Annual Report 2019
Department of Gynecology
Tomoyasu Kato, Mitsuya Ishikawa, Masaya Uno, Yasuhito Tanase, 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/tubal/peritoneal cancer, are still on the rise in Japan.
The Team and What We Do
Dr. Tanase joined our staff in April. He is a doctor who meets the facility requirements and surgeon requirements for laparoscopic surgery in the gynecologic field. Consequently, we started laparoscopic surgery for early endometrial cancer which is covered by Japanese insurance. Moreover we accomplished robot-assisted laparoscopic surgery for uterine cancer in March 2020. Also, Dr. Mayumi Kato was promoted to staff in October after three years of the resident training program and 1.5 years as chief resident. The number of surgeries was 289, including 24 cases of radical hysterectomy and 26 cases of para-aortic lymphadenectomy (Table 1, 2). The numbers are almost the same as last year. Without major post-operative accidents, these radical operations are performed safely and reliably.
Table 1. Number of patients (primary site)
Research activities
Dr. Takahashi reported the recurrence risk score for early-stage endometrial cancer (J Gynecol Oncol. 30:e8). According to this report, many patients with intermediate postoperative risks need no adjuvant chemotherapy.
Dr. Yokoi reported that degenerative uterine fibroids and uterine sarcoma could be differentiated using microRNAs in blood (Yokoi A, et al. Cancer Sci. 110/3718-3726). This research was in collaboration with the laboratory of molecular cell therapy.
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 of conventional paclitaxel and carboplatin versus dose-dense paclitaxel and carboplatin in stage IVB, recurrent, or persistent cervical carcinoma (JCOG 1311) was discontinued prematurely.
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) is ongoing as planned.
Education
We are preparing to accept late training physicians.
Future prospects
In order to obtain facility certification of (robot-assisted) laparoscopic surgery, we are working to improve the skills of the surgeons and work closely with assistants and co-medicals.
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 2019
Journal
1. Hirose S, Murakami N, Takahashi K, Kuno I, Takayanagi D, Asami Y, Matsuda M, Shimada Y, Yamano S, Sunami K, Yoshida K, Honda T, Nakahara T, Watanabe T, Komatsu M, Hamamoto R, Kato MK, Matsumoto K, Okuma K, Kuroda T, Okamoto A, Itami J, Kohno T, Kato T, Shiraishi K, Yoshida H. Genomic alterations in STK11 can predict clinical outcomes in cervical cancer patients. Gynecol Oncol, 156:203-210, 2020
2. Murakami N, Nakamura S, Kashihara T, Kato T, Shibata Y, Takahashi K, Inaba K, Okuma K, Igaki H, Nakayama Y, Galalae R, Itami J. Hyaluronic acid gel injection in rectovaginal septum reduced incidence of rectal bleeding in brachytherapy for gynecological malignancies. Brachytherapy, 19:154-161, 2020
3. Kuno I, Tate K, Yoshida H, Takahashi K, Kato T. Endometrial Endometrioid Carcinoma With Ovarian Metastasis Showing Morula-like Features in a Patient With Cowden Syndrome: A Case Report. Int J Gynecol Pathol, 39:36-42, 2020
4. Ushigusa T, Yoshida H, Kuno I, Kojima N, Ishikawa M, Kato T. Characteristics and prognostic significance of incidentally detected cancer cells in uterine specimens of patients with pelvic high-grade serous carcinoma. Cytopathology, 31:122-129, 2020
5. Uehara T, Yoshida H, Kondo A, Kato T. A case of cervical adenocarcinoma arising from endometriosis in the absence of human papilloma virus infection. J Obstet Gynaecol Res, 46:536-541, 2020
6. Yunokawa M, Sasada S, Takehara Y, Takahashi K, Shimoi T, Yonemori K, Ishikawa M, Kato T, Tamura K. Real-world data on initial treatment strategies for older adult patients with endometrial cancer in Japan. Cancer Chemother Pharmacol, 84:1051-1058, 2019
7. Kuroda T, Ogiwara H, Sasaki M, Takahashi K, Yoshida H, Kiyokawa T, Sudo K, Tamura K, Kato T, Okamoto A, Kohno T. Therapeutic preferability of gemcitabine for ARID1A-deficient ovarian clear cell carcinoma. Gynecol Oncol, 155:489-498, 2019
8. Bun S, Yunokawa M, Ebata T, Kobayashi Kato M, Shimoi T, Kato T, Tamura K. Feasibility of initial treatment in elderly patients with ovarian cancer in Japan: a retrospective study. Int J Clin Oncol, 24:1111-1118, 2019
9. Kobayashi-Kato M, Yunokawa M, Bun S, Miyasaka N, Kato T, Tamura K. Platinum-free interval affects efficacy of following treatment for platinum-refractory or -resistant ovarian cancer. Cancer Chemother Pharmacol, 84:33-39, 2019
10. Ghani FI, Dendo K, Watanabe R, Yamada K, Yoshimatsu Y, Yugawa T, Nakahara T, Tanaka K, Yoshida H, Yoshida M, Ishikawa M, Goshima N, Kato T, Kiyono T. An Ex-Vivo Culture System of Ovarian Cancer Faithfully Recapitulating the Pathological Features of Primary Tumors. Cells, 8:644, 2019
11. Kojima N, Yoshida H, Kuno I, Uehara T, Uno M, Ishikawa M, Kato T. Prognostic impact of intraoperative peritoneal cytology in interval debulking surgery for pelvic high-grade serous carcinoma. Cancer Med, 8:4598-4604, 2019
12. Matsumoto K, Yaegashi N, Iwata T, Yamamoto K, Aoki Y, Okadome M, Ushijima K, Kamiura S, Takehara K, Horie K, Tasaka N, Sonoda K, Takei Y, Aoki Y, Konnai K, Katabuchi H, Nakamura K, Ishikawa M, Watari H, Yoshida H, Matsumura N, Nakai H, Shigeta S, Takahashi F, Noda K, Yoshikawa H. Reduction in HPV16/18 prevalence among young women with high-grade cervical lesions following the Japanese HPV vaccination program. Cancer Sci, 110:3811-3820, 2019
13. Kasamatsu T, Ishikawa M, Murakami N, Okada S, Ikeda SI, Kato T, Itami J. Identifying selection criteria for non-radical hysterectomy in FIGO stage IB cervical cancer. J Obstet Gynaecol Res, 45:882-891, 2019
14. Tate K, Yoshida H, Ishikawa M, Shimizu H, Uehara T, Kato T. Endometrial Carcinoma With an Unusual Morphology in a Patient With Cornelia de Lange Syndrome: A Case Study. Int J Gynecol Pathol, 38:340-345, 2019
15. Yokoi A, Matsuzaki J, Yamamoto Y, Tate K, Yoneoka Y, Shimizu H, Uehara T, Ishikawa M, Takizawa S, Aoki Y, Kato K, Kato T, Ochiya T. Serum microRNA profile enables preoperative diagnosis of uterine leiomyosarcoma. Cancer Sci, 110:3718-3726, 2019
Book
1. Kato T. Abdominal Nerve-sparing Radical Hysterectomy. In: Mikami M (ed), Surgery for Gynecologic Cancer, Singapore, Springer Singapore, 2019