Annual Report 2024
Department of Gynecology
Mitsuya Ishikawa, Masaya Uno, Yasuhito Tanase, Mayumi Kato, 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 326. Table 1 shows the primary sites, while Table 2 shows the type of procedure. Radical hysterectomy was performed in 17 cases, salvage operation for recurrent disease in 29 cases, and laparoscopic or robotic surgery in 88 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 GynecolOncol2024 Nov:190:139-145).
Clinical Trials
1) A prospective observational study to develop a scoring system to predict serious adverse events due to chemotherapy in older patients with ovarian cancer (JCOG1913A) started. It is proceeding with recruitment as planned.
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 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 (JCOG1412) 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.
7) The role of aminolevulinic acid hydrochloride in fluorescence guided debulking surgery and exploratory laparoscopy for patients with ovarian, fallopian tube and peritoneal cancer (GINGA trial) has completed the recruitment and is in the follow-up phase.
Education
Four residents and one 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 2024
Journal
1. Nishimura H, Amano T, Yoneoka Y, Tsuji S, Taga Y, Aki M, Uno M, Moritani S, Murakami R, Kato T, Murakami T. Comparison of postoperative adjuvant platinum-based chemotherapy and no further therapy after radical surgery in intermediate-risk early-stage cervical cancer. Journal of gynecologic oncology, 36:e2, 2025
2. Yazaki S, Chiba Y, Kojima Y, Yoshida H, Takamizawa S, Kitadai R, Saito A, Kita S, Yamamoto K, Sumiyoshi-Okuma H, Nishikawa T, Sudo K, Shimoi T, Noguchi E, Uno M, Ishikawa M, Kato T, Fujiwara Y, Yonemori K. Folate Receptor Alpha Expression and the Tumor Immune Microenvironment in Patients with Cervical Cancer. International journal of gynecological pathology, 44:104-111, 2025
3. Takigawa W, Yoshida H, Kitamura S, Tokutake C, Kondo M, Fujima M, Shibuki Y, Kobayashi-Kato M, Tanase Y, Uno M, Ishikawa M. Intraoperative peritoneal cytology for cervical gastric-type adenocarcinoma: Cytopathology and clinical impact. Cancer cytopathology, 133:e22915, 2025
4. Yoshida H, Kikkawa N, Takigawa W, Uno M, Ishikawa M. Unveiling the swirl sign: A radiologic-pathologic correlation in deep angiomyxoma. Annals of diagnostic pathology, 75:152426, 2025
5. Fujii E, Kato MK, Ono H, Yamaguchi M, Higuchi D, Koyama T, Komatsu M, Hamamoto R, Ishikawa M, Kato T, Kohno T, Shiraishi K, Yoshida H. TP53 Mutations and PD-L1 Amplification in Vulvar Adenocarcinoma of the Intestinal Type: Insights From Whole Exome Sequencing of 2 Cases. International journal of gynecological pathology, 44:358-363, 2025
6. Ishikawa M. Rare malignant ovarian tumors: a review. Japanese journal of clinical oncology, 55:205-209, 2025
7. Natsume T, Kobayashi-Kato M, Tanase Y, Uno M, Ishikawa M. Rectal Injury Due to the Incorrect Insertion of a Vagi-Pipe Into the Rectum During Total Laparoscopic Hysterectomy: A Case Report. Cureus, 17:e78219, 2025
8. Kawano S, Yoshida H, Kikkawa N, Kobayashi-Kato M, Tanase Y, Uno M, Ishikawa M. Underrecognized diagnostic discordance and delay in endometrial dedifferentiated and undifferentiated carcinoma. The journal of obstetrics and gynaecology research, 51:e16260, 2025
9. Iida Y, Kobayashi-Kato M, Komatsu H, Ishikawa M, Satoh T. Questionnaire-based survey on the extent of lymph node dissection during interval debulking surgery after neoadjuvant chemotherapy for patients with advanced ovarian cancer in the Gynecologic Cancer Study Group of JCOG. International journal of clinical oncology, 30:1040-1047, 2025
10. Natsume T, Kobayashi-Kato M, Yoshida H, Tanase Y, Uno M, Ishikawa M. Laparoscopic Resection of Central Ovarian Cancer Recurrence in the Pelvis Utilizing a Fluorescent Ureteral Near-Infrared Ray Catheter (NIRC): A Case Report. Cureus, 17:e78970, 2025
11. Nishio S, Ushijima K, Ishikawa M, Tokunaga H, Horie K, Yamaguchi S, Suzuki S, Yahata H, Tsuda H, Satoh T. Diagnostic accuracy and prognostic factors of uterine serous carcinoma in Japanese women: a multi-center study. Journal of gynecologic oncology, 2025
12. 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
