1
|
Hayashi K, Tanaka Y, Tsuda T, Nomura A, Fujino N, Furusho H, Sakai N, Iwata Y, Usui S, Sakata K, Kato T, Tada H, Kusayama T, Usuda K, Kawashiri MA, Passman RS, Wada T, Yamagishi M, Takamura M, Fujino N, Nohara A, Kawashiri MA, Hayashi K, Sakata K, Yoshimuta T, Konno T, Funada A, Tada H, Nakanishi C, Hodatsu A, Mori M, Tsuda T, Teramoto R, Nagata Y, Nomura A, Shimojima M, Yoshida S, Yoshida T, Hachiya S, Tamura Y, Kashihara Y, Kobayashi T, Shibayama J, Inaba S, Matsubara T, Yasuda T, Miwa K, Inoue M, Fujita T, Yakuta Y, Aburao T, Matsui T, Higashi K, Koga T, Hikishima K, Namura M, Horita Y, Ikeda M, Terai H, Gamou T, Tama N, Kimura R, Tsujimoto D, Nakahashi T, Ueda K, Ino H, Higashikata T, Kaneda T, Takata M, Yamamoto R, Yoshikawa T, Ohira M, Suematsu T, Tagawa S, Inoue T, Okada H, Kita Y, Fujita C, Ukawa N, Inoguchi Y, Ito Y, Araki T, Oe K, Minamoto M, Yokawa J, Tanaka Y, Mori K, Taguchi T, Kaku B, Katsuda S, Hirase H, Haraki T, Fujioka K, Terada K, Ichise T, Maekawa N, Higashi M, Okeie K, Kiyama M, Ota M, Todo Y, Aoyama T, Yamaguchi M, Noji Y, Mabuchi T, Yagi M, Niwa S, Takashima Y, Murai K, Nishikawa T, Mizuno S, Ohsato K, Misawa K, Kokado H, Michishita I, Iwaki T, Nozue T, Katoh H, Nakashima K, Ito S, Yamagishi M. Correction: Characterization of baseline clinical factors associated with incident worsening kidney function in patients with non-valvular atrial fibrillation: the Hokuriku-Plus AF Registry. Heart Vessels 2023; 38:412. [PMID: 36508013 DOI: 10.1007/s00380-022-02218-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Kenshi Hayashi
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
| | - Yoshihiro Tanaka
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.,Center for Arrhythmia Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Toyonobu Tsuda
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Akihiro Nomura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Noboru Fujino
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Hiroshi Furusho
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.,Department of Cardiology, Ishikawa Prefectural Central Hospital, 2-1, Kuratsuki-higashi, Kanazawa, Japan
| | - Norihiko Sakai
- Department of Nephrology and Laboratory Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa, Japan
| | - Yasunori Iwata
- Department of Nephrology and Laboratory Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa, Japan
| | - Soichiro Usui
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Kenji Sakata
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Takeshi Kato
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Hayato Tada
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Takashi Kusayama
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Keisuke Usuda
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Masa-Aki Kawashiri
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Rod S Passman
- Center for Arrhythmia Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Takashi Wada
- Department of Nephrology and Laboratory Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa, Japan
| | - Masakazu Yamagishi
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.,Osaka University of Human Sciences, Settsu, Osaka, Japan
| | - Masayuki Takamura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Togami S, Tanimoto A, Yanazume S, Tokunaga H, Nagai T, Watanabe M, Yahata H, Asanoma K, Yamamoto H, Tanaka T, Ohmichi M, Yamada T, Todo Y, Yamada R, Kato H, Yamagami W, Masuda K, Kawaida M, Niikura H, Moriya T, Kobayashi H. Evaluation of the one-step nucleic acid amplification assay for detecting lymph node metastasis in patients with cervical and endometrial cancer: A multicenter prospective study. Gynecol Oncol 2023; 170:70-76. [PMID: 36638744 DOI: 10.1016/j.ygyno.2022.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/20/2022] [Accepted: 12/26/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE This multicenter study aimed to evaluate the accuracy of the one-step nucleic acid amplification (OSNA) assay in diagnosing lymph node metastasis (LNM) in patients with cervical and endometrial cancers. METHODS Surgically removed LNs from patients with cervical and endometrial cancer were sectioned at 2-mm intervals along the short axis direction and alternately examined using the OSNA assay and conventional histopathological examination. Ultrastaging (200-μm LN sections) was performed for metastatic LNs using hematoxylin and eosin staining and immunostaining with an anti-CK19 antibody in cases where the OSNA assay and histopathological examination (performed using 2-mm LN sections) results showed discordance. RESULTS A total of 437 LNs from 133 patients were included; 61 patients (14%) showed metastasis by histopathological examination, with a concordance rate of 0.979 (95% confidence interval [CI]: 0.961-0.991) with the OSNA assay. The sensitivity and specificity of the OSNA assay were 0.918 (95% CI: 0.819-0.973) and 0.989 (95% CI: 0.973-0.997), respectively. Discordance between the two methods was observed in nine LNs (2.1%), and allocation bias of metastatic foci was identified as the major cause of discordance. CONCLUSIONS The OSNA assay showed equally accurate detection of LN metastasis as the histopathological examination. We suggest that the OSNA assay may be a useful tool for the rapid intraoperative diagnosis of LN metastasis in patients with cervical and endometrial cancers.
Collapse
Affiliation(s)
- Shinichi Togami
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Akihide Tanimoto
- Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Japan
| | - Shintaro Yanazume
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Hideki Tokunaga
- Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Miyagi, Japan
| | - Tomoyuki Nagai
- Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Miyagi, Japan
| | - Mika Watanabe
- Department of Pathology, Tohoku Kosai Hospital, Sendai, Japan
| | - Hideaki Yahata
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazuo Asanoma
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohito Tanaka
- Department of Obstetrics and Gynecology, Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Masahide Ohmichi
- Department of Obstetrics and Gynecology, Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Takashi Yamada
- Department of Pathology, Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo 003-0804, Japan
| | - Ryutaro Yamada
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo 003-0804, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo 003-0804, Japan
| | - Wataru Yamagami
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Kenta Masuda
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Miho Kawaida
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Hitoshi Niikura
- Department of Obstetrics and Gynecology, National Hospital Organization Sendai Medical Center, Miyagi, Japan
| | - Takuya Moriya
- Department of Pathology, Kawasaki Medical School, Okayama, Japan
| | - Hiroaki Kobayashi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan.
| |
Collapse
|
3
|
Gonzalez-Martin J, Garcia-Munoz M, Galdon-Quiroga J, Todo Y, Dominguez-Palacios J, Dunne M, van Vuuren AJ, Liu YQ, Sanchis L, Spong D, Suttrop W, Wang X, Willensdorfer M. Active Control of Alfvén Eigenmodes by Externally Applied 3D Magnetic Perturbations. Phys Rev Lett 2023; 130:035101. [PMID: 36763388 DOI: 10.1103/physrevlett.130.035101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 09/27/2022] [Accepted: 12/19/2022] [Indexed: 06/18/2023]
Abstract
The suppression and excitation of Alfvén eigenmodes have been experimentally obtained, for the first time, by means of externally applied 3D perturbative fields with different spatial spectra in a tokamak plasma. The applied perturbation causes an internal fast-ion redistribution that modifies the phase-space gradients responsible for driving the modes, determining, ultimately their existence. Hybrid kinetic-magnetohydrodynamic simulations reveal an edge resonant transport layer activated by the 3D perturbative field as the responsible mechanism for the fast-ion redistribution. The results presented here may help to control fast-ion driven Alfvénic instabilities in future burning plasmas with a significant fusion born alpha particle population.
Collapse
Affiliation(s)
- J Gonzalez-Martin
- Department of Mechanical Engineering and Manufacturing, University of Seville, Camino de los Descubrimientos s/n, 41092 Seville, Spain
- Department of Physics and Astronomy, University of California, Irvine, California 92697, USA
| | - M Garcia-Munoz
- Department of Atomic, Molecular and Nuclear Physics, University of Seville, 41012 Seville, Spain
| | - J Galdon-Quiroga
- Department of Atomic, Molecular and Nuclear Physics, University of Seville, 41012 Seville, Spain
| | - Y Todo
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - J Dominguez-Palacios
- Department of Atomic, Molecular and Nuclear Physics, University of Seville, 41012 Seville, Spain
| | - M Dunne
- Max Planck Institute for Plasma Physics, Boltzmannstrasse, 2 85748 Garching bei Munchen, Germany
| | - A Jansen van Vuuren
- Department of Atomic, Molecular and Nuclear Physics, University of Seville, 41012 Seville, Spain
| | - Y Q Liu
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
| | - L Sanchis
- Department of Applied Physics, Aalto University, FI-00076, Aalto, Finland
| | - D Spong
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - W Suttrop
- Max Planck Institute for Plasma Physics, Boltzmannstrasse, 2 85748 Garching bei Munchen, Germany
| | - X Wang
- Max Planck Institute for Plasma Physics, Boltzmannstrasse, 2 85748 Garching bei Munchen, Germany
| | - M Willensdorfer
- Max Planck Institute for Plasma Physics, Boltzmannstrasse, 2 85748 Garching bei Munchen, Germany
| |
Collapse
|
4
|
Yamada R, Todo Y, Minowa K, Minobe S, Suzuki Y, Kato H, Kurosu H, Mori Y, Osanai T. Prevalence of sarcopenia in patients with gynecological cancer. Jpn J Clin Oncol 2022; 52:1001-1007. [PMID: 35661218 DOI: 10.1093/jjco/hyac087] [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: 03/23/2022] [Accepted: 05/10/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The aim of the study was to investigate a prevalence of sarcopenia in patients with gynecological cancer in accordance with current diagnostic criteria of sarcopenia. METHODS A series of 513 patients with gynecological cancer who were intended to newly receive initial or salvage treatment were recruited in a prospective study. Eligible patients were examined with dual energy X-ray absorptiometry and underwent handgrip strength test and the Short Physical Performance Battery before treatment. Sarcopenia was defined as both low skeletal muscle mass (skeletal muscle mass index) and low muscle strength (handgrip strength of <18.0 kg) or both low skeletal muscle mass index and low physical performance (Short Physical Performance Battery score of ≤9). RESULTS A total of 475 patients (92.6%) were completely assessed in this study. Eligible patients' median age was 60 years (range: 29-89 years). Frequencies of patients with low skeletal muscle mass index, low hand grip strength and low Short Physical Performance Battery were 118 (24.8%), 70 (14.7%) and 80 (16.8%), respectively. Sarcopenia was finally identified in 45 patients (9.5%), which accounted for 38.1% of patients with low skeletal muscle mass index, 64.3% of the patients with low hand grip strength and 56.3% of the patients with low physical performance, respectively. CONCLUSIONS The prevalence of sarcopenia of 9.5% in patients with gynecological malignancy who were scheduled to newly receive an initial or a salvage treatment. A large-scale, nation-wide study might be planned to elucidate an accurate prevalence of sarcopenia among gynecologic cancer patients.
Collapse
Affiliation(s)
- Ryutaro Yamada
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Kaoru Minowa
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Shinichiro Minobe
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Yutaro Suzuki
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hiroyuki Kurosu
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Sapporo, Japan
| | - Yoichi Mori
- Division of Radiation Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Toshihisa Osanai
- Division of Orthopedic Surgery, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| |
Collapse
|
5
|
Tsuruta T, Todo Y, Yamada R, Kuwahara K, Kurosu H, Minowa K, Minoura Y, Minobe S, Suzuki H, Kato H. Initial screening by immunohistochemistry is effective in universal screening for Lynch syndrome in endometrial cancer patients: a prospective observational study. Jpn J Clin Oncol 2022; 52:752-758. [PMID: 35438162 DOI: 10.1093/jjco/hyac058] [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: 08/31/2021] [Accepted: 04/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Few prospective reports of universal screening for Lynch syndrome exist for patients with endometrial cancer. In this study, we performed immunohistochemical staining for DNA mismatch repair-related genes (MLH1, MSH2, MSH6 and PMS2), to determine the extent to which Lynch syndrome can be diagnosed in endometrial cancer patients through universal screening. METHODS We recruited 116 consecutive patients assumed to have uterine corpus malignancy from October 2019 to February 2021 in a prospective observational study. We performed immunohistochemical for mismatch repair-related proteins on samples from 100 patients who had surgicopathologically confirmed diagnoses of endometrial cancer. Samples with missing immunohistochemical results for any of the proteins had subsequent universal screening tests for microsatellite instability, DNA methylation of the MLH1 promoter region and mismatch repair genetics. RESULTS We identified 19 (19.0%) patients with lost results for any of the proteins. All 19 patient samples had subsequent screening tests. We identified the microsatellite instability-high phenotype in 84.2% (16/19) of these patients and MLH1 methylation in 57.9% (11/19). Mismatch repair genetic testing detected two pathological variants, in MSH2 and MSH6, which indicated that the prevalence of Lynch syndrome was 2.0% in our cohort. Two cases of unclassified variant (MSH6) and one case of benign variant (PMS2) were also detected. CONCLUSIONS Initial screening by immunohistochemical is an effective method in universal screening for Lynch syndrome in endometrial cancer patients.
