記述言語：英語   出版者・発行元：Taiwanese Journal of Obstetrics and Gynecology  

Objective: Recent randomized phase III trial has shown significant benefit in overall survival (OS) for patients with advanced cervical cancer by adding bevacizumab to conventional chemotherapy. The aim of this study was to evaluate the prognostic impact for Japanese recurrent, persistent, or metastatic cervical cancer patients where bevacizumab was added to paclitaxel plus carboplatin. Materials and methods: A retrospective analysis was performed on 90 patients with recurrent, persistent, or metastatic cervical cancer mainly treated by paclitaxel plus carboplatin between 2005 and 2019 at our hospital. Data for the following clinicopathological variables were analyzed: (1) bevacizumab use; (2) histology; (3) disease presentation; (4) performance status; (5) prior chemotherapy containing platinum agent; (6) pelvic disease; (7) prior pelvic radiotherapy; (8) location of target lesions. Survival analysis was performed using Kaplan–Meier curves, log-rank tests, Wilcoxon tests, and Cox proportional hazards models combined with propensity score matching. Results: Adding bevacizumab to paclitaxel plus carboplatin showed significantly increased complete response to compared with that of non-users. In a Cox regression hazard model, bevacizumab use tended to show better OS though without statistically significance. After propensity score matching, adding bevacizumab to paclitaxel plus carboplatin showed a significant better OS by univariate analysis using Wilcoxon test, not by log-rank test. Conclusion: Adding bevacizumab to paclitaxel plus carboplatin showed a limited prognostic impact for recurrent, persistent or advanced cervical cancer patients in the real world. Further effective second-line treatments are needed to prolong OS of patients with recurrent, persistent or advanced cervical cancer.

DOI： 10.1016/j.tjog.2022.06.005

Web of Science

Scopus

PubMed

記述言語：英語   出版者・発行元：Pathology Research and Practice  

Cyclin-dependent kinase 8 (CDK8) is associated with the transcriptional mediator complex and regulates several transcription factors implicated in cancer. CDK8 expression is a poor prognostic marker in colon and breast cancer by immunohistochemistry. However, somatic mutations in exon 2 of the RNA polymerase II transcriptional mediator subunit MED12 occur in 7–30% of cases of uterine leiomyosarcoma (ULMS), suggesting that these alterations contribute to tumorigenesis. Public genomic mutation data of 80 patients with ULMS were used for MED12 and CDK8 mutation analysis. The expression of MED12, CDK8 and β-catenin was evaluated by immunohistochemistry in our cohort of 60 patients with ULMS, in addition with MED12 mutation status and survival stage. Univariate analysis was performed using the log-rank test, and Cox regression was used to identify independent prognostic factors. Multivariate Cox regression analysis revealed that advanced stage (p < 0.0001) and high CDK8 expression (p = 0.0014) were independent predictors of poor prognosis. MED12 mutation status was not significantly associated with CDK8 expression (p = 0.6873) and DSS (p = 0.8075). In conclusion, our data suggest that CDK8 expression may identify a subset of ULMS patients with a poor prognosis.

DOI： 10.1016/j.prp.2022.153920

Web of Science

Scopus

PubMed

記述言語：英語   出版者・発行元：Oncology (Switzerland)  

Introduction: The prognostic significance of lymphovascular space invasion (LVSI) in stage IA endometrial cancer remains unclear. The aim of this study was to evaluate the clinical significance of LVSI in stage IA endometrial cancer. Methods: Clinical data of patients with stage IA endometrial cancer who underwent initial surgery at our institution between January 2008 and December 2018 were reviewed retrospectively. Information of patients, surgery, and characteristics of cancer were obtained from medical records and pathological reports. Results: Two hundred ninety-seven patients were enrolled in this study. With a median follow-up of 60 months, 15 patients experienced recurrence (5.1%) and 4 patients died of endometrial cancer (1.3%). The recurrence and mortality rates did not differ significantly between the LVSI-positive and-negative groups (p = 0.07 and p = 0.41, respectively). Recurrence-free survival and endometrial cancer-specific survival also did not differ significantly between these groups (p = 0.11 and p = 0.49, respectively). The 5-year endometrial cancer-specific survival rates for tumors with and without LVSI were 97.0% and 98.9%, respectively. Among patients with low-grade tumors, recurrence-free survival and endometrial cancer-specific survival did not differ significantly between patients with tumors with and without LVSI (p = 0.92 and p = 0.72, respectively). The 5-year endometrial cancer-specific survival rates for low-grade tumors with and without LVSI were 100% and 99.3%, respectively. Conclusion: LVSI was not a prognostic factor of not only stage IA endometrial cancer but also stage IA low-grade cancer.

