The 2020 Japan Society of Gynecologic Oncology guidelines for the treatment of ovarian cancer, fallopian tube cancer, and primary peritoneal cancer

Hideki Tokunaga,Mikio Mikami,Satoru Nagase,Yoichi Kobayashi,Tsutomu Tabata,Masanori Kaneuchi,Toyomi Satoh,Yasuyuki Hirashima,Noriomi Matsumura,Yoshihito Yokoyama,Kei Kawana,Satoru Kyo,Daisuke Aoki,Hid 대한부인종양학회 2021 Journal of Gynecologic Oncology Vol.32 No.2

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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.

Development of a Plasma Control System for Steady-state Operation on QUEST

Makoto Hasegwa,Kazuo Nakamura,Hideki Zushi,Kazuaki Hanada,Akihide Fujisawa,Keisuke Matsuoka,Hiroshi Idei,Yoshihiko Nagashima,Kazutoshi Tokunaga,Shoji Kawasaki,Hisatoshi Nakashima,Aki Higashijima 한국물리학회 2014 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.65 No.8

A drift error correction technique with machine vision and a real-time equilibrium calculation codehave been developed on the QUEST (Q-shu university experiment with the steady-state sphericaltokamak) for steady-state operation. The drift error caused by the long time-integration of magneticraw signals has to be removed. With a captured image of the plasma’s cross section, the plasma’sposition is identified by use of image filters. The measured magnetic flux values are corrected to thecalculated flux values estimated by using this plasma position. The correction with the capturedimage work as expected in the preliminary result using a flashlight instead of a plasma.

Anisotropic Magnetic Properties in Åkermanite Sr2MSi2O7 (M=Co, Mn) Crystals

Mitsuru Akaki,Tomoya Tadokoro,Hideki Kuwahara,Takumi Kihara,Masashi Tokunaga 한국물리학회 2013 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.62 No.12

We have investigated the magnetic and the dielectric properties of °akermanite Sr2CoSi2O7 and Sr2MnSi2O7 single crystals. Sr2CoSi2O7 shows a canted antiferromagnetism with a large magnetic anisotropy at temperatures below 7 K. By applying a magnetic field along the [110] direction, an electric polarization emerges along the c axis at temperatures below the magnetic transition temperature. In high magnetic fields, the saturation magnetization becomes enhanced only when the electric polarization appears. In contrast, the magnetization of Sr2MnSi2O7 is isotropic at all temperatures, and its magnetic-field-induced electric polarization is very small. These results suggest that the electronic configuration of the transition-metal ion is of crucial importance for the appearance of electric polarization.

FTIR spectroscopy of the two-photon product of sensory rhodopsin I

Sasaki, Jun,Kannaka, Masato,Kandori, Hideki,Tokunaga, Fumio Korean Society of Photoscience 2002 Journal of Photosciences Vol.9 No.2

A halophilic archaeon, Halobacterium salinarum, exhibits phototactic behaviors, by which the organism is guided to red-orange light and evades shorter wavelengths of light. The phototaxis is mediated by two retinal proteins, sensory rhodopsin I and II (SRI and SRII), whose structures are analogous to the cognate protein bacteriorhodopsin, a light-driven proton pump. SRI mediates both attractant and repellent swimming behaviors to orange light and near- UV light, respectively. The two different signaling through the single photoreceptor have been ascribed to the presence of two active structures of SRI (S$\_$373/ and P$\_$520), which are produced upon orange light illumination of SRI and upon subsequent near-UV illumination of S$\_$373/, respectively. In the present study, we have measured the difference FTIR spectra of S$\_$373/ and P$\_$520/ states. In P$\_$520/, the isomeric structure of the chromophore is assignable to all-trans, and the Schiff base of the chromophore is protonated with concomitant deprotonation of Asp76, a combination which allows for the formation of a salt bridge between them. It was suggested that the way of interaction between the Schiff base and the counterion, which is different among SRI$\_$587/, S$\_$373/ and P$\_$520/ and which has been shown to drive the conformational changes in the cognate protein, bacteriorhodopsin, is the key to controlling conformational changes for the attractant and the repellent signaling by SRI.

Risk stratification models for para-aortic lymph node metastasis and recurrence in stage IB–IIB cervical cancer

Koji Matsuo,Muneaki Shimada,Tsuyoshi Saito,Kazuhiro Takehara,Hideki Tokunaga,Yoh Watanabe,Yukiharu Todo,Kenichirou Morishige,Mikio Mikami,Toru Sugiyama 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.1

