Publications by authors named "Jiwoong Yu"

8 Publications

  • Page 1 of 1

Comparison of Efficacy of Different Surgical Techniques for Benign Prostatic Obstruction.

Int Neurourol J 2021 May 5. Epub 2021 May 5.

Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Purpose: We compared success rates of three surgical techniques [holmium laser enucleation of the prostate (HoLEP), transurethral resection of the prostate (TURP), and photoselective laser vaporization prostatectomy (PVP)] for treatment of benign prostatic obstruction (BPO). We aimed to identify preoperative clinical variables and urodynamic parameters that predict surgical success.

Methods: A total of 483 patients who underwent surgical treatment for BPO at Samsung Medical Center between 2006 and 2017 were retrospectively analyzed; of these 361, 81, and 41 patients underwent HoLEP, TURP, and PVP, respectively. Prostate-specific antigen, prostate volume, urodynamic parameters, and International Prostate Symptom Score (I-PSS)/quality of life (QoL) index were evaluated preoperatively; uroflowmetry, post-void residual urine, and I-PSS/QoL index were measured six months postoperatively. Surgical success was defined based on I-PSS, maximum flow rate (Qmax), and QoL index and predictive factors were identified using multiple logistic regression analyses.

Results: Success rates of HoLEP, TURP, and PVP were 67.6%, 65.4%, and 34.1%, respectively, and the HoLEP and TURP groups were not significantly different. Regression analysis revealed prostate volume ≥ 50 cc and bladder outlet obstruction index (BOOI) ≥ 40 to be independent factors predicting HoLEP success. Only high preoperative QoL could predict the success of TURP, whereas other urodynamic parameters remained unrelated.

Conclusions: Patients treated with HoLEP and TURP displayed equivalent efficacies, but PVP was relatively less efficient than both. Preoperative variables of prostate volume ≥ 50 cc and BOOI ≥ 40 were independent predictive factors for the success of HoLEP but not of TURP.
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http://dx.doi.org/10.5213/inj.2040314.157DOI Listing
May 2021

Genomic mutation profiling using liquid biopsy in Korean patients with prostate cancer: Circulating tumor DNA mutation predicts the development of castration resistance.

Investig Clin Urol 2021 Mar;62(2):224-232

Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Purpose: To investigate germline and somatic mutation profiles in Korean patients with prostate cancer using liquid biopsy and solid tissue testing and to evaluate the prognostic value of circulating tumor DNA (ctDNA) in predicting castration resistance in patients with metastatic hormone-sensitive prostate cancer (mHSPC).

Materials And Methods: Plasma samples from 56 prostate cancer patients were subjected to next-generation sequencing (NGS) to identify germline mutations and ctDNA analysis using liquid biopsy to detect somatic mutations. Additionally, paired solid cancer tissues from 18 patients were subject to NGS to detect somatic mutations. The clinical parameters and ctDNA profiles of patients with mHSPC were analyzed to evaluate the prognostic value of ctDNA mutations with respect to predicting castration resistance using Cox proportional hazards regression analysis.

Results: Germline mutations occurred in 3.6% of the patients in this cohort, with mutations identified in (1.8%) and (1.8%). Somatic mutations detected by liquid biopsy and solid tissue testing were common in (12.5%), (3.6%), and (3.6%). Of the 18 patients with paired tissue testing, two patients had at least one identical somatic mutation in both the liquid biopsy and solid tissue testing. In patients with mHSPC, the presence of ctDNA mutations could independently predict the castration resistance development (hazard ratio, 13.048; 95% confidential interval, 1.109-153.505; p=0.041).

Conclusions: Korean patients with prostate cancer showed a relatively low germline mutation rate compared to other ethnicities. The ctDNA mutations detected by liquid biopsy can predict the development of castration resistance in patients with mHSPC.
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http://dx.doi.org/10.4111/icu.20200406DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940855PMC
March 2021

Strategy for Prostate Cancer Patients with Low Prostate Specific Antigen Level (2.5 to 4.0 ng/mL).

J Korean Med Sci 2020 Oct 26;35(41):e342. Epub 2020 Oct 26.

Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background: To evaluate the strategy for detection of prostate cancer (PCa) with low prostate specific antigen (PSA) level (2.5-4.0 ng/mL), prostate biopsy patients with low PSA were assessed. We evaluated the risk of low PSA PCa and the strategy for screening low-PSA patients.

Methods: We retrospectively analyzed the patients who underwent prostate biopsy with low PSA level. Baseline characteristics, PSA level before prostate biopsy, prostate volume, prostate specific antigen density (PSAD), and pathological data were assessed.

