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RISS 인기검색어
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- 저자 : Kazuto Tasaki (검색결과 2 건)
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Kouichiro Kawano,Naotake Tsuda,Shin Nishio,Koji Yonemoto,Kazuto Tasaki,Rurika Tasaki,Kimio Ushijima 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.5
Objective: To identify key factors for predicting positive cone margin and appropriate conelength. Methods: We retrospectively reviewed the margin status of patients who received conizationwith high grade cervical intraepithelial neoplasia, along with other factors such as patientage, parity, preoperative cytology, size of disease, type of transformation zone, and conelength from patient records. Cut-off value of cone length was analyzed in women youngerthan 40 years old because we design conization with minimum length especially forwomen who wish for future pregnancy. Cut-off value of cone length was defined as lengthcorresponds to estimated probability of positive cone margin equal to 0.1 by logisticregression analysis with variables selected by stepwise methods. Results: Among 300 patients, 75 patients had positive cone margin. Multivariable analysisrevealed that squamous cell carcinoma at preoperative cytology (p=0.001), 2 or morequadrant disease (p=0.011), and shorter cone length (p<0.001) were risk factors for positivecone margin. Stepwise methods identified cone length and size of lesion as importantvariables. With this condition, cut-off value of cone length was estimated as 15 mm in singlequadrant disease and 20 mm in 2 or more quadrant disease, respectively. Conclusion: We identified the independent risk factors of positive cone margin and identifiedthe cut-off value of cone length to avoid positive cone margin in women younger than 40years old. Conization should be performed not only according to colposcopic findingsincluding type of transformation zone but size of disease and cone length.
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Review : Epithelial borderline ovarian tumor: Diagnosis and treatment strategy
( Kimio Ushijima ),( Kouichiro Kawano ),( Naotake Tsuda ),( Shin Nishio ),( Atsumu Terada ),( Hiroyuki Kato ),( Kazuto Tasaki ),( Ken Matsukuma ) 대한산부인과학회 2015 Obstetrics & Gynecology Science Vol.58 No.3
Epithelial borderline ovarian tumors (BOT) are distinctive from benign tumors and carcinoma. They occur in younger women more often than carcinoma, and there is some difficulty making correct diagnosis of BOT. Two subtypes of BOT, serous and mucinous borderline tumor have different characteristics and very different clinical behavior. Serous borderline tumor (SBT) with micropapillary pattern shows more incidence of extra ovarian disease and often coexists with invasive implant. SBT with micropapillary pattern in advanced stage has showed a worse prognosis than typical SBT. Huge mucinous borderline tumors have histologic heterogeneity, and the accuracy of frozen section diagnosis is relatively low. Extensive sampling is required to reach a correct pathological diagnosis. Mucinous adenoma (intestinal type) also runs the risk of recurrence after cystectomy, or intraoperative rupture of cyst. Laparoscopic procedure for BOT has not increased the risk of recurrence. Fertility preserving procedures are generally accepted, except in advanced stage SBT with invasive implants. Only cystectomy shows a significant risk of recurrence. Re-staging surgery and full staging surgery is not necessary for all BOT. We should not attempt to treat them uniformly, by the single diagnosis of “borderline tumor”. It depends on histologic type. Close communication with the pathologist is necessary to gain more detail and ask more pathological samples in order to make the optimal treatment strategy for each individual patients.
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