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Kakinuma T, Kakinuma K, Okamoto R, Yanagida K, Ohwada M, Takeshima N. Abnormal uterine bleeding successfully treated via ultrasound-guided microwave ablation of uterine myoma lesions: Three case reports. World J Clin Cases 2024; 12:980-987. [PMID: 38414604 PMCID: PMC10895625 DOI: 10.12998/wjcc.v12.i5.980] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/27/2023] [Accepted: 01/18/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Microwave endometrial ablation (MEA) is a minimally invasive treatment method for heavy menstrual bleeding. However, additional treatment is often required after recurrence of uterine myomas treated with MEA. Additionally, because this treatment ablates the endometrium, it is not indicated for patients planning to become pregnant. To overcome these issues, we devised a method for ultrasound-guided microwave ablation of uterine myoma feeder vessels. We report three patients successfully treated for heavy menstrual bleeding, secondary to uterine myoma, using our novel method. CASE SUMMARY All patients had a favorable postoperative course, were discharged within 4 h, and experienced no complications. Further, no postoperative recurrence of heavy menstrual bleeding was noted. Our method also reduced the myoma's maximum diameter. CONCLUSION This method does not ablate the endometrium, suggesting its potential application in patients planning to become pregnant.
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Affiliation(s)
- Toshiyuki Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Kaoru Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Rora Okamoto
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Kaoru Yanagida
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Michitaka Ohwada
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Nobuhiro Takeshima
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
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Kakinuma K, Kakinuma T, Ueyama K, Shinohara T, Okamoto R, Yanagida K, Takeshima N, Ohwada M. LiNA OperaScope TM for microwave endometrial ablation for endometrial polyps with heavy menstrual bleeding: A case report. World J Clin Cases 2023; 11:8557-8562. [PMID: 38188210 PMCID: PMC10768509 DOI: 10.12998/wjcc.v11.i36.8557] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/28/2023] [Accepted: 12/11/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND The procedure for microwave endometrial ablation (MEA) follows established MEA practice guidelines but requires hysteroscopic observation of the uterine lumen before and after MEA. When a luminal uterine lesion is recognized, its removal requires preoperative dilation of the cervix because the outer diameter of a conventional rigid hysteroscope is 8.7 mm. Recently, a fully disposable rigid hysteroscope (LiNA OperaScopeTM) with a narrow diameter (4.4 mm) and forceps capable of extracting endometrial lesions has become available. CASE SUMMARY Here, we report a case of heavy menstrual bleeding (HMB) complicated by endometrial polyps where MEA was performed after removing endometrial polyps using the LiNA OperaScopeTM device. A 48-year-old woman with three prior pregnancies and three deliveries was referred to our hospital for further examination and treatment after being diagnosed with HMB 2 years earlier. The patient underwent MEA following endometrial polypectomy using LiNA OperaScopeTM. After MEA, endometrial cauterization was again examined using the LiNA OperaScopeTM, and the procedure was completed. No preoperative cervical dilation was performed. The patient's clinical course was favorable, and she was discharged 3 h after surgery. One month after surgery, menstruation resumed, and both HMB and dysmenorrhea improved markedly from 10 preoperatively to 1 postoperatively, as assessed subjectively using the visual analog scale. The patient's postoperative course was uneventful with no complications. CONCLUSION LiNA OperaScopeTM can be a minimally invasive treatment for MEA of HMB with uterine lumen lesions.
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Affiliation(s)
- Kaoru Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
| | - Toshiyuki Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
| | - Kyouhei Ueyama
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
| | - Takumi Shinohara
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
| | - Rora Okamoto
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
| | - Kaoru Yanagida
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
| | - Nobuhiro Takeshima
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
| | - Michitaka Ohwada
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
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Osuka Y, Takeshima N, Kojima N, Kohama T, Fujita E, Kusunoki M, Kato Y, Brechue WF, Sasai H. Discrimination of Frailty Phenotype by Kinect TM-Based Stepping Parameters. JAR Life 2023; 12:100-104. [PMID: 38186668 PMCID: PMC10767484 DOI: 10.14283/jarlife.2023.17] [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] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024]
Abstract
Background Frailty increases the risk of falling, hospitalization, and premature death, necessitating practical early-detection tools. Objectives To examine the discriminative ability of KinectTM-based stepping parameters for identifying frailty phenotype. Design Population-based cross-sectional study. Setting Eighteen neighborhoods near Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan. Participants In total, 563 community-dwelling older adults aged ≥75 years without mobility limitations, neurological disease, or dementia were included. Measurements Step number (SN) and knee total movement distance (KMD) during a 20-s stepping test were evaluated using the KinectTM infrared depth sensor. Results The number (%) of participants with frailty were 51 (9.1). The area under the receiver operating characteristic curves (95% confidence interval) of a parameter consisting of SN and KMD for frailty was 0.72 (0.64, 0.79). Conclusions Stepping parameters evaluated using KinectTM provided acceptable ability in identifying frailty phenotype, making it a practical screening tool in primary care and home settings.
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Affiliation(s)
- Y Osuka
- Department of Frailty Research, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - N Takeshima
- Department of Health and Sports Sciences, Asahi University, Gifu, Japan
| | - N Kojima
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - T Kohama
- Faculty of Biology-Oriented Science and Technology, Kindai University, Wakayama, Japan
| | - E Fujita
- Department of Sports and Life Science, National Institute of Fitness and Sports in Kanoya, Kagoshima, Japan
| | - M Kusunoki
- Faculty of Biology-Oriented Science and Technology, Kindai University, Wakayama, Japan
| | - Y Kato
- Department of Physical Therapy, Nagoya Women's University, Aichi, Japan
| | - W F Brechue
- Department of Physiology, Kirksville College of Osteopathic Medicine, A.T. Still University of Health Sciences, Missouri, USA
| | - H Sasai
- Department of Frailty Research, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
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Kakinuma T, Kaneko A, Kakinuma K, Matsuda Y, Yanagida K, Takeshima N, Ohwada M. Effectiveness of treating menorrhagia using microwave endometrial ablation at a frequency of 2.45 GHz. World J Clin Cases 2023; 11:5653-5659. [PMID: 37727709 PMCID: PMC10505997 DOI: 10.12998/wjcc.v11.i24.5653] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/17/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Microwave endometrial ablation (MEA) is a minimally invasive treatment for menorrhagia. It has been covered by the national insurance in Japan since April 2012, and its demand has been increasing as the importance of women's health has advanced in society. AIM To examine the efficacy of MEA as a treatment option for menorrhagia. METHODS In this study, we retrospectively analyzed 76 patients who underwent MEA between January 2016 and March 2020 in our department. MEA was performed in the lithotomy position, under general anesthesia, and with transabdominal ultrasound guidance, including the entire endometrial circumference while confirming endometrial coagulation. The Microtaze AFM-712 and the Sounding Applicator CSA-40CBL-1006200C were used for MEA, and the endometrium was ablated using a Microtaze output of 70 W and coagulation energization time of 50 s per cycle. The visual analog scale (VAS) was used to evaluate menorrhagia, menstrual pain, and treatment satisfaction. Additionally, the hemoglobin (Hb) levels before and after MEA and associated complications were investigated. RESULTS The average age of the patients was 44.8 ± 4.0 years. While 14 patients had functional menorrhagia, 62 had organic menorrhagia, of whom 14 had endometrial polyps, 40 had uterine fibroids, and 8 had adenomyosis. The VAS score before MEA and 3 and 6 mo after the procedure were 10, 1.3 ± 1.3, and 1.3 ± 1.3, respectively, for menorrhagia and 10, 1.3 ± 1.8, and 1.3 ± 1.8, respectively, for menstrual pain, both showing improvements (P < 0.001). The MEA Hb level significantly improved from 9.2 ± 4.2 g/dL before MEA to 13.4 ± 1.2 g/dL after MEA (P = 0.003). Treatment satisfaction was high, with a VAS score of 9.6 ± 0.7. Endometritis was observed in one patient after surgery and was treated with antibiotics. CONCLUSION MEA is a safe and effective treatment for menorrhagia.
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Affiliation(s)
- Toshiyuki Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Ayaka Kaneko
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Kaoru Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Yoshio Matsuda
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Kaoru Yanagida
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Nobuhiro Takeshima
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Michitaka Ohwada
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
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Kakinuma T, Kaneko A, Kakinuma K, Imai K, Takeshima N, Ohwada M. New native tissue repair for pelvic organ prolapse: Medium-term outcomes of laparoscopic vaginal stump–round ligament fixation. World J Clin Cases 2023; 11:3457-3463. [PMID: 37383910 PMCID: PMC10294204 DOI: 10.12998/wjcc.v11.i15.3457] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/02/2023] [Accepted: 04/14/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Laparoscopic sacrocolpopexy for pelvic organ prolapse (POP) is a new and widely used approach; however, ever since the United States Food and Drug Administration warned against the use of surgical mesh, repairs performed using patients’ tissues [i.e. native tissue repair (NTR)] instead of mesh have attracted much attention. At our hospital, laparoscopic sacrocolpopexy (the Shull method) was introduced in 2017. However, patients with more severe POP who have a long vaginal canal and overextended uterosacral ligaments may not be candidates for this procedure.
AIM To validate a new NTR treatment for POP, we examined patients undergoing laparoscopic vaginal stump–round ligament fixation (the Kakinuma method).
METHODS The study patients were 30 individuals with POP who underwent surgery using the Kakinuma method between January 2020 and December 2021 and who were followed up for > 12 mo after surgery. We retrospectively examined surgical outcomes for surgery duration, blood loss, intraoperative complications, and incidence of recurrence. The Kakinuma method involves round ligament suturing and fixation on both sides, effectively lifting the vaginal stump after laparoscopic hysterectomy.
RESULTS The patients’ mean age was 66.5 ± 9.1 (45-82) years, gravidity was 3.1 ± 1.4 (2-7), parity was 2.5 ± 0.6 (2-4) times, and body mass index was 24.5 ± 3.3 (20.9-32.8) kg/m2. According to the POP quantification stage classification, there were 8 patients with stage II, 11 with stage III, and 11 with stage IV. The mean surgery duration was 113.4 ± 22.6 (88-148) min, and the mean blood loss was 26.5 ± 39.7 (10-150) mL. There were no perioperative complications. None of the patients exhibited reduced activities of daily living or cognitive impairment after hospital discharge. No cases of POP recurrence were observed 12 mo after the operation.
CONCLUSION The Kakinuma method, similar to conventional NTR, may be an effective treatment for POP.
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Affiliation(s)
- Toshiyuki Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare, Nasushiobara 329-2763, Japan
| | - Ayaka Kaneko
- Department of Obstetrics and Gynecology, International University of Health and Welfare, Nasushiobara 329-2763, Japan
| | - Kaoru Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare, Nasushiobara 329-2763, Japan
| | - Ken Imai
- Department of Obstetrics and Gynecology, International University of Health and Welfare, Nasushiobara 329-2763, Japan
| | - Nobuhiro Takeshima
- Department of Obstetrics and Gynecology, International University of Health and Welfare, Nasushiobara 329-2763, Japan
| | - Michitaka Ohwada
- Department of Obstetrics and Gynecology, International University of Health and Welfare, Nasushiobara 329-2763, Japan
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Kakinuma T, Kakinuma K, Shinohara T, Shimizu A, Okamoto R, Kaneko A, Takeshima N, Yanagida K, Ohwada M. Efficacy and safety of an Aron Alpha method in managing giant ovarian tumors. Gynecol Oncol Rep 2023; 46:101167. [PMID: 37033210 PMCID: PMC10073634 DOI: 10.1016/j.gore.2023.101167] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 04/11/2023] Open
Abstract
Background Giant malignant tumors have an increased risk of intraoperative rupture, which might lead to a worse disease condition and tumor recurrence. We performed a clinical study on patients with a giant ovarian mass who underwent laparoscopy combined with an Aron Alpha method. Methods This retrospective clinical study spanned from January 2016 to September 2022 and included 23 patients with giant ovarian tumors treated with an Aron Alpha method. Results The mean age of the subjects was 47.6 ± 17.8 years, mean tumor diameter 20.4 ± 5.8 cm, mean surgical duration 87.2 ± 33.1 min, and mean hemorrhage volume 94.1 ± 92.2 mL. No patient experienced intraoperative tumor rupture or surgery-related symptoms. Histopathology of excised samples revealed serous cyst adenoma and mucinous cystadenoma, mucinous cystadenoma of borderline malignancy and mature cystic teratoma, and endometriotic cyst adenoma in 6, 4, and 3 patients, respectively. The mean hospitalization period was 6.0 ± 1.2 days, and the hospitalization period was not extended in any subject. Conclusion The Aron Alpha method allows tumor resection without capsular rupture and is a useful, minimally invasive surgical method for resecting giant ovarian tumors in which malignancy cannot be ruled out.
