistant
endometrial carcinoma in an oncology centre
organisms. Correlation between stool surveillance cultures
in Eastern India
and cultures from urine and surgical site was weak.
CONCLUSION: The study reveals the need of a randomised
Basumita Chakraborti1, Anik Ghosh1, Asima
1,2 1
Mukhopadhayay , Jaydip Bhaumik , Sanjay Bhattacharya 1 controlled trial to assess the need of surveillance cultures
1
pre-operatively in patients with endometrioid carcinoma.
Department of Gynaecology Oncology, Tata Medical Center,
Signs and symptoms of UTI in the pre-operative and post-
Kolkata, India, 2Newcastle University, UK
operative period with direct questions and urine culture
sensitivity to reduce infectious morbidity in the patients
OBJECTIVE: Stool culture surveillance is done at Tata
with endometrial cancer undergoing surgery.
Medical Center, Kolkata, for the patients undergoing
surgery for endometrial cancer, to decide on prophylactic
antibiotic during surgery and to decide on therapeutic
PO-3002
antibiotic later if needed. To study the correlation between
microbiology results of the stool surveillance cultures with Clinicopathological profile of endometrial
that of organisms isolated in cases with documented hyperplasia, endometrial intraepithelial
infections postoperatively. neoplasia and endometrial carcinoma
METHODS: It is a retrospective stud, where data was
collected on patients between September 2011 and Sabuhi Qureshi, Uma Singh, Nisha Singh
January 2015, with diagnosis of endometriod endometrial Department of Obstetrics and Gynecology, King George's Medical
cancer, undergoing surgery at our institution. The electronic University, Uttar Pradesh, India
database of the hospital is mantained prospectively.
R E S U LT S : E i g h t y - s e v e n p a t i e n t s d i a g n o s e d w i t h OBJECTIVE: The incidence of endometrial hyperplasia &
endometroid carcinoma of the uterus underwent 89 carcinoma is increasing in developing nations. The clinical
surgical procedures and were analysed for infection related risk factors are known but other factors need evaluation.
outcome. Majority had laparotomy and only few had Endometrial intraepithelial neoplasia is a premalignant
laparoscopic surgery during that period. Fifty-eight patients lesion that predisposes to endometroid endometrial
had surveillance culture of the stool. In this cohort 45 carcinoma. The present study was planned to study
(77.6%) were positive for one or more multidrug resistant clicopathological profile of endometrial hyperplasia,
organisms. The multidrug resistant organisms (MDRO) endometrial intraepithelial neoplasia & endometrial cancer.
included AmpC producing Gram negative bacilli in 9 METHODS: Women >40 years of age presenting with
patients, carbapenamase producers in 9 patients, Extended abnormal uterine bleeding presenting in OBGYN
Spectrum Beta-lactmase (ESBL) producers in 34 patients department of KG Medical University were assessed by
and (Vancomycin Resistant Enterococci) VRE in 1 patient. endometrial biopsy. Those with endometrial hyperplasia
Post-operatively, blood culture (as a surrogate marker and & endometrial carcinoma were enrolled. After informed
for investigation of clinical sepsis) was done in 15 patients consent, detailed history & examination was done. The
(16.9%), of which only 1 was positive (6.7%). Wound endometrial hyperplasia slides were reviewed for EIN as per
swabs had multidrug resistant organisms in 12 out of 19 EIN diagnostic criteria in the department of Pathology of
patients (63%), gram negative bacilli in wound swabs KG Medical University.
Poster Session
(89%), being the commonest. Surgical site infection (SSI) RESULTS: 168 women of > 40 years were assessed by
was clinically documented in 12 out of 89 patients (13.5%). endometrial biopsy for abnormal uterine bleeding.
Eight out of 12 were because of gram negative organisms Of these, 50 women were diagnosed as endometrial
339
hyperplasia & 11 women had endometrial carcinoma. into different groups according to if they received surgery
Age, menopausal status, obesity, diabetes mellitus & or chemotherapy or not, and the cycles of chemotherapy
hypertension were significantly associated with endometrial respectively. Vaginal secretion samples were obtained
hyperplasia & endometrial carcinoma. Nulliparity was not from patients pre-operative and post-operative, the post-
associated with endometrial hyperplasia & endometrial op patients received chemotherapy and no chemotherapy,
carcinoma. Post menopausal bleeding was the most and before each cycle of the chemotherapy after the
common symptom in endometrial carcinoma. Endometrial cytoreductive surgery (total hysterectomy, bilateral salpingo-
thickness on TVS was more in endometrial hyperplasia & oophorectomy, omentectomy, appendectomy, with pelvic
endometrial carcinoma as compared to those with normal and para-aortic lymphadenectomy) in ovarian cancer. And
endometrial histopathology. Endometrial thickness was not their vaginal microecology were evaluated by detecting the
a useful marker for prediction of endometrial hyperplasia & pH value and the biochemical status and conducting the
endometrial carcinoma independently. Out of 50 cases of microecosystem after Gram staining.
endometrial hyperplasia, 37 had simple hyperplasia without RESULTS: Vaginal dominant bacteria, vaginal flora
atypia, 4 had simple hyperplasia with atypia, 5 had complex diversity and density, pH value and the rate of vaginal
hyperplasia without atypia & 4 had complex hyperplasia microecological imbalance were compared respectively
with atypia. Endometrial hyperplasia cases were analysed between the preoperative and postoperative, finding that
for EIN. 4 cases (8%) out of 50 were diagnosed as EIN. post-operative gynecological malignancies gained higher
CONCLUSION: Positive correlation of endometrial vaginal microecological imbalance rate. In the ovarian
hyperplasia & endometrial carcinoma was seen with cancer,the preoperative dominant flora were Lactobacillus,
increasing age, menopausal status, obesity, diabetes while the postoperative’s were Gram positive and the
mellitus & hypertension. Endometrial thickness was not a rate of microecological imbalance increased after surgery
useful marker for prediction of endometrial hyperplasia & which consist with the rate in gynecological malignancies.
endometrial carcinoma independently. EIN was found more After thoroughly evaluation, it was found that for cervical
in cases of complex atypical hyperplasia. cancer, endometrial cancer and ovarian cancer, there was
no difference in the dominant vaginal flora,flora diversity
and density, vaginal pH values. So was it between those
PO-3003 receiving chemotherapy and the chemotherapy-free
ones.By monitoring the vaginal microecology of different
The influence of chemotherapy on vaginal chemotherapy cycles, it was found the rate of vaginal
microecology and its mechanism in microecological imbalance in postoperative ovarian cancer
gynecological malignancy after different chemotherapy cycles was not significantly
different from that of the chemotherapy-free. And there
Liang Xudong, Zhu Simin, Peng Erxuan, Wang Jianliu
was no correlation between the imbalance rate and the
Department of Gynecology, Peking University People's Hospital, chemotherapy cycles.
Beijing, China CONCLUSION: 1.The diversity of vaginal flora in patients with
gynecological malignancy decreased while the occurrence
OBJECTIVE: To assess and investigate the vaginal of vaginal microecological imbalance significantly increased
microenvironment in patients with gynecological after operation. 2.There was no correlation between the
malignancy who received chemotherapy according to the changes of the vaginal microecology in the post-op patients
vaginal microecosystem evaluation, in order to provide with gynecological malignancy and the types of cancer.
instructions for the clinics to help restore the balance of 3.Neither chemotherapy nor the number of times receiving
vaginal microecology and improve the quality of life for chemotherapy was related to changes of vaginal microecology
those patients. in gynecological malignancy. 4.The detection rate of BV in
Poster Session
METHODS: 80 patients with gynecological malignancy gynecological malignancies increased after surgeries, while
who received treatment in People’s hospital of Peking there was no significant difference of it whether those post-
University from April 2015 to January 2015 were divided op patients received chemotherapy or not.
340
PO-3004 PO-3005
The outcome of uterine sarcoma found Role of diagnostic laparoscopy in advanced

incidentally after uterus-preserving surgery for epithelial ovarian cancer
presumed benign disease
Jungwon Yoon, Inok Lee, Jung-Yun Lee, Eun Ji Nam,
Jung-Yun Lee, Young Tae Kim Sunghoon Kim, Sang Wun Kim, Young Tae Kim
Department of Obstetrics and Gynecology, Yonsei University Department of Obstetrics and Gynecology, Institute of Women's
College of Medicine, Seoul, Korea Life Medical Science, Yonsei University College of Medicine, Seoul,
Korea
OBJECTIVE: The aims of this study was to evaluate
the impact of initial uterus-preserving surgery such as OBJECTIVE: To evaluate the perioperative outcomes and the
myomectomy or subtotal hysterectomy on the recurrence prognostic impact of use of diagnostic laparoscopy surgery
and survival rates of patients with uterine sarcoma found (DLS) in patients with primary advanced epithelial ovarian
incidentally and to investigate the role of surgical re- cancer (AEOC).
exploration in this disease subset. METHODS: From 2012-2015, 173 epithelial ovarian
METHODS: We performed a retrospective chart review for cancer patients were retrospectively reviewed. All women
patients who have previously undergone total hysterectomy were stratified into three groups based on intention :
or subtotal hysterectomy or myomectomy at the time of primary debulking surgery (PDS), DLS, cytologic confirm
initial surgery for presumed benign uterine leiomyoma of malignancy followed by neo-adjuvant chemotherapy
and are found to have uterine sarcoma on final pathology. (NACT). With the DLS group, resectability was evaluated
Survival analysis was performed comparing patients with Fagtti score, and all patients underwent debulking
according to the type of initial surgery and the presence of surgery according to NCCN guideline. Surgical and survival
morcellation. outcome were evaluated by ANOVA, Kaplan–Meier
RESULTS: Between 2006 and 2014, 45 patients with method.
uterine sarcoma were identified. Myomectomy or subtotal RESULTS: One hundred and twenty two were FIGO stage
hysterectomy was performed in 15 patients, and 30 III and IV and considered as AEOC. In a subgroup analysis
patients underwent total hysterectomy as initial surgery. Of of AEOC, 50 patients underwent PDS, 37 underwent DLS,
patients (n=15) who underwent myomectomy or subtotal 35 underwent NACT. Among 37 consecutive patients
hysterectomy as initial surgery, 14 were re-explored to submitted to DLS, 6 women were considered suitable
complete staging within 21 days from initial surgery. Of for PDS and the remaining 31 were submitted to NACT.
patients (n=14) who underwent re-exploration, five (35.8%) No complications related to the DLS were reported. The
had residual tumor on remaining uterus. With four patients median operative time of debulking surgery was 383 min
with morcellated uterine sarcoma at initial surgery, no (IQR 181-392 min) in the PDS group, 193 min (IQR 147-287
patient had disseminated disease detected at immediate min) in the DLS group, and 353 min (IQR 265-424 min) in
surgical re-exploration. Although there was significant the NAC group, (p < .001) with a median estimated blood
differences between morcellation and nonmorcellation loss of 575 mL (IQR 250-950), 200 mL (IQR 100-500),
cases (P = 0.0476), the type of initial surgery had no effect and 500 ml (IQR 200-1175), respectively (p = .010). One
on recurrence (P = 0.941). patient in PDS group and 2 patients in NAC group were
CONCLUSION: Initial uterus-preserving surgery does not died within 3 months from debulking surgery, whereas no
appear to be associated with an adverse impact on the one died in DLS group. Need for transfusion and ICU care
survival outcome of unexpected uterine sarcoma when rate was significantly low in DLS group. (p<0.001) Optimal
surgical re-exploration achieved immediately. debulking rate was higher in DLS group, but the difference
Poster Session
did not reach statistical significance. (89.6% in PDS, 94.6%

in DLS, 91.4% in NAC, p=0.708). Median overall survival
and disease free survival was not statistically significant,
341
due to relatively short follow-up time. in this study. Further study with more samples is needed to
CONCLUSION: DLS is helpful to individualize the treatment develop our new cutoffs.
avoiding unnecessary laparotomies and surgical
complications, with non-inferiority of survival.
PO-3007
Lodng-term outcome of MRI-invisible

PO-3006
endometrial cancer
Comparison of CA125, HE4, and ROMA (Risk
of Ovarian Malignancy Algorithm) to predict Hyun-Jin Choi, Sunyoung Lee, Byung Kwan Park, Tae-Joong
ovarian cancer, epithelial type in cipto Kim, Chan Kyo Kim, Jung Jae Park, Yoo-Young Lee, Jeong-
mangunkusumo hospital Won Lee, Byoung-Gie Kim, Duk-Soo Bae, Eun Jin Heo

Indira Ongkowidjaja, Hariyono Winarto Center, Sungkyunkwan University School of Medicine, Seoul,
Department of Obstetrics and Gynecology, University of Indonesia, Korea
Rumah Sakit Cipto Mangunkusumo, Jakarta, Indonesia

OBJECTIVE: Magnetic resonance imaging (MRI) is useful in
OBJECTIVE: To compare CA 125, HE4, and ROMA to predict staging endometrial cancer. The treatment and prognosis of
malignancy of ovarian cancer, epitelial type. endometrial cancer that is invisible on MRI are still unclear.
METHODS: This is a diagnostic study using cross sectional The purpose of this study was to retrospectively evaluate the
method performed in the Oncology ward, Cipto long-term outcomes of MRI-invisible endometrial cancer.
Mangunkusumo Natonal Hospital. Sample collection METHODS: Between February 1995 and December 2011,
was carried out during 2010–2014, and 213 samples we reviewed the medical records of 433 patients with
fulfilling the inclusion and exclusion criteria were collected. endometrial cancer, which was staged IA with MRI. Of
Serum was collected to measure CA125 and HE4 levels. these patients, 89 had MRI-invisible cancer and 344 had
Histopathologic examination was performed by the MRI-visible cancer. Both cancers were treated with simple
Pathologic Anatomy Department of RSCM. Data was hysterectomy and/or lymph node dissection according to the
analyzed using 2x2 table and ROC-AUC curve. The ideal surgeon’s decision. Both cancers were compared regarding
cutoff was calculated based on the point which has the pathologic findings, recurrence rates, and survival rates.
best sensitivity and specificity, on our Indonesian samples. RESULTS: The mean lesion sizes of MRI-invisible and MRI-
RESULTS: At standard cut-off, the sensitiviy of CA125, visible cancers were 8.0±9.7 mm and 22.7±15.6 mm,
HE4, and ROMA are 91.5%, 91.5%, and 95.4%; the respectively (p<0.001). Myometrial invasion of these groups
specificity are 37.3%, 49.4%, and 32.5%; the PPV are were 20.2% (18/89) and 56.7% (195/344), respectively
69.6%, 73.9%, and 68.9%; the NPV are 73.8%, 78.8%, (p<0.001). Lymphadenectomy and follow-up imaging
and 81.8%; LR (+) are 1.46, 1.8, and 1.41; and LR (-) are showed no lymph node metastasis in MRI-invisible cancers,
0.23, 0.17, and 0.14. At ideal cutoff, that formed based on while those showed 5.2% (18/344) in MRI-visible cancers
our population sample (CA125:108.3U/ml, HE4:104.5pM, (p=0.031). The recurrent rates of MRI-invisible and MRI-
dan ROMA Premenopause:30,4; Postmenopause 53.1), the visible cancers were 1.1% (1/89) and 7.8% (27/344),
sensitiviy of CA125, HE4, and ROMA are 72.31%, 80.77%, respectively (p=0.026). The recurrence-free rates of
and 82.31%; the specificity are 69.88%, 78.31%, and these groups were 98.9% (88/89) and 91.6% (315/344)
78.31%; the PPV are 78.99%, 85.37%, and 85.60%; the (p=0.0495)
NPV are 61.70%, 72.22%, and 73.86%; LR (+) are 2.4, CONCLUSION: MRI-invisible endometrial cancer can be
3.72, and 3.79; and LR (-) are 0.39, 0.25, and 0.23. treated with less invasive surgery because of lower tumor
Poster Session
CONCLUSION: ROMA has better sensitivity than HE4 and burden and better prognosis. This cancer may not require
CA 125, but HE4 has better specificity than ROMA and CA lymphadenectomy because of no metastasis or recurrence
125, the ideal cutoffs are better than the standard cutoffs in lymph node.
342
PO-3008 OBJECTIVE: The incidence of endometrial hyperplasia &
carcinoma is increasing in developing nations. Newer
Prevalence of HPV infection in the semen of
techniques are being tried to recognise endometrial
Korean men and its effect on sperm parameters
hyperplasia. One of these is tumor suppressor gene
Sung Jae Kim3, Doo-Jin Paik3, Joong Shik Lee2, Hyo Serk Lee2,
phosphatase & tensin homologue (PTEN). It is frequently
2 2 2
Ju Tae Seo , Mi Seon Jeong , Sol Yun , Dong Wook Park , 2 inactivated i.e turned off in endometrial hyperplasia lesions.
2 2
Sangchul Han , Ki Heon Lee , Taejin Kim 1 This is an early event in endometrial tumorigenesis that may
occur in response to known endocrine risk factors & offers an
Department of Obstetrics and Gynecology, Cheil General hospital1
informative immunohistochemical marker for premalignant
Cheil General Hospital and Women’s Healthcare Center2, Dankook
University, Seoul, Korea, 3College of Medicine, Hanyang University,
disease. The present study was planned to study PTEN
Seoul, Korea immunohistochemical expression in endometrial hyperplasia.
METHODS: Women of >40years of age presenting
OBJECTIVE: To evaluate the prevalence of human with abnormal uterine bleeding in the OPD of OBGYN
papillomavirus (HPV) infection in the semen of Korean men department of KG Medical University underwent
and its association with sperm parameters endometrial biopsy. The histopathology of the biopsy
METHODS: Design: Cross-sectional, comparative study tissue was done in department of Pathology of KG Medical
Setting: Academic medical center Patient (s): 400 men University. The cases of endometrial hyperplasia were
attending Cheil General Hospital evaluated for fertility studied for PTEN immunohistochemical expression.
evaluation Intervention (s): None Main Outcome Measure RESULTS: 168 women of >40years of age with abnormal
(s): The prevalence of HPV infection in semen from the uterine bleeding underwent endometrial biopsy. 50
subjects was evaluated. In addition, the sperm parameters, women were diagnosed as endometrial hyperplasia. Of
including semen volume, sperm concentration, total sperm these, PTEN evaluation was done in 27 cases. Loss of PTEN
number, sperm motility, and morphology were investigated. expression was found in 11 cases (40.74%) of endometrial
RESULTS: The HPV infection rate of semen in the study hyperplasia. Loss of PTEN expression was more in complex
participants was 1.5% which was lower than that of previous hyperplasia with atypia (66.66%) as compared to simple
study results of semen in other populations. There was no hyperplasia without atypia (29.4%).
difference in the semen volume, sperm concentration, total CONCLUSION: There is positive correlation between loss of
sperm number, sperm motility, and morphology between PTEN expression and grade of morphological differentiation
HPV-infected sperms and HPV non-infected sperms of hyperplasia.
CONCLUSION: This is the first report evaluating the
HPV infection rate in the semen of Korean men and its
correlation with sperm parameters. The results do not PO-3010
provide sufficient evidence for the necessity of an HPV test

Research on the resistance mechanism
for infertility in Korean men due to the low HPV-infected
of endometrial cancer stem cells to
sperm rate and no alteration of the sperm parameters.
Salinomycin+Paltitaxel
Naotake Tsuda, Kazuto Tasaki, Shin Nishio, Kouichirou

PO-3009 Kawano, Gounosuke Sonoda, Kan Komai, Kimio Ushijima
Study of PTEN immunohistochemical Department of Obstetrics and Gynecology, Kurume University,

expression in endometrial hyperplasia School of Medicine, Fukuoka, Korea
Uma Singh, Sabuhi Qureshi, Shivani Mishra, Nisha Singh, OBJECTIVE: We conducted this study to show whether
Poster Session
Madhumati Goel salinomycin-resistant CSCs in endometrial cancer are

