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( Tomoyasu Kato ),( Ki Ho Seol ),( Jung Soo Youn ),( Dae Gy Hong ) 대한산부인과학회 2018 Obstetrics & Gynecology Science Vol.61 No.5
We report a case of salvage lymphadenectomy for an isolated metastatic lesion in the para-aortic lymph node (LN) in a 49-year old woman with a history of cervical cancer, initially treated with radical hysterectomy and adjuvant radiotherapy. Preoperative 3-dimensional (3D) computed tomography (CT) angiography clearly revealed a huge retro-crural metastatic LN with distinct demarcation. A metastatic lesion, more than 10 cm in size, was located behind the vena cava, aorta, and left kidney, encompassing the left renal and lumbar arteries. The metastatic LN was excised along with the left kidney. On histologic examination, the tumor was found to have invaded the pelvis of the left kidney. Compared with conventional imaging techniques, 3D CT angiography can more clearly visualize such lesions. Thus, 3D CT angiography provides useful anatomical information, such as the exact size and location, and provides clear visualization and demarcation.
Hyperthermic intrathoracic chemotherapy with cisplatin for ovarian cancer with pleural metastasis
전수연,석양기,Tomoyasu Kato,전다솜,이윤희,정근오,이윤순,조영래,홍대기 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.3
Intrathoracic metastasis of ovarian cancer has poor prognosis regardless of treatment modality. Recent development of surgical techniques and the new concept of direct infusion of chemotherapeutic agents with hyperthermia could help with the treatment of disseminated diseases in ovarian cancer. Using video-assisted thoracoscopic surgery and intracavitary chemotherapy with hyperthermia, we tried hyperthermic intrathoracic chemotherapy for a case of stage IV high-grade serous ovarian cancer with pleural metastasis. There was no high-grade complication related to the procedure. The patient is alive without disease at 32 months after initial treatment.
윤정수,홍대기,( Tomoyasu Kato ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-
Background: For the treatment of metastatic lesions in recurrent cervical cancer, surgical resection is attempted in order to reduce tumor burden and increase response to chemotherapy and radiotherapy. However, surgical resection is not easy due to the irregular pattern of metastasis and metastasis to places that are hard to access. We need more anatomical information about the metastatic lesions to achieve a clear surgical resection. Case Presentation: We report a case of salvage lymphadenectomy for an isolated metastatic lesion in the para-aortic lymph node in a 53-year old woman with a history of cervical cancer initially treated by radical hysterectomy. Preoperative 3 dimensional CT angiography showed the huge retrocrural metastatic lymph node with clear visualization and demarcation of the lesion. A more than 10 cm sized metastatic lesion was located behind the vena cava, aorta and left kidney encompassing the left renal artery and lumbar arteries. The metastatic lymph node was excised clearly with left nephrectomy. On histologic examination, the tumor invaded into the renal pelvis of the left kidney. Conclusion: Compared with conventional imaging techniques, 3 dimensional CT angiography can more clearly visualize the lesions. Three dimensional CT angiography provides a useful anatomical information such as the exact size and location with clear visualization and demarcation.
The baseline recurrence risk of patients with intermediate-risk cervical cancer
( Yutaka Yoneoka ),( Mayumi Kobayashi Kato ),( Yasuhito Tanase ),( Masaya Uno ),( Mitsuya Ishikawa ),( Takashi Murakami ),( Tomoyasu Kato ) 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.2
Objective This study aimed to investigate the prognosis of patients with intermediate-risk cervical cancer and to evaluate the necessity of adjuvant therapy. Methods We conducted a retrospective chart review of patients with stage IB-II cervical cancer who underwent type III radical hysterectomy with pelvic lymphadenectomy between 2008 and 2017. In our institution, radical hysterectomy is performed as an open surgery and not as a minimally invasive surgery, and adjuvant therapy is not administered to patients with intermediate-risk cervical cancer. The intermediate-risk group included patients with 2 or more of the following factors: tumor size >4 cm, stromal invasion >1/2, and lymphovascular stromal invasion. Intermediaterisk patients with squamous cell carcinoma were included in the I-SCC group, whereas those with endocervical adenocarcinoma, usual type, or adenosquamous carcinoma were included in the I-Adeno group. Results There were 34 and 18 patients in the I-SCC and I-Adeno groups, respectively. The 5-year recurrence-free survival (RFS) and overall survival rates in the I-SCC group were 90.5% (95% confidence interval [CI], 85.3-95.7%) and 100% (95% CI, 100%), respectively, whereas those in the I-Adeno group were 54.9% (95% CI, 42.0-67.9%) and 76.1% (95% CI, 63.7-88.4%), respectively. Multivariate analysis revealed that endocervical adenocarcinoma, usual type, or adenosquamous carcinoma, and tumor size >4 cm had worse RFS. Conclusion The I-SCC group had good prognosis without adjuvant therapy; therefore, adjuvant therapy may be omitted in these patients. In contrast, the I-Adeno group had poor prognosis without adjuvant therapy; therefore, adjuvant therapy should be considered in their treatment.
