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Kobayashi Y, Shimada M, Tamate M, Cho HW, Zhu J, Chou HH, Kajiyama H, Okamoto A, Aoki D, Kang S, Lee JW, Kim JW, Kim JH, Lin Z, Liu J, Wu X, Lai HC, Chang TC, Lai CH, Kim YM, Enomoto T. Current treatment strategies for ovarian cancer in the East Asian Gynecologic Oncology Trial Group (EAGOT). J Gynecol Oncol 2024; 35:35.e87. [PMID: 38606827 DOI: 10.3802/jgo.2024.35.e87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 03/24/2024] [Indexed: 04/13/2024] Open
Affiliation(s)
- Yusuke Kobayashi
- Department of Obstetrics and Gynecology, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Muneaki Shimada
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Miyagi, Japan.
| | - Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University, Hokkaido, Japan
| | - Hyun Woong Cho
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jun Zhu
- Department of Gynecologic Oncology, Cancer Hospital of Fudan University, Shanghai, China
| | - Hung-Hsueh Chou
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
- National Tsing Hua University, School of Medicine, Hsinchu, Taiwan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | - Daisuke Aoki
- International University of Health and Welfare Graduate School, Tokyo, Japan
| | - Sokbom Kang
- Center for Gynecologic Oncology, National Cancer Center, Goyang, Korea
| | - Jeong-Won Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul, Korea
| | - Jae-Weon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Hoon Kim
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Zhongqiu Lin
- Department of Gynecologic Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jihong Liu
- Department of Gynecologic Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xiaohua Wu
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Hung-Cheng Lai
- Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Ting-Chang Chang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
| | | | - Yong Man Kim
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Kondo A, Tamate M, Nishihara Y, Watanabe Y. Hybrid Train-The-Trainer course for the Fundamental Use of Surgical Energy certificates improves self-confidence in knowledge of surgical energy and develops teaching skills: a feasibility study. Surg Endosc 2024; 38:368-376. [PMID: 37798531 DOI: 10.1007/s00464-023-10422-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/31/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Several well-trained expert instructors who completed the "Train-The-Trainer (TTT)" course are required to disseminate the safe use of surgical energy devices, which can be learned through the Fundamental Use of Surgical Energy (FUSE) program. This study aimed to explore whether the hybrid FUSE TTT course is feasible and effective, which can improve teaching skills of surgical energy. METHODS The hybrid TTT course, which was designed to train FUSE-certified personnel as instructors, comprised three virtual sessions spread over 5 h in total and a 1-day in-person training, followed by a 100-min FUSE electrosurgery hands-on workshop in practice as an instructor. The participants reported on self-confidence regarding knowledge of various energy devices or adverse events before, immediately after, and 6 months after the course. Participants and experienced FUSE instructors assessed the trainees' presentation skills at the beginning of the in-person training and after the hands-on workshop. The primary outcomes were the feasibility and completion rate of the entire course. RESULTS Seventeen participants completed the entire couse; most (94%) were satisfied with the course. Self-confidence in knowledge about various contents improved significantly: the fundamentals of electrosurgery (post, p < 0.001; 6 months, p = 0.01), mechanism and prevention of adverse events (post, p = 0.001; 6 months, p = 0.04), monopolar instruments (post, p = 0.002; 6 months, p = 0.01), bipolar instruments (post, p = 0.01; 6 months, p = 0.06), and integration with other medical devices (post, p = 0.006; 6 months, p = 0.02). The presentation skill index scores of self- and peer assessments improved after the in-person training (self-assessment [pre 44 vs. post 56, p < 0.001], peer assessment [pre 39 vs. post 68, p < 0.001]). CONCLUSIONS The hybrid TTT course can provide FUSE-certified personnel with an improved self-confidence concerning knowledge of surgical energy and improve their presentation skills with midterm retention. This can help build trainees' self-confidence as instructors.
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Affiliation(s)
- Akihiro Kondo
- Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Takamatsu, Kagawa, Japan
| | - Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Yuichi Nishihara
- Department of Surgery, Sassa General Hospital, Nishitokyo, Tokyo, Japan
| | - Yusuke Watanabe
- Clinical Research and Medical Innovation Center, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Kita 14 Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
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Wada N, Tamate M, Matsuura M, Saito T. Diagnosis and Methods of Repair for a Uteroperitoneal Fistula (UPF) Formed After Gynecological Surgeries. Cureus 2023; 15:e51064. [PMID: 38146339 PMCID: PMC10749506 DOI: 10.7759/cureus.51064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2023] [Indexed: 12/27/2023] Open
Abstract
A uteroperitoneal fistula (UPF) is a rare disorder that can lead to infertility and has never been reported. UPFs can cause infertility and perinatal complications. A 34-year-old woman (gravida 0) with a history of three gynecological surgeries using a uterine manipulator was diagnosed with a UPF using hysteroscopy and hysterosalpingography. She underwent laparoscopic uterine repair as an infertility treatment. The uterine perforation may have been caused by uterine manipulator insertion or suture failure in the myometrium during her previous laparoscopic myomectomy and cystectomy procedures. The UPF disappeared after the current surgical treatment. The complications of UPFs include infection, infertility, ectopic pregnancy, and uterine rupture. We expected that the presence of a fistula would increase the risk of impaired fertilization, implantation failure, and ectopic pregnancy. This case report contributes valuable insights into the diagnosis of UPFs and their laparoscopic repair.