Department of Obstetrics and Gynecology, King George's Medical regulated by miRNAs or not.
University, Uttar Pradesh, India METHODS: Firstly, we examined the growth inhibition effect
343
of paclitaxel (PTX) and salinomycin (Sal : anti-cancer stem RESULTS: A-21-years old young lady with endometrial
cell agent) to endometrioid adenocarcinoma grade III cell stromal sarcoma was admitted with severe dismenorrhea
line (HEC-50b) by MTT assay. The protein surface markers and abnormal uterine bleeding. Physical examination
of CSCs (ALDH, CD133, CD171) after 48 hours stimulation revealed enlarged uterus untill three fingers below navel.
(short-time stimulation) with each agents were detected Ultrasound examination showed enlarged, globular uterus
by flowcytometer (BD FACS Verse). By long-time weekly with well-defined hypoechoic foci, about 10 cm in diameter.
stimulation with each agents, we constructed the drug From clinical appearance, the patient was suspected as
resistant cell line. We checked ALDH, CD133, and CD171 adenomyosis. Hormonal therapy administered didn’t
by flowcytometer, and compared with the data from short- give clinical improvement. Patient even once experienced
time stimulation. Also, we checked the changes of 93 enormous vaginal bleeding that deliver patient into
cancer-relatied genes (stem cell pathway, EMT pathway hypovolemic shock condition. The patient was then decided
etc) by Real time PCR among three groups ( no-treatment, to underwent surgical treatment. Intra-operative findings
PTX resistant, PTX+Sal resistant). We selected microRNAs revealed enlarged uterus, size 15 cm in largest diameter,
from the genes which significantly increased after long- other gynecology organ within normal range. There was
time stimulation by PTX+Sal. By transfecting the miRNAs to 10 cm mass identified as adenomyosis at posterior corpus.
the resistant cell line, we examined the miRNAs which can Decided to perform mass resection and conserve of the
inhibit the proliferation of the cell line with MTT assay. uterus with Osada’s technique. Pathological anatomy
RESULTS: We detected Sal has better inhibition ability result revealed low grade endometrial stromal sarcoma. A
compared with PTX only, although the inhibition rate was month after surgery, patient complaining of pain. Physical
not complete. After 48 hour stimulation with PTX, Sal, we examination revealed enlarged uterus. Ultrasonography
could detected increased ALDH positive cells in PTX+Sal findings showed enlarged uterus, with inhomogenous
stimulated group by flowcytometer. Long-time stimulation hyperechogenic appearance of myometrium. Patient was
by PTX + Sal induced much higher expression of ALDH. being advised to underwent hysterectomy, but she refused
We could detect 14 genes increased expression in PTX+Sal at first. Three months after she agreed to perform surgery
stimulated group compared with PTX only stimulated due to unbearable pain. Intra-operative findings of the
group. We examined miRNAs which could bind to these 14 second surgery show enlarged uterus with protruding solid
genes, by Target Scan. After transfected these miRNAs to mass with cystic part from posterior uterine wall, extended
PTX+Sal resistant cells, we could detected miRNAs has the beyond pelvic brim. Tumor nodules was also found along
inhibition of growth ability to PTX+Sal resistant cells. right infundibulopelvicum ligament. Surgeon than decided
CONCLUSION: MiRNAs might inhibit the proliferation of the to perform total hysterectomy, left salphyngectomy
PTX+ Sal-resistant cancer stem cell in endometrial cancer. and right salphyngo-oophorectomy. Until this case was
reported, the patient was in good condition.
CONCLUSION: Rapidly growing tumors of the uterus
PO-3011 with severe complaint may suggest malignant lesion,
such as uterine sarcomas which exclusively happen in
Low grade endometrial stromal sarcoma after
adults. Preoperative diagnosis mighty be difficult in early
adenomyosis Resection: a case report
stage, especially in young age. Precise knowledge of
histology, pathology and imaging finding might helpful in
Affi Angelia Ratnasari, Sigit Purbadi, Aria Wibawa
differentiating benign lesion from malignancy suspicion.
Department of Obstetrics and Gynecology, RS.Cipto Finding the lesion in early stage, with proper treatment
Mangunkusumo, Jakarta, Indonesia
might resulting good prognosis in patient’s survival and
possibility of fertility conservation in patient with young
OBJECTIVE: The present study reports a-21-years old young age.
Poster Session
lady with endometrial stromal sarcoma, with previous

history of adenomyosis resection by gynecologic surgeon.
METHODS: Case report
344
PO-3012 specificity, and PPV of the endometrial carcinoma G1/G2
group were 99.5%, 70.7%, and 91.8%, respectively.
Preoperative diagnostic accuracy of
CONCLUSION: Preoperative pelvic MRI is a sensitive and
myometrial invasion and histological subtypes
specific method of identifying invasion to the inner half
in patients with endometrial cancer
of the myometrium in endometrial cancer. Regarding
pathological evaluation of endometrial biopsy, if the results
Yuri Yano, Akira Kurosaki, Natsuko Takano, Sho Sato, Aiko
Ogasawara, Aki Miyasaka, Akira Yabuno, Yuichi Imai, Hiroyuki of endometrial biopsy indicate high-grade endometrial
Yoshida, Kosei Hasegawa, Keiichi Fujiwara cancer, lymphadenectomy should be considered.
Preoperative MRI and endometrial biopsy are reliable
Department of Gynecologic Oncology, Saitama Medical University
methods in diagnosis when selecting low-risk patients with
International Medical Center, Saitama, Japan
endometrial cancer.
OBJECTIVE: Accurate staging of endometrial cancer

is essential to determine the appropriate treatment
PO-3013
approach. Advocate for lymphadenectomy argue that it
allows precise determination of prognosis and accurate Unenhanced areas in the tumor on MR
tailoring of adjuvant therapy. Others assert that routine imaging is the prognostic factors of uterine
lymphadenectomy is associated with increased operative carcinosarcoma
time and increased risk of intraoperative complications and
that lymphadenectomy is not necessary in women with Ayami Inoue, Ken Yamaguchi, Tsukasa Baba, Kaoru Abiko,
good prognostic factors who are at low risk of lymph node Yumiko Yoshioka, Junzou Hamanishi, Masahumi Koshiyama,
involvement. Therefore, the benefit of complete pelvic Eiji Kondo, Noriomi Matsumura, Ikuo Konishi
and para-aortic lymphadenectomy as a part of the routine Department of Gynecology and Obstetrics, Kyoto University
staging procedures remains controversial. In this study, Graduate School of Medicine, Kyoto, Japan
we determined whether the risk factors were correctly
extracted before surgery for appropriate patient selection OBJECTIVE: Uterine carcinosarcoma represents 3-5%
in performing lymphadenectomy. of uterine malignancies and shows a poor prognosis.
METHODS: We assessed 273 patients with endometrial Although the stage is the only definite independent
cancer who underwent hysterectomy as primary treatment prognostic factor of uterine carcinosarcoma, other
between January 2010 and June 2014 at Saitama Medical factors including presence of heterologous sarcomatous
University International Medical Center. We retrospectively component or grade of carcinoma have been controversial.
examined preoperative myometrial invasion (MI) with It has been reported that necrosis is a significant prognostic
MRI and preoperative and postoperative pathological factor of endometrial carcinoma, while its prognostic
evaluation. impact on carcinosarcoma is unclear. The aim of this study
RESULTS: We could assess MI with MRI in 265 patients. was to determine if unenhanced area on MR imaging,
The positive-predictive values (PPVs) of the less than 1/2 which could represent necrosis, is a prognostic factor of
MI, 1/2 or more MI, and invasion of serosa groups were uterine carcinosarcoma.
93.1%, 79.2%, and 50%, respectively. The sensitivity M E T H O D S : Tw e n t y - n i n e p a t i e n t s w i t h u t e r i n e
and specificity of the less than 1/2 MI group were 93.6% carcinosarcoma at Kyoto University hospital between
and 87.0%, respectively. Next, 249 of 273 patients were 2003 to 2015 were studied retrospectively. In eighteen
included in the analysis of pathological evaluation of cases, magnetic resonance (MR) examinations with
endometrial biopsy. The PPVs of endometrial carcinoma contrast enhancement were performed. The percentage
G1, G2, and high-grade endometrial cancer (including of unenhanced areas in the tumor was designated by the
Poster Session
endometrial carcinoma G3, uterine serous adenocarcinoma, average of sagittal and axial views. We also confirmed with
clear cell adenocarcinoma, and carcinosarcoma) were a microscope if unenhanced areas on MR imaging reflect
80.9%, 55.2%, and 97.6%, respectively. The sensitivity, pathological necrosis. Overall and progression-free survival
345
rates were calculated via the Kaplan-Meier method, and primary infertility, complained vaginal bleeding. She had
differences were determined using the log-rank test. The no history of post coital bleeding. Ocassional dyspareunia
prognostic significance of clinicopathological factors was and odorous vaginal discharge were the only complaint.
assessed using the Cox proportional hazards regression Pelvic examination revealed uterus was equal to 8
model. weeks pregnancy, loose parametrium, and no adnexal
RESULTS: The clinical FIGO stages were Stage I in 16 mass. Ultrasound examination showed hyperechoic
patients, Stage II in 2 patients, Stage III in 7 patients, and inhomogeneous mass with neovascularization in the uterine
Stage IV in 4 patients. Gross examination disclosed polypoid cavity, originated from endometrium/endocervix which had
tumors in all patients. Unenhanced areas on MR imaging infiltrated until more than a half of myometrium.
were significantly related to pathological necrosis (P=0.04). METHODS: Hysteroscopy showed that cervix was smooth,
Although the presence of pathological necrosis was not increased vascularization of cervical canal, and showed
significantly related to the prognosis (P=0.79), unenhanced endometrial cancer appearance. Histopathology result
areas on MR imaging showed significantly poor prognosis taken from tissue of lower uterine segment was non-
when the percentage of the areas were more than 20% keratinizing squamous cell carcinoma, moderate
(P=0.003). Especially, unenhanced areas on MR imaging differentiated with the probability of adenosquamous
exhibited significantly shorter progression-free survival carcinoma couldn’t be excluded due to limited tissue. The
(P=0.0009) in early (I-II) stages, whereas significance was patient was lost of follow up for 3 months. After that
lost in advanced (III-IV) stages (P=0.96). In both univariate clinical examination showed that the uterus was enlarged
and multivariate analyses, clinical stage, lymph node with bulky endophytic cervical mass size 6x7x5 cm
metastasis and the existence of unenhanced areas on MR without any infiltration to both parametrium and vagina.
imaging (>20%) were significantly independent prognostic Laparotomy debulking (total abdominal hysterectomy,
factors for progression-free survival (P<0.05). None of the bilateral salphyngooovorectomy, omentectomy, bilateral
other factors (tumor size, histologic types and grade of the pelvic lymphadenectomy, and peritoneal biopsy) was
carcinomatous component, presence of the heterologous performed due to advanced stage of endometrial cancer.
component, or myometrial and vascular invasion) were Enlarged uterus size 15x12x8 cm, enlarged cervix size
significant prognostic indicators. 8x8x7 cm, peritoneal spreading of the uterine wall,
CONCLUSION: Unenhanced areas on MR imaging reflect bladder, ovarian surface and left hidrosalphing were found.
pathological necrosis. A certain amount of necrosis (>20%) Both ovaries were normal, adhered to posterior broad
on MR imaging can be a prognostic indicator of survival ligament, sigmoid colon, and rectum. Multiple nodules
in patients with uterine carcinosarcoma. In the cases on the omentum were found. There were bulky left pelvic
which show large unenhanced areas, even in early stages, lymph nodes size 4x3x2 cm and right pelvic lymph nodes
appropriate treatments and careful follow up were possibly size 3x3x2 cm. Residual tumor were left as milliary nodule
implants at the anterior peritoneal wall, anterior wall of
necessary to improve the outcome.
bladder and rectum, peritoneal wall of right pararectal
space.
RESULTS: Histopathology result was adenosquamous
PO-3014
carcinoma. More than half of cervical thickness, almost
Case report : an advanced stage endometrial overall endometrium and half of myometrial thickness
cancer with peritoneal spreading that could have been invaded by malignant cells. Metastatic tumor
not be distinguished with cervical cancer cells were found on the right paratubal tissue, left ovary,
left pelvic lymph nodes, multiple metastatic nodules at
Amirah Novaliani1, Hariyono Winarto2 the omentum and peritoneal wall, but no metastasis on
Department of Obstetrics and Gynecology, RS.Cipto the right pelvic lymph nodes and right ovary. Vaginal
Poster Session
Mangunkusumo1University of Indonesia2, Jakarta, Indonesia border was free of tumor. Immunohistochemical staining
of the endometrial tissue showed that vimentin, estrogen
OBJECTIVE: Thirty one years old woman, with 9 years receptor (ER), and progesterone receptor (PR) were positive
346
for endometrial cancer,. Immunohistochemical staining of cancer.
cervical stromal tissue for p16 as a surrogate marker for CONCLUSION: We found PET-CT and abdominal CT most
HPV virus is positive. contributed to detect recurrent endometrial cancer. In
CONCLUSION: It is difficult to distinguish between cervical fact, abnormal vaginal cytology and CA-125 elevation
and endometrial cancer only by histopathologic evaluation. are not significant predictive factors suggesting recurrent
Based on clinical and epidemiologic features, we endometrial cancer than imaging study. But follow-
considered this case as stage IVB endometrial cancer which up using these methods with follow-up imaging, it may
is uncommon, and poor prognosis. helpful to detect recurrence.
PO-3015 PO-3016
Is vaginal cytology and CA-125 measurement Feasibility of uterine preservation in

useful to detect recurrent endometrial cancer the management of early stage uterine
in postoperative patients? adenosarcomas: a single institute experience
Seok Mo Kim, Wan Ho Lee, U Chul Ju, Woo Dae Kang Young-Jae Lee, Shin-Wha Lee, Jeong-Yeol Park, Dae-Yeon
Kim, Dae-Shik Suh, Jong-Hyeok Kim, Yong-Man Kim, Young-
University Medical School, Gwangju, Korea
OBJECTIVE: To evaluate the role of follow-up after surgical University of Ulsan College of Medicine, Seoul, Korea
treatment in endometrial cancer, we investigate predictive
factor (vaginal cytology, CA-125, physical exam) for detect OBJECTIVE: Mullerian adenosarcomas are rare malignancy
recurrence. composed of benign epithelial and malignant stromal
METHODS: 345 Patients undergoing primary surgery with components and usually arising from the uterus. It has a
final pathology consistent with endometrial cancer between limited data on optimal therapy (primary surgery, adjuvant
2000/1/1-2014/5/1 were identified. We retrospectively therapy) due to its rarity. We aimed to analyze the clinical
studied these patients who had a follow-up appointment outcomes according to therapeutic method in patients with
consisting of vaginal cytology, CA-125 and imaging early stage uterine adenosarcomas to evaluate the efficacy
which were evaluated by univariate and multivariate of uterine preservation in the patients who want future
analysis. when we receive a diagnosis of recurrence, were fertility.
evaluate CA-125 measurement, vaginal cytology, physical METHODS: We performed a retrospective review of patients
exam. Recurrence group and non-recurrence group were with stage I uterine adenosarcomas who diagnosed and
performed those test every 3month or 6month. treated at a single institute, Asan Medical Center, Seoul,
RESULTS: -43 patients relapsed in 345 endometrial Korea from 1998 through 2014. All cases were re-staged
cancer patients, the median time from surgical treatment according to FIGO criteria (2009) and evaluated about
to recurrence was 18.25 month (range 1~78month). treatment data and outcomes.
early stage (I,II) -In recurrent group was 22 patients and RESULTS: Total 33 patients were identified and 31
advanced stage (III,IV) was 20. -We found most to detect patients met the inclusion criteria. In 2 excluded patients,
relapse by imaging study (routine PET, CT) 24 (55.8%) one patient was stage IV and another patient was
in 43 patients who had recurrence and CA-125, vaginal adenosarcoma from ovary. Median age at diagnosis was
cytology, physical exam found each 11 (25.6%),0,8 (18.6%) 44.5 years and mean of largest tumor diameter was 4.66
patients. CA-125 is significantly higher (Pearson = 57.5, cm. 13 patients were below 40 years old at diagnosis with
Poster Session
p value<0.001) than the other tests,vaginal cytology 9 of them were nullipara. Uterine preservation surgery like
(Pearson = 14.13, p value<0.001),Physical exam ( = 55.37, hysteroscopic mass excision or dilatation and curettage
p value<0.001) in correlation to the recurrence endometrial was performed in 8 nulliparas and total hysterectomy was
347
performed in the rest of the patients. Of the 8 patients in lower-extremity lymphedema (POLEL). Logistic regression
the uterine preservation group, 3 patients were NED, 4 analysis was used to select the risk factors for POLEL.
patients have persistent disease but just confined to uterus, RESULTS: Of 535 patients evaluated, POLEL was noted in
and 1 patient was AWD after recurrence in the median the medical records of 126 patients (23.6%), with median
follow up of 32 months. One patient with NED status had follow-up of 71 months. The occurrence of POLEL was
a vaginal delivery at term. In uterine preservation group, 2 significantly higher in the CINDEIN-dissection group than in
patients had sarcomatous overgrowth at diagnosis and one the CINDEIN-sparing group (34.3% vs. 7.8%, P<0.0001).
patient has persistent disease in the uterus and another Multivariate analysis confirmed that adjuvant radiation
patient had a tumor recurrence with peritoneal seeding. therapy [odds ratio (OR)=6.3, 95% confidence interval
And in the hysterectomy group, 2 of 23 patients had tumor (CI)=2.6–14.9], resection of more than 31 lymph nodes
recurrences. (OR=2.0, 95% CI=1.2–3.5), and removal of CINDEIN
CONCLUSION: Uterine preservation might be the possible (OR=5.4, 95% CI=3.1–9.3) were independent risk factors
treatment option in young patients who want to for POLEL.
maintain fertility. But, detailed explanation about the CONCLUSION: Elimination of CINDEIN dissection can be
risk of recurrence is necessary, especially in patients with helpful in reducing the incidence of POLEL.
sarcomatous overgrow that seems to be associated with
higher risk.
PO-3018
Mesonephric carcinoma of the uterine corpus:

PO-3017
a report of two cases and review of the
Relationship between removal of circumflex literature
iliac nodes to distal external iliac nodes and
postoperative lower-extremity lymphedema in Jianguo Zhao, Caiyan Liu, Ji Qi, Pengpeng Qu
uterine corpus malignant tumors Department of Gynecologic Oncology, Tianjin Central Hospital of
Obstetrics and Gynecology, Tianjin, China
Yukiharu Todo
Department of Gynecologic Oncology, Hokkaido Cancer Center, OBJECTIVE: Mesonephric carcinoma of the uterine corpus
Sapporo, Japan is an extremely rare malignancy that originates from the
mesonephric remnant of the female reproductive tract.
OBJECTIVE: The aim of this study was to confirm a causal Furthermore, there have been no previous reports of
relationship between removal of circumflex iliac nodes to mesonephric carcinoma accompanied by a sarcomatous
the distal external iliac nodes (CINDEIN) and lower-extremity component. We present the diagnosis,treatment and
lymphedema after systematic lymphadenectomy in patients prognosis of the two cases with postmenopause.
with uterine corpus malignancies. METHODS: The first case was of a 55-year-old woman
METHODS: A retrospective chart review was carried out for admitted for postmenopausal bleeding. The dilation
all patients with uterine corpus malignant tumor managed and curettage pathology report from another hospital
at Hokkaido Cancer Center between 1991 and 2013. indicated mesonephric carcinoma. We performed an extra-
All 318 patients underwent CINDEIN dissection as a part fascia hysterectomy, bilateral salpingo-oophorectomy,
of initial surgery and 217 patients did not. Patients had and pelvic lymphadenectomy. Microscopic analysis
undergone hysterectomy, bilateral salpingo-oophorectomy resulted in a diagnosis of mesonephric carcinoma with
and lymphadenectomy and their medical records were a sarcomatoid component involving the cervical stroma
reviewed. The type of lymphadenectomy gradually shifted and more than half of the uterine myometrium near the
Poster Session
from pelvic lymphadenectomy with removal of CINDEIN to serosa. Chemotherapy with paclitaxel, cisplatin was then
full lymphadenectomy without CINDEIN dissection during administered. The second case was a 62-year-old woman
this period. We identified patients with postoperative admitted for postmenopausal bleeding also. Based on
348
the dilation and curettage pathology report, a diagnosis suppressed by EZH2 in endometrial cancer (EC) cells, and
of mesonephric carcinoma was considered. Extra-fascia further investigated the functional roles of miR-361 and the
hysterectomy, bilateral salpingo-oophorectomy, and interaction between miR-361 and Twist mRNA in EC cells.
pelvic lymphadenectomy performed. Pathological analysis RESULTS: We identified miR-361 as an EZH2-suppressed
resulted in a diagnosis of mesonephric carcinoma of the miRNA that exhibits tumor suppressive effects to attenuate
uterine corpus with sarcomatoid components and the cancer cell proliferation and invasiveness, and abrogated
left internal iliac lymph node involved. The patient then cancer stem cell-like properties. EZH2 acts through YY1
received chemoradiation therapy . to epigenetically suppress miR-361, leading to enhanced
RESULTS: The first patient in this report relapsed 8 months expression of Twist, a direct target of miR-361. Treatment
after operation, a re-challenge chemotherapy regimen with of EC cells with specific EZH2 inhibitor GSK343 induced
cisplatin, ifosfamide, and pirarubicin was administered, but miR-361 expression, decreased Twist levels and inhibited
her overall survival was almost 12 months post-surgery. The EC cell proliferation and invasiveness in vitro. An inverse
second patient demonstrated no evidence of recurrence correlation between EZH2/Twist and miR-361 expression
within 14-months follow-up. was observed in human EC tissues.
CONCLUSION: According to the literature,female genital CONCLUSION: Our findings suggest that EZH2 upregulates
mesonephric carcinoma is a rare malignant tumor derived Twist by epigenetic repression of its negative regulator miR-
from embryonic mesonephric remnants. mesonephric 361 via an YY1-dependent mechanism.
carcinoma occurs more commonly in the cervix than in
the uterus and vagina. The clinical symptoms associated
with mesonephric carcinoma are not specific. In addition, PO-3020
imaging is unable to differentiate between this malignancy
Management of high grade endometrial
and common female reproductive system tumors, and
carcinoma: 10 year experience from the
no specific tumor markers for mesonephric carcinoma
KK Women’s and Children’s Hospital
have been identified thus far. Therefore, the surgical
Gynaecological Oncology group
treatment and staging of this malignancy may require to
be based on the existent guidelines for endometrial cancer.
Weng Yan Ho, Yong Kuei Lim
Furthermore, patients with mesonephric carcinoma who
Department of Obstetrics and Gynecology, KK Women's and
exhibit risk factors should receive appropriate postoperative
Children's Hospital, Singapore
treatments.
OBJECTIVE: This study aims to describe the 10 year

experience of the Gynaecological Oncology group in KK
PO-3019
Hospital in the management of patients with high grade
EZH2 stimulates Twist expression by endometrial carcinoma.
epigenetic silencing of its suppressor miR-361 METHODS: Women with high grade carcinoma diagnosed
through an YY1-dependent mechanism on histopathology from 2003–2013 at KK Hospital were
identified from the hospital’s cancer registry database.
KEI Ihira, Peixin Dong, Noriaki Sakuragi, Hisanori Minakami Information pertaining to patients’ profile, stage,
Department of Gynecology, Hokkaido University, Sapporo, Japan management and follow up was obtained from the medical
records.
OBJECTIVE: Although substantial data indicates that R E S U LT S : 4 7 6 w o m e n w e re d i a g n o s e d b e t w e e n
EZH2 epigenetically silences genes with tumor suppressor 2003–2013. Histological subtypes included high grade
functions, its impact on the activation of oncogenes via the endometrioid carcinoma, serous carcinoma, mixed
Poster Session
suppression of microRNA (miRNA) is poorly understood. malignant mullerian type, clear cell carcinoma. The
METHODS: By using the microarray-based integrating commonest was high grade endometrioid carcinoma:165
approach, we aimed to identify novel miRNAs that are cases (34.7%). The median age of diagnosis was 60.4 and
349
the women had median BMI of 24.7. Stage distribution of PO-3021
disease are: Stage 1A: 112 (23.5%), 1B: 56 (11.8%), Stage
Comparison of MRI and 18F-FDG PET/CT
2: 48 (10.1%), Stage 3A: 30 (8.4%), 3B: 5 (1.1%), 3C1:
in the preoperative evaluation of uterine
67 (14.1%), 3C2: 15 (3.2%), Stage 4A: 3 (0.6%) 4B: 81
carcinosarcoma
(17.0%), unstaged: 49 (10.3%). Surgery was performed
for 393 patients at our institution. 27 (6.9%) had THBSO,
Hyun Ju Lee, Jeong-Yeol Park, Shin-Wha Lee, Dae-Yeon Kim,
213 (54.2%) had THBSO with pelvic lymphadenectomy,
153 (38.9%) had THBSO with pelvic and para-aortic Kim, Joo-Hyun Nam
lymphadenectomy. The median operating time for
Departments of Obstetrics and Gynecology, Asan Medical Center,
THBSO,PLND was 173 minutes (101-436 minutes) with
University of Ulsan College of Medicine, Seoul, Korea
median 25 nodes harvested (1-62 nodes). The median
discharge home was on post-operative day 6 (day 2-66).
OBJECTIVE: We compared the validities of magnetic
The median operating time for THBSO, PLND, PAND was
resonance imaging (MRI) and 18F-fluoro-deoxyglucose
216 minutes (131-352) with median 30 pelvic (2-62) and 4
positron emission tomography/computed tomography
para-aortic nodes (0-21) harvested. The median discharge
(18F-FDG PET/CT) in preoperative evaluation of uterine
was on post-operative day 6 (3-39). Of the 15 patients
carcinosarcoma
with 3C2 disease, 1 had negative pelvic nodes but positive
METHODS: Patients with uterine carcinosarcoma (n=56)
para-aortic nodes. The commonest surgical complication
who underwent preoperative MRI and PET/CT before a
was wound infection. All cases were discussed at the
staging operation were included. As the reference standard,
tumour board meeting with multi-disciplinary input to
pathologic results of primary tumor lesions and paraaortic
guide subsequent management. For stage 1 disease, 23
and pelvic lymph node (LN) areas were compared with the
(13.9%) had no further treatment, 4 (2.4%) had adjuvant
chemotherapy, 82 (49.4%) had adjuvant radiotherapy, 53 preoperative MRI and 18F-FDG PET/CT findings. Differences
(31.9%) had both. For stage 2 disease, 3 (6.4%) had no in the validity parameters of both images were compared
further treatment, 4 (8.5%) had adjuvant chemotherapy, using McNemar test.
22 (46.8%) had adjuvant radiotherapy, 15 (31.9%) RESULTS: For detecting primary tumor lesions, the sensitivity,
had both. For stage 3 disease, 6 (4.8%) had no further specificity, accuracy, positive predictive value, and negative
treatment, 12 (9.7%) had adjuvant chemotherapy, 6 (4.8%) predictive value for 18F-FDG PET/CT versus MRI were
had adjuvant radiotherapy, 91 (73.4%) had both. For stage 98.1% versus 98.1% (P = 1.000), 33.3% versus 100% (P
4 disease, 13 (24.1%) had no further treatment, 28 (51.9%) = 0.157), 94.6% versus 98.2% (P = 0.500), 96.3% versus
had adjuvant chemotherapy, 1 (1.9%) had adjuvant 100%, and 50% versus 75%, respectively. For paraaortic
radiotherapy, 11 (20.4%) had both. The median duration LN areas, the values were 77.8% versus 51.9% (P = 0.016),
of follow up was 3.6 years. 90.2% versus 100% (P = 0.025), 85.9% versus 83.3% (P
CONCLUSION: The age at diagnosis of high grade = 0.774), 80.8% versus 100%, and 88.5% versus 79.7%,
endometrial carcinomas at our institution is similar to the respectively. For pelvic LN areas, the values were 61.1%
age at diagnosis of endometrial carcinomas in general at versus 50% (P = 0.125), 86.8% versus 89.5% (P = 0.727),
60.4 years old. Over three quarters of endometrial cancers 78.6% versus 76.8% (P = 0.774), 68.8% versus 69.2%,
are confined to the uterus at diagnosis, however in our and 82.5% versus 79.1%, respectively. For extrauterine
series only 35.3% of patients with high grade cancers disease, the patient-based values for 18F-FDG PET/CT were
had stage 1 disease. We are currently awaiting survival 100%, 78.9%, 85.7%, 69.2%, and 100%, respectively.
results with a view towards investigating the therapeutic CONCLUSION: In patients with uterine carcinosarcoma,
effect of para-aortic lymph node dissection in high grade 18F-FDG PET/CT had a high sensitivity and accuracy in
endometrial cancers. detecting primary uterine lesions and was comparable
Poster Session
to MRI. 18F-FDG PET/CT had moderate sensitivity and

high specificity for predicting LN metastases but was not
sufficient for replacing lymphadenectomy or MRI. The
350
high negative predictive value of 18F-FDG PET/CT might PO-3023
allow lymphadenectomy to be omitted in poor surgical
Differences in clinical outcomes among the
candidates. The high diagnostic accuracy of 18F-FDG PET/
three common types of uterine sarcoma
CT for the detection of distant metastases could also be
useful to identify unsuspected extrauterine disease.
Chalong Cheewakriangkrai, Prapaporn Suprasert, Jatupol
Srisomboon, Surapan Khunamornpong
Department of Obstetrics and Gynecology, Faculty of Medicine,

