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RISS 인기검색어
- 검색키워드
- 저자 : Seiji Mabuchi (검색결과 9 건)
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Clear cell carcinoma of the ovary: molecular insights and future therapeutic perspectives
Seiji Mabuchi,Toru Sugiyama,Tadashi Kimura 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.3
Clear cell carcinoma (CCC) of the ovary is known to show poorer sensitivity to chemotherapeuticagents and to be associated with a worse prognosis than the more common serousadenocarcinoma or endometrioid adenocarcinoma. To improve the survival of patients withovarian CCC, the deeper understanding of the mechanism of CCC carcinogenesis as well asthe efforts to develop novel treatment strategies in the setting of both front-line treatmentand salvage treatment for recurrent disease are needed. In this presentation, we firstsummarize the mechanism responsible for carcinogenesis. Then, we highlight the promisingtherapeutic targets in ovarian CCC and provide information on the novel agents which inhibitthese molecular targets. Moreover, we discuss on the cytotoxic anti-cancer agents that can bebest combined with targeted agents in the treatment of ovarian CCC.
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Seiji Mabuchi,Fumiaki Isohashi,Mika Okazawa,Fuminori Kitada,Shintaro Maruoka,Kazuhiko Ogawa,Tadashi Kimura 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.1
Objective: To evaluate the efficacy and toxicity of paclitaxel plus carboplatin (TC)-based concurrent chemoradiotherapy (CCRT) followed by consolidation chemotherapy in the International Federation of Gynecology and Obstetrics (FIGO) stage IIIB/IVA cervical cancer patients. Methods: We reviewed the medical records of FIGO stage IIIB/IVA cervical cancer patients (n=30) who had been intended to be treated with TC-based CCRT followed by consolidation chemotherapy (TC-CCRT-group) from April 2012–May 2016. Patients who had been treated with CCRT involving a single platinum agent (CCRT-group; n=52) or definitive radiotherapy alone (RT-group; n=74) from January 1997–September 2012 were also identified and used as historical controls. Survival was calculated using the Kaplan-Meier method and compared using the log-rank test. Results: Of the 30 patients included in the TC-CCRT-group, 22 patients (73.3%) completed the planned TC-based CCRT. The most frequently observed acute grade 3/4 hematological toxicities were leukopenia and neutropenia, and diarrhea was the most common acute grade 3/4 non-hematological toxicity. After a median follow-up of 35 months, 9 patients (30.0%) had developed recurrent disease. The patients’ estimated 3-year progression-free survival (PFS) and overall survival (OS) rates were 67.9% and 90.8%, respectively. In comparisons with historical control groups, the survival outcomes of TC-CCRT-group was significantly superior to CCRT-group in terms of OS (p=0.011) and significantly superior to RT-group in terms of both PFS (p=0.009) and OS (p<0.001). Conclusion: TC-based CCRT followed by consolidation chemotherapy is safe and effective. A randomized controlled study needs to be conducted to further evaluate the efficacy of this multimodal approach in this patient population.
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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.
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( Seiji Mabuchi ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-
Myeloid-derived suppressor cells (MDSC) are a heterogeneous population of immature myeloid cells that exhibit immunosuppressive activity by blocking the proliferation and the activity of both T and natural killer (NK) cells. In addition to their role in suppressing immune responses, MDSCs directly stimulate tumor growth, metastasis, and angiogenesis. As MDSC limits the potency of conventional standard therapeutic interventions including surgery, chemotherapy or radiotherapy, MDSC have emerged as an important target in cancer treatment. Recent evidences demonstrate that MDSC have been implicated in gynecological cancers and are correlated with poor prognosis. Moreover, MDSC levels might serve as a predictive marker for treatment outcome. In this symposium, I summarize our understanding of MDSC biology and their role in cervical cancer progression, and highlight how MDSC can be targeted therapeutically in the clinic for patients with cervical cancer.
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Eriko Yokoi,Seiji Mabuchi,Ryoko Takahashi,Yuri Matsumoto,Hiromasa Kuroda,Katsumi Kozasa,Tadashi Kimura 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.2
Objective: To compare the survival outcomes of patients with cervical squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) among patients with locally advanced cervical cancer that were treated with definitive radiotherapy. Methods: The baseline characteristics and outcome data of patients with locally advanced cervical cancer who were treated with definitive radiotherapy between November 1993 and February 2014 were collected and retrospectively reviewed. A Cox proportional hazards regression model was used to investigate the prognostic significance of AC/ASC histology. Results: The patients with AC/ASC of the cervix exhibited significantly shorter overall survival (OS) (p=0.004) and progression-free survival (PFS) (p=0.002) than the patients with SCC of the cervix. Multivariate analysis showed that AC/ASC histology was an independent negative prognostic factor for PFS. Among the patients who displayed AC/ASC histology, larger tumor size, older age, and incomplete response to radiotherapy were found to be independent prognostic factors. PFS was inversely associated with the number of poor prognostic factors the patients exhibited (the estimated 1-year PFS rates; 100.0%, 77.8%, 42.8%, 0.0% for 0, 1, 2, 3 factors, respectively). Conclusion: Locally advanced cervical cancer patients with AC/ASC histology experience significantly worse survival outcomes than those with SCC. Further clinical studies are warranted to develop a concurrent chemoradiotherapy (CCRT) protocol that is specifically tailored to locally advanced cervical AC/ASC.
