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- 저자 : Eiji Kondoh (검색결과 2 건)
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Groin lymph node detection and sentinel lymph node biopsy in vulvar cancer
Chieko Sakae,Ken Yamaguchi,Noriomi Matsumura,Hidekatsu Nakai,Yumiko Yoshioka,Eiji Kondoh,Junzo Hamanishi,Kaoru Abiko,Masafumi Koshiyama,Tsukasa Baba,Aki Kido,Masaki Mandai,Ikuo Konishi 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.6
Objective: To identify suitable diagnostic tools and evaluate the efficacy of sentinel lymphnode (SLN) biopsy for inguinal lymph node metastasis in vulvar cancer. Methods: Data from 41 patients with vulvar cancer were evaluated retrospectively, includingmagnetic resonance imaging (MRI) measurements, SLN biopsy status, groin lymph nodemetastasis, and prognosis. Results: SLN biopsy was conducted in 12 patients who had stage I to III disease. Groinlymphadenectomy was omitted in five of the nine patients with negative SLNs. All SLNnegativepatients who did not undergo groin lymphadenectomy showed no evidence ofdisease after treatment. On MRI, the long and short diameters of the inguinal node weresignificantly longer in metastasis-positive cases, compared with negative cases, in 25 patientswhose nodes were evaluated pathologically (long diameter, 12.8 mm vs. 8.8 mm, p=0.025;short diameter, 9.2 mm vs. 6.7 mm, p=0.041). The threshold of >10.0 mm for the longaxis gave a sensitivity, specificity, positive predictive value, and negative predictive value of87.5%, 70.6%, 58.3%, and 92.3%, respectively, using a binary classification test. Decisiontree analysis revealed a sensitivity, specificity, and accuracy of 87.5%, 70.6%, and 76.0%,respectively, with the threshold of >10.0 mm for the long axis on MRI. The criteria of >10.0mm for the long axis on MRI predicted an advanced stage and poorer prognosis using avalidation set of 15 cases (p=0.028). Conclusion: Minimally invasive surgery after preoperative evaluation on MRI and SLN biopsyis a feasible strategy for patients with vulvar cancer.
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Ayami Inoue,Ken Yamaguchi,Yasuhisa Kurata,Ryusuke Murakami,Kaoru Abiko,Junzo Hamanishi,Eiji Kondoh,Tsukasa Baba,Aki Kido,Ikuo Konishi,Noriomi Matsumura 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.5
Objective: Carcinosarcoma of the uterine corpus has a poor prognosis. Although pathologicalnecrosis is a prognostic factor of endometrial cancer, the clinicopathological influences of anunenhanced region observed on magnetic resonance imaging (MRI) are inconclusive. The aimof our study was to determine the clinicobiological impact of the presence of an unenhancedregion on MRI, which can represent necrosis, in uterine carcinosarcoma. Methods: The clinicopathological factors of 29 patients diagnosed with uterinecarcinosarcoma were assessed retrospectively. The percentage of the tumor that wasunenhanced on MRI was determined. The clinicopathological factors related to theunenhanced regions were evaluated. The prognostic significance was assessed using theKaplan-Meier method and Cox regression model. Results: Although the presence of pathological necrosis was not a poor prognosticfactor (p=0.704), unenhanced regions on MRI correlated with poor prognosis when theunenhanced regions in the tumor accounted for more than 10% of the total tumor (p=0.019). The percentage of unenhanced regions was positively correlated with stage (p=0.028;r=0.4691) and related to tumor size (p=0.086; r=0.3749). The Cox regression analysisindicated that the presence of lymph node (LN) metastasis and more than 10% of the tumorbeing unenhanced on MRI were prognostic factors of overall survival in the univariateanalyses (p=0.018 and p=0.047, respectively). Conclusion: The unenhanced region on MRI, which represents pathological necrosis, reflectstumor progression, and semi-quantification of the region is useful to predict the prognosis inpatients with uterine carcinosarcoma.
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