PO-3022
Chiang Mai University, Chiang Mai, Thailand
Prognostic values of metabolic parameters
measured by 18F-FDG PET/CT in patients with OBJECTIVE: To evaluate the clinical outcomes and
uterine carcinosarcoma prognostic factors among women with uterine sarcoma
METHODS: Eighty-one patients with a histologically proven
Hyun Ju Lee, Jeong-Yeol Park, Dae-Yeon Kim, Shin-Wha Lee, uterine sarcoma and surgically treated at the Chiang Mai
University Hospital between 1999 and 2009 were identified
Kim, Joo-Hyun Nam
from the gynecologic cancer registry and pathology
Departments of Obstetrics and Gynecology, Asan Medical Center, database. All histopathologic and clinical data were
University of Ulsan College of Medicine, Seoul, Korea reviewed.
RESULTS: Thirty-three (40.7%) patients had a carcinosarcoma
OBJECTIVE: We evaluated the relationship between (CS), 29 (35.8%) had a leiomyosarcoma (LMS), and 19
the metabolic parameters measured by 18F-FDG PET/ (23.5%) had an endometrial stromal sarcoma (ESS).
CT and oncological outcomes in patients with uterine According to 1988 FIGO classification, Stage I-II, and III-
carcinosarcoma IV tumors were identified in 50 (61.7%) and 31 (38.3%)
METHODS: From September 2006 to May 2015, 55 patients
patients, respectively. Patients with stages I-II had a recurrent
with uterine carcinosarcoma had undergone 18F-FDG PET/
rate of 20% compared to 48.4% of those with stages III-
CT as a preoperative disease evaluation. For each patient,
IV (P=0.007). Local, distant, and both recurrences were
maximum standardized uptake value (SUVmax), metabolic
found in 11 (13.6%), 9 (11.1%), and 5 (6.2%) patients,
tumor volume (MTV), and total lesion glycolysis (TLG) of
respectively. The recurrence was found in 14/29 (48.3%) of
primary tumor lesion were measured. And the impact of
LMS group, 7/33 (21.2%) of CS group, and 4/19 (21.1%) of
these metabolic parameters on recurrence and survival was
ESS group (P=0.04). At a median follow-up of 23 months,
evaluated by Cox Proportional Hazard model.
overall 5-year survival rates of the patients with ESS, CS, and
RESULTS: At a median 26 months of follow-up (range,
LMS were 73% (95%CI= 49 to 96%), 31% (95%CI=13 to
2-107 months), 19 patients (34.5%) experienced the
50%), and 14% (95%CI= -13 to 41%), respectively (P=0.05).
recurrence of disease, and 23 patients (41.8%) died of
In multivariate analysis, FIGO stage was the only predictor
their disease. Univariate analyses showed that hazard ratios
for recurrence (P=0.01). Furthermore, histological type
for recurrence of SUVmax (≥ 9.18), MTV (≥ 36.70) and TLG
(≥ 192.49) were 1.818 (95% C.I., 0.714-4.632, P=0.210), (P=0.038), FIGO stage (P=0.001), and patients’ age (P=0.039)
2.586 (95%, C.I., 1.010-6.623, P=0.048), 2.536 (95% were significant predictors for overall survival, respectively.
C.I., 1.004-6.410, P=0.049), respectively. And hazard ratios CONCLUSION: Recurrences remain a major problem of
for death of SUVmax (≥ 9.18), MTV (≥ 36.70) and TLG (≥ patients with uterine sarcoma. In comparison to ESS and
192.49) were 1.124 (95% C.I., 0.492-2.565, P=0.782), CS, patients with LMS tend to have a worse prognosis.
2.461 (95% C.I., 1.039-5.828, P=0.041), 3.058 (95% C.I.,
1.282-7.298, P=0.012), respectively.
CONCLUSION: MTV and TLG of primary tumor lesion are
Poster Session
more prognostic predictors of recurrence-free survival

and overall survival than SUVmax in patients with uterine
carcinosarcoma.
351
PO-3024 Department of Cancer Registry1Department of Obstetrics and
Gynaecology2, Faculty of Medicine Ramathibodi Hospital, Mahidol
Histone deacetylase as a promising University, Bangkok, Thailand
therapeutic target in endometrial stromal
sarcoma OBJECTIVE: In Thailand, endometrial cancer is the third
common cancer found in women. The incidence rate for
Min-Hyun Baek1,2, Jeong-Yeol Park1, Dae-Yeon Kim1, Chae-
endometrial cancer between 2004-2006 and 2007-2009
Chun Rhim2, Dae-Shik Suh1, Jong-Hyeok Kim1, Yong-Man
were 3.6 and 4.0 per 100,000 women, respectively. Limited
Kim1, Young-Tak Kim1, Joo-hyun Nam1
survival data are available on endometrial cancer. The
1
Department of Obstetrics and Gynecology, Asan Medical Center, purpose of the study was to estimate survival probability by
University of Ulsan College of Medicine, Seoul, Korea
stage of endometrial cancer.
2
Department of Obstetrics and Gynecology, Hallym University METHODS: Ramathibodi hospital registered 272 women
Sacred Heart Hospital, Anyang, Korea with endometrial cancer from 2001 to 2008. Medical
records, operative notes and pathological report of women
OBJECTIVE: The purpose of this study was to investigate the with endometrial cancer were reviewed. Demographic,
expression of histone deacetylase (HDAC) in endometrial behaviors were collected in the first time before diagnosed
stromal sarcoma (ESS). with endometrial cancer. The time censoring was dated
METHODS: Forty one patients with ESS were eligible in this December 31, 2014. Overall survivals were method of
study. The immunohistochemical expression of HDAC was Kaplan-Meier method. The results will be analysis by STATA
analyzed using tissue microarrays. Prognostic impact of version 11.
clinicopathologic characteristics of patients and treatment RESULTS: Of the 72 patients were died at the end of the
methods were also investigated. study (26.47%). A total follow-up time for all women
RESULTS: Strong positive immune-reaction was observed in is 644 person-years. Incidence density is 11.3 per 100
32 (78.0%), 23 (56.1%), 8 (19.5%), 36 (87.8%), 7 (17.1%), person-years (95%CI: 8.86 to 14.06). Overall survival at
30 (73.2%), 31 (75.6%), and 33 (80.5%) of HDAC 1, 2, 5 years is 47.0 %. Median survival time was 5.87 years
3, 4, 5, 6, 7, and 8 in ESS. Adjuvant therapy and radicality .Survival probability rate was low in women stage IV. The
of surgery had no statistical relevance with disease-free 5 years overall survival are 68.81%, 45.65%, 49.90% and
and overall survival outcomes. Although, statistically not 38.19 % in women stage I, stage II, stage III and stage IV,
significant, HDAC 1, 4, 6, 7, and 8 which showed high respectively. By Kaplan-Meier method estimates the OS is
frequency of strong immune-reaction showed lower DFS lower than 50% at the end of the study.
(100.0% vs. 81.3%, P = 0.202; 100.0% vs. 83.3%, P = CONCLUSION: The survival is lower than that of developed
0.393; 90.9% vs. 83.3%, P = 0.579; 90.0% vs. 83.9%; countries. A confirmed poor prognostic factor is women
and 100.0% vs. 81.8%, P = 0.207). in high stage. In this study, a less number of women with
CONCLUSION: All of the HDAC series were frequently endometrial cancer may lead to under estimate. Further
expressed in ESS. Target therapy for HDAC1, 4, 6, 7, study might needs a large of number of endometrial cancer
and 8 which especially showed high frequency of strong women to estimate the survival probability.
immunoreactivity can be considered as a promising
therapeutic target to improve prognosis.
PO-3026
Cost-effectiveness analysis of AS04-adjuvanted

PO-3025
human papillomavirus 16/18 vaccine compared
Survival rate for endometrial cancer in with screening alone in adolescent girls in
Thailand: Hospital base cancer registry Korea, with the new 2-dose schedule
Poster Session
Nintita Sripaiboonkij1, Sopit Promchana1, Pronsuda Sooyoung Hur2, Hyunju Lee3, Hyeongap Jang4, I-Heng Lee5,
1 1 2
Jitkasikorn , Tanapon Thonkamdee , Sarikapan Wilailak Woo-Yun Sohn5, Georges Van Kriekinge6, Byoung-Gie Kim1
352
1
Department of Obstetrics and Gynecology, Samsung Medical ICER of KRW 7.18 million per QALY which is highly cost
Center, Sungkyunkwan University School of Medicine, Seoul, effective. Sensitivity analyses indicated key parameters
Korea, 2Department of Obstetrics and Gynecology, Seoul St. to be: HPV distribution in CC, cost of the vaccine,
Mary's Hospital, The Catholic University of Korea, Seoul, Korea, screening participation and oncogenic HPV infection in the
3
Department of Obstetrics and Gynecology Seoul National
population.
University Bundang Hospital, Seongnam Seoul, Korea, 4GSK
CONCLUSION: The 2D-HPV-16/18v plus screening was
Vaccines, Seoul, Korea, 5GSK Vaccines, Singapore, Singapore, 6GSK
modelled to be cost-effective in the Korean context when
Vaccines, Wavre, Belgium
compared with screening alone.
OBJECTIVE: Cervical cancer (CC) is a leading cause of

cancer in Korean women, with 3,584 cases and 892 deaths
PO-3027
in 2012 and 2013, respectively. Currently, in Korea, no
nation-wide human papillomavirus (HPV) immunisation Survival impact of quality of lymphadenectomy
programme for young girls exists. The objective of this in intermediate- or high-risk group of
study was to evaluate the cost-effectiveness of the AS04- endometrioid type endometrial cancer: a multi-
adjuvanted HPV-16/18 vaccine (HPV-16/18v) for universal center retrospective cohort analysis
vaccination of girls in a 2-dose (2D) schedule added to the
current screening programme when compared with the KIM Tae Hun1, Dae-Yeon Kim2
current Korean CC screening programme alone. 1

Department of Obstetrics and Gynecology, Korea Institute of
METHODS: A static lifetime Markov single cohort model Radiological & Medical Sciences, Seoul, Korea
with annual cycles simulated the natural history of low- 2
Department of Obstetrics and Gynecology, University of Ulsan
risk and oncogenic HPV infection and CC screening for a College of Medicine, Seoul, Korea
cohort of 12-year-old Korean girls (N=253,000). Cost and
epidemiology data were obtained from a recently published OBJECTIVE: The aim of this study was to investigate
Health Technology Assessment report on HPV vaccination, whether quality of lymphadenectomy (LND) affect survival
literature and expert validation. Costs were updated to in patients with endometrioid type endometrial cancer
reflect 2014 values. Vaccine effectiveness, including cross- having intermediate- or high-risk factor.
protection, was approximated based on published vaccine METHODS: Eligible patients were retrospectively enrolled
efficacy and Korea-specific HPV type distribution. The and collected from four tertiary centers in Korea. All
analysis included direct medical costs only and reflects the patients underwent surgical staging including hysterectomy
perspective of the Ministry of Health. An annual discount with pelvic lymphadenectomy (PLND) with or without
rate of 5% and an alternative discount rate of 3% were para-aortic lymphadenectomy (PALND) between 2000 and
explored. Vaccination coverage was set at 86%, similar 2013 and finally diagnosed with FIGO stage IB to IIIC2
to other childhood vaccination programmes in Korea. A endometrioid adenocarcinoma. Respective removed lymph
sensitivity analysis on key parameters was undertaken. The node count (LNC) and positive LNC of pelvic and para-
maximum cost-effectiveness threshold was set at 30 Million aortic area were obtained from pathology report. Negative
Korean Won (KRW). LNC was defined as subtraction of positive LNC from total
RESULTS: The 2D-HPV-16/18v, compared with screening removed LNC. Recurrence-free survival (RFS) and overall
alone was estimated to avert 2,608 CC cases and 1,064 survival (OS) were analyzed.
CC deaths (undiscounted) over the lifetime of the cohort. RESULTS: A total of 476 patients were finally enrolled for
At 5% discount rate results show extra cost of KRW analysis. PALND was performed in 298 (62.6%) patients.
38.81 billion and 1,635 quality-adjusted life-years (QALY) Median pelvic and para-aortic removed LNC was 23 (range,
gained, leading to an incremental cost-effectiveness ratio 2-74) and 7 (range, 1-58), respectively. 164 (34.4%) had
Poster Session
(ICER) of KRW 23.7 million per QALY and is cost-effective stage IIIC disease (node positive group). Positive node
in the Korean context. At 3% discount rate 4,435 QALYs detection rate was associated with both pelvic and para-
were gained at additional KRW 31.83 billion leading to an aortic removed LNC. Isolated PALNM presented in 6 of
353
32 (18.8%) in pelvic removed LNC ≤ 20 group, while mass. Pelvic magnetic resonance imaging revealed a
only 1 of 68 (1.5%) in pelvic removed LNC > 20 group. 4.0x3.8x3.4cm sized mass near cervix. The mass showed
In node negative group, patients who received only low diffusion restriction with wall enhancement and thus was
quality PLND (pelvic removed LNC ≤ 20) had inferior RFS suspected of uterine sarcoma rather than cervical cancer
compared with those who received PALND in addition to it. or degenerative myoma. Levels of the tumor markers CA
(p=0.025). In node positive group, total negative LNC was 125, CA 19-9 and SCC were within their normal ranges.
an independent prognostic factor as a continuous variable The patient underwent exploratory laparotomy, and
(for RFS, harzard ratio (HR): 0.974, 95% confidence interval intraoperative frozen examination revealed a endometrial
(CI): 0.949-0.995; for OS, HR: 0.939, 95% CI: 0.899-0.981). stromal tumor. The mass was later pathologically confirmed
In total patients, total negative LNC was an independent to be a mixed endometrial stromal and smooth muscle
prognostic factor for RFS and OS as a continuous variable tumor of the uterus. Total abdominal hysterectomy,
(for RFS, HR: 0.983, 95% confidence interval (CI): 0.967- bilateral salpingo-oophorectomy and omentectomy were
0.999; for OS, HR: 0.962, 95% CI: 0.934-0.991). Quality performed.
of PLND assessed by pelvic negative LNC is the most RESULTS: Microscopically, the tumor consists of an
important prognostic factor. admixture of endometrial stromal tumor and smooth
CONCLUSION: Both positive node detection rate and muscle tumors. The tumor cells shows a bland cytological
survival were affected by removed LNC. Negative LNC is appearance, and mitoses are absent. The boundary
reliable marker for assessing quality of LND and also had between the tumor and myometrium is relatively distinct,
prognostic value in patients with intermediate- or high- risk but only focal minimal myometrial invasion is seen.
endometrial cancer regardless of node positivity. Insuring Lymphovascular involvement is not observed. The patient’'s
high quality PLND is more important than performing postoperative course was uneventful, and aromatase
PALND in those patients. inhibitor adjuvant therapy is currently being administered.
CONCLUSION: We report here a rare case of mixed
endometrial stromal and smooth muscle tumor of the
PO-3028 uterus in a postmenopausal woman.
Mixed endometrial stromal and smooth muscle