Results: Among the 1986 patients, 24.97% were diagnosed with PCa. The PSAD was 0.12 ± 0.04 ng/mL² in the PCa-diagnosed group and 0.10 ± 0.04 ng/mL² in non-cancer-diagnosed group ( < 0.001). Of the 496 patients diagnosed with PCa, 302 (60.89%) were in the intermediate- or high-risk group. PSAD was 0.13 ± 0.04 ng/mL² in the intermediate- or high-risk group and 0.11 ± 0.03 ng/mL² in the very low- and low-risk group ( < 0.001). Of 330 patients who underwent radical prostatectomy, 85.15% were diagnosed as having significant cancer. There was significant correlation between PSAD and PCa ( = 0.294, < 0.001). PSAD with a specificity of 80.00% of a clinically significant cancer diagnosis was assessed at 0.1226 ng/mL².

Conclusion: The PCa detection rate in the low-PSA group was not lower than that of previous studies of patients with PSA from 4.0 to 10.0 ng/mL. Further, it may be helpful to define a strategy for PCa detection using PSAD in the low-PSA group.
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http://dx.doi.org/10.3346/jkms.2020.35.e342DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590649PMC
October 2020

Pneumovesicoscopic bladder tumor resection in a young boy whose urethra was too small to use a resectoscope.

J Pediatr Urol 2020 10 6;16(5):727-728. Epub 2020 Sep 6.

Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address:

Objective: To describe our experience with pneumovesicoscopic bladder tumor resection in a young boy whose urethra was too small to use a resectoscope.

Methods: An 11-year-old boy presented with gross hematuria. The patient was found to have a 2 cm-sized bladder tumor on ultrasound. The patient's urethra was too small to use a pediatric resectoscope, making it impossible to perform a transurethral resection of the bladder tumor. Therefore, pneumovesicoscopic bladder tumor resection was performed. En-bloc resection was performed successfully using 3 mm laparoscopic instruments, and the tumor was safely retrieved within an endo-bag made with a surgical glove.

Results: On postoperative day 1, the Foley catheter was removed and the patient was discharged. The pathology report described bladder papillary urothelial carcinoma, grade II/III without lamina propria invasion. The patient underwent follow-up with ultrasonography and urine cytology every three to six months. There was no recurrence for 21 months after surgery.

Conclusion: This video demonstrates a pneumovesicoscopic approach for the treatment of bladder tumor in a young patient whose urethra was too small to use a resectoscope. Pneumovesicoscopic bladder tumor resection is technically feasible and safe.
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http://dx.doi.org/10.1016/j.jpurol.2020.08.026DOI Listing
October 2020

Incidences and oncological outcomes of urothelial carcinoma in kidney transplant recipients.

Cancer Manag Res 2019 24;11:157-166. Epub 2018 Dec 24.

Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea,

Purpose: We investigated to determine if there is an increased rate of urothelial carcinoma (UC) in kidney transplant (KT) recipients and to compare oncological outcomes of UC in KT recipients with non-KT patients.

Patients And Methods: Among 2,186 patients who underwent KT in our institute, nine patients developed UC after KT in our center. Age-standardized rates (ASRs) were calculated to compare incidence rates of UC between KT patients and the general population. Additional five patients who underwent KT at other hospitals and received UC treatment at our center were included, thus a total of 14 KT patients were compared with non-KT patients in the aspect of the treatment outcomes of bladder cancer and upper urinary tract UC (UTUC) by using generalized estimating equation (GEE).

Results: The ASRs of bladder cancer and UTUC in KT recipients were 25.5 and 129.5 times higher than that of the general population. Although there was no difference in bladder cancer-specific survival rates (-value 0.1186), however, progression rates of bladder cancer were significantly higher in KT recipients with a relative risk of 10.53 (-value 0.0481). There was no significant difference in UTUC recurrence, progression, and specific survival rate (-values 0.8915, 0.8806, and 0.8116, respectively).

Conclusion: Incidence of UC was much higher in KT recipients than the general population. Treatment outcomes for UC in KT recipients were not inferior to those of non-KT patients, except for the progression of bladder cancer. Special attention should be paid to screening and treatment of UC in KT recipients.
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http://dx.doi.org/10.2147/CMAR.S185796DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307682PMC
December 2018

Persistent Erectile Dysfunction after Discontinuation of 5-Alpha Reductase Inhibitor Therapy in Rats Depending on the Duration of Treatment.

World J Mens Health 2019 May 26;37(2):240-248. Epub 2018 Dec 26.

Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Purpose: The current study is aimed to assess whether a longer duration of 5α-reductase inhibitor (5α-RI) exposure was associated with higher rate of permanent erectile dysfunction (ED) in a rat model.

Materials And Methods: Male Sprague-Dawley rats (n=76) were assigned to five groups: (i) normal control group; (ii) dutasteride (0.5 mg/rat/d) for 4-weeks group; (iii) dutasteride for 4-weeks plus 2-weeks of resting group; (iv) dutasteride for 8-weeks group; and (v) dutasteride for 8-weeks plus 2-weeks of resting group. In vivo erectile responses to electrical stimulation, and changes of fibrotic factors and smooth muscle/collagen contents in the corpus cavernosum were evaluated in each group.