Collapse
Affiliation(s)
- Tomohiko Tsuruta
- Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Kagawa, Japan.,Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Ryutaro Yamada
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Ken Kuwahara
- Division of Pathology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hiroyuki Kurosu
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Kaoru Minowa
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Yuko Minoura
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Shinichiro Minobe
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hiroaki Suzuki
- Division of Pathology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| |
Collapse
|
6
|
Kurosu H, Todo Y, Yamada R, Minowa K, Tsuruta T, Minobe S, Nishiyama N, Kato H. Clinical relevance of addition of conventional treatment to concurrent chemoradiotherapy in patients with FIGO stage III-IV cervical cancer: a retrospective analysis of a Japanese cohort. Jpn J Clin Oncol 2021; 52:244-250. [PMID: 34891157 DOI: 10.1093/jjco/hyab191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/22/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Concurrent chemoradiotherapy has limited therapeutic efficacy for stage III-IV cervical cancer. We aimed to identify a subgroup of patients with stage III-IV cervical cancer who benefit from concurrent chemoradiotherapy with additional treatment. METHODS We retrospectively reviewed 120 patients with stage III-IV cervical cancer who were treated with concurrent chemoradiotherapy from 2002 to 2018. We compared overall survival between patients treated with concurrent chemoradiotherapy alone and those who received concurrent chemoradiotherapy with additional conventional treatments (systemic chemotherapy before and/or after concurrent chemoradiotherapy and/or extended-field radiation). Prognostic factors were statistically analysed. RESULTS Overall, 44 (36.7%) and 21 (17.5%) patients were radiologically diagnosed with pelvic and para-aortic lymph node enlargement, respectively. The median tumour diameter was 5.7 cm. A total of 69 (57.5%) patients received no additional treatment, and 51 (42.5%) received additional treatment. Cox regression analysis identified the following prognostic factors: histological non-squamous cell carcinoma (hazard ratio, 3.9; 95% confidence interval, 1.8-8.2), tumour diameter of ≥6 cm (hazard ratio, 2.1; 95% confidence interval, 1.2-3.7), radiological pelvic lymph node enlargement (hazard ratio, 2.1; 95% confidence interval, 1.1-4.0) and radiological para-aortic lymph node enlargement (hazard ratio, 2.1; 95% confidence interval, 1.1-4.1). Even in the lowest risk group (no risk factors), the 5-year overall survival rate was lower in the additional treatment group than in the concurrent chemoradiotherapy alone group (78.7% vs. 80.9%, respectively; log-rank test, P = 0.79). CONCLUSIONS Addition of conventional treatments to concurrent chemoradiotherapy might not improve survival in patients with advanced cervical cancer. Novel treatment strategies including immune checkpoint inhibitors should be considered for such patients.
Collapse
Affiliation(s)
- Hiroyuki Kurosu
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Ryutaro Yamada
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Kaoru Minowa
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Tomohiko Tsuruta
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Shinichiro Minobe
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Noriaki Nishiyama
- Division of Radiation Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| |
Collapse
|
7
|
Du XD, Van Zeeland MA, Heidbrink WW, Gonzalez-Martin J, Särkimäki K, Snicker A, Lin D, Collins CS, Austin ME, McKee GR, Yan Z, Todo Y, Wu W. Visualization of Fast Ion Phase-Space Flow Driven by Alfvén Instabilities. Phys Rev Lett 2021; 127:235002. [PMID: 34936805 DOI: 10.1103/physrevlett.127.235002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 09/23/2021] [Accepted: 10/28/2021] [Indexed: 06/14/2023]
Abstract
Fast ion phase-space flow, driven by Alfvén eigenmodes (AEs), is measured by an imaging neutral particle analyzer in the DIII-D tokamak. The flow firstly appears near the minimum safety factor at the injection energy of neutral beams, and then moves radially inward and outward by gaining and losing energy, respectively. The flow trajectories in phase space align well with the intersection lines of the constant magnetic moment surfaces and constant E-(ω/n)P_{ζ} surfaces, where E, P_{ζ} are the energy and canonical toroidal momentum of ions; ω and n are angular frequencies and toroidal mode numbers of AEs. It is found that the flow is so destructive that the thermalization of fast ions is no longer observed in regions of strong interaction. The measured phase-space flow is consistent with nonlinear hybrid kinetic-magnetohydrodynamics simulation. Calculations of the relatively narrow phase-space islands reveal that fast ions must transition between different flow trajectories to experience large-scale phase-space transport.
Collapse
Affiliation(s)
- X D Du
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
| | - M A Van Zeeland
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
| | - W W Heidbrink
- University of California, Irvine, California 92697, USA
| | | | - K Särkimäki
- Department of Physics, Chalmers University of Technology, SE-41296 Göteborg, Sweden
| | - A Snicker
- Department of Applied Physics, Aalto University, P.O. Box 11100, 00076 AALTO, Finland
| | - D Lin
- University of California, Irvine, California 92697, USA
| | - C S Collins
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
| | - M E Austin
- University of Texas-Austin, Austin, Texas 78712, USA
| | - G R McKee
- University of Wisconsin-Madison, Madison, Wisconsin 53706-1687, USA
| | - Z Yan
- University of Wisconsin-Madison, Madison, Wisconsin 53706-1687, USA
| | - Y Todo
- National Institute for Fusion Science, 509-5292 Toki, Japan
| | - W Wu
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
| |
Collapse
|
8
|
Yamada R, Tsuruta T, Todo Y, Kurosu H, Minowa K, Minobe S, Matsumiya H, Kato H, Mori Y, Osanai T. Validity of skeletal muscle mass index measurements for assessing sarcopenia in patients with gynecological cancer. Jpn J Clin Oncol 2021; 51:1534-1540. [PMID: 34327536 DOI: 10.1093/jjco/hyab116] [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: 04/23/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The current study investigated an optimal method for using CT scan in detection of low skeletal muscle mass quantity (SMQ). METHODS In total, 82 consecutive patients with gynecological cancers were examined using computed tomography (CT) and dual-energy X-ray absorptiometry (DEXA) before treatment. Low SMQ was defined as a DEXA-based skeletal muscle mass index (SMI) of <5.40 kg/m2. Furthermore, CT-based SMI values were measured by six evaluators, and each evaluator measured SMI values two times for each subject. The first SMI value and the average SMI value were used for analyses. Receiver operating characteristic (ROC) analyses were performed to evaluate the performance of CT-based SMI measurements for detecting low SMQ. Interobserver agreement was assessed using the intraclass correlation coefficient (ICC). RESULTS In total, 23 patients (28.0%) were diagnosed with low skeletal muscle mass. All areas under the curve (AUC) values from twelve (six evaluators × two measurements) ROC curves were within the range of 0.8-0.9. AUC values based on a single measurement and those based on two measurements were almost the same. The ICC was 0.828 (95% CI 0.777-0.874, P < 0.001) when using a single measurement value and increased to 0.959 (95% CI 0.944-0.971, P < 0.001) when using the average of the two measurements. CONCLUSIONS A single measurement CT-based SMI efficiently identified patients with low SMQ in a daily clinical setting. The reliability of SMI measurements might be further improved by using a mean value of two measurements compared with the use of a single measurement value.
Collapse
Affiliation(s)
- Ryutaro Yamada
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido, Sapporo, Japan
| | - Tomohiko Tsuruta
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido, Sapporo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido, Sapporo, Japan
| | - Hiroyuki Kurosu
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido, Sapporo, Japan
| | - Kaoru Minowa
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido, Sapporo, Japan
| | - Shinichiro Minobe
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido, Sapporo, Japan
| | - Hiroko Matsumiya
- Division of Obstetrics and Gynecology, Obihiro Kosei General Hospital, Obihiro, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido, Sapporo, Japan
| | - Yoichi Mori
- Division of Radiation Oncology, National Hospital Organization, Hokkaido, Sapporo, Japan
| | - Toshihisa Osanai
- Division of Orthopedic Surgery, National Hospital Organization, Hokkaido, Sapporo, Japan
| |
Collapse
|
9
|
Kurosu H, Todo Y, Yamada R, Minowa K, Tsuruta T, Minobe S, Kato H. A BMI-category distribution pattern of intrinsic and treatment-related prognostic factors in endometrial cancer. Jpn J Clin Oncol 2021; 51:722-727. [PMID: 33532843 DOI: 10.1093/jjco/hyaa274] [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: 08/21/2020] [Accepted: 12/24/2020] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE In patients with endometrial cancer, obesity is associated with favorable prognostic characteristics but not with prolonged survival. The aim of this study was to elucidate the reason for this clinical paradox. METHODS We retrospectively reviewed 1173 patients with endometrial cancer. Patients were divided into a non-obese group [body mass index (BMI) < 30 kg/m2], class I obesity group (BMI 30-35 kg/m2) and class II obesity group (BMI ≥ 35 kg/m2). The relationship between clinicopathological factors and disease-specific survival (DSS) was analyzed by Cox regression analysis. To correct for three-time significance testing, we used the Bonferroni method, giving the level of probability at which findings were considered significant as P < 0.0167. RESULTS Three disease-intrinsic variables-older age, advanced stage and high-risk histology-and three treatment-related variables-no hysterectomy, no lymphadenectomy and no chemotherapy-were independently associated with poor DSS. DSS was similar among the three groups of patients even though the proportion of patients with plural pretreatment-related unfavorable risk factors significantly decreased with increment of BMI category (40.1 vs. 27.5 vs. 17.6%, P = 0.0003). The proportion of patients with plural treatment-related unfavorable prognostic factors significantly increased with increment of BMI category (21.3 vs. 26.7 vs. 39.3%, P = 0.0072). CONCLUSIONS Poor-quality surgical staging in obese women may result in worse than expected survival outcomes.
Collapse
Affiliation(s)
- Hiroyuki Kurosu
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Ryutaro Yamada
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Kaoru Minowa
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Tomohiko Tsuruta
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Shinichiro Minobe
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| |
Collapse
|
10
|
Kurosu H, Todo Y, Yamada R, Minowa K, Tsuruta T, Minobe S, Matsumiya H, Kato H, Mori Y. Clinical implication of psoas muscle mass measurement for predicting death within 3 months in patients with incurable uterine cervical or corpus malignancy. Jpn J Clin Oncol 2021; 51:577-583. [PMID: 33395489 DOI: 10.1093/jjco/hyaa248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/25/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to find a clinical marker for identifying refractory cancer cachexia. METHODS We analyzed computed tomography imaging data, which included the third lumbar vertebra, from 94 patients who died of uterine cervix or corpus malignancy. The time between the date of examination and date of death was the most important attribute for this study, and the computed tomography images were classified into >3 months before death and ≤ 3 months before death. Psoas muscle mass index was defined as the left-right sum of the psoas muscle areas (cm2) at the level of third lumbar vertebra, divided by height squared (m2). RESULTS A data set of 94 computed tomography images was obtained at baseline hospital visit, and a data set of 603 images was obtained at other times. One hundred (16.6%) of the 603 non-baseline images were scanned ≤3 months before death. Mean psoas muscle mass index change rates at >3 months before death and ≤3 months before death were -1.3 and -20.1%, respectively (P < 0.001). Receiver operating characteristic curve analysis yielded a cutoff value of -13.0%. The area under the curve reached a moderate accuracy level (0.777, 95% confidence interval 0.715-0.838). When we used the cutoff value to predict death within 3 months, sensitivity and specificity were 74.0 and 82.1%, respectively. CONCLUSIONS Measuring change in psoas muscle mass index might be useful for predicting cancer mortality within 3 months. It could become a potential tool for identifying refractory cancer cachexia.
Collapse
Affiliation(s)
- Hiroyuki Kurosu
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Ryutaro Yamada
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Kaoru Minowa
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Tomohiko Tsuruta
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Shinichiro Minobe
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hiroko Matsumiya
- Division of Obstetrics and Gynecology, Obihiro Kosei Hospital, Obihiro, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Yoichi Mori
- Division of Radiation Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| |
Collapse
|
11
|
Oyola P, Gonzalez-Martin J, Garcia-Munoz M, Galdon-Quiroga J, Birkenmeier G, Viezzer E, Dominguez-Palacios J, Rueda-Rueda J, Rivero-Rodriguez JF, Todo Y. Implementation of synthetic fast-ion loss detector and imaging heavy ion beam probe diagnostics in the 3D hybrid kinetic-MHD code MEGA. Rev Sci Instrum 2021; 92:043558. [PMID: 34243424 DOI: 10.1063/5.0043757] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/02/2021] [Indexed: 06/13/2023]
Abstract
A synthetic fast-ion loss (FIL) detector and an imaging Heavy Ion Beam Probe (i-HIBP) have been implemented in the 3D hybrid kinetic-magnetohydrodynamic code MEGA. First synthetic measurements from these two diagnostics have been obtained for neutral beam injection-driven Alfvén Eigenmode (AE) simulated with MEGA. The synthetic FILs show a strong correlation with the AE amplitude. This correlation is observed in the phase-space, represented in coordinates (Pϕ, E), being toroidal canonical momentum and energy, respectively. FILs and the energy exchange diagrams of the confined population are connected with lines of constant E', a linear combination of E and Pϕ. First i-HIBP synthetic signals also have been computed for the simulated AE, showing displacements in the strike line of the order of ∼1 mm, above the expected resolution in the i-HIBP scintillator of ∼100 μm.