tumor of the uterus in a postmenopausal
PO-3029
woman
Large cell neuroendocrine carcinoma of
Ka Yeong Yun, Kyung Un Choi, Dong Soo Suh, the endometrium with cancer-associated
Ki Hyung Kim, Man Soo Yoon retinopathy in a postmenopausal woman
Department of Obstetrics and Gynecology, Pusan National
University School of Medicine, Busan, Korea Si Eun Han, Dong Soo Suh, Kyung Un Choi, Ki Hyung Kim,
Man Soo Yoon
OBJECTIVE: Mixed endometrial stromal and smooth Department of Obstetrics and Gynecology, Pusan National
muscle tumor is a rare tumor. The clinical presentation of University Hospital, Busan, Korea
uterine mixed endometrial stromal-smooth muscle tumors
does not appear to differ from that of uterine tumors of OBJECTIVE: Neuroendocrine carcinomas (NEC) of the female
pure endometrial stromal or smooth muscle origin. The genital tract are aggressive and uncommon tumors, which
prognosis and stage of this rare tumor is consistent with usually involve the uterine cervix and ovary, and are seen
the tumor of endometrial stroma. The gross pathology very rarely in the endometrium. Approximately 10 cases
does differ from that of pure endometrial stromal tumors of large cell NEC (LCNEC) of the endometrium have been
Poster Session
and pure smooth muscle tumors in most cases. reported. LCNEC is a highly malignant neoplasm with no
METHODS: A 59-year-old postmenopausal woman characteristic findings in terms of diagnostic imaging and
presented with low abdominal pain and uterine pathology; so definitive diagnosis of LCNEC preoperatively
354
is difficult. Cancer-associated retinopathy (CAR), typically
associated with small cell lung cancer (SCLC), is one of
the paraneoplastic syndromes with deterioration of visual
acuity, visual field constriction, and photophobia.
METHODS: A 61-year-old postmenopausal woman
presented with low abdominal pain and uterine mass. Pelvic
magnetic resonance imaging revealed a 7.5cm sized mass
abutted to the rectum. The patient underwent exploratory
laparotomy, and intraoperative frozen examination
revealed a malignant lesion. Total abdominal hysterectomy,
bilateral salpingo-oophorectomy and omentectomy were
performed.
RESULTS: Microscopically, the mass was later pathologically
confirmed to be a large cell neuroendocrine carcinoma of
the endometrium. The patient was received six cycles of
cisplatin (100 mg/m2, day 1) and etoposide (100 mg/m2,
day 1, 2, and 3). Systemic immunosuppressive medication
was administered for cancer-associated retinopathy. CAR
was diagnosed on the basis of ophthalmological findings
including clinical symptoms, electro-retinographic findings,
and visual field tests. CAR with clinical features of rapid
visual disorder should be considered in LCNEC patients as
well as in SCLC patients.
CONCLUSION: We report a rare case of large cell
neuroendocrine carcinoma of the endometrium with
cancer-associated retinopathy in a postmenopausal woman.
Poster Session
355
Poster Session : Others
PO-4001 PO-4002
Regression curves of serum β-human Bone mineral density in women treated for
chorionic gonadotropin in low risk gestational various types of gynecological cancer
trophoblastic neoplasia patients that initially
treated with single methotrexate chemotherapy Young Bin Whang1, Suk Woo Lee1, In-Hwan Oh2,
at rsup. H. Adam Malik Medan Dong Choon Park1
1
St. Vincent's Hospital, College of Medicine, The Catholic University
Sarah Dina Khaidirman, Juhriyani M Lubis, Deri Edianto of Korea, Seoul, Korea, 2Department of Preventive Medicine,
Department of Obstetrics and Gynecology, Indonesian Society of School of Medicine, Kyung Hee University, Seoul, Korea
Gynecologic Oncology, Jakarta, Indonesia
OBJECTIVE: Patients with gynecologic cancer frequently
OBJECTIVE: To determine the regression curve of serum experience bone loss due to cancer treatments, including
β-hCG patients with low-risk gestational trophoblastic bilateral oophorectomy, chemotherapy and radiotherapy.
neoplasia who were undergoing single methotrexate This study evaluated treatment-associated changes in bone
chemotherapy at RSUP. H. Adam Malik Medan. mineral density (BMD) in women with gynecologic cancer
METHODS: This study is a descriptive research with case and compared changes among patients with different
series design, which was performed on 34 patient’s medical types of gynecologic cancer.
records low risk gestational trophoblastic neoplasia who METHODS: BMD of the lumbar spine and femur were
received a single methotrexate chemotherapy from January retrospectively analyzed using dual-energy X-ray
2010 - December 2014. The parameters were assessed absorptiometry in 118 women who underwent the
were age, parity, anatomical pathology results, low risk treatment for gynecological cancers and 132 women
FIGO scores, presence or absence of metastasis, and the without gynecologic cancers. The cohort included 55
levels of pre-chemotherapy β- hCG as a prognostic factor. women with cervical cancer (CC) who underwent surgery
The level of β-hCG serum curve of complete remission followed by adjuvant chemotherapy and/or radiation
group and resistance groups plotted in the curve and therapy, 33 with endometrial cancer (EC) who underwent
analyzed descriptively. surgery followed by adjuvant radiation therapy, and
RESULTS: 2.5% of patients achieved normal value of 30 with ovarian cancer (OC) who underwent bilateral
β-hCG after receiving 2nd cycle of methotrexate, 50% of oophorectomy followed by adjuvant platinum based
patients achieved normal value of β- hCG after 4th cycle chemotherapy. Lumbar spine and femoral neck BMD were
and 97.5% of patients achieved normal value of β-hCG assessed at baseline and 12 months after treatment.
after 10th cycle. There are variations of β-hCG regression RESULTS: Demographic characteristics and pretreatment
in the 50th percentile group, where there is an increase BMDs, including T-scores, did not differ among cancer
in 8th cycle and returned to normal in 9th cycle. Before types. After adjustment for factors that can affect T-score,
starting chemotherapy, 2 (28.5%) of the 7 patients of cancer type affected change in T-score 12 months after
MTX-resistant group are above the 97,5th percentile of treatment. After adjustment for pre-treatment age, parity,
complete remission group. Before entering the 2nd cycle, BMI and T-score, T-score 12 months after treatment was
3 (42.8%) of the 7 patients are above 9.75th percentile. significantly lower in the EC than in the other groups.
Before entering the 4th cycle, 5 (100%) of 5 patients who CONCLUSION: Women treated for gynecological cancer,
were still undergoing chemotherapy until the end of the particularly those with EC who undergo bilateral
cycle are above the 97.5th percentile oophorectomy followed by adjuvant radiation therapy or
Poster Session
CONCLUSION: β-hCG regression curve of complete chemotherapy, should be managed in a timely manner to
remission group reach to normal level faster than MTX prevent or minimize bone loss.
resistant group’s curve.
356
PO-4003 remaining 7 deaths was newly confirmed with the inquiries
of this investigation. The overall survival, including the
Clinical investigation on the impact of
information from other hospital, was significantly worse
censored cases to the survival probability of
than the survival calculated only with our own medical
gynecological cancer
record.
CONCLUSION: Lost to follow-up cases of censored cases
Takashi Miyatake, Takeshi Yokoi, Takeya Hara, Shinnosuke
Komiya, Naoko Koumura, Asuka Tanaka, Serika Kanao, have serious influence on the survival probability of
Masumi Takeda, Ai Miyoshi, Mayuko Mimura, Masaaki gynecological cancer, because the patient information is
Nagamatsu lost and unknown death may occur after the lost. And
the unknown death may not be reflected in the survival
Department of Obstetrics and Gynecology, Kaizuka City Hospital,
probability. Follow-up inquiry on patient information
Osaka, Japan
were essential on the reliability of survival probability, and
clinician should clearly describe the ratio of censored cases
OBJECTIVE: Prudent observation on cancer death is
in survival analysis. However, for the reliability of survival
essentially important for the estimation on the effectiveness
probability, it is unknown to what extent of proportion
of cancer treatment. However, censored cases (including
of censored cases is permissible. Further statistical
‘withdrawal cases’ and ‘lost to follow-up cases’) often
investigation is necessary for the establishment of reliability
occurs, because of the interruptions of consultation, and of
in survival analysis.
changing hospital. Kaplan-Meier method characteristically
treat the censored cases for the survival analysis and it
does not distinguish withdrawal cases and lost to follow-
PO-4004
up cases, as censored cases. The overall survival probability
estimated with Kaplan-Meier method is blindly believed A study on the epidemiology of vesicular mole
by most clinician, as the most reliable results from cancer and effect of chemotherapy for persistent
treatment. There is no supplemental patient information trophoblastic disease
in withdrawal case, however, lost to follow-up cases may
contain unknown deaths after the lost. This examination Mini Chenicheri
is aimed to investigate the impact of censored cases, Department of Obstetrics and Gynecology, Govt Medical College,
especially lost to follow-up cases, to the survival probability Kerala, India
of gynecological cancer.
METHODS: Gynecological cancer cases, which were OBJECTIVE: • Gestational trophoblastic disease (GTD) is a
treated between Jan. 1st 2008 and Dec. 31st 2013, were spectrum of cellular proliferations arising from the placental
retrospectively analyzed. At Aug. 2014, medical records villous trophoblast encompassing 4 main clinicopathologic
were reviewed for date of last consultation, for occurrence forms: hydatidiform mole (complete and partial), invasive
of death, and for date of death. And for the censored mole, choriocarcinoma, and placental site trophoblastic
cases, inquiries on patient status were send to the hospitals tumor (PSTT) The term “gestational trophoblasticneoplasia”
to which the patient moved. The overall survival was (GTN) has been applied collectively to the latter 3
estimated with Kaplan-Meier method and with log-rank conditions,which can progress, invade, metastasize, and
test. lead to death if left untreated. • To study the Epidemiology
RESULTS: A total of 500 cases were examined. Excluding of GTD. • To study incidence of Gestational trophoblastic
withdrawal cases from censored cases, lost to follow-up Neoplasia and its outcome. Setting- Govt,Medical College,
cases were 101 (20%). And among them, 52 (10%) were Kozhikode. Period- Jan 2011 to Dec 2013 (3 years)
unknown interruption and 49 (10%) had changed to other METHODS: • Method – patients were referred to our
Poster Session
hospital. During the observation period, 75 (15%) deaths institution both before and after vesicular mole evacuation.
has occurred. 46 deaths was at our hospital and 22 deaths Suction evacuation was done to empty the uterus. They
was confirmed with the report from other hospital. And were followed clinically and with β hCG. Those who
357
had a persistent high value, fall followed by a rise, or incidence of 0.6% of all female malignancies. With
Histopathological evidence of malignancy were given the advances in management of carcinoma vulva to
chemotherapy. Methotrexate was used as first line single individualisation of treatment to reduce the psychosexual
agent. impact an aggressive treatment can have, it is imperative
RESULTS: • We had a total number of 243 patients. Age to understand the patterns of recurrence and the common
wise distribution was < 21 yrs - 72 (30%), 22 - 34 yrs prognostic factors involved. The aim of this study was to
-152 (53%), > 35 yrs -19 (21%) Parity - equally distributed determine prognostic variables for recurrence and survival
among Primi 123 (50%) and Multis -123 (50%) Gest. and to identify patterns of recurrence in patients with
age was < 12 wks in 170 (69%) cases and > 12 wks in vulvar cancer.
76 (31%). USG showed theca Lutein cysts in 36 (15%) METHODS: All patients (n=87) with primary vulvar cancer
of cases. Pre evacuation β hCG –n= 200 < 1 Lakh - 122 treated at the Rajiv Gandhi Cancer Institute between
(61%) > 1Lakh - 78 (39%) Suction Evacuation was done January, 2006 to January,2015 who underwent surgery
here in 157 (63%),and outside in 89 (36%) patients. Histo were retrospectively analysed regarding the prognostic
pathology was available in 215 which showed complete relevance of different clinicopathological variables.
mole in 157 and partial mole in 52. We had Hydropic Recurrences were evaluated with regard to their
abortion in 5 and chorio ca in 1 67 (27%)had Prophylactic characteristics and localisation and the variables associated
Methotrexate. Majority responded within < 6 courses - with them were analyzed.
44 3 patients had Actinomycin and EMACO for chorio ca RESULTS: Age, stage of tumor, size of tumor, location
was given in 1. • Side effects seen were Photophobia, Oral of tumor (central or lateral), lymph node metastasis,
ulcers, Neutropaenia, Abnormal liver function • 16 patients depth of invasion and involvement of resection margins,
had previous vesicular mole 3of them had chemotherapy. associated intraepithelial abnormality predicted disease-free
Gestational Trophoblastic Neoplasia. Invasive mole was and overall survival. In multivariate analysis, lymph node
diagnosed in 9 . All had chemo therapy, one patient had status and positive margin status was the most important
Hysterectomy for severe bleeding. One patient had Chorio independent prognostic factor (p=0.002). Irrespective of
carcinoma. the initial nodal involvement, recurrences occurred primarily
CONCLUSION: Hydatdiform mole occurred more in the in the vulvar region.
younger age group. Two third presented early and before CONCLUSION: Inguinofemoral lymph node status at initial
evacuation. PTD occurred in 27% and chemotherapy diagnosis is of critical prognostic importance for patients
resulted preventing the progression to chorio carcinoma. with vulvar cancer. Further tumour biological characteristics
Quality of Life (QOL) is very important in these young pts. need to be identified to stratify patients with nodal
• Gest. trophoblastic neoplasms are some of the most involvement for adjuvant radiotherapy of the vulva to
curable of all solid tumours, with cure rates > 90% even in prevent local recurrences.
the presence of widespread metastatic disease.
PO-4006
PO-4005
Comparison of the prognostic value of F-18
Vulvar cancer : patterns of recurrence and PET metabolic parameters of primary tumor
clinicopathological prognostic factors involved and regional lymph node in locally advanced
in recurrent cases cervical cancer patients treated with
concurrent chemoradiotherapy
Kanika Batra, Rupinder Sekhon, Shweta Giri, Sudhir Rawal
Department of Gynaecologic Oncology, The Rajiv Gandhi Cancer Gun Oh Chong, Yoon Hee Lee, Dae Gy Hong, Yoon Soon Lee,
Poster Session
Institute, New Delhi, India Young Lae Cho
Gynecologic Cancer Center, Kyungpook National University

OBJECTIVE: Vulvar cancer is a rare disease, with an Medical Center, Daegu, Korea
358
OBJECTIVE: This study investigated primary tumor and Department of Obstetrics and Gynecology, Gangnam Severance
regional lymph node metabolic parameters measured by Hospital, Seoul, Korea
pre-treatment F-18 fluorodeoxyglucose positron emission
tomography/computed tomography (F-18 FDG PET/CT) OBJECTIVE: To develop effective targeted therapy for
to compare the prognostic value for predicting tumor gynecologic cancer, the need to understand molecular
recurrence and to identify the most powerful parameter mechanisms related to the tumor generation, metastasis
in locally advanced cervical cancer treated with concurrent and treatment resistance is increasing. Human body
chemoradiotherapy. specimens are the core resources that include these
METHODS: Fifty-six patients who were diagnosed with molecular information. Securing quality specimen can be
cervical cancer with pelvic and/or paraaortic lymph considered an essential for drawing out quality research
node metastasis were enrolled in this study. Metabolic result. This study seeks to review the current status of the
parameters including maximum standardized uptake value database, the cooperation system with other institutions
(SUVmax), metabolic tumor volume (MTV), and total lesion and to evaluate the utility degree of the stored specimens
glycolysis (TLG) of primary tumor and lymph node were as research sources of the Korean Gynecologic Cancer
measured on pre-treatment FDG PET/CT. Univariate and Bank, established in 2012 to store and to make resources
multivariate analyses for disease-free survival (DFS) were out of the body specimen, DNA, RNA and protein obtained
performed using clinical and metabolic parameters. from gynecologic cancer patients
RESULTS: The metabolic parameters of the primary METHODS: Body specimen and data stored in the bank
tumor were not associated with DFS. However, DFS was target primary gynecologic cancer cell line, tissue,
significantly longer in patients with low values of nodal serum, plasma, urine, saliva and pelvic ascites. Specimen
metabolic parameters than in those with high values of extraction was administered starting from 2012, and it was
nodal metabolic parameters. Univariate analysis revealed administered before or during the treatment using the low-
that nodal metabolic parameters (SUVmax, MTV and invasive method with the patients’ agreement. Specimen
TLG), paraaortic lymph node metastasis, and post- quality and quantity was identified by classifying specimen
treatment response correlated significantly with DFS. by cancer type, acquired year and characteristic. Amount
Among these parameters, nodal SUVmax (hazard ratio of specimen that was lent and distributed was verified, and
[HR], 4.158; 95% confidence interval [CI], 1.1–22.7; p = published papers that were studied with these specimen
0.041) and post-treatment response (HR, 7.162; 95% CI, were checked. Moreover, the institutions that signed work
1.5–11.3; p = 0.007) were found to be determinants of agreement with the Bank for collection of the specimen
DFS in multivariate analysis. Only nodal SUVmax was an and academic interaction were verified.
independent pre-treatment prognostic factor for DFS, and RESULTS: Currently, specimen and data in the bank
the optimal cutoff for nodal SUVmax to predict progression numbers total of 32000. Starting from May 2012 to May
was 4.7. 2015, 6371 serum, 4364 plasma, 2078 lymphocyte, 881
CONCLUSION: Nodal SUVmax on pre-treatment F-18 FDG frozen tissue, 2022 pelvic ascites, 443 OCT, 20 HOSE
PET/CT may be a prognostic biomarker for predicting and 392 paraffin block units were stored. As for the data
disease recurrence in patients with locally advanced cervical related to cancer type, 8272 cervical cancer, 2602 uterine
cancer. corpus cancer, 6900 ovarian and fallopian tube cancer, 56
vulva cancer and 35 gestational trophoblastic neoplasia are
stored. As for the data on the research source distribution,
PO-4007 they include 889 serum, 109 plasma, 42 lymphocyte, 234
Current status of resources and work frozen tissue, 57 pelvic ascites, 30 OCT, 3 HOSE and 827
performance of the Korea Gynecologic Cancer paraffin block units. As for the paper using the distribution
bank of research sources, there are 14 papers published on SCI
Poster Session
journals from 2012 to 2015. Institutions that signed work

Doo Byung Chay, Jinkyoung Kong, Jae Hoon Kim, Hyunja agreement include 9 institutions and hospitals in Korea and
Kwon NIH of the US.
359
CONCLUSION: Resources of gynecologic cancer bank Then, the isolated GAGs presence was further determined
is continuing to grow steadily since 2012, and quality using Farndale analysis and gel electrophoresis. GAGs were
resource is being developed through proper management. isolated from cyst fluids derived from malignant and benign
As such, these resources are utilized to publish a number ovarian tumors using DEAE chromatography. The isolated
of outstanding research papers. Likewise, request for GAGs were analyzed by Farndale analysis and agarose gel
distribution and lending for new researches is increasing. It electrophoresis followed by silver staining to visualize the
is necessary to continue to acquire and manage resources GAGs. To analyze the fine structure of the GAGs, a panel
continually to establish the mechanism and the treatment of anti-GAGs antibodies was applied in ELISA assays using
method of the gynecologic cancer that are not confirmed the isolated GAGs.
to this point. It is judged that it would be necessary RESULTS: The IGROV-1 cells which consist of wild type
to provide resources actively according to the fair and p53 with normal functions showed increased CS-E and
appropriate procedure of the related research institutions versican expression after the chemotherapy treatment and
and academic community. estradiol treatment. The cells also showed a high sensitivity
towards doxorubicin and cisplatin by WST analysis. This
implicated that p53 may contribute to the upregulated
PO-4008 CS-E and versican expression and the sensitivity of the
cells towards the treatment. On the ovarian cancer panel
Versican and chondroitin sulfate alterations in
analysis, elevated versican expressions and most of the
ovarian cancer: The role of P53
CS-E expressions have been observed more in malignant
ovarian tumors than benign tumors regardless the
Henny Meitri Andrie Rachmasari Putri, Leon Massuger,
Gerdy Ten Dam histopathological types. Expression of p53 only appeared in
one fifth of the samples in the same panel which suggested
Department of Obstetrics and Gynecology, Indonesia Army
the involvement of type II designated pathway of ovarian
Hospital, Jakarta, Indonesia
tumorigenesis. Using the isolated GAG from the cyst fluids,
cyst fluids of malignant ovarian tumors showed a high CS
OBJECTIVE: To analyze whether there is a link between p53
content as was determined by agarose gel electrophoresis.
status and versican/CS-E expression in ovarian cancer in
This was confirmed by the ELISA studies.
relation to cisplatin, doxorubicin and estradiol treatment in
CONCLUSION: There is a possible role of p53 towards
cancer cells To analyze the alterations of glycosaminoglycan
versican/CS-E expression in ovarian cancer tumorgenesis.
(GAG) levels and fine structure in the cyst fluids of benign
Furthermore, CS-E could be detected from cyst fluid, ascites
and malignant ovarian tumors.
and urine from the ovarian cancer patients. CS levels were
METHODS: Three ovarian cancer cell lines (SKOV-3,
up-regulated in the cyst fluid of malignant ovarian tumors
IGROV-1, and OVCAR-3) with different p53 properties
which provide new information towards the understanding
were included in the study. Versican expression and CS-E
of ovarian cancer tumorigenesis.
expression were analyzed by immunohistochemistry using
monoclonal mouse anti-human versican antibody and
GD3G7 antibody, respectively. Cell viability and proliferation
PO-4009
was analyzed using the cell proliferation reagent WST-1.
The same immunohistochemical method was also used Menstrual pattern after abdominal radical
to analyze an ovarian cancer panel derived from eight trachelectomy
mucinous cystadenomas, eight serous cystadenomas,
eight mucinous borderline tumors, eight serous borderline Xiaohua Wu, Xiaoqi Li
tumors, eight mucinous ovarian carcinomas and eighteen Department of Gynecologic Oncology, Fudan University Shanghai
Poster Session
serous ovarian carcinomas. In addition, GAGs isolation Cancer Center, Shanghai, China
was done from ovarian cyst fluid, ovarian cancer ascites
and urine of ovarian cancer patient by DEAE sepharose. OBJECTIVE: By a prospective self-report, this study aims
360
to assess menstrual pattern and the effectiveness of anti- Tae-Eung Kim
stenosis tools to prevent cervical stenosis after abdominal Department of Obstetrics & Gynecology, Incheon St. Mary's
radical trachelectomy (ART) for patients with early stage Hospital, Incheon, Korea
cervical cancer.
METHODS: Between October 2006 and July 2015, a OBJECTIVE: Concurrent chemoradiation (CCRT) is the
questionnaire or telephone survey was performed in patients standard treatment for locally advanced cervical cancer.
who underwent ART before and at each visit after the This study was undertaken to evaluate the outcomes and
surgery. Patients were divided into 3 groups based on their the prognostic factors of cervical cancer after CCRT.
menstrual status post-trachelectomy : Group 1 “menstrual METHODS: The medical records of 174 patients with FIGO
pattern unchanged”, Group 2 “menstrual pattern changed stage IB1 to IVA treated at three affiliated hospitals of
without amenorrhea”, Group 3 “temporary or permanent Catholic University of Korea between January 1999 and
amenorrhea”. Cervical appearances were evaluated at each December 2008 were reviewed and analyzed. Patients
follow-up visit. Dilation was conducted if patients presented received pelvic teletherapy with one of the three regimens
with cervical stenosis. of cisplatin-based chemotherapy concurrently and high-
RESULTS: Ninety-four patients completed the questionnaire dose-rate brachytherapy. The radiation field was extended
or telephone interview. Two girls were prepubertal several to include para-aortic lymph node, if necessary.
months before diagnosis and had normal menarche after RESULTS: Median follow-up period was 29.5 months
treatment. For the rest 92 patients, 20 (21.7%) women (range, 5 to 96months). Using multivariate analysis, stage
(p=0.014), tumor size (p=0.043) and clinical response
belonged to Group 1, 55 (59.8%) to Group 2 and 17
(p=0.001) showed significant outcome on overall survival
(18.5%) patients belonged to Group 3. Median follow-
(OS). Similarly, Progression free survival (PFS) was influenced
up was 29 months (range 4–101). For women in Group
by stage (p=0.004), tumor size (p=0.02), clinical response
2, the most common presenting symptom was decrease
(p=0.011) and normalized SCC Ag (squamous cell
in the volume of menstrual fluid (39, 71.0%), followed
carcinoma antigen) level after CCRT (p=0.007). The 5-year
by a prolonged or shortened menstrual bleeding (33,
survival rates were 91.7 % (standard error, 5.8%) for stage
60%%) and newly developed dysmenorrhea (19, 34.5%).
IB1 to IIA, 71.5% (standard error, 7.8%) for stage IIB, 44.9
For women in Group 3, 13 patients experienced isthmic
% (standard error, 7.8%) for stage III and 20.9% (standard
stenosis. All but 3 resumed regular menstrual cycles after
error 12.0%) for stage IVA, respectively.
cervical dilation and re-inserted a tailed intrauterine device
CONCLUSION: Good clinical response revealed favorable
(IUD). Among women with permanent amenorrhea,
correlation to survival. Maximal effort to achieve this goal
one had damage of the endometrial blood supply. One
might have possibility to prolong survival in patient with
was due to endometrial organization. One experienced
cervical cancer.
ovarian dysfunction after chemotherapy. One girl had not
experienced menarche due to chemotherapy.
CONCLUSION: The majority of patients suffered from PO-4011
changes of menstruation after ART. Isthmic stenosis was
the main reason of stopped menstruation after surgery and
Robotic single-site versus laparoendoscopic
can be treated by cervical dilation. The use of the tailed IUD
single-site hysterectomy: a propensity score
matching study
could effectively reduce the occurrence of stenosis.
Jiheum Paek, Tae Wook Kong, Suk-Joon Chang, Hee-Sug Ryu
PO-4010 Department of Obstetrics and Gynecology, Ajou University

