Publications by authors named "Keun Won Ryu"
Delayed gastric emptying (DGE) is a well-known complication of laparoscopic pylorus-preserving gastrectomy (LPPG). Patients who underwent LPPG in the KLASS-04 trial, which was a multicenter prospective randomized control trial comparing LPPG and laparoscopic distal gastrectomy (LDG), showed an unneglectable incidence of long-term DGE compared to patients who underwent LDG. This study aimed to identify the multifactorial risk factors associated with DGE and to analyze the quality of life (QoL) of patients with DGE following LPPG.
View Article and Find Full Text PDFUndifferentiated-type (UD-type) gastric cancer is associated with a high frequency of lymph node metastasis (LNM); however, recent reports indicate that LNM frequency varies according to specific histologic components. We conducted a multicenter study to define criteria for distinguishing low- and high-risk histology groups for LNM in UD-type gastric cancers. Histologic components were classified into four types: poorly cohesive signet ring cells (SRC), poorly cohesive non-signet ring cells (non-SRCs), poorly differentiated tubular (PD), and differentiated-type (D-type).
View Article and Find Full Text PDFLong-term outcomes of laparoscopic distal gastrectomy for locally advanced gastric cancer: An individual patient data meta-analysis of KLASS-02 and CLASS-01 randomized controlled trials.
Chin J Cancer Res
June 2025
Objective: Laparoscopic distal gastrectomy (LDG) has potential as a surgical treatment option for locally advanced gastric cancer (LAGC). However, there is uncertainty regarding the generalizability of LDG efficacy across diverse patient populations and treatment settings. This study aimed to assess the outcomes of LDG .
View Article and Find Full Text PDF: During laparoscopic pylorus-preserving gastrectomy (LPPG), the preservation of the infra-pyloric artery (IPA) and dissection of the infra-pyloric lymph node (LN) station 6 are essential, underscoring the importance of understanding the anatomical structure of the IPA. This study aimed to investigate anatomical variations in the IPA and surgical outcomes based on data from a multicenter prospective trial. : A post hoc analysis was conducted based on the Korean Laparoendoscopic Gastrointestinal Surgery Study (KLASS)-04 trial, in which patients randomly underwent LPPG or laparoscopic distal gastrectomy (LDG).
View Article and Find Full Text PDFPurpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer.
Materials And Methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery.
Background: The SENORITA phase III trial demonstrated the effectiveness of laparoscopic sentinel node navigation surgery (LSNNS) in preserving stomach function for patients with early gastric cancer (EGC), although some patients experienced surgical failure or recurrence. The purpose of this study was to analyze patients' clinicopathologic features from the SENORITA trial who were allocated to LSNNS with stomach-preserving surgery but ultimately did not preserve stomach or experienced recurrence.
Patients And Methods: Patients were categorized into two groups: the failure group (stomach preservation failure or cancer recurrence after LSNNS) and the success group (stomach preservation without recurrence following LSNNS).
Purpose: The aim of this study is to compare the detection ability of quality of life (QoL) changes and responsiveness of the KOrean QUality of life in Stomach cancer patients Study group (KOQUSS)-40 and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ).
Materials And Methods: A multicenter prospective observational study was conducted to evaluate QoL changes after various gastrectomies between January 2021 and April 2022. Participants were instructed to complete the KOQUSS-40 and EORTC QLQ-C30/STO22 preoperatively and at 1, 3, 6, and 12 months postoperatively.
A Comprehensive and Comparative Review of Global Gastric Cancer Treatment Guidelines: 2024 Update.
J Gastric Cancer
January 2025
Differences in demographics, medical expertise, and patient healthcare resources across countries have led to significant variations in guidelines. In light of these differences, in this review, we aimed to explore and compare the most recent updates to gastric cancer treatment from five guidelines that are available in English. These English-version guidelines, which have been recently published and updated for journal publication, include those published in South Korea in 2024, Japan in 2021, China in 2023, the United States in 2024, and Europe in 2024.