Objective: To examine the surgical-pathological predictors of para-aortic lymph node (PAN) metastasis at radical hysterectomy, and for PAN recurrence among women who did not undergo PAN dissection at radical hysterectomy. Methods: This is a retrospective analysis of a nation-wide cohort study of surgically-treated stage IB–IIB cervical cancer (n=5,620). Multivariate models were used to identify independent surgical-pathological predictors for PAN metastasis/recurrence. Results: There were 120 (2.1%) cases of PAN metastasis at surgery with parametrial involvement (adjusted odds ratio [aOR]=1.65), deep stromal invasion (aOR=2.61), ovarian metastasis (aOR=3.10), and pelvic nodal metastasis (single-node aOR=5.39 and multiple-node aOR=33.5, respectively) being independent risk factors (all, p<0.05). Without any risk factors, the incidence of PAN metastasis was 0.9%, while women exhibiting certain risk factor patterns (>20% of the study population) had PAN metastasis incidences of ≥4%. Among 4,663 clinically PAN-negative cases at surgery, PAN recurrence was seen in 195 (4.2%) cases that was significantly higher than histologically PAN-negative cases (2.5%, p=0.046). In clinically PAN-negative cases, parametrial involvement (adjusted hazard ratio [aHR]=1.67), lympho-vascular space invasion (aHR=1.95), ovarian metastasis (aHR=2.60), and pelvic lymph node metastasis (single-node aHR=2.49 and multiple-node aHR=8.11, respectively) were independently associated with increased risk of PAN recurrence (all, p<0.05). Without any risk factors, 5-year PAN recurrence risk was 0.8%; however, women demonstrating certain risk factor patterns (>15% of the clinically PAN-negative population) had 5-year PAN recurrence risks being ≥8%. Conclusion: Surgical-pathological risk factors proposed in this study will be useful to identify women with increased risk of PAN metastasis/recurrence.

Lymphadenectomy issues in endometrial cancer

Yosuke Konno,Hiroshi Asano,Ayumi Shikama,Daisuke Aoki,Michihiro Tanikawa,Akinori Oki,Koji Horie,Akira Mitsuhashi,Akira Kikuchi,Hideki Tokunaga,Yasuhisa Terao,Toyomi Satoh,Kimio Ushijima,Mitsuya Ishika 대한부인종양학회 2021 Journal of Gynecologic Oncology Vol.32 No.2

Objectives: This review aims to introduce preoperative scoring systems to predict lymphnode metastasis (LNM) and ongoing clinical trials to investigate the therapeutic role oflymphadenectomy for endometrial cancer. Methods: We summarized previous reports on the preoperative prediction models forLNM and evaluated their validity to omit lymphadenectomy in our recent cohorts. Next, wecompared characteristics of two ongoing lymphadenectomy trials (JCOG1412, ECLAT) toexamine the survival benefit of lymphadenectomy in endometrial cancer, and described thedetails of JCOG1412. Results: Lymphadenectomy has been omitted for 64 endometrial cancer patients who met low risk criteria to omit lymphadenectomy using our scoring system (LNM score) and no lymphaticfailure has been observed. Other two models also produced comparable results. Two randomizedphase III trials to evaluate survival benefit of lymphadenectomy are ongoing for endometrialcancer. JCOG1412 compares pelvic lymphadenectomy alone with pelvic and para-aorticlymphadenectomy to evaluate the therapeutic role of para-aortic lymphadenectomy for patients atrisk of LNM. For quality assurance of lymphadenectomy, we defined several regulations, includinglower limit of the number of resected nodes, and submission of photos of dissected area toevaluate thoroughness of lymphadenectomy in the protocol. The latest monitoring report showedthat the quality of lymphadenectomy has been well-controlled in JCOG1412. Conclusion: Our strategy seems reasonable to omit lymphadenectomy and could begeneralized in clinical practice. JCOG1412 is a high-quality lymphadenectomy trial in terms ofthe quality of surgical procedures, which would draw the bona-fide conclusions regarding thetherapeutic role of lymphadenectomy for endometrial cancer.

Phase 2 single-arm study on the safety of maintenance niraparib in Japanese patients with platinum-sensitive relapsed ovarian cancer

Kazuhiro Takehara,Takashi Matsumoto,Junzo Hamanishi,Kosei Hasegawa,Motoki Matsuura,Kiyonori Miura,Shoji Nagao,Hidekatsu Nakai,Naotake Tanaka,Hideki Tokunaga,Kimio Ushijima,Hidemichi Watari,Yoshihito Y 대한부인종양학회 2021 Journal of Gynecologic Oncology Vol.32 No.2

Objective: The primary objective of this study was to evaluate the safety of niraparib 300 mg/dayin Japanese patients with platinum-sensitive, relapsed ovarian cancer in a maintenance setting. Methods: Phase 2, multicenter, open-label, single-arm study enrolled Japanese patients withplatinum-sensitive, relapsed ovarian cancer who had received ≥2 platinum-based regimens. The primary endpoint (incidence of grade 3 or 4 thrombocytopenia-related events within 30days after initial niraparib administration) was justified by the incidences of a global pivotalphase 3 study and its post-hoc safety analysis on thrombocytopenia, the major hematologicaladverse event of niraparib. The overall safety analysis examined other treatment-emergentadverse events (TEAEs). Results: Enrolled patients (n=19) had a median (min, max) body weight of 53.9 (40.8–79.1)kg; all but one patient weighed <77 kg. Most (94.7%) patients initially received niraparib300 mg/day but this decreased in subsequent cycles (mean±standard deviation doseintensity, 191.6±65.7 mg/day). In total, 6/19 (31.6%) patients experienced grade 3 or 4 thrombocytopenia-related events within 30 days of initial niraparib administration. Other common TEAEs included nausea, and decreased platelet or neutrophil counts. Noprogression-free or overall survival events occurred; only 1 of 4 response-evaluable patientshad a post-baseline tumor assessment (stable disease). Conclusion: The incidence of grade 3 or 4 thrombocytopenia-related events in Japaneseovarian cancer patients was similar to that in the corresponding non-Japanese study. Overall,the safety profile was acceptable and consistent with the known safety profile and previousexperience with niraparib. Trial Registration: ClinicalTrials.gov Identifier: NCT03759587