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RISS 인기검색어
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- 저자 : Satoyo Otsuka (검색결과 2 건)
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Kyoko Nishikimi,Shinichi Tate,Ayumu Matsuoka,Satoyo Otsuka,Makio Shozu 대한부인종양학회 2022 Journal of Gynecologic Oncology Vol.33 No.3
Objective: Splenectomy with or without distal pancreatectomy is occasionally performed during cytoreductive surgery for advanced ovarian cancer. We investigated pre-, intra-, postoperative risk factors and predictors of clinically relevant postoperative pancreatic fistula (CR-POPF) in patients who underwent cytoreductive surgery for advanced ovarian cancer. Methods: We investigated 165 consecutive patients with ovarian, fallopian tube, and peritoneal carcinoma categorized as stage III/IV disease, who underwent splenectomy with or without distal pancreatectomy as a component of cytoreductive surgery performed as initial treatment at Chiba University Hospital. Patient characteristics, clinical factors, and surgical outcomes were compared between those with and without CR-POPF. Results: CR-POPF occurred in 20 patients (12%). There were no significant intergroup differences in the characteristics between patients with CR-POPF and patients without CR-POPF except for operative time, intraoperative blood loss, amylase (AMY) levels in drain fluid on postoperative day (POD)1 and POD3, and pancreatic stump thickness. Multivariate analysis showed that the POD3 drain fluid AMY level was the only significant risk factor and predictor of CR-POPF in patients who underwent cytoreductive surgery for advanced ovarian cancer. The receiver operating characteristic curve of the POD3 drain fluid AMY level, which predicted development of CR-POPF showed an area under the curve of 0.77, and the optimal cut-off value of AMY was 808 U/L. A pancreatic fistula did not occur in patients with POD3 drain fluid AMY levels <130 U/L. Conclusion: The POD3 drain fluid AMY level can be early diagnostic predictor CR-POPF after splenectomy with or without distal pancreatectomy for advanced ovarian cancer.
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Shinichi Tate,Kyoko Nishikimi,Ayumu Matsuoka,Satoyo Otsuka,Kazuyoshi Kato,Yutaka Takahashi,Makio Shozu 대한부인종양학회 2021 Journal of Gynecologic Oncology Vol.32 No.1
Objective: We investigated the efficacy and toxicity of tailored-dose chemotherapy withgemcitabine and irinotecan for platinum-refractory/resistant ovarian or primary peritoneal cancer. Methods: We enrolled patients with ovarian or primary peritoneal cancer who received ≥2previous chemotherapeutic regimens but developed progressive disease during platinum based chemotherapy or within 6 months post-treatment. All patients received gemcitabine(500 mg/m2) and irinotecan (50 mg/m2) on days 1 and 8 every 21 days at the starting dose. Thedose was increased or decreased by 4 levels in subsequent cycles based on hematological ornon-hematological toxicities observed. The primary endpoint was progression-free survival(PFS), and secondary endpoints were disease control rate (DCR), overall survival (OS), andadverse events. Results: We investigated 25 patients who received 267 cycles (median 8 cycles/patient)between October 2008 and May 2011. Tailored-dose gemcitabine was administered up to the5th cycle as follows: 1,000 mg/m2in 1 (4%), 750 mg/m2in 16 (64%), 500 mg/m2in 6 (24%),and 250 mg/m2in 2 patients (8%). The median PFS and OS were 6.2 months (95% confidenceinterval [CI]=2.7–10.7) and 16.8 months (95% CI=9.4–30.7), respectively. The DCR was 76%,and PFS was >6 months in 12 of 25 patients (48%). Grade 3 hematological toxicities includedleukopenia (9.4%), neutropenia (11.2%), anemia (9.8%), and thrombocytopenia (1.1%). Grade 3/4 non-hematological toxicities did not occur except for fatigue in one patient. Conclusions: Tailored-dose chemotherapy with gemcitabine and irinotecan was effective andwell tolerated in patients with platinum-refractory/resistant ovarian or primary peritoneal cancer. Trial Registration: UMIN Clinical Trials Registry Identifier: UMIN000004449
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