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East Asian Gynecologic Oncology Trial Group (EAGOT): founding history and future perspective
Takayuki Enomoto,Aikou Okamoto,Jae-Hoon Kim,Chyong-Huey Lai,Xiaohua Wu,Yong-Man Kim 대한부인종양학회 2023 Journal of Gynecologic Oncology Vol.34 No.5
Racial and regional differences exist in morbidity, histology, drug response, toxicity, and prognosis of gynecologic cancer. However, most large-scale phase III studies have been conducted in Western countries, and these data on Asians, who account for more than half of the world’s population, are limited. To build a global clinical trial network in Asia, four clinical trial groups with high expertise and international competitiveness in East Asia, namely the Japanese Gynecologic Oncology Group in Japan, the Korean Gynecologic Oncology Group in Korea, the Taiwanese Gynecologic Oncology Group in Taiwan, and the Chinese Gynecologic Cancer Society in the People’s Republic of China, established a new group called the East Asia Gynecologic Oncology Trial Group (EAGOT) on November 19, 2021. It includes four committees: the Cervical Cancer Committee, Uterine Corpus Cancer Committee, Ovarian Cancer Committee, and Translational Research Committee. The purpose of EAGOT is to conduct international clinical trials in an effort to provide the best treatments for Asian women affected by gynecologic cancer. Discussions on new collaborative clinical trials have already begun. The first Annual EAGOT Meeting was held on May 25-27, 2023 in Niigata, Japan. EAGOT, the largest healthcare/investigational innovation network in Asia in the area of gynecologic cancers, will become a platform for establishing standards of care and lead to guidelines for Asian women suffering from gynecologic cancer. The harmonization of regulatory/investigator-initiated clinical trials, simultaneous approval of unapproved drugs in the four countries under a common protocol, and expansion of indications will improve the prognosis of gynecologic cancers in Asia in the near future.
Enomoto Keigo,Eguchi Yawara,Sato Takashi,Norimoto Masaki,Inoue Masahiro,Watanabe Atsuya,Sakai Takayuki,Yoneyama Masami,Aoki Yasuchika,Orita Sumihisa,Narita Miyako,Inage Kazuhide,Shiga Yasuhiro,Umimura 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.1
Study Design: Retrospective observational study.Purpose: We investigated the correlation between T2 relaxation times and clinical symptoms in patients with cervical radiculopathy caused by cervical disk herniation.Overview of Literature: There are currently no imaging modalities that can assess the affected cervical nerve roots quantitatively.Methods: A total of 14 patients with unilateral radicular symptoms and five healthy subjects were subjected to simultaneous apparent T2 mapping and neurography with nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation enhancement signaling (SHINKEI-Quant) using a 3-Tesla magnetic resonance imaging. The Visual Analog Scale (VAS) score for neck pain and upper arm pain was used to evaluate clinical symptoms. T2 relaxation times of the cervical dorsal root ganglia of the brachial plexus were measured bilaterally from C4 to C8 in patients with radicular symptoms and from C5 to C8 in healthy controls. The T2 ratio was calculated as the affected side to unaffected side.Results: When comparing nerve roots bilaterally at each spinal level, no significant differences in T2 relaxation times were found between patients and healthy subjects. However, T2 relaxation times of nerve roots in the patients with unilateral radicular symptoms were significantly prolonged on the involved side compared with the uninvolved side (p<0.05). The VAS score for upper arm pain was not significantly correlated with the T2 relaxation times, but was positively correlated with the T2 ratio.Conclusions: In patients with cervical radiculopathy, the SHINKEI-Quant technique can be used to quantitatively evaluate the compressed cervical nerve roots. The VAS score for upper arm pain was positively correlated with the T2 ratio. This suggests that the SHINKEI-Quant is a potential tool for the diagnosis of cervical nerve entrapment.
Masayuki Sekine,Takayuki Enomoto,Masami Arai,Hiroki Den,Hiroyuki Nomura,Takeshi Ikeuchi,Seigo Nakamura 대한부인종양학회 2022 Journal of Gynecologic Oncology Vol.33 No.4
Objective: and mutation carriers are recommended to undergo risk-reducing salpingo-oophorectomy (RRSO) by age 40 and 45, respectively. However, the carriers have a different way of thinking about their life plan. We aimed to investigate the distribution of age at diagnosis of ovarian cancer (OC) patients to examine the optimal timing of RRSO in the carriers. Methods: We examined a correlation between age at diagnosis of OC and common mutation types in 3,517 probands that received genetic testing. Among them, germline mutation (g m), germline mutation (g m) and germline wild-type (g wt) were found in 185, 42 and 241 OC patients, respectively. Results: The average age at diagnosis of OC in g m and g m was 51.3 and 58.3 years, respectively, and the difference from g wt (53.8 years) was significant. Theg m carriers did not develop OC under the age of 40. The average age was 50.1 years for L63X and 52.8 years for Q934X in , and 55.1 years for R2318X and 61.1 years for STOP1861 in . The age at diagnosis in L63X or R2318X carriers was relatively younger than other or carriers, however their differences were not significant. With L63X and R2318X carriers, 89.4% (42/47) and 100% (7/7) of women were able to prevent the development of OC, respectively, when RRSO was performed at age 40. Conclusion: There appears to be no difference in the age at diagnosis of OC depending on the type of common mutation. Further analysis would be needed.