Masaya Uno,Rie Matsuo,Naoki Maezawa,Tomoyasu Kato 대한산부인과학회 2023 Obstetrics & Gynecology Science Vol.66 No.4
Objective We evaluated the usefulness of human epididymis protein 4 (HE4), a tumor marker, during and after treatment in patients with ovarian cancer (OC). Methods We included Japanese patients newly diagnosed with OC treated at the National Cancer Center Hospital between 2014 and 2021. The HE4 levels were measured in the serum stored during diagnosis. To evaluate the concordance between HE4 and the imaging results, we employed sequential pairs of blood sampling points and the results of imaging examinations. We compared the timing of the elevated HE4 levels, imaging diagnoses, and elevated cancer antigen 125 (CA125) levels in patients with recurrence. The Ethics Review Committee of our institution (2021-056) reviewed this study. Results Forty-eight patients with epithelial OC were eligible for enrollment. The sensitivity, specificity, and positive and negative predictive values of HE4 (criterion, 70 pmol/L) for disease progression during the follow-up period were 79.4%, 59.1%, 32.5%, and 92.0%, respectively (time point, n=317). We evaluated the relationship between HE4 and CA125 variability and disease status (recurrence or no recurrence). For recurrence, the sensitivity and negative predictive value of HE4 (criterion, 70 pmol/L), CA125 (criterion, 35 U/mL), and combination of HE4 and CA125 were 77.8%, 85.2%, and 92.6% and 75.0%, 82.6%, and 88.9%, respectively (n=48). Among the 27 patients who exhibited recurrence, 16 and nine showed earlier increased HE4 levels than the relevant imaging and CA125 levels, respectively. Conclusion HE4 may be a valuable marker for follow-up during and after OC therapy. A complementary role for HE4 and CA125 measurements was suggested for follow-up observations.
Preoperative serum microRNAs as potential prognostic biomarkers in ovarian clear cell carcinoma
Kazuhiro Suzuki,Akira Yokoi,Kosuke Yoshida,Tomoyasu Kato,Takahiro Ochiya,Yusuke Yamamoto,Hiroaki Kajiyama 대한부인종양학회 2023 Journal of Gynecologic Oncology Vol.34 No.3
Objective: Ovarian clear cell carcinoma (OCCC) is a subtype of epithelial ovarian carcinoma with poor prognosis. However, no effective biomarkers have been established for predicting unfavorable events, including recurrence and poor prognoses. Serum microRNAs (miRNAs) have been increasingly reported to be useful in predicting a patient’s condition and have been recognized as a potentially less-invasive source for liquid biopsy in cancer. Therefore, this study aimed to evaluate serum miRNA profiles from patients with OCCC and to establish biomarker for predicting the prognoses. Methods: The GSE106817, which included preoperative serum miRNA profiles of patients with ovarian tumors, was used, and clinical information was investigated. In all, 66 patients with OCCC were included, excluding those with other histological subtypes or insufficient prognostic information. Moreover, miRNA profiles of OCCC tissues were also examined. Results: The median follow-up period was 64.3 (8.0–153.3) months. Based on multivariable Cox regression analyses and the expression of miRNAs in OCCC tissues, miR-150-3p, miR-3195, and miR-7704 were selected as miRNA candidates associated with both progression-free survival (PFS) and overall survival (OS). Then, the prognostic index was calculated based on expression values of 3 serum miRNAs. Kaplan-Meier survival analysis indicated that the prognostic index was significantly predictive of PFS and OS (p=0.004 and p=0.012, respectively). Conclusion: Preoperative serum miRNA profiles of miR-150-3p, miR-3195, and miR-7704 can be used to potentially predict the prognosis of patients with OCCC.