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Affiliation(s)
- Nagisa Wada
- Obstetrics and Gynecology, Sapporo Medical University, Sapporo, JPN
| | - Masato Tamate
- Obstetrics and Gynecology, Sapporo Medical University, Sapporo, JPN
| | - Motoki Matsuura
- Obstetrics and Gynecology, Sapporo Medical University, Sapporo, JPN
| | - Tsuyoshi Saito
- Obstetrics and Gynecology, Sapporo Medical University, Sapporo, JPN
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Tamate M, Matsuura M, Saito T. Cervical conization with endoCUT mode applying gastrointestinal endoscopic polypectomy technique. Obstet Gynecol Sci 2023; 66:584-586. [PMID: 37381884 PMCID: PMC10663400 DOI: 10.5468/ogs.23066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/25/2023] [Accepted: 06/09/2023] [Indexed: 06/30/2023] Open
Abstract
OBJECTIVE To show how endoCUT mode can be safely managed with cervical conization. METHODS Demonstration of the technique and explanation of endoCUT and soft coagulation mode with narrated video footage. Cervical conization is a therapeutic and diagnostic procedure performed for the diagnosis of cervical intraepithelial lesions and cervical cancer. Specific. METHODS include cold scalpel, ultrasonically activated device and laser, and loop electrosurgical excision procedure (LEEP), which involves transpiration and partial excision. The endoCUT mode and soft coagulation in VIO3® (ERBE, Tübingen, Germany) were used to perform cervical conical resection safely and at low cost. The endoCUT mode was originally developed for polypectomy in gastrointestinal endoscopy, where no counter traction can be applied. RESULTS The endoCUT mode approach to cervical conization with several key strategies to minimize blood loss and ensure safety: 1) incisions can be made in close contact; 2) resection can be performed with minimal contact with the lesion; 3) control of bleeding from the resected transection by soft coagulation; and 4) low running cost of endoCUT mode. CONCLUSION Conventionally, cervical conical resection has been performed by using a device capable of making a close incision (cold scalpel, ultrasonically activated device and laser, and LEEP etc.), but there have been issues with bleeding control and cost. Here, we present a new technique using the endoCUT mode and several strategies for safe and effective resection.
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Affiliation(s)
- Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, Sapporo, Japan
| | - Motoki Matsuura
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, Sapporo, Japan
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, Sapporo, Japan
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Tamate M, Matsuura M, Wada N, Adachi T, Yorozu K, Arimoto C, Saito T. Laparoscopic retrovesical lower uterine segment bypass for hysterectomy with previous caesarean section: Hung Up the Bladder Bypass (HUBB) technique. J Gynecol Obstet Hum Reprod 2023; 52:102629. [PMID: 37473961 DOI: 10.1016/j.jogoh.2023.102629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023]
Abstract
Patients with a history of cesarean section and a highly adherent bladder may have difficulty in bladder dissection and may suffer damage. It may also be difficult to orient the patient for repair in the event of damage. In such cases, dissection from the side between the bladder and cervix is a good way to avoid complication. This video reviews the steps of the HUBB technique procedure, provides tips and tricks for performing a successful adhesiolysis, and illustrates the procedure's adaptability. The first is the identification of the uterine artery and its position. Step2, a Laparoscopic retrovesical lower uterine segment bypass is created. Step3 a Hung Up the Bladder Bypass is created, the bladder is completely dissected. Step4, an adhesiolysis and leak test is performed. In this report, we would like to introduce a technique for creating a retrovesical lower uterine segment bypass using a laparoscope and traction on the bypass to dissect the bladder.
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Affiliation(s)
- Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, University of Sapporo, South 1 West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan.
| | - Motoki Matsuura
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, University of Sapporo, South 1 West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan
| | - Nagisa Wada
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, University of Sapporo, South 1 West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan
| | - Takaki Adachi
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, University of Sapporo, South 1 West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan
| | - Kazuma Yorozu
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, University of Sapporo, South 1 West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan
| | - Chihiro Arimoto
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, University of Sapporo, South 1 West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, University of Sapporo, South 1 West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan
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Kikuchi A, Yoshida H, Tsuda H, Nishio S, Suzuki S, Takehara K, Kino N, Sumi T, Kato K, Yokoyama M, Nakamura K, Takano M, Sato S, Kato H, Tamate M, Horie K, Kato T, Sakamoto A, Fukunaga M, Kaku T, Yoshida M, Yaegashi N, Satoh T. Clinical characteristics and prognostic factors of endometrial stromal sarcoma and undifferentiated uterine sarcoma confirmed by central pathologic review: A multi-institutional retrospective study from the Japanese Clinical Oncology Group. Gynecol Oncol 2023; 176:82-89. [PMID: 37478616 DOI: 10.1016/j.ygyno.2023.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 07/23/2023]
Abstract
OBJECTIVES Low-grade and high-grade endometrial stromal sarcomas (LGESS and HGESS) and undifferentiated uterine sarcomas (UUS) are rare tumors whose pathological classification and staging system have changed recently. These tumors are reported to contain fusion genes. We aimed to clarify the genetic background, clinical features, prognostic factors, and optimal therapy of these tumors using a new classification and staging system. METHODS We analyzed the clinical features and prognostic information of 72 patients with LGESS, 25 with HGESS, and 16 with UUS using central pathological review. Estrogen and progesterone receptors (PgRs) were examined by immunohistochemistry. JAZF1-SUZ12 and YWHAE-NUTM2A/B gene fusions were tested using real-time polymerase chain reaction. RESULTS The 5-year overall survival (OS) rates of LGESS, HGESS, and UUS were 94%, 53%, and 25%, respectively. In LGESS, stage IV, incomplete surgery, and absence of PgR were associated with poor OS. The presence of JAZF1-SUZ12 fusion gene was not associated with OS. In HGESS, the relationship between stage and prognosis was unclear. None of the 3 patients with YWHAE-NUTM2A/B fusion gene died during follow-up. Adjuvant chemotherapy was associated with a favorable OS. Incomplete resection of UUS was associated with poor OS; however, residual tumors frequently occurred. Although most patients underwent adjuvant chemotherapy, their prognosis was extremely poor even in stage I disease. CONCLUSIONS Prognosis of LGESS is generally good; however, stage IV, incomplete surgery, and PgR-negative tumors are associated with poor prognosis. Adjuvant chemotherapy may be useful for HGESS. Prognosis of UUS is extremely poor, even with adjuvant chemotherapy.
