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Ohshima, Koichi,Kimura, Hiroshi,Yoshino, Tadashi,Kim, Chul Woo,Ko, Young H.,Lee, Seung-Suk,Peh, Suat-Cheng,Chan, John K.C. Blackwell Publishing Asia 2008 Pathology international Vol.58 No.4
<P>EBV-associated T/natural killer (NK)-cell lymphoproliferative disorder (EBV-T/NK LPD) of children and young adults is generally referred to with the blanket nosological term of severe chronic active EBV infection (CAEBV). This disease is rare, associated with high morbidity and mortality, and appears to be more prevalent in East Asian countries. But because there is no grading or categorization system for CAEBV, pathologists and clinicians often disagree regarding diagnosis and therapy. EBV-T/NK LPD includes polyclonal, oligoclonal, and monoclonal proliferation of cytotoxic T and/or NK cells. Moreover, a unique disease previously described as infantile fulminant EBV-associated T-LPD has been identified and overlaps with EBV-T/NK LPD. In the present review a clinicopathological categorization of EBV-T/NK LPD is proposed, based on pathological evaluation and molecular data, as follows: (i) category A1, polymorphic LPD without clonal proliferation of EBV-infected cells; (ii) category A2, polymorphic LPD with clonality; (iii) category A3, monomorphic LPD (T-cell or NK cell lymphoma/leukemia) with clonality; and (iv) category B, monomorphic LPD (T-cell lymphoma) with clonality and fulminant course. Categories A1, A2, and A3 possibly constitute a continuous spectrum and together are equivalent to CAEBV. Category B is the exact equivalent of infantile fulminant EBV-associated T-LPD. It is expected that this categorization system will provide a guide for the better understanding of this disorder. This proposal was approved at the third meeting of the Asian Hematopathology Association (Nagoya, 2006).</P>
Clear cell carcinoma of the ovary: molecular insights and future therapeutic perspectives
Seiji Mabuchi,Toru Sugiyama,Tadashi Kimura 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.3
Clear cell carcinoma (CCC) of the ovary is known to show poorer sensitivity to chemotherapeuticagents and to be associated with a worse prognosis than the more common serousadenocarcinoma or endometrioid adenocarcinoma. To improve the survival of patients withovarian CCC, the deeper understanding of the mechanism of CCC carcinogenesis as well asthe efforts to develop novel treatment strategies in the setting of both front-line treatmentand salvage treatment for recurrent disease are needed. In this presentation, we firstsummarize the mechanism responsible for carcinogenesis. Then, we highlight the promisingtherapeutic targets in ovarian CCC and provide information on the novel agents which inhibitthese molecular targets. Moreover, we discuss on the cytotoxic anti-cancer agents that can bebest combined with targeted agents in the treatment of ovarian CCC.
Seiji Mabuchi,Kenichirou Morishige,Takayuki Enomoto,Tadashi Kimura 대한부인종양학회 2010 Journal of Gynecologic Oncology Vol.21 No.2
Objective: The aim of this study is to evaluate the efficacy of carboplatin-paclitaxel (TC) as an initial treatment in patients with the International Federation of Gynecology and Obstetrics (FIGO) stage IVb cervical cancer. Methods: We retrospectively reviewed seven patients with stage IVb cervical cancer who have been primarily treated with TC. The activity and the toxicity were evaluated. Response rate was the main endpoint. Results: Overall, the treatment of TC was well tolerated. The overall response rate was 71.4% (2 complete response, 3partial response). Although grade 3-4 hematologic toxicities were observed in 3 out of 7 patients (42.8%), no patients experienced grade 3-4 non-hematologic toxicities. When we combined our present results with the previous reports,the overall response rate of TC is 63.6%. Conclusion: TC is active and well tolerated in patients FIGO stage IVb cervical cancer. This combination may be considered as an initial treatment regimen in this patient population.
Seiji Mabuchi,Fumiaki Isohashi,Mika Okazawa,Fuminori Kitada,Shintaro Maruoka,Kazuhiko Ogawa,Tadashi Kimura 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.1
Objective: To evaluate the efficacy and toxicity of paclitaxel plus carboplatin (TC)-based concurrent chemoradiotherapy (CCRT) followed by consolidation chemotherapy in the International Federation of Gynecology and Obstetrics (FIGO) stage IIIB/IVA cervical cancer patients. Methods: We reviewed the medical records of FIGO stage IIIB/IVA cervical cancer patients (n=30) who had been intended to be treated with TC-based CCRT followed by consolidation chemotherapy (TC-CCRT-group) from April 2012–May 2016. Patients who had been treated with CCRT involving a single platinum agent (CCRT-group; n=52) or definitive radiotherapy alone (RT-group; n=74) from January 1997–September 2012 were also identified and used as historical controls. Survival was calculated using the Kaplan-Meier method and compared using the log-rank test. Results: Of the 30 patients included in the TC-CCRT-group, 22 patients (73.3%) completed the planned TC-based CCRT. The most frequently observed acute grade 3/4 hematological toxicities were leukopenia and neutropenia, and diarrhea was the most common acute grade 3/4 non-hematological toxicity. After a median follow-up of 35 months, 9 patients (30.0%) had developed recurrent disease. The patients’ estimated 3-year progression-free survival (PFS) and overall survival (OS) rates were 67.9% and 90.8%, respectively. In comparisons with historical control groups, the survival outcomes of TC-CCRT-group was significantly superior to CCRT-group in terms of OS (p=0.011) and significantly superior to RT-group in terms of both PFS (p=0.009) and OS (p<0.001). Conclusion: TC-based CCRT followed by consolidation chemotherapy is safe and effective. A randomized controlled study needs to be conducted to further evaluate the efficacy of this multimodal approach in this patient population.