View Article and Find Full Text PDFObjective: The laparoscopic approach for locally advanced gastric cancer has recently been adopted based on the results of several randomized controlled trials (RCTs). However, findings from RCTs have not been examined at the national level. This study aimed to investigate the external validity of the Korean Laparoscopic Gastrointestinal Surgery Study-02 (KLASS-02) trial involving 13 tertiary hospitals, using data from the Korean Gastric Cancer Association (KGCA)-led nationwide survey involving 68 tertiary or general hospitals.
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- Precision medicine requires reliable tools for personalized therapy, and this study tested the feasibility of the single patient classifier (SPC) test for stage II-III gastric cancer patients.
- A multicenter study with 237 patients showed that 99.5% of SPC test results were delivered on time before choosing postoperative treatments, with a median delivery time of 4 days.
- The results indicated significant differences in 3-year disease-free survival rates among the risk groups identified by the SPC test, supporting its potential for improving treatment decisions.
Article Synopsis
- The study aimed to compare the long-term outcomes of laparoscopic pylorus preserving gastrectomy (LPPG) and laparoscopic distal gastrectomy (LDG) for treating early gastric cancer (EGC) in a multicenter randomized controlled trial with 256 patients.
- Results showed no significant difference in the incidence of dumping syndrome after one year (13.2% for LPPG vs. 15.8% for LDG), but LPPG had lower rates of gallstone formation and better preservation of hemoglobin and serum protein levels.
- While LPPG had more instances of reflux esophagitis and delayed gastric emptying, overall survival and quality of life after three years were similar between the two
Article Synopsis
- - Sentinel node navigation (SNN) is effective for stomach-preserving surgery in early gastric cancer but has technical challenges in practice.
- - A study analyzed data from the SENORITA trial, evaluating the effectiveness of regional lymphadenectomy without SNN on 237 patients, focusing on lymph node metastasis in relation to tumor location.
- - Results indicated that while SNN showed higher sensitivity and negative predictive values for detecting metastasis compared to regional lymphadenectomy, completely omitting SNN in surgery was deemed insufficient and not recommended.
Adjuvant nivolumab plus chemotherapy versus placebo plus chemotherapy for stage III gastric or gastro-oesophageal junction cancer after gastrectomy with D2 or more extensive lymph-node dissection (ATTRACTION-5): a randomised, multicentre, double-blind, placebo-controlled, phase 3 trial.
Lancet Gastroenterol Hepatol
August 2024
Article Synopsis
- In Asia, adjuvant chemotherapy combined with nivolumab post-gastrectomy is being assessed for effectiveness and safety in treating pathological stage III gastric or gastro-oesophageal junction cancer.
- The ATTRACTION-5 trial involved a randomized, double-blind study across 96 hospitals in East Asia, enrolling patients aged 20-80 with confirmed stage IIIA-C cancer following specific surgeries.
- Patients were divided into two groups to receive either nivolumab with chemotherapy or a placebo with chemotherapy, with the main focus on measuring relapse-free survival and analyzing safety data.
Article Synopsis
- The SENORITA trial aimed to evaluate the quality of life (QoL) and nutritional outcomes of patients undergoing two types of surgeries: laparoscopic sentinel node navigation surgery (LSNNS) and laparoscopic standard gastrectomy (LSG).
- The objective was to compare long-term QoL and nutritional outcomes between patients who had stomach-preserving surgery and those who underwent standard gastrectomy, as well as to identify factors affecting QoL in the stomach-preserving group.
- The analysis included 194 patients who underwent stomach-preserving surgery and 257 who had standard gastrectomy, with findings indicating that the stomach-preserving group experienced better QoL scores three months post-surgery.
Article Synopsis
- Intraoperative pathologic examination of sentinel nodes during gastric cancer surgery is vital for determining how extensive the surgery should be.