Asian Society of Gynecologic Oncology International Workshop 2018
공태욱,유희석,김승철,Takayuki Enomoto,Jin Li,Kenneth H. Kim,심승혁,Peng-Hui Wang,Suwanit Therasakvichya,Yusuke Kobayashi,이마리아,Ting-Yan Shi,이신화,Mikio Mikami,Satoru Nagase,임명철,Jianliu Wang,Sarikapan Wilailak,김상운,홍숙 대한부인종양학회 2019 Journal of Gynecologic Oncology Vol.30 No.2
The Asian Society of Gynecologic Oncology International Workshop 2018 on gynecologic oncology was held in the Ajou University Hospital, Suwon, Korea on the 24th to 25th August 2018. The workshop was an opportunity for Asian doctors to discuss the latest findings of gynecologic cancer, including cervical, ovarian, and endometrial cancers, as well as the future of fertility-sparing treatments, minimally invasive/radical/debulking surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy. Clinical guidelines and position statement of Asian countries were presented by experts. Asian clinical trials for gynecologic cancers were reviewed and experts emphasized the point that original Asian study is beneficial for Asian patients. In Junior session, young gynecologic oncologists presented their latest research on gynecologic cancers.
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.
Masae Ikeda,Mikio Mikami,Miwa Yasaka,Takayuki Enomoto,Yoichi Kobayashi,Satoru Nagase,Masatoshi Yokoyama,Hidetaka Katabuchi 대한부인종양학회 2021 Journal of Gynecologic Oncology Vol.32 No.5
Objective: The Japan Society of Obstetrics and Gynecology conducted a retrospective multi- institutional survey of patients who underwent cervical conization in Japan. This study aimed to determine the predictive factors for positive surgical margins in cervical intraepithelial neoplasia grade 3 (CIN 3) patients after therapeutic cervical conization and those for positive margins in patients who did not experience recurrence and did not undergo additional treatment. Methods: In 2009 and 2013, 14,832 patients underwent cervical conization at 205 institutions in Japan. Of these, 8856 patients who underwent therapeutic conization fulfilled the inclusion criteria. Their histologic findings and clinical outcomes were evaluated based on standard statistical procedures and clinical and demographic characteristics. Results: Negative and positive margins were observed in 7,585 and 1,271 (14.4%) patients, respectively. The predictors of positive margins were menopausal status (p<0.001), loop electrosurgical excision procedure (p<0.001), and Shimodaira-Taniguchi (S-T) conization (p<0.001). Of 1,271 patients with positive margins, 1,060 underwent no additional treatment; among those 1,060 patients, 129 (12.2%) experienced recurrence. The predictors of positive margins in patients who did not undergo additional treatment and did not experience recurrence were age, parity, gravidity, S-T conization, and laser scalpel conization. Conclusion: Menopausal status and treatment procedures were associated with positive margins after therapeutic conization of CIN 3. It is important to understand the characteristics of treatment procedures and select an appropriate procedure for each case. For elderly or menopausal patients with positive margins, immediate additional treatment is recommended.
Kimio Ushijima,Naotake Tsuda,Wataru Yamagami,Akira Mitsuhashi,Mikio Mikami,Nobuo Yaegashi,Takayuki Enomoto 대한부인종양학회 2023 Journal of Gynecologic Oncology Vol.34 No.3
Objective: The objective of this study was to examine the current trends in fertility-sparing (FS) treatment for young atypical endometrial hyperplasia (AEH) and endometrial cancer (EC) patients in Japan. Methods: This study was conducted by the Committee on Gynecologic Oncology of the Japan Society of Obstetrics and Gynecology (JSOG) in the 2017–2018 fiscal year. A nationwide, retrospective questionnaire-style survey—as performed. We collected the data of 413 patients from 102 JSOG gynecological cancer registered institutions. Results: FS treatment was performed with medroxyprogesterone (MPA) (87.2%) or MPA + metformin (11.6%). Pathological complete remission (CR) after initial treatment was achieved in 78.2% of patients. The significant clinicopathological factors correlated to CR after initial treatment were histology (AEH vs. endometrioid carcinoma grade 1 [ECG1]), body mass index (BMI) (<25 vs. ≥25 kg/m2), and treatment period (<6 vs. ≥6 months). ECG1, time to complete remission (TTCR) ≥6 months, maintenance therapy (−), and pregnancy (−) were associated with a significantly higher risk of recurrence on multivariate analysis. The total pregnancy rate was 47%, and the live birth rate was 40.1%. Patients who received infertility treatments showed a higher live birth rate (50.6%) than those who did not (7.7%). Conclusion: In this survey, we confirmed that FS treatment in Japan is centered on MPA alone and in combination with metformin, and that the treatment efficacy is similar to that reported in previous reports. A multicenter survey study in Japan showed FS treatment for young AEH and EC patients in compliance with the indications is feasible.