| 1. |
Keisuke Kodama, Chuya Tateishi, Tsuyoshi Oda, Cui Lin, Kazutaka Kuramoto, Hideaki Yahata, Kaoru Okugawa, Shoji Maenohara, Hiroshi Yagi, Masafumi Yasunaga, Ichiro Onoyama, Kazuo Asanoma, Takeshi Mori, Yoshiki Katayama, Kiyoko Kato, Development of novel tracers for sentinel node identification in cervical cancer, Cancer Science. 2023;00:1–9. , DOI: 10.1111/cas.15927, 2023.09, Indocyanine green (ICG) with near-infrared (NIR) fluorescence imaging is used for lymphatic mapping. However, binding of ICG to blood proteins like serum albumin can shorten its retention time in sentinel lymph nodes (SLNs). Here we investigated the efficacy and safety of a new fluorescence tracer comprising phytate and liposome-encapsulated ICG (LP). Coadministration of phytate with LP containing phosphatidic acid promotes chelation mediated by Ca2+ in bodily fluids to enhance SLN retention. Uniformly-sized LPs (100 nm) encapsulating ICG under conditions that minimized fluorescence self-quenching during storage were produced. We analyzed the behavior of the new tracer (ICG-phytate-LP) and control tracers (ICG and ICG-LP) in the lymphatic flow of mice in terms of lymph node retention time. We also tested lymphatic flow and safety in pigs that have a more human-like lymphatic system. LPs encapsulating stabilized ICG were successfully prepared. Mixing LP with phytate in the presence of Ca2+ increased both the particle size and negative surface charge. In mice, ICG-phytate-LP had the best lymph node retention, with a fluorescence intensity ratio that increased over 6 hours and then decreased slowly over the next 24 hours. In pigs, administration of ICG and ICG-phytate-LP resulted in no death or weight loss. There were no obvious differences between blood test results for the ICG and ICG-phytate-LP groups, and overall safety was good. ICG-phytate-LP may be a useful new tracer for gynecological cancers that require time for lymph node identification due to a retroperitoneal approach.. |
| 2. |
Kodama K, Sonoda K, Kijima M, Yamaguchi S, Yagi H, Yasunaga M, Ohgami T, Onoyama I, Kaneki E, Okugawa K, Yahata H, Ohishi Y, Oda Y, Kato K., Retrospective analysis of treatment and prognosis for uterine leiomyosarcoma: 10-year experience of a single institute., Asia-Pac J Clin Oncol. 2020;16:e63–e67., 2019.10, Aim: Uterine leiomyosarcoma (ULMS) is a highly aggressive and lethal disease. This malignancy
remains the most common type of uterine sarcoma, affecting approximately 0.4/100 000 women
each year.Our aim was to assess the treatment and prognosis of ULMS patients.
Methods: A total of 14 patients were treated at our institution between January 2008 and July
2017.We retrospectively analyzed their clinicopathological variables, treatment and prognosis.
Results: The median patient age was 63 years (range, 35–83 years). The largest group of patients
had stage IB disease (stage IB, n = 8; IIB, n = 2; IIIB, n = 1; IVB, n = 3) and the largest group
by histological subtype was ordinary (ordinary, n = 11; myxoid, n = 2; epithelioid, n = 1). Total
abdominal hysterectomy and bilateral salpingo-oophorectomy were performed for all patients,
with additional surgical procedures (e.g., tumor resection, lymphadenectomy) performed if necessary.
Twelve patients received adjuvant chemotherapy (ACT) consisting of gemcitabine and docetaxel.
Ten patients experienced recurrence and received multidisciplinary therapies, including
tumor resection, chemotherapy, radiation and targeted therapies. The median observation period
was 17months (range, 5–75months), and 11 patients were alive (without disease, n = 5; with disease,
n = 6). Intriguingly, five of eight stage IB patients who received postoperative ACTwere alive
without disease.
Conclusion: ULMS is rare but is associated with a poor prognosis, even if multidisciplinary therapies
are administered. However, ACT appears to be effective in improving the prognosis of
patients with stage IB disease.. |
| 3. |
Kodama K, Yahata H, Okugawa K, Tomonobe H, Yasukake N, Yoshida S, Yagi H, Yasunaga M, Ohgami T, Onoyama I, Asanoma K, Hori E, Shimokawa M, Kato K. , Prognostic outcomes and risk factors for recurrence after laser vaporization for cervical intraepithelial neoplasia: a single‑center retrospective study., Int J Clin Oncol. 2021 Apr;26(4):770-776., 2021.04, 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.. |