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Affiliation(s)
- Akira Kikuchi
- Department of Gynecology, Niigata Cancer Center Hospital, Niigata, Japan.
| | - Hiroshi Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Hitoshi Tsuda
- Department of Basic Pathology, National Defense Medical College, Tokorozawa, Japan
| | - Shin Nishio
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan
| | - Shiro Suzuki
- Department of Gynecologic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Kazuhiro Takehara
- Department of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Nao Kino
- Department of Gynecology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Toshiyuki Sumi
- Department of Obstetrics and Gynecology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Kazuyoshi Kato
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masatoshi Yokoyama
- Department of Obstetrics and Gynecology, Saga University Faculty of Medicine, Saga, Japan
| | - Kazuto Nakamura
- Department of Gynecology, Gunma Prefectural Cancer Center, Ota, Japan
| | - Masashi Takano
- Department of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa, Japan
| | - Shinya Sato
- Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Japan
| | - Hisamori Kato
- Department of Gynecology, Kanagawa Cancer Center, Yokohama, Japan
| | - Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Koji Horie
- Department of Gynecology, Saitama Cancer Center, Kita Adachi Gun, Japan
| | - Tomoyasu Kato
- Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
| | - Atsuhiko Sakamoto
- Department of Pathology and Laboratory Medicine, Omori Red Cross Hospital, Tokyo, Japan
| | - Masaharu Fukunaga
- Department of Pathology, Shin-Yurigaoka General Hospital, Kawasaki, Japan
| | - Tsunehisa Kaku
- Center for Preventive Medicine, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - Masayuki Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Toyomi Satoh
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Matsuura M, Yorozu K, Nagao S, Kurokawa S, Tamate M, Akimoto T, Saito T. Therapeutic efficacy of a four-year treatment with eribulin in a patient with uterine leiomyosarcoma: A case report. Gynecol Oncol Rep 2023; 47:101205. [PMID: 37273765 PMCID: PMC10238571 DOI: 10.1016/j.gore.2023.101205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/10/2023] [Accepted: 05/17/2023] [Indexed: 06/06/2023] Open
Abstract
Uterine leiomyosarcoma (LMS) is a gynecological malignancy with an extremely poor prognosis. Multiple new therapeutic agents, including pazopanib, trabectedin, and eribulin, have been clinically applied to treat uterine LMS, and their therapeutic effects are expected. We encountered one patient with advanced recurrent uterine LMS who achieved a partial response to a four-year treatment with eribulin. A 31-year-old woman was diagnosed with stage 2B LMS. After the first recurrence, Gemcitabine, Docetaxel (GD) therapy was administered, and complete response (CR) was achieved. However, 2 years and 10 months later, recurrence occurred at the vaginal cuff, and GD therapy and doxorubicin hydrochloride were administered, resulting in CR. Five months later, she experienced another recurrence at the same location and was treated with eribulin. To date, 53 courses of eribulin have been administered and are currently ongoing. Maintaining low neutrophil-to-lymphocyte ratio and low platelet-to lymphocyte ratio in this manner is considered to be one of the reasons why eribulin continues to be effective. We encountered a rare case in which eribulin was administered for the longest period of time, and produced an observable effect in uterine LMS.
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Affiliation(s)
- Motoki Matsuura
- Corresponding author at: Department of Obstetrics and Gynecology, Sapporo Medical University, S1 W17, Chuo-ku, Sapporo 060-8543, Japan.