Collapse
Affiliation(s)
- P Oyola
- Department of Atomic, Molecular and Nuclear Physics, Universidad de Sevilla, Sevilla 41012, Spain
| | | | - M Garcia-Munoz
- Department of Atomic, Molecular and Nuclear Physics, Universidad de Sevilla, Sevilla 41012, Spain
| | - J Galdon-Quiroga
- Max Planck Institute for Plasma Physics, 85748 Garching, Germany
| | - G Birkenmeier
- Max Planck Institute for Plasma Physics, 85748 Garching, Germany
| | - E Viezzer
- Department of Atomic, Molecular and Nuclear Physics, Universidad de Sevilla, Sevilla 41012, Spain
| | - J Dominguez-Palacios
- Department of Atomic, Molecular and Nuclear Physics, Universidad de Sevilla, Sevilla 41012, Spain
| | - J Rueda-Rueda
- Department of Atomic, Molecular and Nuclear Physics, Universidad de Sevilla, Sevilla 41012, Spain
| | | | - Y Todo
- National Institute for Fusion Science, 509-5292 Toki, Japan
| |
Collapse
|
12
|
Yamada R, Todo Y, Kurosu H, Minowa K, Tsuruta T, Minobe S, Matsumiya H, Kato H, Mori Y, Osanai T. Validity of measuring psoas muscle mass index for assessing sarcopenia in patients with gynecological cancer. Jpn J Clin Oncol 2021; 51:393-399. [PMID: 33306784 DOI: 10.1093/jjco/hyaa218] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/21/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The current study evaluated the performance of psoas muscle mass measurement for detecting low skeletal muscle mass quantity. METHODS A sample of 82 consecutive patients with gynecological cancers was examined using computed tomography and dual energy X-ray absorptiometric scan before treatment. Skeletal muscle mass index was measured by dual energy X-ray absorptiometric scan and its cut-off value was set at 5.40 kg/m2 for detecting low skeletal muscle mass. Psoas muscle mass index was manually measured with cross-sectional computed tomography imaging at the level of L3 by six evaluators. RESULTS Low skeletal muscle mass index was identified in 23 (28.0%) patients. Two-way analysis of variance confirmed a significant main effect of skeletal muscle mass index on mean psoas muscle mass index values (P < 0.0001). A receiver operating characteristic curve obtained from a total of 492 psoas muscle mass index data points gathered from six evaluators produced an area under the curve value of 0.697 (95% confidence interval 0.649-0.744) and a cut-off value of 3.52 cm2/m2, with sensitivity of 79.0% and specificity of 59.6%. Using the cut-off value, the kappa coefficient for evaluating diagnostic agreement between skeletal muscle mass index (low vs. normal) and psoas muscle mass index (low vs. normal) was 0.308 (95% confidence interval 0.225-0.392), suggesting poor agreement. Fleiss' kappa produced a coefficient of 0.418 (95% confidence interval 0.362-0.473), suggesting moderate agreement. CONCLUSIONS Although relevance between skeletal muscle mass index and psoas muscle mass index was confirmed, intensity of relevance between them was weak. Psoas muscle mass index measurement should be subordinated to skeletal muscle mass index measurement for detection of low skeletal muscle mass.
Collapse
Affiliation(s)
- Ryutaro Yamada
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hiroyuki Kurosu
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Kaoru Minowa
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Tomohiko Tsuruta
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Shinichiro Minobe
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hiroko Matsumiya
- Division of Obstetrics and Gynecology, Obihiro Kosei General Hospital, Obihiro, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Yoichi Mori
- Division of Radiation Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Toshihisa Osanai
- Division of Rehabilitation Medicine, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| |
Collapse
|
13
|
Kawaguchi R, Matsumoto K, Ishikawa T, Ishitani K, Okagaki R, Ogawa M, Oki T, Ozawa N, Kawasaki K, Kuwabara Y, Koga K, Sato Y, Takai Y, Tanaka K, Tanebe K, Terauchi M, Todo Y, Nose-Ogura S, Noda T, Baba T, Fujii E, Fujii T, Miyazaki H, Yoshino O, Yoshimura K, Maeda T, Kudo Y, Kobayashi H. Guideline for Gynecological Practice in Japan: Japan Society of Obstetrics and Gynecology and Japan Association of Obstetricians and Gynecologists 2020 edition. J Obstet Gynaecol Res 2020; 47:5-25. [PMID: 33145837 DOI: 10.1111/jog.14487] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 08/09/2020] [Accepted: 09/02/2020] [Indexed: 11/27/2022]
Abstract
Nine years after the first edition of The Guideline for Gynecological Practice, which was jointly edited by The Japan Society of Obstetrics and Gynecology and The Japan Association of Obstetricians and Gynecologists, the 4th Revised Edition was published in 2020. The 2020 Guidelines includes 4 additional clinical questions (CQ), which brings the total to 99 CQ (12 on infectious disease, 29 on oncology and benign tumors, 29 on endocrinology and infertility and 29 on healthcare for women). Currently, a consensus has been reached on the Guidelines, and therefore, the objective of this report is to present the general policies regarding diagnostic and treatment methods used in standard gynecological outpatient care that are considered appropriate. At the end of each answer, the corresponding Recommendation Level (A, B, C) is indicated.
Collapse
Affiliation(s)
- Ryuji Kawaguchi
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Japan
| | - Koji Matsumoto
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan
| | - Tetsuya Ishikawa
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan
| | - Ken Ishitani
- Department of Gynecology, Kitasato University, Kitasato Institute Hospital, Tokyo, Japan
| | - Ryugo Okagaki
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Mariko Ogawa
- Department of Obstetrics and Gynecology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan
| | - Toshimichi Oki
- Department of Reproductive Health Nursing, School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Nobuaki Ozawa
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Kaoru Kawasaki
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshimitsu Kuwabara
- Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
| | - Kaori Koga
- Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan
| | - Yuichi Sato
- Obstetrics and Gynecology, Tatedebari Sato Hospital, Takasaki, Japan
| | - Yasushi Takai
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Kyoko Tanaka
- Department of Obstetrics and Gynecology, Toho University Ohashi Medical Center, Tokyo, Japan
| | | | - Masakazu Terauchi
- Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Sayaka Nose-Ogura
- Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan.,Sports Medical Center, Japan Institute of Sports Sciences, Tokyo, Japan
| | | | - Tsukasa Baba
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Shiwa
| | | | - Takuma Fujii
- Department of Obstetrics and Gynecology, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hiroaki Miyazaki
- Division of Infection Control and Prevention, Kokura Memorial Hospital, Kitakyusyu, Japan
| | - Osamu Yoshino
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kazuaki Yoshimura
- Department of Obstetrics and Gynecology, Wakamatsu Hospital of University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | - Yoshiki Kudo
- Department of Obstetrics and Gynecology, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Kobayashi
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Japan
| |
Collapse
|
14
|
Nishio S, Murotani K, Nakao S, Takenaka M, Suzuki S, Aoki Y, Todo Y, Hosaka M, Nakai H, Katabuchi H, Nishi H, Takekuma M, Mikami M, Enomoto T. Investigation of clinicopathological features of vulvar cancer in 1068 patients: A Japanese Gynecologic Oncology Group (JGOG) nationwide survey study. Gynecol Oncol 2020; 159:449-455. [PMID: 32854973 DOI: 10.1016/j.ygyno.2020.08.019] [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: 06/13/2020] [Accepted: 08/16/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Vulvar cancer is a rare malignancy in the aging population, and optimizing treatment strategies requires large-scale investigation of the clinicopathological features of this disease. In Japan, no such surveys have been conducted in the past 30 years. This large-scale retrospective multi-center study aimed to examine the clinicopathological features of vulvar cancer in Japan. METHODS Upon obtaining ethical approval by the participating institutions' review boards, the medical records of patients with vulvar cancer, who were treated between 2001 and 2010 were reviewed. The impact of clinicopathological factors on overall survival (OS) was investigated using a multivariate Cox regression model. RESULTS After applying the inclusion and exclusion criteria, 1068 patients treated in 108 centers were included. The median age was 72 years. The disease was in stage I in 402 patients (37.6%), stage II in 249 patients (23.3%), stage III in 252 patients (23.6%), and stage IV in 165 patients (15.4%). Squamous cell carcinoma, Paget's disease, adenocarcinoma, and other diseases were diagnosed in 773 (72.4%), 154 (14.4%), 59 (5.5%), and 82 (7.7%) patients, respectively. Positive inguino-femoral lymph nodes were found in 265 (24.8%) patients. The 5-year OS rate for stage I, II, III, and IV vulvar cancer were 85.6%, 75.1%, 48.8%, and 40.0%, respectively. CONCLUSION Our study shows that advanced age, disease stage, histological diagnosis, tumor diameter, and lymph node metastases significantly affect the OS of patients with vulvar cancer in Japan.
Collapse
Affiliation(s)
- Shin Nishio
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Fukuoka, Japan.
| | - Kenta Murotani
- Biostatistics Center, Graduate School of Medicine, Kurume University, Fukuoka, Japan
| | - Sari Nakao
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Ibaragi, Japan
| | - Motoki Takenaka
- Department of Obstetrics and Gynecology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shiro Suzuki
- Department of Gynecologic Oncology, Aichi Cancer Center, Aichi, Japan
| | - Yoichi Aoki
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Hokkaido, Japan
| | - Masayoshi Hosaka
- Department of Obstetrics and Gynecology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Hidekatsu Nakai
- Department of Obstetrics and Gynecology, Kindai University, Faculty of Medicine, Osaka, Japan
| | - Hidetaka Katabuchi
- Department of Obstetrics and Gynecology, Faculty of Life, Sciences, Kumamoto University, Kumamoto, Japan
| | - Hirotaka Nishi
- Department of Obstetrics and Gynecology, Tokyo Medical University, Tokyo, Japan
| | - Munetaka Takekuma
- Department of Gynecologic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Mikio Mikami
- Department of Obstetrics and Gynecology, Tokai University Hospital, Kanagawa, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| |
Collapse
|
15
|
Sakuragi N, Kaneuchi M, Kato T, Shimada C, Todo Y, Ihira K, Nozaki A, Umazume T, Konno Y, Mitamura T, Kobayashi N, Murakami G, Watari H. Tailored radical hysterectomy for locally advanced cervical cancer. Int J Gynecol Cancer 2020; 30:1136-1142. [PMID: 32522774 DOI: 10.1136/ijgc-2020-001387] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/10/2020] [Accepted: 05/12/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE The survival and prognostic factors for locally advanced cervical cancer treated with nerve-sparing Okabayashi-Kobayashi radical hysterectomy have not been elucidated. We aimed to evaluate the oncological outcomes of those patients after radical hysterectomy with adjuvant chemotherapy. METHODS This retrospective cohort study was conducted from January 2002 to December 2011. Treatment was conducted at a single tertiary center in northern Japan. We used the Okabayashi-Kobayashi radical hysterectomy with lymphadenectomy. We applied unilateral nerve preservation for stage IIA/IIB cancer if there was a one-sided extension of the disease outside the cervix. Indication for adjuvant therapy was based on Sedlis criteria. High-risk was defined as evidence of lymph node metastasis, pathological parametrial invasion, and a positive/close surgical margin. The choice of adjuvant therapy was chemotherapy which consisted of paclitaxel and cisplatin. RESULTS The study included 76 early-stage IB1 (≤4 cm) and IIA1 cervical cancer and 45 locally advanced stage IB2 (>4 cm), IIA2, and IIB disease treated consecutively. The median follow-up was 106 (range: 6-203) months. There were 18 (15%) patients with recurrence, with five of 76 in the early-stage (7%) and 13 of 45 in the locally advanced disease (29%) (P<0.001). For locally advanced cervical cancer, pT classification (P<0.001), lymph node metastasis (P=0.007), and histology (P=0.05) were associated with locoregional recurrence. The five-year locoregional recurrence rate in the locally advanced disease was 20% and 5% in the early-stage disease (P=0.01). The five-year disease-free survival in the locally advanced cervical cancer was 71% and 93% in the early-stage disease (P<0.001). The overall survival in locally advanced disease depended on the adeno-type histology and lymph node metastasis. CONCLUSION The tailored use of nerve-sparing Okabayashi-Kobayashi radical hysterectomy with adjuvant chemotherapy based on tumor histology and lymph node metastasis may be a possible option as a treatment of locally advanced cervical cancer in selected patients.
Collapse
Affiliation(s)
- Noriaki Sakuragi
- Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan .,Gynecology, Otaru General Hospital, Otaru, Japan
| | | | - Tatsuya Kato
- Obstetrics and Gynecology, Hokkaido University Hospital, Sapporo, Japan
| | - Chisa Shimada
- Gynecologic Oncology, National Hospital Organisation Hokkaido Cancer Center, Sapporo, Japan
| | - Yukiharu Todo
- Gynecologic Oncology, National Hospital Organisation Hokkaido Cancer Center, Sapporo, Japan
| | - Kei Ihira
- Obstetrics and Gynecology, Hokkaido University Hospital, Sapporo, Japan
| | - Ayako Nozaki
- Obstetrics and Gynecology, Hokkaido University Hospital, Sapporo, Japan
| | - Takeshi Umazume
- Obstetrics and Gynecology, Hokkaido University Hospital, Sapporo, Japan
| | - Yosuke Konno
- Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takashi Mitamura
- Obstetrics and Gynecology, Hokkaido University Hospital, Sapporo, Japan
| | - Noriko Kobayashi
- Obstetrics and Gynecology, Hokkaido University Hospital, Sapporo, Japan
| | - Gen Murakami
- Anatomy II, Sapporo Medical University, Sapporo, Japan
| | - Hidemichi Watari
- Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| |
Collapse
|
16
|
Yamazaki H, Takeshita S, Todo Y, Matsumiya H, Shimada C, Minobe S, Tsuruta T, Kato H. Imaging-based definition of lower uterine segment carcinoma to improve the detection sensitivity of probable Lynch syndrome. Jpn J Clin Oncol 2020; 50:270-275. [PMID: 31958127 DOI: 10.1093/jjco/hyz162] [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: 05/11/2019] [Accepted: 10/05/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate a magnetic resonance imaging-based definition of lower uterine segment carcinoma. METHODS We retrospectively reviewed 587 consecutive patients with endometrial cancer who underwent hysterectomy. Lower uterine segment carcinoma was determined through pathological examination and magnetic resonance imaging assessment. For imaging assessment, the location of the inner lining of the uterus was classified into four equal parts on a sagittal section image. A tumor was defined as lower uterine segment carcinoma when its thickest part was located in the second or the third part from the uterine fundus. Lower uterine segment carcinoma was further divided into lower uterine segment in a narrow sense, upon which diagnosis was exclusively based on pathological findings, and lower uterine segment in a broad sense that were the remaining lower uterine segment carcinomas except lower uterine segment carcinomas in a narrow sense. The relationship between lower uterine segment carcinoma and probable Lynch syndrome was investigated. Patients with loss of MSH2, MSH6, and PMS2 expression or those with tumors with loss of MLH1 and absence of MLH1 promoter methylation were diagnosed as probable Lynch syndrome. RESULTS Lower uterine segment carcinoma was identified in 59 (10.2%) patients. Twenty-eight (47.5%) patients were categorized as lower uterine segment in a narrow sense and 31 (52.5%) as lower uterine segment in a broad sense. Among them, probable Lynch syndrome was identified in 12 (20.3%) cases. There was no difference in clinical profiles, including the prevalence of probable Lynch syndrome between the two categories. CONCLUSIONS A magnetic resonance imaging-based expanded definition of lower uterine segment carcinoma is likely to secure characteristics equivalent to a conventional pathology-based definition of lower uterine segment carcinoma. The novel definition of lower uterine segment carcinoma might improve the detection of probable Lynch syndrome.
