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Uterine Artery Embolization for Pure Adenomyosis: Predictive Factors Affecting Outcomes

2026-06-01T00:00:00Z

Title: Uterine Artery Embolization for Pure Adenomyosis: Predictive Factors Affecting Outcomes Authors: Han, Kichang; Kim, Man-Deuk; Kwon, Joon Ho; Seo, Seok Kyo; Alqarni, Abdullah Ali; Park, Juil; Kim, Gyoung Min; Won, Jong Yun; Cho, Jaesung; Jeong, Seok Min Abstract: Purpose: To identify factors associated with postprocedural necrosis after uterine artery embolization (UAE) for pure adenomyosis. Materials and Methods: This study included patients who underwent UAE for pure symptomatic adenomyosis between January 2011 and May 2025. Adenomyosis characteristics, including T2-weighted signal intensity, adenomyosis morphology (Types I and II), and focal versus diffuse location, were evaluated using preprocedural magnetic resonance (MR) imaging. Contrast-enhanced MR imaging was used to assess adenomyosis necrosis 3 months after UAE. Symptom severity scores (SSSs) and health-related quality of life (HRQOL) were evaluated before and 3 months after the procedure. Univariate and multivariate analyses were performed to identify factors associated with incomplete necrosis of the adenomyotic tissue. Results: Of the 147 patients (mean age, 42.7 years [SD +/- 4.2]) who underwent UAE for adenomyosis, 116 (78.9%) exhibited complete necrosis. In multivariate analysis, Type II adenomyosis (odds ratio [OR], 10.492; 95% CI, 3.492-31.523; P < .001) and heterogeneous T2 signal intensity (OR, 4.003; 95% CI, 1.565-10.242; P = .003) were significant predictive factors for incomplete necrosis. The rates of incomplete necrosis were 13.6% (17/125) for Type I adenomyosis and 63.6% (14/22) for Type II adenomyosis. The postprocedural SSS and HRQOL scores were significantly improved in patients with complete necrosis compared with those with incomplete necrosis. Conclusions: Type II morphology arising from the subserosa and a heterogeneous T2 signal are associated with an increased risk of incomplete necrosis after UAE. Incorporating these features into preprocedural counseling may help improve clinical outcomes.

A randomized phase III clinical trial of weekly versus tri-weekly cisplatin-based chemoradiotherapy for locally advanced cervical cancer: results of the TACO (GCIG/KGOG 1027/THAI 2012) study

2026-04-01T00:00:00Z

Title: A randomized phase III clinical trial of weekly versus tri-weekly cisplatin-based chemoradiotherapy for locally advanced cervical cancer: results of the TACO (GCIG/KGOG 1027/THAI 2012) study Authors: Y. Ryu, S.; Nam, B. H.; Kim, M. H.; Jang, W. I.; Sitathanee, C.; Linh, T. D.; Lee, K. H.; Lee, W. M.; Kim, E. T.; Kang, S. B.; Kim, J. H.; V. Park, J.; Lee, K. B.; Cho, C. H.; Lou, H.; Kim, Y. H.; Kim, Y. T.; Lee, Y. H.; Wu, X.; Kim, J. W.; Park, S. I.; Jeon, S.; Thinh, D. H.; Kry, S. F.; Gaffney, D.; Small, W.; Wilailak, S. Abstract: Background The standard treatment for locally advanced cervical cancer is cisplatin-based chemoradiotherapy; however, the optimal dose and dosing schedule of cisplatin remain debated. The aim of this study was to compare the clinical outcomes of weekly cisplatin at 40 mg/m(2) versus those of tri-weekly cisplatin at 75 mg/m(2) during radiation in patients with locally advanced cervical cancer. Patients and methods In this prospective, randomized clinical trial, we enrolled 314 patients with stage IIB-IVA cervical cancer, randomly assigning them in a 1 : 1 ratio into two arms. The weekly arm received a weekly dose of 40 mg/m(2) cisplatin for six cycles, whereas the tri-weekly arm received a tri-weekly dose of 75 mg/m(2) cisplatin for three cycles, both concurrently with radiotherapy. The primary endpoints included 3-year recurrence-free survival according to a superiority design, with P < 0.05 indicative of statistical significance. Overall survival, toxicity profiles, and quality of life (QOL) were also analyzed. Results Chemotherapy delay was more frequent in the weekly arm than in the tri-weekly arm (P = 0.008). However, the 3-year recurrence-free survival rate between the two arms did not significantly differ (78.7% in the weekly arm, 84.1% in the tri-weekly arm; hazard ratio 0.71, 95% confidence interval 0.39-1.32, P = 0.28). The pattern of recurrence did not differ significantly between the two arms. Grade 3 and 4 hematological toxicities occurred less frequently in the tri-weekly arm (P < 0.001). Furthermore, the tri-weekly arm had better QOL scores across several domains compared with the weekly arm. Conclusion In this study, tri-weekly cisplatin-based chemoradiotherapy was not statistically superior to a weekly schedule in terms of survival outcomes for patients with locally advanced cervical cancer. However, the tri-weekly regimen exhibited a more favorable toxicity profile and improved QOL compared with the weekly regimen. These results suggest tri-weekly cisplatin administration as a feasible alternative for chemoradiotherapy in cervical cancer.