Hospital, Suwon, Korea
Poster Session
Outcomes and prognostic factors of cervical

cancer after concurrent chemoradiation OBJECTIVE: The aim of this study was to compare the
surgical outcomes of robotic single-site (RSS-H) and
361
laparoendoscopic single-site total hysterectomy (LESS-H) have been no studies showing its correlation with cancer
and to evaluate the feasibility of RSS-H in patients with so far. The aim of our study was to investigate the role of
benign gynecologic disease. TOM40 in ovarian cancer.
METHODS: The RSS-H was performed using the da Vinci METHODS: We used PCR and western blot analysis to
single-site surgical platform and the LESS-H using a single compare the expression of TOM40 in 15 ovarian cancer
multi-channel port system at the umbilicus. Among cell lines and 5 HOSE cell lines. We also analyzed the
467 consecutive patients who had undergone total expression of TOM40 in controls and in ovarian cancer for
hysterectomy for benign gynecologic disease, surgical 3 GEO datasets. IHC was used to analyze TOM40 protein
outcomes were compared between RSS-H group (n = expression in an ovarian cancer TMA block. In addition, a
25) and LESS-H group (n = 442) after propensity score TOM40 knockdown ovarian cancer cell line was developed
matching. using lentivirus, and a growth assay and an invasion assay
RESULTS: All operations were completed robotically were performed. Finally, we used a xenograft mouse model
and laparoscopically without conversion to laparotomy, and investigated the effects of TOM40 knockdown on
respectively. The RSS-H group had longer operating times tumor growth.
and less operative bleeding compared to the LESS-H group. RESULTS: The mRNA and protein expression of TOM40 was
While the LESS-H showed 1.4% of major complication significantly higher in the ovarian cancer cell lines (p < 0.05)
rate, the RSS-H had no perioperative complication. Even than in the control HOSE cells. Similar results were obtain
after propensity score matching, the RSS-H still showed when the GEO datasets were analyzed (opened microarray
longer operating times (170.9 min vs 94.1 min, p < 0.0001) results in NCBI—TOM40 expression was significantly higher
and less operative bleeding (median estimated blood loss, in the ovarian cancer tissue than in the controls (p < 0.01).
20 ml vs 50 ml, p = 0.009; mean hemoglobin drop, 1.6 g/ IHC performed using an ovarian cancer TMA block showed
dl vs 2.0 g/dl, p = 0.038) than the LESS-H. that TOM40 expression was higher in the ovarian cancer
CONCLUSION: The RSS-H could be a feasible and safe tissue than in the benign and borderline tissues (p < 0.001).
procedure in appropriately selected patients with benign Analysis of the overall survival and disease-free survival
gynecologic disease and further experience and technical revealed that the prognosis for patients with overexpression
refinements will continue to improve operative results. of TOM40 was poor, but due to the small number of
Prospective randomized trials will permit the evaluation patients, this result was not statistically significant (p >
of the potential benefits of the RSS surgery as a minimally 0.05). However, when we developed stable cells with an
over-expression of sh-TOM40 to confirm the functions of
invasive surgical approach.
TOM40, we found that TOM40 knockdown decreased
growth in ovarian cancer cell lines and suppressed
PO-4012
invasiveness. Moreover, the results using a xenograft mouse
model also demonstrated a reduction in tumor growth rate
TOM40 plays a major role in ovarian cancer for the cell lines with suppressed TOM40 expression.
growth and invasion CONCLUSION: TOM40 expression increases in ovarian
cancer, and plays an important role in growth and invasion.
Doo Byung Chay, Wookyeom Yang, Hayeon Shin, Eun-ju Lee, Accordingly, TOM40 is expected to be a good therapeutic
Jae-hoon Kim
target that can be applied to suppress the growth of
Department of Obstetrics and Gynecology, Gangnam Severance ovarian cancer.
Hospital, Yonsei University College of Medicine, Seoul, Korea
OBJECTIVE: TOM40, a protein embedded in the outer

membrane of the mitochondria, is a channel-forming
Poster Session
subunit of translocase, which plays an essential role in the

movement of proteins inside the mitochondria. It has been
highlighted to play a role in Alzheimer’s disease, but there
362
PO-4013 PO-4014
Ratio of intra-peritoneal metastatic tumour Effect of ischemic time on gene expression in

to lymph node SUV on preoperative PET/CT ovarian cancer tissue
predicts prognosis in epithelial ovarian cancer
Doo Byung Chay1, Jae-Hoon Kim1, Hyuja Kwon2, Wookyeom
Hyun Hoon Chung, Maria Lee, Hee Seung Kim, Jae-Weon Yang2, Eun Ju Lee2, Ji Hee Choi
Kim, Noh-Hyun Park, Yong Sang Song, Gi Jeong Cheon 1
Department of Obstetrics and Gynecology, 2Department of
Department of Obstetrics and Gynecology, Seoul National Biomedical Research Center, Gangnam Severance Hospital, Yonsei
University College of Medicine, Seoul, Korea University College of Medicine, Seoul, Korea
OBJECTIVE: We hypothesized that normalizing intra- OBJECTIVE: High-quality biospecimens is a very important
peritoneal metastatic tumor standardized uptake value requirement in translational research and among pre-
(SUV) by using the ratio of intra-peritoneal metastatic analytical variables in biobanking, ischemia was previously
tumor to lymph node (LN) SUV (SUVM/N) may be a better reported to alter gene expression and have been implicated
predictor of tumor aggressiveness than SUV alone. We as a variable that affects the quality of preserved tissue. The
investigated if the SUVM/N on preoperative positron purpose of this study is to evaluate the effect of ischemia
emission tomography/computed tomography (PET/CT) on gene expression profiles and RNA integrity in ovarian
imaging has a prognostic significance in patients with cancer tissue.

METHODS: Ovarian cancer tissues were prepared following
epithelial ovarian cancer (EOC).
variable time periods of warm ischemia (0 min up to 60
METHODS: Patients with EOC were imaged with fluorine-18
min) and cold ischemia (0 min up to 90 min) at room
fluorodeoxyglucose ([18F]FDG) PET/CT before surgical
temperature. Warm ischemic time was defined as the
staging. Medical records of clinical and histopathological
time starting from arterial clamping and Cold ischemic
data, and results were retrospectively reviewed. For each
as the time between surgical removal and fixation of the
patient, we determined maximum SUV (SUVmax), SUVM/N
specimen. Tissues were stored in 10% formaldehyde
and compared their predictive value on prognosis.
solution for 2 days and then, paraffin blocks were made.
RESULTS: One hundred twenty-two patients were eligible
Total RNA were separated from three 10μm section slide.
for analysis. Median progression-free survival (PFS) was
RNA purity ware assessed spectrophotometrically based on
26 months (range, 3 - 107 months), and median overall
A260 to A280 ratio and gel electrophoresis was performed
survival (OS) was 46 months (range, 3 - 107 months).
to determine integrity of RNA. Gene expression profiling
SUVM/N was an independent prognostic factor of both
was progressed via gene expression microarray chip and
recurrence (P = 0.029, hazard ratio [HR] 1.758, 95% CI
array data were analyzed.
1.060 – 2.916) and death (P = 0.027, HR 11.037, 95% CI
RESULTS: RNA was well preserved and there was no
1.321 – 92.237). The Kaplan-Meier survival graphs showed difference according to time intervals. Considering gene
significant differences in PFS and OS between the groups expression, there were changes in expression over the time
categorized by SUVM/N respectively (P < 0.001 for PFS, P = points analyzed. Effects of warm ischemic time revealed
0.006 for OS, log-rank test). 4 percentage alterations after 15 min, 6 percentage
CONCLUSION: Preoperative SUVM/N was significantly alterations after 30 min, and 11 percentage alterations
associated with both recurrence and survival in patients after 60 min from the baseline values. For cold ischemic
with EOC, and could be a potential prognostic marker time, there were 3 percentage changes after 30 min,
before treatment. 6 percentage changes after 30 min and 8 percentage
changes after 60 min, respectively.
CONCLUSION: This study shows that ischemic time can
Poster Session
influence gene expression profiling in ovarian cancer tissue

and effort to reduce the ischemic time is essential for high-
quality biospecimens.
363
PO-4015 open surgery than pelviscopic surgery (23.2 versus 18.3,
p<0.001).
Identifying risk factors for CT-based diagnosed
CONCLUSION: This study suggests that post-
post-lymphadenectomy lower extremity
lymphadenectomy 1-year CT might provide a reliable
lymphedema in patients with gynecologic
objective criterion for LEL diagnosis in gynecologic cancer
cancers
patients. Patients who had open surgery, more retrieved
1 1 2 lymph node and no anti-embolic stocking application
Miseon Kim , Jin Young Choi , Myong Cheol Lim , Dong
Hoon Suh1, Kidong Kim1, Jae Hong No1, Yong-Beom Kim1 should be recommended for prophylactic anti-lymphedema
1
management.
University Bundang Hospital, Seongnam, Korea, 2Center for
Uterine Cancer, National Cancer Center, Goyang, Korea
PO-4016
OBJECTIVE: Most retrospective studies evaluating risk Clinical determination of the appropriate
factors for lower extremity lymphedema (LEL) used time for removal of surgical drain in patients
ambiguous diagnosis of LEL by gynecologic oncologists. undergoing lymphadenectomy for the treatment
We conducted this study to evaluate the feasibility of of gynecologic cancer
computed tomography (CT) for objectively diagnosing LEL
and risk factors for LEL using CT-based diagnosis. Byung Su Kwon, Miseon Kim, Jin Young Choi, Dong Hoon
METHODS: We retrospectively reviewed 475 consecutive Suh, Kidong Kim, Jae Hong No, Yong-Beom Kim
gynecologic cancer patients (194 cervical, 138 uterine Department of Obstetrics and Gynecology, Seoul National
corpus, 140 ovarian, 1 vulvar, and 2 other cancers) University Bundang Hospital, Seongnam, Korea
undergoing lymphadenectomy between 2009 and
2014. Mean thickness difference (2.3mm±2.7mm) of OBJECTIVE: To evaluate the appropriate time for
anterior thigh subcutaneous layer on CTs between pre- removal of surgical drain (RSD) in patients undergoing
lymphadenectomy and LEL diagnosis in 111 (23.4%) who lymphadenectomy for the treatment of gynecologic
had a definite LEL diagnosis by a LEL specialist was used cancers in terms of minimizing lymphadenectomy related
for the diagnosis in the whole study population. Post- complcations.
lymphadenectomy 1-year CT-based LEL and its association METHODS: We retrospectively reviewed 371 consecutive
with various clinical characteristics were investigated. gynecologic cancer patients undergoing lymphadenectomy
R E S U LT S : A t o t a l o f 1 6 8 ( 3 5 . 4 % ) h a d a p o s t - with surgical drain in situ between 2009 and 2014.
lymphadenectomy 1-year CT-based LEL diagnosis of thigh. Association of lymphadenectomy related complications
LEL group had more open surgery (versus pelviscopic such as lymphocele and lymphedema with clinical
surgery, p=0.001) and postoperative adjuvant therapy characteristics including RSD day after surgery was
including radiation therapy (p=0.031) than non-LEL group. evaluated.
Total retrieved pelvic lymph node number of LEL group RESULTS: Postoperative lymphocele and lymphedema were
was more than that of non-LEL group (24.0 versus 19.9, observed in 70 (18.9%) and 147 (39.6%), respectively.
p<0.001). However, early ambulation <24 hours (p=0.013) Greater number of retrieved lymph nodes was associated
and anti-embolic stocking application (p=0.016) were with more development of lymphocele (26.4 vs. 20.5,
associated with no LEL. Multivariate analysis showed that p<0.001) and lymphedema (23.6 vs. 20.3, p=0.007).
open surgery (Odds ratio [OR] 1.88; 95% Confidence Lymphocele and lymphedema were associated with
interval [CI] 1.24-2.88; p=0.003), more retrieved lymph removal of surgical drain ≥ postoperative 3 days (p=0.023)
node (OR 1.02; 95% CI 1.01-1.04; p=0.009) and no anti- and ≥ postoperative 5 days (p=0.038), respectively. Open
Poster Session
embolic stocking application (OR 1.55; 95% CI 1.04- surgery (p<0.001), operator (p<0.001), hypertension
2.30; p=0.030) were independent risk factors for LEL. The (p=0.025), and no use of intermittent pneumatic
number of total retrieved pelvic lymph node was more in compression (p=0.008) or anti-embolic stocking (p=0.002)
364
were also significantly associated with postoperative with complaints of retension of urine .On examination
lymphocele development. Multivariate analysis revealed patient had obliteration of vaginal orifice with dense
that operator (odds ratio [OR] 8.3; 95% confidence interval adhesion between labia with urine leaking from a pin
[CI] 2.6-26.2; p<0.001), open surgery (OR 3.8; 95% CI hole orifice.speculum could not be inserted.Suprapubic
1.7-8.5; p=0.001), and hypertension (OR 3.3; 95% CI catheterization was done .Patient underwent vaginoplasty
1.6-6.9; p=0.002) were independent risk factors for the with urethroplasty in August 2001.post operatively wound
development of lymphocele, however, postoperative healed well.patient reported after one year of vaginoplasty
removal of surgical drain day was not. with complaints of 4months amenorrhoea.pregnancy
CONCLUSION: This study suggests that the prevention of confirmed.then with regular antenatalfollowup delivered
lymphocele and lymphedema after lymphadenectomy in live baby at term in 2002.Patient defaulted for followup
gynecologic cancer patients may depend on operator, open for 3years after her second delivery.On continuous
vs. pelviscopic surgery, and hypertension although early followup since 2005.patient had lymphedema of left
RSD before postoperative 2 day appears to reduce them. lowerlimb,managed conservatively.
RESULTS: Discussion: In the present case of young patient
with vulvar cancer who had undergone radical surgery for
PO-4017 disease and the plastic surgeries for vaginal obliteration her
fertility was not impaired with no obstetrics complications
Pregnancy after radical vulvectomy and
during antenatal period .In the literature the reported
vaginoplasty
cases of pregnancy following vulvectomy are less, mainly
Uma Devi, Jayashree Natarajan because the disease is of advanced age.with the increase
in incidence of vulval cancers in younger age groups the
Department of Gyneacological Oncology, Kidwai Memorial
management of reproductive functions also will be a
Institute of Oncology, Bangalore, Karnataka, India
concern.
CONCLUSION: CONCLUSION: The increasing incidence
OBJECTIVE: Vulvar cancer incidence is showing a increasing
of HPV related vulval cancers in young females has
trend in incidence with increase in number of young
to be handled with fertility concerns. With the newer
patients also. We present a case of vulvar cancer who
modifications in surgeries for vulvar cancer fertility issues
underwent Radical vulvectomy with Bilateral groin node
should be minimal.
dissection, and vaginoplasty for post operative vaginal
stenosis and she had delivered a term baby after the
surgeries.
PO-4018
METHODS: Case summary: 24years old lady married for 4
years with one child presented with complaints of itching Clinical value of the gynecologic consultation
in external genitalia for 2years duration and growth over for basal endometrial evaluation before
external genitalia of 2months duration in year 2000.she adjuvant tamoxifen treatment in women with
attained menarche at 14 years and delivered her first child breast cancer
by normal vaginal delivery 2years before.On examination
she had a4x5cm growth arising from the external genitalia Miseon Kim, Dong Hoon Suh, Kidong Kim, Jae Hong No,
which indends in to the anterior vaginal wall, bilateral Yong-Beom Kim
inguinal nodes palpable.She underwent radical Vulvectomy Department of Obstetrics and Gynecology, Seoul National
with Bilateral groin node dissection in March 2000.Her University Bundang Hospital, Seongnam, Korea
final HPR confirmed Squamous cell carcinoma of vulva,
both Groin nodes were negative.Patient had post operative OBJECTIVE: Gynecologic consultation for a basal
Poster Session
gaping of groin ounds with discharge which healed with endometrial evaluation is not routinely performed before
dressings.patient discharged on 21st post operative day. adjuvant tamoxifen treatment in women with breast
Patientdefaulted for one year and 3 months and reviewed cancer. We conducted this study to assess the clinical value
365
of the gynecologic consultation for basal endometrial PO_0137 (PO-4019)
evaluation before the start of adjuvant tamoxifen treatment
Two case of Interventional radiology (IVR)
in women with breast cancer.
on the palliative care in gynecologic
METHODS: We retrospectively reviewed 219 breast cancer
malignancies
patients who received adjuvant tamoxifen treatment
and had endometrial pathologic results during or after
Masumi Takeda, Takashi Miyatake, Takeya Hara, Shinnosuke
tamoxifen treatment. Patients were divided into two
Komiya, Naoko Komura, Asuka Tanaka, Serika Kanao, Ai
groups according to the performance of the gynecologic Miyoshi, Mayuko Mimura, Masaaki Nagamatsu, Takeshi Yokoi
consultation for a basal endometrial evaluation within one
Department of Obstetrics and Gynecology, Kaizuka City Hospital,
month before the start of adjuvant tamoxifen treatment.
Osaka, Japan
Clinicopathologic characteristics including endometrial
pathology between two groups were compared.
OBJECTIVE: Managing pain and bleeding is important on
RESULTS: A total of 111 (50.7%) had the gynecologic
the palliative care of gynecologic malignancies. Transfusion
consultation for a basal endometrial evaluation before
for massive bleeding, and prescription for pain are two
adjuvant tamoxifen treatment. Of them, 4 (3.6%)
of centers of the palliative care, although repetition of
had a pre-tamoxifen pathologic confirmation of no
transfusion, and adverse effect of analgesics make the
premalignant or malignant lesion based on the abnormal
quality of life lower. In Japan many patients hope to stay
basal ultrasonographic findings of endometrium before
home with their families in their last moment. However,
adjuvant tamoxifen treatment. The group with gynecologic
frequent blood transfusions are difficult in the home-
consultation for a basal endometrial evaluation had
based palliative care. As a result, the patient has to keep
more patients with young age (p=0.037), early menarche
hospitalized, and it leads to a decline of the quality of life.
(p=0.045), premenopausal state (p=0.025) and high tumor
METHODS: The effectiveness of interventional
grade (p=0.040) than the group with no gynecologic
consultation before adjuvant tamoxifen treatment. There radiology (Trans-arterial embolization & Trans-arterial
was no difference of risk factors for endometrial pathology chemoembolization) to maintain the quality of life in the
at the time of endometrial pathologic evaluation between palliative care, is retrospectively reviewed from medical
the two groups such as duration of tamoxifen use (32.0 record.
months versus 30.5 months, p=0.607), presence of uterine RESULTS: Case 1; 49-year-old woman were diagnosed
bleeding (9.0% versus 13.9%, p=0.256), and endometrial as ovarian cancer (serous adenocarcinoma of left ovary
thickness on transvaginal ultrasonography (11.1 mm versus ypT3cN0M1). After the 2nd-line chemotherapy, the tumor
10.4 mm, p=0.287). Type of procedure was also similar clinically progressed, therefore we proposed her either oral
between the two groups (hysteroscopy versus dilatation etoposide as 3rd-line chemotherapy, or palliative care. She
and curettage, p=0.091). Endometrial pathologic lesions selected palliative care. Bleeding from her stoma continued
including endometrial polyp (37.8% versus 26.9%, intermittently, and computed tomography imaging could
p=0.082), glandular hyperplasia with/without atypia (3.6% not localize the site of bleeding. Blood transfusions of 2
versus 1.9%, p=0.427) and endometrial cancer (0.9% to 4 units of RCC were repeatedly necessary every two to
versus 0%, p>0.999) was not different between the two three days to keep blood hemoglobin level over 7.0g/dl.
groups. We performed Trans-arterial embolization of mesenteric
CONCLUSION: Gynecologic consultation for a basal artery for her. After the IVR, her blood hemoglobin level
endometrial evaluation before the start of adjuvant had been kept over 8.0g/dl without blood transfusion
tamoxifen treatment does not seem to be associated with for prolonged intervals of 15 days. Case 2; 50-year-old
early detection or prevention of endometrial pathology in woman were diagnosed as cervical cancer (adenosquamous
breast cancer women scheduled for adjuvant tamoxifen. carcinoma pT2bN0M0). The 3rd-line chemotherapy resulted
Poster Session
in progressive disease. She came to suffer from worsening

pain in the right hypochondrium area due to metastatic
liver tumor. For the relief of pain, we proposed her a trans-
366
arterial chemoembolization, with embolization materials postmenopausal patient had edometrioid carcinoma. In
and cisplatin (100mg/body). The chemoembolization were immunohistochemistory, 10 of the 11 patients were positive
performed into the hepatic artery. After the first IVR, the in inhibinα, all in P450aromatase, and 4 in P450c17.
intra-tumor necrosis were suggested by contrasted CT and P450c17 positive cells all had abundant eoshinophilic
her pain in the upper right abdomen became fully relieved. cytoplasm,showing lutenizing. E2 levels were elevated in all
CONCLUSION: It is well known among the radiologist that P450c17 positive patients and P450c17 were negative in
IVR procedure can relieve the bleeding, pain and discomfort low serum E2 level patients.
of malignant disease. However, the availability of IVR for CONCLUSION: Granulosa cell tumor clinically shows
gynecologic malignancies is not well known, and is limited symtoms due to FSH suppression by inhibin or due to
in literature. IVR have contributed to the relief of patients’ estrogen-prducing. It is suggested the lutenizing cells in
suffering, in above two cases. Accumulating such cases, the tumors are attribute to their estrogen-producing in
it is possible that IVR can become one of a choice for a granulosa cell tumor.
palliative care in gynecologic malignancies.
PO-4021
PO-4020
The effectiveness of oral progestin as fertility
Granulosa cell tumor of ovary: retrospective preserving treatment of complex atypical
study of 11 cases hyperplasia and early endometrial cancer in
young women
Sachiko Kitamura, Kaoru Abiko, Ken Yamaguchi, Junzo
Hamanishi, Masafumi Koshiyama, Tsukasa Baba, Noriomi Seok Mo Kim, Ji Sun Baek, U Chul Ju, Woo Dae Kang
Matsumura, Ikuo Konishi
Department of Gynecology and Obstetrics, Kyoto University University Medical School, Gwangju, Korea
Graduate School of Medicine, Kyoto, Japan
OBJECTIVE: The aim of this study is to assess the
OBJECTIVE: Granulosa cell tumor is one of the most famous effectiveness of oral progestin treatment in women
estrogen-producing tumors of ovary, but some of them diagnosed with complex atypical hyperplasia (CAH) or
don’t show high serum E2 level. The purpose of this study grade 1 endometrial cancer (G1EC), who desire to preserve
was to know whether there are any clinical or pathological their fertility, as alternative treatment to a hysterectomy.
differences in terms of hormonal activity. METHODS: We reviewed the medical records of women
METHODS: We reviewed retrospectively the 11 patients younger than 45 years old that had been diagnosed with
who underwent operations at our hospital from 2002 to CAH or G1EC, who expressed a desire to preserve their
2014. fertility using alternative treatment at our institution.
RESULTS: The 6 patients were premenopausal,who Women without evidence of myometrial invasion on pelvic
c o m p l a i n e d o f o l i g o m e n o r r h e a a n d t h e 5 w e re MRI scans were included. The study period was between
postmenopausal with genital bleeding. The mean age 2004 and 2014.Endometrial biopsies were taken at follow-
was 49.5 y.o.The serum E2 levels tended to low in up appointments.
premenopausal and high in postmenopausal patients. RESULTS: We identified 31 young women with CAH or
The serum FSH levels were suppressed in all patients. G1EC.The median age was 33 years old (range 20-41),
The thickness of endometrium had significant difference andthe median period of time undertaking the treatment
between premenopausal and postmenopausal patients was 5.0 months (range 1-12). 23 patients (74.2%)
(2.8mm vs 12.4mm ;P<0.01) Of the 8 patiens,whose achieved CR (median time to CR was 3.0 months, range
Poster Session
endometrial tissues were available after total 1-22), 16 patients (88.9%) with CAH and 7 (53.8%) with
hysterectomy,two patients (both premenopausal and G1EC achieved CR. 6 patients (26.1%) who had achieved
postmenopausal) had endometrial hyperplasia and one CR, had recurrenceof the disease (median time from CR
367
to recurrence was 12.5 months, range 4-18). 8 patients Organization for Research and Treatment of Cancer (EORTC)
(25.8%) finally underwent a hysterectomy (median age 37 QLQ-C30 and OV-28 questionnaires. In CHSM, community
years). clinicians and hospital oncologists co-operated to perform
CONCLUSION: Oral progestin therapy is an effective the interventions and follow-ups, which included leaflets,
alternative treatment for women with CAH or G1EC, who meetings, lectures, one-on-one consultations, mutual-
desire fertility preservation. However, there still remains a help groups and medical complications treatments in a
risk of disease progression and recurrence. Therefore, close timely manner. In this system, oncologists gave lectures
follow-up is important during treatment and after CR. In on treatment side effects, the importance of follow-up
addition, a hysterectomy is recommended as a definitive and the guidance on diet, physical exercise and infection
treatment after completion of childbearing. prevention. In TM, on the other side, the follow-ups were
performed by hospital oncologists and nurses, in which no
intervention was performed.
PO-4022 RESULTS: RESULTS: Physical factors influencing the QoL
mainly included general weakness, weakness in the arms/
The quality of life in gynecologic cancer
legs, fatigue and insomnia. Mental and psychological
survivors under community health services
impacts were the role, emotions, cognitive power,
model in Beijing
social functions and sexual functions which include sex
interest，sexual activity，sex enjoyment and vagina dryness.
CHUNYU XU1, JINWEI MIAO2
Improvements in skin problems, pain, constipation, the
1
Beijing Obstetrics and Gynecology Hospital, Capital Medical
feeling of being less attractive, worrying about the future
University, Beijing, China, 2Department of Oncology, Beijing
and vaginal dryness during sex were observed in the
Obstetrics and Gynecology Hospital, China
CHSM, in which the outcomes of items related to role,
emotion, and cognitive power and social functions as well
OBJECTIVE: Background: With improvements in diagnosis
as pain and constipation were much better compared with
and treatment, the cancer patient’s survival has been
TM group (p<0.05).
prolonged and the cancer has been a controllable chronic
CONCLUSION: Conclusions: After cancer treatment,
disease. As a result, the quality of life (QoL) of cancer
survivors were significantly affected in terms of physical
patients has received increasing attention. The gynecologic
factors, mental factors and psychological factors.
cancer involves the female reproductive and sexual organs,
Comprehensive interventions implemented by hospital
which indicates that the treatments on gynecologic cancer
oncologists and community clinicians under the CHSM
are associated with not only physical and psychological
could effectively improve the QoL of gynecologic cancer
changes but also those involving the female role and sexual
survivors.
activity. Therefore, it is a long-term goal to help gynecologic
cancer survivors to better understand their disease,
restore their confidence and improve their QoL. With the
PO-4023
development of community health services in China, a
trend of establishing a Community Health Services Model A case of primary clear cell adenocarcinoma
(CHSM) in which hospital oncologists and community of the broad ligament
clinicians share responsibilities has emerged. OBJECTIVE: To
evaluate impacts on QoL of gynecologic cancer survivors Naoko Komura, Ai Miyoshi, Takeshi Miyatake, Takeya Hara,
under CHSM. Asuka Tanaka, Shinnosuke Komiya, Serika Kanao, Masumi
METHODS: METHODS: A total of 62 gynecologic cancer

