http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Eiji Kondo,Tsutomu Tabata,Nao Suzuki,Daisuke Aoki,Hideaki Yahata,Yoshio Kotera,Osamu Tokuyama,Keiichi Fujiwara,Eizo Kimura,Fumitoshi Terauchi,Toshiyuki Sumi,Aikou Okamoto,Nobuo Yaegashi,Takayuki Enomo 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.6
Objective: In this study we sought to investigate the clinical factors that affect post progression survival (PPS) in patients with recurrent or persistent clear cell carcinoma (CCC). We utilized the JGOG3017/Gynecological Cancer InterGroup data to compare paclitaxel pluscarboplatin (TC) and irinotecan plus cisplatin (CPT-P) in the treatment of stages I to IV CCC. Methods: We enrolled 166 patients with recurrent or persistent CCC and assessed the impactof variables, including platinum sensitivity, treatment arm, crossover chemotherapy, primarystage, residual tumor at primary surgery, performance status, ethnicity, and tumor reductionsurgery at recurrence on the median of PPS in patients with recurrent or persistent CCC. Results: A total of 77 patients received TC, and 89 patients received CPT-P. The median PPSfor patients with platinum-resistant disease was 10.9 months, compared with 18.8 monthsfor patients with platinum-sensitive disease (hazard ratio [HR]=1.88; 95% confidence interval[CI]=1.30–2.72; log-rank p<0.001). In the multivariate analysis, the platinum sensitivity(resistant vs. sensitivity; HR=1.60; p=0.027) and primary stage (p=0.009) were identified asindependent predictors of prognosis factors for PPS in recurrent or persistent CCC. Conclusions: Our findings revealed that platinum sensitivity and primary stage are clinicalfactors that significantly affect PPS in patients with recurrent or persistent CCC as well as other histologic subtypes of ovarian cancer. PPS in patients with recurrent CCC shouldestablish the basis for future clinical trials in this population.
Eiji Kondo,Kenta Yoshida,Tsutomu Tabata,Yoichi Kobayashi,Wataru Yamagami,Yasuhiko Ebina,Masanori Kaneuchi,Satoru Nagase,Hiroko Machida,Mikio Mikami 대한부인종양학회 2022 Journal of Gynecologic Oncology Vol.33 No.2
Objective: The study compared the treatment outcomes of surgery versus radiotherapy, including concurrent chemoradiotherapy, in stage Ib2–IIb cervical adenocarcinoma patients in Japan. Methods: Of 57,470 patients diagnosed with stage I–IV cervical cancer from January 2001– December 2011, 1,932 patients with stage Ib2–IIb cervical adenocarcinoma were initially treated by surgery or radiotherapy. The primary endpoint was 5-year overall survival (OS) in all and 614 propensity score-matched (PSM) patients (307 per group). We compared OS and prognosis factors based on age, primary stage, and treatment arm. Results: In Japan, >80% (n=1,573) of stage Ib2–IIb cervical adenocarcinoma patients underwent surgery. The 5-year OS of surgery vs. radiotherapy groups were 82.1% (n=704) vs. 79.7% (n=59) (hazard ratio [HR]=1.494; 95% confidence interval [CI]=0.826–2.702; p=0.181)for stage Ib2, 76.6% (n=239) vs. 66.7% (n=54) (HR=1.679; 95% CI=0.986–2.858; p=0.053)for stage IIa, and 71.1% (n=630) vs. 58.9% (n=246) (HR=1.711; 95% CI=1.341–2.184; p<0.001)for stage IIb. In 614 PSM patients balanced for age and carcinoma stage Ib2–IIb, the 5-year OS of surgery vs. radiation groups was 73.0% (n=307) vs. 65.5% (n=307) (HR=1.394; 95% CI=1.044–1.860; p=0.023).In multivariable analysis, age (HR=1.293; 95% CI=1.045–1.601; p=0.018), treatment arm, radiotherapy (HR=1.556; 95% CI=1.253–1.933; p<0.001), and stage IIb (HR=1.783; 95% CI=1.443–2.203; p=0.018) were independent prognosis factors for 5-year OS in stage Ib2–IIb adenocarcinoma patients. Conclusion: Age (>65 years), treatment arm (radiotherapy), and stage IIb significantly affect OS in cervical adenocarcinoma patients. Surgery may be considered for <65-year-old patients with stage IIb adenocarcinoma.