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Kakinuma T, Kakinuma K, Shimizu A, Kaneko A, Kagimoto M, Okusa T, Suizu E, Saito K, Matsuda Y, Yanagida K, Takeshima N, Ohwada M. Effectiveness of microwave endometrial ablation combined with hysteroscopic transcervical resection in treating submucous uterine myomas. World J Clin Cases 2022; 10:13200-13207. [PMID: 36683642 PMCID: PMC9850998 DOI: 10.12998/wjcc.v10.i36.13200] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/29/2022] [Accepted: 12/05/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Hypermenorrhea is characterized by excessive menstrual bleeding that causes severe anemia and interferes with everyday life. This condition can restrict women’s social activities and decrease their quality of life. Microwave endometrial ablation (MEA) using a 2.45-GHz energy source is a minimally invasive alternative to conventional hysterectomy for treating hypermenorrhea that is resistant to conservative treatment, triggered by systemic disease or medications, or caused by uterine myomas and fibrosis. The popularity of MEA has increased worldwide. Although MEA can safely and effectively treat submucous myomas, some patients may still experience recurrent hypermenorrhea postoperatively and may require additional treatment.
AIM To investigate the efficacy of MEA combined with transcervical resection (TCR).
METHODS Participants underwent cervical and endometrial evaluations. Magnetic resonance imaging and hysteroscopy were performed to evaluate the size and location of the myomas. TCR was performed before MEA using a hystero-resectoscope. MEA was performed using transabdominal ultrasound. The variables included operation time, number of ablation cycles, length of hospital stay, and visual analog scale cores for hypermenorrhea, dysmenorrhea, and treatment satisfaction at 3 and 6 mo postoperatively. The postoperative incidence of amenorrhea, changes in hemoglobin concentrations, and MEA-related complications were evaluated.
RESULTS A total of 34 women underwent a combination of MEA and TCR during the study period. Two patients were excluded from the study as their histopathological tests identified uterine malignancies (uterine sarcoma and endometrial cancer). The 32 eligible women (6 nulliparous, 26 multiparous) had a mean age of 45.2 ± 4.3 years (range: 36–52 years). Patients reported very severe hypermenorrhea (10/10 points on the visual analog scale) before the procedure. However, after the procedure, the hypermenorrhea scores decreased to 1.2 ± 1.3 and 0.9 ± 1.3 at 3 and 6 mo, respectively (P < 0.001). The mean follow-up duration was 33.8 ± 16.8 mo. Although 10 women (31.3%) developed amenorrhea during this period, none experienced a recurrence of hypermenorrhea. No surgical complications were observed.
CONCLUSION Reducing the size of uterine myomas by combining MEA and TCR can safely and effectively treat hypermenorrhea in patients with submucous myomas.
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Affiliation(s)
- Toshiyuki Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Kaoru Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Ayano Shimizu
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Ayaka Kaneko
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Masataka Kagimoto
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Takafumi Okusa
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Eri Suizu
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Koyomi Saito
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Yoshio Matsuda
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Kaoru Yanagida
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Nobuhiro Takeshima
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
| | - Michitaka Ohwada
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
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Kakinuma K, Kakinuma T, Kaneko A, Kagimoto M, Takeshima N, Ohwada M, Yanagida K. Natural Pregnancy Associated with Uterine Inversion after Combined Laparoscopic and Hysteroscopic Septum Resection: A Case Report. J Obstet Gynaecol India 2022; 72:382-384. [PMID: 36457431 PMCID: PMC9701277 DOI: 10.1007/s13224-022-01640-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 02/14/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Kaoru Kakinuma
- Department of Obstetrics and Gynecology, International Health and Welfare Hospital, 537-3, Iguchi, Tochigi, Nasushiobara, 327-2763 Japan
| | - Toshiyuki Kakinuma
- Department of Obstetrics and Gynecology, International Health and Welfare Hospital, 537-3, Iguchi, Tochigi, Nasushiobara, 327-2763 Japan
| | - Ayaka Kaneko
- Department of Obstetrics and Gynecology, International Health and Welfare Hospital, 537-3, Iguchi, Tochigi, Nasushiobara, 327-2763 Japan
| | - Masataka Kagimoto
- Department of Obstetrics and Gynecology, International Health and Welfare Hospital, 537-3, Iguchi, Tochigi, Nasushiobara, 327-2763 Japan
| | - Nobuhiro Takeshima
- Department of Obstetrics and Gynecology, International Health and Welfare Hospital, 537-3, Iguchi, Tochigi, Nasushiobara, 327-2763 Japan
| | - Michitaka Ohwada
- Department of Obstetrics and Gynecology, International Health and Welfare Hospital, 537-3, Iguchi, Tochigi, Nasushiobara, 327-2763 Japan
| | - Kaoru Yanagida
- Department of Obstetrics and Gynecology, International Health and Welfare Hospital, 537-3, Iguchi, Tochigi, Nasushiobara, 327-2763 Japan
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Ichii N, Kakinuma T, Fujikawa A, Takeda M, Ohta T, Kagimoto M, Kaneko A, Izumi R, Kakinuma K, Saito K, Maeyama A, Yanagida K, Takeshima N, Ohwada M. Diagnosed corrected transposition of great arteries after cesarean section: A case report. World J Clin Cases 2022; 10:9821-9827. [PMID: 36186208 PMCID: PMC9516933 DOI: 10.12998/wjcc.v10.i27.9821] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/17/2022] [Accepted: 08/21/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Corrected transposition of the great arteries (cTGA) is a cardiac malformation in which the ventricular and arterial-ventricular positions in the heart are doubly reversed. In general, this defect puts a load on the systemic circulation and causes heart failure, resulting in a poor prognosis. This article reports a case of cTGA detected in a patient with post-caesarean pregnancy who had undergone elective caesarean section and was experiencing an episode of acute heart failure.
CASE SUMMARY This was the case of a 36-year-old gravida 3 para 1 woman. No problems were noted in the puerperal course following the previous pregnancy. The current pregnancy was also uneventful. An elective caesarean section was performed and the patient was discharged from the hospital 7 d after the operation. On postoperative day 18, the patient became aware of breathing difficulty and presented at a nearby clinic, where she was referred to our institution after bilateral pleural effusions were detected. She was then diagnosed with acute heart failure after noting the presence of a prominent pedal oedema and SpO2 91% (supine position and room air); the patient was promptly hospitalised for close examination and treatment. Although chest computed tomography revealed the presence of cTGA, no other cardiac malformations were observed. Owing to improvements in both the pedal oedema and pleural effusions, the patient was discharged on day 9.
CONCLUSION Close examination should be performed on the premise of congenital cardiac malformation when heart failure symptoms are noted during perinatal control.
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Affiliation(s)
- Naoki Ichii
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Toshiyuki Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Atsushi Fujikawa
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Morihiko Takeda
- Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Tomoyuki Ohta
- Department of Radiology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Masataka Kagimoto
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Ayaka Kaneko
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Ryo Izumi
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Kaoru Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Koyomi Saito
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Asako Maeyama
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Kaoru Yanagida
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Nobuhiro Takeshima
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
| | - Michitaka Ohwada
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
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Kakinuma T, Kagimoto M, Kaneko A, Ichii N, Kakinuma K, Kawarai Y, Yanagida K, Tanaka H, Ohwada M, Takeshima N. Prevention and management of hypertrophic scars after laparoscopic surgery using silicone gel sheets: a pilot study. J Int Med Res 2022; 50:3000605221107597. [PMID: 35929020 PMCID: PMC9358567 DOI: 10.1177/03000605221107597] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To assess the effectiveness and safety of modified silicone gel sheets applied to hypertrophic scars and keloids following laparoscopic surgery. Methods Patients who had undergone laparoscopic surgery and who had either conventional or modified silicone gel sheets affixed to their surgical lesions for 6 months postoperatively (treatment groups), and control patients who had not received postsurgical treatment involving silicone gel sheets, were enrolled. The surgical wounds were assessed visually and using the Japan Scar Workshop (JSW) Scar Scale. Patients were interviewed before, 3 months after, and 6 months after sheet affixation. Results A total of 45 patients were included, comprising 15 patients per group. Both silicone gel-sheet groups had significantly lower JSW Scar Scale scores at 3 and 6 months after affixation compared with controls. The scores were not significantly different between the conventional and modified treatment groups and no adverse events were observed in the latter. Conclusions Modified silicone gel sheets were more effective than controls and comparable to conventional gel sheets, and there were no adverse events related to laparoscopic surgical wounds in the improved silicone gel sheet group, demonstrating the safety and effectiveness of the modified silicone gel sheets.
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Affiliation(s)
- Toshiyuki Kakinuma
- Department of Obstetrics and Gynaecology, International University of Health and Welfare Hospital, Iguchi, Nasushiobara-City, Tochigi, Japan
| | - Masataka Kagimoto
- Department of Obstetrics and Gynaecology, International University of Health and Welfare Hospital, Iguchi, Nasushiobara-City, Tochigi, Japan
| | - Ayaka Kaneko
- Department of Obstetrics and Gynaecology, International University of Health and Welfare Hospital, Iguchi, Nasushiobara-City, Tochigi, Japan
| | - Naoki Ichii
- Department of Obstetrics and Gynaecology, International University of Health and Welfare Hospital, Iguchi, Nasushiobara-City, Tochigi, Japan
| | - Kaoru Kakinuma
- Department of Obstetrics and Gynaecology, International University of Health and Welfare Hospital, Iguchi, Nasushiobara-City, Tochigi, Japan
| | - Yoshimasa Kawarai
- Department of Obstetrics and Gynaecology, International University of Health and Welfare Hospital, Iguchi, Nasushiobara-City, Tochigi, Japan
| | - Kaoru Yanagida
- Department of Obstetrics and Gynaecology, International University of Health and Welfare Hospital, Iguchi, Nasushiobara-City, Tochigi, Japan
| | - Hirokazu Tanaka
- Department of Obstetrics and Gynaecology, International University of Health and Welfare Hospital, Iguchi, Nasushiobara-City, Tochigi, Japan
| | - Michitaka Ohwada
- Department of Obstetrics and Gynaecology, International University of Health and Welfare Hospital, Iguchi, Nasushiobara-City, Tochigi, Japan
| | - Nobuhiro Takeshima
- Department of Obstetrics and Gynaecology, International University of Health and Welfare Hospital, Iguchi, Nasushiobara-City, Tochigi, Japan
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11
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Kakinuma T, Kakinuma K, Kaneko A, Kagimoto M, Kawarai Y, Ihara M, Saito K, Matsuda Y, Ohwada M, Tanaka H, Takeshima N, Yanagida K. Safety and efficacy of manual vacuum aspiration under local anesthesia compared to general anesthesia in the surgical management of miscarriage: a retrospective cohort study. Patient Saf Surg 2022; 16:16. [PMID: 35614492 PMCID: PMC9131636 DOI: 10.1186/s13037-022-00328-7] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/15/2022] [Indexed: 11/17/2022] Open
Abstract
Background In Japan, dilatation & curettage (D&C) has been performed under general anesthesia as a surgery for an early pregnancy miscarriage for a long time. In 2016, manual vacuum aspiration (MVA) under general anesthesia was introduced at our hospital and has been used as a surgical treatment for first-trimester pregnancy miscarriage, with its utility to date being reported here. In July 2018, our hospital introduced the MVA procedure under local anesthesia. In this study, we evaluated the efficacy and safety of MVA under general and local anesthesia in first-trimester pregnancy miscarriage surgery in Japanese women. Methods In this retrospective observational cohort study, we enrolled 322 pregnant women at less than 12 weeks of gestation, who underwent MVA surgery under local anesthesia (n = 166) or conventional general anesthesia (n = 156). The duration of surgery, blood loss volume, quantity of anesthesia, presence or absence of retained products of conception, and clinical complications were evaluated. In addition, the intraoperative pain and treatment satisfaction were assessed using the visual analog scale (VAS). Results The duration of surgery was significantly shorter in the local anesthesia group. No significant differences were observed between both groups in terms of the blood loss volume and incidence of retained products of conception. In addition, no serious complications were observed in either group. No significant differences were noted between the two groups in the VAS scores for pain and treatment satisfaction. Conclusions In this retrospective study, the use of MVA under local anesthesia for early pregnancy miscarriage surgery was found to be equally safe and effective when performed under conventional general anesthesia. This technique allowed the achievement of appropriate pain control with excellent patient satisfaction. Supplementary Information The online version contains supplementary material available at 10.1186/s13037-022-00328-7.