Takeda, Mayuko Mimura, Masaaki Nagamatu, Takeshi Yokoi
patients in Beijing Obstetrics and Gynecology Hospital Department of Gynecology, Kaizuka City Hospital, Osaka, Japan
Poster Session
and Daxing Hospital were recruited and assigned to the

CHSM group or the traditional model (TM) group. The QoL OBJECTIVE: A case of clear cell carcinoma of the broad
between two groups was compared using the European ligament is reported.
368
METHODS: A 43-year-old woman visited our hospital frequently from the peritoneum, and characterized by
due to a leiomyoma. The tumor was located dorsal to various types of presentation, sometimes with other tumors.
the right side of the cervix and enhanced on magnetic Herein we present a female with high risk of asbestose
resonance imaging (MRI). The patient’s serum CA125 exposure, had past history of cervical adenosquamous
level was normal. Prospective differential diagnoses ware carcinoma (ASC), and developed peritoneal MM, with rare
carcinosarcoma, leiomyoma with degeneration or tumor but fulminate presentation.
of broad ligament. We performed laparotomy and found METHODS: A 45 years old female, manage for curtain
the tumor encapsulated within the right broad ligament. industry, was diagnosed cervical ASC FIGO stage Ib1 status
The tumor was tightly adhesed and invaded to the surface post laparoscopic nerve sparing radical hysterectomy
of the rectum. The cytology of ascites was negative. The with bilateral salpingo-oophorectomy and bilateral pelvic
pathological report on the frozen section of the tumor lymph nodes dissection. The final pathology reported poor
was adenocarcinoma. We performed modified radical differentiated ASC of cervix, with left parametrium, vaginal
hysterectomy (mRH), bilateral salpingo-oophorectomy (BSO) surgical margin and left pelvic lymph node involvement.
and partial omentectomy, removal of the pelvic lymph Due to above risk factors, adjuvant concurrent chemo-
nodes. The tumor measured 3.8cm in diameter and was radio-therapy (CCRT) were prescribed. She underwent
unattached to the uterus, bilateral ovary or fallopian tube. regular follow up and there is no evidence of recurrence.
Histological examination revealed tumor tissue consisting However, one year after operation, she suffered abdominal
of hobnail appearance. The tumor cells were negative for fullness with vague pain and acid regurgitation after meal
WT-1, p-53, ER, PGR and vimentin. We found metastasis for one month. Massive ascites, enlarged omentum, right
on one of the right internal iliac lymph nodes. Final renal infarction maybe due to metastasis or tumor emboli,
pathological diagnosis was clear cell adenocarcinoma of elevated CA-125 (415.8 U/mL) and CEA (58.2 ng/mL)
the broad ligament (pT2bN1M0). were detected. Deep vein thrombosis (DVT) of right leg
RESULTS: The patient received the adjuvant chemotherapy was also noted so that anticoagulant was given. Explore
with paclitaxel and carboplatin for six courses. laparotomy for debulking and decompression showed
CONCLUSION: Primary malignant tumor arising in the broad

massive ascites with huge omentum adhere over transverse
ligament is extremely rare. To our knowledge, only 26 cases colon and less gastric curvature, diffused carcinomatosis
have been reported to date. The tumor should be treated over small bowel and large bowel and thicken bowel wall
as like as ovarian cancer. We report the tumor of the broad of a segment of small bowel, though without peritoneal
seeding. The pelvic cavity was also clear without tumor.
ligament with literature review.
Omentectomy and adhesiolysis were performed. The final
pathology was poorly differentiated carcinoma. By the
PO-4024
histomorphology and results of immunophenotype, a MM
is favored. The patient suffered progressed DVT of right
Malignant mesothelioma of the omentum leg caused impending gangrene change and amputation
with seeding on intestine after therapy for was performed. However, systemic thrombo-embolism
cervial adenosquamous carcinoma, presenting progressed even under anticoagulant. She was died one
progressed systemic thrombosis – an unusual month later due to systemic embolized infarction and
but fulminate clinical course, one case report respiratory failure.
RESULTS: Asbestos exposure is the most important risk
Yihung Sun, Yue-Shan Lin, Kuo-Feng Hung, Chieh Yi Kang, factor for MM, prior therapeutic radiation has also been
Sheng-Tsung Chang postulated as a causative factor. Clotting abnormalities
Department of Obstetrics and Gynecology, Chi Mei Medical Center, occur in 10~20 % of MM. Cervical cancer along or treated
Tainan City, Taiwan with CCRT are also considered associating increased
Poster Session
incidence of venous thromboembolism (VTE).

OBJECTIVE: Malignant mesothelioma (MM) is an insidious CONCLUSION: Peritoneal MM is a rare entity whose
neoplasm arising most commonly from the pleura, less pathomechanism is not yet fully understood and early
369
diagnosis is difficult. In this case, both asbestos exposure day after discharge, she had massive genital bleeding at
and previous radiation may contributed to its development. home and had to be admitted again. We considered that
In addition, clotting abnormality associated with MM the continuous bleeding was caused by the retention of
and cervical cancer may explain the fulminate process placenta or placental polyp, and performed hysteroscope
of systemic VTE. It is to be observed that both MM and to confirm and cure those diseases, and we found out a
distal metastasis from cervical ASC characterized variant small white nodule and removed it.
histological presentation, and the combination of them RESULTS: Histological examination showed the chorionic villi
may be meaningful. on the surface of a small white nodule and the increase of
intermediate trophoblasts without nuclear division on the
surface to endometrium. These intermediate trophoblasts
PO-4025 were immunoactive for human placental lactogen (hPL), Ki-
67 and CD146, but negative for hCG. The Ki-67 labeling
A case of exaggerated placental site
index was only 2%. We diagnosed this nodule as EPS from
diagnosed by hysteroscopic biopsy
a histologically.
CONCLUSION: After hysteroscopic resection of the EPS,
Chiharu Tomonaga, Eiji Shibata, Taeko Ueda, Yoko Aoyama,
genital bleeding was stopped and her serum hCG level
Atsushi Toyama, Yukiyo Aiko, Satoshi Aramaki, Hirohide
became negative 1 week later.
Inagaki, Toru Hachisuga
Department of Obstetrics and Gynecology, University of

Occupational Environmental Health, Fukuoka, Japan
PO-4026
OBJECTIVE: Exaggerated placental site (EPS) is defined The curious case of a deviant mole:
as a non-neoplastic intermediate trophoblastic lesion, a case of an invasive mole metastatic to the
which infiltrate exaggeratedly into endometrium and ovary
myometrium. Normal, ectopic, abortus, or molar pregnancy
may cause EPS and endometrium curratage may cure this Julienne Katrina Beltran1, Marcella Cabatu2, Anne Marie
Trinidad2, Ma. Corazon Zaida Gamilla2
disease. However, it is difficult to distinguish EPS from
1
placental site trophoblastic tumor (PSTT), therefore EPS is Department of Obstetrics and Gynecology, University of Santo
often diagnosed by total hysterectomy. We report a case Tomas Hospital, Manila City, Philippines
of EPS which is diagnosed by endometrium biopsy after 2

Philippine Obstetrical and Gynecological Society, Philippines
artificial abortion.
METHODS: Artificial abortion using gemeprost suppositories OBJECTIVE: The aims of this report are the following: 1.
was performed with a 30-year-old pregnant woman, Present a rare case of invasive mole metastatic to the ovary
gravida 0 para 0, whose fetus was anencepalus at 13 2. Review invasive mole, its incidence and different site of
weeks gestation. She had a continuous genital bleeding metastasis 3. Discuss the different approaches to diagnosis
until 38days after deliver and she lost her consciousness and 4. Analyze the management done in the present case
and fell down by anemia at home, and was transported METHODS: This case report emphasizes the rarity of the
to hospital. A transvaginal ultrasonogram showed massive case and how it can present differently, posing diagnostic
bleeding into the cavity of uterus and hypervascular area dilemma. A high index of suspicion in cases of previous
in posterior myometrium with color dopplar, and 1cm molar pregnancy will direct to the right diagnosis and
diameter nodule was discovered by magnetic resonance appropriate management of metastatic Invasive Mole.
imaging (MRI). The retention of the placenta or placenta RESULTS: This is a 33 year old, G3P1 (1021), presenting
polyp were suspected. Her hemoglobin (Hb) was 6.6g/dl with left lower quadrant pain. The positive pregnancy
Poster Session
and serum human chorionic gonadotropin (hCG) level was test and previous complete mole, lead to the impression,
16.7mIU/ml. After transfusion, genetal bleeding decreased Gestational Trophoblastic Neoplasia, probably ruptured vs.
spontaneously and observation course was chosen. One Ectopic Pregnancy. On laparotomy, a right ovarian mass
370
exuding vesicular tissues and a bluish-black discoloration 84 ( (9.78%) with CIN3 and 6 patient with invasive cervical
at the right postero-lateral aspect of the uterus were cancer in this cohort study. After stratified with age,there
noted. With these findings, total abdominal hysterectomy is an Odds ratio of 0.323 in patients younger than 30
with right salpingo-oophorectomy was performed. harboring with CIN2+, an odds ratio of 0.948 in patient
Histopathologic examination revealed an invasive mole aged 30-49 and an odds ratio of 2.735 in patients age 50
metastatic to the ovary. and older
CONCLUSION: Though the possibility of invasive mole CONCLUSION: Immediate colposcopy could be an effective
metastasizing to the ovary is not an impossibility, simply and feasible way of triage for patients with poor recall rate
because of the adjacency of both organs, this case is and in older age group
still of great interest. This is the very first time that such
occurrence is being accounted and reported, not only
here, but globally, as well. This is a manifestation that truly, PO-4028
invasive mole, as its name implies, can invade or overrun
Adenoid cystic carcinoma of vulva-A case
any organ for that matter, far or near, as the latter in our
series
case, the neighboring ovary. The impression of GTN at any
given time and place, should spark the curiosity in us, “What
Leena Rose Johnson, Rema Prabhakaran Nair, Suchetha
and where it is this time?” And this time, it is the ovary! Sambasivan, Iqbal Ahamed
Department of Surgical Oncology, Regional Cancer Centre,

Thiruvananthapuram, India
PO-4027
The role of immediate colposcopy in Atypical OBJECTIVE: To study the clinical profile and outcome of
Squamous Cells of Undetermined significance adenoid cystic carcinoma of vulva treated at Regional
(ASCUS)- A revisit Cancer Centre,Thiruvananthapuram
METHODS: This is a retrospective, record based study of
KIM-SENG LAW adenoid cystic carcinoma of vulva treated at Regional
Department of Obstetrics and Gynecology, Tung's Taichung Metro Cancer Centre, Thiruvananthapuram from January 2005 to
Harbor Hospital, Taichung, Taiwan September 2015.
RESULTS: Only four patients were diagnosed with adenoid
OBJECTIVE: To investigate the role of immediate colposcopy cystic carcinoma of vulva during the ten years and nine
in uncompliance population diagnosed with atypical months under study.The longest period of follow-up was
squamous cells of undetermined significance and to 123 months.Age at diagnosis ranged from 32-43 years.
evaluate the odds ratio of having CIN2+ in different age All patients were married,parous,premenopausal and
categories presented with labial swelling.Two patients experienced
METHODS: We conducted a retrospective study of 184,938 pain,burning micturition and pruritus with progressive
Pap smear done between 2004-2012 in our hospital and increase in size of the lesion.The duration from the
probing into the incidence of premalignant or malignant detection of the vulval swelling to surgical treatment ranged
disease in 1607 patient with the diagnosis of ASCUS from 6 months to 5 years.All patients had involvement of
with 849 patients underwent immediate colposcopy and the bartholins gland site with normal appearing overlying
calculated the odds ratio in three different age group skin.Surgical treatment included wide excision and
RESULTS: There were 1607 patients with ASCUS and unilateral groin dissection in one patient, and only wide
661patients were excluded due to lost follow up or excision in the rest.The maximal tumour dimension ranged
having a history of cervical cancer,57 patients underwent from 2-12 cm. Three patients who had microscopic positive
Poster Session
repeat cytology with 40 triage with hight risk HPV and the margin (despite re-wide excision in two) received adjuvant
remaining 849 patients proceed to immediate colposcopy radiotherapy.Perineural infiltration was documented in two
There were 92 (10.71%) of histology all confirmed CIN2 cases.Lymphvascular space invasion was documented in
371
one case but there was no lymph node involvement either application in the TC-1 tumor model.
at diagnosis or during follow-up for any of the patients. METHODS: The experimental groups were divided into
Two patients had recurrence of disease. The disease-free 4 groups based on treatment; control, GMCSF, E7DNA
interval was 118 months for one patient and 23 months vaccine, and GMCSF with E7DNA vaccine. The construction
for the other. In both, local (vulval) and distant (multiple of the CRT/E7 plasmid DNA vaccine (pNGVL4a-CRT/
lung) metastases were detected simultaneously.Compared E7 (detox)) was used in this study. For the in vivo tumor
to the patient who had a disease-free interval of 118 experiments, 2x10^4 TC-1 tumor cells, an E7-expressing
months, the patient with disease-free interval of 23 months murine tumor model, were injected into the vaginal cavity.
had a longer symptom onset-treatment interval (5yrs vs Tumor growth was confirmed by IVIS2000 system on
2 yrs);larger tumour-size (12cm vs 2cm),and perineural three days after tumor injection. Four days after tumor
infiltration at diagnosis.Both received adjuvant radiotherapy challenge, mice were vaccinated with 40 µg of pNGVL4a-
for positive margin.The patient with shorter disease-free CRT/E7 (detox) via intramuscular injection. Mice received
interval,died of the disease,25 months after the detection a booster vaccination at three day intervals for a total of
of recurrence while the other is still alive with disease at three vaccinations. Ten days after tumor challenge, mice
last follow up (i.e 2 months after detection of recurrence). were injected with 100ng GMCSF via intravaginal injection
CONCLUSION: Adenoid cystic carcinoma of vulva is an 3 times at 2 day intervals. 21 days after tumor challenge,
extremely rare, slowly progressing neoplasm mainly spleen, draining lymph node, and TC-1 tumors from
involving the Bartholin’s gland.It usually presents as labial the tumor bearing mice treated with various treatment
swelling involving the site of Bartholin’s gland with normal regimens were surgically excised. And then it was
appearing overlying skin.The clinical presentation may stained with phycoerythrin (PE)-conjugated HPV16 H-2D-
mimic benign bartholin's cyst.Misdiagnosis and delay in RAHYNIVTF tetramer combined with surface staining using
treatment is therefore possible.The usual treatment includes APC-Alexa Fluor-conjugated anti-CD8. Intracellular IFN-y
wide excision and adjuvant radiotherapy (if required).There was stained with FITC-conjugated anti-mouse IFN-gamma.
may be late local and distant recurrence.Awareness of late RESULTS: Our data indicated that the combination of
recurrence and the need for long term vigilance is to be systemic E7 DNA vaccination followed by local GMCSF
inculcated among patients. administration induced effective tumor control. Importantly,

40% of the mice vaccinated with CRT/E7 DNA and
followed by GMCSF injection survived for at least 80 days
PO-4029 after tumor challenge, while all the mice in other treatment
groups died within 50 days after tumor challenge. Mice
Granulocyte macrophage colony-stimulating treated the DNA vaccine and GMCSF combination showed
factor induces local accumulation of dendritic significantly reduced tumor growth as measured by
cells and antigen-specific CD8+ T cells and bioluminescence intensity compared to mice treated with
enhances the efficacy of therapeutic vaccine CRT/E7 DNA vaccination alone or GMCSF alone. A much
in cervicovaginal tumor greater percentage of E7-specific CD8+ T cells cultured
with the DCs isolated from the tumor-bearing mice treated
Sungjong Lee1, CF Hung2, TC Wu2 with GMCSF secreted IFN-y compared to the T cells
1
Department of Obstetrics and Gynecology, St. Vincent Hospital, cultured with d DC isolated from tumor-bearing mice not
2
The Catholic University of Korea, Suwon, Korea, The Johns treated with GMCSF. These results suggest that GMCSF can
Hopkins University Medical institution, Baltimore, USA enhance antigen cross presentation by DC, which results in
greater antigen specific CD8+ T cell activation, contributing
OBJECTIVE: Granulocyte macrophage colony-stimulating to anti-tumor effect and leading to tumor control .
factor (GMCSF) has been reported to have the ability to CONCLUSION: We found that therapeutic CRT/E7 DNA
Poster Session
induce migration of antigen presentation cells and CD8+ vaccination followed by local GMCSF application resulted
T cells. Therefore, we employed a combination of systemic in both systemic and local increase of antigen-specific
therapeutic HPV DNA vaccination with local GMCSF CD8+ T cells in mice bearing cervicovaginal tumor and that
372
local application of GMCSF promotes local accumulation, spontaneous vaginal delivery and one spontaneous
maturation and enhance over all cross presentation of abortion (gravida4, para3). Transvaginal ultrasonography
dendritic cell. described an enlarged uterus for her age, and an echogenic
mass in the endometrium. Endometrial dilatation and
curettage resulted in complete hydatidiform mole. No other
PO-4030 lesion of metastasis was detected with chest and head CT
examinations. We performed abdominal hysterectomy and
Two cases of complete hydatidiform mole,
bilateral salpingo-oophorectomy. We had not done any
occurred in perimenopausal women
additional therapy, serum HCG level had spontaneously
become negative after 3 months from the surgery. There is
Serika Kanao, Ayaka Nakashima, Naoko Komura, Asuka
Tanaka, Shinnosuke Komiya, Masumi Takeda, Ai Miyoshi, no recurrent disease for 6 months.
Mayuko Mimura, Takashi Miyatake, Masaaki Nagamatsu, CONCLUSION: We experienced extremely rare cases of
Takeshi Yokoi complete hydatidiform mole at perimenopausal age. In

such ages, hydatidiform mole seemed hard to be taken into
Department of Gynecology, Kaizuka City Hospital, Osaka, Japan
consideration as differential diagnosis at first consultation.
Hysterectomy can be considered as an appropriate
OBJECTIVE: Gestational trophoblastic disease (GTD)
treatment option.
generally occurs in women of the reproductive age and is
rare in perimenopausal women.
METHODS: We describe two case reports of 50-years-old
PO-4031
woman presenting with an invasive hydatidiform mole.
RESULTS: Case1: A 50-years-old woman presented with an Mothers’ awareness of the cervical cancer
abnormal genital bleeding after two months of amenorrhea. prevention for adolescent girls in Korea
Her obstetrical history was 1 normal spontaneous vaginal
delivery and 2 abortions (gravida3, para1). Transvaginal Hae Won Kim
ultrasonography revealed an enlarged uterus with College of Nursing, The Research Institute of Nursing Science,
endometrial thickening of complex echogeneous pattern. Seoul National University, Seoul, Korea
An endometrial cancer was primarily suspected and the
endometrial biopsy revealed decidual tissue. Her serum OBJECTIVE: The aim of this study was to determine how
HCG level was over 225000mlU/mL. Chest X-ray showed aware mothers are about cervical cancer prevention for
multiple lung lesions, which are confirmed as metastatic their adolescent daughters, with a view to developing
lesions with CT scan. Abdominal hysterectomy and bilateral strategies for expanding primary cervical cancer prevention
salpingo-oophorectomy are operated. The histopathological for adolescent girls through the mothers’ involvement.
examination resulted in an invasive hydatidiform mole. METHODS: A qualitative design was employed. Nine
Prior to the operation, newly occurred vulvar bleeding mothers living area in Seoul with adolescent daughters
revealed a metastatic lesion on right labia minora, it was participated in this study and were interviewed using
histologically confirmed as metastatic lesion of mole. With open-ended questions. The snowball method was used to
the final diagnosis of metastatic invasive mole, she received select the mothers.The themes were extracted by content
adjuvant chemotherapy with methotrexate (20mg/body, analysis.
5days for a course of treatment). Serum HCG level reached RESULTS: : Mothers’ awareness of cervical cancer was
negative after 4 courses of methotrexate. The additional 2 not clear, and they exhibited a lack of awareness of the
courses of methotrexate has been completed and there is importance of having a regular Papanicolaou screening
no recurrent disease for 6 months. Case2：A 50-years-old test. The mothers recognized that they were role models
Poster Session
woman consulted to our hospital with lower abdominal for their daughters, and realized and accepted the necessity
pain and abnormal genital bleeding. Her last menstruation of educating their daughters regarding cervical cancer;
was 3 months before. Her obstetrical history was 3 normal however, they perceived barriers related to the prevention
373
of cervical cancer in their daughters. The mothers in the RRSO group was 7.3 months (range, 0.6–33.9).
recommended enforcing sex education in schools and the The prevalence of amenorrhea was greater in the RRSO
provision of financial support for HPV vaccination. group than in the non-RRSO group (59.1% vs. 20.0%;
CONCLUSION: The mothers’ awareness and preparedness P=0.010). More women in the RRSO group consulted with
with respect to the prevention of cervical cancer in their gynecologic oncologists (95.5% vs. 60.0%; P=0.008). In
adolescent daughters were both low and inadequate. multivariate analyses, amenorrhea at the time of genetic
Mothers should be informed and motivated to play a role counseling (OR, 16.44; 95% CI, 1.16-232.82; P=0.038)
in the education of their daughters regarding cervical and consultation with gynecologic oncologists (OR, 30.78;
cancer prevention. Strategies for disseminating information 95% CI, 1.34-707.21; P=0.032) were identified as factors
regarding early cervical cancer prevention for adolescent affecting the carrier’s decision to undergo RRSO. One
girls are recommended by communicating with both the patient in the non-RRSO group (5.0%) developed primary
girls and their mothers and providing them with education peritoneal carcinoma, which was diagnosed 4.6 years after
regarding cervical cancer prevention. Ackowledgement: genetic testing.
This work was supported by Basic Science Research CONCLUSION: The uptake rate of RRSO among BRCA1/2
Program through the National Research Foundation of mutation carriers was affected by the presence of
Korea (NRF) funded by the Ministry of Science, ICT & Future amenorrhea and consultation with gynecologic oncologists.
Planning (grant number: 2015-R1-A1-A3A0-4001267) Gynecologic oncologists with clinical experience with
ovarian cancer should play a major role in aiding carriers’
decision-making concerning RRSO.
PO-4032
Uptake of risk-reducing salpingo-

