Annual Report 2023
Department of Gynecology
Mitsuya Ishikawa, Masaya Uno, Yasuhito Tanase, Mayumi Kato, Erisa Fujii, Takashi Natsume
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 325. Table 1 shows the primary sites, while Table 2 shows the type of procedure. Radical hysterectomy was performed in 13 cases, salvage operation for recurrent disease in 15 cases, and laparoscopic or robotic surgery in 75 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
Mayumi Kato reports on the results of her work on molecular genetic classification of uterine cancer (Kato GynecolOncol2023 Nov:178:36-43).
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 presented at ASCO2023.
2) A nonrandomized verification study regarding the selection of fertility-sparing surgery for patients with epithelial ovarian cancer (JCOG 1203) has completed the recruitment and is in the follow-up phase.
3) 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.
4) A randomized phase III trial to confirm the survival effect of para-aortic lymphadenectomy for patients with endometrial cancer (JCOG 1412) has completed the recruitment and is in the follow-up phase.
5) A study for monitoring the impact of a national HPV vaccination program in Japan (MINT study II) is proceeding with recruitment as planned.
6) A study of development of the AI system for early detection of ovarian cancer using cancer specific glycoprotein markers and peaks from comprehensive serum glycopeptide spectra analysis (CSGSA) is proceeding with recruitment as planned.
Education
Five residents and two chief residents are under training. In addition, two doctors from Chibune Hospital are training as late-career trainees.
Future Prospects
Our doctors will contribute to educating 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 2023
Journal
1. Yoshida H, Hiranuma K, Nakahara M, Kobayashi-Kato M, Tanase Y, Uno M, Shiraishi K, Ishikawa M, Kato T. Ovarian Mucinous Tumor Presenting Atypical Lobular Endocervical Glandular Hyperplasia-Like Appearance in a Patient With Germline STK11 p.F354L Variant: A Case Report. International journal of surgical pathology, 32:394-400, 2024
2. Sugitani A, Ogawa A, Yoshida H, Kobayashi-Kato M, Kikkawa N, Tanase Y, Uno M, Ishikawa M, Kato T. Ovarian Mesonephric-Like Adenocarcinoma With Recurrent Liver Metastases: A Case Report with Analysis of Therapeutic Molecular Targets. International journal of surgical pathology, 32:578-585, 2024
3. Ueno Y, Yoshida E, Nojiri S, Kato T, Ohtsu T, Takeshita T, Suzuki S, Yoshida H, Kato K, Itoh M, Notomi T, Usui K, Sozu T, Terao Y, Kawaji H, Kato H. Use of clinical variables for preoperative prediction of lymph node metastasis in endometrial cancer. Japanese journal of clinical oncology, 54:38-46, 2024
4. Kitadai R, Nishikawa T, Yoshida H, Mizoguchi C, Yamamoto K, Kato T, Yonemori K. Mesothelin expression in gynecologic carcinosarcoma: clinicopathological significance and correlation with HER2 expression. Journal of gynecologic oncology, 35:e11, 2024
5. Nagao Y, Yokoi A, Yoshida K, Kitagawa M, Asano-Inami E, Kato T, Ishikawa M, Yamamoto Y, Kajiyama H. Uterine leiomyosarcoma cell-derived extracellular vesicles induce the formation of cancer-associated fibroblasts. Biochimica et biophysica acta. Molecular basis of disease, 1870:167103, 2024
6. Kato MK, Fujii E, Asami Y, Momozawa Y, Hiranuma K, Komatsu M, Hamamoto R, Ebata T, Matsumoto K, Ishikawa M, Kohno T, Kato T, Yoshida H, Shiraishi K. Clinical features and impact of p53 status on sporadic mismatch repair deficiency and Lynch syndrome in uterine cancer. Cancer science, 115:1646-1655, 2024