DOI： 10.1159/000521382

Web of Science

Scopus

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Objectives Cervical intraepithelial neoplasia (CIN) is a precancerous lesion that may progress to invasive cervical cancer without intervention. We aim to examine the prognostic outcomes and risk factors for recurrence after laser vaporization for CIN 3, CIN 2 with high-risk human papillomavirus (HPV) infection, and CIN 1 persisting for more than 2 years. Methods and Material Between 2008 and 2016, a total of 1070 patients underwent cervical laser vaporization using a carbon dioxide laser. We performed a retrospective review of their medical records to assess their clinical characteristics, pathologic factors, and prognostic outcomes. Results The mean patient age was 34 years (range, 18-64 yr). The preoperative diagnosis was CIN 1 in 27 patients, CIN 2 in 485 patients, and CIN 3 in 558 patients. Over a median follow-up period of 15 months, the 2-year recurrence rate was 18.9%, and the 5-year recurrence rate was 46.5%. The 2-year retreatment rate was 12.6%, and the 5-year retreatment rate was 30.5%. We diagnosed 9 patients with invasive cancer after treatment; all patients underwent combined multidisciplinary treatment, and there were no deaths during follow-up. The recurrence-free interval was correlated with patient age (hazard ratio [HR], 1.028; 95%CI, 1.005-1.051; P = 0.0167), body mass index (HR, 1.052; 95%CI, 1.008-1.098; P = 0.0191), and glandular involvement (HR, 1.962; 95%CI, 1.353-2.846; P = 0.0004). Conclusion Cervical laser vaporization is effective and useful for patients with CIN who wish to preserve fertility. However, patients with glandular involvement, older age, and higher body weight require close follow-up for recurrence.

記述言語：英語   掲載種別：研究論文（学術雑誌）  

開催年月日： 2016年10月

記述言語：日本語   会議種別：口頭発表（一般）  

開催地：長崎   国名：日本国  

【緒言】近年婦人科良性疾患に対する腹腔鏡下手術が普及してきたが、悪性腫瘍に対しても2014年4月に子宮体癌の腹腔鏡下手術が保険収載された。外科・泌尿器科領域のほぼ全ての臓器由来悪性腫瘍に対して腹腔鏡下手術が保険収載されているなか、子宮頸癌・卵巣癌においては保険収載されておらず、他科領域や諸外国に比し遅れているのが現状である。その中で子宮頸癌腹腔鏡下子宮全摘出術が2014年12月に先進医療Aとして承認され、現在は全国22施設で当該手術が先進医療として行われている。【目的と対象】2015年11月より当院臨床研究倫理審査委員会の承認下に子宮頸癌ⅠA2・ⅠB１・ⅡA１期と診断した症例に対して腹腔鏡下子宮全摘出術を開始した。これまで経験した3症例について報告する。【結果】全症例とも病期はFIGO分類ⅠB1期で、円錐切除術の既往はなかった。年齢中央値：57歳（34～66歳）、体格指数BMI中央値：19.5kg/m2（18.8～22.71 kg/m2）、腫瘍最大径中央値：30mm（12～33mm）であった。手術時間中央値：785分（484～798分）、出血量中央値：460mL（320～596mL）で術中輸血は施行しなかった。摘出リンパ節個数中央値：54個（32～61個）で、手術入院日数中央値：12日（8～12日）であった。術後診断pT1bN1M0およびpT2bN1M0の2症例に対して同時化学放射線療法を追加施行した。【結語】先進医療に向けた腹腔鏡下広汎子宮全摘出術の3症例を経験した。手術時間は開腹手術に比し長い傾向にあったが、その他の成績は開腹手術に劣らなかった。現在は先進医療承認申請中である。