PO-4033
oophorectomy among female BRCA mutation
carriers: Experience at the national cancer The safety of gynecologic surgery combined
center of Korea with panniculectomy for highly obese women
Se Ik Kim1, Myong Cheol Lim2, Dong Ock Lee2, Sun-Young Kazuto Tasaki1, Kouichirou Kawano1, Shingo Tasaki1, Shin
Kong2, Sang-Soo Seo2, Sokbom Kang2, Eun Sook Lee2, Sang- Nishio1, Naotake Tsuda1, Gounosuke Sonoda1, Kimio Ushijima1,
2
Yoon Park Hiroaki Tanaka2, Hideaki Rikimaru2, Kensuke Kiyokawa2
1 1
Department of Obstetrics and Gynecology, Seoul National Department of Obstetrics and Gynecology, 2Department of Plastic
2
University College of Medicine, Seoul, Korea, Center for Uterine and Reconstructive Surgery and Maxillofacial Surgery, Kurume
Cancer, National Cancer Center, Goyang, Korea University, Fukuoka, Japan
OBJECTIVE: The aim of this study was to identify the uptake OBJECTIVE: A panniculectomy is designed to remove a
rate of risk-reducing salpingo-oophorectomy (RRSO) and the pannus* of loose skin and fat from the abdomen. To reduce
factors affecting this rate among female BRCA1 or BRCA2 the operative morbidity, the combination of abdominal
mutation carriers at the National Cancer Center of Korea. panniclectomy and pelvic surgery were reported for highly
METHODS: Between April 2007 and December 2014, 450 obese women with gynecologic tumors. We introduced
women underwent BRCA gene testing, and 97 women this procedure by the cooperation with the Kurume
were found to have BRCA1/2 mutations. Through the University Department of Plastic and Reconstructive Surgery
review of medical records, 42 candidates for RRSO were and Maxillofacial Surgery. The purpose of this study is to
identified. Of these, 22 underwent RRSO. Demographic, evaluate the clinical benefit of panniculectomy combined
clinical, and consultation-related factors were compared with pelvic surgery for obese women with gynecologic
Poster Session
between the RRSO and non-RRSO groups. tumor.*Pannus : abdominal layer of fibrovascluar tissue or
RESULTS: The uptake rate of RRSO was 52.4%. The granulation tissue.
mean time interval between genetic testing and surgery METHODS: We reviewed the patients’ records of 13 cases
374
more than 35 kg/m2 in body mass index (BMI) received practice. This study is to validate 3-year follow-up rate, a
pelvic surgery combined with panniculectomy at Kurume newly developed real-time EMR-based surrogate marker
University Hospital since November, 2012 to September for survival outcomes in gynecologic cancer patients, by
2015. The procedure was carried out as follows. After evaluate the correlation with 5-year survival rates.
removing subcutaneous fat tissue, the fascia was entered METHODS: Three-year follow-up rate was defined as a
vertical incision. Gynecological procedure was done as proportion of the patients with hospital visit records on
routinely. Some patients received liposuction for cosmetic EMR during the period of 37 to 48 months after the initial
reason. Fascia was closed by Smed & Jones technic and skin diagnosis of the cancer in the whole population with the
was closed by dermostich. Four subcutaneous closed suction initial diagnosis of the cancer at Seoul National University
drainages were placed until drainage fluid became scanty. Bundang Hospital. Five-year survival rates were calculated
RESULTS: The median age of the cases was 50 (19 - for the patients with cancer of uterine cervix, ovary, and
70) years and the median BMI were 39 (30-59) kg/ endometrium every year from 2003 to 2010. Patients who
m2. Patients included seven endometrial cancers, two lost follow-up within 1 month after the diagnosis of the
borderline malignant ovarian tumors, two myomas of the cancer were excluded. The correlations of yearly trends
uterus, one huge benign ovarian tumor and one cervical between 3-year follow-up rates and 5-year survival rates
adenosarcoma. The gynecologic surgery included ten were evaluated according to the type of cancer.
total abdominal hysterectomy, two adnexectomy and one RESULTS: During the median follow-up of 21.5 months
myomectomy. The median operative time was 505 (355 (range 2-130 months), a total of 329 mortalities were
- 595) minutes and the median blood loss was 458 (70 confirmed by the database of the Ministry of Public
- 3,230) g, and blood transfusion was given in one case. Administration and Security. Three-year follow-up rates
Wound complication was seen in 3 cases, but they were for all gynecologic cancer had excellent correlations with
managed conservatively. No other serious complications 3-year (rho 0.700, p<0.001) and 5-year survival rates
such as fat embolism or thromboembolism were found. (rho 0.502, p=0.007). Three-year follow-up rates showed
The median of the hospital stay was 18 (13-24) days. excellent correlations with 3-year survival rates for cervical
Prognosis of gynecologic disease was favorable. (rho 0.952, p<0.001) and ovarian cancer (rho 0.857,
CONCLUSION: The pelvic surgery combined with p=0.007), however, not for endometrial cancer (rho 0.515,
panniculectomy has less morbidity and effectiveness for the p=0.192). Three-year follow-up rates failed to show a
highly obese patients with gynecologic tumors. significant correlation with 5-year survival rates in individual
cancers: cervical (rho 0.357, p=0.432), ovarian (rho 0.536,
p=0.215), and endometrial cancer (rho 0.500, p=0.253).
PO-4034 CONCLUSION: Three-year follow-up rates could be used
as a real-time EMR-based surrogate marker for survival
A real-time EMR-based surrogate marker
outcomes in overall gynecologic cancer patients. Further
for survival outcomes in gynecologic cancer
studies are needed for validating their clinical usefulness in
patients: 3-year follow-up rate
individual cancer types, especially according to the stage.
Byung Su Kwon

PO-4035
University Bundang Hospital, Seongnam, Korea
Symptom severity in gynecological oncology
OBJECTIVE: Improvement of survival outcomes are ultimate patients receiving paclitaxel and carboplatin
goal of treatment in patients with cancer. Five-year survival
rates, one of the most commonly used markers for survival Rachadapan Chaitosa
Poster Session
outcomes, is not easy to calculate frequently. A surrogate Department of Gynecology Oncology, Ramathibodi Hospital,
marker with easy accessibility and high quality could be Bangkok, Thailand
of much help to objectively evaluate the recent oncologic
375
OBJECTIVE: Gynecological oncology patients were distress Kaen, Thailand
from cancer and treatment symptom severity. To pass the
suffering period of life is meant that patients can pass OBJECTIVE: Although, a mammography was the best tool
every symptoms of treatment. Purpose of this part of the for detection and screening breast cancer but in Thailand,
longitudinal study was to examine the severity grading of mammography is unable to provide for all women for many
symptoms occurred in gynecologic oncology patients after reasons. In Thailand; information on the opportunistic
receiving the 3rd cycle of Paclitaxel and Carboplatin. mammography screening is limited. The incidence of breast
METHODS: One hundred and ten patients were recruited cancer was also lacking. . The aims of the study was to
from gynecologic oncology department in a hospital estimate the breast cancer detection rate by MMG, the
affiliated university. The National Cancer Institute Symptom prevalence at the first MMG, and the incidence at each
Severity Diary and the Demographic, Disease, and subsequence follow-up MMG among Thai womenI
Treatment Questionnaires were used to collected data. METHODS: We prospectively followed 47,430 normal
The National Cancer Institute Symptom Severity Diary was women age of 30-80 years old that underwent
recorded from the 1st day to 14th day after the 3rd cycle of opportunistic mammography screening at a breast cancer
chemotherapy. Descriptive statistic was used for analyzing center in a tertiary hospital in Thailand between January
data. 2001 and December 2010. The mammography was based
RESULTS: Results reported top 5 most symptom severity on opportunistic screening and all women were followed
were different at each day after receiving chemotherapy. and repeated MMG approximately twice a year until
They were fatigue, numbness, pain, difficulty sleeping, and December 2012. The maximum number of the follow-up
constipation. Fatigue increased the severity grade during MMG was 10. The detection rate was calculated for the
day 4-6; Numbness increased the severity grade during whole period of observation using number of women with
day 4-7; Pain increased the severity grade during day 4-5; positive findings divided by the total number of women
Difficulty sleeping increased the severity grade during day who were screened. The prevalence was calculated only
3-6; and Constipation increased the severity grade during at the first MMG while the incidence rate was calculated
day 1-9. based on all new cases detected at each subsequence
CONCLUSION: Result findings can be provided an evidenced MMG.
data for appropriate side effects’ management in each day RESULTS: Of the 47,430 women, there were 152,091
of first cycle of Carboplatin and Paclitaxel in gynecological MMGs or approximately 3.2 occasions per person (range
oncology patients. It can be reduce symptom distress and 1-10). Rates of returning visit were 68.2 % and 47.3% for
improve their quality of life. the second and the third MMG. However, 1,291 (2.7%)
women returned for their tenth MMG screening. An
average duration of the interval between each subsequence
PO-4036 visit was 1.8 years. Overall, breast cancer was detected
in 543 women, with a detection rate of 11.83 per 1,000
Breast cancer detection rate, the prevalence
persons (95%CI: 10.58 to 12.52). The prevalence of breast
and incidence of breast cancer among Thai
cancer at the first visit was 5.78 (95%CI: 5.11 to 6.50) per
women by opportunistic mammography
1,000 persons. The incidence or new cases detected at any
screening
follow-up visits was 10.36 (95%CI: 9.46 to 11.31) per 1,000
1 2
Nintita Sripaiboonkij , Voranuj Tangcharoensathien , Suthee persons. The overall interval cancer was 0.87 per 1,000
3
Rattanamongkolgul , Bandit Thinkamrop 4
women, mainly detected before their second and third
1 MMG, with a rate of 0.42 and 0.43 per 1,000 women
Department of Cancer Registry, Ramathibodi Hospital, Bankok,
2 CONCLUSION: Opportunistic mammography screening in
Thailand, Thanyarak Breast Center, Siriraj Hospital, Mahidol
University, Bankok, Thailand, 3Department of Preventive and Thailand detected a case of breast cancer from every a
Poster Session
Social Medicine, Faculty of Medicine, Srinakharinwirot University hundred women. After the first screening there should
4
Ongkharak, Nakhon Nayok, Thailand, Department of Biostatistics be at least two rounds of follow up screening annually.
and Demography, Faculty of Medicine, Khon Kean University, Khon Annually screening were no benefit for detected. To
376
estimate mean sojourn time for Thai women by estimating neuropathy side effects.
and using information from Thai women data will be CONCLUSION: Result findings can be provided an evidenced
appropriate information for making a decision regarding to data for appropriate side effects’ management in each day
breast cancer screening in Thai women. of first cycle of Carboplatin and Paclitaxel in gynecological
oncology patients. It can reduce the symptom distress and
patients can receive effective treatment of chemotherapy.
PO-4037
Symptom clusters in Thai gynecological

oncology patients receiving first cycle of
carboplatin and paclitaxel
Rachadapan Chaitosa
Department of Gynecology Oncology, Ramathibodi Hospital,

Bangkok, Thailand
OBJECTIVE: Gynecological oncology patients have been

suffering from cancer and a set of symptom cluster from
treatment. To pass the suffering from the first cycle of
chemotherapy is meant that patients can pass all the left
five cycles of them. Purposes of this study were to examine
(1) symptom occurrence and severity after chemotherapy
day 1 to 14 and (2) the change of symptom cluster
occurrences in Thai gynecologic oncology patients receiving
first cycle of Carboplatin and Paclitaxel at day 1. 3,7, and
14.
METHODS: This is descriptive study One hundred and
ten women were recruited from gynecologic oncology
department in a hospital affiliated university. The
National Cancer Institute Symptom Severity Diary and
the Demographic, Disease, and Treatment Questionnaires
were used to collected data. The National Cancer Institute
Symptom Severity Diary was recorded from the 1st day to
14th day after first cycle of chemotherapy. Factor analysis
was used for analyzing data.
RESULTS: Results reported top five most symptom
occurrences were fatigue, numbness, anorexia, pain, and
constipation. Top 5 most symptom severity were pain,
numbness, fatigue, anorexia, and alopecia. These symptom
were change from day 1-14 after receiving first cycle
of Carboplatin and Paclitaxel. There were 2 clusters of
symptom occurrence at day 1 after receiving chemotherapy
were neuropathy side effects and gastro – intestinal effects.
At day 3, there were gastro – intestinal effects and sleep
Poster Session
pattern change. At day 7, there were gastro – intestinal