Collapse
Affiliation(s)
- Hiroyuki Yamazaki
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan, and
| | - Sho Takeshita
- Department of Obstetrics and Gynecology, Ichinomiya municipal hospital, Ichinomiya, Aichi, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan, and
| | - Hiroko Matsumiya
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan, and
| | - Chisa Shimada
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan, and
| | - Shinichiro Minobe
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan, and
| | - Tomohiko Tsuruta
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan, and
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan, and
| |
Collapse
|
17
|
Sakuragi N, Kato T, Shimada C, Kaneuchi M, Todo Y, Mitamura T, Takeda M, Kudo M, Murakami G, Watari H. Oncological Outcomes After Okabayashi-Kobayashi Radical Hysterectomy for Early and Locally Advanced Cervical Cancer. JAMA Netw Open 2020; 3:e204307. [PMID: 32379332 PMCID: PMC7206506 DOI: 10.1001/jamanetworkopen.2020.4307] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 03/02/2020] [Indexed: 12/24/2022] Open
Abstract
Importance The role of surgery in early-stage cervical cancer has been established, but it is controversial in locally advanced cervical cancer. Objective To determine whether a radical hysterectomy method with extended removal of paracervical tissue for locally advanced cervical cancer is associated with satisfactory oncological outcomes. Design, Setting, and Participants This retrospective cohort study was conducted from January 1, 2002, to December 31, 2011, and participants were patients with cervical cancer at a single tertiary center in Northern Japan. The median follow-up period was 106 months, and none of the patients were lost to follow-up at less than 60 months. Data analyses were performed from July 1, 2017, to December 31, 2018. Exposures Patients underwent radical hysterectomy using the Okabayashi-Kobayashi method. Bilateral nerve preservation was used for stage IB1/IB2 disease and unilateral nerve preservation for stage IIA/IIB if disease extension outside the uterine cervix was 1-sided. Chemotherapy was used as the choice of adjuvant treatment for patients with an intermediate or high risk of recurrence, while some patients chose or were assigned to radiotherapy. Main Outcomes and Measures Primary outcomes were the 5-year local control rate and 5-year overall survival rate along with risk factor analysis. Results Of 121 consecutive patients, 76 (62.8%) had early-stage cervical cancer in 2008 International Federation of Gynecology and Obstetrics stages IB1 and IIA1 and 45 (37.2%) had locally advanced cervical cancer in stages IB2, IIA2, and IIB. The median (range) age was 42 (26-68) years. Adjuvant radiotherapy was used in 2 patients (3%) with early-stage cervical cancer and 3 (7%) of those with locally advanced cervical cancer. The 5-year local control rates for early-stage cervical cancer and locally advanced cervical cancer were 99% and 87%, respectively. The 5-year overall survival rates for early-stage cervical cancer and locally advanced cervical cancer were 95% and 82%, respectively. Cox regression analysis showed that lymph node metastasis and histology of adeno(squamous)carcinoma were independent risk factors for the overall survival of patients with cervical cancer treated with radical hysterectomy. Conclusions and Relevance The nerve-sparing Okabayashi-Kobayashi radical hysterectomy for locally advanced cervical cancer may provide survival not inferior to radical hysterectomy or radiotherapy in published literature. The applicability of radical hysterectomy with adjuvant chemotherapy for locally advanced cervical cancer needs to be validated by prospective comparative trials.
Collapse
Affiliation(s)
- Noriaki Sakuragi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- Department of Gynecology, Otaru General Hospital, Otaru, Japan
| | - Tatsuya Kato
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Chisa Shimada
- Department of Gynecology, Hokkaido Cancer Center, Sapporo, Japan
| | | | - Yukiharu Todo
- Department of Gynecology, Hokkaido Cancer Center, Sapporo, Japan
| | - Takashi Mitamura
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Mahito Takeda
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Masataka Kudo
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Gen Murakami
- Department of Anatomy II, Sapporo Medical University, Sapporo, Japan
- Division of Internal Medicine, Jikou-kai Clinic of Home Visits, Sapporo, Japan
| | - Hidemichi Watari
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| |
Collapse
|
18
|
Xu D, Dong P, Xiong Y, Yue J, Konno Y, Ihira K, Kobayashi N, Todo Y, Watari H. MicroRNA-361-Mediated Inhibition of HSP90 Expression and EMT in Cervical Cancer Is Counteracted by Oncogenic lncRNA NEAT1. Cells 2020; 9:cells9030632. [PMID: 32151082 PMCID: PMC7140536 DOI: 10.3390/cells9030632] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [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: 01/23/2020] [Revised: 02/25/2020] [Accepted: 03/03/2020] [Indexed: 12/12/2022] Open
Abstract
Epithelial-mesenchymal transition (EMT) is a key process contributing to cervical cancer (CC) metastasis, and microRNAs (miRNAs) modulate the expression of genes implicated in EMT. However, the accurate role of miR-361 in CC-associated EMT and the mechanisms underlying its function in CC remains largely unknown. The functional roles of miR-361 in CC cells were explored by a series of cell functional assays. Luciferase reporter assays were used to demonstrate the potential interaction between miR-361, HSP90, and long non-coding RNA (lncRNA) NEAT1. We detected a reduction of miR-361 expression in CC tissues compared with normal tissues, and miR-361 overexpression inhibited invasion and EMT phenotypes of CC cells by directly targeting a key EMT activator HSP90. Additionally, we detected significantly higher levels of HSP90 in CC tissues compared with normal tissues, and high expression of HSP90 predicted a poorer prognosis. We further identified NEAT1 as a significantly upregulated lncRNA in CC tissues and high expression of NEAT1 was associated with worse survival in CC patients. NEAT1 directly repressed miR-361 expression and played an oncogenic role in CC cell invasion and sphere formation. Conclusions: These results demonstrated that miR-361 directly targets HSP90 to inhibit the invasion and EMT features, and NEAT1 functions as an oncogenic lncRNA that suppresses miR-361 expression and induces EMT and sphere formation in CC cells, thus providing critical insights into the molecular pathways operating in this malignancy.
Collapse
Affiliation(s)
- Daozhi Xu
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo 060-0817, Japan; (D.X.); (Y.K.); (K.I.); (N.K.)
| | - Peixin Dong
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo 060-0817, Japan; (D.X.); (Y.K.); (K.I.); (N.K.)
- Correspondence: (P.D.); (H.W.); Tel.: +81-11-706-5941 (P.D.)
| | - Ying Xiong
- Department of Gynecology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510275, China;
| | - Junming Yue
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA;
- Center for Cancer Research, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Yosuke Konno
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo 060-0817, Japan; (D.X.); (Y.K.); (K.I.); (N.K.)
| | - Kei Ihira
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo 060-0817, Japan; (D.X.); (Y.K.); (K.I.); (N.K.)
| | - Noriko Kobayashi
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo 060-0817, Japan; (D.X.); (Y.K.); (K.I.); (N.K.)
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo 060-0042, Japan;
| | - Hidemichi Watari
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo 060-0817, Japan; (D.X.); (Y.K.); (K.I.); (N.K.)
- Correspondence: (P.D.); (H.W.); Tel.: +81-11-706-5941 (P.D.)
| |
Collapse
|
19
|
Xu D, Dong P, Xiong Y, Yue J, Ihira K, Konno Y, Kobayashi N, Todo Y, Watari H. MicroRNA-361: A Multifaceted Player Regulating Tumor Aggressiveness and Tumor Microenvironment Formation. Cancers (Basel) 2019; 11:E1130. [PMID: 31394811 PMCID: PMC6721607 DOI: 10.3390/cancers11081130] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 12/22/2022] Open
Abstract
MicroRNA-361-5p (miR-361) expression frequently decreases or is lost in different types of cancers, and contributes to tumor suppression by repressing the expression of its target genes implicated in tumor growth, epithelial-to-mesenchymal transition (EMT), metastasis, drug resistance, glycolysis, angiogenesis, and inflammation. Here, we review the expression pattern of miR-361 in human tumors, describe the mechanisms responsible for its dysregulation, and discuss how miR-361 modulates the aggressive properties of tumor cells and alter the tumor microenvironment by acting as a novel tumor suppressor. Furthermore, we describe its potentials as a promising diagnostic or prognostic biomarker for cancers and a promising target for therapeutic development.
Collapse
Affiliation(s)
- Daozhi Xu
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Peixin Dong
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
| | - Ying Xiong
- Department of Gynecology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Junming Yue
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Center for Cancer Research, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Kei Ihira
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Yosuke Konno
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Noriko Kobayashi
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo 003-0804, Japan
| | - Hidemichi Watari
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
| |
Collapse
|
20
|
Dong P, Xiong Y, Yue J, Xu D, Ihira K, Konno Y, Kobayashi N, Todo Y, Watari H. Long noncoding RNA NEAT1 drives aggressive endometrial cancer progression via miR-361-regulated networks involving STAT3 and tumor microenvironment-related genes. J Exp Clin Cancer Res 2019; 38:295. [PMID: 31287002 PMCID: PMC6615218 DOI: 10.1186/s13046-019-1306-9] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [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: 05/22/2019] [Accepted: 07/02/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND High-grade endometrioid and serous endometrial cancers (ECs) are an aggressive subtype of ECs without effective therapies. The reciprocal communication between tumor cells and their surrounding microenvironment drives tumor progression. Long noncoding RNAs (lncRNAs) are key mediators of tumorigenesis and metastasis. However, little is known about the role of lncRNAs in aggressive EC progression and tumor microenvironment remodeling. METHODS We performed an array-based lncRNA analysis of a parental HEC-50 EC cell population and derivatives with highly invasive, sphere-forming, and paclitaxel (TX)-resistant characteristics. We characterized the roles of the lncRNA NEAT1 in mediating aggressive EC progression in vitro and in vivo and explored the molecular events downstream of NEAT1. RESULTS We identified 10 lncRNAs with upregulated expression (NEAT1, H19, PVT1, UCA1, MIR7-3HG, SNHG16, HULC, RMST, BCAR4 and LINC00152) and 10 lncRNAs with downregulated expression (MEG3, GAS5, DIO3OS, MIR155HG, LINC00261, FENDRR, MIAT, TMEM161B-AS1, HAND2-AS1 and NBR2) in the highly invasive, sphere-forming and TX-resistant derivatives. NEAT1 expression was markedly upregulated in early-stage EC tissue samples, and high NEAT1 expression predicted a poor prognosis. Inhibiting NEAT1 expression with small hairpin RNAs (shRNAs) diminished cellular proliferation, invasion, sphere formation, and xenograft tumor growth and improved TX response in aggressive EC cells. We showed that NEAT1 functions as an oncogenic sponge for the tumor suppressor microRNA-361 (miR-361), which suppresses proliferation, invasion, sphere formation and TX resistance by directly targeting the oncogene STAT3. Furthermore, miR-361 also suppressed the expression of multiple prometastatic genes and tumor microenvironment-related genes, including MEF2D, ROCK1, WNT7A, VEGF-A, PDE4B, and KPNA4. CONCLUSIONS NEAT1 initiates a miR-361-mediated network to drive aggressive EC progression. These data support a rationale for inhibiting NEAT1 signaling as a potential therapeutic strategy for overcoming aggressive EC progression and chemoresistance.
Collapse
Affiliation(s)
- Peixin Dong
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ying Xiong
- Department of Gynecology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China
| | - Junming Yue
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN 38163 USA
- Center for Cancer Research, University of Tennessee Health Science Center, Memphis, TN 38163 USA
| | - Daozhi Xu
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kei Ihira
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yosuke Konno
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo, Japan
| | - Noriko Kobayashi
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hidemichi Watari
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo, Japan
| |
Collapse
|
21
|
Shimada C, Todo Y, Yamazaki H, Minobe S, Kato H. Cervical laser vaporization for women with cervical intraepithelial neoplasia-3. Jpn J Clin Oncol 2019; 49:447-451. [PMID: 30796831 DOI: 10.1093/jjco/hyz001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 08/23/2018] [Revised: 11/06/2018] [Accepted: 02/15/2019] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE This study evaluated outcomes of laser vaporization of the cervix for women with cervical intraepithelial neoplasia (CIN)-3. METHODS We retrospectively reviewed 161 consecutive patients with CIN3 who were treated with cervical laser vaporization between January 2008 and December 2012. At each follow-up visit, histologically confirmed CIN2, CIN3 and invasive carcinoma were defined as treatment failures, as were high-grade squamous intraepithelial lesion (HSIL) or atypical squamous cells that cannot exclude HSIL with subsequent treatment or lost to follow-up. Primary endpoints included long-term follow-up (at least 5 years of regular hospital visits) and treatment failure rate. Treatment failure rates were estimated by the Kaplan-Meier method. RESULTS Patients' median age was 31 years old. Median follow-up period was 67 months (interquartile range: 52-74 months). Over 5 years, 70.8% continued their follow-up visits, but significantly more patients aged ≥35 years did so (86.4%) than did those aged ≤34 years (61.8%, P = 0.0009). Treatment failure was observed in 14 (8.7%) patients, 1 of whom progressed to invasive cancer (0.6%). Cumulative treatment failure rates were 1-year: 5.1%, 2-year: 6.4% and 5-year: 9.5%. Among patients who suffered treatment failures, 57.1% initial failures occurred within the first year and 71.4% within the first 2 years. CONCLUSIONS Long-term oncologic outcomes of cervical vaporization in CIN3 remain at a suboptimal level. The importance of a minimum of 5 years of regular hospital visits should be emphasized to patients with CIN3 who are candidates for cervical laser vaporization, especially those aged ≤34 years.