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Affiliation(s)
- Toshiyuki Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan.
| | - Kaoru Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Ayaka Kaneko
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Masataka Kagimoto
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Yoshimasa Kawarai
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Motomasa Ihara
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Koyomi Saito
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Yoshio Matsuda
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Michitaka Ohwada
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Hirokazu Tanaka
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Nobuhiro Takeshima
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Kaoru Yanagida
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan
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12
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Tanigawa T, Takeshima N, Ishikawa H, Nishio S, Usami T, Yamawaki T, Oishi T, Ihira K, Kato H, Goto M, Saito M, Taira Y, Yokoyama M, Shoji T, Kondo E, Mori A, Yokoi T, Iwasa-Inoue N, Hirashima Y, Nagasawa T, Takenaka M, Mikami M, Sugiyama T, Enomoto T. Paclitaxel-carboplatin and bevacizumab combination with maintenance bevacizumab therapy for metastatic, recurrent, and persistent uterine cervical cancer: An open-label multicenter phase II trial (JGOG1079). Gynecol Oncol 2022; 165:413-419. [PMID: 35487773 DOI: 10.1016/j.ygyno.2022.04.011] [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: 12/28/2021] [Revised: 04/15/2022] [Accepted: 04/15/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This multicenter, open-label, phase II study aimed to evaluate the efficacy and safety of paclitaxel-carboplatin, bevacizumab, and bevacizumab-based maintenance therapy for metastatic, recurrent, and persistent uterine cervical cancer. METHODS Patients with measurable diseases that were not adapted to regional therapies, such as surgery or radiotherapy, and were systematic chemotherapy-naïve were eligible. The participants received paclitaxel (175 mg/m2), carboplatin (AUC 5), and bevacizumab (15 mg/m2) every three weeks until disease progression or unacceptable adverse events occurred. The primary endpoint was progression-free survival (PFS). The secondary endpoints were overall response rate (ORR), overall survival (OS), safety, and time to treatment failure. RESULTS Sixty-nine patients were analyzed using our protocol. The median paclitaxel- carboplatin therapy duration was six cycles; 40% of patients received bevacizumab maintenance therapy. The median PFS was 11.3 months. The median OS was not reached; the median time to treatment failure was 5.9 months. The ORR was 79.7% [95% confidence interval (CI) 63.8-88.4]; 16 patients (23.2%) showed complete response (CR) and 39 patients (56.5%) showed partial response (PR). The median PFS was 14.3 months (95% CI 7.3-17 months) for the 25 patients who received maintenance therapy and 7.4 months (95% CI 6.1-11 months) for nonrecipients (p = 0.0449). Gastrointestinal perforation/fistulas occurred in four patients (5.6%), all of whom had a history of radiation therapy. CONCLUSIONS Paclitaxel-carboplatin and bevacizumab therapy is an acceptable and tolerable treatment for advanced or recurrent cervical cancer.
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Affiliation(s)
- Terumi Tanigawa
- Department of Gynecology, The Cancer Institute Hospital of JFCR, Tokyo, Japan.
| | - Nobuhiro Takeshima
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Hideki Ishikawa
- JGOG1079 Data Center, Medical Research Support, Osaka, Japan
| | - Shin Nishio
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Fukuoka, Japan
| | - Tomoka Usami
- Department of Obstetrics and Gynecology, Ehime University School of Medicine, Ehime, Japan
| | - Takaharu Yamawaki
- Department of Obstetrics and Gynecology, Ise Red Cross Hospital, Mie, Japan
| | - Tetsuro Oishi
- Department of Obstetrics and Gynecology, Tottori University School of Medicine, Tottori, Japan
| | - Kei Ihira
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido, Japan
| | - Hisamori Kato
- Department of Gynecology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Mayako Goto
- Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Hyogo, Japan
| | - Motoaki Saito
- Department of Obstetrics and Gynecology, Tokyo Jikei kai Medical University School of Medicine, Tokyo, Japan
| | - Yusuke Taira
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan
| | - Masatoshi Yokoyama
- Department of Obstetrics and Gynecology, Saga University School of Medicine, Saga, Japan
| | - Tadahiro Shoji
- Department of Obstetrics and Gynecology, Hachinohe Red Cross Hospital, Aomori, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Atsushi Mori
- Department of Obstetrics and Gynecology, Nagano Municipal Hospital, Nagano, Japan
| | - Takeshi Yokoi
- Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan
| | - Naomi Iwasa-Inoue
- Department of Obstetrics and Gynecology, National Hospital Organization Saitama Hospital, Saitama, Japan
| | | | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University school of Medicine, Iwate, Japan
| | - Motoki Takenaka
- Department of Obstetrics and Gynecology, Gihu University School of Medicine, Gihu, Japan
| | - Mikio Mikami
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, St. Mary's Hospital, Fukuoka, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University School of Medicine, Niigata, Japan
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13
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Kanno M, Yunokawa M, Nakabayashi M, Omi M, Ikki A, Mizusaki M, Nishimura M, Shimizu Y, Okamoto K, Tanaka Y, Fusegi A, Netsu S, Kurita T, Aoki Y, Tanigawa T, Matoda M, Okamoto S, Nomura H, Omatsu K, Sugiyama Y, Utsugi K, Takeshima N, Kanao H. Prognosis and adjuvant chemotherapy for patients with positive peritoneal cytology in stage IA endometrial cancer. Sci Rep 2022; 12:166. [PMID: 34997003 PMCID: PMC8741827 DOI: 10.1038/s41598-021-03975-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/24/2021] [Accepted: 12/06/2021] [Indexed: 12/19/2022] Open
Abstract
This study evaluated the influence of positive peritoneal cytology (PPC) on the prognosis of patients with stage IA endometrial cancer, and the usefulness of adjuvant chemotherapy in their treatment. We retrospectively analyzed the data of patients with stage IA endometrial cancer admitted in our hospital between 2005 and 2015. Among 989 patients who underwent peritoneal cytology, 135 (13.7%) had PPC. Multivariate analysis extracted several independent risk factors for recurrence in stage IA patients, including those with PPC. Adjuvant chemotherapy did not cause a significant difference in the 5-year relapse-free survival rate in patients with PPC (p = 0.78). Similarly, the 5-year recurrence-free survival rate with or without chemotherapy was not different among type II cancer patients (p = 0.11). However, the baseline risk of 5-year relapse-free survival without chemotherapy in patients with PPC and type II was very low (66.7%). While PPC was an independent risk factor for recurrence in stage IA endometrial cancer, adjuvant chemotherapy did not influence the survival rate in patients with PPC. While it is controversial whether adjuvant chemotherapy should be administered in stage IA uterine cancer with only PPC as a prognostic factor, it should be considered for early-stage patients who have multiple risk factors for recurrence.
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Affiliation(s)
- Motoko Kanno
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Mayu Yunokawa
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan. .,Department of Medical Oncology, The Cancer Institute Hospital of JFCR, Tokyo, Japan.
| | - Makoto Nakabayashi
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Makiko Omi
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Ai Ikki
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Megumi Mizusaki
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Mai Nishimura
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Yusuke Shimizu
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Kota Okamoto
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Yuji Tanaka
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Atsushi Fusegi
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Sachiho Netsu
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Tomoko Kurita
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Yoichi Aoki
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Terumi Tanigawa
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Maki Matoda
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Sanshiro Okamoto
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Hidetaka Nomura
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Kohei Omatsu
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Yuko Sugiyama
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Kuniko Utsugi
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Nobuhiro Takeshima
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Hiroyuki Kanao
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
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14
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Shoji T, Enomoto T, Abe M, Okamoto A, Nagasawa T, Oishi T, Nagase S, Mori M, Inokuchi Y, Kamiura S, Komiyama S, Takeshima N, Sugiyama T. Efficacy and safety of standard of care with/without bevacizumab for platinum-resistant ovarian/fallopian tube/peritoneal cancer previously treated with bevacizumab: The Japanese Gynecologic Oncology Group study JGOG3023. Cancer Sci 2021; 113:240-250. [PMID: 34716979 PMCID: PMC8748228 DOI: 10.1111/cas.15185] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 07/20/2021] [Revised: 10/04/2021] [Accepted: 10/20/2021] [Indexed: 11/28/2022] Open
Abstract
We investigated the efficacy and safety of further bevacizumab therapy in patients with platinum-resistant ovarian cancer whose disease had progressed after bevacizumab plus chemotherapy. In this multicenter, open-label, phase II trial (JGOG3023), patients were randomized 1:1 to a single-agent chemotherapy alone (either pegylated liposomal doxorubicin [40 or 50 mg/m2 administered intravenously], topotecan [1.25 mg/m2 intravenously], paclitaxel [80 mg/m2 intravenously], or gemcitabine [1000 mg/m2 intravenously]) or single-agent chemotherapy + bevacizumab (15 mg/m2 intravenously). The primary endpoint was investigator-assessed progression-free survival (PFS) according to RECIST version 1.1. Secondary endpoints were overall survival (OS), objective response rate (ORR), and response rate according to Gynecological Cancer Intergroup cancer antigen 125 criteria. In total, 103 patients were allocated to chemotherapy (n = 51) or chemotherapy + bevacizumab (n = 52). Median investigator-assessed PFS was 3.1 and 4.0 mo in each group, respectively (hazard ratio [HR] = 0.54, 95% confidence interval [CI]: 0.32-0.90, P = .0082). Median OS was 11.3 and 15.3 mo in each group, respectively (HR = 0.67, 95% CI: 0.38-1.17, P = .1556). Respective ORRs were 13.7% and 25.0% (P = .0599) and response rates were 16.7% and 21.4% (P = .8273). The incidence of grade ≥3 treatment-related AEs was 42.0% in the chemotherapy group and 54.9% in the chemotherapy + bevacizumab group; AEs were well tolerated, with only 2 and 12 events leading to discontinuation of therapy, respectively. Bevacizumab was effective beyond progressive disease and AEs were manageable. The observed improvement in PFS requires further verification.
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Affiliation(s)
- Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University School of Medicine, Niigata, Japan
| | - Masakazu Abe
- Department of Gynecology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Tetsuro Oishi
- Department of Obstetrics and Gynecology, Tottori University School of Medicine, Tottori, Japan
| | - Satoru Nagase
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Masahiko Mori
- Department of Gynecology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Yuki Inokuchi
- Department of Biostatistics, Kitasato Academic Research Organization, Kitasato University, Tokyo, Japan
| | - Shoji Kamiura
- Department of Gynecologic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Shinichi Komiyama
- Department of Obstetrics and Gynecology, Faculty of Medicine, Toho University, Tokyo, Japan
| | | | - Toru Sugiyama
- Department of Obstetrics and Gynecology, St. Mary's Hospital, Fukuoka, Japan
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15
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Hamanishi J, Takeshima N, Katsumata N, Ushijima K, Kimura T, Takeuchi S, Matsumoto K, Ito K, Mandai M, Nakai H, Sakuragi N, Watari H, Takahashi N, Kato H, Hasegawa K, Yonemori K, Mizuno M, Takehara K, Niikura H, Sawasaki T, Nakao S, Saito T, Enomoto T, Nagase S, Suzuki N, Matsumoto T, Kondo E, Sonoda K, Aihara S, Aoki Y, Okamoto A, Takano H, Kobayashi H, Kato H, Terai Y, Takazawa A, Takahashi Y, Namba Y, Aoki D, Fujiwara K, Sugiyama T, Konishi I. Nivolumab Versus Gemcitabine or Pegylated Liposomal Doxorubicin for Patients With Platinum-Resistant Ovarian Cancer: Open-Label, Randomized Trial in Japan (NINJA). J Clin Oncol 2021; 39:3671-3681. [PMID: 34473544 PMCID: PMC8601279 DOI: 10.1200/jco.21.00334] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
[Figure: see text].