7. Komatsu H, Matsumoto K, Morita M, Nagasawa T, Nishio H, Suzuki J, Nishio S, Kobara H, Yunokawa M, Ariyoshi K, Hirayama T, Tokunaga H, Ukita M, Yoriki K, Mori-Uchino M, Furusawa A, Togami S, Nakamura H, Ishikawa M, Satoh T. A survey of carboplatin desensitization therapy in Japan: A multicenter retrospective study. Cancer medicine, 13:e6968, 2024
8. 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
9. Matsuzaki J, Kato K, Oono K, Tsuchiya N, Sudo K, Shimomura A, Tamura K, Shiino S, Kinoshita T, Daiko H, Wada T, Katai H, Ochiai H, Kanemitsu Y, Takamaru H, Abe S, Saito Y, Boku N, Kondo S, Ueno H, Okusaka T, Shimada K, Ohe Y, Asakura K, Yoshida Y, Watanabe SI, Asano N, Kawai A, Ohno M, Narita Y, Ishikawa M, Kato T, Fujimoto H, Niida S, Sakamoto H, Takizawa S, Akiba T, Okanohara D, Shiraishi K, Kohno T, Takeshita F, Nakagama H, Ota N, Ochiya T. Prediction of tissue-of-origin of early stage cancers using serum miRNomes. JNCI cancer spectrum, 7:pkac080, 2023
10. Ito T, Takayanagi D, Sekine S, Hashimoto T, Shimada Y, Matsuda M, Yamada M, Hamamoto R, Kato T, Shida D, Kanemitsu Y, Boku N, Kohno T, Takashima A, Shiraishi K. Comparison of clinicopathological and genomic profiles in anal squamous cell carcinoma between Japanese and Caucasian cohorts. Scientific reports, 13:3587, 2023
11. 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, 31:778-784, 2023
12. 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, 31:819-824, 2023
13. Asami Y, Kobayashi Kato M, Hiranuma K, Matsuda M, Shimada Y, Ishikawa M, Koyama T, Komatsu M, Hamamoto R, Nagashima M, Terao Y, Itakura A, Kohno T, Sekizawa A, Matsumoto K, Kato T, Shiraishi K, Yoshida H. Utility of molecular subtypes and genetic alterations for evaluating clinical outcomes in 1029 patients with endometrial cancer. British journal of cancer, 128:1582-1591, 2023
14. 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
15. Nishikawa T, Hasegawa K, Matsumoto K, Mori M, Hirashima Y, Takehara K, Ariyoshi K, Kato T, Yagishita S, Hamada A, Kawasaki M, Kawashima S, Tomatsuri S, Nagasaka Y, Yoshida H, Machida R, Hirakawa A, Nakamura K, Yonemori K. Trastuzumab Deruxtecan for Human Epidermal Growth Factor Receptor 2-Expressing Advanced or Recurrent Uterine Carcinosarcoma (NCCH1615): The STATICE Trial. Journal of clinical oncology, 41:2789-2799, 2023
16. Yoshida H, Mizoguchi C, Saito A, Kitadai R, Yamamoto K, Nishikawa T, Kato T, Yonemori K. Discordances in expression of human epidermal growth factor receptor 2 between primary and metastatic uterine carcinosarcoma: A proposal for HER2-targeted therapy specimen selection. Annals of diagnostic pathology, 65:152150, 2023
17. Imai T, Yoshida H, Machida Y, Kuramochi M, Ichikawa H, Kubo T, Takahashi M, Kato T. Alteration in molecular properties during establishment and passaging of endometrial carcinoma patient-derived xenografts. Scientific reports, 13:8511, 2023
18. Saito R, Kuroda T, Yoshida H, Sudo K, Saito M, Tanabe H, Takano H, Yamada K, Kiyokawa T, Yonemori K, Kato T, Okamoto A, Kohno T. Genetic characteristics of platinum-sensitive ovarian clear cell carcinoma. Japanese journal of clinical oncology, 53:781-790, 2023
19. Yoneoka Y, Amano T, Tsuji S, Uno M, Ishikawa M, Kato T, Murakami T. The efficacy of adjuvant chemotherapy on the survival of early stage endometrial cancer. European journal of obstetrics, gynecology, and reproductive biology, 287:155-160, 2023
20. Uno M, Matsuo R, Maezawa N, Kato T. Evaluation of follow-up observation using human epididymis protein 4, a tumor marker, in patients with ovarian cancer. Obstetrics & gynecology science, 66:290-299, 2023
21. Tanase Y, Shimada M, Kato MK, Uno M, Ishikawa M, Kato T. Reconsideration of Sharp Dissection in Gynecological Surgery. Gynecology and minimally invasive therapy, 12:96-98, 2023
