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Doi T, Takahashi S, Aoki D, Yonemori K, Hara H, Hasegawa K, Takehara K, Harano K, Yunokawa M, Nomura H, Shimoi T, Horie K, Ogasawara A, Okame S. A first-in-human phase I study of TAS-117, an allosteric AKT inhibitor, in patients with advanced solid tumors. Cancer Chemother Pharmacol 2024:10.1007/s00280-023-04631-7. [PMID: 38411735 DOI: 10.1007/s00280-023-04631-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/08/2023] [Indexed: 02/28/2024]
Abstract
PURPOSE TAS-117 is a highly potent and selective, oral, allosteric pan-AKT inhibitor under development for advanced/metastatic solid tumors. The safety, clinical pharmacology, pharmacogenomics and efficacy were investigated. METHODS This phase I, open-label, non-randomized, dose-escalating, first-in-human study enrolled patients with advanced/metastatic solid tumors and comprised three phases (dose escalation phase [DEP], regimen modification phase [RMP], and safety assessment phase [SAP]). The SAP dose and regimen were determined in the DEP and RMP. Once-daily and intermittent dosing (4 days on/3 days off, 21-day cycles) were investigated. The primary endpoints were dose-limiting toxicities (DLTs) in Cycle 1 of the DEP and RMP and incidences of adverse events (AEs) and adverse drug reactions (ADRs) in the SAP. Secondary endpoints included pharmacokinetics, pharmacodynamics, pharmacogenomics, and antitumor activity. RESULTS Of 66 enrolled patients, 65 received TAS-117 (DEP, n = 12; RMP, n = 10; SAP, n = 43). No DLTs were reported with 24-mg/day intermittent dosing, which was selected as a recommended dose in SAP. In the SAP, 98.5% of patients experienced both AEs and ADRs (grade ≥ 3, 67.7% and 60.0%, respectively). In the dose range tested (8 to 32 mg/day), TAS-117 pharmacokinetics were dose proportional, and pharmacodynamic analysis showed a reduction of phosphorylated PRAS40, a direct substrate of AKT. Four patients in the SAP had confirmed partial response. CONCLUSION Oral doses of TAS-117 once daily up to 16 mg/day and intermittent dosing of 24 mg/day were well tolerated. TAS-117 pharmacokinetics were dose proportional at the doses evaluated. Antitumor activity may occur through AKT inhibition. TRIAL REGISTRATION jRCT2080222728 (January 29, 2015).
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Affiliation(s)
- Toshihiko Doi
- National Cancer Center Hospital East, Kashiwa, Japan.
| | - Shunji Takahashi
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Daisuke Aoki
- Keio University School of Medicine, Tokyo, Japan
- Akasaka Sannou Medical Center, Tokyo, Japan
- International University of Health and Welfare Graduate School, Tokyo, Japan
| | | | | | - Kosei Hasegawa
- Saitama Medical University International Medical Center, Hidaka, Japan
| | | | | | - Mayu Yunokawa
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroyuki Nomura
- Keio University School of Medicine, Tokyo, Japan
- Fujita Health University, Toyoake, Japan
| | | | - Koji Horie
- Saitama Cancer Center, Kita-Adachi, Japan
| | - Aiko Ogasawara
- Saitama Medical University International Medical Center, Hidaka, Japan
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Hibino Y, Okazawa-Sakai M, Yokoyama T, Fujimoto E, Okame S, Teramoto N, Takehara K. Abnormal Vaginal Cytology after Total Laparoscopic Hysterectomy in Patients with Cervical Intraepithelial Neoplasia. Acta Med Okayama 2023; 77:627-634. [PMID: 38145937 DOI: 10.18926/amo/66155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
To explore the incidence of abnormal vaginal cytology after total laparoscopic hysterectomy for the treatment of cervical intraepithelial neoplasia 3, we retrospectively analyzed the medical records of patients treated at NHO Shikoku Cancer Center (Japan) in 2014-2019. The cases of 99 patients who underwent a laparoscopic (n=36) or open (n=63) hysterectomy and postoperative follow-up were examined. Abnormal vaginal cytology was detected in 13.9% (5/36) of the laparoscopic-surgery (LS) group and 14.3% (9/63) of the open-surgery (OS) group. A vaginal biopsy was performed at the physicians' discretion; one LS patient and six OS patients were diagnosed with vaginal intraepithelial neoplasia. The cumulative incidence of abnormal vaginal cytology at 3 years post-hysterectomy was 21.4% (LS group) and 20.5% (OS group), a nonsignificant difference. A multivariate analysis showed that age > 50 years was the only independent risk factor for abnormal vaginal cytology among the covariates examined including age; body mass index; histories of vaginal delivery, abdominal surgery, and smoking; and surgical approach (hazard ratio 8.11; 95% confidence interval 1.73-37.98; p=0.01). These results suggest that the occurrence of abnormal vaginal cytology after a hysterectomy may not be influenced by the laparoscopic procedure but is associated with older age.
