Annual Report 2024

Department of Gynecology

Hiroshi Tanabe, Shin Takenaka, Hiromi Komazaki→Kazuaki Takahashi, Junki Onishi, Erika Habuchi

Introduction

 This was the seventh 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, 180 in 2022 and 166 in 2023) (Table 1). As a result, the number of surgeries performed in 2024 was 221. 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 LIFE support 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.

The Team and What We Do

 We are the debulking team for advanced ovarian cancer. We aim to perform the most complete surgery possible.

Research Activities

• A retrospective study of dose-dense paclitaxel and carboplatin plus bevacizumab as first-line treatment of advanced epithelial ovarian cancer. H Komazaki, K Takahashi, H Tanabe, et al. J Gynecol Oncol. 2024 Nov;35(6):e76
• Prognostic significance of adjuvant chemotherapy in stageI-II endometrial carcinoma patients who underwent lymphadenectomy. Suzuki J, Tanabe H, et al. Suzuki J, Tanabe H, Michimae. et al. Int J Clin Oncol. 2024 Sep;29(9): 1380-1390.

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 2024, the department accepted 1 clinical follow and became a provider of education to become a gynecologic oncology specialist.

Future Prospects

 The number of operating rooms increased in 2023. In conjunction with this, our surgical slots will increase from 2 to 2.5 per week starting in December 2024. We aim to further increase the number of surgeries performed and establish a system capable of contributing to numerous clinical trials and investigational studies. We also intend to develop the department as one that can accept and train many residents.

List of papers published in 2024

Journal

1. Baba T, Hiraike O, Iwase A, Tanimura S, Sunada M, Takenaka S, Horie A, Nishi H, Mandai M. Current trends and challenges in minimally invasive surgical treatment for gynecologic cancers in Japan: a cancer statistics report. International journal of clinical oncology, 30:837-843, 2025

2. Onishi J, Odajima S, Koike Y, Takenaka S, Tanabe H. Portal vein thrombosis and hepatic infarction due to hepatic mobilization after primary debulking surgery for advanced ovarian cancer: A case report. The journal of obstetrics and gynaecology research, 50:1990-1994, 2024