Joo Han Lim

Background: Internet search engines serve as primary gateways to cancer information; yet, the commercialization of health content within organic search results remains understudied. While covert promotional content—such as native advertising and stealth marketing—has been documented in various contexts, systematic comparisons across structurally divergent search platforms are lacking. Objective: This study examined the prevalence, distribution, and information quality characteristics of covert promotional cancer-related content across Naver and Google, South Korea’s 2 dominant search engines, which have fundamentally different platform architectures. Methods: A 2-phase cross-sectional content analysis was conducted. Phase 1 used natural language processing to identify 34 cancer-related keywords from 1400 preliminary posts. Phase 2 systematically collected 5848 posts in October 2023, yielding 919 unique posts (598 from Naver and 321 from Google) that covered 7 major cancer types, collectively accounting for over 70% of Korean cancer incidence. Two trained coders analyzed promotional status, intensity, institutional sources, and information quality indicators (citation practices, information depth, and source attribution), with intercoder reliability exceeding κ=0.80. Chi-square tests were used to examine associations between platform and content characteristics across cancer type. Results: Covert promotional content appeared in 48.6% (447/919) of analyzed posts, with a significantly higher prevalence on Google (174/321, 54.2%) than on Naver (273/598, 45.7%; χ ² ₁ =5.78; P =.02). Platform differences were pronounced. Naver promotional posts predominantly originated from blogs (262/273, 96.0%) and exhibited full promotional intensity (126/242, 52.1%), while Google posts primarily came from hospital websites (141/174, 81.0%) with simple institutional identification (52/90, 57.8%). Institutional source distribution varied significantly by platform ( χ ² ₅ =209.642; P< .001). Traditional medicine institutions dominated Naver (119/120, 99.2%), whereas university-affiliated hospitals predominated on Google (96/113, 85.0%). Information quality also differed substantially. Indirect citation was more common on Google (142/174, 81.6%) than on Naver (160/273, 58.6%; χ ² ₁ =25.653; P<. 001), while comparative informational depth was higher on Google (97/174, 55.7%) versus Naver (53/273, 19.4%; χ ² ₂ =64.683; P<. 001). Conclusions: Covert promotional cancer content is pervasive in Korean search results, with platform architecture systematically shaping promotional patterns, institutional sources, and information quality rather than reflecting deliberate marketing strategies. These findings underscore the need for platform-sensitive regulation and enhanced digital health literacy to protect vulnerable cancer information seekers from commercial exploitation embedded within ostensibly neutral search environments.

Rectal cancer, which accounts for approximately 40% of colorectal cancers, remains a major clinical concern. Recent advances in diagnostic imaging, surgical techniques, radiotherapy, and systemic treatment have steadily improved rectal cancer outcomes. Considering this, the Korean Rectal Cancer Multidisciplinary (KRCM) Committee has aimed to provide clinicians and policymakers with up-to-date, evidence-based clinical practice guidelines to support optimal decision-making, reflecting current evidence, the Korean healthcare context, and patient values and preferences. The Clinical Practice Guidelines for Rectal Cancer version 2.0 were developed through multidisciplinary collaboration with related academic societies, building upon and updating the KRCM Clinical Practice Guidelines version 1.0 (titled “Multidisciplinary guidelines for the management of rectal cancer”). These consensus guidelines of the KRCM were established based on a comprehensive literature review, evidence synthesis, with recommendation development guided by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology, and consideration of applicability in real-world clinical practice under the national health insurance system. Each recommendation has been presented with its strength and level of evidence.

Renal cell carcinoma (RCC) remains a significant challenge in oncology, prompting thorough investigations into adjuvant treatments aimed at enhancing both survival and quality of life for patients. In this review, we explore the complex landscape of adjuvant treatments for managing RCC, highlighting the pivotal roles and efficacy of tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs). This review article presents a detailed exploration of both historical and contemporary trials involving TKIs, spotlighting their capabilities, successes, and limitations in the adjuvant setting. Furthermore, we examine the emerging significance of ICIs, analyzing recent trials and assessing their impact on outcomes such as disease-free survival and overall survival. Additionally, this review provides insights into the application, adaptation, and outcomes of these adjuvant therapies within the specific context and circumstances of Korean healthcare.

