Annual Report 2022
Department of Gynecology
Tomoyasu Kato, Mitsuya Ishikawa, Masaya Uno, Yasuhito Tanase, Mayumi Kato, Erisa Fujii
Introduction
The Department of Gynecology deals with tumors originating from the female genital and reproductive organs. Surgery is the primary treatment modality for most gynecologic cancers. However, 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. We are also working on the diagnosis of and surgery for rare cancers in gynecology.
The Team and What We Do
With the introduction of laparoscopic surgery in June 2019 and the da Vinci surgery in March 2020, minimum invasive surgery (MIS) has become more prevalent in the department, along with an increase in the number of capable surgeons. The number of surgeries performed this year was 314. Table 1 shows the primary sites, while Table 2 shows the type of procedure. Radical hysterectomy was performed in 24 cases, salvage operation for recurrent disease in 10 cases, and laparoscopic or robotic surgery in 61 cases. The surgical options for patients with gynecological cancer have grown and become more established, with extended surgery for locally advanced cases being performed safely and reliably, and MIS performed for early-stage cases.
Research Activities
The final analysis of JCOG1311, for which Ishikawa is the principal investigator, was published, and the efficacy of the new chemotherapy dose-dense TC therapy for recurrent cervical cancer did not show the expected results (Ishikawa IntJGynecolCancer. 33 (5): 692, 2023).
Clinical Trials
1) A nonrandomized confirmatory trial of modified radical hysterectomy among patients with FIGO Stage Ib1 (< 2 cm) uterine cervical cancer (JCOG1101) has been completed and will be presented in 2023.
2) A nonrandomized verification study regarding the selection of fertility-sparing surgery for patients with epithelial ovarian cancer (JCOG1203) has completed the recruitment and is in the follow-up phase.
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) has been completed and presented.
4) A non-randomized confirmatory trial of postoperative concurrent chemotherapy (CCRT) using IMRT for patients with curatively resected high-risk uterine cervical cancer (JCOG1402) has completed the recruitment and is in the follow-up phase.
5) A randomized phase III trial to confirm the survival effect of para-aortic lymphadenectomy for patients with endometrial cancer (JCOG1412) has completed the recruitment and is in the follow-up phase.
6) A study for monitoring the impact of a national HPV vaccination program in Japan (MINT study II) is proceeding with recruitment as planned.
Education
Five residents and one chief resident are under training. Additionally, two doctors from Chibune Hospital are training as late-career trainees.
Future Prospects
Our doctors will continue to educate future generations and pass on to them our department's higher surgical results than those of other institutions, which is due to our surgical skills.
List of papers published in 2022
Journal
1. Ishikawa M, Shibata T, Kataoka T, Takekuma M, Kobayashi H, Yaegashi N, Satoh T. Final analysis of a randomized phase II/III trial of conventional paclitaxel and carboplatin with or without bevacizumab versus dose-dense paclitaxel and carboplatin with or without bevacizumab, in stage IVB, recurrent, or persistent cervical carcinoma (JCOG1311). International journal of gynecological cancer, 33:692-700, 2023
2. Kojima Y, Sudo K, Yoshida H, Yazaki S, Tokura M, Mizoguchi C, Okuma HS, Kita S, Yamamoto K, Nishikawa T, Noguchi E, Shimoi T, Tanase Y, Uno M, Ishikawa M, Kato T, Koyama K, Kobayashi M, Kakegawa T, Fujiwara Y, Yonemori K. Changes in HER3 expression profiles between primary and recurrent gynecological cancers. Cancer cell international, 23:18, 2023
3. Kim C, Salvo G, Ishikawa M, Chen TC, Jhingran A, Bhosale P, Ramalingam P, Frumovitz M. The role of postoperative radiation after radical hysterectomy for women with early-stage neuroendocrine carcinoma of the cervix: A meta-analysis. Gynecologic oncology, 170:328-332, 2023
4. Yoshida H, Uno M, Ogimoto K, Kobayashi-Kato M, Tanase Y, Ishikawa M, Kato T. Endometrioid Endometrial Carcinoma With NKX3.1 Expression in a Transgender Man: A Case Report. International journal of gynecological pathology, 42:308-314, 2023
5. Yazaki S, Kojima Y, Yoshida H, Takamizawa S, Kitadai R, Nishikawa T, Shimoi T, Sudo K, Saito A, Okuma HS, Tanioka M, Noguchi E, Uno M, Ishikawa M, Kato T, Fujiwara Y, Ohe Y, Yonemori K. High expression of folate receptor alpha is associated with poor prognosis in patients with cervical cancer. Journal of gynecologic oncology, 33:e82, 2022