Collapse
Affiliation(s)
- Chisa Shimada
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo, Japan
| | - Hiroyuki Yamazaki
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo, Japan
| | - Shinichiro Minobe
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo, Japan
| |
Collapse
|
22
|
Kawaguchi R, Matsumoto K, Akira S, Ishitani K, Iwasaku K, Ueda Y, Okagaki R, Okano H, Oki T, Koga K, Kido M, Kurabayashi T, Kuribayashi Y, Sato Y, Shiina K, Takai Y, Tanimura S, Chaki O, Terauchi M, Todo Y, Noguchi Y, Nose-Ogura S, Baba T, Hirasawa A, Fujii T, Fujii T, Maruyama T, Miyagi E, Yanagida K, Yoshino O, Iwashita M, Maeda T, Minegishi T, Kobayashi H. Guidelines for office gynecology in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2017 edition. J Obstet Gynaecol Res 2019; 45:766-786. [PMID: 30675969 DOI: 10.1111/jog.13831] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [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: 08/07/2018] [Accepted: 09/15/2018] [Indexed: 11/29/2022]
Abstract
Six years after the first edition of The Guideline for Gynecological Practice, which was jointly edited by The Japan Society of Obstetrics and Gynecology and The Japan Association of Obstetricians and Gynecologists, the third revised edition was published in 2017. The 2017 Guidelines includes 10 additional clinical questions (CQ), which brings the total to 95 CQ (12 on infectious disease, 28 on oncology and benign tumors, 27 on endocrinology and infertility and 28 on healthcare for women). Currently a consensus has been reached on the Guidelines and therefore the objective of this report is to present the general policies regarding diagnostic and treatment methods used in standard gynecological outpatient care that are considered appropriate. At the end of each answer, the corresponding recommendation level (A, B, C) is indicated.
Collapse
Affiliation(s)
- Ryuji Kawaguchi
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Japan
| | - Koji Matsumoto
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan
| | - Shigeo Akira
- Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
| | - Ken Ishitani
- Department of Obstetrics and Gynecology, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Kazuhiro Iwasaku
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, School of Nursing, Kyoto, Japan
| | - Yutaka Ueda
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Ryugo Okagaki
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | | | - Toshimichi Oki
- Department of Reproductive Health Nursing, School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Kaori Koga
- Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan
| | - Michiko Kido
- Department of Obstetrics and Gynecology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Takumi Kurabayashi
- Department of Obstetrics and Gynecology, Niigata City General Hospital, Niigata, Japan
| | - Yasushi Kuribayashi
- Center for Reproductive Medicine and Endoscopy, Sugiyama Clinic Marunouchi, Tokyo, Japan
| | - Yuichi Sato
- Department of Obstetrics and Gynecology, Tatedebari Sato Hospital, Takasaki, Japan
| | | | - Yasushi Takai
- Department of Obstetrics and Gynecology, Saitama Medical Center/Saitama Medical University, Kawagoe, Japan
| | - Satoshi Tanimura
- Department of Obstetrics and Gynecology, Toyama Central Prefectural Hospital, Toyama, Japan
| | - Osamu Chaki
- Department of Obstetrics and Gynecology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Masakazu Terauchi
- Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Yasuyuki Noguchi
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Nagakute, Japan
| | | | - Tsukasa Baba
- Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akira Hirasawa
- Department of Clinical Genomic Medicine. Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Takuma Fujii
- Department of Obstetrics and Gynecology, School of Medicine, Fujita Health University, Toyoake, Japan
| | | | - Tetsuo Maruyama
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan
| | - Kaoru Yanagida
- Center for IVF and Infertility, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Osamu Yoshino
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Mitsutoshi Iwashita
- Department of Obstetrics and Gynecology, Kyorin University School of Medicine, Tokyo, Japan
| | | | - Takashi Minegishi
- Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hiroshi Kobayashi
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Japan
| |
Collapse
|
23
|
Shimada C, Todo Y, Yamazaki H, Takeshita S, Okamoto K, Minobe S, Yamashiro K, Kato H. A feasibility study of sentinel lymph node mapping by cervical injection of a tracer in Japanese women with early stage endometrial cancer. Taiwan J Obstet Gynecol 2018; 57:541-545. [PMID: 30122575 DOI: 10.1016/j.tjog.2018.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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] [Accepted: 10/11/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the feasibility of sentinel lymph node mapping characterized by a cervical tracer injection in endometrial cancer. MATERIALS AND METHODS This retrospective study was carried out using data for 57 patients with endometrial carcinoma who had undergone intraoperative sentinel lymph node mapping and subsequent surgical staging. Technetium colloid and/or indocyanine green was injected into the uterine cervix and a gamma-detecting probe and/or photodynamic eye camera system was used intraoperatively to locate hot spots. RESULTS Of the 57 patients, 52 (91.2%) had FIGO Stage I disease. Successful unilateral or bilateral mapping occurred in 54 patients (94.7%) and 46 (80.7%), respectively. The median number of sentinel lymph nodes detected was two (range, 0-5). Following sentinel lymph node mapping, 41 patients (71.9%) underwent pelvic lymphadenectomy alone and 16 (28.1%) full lymphadenectomy. The median number of lymph nodes resected was 17 (range, 8-110). Sentinel lymph nodes were involved in four patients (7.0%), two with macrometastases and two with low-volume metastases. The sensitivity and negative predictive value for detecting lymph node metastasis were both 100%. CONCLUSION Sentinel lymph node mapping with the use of cervical tracer injection is highly feasible in Japanese women with early stage endometrial cancer.
Collapse
Affiliation(s)
- Chisa Shimada
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo 003-0804, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo 003-0804, Japan.
| | - Hiroyuki Yamazaki
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo 003-0804, Japan
| | - Sho Takeshita
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo 003-0804, Japan
| | - Kazuhira Okamoto
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo 003-0804, Japan
| | - Shinichiro Minobe
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo 003-0804, Japan
| | - Katsushige Yamashiro
- Division of Pathology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo 003-0804, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo 003-0804, Japan
| |
Collapse
|
24
|
Dong P, Xiong Y, Yue J, Hanley SJB, Kobayashi N, Todo Y, Watari H. Long Non-coding RNA NEAT1: A Novel Target for Diagnosis and Therapy in Human Tumors. Front Genet 2018; 9:471. [PMID: 30374364 PMCID: PMC6196292 DOI: 10.3389/fgene.2018.00471] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [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: 08/09/2018] [Accepted: 09/24/2018] [Indexed: 12/13/2022] Open
Abstract
The nuclear paraspeckle assembly transcript 1 (NEAT1, a long non-coding RNA) is frequently overexpressed in human tumors, and higher NEAT1 expression is correlated with worse survival in cancer patients. NEAT1 drives tumor initiation and progression by modulating the expression of genes involved in the regulation of tumor cell growth, migration, invasion, metastasis, epithelial-to-mesenchymal transition, stem cell-like phenotype, chemoresistance and radioresistance, indicating the potential for NEAT1 to be a novel diagnostic biomarker and therapeutic target. Mechanistically, NEAT1 functions as a scaffold RNA molecule by interacting with EZH2 (a subunit of the polycomb repressive complex) to influence the expression of downstream effectors of EZH2, it also acts as a microRNA (miRNA) sponge to suppress the interactions between miRNAs and target mRNAs, and affects the expression of miR-129 by promoting the DNA methylation of the miR-129 promoter region. Knockdown of NEAT1 via small interfering RNA or short hairpin RNA inhibits the malignant behavior of tumor cells. In this review, we highlight the latest insights into the expression pattern, biological roles and mechanisms underlying the function and regulation of NEAT1 in tumors, and especially focus on its clinical implication as a new diagnostic biomarker and an attractive therapeutic target for cancers.
Collapse
Affiliation(s)
- Peixin Dong
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ying Xiong
- State Key Laboratory of Oncology in South China, Department of Gynecology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Junming Yue
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN, United States.,Center for Cancer Research, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Sharon J B Hanley
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo, Japan
| | - Noriko Kobayashi
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center (NHO), Sapporo, Japan
| | - Hidemichi Watari
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido University, Sapporo, Japan
| |
Collapse
|
25
|
Matsuo K, Shimada M, Saito T, Takehara K, Tokunaga H, Watanabe Y, Todo Y, Morishige KI, Mikami M, Sugiyama T. Risk stratification models for para-aortic lymph node metastasis and recurrence in stage IB-IIB cervical cancer. J Gynecol Oncol 2018; 29:e11. [PMID: 29185269 PMCID: PMC5709521 DOI: 10.3802/jgo.2018.29.e11] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 10/15/2017] [Accepted: 10/15/2017] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To examine the surgical-pathological predictors of para-aortic lymph node (PAN) metastasis at radical hysterectomy, and for PAN recurrence among women who did not undergo PAN dissection at radical hysterectomy. METHODS This is a retrospective analysis of a nation-wide cohort study of surgically-treated stage IB-IIB cervical cancer (n=5,620). Multivariate models were used to identify independent surgical-pathological predictors for PAN metastasis/recurrence. RESULTS There were 120 (2.1%) cases of PAN metastasis at surgery with parametrial involvement (adjusted odds ratio [aOR]=1.65), deep stromal invasion (aOR=2.61), ovarian metastasis (aOR=3.10), and pelvic nodal metastasis (single-node aOR=5.39 and multiple-node aOR=33.5, respectively) being independent risk factors (all, p<0.05). Without any risk factors, the incidence of PAN metastasis was 0.9%, while women exhibiting certain risk factor patterns (>20% of the study population) had PAN metastasis incidences of ≥4%. Among 4,663 clinically PAN-negative cases at surgery, PAN recurrence was seen in 195 (4.2%) cases that was significantly higher than histologically PAN-negative cases (2.5%, p=0.046). In clinically PAN-negative cases, parametrial involvement (adjusted hazard ratio [aHR]=1.67), lympho-vascular space invasion (aHR=1.95), ovarian metastasis (aHR=2.60), and pelvic lymph node metastasis (single-node aHR=2.49 and multiple-node aHR=8.11, respectively) were independently associated with increased risk of PAN recurrence (all, p<0.05). Without any risk factors, 5-year PAN recurrence risk was 0.8%; however, women demonstrating certain risk factor patterns (>15% of the clinically PAN-negative population) had 5-year PAN recurrence risks being ≥8%. CONCLUSION Surgical-pathological risk factors proposed in this study will be useful to identify women with increased risk of PAN metastasis/recurrence.
Collapse
Affiliation(s)
- 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
| | - Muneaki Shimada
- Department of Obstetrics and Gynecology, Tottori University, Tottori, Japan.
- Department of Gynecology, Tohoku University Hospital, Miyagi, Japan
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, School of Medicine, Sapporo Medical University, Hokkaido, Japan
| | - Kazuhiro Takehara
- Department of Gynecologic Oncology, Shikoku Cancer Center, Matsuyama, Japan
| | - Hideki Tokunaga
- Department of Gynecology, Tohoku University Hospital, Miyagi, Japan
| | - Yoh Watanabe
- Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Hokkaido, Japan
| | - Ken Ichirou Morishige
- Department of Obstetrics and Gynecology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Mikio Mikami
- Department of Obstetrics and Gynecology, Tokai University, Kanagawa, Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, Iwate Medical University, Iwate, Japan
| |
Collapse
|
26
|
Yamazaki H, Todo Y, Shimada C, Takeshita S, Minobe S, Okamoto K, Yamashiro K, Kato H. Therapeutic significance of full lymphadenectomy in early-stage ovarian clear cell carcinoma. J Gynecol Oncol 2017; 29:e19. [PMID: 29400012 PMCID: PMC5823980 DOI: 10.3802/jgo.2018.29.e19] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 06/30/2017] [Revised: 11/11/2017] [Accepted: 11/26/2017] [Indexed: 11/30/2022] Open
Abstract
Objectives This study evaluated the therapeutic significance of full lymphadenectomy in early-stage ovarian clear cell carcinoma (OCCC). Methods We retrospectively reviewed records of 127 consecutive patients with pT1/pT2 and M0 OCCC who were treated between January 1995 and December 2015. We compared survival outcomes between those who did and did not undergo para-aortic lymph node dissection (PAND), and analyzed independent prognostic factors (Cox proportional hazards model with backward stepwise elimination). Results Of the 127 patients, 36 (28%) did not undergo lymphadenectomy; 12 (10%) patients underwent pelvic lymph node dissection (PLND) only; and 79 (62%) patients underwent both PLND and PAND. Of the 91 patients with lymphadenectomy, 11 (12%) had lymph node metastasis (LNM). The PAND− and PAND+ groups did not significantly differ in age, distribution of pT status, radiologically enlarged lymph nodes, positive peritoneal cytology, capsule rupture, peritoneal involvement, and combined chemotherapy. Cox regression multivariate analysis confirmed that older age (hazard ratio [HR]=2.1; 95% confidence interval [CI]=1.0–4.3), LNM (HR=4.4; 95% CI=1.7–11.6), and positive peritoneal cytology (HR=4.2; 95% CI=2.1–8.4) were significantly and independently related to poor disease-specific survival (DSS), but implementation of both PLND and PAND (HR=0.4; 95% CI=0.2–0.8) were significantly and independently related to longer DSS. Conclusion Although few in number, there are some patients with early-stage OCCC who can benefit from full lymphadenectomy. Its therapeutic role should be continuously investigated in OCCC patients at potential risk of LNM.