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Affiliation(s)
- Yumi Hibino
- Department of Gynecologic Oncology, NHO Shikoku Cancer Center
| | | | | | - Etsuko Fujimoto
- Department of Gynecologic Oncology, NHO Shikoku Cancer Center
| | - Shinichi Okame
- Department of Gynecologic Oncology, NHO Shikoku Cancer Center
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Seki T, Kojima A, Okame S, Yamaguchi S, Okamoto A, Tokunaga H, Nishio S, Takei Y, Yokoyama Y, Yoshida M, Teramoto N, Mikami Y, Shimada M, Kigawa J, Takehara K. Poor Treatment Outcomes of Locally Advanced Cervical Adenocarcinoma of Human Papilloma Virus Independent Type, Represented by Gastric Type Adenocarcinoma: A Multi-Center Retrospective Study (Sankai Gynecology Study Group). Cancers (Basel) 2023; 15:cancers15061730. [PMID: 36980616 PMCID: PMC10046139 DOI: 10.3390/cancers15061730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/18/2023] Open
Abstract
The revised World Health Organization classification of cervical cancer divides adenocarcinomas into human papillomavirus-associated (HPVa) and -independent (HPVi) types; the HPVi type is represented by the gastric type. The treatment outcomes of locally advanced adenocarcinoma (LaAC), based on this classification, are understudied. We investigated the outcomes of patients with HPVa and HPVi LaACs. Data for all consecutive patients with stage IB3 to IIIC1 adenocarcinoma who received treatment at 12 institutions throughout Japan between 2004 and 2009 were retrieved to analyze progression-free and overall survival. Central pathological review classified 103 and 48 patients as having HPVa and HPVi tumors, respectively. Usual- (84%) and gastric- (90%) type adenocarcinomas were the most frequent subtypes. Surgery was the primary treatment strategy for most patients. Progression-free and overall survival of patients with HPVi were worse than those of patients with HPVa (p = 0.009 and 0.032, respectively). Subgroup analysis by stage showed that progression-free survival was significantly different for stage IIB. The current surgical treatment strategy for LaACs is less effective for HPVi tumors than for HPVa tumors, especially those in stage IIB.
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Affiliation(s)
- Toshiyuki Seki
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo 105-8461, Japan; (T.S.)
| | - Atsumi Kojima
- Department of Obstetrics and Gynecology, Iwate Medical University, Yahaba 028-3695, Japan
- Correspondence: ; Tel.: +81-19-613-7111
| | - Shinichi Okame
- Department of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama 791-0280, Japan
| | - Satoshi Yamaguchi
- Department of Gynecologic Oncology, Hyogo Cancer Center, Akashi 673-8558, Japan
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo 105-8461, Japan; (T.S.)
