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RISS 인기검색어
- 검색키워드
- 저자 : Tatsuhiro Ohgami (검색결과 2 건)
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Kaoru Okugawa,Hideaki Yahata,Tatsuhiro Ohgami,Masafumi Yasunaga,Kazuo Asanoma,Hiroaki Kobayashi,Kiyoko Kato 대한부인종양학회 2023 Journal of Gynecologic Oncology Vol.34 No.3
Objective: To apply the International Federation of Gynecology and Obstetrics (FIGO) 2018 staging system to all patients who underwent trachelectomy in our previous study and to update the oncologic and obstetric results. Methods: We retrospectively reviewed the medical records of patients in whom abdominal trachelectomy was attempted between June 2005 and September 2021. The FIGO 2018 staging system for cervical cancer was applied to all patients. Results: Abdominal trachelectomy was attempted for 265 patients. Trachelectomy was converted to hysterectomy in 35 patients, and trachelectomy was completed successfully in 230 (conversion rate: 13%). Applying the FIGO 2018 staging system, 40% of the patients who underwent radical trachelectomy had stage IA tumors. Among 71 patients who had tumors measuring ≥2 cm, 8 patients were classified as stage IA1 and 14 as stage IA2. Overall recurrence and mortality rates were 2.2% and 1.3%, respectively. One hundred twelve patients attempted to conceive after trachelectomy; 69 pregnancies were achieved in 46 patients (pregnancy rate: 41%). Twenty-three pregnancies ended in first-trimester miscarriage, and 41 infants were delivered between gestational weeks 23 and 37; 16 were deliveries at term (39%) and 25 were premature deliveries (61%). Conclusion: This study suggested that patients judged to be ineligible for trachelectomy and patients receiving overtreatment will continue to appear using the current standard eligibility criteria. With the revisions to the FIGO 2018 staging system, the preoperative eligibility criteria for trachelectomy, which were based on the FIGO 2009 staging system and tumor size, should be changed.
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Kaoru Okugawa,Hideaki Yahata,Kenzo Sonoda,Tatsuhiro Ohgami,Masafumi Yasunaga,Eisuke Kaneki,Kiyoko Kato 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.4
Objective: For oncologic safety, vaginal radical trachelectomy is generally performed onlyin patients with cervical cancers smaller than 2 cm. However, because inclusion criteriafor abdominal trachelectomy are controversial, we evaluated the safety of abdominaltrachelectomy for cervical cancers ≥2 cm. Methods: We began performing abdominal trachelectomies at our institution in 2005,primarily for squamous cell carcinoma ≤3 cm or adenocarcinoma/adenosquamous carcinoma≤2 cm. If a positive sentinel lymph node or cervical margin was diagnosed intraoperativelyby frozen section, the trachelectomy was converted to a hysterectomy. Medical records ofthese patients were reviewed retrospectively. Patients who had undergone simple abdominaltrachelectomy were excluded from this study. Results: We attempted trachelectomy in 212 patients. Among the 135 patients with tumors<2 cm, trachelectomy was successful in 120, one of whom developed recurrence and noneof whom died of their disease. Among 77 patients with tumors ≥2 cm, trachelectomy wassuccessful in 62, 2 of whom developed recurrence and 1 of whom died of her disease. Theoverall relapse rate after trachelectomy was 1.6% (0.8% in <2 cm group and 3.2% in ≥2 cmgroup), and the mortality rate was 0.5% (0% in <2 cm group and 1.6% in ≥2 cm group). Recurrence-free survival (p=0.303) and overall survival (p=0.193) did not differ significantlybetween the <2 cm and ≥2 cm groups. Conclusions: Abdominal trachelectomy with intraoperative frozen sections of sentinel lymphnodes and cervical margins is oncologically safe, even in patients with tumors ≥2 cm.
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