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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.
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.
Ryo Kanematsu,Junya Hanakita,Toshiyuki Takahashi,Manabu Minami,Tomoo Inoue,Kazuhiro Miyasaka,Hiroya Shimauchi-Ohtaki,Manabu Ueno,Fumiaki Honda 대한척추신경외과학회 2021 Neurospine Vol.18 No.4
Objective: The mechanisms of neurogenic bowel dysfunction (NBD) and neurogenic bladder (NB), which are major consequences of spinal cord injury and occasionally degenerative lumbar disease. The following in patients with cauda equina syndrome who underwent posterior decompression surgery was investigated: (1) the preoperative prevalence of NBD and NB, measured using the Constipation Scoring System (CSS) and International Prostate Symptoms Score (IPSS); (2) the degree and timing of postoperative improvement of NBD and NB. Methods: We administered the CSS and IPSS in 93 patients before surgery and at 1, 3, 6, and 12 months postoperatively. We prospectively examined patient characteristics, Japanese Orthopaedic Association (JOA) score, and postoperative improvements in each score. Results: The prevalence of symptomatic defecation and urinary symptoms at admission were 37 patients (38.1%) and 31 patients (33.3%), respectively. Among the symptomatic patients with defecation problems, 12 patients had improved at 1 month, 13 at 3 months, 14 at 6 months, and 13 at 12 months postoperatively. Among the symptomatic patients with urinary problems, 5 patients improved at 1 month, 11 at 3 months, 6 at 6 months, and 10 at 1 year postoperatively. Comparing patients with improved versus unimproved in CSS, the degree of JOA score improvement was a significant prognosis factor (p<0.05; odds ratio, 1.05). Conclusion: The prevalence of symptomatic defecation and urinary symptoms in patients with cauda equina syndrome was 38.1% and 33.3%, respectively. Decompression surgery improved symptoms in 30%–50%. These effects were first observed 1 month after the operation and persisted up to 1 year.
Hiroko Machida,Koji Matsuo,Yoichi Kobayashi,Mai Momomura,Fumiaki Takahashi,Tsutomu Tabata,Eiji Kondo,Wataru Yamagami,Yasuhiko Ebina,Masanori Kaneuchi,Satoru Nagase,Mikio Mikami 대한부인종양학회 2022 Journal of Gynecologic Oncology Vol.33 No.3
Objective: To assess the efficacy of the FIGO 2018 classification system for nodal-specific classifications for early-stage cervical cancer; specifically, to examine the impact of nodal metastasis on survival and the effect of postoperative treatments, according to histological subtypes. Methods: This society-based retrospective observational study in Japan examined 16,539 women with the 2009 FIGO stage IB1 cervical cancer who underwent primary surgical treatment from 2004 to 2015. Associations of cause-specific survival (CSS) with nodal metastasis and postoperative adjuvant therapy were examined according to histology type (squamous cell carcinoma [SCC], n=10,315; and non-SCC, n=6,224). Results: The nodal metastasis rate for SCC was higher than that for non-SCC (10.7% vs. 8.3%, p<0.001). In multivariable analysis, the impact of nodal metastasis on CSS was greater for non-SCC tumors (adjusted-hazard ratio [HR], 3.11; 95% confidence interval [CI], 2.40– 4.02) than for SCC tumors (adjusted-HR, 2.20; 95% CI, 1.70–2.84; p<0.001). Propensity score matching analysis showed significantly lower CSS rates for women with pelvic nodal metastasis from non-SCC tumors than from SCC tumors (5-year CSS rate, 75.4% vs. 90.3%, p<0.001).The CSS rates for women with nodal metastasis in SCC histology were similar between the postoperative concurrent chemoradiotherapy/radiotherapy and chemotherapy groups (89.2% vs. 86.1%, p=0.42), whereas those in non-SCC histology who received postoperative chemotherapy improved the CSS (74.1% vs. 67.7%, p=0.043). Conclusion: The node-specific staging system in the 2018 FIGO cervical cancer classification is applicable to both non-SCC tumors and SCC tumors; however, the prognostic significance of nodal metastases and efficacy of postoperative therapies vary according to histology.
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.
Suwa, Tomone,Nabara, Yoshihiro,Ozeki, Hidemasa,Hemmi, Tsutomu,Isono, Takaaki,Takahashi, Yoshikazu,Kawano, Katsumi,Oshikiri, Masayuki,Tsutsumi, Fumiaki,Shibutani, Kazuyuki,Nunoya, Yoshihiko,Okuno, Kiyo Institute of Electrical and Electronics Engineers 2015 IEEE transactions on applied superconductivity Vol.25 No.3
<P>Japan Atomic Energy Agency (JAEA) is procuring 100% of the ITER Central Solenoid (CS) conductors. The CS conductor is required to maintain the performance under 60000 pulsed electromagnetic cycles. JAEA tested two internal-tin Nb<SUB>3</SUB>Sn conductors for the CS at the SULTAN test facility. As a result of destructive examination, the twist pitches of both of the cables satisfied requirements of the ITER Organization (IO). The current sharing temperatures T<SUB>cs</SUB> of each sample were 6.6 and 6.8 K before cyclic operation, and the T<SUB>cs</SUB> values were 6.8 and 6.9 K after 9700 electromagnetic cycles, including three warm-up/cooldowns, respectively. The T<SUB>cs</SUB> performance of both samples satisfied the IO requirement. The ac losses of CSKO1-C and CSKO1-D were approximately half of typical bronze-route CS conductors at 2 and 9 T. The ac loss at 45.1 kA after the cycling was 1.5 times higher than that without the transport current. An almost constant strain of the jacket was observed after the test as a result of the residual strain measurement. Therefore, the deformation of the cable might have been homogeneous along the conductor axis. Because of the higher T<SUB>cs</SUB> of CSKO1-D than CSKO1-C, JAEA started the manufacturing of the CS conductor with the same specification as CSKO1-D.</P>
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.