Annual Report 2018
Department of Gynecology
Tomoyasu Kato, Mitsuya Ishikawa, Takashi Uehara, Hanako Shimizu, Masaya Uno. Mayumi Kato, Yutaka Yoneoka
Introduction
The Department of Gynecology deals with tumors originating from the female genital and reproductive organs. Surgery is the main treatment modality for most gynecologic cancers, but multidisciplinary treatments consisting of radiotherapy and chemotherapy are routinely considered in close cooperation with therapeutic radiation oncologists and medical oncologists. The incidences of three common gynecologic cancers, that is, cervical, endometrial and ovarian cancer, are now on the rise in Japan.
The Team and What We Do
Dr. Masaya Uno joined our staff in April. So, more time can be spent on research as well as medical treatment. The number of surgeries was 284, including 29 cases of radical hysterectomy and 20 cases of para-aortic lymphadenectomy. The number is almost the same as last year, but since last year's total was 15 months, it was about 20% higher. Without major post-operative accidents, these expanded operations are performed safely and reliably, and true minimally invasive treatment continues.
Research activities
For ovarian cancer, which is difficult to diagnose early and has a poor prognosis, we have succeeded in creating a diagnostic model that detects ovarian cancer with higher accuracy (99% sensitivity, 100% specificity). A total of 4,046 microRNAs in blood (serum) with and without ovarian cancer were comprehensively analyzed to identify multiple microRNAs that significantly change in ovarian cancer. By combining ten microRNAs, ovarian cancer can be detected from an early stage. This research is in collaboration with the laboratory of molecular cell therapy (Nature Communications).
Clinical trials
1) A nonrandomized confirmatory trial of modified radical hysterectomy for patients with FIGO Stage Ib1 (< 2 cm) uterine cervical cancer (JCOG1101) is complete and follow-up is in progress.
2) A non-randomized verification study regarding selection of fertility-sparing surgery for patients with epithelial ovarian cancer (JCOG1203) is ongoing as planned.
3) A randomized phase II/III trial conventional paclitaxel and carboplatin versus dosedense paclitaxel and carboplatin in stage IVB, recurrent, or persistent cervical carcinoma (JCOG 1311) resumed.
4) A non-randomized confirmatory trial of postoperative concurrent chemotherapy (CCRT) using IMRT for patients with curatively resected high-risk uterine cervical cancer (JCOG1402) is ongoing as planned.
5) A randomized phase III trial to confirm the survival effect of para-aortic lymphadenectomy for patients with endometrial cancer (JCOG1412) has started.
Education
Chief resident doctor: 1
Resident doctors: 4
Future prospects
The application to include (Robot-assisted) laparoscopic surgery for uterine malignant disease in Japanese medical insurance was made. A doctor who meets facility requirements and surgeon requirements will join our department in April. We are pursuing "realizing true minimally invasive surgery" and "the enforcement of radical surgery safely", and are collaborating with the Research Institute to overcome existing treatment outcomes.
List of papers published in 2018
Journal
1. Tsuchiya M, Masujima M, Kato T, Ikeda SI, Shimizu C, Kinoshita T, Shiino S, Suzuki M, Mori M, Takahashi M. Knowledge, fatigue, and cognitive factors as predictors of lymphoedema risk-reduction behaviours in women with cancer. Support Care Cancer, 27:547-555, 2019
2. Murakami N, Kobayashi K, Shima S, Tsuchida K, Kashihara T, Tselis N, Umezawa R, Takahashi K, Inaba K, Ito Y, Igaki H, Nakayama Y, Masui K, Yoshida K, Kato T, Itami J. A hybrid technique of intracavitary and interstitial brachytherapy for locally advanced cervical cancer: initial outcomes of a single-institute experience. BMC Cancer, 19:221, 2019
3. Murakami N, Shima S, Kashihara T, Tselis N, Kato T, Takagawa Y, Masui K, Yoshida K, Takahashi K, Inaba K, Okuma K, Igaki H, Nakayama Y, Itami J. Hyaluronic gel injection into the vesicovaginal septum for high-dose-rate brachytherapy of uterine cervical cancer: an effective approach for bladder dose reduction. J Contemp Brachytherapy, 11:1-7, 2019
4. Yoneoka Y, Yoshida H, Ishikawa M, Shimizu H, Uehara T, Murakami T, Kato T. Prognostic factors of synchronous endometrial and ovarian endometrioid carcinoma. J Gynecol Oncol, 30:e7, 2019
5. Uehara T, Yoshida H, Tate K, Kato T. Metachronous occurrence of two different histological subtypes of endometriosis-related neoplasms. Gynecol Oncol Rep, 27:42-45, 2019
6. Takahashi K, Yunokawa M, Sasada S, Takehara Y, Miyasaka N, Kato T, Tamura K. A novel prediction score for predicting the baseline risk of recurrence of stage I-II endometrial carcinoma. J Gynecol Oncol, 30:e8, 2019
7. Ogiwara H, Takahashi K, Sasaki M, Kuroda T, Yoshida H, Watanabe R, Maruyama A, Makinoshima H, Chiwaki F, Sasaki H, Kato T, Okamoto A, Kohno T. Targeting the Vulnerability of Glutathione Metabolism in ARID1A-Deficient Cancers. Cancer Cell, 35:177-190.e8, 2019
8. Tsuchiya M, Masujima M, Mori M, Takahashi M, Kato T, Ikeda SI, Shimizu C, Kinoshita T, Shiino S, Suzuki M. Information-seeking, information sources and ongoing support needs after discharge to prevent cancer-related lymphoedema. Jpn J Clin Oncol, 48:974-981, 2018
9. Kuno I, Yoshida H, Shimizu H, Uehara T, Uno M, Ishikawa M, Kato T. Incidental lymphangioleiomyomatosis in the lymph nodes of gynecologic surgical specimens. Eur J Obstet Gynecol Reprod Biol, 231:93-97, 2018
10. Yamada K, Shida D, Kato T, Yoshida H, Yoshinaga S, Kanemitsu Y. Adenocarcinoma arising in sigmoid colon neovagina 53 years after construction. World J Surg Oncol, 16:88, 2018
11. Tate K, Yoshida H, Ishikawa M, Uehara T, Ikeda SI, Hiraoka N, Kato T. Prognostic factors for patients with early-stage uterine serous carcinoma without adjuvant therapy. J Gynecol Oncol, 29:e34, 2018
12. Sekine K, Hamaguchi T, Shoji H, Takashima A, Honma Y, Iwasa S, Kato K, Takahashi K, Kato T, Kanemitsu Y, Boku N. Retrospective Analyses of Systemic Chemotherapy and Cytoreductive Surgery for Patients with Ovarian Metastases from Colorectal Cancer: A Single-Center Experience. Oncology, 95:220-228, 2018
13. Yokoi A, Matsuzaki J, Yamamoto Y, Yoneoka Y, Takahashi K, Shimizu H, Uehara T, Ishikawa M, Ikeda SI, Sonoda T, Kawauchi J, Takizawa S, Aoki Y, Niida S, Sakamoto H, Kato K, Kato T, Ochiya T. Integrated extracellular microRNA profiling for ovarian cancer screening. Nat Commun, 9:4319, 2018
14. Makise N, Sekimizu M, Kubo T, Wakai S, Watanabe SI, Kato T, Kinoshita T, Hiraoka N, Fukayama M, Kawai A, Ichikawa H, Yoshida A. Extraskeletal osteosarcoma: MDM2 and H3K27me3 analysis of 19 cases suggest disease heterogeneity. Histopathology, 73:147-156, 2018