effects; neuropathy side effects; and sleep pattern change.
Lastly, at day14, there were gastro – intestinal effects and
377
Author Index
A Bae, Jaeman 370
Abiko, Kaoru 119, 243, 282, 345, 367 Baek, Ji Sun 367
Agui, Chisa 292 Baek, Min-Hyun 275, 297, 315, 352
Ahamed, Iqbal 250, 271 Bafna, Uththamchand D 152, 245, 277,
Ahmed, Saad 139 278, 298, 152
Ahn, Jung-Hyuck 300 Bafna, Uttam 270
Aiko, Yukiyo 370 Bahk, Yemi 278
Aiko, Yukiyo 370 Banno, Kouji 295
Aiso, Sadakazu 331 Batra, Kanika 271, 309, 358
Akahane, Tomoko 295 Beltran, Julienne Katrina 370
Akhtar, Naseem 272 Bhattacharya, Sanjay 339
Akhtar, Nasem 285 Bhaumik, Jaydip 121, 279, 290, 339
Ando, Hirofumi 304, 328 Billod, Jimmy Awisan 255
Ando, Hirohumi 294 Bookman, Michael 98
Andrijono, Andrijono 137, 273, 317 Budiman, Kharma 268
Anggraeni, Tricia Dewi 137, 143, 273, 307
Aoki, Daisuke 295, 331 C
Aoki, Masato 324 Cabatu, Marcella 370
Aoyama, Yoko 370 Cha, Soon-Do 271
Aramaki, Satoshi 370 Chaitosa, Rachadapan 375, 377
Armanza, Ferry 322 Chakraborti, Basumita 121, 279, 289, 290, 339
Asai, Satoshi 288, 292 Chan, Karen 90
Asaka, Ryoichi 294, 304 Chang, Bin 309
Askandar, Brahmana 125, 305, 322 Chang, Chih-Long 133
Awang, Mokhtar 309, 311, 325 Chang, Ha Kyun 316
Aziz, M. Farid 143, 307 Chang, Kyoungjin 286
Chang, Sheng-Tsung 296, 369
B Chang, Suk-Joon 41, 150, 286, 311,
Baba, Tsukasa 119, 243, 268, 282, 345, 367 312, 323, 361
Bae, Duk-Soo 256, 268, 280, 281, 293, Chang, Ting-Chang 306
298, 299, 320, 335, 342 Chang, Wei-Chung 236
378
Chang, Wen-Chun 337 Cho, Young-Jae 280
Chang, Yin-Yi 132 Choi, Chel Hun 256, 268, 281, 293,
Charoenkwan, Kittipat 297 298, 320, 335
Chay, Doo Byung 359, 362, 363 Choi, Ho Sun 143, 332
Che, Mo 245 Choi, Hyun-Jin 335, 342
Chee Meng, Yong 256 Choi, Ji Hee 363
Cheewakriangkrai, Chalong 351 Choi, Jin Young 134, 364
Chen, Chi-An 121 Choi, Joong Sub 270
Chen, Chi-Hau 306 Choi, Seungdo 120
Chen, Jen-Ruei 132 Choi, Youn Jin 145
Chen, Lumin 236 Choi, Young Soo 335
Chen, Min-Yu 132, 133 Chong, Gun Oh 149, 316, 358
Chen, Tze-Chien 306 Chu, Mandy Man Yee 251
Chen, Xiaojun 202 Chun, Mison 323
Chen, Ying 133, 309 Chung, Hyewon 271
Chen, Yu-Li 120 Chung, Hyun Hoon 56, 134, 240, 275, 278,
Chen, Yu-Li 120 279, 294, 319, 363
Cheng, Wen-Fang 121, 132 Chung, Wie-Min 236
Cheng, Xi 121 Coleman, Robert 69
Cheng, Ya-Min 306, 334 Cossair, Kathryn 132
Chenicheri, Mini 357
Cheon, Gi Jeong 275, 363 D
Cheung, Annie Nga Yin 251 Devi K, Uma 152, 245, 270, 277,
Chi, Dennis S. 38 278, 298, 365
Chia, Dr John Whay-Kuang 230 Dewi, Primaria 307
Chiang, An Jen 132, 133 Dianika, Hasra Depiesa 314
Chiang, Ying-Cheng 133 Djajasasmita, Fitriyadi Kusuma 332
Chiang, An-Jen 132, 133 Do, A Young 335
Cho, Chi-Heum 143, 271 Dong, Peixin 349
Cho, Hana 150 Dontula, Prashant 272
Cho, Hye-yon 332 Dorigo, Oliver 120
Cho, Oyeon 323 Dy Echo, Ana Victoria 249
Cho, Young Lae 149, 316, 358
379
E Hananishi, Junzo 119
Ebi, Ryuichiro 309 Handayani, Lulus 125
Edianto, Deri 356 Hara, Takeya 281, 357, 366, 368
Enomoto, Takayuki 214 Harada, Tasuku 144, 284
Erxuan, Peng 340 Harsono, Ali Budi 269
Hasegawa, Kiyoshi 327
F Hasegawa, Kosei 283
Firmansyah, Abdullah 138 Hasumi, Yoko 173
Fu, Hunh-Chun 132 He, Huanhuan 120
Fujii, Takuma 331 Heo, Eun-jin 268
Fujiwara, Hiroyuki 144, 284 Heriyanto, Agus 138
Fujiwara, Keiichi 283, 345 Higuchi, Shotaro 294, 304, 328
Fukagawa, Tomoyuki 321 Hirasawa, Akira 295
Fukasawa, Ichio 327 Hirasawa, Takeshi 288, 290, 292
Ho, Chih-Ming 306
G Ho, Weng Yan 349
Gamilla, Ma. Corazon Zaida 370 Hong, Dae Gy 149, 318, 358
Geng, Jing 138 Hong, Jin Hwa 287
Ghosh, Anik 121, 187, 279, 290, 339 Hong, Shanshan 245
Giri, Shweta 271, 358 Hong, Sung Ran 143, 328
Goel, Madhumati 343 Hong, Sung-Tae 186
Goswami, Jyotsna 289 Hood, Juliati 305
Gupta, Sameer 272, 285 Hsu, Keng-Fu 132
Gweon, Seong-Hye 311 Hsu, Shih-Tien 306
Huang, Chueh-Yi 249
H Huang, Huei-Jean 306
Hachisuga, Toru 304, 320, 370 Huang, Ruby 234
Hamanishi, Junzo 243, 282, 367 Huang, Xiao 272
Hamanishi, Junzou 345 Huang, Xiaowei 272
Hamisi, David 328 Huang, Yu-Fang 133
Han, Sangchul 343 Huh, Warner 54
Han, Su-Jin 320 Hung, CF 372
Han, Xiaotian 309 Hung, Kuo-Feng 369
380
Hung, Yao-Ching 236, 306 Jin, Jinghui 285, 329
Hur, Soo Young 145, 316, 328 Jinzaki, Masahiro 331
Hutapea, Manuel 322 Jitkasikorn, Pornsuda 299, 336
Hwang, Chang Sun 328 Jitkunnatumkul, Aurapin 297
Hwang, Jae Ryoung 280 Jo, In-Young 327
Johnson, Leena Rose 250, 371
I Johnson, Liaquat Roopesh 250
Ibrahim, Fera 317 Joo, Jungnam 330
Ida, Koichi 294, 304, 328 Jovian, Rivaldi 332
Ihira, Kei 349 Ju, U Chul 321, 332, 347, 367
Ikeda, Masae 288, 290, 292 Ju, Woong 228, 285, 300, 329, 338
Ikeda, Shunichi 128 Jung, Phill-Seung 149, 273, 291
Ikuo, Konishi 268 Jyunzo, Hamanishi 268
Imai, Yuichi 283, 345
Imai, Yuichi 283, 345 K
Imanishi, Nobuaki 331 K, Shobha 152, 298
Inagaki, Hirohide 370 Kagami, Seiji 304, 320
Inoue, Ayami 345 Kajiyama, Hiroaki 283, 287
Inoue, Junya 309 Kanao, Serika 281, 357, 366, 368, 373
Ip, Philip Pun Ching 251 Kang, Chieh Yi 296, 369
Ishikawa, Mitsuya 128 Kang, Chun 143, 328
Isohashi, Fumiaki 173 Kang, Hye-Jin 327
Itamochi, Hiroaki 144, 284 Kang, Seong Woo 286
Iwata, Takashi 331 Kang, Sokbom 131, 276, 374
Kang, Woo Dae 216, 291, 321, 347, 367
J Kang, Woo dai 332
Jang, Hyeongap 352 Kant, Ravi 272
Jeon, Seob 120 Kaoru, Abiko 268
Jeong, Dae Hoon 220, 328, 0 Kasamatsu, Takahiro 173
Jeong, Mi Seon 143, 343 Kashima, Hiroyasu 294, 304, 328
Jeong, Seong Hoon 285 Katabuchi, Hidetaka 159, 306
Jiang, Rong 121 Kataoka, Fumio 295
Jianliu, Wang 138, 251, 313, 340 Kato, Hidenori 324
381
Kato, Kazuyoshi 43 Kim, Jae-hoon 103, 362, 363
Kato, Kiyoko 206 Kim, Jae-Weon 134, 278, 279, 294, 319, 363
Kato, Tomoyasu 128 Kim, Jhin Gook 335
Kawagoe, Toshinori 304, 320 Kim, Ju-Hyun 149
Kawano, Kouichirou 374, 343 Kim, Ki Hyung 301, 302, 338, 354
Kay, Chul Seung 327 Kim, Ki Tae 143
Ke, Yu-Min 132 Kim, Kidong 134, 269, 364, 365
Ke, Yu-Min 132 Kim, Meseon 134
Kee, Mee-Kyung 143 Kim, Mi-Kyung 143
Ken, Yamaguchi 119, 243, 268, 282, 345, 367 Kim, Min Kyu 119
Khaidirman, Sarah Dina 356 Kim, Miseon 364, 365
Khatun, Sabera 139 Kim, Moon-Hong 127
Khonsa, Oni 319 Kim, Myungsoo 327
Khunamornpong, Surapan 351 Kim, Nam Ah 285
Ki, Jinoo 150 Kim, Se Ik 276, 300, 330, 374
Kigawa, Junzo 144, 284 Kim, Seok Mo 291, 321, 328, 332, 347, 367
Kikkawa, Fumitaka 283, 287 Kim, So Yeon 319
Kim, Beob-Jong 127 Kim, Soo Hyun 119
Kim, Bo Wook 332 Kim, Soo-Nyung 292
Kim, Byoung-Gie 66, 256, 268, 280, 281, Kim, Su Hyun 312
293, 298, 299, 320, 335 Kim, Sun Ho 300
Kim, Chan Kyo 342 Kim, Sung Jae 343
Kim, Chanyoung 338 Kim, Sung Joo 332
Kim, Dae-yeon 291, 295, 297, 315, 331, Kim, Sunghoon 232, 302, 341
347, 350, 351, 352, 353 Kim, Tae Hun 353
Kim, Hae Won 373 Kim, Tae Jin 31
Kim, Hee Jung 302 Kim, Tae-Eung 327, 361
Kim, Hee Seung 134, 212, 278, 279, Kim, Tae-Hyung 300
294, 319, 363 Kim, Tae-Joong 110, 256, 268, 281,
Kim, Hong Bae 332 293, 298, 299, 335
Kim, Hong Kwan 335 Kim, Yeon-Joo 176
Kim, Hong-Jin 329 Kim, Yong Bae 179
Kim, Hyun-Jung 338 Kim, Yong-Beom 134, 269, 364, 365
382
Kim, Yong-Wook 327 Kotani, Yasushi 284, 324, 326
Kim, Young Tae 302, 314, 341 Koumura, Naoko 357
Kim, Young-Tak 273, 275, 291, 295, 297, Krisnadi, Sofie R 138, 305
315, 331, 350, 352 Kumar, Lalit 315
Kim, Yun-Hwan 228 Kumar, Sunesh 315
Kim, Yun-Hwan 228 Kumar, Vijay 272, 285
Kim, Jong-Hyeok 273, 275, 291, 295, 297, Kumarasamy, Suresh 52
315, 331, 347, 350, 351 Kundargi, Rajshekar 270
Kim, Sang Wun 302, 341 Kurihara, Tomoko 331
Kim, Seoung Cheol 300 Kurita, Tomoko 304, 320
Kim, Yong-Man 273, 275, 276, 291, 295, Kurosaki, Akira 283, 345
297, 315, 347, 351 Kusuma, Fitriyadi 137, 332
Kitamura, Sachiko 367 Kwon, Byung Su 364, 375
Kiuchi, Kaori 327 Kwon, Hyuja 363
Kiyokawa, Kensuke 374 Kwon, Hyunja 359
Kobara, Hisanori 294, 328 Kwon, Sang-Hoon 271, 328
Kobayashi, Hiroaki 58 Kyung, Min Sun 332
Kobayashi, Mayumi 128
Koh, A Ra 270 L
Kojima, Atsumi 321 Lai, Hung-Cheng 163
Kolawole, Abimbola 139 Lasera, Ceza Kautsar 317
Komai, Kan 343 Lasminingrum, Lina 305
Komiya, Shinnosuke 281, 357, 366, 368, 373 Lau, Hei-Yu 132
Komura, Naoko 281, 366, 368, 373 Law, Kim-seng 371
Kondo, Eiji 345 Le, Tien 132
Kondoh, Eiji 282 Ledermann, Jonathan 26
Kong, Jinkyoung 359 Lee, Banghyun 269
Kong, Sun-Young 374 Lee, Chulmin 188
Kong, Tae-Wook 150, 286, 311, 312 Lee, Dong Ock 330, 374
Konishi, Ikuo 119, 243, 282, 345, 367 Lee, Donghee 374
Koo, Yu Jin 287 Lee, Doo Haeng 274
Kosaka, Nobuyuki 327 Lee, Eun Ju 286, 362, 363
Koshiyama, Masahumi 345 Lee, Eun Sook 374
383
Lee, Hyo Serk 343 Lee, Yoo-Young 256, 268, 280, 281,
Lee, Hyun Jong 275 293, 298, 299, 335
Lee, Hyun Ju 331, 350, 351 Lee, Youjung 276
Lee, Hyun-Gyo 271 Lee, Young-Jae 295, 347
Lee, Inok 302, 341 Lee, Yumi 301, 330
Lee, Jae Kwan 287 Lee, Yumi 301, 330
Lee, Je-Ho 280 Lee, Suk Woo 356
Lee, Jeong-Won 165, 256, 268, 275, 280, 281, Lekskul, Navamol 131, 249
293, 298, 299, 320, 327 Li, Jin 127, 318
Lee, Jisun 312 Li, Xiaoqi 126, 360
Lee, Joohyung 312 Liang, Sichen 251
Lee, Joong Shik 343 Lim, Myong Cheol 131, 190, 276, 300,
Lee, Jung-Yun 151, 314, 341 301, 330, 364
Lee, Keun Ho 92, 313, 316 Lim, Peter C. 112
Lee, Ki-Heon 143 Lim, Sheow Lei 256
Lee, Maria 134, 246, 278, 279, Lim, Yong Kuei 256, 349
294, 319, 363 Lin, Hao 133
Lee, Seungmee 279 Lin, Yue-Shan 323, 369
Lee, Shin-Wha 273, 275, 291, 295, Liou, Wen-Hsiung 306
331, 347, 350 Liu, Caiyan 348
Lee, Si-Chen 337 Liu, Shih-Chieh 308
Lee, Sug Hyung 145 Loho, Ditha Adriana 137
Lee, Sungjong 372 Lu, Chien-Hsing 133
Lee, Sun-Joo 292 Lu, Qun 313
Lee, Sunyoung 342 Lubis, Juhriyani M 356
Lee, Taek Sang 151, 200 Lucksom, Pesona 121, 279
Lee, Wan Ho 347 Luna, Jericho Thaddeus 249
Lee, Won Moo 270 Luo, Xuezhen 202
Lee, Won-Chul 143, 328
Lee, Yoon Hee 149, 316, 358 M
Lee, Yoon Kyung 313 Ma, Wen-Lung 236
Lee, Yoon Soon 33, 149, 316, 358 Macalinao, Maria Divina Gracia 249
Lee, Yoonna 280 Madjid, Tita H 305
384
Magno, Angelito 249 Miyazawa, Masaki 290
Manan, Hariadi 151 Miyoshi, Ai 281, 357, 366, 368, 373
Mandai, Masaki 119, 284, 324, 326 Momose, Misaki 292
Marth, Christian 106 Moon, Seung Hwan 275
Masafumi, Koshiyama 268 Morisada, Tohru 331
Massuger, Leon 360 Morita, Masakatsu 309
Masuda, Kenta 295 Motegi, Emi 327
Mat Ali, Norhuda 309, 311, 325 Motohara, Takeshi 306
Mathai, Sonia 279 Mukhopadhayay, Asima 339
Mathur, Sandeep 315 Mukhopadhyay, Asima 121, 279, 289, 290
Matsumura, Noriomi 119, 243, 268, Mulyana Hidayat, Yudi 208
282, 345, 367 Murakami, Kosuke 324, 326
Matsuura, Yusuke 304 Murakami, Naoya 173
Matsuura, Yusuke 304 Murakami, Ryusuke 282
Meilany, Sofy 317 Muramatsu, Toshinari 290
Meng, Yong Chee 256 Mvunta, David 304
Miao, Jinwei 125, 368
Miao, Yali 313 N
Mikami, Mikio 226, 288, 290, 292 Nagamatsu, Masaaki 281, 357, 366, 368, 373
Mimjra, Mayuko 281 Nagasawa, Takayuki 321
Mimura, Mayuko 357, 366, 368, 373 Nakai, Hidekatsu 284, 324, 326
Min, Kyung Jin 287 Nakajima, Rie 288, 292
Minakami, Hisanori 349 Nakamura, Kenichi 283
Mishra, Shivani 343 Nakamura, Masaru 331
Misra, Sanjeev 272 Nakashima, Ayaka 373
Mitsui, Hiroko 287 Nam, Eun Ji 161, 302, 341
Miura, Fumiharu 321 Nam, Joo-Hyun 77, 273, 275, 291, 295, 297,
Miyagawa, Chiho 296 315, 331, 347, 350, 343
Miyamoto, Tsutomu 304, 328 Nam, Kyehyun 120
Miyamoto, Tutomu 294 Nam, Se Hyun 274
Miyasaka, Aki 283, 345 Narayama, Chisa 288
Miyatake, Takeshi 281, 357, 366, 368, 373 Natarajan, Jayashree 152, 245, 277,
Miyauchi, Azumi 331 278, 298, 365
385
Ngan, Hextan Yuen Sheung 251 P
Ngu, Siew Fei 251 Paek, Jiheum 150, 286, 311, 312, 361
Niimi, Kaoru 283, 287 Paik, Doo-Jin 343
Ninomiya, Tomomi 295 Paik, E Sun 268, 281, 293, 298,
Nishio, Shin 343, 374 299, 320, 335
No, Jae Hong 134, 269, 364, 365 Paiwattananupant, Krissada 255
Noh, O Kyu 323 Pal, Angshuman Rudra 289
Nomura, Hiroyuki 295 Pal, Radhakanta 290
Noriomi, Matsumura 119, 243, 268, 282, Pariyar, Jintendra 243
345, 367 Park, Boyoung 131
Novaliani, Amirah 346 Park, Byung Kwan 342
Nugroho, Hari 125 Park, Dong Choon 358
Nuranna, Laila 137, 273, 314 Park, Dong Wook 343
Nuryanto, Kartiwa Hadi 137, 273 Park, Hyogyeong 150
Park, Hyun 278, 279, 294, 319
O Park, Jeong-Yeol 196, 273, 275, 291, 295,
Octaviani, Jessica 273 331, 347, 350, 351, 352
Ogasawara, Aiko 283, 345 Park, Jong Sup 143, 316, 318
Oguntayo, Adekule 139 Park, Jung Jae 342
Oh, In-Hwan 356 Park, Jung Min 335
Oh, Tak Kyu 301 Park, Ki Byung 330
Oh, Young-Taek 323 Park, Noh-Hyun 363
Ohsuga, Takuma 282 Park, Sang-Il 127
Oishi, Teturo 144, 284 Park, Sang-Yoon 131, 276, 300, 301, 330, 374
Okamoto, Aikou 64 Park, Sung Ho 332
Okamoto, Hiroyuki 173 Park, Sung Taek 332
Olasinde, Tajudeen 139 Park, Tae Chul 316
Omar, Jamil 256 Park, Young-Han 275, 288, 297, 315, 332
Ongkowidjaja, Indira 342 Park, Youngmee 280
Ou, Yu-Che 306 Permatasari, Ranti Pratiwi 332
Oumi, Nao 144, 284 Pichlik, Tomas 308
Ping, Bo 309
Pluta, Marek 308
386
Prabhakaran Nair, Rema 250, 371 Roy, Kishore Kumar 289
Promchana, Sopit 299, 336, 352 Ryu, Hyun Kyung 321
Promwattanaphan, Lukkana 333 Ryu, Sang-Young 127
Pujade-Lauraine, Eric 70, 71, 82 Ryu, Hee-Sug 150, 286, 311, 312, 361
Purbadi, Sigit 137, 244, 273, 319, 344
Purwana, Benny H 138 S
Purwoto, Gatot 137, 273, 314, 332 Saeteng, Charuwan 297
Sagara, Yusuke 288, 292
Q Sagara, Yusuke 288, 292
Qi, Ji 348 Saito, Fumitaka 306
Qu, Pengpeng 310, 348 Sakaguchi, Isao 306
Qureshi, Sabuhi 339, 343 Sakuragi, Noriaki 349
Salah, Ali 268
R Sambasivan, Suchetha 250, 371
Rachmasari Putri, Henny Meitri Andrie 307, 360 Sanif, Rizal 151
Rajan, Shiv 272, 285 Sato, Sho 283, 345
Rathod, Praveen 270 Sekhon, Rupinder 271, 309, 358
Ratnasari, Affi Angelia 344 Sekiya, Ryuichiro 287
Rattanamongkolgul, Suthee 376 Seo, Ju Tae 343
Rawal, Sudhir 271, 309, 358 Seo, Sang-Soo 131, 276, 300, 374
Reddy, Pallavi 277 Seoung, Jungyeob 288, 332
Rema, Prabhakaran Nair 250, 371 Shan, Boer 272
Ren, Yulan 121, 272 Shan, Weiwei 202
Ren, Yulan 121, 272 Sharma, DN 315
Rhee, Jee Eun 328 Sheu, Bor-Ching 337
Rhim, Chae-Chun 297, 315, 332, 375 Shi, Daren 272
Rijal, Pappu 137 Shi, Tingyan 121
Rikimaru, Hideaki 374 Shibata, Eiji 370
Rivany, Riza 269 Shibata, Kiyosumi 283, 287
Ro, Duck-Young 327 Shida, Masako 288, 290, 292
Rob, Lukas 308 Shim, Seung-Hyuk 192, 292
Robova, Helena 308 Shimaoka, Masao 324
Roslani, Anna Liza 325 Shin, So-Jin 271
387
Shiozawa, Tanri 294, 304, 328 Sunwoo, Jaegun 120
Shivdas, Shruthi 278 Suprasert, Prapaporn 351
Shoji, Tadahiro 321 Supriana, Nana 319
Shouji, Tadahiro 144, 284 Susanto, Herman 269, 305
Shrestha, Binuma 243 Sushama, Kalyani 271
Simin, Zhu 340 Susumu, Nobuyuki 295
Simin, Zhu 340 Sutandar, Yosep 273
Singh, Nisha 339, 343 Sutrisna, Bambang 244, 319
Singh, Uma 339, 343 Suzuki, Ayako 284, 324, 326
Singhal, Seema 315 Suzuki, Mitsuaki 144, 284
Siregar, Bundiningsih 244 Suzuki, Nao 29
Sitathanee, Chomporn 198 Suzuki, Shiro 287
Skapa, Petr 308
Sohn, Insuk 298 T
Sohn, Woo-Yun 353 Taha, Ahmed 268
Son, Joo-Hyuk 311 Tajima, Toshiki 288, 292
Song, Yong-Sang 294 Takahashi, Kenta 128
Sonoda, Gounosuke 343, 374 Takaishi, Kiyomi 306
Sripaiboonkij, Nintita 299, 333, 334, Takano, Natsuko 345
336, 352, 376 Takatori, Eriko 321
Srisomboon, Jatupol 297, 351 Takatsu, Akiko 328
Stuart, Gavin 96 Takaya, Hisamitsu 324, 326
Suchetha, Sambasivan 250, 371 Takeda, Masumi 281, 357, 366, 368, 373
Suga, Yasuko 321 Takehara, Yae 128
Sugiyama, Toru 101, 144, 284, 321 Takeshita, Sho 324
Suh, Dae-Shik 273, 275, 291, 295, 297, Takeuchi, Satoshi 321
315, 331, 347, 350, 351 Tanaka, Asuka 281, 357, 366, 368, 373
Suh, Dong Hoon 134, 269, 364, 365 Tanaka, Hiroaki 374
Suhatno, Suhatno 305 Tanaka, Kyoko 331
Sulistiadi, Wahyu 151 Tanaka, Shino 321
Sumikura, Tomoko 128 Tanaka, Yosuke 309
Sun, Yihung 296, 323, 369 Tang, Jie 121
Sung, Hye Youn 300 Tangcharoensathien, Voranuj 376
388
Tasaki, Kazuto 343, 374 V
Tasaki, Shingo 374 V R, Pallavi 270
Tashiro, Hironori 306 Van Kriekinge, Georges 353
Ten Dam, Gerdy 360 Vishnoi, Jeevan 272
Termrungruanglert, Wichai 218 Vistani, Devi R 305
Thangjam, Dhanabir 121, 279 Vitantri, Fara 244
Therasakvichy, Suwanit 86
Thinkamrop, Bandit 334, 336 W
Thonkamdee, Tanapon 299, 352 Wan, Xiaochun 309
Tobing, Maringan 222 Wang, Huaying 272
Tobiume, Takako 284, 324, 326 Wang, Jianliu 138, 251, 313
Todo, Yukiharu 324, 348 Wang, Pan 121
Todo, Yukiharu 324, 348 Wang, Peng-Hui 133
Toita, Takafumi 173 Wang, Shijun 313
Tomonaga, Chiharu 370 Wang, Xiaofeng 310
Torng, Pao-Ling 114 Wang, Xipeng 88
Toyama, Atsushi 270 Wang, Yan 60
Trinidad, Anne Marie 270 Wang, Zhiqi 251, 313
Tse, Ka Yu 251 Wang, Zhiqi 251, 313
Tsuda, Naotake 343, 374 Wei, lihui 313
Tsuji, Isao 324, 326 Wen, Kuo-Chang 306
Tsukasa, Baba 268 Weng, Chia-Sui 133
Tzeng, Ching-Cherng 323 Whang, Young Bin 356
Wibawa, Aria 344
U Wilailak, Sarikapan 299, 334, 336, 352
Udagawa, Yasuhiro 327 Winarno, Gatot N A 138, 305
Ueda, Taeko 304, 320, 370 Winarto, Hariyono 181, 342, 346
Ukita, Masayo 324, 326 Won, Je Hwan 150
Urabe, Rie 304, 320 Won, Young-Joo 276
Ushijima, Kimio 343, 374 Wu, TC 372
Utami, Tofan Widya 137, 273, 317 Wu, Xiaohua 126, 127, 272, 309, 318, 360
Utsumi, Fumi 283, 287 Wulandari, Dewi 317
389
X Yu, Mu-Hsien 133
Xia, Wei 251 Yun, Jung Yeon 301
Xian, Hui 256 Yun, Sol 343
Xie, Lan 60
Xu, Chunyu 368 Z
Xu, Congjian 245 Zakaria, Alik Riasadesa 309, 311, 325
Xudong, Liang 340 Zang, Rongyu 46, 121
Zayyan, Marliyya 139
Y Zhang, Mingxing 245
Yabuno, Akira 283, 345 Zhang, Xiaoyan 245
Yamada, Yasushi 294, 304, 328 Zhang, Yuqin 121
Yamagami, Wataru 295 Zhang, Yuqin 121
Yamaguchi, Ken 119, 243, 282, 345, 367 Zhao, Chao 313
Yamanoi, Koji 243 Zhao, Jianguo 348
Yamazaki, Hiroyuki 326 Zhao, Lijun 144
Yang, Bingyi 202 Zhou, Rong 313
Yang, Wentao 309
Yang, Wookyeom 362, 363
Yang, Yuan 138, 313
Yano, Yuri 283, 345
Yano, Yuri 283, 345
Yao, Liangqing 245
Yen, Ming-Shyen 132
Yin, Sheng 121
Yokoi, Takeshi 281, 357, 366, 368, 373
Yoo, Chong Woo 300
Yoo, Ha-Na 281
Yoon, Aera 256, 268, 293
Yoon, Gun 145
Yoon, Jungwon 341
Yoshida, Hiroyuki 283, 345
Yoshida, Kosuke 287
Yoshioka, Yumiko 282, 345
Yoshioka, Yumiko 282, 345
390
[Date]
December 1 (Fri) – 2 (Sat), 2017
[Venue]
Sankei-plaza, Tokyo, Japan
[President]
Daisuke Aoki M.D., PhD.
Professor, Keio University
ASGO 2015 APP Download
AIM Korea
#103-1106 Park Tower 67 Seobinggo-ro, Yongsan-gu
140-904, Seoul, Korea
Tel. +82-2-3452-1855 / Fax. +82-2-2192-3955 / E-mail: [email protected]
www.asgo2015.org www.asiansgo.org

4th Biennial Meeting 2015

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C O N T E N T S

004 Welcome Message Day 2

006 ASGO 2015 Executive Committee 061 Plenary Session IV

011 Exhibition 093 Symposium II

Abstracts 117 Free Communication I

141 Free Communication V

147 Free Communication VI

193 Symposium VII

209 Symposium VIII

237 Luncheon Symposium III

241 Young Doctors Session I

247 Young Doctors Session II

253 Young Doctors Session III

257 Poster Session

378 Author Index

Joo-Hyun Nam, M.D., Ph.D. Hee-Sug Ryu, M.D., Ph.D.

V E N U E Lotte Hotel Seoul

T H E M E For the Most, For the Best Practice in Gynecologic Oncology

HOSTED BY Asian Society of Gynecologic Oncology (ASGO)

SUPPORTED BY KSGO, KGOG, GCIG, IGCS, ESGO, SGO, AOFOG, AOGIN

Registration & Information Desk

Place Lobby (2F), Lotte Hotel Seoul

November 12 (Thu) 07:00-18:00

Operation Hours November 13 (Fri) 07:00-18:00

November 14 (Sat) 07:00-12:00

Joo-Hyun Nam (Korea)

Ikuo Konishi (Japan)

Toshiharu Kamura (Japan)

Soon-Beom Kang (Korea) Shingo Fujii (Japan)

Mohamad Farid Aziz (Indonesia) Duk-Soo Bae (Korea)

Jong-Hyeok Kim (Korea)

Jae-Weon Kim (Korea)

Editor-in-Chief, Journal of Gynecologic Oncology

Jae-Weon Kim (Korea)

Hee-Sug Ryu Soon-Beom Kang

Secretary General Assistant Secretary General

Suk-Joon Chang Eun Ji Nam Dong Hoon Suh

International Relations Committee

Abstract Reviewer Committee

Exhibition & Poster (2F Lobby & Emerald Room)

10:30 Coffee Break

11:30 (10:50- (10:30- Corpus] Cervix]

Video Recording Session

Jade Emerald Room

• Domestic Meeting (KSGO, KGOG) Crystal Ballroom

• VIP Room (Nov. 11 - 13)

Exhibition Floor Plan

S9 S10 S11 S12 S13 S14 S15

S24 S16 S17 S18 S19 S20 S21

Registration S22 S23 D1 D2 P1

Plenary Session I. Current Issues in Gynecologic Cancers

Time & Place: 15:00-16:20, Crystal Ballroom (2F)

Fertility preservation in patients with gynecologic cancer:

Clearance of persistent HPV infection and cervical lesion by

Robot assisted radical hysterectomy with complete resection of

Plenary Session II. Surgery for Gynecologic Cancers

Time & Place: 16:20-17:40, Crystal Ballroom (2F)

Role of modified posterior pelvic exenteration in gynecologic

PS2-04 (17:20-17:40) Radical Trachelectomy: Nerve-Sparing Procedures Rongyu Zang (China)

Opening Ceremony & Welcome Reception