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Affiliation(s)
- Junzo Hamanishi
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Nobuhiro Takeshima
- Department of Gynecology, Cancer Institute Hospital of JFCR, Tokyo, Japan.,Current affiliation: Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Otawara, Japan
| | - Noriyuki Katsumata
- Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Japan
| | - Kimio Ushijima
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Satoshi Takeuchi
- Department of Obstetrics and Gynecology, Iwate Medical University Hospital, Iwate, Japan.,Current affiliation: Department of Gynecology, Kobe Tokushukai Hospital, Kobe, Japan
| | - Koji Matsumoto
- Department of Medical Oncology, Hyogo Cancer Center, Akashi, Japan
| | - Kimihiko Ito
- Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Japan
| | - Masaki Mandai
- Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, Osakasayama, Japan.,Current affiliation: Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hidekatsu Nakai
- Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Noriaki Sakuragi
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,Current affiliation: Department of Gynecology, Otaru General Hospital, Otaru, Japan
| | - Hidemichi Watari
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | - Hidenori Kato
- Department of Gynecology, Hokkaido Cancer Center, Sapporo, Japan
| | - Kosei Hasegawa
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Kan Yonemori
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Mika Mizuno
- Department of Obstetrics and Gynecology, Aichi Cancer Center Hospital, Nagoya, Japan.,Current affiliation: Department of Obstetrics and Gynecology, Kagoshima University Hospital, Kagoshima, Japan
| | - Kazuhiro Takehara
- Department of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Hitoshi Niikura
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Current affiliation: Department of Obstetrics and Gynecology, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Takashi Sawasaki
- Department of Obstetrics and Gynecology, National Hospital Organization Kure Medical Center, Kure, Japan.,Current affiliation: SAWASAKI Obstetrics Gynecology Clinic, Kure, Japan
| | - Sari Nakao
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba Hospital, Tsukuba, Japan
| | - Toshiaki Saito
- Gynecology Service, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Satoru Nagase
- Department of Obstetrics and Gynecology, Yamagata University Hospital, Yamagata, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St Marianna University School of Medicine, Kawasaki, Japan
| | - Takashi Matsumoto
- Department of Obstetrics and Gynecology, Ehime University Hospital, Toon, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University Hospital, Tsu, Japan
| | - Kenzo Sonoda
- Department of Obstetrics and Gynecology, Kyushu University Hospital, Fukuoka, Japan.,Current affiliation: Department of Gynecologic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Satomi Aihara
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University Hospital, Saga, Japan.,Current affiliation: Department of Medical Oncology, Eguchi Hospital, Saga, Japan
| | - Yoichi Aoki
- Department of Obstetrics and Gynecology, University of the Ryukyus Hospital, Okinawa, Japan
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, The Jikei University Hospital, Tokyo, Japan
| | - Hirokuni Takano
- Department of Obstetrics and Gynecology, The Jikei University Kashiwa Hospital, Kashiwa, Japan
| | - Hiroshi Kobayashi
- Department of Obstetrics and Gynecology, Nara Medical University Hospital, Kashihara, Japan.,Current affiliation: Ms Clinic MayOne, Kashihara, Japan
| | - Hisamori Kato
- Department of Gynecology, Kanagawa Cancer Center, Yokohama, Japan
| | - Yoshito Terai
- Department of Gynecologic Oncology, Osaka Medical College Hospital, Takatsuki, Japan.,Current affiliation: Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | | | - Yusuke Takahashi
- Oncology Clinical Development Unit, Ono Pharmaceutical Co, Ltd, Osaka, Japan
| | | | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Keiichi Fujiwara
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, Iwate Medical University Hospital, Iwate, Japan.,Current affiliation: Department of Obstetrics and Gynecology, St Mary's Hospital, Kurume, Japan
| | - Ikuo Konishi
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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16
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Kanao H, Aoki Y, Fusegi A, Takeshima N. Should indications for laterally extended endopelvic resection (LEER) exclude patients with sciatica? J Gynecol Oncol 2021; 31:e63. [PMID: 32808494 PMCID: PMC7440975 DOI: 10.3802/jgo.2020.31.e63] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 03/18/2020] [Revised: 04/07/2020] [Accepted: 04/18/2020] [Indexed: 11/30/2022] Open
Abstract
Objective Previously, indications for laterally extended endopelvic resection (LEER) have excluded patients with sciatica because R0 resection has not been deemed possible [1]. Because laparoscopy optimizes visualization and thus provides for meticulous dissection, we hypothesized that R0 resection can be achieved by means of laparoscopic LEER in patients with sciatica. This video article aimed to clarify the technical feasibility of laparoscopic LEER performed for laterally recurrent previously irradiated cervical cancer with concomitant sciatica. Methods We investigated technical feasibility of laparoscopic LEER performed as a salvage therapy following abdominal radical hysterectomy and concurrent chemoradiotherapy in a patient suffering laterally recurrent cervical carcinoma with concomitant sciatica. The recurrent tumor involved the right external and internal iliac artery and vein, ileocecum, rectosigmoid colon, right ureter, right obturator nerve, and right sciatic nerve, with a resulting fistula between the tumor and the rectosigmoid colon, and severe sciatica. Resection of all these structures was essential for achievement of R0 status, and such resection means concomitant femoral bypass with prosthetic graft interposition and gastrointestinal/urinary tract resection. Results Laparoscopic LEER with femoral-femoral artery bypass could be conducted without any postoperative complications. Pathological R0 resection could be achieved, and local recurrence could have been controlled. However, the patient died from liver and lung metastasis at 1 year after this resection surgery. Conclusion Laparoscopic LEER for a laterally recurrent previously irradiated cervical cancer with concomitant sciatica was technically feasible, however, further study involving a greater number of patients and longer follow-up period is warranted to determine the stringent indications.
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Affiliation(s)
- Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan.
| | - Yoichi Aoki
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Atsushi Fusegi
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Nobuhiro Takeshima
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
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17
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Kobayashi E, Kanao H, Takekuma M, Nishio S, Kojima-Chiba A, Tozawa A, Yamaguchi S, Takeshima N, Nakatani E, Mikami M. A retrospective assessment of the safety and efficacy of laparoscopic radical hysterectomy in Japan during the early years following its introduction: a Japanese Gynecologic Oncology Group study (JGOG1081S). Int J Clin Oncol 2021; 26:417-428. [PMID: 33433752 DOI: 10.1007/s10147-020-01799-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 04/06/2020] [Accepted: 09/28/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the safety and efficacy of laparoscopic radical hysterectomy (LRH) for cervical cancer, in terms of morbidity and short-term oncologic outcome following LRH's introduction into Japan. METHODS We conducted a retrospective analysis of patients with early-stage cervical cancer (FIGO staging IA2, IB1, and IIA1) who underwent LRH from Dec 2014 to Dec 2016. We assessed the morbidity, overall survival (OS) and recurrence-free survival (RFS), and prognostic factors for RFS. RESULTS A total of 251 patients were included from 22 facilities across Japan. There were 8 cases of stage IA2 cervical cancer, 226 of IB1, and 17 of IIA1. The median operating time was 343 min and the median blood loss was 190 ml. Two patients (0.8%) had a postoperative complication with a Clavien-Dindo classification of grade 3 or higher. After a median follow-up time of 15.6 months, the 2-year RFS was 87.4%, and the 2-year OS was 97.8%. When the 2-year RFS rate was compared with whether the patient pathologically had tumors of less than 2 cm, versus 2 cm or more, the RFS was 95.8% and 80.4%, respectively. Multivariate analysis found that tumor size and the route of lymph node removal were independent prognostic factors for recurrence. CONCLUSION When LRH was first introduced into Japan, we found that the route of lymph node removal was an independent prognostic factor for recurrence in addition to large tumors (≥ 2 cm). Our results suggest that prognosis may be secured by paying attention to the lymph node removal route.
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Affiliation(s)
- Eiji Kobayashi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan.
| | - Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | | | - Shin Nishio
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan
| | - Atsumi Kojima-Chiba
- Department of Obstetrics and Gynecology, Faculty of Medicine, Iwate Medical University, Morioka, Japan
| | - Akiko Tozawa
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Satoshi Yamaguchi
- Department of Gynecologic Oncology, Hyogo Cancer Center, Hyogo, Japan
| | - Nobuhiro Takeshima
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Eiji Nakatani
- Division of Statistical Analysis of Research Support Center, Shizuoka General Hospital, Shizuoka, Japan
| | - Mikio Mikami
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan
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18
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Takehara K, Matsumoto T, Hamanishi J, Hasegawa K, Matsuura M, Miura K, Nagao S, Nakai H, Tanaka N, Tokunaga H, Ushijima K, Watari H, Yokoyama Y, Kase Y, Sumino S, Suri A, Itamochi H, Takeshima N. Phase 2 single-arm study on the safety of maintenance niraparib in Japanese patients with platinum-sensitive relapsed ovarian cancer. J Gynecol Oncol 2021; 32:e21. [PMID: 33470063 PMCID: PMC7930455 DOI: 10.3802/jgo.2021.32.e21] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 07/16/2020] [Revised: 11/12/2020] [Accepted: 11/29/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The primary objective of this study was to evaluate the safety of niraparib 300 mg/day in Japanese patients with platinum-sensitive, relapsed ovarian cancer in a maintenance setting. METHODS Phase 2, multicenter, open-label, single-arm study enrolled Japanese patients with platinum-sensitive, relapsed ovarian cancer who had received ≥2 platinum-based regimens. The primary endpoint (incidence of grade 3 or 4 thrombocytopenia-related events within 30 days after initial niraparib administration) was justified by the incidences of a global pivotal phase 3 study and its post-hoc safety analysis on thrombocytopenia, the major hematological adverse event of niraparib. The overall safety analysis examined other treatment-emergent adverse events (TEAEs). RESULTS Enrolled patients (n=19) had a median (min, max) body weight of 53.9 (40.8-79.1) kg; all but one patient weighed <77 kg. Most (94.7%) patients initially received niraparib 300 mg/day but this decreased in subsequent cycles (mean±standard deviation dose intensity, 191.6±65.7 mg/day). In total, 6/19 (31.6%) patients experienced grade 3 or 4 thrombocytopenia-related events within 30 days of initial niraparib administration. Other common TEAEs included nausea, and decreased platelet or neutrophil counts. No progression-free or overall survival events occurred; only 1 of 4 response-evaluable patients had a post-baseline tumor assessment (stable disease). CONCLUSION The incidence of grade 3 or 4 thrombocytopenia-related events in Japanese ovarian cancer patients was similar to that in the corresponding non-Japanese study. Overall, the safety profile was acceptable and consistent with the known safety profile and previous experience with niraparib. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03759587.
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Affiliation(s)
- Kazuhiro Takehara
- Department of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Takashi Matsumoto
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Matsuyama, Japan
| | - Junzo Hamanishi
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kosei Hasegawa
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Motoki Matsuura
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Kiyonori Miura
- Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Shoji Nagao
- Department of Gynecologic Oncology, Hyogo Cancer Center, Akashi, Japan
| | - Hidekatsu Nakai
- Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Naotake Tanaka
- Department of Gynecology, Chiba Cancer Center, Chiba, Japan
| | - Hideki Tokunaga
- Department of Obstetrics and Gynecology, Tohoku University, Sendai, Japan
| | - Kimio Ushijima
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan
| | - Hidemichi Watari
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yoshihito Yokoyama
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Yoichi Kase
- Oncology Clinical Research Department, Oncology Therapeutic Area Unit for Japan and Asia, Takeda Pharmaceutical Company Limited, Osaka, Japan
| | - Shuuji Sumino
- Biostatistics, Japan Development Center, Takeda Pharmaceutical Company Limited, Osaka, Japan
| | - Ajit Suri
- Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA, USA
| | - Hiroaki Itamochi
- Department of Clinical Oncology, Iwate Medical University School of Medicine, Yahaba, Japan.
| | - Nobuhiro Takeshima
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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19
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Yoshihara K, Enomoto T, Aoki D, Watanabe Y, Kigawa J, Takeshima N, Inomata H, Hattori K, Tsuda H, Sugiyama T. The first study evaluating the distribution of gBRCA1/2 variants within the ovarian cancer cluster region in Japanese ovarian cancer patients. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.632] [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] [Indexed: 11/24/2022]
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20
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Tanigawa T, Matoda M, Omi M, Aoki Y, Netsu S, Nomura H, Okamoto S, Omatsu K, Yunokawa M, Kanao H, Takeshima N. Continuous Administration of Bevacizumab After Disease Progression in Recurrent Ovarian Cancer: A Retrospective Observational Study. Anticancer Res 2020; 40:5285-5290. [PMID: 32878818 DOI: 10.21873/anticanres.14533] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Chemotherapy with additional bevacizumab is the standard treatment for primary and recurrent ovarian cancer. We aimed to investigate the clinical utility and safety of bevacizumab when used in combination with chemotherapy after disease progression. PATIENTS AND METHODS This retrospective, observational study recruited patients treated for recurrent ovarian cancer from 2014 to 2016. We evaluated the effects of bevacizumab with chemotherapy in patients whose disease had progressed following treatment with bevacizumab. We assessed progression-free survival and adverse events. RESULTS Thirty-three patients received post-progression treatment with bevacizumab. The median progression-free survival was 8.7 months (95% confidence interval=5.5-11). The progression-free survival was compared pre- and post-progression treatment, and was longer in platinum-resistant than platinum-sensitive cases after treatment (p=0.06). The most common non-hematological toxicity was proteinuria. The incidence of serious adverse events was low. CONCLUSION Continuous administration of bevacizumab may be beneficial for ovarian cancer patients after disease progression.
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21
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Aoki Y, Kanao H, Wang X, Yunokawa M, Omatsu K, Fusegi A, Takeshima N. Adjuvant treatment of endometrial cancer today. Jpn J Clin Oncol 2020; 50:753-765. [PMID: 32463094 DOI: 10.1093/jjco/hyaa071] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 02/24/2020] [Revised: 01/15/2020] [Accepted: 04/30/2020] [Indexed: 01/22/2023] Open
Abstract
Endometrial cancer frequently occurs in post-menopausal women, and the endometrium is a well-known site of cancer affecting women. Endometrial cancer is found with genital bleeding and often at an early stage. However, there are some risks of recurrence after hysterectomy. As a medical treatment after the diagnosis of endometrial cancer, appropriate adjuvant therapy is considered to lead to a decrease in the rate of recurrence and improvement of prognosis according to the determination of the cancer stage from the surgical and histopathological results. In this review, we describe post-operative adjuvant therapy administered for endometrial cancer and advanced disease, focusing on chemotherapy, radiation therapy and the combination of both. These treatments are divided according to the risk of recurrence as based primarily on the reported evidence.
