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Manabu Seino,Satoru Nagase,Tsuyoshi Ohta,Wataru Yamagami,Yasuhiko Ebina,Yoichi Kobayashi,Tsutomu Tabata,Masanori Kaneuchi,Takayuki Enomoto,Mikio Mikami 대한부인종양학회 2023 Journal of Gynecologic Oncology Vol.34 No.1
Objective: The aim of this study was to review the clinicopathological characteristics of small cell neuroendocrine cervical cancer (SCNEC) and to identify the optimal treatment. Methods: The Japanese Society of Gynecologic Oncology conducted a retrospective cohort study of SCNECs enrolled in the Gynecological Tumor Registry of the Japan Society of Obstetrics and Gynecology between 2004 and 2015. All cases were modified and unified by International Federation of Gynecology and Obstetrics 2008 (Union for International Cancer Control 7th edition). Results: There were 822 registered patients diagnosed with SCNEC from 2004 to 2015 which comprised 1.1% (822/73,698) of all uterine cervical cancer cases. Rates of lymph-node and distant metastasis were significantly higher in T1b2 (38.9% and 13.7%, respectively) than T1b1 (14.2% and 4.4%, respectively) (p<0.01). In IB2 and T1bN1M0 SCNEC, the 5-year survival rate with surgery followed by chemotherapy was significantly higher than that with surgery followed by radiation therapy/concurrent chemoradiation therapy (p<0.01). Conclusion: SNCEC tumors >4 cm in size had greater rates of lymph-node and distant metastasis when compared with tumors ≤4 cm. Adjuvant chemotherapy, rather than radiotherapy, may improve prognosis after surgery in T1bN1M0 SCNEC.
Japan Society of Gynecologic Oncology 2022 guidelines for uterine cervical neoplasm treatment
Manabu Seino,Satoru Nagase,Hideki Tokunaga,Wataru Yamagami,Yoichi Kobayashi,Tsutomu Tabata,Masanori Kaneuchi 대한부인종양학회 2024 Journal of Gynecologic Oncology Vol.35 No.1
The Japan Society of Gynecologic Oncology (JSGO) Guidelines 2022 for the Treatment ofUterine Cer vical Cancer are revised from the 2017 guideline. This guideline aimed to providestandard care for cer vical cancer, indicate appropriate current treatment methods for cer vicalcancer, minimize variances in treatment methods among institutions, improve diseaseprognosis and treatment safety, reduce the economic and psychosomatic burden of patientsby promoting the performance of appropriate treatment, and enhance mutual understandingbetween patients and healthcare professionals. The guidelines were prepared through theconsensus of the JSGO Guideline Committee, based on a careful review of evidence gatheredthrough the literature searches and the medical health insurance system and actual clinicalpractice situations in Japan. The guidelines comprise seven chapters and 5 algorithms. The main features of the 2022 revision are as follows: 1) added discussed points at the finalconsensus meeting; 2) revised the treatment methods based on the International Federationof Gynecology and Obstetrics 2018 staging system; 3) examined minimally invasive surger ybased on Laparoscopic Approach to Cer vical Cancer trial; 4) added clinical question (CQ)for treatments of rare histological types, gastric type, and small-cell neuroendocrinecarcinoma; 5) added CQ for intensity-modulated radiation therapy; 6) added CQ for cancergenomic profiling test; and 7) added CQ for cancer sur vivorship. Each recommendationis accompanied by a classification of recommendation categories based on the consensusreached by the Guideline Committee members. Here, we present the English version of theJSGO Guidelines 2022 for the Treatment of Uterine Cer vical Cancer.
Shogo Shigeta,Satoru Nagase,Mikio Mikami,Masae Ikeda,Masako Shida,Isao Sakaguchi,Norichika Ushioda,Fumiaki Takahashi,Wataru Yamagami,Nobuo Yaegashi,Yasuhiro Udagawa,Hidetaka Katabuchi 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.6
Objective: The Japan Society of Gynecologic Oncology (JSGO) published the first practiceguideline for endometrial cancer in 2006. The JSGO guideline evaluation committee assessedthe effect of this guideline introduction on clinical practice and patient outcome using dataprovided by the Japan Society of Obstetrics and Gynecology (JSOG) cancer registration system. Methods: Data of patients with endometrial cancer registered between 2000 and 2012 wereanalyzed, and epidemiological and clinical trends were assessed. The influence of guidelineintroduction on survival was determined by analyzing data of patients registered between2004 and 2009 using competing risk model. Results: In total, 65,241 cases of endometrial cancer were registered. Total number ofpatients registered each year increased about 3 times in the analyzed period, and theproportion of older patients with type II endometrial cancer rapidly increased. The frequencyof lymphadenectomy had decreased not only among the low-recurrence risk group but alsoamong the intermediate- or high-recurrence risk group. Adjuvant therapy was integratedinto chemotherapy (p<0.001). Overall survival did not significantly differ before and afterthe guideline introduction (hazard ratio [HR]=0.891; p=0.160). Additional analyses revealedpatients receiving adjuvant chemotherapy showed better prognosis than those receivingadjuvant radiation therapy when limited to stage I or II (HR=0.598; p=0.003). Conclusion: It was suggested that guideline introduction influenced the managementof endometrial cancer at several aspects. Better organized information and continuousevaluation are necessary to understand the causal relationship between the guideline andpatient outcome.