22. Kikuchi A, Yoshida H, Tsuda H, Nishio S, Suzuki S, Takehara K, Kino N, Sumi T, Kato K, Yokoyama M, Nakamura K, Takano M, Sato S, Kato H, Tamate M, Horie K, Kato T, Sakamoto A, Fukunaga M, Kaku T, Yoshida M, Yaegashi N, Satoh T. Clinical characteristics and prognostic factors of endometrial stromal sarcoma and undifferentiated uterine sarcoma confirmed by central pathologic review: A multi-institutional retrospective study from the Japanese Clinical Oncology Group. Gynecologic oncology, 176:82-89, 2023
23. Saito A, Nishikawa T, Yoshida H, Mizoguchi C, Kitadai R, Yamamoto K, Yazaki S, Kojima Y, Ishikawa M, Kato T, Yonemori K. Folate receptor alpha is widely expressed and a potential therapeutic target in uterine and ovarian carcinosarcoma. Gynecologic oncology, 176:115-121, 2023
24. Baba T, Koshiyama M, Kagabu M, Mikami Y, Minamiguchi S, Moritani S, Ishikawa M, Okamoto A, Terao Y, Nakanishi T, Katabuchi H, Tokunaga H, Satoh T, Konishi I, Yaegashi N. Ovarian serous borderline tumors with recurrent or extraovarian lesions: a Japanese, retrospective, multi-institutional, population-based study. International journal of clinical oncology, 28:1411-1420, 2023
25. Hiranuma K, Asami Y, Kato MK, Murakami N, Shimada Y, Matsuda M, Yazaki S, Fujii E, Sudo K, Kuno I, Komatsu M, Hamamoto R, Makinoshima H, Matsumoto K, Ishikawa M, Kohno T, Terao Y, Itakura A, Yoshida H, Shiraishi K, Kato T. Rare FGFR fusion genes in cervical cancer and transcriptome-based subgrouping of patients with a poor prognosis. Cancer medicine, 12:17835-17848, 2023
26. Yoshida H, Takigawa W, Kobayashi-Kato M, Nishikawa T, Shiraishi K, Ishikawa M. Mismatch Repair Protein Expression in Endometrial Cancer: Assessing Concordance and Unveiling Pitfalls in Two Different Immunohistochemistry Assays. Journal of personalized medicine, 13:1260, 2023
27. Onuki M, Takahashi F, Iwata T, Nakazawa H, Yahata H, Kanao H, Horie K, Konnai K, Nio A, Takehara K, Kamiura S, Tsuda N, Takei Y, Shigeta S, Matsumura N, Yoshida H, Motohara T, Yamazaki H, Nakamura K, Hamanishi J, Tasaka N, Ishikawa M, Hirashima Y, Kudaka W, Mori-Uchino M, Kukimoto I, Fujii T, Watanabe Y, Noda K, Yoshikawa H, Yaegashi N, Matsumoto K. Human papillomavirus vaccine impact on invasive cervical cancer in Japan: Preliminary results from cancer statistics and the MINT study. Cancer science, 114:4426-4432, 2023
28. Kobayashi-Kato M, Fujii E, Asami Y, Ahiko Y, Hiranuma K, Terao Y, Matsumoto K, Ishikawa M, Kohno T, Kato T, Shiraishi K, Yoshida H. Utility of the revised FIGO2023 staging with molecular classification in endometrial cancer. Gynecologic oncology, 178:36-43, 2023
29. Machino H, Dozen A, Konaka M, Komatsu M, Nakamura K, Ikawa N, Shozu K, Asada K, Kaneko S, Yoshida H, Kato T, Nakayama K, Saloura V, Kyo S, Hamamoto R. Integrative analysis reveals early epigenetic alterations in high-grade serous ovarian carcinomas. Experimental & molecular medicine, 55:2205-2219, 2023
30. Matsumoto YK, Himoto Y, Nishio M, Kikkawa N, Otani S, Ito K, Yamanoi K, Kato T, Fujimoto K, Kurata Y, Moribata Y, Yoshida H, Minamiguchi S, Mandai M, Kido A, Nakamoto Y. Nodal infiltration in endometrial cancer: a prediction model using best subset regression. European radiology, 34:3375-3384, 2023
31. Kojima Y, Yoshida H, Okuya T, Okuma HS, Nishikawa T, Tanioka M, Sudo K, Noguchi E, Shimoi T, Tamura K, Tanase Y, Uno M, Ishikawa M, Arakaki M, Ichikawa H, Yagishita S, Hamada A, Fujiwara Y, Yonemori K, Kato T. Therapeutic target biomarkers of patient-derived xenograft models of gastric-type cervical adenocarcinoma. Gynecologic oncology reports, 50:101302, 2023
32. Sakuramachi M, Murakami N, Nagao A, Kojima K, Miyata Y, Kashihara T, Kaneda T, Takahashi K, Inaba K, Okuma K, Nakayama Y, Okamoto H, Ishikawa M, Igaki H. Hydrogel spacer injection to the meso-sigmoid to protect the sigmoid colon in cervical cancer brachytherapy: A technical report. Journal of contemporary brachytherapy, 15:465-469, 2023