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Nishimura Y, Matsuura M, Terada N, Nagao S, Shimada H, Isoyama K, Tamate M, Iwasaki M, Saito T. Mailing human papillomavirus self-sampling kits to women under-screened for cervical cancer improved detection in cervical cancer screening in a general population study in Japan. BMC Public Health 2023; 23:473. [PMID: 36906527 PMCID: PMC10008572 DOI: 10.1186/s12889-023-15402-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 03/08/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND One cause of the increase in cervical cancer rates in Japan is the long-term stagnation in the cervical cancer screening consultation rate. Therefore, improving the screening consultation rate is of urgent concern to reduce cervical cancer incidence. Self-collected human papilloma virus (HPV) tests have been successfully adopted in several countries, such as the Netherlands and Australia, as a measure of individuals who have not undergone cervical cancer screening in national programs. This study aimed to verify whether self-collected HPV tests presented an effective countermeasure for individuals who had not undergone the recommended cervical cancer screenings. METHODS This study was conducted from December 2020 to September 2022 in Muroran City, Japan. The primary evaluated endpoint was the percentage of citizens who underwent cervical cancer screening at a hospital with positive self-collected HPV test results. The secondary endpoint was the percentage of included participants who were diagnosed with cervical intraepithelial neoplasia (CIN) or higher among those who visited a hospital and underwent cervical cancer screening. RESULTS The included study participants were 7,653 individuals aged 20-50 years with no record of previous cervical cancer examination in the past 5 years. We mailed these participants information on self-administered HPV tests as an alternative screening procedure and sent the kit to 1,674 women who requested the test. Among them, 953 returned the kit. Among the 89 HPV-positive individuals (positive rate, 9.3%), 71 (79.8%) visited the designated hospital for an examination. A closer examination revealed that 13 women (18.3% of hospital visits) had a CIN finding of CIN2 or higher, among whom one each had cervical cancer and vulvar cancer, eight presented with CIN3, and three presented with CIN2; two cases of invasive gynecologic cancer were also identified. CONCLUSIONS We conclude that the self-collected HPV tests showed a certain efficacy as a measure of individuals who had not undergone the recommended cervical cancer screening. We devised ways to have the unexamined patients undergo HPV testing and ensure that HPV-positive individuals visited the hospital. Despite a few limitations, our findings suggest the effectiveness of this public health intervention.
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Affiliation(s)
- Yoko Nishimura
- Department of Obstetrics and Gynecology, Sapporo Medical University, S1 W17, Chuo-Ku, Sapporo, 060-8543, Japan
| | - Motoki Matsuura
- Department of Obstetrics and Gynecology, Sapporo Medical University, S1 W17, Chuo-Ku, Sapporo, 060-8543, Japan.
| | - Noriko Terada
- Department of Obstetrics and Gynecology, Sapporo Medical University, S1 W17, Chuo-Ku, Sapporo, 060-8543, Japan
| | - Sachiko Nagao
- Department of Obstetrics and Gynecology, Steel Memorial Muroran Hospital, Muroran, Japan
| | - Hiroshi Shimada
- Department of Obstetrics and Gynecology, Nikko Memorial Hospital, Muroran, Japan
| | - Kyoko Isoyama
- Department of Obstetrics and Gynecology, Sapporo Medical University, S1 W17, Chuo-Ku, Sapporo, 060-8543, Japan
| | - Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University, S1 W17, Chuo-Ku, Sapporo, 060-8543, Japan
| | - Masahiro Iwasaki
- Department of Obstetrics and Gynecology, Sapporo Medical University, S1 W17, Chuo-Ku, Sapporo, 060-8543, Japan
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University, S1 W17, Chuo-Ku, Sapporo, 060-8543, Japan
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Tamate M, Matsuura M, Kanao H, Saito T. A mixed-method evaluation of cadaver surgery training for gynecologic oncology. J Obstet Gynaecol Res 2022; 48:3252-3261. [PMID: 36128608 DOI: 10.1111/jog.15424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 08/23/2022] [Accepted: 08/28/2022] [Indexed: 11/27/2022]
Abstract
AIM Traditional surgical training techniques with using patients, and new advances with live animals, artificial models, and simulation methods have several shortcomings. There are a few reports on the usefulness of cadaver surgery training (CST) in gynecology. Herein, we used a mixed-method evaluation to qualitatively and quantitatively explore the educational efficacy of CST by conducting CST programs at the Sapporo Medical University, Japan. METHODS In 2020, we conducted two CST programs with 45 participants-13 residents, 8 specialists recognized by Japan Society of Obstetrics and Gynecology, 23 certified endoscopists recognized by Japan Society of Gynecology and Obstetrics Endoscopy and Minimally Invasive Therapy, 15 specialists recognized by Japan Society of Gynecologic Oncology, and 14 certified endoscopists cum oncology. Three participants observed the procedure virtually and 42 were physically present. Laparoscopic radical hysterectomy and pelvic exenteration were performed on five Thiel-embalmed cadavers. Participants were asked to complete pre- and post-training surveys that included qualitative questions, concerning the purpose and cost of CST, and quantitative questions, testing anatomical knowledge. RESULTS We observed that the rate of score improvement to the quantitative questions increased from 58.6% pre-CST to 75.6% post-CST. Furthermore, oncology specialists and those who performed more surgeries and faced more complications during surgeries recorded high percentage of correct answers. Multiple regression analysis statistically confirmed these results. CONCLUSIONS This study confirmed the educational efficacy of CST.