Although approximately 50% of patients with acute myeloid leukemia (AML) are diagnosed over the age of 60 years, there is currently no established consensus on the treatment of elderly AML patients. Herein, we aimed to explore the incidence, medical expenditure, treatment, and outcomes of elderly AML patients in Korea by analyzing a nationwide cohort. We employed the Korean National Health Insurance Service-Senior cohort, which represents 10% of a random selection from a total of 5.5 million subjects aged 60 years or older. AML patients were identified according to the main diagnostic criteria of acute leukemia. Treatment for AML was divided into high- (high-dose cytarabine ± idarubicin) and low- (low-dose cytarabine or hypomethylating agents) intensity chemo-therapy and classified according to the chemotherapeutics protocol. We analyzed the survival outcomes and medical expenditures. Among 558,147 elderly patients, 471 were diagnosed with AML, and 195 (41.4%) were treated with chemotherapy. The median age was 65 years, and the median overall survival (OS) was 4.93 months (95% confidence interval, 4.47–5.43). Median OS was longer in patients undergoing chemotherapy than those in the best supportive care group (6.28 vs. 3.45 months, p < 0.001), and the difference was prominent in patients aged < 70 years. Twenty-eight (5.9%) patients received high-intensity chemotherapy, while 146 (31.0%) received low-intensity chemotherapy. The difference in median OS according to dose intensity was 4.6 months, which was longer in the high-intensity chemotherapy group (9.8 vs. 5.2 months in low-intensity group); however, the difference was not statistically significant. Patients who received high-intensity chemotherapy recorded longer hospital stays and incurred greater expenses on initial hospitalization. Elderly AML patients in Korea exhibited clinical benefits from chemotherapy. Although patients should be carefully selected for intensive treatment, chemotherapy, including low-intensity treatment, can be considered in elderly patients. Moreover, prospective studies on new agents or new treatment strategies are needed.

Ha H, et al. Brain Tumor Res Treat. 2022 Jul;10(3):158-163. https://doi.org/10.14791/btrt.2022.0018

Pancreatic cancer generally has a dismal prognosis, with a 5-year overall survival rate of approximately 10%. At present, surgical resection is the only treatment with a curative aim; however, it is applicable to only 15–20% patients with pancreatic cancer at the time of diagnosis and the median survival following treatment with surgery alone is only 11–20 months. Many trials have shown that adjuvant chemotherapy offers improved outcomes over observation following surgical resection. Recently, modified folinic acid–fluorouracil–irinotecan–oxaliplatin (FOLFIRINOX) treatment following surgical resection in patients with good performance status has shown an impressive 9-month increase in disease-free survival. However, patients included in the study were selected based on a narrow set of criteria, and adverse events during adjuvant chemotherapy remain a limitation. In this article, we review some key trials of adjuvant chemotherapy treatment for pancreatic cancer and discuss future perspectives including neoadjuvant treatment approaches.

Several clinical trials that tested the efficacy of systemic treatments for advanced hepatocellular carcinoma (HCC) showed a tendency that patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) infection had different survival benefits from targeted agents.

Despite increased demand for cancer patient's to make their own decisions based on an adequate understanding of what is involved in chemotherapy, the primary signing agent and the reasons for surrogate signing have not been appropriately evaluated. The ethics committee of the palliative medicine subgroup of the Korean Cancer Study Group designed this study and solid cancer patients to whom chemotherapy was offered, from seven institutions, were evaluated. The details relating to surrogate's signing of chemotherapy consent were evaluated. Then, we analyzed the factors associated with surrogate's signing according to patient's demographics and characteristics related to chemotherapy consent. Surrogate's signing was noted for 20.7% (84/405) of patient and over half of surrogate signings were performed by the patients' son or daughter (60.7%). Two main reasons for surrogate signing were patient's incapacity (34.5%) and taking over authorization from patients (33.3%). The factors associated with more frequent surrogate's signing were absence of spouse, lower education level, outpatient, and when residents played a role as a principle provider of chemotherapy consent. This study suggests the lack of patients' own decision making for chemotherapy in some situations. This ethical dilemma must be considered for adequately informed decision making for chemotherapy while ensuring the patients' autonomy is maintained.

Substantial alterations at the multi-omics level of pancreatic cancer (PC) impede the possibility to diagnose and treat patients in early stages. Herein, we conducted an integrative omics-based translational analysis, utilizing next-generation sequencing, transcriptome meta-analysis, and immunohistochemistry, combined with statistical learning, to validate multiplex biomarker candidates for the diagnosis, prognosis, and management of PC. Experiment-based validation was conducted and supportive evidence for the essentiality of the candidates in PC were found at gene expression or protein level by practical biochemical methods. Remarkably, the random forests (RF) model exhibited an excellent diagnostic performance and LAMC2, ANXA2, ADAM9, and APLP2 greatly influenced its decisions. An explanation approach for the RF model was successfully constructed. Moreover, protein expression of LAMC2, ANXA2, ADAM9, and APLP2 was found correlated and significantly higher in PC patients in independent cohorts. Survival analysis revealed that patients with high expression of ADAM9 (Hazard ratio (HR)_OS = 2.2, p-value < 0.001), ANXA2 (HR_OS = 2.1, p-value < 0.001), and LAMC2 (HR_DFS = 1.8, p-value = 0.012) exhibited poorer survival rates. In conclusion, we successfully explore hidden biological insights from large-scale omics data and suggest that LAMC2, ANXA2, ADAM9, and APLP2 are robust biomarkers for early diagnosis, prognosis, and management for PC.