13. Uehara T, Matsuzaki J, Yoshida H, Ogawa Y, Miura J, Fujimiya H, Yamamoto Y, Kawauchi J, Takizawa S, Yonemori K, Sakamoto H, Kato K, Ishikawa M, Ochiya T. Potential utility of pretreatment serum miRNAs for optimal treatment selection in advanced high-grade serous ovarian cancer. Japanese journal of clinical oncology, 54:917-925, 2024
14. Chiba Y, Kojima Y, Yazaki S, Yoshida H, Takamizawa S, Kitadai R, Saito A, Okuma HS, Nishikawa T, Shimoi T, Sudo K, Noguchi E, Uno M, Ishikawa M, Kato T, Fujiwara Y, Yonemori K. Trop-2 expression and the tumor immune microenvironment in cervical cancer. Gynecologic oncology, 187:51-57, 2024
15. Ozawa R, Nishikawa T, Yoshida H, Shiraishi K, Shimoi T, Kato T, Yonemori K. Unveiling pembrolizumab effectiveness in diverse subtypes of MSI-high endometrial cancers. Journal of gynecologic oncology, 35:e103, 2024
16. Fujii E, Kato MK, Yamaguchi M, Higuchi D, Koyama T, Komatsu M, Hamamoto R, Ishikawa M, Kato T, Kohno T, Shiraishi K, Yoshida H. Genomic profiles of Japanese patients with vulvar squamous cell carcinoma. Scientific reports, 14:13058, 2024
17. Natsume T, Kobayashi-Kato M, Tanase Y, Uno M, Yoshida H, Moritani K, Kanemitsu Y, Ishikawa M. Laparoscopic Posterior Pelvic Exenteration with Radical Vulvectomy for Intestinal-type Vulvar Adenocarcinoma. Gynecology and minimally invasive therapy, 13:126-129, 2024
18. Takahashi N, Seki T, Sasaki K, Machida R, Ishikawa M, Yunokawa M, Matsuoka A, Kagabu M, Yamaguchi S, Hiranuma K, Ohnishi J, Sato T. High cost of chemotherapy for gynecologic malignancies. Japanese journal of clinical oncology, 54:1078-1083, 2024
19. Zhu Y, Li Y, Tang Y, Zhang J, Jia S, Jiang Z, Luo X, Ishikawa M, Kato T. Comparing qSMI and qCEUS for assessing vascularization in uterine cervical cancer: operable versus non-operable group. Frontiers in oncology, 14:1380725, 2024
20. Kato MK, Fujii E, Yamaguchi M, Higuchi D, Asami Y, Hiranuma K, Komatsu M, Hamamoto R, Matumoto K, Kato T, Kohno T, Ishikawa M, Shiraishi K, Yoshida H. Excellent concordance of the molecular classification between preoperative biopsy and final hysterectomy in endometrial carcinoma. Gynecologic oncology, 190:139-145, 2024
21. Takekuma M, Matsuo K, Matsuzaki S, Ishikawa M, Satoh T. Salvage hysterectomy for persistent residual cervical cancer: assessment of prognostic factors. Journal of gynecologic oncology, 35:e113, 2024
22. Ozawa R, Nishikawa T, Yamamoto K, Shimoi T, Ishikawa M, Kato T, Yonemori K. The efficacy and safety of lenvatinib plus pembrolizumab therapy in patients with uterine carcinosarcoma. Gynecologic oncology reports, 55:101479, 2024
23. Ogawa A, Yoshida H, Kawano S, Kikkawa N, Kobayashi-Kato M, Tanase Y, Uno M, Ishikawa M. Ovarian Mesonephric-like Adenocarcinoma: Its Prevalence in a Japanese High-Volume Cancer Center and a Literature Review on Therapeutic Targets. Current oncology (Toronto, Ont.), 31:5107-5120, 2024
24. Nakahara M, Yoshida H, Sakamoto A, Taguchi T, Uno M, Kato T, Ishikawa M. Endometrial cancer and endometrial changes in transgender men: Insights from Japanese individuals on testosterone. The journal of obstetrics and gynaecology research, 50:2019-2028, 2024
25. Miwa M, Kitagawa M, Asami Y, Kobayashi-Kato M, Watanabe T, Ogasawara A, Hiranuma K, Kato H, Saito M, Miyagi Y, Kato T, Yoshida H, Momozawa Y, Kohno T, Shiraishi K, Hasegawa K. Prevalence and outcomes of germline pathogenic variants of homologous recombination repair genes in ovarian cancer. Cancer science, 115:3952-3962, 2024
26. Suzuki K, Yokoi A, Matsuzaki J, Yoshida K, Yamamoto Y, Kato T, Ishikawa M, Ochiya T, Kajiyama H. Circulating serum miRNAs predict response to platinum chemotherapy in high-grade serous ovarian cancer. Cancer medicine, 13:e70251, 2024
27. Yoshiizumi E, Onuki M, Kukimoto I, Takahashi F, Matsui T, Hamasaki K, Kanao H, Nio A, Yahata H, Goda M, Yokoyama T, Hisa T, Tasaki K, Tenjimbayashi Y, Saji H, Kudaka W, Takei Y, Shigeta S, Motohara T, Matsumiya H, Nakamura K, Yoshida H, Ishikawa M, Hamanishi J, Nakai H, Mori-Uchino M, Hirashima Y, Sekizawa A, Yoshikawa H, Yaegashi N, Matsumoto K. Declining Prevalence of Human Papillomavirus Co-Infections Among Young Japanese Women With Cervical Cancer and Its Precursors. Journal of medical virology, 96:e70096, 2024