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Affiliation(s)
- Yoichi Aoki
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Xipeng Wang
- Department of Gynecology and Obstetrics, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mayu Yunokawa
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Kohei Omatsu
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Atsushi Fusegi
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan.,Department of Perinatal and Women's Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nobuhiro Takeshima
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
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22
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Yoshihara K, Enomoto T, Aoki D, Watanabe Y, Kigawa J, Takeshima N, Inomata H, Hattori K, Jinushi M, Tsuda H, Sugiyama T. Association of gBRCA1/2 mutation locations with ovarian cancer risk in Japanese patients from the CHARLOTTE study. Cancer Sci 2020; 111:3350-3358. [PMID: 32495382 PMCID: PMC7469841 DOI: 10.1111/cas.14513] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 02/13/2020] [Revised: 05/22/2020] [Accepted: 05/29/2020] [Indexed: 12/14/2022] Open
Abstract
Whether germline (g) breast cancer susceptibility gene (BRCA) mutations are located within or outside the ovarian cancer cluster region (OCCR) (1380-4062 bp for gBRCA1, and between 3249-5681 bp and 6645-7471 bp for gBRCA2) may influence risk variations for ovarian cancers. This ad hoc analysis of the CHARLOTTE epidemiological study in Japan assessed the distribution of gBRCA1/2 mutations in patients with newly diagnosed ovarian cancer, and investigated an association between gBRCA1/2 mutation locations and ovarian cancer risk. Differences in patient background and clinical characteristics in subgroups stratified by gBRCA1/2 mutation locations were also evaluated. We analyzed the data of 93 patients (14.7%) from the CHARLOTTE study who were positive for gBRCA1/2 mutations. After excluding 16 cases with L63X founder mutation, 28 (65.1%) of gBRCA1 mutations were within the OCCR. Of 30 gBRCA2 mutations, 15 (50.0%) were within the OCCR. Of 27 patients (one patient excluded for unknown family history) with gBRCA1 mutations located in the OCCR, 11 (40.7%) had a family history of ovarian cancer; the proportion of patients with a family history of ovarian cancer and gBRCA1 mutations outside the OCCR was lower (13.3%). Sixty percent of patients with gBRCA1 mutations outside the OCCR had a family history of breast cancer; the proportion of patients with a family history of breast cancer and gBRCA1 mutations within the OCCR was relatively lower (33.3%). Understanding the mutation locations may contribute to more accurate risk assessments of susceptible individuals and early detection of ovarian cancer among gBRCA mutation carriers.
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Affiliation(s)
- Kosuke Yoshihara
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Yoh Watanabe
- Department of Obstetrics and Gynecology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Junzo Kigawa
- Department of Obstetrics and Gynecology, Matsue City Hospital, Matsue, Japan
| | | | - Hyoe Inomata
- Medical Department, AstraZeneca K.K., Osaka, Japan
| | - Kana Hattori
- Medical Department, AstraZeneca K.K., Osaka, Japan
| | | | - Hitoshi Tsuda
- Department of Basic Pathology, National Defense Medical College, Tokorozawa, Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, St. Mary's Hospital, Kurume, Japan
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23
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Ota E, Nomura H, Omatsu K, Takazawa Y, Takeshima N. A case of endometrial carcinoma progressed during pregnancy resulting in fetal death. Int Cancer Conf J 2020; 9:159-161. [PMID: 32582523 DOI: 10.1007/s13691-020-00417-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/08/2020] [Accepted: 05/06/2020] [Indexed: 11/28/2022] Open
Abstract
Most endometrial carcinomas (ECs) occurring during pregnancy are diagnosed in the first trimester. During the gestation period, progesterone level, which has a protective effect on the endometrium, is found to increase. In EC cases, administering high-dose progesterone is a therapeutic strategy because this hormone can considerably shrink tumors. Herein, the case of a woman in whom EC progressed during pregnancy is reported. Before pregnancy, she was diagnosed with atypical polypoid adenomyoma based on a blind office biopsy. She spontaneously conceived 2 months later, although she was suggested to undergo dilatation and curettage under general anesthesia to confirm the diagnosis. Subsequently, fetal death occurred at 26 weeks. A vaginal delivery was deemed impossible due to vaginal metastasis of EC; thus, cesarean section was performed. Computed tomography revealed multiple lung, pelvic, and inguinal lymph node metastases. Additional biopsy demonstrated poorly differentiated endometrioid carcinoma. She underwent systemic chemotherapy. However, eventually, the disease progressed, resulting in death 11 months after the cesarean section. In the present case, grade 3 EC may have existed before pregnancy, and this condition could have been diagnosed if hysteroscopic resection or total curettage under general anesthesia was performed. Grade 1 tumor may have been eliminated by the high progesterone level maintained during pregnancy, and thus, only grade 3 tumor progressed. Women who wish to preserve their fertility should undergo precise whole endometrial examination. If not, the fetus and mother may consequently experience an eventful clinical course.
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Affiliation(s)
- Emi Ota
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Koto-ku, Ariake, Tokyo, 135-8550 Japan
| | - Hidetaka Nomura
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Koto-ku, Ariake, Tokyo, 135-8550 Japan
| | - Kohei Omatsu
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Koto-ku, Ariake, Tokyo, 135-8550 Japan
| | | | - Nobuhiro Takeshima
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Koto-ku, Ariake, Tokyo, 135-8550 Japan
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24
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Kanao H, Kanno M, Takeshima N. Laparoscopic Ureteral Reimplantation for the Management of Long-segment Ureteral Defect in Gynecologic Surgeries. J Minim Invasive Gynecol 2020; 27:1476-1477. [PMID: 32276077 DOI: 10.1016/j.jmig.2020.03.012] [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: 02/19/2020] [Accepted: 03/04/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To demonstrate techniques of laparoscopic ureteral reconstruction for long-segment ureteral defects in gynecologic surgeries. DESIGN Step-by-step demonstration of a laparoscopic ureteral reimplantation using the Boari flap and ileal interposition. SETTING Gynecologic diseases often involve the ureter; hence, knowledge of ureteral reconstruction techniques is imperative in gynecologic surgeries. The important aspect of ureteral reconstruction is to ensure tension-free anastomosis; therefore, various methods are required depending on the length of the ureteral defect [1]. The Boari flap and ileal interposition are preferred for repairing 8-cm to 12-cm and >12-cm ureteral defects, respectively. These methods have traditionally required large incisions [2,3]. Laparoscopic ureteral reimplantation using the Boari flap and ileal interposition has been reported to be as safe as the open technique and superior in terms of postoperative recovery in urologic surgeries [3,4]; however, to the best of our knowledge, it has not been reported in the field of gynecology. To our knowledge, this is the first report to demonstrate the techniques of laparoscopic Boari flap and ileal ureter replacement in gynecologic surgeries. The technique was approved by our institutional review board. INTERVENTIONS The first case involved an intra-abdominal desmoid tumor, whereas the second case involved recurrent endometrial cancer. In both cases, long-segment ureteral resection was required to achieve complete tumor clearance. Laparoscopic ureteral reimplantation was performed successfully, without any complications, using the Boari flap in the first case and ileal interposition in the second. CONCLUSION Laparoscopic ureteral reimplantation is technically feasible for the management of long-segment ureteral defects.
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Affiliation(s)
- Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital, Koutouku, Tokyo, Japan (all authors).
| | - Motoko Kanno
- Department of Gynecologic Oncology, Cancer Institute Hospital, Koutouku, Tokyo, Japan (all authors)
| | - Nobuhiro Takeshima
- Department of Gynecologic Oncology, Cancer Institute Hospital, Koutouku, Tokyo, Japan (all authors)
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25
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Nishio S, Matsumoto K, Takehara K, Kawamura N, Hasegawa K, Takeshima N, Aoki D, Kamiura S, Arakawa A, Kondo E, Hirakawa T, Yamamoto K, Aoki M, Stein K, Keefe S, Fujiwara K, Ushijima K. Pembrolizumab monotherapy in Japanese patients with advanced ovarian cancer: Subgroup analysis from the KEYNOTE-100. Cancer Sci 2020; 111:1324-1332. [PMID: 32012411 PMCID: PMC7156846 DOI: 10.1111/cas.14340] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 12/24/2022] Open
Abstract
Interim results from the two-cohort, phase 2 KEYNOTE-100 study (NCT02674061) of 376 patients with previously treated advanced recurrent ovarian cancer (ROC) showed that pembrolizumab monotherapy was associated with an objective response rate (ORR) of 8.0% (95% CI, 5.4-11.2). We present outcomes for the Japanese patients (n = 21) enrolled in KEYNOTE-100. Patients with epithelial ROC had received either 1-3 prior chemotherapy lines and had platinum-free interval or treatment-free interval (PFI; TFI) of 3-12 months (cohort A) or 4-6 prior chemotherapy lines and had PFI/TFI of ≥3 months (cohort B). All patients received pembrolizumab 200 mg every 3 weeks as monotherapy for 2 years or until progression, death, unacceptable toxicity or consent withdrawal. Primary objectives were ORR per RECIST v1.1 for each cohort and higher programmed death ligand-1 (PD-L1) tumor expression. The relationship between PD-L1 expression (measured as combined positive score [CPS]) and ORR was assessed. Twenty-one Japanese patients (cohort A, n = 19; cohort B, n = 2) were treated. The median (range) age was 57 (37-78) years; 19 (90.5%) patients had ECOG status of 0 and 16 (76.2%) patients had stage III-IV disease. ORR was 19.0% (95% CI, 5.4-41.9) and seemed to increase with increasing PD-L1 expression. A total of 13 (61.9%) patients had treatment-related adverse events (TRAE), and 5 (23.8%) had grade 3-4 TRAE. There were no treatment-related deaths in this subpopulation. Pembrolizumab monotherapy was associated with antitumor activity in Japanese patients with ROC, with no new safety signals identified in this subpopulation. The data suggested a trend toward higher PD-L1 expression among some patients with higher ORR.
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Affiliation(s)
- Shin Nishio
- Kurume University School of MedicineKurumeJapan
| | | | | | | | - Kosei Hasegawa
- Saitama Medical University International Medical CenterHidakaJapan
| | | | | | | | | | | | | | | | | | | | | | - Keiichi Fujiwara
- Saitama Medical University International Medical CenterHidakaJapan
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Omi M, Kanao H, Aoki Y, Okamoto S, Takeshima N. Minimally invasive diagnostic and therapeutic surgery for an intra-abdominal desmoid tumor: A case report. Gynecol Oncol Rep 2020; 32:100560. [PMID: 32215316 PMCID: PMC7090365 DOI: 10.1016/j.gore.2020.100560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 01/12/2020] [Revised: 03/09/2020] [Accepted: 03/10/2020] [Indexed: 11/25/2022] Open
Abstract
Intra-abdominal desmoid tumor is rare with no particular imaging features, so preoperative diagnosis is quite difficult. R0 resection is essential for treatment but often requires extensive surgical trauma, which can be a risk for recurrence. A laparoscopic approach for this tumor was effective, with the resulting diagnosis and resection being less traumatic. The first report of successful laparoscopic complete resection and reconstructive procedures were demonstrated.
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Affiliation(s)
- Makiko Omi
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koutouku, Tokyo 135-8550, Japan
| | - Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koutouku, Tokyo 135-8550, Japan
| | - Yoichi Aoki
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koutouku, Tokyo 135-8550, Japan
| | - Sanshiro Okamoto
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koutouku, Tokyo 135-8550, Japan
| | - Nobuhiro Takeshima
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koutouku, Tokyo 135-8550, Japan
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Nomura H, Tanaka Y, Omi M, Netsu S, Aoki Y, Tanigawa T, Kurita T, Matoda M, Okamoto S, Omatsu K, Kanao H, Takeshima N. Surgical outcomes of early-stage primary vaginal nonsquamous cell carcinoma. Int J Clin Oncol 2020; 25:1412-1417. [PMID: 32219631 DOI: 10.1007/s10147-020-01663-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/13/2019] [Accepted: 03/12/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Definitive radiation therapy (RT), using external beam RT and/or brachytherapy, is a standard treatment option for primary vaginal carcinoma. However, this treatment has poor prognosis when applied to vaginal nonsquamous cell carcinoma (non-SCC). We aimed to clarify treatment outcome and surgical safety in early-stage primary vaginal non-SCC. METHODS After receiving approval from the institutional review board, we retrospectively reviewed the clinical records and pathological samples of patients treated at our hospital between 1991 and 2018. Among 49 patients with primary vaginal carcinoma, 12 with histologically confirmed early-stage primary vaginal non-SCC were included in this study. RESULTS In total, 40% of patients with primary vaginal carcinoma treated at our hospital had primary vaginal non-SCC. The average observation time was 34 months (median 53.3 months). Three patients had local recurrence: 2 in pelvic lymph nodes and 1 in the vagina. Furthermore, 2 patients died of their disease. Five-year local control rate of stage I and stage II non-SCC was 75% and 100%, respectively. Disease-specific survival rate of stage I and stage II non-SCC was 81.8% and 100%, respectively. No major morbidity was observed. Three patients required allogeneic blood transfusion, whereas 1 underwent autotransfusion. None of the 12 patients were discharged with self-catheterization. CONCLUSION Five-year local control and disease-specific survival rates of patients surgically treated for vaginal non-SCC were favorable. Therefore, surgery could be a safe and reasonable option for early-stage primary vaginal non-SCC.