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Affiliation(s)
- Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, University of Sapporo, Hokkaido, Japan
| | - Motoki Matsuura
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, University of Sapporo, Hokkaido, Japan
| | - Hiroyuki Kanao
- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, University of Sapporo, Hokkaido, Japan
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Terada N, Matsuura M, Kurokawa S, Nishimura Y, Tamate M, Isoyama K, Yamazaki S, Shimada H, Suzuki M, Tabuchi Y, Teramoto M, Saito T. Human papillomavirus testing and cytology using physician-collected uterine cervical samples vs. self-collected vaginal samples and urine samples. Int J Clin Oncol 2022; 27:1742-1749. [DOI: 10.1007/s10147-022-02238-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 08/09/2022] [Indexed: 11/05/2022]
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Saito T, Matsuura M, Tamate M, Iwasaki M, Mariya T. Radical Vaginal Trachelectomy. Surg J (N Y) 2021; 7:S103-S107. [PMID: 35111936 PMCID: PMC8799313 DOI: 10.1055/s-0041-1739120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
AbstractRecently, radical vaginal hysterectomy (RVH) has developed into laparoscopically assisted radical vaginal hysterectomy (LARVH), which is associated with the laparoscopical procedure, and it is applied as radical vaginal trachelectomy and semi-radical vaginal hysterectomy. LARVH is indicated for patients with stage IB1 and IIA1 cervical carcinoma, especially those with a tumor size of less than 2 cm, because the cardinal ligaments cannot be resected widely. Although RVH that is associated with laparoscopic pelvic lymphadenectomy is the most used surgical procedure, radical trachelectomy may be performed either abdominally or vaginally (laparoscopic or robotic). One report found that the pregnancy rate was higher in patients who underwent minimally invasive or radical vaginal trachelectomy than in those who underwent radical abdominal trachelectomy.
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Affiliation(s)
- Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Motoki Matsuura
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Masahiro Iwasaki
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Tasuku Mariya
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
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Abe S, Iwasaki M, Habata S, Mariya T, Tamate M, Matsuura M, Satohisa S, Saito T. ERα increases endometrial cancer cell resistance to cisplatin via upregulation of BAG3. Oncol Lett 2020; 21:20. [PMID: 33240426 PMCID: PMC7681203 DOI: 10.3892/ol.2020.12281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/03/2020] [Indexed: 12/14/2022] Open
Abstract
Endometrial cancer is a leading cause of cancer-associated mortality in women and has a poor prognosis in advanced stages. Our previous study revealed that BCL-2-associated athanogene 3 (BAG3) may contribute to enhancing cell viability through downregulation of microRNA (miR)-29b in endometrial cancer cell lines. In addition, a relationship between estrogen receptor α (ERα) and BAG3 was recently reported in several cancer cell types. The present study investigated the relationship between ERα and BAG3 in endometrial cancer cell lines. The results demonstrated that exogenous ERα overexpression enhanced BAG3 expression in the EMTOKA endometrial cancer cell line, which does not endogenously express ERα, but had no effect on BAG3 expression levels in the Ishikawa cell line, which does endogenously express ERα. In addition, ERα overexpression suppressed miR-29b expression and enhanced the expression of Mcl-1, a mediator situated downstream of BAG3, in EMTOKA cells, but not Ishikawa cells. ERα overexpression also enhanced EMTOKA, but not Ishikawa, endometrial cancer cell viability in the presence of cisplatin. These findings suggested that ERα may contribute to enhancing endometrial cancer cell resistance to anticancer agents through BAG3 overexpression.
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Affiliation(s)
- Shuetsu Abe
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
| | - Masahiro Iwasaki
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
| | - Shutaro Habata
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
| | - Tasuku Mariya
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
| | - Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
| | - Motoki Matsuura
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
| | - Seiro Satohisa
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Hokkaido 060-8543, Japan
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Nagao S, Matsuura M, Tamate M, Sugita S, Saito T. Mucinous carcinoma originating in the peritoneum diagnosed by an ascites cell block: a case report. J Med Case Rep 2020; 14:99. [PMID: 32660614 PMCID: PMC7359487 DOI: 10.1186/s13256-020-02435-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 06/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Peritoneal carcinoma is a rare disease that is diagnosed and treated in a manner similar to ovarian cancer. In most cases, the histological type is serous carcinoma, and chemotherapy is effective. However, there are a few case reports of mucinous peritoneal carcinoma. We inferred the histological type before surgery using an ascites cell block sample, which was useful for determining the treatment plan. CASE PRESENTATION Our patient was a 60-year-old Japanese woman. She presented with a feeling of fullness in the abdomen. A computed tomographic scan showed a large quantity of ascitic fluid and thickening of the greater omentum, as well as thickening of the peritoneum at the pouch of Douglas and diaphragm. Hence, peritoneal carcinoma was suspected. The tumor markers carcinoembryonic antigen, cancer antigen 19-9, and cancer antigen 125 were all increased, and no malignant findings were observed in the uterus or ovaries. Cells suggestive of carcinoma were found in the ascitic fluid, and immunostaining by the cell block method suggested the possibility of mucinous carcinoma. The preoperative chemotherapy strategy was changed to short courses, and tumor reduction surgery was planned. Similar to the suspicion before surgery, the pathology results indicated mucinous carcinoma, and the therapeutic effect of chemotherapy was grade 0. CONCLUSIONS Determining whether peritoneal carcinoma is serous carcinoma is important for therapy and prognostic prediction. In this case, we encountered a patient for whom surgery was chosen because of drug therapy resistance inferred through histological type estimation using the cell block method. Inferring the histological type by cell block preparation is useful for diagnosis and treatment selection.