Japan Society of Gynecologic Oncology 2018 guidelines for treatment of uterine body neoplasms
Wataru Yamagami,Mikio Mikami,Satoru Nagase,Tsutomu Tabata,Yoichi Kobayashi,Masanori Kaneuchi,Hiroaki Kobayashi,Hidekazu Yamada,Kiyoshi Hasegawa,Hiroyuki Fujiwara,Hidetaka Katabuchi,Daisuke Aoki 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.1
The Fourth Edition of the Guidelines for Treatment of Uterine Body Neoplasm was published in 2018. These guidelines include 9 chapters: 1. Overview of the guidelines, 2. Initial treatment for endometrial cancer, 3. Postoperative adjuvant therapy for endometrial cancer, 4. Post-treatment surveillance for endometrial cancer, 5. Treatment for advanced or recurrent endometrial cancer, 6. Fertility-sparing therapy, 7. Treatment of uterine carcinosarcoma and uterine sarcoma, 8. Treatment of trophoblastic disease, 9. Document collection; and nine algorithms: 1-3. Initial treatment of endometrial cancer, 4. Postoperative adjuvant treatment for endometrial cancer, 5. Treatment of recurrent endometrial cancer, 6. Fertility-sparing therapy, 7. Treatment for uterine carcinosarcoma, 8. Treatment for uterine sarcoma, 9. Treatment for choriocarcinoma. Each chapter includes overviews and clinical questions, and recommendations, objectives, explanation, and references are provided for each clinical question. This revision has no major changes compared to the 3rd edition, but does have some differences: 1) an explanation of the recommendation decision process and conflict of interest considerations have been added in the overview, 2) nurses, pharmacists and patients participated in creation of the guidelines, in addition to physicians, 3) the approach to evidence collection is listed at the end of the guidelines, and 4) for clinical questions that lack evidence or clinical validation, the opinion of the Guidelines Committee is given as a “Recommendations for tomorrow”.
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.
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.
( Keiko Saotome ),( Wataru Yamagami ),( Hiroko Machida ),( Yasuhiko Ebina ),( Yoichi Kobayashi ),( Tsutomu Tabata ),( Masanori Kaneuchi ),( Satoru Nagase ),( Takayuki Enomoto ),( Daisuke Aoki ),( Miki 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.1
Objective Regional lymph node (LN) dissection is a standard surgical procedure for endometrial cancer, but there is currently no clear consensus on its therapeutic significance. We aimed to determine the impact of regional LN dissection on the outcome of endometrial cancer. Methods Study subjects comprised 36,813 patients who were registered in the gynecological tumor registry of the Japan Society of Obstetrics and Gynecology, had undergone initial surgery for endometrial cancer between 2004 and 2011, and whose clinicopathological factors and prognosis were appropriate for our investigation. The following clinicopathological factors were obtained from the registry: age, surgical stage classification, Union for International Cancer Control tumor, node, metastasis classification, histological type, histological differentiation, presence or absence of LN dissection, and postoperative treatment. We retrospectively analyzed the clinicopathological factors and therapeutic outcomes for patients with endometrial cancer. Results Analysis of all subjects showed that the group that underwent LN dissection had a significantly better overall survival than the group that did not undergo dissection. Analysis based on stage showed similar results across groups, except for stage Ia. Analysis based on stage and histological type showed similar results across groups, except for stage Ia endometrial carcinoma G1 or Ia G2. Multivariate analysis of prognostic factors indicated that LN dissection is an independent prognostic factor and that it has a greater impact on prognosis than adjuvant chemotherapy. Conclusion Despite the limitations of a retrospective study with some biases, the results suggest that LN dissection in endometrial cancer has a prognostic effect.