| | - Hideki Tokunaga
- Department of Obstetrics and Gynecology, Tohoku University, Sendai 980-8574, Japan
| | - Shin Nishio
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Yuji Takei
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke 329-0498, Japan
| | - Yoshihito Yokoyama
- Department of Obstetrics and Gynecology, Hirosaki University, Hirosaki 036-8562, Japan
| | - Manabu Yoshida
- Department of Pathology, Matsue City Hospital, Matsue 690-8509, Japan
| | - Norihiro Teramoto
- Department of Pathology, National Hospital Organization Shikoku Cancer Center, Matsuyama 791-0280, Japan
| | - Yoshiki Mikami
- Department of Diagnostic Pathology, Kumamoto University, Kumamoto 860-8556, Japan
| | - Muneaki Shimada
- Department of Obstetrics and Gynecology, Tohoku University, Sendai 980-8574, Japan
| | | | - Kazuhiro Takehara
- Department of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama 791-0280, Japan
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Yunokawa M, Takahashi S, Aoki D, Yonemori K, Hara H, Hasegawa K, Takehara K, Harano K, Nomura H, Noguchi E, Horie K, Ogasawara A, Okame S, Doi T. First-in-human phase I study of TAS-117, an allosteric AKT inhibitor, in patients with advanced solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Okazawa-Sakai M, Yokoyama T, Fujimoto E, Okame S, Shiroyama Y, Yokoyama T, Takehara K. Long-term outcomes of postoperative taxane/platinum chemotherapy for early stage cervical cancer: a retrospective study. Int J Clin Oncol 2018; 23:715-725. [DOI: 10.1007/s10147-018-1249-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 02/07/2018] [Indexed: 11/24/2022]
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Matsuoka N, Yokoyama T, Fujimoto E, Sakai M, Okame S, Shiroyama Y, Yokoyama T, Takehara K. [Safety and Efficacy of Cisplatin Treatment after Carboplatin Hypersensitivity Reactions in Gynecologic Malignancies]. Gan To Kagaku Ryoho 2017; 44:2091-2095. [PMID: 29361624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
To investigate the safety and efficacy of cisplatin(CDDP)treatment after carboplatin(CBDCA)hypersensitivity reactions (CHSR)in gynecologic malignancies, we retrospectively reviewed the clinical records of 544 patients who underwent paclitaxel and CBDCA therapy(TC therapy). CHSR was observed in 18 patients. Eight patients were administered weekly paclitaxel and CDDP therapy(wTP therapy)continuously, to confirm that there was no CDDP hypersensitivity followingintravenous administration of 10 mgCDDP. At the onset of CHSR, the patients had received a median of 9 TC therapy cycles, and the median number of CBDCA administrations was 14. The frequency of CHSR was significantly higher in patients who received 7 cycles or more of TC therapy and CBDCA administration(p<0.0001). The median number of wTP therapy administrations was 8. Although CDDP hypersensitivity reactions were observed in 2 patients, their symptoms were mild(Grade 2, CTCAE v4.0). Of the 6 patients who received wTP therapy and had evaluable disease sites, 1, 2, 2 and 1 patients showed CR, PR, SD, and PD, respectively. The median progression-free survival in these 6 patients was 9.5 months. For patients with the platinum- sensitive disease who have CHSR, CDDP could improve their prognosis.
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Affiliation(s)
- Naoki Matsuoka
- Dept. of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center
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Kusumoto S, Konishi H, Okame S, Komatsu M, Shiroyama Y, Yokoyama T, Takehara K. [Outcomes of Tertiary Debulking Surgery(TDS)for Re-Recurrent Ovarian Cancer]. Gan To Kagaku Ryoho 2016; 43:357-360. [PMID: 27067855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The survival of patients with recurrent ovarian cancer who have completed secondary debulking surgery (SDS) has been shown to increase. However, whether tertiary debulking surgery (TDS) aimed at complete surgery is useful in patients with a second recurrence is unclear. Eight patients who had undergone SDS were treated after a second recurrence in our hospital. Their medical records were retrospectively reviewed. Consequently, TDS was performed in 4 of the patients (TDSgr). All 4 patients underwent complete debulking surgery, 2 patients received blood transfusions, and none had serious postoperative complications. The median treatment free interval (TFI) from recurrence surgery to the second recurrence was 16 months (range, 9-23 months), and the median TFI after the second recurrence was 30.5 months (range, 15-69 months). Meanwhile, the median TFI after the second recurrence was 7.5 months (range, 1-31 months) in the 4 patients who did not undergo TDS (non-TDSgr). The median survival times after the second recurrence in TDSgr and non-TDSgr were 53 months (range, 41-69 months) and 12 months (range, 2-30 months), respectively. When complete surgery is indicated in patients with a second recurrent ovarian cancer after SDS, in case of good physical condition with single or multiple recurrent lesions, TDS may increase survival and TFI.
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Affiliation(s)
- Shinya Kusumoto
- Dept. of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center
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Yamamoto Y, Takehara K, Okame S, Komatsu M, Shiroyama Y, Yokoyama T, Tanaka S, Sato M, Nishimura R, Teramoto N. A case of ependymoma arising from the peritoneum. Int Cancer Conf J 2015; 5:121-125. [PMID: 31149438 DOI: 10.1007/s13691-015-0240-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022] Open
Abstract
Ependymoma arising from the peritoneum is extremely rare. We present the case of a 23-year-old woman who underwent urgent laparoscopic surgery because of a pelvic mass and intraperitoneal bleeding. Although peritoneal carcinoma was suspected, pathological re-examination revealed ependymoma with a perivascular pseudorosette and positive for glial fibrillary acidic protein. Residual tumor extraction indicated that the ependymoma had developed from the peritoneum. This case highlights the need to consider ependymoma as a potential diagnosis in young women with suspected ovarian or peritoneal cancer.