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Affiliation(s)
- Hidetaka Nomura
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Yuji Tanaka
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Makiko Omi
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Sachiho Netsu
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yoichi Aoki
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Terumi Tanigawa
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Tomoko Kurita
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Maki Matoda
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Sanshiro Okamoto
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Kohei Omatsu
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Hiroyuki Kanao
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Nobuhiro Takeshima
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
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Enomoto T, Aoki D, Hattori K, Jinushi M, Kigawa J, Takeshima N, Tsuda H, Watanabe Y, Yoshihara K, Sugiyama T. The first Japanese nationwide multicenter study of BRCA mutation testing in ovarian cancer: CHARacterizing the cross-sectionaL approach to Ovarian cancer geneTic TEsting of BRCA (CHARLOTTE). Int J Gynecol Cancer 2020; 29:1043-1049. [PMID: 31263023 DOI: 10.1136/ijgc-2019-000384] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [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: 02/28/2019] [Revised: 04/26/2019] [Accepted: 05/02/2019] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION BRCA gene mutations are associated with hereditary ovarian cancer. BRCA plays a key role in genome integrity, and mutations result in an increased risk for ovarian cancer. Although various guidelines recommend BRCA testing in patients with ovarian cancer, data on germline BRCA (gB RCA) mutation frequency in ovarian cancer in Japan are scarce. OBJECTIVE This study aimed to determine gBRCA1/2 mutations in Japanese patients with ovarian cancer, stratified by clinicopathological characteristics, and to assess patients' satisfaction with pre-test genetic counseling. METHODS The CHARLOTTE study (CHARacterizing the cross-sectionaL approach to Ovarian cancer: geneTic TEsting of BRCA; UMIN000025597) is the first large multicenter epidemiological survey of Japanese women, aged ≥20, with newly diagnosed ovarian cancer (epithelial, primary peritoneal, or fallopian tube cancer), with histologically confirmed specimens. Patients were enrolled sequentially and underwent pre-test genetic counseling for BRCA testing. Blood samples were centrally tested for the presence or absence of known gBRCA mutations. A questionnaire was used to assess patient satisfaction with pre-test genetic counseling. RESULTS A total of 634 patients with a mean age of 56.9 years were included. Most patients (84.2%) had epithelial ovarian cancer, and 51.1% had FIGO stage III-IV cancer. Nearly all patients (99.5%) received genetic counseling before the BRCA testing, either by an obstetrician-gynecologist (42.0%) or a clinical geneticist (42.0%). The overall prevalence of gBRCA1/2 mutations was 14.7% (93/634), with gBRCA1 mutations (9.9%) more common than gBRCA2 mutations (4.7%). High-grade serous carcinoma showed a prevalence of gBRCA mutations of 28.5%. Most patients were satisfied with pre-test counseling, irrespective of the service provider's professional position. DISCUSSION Patients with high-grade serous carcinoma and family history of ovarian cancer had a slightly higher prevalence of gBRCA mutations, but none of the subgroups had considerably high gBRCA mutation prevalence. These data suggest that gBRCA testing should be carried out in all patients with ovarian cancer.
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Affiliation(s)
- Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Kana Hattori
- Medical Department, AstraZeneca K.K, Osaka, Japan
| | | | - Junzo Kigawa
- Department of Obstetrics and Gynecology, Matsue City Hospital, Matsue, Japan
| | | | - Hitoshi Tsuda
- Department of Basic Pathology, National Defense Medical College, Tokorozawa, Japan
| | - Yoh Watanabe
- Department of Obstetrics and Gynecology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Kosuke Yoshihara
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Toru Sugiyama
- Women's Cancer Center, Takagi Hospital, Okawa, Japan
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Kanao H, Matsuo K, Aoki Y, Tanigawa T, Nomura H, Okamoto S, Takeshima N. Feasibility and outcome of total laparoscopic radical hysterectomy with no-look no-touch technique for FIGO IB1 cervical cancer. J Gynecol Oncol 2019; 30:e71. [PMID: 30887768 PMCID: PMC6424854 DOI: 10.3802/jgo.2019.30.e71] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [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: 02/12/2019] [Revised: 02/20/2019] [Accepted: 02/24/2019] [Indexed: 11/30/2022] Open
Abstract
Objectives Intraoperative tumor manipulation and dissemination may possibly compromise survival of women with early-stage cervical cancer who undergo minimally-invasive radical hysterectomy (RH). The objective of the study was to examine survival related to minimally-invasive RH with a “no-look no-touch” technique for clinical stage IB1 cervical cancer. Methods This retrospective study compared patients who underwent total laparoscopic radical hysterectomy (TLRH) with no-look no-touch technique (n=80) to those who underwent an abdominal radical hysterectomy (ARH; n=83) for stage IB1 (≤4 cm) cervical cancer. TLRH with no-look no-touch technique incorporates 4 specific measures to prevent tumor spillage: 1) creation of a vaginal cuff, 2) avoidance of a uterine manipulator, 3) minimal handling of the uterine cervix, and 4) bagging of the specimen. Results Surgical outcomes of TLRH were significantly superior to ARH for operative time (294 vs. 376 minutes), estimated blood loss (185 vs. 500 mL), and length of hospital stay (14 vs. 18 days) (all, p<0.001). Oncologic outcomes were similar between the 2 groups, including disease-free survival (DFS) (p=0.591) and overall survival (p=0.188). When stratified by tumor size (<2 vs. ≥2 cm), DFS was similar between the 2 groups (p=0.897 and p=0.602, respectively). The loco-regional recurrence rate following TLRH was similar to the rate after ARH (6.3% vs. 9.6%, p=0.566). Multiple-pelvic recurrence was observed in only 1 patient in the TLRH group. Conclusion Our study suggests that the no-look no-touch technique may be a useful surgical procedure to reduce recurrence risk via preventing intraoperative tumor spillage during TLRH for early-stage cervical cancer.
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Affiliation(s)
- Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan.
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Yoichi Aoki
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Terumi Tanigawa
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Hidetaka Nomura
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Sanshiro Okamoto
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Nobuhiro Takeshima
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
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Kanao H, Omi M, Takeshima N. Laparoscopic Mesh Repair for Perineal Hernia after En Bloc Resection of an Aggressive Angiomyxoma Using a Modified Sacral Colpopexy Technique. J Minim Invasive Gynecol 2019; 27:1258-1259. [PMID: 31863864 DOI: 10.1016/j.jmig.2019.12.012] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/10/2019] [Accepted: 12/12/2019] [Indexed: 11/20/2022]
Abstract
STUDY OBJECTIVE To demonstrate laparoscopic mesh repair of perineal hernia (PH) by a modified sacral colpopexy technique. DESIGN Step-by-step demonstration of the technique used for the surgical repair of PH after gynecologic surgery. SETTING PH is defined as a pelvic floor defect through which the intra-abdominal viscera may protrude [1]. The reported incidence of PH ranges from 0.6% to 3%, and it generally occurs after rectal or prostate surgery [2]. Owing to its low incidence, there is no standard procedure to treat PH [3]. Herein, we demonstrate a successful case of PH treatment with a composite mesh (Dual Mesh; W. L. Gore & Associates, Newark, DE) after gynecologic surgery by a modified laparoscopic sacral colpopexy technique, which was approved by our institutional review board. INTERVENTIONS The patient had undergone extralevator abdominoperineal excision for an aggressive angiomyxoma and developed a sigmoid colon-protrudent PH after the surgery [4]. The patient suffered from defecatory dysfunction and dysmenorrhea. A total laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and mesh repair of the PH were performed at 2 years after the primary surgery, and they were successful without any intra- or postoperative complications. Because the pelvic floor defect was too large to secure the mesh by a simple placement, we applied the modified sacral colpopexy technique using 2-0 proline (ETHICON, Tokyo, Japan) to cover and support this defect. At 12 months after the second surgery, there was no sign of recurrence of PH and aggressive angiomyxoma, and the preoperative symptoms had diminished. CONCLUSION Laparoscopic mesh repair by the modified sacral colpopexy technique is safe and effective to manage PH.
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Affiliation(s)
- Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan (all authors)..
| | - Makiko Omi
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan (all authors)
| | - Nobuhiro Takeshima
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan (all authors)
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Tajika A, Furukawa TA, Inagaki M, Kato T, Mantani A, Kurata K, Ogawa Y, Takeshima N, Hayasaka Y, Noma H, Maruo K. Trajectory of criterion symptoms of major depression under newly started antidepressant treatment: sleep disturbances and anergia linger on while suicidal ideas and psychomotor symptoms disappear early. Acta Psychiatr Scand 2019; 140:532-540. [PMID: 31618446 DOI: 10.1111/acps.13115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/13/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In modern psychiatry, depression is diagnosed with the diagnostic criteria; however, the trajectory of each of the criterion symptoms is unknown. This study aims to examine this. METHODS We made repeated assessments of the nine diagnostic criterion symptoms with the Patient Health Questionnaire-9 (PHQ-9) among 2011 participants of a 25-week pragmatic randomised controlled trial of sertraline and/or mirtazapine for hitherto untreated major depressive episodes. The changes from baseline were estimated with the mixed-effects model with repeated measures. The time to disappearance of each symptom was modeled using the Kaplan-Meier survival analysis. RESULTS The total score on PHQ-9 was 18.5 (SD = 3.9, n = 2011) at baseline, which decreased to 15.3 (5.2, n = 2011) at week 1, to 11.5 (5.9, n = 1953) at week 3, to 7.8 (6.0, n = 1927) at week 9, and to 6.0 (5.9, n = 1910) at week 25. Suicidal ideas, psychomotor symptoms decreased rapidly, while anergia and sleep disturbance also decreased but only slowly. The survival analyses confirmed the primary analyses. CONCLUSIONS Upon initiation of antidepressant treatment, patients with newly treated major depressive episodes can expect their suicidal ideas and psychomotor symptoms to disappear first but sleep disturbances and anergia to linger on.
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Affiliation(s)
- A Tajika
- Department of Neurosychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - M Inagaki
- Department of Psychiatry, Shimane University Faculty of Medicine, Izumo, Japan
| | - T Kato
- Aratama Kokorono Clinic, Nagoya, Japan
| | - A Mantani
- Mantani Mental Clinic, Hiroshima, Japan
| | - K Kurata
- Kabe Mental Health Clinic, Hiroshima, Japan
| | - Y Ogawa
- Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - N Takeshima
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Y Hayasaka
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - H Noma
- Department of Data Science, The Institute of Statistical Mathematics, Tokyo, Japan
| | - K Maruo
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Kanao H, Omi M, Takeshima N. Step-by-step demonstration of laparoscopic laterally extended endopelvic resection for a recurrent endometrial cancerous tumor at a sciatic foramen, with a detailed explanation of the pelvic sidewall anatomy. Gynecol Oncol 2019; 156:260-261. [PMID: 31785862 DOI: 10.1016/j.ygyno.2019.11.015] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/26/2019] [Accepted: 11/08/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Laterally extended endopelvic resection (LEER) is regarded as a surgical salvage therapy for patients with laterally recurrent gynecologic carcinomas [1]. A prerequisite for R0 resection using this excision technique is carcinoma location remote from the sciatic foramen [1,2]. However, considering the advantages provided by laparoscopy in terms of visualization and dissection, laparoscopic LEER can potentially be used to achieve R0 resection of a laterally recurrent carcinoma at the sciatic foramen [3]. METHODS The patient underwent an abdominal radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection due to stage II endometrial carcinoma. Almost 30 years later, a recurrent endometrial carcinoma, diagnosed by needle biopsy, was detected at the pelvic sidewall. Abdominal CT scan revealed that the recurrent tumor involved the bladder, right ureter, and rectum, and was located at the right sciatic foramen. Due to a long recurrence-free interval, resection surgery was chosen as the treatment. RESULTS Tumor resection (LEER) and reconstructive surgery were performed laparoscopically. The operation time was 540 minutes, and blood loss volume was 350 ml, with no blood transfusion. R0 resection was achieved without any intraoperative and postoperative complications. There has been no sign of recurrence during the 6 months that have passed since this surgery. CONCLUSIONS Total laparoscopic LEER and reconstructive surgery for a recurrent endometrial carcinoma located at the right sciatic foramen is technically feasible in experienced hands.
