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RISS 인기검색어
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- 저자 : Kaoru Niimi (검색결과 3 건)
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Epidemiologic study on gestational trophoblastic diseases in Japan
Eiko Yamamoto,Kimihiro Nishino,Kaoru Niimi,Kazuhiko Ino 대한부인종양학회 2022 Journal of Gynecologic Oncology Vol.33 No.6
Objective: This study aims to estimate the population-based incidence of gestational trophoblastic diseases (GTDs) and to identify the characteristics of gestational trophoblastic neoplasia (GTN) in Japan. Methods: The annual number of GTD and live births from 1974 to 2018 were used to estimate the incidence of GTD. The data of 1,574 GTN cases from 1999 to 2018 were analyzed to identify the characteristics of low-risk GTN, high-risk GTN, placental site trophoblastic tumor (PSTT), and epithelioid trophoblastic tumor (ETT). Results: The incidence of hydatidiform mole was 2.02 per 1,000 live births on average which decreased from 1974 to 2008 and increased from 2009 to 2018. The incidence of low-risk GTN, high-risk GTN, PSTT, and ETT was 15.3, 3.5, 0.3, and 0.07 per 100,000 live births, respectively. The estimated incidence of post-molar GTN was 9.8% of molar patients. High-risk GTN was diagnosed more pathologically, had more various kinds of antecedent pregnancies, and had longer intervals after the antecedent pregnancy compared to low- risk GTN. Furthermore, 8.2% of high-risk GTN occurred after the subsequent non-molar pregnancy of hydatidiform mole. The cumulative percentage of developing high-risk GTN after hydatidiform mole reached 89.3% at the 60th month. Conclusion: The incidence of hydatidiform mole, low-risk GTN, high-risk GTN was 2.02 per 1,000 live births, 15.3 per 100,000 live births, and 3.5 per 100,000 live births, respectively. High-risk GTN was diagnosed more pathologically and later after the antecedent pregnancy than low-risk GTN. Following molar patients for five years is needed to improve the mortality of malignant GTN.
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Prognostic value of neutrophil-to-lymphocyte ratio in early-stage ovarian clear-cell carcinoma
Kosuke Yoshida,Nobuhisa Yoshikawa,Akira Shirakawa,Kaoru Niimi,Shiro Suzuki,Hiroaki Kajiyama,Fumitaka Kikkawa 대한부인종양학회 2019 Journal of Gynecologic Oncology Vol.30 No.6
Objectives: There is increasing evidence that systemic inflammatory response (SIR) markersare prognostic factors for various types of cancers. This is the first study to evaluate theusefulness of SIR markers for the prognosis of early-stage ovarian clear-cell carcinoma (OCCC). Methods: We retrospectively investigated 83 patients diagnosed with stage I–II OCCC whounderwent surgery between 2005 and 2017. Initially, receiver operating characteristic curveanalysis for overall survival (OS) was used to determine optimal cut-off values for neutrophilto-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Patients were stratifiedinto 2 groups by the cut-off values (NLR=3.26, PLR=160). Univariate and multivariateanalyses were performed to elucidate the significance of SIR markers as prognostic factors. Results: In the median follow-up period of 64.1 months, 16 patients experienced recurrence,and nine patients died. The Kaplan-Meier curve showed that OS of the NLR-low group wassignificantly longer than the NLR-high group (p=0.021). There was no significant differencein progression-free survival between the 2 groups (p=0.668), but the post-recurrencesurvival of the NLR-low group was significantly longer than the NLR-high group (p=0.019). Furthermore, multivariate analysis showed that increase in NLR is a significant independentprognostic factor for poor prognosis (hazard ratio=7.437, p=0.017). There was no significantdifference between PLR-low and PLR-high group. Conclusion: Results suggest that NLR can be a significant independent prognostic factor forearly-stage OCCC.
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Hiroaki Kajiyama,Kiyosumi Shibata,Mika Mizuno,Tomokazu Umezu,Shiro Suzuki,Ryuichiro Sekiya,Kaoru Niimi,Hiroko Mitsui,Eiko Yamamoto,Michiyasu Kawai,Tetsuro Nagasaka,Fumitaka Kikkawa 대한부인종양학회 2014 Journal of Gynecologic Oncology Vol.25 No.1
Objective: This study was conducted to examine the effects of front-line chemotherapy on overall survival (OS) and postrecurrence survival (PRS) of patients with recurrent ovarian cancer, when stratifying the histologic type. Methods: Five hundred and seventy-four patients with recurrent ovarian cancer with sufficient clinical information, including front-line chemotherapy, were analyzed. The pathologic slides were evaluated by central pathologic review. The patients were divided into two groups: group A (n=261), who underwent taxane plus platinum, and group B (n=313), who underwent conventional platinum-based chemotherapy without taxanes. Results: The median age was 54 years (range, 14 to 89 years). Group A had significantly better median OS (45.0 months vs. 30.3 months, p<0.001) and PRS (23.0 months vs. 13.0 months, p<0.001) compared to group B. The OS and PRS were similar between the groups in patients with clear cell or mucinous histology. In contrast, among patients with non-clear cell, non-mucinous histologies, the OS and PRS of group A were significantly better than those of group B (OS, p<0.001; PRS, p<0.001). Multivariable analyses revealed that, among patients with non-clear cell, non-mucinous histologies, chemotherapy including taxane and platinum was an independent predictor of favorable survival outcomes. Conversely, in patients with clear cell or mucinous histology, taxane-including platinum-based combination chemotherapy did not improve the OS and PRS compared to a conventional platinum-based regimen which did not include taxanes. Conclusion: Since the emergence of taxane plus platinum, the prognosis of patients with recurrent ovarian cancer has improved. However, we here demonstrate that this improvement is limited to patients with non-clear cell, non-mucinous histologies.
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