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Affiliation(s)
- Sachiko Nagao
- Department of Obstetrics and Gynecology, Sapporo Medical University, South 1 West 16, Chuo-ku, Sapporo, 060-8543, Japan. .,Department of Obstetrics and Gynecology, Kushiro City General Hospital, Kushiro, Hokkaido, Japan.
| | - Motoki Matsuura
- Department of Obstetrics and Gynecology, Sapporo Medical University, South 1 West 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University, South 1 West 16, Chuo-ku, Sapporo, 060-8543, Japan.,Department of Obstetrics and Gynecology, Kushiro City General Hospital, Kushiro, Hokkaido, Japan
| | - Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University, Sapporo, Japan
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University, South 1 West 16, Chuo-ku, Sapporo, 060-8543, Japan
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Takenaka S, Chikazawa K, Yoshiizumi E, Hirose Y, Tamate M, Nakayama K, Morioka M, Sekizawa A, Matsumoto K. Three-Dimensional Peripheral Bloodstream Model of the Uterus for Laparoscopic Radical Hysterectomy. J Minim Invasive Gynecol 2019; 27:1196-1202. [PMID: 31812612 DOI: 10.1016/j.jmig.2019.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 11/20/2019] [Accepted: 11/26/2019] [Indexed: 11/25/2022]
Abstract
Trainees require extensive experience to perform radical hysterectomy. Before starting training during an actual operation, trainees should be familiar with the pelvic anatomy and should simulate surgical procedures. Many simulators are available for virtual reality training of laparoscopic operations, but they are very expensive. The materials required to construct our model included sponges and colored wires sold in home improvement stores that allowed for superior cost effectiveness. The model represented almost all peripheral vessels and nerves around the uterus, including the minor vessels. Attaching and detaching the vessels was easy, facilitating reconstruction of the dissected vessels. The wires were easy to bend, ensuring high operability. This model allows for the simulation of laparoscopic radical hysterectomy in a dry box. Our model was superior to a 2-dimensional picture for the memorization of branching and positional relationships of the blood vessels. Comparison of our model with actual operative videos showed that the dry box provided an identical surgical view of an actual laparoscopic radical hysterectomy. We developed a peripheral bloodstream model of the uterus for repeated simulation of laparoscopic radical hysterectomy with an actual surgical view using a dry box.
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Affiliation(s)
- Shin Takenaka
- Department of Obstetrics and Gynecology, Showa University Fujigaoka Hospital, Yokohama (Drs. Takenaka, Yoshiizumi, Nakayama, and Morioka).
| | - Kenro Chikazawa
- Department of Obstetrics and Gynecology, Jichi Medical University, Saitama Medical Center, Saitama (Dr. Chikazawa)
| | - Eri Yoshiizumi
- Department of Obstetrics and Gynecology, Showa University Fujigaoka Hospital, Yokohama (Drs. Takenaka, Yoshiizumi, Nakayama, and Morioka)
| | - Yusuke Hirose
- Department of Obstetrics and Gynecology, Showa University Hospital, Tokyo (Drs. Hirose, Sekizawa, and Matsumoto), Japan
| | - Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo (Dr. Tamate)
| | - Ken Nakayama
- Department of Obstetrics and Gynecology, Showa University Fujigaoka Hospital, Yokohama (Drs. Takenaka, Yoshiizumi, Nakayama, and Morioka)
| | - Miki Morioka
- Department of Obstetrics and Gynecology, Showa University Fujigaoka Hospital, Yokohama (Drs. Takenaka, Yoshiizumi, Nakayama, and Morioka)
| | - Akihiko Sekizawa
- Department of Obstetrics and Gynecology, Showa University Hospital, Tokyo (Drs. Hirose, Sekizawa, and Matsumoto), Japan
| | - Koji Matsumoto
- Department of Obstetrics and Gynecology, Showa University Hospital, Tokyo (Drs. Hirose, Sekizawa, and Matsumoto), Japan
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Kikuchi A, Koide R, Iwasaki M, Teramoto M, Satohisa S, Tamate M, Horiguchi M, Niwa N, Saito T, Mizuguchi T. Assessing quality of life using the brief cancer-related worry inventory for gynecological surgery. World J Obstet Gynecol 2019; 8:1-7. [DOI: 10.5317/wjog.v8.i1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 08/24/2019] [Accepted: 10/09/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The mental status of gynecologic patients has an important influence on their quality of life (QOL). Although high-quality QOL studies into breast cancer patients have been performed internationally, few QOL studies have examined patients with gynecological cancer.
AIM To investigate the brief cancer-related worry inventory (BCWI) could evaluate the mental status of gynecological patients.
METHODS Between July 2018 and December 2018, 19 consecutive gynecological cancer patients were prospectively recruited for this study. The BCWI is a 15-item self-reported questionnaire that assesses cancer-related worries on a numeric scale (0–100).
RESULTS The high BCWI group was significantly younger than the low BCWI group. Regarding social status, the absence of a spouse and children was significantly more common in the high BCWI group than in the low BCWI group. The operation time was longer in the worsening BCWI group than in the stable BCWI group (305.3 ± 140.5 min vs 171.1 ± 97.2 min; P = 0.026).
CONCLUSION Being young, having no family, and a long operation time were found to be risk factors for increased anxiety. Therefore, gynecological cancer patients should be assessed using the BCWI, and specific perioperative mental care should be considered for highly anxious patients.