Association between relative handgrip strength and metabolic syndrome in Korean postmenopausal women by time since menopause

2026-03-01T00:00:00Z

Title: Association between relative handgrip strength and metabolic syndrome in Korean postmenopausal women by time since menopause Authors: Baek, Jin Kyung; Chung, Yun Soo; Kim, Hae-Rim; Kim, Hee Yon; Yun, Bo Hyon; Seo, Seok Kyo Abstract: Objectives:To investigate the association between relative handgrip strength (RHGS) and metabolic syndrome (MetS) in Korean postmenopausal women, and whether this association differs by time since menopause. Methods:We conducted a cross-sectional analysis of 4,098 naturally postmenopausal women aged 45-65 years from the Korea National Health and Nutrition Examination Survey (2014-2019). RHGS was calculated as the dominant handgrip strength divided by body mass index and categorized into quartiles. MetS was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria with an Asian-specific waist circumference cutoff (>= 85 cm). Survey-weighted logistic regression was used to estimate adjusted odds ratios (ORs) for MetS and its components across RHGS quartiles. Subgroup analyses were stratified by time since menopause (<= 10 vs. >10 y). Results:Lower RHGS was significantly associated with higher odds of MetS. Compared with Q1 (reference), adjusted ORs for MetS were 0.49 (95% CI: 0.40-0.60) in Q2, 0.28 (0.22-0.34) in Q3, and 0.17 (0.13-0.21) in Q4 (P for trend <0.001). Similar inverse gradients were observed for all MetS components. The association was stronger in women >10 years postmenopause, with OR for Q4 versus Q1 at 0.04 (0.02-0.08) compared with 0.07 (0.05-0.10) in those <= 10 years. Conclusion:Lower RHGS is independently and dose-dependently associated with increased odds of MetS, particularly among women beyond 10 years postmenopause. RHGS may serve as a simple, low-cost tool for identifying women at elevated cardiometabolic risk in later life.

Comparison Between Catheter-Directed Sclerotherapy and Surgical Removal of Large Ovarian Endometriomas: A Retrospective, Single-Center Observational Study

2026-03-01T00:00:00Z

Title: Comparison Between Catheter-Directed Sclerotherapy and Surgical Removal of Large Ovarian Endometriomas: A Retrospective, Single-Center Observational Study Authors: Chung, Yun Soo; Kim, Hae-Rim; Baek, Jin Kyung; Kim, Heeyon; Yun, Bo Hyon; Kim, Man-Deuk; Lee, Yong Jae; Seo, Seok Kyo Abstract: Background/Objectives: The treatment options for endometriosis vary depending on individual needs and clinical circumstances. To preserve ovarian reserve, ethanol catheter-directed sclerotherapy may be considered as a treatment option. We compared the efficacy of catheter-directed sclerotherapy with that of surgical removal for the treatment of large ovarian endometriomas. Methods: This retrospective, single-center study was conducted at a tertiary care center. Patients diagnosed with ovarian endometriomas of >10 cm between 1 January 2019 and 5 December 2024 were included. Fifteen patients underwent catheter-directed sclerotherapy, and 69 underwent laparoscopic ovarian cystectomy or oophorectomy. The changes in ovarian cyst size, anti-M & uuml;llerian hormone levels, and cancer antigen 125 levels after six months of treatment were determined. Results: Before matched comparison, anti-M & uuml;llerian hormone levels decreased from 2.48 ng/mL to 1.11 ng/mL 6 months after surgical treatment. In the catheter-directed sclerotherapy group, anti-M & uuml;llerian hormone levels decreased from 1.33 ng/mL to 1.19 ng/mL. In the 1:1 matched comparison between the catheter-directed sclerotherapy and surgical groups, the anti-M & uuml;llerian hormone levels decreased by approximately -0.13 and -0.59 in the catheter-directed sclerotherapy and surgical groups, respectively. The relative reduction in the anti-M & uuml;llerian hormone levels was approximately -0.25 and -0.78 in the unilateral and bilateral ovarian surgery groups, respectively. In the surgical group, cyst size decreased to 0 cm six months after treatment, whereas CA-125 levels decreased from 62.10 U/mL to 11.20 U/mL. In the CDS group, cyst size reduced to 3.30 cm, whereas CA-125 levels decreased from 74.20 U/mL to 17.60 U/mL. Conclusions: Catheter-directed sclerotherapy preserves ovarian reserve more effectively than surgical treatment, even in cases of large endometriomas. It may be a promising treatment option for individuals with low anti-M & uuml;llerian hormone levels who are planning to conceive.