Collapse
Affiliation(s)
- Hiroyuki Yamazaki
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.
| | - Chisa Shimada
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Sho Takeshita
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Shinichiro Minobe
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Kazuhira Okamoto
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Katsushige Yamashiro
- Division of Pathology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| |
Collapse
|
27
|
Takeshita S, Todo Y, Furuta Y, Okamoto K, Minobe S, Yamashiro K, Kato H. Prognostic factors for patients with brain metastasis from gynecological cancer: a significance of treatment-free interval of more than 6 months. Jpn J Clin Oncol 2017; 47:604-610. [PMID: 28398498 DOI: 10.1093/jjco/hyx047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 12/19/2016] [Accepted: 03/21/2017] [Indexed: 11/14/2022] Open
Abstract
Objective Treatment-free interval has been confirmed as a significant prognostic factor in recurrent gynecological cancers. However, treatment-free interval has not been evaluated in previous studies investigating brain metastasis from gynecological malignancies. The aim of the study was to establish a predictive model of survival period after brain metastasis from gynecological cancer. Methods Of a total of 2848 patients with gynecological cancer, patients with brain metastasis were included in the study. Data at the time of brain metastasis diagnosis, which included primary origin, presence of extracranial metastasis, the Eastern Cooperative Oncology Group (ECOG) performance status, the number of brain metastases, brain-metastasis free-interval, treatment-free interval and treatment for brain metastasis were collected. Survival data were analyzed using Kaplan-Meier methods and Cox proportional hazards models. Results Incidences of brain metastasis were 1.7% (47/2848). Median survival period after diagnosis of brain metastasis was 20 weeks (4-5 months). The 6-, 12- and 24-month survival rates after brain metastasis were 44.0%, 22.0% and 16.5%, respectively. Cox regression analysis showed that extracranial metastasis (hazard ratio [HR], 5.2; 95% confidence interval [CI]: 1.04-26.3), ECOG performance status of 3-4 (HR, 3.1; 95% CI: 1.20-7.91), treatment-free interval of <6 months (HR, 3.8; 95% CI: 1.09-13.1), and no anti-cancer treatment for brain metastasis (HR, 3.6; 95% CI: 1.34-9.41) were significantly and independently related to poor survival. Conclusion Treatment-free interval should be assessed in a future study to verify prognostic predictors of brain metastasis from gynecological cancer.
Collapse
Affiliation(s)
- Sho Takeshita
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center
| | - Yu Furuta
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center
| | - Kazuhira Okamoto
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center
| | - Shinichiro Minobe
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center
| | - Katsushige Yamashiro
- Division of Pathology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center
| |
Collapse
|
28
|
Tsuda H, Ito YM, Todo Y, Iba T, Tasaka K, Sutou Y, Hirai K, Dozono K, Dobashi Y, Manabe M, Sakamoto T, Yamamoto R, Ueda K, Akatsuka M, Kiyozuka Y, Nagai N, Imai M, Kobiki K, Fujita H, Itamochi H, Oshita T, Kawarada T, Hatae M, Yokoyama Y. Measurement of endometrial thickness in premenopausal women in office gynecology. Reprod Med Biol 2017; 17:29-35. [PMID: 29371818 PMCID: PMC5768977 DOI: 10.1002/rmb2.12062] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 08/22/2017] [Indexed: 11/05/2022] Open
Abstract
Purpose To define the median endometrial thickness (ET) in office gynecology is thought to be important for clinical practice. However, there are few reports about ET that have included the general female population on a large scale. The median ET was determined prospectively in premenopausal women who attended office gynecology for cervical cancer screening. Methods In total, 849 women were enrolled. The median ET was determined by using transvaginal ultrasound and the relationships between the ET and various clinical factors were analyzed. Results The participants' median age was 38.5 years. The median ET was 8.6 mm (90% and 95% quantiles: 13.8 and 15.8 mm). The ET was not related to their age, symptoms, obstetric history, geographical location, or risk factors for endometrial cancer. In the women with a menstrual cycle length of 28-30 days, the ET was 7 mm on days 1-6, but it increased from 5.4 mm immediately after menstruation (day 7 or 8) to 9.2 mm on days 13-14. Subsequently, the ET increased further to 11.1 mm on day 18. Conclusion In all the women, the upper limit of the ET was 13.8 mm and 15.8 mm in the 90% and 95% quantile, respectively, in office gynecology.
Collapse
Affiliation(s)
| | - Yoichi M Ito
- Department of Biostatistics Hokkaido University Graduate School of Medicine Sapporo Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology National Hospital Organization Hokkaido Cancer Center Sapporo Japan
| | | | | | | | - Kozo Hirai
- Minamimorimachi Ladies' Clinic Osaka Japan
| | - Koichiro Dozono
- Department of Obstetrics, Gynecology and Andanestheology Dozono Clinic Kagoshima Japan
| | | | | | | | | | | | - Moe Akatsuka
- Yokohama First Health Check Place Yokohama Japan
| | | | | | - Manami Imai
- Azabu Juban Manami Women's Clinic Tokyo Japan
| | | | | | - Hiroaki Itamochi
- Department of Obstetrics and Gynecology Iwate Medical University School of Medicine Morioka Japan
| | | | - Takahiro Kawarada
- Department of Translational Research Management Hokkaido University Graduate School of Medicine Sapporo Japan
| | | | - Yoshihito Yokoyama
- Department of Obstetrics and Gynecology Hirosaki University Graduate School of Medicine Hirosaki Japan
| |
Collapse
|
29
|
Todo Y, Takeshita S, Okamoto K, Yamashiro K, Kato H. Implications of para-aortic lymph node metastasis in patients with endometrial cancer without pelvic lymph node metastasis. J Gynecol Oncol 2017; 28:e59. [PMID: 28657221 PMCID: PMC5540719 DOI: 10.3802/jgo.2017.28.e59] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 03/31/2017] [Revised: 04/21/2017] [Accepted: 05/04/2017] [Indexed: 11/30/2022] Open
Abstract
Objective The aim of this study was to confirm the incidence and implications of a lymphatic spread pattern involving para-aortic lymph node (PAN) metastasis in the absence of pelvic lymph node (PLN) metastasis in patients with endometrial cancer. Methods We carried out a retrospective chart review of 380 patients with endometrial cancer treated by surgery including PLN dissection and PAN dissection at Hokkaido Cancer Center between 2003 and 2016. We determined the probability of PAN metastasis in patients without PLN metastasis and investigated survival outcomes of PLN−PAN+ patients. Results The median numbers of PLN and PAN removed at surgery were 41 (range: 11–107) and 16 (range: 1–65), respectively. Sixty-four patients (16.8%) had lymph node metastasis, including 39 (10.3%) with PAN metastasis. The most frequent lymphatic spread pattern was PLN+PAN+ (7.9%), followed by PLN+PAN− (6.6%), and PLN−PAN+ (2.4%). The probability of PAN metastasis in patients without PLN metastasis was 2.8% (9/325). The 5-year overall survival rates were 96.5% in PLN−PAN−, 77.6% in PLN+PAN−, 63.4% in PLN+PAN+, and 53.6% in PLN−PAN+ patients. Conclusion The likelihood of PAN metastasis in endometrial cancer patients without PLN metastasis is not negligible, and the prognosis of PLN−PAN+ is likely to be poor. The implications of a PLN−PAN+ lymphatic spread pattern should thus be taken into consideration when determining patient management strategies.
Collapse
Affiliation(s)
- Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.
| | - Sho Takeshita
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Kazuhira Okamoto
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Katsushige Yamashiro
- Division of Pathology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| |
Collapse
|
30
|
Todo Y, Murakami S, Yamamoto T, Fukuyama A, Spong DA, Yamamoto S, Osakabe M, Nakajima N. Numerical Analyses of Energetic Particles in LHD. Fusion Science and Technology 2017. [DOI: 10.13182/fst10-a10814] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Y. Todo
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - S. Murakami
- Kyoto University, Department of Nuclear Engineering, Kyoto 606-8501, Japan
| | - T. Yamamoto
- Kyoto University, Department of Nuclear Engineering, Kyoto 606-8501, Japan
| | - A. Fukuyama
- Kyoto University, Department of Nuclear Engineering, Kyoto 606-8501, Japan
| | - D. A. Spong
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831
| | - S. Yamamoto
- Institute of Advanced Energy, Kyoto University, Uji 611-0011, Japan
| | - M. Osakabe
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - N. Nakajima
- National Institute for Fusion Science, Toki 509-5292, Japan
| |
Collapse
|
31
|
Toi K, Isobe M, Osakabe M, Watanabe F, Ogawa K, Yamamoto S, Nakajima N, Spong DA, Ida K, Ido T, Ito T, Morita S, Nagaoka K, Narihara K, Nishiura M, Ohdachi S, Sakakibara S, Shimizu A, Tanaka K, Todo Y, Tokuzawa T, Weller A. MHD Modes Destabilized by Energetic Ions on LHD. Fusion Science and Technology 2017. [DOI: 10.13182/fst10-a10805] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- K. Toi
- National Institute for Fusion Science, Toki, Japan
| | - M. Isobe
- National Institute for Fusion Science, Toki, Japan
| | - M. Osakabe
- National Institute for Fusion Science, Toki, Japan
| | - F. Watanabe
- Department of Energy Engineering and Science, Nagoya University, Nagoya, Japan
| | - K. Ogawa
- Department of Energy Engineering and Science, Nagoya University, Nagoya, Japan
| | - S. Yamamoto
- Institute of Advanced Energy, Kyoto University, Uji, Japan
| | - N. Nakajima
- National Institute for Fusion Science, Toki, Japan
| | - D. A. Spong
- Oak Ridge National Laboratory, Oak Ridge, Tennessee
| | - K. Ida
- National Institute for Fusion Science, Toki, Japan
| | - T. Ido
- National Institute for Fusion Science, Toki, Japan
| | - T. Ito
- Department of Energy Engineering and Science, Nagoya University, Nagoya, Japan
| | - S. Morita
- National Institute for Fusion Science, Toki, Japan
| | - K. Nagaoka
- National Institute for Fusion Science, Toki, Japan
| | - K. Narihara
- National Institute for Fusion Science, Toki, Japan
| | - M. Nishiura
- National Institute for Fusion Science, Toki, Japan
| | - S. Ohdachi
- National Institute for Fusion Science, Toki, Japan
| | | | - A. Shimizu
- National Institute for Fusion Science, Toki, Japan
| | - K. Tanaka
- National Institute for Fusion Science, Toki, Japan
| | - Y. Todo
- National Institute for Fusion Science, Toki, Japan
| | - T. Tokuzawa
- National Institute for Fusion Science, Toki, Japan
| | - A. Weller
- Max-Planck Institut für Plasma Physik, Greifswald, Germany
| | | |
Collapse
|
32
|
Takeshita S, Todo Y, Matsumiya H, Okamoto K, Yamashiro K, Kato H. A prediction model of survival for patients with bone metastasis from uterine corpus cancer. Jpn J Clin Oncol 2016; 46:973-978. [PMID: 27655906 DOI: 10.1093/jjco/hyw120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 04/28/2016] [Revised: 08/02/2016] [Accepted: 08/08/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of the study was to establish a predictive model of survival period after bone metastasis from endometrial cancer. METHODS A total of 28 patients with bone metastasis from uterine corpus cancer were included in the study. Data at the time of bone metastasis diagnosis, which included presence of extraskeletal metastasis, performance status, history of any previous radiation/chemotherapy and the number of bone metastases, were collected. Survival data were analyzed using Kaplan-Meier methods and Cox proportional hazard models. RESULTS The most common site of bone metastasis was the pelvis (50.0%), followed by lumbar spine (32.1%), thoracic spine (25.0%) and rib bone (17.9%). The median survival period after bone metastasis was 25 weeks. The overall rate of survival after bone metastasis of the entire cohort was 75.0% at 13 weeks, 46.4% at 26 weeks and 42.9% at 52 weeks. Performance status of 3-4 was confirmed as an independent prognostic factor (Hazard ratio, 3.5; 95% confidence interval, 1.41-8.70) and multiple bone metastases tended to be associated with poor prognosis (Hazard ratio, 2.4; 95% confidence interval, 0.95-5.97). A prognostic score was calculated by adding up the number of these two factors. The 26-week survival rates after bone metastasis were 88.9% for those with a score of 0, 45.5% for those with a score of 1 and 0% for those with a score of 2 (P = 0.0006). CONCLUSIONS This scoring system can be used to determine the optimal treatment for patients with bone metastasis from endometrial cancer.
Collapse
Affiliation(s)
- Sho Takeshita
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Shiroishi-ku, Sapporo
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Shiroishi-ku, Sapporo
| | - Hiroko Matsumiya
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Shiroishi-ku, Sapporo
| | - Kazuhira Okamoto
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Shiroishi-ku, Sapporo
| | - Katsushige Yamashiro
- Division of Pathology, National Hospital Organization, Hokkaido Cancer Center, Shiroishi-ku, Sapporo, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Shiroishi-ku, Sapporo
| |
Collapse
|
33
|
Furukawa S, Sakai T, Niiya T, Miyaoka H, Miyake T, Yamamoto S, Maruyama K, Ueda T, Senba H, Todo Y, Torisu M, Minami H, Onji M, Tanigawa T, Matsuura B, Hiasa Y, Miyake Y. Diabetic peripheral neuropathy and prevalence of erectile dysfunction in Japanese patients aged <65 years with type 2 diabetes mellitus: The Dogo Study. Int J Impot Res 2016; 29:30-34. [PMID: 27784886 DOI: 10.1038/ijir.2016.40] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 07/13/2016] [Accepted: 10/03/2016] [Indexed: 12/22/2022]
Abstract
Only limited epidemiological evidence exists regarding the relationship between diabetic neuropathy and erectile dysfunction (ED) among Japanese patients with type 2 diabetes mellitus. To investigate the relationship between diabetic neuropathy and ED among Japanese patients with type 2 diabetes mellitus, a multicenter cross-sectional study was conducted in 287 male Japanese patients with type 2 diabetes mellitus, age (19-65 years). Diabetic neuropathy was diagnosed if the patients showed two or more of the following three characteristics: neuropathic symptoms, decreased or disappeared Achilles tendon reflex and/or abnormal vibration perception. ED, moderate to severe ED, and severe ED were defined as present when a subject had a Sexual Health Inventory for Men score <22, <12 and <8, respectively. The prevalence values of diabetic neuropathy and severe ED were 47.0 and 39.0%, respectively. Diabetic neuropathy was independently positively associated with severe ED, but not ED and moderate ED: the adjusted odds ratio was 1.90 (95% confidence interval: 1.08-3.38). No relationships were found between diabetic retinopathy or diabetic nephropathy and ED. Diabetic neuropathy is positively associated with severe erectile dysfunction among Japanese type 2 diabetes mellitus patients aged <65 years.