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Affiliation(s)
- Ami Kikuchi
- Department of Nursing and Surgical Science, Sapporo Medical University Postgraduate School of Health Science, Sapporo 0608556, Japan
| | - Ryo Koide
- Department of Nursing and Surgical Science, Sapporo Medical University Postgraduate School of Health Science, Sapporo 0608556, Japan
| | - Masahiro Iwasaki
- Department of Obstetrics and Gynecology, Sapporo Medical University Postgraduate School of Medicine, Sapporo 0608556, Japan
| | - Mizue Teramoto
- Department of Obstetrics and Gynecology, Sapporo Medical University Postgraduate School of Medicine, Sapporo 0608556, Japan
| | - Seiro Satohisa
- Department of Obstetrics and Gynecology, Sapporo Medical University Postgraduate School of Medicine, Sapporo 0608556, Japan
| | - Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University Postgraduate School of Medicine, Sapporo 0608556, Japan
| | - Masami Horiguchi
- Department of Nursing and Surgical Science, Sapporo Medical University Postgraduate School of Health Science, Sapporo 0608556, Japan
| | - Nozomi Niwa
- Department of Obstetrics and Gynecology, Sapporo Medical University Postgraduate School of Medicine, Sapporo 0608556, Japan
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University Postgraduate School of Medicine, Sapporo 0608556, Japan
| | - Toru Mizuguchi
- Department of Nursing and Surgical Science, Sapporo Medical University Postgraduate School of Health Science, Sapporo 0608556, Japan
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Matsuura M, Yamaguchi K, Tamate M, Satohisa S, Teramoto M, Iwasaki M, Sugita S, Hasegawa T, Koubo R, Takane K, Ikenoue T, Furukawa Y, Saito T. Efficacy of liquid-based genetic diagnosis of endometrial cancer. Cancer Sci 2018; 109:4025-4032. [PMID: 30289582 PMCID: PMC6272085 DOI: 10.1111/cas.13819] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 09/21/2018] [Accepted: 09/26/2018] [Indexed: 12/17/2022] Open
Abstract
Although liquid-based cytology (LBC) has increased the sensitivity of cytological diagnosis of endometrial cancer (EC) compared with conventional smear cytology, the sensitivity of LBC for the detection of EC is between 70% and 96% and remains unsatisfactory. In the present study, we compared the efficacy of LBC with liquid-based genetic diagnosis (LBGDx) by amplicon sequencing of five genes including PTEN, PIK3CA, CTNNB1, KRAS, and TP53 in 48 LBC subjects who underwent endometrial screening. Consequently, LBC classified 15 samples as "positive or suspicious for malignancy" and the 15 were later confirmed as EC. However, LBC failed to identify five cases who were diagnosed as EC by additional transvaginal ultrasound and endometrial curettage, indicating that the sensitivity of cytology alone was 75% (15/20). LBGDx identified 11 pathogenic PTEN variants in 10 subjects, six PIK3CA variants in nine, three CTNNB1 variants in five, two KRAS variants in four, and three TP53 variants in three. Collectively, at least one pathogenic variant was identified in 19 subjects, which included 17 EC (15 endometrioid carcinoma and 2 endometrial carcinosarcomas), and one cervical adenocarcinoma. However, LBGDx did not identify any pathogenic mutations in three of the 20 EC, indicating that the sensitivity of LBGDx alone was 85% (17/20). Although five EC were negative for malignancy by LBC and three were negative for pathogenic mutations by LBGDx, the combination of LBC and LBGDx would successfully diagnose all 20 EC. These data suggested that LBGDx is a useful strategy to improve the sensitivity of screening of EC by LBC.
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Affiliation(s)
- Motoki Matsuura
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Kiyoshi Yamaguchi
- Division of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Seiro Satohisa
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Mizue Teramoto
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Masahiro Iwasaki
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University, Sapporo, Japan
| | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University, Sapporo, Japan
| | - Rika Koubo
- Division of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Kiyoko Takane
- Division of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Tsuneo Ikenoue
- Division of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yoichi Furukawa
- Division of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
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Habata S, Iwasaki M, Sugio A, Suzuki M, Tamate M, Satohisa S, Tanaka R, Saito T. BAG3-mediated Mcl-1 stabilization contributes to drug resistance via interaction with USP9X in ovarian cancer. Int J Oncol 2016; 49:402-10. [PMID: 27120977 DOI: 10.3892/ijo.2016.3494] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 03/30/2016] [Indexed: 12/21/2022] Open
Abstract
Paclitaxel in combination with carboplatin improves survival among patients with susceptible ovarian cancers, but no strategy has been established against resistant ovarian cancers. BAG3 (Bcl-2-associated athanogene 3) is one of six BAG family proteins, which are involved in such cellular processes as proliferation, migration and apoptosis. In addition, expression of BAG3 with Mcl-1, a Bcl-2 family protein, reportedly associates with resistance to chemotherapy. Our aim in this study was to evaluate the functional role of BAG3 and Mcl-1 in ovarian cancer chemoresistance and explore possible new targets for treatment. We found that combined expression of BAG3 and Mcl-1 was significantly associated with a poor prognosis in ovarian cancer patients. In vitro, BAG3 knockdown in ES2 clear ovarian cancer cells significantly increased the efficacy of paclitaxel in combination with the Mcl-1 antagonist MIM1, with or without the Bcl-2 family antagonist ABT737. Moreover, BAG3 was found to positively regulate Mcl-1 levels by binding to and inhibiting USP9X. Our data show that BAG3 and Mcl-1 are key mediators of resistance to chemotherapy in ovarian cancer. In BAG3 knockdown ES2 clear ovarian cancer cells, combination with ABT737 and MIM1 enhanced the efficacy of paclitaxel. These results suggest that inhibiting BAG3 in addition to anti-apoptotic Bcl-2 family proteins may be a useful therapeutic strategy for the treatment of chemoresistant ovarian cancers.