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Affiliation(s)
- Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koutouku, Tokyo, 135-8550, Japan.
| | - Makiko Omi
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koutouku, Tokyo, 135-8550, Japan
| | - Nobuhiro Takeshima
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koutouku, Tokyo, 135-8550, Japan
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Gotoh O, Sugiyama Y, Takazawa Y, Kato K, Tanaka N, Omatsu K, Takeshima N, Nomura H, Hasegawa K, Fujiwara K, Taki M, Matsumura N, Noda T, Mori S. Clinically relevant molecular subtypes and genomic alteration-independent differentiation in gynecologic carcinosarcoma. Nat Commun 2019; 10:4965. [PMID: 31672974 PMCID: PMC6823358 DOI: 10.1038/s41467-019-12985-x] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 10/11/2019] [Indexed: 12/27/2022] Open
Abstract
Carcinosarcoma (CS) of the uterus or ovary is a rare, aggressive and biphasic neoplasm composed of carcinoma and sarcoma elements. Previous genomic studies have identified the driver genes and genomic properties associated with CS. However, there is still no molecular subtyping scheme with clinical relevance for this disease. Here, we sequence 109 CS samples, focusing on 596 genes. We identify four molecular subtypes that resemble those observed in endometrial carcinoma: POLE-mutated, microsatellite instability, copy number high, and copy number low subtypes. These molecular subtypes are linked with DNA repair deficiencies, potential therapeutic strategies, and multiple clinicopathological features, including patient outcomes. Multi-regional comparative sequencing reveals genomic alteration-independent CS cell differentiation. Transcriptome and DNA methylome analyses confirm epithelial-mesenchymal transition as a mechanism of sarcoma differentiation. The current study thus provides therapeutic possibilities for CS as well as clues to understanding the molecular histogenic mechanism of its development.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Endometrioid/genetics
- Carcinoma, Endometrioid/pathology
- Carcinosarcoma/classification
- Carcinosarcoma/genetics
- Carcinosarcoma/pathology
- Cluster Analysis
- DNA Copy Number Variations/genetics
- DNA Methylation
- DNA Polymerase II/genetics
- DNA Repair-Deficiency Disorders/genetics
- Decision Trees
- Epithelial-Mesenchymal Transition/genetics
- Female
- Genital Neoplasms, Female/genetics
- High-Throughput Nucleotide Sequencing
- Humans
- INDEL Mutation
- Microsatellite Instability
- Middle Aged
- Mutation
- Neoplasms, Cystic, Mucinous, and Serous/genetics
- Neoplasms, Cystic, Mucinous, and Serous/pathology
- Ovarian Neoplasms/classification
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/pathology
- Peritoneal Neoplasms/genetics
- Poly-ADP-Ribose Binding Proteins/genetics
- Polymorphism, Single Nucleotide
- RNA, Messenger/metabolism
- Sequence Analysis, DNA
- Transcriptome
- Uterine Neoplasms/classification
- Uterine Neoplasms/genetics
- Uterine Neoplasms/pathology
- Young Adult
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Affiliation(s)
- Osamu Gotoh
- Project for Development of Innovative Research on Cancer Therapeutics, Cancer Precision Medicine Center, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, Japan
| | - Yuko Sugiyama
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, Japan
| | - Yutaka Takazawa
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, Japan
| | - Kazuyoshi Kato
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, Japan
| | - Norio Tanaka
- Project for Development of Innovative Research on Cancer Therapeutics, Cancer Precision Medicine Center, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, Japan
| | - Kohei Omatsu
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, Japan
| | - Nobuhiro Takeshima
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, Japan
| | - Hidetaka Nomura
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, Japan
| | - Kosei Hasegawa
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, Japan
| | - Keiichi Fujiwara
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, Japan
| | - Mana Taki
- Department of Gynecologic Oncology, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, Japan
| | - Noriomi Matsumura
- Department of Gynecologic Oncology, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, Japan
| | - Tetsuo Noda
- Project for Development of Innovative Research on Cancer Therapeutics, Cancer Precision Medicine Center, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, Japan
| | - Seiichi Mori
- Project for Development of Innovative Research on Cancer Therapeutics, Cancer Precision Medicine Center, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, Japan.
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Takeshima N, Kohama T, Kusunoki M, Fujita E, Okada S, Kato Y, Kofuku K, Islam MM, Brechue WF. Development of Simple, Objective Chair-Standing Assessment of Physical Function in Older Individuals Using a KinectTM Sensor. J Frailty Aging 2019; 8:186-191. [PMID: 31637404 DOI: 10.14283/jfa.2019.23] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND With increasing interest in addressing quality of life of older individuals, tests such as the Functional Independence Measure (FIM) are widely used measures of infirmity and burden of care. However, these scales are largely qualitative and especially problematic when assessing movement-based tasks. While effective, reliable analysis of human movement is technically complicated and expensive; an infrared depth sensor is potentially a low-cost, portable devise which may provide a quantitative aspect to clinical testing. OBJECTIVE to assess the utility of the KinectTM sensor in providing an objective evaluation of human movement using an oft measured ADL (chair stand). DESIGN Cross-sectional study. SETTING Community, geriatric day-care center in Japan. PARTICIPANTS Men (n=136) and women (n=266) between 50 and 93 years of age, consisting of healthy (HE; n=312) and physically frail (FR; n= 90) individuals. MEASUREMENTS Subjects completed two trials of the chair stand, conducted without assistance. Trials were timed and recorded with KinectTM v2. Coronal plane angle (CPA) was determined by a line transecting the shoulder-center and waist relative to the vertical axis and was used to assess quality of the chair stand movement pattern. RESULTS Age, height, and body mass were not different between groups. CPA was significantly greater in FR (29.3 ± 8.3°) than HE (19.5 ± 6.5°). CPA and age were significantly related (r=0.148, p<0.01). An optimal threshold for CPA identifying frailty was determined by a receiver-operator characteristic curve with a CPA of 23.1° providing the greatest combination of sensitivity (79%) and specificity (73%). CONCLUSION During the chair stand, frail older adults adopted a forward lean position (increased CPA) compared to healthy older adults. This compensatory posture appears to facilitate torso rotation while reducing lower-limb muscular effort during standing. As such, CPA serves as an indicator of reduced lower-body function in older, frail adults.
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Affiliation(s)
- N Takeshima
- Nobuo Takeshima, PhD, Department of Health and Sports Sciences, School of Health Sciences, Asahi University, 1851 Hozumi, Mizuho, 501-0296 Japan, Phone: +81-58-329-1352, e-mail:
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Matsumoto K, Nishio S, Takehara K, Kawamura N, Hasegawa K, Takeshima N, Aoki D, Kamiura S, Arakawa A, Kondo E, Hirakawa T, Yamamoto K, Han SR, Stein K, Keefe S, Lederman J, Matulonis U, Fujiwara K. KN100: Results from Japanese patients with advanced recurrent ovarian cancer treated with pembrolizumab monotherapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz374.004] [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] [Indexed: 11/14/2022] Open
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Lee CL, Huang KG, Nam JH, Lim PC, Shun FWW, Lee KW, Kanao H, Aoki Y, Takeshima N, Hadisaputra W, Liang Z, Supakarapongkul W, Wang KL. The Statement of the Asia-Pacific Association for Gynecologic Endoscopy and Minimally Invasive Therapy for LACC Study. Gynecol Minim Invasive Ther 2019; 8:91-93. [PMID: 31544017 PMCID: PMC6743232 DOI: 10.4103/gmit.gmit_75_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 07/15/2019] [Indexed: 12/21/2022] Open
Affiliation(s)
- Chyi-Long Lee
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Kweishan, Taoyuan, Taiwan.,Chang Gung University College of Medicine, Kweishan, Taoyuan, Taiwan
| | - Kuan-Gen Huang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Kweishan, Taoyuan, Taiwan
| | - Joo-Hyun Nam
- Department of Obsteterics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea
| | - Peter C Lim
- Department of Gynecology Oncology and Robotic Surgery, Center of Hope, University of Nevada, Reno School of Medicine, Reno, Nevada, USA
| | - Felix Wong Wu Shun
- Division of Women and Child Health, The University of New South Wales, Sydney, Australia
| | | | - Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Yoichi Aoki
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Nobuhiro Takeshima
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Wachyu Hadisaputra
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, West Java, Indonesia
| | - Zhiqing Liang
- Department of Obstetrics and Gynecology, Southwestern Hospital, Third Military Medical University, Chongqing, China
| | | | - Kung-Liahng Wang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
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Kato K, Omi M, Fusegi A, Takeshima N. Modified posterior pelvic exenteration with pelvic side-wall resection requiring both intestinal and urinary reconstruction during surgery for ovarian cancer. Gynecol Oncol 2019; 155:172-173. [PMID: 31351675 DOI: 10.1016/j.ygyno.2019.07.015] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/11/2019] [Accepted: 07/15/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Because of the anatomic proximity of the rectosigmoid to the female pelvic organs and its frequent involvement in ovarian cancer, an en bloc resection of ovarian tumors together with the uterus and rectosigmoid, also known as a modified posterior pelvic exenteration (MPPE), is frequently performed to achieve optimal cytoreduction [1]. Additionally, if the tumor has infiltrated the pelvic side-wall, a MPPE combined with pelvic side-wall resection can be selected [2]. We report the details of a technique for this surgery requiring intestinal and urinary reconstruction. METHODS A 55-year-old woman underwent an up-front cytoreductive surgery for FIGO stage IIIC (pT3c N1 M0) ovarian cancer. Preoperatively, a tumor infiltrating the left pelvic side-wall was suspected; however, hydronephrosis of the left kidney was not observed on an enhanced computed tomography examination. During a laparotomy, tumor involvement of the left ureter and internal iliac vessels was observed; a MPPE with pelvic side-wall resection including a partial ureterectomy was thus performed. After the resection of the pelvic and omental tumors, colorectal and vesicoureteral anastomoses were performed. RESULTS Histopathologically, a high-grade serous adenocarcinoma spreading into the muscular layer of the rectum, located close to the ureter and artery, and within 5 mm of the left pelvic side-wall was identified. Diet intake was started on postoperative day (POD) 3. The indwelling bladder catheter was removed on POD 10. Spontaneous voiding after surgery was sufficient and the volume of postvoid residual urine was noted to be <50 mL. The postoperative hospital stay was 12 days. No surgery-related complications occurred. Chemotherapy was initiated 3 weeks after the surgery. The ureteral stent was placed until 3 months after surgery. DISCUSSION A MPPE requiring intestinal and urinary reconstruction is both feasible and safe and can be considered for patients with ovarian cancer involving the pelvic side-wall. Postoperative bladder function was preserved in this patient. However, difficulty in spontaneous voiding after surgery occurs and self-intermittent catheterization is necessary in some patients undergoing a MPPE combined with pelvic side-wall resection. In the previous study, we evaluated the impact of MPPE with or without nerve preservation on bladder function of the patients with ovarian and endometrial cancer [2]. All patients with bilateral nerve-sparing surgery had sufficient micturition from the early postoperative period. Though 40% of the patients with unilateral nerve-sparing surgery had difficulty in spontaneous voiding and needed intermittent catheterization, voiding ability of them improved and no self-catheterization was required 3 months after surgery. The assessment of patient questionnaires suggested that bladder function was acceptable in both groups at 6 months. Patients with bilateral nerve-sacrificing surgery complained of neurogenic bladder requiring self-catheterization even 6 months after surgery. Careful follow-up is required to assess bladder function after MPPE to the extent of pelvic autonomic nerve preservation.