Collapse
Affiliation(s)
- S Furukawa
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan.,Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Shitsukawa, Toon, Japan
| | - T Sakai
- Department of Internal Medicine, Yawatahama General City Hospital, Yawatahama, Japan
| | - T Niiya
- Department of Internal Medicine, Matsuyama Shimin Hospital, Otemachi, Matsuyama, Japan
| | - H Miyaoka
- Department of Internal Medicine, Saiseikai Matsuyama Hospital, Matsuyama, Japan
| | - T Miyake
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan
| | - S Yamamoto
- Department of Lifestyle-related Medicine and Endocrinology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan
| | - K Maruyama
- Department of Public Health, Juntendo University School of Medicine, Bunkyo, Tokyo, Japan
| | - T Ueda
- Department of Internal Medicine, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - H Senba
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan.,Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan
| | - Y Todo
- Department of Internal Medicine, Matsuyama Shimin Hospital, Otemachi, Matsuyama, Japan
| | - M Torisu
- Department of Internal Medicine, Saiseikai Saijo Hospital, Saijo, Japan
| | - H Minami
- Department of Internal Medicine, Ehime Niihama Hospital, Niihama, Japan
| | - M Onji
- Department of Internal Medicine, Saiseikai Imabari Hospital, Imabari, Japan
| | - T Tanigawa
- Department of Public Health, Juntendo University School of Medicine, Bunkyo, Tokyo, Japan
| | - B Matsuura
- Department of Lifestyle-related Medicine and Endocrinology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan
| | - Y Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan
| | - Y Miyake
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan.,Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Shitsukawa, Toon, Japan
| |
Collapse
|
34
|
Matsumiya H, Todo Y, Okamoto K, Takeshita S, Yamazaki H, Yamashiro K, Kato H. A prediction model of survival for patients with bone metastasis from uterine cervical cancer. J Gynecol Oncol 2016; 27:e55. [PMID: 27550401 PMCID: PMC5078818 DOI: 10.3802/jgo.2016.27.e55] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 03/07/2016] [Revised: 04/06/2016] [Accepted: 05/13/2016] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The aim of the study was to establish a predictive model of survival period after bone metastasis from cervical cancer. METHODS A total of 54 patients with bone metastasis from cervical cancer were included in the study. Data at the time of bone metastasis diagnosis, which included presence of extraskeletal metastasis, performance status, history of any previous radiation or chemotherapy, the number of bone metastases, onset period, and treatment were collected. Survival data were analyzed using Kaplan-Meier method and Cox proportional hazards model. RESULTS The median survival period after diagnosis of bone metastasis was 22 weeks (5 months). The 26- and 52-week survival rates after bone metastasis were 36.5% and 15.4%, respectively. Cox regression analysis showed that extraskeletal metastasis (hazard ratio [HR], 6.1; 95% CI, 2.2 to 16.6), performance status of 3 to 4 (HR, 7.8; 95% CI, 3.3 to 18.2), previous radiation or chemotherapy (HR, 3.3; 95% CI, 1.4 to 7.8), multiple bone metastases (HR, 1.9; 95% CI, 1.0 to 3.5), and a bone metastasis-free interval of <12 months (HR, 2.5; 95% CI, 1.2 to 5.3) were significantly and independently related to poor survival. A prognostic score was calculated by adding the number of each significant factor. The 26-week survival rates after diagnosis of bone metastasis were 70.1% in the group with a score ≤2, 46.7% in the group with a score of 3, and 12.5% in the group with a score ≥4 (p<0.001). CONCLUSION This scoring system provided useful prognostic information on survival of patients with bone metastasis of cervical cancer.
Collapse
Affiliation(s)
- Hiroko Matsumiya
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.
| | - Kazuhira Okamoto
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Sho Takeshita
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hiroyuki Yamazaki
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan
| | - Katsushige Yamashiro
- Division of Pathology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| |
Collapse
|
35
|
Endo D, Todo Y, Okamoto K, Suzuki H. A case of recurrent group II uterine tumor resembling ovarian sex-cord tumors, against which two hormonal agents were ineffective. Taiwan J Obstet Gynecol 2016; 55:751-753. [DOI: 10.1016/j.tjog.2015.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2015] [Indexed: 11/29/2022] Open
|
36
|
Takeshita S, Todo Y, Okamoto K, Minobe S, Kato H. Thoracic laminectomy with spinal fixation in a nonambulatory patient with metastatic vertebral tumor from endometrial carcinoma. J Obstet Gynaecol Res 2016; 42:1395-1399. [PMID: 27277163 DOI: 10.1111/jog.13054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 03/15/2016] [Accepted: 04/09/2016] [Indexed: 11/27/2022]
Abstract
Vertebral metastasis from endometrial cancer is a rare event and requires emergency treatment at the onset of neurologic symptoms caused by spinal cord compression. We report a case of a metastatic vertebral tumor, according to the International Federation of Gynecology and Obstetrics classification, of stage IVb endometrial cancer with multiple lung metastases. Emergency irradiation to the spinal tumor was conducted as a result of a loss of ambulation. Thoracic laminectomy with spinal fixation was subsequently performed because the patient remained nonambulatory and her neurological function deteriorated. Spinal decompression surgery enabled her to regain the ability to walk. Complete remission was achieved by subsequent pelvic surgery followed by combined chemotherapy consisting of docetaxel and carboplatin. Finally, the patient had no evidence of disease 45 months after the initial treatment. Early recognition and expeditious treatment is crucial for neurological recovery from metastatic spinal cord compression.
Collapse
Affiliation(s)
- Sho Takeshita
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Kazuhira Okamoto
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Shinichiro Minobe
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| |
Collapse
|
37
|
Abstract
The aim of this review is to address the current status of adjuvant chemotherapy alone in early-stage cervical cancer treatments in the literature. At present, the therapeutic effect of adjuvant chemotherapy alone after radical surgery (RS) has not yet been established, and radiation therapy (RT) or concurrent chemoradiotherapy (CCRT) is recommended as the standard adjuvant therapy after RS for early-stage cervical cancer in various guidelines. The main purpose of adjuvant therapy after RS, however, should be to reduce extrapelvic recurrence rather than local recurrence, although adjuvant RT or CCRT has survival benefits for patients with intermediate- or high-risk factors for recurrence. Moreover, several studies reported that adjuvant therapies including RT were associated with a higher incidence of complications, such as lymphedema, bowel obstruction and urinary disturbance, and a lower grade of long-term quality of life (QOL) or sexual functioning than adjuvant chemotherapy alone. The effect of adjuvant chemotherapy alone for early-stage cervical cancer with intermediate- or high-risk factors for recurrence were not fully investigated in prospective studies, but several retrospective studies suggest that the adjuvant effects of chemotherapy alone are at least similar to that of RT or CCRT in terms of recurrence rate, disease-free survival, or overall survival (OS) with lower incidence of complications. Whereas cisplatin based combination regimens were used in these studies, paclitaxel/cisplatin (TP) regimen, which is currently recognized as a standard chemotherapy regimen for patients with metastatic, recurrent or persistent cervical cancer by Gynecologic Oncology Group (GOG), had also survival benefit as an adjuvant therapy. Therefore, it may be worth considering a prospective randomized controlled trial (RCT) of adjuvant chemotherapy alone using TP regimen versus adjuvant RT as an alternative adjuvant therapy. Because early-stage cervical cancer is a curable condition, it is necessary that the therapeutic strategies should be improved with considering adverse events and QOL for long-term survivors.
Collapse
Affiliation(s)
- Hiroshi Asano
- 1Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo 060-8648, Japan
| | - Yukiharu Todo
- 2Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo 003-0804, Japan
| | - Hidemichi Watari
- 1Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo 060-8648, Japan
| |
Collapse
|
38
|
Todo Y, Watari H. Concurrent chemoradiotherapy for cervical cancer: background including evidence-based data, pitfalls of the data, limitation of treatment in certain groups. Chin J Cancer Res 2016; 28:221-7. [PMID: 27199520 PMCID: PMC4865615 DOI: 10.21147/j.issn.1000-9604.2016.02.10] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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: 11/18/2022] Open
Abstract
Concurrent chemoradiotherapy (CCRT) is regarded as the standard treatment for locally advanced uterine cervical cancer (LACC), including stage Ib2-IVa disease [International Federation of Gynecology and Obstetrics (FIGO) staging]. However, approximately a third of eligible patients in previous studies died of LACC despite receiving CCRT. The therapeutic significance of CCRT alone in stage III-IVa disease has not yet been confirmed. Effective treatment of some LACC is beyond the scope of CCRT. The objective of the present review is to highlight some challenging work aimed at overcoming this seemingly intractable disease. CCRT with increased peak concentrations of cisplatin (CDDP), surgery following CCRT, adjuvant chemotherapy (CT) following CCRT, and neoadjuvant CT followed by CCRT are strategies expected to enhance the therapeutic efficacy of CCRT. If patients with LACC were divided into those with low-risk or high-risk systemic disease or prognoses, novel strategies should be assessed in the group with high-risk disease.
Collapse
Affiliation(s)
- Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo 003-0804, Japan
| | - Hidemichi Watari
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo 060-8648, Japan
| |
Collapse
|
39
|
Takeshita S, Todo Y, Okamoto K, Sudo S, Yamashiro K, Kato H. Incidence of metastasis in circumflex iliac nodes distal to the external iliac nodes in cervical cancer. J Gynecol Oncol 2016; 27:e42. [PMID: 27102250 PMCID: PMC4864518 DOI: 10.3802/jgo.2016.27.e42] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 12/05/2015] [Revised: 03/31/2016] [Accepted: 04/11/2016] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE A causal relationship between removal of circumflex iliac nodes distal to the external iliac nodes (CINDEIN) and lower leg edema has been recently suggested. The aim of this study was to elucidate the incidence of CINDEIN metastasis in cervical cancer. METHODS A retrospective chart review was carried out for 531 patients with cervical cancer who underwent lymph node dissection between 1993 and 2014. CINDEIN metastasis was pathologically identified by microscopic investigation. After 2007, sentinel lymph node biopsy was performed selectively in patients with non-bulky cervical cancer. The sentinel node was identified using (99m)Tc-phytate and by scanning the pelvic cavity with a γ probe. RESULTS Two hundred and ninety-seven patients (55.9%) underwent CINDEIN dissection and 234 (44.1%) did not. The percentage of International Federation of Gynecology and Obstetrics stage IIb to IV (42.4% vs. 23.5%, p<0.001) was significantly higher in patients who underwent CINDEIN dissection than those who did not. CINDEIN metastasis was identified in 1.9% overall and in 3.4% of patients who underwent CINDEIN dissection. For patients with stage Ia to IIa disease, CINDEIN metastasis was identified in 0.6% overall and in 1.2% of patients who underwent CINDEIN dissection. Of 115 patients with sentinel node mapping, only one (0.9%) had CINDEIN detected as a sentinel node. In this case, the other three lymph nodes were concurrently detected as sentinel lymph nodes. CONCLUSION CINDEIN dissection can be eliminated in patients with stage Ia to IIa disease. CINDEIN might not be regional lymph nodes in cervical cancer.
Collapse
Affiliation(s)
- Sho Takeshita
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.
| | - Kazuhira Okamoto
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Satoko Sudo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Katsushige Yamashiro
- Division of Pathology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| |
Collapse
|
40
|
Todo Y, Kato H, Okamoto K, Minobe S, Yamashiro K, Sakuragi N. Isolated tumor cells and micrometastases in regional lymph nodes in stage I to II endometrial cancer. J Gynecol Oncol 2015; 27:e1. [PMID: 25925293 PMCID: PMC4695449 DOI: 10.3802/jgo.2016.27.e1] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [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: 03/01/2015] [Revised: 03/25/2015] [Accepted: 03/31/2015] [Indexed: 12/02/2022] Open
Abstract
Objective The aim of this study was to clarify the clinical significance of isolated tumor cells (ITCs) or micrometastasis (MM) in regional lymph nodes in patients with International Federation of Gynecology and Obstetrics (FIGO) stage I to II endometrial cancer. Methods In this study, a series of 63 patients with FIGO stage I to II were included, who had at least one of the following risk factors for recurrence: G3 endometrioid/serous/clear cell adenocarcinomas, deep myometrial invasion, cervical involvement, lympho-vascular space invasion, and positive peritoneal cytology. These cases were classified as intermediate-risk endometrial cancer. Ultrastaging by multiple slicing, staining with hematoxylin and eosin and cytokeratin, and microscopic examination was performed on regional lymph nodes that had been diagnosed as negative for metastases. Results Among 61 patients in whom paraffin-embedded block was available, ITC/MM was identified in nine patients (14.8%). Deep myometrial invasion was significantly associated with ITC/MM (p=0.028). ITC/MM was an independent risk factor for extrapelvic recurrence (hazard ratio, 17.9; 95% confidence interval [CI], 1.4 to 232.2). The 8-year overall survival (OS) and recurrence-free survival (RFS) rates were more than 20% lower in the ITC/MM group than in the node-negative group (OS, 71.4% vs. 91.9%; RFS, 55.6% vs. 84.0%), which were statistically not significant (OS, p=0.074; RFS, p=0.066). Time to recurrence tended to be longer in the ITC/MM group than in the node-negative group (median, 49 months vs. 16.5 months; p=0.080). Conclusions It remains unclear whether ITC/MM have an adverse influence on prognosis of intermediate-risk endometrial cancer. A multicenter cooperative study is needed to clarify the clinical significance of ITC/MM.