Clinical statistics of gynecologic cancers in Japan
Wataru Yamagami,Satoru Nagase,Fumiaki Takahashi,Kazuhiko Ino,Toru Hachisuga,Daisuke Aoki,Hidetaka Katabuchi 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.2
Cervical, endometrial, and ovarian cancers, have both high morbidity and mortality among the gynecologic malignant tumors in Japan. The present study was conducted using both the population-based cancer registry and the gynecologic cancer registry to elucidate the characteristics of gynecologic malignant tumors in Japan. Based on nationwide estimates from the population-based cancer registry in Japan, the morbidities and mortality of cervical, endometrial, and ovarian cancers were obtained and used for analysis. Clinicopathologic factors for cervical cancer, endometrial cancer, ovarian cancer, including age, clinical stage, postsurgical stage, histological type, therapeutic strategy, and prognosis were retrieved from the gynecologic cancer registry published by the Japan Society of Obstetrics and Gynecology and used for analysis. The morbidities of cervical, endometrial, and ovarian cancers were 10,908, 13,606, and 9,384 women in 2012, respectively. The prevalence of endometrial cancer has significantly and consistently been increasing and represents the most common gynecologic malignant tumor in Japan. The mortalities of cervical, endometrial, and ovarian cancers were 2.1, 1.3, and 3.2 per 100,000 in 2012, respectively. In 2014, 52.2% of cervical cancer patients were classified as stage I, 22.5% as stage II, 10.2% as stage III, and 11.2% as stage IV. In addition, 71.9% of endometrial cancer patients were classified as stage I, 6.0% as stage II, 13.3% as stage III, and 7.5% as stage IV. Finally, 43.2% of ovarian cancer patients were classified as stage I, 9.1% as stage II, 27.6% as stage III, and 7.2% as stage IV. Twelve point five percent of ovarian cancer patients received neoadjuvant chemotherapy.
Mikio Mikami,Satoru Nagase,Wataru Yamagami,Kimio Ushijma,Hironori Tashiro,Hidetaka Katabuchi 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.4
Objective: Recent evidence has supported the concept that epithelial ovarian cancer (EOC)arises from the cells of the fallopian tube or endometrium. This study investigated currentpractice in Japan with respect to performing opportunistic bilateral salpingectomy (OBS)during gynecological surgery for benign disease for Ovarian Cancer Prevention. Methods: We mailed a questionnaire to 767 hospitals and clinics, comprising 628 accreditedtraining institutions of the Japan Society of Obstetrics and Gynecology (JSOG), Japan Societyof Gynecologic Oncology (JSGO), or Japan Society of Gynecologic and Obstetric Endoscopyand Minimally Invasive Therapy (JSGOE) and 139 private institutions with at least one JSGOEcertifiedlicensed gynecologic laparoscopist. Results: Among the 767 institutions, 444 (57.9%) provided responses, including 91 (20.6%)that were both JSGOE and JSGO accredited, 71 (16.0%) that were only JSGO accredited, 88(19.8%) that were only JSGOE accredited, and 194 (43.7%) that were unaccredited. It wasfound that awareness and performance of OBS largely depended on the JSGO and/or JSGOEaccreditation status. OBS was only performed at 54.0% of responding institutions and just6.8% of the institutions were willing to participate in randomized controlled trials to validatethis method for reducing the incidence of ovarian cancer. Conclusion: The JSOG Gynecologic Tumor Committee will announce its opinion onsalpingectomy for ovarian cancer prevention to all JSOG members and will develop a systemfor monitoring the number of OBS procedures in Japan.
Wataru Yamagami,Satoru Nagase,Fumiaki Takahashi,Kazuhiko Ino,Toru Hachisuga,Mikio Mikami,Takayuki Enomoto,Hidetaka Katabuchi,Daisuke Aoki 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.4
Objective: International Federation of Gynecology and Obstetrics (FIGO) staging for ovarian,fallopian tube, and peritoneal cancers was revised in 2014. The aim of this study is to clarifywhether the revised FIGO2014 staging reflects the prognosis of patients with ovarian cancerby histological type in Japan. Methods: We extracted 9,747 patients who were diagnosed with ovarian cancer since 2004until 2008 and who could be classified into appropriate stages from the Gynecologic CancerRegistry of Japan Society of Obstetrics and Gynecology. These cases were analyzed afterrevision to FIGO2014 based on the pTNM classification. Results: Among stage I, the 5-year overall survival rate (5y-OS) in FIGO2014 was 94.9% instage IA, 92.3% in stage IC1, 86.1% in IC2, and 84.9% in IC3 with significant differencesbetween stages IA and IC1 (p=0.012), IC1 and IC2 (p<0.001). There was a significantdifference between stages IA and IC1 in clear cell and mucinous carcinoma but not in serousand endometrioid carcinoma. Among stage III, the 5y-OS was 75.6% in stage IIIA1, 68.9% inIIIA2, 58.6% in IIIB, and 44.4% in IIIC, with significant differences between stages IIIA2 andIIIB (p=0.009), IIIB and IIIC (p<0.001). Among stage IV, the 5y-OS was 43.1% in stage IVA*and 32.1% in IVB with a significant difference (p=0.002). Conclusion: The results suggest that changes in classification for stage III and stage IVare appropriate, but the subclassification for stage IC might be too detailed. There was adiscrepancy of prognosis by histological type between stage IA and IC1.