Results: Dutasteride administration for 4 and 8 weeks significantly decreased erectile parameters compared with the control group. Reduced erectile responses were recovered during 2 weeks of drug-free time in the 4-week treatment group, but were not in the 8-week group. Protein levels of fibrosis-related factors transforming growth factor (TGF)-β1, TGF-β2, and p-Smad/Smad (Smad 2/3) in the corpus cavernosum showed no significant change after 4 weeks of dutasteride oral administration, but were enhanced after 8 weeks. Dutasteride markedly decreased smooth muscle content and increased collagen after 4 and 8 weeks of use, but no nuclear size changes; however, neither group showed significant improvement in the smooth muscle to collagen ratio after the rest period.

Conclusions: Our study showed that recovery from ED depended on the duration of medication, and administration of dutasteride for more than 8-weeks in rats could result in irreversible ED even after discontinuation of medication.
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http://dx.doi.org/10.5534/wjmh.180082DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6479083PMC
May 2019

Prognostic impact of the pretreatment aspartate transaminase/alanine transaminase ratio in patients treated with first-line systemic tyrosine kinase inhibitor therapy for metastatic renal cell carcinoma.

Int J Urol 2018 06 13;25(6):596-603. Epub 2018 May 13.

Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Objectives: To examine the prognostic role of the pretreatment aspartate transaminase/alanine transaminase or De Ritis ratio in patients with metastatic renal cell carcinoma receiving first-line systemic tyrosine kinase inhibitor therapy.

Methods: We retrospectively searched the medical records of 579 patients with metastatic renal cell carcinoma who visited Samsung Medical Center, Seoul, Korea, from January 2001 through August 2016. After excluding 210 patients, we analyzed 360 patients who received first-line tyrosine kinase inhibitor therapy. Cancer-specific survival and overall survival were defined as the primary and secondary end-points, respectively. A multivariate Cox proportional hazards regression model was used to identify independent prognosticators of survival outcomes.

Results: The overall population was divided into two groups according to the pretreatment De Ritis ratio as an optimal cut-off value of 1.2, which was determined by a time-dependent receiver operating characteristic curve analysis. Patients with a higher pretreatment De Ritis ratio (≥1.2) had worse cancer-specific survival and overall survival outcomes, compared with those with a lower De Ritis ratio (<1.2). Notably, a higher De Ritis ratio (≥1.2) was found to be an independent predictor of both cancer-specific survival (hazard ratio 1.61, 95% confidence interval 1.13-2.30) and overall survival outcomes (hazard ratio 1.69, 95% confidence interval 1.19-2.39), along with male sex, multiple metastasis (≥2), non-clear cell histology, advanced pT stage (≥3), previous metastasectomy and the Memorial Sloan Kettering Cancer Center risk classification.

Conclusion: Our findings show that the pretreatment De Ritis ratio can provide valuable information about the survival outcomes of metastatic renal cell carcinoma patients receiving first-line tyrosine kinase inhibitor therapy.
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http://dx.doi.org/10.1111/iju.13574DOI Listing
June 2018

Pathological Outcome following Radical Prostatectomy in Men with Prostate Specific Antigen Greater than 10 ng/ml and Histologically Favorable Risk Prostate Cancer.

J Urol 2016 May 1;195(5):1464-1470. Epub 2015 Dec 1.

Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey and Division of Urology, Rutgers Robert Wood Johnson Medical School, Rutgers, State University of New Jersey, New Brunswick. Electronic address:

Purpose: Active surveillance is now the treatment of choice in men with low risk prostate cancer. Although there is no consensus on which patients are eligible for active surveillance, prostate specific antigen above 10 ng/ml is generally excluded. In an attempt to determine the validity of using a prostate specific antigen cutoff of 10 ng/ml to counsel men considering active surveillance we analyzed a multi-institution database to determine the pathological outcome in men with prostate specific antigen greater than 10 ng/ml but histologically favorable risk prostate cancer.

Materials And Methods: We queried a prospectively maintained database of men with histologically favorable risk prostate cancer who underwent radical prostatectomy between 2003 and 2015. The cohort was categorized into 3 groups based on prostate specific antigen level, including low-less than 10 ng/ml, intermediate-10 or greater to less than 20 and high-20 or greater. Associations of prostate specific antigen group with adverse pathological and oncologic outcomes were analyzed.

Results: Of 2,125 patients 1,327 were categorized with histologically favorable risk disease. However on multivariate analyses the rates of up staging and upgrading were similar between the intermediate and low prostate specific antigen groups. In contrast compared to the intermediate prostate specific antigen group the high group had higher incidences of up staging (p = 0.02) and upgrading to 4 + 3 or greater disease (p = 0.046). Biochemical recurrence-free survival rates revealed no pairwise intergroup differences except between the low and high groups.

Conclusions: Patients with preoperatively elevated prostate specific antigen between 10 and less than 20 ng/ml who otherwise had histologically favorable risk prostate cancer were not at higher risk for adverse pathological outcomes than men with prostate specific antigen less than 10 ng/ml.
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http://dx.doi.org/10.1016/j.juro.2015.11.031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5769700PMC
May 2016