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RISS 인기검색어
- 검색키워드
- 저자 : Sho Takeshita (검색결과 4 건)
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Sho Takeshita,Yukiharu Todo,Kazuhira Okamoto,Satoko Sudo,Katsushige Yamashiro,Hidenori Kato 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.4
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 99mTc-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.
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Yukiharu Todo,Sho Takeshita,Kazuhira Okamoto,Katsushige Yamashiro,Hidenori Kato 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.5
Objective: The aim of this study was to confirm the incidence and implications of a lymphaticspread pattern involving para-aortic lymph node (PAN) metastasis in the absence of pelviclymph node (PLN) metastasis in patients with endometrial cancer. Methods: We carried out a retrospective chart review of 380 patients with endometrial cancertreated by surgery including PLN dissection and PAN dissection at Hokkaido Cancer Centerbetween 2003 and 2016. We determined the probability of PAN metastasis in patients withoutPLN 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 wasPLN+PAN+ (7.9%), followed by PLN+PAN− (6.6%), and PLN−PAN+ (2.4%). The probabilityof PAN metastasis in patients without PLN metastasis was 2.8% (9/325). The 5-year overallsurvival rates were 96.5% in PLN−PAN−, 77.6% in PLN+PAN−, 63.4% in PLN+PAN+, and53.6% in PLN−PAN+ patients. Conclusion: The likelihood of PAN metastasis in endometrial cancer patients withoutPLN 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 intoconsideration when determining patient management strategies
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A prediction model of survival for patients with bone metastasis from uterine cervical cancer
Hiroko Matsumiya,Yukiharu Todo,Kazuhira Okamoto,Sho Takeshita,Hiroyuki Yamazaki,Katsushige Yamashiro,Hidenori Kato 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.6
Objective: The aim of the study was to establish a predictive model of survival period afterbone metastasis from cervical cancer. Methods: A total of 54 patients with bone metastasis from cervical cancer were included in thestudy. Data at the time of bone metastasis diagnosis, which included presence of extraskeletalmetastasis, performance status, history of any previous radiation or chemotherapy, thenumber of bone metastases, onset period, and treatment were collected. Survival data wereanalyzed using Kaplan-Meier method and Cox proportional hazards model. Results: The median survival period after diagnosis of bone metastasis was 22 weeks (5months). 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), previousradiation 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, 1.2to 5.3) were significantly and independently related to poor survival. A prognostic score wascalculated by adding the number of each significant factor. The 26-week survival rates afterdiagnosis of bone metastasis were 70.1% in the group with a score ≤2, 46.7% in the groupwith 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 ofpatients with bone metastasis of cervical cancer.
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Therapeutic significance of full lymphadenectomy in early-stage ovarian clear cell carcinoma
Hiroyuki Yamazaki,Yukiharu Todo,Chisa Shimada,Sho Takeshita,Shinichiro Minobe,Kazuhira Okamoto,Katsushige Yamashiro,Hidenori Kato 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.2
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.
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