Collapse
Affiliation(s)
- Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Kazuhira Okamoto
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Shinichiro Minobe
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Katsushige Yamashiro
- Division of Pathology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Noriaki Sakuragi
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan
| |
Collapse
|
41
|
Yamazaki H, Todo Y, Takeshita S, Ohba Y, Sudo S, Minobe S, Okamoto K, Yamashiro K, Kato H. Relationship between removal of circumflex iliac nodes distal to the external iliac nodes and postoperative lower-extremity lymphedema in uterine cervical cancer. Gynecol Oncol 2015; 139:295-9. [DOI: 10.1016/j.ygyno.2015.09.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 09/01/2015] [Accepted: 09/06/2015] [Indexed: 11/25/2022]
|
42
|
Todo Y, Yamazaki H, Takeshita S, Ohba Y, Sudo S, Minobe S, Okamoto K, Kato H. Close relationship between removal of circumflex iliac nodes to distal external iliac nodes and postoperative lower-extremity lymphedema in uterine corpus malignant tumors. Gynecol Oncol 2015; 139:160-4. [DOI: 10.1016/j.ygyno.2015.07.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 07/02/2015] [Accepted: 07/03/2015] [Indexed: 11/15/2022]
|
43
|
Abstract
Objective All patients with stage IB1 cervical cancer do not need to undergo parametrectomy. Some low-risk criteria for parametrial involvement (PI) have been proposed based on pathological findings. The aim of this study was to determine pretreatment risk factors for PI in stage IB1 cervical cancer. Methods We retrospectively reviewed 115 patients with stage IB1 cervical cancer who underwent radical hysterectomy or radical trachelectomy. Magnetic resonance imaging (MRI) was performed and serum concentrations of squamous cell carcinoma antigen (SCC-Ag) and cancer antigen 125 (CA-125) were determined in all patients before initial treatment. The following pretreatment factors were investigated: histological variant, maximum tumor diameter, tumor volume (volume index), pelvic lymph node enlargement, and serum tumor markers. Logistic regression analysis was used to select the independent risk factors for PI. Results Eighteen of the 115 patients (15.7%) were pathologically diagnosed with PI. Multivariate analysis confirmed the following independent risk factors for PI: MRI-based tumor diameter ≥25 mm (odds ratio [OR], 9.9; 95% confidence interval [CI], 2.1 to 48.1), MRI-based volume index ≥5,000 mm3 (OR, 13.3; 95% CI, 1.4 to 125.0), and positive serum tumor markers SCC-Ag ≥1.5 ng/mL or CA-125 ≥35 U/mL (OR, 5.7; 95% CI, 1.3 to 25.1). Of 53 patients with no risk factors for PI, none had PI. Conclusion Less radical surgery may become one of the treatment options for stage IB1 cervical cancer patients with MRI-based tumor diameter <25 mm, MRI-based volume index <5,000 mm3, and negativity for SCC-Ag and CA-125.
Collapse
Affiliation(s)
- Hiroyuki Yamazaki
- Division of Gynecologic Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan.
| | - Kazuhira Okamoto
- Division of Gynecologic Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Katsushige Yamashiro
- Division of Pathology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| |
Collapse
|
44
|
Kato H, Ohba Y, Yamazaki H, Minobe SI, Sudo S, Todo Y, Okamoto K, Yamashiro K. Availability of tissue rinse liquid-based cytology for the rapid diagnosis of sentinel lymph node metastasis and improved bilateral detection by photodynamic eye camera. Jpn J Clin Oncol 2015; 45:727-31. [PMID: 26056322 DOI: 10.1093/jjco/hyv079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 05/03/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE On sentinel lymph node navigation surgery for early invasive cervical cancers, to gain high sensitivity and specificity, the sentinel nodes should be detected bilaterally and pathological diagnosis should be sensitive to detect micrometastasis. To improve these problems, we tried tissue rinse liquid-based cytology and the photodynamic eye. METHODS From 2005 to 2013, 102 patients with Stage Ib1 uterine cervical cancer were subjected to sentinel lymph node navigation surgery with Technetium-99 m colloid and blue dye. For the recent 11 patients with whom bilateral sentinel node detection was not available, the photodynamic eye was selectively examined. The detected sentinel node was cut along the minor axis into 2 mm slices, soaked in 10 ml CytoRich red and then subjected to tissue rinse liquid-based cytology at the time of surgery. RESULTS With the accumulation of 102 Ib1 patients subjected to sentinel lymph node navigation surgery, the bilateral sentinel node detection rate was 67.7%. The photodynamic eye was examined for the recent 11 patients who did not have bilateral signals. Out of the 11, 10 patients obtained bilateral signals successfully. During the period of examining the photodynamic eye, a total of 34 patients were subjected to sentinel lymph node navigation surgery. Thus, the overall bilateral detection rate increased to 97% in this subset. Two hundred and five lymph nodes were available as sentinel nodes. The sensitivity of tissue rinse liquid-based cytology was 91.7%, and the specificity was 100%. False positivity was 0% and false negativity was 8.3%. Detection failure was observed only with one micrometastasis and one case of isolated tumor cells. CONCLUSION Combination of photodynamic eye detection and tissue rinse liquid-based cytology pathology can be a promising method for more rewarding sentinel node detection.
Collapse
Affiliation(s)
- Hidenori Kato
- Division of Gynecologic Oncology, Hokkaido Cancer Center, Hokkaido, Japan
| | - Yoko Ohba
- Division of Gynecologic Oncology, Hokkaido Cancer Center, Hokkaido, Japan
| | - Hiroyuki Yamazaki
- Division of Gynecologic Oncology, Hokkaido Cancer Center, Hokkaido, Japan
| | - Shin-Ichiro Minobe
- Division of Gynecologic Oncology, Hokkaido Cancer Center, Hokkaido, Japan
| | - Satoko Sudo
- Division of Gynecologic Oncology, Hokkaido Cancer Center, Hokkaido, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, Hokkaido Cancer Center, Hokkaido, Japan
| | - Kazuhira Okamoto
- Division of Gynecologic Oncology, Hokkaido Cancer Center, Hokkaido, Japan
| | | |
Collapse
|
45
|
Yamazaki H, Todo Y, Mitsube K, Hareyama H, Shimada C, Kato H, Yamashiro K. Long-term survival of patients with recurrent endometrial stromal sarcoma: a multicenter, observational study. J Gynecol Oncol 2015; 26:214-21. [PMID: 25925291 PMCID: PMC4510338 DOI: 10.3802/jgo.2015.26.3.214] [Citation(s) in RCA: 18] [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: 11/27/2014] [Revised: 03/01/2015] [Accepted: 03/01/2015] [Indexed: 02/03/2023] Open
Abstract
Objective The aim of this study was to evaluate the clinical behavior and management outcome of recurrent endometrial stromal sarcoma (ESS). Methods A retrospective review of charts of 10 patients with recurrent ESS was performed and relapse-free interval, relapse site, treatment, response to treatment, duration of follow-up and clinical outcome extracted. Survival outcome measures used were post-relapse survival which was defined as the time from first evidence of relapse to death from any cause. Living patients were censored at the date of last follow-up. Results The median age and median relapse-free interval at the time of initial relapse were 51.5 years and 66.5 months, respectively. The number of relapses ranged from one to five. Sixteen surgical procedures for recurrent disease included nine (56.0%) complete resections. There was no statistically significant difference between initial recurrent tumors and second/subsequent recurrent tumors in the rate of complete surgery (44.4% vs. 71.4%, respectively, p=0.36). Of the eleven evaluable occasions when hormonal therapy was used for recurrent disease, disease control was achieved in eight (72.7%). There was no difference between initial recurrent tumors and second/subsequent recurrent tumors in disease control rate by hormonal therapy (85.7% vs. 50.0%, respectively, p=0.49). The 10-year post-relapse survival rate was 90.0% and the overall median post-relapse survival 119 months (range, 7 to 216 months). Conclusion Post-relapse survival of patients with ESS can be expected to be >10 years when treated by repeated surgical resection and hormonal therapy or both.
Collapse
Affiliation(s)
- Hiroyuki Yamazaki
- Division of Gynecologic Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan.
| | - Kenrokuro Mitsube
- Division of Obstetrics and Gynecology, Asahikawa Kosei General Hospital, Asahikawa, Japan
| | - Hitoshi Hareyama
- Division of Obstetrics and Gynecology, Sapporo Municipal Hospital, Sapporo, Japan
| | - Chisa Shimada
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Katsushige Yamashiro
- Division of Pathology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| |
Collapse
|
46
|
Watari H, Todo Y, Kang S, Odagiri T, Sakuragi N. Proposal of a concept and design of a randomized phase III trial investigating the survival effect of para-aortic lymphadenectomy in endometrial cancer. J Obstet Gynaecol Res 2015; 40:312-6. [PMID: 24472048 DOI: 10.1111/jog.12305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 09/17/2013] [Accepted: 09/20/2013] [Indexed: 11/28/2022]
Abstract
Although prospective studies have failed to show the therapeutic effect of lymphadenectomy in the surgical treatment of endometrial cancer, several retrospective studies including the SEPAL study revealed the survival effect of lymphadenectomy. To prospectively investigate the survival benefit of para-aortic lymphadenectomy shown in the SEPAL study, we are proposing a new concept of a randomized phase III trial. An appropriate study population will be selected according to the preoperative assessments (evaluation of myometrial invasion and cervical invasion with magnetic resonance imaging, extrauterine spread with computed tomography, and histological type and grade by pathological evaluation) to estimate the risk of lymph node metastasis. Patients relevant to potential International Federation of Gynecology and Obstetrics (2008) stage IB, II and III diseases will be eligible, and randomly assigned to two arms: pelvic lymphadenectomy alone (control), or pelvic and para-aortic lymphadenectomy (experimental). After initial surgery, patients with postoperative pathological risk factors for recurrence will receive adjuvant chemotherapy. Because we aim to investigate the therapeutic significance of primary treatments, including surgery and adjuvant chemotherapy, the primary end-point could be recurrence-free survival. One of the most important issues to successfully perform this prospective study is to assure the quality of lymphadenectomy (extent and area), which could be evaluated based on the number of harvested nodes and objective evaluation of dissected area by videos and/or photos.
Collapse
Affiliation(s)
- Hidemichi Watari
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | | | | | | |
Collapse
|
47
|
Affiliation(s)
- Yoshihiro Suzuki
- Department of Obstetrics and Gynecology, Abashiri Kosei hospital, Abashiri, Japan
| | | | | | | | | | | |
Collapse
|
48
|
Endo D, Todo Y, Okamoto K, Minobe S, Kato H, Nishiyama N. Prognostic factors for patients with cervical cancer treated with concurrent chemoradiotherapy: a retrospective analysis in a Japanese cohort. J Gynecol Oncol 2014; 26:12-8. [PMID: 25310853 PMCID: PMC4302279 DOI: 10.3802/jgo.2015.26.1.12] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [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: 07/08/2014] [Revised: 08/13/2014] [Accepted: 08/14/2014] [Indexed: 12/05/2022] Open
Abstract
Objective Concurrent chemoradiotherapy (CCRT) is the primary treatment for locally advanced cervical cancer. We studied prognostic factors for patients treated with CCRT. Methods We retrospectively reviewed records of 85 consecutive patients with cervical cancer who were treated with CCRT between 2002 and 2011, with external beam radiation therapy, intracavitary brachytherapy, and platinum-based chemotherapy. Survival data were analyzed with Kaplan-Meier methods and Cox proportional hazard models. Results Of the 85 patients, 69 patients (81%) had International Federation of Gynecology and Obstetrics (FIGO) stage III/IV disease; 25 patients (29%) had pelvic lymph node enlargement (based on magnetic resonance imaging), and 64 patients (75%) achieved clinical remission following treatment. Median maximum tumor diameter was 5.5 cm. The 3- and 5-year overall survival rates were 60.3% and 55.5%, respectively. Cox regression analysis showed tumor diameter >6 cm (hazard ratio [HR], 2.3; 95% confidence interval [CI], 1.2 to 4.6), pelvic lymph node enlargement (HR, 2.2; 95% CI, 1.1 to 4.5), and distant metastasis (HR, 10.0; 95% CI, 3.7 to 27.0) were significantly and independently related to poor outcomes. Conclusion New treatment strategies should be considered for locally advanced cervical cancers with tumors >6 cm and radiologically enlarged pelvic lymph nodes.
Collapse
Affiliation(s)
- Daisuke Endo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.
| | - Kazuhira Okamoto
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Shinichiro Minobe
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Hidenori Kato
- Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Noriaki Nishiyama
- Division of Radiation Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| |
Collapse
|
49
|
Shimada C, Todo Y, Okamoto K, Akashi D, Yamashiro K, Hasegawa T. Central type primitive neuroectodermal tumor/neuroblastoma of the uterus: A case report. J Obstet Gynaecol Res 2014; 40:2118-22. [DOI: 10.1111/jog.12459] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 03/26/2014] [Indexed: 01/11/2023]
Affiliation(s)
- Chisa Shimada
- Department of Obstetrics and Gynaecology; Hokkaido University School of Medicine; Sapporo Japan
| | - Yukiharu Todo
- Division of Gynecologic Oncology; National Hospital Organization, Hokkaido Cancer Center; Sapporo Japan
| | - Kazuhira Okamoto
- Division of Gynecologic Oncology; National Hospital Organization, Hokkaido Cancer Center; Sapporo Japan
| | - Daisuke Akashi
- Division of Gynecologic Oncology; National Hospital Organization, Hokkaido Cancer Center; Sapporo Japan
| | - Katsushige Yamashiro
- Division of Pathology; National Hospital Organization, Hokkaido Cancer Center; Sapporo Japan
| | - Tadashi Hasegawa
- Department of Surgical Pathology; Sapporo Medical University School of Medicine; Sapporo Japan
| |
Collapse
|
50
|
Todo Y, Okamoto K, Minobe S, Kato H. Clinical Significance of Surgical Staging for Obese Women with Endometrial Cancer: A Retrospective Analysis in a Japanese Cohort. Jpn J Clin Oncol 2014; 44:903-9. [DOI: 10.1093/jjco/hyu106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|