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Annual Report 2022

Department of Gynecology

Hiroshi Tanabe, Shin Takenaka, Suguru Odajima, Yuki Koike, Keiko Takekuma

Introduction

 This was the fifth year since this department adopted a system with full-time medical staff since April 2018. The number of surgeries continues to increase as more patients are referred from neighboring facilities as well as from outside the Chiba prefecture (107 in 2019, 173 in 2020, 196 in 2021, and 202 in 2022) (Table 1). As a result, a resident staff was added in 2021, and the number of staff members increased from 2 to 3 in 2022. By target disease, the intracavitary irradiation (RALS) equipment required for radiotherapy for localized cervical cancer was introduced at our hospital in 2022. Thus, we no longer need to visit the NCC Hospital to conduct some of our treatments. The number of referred patients for concurrent chemoradiation therapy (CCRT) for localized cervical cancer is increasing. The number of surgeries for early-stage uterine cancer, endometrial hyperplasia, and cervical intraepithelial carcinoma has been steadily increasing since the resumption of robot-assisted surgery at the end of 2021. In particular, for advanced ovarian cancer, fallopian tube cancer, and primary peritoneal cancer, which are the main focus of our department, laparoscopy can be performed a week after the initial consultation with the cooperation of the Department of Anesthesiology. The R0 (complete surgery) rate for tumor reduction surgery, which is a radical surgery following laparoscopy, is approximately 90% with the cooperation of the Department of Colorectal Surgery and the Department of Hepatobiliary and Pancreatic Oncology, and the number of cases is 50-60 per year, one of the highest in Japan. As the East Hospital Lady’s Center Division, the Department of Gynecology is also working with the AYA Nursing Outpatient Clinic to raise awareness within the hospital regarding fertility preservation for AYA generation cases. In cooperation with other facilities, we can provide sufficient medical support and follow-up for frozen embryos before and after cancer treatment. Furthermore, in cooperation with the outpatient clinic for familial tumors, the number of surgeries, including those performed on referred patients, has been increasing as one of the few facilities in the Tokatsu area that can perform risk-reducing salpingo oophorectomy (RRSO) for hereditary breast and ovarian cancer syndrome (HBOC) cases since 2020, when the procedure was covered by insurance.

Table 1
Table 1

Table 1
Table 1

Clinical Trials

 JGOG3020:

 A randomized clinical trial with multiple international institutions (in Japan, Korea, and China) with Dr. Tanabe as the principal investigator, "Randomized Phase III Trial of the need for adjuvant chemotherapy in stage I epithelial ovarian cancer after comprehensive staging surgery," reached 280 cases, which almost attained the goal of 300 cases.

Research Activities

 We presented an English research paper in "Cancer Diagn Progn" regarding parietal peritoneal excision as a cytoreduction surgery for advanced ovarian cancer in 2022. Subsequently, a "Prospective P2 study to evaluate the efficacy and safety of Total Parietal Peritonectomy for stage III/IV ovarian cancer" was initiated in September 2022.

Education

 In 2021, the department accepted 1 resident doctor and became a provider of education to become a gynecologic medical specialist.

Future Prospects

 The number of operating rooms will be increased in the future. In conjunction with this, we would like to increase the number of surgeries in our department and the number of gynecology staff from the current 3 to 4 so that we can contribute to more clinical trials and clinical studies. We also intend to develop the department as one that can accept and train many residents.

Author

 Hiroshi Tanabe

List of papers published in 2022

Journal

1. Odajima S, Tanabe H, Koike Y, Yokosu K. Retrospective Analysis of Total Parietal Peritonectomy Without Systematic Lymphadenectomy for Advanced Epithelial Ovarian Cancer. Cancer diagnosis & prognosis, 2:482-488, 2022