- A study from 2013 to 2016 evaluated the feasibility and accuracy of these intraoperative protocols, using data from a multicenter trial and examining sentinel lymph nodes with various staining methods.
- Results showed that the single-section HE staining method effectively detected macrometastasis, and if sentinel nodes are negative, it is safe to proceed with sentinel basin dissection; otherwise, standard surgery is necessary.
Purpose: The study aimed to investigate real-world surgical outcomes of minimally invasive surgery (MIS) for advanced gastric cancer using Korean Gastric Cancer Association (KGCA)-led nationwide data.
Materials And Methods: A nationwide survey of patients who underwent surgical treatment for gastric cancer in 2019 was conducted by the KGCA. A total of 14,076 patients from 68 institutions underwent surgery, and 4,953 patients diagnosed with pathological stages IB-III gastric cancer were included.
Article Synopsis
- This study compared laparoscopic standard gastrectomy (LSG) and laparoscopic sentinel node navigation surgery (LSNNS) for early gastric cancer (EGC) to assess their long-term oncologic outcomes over 5 years.
- The SENORITA trial did not demonstrate that LSNNS was non-inferior to LSG; while 5-year disease-free survival (DFS) was similar between the two groups, LSNNS had a higher occurrence of gastric cancer-related events.
- The conclusion suggests that despite no significant differences in 5-year DFS, overall survival (OS), and disease-specific survival (DSS) between LSG and LSNNS, LSNNS may offer benefits in postoperative quality of life and
Article Synopsis
- * Subtotal or total gastrectomy combined with D2 lymph node dissection is now the standard procedure, and cancer screening has led to more early diagnoses, improving survival rates.
- * Advances in surgical tools and techniques have promoted the use of minimally invasive surgery for both early and advanced stages of gastric cancer.
Purpose: This study aimed to compare the long-term functional and patient-reported outcomes between intra-corporeal delta-shaped gastroduodenostomy and gastrojejunostomy after laparoscopic distal gastrectomy for gastric cancer.
Materials And Methods: We retrospectively reviewed clinicopathological data from 616 patients who had undergone laparoscopic distal gastrectomy for stage I gastric cancer between January 2015 and September 2020. Among them, 232 patients who had undergone delta-shaped anastomosis and another 232 who had undergone Billroth II anastomosis were matched using propensity scores.
Article Synopsis
- This study assessed how well surgeons in Korea followed the 2018 gastric cancer treatment guidelines using data from a national survey in 2019.
- The compliance rates for surgical procedures like gastric resection and lymph node dissection were overall high, ranging between 83% to 100% in 2019, akin to rates from 2014.
- However, the survey also revealed that nearly half of the patients who had surgery were at stage IV disease, which goes against the guidelines, indicating areas for improvement.
The management of patients with vitamin B12 deficiency after total gastrectomy (TG) remains controversial. We aimed to evaluate the effect of vitamin B12 replacement intervals on the clinical characteristics in these patients. The data from patients who received vitamin B12 supplementation after TG between 2007 and 2018 at the National Cancer Center, Korea, were retrospectively evaluated.
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- Recent research indicates that the oral microbiome might significantly contribute to the initiation and progression of cancer, though the exact causal mechanisms remain unclear.
- A study involving 309 cancer patients and 745 healthy controls identified six specific bacterial genera linked to various cancers, with notable shifts in their abundance between groups.
- The findings suggest that changes in oral microbiota could lead to lower levels of beneficial short-chain fatty acids and upregulation of inflammatory markers in cancer patients, which may heighten cancer risk through an activated immune response.
Article Synopsis
- * Results showed that patients with LC had significantly lower 5-year cancer-specific survival rates and higher tumor recurrence rates compared to those with no complications (NC) and systemic complications (SC).
- * The presence of LC was identified as an independent factor negatively affecting both overall survival and cancer recurrence, highlighting the importance of managing local complications in these patients.