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Affiliation(s)
- Shutaro Habata
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo 060-8543, Japan
| | - Masahiro Iwasaki
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo 060-8543, Japan
| | - Asuka Sugio
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo 060-8543, Japan
| | - Miwa Suzuki
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo 060-8543, Japan
| | - Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo 060-8543, Japan
| | - Seiro Satohisa
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo 060-8543, Japan
| | - Ryoichi Tanaka
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo 060-8543, Japan
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo 060-8543, Japan
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Tamate M, Matsuura M, Habata S, Akashi Y, Tanaka R, Ishioka S, Endo T, Saito T. Preservation of fertility and subsequent childbirth after methotrexate treatment of placenta percreta: a case report. J Med Case Rep 2015; 9:232. [PMID: 26480940 PMCID: PMC4617897 DOI: 10.1186/s13256-015-0716-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 09/28/2015] [Indexed: 11/28/2022] Open
Abstract
Introduction Placenta percreta is associated with maternal morbidity and mortality. A hysterectomy is often needed to control the bleeding in such cases. However, it has been advocated that placenta percreta be managed conservatively to avoid massive pelvic bleeding and to preserve the patient’s fertility. Here, we present a case of placenta percreta diagnosed by magnetic resonance imaging, and treated with systemic administration of methotrexate. Case presentation A 27-year-old nulliparous Japanese woman at 39 gestational weeks had an uncomplicated vaginal delivery of a 3244-g infant. However, her placenta was not delivered, and we could not remove it manually. Contrast-enhanced magnetic resonance imaging indicated deep myometrial invasion by placental tissue and the whole placenta was strongly enhanced. Seven days post-partum, her serum human chorionic gonadotropin level was 12,656IU/L. Our patient hoped to preserve her uterus for a future pregnancy. She therefore received 13 courses of methotrexate (50mg/week, intravenous injection). Her serum human chorionic gonadotropin level was undetectable 97 days after the first methotrexate injection. At 117 days post-partum, she had a labor-like pain every three minutes and delivered the placenta. Our patient regained normal menses and at follow-up remained in good health. Two years later, she delivered a healthy daughter. Conclusion We should try to detect placenta percreta in high-risk patients by any means. For low-risk patients, we should give a diagnosis swiftly and control any intrauterine infection and massive bleeding.
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Affiliation(s)
- Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, South 1, West 16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
| | - Motoki Matsuura
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, South 1, West 16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Shutaro Habata
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, South 1, West 16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Yushi Akashi
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, South 1, West 16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Ryoichi Tanaka
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, South 1, West 16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Shinichi Ishioka
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, South 1, West 16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Toshiaki Endo
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, South 1, West 16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University Hospital, South 1, West 16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
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Sugio A, Iwasaki M, Habata S, Mariya T, Suzuki M, Osogami H, Tamate M, Tanaka R, Saito T. BAG3 upregulates Mcl-1 through downregulation of miR-29b to induce anticancer drug resistance in ovarian cancer. Gynecol Oncol 2014; 134:615-23. [DOI: 10.1016/j.ygyno.2014.06.024] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 06/23/2014] [Accepted: 06/24/2014] [Indexed: 01/10/2023]
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20
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Matsuura M, Tamate M, Tabuchi Y, Takada S, Tanaka R, Iwasaki M, Saito T. Prediction of the therapeutic effect of dienogest in ovarian endometrial cysts using the apparent diffusion coefficient. Gynecol Endocrinol 2014; 30:597-9. [PMID: 24811093 DOI: 10.3109/09513590.2014.911277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to investigate whether apparent diffusion coefficient (ADC) mean values can be used for predicting the treatment response in ovarian endometrial cyst patients with dienogest (DNG) administration. Eighteen patients received DNG (2 mg/day, orally) for 60 days, among whom 26 ovarian endometrial cysts were retrospectively identified. Mean ADC values of individual ovarian endometrial cysts were obtained by ADC maps inside the tumor. There was a significant correlation between ADC values and reduction ratio. When calculating the mean ADC values for three groups; more than 50%, 50-25% and less than 25%, ADC values significantly increased with increasing reduction ratio; 2.05 × 10(-3)mm(2)/s, 1.28 × 10(-3)mm(2)/s and 0.94 × 10(-3)mm(2)/s, respectively (p = 0.0180). Multiple regression analysis by reduction ratio (%), ADC mean values (× 10(-3)mm(2)/s), tumor longest diameter (cm) and CA125 (U/ml) revealed that tumor reduction ratio by DNG administration could be predicted by the following equation; R = 19.3 + 24.0x - 0.4y + 0.1z (R: Reduction ratio, x: ADC mean, y: Longest diameter, z: CA125). In conclusion, the ADC mean value is useful for the prediction of the treatment response in ovarian endometrial cyst patients with DNG administration.
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Affiliation(s)
- Motoki Matsuura
- Department of Obstetrics and Gynecology, Sapporo Medical University , Sapporo , Japan and
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