6. Yoshida H, Asami Y, Kobayashi-Kato M, Tanase Y, Uno M, Ishikawa M, Shiraishi K, Kato T. Genetic features of endometrioid-type endometrial carcinoma arising in uterine adenomyosis. Virchows Archiv, 481:117-123, 2022
7. Nagai T, Shimada M, Tokunaga H, Ishikawa M, Yaegashi N. Clinical issues of surgery for uterine endometrial cancer in Japan. Japanese journal of clinical oncology, 52:346-352, 2022
8. Onuki M, Yamamoto K, Yahata H, Kanao H, Yokota H, Kato H, Shimamoto K, Takehara K, Kamiura S, Tsuda N, Takei Y, Shigeta S, Matsumura N, Yoshida H, Motohara T, Watari H, Nakamura K, Ueda A, Tasaka N, Ishikawa M, Hirashima Y, Kudaka W, Taguchi A, Iwata T, Takahashi F, Kukimoto I, Yoshikawa H, Yaegashi N, Matsumoto K. Human papillomavirus vaccine effectiveness by age at first vaccination among Japanese women. Cancer science, 113:1428-1434, 2022
9. Kobayashi Kato M, Asami Y, Takayanagi D, Matsuda M, Shimada Y, Hiranuma K, Kuno I, Komatsu M, Hamamoto R, Matsumoto K, Ishikawa M, Kohno T, Kato T, Shiraishi K, Yoshida H. Clinical impact of genetic alterations of CTNNB1 in patients with grade 3 endometrial endometrioid carcinoma. Cancer science, 113:1712-1721, 2022
10. Nishio S, Matsuo K, Nasu H, Murotani K, Mikami Y, Yaegashi N, Satoh T, Okamoto A, Ishikawa M, Miyamoto T, Mandai M, Takehara K, Yahata H, Takekuma M, Ushijima K. Analysis of postoperative adjuvant therapy in 102 patients with gastric-type mucinous carcinoma of the uterine cervix: A multi-institutional study. European journal of surgical oncology, 48:2039-2044, 2022
11. Yunokawa M, Onda T, Ishikawa M, Yaegashi N, Kanao H. Current treatment status of older patients with gynecological cancers. Japanese journal of clinical oncology, 52:825-832, 2022
12. Shigeta S, Shimada M, Tsuji K, Nagai T, Tanase Y, Matsuo K, Kamiura S, Iwata T, Yokota H, Mikami M. Risk assessment in the patients with uterine cervical cancer harboring intermediate risk factors after radical hysterectomy: a multicenter, retrospective analysis by the Japanese Gynecologic Oncology Group. International journal of clinical oncology, 27:1507-1515, 2022
13. Shigeta S, Shimada M, Tsuji K, Nagai T, Tanase Y, Matsuo K, Kamiura S, Iwata T, Yokota H, Mikami M. Correction to: Risk assessment in the patients with uterine cervical cancer harboring intermediate risk factors after radical hysterectomy: a multicenter, retrospective analysis by the Japanese Gynecologic Oncology Group. International journal of clinical oncology, 27:1516, 2022
14. Shibuya Y, Shimada M, Tsuji K, Shigeta S, Tanase Y, Matsuo K, Yamaguchi S, Kanao H, Saito T, Mikami M. Prognostic factors of 2018 FIGO stage IB-IIA cervical cancer with absence of high/ intermediate surgical-pathological risk factors. Japanese journal of clinical oncology, 52:1289-1296, 2022
15. Kukimoto I, Onuki M, Yamamoto K, Yahata H, Aoki Y, Yokota H, Konnai K, Nio A, Takehara K, Kamiura S, Tsuda N, Takei Y, Shimada M, Nakai H, Yoshida H, Motohara T, Yamazaki H, Nakamura K, Okunomiya A, Tasaka N, Ishikawa M, Hirashima Y, Shimoji Y, Mori M, Iwata T, Takahashi F, Yoshikawa H, Yaegashi N, Matsumoto K. Regional differences in human papillomavirus type 52 prevalence among Japanese women with cervical intraepithelial neoplasia†. Japanese journal of clinical oncology, 52:1242-1247, 2022
16. Tanase Y, Kato MK, Uno M, Ishikawa M, Kato T. Variations in Procedures for Ureterolysis with Sharp Dissection in Minimally Invasive Hysterectomy. Gynecology and minimally invasive therapy, 11:171-173, 2022
17. Natsume T, Yoshida H, Nishikawa T, Kikkawa N, Naka T, Kobayashi-Kato M, Tanase Y, Uno M, Ishikawa M, Kato T. Uterine Leiomyosarcoma Masquerading as a Malignant Perivascular Epithelioid Cell Tumor: A Diagnostic Challenge. International journal of surgical pathology, 10668969221133348, 2022
18. Asami Y, Hiranuma K, Takayanagi D, Matsuda M, Shimada Y, Kato MK, Kuno I, Murakami N, Komatsu M, Hamamoto R, Kohno T, Sekizawa A, Matsumoto K, Kato T, Yoshida H, Shiraishi K. Predictive model for the preoperative assessment and prognostic modeling of lymph node metastasis in endometrial cancer. Scientific reports, 12:19004, 2022
19. Takamizawa S, Yazaki S, Kojima Y, Yoshida H, Kitadai R, Nishikawa T, Shimoi T, Sudo K, Okuma HS, Tanioka M, Noguchi E, Uno M, Ishikawa M, Kato T, Fujiwara Y, Yonemori K. High mesothelin expression is correlated with non-squamous cell histology and poor survival in cervical cancer: a retrospective study. BMC cancer, 22:1215, 2022
20. Kitamura SI, Yoshida H, Kobayashi-Kato M, Kikkawa N, Tanase Y, Uno M, Ishikawa M, Kato T. Adenoid Basal Carcinoma with Adenoid Cystic Carcinoma Component of the Uterine Cervix: A Case Report and Literature Review. International journal of surgical pathology, 10668969221134691, 2022