Kyushu University Academic Staff Educational and Research Activities Database
List of Presentations
Yasunaga Masafumi Last modified date:2022.06.17

Assistant Professor / Gynecology & Obstetrics / Kyushu University Hospital

1. Masafumi Yasunaga, Keisuke Kodama, Shinichiro Yamaguchi, Hiroshi Yagi, Tatsuhiro Ohgami, Ichiro Onoyama, Eisuke Kaneki, Kaoru Okugawa, Hideaki Yahata, Kenzo Sonoda, Kiyoko Kato  , Analysis of risk factors related to recurrence and treatment failure of conservative management for atypical endometrial hyperplasia and endometrial carcinoma patients.
, 日本産科婦人科学会, 2018.05, 【Objective】 Hormonal therapy for atypical endometrial hyperplasia (AEH) and well differentiated endometrioid cancer (EC) is one of treatment options for young patients who desire childbearing. However, this treatment is not optimal because of high recurrence rate. This study was performed to clarify clinicopathologic risk factors related to recurrence and treatment failure of hormonal therapy.
【Methods】 Clinical information was obtained regarding all AEH and EC patients treated with medroxyprogesterone acetate (MPA) from 1999 to 2016 in our institute. We performed the Wilcoxon rank sum test or χ2 test to analyze the statistical significance of the association between clinicopathologic variables and treatment failure. p-values of less than 0.05 were considered statistically significant.
【Results】 Between 1999 to 2016, 22 patients were identified.: EC, n=14; AEH, n=6; and atypical polypoid adenomyoma, n=2. The median patient age was 30.5 years (range, 17 to 42). The median Body Mass Index (BMI) was 22.9 kg/m2 (range, 17.6 to 43.4). The response for treatment was as follows: complete response (CR), n=17; partial response (PR), n=1, stable disease (SD), n=3; and progression of disease, n=1. Seven of 16 CR patients relapsed. Hysterectomy was performed for total 7 patients who either relapsed or had SD or PD. The other 5 patients went on with hormonal therapy.. There was no significant relationship between age, BMI, histology, ALDH1 positivity and treatment failure including recurrence.
【Conclusion】 It is necessary to detect a risk factor for recurrence or treatment failure of hormonal therapy in order to provide more effective tailor-made therapy.
2. Masafumi Yasunaga, Keiske Kodama, Hiroshi Yagi, Tatsuhiro Ohgami, Ichiro Onoyama, Yoshiaki Kawano, Eisuke Kanekei, Kaoru Okugawa, Hideaki Yahata, Kenzo Sonoda, Kiyoko Kato, Prognostic impact of ovarian cancer stage IV subclassification in FIGO 2014 staging system, 日本産科婦人科学会, 2017.04, 【Objective】 FIGO staging system for epithelial ovarian cancer was changed in 2014. Prognostic impact of stage IV subclassification in this new staging system was evaluated.
【Methods】 Sixty of stage IV epithelial ovarian cancer patients treated between 2005 and 2015 at our hospital were retrospectively analyzed. Data regarding the following clinicopathological variables were recorded for analysis: (1) age at the time of initial therapy; (2) FIGO stage; (3) performance status; (4) tumor stage; (5) lymph node status; (6) histologic type; (7) neoadjuvant chemotherapy; (8) optimal surgery. Survival analysis included the Kaplan-Meier method, log-rank test and Cox proportional hazards models.
【Results】 According to the new classification, 14 and 46 patients were classified into FIGO IVA and IVB, respectively. Median overall survival was 28 and 22 months in each stage. In log-rank test and Cox regression hazard model, low tumor stage (T1b-3b) and optimal surgery were favorable prognostic factors with statistically significant better overall survival. However, new FIGO system did not induce any prognostic difference between stage IVA and IVB on univariate and multivariate analysis.
【Conclusion】 In the present analysis, the revised FIGO system for stage IV did not add prognostic information for patients with FIGO IVA or IVB..