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Kotaro Shimura,Seiji Mabuchi,Takeshi Yokoi,Tomoyuki Sasano,Kenjirou Sawada,Toshimitsu Hamasaki,Tadashi Kimura 대한부인종양학회 2013 Journal of Gynecologic Oncology Vol.24 No.4
Objective: To investigate the utility of serum squamous cell carcinoma antigen (SCC-Ag) levels upon the diagnosis of recurrent cervical cancer for decision making in patient management. Methods: Clinical records from 167 cervical cancer patients who developed recurrence between April 1996 and September 2010 were reviewed. A Cox proportional hazards regression model was used to investigate the prognostic significance of serum SCC-Ag levels at the time of recurrence. The effects of various salvage treatments on survival outcomes of recurrent cervical cancer were examined with respect to serum SCC-Ag levels. Results: Serum SCC-Ag levels were elevated (>2.0 ng/mL) in 125 patients (75%) when recurrence was diagnosed. These patients exhibited significantly shorter postrecurrence survival than those with normal SCC-Ag levels (log-rank; p=0.033). Multivariate analyses revealed that an elevated serum SCC-Ag level was an independent prognostic factor for poor postrecurrence survival. In patients with SCC-Ag levels <14.0 ng/mL, radiotherapy or surgery resulted in improved survival compared with chemotherapy or supportive care. In contrast, in patients with SCC-Ag levels of ≥14.0 ng/mL, salvage treatment with radiotherapy had only a minimal impact on postrecurrence survival. Conclusion: The serum SCC-Ag level measured when cervical cancer recurrence is diagnosed can be useful for deciding upon the appropriate salvage treatment.
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Prognostic significance of tumor laterality in advanced ovarian cancer
( Yuki Yamada ),( Seiji Mabuchi ),( Naoki Kawahara ),( Ryuji Kawaguchi ) 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.6
Objective This study aimed to investigate the effect of incorporating tumor laterality into the International Federation of Gynecology and Obstetrics (FIGO) staging system for advanced ovarian cancer. Methods The clinical data of 131 patients with advanced ovarian cancer treated between 2008 and 2018 were retrospectively reviewed. To investigate the prognostic significance of tumor laterality, we divided the patients into unilateral and bilateral groups. The prognostic significance of tumor laterality (bilateral vs. unilateral) was evaluated using univariate and multivariate analyses. The effect of incorporating tumor laterality into the FIGO staging system to predict survival outcomes was evaluated using the Kaplan-Meier method. Results Both overall survival (OS) and progression-free survival (PFS) were longer in the unilateral group than in the bilateral group. Multivariate analysis demonstrated that tumor laterality was an independent predictor of OS (hazard ratio, 1.75; confidence interval, 1.05-2.92; P=0.032). In patients with stage III disease, the bilateral group had a shorter OS than the unilateral group, but it was comparable to the OS in stage IV patients (P=0.354). The incorporation of tumor laterality into the FIGO staging system improved the stratification of survival probabilities. Conclusion Tumor laterality can be an independent prognostic factor in patients with advanced ovarian cancer. The incorporation of tumor laterality may improve the predictive performance of the FIGO staging system in patients with advanced ovarian cancer.
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Koji Matsuo,Seiji Mabuchi,Mika Okazawa,Mahiru Kawano,Hiromasa Kuroda,Shoji Kamiura,Tadashi Kimura 대한부인종양학회 2015 Journal of Gynecologic Oncology Vol.26 No.1
Objective: Presence of high-risk factor in cervical cancer is known to be associated with decreased survival outcomes. However, the significance of multiple high-risk factors in early-stage cervical cancer related to survival outcomes, recurrence patterns, and treatment implications is not well elucidated. Methods: A retrospective study was conducted for surgically treated cervical cancer patients (stage IA2–IIB, n=540). Surgical-pathological risk factors were examined and tumors expressing ≥1 high-risk factors (nodal metastasis, parametrial involvement, or positive surgical margin) were eligible for analysis (n=177, 32.8%). Survival analysis was performed based on the number of high-risk factors and the type of adjuvant therapy. Results: There were 68 cases (38.4%) expressed multiple high-risk factors (2 high-risk factors: n=58, 32.8%; 3 high-risk factors: n=10, 5.6%). Multiple high-risk factors remained an independent prognosticator for decreased survival outcomes after controlling for age, histology, stage, and treatment type (disease-free survival: hazard ratio [HR], 2.34; p=0.002; overall survival: HR, 2.32; p=0.007). Postoperatively, 101 cases (57.1%) received concurrent chemoradiotherapy (CCRT) and 76 cases (42.9%) received radiotherapy (RT) alone. CCRT was beneficial in single high-risk factor cases: HRs for CCRT over RT alone for cumulative risk of locoregional and distant recurrence, 0.27 (p=0.022) and 0.27 (p=0.005), respectively. However, tumor expressing multiple high-risk factors completely offset the benefit of CCRT over RT alone for the risk of distant recurrence: HR for locoregional and distant recurrence, 0.31 (p=0.071) and 0.99 (p=0.980), respectively. Conclusion: Special consideration for the significance of multiple high-risk factors merits further investigation in the management of surgically treated early-stage cervical cancer.
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