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Affiliation(s)
- Kazuyoshi Kato
- Department of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koutou-ku, Tokyo 135-8550, Japan.
| | - Makiko Omi
- Department of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koutou-ku, Tokyo 135-8550, Japan
| | - Atsushi Fusegi
- Department of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koutou-ku, Tokyo 135-8550, Japan
| | - Nobuhiro Takeshima
- Department of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koutou-ku, Tokyo 135-8550, Japan
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Yoshihara K, Enomoto T, Aoki D, Watanabe Y, Kigawa J, Takeshima N, Fujikawa K, Hattori K, Tsuda H, Sugiyama T. The first nationwide Japanese multicenter study: Characterizing the cross-sectional approach to ovarian cancer genetic testing of (CHARLOTTE). Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.074] [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] [Indexed: 12/01/2022]
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Kanao H, Aoki Y, Tanigawa T, Matoda M, Okamoto S, Nomura H, Omatsu K, Kato K, Utsugi K, Takeshima N. En Bloc Resection of an Aggressive Angiomyxoma by a Novel Combination Laparoscopic and Open Perineal Approach. J Minim Invasive Gynecol 2019; 26:598-599. [DOI: 10.1016/j.jmig.2018.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/10/2018] [Accepted: 07/12/2018] [Indexed: 11/30/2022]
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Takatani J, Takeshima N, Okuda K, Uchino T, Hagiwara S, Noguchi T. Enhanced Needle Visualization: Advantages and Indications of an Ultrasound Software Package. Anaesth Intensive Care 2019; 40:856-60. [DOI: 10.1177/0310057x1204000514] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- J. Takatani
- Department of Anesthesiology and Intensive Care Medicine, Oita University, Yufu-city, Oita, Japan
| | - N. Takeshima
- Department of Anesthesiology and Intensive Care Medicine, Oita University, Yufu-city, Oita, Japan
| | - K. Okuda
- Department of Anesthesiology and Intensive Care Medicine, Oita University, Yufu-city, Oita, Japan
| | - T. Uchino
- Department of Anesthesiology and Intensive Care Medicine, Oita University, Yufu-city, Oita, Japan
| | - S. Hagiwara
- Department of Anesthesiology and Intensive Care Medicine, Oita University, Yufu-city, Oita, Japan
| | - T. Noguchi
- Department of Anesthesiology and Intensive Care Medicine, Oita University, Yufu-city, Oita, Japan
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Kanao H, Hisa T, Omi M, Nagashima M, Okamoto S, Aoki Y, Tanigawa T, Matoda M, Okamoto S, Nomura H, Omatsu K, Kato K, Utsugi K, Takeshima N. Laparoscopic Anterior Pelvic Exenteration with Super Radical Parametrectomy for a Recurrent Low-Grade Endometrial Sarcoma That is Resistant to Hormone Therapy and Chemotherapy. J Minim Invasive Gynecol 2019; 26:34-35. [DOI: 10.1016/j.jmig.2018.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 03/27/2018] [Indexed: 10/17/2022]
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Aoki Y, Kanao H, Kikuchi I, Nomura H, Okamoto S, Hisa T, Sugihara T, Kitano R, Omatsu K, Tanigawa T, Takeshima N. Comparison of the Technical Feasibility and Safety of Three Contained Morcellation Techniques: A Pilot Study in an Animal Model. J Minim Invasive Gynecol 2018; 26:1288-1296. [PMID: 30562578 DOI: 10.1016/j.jmig.2018.12.008] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/05/2018] [Accepted: 12/08/2018] [Indexed: 10/27/2022]
Abstract
STUDY OBJECTIVE To compare 3 laparoscopic contained morcellation techniques in terms of feasibility and safety. DESIGN Pilot study in an animal model (Canadian Task Force classification II-1). SETTING Gynecologic oncology department at a cancer institute in Japan. PATIENTS Porcine model. INTERVENTIONS Three contained morcellation techniques were tested, each multiple times in 1 of 3 anesthetized female pigs: manual morcellation (8 times), dual-site power morcellation (8 times), and single-site power morcellation (6 times). All were tested on beef tongue introduced abdominally. MEASUREMENTS AND MAIN RESULTS The following variables were compared: bag insertion time, morcellation time, bag removal time, total in-bag morcellation time, and the volume of pneumoperitoneum CO2 consumed. Bag rupture was evaluated ex vivo on completion of the procedure. Bag insertion time (in minutes) was significantly greater for dual-site morcellation (10.91 ± 3.38) than for manual (4.58 ± 2.47, p = .003) or single-site power (7.25 ± .77, p = .014) morcellation. Bag removal time (in minutes) was also significantly greater for dual-site morcellation (.85 ± .11 vs .27 ± .14, p<.001, vs .33 ± .59, p = .001). Total in-bag morcellation time, although greatest for manual morcellation at 21.4 ± 10.2 minutes, did not differ significantly between techniques. CO2 consumption was significantly low for manual morcellation. Visual inspection revealed no bag damage when manual morcellation was performed, but bag damage occurred in 3 dual-site cases and in 1 single-site case. CONCLUSION Considering preventing specimen leakage as the main aim of contained morcellation, the bag used for power morcellation needs improvement. Although manual morcellation requires an umbilical wound of about 25 mm, the absence of bag damage, acceptable total morcellation time, relatively low CO2 consumption, and nonuse of a power device, which translate to an economic benefit, lead us to conclude that manual morcellation will remain advantageous into the future.
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Affiliation(s)
- Yoichi Aoki
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan.
| | - Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan
| | - Iwaho Kikuchi
- Department of Obstetrics and Gynecology, Juntendo Urayasu Hospital (Dr. Kikuchi), Urayasu, Japan
| | - Hidetaka Nomura
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan
| | - Syuhei Okamoto
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan
| | - Tsuyoshi Hisa
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan
| | - Takeru Sugihara
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan
| | - Rie Kitano
- Department of Obstetrics and Gynecology, Tsuchiura Kyodo General Hospital (Dr. Kitano), Tsuchiura, Japan
| | - Kohei Omatsu
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan
| | - Terumi Tanigawa
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan
| | - Nobuhiro Takeshima
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan
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Nomura H, Sekine M, Yokoyama S, Takeshima N, Arai M, Nakamura S. Clinical background and outcomes of risk-reducing salpingo-oophorectomy for patients with hereditary breast and ovarian cancer in Japan. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy436.019] [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] [Indexed: 11/13/2022] Open
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Nomura H, Sugiyama Y, Ito T, Furuta N, Komatsu K, Takazawa Y, Aoki Y, Tanigawa T, Matoda M, Okamoto S, Kanao H, Omatsu K, Kato K, Utsugi K, Takeshima N. Clinical management of the status of atypical endometrial cells using the descriptive reporting format for endometrial cytology. Cytopathology 2018; 30:209-214. [DOI: 10.1111/cyt.12638] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 08/21/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Hidetaka Nomura
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Yuko Sugiyama
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Takahiko Ito
- Department of Cytology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Noriyuki Furuta
- Department of Cytology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Kyoko Komatsu
- Department of Cytology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Yutaka Takazawa
- Division of Pathology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Yoichi Aoki
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Terumi Tanigawa
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Maki Matoda
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Sanshiro Okamoto
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Hiroyuki Kanao
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Kohei Omatsu
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Kazuyoshi Kato
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Kuniko Utsugi
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Nobuhiro Takeshima
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
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Komiyama S, Kato K, Inokuchi Y, Takano H, Matsumoto T, Hongo A, Asai-Sato M, Arakawa A, Kamiura S, Tabata T, Takeshima N, Sugiyama T. Bevacizumab combined with platinum-taxane chemotherapy as first-line treatment for advanced ovarian cancer: a prospective observational study of safety and efficacy in Japanese patients (JGOG3022 trial). Int J Clin Oncol 2018; 24:103-114. [PMID: 30030657 PMCID: PMC6326987 DOI: 10.1007/s10147-018-1319-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 06/05/2018] [Accepted: 07/17/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND This was the first large-scale prospective observational Japanese study evaluating the safety and efficacy of bevacizumab combined with paclitaxel and carboplatin for newly diagnosed advanced ovarian cancer. METHODS Patients were prospectively enrolled in the primary analysis cohort if they had Stage III or IV epithelial ovarian/fallopian tube/primary peritoneal cancer and were scheduled to receive paclitaxel plus carboplatin every 3 weeks in Cycles 1-6 and bevacizumab every 3 weeks in Cycles 2-22. Primary endpoints were bevacizumab-specific adverse events and adverse events ≥ Grade 3. Secondary endpoints were progression-free survival (PFS) and the response rate. RESULTS Among 346 patients enrolled, 293 patients formed the primary analysis cohort. Regarding bevacizumab-specific adverse events ≥ grade 3, incidence rates of thromboembolic events (1.4%), gastrointestinal perforation (0.3%), fistula (0.7%), wound dehiscence (0%), and bleeding (0%) were very low. While incidence rates of hypertension (23.2%) and proteinuria (12.6%) were high, all such events were tolerable. No patient with prior bowel resection developed perforation or fistula. Median PFS was 16.3 months (95% CI 14.5-18.9). The response rate was 77.5% (95% CI 67.4-85.7). The response rate was 63.6% in patients with clear cell carcinoma, which tended to be better than previously reported. The median platinum-free interval was 11.5 months, and the platinum-resistant recurrence rate was 24.5%. CONCLUSIONS Combining bevacizumab with chemotherapy was tolerable and efficacy was acceptable in Japanese patients with advanced epithelial ovarian cancer. Bevacizumab seems to reduce platinum-resistant recurrence and is promising for clear cell carcinoma.
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Affiliation(s)
- Shinichi Komiyama
- Department of Gynecology, Toho University Ohashi Medical Center, 2-17-6, Meguro-ku, Tokyo, 153-8515, Japan.
| | - Kazuyoshi Kato
- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
| | - Yuki Inokuchi
- Department of Biostatistics, Kitasato Academic Research Organization, Kitasato University, Tokyo, Japan
| | - Hirokuni Takano
- Department of Obstetrics and Gynecology, The Jikei University Kashiwa Hospital, Kashiwa, Japan
| | - Takashi Matsumoto
- Department of Obstetrics and Gynecology, Ehime University School of Medicine, Matsuyama, Japan
| | - Atsushi Hongo
- Department of Obstetrics and Gynecology 2, Kawasaki Medical School, Okayama, Japan
| | - Mikiko Asai-Sato
- Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Atsushi Arakawa
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shoji Kamiura
- Department of Gynecologic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Tsutomu Tabata
- Department of Obstetrics and Gynecology, Mie University Faculty of Medicine, Tsu, Japan
| | | | - Toru Sugiyama
- Department of Obstetrics and Gynecology, Iwate Medical University, Morioka, Japan
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Matoda M, Takeshima N, Michimae H, Iwata T, Yokota H, Torii Y, Yamamoto Y, Takehara K, Nishio S, Takano H, Mizuno M, Takahashi Y, Takei Y, Hasegawa T, Mikami M, Enomoto T, Aoki D, Sugiyama T. Postoperative chemotherapy for node-positive cervical cancer: Results of a multicenter phase II trial (JGOG1067). Gynecol Oncol 2018; 149:513-519. [DOI: 10.1016/j.ygyno.2018.04.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 04/07/2018] [Accepted: 04/09/2018] [Indexed: 11/27/2022]
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Kanao H, Aoki Y, Takeshima N. Unexpected result of minimally invasive surgery for cervical cancer. J Gynecol Oncol 2018; 29:e73. [PMID: 29770633 PMCID: PMC5981114 DOI: 10.3802/jgo.2018.29.e73] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 04/25/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
- Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan.
| | - Yoichi Aoki
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Nobuhiro Takeshima
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
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Kanao H, Aoki Y, Hisa T, Takeshima N. Laparoscopic laterally extended endopelvic resection (LEER) for cervical carcinoma recurring at the pelvic sidewall after concurrent chemoradiotherapy: Our experience in three cases. Gynecol Oncol 2018; 149:428-429. [DOI: 10.1016/j.ygyno.2018.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 02/03/2018] [Accepted: 02/07/2018] [Indexed: 11/28/2022]
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Nishio H, Iwata T, Nomura H, Morisada T, Takeshima N, Takano H, Sasaki H, Nakatani E, Teramukai S, Aoki D. Liquid-based cytology versus conventional cytology for detection of uterine cervical lesions: a prospective observational study. Jpn J Clin Oncol 2018; 48:522-528. [DOI: 10.1093/jjco/hyy050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 03/28/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hiroshi Nishio
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Iwata
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Hidetaka Nomura
- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
| | - Tohru Morisada
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | | | - Hirokuni Takano
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Chiba, Japan
| | - Hiroshi Sasaki
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Chiba, Japan
| | - Eiji Nakatani
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Satoshi Teramukai
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
- Department of Biostatistics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
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Tanaka YO, Takazawa Y, Matsuura M, Omatsu K, Takeshima N, Matsueda K. MR Imaging of Secondary Massive Ovarian Edema Caused by Ovarian Metastasis from Appendiceal Adenocarcinoma. Magn Reson Med Sci 2018. [PMID: 29515086 PMCID: PMC6460129 DOI: 10.2463/mrms.ci.2017-0146] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Yumiko Oishi Tanaka
- Diagnostic Imaging Department, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Yutaka Takazawa
- Department of Pathology, The Cancer Institute of Japanese Foundation for Cancer Research
| | - Motoki Matsuura
- Department of Gynecologic Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Kohei Omatsu
- Department of Gynecologic Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Nobuhiro Takeshima
- Department of Gynecologic Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Kiyoshi Matsueda
- Diagnostic Imaging Department, The Cancer Institute Hospital of Japanese Foundation for Cancer Research
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