Annual Report 2023

Department of Gynecology

Hiroshi Tanabe, Shin Takenaka, Suguru Odajima, Junki Oonishi, Teppei Ichikawa

Introduction

 This was the sixth year since this department adopted a system with full-time medical staff since April 2018. The number of new gynecological malignant patients continues to increase as more patients are referred from neighboring facilities as well as from outside the Chiba prefecture (49 in 2018, 88 in 2019, 107 in 2020, 126 in 2021, 155 in 2022 and 180 in 2022) (Table 1). As a result, the number of surgeries performed in 2023 was 185. 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 endometrial 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, diagnostic 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 diagnostic laparoscopy, is approximately 90% with the cooperation of the Department of Colorectal Surgery and the Department of Hepatobiliary and Pancreatic Surgery, and the number of cases is 50-60 per year, one of the highest institutions 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.

Clinical Trials

 JGOG3020:

 A randomized clinical trial with multiple international institutions (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 300 cases in October 2023, which was the target number of cases.

 The "prospective P2 study to evaluate the efficacy and safety of Total Parietal Peritonectomy for stage III/IV ovarian cancer" that our hospital is playing a central role in started in September 2022, and we are currently registering cases.

Education

 In 2021, the department accepted 1 resident doctor and became a provider of education to become a gynecologic oncology specialist. Since 2023, we have accepted two residents.

Future Prospects

 The number of operating rooms increased in 2023. 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.

List of papers published in 2023

Journal

1. Komazaki H, Takahashi K, Tanabe H, Shoburu Y, Kamii M, Tsuda A, Saito M, Yamada K, Takano H, Michimae H, Okamoto A. A retrospective study of dose-dense paclitaxel and carboplatin plus bevacizumab as first-line treatment of advanced epithelial ovarian cancer. Journal of gynecologic oncology, 2024

2. Odajima S, Tanabe H, Koike Y, Onishi J, Ichikawa T, Yokosu K, Takaneka S, Okamoto A. Short- and long-term morbidity of total parietal peritonectomy for advanced ovarian cancer. International journal of gynecological cancer, 33:1771-1777, 2023