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Affiliation(s)
- Yasuko Yamamoto
- 1Department of Gynecologic Oncology, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan.,2Department of Obstetrics and Gynecology, Graduate School of Biomedical Science, Hiroshima University, Kasumi 1-2-3 Minami-ku, Hiroshima, 734-8551 Japan
| | - Kazuhiro Takehara
- 1Department of Gynecologic Oncology, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
| | - Shinichi Okame
- 1Department of Gynecologic Oncology, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
| | - Masaaki Komatsu
- 1Department of Gynecologic Oncology, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
| | - Yuko Shiroyama
- 1Department of Gynecologic Oncology, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
| | - Takashi Yokoyama
- 1Department of Gynecologic Oncology, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
| | - Shinichi Tanaka
- 3Department of Clinical Laboratory, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
| | - Masakazu Sato
- 3Department of Clinical Laboratory, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
| | - Rieko Nishimura
- 3Department of Clinical Laboratory, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
| | - Norihiro Teramoto
- 4Department of Pathology, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
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Onoe T, Tanioka M, Yamaguchi S, Sato S, Shimada M, Nishimura M, Okame S, Kojima A, Kigawa J, Fujiwara K. Dose-dense paclitaxel with cisplatin as perioperative chemotherapy for locally advanced cervical cancer: Early efficacy results of a multicenter phase II study. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e16515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Takuma Onoe
- Department of Medical Oncology, Hyogo Cancer Center, Akashi, Japan
| | - Maki Tanioka
- Department of Medical Oncology, Hyogo Cancer Center, Akashi, Japan
| | | | - Shinya Sato
- Gynecologic Oncology Division, Tottori University Hospital, Yonago, Japan
| | - Muneaki Shimada
- Gynecologic Oncology Division, Tottori University Hospital, Yonago, Japan
| | - Masato Nishimura
- Obstetrics and Gynecology, University of Tokushima, Graduate School, Tokushima, Japan
| | - Shinichi Okame
- Gynecologic Oncology, Shikoku Cancer Center, Matsuyama, Japan
| | - Atsumi Kojima
- Gynecologic Oncology, Shikoku Cancer Center, Matsuyama, Japan
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Konishi H, Takehara K, Okame S, Yamamoto Y, Kojima A, Shiroyama Y, Yokoyama T, Nogawa T. [A case of platinum-resistant, recurrent ovarian clear cell adenocarcinoma successfully treated with irinotecan (CPT-11) and paclitaxel (PTX) chemotherapy]. Gan To Kagaku Ryoho 2014; 41:1437-1439. [PMID: 25434451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A 40-year-old woman presented to a local clinic with abdominal distension. She was referred to our hospital for suspected ovarian cancer. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed an ovarian tumor with mural nodules, ascites, pleural effusion, and peritoneal dissemination. Laparotomy revealed a 20-cm right ovarian tumor with strong adhesion to the uterus and rectum. Bilateral salpingo-oophorectomy was performed as a primary surgery. The histopathological diagnosis was stage IVovarian clear cell adenocarcinoma, and 6 cycles of postoperative chemotherapy with a combination of TC (paclitaxel [PTX] and carboplatin) and the mTOR inhibitor temsirolimus was administered. During maintenance treatment with temsirolimus, the lesion recurred, and progressive disease was confirmed. Because relapse occurred after 5 months from the last TC treatment, the disease was considered platinum-resistant ovarian cancer, and second-line chemotherapy with 6 cycles of irinotecan (CPT-11 ) and PTX was administered. Partial response was observed after 2 cycles, and the response period was 7 months. We suggest that chemotherapy with CPT-11/PTX could be a treatment option for platinum resistant recurrent ovarian clear cell adenocarcinoma.
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Affiliation(s)
- Haruhisa Konishi
- Dept. of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center
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Takehara K, Konishi H, Kojima A, Okame S, Shiroyama Y, Yokoyama T, Nogawa T, Sugawara Y. SUV max of FDG-PET/CT as a prognostic factor in ovarian clear cell adenocarcinoma. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e16509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Takayoshi Nogawa
- Department of Gynecology, National Shikoku Cancer Center, Matsuyama, Japan
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Okame S, Tomono K, Kojima A, Shiroyama Y, Takehara K, Matsumoto T, Yokoyama T, Teramoto N, Nogawa T. Neuroendocrine Tumors of the Uterine Cervix; a Retrospective Review of 16 Cases. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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