Manabu Seino,Satoru Nagase,Tsuyoshi Ohta,Wataru Yamagami,Yasuhiko Ebina,Yoichi Kobayashi,Tsutomu Tabata,Masanori Kaneuchi,Takayuki Enomoto,Mikio Mikami 대한부인종양학회 2023 Journal of Gynecologic Oncology Vol.34 No.1
Objective: The aim of this study was to review the clinicopathological characteristics of small cell neuroendocrine cervical cancer (SCNEC) and to identify the optimal treatment. Methods: The Japanese Society of Gynecologic Oncology conducted a retrospective cohort study of SCNECs enrolled in the Gynecological Tumor Registry of the Japan Society of Obstetrics and Gynecology between 2004 and 2015. All cases were modified and unified by International Federation of Gynecology and Obstetrics 2008 (Union for International Cancer Control 7th edition). Results: There were 822 registered patients diagnosed with SCNEC from 2004 to 2015 which comprised 1.1% (822/73,698) of all uterine cervical cancer cases. Rates of lymph-node and distant metastasis were significantly higher in T1b2 (38.9% and 13.7%, respectively) than T1b1 (14.2% and 4.4%, respectively) (p<0.01). In IB2 and T1bN1M0 SCNEC, the 5-year survival rate with surgery followed by chemotherapy was significantly higher than that with surgery followed by radiation therapy/concurrent chemoradiation therapy (p<0.01). Conclusion: SNCEC tumors >4 cm in size had greater rates of lymph-node and distant metastasis when compared with tumors ≤4 cm. Adjuvant chemotherapy, rather than radiotherapy, may improve prognosis after surgery in T1bN1M0 SCNEC.
Isao Murakami,Hiroko Machida,Tohru Morisada,Yasuhisa Terao,Tsutomu Tabata,Mikio Mikami,Yasuyuki Hirashima,Yoichi Kobayashi,Tsukasa Baba,Satoru Nagase 대한부인종양학회 2023 Journal of Gynecologic Oncology Vol.34 No.4
Objective: To examine the effectiveness of progestin re-treatment for recurrent endometrial intraepithelial neoplasia (EIN), atypical endometrial hyperplasia (AH) and endometrial cancer (EC) following initial fertility-sparing treatment. Methods: A comprehensive systematic review and meta-analysis were conducted by an Expert Panel of the Japan Society of Gynecologic Oncology Endometrial Cancer Committee. Multiple search engines, including PubMed/MEDLINE and the Cochrane Database, were searched in December 2021 using the keywords “Endometrial neoplasms,” “Endometrial hyperplasia,” “Endometrial intraepithelial neoplasia,” “Fertility preservation,” “Progestins,” AND “Recurrence.” Cases describing progestin re-treatment for recurrent EIN, AH and EC were compared with cases that underwent conventional hysterectomy. The primary outcomes were survival and disease recurrence, and the secondary outcome was pregnancy. Results: After screening 238 studies, 32 with results for recurrent treatment were identified. These studies included 365 patients (270 received progestin re-treatment and 95 underwent hysterectomy). Most progestin re-treatment involved medroxyprogesterone acetate or megestrol acetate (94.5%). Complete remission (CR) following progestin re-treatment was achieved in 219 (81.1%) cases, with 3-, 6- and 9-month cumulative CR rates of 22.8%, 51.7% and 82.6%, respectively. Progestin re-treatment was associated with higher risk of disease recurrence than conventional hysterectomy was (odds ratio [OR]=6.78; 95% confidence interval [CI]=1.99–23.10), and one patient (0.4%) died of disease. Fifty-one (14.0%) women became pregnant after recurrence, and progestin re-treatment demonstrated a possibility of pregnancy (OR=2.48; 95% CI=0.94–6.58). Conclusion: This meta-analysis suggests that repeat progestin therapy is an effective option for women with recurrent EIN, AH and EC, who wish to retain their fertility.