Japan Society of Gynecologic Oncology 2018 guidelines for treatment of uterine body neoplasms
Wataru Yamagami,Mikio Mikami,Satoru Nagase,Tsutomu Tabata,Yoichi Kobayashi,Masanori Kaneuchi,Hiroaki Kobayashi,Hidekazu Yamada,Kiyoshi Hasegawa,Hiroyuki Fujiwara,Hidetaka Katabuchi,Daisuke Aoki 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.1
The Fourth Edition of the Guidelines for Treatment of Uterine Body Neoplasm was published in 2018. These guidelines include 9 chapters: 1. Overview of the guidelines, 2. Initial treatment for endometrial cancer, 3. Postoperative adjuvant therapy for endometrial cancer, 4. Post-treatment surveillance for endometrial cancer, 5. Treatment for advanced or recurrent endometrial cancer, 6. Fertility-sparing therapy, 7. Treatment of uterine carcinosarcoma and uterine sarcoma, 8. Treatment of trophoblastic disease, 9. Document collection; and nine algorithms: 1-3. Initial treatment of endometrial cancer, 4. Postoperative adjuvant treatment for endometrial cancer, 5. Treatment of recurrent endometrial cancer, 6. Fertility-sparing therapy, 7. Treatment for uterine carcinosarcoma, 8. Treatment for uterine sarcoma, 9. Treatment for choriocarcinoma. Each chapter includes overviews and clinical questions, and recommendations, objectives, explanation, and references are provided for each clinical question. This revision has no major changes compared to the 3rd edition, but does have some differences: 1) an explanation of the recommendation decision process and conflict of interest considerations have been added in the overview, 2) nurses, pharmacists and patients participated in creation of the guidelines, in addition to physicians, 3) the approach to evidence collection is listed at the end of the guidelines, and 4) for clinical questions that lack evidence or clinical validation, the opinion of the Guidelines Committee is given as a “Recommendations for tomorrow”.
Mizuki Shigematsu,Takaaki Udagawa,Satoru Nagase Council on Tall Building and Urban Habitat Korea 2023 International journal of high-rise buildings Vol.12 No.3
This paper presents the structural design and response control system of the JR MEGURO MARC building, a 70 meters high office building with steel structure located in Tokyo (Figure 1). In order to achieve high earthquake resistance and useable office space, this building integrates a centralized response control system with deformation amplification mechanisms and tuned viscous mass dampers on the lower floor. Moreover, buckling-restrained braces (BRB) are installed on the upper floors to increase the effectiveness of centralized response control system and to reduce damage of the main frames in the event of a major earthquake. It features an efficient centralized response control system by amplifying the deformation of the dampers without creating a soft story.
Masae Ikeda,Masako Shida,Shogo Shigeta,Satoru Nagase,Fumiaki Takahashi,Wataru Yamagami,Hidetaka Katabuchi,Nobuo Yaegashi,Daisuke Aoki,Mikio Mikami 대한부인종양학회 2021 Journal of Gynecologic Oncology Vol.32 No.3
Objective: The Japan Society of Gynecologic Oncology published the first guidelines for thetreatment of cervical cancer in 2007. The aim of this research was to evaluate the influence ofthe introduction of the first guideline on clinical trends and outcomes of patients with early stage cervical cancer who underwent surgery. Methods: This analysis included 9,756 patients who were diagnosed based on thepathological Tumor-Node-Metastasis (pTNM) classification (i.e., pT1b1, pT1b2, pT2b andpN0, pN1, pNX) and received surgery as a primary treatment between 2004 and 2009. Dataof these patients were retrospectively reviewed, and clinicopathological trends were assessed. The influence of the introduction of the guideline on survival was determined by using acompeting risk model. Results: For surgery cases, the estimated subdistribution hazard ratio (HR) by the competingrisk model for the influence of the guideline adjusted for age, year of registration, pTclassification, pN classification, histological type, and treatment methods was 1.024(p=0.864). Following the introduction of the first guideline in 2007, for patients with lymphnode metastasis, the use of chemotherapy (CT) as a postsurgical therapy increased, whereasthat of concurrent chemoradiotherapy (CCRT)/radiotherapy (RT) decreased (p<0.010). ForpN1 cases, the estimated subdistribution HR by the competing risk model for the influenceof the guideline was 1.094 (p=0.634). There was no significance in the postsurgical therapybetween CT and CCRT/RT (p=0.078). Conclusions: Survival of surgical cases was not improved by the introduction of theguidelines. It is necessary to consider more effective postsurgical therapy for high-risk early stage cervical cancer.